In the Gut Health workstream, led by LSTM’s Prof Stephen Allen, we will measure enteropathogen colonisation and biomarkers of gut health and inflammation in infants and young children in the three countries (Senegal, India, Indonesia). This will contribute to a deeper understanding of impaired linear growth and stunting alongside the findings of other workstreams including gut microbiome, epigenetics and nutrition.
SENeGal SYNbiotic (SENGSYN) Study
In the Kaffrine district of Senegal, we will also test whether administration of a synbiotic from 0-6 months improves linear growth.
Young children exposed to poor sanitation and hygiene develop a disorder of the gut called “environmental enteric dysfunction” (EED) characterised by abnormal histology, permeability defects, and inflammation. EED significantly impairs growth through reduced digestion and absorption of nutrients, increased susceptibility to infections and systemic inflammation that directly inhibits growth hormones. EED likely results from pathogenic microbes colonising the gut despite exclusive breastfeeding and improved hygiene. A healthy gut microbiome may provide colonisation resistance against enteropathogens. Probiotics are live beneficial bacteria such as bifidobacteria and lactobacilli and prebiotics are non-digestible compounds that encourage the growth of healthy gut bacteria. Synbiotics are prebiotics combined with probiotics. Dietary supplementation with a synbiotic may provide resilience to the developing gut microbiome against adverse environmental conditions that are associated with EED. As part of the GCRF Action Against Stunting Hub, we plan to evaluate whether administration of a synbiotic to infants up to age 6 months in Senegal improves linear growth through improved gut health. The synbiotic will contain a total of 5 billion live bacteria including two strains of bifidobacteria and one strain of lactobacilli. We will assess the effects of the intervention by measuring growth and also biomarkers of gut health, inflammation and growth in blood and stool samples collected during 1-24 months. We will also record episodes of illness with follow-up to 2 years. We will compare the infants in the intervention arm with controls recruited in an observation cohort who receive standard care but no dietary supplements.
Dr Ben Kadia, Clinical Research Associate, is leading implementation of the research across the three countries.
(Pan African Clinical Trial Registry (www.pactr.org) PACTR202102689928613).