Tropical enteropathy in Rhodesia.

Abstract

SUMMARY Tropical enteropathy, which may be related to tropical sprue, has been described in many developing countries including parts of Africa. The jejunal changes of enteropathy are seen in Rhodesians of all social and racial categories. Xylose excretion, however, is related to socioeconomic status, but not race. Upper socioeconomic Africans and Europeans excrete significantly more xylose than lower socioeconomic Africans. Vitamin B12 and fat absorption are normal, suggesting predominant involvement of the proximal small intestine. Tropical enteropathy in Rhodesia is similar to that seen in Nigeria but is associated with less malabsorption than is found in the Caribbean, the

Fecal Markers of Environmental Enteropathy are Associated with Animal Exposure and Caregiver Hygiene in Bangladesh

“…[5][6][7][8][9][10][11][12][13] A previous study in Zimbabwe found that individuals of a lower economic status excreted significantly less xylose, a measure of intestinal absorption, than those individuals of a higher economic status. 18 A more recent study in rural Bangladesh found that children residing in "contaminated" environments *Address correspondence to Christine Marie George, Department of International Health, Johns Hopkins University, 615 N. Wolfe Street, Room E5535, Baltimore, MD 21205-2103. E-mail: cmgeorge@jhsph.edu defined by water quality, improved sanitation, and hygiene conditions had significantly higher L:M ratios in urine compared with children in "clean" environments.…”

“…7,8,14 EE is thought to arise from unsanitary environmental conditions that lead to repeated exposure to enteric pathogen causing chronic infections. [15][16][17][18] There is a growing body of literature suggesting that these chronic enteric infections alter intestinal structure and function in a manner that is suboptimal for child growth. [7][8][9] It is suspected that many of these infections in children are subclinical and that diarrhea only accounts for a small proportion of EE.…”

Endemic tropical sprue in Rhodesia.

“…There was a dense infiltration of lymphocytes and plasma cells in the lamina propria of every specimen; 20 were grade 3 and 11 grade 2. The histological, dissecting microscopy and cellular infiltration grades (x2) and the histological measurements (Mann Whitney U test) were all significantly inferior to a group of healthy African controls (Thomas et al, 1976) (p< 0-001). …”

“…In 1968 Clain presented preliminary data on tropical Received for publication 4 August 1976 sprue in Rhodesia. We have now established the presence of subclinical tropical enteropathy in Rhodesia (Thomas et al, 1976) and in this paper describe 31 cases of tropical sprue, 28 of which had megaloblastic anaemia and the remaining three gastrointestinal complaints and weight loss.…”

“…Vitamin B12 absorption was measured using the plasma uptake method (Workman and Rusche, 1966), repeated with intrinsic factor when abnormal, and calculated as a percentage of the administered dose per litre of plasma. The normal value is defined as more than 0 75% of the administered dose per litre of plasma, which is the 95th percentile of a group of healthy Rhodesian African controls (Thomas et al, 1976). Biopsies were obtained from the body of the stomach using a Quinton suction biopsy tube, and augmented histamine tests were performed (Kay, 1953).…”