Association between stunting and fecal calprotectin levels in breastfed infants living in a rural area of the Democratic Republic of the Congo: a cross sectional study.

Marius Baguma, Espoir Bwenge Malembaka, Paluku Bahwere, Richard Mbusa Kambale, Joe Bwija Kasengi, Ghislain Maheshe Balemba, Oreste Battisti, Ghislain Bisimwa Balaluka

Journal: African health sciences 2025;24(3):313-321

PMID: 40777933

Free Full Text on PubMed Central View on PubMed

Abstract

BACKGROUND

Stunting is a major public health problem in low- and middle-income countries as in Democratic Republic of the Congo (DRC). Many factors, such as environmental enteric dysfunction (EED), are incriminated in the pathogenesis of stunting. EED, characterized by intestinal inflammation, can be evaluated by a non-invasive marker, the fecal calprotectin (FC). The aim of this study was to determine the concentration of FC, to compare the FC of exclusively breastfed infants with that of mixed-fed infants, and to assess the association between the stunting and the FC in infants aged 4 to 7 months.

METHODS

Socio-demographic, nutritional, and clinical data were collected in infants aged 4 to 7 months attending child welfare clinic activities from eight targeted rural health areas of South-Kivu province, eastern DRC. A single assay of calprotectin was performed in stool samples by Bühlmann Quantum Blue® Calprotectin Extended device.

RESULTS

A total of 240 infants (median age: 6 months, interquartile range: 5-6 months) were enrolled in this study. Among them, 41 (17.1%) were stunted. The median FC was 87 µg/g of stool. Exclusive breastfed infants had significantly higher FC compared to mixed-fed infants (median FC: 108 µg/g versus 79 µg/g, p=0.031). In addition, stunted infants had higher FC levels (107 µg/g) compared to infants with normal length for age (82 µg/g) but without reaching the statistical significance level (p= 0.41).

CONCLUSION

This study shows higher FC levels in exclusively breastfed and in stunted infants living in rural areas of South-Kivu. Further studies are needed to assess the prevalence of EED and its association with stunting in the DRC.

Address: Department of Pediatrics, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.; Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.; Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.; Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.; Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.; Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.; Center for Tropical Diseases and Global Health (CTDGH), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.; Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.; Center for Tropical Diseases and Global Health (CTDGH), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.; Ecole Régionale de Santé Publique (ERSP), Faculté de Médecine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.; Department of Pediatrics, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.; Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.; Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium.; Department of Pediatrics, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.; Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.; Département des sciences cliniques, Université de Liège, Liège, Belgium.; Valid International, Oxford, United Kingdom.; Centre de Recherche en Épidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium.; Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.; Ecole Régionale de Santé Publique (ERSP), Faculté de Médecine, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo.

DOI: 10.4314/ahs.v24i3.35

Link outs

Free resources

Full Text Sources:

https://pmc.ncbi.nlm.nih.gov/articles/pmid/4077793...

Medical:

MeSH Terms: Humans, Leukocyte L1 Antigen Complex, Feces, Breast Feeding, Democratic Republic of the Congo, Cross-Sectional Studies, Infant, Female, Male, Growth Disorders, Rural Population, Biomarkers