Environmental Enteric Dysfunction is Associated with Poor Linear Growth and Can be Identified by Host Fecal mRNAs.

Background and Objective: Environmental enteric dysfunction (EED) can be assessed by the lactulose:mannitol (L:M) test. Our objective was to determine if selected host fecal transcripts were correlated with EED, and whether transcripts and clinical characteristics could be used to predict EED in rural African children. Methods: Demographic and sanitation characteristics, along with L:M testing and host fecal transcript analyses from 798 asymptomatic Malawian children aged 12-61 months were compared to linear growth over the subsequent 3 months. Fecal host mRNA analysis included quantification of expression of 18 transcripts associated with L:M. Permeability was categorized as normal (L:M = 0.45), and random forest predictive models were created. Results: L:M was inversely correlated with linear growth over the subsequent 3 months (r = -0.32, P

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