With one in five children in the developing world malnourished, poor nutrition has been linked to more than half of all child deaths worldwide. Early childhood malnutrition is one of the biggest risk factors for illness and death in children under five and is linked to cognitive and physical deficits later in life. When grown, these now-malnourished women give birth to low birth weight children who are again at greater risk for childhood disease and malnourishment. This vicious cycle of malnutrition is compounded by the tremendous burden of enteric infectious disease in children in the developing world. These infections impair absorption of nutrients, resulting in further malnutrition; which in turn increases susceptibility to further infection and disease, and faltering growth.

Researchers from NIH and around the world gathered for the 3rd Annual MAL-ED Project Meeting.

In May 2011, the 3rd Malnutrition and Enteric Diseases (MAL-ED) Project annual meeting took place, bringing together the network of scientists from sites in eight different participating countries and their US collaborators to present and discuss preliminary data and analyses stemming from the first year of the MAL-ED study. Additionally, this forum allowed for consideration of steps to further refine protocols and their implementation, for development of plans for multicenter analyses, and for feedback from the MAL-ED Scientific Advisory Committee on potential future projects.
 
The MAL-ED Project is unique in that the investigators at these eight sites - including those in Peru, Brazil, Bangladesh, India, Pakistan, Tanzania, South Africa and Nepal - and their colleagues use shared and harmonized protocols to identify and characterize the relationships between a child’s risk of enteric infection, diarrhea, and malnutrition and their role in impairing normal gut function, diminishing protective immune responsiveness to childhood vaccines and negatively affecting cognitive and physical development. In addition, colleagues at the NIH Fogarty International Center (FIC) are generating comprehensive geospatial models on a global scale based on MAL-ED and related data sets to determine which factors are most important in contributing to public health outcomes. It is hoped that these analyses will assist decision-makers and health professionals in how to best treat malnutrition and enteric diseases worldwide.
 
In order to improve understanding of the complex interrelationship between enteric infections and malnutrition, and to design better intervention strategies, FNIH and FIC are coordinating and leading an international network of investigators to collaborate on the MAL-ED project. The MAL-ED project provides the knowledge base to address questions of practical importance, such as: which types of enteric infections cause the greatest impact on growth faltering and cognitive impairment in children; and why certain types of childhood vaccines that prevent diseases caused by polio and rotavirus are less effective in developing countries than in the developed world.
 
With support from the Bill & Melinda Gates Foundation, the FNIH and FIC are leading the MAL-ED program. Partnerships include a number of U.S. and internationally-based academic institutions, the U.S. and Thai military, and a network of eight sites in the developing world that focus on populations with high levels of malnutrition and enteric infections.
 
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