{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T09:19:35Z","timestamp":1778750375352,"version":"3.51.4"},"reference-count":64,"publisher":"The Royal Society","issue":"1950","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000691","name":"Academy of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005627","name":"Thrasher Research Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005627","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000286","name":"British Academy","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000286","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000288","name":"Royal Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000288","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Stunting (low height-for-age &amp;gt;\u20092 s.d. below the WHO child growth standards median) is a key indicator of chronic malnutrition and is influenced by poor nutrition, infections, chronic inflammation and impaired gut health. In sub-Saharan Africa, stunting frequently occurs in regions where schistosomiasis is endemic. Our previous research in Zimbabwean preschool children (\u2264\u20095 years) found that Schistosoma haematobium infection alone could account for up to one-third of stunting cases. Using epidemiological, gut microbiome and metabolomic analyses, we investigated how this parasitic infection contributes to poor growth. Infected children showed significantly altered gut microbiome profiles compared to uninfected peers, indicating potential microbiome disruption linked to disease and impaired development. Metabolomic profiling revealed that S. haematobium infection elevated energy- and purine-related metabolites, reflecting metabolic stress associated with malnutrition. Early treatment with praziquantel did not significantly alter the microbiome but did restore normal metabolic profiles, aligning with observed catch-up growth. Here, we synthesize findings from our studies and others to highlight opportunities for intervention and key research gaps, supporting the inclusion of praziquantel in early health programmes and integrated strategies combining treatment with nutrition. Further research, particularly longitudinal studies, is needed to confirm causality and optimize child health outcomes in endemic areas.<\/jats:p>\n                  <jats:p>This article is part of the theme issue \u2018Biological, biomedical and environmental drivers of stunting\u2019.<\/jats:p>","DOI":"10.1098\/rstb.2025.0094","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T08:53:47Z","timestamp":1778748827000},"source":"Crossref","is-referenced-by-count":0,"title":["Schistosomiasis and stunting: microbial and metabolic mechanisms in early childhood"],"prefix":"10.1098","volume":"381","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4853-5384","authenticated-orcid":false,"given":"Derick Nii Mensah","family":"Osakunor","sequence":"first","affiliation":[{"name":"University of Glasgow 1 , ,","place":["Glasgow, UK, G12 8QQ"],"department":["School of Biodiversity, One Health and Veterinary Medicine"]},{"name":"University of Edinburgh 2 , ,","place":["Edinburgh, UK"],"department":["Tackling Infections to Benefit Africa (TIBA) Partnership"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9552-9529","authenticated-orcid":false,"given":"Lorraine Tsitsi","family":"Pfavayi","sequence":"additional","affiliation":[{"name":"University of Edinburgh 2 , ,","place":["Edinburgh, UK"],"department":["Tackling Infections to Benefit Africa (TIBA) Partnership"]},{"name":"The University of Edinburgh Institute of Immunology and Infection Research 3 , ,","place":["Edinburgh, UK, EH9 3FL"],"department":["Centre for Immunity, Infection and Evolution"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5613-5014","authenticated-orcid":false,"given":"Takafira","family":"Mduluza","sequence":"additional","affiliation":[{"name":"University of Zimbabwe Faculty of Science 4 , ,","place":["Harare,, Zimbabwe, P.O. Box MP167"],"department":["Department of Biochemistry and Biotechnology"]},{"name":"University of Zimbabwe 5 , , ,","place":["Harare, Harare Province, Zimbabwe"],"department":["Tackling Infections to Benefit Africa (TIBA) Partnership"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2537-3466","authenticated-orcid":false,"given":"Francisca","family":"Mutapi","sequence":"additional","affiliation":[{"name":"University of Edinburgh 2 , ,","place":["Edinburgh, UK"],"department":["Tackling Infections to Benefit Africa (TIBA) Partnership"]},{"name":"The University of Edinburgh Institute of Immunology and Infection Research 3 , ,","place":["Edinburgh, UK, EH9 3FL"],"department":["Centre for Immunity, Infection and Evolution"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"175","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"2026051404534195000_R1","unstructured":"World Health Organization (WHO)\n          . 2015Stunting in a nutshell. Seehttps:\/\/www.who.int\/news\/item\/19-11-2015-stunting-in-a-nutshell."},{"key":"2026051404534195000_R2","volume-title":"Levels and trends in child malnutrition: UNICEF \/ WHO \/ World Bank group joint child malnutrition estimates: key findings of the 2023 edition","author":"United Nations Children\u2019s Fund (UNICEF), World Health Organization (WHO) & International Bank for Reconstruction and Development\/The World Bank","year":"2023"},{"key":"2026051404534195000_R3","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2022.899296","article-title":"Stunting status and exposure to infection and inflammation in early life shape antibacterial immune cell function among zimbabwean children","volume":"13","author":"Mutasa","year":"2022","journal-title":"Front. Immunol."},{"key":"2026051404534195000_R4","volume-title":"Near East and North Africa\u2014regional overview of food security and nutrition: trade as an enabler for food security and nutrition","author":"FAO, IFAD, UNICEF, WFP, WHO & UNESCWA","year":"2023"},{"key":"2026051404534195000_R5","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.3386","article-title":"Factors associated with child stunting, wasting, and underweight in 35 low- and middle-income countries","volume":"3","author":"Li","year":"2020","journal-title":"JAMA Netw. 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Seehttps:\/\/www.pediatricpraziquantelconsortium.org\/sites\/ppc\/files\/2025-03\/PediatricPraziquantelConsortiumPressRelease_4March2025_ENG.pdf."},{"key":"2026051404534195000_R55","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/j.pt.2020.04.012","article-title":"Schistosomiasis control: leave no age group behind","volume":"36","author":"Faust","year":"2020","journal-title":"Trends Parasitol."},{"key":"2026051404534195000_R56","doi-asserted-by":"crossref","DOI":"10.1186\/s40249-018-0483-7","article-title":"Reinfection of urogenital schistosomiasis in pre-school children in a highly endemic district in Northern Zimbabwe: a 12 months compliance study","volume":"7","author":"Mutsaka-Makuvaza","year":"2018","journal-title":"Infect. Dis. 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