{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:17:47Z","timestamp":1788268667779,"version":"build-2803163510"},"reference-count":191,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recognition of the synergistic cycle of malnutrition, immune dysfunction, and recurrent enteric infection in children and its role in linear growth stunting and impaired cognitive development (the \u201cstunting syndrome\u201d), dates back to the 1960s. Early hypotheses emphasized reduced intestinal absorption associated with diarrhea as the primary enteropathy driving malnutrition and developmental deficits. However, recent evidence indicates that a subclinical condition termed environmental enteropathy (EE), or environmental enteric dysfunction (EED), may be a more critical contributor. Mitigating the adverse impacts of EE\/EED requires a holistic, integrated approach that combines improved nutrition, water, sanitation, and hygiene (WASH), appropriate vaccination, and targeted non-pharmaceutical hygiene interventions designed to prevent recurrent enteric infections. These interventions aim to reduce pathogen exposure in infants\u2019 immediate environments, a prerequisite for achieving sustained physical and neurocognitive development and, ultimately, economic progress in low- and middle-income countries (LMICs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This Hypothesis and Theory article synthesizes current understanding of EE\/EED as a proximate driver of chronic childhood malnutrition and its major sequelae: stunting, impaired neurocognitive development, immune dysfunction (including poor pediatric vaccine response), and nutrient malabsorption. We hypothesize the necessity of reducing enteric infection occurrence as a cornerstone for breaking the malnutrition\u2013infection cycle and propose that non-pharmaceutical interventions targeting pathogen exposure in household and infant play environments are essential. In addition to pathogen exposure, we examine other determinants of malnutrition, including microbiome dysbiosis and epigenetic alterations as possible targets for therapeutic interventions intended to mitigate negative outcomes on health and nutrition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed literature addressing malnutrition, immune impacts, enteric infections, EE, growth stunting, cognitive impairment, epigenetic alterations, and mitigation strategies including WASH, baby WASH, hand and surface hygiene, and vaccination, using databases such as PubMed, Embase, and Google Scholar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The synergistic malnutrition and infection cycle underlying the stunting syndrome comprises multiple interdependent components: chronic malnutrition, immune dysfunction, recurrent pathogen assault, microbiome dysbiosis, and EE\/EED. Previous interventions have largely failed, likely because they targeted isolated components rather than the entire cycle. Here, we describe this cycle, its interactions, and prior attempts at disruption. We advocate for a novel, integrated approach, termed\n                      <jats:italic>baby WASH<\/jats:italic>\n                      or environmental hygiene, focused on creating hygienically clean environments where infants live and play, thereby reducing exposure to enteric pathogens. We also explore the link between malnutrition, EE\/EED, and epigenetic reprogramming, as a contributor to health risks. Importantly, malnutrition is linked to epigenetic reprogramming, which contributes to neurocognitive impairment. We hypothesize that by combining baby WASH strategies with emerging pharmaceutical interventions addressing epigenetic and nutritional deficits, and associated socioeconomic and political factors, a comprehensive maternal\u2013child health framework may be established to interrupt this vicious cycle.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preventing recurrent pathogen exposure during both prenatal and postnatal periods is hypothesized to be essential to interrupting the malnutrition and infection cycle and reducing stunting. Interventions must address infants\u2019 immediate living, feeding, and educational environments, as well as maternal environments during gestation. Early-life nutritional deficiencies may influence epigenetic programming, with developmental consequences. Breaking this cycle remains an unmet global health priority, warranting urgent international attention due to the human and economic tolls in resource-limited settings LMICs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1792466","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:36:12Z","timestamp":1788266172000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Disrupting the vicious cycle of malnutrition and enteropathy: advancing strategies to improve child physical and neurocognitive outcomes"],"prefix":"10.3389","volume":"14","author":[{"given":"M. Khalid","family":"Ijaz","sequence":"first","affiliation":[{"name":"Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC","place":["Montvale, NJ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond W.","family":"Nims","sequence":"additional","affiliation":[{"name":"Syner-G Biopharma","place":["Boulder, CO, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph R.","family":"Rubino","sequence":"additional","affiliation":[{"name":"Home and Community Hygiene","place":["Parsippany, NJ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bushra S. F.","family":"Hasan","sequence":"additional","affiliation":[{"name":"Water-WISER CDT, University of Leeds","place":["Leeds, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryum K.","family":"Ijaz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry & Behavioral Sciences, Tulane University School of Medicine","place":["New Orleans, LA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank Y.","family":"Xu","sequence":"additional","affiliation":[{"name":"Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC","place":["Montvale, NJ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles P.","family":"Gerba","sequence":"additional","affiliation":[{"name":"Water & Energy Sustainable Technology Center, University of Arizona","place":["Tucson, AZ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"316S","DOI":"10.1093\/jn\/133.1.316S","article-title":"Historical concepts of interactions, synergism and antagonism between nutrition and infection","volume":"133","author":"Scrimshaw","year":"2003","journal-title":"J Nutr"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"464S","DOI":"10.1093\/ajcn\/66.2.464S","article-title":"Synergism of nutrition, infection, and immunity: an overview","volume":"66","author":"Scrimshaw","year":"1997","journal-title":"Am J Clin Nutr"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1046\/j.1365-3156.2000.00512.x","article-title":"Domestic hygiene and diarrhoea \u2013 pinpointing the problem","volume":"5","author":"Curtis","year":"2000","journal-title":"Trop Med Int Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"336S","DOI":"10.1093\/jn\/133.1.336S","article-title":"The history of nutrition: malnutrition, infection and immunity","volume":"133","author":"Keusch","year":"2003","journal-title":"J Nutr"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e115","DOI":"10.1371\/journal.pmed.0040115.g001","article-title":"Malnutrition and infection: complex mechanisms and global impacts","volume":"4","author":"Schaible","year":"2007","journal-title":"PLoS Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1582","DOI":"10.1086\/587658","article-title":"The interaction between nutrition and infection","volume":"46","author":"Katona","year":"2008","journal-title":"Clin Infect Dis"},{"key":"ref7","first-page":"1","volume-title":"Interactions of: Malnutrition, Water Sanitation and Hygiene, Infections","year":"2007"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1172\/JCI34005","article-title":"Enteric infections, diarrhea, and their impact on function and development","volume":"118","author":"Petrie","year":"2008","journal-title":"J Clin Invest"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1093\/ije\/dyn099","article-title":"Multi-country analysis of the effects of diarrhoea on childhood stunting","volume":"37","author":"Checkley","year":"2008","journal-title":"Int J Epidemiol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"65","DOI":"10.2174\/1874279301206010065","article-title":"Impact of infectious diseases on cognitive development in childhood and beyond: potential mitigational role of hygiene","volume":"6","author":"Ijaz","year":"2012","journal-title":"Open Infect Dis J"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1038\/nrgastro.2012.239","article-title":"The impoverished gut \u2013 a triple burden of diarrhoea, stunting and chronic disease","volume":"10","author":"Guerrant","year":"2013","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"168","DOI":"10.4103\/bbrj.bbrj_69_18","article-title":"The relationship between nutrition and infectious diseases: a review","volume":"2","author":"Farhadi","year":"2018","journal-title":"Biomed Biotechnol Res J (BBRJ)"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1186\/s12889-020-09302-3","article-title":"Association of nutrition, water, sanitation and hygiene practices with children\u2019s nutritional status, intestinal parasitic infections and diarrhoea in rural Nepal: a cross-sectional study","volume":"20","author":"Shrestha","year":"2020","journal-title":"BMC Public Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e000752","DOI":"10.1136\/bmjgh-2018-000752","article-title":"Early childhood cognitive development is affected by interactions among illness, diet, enteropathogens and the home environment: findings from the MAL-ED birth cohort study","volume":"3","year":"2018","journal-title":"BMJ Glob Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1179\/2046905514Y.0000000158","article-title":"The stunting syndrome in developing countries","volume":"34","author":"Prendergast","year":"2014","journal-title":"Paediatr Int Child Health"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1111\/mcn.12258","article-title":"Can water, sanitation and hygiene help eliminate stunting? Current evidence and policy implications","volume":"12","author":"Cumming","year":"2016","journal-title":"Matern Child Nutr"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1017\/S0954422416000238","article-title":"Nutrition, infection, and stunting: the roles of deficiencies of individual nutrients and foods, and of inflammation, as determinants of reduced linear growth of children","volume":"30","author":"Millward","year":"2017","journal-title":"Nutr Res Rev"},{"key":"ref18","volume-title":"Compendium of WHO and other UN Guidance on Health and Environment. Chapter 3. WASH","year":"2021"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e13257","DOI":"10.1111\/mcn.13257","article-title":"Water, sanitation and hygiene interventions and the prevention and treatment of childhood acute malnutrition: a systematic review","volume":"18","author":"Patl\u00e1n-Hern\u00e1ndez","year":"2022","journal-title":"Matern Child Nutr"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1007\/s13312-018-1279-3","article-title":"Impact of water, sanitation and hygiene interventions on growth, non-diarrheal morbidity and mortality in children residing in low- and middle-income countries: a systematic review","volume":"55","author":"Gera","year":"2018","journal-title":"Ind Pediatr"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1186\/s12916-019-1410-x","article-title":"The implications of three major new trials for the effect of water, sanitation and hygiene on childhood diarrhea and stunting: a consensus statement","volume":"17","author":"Cumming","year":"2018","journal-title":"BMC Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e16","DOI":"10.1016\/S2214-109X(18)30420-0","article-title":"WASH alone cannot prevent childhood linear growth failure","volume":"7","author":"Maleta","year":"2019","journal-title":"Lancet Glob Health"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e1139","DOI":"10.1016\/S2214-109X(19)30268-2","article-title":"The WASH benefits and SHINE trials: interpretation of WASH intervention effects on linear growth and diarrhoea","volume":"7","author":"Pickering","year":"2019","journal-title":"Lancet Glob Health"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"115002-12024","DOI":"10.1289\/EHP14780","article-title":"TIDieR-WASH: a guideline for reporting implementation of water, sanitation, and hygiene interventions","volume":"132","author":"Crocker","year":"2024","journal-title":"Environ Health Perspect"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1016\/j.molmed.2012.04.007","article-title":"Environmental enteropathy: critical implications of a poorly understood condition","volume":"18","author":"Korpe","year":"2012","journal-title":"Trends Mol Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1111\/nyas.12330","article-title":"Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links","volume":"1308","author":"Ngure","year":"2014","journal-title":"Ann N Y Acad Sci"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1016\/j.pcl.2017.03.003","article-title":"The burden of enteropathy and \u201csubclinical infections\u201d","volume":"64","author":"Rogawski","year":"2017","journal-title":"Pediatr Clin N Am"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1111\/mcn.12220","article-title":"Preventing environmental enteric disfunction through improved water, sanitation and hygiene: an opportunity for stunting reduction in developing countries","volume":"12","author":"Mbuya","year":"2016","journal-title":"Matern Child Nutr"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.ebiom.2017.02.024","article-title":"The MAL-ED birth cohort study investigators. Causal pathways from enteropathogens to environmental enteropathy: findings from the MAL-ED birth cohort study","volume":"18","author":"Kosek","year":"2017","journal-title":"EBioMedicine"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1186\/s12916-019-1417-3","article-title":"Environmental enteric disfunction: a review of potential mechanisms, consequences and management strategies","volume":"17","author":"Tickell","year":"2019","journal-title":"BMC Med"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1016\/j.jcmgh.2018.12.006","article-title":"Disentangling microbial mediators of malnutrition: modeling environmental enteric dysfunction","volume":"7","author":"Bartelt","year":"2019","journal-title":"Cell Mol Gastroenterol Hepatol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.ebiom.2019.06.015","article-title":"Understanding & ameliorating enteropathy and malnutrition in impoverished areas","volume":"45","author":"Bolick","year":"2019","journal-title":"EBioMedicine"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1093\/nutrit\/nyu068","article-title":"Environmental enteric disfunction and child stunting","volume":"77","author":"Budge","year":"2019","journal-title":"Nutr Rev"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"e0004600","DOI":"10.1371\/journal.pntd.0004600","article-title":"Endomicroscopic and transcriptomic analysis of impaired function and malabsorption in environmental enteropathy","volume":"10","author":"Kelly","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"eabi8633","DOI":"10.1126\/scitranslmed.abi8633","article-title":"Single-cell profiling of environmental enteropathy reveals signatures of epithelial remodeling and immune activation","volume":"14","author":"Kummerlowe","year":"2022","journal-title":"Sci Transl Med"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"e0286866","DOI":"10.1371\/journal.pone.0286866","article-title":"Environmental enteropathy and its association with water sanitation and hygiene in slum areas of Jimma town Ethiopia","volume":"18","author":"Regassa","year":"2023","journal-title":"PLoS One"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/j.ajcnut.2024.05.012","article-title":"Environmental enteropathy: an old clinical conundrum with new diagnostic and therapeutic opportunities","volume":"120","author":"Fasano","year":"2024","journal-title":"Am J Clin Nutr"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1016\/j.tree.2019.07.012","article-title":"The pathobiome in animal and plant diseases","volume":"34","author":"Bass","year":"2019","journal-title":"Trends Ecol Evol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1290","DOI":"10.1038\/s41385-018-0036-1","article-title":"Pathophysiology of environmental enteric disfunction and its impact on oral vaccine efficacy","volume":"11","author":"Marie","year":"2018","journal-title":"Mucosal Immunol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"20140143","DOI":"10.1098\/rstb.2014.0143","article-title":"Exploring the role of environmental enteropathy in malnutrition, infant development and oral vaccine response","volume":"370","author":"Gilmartin","year":"2015","journal-title":"Philos Trans R Soc Lond Ser B Biol Sci"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1146\/annurev-nutr-061121-091234","article-title":"Malnourished microbes: host-microbiome interactions in child undernutrition","volume":"43","author":"Jones","year":"2023","journal-title":"Annu Rev Nutr"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"bvae117","DOI":"10.1210\/jendoso\/bvae117","article-title":"Emerging insights into the endocrine regulation of bone homeostasis by gut microbiome","volume":"8","author":"Hansdah","year":"2024","journal-title":"J Endocr Soc"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1564755","DOI":"10.3389\/fmicb.2025.1564755","article-title":"Viral metagenomics reveals diverse viruses in the fecal samples of children with acute respiratory infection","volume":"16","author":"Xu","year":"2025","journal-title":"Front Microbiol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"3884","DOI":"10.1016\/j.cell.2021.05.030","article-title":"Bifidobacteria-mediated immune system imprinting early in life","volume":"184","author":"Henrick","year":"2021","journal-title":"Cell"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"53","DOI":"10.2105\/ajph.47.1.53","article-title":"Epidemiology and prevention of severe protein malnutrition (kwashiorkor) in Central America","volume":"47","author":"Scrimshaw","year":"1957","journal-title":"Am J Public Health Nations Health"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1097\/00000441-195903000-00012","article-title":"Interactions of nutrition and infection","volume":"237","author":"Scrimshaw","year":"1959","journal-title":"Am J Med Sci"},{"key":"ref47","first-page":"S75","article-title":"Nutritional influences on linear growth: a general review","volume":"48","author":"Allen","year":"1994","journal-title":"Eur J Clin Nutr"},{"key":"ref48","first-page":"3","article-title":"Interactions of nutrition and infection","volume":"57","author":"Scrimshaw","year":"1968","journal-title":"Monogr Ser World Health Organ"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1080\/09603123.2021.1888894","article-title":"Lessons learned from 25 years of research into long term consequences of prenatal exposure to the Dutch famine 1944\u201345: the Dutch famine birth cohort","volume":"32","author":"De Rooij","year":"2021","journal-title":"Int J Environ Health Res"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1111\/cge.13748","article-title":"Epigenetic variations due to nutritional status in early-life and its later impact on aging and disease","volume":"98","author":"Gomez-Verjan","year":"2020","journal-title":"Clin Genet"},{"key":"ref51","volume-title":"Malnutrition Rates Reach Alarming Levels in Gaza, WHO Warns","year":"2025"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"1993","DOI":"10.1016\/S0140-6736(25)01820-3","article-title":"Assessment of malnutrition in preschool-aged children by mid-upper arm circumference in the Gaza strip (January, 2024\u2013august, 2025): a longitudinal, cross-sectional, surveillance study","volume":"406","author":"Horino","year":"2025","journal-title":"Lancet"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"2055","DOI":"10.1053\/j.gastro.2021.01.221","article-title":"Mucosal genomics implicate lymphocyte activation and lipid metabolism in refractory environmental enteric disfunction","volume":"160","author":"Haberman","year":"2021","journal-title":"Gastroenterology"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.pt.2022.12.004","article-title":"Parasites and childhood stunting \u2013 a mechanistic interplay with nutrition, anaemia, gut health, microbiota, and epigenetics","volume":"39","author":"Gabain","year":"2022","journal-title":"Trends Parasitol"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"8658","DOI":"10.3390\/ijms26178658","article-title":"The gut microbiome and epigenomic reprogramming: mechanisms, interactions, and implications for human health and disease","volume":"26","author":"Rubas","year":"2025","journal-title":"Int J Mol Sci"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"e001770","DOI":"10.1136\/bmjpo-2022-001770","article-title":"Epigenetic studies in children at risk of stunting and their parents in India, Indonesia and Senegal: a UKRI GCRF action against stunting hub protocol paper","volume":"8","author":"Ramsteijn","year":"2024","journal-title":"BMJ Paediatr Open"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"4055","DOI":"10.3390\/ijms19124055","article-title":"Molecular mechanisms underlying the link between diet and DNA methylation","volume":"19","author":"Kadayifci","year":"2018","journal-title":"Int J Mol Sci"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1016\/j.jnutbio.2012.03.003","article-title":"Nutrition and epigenetics: an interplay of dietary methyl donors, one-carbon metabolism and DNA methylation","volume":"23","author":"Anderson","year":"2012","journal-title":"J Nutr Biochem"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1056\/NEJMra1402513","article-title":"The key role of epigenetics in human disease prevention and mitigation","volume":"378","author":"Feinberg","year":"2018","journal-title":"N Engl J Med"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"5791","DOI":"10.1038\/s41467-019-13433-6","article-title":"Edematous severe acute malnutrition is characterized by hypomethylation of DNA","volume":"10","author":"Schulze","year":"2019","journal-title":"Nat Commun"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"1799","DOI":"10.1289\/ehp.0900741","article-title":"Hypothesis: a unifying mechanism for nutrition and chemicals as lifelong modulators of DNA hypomethylation","volume":"117","author":"Lee","year":"2009","journal-title":"Environ Health Perspect"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"E11264","DOI":"10.1073\/pnas.1722125115","article-title":"Histone H3 lysine 4 methylation signature associated with human undernutrition","volume":"115","author":"Uchiyama","year":"2018","journal-title":"Proc Natl Acad Sci USA"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/S0140-6736(19)32472-9","article-title":"The double burden of malnutrition: aetiological pathways and consequences for health","volume":"395","author":"Wells","year":"2020","journal-title":"Lancet"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1017\/S0954422418000239","article-title":"Interplay between early-life malnutrition, epigenetic modulation of the immune function and liver diseases","volume":"32","author":"Campisano","year":"2019","journal-title":"Nutr Res Rev"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"111912","DOI":"10.5501\/wjv.v14.i3.111912","article-title":"Gut microbiome and viral infections: a hidden nexus for immune protection","volume":"14","author":"Gavkare","year":"2025","journal-title":"World J Virol"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1093\/nutrit\/nuw008","article-title":"Early-life enteric infections: relation between chronic systemic inflammation and poor cognition in children","volume":"74","author":"Ori\u00e1","year":"2016","journal-title":"Nutr Rev"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/jchom.2020.06.008","article-title":"The microbiome as a modifier of neurodegenerative disease risk","volume":"28","author":"Fang","year":"2020","journal-title":"Cell Host Microb"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1126\/science.aar7201","article-title":"Mechanisms and consequences of gut commensal translocation in chronic diseases","volume":"11","author":"Fine","year":"2020","journal-title":"Gut Microbes"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.it.2020.12.005","article-title":"Systemic immunoregulatory consequences of gut commensal translocation","volume":"42","author":"McPherson","year":"2021","journal-title":"Trends Immunol"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1038\/s41422-020-0332-7","article-title":"Interaction between microbiota and immunity in health and disease","volume":"30","author":"Zheng","year":"2020","journal-title":"Cell Res"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1186\/1741-7007-8-129","article-title":"Immunogenicity and efficacy of oral vaccines in developing countries: lessons from a live cholera vaccine","volume":"8","author":"Levine","year":"2010","journal-title":"BMC Biol"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1016\/j.chom.2022.02.005","article-title":"Secretory IgA: linking microbes, maternal health, and infant health through maternal milk","volume":"30","author":"Donald","year":"2022","journal-title":"Cell Host Microbe"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.1093\/ismejo\/wraf266","article-title":"Milk IgA promotes symbionts and limits pathobionts in the early life gut","volume":"19","author":"Donald","year":"2025","journal-title":"ISME J"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.4161\/hv.29199","article-title":"Maximizing protection from use of oral cholera vaccines in developing country settings. An immunological review of oral cholera vaccines","volume":"10","author":"Desai","year":"2014","journal-title":"Human Vaccin Immunother"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1016\/j.vaccine.2013.11.056","article-title":"Oral polio vaccine response in breast fed infants with malnutrition and diarrhea","volume":"32","author":"Haque","year":"2014","journal-title":"Vaccine"},{"key":"ref76","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1093\/infdis\/jiu182","article-title":"Influence of enteric infections on response to oral poliovirus vaccine: a systemic review and meta-analysis","volume":"210","author":"Parker","year":"2014","journal-title":"J Infect Dis"},{"key":"ref77","doi-asserted-by":"publisher","first-page":"1759","DOI":"10.1016\/j.ebiom.2015.09.036","article-title":"Environmental enteropathy, oral vaccine failure and growth faltering in infants in Bangladesh","volume":"2","author":"Naylor","year":"2015","journal-title":"EBioMedicine"},{"key":"ref78","doi-asserted-by":"publisher","first-page":"20140141","DOI":"10.1098\/rstb.2014.0141","article-title":"Malnutrition and vaccination in developing countries","volume":"370","author":"Prendergast","year":"2015","journal-title":"Philos Trans R Soc B Biol Sci"},{"key":"ref79","doi-asserted-by":"publisher","first-page":"744","DOI":"10.4269\/ajtmh.14-0518","article-title":"The \u201cperformance of rotavirus and oral polio vaccines in developing countries\u201d (PROVIDE) study: description of methods of an interventional study designed to explore complex biologic problems","volume":"92","author":"Kirkpatrick","year":"2015","journal-title":"Am J Trop Med Hyg"},{"key":"ref80","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.ebiom.2016.07.030","article-title":"Environmental enteropathy: elusive but significant subclinical abnormalities in developing countries","volume":"10","author":"Watanabe","year":"2016","journal-title":"EBioMedicine"},{"key":"ref81","doi-asserted-by":"publisher","first-page":"3068","DOI":"10.1016\/j.vaccine.2016.04.080","article-title":"Impact of enterovirus and other enteric pathogens on oral polio and rotavirus vaccine performance in Bangladeshi infants","volume":"34","author":"Taniuchi","year":"2016","journal-title":"Vaccine"},{"key":"ref82","doi-asserted-by":"publisher","first-page":"97","DOI":"10.2217\/fmb-2017-0128","article-title":"Causes of impaired oral vaccine in developing countries","volume":"13","author":"Parker","year":"2018","journal-title":"Future Microbiol"},{"key":"ref83","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1016\/j.vaccine.2017.11.031","article-title":"Influence of the intestinal microbiota on the immunogenicity of oral rotavirus vaccine given to infants in South India","volume":"36","author":"Parker","year":"2018","journal-title":"Vaccine"},{"key":"ref84","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1042\/cs20171106","article-title":"Role of nutrition, infection, and the microbiota in the efficacy of oral vaccines","volume":"132","author":"Bhattacharjee","year":"2018","journal-title":"Clin Sci (Lond)"},{"key":"ref85","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.2217\/fmb-2018-0016","article-title":"Exploring the relationship between environmental enteric dysfunction and oral vaccine responses","volume":"13","author":"Church","year":"2018","journal-title":"Future Microbiol"},{"key":"ref86","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1080\/14760584.2018.1418665","article-title":"Decreased performance of live attenuated, oral rotavirus vaccines in low-income settings: causes and contributing factors","volume":"17","author":"Velasquez","year":"2018","journal-title":"Expert Rev Vaccines"},{"key":"ref87","doi-asserted-by":"publisher","first-page":"2074","DOI":"10.1093\/cid\/ciz140","article-title":"The impact of improved water, sanitation, and hygiene on oral rotavirus vaccine immunogenicity in Zimbabwean infants: substudy of a cluster-randomized trial","volume":"69","author":"Church","year":"2019","journal-title":"Clin Infect Dis"},{"key":"ref88","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.coviro.2019.05.001","article-title":"How the gut microbiome regulates host immune responses to viral vaccines","volume":"37","author":"Vlasova","year":"2019","journal-title":"Curr Opin Virol"},{"key":"ref89","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1038\/s41541-020-0178-5","article-title":"Immune predictors of oral poliovirus vaccine immunogenicity among infants in South India","volume":"5","author":"Babji","year":"2020","journal-title":"NPJ Vaccin"},{"key":"ref90","doi-asserted-by":"publisher","first-page":"213","DOI":"10.4269\/ajtmh.19-0355","article-title":"Association between gut microbiome composition and rotavirus vaccine response among Nicaraguan infants","volume":"102","author":"Fix","year":"2020","journal-title":"Am J Trop Med Hyg."},{"key":"ref91","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1080\/14760584.2021.1951247","article-title":"Rotavirus vaccines performance: dynamic interdependence of host, pathogen and environment","volume":"20","author":"Saha","year":"2021","journal-title":"Expert Rev Vaccines"},{"key":"ref92","doi-asserted-by":"publisher","first-page":"1745","DOI":"10.1016\/j.immuni.2021.07.005","article-title":"Environmental enteric dysfunction induces intestinal regulatory T cells that inhibit local CD4+ T cell responses and impair the efficacy of oral vaccines","volume":"54","author":"Bhattacharjee","year":"2021","journal-title":"Immunity"},{"key":"ref93","doi-asserted-by":"publisher","first-page":"3444","DOI":"10.1016\/j.vaccine.2022.04.032","article-title":"Association of anti-rotavirus IgA seroconversion with growth, environmental enteric disfunction and enteropathogens in rural Pakistani infants","volume":"40","author":"Ahmed","year":"2022","journal-title":"Vaccine"},{"key":"ref94","doi-asserted-by":"publisher","first-page":"2545","DOI":"10.1016\/j.vaccine.2006.12.028","article-title":"Analysis of strategies to successfully vaccinate infants in developing countries against enterotoxigenic E. coli (ETEC) disease","volume":"25","author":"Walker","year":"2007","journal-title":"Vaccine"},{"key":"ref95","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1038\/nrmicro1662","article-title":"Clinical trials of Shigella vaccines: two steps forward and one step back on a long, hard road","volume":"5","author":"Levine","year":"2007","journal-title":"Nat Rev Microbiol"},{"key":"ref96","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.jpeds.2016.05.035","article-title":"Unsafe child feces disposal is associated with environmental enteropathy and impaired growth","volume":"176","author":"George","year":"2016","journal-title":"J Pediatr"},{"key":"ref97","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.4269\/ajtmh.14-0672","article-title":"Geophagy is associated with environmental enteropathy and stunting in children in rural Bangladesh","volume":"92","author":"George","year":"2015","journal-title":"Am J Trop Med Hyg"},{"key":"ref98","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1111\/tmi.12869","article-title":"Mouthing of soil contaminated objects is associated with environmental enteropathy in young children","volume":"22","author":"Morita","year":"2017","journal-title":"Trop Med Int Health"},{"key":"ref99","doi-asserted-by":"publisher","first-page":"11","DOI":"10.14252\/foodsafetyfscj.2018013","article-title":"Quantitative analysis of houseflies-mediated food contamination with bacteria","volume":"7","author":"Fukuda","year":"2019","journal-title":"Food Saf (Tokyo)"},{"key":"ref100","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1186\/s12889-018-5934-3","article-title":"A systematic review of human pathogens carried by the housefly (Musca domestica L.)","volume":"18","author":"Khamesipour","year":"2018","journal-title":"BMC Public Health"},{"key":"ref101","volume-title":"Disinfection, Sterilization, & Preservation","author":"Spaulding","year":"1968"},{"key":"ref102","first-page":"34","volume-title":"Disinfection, Sterilization, & Preservation, 3rd Edition","author":"Klein","year":"422"},{"key":"ref103","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1128\/CMR.12.1.147","article-title":"Antiseptics and disinfectants: activity, action, and resistance","volume":"12","author":"McDonnell","year":"1999","journal-title":"Clin Microbiol Rev"},{"key":"ref104","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.1093\/jaoac\/90.6.1655","article-title":"Hierarchy of susceptibility of viruses to environmental surface disinfectants: a predictor of activity against new and emerging viral pathogens","volume":"90","author":"Sattar","year":"2007","journal-title":"J AOAC Int"},{"key":"ref105","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1086\/526441","article-title":"Should test methods for disinfectants use vertebrate virus dried on carriers to advance virucidal claims?","volume":"29","author":"Ijaz","year":"2008","journal-title":"Infect Control Hosp Epidemiol"},{"key":"ref106","doi-asserted-by":"publisher","first-page":"e9914","DOI":"10.7717\/peerj.9914","article-title":"Combating SARS-CoV-2: leveraging microbicidal experiences with other emerging\/re-emerging viruses","volume":"8","author":"Ijaz","year":"2020","journal-title":"PeerJ"},{"key":"ref107","doi-asserted-by":"publisher","first-page":"S76","DOI":"10.1177\/15648265150361S113","article-title":"Environmental enteric dysfunction: an overview","volume":"36","author":"Crane","year":"2015","journal-title":"Food Nutri Bull"},{"key":"ref108","doi-asserted-by":"publisher","first-page":"S193","DOI":"10.1093\/cid\/ciu653","article-title":"The MAL-ED study: a multinational and multidisciplinary approach to understand the relationship between enteric pathogens, malnutrition, gut physiology, physical growth, cognitive development, and immune responses in infants and children up to 2 years of age in resource-poor environments","volume":"59","year":"2014","journal-title":"Clin Infect Dis"},{"key":"ref109","doi-asserted-by":"publisher","first-page":"119144","DOI":"10.1016\/j.neuroimage.2022.119144","article-title":"Early protein energy malnutrition impacts life-long developmental trajectories of the sources of EEG rhythmic activity","volume":"254","author":"Bosch-Bayard","year":"2022","journal-title":"NeuroImage"},{"key":"ref110","doi-asserted-by":"publisher","first-page":"323","DOI":"10.3945\/an.116.013938","article-title":"The impact of nutritional interventions beyond the first 2 years of life on linear growth: a systematic review and meta-analysis","volume":"8","author":"Roberts","year":"2017","journal-title":"Adv Nutr"},{"key":"ref111","doi-asserted-by":"publisher","first-page":"CD011695","DOI":"10.1002\/14651858.CD011695.pub2","article-title":"Nutritional interventions for preventing stunting in children (birth to 59 months) living in urban slums in low- and middle-income countries (LMIC) (review)","volume":"6","author":"Goudet","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"ref112","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s40795-021-00421-7","article-title":"Effectiveness of integrated nutrition interventions on childhood stunting: a quasi-experimental evaluation design","volume":"7","author":"Elisaria","year":"2021","journal-title":"BMC Nutr"},{"key":"ref113","doi-asserted-by":"publisher","first-page":"e419","DOI":"10.1016\/52214-109X(23)00562-4","article-title":"The effect of nutrition-specific and nutrition-sensitive interventions on the double burden of malnutrition in low-income and middle-income countries: a systematic review","volume":"12","author":"Escher","year":"2024","journal-title":"Lancet"},{"key":"ref114","doi-asserted-by":"publisher","first-page":"2149","DOI":"10.3390\/nu16132149","article-title":"The effectiveness of nutritional interventions implemented through lady health workers on the reduction of stunting in children under 5 in Pakistan: the difference-in-difference analysis","volume":"16","author":"Ashraf","year":"2024","journal-title":"Nutrients"},{"key":"ref115","doi-asserted-by":"publisher","first-page":"709","DOI":"10.4269\/ajtmh.12-0568","article-title":"Formative research on hygiene behaviors and geophagy among infants and young children and implications of exposure to fecal bacteria","volume":"89","author":"Ngure","year":"2013","journal-title":"Am J Trop Med Hyg"},{"key":"ref116","doi-asserted-by":"publisher","first-page":"286","DOI":"10.2471\/BLT.21.287137","article-title":"Environmental sanitation and the evolution of water, sanitation and hygiene","volume":"100","author":"Budge","year":"2022","journal-title":"Bull World Health Organ"},{"key":"ref117","doi-asserted-by":"publisher","first-page":"1865","DOI":"10.1186\/s12889-022-14259-6","article-title":"Determinants of food preparation and hygiene practices among caregivers of children under two in Western Kenya: a formative research study","volume":"22","author":"Ogutu","year":"2020","journal-title":"BMC Public Health"},{"key":"ref118","doi-asserted-by":"publisher","first-page":"371","DOI":"10.3390\/tropicalmed7110371","article-title":"Intestinal parasitic infection and nutritional status in children under five years old: a systematic review","volume":"7","author":"Fauziah","year":"2022","journal-title":"Trop Med Infect Dis"},{"key":"ref119","doi-asserted-by":"publisher","first-page":"130","DOI":"10.4269\/ajtmh.12-0629","article-title":"Household environmental conditions are associated with enteropathy and impaired growth in rural Bangladesh","volume":"89","author":"Lin","year":"2013","journal-title":"Am J Trop Med Hyg."},{"key":"ref120","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1111\/tmi.13510","article-title":"Child hand contamination is associated with subsequent pediatric diarrhea in rural Democratic Republic of the Congo (REDUCE program)","volume":"26","author":"George","year":"2021","journal-title":"Trop Med Int Health"},{"key":"ref121","doi-asserted-by":"publisher","first-page":"e0009514","DOI":"10.1371\/journal.pntd.0009514","article-title":"A randomised controlled feasibility trial of a BabyWASH household playspace: the CAMPI study","volume":"15","author":"Budge","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"key":"ref122","doi-asserted-by":"publisher","first-page":"1998","DOI":"10.1186\/s12889-023-16887-y","article-title":"BabyWASH and diarrhea prevention practices following multimedia educational intervention in hard-to-reach areas of the Afar and Somali regions of Ethiopia: a mixed-method endline evaluation","volume":"23","author":"Negussie","year":"2023","journal-title":"BMC Public Health"},{"key":"ref123","volume-title":"Microbial Risk Assessment Guideline: Pathogenic Microorganisms with Focus on Food and Water","year":"2025"},{"key":"ref124","volume-title":"Quantitative Microbial Risk Assessment: Application for Water Safety Management","year":"2025"},{"key":"ref125","doi-asserted-by":"publisher","first-page":"27","DOI":"10.3390\/hygiene5030027","article-title":"Bacterial contamination of public and household restrooms, and implications for the potential risk of norovirus transmission","volume":"5","author":"Gerba","year":"2025","journal-title":"Hygiene (Lond)"},{"key":"ref126","doi-asserted-by":"publisher","first-page":"100069","DOI":"10.1016\/j.indenv.2024.100069","article-title":"A quantitative microbial risk assessment (QMRA) framework for exposure from toilet flushing using experimental aerosol concentration measurements","volume":"2","author":"Higham","year":"2025","journal-title":"Indoor Environ"},{"key":"ref127","doi-asserted-by":"publisher","first-page":"1941","DOI":"10.1021\/acs.est.0c06972","article-title":"Quantitative microbial risk assessment of pediatric infections attributable to ingestion of fecally contaminated domestic soils in low-income urban Maputo, Mozambique","volume":"55","author":"Capone","year":"2021","journal-title":"Environ Sci Technol"},{"key":"ref128","doi-asserted-by":"publisher","first-page":"e00709-18","DOI":"10.1128\/AEM.00709-18","article-title":"Modeling surface disinfection needs to meet microbial risk reduction targets","volume":"84","author":"Wilson","year":"2018","journal-title":"Appl Environ Microbiol"},{"key":"ref129","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1007\/s40265-022-01832-x","article-title":"Emerging options for the prevention and management of Clostridioides difficile infection","volume":"83","author":"Gonzales-Luna","year":"2023","journal-title":"Drugs"},{"key":"ref130","doi-asserted-by":"publisher","first-page":"2374147","DOI":"10.1080\/21645515.2024.2374147","article-title":"Immunogenicity and safety of an Entamoeba histolytica adjuvanted protein vaccine candidate (LecA+GLA-3M-052 liposomes) in rhesus macaques","volume":"20","author":"Abhyankar","year":"2024","journal-title":"Hum Vaccin Immunother"},{"key":"ref131","volume-title":"Intestinal Parasites - New Developments in Diagnosis, Treatment, Prevention and Future Directions","author":"Akinnubi","year":"2024"},{"key":"ref132","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1016\/j.vaccine.2010.10.035","article-title":"Safety, dose, immunogenicity, and transmissibility of an oral live attenuated Shigella flexneri 2a vaccine candidate (SC602) among healthy adults and school children in Matlab, Bangladesh","volume":"29","author":"Rahman","year":"2011","journal-title":"Vaccine"},{"key":"ref133","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1038\/ni0910-769","article-title":"Improving the performance of enteric vaccines in the developing world","volume":"11","author":"Serazin","year":"2010","journal-title":"Nat Immunol"},{"key":"ref134","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1586\/14760584.2014.882235","article-title":"Advances in enteric disease vaccines: from innovation to implementation","volume":"13","author":"Parker","year":"2014","journal-title":"Expert Rev Vaccines"},{"key":"ref135","doi-asserted-by":"publisher","first-page":"2910","DOI":"10.1038\/s41467-024-45528-0","article-title":"Malnutrition enteropathy in Zambian and Zimbabwean children with severe acute malnutrition: a multi-arm randomized phase II trial","volume":"15","author":"Chandwe","year":"2024","journal-title":"Nat Commun"},{"key":"ref136","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1186\/s12916-014-0133-2","article-title":"Mesalazine in the initial management of severely acutely malnourished children with environmental enteric dysfunction: a pilot randomized controlled trial","volume":"12","author":"Jones","year":"2014","journal-title":"BMC Med"},{"key":"ref137","doi-asserted-by":"publisher","first-page":"105478","DOI":"10.1016\/j.ebiom.2024.105478","article-title":"Therapeutic interventions targeting enteropathy in severe acute malnutrition modulate systemic and vascular inflammation and epithelial regeneration","volume":"111","author":"Sturgeon","year":"2024","journal-title":"EBioMedicine"},{"key":"ref138","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1016\/j.clnu.2024.03.029","article-title":"The infant gut microbiome and cognitive development in malnutrition","volume":"43","author":"Shennon","year":"2024","journal-title":"Clin Nutr"},{"key":"ref139","doi-asserted-by":"publisher","first-page":"105166","DOI":"10.1016\/j.ebiom.2024.105166","article-title":"A microbiota-directed complementary food intervention in 12-18-month-old Bangladeshi children improves linear growth","volume":"104","author":"Mostafa","year":"2024","journal-title":"EBioMedicine"},{"key":"ref140","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1038\/s41564-024-01628-7","article-title":"Prevotella copri and microbiota members mediate the beneficial effects of a therapeutic food for malnutrition","volume":"9","author":"Chang","year":"2024","journal-title":"Nat Microbiol"},{"key":"ref141","doi-asserted-by":"publisher","first-page":"596166","DOI":"10.3389\/fcimb.2020.596166","article-title":"Viral infections, the microbiome, and probiotics","volume":"10","author":"Harper","year":"2021","journal-title":"Front Cell Infect Microbiol"},{"key":"ref142","doi-asserted-by":"publisher","first-page":"5231","DOI":"10.3390\/jcm12165231","article-title":"The impact of microbiota on the gut-brain axis: examining the complex interplay and implications","volume":"12","author":"Chaudhry","year":"2023","journal-title":"J Clin Med"},{"key":"ref143","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/B978-0-12-824412-8.00005-9","volume-title":"Role of Nutrigenomics in Modern-Day Healthcare and Drug Discovery","author":"Tupas","year":"2023"},{"key":"ref144","doi-asserted-by":"publisher","first-page":"116471","DOI":"10.1016\/j.celrep.2025.116471","article-title":"Maternal undernutrition exacerbates microbiota-driven growth stunting through pre- and postnatal effects","volume":"44","author":"Matos","year":"2025","journal-title":"Cell Rep"},{"key":"ref145","doi-asserted-by":"publisher","first-page":"3290","DOI":"10.3390\/ijms21093290","article-title":"The effects of maternal and postnatal dietary methyl nutrients on epigenetic changes that lead to non-communicable diseases in adulthood","volume":"21","author":"Randunu","year":"2020","journal-title":"Int J Mol Sci"},{"key":"ref146","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1152\/physrev.00010.2017","article-title":"Dietary modulation of the epigenome","volume":"98","author":"Ideraabdullah","year":"2018","journal-title":"Physiol Rev"},{"key":"ref147","doi-asserted-by":"publisher","first-page":"4036","DOI":"10.3390\/ijms25074036","article-title":"Epigenetics, nutrition, and the brain: improving mental health through diet","volume":"25","author":"Bekdash","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref148","doi-asserted-by":"publisher","first-page":"1020","DOI":"10.1021\/acsinfecdis.0c00831","article-title":"Modeling enteropathy or diarrhea with the top bacterial and protozoal pathogens: differential determinants of outcomes","volume":"7","author":"Guerrant","year":"2021","journal-title":"ACS Infect Dis"},{"key":"ref149","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/2333794X221099266","article-title":"Effect of zinc supplementation in children less than 5 years on diarrhea attacks: a randomized controlled trial","volume":"9","author":"El-Ghaffar","year":"2023","journal-title":"Glob Pediatr Health"},{"key":"ref150","doi-asserted-by":"publisher","first-page":"e2422749","DOI":"10.1001\/jamanetworkopen.2024.22749","article-title":"Essential nutrients, added sugar intake, and epigenetic age in midlife black and white women: NIMHD social Epigenomics program","volume":"7","author":"Chiu","year":"2024","journal-title":"JAMA Netw Open"},{"key":"ref151","doi-asserted-by":"publisher","first-page":"1169168","DOI":"10.3389\/fonc.2023.1169168","article-title":"Metabolo-epigenetic interplay provides targeted nutritional interventions in chronic diseases and ageing","volume":"13","author":"de Cedr\u00f3n","year":"2023","journal-title":"Front Oncol"},{"key":"ref152","doi-asserted-by":"publisher","first-page":"2633","DOI":"10.3390\/ijms21072633","article-title":"Genes and diet in the prevention of chronic diseases in future generations","volume":"21","author":"Franzago","year":"2020","journal-title":"Int J Mol Sci"},{"key":"ref153","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.3390\/ijms25021228","article-title":"Modulation of the gut microbiota by nutrition and its relationship to epigenetics","volume":"25","author":"Ferenc","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref154","doi-asserted-by":"publisher","first-page":"e472","DOI":"10.1016\/S2214-109X(20)30063-2","article-title":"Air pollution and stunting: a missing link","volume":"8","author":"Sinharoy","year":"2020","journal-title":"Lancet Glob Health"},{"key":"ref155","doi-asserted-by":"publisher","first-page":"128","DOI":"10.47134\/ijhis.v1i3.3","article-title":"The implementation of smart application system for early detection of stunting as a solution to nutritional problems based on anthropometry standards","volume":"1","author":"Muflihatin","year":"2024","journal-title":"Int J Health Inf Syst"},{"key":"ref156","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.worlddev.2015.10.032","article-title":"Barriers to prosperity: parasitic and infectious diseases, IQ, and economic development","volume":"78","author":"Madsen","year":"2016","journal-title":"World Dev"},{"key":"ref157","doi-asserted-by":"publisher","first-page":"3704","DOI":"10.1128\/aem.60.10.3704-3710.1994","article-title":"Survival of enteric viruses on environmental fomites","volume":"60","author":"Abad","year":"1994","journal-title":"Appl Environ Microbiol"},{"key":"ref158","doi-asserted-by":"publisher","first-page":"3904","DOI":"10.1128\/AEM.67.9.3904-3907.2001","article-title":"Potential role of fomites in the vehicular transmission of human astroviruses","volume":"67","author":"Abad","year":"2001","journal-title":"Appl Environ Microbiol"},{"key":"ref159","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/s0195-6701(99)90037-3","article-title":"Inactivation of feline calicivirus, a Norwalk virus surrogate","volume":"41","author":"Doultree","year":"1999","journal-title":"J Hosp Infect"},{"key":"ref160","doi-asserted-by":"publisher","first-page":"e01697","DOI":"10.1128\/mBio.01697-15","article-title":"Human coronavirus 229E remains infectious on common touch surface materials","volume":"6","author":"Warnes","year":"2015","journal-title":"MBio"},{"key":"ref161","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1136\/bmj.3.5568.767","article-title":"Effects of a \u201cnew\u201d human respiratory virus in volunteers","volume":"3","author":"Bradburne","year":"1967","journal-title":"Brit Med J"},{"key":"ref162","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1093\/infdis\/146.1.47","article-title":"Survival of influenza viruses on environmental surfaces","volume":"146","author":"Bean","year":"1982","journal-title":"J Infect Dis"},{"key":"ref163","doi-asserted-by":"publisher","first-page":"2712","DOI":"10.1128\/AEM.02291-09","article-title":"Effects of air temperature and relative humidity on coronavirus survival on surfaces","volume":"76","author":"Casanova","year":"2010","journal-title":"Appl Environ Microbiol"},{"key":"ref164","doi-asserted-by":"publisher","first-page":"115S","DOI":"10.1046\/j.1365-2672.2001.01359.x","article-title":"Campylobacter spp. in the kitchen: spread and persistence","volume":"90","author":"Humphrey","year":"2001","journal-title":"J Appl Microbiol"},{"key":"ref165","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1111\/j.1745-4565.2001.tb00307.x","article-title":"Infective dose of foodborne pathogens in volunteers: a review","volume":"21","author":"Kothary","year":"2001","journal-title":"J Food Safety"},{"key":"ref166","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1128\/JCM.02004-08","article-title":"Survival of nosocomial bacteria and spores on surfaces and inactivation by hydrogen peroxide vapor","volume":"47","author":"Otter","year":"2009","journal-title":"J Clin Microbiol"},{"key":"ref167","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1016\/j.ijfoodmicro.2005.04.021","article-title":"The survival of Escherichia coli O157 on a range of metal surfaces","volume":"105","author":"Wilks","year":"2005","journal-title":"Int J Food Microbiol"},{"key":"ref168","doi-asserted-by":"publisher","first-page":"343","DOI":"10.3390\/microorganisms9020343","article-title":"Persistence of pathogens on inanimate surfaces: a narrative review","volume":"9","author":"Wi\u00dfmann","year":"2021","journal-title":"Microorganisms"},{"key":"ref169","volume-title":"QMRA Wiki","year":"2017"},{"key":"ref170","doi-asserted-by":"publisher","first-page":"210385","DOI":"10.1155\/2014\/210385","article-title":"Impact of environmental conditions on the survival of Cryptosporidium and Giardia on environmental surfaces","volume":"2014","author":"Alum","year":"2014","journal-title":"Interdiscip Perspect Infect Dis"},{"key":"ref171","volume-title":"Pathogen Safety Data Sheets","year":"2026"},{"key":"ref172","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/S0174-3031(83)80076-6","article-title":"Minimal infectious doses and prepatent periods in Giardia muris, Spironucleus muris and Tritrichomonas muris","volume":"256","author":"Stachan","year":"1983","journal-title":"Zentralbl Bakteriol Mikrobiol Hyg A"},{"key":"ref173","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1038\/s41586-025-09415-y","article-title":"Commensal yeast promotes Salmonella typhimurium virulence","volume":"645","author":"Jaswal","year":"2025","journal-title":"Nature"},{"key":"ref174","doi-asserted-by":"publisher","first-page":"100237","DOI":"10.1016\/j.cellin.2025.100237","article-title":"The interplay between Salmonella and host: mechanisms and strategies for bacterial survival","volume":"4","author":"Zhao","year":"2025","journal-title":"Cell Insight"},{"key":"ref175","doi-asserted-by":"publisher","first-page":"2163839","DOI":"10.1080\/19490976.2022.2163839","article-title":"Immune evasion and persistence in enteric bacterial pathogens","volume":"15","author":"Worley","year":"2023","journal-title":"Gut Microbes"},{"key":"ref176","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1038\/s41467-025-56309-8","article-title":"Klebsiella pneumoniae employs a type VI secretion system to overcome microbiota-mediated colonization resistance","volume":"16","author":"Bray","year":"2025","journal-title":"Nat Commun"},{"key":"ref177","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/j.tim.2025.01.003","article-title":"Klebsiella pneumoniae emerging anti-immunology paradigms: from stealth to evasion","volume":"33","author":"S\u00e1-Pessoa","year":"2025","journal-title":"Trends Microbiol"},{"key":"ref178","doi-asserted-by":"publisher","first-page":"1680448","DOI":"10.3389\/fvets.2025.1680448","article-title":"Interplay between nutrition, microbiota, and immunity in rotavirus infection: insights from human and animal models","volume":"12","author":"Huo","year":"2025","journal-title":"Front Vet Sci"},{"key":"ref179","doi-asserted-by":"publisher","first-page":"619","DOI":"10.3390\/v12060619","article-title":"Infectious norovirus is chronically shed by immunocompromised pediatric hosts","volume":"12","author":"Davis","year":"2020","journal-title":"Viruses"},{"key":"ref180","doi-asserted-by":"publisher","first-page":"e02177-23","DOI":"10.1128\/mbio.02177-23","article-title":"Norovirus evolves as one or more distinct clonal populations in immunocompromised hosts","volume":"14","author":"Chaimongkol","year":"2023","journal-title":"MBio"},{"key":"ref181","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1093\/infdis\/jiae440","article-title":"A decade of chronic norovirus infection surveillance at the National Institutes of Health clinical research center: clinical characteristics, molecular epidemiology, and replication","volume":"231","author":"Chaimongkol","year":"2025","journal-title":"J Infect Dis"},{"key":"ref182","doi-asserted-by":"publisher","first-page":"381.e1","DOI":"10.1016\/j.cmi.2015.12.013","article-title":"Persistence and reactivation of human adenoviruses in the gastrointestinal tract","volume":"22","author":"Kosulin","year":"2016","journal-title":"Clin Microbiol Infect"},{"key":"ref183","doi-asserted-by":"publisher","first-page":"1479","DOI":"10.3390\/nu17091479","article-title":"Undernutrition and intestinal infections in children: a narrative review","volume":"17","author":"da Cruz Carvalho","year":"2025","journal-title":"Nutrients"},{"key":"ref184","volume-title":"Understanding human Astrovirus from Pathogenesis to Treatment. Theses and Dissertations (ETD). The University of Tennessee Health Science Center","author":"Hargest","year":"2020"},{"key":"ref185","doi-asserted-by":"publisher","first-page":"100285","DOI":"10.1016\/j.crpvbd.2025.100285","article-title":"Cryptosporidium-host interactions: what\u2019s new?","volume":"8","author":"Abdallah","year":"2025","journal-title":"Curr Res Parasitol Vector Borne Dis"},{"key":"ref186","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1097\/QCO.0000000000000877","article-title":"Giardia and growth impairment in children in high-prevalence settings: consequence or co-incidence","volume":"35","author":"Dougherty","year":"2022","journal-title":"Curr Opin Infect Dis"},{"key":"ref187","volume-title":"Block\u2019s Disinfection, Sterilization, and Preservation","author":"Scott","year":"2020"},{"key":"ref188","doi-asserted-by":"publisher","first-page":"114363","DOI":"10.1016\/j.ijheh.2024.114363","article-title":"The state of reporting context and implementation in peer-reviewed evaluations of water, sanitation, and hygiene interventions: a scoping review","volume":"259","author":"Crocker","year":"2024","journal-title":"Int J Hyg Environ Health"},{"key":"ref189","doi-asserted-by":"publisher","first-page":"e302","DOI":"10.1016\/S2214-109X(17)30490-4","article-title":"Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Bangladesh: a cluster randomised controlled trial","volume":"6","author":"Luby","year":"2018","journal-title":"Lancet Glob Health"},{"key":"ref190","doi-asserted-by":"publisher","first-page":"8725","DOI":"10.1021\/acs.est.7b01710","article-title":"Animal feces contribute to domestic fecal contamination: evidence from E. coli measured in water, hands, food, flies, and soil in Bangladesh","volume":"51","author":"Ercumen","year":"2017","journal-title":"Environ Sci Technol"},{"key":"ref191","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1080\/00439339.2024.2368819","article-title":"Recent advances and challenges in developing vaccines for Campylobacter jejuni: a comprehensive review","volume":"80","author":"Poudel","year":"2024","journal-title":"Worlds Poult Sci J"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1792466\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:36:17Z","timestamp":1788266177000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1792466\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":191,"alternative-id":["10.3389\/fpubh.2026.1792466"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1792466","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]},"article-number":"1792466"}}