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To date, the gold standard for diagnosis is small intestine biopsy followed by histology. Several putative biomarkers for EED have been proposed and are widely used in the field. Here, we assessed in a cross-sectional study of children aged 2\u20135 years for a large set of biomarkers including markers of protein exudation (duodenal and fecal alpha-1-antitrypsin (AAT)), inflammation (duodenal and fecal calprotectin, duodenal, fecal and blood immunoglobulins, blood cytokines, C-reactive protein (CRP)), gut permeability (endocab, lactulose-mannitol ratio), enterocyte mass (citrulline) and general nutritional status (branched-chain amino acids (BCAA), insulin-like growth factor) in a group of 804 children in two Sub-Saharan countries. We correlated these markers with each other and with anemia in stunted and non-stunted children. AAT and calprotectin, CRP and citrulline and citrulline and BCAA correlated with each other. Furthermore, BCAA, citrulline, ferritin, fecal calprotectin and CRP levels were correlated with hemoglobin levels. Our results show that while several of the biomarkers are associated with anemia, there is little correlation between the different biomarkers. Better biomarkers and a better definition of EED are thus urgently needed.<\/jats:p>","DOI":"10.3390\/nu14163312","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T03:33:20Z","timestamp":1660534400000},"page":"3312","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Putative Biomarkers of Environmental Enteric Disease Fail to Correlate in a Cross-Sectional Study in Two Study Sites in Sub-Saharan Africa"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1064-6505","authenticated-orcid":false,"given":"Pascale","family":"Vonaesch","sequence":"first","affiliation":[{"name":"Unit\u00e9 de Pathog\u00e9nie Microbienne, Institut Pasteur, 25-28 Rue du Dr Roux, 75015 Paris, France"},{"name":"Department of Fundamental Microbiology, University of Lausanne, Campus UNIL-Sorge, 1015 Lausanne, Switzerland"},{"name":"Human and Animal Health Unit, Swiss Tropical and Public Health Institute & University of Basel, Kreuzstrasse 2, 4123 Allschwil, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munir","family":"Winkel","sequence":"additional","affiliation":[{"name":"Department of Fundamental Microbiology, University of Lausanne, Campus UNIL-Sorge, 1015 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathalie","family":"Kapel","sequence":"additional","affiliation":[{"name":"Service de Coprologie Fonctionnelle, H\u00f4pital Piti\u00e9-Salp\u00e9tri\u00e8re, Assistance Publique-H\u00f4pitaux de Paris, 47-83 boulevard de l\u2019H\u00f4pital, 75013 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Nestoret","sequence":"additional","affiliation":[{"name":"Service de Coprologie Fonctionnelle, H\u00f4pital Piti\u00e9-Salp\u00e9tri\u00e8re, Assistance Publique-H\u00f4pitaux de Paris, 47-83 boulevard de l\u2019H\u00f4pital, 75013 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Biomarkers Unit of Technology and Service, Institut Pasteur and Universit\u00e9 Paris Cit\u00e9, 25-28 Rue du Dr Roux, 75015 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u00e8s","family":"Vigan-Womas","sequence":"additional","affiliation":[{"name":"Unit\u00e9 d\u2019Immunologie des Maladies Infectieuses, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Marc","family":"Collard","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Bact\u00e9riologie Exp\u00e9rimentale, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Chrysostome","family":"Gody","sequence":"additional","affiliation":[{"name":"Complexe Hospitalo-Universitaire de Bangui, Bangui BP 923, Central African 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