The Enteric and Diarrheal Disease Team of the Bill & Melinda Gates Foundation engaged the START team to conduct a landscape analysis for pre- and pro-biotic interventions for growth faltering that may be caused by Environmental Enteric Dysfunction (EED).
The Enteric and Diarrheal Disease Team of the Bill & Melinda Gates Foundation previously engaged the START team to conduct a landscape analysis of intervention trials for EED. During this phase an additional but parallel track of work was identified to conduct a similar landscape analysis examining the safety and efficacy of prebiotics and/or probiotics in interventions using growth markers associated with EED. An extensive and comprehensive literature review was conducted in Embase, targeting published literature that assessed the safety, tolerability and efficacy of prebiotic and/or probiotic interventions including growth measures commonly accepted as potentially diagnostic or indicative of growth faltering in young children. From 403 titles, 25 full text articles were included in the final review. Our landscape review found Bifidobacteria and Lactobacillus were the most common genus of bacteria identified, though there was considerable variability in the use and reporting of probiotic strains. The most commonly cited prebiotic were galacto-oligosaccharides. The majority of the studies found probiotics and prebiotics were safe and well tolerated in children. Growth measures were less conclusive, as the majority of participants identified in studies were healthy children. This may be due to the limited body of evidence for pre- and/or probiotic trials assessing growth endpoints in children from Low and Middle-Income Countries.
It was determined that a review of safety and efficacy for probiotic interventions conducted in LMICs and children whose immune and gut function more closely approximate EED was beyond the initial scope for this project. Consequently, a new project was established to conduct a similar landscape review titled, "EED version 3.0."
Final deliverables included:
- PowerPoint presentation covering review findings
- Table of interventional trials