Here's a brand new paper in full attached:




Exploring the role of environmental enteropathy in malnutrition, infant development and oral vaccine response
rstb.royalsocietypublishing.org/content/370/1671/20140143

What is still not associated with poor vaccine response due to imbalanced gut flora is risk of vaccine injury. So, not only are vaccines ineffective amid poor sanitation, but they are causing injury.

But it's good to see "suppressed insulin-like growth factor 1" discussed as EE biomarker. Reduced IGF-1 is associated with diabetes, also not discussed in the new paper.
Association Between Serum IGF-1 and Diabetes Among U.S. Adults
care.diabetesjournals.org/content/33/10/2257.long

The global diabetes epidemic is still not linked with poor sanitation. Sanitation is still not on the non-communicable disease (NCD) agenda even as the UN and WHO prepare for the third high level meeting about NCDs. They still wrongly believe NCDs are about diet, exercise and smoking when the problem is pollution, including sewage. NCDs are on the agenda of the World Health Assembly next week: