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Abstract
Objective:
This longitudinal study aimed to investigate the role of microbial contaminants in food as contributing factors to malnutrition among pediatric patients diagnosed with gastrointestinal (GI) diseases. The research sought to identify associations between specific microbial profiles in consumed foods and the nutritional status of children, with the ultimate goal of developing evidence-based recommendations for improving food safety and hygiene practices within healthcare and community settings in Pakistan.
Study Type: Longitudinal Study.
Methods:
The study was conducted over 18 months (January 2023 – June 2024) at the Department of Pediatrics of a tertiary care hospital in Pakistan. A total of 220 pediatric patients aged 6 months to 12 years who were admitted with various GI diseases, including gastroenteritis, inflammatory bowel disease (IBD), and chronic malabsorption syndromes, were enrolled. Food samples from hospital-provided and home-brought meals were analyzed for microbial contamination using culture and polymerase chain reaction (PCR)-based identification of bacteria, viruses, and fungi. Nutritional assessments were performed at baseline and follow-up intervals (3, 6, and 12 months) using anthropometric indicators (weight-for-age, height-for-age, and mid-upper arm circumference). The relationship between microbial contamination levels and nutritional deterioration was evaluated using regression analysis, adjusting for socioeconomic and environmental confounders.
Results:
The findings revealed that 67.3% of analyzed food samples were contaminated with at least one pathogenic microorganism, most commonly Escherichia coli (42.5%), Salmonella spp. (28.6%), and Staphylococcus aureus (24.1%). Children exposed to higher levels of foodborne microbial contaminants showed a significantly higher prevalence of undernutrition (p < 0.001) and slower recovery from GI illnesses. Multivariate regression indicated that bacterial contamination in food independently predicted a decline in weight-for-age z-scores (β = −0.46, 95% CI: −0.61 to −0.28, p < 0.001). Improvements in hygiene practices and caregiver food handling education were associated with a 31% reduction in new malnutrition cases at the 12-month follow-up.
Conclusion:
This study demonstrated that microbial contamination in food contributed significantly to malnutrition among pediatric patients with gastrointestinal diseases in Pakistan. Strengthening food hygiene education, enforcing safe food handling protocols, and regular microbiological surveillance are critical to preventing malnutrition and improving child health outcomes in similar low-resource healthcare settings.