Micronutrient and EED Assessment Tool (MEEDAT)

Environmental enteric dysfunction (EED) is an intestinal disorder common among children in low-resource settings and is associated with increased risk of growth stunting, cognitive deficits, and reduced oral vaccine immunogenicity. The Micronutrient and EED Assessment Tool (MEEDAT) is a multiplexed immunoassay that measures biomarkers previously associated with child growth faltering and/or oral vaccine immunogenicity: intestinal fatty acid–binding protein (I-FABP), soluble CD14 (sCD14), insulin-like growth factor 1 (IGF-1), and fibroblast growth factor 21 (FGF21). MEEDAT also measures systemic inflammation (AGP, CRP), micronutrient deficiency (ferritin, soluble transferrin receptor, retinol binding protein 4, thyroglobulin), and Plasmodium falciparum antigenemia (histidine-rich protein 2).

We are evaluating the performance of MEEDAT compared with standard enzyme-linked immunosorbent assays (ELISAs) using 48 biorepository specimens and 300 specimens from Malian infants. Regression methods are being used to test if MEEDAT biomarkers were associated with seroconversion in response to Meningitis A conjugate vaccine (MenAV), yellow fever vaccine (YFV), and pentavalent rotavirus vaccine (PRV) after 28 days, or with growth faltering over 12 weeks.

This tool could improve the efficiency by which children could be screened for both EED and micronutrient deficiencies prior to enrollment into clinical trials and streamline the evaluation of efficacy in trials where markers are clinical endpoints.