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Environmental Enteric Dysfunction as a Risk Factor for Growth Failure in the Agricultural Areas of Brebes Regency

JURNAL KESEHATAN LINGKUNGAN (Journal of Environmental Health) · Vol. 18 No. 1 (2026) · pp. 53–62

DOI
10.20473/jkl.v18i1.2026.53-62
ISSN
2540-881X, 1829-7285
Published
2026-01-27
Publisher
Universitas Airlangga
Language
eng
License
creativecommons.org/licenses/by-nc-sa/4.0

Abstract

Background: Growth faltering in early childhood remains a global concern. Major contributing factors include poor sanitation, recurrent infections, a history of low birth weight (LBW), and environmental enteric dysfunction (EED) that reduces nutrient absorption. This study examines the determinants of growth faltering among children aged 6–23 months in the agricultural areas of Brebes Regency, Indonesia. Methods: This study employed a case–control design involving non-stunted children aged 6–23 months. The case group consisted of 64 children with weight-for-age (WAZ) < 5th percentile, while the control group included children with WAZ ≥ 5th percentile, classified according to the WHO Child Growth Standards. Data were collected through anthropometric assessments and standardized, structured interviews, with participants selected through purposive sampling. Multivariable logistic regression analysis was performed to identify the determinants of growth faltering. Results and Discussion: There were no significant differences between groups in mean maternal age, child age, or maternal employment status. Maternal education levels were lower in the case group. Acute respiratory infection (ARI) (OR = 2.3; 95% CI: 1.10–5.08), history of LBW (OR = 4.9; 95% CI: 1.21–19.94), and EED (OR = 2.0; 95% CI: 0.93–4.32) were identified as determinants of growth faltering among children living in the agricultural areas of Brebes Regency. Conclusion: EED is a key determinant of growth faltering among children aged 6–23 months in the agricultural areas of Brebes Regency, alongside recent ARI and a history of LBW. Keywords: Brebes Regency, Environmental Enteric Dysfunction, Growth failure, Low Birth Weight, Upper Respiratory Tract Infections

Keywords

Collaboration network of the authors

40 authors · 128 co-authorship links · 12 across different organisations · showing the 40 most connected

Hover or tap a name to highlight its co-authors. Double-click to open the author's page.

  • Diponegoro University
  • State University of Semarang
  • University of Indonesia
  • Affiliation unknown
  • Different organisations
  • Same organisation
  • Affiliation unknown
  • Thicker line = more joint articles · bigger circle = more articles
Show as table
Co-authorOrganisationJoint articles
Sri Achadi NugraheniDiponegoro University5
Suyatno SuyatnoDiponegoro University3
Siti Fatimah PradigdoDiponegoro University2
Ani MargawatiDiponegoro University2
Etika Ratna NoerDiponegoro University2
Lia Awwalia MajidaDiponegoro University2
Zahroh ShaluhiyahDiponegoro University2
Alfi Fairuz AsnaDiponegoro University2
Sulicha NurhayatiDiponegoro University2
BudiyonoAffiliation unknown1
Efa NugrohoState University of Semarang1
Yusniar Hanani DarundiatiDiponegoro University1
Ayu IstiadaState University of Semarang1
Sutopo Patria JatiDiponegoro University1
Kristin MariyanaAffiliation unknown1
Apoina KartiniDiponegoro University1
Septo Pawelas ArsoDiponegoro University1
Sri WinarniDiponegoro University1
Novia HandayaniDiponegoro University1
Atik MawarniDiponegoro University1
Naila FauziatinDiponegoro University1
Mahalul AzamState University of Semarang1
Mateus Sakundarno AdiDiponegoro University1
Dwi SutiningsihDiponegoro University1
Akmaliya HayuningsihDiponegoro University1
Suhartono SuhartonoDiponegoro University1
Henry Setyawan SusantoDiponegoro University1
Ligar Tresna DharmawanAffiliation unknown1
Hanifa Maher DennyDiponegoro University1
Dion Zein NuridzinDiponegoro University1
Siti FatimahDiponegoro University1
Hasna Izdihar LatifahUniversity of Indonesia1
Lilis WijayantiDiponegoro University1
Rizal KurniawanDiponegoro University1
Heri NugrohoDiponegoro University1
Shabrina Arifia QatrannadaDiponegoro University1

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) https://e-journal.unair.ac.id/JKL/oai, first harvested 9 Nov 2026, last seen 9 Nov 2026.
Original metadata (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">Environmental Enteric Dysfunction as a Risk Factor for Growth Failure in the Agricultural Areas of Brebes Regency</dc:title>
	<dc:creator>Gandha Sunaryo Putra</dc:creator>
	<dc:creator>Suhartono</dc:creator>
	<dc:creator>Cahya Tri Purnami</dc:creator>
	<dc:creator>Martha Irene Kartasurya</dc:creator>
	<dc:subject xml:lang="en-US">Agrarian Communities</dc:subject>
	<dc:subject xml:lang="en-US">Alpha-1 Antitrypsin</dc:subject>
	<dc:subject xml:lang="en-US">Growth Failure</dc:subject>
	<dc:subject xml:lang="en-US">Low Birth Weight</dc:subject>
	<dc:subject xml:lang="en-US">Upper Respiratory Tract Infections</dc:subject>
	<dc:description xml:lang="en-US">Background: Growth faltering in early childhood remains a global concern. Major contributing factors include poor sanitation, recurrent infections, a history of low birth weight (LBW), and environmental enteric dysfunction (EED) that reduces nutrient absorption. This study examines the determinants of growth faltering among children aged 6–23 months in the agricultural areas of Brebes Regency, Indonesia. Methods: This study employed a case–control design involving non-stunted children aged 6–23 months. The case group consisted of 64 children with weight-for-age (WAZ) &amp;lt; 5th percentile, while the control group included children with WAZ ≥ 5th percentile, classified according to the WHO Child Growth Standards. Data were collected through anthropometric assessments and standardized, structured interviews, with participants selected through purposive sampling. Multivariable logistic regression analysis was performed to identify the determinants of growth faltering. Results and Discussion: There were no significant differences between groups in mean maternal age, child age, or maternal employment status. Maternal education levels were lower in the case group. Acute respiratory infection (ARI) (OR = 2.3; 95% CI: 1.10–5.08), history of LBW (OR = 4.9; 95% CI: 1.21–19.94), and EED (OR = 2.0; 95% CI: 0.93–4.32) were identified as determinants of growth faltering among children living in the agricultural areas of Brebes Regency. Conclusion: EED is a key determinant of growth faltering among children aged 6–23 months in the agricultural areas of Brebes Regency, alongside recent ARI and a history of LBW.
Keywords: Brebes Regency, Environmental Enteric Dysfunction, Growth failure, Low Birth Weight, Upper Respiratory Tract Infections </dc:description>
	<dc:publisher xml:lang="en-US">Universitas Airlangga</dc:publisher>
	<dc:date>2026-01-27</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:format>text/xml</dc:format>
	<dc:identifier>https://e-journal.unair.ac.id/JKL/article/view/81004</dc:identifier>
	<dc:identifier>10.20473/jkl.v18i1.2026.53-62</dc:identifier>
	<dc:source xml:lang="en-US">JURNAL KESEHATAN LINGKUNGAN ; Vol. 18 No. 1 (2026): JURNAL KESEHATAN LINGKUNGAN; 53-62</dc:source>
	<dc:source>2540-881X</dc:source>
	<dc:source>1829-7285</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>https://e-journal.unair.ac.id/JKL/article/view/81004/35720</dc:relation>
	<dc:relation>https://e-journal.unair.ac.id/JKL/article/view/81004/36000</dc:relation>
	<dc:rights xml:lang="en-US">http://creativecommons.org/licenses/by-nc-sa/4.0</dc:rights>
</oai_dc:dc>