Impact of Infectious Diseases on Cognitive Development in Childhood andBeyond: Potential Mitigational Role of Hygiene

Enteric infections in the early years of childhood can exacerbate underlying malnutrition and, if not addressed, can lead to a vicious and synergistic cycle of malnutrition-enteric infection-malnutrition. Cognitive impairment is a key detrimental outcome associated with this cycle of malnutrition and enteric infection. Mechanistically, diversion of metabolic resources away from the developing brain under conditions of nutritional stress may underlie the impairment of cognitive function. Evidence indicates that the effects of the synergy between malnutrition and enteric pathogens last far beyond the time of infection and can lead to long-term effects on cognition. Indeed, emerging evidence suggests a potential for later-life vulnerability to neurodegenerative diseases as a consequence of enteric infectious diseases on early-life brain development. Simple interventions for improving hygiene have proven to lessen the burden of enteric infectious disease. The mitigational role of good hygiene practices has the potential to break the vicious cycle of malnutrition and enteric infection, and contribute to improving the cognitive development potential of children at risk.