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Article History

Received: 27 May 2025

Accepted: 26 September 2025

First Online: 21 October 2025

Declarations

:

: This study involves secondary data analysis of the MAL-ED multi-country birth cohort study and was approved by the Research Review Committee and the Ethical Review Committee, two integral components of the Institutional Review Board of icddr, b. The protocol approval number for this study is PR-20129. The original MAL-ED study was approved by the Research Review Committee and the Ethical Review Committee of icddr, b (Bangladesh); the Local Institutional Review Board at the Federal University of Ceará and the national IRB Conselho Nacional de Ética em Pesquisa (Brazil); the Christian Medical College Institutional Review Board and the Emory University Institutional Review Board (India); the Nepal Health Research Council and Walter Reed Institute of Research (Nepal); the Ethics Committee of Asociación Benéfica PRISMA, the Regional Health Directorate of Loreto, and the IRB of Johns Hopkins Bloomberg School of Public Health (Peru); the Ethical Review Committee of Aga Khan University (Pakistan); the Institutional Review Board at the University of Venda (South Africa); the National Institute for Medical Research (Tanzania); and the Institutional Review Board of the University of Virginia (USA).

: Not applicable.

: The authors declare no competing interests.

: Written informed consent was obtained from the parents or legal guardians of each child prior to data collection. All methods were performed in accordance with relevant guidelines and regulations, and the study was conducted in compliance with the principles of the Declaration of Helsinki(WMA, 2013). All assays were conducted as part of the MAL-ED study, with no additional assays or sample collection performed.

: Not Applicable.

: Murad Alam Khan, Md. Ahshanul Haque contributed equally to this work.Md. Tariqujjaman, ASG Faruque, Tahmeed Ahmed, Mustafa Mahfuz, agreed to review the final version of the manuscript.