Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun 25;9(6):e0003877.
doi: 10.1371/journal.pntd.0003877. eCollection 2015.

Soil-Transmitted Helminths in Southwestern China: A Cross-Sectional Study of Links to Cognitive Ability, Nutrition, and School Performance among Children

Chengfang Liu  1 , Renfu Luo  1 , Hongmei Yi  1 , Linxiu Zhang  1 , Shaoping Li  2 , Yunli Bai  2 , Alexis Medina  3 , Scott Rozelle  3 , Scott Smith  4 , Guofei Wang  5 , Jujun Wang  5
Affiliations

Soil-Transmitted Helminths in Southwestern China: A Cross-Sectional Study of Links to Cognitive Ability, Nutrition, and School Performance among Children

Chengfang Liu et al. PLoS Negl Trop Dis. .

Abstract

Background: Empirical evidence suggests that the prevalence of soil-transmitted helminth (STH) infections in remote and poor rural areas is still high among children, the most vulnerable to infection. There is concern that STH infections may detrimentally affect children's healthy development, including their cognitive ability, nutritional status, and school performance. Medical studies have not yet identified the exact nature of the impact STH infections have on children. The objective of this study is to examine the relationship between STH infections and developmental outcomes among a primary school-aged population in rural China.

Methodology/principal findings: We conducted a large-scale survey in Guizhou province in southwest China in May 2013. A total of 2,179 children aged 9-11 years living in seven nationally-designated poverty counties in rural China served as our study sample. Overall, 42 percent of the sample's elementary school-aged children were infected with one or more of the three types of STH--Ascaris lumbricoides (ascaris), Trichuris trichuria (whipworm) and the hookworms Ancylostoma duodenale or Necator americanus. After controlling for socioeconomic status, we observed that infection with one or more STHs is associated with worse cognitive ability, worse nutritional status, and worse school performance than no infection. This study also presents evidence that children with Trichuris infection, either infection with Trichuris only or co-infected with Trichuris and Ascaris, experience worse cognitive, nutritional and schooling outcomes than their uninfected peers or children infected with only Ascaris.

Conclusions/significance: We find that STH infection still poses a significant health challenge among children living in poor, rural, ethnic areas of southwest China. Given the important linkages we find between STH infection and a number of important child health and educational outcomes, we believe that our results will contribute positively to the debate surrounding the recent Cochrane report.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Sample selection process.
Fig 2
Fig 2. Distribution of cognition by infection status.
Note: Any scores to the left of the boarder-line (at 80) mean “delay”.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Taylor-Robinson DC, Maayan N, Soares-Weiser K, Donegan S, Garner P. (2012) Deworming Drugs for Soil-Transmitted Intestinal Worms in Children: Effects on Nutritional Indicators, Haemoglobin and School Performance (Review). The Cochrane Library 11. The Cochrane Collaboration. - PubMed
    1. Wang XB, Zhang LX, Luo RF, Wang GF, Chen YD, Medina A., et al. Soil-Transmitted Helminth Infections and Correlated Risk Factors in Preschool and School-aged Children in Rural Southwest China. PLoS One. 2012; 7(9). - PMC - PubMed
    1. Shang Y. Burden of diseases on soil-transmitted helminth infections among school-age children in China [in Chinese]. 2011. Doctoral Thesis, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention. Shanghai, China.
    1. Shen LY, Gan XX, Ding JZ, Yuan XZ, Song CC, Hu SL, et al. Consequences of soil-transmitted helminth infections on children’s health. Chinese Journal of Parasitic Disease Control [in Chinese]. 1996; 9(2): 125–127.
    1. Ma XB, Cai L, Zhang BX, Fu YH, Huang DS. The relationship between whipworm infection and children’s development. Chinese Journal of Parasitic Disease Control [in Chinese], 1999; 12(4): 310–311.

Publication types

LinkOut - more resources