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. 2018 Apr 5;15(4):688.
doi: 10.3390/ijerph15040688.

Subclinical Enteric Parasitic Infections and Growth Faltering in Infants in São Tomé, Africa: A Birth Cohort Study

Marisol Garzón  1   2 , Luís Pereira-da-Silva  3   4 , Jorge Seixas  5   6 , Ana Luísa Papoila  7 , Marta Alves  8
Affiliations

Subclinical Enteric Parasitic Infections and Growth Faltering in Infants in São Tomé, Africa: A Birth Cohort Study

Marisol Garzón et al. Int J Environ Res Public Health. .

Abstract

The associations between enteric pathogenic parasites and growth in infants in São Tomé were explored using a refined anthropometric approach to recognize early growth faltering. A birth cohort study was conducted with follow-up to 24 months of age. Microscopic examination for protozoa and soil-transmitted helminths was performed. Anthropometric assessments included: z-scores for weight-for-length (WLZ), length-for-age (LAZ), weight (WAVZ) and length velocities (LAVZ), length-for-age difference (LAD), and wasting and stunting risk (≤-1 SD). Generalized additive mixed effects regression models were used to explore the associations between anthropometric parameters and enteric parasitic infections and cofactors. A total of 475 infants were enrolled, and 282 completed the study. The great majority of infants were asymptomatic. Giardia lamblia was detected in 35.1% of infants in at least one stool sample, helminths in 30.4%, and Cryptosporidium spp. in 14.7%. Giardia lamblia and helminth infections were significantly associated with mean decreases of 0.10 in LAZ and 0.32 in LAD, and of 0.16 in LAZ and 0.48 in LAD, respectively. Cryptosporidium spp. infection was significantly associated with a mean decrease of 0.43 in WAVZ and 0.55 in LAVZ. The underestimated association between subclinical parasitic enteric infections and mild growth faltering in infants should be addressed in public health policies.

Keywords: birth cohort; enteric parasitic infection; infant growth; low-middle-income country; subclinical infection.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow-chart with the number of evaluated patients and number of stool samples collected at each point of assessment.
See this image and copyright information in PMC

References

    1. Savioli L., Smith H., Thompson A. Giardia and Cryptosporidium join the Neglected Diseases Initiative. Trends Parasitol. 2006;22:203–208. doi: 10.1016/j.pt.2006.02.015. - DOI - PubMed
    1. Platts-Mills J.A., Babji S., Bodhidatta L., Gratz J., Haque R., Havt A., McCormick B.J., McGrath M., Olortegui M.P., Samie A., et al. Pathogen-specific burdens of community diarrhea in developing countries: A multisite birth cohort study (MAL-ED) Lancet Glob. Health. 2015;3:e564–e575. doi: 10.1016/S2214-109X(15)00151-5. - DOI - PMC - PubMed
    1. Donowitz J.R., Alam M., Kabir M., Ma J.Z., Nazib F., Platts-Mills J.A., Bartelt L.A., Haque R., Petri W.A. A Prospective longitudinal cohort to investigate the effects of early life giardiasis on growth and all cause diarrhea. Clin. Infect. Dis. 2016;63:792–797. doi: 10.1093/cid/ciw391. - DOI - PMC - PubMed
    1. Rogawski E.T., Bartelt L.A., Platts-Mills J.A., Seidman J.C., Samie A., Havt A., Babji S., Trigoso D.R., Qureshi S., Shakoor S., et al. Determinants and impact of Giardia infection in the first 2 years of life in the MAL-ED Birth Cohort. J. Pediatr. Infect. Dis. Soc. 2017;6:153–160. doi: 10.1093/jpids/piw082. - DOI - PMC - PubMed
    1. Checkley W., Gilman R.H., Epstein L.D., Suarez M., Diaz J.F., Cabrera L., Black R.E., Sterling C.R. Asymptomatic and symptomatic cryptosporidiosis: Their acute effect on weight gain in Peruvian children. Am. J. Epidemiol. 1997;145:156–163. doi: 10.1093/oxfordjournals.aje.a009086. - DOI - PubMed

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