Infection by Intestinal Parasites, Stunting and Anemia in School-Aged Children from Southern Angola.
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ABSTRACT:
SUBMITTER: Oliveira D
PROVIDER: S-EPMC4570803 | biostudies-other | 2015
REPOSITORIES: biostudies-other
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Project description:BackgroundInadequate nutrition; neglected topical diseases; and insufficient water, sanitation, and hygiene (WASH) are interrelated problems in schools in low-income countries, but are not routinely tackled together. A recent three-year longitudinal study investigated integrated school health and nutrition approaches in 30 government primary schools in southern Ethiopia. Here, we report on baseline associations between sanitation, hookworm infection, anemia, stunting, and wasting.MethodsIn each school, the Schistosoma mansoni, S. haematobium, and soil-transmitted helminth infection intensities; blood hemoglobin concentrations; heights; and weights of approximately 125 students were assessed. Of these 125 students, approximately 20 were randomly selected for student WASH surveys. Of these 20, approximately 15 were randomly selected for household sanitation observations. School WASH was also assessed through a combination of observations and questions to the headteacher. Mixed-effects logistic regression was used to compare household sanitation with hookworm infection (the other parasites being much less prevalent); and hookworm infection with anemia, stunting, and wasting.FindingsBlood, stool, and urine samples were provided by 3,729 children, and student WASH and household WASH surveys were conducted with 596 and 448 of these students, respectively. Hookworm, Ascaris lumbricoides, Trichuris trichiura, and S. mansoni infections had prevalences of 18%, 4.8%, 0.6%, and 0.3%, respectively, and no S. haematobium infections were found. Anemia, stunting, and wasting had prevalences of 23%, 28%, and 14%, respectively. No statistically significant associations were found between latrine absence or evidence of open defecation at home, and hookworm infection (adjusted odds ratio, OR = 1.28, 95% confidence interval, CI: 0.476-3.44; and adjusted OR = 1.21, 95% CI: 0.468-3.12; respectively); or between hookworm infection and anemia, stunting, or wasting (adjusted OR = 1.24, 95% CI: 0.988-1.57; adjusted OR = 0.992, 95% CI: 0.789-1.25; and adjusted OR = 0.969, 95% CI: 0.722-1.30; respectively).ConclusionsIn this setting, no statistically significant associations were found between sanitation and hookworm; or between hookworm and anemia, stunting, or wasting. More evidence on best practices for integrated school health interventions will be gathered from the follow-up surveys in this study.
| S-EPMC5633169 | biostudies-literature
Project description:Background: The aim of this study was to assess the geographic disparity in anemia and whether stunting was associated with anemia in different geographic groups among school-aged children in China. Methods: 71,129 Han children aged 7, 9, 12, and 14 years old were extracted from the 2014 cycle of Chinese National Surveys on Children Constitution and Health. Anemia, anemia severity, and stunting were defined according to WHO definitions. Binary logistic regression models were used to estimate the association between anemia and stunting in different geographic groups. Results: The prevalence of anemia was significantly higher in girls (10.8%) than boys (7.0%). The highest anemia prevalence was in Group VII (lower class/rural, 12.0%). A moderate/severe prevalence of anemia was concentrated in Group VII and Group VIII (western/lower class/rural) for both sexes. The prevalence of anemia was higher in stunting boys than non-stunting boys in Group IV (lower class/city, ?2 = 12.78, P = 0.002) and Group VII (?2 = 6.21, P = 0.018), while for girls, it was higher in stunting girls than their non-stunting peers only in Group II (upper class/large city, ?2 = 4.57, P = 0.046). Logistic regression showed that the stunting children have 30% higher risk of anemia than non-stunting children after adjustment for age, sex and school (OR = 1.30, 95% CI: 1.05-1.60). Conclusion: A significant geographic disparity and an association between anemia and stunting among specific groups of school-aged children in China was demonstrated. Consequently, eliminating the geographic disparity and ameliorating stunting might contribute to the improvement of Chinese children's anemia. Specific guidelines and interventions are needed, especially for adolescent girls and the groups with serious anemia burden.
| S-EPMC7235374 | biostudies-literature
Project description:BACKGROUND: Nutrition is one of many factors affecting the cognitive development of children. In Cambodia, 55% of children <5 y were anemic and 40% stunted in 2010. Currently, no data exists on the nutritional status of Cambodian school-aged children, or on how malnutrition potentially affects their cognitive development. OBJECTIVE: To assess the anthropometric and micronutrient status (iron, vitamin A, zinc, iodine) of Cambodian schoolchildren and their associations with cognitive performance. METHODS: School children aged 6-16 y (n = 2443) from 20 primary schools in Cambodia were recruited. Anthropometry, hemoglobin, serum ferritin, transferrin receptors, retinol-binding protein and zinc concentrations, inflammation status, urinary iodine concentration and parasite infection were measured. Socio-economic data were collected in a sub-group of children (n = 616). Cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM) and block design and picture completion, two standardized tests from the Wechsler Intelligence Scale for Children (WISC-III). RESULTS: The prevalence of anemia, iron, zinc, iodine and vitamin A deficiency were 15.7%; 51.2%, 92.8%, 17.3% and 0.7% respectively. The prevalence of stunting was 40.0%, including 10.9% of severe stunting. Stunted children scored significantly lower than non-stunted children on all tests. In RCPM test, boys with iron-deficiency anemia had lower scores than boys with normal iron status (-1.46, p<0.05). In picture completion test, children with normal iron status tended to score higher than iron-deficient children with anemia (-0.81; p = 0.067) or without anemia (-0.49; p = 0.064). Parasite infection was associated with an increase in risk of scoring below the median value in block design test (OR = 1.62; p<0.05), and with lower scores in other tests, for girls only (both p<0.05). CONCLUSION: Poor cognitive performance of Cambodian school-children was multifactorial and significantly associated with long-term (stunting) and current nutritional status indicators (iron status), as well as parasite infection. A life-cycle approach with programs to improve nutrition in early life and at school-age could contribute to optimal cognitive performance.
| S-EPMC4236074 | biostudies-other
Project description:Background:Stunting and anemia are long-standing public health challenges which adversely affects the cognitive development and physical wellbeing of children in low income settings. The aim of this study was to assess the prevalence and associated factors of stunting and anemia among 6-23?months old children in Damot Sore District, Southern Ethiopia. Methods:Cross-sectional survey was conducted among 477 children aged 6-23?months, which were living in Damot Sore District, in April 2017. A multistage sampling technique was used. Villages were randomly selected and systematic random sampling method was used to select study participants. Data on socio-demographic, anthropometric, dietary, blood samples for hemoglobin were collected. Data were entered into EPI Data V. 3.1 and exported into SPSS Version 21.0 for analysis. A principal component analysis (PCA) was done to generate wealth score of households. Binary logistic regression model was used to identify factors associated with the outcome variables (stunting and anemia) separately, those variables having less than a p-value of 0.25 were chosen as candidate for multivariable analyses and finally multivariable logistic regression model was used to identify independent variables of each outcomes, with statistical significance set at p?<?0.05 (95% confidence interval (CI)). Results:Out of 477 children studied, 31.7% were stunted and 52% were anemic. In the multivariable analyses, the number of under five children within a household (AOR?=?4.18, 95% CI: 2.65-6.57), drinking water from unsafe source (AOR?=?4.08, 95% CI: 1.33-12.54) and anemia (AOR?=?3.13, 95% CI 2.00-4.92) were factors significantly associated with stunting. On the other hand, independent variables of anemia were early initiation of complementary feeding (AOR?=?2.96, 95% CI: 1.23-4.85), poor dietary diversity (AOR?=?2.95, 95% CI: 1.78-4.91), poor breast feeding practice (AOR?=?2.94, 95% CI: 1.63-5.32) and stunting (AOR?=?3.65, 95% CI: 2.15-6.19). Conclusion:This study revealed higher level of stunting and anemia among children aged 6-23?months than WHO (world health organization) criteria of public health importance. Sustainable promotion of diversified diet, optimal complementary feeding, optimal and complementary breast feeding practices, improving sanitation infrastructure are measures needed to tackle these severe public health challenges.
| S-EPMC7050695 | biostudies-literature
Project description:BACKGROUND:Schistosomiasis is a neglected tropical disease that continues to cause morbidity and mortality in Sub Saharan Africa. Due to its endemicity, co-infection with malaria is common. The diseases cause anaemia and impaired nutritional status among children. We investigated the prevalence of intestinal schistosomiasis and its association with malaria, anaemia and nutritional status among school children. METHODS:This was a cross sectional survey among 830 children in Nyamikoma village along Lake Victoria in Tanzania. A pre-tested questionnaire was used to collect socio-demographic data, history of drug use, and clinical data. Two faecal samples were collected on two consecutive days and analyzed using thick smears Kato Katz method. Diagnosis of malaria was done by malaria rapid diagnostic test, and haemoglobin concentration was determined using HemoCue. Nutritional status was assessed by anthropometric measurements. RESULTS:The overall prevalence of intestinal schistosomiasis was 90.6% (95% CI = 88.6% - 92.6%). Intensity of infection was light 24.1% (200/830), moderate 38.4% (319/830) and heavy 28.1% (233/830). Pre-adolescents (≤12 years) were more infected with intestinal schistosomiasis (93.2%) than adolescents (>12 years) (84.7%) (p < 0.001). Prevalence of malaria was 1.7% (14/824), and that of intestinal schistosomiasis-malaria co-infection was 1.6% (13/824). The overall prevalence of anaemia was 24.6% (95%CI = 18.7% - 30.5%). Severe anaemia was found in 2.3% (19/824) of study participants. The prevalence of stunting and wasting were 29.0% and 11.3%, respectively. On both univariate and multivariate regression analysis, only lower age was significantly associated intestinal schistosomiasis infection, but not anemia, malaria, stunting or wasting. However among those infected, a negative binomial regression analysis indicated independent significant association of male sex, loose stool consistency, and stunting with high eggs count/gram of stool. CONCLUSIONS:Despite several rounds of annual mass praziquantel administration, intestinal schistosomiasis is highly prevalent among school children particularly in younger children living in the study area. Biannual targeted mass praziquantel treatments or alternative regimens may be considered in future in the study area to redress the situation.
| S-EPMC7001966 | biostudies-literature
Project description:Anemia affects approximately 25% of school-aged children (SAC-aged 5.00-14.99 years) globally. We determined in three countries the prevalence and determinants of anemia in SAC. Data on sociodemographics, inflammation and nutrition status were obtained from the 2006 Mexican National Nutrition Survey, the 2003-6 US National Health and Nutrition Examination Surveys, and the 2010 Encuesta Nacional de Nutrición Situación Colombia. In the US, vitamin A and iron deficiency (ID) were available only for girls aged 12.00-14.99 years to which our analysis was limited. Associations were evaluated by country using multivariable logistic regression adjusting for confounders and complex survey design. The prevalence of anemia and ID were: Mexico 12% (ID 18%), n = 3660; US 4% (ID 10%), n = 733; and Colombia 4% (ID 9%), n = 8573. The percentage of anemia associated with ID was 22.4% in Mexico, 38.9% in the US and 16.7% in Colombia. In Mexico, anemia was associated with ID (adjusted OR: 1.5, p = 0.02) and overweight (aOR 0.4, p = 0.007). In the US, anemia was associated with black race/ethnicity (aOR: 14.1, p < 0.0001) and ID (aOR: 8.0, p < 0.0001). In Colombia, anemia was associated with black race/ethnicity (aOR: 1.6, p = 0.005), lowest socio-economic status quintile (aOR: 1.8, p = 0.0005), ID (aOR: 2.7, p < 0.0001), and being stunted (aOR: 1.6, p = 0.02). While anemia was uniformly associated with iron deficiency in Mexico, Columbia, and the United States, other measured factors showed inconsistent associations with anemia. Additional data on anemia determinants in SAC are needed to guide interventions.
| S-EPMC4963863 | biostudies-other
Project description:BACKGROUND:Prior studies reported controversial results about the association between intestinal parasitic infections and childhood under-nutrition. We investigated the association of intestinal parasitic infections with under-nutrition among children aged 6-59?months in Boricha Woreda, Southern Ethiopia. METHODS:This community-based prospective cross-sectional study was carried out from January 1-30, 2019 among 622 children aged 6-59?months. A two-stage stratified sampling procedure was used. Data were collected using a structured, face-to-face interviewer-administered questionnaire and standard anthropometric measurements. The stool specimens were collected using standard technique and examined for the existence and species of intestinal parasites using direct wet mount, Kato Katz and staining technique. We have entered data using Epi Data 3.1 and WHO Anthro software and all analyses were conducted using SPSS version 20. The descriptive analyses were done to find descriptive measures for the socio-demographic and other important variables. Multivariable logistic regression analysis was used to identify factors associated with under-nutrition. Adjusted odds ratios (AORs) with a 95% confidence interval (CI) were computed to assess the presence and strength of associations. RESULTS:The total prevalence of intestinal parasitic infection was 48.7% (95% CI, 44.77-52.62). Approximately one-fourth (22%) of the children were infected with moderate intensity infections. Prevalence of stunting, underweight, wasting were 39.3, 24 and 11.6%, respectively. The prevalence of stunting among children infected with the intestinal parasite (59.4%) was significantly higher than the prevalence in non-infected children (20.6%) (p?<?0.001). The absence of sanitation facility, living in medium and large family size, lack of shoes wearing practice, consuming raw vegetables and fruits were positively associated with intestinal parasitic infections. The presence of intestinal parasitic infections was positively associated with stunting (AOR?=?2.18, 95% CI: 1.36-3.50) but not with wasting (AOR?=?0.58, 95% CI: 0.3-1.13) and underweight (AOR: 0.92, 95% CI?=?0.55-1.54). CONCLUSIONS:Under-nutrition and intestinal parasitic infections were serious public health concerns. Consolidating the prevailing water, sanitation and hygiene packages and routine deworming of children aged 6-59?months may aid to decrease the burden of both stunting and intestinal parasitic infection in children. Also, improving modern contraceptive methods utilization to reduce family size is recommended.
| S-EPMC7441631 | biostudies-literature
Project description:The effect of maternal anemia on childhood hemoglobin status has received little attention. Thus, we examined the potential association between maternal anemia and childhood anemia (aged 6-59 months) from selected Southern Africa countries.A cross-sectional study using nationally representative samples of children aged 6-59 months from the 2010 Malawi, 2011 Mozambique, 2013 Namibia, and 2010-11 Zimbabwe demographic and health surveys (DHS) was conducted. Generalized linear mixed models (GLMMs) were constructed to test the associations between maternal anemia and childhood anemia, controlling for individual and community sociodemographic covariates.The GLMMs showed that anemic mothers had increased odds of having an anemic child in all four countries; adjusted odds ratio (aOR?=?1.69 and 95% confidence interval [CI]:1.37-2.13) in Malawi, (aOR?=?1.71; 95% CI: 1.37-2.13) in Mozambique, (aOR?=?1.55; 95% CI: 1.08-2.22) in Namibia, and (aOR?=?1.52; 95% CI: 1.25-1.84) in Zimbabwe. Furthermore, the odds of having an anemic child was higher in communities with a low percentage of anemic mothers (aOR?=?1.52; 95% CI: 1.19-1.94) in Mozambique.Despite the long-standing efforts to combat childhood anemia, the burden of this condition is still rampant and remains a significant problem in Southern Africa. Thus, public health strategies aimed at reducing childhood anemia should focus more on addressing infections, and micronutrient deficiencies both at individual and community levels in Southern Africa.
| S-EPMC5964691 | biostudies-other
Project description:BackgroundNutrition in the school-aged child matters for brain development and public policy investments globally. Our group previously conducted a trial in urban schools of Haiti to examine the effects of a fortified peanut butter snack, Vita Mamba, with limited findings for anemia.ObjectiveWe aimed to test the hypothesis that Vita Mamba, with systematic deworming in both study arms, would significantly reduce anemia among rural, school-aged children.MethodsA cluster, randomized longitudinal study was conducted in two rural communities of the North-East Department of Haiti, 2014-2015. Healthy children ages 3-16 years were enrolled (n = 321) and assigned by school to intervention (Vita Mamba and deworming) and control (deworming). Vita Mamba contains 260 kcal and meets >75% of the Recommended Dietary Allowance for critical micronutrients. Multivariate regression analyses including propensity score matching techniques to correct for potential group imbalance (Kernel-based Matching and Propensity Score Weighting) were applied to examine difference-in-difference intervention effects.ResultsAt baseline, 51% of the children were anemic with no significant differences between study groups. Vita Mamba supplementation showed a consistent, positive effect across regression models on increasing Hb concentration and reducing the odds of anemia compared to the control group after adjusting for child age, vitamin A supplementation, milk consumption, and height-for-age z score. The average treatment effect for the treated in the Propensity Score Weighting models was 0.62±0.27 grams per 100 milliliters (g/dL) for Hb concentration (F = 4.64, P = 0.001), and the odds of anemia were reduced by 88% (Wald ?² = 9.77, P = 0.02). No differences in change in anthropometric markers were evident.ConclusionsSchool feeding programs that integrate fortified foods with deworming could reduce anemia burden with important implications for learning, health, and well-being. The rural-urban differences in anemia require further study.
| S-EPMC5179061 | biostudies-literature
Project description:BACKGROUND:Anemia, the world's most common micro-nutrient deficiency disorder, can affect a person at any time and at all stages of life. Though all members of the community may face the problem, children aged 6-23 months are particularly at higher risk. If left untreated, it adversely affects the health, cognitive development, school achievement, and work performance. However, little was investigated among young children in Sub-Saharan countries including Ethiopia. This research aimed to investigate its magnitude and correlates to address the gap and guide design of evidence based intervention. METHODS:A community-based cross-sectional study was conducted from May -June 2016 in rural districts of Wolaita Zone. Multi-stage sampling technique was applied and 990 mother-child pairs were selected. Socio-demography, health and nutritional characteristics were collected by administering interview questionnaire to mothers/care-givers. Blood samples were taken to diagnose anemia by using HemoCue device, and the status was determined using cut-offs used for children aged 6-59 months. Hemoglobin concentration below 11.0 g/dl was considered anemic. Data were analyzed with Stata V14. Bivariate and multivariable logistic regressions were applied to identify candidates and predictor variables respectively. Statistical significance was determined at p-value < 0.05 at 95% confidence interval. RESULTS:The mean hemoglobin level of children was 10.44±1.3g/dl, and 65.7% of them were anemic. Among anemic children, 0.4% were severely anemic (<7.0g/dl), while 28.1% and 37.2% were mildly (10.0-10.9g/dl) and moderately (7.0-9.9g/dl) anemic, respectively. In the multivariable analysis, having maternal age of 35 years and above (AOR = 1.96), being government employee (AOR = 0.29), being merchant (AOR = 0.43) and 'other' occupation (AOR = 3.17) were correlated with anemia in children in rural Wolaita. Similarly, receiving anti-helminthic drugs (AOR = 0.39), being female child (AOR = 1.76), consuming poor dietary diversity (AOR = 1.40), and having moderate household food insecurity (AOR = 1.72) were associated with anemia in rural Wolaita. CONCLUSION:A large majority of children in the rural Wolaita were anemic and the need for proven public health interventions such as food diversification, provision of anti-helminthic drugs and ensuring household food security is crucial. In addition, educating women on nutrition and diet diversification, as well as engaging them with alternative sources of income might be interventions in the study area.
| S-EPMC6407854 | biostudies-literature