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Parasitism in Children Aged Three Years and Under: Relationship between Infection and Growth in Rural Coastal Kenya.

LaBeaud AD, Nayakwadi Singer M, McKibben M, Mungai P, Muchiri EM, McKibben E, Gildengorin G, Sutherland LJ, King CH, King CL, Malhotra I - PLoS Negl Trop Dis (2015)

Bottom Line: We used generalized estimating equation (GEE) models to examine the relationship between parasitic infections experienced in the first three years of life and growth outcomes (weight, length and head circumference).Our results demonstrate an under-recognized burden of parasitism in the first three years of childhood in rural Kenya.Parasitic infection and polyparasitism were common, and were associated with a range of significant growth impairment in terms of weight, length and/or head circumference.

View Article: PubMed Central - PubMed

Affiliation: Division of Pediatric Infectious Diseases, Stanford School of Medicine, Palo Alto, California, United States of America; Center for Immunobiology and Vaccine Development, UCSF Benioff Children's Hospital Oakland, Children's Hospital Oakland Research Institute, Oakland, California, United States of America.

ABSTRACT

Background: Parasitic infections, which are among the most common infections worldwide, disproportionately affect children; however, little is known about the impact of parasitic disease on growth in very early childhood. Our objective was to document the prevalence of parasitic infections and examine their association with growth during the first three years of life among children in coastal Kenya.

Methodology/principal findings: Children enrolled in a maternal-child cohort were tested for soil transmitted helminths (STHs: Ascaris, Trichuris, hookworm, Strongyloides), protozoa (malaria, Entamoeba histolytica and Giardia lamblia), filaria, and Schistosoma infection every six months from birth until age three years. Anthropometrics were measured at each visit. We used generalized estimating equation (GEE) models to examine the relationship between parasitic infections experienced in the first three years of life and growth outcomes (weight, length and head circumference). Of 545 children, STHs were the most common infection with 106 infections (19%) by age three years. Malaria followed in period prevalence with 68 infections (12%) by three years of age. Filaria and Schistosoma infection occurred in 26 (4.8%) and 16 (2.9%) children, respectively. Seven percent were infected with multiple parasites by three years of age. Each infection type (when all STHs were combined) was documented by six months of age. Decreases in growth of weight, length and head circumference during the first 36 months of life were associated with hookworm, Ascaris, E. histolytica, malaria and Schistosoma infection. In a subset analysis of 180 children who followed up at every visit through 24 months, infection with any parasite was associated with decelerations in weight, length and head circumference growth velocity. Multiple infections were associated with greater impairment of linear growth.

Conclusions/significance: Our results demonstrate an under-recognized burden of parasitism in the first three years of childhood in rural Kenya. Parasitic infection and polyparasitism were common, and were associated with a range of significant growth impairment in terms of weight, length and/or head circumference.

No MeSH data available.


Related in: MedlinePlus

Cumulative incidence of parasitic infections.Shown are rates of any parasitic infection (solid lines with circles) or of >1 (multiple) parasitic infections (dashed lines with squares) by the age of each study visit during the first 36 months of life for the total study cohort (N = 545), and for the first 24 months of life for the full follow-up cohort (N = 180). The number of children infected at each time point is indicated near the marker.
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pntd.0003721.g002: Cumulative incidence of parasitic infections.Shown are rates of any parasitic infection (solid lines with circles) or of >1 (multiple) parasitic infections (dashed lines with squares) by the age of each study visit during the first 36 months of life for the total study cohort (N = 545), and for the first 24 months of life for the full follow-up cohort (N = 180). The number of children infected at each time point is indicated near the marker.

Mentions: During the infant observation period, soil transmitted helminths were the most common infection, with 106 of 545 or 19% (CI95: 16–23%), of children experiencing infections by age three (Fig 1). Malaria followed in period prevalence with 68 (12%, CI95: 10–16%) infected by three years of age. Filaria and S. haematobium infection occurred in 26 (4.8%, CI95: 3–7%) and 16 (2.9%, CI95: 2–5%) children, respectively. Thirty-two percent (176 of 545) of children experienced at least one parasitic infection and 7% (37 of 545) were infected with more than one parasite in the first 36 months of life (Fig 2). All infection categories were documented as early as six months of age. For Schistosoma infection, the infants less than 18 months were only positive by IgG4 assays. Of the three positive infants positive for filarial infection under 18 months of age, one was only positive via BMA IgG4 assay. Prenatal maternal infections increased the odds of infant infections (see S1 Table).


Parasitism in Children Aged Three Years and Under: Relationship between Infection and Growth in Rural Coastal Kenya.

LaBeaud AD, Nayakwadi Singer M, McKibben M, Mungai P, Muchiri EM, McKibben E, Gildengorin G, Sutherland LJ, King CH, King CL, Malhotra I - PLoS Negl Trop Dis (2015)

Cumulative incidence of parasitic infections.Shown are rates of any parasitic infection (solid lines with circles) or of >1 (multiple) parasitic infections (dashed lines with squares) by the age of each study visit during the first 36 months of life for the total study cohort (N = 545), and for the first 24 months of life for the full follow-up cohort (N = 180). The number of children infected at each time point is indicated near the marker.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440755&req=5

pntd.0003721.g002: Cumulative incidence of parasitic infections.Shown are rates of any parasitic infection (solid lines with circles) or of >1 (multiple) parasitic infections (dashed lines with squares) by the age of each study visit during the first 36 months of life for the total study cohort (N = 545), and for the first 24 months of life for the full follow-up cohort (N = 180). The number of children infected at each time point is indicated near the marker.
Mentions: During the infant observation period, soil transmitted helminths were the most common infection, with 106 of 545 or 19% (CI95: 16–23%), of children experiencing infections by age three (Fig 1). Malaria followed in period prevalence with 68 (12%, CI95: 10–16%) infected by three years of age. Filaria and S. haematobium infection occurred in 26 (4.8%, CI95: 3–7%) and 16 (2.9%, CI95: 2–5%) children, respectively. Thirty-two percent (176 of 545) of children experienced at least one parasitic infection and 7% (37 of 545) were infected with more than one parasite in the first 36 months of life (Fig 2). All infection categories were documented as early as six months of age. For Schistosoma infection, the infants less than 18 months were only positive by IgG4 assays. Of the three positive infants positive for filarial infection under 18 months of age, one was only positive via BMA IgG4 assay. Prenatal maternal infections increased the odds of infant infections (see S1 Table).

Bottom Line: We used generalized estimating equation (GEE) models to examine the relationship between parasitic infections experienced in the first three years of life and growth outcomes (weight, length and head circumference).Our results demonstrate an under-recognized burden of parasitism in the first three years of childhood in rural Kenya.Parasitic infection and polyparasitism were common, and were associated with a range of significant growth impairment in terms of weight, length and/or head circumference.

View Article: PubMed Central - PubMed

Affiliation: Division of Pediatric Infectious Diseases, Stanford School of Medicine, Palo Alto, California, United States of America; Center for Immunobiology and Vaccine Development, UCSF Benioff Children's Hospital Oakland, Children's Hospital Oakland Research Institute, Oakland, California, United States of America.

ABSTRACT

Background: Parasitic infections, which are among the most common infections worldwide, disproportionately affect children; however, little is known about the impact of parasitic disease on growth in very early childhood. Our objective was to document the prevalence of parasitic infections and examine their association with growth during the first three years of life among children in coastal Kenya.

Methodology/principal findings: Children enrolled in a maternal-child cohort were tested for soil transmitted helminths (STHs: Ascaris, Trichuris, hookworm, Strongyloides), protozoa (malaria, Entamoeba histolytica and Giardia lamblia), filaria, and Schistosoma infection every six months from birth until age three years. Anthropometrics were measured at each visit. We used generalized estimating equation (GEE) models to examine the relationship between parasitic infections experienced in the first three years of life and growth outcomes (weight, length and head circumference). Of 545 children, STHs were the most common infection with 106 infections (19%) by age three years. Malaria followed in period prevalence with 68 infections (12%) by three years of age. Filaria and Schistosoma infection occurred in 26 (4.8%) and 16 (2.9%) children, respectively. Seven percent were infected with multiple parasites by three years of age. Each infection type (when all STHs were combined) was documented by six months of age. Decreases in growth of weight, length and head circumference during the first 36 months of life were associated with hookworm, Ascaris, E. histolytica, malaria and Schistosoma infection. In a subset analysis of 180 children who followed up at every visit through 24 months, infection with any parasite was associated with decelerations in weight, length and head circumference growth velocity. Multiple infections were associated with greater impairment of linear growth.

Conclusions/significance: Our results demonstrate an under-recognized burden of parasitism in the first three years of childhood in rural Kenya. Parasitic infection and polyparasitism were common, and were associated with a range of significant growth impairment in terms of weight, length and/or head circumference.

No MeSH data available.


Related in: MedlinePlus