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Bogza A, King IL, Maurice CF. Worming into infancy: Exploring helminth-microbiome interactions in early life. Cell Host Microbe 2024; 32:639-650. [PMID: 38723604 DOI: 10.1016/j.chom.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/25/2024] [Accepted: 04/04/2024] [Indexed: 06/06/2024]
Abstract
There is rapidly growing awareness of microbiome assembly and function in early-life gut health. Although many factors, such as antibiotic use and highly processed diets, impinge on this process, most research has focused on people residing in high-income countries. However, much of the world's population lives in low- and middle-income countries (LMICs), where, in addition to erratic antibiotic use and suboptimal diets, these groups experience unique challenges. Indeed, many children in LMICs are infected with intestinal helminths. Although helminth infections are strongly associated with diverse developmental co-morbidities and induce profound microbiome changes, few studies have directly examined whether intersecting pathways between these components of the holobiont shape health outcomes in early life. Here, we summarize microbial colonization within the first years of human life, how helminth-mediated changes to the gut microbiome may affect postnatal growth, and why more research on this relationship may improve health across the lifespan.
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Affiliation(s)
- Andrei Bogza
- Department of Microbiology & Immunology, McGill University, Montreal, QC, Canada; McGill Centre for Microbiome Research, McGill University, Montreal, QC, Canada; Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Montreal, QC, Canada; McGill University Research Centre on Complex Traits, Montreal, QC, Canada
| | - Irah L King
- Department of Microbiology & Immunology, McGill University, Montreal, QC, Canada; McGill Centre for Microbiome Research, McGill University, Montreal, QC, Canada; Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
| | - Corinne F Maurice
- Department of Microbiology & Immunology, McGill University, Montreal, QC, Canada; McGill Centre for Microbiome Research, McGill University, Montreal, QC, Canada; McGill University Research Centre on Complex Traits, Montreal, QC, Canada.
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Ng'etich AI, Amoah ID, Bux F, Kumari S. Anthelmintic resistance in soil-transmitted helminths: One-Health considerations. Parasitol Res 2023; 123:62. [PMID: 38114766 PMCID: PMC10730643 DOI: 10.1007/s00436-023-08088-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
The One-Health approach recognizes the intricate connection between human, animal, and environmental health, and that cooperative effort from various professionals provides comprehensive awareness and potential solutions for issues relating to the health of people, animals, and the environment. This approach has increasingly gained appeal as the standard strategy for tackling emerging infectious diseases, most of which are zoonoses. Treatment with anthelmintics (AHs) without a doubt minimizes the severe consequences of soil-transmitted helminths (STHs); however, evidence of anthelmintic resistance (AR) development to different helminths of practically every animal species and the distinct groups of AHs is overwhelming globally. In this regard, the correlation between the application of anthelmintic drugs in both human and animal populations and the consequent development of anthelmintic resistance in STHs within the context of a One-Health framework is explored. This review provides an overview of the major human and animal STHs, treatment of the STHs, AR development and drug-related factors contributing towards AR, One-Health and STHs, and an outline of some One-Health strategies that may be used in combating AR.
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Affiliation(s)
- Annette Imali Ng'etich
- Institute for Water and Wastewater Technology, Durban University of Technology (DUT), Durban, South Africa
| | - Isaac Dennis Amoah
- Institute for Water and Wastewater Technology, Durban University of Technology (DUT), Durban, South Africa
- Department of Environmental Science, University of Arizona, Tucson, AZ, USA
| | - Faizal Bux
- Institute for Water and Wastewater Technology, Durban University of Technology (DUT), Durban, South Africa
| | - Sheena Kumari
- Institute for Water and Wastewater Technology, Durban University of Technology (DUT), Durban, South Africa.
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Rotejanaprasert C, Chuaicharoen P, Prada JM, Thantithaveewat T, Adisakwattana P, Pan-ngum W. Evaluation of Kato-Katz and multiplex quantitative polymerase chain reaction performance for clinical helminth infections in Thailand using a latent class analysis. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220281. [PMID: 37598708 PMCID: PMC10440171 DOI: 10.1098/rstb.2022.0281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 05/27/2023] [Indexed: 08/22/2023] Open
Abstract
Using an appropriate diagnostic tool is essential to soil-transmitted helminth control and elimination efforts. Kato-Katz (KK) is the most commonly used diagnostic, but recently other tools, such as real-time quantitative polymerase chain reaction (multiplex qPCR), are starting to be employed more. Here, we evaluated the performance of these two diagnostic tools for five helminth species in Thailand. In the absence of a gold standard, diagnostic performance can be evaluated using latent class analysis. Our results suggest that in moderate to high prevalence settings above 2% multiplex qPCR could be more sensitive than KK, this was particularly apparent for Opisthorchis viverrini in the northeastern provinces. However, for low prevalence, both diagnostics suffered from low sensitivity. Specificity of both diagnostics was estimated to be high (above 70%) across all settings. For some specific helminth infection such as O. viverrini, multiplex qPCR is still a preferable choice of diagnostic test. KK performed equally well in detecting Ascaris lumbricoides and Taenia solium when the prevalence is moderate to high (above 2%). Neither test performed well when the prevalence of infection is low (below 2%), and certainly in the case for hookworm and Trichuris trichiura. Combination of two or more diagnostic tests can improve the performance although the cost would be high. Development of new methods for helminth surveillance at the pre-elimination phase is therefore very important. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'.
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Affiliation(s)
- Chawarat Rotejanaprasert
- Department of Tropical Hygiene, Mahidol University, Bangkok, Thailand
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
| | | | - Joaquin M. Prada
- Faculty of Health and Medical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, UK
| | | | - Poom Adisakwattana
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Wirichada Pan-ngum
- Department of Tropical Hygiene, Mahidol University, Bangkok, Thailand
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
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Piazzesi A, Putignani L. Impact of helminth-microbiome interactions on childhood health and development-A clinical perspective. Parasite Immunol 2023; 45:e12949. [PMID: 36063358 DOI: 10.1111/pim.12949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/26/2022] [Accepted: 09/01/2022] [Indexed: 12/01/2022]
Abstract
Humans have co-existed with parasites for virtually the entirety of our existence as a species. Today, nearly one third of the human population is infected with at least one helminthic species, most of which reside in the intestinal tract, where they have co-evolved alongside the human gut microbiota (GM). Appreciation for the interconnected relationship between helminths and GM has increased in recent years. Here, we review the evidence of how helminths and GM can influence various aspects of childhood development and the onset of paediatric diseases. We discuss the emerging evidence of how many of the changes that parasitic worms inflict on their host is enacted through gut microbes. In this light, we argue that helminth-induced microbiota modifications are of great importance in both facing the global challenge of overcoming parasitic infections, and in replicating helminthic protective effects against inflammatory diseases. We propose that deepening our knowledge of helminth-microbiota interactions will uncover novel, safer and more effective therapeutic strategies in combatting an array of childhood disorders.
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Affiliation(s)
- Antonia Piazzesi
- Multimodal Laboratory Medicine Research Area, Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Lorenza Putignani
- Department of Diagnostic and Laboratory Medicine, Unit of Microbiology and Diagnostic Immunology, Unit of Microbiomics and Multimodal Laboratory Medicine Research Area, Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Prevalence and intensity of soil-transmitted helminth infections and associated risk factors among household heads living in the peri-urban areas of Jimma town, Oromia, Ethiopia: A community-based cross-sectional study. PLoS One 2022; 17:e0274702. [PMID: 36107925 PMCID: PMC9477373 DOI: 10.1371/journal.pone.0274702] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/02/2022] [Indexed: 11/29/2022] Open
Abstract
Background Ethiopia has set national targets for eliminating soil-transmitted helminths (STH) as public health problems by 2020 and for breaking their transmission by 2025 using periodic mass treatment of children in endemic areas. However, the status of STH infection among the adults living in the same communities remains unknown. The aim of this study, therefore, was to determine the prevalence and intensity of STH infections and associated factors among the household heads in the peri-urban areas of Jimma town, Oromia, Ethiopia. Methods A community-based cross-sectional study was conducted in five peri-urban kebeles (smallest administrative unit in Ethiopia) of Jimma town from May to July 2021. A semi-structured questionnaire was used to collect data on socio-demographic and predisposing factors. The Kato-Katz concentration technique was utilized to detect and quantify the STH in stool samples. Both bivariate and multivariate analyses were done. P-value <0.05 was considered statistically significant. Results A total of 376 household heads (19.9% women and 80.1% men) from peri-urban areas were included in the study. The overall STH prevalence was 18.1% (95% CI: 14.6–22.1) with A. lumbricoides being the predominant species (11.4%) followed by T. trichiura (7.2%) and hookworm (2.1%). Most of the STH positive household heads had single infections (85.3%) and light-intensity infections (88.5%). Wealth status (AOR = 2.7; 95% CI: 1.31–5.50, P = 0.007), hand washing habits before meals (AOR = 7.07; 95% CI: 1.79–27.88, p = 0.005), fingernails status (AOR = 2.99; 95% CI: 1.59–5.65, p = 0.001), and toilet facility type (AOR = 2.06; 95% CI: 1.13–3.76, p = 0.017) were found to have statistically significant associations with the STH infection. Conclusion The findings of this study showed a nearly moderate level of STH prevalence among household heads in the peri-urban community. This could serve as an important reservoir for reinfection of the treated children and other at-risk groups in the community.
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Chis Ster I, Niaz HF, Chico ME, Oviedo Y, Vaca M, Cooper PJ. The epidemiology of soil-transmitted helminth infections in children up to 8 years of age: Findings from an Ecuadorian birth cohort. PLoS Negl Trop Dis 2021; 15:e0009972. [PMID: 34797823 PMCID: PMC8641893 DOI: 10.1371/journal.pntd.0009972] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 12/03/2021] [Accepted: 11/03/2021] [Indexed: 12/11/2022] Open
Abstract
Background There are few prospective longitudinal studies of soil-transmitted helminth (STH) infections during early childhood. We studied the epidemiology of and risk factors for soil-transmitted helminth infections from birth to 8 years of age in tropical Ecuador. Methods 2,404 newborns were followed to 8 years of age with periodic stool sample collections. Stool samples were collected also from household members at the time of the child’s birth and examined by microscopy. Data on social, environmental, and demographic characteristics were collected by maternal questionnaire. Associations between potential risk factors and STH infections were estimated using generalized estimated equations applied to longitudinal binary outcomes for presence or absence of infections at collection times. Results Of 2,404 children, 1,120 (46.6%) were infected with at least one STH infection during the first 8 years of life. The risk of A. lumbricoides (16.2%) was greatest at 3 years, while risks of any STH (25.1%) and T. trichiura (16.5%) peaked at 5 years. Factors significantly associated with any STH infection in multivariable analyses included age, day-care (OR 1.34, 95% CI 1.03–1.73), maternal Afro-Ecuadorian ethnicity (non-Afro vs. Afro, OR 0.55, 95% CI 0.43–0.70) and lower educational level (secondary vs. illiterate, OR 0.31, 95% CI 0.22–0.45)), household overcrowding (OR 1.53, 95% CI 1.21–1.94)), having a latrine rather than a water closet (WC vs. latrine, OR 0.77, 95% CI 0.62–0.95)), and STH infections among household members (OR 2.03, 95% CI 1.59–2.58)). T. trichiura was more associated with poverty (high vs. low socioeconomic status, OR, 0.63, 95% CI 0.40–0.99)] and presence of infected siblings in the household (OR 3.42, 95% CI 2.24–5.22). Conclusion STH infections, principally with A. lumbricoides and T. trichiura, peaked between 3 and 5 years in this cohort of children in tropical Ecuador. STH infections among household members were an important determinant of infection risk and could be targeted for control and elimination strategies. Soil-transmitted helminths (STH) cause significant morbidity among children in low and middle-income countries (LMICs). We followed a birth cohort to 8 years of age in a rural area of coastal Ecuador and showed almost half acquired STH infections during childhood. The dominant STH parasites in this setting in children were Ascaris lumbricoides and Trichuris trichiura and infections peaked in frequency between 3 and 5 years of age. Risk of infection during childhood was associated with markers of marginalisation (Afro-Ecuadorian ethnicity and low educational level), household poverty (overcrowding and poor sanitation), and STH infections among other household members. There was evidence of a reduction in STH infection risk across all ages in study households over the calendar time course of this longitudinal study in parallel with improvements in living conditions, a period of economic growth, and increased government support for those living in extreme poverty. Our data indicate that targeting anthelmintic treatment at members of STH-infected households is likely to reduce the risk of infection in young children.
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Affiliation(s)
- Irina Chis Ster
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Hamzah F. Niaz
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Martha E. Chico
- Fundacion Ecuatoriana Para La Investigacion en Salud, Quito, Ecuador
| | - Yisela Oviedo
- Fundacion Ecuatoriana Para La Investigacion en Salud, Quito, Ecuador
| | - Maritza Vaca
- Fundacion Ecuatoriana Para La Investigacion en Salud, Quito, Ecuador
| | - Philip J. Cooper
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
- Fundacion Ecuatoriana Para La Investigacion en Salud, Quito, Ecuador
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
- * E-mail:
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Japa I, Ancha B, Custodio A, Ohrenschall R, Cordero R, Deverlis A, Chapman J, Hickson MR, Steenhoff AP, Lowenthal ED. Effectiveness of Deworming with Single-Dose Albendazole for Preschool-Aged Children in the Dominican Republic. Glob Pediatr Health 2021; 8:2333794X211002949. [PMID: 33796636 PMCID: PMC7983463 DOI: 10.1177/2333794x211002949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/23/2021] [Indexed: 11/17/2022] Open
Abstract
Background. The World Health Organization recommends biannual deworming with single-dose albendazole for all children over 1 year in regions where soil-transmitted helminths (STH) are endemic. There are limited data from the Dominican Republic (DR) on the effectiveness of deworming programs. Methods. Between January and June 2019, we enrolled 63 preschool-aged children at a community clinic in the DR. Participants received albendazole at enrollment. Stool samples were collected and examined for parasites at enrollment, 2 to 4 and 12 to 16 weeks post-albendazole. Caregivers were surveyed on home hygiene practices and children’s symptoms. Findings. At enrollment, 1 or more parasites were noted in 89% of samples. Ascaris lumbricoides (68%) was the most common species, followed by Entamoeba histolytica (35%) and Giardia intestinalis (8%). Two-to-four weeks post-albendazole, fewer than half of those with A. lumbricoides infections at baseline had cleared the infection. STH symptoms significantly improved between enrollment and 2 to 4 weeks. By 12 to 16 weeks after treatment, A. lumbricoides infections were as high as baseline. Interpretation. Although limited by size and available technology, our study contributes data on STH in the DR. Single-dose deworming with albendazole did not reduce Ascaris lumbricoides infections in our sample. As STH are the most common neglected tropical diseases and negatively impact children’s health globally, further studies on both effective deworming programs and interventions to prevent STH are needed.
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Affiliation(s)
- Ingrid Japa
- Niños Primeros en Salud, Consuelo, Dominican Republic.,Universidad Central del Este, San Pedro de Macorís, Dominican Republic
| | - Bhavya Ancha
- Children's Hospital of Philadelphia Center for Global Health, Philadelphia, PA, USA
| | - Antonio Custodio
- Universidad Central del Este, San Pedro de Macorís, Dominican Republic
| | | | | | - Adriana Deverlis
- Children's Hospital of Philadelphia Center for Global Health, Philadelphia, PA, USA
| | - Jennifer Chapman
- Children's Hospital of Philadelphia Center for Global Health, Philadelphia, PA, USA
| | - Meredith R Hickson
- Children's Hospital of Philadelphia Center for Global Health, Philadelphia, PA, USA
| | - Andrew P Steenhoff
- Children's Hospital of Philadelphia Center for Global Health, Philadelphia, PA, USA
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Zeleke AJ, Derso A, Bayih AG, Gilleard JS, Eshetu T. Prevalence, Infection Intensity and Associated Factors of Soil-Transmitted Helminthiasis Among School-Aged Children from Selected Districts in Northwest Ethiopia. Res Rep Trop Med 2021; 12:15-23. [PMID: 33623469 PMCID: PMC7894853 DOI: 10.2147/rrtm.s289895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/03/2021] [Indexed: 11/28/2022] Open
Abstract
Background Globally, soil-transmitted helminths affect beyond a billion people and cause 1.9 million disability-adjusted life years worldwide. It affects children disproportionately due to their unaware activities like walking barefoot, playing with dirty objects that might be contaminated with feces. The control of soil-transmitted helminths principally relies on periodic deworming using either a single dose of albendazole/mebendazole. To assure the effectiveness of this measure, performing continuous parasitological survey is necessary. Herein, the prevalence, intensity and associated factors of soil-transmitted helminth infections were assessed among school-aged children in northwest Ethiopia. Methods A cross-sectional study design was conducted among school-aged children (6–14 years old) from January 21st to February 21st/2019. Multistage sampling technique was employed. A Kato-Katz concentration technique was utilized to detect STHs in stool samples. Moreover, risk factors for STH infections were assessed using well-structured questionnaire. Bivariate and multivariate analyses were used to assess the association between explanatory and the outcome variables. The magnitude of the association was measured using the adjusted odds ratio (AOR) and 95% confidence interval (CI). A P-value <0.05 was considered statistically significant. Results The overall STHs prevalence in this study was 32.3% (95% CI: 29–35.6%) with Ascaris lumbricoides being the predominant species (24.3%) followed by hookworm (8.9%) and Trichuris trichiura (1%). Most (80.3%) of the infected school-aged children had light-intensity infections. Age of 11 years and above (AOR, 12.9, 95% CI, 1.6–103.6, P=0.004), being residing in Chuahit district (AOR, 3.9, 95% CI, 2.3–6.5, P<0.001), and untreated water supply (AOR, 1.7, 95% CI, 1.1–2.7, P=0.018) were identified as predictors for the overall STH prevalence. Conclusion Our findings revealed STH infections are considerable health problems in the study areas. Thus, public health interventions such as provision of safe water supply, health education, and de-worming programs should be regularly implemented in the study areas.
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Affiliation(s)
- Ayalew Jejaw Zeleke
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adane Derso
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebe Genetu Bayih
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - John S Gilleard
- Host-Parasite Interactions Program, Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, Canada
| | - Tegegne Eshetu
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Re: Bayesian Methods for Exposure Misclassification Adjustment in a Mediation Analysis. Epidemiology 2020; 31:e41-e42. [DOI: 10.1097/ede.0000000000001213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Blouin B, Casapia M, Joseph L, Gyorkos TW. A longitudinal cohort study of soil-transmitted helminth infections during the second year of life and associations with reduced long-term cognitive and verbal abilities. PLoS Negl Trop Dis 2018; 12:e0006688. [PMID: 30052640 PMCID: PMC6082574 DOI: 10.1371/journal.pntd.0006688] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 08/08/2018] [Accepted: 07/15/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Soil-transmitted helminth (STH) infection leads to malnutrition and anemia, and has been linked to impaired child development. Previous research on this topic is limited and mostly conducted in school-age children. The goal of this study was to determine the effect of the number of detected STH infections between one and two years of age on subsequent cognitive and verbal abilities, in a cohort of preschool children. METHODOLOGY/PRINCIPAL FINDINGS A longitudinal cohort study was conducted in 880 children in Iquitos, Peru between September 2011 and July 2016. Children were recruited at one year of age and followed up at 18 months and then annually between two and five years of age. STH infection was measured with the Kato-Katz technique or the direct smear technique. Child development was measured with the Bayley Scales of Infant and Toddler Development-III at the one to three-year visits and with the Wechsler Preschool and Primary Scale of Intelligence-III at the four and five-year visits. Hierarchical multivariable linear regression models were used to account for the repeated outcome measures for each child and Bayesian latent class analysis was used to adjust for STH misclassification. Children found infected with any STH infection between one and two years of age had lower cognitive scores between two and five years of age (between group score differences (95% credible intervals) for infected once, and infected two or three times, compared to never infected: -4.31 (-10.64, -0.14) and -3.70 (-10.11, -0.11), respectively). Similar results were found for Ascaris infection and for verbal scores. CONCLUSIONS/SIGNIFICANCE An association was found between having been infected with Ascaris or any STH between one and two years of age and lower cognitive and verbal abilities later in childhood. These results suggest that targeting children for STH control as of one year of age is particularly important.
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Affiliation(s)
- Brittany Blouin
- Division of Clinical Epidemiology and Centre for Outcomes Research, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | | | - Lawrence Joseph
- Division of Clinical Epidemiology and Centre for Outcomes Research, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Theresa W. Gyorkos
- Division of Clinical Epidemiology and Centre for Outcomes Research, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
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