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Krause RJ, Scott ME, Sinisterra OT, Koski KG. Preschool child growth attainment and velocity during an agriculture intervention in rural Panama may be diminished by soil-transmitted helminths. Front Public Health 2023; 11:1122528. [PMID: 37829089 PMCID: PMC10565504 DOI: 10.3389/fpubh.2023.1122528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 09/06/2023] [Indexed: 10/14/2023] Open
Abstract
Background Agricultural interventions are often recommended to address undernutrition in subsistence farming communities. However, intensified agriculture exposure can increase soil transmitted helminth (STH) infections, which are linked with poor child growth. This study examined impacts of the VERASAN public health and agricultural intervention program on preschool child growth attainment (HAZ and WAZ) and relative growth velocity over 7 months [change in height-for-age (∆HAD) and weight-for-age (∆WAD) difference]. Methods VERASAN was initiated in 15 subsistence farming communities in rural Panama experiencing chronic undernutrition. Activities targeted improved household food security, preschool child diets and growth by intensifying and diversifying household agriculture. Our objectives were to explore the relationship between VERASAN and preschool child growth attainment (HAZ and WAZ) and velocity (∆HAD and ∆WAD) during one agricultural cycle in 238 households. We compared those new to VERASAN with those involved for 1 or 5 years, and identified if agricultural practices, food security, diet diversity and treatment of pre-existing STH infection were associated with growth attainment or velocity. Results Prior participation in VERASAN did not directly influence WAZ, HAZ or ΔHAD but VERASAN-related benefits had an indirect influence. ΔHAD was positively associated with VERASAN-associated improvements in diet diversity and food security. HAZ and WAZ during land preparation were positively associated with diet diversity and HAZ with food security during harvest. HAZ was negatively associated with children visiting the agricultural plot, consuming leafy green vegetables and pre-existing hookworm infections. Both agricultural season and STH influenced ΔWAD. Children in VERASAN for 1 or 5 years experienced growth faltering between land preparation and growing season, but not those new to VERASAN. In contrast, between growing and harvest, ∆WAD declined in children new to VERASAN compared to children in VERASAN for longer. ΔWAD from land preparation to harvest was higher with pre-existing Ascaris infection whereas it was lower between growing season and harvest for pre-existing hookworm infection. Conclusion In a context of preschool child growth faltering, malnutrition and STH infections, improved food security, agricultural production and diet diversity associated with VERASAN were associated with improved growth. In contrast, STH infections were negatively associated with some, but not all, growth outcomes.
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Affiliation(s)
- Rachel J. Krause
- Department of Science, Canadian Mennonite University, Winnipeg, MB, Canada
- Institute of Parasitology, McGill University, Montreal, QC, Canada
| | - Marilyn E. Scott
- Institute of Parasitology, McGill University, Montreal, QC, Canada
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Ortiz-Prado E, Simbaña-Rivera K, Cevallos G, Gómez-Barreno L, Cevallos D, Lister A, Fernandez-Naranjo R, Ríos-Touma B, Vásconez-González J, Izquierdo-Condoy JS. Waterborne diseases and ethnic-related disparities: A 10 years nationwide mortality and burden of disease analysis from Ecuador. Front Public Health 2022; 10:1029375. [PMID: 36620267 PMCID: PMC9811003 DOI: 10.3389/fpubh.2022.1029375] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background Despite worldwide progress in terms of clean water supply, sanitation, and hygiene knowledge, some middle and most of low-income countries are still experiencing many diseases transmitted using unsafe water and the lack of sanitation. Methods To understand the impact of all waterborne diseases (WBD) registered in Ecuador. We performed a population-based analysis of all cases and deaths due to WBD in Ecuador based on the national public databases of hospital discharges as a proxy of incidence, in-hospital mortality, and countrywide general mortality rates from 2011 to 2020. Results In Ecuador, mestizos (mixed European and Indigenous American ancestry) had the greatest morbidity rate (141/100,000), followed by indigenous (63/100,000) and self-determined white patients (21/100,000). However, in terms of mortality, indigenous population have the greatest risk and rates, having a 790% additional mortality rate (2.6/100,000) than the reference group (self-determined white populations) at 0.29/100,000. The burden of disease analysis demonstrated that indigenous had the highest burden of disease caused by WBD with 964 YLL per every 100,000 people while mestizos have 360 YYL per 100,000 and self-determined white Ecuadorians have 109 YYL per 100,000. Conclusions In Ecuador, waterborne diseases (WBD) are still a major public health problem. We found that indigenous population had higher probability of getting sick and die due to WBD than the rest of the ethnic groups in Ecuador. We also found that younger children and the elderly are more likely to be admitted to the hospital due to a WBD. These epidemiological trends are probably associated with the lower life expectancy found among Indigenous than among the rest of the ethnic groups, who die at least, 39 years earlier than the self-determined white populations, 28 years earlier than Afro-Ecuadorians and 12 years earlier than the mestizos.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Katherine Simbaña-Rivera
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Gabriel Cevallos
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Lenin Gómez-Barreno
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Domenica Cevallos
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Alex Lister
- University Hospital Southampton NHS FT, University of Southampton, Southampton, United Kingdom
| | - Raul Fernandez-Naranjo
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
| | - Blanca Ríos-Touma
- Biodiversity, Environment and Health Research Group (BIOMAS), Faculty of Engineering and Applied Sciences, Universidad de Las Américas, Quito, Ecuador
| | - Jorge Vásconez-González
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
- Facultad de Ciencias de la Salud, Universidad Latina de Costa Rica, San Pedro, Costa Rica
| | - Juan S. Izquierdo-Condoy
- One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador
- Health Management and Research Area, Universidad Internacional Iberoamericana, Arecibo, Puerto Rico
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González-Fernández D, Nemeth E, Pons EDC, Sinisterra OT, Rueda D, Starr L, Sangkhae V, Murillo E, Scott ME, Koski KG. Multiple Indicators of Undernutrition, Infection, and Inflammation in Lactating Women Are Associated with Maternal Iron Status and Infant Anthropometry in Panama: The MINDI Cohort. Nutrients 2022; 14:nu14173497. [PMID: 36079755 PMCID: PMC9460351 DOI: 10.3390/nu14173497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 02/06/2023] Open
Abstract
Maternal infections, nutrient deficiencies, and inflammation (MINDI) co-exist in lactating indigenous women in Panama, but their impact on maternal iron status and infant growth is unknown. For this secondary analysis of cross-sectional data of lactating mothers from our MINDI cohort, we investigated associations of MINDI variables with maternal anemia, elevated serum transferrin receptor (sTfR), low serum iron, hepcidin, ferritin, and infant weight-for-age (WAZ), length-for-age (LAZ), and head-circumference-for-age (HCAZ) Z-scores in 99 mother-infant dyads. A bootstrapping resampling procedure preselected covariates for inclusion in multivariable regressions models from chronic maternal infections and nutritional status [folate, vitamins A, D, retinol-binding protein (RBP), insulin-growth factor-1 (IGF-1)] and inflammation [C-reactive protein (CRP), cytokines, platelet indices] indicators. Anemia was prevalent (53.5%) but underestimated due to widespread low plasma volume (<2.2 L, 79.9%) and was associated with indicators of malnutrition [lower IGF-1, body mass index (BMI), vitamin D, and intake of green/leafy vegetables], but not inflammation. Higher CRP was associated with lower serum iron, and higher hepcidin and ferritin, whereas maternal platelets were associated with lower HCAZ (β = −0.22), WAZ (β = −0.17), and LAZ (β = −0.17). Higher LAZ was also associated with maternal serum vitamin D (β = 0.23), whereas maternal iron supplementation lowered LAZ (β = −0.22). Assessment of iron status in this MINDI cohort is complex and supplementation strategies must consider consequences for both the mother and the infant.
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Affiliation(s)
- Doris González-Fernández
- School of Human Nutrition, McGill University, (Macdonald Campus), Ste-Anne de Bellevue, QC H9X 3V9, Canada
| | - Elizabeta Nemeth
- Center for Iron Disorders, David Geffen School of Medicine, University of California, Los Angeles, CA 90089, USA
| | | | | | - Delfina Rueda
- “Comarca Ngäbe-Buglé” Health Region, Panamanian Ministry of Health, Panama City, Panama
| | - Lisa Starr
- Department of Biochemistry, University of Panama, Panama City, Panama
| | - Veena Sangkhae
- Center for Iron Disorders, David Geffen School of Medicine, University of California, Los Angeles, CA 90089, USA
| | - Enrique Murillo
- Department of Biochemistry, University of Panama, Panama City, Panama
| | - Marilyn E. Scott
- Institute of Parasitology, McGill University, (Macdonald Campus), Ste-Anne de Bellevue, QC H9X 3V9, Canada
| | - Kristine G. Koski
- School of Human Nutrition, McGill University, (Macdonald Campus), Ste-Anne de Bellevue, QC H9X 3V9, Canada
- Correspondence: ; Tel.: +1-514-398-7845
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Mayfour KW, Hruschka D. Assessing comparative asset-based measures of material wealth as predictors of physical growth and mortality. SSM Popul Health 2022; 17:101065. [PMID: 35345449 PMCID: PMC8956810 DOI: 10.1016/j.ssmph.2022.101065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/27/2022] [Accepted: 03/03/2022] [Indexed: 11/18/2022] Open
Abstract
Social scientists and policymakers have increasingly relied on asset-based indices of household wealth to assess social disparities and to identify economically vulnerable populations in low- and middle-income countries. In the last decade, researchers have proposed a number of asset-based measures that permit global comparisons of household wealth across populations in different countries and over time. Each of these measures relies on different assumptions and indicators, and little is known about the relative performance of these measures in assessing disparities. In this study, we assess four comparative, asset-based measures of wealth—the Absolute Wealth Estimate (AWE), the International Wealth Index (IWI), the Comparative Wealth Index (CWI), and the “Standard of Living” portion of the Multi-Dimensional Poverty Index (MPI), along with a variable measuring television ownership—and compare how well each predicts health related variables such as women's BMI, children's height-for-age Z scores, and infant mortality at the household and survey level. Analyzing data from over 300 Demographic and Health surveys in 84 countries (n = 2,304,928 households), we found that AWE, IWI, CWI, MPI are all highly correlated (r = 0.7 to 0.9). However, IWI which is based on a common set of universally weighted indicators, typically best accounts for variation in all three health measures. We discuss the implications of these findings for choosing and interpreting these measures of wealth for different purposes. Assessing four comparative, asset-based measures of wealth. The four comparative asset-based measures of wealth are all highly correlated. International Wealth Index best accounts for variation in adult female BMI, child height-for-age, and infant mortality. Asset-based measures of wealth relying on universal indicators and weights perform better at explaining variance.
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Rivero MR, De Angelo C, Feliziani C, Liang S, Tiranti K, Salas MM, Salomon OD. Enterobiasis and its risk factors in urban, rural and indigenous children of subtropical Argentina. Parasitology 2022; 149:396-406. [PMID: 35264264 PMCID: PMC11010470 DOI: 10.1017/s0031182021001955] [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: 08/10/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 11/07/2022]
Abstract
A cross-sectional survey to assess the prevalence of Enterobius vermicularis infection and its associated factors among the child population of infant, preschool and school age in the urban, rural and indigenous population of Iguazú city, in subtropical Argentina was presented. Additionally, the status of enterobiasis at country level was reviewed and analysed. Enterobius vermicularis presence was assessed employing an oviscopic serial sampling technique. Statistical analysis of socio-demographic determinants was performed by generalized linear mixed models at individual, household and community levels. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used to gather national information about E. vermicularis prevalence spanning the decade 2010–2020. A total of 916 children from 470 families participated. Overall prevalence was 29.8%, with 25.3, 30.7 and 34.2% detected for children inhabiting urban, rural and indigenous villages, respectively. The multi-level analysis showed that the presence of E. vermicularis was mostly determined by individual (e.g. age, playing habits, previous pinworm infection) and household-level factors (e.g. family size, overcrowding conditions). Interestingly, WASH variables, such as waste disposal, analysed at community level were also important. Data were analysed to provide eco-epidemiological features of enterobiasis in a heterogeneous subtropical child population in the same territory but with different socio-sanitary realities. The importance of promoting multi-level actions against the determinants identified, to control this public health problem integratively was evidenced. The scoping review of national data updated the state of knowledge of this parasitosis, identifying risk determinants and gaps in knowledge at country level.
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Affiliation(s)
- Maria Romina Rivero
- Instituto Nacional de Medicina Tropical, INMeT, Neuquén y Jujuy s/n., Puerto Iguazú, Misiones3370, Argentina
- Instituto de Desarrollo Agroindustrial y de la Salud (IDAS-CONCIET), Universidad Nacional de Rio Cuarto, Ruta 36 Km 601, Rio Cuarto, Córdoba5800, Argentina
| | - Carlos De Angelo
- Assoc. Civil Centro de Investigaciones del Bosque Atlántico (CeIBA), Bertoni 85, Puerto Iguazú, Misiones3370, Argentina
- Instituto de Ciencias de la Tierra, Biodiversidad y Ambiente (ICBIA-CONICET), Universidad Nacional de Rio Cuarto, Ruta 36 Km 601, Rio Cuarto, Córdoba5800, Argentina
| | - Constanza Feliziani
- Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONCIET, Universidad Nacional de Córdoba, Friuli 2434, Córdoba5000, Argentina
| | - Song Liang
- Department of Environmental and Global Health, University of Florida, Gainesville, FL32610, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL32610, USA
| | - Karina Tiranti
- Departamento de Patología Animal, Facultad de Agronomía y Veterinaria, Universidad Nacional de Rio Cuarto, Ruta 36 Km 601, Rio Cuarto, Córdoba5800, Argentina
| | - Martin Miguel Salas
- Instituto Nacional de Medicina Tropical, INMeT, Neuquén y Jujuy s/n., Puerto Iguazú, Misiones3370, Argentina
| | - Oscar Daniel Salomon
- Instituto Nacional de Medicina Tropical, INMeT, Neuquén y Jujuy s/n., Puerto Iguazú, Misiones3370, Argentina
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Knee J, Sumner T, Adriano Z, Anderson C, Bush F, Capone D, Casmo V, Holcomb D, Kolsky P, MacDougall A, Molotkova E, Braga JM, Russo C, Schmidt WP, Stewart J, Zambrana W, Zuin V, Nalá R, Cumming O, Brown J. Effects of an urban sanitation intervention on childhood enteric infection and diarrhea in Maputo, Mozambique: A controlled before-and-after trial. eLife 2021; 10:e62278. [PMID: 33835026 PMCID: PMC8121544 DOI: 10.7554/elife.62278] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 04/03/2021] [Indexed: 12/12/2022] Open
Abstract
We conducted a controlled before-and-after trial to evaluate the impact of an onsite urban sanitation intervention on the prevalence of enteric infection, soil transmitted helminth re-infection, and diarrhea among children in Maputo, Mozambique. A non-governmental organization replaced existing poor-quality latrines with pour-flush toilets with septic tanks serving household clusters. We enrolled children aged 1-48 months at baseline and measured outcomes before and 12 and 24 months after the intervention, with concurrent measurement among children in a comparable control arm. Despite nearly exclusive use, we found no evidence that intervention affected the prevalence of any measured outcome after 12 or 24 months of exposure. Among children born into study sites after intervention, we observed a reduced prevalence of Trichuris and Shigella infection relative to the same age group at baseline (<2 years old). Protection from birth may be important to reduce exposure to and infection with enteric pathogens in this setting.
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Affiliation(s)
- Jackie Knee
- London School of Hygiene & Tropical Medicine, Faculty of Infectious Tropical Diseases, Disease Control DepartmentLondonUnited Kingdom
- Georgia Institute of Technology, School of Civil and Environmental EngineeringAtlantaUnited States
| | - Trent Sumner
- Georgia Institute of Technology, School of Civil and Environmental EngineeringAtlantaUnited States
| | | | - Claire Anderson
- Georgia Institute of Technology, School of Civil and Environmental EngineeringAtlantaUnited States
| | - Farran Bush
- Georgia Institute of Technology, School of Chemical and Biomolecular EngineeringAtlantaUnited States
| | - Drew Capone
- Georgia Institute of Technology, School of Civil and Environmental EngineeringAtlantaUnited States
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of EpidemiologyChapel HillUnited States
| | | | - David Holcomb
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of EpidemiologyChapel HillUnited States
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Environmental Sciences and EngineeringChapel HillUnited States
| | - Pete Kolsky
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of EpidemiologyChapel HillUnited States
| | - Amy MacDougall
- London School of Hygiene & Tropical Medicine, Faculty of Epidemiology and Population Health, Department of Medical StatisticsLondonUnited Kingdom
| | - Evgeniya Molotkova
- Georgia Institute of Technology, School of Biological SciencesAtlantaUnited States
| | | | - Celina Russo
- Georgia Institute of Technology, School of Civil and Environmental EngineeringAtlantaUnited States
| | - Wolf Peter Schmidt
- London School of Hygiene & Tropical Medicine, Faculty of Infectious Tropical Diseases, Disease Control DepartmentLondonUnited Kingdom
| | - Jill Stewart
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of EpidemiologyChapel HillUnited States
| | - Winnie Zambrana
- Georgia Institute of Technology, School of Civil and Environmental EngineeringAtlantaUnited States
| | - Valentina Zuin
- Yale-NUS College, Division of Social ScienceSingaporeSingapore
| | | | - Oliver Cumming
- London School of Hygiene & Tropical Medicine, Faculty of Infectious Tropical Diseases, Disease Control DepartmentLondonUnited Kingdom
| | - Joe Brown
- Georgia Institute of Technology, School of Civil and Environmental EngineeringAtlantaUnited States
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of EpidemiologyChapel HillUnited States
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Younes N, Behnke JM, Ismail A, Abu-Madi MA. Socio-demographic influences on the prevalence of intestinal parasitic infections among workers in Qatar. Parasit Vectors 2021; 14:63. [PMID: 33472686 PMCID: PMC7816503 DOI: 10.1186/s13071-020-04449-9] [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: 07/14/2020] [Accepted: 10/30/2020] [Indexed: 11/26/2022] Open
Abstract
Background The rapid growth of Qatar in the last two decades has been associated with an enormous expansion of building programs in its cities and in the provision of new service industries. This in turn has attracted a large influx of immigrant workers seeking employment in jobs associated with food handling, domestic service, and the building industry. Many of these immigrants come from countries in the tropics and subtropics where intestinal parasitic infections are common. In this study, we explored the environmental and socio-demographic characteristics of immigrant workers in Doha Qatar, which might explain the persistence of the parasites that they harbor. Methodology This cross-sectional survey was conducted among 2486 newly arrived immigrant workers and those who visited Qatar previously during the period 2012–2014. Through questionnaires and census data, we characterized the socio-demographic conditions at an individual, family, and neighborhood levels. Results Overall, the prevalence of combined protozoan infection was 11.7% and that of helminth was 7.0%. Combined protozoan infections were significantly associated with immigrant workers arriving in Doha for the first time. In univariate log-linear statistical models fitted in phase 1 of the analysis, significant associations were observed between the prevalence of combined protozoan infections and personal and familial factors that included religion, the level of education of subjects, both parents’ educational levels and their jobs, and the number of siblings. Furthermore, environmental effects on the prevalence of protozoan infections including the country of origin, the floor of the house, toilet type, household content index, provision of household water, farming background showed strong associations with protozoan infections. However, in phase 2, multifactorial binary logistic generalized linear models focusing only on the significant effects identified in phase 1, showed that only five factors retained significance (age class, floor of the house, household contents index, father’s education, and the number of siblings). The only factors that had a significant effect on the prevalence of helminth infections were the subjects’ age class and the mother’s educational level. Conclusions The prevalence of intestinal protozoan parasites among immigrant workers in Qatar is clearly multifactorial in origin determined by key familial relationships of subjects and also the environment, in which the subjects lived prior to their arrival in Qatar. Moreover, our results suggest that screening protocols for applicants for visas/work permits need to be revised giving more careful attention to the intestinal protozoan infections that potential immigrant workers may harbor.![]()
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Affiliation(s)
- Nadin Younes
- Biomedical Science Department, College of Health Sciences, Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Jerzy M Behnke
- School of Life Sciences, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Ahmed Ismail
- Medical Commission, Ministry of Public Health, P.O. Box 42, Doha, Qatar
| | - Marawan A Abu-Madi
- Biomedical Science Department, College of Health Sciences, Biomedical Research Center, Qatar University, P.O. Box 2713, Doha, Qatar.
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Brito RS, Carmo Filho JRD, Vila VDSC, Souza ACSE. Epidemiological characteristics and strategies for the prevention of diarrheal disease in indigenous children: A scoping review. ENFERMERIA CLINICA 2019; 30:53-62. [PMID: 31791883 DOI: 10.1016/j.enfcli.2019.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/05/2019] [Accepted: 08/13/2019] [Indexed: 11/18/2022]
Abstract
AIM The aim of the present scoping review was to map the scientific evidence about diarrheal disease in indigenous children and the strategies that can be used to prevent it. METHODS The subject headings were indigenous population; child; diarrhea; dysentery; epidemiology; and prevention, primary; also the following keywords characteristic, epidemiologic study; and children. The databases consulted were Latin American and Caribbean Health Sciences Literature, MEDLINE via the US National Library of Medicine/National Institutes of Health, and Web of Science. Initially, 268 studies were identified, and after being screened using the eligibility criteria, six were selected. Finally, via reference tracking, five more were identified. The final sample was made up of eleven articles. RESULTS The results confirmed higher mortality rates due to diarrheal disease among indigenous children who are socially disadvantaged and living in poor hygienic and basic sanitation conditions. Among the primary prevention strategies are basic sanitation, health education better hygiene habits, animal control, breastfeeding, supplementing the diet with zinc, vitamins, and the rotavirus vaccine. The preventive strategies included the use of oral rehydration solutions, adequate nutrition, prescribed antimicrobials, and intravenous fluid replacement with glycaemic and electrolyte correction in severe cases. CONCLUSION In conclusion, public policies regarding the indigenous population and cross-cultural care should be strengthened. The present study confirmed that, at a global level, there is a lack of publications studying this issue.
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Affiliation(s)
- Raquel Santos Brito
- Master in Health Care, Feral University of Mato Grosso, Av: Valdon Varjão, N° 6.390, CEP: 78.600-000 Barra do Garças, Mato Grosso, Brazil
| | - José Rodrigues do Carmo Filho
- Master's Program in Health Care, School of Social and Health Sciences Pontifical Catholic University of Goiás, Mestrado em Atenção à Saúde, Área IV, Av, Universitária 1.440, Setor Leste Universitário, CEP: 74605-010 Goiânia, Goiás, Brazil.
| | - Vanessa da Silva Carvalho Vila
- Master's Program in Health Care, School of Social and Health Sciences Pontifical Catholic University of Goiás, Mestrado em Atenção à Saúde, Área IV, Av, Universitária 1.440, Setor Leste Universitário, CEP: 74605-010 Goiânia, Goiás, Brazil
| | - Adenícia Custódia Silva E Souza
- Master's Program in Health Care, School of Social and Health Sciences Pontifical Catholic University of Goiás, Mestrado em Atenção à Saúde, Área IV, Av, Universitária 1.440, Setor Leste Universitário, CEP: 74605-010 Goiânia, Goiás, Brazil
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Household food insecurity in Panamanian subsistence farming communities is associated with indicators of household wealth and constraints on food production. Public Health Nutr 2019; 22:2398-2407. [PMID: 31122305 DOI: 10.1017/s1368980019001186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine if constraints on agricultural production were a novel construct in the Panama Food Security Questionnaire (FSQ) and to characterize agricultural and economic determinants of food insecurity during the planting, growing and harvesting time periods in subsistence farming communities. DESIGN This longitudinal study followed households during land preparation, growing and harvest periods in one agricultural cycle. Agricultural production and economic variables were recorded and the Panama FSQ was administered. Exploratory factor analysis was used to verify construct validity of the FSQ. A food insecurity score (FIS), ranging from 0 to 42, was derived. Multiple regression analyses of FIS were conducted for each agricultural period. SETTING Fifteen rural villages in Panama. PARTICIPANTS Subsistence farming households (n 237). RESULTS The FSQ contained four constructs: (i) ability to buy food; (ii) decreased amount/number of meals; (iii) feeling hungry; and (iv) lower agricultural production because of weather or lack of resources. Although most households were mildly food insecure in all time periods, determinants of food insecurity differed in each. Higher FIS was associated during land preparation with less rice and legumes planted and lower asset-based wealth; during growing months with less rice, more maize and pigeon peas planted and not selling produce; and during harvest with less rice planted, fewer chickens and lower income. CONCLUSIONS Constraints on agriculture was a novel construct of the Panama FSQ. Different income-related variables emerged in each agricultural period. Planting staple foods and raising chickens were associated with food security, but some crop choices were associated with food insecurity.
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Knee J, Sumner T, Adriano Z, Berendes D, de Bruijn E, Schmidt WP, Nalá R, Cumming O, Brown J. Risk factors for childhood enteric infection in urban Maputo, Mozambique: A cross-sectional study. PLoS Negl Trop Dis 2018; 12:e0006956. [PMID: 30419034 PMCID: PMC6258421 DOI: 10.1371/journal.pntd.0006956] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 11/26/2018] [Accepted: 10/29/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Enteric infections are common where public health infrastructure is lacking. This study assesses risk factors for a range of enteric infections among children living in low-income, unplanned communities of urban Maputo, Mozambique. METHODS & FINDINGS We conducted a cross-sectional survey in 17 neighborhoods of Maputo to assess the prevalence of reported diarrheal illness and laboratory-confirmed enteric infections in children. We collected stool from children aged 1-48 months, independent of reported symptoms, for molecular detection of 15 common enteric pathogens by multiplex RT-PCR. We also collected survey and observational data related to water, sanitation, and hygiene (WASH) characteristics; other environmental factors; and social, economic, and demographic covariates. We analyzed stool from 759 children living in 425 household clusters (compounds) representing a range of environmental conditions. We detected ≥1 enteric pathogens in stool from most children (86%, 95% confidence interval (CI): 84-89%) though diarrheal symptoms were only reported for 16% (95% CI: 13-19%) of children with enteric infections and 13% (95% CI: 11-15%) of all children. Prevalence of any enteric infection was positively associated with age and ranged from 71% (95% CI: 64-77%) in children 1-11 months to 96% (95% CI: 93-98%) in children 24-48 months. We found poor sanitary conditions, such as presence of feces or soiled diapers around the compound, to be associated with higher risk of protozoan infections. Certain latrine features, including drop-hole covers and latrine walls, and presence of a water tap on the compound grounds were associated with a lower risk of bacterial and protozoan infections. Any breastfeeding was also associated with reduced risk of infection. CONCLUSIONS We found a high prevalence of enteric infections, primarily among children without diarrhea, and weak associations between bacterial and protozoan infections and environmental risk factors including WASH. Findings suggest that environmental health interventions to limit infections would need to be transformative given the high prevalence of enteric pathogen shedding and poor sanitary conditions observed. TRIAL REGISTRATION ClinicalTrials.gov NCT02362932.
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Affiliation(s)
- Jackie Knee
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Trent Sumner
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Zaida Adriano
- We Consult, Maputo, Mozambique
- Departamento de Geografia, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - David Berendes
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Wolf-Peter Schmidt
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rassul Nalá
- Ministério da Saúde, Instituto Nacional de Saúde Maputo, Maputo, Republic of Mozambique
| | - Oliver Cumming
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Joe Brown
- School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
- * E-mail:
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Vilcins D, Sly PD, Jagals P. Environmental Risk Factors Associated with Child Stunting: A Systematic Review of the Literature. Ann Glob Health 2018. [PMID: 30779500 PMCID: PMC6748290 DOI: 10.29024/aogh.2361] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Stunting, a form of malnutrition characterized by impaired linear growth in the first two years of life, affects one quarter of children globally. While nutritional status remains the key cause of stunting, there is evidence that environmental risk factors are associated with stunting. OBJECTIVE The objective of this review is to explore the current literature and compile the environmental risk factors that have been associated with stunting. Further, we seek to discover which risk factors act independently of nutritional intake. METHODS A systematic search of the literature was performed using PubMed, EMBASE, Scopus, TOXNET, and CINAHL. A search of the grey literature was conducted. Papers were included in this review if they examined an association between childhood stunting and exposure to environmental risk factors. FINDINGS We included 71 reports in the final analysis. The included studies showed that foodborne mycotoxins, a lack of adequate sanitation, dirt floors in the home, poor quality cooking fuels, and inadequate local waste disposal are associated with an increased risk of childhood stunting. Access to safe water sources was studied in a large number of studies, but the results remain inconclusive due to inconsistent study findings. Limited studies were available for arsenic, mercury, and environmental tobacco, and thus their role in stunting remains inconclusive. The identified research did not control for nutritional intake. A causal model identified solid fuel use and foodborne mycotoxins as being environmental risk factors with the potential to have direct effects on childhood growth. CONCLUSIONS A diverse range of environmental risk factors are, to varying degrees, associated with stunting, demonstrating the importance of considering how the environment interacts with nutrition. Health promotion activities may be more effective if they consider environmental factors alongside nutritional interventions.
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Affiliation(s)
- Dwan Vilcins
- Child Health Research Centre, The University of Queensland, Center for Children's Health Research, South Brisbane.,School of Public Health, University of Queensland, AU
| | - Peter D Sly
- Child Health Research Centre, The Universit of Queensland, Center for Children's Health Research South Brisbane, AU
| | - Paul Jagals
- Child Health Research Centre, The University of Queensland, Center for Children's Health Research South Brisbane, AU
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Vilcins D, Sly PD, Jagals P. Environmental Risk Factors Associated with Child Stunting: A Systematic Review of the Literature. Ann Glob Health 2018; 84:551-562. [PMID: 30779500 PMCID: PMC6748290 DOI: 10.9204/aogh.2361] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Stunting, a form of malnutrition characterized by impaired linear growth in the first two years of life, affects one quarter of children globally. While nutritional status remains the key cause of stunting, there is evidence that environmental risk factors are associated with stunting. OBJECTIVE The objective of this review is to explore the current literature and compile the environmental risk factors that have been associated with stunting. Further, we seek to discover which risk factors act independently of nutritional intake. METHODS A systematic search of the literature was performed using PubMed, EMBASE, Scopus, TOXNET, and CINAHL. A search of the grey literature was conducted. Papers were included in this review if they examined an association between childhood stunting and exposure to environmental risk factors. FINDINGS We included 71 reports in the final analysis. The included studies showed that foodborne mycotoxins, a lack of adequate sanitation, dirt floors in the home, poor quality cooking fuels, and inadequate local waste disposal are associated with an increased risk of childhood stunting. Access to safe water sources was studied in a large number of studies, but the results remain inconclusive due to inconsistent study findings. Limited studies were available for arsenic, mercury, and environmental tobacco, and thus their role in stunting remains inconclusive. The identified research did not control for nutritional intake. A causal model identified solid fuel use and foodborne mycotoxins as being environmental risk factors with the potential to have direct effects on childhood growth. CONCLUSIONS A diverse range of environmental risk factors are, to varying degrees, associated with stunting, demonstrating the importance of considering how the environment interacts with nutrition. Health promotion activities may be more effective if they consider environmental factors alongside nutritional interventions.
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Affiliation(s)
- Dwan Vilcins
- Child Health Research Centre, The University of Queensland, Center for Children’s Health Research South Brisbane, Queensland, AU
- School of Public Health, University of Queensland, Brisbane, Queensland, AU
| | - Peter D. Sly
- Child Health Research Centre, The University of Queensland, Center for Children’s Health Research South Brisbane, Queensland, AU
| | - Paul Jagals
- Child Health Research Centre, The University of Queensland, Center for Children’s Health Research South Brisbane, Queensland, AU
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Rivero MR, De Angelo C, Nuñez P, Salas M, Motta CE, Chiaretta A, Salomón OD, Liang S. Environmental and socio-demographic individual, family and neighborhood factors associated with children intestinal parasitoses at Iguazú, in the subtropical northern border of Argentina. PLoS Negl Trop Dis 2017; 11:e0006098. [PMID: 29155829 PMCID: PMC5714390 DOI: 10.1371/journal.pntd.0006098] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 12/04/2017] [Accepted: 11/05/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Intestinal parasitoses are a major concern for public health, especially in children from middle and low-income populations of tropical and subtropical areas. We examined the presence and co-infection of parasites in humans as well as parasitic environmental contamination in Puerto Iguazú, Argentina. We explored the environmental and socio-demographic characteristics of the persistence of parasites in children and their environment. METHODOLOGY/PRINCIPAL FINDINGS This cross-section survey was conducted among children population comprised into the area of the public health care centers of Iguazú during June 2013 to May 2016. Copro-parasitological status of 483 asymptomatic children was assessed. Simultaneously, a design-based sampling of 744 soil samples and 530 dog feces was used for characterize the environmental contamination. The 71.5% of these sites were contaminated. Sixteen genera were detected in the environment being hookworms (62.0%) the main pathogens group detected followed by Toxocara spp (16.3%), Trichuris spp (15.2%) and Giardia (6.5%). Total children prevalence raised 58.8%, detecting twelve genera of parasite with Giardia intestinalis as the most prevalent pathogen (29.0%) followed by Enterobius vermicularis (23.0%), Hymenolepis nana (12.4%) and hookworms (4.4%). Through questionnaires and census data, we characterized the socio-demographics conditions at an individual, family and neighborhood levels. A multi-level analysis including environmental contamination data showed that the ´presence of parasites´ was mostly determined by individual (e.g. age, playing habits, previous treatment) and household level (e.g. UBN, WASH, mother's literacy) determinants. Remarkably, to define the level of 'parasite co-infection', besides individual and household characteristics, environmental factors at a neighborhood level were important. CONCLUSION/SIGNIFICANCE Our work represents the major survey of intestinal parasites in human and environmental samples developed in the region. High prevalence was detected in the children population as well as in their environment. This work shows the importance of considering and promoting multi-level actions over the identified determinants to face this public health problem from integrative approaches.
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Affiliation(s)
- Maria Romina Rivero
- Instituto Nacional de Medicina Tropical, INMeT. Ministerio de Salud de la Nación. Puerto Iguazú, Misiones. Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET. Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Carlos De Angelo
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET. Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Instituto de Biología Subtropical (IBS, UNaM-CONICET). Puerto Iguazú, Misiones. Argentina
- Assoc. Civil Centro de Investigaciones del Bosque Atlántico (CeIBA). Puerto Iguazú, Misiones. Argentina
| | - Pablo Nuñez
- Instituto Nacional de Medicina Tropical, INMeT. Ministerio de Salud de la Nación. Puerto Iguazú, Misiones. Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET. Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Martín Salas
- Instituto Nacional de Medicina Tropical, INMeT. Ministerio de Salud de la Nación. Puerto Iguazú, Misiones. Argentina
| | - Carlos E. Motta
- Departamento de Patología Animal, Facultad de Agronomía y Veterinaria, Universidad Nacional de Rio Cuarto. Rio Cuarto, Córdoba. Argentina
| | - Alicia Chiaretta
- Departamento de Patología Animal, Facultad de Agronomía y Veterinaria, Universidad Nacional de Rio Cuarto. Rio Cuarto, Córdoba. Argentina
| | - Oscar D. Salomón
- Instituto Nacional de Medicina Tropical, INMeT. Ministerio de Salud de la Nación. Puerto Iguazú, Misiones. Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET. Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Song Liang
- Department of Environmental and Global Health, University of Florida, Gainesville, Florida, United States of America
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
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Herrera D, Ellis A, Fisher B, Golden CD, Johnson K, Mulligan M, Pfaff A, Treuer T, Ricketts TH. Upstream watershed condition predicts rural children's health across 35 developing countries. Nat Commun 2017; 8:811. [PMID: 28993648 PMCID: PMC5634511 DOI: 10.1038/s41467-017-00775-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 07/27/2017] [Indexed: 12/02/2022] Open
Abstract
Diarrheal disease (DD) due to contaminated water is a major cause of child mortality globally. Forests and wetlands can provide ecosystem services that help maintain water quality. To understand the connections between land cover and childhood DD, we compiled a database of 293,362 children in 35 countries with information on health, socioeconomic factors, climate, and watershed condition. Using hierarchical models, here we find that higher upstream tree cover is associated with lower probability of DD downstream. This effect is significant for rural households but not for urban households, suggesting differing dependence on watershed conditions. In rural areas, the effect of a 30% increase in upstream tree cover is similar to the effect of improved sanitation, but smaller than the effect of improved water source, wealth or education. We conclude that maintaining natural capital within watersheds can be an important public health investment, especially for populations with low levels of built capital.Globally diarrheal disease through contaminated water sources is a major cause of child mortality. Here, the authors compile a database of 293,362 children in 35 countries and find that upstream tree cover is linked to a lower probability of diarrheal disease and that increasing tree cover may lower mortality.
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Affiliation(s)
- Diego Herrera
- Gund Institute for Environment, University of Vermont, 617 Main Street Burlington, Burlington, VT, 05405, USA.
- Rubenstein School of Environment and Natural Resources, University of Vermont, Aiken Center 81 Carrigan Drive Burlington, Burlington, VT, 05405, USA.
- Environmental Defense Fund, 1875 Connecticut Ave NW # 600, Washington, DC, 20009, USA.
| | - Alicia Ellis
- Duke Clinical Research Institute, Duke University, 2400 Pratt St Durham, Durham, NC, 27705, USA
| | - Brendan Fisher
- Gund Institute for Environment, University of Vermont, 617 Main Street Burlington, Burlington, VT, 05405, USA
- Rubenstein School of Environment and Natural Resources, University of Vermont, Aiken Center 81 Carrigan Drive Burlington, Burlington, VT, 05405, USA
| | - Christopher D Golden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Kiersten Johnson
- USAID Bureau for Food Security, 1300 Pennsylvania Ave NW, Washington, DC, 20004, USA
| | - Mark Mulligan
- Department of Geography, King's College London, London, WC2R 2LS, UK
| | - Alexander Pfaff
- Sanford School of Public Policy, Duke University, 201 Science Dr, Durham, NC, 27708, USA
| | - Timothy Treuer
- Department of Ecology and Evolutionary Biology, Princeton University, 117 Eno Hall Princeton, Princeton, NJ, 08544, USA
| | - Taylor H Ricketts
- Gund Institute for Environment, University of Vermont, 617 Main Street Burlington, Burlington, VT, 05405, USA
- Rubenstein School of Environment and Natural Resources, University of Vermont, Aiken Center 81 Carrigan Drive Burlington, Burlington, VT, 05405, USA
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Bradley RH, Putnick DL. THE ROLE OF PHYSICAL CAPITAL ASSETS IN YOUNG GIRLS' AND BOYS' MORTALITY AND GROWTH IN LOW- AND MIDDLE-INCOME COUNTRIES. Monogr Soc Res Child Dev 2016; 81:33-59. [PMID: 29593364 DOI: 10.1111/mono.12225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Diane L Putnick
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
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REFERENCES. Monogr Soc Res Child Dev 2016. [DOI: 10.1111/mono.12230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jarquin C, Arnold BF, Muñoz F, Lopez B, Cuéllar VM, Thornton A, Patel J, Reyes L, Roy SL, Bryan JP, McCracken JP, Colford JM. Population Density, Poor Sanitation, and Enteric Infections in Nueva Santa Rosa, Guatemala. Am J Trop Med Hyg 2016; 94:912-919. [PMID: 26856919 PMCID: PMC4824239 DOI: 10.4269/ajtmh.15-0555] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 01/03/2016] [Indexed: 11/16/2022] Open
Abstract
Poor sanitation could pose greater risk for enteric pathogen transmission at higher human population densities because of greater potential for pathogens to infect new hosts through environmentally mediated and person-to-person transmission. We hypothesized that incidence and prevalence of diarrhea, enteric protozoans, and soil-transmitted helminth infections would be higher in high-population-density areas compared with low-population-density areas, and that poor sanitation would pose greater risk for these enteric infections at high density compared with low density. We tested our hypotheses using 6 years of clinic-based diarrhea surveillance (2007–2013) including 4,360 geolocated diarrhea cases tested for 13 pathogens and a 2010 cross-sectional survey that measured environmental exposures from 204 households (920 people) and tested 701 stool specimens for enteric parasites. We found that population density was not a key determinant of enteric infection nor a strong effect modifier of risk posed by poor household sanitation in this setting.
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Affiliation(s)
- Claudia Jarquin
- *Address correspondence to Claudia Jarquin, Emerging Infectious Diseases Program, Center for Health Studies, Universidad del Valle de Guatemala, 11 Calle 15-79, Zona 15 VH III, Guatemala City 01015, Guatemala. E-mail:
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Gómez-Duarte OG. [Acute diarrheal disease caused by enteropathogenic Escherichia coli in Colombia]. Rev Chilena Infectol 2015; 31:577-86. [PMID: 25491457 DOI: 10.4067/s0716-10182014000500010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 06/02/2014] [Indexed: 02/07/2023] Open
Abstract
Intestinal Escherichia coli pathogens are leading causes of acute diarrheal disease in children less than 5 years in Latin America, Africa and Asia and a leading cause of death in children living in poorest communities in Africa and South East Asia. Studies on the role of E. coli pathogens in childhood diarrhea in Colombia and other countries in Latin America are limited due to the lack of detection assays in clinical laboratories at the main urban medical centers. Recent studies report that enterotoxigenic E. coli is the most common E. coli pathogens associated with diarrhea in children less than 5 years of age. Other E. coli pathotypes have been detected in children with diarrhea including enteropathogenic, enteroaggregative, shiga-toxin producing and diffusely adherent E. coli. It was also found that meat and vegetables at retail stores are contaminated with Shiga-toxin producing E. coli and enteroaggregative E. coli, suggesting that food products are involved in transmission and infection of the susceptible host. More studies are necessary to evaluate the mechanisms of transmission, the impact on the epidemiology of diarrheal disease, and management strategies and prevention of these pathogens affecting the pediatric population in Colombia.
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Bornstein MH, Putnick DL, Bradley RH, Lansford JE, Deater-Deckard K. Pathways among Caregiver Education, Household Resources, and Infant Growth in 39 Low- and Middle-Income Countries. INFANCY 2015; 20:353-376. [PMID: 26273231 PMCID: PMC4530992 DOI: 10.1111/infa.12086] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 04/20/2015] [Indexed: 11/27/2022]
Abstract
Caregiver education is known to relate to the growth of children, but possible mediation mechanisms of this association are poorly characterized and generally lack empirical support. We test whether instructional capital (caregiver education) leads to improved infant growth through availability of physical capital (household resources) across a wide swath of low- and middle-income countries (LMIC). Using the Multiple Indicator Cluster Survey (MICS3), we explore relations among caregiver education, household resources, and infant (M age = .99 years) growth in 117,881 families living in 39 LMIC. Overall, household resources mediated 76% of the small association between caregiver education and infant growth. When disaggregated by countries characterized by low, medium, and high levels of human development (as indexed by average life expectancy, education, and gross domestic product), household resources mediated 48% to 78% of the association between caregiver education and infant growth. Caregiver education had effects on infant growth through household resources in countries characterized by low, medium, and high levels of human development; for girls and boys; and controlling for indexes of infant feeding and health.
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Affiliation(s)
- Marc H. Bornstein
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Public Health Service
| | - Diane L. Putnick
- Child and Family Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Public Health Service
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Sandoval NR, Ríos N, Mena A, Fernández R, Perea M, Manzano-Román R, Santa-Quiteria JAR, Hernández-Gonzalez A, Siles-Lucas M. A survey of intestinal parasites including associated risk factors in humans in Panama. Acta Trop 2015; 147:54-63. [PMID: 25823566 DOI: 10.1016/j.actatropica.2015.03.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/19/2015] [Accepted: 03/20/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Intestinal parasitic infections are among the most common infections worldwide, leading to illness with serious and long lasting implications in children and immunocompromised people. Transmission of intestinal parasites is more frequent in tropical and sub-tropical areas where sanitation is poor and socioeconomic conditions are deficient. Panama is a country where climate and social conditions could be reflected in a high number of people infected with intestinal parasites. The presence, prevalence, and distribution of intestinal parasites in this country have been approached to date only in very restricted areas and population groups, but the impact of intestinal parasite infections at the national level is unknown. METHODOLOGY/PRINCIPAL FINDINGS We conducted a cross-sectional survey between 2008 and 2010 to determine the prevalence of intestinal parasites across Panama. Overall, 14 municipalities in seven provinces of Panama were surveyed. The presence of eggs, cysts, and larvae was assessed by microscopy in 1123 human fecal samples using a concentration technique. A questionnaire to identify risk factors associated with the frequency of intestinal parasites in the study population was also prepared and performed. Overall, 47.4% of human samples presented parasites. Variables including community type, age group, occupation, co-presence of commensals and socioeconomic factors (use of shoes and type of sanitation) were significantly associated with intestinal parasites (p<0.05). CONCLUSIONS/SIGNIFICANCE The preliminary data obtained in the current study, showing a high prevalence of fecal-oral transmitted parasites in Panama, place intestinal parasitism as a major health problem in this country. Specific interventions should be planned for the indigenous population, the group most afflicted by intestinal parasites.
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Jiménez Gutiérrez E, Pineda V, Calzada JE, Guerrant RL, Lima Neto JB, Pinkerton RC, Saldaña A. Enteric parasites and enteroaggregative Escherichia coli in children from Cañazas County, Veraguas Province, Panama. Am J Trop Med Hyg 2014; 91:267-72. [PMID: 24980494 DOI: 10.4269/ajtmh.13-0438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
This study was designed to examine the height-for-age z-scores (HAZ), and the prevalence of intestinal inflammation, gastrointestinal infections with parasites, and enteroaggregative Escherichia coli (EAEC) in rural Panamanian children. Stool microscopy and polymerase chain reaction (PCR) testing for EAEC detected Giardia lamblia (32%, 32 of 100) and EAEC (13%, 11 of 87) in the study participants, respectively. Anthropometric analyses showed that those children who were > 12 months of age had lower HAZ scores (mean of -1.449) than the reference population. As a group, the children in the study 1 to 5 years of age did not show recovery from the previously mentioned decline in terms of their HAZ. The HAZ means of the children infected with G. lamblia, EAEC, and Ascaris lumbricoides were -1.49, -1.67, and -2.11, respectively. Furthermore, the study participants with A. lumbricoides and EAEC infections in the presence of lactoferrin showed another decrease of 0.19 and 0.13, respectively, in their HAZ means.
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Affiliation(s)
- Elena Jiménez Gutiérrez
- Center for Global Health University of Virginia, Charlottesville, Virginia; Departamento de Parasitologia, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama
| | - Vanessa Pineda
- Center for Global Health University of Virginia, Charlottesville, Virginia; Departamento de Parasitologia, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama
| | - Jose E Calzada
- Center for Global Health University of Virginia, Charlottesville, Virginia; Departamento de Parasitologia, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama
| | - Richard L Guerrant
- Center for Global Health University of Virginia, Charlottesville, Virginia; Departamento de Parasitologia, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama
| | - Jones B Lima Neto
- Center for Global Health University of Virginia, Charlottesville, Virginia; Departamento de Parasitologia, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama
| | - Relana C Pinkerton
- Center for Global Health University of Virginia, Charlottesville, Virginia; Departamento de Parasitologia, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama
| | - Azael Saldaña
- Center for Global Health University of Virginia, Charlottesville, Virginia; Departamento de Parasitologia, Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panama
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Calvo A, Hess-Holtz M, Guardado AR, Alguero L, Vega S. Participatory Processes Applied to Developing Culturally Appropriate Educational Material Among the Ngäbe-Buglé Women of Panama for Domestic Violence Prevention. J Cogn Psychother 2014; 28:238-248. [PMID: 32759159 DOI: 10.1891/0889-8391.28.3.238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The Ngäbe-Buglé is the largest underserved indigenous population in Panama facing extreme health disparities compounded by structural, social, and cultural factors. Contributing factors to the poor health outcomes in this region include extreme poverty, low education, high maternal and infant mortality, alcohol use, and an increasing trend of domestic violence. The present intervention used community participatory processes to develop tailored material within the Ngäbe-Buglé community and training health promoters to deliver health education to the most rural areas. There were 78 health promoters who were trained using the training-of-trainers approach. Promoters distributed the health messages to their communities using the tailored material, the main topic discussed being domestic violence. Almost 7,000 community members received health education, demonstrating increased knowledge and intent to act on information received. Future directions include further funding, research, and education of indigenous groups in Panama on domestic violence.
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Affiliation(s)
- Arlene Calvo
- University of South Florida, Department of Community and Family Health
| | - Morgan Hess-Holtz
- University of South Florida, Department of Community and Family Health.,University of South Florida, USF Health Panamá.,University of Panama.,American Telemedicine Association Latin-American & Caribbean Chapter (ATALACC)
| | | | | | - Silvio Vega
- American Telemedicine Association Latin-American & Caribbean Chapter (ATALACC)
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Diawara A, Halpenny CM, Churcher TS, Mwandawiro C, Kihara J, Kaplan RM, Streit TG, Idaghdour Y, Scott ME, Basáñez MG, Prichard RK. Association between response to albendazole treatment and β-tubulin genotype frequencies in soil-transmitted helminths. PLoS Negl Trop Dis 2013; 7:e2247. [PMID: 23738029 PMCID: PMC3667785 DOI: 10.1371/journal.pntd.0002247] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 04/16/2013] [Indexed: 11/20/2022] Open
Abstract
Background Albendazole (ABZ), a benzimidazole (BZ) anthelmintic (AH), is commonly used for treatment of soil-transmitted helminths (STHs). Its regular use increases the possibility that BZ resistance may develop, which, in veterinary nematodes is caused by single nucleotide polymorphisms (SNPs) in the β-tubulin gene at positions 200, 167 or 198. The relative importance of these SNPs varies among the different parasitic nematodes of animals studied to date, and it is currently unknown whether any of these are influencing BZ efficacy against STHs in humans. We assessed ABZ efficacy and SNP frequencies before and after treatment of Ascaris lumbricoides, Trichuris trichiura and hookworm infections. Methods Studies were performed in Haiti, Kenya, and Panama. Stool samples were examined prior to ABZ treatment and two weeks (Haiti), one week (Kenya) and three weeks (Panama) after treatment to determine egg reduction rate (ERR). Eggs were genotyped and frequencies of each SNP assessed. Findings In T. trichiura, polymorphism was detected at codon 200. Following treatment, there was a significant increase, from 3.1% to 55.3%, of homozygous resistance-type in Haiti, and from 51.3% to 67.8% in Kenya (ERRs were 49.7% and 10.1%, respectively). In A. lumbricoides, a SNP at position 167 was identified at high frequency, both before and after treatment, but ABZ efficacy remained high. In hookworms from Kenya we identified the resistance-associated SNP at position 200 at low frequency before and after treatment while ERR values indicated good drug efficacy. Conclusion Albendazole was effective for A. lumbricoides and hookworms. However, ABZ exerts a selection pressure on the β-tubulin gene at position 200 in T. trichiura, possibly explaining only moderate ABZ efficacy against this parasite. In A. lumbricoides, the codon 167 polymorphism seemed not to affect drug efficacy whilst the polymorphism at codon 200 in hookworms was at such low frequency that conclusions cannot be drawn. The soil-transmitted helminths (STH) Ascaris lumbricoides, Trichuris trichiura and the hookworms Ancylostoma duodenale and Necator americanus are endemic in many tropical countries. Regular treatment with albendazole or mebendazole is the major means for controlling STHs. However, repeated treatment with the same class of benzimidazole anthelmintics has caused resistance in veterinary parasites, characterized by mutations at either codon 200, 167 or 198 in the β-tubulin gene. There is a concern that resistance may develop in human STH. Drug efficacy and mutation frequencies were assessed in T. trichiura, A. lumbricoides and hookworms collected in Haiti, Kenya and Panama prior to and after albendazole treatment. In T. trichiura from Haiti and Kenya, a significant increase of the frequency of the mutation at codon 200 was identified after treatment and drug efficacy was mediocre. Against A. lumbricoides, albendazole efficacy was good, even though the frequency of a mutation at codon 167 was relatively high, suggesting that, in this nematode, the codon 167 polymorphism does not impact efficacy. In hookworms, the mutation at codon 200 was identified, but at low frequencies and the response to albendazole was good. We conclude that monitoring for possible resistance in control programmes should be undertaken.
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Affiliation(s)
- Aïssatou Diawara
- Institute of Parasitology, McGill University, Sainte-Anne-de-Bellevue, Quebéc, Canada
| | - Carli M. Halpenny
- Institute of Parasitology, McGill University, Sainte-Anne-de-Bellevue, Quebéc, Canada
| | - Thomas S. Churcher
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus Imperial College London, London, United Kingdom
| | - Charles Mwandawiro
- Eastern and Southern Africa Center of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Jimmy Kihara
- Eastern and Southern Africa Center of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Ray M. Kaplan
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, Georgia, United States of America
| | - Thomas G. Streit
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, United States of America
| | - Youssef Idaghdour
- Sainte Justine Research Centre, Université de Montréal, Montréal, Québec, Canada
| | - Marilyn E. Scott
- Institute of Parasitology, McGill University, Sainte-Anne-de-Bellevue, Quebéc, Canada
| | - Maria-Gloria Basáñez
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus Imperial College London, London, United Kingdom
| | - Roger K. Prichard
- Institute of Parasitology, McGill University, Sainte-Anne-de-Bellevue, Quebéc, Canada
- * E-mail:
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Halpenny CM, Paller C, Koski KG, Valdés VE, Scott ME. Regional, household and individual factors that influence soil transmitted helminth reinfection dynamics in preschool children from rural indigenous Panamá. PLoS Negl Trop Dis 2013; 7:e2070. [PMID: 23437411 PMCID: PMC3578751 DOI: 10.1371/journal.pntd.0002070] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 01/08/2013] [Indexed: 11/22/2022] Open
Abstract
Background Few studies have investigated the relative influence of individual susceptibility versus household exposure factors versus regional clustering of infection on soil transmitted helminth (STH) transmission. The present study examined reinfection dynamics and spatial clustering of Ascaris lumbricoides, Trichuris trichiura and hookworm in an extremely impoverished indigenous setting in rural Panamá over a 16 month period that included two treatment and reinfection cycles in preschool children. Methodology/Principle Findings Spatial cluster analyses were used to identify high prevalence clusters for each nematode. Multivariate models were then used (1) to identify factors that differentiated households within and outside the cluster, and (2) to examine the relative contribution of regional (presence in a high prevalence cluster), household (household density, asset-based household wealth, household crowding, maternal education) and individual (age, sex, pre-treatment eggs per gram (epg) feces, height-for-age, latrine use) factors on preschool child reinfection epgs for each STH. High prevalence spatial clusters were detected for Trichuris and hookworm but not for Ascaris. These clusters were characterized by low household density and low household wealth indices (HWI). Reinfection epg of both hookworm and Ascaris was positively associated with pre-treatment epg and was higher in stunted children. Additional individual (latrine use) as well as household variables (HWI, maternal education) entered the reinfection models for Ascaris but not for hookworm. Conclusions/Significance Even within the context of extreme poverty in this remote rural setting, the distinct transmission patterns for hookworm, Trichuris and Ascaris highlight the need for multi-pronged intervention strategies. In addition to poverty reduction, improved sanitation and attention to chronic malnutrition will be key to reducing Ascaris and hookworm transmission. Control of soil transmitted helminth (STH) infections is of central importance to improving preschool child health because these infections can have long lasting consequences on growth and development. Our study in indigenous Ngäbe preschool children in western Panama was conducted over a period of 16 months. We monitored reinfection dynamics of three STH infections (Ascaris, Trichuris and hookworm) over two reinfection cycles to gain an understanding of regional, household and individual factors that influenced transmission of these infections among preschool children. Despite the rural setting, where virtually all households live under conditions of extreme poverty, we identified spatial clusters of high prevalence of Trichuris and hookworm in the most remote and poorest area, whereas Ascaris was present throughout the study area. Preschool children who were chronically malnourished (low height-for-age) had a higher reinfection burden of Ascaris and hookworm. Household poverty (low relative household wealth and maternal education) and infrequent latrine use were also influential in Ascaris reinfection. This cross-disciplinary analysis of preschool child STH transmission in a poor rural setting provides pertinent information for STH control programs that aim to break the cycle of poverty and infection.
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Affiliation(s)
- Carli M. Halpenny
- Institute of Parasitology and McGill School of Environment Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada
| | - Claire Paller
- Institute of Parasitology and McGill School of Environment Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada
| | - Kristine G. Koski
- School of Dietetics and Human Nutrition Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada
| | - Victoria E. Valdés
- Escuela de Nutrición y Dietética, Facultad de Medicina, Universidad de Panamá, Ciudad de Panamá, Panamá
| | - Marilyn E. Scott
- Institute of Parasitology and McGill School of Environment Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada
- * E-mail:
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