1 - Tropical Clinic Teaching and Research Unit, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal;
2 - Global Health and Tropical Medicine R&D Center, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal;
3 - Medicine of Woman, Childhood and Adolescence Teaching and Research Area, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal;
4 - Research Unit, Centro Hospitalar de Lisboa Central, Lisbon, Portugal;
- Int J Environ Res Public Health.2018 Apr 5;15(4). pii: E688. doi: 10.3390/ijerph15040688.
- III Encontro Luso-Galaico de Biometria (EBio2018). Aveiro, 2018 (Poster)
Introduction: The associations between enteric pathogenic parasites and growth in infants in São Tomé were explored using a refined anthropometric approach to recognize early growth faltering.
Methods: A birth cohort study was conducted with follow-up to 24 months of age. Microscopic examination for protozoa and soil-transmitted helminths was performed. Anthropometric assessments included: z-scores for weight-for-length (WLZ), length-for-age (LAZ), weight (WAVZ) and length velocities (LAVZ), length-for-age difference (LAD), and wasting and stunting risk (≤-1 SD). Generalized additive mixed effects regression models were used to explore the associations between anthropometric parameters and enteric parasitic infections and cofactors.
Results:: A total of 475 infants were enrolled, and 282 completed the study. The great majority of infants were asymptomatic. Giardia lamblia was detected in 35.1% of infants in at least one stool sample, helminths in 30.4%, and Cryptosporidium spp. in 14.7%. Giardia lamblia and helminth infections were significantly associated with mean decreases of 0.10 in LAZ and 0.32 in LAD, and of 0.16 in LAZ and 0.48 in LAD, respectively. Cryptosporidium spp. infection was significantly associated with a mean decrease of 0.43 in WAVZ and 0.55 in LAVZ.
Conclusion: The underestimated association between subclinical parasitic enteric infections and mild growth faltering in infants should be addressed in public health policies.
Palavras Chave: birth cohort; enteric parasitic infection; infant growth; low-middle-income country; subclinical infection