Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-03T17:53:01.619Z Has data issue: false hasContentIssue false
  • English
  • Français

Ascariasis and childhood malnutrition

Published online by Cambridge University Press:  06 April 2009

Thein Hlaing
Thein Hlaing
Affiliation:
Department of Medical Research, Ministry of Health, Yangon 11191, Myanmar
Get access Rights & Permissions [Opens in a new window]

Summary

The present review will examine epidemiological perspectives and be confined mainly to the results of those field studies published since 1975 in order to provide concrete scientific evidence of the effect of ascariasis on childhood malnutrition, particularly on growth. The field studies were done in many developing countries from Africa, Asia and Latin America, using cross-sectional and intervention studies in which anthelmintics were employed, with different dosing frequency and follow-up periods ranging from 33 days to 2 years. In general, a better nutritional status in terms of growth, lactose tolerance, vitamins A and C, and albumin levels were observed among Ascaris–free or treated than among Ascaris–infected or untreated children even in cross-sectional or non-randomized studies. More importantly, the improvement in weight or height after chemotherapeutic treatment was found to be significant particularly in those randomized controlled studies with an initially high prevalence of ascariasis and malnutrition, a low prevalence of other intestinal parasites, repetitive and regular treatments of children with tetramisole, levamisole or pyrantel, within a period of 12 or 24 months. Reasons for failures to detect improved growth in some studies are provided. This review strongly indicates that A. lumbricoides infection definitely retards childhood growth.

Keywords

Ascariasiscross-sectional studiesintervention studiesanthelminticsnutritional status
Type
Research Article
Information
Parasitology , Volume 107 , supplement S1: Human nutrition and parasitic infection , January 1993 , pp. S125 - S136
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Arfaa, F. & Ghadirian, E. (1977). Epidemiology and mass treatment of ascariasis in six rural communities in central Iran. American Journal of Tropical Medicine and Hygiene 26, 866–71.CrossRefGoogle ScholarPubMed
Blumenthal, D. S. & Schultz, M. G. (1976). Effects of Ascaris infection on nutritional status in children. American Journal of Tropical Medicine and Hygiene 25, 682–90.CrossRefGoogle ScholarPubMed
Brown, K. H., Gilman, R. H., Khatum, M. & Ahmed, M. G. (1980). Absorption of macronutrients from a rice vegetable diet before and after treatment for ascariasis in children. American Journal of Clinical Nutrition 33, 1975–82.CrossRefGoogle ScholarPubMed
Carrera, E., Nesheim, M. C. & Crompton, D. W. T. (1984). Lactose maldigestion in Ascaris-infected preschool children. American Journal of Clinical Nutrition 39, 255–64.Google ScholarPubMed
Cerf, B. J., Rohde, J. E. & Soesanto, T. (1981). Ascaris and malnutrition in a Balinese village: a conditional relationship. Tropical and Geographical Medicine 33, 367–73.Google Scholar
Cole, T. J. & Parkin, J. M. (1977). Infection and its effect on the growth of young children: a comparison of The Gambia and Uganda. Transactions of the Royal Society of Tropical Medicine and Hygiene 71, 196–8.CrossRefGoogle ScholarPubMed
Cole, T. J., Salem, S. I., Hafez, A. S., Galal, O. M. & Massoud, A. (1982). Plasma albumin, parasitic infection and pubertal development in Egyptian boys. Transactions of the Royal Society of Tropical Medicine and Hygiene 76, 17–20.CrossRefGoogle ScholarPubMed
Cooper, E. S. & Bundy, D. A. P. (1986). Trichuriasis in St Lucia. In Diarrhoea and Malnutrition in Children (ed. McNeish, A. S. & Smith, J. A. Walker), pp. 91–6. London: Butterworths.CrossRefGoogle Scholar
Croll, N. A., Anderson, R. M., Gyorkos, T. W. & Ghadirian, E. (1982). The population biology and control of Ascaris lumbricoides in a rural community in Iran. Transactions of the Royal Society of Tropical Medicine and Hygiene 76, 187–97.CrossRefGoogle Scholar
Crompton, D. W. T. (1986). Nutritional aspects of infection. Transactions of the Royal Society of Tropical Medicine and Hygiene 80, 697–705.CrossRefGoogle ScholarPubMed
Crompton, D. W. T. (1989 a). Prevalence of ascariasis. In Ascariasis and its Prevention and Control (ed. Crompton, D. W. T., Nesheim, M. C. & Pawlowski, Z. S.), pp. 45–69. London, New York and Philadelphia: Taylor and Francis Ltd.Google Scholar
Crompton, D. W. T. (1989 b). Biology of Ascaris lumbricoides. In Ascaris and its Prevention and Control (ed. Crompton, D. W. T., Nesheim, M. C. & Pawlowski, Z. S.), pp. 9–44. London, New York and Philadelphia: Taylor and Francis Ltd.Google Scholar
Crompton, D. W. T. & Stephenson, L. (1985). Ascariasis in Africa. In Ascariasis and its Public Health Significance (ed. Crompton, D. W. T., Nesheim, M. C. & Pawlowski, Z. S.), pp. 185–201. London: Taylor and Francis Ltd.Google Scholar
Egger, R. J., Hofhuis, E. H., Bloem, M. W., Chusilp, K., Wedel, M., Intarakhao, C., Saowakontha, S. & Schreurs, W. H. P. (1990). Association between intestinal parasitoses and nutritional status in 3–8-year-old children in north-east Thailand. Tropical and Geographical Medicine 42, 312–23.Google Scholar
Forsum, E., Nesheim, M. C. & Crompton, D. W. T. (1981). Nutritional aspects of Ascaris infection in young protein deficient pigs. Parasitology 83, 497–512.CrossRefGoogle Scholar
Freij, L., Meeuwisse, G. W., Berg, N. O., Wall, S. & Gebre-Medhin, M. (1979). Ascariasis and malnutrition: a study in urban Ethiopian children. American Journal of Clinical Nutrition 32, 1545–53.CrossRefGoogle ScholarPubMed
Grant, J. P. (1982). The State of the World's Children. Oxford: Oxford University Press.Google Scholar
Greenberg, B. K., Gilman, R. H. & Shapiro, H. (1981). Single dose piperazine therapy for Ascaris lumbricoides: an unsuccessful method of promoting growth. American Journal of Clinical Nutrition 34, 2508–16.CrossRefGoogle ScholarPubMed
Gupta, M. C. (1990). Effect of ascariasis upon nutritional status of children. Journal of Tropical Pediatrics 36, 189–91.CrossRefGoogle ScholarPubMed
Gupta, M. C., Mithal, S. & Tandon, B. N. (1976). Use of tetramisole for mass deworming in a community with heavy Ascaris infection. Journal of the Indian Medical Association 67, 180–2.Google Scholar
Gupta, M. C. & Urrutia, J. J. (1982). Effect of periodic anti-Ascaris and anti-Giardia treatment upon nutritional status of preschool children. American Journal of Clinical Nutrition 36, 79–86.CrossRefGoogle Scholar
Gupta, M. C., Mithal, S., Arora, K. L. & Tandon, B. N. (1977). Effect of periodic deworming on nutritional status of Ascaris-infected preschool children receiving supplementary food. Lancet ii, 108–10.CrossRefGoogle Scholar
Gupta, M. C., Prasad, N. & Tandon, B. N. (1978). Effect of round worm infection upon growth and nutritional status. Indian Journal of Preventive and Social Medicine 9, 31–3.Google Scholar
Haller, L. & Lauber, E. (1980). Santé de l'enfant d'âge scolaire en Côte d' lvoire. Acta Tropica (Supplement) 37, 1–132.Google Scholar
Haswell-Elkins, M. R., Elkins, D. B. & Anderson, R. M. (1987). Evidence for predisposition in humans to infection with Ascaris, hookworm, Enterobius and Trichuris in a South Indian fishing community. Parasitology 95, 323–37.CrossRefGoogle Scholar
Holland, C. V. (1989). An assessment of the impact of four intestinal nematode infections on human nutrition. Clinical Nutrition 8, 239–50.Google Scholar
Hussain, M. A. (1980). A study of intestinal parasites, diet and growth of children in a Nigerian village. Nigerian Journal of Nutrition Science 1, 5–15.Google Scholar
Ismail, M. M. & Perera, W. D. a. (1986). Relationship between soil-transmitted helminthiases and nutritional status in 3–12-year-olds in a semi-urban community in Sri Lanka. In Collected Papers on the Control of Soil-Transmitted Helminthiases, Vol. 3 (ed. Yokogawa, M. et al. ), pp. 186–99. Tokyo: Asian Parasite Control Organization.Google Scholar
Kaba, A. S., Luvwezo, M., Nzuzi, K. & Thiepont, D. (1978). Le traitement anthelminthique périodique d'enfants d'âge scolaire au Zaïre. Annates de la Société Beige de Médecine Tropicale, 58, 241–9.Google ScholarPubMed
Kan, S. P., Subramaniam, K. & Varghese, T. (1983). The effect of ascariasis on weight and height gain among Indian primary schoolchildren: a preliminary report. In Collected Papers on the Control of Soil-Transmitted Helminthiases, Vol. 2 (ed. Yokogawa, M. et al. ), pp. 309–19. Tokyo: Asian Parasite Control Organization.Google Scholar
Kloetzel, K., Filho, T. M. J. & Kloetzel, D. (1982). Ascariasis and malnutrition in a group of Brazilian children: a follow-up study. Journal of Tropical Pediatrics 28, 41–3.CrossRefGoogle Scholar
Martin, J., Crompton, D. W. T., Carrera, E. & Nesheim, M. C. (1984). Mucosal surface lesions in young protein deficient pigs infected with Ascaris suum (Nematoda). Parasitology 88, 333–40.CrossRefGoogle ScholarPubMed
Meakins, R. H., Harland, P. S. E. G. & Caswell, F. (1981). A preliminary survey of malnutrition and helminthiasis among school children in one mountain and one lowland Ujamaa village in Northern Tanzania. Transactions of the Royal Society of Tropical Medicine and Hygiene 75, 731–5.CrossRefGoogle Scholar
Murray, J. J., Murray, A. B., Murray, M. B. & Murray, C. J. (1977). Parotid enlargement, forehead edema, and suppression of malaria as nutritional consequences of ascariasis. American Journal of Clinical Nutrition 30, 2117–21.CrossRefGoogle ScholarPubMed
Nesheim, M. C. (1989). Ascariasis and human nutrition. In Ascariasis and its Prevention and Control (ed. Crompton, D. W. T., Nesheim, M. C. & Pawlowski, Z. S.), pp. 87–100. London, New York & Philadelphia: Taylor & Francis Ltd.Google Scholar
Ochola-Abila, P. & Barrack, S. M. (1982). Roundworm intestinal obstruction in children at Kenyatta National Hospital, Nairobi. East African Medical Journal 59 113–17.Google Scholar
Prihartono, J., Effendi, F., Suyardi, A., Djalil, H., Ilahude, H. D., Rasad, R., Mahfudin, H. & Rukmono, B. (1983). The effect of regular deworming on the nutritional status of underfives. In Collected Papers on the Control of Soil-Transmitted Helminthiases, Vol. 2 (ed. Yokogawa, M. et al. ), pp. 312–31. Tokyo: Asian Parasite Control Organization.Google Scholar
Reddy, V., Vijayaraghavan, K. & Mathur, K. K. (1986). Effect of deworming and vitamin A administration on serum vitamin A levels in pre-school children. Journal of Tropical Pediatrics 32, 196–9.CrossRefGoogle Scholar
Schultz, M. G. (1982). Ascariasis: nutritional implications. Review of Infectious Diseases 4, 815–19.CrossRefGoogle ScholarPubMed
Shah, P. M., Jummarkar, A. R., Monterio, D. & Khare, R. D. (1975). The effect of periodic deworming on the nutritional status of pre-school community: a preliminary communication. Indian Journal of Pediatrics 12, 1015–20.Google ScholarPubMed
Stephenson, L. S. (1980). The contribution of Ascaris lumbricoides to malnutrition in children. Parasitology 81, 221–33.CrossRefGoogle Scholar
Stephenson, L. S. (1987). Impact of Helminth Infections on Human Nutrition. London, New York and Philadelphia: Taylor and Francis Ltd.Google Scholar
Stephenson, L. S., Pond, W. G., Nesheim, M. C., Knook, L. P. & Crompton, D. W. T. (1980 a). Ascaris suum nutrient absorption, growth and intestinal pathology in young pigs experimentally infected with 15-day-old larvae. Experimental Parasitology 49, 15–25.CrossRefGoogle ScholarPubMed
Stephenson, L. S., Crompton, D. W. T., Latham, M. C., Schulpen, T. W. J., Nesheim, M. C. & Jansen, A. A. J. (1980 b). Relationships between Ascaris infection and growth of malnourished pre-school children in Kenya. American Journal of Clinical Nutrition 33, 1165–72.CrossRefGoogle ScholarPubMed
Stephenson, L. S., Latham, M. C., Kurz, K. M., Kinoti, S. N. & Brigham, H. (1989). Treatment with a single dose of albendazole improves growth of Kenya schoolchildren with hookworm, Trichuris trichiura and Ascaris lumbricoides infections. American Journal of Tropical Medicine and Hygiene 41, 78–87.CrossRefGoogle ScholarPubMed
Taren, D. L. & Crompton, D. W. T. (1989). Nutrition interactions during parasitism. Clinical Nutrition 8, 227–38.Google Scholar
Taren, D. L., Nesheim, M. C., Crompton, D. W. T., Holland, C., Barbean, I., Rivera, G., Sanjur, D., Tiffany, J. & Tucker, K. (1987). Contributions of ascariasis to poor nutritional status in children from Chiriqui Province, Republic of Panama. Parasitology 95, 603–13.CrossRefGoogle ScholarPubMed
Thein, Hlaing (1987). A profile of ascariasis morbidity in the Rangoon Children's Hospital, Burma. Journal of Tropical Medicine and Hygiene 90, 165–9.Google Scholar
Thein, Hlaing (1989). Epidemiological basis of survey design, methodology and data analysis for ascariasis. In Ascariasis and its Prevention and Control (ed. Crompton, D. W. T., Nesheim, M. C. & Pawlowski, Z. S.), pp. 351–68. London, New York & Philadelphia: Taylor & Francis Ltd.Google Scholar
Thein, Hlaing (1993). The effect of targeted chemotherapy against height of children in rural Myanmar. (Sent for publication).Google Scholar
Thein, Hlaing, Than, Saw, Myint, Lwin, HTAY, Aye Htay & maung, Myint Thein (1984). Epidemiology and transmission dynamics of Ascaris lumbricoides in Okpo, rural Burma. Transactions of the Royal Society of Tropical Medicine and Hygiene 78, 497–504.CrossRefGoogle Scholar
Thein, Hlaing, Than, Saw & Myint, Lwin (1987). Reinfection of people with Ascaris lumbricoides following single, 6-month and 12-month interval mass chemotherapy in Okpo village, rural Burma. Transactions of the Royal Society of Tropical Medicine and Hygiene, 81, 140–6.Google Scholar
Thein, Hlaing, Myat, Lay Kyin, Hlaing, Mya & Maung, Maung (1990 a). Role of ascariasis in surgical abdominal emergencies in the Rangoon Children's Hospital, Burma. Annals of Tropical Paediatrics, 10, 53–60.CrossRefGoogle Scholar
Thein, Hlaing, Than, Saw & Myat, Lay Kyin. (1990 b). Control of ascariasis through age-targeted chemotherapy: impact of 6-monthly chemotherapeutic regimens. Bulletin of the World Health Organization 68, 747–53.Google Scholar
Thein, Hlaing, Thane, Toe, Than, Saw, LAY, Kyin Myat & Myint, Lwin (1991). A controlled chemotherapeutic intervention trial on the relationship between Ascaris lumbricoides infection and malnutrition in children. Transactions of the Royal Society of Tropical Medicine and Hygiene 85, 523–8.CrossRefGoogle Scholar
Tripathy, K., Gonzales, F., Lotero, H. & Bolanos, O. (1971). Effects of Ascaris infection on human nutrition. American Journal of Tropical Medicine and Hygiene 20, 212–18.CrossRefGoogle ScholarPubMed
Tripathy, K., Duque, E., Bolanos, O., Lotero, H. & Mayoral, L. G. (1972). Malabsorption syndrome in ascariasis. American Journal of Clinical Nutrition 25, 1276–87.CrossRefGoogle ScholarPubMed
Willett, W. C., Kilama, W. L. & Kihamia, C. M. (1979). Ascaris and growth rates: a randomized trial of treatment. American Journal of Public Health 69, 987–91.CrossRefGoogle Scholar
WHO. (1985). Diagnostic techniques for intestinal parasitic infections applicable to primary health care services. Geneva: World Health Organization (PDP/85.2).Google Scholar