Early helminth infections are inversely related to anemia, malnutrition, and malaria and are not associated with inflammation in 6- to 23-month-old Zanzibari children

Jacqueline K. Kung'u, David Goodman, Hamad J. Haji, Mahdi Ramsan, Victoria J. Wright, Quentin D. Bickle, James M. Tielsch, John G. Raynes, Rebecca J. Stoltzfus

Research output: Contribution to journalArticlepeer-review

Abstract

Helminths aggravate anemia and malnutrition among school children. We studied this association in a cross-sectional study of 6- to 23-month-old Zanzibari children (N = 2322) and a sub-sample of 690 children matched on age and helminth infection status. Ascaris, hookworm, and Trichuris infections were diagnosed along with recent fever, malaria infection, mid-upper arm circumference (MUAC) and hemoglobin concentration (Hb). Alpha-1-acid glycoprotein (AGP), C-reactive protein (CRP), height, and weight were measured in the sub-sample. Infected children had higher Hb (β = 5.44 g/L, P < 0.001) and MUAC-for-age Z score (β = 0.30 Z, P < 0.001) compared with uninfected children after adjusting for covariates. Although helminths were not associated with inflammation, their association with Hb or MUAC-for-age Z score was modified by inflammation. Malaria-infected children were less likely to be infected with helminths (adjusted odds ratios 0.63 [95% confidence interval: 0.49, 0.81]). Non-anemic, better nourished, or non-malaria-infected children may be more exploratory of their environments and therefore increase their exposure to soil-transmitted helminths.

Original languageEnglish (US)
Pages (from-to)1062-1070
Number of pages9
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume81
Issue number6
DOIs
StatePublished - Dec 2009

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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