Effects of Cryptosporidium parvum infection in Peruvian children: Growth faltering and subsequent catch-up growth

William Checkley, Leonardo D. Epstein, Robert H Gilman, Robert E Black, Lilia Cabrera, Charles R. Sterling

Research output: Contribution to journalArticle


The authors conducted a 2-year (1989-1991) community-based longitudinal study in a shantytown in Lima, Peru, to examine the effect of Cryptosporidium parvum infection on child growth during the year following the onset of infection. A cohort of children, aged 0-3 months at recruitment, was followed monthly for anthropometrics, weekly for stool samples, and daily for diarrheal status. Data from 185 children in the cohort permitted a comparison of growth in C. parvum-infected and noninfected children. The analyses fitted smooth, flexible curves with a linear random-effects model to estimate growth differences between C. parvum-infected and noninfected children. Children infected with C. parvum experienced growth faltering, both in weight and in height, for several months after the onset of infection, followed by a period of catch-up growth. Younger children took longer to catch up in weight than did older children. Catch-up growth, however, did not occur in children infected between ages 0 and 5 months. These children did not catch up in height, and one year after infection they exhibited an average deficit of 0.95 cm (95% confidence interval (CI) 0.38-1.53) relative to noninfected children of similar age. Stunted children who became infected also did not catch up in either weight or height, and one year after infection they exhibited a height deficit of 1.05 cm (95% CI 0,46-1;66) relative to noninfected, stunted children of similar age. These results indicate that Cryptosporidium parvum has a lasting adverse effect on linear (height) growth, especially when acquired during infancy and when children are stunted before they become infected.

Original languageEnglish (US)
Pages (from-to)497-506
Number of pages10
JournalAmerican Journal of Epidemiology
Issue number5
StatePublished - Sep 1 1998



  • Cryptosporidium parvum
  • Diarrhea, infantile
  • Growth disorders
  • Infection
  • Longitudinal studies
  • Nutrition disorders
  • Smoothing splines
  • Statistics

ASJC Scopus subject areas

  • Epidemiology

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