Malnutrition and intestinal helminth infections in schoolchildren from Dibanda, Cameroon
ABSTRACT Intestinal helminth infections and malnutrition constitute a major health burden in developing countries, with infants and children being the most vulnerable groups. The extent of the burden of intestinal helminth infections and malnutrition was investigated in a cross-sectional study involving 265 children aged between 4 and 14 years residing in Dibanda, a semi-rural area located in Buea, South West Region, Cameroon. The prevalence of intestinal helminth infections was determined microscopically after faecal samples were prepared by the formol-ether sedimentation concentration technique of stool analysis. Nutritional status was determined using age and the anthropometric parameters of weight and height. Standard deviation (SD) or Z scores of height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ) were computed based on the World Health Organization 2006 growth reference curves. Anaemia was assessed by packed cell volume (PCV). The prevalence of intestinal helminth infection in the study population was 47.2% (125/265). All infections were of low intensity, with Ascaris recording the highest geometric mean egg count (GMEC) ± SEM of 363.51 ± 60.35 (egg count range: 76-3000 eggs/gram of stool). Overall, 42.3% of children had PCV < 31%. Also, 47.2% of those with intestinal helminth infections also had PCV < 31%. The prevalence of malnutrition was 30.2% (80/265). Of 80 malnourished children, 5.3% were wasted ( < - 2SD weight-for-height Z-score), 7.2% underweight ( < - 2SD weight-for-age Z score) and 24.2% stunted ( < - 2SD height-for-age Z score). The mean values of all the anthropometric indices were lower in helminth-infected children. Findings from this study are strongly suggestive that intestinal helminth infections and malnutrition exist in children residing in Dibanda and constitute a major health problem that needs to be addressed immediately to reduce morbidity and mortality.
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ABSTRACT: This study evaluates the economic consequences of the successful eradication of hookworm disease from the American South. The hookworm-eradication campaign (c. 1910) began soon after (i) the discovery that a variety of health problems among Southerners could be attributed to the disease and (ii) the donation by John D. Rockefeller of a substantial sum to the effort. The Rockefeller Sanitary Commission (RSC) surveyed infection rates in the affected areas (eleven southern states) and found that an average of forty percent of school-aged children were infected with hookworm. The RSC then sponsored treatment and education campaigns across the region. Follow-up studies indicate that this campaign substantially reduced hookworm disease almost immediately. The sudden introduction of this treatment combines with the cross-area differences in pre-treatment infection rates to form the basis of the identification strategy. Areas with higher levels of hookworm infection prior to the RSC experienced greater increases in school enrollment, attendance, and literacy after the intervention. This result is robust to controlling for a variety of alternative factors, including differential trends across areas, changing crop prices, shifts in certain educational and health policies, and the effect of malaria eradication. No significant contemporaneous results are found for adults, who should have benefited less from the intervention owing to their substantially lower (prior) infection rates. A long-term follow-up of affected cohorts indicates a substantial gain in income that coincided with exposure to hookworm eradication. I also find evidence that eradication increased the return to schooling.Quarterly Journal of Economics 02/2007; 122(1):73-117. DOI:10.1162/qjec.121.1.73 · 5.92 Impact Factor
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ABSTRACT: Poor people in developing countries endure the burden of disease caused by four common species of soil-transmitted nematode that inhabit the gastrointestinal tract. Disease accompanying these infections is manifested mainly as nutritional disturbance, with the differing infections having their deleterious effects at different phases during the human life cycle. Reduced food intake, impaired digestion, malabsorption, and poor growth rate are frequently observed in children suffering from ascariasis and trichuriasis. Poor iron status and iron deficiency anemia are the hallmarks of hookworm disease. The course and outcome of pregnancy, growth, and development during childhood and the extent of worker productivity are diminished during hookworm disease. Less is known about the impact of these infections in children under 2 years of age. The severity of disease caused by soil-transmitted nematodes has consistently been found to depend on the number of worms present per person. Cost-effective measures based on highly efficacious anthelminthic drugs are now available to reduce and control disease caused by these infections.Annual Review of Nutrition 02/2002; 22:35-59. DOI:10.1146/annurev.nutr.22.120501.134539 · 10.46 Impact Factor
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ABSTRACT: Over the last five years, there has been increasing recognition of the global health importance of hookworm. New international efforts to control the morbidity of hookworm are in progress.PLoS Medicine 04/2005; 2(3):e67. DOI:10.1371/journal.pmed.0020067 · 14.00 Impact Factor