Cognitive Effects of Diarrhea, Malnutrition, and Entamoeba Histolytica Infection on School Age Children in Dhaka, Bangladesh

Division of Infectious Diseases and International Health, University of Virginia, Charlottesville Virginia, USA.
The American journal of tropical medicine and hygiene (Impact Factor: 2.7). 04/2006; 74(3):475-81.
Source: PubMed


Cognitive function was assessed in 191 Bangladeshi children 6-9 years of age using verbal and nonverbal tests. These scores were added to a health surveillance database that was compiled over the four previous years that includes incidence of diarrhea and Entamoeba histolytica infection and nutritional status. The associations of diarrhea, malnutrition, and social factors with cognitive scores were analyzed statistically, and associations between diarrhea and test scores were controlled for the influence of social factors. Cognitive scores were negatively associated with stunting during school age, as well as the height-for-age and weight-for-age scores at study enrollment. Incidence of diarrhea was associated with nonverbal test scores before, but not after, controlling for socioeconomic factors. Generally E. histolytica infection was not found to independently influence scores, except that E. histolytica-associated dysentery was associated with lower test scores while dysentery of any etiology was not. Thus, malnutrition during the school age years, but not diarrhea or E. histolytica infection, was associated with a lower level of cognitive functioning. This suggested that intervention during school age years may be able to mitigate the cognitive deficiencies associated with malnutrition.

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    • "In Bangladesh , cognitive scores, measured by the CPM and the Wechsler abbreviated scale of intelligence, were associated with height-for-age and weight-for-age in children. Age of child, mothers' and fathers' education , as well as socio-economic status indicators such as family income and possession of radio and type of school the children attend were also significantly associated with Raven's CPM in the Bangladeshi study (Tarleton et al. 2006). A dietary supplementation and stimulation study of stunted children (9–24 months) in Jamaica resulted in a significant improvement of cognitive test outcomes in all groups (Walker et al. 2005). "
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    ABSTRACT: The purpose of this study was to assess the nutritional status and cognitive performance of women and their 5-year-old children using a cross-sectional design. Cognitive performance of mothers and children was assessed with Raven's Colored Progressive Matrices (CPM) and Kaufman Assessment Battery for Children-II (KABC-II). Demographic characteristics, food consumption patterns and anthropometry were also measured. Four rural districts in Sidama, southern Ethiopia served as the setting for this study. Subjects were one hundred women and their 5-year-old children. Mean ± standard deviation age of the mothers was 29 ± 6 years and family size was 7.0 ± 2.6. Maternal body mass index (BMI) ranged from 15.3 to 29.0 with 14% of the mothers having BMI < 18.5. Anthropometric assessment of children revealed 29% to be stunted (height-for-age z-score < −2) and 12% to be underweight (weight-for-age z-score < −2). Mothers' education significantly contributed to prediction of both mothers' and children's cognitive test scores. There were significant differences in mean cognitive test scores between stunted and non-stunted, and between underweight and normal-weight children. Height-for-age z-scores were correlated with scores for short-term memory (r = 0.42, P < 0.001), and visual processing (r = 0.42, P < 0.001) indices and weight-for-age z-scores were also correlated with scores of short-term memory (r = 0.41, P < 0.001) and visual processing (r = 0.43, P < 0.001) indices. Malnutrition in the community likely contributed to the cognitive performance of the subjects. Performance on memory and visual processing tasks was significantly lower in children with growth deficits suggesting that efficient and cost effective methods to alleviate malnutrition and food insecurity would impact not only child health but also cognitive function.
    Maternal and Child Nutrition 08/2011; 9(2). DOI:10.1111/j.1740-8709.2011.00345.x · 3.06 Impact Factor
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    • "It is possible that chronic malnutrition is an environmental determinant that leads to reduced educative and reproductive abilities, and therefore, poor performance on the Raven test, among children with heavy A. lumbricoides infections. Another analysis has supported the notion that growth stunting and chronic malnutrition are related to poor performance on Raven tests (Tarleton et al. 2006). The intestinal blood loss caused by adult hookworms is a well-known cause of iron-deficiency anaemia in endemic populations (Crompton & Nesheim 2002). "
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    ABSTRACT: To investigate the relationship between hookworm and Ascaris lumbricoides infection and performance on three subsets of the Wechsler Intelligence Scale for Children - third edition (WISC-III) (Digit Span, Arithmetic and Coding) and Raven Colored Progressive Matrices. Cross-sectional study of 210 children between the ages of 6 and 11 years in Americaninhas, Minas Gerais, Brazil. Separate proportional odds models were used to measure the association between the intensity of helminth infections and poor performance on each of the four cognitive tests. After adjusting for sex, age, socioeconomic status and other helminth infections, moderate-to-high-intensity hookworm infection was associated with poor performance on the WISC-III Coding subtest [OR = 3.20; 95% confidence interval (CI) = 1.43-7.17], low intensity of hookworm infection was associated with poor performance on the WISC-III Coding subtest [odds ratio (OR) = 3.71; 95% CI = 1.80-7.66] and moderate-to-high-intensity A. lumbricoides infection was associated with poor performance on the Raven test (OR = 2.03; 95% CI = 1.04-3.99), all in comparison with uninfected children. Children co-infected with A. lumbricoides infection and hookworm infection had greater odds of poor performance on some WISC-III subtests than children with only A. lumbricoides infection. These findings suggest that hookworm infection may be associated with poorer concentration and information processing skills, as measured on the WISC-III Coding subtest, and that A. lumbricoides infection may be associated with poorer general intelligence, as measured through the Raven Colored Progressive Matrices. This study also presents evidence that polyparasitized children experience worse cognitive outcomes than children with only one helminth infection.
    Tropical Medicine & International Health 08/2008; 13(8):994-1004. DOI:10.1111/j.1365-3156.2008.02103.x · 2.33 Impact Factor
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    ABSTRACT: Online document. Incl. bibl.
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