Cognitive effects of diarrhea, malnutrition, and Entamoeba histolytica infection on school age children in Dhaka, Bangladesh.
ABSTRACT 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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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 · 2.30 Impact Factor
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ABSTRACT: Rapid, point-of-care detection of enteric protozoa in diarrheal stool is desirable in clinical and research settings to efficiently determine the etiology of diarrhea. We analyzed the ability of the third-generation E. HISTOLYTICA QUIK CHEK™ developed by TECHLAB to detect amebic antigen in fecal samples from independent study populations in South Africa and Bangladesh. We compared the performance of this recently released rapid test to those of the commercially available ProSpecT(TM) Entamoeba histolytica microplate assay from Remel and the E. HISTOLYTICA II ELISA from TECHLAB, using real-time and nested PCR for Entamoeba species to resolve discrepant results. After discrepant resolution, The E. HISTOLYTICA QUIK CHEK™ exhibited sensitivity and specificity compared to the E. HISTOLYTICA II ELISA of 98.0 percent (95% CI: 92.9%-99.8%) and 100 percent (95% CI: 99.0%-100%) respectively. Compared to the ProSpecT™ microplate assay the QUIK CHEK exhibited 97.0 percent (95% CI: 91.5%-99.4%) sensitivity and 100 percent (95% CI: 99.0%-100%) specificity. Our results indicate that the QUIK CHEK is a robust assay for specific detection of Entamoeba histolytica trophozoites in un-fixed frozen clinical stool samples. Copyright © 2014, American Society for Microbiology. All Rights Reserved.Journal of Clinical Microbiology 11/2014; 53(2). DOI:10.1128/JCM.02836-14 · 4.23 Impact Factor
- Public health nutrition: principles and practice in community and global health, Edited by Favilene C, Brown M, 01/2014: chapter Childhood diarrhea and severe malnutrition: pages 235-55; Jones & Bartlett Learning.