One-hundred eighty-five Bangladeshi children age 1 1/2 to 8 yr with no Ascaris lumbricoides infection or with light, moderate, or heavy infection were randomly assigned to treatment of placebo groups, with treatment given in a double-blind fashion. The groups were comparable for nutritional and socioeconomic parameters. Treatment consisted of a single dose of piperazine citrate administered twice within a 2-wk period. The cure rates for the low, moderate, and heavy A. lumbricoides infected subgroups were 53, 31, and 36%, respectively. With more severe infections, worm eradication was more difficult and the rate of reinfection after treatment was more rapid. The rate of reinfection was significantly different for the low A. lumbricoides infected treatment and placebo subgroups for 5 months after treatment, for the moderate treatment and placebo subgroups for 3 months after treatment, and for the heavy A. lumbricoides infected treatment and placebo subgroups there was a difference, although not significant, for 1 month after treatment. Anthropometric measurements were obtained for a period of 11 months. Analysis of covariance revealed no significant difference for change of weight, change of height, weight-for age, weight-for-height, height-for-age, triceps skinfold, midarm circumference, and the abdominal girth to chest circumference ratio between the treatment and placebo groups after drug administration. The results of this study do not support single dose worm therapy as a means to enhance growth.

No abstract

Seasonal variation in nutritional status among young children has been described in rural populations, but in few urban settings. We examined seasonality in 7 years of nutritional surveillance data from an urban shanty town near Lima, Peru, where children 0-35 months old were measured at intervals of 4-5 months. We compared nutritional status by month, using generalized estimating equations to account for the intercorrelations among measurements of the same person at different times. The periodicity of the seasonal variation was found to fit a model in which the month of the year was sine-transformed, and this sine-transformed model was used to examine possible interactions with age, sex and year of examination. A total of 38,626 measurements was available from 11,333 children. In late winter, mean weight-for-height was an estimated 0.38 Z score higher than in late summer. The seasonal effect occurred at all ages, in both sexes, and in each year of surveillance. The amplitude was greatest for children 6-23 months old. The summer trough in weight-for-height was lower in 1989 than in other years; children who experienced this summer low had lower mean height-for-age in subsequent years. The seasonal variation in nutritional status may be related to differences in dietary intake, or to the higher prevalence of bacterial diarrhoea in summer than in winter. The more marked drop in weight-for-height in 1989 and subsequent trough in height-for-age may be related to political and economic changes than adversely affected food access in Peru.

No abstract

In a peri-urban shanty town located in Lima, Peru, a nutritional census of children 0-3 years old revealed a number of second and third degree malnourished children. In order to treat these children a home-based nutritional rehabilitation (HNR) programme was developed utilizing available community health staff. The programme focused on individual and group maternal education, home-based therapy such as oral rehydration solution for diarrhoea, periodic growth monitoring, and a strong trust relationship between mother and health professional. There was one death and four (7%) hospital admissions among the 54 HNR children. These morbidity and mortality rates were similar to those achieved by more traditional programmes in Bangladesh, India, and Guatemala. NHR can provide an inexpensive, reproducible method useful for the treatment of malnourished 'third world' children in peri-urban slums.