The effects of treating Trichuris trichiura infections were investigated in 407 Jamaican children age 6 to 12 y. The children were randomly assigned to receive treatment (albendazole) or a placebo. The outcome variables included growth, tests of reading, spelling and arithmetic, and school attendance. After 6 mo of treatment, there was no significant main effect on any of the outcomes. However, there were significant treatment-by-infection intensity interactions with spelling (P < 0.05) and body mass index (P < 0.01), and a significant treatment-by-stunting interaction with school attendance (P < 0.01). In spelling, the children with heavy infections showed improvements with treatment that approached significance (P = 0.06), whereas those with lower intensities did not. However, the children with lower infection intensities had increased body mass index with treatment (P = 0.02), although there was no difference in children with heavy infections. In school attendance, the stunted children improved with treatment (P < 0.04), whereas there was no difference in the nonstunted children. These findings suggest that in the sample of Jamaican children examined, the treatment of T. trichiura was more likely to benefit school performance in children of poor nutritional status and those with heavy infections, and to improve weight gain in children with lighter infection intensities.

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Severe infections by the geohelminth Trichuris trichiura detrimentally affect young children's growth and development. There is concern that mild to moderate infections may affect older children's school performance and nutritional status. We therefore examined the relationship between varying intensities of infection and school achievement, attendance and nutritional status in 616 schoolchildren. A total of 409 children with Trichuris infection of intensities greater than 1200 eggs per gram of stool (epg) were first identified, then for every 2 infected children in a class, an uninfected child was selected. After controlling for socioeconomic status, gender, age, school and the presence of Ascaris infections, the uninfected children had higher reading and arithmetic scores than children with infections of more than 4000 epg and were taller than those with intensities greater than 2000 epg. However, there were no significant differences in spelling, school attendance and body mass index. Although a treatment trial is needed to determine causation, these results indicate that moderate levels of infection are associated with poor school achievement and growth.

Heavy infection with the geohelminth Trichuris trichiura causes the Trichuris dysentery syndrome (TDS). Growth retardation and anaemia are characteristic of TDS and both are associated with poor development. We have examined the growth and developmental responses to treatment in 19 children aged 27–84 months with TDS. Developmental levels (DQ) were measured with the Griffiths mental development scales. Compared with a control group matched for age, gender and neighbourhood, the TDS children initially had serious deficits in DQ (24 points, p < 0.001). After a year of anthelmintic treatment, the TDS children showed improvement in locomotor development (p < 0.001) compared with the controls. The TDS children also had initial deficits in height‐for‐age, weight‐for‐height, mid‐upper arm circumference and haemoglobin levels. They caught up rapidly in indices of wasting (weight‐for‐height and mid‐upper arm circumference) and showed steady improvement in height‐for‐age and haemoglobin levels. Catch‐up in height was comparable to that of children recovering from coeliac disease. The importance of continuing prevention after initial treatment is highlighted.