Risk Factors Associated with Malnutrition in One-Year-Old Children Living in the Peruvian Amazon

Abstract

BackgroundChildren under two years of age are in the most critical window for growth and development. As mobility increases, this time period also coincides with first exposure to soil-transmitted helminth (STH) infections in tropical and sub-tropical environments. The association between malnutrition and STH infection, however, has been understudied in this vulnerable age group.Methodology/Principal FindingsA nested cross-sectional survey was conducted in 12 and 13-month old children participating in a deworming trial in Iquitos, an STH-endemic area of the Peruvian Amazon. An extensive socio-demo-epi questionnaire was administered to the child's parent. Length and weight were measured, and the Bayley Scales of Infant and Toddler Development were administered to measure cognition, language, and fine motor development. Stool specimens were collected to determine the presence of STH. The association between malnutrition (i.e. stunting and underweight) and STH infection, and other child, maternal, and household characteristics, was analyzed using multivariable Poisson regression. A total of 1760 children were recruited between September 2011 and June 2012. Baseline data showed a prevalence of stunting and underweight of 24.2% and 8.6%, respectively. In a subgroup of 880 randomly-allocated children whose specimens were analyzed by the Kato-Katz method, the prevalence of any STH infection was 14.5%. Risk factors for stunting in these 880 children included infection with at least one STH species (aRR = 1.37; 95% CI 1.01, 1.86) and a lower development score (aRR = 0.97; 95% CI: 0.95, 0.99). A lower development score was also a significant risk factor for underweight (aRR = 0.92; 95% CI: 0.89, 0.95).ConclusionsThe high prevalence of malnutrition, particularly stunting, and its association with STH infection and lower developmental attainment in early preschool-age children is of concern. Emphasis should be placed on determining the most cost-effective, integrated interventions to reduce disease and malnutrition burdens in this vulnerable age group.

Nutritional survey among under five children at Tamyia district in Fayoum, Egypt

“…The current study revealed that these causes were statistically associated with wasting, stunting, and underweight, these results were agreed with studies concluded in Alexandria, Malaysia, and The Peruvian Amazon that high socioeconomic and good environmental conditions were the most important factors associated with the lower prevalence of malnutrition. 13,21,22 Study conducted in Sub -Saharan Africa reported that parasitic infestation had serious impact on children nutritional status and considered as a root cause of malnutrition, but study conducted in the Peruvian Amazon reported that the most prevalent cause of malnutrition in preschool children was lead poisoning due to oil extraction. 15,17 What this paper adds  The Prevalence of hospital-based malnutrition is evaluated.…”

Novel approaches to the diagnosis of Strongyloides stercoralis infection

“…Until now, faecal surveys on the prevalence of STHs have often relied on stool concentration methods such as the Kato-Katz [ [15][16][17][18], Mini-FLOTAC and McMaster [19] techniques. With standard methods, prevalence studies are affected by a lack of sensitivity.…”

Adverse Events from a Randomized, Multi-Arm, Placebo-Controlled Trial of Mebendazole in Children 12–24 Months of Age

“…However, we had conducted a pretrial canvassing of the study area before commencing the trial to identify and enroll children who may not have been regularly attending their CRED visits to increase the generalizability of our results. 13 A concern regarding anthelminthic use in children in this younger age group is the risk of choking on the tablet. 5 As recommended by WHO, we eliminated this risk by crushing the tablet and mixing it with a fruit juice.…”

“…Detailed information on trial procedures, including copies of the protocol and CONSORT checklist, is described elsewhere. 13,14 In brief, we conducted a double-blind, multi-arm, block-randomized, placebo-controlled trial on the effect of different timings and frequencies of mebendazole administration (500 mg, single-dose tablet, crushed and mixed with fruit juice) on growth and development in early childhood (ClinicalTrials.gov NCT01314937). Children were enrolled at 12 and 13 months of age during routine growth and development ("Crecimiento y Desarrollo" [CRED]) visits in 12 participating study health centers in Iquitos, Peru.…”