Stunting in pre-school and school-age children in the Peruvian highlands and its association with Fasciola infection and demographic factors

Abstract

Fascioliasis is a zoonotic trematode infection that is endemic in the highlands of Peru. Chronic fascioliasis can be asymptomatic and remain undiagnosed for years. Chronic malnutrition in children, as manifested by stunting, leads to delayed cognitive development and lost productivity. We hypothesized that fascioliasis is among the factors associated with stunting in children from endemic areas. We conducted a cross-sectional study among children attending pre-school and school in 26 communities in the Anta province in the Cusco region of Peru. We conducted interviews to collect information on demographic, socioeconomic, and medical history. Blood was collected and tested for complete cell count and FAS2 ELISA for Fasciola antibodies. Three stool samples per participant were tested for parasites by Kato-Katz and Lumbreras rapid sedimentation methods. Chronic fascioliasis was determined by the presence of ova in stool. Children’s height, weight, and age were recorded and used to calculate height for age (HAZ) Z scores. Three thousand children participated in the study. Nine percent (264) of children had at least one positive test for Fasciola infection, 6% (164) had chronic fascioliasis, and 3% (102) had only positive antibody tests. The median HAZ was -1.41 (IQR: -2.03 to -0.81) and was similar in males and females. Twenty six percent (776) of children had stunting with HAZ < -2. Children with chronic fascioliasis had a lower median HAZ than children with without Fasciola (-1.54 vs. -1.4, p = 0.014). History of treatment for malnutrition, history of treatment for anemia, having other helminths in stool, lower socioeconomic score, living at a higher elevation, and fewer years of schooling of both parents were associated with a lower HAZ score. In a multiple regression analysis, older age and a lower socioeconomic score were associated with a lower HAZ score. While fascioliasis and other helminths were associated with lower HAZ, they were not independent of the socioeconomic score.

Family Empowerment Model on Sensitive Nutrition Intervention for Stunting

“…However, if you look deeper, these two direct causes are greatly influenced by how the mother's parenting, food availability at the household level, and environmental sanitation [7][14] [15]. The results of Sri Supadmi's research (2018) concluded that several options related to stunting are optimising specific nutrition, sensitive nutrition and other factors such as maternal education, empowering mothers and communities through targeted advocacy at the regional level that refers to national health development program policies in a sustainable manner [16][17] [18]. The family is the first and main social environment for child development.…”

Relationship Between Economic Status, Infectious Diseases and Urinary Iodine Excretion with Stunting Incidence of Elementary School Children in IDD Endemic Areas, Enrekang Regency

“…The low purchasing power of food causes the lack of fulfilment of nutritional needs. The Large Epidemiological Study in Peru found lower socioeconomic status was associated with lower HAZ scores (12). 82 families had low incomes (<Rp.…”

Heavy Load of Intestinal Fluke in a Four-Year-Old Child with Severe Acute Malnutrition: A Case Report

“…She was found to have severe wasting with less than À3 z-score of the median World Health Organization (WHO) growth standard and was classified to have severe acute malnutrition (SAM). 9 Following hospitalization, a detailed history was taken, and the parents of the child denied any history of travel, the passage of any parasites in stool in the past, severe illnesses such as viral hepatitis, tuberculosis, or intake of any anti-helminthic medicines. Her stool was collected, and on macroscopic examination, the adult form of Fasciolopsis buski was identified (►Fig.…”