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Subclinical Enteric Parasitic Infections and Growth Faltering in Infants in São Tomé, Africa: A Birth Cohort Study

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  • Marisol Garzón

    (Tropical Clinic Teaching and Research Unit, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa; 1349-008 Lisbon, Portugal
    Global Health and Tropical Medicine R&D Center, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa; 1349-008 Lisbon, Portugal)

  • Luís Pereira-da-Silva

    (Medicine of Woman, Childhood and Adolescence Teaching and Research Area, NOVA Medical School, Universidade NOVA de Lisboa; 1169-056 Lisbon, Portugal
    Research Unit, Centro Hospitalar de Lisboa Central; 1169-045 Lisbon, Portugal)

  • Jorge Seixas

    (Tropical Clinic Teaching and Research Unit, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa; 1349-008 Lisbon, Portugal
    Global Health and Tropical Medicine R&D Center, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa; 1349-008 Lisbon, Portugal)

  • Ana Luísa Papoila

    (Research Unit, Centro Hospitalar de Lisboa Central; 1169-045 Lisbon, Portugal)

  • Marta Alves

    (Research Unit, Centro Hospitalar de Lisboa Central; 1169-045 Lisbon, Portugal)

Abstract

The associations between enteric pathogenic parasites and growth in infants in São Tomé were explored using a refined anthropometric approach to recognize early growth faltering. A birth cohort study was conducted with follow-up to 24 months of age. Microscopic examination for protozoa and soil-transmitted helminths was performed. Anthropometric assessments included: z-scores for weight-for-length (WLZ), length-for-age (LAZ), weight (WAVZ) and length velocities (LAVZ), length-for-age difference (LAD), and wasting and stunting risk (≤−1 SD). Generalized additive mixed effects regression models were used to explore the associations between anthropometric parameters and enteric parasitic infections and cofactors. A total of 475 infants were enrolled, and 282 completed the study. The great majority of infants were asymptomatic. Giardia lamblia was detected in 35.1% of infants in at least one stool sample, helminths in 30.4%, and Cryptosporidium spp. in 14.7%. Giardia lamblia and helminth infections were significantly associated with mean decreases of 0.10 in LAZ and 0.32 in LAD, and of 0.16 in LAZ and 0.48 in LAD, respectively. Cryptosporidium spp. infection was significantly associated with a mean decrease of 0.43 in WAVZ and 0.55 in LAVZ. The underestimated association between subclinical parasitic enteric infections and mild growth faltering in infants should be addressed in public health policies.

Suggested Citation

  • Marisol Garzón & Luís Pereira-da-Silva & Jorge Seixas & Ana Luísa Papoila & Marta Alves, 2018. "Subclinical Enteric Parasitic Infections and Growth Faltering in Infants in São Tomé, Africa: A Birth Cohort Study," IJERPH, MDPI, vol. 15(4), pages 1-16, April.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:4:p:688-:d:139723
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