Effect of deworming on school-aged children’s physical fitness, cognition and clinical parameters in a malaria-helminth co-endemic area of Côte d’Ivoire

BMC Infectious Diseases

Jürg Utzinger²  Giovanna Raso³  Eliézer K N’Goran¹  Kigbafori D Silué¹  Peiling Yap²  Jean T Coulibaly¹  Dominique Bänninger²  Prisca B N’Dri⁴  Clarisse A Houngbedji⁴  Eveline Hürlimann³ 

[1] Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire;University of Basel, Basel, Switzerland;Département Environnement et Santé, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire;Unité de Formation et de Recherche Sciences de la Nature, Université Nangui Abrogoua, Abidjan, Côte d’Ivoire

关键词: Physical fitness;    Malnutrition;    Malaria;    Helminth;    Deworming;    Côte d’Ivoire;    Co-infection;    Cognition;    Anaemia;   

Others  :  1127286
DOI  :  10.1186/1471-2334-14-411

 received in 2014-03-11, accepted in 2014-07-09,  发布年份 2014

【 摘 要 】

Background

Malaria and helminth infections are thought to negatively affect children’s nutritional status and to impair their physical and cognitive development. Yet, the current evidence-base is weak. The purpose of this study was to determine the effect of deworming against soil-transmitted helminthiasis and schistosomiasis on children’s physical fitness, cognition and clinical parameters in a malaria-helminth co-endemic setting of Côte d’Ivoire.

Methods

We designed an intervention study with a 5-month follow-up among schoolchildren aged 5–14 years from Niablé, eastern Côte d’Ivoire. In late 2012, a baseline cross-sectional survey was conducted. Finger-prick blood, stool and urine samples were subjected to standardised, quality-controlled techniques for the diagnosis of Plasmodium spp., Schistosoma spp., soil-transmitted helminths and intestinal protozoa infections. Haemoglobin level was determined and anthropometric measurements were taken for appraisal of anaemia and nutritional status. Children underwent memory (digit span) and attention (code transmission) cognitive testing, and their physical fitness and strength were determined (20 m shuttle run, standing broad jump and grip strength test). All children were treated with albendazole (against soil-transmitted helminthiasis) and praziquantel (against schistosomiasis) after the baseline cross-sectional survey and again 2 months later. Five months after the initial deworming, the same battery of clinical, cognitive and physical fitness tests was performed on the same children.

Results

Lower scores in strength tests were significantly associated with children with harbouring nutritional deficiencies. Surprisingly, boys infected with Schistosoma mansoni achieved longer jumping distances than their non-infected counterparts. Light-intensity infection with S. mansoni was associated with slightly better aerobic capacity. Deworming showed no effect on haemoglobin levels and anaemia, but children with moderate- to heavy-intensity Schistosoma infection at baseline gained weight more pronouncedly than non-infected children. Interestingly, children with soil-transmitted helminth or Schistosoma infection at baseline performed significantly better in the sustained attention test than their non-infected counterparts at the 5-month follow-up.

Conclusions

This study revealed conflicting results regarding clinical parameters and cognitive behaviour of children after two rounds of deworming. We speculate that potential beneficial effects of deworming are likely to be undermined in areas where malaria is co-endemic and nutritional deficiencies are widespread.

【 授权许可】

   
2014 Hürlimann et al.; licensee BioMed Central Ltd.

【 图 表 】

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