title: Effects of Cryptosporidium parvum infection in Peruvian children: growth faltering and subsequent catch-up growth.
abstract: The authors conducted a 2-year (1989-1991) community-based longitudinal study in a shantytown in Lima, Peru, to examine the effect of Cryptosporidium parvum infection on child growth during the year following the onset of infection. A cohort of children, aged 0-3 months at recruitment, was followed monthly for anthropometrics, weekly for stool samples, and daily for diarrheal status. Data from 185 children in the cohort permitted a comparison of growth in C. parvum-infected and noninfected children. The analyses fitted smooth, flexible curves with a linear random-effects model to estimate growth differences between C. parvum-infected and noninfected children. Children infected with C. parvum experienced growth faltering, both in weight and in height, for several months after the onset of infection, followed by a period of catch-up growth. Younger children took longer to catch up in weight than did older children. Catch-up growth, however, did not occur in children infected between ages 0 and 5 months. These children did not catch up in height, and one year after infection they exhibited an average deficit of 0.95 cm (95% confidence interval (CI) 0.38-1.53) relative to noninfected children of similar age. Stunted children who became infected also did not catch up in either weight or height, and one year after infection they exhibited a height deficit of 1.05 cm (95% CI 0.46-1.66) relative to noninfected, stunted children of similar age. These results indicate that Cryptosporidium parvum has a lasting adverse effect on linear (height) growth, especially when acquired during infancy and when children are stunted before they become infected.
authors.affiliation: Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205, USA.
authors.forename: W
authors.initials: W
authors.lastname: Checkley
authors.forename: L D
authors.initials: LD
authors.lastname: Epstein
authors.forename: R H
authors.initials: RH
authors.lastname: Gilman
authors.forename: R E
authors.initials: RE
authors.lastname: Black
authors.forename: L
authors.initials: L
authors.lastname: Cabrera
authors.forename: C R
authors.initials: CR
authors.lastname: Sterling
mesh_terms: D000818:Animals; D000886:Anthropometry; D002675:Child, Preschool; D003457:Cryptosporidiosis / Q000503:physiopathology*; D016785:Cryptosporidium parvum; D006128:Growth; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D009752:Nutritional Status; D010568:Peru; D012044:Regression Analysis