Anthelmintic treatment of rural Bangladeshi children: effect on host physiology, growth, and biochemical status.
BACKGROUND
The effect of helminth infestation on the nutrition, growth, and physiology of the host is still poorly understood. Anthelmintic treatment of children in developing countries has had varying success in terms of growth improvements.


OBJECTIVE
The objective of this study was to assess the effect of regular deworming on child growth, physiology, and biochemical status.


METHODS
The study was a 12-mo longitudinal intervention in 123 Bangladeshi children aged 2-5 y. Treatment (mebendazole) or placebo tablets were administered every 2 mo for 8 mo and again at 12 mo. Weight, height, midupper arm circumference, intestinal permeability, plasma albumin, alpha(1)-antichymotrypsin, and total protein concentration were assessed every 2 mo.


RESULTS
Treatment with mebendazole reduced the prevalence of Ascaris lumbricoides from 78% to 8%, of Trichuris trichiura from 65% to 9%, and of hookworm from 4% to 0%. There was no significant difference in the growth of treated children compared with those given placebo tablets. No changes in intestinal permeability or plasma albumin were observed after deworming. Significant decreases in total protein (P<0.001) and alpha(1)-antichymotrypsin (P<0.001) were observed in the treatment group, indicating possible reductions in inflammation and immunoglobulin concentration after deworming. A significant increase in the prevalence of Giardia intestinalis (from 4% to 49%) in the treatment group was associated with a short-term reduction in weight (P = 0.02) and higher intestinal permeability (P <0.001) in infected subjects. No long-term effects of G. intestinalis on growth were observed.


CONCLUSIONS
Low-intensity helminth infections, predominantly of A. lumbricoides and T. trichiura, do not contribute significantly to the poor growth and biochemical status of rural Bangladeshi children.
Northrop-Clewes
C A
CA
Human Nutrition Research Group, School of Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland, United Kingdom.
Rousham
E K
EK
Mascie-Taylor
C N
CN
Lunn
P G
PG
D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D000886:Anthropometry; D001196:Ascariasis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D017164:Ascaris lumbricoides / Q000187:drug effects; D001459:Bangladesh / Q000453:epidemiology; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D004311:Double-Blind Method; D005243:Feces / Q000469:parasitology; D005260:Female; D005873:Giardiasis / Q000453:epidemiology / Q000503:physiopathology; D006373:Helminthiasis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D006725:Hookworm Infections / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000187:drug effects; D008137:Longitudinal Studies; D008297:Male; D008463:Mebendazole / Q000627:therapeutic use*; D009752:Nutritional Status; D010270:Parasite Egg Count; D010539:Permeability; D015995:Prevalence; D012424:Rural Population; D014257:Trichuriasis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology
D000871:Anthelmintics; D008463:Mebendazole