title: Childhood stunting in Northeast Brazil: the role of Schistosoma mansoni infection and inadequate dietary intake.
abstract: OBJECTIVE
  To evaluate the relationship between stunting, Schistosoma mansoni infection and dietary intake in schoolchildren.
  
  
  METHODS
  This is a cross-sectional study. Two stool samples were obtained from each child and examined quantitatively for the presence of S. mansoni, Ascaris lumbricoides and Trichuris trichiuria eggs. Information on dietary intake, and demographic, biologic and socioeconomic variables was elicited during the in-home survey. Logistic regression was used to evaluate the association between stunting (height for age < -2s.d.), parasitic infection and food consumption.
  
  
  METHODS
  The study was carried out in the city of Nazaré, located in the Recôncavo region of the State of Bahia, Northeastern Brazil.
  
  
  METHODS
  The sample consisted of 461 children 7-14 y old, 228 boys and 233 girls, recruited from public schools.
  
  
  RESULTS
  Of the children studied, 55.1% presented with S. mansoni infection and 22.1% were stunted. The median protein, lipid and carbohydrates intake were 47.8, 36.0 and 248.2 g/day, respectively. The median caloric consumption was 1527.0 kcal (6388.97 kJ/day). The analysis indicated that children heavily infected (> or = 400 eggs/g of stool) with S. mansoni had a 2.74-fold (95% CI: 1.32-5.67) higher risk of stunting than uninfected children, and those with inadequate intake of lipid (< 36 g/day) had a 1.83-fold (95% CI: 1.05-3.20) increased risk of stunting compared to those with adequate diets.
  
  
  CONCLUSIONS
  Heavy S. mansoni infection and inadequate dietary intake of fat in schoolchildren play a significant and independent role in the development of stunting. This meaning that nutritional interventions in this age group in S. mansoni endemic areas must include the diagnosis and treatment of the infection associated with dietary measures.
  
  
  BACKGROUND
  This study was supported by the Thrasher Foundation. Sandra Maria Conceição Pinheiro is a National Council on Technological Development Scholarship Awardee (CNPq), #302228/81-0.
authors.affiliation: The School of Nutrition, Federal University of Bahia, Salvador, Brazil. amos@ufba.br
authors.forename: A M O
authors.initials: AM
authors.lastname: Assis
authors.forename: M S
authors.initials: MS
authors.lastname: Prado
authors.forename: M L
authors.initials: ML
authors.lastname: Barreto
authors.forename: M G
authors.initials: MG
authors.lastname: Reis
authors.forename: S M
authors.initials: SM
authors.lastname: Conceição Pinheiro
authors.forename: I M
authors.initials: IM
authors.lastname: Parraga
authors.forename: R E
authors.initials: RE
authors.lastname: Blanton
mesh_terms: D000293:Adolescent; D000818:Animals; D001827:Body Height; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D003430:Cross-Sectional Studies; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005243:Feces / Q000469:parasitology; D005260:Female; D006130:Growth Disorders / Q000209:etiology*; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000150:complications* / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D012555:Schistosomiasis mansoni / Q000150:complications* / Q000453:epidemiology
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins