Nutritional status improves after treatment of schistosoma japonicum-infected children and adolescents.
Studies addressing the relation between chronic schistosomiasis japonica and nutritional status are limited. We conducted a longitudinal treatment-reinfection study in Leyte, the Philippines, among 477 Schistosoma japonicum-infected subjects aged 7-20 y, to evaluate changes in nutritional status after treatment with praziquantel. Stool, Tanner stage, anthropometric indices, and hemoglobin (Hb) were evaluated at baseline, 4 wk post-treatment, and every 3 mo for 18 mo. Height-for-age Z-score (HAZ) and BMI Z-score (BMIZ) were calculated. Change scores relative to baseline were created for all outcome measures. Multilevel repeated-measures analyses were used to adjust for socioeconomic status, sex, either pubertal status or age, and household-level clustering. Z-scores improved modestly but significantly over time. BMIZ in children wasted at baseline improved the most [0.41 (0.26-0.56) Z-score unit] and HAZ improved only in children stunted at baseline [0.17 (0.l2-0.21) Z-score unit]. Hb improvement peaked at 15 mo and occurred only in subjects that were anemic at baseline [peak improvement: 8.3 (6.0-10.6) g/L] and in males [peak improvement 4.7 (2.9-6.6) g/L]. Reinfection, evaluated as egg count over time and egg count 3 mo earlier to assess a delay in effect, was inversely associated with improvement in Hb (P = 0.06 and 0.004, respectively). High-intensity reinfection at 18 mo was associated with significantly less absolute growth from baseline compared with lower-intensity and no reinfection. Based on the peak Hb improvement at 15 mo post-treatment, annual treatment intervals are recommended to reduce schistosomiasis-associated nutritional morbidity.
Coutinho
Hannah M
HM
Center for International Health Research, Brown University Medical School, Providence, RI, USA. hannah_coutinho@Brown.edu
Acosta
Luz P
LP
McGarvey
Stephen T
ST
Jarilla
Blanca
B
Jiz
Mario
M
Pablo
Archie
A
Su
Li
L
Manalo
Daria L
DL
Olveda
Remigio M
RM
Kurtis
Jonathan D
JD
Friedman
Jennifer F
JF
D000293:Adolescent; D000328:Adult; D000871:Anthelmintics / Q000627:therapeutic use*; D002648:Child; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009752:Nutritional Status; D010270:Parasite Egg Count; D010679:Philippines; D011223:Praziquantel / Q000627:therapeutic use*; D012554:Schistosomiasis japonica / Q000188:drug therapy*; D015430:Weight Gain
D000871:Anthelmintics; D011223:Praziquantel