title: Early helminth infections are inversely related to anemia, malnutrition, and malaria and are not associated with inflammation in 6- to 23-month-old Zanzibari children.
abstract: Helminths aggravate anemia and malnutrition among school children. We studied this association in a cross-sectional study of 6- to 23-month-old Zanzibari children (N = 2322) and a sub-sample of 690 children matched on age and helminth infection status. Ascaris, hookworm, and Trichuris infections were diagnosed along with recent fever, malaria infection, mid-upper arm circumference (MUAC) and hemoglobin concentration (Hb). Alpha-1-acid glycoprotein (AGP), C-reactive protein (CRP), height, and weight were measured in the sub-sample. Infected children had higher Hb (beta = 5.44 g/L, P < 0.001) and MUAC-for-age Z score (beta = 0.30 Z, P < 0.001) compared with uninfected children after adjusting for covariates. Although helminths were not associated with inflammation, their association with Hb or MUAC-for-age Z score was modified by inflammation. Malaria-infected children were less likely to be infected with helminths (adjusted odds ratios 0.63 [95% confidence interval: 0.49, 0.81]). Non-anemic, better nourished, or non-malaria-infected children may be more exploratory of their environments and therefore increase their exposure to soil-transmitted helminths.
authors.affiliation: Cornell University, Division of Nutritional Sciences, Ithaca, New York 14853, USA. jm453@cornell.edu
authors.forename: Jacqueline K
authors.initials: JK
authors.lastname: Kung'u
authors.forename: David
authors.initials: D
authors.lastname: Goodman
authors.forename: Hamad J
authors.initials: HJ
authors.lastname: Haji
authors.forename: Mahdi
authors.initials: M
authors.lastname: Ramsan
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Wright
authors.forename: Quentin D
authors.initials: QD
authors.lastname: Bickle
authors.forename: James M
authors.initials: JM
authors.lastname: Tielsch
authors.forename: John G
authors.initials: JG
authors.lastname: Raynes
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Stoltzfus
mesh_terms: D000740:Anemia / Q000150:complications* / Q000453:epidemiology; D000818:Animals; D006373:Helminthiasis / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007228:Infant Nutrition Disorders / Q000150:complications* / Q000453:epidemiology; D007249:Inflammation / Q000150:complications* / Q000453:epidemiology; D008288:Malaria / Q000150:complications* / Q000453:epidemiology; D013636:Tanzania / Q000453:epidemiology