title: Wealth and its associations with enteric parasitic infections in a low-income community in Peru: use of principal component analysis.
abstract: The association of wealth and infections with Giardia, Cryptosporidium, Cyclospora, and microsporidia were examined in a longitudinal cohort conducted in Peru from 2001 to 2006. Data from 492 participants were daily clinical manifestations, weekly copro-parasitological diagnosis, and housing characteristics and assets owned (48 variables), and these data were used to construct a global wealth index using principal component analysis. Data were analyzed using continuous and categorical (wealth tertiles) models. Participant's mean age was 3.43 years (range = 0-12 years), with average follow-up of 993 days. Univariate and multivariate analyses identified significant associations between wealth and infections with Giardia and microsporidia. Participants with greater wealth indexes were associated with protection against Giardia (P < 0.001) and persistent Giardia infections (> 14 days). For microsporidia, greater wealth was protective (P = 0.066 continuous and P = 0.042 by tertiles). Contrarily, infections with Cryptosporidium and Cyclospora were independent of wealth. Thus, subtle differences in wealth may affect the frequency of specific parasitic infections within low-income communities.
authors.affiliation: Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland, USA. shantanu.nundy@gmail.com
authors.forename: Shantanu
authors.initials: S
authors.lastname: Nundy
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
authors.forename: Lihua
authors.initials: L
authors.lastname: Xiao
authors.forename: Lilia
authors.initials: L
authors.lastname: Cabrera
authors.forename: Rosa
authors.initials: R
authors.lastname: Cama
authors.forename: Ynes R
authors.initials: YR
authors.lastname: Ortega
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Kahn
authors.forename: Vitaliano A
authors.initials: VA
authors.lastname: Cama
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003457:Cryptosporidiosis / Q000191:economics / Q000453:epidemiology; D021866:Cyclosporiasis / Q000191:economics / Q000453:epidemiology; D003967:Diarrhea / Q000453:epidemiology / Q000469:parasitology; D005260:Female; D005873:Giardiasis / Q000191:economics / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007411:Intestinal Diseases, Parasitic / Q000191:economics* / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010568:Peru / Q000453:epidemiology; D011203:Poverty / Q000191:economics / Q000706:statistics & numerical data*; D025341:Principal Component Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors