Intestinal parasites, growth and physical fitness of schoolchildren in poor neighbourhoods of Port Elizabeth, South Africa: a cross-sectional survey.
As traditional lifestyle and diets change with social and economic development, disadvantaged communities in low- and middle-income countries increasingly face a double burden of communicable and non-communicable diseases. We studied the relationship between physical fitness and infections with soil-transmitted helminths (STHs), intestinal protozoa and Helicobacter pylori among schoolchildren in Port Elizabeth, South Africa.



We conducted a cross-sectional survey among 1009 children, aged 9 to 12 years, from eight primary schools in socioeconomically disadvantaged neighbourhoods of Port Elizabeth. Physical fitness was determined using field-deployable tests of the Eurofit fitness test battery. Stool samples were analysed with the Kato-Katz thick smear technique to diagnose STHs and with rapid diagnostic tests (RDTs) to detect intestinal protozoa and H. pylori infections. Haemoglobin (Hb) levels were assessed and anthropometric indicators determined.



Complete data were available for 934 children (92 %). In two schools, high STH prevalences were found (Ascaris lumbricoides 60 and 72 %; Trichuris trichiura 65 % each). For boys and girls co-infected with A. lumbricoides and T. trichiura (n = 155) the maximal oxygen uptake (VO2 max) was estimated to be 50.1 and 47.2 ml kg(-1) min(-1), compared to 51.5 and 47.4 ml kg(-1) min(-1) for their non-infected peers (n = 278), respectively. On average, children without helminth infections had greater body mass (P = 0.011), height (P = 0.009) and a higher body mass index (P = 0.024) and were less often stunted (P = 0.006), but not significantly less wasted compared to their peers with a single or dual species infection. Among 9-year-old boys, a negative correlation between helminth infections and VO2 max, grip strength and standing broad jump distance was observed (P = 0.038). The overall mean Hb level was 122.2 g l(-1). In the two schools with the highest prevalence of STHs the Hb means were 119.7 and 120.5 g l(-1), respectively.



Intestinal parasite infections appear to have a small but significant negative effect on the physical fitness of infected children, as expressed by their maximal oxygen uptake. We observed a clear impact on anthropometric indicators.
Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland.|University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.|Department of Sport, Exercise and Health, University of Basel, St. Jakobsturm, Birsstrasse 320B, CH-4056, Basel, Switzerland.
Ivan
I
Müller
Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland.|University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.|Institute of Infectious Disease and Epidemiology, Tan Tock Seng Hospital, 308433, Singapore, Singapore.
Peiling
P
Yap
Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland.|University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.
Peter
P
Steinmann
Faculty of Education, Nelson Mandela Metropolitan University, P.O. Box 77000, Port Elizabeth, 6031, South Africa.|Department of Human Movement Science, Nelson Mandela Metropolitan University, P.O. Box 77000, Port Elizabeth, 6031, South Africa.
Bruce P
BP
Damons
Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland.|University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.
Christian
C
Schindler
University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.|Department of Sport, Exercise and Health, University of Basel, St. Jakobsturm, Birsstrasse 320B, CH-4056, Basel, Switzerland.
Harald
H
Seelig
Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland.|University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.
Nan S N
NS
Htun
Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland.|University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.
Nicole
N
Probst-Hensch
University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.|Department of Sport, Exercise and Health, University of Basel, St. Jakobsturm, Birsstrasse 320B, CH-4056, Basel, Switzerland.
Markus
M
Gerber
Department of Human Movement Science, Nelson Mandela Metropolitan University, P.O. Box 77000, Port Elizabeth, 6031, South Africa.
Rosa
R
du Randt
University of Basel, P.O. Box, , CH-4003, Basel, Switzerland.|Department of Sport, Exercise and Health, University of Basel, St. Jakobsturm, Birsstrasse 320B, CH-4056, Basel, Switzerland.
Uwe
U
Pühse
Department of Human Movement Science, Nelson Mandela Metropolitan University, P.O. Box 77000, Port Elizabeth, 6031, South Africa.
Cheryl
C
Walter
Swiss Tropical and Public Health Institute, P.O. Box, , CH-4002, Basel, Switzerland. juerg.utzinger@unibas.ch.|University of Basel, P.O. Box, , CH-4003, Basel, Switzerland. juerg.utzinger@unibas.ch.
Jürg
J
Utzinger
D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D060085:Coinfection / Q000453:epidemiology / Q000469:parasitology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005243:Feces / Q000469:parasitology; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006373:Helminthiasis / Q000150:complications / Q000453:epidemiology / Q000469:parasitology / Q000503:physiopathology*; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000150:complications / Q000453:epidemiology / Q000469:parasitology / Q000503:physiopathology*; D008297:Male; D010809:Physical Fitness; D011204:Poverty Areas; D011528:Protozoan Infections / Q000150:complications / Q000453:epidemiology / Q000469:parasitology / Q000503:physiopathology*; D012987:Soil / Q000469:parasitology; D013019:South Africa / Q000453:epidemiology; D013334:Students
D012987:Soil
Anthropometric indicators; Haemoglobin; Intestinal polyparasitism; Intestinal protozoa; Physical fitness; Soil-transmitted helminths; South Africa