Soil-Transmitted Helminth Infections and Nutritional Status in School-age Children from Rural Communities in Honduras

Background: Soil-transmitted helminth (STH) infections are endemic in Honduras and efforts are underway to decrease their transmission. However, current evidence is lacking in regards to their prevalence, intensity and their impact on children’s health. Objectives: To evaluate the prevalence and intensity of STH infections and their association with nutritional status in a sample of Honduran children. Methodology: A cross-sectional study was done among school-age children residing in rural communities in Honduras, in 2011. Demographic data was obtained, hemoglobin and protein concentrations were determined in blood samples and STH infections investigated in single-stool samples by Kato-Katz. Anthropometric measurements were taken to calculate heightfor- age (HAZ), BMI-for-age (BAZ) and weight-for-age (WAZ) to determine stunting, thinness and underweight, respectively. Results: Among 320 children studied (48% girls, aged 7–14 years, mean 9.7661.4) an overall STH prevalence of 72.5% was found. Children .10 years of age were generally more infected than 7–10 year-olds (p = 0.015). Prevalence was 30%, 67% and 16% for Ascaris, Trichuris and hookworms, respectively. Moderate-to-heavy infections as well as polyparasitism were common among the infected children (36% and 44%, respectively). Polyparasitism was four times more likely to occur in children attending schools with absent or annual deworming schedules than in pupils attending schools deworming twice a year (p,0.001). Stunting was observed in 5.6% of children and it was associated with increasing age. Also, 2.2% of studied children were thin, 1.3% underweight and 2.2% had anemia. Moderate-to-heavy infections and polyparasitism were significantly associated with decreased values in WAZ and marginally associated with decreased values in HAZ. Conclusions: STH infections remain a public health concern in Honduras and despite current efforts were highly prevalent in the studied community. The role of multiparasite STH infections in undermining children’s nutritional status warrants more research

Soil-Transmitted Helminths, Poverty, and Malnutrition in Honduran Children Living in Remote Rural Communities

Soil-transmitted helminth (STH) infections are endemic in Honduras, but their prevalence according to the levels of poverty in the population has not been examined. The present cross-sectional study is aimed to determine the role of different levels of poverty in STH prevalence and infection intensity as well as the potential associations of STH infections with malnutrition and anemia. Research participants were children attending a medical brigade serving remote communities in Northern Honduras in June 2014. Demographic data were obtained, and poverty levels were determined using the unsatisfied basic needs method. STH infections were investigated by the Kato-Katz method; hemoglobin concentrations were determined with the HemoCue system; and stunting, thinness, and underweight were determined by anthropometry. Data were analyzed using descriptive statistics and univariate and multivariable logistic regression models. Among 130 children who participated in this study, a high prevalence (69.2%) of parasitism was found and the poorest children were significantly more infected than those living in less poor communities (79.6% vs. 61.8%; P = 0.030). Prevalence rates of Trichuris trichiura, Ascaris lumbricoides, and hookworms were 69.2%, 12.3%, and 3.85%, respectively. In total, 69% of children had anemia and 30% were stunted. Households’ earthen floor and lack of latrines were associated with infection. Greater efforts should be made to reduce STH prevalence and improve overall childhood health, in particular, among the poorest children lacking the basic necessities of life

Soil-Transmitted Helminth Infections and Nutritional Status in School-age Children from Rural Communities in Honduras

<div><p>Background</p><p>Soil-transmitted helminth (STH) infections are endemic in Honduras and efforts are underway to decrease their transmission. However, current evidence is lacking in regards to their prevalence, intensity and their impact on children's health.</p><p>Objectives</p><p>To evaluate the prevalence and intensity of STH infections and their association with nutritional status in a sample of Honduran children.</p><p>Methodology</p><p>A cross-sectional study was done among school-age children residing in rural communities in Honduras, in 2011. Demographic data was obtained, hemoglobin and protein concentrations were determined in blood samples and STH infections investigated in single-stool samples by Kato-Katz. Anthropometric measurements were taken to calculate height-for-age (HAZ), BMI-for-age (BAZ) and weight-for-age (WAZ) to determine stunting, thinness and underweight, respectively.</p><p>Results</p><p>Among 320 children studied (48% girls, aged 7–14 years, mean 9.76±1.4) an overall STH prevalence of 72.5% was found. Children >10 years of age were generally more infected than 7–10 year-olds (<i>p</i> = 0.015). Prevalence was 30%, 67% and 16% for <i>Ascaris</i>, <i>Trichuris</i> and hookworms, respectively. Moderate-to-heavy infections as well as polyparasitism were common among the infected children (36% and 44%, respectively). Polyparasitism was four times more likely to occur in children attending schools with absent or annual deworming schedules than in pupils attending schools deworming twice a year (<i>p</i><0.001). Stunting was observed in 5.6% of children and it was associated with increasing age. Also, 2.2% of studied children were thin, 1.3% underweight and 2.2% had anemia. Moderate-to-heavy infections and polyparasitism were significantly associated with decreased values in WAZ and marginally associated with decreased values in HAZ.</p><p>Conclusions</p><p>STH infections remain a public health concern in Honduras and despite current efforts were highly prevalent in the studied community. The role of multiparasite STH infections in undermining children's nutritional status warrants more research.</p></div

Adjusted coefficients (β) from multivariable GEE linear models of anthropometric indicators, accounting for within-school clustering.

<p>GEE: Generalized estimating equations.</p><p>HAZ: height-for-age Z-score; BAZ: BMI-for-age Z-score; WAZ: weight-for-age Z-score.</p>†<p>WAZ calculation is not recommended for children >10 years of age.</p>a<p>Age as continuous variable in years.</p>b<p>SES: Socio-economic status. Factor constructed as described in ‘<a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002378#s2" target="_blank">Methods</a>’ section.</p

Demographic, household and nutritional characteristics of the study sample according to STH infection.

a<p>For continuous variables, values in parentheses are the standard deviation.</p>b<p>Independent <i>t</i>-test used for continuous variables and chi-square test used for categorical variables.</p>c<p>One-way ANOVA used for continuous variables and chi-square test used for categorical variables.</p>d<p>WAZ calculation is not recommended for children >10 years of age.</p