Nutritional status improves after treatment of Schistosoma japonicum -: Infected children and adolescents

被引:40
作者
Coutinho, HM [1 ]
Acosta, LP
McGarvey, ST
Jarilla, B
Jiz, M
Pablo, A
Su, L
Manalo, DL
Olveda, RM
Kurtis, JD
Friedman, JF
机构
[1] Brown Univ, Sch Med, CIHR, Providence, RI 02912 USA
[2] Brown Univ, Sch Med, Dept Pathol & Lab Med, Providence, RI 02912 USA
[3] Brown Univ, Rhode Isl Hosp, Sch Med, Dept Pediat, Providence, RI 02912 USA
[4] Res Inst Trop Med, Manila, Philippines
[5] Brown Univ, Int Hlth Inst, Providence, RI 02912 USA
[6] Brown Univ, Ctr Stat Sci, Providence, RI 02912 USA
关键词
Schistosoma japonicum; praziquantel; nutritional status; longitudinal;
D O I
10.1093/jn/136.1.183
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 [营养与食品卫生学];
摘要
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 (0.12-0.21) 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.
引用
收藏
页码:183 / 188
页数:6
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