Subclinical enteric parasitic infections and growth faltering in infants in São Tomé, Africa: a birth cohort study
Open accessAbstract
The associations between enteric pathogenic parasites and growth in infants in São Tomé were explored using a refined anthropometric approach to recognize early growth faltering. A birth cohort study was conducted with follow-up to 24 months of age. Microscopic examination for protozoa and soil-transmitted helminths was performed. Anthropometric assessments included: z-scores for weight-for-length (WLZ), length-for-age (LAZ), weight (WAVZ) and length velocities (LAVZ), length-for-age difference (LAD), and wasting and stunting risk (≤−1 SD). Generalized additive mixed effects regression models were used to explore the associations between anthropometric parameters and enteric parasitic infections and cofactors. A total of 475 infants were enrolled, and 282 completed the study. The great majority of infants were asymptomatic. Giardia lamblia was detected in 35.1% of infants in at least one stool sample, helminths in 30.4%, and Cryptosporidium spp. in 14.7%. Giardia lamblia and helminth infections were significantly associated with mean decreases of 0.10 in LAZ and 0.32 in LAD, and of 0.16 in LAZ and 0.48 in LAD, respectively. Cryptosporidium spp. infection was significantly associated with a mean decrease of 0.43 in WAVZ and 0.55 in LAVZ. The underestimated association between subclinical parasitic enteric infections and mild growth faltering in infants should be addressed in public health policies.
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There might be multiple additional mechanisms by which WASH could contribute to undernutrition, such as via parasitic infections, asymptomatic carriage of certain enteric pathogens, and environmental enteric dysfunction.
“There might be multiple additional mechanisms by which WASH could contribute to undernutrition, such as via parasitic infections,53 the asymptomatic carriage of certain enteric pathogens,48 and environmental enteric dysfunction.12, 54”
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- Authors
- Garzón, M., Pereira-da-Silva, L., Seixas, J., Papoila, A., & Alves, M.
- Affiliations
- Universidade Nova de Lisboa (PT)
- Unidade Local de Saúde de São José (PT)
- Corresponding author
- Pereira-da-Silva, Luís
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2018-04-05
- Volume
- 15
- Issue
- 4
- Pages
- 688
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC5923730
- OpenAlex
- W2795480121
- Cited by
- 28
- References
- 57
- Citations by year
- 2026: 1 · 2025: 4 · 2023: 5 · 2022: 2 · 2021: 7 · 2020: 3 · 2019: 5 · 2018: 1
- FWCI
- 3.31
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Universidade Nova de Lisboa
- Fundação para a Ciência e a Tecnologia (SFRH/BD/81431/2011)
- Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Life Sciences › Immunology and Microbiology › Parasitology › Parasitic Infections and Diagnostics
- Life Sciences › Immunology and Microbiology › Parasitology › Parasites and Host Interactions
- Keywords
- infant growth faltering, Giardia lamblia, soil-transmitted helminths, Cryptosporidium, stunting, wasting, length-for-age z-score, weight-for-length
- MeSH terms
- Sao Tome and Principe, Animals, Anthropometry, Body Weight, Child Development, Child, Preschool, Female, Helminthiasis, Humans, Infant, Infant, Newborn, Intestinal Diseases, Parasitic, Male, Parasitic Diseases, Pregnancy, Cohort Studies, Giardia lamblia, Asymptomatic Infections
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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