Intestinal helminthiasis and nutritional status including iron, zinc and copper in Papua New Guinea urban children aged 1 to 5 years and effect of anthelmintic intervention
Shield, J.; Karr, M.; Kimber, R.; Casey, G.; Dreosti, I.
Papua and New Guinea Medical Journal 29(4): 317-331
1986
ISSN/ISBN: 0031-1480 PMID: 3469822 Document Number: 271484
In a study group of 281 urban children aged 1-5 years in Papua new Guinea, 58% were infected with hookworm, Necator americanus, 36% had Strongyloides ssp., mostly Strongyloides stercoralis with 2% identified as Strongyloides fuelleborni-like, 5% had Ascaris lumbricoides and 18% had Trichuris trichiura. Overall, 70% were infected with intestinal parasitic nematodes. The means of indices of nutritional status were as follows: standard weight-for-age 83.9%, length-for-age 93.5%, weight-for-length 93.5%, haemoglobin 10.3g/dl, PCV 31.7%, MCHC 32.2%, WBC 15.38 .times. 103/ml, serum ferritin 20.1.mu.g/l, serum transferrin 34.6 .mu.mol/l, serum zinc 0.89 .mu.g/ml and serum copper 2.18 .mu.g/ml. Malaria was present in 23% of blood slides and 67% had eosinophil counts of more than 600/.mu.l, 68% of blood sites showed some anisocytosis, 64% hypochromia and 11% microcytosis. There was a statistically significant association of below 80% weight-for-age with N. americanus of more than 2,000 eggs/g faeces, and a statistically significant negative correlation of egg/larva counts of N. americanus, Strongyloides spp. and T. trichiura with weight-for-age, length-for-age and weight-for-length in two-thirds of the combinations. Haemoglobin levels were significantly negatively correlated with egg counts of N. americanus and T. trichiura and PCV with N. americanus; haemoglobin of less than 10 g/dl, PCV of less than 25% and the presence of anisocytosis and hypochromia were associated with egg counts of N. americanus of greater than 2,000/g faeces. Serum copper was significantly negatively correlated with weight-for-age and length-for-age. Infected children were offered anthelmintic treatment of 1/4 .times. 125 mg tab pyrantel pamoate with 1 1/2 .times. 150 mg tabs mebendazole on 3 consecutive work days, from 3 months after the initial assessment and again 3 months later, and were examined finally 8 months after the original assessment. There was no statistically significant change in weight-for-age, length-for-age, PCV or red cell morphology either before treatment or after treatment. In serum ferritin and transferrin analyses, there was a significant difference in a treated group with medium egg count (N. americanus plus T. trichiura) where serum ferritin fell significantly after treatment and serum transferrin rose significantly before treatment and fell significantly after treatment. There was a significant fall in serum copper levels after treatment but no significant change in serum zinc levels. Although the anthelmintic treatment was effective, there was no noticeable effect on prevalence rates until 5 months after initial treatment, due to reinfection in many subjects. The results showed that a 5-month deworming program had little effect on nutritional stauts, but suggest that a long-term program could be beneficial.