Abstract

BackgroundHelminthic and protozoan infections are common, particularly in low- or middle-income countries. Although an association between parasite carriage and markers of poor growth have been shown in some studies, systematic reviews have suggested only a modest impact of clearing carriage. The prevalence of these pathogens and the effect that they have on growth in preschool children has never been investigated in Malawi.MethodsOne hundred ninety-three children aged 0–72 months were randomly recruited from rural villages in the Mangochi district of Malawi. Formol-ether concentration was performed on stool and the samples examined with a light microscope. Anthropometric data was taken for each child and the haemoglobin measured with a point of care test.ResultsThe mean age of the children was 2 years 4 months. Overall prevalence of intestinal parasite infection was 37.3%. Protozoa were found in 28.5% of children, while helminths were found in 8.8%. The most commonly found organisms were Giardia lambia (12.4%), Entamoeba coli (10.4%) and Hookworm species (3.6%). Stunting was seen in 47.8% of children, 12.9% were underweight and 5.0% were wasted. No significant association was found between markers of poor growth and infection with any intestinal parasite.ConclusionsWe found that prevalence of helminth infection was low in preschool children living in the Mangochi district compared to international standards. However a significant proportion of the preschool population are infected with protozoa, particularly Giardia lambia. In this cohort, despite a significant prevalence of stunting, helminth infection was not significantly associated with any markers of poor growth. The significance of protozoal carriage and contribution to growth restriction in this context creates further avenues for future research.

Highlights

  • Helminthic and protozoan infections are common, in low- or middle-income countries

  • This study found a low prevalence of helminthic infection in preschool children compared to international guidelines from the WHO [19]

  • The finding of a low prevalence of helminthic infection in preschool children in this region of Malawi would be in line with the more recent epidemiological surveys that have been performed on school aged children, which reported a prevalence of soil-transmitted helminths of just 1.8% [13]

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Summary

Introduction

Helminthic and protozoan infections are common, in low- or middle-income countries. An association between parasite carriage and markers of poor growth have been shown in some studies, systematic reviews have suggested only a modest impact of clearing carriage. The prevalence of these pathogens and the effect that they have on growth in preschool children has never been investigated in Malawi. Diarrhoeal diseases are the fifth leading cause of under 5 mortality worldwide, with the highest rates of death in Africa and Asia. Mass drug administration protocols from the WHO advocate treatment of communities where prevalence of soil-transmitted helminths is > 20% These endeavour to target both direct effects on growth

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