Abstract
BackgroundThere is considerable debate on the health impacts of soil-transmitted helminth infections. We assessed effects of deworming on physical fitness and strength of children in an area in Yunnan, People's Republic of China, where soil-transmitted helminthiasis is highly endemic.MethodologyThe double-blind, randomized, placebo-controlled trial was conducted between October 2011 and May 2012. Children, aged 9–12 years, were treated with either triple-dose albendazole or placebo, and monitored for 6 months post-treatment. The Kato-Katz and Baermann techniques were used for the diagnosis of soil-transmitted helminth infections. Physical fitness was assessed with a 20-m shuttle run test, where the maximum aerobic capacity within 1 min of exhaustive exercise (VO2 max estimate) and the number of 20-m laps completed were recorded. Physical strength was determined with grip strength and standing broad jump tests. Body height and weight, the sum of skinfolds, and hemoglobin levels were recorded as secondary outcomes.Principal FindingsChildren receiving triple-dose albendazole scored slightly higher in the primary and secondary outcomes than placebo recipients, but the difference lacked statistical significance. Trichuris trichiura-infected children had 1.6 ml kg−1 min−1 (P = 0.02) less increase in their VO2 max estimate and completed 4.6 (P = 0.04) fewer 20-m laps than at baseline compared to non-infected peers. Similar trends were detected in the VO2 max estimate and grip strength of children infected with hookworm and Ascaris lumbricoides, respectively. In addition, the increase in the VO2 max estimate from baseline was consistently higher in children with low-intensity T. trichiura and hookworm infections than in their peers with high-intensity infections of all soil-transmitted helminths (range: 1.9–2.1 ml kg−1 min−1; all P<0.05).Conclusions/SignificanceWe found no strong evidence for significant improvements in physical fitness and anthropometric indicators due to deworming over a 6-month follow-up period. However, the negative effect of T. trichiura infections on physical fitness warrants further investigation.
Highlights
Soil-transmitted helminths, namely Ascaris lumbricoides, Trichuris trichiura, and the hookworms (Ancylostoma duodenale and Necator americanus), are the most common parasitic worm infections of humans
The global burden of soil-transmitted helminthiasis is currently estimated at 5.2 million disability-adjusted life years (DALYs), mainly due to sub-clinical morbidities, and anemia and reduced cognitive and physical development [7,8,9]
Children from the developing world are often burdened with intestinal worms due to poor water supply, sanitation, and hygiene
Summary
Soil-transmitted helminths, namely Ascaris lumbricoides, Trichuris trichiura, and the hookworms (Ancylostoma duodenale and Necator americanus), are the most common parasitic worm infections of humans. In 2011, an estimated 875 million children, 70% of whom were school-aged, were at risk globally [4]. The global burden of soil-transmitted helminthiasis is currently estimated at 5.2 million disability-adjusted life years (DALYs), mainly due to sub-clinical morbidities, and anemia and reduced cognitive and physical development [7,8,9]. Infections are largely chronic and usually asymptomatic, and the study and quantification of the morbidity associated with soil-transmitted helminth infections are difficult, and only few studies have ventured to do so. No conclusive evidence has yet been established whether reduced physical fitness or strength are a consequence of soil-transmitted helminth infections. We assessed effects of deworming on physical fitness and strength of children in an area in Yunnan, People’s Republic of China, where soil-transmitted helminthiasis is highly endemic
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