Abstract
Malnutrition and parasitic diseases are within the major issues in rural areas in developing countries. In this study, the nutritional status, dietary intake including mineral absorption inhibitor (phytate), hematological indicators and trace element status (zinc, iron) were evaluated and associated to the presence of intestinal parasites in a group of children from a rural area of Bolivia. The results showed that 96% of the children had intestinal parasites; 7 types of parasites (Ascaris lumbricoides, Giardia lamblia, Ancylostoma duodenale, Entamoeba histolytica, Entamoeba coli, Trichuris trichiura, Strongyloides stercolaris) were identified. Anthropometric measurements indicated that 37% of the children were stunted and 17% were underweight. Iron and zinc intake showed that 34% and 30% of children had inadequate intake of these nutrients respectively. Phytate: zinc molar ratios were between 6.5 and 21, and from 6.2 to 15 for phytate: iron, indicating that the absorption of zinc and iron might be compromised by the level of phytate in the diet. The serum zinc was below the lower cut-off in 87% of the children, indicating zinc deficiency. Moreover, a multiple regression model showed the significant effect of the presence of the parasite Giardia lamblia and phytate intake on the serum zinc levels. Regarding the iron status, 30% of the children presented with anemia and about 66% had iron deficiency; a simple linear regression model showed the significant negative effect of the presence of the parasite Ancylostoma duodenale on iron status. In conclusion, the levels of zinc and iron, which were low in this child population, were greatly affected by the presence of intestinal parasites; in addition, the consumption of plant-based diets with high levels of phytate also impaired the zinc absorption.
Highlights
Micronutrient deficiencies are a major health problem in developing countries; the conditions can be aggravated by poor diets and infectious diseases which create a complex cycle that is difficult to overcome, especially so in vulnerable populations such as those of pre-schoolchildren because of their higher growth requirements [1]-[3]
The dietary evaluation showed that the energy distribution was within the recommended values from WHO [21], 68E% was from carbohydrates, 14E% was from protein and 19E% was from total fat (Table 2).The dietary patterns are mainly based on carbohydrates from cereals, tubers, and legumes, with protein from small portions of meat or eggs and fat from oil and tallow; the vegetables and fruits are present randomly and in small portions
The diet of the children in this study showed molar ratios of Phy:Zn between 6.5 and 21.According to the WHO committee, the zinc absorption in this type of diet may be between 15% and 30% of zinc absorption
Summary
Micronutrient deficiencies are a major health problem in developing countries; the conditions can be aggravated by poor diets and infectious diseases which create a complex cycle that is difficult to overcome, especially so in vulnerable populations such as those of pre-schoolchildren because of their higher growth requirements [1]-[3]. Micronutrient deficiencies can be caused by insufficient intake and the presence of absorption inhibitors in the diet, as well as by disease states, such as parasitic infections which are highly prevalent in rural areas in developing countries [4] [5]. According to WHO in developing countries, 48% of children aged between 4 and 15 years old present with anemia [11]
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