Soil‐transmitted helminthic infection and nutritional status among urban slum children in Kenya

Abstract

To evaluate the impact of soil‐transmitted helminth (STH) infection on nutritional status, we conducted a survey of 206 preschool (PSC) and 499 school‐aged children (SAC) randomly selected from CDC's population surveillance platform in the Kibera slum, Nairobi, Kenya. Hemoglobin, ferritin, inflammatory markers, retinol binding protein and malaria were measured from capillary blood; anthropometry and analysis of 3 stools for STH ova were performed. Approximately 40% of children had STH infection (39.9% PSC, 39.7% SAC), primarily Ascaris and Trichuris spp. Only 2.9% PSC and 1.0% SAC had heavy infection. Indicators of malnutrition among PSC and SAC were as follows: anemia 37.4% and 14.4%, iron deficiency (ID) 19.3% and 4.4%, vitamin A deficiency (VAD) 15.1% and 5.9%, and stunting 28.8% and 16.5%. Among PSC, STH was associated with VAD but not anemia, ID, stunting or inflammation. PSC with Trichuris infection were more likely to have ID than those without Trichuris (p=.04). The association between any STH and VAD remained significant in multivariate analysis, adjusting for age, sex, inflammation, maternal education and income (aOR=2.3, p=0.04). Our results suggest that STH infection is associated primarily with VAD, which may inform deworming and micronutrient supplementation programs.