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      Intestinal Parasites, Anemia and Nutritional Status in Young Children from Transitioning Western Amazon

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          Abstract

          Young children are particularly vulnerable to the chronic sequelae of anemia, including poor nutritional status. The aim of this study was to assess intestinal parasitic-infections and nutritional status (anemia and linear growth) in preschool children living in contemporary Amazonian communities. A cross-sectional study measured children’s intestinal parasites and hair-Hg (HHg)—biomarkers of fish consumption, hemoglobin levels, and growth (anthropometric Z-scores). Children came from traditional-living families (Itapuã), and tin-mining settlements (Bom Futuro) representing current transitioning populations. It covered 937 pre-school children (from 1 to 59 months of age) from traditional (247) and immigrant tin-mining families (688). There was a high prevalence of intestinal polyparasitic-infection in children from both communities, but mild anemia (hemoglobin concentrations) and moderate (chronic) malnutrition were more frequent in children from traditional families than in children from tin-mining settlers. Children from traditional families ate significantly more fish (HHg mean of 4.3 µg/g) than children from tin-mining families (HHg mean of 2.3 µg/g). Among traditional villagers, children showed a significant correlation (r = 0.2318; p = 0.0005) between hemoglobin concentrations and HHg concentrations. High rates of parasitic infection underlie the poverty and attendant health issues of young children in the Brazilian Amazon. The intestinal parasite burden affecting poor Amazonian children resulting from unsafe water, lack of sanitation and poor hygiene is the most urgent environmental health issue.

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          Malnutrition as an enteric infectious disease with long-term effects on child development.

          Malnutrition is a major contributor to mortality and is increasingly recognized as a cause of potentially lifelong functional disability. Yet, a rate-limiting step in achieving normal nutrition may be impaired absorptive function due to multiple repeated enteric infections. This is especially problematic in children whose diets are marginal. In malnourished individuals, the infections are even more devastating. This review documents the evidence that intestinal infections lead to malnutrition and that malnutrition worsens intestinal infections. The clinical data presented here derive largely from long-term cohort studies that are supported by controlled animal studies. Also reviewed are the mechanisms by which enteric infections lead to undernutrition and by which malnutrition worsens enteric infections, with implications for potential novel interventions. Further intervention studies are needed to document the relevance of these mechanisms and, most importantly, to interrupt the vicious diarrhea-malnutrition cycle so children may develop their full potential.
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            Pit Latrines and Their Impacts on Groundwater Quality: A Systematic Review

            Background: Pit latrines are one of the most common human excreta disposal systems in low-income countries, and their use is on the rise as countries aim to meet the sanitation-related target of the Millennium Development Goals. There is concern, however, that discharges of chemical and microbial contaminants from pit latrines to groundwater may negatively affect human health. Objectives: Our goals were to a) calculate global pit latrine coverage, b) systematically review empirical studies of the impacts of pit latrines on groundwater quality, c) evaluate latrine siting standards, and d) identify knowledge gaps regarding the potential for and consequences of groundwater contamination by latrines. Methods: We used existing survey and population data to calculate global pit latrine coverage. We reviewed the scientific literature on the occurrence of contaminants originating from pit latrines and considered the factors affecting transport of these contaminants. Data were extracted from peer-reviewed articles, books, and reports identified using Web of ScienceSM, PubMed, Google, and document reference lists. Discussion: We estimated that approximately 1.77 billion people use pit latrines as their primary means of sanitation. Studies of pit latrines and groundwater are limited and have generally focused on only a few indicator contaminants. Although groundwater contamination is frequently observed downstream of latrines, contaminant transport distances, recommendations based on empirical studies, and siting guidelines are variable and not well aligned with one another. Conclusions: In order to improve environmental and human health, future research should examine a larger set of contextual variables, improve measurement approaches, and develop better criteria for siting pit latrines.
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              Dietary diversification/modification strategies to enhance micronutrient content and bioavailability of diets in developing countries.

              Both cereal staples and household diets can be manipulated to enhance the content of micronutrients and/or alter the levels of absorption modifiers to improve micronutrient bioavailability. Strategies described range from plant breeding, use of fertilizers and genetic engineering to changes in food preparation and processing methods at the household level involving soaking, fermentation and germination. The impact of five household strategies designed to enhance the content and bioavailability of iron, zinc and calcium in a representative daily menu for rural Malawian preschool children has been calculated using food composition data. In the five strategies, relishes based on small dried fish replaced plant-based relishes, maize-based porridges prepared with maize flour soaked to reduce its hexa (IP-6)- and penta (IP-5)-inositol phosphate content replaced conventional porridges; and a pumpkin-leaf relish replaced sweet potato to increase the retinol content of the daily menu. Comparison of the calculated energy, nutrient, and phytate content, and [phytate]:[zinc] molar ratios of the five modified menus compared with the unmodified menu emphasizes that to ensure that the estimated requirements for iron and zinc are met, the optimal strategy includes dried fish relish twice daily together with porridges prepared using soaked (or fermented) maize flour to reduce their hexa- and penta-inositol phosphate content. Implementation of these household strategies has the potential to increase the bioavailability of iron and zinc in rural Malawian diets from low to high.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                16 January 2020
                January 2020
                : 17
                : 2
                : 577
                Affiliations
                [1 ]Instituto de Biofísica Carlos Chagas Filho Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-901, Brazil; rejanecmarques@ 123456globo.com
                [2 ]Department of Nutrition, Universidade de Brasília, Brasilia 70910-900, Brazil; bernardi.jve@ 123456gmail.com (J.V.E.B.); jg.dorea@ 123456gmail.com (J.G.D.)
                [3 ]Department of Civil Engineering, University of Victoria, Victoria, BC V8P 5C2, Canada
                [4 ]Environment & Regional Development Graduate Program (PGDRA), Universidade Federal de Rondônia (UNIR), Porto Velho 76801-974, Brazil
                Author notes
                [* ]Correspondence: caetanodorea@ 123456uvic.ca
                Author information
                https://orcid.org/0000-0001-6730-7769
                https://orcid.org/0000-0001-9367-0668
                https://orcid.org/0000-0002-3941-1638
                Article
                ijerph-17-00577
                10.3390/ijerph17020577
                7014309
                31963189
                a991565e-3cc9-4136-9a6a-35888acf4c02
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 07 November 2019
                : 14 January 2020
                Categories
                Article

                Public health
                amazon,anemia,fish consumption,hair mercury,hemoglobin,parasites,sanitation
                Public health
                amazon, anemia, fish consumption, hair mercury, hemoglobin, parasites, sanitation

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