Soil-Transmitted Helminth Infections and Nutritional Status in School-age Children from Rural Communities in Honduras

Abstract

Background

Soil-transmitted helminth (STH) infections are endemic in Honduras and efforts are underway to decrease their transmission. However, current evidence is lacking in regards to their prevalence, intensity and their impact on children's health.

Objectives

To evaluate the prevalence and intensity of STH infections and their association with nutritional status in a sample of Honduran children.

Methodology

A cross-sectional study was done among school-age children residing in rural communities in Honduras, in 2011. Demographic data was obtained, hemoglobin and protein concentrations were determined in blood samples and STH infections investigated in single-stool samples by Kato-Katz. Anthropometric measurements were taken to calculate height-for-age (HAZ), BMI-for-age (BAZ) and weight-for-age (WAZ) to determine stunting, thinness and underweight, respectively.

Results

Among 320 children studied (48% girls, aged 7–14 years, mean 9.76±1.4) an overall STH prevalence of 72.5% was found. Children >10 years of age were generally more infected than 7–10 year-olds ( p = 0.015). Prevalence was 30%, 67% and 16% for Ascaris, Trichuris and hookworms, respectively. Moderate-to-heavy infections as well as polyparasitism were common among the infected children (36% and 44%, respectively). Polyparasitism was four times more likely to occur in children attending schools with absent or annual deworming schedules than in pupils attending schools deworming twice a year ( p<0.001). Stunting was observed in 5.6% of children and it was associated with increasing age. Also, 2.2% of studied children were thin, 1.3% underweight and 2.2% had anemia. Moderate-to-heavy infections and polyparasitism were significantly associated with decreased values in WAZ and marginally associated with decreased values in HAZ.

Conclusions

STH infections remain a public health concern in Honduras and despite current efforts were highly prevalent in the studied community. The role of multiparasite STH infections in undermining children's nutritional status warrants more research.

Author Summary

Soil-transmitted helminth (STH) infections are endemic in Honduras but their impact on children's health is not well studied. With the purpose of determining the prevalence and intensity of STH infections and their association with nutritional status in a sample of Honduran children, a cross-sectional study was undertaken in 2011. School-age children were enrolled, and in addition to demographic data, blood and stool samples and anthropometric measurements were obtained to determine nutritional status and STH infection. The overall STH prevalence among 320 studied children was 72.5% and almost half of the infected children harboured multiple parasites. Polyparasitism was more likely to occur in children attending schools with absent or annual deworming schedules than in pupils attending schools deworming twice a year. Prevalence by species was 30%, 67% and 16% for Ascaris, Trichuris and hookworms, respectively. Infections of moderate to heavy intensity as well as multiparasite infections were significant predictors of decreased weight-for-age scores in children ages 7–10 years after controlling for key confounders. Sustainable efforts to control STH infections in Honduras are required. Future research providing more insight on the nutritional impact of polyparasitic STH infections in childhood is necessary.