Effects of Cryptosporidium parvum Infection in Peruvian Children: Growth Faltering and Subsequent Catch-up Growth

Abstract

The authors conducted a 2-year (1989-1991) community-based longitudinal study in a shantytown in Lima, Peru, to examine the effect of Cryptosporidium parvum infection on child growth during the year following the onset of infection. A cohort of children, aged 0-3 months at recruitment, was followed monthly for anthropometrics, weekly for stool samples, and daily for diarrheal status. Data from 185 children in the cohort permitted a comparison of growth in C. parvum-infected and noninfected children. The analyses fitted smooth, flexible curves with a linear random-effects model to estimate growth differences between C. parvum-infected and noninfected children. Children infected with C. parvum experienced growth faltering, both in weight and in height, for several months after the onset of infection, followed by a period of catch-up growth. Younger children took longer to catch up in weight than did older children. Catch-up growth, however, did not occur in children infected between ages 0 and 5 months. These children did not catch up in height, and one year after infection they exhibited an average deficit of 0.95 cm (95% confidence interval (CI) 0.38-1.53) relative to noninfected children of similar age. Stunted children who became infected also did not catch up in either weight or height, and one year after infection they exhibited a height deficit of 1.05 cm (95% CI 0.46-1.66) relative to noninfected, stunted children of similar age. These results indicate that Cryptosporidium parvum has a lasting adverse effect on linear (height) growth, especially when acquired during infancy and when children are stunted before they become infected.

Epidemiologic Differences Between Cyclosporiasis and Cryptosporidiosis in Peruvian Children

“…Nevertheless, serologic data suggest that even intensive stool surveillance may miss a substantial proportion of cryptosporidiosis episodes (20). Data from the same Peruvian community showed that cryptosporidiosis without diarrhea had a substantial effect on childhood growth (21,22); because such infections may have long-term sequelae it is somewhat misleading to call them asymptomatic.…”

Symptomatic and Asymptomatic Cryptosporidium Infections in Children in a Semi-Urban Slum Community in Southern India

“…Diarrhea caused by these parasites in early childhood has been associated with subsequent cognitive function deficits and growth faltering and stunting, and the risk of stunting increases with the number of episodes per year. [1][2][3][4][5][6] A study from Peru found that symptomatic and asymptomatic cryptosporidiosis in children were associated with growth faltering after an infection but recovery was slower in children with symptomatic infection. 7 In India, several studies have reported Cryptosporidium spp.…”

Novel Bumped Kinase Inhibitors Are Safe and Effective Therapeutics in the Calf Clinical Model for Cryptosporidiosis

“…In immunocompetent individuals, Cryptosporidium infection causes watery diarrhea, often continuing beyond 10 days from the onset [7]. Cryptosporidium is a major cause of diarrhea in children in developing countries and is associated with stunting, irreversibly impaired cognitive development, and decreased fitness [9][10][11]. With improved diagnostic data from the Global Enteric Multicenter Study (GEMS), Cryptosporidium infections are now linked to approximately 25% of moderate-to-severe diarrheal episodes in children aged <2 years in resource-limited countries, second only to rotavirus [3].…”