Intestinal parasites, growth and physical fitness of schoolchildren in poor neighbourhoods of Port Elizabeth, South Africa: a cross-sectional survey

Abstract

BackgroundAs traditional lifestyle and diets change with social and economic development, disadvantaged communities in low- and middle-income countries increasingly face a double burden of communicable and non-communicable diseases. We studied the relationship between physical fitness and infections with soil-transmitted helminths (STHs), intestinal protozoa and Helicobacter pylori among schoolchildren in Port Elizabeth, South Africa.MethodsWe conducted a cross-sectional survey among 1009 children, aged 9 to 12 years, from eight primary schools in socioeconomically disadvantaged neighbourhoods of Port Elizabeth. Physical fitness was determined using field-deployable tests of the Eurofit fitness test battery. Stool samples were analysed with the Kato-Katz thick smear technique to diagnose STHs and with rapid diagnostic tests (RDTs) to detect intestinal protozoa and H. pylori infections. Haemoglobin (Hb) levels were assessed and anthropometric indicators determined.ResultsComplete data were available for 934 children (92 %). In two schools, high STH prevalences were found (Ascaris lumbricoides 60 and 72 %; Trichuris trichiura 65 % each). For boys and girls co-infected with A. lumbricoides and T. trichiura (n = 155) the maximal oxygen uptake (VO2 max) was estimated to be 50.1 and 47.2 ml kg-1 min-1, compared to 51.5 and 47.4 ml kg-1 min-1 for their non-infected peers (n = 278), respectively. On average, children without helminth infections had greater body mass (P = 0.011), height (P = 0.009) and a higher body mass index (P = 0.024) and were less often stunted (P = 0.006), but not significantly less wasted compared to their peers with a single or dual species infection. Among 9-year-old boys, a negative correlation between helminth infections and VO2 max, grip strength and standing broad jump distance was observed (P = 0.038). The overall mean Hb level was 122.2 g l-1. In the two schools with the highest prevalence of STHs the Hb means were 119.7 and 120.5 g l-1, respectively.ConclusionsIntestinal parasite infections appear to have a small but significant negative effect on the physical fitness of infected children, as expressed by their maximal oxygen uptake. We observed a clear impact on anthropometric indicators.Electronic supplementary materialThe online version of this article (doi:10.1186/s13071-016-1761-5) contains supplementary material, which is available to authorized users.

Comparison of Physical Fitness in Infected and Non-Infected Children With Soil-Transmitted Helminth

“…When viewed from the median value of VO2max in our study, the value of VO2max generated is reaching the average to good value. So in our study, the [12] cardiorespiratory function in infected and non-infected school children with STH was good. This result was probably due to in our study we did not found hookworm infection.…”

Why were Sardinians the shortest Europeans? A journey through genes, infections, nutrition, and sex

“…However, chronic exposure to enteric infections in infancy may also produce decreased absorption of macro‐ and micronutrients, as well as an increase in systemic inflammation, both able to affect childhood growth. This association was described in some populations where the infection was widespread (Müller et al, ). Soil‐based helminth infestation was common in traditional Sardinia (Palmas et al, ) and may have been an additional causal factor of malnutrition and shortened stature.…”

Parasitic Infestation in the Incidence of Diarrhea Among Toddlers in Jakarta, Bogor, Banjarmasin and Makassar

“…In 2018, the number of diarrhea sufferers was 1,516,438 [9]. A study from Port Elizabeth South Africa reported that of 934 children, 26% were infected with A. lumbricoides and 22% with T. trichiura [10]. Diarrhea can be caused by infection or non-infection.…”