The physical fitness and work performance of agricultural workers infected with<i>Schistosoma mansoni</i>in Zimbabwe

Ndamba, J.; Makaza, N.; Munjoma, Marshall; Gomo, Exnevia; Kaondera, K

doi:10.1080/00034983.1993.11812810

Cited by 39 publications

(19 citation statements)

References 21 publications

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“…27 Like most ultrasound investigations, studies that showed decreased physical fitness in association with schistosomiasis focused on adults, specifically their working capacity. [13][14][15]56 In these studies, productivity was measured over the course of a day. We did not find an association with schistosomiasis and the 20-m shuttle run, suggesting that the impact of schistosome infections associated with exercise tolerance may be from lack of stamina rather than an effect on shorter duration intense exertion.…”

Section: Discussionmentioning

confidence: 99%

“…Over time, morbidity may progress from subtle manifestations such as anemia, to more severe, debilitating, and irreversible conditions such as growth stunting, impaired cognitive development, increased susceptibility to co-infection, decreased quality of life, exercise intolerance, infertility, portal hypertension, and liver failure. [9][10][11][12][13][14][15] The key determinants of morbidity progression are repeated infection, intensity of infection, and duration of infection. 16 Currently, the WHO strategy for schistosomiasis control relies on mass-drug administration (MDA) of praziquantel, 17 which is effective in reducing disease-associated morbidity.…”

Section: Introductionmentioning

confidence: 99%

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Schistosoma mansoni Morbidity among School-Aged Children: A SCORE Project in Kenya

Samuels

Matey²,

Mwinzi³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. Schistosomiasis control programs aim to reduce morbidity but are evaluated by infection prevalence and intensity reduction. We present baseline cross-sectional data from a nested cohort study comparing indicators of morbidity for measuring program impact. Eight hundred twenty-two schoolchildren 7-8 years of age from Nyanza Province, Kenya, contributed stool for diagnosis of Schistosoma mansoni and soil-transmitted helminths (STH) and blood smears for malaria, and were evaluated for anemia, quality of life, exercise tolerance, anthropometry, and ultrasound abnormalities. Schistosoma mansoni, STH, and malaria infection prevalence were 69%, 25%, and 8%, respectively. Only anemia and S. mansoni infection (adjusted odds ratio [aOR] = 1.70; confidence interval [CI] = 1.03-2.80), and hepatomegaly and heavy S. mansoni infection (aOR = 2.21; CI = 1.19-4.11) were associated. Though anemia and hepatomegaly appeared most useful at baseline, additional morbidity indicators may be sensitive longitudinal measures to evaluate schistosomiasis program health impact.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Schistosoma mansoni Morbidity among School-Aged Children: A SCORE Project in Kenya

Samuels

Matey²,

Mwinzi³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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“…[7][8][9] Thus, the additive and lasting effects of early childhood diarrhea and malnutrition are of potential paramount importance in the development to full functional capacity. When taken with impaired fitness (that correlates in adults with impaired work productivity) 10 and with impaired growth, the additional impact of early childhood diarrhea on cognitive function even further magnifies its potential lasting "disability costs." Furthermore, these findings likely represent a "best case" scenario in that our long-term follow-up (with its concomitant education about breast-feeding, oral rehydration, and treatment of recognized helminthic infections) has been associated with reduced diarrhea rates and improvement in nutritional status over the study period, 11 effects that we have not seen in nearby shantytown communities not under study (Lima and Guerrant, unpublished observations).…”

Section: Discussionmentioning

confidence: 99%

Early childhood diarrhea is associated with diminished cognitive function 4 to 7 years later in children in a northeast Brazilian shantytown.

Niehaus

Moore²,

Patrick³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

272

154

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Abstract. Diarrhea is well recognized as a leading cause of childhood mortality and morbidity in developing countries; however, possible long-term cognitive deficits from heavy diarrhea burdens in early childhood remain poorly defined. To assess the potential long-term impact of early childhood diarrhea (in the first 2 years of life) on cognitive function in later childhood, we studied the cognitive function of a cohort of children in an urban Brazilian shantytown with a high incidence of early childhood diarrhea. Forty-six children (age range, 6-10 years) with complete diarrhea surveillance during their first 2 years of life were given a battery of five cognitive tests. Test of Non-Verbal Intelligence-III (TONI) scores were inversely correlated with early childhood diarrhea (P ‫ס‬ .01), even when controlling for maternal education, duration of breast-feeding, and early childhood helminthiasis (Ascaris or Trichuris). Furthermore, Wechsler Intelligence Scale for Children (WISC-III) Coding Tasks and WISC-III Digit Span (reverse and total) scores were also significantly lower in the 17 children with a history of early childhood persistent diarrhea (PD; P < .05), even when controlling for helminths and maternal education. No correlations were seen between diarrhea rates and Wide Range Assessment of Memory and Learning subtests or WISC-III Mazes. This report (with larger numbers of participants and new tests) confirms and substantially extends previous pilot studies, showing that long-term cognitive deficits are associated with early childhood diarrhea. These findings have important implications for the importance of interventions that may reduce early childhood diarrheal illnesses or their consequences.

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“…A randomized, controlled trial in Zimbabwe showed that workers treated for schistosomiasis experienced a mean 4.3% increase in Harvard Step Test fitness scores and were 16.6% more productive in their daily job of cutting sugar cane. 37 Thus, the association of early childhood diarrhea with fitness may extend to hampered potential work productivity. Because of the documented secular improvement in nutritional status and diarrhea rates over this study period in these children (Moore SR, unpublished data), these findings represent a best case scenario.…”

Section: Discussionmentioning

confidence: 99%

Association of early childhood diarrhea and cryptosporidiosis with impaired physical fitness and cognitive function four-seven years later in a poor urban community in northeast Brazil.

Guerrant¹,

Moore²,

Lima³

et al. 1999

Am J Trop Med Hyg

417

286

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Abstract. To determine potential, long-term deficits associated with early childhood diarrhea and parasitic infections, we studied the physical fitness (by the Harvard Step Test) and cognitive function (by standardized tests noted below) of 26 children who had complete surveillance for diarrhea in their first 2 years of life and who had continued surveillance until 6-9 years of age in a poor urban community (favela) in Fortaleza in northeast Brazil. Early childhood diarrhea at 0-2 years of age correlated with reduced fitness by the Harvard Step Test at 6-9 years of age (P ϭ 0.03) even after controlling for anthropometric and muscle area effects, anemia, intestinal helminths, Giardia infections, respiratory illnesses, and socioeconomic variables. Early childhood cryptosporidial infections (6 with diarrhea and 3 without diarrhea) were also associated with reduced fitness at 6-9 year of age, even when controlling for current nutritional status. Early diarrhea did not correlate with activity scores (P ϭ 0.697), and early diarrhea remained significantly correlated with fitness scores (P ϭ 0.035) after controlling for activity scores. Early diarrhea burdens also correlated in pilot studies with impaired cognitive function using a McCarthy Draw-A-Design (P ϭ 0.01; P ϭ 0.017 when controlling for early helminth infections), Wechsler Intelligence Scale for Children coding tasks (P ϭ 0.031), and backward digit span tests (P ϭ 0.045). These findings document for the first time a potentially substantial impact of early childhood diarrhea and cryptosporidial infections on subsequent functional status. If confirmed, these findings have major implications for calculations of global disability adjusted life years and for the importance and potential cost effectiveness of targeted interventions for early childhood diarrhea.Diarrhea persists as a major health threat for children in developing areas. It remains a leading cause of mortality worldwide, causing more than 3 million deaths each year. 1 However, the true long-term impact among those who live through repeated or prolonged diarrheal illnesses is poorly defined and likely under-recognized. 2 Children in impoverished urban areas of northeast Brazil have rates of diarrheal illnesses that are among the highest in the world in their first 2 years of life, 3 with enterotoxigenic and enteropathogenic Escherichia coli, rotaviruses, and Norwalk-like viruses predominating in acute diarrhea 3,4 (Lima AAM and others, unpublished data), and Cryptosporidium, enteroaggregative E. coli, and toroviruses predominating in persistent diarrhea. [5][6][7][8] The global economic disparity is also typified in the state of Ceará where nearly half of the families earn less than $113 per month, many families having at least five members. 9 Favelas are extremely poor urban communities where sewage is visible, mud-brick houses often have only 1-2 rooms, and most have no running water and have pit or no toilets. In this setting, we explored the relationships of early childhood diarrhea with subsequent ...

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The physical fitness and work performance of agricultural workers infected withSchistosoma mansoniin Zimbabwe

Cited by 39 publications

References 21 publications

Schistosoma mansoni Morbidity among School-Aged Children: A SCORE Project in Kenya

Schistosoma mansoni Morbidity among School-Aged Children: A SCORE Project in Kenya

Early childhood diarrhea is associated with diminished cognitive function 4 to 7 years later in children in a northeast Brazilian shantytown.

Association of early childhood diarrhea and cryptosporidiosis with impaired physical fitness and cognitive function four-seven years later in a poor urban community in northeast Brazil.

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