Establishing associated risk factors, including fungal and parasitic infections among Malaysians living with schizophrenia.

The aetiology of schizophrenia is multifactorial, and the identification of its risk factors are scarce and highly variable. A cross-sectional study was conducted to investigate the risk factors associated with schizophrenia among Malaysian sub-population. A total of 120 individuals diagnosed with schizophrenia (SZ) and 180 non-schizophrenic (NS) individuals participated in a questionnaire-based survey. Data of complete questionnaire responses obtained from 91 SZ and 120 NS participants were used in statistical analyses. Stool samples were obtained from the participants and screened for gut parasites and fungi using conventional polymerase chain reaction (PCR). The median age were 46 years (interquartile range (IQR) 37 to 60 years) and 35 years (IQR 24 to 47.75 years) for SZ and NS respectively. Multivariable binary logistic regression showed that the factors associated with increased risk of SZ were age, sex, unemployment, presence of other chronic ailment, smoking, and high dairy consumption per week. These factors, except sex, were positively associated with the severity of SZ. Breastfed at infancy as well as vitamin and supplement consumption showed a protective effect against SZ. After data clean-up, fungal or parasitic infections were found in 98% (39/42). of SZ participants and 6.1% (3/49) of NS participants. Our findings identified non-modifiable risk factors (age and sex) and modifiable lifestyle-related risk factors (unemployment, presence of other chronic ailment, smoking, and high dairy consumption per week) associated with SZ and implicate the need for medical attention in preventing fungal and parasitic infections in SZ.

Zoonotic Diseases in Oman: Successes, Challenges, and Future Directions.

Objective: This article describes the situation analysis of endemic and emerging zoonoses, and includes prevention and control of zoonoses in Oman. It also suggests possible recommendations toward elimination and risk reduction of emerging zoonoses. Methods: Epidemiologic information has been drawn from official to assess the situation. There has been significant progress in reducing the risk of brucellosis, Middle East Respiratory Syndrome Coronavirus, Crimean-Congo hemorrhagic fever, and cutaneous leishmaniasis. Rabies, West Nile fever, Q fever, and cystic hydatid disease have been confined to wildlife or livestock. Results: There is an increasing threat of emerging and re-emerging zoonoses in Oman due to globalization of travel and trade, development activities, and impact of climate change and vector bionomics. Prevention, control, and subsequent elimination of zoonoses on a sustainable basis shall not be possible without intersectoral collaboration between the human and animal health sectors. There are challenges for establishing such strong collaboration and coordination mechanisms in Oman. Institutional and cultural barriers, data and resource sharing, and national capability for rapid and effective investigation of zoonotic infections and emerging zoonoses in humans and animal reservoirs are among others. Conclusions: In the light of achievements made on the prevention and control of zoonoses in Oman during the past decades, priority zoonoses should be identified for elimination, and continuous efforts should be made to further strengthen a holistic multidisciplinary and multisectorial approach for controlling zoonoses at source. Pivotal interventions would include urgent adoption of "One Health" strategic approach as well as establishment of a robust, integrated surveillance system with a strong laboratory investigation capacity to eliminate priority zoonoses and minimize the risk of entry, establishment, and spread of emerging zoonoses in Oman.

Parasitic infections and medical expenses according to Health Insurance Review Assessment claims data in South Korea, 2011-2018.

INTRODUCTION: In South Korea, Health Insurance Review and Assessment claims data contain comprehensive information on healthcare services for almost the entire population. The present study used claims data on parasitic diseases from 2011 to 2018, and associated medical expenses to investigate infection trends associated with endemic parasitic diseases in South Korea, including those not monitored by Korea Centers for Disease Control and Prevention. METHODS: Basic data regarding each parasitic disease were curated from the Healthcare Bigdata Hub (http://opendata.hira.or.kr). Ten endemic parasitic diseases, three pandemic protozoan diseases, and three ectoparasitic diseases were evaluated between 2011 and 2018. Data on each parasitic disease included the number of patients of each sex, age range within 5 years, province, and total medical expenses. Heatmap and principal component analysis were performed to visualize the incidence pattern of parasitic diseases by provinces. RESULTS: Clonorchiasis and pinworm infections decreased remarkably from 6,097 and 4,018 infections in 2011 to 3,008 and 1,988 infections in 2018, respectively. Other endemic parasitic diseases mostly declined or remained steady over the 8-year period, except for anisakiasis, which doubled from 409 in 2011 to 818 in 2018. Provinces close to North Korea had a higher frequency of claims for Plasmodium vivax infection. The highest rate of clonorchiasis was in Gyeongsangnam-do, while that of anisakiasis was in southern Korea. Jeju province had the highest number of claims for cysticercosis, anisakiasis, pinworm infection, and soil-transmitted helminth infections. The total medical expense for anisakiasis was 65 million Korean won (57,000 US$) in 2011, rising to 237 million Korean won (206,000 US$) in 2018. The medical expense for trichomoniasis was 6,063 million won and for scabies was 1,669 million won in 2018. Since the claims data include only data reported by healthcare providers, some discrepancies might have occurred. CONCLUSION: Our findings provide the basis for a health policy to reduce further infections and medical expense.

Development and application of anthelminthic drugs in China.

China was once a country plagued by parasitic diseases. At the beginning of the founding of the People's Republic of China, nearly 80% of the population suffered from parasitic diseases because of poverty and poor sanitary conditions. After nearly 70 years of development, China has made remarkable achievements in the prevention and control of parasitic diseases, and the prevalence of parasitic diseases has been greatly reduced. In addition to organizational leadership from the government and various preventive measures, drug treatment and drug research & development are important and irreplaceable links in prevention and control work. Since the 1950s, China has begun to introduce, produce and imitate antiparasitic drugs from abroad, such as santonin, benzimidazole, and praziquantel. Chinese scientists have also contributed to the optimization of production techniques, improvements in drug formulation, the application in the clinic and the mechanisms of actions of generic drugs. At the same time, China has independently developed tribendimidine (TrBD, a broad spectrum anthelminthic), and its anthelminthic spectrum has been comprehensively studied. It is active against almost 20 parasites, is especially superior to benzimidazoles against Necator americanus, and surpasses the effectiveness of praziquantel against Clonorchis sinensis. In the treatment of tapeworm disease, the traditional Chinese medicines pumpkin seeds and betel nuts have good curative effects for taeniasis. Chinese scientists have explored the action modes and clinical administration methods of pumpkin seeds and betel nuts, which is still the main clinical regimen for the disease. This paper reviews the history and progress of the study of anthelmintics in intestinal helminth infections since the founding of the People's Republic of China and aiming to support clinicians and drug researchers in China and other countries.

A comparison of ancient parasites as seen from archeological contexts and early medical texts in China.

This paper integrates our knowledge from traditional Chinese medical texts and archeological findings to discuss parasitic loads in early China. Many studies have documented that several different species of eukaryotic endoparasites were present in early human populations throughout China. Nevertheless, comprehensive paleoparasitological records from China are patchy, largely due to taphonomic and environmental factors. An examination of early Chinese medical texts allows us to fill in some of the gaps and counteract apparent biases in the current archeoparasitological records. By integrating the findings of paleoparasitology with historic textual sources, we show that parasites have been affecting the lives of humans in China since ancient times. We discuss the presence and prevalence of three groups of parasites in ancient China: roundworm (Ascaris lumbricoides), Asian schistosoma (Schistosoma japonicum), and tapeworm (Taenia sp.). We also examine possible factors that favored the spread of these endoparasites among early humans. Therefore, this paper not only aims to reveal how humans have been affected by endoparasites, but also addresses how early medical knowledge developed to cope with the parasitic diseases.

Ancient DNA from latrines in Northern Europe and the Middle East (500 BC-1700 AD) reveals past parasites and diet.

High-resolution insight into parasitic infections and diet of past populations in Northern Europe and the Middle East (500 BC- 1700 AD) was obtained by pre-concentration of parasite eggs from ancient latrines and deposits followed by shotgun sequencing of DNA. Complementary profiling of parasite, vertebrate and plant DNA proved highly informative in the study of ancient health, human-animal interactions as well as animal and plant dietary components. Most prominent were finding of soil-borne parasites transmitted directly between humans, but also meat-borne parasites that require consumption of raw or undercooked fish and pork. The detection of parasites for which sheep, horse, dog, pig, and rodents serves as definitive hosts are clear markers of domestic and synanthropic animals living in closer proximity of the respective sites. Finally, the reconstruction of full mitochondrial parasite genomes from whipworm (Ascaris lumbricoides) and roundworm species (Trichuris trichiura and Trichuris muris) and estimates of haplotype frequencies elucidates the genetic diversity and provides insights into epidemiology and parasite biology.

A review of the traditional use of southern African medicinal plants for the treatment of selected parasite infections affecting humans.

ETHNOPHARMACOLOGICAL RELEVANCE: Worldwide, more than three billion cases of parasitic disease are reported yearly and it is likely that this figure is substantially under-estimated. Approximately one in six people globally are estimated to be infected with at least one parasite species annually. In South Africa, the prevalence of Schistosoma haematobium (bilharzia) and intestinal worms and helminths are particularly high, especially in children and in crowded or poorer rural communities with inadequate sanitation and nutrition. Despite alarmingly high estimates, medical research into parasitic diseases remains neglected and only malaria receives significant attention and funding. Traditional medicines have been used for centuries in Africa by multiple ethnic groups and many people rely on these healing systems as their primary healthcare modality. The traditional use of South African medicinal plants to treat parasite infestations is relatively well documented, and it is important to link these traditional uses to scientific evidence validating efficacy. AIM OF THE STUDY: To document the medicinal plants used for parasitic infections and critically review the literature on the anti-parasitic properties of South African plants against some neglected parasitic diseases. MATERIALS AND METHODS: A review of the literature (ethnobotanical books and publications documenting traditional plant use) was undertaken related to specific medicinal use for parasitic infections in Southern Africa. Inclusion criteria focused on human use. Exclusion criteria included veterinary use and malaria due to the extensive nature of these subject matters. An in-depth analysis of previous studies was undertaken and future prospectives are considered. RESULTS: In particular, bilharzia, gastrointestinal worms and helminths, ectoparasites, trichomoniasis, leishmaniasis and trypanosomiasis are reviewed with special emphasis on the gaps in research. CONCLUSIONS: Despite the availability of relatively extensive ethnobotanical records on the anti-parasitic properties of southern African medicinal plants, the antiparasitic properties of many plants have been poorly examined. There was in many instances a lack of evidence to support traditional use of many species towards some parasites and research is urgently needed in this area.

Recent epidemiology of sexually transmissible enteric infections in men who have sex with men.

PURPOSE OF REVIEW: Sexual transmission of enteric pathogens in men who have sex with men (MSM) has been described since the 1970s. Recently, an increasing number of enteric infection outbreaks have been reported in MSM. This article summarizes recent outbreaks and discusses the key issues for prevention and control. RECENT FINDINGS: Sexually transmissible enteric infections (STEIs) can spread rapidly and internationally within highly connected MSM populations and are often associated with antimicrobial resistance (AMR). The infections often cluster in high-risk groups of HIV-positive MSM who are more likely to engage in diverse sexual practices and chemsex, and to have multiple other sexually transmitted infections (STIs). SUMMARY: The roles of asymptomatic and/or persistent infection and other contextual factors in STEI transmission are not well described. STEI-associated AMR is increasing and has potential to spread rapidly in MSM, warranting further public health attention. A better understanding of the factors associated with sexual transmission will enable the development of more effective control measures. A holistic approach that promotes health and wellbeing as well as infection prevention and management is needed.

Human parasites in the Roman World: health consequences of conquering an empire.

The archaeological evidence for parasites in the Roman era is presented in order to demonstrate the species present at that time, and highlight the health consequences for people living under Roman rule. Despite their large multi-seat public latrines with washing facilities, sewer systems, sanitation legislation, fountains and piped drinking water from aqueducts, we see the widespread presence of whipworm (Trichuris trichiura), roundworm (Ascaris lumbricoides) and Entamoeba histolytica that causes dysentery. This would suggest that the public sanitation measures were insufficient to protect the population from parasites spread by fecal contamination. Ectoparasites such as fleas, head lice, body lice, pubic lice and bed bugs were also present, and delousing combs have been found. The evidence fails to demonstrate that the Roman culture of regular bathing in the public baths reduced the prevalence of these parasites. Fish tapeworm was noted to be widely present, and was more common than in Bronze and Iron Age Europe. It is possible that the Roman enthusiasm for fermented, uncooked fish sauce (garum) may have facilitated the spread of this helminth. Roman medical practitioners such as Galen were aware of intestinal worms, explaining their existence and planning treatment using the humoural theory of the period.

Ancient Human Parasites in Ethnic Chinese Populations.

Whilst archaeological evidence for many aspects of life in ancient China is well studied, there has been much less interest in ancient infectious diseases, such as intestinal parasites in past Chinese populations. Here, we bring together evidence from mummies, ancient latrines, and pelvic soil from burials, dating from the Neolithic Period to the Qing Dynasty, in order to better understand the health of the past inhabitants of China and the diseases endemic in the region. Seven species of intestinal parasite have been identified, namely roundworm, whipworm, Chinese liver fluke, oriental schistosome, pinworm, Taenia sp. tapeworm, and the intestinal fluke Fasciolopsis buski. It was found that in the past, roundworm, whipworm, and Chinese liver fluke appear to have been much more common than the other species. While roundworm and whipworm remained common into the late 20th century, Chinese liver fluke seems to have undergone a marked decline in its prevalence over time. The iconic transport route known as the Silk Road has been shown to have acted as a vector for the transmission of ancient diseases, highlighted by the discovery of Chinese liver fluke in a 2,000 year-old relay station in northwest China, 1,500 km outside its endemic range.

Association between anaemia, iron deficiency anaemia, neglected parasitic infections and socioeconomic factors in rural children of West Malaysia.

BACKGROUND: Given that micronutrient deficiency, neglected intestinal parasitic infections (IPIs) and poor socioeconomic status are closely linked, we conducted a cross-sectional study to assess the relationship between IPIs and nutritional status of children living in remote and rural areas in West Malaysia. METHODS/FINDINGS: A total of 550 children participated, comprising 520 (94.5%) school children aged 7 to 12 years old, 30 (5.5%) young children aged 1 to 6 years old, 254 (46.2%) boys and 296 (53.8%) girls. Of the 550 children, 26.2% were anaemic, 54.9% iron deficient and 16.9% had iron deficiency anaemia (IDA). The overall prevalence of helminths was 76.5% comprising Trichuris trichiura (71.5%), Ascaris lumbricoides (41.6%) and hookworm infection (13.5%). It was observed that iron deficiency was significantly higher in girls (p = 0.032) compared to boys. Univariate analysis demonstrated that low level of mother's education (OR = 2.52; 95% CI = 1.38-4.60; p = 0.002), non working parents (OR = 2.18; 95% CI = 2.06-2.31; p = 0.013), low household income (OR = 2.02; 95% CI = 1.14-3.59; p = 0.015), T. trichiura (OR = 2.15; 95% CI = 1.21-3.81; p = 0.008) and A. lumbricoides infections (OR = 1.63; 95% CI = 1.04-2.55; p = 0.032) were significantly associated with the high prevalence of IDA. Multivariate analysis confirmed that low level of mother's education (OR = 1.48; 95 CI% = 1.33-2.58; p<0.001) was a significant predictor for IDA in these children. CONCLUSION: It is crucial that a comprehensive primary health care programme for these communities that includes periodic de-worming, nutrition supplement, improved household economy, education, sanitation status and personal hygiene are taken into consideration to improve the nutritional status of these children.

[Globalization and infectious diseases: the past and future]. / Globalizzazione e malattie infettive: tra passato e futuro.

Globalization is a widely-used term that can be defined in a number of different ways. When used in an economic context, it refers to the reduction and removal of barriers between national borders in order to facilitate the flow of goods, capital, services and labour. Globalization is not a new phenomenon. Today the concept of globalization can be extended to include global exposure to infectious diseases, which is becoming more apparent. The aim of this article is to examine the influence of globalization on the outbreak and spread of infections in the world.

Enfermedades tropicales: esquistosomiasis, leishmaniasis y tripanosomiasis. Revisión bibliográfica / Tropical diseases: schistosomiasis, leishmaniasis and trypanosomiasis. Bibliographic revision

Con el objetivo de profundizar en el estudio de las enfermedades tropicales causadas por parásitos, presentes en numerosos países donde la colaboración medica cubana brinda sus servicios integrales de salud y en aras de incrementar los conocimientos de nuestros médicos, se realizó una revisión bibliográfica, detallando aspectos clínicos, epidemiológicos y terapéuticos de la Esquistosomiasis, la Leishmaniasis y la Tripanosomiasis Africana.(AU)

With the objective to develop the research of tropical diseases caused by parasites in many countries where the cuban medical collaboration offers integrated health services, and in order to increase our professionals knowledge, it was performed a bibliographical revision, emphasizing the clinical, epidemiological and therapeutic aspects of the Schistosomiasis, Leishmaniasis and Trypanosomiasis.(EU)

Prevalence of anaemia, deficiencies of iron and folic acid and their determinants in Ethiopian women.

A cross-sectional community-based study with analytic component was conducted among Ethiopian women during June-July 2005 to assess the magnitude of anaemia and deficiencies of iron and folic acid and to compare the factors responsible for anaemia among anaemic and non-anaemic cases. In total, 970 women, aged 15-19 years, were selected systematically for haematological and other important parameters. The overall prevalence of anaemia, iron deficiency, iron-deficiency anaemia, deficiency of folic acid, and parasitic infestations was 30.4%, 50.1%, 18.1%, 31.3%, and 13.7% respectively. Women who had more children aged less than five years but above two years, open-field toilet habits, chronic illnesses, and having intestinal parasites were positively associated with anaemia. Women who had no formal education and who did not use contraceptives were negatively associated with anaemia. The major determinants identified for anaemia were chronic illnesses [adjusted odds ratio (AOR) = 1.1, 95% confidence interval (CI) 1.15-1.55), deficiency of iron (AOR = 0.4, 95% CI 0.35-0.64), and deficiency of folic acid (AOR = 0.5, 95% CI 0.50-0.90). The odds for developing anaemia was 1.1 times more likely among women with chronic illnesses, 60% more likely in the iron-deficient and 40% more likely in the folic acid-deficient than their counterparts. One in every three women had anaemia and deficiency of folic acid while one in every two had iron deficiency, suggesting that deficiencies of both folic acid and iron constitute the major micronutrient deficiencies in Ethiopian women. The risk imposed by anaemia to the health of women ranging from impediment of daily activities and poor pregnancy outcome calls for effective public-health measures, such as improved nutrient supplementation, health education, and timely treatment of illnesses.

Risk of parasite transmission influences perceived vulnerability to disease and perceived danger of disease-relevant animals.

Adaptationist view proposes that emotions were shaped by natural selection and their primary function is to protect humans against predators and/or disease threat. This study examined cross-cultural and inter-personal differences in behavioural immune system measured by disgust, fear and perceived danger in participants from high (Turkey) and low (Slovakia) pathogen prevalence areas. We found that behavioural immune system in Turkish participants was activated more than those of Slovakian participants when exposed to photographs depicting disease-relevant cues, but not when exposed to disease-irrelevant cues. However, participants from Slovakia, where human to human disease transmission is expected to be more prevalent than in Turkey, showed lower aversion in Germ Aversion subscale supporting hypersensitiveness of the behavioural immune system. Having animals at home was less frequent both in Turkey and in participants who perceived higher danger about disease relevant animals. Participants more vulnerable to diseases reported higher incidence of illness last year and considered perceived disease-relevant animals more dangerous than others. Females showed greater fear, disgust and danger about disease-relevant animals than males. Our results further support the finding that cultural and inter-personal differences in human personality are influenced by parasite threat.

Major trends in human parasitic diseases in China.

Tremendous progress has been made in the control and prevention of human parasitic diseases in mainland China in the past 30 years because of China's Reform and Opening to the Outside Policies initiated in 1978. However, parasitic diseases remain a major human health problem, with significant morbidity and mortality as well as adverse socioeconomic consequences. Although soil-transmitted parasitic diseases are in the process of being gradually controlled, food-borne parasitic diseases and emerging parasitic diseases are becoming the focus of new campaigns for control and prevention. This article reviews major trends in human parasitic diseases in mainland China, with perspectives for control.

Control of human parasitic diseases: Context and overview.

The control of parasitic diseases of humans has been undertaken since the aetiology and natural history of the infections was recognized and the deleterious effects on human health and well-being appreciated by policy makers, medical practitioners and public health specialists. However, while some parasitic infections such as malaria have proved difficult to control, as defined by a sustained reduction in incidence, others, particularly helminth infections can be effectively controlled. The different approaches to control from diagnosis, to treatment and cure of the clinically sick patient, to control the transmission within the community by preventative chemotherapy and vector control are outlined. The concepts of eradication, elimination and control are defined and examples of success summarized. Overviews of the health policy and financing environment in which programmes to control or eliminate parasitic diseases are positioned and the development of public-private partnerships as vehicles for product development or access to drugs for parasite disease control are discussed. Failure to sustain control of parasites may be due to development of drug resistance or the failure to implement proven strategies as a result of decreased resources within the health system, decentralization of health management through health-sector reform and the lack of financial and human resources in settings where per capita government expenditure on health may be less than $US 5 per year. However, success has been achieved in several large-scale programmes through sustained national government investment and/or committed donor support. It is also widely accepted that the level of investment in drug development for the parasitic diseases of poor populations is an unattractive option for pharmaceutical companies. The development of partnerships to specifically address this need provides some hope that the intractable problems of the treatment regimens for the trypanosomiases and leishmaniases can be solved in the not too distant future. However, it will be difficult to implement and sustain such interventions in fragile health services often in settings where resources are limited but also in unstable, conflict-affected or post-conflict countries. Emphasis is placed on the importance of co-endemicity and polyparasitism and the opportunity to control parasites susceptible to cost-effective and proven chemotherapeutic interventions for a package of diseases which can be implemented at low cost and which would benefit the poorest and most marginalized groups. The ecology of parasitic diseases is discussed in the context of changing ecology, environment, sociopolitical developments and climate change. These drivers of global change will affect the epidemiology of parasites over the coming decades, while in many of the most endemic and impoverished countries parasitic infections will be accorded lower priority as resourced stressed health systems cope with the burden of the higher-profile killing diseases viz., HIV/AIDS, TB and malaria. There is a need for more holistic thinking about the interactions between parasites and other infections. It is clear that as the prevalence and awareness of HIV has increased, there is a growing recognition of a host of complex interactions that determine disease outcome in individual patients. The competition for resources in the health as well as other social sectors will be a continuing challenge; effective parasite control will be dependent on how such resources are accessed and deployed to effectively address well-defined problems some of which are readily amenable to successful interventions with proven methods. In the health sector, the problems of the HIV/AIDS and TB pandemics and the problem of the emerging burden of chronic non-communicable diseases will be significant competitors for these limited resources as parasitic infections aside from malaria tend to be chronic disabling problems of the poorest who have limited access to scarce health services and are representative of the poorest quintile. Prioritization and advocacy for parasite control in the national and international political environments is the challenge.

Ocorrência de enteroparasitos em crianças atendidas no programa de saúde da família de uma area de abrangência do município de vespasiano, Minas gerais, Brasil / Occurrence of parasitic diseases in children assisted at the family health program of a vespasiano city district, Minas gerais, Brazil

No Brasil, os grandes inquéritos coproparasitológicos foram realizados até a década de 70. Apesar disto, as parasitoses intestinais são de grande importância, uma vez que constituem graves problemas de saúde pública, contribuindo para o agravamento de problemas econômicos, sociais e médicos. Por esta razão, o presente trabalho objetivou verificar a ocorrência dos enteroparasitos mais freqüentes entre cianças (0-10 anos) cadastradas e residentes na área de abrangência do Programa de Saúde da Família (PSF) do bairro Morro Alto em Vespasiano, estado de Minas Gerais, Brasil. Foram analisados 3250 prontuários de três unidades de PSF. A ocorrência geral de enteroparasitoses foi de 18,4 por cento, sendo que algumas crianças se apresentavam poliparasitadas. Os enteroparasitos mais frequentes foram Giardia lamblia (43 por cento), Ascaris lumbricoides (34 por cento) e Entamoeba coli (13 por cento). A faixa etária de 6 a 8 anos foi a que apresentou um maior número de indivíduos parasitados. A coleta de dados para este projeto evidenciou que o município não possui levantamentos sobre a ocorrência de parasitoses, justificando com isso a importância desse estudo uma vez que seus resultados oferecem subsídios para a elaboração de políticas municipais de saúde pública voltados à infância e juventude.(AU)

Manifestaciones orales de patologías tropicales / Oral manifestations of tropical diseases

El presente trabajo expone las características clínias e histopatológicas de las pricnipales patologías tropicales (micóticas, parasitarias y virales) que presentan manifestaciones bucales, poniendo énfasis en la paracoccidioidomicosis, histoplasmosis, critpcocosis, dengue, leishmaniasis e infección micótica (AU)

Kenyan school children have multiple micronutrient deficiencies, but increased plasma vitamin B-12 is the only detectable micronutrient response to meat or milk supplementation.

Animal source foods (ASF) can provide micronutrients in greater amounts and more bioavailable forms compared to plant source foods, but their intake is low in many poor populations. However, the impact of ASF on micronutrient status of undernourished populations has not been assessed. Supplemental meat (60-85 g/d), milk (200-250 mL/d) or energy (isocaloric with the meat and milk, 240-300 kcal/d) were randomly assigned to 555 undernourished school children aged 5-14 y in a rural malaria-endemic area of Kenya, at one school meal daily for one school year. Blood and stool samples were collected at baseline and after 1 y to assess stool parasites, malaria, hemoglobin, serum or plasma C-reactive protein, ferritin, iron, zinc, copper, vitamin B-12, folate and retinol, and erythrocyte riboflavin. At baseline, there was a high prevalence of micronutrient deficiencies (iron, zinc, vitamins A and B-12 and riboflavin), yet plasma ferritin was low in few children, and none had low serum copper. At the end of the year of supplementation, plasma vitamin B-12 concentrations were significantly increased in children fed the Meat or Milk meal; prevalence of severe plus moderate deficiency fell from 80.7% at baseline to 64.1% in the Meat group and from 71.6 to 45.1% in the Milk group, respectively. No significant improvement was observed in the status of other micronutrients compared to the Energy and Control groups, although malaria and other infections may have obscured effects. Supplementation with small amounts of meat or milk reduced the high prevalence of vitamin B-12 deficiency in these children.