Diarrhea and novel dietary factors emerge as predictors of serum vitamin B12 in Panamanian children.

BACKGROUND: The role of gastrointestinal infection as a factor determining vitamin B12 status in populations with low intake of animal-source foods is unclear. OBJECTIVE: To determine dietary adequacy and serum concentrations of vitamin B12 in an extremely impoverished indigenous population of Panamanian children aged 12 to 60 months, and to identify predictors of both dietary and serum vitamin B12. METHODS: A previous community-based survey provided the usual dietary intake and personal, household, and infection (Ascaris and diarrheal disease) information for 209 weaned children. Serum vitamin B12 was assayed using electrochemiluminescence for 65 of these children. Children with adequate or inadequate dietary vitamin B12 intake were compared, and predictors of dietary and serum vitamin B12 were identified using stepwise regression analyses of one index child per household. RESULTS: Dietary vitamin B12 intake was inadequate in 43% of children; these children were poorer, had less frequent diarrhea, and obtained a higher percentage of their energy from carbohydrate than children with adequate intake. Energy intake positively predicted dietary vitamin B12 intake. In contrast, serum vitamin B12 concentrations were normal in all but 3% of the children. Serum vitamin B12 was positively associated with weekly servings of fruit, corn-based food, and name (a traditional starchy food), but not with animal-source foods. Finally, serum vitamin B12 was not associated with Ascaris intensity but was lowered with increasing frequency of diarrhea. CONCLUSIONS: Although inadequate dietary intake of vitamin B12 was common, most serum values were normal. Nevertheless, diarrheal disease emerged as a negative predictor of serum vitamin B12 concentration.

Complicated and fatal cases of ascariasis in Suriname

Ascariasis is soil transmitted disease that is endemic in Suriname. Usually it does not cause symptoms worth mentioning, but dependent on worm burden, location and migration of the worms, it may cause of ascariasis in children are reported and the pathogenesis of ascariasis is discussed.....(AU)

Abscesos hepáticos por áscaris lumbricoides / Hepatic abscesses by ascaris lumbricoides

Se describen dos niños con absceso hepático por áscaris lumbricoides: una niña de 14 meses de edad, quien se internó por síndrome febril prolongado y un varón de 20 meses, quien ingresó por distensión abdominal, fiebre y eliminación de áscaris en materia fecal. Se promovió búsqueda de la localización abdominal extraintestinal de los niños parasitados por áscaris con síndrome febril. La ultrasonografía fue el método de gran utilidad

Abscesos hepáticos por áscaris lumbricoides / Hepatic abscesses by ascaris lumbricoides

Se describen dos niños con absceso hepático por áscaris lumbricoides: una niña de 14 meses de edad, quien se internó por síndrome febril prolongado y un varón de 20 meses, quien ingresó por distensión abdominal, fiebre y eliminación de áscaris en materia fecal. Se promovió búsqueda de la localización abdominal extraintestinal de los niños parasitados por áscaris con síndrome febril. La ultrasonografía fue el método de gran utilidad (AU)

Gender differences in growth of school-aged children with schistosomiasis and geohelminth infection.

Light or moderate intensity infection with Schistosoma mansoni may contribute to growth deficits. We report on the effects of treatment for S. mansoni on growth and development in Brazilian schoolchildren. Anthropometric measurements were taken from 539 S. mansoni-infected children and their age- and sex-matched egg-negative controls between the ages of 7 and 15 years. The children as a whole exhibited chronic malnutrition, with growth retardation in height evident in 21% of the population. Infected children, however, were significantly smaller in height, weight, mid upper arm circumference (UAC), tricep skinfold (TSF), and subscapular skinfold (SSF) measurements than control children (P < 0.05). These differences were due primarily to a greater disparity between infected and egg-negative girls in height (P < 0.01), weight (P = 0.01), UAC (P = 0.O2), and TSF (P < 0.01). Nevertheless, girls demonstrated a better level of development and nutrition compared with boys. While infected boys were shorter and weighed less than controls, these differences were not significant. Growth and development in girls was negatively correlated with intensity of infection. Coinfection with S. mansoni and Trichuris appeared to act synergistically in the development of malnutrition.

Intestinal nematode infections in children: the pathophysiological price paid.

The mechanism by which small animals such as rodents resist or eliminate nematode parasites requires mucosal inflammation as the final effector of the immune response. The resulting freedom from chronic infection may be worth the price of short-term illness. Putative vaccines which attempt to enhance the natural effect will have to take into account the inflammatory cost to the host. Human helminthiases involve a more stable equilibrium between host and parasite. The medical literature on hookworm disease and clinical ascariasis describes, for the former, some chronic inflammatory effects correlated with worm burden, but for the latter a less quantified or predictable set of detrimental effects. We describe a current, systematic study of the inflammatory response to whipworm infection, in which anaemia, growth retardation and intestinal leakiness are viewed as predictable consequences related to infection intensity. There is evidence for the absence of cell-mediated immunopathology. However, a specific, IgE-mediated local anaphylaxis may, at least partly, mediate the deleterious effects. Increased numbers of mucosal macrophages may also contribute to the chronic, systemic effects through their output of cytokines. Similar attempts to show the mechanisms of pathogenesis and quantify the effects of hookworm disease should be undertaken.

Contributions of ascariasis to poor nutritional status in children from Chiriqui Province, Republic of Panama.

Relationships between ascariasis and lactose digestion and between ascariasis and food transit time from mouth to caecum were investigated in young children from Chiriqui Province, Republic of Panama. The breath hydrogen method was used in both studies. Ascaris-infected children showed a significantly poorer degree of lactose digestion following a test oral load than uninfected children. Recovery of the capacity of the children to digest lactose was still not fully complete for at least 3 weeks following anthelmintic treatment. On average, the mouth-to-caecum transit time was similar in infected and uninfected children, but among the Ascaris-infected children the transit time tended to be shorter in relation to the intensity of infection. Evidence from a cross-sectional survey indicated that ascariasis was significantly associated with reduced plasma vitamin A and carotenoid concentrations. This relationship remained after controlling for a range of socio-economic variables. Ascaris-infected children were frequently found to have lower haematocrits and blood haemoglobin concentrations than uninfected children, but these relationships could not be attributed to ascariasis alone.

Ascariasis errática: presentación de un caso / Eratic ascariasis: report of a case

Se revisan los conceptos de la ascarisis errática y sus aplicaciones fisiopatogénicas y clínicas. Se presenta un caso de evolución intrahospitalaria mortal con abscesos hepáticos y pancreáticos, invasión de sus canales respectivos e invasión de vías aéreas. Se hace una correlación de algunas publicaciones de ascariasis erráticas y se propone una secuencia clínico-epidemiógica de datos que pueden servir para alertar al clínico, sobre este cuadro

Prurito anal, nasal, bruxismo y sialorrea en niños con enterobiasis o ascariasis / Anal and nasal pruritus, bruxism and sialorrhea in children with enterobiasis or ascariasis

Se estudiaron 120 niños en edades comprendidas entre 1 y 14 años. Se dividieron en cuatro grupos constituídos por 30 niños cada uno. Grupo 1. pacientes con enterobiasis pura: Grupo 2, pacientes con ascariasis pura; Grupo 3, pacientes con giardíasis y Grupo 4, niños sin parasitosis. A todos se les practicó coproparasitoscópico por los métodos de Faust y Graham, todos en series de tres. Los resultados se procesaron estadísticamente por la prueba de X2 y se encontró significación en el caso de enterobiasis (prurito nasal, bruxismo y sialorrea); no hubo significación estadística de estos síntomas en el caso de pacientes con giardiasis o niños sin parasitosis. Se concluye que en niños que presenten los sintomas citados, se efectúe diagnóstico presuncional de enterobiasis y/o ascariasis, comprobándose por exámenes parasitoscópicos

Nutritional requirements in parasitic diseases.

"Nutritional requirements" means different things in different contexts. Generally, the term refers to national or international standards or allowances of nutrients. Concern here involves the potential need for a change of standards where conditions of disease prevail, because disease increases the nutritional requirements of most individuals. "Nutritional requirements" may also be viewed in terms of food supplies. Analysis of a number of studies indicates that the average growth deficit due to endemic infectious diseases in early life is less than or equal to 20 kcal per day (calculated as 5 kcal/g of tissue). Increased weight gain following treatment of intestinal parasites such as Ascaris lumbricoides or Giardia lamblia provides similar estimates, as does measurement of energy and protein absorption. These values are within normal variance estimates. Sick children do not eat well and apparently do not eat enough on healthy days to correct for the accrued food deficit. Research on nutritional requirements of children needs to focus on management of food resources in entire families.