Effects of Cryptosporidium parvum infection in Peruvian children: growth faltering and subsequent catch-up growth.

ABSTRACT

PIP: A 2-year (1989-91) community-based study conducted in a shantytown in Lima, Peru, used regression splines to assess the effect of Cryptosporidium parvum infection on child growth during the year following the onset of infection. The 185 children 0-3 months of age at enrollment who comprised the study cohort underwent daily monitoring of diarrheal status, weekly stool analysis, and monthly anthropometric measurements. 88 children (48%) became infected with C. parvum during the study period. A linear random effects model was used to model differences in temporal growth patterns between C. parvum-infected and noninfected children. Children infected with C. parvum demonstrated growth faltering, both in weight and height, for several months after the onset of infection, followed by a period of catch-up growth. Younger age at infection intensified the effect of C. parvum infection on growth. In children infected between 0 and 5 months of age, catch-up weight gain was complete 6 months later but, 12 months after infection, these children exhibited an average height deficit of 0.95 cm relative to uninfected children the same age. Stunting also increased the magnitude and duration of the effect of C. parvum infection on growth. 12 months after infection onset, stunted children demonstrated a 1.05 cm height deficit relative to their noninfected, nonstunted age counterparts. These findings indicate that cryptosporidiosis has an adverse effect on child growth, especially when infection is acquired during infancy. C. parvum-related intestinal damage and malabsorption are presumed to be the mechanisms associated with growth retardation.