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Wasting, Stunting, and Anemia in Angolan Children after Deworming with Albendazole or a Test-and-Treat Approach for Intestinal Parasites

2022-06-01Artigo científico Acesso aberto
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dc.contributor.authorGasparinho, Carolina
dc.contributor.authorGonçalves, Maria Helena
dc.contributor.authorChissaque, Assucênio
dc.contributor.authorSilva, Giovani L.
dc.contributor.authorFortes, Filomeno
dc.contributor.authorGonçalves, Luzia
dc.contributor.institutionIndividual Health Care (IHC)
dc.contributor.institutionGlobal Health and Tropical Medicine (GHTM)
dc.contributor.institutionInstituto de Higiene e Medicina Tropical (IHMT)
dc.contributor.institutionPopulation health, policies and services (PPS)
dc.contributor.pblMDPI AG
dc.date.accessioned2023-01-23T22:15:53Z
dc.date.available2023-01-23T22:15:53Z
dc.date.issued2022-06-01
dc.descriptionFunding Information: Funding: This work was supported by the promoters of CISA (Camões, Institute of Cooperation and Language, Portugal; Calouste Gulbenkian Foundation (FCG); Government of Bengo Province; Angolan Ministry of Health—MINSA) and the National Malaria Control Program, Angola; the Foundation for Science and Technology (FCT, grants reference SFRH/BD/91566/2012, UIDB/00006/2020, UIDP/00006/2020, and UID/04413/2020); and the FCG (grant number 212008), Lisbon, Portugal. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
dc.description.abstractUndernutrition, anemia, and intestinal parasitic infections are public health problems in Angola, especially in pre-school children. We analyzed binary data from a longitudinal four-arm randomized parallel trial conducted in Bengo Province, northern Angola, over the course of two years, with seven follow-up assessments to explore the effects of four interventions (deworming and a test-and-treat approach for intestinal parasites, at both the individual and household levels) on wasting and stunting, and to understand their indirect benefits for anemia, malaria, diarrhea, and vomiting. A total of 121 children with intestinal parasitic infections received baseline treatment, and were allocated to the four arms (1:1:1:1). Using continuous outcome variables of height-for-age (HAZ) and weight-for-height (WHZ) statistical approaches did not reveal a clear benefit of any particular arm (Pathogens 2021, 10, 309). Next, HAZ and WHZ were transformed into binary variables of stunting and wasting, respectively, considering their mild-to-severe (Z-score < −1) and moderate-to-severe degrees (Z-score < −2). Original clinical data (on anemia, diarrhea, vomiting, and malaria) were also analyzed. From a binary longitudinal analysis with different dependence structures, using the R package bild, fitted models revealed the potential benefit of a test-and-treat approach at the individual level for wasting compared with annual albendazole at the individual level, especially considering mild-to-severe forms (ORadj = 0.27; p = 0.007). All arms showed similar effects on stunting, compared with annual albendazole, at a 5% significance level. Time and age at baseline presented favorable effects in the percentage of stunting using both severity degrees. Results showed a decreased chance of having anemia and diarrhea over time, although with no significant differences between arms. Data from longitudinal studies are essential to study the direct and indirect effects of interventions, such as deworming, and to explore additional approaches aiming at better understanding the temporal structure of nutrition and health outcomes in children.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent3045477
dc.identifier.doi10.3390/nu14112185
dc.identifier.issn1422-8599
dc.identifier.otherPURE: 50841983
dc.identifier.otherPURE UUID: 52c2e2bc-e20a-4c92-ad45-63d5183d2423
dc.identifier.otherScopus: 85130985463
dc.identifier.otherPubMed: 35683985
dc.identifier.otherWOS: WOS:000808640900001
dc.identifier.urihttp://hdl.handle.net/10362/148019
dc.identifier.urlhttps://www.scopus.com/pages/publications/85130985463
dc.language.isoeng
dc.peerreviewedyes
dc.subjectanemia
dc.subjectAngola
dc.subjectdeworming
dc.subjectintestinal parasites
dc.subjectlongitudinal
dc.subjectmalnutrition
dc.subjectmild-to-severe
dc.subjectmoderate-to-severe
dc.subjectstunting
dc.subjecttest-and-treat
dc.subjectwasting
dc.subjectRA0421 Public health. Hygiene. Preventive Medicine
dc.subjectQR Microbiology
dc.subjectFood Science
dc.subjectNutrition and Dietetics
dc.subjectGastroenterology
dc.subjectInfectious Diseases
dc.subjectPediatrics, Perinatology, and Child Health
dc.subjectParasitology
dc.subjectGeneral Immunology and Microbiology
dc.subjectSDG 3 - Good Health and Well-being
dc.subjectSDG 1 - No Poverty
dc.subjectSDG 10 - Reduced Inequalities
dc.subjectSDG 9 - Industry, Innovation, and Infrastructure
dc.subjectSDG 2 - Zero Hunger
dc.titleWasting, Stunting, and Anemia in Angolan Children after Deworming with Albendazole or a Test-and-Treat Approach for Intestinal Parasitesen
dc.title.subtitleBinary Longitudinal Models with Temporal Structure in a Four-Arm Randomized Trialen
dc.typejournal article
degois.publication.issue11
degois.publication.titleNutrients
degois.publication.volume14
dspace.entity.typePublication
rcaap.rightsopenAccess

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