12 In a number of developing countries, hookworm is the leading underlying cause of anemia due to blood loss and consequent iron deficiency (ID). 11Īmong STHs, the hookworm species, Necator americanus and Ancylostoma duodenale, are estimated to infect about 600 million people globally with the highest infection intensity among children between 5 and 15 years of age. 10 This Cochrane review did not look specifically at different STH species, whereas we recently showed that different STH species can have different effects, for example, on micronutrient status. Indeed, despite the apparent convincing studies and recommendations, a recent Cochrane review concluded that there is hardly any benefit for blanket distribution of deworming medication for children living in STH-endemic areas, with no benefit for anthropometry, hemoglobin concentrations, cognitive development, or school attendance. 9Īlthough several studies have examined associations between helminth infection and children's academic performance or cognitive function, the findings have been inconsistent. 8 Both the World Bank and World Health Organization (WHO) promote helminth control programs in developing countries as a cost-effective intervention. 3 – 6 School-aged children are considered particularly at risk to STH infection, 7 often having the highest intensity and prevalence of infection. 2 Studies have shown helminth infection to be associated with undernutrition, stunted growth, iron-deficiency anemia (IDA), poor school attendance, and poor performance in cognition tests. 1 It is estimated that a third of the world's population is infected with one or more species of intestinal helminths, which may impair children's nutritional status, growth, and development. Soil-transmitted helminth (STH) infections are a significant public health problem in most low- and middle-income countries in Asia, Africa, and Latin America. Interventions that are more effective against hookworm infection are needed to contribute to better health and improvement of cognitive performance. Hookworm infection in Cambodian schoolchildren was associated with lower cognitive performance, an effect most likely mediated through lower body iron. Body iron was negatively associated with increased intensity of hookworm infection ( R = 0.22, P < 0.001). Hookworm infection was associated with iron status (total body iron), but not with vitamin A and zinc status, nor with inflammation or anthropometry. ![]() After adjusting for age and gender, raw cognitive test scores were significantly lower in hookworm-infected children (−0.65 −0.78 −2.03 points for picture completion, RCPM, and block design, respectively P < 0.05 for all). STH infection was found in 18% of the children almost exclusively hookwork infection. STH infection was identified using Kato–Katz, whereas cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM), block design, and picture completion. ![]() Complete data on anthropometry, cognitive performance, and micronutrient status were available for 1,760 schoolchildren, 6–16 years of age. To identify pathways through which STH infection might affect school performance, baseline data from a large rice-fortification trial in Cambodian schoolchildren were used to investigate associations between STH infection, micronutrient status, anemia, and cognitive performance. Soil-transmitted helminth (STH) infection has been associated with lower cognitive performance of schoolchildren.
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