Hookworm, Ascaris lumbricoides infection and polyparasitism associated with poor cognitive performance in Brazilian schoolchildren.

Full Abstract

OBJECTIVE:
To investigate the relationship between hookworm and Ascaris lumbricoides infection and performance on three subsets of the Wechsler Intelligence Scale for Children - third edition (WISC-III) (Digit Span, Arithmetic and Coding) and Raven Colored Progressive Matrices.

METHODS:
Cross-sectional study of 210 children between the ages of 6 and 11 years in Americaninhas, Minas Gerais, Brazil. Separate proportional odds models were used to measure the association between the intensity of helminth infections and poor performance on each of the four cognitive tests.

RESULTS:
After adjusting for sex, age, socioeconomic status and other helminth infections, moderate-to-high-intensity hookworm infection was associated with poor performance on the WISC-III Coding subtest [OR = 3.20; 95% confidence interval (CI) = 1.43-7.17], low intensity of hookworm infection was associated with poor performance on the WISC-III Coding subtest [odds ratio (OR) = 3.71; 95% CI = 1.80-7.66] and moderate-to-high-intensity A. lumbricoides infection was associated with poor performance on the Raven test (OR = 2.03; 95% CI = 1.04-3.99), all in comparison with uninfected children. Children co-infected with A. lumbricoides infection and hookworm infection had greater odds of poor performance on some WISC-III subtests than children with only A. lumbricoides infection.

CONCLUSIONS:
These findings suggest that hookworm infection may be associated with poorer concentration and information processing skills, as measured on the WISC-III Coding subtest, and that A. lumbricoides infection may be associated with poorer general intelligence, as measured through the Raven Colored Progressive Matrices. This study also presents evidence that polyparasitized children experience worse cognitive outcomes than children with only one helminth infection.

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Author information

Author/s: Jardim-Botelho, Anne (A); Raff, Sophia (S); Rodrigues, Renato de Avila (Rde A); Hoffman, Heather J (HJ); Diemert, David Joseph (DJ); Corrêa-Oliveira, Rodrigo (R); Bethony, Jeffrey Michael (JM); Gazzinelli, Maria Flávia (MF);

Affiliation: Instituto René Rachou, FIOCUZ, Belo Horizonte, Brazil.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Tropical medicine & international health : TM & IH (Trop Med Int Health), published in England. (Language: eng)

Reference: 2008-Aug; vol 13 (issue 8) : pp 994-1004

Dates: Created 2008/09/04; Completed 2008/09/29;

PMID: 18627581, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Animals
Ascariasis - epidemiology; parasitology
Ascaris lumbricoides - isolation & purification
Brazil - epidemiology
Child
Child Development - physiology
Cognition - physiology
Cognition Disorders - parasitology

Cognition Disorders - parasitology
Cross-Sectional Studies
Hookworm Infections - complications; epidemiology
Humans
Necator americanus - isolation & purification
Parasite Egg Count
Regression Analysis
Rural Health

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