Brechje de Gier1, Maiza Campos Ponce1, Margot van de Bor1, Colleen M Doak1, Katja Polman1. 1. From the Department of Health Sciences (MCP, CMD, and KP) and Section of Health and Life Sciences (BdG and MvdB), VU University Amsterdam, Amsterdam, Netherlands, and the Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium (KP).
Abstract
BACKGROUND: Helminth infections and micronutrient deficiencies are highly prevalent in developing countries. Neither condition typically causes overt disease, but they do lead to indirect morbidity such as impaired physical and cognitive development. OBJECTIVE: We aimed to systematically review current evidence on the relation of helminth infections with micronutrient status in school-age children worldwide. DESIGN: We included both observational studies and randomized controlled trials (RCTs). We applied a random-effects meta-analysis to estimate 1) cross-sectional associations between helminths and micronutrient status, 2) effects of anthelminthic treatment on micronutrient status, and 3) effects of micronutrient supplementation on helminth infection and reinfection. RESULTS: Meta-analyses of observational studies showed an association between helminth infections and serum retinol [standardized mean difference (SMD): -0.30; 95% CI: -0.48, -0.13] but not serum ferritin (SMD: 0.00; 95% CI: -0.7, 0.7). Conversely, meta-analyses of anthelminthic treatment RCTs showed a positive effect on ferritin (SMD: 0.16; 95% CI: 0.09, 0.22) but not retinol (SMD: 0.04; 95% CI: -0.06, 0.14). The number of studies on micronutrients other than ferritin and retinol was not sufficient for pooling. Meta-analyses of micronutrient-supplementation RCTs showed only a modest protective effect for multimicronutrient interventions on helminth infection and reinfection rates (OR: 0.77; 95% CI: 0.61, 0.97). CONCLUSIONS: In this review, we show evidence of distinct associations between helminth infections and micronutrients in school-age children. More studies are needed on micronutrients other than iron and vitamin A and on possible helminth species-specific effects. A thorough comprehension of the interplay between helminth infections and micronutrients will help guide integrated and sustainable intervention strategies in affected children worldwide.
BACKGROUND:Helminth infections and micronutrient deficiencies are highly prevalent in developing countries. Neither condition typically causes overt disease, but they do lead to indirect morbidity such as impaired physical and cognitive development. OBJECTIVE: We aimed to systematically review current evidence on the relation of helminth infections with micronutrient status in school-age children worldwide. DESIGN: We included both observational studies and randomized controlled trials (RCTs). We applied a random-effects meta-analysis to estimate 1) cross-sectional associations between helminths and micronutrient status, 2) effects of anthelminthic treatment on micronutrient status, and 3) effects of micronutrient supplementation on helminth infection and reinfection. RESULTS: Meta-analyses of observational studies showed an association between helminth infections and serum retinol [standardized mean difference (SMD): -0.30; 95% CI: -0.48, -0.13] but not serum ferritin (SMD: 0.00; 95% CI: -0.7, 0.7). Conversely, meta-analyses of anthelminthic treatment RCTs showed a positive effect on ferritin (SMD: 0.16; 95% CI: 0.09, 0.22) but not retinol (SMD: 0.04; 95% CI: -0.06, 0.14). The number of studies on micronutrients other than ferritin and retinol was not sufficient for pooling. Meta-analyses of micronutrient-supplementation RCTs showed only a modest protective effect for multimicronutrient interventions on helminth infection and reinfection rates (OR: 0.77; 95% CI: 0.61, 0.97). CONCLUSIONS: In this review, we show evidence of distinct associations between helminth infections and micronutrients in school-age children. More studies are needed on micronutrients other than iron and vitamin A and on possible helminth species-specific effects. A thorough comprehension of the interplay between helminth infections and micronutrients will help guide integrated and sustainable intervention strategies in affected children worldwide.
Authors: Brechje de Gier; Tran Thuy Nga; Pattanee Winichagoon; Marjoleine A Dijkhuizen; Nguyen Cong Khan; Margot van de Bor; Maiza Campos Ponce; Katja Polman; Frank T Wieringa Journal: Am J Trop Med Hyg Date: 2016-05-31 Impact factor: 2.345
Authors: Lynne S Garcia; Michael Arrowood; Evelyne Kokoskin; Graeme P Paltridge; Dylan R Pillai; Gary W Procop; Norbert Ryan; Robyn Y Shimizu; Govinda Visvesvara Journal: Clin Microbiol Rev Date: 2017-11-15 Impact factor: 26.132
Authors: Brechje de Gier; Liliane Mpabanzi; Kim Vereecken; Suzanne D van der Werff; Patrick C D'Haese; Marion Fiorentino; Kuong Khov; Marlene Perignon; Chhoun Chamnan; Jacques Berger; Megan E Parker; Raquel Junco Díaz; Fidel Angel Núñez; Lázara Rojas Rivero; Mariano Bonet Gorbea; Colleen M Doak; Maiza Campos Ponce; Frank T Wieringa; Katja Polman Journal: Nutrients Date: 2015-04-20 Impact factor: 5.717
Authors: Brechje de Gier; Maiza Campos Ponce; Marlene Perignon; Marion Fiorentino; Kuong Khov; Chhoun Chamnan; Michiel R de Boer; Megan E Parker; Kurt Burja; Marjoleine A Dijkhuizen; Jacques Berger; Katja Polman; Frank T Wieringa Journal: PLoS One Date: 2016-01-06 Impact factor: 3.240