Hostname: page-component-84b7d79bbc-g7rbq Total loading time: 0 Render date: 2024-08-01T17:49:13.575Z Has data issue: false hasContentIssue false

Trichuris trichiura infection and cognition in children: results of a randomized clinical trial

Published online by Cambridge University Press:  06 April 2009

D. T. Simeon
Affiliation:
Tropical Metabolism Research Unit, University of the West Indies, Mono, Kingston 7, Jamaica
S. M. Grantham-McGregor
Affiliation:
Tropical Metabolism Research Unit, University of the West Indies, Mono, Kingston 7, Jamaica
M. S. Wong
Affiliation:
Tropical Metabolism Research Unit, University of the West Indies, Mono, Kingston 7, Jamaica

Summary

The effects of mild to moderate infections of Trichuris trichiura on cognitive functions were investigated in Jamaican children aged 7 to 10 years. In all, 189 infected children and 100 uninfected classmates were studied. The infected children were randomly assigned to receive treatment (albendazole) or a placebo. All children were given cognitive tests on enrolment and 14 weeks later. These included verbal fluency (generation of ideas), digit span (working memory), number choice (speed of processing of visual stimuli), visual search (sustained attention) and a French Vocabulary test (paired-associate learning). At baseline, the infected children had lower scores than the uninfected ones in fluency (P = 0·01), search (P = 0·02) and French (P = 0·01). Treatment effects were examined among infected children and there was no significant treatment effect for any of the tests. However, there was a significant treatment by weight-for-age interaction in fluency (P < 0·05). The children with low weight-for-age (Z-score < – 1) improved with treatment while there was no improvement with treatment among the other children. We concluded that treatment of children with mild to moderate T. trichiura infections using albendazole produces little benefit in cognition if they are adequately nourished; however, undernourished children are more likely to benefit.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Baddeley, A. (1986). Working Memory. Oxford: Oxford University Press.Google ScholarPubMed
Baddeley, A. (1992). Cognitive functions and whipworm infections. Parasitology Today 8, 394–5.CrossRefGoogle Scholar
Baddeley, A., Meeks, Gardner J. & Grantham-McGregor, S. (1994). Cross-cultural cognition:developing tests for developing countries. Applied Cognitive Psychology (in the Press).Google Scholar
Bundy, D. & Cooper, E. (1989). Trichuris and trichuriasis in humans. Advances in Parasitology 28, 107–73.CrossRefGoogle ScholarPubMed
Callender, J., Grantham-McGregor, S., Walker, S. & Cooper, E. (1994). Treatment effects in Trichuris Dysentery Syndrome. Acta Paediatrica 83, 1182–7.CrossRefGoogle ScholarPubMed
Chandler, A., Walker, S., Connolly, K. & Grantham-Mcgregor, S. (1995). School breakfast improves verbal fluency in undernourished Jamaican children. Journal of Nutrition (in the Press).Google ScholarPubMed
Connolly, K. & Kvalsvig, J. (1993). Infection, nutrition and cognitive performance in children. Parasitology 107, 187200.CrossRefGoogle ScholarPubMed
Cooper, E., Bundy, D., McDonald, T. & Golden, M. (1990). Growth suppression in the Trichuris Dysentery Syndrome. European Journal of Clinical Nutrition 44, 285–91.Google ScholarPubMed
Cooper, E., Whyte-Alleng, C., Finzi-Smith, J. & McDonald, T. (1992). Intestinal nematode infections in children: the pathophysiological price paid. Parasitology 104 (Suppl), S91–S103.CrossRefGoogle ScholarPubMed
Halloran, M., Bundy, D. & Pollitt, E. (1989). Infectious disease and the UNESCO basic education initiative. Parasitology Today 5, 359–62.CrossRefGoogle ScholarPubMed
Hamill, P., Drizd, T., Johnson, C., Reed, R., Roche, A. & Moore, W. (1979). Physical growth: National Centre for Health Statistics percentiles. American Journal of Clinical Nutrition 32, 607–29.CrossRefGoogle ScholarPubMed
Kvalsvig, J., Coopan, R. & Connolly, K. (1991). The effects of parasite infection on cognitive processes in children. Annals of Tropical Medicine and Parasitology 85, 551–68.CrossRefGoogle ScholarPubMed
Lohman, T., Roche, A. & Martorell, R. (1989). Anthropometric Standardization Reference Manual. Champaign, Il: Human Kinetics Books.Google Scholar
Martin, L. & Beaver, P. (1968). Evaluation of the Kato thick smear technique for quantitative diagnosis of helminth infections. American Journal of Tropical Medicine and Hygiene 17, 382–91.CrossRefGoogle ScholarPubMed
Nokes, C. & Bundy, D. (1994). Does helminth infection affect mental processing and educational achievement? Parasitology Today 10, 48.CrossRefGoogle ScholarPubMed
Nokes, C., Grantham-McGregor, S., Sawyer, A., Cooper, E., Robinson, B. & Bundy, D. (1992). Moderate to heavy infections of Trichuris trichiura affect cognitive function in Jamaican school children. Parasitology 104, 539–47.CrossRefGoogle ScholarPubMed
Pollitt, E. (1990). Malnutrition and Infection in the Classroom. Paris: UNESCO.Google Scholar
Ramdath, D., Simeon, D., Wong, M. & Grantham-McGregor, S. (1995). Iron status of schoolchildren with varying intensities of Trichuris trichiura infection. Parasitology (in the Press).CrossRefGoogle ScholarPubMed
Richardson, S. (1974). The background histories of school children severely malnourished in infancy. Advances in Pediatrics 21, 167–95.CrossRefGoogle ScholarPubMed
Simeon, D. & Grantham-McGregor, S. (1989). Effects of missing breakfast on the cognitive functions of school children with differing nutritional status. American Journal of Clinical Nutrition 49, 646–53.CrossRefGoogle ScholarPubMed
Simeon, D. & Grantham-McGregor, S. (1990). Nutritional deficiencies and children's behaviour and mental development. Nutrition Research Reviews 3, 124.CrossRefGoogle ScholarPubMed
Simeon, D., Callender, J., Wong, M., Grantham-McGregor, S. & Ramdath, D. (1994). School performance, nutritional status and trichuriasis in Jamaican schoolchildren. Acta Paediatrica 83, 1188–93.CrossRefGoogle ScholarPubMed
Smith, A. (1990). Respiratory virus infections and performance. Philosophical Transactions of the Royal Society of London B 327, 519–28.Google ScholarPubMed
Watkins, W. & Pollitt, E. (1994). Improved cognition in dewormed Guatemalan school children. Faseb Journal 8, A155.Google Scholar
World Health Organization (1992). WHO Model Prescribing Information. Drugs Used in Parasitic Diseases. Geneva: WHO.Google Scholar