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Treatment effects in Trichuris dysentery syndrome
J E Callender1, S M Grantham-McGregor, S P Walker
1Tropical Metabolism Research Unit, University of the West Indies, Mona, Kingston, Jamaica.
Insights
Children with Trichuris dysentery syndrome (TDS) experience significant developmental deficits. Anthelmintic treatment improved motor skills and physical growth, highlighting the need for ongoing prevention strategies.
Area of Science:
- Pediatric Health
- Infectious Diseases
- Developmental Pediatrics
Background:
- Heavy Trichuris trichiura infection causes Trichuris dysentery syndrome (TDS), characterized by growth retardation and anemia.
- TDS is associated with impaired child development, impacting overall well-being and future potential.
Purpose of the Study:
- To evaluate the growth and developmental outcomes in children with TDS following anthelmintic treatment.
- To compare the developmental trajectories of TDS children with a matched control group.
Main Methods:
- Assessed 19 children (27-84 months) with TDS using Griffiths mental development scales.
- Monitored growth parameters (height-for-age, weight-for-height, mid-upper arm circumference) and hemoglobin levels.
- Compared TDS children's progress with a control group over one year post-treatment.
Main Results:
- TDS children initially presented with significant developmental quotient (DQ) deficits (24 points, p < 0.001).
- After treatment, TDS children showed significant improvement in locomotor development compared to controls (p < 0.001).
- Rapid catch-up in wasting indices and steady improvement in height-for-age and hemoglobin levels were observed.
Conclusions:
- Anthelmintic treatment effectively improves motor development and physical growth in children with TDS.
- Catch-up growth in height was comparable to children recovering from coeliac disease.
- Sustained prevention strategies are crucial following initial treatment to maintain health gains.
Abstract:
Heavy infection with the geohelminth Trichuris trichiura causes the Trichuris dysentery syndrome (TDS). Growth retardation and anaemia are characteristic of TDS and both are associated with poor development. We have examined the growth and developmental responses to treatment in 19 children aged 27-84 months with TDS. Developmental levels (DQ) were measured with the Griffiths mental development scales. Compared with a control group matched for age, gender and neighbourhood, the TDS children initially had serious deficits in DQ (24 points, p < 0.001). After a year of anthelmintic treatment, the TDS children showed improvement in locomotor development (p < 0.001) compared with the controls. The TDS children also had initial deficits in height-for-age, weight-for-height, mid-upper arm circumference and haemoglobin levels. They caught up rapidly in indices of wasting (weight-for-height and mid-upper arm circumference) and showed steady improvement in height-for-age and haemoglobin levels. Catch-up in height was comparable to that of children recovering from coeliac disease. The importance of continuing prevention after initial treatment is highlighted.