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Determining Soil-transmitted Helminth Infection Status and Physical Fitness of School-aged Children
Published on: August 22, 2012
Anthelminthic treatment raises plasma iron levels but does not decrease the acute-phase response in Jakarta school
E Karyadi1, R Gross, S Sastroamidjojo
1SEAMEO-TROPMED Regional Center for Community Nutrition, University of Indonesia, Jakarta.
Insights
Albendazole treatment significantly reduced intestinal worm infections in Indonesian school children. This deworming also led to a notable increase in plasma iron levels, improving iron status.
Area of Science:
- Public Health
- Infectious Diseases
- Nutritional Science
Background:
- Intestinal helminthiasis is prevalent in Indonesian school children, impacting their health and nutritional status.
- High prevalence of Ascaris lumbricoides and Trichuris trichiura infections were observed in the study population.
- The study aimed to assess the effects of helminthiasis treatment on iron status and acute phase response.
Purpose of the Study:
- To investigate the impact of intestinal helminthiasis and albendazole treatment on iron status.
- To evaluate the effect of treatment on the acute phase response (APR) in urban Indonesian primary school children.
- To determine changes in plasma iron, hemoglobin, and inflammatory markers post-treatment.
Main Methods:
- A randomized, placebo-controlled trial involving 120 primary school children aged 8-11 years.
- Treatment group received a single dose of albendazole (400 mg), while the control group received a placebo.
- Measurements of plasma iron, hemoglobin, CRP, ESR, WBC, IL-1, IL-6, and TNF were taken before and 10 days after intervention.
Main Results:
- Albendazole treatment drastically reduced ascariasis and trichuriasis prevalence.
- Plasma iron concentrations and white blood cell (WBC) counts significantly increased in the treatment group post-intervention.
- Hemoglobin levels showed a non-significant increase, while inflammatory markers remained within normal limits or showed non-specific increases in ESR.
Conclusions:
- Albendazole treatment is effective in reducing intestinal worm burden in school children.
- Treatment with albendazole is associated with improved iron status, indicated by increased plasma iron levels.
- Further research may be needed to explore the long-term effects on hemoglobin and inflammatory markers.
Abstract:
The study was conducted to investigate the impact of intestinal helminthiasis and treatment on iron status and acute phase response (APR) among urban Indonesian primary school children, aged 8-11 years old. The prevalence of helminthiasis among these children was; Ascaris lumbricoides, 81.6%; Trichuris trichiura, 88.3%; and mixed infection of A. lumbricoides and T. trichiura, 70.0%. Of 120 children enrolled in the investigation, 59 received a single 400 mg dose of albendazole, and 61 received a placebo. Ten days following treatment, the prevalence of ascariasis and trichuriasis in the treatment group diminished to 0% and 27%, respectively, and in the placebo group to 63.9% and 68.9%. Plasma iron, hemoglobin, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC), interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor (TNF) concentrations were determined prior to the intervention and 10 days after. Plasma iron concentrations and WBC count rose in the treatment group (p=< or =0.05) when compared to baseline status. Increases in hemoglobin concentrations observed in the treatment group 10 days post-treatment were not statistically significant. CRP, IL-1, IL-6 and TNF were found to be within normal limits for both groups both before and after treatment. ESR increased significantly in both treatment and placebo groups when compared the rates measured before treatment. These findings show that treatment with albendazole is associated not only with a decreased worm burden in school children, but also a rise in plasma iron.
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