CORRELATIONS BETWEEN INTESTINAL PARASITOSIS, PHYSICAL GROWTH, AND PSYCHOMOTOR DEVELOPMENT AMONG INFANTS AND CHILDREN FROM RURAL NICARAGUA

The correlations between malnutrition, parasitosis (especially helmint h infections), and child development are complex, and studies of these interrelationships will allow health agencies to maximize screening a nd intervention strategies for developing countries. We examined these correlations in a cross-sectional program in Carazo State, Nicaragua. Nine hundred sixty-one children in two age strata (ages 0-24 months a nd ages 2-10 years) from one urban and three rural communities were sc reened for intestinal parasites (direct smear and ZnSO4 flotation), ma lnutrition, and developmental delays. Nutritional status was determine d as weight-for-age (WFA), weight-for-height (WFH), and height-for-age (HFA). Developmental status (normal, suspect) was determined for the four subtests of the Denver II Screening Test. The prevalence of malnu trition was 14.6% (WFA), 8.4% (WFH), and 36.3% (HFA). Parasitosis was more prevalent in children less than 24 months of age with low HFA, wh ereas in older children low WFA was more closely associated with paras itic infections. Ascaris and Trichuris were more prevalent in malnouri shed children. On the Denver II, suspect test results in all four cate gories (language, social, gross motor, and fine motor) were associated with low WFA, and suspect language tests were associated with both in testinal parasites (P = 0.0003) and Ascaris infection in particular (P = 0.044). Developmental disabilities are a significant and frequently undetected health problem in developing countries, and malnutrition a ssociated with intestinal helminth infections may be an important cont ributory factor for these disabilities.