Anthelmintic treatment of rural Bangladeshi children: effect on host physiology, growth, and biochemical status

Background: The effect of helminth infestation on the nutrition, growth, an d physiology of the host is still poorly understood. Anthelmintic treatment of children in developing countries has had varying success in terms of gr owth improvements. Objective: The objective of this study was to assess the effect of regular deworming on child growth, physiology, and biochemical status. Design: The study was a 12-mo longitudinal intervention in 123 Bangladeshi children aged 2-5 y. Treatment (mebendazole) or placebo tablets were admini stered every 2 mo for 8 mo and again at 12 mo. Weight, height, midupper arm circumference, intestinal permeability, plasma albumin, alpha (1)-antichym otrypsin, and total protein concentration were assessed every 2 mo. Results: Treatment with mebendazole reduced the prevalence of Ascaris lumbr icoides from 78% to 8%, of Trichuris trichiura from 65% to 9%, and of hookw orm from 4% to 0%. There was no significant difference in the growth of tre ated children compared with those given placebo tablets. No changes in inte stinal permeability or plasma albumin were observed after deworming. Signif icant decreases in total protein (P < 0.001) and <alpha>(1)-antichymotrypsi n (P < 0.001) were observed in the treatment group, indicating possible red uctions in inflammation and immunoglobulin concentration after deworming. A significant increase in the prevalence of Giardia intestinalis (from 4% to 49%) in the treatment group was associated with a short-term reduction in weight (P = 0.02) and higher intestinal permeability (P < 0.001) in infecte d subjects. No long-term effects of G. intestinalis on growth were observed . Conclusion: Low-intensity helminth infections, predominantly of A. lumbrico ides and T. trichiura, do not contribute significantly to the poor growth a nd biochemical status of rural Bangladeshi children.