Background

Limited research has documented an association between soil-transmitted helminth (STH) infections and child development. This has recently been identified as an important knowledge gap.

Methods

A longitudinal cohort study was conducted in Iquitos, Peru, between September 2011 and July 2016. A cohort of 880 children, recruited at 1 year of age, was followed up to 5 years. STH infection was measured annually and child development was measured with the Wechsler Preschool and Primary Scale of Intelligence III (WPPSI-III) at 5 years. Linear-regression models were used to investigate the effect of the number of detected STH infections between 1 and 5 years of age on WPPSI-III scores at 5 years of age. Bayesian latent class analysis was used to adjust for exposure misclassification.

Results

A total of 781 (88.8%) children were included in the analysis. In multivariable analysis, adjusted for STH misclassification, increasing numbers of Ascaris, Trichuris, hookworm and any STH infections were associated with lower WPPSI-III scores. Among the largest observed effects were those for the effect of Ascaris infection on verbal IQ scores [difference in IQ (95% CrI) for two, three, and four or five detected infections compared with zero or one infection: –8.27 (–13.85, –3.10), –6.69 (–12.05, –2.05) and –5.06 (–10.75, 0.05), respectively]. Misclassification of STH infection generally led to a bias towards the null.

Conclusions

These results document an association between STH infection and child development. The results highlight the importance of adjusting for STH misclassification; however, future research is needed to accurately determine the sensitivity of STH diagnostic techniques. STH control in preschool children may contribute to lowering the disease burden associated with poor child development.

中文翻译：

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随着时间的推移累积的土源性蠕虫感染对儿童发育的影响：一项针对学龄前儿童的 4 年纵向队列研究，使用贝叶斯方法调整暴露错误分类

 背景

有限的研究记录了土源性蠕虫 (STH) 感染与儿童发育之间的关联。最近这被认为是一个重要的知识差距。

 方法

2011 年 9 月至 2016 年 7 月在秘鲁伊基托斯进行了一项纵向队列研究。队列研究了 880 名 1 岁时招募的儿童，并对其进行了长达 5 年的随访。每年测量一次 STH 感染情况，并在 5 岁时使用韦克斯勒学前和小学智力量表 III (WPPSI-III) 测量儿童发育情况。使用线性回归模型研究 1 至 5 岁之间检测到的 STH 感染数量对 5 岁时 WPPSI-III 评分的影响。使用贝叶斯潜在类别分析来调整暴露错误分类。

 结果

共有 781 名 (88.8%) 儿童参与分析。在多变量分析中，根据 STH 错误分类进行调整，蛔虫、鞭虫、钩虫和任何 STH 感染数量的增加与较低的 WPPSI-III 评分相关。观察到的最大影响是蛔虫感染对言语智商评分的影响[检测到的 2 次、3 次、4 次或 5 次感染与 0 次或 1 次感染相比，智商 (95% CrI) 差异：–8.27 (–13.85，分别为 –3.10)、–6.69 (–12.05、–2.05) 和 –5.06 (–10.75、0.05)]。 STH 感染的错误分类通常会导致零值的偏差。

 结论

这些结果证明了 STH 感染与儿童发育之间的关联。结果强调了调整 STH 错误分类的重要性；然而，需要未来的研究来准确确定 STH 诊断技术的敏感性。学龄前儿童的 STH 控制可能有助于减轻与儿童发育不良相关的疾病负担。