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Anemia is common among children in sub-Saharan Africa and its etiology is multifactorial. Likely causes of anemia are low bioavailability of dietary iron, malaria, and helminth infection. In this study, we aimed to assess the effect of iron fortification, intermittent preventive treatment (IPT) of malaria, and anthelmintic treatment on hemoglobin concentration and anemia prevalence among school children. The study was a 6-mo, randomized, double-blind, controlled trial enrolling 591 6- to 14-y-old school children in Cote d'lvoire using the following: 1) iron-fortified biscuits providing an additional 20 mg iron/d as electrolytic iron 4 times/wk; 2) IPT of malaria with sulfadoxine-pyrimethamine at 0 and 3 mo; and 3) anthelmintic treatment at 0 and 3 mo as the interventions. Prevalence of anemia, iron deficiency, malaria parasitemia, and helminth infection was 70.4, 9.3, 57.7, and 54.8%, respectively. Iron fortification did not improve iron status, IPT of malaria did not affect malaria burden, and neither had an impact on anemia prevalence. Anthelmintics significantly reduced the burden of helminth infections and decreased anemia prevalence (odds ratio: 0.4, 95% CI: 0.3, 0.7). The low prevalence of iron deficiency and an extended dry season that decreased malaria transmission likely reduced the potential impact of iron fortification and IPT. In this setting, anthelmintic treatment was the only intervention that modestly decreased rates of anemia. doi: 10.3945/jn.109.114256.

A study was conducted on the relationship between intestinal helminthiases and growth in urban slum children. The subjects were given single doses of either pyrantel, albendazole or placebo at baseline and at six months. The children were then examined for helminth infections and anthropometry. The results indicate that treatment of helminth infections in school-age children may enhance growth in places where helminth infections and malnutrition are prevalent.

A survey was conducted on 131 mothers in rural Bangladesh to examine knowledge and perceptions of helminth infection in relation to use of health facilities and treatment-seeking behaviour. Almost all respondents considered worms to be a cause of bad health and a high percentage of mothers had obtained deworming treatment for their children. However, marked differences were found in mothers' descriptions of the causes and prevention of helminth infection in two adjacent areas; Pullakandi and Shekpara. The discrepancies in biomedical knowledge corresponded with differences in treatment-seeking behaviour in the two areas. All households in the area had access to free deworming treatment provided by a health clinic, but this facility was predominantly used by women living nearby in Pullakandi. Because of the cultural and social constraints on female activities, women living further from the clinic, in Shekpara, preferred to send their husbands to a pharmacy in the nearby town to buy deworming treatment. As a consequence, these households were at a relative disadvantage in respect of the low exposure of women to health education and the greater financial cost of deworming treatment. The study highlights the influences of social and cultural factors on treatment-seeking behaviour, which in turn affect women's exposure to health education and biomedical knowledge of helminths. Further questions are raised, however, on the ability of women to implement preventive measures and the impact of health education on rates of parasitic infection. Key words - helminths, deworming, behaviour, perceptions

Changes in the diagnosis and treatment of helminthic infection were examined during a longitudinal study in a rural community in Guatemala. Self-diagnosis was predominant, with an increase in perceived helminthic infection during an economic crisis within the community. Allium sativum L. and Chenopodium ambrosoides L. were used as anthelmintics, often in conjunction with commercial drugs. During the economic crisis the use of plants as treatment for perceived infection increased whereas use of commercial helminthic medicine decreased. Dietary modifications were observed during periods of perceived infection, but were not consistent in the food items modified or the nature of the modification. Within the community individuals exhibited considerable heterogeneity in their approaches to treatment.

To the Editor: Mammonogamus laryngeus (Syngamus laryngeus) is a nematode parasite found in the larynx of tropical mammals (1), especially cattle and cats and occasionally humans (2). We report a [...]

A pilot project in Nepali schools, giving deworming tablets, a hot meal for the children and food gifts for girls to take back to their parents, has created such a [...]