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Home / Publications / Impact of annual albendazole versus four-monthly test-and-treat approach of intestinal parasites on children growth — a longitudinal four-arm randomized parallel trial during two years of a community follow-up in Bengo, Angola

Impact of annual albendazole versus four-monthly test-and-treat approach of intestinal parasites on children growth — a longitudinal four-arm randomized parallel trial during two years of a community follow-up in Bengo, Angola

  • Authors: Carolina Gasparinho, Aguinaldo Kanjungo, Félix Zage, Isabel Clemente, Ana Santos-Reis, Miguel Brito, José Carlos Sousa-Figueiredo, Filomeno Fortes, Luzia Gonçalves
  • Publication Year: 2021
  • Journal: Pathogens, 10(3), art 309
  • Link: https://doi.org/10.3390/pathogens10030309

ABSTRACT

Malnutrition and intestinal parasites continue to have serious impacts on growth and cognitive development of children in Angola. A longitudinal four-arm randomized parallel trial was conducted to investigate if deworming with a single annual dose of albendazole (annual-ALB) or a four-monthly test-and-treat (4TT) intestinal parasites approach at individual or household levels improve nutritional outcomes of pre-school children in Bengo province. Children with intestinal parasites (n = 121) were randomly assigned (1:1:1:1) to arm A1: annual-ALB*individual level; A2: annual-ALB*household level; A3: 4TT*individual; and A4: 4TT*household level. At baseline, 4, 8, 12, 16, 20, and 24 months of follow-up, growth was assessed by height, weight, height-for-age, weight-for-height, weight-for-age, and mid-upper arm circumference. Intention-to-treat analysis was done using non-parametric approach, mixed effect models, and generalized estimating equations (GEE). Initially, 57% and 26% of the children were infected by Giardia lamblia and Ascaris lumbricoides, respectively. This study did not show that a 4TT intestinal parasites approach results on better growth outcomes of children (height, weight, HAZ, WAZ, WHZ and MUACZ) when compared with annual ALB, with exception of height and WHZ using GEE model at 5% level. Positive temporal effects on most nutrition outcomes were observed. Implementing a longitudinal study in a poor setting is challenging and larger sample sizes and ‘pure and clean’ data are difficult to obtain. Nevertheless, learned lessons from this intensive study may contribute to future scientific research and to tailor multidisciplinary approaches to minimize malnutrition and infections in resource-poor countries.

 

KEYWORDS

stunting; Z-score; growth; longitudinal; deworming; intestinal parasites.

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About GHTM

GHTM is a R&D Unit that brings together researchers with a track record in Tropical Medicine and International & Global Health. It aims at strengthening Portugal's role as a leading partner in the development and implementation of a global health research agenda. Our evidence-based interventions contribute to the promotion of equity in health and to improve the health of populations.

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