Unveiling the Role of Intestinal Parasitic Infections in Childhood Malnutrition in Assiut Governorate.
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- This is an observational study: the protocol does not assign a study treatment.
- Who it may be relevant to
- Registry conditions: Malnourished Children. Basic parameters: 2 years — 15 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
Intestinal parasitic infections (IPIs) are highly prevalent worldwide, particularly among children living in lowresource settings. (1) These infections pose a significant public health challenge due to their widespread distribution and their impact on vulnerable populations, especially preschool and school-aged children. (2) Common intestinal parasites include protozoa such as Giardia lamblia and Entamoeba histolytica, as well as helminths like Ascaris lumbricoides, Trichuris trichiura, and hookworms.(3) IPIs contribute to a range of health problems in children, including diarrhea, anemia, general weakness, and impaired physical development. These infections often cause malabsorption of nutrients and chronic blood loss, which can severely affect children's growth and overall health status. (2) Malnutrition has been defined by the World Health Organization as a major global health challenge with significant implications for morbidity and mortality worldwide.(4) It is characterized by conditions such as stunting, wasting, and underweight, all of which reflect inadequate nutrition and impaired growth. . (Yoseph \& Beyene, 2020).Malnutrition is influenced by multiple interconnected factors including socioeconomic status, inadequate feeding practices, lack of exclusive breastfeeding, recurrent infections, limited healthcare access, and poor environmental conditions such as unsafe water and sanitation. (5) Persistent and/or recurring IPIs are considered important contributors to adverse developmental outcomes depending on parasite species and infection dynamics.(6) They may contribute to malnutrition through both direct and indirect mechanisms. Directly, they can induce chronic subclinical systemic inflammation and modulate the host immune response to ensure persistence, resulting in adverse effects on growth.(7) For example, infection with Cryptosporidium spp. has been linked to reduced length-for-age, mediated by increased systemic inflammation and decreased circulating IGF-1 concentrations.(8) Indirectly, they may promote environmental enteric dysfunction (EED), which is subclinical disorder of the small intestine that can contribute to malnutrition. It involves villous atrophy and crypt hyperplasia, reducing nutrient absorption, and infections such as G. lamblia may play a key role in its development.(6) Additionally IPIs may interact with the normal gut microbiota, with each influencing the other's pathogenic potential, and this interaction can contribute to malnutrition.(7) IPIs can reduce food intake by causing illness, abdominal discomfort, or altering appetite regulation.(8) They may affect neuroendocrine signals, modifying taste perception and satiety hormones, such as elevated leptin levels observed in children infected with E. histolytica, Strongyloides spp., and G. lamblia. Infections like Trichuris trichiura have also been linked to lower intake of protein, energy, iron and riboflavin.(6) While parasites like hookworm directly cause nutrient loss through blood and iron depletion, often resulting in anaemia. (1) Deficiencies in zinc, vitamin D and omega-3 fatty acids are common in children affected by malnutrition and parasitic infections. Zinc and vitamin D is essential for gut integrity, immune function, and growth, while omega-3 fatty acids support intestinal structure and have anti-inflammatory effects. Low levels of these nutrients may worsen intestinal dysfunction, including EED, and contribute to impaired growth.(9) In the light of the previously discussed mechanisms, a strong bidirectional relationship exists between parasitic infections and malnutrition, whereby each condition aggravates the other, forming a vicious cycle that increases the risk of stunting, poor growth, anaemia, and impaired immune function.(3)
Primary outcome measures
- the prevelance of intestinal parasitic infections [Time frame: baseline]
Eligibility criteria
Inclusion criteria
- Children aged 2-15 years of both sexes.
- Children whose parents provide informed written consent.
- Malnourished children identified based on anthropometric measurements according to the growth standards of the World Health Organization. Height-for-Age, Weight-for-Age and Weight-for-Height were <-2 standard deviation (SD) were classified as stunted, wasted, and underweight, respectively.
- Apparently healthy control children of similar age groups
Exclusion criteria
- • Children with chronic systemic diseases (e.g., chronic renal, hepatic, cardiac, or endocrine disorders).
- Children with known genetic or congenital disorders affecting growth.
- Children who received micronutrient supplementation (omega 3, zinc, vitamin D) within the last 3 months.
- Children who received antiparasitic treatment within the last 3 months.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Observational model
- Case-control
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT07496801 · Intestinal Parasitic Infection