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Am. J. Trop. Med. Hyg., 74(3), 2006, pp. 475-481
Copyright © 2006 by The American Society of Tropical Medicine and Hygiene

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COGNITIVE EFFECTS OF DIARRHEA, MALNUTRITION, AND ENTAMOEBA HISTOLYTICA INFECTION ON SCHOOL AGE CHILDREN IN DHAKA, BANGLADESH

JESSICA L. TARLETON, RASHIDUL HAQUE, DINESH MONDAL, JIANFEN SHU, BARRY M. FARR, AND WILLIAM A. PETRI, JR.*
Division of Infectious Diseases and International Health and Division of Biostatistics and Epidemiology, University of Virginia, Charlottesville Virginia; International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh

Cognitive function was assessed in 191 Bangladeshi children 6–9 years of age using verbal and nonverbal tests. These scores were added to a health surveillance database that was compiled over the four previous years that includes incidence of diarrhea and Entamoeba histolytica infection and nutritional status. The associations of diarrhea, malnutrition, and social factors with cognitive scores were analyzed statistically, and associations between diarrhea and test scores were controlled for the influence of social factors. Cognitive scores were negatively associated with stunting during school age, as well as the height-for-age and weight-for-age scores at study enrollment. Incidence of diarrhea was associated with nonverbal test scores before, but not after, controlling for socioeconomic factors. Generally E. histolytica infection was not found to independently influence scores, except that E. histolytica-associated dysentery was associated with lower test scores while dysentery of any etiology was not. Thus, malnutrition during the school age years, but not diarrhea or E. histolytica infection, was associated with a lower level of cognitive functioning. This suggested that intervention during school age years may be able to mitigate the cognitive deficiencies associated with malnutrition.

Received August 17, 2005. Accepted for publication October 31, 2005.

Acknowledgments: We thank the parents and children of Mirpur for their participation and the field team, including field assistants and laboratory staff, for their involvement in the study.

Financial support: This study was supported by a grant (AI-43596) from the National Institutes of Health (NIH) and by the ICDDR,B. The ICDDR,B is supported by countries and agencies that share its concern for the health problems of developing countries.

Disclosure: William A. Petri Jr. received research support from TechLab, Inc. and royalties from a patent license agreement with TechLab for a diagnostic test for amebiasis. These royalties accrue to the American Society of Tropical Medicine and Hygiene without benefit to Dr. Petri. The NIH had no role in the design of the study but did review and approve the human investigation protocol.

* Address correspondence to William A. Petri Jr., Division of Infectious Diseases and International Health, University of Virginia Health System, Room 2115 MR4 Building, P.O. Box 801340, Charlottesville, VA 22908-1340. E-mail: wap3g{at}virginia.edu

Authors’ addresses: Jessica L. Tarleton and William A. Petri Jr., Division of Infectious Diseases and International Health, University of Virginia Health System, Room 2115 MR4 Building, P.O. Box 801340, Charlottesville, VA 22908-1340. Rashidul Haque and Dinesh Mondal, International Centre for Diarrhoeal Disease Research, Dhaka Bangladesh. Jianfen Shu and Barry M. Farr, Division of Biostatistics and Epidemiology, University of Virginia, Charlottesville, VA 22908-1340.

Reprint requests: William A. Petri Jr., Division of Infectious Diseases and International Health, University of Virginia Health System, Room 2115 MR4 Building, P.O. Box 801340, Charlottesville, VA 22908-1340, E-mail: wap3g{at}virginia.edu.




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R. HAQUE, D. MONDAL, J. SHU, S. ROY, M. KABIR, A. N. DAVIS, P. DUGGAL, and W. A. PETRI JR
CORRELATION OF INTERFERON-{gamma} PRODUCTION BY PERIPHERAL BLOOD MONONUCLEAR CELLS WITH CHILDHOOD MALNUTRITION AND SUSCEPTIBILITY TO AMEBIASIS
Am J Trop Med Hyg, February 1, 2007; 76(2): 340 - 344.
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