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

JESSICA L. TARLETON 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

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RASHIDUL HAQUE 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

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DINESH MONDAL 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

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JIANFEN SHU 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

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BARRY M. FARR 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

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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

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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.

Author Notes

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@virginia.edu.
  • 1

    Berkman DS, Lescano AG, Gilman RH, Lopez SL, Black MM, 2002. Effects of stunting, diarrhoeal disease, and parasitic infection during infancy on cognition in late childhood: a follow-up study. Lancet 359 :546–571.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Niehaus MD, Moore SR, Patrick PD, Derr LL, Lorntz B, Lima AA, Guerrant RL, 2002. Early childhood diarrhea is associated with diminished cognitive function 4 to 7 years later in a northeast Brazilian shantytown. Am J Trop Med Hyg 66 :590–593.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Haque R, Mondal D, Kirkpatrick BD, Akther S, Farr BM, Sack RB, Petri WA Jr, 2003. Epidemiological and clinical characteristics of acute diarrhea with emphasis on Entamoeba histolytica infections in preschool children in an urban slum of Dhaka, Bangladesh. Am J Trop Med Hyg 69 :389–405.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Ayeh-Kumi PF, Ali IM, Lockhart LA, Gilchrist CA, Petri WAJ, Haque R, 2001. Entamoeba histolytica: genetic diversity of clinical isolates from Bangladesh as demonstrated by polymorphisms in the serine-rich gene. Exp Parasitol 99 :80–88.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Haque R, Ali IM, Sack RB, Farr BM, Ramakrishnan G, Petri WAJ, 2001. Amebiasis and mucosal IgA antibody against the Entamoeba histolytica adherence lectin in Bangladeshi children. J Infect Dis 183 :1787–1793.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Kordas K, Lopez P, Rosado JL, Garcia Vargas G, Alatorre Rico J, Ronquillo D, Cebrian ME, Stoltzfus RJ,2004. Blood lead, anemia, and short stature are independently associated with cognitive performance in Mexican school children. J Nutr 134 :363–371.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Black MM, 2003. Micronutrient deficiencies and cognitive functioning. J Nutr 133 (11 Suppl 2):3927S–3931S.

  • 8

    Elbedour S, Bart WM, Hekter J, 2003. Intelligence and family marital structure: the case of adolescents from monogamous and polygamous families among Bedouin Arabs in Israel. J Soc Psychol 143 :95–110.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Daley TC, Whaley SE, Sigman MD, Espinosa MP, Neumann C, 2003. IQ on the rise: the Flynn effect in rural Kenya. Psychol Sci 14 :215–219.

  • 10

    Counter SA, Buchanan LH, Rosas HD, Ortega F, 1998. Neurocognitive effects of chronic lead intoxication in Andean children. J Neurol Sci 160 :47–53.

  • 11

    Lai TJ, Guo YL, Guo NW, Hsu CC, 2001. Effect of prenatal exposure to polychorinated biphenyls on cognitive development in children: a longitudinal study in Taiwan. Br J Psychiatry 178 :S49–S52.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Esquivel GB, 1965. Coloured progressive matrices. Buros OK, ed. Mental Measurements Yearbook. Highland Park, NJ: Gryphon Press, 206–212.

    • PubMed
    • Export Citation
  • 13

    Raven J, Raven JC, Court JH, 1998. Section 2: Coloured Progressive Matrices. Manual for Raven’s Progressive Matrices and Vocabulary Scales. Oxford, United Kingdom: Oxford Psychologists Press, Ltd.

    • PubMed
    • Export Citation
  • 14

    Hadidjaja P, Bonang E, Suyardi MA, Abidin SA, Ismid IS, Margono SS, 1998. The effect of intervention methods on nutritional status and cognitive function of primary school children infected with Ascaris lumbricoides. Am J Trop Med Hyg 59 :791–795.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Gardner JM, Grantham-McGregor S, 1996. Baddeley A. Trichuris trichiura infection and cognitive function in Jamaican school children. Ann Trop Med Parasitol 90 :55–63.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Checkley W, Epstein LD, Gilman RH, Black RE, Cabrera L, Sterling CR, 1998. Effects of Cryptosporidium parvum infection in Peruvian children: growth faltering and subsequent catch-up growth. Am J Epidemiol 148 :497–506.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Guerrant RL, Schorling JB, McAuliffe JF, de Souza MA, 1992. Diarrhea as a cause and an effect of malnutrition: diarrhea prevents catch-up growth and malnutrition increases diarrhea frequency and duration. Am J Trop Med Hyg 47 :28–35.

    • PubMed
    • Search Google Scholar
    • Export Citation
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