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

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  • 1 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.

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.
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