MODERATE- AND LOW-INTENSITY CO-INFECTIONS BY INTESTINAL HELMINTHS AND SCHISTOSOMA MANSONI, DIETARY IRON INTAKE, AND ANEMIA IN BRAZILIAN CHILDREN

LUCIARA L. BRITO Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil; Escola de Nutrição, Federal University of Bahia, Salvador, Brazil; Centro de Pesquisa Gonçalo Muniz, Oswaldo Cruz Foundation, Salvador, Brazil; Department of Nutrition, Case University, Cleveland, Ohio; Center for Global Health and Diseases, Case University, Cleveland, Ohio

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MAURÍCIO L. BARRETO Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil; Escola de Nutrição, Federal University of Bahia, Salvador, Brazil; Centro de Pesquisa Gonçalo Muniz, Oswaldo Cruz Foundation, Salvador, Brazil; Department of Nutrition, Case University, Cleveland, Ohio; Center for Global Health and Diseases, Case University, Cleveland, Ohio

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RITA DE CÁSSIA R. SILVA Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil; Escola de Nutrição, Federal University of Bahia, Salvador, Brazil; Centro de Pesquisa Gonçalo Muniz, Oswaldo Cruz Foundation, Salvador, Brazil; Department of Nutrition, Case University, Cleveland, Ohio; Center for Global Health and Diseases, Case University, Cleveland, Ohio

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ANA MARLÚCIA O. ASSIS Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil; Escola de Nutrição, Federal University of Bahia, Salvador, Brazil; Centro de Pesquisa Gonçalo Muniz, Oswaldo Cruz Foundation, Salvador, Brazil; Department of Nutrition, Case University, Cleveland, Ohio; Center for Global Health and Diseases, Case University, Cleveland, Ohio

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MITERMAYER G. REIS Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil; Escola de Nutrição, Federal University of Bahia, Salvador, Brazil; Centro de Pesquisa Gonçalo Muniz, Oswaldo Cruz Foundation, Salvador, Brazil; Department of Nutrition, Case University, Cleveland, Ohio; Center for Global Health and Diseases, Case University, Cleveland, Ohio

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ISABEL M. PARRAGA Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil; Escola de Nutrição, Federal University of Bahia, Salvador, Brazil; Centro de Pesquisa Gonçalo Muniz, Oswaldo Cruz Foundation, Salvador, Brazil; Department of Nutrition, Case University, Cleveland, Ohio; Center for Global Health and Diseases, Case University, Cleveland, Ohio

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RONALD E. BLANTON Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil; Escola de Nutrição, Federal University of Bahia, Salvador, Brazil; Centro de Pesquisa Gonçalo Muniz, Oswaldo Cruz Foundation, Salvador, Brazil; Department of Nutrition, Case University, Cleveland, Ohio; Center for Global Health and Diseases, Case University, Cleveland, Ohio

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To determine the role of moderate- and low-intensity infections with Schistosoma mansoni and intestinal helminths (hookworm, Trichuris trichiura, Ascaris lumbricoides) on the prevalence of anemia and their relationship to iron consumption, a cross-section of 1,709 children in rural Brazil was studied. All participants were selected for infection with one or multiple helminthic parasites, and demographic, anthropometric, and dietary intake were surveyed. The prevalence and intensity were as follows: hookworm infection, 15.7% and 8.6 eggs/g; T. trichiura, 74.8% and 190.5 eggs/g; A. lumbricoides, 63% and 1,905.5 eggs/g; S. mansoni, 44.5% and 60.3 eggs/g. There was no increase in odds ratio for anemia with any combination of intestinal helminths without S. mansoni infection. By logistic regression, the odds ratio for having anemia when infected with S. mansoni and two intestinal helminths was 1.7 (95% CI, 1.1–2.5) and for S. mansoni and three intestinal helminths was 2.4 (95% CI, 1.2–4.6) compared with children with a single parasite species. Children with an adequate intake of iron had no increased odds of anemia independent of the combination of parasite infections.

Author Notes

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