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Wasting, stunting, and anemia in angolan children after deworming with albendazole or a test-and-treat approach for intestinal parasites: binary longitudinal models with temporal structure in a four-arm randomized trial

dc.contributor.authorGasparinho, Carolina
dc.contributor.authorHelena Gonçalves, M.
dc.contributor.authorChissaque, Assucênio
dc.contributor.authorSilva, Giovani L.
dc.contributor.authorFortes, Filomeno
dc.contributor.authorGonçalves, Luzia
dc.date.accessioned2022-07-12T09:15:58Z
dc.date.available2022-07-12T09:15:58Z
dc.date.issued2022-05-24
dc.date.updated2022-06-09T13:40:54Z
dc.description.abstractUndernutrition, anemia, and intestinal parasitic infections are public health problems in Angola, especially in pre-school children. We analyzed binary data from a longitudinal four-arm randomized parallel trial conducted in Bengo Province, northern Angola, over the course of two years, with seven follow-up assessments to explore the effects of four interventions (deworming and a test-and-treat approach for intestinal parasites, at both the individual and household levels) on wasting and stunting, and to understand their indirect benefits for anemia, malaria, diarrhea, and vomiting. A total of 121 children with intestinal parasitic infections received baseline treatment, and were allocated to the four arms (1:1:1:1). Using continuous outcome variables of height-for-age (HAZ) and weight-for-height (WHZ) statistical approaches did not reveal a clear benefit of any particular arm (Pathogens 2021, 10, 309). Next, HAZ and WHZ were transformed into binary variables of stunting and wasting, respectively, considering their mild-to-severe (Z-score < −1) and moderate-to-severe degrees (Z-score < −2). Original clinical data (on anemia, diarrhea, vomiting, and malaria) were also analyzed. From a binary longitudinal analysis with different dependence structures, using the R package <i>bild</i>, fitted models revealed the potential benefit of a test-and-treat approach at the individual level for wasting compared with annual albendazole at the individual level, especially considering mild-to-severe forms (OR<sub>adj</sub> = 0.27; <i>p</i> = 0.007). All arms showed similar effects on stunting, compared with annual albendazole, at a 5% significance level. Time and age at baseline presented favorable effects in the percentage of stunting using both severity degrees. Results showed a decreased chance of having anemia and diarrhea over time, although with no significant differences between arms. Data from longitudinal studies are essential to study the direct and indirect effects of interventions, such as deworming, and to explore additional approaches aiming at better understanding the temporal structure of nutrition and health outcomes in children.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationNutrients 14 (11): 2185 (2022)pt_PT
dc.identifier.doi10.3390/nu14112185pt_PT
dc.identifier.eissn2072-6643
dc.identifier.urihttp://hdl.handle.net/10400.1/17962
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherMDPIpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectMalnutritionpt_PT
dc.subjectWastingpt_PT
dc.subjectStuntingpt_PT
dc.subjectAnemiapt_PT
dc.subjectModerate-to-severept_PT
dc.subjectMild-to-severept_PT
dc.subjectLongitudinalpt_PT
dc.subjectDewormingpt_PT
dc.subjectTest-and-treatpt_PT
dc.subjectIntestinal parasitespt_PT
dc.subjectAngolapt_PT
dc.titleWasting, stunting, and anemia in angolan children after deworming with albendazole or a test-and-treat approach for intestinal parasites: binary longitudinal models with temporal structure in a four-arm randomized trialpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage2185pt_PT
oaire.citation.issue11pt_PT
oaire.citation.titleNutrientspt_PT
oaire.citation.volume14pt_PT
person.familyNameGonçalves
person.givenNameMaria Helena Neves de Queirós
person.identifier.ciencia-id8D1A-6263-EDFD
person.identifier.orcid0000-0002-6990-7239
person.identifier.ridK-9285-2015
person.identifier.scopus-author-id55023817000
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication1c45e12e-ef16-4692-91cc-36193d403399
relation.isAuthorOfPublication.latestForDiscovery1c45e12e-ef16-4692-91cc-36193d403399

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