Association between maternal deworming and stunting in the offspring in Guatemala, Central America Restricted; Files Only

Shedd, Rebecca (Fall 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/vm40xs65r?locale=es
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Abstract

Soil- transmitted helminth (STH) infections are among the most common infections in humans, particularly in low-income, developing countries where there is poor sanitation infrastructure. A vast majority of children and adults in Guatemala, Central America are heavily infected with parasites leaving them sick and undernourished. Anthelmintic medications are recommended to populations at risk, to include pregnant women in their second and third trimesters. Women who are undernourished are likely to have an undernourished, stunted child. While stunting results in short stature, it also contributes to cognitive impairment and chronic disease later in life. The objective of this study was to examine whether maternal use of anthelmintics (deworming) for STH infections during pregnancy is associated with stunting in children in Guatemala, Central America. Survey data from the 2014-2015 Demographic and Health Surveys (DHS) Program in Guatemala was used to assess the relationship between maternal deworming and stunting in the offspring. Multivariate logistic analysis, accounting for the complex survey design, was used to obtain the odds ratios with 95 % confidence intervals; interaction was only identified by place of residence (rural or urban status). There was no significant association between child stunting and maternal deworming in urban areas (OR, 0.67; 95% CI, 0.28-1.57), but there was a significant association between child stunting and maternal deworming in rural areas (OR, 2.00; 95% CI, 1.01-3.97). Children of the mothers who received anthelmintics in rural areas were more two times more likely to be stunted than the children of the women who did not receive anthelmintics during pregnancy. Despite these findings, there are known benefits of deworming during pregnancy. In addition, it is unknown whether the results from families living in rural area are causal or if there may be other factors that might explain the association, we observed in this study. Further study is warranted to determine whether any potential risk in increased stunting outweighs the benefits of interrupting STH transmission.

Table of Contents

CHAPTER I: REVIEW OF THE LITERATURE…………………………………1

CHAPTER II: JOURNAL ARTICLE……………………………………………….8

Introduction………………….…...8

Methods………………………......10

Results……………………………..12

Discussion…………………………13

References…………………………16

Tables……………………………....19

CHAPTER III: CONCLUSION…………………………………………………….22

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