Factors infl uencing growth and intestinal parasitic infections in preschoolers attending philanthropic daycare centers in Salvador, Northeast Region of Brazil Crescimento linear e infecções parasitárias intestinais em pré-escolares matriculados em creches fi lantrópicas de Salvador, Nordeste do Brasil

Poor growth and intestinal parasitic infections are widespread in disadvantaged urban children. This cross-sectional study assessed factors influencing poor growth and intestinal parasites in 376 children aged three to six years in daycare centers in Salvador, in the Northeast Region of Brazil. Data was obtained from seven daycare centers on child weight, height, socio-economic status, health and intestinal parasites in stool samples. Prevalence of moderate underweight (< -1SD > -2SD), wasting and stunting was 12%, 16% and 6% respectively. Socioeconomic status, birth order, and maternal weight were predictors of poor anthropometric status. Almost 30% of children were infected with more than one intestinal parasite. Helminths (17.8%), notably Trichuris trichiura (12%) and Ascaris lumbricoides (10.5%), and protozoan Giardia duodenalis (13%) were the most common types of parasites detected. One percent of children had hookworm and Cryptosporidium sp. and 25% had nonpathogenic protozoan cysts. Boys from families with very low socio-economic status had lower linear growth and presented a greater risk of helminth infection. Deworming is considered an alternative for reducing the prevalence of intestinal parasitic infections in this age group. Preschool Child; Child Day Care Centers; Parasites; Parasitic Intestinal Diseases Introduction Gastro-intestinal parasitic infections, including soil-transmitted helminths are widespread in crowded urban environments with poor sanitation 1. Therefore, it is not surprising that the risk of intestinal parasitic infection is particularly high in urban and periurban areas in the Northeast Region of Brazil, one of the poorest and most populous regions of this tropical country 2. Preschool children living in such environments are especially vulnerable to helminth infections with Ascaris lumbricoides (roundworm) and Trichuris trichiura (whipworm) because of the increased activity of these species in potentially infective environments and lack of appropriate sanitary behavior 3. Pathogenic protozoan infections are also common in poor urban settings 3. Children attending daycare centers are especially vulnerable to Giardia duodenalis and Cryptosporidium sp. because the primary mode of transmission of these organisms is fecal-oral 4. Both helminth and protozoan infections have been linked with several adverse health consequences, notably impaired growth and deficiencies in vitamin A and iron, induced by anorexia, nausea, diarrhea and vomiting, reductions in digestion and absorption, and enhanced nutrient loss 5,6. Our study therefore aimed to: (1) assess the prevalence of poor growth and gastro-intestinal parasites in a selected group of preschool children aged three ARTIGO ARTICLE Lander RL et al. 2178 Cad. Saúde Pública, Rio de Janeiro, 28(11):2177-2188, nov, 2012 to six years attending urban and periurban daycare centers in Salvador; and (2) explore the factors that might influence poor growth and intestinal parasitic infections.