American Journal of Epidemiology Vol. 145, No. 2: 156-163
Copyright © 1997 by The Johns Hopkins University School of Hygiene and Public Health
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Asymptomatic and Symptomatic Cryptosporidiosis: Their Acute Effect on Weight Gain in Peruvian Children
1Departments of International Health and Biostatistics, School of Hygiene and Public Health, The Johns Hopkins University Baltimore, MD
2Proyectors en Informática, Salud, Medicina, y Agriculture (Asociaciófica Benéfica PRISMA) Lima, Peru
3Battelle Memorial Institute Rockville, MD
4Department of Veterinary Science, The University of Arizona Tucson, AZ
Reprint requests to Dr. R. H. Gilman, Department of International Health, School of Hygiene and Public Health, The Johns Hopkins University, 615 North Wolfe Street, Room 5521, Baltimore, MD 21205
This study investigated whether a child's first infection with Cryptosporidium parvum had an acute effect on weight gain. Specifically, the authors compared monthly rates of weight gain between C. parvum-infected and noninfected children. Over a 2-year period (1989–1991), a cohort of Peruvian children aged 0–3 months at recruitment were followed twice weekly for assessment of daily diarrheal status, weekly for C. parvum stool examinations, and monthly for anthropometric measurements. Data on 207 children permitted the authors to examine the effect of C. parvum infection on weight gain. During the 2-year study period, 45% (94/207) of the children became infected with C. parvum for the first time. Weight gain intervals in 57 of the 94 infected children met criteria for analysis. Of these, 63 percent (36/57) were asymptomatic (i.e., had no diarrhea). On average, children with symptomatic cryptosporidiosis gained (i.e., grew) 342 g less (95% confidence interval 167–517) during the first month of infection than did children without diarrhea who were not yet infected. The effect of asymptomatic cryptosporidiosis was less severe: On average, children with asymptomatic infection gained 162 g less (95% confidence interval 27–297) during the first month of infection than did children without diarrhea who were not yet infected. Symptomatic cryptosporidiosis retarded weight gain more than did asymptomatic cryptosporidiosis, but the latter was twice as common. Since asymptomatic cryptosporidiosis is more prevalent, it may have more of an overall adverse effect on child growth in the community than symptomatic cryptosporidiosis. Am J Epidemiol 1997; 145: 156–63.
asymptomatic infection; cryptosporidiosis; Cryptosporidium parvum; diarrhea, infantile; growth; nutrition disorders
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