[Intestinal parasitoses in a village of Côte d'Ivoire. II: Relationship between intestinal parasitoses, physical and physiological development and child nutrition].

In a village situated at the border of the Ebrié lagoon, with economical problems, 343 school and preschool children, aged 4 to 15 (195 boys and 148 girls), considered by the school and their families to be in good health, were submitted for clinical and coproparasitologic examination. Basic clinical tests, anthropometric examination, spleen rate, nutrition status assessment (brachial perimeter of children aged 4 to 10 years) and the puberty level evaluation (using Tanner's scale) were independently completed. Splenomegaly rate among children between 4 and 9 years old was particularly important (78.0 %). Intestinal parasites were found in 84.8% of cases during the first examination (70.4% of children were diagnosed with multiple parasitosis). The most frequent parasite identified was Ascaris lumbricoides, being in 62.1 % of the cases, with a parasitic intensity between 1.000 and 52.000 OPG and worm burden between 1 and 16. According to the age, the highest prevalence of A. lumbricoides was higher (78.6 %) in children between 7 and 10 years. Results of anthropometric data, interpreted using NCHS percentile chart, indicated a significant stature-ponderal underdevelopment. Thus, concerning the height, 22.7% of all children were below normal value (below the 5th percentile), 74.3% between normal values and only 2.9% were above the 95th percentile. Among the 255 children with values between the normal limits, 73.7% (more than two thirds) were in the lower half, below the 50th percentile and only 26.3% (less than one third) were between the 50th and 95th percentile. According to the weight, 20.7% of children were below the normal value (below the 5th percentile), 77.8% had normal weight and 1.5% were above the 95th percentile. Even among children with normal weight, two thirds were in the lower half, below the 50th percentile. The underdevelopment was more evident after 9 years of age, particularly in girls. This coincided with higher rates of infection with roundworms. Regarding the nutritional status, 76.9% of the boys and 77.2% of the girls had a lower brachial perimeter than normal data, most frequently by one or two centimeters. A deficit of 3 to 4 cm. was found in 16.2% of the children, and it was higher among girls. The evaluation of pubertal development highlighted a certain delay in girls aged 10 to 12, with a preadolescence state of 76.0 % at age 10, 20.0 % at age 11 and 15.8 % at age 12. Between 13 and 15 years of age, all girls began pubertal development, but none reached Tanner's stage 5. It is concluded that the highest intestinal parasitism (particularly roundworms) can have a negative effect on the staturo-ponderal development of children, their nutrition status and pubertal development. Paludism and alimentary deficiencies have to be also considered.