Ajjampur S S R, Koshy B, Venkataramani M, Sarkar R, Joseph A A, Jacob K S, Ward H, Kang G
Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
Ann Trop Paediatr. 2011;31(3):205-12. doi: 10.1179/1465328111Y.0000000003.
Early childhood diarrhoea is a major cause of infant morbidity and mortality in developing countries. Recurrent and persistent diarrhoea affect growth and cognition in children as young as 6 years.
To evaluate the effect of early childhood cryptosporidial and giardial diarrhoea on growth and development in children in a semi-urban slum in India. This is the first report of such assessment at 3 years of age.
This study was undertaken on 116 children who were part of an ongoing birth cohort study (n=452) of rotaviral and cryptosporidial diarrhoea between June and December 2005. Social quotients (SQ) assessed by the Vineland Social Maturity Scale, intelligence quotients (IQ) assessed by the Seguin Form Board Test, physical growth parameters and sociodemographic data in 84 children with a history of cryptosporidial or giardial diarrhoea were compared with those of 32 without diarrhoea.
Children with a past history of giardial diarrhoea showed a trend towards lower SQ (p=0.09) and had significantly lower IQ (p=0.04) and increased wasting (p=0.04). Cryptosporidial diarrhoea was not associated with poor IQ, SQ or physical growth.
This study demonstrates the long-term effect of protozoan diarrhoea, especially that caused by giardia, on both intelligence and physical growth in Indian children as early as 3 years of age and re-inforces the need for early detection and prevention of early childhood protozoan diarrhoea.
在发展中国家，幼儿腹泻是婴儿发病和死亡的主要原因。反复和持续腹泻会影响年仅6岁儿童的生长和认知。
评估印度半城市贫民窟幼儿隐孢子虫和贾第虫腹泻对儿童生长发育的影响。这是3岁时此类评估的首份报告。
本研究针对116名儿童开展，他们是2005年6月至12月正在进行的轮状病毒和隐孢子虫腹泻出生队列研究（n = 452）的一部分。采用文兰社会成熟量表评估社会商数（SQ），采用塞金形板测验评估智商（IQ），将84名有隐孢子虫或贾第虫腹泻病史儿童的身体生长参数和社会人口学数据与32名无腹泻儿童的进行比较。
有贾第虫腹泻既往史的儿童显示出社会商数较低的趋势（p = 0.09），智商显著较低（p = 0.04），消瘦增加（p = 0.04）。隐孢子虫腹泻与智商、社会商数或身体生长不良无关。
本研究表明原生动物腹泻，尤其是由贾第虫引起的腹泻，早在3岁时就对印度儿童的智力和身体生长产生长期影响，并强化了早期发现和预防幼儿原生动物腹泻的必要性。
