Checkley W, Epstein L D, Gilman R H, Black R E, Cabrera L, Sterling C R
Department of International Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205, USA.
Am J Epidemiol. 1998 Sep 1;148(5):497-506. doi: 10.1093/oxfordjournals.aje.a009675.
The authors conducted a 2-year (1989-1991) community-based longitudinal study in a shantytown in Lima, Peru, to examine the effect of Cryptosporidium parvum infection on child growth during the year following the onset of infection. A cohort of children, aged 0-3 months at recruitment, was followed monthly for anthropometrics, weekly for stool samples, and daily for diarrheal status. Data from 185 children in the cohort permitted a comparison of growth in C. parvum-infected and noninfected children. The analyses fitted smooth, flexible curves with a linear random-effects model to estimate growth differences between C. parvum-infected and noninfected children. Children infected with C. parvum experienced growth faltering, both in weight and in height, for several months after the onset of infection, followed by a period of catch-up growth. Younger children took longer to catch up in weight than did older children. Catch-up growth, however, did not occur in children infected between ages 0 and 5 months. These children did not catch up in height, and one year after infection they exhibited an average deficit of 0.95 cm (95% confidence interval (CI) 0.38-1.53) relative to noninfected children of similar age. Stunted children who became infected also did not catch up in either weight or height, and one year after infection they exhibited a height deficit of 1.05 cm (95% CI 0.46-1.66) relative to noninfected, stunted children of similar age. These results indicate that Cryptosporidium parvum has a lasting adverse effect on linear (height) growth, especially when acquired during infancy and when children are stunted before they become infected.
作者在秘鲁利马的一个棚户区开展了一项为期两年（1989 - 1991年）的基于社区的纵向研究，以考察微小隐孢子虫感染对感染发生后一年内儿童生长的影响。招募了一组0至3个月大的儿童队列，每月进行人体测量随访，每周采集粪便样本，每天记录腹泻状况。该队列中185名儿童的数据使得能够比较微小隐孢子虫感染儿童与未感染儿童的生长情况。分析采用线性随机效应模型拟合平滑、灵活的曲线，以估计微小隐孢子虫感染儿童与未感染儿童之间的生长差异。感染微小隐孢子虫的儿童在感染发生后的几个月内体重和身高增长均出现迟缓，随后是一段追赶生长时期。年龄较小的儿童体重追赶生长所需时间比年龄较大的儿童更长。然而，0至5个月龄时感染的儿童并未出现追赶生长。这些儿童身高未追赶上来，感染一年后，相对于年龄相仿的未感染儿童，他们平均矮0.95厘米（95%置信区间（CI）0.38 - 1.53）。已发育迟缓的儿童感染后体重和身高也未追赶上来，感染一年后，相对于年龄相仿的未感染且已发育迟缓的儿童，他们身高矮1.05厘米（95% CI 0.46 - 1.66）。这些结果表明，微小隐孢子虫对线性（身高）生长有持久的不良影响，尤其是在婴儿期感染以及儿童在感染前就已发育迟缓的情况下。
