Impact of annual albendazole versus four-monthly test-and-treat approach of intestinal parasites on children growth: a longitudinal four-arm randomized parallel trial during two years of a community follow-up in Bengo, Angola

• Autor(a) principal: Gasparinho, Carolina
• Data de Publicação: 2021
• Outros Autores: Kanjungo, Aguinaldo, Zage, Félix, Clemente, Isabel, Santos-Reis, Ana, Brito, Miguel, Sousa-Figueiredo, José Carlos, Fortes, Filomeno, Gonçalves, Luzia
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.21/13052
• topic: Stunting; Z-score; Growth; Longitudinal randomized trial; Deworming; Intestinal parasite; Albendazole; Angola; Província do Bengo

Malnutrition and intestinal parasites continue to have serious impacts on the growth and cognitive development of children in Angola. A longitudinal four-arm randomized parallel trial was conducted to investigate if deworming with a single annual dose of albendazole (annual-ALB) or a four-monthly test-and-treat (4TT) intestinal parasites approach at an individual or household levels improve nutritional outcomes of pre-school children in Bengo province. Children with intestinal parasites (n = 121) were randomly assigned (1:1:1:1) to arm A1: annual-ALB*individual level; A2: annual-ALB*household level; A3: 4TT*individual; and A4: 4TT*household level. At baseline, 4, 8, 12, 16, 20, and 24 months of follow-up, growth was assessed by height, weight, height-for-age, weight-for-height, weight-for-age, and mid-upper arm circumference. Intention-to-treat analysis was done using a non-parametric approach, mixed effect models, and generalized estimating equations (GEE). Initially, 57% and 26% of the children were infected by Giardia lamblia and Ascaris lumbricoides, respectively. This study did not show that a 4TT intestinal parasites approach results in better growth outcomes of children (height, weight, HAZ, WAZ, WHZ, and MUACZ) when compared with annual ALB, with exception of height and WHZ using the GEE model at 5% level. Positive temporal effects on most nutrition outcomes were observed. Implementing a longitudinal study in a poor setting is challenging and larger sample sizes and ‘pure and clean’ data are difficult to obtain. Nevertheless, learned lessons from this intensive study may contribute to future scientific research and tailor multidisciplinary approaches to minimize malnutrition and infections in resource-poor countries.