HOUSEHOLD WATER ACCESS AND SANITATION AS INDICATORS OF VITAMIN A AND ZINC EFFICACY ON GUT PARASITE RESOLUTION | 20th International Congress of Nutrition , Granada, Spain, September 15–20, 2013
K. Long1, P. Vasan2, H. Raga3, J. Santos4, J. Rosado5, A. Mamun6 | 1 School of Population Health, University of Queensland, Australia | 2 Government Primary Health Center, Madurai, India | 3 UN World Food Programme, West Timor, Indonesia | 4 School of Medicine, National Autonomous University of Mexico, Mexico | 5 School of Natural Sciences, Universidad Autonoma de Queretaro, Queretaro, Mexico | 6 School of Population Health, University of Queensland, Australia
Background and objectives: Vitamin A and zinc supplementation can reduce childhood intestinal parasite burden but household characteristics involved in parasite transmission may modify efficacy. We evaluated supplementation efficacy on Ascaris lumbricoides, Entamoeba histolytica and Giardia lamblia infection resolution among children from households differing in water access, sanitation and hygiene.
Methods: A randomized, double-blind, placebo-controlled trial carried out in Mexico City assigned children 6-15 mo of age to receive vitamin A every 2 months, a daily zinc supplement, a combined vitamin A – zinc supplement or a placebo and followed them for 1 year. Parasite infection durations among children in the different treatment arms determined in monthly collected stools were compared using hazard analyses stratified by personal and household factors.
Results: Vitamin A + zinc supplemented children from households with no piped water had reduced G. lamblia infection resolution compared to children from households with piped water. Children in all three treatment arms from households with dirt floors had reduced A. lumbricoides resolution compared to children from households with concrete floors (P for interaction=0.06, 0.01 and 0.07, respectively). Increased E. histolytica infection resolution was found among vitamin A supplemented children from households with dirt floors and no indoor bathrooms.
Conclusions: The contrasting outcomes of supplementation found in the stratified analyses suggest that children enrolled in mass chemoprophylaxis programs may be targeted for specific supplementation regimens using household characteristics as indictors.
