Nutrition Publication

Tropical Diseases

Editor(s): N.W. Solomons . 66 / 1

The number of organisms that depend on humans as their home and feeding range, and can cause damage and even death to their human hosts, is extensive. In the current issue of Annales Nestlé, we have analyses from experts on: a) common roundworm ( Ascaris lumbricoides) and the factors related to infection with roundworms; b) giardiasis - the most frequently diagnosed waterborne disease and it’s public health impact; and finally c) paediatric malaria with four keys to successful case management of malarial attacks including accurate and reliable diagnosis.

Related Articles

Editorial

The number of organisms that depend on humans as their home and feeding range, and can cause damage and even death to their human hosts, is extensive. In the current issue of Annales Nestlé, we have analyses from experts on: a) common roundworm ( Ascaris lumbricoides) and the factors related to infection with roundworms; b) giardiasis - the most frequently diagnosed waterborne disease and it’s public health impact; and finally c) paediatric malaria with four keys to successful case management of malarial attacks including accurate and reliable diagnosis.

Ascaris lumbricoides : A Review of Its Epidemiology and Relationship to Other Infections

Author(s): M.E. Scott

This review highlights advances made since 2004 in understanding the epidemiology of infection and the interactions between Ascaris lumbricoides and other concurrent infections. As water scarcity increases, untreated wastewater is increasingly used to irrigate crops, thus increasing the risk of transmission. New methods to detect and inactivate Ascaris eggs in water, soil and food are described. The association between pig ownership and Ascaris infection in humans may represent cross-transmission as hybridization among the pig and human ascarids occurs more frequently than previously believed. Geospatial analyses have successfully predicted infection levels both at a regional level (based on vegetation indices, temperature and humidity) and within communities (based on social and environmental factors). The interpretation of antibody and cytokine responses to Ascaris is becoming clearer, as researchers recognize the role of antigen type, age, the history of Ascaris and other infections. The considerable interest emerging on the interactions between Ascaris and other infections (helminths, malaria, HIV, tuberculosis) and allergy is explored. The impact of concurrent infection on the design of control strategies is discussed including the benefits arising from combination therapies and the evidence that intestinal nematodes impair the efficacy of childhood vaccines. Finally, recommended areas for future research are identified.

Giardiasis: Modern Concepts in Control and Management

Author(s): R.C.A. Thompson

Giardia is the most common enteric protozoan pathogen of humans, domestic animals and wildlife. Children are at the most risk from the clinical consequences of Giardia infection, particularly those in developing countries and living in disadvantaged community settings. Molecular epidemiological studies have helped to elucidate sources of infection and the public health significance of animal reservoirs. Although aspects of the pathogenesis of Giardia infection are now understood, we are still a long way from understanding the factors that predispose to clinical disease. Effective drugs are available to treat giardial infections but can serve only as an adjunct to traditional public health approaches in endemic settings where children are commonly infected.

Management of Pediatric Malaria: Role of Nutritional Interventions

Author(s): A.K. Osei, D.H. Hamer

Malaria is a leading cause of morbidity and mortality among children, particularly in sub-Saharan Africa. Although substantial progress has been made in the treatment of pediatric malaria with artemisinin-based combination therapy, there remain many obstacles to the effective implementation of these highly efficacious new treatment options. Similarly, while effective tools are available for the prevention of malaria in children, scaling these up so that they have a clear impact on malaria-associated morbidity and mortality has presented significant challenges to public health officials. Host nutritional status influences the acquisition and potential severity of malaria infection. While there is substantial evidence that malaria contributes to impaired weight and height gain in children, the impact of undernutrition on malaria is complex. There is increasing evidence that supplementation with certain micronutrients may play a critical role in the prevention of malaria in young children. Micronutrient interventions such as zinc or vitamin A supplementation may help reduce the burden of disease due to malaria whereas others such as iron may exacerbate infection. Differences in study design, quality, intensity of malaria transmission, and other study site characteristics complicate the interpretation of the limited number of studies that have evaluated the impact of specific micronutrients for the treatment and prevention of malaria. There has only been one trial to evaluate the use of zinc as an adjunct in the treatment of malaria and it failed to demonstrate any benefit of zinc in this role. This article reviews the clinical management of malaria in children, interactions between malaria and nutritional status, and the potential role of micronutrient supplementation for the prevention of clinical malaria episodes in young children, with a particular focus on whether each nutrient supplement improves or worsens malaria outcomes.