Abstract
Introduction: reports on the hematological profile of Colombian children living in malarious areas are scarce in Colombia; in these areas, coexisting pathogenic intestinal parasites and chronic malnutrition. Objective: to determine the hematological profile of children in Urabá Antioqueño and explore its relationship with pathogenic intestinal parasites and chronic malnutrition. Materials and methods: prevalence survey in 1.600 children. Results: chronic malnutrition is at 25%; intestinal parasites in 83%; chronic malnutrition or intestinal parasites in 89%. The average hemoglobin indicates iron deficiency anemia in 100%. Serum retinol is deficient in 71%. The mean ferritin is normal in all. Hemoglobin has significant difference by sex, age, chronic malnutrition and chronic sex strata malnutrition. Anemia has these frequencies: 71% hypochromic microcytic; normochromic microcytic 27%. Conclusions: because pathogenic intestinal parasites and chronic malnutrition alter immune function, it seems fair to conclude that these children must be altered such function and do not know the impact this can have on your current and future health. It is urgent to implement and maintain the recommendations and public health policies that Colombia has signed and which relate to the provision of food aid, vitamin A supplementation and periodic mass deworming. MÉD.UIS. 2015;28(2):195-208.
Key words: Anemia. Malnutrition. Intestinal diseases, Parasitic. Vitamin A. Ferritins. C-reactive protein. Child. Colombia.
References
Kosky KG, Scott ME. Gastrointestinal nematodes, nutrition and immunity: Breaking the negative spiral. Annu Rev Nutr 2001; 21: 297-321.
Taylor V, Velásquez C, Burgos LC, Carmona J, Correa A, Maestre A, et al. Retinol, estado del hierro, malaria y parasitos intestinales: relación por medio de las citocinas TH1/TH2. Colomb méd 2008; 39: 276-286.
Taylor V, Uscátegui R, Correa A, Maestre A, Carmona J. The effect of retinol supplement on blood cytokine concentrations in children with non-severe malaria vivax. In: Silverberg DS, editor. Anemia: InTech 2012. p 313-28.
Toro G, Castro L. Patología del hambre. Sus efectos en el sistema nervioso: situación nutricional de América Latina. Acta Neurol Colom 2001; 17: 178-208.
Morales-González J. El hambre al servicio del neoliberalismo. Bogotá: Ediciones Desdeabajo, 2006.
Robledo JE. Globalización y seguridad alimentaria. Seminario: Desarrollo rural y seguridad alimentaria: Un reto para Colombia Universidad Nacional de Colombia, Bogotá, 6 y 7 de noviembre de 2001. Bogotá: Universidad Nacional,2001. pp. 31-38.
Consulta: 34 junio 2010. http://www.salvacionagropecuaria.net/
globalizacion%2020y%2020seguridad%2020alimentaria.htm.
Carmona-Fonseca J. La malaria en Colombia, Antioquia y las zonas de Urabá y Bajo Cauca: panorama para interpretar la respuesta terapéutica antimalárica. Parte 1. Iatreia 2003; 16: 299-318.
Carmona-Fonseca J. La malaria en Colombia, Antioquia y las zonas de Urabá y Bajo Cauca: panorama para interpretar la respuesta terapéutica antimalárica. Parte 2. Iatreia 2004; 17: 34-53.
Padilla J, Álvarez G, Montoya R, Chaparro P, Herrera S. Epidemiology and control of malaria in Colombia. Mem Inst Oswaldo Cruz, Rio de Janeiro 2011; 106(Suppl. I): 114-122.
Escobar A. La invención del Tercer Mundo. Bogotá: Editorial Norma,1998.
Cats Hematopathology--Diseases of erythrocytes: anemia. Parts 1 and 2. Consulta: 4 junio 2005. http://cats.med.uvm.edu/ats_techingmod/pathology/path302/heme/heel/heintrod.htm.
A.C.A. Asociación Campesina de Antioquia. Tierra, reforma agraria y desplazamiento forzado. Medellín, 28 agosto 2003. Consulta: 17 mayo 2010. http://www.acantioquia.org/ documentos/prob_agraria/tierra-refor_agraria.doc.
Carmona-Fonseca J, Uscátegui R, Correa A. Parasitosis intestinal en niños de zonas palúdicas de Antioquia (Colombia). Iatreia 2009; 22: 27-46.
Khieu V, Odermatt P, Mel Y, Keluangkhot V, Strobel M. Anémie dans une école de zones rurales du Cambodge: la détection, la prévalence et les liens avec les vers intestinaux et de la malnutrition. Bull Soc Pathol Exot 2006; 99: 115-118.
Lim YA, Romano N, Colin N, Chow SC, Smith HV. Intestinal parasitic infections amongst Orang Asli (indigenous) in Malaysia: has socioeconomic development alleviated the problem? Trop Biomed 2009; 26: 110-122. Review.
Mbanya D, Tagny CT, Akamba A, Mekongo MO, Tetanye E. Etiologies de l’anemie chez l’enfant africain de 5 a 10 ans. Sante. 2008;18(4):227-30.
Melo GC, Reyes-Lecca RC, Vitor-Silva S, Monteiro WM, Martins M, Benzecry SG, et al. Concurrent helminthic infection protects schoolchildren with Plasmodium vivax from anemia. PLoS One. 2010;5(6):e11206.
Tienboon P, Wangpakapattanawong P. Nutritional status, body composition and health conditions of the Karen hill tribe children aged 1-6 years in Northern Thailand. Asia Pac J Clin Nutr. 2007;16(2): 279-85.
Cox F. Concomitant infections, parasites and immune responses. Parasitology. 2001; 122 Suppl S1:23-38.
Crompton DW, Nesheim MC. Nutritional impact of intestinal helminthiasis during the human life cycle. Annu Rev Nutr. 2002;22:35-59.
Hall A, Hewitt G, Tuffrey V, de Silva N. A review and metaanalysis of the impact of intestinal worms on child growth and nutrition. Matern Child Nutr. 2008; 4 Suppl 1: 118-236.
Jardim-Botelho A, Brooker S, Geiger S, Fleming F, Souza Lopes AC, Diemert DJ, et al. Age patterns in undernutrition and helminth infection in a rural area of Brazil: associations with ascariasis and hookworm. Trop Med Int Health. 2008;13(4):458-67.
Jardim-Botelho A, Raff S, Rodrigues R, Hoffman HJ, Diemert DJ, Corrêa-Oliveira R, et al. Hookworm, A. lumbricoides infection and polyparasitism associated with poor cognitive performance in Brazilian schoolchildren. Trop Med Int Health 2008;13(8):994-1004.
Solomons NW. Pathways to the impairment of human nutritional status by gastrointestinal pathogens. Parasitology. 1993;107 Suppl: S:19-35.
Chandra R. Nutrition and the immune system. Proc Nutr Soc. 1993;52(1):77-84.
Martin R, Nauta A, Ben Amor K, Knippels LMç, Knol J, Garssen J. Early life: gut microbiota and immune development in infancy. Benef Microbes. 2010;1(4):367-82.
Raqib R, Cravioto A. Nutrition, immunology, and genetics: future perspectives. Nutr Rev. 2009;67 Suppl 2:227-36.
Schlaudecker EP, Steinhoff MC, Moore SR. Interactions of diarrhea, pneumonia, and malnutrition in childhood: recent evidence from developing countries. Curr Opin Infect Dis. 2011;24(5):496-502.
Semba RD. Vitamin A, immunity, and infection. Clin Infect Dis. 1994;19(3):489-99.
Christensen N, Nansen P, Fagbemi B, Monrad J. Heterologous antagonistic and synergistic interactions between helminths and between helminths and protozoans in concurrent experimental infection of mammalian hosts. Parasitol Res. 987;73(5):387-410.
Booth M, Graham A, Viney M. Parasitic co-infections: challenges and solutions. Parasitology. 2008;135(7):749.
Mayo-Wilson E, Imdad A, Herzer K, Yakoob MY, Bhutta ZA. Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5: systematic review and metaanalysis. BMJ. 2011;343:d5094.
Kim CH. Retinoic acid, immunity, and inflammation. Vitam Horm. 2011;86:83-101.
Fishman SM, Christian P, West KP. The role of vitamins in the prevention and control of anaemia. Public Health Nutr. 2000;3(2):125-50.
Van Nhien N, Khan N, Ninh N, Van Huan P, Hop le T, Lam N, et al. Micronutrient deficiencies and anemia among preschool children in rural Vietnam. Asia Pac J Clin Nutr. 2008;17(1):48-55.
Sauvant P, Féart C, Atgié C. Vitamin A supply to mothers and children: challenges and opportunities. Curr Opin Clin Nutr Metab Care. 2012;15(3):310-4.
Haider BA, Bhutta ZA. Neonatal vitamin A supplementation for the prevention of mortality and morbidity in term neonates in developing countries. Cochrane Database Syst Rev. 2011;(10):CD006980.
Imdad A, Herzer K, Mayo-Wilson E, Yakoob MY, Bhutta ZA. Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age. Cochrane Database Syst Rev 2010;(12):CD008524.
Sommer A, Tarwotjo I, Djunaedi E, West KP Jr, Loeden AA, Tilden R, et al. Impact of vitamin A supplementation on childhood mortality. A randomised controlled community trial. Lancet 1986;1(8491):1169-73.
Sommer A. Vitamin A, infectious disease, and childhood mortality: a 2 solution? J Infect Dis. 1993;167(5):1003-7.
Chowdhury S, Kumar R, Ganguly NK, Kumar L, Walia BN. Effect of vitamin A supplementation on childhood morbidity and mortality. Indian J Med Sci. 2002;56(6):259-64.
Chen H, Zhuo Q, Yuan W, Wang J, Wu T. Vitamin A for preventing acute lower respiratory tract infections in children up to seven years of age. Cochrane Database Syst Rev. 2008;(1):CD006090.
Cameron C, Dallaire F, Vézina C, Muckle G, Bruneau S, Ayotte P, et al. Neonatal vitamin A deficiency and its impact on acute respiratory infections among preschool Inuit children. Can J Public Health. 2008;99(2):102-6.
Gogia S, Sachdev HS. Neonatal vitamin A supplementation for prevention of mortality and morbidity in infancy: systematic review of randomised controlled trials. BMJ. 2009;338:b919.
Gogia S, Sachdev HS. Maternal postpartum vitamin A supplementation for the prevention of mortality and morbidity in infancy: a systematic review of randomized controlled trials. Int J Epidemiol. 2010;39(5):1217-26. Epub 2010 Jun 3.
Gogia S, Sachdev HS. Vitamin A supplementation for the prevention of morbidity and mortality in infants six months of age or less. Cochrane Database Syst Rev 2011;(10):CD007480.
Organización Mundial de la Salud. Informe de una reunión de consulta sobre uncinariasis y anemia en niñas y mujeres; 5-7 diciembre 1994, Ginebra (Suiza). Washington: OPS; 1999.
Organización Mundial de la Salud. Informe de una reunión de consulta sobre el uso de quimioterapia para el control de la morbilidad debida a nemátodos transmitidos por el suelo en humanos; 29 abril-1 mayo 1996. Washington: OPS; 1999.
World Health Organization. Report of WHO Expert Committee about prevention and control of intestinal parasitic infections. Ginebra: WHO; 1987.
Ministerio de Salud y Protección Social de Colombia, Organización Panamericana de la Salud-Colombia. Prevencion y control de enfermedades. Atencion Integral Enfermedades Prevalentes de la Infancia (libro en internet). Bogota DC, Colmbia:
OPS; 2003. [Citado 1 Dic 2004]. Disponible en: http://www.col.ops-oms.org/prevencion/aiepi/aiepi2003feb_2.asp.
Organización Panamerica de la Salud. Salud en las Américas 2005. PAOH. Consulta: [Citado 17 Jun 2007]. Disponible en: http://www.paho.org/saludenlasamericas/.
Ministerio de Salud de Colombia. Boletín Epidemiológico Semanal. Stuacion epidemiologica de las enfermedades trasnmitidas por vectores 2003-2004. Bogota,Colombia: OPS; 2004.
Carmona-Fonseca J. Alimentación y estado nutricional de los niños en zonas palúdicas de Antioquia (Colombia). MedUNAB. 2011;14(2):94-102.
Gobernación de Antioquia. Atlas veredal. 2a ed. Medellín: Gobernación Antioquia; 2006. p 253.
Campuzano G. Del hemograma manual al hemograma de cuarta generación. Medicina & Laboratorio. 2007;13(11-12):511-50.
Campuzano G. Utilidad del extendido de sangre periférica: los eritrocitos. Medicina & Laboratorio. 2008;14(7-8):311-57.
Campuzano G. Utilidad clínica del extendido de sangre periférica: las plaquetas. Medicina & Laboratorio. 2008;14(11-12):511-31.
Campuzano G. Utilidad del extendido de sangre periférica: los leucocitos. Medicina & Laboratorio. 2008;14(9-10):411-55.
Castro L, Nicholls R. Deficiencia de hierro, vitamina A y prevalencia de parasitismo intestinal en la población infantil y anemia nutricional en mujeres de edad fértil: Colombia 1995-96. Bogotá, Colombia: Instituto Nacional de Salud; 1998.
Romero J, Carbia CD, Ceballo MF, Diaz NB. Indice de distribución de globulos rojos (rdw): su aplicacion en la caracterizacion de anemias microciticas e hipocromicas. Medicina (Buenos Aires). 1999;59(1):17-22.
Becerra-Flores MC, Farfán-Canto JM, Nieva-García B, FajardoGutiérrez A. Valores plaquetarios de referencia en niños sanos residentes de la Ciudad de México. Rev Med Inst Mex Seguro Soc. 2006;44(2):121-30.
Taylor MR, Holland CV, Spencer R, Jackson JF, O’Connor GI, O’Donell JR. Hematological reference ranges for schoolchildren. Clin Lab Haematol. 1997;19(1):1-15.
Graham SS, Traub B, Mink IB. Automated platelet sizing parameters on normal population. Am J Clin Pathol. 1987;87(3):365-69.
Wiwanitkit V, Soogarun S, Saksirisampant W, Suwansaksri J. Platelet parameters in subjects infected with hookworm. Platelets. 2003;14(6):391-3.
Chadderdon RC, Cappello M. The hookworm platelet inhibitor: functional blockade of integrins GPIIb/IIIa (alphaIIbbeta3) and GPIa/IIa (alpha2beta1) inhibits platelet aggregation and adhesion in vitro. J Infect Dis. 1999;179(5):1235-41.
Ruiz-Sáez A, Sifontes LN, Feijoo R, Certad G, Arenas-Pinto A, Pocaterra L, et al. Platelet dysfunction-eosinophilia syndrome in parasitized Venezuelan children. Am J Trop Med Hyg. 2005;73(2):381-85.
Moqbel R. Helminth-induced intestinal inflammation. Trans R Soc Trop Med Hyg. 1986;80(5):719-27.
Cotton JA, Beatty JK, Buret AG. Host parasite interactions and pathophysiology in Giardia infections. Int J Parasitol. 2011;41(9):925-33.
Beard JL, Murray-Kolb LE, Rosales F, Solomons NW, Angelilli ML. Interpretation of serum ferritin concentrations as indicators of total-body iron stores in survey populations: the role of biomarkers for the acute phase response. Am J Clin Nutr.
;84(6):1498–505.
Vieira MM, Paik J, Blaner WS, Soares AM, Mota RM, Guerrant RL, et al. Carotenoids, retinol, and intestinal barrier function in children from northeastern Brazil. J Pediatr Gastroenterol Nutr. 2008;47(5):652-59.
Carmona-Fonseca J, Arias MM, Correa A, Lemos M. Malaria gestacional y condiciones de vida. Medicina Social. 2011;6(2):97-107.
Correa-Botero AM, Arias-Valencia MM, Carmona-Fonseca J. Equidad e igualdad sociales y sanitarias. Necesidad de un marco conceptual científ co. Medicina Social. 2012;7(1):5-13.
Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev. 2012;4(3):CD007176.
Arango-Quintero JC. Desigualdad y exclusión en Colombia (1990- 2000). Los problemas nutricionales desde una aproximación del enfoque de las capacidades humanas[Tesis]. Medellín: Universidad de Antioquia, Facultad de Derecho y Ciencias
Políticas, Instituto de Estudios Políticos; 2005. [Citado 4 Dic 2011]. Disponible en: http://sala.clacso.edu.ar/gsdl/cgi-bin/library?e=d- 000-00---0iepco3-iepco3%2Ciepco2%2Ciepco-01-0-0--0prompt- 10---4------0-1l--1-es-50---20-about---00031-001-1-0utfZz-8- 00&cl=CL1&d=HASH01afd33bd8ca1589fba166e5&x=1