Prevalence of undernutrition, parasitosis and anemia in children 5-12 years old from Ecuadorian rural coast: Post-earthquake analysis

M. Chisaguano1*, M. E. Herrera Fontana1, V. Villagomez 1, M. Villar 1, Soledad Sarzosa1, N. Castro1

1Nutricin, Escuela de Salud Publica, Universidad San Francisco de Quito, Quito, Ecuador

Tel: (+5932) 2971700 Ext1077. *e-mail: achisaguano@usfq.edu.ec

MON-P222

INTRODUCTION EXPERIMENTAL DESING METHODS

Undernutrition wasting or stunting-, intestinal parasitic infections, and anemia are
major public health problem in resource-limited regions. School-aged children (5-
14 years) are more at risk for disease than any other age group, because they are
particularly susceptible to parasitic infections. Human gastrointestinal parasites
and anemia are linked with an increased risk for childhood malnutrition and growth
deficits (it affects neuropsychological, motor and cognitive functions)1.
These afections are problems that usually occur
or complicate after a natural disasters, such as
the April 2016 earthquake in Ecuador, since a
natural disaster can adversely affect the
La Punta
nutritional status of the population due to their
impact on one or more components of the food
chain, which will depend on the type, duration
Pedernales
and magnitude of the disaster, as well as on
previously existing food and nutrition conditions in
the zone2.
If there is an immediate increase in undernutrition
rates in young children immediately after the
disaster, it is more likely to be due to the effect of
gastrointestinal diseases than to actual food
shortages, which must be borne in mind when
establishing mechanisms of vigilance.
AIM
To assess the prevalence of undernutrition, intestinal parasitosis, and anemia in
children from vulnerable families.
PARTICIPANTS ANTHROPOMETRY
Four months after earthquake, we start to work with Height and weight were collected using standard
families from rural communities. For this study we protocols for all participants in light clothing. BMI
selected a subgroup of children from the rural were calculated and used to define
community "La Punta", located in the parish of under/overweight in children using the WHO cut-
Cojimes, province of Manab, Ecuador. points.
Heigh-for-age (LAZ), weight-for-age (WAZ) and
BMI-for-age (BMIZ) were converted into z-scores
using WHO standards for children under 18.
Standard cut-points (<-2SD and >2SD) were
used to assess undernutrition (wasting, stunting)
and overnutrition (high body fat), respectively.
PARASITOSIS
Stool samples were preserved in 10% formalin for
transportation. Direct examination and rapid
sedimentation methods were used to detect
protozoa and helminth ova or larvae.
HEMOGLOBIN - ANEMIA
Children aged from 5 to 12 years old (n:70). Height,
weight, a blood sample, and stool sample were
Levels of anemia were determined using the
Hemocue method and hemoglobin cut-off points
collected from children within a week of enrollment.
at sea level.

RESULTS
Table 1. Characteristics of population. 25
21.7
20 18.8
Male Female
Characteristics
5 to 9 y. 10 to 12 y. 5 to 9 y. 10 to 12 y. 15
(n:23) (n:9) (n:23) (n:15) 10
Age (years) 71 11 1 72 11 1 4.4
6.7
5
Weight (Kg) 20.96 5.09 27.29 9.11 20.24 4.42 31.44 4.44
0
Height (cm) 115 9.1 131.7 12.5 114.8 8.4 135.6 6.4
Male Female
Hemoglobin(g/L) 113 15.0 118 20.0 109 15.0 116 11.0 Stunting Global undernutrition
Figure 1. Types of undernutrition according to sex of children.
Stunting: LAZ. Global undernutrition: WAZ.

Table 2. Levels of anemia according to sex of children.

Levels of Male Female .

Hymenolepis nana
anemia*
(g/L) 5 to 9 y. 10 to 12 y. 5 to 9 y. 10 to 12 y. Ascaris sp/Entamoeba histolytica/dispar & trichuris

Mild (2) 113 1 (3) 111 1 (5) 112 1 (4) 112 2

Ascaris sp & Trichuris trichuria

Moderate (8) 99 10 (1) 102 (8) 94 9 (4) 103 3

Giardia lamblia
Severe - - - -
Giardia lamblia & Entamoeba histolytica/dispar
Normal (11) 123 9 (5) 126 6 (8) 124 9 (7) 126 6
Schistosoma & Ascaris
*Hemoglobin en gramos por litro. Mild anemia (110-114 g/L). Moderate anemia (80-109 g/L). Severe anemia (< 80
g/L). Normal status (115 g/L).
Entamoeba histolytica/dispar

21.9% of the children had mild anemia and 31.3% had moderate anemia. Taenia (levamizol)
Anemia was more prevalent in the age group 5-9 years.
Ascaris
34.4% of the children are infected with some type of parasite, being Entamoeba
histolytica the most predominant. Not all cases of undernutrition had anemia N.P.
and parasites, showing that other factors can contribute to its development,
such as the quality of diet, the access to basic services, and the socioeconomic 0 2 4 6 8 10 12 14 16 18
level. Without anemia Moderate (g/L) Mild (g/L)

40.6% of the children are stunted. Of these, a higher prevalence is observed in Figure 2. Types of parasites according to levels of anemia. Subgruop (N=48). Mild anemia (110-114 g/L), Moderate
females. anemia (80-109 g/L), without anemia ( 115 g/L). NP: Absence of parasites.

CONCLUSIONS BIBLIOGRAPHY
Undernutrition and anemia remain significant problems in Ecuadorian rural 1Best, C., Neufingerl, N., van Geel, L., van den Briel, T. & Osendarp S. (2010). The nutritional status of school-aged children: why should we care?
Food Nutr Bull, 31(3),40017.
areas, showing a higher level of undernutrition when compared to the last 2Organizacin Panamericana de la Salud. (2000). Los desastres naturales y la proteccin de la salud. Washington: OPS.

regional data of Manab province (<20%)3. These findings show how 3Freire, W.B., Ramrez-Luzuriaga, M.J., Belmont, P., Mendieta, M.J., Silva-Jaramillo, M.K., Romero, N., Senz, K., Pieiros, P., Gmez, L.F. & Monge,

necessary it is to intervene appropriately in rural communities after natural
disasters.
Copyright 2017 Maribel Chisaguano, achisaguano@usfq.edu.ec
R.(2014). Tomo I: Encuesta Nacional de Salud y Nutricin de la poblacin ecuatoriana de cero a 59 aos. ENSANUT-ECU 2012. Ministerio de Salud
Pblica/Instituto Nacional de Estadsticas y Censos. Quito-Ecuador.
FINANCIAL SUPPORT
This study was supported in part by Sistemas Mdicos USFQ SIME. The authors want to thank all volunteers families who
participated in the project.