Cognitive performance and iron status are negatively associated with hookworm infection in Cambodian schoolchildren

Kuong Khov; Marion Fiorentino; Marlene Perignon; Chhoun Chamnan; Jacques Berger; Sinuon Muth; Vann Molyden; Kurt Burja; Megan Parker; Sou Chheng Ly; Henrik Friis; Nanna Roos; Frank T Wieringa

doi:10.4269/ajtmh.15-0813

Cognitive performance and iron status are negatively associated with hookworm infection in Cambodian schoolchildren

Kuong Khov, Marion Fiorentino, Marlene Perignon, Chhoun Chamnan, Jacques Berger, Sinuon Muth, Vann Molyden, Kurt Burja, Megan Parker, Sou Chheng Ly, Henrik Friis, Nanna Roos, Frank T Wieringa

Lifecourse Nutrition & Health

11 Citations (Scopus)

Abstract

Soil-transmitted helminth (STH) infection has been associated with lower cognitive performance of schoolchildren. To identify pathways through which STH infection might affect school performance, baseline data from a large rice-fortification trial in Cambodian schoolchildren were used to investigate associations between STH infection, micronutrient status, anemia, and cognitive performance. Complete data on anthropometry, cognitive performance, and micronutrient status were available for 1,760 schoolchildren, 6-16 years of age. STH infection was identified using Kato-Katz, whereas cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM), block design, and picture completion. STH infection was found in 18% of the children; almost exclusively hookwork infection. After adjusting for age and gender, raw cognitive test scores were significantly lower in hookworm-infected children (-0.65; -0.78; -2.03 points for picture completion, RCPM, and block design, respectively; P < 0.05 for all). Hookworm infection was associated with iron status (total body iron), but not with vitamin A and zinc status, nor with inflammation or anthropometry. Body iron was negatively associated with increased intensity of hookworm infection (R = 0.22, P < 0.001). Hookworm infection in Cambodian schoolchildren was associated with lower cognitive performance, an effect most likely mediated through lower body iron. Interventions that are more effective against hookworm infection are needed to contribute to better health and improvement of cognitive performance.

Original language	English
Journal	American Journal of Tropical Medicine and Hygiene
Volume	95
Issue number	4
Pages (from-to)	856-863
Number of pages	8
ISSN	0002-9637
DOIs	https://doi.org/10.4269/ajtmh.15-0813
Publication status	Published - Oct 2016

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Khov, K., Fiorentino, M., Perignon, M., Chamnan, C., Berger, J., Muth, S., Molyden, V., Burja, K., Parker, M., Ly, S. C., Friis, H., Roos, N., & Wieringa, F. T. (2016). Cognitive performance and iron status are negatively associated with hookworm infection in Cambodian schoolchildren. American Journal of Tropical Medicine and Hygiene, 95(4), 856-863. https://doi.org/10.4269/ajtmh.15-0813

Khov, K, Fiorentino, M, Perignon, M, Chamnan, C, Berger, J, Muth, S, Molyden, V, Burja, K, Parker, M, Ly, SC, Friis, H , Roos, N & Wieringa, FT 2016, 'Cognitive performance and iron status are negatively associated with hookworm infection in Cambodian schoolchildren', American Journal of Tropical Medicine and Hygiene, vol. 95, no. 4, pp. 856-863. https://doi.org/10.4269/ajtmh.15-0813

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title = "Cognitive performance and iron status are negatively associated with hookworm infection in Cambodian schoolchildren",

abstract = "Soil-transmitted helminth (STH) infection has been associated with lower cognitive performance of schoolchildren. To identify pathways through which STH infection might affect school performance, baseline data from a large rice-fortification trial in Cambodian schoolchildren were used to investigate associations between STH infection, micronutrient status, anemia, and cognitive performance. Complete data on anthropometry, cognitive performance, and micronutrient status were available for 1,760 schoolchildren, 6-16 years of age. STH infection was identified using Kato-Katz, whereas cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM), block design, and picture completion. STH infection was found in 18% of the children; almost exclusively hookwork infection. After adjusting for age and gender, raw cognitive test scores were significantly lower in hookworm-infected children (-0.65; -0.78; -2.03 points for picture completion, RCPM, and block design, respectively; P < 0.05 for all). Hookworm infection was associated with iron status (total body iron), but not with vitamin A and zinc status, nor with inflammation or anthropometry. Body iron was negatively associated with increased intensity of hookworm infection (R = 0.22, P < 0.001). Hookworm infection in Cambodian schoolchildren was associated with lower cognitive performance, an effect most likely mediated through lower body iron. Interventions that are more effective against hookworm infection are needed to contribute to better health and improvement of cognitive performance.",

author = "Kuong Khov and Marion Fiorentino and Marlene Perignon and Chhoun Chamnan and Jacques Berger and Sinuon Muth and Vann Molyden and Kurt Burja and Megan Parker and Ly, {Sou Chheng} and Henrik Friis and Nanna Roos and Wieringa, {Frank T}",

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T1 - Cognitive performance and iron status are negatively associated with hookworm infection in Cambodian schoolchildren

AU - Khov, Kuong

AU - Fiorentino, Marion

AU - Perignon, Marlene

AU - Chamnan, Chhoun

AU - Berger, Jacques

AU - Muth, Sinuon

AU - Molyden, Vann

AU - Burja, Kurt

AU - Parker, Megan

AU - Ly, Sou Chheng

AU - Friis, Henrik

AU - Roos, Nanna

AU - Wieringa, Frank T

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N2 - Soil-transmitted helminth (STH) infection has been associated with lower cognitive performance of schoolchildren. To identify pathways through which STH infection might affect school performance, baseline data from a large rice-fortification trial in Cambodian schoolchildren were used to investigate associations between STH infection, micronutrient status, anemia, and cognitive performance. Complete data on anthropometry, cognitive performance, and micronutrient status were available for 1,760 schoolchildren, 6-16 years of age. STH infection was identified using Kato-Katz, whereas cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM), block design, and picture completion. STH infection was found in 18% of the children; almost exclusively hookwork infection. After adjusting for age and gender, raw cognitive test scores were significantly lower in hookworm-infected children (-0.65; -0.78; -2.03 points for picture completion, RCPM, and block design, respectively; P < 0.05 for all). Hookworm infection was associated with iron status (total body iron), but not with vitamin A and zinc status, nor with inflammation or anthropometry. Body iron was negatively associated with increased intensity of hookworm infection (R = 0.22, P < 0.001). Hookworm infection in Cambodian schoolchildren was associated with lower cognitive performance, an effect most likely mediated through lower body iron. Interventions that are more effective against hookworm infection are needed to contribute to better health and improvement of cognitive performance.

AB - Soil-transmitted helminth (STH) infection has been associated with lower cognitive performance of schoolchildren. To identify pathways through which STH infection might affect school performance, baseline data from a large rice-fortification trial in Cambodian schoolchildren were used to investigate associations between STH infection, micronutrient status, anemia, and cognitive performance. Complete data on anthropometry, cognitive performance, and micronutrient status were available for 1,760 schoolchildren, 6-16 years of age. STH infection was identified using Kato-Katz, whereas cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM), block design, and picture completion. STH infection was found in 18% of the children; almost exclusively hookwork infection. After adjusting for age and gender, raw cognitive test scores were significantly lower in hookworm-infected children (-0.65; -0.78; -2.03 points for picture completion, RCPM, and block design, respectively; P < 0.05 for all). Hookworm infection was associated with iron status (total body iron), but not with vitamin A and zinc status, nor with inflammation or anthropometry. Body iron was negatively associated with increased intensity of hookworm infection (R = 0.22, P < 0.001). Hookworm infection in Cambodian schoolchildren was associated with lower cognitive performance, an effect most likely mediated through lower body iron. Interventions that are more effective against hookworm infection are needed to contribute to better health and improvement of cognitive performance.

U2 - 10.4269/ajtmh.15-0813

DO - 10.4269/ajtmh.15-0813

M3 - Journal article

C2 - 27573634

SN - 0002-9637

VL - 95

SP - 856

EP - 863

JO - American Journal of Tropical Medicine and Hygiene

JF - American Journal of Tropical Medicine and Hygiene

IS - 4

ER -

Cognitive performance and iron status are negatively associated with hookworm infection in Cambodian schoolchildren

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