Parasitic infections – a hidden challenge to improving nutrition

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Parasiticinfections–ahidden challengetoimprovingnutrition

Whatareparasiticinfections?

Parasitic worm infections are estimated to infect over 1.5 billion globally. They affect people living in poverty without access to clean water and sanitation, and the highest burden is mostly found in children. Examples of parasitic infections are:

Schistosomiasis (bilharzia) is caused by parasitic flatworms transmitted between people through freshwater snails. There are two main types of schistosomiasis: urogenital and intestinal.

Soil-transmitted helminths (STH) are parasitic intestinal worms transmitted between humans through soil contaminated with human excreta in which parasite eggs mature The main species of STH that infect people inclu

Schistosomiasis and STH are commonly addressed through mass drug administration programmes, targeted at school-aged children in accordance with World Health Organization recommendations. Treatment is effective at expelling adult worms, although it does not prevent reinfection. Left untreated, they can lead to long-term illness and complications, such as organ damage, cancer and death.

Primary prevention of infection requires sustained access to adequate water supply and sanitation services and avoidance of risk behaviours like contact with contaminated water and poor food safety.

Parasiticinfectionsandnutrition

Life cycle of schistosomiasis

The nutritional impact of parasitic infections manifests through affecting intake of nutrients due to abdominal pain, appetite loss and diarrhoea; absorption of nutrients in the body; and utilisation of nutrients.

Anaemia: in schistosomiasis-infected individuals it is frequently ‘anaemia of inflammation’ , leading to iron deficiency. Blood loss can also be caused by intestinal lesions, while urogenital schistosomiasis can decrease haemoglobin levels by increasing blood loss and decreasing food intake. STH feed on host tissues, including blood, causing loss of iron and protein; hookworms can cause chronic intestinal blood loss.

Stunting: schistosomiasis infection can result in slow growth due to continued or chronic inflammation during childhood. STH infection has been associated with impaired growth in children under five years of age, linked with overall poor nutritional status. Roundworm may compete for vitamin A in the intestine.

The effect on anaemia, aerobic capacity, fatigue, weakness and reduced cognitive function and educational loss can result in lost productivity and capacity for work, contributing to a vicious cycle of disease, poverty, and undernutrition.

Opportunitiesforcollabo

Integration of treatment into health and nutrition programmes:

Delivery of treatment solely through dedicated campaigns misses opportunities for joint implementation with nutrition programmes that can lead to improved efficiency, reach and outcomes. Areas for potential integration that offer benefits for health and nutritional outcomes include community-based feeding, micronutrient supplementation and health promotion.

Linking primary prevention efforts:

Environmental and behavioural measures such as improvement in access to safe water supply and sanitation services and hygiene practices are needed to prevent parasitic infections. Such improvements can support prevention of undernutrition through reducing infectious diseases, diarrhoea and dysentery, and environmental enteric dysfunction. Collaboration between nutrition, disease control, and water and sanitation programmes, can therefore help ensure that services are delivered to communities with the highest burden of disease and undernutrition, while also contributing to programme efficiency and improved health outcomes.

AboutUnlimitHealth

Unlimit Health is an international organisation working to end parasitic disease. We work closely with affected countries, sharing evidence and expertise to eliminate preventable infections. Our purpose is to support people to live healthy lives, free from limiting disease.

Our vision is for resilient systems that sustain good health, so everyone everywhere can reach their full potential. We achieve this by working across multiple sectors in numerous countries to deliver effective and robust health programmes that have a lasting impact.

WhatUnlimitHealthisdoingabout parasiticwormsandnutrition

Improving evidence on the link between parasitic infections and nutrition.

Development of programme and funding integration

approaches, particularly on paediatric treatment (more information on pediatricpraziquantelconsortium.org/).

Contributing to UK nutrition policy and advocacy through membership of the International Coalition for Advocacy on Nutrition (ICAN).

Image by: William Mgobela/ Unlimit Health

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