Worms and low marks are bedfellows among kids – Eastern Cape study

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RAWhipwormsWorms and low marks are bedfellows among primary school children‚ a study in the Eastern Cape by academics from Nelson Mandela Metropolitan University and Basel University found.

The researchers probed the infestation of roundworm and whip worm among Grade 4 children.

They found that the worms were “associated with lower selective attention capacity and reduced physical fitness … Moreover‚ children infected with (worms) had significantly lower academic achievement scores.”

The report says the researchers put 835 Grade 4 pupils from eight schools in disadvantaged areas of Port Elizabeth through a series of physical and mental tests‚ and found that one in three had worms transmitted through soil. And, they said, there was a link between worm infections and socioeconomic class as most students in the study fell well below the poverty line.

Children born in “challenging environments such as townships” were at an increased risk of contracting parasites due to limited access to healthcare and proper nutrition.

The academics said provinces with the highest rates of child poverty – the Eastern Cape‚ KwaZulu-Natal‚ and Limpopo – would see continued patterns of poor academic performance‚ in part due to rates of infection.

Without proper nutritional and health programmes aimed at reducing worm infections‚ researchers said the “vicious cycle of poverty and ill health” would continue. “It is conceivable that the general well-being of infected children‚ as expressed in abdominal pain‚ fatigue and listlessness‚ negatively affects their cognitive performance‚” they are quoted in the report as saying.

The children in the study were aged between 8 and 12‚ and the younger ones outperformed their older peers in academic tests. “Children suffering from reading difficulties‚ attention deficit hyperactivity disorder‚ foetal alcohol syndrome or neglect do not get the required academic support and as a consequence are not able to keep up with their peers‚” they said.

“Students failing to achieve adequate grades are retained up to three years until they get too old and automatically progress to the next grade.”

Background: Socioeconomically deprived children are at increased risk of ill-health associated with sedentary behaviour, malnutrition, and helminth infection. The resulting reduced physical fitness, growth retardation, and impaired cognitive abilities may impede children’s capacity to pay attention. The present study examines how socioeconomic status (SES), parasitic worm infections, stunting, food insecurity, and physical fitness are associated with selective attention and academic achievement in school-aged children.
Methodology: The study cohort included 835 children, aged 8–12 years, from eight primary schools in socioeconomically disadvantaged neighbourhoods of Port Elizabeth, South Africa. The d2-test was utilised to assess selective attention. This is a paper and pencil letter-cancellation test consisting of randomly mixed letters d and p with one to four single and/or double quotation marks either over and/or under each letter. Children were invited to mark only the letters d that have double quotation marks. Cardiorespiratory fitness was assessed via the 20 m shuttle run test and muscle strength using the grip strength test. The Kato-Katz thick smear technique was employed to detect helminth eggs in stool samples. SES and food insecurity were determined with a pre-tested questionnaire, while end of year school results were used as an indicator of academic achievement.
Principal findings: Children infected with soil-transmitted helminths had lower selective attention, lower school grades (academic achievement scores), and lower grip strength (all p<0.05). In a multiple regression model, low selective attention was associated with soil-transmitted helminth infection (p<0.05) and low shuttle run performance (p<0.001), whereas higher academic achievement was observed in children without soil-transmitted helminth infection (p<0.001) and with higher shuttle run performance (p<0.05).
Conclusions/Significance: Soil-transmitted helminth infections and low physical fitness appear to hamper children’s capacity to pay attention and thereby impede their academic performance. Poor academic achievement will make it difficult for children to realise their full potential, perpetuating a vicious cycle of poverty and poor health.

Stephanie Gall, Ivan Müller, Cheryl Walter, Harald Seelig, Liana Steenkamp, Uwe Pühse, Rosa du Randt, Danielle Smith, Larissa Adams, Siphesihle Nqweniso, Peiling Yap, Sebastian Ludyga, Peter Steinmann, Jürg Utzinger, Markus Gerber

The Times report
PLOS Neglected Tropical Diseases abstract

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