Peer-reviewed article
Impact of asymptomatic Cryptosporidium infection on nutritional status in children under two: a multi-country cohort study.
Khan MA, Haque MA, Tariqujjaman M, Faruque A, Ahmed T et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how asymptomatic Cryptosporidium infections—parasite infections without visible symptoms—affect the growth and nutrition of children under 2 years old across seven countries. Using data from a large longitudinal birth cohort study, researchers found that even without symptoms, these infections were significantly associated with stunting, wasting, and being underweight. The burden of infection was highest in Tanzania and Peru but varied across countries, suggesting different regional health contexts.
Key points
- Asymptomatic Cryptosporidium infections occurred at a rate of 7.89 per 100 child-months across the study population
- Infection was significantly associated with stunting (odds ratio 1.32), wasting (odds ratio 1.47), and underweight (odds ratio 1.47)
- Incidence rates varied substantially by country: Tanzania 14.35, Peru 12.55, Brazil 1.34 per 100 child-months
- Stunting was most strongly associated with infection in India, Peru, and Tanzania; underweight in Bangladesh and Tanzania; wasting in Peru
- The study demonstrates a hidden burden of infection that contributes to malnutrition even in the absence of clinical symptoms
Limitations
This is a secondary analysis of existing data, so the study cannot establish causation definitively or explore mechanisms of how infection affects nutrition. The variation across countries may reflect differences in detection methods, climate, water quality, and other contextual factors that are not fully explained.
Abstract
Background Subclinical or asymptomatic cryptosporidiosis can contribute to malnutrition in children, especially in environments where the infection is persistent or occurs repeatedly. Despite the absence of symptoms, these infections are associated with impaired growth and nutritional deficiencies, potentially increasing the risk of stunting, wasting, and underweight. This study examined the association between asymptomatic Cryptosporidium infection and nutritional status in children under 2 years old. Methods This is a secondary analysis of data from the MAL-ED study which is a longitudinal birth cohort study conducted in eight countries: Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa, and Tanzania, a multi-country investigation of enteric infections and malnutrition. We excluded Pakistan due to the lack of available anthropometric data. Nutritional indicators were assessed using the World Health Organization growth chart,[18] including stunting (length-for-age <-2 standard deviations [SD]), underweight (weight-for-age <-2 SD), and wasting (weight-for-length <-2 SD). Poisson regression estimated Cryptosporidium incidence rates, while GEE (generalized estimation equation) with a binomial family and logit link assessed associations with nutritional indicators, calculating odds ratios. Result Findings indicate an incidence rate of 7.89 per 100 child-months for asymptomatic Cryptosporidium infections, which are significantly associated with stunting (aOR: 1.32; 95% CI: 1.24-1.41), wasting (aOR: 1.47; 95% CI: 1.08-1.49), and underweight (aOR: 1.47; 95% CI: 1.08-1.49). Incidence was highest in Tanzania (14.35) and Peru (12.55), indicating a hidden burden, while Brazil (1.34) had the lowest. Stunting was strongly associated with infection in India, Peru, and Tanzania, underweight in Bangladesh and Tanzania, and wasting was notably high in Peru. Conclusions This study highlights the significant burden of asymptomatic Cryptosporidium infections and their potential impact on child growth and nutrition. The strong associations with stunting, wasting, and underweight suggest that even in the absence of symptoms, these infections may contribute to long-term developmental challenges. Furthermore, the differential effects on nutritional outcomes across countries emphasize the importance of targeted strategies to mitigate the hidden consequences of Cryptosporidium infections and improve child health globally.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.