Diarrhea, respiratory infections, protozoan gastrointestinal parasites, and child growth in Kathmandu, Nepal

The differential impact of diarrhea, respiratory infections, and protozoan parasitism on growth is investigated among children under five years of age living in periurban Kathmandu, Nepal. The children's parents are all carpet-making workers who live in an environment with crowded living conditions, poor sanitation, and contaminated water. Anthropometric data, both cross-sectional and longitudinal, were collected over a 9-month period. Morbidity data were gathered from maternal reports, and a subsample of children's stools were examined for gastrointestinal parasites. In a comparison of current growth status and growth velocity for children with and without diarrhea and respiratory infections, it is found that body weight is most affected by infections, particularly for children under 24 months of age. For a subsample of children whose stools were tested for parasites, there is a statistically significant association between stunting (low height-for-age) and the presence of a protozoan gastrointestinal parasite. It is concluded that although growth faltering is associated with diarrhea and respiratory infections, the impact of these infections is of less importance for long-term linear growth retardation than is infection by protozoan gastrointestinal parasites.