THE SILENT IMPACT OF ENTAMOEBA HISTOLYTICA: ASSOCIATIONS WITH GROWTH RETARDATION AND MICRONUTRIENT DEPLETION IN CHILDREN

Abstract

Entamoeba histolytica (E. histolytica) is an intestinal pathogen that causes high morbidity in children from developing nations. E. histolytica cause gastrointestinal symptoms, but its presence can also lead to malnutrition and micronutrient deficiencies due to poor absorption of nutrients, intestinal inflammation, and high energy requirements. The purpose of this study was to evaluate the association between E. histolytica infection, clinical presentation, anthropometric measures, and serum micronutrients among children. The comparative cross-sectional study was designed in which children were divided into the infected and non-infected groups by examining their stool samples for E. histolytica. Socio-demographic parameters and clinical symptoms were recorded by the utilization of questionnaire. GraphPad prism version 8 were used to perform statistical analysis. According to the results, 57.8% children were infected with E. histolytica and 42.1% were found as non infected. Among the infected children, females (55.5%) were highly prevalent to this infection compared to males (44.4%). The infected children particularly 43.4% were highly belong to > 5 – 9 age group and most of them about 59.3% lived in rural areas. Abdominal pain (67.9%), diarrhea (58%) and fever (54.3%) were the most noted clinical symptoms among the infected children. The anthropometric parameters significantly (P < 0.01) reduced in all infected children including weight, height and BMI. The serum ferritin (ng/mL) and zinc (µg/dL) levels in infected children were significantly reduced with the p-value of < 0.01 in comparison to non-infected children while dramatic significant reduction noted in vitamin D (ng/mL) levels with p-value of < 0.0001. These all micronutrient deficiencies were significantly correlated with the anthropometric parameters of infected children (p < 0.0001). The elevated serum levels of these micronutrients were found in the reduced weight group, whereas decreased levels were detected in the reduced height and reduced BMI groups (p < 0.01-0.0001). Micronutrient deficiencies were highly correlated with poor growth in infected children. These findings demonstrate the necessity for integrated nutritional programs, routine micronutrient testing, and effective parasitic control measures to enhance child growth and health.