Soil-Transmitted Helminths, Poverty, and Malnutrition in Honduran Children Living in Remote Rural Communities

Soil-transmitted helminth (STH) infections are endemic in Honduras, but their prevalence according to the levels of poverty in the population has not been examined. The present cross-sectional study is aimed to determine the role of different levels of poverty in STH prevalence and infection intensity as well as the potential associations of STH infections with malnutrition and anemia. Research participants were children attending a medical brigade serving remote communities in Northern Honduras in June 2014. Demographic data were obtained, and poverty levels were determined using the unsatisfied basic needs method. STH infections were investigated by the Kato-Katz method; hemoglobin concentrations were determined with the HemoCue system; and stunting, thinness, and underweight were determined by anthropometry. Data were analyzed using descriptive statistics and univariate and multivariable logistic regression models. Among 130 children who participated in this study, a high prevalence (69.2%) of parasitism was found and the poorest children were significantly more infected than those living in less poor communities (79.6% vs. 61.8%; P = 0.030). Prevalence rates of Trichuris trichiura, Ascaris lumbricoides, and hookworms were 69.2%, 12.3%, and 3.85%, respectively. In total, 69% of children had anemia and 30% were stunted. Households’ earthen floor and lack of latrines were associated with infection. Greater efforts should be made to reduce STH prevalence and improve overall childhood health, in particular, among the poorest children lacking the basic necessities of life.

Socio-demographic factors, smoking, symptoms, morbidities and pulmonary function and quality of life in individuals with a heavy smoking history

Objective: To determine which socio-demographic, exposure, morbidity and symptom variables are associated with health-related quality of life among former and current heavy smokers. Methods: Cross sectional data from 2537 participants were studied. All participants were at ≥2% risk of developing lung cancer within 6 years. Linear and logistic regression models utilizing a multivariable fractional polynomial selection process identified variables associated with health-related quality of life, measured by the EQ-5D. Results: Upstream and downstream associations between smoking cessation and higher health-related quality of life were evident. Significant upstream associations, such as education level and current working status and were explained by the addition of morbidities and symptoms to regression models. Having arthritis, decreased forced expiratory volume in one second, fatigue, poor appetite or dyspnea were most highly and commonly associated with decreased HRQoL. Discussion: Upstream factors such as educational attainment, employment status and smoking cessation should be targeted to prevent decreased health-related quality of life. Practitioners should focus treatment on downstream factors, especially symptoms, to improve health-related quality of life.