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The Impact of Helminth Infections on Developmental and Educational Outcomes

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Handbook of Applied Developmental Science in Sub-Saharan Africa

Abstract

Many of the world’s children still battle with disease, poverty, and malnutrition. Worms affect about 90 million children, the majority from sub-Saharan Africa in whom they are reported to impair growth and cognition. However, findings of these studies have not been consistent in part because many of them were observational and were limited by confounding. There has been much advocacy for mass de-worming, often based on the assumption that worm infections influence growth, cognitive ability, and school performance but like the observational studies, trials have also been inconclusive regarding benefits for cognitive performance. Further, despite the widely held belief that worm infections are associated with cognitive impairment, underlying mechanisms are not yet understood. General pathways (anemia, malaise, and reduced physical activity) which may negatively affect task-taking and the child’s ability to explore and learn from the environment have been proposed. These mechanisms predict a generalized impairment across cognitive functions. However, many studies report selective susceptibility of certain functions, notably executive functions, to effects of worms implying that the general pathways may not provide a sufficient explanation. Specific mechanisms such as iron deficiency, amino acid depletion, and elevated circulating cytokines due to worm infection are believed to affect availability of CNS dopamine, thereby interfering with executive functions and other processes of the frontal lobe which depend on dopamine as the main neurotransmitter. The current chapter evaluates the impact of worm infections on cognitive and educational performance of children in the African context by reviewing findings from various populations, and from one recent trial, the Entebbe Mother and Baby Study which has investigated effects of worms on executive functioning in Ugandan children.

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Authors and Affiliations

  1. MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda

    Margaret Nampijja

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  1. Margaret Nampijja
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Correspondence to Margaret Nampijja .

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  1. Department of Culture Studies, Tilburg University, Tilburg, The Netherlands

    Amina Abubakar

  2. Department of Culture Studies, Tilburg University, Tilburg, The Netherlands

    Fons J.R. van de Vijver

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Nampijja, M. (2017). The Impact of Helminth Infections on Developmental and Educational Outcomes. In: Abubakar, A., van de Vijver, F. (eds) Handbook of Applied Developmental Science in Sub-Saharan Africa. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-7328-6_8

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