Association between Entamoeba Histolytica infection and nutritional status among under-five children with severe diarrheal disease in South Asia: evidence from Global Enteric Multicenter Study (GEMS).

Abstract: ABSTRACT Background: South Asia has the highest burden of malnutrition compared to the rest of the countries in the world. The purpose of this study was to investigate association between Entamoeba Histolytica infection and nutritional status in a cohort of under-5 children treated for severe diarrheal disease. Methods: From Global Enteric Multicenter Study (GEMS), a sub sample cohort of total 4,220 under-five children were analyzed from South Asia where 155 study participants had severe diarrheal disease with Entamoeba Histolytica infection (amebiasis). The WHO child growth standard median, 2006 was used to measure the three anthropometric indices after 60 days of hospital discharge. Chi-square (X2) test and binary logistic regression were done to calculate the significance and strength of association between diarrheal disease with E. Histolytica and nutritional status; 95% Confidence interval were also estimated. Results: The children aged under-five who had severe diarrheal disease due to amebiasis had no significant aggravated effect on any indices of nutritional status (stunting, wasting, and underweight) in comparison to non-amebic diarrhea. The under five children whose mothers were illiterate (aOR= 2.12, 95% CI 1.76-2.56) and had poor wealth index (aOR= 1.53, 95% CI 1.32-1.77) had significantly higher odds for three indices of nutritional status. Pakistan had poor nutritional status (aOR= 2.23, 95% CI 1.74-2.85) compare to India and Bangladesh.  Conclusion: Severe diarrhea due to amebiasis had no aggravated effect on post diarrheal nutritional status among under five children in comparison to non-amebic diarrhea. There was no correlation found in this study between diarrheal disease associated by Entamoeba Histolytica infection and malnutrition.