{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T12:58:02Z","timestamp":1769000282122,"version":"3.49.0"},"reference-count":68,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003508","name":"Development Cooperation Projects","doi-asserted-by":"publisher","award":["COOP16\/2022"],"award-info":[{"award-number":["COOP16\/2022"]}],"id":[{"id":"10.13039\/501100003508","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Undernutrition and intestinal parasitic infections are critical public health problems in low-income countries, with adverse effects on child growth and increasing anaemia. Madagascar, with a high prevalence of these factors, lacks comprehensive studies analysing their interaction. This study aimed to assess the nutritional status, the prevalence of anaemia, and the occurrence of intestinal parasitic infections among children and adolescents in three southern regions of Madagascar. Methods: A cross-sectional, prospective study of 289 children and adolescents (10\u201318 years) from three schools located in Antsoamadiro, Fianarantsoa, and Toliara was conducted. Sociodemographic, anthropometric, and haemoglobin concentration data, as well as faecal samples, were collected. Nutritional status was assessed by Nutrimetry, combining Height-for-Age and BMI-for-Age indicators. Stool samples were analysed by optical microscopy and molecular methods. Results: Nutricode 1 (short stature\/stunting + thinness\/wasting) was significantly more frequent in Toliara. Nutricode 1 was also significantly more prevalent in males than females. Anaemia affected 57.8% of participants and was significantly associated with Nutricode 1. The overall parasitism rate was also associated with Nutricode 1. Trichuris trichiura and Ascaris lumbricoides significantly increased the risk of stunting, wasting, and Nutricode 1. Co-infection with Trichuris trichiura + Giardia duodenalis was significantly associated with wasting and Nutricode 1. This co-infection was also related to the presence of anaemia, as was moderate-intensity infection with T. trichiura. Conclusions: There is a high co-burden of undernutrition, anaemia, and parasitic infections in southern Madagascar. These findings highlight the urgency of implementing comprehensive health programmes combining parasite control, nutritional support, and iron supplementation adapted to regional realities.<\/jats:p>","DOI":"10.3390\/children12080990","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T14:50:03Z","timestamp":1753714203000},"page":"990","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Integrated Evaluation of Undernutrition, Anaemia, and Intestinal Parasitic Infections in School-Aged Children: A Cross-Sectional Study in Three Regions of Southern Madagascar"],"prefix":"10.3390","volume":"12","author":[{"given":"Gabriela","family":"Tapia-Veloz","sequence":"first","affiliation":[{"name":"Parasite & Health Research Group, Department of Pharmacy, Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, 46100 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6299-7665","authenticated-orcid":false,"given":"M\u00f3nica","family":"Gozalbo","sequence":"additional","affiliation":[{"name":"Department of Medicine and Public Health, Science of the Food, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venny","family":"Guirao","sequence":"additional","affiliation":[{"name":"Department of Health, ONG Bel Avenir, Toliara 601, Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hafsa","family":"Dinari","sequence":"additional","affiliation":[{"name":"Department of Medicine and Public Health, Science of the Food, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9508-6390","authenticated-orcid":false,"given":"M\u00e0rius Vicent","family":"Fuentes","sequence":"additional","affiliation":[{"name":"Parasite & Health Research Group, Department of Pharmacy, Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, 46100 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5977-3337","authenticated-orcid":false,"given":"Mar\u00eda","family":"Trelis","sequence":"additional","affiliation":[{"name":"Parasite & Health Research Group, Department of Pharmacy, Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, 46100 Valencia, Spain"},{"name":"Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"ref_1","unstructured":"FAO (2024). The State of Food Security and Nutrition in the World 2024, FAO."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Hailegebriel, T. (2018). Undernutrition, Intestinal Parasitic Infection and Associated Risk Factors among Selected Primary School Children in Bahir Dar, Ethiopia. BMC Infect. Dis., 18.","DOI":"10.1186\/s12879-018-3306-3"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"111565","DOI":"10.1016\/j.nut.2021.111565","article-title":"Determinants of Malnutrition among Children: A Systematic Review","volume":"96","author":"Katoch","year":"2022","journal-title":"Nutrition"},{"key":"ref_4","unstructured":"World Food Programme (2025, June 04). Madagascar Country Strategic Plan 2024\u20132028. Available online: https:\/\/www.wfp.org\/operations\/mg03-madagascar-country-strategic-plan-2024-2028."},{"key":"ref_5","unstructured":"World Bank (2025, June 03). Madagascar. World Bank Data. Available online: https:\/\/datos.bancomundial.org\/pais\/madagascar."},{"key":"ref_6","unstructured":"UNICEF (2025, June 03). Plan de Pa\u00eds de Madagascar (2025\u20132029). Available online: https:\/\/www.unicef.org\/executiveboard\/media\/19606\/file\/2024-PL3-Madagascar-CPD-ES-ODS.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/S0140-6736(15)61526-4","article-title":"Madagascar\u2019s Health Challenges","volume":"386","author":"Barmania","year":"2015","journal-title":"Lancet"},{"key":"ref_8","unstructured":"Global Hunger Index (2025, May 05). Madagascar\u2014Global Hunger Index (GHI), a Peer-Reviewed Annual Publication Designed to Comprehensively Measure and Track Hunger at the Global, Regional, and Country Levels. Available online: https:\/\/www.globalhungerindex.org\/madagascar.html."},{"key":"ref_9","unstructured":"The DHS Program (2025, June 03). Madagascar 2003\u20132004, Nutrition of Young Children and Mothers (English, French). Available online: https:\/\/dhsprogram.com\/publications\/publication-anc18-africa-nutrition-chartbooks.cfm."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Randrianarisoa, M.M., Rakotondrainipiana, M., Randriamparany, R., Andriantsalama, P.V., Randrianarijaona, A., Habib, A., Robinson, A., Raharimalala, L., Hunald, F.A., and Etienne, A. (2022). Factors Associated with Anaemia among Preschool-Age Children in Underprivileged Neighbourhoods in Antananarivo, Madagascar. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-13716-6"},{"key":"ref_11","first-page":"1240","article-title":"Anemia por Deficiencia de Hierro en Adolescentes; una Revision de la Literatura","volume":"29","author":"Cairo","year":"2014","journal-title":"Nutr. Hosp."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Oktarina, C., Dilantika, C., Sitorus, N.L., and Basrowi, R.W. (2024). Relationship Between Iron Deficiency Anemia and Stunting in Pediatric Populations in Developing Countries: A Systematic Review and Meta-Analysis. Children, 11.","DOI":"10.3390\/children11101268"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Greigert, V., Abou-Bacar, A., Brunet, J., Nourrisson, C., Pfaff, A.W., Benarbia, L., Pereira, B., Randrianarivelojosia, M., Razafindrakoto, J.L., and Rakotomalala, R.S. (2018). Human Intestinal Parasites in Mahajanga, Madagascar: The Kingdom of the Protozoa. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0204576"},{"key":"ref_14","unstructured":"Minist\u00e8re de la Sant\u00e9 Publique \u00e0 Madagascar (2023). Plan Directeur de Lutte Contre les Maladies Tropicales N\u00e9glig\u00e9es 2023\u20132027."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Deka, M.A. (2022). Predictive Risk Mapping of Schistosomiasis in Madagascar Using Ecological Niche Modeling and Precision Mapping. Trop. Med. Infect. Dis., 7.","DOI":"10.3390\/tropicalmed7020015"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.bjid.2014.11.004","article-title":"Impact of Human Schistosomiasis in Sub-Saharan Africa","volume":"19","author":"Adenowo","year":"2015","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Habib, A., Andrianonimiadana, L., Rakotondrainipiana, M., Andriantsalama, P., Randriamparany, R., Randremanana, R.V., Rakotoarison, R., Vigan-Womas, I., Rafalimanantsoa, A., and Vonaesch, P. (2021). High Prevalence of Intestinal Parasite Infestations among Stunted and Control Children Aged 2 to 5 Years Old in Two Neighborhoods of Antananarivo, Madagascar. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009333"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e00267","DOI":"10.1016\/j.parepi.2022.e00267","article-title":"Risk Factors for Intestinal Parasite Portage in an Informal Suburb on the West Coast of Madagascar","volume":"19","author":"Razafiarimanga","year":"2022","journal-title":"Parasite Epidemiol. Control"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Richert, W., Ko\u0142odziej, D., Zarudzka, D., Kasprowicz, D., \u015awietlik, D., and Korzeniewski, K. (2024). Intestinal Parasites and Hematological Parameters in Children Living in Ambatoboeny District, Madagascar. Pathogens, 13.","DOI":"10.3390\/pathogens13110930"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Irisarri-Guti\u00e9rrez, M.J., Acosta, L., Parker, L.A., Toledo, R., Bornay-Llinares, F.J., Esteban, J.G., and Mu\u00f1oz-Antol\u00ed, C. (2022). Anemia and Undernutrition in Intestinally Parasitized Schoolchildren from Gakenke District, Northern Province of Rwanda. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0262361"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Al-Haidari, S.A., Mahdy, M.A.K., Al-Mekhlafi, A.M., Al Murisi, W.M.S., Thabit, A.A.Q., Al-Amad, M.A., Al-Shamahi, H., Bahashwan, O.S., and Al Serouri, A. (2021). Intestinal Schistosomiasis among Schoolchildren in Sana\u2019a Governorate, Yemen: Prevalence, Associated Factors and Its Effect on Nutritional Status and Anemia. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009757"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3614","DOI":"10.1038\/s41598-022-07669-4","article-title":"Soil-Transmitted Helminthiasis and Undernutrition among Schoolchildren in Mettu Town, Southwest Ethiopia","volume":"12","author":"Yeshanew","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Fauziah, N., Aviani, J.K., Agrianfanny, Y.N., and Fatimah, S.N. (2022). Intestinal Parasitic Infection and Nutritional Status in Children under Five Years Old: A Systematic Review. Trop. Med. Infect. Dis., 7.","DOI":"10.3390\/tropicalmed7110371"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Caldrer, S., Ursini, T., Santucci, B., Motta, L., and Angheben, A. (2022). Soil-Transmitted Helminths and Anaemia: A Neglected Association Outside the Tropics. Microorganisms, 10.","DOI":"10.3390\/microorganisms10051027"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"862","DOI":"10.4269\/ajtmh.2012.12-0248","article-title":"Mechanism of Anemia in Schistosoma mansoni\u2013Infected School Children in Western Kenya","volume":"87","author":"Butler","year":"2012","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_26","unstructured":"A-Contresens (2025, June 04). Atsimo Atsinanana Region\u2014Ihorombe, Madagascar. Available online: https:\/\/planificateur.a-contresens.net\/afrique\/madagascar\/atsimo-atsinanana-region\/ihorombe\/1064277.html."},{"key":"ref_27","unstructured":"A-Contresens (2025, June 04). Haute Matsiatra Region, Madagascar. Available online: https:\/\/planificateur.a-contresens.net\/afrique\/madagascar\/haute-matsiatra-region\/haute_matsiatra_region\/7670905."},{"key":"ref_28","unstructured":"A-Contresens (2025, June 04). Atsimo Andrefana Region, Madagascar. Available online: https:\/\/planificateur.a-contresens.net\/afrique\/madagascar\/atsimo-andrefana-region\/7670913."},{"key":"ref_29","unstructured":"INSTAT Madagascar (2025, June 04). Mesure Cartographique de la Pauvret\u00e9 non Mon\u00e9taire des M\u00e9nages \u00e0 Madagascar. Available online: https:\/\/www.instat.mg\/documents\/upload\/main\/INSTAT-RGPH3_MesureCartoPauvreteNonMonetaireMenages.pdf."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1136\/adc.2007.136010","article-title":"WHO Child Growth Standards in Action","volume":"93","year":"2008","journal-title":"Arch. Dis. Child."},{"key":"ref_31","unstructured":"World Health Organization (2008). Measuring a Child\u2019s Growth Department of Nutrition for Health and Development, World Health Organization."},{"key":"ref_32","first-page":"84","article-title":"Nutrimetry: BMI Assessment as a Function of Development","volume":"65","year":"2018","journal-title":"Endocrinol. Diabetes Nutr."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Tapia-Veloz, E., Gozalbo, M., Tapia-Veloz, G., Carpio-Arias, T.V., Trelis, M., and Guill\u00e9n, M. (2022). Evaluation of School Children Nutritional Status in Ecuador Using Nutrimetry: A Proposal of an Education Protocol to Address the Determinants of Malnutrition. Nutrients, 14.","DOI":"10.3390\/nu14183686"},{"key":"ref_34","unstructured":"World Health Organization (2025, June 04). Global Status Report on Noncommunicable Diseases 2014. Available online: https:\/\/www.who.int\/publications\/i\/item\/WHO-NMH-NHD-MNM-11.1."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Levy, T.S., M\u00e9ndez-G\u00f3mez-Humar\u00e1n, I., Ru\u00e1n, M.D.C.M., Tapia, B.M., Hern\u00e1ndez, S.V., and \u00c1vila, M.H. (2017). Validation of Masimo Pronto 7 and HemoCue 201 for Hemoglobin Determination in Children from 1 to 5 Years of Age. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0170990"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1007\/s12288-019-01196-5","article-title":"Validation of Point of Care Hemoglobin Estimation Among Pregnant Women Using Digital Hemoglobinometers (HemoCue 301 and HemoCue 201+) as Compared with Auto-Analyzer","volume":"36","author":"Yadav","year":"2019","journal-title":"Indian J. Hematol. Blood Transfus."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Matamoros, G., Sanchez, A., Cimino, R., Krolewiecki, A., and Mejia, R. (2024). A Comparison of the Diagnostic Capability of Kato-Katz and Real-Time PCR for the Assessment of Treatment Efficacy of Ivermectin and Albendazole Combination against T. trichiura Infections. PLoS Negl. Trop. Dis., 18.","DOI":"10.1371\/journal.pntd.0012677"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1186\/s13071-017-2249-7","article-title":"High Burden of Schistosoma Mansoni Infection in School-Aged Children in Marolambo District, Madagascar","volume":"10","author":"Spencer","year":"2017","journal-title":"Parasit. Vectors"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S0890-8508(03)00057-4","article-title":"Real-Time PCR for the Detection of Giardia Lamblia","volume":"17","author":"Verweij","year":"2003","journal-title":"Mol. Cell Probes"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Aiga, H., Abe, K., Andrianome, V.N., Randriamampionona, E., Razafinombana, A.R., Murai, T., and Hara, M. (2019). Risk Factors for Malnutrition among School-Aged Children: A Cross-Sectional Study in Rural Madagascar. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-7013-9"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1093\/inthealth\/ihv016","article-title":"Malnutrition Prevalence and Nutrition Barriers in Children under 5 Years: A Mixed Methods Study in Madagascar","volume":"7","author":"Asgary","year":"2015","journal-title":"Int. Health"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Addo, I.Y., Boadu, E.F., Bonsu, E.O., Boadi, C., and Dadzie, F.A. (2023). Prevalence and Factors Associated with Undernutrition among Children under the Age of Five Years in Benin. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0289933"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/S0140-6736(08)60169-5","article-title":"Effect of Parental Formal Education on Risk of Child Stunting in Indonesia and Bangladesh: A Cross-Sectional Study","volume":"371","author":"Semba","year":"2008","journal-title":"Lancet"},{"key":"ref_44","unstructured":"UNICEF (2025, June 04). Madagascar Humanitarian Situation Report\u2014March 2024. Available online: https:\/\/www.unicef.org\/documents\/madagascar-humanitarian-situation-report-march-2024."},{"key":"ref_45","unstructured":"IPC Global Platform (2025, June 04). Madagascar IPC Acute Food Insecurity Situation. Available online: https:\/\/www.ipcinfo.org\/ipc-country-analysis\/details-map\/en\/c\/1157106\/."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1301\/nr.2003.may.168-175","article-title":"The link between childhood undernutrition and risk of chronic diseases in adulthood: A case study of Brazil","volume":"61","author":"Sawaya","year":"2003","journal-title":"Nutr. Rev."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/S0140-6736(13)60937-X","article-title":"Maternal and child undernutrition and overweight in low-income and middle-income countries","volume":"382","author":"Black","year":"2013","journal-title":"Lancet"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1159\/000488865","article-title":"Adolescent Undernutrition: Global Burden, Physiology, and Nutritional Risks","volume":"72","author":"Christian","year":"2018","journal-title":"Ann. Nutr. Metab."},{"key":"ref_49","first-page":"263","article-title":"Adolescents\u2019 Undernutrition and Its Determinants among in-School Communities of Ambo Town, West Oromia, Ethiopia","volume":"7","author":"Alemayehu","year":"2010","journal-title":"East Afr. J. Public Health"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Soni, A., Fahey, N., Bhutta, Z.A., Li, W., Frazier, J.A., Simas, T.M., Nimbalkar, S.M., and Allison, J.J. (2021). Research Article Early Childhood Undernutrition, Preadolescent Physical Growth, and Cognitive Achievement in India: A Population-Based Cohort Study. PLoS Med., 18.","DOI":"10.1371\/journal.pmed.1003838"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e004030","DOI":"10.1136\/bmjgh-2020-004030","article-title":"Boys Are More Likely to Be Undernourished than Girls: A Systematic Review and Meta-Analysis of Sex Differences in Undernutrition","volume":"5","author":"Thurstans","year":"2020","journal-title":"BMJ Glob. Health"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e33","DOI":"10.1017\/jns.2023.19","article-title":"Undernutrition and Anaemia among Indian Adolescents: Role of Dietary Diversity and Hygiene Practices","volume":"12","author":"Kumar","year":"2023","journal-title":"J. Nutr. Sci."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Akbarpour, E., Paridar, Y., Mohammadi, Z., Mard, A., Danehchin, L., Abolnezhadian, F., Azadpour, S., Rahimi, Z., Zamani, M., and Cheraghian, B. (2022). Anemia prevalence, severity, types, and correlates among adult women and men in a multiethnic Iranian population: The Khuzestan Comprehensive Health Study (KCHS). BMC Public Health, 22.","DOI":"10.1186\/s12889-022-12512-6"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Yusufu, I., Cliffer, I.R., Yussuf, M.H., Anthony, C., Mapendo, F., Abdulla, S., Masanja, M., Tinkasimile, A., Ali, A.S., and Mwanyika-Sando, M. (2023). Factors associated with anemia among school-going adolescents aged 10\u201317 years in Zanzibar, Tanzania: A cross sectional study. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-16611-w"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1186\/s13045-021-01202-2","article-title":"Burden of Anemia and Its Underlying Causes in 204 Countries and Territories, 1990\u20132019: Results from the Global Burden of Disease Study 2019","volume":"14","author":"Safiri","year":"2021","journal-title":"J. Hematol. Oncol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.appet.2014.05.032","article-title":"Studying the Nutritional Beliefs and Food Practices of Malagasy School Children Parents. A contribution to the understanding of malnutrition in Madagascar","volume":"81","author":"Arvisenet","year":"2014","journal-title":"Appetite"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Rousseau, S., Steinke, J., Vincent, M., Andriatseheno, H., and Pontarollo, J. (2023). Strong Seasonality in Diets and Alarming Levels of Food Insecurity and Child Malnutrition in South-Eastern Madagascar. Front. Sustain. Food Syst., 7.","DOI":"10.3389\/fsufs.2023.1126053"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"3067","DOI":"10.1017\/S1368980018001775","article-title":"Food Insecurity and Anaemia Risk: A Systematic Review and Meta-Analysis","volume":"21","author":"Moradi","year":"2018","journal-title":"Public Health Nutr."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1186\/s13071-024-06611-z","article-title":"The impact of an integrated intervention program combining drug therapy with water, sanitation, and hygiene (WASH) education on reinfection with intestinal parasitic infections among the Karen hill tribe in northern Thailand","volume":"17","author":"Nachaiwieng","year":"2024","journal-title":"Parasites Vectors"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e42114","DOI":"10.1097\/MD.0000000000042114","article-title":"Trichuris trichiura Infection in Children: Two Case Reports and Literature Review","volume":"104","author":"Chen","year":"2025","journal-title":"Medicine"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Kebede, D., Getaneh, F., Endalamaw, K., Belay, T., and Fenta, A. (2021). Prevalence of Anemia and Its Associated Factors among Under-Five Age Children in Shanan Gibe Hospital, Southwest Ethiopia. BMC Pediatr., 21.","DOI":"10.1186\/s12887-021-03011-5"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e36835","DOI":"10.1097\/MD.0000000000036835","article-title":"Anemia among Malaria Patients with and without Soil-Transmitted Helminths in Arba Minch Town Health Facilities: A Comparative Cross-Sectional Study","volume":"103","author":"Genanew","year":"2024","journal-title":"Medicine"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"23125","DOI":"10.1155\/IDOG\/2006\/23125","article-title":"Intestinal parasitic infections among pregnant women in Venezuela","volume":"2006","author":"Barbella","year":"2006","journal-title":"Infect. Dis. Obstet. Gynecol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Mupfasoni, D., Karibushi, B., Koukounari, A., Ruberanziza, E., Kaberuka, T., Kramer, M.H., Mukabayire, O., Kabera, M., Nizeyimana, V., and Deville, M.A. (2009). Polyparasite Helminth Infections and Their Association to Anaemia and Undernutrition in Northern Rwanda. PLoS Negl. Trop. Dis., 3.","DOI":"10.1371\/journal.pntd.0000517"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"8929025","DOI":"10.1155\/2022\/8929025","article-title":"Stunting as a Risk Factor of Soil-Transmitted Helminthiasis in Children: A Literature Review","volume":"2022","author":"Fauziah","year":"2022","journal-title":"Interdiscip. Perspect. Infect. Dis."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s41182-022-00436-1","article-title":"Epidemiology of Soil-Transmitted Helminthiasis and Associated Malnutrition among under-Fives in Conflict Affected Areas in Southern Ethiopia","volume":"50","author":"Geleto","year":"2022","journal-title":"Trop. Med. Health"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"133","DOI":"10.2174\/22122710MTA3eOTIl5","article-title":"Human Ascariasis: An Updated Review","volume":"14","author":"Leung","year":"2020","journal-title":"Recent Pat. Inflamm. Allergy Drug Discov."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1007\/s10995-021-03201-8","article-title":"Factors Associated with Stunted Growth in Children Under Five Years in Antananarivo, Madagascar and Bangui, Central African Republic","volume":"25","author":"Vonaesch","year":"2021","journal-title":"Matern. Child Health J."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/8\/990\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:17:13Z","timestamp":1760033833000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/8\/990"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,28]]},"references-count":68,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["children12080990"],"URL":"https:\/\/doi.org\/10.3390\/children12080990","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,28]]}}}