{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T13:00:45Z","timestamp":1770555645487,"version":"3.49.0"},"reference-count":64,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2018,4,5]],"date-time":"2018-04-05T00:00:00Z","timestamp":1522886400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The associations between enteric pathogenic parasites and growth in infants in S\u00e3o Tom\u00e9 were explored using a refined anthropometric approach to recognize early growth faltering. A birth cohort study was conducted with follow-up to 24 months of age. Microscopic examination for protozoa and soil-transmitted helminths was performed. Anthropometric assessments included: z-scores for weight-for-length (WLZ), length-for-age (LAZ), weight (WAVZ) and length velocities (LAVZ), length-for-age difference (LAD), and wasting and stunting risk (\u2264\u22121 SD). Generalized additive mixed effects regression models were used to explore the associations between anthropometric parameters and enteric parasitic infections and cofactors. A total of 475 infants were enrolled, and 282 completed the study. The great majority of infants were asymptomatic. Giardia lamblia was detected in 35.1% of infants in at least one stool sample, helminths in 30.4%, and Cryptosporidium spp. in 14.7%. Giardia lamblia and helminth infections were significantly associated with mean decreases of 0.10 in LAZ and 0.32 in LAD, and of 0.16 in LAZ and 0.48 in LAD, respectively. Cryptosporidium spp. infection was significantly associated with a mean decrease of 0.43 in WAVZ and 0.55 in LAVZ. The underestimated association between subclinical parasitic enteric infections and mild growth faltering in infants should be addressed in public health policies.<\/jats:p>","DOI":"10.3390\/ijerph15040688","type":"journal-article","created":{"date-parts":[[2018,4,5]],"date-time":"2018-04-05T16:50:58Z","timestamp":1522947058000},"page":"688","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Subclinical Enteric Parasitic Infections and Growth Faltering in Infants in S\u00e3o Tom\u00e9, Africa: A Birth Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Marisol","family":"Garz\u00f3n","sequence":"first","affiliation":[{"name":"Tropical Clinic Teaching and Research Unit, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa; 1349-008 Lisbon, Portugal"},{"name":"Global Health and Tropical Medicine R&amp;D Center, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa; 1349-008 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7069-6451","authenticated-orcid":false,"given":"Lu\u00eds","family":"Pereira-da-Silva","sequence":"additional","affiliation":[{"name":"Medicine of Woman, Childhood and Adolescence Teaching and Research Area, NOVA Medical School, Universidade NOVA de Lisboa; 1169-056 Lisbon, Portugal"},{"name":"Research Unit, Centro Hospitalar de Lisboa Central; 1169-045 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Seixas","sequence":"additional","affiliation":[{"name":"Tropical Clinic Teaching and Research Unit, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa; 1349-008 Lisbon, Portugal"},{"name":"Global Health and Tropical Medicine R&amp;D Center, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa; 1349-008 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2918-8364","authenticated-orcid":false,"given":"Ana","family":"Papoila","sequence":"additional","affiliation":[{"name":"Research Unit, Centro Hospitalar de Lisboa Central; 1169-045 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7421-8550","authenticated-orcid":false,"given":"Marta","family":"Alves","sequence":"additional","affiliation":[{"name":"Research Unit, Centro Hospitalar de Lisboa Central; 1169-045 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,4,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.pt.2006.02.015","article-title":"Giardia and Cryptosporidium join the Neglected Diseases Initiative","volume":"22","author":"Savioli","year":"2006","journal-title":"Trends Parasitol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e564","DOI":"10.1016\/S2214-109X(15)00151-5","article-title":"Pathogen-specific burdens of community diarrhea in developing countries: A multisite birth cohort study (MAL-ED)","volume":"3","author":"Babji","year":"2015","journal-title":"Lancet Glob. Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1093\/cid\/ciw391","article-title":"A Prospective longitudinal cohort to investigate the effects of early life giardiasis on growth and all cause diarrhea","volume":"63","author":"Donowitz","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1093\/jpids\/piw082","article-title":"Determinants and impact of Giardia infection in the first 2 years of life in the MAL-ED Birth Cohort","volume":"6","author":"Rogawski","year":"2017","journal-title":"J. Pediatr. Infect. Dis. Soc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1093\/oxfordjournals.aje.a009086","article-title":"Asymptomatic and symptomatic cryptosporidiosis: Their acute effect on weight gain in Peruvian children","volume":"145","author":"Checkley","year":"1997","journal-title":"Am. J. Epidemiol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Korpe, P.S., Haque, R., Gilchrist, C., Valencia, C., Niu, F., Lu, M., Ma, J.Z., Petri, S.E., Reichman, D., and Kabir, M. (2016). Natural history of Cryptosporidiosis in a longitudinal study of slum-dwelling Bangladeshi children: association with severe malnutrition. PLoS Negl. Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004564"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.trstmh.2010.12.003","article-title":"Stunting and helminth infection in early preschool-age children in a resource-poor community in the Amazon lowlands of Peru","volume":"105","author":"Gyorkos","year":"2011","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"LaBeaud, A.D., Nayakwadi Singer, M., McKibben, M., Mungai, P., Muchiri, E.M., McKibben, E., Gildengorin, G., Sutherland, L.J., King, C.H., and King, C.L. (2015). Parasitism in children aged three years and under: Relationship between infection and growth in rural coastal Kenya. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003721"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/j.pcl.2017.03.003","article-title":"The Burden of enteropathy and subclinical infections","volume":"64","author":"Rogawski","year":"2017","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s40794-016-0028-7","article-title":"Diarrheal disease and enteric infections in LMIC communities: How big is the problem?","volume":"2","author":"McCormick","year":"2016","journal-title":"Trop. Dis. Travel Med. Vaccines"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.ehb.2010.05.002","article-title":"Effects and determinants of mild underweight among preschool children across countries and over time","volume":"9","author":"Bhagowalia","year":"2011","journal-title":"Econ. Hum. Biol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"World Health Organization (2006). Multicentre Growth Reference Study Group WHO Child Growth Standards Based on Length\/Height, Weight and Age. Acta Paediatr. Suppl., 450, 76\u201385.","DOI":"10.1111\/j.1651-2227.2006.tb02378.x"},{"key":"ref_13","unstructured":"World Health Organization (2018, April 04). Growth Velocity Based on Weight, Length and Head Circumference. Available online: http:\/\/www.who.int\/childgrowth\/standards\/velocity\/technical_report\/en\/."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.jpeds.2016.11.013","article-title":"Predicting undernutrition at age 2 years with early attained weight and length compared with weight and length velocity","volume":"182","author":"Schwinger","year":"2017","journal-title":"J. Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Leroy, J.L., Ruel, M., Habicht, J.P., and Frongillo, E.A. (2015). Using height-for-age difference (HAD) instead of height-for-age z-scores (HAZ) for the meaningful measurement of population-level catch-up in linear growth in children less than 5 years of age. BMC Pediatr., 15.","DOI":"10.1186\/s12887-015-0458-9"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1093\/jn\/133.1.107","article-title":"Changes in child survival are strongly associated with changes in malnutrition in developing countries","volume":"133","author":"Pelletier","year":"2003","journal-title":"J. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1080\/20477724.2017.1299831","article-title":"Association of enteric parasitic infections with intestinal inflammation and permeability in asymptomatic infants of S\u00e3o Tom\u00e9 Island","volume":"111","author":"Seixas","year":"2017","journal-title":"Pathog. Glob. Health"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Alkire, S., and Santos, M.E. (2010). Acute Multidimensional Poverty: A New Index for Developing Countries, OPHI Oxford Poverty & Human Development Initiative, University of Oxford. Working Papers 38.","DOI":"10.2139\/ssrn.1815243"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1478-7954-12-8","article-title":"Measuring socioeconomic status in multicountry studies: Results from the eight-country MAL-ED study","volume":"12","author":"Psaki","year":"2014","journal-title":"Popul. Health Metr."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Abuya, B.A., Ciera, J., and Kimani-Murage, E. (2012). Effect of mother\u2019s education on child\u2019s nutritional status in the slums of Nairobi. BMC Pediatr., 12.","DOI":"10.1186\/1471-2431-12-80"},{"key":"ref_21","unstructured":"World Health Organization (2018, April 04). Infant and Young Child Feeding. Available online: http:\/\/apps.who.int\/iris\/bitstream\/10665\/42590\/1\/9241562218.pdf."},{"key":"ref_22","unstructured":"World Health Organization (2018, April 04). The Treatment of Diarrhea. Available online: http:\/\/apps.who.int\/iris\/bitstream\/10665\/43209\/1\/9241593180.pdf."},{"key":"ref_23","unstructured":"World Health Organization (2018, April 04). Revised WHO Classification and Treatment of Childhood Pneumonia at Health Facilities. Available online: http:\/\/www.who.int\/maternal_child_adolescent\/documents\/child-pneumonia-treatment\/en\/."},{"key":"ref_24","unstructured":"World Health Organization (2018, April 04). Bench Aids for the Diagnosis of Intestinal Parasites. Available online: http:\/\/www.who.int\/neglected_diseases\/resources\/9789241544764\/en\/."},{"key":"ref_25","unstructured":"World Health Organization (2018, April 04). Preventive Chemotherapy in Human Helminthiasis: Coordinated Use of Anthelminthic Drugs in Control Interventions: A Manual for Health Professionals and Programme Managers. Available online: http:\/\/apps.who.int\/iris\/bitstream\/10665\/43545\/1\/9241547103_eng.pdf."},{"key":"ref_26","unstructured":"Kimberlin, D.W., Brady, M.T., Jackson, M.A., and Long, S.S. (2015). Giardia intestinalis (formerly Giardia lamblia and Giardia duodenalis) infections. Red Book: Northwest Point Blvd, American Academy of Pediatrics."},{"key":"ref_27","unstructured":"(2018, April 04). IV Recenseamento Geral da Popula\u00e7\u00e3o e Habita\u00e7\u00e3o\u20142012. ed. Instituto Nacional de Estat\u00edstica, Rep\u00fablica Democr\u00e1tica de S\u00e3o Tom\u00e9 e Pr\u00edncipe. Available online: http:\/\/passthrough.fw-notify.net\/download\/454192\/http:\/\/www.ine.st\/Documentacao\/Recenseamentos\/2012\/TemasRGPH2012\/2_ESTRUTURA%20DA%20POPULACAO%20Recenseamento%202012.pdf."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Lobo, M.L., Augusto, J., Antunes, F., Ceita, J., Xiao, L., Codices, V., and Matos, O. (2014). Cryptosporidium spp., Giardia duodenalis, Enterocytozoon bieneusi and other intestinal parasites in young children in Lobata province, Democratic Republic of S\u00e3o Tom\u00e9 and Principe. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0097708"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1093\/tropej\/fmu078","article-title":"Giardia duodenalis and soil-transmitted helminths infections in children in S\u00e3o Tom\u00e9 and Pr\u00edncipe: Do we think Giardia when addressing parasite control?","volume":"61","author":"Ferreira","year":"2015","journal-title":"J. Trop. Pediatr."},{"key":"ref_30","first-page":"227","article-title":"Prevalence, behavioural and social factors associated with Schistosoma intercalatum and geohelminth infections in S\u00e3o Tom\u00e9 and Principe","volume":"47","author":"Belo","year":"2005","journal-title":"Parassitologia"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"690","DOI":"10.4314\/ahs.v16i3.8","article-title":"Prevalence of intestinal parasitic infections among school children in capital areas of the Democratic Republic of S\u00e3o Tom\u00e9 and Pr\u00edncipe, West Africa","volume":"16","author":"Liao","year":"2016","journal-title":"Afr. Health Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"912","DOI":"10.4269\/ajtmh.15-0555","article-title":"Population density, poor sanitation, and enteric infections in Nueva Santa Rosa, Guatemala","volume":"94","author":"Jarquin","year":"2016","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1093\/cid\/ciw730","article-title":"Natural history of Cryptosporidiosis in a birth cohort in Southern India","volume":"64","author":"Kattula","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/S0140-6736(13)60844-2","article-title":"Burden and etiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): A prospective, case-control study","volume":"382","author":"Kotloff","year":"2013","journal-title":"Lancet"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"S303","DOI":"10.1093\/cid\/cis789","article-title":"Factors that explain excretion of enteric pathogens by persons without diarrhea","volume":"55","author":"Levine","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1038\/mi.2012.80","article-title":"Regulation of intestinal epithelial cell cytoskeletal remodeling by cellular immunity following gut infection","volume":"6","author":"Singer","year":"2013","journal-title":"Mucosal. Immunol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1128\/CMR.05040-11","article-title":"Helminth Infections and Host Immune Regulation","volume":"25","author":"McSorley","year":"2012","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"847","DOI":"10.12980\/APJTB.4.201414B355","article-title":"Breastfeeding and risk of parasitic infection\u2014A review","volume":"4","author":"Kutty","year":"2014","journal-title":"Asian Pac. J. Trop. Dis."},{"key":"ref_39","unstructured":"(2018, April 04). S\u00e3o Tom\u00e9 and Principe, Multiple Indicator Cluster Survey 2014. Available online: https:\/\/mics-surveys-prod.s3.amazonaws.com\/MICS5\/West%20and%20Central%20Africa\/Sao%20Tome%20and%20Principe\/2014\/Final\/Sao%20Tome%20and%20Principe%202014%20MICS_English.pdf."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1016\/S0140-6736(12)60647-3","article-title":"Trends in mild, moderate, and severe stunting and underweight, and progress towards MDG 1 in 141 developing countries: A systematic analysis of population representative data","volume":"380","author":"Stevens","year":"2012","journal-title":"Lancet"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/mcn.12231","article-title":"Childhood stunting: A global perspective","volume":"12","author":"Branca","year":"2016","journal-title":"Matern. Child Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1093\/ajcn\/43.3.395","article-title":"Natural history of Giardia infection of infants and children in rural Guatemala and its impact on physical growth","volume":"43","author":"Farthing","year":"1986","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1093\/ije\/30.6.1457","article-title":"Early childhood diarrhea and helminthiases associate with long-term linear growth faltering","volume":"30","author":"Moore","year":"2001","journal-title":"Int. J. Epidemiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1093\/oxfordjournals.aje.a009675","article-title":"Effects of Cryptosporidium parvum infection in Peruvian children: Growth faltering and subsequent catch-up growth","volume":"148","author":"Checkley","year":"1998","journal-title":"Am. J. Epidemiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1128\/JCM.02509-09","article-title":"Multisite study of cryptosporidiosis in children with diarrhea in India","volume":"48","author":"Ajjampur","year":"2010","journal-title":"J. Clin. Microbiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.3945\/jn.111.154922","article-title":"Wasting is associated with stunting in early childhood","volume":"142","author":"Richard","year":"2012","journal-title":"J. Nutr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1093\/cid\/cis1044","article-title":"Breast milk parasite-specific antibodies and protection from amebiasis and cryptosporidiosis in Bangladeshi infants: A prospective cohort study","volume":"56","author":"Korpe","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1097\/QCO.0000000000000293","article-title":"Giardia: A pathogen or commensal for children in high-prevalence settings","volume":"29","author":"Bartelt","year":"2016","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1645\/GE-2848.1","article-title":"Cryptosporidium-malnutrition interactions: Mucosal disruption, cytokines, and TLR signaling in a weaned murine model","volume":"97","author":"Costa","year":"2011","journal-title":"J. Parasitol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2672","DOI":"10.1172\/JCI67294","article-title":"Persistent G. lamblia impairs growth in a murine malnutrition model","volume":"123","author":"Barlet","year":"2013","journal-title":"J. Clin. Investig."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1093\/ajcn\/25.11.1276","article-title":"Malabsorption syndrome in ascariasis","volume":"25","author":"Tripathy","year":"1972","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1079\/BJN2002599","article-title":"Poor intestinal permeability in mildly stunted Nepali children: Associations with weaning practices and Giardia lamblia infection","volume":"88","author":"Goto","year":"2002","journal-title":"Br. J. Nutr."},{"key":"ref_53","first-page":"16","article-title":"Lactulose-mannitol intestinal permeability test in children with diarrhea caused by rotavirus and cryptosporidium. Diarrhea Working Group, Peru","volume":"31","author":"Zhang","year":"2000","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1016\/0035-9203(87)90040-X","article-title":"Plasma albumin concentrations and intestinal permeability in Bangladeshi children infected with Ascaris lumbricoides","volume":"81","author":"Northrop","year":"1987","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Bartelt, L.A., Lima, A.A., Kosek, M., Pe\u00f1ataro Yori, P., Lee, G., and Guerrant, R.L. (2013). Barriers to child development and human potential: The case for including the neglected enteric protozoa (NEP) and other enteropathy-associated pathogens in the NTDs. PLoS Negl. Trop. Dis., 7.","DOI":"10.1371\/journal.pntd.0002125"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1111\/j.1753-4887.2008.00082.x","article-title":"Malnutrition as an enteric infectious disease with long-term effects on child development","volume":"66","author":"Guerrant","year":"2008","journal-title":"Nutr. Rev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S0140-6736(15)01024-7","article-title":"Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect","volume":"387","author":"Victora","year":"2016","journal-title":"Lancet"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.jpeds.2013.02.002","article-title":"Maternal height and child growth patterns","volume":"163","author":"Addo","year":"2013","journal-title":"J. Pediatr."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1016\/j.childyouth.2010.03.015","article-title":"Assets and child well-being in developing countries: A research review","volume":"32","author":"Chowa","year":"2010","journal-title":"Child. Youth Ser. Rev."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1093\/aje\/kwt094","article-title":"Diarrhea in early childhood: Short-term association with weight and long-term association with length","volume":"178","author":"Richard","year":"2013","journal-title":"Am. J. Epidemiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1023\/B:EJEP.0000036568.02655.f8","article-title":"Loss to follow-up in cohort studies: How much is too much?","volume":"19","author":"Kristman","year":"2004","journal-title":"Eur. J. Epidemiol."},{"key":"ref_62","first-page":"46","article-title":"Systematic review of birth cohort studies in Africa","volume":"1","author":"Campbell","year":"2011","journal-title":"J. Glob. Health"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2408","DOI":"10.1128\/JCM.37.8.2408-2411.1999","article-title":"Utility of multiple-stool-specimen ova and parasite examinations in a high-prevalence setting","volume":"37","author":"Cartwright","year":"1999","journal-title":"J. Clin. Microbiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1086\/500937","article-title":"A rational approach to the stool ova and parasite examination","volume":"42","author":"Branda","year":"2006","journal-title":"Clin. Infect. Dis."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/4\/688\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T14:59:44Z","timestamp":1760194784000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/4\/688"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,5]]},"references-count":64,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,4]]}},"alternative-id":["ijerph15040688"],"URL":"https:\/\/doi.org\/10.3390\/ijerph15040688","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,5]]}}}