{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:57:36Z","timestamp":1789757856554,"version":"4.0.1"},"reference-count":45,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Trop Med Hyg"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:p>Helminths aggravate anemia and malnutrition among school children. We studied this association in a cross-sectional study of 6- to 23-month-old Zanzibari children (<jats:italic>N<\/jats:italic> = 2322) and a sub-sample of 690 children matched on age and helminth infection status. <jats:italic>Ascaris<\/jats:italic>, hookworm, and <jats:italic>Trichuris<\/jats:italic> infections were diagnosed along with recent fever, malaria infection, mid-upper arm circumference (MUAC) and hemoglobin concentration (Hb). Alpha-1-acid glycoprotein (AGP), C-reactive protein (CRP), height, and weight were measured in the sub-sample. Infected children had higher Hb (\u03b2 = 5.44 g\/L, <jats:italic>P<\/jats:italic> &lt; 0.001) and MUAC-for-age Z score (\u03b2 = 0.30 Z, <jats:italic>P<\/jats:italic> &lt; 0.001) compared with uninfected children after adjusting for covariates. Although helminths were not associated with inflammation, their association with Hb or MUAC-for-age Z score was modified by inflammation. Malaria-infected children were less likely to be infected with helminths (adjusted odds ratios 0.63 [95% confidence interval: 0.49, 0.81]). Non-anemic, better nourished, or non-malaria-infected children may be more exploratory of their environments and therefore increase their exposure to soil-transmitted helminths.<\/jats:p>","DOI":"10.4269\/ajtmh.2009.09-0091","type":"journal-article","created":{"date-parts":[[2009,12,8]],"date-time":"2009-12-08T22:29:10Z","timestamp":1260311350000},"page":"1062-1070","source":"Crossref","is-referenced-by-count":22,"title":["Early Helminth Infections Are Inversely Related to Anemia, Malnutrition, and Malaria and Are Not Associated with Inflammation in 6- to 23-Month-Old Zanzibari Children"],"prefix":"10.4269","volume":"81","author":[{"given":"Jacqueline K.","family":"Kung\u2019u","sequence":"first","affiliation":[{"name":"Cornell University, Division of Nutritional Sciences, Ithaca, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Public Health Laboratory-Ivo de Carneri, Zanzibar, Tanzania; London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Goodman","sequence":"additional","affiliation":[{"name":"Cornell University, Division of Nutritional Sciences, Ithaca, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Public Health Laboratory-Ivo de Carneri, Zanzibar, Tanzania; London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamad J.","family":"Haji","sequence":"additional","affiliation":[{"name":"Cornell University, Division of Nutritional Sciences, Ithaca, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Public Health Laboratory-Ivo de Carneri, Zanzibar, Tanzania; London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdi","family":"Ramsan","sequence":"additional","affiliation":[{"name":"Cornell University, Division of Nutritional Sciences, Ithaca, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Public Health Laboratory-Ivo de Carneri, Zanzibar, Tanzania; London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria J.","family":"Wright","sequence":"additional","affiliation":[{"name":"Cornell University, Division of Nutritional Sciences, Ithaca, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Public Health Laboratory-Ivo de Carneri, Zanzibar, Tanzania; London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin D.","family":"Bickle","sequence":"additional","affiliation":[{"name":"Cornell University, Division of Nutritional Sciences, Ithaca, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Public Health Laboratory-Ivo de Carneri, Zanzibar, Tanzania; London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Tielsch","sequence":"additional","affiliation":[{"name":"Cornell University, Division of Nutritional Sciences, Ithaca, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Public Health Laboratory-Ivo de Carneri, Zanzibar, Tanzania; London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G.","family":"Raynes","sequence":"additional","affiliation":[{"name":"Cornell University, Division of Nutritional Sciences, Ithaca, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Public Health Laboratory-Ivo de Carneri, Zanzibar, Tanzania; London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J.","family":"Stoltzfus","sequence":"additional","affiliation":[{"name":"Cornell University, Division of Nutritional Sciences, Ithaca, New York; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Public Health Laboratory-Ivo de Carneri, Zanzibar, Tanzania; London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Annu Rev Nutr","first-page":"35","volume":"22","year":"2002"},{"key":"R2","year":"2005a"},{"key":"R3","year":"2002a"},{"key":"R4","year":"2007"},{"key":"R5","series-title":"J Nutr","first-page":"348","volume":"134","year":"2004"},{"key":"R6","year":"2002b"},{"key":"R7","series-title":"BMJ","first-page":"1389","volume":"323","year":"2001"},{"key":"R8","series-title":"BMJ","first-page":"1697","volume":"320","year":"2000"},{"key":"R9","series-title":"Protein Pept 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