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DOI: 10.1055/s-0029-1244985
© Georg Thieme Verlag Stuttgart · New York
Körperliche und mentale Kindesentwicklung in tropischen Ländern – Infektionskrankheiten und andere Risiken
Physical and mental development of children in the tropics – Infectious diseases and other risksPublication History
Publication Date:
18 December 2009 (online)
![](https://www.thieme-connect.de/media/flugundreise/200904/lookinside/thumbnails/10.1055-s-0029-1244985-1.jpg)
Neben den infektiösen haben auch alimentäre und psychosoziale Faktoren Einfluss auf die frühkindliche Gesundheit und mentale Entwicklung im tropischen Afrika. Infektionen mit intestinalen Helminthen und Protozoen, mit Bakterien wie Helicobacter pylori, mit HIV und Tuberkulose sowie Malaria gehören zu den größten Gefahren für eine normale Kindesentwicklung. Auch ein mangelhafter Ernährungszustand, assoziiert mit verzögertem Wachstum, Iod– und Eisenmangel, beeinflusst die physische und geistige Entwicklung negativ. Daneben können sich auch die schwierigen sozialen und ökonomischen Lebensumstände in Entwicklungsländern und die hohe psychische Belastung der Eltern negativ auf die Kindesentwicklung auswirken. All dies hat letztlich auch nicht absehbare Folgen auf den wirtschaftlichen, sozialen und kulturellen Fortschritt in diesen Ländern. Longitudinale Studien mit multivariaten statistischen Auswertungen sind notwendig, um die komplexen Determinanten der kognitiven, emotionalen und sozialen Entwicklung von Kindern genauer zu erforschen.
In tropical Africa, health and mental development of infants are affected not only by infections but also by nutritional and psychosocial factors already at a very early age. Among the greatest perils are infections with intestinal helminths and protozoa, with bacteria such as Helicobacter pylori, with HIV, tuberculosis and malaria, greatly endangering child development in the tropics. Their physical and mental development is also hampered by undernourishment associated with retarded growth; additional negative factors are insufficient iodine and iron levels. There are also other influences on child development, such as the social and economic conditions in developing countries and parental stress. These factors also exercise unforeseeable influences on economic, social and cultural changes in these countries. Longitudinal studies with multivariate statistical analyses are imperative to explore the complex determinants governing the cognitive, emotional and social factors of child development.
Key words
child development - physical - mental - infectious diseases - nutritional status - psychosocial risk factors - developing countries
Literatur
- 1 Carter JA, Neville BG, Newton CR.. Neuro–cognitive impairment following acquired central nervous system infections in childhood: a systematic review. Brain Res Brain Res Rev. 2003; 43 57-69
- 2 Walker SP, Wachs TD, Gardner JM. et al. . International Child Development Steering Group. Child development: risk factors for adverse outcomes in developing countries. Lancet. 2007; 369 145-157
- 3 Patel V, DeSouza N, Rodrigues M.. Postnatal depression and infant growth and development in low income countries: a cohort study from Goa, India. Arch Dis Child. 2003; 88 34-37
- 4 Patel V, Fisher AJ, Hetrick S, McGory P.. Mental health of young people: a global public–health challenge. Lancet. 2007; 369 1302-1313
- 5 Grantham–McGregor S, Cheung YB, Cueto S. et al. . Developmental potential in the first 5 years for children in developing countries. Lancet. 2007; 369 60-70
- 6 World Health Organization. .International Classification of Functioning, Disability and Health Checklist. Geneva: WHO 2001
- 7 Prince M, Patel V, Saxena S. et al. . Global mental health 1 – no health without mental health. Lancet. 2007; 370 859-877
- 8 Watkins WE, Pollitt E.. «Stupidity or worms»: do intestinal worms impair mental performance?. Psychol Bull. 1997; 121 171-191
- 9 Oberhelman RA, Guerrero ES, Fernandez ML. et al. . Correlations between intestinal parasitosis, physical growth, and psychomotor development among infants and children from rural Nicaragua. Am J Trop Med Hyg. 1998; 58 470-475
- 10 Roche M, Layrisse M.. The nature and causes of «hookworm anemia». Am J Trop Med Hyg. 1966; 15 1029-1102
- 11 Stephenson LS, Latham MC, Adams EJ. et al. . Physical fitness, growth and appetite of Kenyan school boys with hookworm, Trichuris trichiura and Ascaris lumbricoides infections are improved four months after a single dose of albendazole. J Nutr. 1993; 123 1036-1046
- 12 Hotez PJ, Cerami A.. Secretion of a proteolytic anticoagulant by Ancylostoma hookworms. J Exp Med. 1983; 157 1594-1603
- 13 Martin J, Nesheim MC, Crompton DW, Carrera E.. Mucosal surface lesions in young proteindeficient pigs infected with Ascaris suum (Nematoda). Parasitology. 1984; 88 333-340
- 14 Carrera E, Nesheim MC, Crompton DW.. Lactose maldigestion in Ascaris–infected preschool children. Am J Clin Nutr. 1984; 39 255-264
- 15 Prado MS, Strina A, Barreto ML. et al. . Risk factors for infection with Giardia duodenalis in pre–school children in the city of Salvador, Brazil. Epidemiol Infect. 2003; 131 899-906
- 16 Berkman DS, Lescano AG, Gilman RH. et al. . Effects of stunting, diarrhoeal disease, and parasitic infection during infancy on cognition in late childhood: a follow–up study. Lancet. 2002; 359 564-571
- 17 Müller N, von Allmen N.. Recent insights into the mucosal reactions associated with Giardia lamblia infections. Int J Parasitol. 2005; 35 1339-1347
- 18 Checkley W, Gilman RH, Epstein LD. et al. . Asymptomatic and symptomatic cryptosporidiosis: their acute effect on weight gain in Peruvian children. Am J Epidemiol. 1997; 145 156-163
- 19 Niehaus MD, Moore SR, Patrick PD. et al. . Early childhood diarrhea is associated with diminished cognitive function 4 to 7 years later in children in a northeast Brazilian shantytown. Am J Trop Med Hyg. 2002; 66 590-593
- 20 Hiatt RA, Markell EK, Ng E.. How many stool examinations are necessary to detect pathogenic intestinal protozoa?. Am J Trop Med Hyg. 1995; 53 36-39
- 21 Morgan UM, Sargent KD, Elliot A, Thompson RC.. Cryptosporidium in cats––additional evidence for C. felis. Vet J. 1998; 156 159-161
- 22 Verweij JJ, Blangé RA, Templeton K. et al. . Simultaneous detection of Entamoeba histolytica, Giardia lamblia, and Cryptosporidium parvum in fecal samples by using multiplex real–time PCR. J Clin Microbiol. 2004; 42 1220-1223
- 23 Rowland M.. Transmission of Helicobacter pylori: is it all child's play?. Lancet. 2000; 355 332-333
- 24 Thomas JE, Dale A, Bunn JE. et al. . Early Helicobacter pylori colonisation: the association with growth faltering in The Gambia. Arch Dis Child. 2004; 89 1149-1154
- 25 Lee A.. Early influences and childhood development. Does helicobacter play a role?. Helicobacter. 2007; 12 69-74
- 26 Carter JA, Mung'ala–Odera V, Neville BG. et al. . Persistent neurocognitive impairments associated with severe falciparum malaria in Kenyan children. J Neurol Neurosur Ps. 2005; 76 476-481
- 27 Carter JA, Lees JA, Gona JK. et al. . Severe falciparum malaria and acquired childhood language disorder. Dev Med Child Neurol. 2006; 48 51-57
- 28 UNICEF. .The State of the World's Children 2005: childhood under threat. New York: UNICEF 2004
- 29 UNAIDS/WHO. HIV and AIDS estimates and data, 2007 and 2001. . 2008 Report on the global AIDS epidemic. Im Internet: www.data.unaids. org/pub/GlobalReport/ 2008/jc1510_2008_global_report_pp211_234_en.pdf; Stand. 09; 11 2009
- 30 Brown LK, Lourie KJ, Pao M.. Children and adolescents living with HIV and AIDS: a review. J Child Psychol Psych. 2000; 41 81-96
- 31 World Health Organization. . World malaria report 2008. Geneva: WHO; 2008. Im Internet: www.who.int/malaria/wmr2008/; Stand. 09; 11 2009
- 32 Marsh K, Forster D, Waruiru C. et al. . Indicators of life–threatening malaria in African children. N Engl J Med. 1995; 332 1399-1404
- 33 Fernando SD, Gunawardena DM, Bandara MR. et al. . The impact of repeated malaria attacks on the school performance of children. Am J Trop Med Hyg. 2003; 69 582-588
- 34 Jain L.. School outcome in late preterm infants: a cause for concern. J Pediatr. 2008; 153 5-6
- 35 Grantham–McGregor SM, Lira PI, Ashworth A. et al. . The development of low birth weight term infants and the effects of the environment in northeast Brazil. J Pediatr. 1998; 132 661-666
- 36 Gorman KS, Pollitt E.. Relationship between weight and body proportionality at birth, growth during the fi rst year of life, and cognitive development at 36, 48, and 60 months. Infant Behav Dev. 1992; 15 279-296
- 37 Villar J, Smeriglio V, Martorell R. et al. . Heterogeneous growth and mental development of intrauterine growth–retarded infants during the first 3 years of life. Pediatrics. 1984; 74 783-791
- 38 Gardner JM, Walker SP, Powell CA. et al. . A randomized controlled trial of a home–visiting intervention on cognition and behavior in term low birth weight infants. J Pediatr. 2003; 143 634-639
- 39 Walker SP, Chang SM, Powell CA, Grantham–McGregor SM.. Psychosocial intervention improves the development of term low birth–weight infants. J Nutr. 2004; 134 1417-1423
- 40 Ehrhardt S, Burchard GD, Mantel C. et al. . Malaria, anemia, and malnutrition in african children–defining intervention priorities. J Infect Dis. 2006; 194 108-114
- 41 Pharoah PO, Connolly KJ.. Iodine and brain development. Dev Med Child Neurol. 1995; 37 744-748
- 42 World Health Organization. .Global Database on Iodine Deficiency. Iodine status worldwide. Geneva: WHO 2004
- 43 Black MM.. Micronutrient deficiencies and cognitive functioning. J Nutr. 2003; 133
- 44 Grantham–McGregor SM, Fernald L, Sethuraman K.. Effects of health and nutrition on cognitive and behavioral development in the first 3 years of life. Part 2. Infections and micronutrient defi ciencies: iodine, iron and zinc. Food Nutr Bull. 1999; 20 76-99
- 45 Stoltzfus RJ, Mullany L, Black RE.. Iron deficiency anaemia. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors. Vol 1. Geneva: World Health Organization 2005: 163-209
- 46 Lozoff B, Beard J, Connor J. et al. . Longlasting neural and behavioral eff ects of iron deficiency in infancy. Nutr Rev. 2006; 64
- 47 Grantham–McGregor SM, Ani C.. A review of studies on the eff ect of iron deficiency on cognitive development in children. J Nutr. 2001; 131
- 48 Zimmermann MB, Molinari L, Staubli–Asobayire F. et al. . Serum transferrin receptor and zinc protoporphyrin as indicators of iron status in African children. Am J Clin Nutr. 2005; 81 615-623
- 49 Engle PL, Black MM, Behrman JR. et al. . Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. Lancet. 2007; 369 229-242
- 50 Rutter M.. Environmentally mediated risks for pschopathology: research strategies and findings. J Am Acad Child Adolesc Psychiatry. 2005; 44 3-18
- 51 Jaffee SR, Caspi A., Moffitt TE. et al. . Individual, family, and neighborhood factors distinguish resilient from non–resilient maltreated children: A cumulative stressors model. Child Abuse Negl. 2007; 31 231-253
- 52 Ustün TB, Ayuso–Mateos JL, Chatterji S.. Global burden of depressive disorders in the year 2000. Br J Psychiatry. 2004; 184 386-392
- 53 Oates M, Cox JL.. Postnatal depression across countries and cultures. Br J Psychiatry. 2004; 184 10-16
- 54 Gorman LL, O'Hara MW, Figueiredo B.. Adaptation of the Structured Clinical Interview for DSM–IV Disorders for assessing depression in women during pregnancy and post–partum across countries and cultures. Br J Psychiatry. 2004; 184 17-23
- 55 Affonso DD, Horowitz JA, Mayberry IJ.. An international study exploring levels of postpartum depressive symptomatology. J Psychosom Res. 2000; 49 207-216
- 56 Lawrie TA, Hofmeyer GJ, de Jager M.. Validation of the Edinburgh Postnatal Depression Scale on a cohort of South African women. S Afr Med J. 1998; 88 1340-1344
- 57 Adewuya AO.. Postnatal depression in primary care populations in Nigeria. Gen Hosp Psychiatry. 2006; 28 133-136
- 58 Murray L, Sinclair D, Cooper P. et al. . The socioemotional development of 5–year–old children of postnatally depressed mothers. J Child Psychol Psychiatry. 1999; 40 1259-1271
- 59 Halligan SL, Herbert J, Goodyer IM, Murray L.. Exposure to postnatal depression predicts elevated cortisol in adolescent offspring. Biol Psychiatry. 2004; 55 376-381
- 60 Walker SP, Chang SM, Powell CA. et al. . Effects of psychosocial stimulation and dietary supplementation in early childhood on psychosocial functioning in late adolescence: follow–up of a randomised controlled trial. BMJ. 2006; 333 472-477
- 61 Uwakwe R.. Affective (depressive) morbidity in puerperal Nigerian women: validation of the Edinburgh Postnatal Depression Scale. Acta Psychiatr Scand. 2003; 107 251-259
- 62 Abidin R.. Parenting Stress Index. Short Form. Odessa (Florida): Psychological Assessment Resources 1995
- 63 Loyd BH, Abidin RR.. Revision of the Parenting Stress Index. J Pediatr Psychol. 1985; 10 169-177
- 64 Candelaria MA, O'Connell MA, Teti DM.. Cumulative psychosocial and medical risk as predictors of early infant development and parenting stress in an African–American preterm sample. Journal of Applied Developmental Psychology. 2006; 27 588-597
- 65 Faught J, Bierl C, Barton B, Kemp A.. Stress in mothers of young children with eczema. Arch Dis Child. 2007; 92 683-686
- 66 Slykerman RF, Thompson JM, Pryor JE. et al. . Maternal stress, social support and preschool children's intelligence. Early Hum Dev. 2005; 81 815-821
- 67 Yeh CH, Chen ML, Li W, Chuang HL.. The Chinese version of the Parenting Stress Index: a psychometric study. Acta Paediatrica. 2001; 90 1470-1477
- 68 Fayer R, Morgan U, Upton SJ.. Epidemiology of Cryptosporidium: transmission, detection and identification. Int J Parasitol. 2000; 30 1305-1322
- 69 Guerrant DI, Moore SR, Lima AA. et al. . Association of early childhood diarrhea and cryptosporidiosis with impaired physical fitness and cognitive function four–seven years later in a poor urban community in northeast Brazil. Am J Trop Med Hyg. 1999; 61 707-713
- 70 Lima AA, Guerrant RL.. Strategies to reduce the devastating costs of early childhood diarrhea and its potential long–term impact: imperatives that we can no longer afford to ignore. Clin Infect Dis. 2004; 38 1552-1554
- 71 Mara DD.. Water, sanitation and hygiene for the health of developing nations. Public Health. 2003; 117 452-456
- 72 Snow RW, Guerra CA, Noor AM. et al. . The global distribution of clinical episodes of Plasmodium falciparum malaria. Nature. 2005; 434 214-217
Korrespondenz
Dr. Stephan Ehrhardt
Bernhard Nocht Institut für Tropenmedizin Klinische Forschung
Bernhard Nocht Str. 74
20359 Hamburg
Email: ehrhardt@bni-hamburg.de