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- Title
Measuring Fitness of Kenyan Children with Polyparasitic Infections Using the 20-Meter Shuttle Run Test as a Morbidity Metric.
- Authors
Bustinduy, Amaya L.; Thomas, Charles L.; Fiutem, Justin J.; Parraga, Isabel M.; Mungai, Peter L.; Muchiri, Eric M.; Mutuku, Francis; Kitron, Uriel; King, Charles H.
- Abstract
Background: To date, there has been no standardized approach to the assessment of aerobic fitness among children who harbor parasites. In quantifying the disability associated with individual or multiple chronic infections, accurate measures of physical fitness are important metrics. This is because exercise intolerance, as seen with anemia and many other chronic disorders, reflects the body's inability to maintain adequate oxygen supply (VO2 max) to the motor tissues, which is frequently linked to reduced quality-of-life in terms of physical and job performance. The objective of our study was to examine the associations between polyparasitism, anemia, and reduced fitness in a high risk Kenyan population using novel implementation of the 20-meter shuttle run test (20mSRT), a well-standardized, low-technology physical fitness test. Methodology/Principal Findings: Four villages in coastal Kenya were surveyed during 2009–2010. Children 5–18 years were tested for infection with Schistosoma haematobium (Sh), malaria, filaria, and geohelminth infections by standard methods. After anthropometric and hemoglobin testing, fitness was assessed with the 20 mSRT. The 20 mSRT proved easy to perform, requiring only minimal staff training. Parasitology revealed high prevalence of single and multiple parasitic infections in all villages, with Sh being the most common (25–62%). Anemia prevalence was 45–58%. Using multiply-adjusted linear modeling that accounted for household clustering, decreased aerobic capacity was significantly associated with anemia, stunting, and wasting, with some gender differences. Conclusions/Significance: The 20 mSRT, which has excellent correlation with VO2, is a highly feasible fitness test for low-resource settings. Our results indicate impaired fitness is common in areas endemic for parasites, where, at least in part, low fitness scores are likely to result from anemia and stunting associated with chronic infection. The 20 mSRT should be used as a common metric to quantify physical fitness and compare sub-clinical disability across many different disorders and community settings. Author Summary: Reduced physical fitness, which is a manifestation of the body's inability to maintain adequate oxygen supply to the tissues, can have many causes. In developing countries, a person's low physical fitness is often the result of anemia and undernutrition, which have multifactorial etiologies including poor diet and chronic infections such as malaria, hookworm and schistosomiasis. In past surveys, exercise tolerance has been measured using non-standardized tests that were poorly-suited to young children. In this study, we implemented a well-validated and reliable 20-meter shuttle run test in a low-resource area of Kenya. Results for 1950 children, aged 5–18 years, showed that impaired fitness was common and associated with anemia and poor growth with boys being more affected than girls. The 20 mSRT is a feasible and low-cost tool that can be easily delivered in low-resource settings to identify children who manifest the disabling but often sub-clinical manifestations of their disease. We propose its implementation as a standard fitness test in less developed areas to allow comparisons across morbidity studies assessing the impact of different interventions.
- Subjects
KENYA; HOOKWORM disease; KENYANS; PHYSICAL fitness testing; RESOURCE-limited settings; PHYSICAL fitness; SCHISTOSOMA haematobium
- Publication
PLoS Neglected Tropical Diseases, 2011, Vol 5, Issue 7, p1
- ISSN
1935-2727
- Publication type
Article
- DOI
10.1371/journal.pntd.0001213