Schistosoma mansoni infection as a predictor of low aerobic capacity in Ugandan Children

Smith, C. and McLachlan, G. and Al Shehri, H. and Adriko, M. and Arinaitwe, M. and Atuhaire, A. and Tukahebwa, E.M. and LaCourse, E.J. and Stanton, M. and Stothard, J.R. and Bustinduy, A.L. (2019) Schistosoma mansoni infection as a predictor of low aerobic capacity in Ugandan Children. The American Journal of Tropical Medicine and Hygiene, 100 (6). pp. 1498-1506. ISSN 0002-9637

Abstract

Using the 20-meter shuttle run test (20mSRT) as a morbidity metric, we assessed whether Schistosoma mansoni infection was associated with decreased aerobic capacity in Ugandan children across a range of altitudes, either at low (∼600 m) or high (∼1,000 m) altitudes. A total of 305 children were recruited from six schools within the Buliisa District, Lake Albert, Uganda. A subset (n = 96) of these had been previously assessed and treated for schistosomiasis ± malaria 2 weeks prior. Fitness scores on the 20mSRT were translated into VO2max using a standardized equation. Unadjusted and multivariable-adjusted analyses were performed using VO2max as the primary outcome. Analysis of fitness scores from 304 children, inclusive of the subset follow-up cohort, revealed a median VO2max of 45.4 mL kg-1 min-1 (interquartile range: 42.9-48.0 mL kg-1 min-1). Children residing at high altitudes demonstrated increased aerobic capacities (46.3 versus 44.8 mL kg-1 min-1, P = 0.031). The prevalence of stunting, wasting, S. mansoni egg patent infection, malaria, giardiasis, anemia, and fecal occult blood were 36.7%, 16.1%, 44.3%, 65.2%, 21.4%, 50.6%, and 41.2%, respectively. Median VO2max was elevated in those previously treated, compared with those newly recruited (46.3 versus 44mLkg-1 min-1,P< 0.001). Multivariable-adjusted analysis revealed a strong negative association between S. mansoni egg patent infection and VO2max at low altitude (beta coefficient: -3.96, 95% CI: ?6.56 to -137, P = 0.004). This is the first study to document a negative association between S. mansoni infection and aerobic capacity at low altitudes using the 20mSRT.