Ultimately, the causal direction of the relationship between
helminths and anemia or malnutrition needs to be confirmed
using a prospective experimental design. In the previous,
smaller study,
21
the cross-sectional relationship was similar
to what we report here: helminth infection in young children
(6–29 months) was associated with higher hemoglobin. And
yet in the randomized trial that followed, anthelminthic treatment resulted in fewer cases of severe anemia. 5
The data used
in the present analysis study were baseline data for a larger
randomized trial of children 6 to 24 months of age, the results
of which will be published separately. However, based on the
speculation that less severe anemia and malnutrition in children causes greater exposure to soil-transmitted helminths
(rather than the reverse), and that longer duration of infection
is associated with greater nutritional risk, anthelminthic treatment in this young age group might indeed prove beneficial
to be evident immediately,