Bad Things Come in Threes: Childhood Malnourishment, Intestinal Worm Burden, and Vitamin A Deficiency in Northeastern India

Abstract

Malnourishment, Vitamin A deficiency, and high rates of soil-transmitted helminthiasis coexist in many regions of the world. This thesis analyzes possible connections between the three using ethnographical observational data, a mathematical model of worm infections in children, and a re-worked data analysis based on the 2013 DEVTA trial run by Dr. Shally Awasthi of King George Medical University in Lucknow, a city in Uttar Pradesh India. The observational section of the thesis reports cultural misunderstandings, logistical difficulties, communication network unreliability, lack of technology, and lack of manpower as reasons to view this study as a piece of the answer but not as the “gold standard” it was once viewed as. This is supplemented by the modeling analysis that identifies worm burden as a confounding factor to Vitamin A deficiency (VAD) and that idea that more complicated interactions are occurring. This leads us to believe this field should continue to explore the benefits of vitamin A supplementation concurrently with deworming treatment.