@article{fdi:010063659,
  title = {{S}tunting, poor iron status and parasite infection are significant risk factors for lower cognitive performance in {C}ambodian school-aged children},
  author = {{P}erignon, {M}arl{\`e}ne and {F}iorentino, {M}. and {K}uong, {K}. and {B}urja, {K}. and {P}arker, {M}. and {S}isokhom, {S}. and {C}hamnan, {C}. and {B}erger, {J}acques and {W}ieringa, {F}ranck},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {N}utrition is one of many factors affecting the cognitive development of children. {I}n {C}ambodia, 55% of children <5 y were anemic and 40% stunted in 2010. {C}urrently, no data exists on the nutritional status of {C}ambodian school-aged children, or on how malnutrition potentially affects their cognitive development. {O}bjective: {T}o assess the anthropometric and micronutrient status (iron, vitamin {A}, zinc, iodine) of {C}ambodian schoolchildren and their associations with cognitive performance. {M}ethods: {S}chool children aged 6-16 y (n = 2443) from 20 primary schools in {C}ambodia were recruited. {A}nthropometry, hemoglobin, serum ferritin, transferrin receptors, retinol-binding protein and zinc concentrations, inflammation status, urinary iodine concentration and parasite infection were measured. {S}ocio-economic data were collected in a sub-group of children (n = 616). {C}ognitive performance was assessed using {R}aven's {C}olored {P}rogressive {M}atrices ({RCPM}) and block design and picture completion, two standardized tests from the {W}echsler {I}ntelligence {S}cale for {C}hildren ({WISC}-{III}). {R}esults: {T}he prevalence of anemia, iron, zinc, iodine and vitamin {A} deficiency were 15.7%; 51.2%, 92.8%, 17.3% and 0.7% respectively. {T}he prevalence of stunting was 40.0%, including 10.9% of severe stunting. {S}tunted children scored significantly lower than non-stunted children on all tests. {I}n {RCPM} test, boys with iron-deficiency anemia had lower scores than boys with normal iron status (-1.46, p<0.05). {I}n picture completion test, children with normal iron status tended to score higher than iron-deficient children with anemia (-0.81; p = 0.067) or without anemia (-0.49; p = 0.064). {P}arasite infection was associated with an increase in risk of scoring below the median value in block design test ({OR} = 1.62; p<0.05), and with lower scores in other tests, for girls only (both p<0.05). {C}onclusion: {P}oor cognitive performance of {C}ambodian school-children was multifactorial and significantly associated with long-term (stunting) and current nutritional status indicators (iron status), as well as parasite infection. {A} life-cycle approach with programs to improve nutrition in early life and at school-age could contribute to optimal cognitive performance.},
  keywords = {{CAMBODGE}},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {9},
  numero = {11},
  pages = {e112605 [11 ]},
  ISSN = {1932-6203},
  year = {2014},
  DOI = {10.1371/journal.pone.0112605},
  URL = {https://www.documentation.ird.fr/hor/fdi:010063659},
}