Association of Parasitic Infections and Neurotropic Vitamins With Developmental Delay in Children With Severe Acute Malnutrition in Datia District, Madhya Pradesh: A Cross-Sectional Observational Study

Background and objectiveSevere acute malnutrition (SAM) remains a significant health challenge among children under five in India and is often complicated by parasitic infestations and deficiencies of neurotropic vitamins.These factors may contribute to developmental delay.This study assessed the association between parasitic infestations and neurotropic vitamin deficiencies with developmental delay in children with SAM in Datia district, Madhya Pradesh, India. MethodsThis hospital-based, cross-sectional observational study was conducted at the Nutritional Rehabilitation Centre (NRC) of the Government Medical College and its associated hospital in Datia district, Madhya Pradesh, India, from April 2022 to April 2024.Stool microscopy and blood investigations were performed to identify parasitic infections and estimate vitamin B1, B6, and holotranscobalamin (HoloTC) levels.Developmental status was assessed using the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-IV).Data were analyzed using chi-square tests and logistic regression. ResultsParasitic infections were detected in 30 (30%) children, with Ascaris lumbricoides identified in 10 (33%).Developmental delay was observed in 25 (71%) children with parasitic infections compared to 10 (29%) without infection.Mean vitamin levels were lower in infected than in non-infected children: vitamin B1 (0.132 ng/mL vs. 0.98 ng/mL), vitamin B6 (0.142 ng/mL vs. 0.768 ng/mL), and HoloTC (17 pmol/L vs. 27 pmol/L).On multivariate analysis, parasitic infection (adjusted odds ratio (aOR): 18.9, 95% CI: 5.2-68.2,p < 0.001) and HoloTC deficiency (aOR: 3.2, 95% CI: 1.05-9.7,p = 0.041) were independent predictors of developmental delay. ConclusionsParasitic infections and neurotropic vitamin deficiencies were strongly associated with developmental delay in children with SAM.Routine screening, deworming, and targeted nutritional interventions are essential to improve developmental outcomes in this vulnerable population.