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Anemia and intestinal parasitic infections in primary school students in Aracaju, Sergipe, Brazil.

Anemia is estimated to affect half the school-age children and adolescents in developing countries. The main causes are parasitic infections, malaria, and low iron intake. This study aimed to describe the prevalence of anemia, parasitic infections, and nutritional status of children attending public primary schools in Aracaju, Northeast Brazil. Of 360 students, 26.7% were anemic, and prevalence was higher in children under 8 and over 15 years of age. Overall prevalence of intestinal parasites was 42%, with Ascaris lumbricoides (28.7%), Trichuris trichiura (15.6%), and hookworm (1. 7%) most frequently found. There was an association between parasitic infections and poor sanitary conditions, but there was no association between anemia and presence of intestinal parasites. Height-for-age Z scores were lower than the NCHS standard, and prevalence of stunting was 5.4%. Although intestinal parasites were not associated with anemia, children with parasites had lower nutritional indices (weight- and height-for-age Z scores) than those without parasites.

Adolescent↗

Intestinal parasites in metropolitan Toronto day-care centres.

In 1981, 900 children (aged 3 months to 10 years) and 146 staff attending 22 day-care centres in metropolitan Toronto chosen at random provided a stool specimen in a survey for intestinal parasites. Of the children, 4% to 36% were infected in 20 of 22 centres. Overall, 19% of the children and 14% of the staff had intestinal parasites: 8.6% and 4.0% respectively had Dientamoeba fragilis, and 7.8% and 2.0% respectively had Giardia lamblia. The highest prevalence of dientamebiasis was in the 7- to 10-year-olds, whereas giardiasis was detected most frequently in the 6-year-olds. Infection with intestinal parasites was not correlated with age, sex, duration in the day-care centre, dog ownership, travel history, gastrointestinal symptoms or the proportion of children in the day-care centre who were born in less developed countries. Immigrant children and children of parents born in industrialized countries (including Canada) were more likely to be infected than were children born in Canada of parents from the developing world. Dientamebiasis was associated with cat ownership. Thus, intestinal protozoa--in particular, D. fragilis and G. lamblia--are endemic in Toronto day-care centres.

Canada↗

Intestinal parasites among Southeast Asian refugees in Massachusetts.

This laboratory examined 2,158 stool specimens for intestinal parasites from 1,478 Southeast Asian refugees who immigrated to Massachusetts between September 1981 and April 1982. Seventy-five per cent of refugees harbored one or more of 20 different species of intestinal parasites. Multiple infections occurred in 49% of refugees. Twenty-one per cent had pathogenic protozoa, which are transmissible from person to person. Six per cent had nonpathogenic protozoa only. Entamoeba polecki, an ameba rarely seen in the United States, was found in 5% of refugees.

Asia, Southeastern↗

A survey of intestinal parasites in rural children.

A study was undertaken to determine the prevalence of intestinal parasites in a group of rural, economically disadvantaged children. Thirty-four percent of 108 children were found to have a clinically significant parasite. The most common organism was Giardia lamblia (22 percent). Those children with Giardia were significantly (P = .05) smaller than those with negative stool examinations. Even in areas with a low overall prevalence of intestinal parasites, certain high-risk groups may have significant levels of infection.

Ascaris↗

Seasonal prevalence of intestinal parasites in the United States during 2000.

One-third of 5,792 fecal specimens from 2,896 patients in 48 states and the District of Columbia tested positive for intestinal parasites during the year 2000. Multiple infections with 2-4 parasitic species constituted 10% of 916 infected cases. Blastocystis hominis infected 662 patients (23% or 72% of the 916 cases). Its prevalence appears to be increasing in recent years. Eighteen other species of intestinal parasites were identified. Cryptosporidium parvum and Entamoeba histolytica/E. dispar ranked second and third in prevalence, respectively. Prevalence of infection was lowest (22-27%) in winter, gradually increased during the spring, reached peaks of 36-43% between July and October, and gradually decreased to 32% in December. A new superior method of parasite detection using the Proto-fix-CONSED system for fixing, transport, and processing of fecal specimens is described. In single infections, pathogenic protozoa caused asymptomatic subclinical infections in 0-31 % of the cases and non-pathogenic protozoa unexpectedly caused symptoms in 73-100% of the cases. The relationship between Charcot-Leyden crystals and infection with four species of intestinal parasites is examined and the list of provoking parasitic causes is expanded.

Animals↗

Effect of age and sex on the prevalence of intestinal parasitism in dogs.

The effects of age, sex, and neutering on the prevalence of canine intestinal parasitism were evaluated by fecal examination of 1,468 pet dogs admitted to the University of Missouri Veterinary Teaching Hospital during 1975. Evidence of hookworm infection was encountered in 35.8% of the dogs examined, whipworms in 18.5%, ascarids in 17.9%, tapeworms in 5.2%, and coccidia in 4.5%. Evidence of intestinal parasitism was not detected in 653 (44.4%) dogs. Whipworm infections were detected less often in young dogs than in older ones, whereas ascarid and coccidial infections were more prevalent in pups that in mature dogs. In dogs more than 6 months old, hookworm infections were the most common parasitism. Tapeworm infections were diagnosed sporadically in all age groups. For most of these parasites, castrated males and spayed females had decreased prevalence of infection, compared with their respective intact counterparts. There were significant (P less than 0.05) differences in the prevalence of both ascarid and hookworm infections between intact and spayed female dogs. Also, there were significant (P less than 0.001) differences between age categories for all parasites observed. Overall, parasitism tended to decrease with age.

Age Factors↗

Intestinal parasites and HIV infection in Tanzanian children with chronic diarrhea.

OBJECTIVE: To determine whether specific intestinal parasites are associated with HIV infection in Tanzanian children with chronic diarrhea. DESIGN: A prospective, cross-sectional study. SETTING: Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania. SUBJECTS: All children aged 15 months to 5 years admitted with chronic diarrhea, and age-matched controls. METHODS: Standardized history, physical examination, HIV serology, and stool parasitology were evaluated for all subjects. We compared three groups: HIV-infected and non-HIV-infected children with chronic diarrhea and controls without diarrhea. MAIN OUTCOME MEASURES: Fecal parasites and nutritional status. RESULTS: Chronic diarrhea accounted for one-quarter of all cases of diarrheal disease in the defined age range, and children with chronic diarrhea were severely malnourished. Forty per cent of subjects with chronic diarrhea were HIV-seropositive. Although intestinal parasites were detected in approximately 50% of all three groups, diarrheagenic parasites were detected in up to 40% of children with chronic diarrhea. Blastocystis hominis was detected only in HIV-infected patients. CONCLUSIONS: HIV infection was common in children with chronic diarrhea, and parasitic agents of diarrhea may be important in children with chronic diarrhea both with and without HIV infection in this setting. B. hominis was more frequent in HIV-infected children. The immunocompromising effects of severe malnutrition may have diminished the difference between HIV-infected and non-HIV-infected children.

Child, Preschool↗

Prevalence of intestinal parasitic infections in the Islamic Republic of Iran.

A national survey of the prevalence of intestinal parasitic infections in the Islamic Republic of Iran was made on a random sample of families covered by local health centres affiliated to the medical universities. Out of 53,995 people aged 2+ years, from 12,495 families (0.1% of all families in 1999), 45,128 stool samples were analysed by formalin-ether precipitation. Intestinal parasitic infections were found in 19.3% of the study population (19.7% male, 19.1% female). Giardia lamblia (10.9%), Ascaris lumbricoides (1.5%), Entamoeba histolytica (1.0%) and Enterobius vermicularis (0.5%) were the most common infections. The infection rate was highest in the 2-14 years age group (25.5%) and in rural residents (23.7%).

Adolescent↗

Anaemia and intestinal parasitic infections among school age children in Behera Governorate, Egypt. Behera Survey Team.

Anaemia is considered a serious public health problem in Egypt, although updated population-based data are lacking. Similarly, data on prevalence and intensity of infection with intestinal parasites, which are considered one possible cause of anaemia, are available only from small, unrepresentative sample surveys. The present research was implemented on an entire Governorate representative sample. The aim of the study was to assess the prevalence of anaemia and intestinal parasites in the area and to evaluate the role of each parasite in the epidemiology of anaemia among school age children. At the end of the survey, results of faecal analyses from direct smear and the Kato-Katz examination techniques were available from 1844 and 1783 children respectively, as well as haemoglobin levels measured by spectrophotometer from 1238 children aged 6-12 years. The prevalence of anaemia in the area was high (90 per cent), but very few serve forms were detected (< 2 per cent). Prevalence of intestinal parasites was high only for protozoa (Giardia intestinalis 24.7 per cent Entamoeba histolytica 17.5 per cent) and Schistosoma mansoni (20.7 per cent). From analysis of the results, Fasciola infection appeared to be highly endemic, even among children (3 per cent), and emerged as the factor most strongly correlated with low levels of haemoglobin (p < 0.0001). The effect of Fasciola on haemoglobin levels was related to the intensity of infection with this parasite. The role of S. mansoni as a risk factor for anaemia was supported by the present study. Among the protozoa, G. intestinalis was significantly correlated with low haemoglobin levels (p < 0.05). The present results substantiated similar findings from smaller studies. In future research, the relationship between Fasciola infection and anaemia needs to be studied with a well-controlled longitudinal design.

Age Distribution↗

Intestinal parasites, including Cryptosporidium species, in Iraqi patients with sickle-cell anaemia.

Stool samples were obtained from individuals admitted to three hospitals in Basra during November 1997-May 1998. Of 40 patients with sickle-cell anaemia, 25 (62.5%) had parasitic infections. In the apparently healthy comparison group, 26 of 175 individuals (14.8%) had intestinal parasitic infections, a statistically significant difference. The most common intestinal parasites isolated in the sickle-cell patients were Blastocystis hominis (36%) and Giardia lamblia (28%). The isolation rate of Cryptosporidium species in sickle-cell patients (5%) was not significantly different from that in apparently healthy individuals (1.14%). We report for the first time the isolation of Isospora belli from a sickle-cell patient in Iraq and the Mediterranean region.

Adolescent↗

[Prevalence of intestinal parasitism in the public laboratories of Martinique: development from 1988 to 1995].

This survey drew up the epidemiological situation of intestinal parasitism in Martinique in 1994-1995. 13,978 stool specimens collected in 1994-1995 were tested by parasitologic examination. Stool specimens were from patients hospitalised in the 3 principal hospitals of Martinique or coming to the Laboratoire départemental d'hygiène. The parasitism rate was 8.73%. This study showed a significant reduction of intestinal parasitism between results of 1988 and results of 1994-1995. The oro-faecal parasitism was not very important that reflected the good economic and sanitation level of Martinique. On the other hand, regarding the important prevalence of parasitism with Strongyloïdes stercoralis and hookworm, it would be good to improve detection, sanitary education and know better local contamination factors to decrease the prevalence of this parasitism.

Amebiasis↗

A survey on the intestinal parasites of the school children in Kaohsiung county.

The present study on the prevalence of intestinal parasites infection, from September to December 1999, was conducted among school children in Taoyuan Hsiang, Kaohsiung county. The investigated areas included three (Jiannshan, Shingjong and Taoyuan) primary schools. The overall infection rate in 305 children determined by Merthiolate-Iodine-Formaldehyde Concentration method of stools was 17%. Four confirmed species of helminthes (Ascaris lumbricoides, Hookworm, Trichuris trichiura and Hymenolepis nana) and three species of protozoa (Giardia lamblia, Entamoeba coli and Blastocystis hominis) were detected. Males and females had the infection rates of 24% and 11%. The infection rates of aboriginal and non-aboriginal children were 17% and 14%, respectively. Grade 1 and Grade 6 had the highest infection rate (21%). Following tape perianal examination of 302 children, the overall infection rate of Enterobius vermicularis was 25%. Males and females had the infection rates of 24% and 26%. The infection rates of aboriginal and non-aboriginal children were 27% and 11%, respectively. Grade 1 had the highest infection rate (37%). Based on these data, the infection rate of intestinal parasites among rural primary school children in Kaohsiung county remains high.

Child↗

Incidence of intestinal parasitic disease in an acquired immunodeficiency syndrome day-care center.

In June, 1986, the Bronx Municipal Hospital Center opened an acquired immunodeficiency syndrome day-care center to provide a quality educational experience for children infected with the human immunodeficiency virus. A major concern was the possibility of increasing secondary infections among these immunocompromised children by placing them in a group environment. One particular worry was intestinal parasitic disease, a serious public health problem in day-care centers throughout the United States. To minimize the risk of parasitic infections, scrupulous hygienic and monitoring procedures were instituted at the acquired immunodeficiency syndrome day-care center. This study reports the incidence of intestinal parasitic disease at the acquired immunodeficiency syndrome day-care center during its first 40 months of operation, encompassing 669 child-months of enrollment, with 131 stool specimens examined for ova and parasites. There were 2 cases of parasitic infection: Entamoeba histolytica in an asymptomatic 6-year-old and Giardia intestinalis in a 7-year-old with diarrhea. In neither case was there any secondary spread. None of the 15 children in diapers had a positive specimen, and we found no Cryptosporidium. Our experience suggests that with appropriate precautions human immunodeficiency virus-infected children can participate in a group day-care program without excessive risk for parasitic disease. Strict adherence to hygienic procedures may also decrease the risk of intestinal parasitic disease among healthy children attending day-care centers.

Acquired Immunodeficiency Syndrome↗

[Intestinal parasitic colonization and protein-caloric malnutrition].

Intestinal parasitic infection was determined by fecal examination for parasites with several complementary methods in 380 young Gabonese infants aged 6 to 24 months (190 with normal weights and 190 with malnutrition, matched for age). Trichuris trichiura, Ascaris lombricoides, Giardia intestinalis, Entamoeba histolytica and Strongyloides stercoralis were the most prevalent parasites, without any difference between well-fed infants and patients with malnutrition. The higher prevalence of Strongyloides stercoralis in protein energy malnutrition might be related to a methodologic problem. However, more than 20% of diarrheas in infants with severe malnutrition were dramatically improved by specific treatment of S. stercoralis or Giardia with thiabendazole or metronidazole.

Diarrhea, Infantile↗

Intestinal parasite carriage in workers exposed to sewage.

The presence of protozoan cysts and helminth eggs in sewage and the very low minimal infective doses of parasites suggest an occupational risk for workers exposed to sewage. The objective of this study was to assess this risk in a group of raw sewage-exposed workers. The relationship between sewage exposure and intestinal parasite carriage was estimated by a multiple cross-sectional survey comparing yearly prevalence rates in 126 employees working in sewers in Paris, France, with the prevalence rate in 363 food-handlers employed between 1988 and 1993. The incidence of intestinal parasitic infestation was estimated among sewage-exposed workers. Four parasite species were identified among sewage-exposed workers: whipworm, Giardia lamblia, Entamoeba coli and Endolimax nanus. The prevalence mean of intestinal parasite carriage was 11.8% (57/480), related to the presence of protozoa in 91% of samples. G. lamblia was present in 3.5% (17/480) of samples. The incidence of positive parasitological stool examination was 5.9/100 person-years. The incidence of G. lamblia in stool examinations was 1.7/100 person-years. Age-adjusted odds ratios were significantly higher in exposed workers in 1988 (OR: 6.5; 95% CI: 2.0-14.5), 1990 (OR: 4.4; 95% CI: 1.2-10.1) and 1991 (OR: 3.4; 95% CI: 1.0-8.2), but not during the other three years. The results of this study emphasize an occupational risk of intestinal protozoan infestation in workers exposed to sewage. The decrease of adjusted OR with time reflects the efficacy of compliance with rules of hygiene.

Adult↗

[Intestinal parasite infections in a periurban community from the Province of Buenos Aires, Argentina].

A survey for intestinal parasites was performed on 38 individuals within the urban area of La Plata City (Province of Buenos Aires, Argentina). This community is composed of brick-factory workers who also live in the factory premises. An analysis for intestinal parasites was done on fecal samples collected serially and by means of anal swabs and thereafter preserved in formol solution. At the same time, the occurrence of the parasites under study as well as that of commensal organisms was investigated in water and soil samples within the factory environs. Information was also obtained from the members of this community as their age, sex, birthplace, and recent travels, either abroad or to the interior of Argentina. The prevalence of the pathogens and commensal parasites was 89.5%. The frequency of protozoans and helminths was: G. lamblia 26.3%, B. hominis 65.8%, A. lumbricoides 7.9%, H. nana 2.6%, Uncinaria sp. 7.9%, S. stercoralis 2.6% and E. vermicularis 42.1%. None of these parasite or commensal organisms were present in the water samples investigated. Four out of 20 soil samples analyzed contained parasitic elements: T. canis eggs (one), G. lamblia cysts (two) and A. lumbricoides eggs (one). These results indicated that most important factors causing such a high prevalence of coproparasites were the poor conditions of personal and community hygiene in combination with the frequent travels to the north and the northeast of the country, regions which are endemic parasitic areas. The implementation of programs on health education and communal sanitation would contribute in the control of this health problem.

Adolescent↗

Intestinal parasites in Hong Kong.

A retrospective survey of laboratory records of 8590 stool samples examined for intestinal parasites from local Hong Kong residents during the first 6 months of 1992 showed changes in the pattern of such infestations, particularly in the age of first acquiring infection and the peak age of occurrence for the different intestinal parasites, in comparison with data obtained 12 years ago. The largest percentage decline was seen for Ascaris, reflecting the rapid urbanization of the territory, while clonorchiasis showed a much slower decline, probably related to the difficulty of changing local culinary habits. A similar decline is also seen amongst Vietnamese migrants in Hong Kong. Published epidemiological data from the South-east Asian region showed widely varying patterns from countries in different socioeconomic states.

Adolescent↗

Intestinal parasitic infestation in urban and rural Xhosa children. A comparative study.

Evidence of helminthic intestinal parasites was found in 97,0% of stools of 544 Xhosa schoolchildren living in Cape Town. The commonest parasite was Trichuris trichiura, which infested 89,9% of the children. In contrast, only 9,8% of 387 Xhosa children living in the Tsolo district, Transkei, had evidence of intestinal parasites in their stools, Hymenolepis nana being the commonest. In spite of the unsatisfactory sanitary conditions in the Tsolo area compared with those in Guguletu, Cape Town, where all sewage is waterborne, few rural children were infested. The high prevalence of infestation in the Guguletu children suggests extensive contamination of the soil in the area by parasitic ova. In view of the magnitude of the extent of parasitic infestation in the Guguletu children, a vigorous and sustained programme of medication and education will have to be undertaken if the problem is to be resolved.

Black or African American↗