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PubMed1976

Clinical trial methodology in intestinal parasitic diseases.

The high prevalence of intestinal parasitic infections as an index of underdevelopment, especially in tropical countries, is related to poverty, poor housing, lack of sanitation, malnutrition, and ignorance. The effects are lowered work capacity, physical and mental retardation, leading to recurrences and exacerbations of the parasitism and malnutrition. The most prevalent parasites, methods of detection by specific tests in patients in clinical trials involving antiparasitic drugs are dealt with. How and by whom investigations of new drugs should be undertaken, the need for a basic knowledge of parasitology and techniques of the discipline, of biostatistics, and use of such controls as randomized allotment to treatment groups, placebo administration, and double-blind assessments are emphasized. The justification for undertaking an evaluation of an antiparasitic drug is predicated on the demonstration of safety in exhaustive in vitro and animal studies and of the drug's potential superiority as to efficacy and lower incidence of unwanted side effects, as compared with existing agents. Tolerance and dose-range studies should be conducted in male adult hospitalized patients under close supervision. The evaluation of amebicides in clinical trials, as well as of anthelmintics, is considered in terms of differentiation and reproductive habits of specific causative agents and tests for detecting their elimination to determine improvement under drug therapy. The problem of reinfection, particuarly of nonhospitalized patients under the adverse conditions of life, is stressed.

Amebiasis↗
PubMed1991

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↗
PubMed2000

[Secular trends in intestinal parasitic diseases of childhood in the city of São Paulo, Brazil (1984-1996)].

OBJECTIVE: Data from two consecutive household surveys undertaken in mid-80s and mid-90s allow to characterize and analyse secular trends in infant and child intestinal parasitic diseases in the city of S. Paulo, Brazil. METHODS: The two surveys included random population samples aged from zero to 59 months (1,016 in the period of 1984-85 and 1,280 in 1995-96). Stool samples were collected in both surveys and examined by sedimentation techniques using both unstained and Lugol-stained preparations. For each survey, the study of the social distribution of the parasitic diseases took into account tertiles of the per capita family income. For the study of the determinants of secular trends, hierarchical causal models, multivariate regression analyses and calculations analogous to the ones used to assess population attributable risks were applied. RESULTS/CONCLUSIONS: In the time span from the first to the second survey, there was a substantial reduction in the prevalence of all parasites (from 30.9% to 10.7%), helminths in general (from 22.3% to 4.8%), giardiasis (from 14.5% to 5.5%) and two or more species of parasites (from 13.1% to 0.5%). A significant decline in prevalence was observed in all social strata and the inverse association between income and intestinal parasites was kept unchanged in the period. Positive changes in distal (family income and maternal schooling) and intermediate determinants (housing, sanitation, and access to health care) of helminthic disease could substantially explain part of its decline in the period. The decline in giardiasis was attributed to improvement in maternal schooling, housing and sanitation. The duplication in the attendance rate to day care nurseries may have restricted the decline rate in the giardiasis prevalence in the study period.

Brazil↗
PubMed1999

[Prevalence of intestinal parasitic disease in three provinces in Morocco].

A study of intestinal parasites was carried out in Taounate, Béni Mellal and Tizinit provinces in Morocco on a sample of 1682 individuals who were representative of the urban and rural area population. For each stool specimen, three microscopic examinations and a Kato test were performed. In the three provinces, about two-thirds of the study participants from rural areas and around 50% of those from urban areas had parasites. The reproducibility of the prevalence figures allowed the study results be generalized to the other provinces of the country. Among the parasite groups encountered, amoebas were the most frequent, followed by flagellates and helminths. Concerning pathogenic species, Entamoeba histolytica, in the amoebic group, was the most commonly found. All the positive cases were treated by specific medication.

Adolescent↗
PubMed1994

[Intestinal parasitic diseases and tinea of the scalp in Dakar school population: influence of environmental factors on the infestation level].

We carried out a study during February 1993 in a french and three coranic schools in order to evaluate the incidence of the economical level on the prevalence of intestinal parasites and tinea's scalp. Infection rate by intestinal parasites were 67.4% and 84% respectively in french and coranic schools with significant differences: X2 = 10.8. Infection rate by dermatophytes were 10.6% and 48.8% respectively in francophone and coranic schools with significant differences: X2 = 29.3. Ascaris was predominant through all ages in coranic schools, while amaeba were the main parasites in the upper ages in the french school. Bad environmental features observed in coranic schools as well as in popular areas are risk factors to the infection and contribute to increase the prevalence of intestinal parasitic diseases and tinea's scalp.

Child↗