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Intestinal parasites prevalence and related factors in school children, a western city sample--Turkey.

BACKGROUND: Intestinal parasitic infections are amongst the most common infections worldwide. Epidemiological research carried out in different countries has shown that the social and economical situation of the individuals is an important cause in the prevalence of intestinal parasites. Previous studies in Turkey revealed a high prevalence of intestinal parasitic infection. The objectives of the current study were to determine the prevalence of intestinal parasitic infections in Aydin among 7-14 years old school children and to identify associated socio-demographic and environmental factors, behavioral habits and also related complaints. METHODS: Multistage sampling was used in the selection of the study sample. A questionnaire, cellulose adhesive and a stool specimen examination were done. RESULTS: A total of 456 stool specimens were collected. 145 students (31.8%) were infected with one or more intestinal parasites. 29 (6.4%) of the students were infected more than one parasite, 26 (5.7%) with two parasites and 3 (0.7%) with three parasites. The three most common were E. vermicularis, G. intestinalis and E. coli. Intestinal parasite prevalence was higher in rural area, in children with less than primary school educated mother, in children who use hands for washing anal area after defecation, and in children who use toilet paper sometimes or never. The relation between child health and mother education is well known. Children were traditionally taught to wash anal area by hand. Toiler paper usage was not common and might be due to low income or just a behavioral habit also. Most of the complaints of the study population were not significantly related with the intestinal parasitic infection. CONCLUSIONS: Intestinal parasitic infection is an important public health problem in Aydin, Turkey. Rural residence, mother education less than primary school, sometimes or never usage of toilet paper, and washing anal area by hands after defecation were the significant associations. Interventions including health education on personal hygiene to the students and to the parents, especially to mothers are required. The ratio of uneducated women should be declined with specific programs. A multisectoral approach is needed.

Adolescent↗

Intestinal parasites among young children in the interior of Guyana.

Intestinal parasites contribute greatly to morbidity in developing countries. While there have been several studies of the problem in the Caribbean, including the implementation of control programmes, this has not been done for Guyana. The aim of this study was to determine the prevalence of intestinal parasites among young children in a town located in the interior of Guyana. Eighty-five children under the age of 12 years were studied prospectively for intestinal parasites in Mahdia, Guyana. Stool samples were transported in formalin to the Department of Microbiology, The University of the West Indies, Jamaica, for analysis using the formalin-ether concentration and Ziehl-Neelsen techniques. Data on age and gender of the children were recorded on field data sheets. At least one intestinal parasite was detected in 43.5% (37/85) of the children studied and multiple parasitic infections were recorded in 21.2% (18/85). The most common intestinal helminth parasite was hookworm (28.2%; 24/85), followed by Ascaris lumbricoides (18.8%; 16/85) and then Trichuris trichuria (14.1%; 12/85). Among the protozoan infections Giardia lamblia was detected in 10.5% (9/85) of the study population while Entamoeba histolytica appeared rarely. All stool samples were negative for Cryptosporidium and other intestinal Coccidia. There was no predilection for gender with any of the parasites. The pattern of distribution of worms in this area of Guyana was unlike that seen in other studies. Hookworm infection was the most common among the children and a large proportion had multiple infections. The study established the occurrence and prevalence of a number of intestinal parasites in the population of Guyana. This sets the stage for the design and implementation of more detailed epidemiological studies.

Child↗

Epidemiology of infections with intestinal parasites and human immunodeficiency virus (HIV) among sugar-estate residents in Ethiopia.

Intestinal parasitic infections could play an important role in the progression of infection with human immunodeficiency virus (HIV), by further disturbing the immune system whilst it is already engaged in the fight against HIV. HIV and intestinal parasitic infections were investigated in 1239, randomly selected individuals, aged 15-54 years, living on a sugar estate in central Ethiopia. Intestinal parasites were identified in faecal samples (one/subject) using direct, concentration, and (for Strongyloides stercoralis larvae) Baermann methods. HIV serological status was determined using ELISA, with ELISA-positive samples confirmed as positive by western blotting. Most (70.1%) of the subjects were infected with at least one intestinal parasite and 3.1% were seropositive (but asymptomatic) for HIV. The intestinal parasites identified in the study population were amoebic parasites (Entamoeba histolytica/Enta. dispar) (24.6%), hookworms (23.8%), Ascaris lumbricoides (22.2%), Trichuris trichiura (19.5%), S. stercoralis (13.0%), Taenia saginata (4.5%), Giardia lamblia (3.0%), and Enterobius vermicularis (1.3%). Overall, the HIV-positives were no more or less likely to carry intestinal parasites than the HIV-negatives (76.2% v. 69.9%; P > 0.05). However, when each parasite was considered separately, amoebic parasites were found to be more common in the HIV-positives than the HIV-negatives (43.7% v. 24.0%; P < 0.05). This difference remained significant in a multivariate analysis, after controlling for the socio-demographic characteristics of the study participants. In conclusion, there was moderate interaction between intestinal parasites and HIV at the asymptomatic stage of HIV infection. The observed association between amoebic and HIV infections requires confirmation in a prospective study, allowing for the analysis of biological mechanisms involved in the association.

Adolescent↗

Parasite-reactive serum IgE antibodies in African populations. Relation to intestinal parasite load.

Serum IgE levels and IgE antibodies against four intestinal parasites, and the presence and abundance of parasites in stool samples were investigated in 161 Rwanda natives. Most of the IgE turn out to be helminth-reacting antibodies. The stimulation and production of these antibodies are much different from those of anti-amoeba antibodies in their relation to the specific intestinal parasite load; helminth infestations seem to play a major role in the development of anti-amoeba antibodies as well.

Ascaris↗

Intestinal parasites in Southeast Asian refugees.

A survey of intestinal parasitism in 6,241 Southeast Asian refugees (3,576 males and 2,665 females) indicated that 32.9 percent of the refugees had one or more intestinal parasites. A total of 1,178 (57.3 percent) males and 878 (42.7 percent) females harbored the parasites, with helminths representing the most frequent isolate. Intestinal parasitic infections may be considered minimal public health threats in the United States because of effective hygienic practices and sanitation facilities. However, it is important to emphasize that the attack rate also will be influenced by continued health education, job activities, and diagnosis and treatment of the refugees for these parasites.

Adolescent↗

Mass treatment of intestinal parasites among Ethiopian immigrants.

Intestinal parasites are common among the Ethiopian immigrants to Israel and mass treatment is necessary to prevent local transmission. For this purpose, stool samples obtained from the immigrants in absorption centers were examined. Of 5,412 samples obtained, 4,399 (81.3%) were positive: 2,644 (54.2%) for Necator americanus, 2,273 (46.6%) for Schistosoma mansoni, 990 (20.3%) for Ascaris lumbricoides, 1,040 (21.3%) for Hymenolepsis nana, 940 (19.2%) for Trichuris trichiura, 219 (4.5%) for Strongyloides stercoralis, 17 (0.4%) for Fasciola hepatica, 551 (11.3%) for Giardia lamblia, and 499 (9.2%) for Entamoeba histolytica. The cure rate for necatoriasis by treatment with 400 mg of albendazole was 84.4% (better than with other drugs), either alone or in combination (pyrantel with bephenium or pyrantel with praziquantel, or praziquantel with albendazole). Albendazole, 400 mg for 3 days, cured 92% of the cases of S. stercoralis infection. Praziquantel, 40 mg/kg body weight, in a single dose was effective in 89.7% of cases of S. mansoni, and 60% of cases of H. nana, although a 100% cure rate for H. nana was achieved with praziquantel at a dose of 20 mg/kg per day for 2 days. Two persons infected with F. hepatica were cured by 40 mg/kg praziquantel for 7 days. Tinidazole, 2 g in a single dose, cured 100% of persons infected with G. lamblia, while 60% of persons infected with E. histolytica were cured when treated with 2 g tinidazole for 3 days. Mass treatment of all the immigrants with 400 mg albendazole and 40 mg/kg praziquantel concomitantly resulted in a cure rate of 84.4% of all intestinal worms.

Adolescent↗

Prevalence and risk factors of intestinal parasites in Cuban children.

OBJECTIVES: To determine the prevalence of intestinal parasite infections and their risk factors in children in urban and rural settings in two Cuban municipalities. METHODS: A total of 1320 Cuban schoolchildren aged 4-14 were tested by stool examination for intestinal parasite infections and evaluated by parental questionnaire for a number of common environmental, sanitary, socioeconomic and behavioural risk factors. Multivariate regression was applied to examine the relationship between the respective parasite infections and the risk factors. RESULTS: Prevalences of intestinal parasite infections were 58% in Fomento and 45% in San Juan y Martínez; for helminth infections, these were 18% and 24% and for protozoa infections, 50% and 29%, respectively. Helminth infections were associated with high parental education (maternal: OR 0.68, CI 0.50-0.93; paternal: OR 0.71, CI 0.52-0.96), absence of toilet (OR 1.57, CI 1.12-2.19), consumption of water from a well or river (OR 0.56, CI 0.41-0.77) and eating unpeeled/unwashed fruit (OR 1.37, CI 1.01-1.87); protozoa infections were only associated with high maternal education (OR 0.72, CI 0.57-0.91). CONCLUSIONS: Paediatric intestinal parasite infections are still prevalent in certain areas in Cuba and associated with a number of common environmental, socioeconomic and sanitary risk factors.

Adolescent↗

[Intestinal parasitic infections in Serbia].

To determine the public health significance of intestinal parasitism in Serbia today, systematic parasitologic examination of 16 regions (Kragujevac, Luchani, Zhagubica, Bor, Sjenica, Novi Pazar, Valjevo, Aleksandrovac, Pirot, Bosilegrad, Ivanjica, Golubac, Uzhice, Kladovo, Negotin, Beograd) in central Serbia were carried out over the period 1984-1993. The study involved a total of 5981 schoolchildren (2887 F, 3094 M), 7-11 years old representing 10% of the total age-matched population (N = 58,228) of the examined regions, residing in 91 settlements. Field parasitological examinations included the examination of perianal swabs for E. vermicularis and Taenia sp., and examination of a single feces sample by direct saline smear and Lugol stained smear for intestinal protozoa, and the Kato and Lörincz methods for intestinal helminths. Nine species of intestinal parasites were detected, of which five protozoan: Entamoeba histolytica (0.02%), Entamoeba hartmanni (0.02%), Entamoeba coli (1.3%), Iodamoeba bütschlii (0.02%), Giardia lamblia (6.8%), and four helminthic: Hymenolepis nana (0.06%), Enterobius vermicularis (14.7%), Ascaris lumbricoides (3.3%), Trichuris trichiura (1.8%). The overall prevalence of intestinal parasite infections amounted to 24.6% (1207/4913), with a highly significant difference (p < 0.001) between particular sites (range 14.4%-43.8%) (Figure 1). Helminthic infections (810) were significantly more frequent (p < 0.001) as compared to both protozoan (296) and combined helminthic-protozoan infections (101). Of these, two species (G. lamblia, E. vermicularis) were found in all examined regions, three (E. coli, A. lumbricoides, T. trichiura) were detected in two or more, while four species (E. histolytica, E. hartmanni, I. bütschlii, H. nana) were each found in a single region (Figure 2). The predominant species (E. coli, G. lamblia, E. vermicularis, A. lumbricoides, T. trichiura) were distributed at considerably different prevalence rates, with a significant difference between the minimal and maximal values (p < 0.01). Of 91 settlements examined, intestinal parasites were found in all but one. However, the prevalence rates in 90 settlements varied significantly (p = 0.0004), from a low of 5.9% to a high of 66.7%. Thus, according to the World Health Organization criteria [19], infections with the four clinically relevant species (G. lamblia, E. vermicularis, A. lumbricoides, T. trichiura) ranged from sporadic to endemic and hyperendemic (Figure 3). The results obtained provide the basic epidemiological data about intestinal parasite infections in Serbia, and indicate their significance in terms of both the number of species and their respective prevalence rates. Given the significant differences obtained in the frequency and distribution of particular parasite infections in different regions, a programme for the control of these infections in Serbia should obviously include a wide variety of measures.

Adolescent↗

A small-scale survey on the status of intestinal parasite infections in rural villages in Nepal.

The status of intestinal parasite infections was investigated in two rural villages (Chitrasar, Jerona) in Chitwan District, Nepal in 1999. Stool examination was performed with a total of 300 specimens from schoolchildren by formalin-ether sedimentation technique. The prevalence rate of intestinal parasite infections in the surveyed areas was 44.0%. The prevalence rate in Jerona was slightly higher than that in Chitrasar. The prevalence rate of intestinal parasite infections in female was slightly higher than that in male without statistically significant difference. Entamoeba coli was the most commonly found protozoan parasite (21.0%) followed by Giardia lamblia (13.7%) and others (5.3%). Hookworm was the most prevalent intestinal helminth (13.0%) followed by Trichuris trichiura (3.0%) and others (5.0%). Forty-three specimens (14.3%) showed mixed infections. It is necessary to implement large-scale treatment with anthelminthics, health education and sanitary improvement for intestinal parasite control in the surveyed areas.

Child↗

[The effects of intestinal parasites on enteric bacterial flora].

Intestinal parasites, can cause malabsorption syndromes and shifts in intestinal bacterial flora. In this study 200 cases with parasitic infestations were examined in regard to their intestinal flora. The series included 96 giardiasis. 58 Ascariasis, 20 Oxyuriasis and 17 H. nana 14 T. trichiura, 8 Tenia cases. The stool cultures yielded mainly E. coli, Strep. faecalis and other gram negative enteric bacteria, yeasts along with uncommon species as B. subtilis, Herellea, Shigella at low frequencies. The control group of 50 patients without parasitic infestations had the same distribution ratio for the same species. The observed frequencies of the isolated bacterial species showed no significant differences between the parasite positive and control cases.

Enterobacteriaceae↗

[Malnutrition and its association with intestinal parasitism among children from a village in the Colombian Amazonian region].

Intestinal parasites and malnutrition cause high morbidity among children in developing countries. A study to establish the associations between intestinal parasitism and undernourishment was undertaken in a village in the Colombian Amazon region. Two hundred thirty seven children each provided four stool samples for parasitic analysis. Anthropometric indices were calculated based on height and weight (HAZ), weight and age (WAZ) and height and weight (WHZ) using the international growth standards recommended by the World Health Organization. Of the 237 children, 86.1% were carrying parasites, 54% had 2 or more parasites, 30% were stunted, 10% were underweight, and 2.5% were wasting. HAZ and WAZ indices were inversely related to age and number of parasites. Socioeconomic status was positively correlated with the number of parasites and inversely related to the HAZ index (p < 0.05). In conclusion, frequencies of undernourishment and intestinal parasites among the sample population were higher than the national average for Colombia. As previous studies have indicated, age, intestinal parasitism and socio-economic level are variables significantly related to nutritional state.

Adolescent↗

Intestinal parasitic infections among pregnant women in Venezuela.

INTRODUCTION: Intestinal parasitic infections, especially due to helminths, increase anemia in pregnant women. The results of this are low pregnancy weight gain and IUGR, followed by LBW, with its associated greater risks of infection and higher perinatal mortality rates. For these reasons, in the setting of no large previous studies in Venezuela about this problem, a national multicentric study was conducted. METHODS: Pregnant women from nine states were studied, a prenatal evaluation with a coproparasitological study. Univariated and multivariated analyses were made to determine risk factors for intestinal parasitosis and related anemia. RESULTS: During 19 months, 1038 pregnant women were included and evaluated. Intestinal parasitosis was evidenced in 73.9%: A lumbricoides 57.0%, T trichiura 36.0%, G lamblia 14.1%, E hystolitica 12.0%, N americanus 8.1%, E vermicularis 6.3%, S stercoralis 3.3%. Relative risk for anemia in those women with intestinal parasitosis was 2.56 (P < .01). DISCUSSION: Intestinal parasitoses could be associated with conditions for development of anemia at pregnancy. These features reflect the need of routine coproparasitological study among pregnant women in rural and endemic zones for intestinal parasites. Further therapeutic and prophylactic protocols are needed. Additional research on pregnant intestinal parasitic infection impact on newborn health is also considered.

Adult↗

Intestinal parasites of the Pacific.

Information about intestinal parasites in Hawaii and the Pacific is not current. We reviewed reports on fecal samples obtained from two laboratories and found recovery rates of 9.3% in Hawaii, 14.2% in Saipan, 18% in Rota and 9.5% in Guam. The most frequently identified parasites were Blastocystis hominis (7.6%), Giardia lamblia (1.2%), and Entamoeba coli (0.7%). Although the incidence and types of organisms have changed with time, physicians in Hawaii should continue looking for intestinal parasites.

Animals↗

[Prevalence Of Intestinal Parasites In Korea]

A survey of intestinal parasites infection among Korean people has been carried out during July 1969 to December 1970. A total of 2,250 stool specimens (male 1,101, female 1,146) was collected from all the provinces and Seoul city in Korea. The specimens were examined routinely by direct fecal smear, zinc sulfate flotation and formalin-ether sedimentation techniques. The results are summarized as follows: 1. Of 2,250 specimens examined, l,803(80.l %) were positive for intestinal parasites. 2. The positive rates of intestinal helminths were 1,644(73.1 %) among 2,250; Ascaris lumbricoides 46.0 %, Trichocephalus trichiurus 46.8 percent, hookworm 6.8 %, Trichostrongylus orientalis 7.0 percent, Clonorchis sinensis 12.1 percent, Enterobius vermicularis 1.6 %, Hymenolepis nana 0.7 percent, Taenia species 0.3 %, Metagonimus yokogawai 0.04 percent, Fasciolidae 0.04 % and one case of lung fluke Paragonimu westermani. 3. The positive rstes of intestinal protozoa were 786(34.9 %); Entamoeba histolytica 6.4 %, Entamoeba coli 20.5 percent, Endolimax nana 10.0 %, Giardia lamblia 5.1 %, Trichomonas hominis 1.1 percent, Chilomastix mesnili 0.5 percent, Iodamoeba butschlii 0.6 percent, Enteromonas hominis 0.7 percent, Dientamoeba fragilis 0.1 % and one case of Isospora hominis. 4. Sexual distribution of helminths and protozoan infections showed higher rate in female than that of male, except C. sinensis, H. nana, Taenia species or G. lamblia. 5. Infections of T. trichiurus, hookworm, T. orientalis, C. sinensis, Taenia species, E. histolytica, E. coli and E. nana increased with age. Conversely, H. nana and G. lamblia infections were more predominent in younger ages.

Journal Article↗

Prevalence of intestinal parasitic pathogens in HIV-seropositive individuals in Northern India.

To assess the prevalence of intestinal parasitic infections in human immunodeficiency virus (HIV)-seropositive subjects, fecal samples were collected from 120 HIV-seropositive patients and were analyzed for various intestinal parasites. Thirty-six patients (30%) were found to harbor an intestinal parasite. Cryptosporidium parvum was the most common (10.8%), followed by Giardia lamblia (8.3%). Cyclospora cayetanensis and Blastocystis hominis each were detected in 3.3% of the patients, while Isospora belli and Enterocytozoon bieneusi were each detected in 2.5% of the patients. The other parasites observed were Entamoeba histolytica/E. dispar in two cases and hookworm ova in one patient. Of the 36 patients who tested positive for intestinal parasites, 27 (75%) had diarrhea. The most common parasite, which was associated with diarrhea, was C. parvum. The present study highlights the importance of testing for intestinal parasites in patients who are HIV-positive, and emphasizes the necessity of increasing awareness among clinicians regarding the occurrence of these parasites in this population.

AIDS-Related Opportunistic Infections↗

Prevalence and etiology of intestinal parasites in Lebanon.

As there are no studies done on the prevalence of intestinal parasites in Lebanon since 1967, this study was undertaken to reveal the current patterns of intestinal parasitic infestations in Lebanese patients from two geographic regions: Beirut and Tripoli. Analysis was based on 33,253 stool specimens examined at the American University of Beirut Medical Center (AUH) and 11,611 specimens examined at the Islamic Hospital (IH) in Tripoli over five and three years, respectively. The prevalence of intestinal parasites at AUH and IH were 8.47% and 45.35%, respectively (overall 18%). The prevalence in males vs females was almost the same; being 8.23% vs 8.74%, and 44.67% vs 45.88%, at AUH and IH, respectively. Multiple infections were noted in 8.8% and 3.5% of stool specimens at AUH and IH, respectively. Although 18 different types of parasites were encountered, the most common pathogenic parasites found at AUH vs IH were: Giardia lamblia (20.7% vs 10.5% of parasites found), Entamoeba histolytica (19.41% vs 1.25%), Taenia spp. (6.03% vs 4.08%) and Ascaris lumbricoides (2.09% vs 46.97%). The overall yearly or monthly prevalence of parasites recovered from both hospitals did not show clear seasonal patterns. Compared to developed countries, Lebanon still suffers from a high prevalence and a wide spectrum of intestinal parasites.

Animals↗

Prevalence and intensity of intestinal parasitic infections in relation to nutritional status in Mexican schoolchildren.

Undernutrition and intestinal parasitic infections affect childhood development and morbidity in many developing countries. Undernutrition may increase susceptibility to parasitic infections which in turn impair the nutritional status of the host. The relationship between intestinal parasitic infections and nutritional status in 400 Mexican schoolchildren was investigated. More than half of the children in the study showed intestinal parasites and polyparasitism. The prevalence of helminth infections was significantly higher in Oaxaca than in Sinaloa (P < 0.05). Z scores for weight-for-age (WA) and height-for-age (HA) were much lower in children of Oaxaca than in Sinaloa (P < 0.001). A significantly higher Z score for weight-for-height (WH), WA, and HA were found in non-infected versus infected children (P < 0.05). Higher prevalences of intestinal infections were found in children with lower HA and WA than in normally nourished children (P < 0.05). Higher intensities of Ascaris lumbricoides and Trichuris trichiura were found in the schoolchildren of Sinaloa than in Oaxaca (P < 0.01). Negative and significant associations were found between Hymenolepis nana and T. trichiura infection (eggs per gram) and nutritional status. Intestinal parasitic infections may be regarded as main risk factors associated with poor nutritional status in Mexican schoolchildren.

Analysis of Variance↗

Prevalence of intestinal parasitic pathogens among HIV-positive individuals in Iran.

Parasites are important enteric pathogens among patients with human immunodeficiency virus (HIV) infection. There have been very few reports on the prevalence of intestinal parasites among such patients in Iran. To determine the prevalence of intestinal parasites among HIV-positive individuals, we collected single stool samples and analyzed them for detection of various intestinal parasites from 206 HIV-positive individuals with different immune status visited in different medical centers in Iran. The data were tested for statistical significance with chi(2) and Mann-Whitney U tests. The overall prevalence of intestinal parasites was 18.4% (95%CI: 13.7, 24.3). More specifically, the following parasites were identified: Giardia lamblia (7.3%), Blastocystis hominis (4.4%), Entamoeba coli (3.9%), and Cryptosporidium parvum (1.5%). Other parasites observed included Strongyloides stercoralis and Hymenolepis nana in two cases and Dicrocoelium dendriticum in one. Of the 38 patients who tested positive for intestinal parasites, 15 (39.2%) had diarrhea. Intestinal parasites were significantly more common among patients with diarrhea than those without (P < 0.001). Further, CD4 counts were significantly lower among individuals with diarrhea than those without (P < 0.001). This study highlights the importance of testing for intestinal parasites among Iranian HIV-positive patients, especially those with low immunity presenting with diarrhea.

Adult↗