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Vitamin B12 and folic acid in children with intestinal parasitic infection.

OBJECTIVE: To determine prospectively plasma levels of vitamin B12 and folic acid in children with intestinal parasitic infection before and three months after antiparasitic treatment. METHODS: 3036 stool samples were collected from 1959 children and 939 cello-tape anal swabs were taken from 688 children for intestinal parasite investigation. Of these, 155 children were identified as having a parasitic infection; however, only 86 were followed up during this study: 26 children with Giardia lamblia infection were treated with tinidazole and metronidazole, pyrantel pamoate was used in the treatment of 40 children with Enterobius vermicularis, and 20 patients infected with Cryptosporidium parvum received only symptomatic treatment. Vitamin B12 and folic acid levels were measured by radioimmunoassay, before and three months after the completion of treatment. RESULTS: Vitamin B12 serum concentrations did not show any significant differences among the three groups. There was a significant increase in vitamin B12 serum concentrations after three months of anti-parasitic treatment (630.57+/-200.97 vs. 667.97+/-181.55 pg/dL, p = 0.002, n = 86). Paired analysis in each group showed only significant increases for vitamin B12 in the Giardia lamblia group and in the Enterobius vermicularis group. No statistically significant differences were found for folic acid serum concentrations before and three months after treatment. CONCLUSIONS: Patients with symptomatic infection by Giardia lamblia and Enterobius vermicularis have lower vitamin B12 levels than asymptomatic patients. This could reflect a more affected intestinal mucous. These results could present the opportunity to treat these parasitic infections and to use vitamin B12 supplementation in symptomatic children with Giardia lamblia and Enterobius vermicularis infection.

Adolescent↗

Intestinal parasitism in Malayan aborigines (Orang Asli).

Surveys were conducted in the southern Malay peninsula to assess intestinal parasitism in the aboriginal ethnic minority groups. Faecal specimens from 1 273 persons were examined by the thiomersal-iodine-formol direct-smear technique. Prevalences are reported and, for helminth infections, data on worm burdens. The state of sanitation in each of 9 cultural-ecological groups was assessed by means of a simplified system of scoring for variables. Particular attention was paid to relationships between cultural and ecological factors, sanitation, and observed patterns of intestinal parasitism. The author also discusses the fact that the number of parasitic species diminishes in habitats simplified by man, whereas an increase occurs in the prevalence and intensity of the more adaptable species that persist in ecosystems of low complexity.

Adolescent↗

Effects of treatment for intestinal parasites and malaria on the cognitive abilities of schoolchildren in Zaire, Africa.

Ninety-seven Zairian schoolchildren were evaluated for cognitive ability, health status, and quality of home environment. Children successfully treated for serious types of chronic intestinal parasites demonstrated significant improvements in K-ABC Spatial Memory, supporting this task as one of the more sensitive measures to changes in general health and neurological integrity. These findings were not obtained for successful treatment of low-grade malaria infection. Children initially negative for intestinal parasites tended to come from more economically and socially favorable home environments. They also demonstrated more dramatic improvements in visual-spatial analysis tasks. The implication is that the home environment factors conducive to chronic infestation with intestinal parasites are markers for favorability of the developmental milieu affecting long-term intellectual development.

Anemia↗

Intestinal parasitism in the Xavánte Indians, central Brazil.

This paper reports the findings of a survey for intestinal parasites among the Xavánte Indians from Central Brazil. A. lumbricoides (25.0%) and hookworms (33.6%) were the two most common helminths; E. histolytica complex (7.8%) and G. lamblia (8.6%) the most common protozoans. The majority (58.5%) of positive individuals hosted only one species of helminth. Egg counts for helminths, and for A. lumbricoides in particular, were found to be not dispersed at random, with a few individuals, all of whom young children, showing very high counts. The prevalence rates of intestinal parasites for the Xavánte are below those reported for other Amerindian populations from Brazil.

Adolescent↗

Intestinal parasitic infections, with a special emphasis on cryptosporidiosis, in Amerindians from western Venezuela.

The prevalences of intestinal parasites and intensities of helminth infections were studied in two Amerindian villages in Venezuela. Single stool specimens were collected from 303 individuals from Saimadoyi and 130 from Campo Rosario. Wet mounts, iron-hematoxylin-stained smears, and formalin-ether concentrates were examined for the presence of parasites; modified Ziehl-Neelsen carbol-fuchsin staining of 10% formalin-preserved stool was used to identify Cryptosporidium parvum. Helminth ova counts were made using the standard smear egg count technique. Mixed infections (Campo Rosario = 69.9%, Saimadoyi = 71.6%) were frequent. Overall infection rates with one or more species (Campo Rosario = 79.2%, Saimadoyi = 95.4%; P < 0.01) and with any protozoans (Campo Rosario = 60.8%, Saimadoyi = 72.3%; P < 0.05) were high and predominant (P < 0.05) in Saimadoyi. Cryptosporidiosis was identified in 38 subjects (8.8%) in both villages; 60.6% were asymptomatic carriers. The mean egg counts of helminths were heavier in Campo Rosario (P < 0.05), which was probably due to the drastic reduction of their lands along with their low standard of living. This study documents the change of intestinal parasitism pattern and deterioration of the health of Amerindians by the process of acculturation.

Age Factors↗

Survey of intestinal parasites in pigs from intensive farms in Guangdong Province, People's Republic of China.

The prevalence of intestinal parasites was investigated in intensive pig farms in Guangdong Province, China between July 2000 and July 2002. Faecal samples from 3636 pigs (both sexes and five age groups) from 38 representative intensive pig farms employing different parasite control strategies were examined for the presence of helminth ova and protozoan oocysts, cysts and/or trophozoites using standard techniques. Of the 3636 pigs sampled, 209 (5.7%) were infected with Trichuris suis, 189 (5.2%) with Ascaris, 91 (2.5%) with Oesophagostomum spp., 905 (24.9%) with coccidia (Eimeria spp. and/or Isospora suis) and 1716 (47.2%) with Balantidium coli. These infected pigs were mainly from farms without a strategic anti-parasite treatment regime. Concurrent infection of multiple parasites was common, and T. suis was the most common nematode infecting breeding, young and mature pigs. The results of the present investigation provide relevant 'base-line' data for assessing the effectiveness of control strategies against intestinal parasitism in intensively raised pigs in Guangdong Province, China.

Animals↗

[Prevalence of intestinal parasites in a student population].

OBJECTIVE: We performed a transversal descriptive study to know the prevalence of intestinal parasites of our children's community. A 891 fecal sample analyzed from an equal number of apparently healthy children, whose ages were between 5-14 years old, randomly selected by stratified sampling by years old. RESULTS: The study included 297 children of which 133 were parasitized. The percentage of parasitization obtained was of 44.78%; no differences with regard to sex. The 16.53% was poly-parasitic. The mean age of the parasitized subjects was 9.3 years old. The species encountered by decreasing frequency were: Giardia lamblia (36.36%), Entamoeba coli (10.43%), Entamoeba hartmanni (2.02%), Endolimax nana (1.34%), Enterobius vermicularis (1.34%), Ascaris lumbricoides (0.67%) and Trichuris trichiura (0.67%). CONCLUSIONS: The frequency of intestinal parasites is high in school-age children, probably due to the mid-low to low socioeconomic level to which this age-group belongs. The most-found parasite was Giardia lamblia. Significant differences (p <0.001) were only seen between the mean ages of parasitized subjects of Giardia and Entamoeba coli.

Adolescent↗

Intestinal parasitic infection among sewage workers in Alexandria, Egypt.

This research was conducted to study the risk of intestinal parasitic infections among sewage workers. A hundred sewage workers in Alexandria and another hundred as control group not exposed to sewage were selected for this research. The results indicated that sewage workers were at a higher risk of developing intestinal parasitic infection especially Ascariasis and Amoebiasis. Nail examination revealed that sewage workers were at a higher risk of infection by Entrobius vermicularis.

Egypt↗

Association between intestinal parasitic infections and type of sanitation system in rural El Salvador.

OBJECTIVE: To identify demographic, behavioural and environmental determinants of intestinal parasitic infection, evaluate the impact of a variety of dry sanitation systems on intestinal parasitic infection, and evaluate the safety of using stored biosolids in agriculture in order to guide future sanitation interventions in rural areas of El Salvador. METHODS: Interviews were conducted with 109 households in eight communities where double-vaulted and solar urine-diverting desiccating latrines, pit latrines or no latrines were used. Faecal samples from 499 individuals were tested for enteric helminths and protozoa. RESULTS: Users of solar desiccating latrines had the lowest prevalence of enteric parasite infection. Double-vault, urine-diverting desiccating latrines effectively reduced the transmission of some pathogens, but may not achieve the conditions sufficient for the complete destruction of the more environmentally persistent pathogens, Ascaris lumbricoides and Trichuris trichiura. Contact with inadequately treated latrine biosolids was associated with an increased risk of Ascaris infection. CONCLUSIONS: Solar latrines were associated with the overall lowest prevalence of enteric parasitic infections. Members of households where latrine biosolids were used in agriculture had a higher prevalence of infection than those where biosolids were buried. We therefore recommend the promotion of solar latrines in rural areas of El Salvador over other dry sanitation systems, and recommend that stored biosolids not be used in agriculture.

Adolescent↗

Opportunistic intestinal parasites among children with chronic liver disease.

Two hundred children were included in this study, 80 patients showing clinical and/or biochemical evidence of chronic liver disease, 80 immuno-compromised children due to causes other than chronic liver disease and 40 healthy control. All were subjected to detailed history, thorough clinical examination, investigated by liver function tests and stool examination by special techniques for opportunistic intestinal parasites. Autoimmune chronic hepatitis represented 12.5% of cases with chronic liver disease, hepatic schistosomiasis 30%, congenital cholestasis 25%, chronic viral hepatitis 20% and metabolic liver diseases 12.5%. The incidence of opportunistic intestinal parasites with chronic liver disease (92.5%) was nearly similar to the immuno-compromised ones (90%) and significantly higher than controls (30%). Mixed infection was not detected in controls while 57.5% of patients with chronic liver disease and 35% of immuno-compromised were infected by 2 parasites and 12.5% of each group was infected by more parasites. The commonest parasites were G. lamblia, E. histolytica and C. parvum but no Strongyloides stercoralis was detected. Children with chronic liver disease can be considered immuno-compromised and are liable to infection by opportunistic intestinal parasites.

Adolescent↗

Relationship of intestinal parasitism, malaria and under-nutrition to prevalence of anaemia in an urban community.

The presence of intestinal parasitic infection, malaria and under-nutrition in relation to prevalence of anaemia was evaluated in a cluster of urban population in Hyderabad. Prevalence of anaemia was 25.7 per cent by clinical assessment from pallor as against 80.5 per cent by estimation of haemoglobin concentration. Presence of intestinal parasitic infection (48.4 per cent) and malaria infection (18.3 per cent) had no statistical significant association with anaemic state. Under-nutrition (31.9 per cent of anaemic individuals) and low per capita monthly income of Rs. 100 and below (60.9 per cent of enaemic individuals) had a statistically significant relationship to anaemia. Clinical assessment of anaemia from pallor had a low sensitivity (31.9 per cent) and a high false negative rate (54.9 per cent), though clinical pallor had a strong statistical association to the presence of anaemia. (p less than 10.01), (Q = 1.0).

Anemia↗

[Prevalence of intestinal parasites in children of Yukpa Ethnia in Toromo, Zulia State, Venezuela].

BACKGROUND: Yupkpa community in Perijá Sierra does not have drinking water or sewage elimination systems. Thus it becomes a propitious place for infection with intestinal parasites. AIM: To determine the prevalence of intestinal parasites in children, ages 0 to 14 years, in the Yukpa ethnic population of Toromo in the Perijá Mountains, Zulia State, Venezuela. MATERIAL AND METHODS: Ninety one fecal samples were analyzed by the following coproparasitologic methods: saline solution and lugol fresh mount, formalin-ether concentration (Ritchie), and Kinyoun stain for intestinal coccidians. RESULTS: Overall parasite infection prevalence was 83.5%. The most frequently observed parasites were: Ascaris lumbricoides (57.1%), Trichuris trichiura (20.8%), Hymenolepis nana (14.2%), Blastocystis hominis (51.6%), Giardia lamblia (30.7%), and Entamoeba histolytica/E. dispar complex (21.9%). Coccidians were nont observed in any of the stool samples. CONCLUSIONS: The large number of infected people is directly related to the hygienic and sanitary conditions of the population studied.

Adolescent↗

Field and laboratory investigations into the role of the Musca species in the transmission of intestinal parasitic cysts and eggs in Nigeria.

Houseflies caught on refuse dumps in six areas of Ibadan were dissected and the intestinal parasitic cysts and eggs which were found in their alimentary canal were similar to those found in the examined faeces of the community living in the environment. Strongly eggs were also found in the alimentary canal of Musca species which had fed on the faeces of an infected sheep. While the houseflies caught in the living quarters the high income group were free of parasites, some of these caught in and around low income group residential areas possessed various parasitic eggs and cysts. Musca domestica specimens were exposed in the laboratory to eggs of three intestinal parasites. Their ability to transmit these eggs by regurgitation was highest within 1/2 hour of ingestion and it decreased with time until it was lost after 2 hours.

Animals↗

Malaria, intestinal parasites, and schistosomiasis among Barawan Somali refugees resettling to the United States: a strategy to reduce morbidity and decrease the risk of imported infections.

In 1997, enhanced health assessments were performed for 390 (10%) of approximately 4,000 Barawan refugees resettling to the United States. Of the refugees who received enhanced assessments, 26 (7%) had malaria parasitemia and 128 (38%) had intestinal parasites, while only 2 (2%) had Schistosoma haematobium eggs in the urine. Mass therapy for malaria (a single oral dose of 25 mg/kg of sulfadoxine-pyrimethamine) was given to all Barawan refugees 1-2 days before resettlement. Refugees >2 years of age and nonpregnant women received a single oral dose of 600 mg albendazole for intestinal parasite therapy. If mass therapy had not been provided, upon arrival in the United States an estimated 280 (7%) refugees would have had malaria infections and 1,500 (38%) would have had intestinal parasites. We conclude that enhanced health assessments provided rapid on-site assessment of parasite prevalence and helped decrease morbidity among Barawan refugees, as well as, the risk of imported infections.

Adolescent↗

Intestinal parasites in relation to haemoglobin level and nutritional status of school children in Gaza.

The prevalence of intestinal parasites and their relations to anaemia and nutritional status among school children aged 6-11 years in Gaza was studied. The target area is overcrowded with improper sewage disposal system and low socioeconomic levels. Anaemia was assessed by haemoglobin level (Hb) and nutritional status by anthropometric measurements including weight for age (WA), weight for height (WH) and height for age (HA). Intestinal parasites were found to be prevalent in Gaza. The overall prevalence was 24.5%. Giardia lamblia (62.2%) was the most common parasite detected particularly in age group 6-7 years, followed by Ascaris Iumbricoides (20.0%), then Entamoeba histolytica (18.0%). Parasitosis was generally declining with older age groups for both sexes. In general, the prevalence of anaemia was more common in the younger children. Malnutrition was found to be prevalent among children. Infected children of age group 8-9 years showed higher incidence of low WA than non infected ones. The prevalence of stunting and wasting among infected children of the youngest group was greater than that observed for controls. Regarding sex, no specific trend that relates the prevalence of anaemia with sex. Malnutrition was more prevalent among females than males.

Child↗

Intestinal parasites in Central American immigrants in the United States.

We describe the results of ova and parasite examinations of 216 Central Americans who were seen at a Los Angeles, Calif, clinic during an 8-month period. Among the 125 immigrants from Central America, intestinal parasitic prevalence was 53%. Pathogens were found in 45% and multiple pathogens in 21%. Of the 91 US born Central American children, parasite prevalence was 14%. Pathogens were found in 12%. The most common pathogens were Trichuris trichiura, Giardia lamblia, and Ascaris lumbricoides. Giardia lamblia was more prevalent in the younger than 5-year-old age group, and helminths were more prevalent in the 6- to 10-year-old age group. No helminths were found in immigrants who had been in the US for more than 3 years. Gastrointestinal symptoms did not correlate with prevalence of parasites. The high prevalence of intestinal parasites supports previous recommendations for screening; decisions for screening should be based on morbidity (probably low), efficacy and safety of treatment (good), and costs.

Adolescent↗

Intestinal parasites in healthy subjects in Albania.

The purpose of this study was to evaluate the prevalence of intestinal parasites in 277 healthy subjects in the city of Mamuras (Albania, South Eastern Europe) and the correlation between parasitic infections and possible risk factors. Faecal samples collected with sodium-acetate-formalin fixative were concentrated by formalin ethylacetate sedimentation and examined as wet mounts, permanent stains and by anti-Giardia/Cryptosporidium fluorescent antibodies. Data concerning age, sex, level of education, availability of piped water, number of people living in the same house, and residence in rural or urban area were collected for each subject. Statistical analysis was performed by chi-square test and regression logistic analysis. The overall prevalence of intestinal parasites was 183/277 (66.06%). In particular, pathogenic protozoa or helminths were found in 67 subjects (24.18%), including Trichuris trichiura in 34 (12.27%), Giardia duodenalis in 31 (11.19%), Hymenolepis nana in 5 (1.8%), Ascaris lumbricoides in 3 (1.08%). A significant correlation was observed only between parasite colonization and older age and between Trichuris trichiura infection and residence in rural areas.

Adolescent↗