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PubMed2001

[Dientamoeba fragilis and dientamoebiasis: aspects of clinical parasitology and laboratory diagnosis].

The flagellate Dientamoeba fragilis is a potential intestinal pathogen of humans. It is probably undervalued overall because its identification relies on permanent stains directly on fresh fecal specimens (Giemsa) or preserved in PVA or SAF (Trichrome or Iron-hematoxylin). During 1999 we processed stoll samples of 151 subjects and we searched also D. fragilis. We processed 105 cases of enteritis (82 children and 23 adults) and 46 samples of formed stools to investigate only for intestinal parasites (12 children and 34 adults). The microscopical observations were made on smears directly in saline solution, and after Dobell solution, MIF and Giemsa stained. Iron hematoxylin and trichrome stains were performed in some circumstances only. D. fragilis was observed in 11.3% of cases, 7.6% among the group of enteritis and 13.8% among the other subjects. These positive 17 cases were observed more often among adults (76.5% of cases) than among children (23.5%). In our study area D. fragilis seems more frequent than Giardia intestinalis and represents the third important intestinal parasite, following Enterobius vermicularis (children) and Strongyloides stercoralis (elders).

Adolescent↗
PubMed1980

Potential health hazards of the water resources development: a health survey in the Phitsanulok Irrigation Project, Nan River Basin, Northern Thailand.

A health survey was carried out among residents of 33 villages under the Phitsanulok Irrigation Project Area, Nan River Basin, Northern Thailand, whereby general health conditions were examined including intradermal tests for schistosomiasis japonica, stools for intestinal parasites and sera tested by circumoval precipitin test for antibodies to S. japonicum and by agglutination test for leptospiral infection. Health investigations revealed that 913 (60.9%) of 1,499 people examined had experienced gastro-intestinal disorders, 254 (17%) had poor oral hygiene and a few had mild anemia. 799 (62%) of 1,298 examined had intestinal parasites. Hookworm (45%) was most common, followed by Opisthorchis viverrini (20%), Entamoeba coli (10%), Ascaris lumbricoides (6%), intestinal flukes (2%), Enterobius vermicularis (1%) and Giardia lamblia (1%). 149 (10%) of 1,422 people gave positive skin reaction to crude S. japonicum antigen. Circumoval precipitin test was strongly positive in 7 (1.6%) persons out of 449 tested for schistosome infection and 6 (4.0%) out of 1,358 people were positive for leptospiral infection. The significant endemic diseases as potential health problems in this water resources development are discussed.

Adolescent↗
PubMed1999

Praziquantel side effects and efficacy related to Schistosoma mansoni egg loads and morbidity in primary school children in north-east Ethiopia.

A total of 611 Schistosoma mansoni infected primary school children from three schools in north-east Ethiopia were treated with praziquantel at 40 mg/kg body weight in a single dose. Pre-treatment, 40.4% had no presenting symptoms and 30-40% had nausea, abdominal cramps and/or bloody-mucoid diarrhoea. None of the pre-treatment symptoms was related to nutritional status, intensity of S. mansoni egg excretion, or to the presence of other concomitant intestinal parasitic infections. During the first 4-6 h post-treatment observation period, 90 (14.7%) children self-presented with severe gastro-intestinal symptoms. Children who self-presented with severe symptoms had a higher mean age and mean S. mansoni egg excretion compared with children who did not self-present. The following day a total of 529 (86.6%) children, including all who self-presented during the first 4-6 h post-treatment, reported for clinical check-up and were subjected to a structured questionnaire interview on symptoms they had experienced over the time lapse following treatment. Among these, 91.5% reported one or more treatment related symptoms which were at times severe. Abdominal cramps (86.9%), diarrhoea with blood and/or mucus (49.5%), dizziness (31.2%) and vomiting (24.9%) were the most common treatment related symptoms. Skin rash with oedema were observed in four cases. Among treatment related symptoms, the combination of abdominal cramps with vomiting, bloody diarrhoea, vomiting alone and general weakness were significantly higher among the malnourished. A proportion of these symptoms increased with increasing categories of S. mansoni egg excretion before and after adjusting for nutritional status and concurrent intestinal parasitic infections. Overall, the cure rate of praziquantel, among 541 children who had stool examination 5 weeks after treatment was 83.2% and this rate decreased with increasing pre-treatment egg counts. In conclusion, most of the treatment related symptoms were mild. However, some of the objective symptoms were at times severe and may reduce drug compliance in primary health care based population chemotherapy.

Animals↗
PubMed2002

Infectious diseases in sub-Saharan African immigrant children in Madrid, Spain.

BACKGROUND: Immigration flow from developing countries to European countries is growing continually, but data about imported infectious diseases in immigrant children are few. METHODS: Descriptive and retrospective study of 125 sub-Saharan African children <14 years of age attending a tropical medicine referral unit in Madrid, Spain, between 1989 and 2001. RESULTS: Of the 125 children 79% had 1 or more symptoms. The remaining 21% (26 cases) were asymptomatic and were screened for infectious diseases. Of them 57.7% (15 cases) had 1 or more infectious diseases. Significant association ( < 0.05) was found between fever and malaria, between cutaneous pruritus and filariasis and between eosinophilia and filariasis and intestinal helminthiasis. Seventy-nine percent had infectious pathology and 33.3% were infected by 3 or more agents. Fifty-six (44.8%) cases of malaria were diagnosed: 7 (12.5%) were asymptomatic; 43 (76.8%) were caused by and 5 (8.9%) were mixed malarial infections. Intestinal parasitic infection was diagnosed in 44 (49.4%) of the 89 cases investigated. No significant difference existed between gastrointestinal symptoms and the presence of intestinal parasites ( > 0.05). Thirty-nine (21.9%) cases of filariasis were diagnosed. Hepatitis B serology was performed in 75 children: 24 (32%) were cured hepatitis B (antibody-positive only); 5 (6.6%) were hepatitis B surface antigen-positive; and 1 of 59 cases (1.7%) was hepatitis C-positive. The prevalence of latent tuberculosis infection was 12.9% (7 of 54 purified protein derivative skin tests performed). CONCLUSIONS: The high infection rates of some diseases in immigrant children point to the need for screening sub-Saharan African children.

Adolescent↗
PubMed1982

Epidemiologic features of Strongyloides stercoralis infection in an endemic area of the United States.

The epidemiologic features of Strongyloides stercoralis infection in Kentucky were studied by an analysis of clinical cases at the University of Kentucky Medical Center (UKMC); by an analysis of parasitologic records of the Kentucky Bureau for Health Services (KBHS); and by a prospective stool survey of school children in Clay County, located in southeastern Kentucky, an area of the state previously found to be highly endemic for intestinal parasites. S. stercoralis was the most common parasitic infection diagnosed at UKMC. The patients were predominantly white male adults who were over 50 years old, had an associated chronic or debilitating medical illness, were of low socioeconomic background, and resided in southeastern Kentucky. S. stercoralis was a common parasitic infection at KBHS ad the patients showed a similar geographic distribution. Of 561 Clay County children surveyed, 23.7% harbored one or more intestinal parasite pathogens and 3.0% had S. stercoralis. Thus, S. stercoralis remains highly endemic in Kentucky and may cause disease even in geriatric patients.

Adolescent↗
PubMed1991

Intestinal helminths in lowland South American Indians: some evolutionary interpretations.

Data on intestinal parasite infections for South American Indians in prehistoric times as revealed by coprolite analysis are being used to support transoceanic migration routes from the Old World to the New World. These same findings on modern semi-isolated aborigines, considered persisting prehistoric patterns, are also of great importance as indicators of pre-Columbian peopling of South America. This is the case for the Lengua Indians from Paraguay, studied in the 1920s, and the Yanomami and the Salumã from Brazil, studied in the 1980s. The intestinal parasitic profile of these groups can be empirically associated with culture change, but no clear correlations with the population biology of their hosts can be made at present because of scarcity of data.

Biological Evolution↗
PubMed1980

Serum and plasma zinc, copper and iron concentrations in Aboriginal communities of North Western Australia.

Two aboriginal communities situated in the tropical north-west of the Australian continent have been investigated in regard to trace metal status (zinc, copper, and iron) and other laboratory and epidemiological information. A total of 364 persons, ranging in age from 5 to 77 years were studied. The incidence of hypozincemia (serum or plasma zinc concentration less than 0.71 micrograms/ml) of the two communities when combined was 24.4%, while hypercupremia (defined as serum or plasma copper levels greater than 1.38 micrograms/ml) was 47.9%. Depressed serum iron levels were demonstrated in more than 50% of the Aborigines studied. Hypozincemia was most prevalent (incidence 31 to 67%) in children at the time of the important pre- and postadolescent growth period (10 to 15 years) and in women beyond 60 years of age (incidence 33 to 64%). Serum total protein and vitamin B12 levels tended to be increased. Mild anemia was seen in approximately one in five persons aged less than 20 years. Intestinal parasites and pathogenic enterobacteria were frequently isolated in fecal specimens. In one community, half of the persons examined had positive isolates of enteric pathogens. Intestinal parasites predominated and were more frequently isolated from persons aged less than 20 years. Ancylostoma duodenale accounted for 32% of the pathogens isolated. Evidence is presented that suggests that both communities are exposed to numerous bacterial, viral, and parasitic infections. The diet consumed in these communities is predominately white flour and refined sugar. Geophagia is practiced in this area of Australia. It is emphasied that all the etiological prerequisites and many of the laboratory findings ascribed to the zinc deficiency syndrome appear to be operating in the two Aboriginal communities studied.

Adolescent↗
PubMedDate not supplied

The health of children adopted from Romania.

OBJECTIVE: To determine the medical condition of Romanian adoptees and the effects of the Romanian orphanage system on their health. DESIGN: Case series. SETTING: The international adoption clinics at the University of Minnesota, Minneapolis, and the New England Medical Center, Tufts University, Boston, Mass. PARTICIPANTS: Sixty-five Romanian adoptees who were brought to the United States during a 12-month period beginning in October 1990. MAIN OUTCOME MEASURES: Incidence of hepatitis B, intestinal parasites, tuberculosis, syphilis, human immunodeficiency virus type 1, growth failure, and developmental delay. RESULTS: Although the adopted children were presumably chosen from the most vital and attractive adoptees, only 15% were judged to be physically healthy and developmentally normal. Fifty-three percent had serological evidence of past or present hepatitis B infection, and 20% of screened children tested positive for hepatitis B surface antigen. In children aged 7 months or older, the overall prevalence of chronic hepatitis B was 23%. Intestinal parasites were found in 33% of subjects, and 45% of infected children had two or more pathogens identified. All the children tested for human immunodeficiency virus type 1 were negative. Two patterns of growth failure were observed that resembled the two subtypes of psychosocial short stature that occur in association with prolonged psychological harassment or emotional deprivation. Infants' length, weight, head circumference, and weight-for-height were adversely affected by institutionalization. Older children's height was reduced. Only 10% of children older than 12 months were developmentally normal. CONCLUSION: Romanian adoptees are an extraordinarily high-risk pediatric group as a consequences of decades of government-sanctioned child neglect and abuse.

Adoption↗
PubMedDate not supplied

[Subclinical coccidiosis in broilers and pullets].

In the period from 1985 to 1987, 24 broiler crops (12 houses; one integration and 3 farms) and 9 pullet flocks (9 houses, 4 farms) were examined for parasites. Intestinal lesion scores and the number of parasites in the intestinal lumen (semiquantitative estimation) were recorded, and the Eimeria species determined when possible (broilers crops: 3rd and 5th week, pullet flocks 4th, 8th, 12th and 18th week). Additionally, the quantity of parasites in litter or faecal samples was examined in regular intervals. Clues for economic damage were only found in broiler crops with increased numbers of coccidial oocysts per gram litter in the 5th week of the fattening period. Eimeria tenella and E. acervulina were the dominating species in broiler chickens and also pullets, E. maxima oocysts however were only casual findings. No ectoparasites, helminths or other protozoa than Eimeria were observed. With regard to the intestinal lesions and the quantities of parasites in the intestine no significant differences were seen when comparing selected broiler chicks and birds taken at random. In pullet flocks the examination of random samples was the superior method, because only freshly dead bodies, collected in insufficient numbers, were suitable for diagnostics. In 3 broiler crops and one flock of replacement pullets kept on a wired floor no Eimeria were diagnosed.

Animals↗
PubMed2004

[Basic sanitary conditions in Iporanga, São Paulo State, Brazil].

OBJECTIVE: To assess the pollution of water bodies by domestic sewage and to evaluate the basic sanitation conditions of residences and the knowledge of the local population concerning intestinal parasitic diseases and the hazards they present to public health. METHODS: Thirteen water samples were collected from each of four sites in different water bodies of the Bairro da Serra region, in Iporanga, São Paulo State. Rates of total and fecal coliforms were measured and median values were presented so as to show domestic sewage contamination in the area. Questionnaires were administered to 50% of local households in order to obtain information on water supply and disposal of domestic sewage and solid waste, and to evaluate knowledge of the transmission, health hazards, and prevention of intestinal parasitic diseases among the local population. RESULTS: The Betari river showed microbiological indexes indicative of pollution by domestic sewage. Higher levels were verified both upstream and downstream from the Bairro da Serra. Median values were even higher in two of the river's tributary streams, indicating strong pollution by domestic sewage and lack of conformity with current legislation. In 91% of the households investigated, sewage disposal was done by means of septic tanks, most of which were rudimentary and contributed to the contamination of the environment. The knowledge of 62% of interviewed subjects concerning the transmission of helminthic diseases was considered as poor. CONCLUSIONS: Our results indicate a risk of proliferation of intestinal parasitoses and of other water-transmitted diseases, an issue which is aggravated by increases in population caused by the region's vocation for ecotourism.

Brazil↗
PubMed1999

Ascaris-Trichuris association and malnutrition in Brazilian children.

This work was designed to evaluate the role of intestinal parasites on nutritional status in three rural areas of Brazil. A total of 520 children aged 1-12 years were studied through a questionnaire concerning housing, socio-economic conditions and a 24-h food intake recall. Measurements of weight and height were also performed, and three stool samples were collected on consecutive days for parasitological analysis. Scores of the standard deviation (z-scores) for the weight-for-height and height-for-age were used to characterise the growth profile. A high prevalence of intestinal parasites was detected, with Giardia lamblia (44%), Endolimax nana (43%), Ascaris lumbricoides (41%) and Trichuris trichiura (40%) being the most prevalent. Eleven per cent of the children were classified as showing stunting. Inadequate daily caloric intake was observed in 78% of the population and the proportion of those with inadequate protein intake was 34%. Logistic regression analysis was employed for the multivariate study. Stunting was significantly associated with estimators of low economic income, inadequate protein intake and polyparasitism, especially the association between Ascaris lumbricoides and Trichuris trichiura.

Analysis of Variance↗
PubMed2002

[Prevalence of intestinal nematodes in dogs from Warsaw region].

Prevalence of intestinal nematodes in dogs from Warsaw region. Investigation of prevalence of intestinal parasites in dogs have been conducted in order to protect human and animal health. The aim of the study was to establish species composition of intestinal parasites and to evaluate their prevalence in dogs from the shelter in Józefów situated on north from Warsaw. Additionally, urban dogs from Warsaw and village dogs from areas near the shelter, were examined. The prevalence of nematodes was: 62.3% in dogs from shelter, 37.5% in village dogs and 18.8% in urban dogs. In homeless dogs, the most common parasite was Uncinaria stenocephala, then Trichuris vulpis and Toxascaris leonina. In village dogs only eggs of U. stenocephala were detected; in urban dogs Toxocara canis and U. stenocephala were found.

Animals↗
PubMed1995

[Routines for infection testing and vaccination against hepatitis B among applicants for asylum. A questionnaire study among health personnel responsible for reception of asylum applicants].

The authors performed a questionnaire survey to investigate the current routines for screening applicants for asylum for hepatitis B virus, HIV and intestinal parasites, and for vaccination against hepatitis B. The response rate was 82% (n = 80). Of the respondents, 58% were physicians, 23% public health nurses and 18% nurses. Without regard to country of origin of the applicant 71% of the health personnel usually offer an HIV-test and 77% an HBsAg-test. Few differentiated their testing routines according to country of origin. Many agreed that an HIV-test (49%) and an HBsAg-test (65%) ought to be made compulsory. 26% usually offer vaccination against hepatitis B, while 54% do so if the person concerned is an infant. Routine screening for intestinal parasites was reported by 27% of the health personnel, but more than half (54%) take only one sample from each patient. Health control of applicants for asylum provides a good opportunity to give information about the transmission of hepatitis B and HIV, preventive measures, and testing.

Adult↗
PubMed2004

[Comparative study of infectious diseases in immigrant children from various countries].

INTRODUCTION: Immigrants have a higher risk of contracting some infectious diseases. The aim of this study was to determine and compare the morbidity profile of immigrant children according to their country of origin. MATERIAL AND METHODS: We performed a descriptive study of all immigrants aged less than 14 years old who attended the Tropical Medicine Unit of the Ramon y Cajal Hospital in Madrid between 1989 and 2001. RESULTS: A total of 170 children were included (73 % from Africa, 19 % from Latin America, and 5 % from Asia). Seventy-five percent had at least one infectious disease (78 % of Africans and 62 % of Latin Americans) and 27 % were co-infected (> 2 pathogenic agents). The proportion of healthy children was higher (p < 0.05) among Latin Americans (21 %) than among Africans (9 %). The most frequent infectious diseases were malaria (35 %), intestinal parasites (48 %), filariasis (23 %), and viral hepatitis (19 %). Malaria, filariasis and hepatitis were more frequent in Africans than in Americans (p < 0.05). Other helminthic infections (15 %) were more frequent in Americans. In both groups intestinal parasites and tuberculosis (6 %) were prevalent. Of the 36 (21 %) asymptomatic children, 53 % had at least one infectious disease. The most frequently diagnosed diseases in Africans were intestinal parasitosis (35 %), malaria (7 %), cured hepatitis B (15 %), filariasis (12 %) and superficial mycosis (4 %). The most frequent infectious diseases in Latin Americans were intestinal parasitosis (38 %) and visceral toxocariasis (25 %). CONCLUSIONS: Infectious diseases and co-infections are frequent in immigrant children, even in those who are asymptomatic. We propose screening of certain infectious diseases in these children according to their country of origin and their length of residence in Spain.

Adolescent↗
PubMed2003

[Estacionalidad de parásitos intestinales en suelos periurbanos de la ciudad de Neuquén, Patagonia, Argentina].

OBJECTIVE: To determine the presence of eggs, larva, cysts and oocysts of intestinal parasites in the soil of a suburb of Neuquén city during 1 year in order to evaluate their seasonal fluctuations in relation to climatic data and soil characteristics in the studied area. METHODS: A total of 107 soil samples were processed for parasite isolation by sedimentation and flotation methods during the four seasons of the year. Meteorological data were registered and physical, chemical and structural characteristics of the soil were analysed. RESULTS: About 28.9% of the soil samples were positive for at least one parasite form. Six protozoa species (cysts of Entamoeba sp., Enteromonas sp., Endolimax sp., Giardia sp., Iodamoeba sp. and coccidia oocysts) were recovered, but neither larvae nor eggs of human or animal helminths parasites were detected. The percentage of contaminated soil samples and the diversity of species showed a marked decrease in the warm and dry months of the summer. The soil was sandy, without vegetable cover, well drained, and with scarce organic matter content. CONCLUSION: The frequencies of parasite recovery and the number of species show seasonal fluctuations related to the rainfall. The importance of soil as a risk factor for the transmission of intestinal parasites in the studied area is conditioned by its structural characteristics, which prevent retaining the humidity, and by climatic variables. The interrelation of both factors determines unfavourable conditions that could explain the low level of contamination observed in soil as well as the absence of eggs and helminth larvae.

Animals↗
PubMedDate not supplied

Relationship between protein-energy malnutrition, vitamin A, and parasitoses in living in Brasília.

It is still controversial whether intestinal parasitic infections can influence the nutritional status of children. The relationship between protein-energy malnutrition, vitamin A and parasitic infections was evaluated in 124 children. The food intake estimated by recall method was generally low and poor. Seventy five percent of the children were infected with intestinal parasites. The mean+/-SD weight-for-age and height-for-age Z-score were skewed one standard deviation to the left, when compared to normal standards. An association was found between protein-energy malnutrition and Giardia lamblia, but not with Ascaris lumbricoides or Hymenolepis nana infection. Only Giardia-infected children had a decreased weight-for-age and weight-for-height Z-score. Hypovitaminosis A was a major nutritional problem, but no relationship between this deficiency and parasitic infection was found. Our data indicate that low and poor food intake were the major cause of protein-energy malnutrition among the children, and except for Giardia, this was not influenced by parasitic infections.

Brazil↗
PubMedDate not supplied

[Blind treatment or treatment oriented to intestinal parasitoses in a Parisian health center for refugees].

The Comede health care center for political refugees received 4,414 first arrivals from 70 African, Asian and South American countries in 1989. Many arrived from areas where intestinal parasitic infections are endemic, and where infections by nematodes (Ancyclostoma duodenale, Necator americanus, Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis), trematodes (Schistosoma hematobium, Schistosoma stercoralis) and protozoa (Entamoeba coli) cause significant morbidity. The question that arises is whether we should screen stools and urine only in the case of African refugees, or treat all refugees empirically (mass treatment program). We carried out a retrospective study of 1,425 patients seen for the first time in the Comede from August 1, 1989 to December 31, 1989. Three-quarters of the subjects were men and the mean age was 29 years. 63.2% of the subjects were from 28 African countries, 18.6% from 8 Asian countries, 10% from 5 South American countries and the West Indies, and 6.4% from 4 countries of the Mediterranean basin. 4 countries of the Mediterranean basin. All the subjects were asked to provide stool and urine specimens at the Paris City Laboratory, which were examined using the merthiolate iodo formol direct methods, two concentration methods (MIF and Kato) and Baermann's technique. Patients with infestations were prescribed appropriate treatment at a second visit, compliance with which was good (86%). The prevalence of intestinal parasite infections was 60%. Albendazole was given to 44% of patients, while 45% of African patients were given praziquantel and 2.7% tinidazole.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗