Risk factors for epilepsy in rural Lao PDR: a case-control study.

The objective of this study was to assess the major etiologic categories of epilepsy in a rural district of the Lao PDR. Thirty-one newly identified patients with confirmed active epilepsy were compared with 124 controls, matched for gender, age and village residence. Risk factors for epilepsy were investigated with particular focus on cysticercosis serology. A history of head trauma (OR=4.7, p=0.05), family history of epilepsy (OR=12.8, p=0.03), and the use of human feces to fertilize domestic vegetable gardens (OR=4.9, p=0.04) were significantly associated with epilepsy. The study did not confirm any direct relation between epilepsy and cysticercosis serology. The cysticercosis seroprevalence was nil in the epilepsy group. This is the first study in the Lao PDR on epilepsy risk factors representing important data for the subregion. Parasitic, environmental, and behavioral factors of this traditional population deserve further studies to explain the missing link between epilepsy and cysticercosis.

Intestinal parasites in school-aged children in villages bordering Tonle Sap Lake, Cambodia.

The objective of this study was to study Schistosoma mekongi and other intestinal parasitic infections, and intestinal symptoms and related complaints among school-age children and adolescents living around Tonle Sap Lake. Villages were selected where there were potential signs of schistosomiasis (hepatomegaly), and where subjects complained of intestinal symptoms. Stool samples were collected from 1,616 children and were examined by Kato-Katz, SAF concentration, and Baermann technique; short clinical examinations were also performed. No S. mekongi infection was detected, although a high level of intense human water contacts was reported. Helminth infection such as Ascaris lumbricoides (27.7%) and hookworms (29.7%) were common. Trichuris trichiura 4.4%), Hymenolepis nana (6.2%), Giardia lamblia (4.2%), and Entamoeba spp (14.4%) were also recorded. Strongyloides stercoralis was frequently diagnosed (20.2%). It was concluded that it is unlikely that S. mekongi is transmitted in Tonle Sap Lake. However, other intestinal parasitic infections are widespread. In particular, S. stercoralis should be considered an important etiologic agent in children and adolescents with abdominal complaints.

Bladder stones in childhood: a descriptive study in a rural setting in Saravan Province, Lao PDR.

The aim of the study was to describe clinical cases of childhood bladder stones and associated risk factors. Forty children (9 girls), aged 1-14-years old, (means 4.7 +/- 0.5 years), who underwent surgical stone removal in the Saravane Provincial Hospital during a 13-month period, were included. Bladder stone removal accounted for 55% of all surgical procedures performed on children. Most frequent symptoms were impaired micturition (97%) and acute urinary retention (32%). Body mass index was low, at < 18.5 in 92% of all cases, indicating serious associated malnutrition. Parental interviews disclosed a history of recent episodes of diarrhea (> 3 episodes in the previous year), recurrent urinary tract infection, and familial urolithiasis, in 60, 32, and 27% of patients, respectively. All children had been or were being breastfed, but 72% of the mothers introduced white rice into their children' diet as early as the first week of life, while 85% of them used to vary the food regimen (introducing meat, fish, fruit and vegetables) only after 1 year of age. This preliminary study suggests that the morbidity and social cost of childhood bladder stones may be high. A larger scale prospective and comparative study assessing their incidence and associated nutritional factors is warranted and feasible, and may lead to preventive measures.