Parásitos intestinales en una comunidad Amerindia, Costa Rica / Intestinal parasites in an Amerindian community

In Costa Rica there were three national surveys of intestinal parasitism (1966, 1982, and 1996) that showed dramatic reduction of the prevalence of Trichuris, Ascaris, and Necator/Ancylostoma (hookworms); however, these nematodes persist with high prevalence in low socio-economically groups, as the squatter settlements around the cities; however, it is possible that pour Amerindian communities with substandard housing condition also suffer the burden of intestinal parasites. For this reason, the present study was planted in a rural disperse Amerindian community from the South of Costa Rica. 45 fecal samples were collected from children under 15 years old, and were processed according a modification of the Baermann method, which also permits the observation of other parasites beyond Strongyloides. 38 (84 percent) of the analyzed samples were positive for at least one parasite. The prevalence for nematodes was Ascaris (36 percent), hookworms (22 percent) Enterobius (4 percent), and Trichuris (2 percent). For protozoa was Endolimax nana (33 percent), Entamoeba coli (27 percent), and Entamoeba histolytica/dispar (11 percent). These data are the reflect of the inadequate sanitation conditions of this community.

In Costa Rica there were three national surveys of intestinal parasitism (1966, 1982, and 1996) that showed dramatic reduction of the prevalence of Trichuris, Ascaris, and Necator/Ancylostoma (hookworms); however, these nematodes persist with high prevalence in low socio-economically groups, as the squatter settlements around the cities; however, it is possible that pour Amerindian communities with substandard housing condition also suffer the burden of intestinal parasites. For this reason, the present study was planted in a rural disperse Amerindian community from the South of Costa Rica. 45 fecal samples were collected from children under 15 years old, and were processed according a modification of the Baermann method, which also permits the observation of other parasites beyond Strongyloides. 38 (84%) of the analyzed samples were positive for at least one parasite. The prevalence for nematodes was Ascaris (36%), hookworms (22%) Enterobius (4%), and Trichuris (2%). For protozoa was Endolimax nana (33%), Entamoeba coli (27%), and Entamoeba histolytica/dispar (11%). These data are the reflect of the inadequate sanitation conditions of this community.

Strongyloides stercoralis en pacientes psiquiátricos / Strongyloides stercoralis in psychiatric patients

Strongyloides stercoralis es un parásito intestinal, cuya prevalencia es usualmente subestimada en Costa Rica, porque se emplea sólo el examen directo de las muestras de heces; mientras que, para S. stercoralis es necesario emplear métodos más sensibles, como el Baermann o el cultivo en agar. En otros países se ha considerado a los pacientes psiquiátricos como un grupo de riesgo para esta parasitosis; por lo que estudiamos un grupo de pacientes (n=108)y del personal (n=71) del Hospital Nacional Psiquiátrico, analizado mediante una modificación del método de Baermann y el examen directo estándar. Los parásitos más frecuentes fueron Endolimax nana (20 por ciento), Entamoeba coli (16 por ciento), Giardia duodenalis (4 por ciento) y dos casos de S. stercoralis, uno del grupo de pacientes y el otro del personal. Este informe corrobora la importancia del método de Baermann, porque los dos casos de S. stercoralis spp., encontrados, además de dos de Trichuris spp. y otros dos de uncinarias solo fueron detectados por el método de Baermann. Adicionalmente, la prevalencia global de parásitos intestinales encontrada fue un 10 por ciento superior a la prevalencia informada para el país en la encuestra nacional de 1996. Los datos presentados corroboran un grupo de alto riesgo para los parásitos intestinales y cualquier otro agente transmitido por contaminación fecal.

Strongyloides stercoralis is an intestinal parasite, which prevalence is usually underestimated in Costa Rica, because the stool samples are analyzed only by direct fecal smears; where as, for S. stercoralis analysis is necessary to use more sensible methods; such as the Baermann or agar culture methods. In other countries the psychiatric patients are considered as a risk group for this parasite. For this reason, a group of patients (n=108) and personal (n=71) from the National Hospital of Psychiatric were studied using a modification of the Baermann method and the standard direct fecal analysis. The most frequent parasites found were Endolimax nana (20%), Entamoeba coli (16%), Giardia duodenalis (4%), and two cases of S. stercoralis were diagnosed, one from the patients and the other in the staff. This report stresses the importance of the use of Baermann method, because the two cases of S. stercoralis found and other two cases of Trichuris and another two of hookworms were diagnosed only with this method. The global prevalence of intestinal parasites of the psychiatric patients was 30%, a 10% higher than the prevalence described for the country, according to the national survey from 1996. Our data corroborate that the psychiatric patients represent a high-risk group for intestinal parasites and also to any other agent transmitted by fecal contamination.