A Human Case of Hymenolepis diminuta in a Child from Eastern Sicily

We report a case of Hymenolepis diminuta infection in a 2-year-old child living in a suburban area of Catania, Italy. This case was initially referred to us as Dipylidium caninum infection, which was not cured after being treated twice with mebendazole. However, by analyzing the clinical presentation and stool samples we arrived to the diagnosis of H. diminuta infection. The case presented with atypical allergic manifestations which had never been reported as clinical features of symptomatic H. diminuta infection; remittent fever with abdominal pain, diffuse cutaneous itching, transient thoracic rash, and arthromyalgias. The patient was treated with a 7-day cycle of oral niclosamide, which proved to be safe and effective. This case report emphasizes that a correct parasitological diagnosis requires adequate district laboratories and trained personnel. In addition, we recommend the importance of reporting all H. diminuta infection cases, in order to improve knowledge on epidemiology, clinical presentation, and treatment protocols.

Frecuencia de helmintiasis intestinal y su asociación con deficiencia de hierro y desnutrición en niños de la región occidente de México / Frequency of intestinal helminthiasis and its association with iron deficiency and malnutrition in children from western Mexico

Objetivo: Determinar la frecuencia de helmintiasis intestinal y su asociación con desnutrición y deficiencia de hierro. Material y métodos: Se realizó un estudio transversal analítico en el municipio de Comala, Colima, México. A todos los niños, se les determinó coproparasitoscópico seriado de tres días con la técnica de Kato-Katz. Para evaluar el grado de desnutrición; se establecieron los siguientes índices antropométricos: mediana y puntajes Z para peso/ talla, talla/edad y peso/edad. Se consideró que había deficiencia de hierro severa, moderada o leve con ferritina ≤ 12 ng/ ml, de 12 a 18 ng/mL y de 19 a 24 ng/mL respectivamente. Resultados: Se estudiaron 243 niños con una edad promedio de 65.3 ± 8.7 meses. El 60.9 % (n = 148) y el 2.5 % (n = 6) de los niños presentaron disminución de la ferritina y anemia respectivamente. El 16 % (n = 39) mostró trichuriasis, el 6.9 % (n = 17) ascariasis y el 5.3 % (n = 13) ambas. La infección por Trichuris trichiura se asoció a desmedro (OR 11.0, IC 3.9-30.8; p < 0.001) y a deficiencia de hierro con puntos de corte de < 24 ng (OR 2.0, IC 1.0-3.9, p = 0.02) y < 18 ng/dL (OR 2.2, IC 1.2-4.2, p = 0.009). La infección por ascaris no se asoció con desnutrición o deficiencia de hierro. Conclusiones: La infección de T. trichiura se asoció con desmedro y deficiencia de hierro grado leve y moderado.

OBJECTIVE: To determine intestinal helminthiasis frequency and its association with malnutrition and iron deficiency. Material and METHODS: An analytical cross-over study was carried out on children in the municipality of Comala, Colima, Mexico. Coproparasitoscopic exams in series of three using the Kato-Katz technique were performed in all children. To evaluate the degree ofmalnutrition, the following anthropometric indices were determined: means and z-scores for weight/height, height/age, weight/age. Severe, moderate and minimal iron deficiency was considered when ferritin was: < or = 12 ng/ml, 12 to 18 ng/mL and 19 to 24 ng/mL, respectively. RESULTS: 243 children were studied with an average age of 65.3+/-8.7 months. 60.9% (n = 148) of the children showed a decrease in ferritin levels and 2.5% (n = 6) had anemia. 16% (n = 39) had trichuriasis, 6.9% (n = 17) ascariasis and 5.3% (n = 13) had both parasites. Trichiura infection was associated with declining health (OR 11.0, CI 3.9-30.8; p<0.001) and with iron deficiency, with cut-off points of <24 ng (OR 2.0, CI 1.0-3.9, p = 0.02) and <18 ng/ dL (OR 2.2, CI 1.2-4.2, p= 0.009). Ascaris infection was not associated with malnutrition or iron deficiency. CONCLUSIONS: Trichiura infection was associated with declining health and slight and moderate degrees of iron deficiency.

Intestinal helminthiasis in primary school children and its control in Kien Giang province

Mass deworming with mebendazol 500mg was made in three schools in the districts of Tan Hiep, Hon Dat and An Bien. A prior treatment survey showed a cumulative infection rate of helminth of 15.6% in the school children of which a light infection of Ascariasis, Trichuris and hookworm but high rate of mixed infection (23%) were found. The post-treatment survey showed a 10.7% of the cumulative infection and 9.2% of the mixed infection. The density of three species was light reduced. Six months after treatment, in Hon Dat where the treatment was combined with IEC, the infection rate was found 6.4%, and it was 13.3% in Tan Hiep where no IEC was made. Mass drug administration is thought to be a simple, safe and highly effective method of deworming that can be supported by both teachers and parents of school children. Periodical mass treatment will be more helpful if combined with IEC.