Day care attendance during the first 12 months of life and occurrence of infectious morbidities and symptoms / Frequência em creches durante os primeiros 12 meses de vida e ocorrência de morbidades e sintomas infecciosos

ABSTRACT Objective: To investigate the occurrence of infectious morbidities according to day care attendance during the first year of life. Methods: This was a cross-sectional analysis of data from the 12-month follow-up of a medium-sized city birth cohort from children born in 2015, in the Southern Brazil. Main exposure variables were day care attendance from 0 to 11 months of age, type of day care center (public or private), and age at entering day care. Health outcomes were classified as follows: "non-specific respiratory symptoms," "upper respiratory tract infection," "lower respiratory tract infection," "flu/cold," "diarrhea," or "no health problem," considering the two weeks prior to the interview administered at 12 months of life. Associations were assessed using Poisson regression adjusted by demographic, behavioral, and socioeconomic variables. Results: The sample included 4018 children. Day care attendance was associated with all classifications of health outcomes mentioned above, except for flu/cold. These were stronger among children who entered day care at an age closer to the outcome time-point. An example are the results for lower respiratory tract infection and diarrhea, with adjusted prevalence ratios of 2.79 (95% CI: 1.67-4.64) and 2.04 (95% CI: 1.48-2.82), respectively, for those who entered day care after 8 months of age when compared with those who never attended day care. Conclusions: The present study consistently demonstrated the association between day care attendance and higher occurrence of infectious morbidities and symptoms at 12 months of life. Hence, measures to prevent infectious diseases should give special attention to children attending day care centers.

RESUMO Objetivo: Investigar a ocorrência de morbidades infecciosas de acordo com a frequência em creches durante o primeiro ano de vida. Métodos: Esta foi uma análise transversal dos dados de uma coorte de nascimento, em uma cidade de tamanho médio, na visita aos 12 meses de idade de crianças nascidas em 2015 no Sul do Brasil. As principais variáveis de exposição foram frequência em creches de zero aos 11 meses de idade, tipo de creche (pública ou particular) e idade ao entrar na creche. Os resultados de saúde foram classificados como: "sintomas respiratórios não específicos", "infecção do trato respiratório superior", "infecção do trato respiratório inferior", "gripe/resfriado", "diarreia" ou "nenhum problema de saúde", considerando as duas semanas anteriores à entrevista feita aos 12 meses de vida da criança. As associações foram avaliadas com a regressão de Poisson ajustada pelas variáveis demográficas, comportamentais e socioeconômicas. Resultados: A amostra incluiu 4.018 crianças. O ato de frequentar creches foi associado a todas as classificações de resultados de saúde mencionados, exceto gripe/resfriado. Esses resultados foram mais fortes entre as crianças que começaram a frequentar creches em uma idade mais próxima ao ponto de tempo do resultado. Um exemplo são os resultados para infecção do trato respiratório inferior e diarreia, índice de prevalência ajustado de 2,79 (IC de 95%: 1,67-4,64) e 2,04 (IC de 95%: 1,48-2,82), respectivamente, naqueles que ingressaram nas creches após os oito meses de idade, em comparação com aqueles que nunca frequentaram creche. Conclusões: O presente estudo mostra sistematicamente a associação entre a frequência em creches e a maior ocorrência de morbidades infecciosas e sintomas aos 12 meses de vida da criança. Assim, deve-se dar atenção especial às medidas para prevenir as doenças infecciosas em crianças que frequentes creches.

Norovírus no município de São Paulo, 2010-2016: estudo transversal sobre a principal causa de gastroenterite infantil / Norovirus en el Municipio de São Paulo, Brasil, 2010-2016: estudio transversal sobre la principal causa de gastroenteritis infantil / Norovirus in São Paulo city, Brazil, 2010-2016: a cross-sectional study of the leading cause of gastroenteritis in children

Objetivo: descrever casos de doença diarreica aguda por norovírus em crianças menores de 5 anos do município de São Paulo, Brasil. Métodos: estudo transversal com dados provenientes da Vigilância Epidemiológica das Gastroenterites Causadas por Rotavírus; foi definido como caso o paciente internado em unidade sentinela por doença diarreica aguda e identificação laboratorial do norovírus como agente etiológico, entre os anos de 2010 e 2016. Resultados: durante o período estudado, a proporção de casos de norovírus em menores de 5 anos de idade ultrapassou a proporção de casos de rotavírus, agente considerado predominante na infância; o norovírus foi associado a 28,4% do total de casos notificados, ocorrendo o ano todo, principalmente nos meses mais quentes. Conclusão: norovírus foi o principal agente etiológico identificado em crianças menores de 5 anos com doença diarreica aguda no município de São Paulo.

Objetivo: describir casos de enfermedad diarreica aguda por Norovirus en niños menores de 5 años provenientes del Municipio de São Paulo, Brasil. Métodos: Estudio transversal con datos de la Vigilancia Epidemiológica de las Gastroenteritis causadas por Rotavirus. Se definió como caso el paciente internado en unidad centinela por enfermedad diarreica aguda e identificación de laboratorio del Norovirus como agente etiológico entre los años de 2010 y 2016. Resultados: Durante el período estudiado, la proporción de casos de Norovirus en menores de 5 años superó la proporción de casos de Rotavirus, agente considerado predominante en la infancia. El Norovirus fue asociado al 28,4% del total de los casos notificados, ocurriendo todo el año, principalmente en los meses más cálidos. Conclusión: el Norovirus fue el principal agente etiológico identificado en niños menores de 5 años con enfermedad diarreica aguda en el Municipio de São Paulo.

Objective: to describe cases of acute diarrheal disease caused by norovirus in children under 5 years old in São Paulo city, Brazil. Methods: this was a cross-sectional study using data from Epidemiological Surveillance of Gastroenteritis due to Rotavirus; cases were defined as patients hospitalized in a sentinel unit because of acute diarrheal disease and laboratory identification of norovirus as the etiological agent between 2010 and 2016. Results: during the study period, the proportion of norovirus cases in children under 5 years old exceeded the proportion of Rotavirus, an agent considered predominant in childhood; norovirus was associated with 28.4% of total reported cases, occurring all year round, especially in warmer months. Conclusion: norovirus was the leading etiological agent identified in children under 5 years old with acute diarrheal disease in São Paulo city.

Relação entre diarreia infantil e hospitalização por desidratação / Relation between childhood diarrhea and hospitalization due to dehydration

OBJETIVO: Traçar o perfil epidemiológico e a relação entre diarreia infantil e hospitalização por desidratação. MÉTODOS: Trata-se de estudo retrospectivo, descritivo, de abordagem quantitativa. A população estudada correspondeu a crianças que geraram notificação por diarreia e/ou hospitalização por desidratação no Estado do Tocantins, entre 2010 e 2015. A informação foi extraída do banco de dados do Departamento de Informática do Sistema Único de Saúde (DATASUS) e do Sistema de Informação de Agravos e Notificação (SINAN) disponibilizados pelo Ministério da Saúde. RESULTADOS: Entre os anos de 2010 a 2015, foram registrados 82.973 casos de crianças com diarreia no Tocantins. Já o número de internações infantis por desidratação neste período totalizou 1.851. A prevalência média no período analisado foi de 1.382 casos de diarreia infantil por mês, com 31 registros de internações por desidratação infantil mensais. Em todos os anos estudados, a incidência foi aumentada entre junho e setembro, com acréscimo de até 50% em casos de diarreia e 185% em internações. Em geral, os parâmetros relacionados ao número de casos de diarreia em crianças e ao número de hospitalização por desidratação seguiram comportamentos associados, o que reforçou uma relação causal entre eles. CONCLUSÃO: O Tocantins apresentou destaque, em nível nacional, em relação a casos de desidratação e mortalidade infantil no período de 2010 e 2015. Por ser tão relevante na morbimortalidade infantil, a revisão de políticas públicas é urgente, com foco na prevenção e na terapêutica efetivas da diarreia e da desidratação infantis. (AU)

OBJECTIVE: To outline the epidemiological profile and relation between childhood diarrhea and hospitalization for dehydration. METHODS: This is a retrospective, descriptive, quantitative study. The studied population consisted of children who generated notification of diarrhea and/or hospitalization due to dehydration in the state of Tocantins from 2010 to 2015. The information was extracted from the database of the Informatics Department of the Brazilian Unified Health System (DATASUS), and from the National Disease Notification System (SINAN) provided by the Brazilian Ministry of Health. RESULTS: Between the years 2010 and 2015, 82,973 cases of children with diarrhea were recorded in Tocantins. The number of children hospitalizations due to dehydration in this period was 1,851. The mean prevalence in the analyzed period was 1382 cases of child's diarrhea per month, with 31 records of monthly hospitalizations from child's diarrhea. In all the years studied, the incidence was increased between June and September with an increase of up to 50% in cases of diarrhea, and 185% in hospitalizations. In general, the parameters related to the number of cases of child's diarrhea and the number of admissions due to dehydration followed associated behaviors, which reinforced a causal relation between them. CONCLUSION: Tocantins stands out nationally regarding the cases of dehydration and children mortality from 2010 to 2015. Due to its relevance to children's morbidity and mortality, the review of public policies focusing effective prevention and treatment of diarrhea and infant dehydration is urgent. (AU)

Características clinicoepidemiológicas de la enfermedad diarreica aguda por Vibrio cholerae en pacientes de hasta 10 años / Clinical epidemiological characteristics of the acute diarrheal disease due to Vibrio cholerae in patients up to 10 years

Se realizó una investigación observacional, descriptiva y transversal de 95 niños en las edades de 0 a 10 años, con diagnóstico de enfermedad diarreica aguda a causa del Vibrio cholerae, atendidos en el Hospital Infantil Norte Dr Juan de la Cruz Martínez Maceira de Santiago de Cuba, durante el 2016, a fin de caracterizarles según algunas variables clínicas y epidemiológicas. Entre los principales resultados se obtuvo que el grupo etario más afectado fuera el de 0 a 11 meses y el municipio con mayor número de casos el de Santiago de Cuba, los que correspondieron fundamentalmente a las áreas de salud de los policlínicos Frank País García, José Martí Pérez y Josué País García. Asimismo se evidenció que la principal manifestación del proceso infeccioso fue la diarrea líquida y la complicación más frecuente, la deshidratación isotónica moderada. Todos los niños egresaron vivos, lo cual demuestra la eficacia de la atención médica en el territorio suroriental de Cuba

An observational, descriptive and cross-sectional investigation of 95 children aged 0 to 10, with diagnosis of acute diarrheal disease due to Vibrio cholerae, assisted in Dr Juan de la Cruz Martínez Maceira Northern Children Hospital in Santiago de Cuba, was carried out during 2016, in order to characterize them according to some clinical and epidemiological variables. Among the predominant results there were the 0 to 11 months age group as the most affected and the presence of a higher number of cases in Santiago de Cuba municipality, that corresponded mainly to the health areas of Frank País García, José Martí Pérez and Josué País García polyclinics. Also it was evidenced that the main manifestation of the infectious process was the liquid diarrhea and the most frequent complication, the moderate isotonic dehydration. None of the children died, which demonstrates the effectiveness of medical care in the southeastern territory of Cuba

Diarrea aguda, prolongada y persistente en niños y su diferencia de la diarrea crónica / Acute, prolonged and persistent diarrhea in children and its difference with chronic diarrhea

Sobre la base de 55 años de experiencia en el tratamiento de niños con diarrea aguda y la actualización de los conocimientos adquiridos en las últimas décadas en el Programa de Control de la Enfermedad Diarreica de la Organización Mundial de la Salud, se decidió revisar las definiciones de los diferentes tipos clínicos de esta entidad y su diferenciación con la diarrea crónica. Así, se aportan algunos aspectos importantes como los factores que prolongan la diarrea aguda común, el uso de antibióticos, la vacunación contra el rotavirus, el círculo vicioso diarrea-desnutrición, el uso de agentes probióticos y bioterapéuticos, el sobrecrecimiento bacteriano intestinal y la diarrea del viajero. Se concluyó que es necesario identificar precozmente la diarrea prolongada e indicar un tratamiento oportuno para evitar su progresión hacia diarrea persistente, así como el efecto negativo de esta sobre el crecimiento y desarrollo de los niños pequeños, que en ocasiones puede provocarles la muerte.

On the base of 55 years experience in the treatment of children with acute diarrhea and the updating of the knowledge acquired in the last decades in the Control Program for the Diarrheal disease of World Health Organization, it was decided to review the definitions of the different clinical types of this disorder and its differentiation with chronic diarrhea. Thus, some important aspects are offered such as the factors which prolong the common acute diarrhea, the use of antibiotics, vaccination against rotavirus, the vicious circle diarrhea-malnutrition, the use of probiotic and biotherapeutic agents, the intestinal bacterial overgrowth and the traveler's diarrhea. It was concluded that it is necessary to identify early the prolonged diarrhea and to indicate an opportune treatment to avoid its course toward persistent diarrhea, as well as its the negative effect on the growth of small children, which occasionally can cause them death

Prevalencia de bacterias enteropatógenas en niños que asisten a un hospital pediátrico en Resistencia, Chaco, Argentina / Prevalence of enteropathogenic bacteria in children attending a pediatric hospital in Resistencia, Chaco, Argentina

La enfermedad diarreica aguda continúa siendo uno de los problemas de salud pública más serios en los países en desarrollo, en los que constituye una de las causas principales de enfermedad y muerte en los niños menores de 5 años. Su epidemiología es totalmente dependiente de la región geográfica, nivel socio económico, costumbres y hábitos de la población.El objetivo del presente trabajo fue determinar la prevalencia de agentes etiológicos bacterianos causantes de diarrea aguda, en niños atendidos en un Hospital Pediátrico de Resistencia, Chaco, en el año 2013.Se investigó la presencia de Shigella spp., Salmonella spp., Campylobacte rspp., Escherichia coli O157:H7 en muestras de materia fecal de niños con enfermedad diarreica aguda. Sobre 823 muestras de materia fecal analizadas en el período mencionado, 93 resultaron positivas para alguno de los enteropatógenos estudiados (Tasa de recuperación del 11,3%).Las frecuencias de aislamiento de los enteropatógenos fueron: Shigella spp (82,8%), Salmonella spp (9,7%), Campylobacter spp (6,5%), y E. coli O157:H7 (1%).Con respecto a las especies, dentro del género Shigella predominó S. flexneri (60/77) seguida de S. sonnei (13/77) y S. boydii (4/77). Con excepción de E. coli O157, en el presente trabajo no se estudiaron los diferentes tipos patogénicos.Como en el resto del país, S. flexneri continúa siendo el agente etiológico más frecuentemente aislado. Este es el primer informe sobre la presencia de Campylobacter en coprocultivos en la provincia del Chaco.

Acute diarrheal disease remains one of the most serious problems of public health in developing countries, which is one of the leading causes of illness and death in children under 5 years. Its epidemiology is totally dependent on the geographic region, socioeconomic status, customs and habits of the population.The aim of this study was to determine the prevalence of bacterial etiologic agents causing acute diarrhea in children attending a Pediatric Hospital in the city of Resistencia, Chaco, during 2013.In this work Shigella spp, Salmonella sp, Campylobacter spp, Escherichia coli O157:H7 were investigatedAmong 823 stool samples analyzed, 93 were positive for any of the enteropathogens studied (recovery rate 11.3%).The frequency of isolation of enteric pathogens were: Shigella spp (82.8%), Salmonella spp (9.7%), Campylobacter spp (6.5%), and E. coli O157: H7 (1%).Respect to genus Shigella, Shigella flexneri was the prevalent (60/77) followed by S. sonnei (13/77) and S. boydii (4/77). With the exception of E. coli O157 in the present work the other pathogenic types were not studied.As in the rest of the country, S. flexneri remains the most frequently isolated etiologic agent. This is the first report about the presence of Campylobacter in stool cultures in the province of Chaco

Poor utilization and wrong preparation of oral rehydration salt solution during childhood diarrhea in Ilesa, Nigeria

Background and Aim: Diarrheal deaths are largely preventable with the use of oral rehydration salt (ORS) solution. The aim of this study was to investigate the preparation and use of ORS for the treatment of childhood diarrhea in Ilesa, Nigeria. Materials and Methods: The characteristics of the present diarrheal illness as well as biodata, social class, use of ORS solution, and the method of preparation were documented in 250 children with diarrhea at the Wesley Guild Hospital, Ilesa, Nigeria. Data were analyzed using the statistical program for the social sciences (SPSS) version 16.0. Results: A total of 151 (60.4%) of the children had been given ORS before the presentation. The ORS was correctly prepared in 38 (25.2%) of them, whereas hypertonic ORS solution was mostly given to the others. A significantly higher proportion (66.7%) of those from high social class had their ORS correctly prepared, compared with 16.1% of those from low social class (P = 0.000). The use of ORS was more prevalent among children with longer duration of diarrhea (P = 0.004). A significantly higher proportion of children who were still breastfeeding were given ORS, compared with those who had stopped breastfeeding (P = 0.007). Conclusion: Teachings on the use and correct preparation of ORS should not be limited to diarrhea treatment units, but should rather be included in the routine health talks given to mothers at antenatal and immunization clinics. The provision of a 1 L measure to be used for measuring water for ORS preparation should be seriously considered to combat the problem of hypertonic ORS preparations

Morbimortalidade por doenças diarreicas agudas em crianças menores de 10 anos no Distrito Federal, Brasil, 2003 a 2012 / Acute diarrhoeal disease morbidity and mortality in children under 10 years old in the Brazilian Federal District, 2003 to 2012 / Morbimortalidad de las enfermedades diarreicas agudas en niños menores de 10 años en el Distrito Federal, Brasil, 2003 a 2012

OBJETIVO: descrever a morbimortalidade e a sazonalidade das doenças diarreicas nos menores de 10 anos de idade residentes no Distrito Federal, Brasil, de 2003 a 2012. MÉTODOS: estudo descritivo, com dados dos Sistemas de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS), sobre Mortalidade (SIM), de Vigilância Epidemiológica das Doenças Diarreicas Agudas (Sivep-DDA) e planilhas de monitoramento da diarreia. RESULTADOS: foram contabilizados 558.737 casos de diarreia, com maior incidência entre menores de 1 ano (32,3 casos/100 crianças em 2003); no período, reduziram-se as taxas de hospitalização (de 6,5 para 3,0 internações/1000 crianças), mortalidade (de 4,5 para 1,5 óbitos/100 mil crianças) e letalidade hospitalar (de 0,70 para 0,49/100 crianças), com queda mais acentuada após a implantação da vacina contra rotavírus em 2006; as maiores taxas de internações ocorreram entre julho e setembro. CONCLUSÃO: houve redução de morbimortalidade por diarreia, principalmente em menores de 1 ano, com predomínio de internações na estação seca.

OBJECTIVE: to describe diarrhoeal disease morbidity, mortality and seasonality in children aged under 10 resident in Brazil's Federal District, 2003-2012. METHODS: this was a descriptive study using National Hospital Information System (SIH/SUS), Mortality Information System (SIM), Acute Diarrhoeal Disease Epidemiological Surveillance System (Sivep-DDA) as well as diarrhoea monitoring spreadsheets. RESULTS: 558,737 diarrhoea cases were registered with the highest incidence among children with less than one year old (32.3 cases/100 children in 2003); during the period there was a reduction in the hospitalization rates (from 6.5 to 3.0 hospitalizations/1,000 children), mortality rates (from 4.5 to 1.5 deaths/100,000 children) and hospital lethality (from 0.70 to 0.49/100 children), with a sharper decline after the implementation of rotavirus vaccine in 2006; highest hospitalization rates occurred between July and September. CONCLUSION: morbidity and mortality from diarrhoea reduced, particularly in children under one year old. Hospitalizations were more frequent during in the dry season.

OBJETIVO: describir la morbimortalidad y temporalidad de las enfermedades diarreicas agudas en niños menores de 10 años, residentes del Distrito Federal, Brasil, de 2003 a 2012. MÉTODO: estudio descriptivo, con datos del Sistema de Informaciones Hospitalarios (SIH/SUS), sobre Mortalidad (SIM), Vigilancia Epidemiológica de Enfermedades Diarreicas Agudas (SIVEP-DDA) y planillas de monitoreo de diarrea. RESULTADOS: fueron contabilizados 558.737 casos de diarrea, con mayor incidencia en niños menores de 1 año (32,3 casos/100 niños en 2003); en el período hubo reducción de las tasas de hospitalización (6,5 a 3,0 hospitalizaciones/1.000 niños), mortalidad (de 4,5 a 1,5 muertes/100 mil niños) y letalidad (de 0,70 a 0,49/100 niños), con declive más agudo después de la implantación de la vacuna contra rotavirus en 2006; las tasas de hospitalización más altos han ocurrido entre julio y septiembre. CONCLUSIÓN: hubo reducción de la morbimortalidad por diarrea, especialmente en niños menores de 1 año, con predominio de hospitalizaciones en la estación seca.

Changes in epidemiology of rotavirus in the Triângulo Mineiro region of Brazil: lack of two consecutive rotavirus seasons

Rotaviruses are the main cause of infantile acute diarrhea, and a monovalent (G1P[8]) vaccine against the virus was introduced into the Brazilian National Immunization Program for all infants in March 2006. The objectives of this study were to determine the rate and genotype distribution of rotavirus causing infantile diarrhea in the Triângulo Mineiro region of Brazil during 2011-2012 and to assess the impact of local vaccination. Fecal specimens were analyzed for detection and characterization of rotavirus using polyacrylamide gel electrophoresis, reverse transcription followed by polymerase chain reaction (PCR), and PCR-genotyping assays. Overall, rotavirus was diagnosed in 1.7% (6/348) of cases. Rotavirus positivity rates decreased 88% [95% confidence intervals (CI)=15.2, 98.3%; P=0.026] in 2011 and 78% (95%CI=30.6, 93.0%; P=0.007) in 2012 when compared with available data for baseline years (2005/2006) in Uberaba. In Uberlândia, reductions of 95.3% (95%CI=66.0, 99.4%; P=0.002) in 2011, and 94.2% (95%CI=56.4, 99.2%; P=0.004) in 2012 were also observed compared with data for 2008. The circulation of rotavirus G2P[4] strains decreased during the period under study, and strains related to the P[8] genotype reemerged in the region. This study showed a marked and sustained reduction of rotavirus-related cases, with a lack of rotavirus in the 2011 and 2012 seasons, suggesting a positive impact of the vaccination program.

Hallazgos epidemiológicos en infecciones parasitarias intestinales de un grupo de niños ingresados por diarreas / Epidemiological findings in intestinal parasitic infections from a group of hospitalized children with diarrhea

Introducción: la enfermedad diarreica es aún una causa importante de mortalidad en países en desarrollo, en los que afecta principalmente a los niños menores de 5 años de edad. En Cuba, aunque la mortalidad por esta causa se ha reducido, puede ser un importante problema de salud en ciertas épocas del año. Entre los grupos de agentes biológicos que se pueden encontrar en niños con diarreas están los parásitos, de los cuales no siempre se conoce bien su papel como agente causal. Objetivo: determinar algunas características epidemiológicas de las infecciones parasitarias en niños ingresados con diarrea. Métodos: se realizó un estudio observacional descriptivo en niños ingresados con diarrea en la sala de gastroenterología del hospital pediátrico William Soler de La Habana, desde noviembre de 2006 a octubre de 2007. A todos los niños se les recogieron muestras de heces para estudios parasitológicos y se les llenó un cuestionario con datos clínicos y epidemiológicos. Resultados: se encontró una mayor frecuencia de infecciones por protozoos para todas las edades (p< 0,01); el grupo mayor de 2 años resultó el más frecuente infectado en general (68,52 porciento) y el más parasitado por Giardia lamblia (35,18 porciento), mientras que los lactantes presentaron la menor frecuencia de parasitismo intestinal (18,18 porciento). Las infecciones por protozoos en general y por el complejo Entamoeba histolytica/Entamoeba dispar en particular, fueron más frecuentes en la estación de lluvia que en la de seca (p< 0,05). Por último, se encontró que los niños asistentes a círculos infantiles y a escuelas primarias, presentaron una mayor frecuencia de infección con Giardia lamblia que por Entamoeba histolytica/Entamoeba dispar y Cryptosporidium (p< 0,05). Conclusiones: se encontró un predominio de infecciones por protozoos en niños ingresados con diarreas, las cuales se presentaron más frecuentes en los mayores de 2 años y en la estación de lluvia

Introduction: acute diarrhea is a major cause of mortality in developing countries, and children aged less than five years are the most affected. Despite of decreasing mortality rates in Cuba, this illness may be an important health problem in some periods of the year. Among the groups of biological agents found in children with diarrhea are the parasites but their role as etiological agent is not always well recognized. Objective: to determine some epidemiological characteristics of parasitic infections in hospitalized children due to diarrhea. Methods: an observational descriptive study was performed on children who had diarrhea and were admitted to the gastroenterology service ward in William Soler pediatric hospital in Havana from November 2006 to October 2007. Their stool samples were collected for parasitological studies, and some questionnaires were filled out with corresponding clinical and epidemiological data. Results: the frequency of protozoan infections was higher than that of helminthic ones for all the age groups(p< 0.01), and children aged over 2 years was the most frequently infected with all types of parasites in general (68.52 percent), and with Giardia lamblia (35.18 percent) in particular whereas the infant group was the less frequently infected with intestinal parasites (18.18 percent). The infections caused by protozoa and by Entamoeba histolytica/Entamoeba dispar were more frequent in the rainy season than in the dry season (p< 0.05). Finally, a higher prevalence of infections with Giardia lamblia than with Entamoeba histolytica/Entamoeba dispar or Cryptosporidium was found in day care and primary school children (p< 0.05). Conclusions: a higher prevalence of protozoan infections was observed and they occur more frequently in children aged more than two years old and during the rainy season