Intestinal Perforation and Perianal Ulcer Due to Parasitic Infection / Perforación intestinal y úlcera perianal por infección parasitaria

Abstract Balantidium coli is the largest protozoan and the only ciliated parasite that infects humans. It causes balantidiasis, a disease humans acquire by fecal-oral transmission from its usual host: the pig. We report the case of an immunocompetent schoolgirl who presented with peritonitis due to intestinal perforation, with perianal ulceration secondary to polyparasitism caused by Balantidium coli, Enterobius vermicularis, and Trichuris trichiura. It is a rare, potentially preventable complication with extremely high mortality rates. The patient required eight surgical interventions.

Resumen Balantidium coli es el protozoario más grande y el único parásito ciliado que infecta a los seres humanos. Es el causante de la balantidiasis, enfermedad adquirida por los humanos por transmisión fecal-oral desde su hospedero habitual: el cerdo. Reportamos el caso de una escolar inmunocompetente, que presentó peritonitis por perforación intestinal, con ulceración perianal secundaria a poliparasitismo por Balantidium coli, Enterobius vermicularis y Trichuris trichiura. Esta es una complicación poco frecuente, potencialmente prevenible y con tasas de mortalidad extremadamente altas. La paciente requirió 8 intervenciones quirúrgicas.

Pinworm infection in school children of four districts of Malakand region, Khyber Pakhtunkhwa, Pakistan / Infecção por Pinworm em crianças em idade escolar de quatro distritos da região de Malakand, Khyber Pakhtunkhwa, Paquistão

Illnesses caused by human pinworm remains a pediatric health problem in developing nations including Pakistan. This study aimed to investigate the prevalence of Enterobius vermicularis in school children of four districts in Malakand region, Pakistan. Four hundred faecal specimens were screened from May 2014 to July 2017 using normal saline and Lugol Iodine solution. Twenty three (5.75%) individuals were found infected with E. vermicularis. Five children (1.25%) were infected with only E. vermicularis and eighteen (4.5%) were mixed with other helminths. E. vermicularis 23 (5.75%), hookworm 11 (2.75%), Ascaris lumbricoides 5 (1.25%), Taenia saginata 2 (0.5%) and Trichuris trichuira 4 (1%) were detected. Age wise 5-8 years were more parasitized followed by 13-15 and 9-12 years of age (0.0296, P<0.05). Male children were highly (0.06700, P<0.05) infected than female. Children in Malakand district were found more infected followed by Dir Upper, similar infection rate was noted in children of districts Lower Dir and Swat (0.0192, P<0.05). Children in primary level were highly (0.0013, P<0.05) infected than those of middle and high levels. Enterobiosis is still the most common parasitic diseases in children. Studies on enterobiosis should be conducted time by time to recognize the hazardous of such parasitic infection in remote areas of the country.

As doenças causadas pela traça humana continuam sendo um problema de saúde pediátrica nos países em desenvolvimento, incluindo o Paquistão. Este estudo teve como objetivo investigar a prevalência de Enterobius vermicularis em escolares de quatro distritos na região de Malakand, Paquistão. Quatrocentos espécimes fecais foram selecionados de maio de 2014 a julho de 2017, usando solução salina normal e solução de lugol iodo. Vinte e três (5,75%) indivíduos foram encontrados infectados por E. vermicularis. Cinco crianças (1,25%) foram infectadas apenas com E. vermicularis e dezoito (4,5%) foram misturadas com outros helmintos. Foram detectados E. vermicularis 23 (5,75%), ancilóstomo 11 (2,75%), Ascaris lumbricoides 5 (1,25%), Taenia saginata 2 (0,5%) e Trichuris trichuira 4 (1%). Com relação à idade, 5-8 anos foram mais parasitados, seguidos por 13-15 e 9-12 anos de idade (0,0296, P <0,05). Crianças do sexo masculino foram altamente (0,06700, P <0,05) infectadas do que as do sexo feminino. As crianças no distrito de Malakand foram encontradas mais infectadas, seguidas por Dir Upper, taxa de infecção semelhante foi observada em crianças dos distritos Lower Dir e Swat (0,0192, P <0,05). As crianças do nível primário foram altamente (0,0013, P <0,05) infectadas do que as dos níveis médio e alto. A enterobiose ainda é a doença parasitária mais comum em crianças. Os estudos sobre enterobiose devem ser conduzidos periodicamente para reconhecer a periculosidade dessa infecção parasitária em áreas remotas do país.

Bruxismo y desagaste oclusal asociado a enterobiasis en niños en edad preescolar de la provincia Junín / Bruxism and occlusal wear associated with enterobiasis in preschool children from Junín province

Debido a que el bruxismo es un hábito oral prevalente entre los niños y un potencial destructor de los tejidos orales, el presente estudio tuvo como objetivo investigar la relación entre las infecciones por Enterobius vermicularis y el bruxismo entre los niños de un preescolar en la provincia de Junin. La muestra estuvo conformoda por 96 niños de 4 a 6 años. El bruxismo se investigó en base a los informes de los padres sobre el rechinar de dientes por la noche, la calidad del sueño y aspectos clínicos tanto intraorales como extraorales relacionados con la afección. El análisis de datos involucró estadísticas descriptivas, chi-cuadrado de Pearson. La prevalencia de bruxismo fue de 65,62%. Se observó a través del índice de BEWE en los infantes con bruxismo y parasitados por E. vermicularis que el 30,15% se diagnóstico defecto evidente con pérdida de tejido duro menor. No se evidenció asociación estadísticamente significativa entre el bruxismo y el parsitismo por E. vermicularis. Con base en los presentes hallazgos, la prevalencia del bruxismo del sueño fue significativo(AU)

Because bruxism is a prevalent oral habit among children and a potential destroyer of oral tissues, the present study aimed to investigate the relationship between Enterobius vermicularis infections and bruxism among children of a preschool in the province of Junin. The sample consisted of 96 children from 4 to 6 years old. Bruxism was investigated based on parental reports of nighttime teeth grinding, sleep quality, and both intraoral and extraoral clinical aspects related to the condition. Data analysis involved descriptive statistics, Pearson's chi-square. The prevalence of bruxism was 65.62%. It was observed through the BEWE index in infants with bruxism and parasitized by E. vermicularis that 30.15% were diagnosed with an obvious defect with minor hard tissue loss. No statistically significant association was found between bruxism and E. vermicularis parasitism. Based on the present findings, the prevalence of sleep bruxism was significant(AU)

Pinworm infection in school children of four districts of Malakand region, Khyber Pakhtunkhwa, Pakistan / Infecção por Pinworm em crianças em idade escolar de quatro distritos da região de Malakand, Khyber Pakhtunkhwa, Paquistão

Illnesses caused by human pinworm remains a pediatric health problem in developing nations including Pakistan. This study aimed to investigate the prevalence of Enterobius vermicularis in school children of four districts in Malakand region, Pakistan. Four hundred faecal specimens were screened from May 2014 to July 2017 using normal saline and Lugol Iodine solution. Twenty three (5.75%) individuals were found infected with E. vermicularis. Five children (1.25%) were infected with only E. vermicularis and eighteen (4.5%) were mixed with other helminths. E. vermicularis 23 (5.75%), hookworm 11 (2.75%), Ascaris lumbricoides 5 (1.25%), Taenia saginata 2 (0.5%) and Trichuris trichuira 4 (1%) were detected. Age wise 5-8 years were more parasitized followed by 13-15 and 9-12 years of age (0.0296, P<0.05). Male children were highly (0.06700, P<0.05) infected than female. Children in Malakand district were found more infected followed by Dir Upper, similar infection rate was noted in children of districts Lower Dir and Swat (0.0192, P<0.05). Children in primary level were highly (0.0013, P<0.05) infected than those of middle and high levels. Enterobiosis is still the most common parasitic diseases in children. Studies on enterobiosis should be conducted time by time to recognize the hazardous of such parasitic infection in remote areas of the country.

As doenças causadas pela traça humana continuam sendo um problema de saúde pediátrica nos países em desenvolvimento, incluindo o Paquistão. Este estudo teve como objetivo investigar a prevalência de Enterobius vermicularis em escolares de quatro distritos na região de Malakand, Paquistão. Quatrocentos espécimes fecais foram selecionados de maio de 2014 a julho de 2017, usando solução salina normal e solução de lugol iodo. Vinte e três (5,75%) indivíduos foram encontrados infectados por E. vermicularis. Cinco crianças (1,25%) foram infectadas apenas com E. vermicularis e dezoito (4,5%) foram misturadas com outros helmintos. Foram detectados E. vermicularis 23 (5,75%), ancilóstomo 11 (2,75%), Ascaris lumbricoides 5 (1,25%), Taenia saginata 2 (0,5%) e Trichuris trichuira 4 (1%). Com relação à idade, 5-8 anos foram mais parasitados, seguidos por 13-15 e 9-12 anos de idade (0,0296, P <0,05). Crianças do sexo masculino foram altamente (0,06700, P <0,05) infectadas do que as do sexo feminino. As crianças no distrito de Malakand foram encontradas mais infectadas, seguidas por Dir Upper, taxa de infecção semelhante foi observada em crianças dos distritos Lower Dir e Swat (0,0192, P <0,05). As crianças do nível primário foram altamente (0,0013, P <0,05) infectadas do que as dos níveis médio e alto. A enterobiose ainda é a doença parasitária mais comum em crianças. Os estudos sobre enterobiose devem ser conduzidos periodicamente para reconhecer a periculosidade dessa infecção parasitária em áreas remotas do país.

Parásitos intestinales en poblaciones infantojuveniles; ambiente y comportamiento social / Prevalence of intestinal parasites in child and youth populations; environment and social behavior

Introduction: The decreasing prevalence of parasitosis from north to south in Argentina has led the scientific community to focus the epidemiological studies on the most vulnerable areas and, consequently, neglect the populations of Patagonia (South Argentina). The objectives of the present study were (i) to determine the prevalence of intestinal parasites in children and youth of Puerto Madryn (Chubut province, Patagonia), and (ii) to evaluate the parasitic infections found concerning socio-environmental factors and hygiene practices of the population. Materials and methods: Serial stool samples were processed using modified Ritchie and FLOTAC dual pellet techniques, and samples of anal swabs were examined by sedimentation. Socio-environmental variables and hygiene practices of the participants were surveyed using a semi-structured questionnaire. Results: Of all examined participants, 39.1% (68/174) were parasitized. A total of 6 parasite species were found and the most prevalent were Blastocystis sp (19.0%), Enterobius vermicularis (17.8%), and Giardia lamblia (6.3%). The risk of parasitosis and infection for Blastocystis sp was greater in participants who lived in houses without piped water (OR = 2.9 and OR = 3.2, respectively). The risk of infection for G. lamblia was positively associated with the lack of public waste collection service (OR = 5.6). Infection for E. vermicularis was higher in participants whose parents had a basic level of education (OR = 5.0). Conclusion: The parasitic infections observed reflect the environmental conditions of Patagonia and the need to focus studies on populations from peripheral areas to urban centers that are exposed to greater socio-economic vulnerability.

Introducción: La prevalencia de parasitosis decreciente de norte a sur en la Argentina, ha llevado a la comunidad científica a enfocar sus estudios epidemiológicos hacia las zonas más vulnerables y desatender a las poblaciones de la Patagonia (sur de Argentina). Los objetivos del presente estudio fueron: determinar la prevalencia de parásitos intestinales en niños y jóvenes de Puerto Madryn (Chubut, Patagonia), y evaluar las infecciones parasitarias en relación con los factores socioambientales y las prácticas de higiene de la población. Materiales y métodos: Se procesaron muestras seriadas de materia fecal mediante las técnicas Ritchie modificada y FLOTAC dual pellet, y muestras de escobillado anal por sedimentación. Se relevaron las variables socioambientales y las prácticas de higiene de los participantes mediante cuestionarios semiestructurados. Resultados: El 39.1% (68/174) de la población analizada estuvo parasitado. Se halló un total de 6 especies parásitas, las más prevalentes de las cuales fueron Blastocystis sp (19.0%), Enterobius vermicularis (17.8%) y Giardia lamblia (6.3%). El riesgo de parasitosis y de infección por Blastocystis sp fue mayor en los participantes que no poseían agua de red (odds ratio [OR] = 2.9 y OR = 3.2, respectivamente). La infección por G. lamblia se asoció de manera positiva con la falta de recolección pública de residuos (OR = 5.6). La infección por E. vermicularis fue superior en los participantes con padres que tenían un nivel de estudios primario (OR = 5.0). Conclusión: Las infecciones parasitarias observadas reflejan las condiciones ambientales de la Patagonia y la necesidad de orientar los estudios a poblaciones periféricas de los centros urbanos, las cuales están expuestas a mayor vulnerabilidad socioeconómica

Prevalencia y variables asociadas a la transmisión de Enterobius vermicularis en niños en edad preescolar y escolar en dos municipios de Cundinamarca, Colombia / Prevalence and Variables Associated with Enterobius vermicularis Transmission in Preschool and School Children in Two Municipalities of Cundinamarca, Colombia / Prevalência e variáveis associadas à transmissão de Enterobius vermicularis em crianças pré-escolares e escolares em dois municípios de Cundinamarca, Colômbia

Resumen: El presente artículo busca determinar la prevalência de Enterobius vermicularis y variables asociadas en población preescolar y escolar del área urbana del municipio de Chaguaní y dos jardines en Cajicá, Cundinamarca, Colombia. Para esto se realizó un estudio descriptivo, de corte transversal con toma única de muestra en la población mencionada en 44 y 42 participantes, respectivamente, cuyos padres aceptaron participar voluntariamente firmando un consentimiento para desarrollar una encuesta epidemiológica estructurada, que indagó condiciones socioeconómicas, epidemiológicas y medioambientales. El diagnóstico parasitológico se realizó con la técnica de Graham. Los participantes se distribuyeron por grupo etario: el primero estuvo conformado por 76 niños (88,4 %) con edades entre 1,5 y 8 años; el segundo, por 7 niños mayores de 8 años (8,1%), y el tercero, por 3 niños (3,5 %) sin información al respecto. La variable con significancia estadística (p≤0.05) y posible asociación protectora fue la asistencia médica trimestral y como posible riesgo el contacto con fómites. Así, se encontró que la oxiuriasis es una parasitosis prevalente en la población preescolar y escolar, asociada a condiciones higiénico-sanitarias deficientes.

Abstract: This article seeks to determine the prevalence of Enterobius vermicularis and associated variables in preschool and school population in the urban area of the municipality of Chaguaní and two kindergartens in Cajicá, Cundinamarca, Colombia. To this end, a descriptive, cross-sectional study was conducted by taking a single sample from 44 and 42 participants from such populations, respectively, whose parents agreed to participate voluntarily by signing a consent to respond to a structured epidemiological survey. This survey inquired into their socioeconomic, epidemiological, and environmental conditions. Parasitological diagnosis was made using Graham's test. Participants were distributed by age group: the first one was made up of 76 children (88.4%) between 1.5 and 8 years old; the second one, of seven children (8.1 %) over 8; and the third one, of three children (3.5 %) with no age information. A statistically significant variable (p ≤ 0.05) and possible protection factor was quarterly medical care. A possible risk factor was contact with fomites. Therefore, it was found that oxyuriasis is a prevalent form of parasitosis in preschool and school population associated with poor hygienic and sanitary conditions.

Resumo: Este artigo pretende determinar a prevalência de Enterobius vermicularis e de variáveis associadas em população pré-escolar e escolar da área urbana do município de Chaguaní e de dois jardins de infância em Cajicá, Cundinamarca, Colômbia. Para isso, foi realizado um estudo descritivo, de corte transversal, com tomada única de amostras na população em 44 e 42 participantes, respectivamente, cujos responsáveis aceitaram a participar de forma voluntária e assinaram o consentimento para responder a um questionário epidemiológico estruturado, que indagou sobre condições socioeconómicas, epidemiológicas e meio ambientais. O diagnóstico parasitológico foi realizado com a técnica Graham. Os participantes foram distribuídos por grupo de idade: o primeiro formado por 76 crianças (88,4%) entre 1,5 e 8 anos; o segundo, por 7 crianças com maios de 8 anos (8,1%), e o terceiro, por 3 crianças (3,5%) sem informação a respeito. A variável com significância estatística (p≤0,05) e possível associação protetora foi a assistência médica trimestral e, como possível risco, o contato com fômites. Assim, foi verificado que a oxiuriase é uma parasitose prevalente na população pré-escolar e escolar, associada a condições higiênico-sanitárias deficientes.

Comparison of Helminth Infection among the Native Populations of the Arctic and Subarctic Areas in Western Siberia Throughout History: Parasitological Researches on Contemporary and the Archaeological Resources

The aim of this parasitological study is examining contemporary (the late 20th century) specimens of the arctic or subarctic areas in Western Siberia and comparing them with the information acquired from archaeological samples from the same area. In the contemporary specimens, we observed the parasite eggs of 3 different species: Opisthochis felineus, Ascaris lumbricoides, and Enterobius vermicularis. Meanwhile, in archaeoparasitological results of Vesakoyakha, Kikki-Akki, and Nyamboyto I burial grounds, the eggs of Diphyllobothrium and Taenia spp. were found while no nematode (soil-transmitted) eggs were observed in the same samples. In this study, we concluded helminth infection pattern among the arctic and subarctic peoples of Western Siberia throughout history as follows: the raw fish-eating tradition did not undergo radical change in the area at least since the 18th century; and A. lumbricoides or E. vermicularis did not infect the inhabitants of this area before 20th century. With respect to the Western Siberia, we caught glimpse of the parasite infection pattern prevalent therein via investigations on contemporary and archaeoparasitological specimens.

Confusing a Pollen Grain with a Parasite Egg: an Appraisal of “Paleoparasitological Evidence of Pinworm (Enterobius Vermicularis) Infection in a Female Adolescent Residing in Ancient Tehran”

There is often the risk of confusing pollen grains with helminth eggs from archaeological sites. Thousands to millions of pollen grains can be recovered from archaeological burial sediments that represent past ritual, medication and environment. Some pollen grain types can be similar to parasite eggs. Such a confusion is represented by the diagnosis of enterobiasis in ancient Iran. The authors of this study confused a joint-pine (Ephedra spp.) pollen grain with a pinworm egg. This paper describes the specific Ephedra pollen morphology that can be confused with pinworm eggs.

Pinworm Infection at Salmon Ruins and Aztec Ruins: Relation to Pueblo III Regional Violence

The study of coprolites has been a theme of archaeology in the American Southwest. A feature of archaeoparasitology on the Colorado Plateau is the ubiquity of pinworm infection. As a crowd parasite, this ubiquity signals varying concentrations of populations. Our recent analysis of coprolite deposits from 2 sites revealed the highest prevalence of infection ever recorded for the region. For Salmon Ruins, the deposits date from AD 1140 to 1280. For Aztec Ruins, the samples can be dated by artifact association between AD 1182–1253. Both sites can be placed in the Ancestral Pueblo III occupation (AD 1100–1300), which included a period of cultural stress associated with warfare. Although neither of these sites show evidence of warfare, they are typical of large, defensible towns that survived this time of threat by virtue of large populations in stonewalled villages with easily accessible water. We hypothesize that the concentration of large numbers of people promoted pinworm infection and, therefore, explains the phenomenal levels of infection at these sites.

Enteroparasitism and Risk Factors Associated with Clinical Manifestations in Children and Adults of Jalisco State in Western Mexico

OBJECTIVES: To determine the prevalence and risk factors associated with intestinal parasites in the population of San Juan Cosala, Jalisco, Mexico. METHODS: A total of 277 samples from 104 participants were analysed using direct smear, flotation, formaldehyde/ethyl acetate, and modified Kinyoun’s acid-fast stain methods. The Graham method was applied only for samples from children under 12 years of age for the diagnosis of Enterobius vermicularis. RESULTS: The prevalence of parasite infections in the study population was 77.9% including: Entamoeba histolytica/E. dispar/E. moshkovskii/E. bangladeshi (37.5%), Giardia intestinalis (11.5%); commensals: Endolimax nana (44.2%), Entamoeba coli (27.9%), Chilomastix mesnili (6.7%) and Iodamoeba bütschlii, (2.9%); emerging intestinal protozoans: Blastocystis spp. (49%), Cryptosporidium spp. (7.7%) and Cyclospora cayetanensis (2.9%); and helminths: Enterobius vermicularis (18.3%) and Ascaris lumbricoides (5.8%). The results also showed that 58.64% of the studied population presented polyparasitism. A significant association was found between protozoan infections and housewives, and houses that were not built with concrete ceilings, brick walls and cement floors (p < 0.05). CONCLUSION: Polyparasitism was observed in over half the study population. The most prevalent parasite was Blastocystis spp, whilst the prevalence of helminths was less than that of protozoans. The risk factors for infection to intestinal parasites were being a housewife and not having solid brick, cement and concrete materials for house construction.

Internal Quality Assurance Status of Stool Examination as Assessed by a Questionnaire in Korean Clinical Laboratories

This study aimed to survey the status of quality control (QC) assurance for stool examinations at clinical laboratories in Korea. We sent a questionnaire related to QC practices in stool examination by electronic mail to Korean clinical laboratories that performed stool examination. Overall, 20 of the 39 laboratories (51.3%) reported performing stool concentration methods, and 28 (71.8%) examined the slides using only saline. A large proportion (74.4%) of respondents did not check the internal QC because of the restriction of appropriate control materials. Only four laboratories (10.3%) checked the reactivity of the dye solution routinely. For appropriate external QC systems, QC slides (43.6%) were preferred, followed by QC materials (30.8%), virtual slides (17.9%), and a combination of the above options (7.7%). The most commonly observed parasites in stool samples at the clinical laboratories were Clonorchis sinensis (75%), followed by Endolimax nana, Enterobius vermicularis, and Entamoeba coli. The present study describes the difficulties in internal QC assessment due to the absence of standardized QC materials and systems. We hope the findings of this report will provide a foundation for a QC assessment program for stool examinations in the near future.

Annual Report on the External Quality Assessment Scheme for Clinical Parasitology in Korea (2017)

Annual proficiency surveys were conducted in March, May, and August of 2017 as the Korean Association of External Quality Assessment Service. Overall, four image samples (MPI-17-01, MPI-17-02, MPI-17-03, MPI-17-04) in the first trial, three image samples (MPI-17-05, MPI-17-06 , MPI-17-07) in the second trial, and a slide specimen (MPS-17-01) using parasite samples in the third trial were distributed to participating institutions. The first and second trial specimens were prepared by photographing slides made of formalin-ether concentrate of positive samples stored for educational purposes. The slide distributed in the third trial was prepared using cellophane tape, which was stored after diagnosis of the patients infected with Enterobius vermicularis . There were 191 participating institutions in the first, 204 in the second, and 212 in the third trial. The correct identification rates were 27.2% for MPI-17-01 Diphyllobothrium species (sp.), 96.6% for MPI-17-02 no parasite, 67.5% for MPI-17-03 Metagonimus yokogawai , 71.2% for MPI-17-04 Balantidium coli , 99.0% for MPI-17-05 Taenia sp., 99.0% for MPI-17-06 Trichuris trichiura , 92.7% for MPI-17-07 Cryptosporidium sp., and 96.7% for MPS-17-01 E. vermicularis . The current external quality assessment for clinical parasitology was performed using image samples and standard slides. Surveys of parasitic infections should be accompanied by continuous education on various parasitic infections, for which there was lack of experience of inspection in clinical laboratories. In the future, it will be necessary to establish a standard material using parasitic samples, and ultimately to conduct a survey on whole series of tests for the diagnosis of parasitic diseases.

Is it necessary to take anthelmintics every year in Korea?

Is it necessary to intake anthelmintics every year in Korea? To answer to this question, the recent nation-wide egg positive rate of the intestinal nematodes in Korea was presented. The anthelminthics which are purchasable without physician's prescription were also introduced with their pharmacological reaction and indication. The egg positive rate of Ascaris lumbricoides in 2012 was 0.025%. Those of Trichuris trichiura and Enterobius vermicularis were 0.27% and 0.004%, respectively. In 2018, purchasable anthelmintics without physician's prescription in Korea were albendazole and flubendazole only. Those two anthelmintics were derivatives of benzimidazole that may cause some side effects such as hepatitis, increase of hepatic enzymes, granulocytopenia, or pancytopenia. These anthelmintics showed excellent effect to ascariasis; while, they are not sufficient to treat trichuriaiss. For treatment of enterobiasis, repeated taking 3 times with 3 weeks interval and mass treatment of the family of egg positive person are required. In conclusion, it is not necessary to take anthelmintics every year without specific diagnosis because of negligible egg positive rate of intestinal nematodes and complicated therapeutic module for enterobiasis. There was no specific symptom of ascariasis or trchuriasis if worm burden is not high. The common symptoms of enterobiasis were pain or itching at the perianal area, sleep difficulty, or diarrhea. If intestinal nematode infection is suspected, stool examination or perianal swab should be done before prescribing anthelmintics.

Análise parasitológica em estudantes com deficiência intelectual e/ou múltipla (o múltiple) / Parasitological analysis in students with intellectual and/or multiple disabilities

O parasitismo acontece quando há associação de dois seres vivos onde um deles se desenvolve e prejudica de alguma forma o outro ser, chamado hospedeiro (El parasitismo ocurre cuando existe una asociación de dos seres vivos, donde uno de ellos se desarrolla y afecta de algún modo al otro, que se llama huésped). Alguns parasitos como Entamoeba histolytica/Entamoeba dispar, Giardia lamblia, Hymenolepis nana, Taenia solium, Ascaris lumbricoides, Trichuris trichiura e Enterobius vermicularis são transmitidos pela água e/ou (se transmiten por el agua o por) alimentos contaminados e afetam grande parte da população mundial no desempenho (y afectan a una gran parte de la población mundial en el desarrollo) de suas atividades físicas, mentais e sociais, expondo-a a diversas manifestações clínicas que podem gerar elevados níveis (pueden generar altos niveles) de morbidade. Considerando que, aproximadamente, 11% da população brasileira sofrem com algum tipo de deficiência intelectual e/ou múltipla e pouco se tem estudado sobre a ocorrência (y poco se ha estudiado acerca de la existencia) de enteroparasitos nesse grupo populacional, estudos parasitológicos laboratoriais foram realizados em 50 estudantes da Associação de Pais e Amigos dos Excepcionais (APAE) da cidade de São Mateus, Espírito Santo, Brasil. Do total de amostras analisadas 28 (56%) estavam positivas para um ou mais parasitos e comensais, sendo (uno o más parásitos y comensales, siendo) 5 (17.85%) por G. lamblia, 7 (25.00%) por E. histolytica/E. dispar/E. moschkovskii, 11 (39.28%) por Entamoeba coli, 6 (21.43%) por Balantidium coli, 2 (7.14%) por Endolimax nana e 3 (10.7%) por E. vermicularis. Considerando a elevada frequência de indivíduos parasitados torna-se necessário a busca (se hace necesaria la búsqueda) de investimentos em profilaxia e educação higiênico-sanitária, além da realização (además de la realización) constante de exames parasitológicos, garantindo uma melhor (garantizando una mejor) qualidade de vida à população da APAE de São Mateus.

Parasitism occurs when there is an association between two living beings, in which one develops and in some way harms the other being, called host. Some parasites such as Entamoeba histolytica/Entamoeba dispar, Giardia lamblia, Hymenolepis nana, Taenia solium, Ascaris lumbricoides, Trichuris trichiura and Enterobius vermicularis are transmitted by contaminated water and/or food and affect a large number of the world population in their physical, mental and social activities, exposing them to diverse clinical manifestations that can generate high levels of morbidity. Considering that approximately 11% of the Brazilian population suffers from some type of intellectual and/or multiple deficiency and little has been studied about the occurrence of enteroparasites in this population group, laboratory parasitological studies were performed in 50 students of the Associação de Pais e Amigos dos Excepcionais (APAE) of the city of São Mateus, Espírito Santo, Brazil. From the total of the analyzed samples, 28 (56%) were positive for one or more parasites and commensals, of which 5 (17.85%) were positive for G. lamblia, 6 (25.00%) for E. histolytica/E. dispar, 11 (39.28%) for Entamoeba coli, 7 (21.43%) for Balantidium coli, 2 (7.14%) for Endolimax nana and 3 (10.7%) for E. vermicularis. Considering the high prevalence of parasitic infection in this population, it is necessary to seek greater investment in prophylaxis and hygienic-sanitary education, in addition to constantly conducting parasitological examinations that might guarantee a better quality of life for the population of São Mateus APAE.

Soil transmitted helminthiasis in different occupational groups in Swat, Khyber Pakhtunkhwa, Pakistan

We investigated the prevalence of geohelminth parasites in farmers, education concerned and shepherd of Swat, Khyber Pakhtunkhwa, Pakistan. A total of 1041 stool samples were examined from January 2006 to December 2008 using direct smear [Normal saline and Lugol,s Iodine solution] the concentration methods and procedures. Seven hundred and sixty three [73.2%] individuals were found infected with one or more than one geohelminth parasites. Four hundred and eighteen [54.7%] were infected with single parasite and three hundred forty five [45.3%] with multiple infections. Ascaris lumbricoides 460 [53.0%], Trichuris trichura 228 [26.2%], Enterobius vermicularis 123 [14.1%] and Ancylostoma duedenale 56 [6.45%] were detected. The adults were found more parasitized than children and males were more infected than females. Shepherds were found more infected than farmers and education concerned. Although Swat is an area with poor hygiene located in temperate zone near the border of Afghanistan and China. The prevalence of reported geohelminth parasites here compared with the same studies is unexpectedly high. These type of studies should continue time to time to know the hazardous of such parasitic infections for the betterment of the human health

Prevalence of Enterobius vermicularis among Children in Iran: A Systematic Review and Meta-analysis

OBJECTIVES: Enterobius vermicularis is a parasitic disease that is common in crowded areas such as schools and kindergartens. Primary investigations of electronic evidence have reported different prevalences of E. vermicularis in Iran. Therefore, we aimed to estimate the total prevalence of this infection among Iranian children using a meta-analysis. METHODS: Relevant studies were identified in national and international databases. We selected eligible papers for meta-analysis after investigating titles, abstracts, and full texts; assessing study quality; and applying inclusion/exclusion criteria. Data were extracted by two independent researchers. The results were combined using a random effects model in Stata v. 11 software. RESULTS: Among 19 eligible articles including 11,676 participants, the prevalences of E. vermicularis among all children, boys, and girls were 1.2%–66.1%, 2.3%–65.5%, and 1.7%–65.5%, respectively. Pooled prevalences (95% confidence interval) of E. vermicularis among all children, boys, and girls were 17.2% (12.6%–21.8%), 17.2% (12.6%–21.8%), and 16.9% (9.03%–24.8%), respectively. CONCLUSION: This meta-analysis showed that a great majority of Iranian children are infected with E. vermicularis, possibly due to poor public health.

Intestinal Parasite Infections among Inhabitants in Yanbian Prefecture, Jilin Province, China

To investigate the prevalence of intestinal parasite infections in Yanbian Prefecture, Jilin Province, China, epidemiological surveys were conducted on a collaboration basis between the Korean Centers for Disease Control and Prevention and the Yanbian Center for Disease Control and Prevention. A total of 8,396 (males 3,737 and females 4,659) stool samples were collected from 8 localities and examined with the formalin-ether sedimentation technique, and additionally examined with the cellotape anal swab to detect Enterobius vermicularis eggs. The overall rate of intestinal parasites was 1.57%. The prevalence of Ascaris lumbricoides was the highest (0.80%), followed by Entamoeba spp. (0.23%), heterophyid flukes (0.15%), Clonorchis sinensis (0.08%), Enterobius vermicularis (0.07%), hookworms (0.06%), Trichostrongylus spp. (0.06%), Giardia lamblia (0.04%), Paragonimus spp. (0.02%), Diphyllobothrium spp. (0.02%), Trichuris trichiura (0.02%). The prevalence by sex was similar, 1.58% (n=59) in males and 1.57% (n=73) in females. By the present study, it is partly revealed that the prevalences of intestinal parasite infections are relatively low among the inhabitants of Yanbian Prefecture, Jilin Province, China.

Apendicitis y parásitos: a propósito de 2 casos / Appendicitis and parasites: Reporting of 2 cases

Objetivo: Enfatizar la importancia de sospechar esta etiología en la patogenia de la apendicitis aguda, especialmente en pacientes procedentes de países endémicos. Casos clínicos: Presentamos dos casos, con cursos clínicos divergentes.

Aim: We would like to emphasize the importance of having a high grade of suspect about the parasitic etiology of appendicitis acute, especially in patients from endemic countries. Case report: We present two cases with divergent clinical evolution.

Parasitosis intestinales y factores socioambientales: estudio preliminar en una población de horticultores / Intestinal parasitoses and socio-environmental factors: a preliminary study on a population of horticulturists

Introduction: Various families of small horticultural producers who supply the regional market live in Pereyra Iraola Park. This paper addresses an integral parasitological study designed to assess the sanitary conditions in the place and their impact on human health. Material and methods: Serial human stool and anal swabs (n = 80), canine faeces (n = 8), farm animals (n = 12), and vegetables samples (n = 21) were analyzed. Concentration techniques by flotation and sedimentation were applied. Through semi-structured surveys socio-environmental variables were studied. Results: The study showed that 84% of the human population was parasitized. The highest prevalence corresponded to Blastocystis sp. (41.2%), Enterobius vermicularis (37.5%) and Entamoeba coli (33.7%). Significant associations between parasitic species were found. Trichuris vulpis (37.5%) was the most prevalent species in canines followed by Ancylostoma caninum, Uncinaria stenocephala and Toxocara canis (25%). Farm animals showed Balantidium coli, Trichuris suis, Capillaria sp., Heterakis sp., Trichostrongylus sp., among others. In vegetables, amoeba cysts, coccidia oocysts, strongylid eggs and larvae of free-living nematodes were found. The presence of G. lamblia in the human population was significantly associated with irregular work of the mother, the lack of parental education and the possession of a vegetable garden. Conclusions: The results observed in the population, and species of zoonotic importance in animals and vegetables suggest that these studies should be furthered and control and environmental sanitation measures implemented in order to improve the quality of life of horticulturists and their productive activity

Introducción: En el parque Pereyra Iraola viven familias de pequeños productores hortícolas que abastecen al mercado regional. El presente trabajo aborda un estudio parasitológico integral, con el fin de evaluar las condiciones sanitarias y su impacto en la salud humana. Materiales y métodos: Se analizaron muestras seriadas de heces humanas y escobillado anal (n = 80), heces caninas (n = 8), de animales de cría (n = 12), y muestras de hortalizas (n = 21). Se aplicaron técnicas de concentración por flotación y sedimentación. Mediante encuestas semiestructuradas se relevaron variables socioambientales. Resultados: El 84% de la población humana resultó parasitada. Las mayores prevalencias correspondieron a Blastocystis sp. (41.2%), Enterobius vermicularis (37.5%) y Entamoeba coli (33.7%). Se hallaron asociaciones significativas entre especies parásitas. En perros, la especie más prevalente fue Trichuris vulpis (37.5%), seguida de Ancylostoma caninum, Uncinaria stenocephala y Toxocara canis (25%). En animales de cría se halló Balantidium coli, Trichuris suis, Capillaria sp., Heterakis sp., Trichostrongylus sp., entre otros. En las hortalizas se encontraron quistes de amebas, ooquistes de coccidios, huevos de estrongilídeos y larvas de nematodes de vida libre. La presencia de G. lamblia en la población humana se asoció significativamente con trabajo inestable de la madre, falta de educación paterna y tenencia de huerta. Conclusiones: Los resultados observados en la población y las especies de importancia zoonótica en animales y hortalizas sugieren profundizar estos estudios y llevar adelante medidas de control y saneamiento ambiental, que mejoren la calidad de vida de los horticultores y su actividad productiva

Ancient Human Parasites in Ethnic Chinese Populations

Whilst archaeological evidence for many aspects of life in ancient China is well studied, there has been much less interest in ancient infectious diseases, such as intestinal parasites in past Chinese populations. Here, we bring together evidence from mummies, ancient latrines, and pelvic soil from burials, dating from the Neolithic Period to the Qing Dynasty, in order to better understand the health of the past inhabitants of China and the diseases endemic in the region. Seven species of intestinal parasite have been identified, namely roundworm, whipworm, Chinese liver fluke, oriental schistosome, pinworm, Taenia sp. tapeworm, and the intestinal fluke Fasciolopsis buski. It was found that in the past, roundworm, whipworm, and Chinese liver fluke appear to have been much more common than the other species. While roundworm and whipworm remained common into the late 20th century, Chinese liver fluke seems to have undergone a marked decline in its prevalence over time. The iconic transport route known as the Silk Road has been shown to have acted as a vector for the transmission of ancient diseases, highlighted by the discovery of Chinese liver fluke in a 2,000 year-old relay station in northwest China, 1,500 km outside its endemic range.