Diagnosis of giardiasis using an enzyme-linked immunosorbent assay (ELISA) on formalin preserved stools.

From a total of 162 children, three stool samples were collected from each child over a period of one week and preserved in formalin. Giardia lamblia was diagnosed by direct microscopy of formol-ether concentrates for each of the three samples. The first sample was also subjected to an ELISA test for detection of Giardia Iambia stool antigen in formalin preserved stool specimens. Microscopic examination revealed that 45 children were infected whereas ELISA detected 41 cases giving a sensitivity of 91.1% and a specificity of 99.1%. Predictive value of a positive test was 97.6% and that of a negative test was 96.7%. A significant correlation was present between mean optical density readings of ELISA and number of cysts present. No crossreactivity was observed ELISA is a simple, sensitive and specific test that can be applied in epidemiological studies for detection of Giardia lamblia coproantigen in formalin preserved stool specimens.

Parasitic infections and maternal awareness of preschool children in Karmouz district, Alexandria.

Intestinal parasitic infections are widespread especially among preschool children living in poor areas. Also pediculosis has been perceived as a public health nuisance for decades. A cross-sectional study was conducted on 256 children and their mothers in a poor urban district to assess mothers' knowledge and practices as regards parasitic infections and infestations that may be present in her preschool child, and to correlate the presence of these infections with her awareness. A pre-designed questionnaire that included socio-demographic data, items to assess mothers' knowledge of sources and preventive measures of parasitic infections and infestations and her practices was completed. A stool sample was collected from children and examined using formol-ether technique and Sellotape technique was used to detect Enterobius vermicularis. Pediculus capitis was diagnosed by inspection of the scalp and was found to be the most prevalent parasite found in 58.9% of those children followed by Enterobius vermicularis in 46%. A strong positive association between pediculosis and enterobiasis was detected (phi coefficient = 0.956, p < 0.001). Socioeconomic level affected both knowledge and practices scores where one point change in knowledge score or socioeconomic score caused an increase in practice score of 0.279 and 0.071, respectively. Also higher risk of pediculosis was found to be significantly associated with female sex and low socioeconomic level. An increase of one point in practice score showed a decrease in the log likelihood ratio of enterobiasis of 14.3%. The majority of mothers (77.3%) were found to be aware that their children had a parasitic infection, which was significantly associated with results of stool analysis. This indicates that awareness building is not enough to be of practical benefit. Appropriate and detailed control methods of parasitic infections and pediculosis must be taught and applied by parents and community. Socio-economic development, organized health programs and motivation should be undertaken to help today's children.

The impact of intestinal parasitic infections on the nutritional status of primary school children in Alexandria, Egypt.

In order to investigate the relationship between intestinal parasitism and nutritional status, stool specimens obtained from 1674 school children aged 6-13 years, enrolled in primary governmental schools in the Eastern zone of Alexandria, Egypt were examined for helminth and protozoan parasites. The findings were collated with anthropometric data (weight and height) on the same children. The prevalence of parasitic infections was found to be 31.5%. The most common infections were found to be with Giardia lamblia (15.4%) and Ascaris lumbricoides (10.2%). Children infected with both helminths and protozoa showed an increased but insignificant risk of underweight relative to those without infections. The risk of stunting was found among all types of parasites as compared to children with no parasites. Also there was a higher non significant risk of wasting among those with protozoal infection especially Giardia lamblia. Children infected with three species or more of intestinal parasitic infections were significantly underweight than non infected children (OR = 4.68, 95% confidence limit = 1.04-18.03). Using stepwise logistic regression analysis, number of parasites appeared to be the most effective variable of the nutritional status of children indicated by weight for age Z score, followed by education of the mother.

Association of parasites and diarrhoea among children less than five years of age in a rural area in Egypt.

A case control study was conducted in Kafr El-Sheikh Governorate, Egypt, a rural community, to assess the relation of parasites and diarrhoea among children <5 years. A sample of 196 cases with diarrhoea and 83 non-diarrhoeic controls were included in the study. A questionnaire was completed for every child and weight and height were recorded. A stool sample was obtained and examined for parasites present. The results revealed that 70.3% of cases had parasites compared to 59% of controls. The most common parasites found were Entamoeba histolytica, cryptosporidium, and Giardia lamblia consecutively. In both groups the percent positive parasitic infection increased with age. The different socioeconomic and sanitary indicators studied were similar among both groups and could not explain the diarrhoea present except for the significantly higher presence of piped water inside houses of controls. Study of malnutrition revealed that a significantly higher percentage were stunted (15.6%) among cases than among controls (6.5%) and 13.8% were wasted among cases compared to only 2% among controls. Undernourished cases were 14.8% compared to 4.3% of controls.