The burden of intestinal parasitic infections in Antioquia, Colombia: Impact in childhood growth development and nutritional status.

Gastrointestinal protist (GP) and soil-transmitted helminth (STH) infections cause significant morbidity among children in poor-resource settings of tropical and sub-tropical countries including Colombia. Few prospective transversal studies investigating how GP and STH infections affect growth development and nutritional status during childhood have been conducted in this country, none of them in the Antioquia Department. This microscopy-based study estimated the prevalence of GP and helminth (including STH) infections in faecal samples from schoolchildren (n = 384) collected during April-May 2019 in three municipalities of the Antioquia Department. Demographic, epidemiological, and household data were elicited through face-to-face interviews. Parasite detection was carried out by direct microscopic examination of both fresh smears and concentrated faecal material. Children (aged 6-15 years) also had their haemoglobin (Hb) levels, height and weight data collected, and BMI estimated. Data were analysed using bivariate and multivariate logistic regression analysis. Overall, 60.7 % (233/384) of schoolchildren were infected by at least one intestinal parasitic species. Among GPs, Blastocystis sp. was the most common species found (47.7 %, 95 % CI: 42.6-52.8), followed by G. duodenalis (15.9 %, 95 % CI: 12.4-19.9). Cryptosporidium spp. and Cyclospora cayetanensis were sporadically identified (0.3 %, 95 % CI: 0.1-1.4 each). Among helminths, the most prevalent species found were Trichuris trichiura (6.0 %, 95 % CI: 3.8-8.9) and Enterobius vermicularis (1.0 %, 95 % CI: 0.3-2.6). Hookworms, Ascaris lumbricoides, and Strongyloides stercoralis were found at prevalence rates <1 %. Underweight, overweigh, or obese schoolchildren had 1.2 times greater chance of being infected with intestinal parasites than their counterparts with a healthy weight (P-value: 0.015). Variables significantly associated with an increased likelihood of being infected by intestinal parasites include living in a household with unfinished flouring, not wearing shoes, being in close proximity to rodents, and having improper waste disposal. Relatively simple interventional measures directed towards the improvement of household conditions, access to sanitary toilets, and promoting shoe wearing can significantly reduce childhood infections by GP and helminths in the Antioquia Department.

Prevalence of soil transmitted helminths in school-aged children, Colombia, 2012-2013.

BACKGROUND: This study aims to establish the prevalence of soil-transmitted helminth (STH) intestinal infections, nutritional status, and anemia in school children aged 7 to 10 years old in the biogeographic provinces of Colombia in 2012-2013. STH prevalence in the country has not been described within the last 30 years and it is needed in order to establish policies its control in the country. METHODOLOGY: National Survey of STH in school-aged children with a multistage stratified probability sampling was conducted. The overall prevalence and intensity of STH infection, as well as for each parasite, (A. lumbricoides, T. trichiura and hookworms) were calculated for the country and for each of the nine biogeographic provinces. PRINCIPAL FINDINGS: Stool samples were collected from 6045 children in eight out of nine biogeographic provinces. The combined prevalence of STH in the country was 29.6%. T. trichiura was the most prevalent helminth (18.4%), followed by A. lumbricoides (11.3%), and hookworms (6.4%). For A. lumbricoides and hookworms, the highest prevalence values were found in the Amazonía province (58.0% and 35.7%, respectively). Regarding STH intensity, most cases showed moderate intensity (41.3%) for A. lumbricoides, and light intensity, for T. trichiura and hookworms. The national prevalence of anemia in school-aged children was 14.2%, lowest in the Nor-Andina province (3.5%), and highest in the Territorios Insulares oceánicos del Caribe province (45.1%). SIGNIFICANCE: Colombia has a moderate risk of STH infection in school-aged populations, with considerable variation in the prevalence values among the biogeographic provinces. Like any public health issue, this problem should be handled with a comprehensive approach that involves deworming programs and strategies for STH control according to the specific epidemiological and socioeconomic conditions and sanitation service coverage in each biogeographic province. The program should be further supported by intersectoral action to improve living conditions, particularly the excreta disposal, promoted at municipality levels.

Common occurrence of Cryptosporidium hominis in children attending day-care centers in Medellin, Colombia.

Cryptosporidium spp. are apicomplexan protozoa associated with chronic diarrhea in AIDS and other immunocompromised patients, and one of the commonest causes of childhood diarrhea and malnutrition, particularly in low-income settings. In Colombia, there are few molecular epidemiological studies on Cryptosporidium spp.; thereby, the transmission dynamics of this parasite in the country is poorly known. This study evaluated the diversity of Cryptosporidium at species, subtype family, and subtype level in children attending various day-care centers in Medellin, Colombia. Two hundred and ninety stool samples from children < 5 years of age were collected from April to November of 2015. All samples were processed by PCR and sequence analysis of the ssu RNA gene and the gp60 gene. An infection rate of 2.4% was observed, with only two Cryptosporidium species identified: C. hominis (6/7) and C. meleagridis (1/7). Cryptosporidium hominis isolates belonged to the subtypes IbA10G2, IaA13R6 and IaA13R7; IIIbA26G1R1 C. meleagridis subtype was also detected. There is a C. hominis predominance in the children evaluated, suggesting an important role of the anthroponotic transmission cycle in the day-care centers analyzed. Further investigation is required to determine infection sources and susceptible hosts in order to define appropriate management of cryptosporidiosis.

Prevalencia de parásitos intestinales en niños que asisten al Templo Comedor Sagrado Corazón Teresa Benedicta de la Cruz, del barrio Vallejuelos, Medellín, 2007 / Intestinal parasites prevalence in children from "Templo-Comedor Sagrado Corazón Teresa Benedicta de la Cruz",Vallejuelos-Medellín, 2007.

Introducción: los seres humanos estamos expuestos a los parásitos presentes en el medio en quehabitamos, lo que puede plantear un problema de salud pública, especialmente en los países en vías de desarrollo como Colombia. La población más vulnerable es la infantil, especialmente la de comunidades en condiciones socioeconómicas precarias.Objetivo: determinar la prevalencia de parásitos intestinales en los niños que acuden a un templocomedor en un barrio marginal de Medellín.Métodos: en octubre y noviembre de 2007 se hizo un estudio descriptivo transversal, mediante un coprológico directo y por concentración, en 58 de los 150 niños que acuden al templo-comedor; lo anterior se complementó con una encuesta sobre algunas variables sociodemográficas.Resultados: se halló que 54 de los 58 niños (93%) estaban parasitados y que en 48 de ellos (88,9%) losparásitos eran potencialmente patógenos; entre estos predominó Entamoeba histolytica/dispar(46,6%), seguida por Giardia intestinalis (25,9%), Trichuris trichiura (25,9%), Ascaris lumbricoides (24,1%) y Enterobius vermicularis (8,6%). Se halló multiparasitismo en 21 niños (38,8%). En cuanto a la relación entre algunas variables sociodemográficas y la frecuencia de parásitos solo se halló que el hacinamiento en la vivienda se asociaba significativamente con la presencia de Entamoeba histolytica/dispar y de Blastocystis hominis, y la tenencia de mascotas, con la infección por Enterobiusvermicularis.Conclusión: la prevalencia de parasitosis intestinales hallada en este trabajo superó la de otros grupos tanto colombianos como extranjeros. Se discuten las implicaciones de este hallazgo desde el punto de vista de la salud pública.

Introduction: Human beings are exposed to the parasites present in their habitat. This situation poses a public health problem, especially in underdeveloped countries such as Colombia. The pediatric population is the most vulnerable, particularly that of communities in poor socioeconomic conditions.Objective: To determine the prevalence of intestinal parasites in children attending a social aid institution in a poor neighborhood of Medellín, Colombia.Methods: In October and November 2007 a descriptive cross-sectional study was carried out by means of direct and concentration stool examination in 58 out of 150children attending the aforementioned institution. In addition, a survey was made of some socio-demographicvariables.Results: 54 of the 58 children (93%) were infected by intestinal parasites. In 48 of them (88.9%) potentiallypathogen parasites were present, namely: Entamoeba histolytica/dispar (46.6%), Giardia intestinalis (25.9%), Trichuris trichiura (25.9%), Ascaris lumbricoides (24.1%), and Enterobius vermicularis (8.6%). Twenty one children (38.8%) were infected with either 2 or 3 parasites. The only significant associations between socio demographic variables and parasitic infections were as follows:overcrowding was associated with Entamoeba histolytica/dispar and Blastocystis hominis, and thepresence of pets (mostly dogs) in the house was associated with Enterobius vermicularis.Conclusion: Prevalence rate of intestinal parasites was higher in the studied group than in other communities, both Colombian and from other countries. Implicationsof this finding from the public health perspective are discussed.