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Parasitism and diarrhoea in children from two rural communities and marginal barrio in Honduras
1Dirección de Investigación Cientifica, National Autonomous University of Honduras.
Insights
Diarrhoea is a major childhood health issue in Honduras. Giardia lamblia was the most common parasite found, contributing to chronic diarrhoea and multiple infections, exacerbated by poor sanitation and poverty.
Area of Science:
- Pediatric Infectious Diseases
- Parasitology
- Public Health in Developing Nations
Background:
- Diarrhoea is a leading cause of child morbidity and mortality in Honduras.
- Limited understanding exists regarding the specific causes and risk factors for childhood diarrhoea in the region.
Purpose of the Study:
- To investigate the aetiology and risk factors of diarrhoea in children under 36 months in rural and marginalized Honduran communities.
- To identify common parasitic infections and their association with diarrhoeal episodes and chronic diarrhoea.
Main Methods:
- Prospective longitudinal study conducted over 12 months involving 266 children.
- Data collection included monitoring diarrhoeal episodes, parasite identification in stool samples, and assessment of environmental and socioeconomic risk factors.
- Parasitological examination included analysis for Giardia lamblia, Entamoeba histolytica, Cryptosporidium sp., Hymenolepis nana, Strongyloides stercoralis, and Dientamoeba fragilis.
Main Results:
- High diarrhoea attack rates (7 episodes/child/year) were observed in children under 36 months.
- Giardia lamblia was the most prevalent parasite (61% of children, 29% of episodes), strongly associated with chronic diarrhoea (81% of chronic cases).
- Multiple parasitic infections were common (47%); significant risk factors included poor sanitation, lack of potable water, inadequate housing, and poverty, with the marginal barrio showing higher impact.
Conclusions:
- Giardia lamblia is a primary driver of childhood diarrhoea, particularly chronic forms, in this Honduran population.
- Environmental contamination, poor water access, and socioeconomic factors are critical determinants of diarrhoea prevalence.
- Addressing these modifiable risk factors is essential to combat endemic, life-threatening infectious diarrhoea in Honduras.
Abstract:
In Honduras, one of the leading causes of morbidity and mortality among children is diarrhoea, but little is known about its aetiology and risk factors. A prospective longitudinal study of 266 children over a 12 month period in 2 rural villages and a marginal barrio revealed attack rates of 7 episodes per child per year among those less than 36 months of age. The most common parasite was Giardia lamblia, found in 61% of the children and in 29% of 848 episodes of diarrhoea. Chronic diarrhoea was noted in 46.6% of the children and 81% of them were infected with G. lamblia. Multiple infections with 5-10 different species of parasites or commensals were common (47%); no parasites or commensals were found in 17 children (6.4%). No case of acute amoebic dysentery was diagnosed either clinically or parasitologically, although 20% of the children had cysts of E. histolytica in the stools. Other potential parasitic pathogens identified were Cryptosporidium sp. (6.7%), Hymenolepis nana (8%), and Strongyloides stercoralis (2.6%). Dientamoeba fragilis was found in iron haematoxylin smears for the first time in Honduras. Important risk factors recognized included high faecal contamination of the environment, lack of potable water, education and housing in the midst of poverty. The marginal barrio was more affected than the rural villages. Should these factors not be changed or modified, diarrhoea caused by infectious agents will remain an endemic life-threatening problem.