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Protozoal colonization of the intestinal tract in institutionalized Romanian children
D K Brannan1, R A Greenfield, W L Owen
1Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
Insights
Intestinal parasitic infections are common in institutionalized Romanian children, with Giardia lamblia affecting 72%. HIV seropositivity and normal nutrition were linked to Giardia, while Cryptosporidium was associated with living location.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pediatrics
Background:
- Institutionalized children are a vulnerable population for infectious diseases.
- Intestinal parasitic infections can cause significant morbidity and mortality in children.
- Previous data on parasitic infections in Romanian institutionalized children is limited.
Purpose of the Study:
- To determine the prevalence of intestinal parasitic infections in institutionalized Romanian children.
- To identify risk factors associated with specific parasitic infections.
- To assess the association between parasitic infections and nutritional status and HIV seropositivity.
Main Methods:
- Review of medical charts and physical examinations of 92 institutionalized children.
- Laboratory analysis of fecal samples for intestinal parasites using immunofluorescent assay and trichrome staining.
- Serological testing for antibodies to human immunodeficiency virus (HIV) and Cryptosporidium.
Main Results:
- Protozoan parasites were identified in 77% of fecal specimens.
- Giardia lamblia was the most prevalent parasite (72%), followed by Cryptosporidium parvum (12%).
- Normal nutritional status and HIV seropositivity predicted Giardia colonization, while living location predicted Cryptosporidium colonization.
Conclusions:
- Intestinal protozoal colonization is highly prevalent in institutionalized Romanian children.
- Parasitic infections may contribute to morbidity and mortality in this high-risk population.
- Targeted interventions are needed to address parasitic infections in institutionalized children.
Abstract:
To determine the prevalence of intestinal parasitic infections in 92 Romanian children institutionalized at Colentina Hospital (Bucharest, Romania) and at the Dystrophic Center (Vidra, Romania), medical charts were reviewed and complete physical examinations were performed. The nutritional status of each child was evaluated, and their sera were tested for the presence of antibodies to human immunodeficiency virus (HIV) and Cryptosporidium. Fecal samples were collected in 10% formalin and examined by an immunofluorescent assay and by trichrome staining for intestinal parasites. At least one protozoan was identified in 77% of the fecal specimens examined. Giardia lamblia (72% of cases), Cryptosporidium parvum (12%), and Entamoeba coli (4%) were the only parasites identified. Stepwise logistic regression revealed that the only factors predictive of giardia colonization were normal nutritional status (P < .01) and HIV seropositivity (P < .02), while cryptosporidium colonization was only associated with where the children lived (P < .01). Seventy-three percent of the children had IgA and/or IgG antibodies to Cryptosporidium in their sera. The presence of these antibodies was strongly associated with the severity of symptoms present in the HIV-infected children (P < .01). Protozoal colonization of the intestinal tract is common in institutionalized Romanian children and may play a role in causing morbidity and mortality in this high-risk group of children.