Coccidios intestinales en niños menores de 5 años con diarrea: Emergencia pediátrica, Hospital Universitario “Ruiz y Páez”  <span class="so-article-trans-title" dir="auto"> Translated title: Intestinal coccidia in children under 5 years of age with diarrhea: Pediatric Emergency Service of the “Ruiz Paez” University Hospital </span>

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Abstract

Entre agosto y octubre de 2006 se realizó un estudio con el objetivo de determinar la prevalencia de coccidios intestinales en niños menores de 5 años con diarrea, atendidos en la emergencia pediátrica del Hospital Universitario “Ruiz y Páez”. Una muestra fecal obtenida de cada paciente fue sometida a las técnicas de examen directo, formol-éter y coloración de Kinyoun. Se examinaron 130 muestras fecales procedentes de igual número de niños, de ellos, 60 eran niñas (46,2%) y 70 niños (53,8%) con una edad media de 2 ± 1,4 años. Se encontró una prevalencia general de parasitosis intestinales de 38,5% (50/130). La prevalencia de coccidios intestinales fue de 12,3%, siendo Cryptosporidium spp. el más frecuente con 10 casos (7,7%), seguido de Cyclospora cayetanensis con seis casos (4,6%). No hubo diferencias con relación al género (p>0,05) y la edad (X2 =7,41; g.l.= 5) de los niños con coccidios. En 11 casos sólo se identificó el coccidio mientras que en 5 casos los coccidios estaban asociados con otros enteroparásitos. Se concluyó que la prevalencia de coccidios intestinales en niños con diarrea aguda atendidos en la emergencia pediátrica del Hospital Universitario “Ruiz y Páez” fue relativamente alta (10,9%), siendo Cryptosporidium el coccidio más frecuentemente diagnosticado

Translated abstract

A study was carried out between August and October 2006 with the purpose of determining the prevalence of intestinal coccidia in children under 5 years of age with diarrhea who attended the Pediatric Emergency Service of the “Ruiz Paez” University Hospital. A fecal sample obtained from each patient was submitted to the following tests: direct examination, formaldehyde-ether and Kinyoun staining. A total of 130 fecal samples obtained from the same number of patients were examined; 60 of the patients were girls (46.2%) and 70 were boys (53.8%), with a mean age of 2 ± 1.4 years. A general prevalence of 38.5% (50/130) intestinal parasites was found. The intestinal coccidia prevalence was 12.3%, and Cryptosporidium spp. was the most frequent parasite with 10 cases (7.7%), followed by Cyclospora cayetanensis with six cases (4.6%). There were no differences regarding gender (p>0.05) and age (χ² = 7.41; g.l. = 5) of children with coccidia. Coccidia alone were identified in 11 cases, while in other 5 cases the coccidia were associated with other enteroparasites. It was concluded that the prevalence of intestinal coccidia in children with acute diarrhea attending the Pediatric Emergency Service of the “Ruiz Paez” University Hospital was relatively high (10.9%) and that Cryptosporidium was the most frequent coccidia identified

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Most cited references 75

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Cryptosporidium parvum in children with diarrhea in Mulago Hospital, Kampala, Uganda.

James K. Tumwine, Stephen S Rich, Addy Kekitiinwa … (2003)

A cross-sectional case-control study (ratio = 3:1) was conducted over a 15-month period to determine the prevalence and consequences of cryptosporidiosis in hospitalized diarrheic children (0-5 years old) at Mulago Hospital in Kampala, Uganda. Cryptosporidium parvum was detected and genotyped among 2,446 children of whom 1,779 (72.7%) had diarrhea, and 667 (27.3%) were age- and sex-matched controls. Of the 1,779 children with diarrhea, 532 (29.9%) had persistent (> 14 days) diarrhea and 1,247 (70.1%) had acute diarrhea. Overall, 444 (25.0%) of the 1,779 children with diarrhea had C. parvum, compared with only 57 (8.5%) of the 667 children without diarrhea (chi2 = 80.2, P < or = 0.0001). Within this group of infected children, 72.8% were infected with genotype 1, 18.4% with genotype 2, and 4.1% with a mixture of both genotypes, and 4.1% isolates were either unclassified or C. meleagridis. The prevalence was highest during the rainy months of April to June. Of the 532 children with persistent diarrhea, 166 (31.2%) had C. parvum compared with 278 (22.3%) of the 1,247 children with acute diarrhea (chi2 = 15.8, P < or = 0.0001). There was a significant association between C. parvum and malnutrition including stunting, being underweight, and wasting. Unfavorable outcome (death or failure to resolve within 14 days) occurred in 139 (72.8%) of the 191 children with C. parvum, and in only 65.1% of the 545 without (odds ratio = 1.117, 95% confidence interval = 1.005-1.243, P = 0.05), Of the 191 children with C. parvum, 24 (12.6%) died, compared with 34 (6.2%) of the 545 without C. parvum (P = 0.005). Mortality rates were higher among children with severe dehydration and persistent diarrhea, and in stunted or underweight children infected with C. parvum. Among Ugandan children, cryptosporidiosis, which remains untreatable, is frequently associated with diarrhea and other serious and unfavorable consequences.

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Epidemiologic and clinical characteristics of acute diarrhea with emphasis on Entamoeba histolytica infections in preschool children in an urban slum of Dhaka, Bangladesh.

Dinesh Mondal, S B Farr, William Petri … (2003)

The epidemiology, clinical features, nutritional status, and causative agents of diarrhea were studied in 289 Bangladeshi children (147 boys and 142 girls) 2-5 years old. The use of improved diagnostic tests for amebiasis enabled for the first time analysis of the contribution of Entamoeba histolytica to total diarrheal illness in this community setting. The average incidence rate of diarrhea was 1.8/child-year, and the average number of diarrheal days was 3.7 days/child-year over an average observation period of 2.8 years/child. Seventy-five percent of the diarrheal episodes were < or = 2 days in duration. Persistent diarrhea was relatively uncommon (0.2% of the children) and chronic diarrhea was observed in only one episode. Compared with malnourished and/or stunted children, better-nourished children experienced significantly fewer diarrheal episodes. The diarrheal incidence rate for children with blood group A was significantly less that that of the children with blood groups O and AB. The most frequent bacterial enteropathogens isolated from diarrheal stool specimens were enterotoxigenic Escherichia coli (9%) and Aeromonas species (9%), followed by Plesimonas shigelloides (4%) and Shigella flexneri (3.8%). Rotavirus was the most common viral agent isolated from diarrheal stool samples (5%). Giardia lamblia, Cryptosporidium parvum, and E. histolytica were identified in 11%, 8.4%, and 8%, respectively, of the diarrheal stool specimens. Dysentery was observed in 7.7% of all diarrheal episodes. The most common pathogens isolated from dysenteric stool were S. flexneri (11.6%), Aeromonas sp. (10%), E. histolytica (8.7%), Campylobacter jejunii (5.8%), P. shigelloides (4.3%), and A. caviae (4.3%). The overall incidence rate of E. histolytica-associated diarrhea was 0.08/child-year. Visible blood and hemoccult test-detected blood loss was found in 7% and 25%, respectively, of cases of E. histolytica-associated diarrhea. Children who had recovered from a diarrheal episode with E. histolytica, but not E. dispar, had half the chance of developing subsequent E. histolytica-associated diarrhea, consistent with the development of species-specific acquired immunity. In conclusion, the use of modern diagnostic tests demonstrated that E. histolytica contributed to overall morbidity from diarrheal illness. Understanding the etiology, frequency, and consequences of acute diarrhea in children from a developing country should aid in the design of interventions to improve child health.