Brief report. Intestinal parasites in Malaysian children with cancer

Menon, Bina; Abdullah, M; Mahamud, F.; Singh, Balbir

doi:10.1093/tropej/45.4.241

Cited by 42 publications

(37 citation statements)

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“…In this study, the rate of intestinal parasitic infection in immunocompromised children with persistent and/or recurrent diarrhoea was 57%, slightly higher than that found in a similar study in Malaysia (42%) [7] on paediatric cancer patients and one on HIV-positive children in Thailand (33%) [13]. The difference could be due to different epidemiological patterns of parasitic infection in Indonesia.…”

Section: Discussioncontrasting

confidence: 50%

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Intestinal parasitic infection of immunocompromised children with diarrhoea: clinical profile and therapeutic response

Idris

Dwipoerwantoro

Kurniawan

et al. 2010

J Infect Dev Ctries

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Background: Parasitic gastrointestinal infections have been variably reported among immunocompromised adults while data on children have been limited. This prospective cross-sectional study aimed to assess the clinical profile of intestinal parasitic infections among immunocompromised children with diarrhoea and their treatment response. Methodology: Two freshly voided stool samples taken for two consecutive days were examined by direct and formalin-ether concentrated smears. Modified Ziehl-Neelsen staining was used to detect Cryptosporidium, Isospora belli, and Cyclospora cayetanensis. Blastocystis hominis was identified using in vitro culture. Subjects positive for stool parasite(s) received standard therapy according to the aetiology and were evaluated afterward. Results: Forty-two subjects from Jakarta, Indonesia were included in this study, mostly aged one to five years (78%) and HIV infected (52%). Parasites were found in 24/42 (57%) subjects in which B. hominis comprised the largest proportion (23/24 = 96%). Cryptosporidium was identified in two subjects who were HIV infected with CD4 percentages of < 15%. No helminth infestations were found. Parasites were most frequently found in preschool age children (16/23), in those with recurrent or watery diarrhoea (23/24 and 14/18, respectively), and in HIV subjects not receiving antiretrovirals (16/22). Of 13 subjects evaluated for response to a 10-day metronidazole course for B. hominis infection, seven achieved clinical remission and nine had their parasites eradicated. Conclusions: The prevalence of intestinal parasitic infection in immunocompromised children with persistent and/or recurrent diarrhoea is moderately high and dominated by B. hominis infection. Clinical remission and parasite eradication can be achieved in B. hominis infection treated with metronidazole.

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Section: Discussioncontrasting

confidence: 50%

“…The incidence of parasitic infection in HIV patients with diarrhoea was reported to be 53-83% [5,6]. Similar prevalence rates (42%) were also found in children with malignancy [7].…”

Section: Introductionmentioning

confidence: 63%

Intestinal parasitic infection of immunocompromised children with diarrhoea: clinical profile and therapeutic response

Idris

Dwipoerwantoro

Kurniawan

et al. 2010

J Infect Dev Ctries

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“…By comparison, 13% of stools from non-oncology patients were positive. The second study was performed in Malaysia, where Cryptosporidium was found in 2% of children (86).…”

Section: Cryptosporidiosis In Patients With Malignant Diseasementioning

confidence: 99%

Epidemiology and Clinical Features ofCryptosporidiumInfection in Immunocompromised Patients

Hunter

Nichols²

2002

Clin Microbiol Rev

490

363

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SUMMARY Cryptosporidium spp. are a major cause of diarrheal disease in both immunocompetent and immunodeficient individuals. They also cause waterborne disease in both the United States and United Kingdom. Studies on the mechanisms of immunity to cryptosporidiosis indicate the importance of the T-cell response. The spectrum and severity of disease in immunocompromised individuals with cryptosporidiosis reflect this importance since the most severe disease is seen in individuals with defects in the T-cell response. The most commonly studied group is that of patients with AIDS. These patients suffer from more severe and prolonged gastrointestinal disease that can be fatal; in addition, body systems other than the gastrointestinal tract may be affected. The widespread use of antiretroviral therapy does appear to be having a beneficial effect on recovery from cryptosporidiosis and on the frequency of infection in human immunodeficiency virus-positive patients. Other diseases that are associated with increased risk of severe cryptosporidiosis, such as primary immunodeficiencies, most notably severe combined immunodeficiency syndrome, are also predominantly associated with T-cell defects. Of the remaining groups, children with acute leukemia seem to be most at risk from cryptosporidiosis. There is less evidence of severe complications in patients with other malignant diseases or in those receiving immunosuppressive chemotherapy.

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“…Subsequently, studies on cryptosporidiosis have been limited to hospital cases. The incidence of cryptosporidiosis among paediatric patients ranged from 1-11% (Mendez et al 1988;Mat Ludin et al 1991;Lai 1992;Kan & Shekhar 1993;Ng & Shekhar 1993;Menon et al 2001) and among immunosuppressed children, suffering from cancer and receiving chemotherapy, was 2% (Menon et al 1999). In a community study of diarrhoeic young children in Kelantan, 11% had cryptosporidiosis (Lai 1992).…”

Section: Cryptosporidiummentioning

confidence: 99%

“…Among hospitalized children, a high incidence (25%) of giardiasis was observed in Orang Asli children (Bisseru & Aziz 1970). In children with cancer and undergoing chemotherapy, giardiasis was observed in 6% of the patients (Menon et al 1999).…”

Section: Giardiamentioning

confidence: 99%

Current status and future trends in Cryptosporidium and Giardia epidemiology in Malaysia

Lim

Ahmad

Smith

2008

Journal of Water and Health

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Cryptosporidium and Giardia are major causes of diarrhoeal diseases of humans worldwide, and are included in the World Health Organisation's 'Neglected Diseases Initiative'. Cryptosporidium and Giardia occur commonly in Malaysian human and non-human populations, but their impact on disease, morbidity and cost of illness is not known. The commonness of contributions from human (STW effluents, indiscriminate defaecation) and non-human (calving, lambing, muck spreading, slurry spraying, pasturing/grazing of domestic animals, infected wild animals) hosts indicate that many Malaysian environments, particularly water and soil, are sufficiently contaminated to act as potential vehicles for the transmission of disease. To gain insight into the morbidity and mortality caused by human cryptosporidiosis and giardiasis, they should be included into differential diagnoses, and routine laboratory testing should be performed and (as for many infectious diseases) reported to a centralised public health agency. To understand transmission routes and the significance of environmental contamination better will require further multidisciplinary approaches and shared resources, including raising national perceptions of the parasitological quality of drinking water. Here, the detection of Cryptosporidium and Giardia should be an integral part of the water quality requirement. A multidisciplinary approach among public health professionals in the water industry and other relevant health-and environment-associated agencies is also required in order to determine the significance of Cryptosporidium and Giardia contamination of Malaysian drinking water. Lastly, adoption of validated methods to determine the species, genotype and subgenotype of Cryptosporidium and Giardia present in Malaysia will assist in developing effective risk assessment, management and communication models.

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Brief report. Intestinal parasites in Malaysian children with cancer

Cited by 42 publications

References 0 publications

Intestinal parasitic infection of immunocompromised children with diarrhoea: clinical profile and therapeutic response

Intestinal parasitic infection of immunocompromised children with diarrhoea: clinical profile and therapeutic response

Epidemiology and Clinical Features ofCryptosporidiumInfection in Immunocompromised Patients

Current status and future trends in Cryptosporidium and Giardia epidemiology in Malaysia

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