High prevalence of intestinal parasite infestations among stunted and control children aged 2 to 5 years old in two neighborhoods of Antananarivo, Madagascar

Abstract

Background This study aimed to compare the prevalence of intestinal parasite infestations (IPIs) in stunted children, compared to control children, in Ankasina and Andranomanalina Isotry (two disadvantaged neighborhoods of Antananarivo, Madagascar), to characterize associated risk factors and to compare IPI detection by real-time PCR and standard microscopy techniques. Methodology/Principal findings Fecal samples were collected from a total of 410 children (171 stunted and 239 control) aged 2–5 years. A single stool sample per subject was examined by simple merthiolate-iodine-formaldehyde (MIF), Kato-Katz smear and real-time PCR techniques. A total of 96.3% of the children were infested with at least one intestinal parasite. The most prevalent parasites were Giardia intestinalis (79.5%), Ascaris lumbricoides (68.3%) and Trichuris trichiura (68.0%). For all parasites studied, real-time PCR showed higher detection rates compared to microscopy (G. intestinalis [77.6% (n = 318) versus 20.9% (n = 86)], Entamoeba histolytica [15.8% (n = 65) versus 1.9% (n = 8)] and A. lumbricoides [64.1% (n = 263) versus 50.7% (n = 208)]). Among the different variables assessed in the study, age of 4 to 5 years (AOR = 4.61; 95% CI, (1.35–15.77)) and primary and secondary educational level of the mother (AOR = 12.59; 95% CI, (2.76–57.47); AOR = 9.17; 95% CI, (2.12–39.71), respectively) were significantly associated with IPIs. Children drinking untreated water was associated with infestation with G. intestinalis (AOR = 1.85; 95% CI, (1.1–3.09)) and E. histolytica (AOR = 1.9; 95% CI, (1.07–3.38)). E. histolytica was also associated with moderately stunted children (AOR = 0.37; 95% CI, 0.2–0.71). Similarly, children aged between 4 and 5 years (AOR = 3.2; 95% CI (2.04–5.01)) and living on noncemented soil types (AOR = 1.85; 95% CI, (1.18–2.09)) were associated with T. trichiura infestation. Conclusions/Significance The prevalence of IPIs is substantial in the studied areas in both stunted and control children, despite the large-scale drug administration of antiparasitic drugs in the country. This high prevalence of IPIs warrants further investigation. Improved health education, environmental sanitation and quality of water sources should be provided.

Factors associated with anaemia among preschool- age children in underprivileged neighbourhoods in Antananarivo, Madagascar

“…All faecal samples were physically examined and screened for intestinal parasites as previously described [ 17 ].…”

Changes in Systemic Regulatory T Cells, Effector T Cells, and Monocyte Populations Associated With Early-Life Stunting

“…Methods for stool sample collection and examination for the presence of helminth eggs, helminth larvae, and protozoan infestation using Kato–Katz smear, formol-ethyl acetate-concentration methods (MIF), and real-time PCR have been previously described ( 31 ). Real-time PCR was carried out on a CFX 96 Real Time system (BIO-RAD, France) for the following parasites: A. lumbricoides, G. intestinalis, E. histolytica, Cryptosporidium parvum , and Isospora belli , and the microsporidia species Enterocytozoon bieneusi and Encephalitozoon spp.…”

Changes in Systemic Regulatory T Cells, Effector T Cells and Monocyte Populations Associated with Early Life Stunting

“…Methods for stool sample collection and examination for the presence of helminth eggs, helminth larvae, and protozoan infestation using Kato-Katz smear, formol-ethyl acetateconcentration methods (MIF), and real-time PCR have been previously described (31). Real-time PCR was carried out on a CFX 96 Real Time system (BIO-RAD, France) for the following parasites: A. lumbricoides, G. intestinalis, E. histolytica, Cryptosporidium parvum, and Isospora belli, and the microsporidia species Enterocytozoon bieneusi and Encephalitozoon spp.…”