Hymenolepis nana—An Emerging Intestinal Parasite Associated with Anemia in School Children from the Bolivian Chaco

Abstract

Tropical anaemia can have multiple causes, whether socio-economic, dietary or infectious. In the Bolivian Chaco, soil-transmitted helminthiases (STH), malaria and Chagas disease are potential infectious causes of anaemia among school-aged children (SAC). Following years of preventive chemotherapy with mebendazole, the prevalence of STH among SAC living in that area is now negligible, while protozoan infections are still highly prevalent (81%); Hymenolepis nana is the most frequent intestinal helminth (~13%). We present results of haemoglobin (Hb) assessment and the association between parasitic infections and Hb levels of that SAC population. Overall, 511 SAC (girls:boys ratio 1:1, mean age 9.4 years (95%CI 9.3-9.5)) had Hb levels measured by using a portable Hb system HB 301+ (HemoCue1 AB, Angelhome, Sweden). The prevalence of anaemia was 23% (117/511), with mean and median Hb level = 12.2 g/dl (95%CI 12.1-12.3; range 9.2-15.4 g/dl). By multivariate analysis, H. nana infection was associated with an increased risk of anaemia (OR 2.9, 95%CI 1.5-5.7, p=0.002). Two samples (0.5%) were positive for T. cruzi and none for Plasmodium spp by polymerase chain reaction (PCR) of the 439 children tested. Anaemia is still a concern among SAC living in the Bolivian Chaco. Our findings call for a greater attention to faecal-oral emerging pathogens, such as H. nana, and highlight the importance of water, sanitation and hygiene improvements for disadvantaged population such as those living in the Bolivian Chaco.

The neglected cestode infection: Epidemiology of Hymenolepis nana infection among children in rural Yemen

“…Moreover, mass drug administration (MDA), the key strategy for controlling schistosomiasis and STH infections in Yemen, has been largely interrupted due to the war (Al-Mekhlafi et al, 2018). A much lower prevalence of H. nana infection is commonly reported worldwide (Oliveira et al, 2015;Asai et al, 2016;Spinicci et al, 2018;Periago et al, 2018;von Huth et al, 2019). However, a similar prevalence (17.4 %) has been reported among children aged 3 -16 years in the highlands of Peru (Cabada et al, 2016).…”

“…Likewise, H. nana-infected Sudanese children have been found to have a nine-fold higher risk of diarrhoea compared with uninfected children (Abdel Hamid et al, 2015). Moreover, H. nana infection has been identified as a significant predictor of malnutrition and anaemia (Mohammad and Hegazi, 2007;Oliveira et al, 2015;Spinicci et al, 2018). Thus, further studies are warranted on the burden and clinical profile of H. nana infection among children in rural Yemen.…”

“…A much lower prevalence of H. nana infection is commonly reported worldwide ( Oliveira et al, 2015 ; Asai et al, 2016 ; Spinicci et al, 2018 ; Periago et al, 2018 ; von Huth et al, 2019 ). However, a similar prevalence (17.4 %) has been reported among children aged 3 – 16 years in the highlands of Peru ( Cabada et al, 2016 ).…”

Hymenolepiasis in a Pregnant Woman: A Case Report of Hymenolepis nana Infection

“…nana may be associated with other factors that include hygiene, sanitation, auto-infection, and co-morbidities (prevalence of other parasitic infections like schistosomiasis) [16]. A recent study impressed on the significance of hymenolepiasis as an emerging intestinal parasitic infection in children and its association with anemia [17].…”

Long-Standing International Cooperation in Parasitology Research: A Summary of 35 Years of Activities in the Bolivian Chaco

“…Indeed, a study conducted in 1990 in two rural communities in the same region showed 22% and 16% and a mean Hb of 11.8 and 12.4 g/dL among pre-SAC (2–5 years old) and SAC (6–9 years old), respectively [ 11 ]. Interestingly, in the population from the 2016 survey, H. nana infection was associated with a three-fold greater risk of anemia [ 12 ].…”