Intestinal parasitic infections in children under five in the Central Hospital of Nampula, Northern Mozambique

Abstract

Introduction: Intestinal parasites are known to cause infection in humans worldwide, with higher prevalence in low- and middle- incoming countries. Children are greatly affected leading to malnutrition and subsequently to physical and cognitive development impairment. Despite the scale and importance of this issue, there are few studies conducted in Mozambique concerning parasitic intestinal infections in hospitalized children. To our knowledge this is the first published report with data on this subject from Northern Mozambique.
 Methodology: A cross-sectional study was conducted in 2012 and 2013 in 831 children, attending the Central Hospital of Nampula in Northern Mozambique. One single stool sample was obtained from each child. Socio-demographic and clinical data were also obtained. Parasitological analysis of feces was performed through direct examination and Ritchie concentration technique and Giardia duodenalis antigen detection by rapid immunochromatographic test. Modified Ziehl-Neelsen staining was used for coccidia detection.
 Results: The global prevalence of pathogenic intestinal parasites was 31.6%. G. duodenalis (23.9%) was by far the most prevalent parasite followed by Strongyloides stercoralis (4.1%) and Cryptosporidium sp. (3.4%). Intestinal parasites were more frequent in older children (p = 0.005; aOR = 1.025).
 Conclusions: This work is one of the few published studies reporting intestinal parasites infection in hospitalized children. The percentage of children affected with G. duodenalis is higher than found in other studies in the African region. This highlights the need of particular attention being given to this intestinal protozoan and its resistance to water treatment, as well as to environmental health and personal hygiene.

Fecal indicator bacteria along multiple environmental exposure pathways (water, food, and soil) and intestinal parasites among children in the rural northwest Ethiopia

“…Ova of one or more intestinal parasites was detected in 47.8% (95% CI 42.8, 52.6%) of the children, which is high compared with reports of community-based studies among under-five children in different parts of Ethiopia, such as in Chuahit (35.2%) [ 15 ], Goncha Siso Enese (11.8%) [ 59 ], Wonji Shoa (24.3%) [ 60 ], and Butajira (23.3%) [ 61 ]. Moreover, the burden of intestinal parasites reported in the current study is higher compared to findings of studies in other developing countries, such as in Kenya (25.6%) [ 62 ], India (17.0%) [ 63 ], Mozambique (31.6%) [ 64 ], and Nigeria (23.3%) [ 65 ]. The high burden of intestinal parasites in children is linked to extensive E. coli contamination water, ready-to-eat foods and courtyard soil from children’s outdoor play area.…”

Molecular Detection of Soil-Transmitted Helminths and Enteric Protozoa Infection in Children and Its Association with Household Water and Sanitation in Manhiça District, Southern Mozambique

“…However, Bauhofer et al’s (2020) study in Mozambique found no association between water use and enteric protozoan infection [ 22 ]. Moreover, other studies focusing on water treatment did not find any association either, since cysts can be chlorination resistant [ 24 , 36 , 37 ]. On the other hand, we did not find any association between sanitation and protozoa infection.…”

“…However, their prevalence assessed were lower than in our study. They used techniques with different sensitivity such as ELISA [ 22 , 23 , 24 ], and direct microscopy or Ritchie’s concentration technique [ 25 ]. But, in addition, environmental and socioeconomical conditions can be dissimilar inside the country and prompt different patterns of Giardia contamination [ 26 ].…”

“…and E. histolytica , were less prevalent in children attending healthcare in Manhiça district. Regarding Cryptosporidium spp , other hospital-based studies in Mozambique also detected prevalence below 6% by microscopy or PCR [ 21 , 24 ]. Nonetheless, Cryptosporidium spp .…”

“…The Global Enteric Multi-center Study (GEMS) also detected only 0.4% infection in hospitalized children for diarrhea in Manhiça district in 2007 [ 27 ]. Meanwhile, E. histolytica cysts antigens were detected by immunoassays and E. hystolitica/dispar was identified by microscopy in Nampula province [ 22 , 24 ], but other studies using molecular diagnostics did not detect E. histolytica in Zambezia province [ 18 , 20 ]. Furthermore, most cross-sectional studies on enteric protozoa infection in the country are in children younger than 5 years old [ 19 , 27 ].…”