Health and disease: exploring the relation between parasitic infections, child nutrition status, and markets.

Research in bioarchaeology and among living people provides insight into the biological and biocultural consequences of subsistence, political, and economic transitions. Central to this effort is examining infectious disease, such as diarrheal disease, respiratory infections, and parasitic infections because they are an important source of nutritional and energetic stress in both past and current groups. Although infection may not always result in overt disease, frequent exposure results in biological stress with a negative effect on child growth and, by extension, health. The goal of this article is to examine the association between a common class of infectious disease, soil-transmitted helminth worms, and nutritional status among youth living in communities that vary with respect to their distance from a commercial center. In 2007, anthropometric measurements and parasitological surveys were collected for 338 2-14-year-old children and adolescents living in lowland Bolivia as part of the Tsimane' Amazonian Panel Study. Associations between the presence of helminth infections and markers of both short- and long-term nutritional status were overall weak. Youth living in communities distant from the commercial center were more likely to be positive for multiple parasite species than youth in near communities, but youth in mid-distance communities had lower infection rates. This article demonstrates the challenge of identifying associations between nutritional and disease stress when individual and household factors are nested in a larger context of socioeconomic and environmental change. Increased collaboration between bioarchaeology and human biology should continue to examine the connections between stress and disease across time.

Hookworm with hypereosinophilia: atypical presentation of a typical disease.

We describe a 55-year-old man returning from the Philippines infected with a hookworm, the novel bacterium Laribacter hongkongensis, and a Blastocystis hominis and presenting with both gastrointestinal and neurological symptoms. The high eosinophilia caused by the hookworm infection resulted in both gastrointestinal and neurological symptoms, resembling a hypereosinophilic syndrome.

Nutritional status, body composition, and intestinal parasitism among the Mbyá-Guaraní communities of Misiones, Argentina.

Indigenous communities in Argentina represent socially and economically neglected populations. They are living in extreme poverty and environmental degradation conditions. New information about health status and socio-environmental features is urgently needed to be applied in future sanitary policies. Present study describes the nutritional status, body composition, and intestinal parasitism among Mbyá-Guaraní children from three communities in the Misiones Province. Anthropometric parameters were analyzed for 178 individuals (aged 1-14). Data were transformed to z-scores using NHANES I and II. Stunting showed the greatest prevalence (44.9%). Children were found to have low arm circumference and low arm muscle area, although with tricipital skinfold value near to the reference. They also tend to have shorter than normal lower limbs. Fecal samples and anal brushes (for Enterobius vermicularis) were collected in 45 children (aged 1-13). Ritchie's sedimentation and Willis' flotation techniques were used to determine parasitoses. Ninety five percent of children were infected with at least one species and 81.4% were polyparasitized. The higher prevalences corresponded to Blastocystis hominis, hookworms (Ancylostoma duodenale/Necator americanus), and Entamoeba coli. Associations occurred between hookworms with B. hominis/E. coli and B. hominis with nonpathogenic amoebas. Thirty nine percent of the children with stunting presented B. hominis, Strongyloides, and hookworms. Our results indicate that this indigenous population is subjected to extreme poverty conditions and is one of the most marginalized in this country. Severe growth stunting and parasitic infection are still quite common among Mbyá children affecting about half of them along with significant changes in body composition and proportions.

Influence of helminth infections on childhood nutritional status in lowland Bolivia.

Infectious disease, such as diarrheal disease, respiratory infections, and parasitic infections, are an important source of nutritional and energetic stress in many populations. Inspired by the research and methodological innovations of A. Roberto Frisancho, this work considers the impact of childhood environment and local disease ecology on child health and nutritional patterns among an indigenous group in lowland Bolivia. Specifically, we examine the association between soil-transmitted helminth infection, especially hookworm species, and anthropometric markers of short- and long-term nutritional status. Fecal samples, anthropometric dimensions, and health interviews were collected for 92 children ranging in age from 2.0 to 10.9 years. Microscopic examination revealed high levels of parasitic infection, with 76% of children positive for hookworm species infections (77% of girls and 74% of boys). Less common infections included Ascaris lumbricoides, Trichurius trichiura, and Strongyloides stercoralis with only 15% of children positive for multiple-species infections. After adjusting for sex and age, no statistically significant associations were observed between helminth infections and the frequency of reported illness or anthropometric measures of nutritional status. These data demonstrate the difficulty of assessing nutritional impacts of endemic infections.

Anemia, malaria and hookworm infections in a Vietnamese ethnic minority.

The aim of this study was to determine the prevalence of anemia and evaluate the relationship of malaria and helminth infections on anemia status in Phan Tien village, a mountainous ethnic minority community in southern Vietnam. This longitudinal study was performed from April 1997 to 2000 by measuring the hemoglobin concentration of 2,767 people who participated in six annual surveys at the end of the rainy seasons. Ferritin concentration was measured in 2000 to evaluate the proportion of iron deficiency anemia. The relation between malaria and intestinal helminth infections with anemia was investigated. Anemia was always over 43% and mainly associated with iron deficiency (80.1%). Using generalized estimating equations, a small but significant decline of the anemia prevalence was detected (OR: 0.805; p < 0.0001). Malaria was significantly associated with anemia (OR: 2.408; p = 0.0006). There was no significant effect of the control of intestinal helminth infections on the time course of anemia (95% CI: -0.1548 to 0.1651).

Towards the eradication of hookworm in an isolated Australian community.

Hookworm (Ancylostoma duodenale) and other enteric parasites such as Giardia and Hymenolepis are common in Aboriginal communities in northem Australia, and their presence is associated with iron deficiency, anaemia, and failure to thrive. We report the outcome of a sustained, community-based control programme that used regular albendazole in one isolated community. Whereas hookworm has been effectively controlled by the programme, no sustained effect on the prevalence of Giardia and Hymenolepis was seen; the control of these parasites will depend on improvements in health education. This programme might serve as a model for community-based or population-based drug treatment programmes elsewhere.

Prevalence of anaemia and worm infestation in tribal areas of Madhya Pradesh.

The study was conducted among school going children (6-14 years) of Baiga, Abuihmadia and Bharia tribes of Madhya Pradesh to assess the prevalence of anaemia and intestinal parasitic infestation among themselves. A total of 776 school going children were included in the study of whom blood samples of all and stool samples of 409 were collected. Their haemoglobin was measured and stool samples were examined under microscope for ova and cysts. The results revealed that 30.3% of the children had severe anaemia (Hb < 7g/dl) and 50% children had intestinal parasites. The most common parasites were hookworn (16.3%) and A lumbricoides (18.5%). Though hookworm ova loads indicated mild to moderate infestation in most of the children, the continued presence of worms in marginally nourished children could contribute significantly to blood loss in the intestine with resultant anaemia.

Detection of hookworm and hookworm-like larvae in human fecocultures in Suriname.

Estimation of the prevalence of hookworm infection is usually based on finding eggs of the parasite in the stool. Eggs of the different hookworm species are difficult to distinguish and can be confused with those of hookworm-like species. Proper identification can be made after hatching the eggs and cultivating larvae to the infective stage. We have used the Harada-Mori method to study the stools of Bushnegroes in Suriname and have identified the emerged larvae. Of the 804 individuals examined, 53.6% had positive fecal cultures. The identification of emerged larvae revealed that 75% of the positive cultures contained Necator americanus and Strongyloides stercoralis was detected in 19.7%. Oesophagostomum and Ternidens species were also found. Ancylostoma duodenale larvae were not found. Six percent of fecal cultures in which larvae emerged contained only hookworm-like larvae hatching from eggs that resembled hookworm eggs. The diagnosis of hookworm infection, based solely on the microscopic detection of eggs in the stool, must be considered with special caution.

[Prevalence of intestinal parasites among Thais in Israel].

Stool samples from 93 Thais working in Israel were examined for the presence of parasites. The overall prevalence of infection by 1 or more species was 74%. Opisthorchis viverrini and hookworm were the most prevalent parasites (51.6% and 44.1%, respectively). They were also the parasites most frequently found in mixed infections; about a quarter of the workers were infected with both. Other helminths found in only a few cases were: Fasciolopsis buski (3 cases), Taenia sp. (3), Paragonimus sp. (1), Ascaris lumbricoides (1), Trichuris trichiura (1) and Trichostrongylus sp. (1).

Prevalence of hookworm infection, anaemia and faecal blood loss among the Yupno people of Papua New Guinea.

The present report describes a study of hookworm infection, anaemia and the presence of blood in stool among the inhabitants of the Yupno area in Madang Province, Papua New Guinea. The study group comprised 588 persons of all age groups. A second group of 45 patients attending the Madang General Hospital, in the provincial capital on the coast, was used for comparison. In the Yupno area, 59% of the subjects were infected with hookworm; in the coastal group the infection rate was 82%, which was significantly higher. There is therefore a moderate prevalence of hookworm infection in the Yupno area, which does not impair the health of the population to any great extent. In both places there was a clear increase in the infection rate between the group of children 1-5 years old and the older groups. The mean blood haemoglobin level was 15.1 g/dl among the Yupno, which was significantly higher than that of the second group (10.7 g/dl). There was a significant negative linear correlation between the intensity of hookworm infection and blood haemoglobin level. The Colo-Rectal-Test for blood in stool was used on samples from 145 persons in the Yupno and from 43 in the coastal group. The test gave positive results in 17% of the cases without worm infection. In infected persons, the Colo-Rectal-Test gave an increasing rate of positive results as the parasite burden increased: 24% for subjects with low levels of infection, and 57% and 67% for moderate and high levels, respectively. The Colo-Rectal-Test is therefore a simple method for the detection of faecal blood loss in populations with a high prevalence of hookworm infection. However, it is not useful as an instrument for general screening for hookworm infections.