Prevalence of intestinal helminths, anemia, and malnutrition in Paucartambo, Peru.

OBJECTIVE: To evaluate the prevalence of soil-transmitted helminth infections, anemia, and malnutrition among children in the Paucartambo province of Cusco region, Peru, in light of demographic, socio-economic, and epidemiologic contextual factors. METHODS: Children from three to twelve years old from six communities in Huancarani district in the highlands of Peru were evaluated for helminth infections, anemia, and nutritional status. Data collected included demographic variables, socioeconomic status, exposures, complete blood counts, and direct and sedimentation stool tests. RESULTS: Of 240 children analyzed, 113 (47%) were infected with one or more parasites. Giardia (27.5%) and Fasciola (9.6%) were the most commonly identified organisms. Eosinophilia was encountered in 21% of the children. Anemia (48.8%) was associated with age (3-4 vs 5-12 years old; odds ratio (OR): 5.86; 95% confidence interval (CI): 2.81-12.21). Underweight (10%) was associated with male sex (OR: 5.97; CI: 1.12-31.72), higher eosinophil count (OR: 4.67; CI: 1.31-16.68) and education of the mother (OR: 0.6; CI: 0.4-0.9). Stunting (31.3%) was associated with education of the mother (OR: 0.83; CI: 0.72-0.95); wasting (2.7%) was associated with higher eosinophil count (OR: 2.75; CI: 1.04-7.25). CONCLUSIONS: Anemia and malnutrition remain significant problems in the Peruvian highlands. These findings suggest that demographic factors, socio-economic status, and possibly parasitic infections intertwine to cause these health problems.

Prevalence of intestinal helminths, anemia, and malnutrition in Paucartambo, Peru / Prevalencia de helmintiasis intestinal, anemia y desnutrición en Paucartambo, Perú

Objective. To evaluate the prevalence of soil-transmitted helminth infections, anemia, and malnutrition among children in the Paucartambo province of Cusco region, Peru, in light of demographic, socio-economic, and epidemiologic contextual factors. Methods. Children from three to twelve years old from six communities in Huancarani district in the highlands of Peru were evaluated for helminth infections, anemia, and nutritional status. Data collected included demographic variables, socioeconomic status, exposures, complete blood counts, and direct and sedimentation stool tests. Results. Of 240 children analyzed, 113 (47%) were infected with one or more parasites. Giardia (27.5%) and Fasciola (9.6%) were the most commonly identified organisms. Eosinophilia was encountered in 21% of the children. Anemia (48.8%) was associated with age (3-4 vs 5-12 years old; odds ratio (OR): 5.86; 95% confidence interval (CI): 2.81-12.21). Underweight (10%) was associated with male sex (OR: 5.97; CI: 1.12-31.72), higher eosinophil count (OR: 4.67; CI: 1.31-16.68) and education of the mother (OR: 0.6; CI: 0.4-0.9). Stunting (31.3%) was associated with education of the mother (OR: 0.83; CI: 0.72-0.95); wasting (2.7%) was associated with higher eosinophil count (OR: 2.75; CI: 1.04-7.25). Conclusions. Anemia and malnutrition remain significant problems in the Peruvian highlands. These findings suggest that demographic factors, socio-economic status, and possibly parasitic infections intertwine to cause these health problems.

Objetivo. Evaluar la prevalencia de geohelmintiasis, anemia y desnutrición en los niños de la provincia de Paucartambo (departamento de Cusco, Perú), teniendo en cuenta los factores contextuales demográficos, socioeconómicos y epidemiológicos. Métodos. Se determinó la presencia de helmintiasis y anemia y el estado nutricional de niños de 3 a 12 años de edad de seis comunidades del distrito de Huancarani, en la sierra peruana. Se documentaron las variables demográficas, el nivel socioeconómico, la exposición, los hemogramas y pruebas de observación directa y de sedimentación de parásitos en materia fecal. Resultados. De los 240 niños estudiados, 113 (47%) estaban infectados por uno o más parásitos. Los organismos encontrados con mayor frecuencia fueron de los géneros Giardia (27,5%) y Fasciola (9,6%). El 21% de los niños presentaban eosinofilia. La anemia (48,8%) se asoció con la edad (3-4 años frente a 5-12 años; razón de posibilidades [OR]: 5,86; intervalo de confianza [IC] de 95%: 2,81-12,21). El peso inferior al normal (10%) se asoció con el sexo masculino (OR: 5,97; IC: 1,12-31,72), con un recuento de eosinófilos más alto (OR: 4,67; IC: 1,31-16,68) y con el nivel educativo de la madre (OR: 0,6; IC: 0,4-0,9). El retraso del crecimiento (31,3%) se asoció con el nivel educativo de la madre (OR: 0,83; IC: 0,72-0,95), y la emaciación (2,7%) se asoció con un recuento de eosinófilos más alto (OR: 2,75; IC: 1,04-7,25). Conclusiones. La anemia y la desnutrición siguen siendo problemas importantes en la sierra peruana. Estos resultados sugieren que estas enfermedades se deben a una interacción de los factores demográficos, el nivel socioeconómico y, posiblemente, las parasitosis.

Advice on malaria and yellow fever prevention provided at travel agencies in Cuzco, Peru.

BACKGROUND: Travelers receive medical advice from a variety of sources, including travel agencies. The aim of this study is to describe the quality of pre-travel advice provided by travel agencies in Cuzco to travelers interested in visiting malaria and yellow fever endemic areas. METHODS: Trained medical students posed as tourists and visited travel agencies in Cuzco requesting travel advice for a trip to the southern Amazon of Peru, recording advice regarding risk and prevention of malaria and yellow fever. RESULTS: A total of 163 registered travel agencies were included in the study. The mean proposed tour duration was 6.8 days (±1.4 days) with a median time to departure of 3 days and a median tour cost of 805 US dollars (USD) [interquartile range (IQR) 580-1,095]. Overall, 45% employees failed to mention the risk for any illness. Eighteen percent of the employees acknowledged risk of malaria and 53% risk of yellow fever. However, 36% denied malaria risk and 2% denied risk of yellow fever in the region. The price of tours from travel agencies that did not mention any health risk was significantly lower [1,009.6 ± 500.5 vs 783.9 ± 402 USD, t (152) = 3, p < 0.01] compared with the price from agencies that did mention health risks. Almost all who acknowledged malaria (97%) and/or yellow fever (100%) were able to provide at least one recommendation for prevention. However, advice was not always accurate or spontaneously volunteered. Only 7% of the employees provided both correct scheduling and location information for administration of the yellow fever vaccine. CONCLUSIONS: The majority of registered travel agencies in Cuzco did not provide sufficient and accurate information regarding risk and prevention of malaria and yellow fever to travelers inquiring about trips to the southern Amazon of Peru.

Fascioliasis and eosinophilia in the highlands of Cuzco, Peru and their association with water and socioeconomic factors.

There are limited data about the epidemiology of fascioliasis in Cuzco, Peru. We studied children 3-12 years old from six communities in the highlands of Cuzco to evaluate the epidemiology of fascioliasis; 227 children were included, one-half were female, the mean age was 7.5 (±2.6) years, and 46.2±% had one or more parasites, including Fasciola (9.7%), Ascaris (12.8%), Hymenolepis (9.3%), Trichuris (1.3%), hookworm (1.8%), Strongyloides (0.9%), and Giardia (27.8%). Fasciola was associated with the number of siblings in the household, drinking untreated water, and giardiasis. Eosinophilia was encountered in 21% of children and more common in those drinking untreated water at home and those infected with a parasite, but the differences were not significant. Eating water plants was not associated with Fasciola or eosinophilia. Fascioliasis and eosinophilia were common in the highlands of Cuzco. Fascioliasis was associated with socioeconomic factors and drinking water.