Management and Incidence of Enterobius vermicularis Infestation in Appendectomy Specimens: A Cross-Sectional Study of 6359 Appendectomies.

Background: The role of Enterobius vermicularis infestation in the context of appendicitis is largely overlooked, but Enterobius vermicularis is considered an unexpected and significant appendicectomy finding. The aim of this study was to investigate the frequency of Enterobius vermicularis findings in appendectomies and to evaluate the clinical and histopathologic features of patients with Enterobius vermicularis-associated acute appendicitis and those with appendiceal Enterobius vermicularis infestation. Methods: The medical records of all children who underwent an appendectomy in two large pediatric centers in Croatia between 1 January 2009 and 1 January 2024 were retrospectively reviewed. Of 6359 appendectomies, 61 (0.96%) children were diagnosed with Enterobius vermicularis on histopathology and included in further analysis. The groups were compared with regard to demographic characteristics, laboratory values, clinical features and histopathological findings. Results: The incidence of enterobiasis fluctuated slightly in the individual study years, but was constant overall. The median age of all patients was 11 years (IQR 8.5, 13), with females predominating (60.7%). Acute appendicitis was observed in 34% of the appendiceal species. The patients with Enterobius vermicularis infestation, without appendicitis, were younger (9 years (IQR 8, 13) vs. 12 years (IQR 10, 15); p = 0.020), had longer duration of symptoms (36 h (IQR, 12, 48) vs. 24 h (IQR, 12, 36); p = 0.034), lower body temperature (37 °C (IQR 36.8, 37.4) vs. 37.6 °C (IQR, 37, 38.6) p = 0.012), lower Appendicitis Inflammation Response (AIR) score (3 (IQR 2, 5) vs. 7 (IQR 5, 9.5) p < 0.001), lower incidence of rebound tenderness (57.1% vs. 20%; p = 0.003) and less frequent vomiting (12.5% vs. 47.6%; p = 0.004) compared to the patients with Enterobius vermicularis-associated acute appendicitis. Acute inflammatory markers in the laboratory showed significantly higher values in the group of patients with acute appendicitis: C-reactive protein (p = 0.009), White blood cells (p = 0.001) and neutrophils (p < 0.001). Eosinophilia was not found in any of the groups, although eosinophil counts were significantly higher in children who had Enterobius vermicularis infestation than in those with Enterobius vermicularis-related appendicitis (2.5% (IQR 0.9, 4.3) vs. 1.8% (IQR 0.7, 2.1); p = 0.040). Conclusions: Pediatric surgeons should consider Enterobius vermicularis infestation as a differential diagnosis when removing a vermiform appendix. Younger age, longer duration of symptoms, lower body temperature, lower AIR score, lower diameter of the appendix and normal laboratory inflammatory markers could predict Enterobius vermicularis infection in children presenting with right iliac fossa pain and avoid unnecessary appendectomy.

Vulvovaginitis due to Enterobius vermicularis in a girl and epidemic enterobiasis in her family.

Key Clinical Message: Here we present a case of a 4-year-old girl who suffered from vulvovaginitis caused by Enterobius vermicularis. All members of her family were also infected by this helminth. Treatment with mebendazole was administered to all family members and it was found that the entire family had been cured. Abstract: Vulvovaginitis, an inflammation of the vulvovaginal mucous membranes, is a common reason for pediatric gynecology consultations. One of the causes of this condition is a parasitic worm known as Enterobius vermicularis (E. vermicularis). In girls, adult worms can infiltrate the vagina and release eggs, leading to the development of vulvovaginitis. Furthermore, these worms have the ability to invade the endometrial cavity too. Here we present a case of a 4-year-old girl who suffered from vulvovaginitis caused by E. vermicularis. All members of her family were also infected by this parasitic helminth. In the vaginal sample, apart from the eggs, the female adult worm was observed under the microscope. Treatment with mebendazole was administered to all family members, and their progress was followed for a period of 3 weeks, during which it was found that the entire family had been cured. This patient experienced significant improvement in symptoms related to severe anxiety, nervousness, vaginal inflammation, itching, and vulvovaginitis caused by E. vermicularis. To prevent infection by E. vermicularis, it is crucial to disinfect underwear and bed sheets. In kindergartens, the spread of this parasite should not be underestimated, and asymptomatic individuals who have been exposed to infected persons should receive treatment to prevent an epidemic. Maintaining cleanliness and hygiene, especially after using the toilet, is of the most importance, particularly for girls who are more susceptible to E. vermicularis infection. Additionally, it is essential for all family members to be aware of the transmission routes of this parasite.

Analysis of enterobiasis in the Czech Republic in 2018-2022.

AIM: Pinworm infection (known as enterobiasis or oxyuriasis) is one of the most common parasitic diseases globally and in the Czech Republic (CZ). The aim of this study is to analyse the available epidemiological data on the incidence of enterobiasis in the CZ from 2018-2022. METHODS: A descriptive analysis was done of enterobiasis (ICD-10 code B80) data reported to the electronic Infectious Disease Information System in the CZ from 2018 to 2022. Data processing and analysis were conducted using MS Excel 2016. Univariate and multivariate logistic regression analyses were performed to assess the association between the probability of hospitalization and categorical variables using STATA version 17. The ECDC Map Maker tool (EMMa) was used to create the incidence map. RESULTS: A total of 4,836 cases were reported during the study period, with an average annual incidence of 9.1 cases per 100,000 population. The highest number of cases occurred in 2019 (n = 1,174), and the lowest in 2021 (n = 780). The disease was most common in the paediatric population, with the highest average age-specific incidence rates observed in children aged 5-9 years (80.9 per 100,000 population) and 10-14 years (42.3 per 100,000 population). Of 14 administrative regions of the CZ, the Olomouc Region had the highest average annual incidence (28.7 per 100,000 population), while the Pilsen Region had the lowest (2.2 per 100,000 population). A total of 472 (9.8%) patients needed hospitalization, most of them in the categories 10-14 years (n = 200, 42.4%) and 5-9 years (n = 178, 38%). The highest hospitalization rate was found in the age group 75+ (36.4%). A significantly higher probability of hospitalization was found in the age groups 6-19 years and 65+ compared to working-age population with enterobiasis. A significantly lower probability of hospitalization was seen in 2020-2022 compared to 2019. No difference in the hospitalization rates was noted between genders. No enterobiasis-related death was reported during the study period. The disease occurs year-round. A decrease in reported cases was observed annually during the school summer holidays in July and August. Neither outbreak nor imported cases were noted. CONCLUSION: Given that enterobiasis is often asymptomatic, many cases are not captured in the surveillance system. The Czech prevalence data indicate that it mainly affects the paediatric population. Therefore, preventive measures and programs should primarily target children.

Comparison of miRNA profiles in the immune response of pediatric acute appendicitis and pediatric enterobiasis patients caused by Enterobius vermicularis.

BACKGROUND: The aim of this study was to determine and compare the miRNA profile in the immune response with the parasite in pediatric patients with acute appendicitis caused by Enterobius vermicularis and in pediatric patients with enterobiasis. METHODS: A total of 30 tissue samples, which were operated with the diagnosis of pediatric acute appendicitis in the last 10 y and Enterobius vermicularis was detected by histopathological findings, were analyzed. In addition, blood samples were taken from 30 pediatric patients diagnosed with enterobiasis for this study. The miRNAs that activate T and B cells were evaluated by a quantitative real-time PCR, statistically calculated within ΔΔCt values, and fold changes were evaluated by Welch's T test, in which p<0.5 was considered to be significant. RESULTS: It was found that 48 out of 136 (35.3%) miRNAs differed between the pediatric patient and healthy control groups. It was determined that 22 (57.9%) of the different miRNAs were T cell activating miRNAs and 26 (68.4%) were B cell activating miRNAs. While there was a significant difference in miRNA values activating T cells in two patient groups (p<0.01), there was no significant difference in miRNA values activating B cells (p>0.01). CONCLUSIONS: In the study, although Enterobius vermicularis was the causative agent in both patient groups, it was revealed that the immune response of patients with acute appendicitis was more affected than enterobiasis patients.

Pinworm (Enterobius Vermicularis) Infestation: An Updated Review.

BACKGROUND: Pinworm infestation is an important public health problem worldwide, especially among children 5 to 10 years of age in developing countries with temperate climates. The problem is often overlooked because of its mild or asymptomatic clinical manifestations. OBJECTIVE: The purpose of this article was to familiarize pediatricians with the diagnosis and management of pinworm infestation. METHODS: A search was conducted in August 2023 in PubMed Clinical Queries using the key terms "Enterobius vermicularis," OR "enterobiasis," OR "pinworm." The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article. RESULTS: Enterobiasis is a cosmopolitan parasitosis caused by Enterobius vermicularis. It affects approximately 30% of children worldwide and up to 60% of children in some developing countries. Predisposing factors include poor socioeconomic conditions, inadequate sanitation, poor personal hygiene, and overcrowding. Children aged 5 to 14 years have shown the highest prevalence of enterobiasis.. Egg transmission is mainly by the fecal-oral route. Approximately 30 to 40% of infested patients do not show any clinical symptoms of the disease. For symptomatic patients, the most common presenting symptom is nocturnal pruritus ani. The diagnosis of E. vermicularis infection is best established by the cellophane tape test. The sensitivity of one single test is around 50%; however, the sensitivity increases to approximately 90% with tests performed on three different mornings. If a worm is visualized in the perianal area or the stool, a pathological examination of the worm will yield a definitive diagnosis. As pinworms and eggs are not usually passed in the stool, examination of the stool is not recommended. The drugs of choice for the treatment of pinworm infestation are mebendazole (100 mg), pyrantel pamoate (11 mg/kg, maximum 1 g), and albendazole (400 mg), all of the above-mentioned drugs are given in a single dose and repeated in two weeks. Mebendazole and albendazole are both adulticidal and ovicidal, whereas pyrantel pamoate is only adulticidal. Given their safety and effectiveness, mebendazole and albendazole are currently the best available drugs for the treatment of pinworm infestation. For pregnant women, pyrantel is preferred to mebendazole and albendazole. Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections because reinfection is common even when effective medication is given. CONCLUSION: In spite of effective treatment of pinworm infestation, recurrences are common. Recurrences are likely due to repeated cycles of reinfection (particularly, autoinfection) because of the short life span of adult pinworms. Good personal hygiene, such as frequent handwashing, especially after bowel movements and before meals, clipping of fingernails, avoidance of finger-sucking, nail-biting, and scratching in the anogenital area, are important preventive measures. Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections.

Global prevalence of enterobiasis in young children over the past 20 years: a systematic review and meta-analysis.

Parasitic infections are the most common diseases worldwide, and enterobiasis is a common parasitic infection in children. Various studies have reported on the prevalence of Enterobius vermicularis in different regions of the world. However, no study has gathered and analyzed this data systematically. Our systematic review and meta-analysis investigated the overall prevalence of E. vermicularis among children globally. Data were extracted from 4 available databases for studies published from January 2002 to April 2022. The quality of the included studies was scored based on the standard Strengthening the Reporting of Observational Studies in Epidemiology. A random-effect model was chosen to calculate the pooled prevalence and corresponding 95% confidence interval (CI) according to the degree of heterogeneity in the included studies. Thus, 40 publications (42 data sets) that included 3,279 children with enterobiasis met all criteria and were included in the analysis. The meta-analysis showed that heterogeneity among the included studies was high (Q=4,399.35, I2=99.96%; df=41; p<0.001). The pooled global prevalence of enterobiasis among the studied children was 12.9% (95% CI, 8.2%-17.7%). Our systematic review and meta-analysis estimated that, for the past 20 years, 12.9% of children around the world have been infected with E. vermicularis.

Surveillance on pinworm infection among rural children in Anhui Province from 2017 to 2021 / 中国学校卫生

Objective@#To understand the status of pinworm infection in rural children aged 3-9 years in Anhui Province, and to provide scientific basis for the prevention and control strategy of pinworm disease.@*Methods@#According to the National Surveillance Program of Liver Fluke Disease and Soil Transmitted Nematodiasis(Trial), no less than 10% counties(cities and districts) in Anhui Province were selected as mobile surveillance sites every year. Each surveillance site was divided into 5 areas on the basis of geographical location(east, west, south, north and middle), from each of the areas, one administrative village was selected from one township(town, community) for conducting surveillance. Children at age 3-9 years from each site were examined for pinworm infection with the modified Kato-Katz thick smear method and the adhesive cellophane tape perianal swab method. Chi square test was used to compare the infection rate.@*Results@#From 2017 to 2021, the 5 year average infection rate of pinworm in rural Anhui was 1.34%(128/9 557), and there was no significant difference in the infection rate over the years( P >0.05). The detection rates of the modified Kato-Katz thick smear method and the adhesive cellophane tape perianal swab method were 0.28% and 1.23%, respectively, the difference was statistically significant( χ 2=72.97, P <0.01). In different regions, the 5 year average infection rate of Fuyang City was the highest(4.27%), and the rate of each city was positively correlated with the number of local resident population( r =0.54, P <0.05). There was no significant sex difference in the 5 year average infection rates( P >0.05). The 5 year average infection rate of children aged 3 to 9 years in rural areas were 0.62%, 1.10%, 1.44%, 1.57%, 0.94%, 2.09% and 1.57%, respectively, showed an increasing trend with the increase of age( χ 2=14.41, χ 2 trend =6.70, P <0.05). There was no significant difference in the average infection rate between scattered children and collectively living children( P >0.05).@*Conclusion@#From 2017 to 2021, the infection rate of pinworm among children in rural Anhui province remains at a low level. In the future, health education and monitoring should be strengthened.

Prevalencia de enterobiasis y factores socioambientales en una zona rural de Ecuador / Prevalence of enterobiasis and socio-environmental factors in a rural area from Ecuador

La gestión de los residuos sanitarios requiere atención especial y todos los equipos sanitarios deben participar en la manipulación de los residuos. Se presta menos atención a la gestión de residuos sanitarios en países en vías de desarrollo y no hay evidencia sobre las prácticas de gestión de residuos sanitarios en algunas instituciones sanitarias. Este estudio se realizó para evaluar las prácticas de gestión de residuos sanitarios y los factores asociados en tres hospitales de Perú. Es un estudio descriptivo, cuantitativo y de corte transversal basado en tres establecimientos de salud. Los datos se recopilaron mediante cuestionarios y listas de verificación de observación. El (66,67%) de los trabajadores conocían sobre el manejo de los desechos biológicos. La mayoría conocía los riesgos asociados con el manejo de los mismos (95,91%). Los participantes tenían el conocimiento de que pueden evitarse las infecciones. Nueve de cada diez de los trabajadores realizaron por lo menos dos capacitaciones en la gestión del manejo de los desechos biológicos. El 95,91% conocía los códigos de colores correctos de los contenedores para diferentes flujos de desechos. En cuanto a las actitudes, 161 (94,15 %) indicó que la gestión de los desechos biológicos era importante y 162 (94,74%) estuvo de acuerdo en que era necesaria una implementación estricta para la gestión adecuada de los mismos en el establecimiento de salud. Elementos clave para mejorar las prácticas de gestión de residuos sanitarios en hospitales: promover prácticas que reduzcan el volumen de residuos generados y aseguren una adecuada segregación de residuos(AU)

Healthcare waste management requires special attention and every healthcare teams should be involved in handling of wastes. However, less attention is paid to health care waste management in developing countries and there is no evidence on health care waste management practices in some institutions providing health services. This study was conducted to assess healthcare waste management practices and associated factors in three hospitals in Peru. It is a descriptive, quantitative and cross-sectional study based on three health establishments. Data were collected using questionnaire and observational checklists. The (66.67%) of the workers knew about the management of biological waste. The majority knew the risks associated with handling them (95.91%). Participants were aware that infections can be prevented. Nine out of ten of the workers completed at least two trainings in the management of biological waste. 95.91% knew the correct container color codes for different waste streams. Regarding attitudes, 161 (94.15%) indicated that the management of biological waste was important and 162 (94.74%) agreed that strict implementation was necessary for proper management of biological waste in the environment health facility. Key elements to improve healthcare waste management practices in hospitals: promote practices that reduce the volume of waste generated and ensure proper waste segregation(AU)

Appendicular enterobiasis / Enterobiasis apendicular

Introducción. La presencia de parásitos en el apéndice puede desencadenar, de forma excepcional, un cuadro de apendicitis aguda.El dolor es secundario a los cólicos apendiculares, sin que implique necesariamente una invasión o inflamación apendicular.Caso clínico. Presentamos el caso de una adolescente de 13 añosque consulta en urgencias por cuadro de 4 días de evolución dedolor abdominal en fosa ilíaca derecha con vómitos y anorexia. Seorienta como apendicitis aguda. La ecografía no permite visualizarel apéndice y se realiza una tomografía computarizada que muestra signos de apendicitis aguda incipiente. Se decide practicarapendicectomía, observándose en la luz apendicular estructurasparasitarias compatibles con enterobiasis. Se realiza tratamientoantihelmíntico con mebendazol, tanto para la paciente como paralos convivientes.Comentarios. La infestación por Enterobius vermicularis puedeafectar al apéndice, causando un síndrome apendicular, por lo quela enterobiasis debe incluirse en el diagnóstico diferencial del dolor abdominal agudo. Para resolver el proceso, además de la apendicectomía, si existen signos de inflamación apendicular, es necesario realizar un tratamiento antihelmíntico con mebendazol. (AU)

Introduction. Parasitic infestation is a very uncommon cause ofacute appendicitis. Helminths can cause appendicular colic due toobstruction without involving invasion or inflammation of the mucous membrane.Case report. We present the case of a 13-year-old girl attended inthe emergency room due to a 4-day history of acute abdominalpain in the right iliac fossa with emesis and anorexia. As ultrasound examination did not visualize the appendix, a computedtomography scan was performed, showing signs of incipient acuteappendicitis. During the appendectomy, parasitic structures compatible with enterobiasis in the appendicular lumen were observed. Anthelmintic treatment with mebendazole was administeredto both the patient and the parents.Comments. Enterobius vermicularis infestation of the appendix cancause appendicular syndrome. Enterobiasis should be included inthe differential diagnosis of abdominal pain. Antihelminthictreatment with mebendazole is required to resolve the process together with appendectomy if there are signs of appendicular inflammation. (AU)

Introducció. La presència de paràsits a l’interior de l’apèndix pot desencadenar, de manera excepcional, un quadre d’apendicitis aguda. El dolor és secundari a còlics apendiculars, sense implicar necessàriament invasió o inflamació de l’apèndix. Cas clínic. Presentem el cas d’una adolescent de 13 anys que consulta a urgències per quadre de 4 dies d’evolució de dolor abdominal a la fossa ilíaca dreta amb vòmits i anorèxia. Inicialment s’orienta com a apendicitis aguda. L’ecografia abdominal no permet visualitzar l’apèndix i per tomografia computada s’observen signes d’apendicitis aguda incipient. Es procedeix a apendicectomia, i a la llum apendicular s’observen estructures parasitàries compatibles amb Enterobius vermicularis. S’inicia tractament antihelmíntic amb mebendazole, tant per a la pacient com per als convivents. Comentaris. L’enterobiasi s’ha d’incloure en el diagnòstic diferencial de dolor abdominal agut, perquè la infestació per Enterobius vermicularis afecta l’apèndix pot causar síndrome apendicular. Per tal de resoldre el procés, cal fer un tractament antihelmíntic amb mebendazole, juntament amb apendicectomia si hi ha signes d’inflamació apendicular. (AU)

Bruxismo y desagaste oclusal asociado a enterobiasis en niños en edad preescolar de la provincia Junín / Bruxism and occlusal wear associated with enterobiasis in preschool children from Junín province

Debido a que el bruxismo es un hábito oral prevalente entre los niños y un potencial destructor de los tejidos orales, el presente estudio tuvo como objetivo investigar la relación entre las infecciones por Enterobius vermicularis y el bruxismo entre los niños de un preescolar en la provincia de Junin. La muestra estuvo conformoda por 96 niños de 4 a 6 años. El bruxismo se investigó en base a los informes de los padres sobre el rechinar de dientes por la noche, la calidad del sueño y aspectos clínicos tanto intraorales como extraorales relacionados con la afección. El análisis de datos involucró estadísticas descriptivas, chi-cuadrado de Pearson. La prevalencia de bruxismo fue de 65,62%. Se observó a través del índice de BEWE en los infantes con bruxismo y parasitados por E. vermicularis que el 30,15% se diagnóstico defecto evidente con pérdida de tejido duro menor. No se evidenció asociación estadísticamente significativa entre el bruxismo y el parsitismo por E. vermicularis. Con base en los presentes hallazgos, la prevalencia del bruxismo del sueño fue significativo(AU)

Because bruxism is a prevalent oral habit among children and a potential destroyer of oral tissues, the present study aimed to investigate the relationship between Enterobius vermicularis infections and bruxism among children of a preschool in the province of Junin. The sample consisted of 96 children from 4 to 6 years old. Bruxism was investigated based on parental reports of nighttime teeth grinding, sleep quality, and both intraoral and extraoral clinical aspects related to the condition. Data analysis involved descriptive statistics, Pearson's chi-square. The prevalence of bruxism was 65.62%. It was observed through the BEWE index in infants with bruxism and parasitized by E. vermicularis that 30.15% were diagnosed with an obvious defect with minor hard tissue loss. No statistically significant association was found between bruxism and E. vermicularis parasitism. Based on the present findings, the prevalence of sleep bruxism was significant(AU)

Factores asociados a enterobiosis en niños de dos comunidades nativas Ese'Eja del departamento Madre de Dios, Perú / Factors associated with enterobiosis in children of the Ese'Eja native communities in department of Madre de Dios, Peru

Introducción: La enterobiosis es una de las principales infecciones intestinales del mundo. Objetivo: Determinar los factores asociados a la infección por Enterobius vermicularis en niños de dos comunidades nativas Ese'Eja en Madre de Dios, Perú. Métodos: Estudio transversal analítico. Se trabajó con niños (77) de 1 a 11 años durante los meses de febrero a marzo de 2014. Para diagnosticar la enterobiosis se usó el test de Graham. Las manifestaciones clínicas fueron evaluadas por un médico y los factores asociados mediante una encuesta aplicada a los padres de los niños evaluados. Se usó estadística descriptiva y analítica, se utilizaron razones de prevalencia crudas y ajustadas con un IC 95 por ciento se consideró p< 0,05 como significativo. Resultados: La prevalencia de enterobiosis fue de 32,47 por ciento (25). Los factores asociados (RP e IC 95 por ciento) en el análisis bivariado fueron onicofagia 2,1 (1,1-3,9), chuparse los dedos 5,4 (2,1-2,7), uñas largas 7 (2,6-18,6), intercambio de ropa 2,3 (1,1-3,7), cambio de ropa interior 3,3 (1,8-5,9), uso de calzado 7 (2,6-18,4), juego con tierra 6,9 (1,7-27,3), juego con mascotas 6,4 (2,1-19,7), lavado de manos antes de comer 7,9 (3,6-17,1), lavado de manos después de comer 1,9 (1,7-3,66), 6 o más personas en la casa 3,9 (1,9-7,9), disposición de excretas a campo abierto 3,3 (1,7-6,2) y el menor nivel socioeconómico 2,6 (1,3-5,4). No hubo asociaciones en el análisis multivariado. Conclusiones: Existe una alta prevalencia de enterobiosis en la población estudiada y los factores de riesgo son similares a los antecedentes locales. Urge hacer programas de prevención y promoción de salud respecto al tema para reducir este problema(AU)

Introduction: Enterobiasis is one of the main intestinal infections worldwide. Objective: Determine the factors associated to Enterobius vermicularis infection in children from two native Ese'Eja communities in Madre de Dios, Peru. Methods: An analytical cross-sectional study was conducted in February-March 2014 of 77 children aged 1-11 years. Enterobiasis diagnosis was based on Graham's test. Clinical manifestations were evaluated by a physician, whereas associated factors were determined through a survey applied to the parents of the children studied. Use was made of descriptive and analytical statistical analysis, and crude and adjusted prevalence ratios with a CI of 95 percent. A p value of 0.05 was considered significant. Results: Enterobiasis prevalence was 32.47 percent (25). The associated factors (PR and CI 95 percent) in the bivariate analysis were onychophagia 2.1 (1.1-3.9), finger sucking 5.4 (2.1-2.7), long nails 7 (2.6-18.6), exchanging clothes 2.3 (1.1-3.7), changing underwear 3.3 (1.8-5.9), wearing shoes 7 (2.6-18.4), playing with earth 6.9 (1.7-27.3), playing with pets 6.4 (2.1-19.7), handwashing before eating 7.9 (3.6-17.1), handwashing after eating 1.9 (1.7-3.66), six or more people in the household 3.9 (1.9-7.9), feces disposal in open areas 3.3 (1.7-6.2) and a lower socioeconomic level 2.6 (1.3-5.4). Multivariate analysis did not find any association. Conclusions: Enterobiasis prevalence is high in the population studied, and the risk factors are similar to the local antecedents. It is urgent to develop health prevention and promotion programs about the topic to reduce this problem(AU)

National surveillance on Enterobius vermicularis infections among children at ages of 3 to 9 years in China from 2016 to 2018 / 中国血吸虫病防治杂志

Objective To understand the epidemic status of Enterobius vermicularis infections among children aged 3 to 9 years in China, so as to provide scientific basis for the formulation of the prevention and control strategies for enterobiasis. Methods The national surveillance of enterobiasis was performed in 736 national surveillance sites (counties) from 30 provinces (municipalities/autonomous regions) in China from 2016 to 2018. All surveillance sites were classified into parts according to the geographical directions, including the eastern, western, southern, northern and middle parts, and a township was randomly selected from each part. Then, an administrative village was randomly selected from the township, and 200 permanent residents at ages of over 3 years living in the administrative village were randomly selected using the cluster sampling method. A total of 1 000 residents were examined in each surveillance site. E. vermicularis infections were detected among children at ages of 3 to 9 years using the modified Kato-Katz technique and the adhesive cellophane-tape perianal swab method, and the prevalence of infections was calculated and compared. Results The prevalence of E. vermicularis infections was 2.50%, 2.84% and 2.46% among children at ages of 3 to 9 years in the 736 surveillance sites from 30 provinces (municipalities/autonomous regions) in China from 2016 to 2018, and there was no gender-specific prevalence of E. vermicularis infections (P > 0.05). Enterobiasis was main prevalent in the southern and southwestern part of China (Jiangxi, Guangxi, Guangdong, Sichuan, Fujian, Chongqing and Hainan), with 5.00% prevalence and greater, and the highest prevalence was seen in Jiangxi and Guangxi for successive 3 years. In addition, the prevalence of E. vermicularis infections was higher in children with the Han ethnicity than in those with the minority ethnicity, and a high prevalence was found in children at ages of 4 to 7 years, and a low prevalence seen in children at ages of 3, 8 and 9 years. Conclusions The prevalences of E. vermicularis infections have not changed much among children at ages of 3 to 9 years in China from 2016 to 2018, and high prevalence is seen in southern and southwestern China, which should be given a high priority.

Surveillance of soil-transmitted nematode infections in Zhenjiang City from 2006 to 2018 / 中国血吸虫病防治杂志

Objective To understand the epidemic trend of soil-transmitted nematodiasis in Zhenjiang City from 2006 to 2018, so as to provide evidence for formulating targeted control measures. Methods The permanent residents at ages of 3 years and greater and the immigrants who had lived in Zhenjiang City for more than one year were selected as the study subjects. Fecal samples were collected, and the soil-transmitted nematode eggs were detected in fecal samples with the modified Kato-Katz technique (three smears from one stool sample), while the children at ages of 12 years and lower were tested for Enterobius vermicularis eggs using the adhesive cellophane-tape perianal swab method. The prevalence and intensity of parasitic infections were estimated in Zhenjiang City each year from 2006 to 2018, and the data pertaining to the deworming for soil-transmitted nematode infections were collected during the study period. Results A total of 202 880 person-times were subjected to stool examinations in Zhenjiang City from 2006 to 2018, and 946 persons were detected with soil-transmitted nematode infections, with a mean prevalence of 0.47%. The overall prevalence of human soil-transmitted nematode infections appeared a decline tendency (P < 0.01), with a reduction from 1.10% in 2006 to 0.11% in 2018, and there was a region-specific overall prevalence (P < 0.01), with the highest prevalence seen in Runzhou District (1.65%) and the lowest detected in New District (0.04%). The mean prevalence of human Ascaris lumbricoides, hookworm and Trichuris trichiura infections was 0.33%, 0.09% and 0.04% in Zhenjiang City, respectively, and showed a decline tendency year by year from 2006 to 2018 (P < 0.01). Among all infections, mild infections were predominant. During the period from 2006 through 2018, a total of 45 427 children were examined in Zhenjiang City from 2006 to 2018, and 145 children were positive for E. vermicularis infections, with a mean prevalence of 0.32%. The prevalence of E. vermicularis infections decreased from 1.33% in 2006 to 0.22% in 2018 in children, and the overall prevalence appeared a decline tendency (P < 0.01). A single parasite infection was predominant in soil-transmitted nematode infections (97.46%), and mixed infection of two parasites were mainly detected before 2007. A total of 535 089 person-times received deworming in Zhenjiang City from 2006 to 2018, and the rate of adverse events was 0.002%. Conclusions Currently, the soil-transmitted nematode infection is at a low level in Zhenjiang City, and the overall prevalence of soil-transmitted nematode infections shows a decline tendency year by year. The surveillance and health education of soil-transmitted nematodiasis should be further intensified to consolidate the control achievements.

Analysis of monitoring results of soil-borne nematode disease in Jianhe County of Guizhou in 2016 / 中华地方病学杂志

Objective To investigate the infection status of soil-borne nematode in rural areas of Jianhe County of Guizhou Province and to provide scientific basis for formulating prevention and control measures.Methods In 2016,according to "the Implementation Plan of Soil-Borne Nematode Surveillance in Jianhe County",five surveillance sites were set up in Jianhe rural areas,and 200 permanent residents over 3 years old at each monitoring site were selected to collect fecal samples.The eggs of intestinal nematodes (Ascaris,Hookworm,Trichuris,etc.) in samples were detected with the Kato thick smear method,and the enterobius vermicularis was looked for using the transparent adhesive paper anal swab method.Results A total of 1 000 human fecal samples were tested,and 169 persons were identified to be positive for Ascaris,Hookworm,and Trichuris,and the infection rate was 16.90％ (169/1 000),in which the infection rates of Ascaris,Hookworm and Trichuris were 13.80％ (138/1 000),2.00％ (20/1 000) and 1.10％ (11/1 000),respectively,and Tapeworm and Liver fluke were not detected.The infection rates of soil-borne nematode in male and female were 14.09％ (72/511) and 19.84％ (97/489),respectively,and the difference between genders was statistically significant (x2 =5.88,P ＜ 0.05).The infection rates of soilborne nematode in the ages group of 0-,18-,41-and ≥66 were 18.94％ (50/264),13.18％ (29/220),15.12％ (52/344) and 22.09％ (38/172),respectively,but the differences were not statistically significant (x2=7.03,P ＞ 0.05).Hookworm infection was not found in the group of 0 to 17 years old.The prevalence rates of soil-borne nematodes in primary school and below,junior high school,high school and secondary school education were 18.52％ (138/745),14.83％ (31/209),and 0 (0/46),respectively,and the differences in educational levels were statistically significant (x2 =11.39,P ＜ 0.05).A total of 174 children aged 3 to 9 years old were tested for enterobius vermicularis,18 were infected,and the infection rate was 10.34％ (18/174).Conclusions The situation of soilborne nematode infection is still severe in rural areas of Jianhe County.It should be strengthen health education and improve the knowledge of nematode diseases control among the population.

Enterobíase: aspectos atuais / Enterobiasis: current issues

Justificativa e objetivos: A enterobíase - oxiuríase - é uma parasitose intestinal causada pelo nematódeo Enterobius vermicularis. Trata-se de infecção de grande importância na prática clínica por causar parasitose intestinal e estar envolvida com infecções do trato urinário. O objetivo do manuscrito é apresentar os principais aspectos epidemiológicos, clínicos e terapêuticos relacionados com a enterobíase. Conteúdo: Foram utilizadas as palavras enterobíase e Enterobius vermicularis como descritores na pesquisa de dados nas bases SciELO e Pubmed, assim como em livros-texto relacionados com o tema. A prevalência estimada da infecção no Brasil é de 5,9%, fortemente associada a fatores ambientais, culturais e sociais. O quadro clínico predominante compreende o prurido anal e infecções urinárias em meninas. Possui evolução benigna, com raras complicações, cujo tratamento apresenta eficácia na grande maioria dos casos. Conclusão: Embora possua excelente prognóstico, a disseminação do conhecimento dos aspectos clínicos, epidemiológicos e terapêuticos da enterobíase é essencial para sua melhor abordagem pelos profissionais médicos.

Negligible Egg Positive Rate of Enterobius vermicularis and No Detection of Head Lice among Orphanage Children in Busan and Ulsan, Korea (2014)

To determine whether pinworm infections and head lice infestations spread among children in orphanages, 117 children from 4 orphanages in Busan-si and Ulsan-si, Korea, were examined for enterobiasis and head lice infestation between January and February 2014. The overall rate of Enterobius vermicularis egg positivity was 0.85%, whereas none of the children had head lice infestations. The rate of pinworm infection was much lower among the orphanage children compared to the rates observed in previous studies among kindergarten and primary school students. Moreover, the risk factors for enterobiasis were less frequent among these subjects than previously reported. The personal hygiene and health of the orphanage children were supervised by a regular, employed nurse through a health education program. In conclusion, pinworm infection was efficiently controlled among the children in orphanages, and this might be related to good personal hygiene practices in Korea.

High Prevalence of Enterobius vermicularis Infection among Schoolchildren in Three Townships around Yangon, Myanmar

In order to determine the status of Enterobius vermicularis infection among schoolchildren in suburban areas of Myanmar, 761 primary schoolchildren in 3 different townships around Yangon City were subjected to a survey using cello-tape anal swabs. The subjected schoolchildren were 383 boys and 378 girls who were 5-7 years of age. Only 1 anal swab was obtained from each child. The overall egg positive rate of E. vermicularis was 47.2% (359 positives), and sex difference was not remarkable (48.6% in boys and 45.8% in girls). However, the positive rate was the highest in South Dagon (54.6%) followed by Hlaing Thayar (43.8%) and North Dagon (34.8%). This difference was highly correlated with the living standards of the people in each township. Nucleotide sequence of the 5S rDNA from the eggs on the cello-tape (2 children) revealed 99.7% identity with that of E. vermicularis reported in GenBank. The results indicated that E. vermicularis infection is highly prevalent among primary schoolchildren around Yangon, Myanmar.

Ausencia de diferencia en niveles séricos de sodio, potasio, cobre, hierro y zinc en niños con enterobiasis del semiárido rural del estado Falcón, Venezuela / Absence of difference in serum levels of sodium, potassium, copper, iron and zinc in children with enterobiasis in the rural semiarid area from Falcón state, Venezuela

Las infecciones por parásitos intestinales han sido señaladas de alterar las concentraciones séricas de macro y micro elementos esenciales, especialmente en niños. Mediante un espectrofotómetro de absorción atómica Varian Spectraa-20 Plus, se determinaron los niveles séricos de sodio (Na), potasio (K), cobre (Cu), hierro (Fe) y zinc (Zn) en 59 niños en edad preescolar y escolar de Taratara, estado Falcón, Venezuela. De estos, 27 estaban infectados solamente con Enterobius vermicularis y los restantes sin infecciones entero-parasitarias (grupo control). No se encontraron diferencias estadísticamente significativas (P<0,05) entre los niveles séricos para ninguno de los elementos minerales medidos, cuando se comparó el grupo de los niños con enterobiasis vs. un grupo control no parasitado. Se sugiere que los resultados detectados en Taratara, estado Falcón, Venezuela, son una variación local de la problemática de la enterobiasis.

Intestinal parasitic infections have been shown to have deleterious effects on serum levels of essential macro and micro elements, especially in children. By means of the Atomic Absorption Spectrophometer Varian Spectraa-20 Plus, serological levels of sodium (Na), potassium (K), copper (Cu), iron (Fe) and zinc (Zn) were measured in 59 preschool and school aged children of Taratara, Falcon state, Venezuela. Of these, 27 were monoparasited with Enterobius vermicularis, and remaining ones were without any entero-parasitic complaints (control group). There was no statistically significant difference in Cu, Zn, K, Na and Fe levels between the groups of oxyuros infected children vs. those non parasitized. This situation observed at Taratara, Falcón state, Venezuela, appears to be a particular local variation on the enterobiasis framework.

Estudio clínico-epidemiológico de enterobiasis en niños de una comunidad rural del estado Falcón - Venezuela / Clinical and epidemiological study of enterobiasis in children of a rural community from Falcon state, Venezuela

El objetivo del presente estudio fue determinar las características clínicas-epidemiológicas de la enterobiasis en niños de una comunidad rural (Arenales) del estado Falcón, Venezuela. Entre marzo-julio de 2011, se evaluaron 113 muestras por la técnica de Graham. Se determinó una prevalencia global de 23% (26/113). El prurito anal (P=0,01) y secreción vaginal (P=0,03) fueron los síntomas significativamente asociados con enterobiasis. Los factores de riesgo asociados con esta patología, tal como lo sugieren sus elevados Odds Ratios (OR), fueron: prurito anal (OR= 3,43) y hacinamiento (OR=3,97). Concluimos que los factores potenciales que hacen posible el mantenimiento endémico de la enterobiasis en niños de Arenales están relacionados directamente con las condiciones socioeconómicas de pobreza y la carencia o deficiente aplicación de medidas higiénicas sanitarias.

The objective of this investigation was to determine the clinical-epidemiological characteristics of enterobiasis in children of a rural community (Arenales) in the State of Falcón, Venezuela. Between the months of March and July of 2011, 113 samples were tested using the Graham method. A global prevalence of 23% was determined (26/113). Pruritus ani (P= 0.01) and vaginal discharge (P= 0.03) were the significant Enterobiasis associated symptoms. The risk factors associated to the pathology, as suggested by their increased Odds Ratios (OR), were: pruritus ani (OR= 3.43), and overcrowding (OR = 3.97). In conclusion, the potential factors which make enterobiasis endemic in children of the community of Arenales are directly related to the socioeconomical conditions of poverty and the lack of hygienic habits.

Comparison of Egg Positive Rates of Enterobius vermicularis among Preschool Children in Three Korean Localities

This survey was performed to investigate and compare egg positive rates (EPRs) of Enterobius vermicularis among preschool children in 3 Korean localities (Chuncheon-si, Inje-gun, and Paju-si) in 2008. A total of 7,048 preschool children were examined. Overall, the total EPR was 4.0%; the EPR was the highest in Chuncheon-si (5.6%), followed by Inje-gun (4.5%) and Paju-si (3.4%). The EPR of boys (4.9%) was higher than that of girls (3.1%). The EPR significantly increased with age, with the highest observed in 5~7-year-olds. These findings demonstrate that E. vermicularis infection is widely prevalent among preschool children in Chuncheon-si, Inje-gun, and Paju-si, Republic of Korea.