Socio‐environmental variables associated with malnutrition and intestinal parasitoses in the child population of Misiones, Argentina

Malnutrition and intestinal parasitosis: Current prevalences and risk factors among schoolchildren in Misiones (Argentina)

OBJECTIVES

To assess the current prevalences of nutritional status and intestinal parasites, and their potential association with socio-environmental conditions among schoolchildren in Aristóbulo del Valle, Misiones.

METHODS

We measured body weight and height in 444 schoolchildren aged 3-14 years and evaluated their nutritional status following WHO criteria. We examined fecal samples and anal swabs from 234 schoolchildren and collected socio-environmental data through questionnaires.

RESULTS

The prevalence of undernutrition was 4.5% and excess of weight was 24.1%. The prevalence of stunting and of being overweight reached 2.3% and 12.4%, respectively. About 42% of the schoolchildren were infected with at least one of the 12 species identified. The most prevalent species were Blastocystis sp., Enterobius vermicularis, and Giardia lamblia. Entamoeba dispar was recorded for the first time in the locality. The multiple correspondence analysis identified peri-urban, urban, and rural groups. Underweight, stunting and obesity were highest in the peri-urban group, while overweight, wasting and parasitism rates were highest in the rural group. The urban group showed the lowest parasitic prevalences. Bed-sharing, mother's education, and animal husbandry were associated with parasitic infections.

CONCLUSIONS

The study highlights a decrease in undernutrition but a rise in overweight and obesity, indicating an ongoing nutritional transition. The association between socio-environmental risk factors and parasitic infections underscore the need for comprehensive interventions addressing both nutritional and socio-environmental conditions to improve the population's life quality.

Intestinal parasitic infections in a community from Pampa del Indio, Chaco (Argentina) and their association with socioeconomic and environmental factors

Neglected tropical diseases are a group of 20 disabling diseases, which, in particular, are the most common chronic infections in the most vulnerable people. This study aimed to characterize the infection by intestinal parasites (IPs) in dwellings from a peri-urban neighborhood in Pampa del Indio, Chaco (Argentina), and its association with socioeconomic and environmental variables. Single stool samples were collected from all individuals older than 1 year through household visits and processed using coprological sedimentation and flotation techniques. Standardized questionnaires were used at the household level to collect socio-economic information. Environmental variables were obtained from the Planetscope image, Landsat 8 images and remote sensors, while land-use layers were obtained through the use of a maximum likelihood algorithm. Stool samples were provided by 314 individuals. The prevalence of IPs found was 30.6% (n = 96), with a predominance of Giardia lamblia (12.7%, n = 40) and Hymenolepis nana (7.6%, n = 24). The only soil-transmitted helminth found was Strongyloides stercoralis with a 2.5% prevalence (n = 8). Individuals of adult age (> 18 years) were 0.65 times less likely to present parasitic infections with respect to children and adolescents. The only environmental variable that was closely associated with the presence of IPs, was the Normalized Difference Water Index (NDWI), a measure of humidity; being higher around houses with positive individuals. Most of the IPs found in this study were of water-borne transmission and those transmitted directly from person-to-person, therefore fecal contamination is present. We believe that the low prevalence of STH in this area, which requires a passage through the soil, is related to the environmental characteristics, which are unsuitable for the development/permanence of the infective stages of these parasites. The geospatial data and tools used herein proved to be useful for the study of the relationship between the different factors that influence the presence of IPs in a community, from an eco-health approach.

Socio-demographic influences on the prevalence of intestinal parasitic infections among workers in Qatar

Background

The rapid growth of Qatar in the last two decades has been associated with an enormous expansion of building programs in its cities and in the provision of new service industries. This in turn has attracted a large influx of immigrant workers seeking employment in jobs associated with food handling, domestic service, and the building industry. Many of these immigrants come from countries in the tropics and subtropics where intestinal parasitic infections are common. In this study, we explored the environmental and socio-demographic characteristics of immigrant workers in Doha Qatar, which might explain the persistence of the parasites that they harbor.

Methodology

This cross-sectional survey was conducted among 2486 newly arrived immigrant workers and those who visited Qatar previously during the period 2012–2014. Through questionnaires and census data, we characterized the socio-demographic conditions at an individual, family, and neighborhood levels.

Results

Overall, the prevalence of combined protozoan infection was 11.7% and that of helminth was 7.0%. Combined protozoan infections were significantly associated with immigrant workers arriving in Doha for the first time. In univariate log-linear statistical models fitted in phase 1 of the analysis, significant associations were observed between the prevalence of combined protozoan infections and personal and familial factors that included religion, the level of education of subjects, both parents’ educational levels and their jobs, and the number of siblings. Furthermore, environmental effects on the prevalence of protozoan infections including the country of origin, the floor of the house, toilet type, household content index, provision of household water, farming background showed strong associations with protozoan infections. However, in phase 2, multifactorial binary logistic generalized linear models focusing only on the significant effects identified in phase 1, showed that only five factors retained significance (age class, floor of the house, household contents index, father’s education, and the number of siblings). The only factors that had a significant effect on the prevalence of helminth infections were the subjects’ age class and the mother’s educational level.

Conclusions

The prevalence of intestinal protozoan parasites among immigrant workers in Qatar is clearly multifactorial in origin determined by key familial relationships of subjects and also the environment, in which the subjects lived prior to their arrival in Qatar. Moreover, our results suggest that screening protocols for applicants for visas/work permits need to be revised giving more careful attention to the intestinal protozoan infections that potential immigrant workers may harbor.

Parasitic risk factors in migrant horticultural families from Bolivia settled in the rural area of La Plata, Buenos Aires, Argentina

Objective

The aims were to diagnose intestinal parasites in migrant horticultural families in the rural area of La Plata, and assess factors that increase the risk of parasitic infection.

Materials and methods

Serial stool samples and anal swabs of 350 individuals were processed using sedimentation and flotation techniques. Socio-sanitary and environmental characteristics were surveyed using a semi-structured questionnaire. A generalized linear model was used to assess the change in parasitic prevalence with different predictor variables.

Results

Of all examined individuals, 79.1% were parasitized, and 12 parasites were identified. Blastocystis sp. (58.9%), Entamoeba coli (26.3%), Enterobius vermicularis (26.0%), and Giardia lamblia (24.0%) were the most prevalent species. Risk factors were age group (<12 years), sampling site, and a basic education of parents.

Conclusion

The high prevalence of intestinal parasites in horticultural families is associated with inadequate environmental sanitation, a limited access to education, and insufficient hygienic habits. An increase in parasitological references in integrated studies (human, animal and environmental health) would result in an understanding of the parasitic etiology, and the development of effective actions for the control of intestinal parasites.

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La Plata Horticultural area is the most important region for vegetable production in Argentina.

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79.1% of analyzed farming population was parasitized and the species found indicate an inadequate environmental sanitation.

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An increase in parasitological references in integrated studies could mitigate the effect of intestinal parasitoses.

Risk factors for intestinal parasitoses among children and youth of Buenos Aires, Argentina

Introduction

Intestinal parasitoses affect millions of people worldwide, especially children of developing countries. In Argentina, the prevalence of these infections varies among areas according to socio-economic and climatic variability. This study aimed to evaluate the prevalence of intestinal parasitoses and risk factors in child and youth populations from neighbourhoods of La Plata (Buenos Aires province, Argentina) affected by occasional floods, including a serious flood in 2013.

Methods

Serial stool samples and anal swabs of 398 individuals were processed using techniques of sedimentation and flotation. Socio-economic variables were surveyed using a semi-structured questionnaire and the land use/cover was determined by classification of a satellite image.

Results

Of all examined individuals, 70.9% were parasitized by at least one of the 12 parasites identified. The most prevalent species were Blastocystis sp. (42.7%), Enterobius vermicularis (34.7%) and Giardia lamblia (17.6%). Infection risk factors included houses built with makeshift materials and dirt floors; lack of piped water and public waste collection service, bed-sharing and living in the non-urban area. >70.3% of the participants that lived within <200 m from watercourses or permanent water bodies were parasitized.

Conclusion

This research shows that parasitic infections are still a serious public health problem and that they are strongly associated with socio-economic conditions and land use/cover. In this context, studies focused on One Health strategy are need to ensure the diagnosis and surveillance of parasitosis and to tackle zoonotic diseases as well as to encourage the development of sanitary and educational programs sustainable over time.

Nutritional transition in schoolchildren from Tucumán, Argentina: A cross-sectional analysis of nutritional status and body composition

OBJECTIVE

The aim of this article was to describe the nutritional status and body composition of schoolchildren from Tucumán (Argentina) and analyze variations according to sex, area of residence, and socioeconomic status (SES).

METHODS

A cross-sectional study was performed in 1948 schoolchildren aged 8.0 to 11.9 years. Body weight, height, triceps skinfold, waist, and upper arm circumferences were measured. Nutritional status and body composition were estimated using the NHANES III reference. SES was surveyed with the Family Affluence Scale. Area of residence was classified as urban or rural based on the criteria of the National Institute of Statistics and Censuses of Argentina. Logistic regression analysis was applied to evaluate nutritional status and body composition according to sex, area of residence, and SES.

RESULTS

The prevalence of overweight and obesity was 12.3% and 18.2%, respectively, as compared with that of underweight (2.3%), stunting (3%), and wasting (2.1%). The prevalence of stunting and wasting was higher in girls, while that of obesity was higher in boys. Low SES schoolchildren registered a higher prevalence of stunting. Analysis of body composition indicated modifications in adipose and muscular tissues, especially in undernourished (underweight, stunting, or wasting) children and children with excess weight (overweight or obesity).

CONCLUSION

The child population from Tucumán is undergoing an accelerated process of nutritional transition, manifested by the double burden of malnutrition. The distribution of stunting, wasting, and obesity, and changes in fat and muscular tissues were not homogeneous, revealing differences according to sex, area of residence, and SES.

Intestinal parasitosis, undernutrition and socio-environmental factors in schoolchildren from Clorinda Formosa, Argentina

Objective To evaluate intestinal parasitosis, undernutrition and socio-environmental factors in schoolchildren from Clorinda (Formosa, Argentina).Materials and Methods Serial fecal samples and anal swabs of 114 schoolchildren, canine feces and soil samples were analyzed. Body weight and height of 215 schoolchildren were measured and undernutrition was estimated according to the World Health Organization criteria. Socio-environmental variables were assessed by means of a semi-structured questionnaire.Results 78.1% of children were infected by at least one of the 12 species identified and 70.8% had multiple parasitic infections. Blastocystis sp., Giardia lamblia and Enterobius vermicularis were the most prevalent. Additionally, 17.5% of children were infected by at least one geohelminth (e.g. Ascaris lumbricoides, Trichuris trichiura, hookworms). 64.3%of canine of canine feces were positive and six parasitic species were found; the most frequent were Ancylostoma caninum, Uncinaria stenocephala and G. lamblia. Furthermore, 37.5% of soil samples showed zoonotic parasites (i.e. Ascaris sp., Toxocara sp.). Finally, 10.0% of the children were undernourished and 85.7% of them had parasites. The risk for parasitosis was higher in children that lived in houses with inadequate solid waste disposal and whose parents were unemployed or had temporary jobs.Conclusions The lack of environmental sanitation, unstable employment of parents and the presence of zoonotic species were the most relevant factors observed. Consequently, these conditions result in an increase of parasitic infections and negatively influence the growth of children.

Prevalence of intestinal parasites and the absence of soil-transmitted helminths in Añatuya, Santiago del Estero, Argentina

BACKGROUND

Intestinal parasites (IP) have been reported in point studies from different provinces of Argentina. The presence of soil-transmitted helminths (STH) was detected in many of these studies, including varied prevalences of all five species of STH in the north were the climate is more appropriate for transmission. Nonetheless, Argentina lacks a comprehensive prevalence map of STH. Therefore, the objective of this study was to determine the prevalence of intestinal parasites, focusing on STH, in rural and peri-urban areas of Añatuya, Santiago del Estero Province and identifying risk factors for their transmission.

METHODS

We conducted a cross-sectional survey in the entire population of three rural lots located on the outskirts of the city between March and June of 2015 and among children in a peri-urban neighbourhood of Añatuya city in July 2016. Socio-economic variables, characteristics of the house and stool samples were collected from each household.

RESULTS

A total of 470 stool samples were analysed. The prevalence of STH was extremely low, with only 2 people being positive for hookworm and no detection of other STH. The prevalence of IP was 11.7% for protozoans and 11.1% for helminths. IP were significantly more prevalent in pre-school and school-aged children than in adults (P < 0.05). The level of education of adults was also significantly associated with infection (P = 0.001), as well as the practice of informal slaughter of animals (P = 0.002) and the presence of unimproved walls (P = 0.046) and unimproved floors (P = 0.021) in the household. Nonetheless, the only significant predictors of IP in the logistic regression analysis were age (P < 0.001) and main source of electricity (P = 0.026).

CONCLUSIONS

The total prevalence of intestinal parasites in the study population was 22.6%. The intestinal parasites detected are transmitted mostly through water (Giardia lamblia) and close contact (Hymenolepis nana), evidencing the need to improve quality control in water facilities and access to improved sanitation to avoid contamination of stored water. The presence of IP was significantly associated with age (with children being more susceptible), households containing unimproved walls and those that did not have access to an electricity network.

[Comparative study of the nutritional status of children living in four counties of the province of Buenos Aires (Argentina), in the context of nutrition transition]

The aim of this study was to evaluate and compare the nutritional status of child populations living in four counties of the province of Buenos Aires to observe differences related to particular environmental and socioeconomic contexts in the framework of the nutrition transition. During the school years corresponding to the 2008-2012 period, weight and height were measured and body mass index was calculated for 7,873 school children between the ages of 4 and 12 years from the counties of La Plata, Brandsen, Magdalena and Punta Indio. Information about the contexts of residence was obtained using self-administered structured surveys. About 40% of schoolchildren presented malnutrition, with a prevalence of overweight in La Plata, obesity in Punta Indio and undernutrition in Magdalena. The nutritional status of the study populations was associated with the socioenvironmental conditions of residence, indicating that these populations are at different stages of the nutrition transition process.

Molecular identification of Giardia intestinalis in two cities of the Colombian Caribbean Coast

INTRODUCTION

Parasitoses are an important health problem and its post-infectious consequences can cause high morbidity and mortality, worldwide. Epidemiological data is scarce in our region. We aimed to obtain frequency and circulating genotypes of Giardia intestinalis in two cities of the Caribbean Coast.

METHODS

To identify parasites in samples, a fecal concentration and microscopical examination were performed. For further identification and genotyping of G. intestinalis, molecular analyses were performed using specific available primers.

RESULTS

Only 22.1% of participants had gastrointestinal symptoms (most frequently: abdominal pain and diarrhea). Microscopy examination was positive in 72.7% of the samples. The most frequent parasite was G. intestinalis (48.1%) and we found mixed parasitic infections in 46.7% of the participants. All the samples from Santa Marta were molecularly characterized as assemblage A of G. intestinalis, while in Cartagena we confirmed the presence of assemblages A and B.

CONCLUSIONS

Molecular tools are important in the diagnosis of parasites and to increase comprehension of their distribution. In this study, a higher frequency of parasites, mostly protozoa, was observed.

Environmental and socio-demographic individual, family and neighborhood factors associated with children intestinal parasitoses at Iguazú, in the subtropical northern border of Argentina

BACKGROUND

Intestinal parasitoses are a major concern for public health, especially in children from middle and low-income populations of tropical and subtropical areas. We examined the presence and co-infection of parasites in humans as well as parasitic environmental contamination in Puerto Iguazú, Argentina. We explored the environmental and socio-demographic characteristics of the persistence of parasites in children and their environment.

METHODOLOGY/PRINCIPAL FINDINGS

This cross-section survey was conducted among children population comprised into the area of the public health care centers of Iguazú during June 2013 to May 2016. Copro-parasitological status of 483 asymptomatic children was assessed. Simultaneously, a design-based sampling of 744 soil samples and 530 dog feces was used for characterize the environmental contamination. The 71.5% of these sites were contaminated. Sixteen genera were detected in the environment being hookworms (62.0%) the main pathogens group detected followed by Toxocara spp (16.3%), Trichuris spp (15.2%) and Giardia (6.5%). Total children prevalence raised 58.8%, detecting twelve genera of parasite with Giardia intestinalis as the most prevalent pathogen (29.0%) followed by Enterobius vermicularis (23.0%), Hymenolepis nana (12.4%) and hookworms (4.4%). Through questionnaires and census data, we characterized the socio-demographics conditions at an individual, family and neighborhood levels. A multi-level analysis including environmental contamination data showed that the ´presence of parasites´ was mostly determined by individual (e.g. age, playing habits, previous treatment) and household level (e.g. UBN, WASH, mother's literacy) determinants. Remarkably, to define the level of 'parasite co-infection', besides individual and household characteristics, environmental factors at a neighborhood level were important.

CONCLUSION/SIGNIFICANCE

Our work represents the major survey of intestinal parasites in human and environmental samples developed in the region. High prevalence was detected in the children population as well as in their environment. This work shows the importance of considering and promoting multi-level actions over the identified determinants to face this public health problem from integrative approaches.

Investigation of Factors Affecting Frequency of Intestinal Parasites in Primary School Students in an Urban Region in Turkey

AIM

The aim of the study was to determine the incidence of intestinal parasitic diseases (IPD) and associated factors in primary school students and to assess the knowledge and practices of mothers about these diseases.

METHODS

This is a cross-sectional study carried out in January-March 2014 in 471 students aged 5-11 years, studying at 3 schools randomly selected from the city centre regions with different socioeconomic levels. Stratified sampling method was used in the present study and the data were collected in two stages. In the first stage, parents were informed about the study and pre-prepared questionnaire forms were used to collect the data about the students and parents. In the second stage, laboratory analyses of collected stool samples were performed.

RESULTS

The total prevalence of IPD was 18.3%, it was higher in the primary school located in a region with a lower socioeconomic level compared to other two schools (27.6% vs. 14.4%, and 10%, respectively). Most commonly detected parasite was E. vermicularis (12.1%). The prevalence of IPD was not associated with the classroom, gender, number of siblings, and the use of purified drinking water at home, while it was found to decrease with the increasing maternal education level. The maternal knowledge level score was 12.01±4.29 vs. 13.41±3.94 in students with and without IPD, respectively. With regard to the methods used to treat IPD, 23% of the mothers reported that they are using conventional methods.

CONCLUSION

The health education programmes about the associated risk factors are of great importance for early detection and treatment of childhood parasitic infections.

Malnutrition and body composition in urban and rural schoolchildren: A cross-sectional study in San Rafael, Mendoza (Argentina)

OBJECTIVES

The aim of the present study was to analyze the nutritional status and body composition of children from San Rafael, Mendoza, avoiding urban and rural categorization by generating subpopulations as a function of their socio-environmental characteristics.

METHODS

A cross-sectional study was performed in 3,596 schoolchildren from 4.0 to 13.9 years of age. Body weight, height, upper arm circumference, and triceps skinfold were measured. Body mass index, total muscle, and fat areas of the arm were calculated. To estimate nutritional status and body composition, the NHANES III reference was used. The socio-environmental variables were surveyed using a structured questionnaire. These variables were processed by categorical principal-component analysis (catPCA).

RESULTS

The catPCA allowed the differentiation of four groups, three with urban characteristics (high urban, medium urban, impoverished urban), and a rural group. Stunting occurred at a higher rate in the impoverished urban group, and the occurrence of underweight children was higher in the rural group. The prevalence of excess weight varied in the range of 20-26%. The latter value corresponded to children of the high urban group, who also did not show reduced muscle mass.

CONCLUSION

Children from San Rafael presented differences in nutritional condition and body composition associated with pronounced socio-environmental heterogeneity. Thus, we could observe a gradient from the "high urban" group, with better social, economic, and sanitation conditions and at the same time a more obesogenic environment to the "impoverished urban" and "rural" groups, whose vulnerability reflected a higher prevalence of child undernutrition and the association with excess weight and reduced muscle mass. Am. J. Hum. Biol. 28:796-803, 2016. © 2016Wiley Periodicals, Inc.