The Prevalence and Associated Risk Factors of Intestinal Protozoan Parasites in Iranian Children with Hypereosinophilia

Mahmoudvand, Hossein and Sepahvand, Maryam and Nasiri, Bahram and Khatami, Mehrdad and Badparva, Ebrahim (2021) The Prevalence and Associated Risk Factors of Intestinal Protozoan Parasites in Iranian Children with Hypereosinophilia. Iran J Public Health.

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Abstract

Intestinal parasitic infections are considered as one of the most widespread infections in humans around the world especially in developing countries (1). Eosinophilia (peripheral blood eosinophils >500 cells/μl, or >7% of the white blood cells) can be caused by some pathogenic parasites such as Cryptosporidium parvum, Cystoisospora belli, Giardia lamblia, Entamoeba histolytica, Ascaris lumbricoides, Hymenolepis spp., Trichostrongylus spp., Strongyloides stercoralis, hookworms parasites in human (2). We aimed to assess the prevalence of the intestinal protozoan parasites among children with hypereosinophilia compared to healthy children from Lorestan province, western Iran. The present case-control investigation was performed from Jun 2016 to Sep 2017 on 260 children) ranging from 2 to 15 yr old) including 130 children with peripheral blood eosinophils greater than 1000 per microliter who referring to health centers of Lorestan Province, Iran (case group) and 130 healthy children with normal peripheral blood eosinophils, referring the health centers during the above time period for routine examination (control group). The exclusion criteria were: subjects who did not agree to sign an informed consent, patients who have taken systemic antibiotics in the last three month and also immunocompromised individuals. A planned questionnaire was provided to get demographics data and some risk factors linked to protozoan infections, such as age, sex, residence, hand washing habit before eating, and consumption of raw or unwashed vegetables and fruits. All collected stool samples were tested by microscopic examination using the direct smear technique (wet mount and Lugol’s iodine), formol-ether concentration methods. In the next step, after preparing the slide smear from the fresh stools, they were stained with trichrome staining to exact separates intestinal protozoa (Entamoeba, Giardia, Blastocystis sp. etc.). Moreover, to detect the parasites of coccidian family such as Cryptosporidium sp., we used Zeihl-Neelsen staining after the sucrose flotation (Sheather’ technique) procedure (3). SPSS 24.0 software (SPSS Inc., Chicago, IL, USA) was utilized to perform data analysis. Table 1 shows some demographic and risk factors among participates in this study. Out of 130 children with eosinophilia (case group), intestinal protozoan infection were found in 28 (21.5%) children; whereas from 130 health children in control group, intestinal protozoan parasites were found in 15 (11.5%) children; indicating the significant difference (P<0.001) in the prevalence intestinal protozoan infections among the children in case and control group

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