Intestinal Parasites in Children from a Day Care Centre in Matanzas City, Cuba

Cuba. PLoS ONE 7(12): e51394. doi:10.1371/journal.pone.0051394 Intestinal Parasites in Children from a Day Care Centre in Matanzas City, Cuba Roberto Can ete 0 1 Mariuska Morales Daz 0 1 Roxana Avalos Garca 0 1 Pedro Miguel Lau d Martinez 0 1 Fe lix Manuel Ponce 0 1 Gordon Langsley, Institut national de la sante et de la recherche medicale - Institut Cochin, France 0 A cross-sectional study was carried out from March to June 2012 by researchers form the Department of Gastroenterology at Faustino Pe rez Herna ndez Hospital and the Centre of Hygiene, Epidemiology and Microbiology , Matanzas city- Cuba 1 1 Centre for Hygiene, Epidemiology and Microbiology, Matanzas City, Cuba, 2 Faustino Pe rez Herna ndez Hospital , Matanzas , Cuba , 3 Cuban Institute of Gastroenterology , Havana City , Cuba Background: Intestinal parasitic infections are widely distributed throughout the world and children are the most affected population. Day care centres are environments where children have proven to be more susceptible to acquiring IP. Methods and Principal Findings: A cross-sectional study was carried to determine the prevalence of intestinal parasites in stool samples among children who attend to a day care centre in an urban area of Matanzas city, Cuba, from March to June 2012. 104 children under five years old were included on the study after informed consent form was signed by parents or legal guardians. Three fresh faecal samples were collected from each child in different days and were examined by direct wet mount, formalin-ether, and Kato- Katz techniques. Data relating to demography, socioeconomic status, source of drinking water, and personal hygiene habits were also collected using a standardized questionnaire. In total, 71.1% of children harbored at least one type of intestinal parasite and 47 (45.2%) were infected by more than one species. Giardia duodenalis and Blastocystis sp. were the most common parasites found, with prevalence rates of 54.8% and 38.5% respectively. Conclusions: Despite public health campaigns, improvement in the level of education, and the availability of and access to medical services in Cuba infections by intestinal protozoan is high in this centre. Almost nothing is published regarding intestinal parasites in Matanzas province during the last 40 years so this work could also be the initial point to carry out other studies to clarify the IP status in this region. - Funding: This study was supported by grants from the institution of affiliation of the authors. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist. Intestinal parasitic infections are widely distributed throughout the world and have been identified as one of the most significant causes of illnesses and diseases among the disadvantaged population [1]. It is estimated that 3 billion people are infected with intestinal parasites (IP) and children are the most common affected population [2]. In this group intestinal parasites can have devastating consequences affecting intestinal absorption, nutrition, and childhood development. While those infections are seen in developing countries, they are especially a threat to those living in developed countries because of traveling, trade and migration [3]. Day care centres are environments where children have proven to be more susceptible to acquiring IP. This observation agrees with the results reported by Goncalves [3] and Menezes [4] in Brazil in 2011 and 2008, respectively. In Cuba, despite of the implementation of government initiatives to improve socioeconomic conditions, health, sanitation and water supplies [5], some parasitic infections, particularly intestinal protozoa, are still important causes of morbidity. This is particularly so in some high-risk groups, such as children attending day care, and preschool children in rural mountainous areas [69]. The aim of this study was to determine the prevalence of IP in stool samples from children who attend to a day care centre in an urban area of Matanzas city, Cuba. Study Population 104 children (the total population of the centre) from six months to five years of age, who attended to Amiguitos de Nicaragua day care centre, were studied. Parents or legal guardians signed the free informed consent form agreeing to the participation of the children. The institution belongs to an urban area of the city. Collection of Faecal Samples Three faecal samples from each child were collected in a wide mouth screw capped containers free of preservative at intervals of two days. The samples were collected by parents, relatives or by the educator and immediately sent to the Department of Gastroenterology at Faustino Perez Hernandez Hospital. Three slides of each sample were prepared and examined by two analysts (one technician and one medical parasitologist); such that six slides per sample were analyzed. Three fresh faecal samples were collected from each child in different days and were examined by direct wet mount and formalin-ether (Ritchie) techniques. Kato-Katz was used when analyzing the first sample of each child. The intensity of each STH infection was expressed as the mean of eggs per gram counts of the sample. Community Return All families and educators received the results of the laboratory diagnosis. The positive cases were referred to appropriate healthcare units, where they received specific treatment and follow-up. Data Collection A questionnaire was administered by researchers to each parent or legal guardian seeking for demography, socioeconomic status, source of drinking water, and personal hygiene habits which will be used to assess the potential risk factors for IPIs. All children were apparently in good health condition and had no history of medication one month before the study commencement. Data Management and Statistical Analysis Data derived from questionnaires and parasitological examinations were analyzed using EpiInfo 6.0 software (Public Health Domain Software, CDC, Atlanta, GA, USA). Initial data entry was cross-checked by two independent individuals in order to be sure that data were entered correctly. Prevalence was determined on the basis of combined results from the different diagnostic methods. For descriptive data, rate (percentage) was used to describe the characteristics of the studied group, including the prevalence of intestinal parasites according to age and gender. A Pearsons Chi-square (X2) on proportion was used to test the associations between each variable. In univariate statistical model, the dependent variable was prevalence of intestinal parasites, while the independent variables were sociodemographic, behavior, environmental sanitation and living condition characteristics. A significant level of p,0.05 was adopted, Relative Risk (RR) and 95% confidence interval was computed by the an (...truncated)