Blood loss due to infection with Trichuris trichiura.

Abstract

Fecal blood loss measured with Cyanomet-hemoglobin method was estimated in 9 children with various degrees of infection with Trichuris trichiura. The children ranged in age from 3-14 years. Stools were examined several times to rule out other parasitic infections. The eggs of only 1 other parasite Ascaris were found in 4 children. The red cell count packed red cell volume and hemoglobin were determined every 3-4 days. Serum iron and iron binding capacity were determined also. 6 of the 9 children had anemia with hemoglobin ranging from 4-11.2 g/100 ml of blood. The study children were passing in the stool from 1-14 million Trichuris eggs per day--4-118.7 thousand eggs per gram of feces. Expressing infection in terms of grams of feces gives only a very rough measure of burden since stools were watery in 6 cases. This means of expression was used because diarrhea is the most common symptom of the disease. Fecal blood loss ranged from 0.8-8.6 ml per day depending roughly on the degree of infection. It was reduced markedly after treatment except in case 3. This child expelled only 11 parasites and continued to pass over 1 million eggs daily. A high correlation was found between the net fecal blood loss and net number of eggs per day. There was no correlation between the fecal blood loss and the number of eggs per gram of feces because of the variable consistency of the feces. According to these results about 0.005 ml of blood is lost per day per each Trichuris which is 6-10 times less than from Necator americanus and 30-50 times less than from Ancylostoma duodenale. The amount of fecal blood loss per day per million eggs ranges from 0.21-1.58 ml with a mean of 0.78 ml. Approximately 0.25 ml of blood is lost per each 1000 eggs per gram of feces. It was estimated that infections of over 800 parasites producing over 5 million eggs daily induce anemia in children.