Abstract
BackgroundProtozoan enteroparasites Cryptosporidium species and Giardia duodenalis are major contributors to the burden of gastrointestinal illness in children globally, whereas the stramenopile Blastocystis species has been associated with irritable bowel syndrome and skin disorders.AimTo investigate the carriage of these parasites in voluntary asymptomatic schoolchildren (4‒14 years) in 12 different primary and secondary schools in Leganés (Madrid, Spain).MethodsIn a prospective cross-sectional study, stool samples and epidemiological questionnaires on demographics and potential risk factors were collected from participating schoolchildren. Detection of enteric parasites was conducted by PCR-based methods and confirmed by sequence analysis. We calculated prevalence and odds ratios (OR) with logistic regression.ResultsStool samples and questionnaires were provided by 1,359 schoolchildren from 12 schools. The individual prevalence for any parasite was 28%; Blastocystis sp.: 13%; G. duodenalis: 18%; Cryptosporidium spp.: 1%. Two schoolchildren were infected with all three species and 53 with two species. Multivariable risk factor analysis using logistic regression models indicated that an existing infection with one parasite increased the odds for an additional infection with another parasite. The odds of Blastocystis sp. carriage increased up to the age of 10 years and being female increased the odds of Cryptosporidium spp. infection. Washing vegetables before preparing a meal was protective for Blastocystis sp. infection.ConclusionWe detected a larger than expected proportion of asymptomatic cases in the participanting schoolchildren. Further investigation of asymptomatic children should be considered. Good hygiene measures should be encouraged for individuals of all ages to protect from protozoal infections.
Highlights
Enteric parasites Cryptosporidium spp. (Apicomplexa: Cryptosporidiidae), Giardia duodenalis (Metamonada: Hexamitidae) and, to a lesser extent, Blastocystis sp. (Stramenopiles: Blastocystidae) are important contributors to the global burden of childhood gastrointestinal illness
The median age that schoolchildren were infected with Blastocystis sp. was 8 years, for Cryptosporidium spp. 9 years and for G. duodenalis 7 years (Figure 1)
Studies focusing on high-income countries like Spain are less common. In this cross-sectional study, we investigated the asymptomatic carriage of G. duodenalis, Cryptosporidium spp. and Blastocystis sp. in a large paediatric population in central Spain
Summary
Enteric parasites Cryptosporidium spp. (Apicomplexa: Cryptosporidiidae), Giardia duodenalis (Metamonada: Hexamitidae) and, to a lesser extent, Blastocystis sp. (Stramenopiles: Blastocystidae) are important contributors to the global burden of childhood gastrointestinal illness. In 2015, 10,915 and 18,031 confirmed cryptosporidiosis and giardiasis cases, respectively, were reported in the EU/EEA; infections disproportionally affected children in the age group 0–4 years [7,8]. In EU/EEA countries, molecular-based assays with high diagnostic sensitivity and specificity should be the preferred method for the detection of enteric parasites in asymptomatic populations due to typically moderate to low infection rates and parasite burden [10]. Protozoan enteroparasites Cryptosporidium species and Giardia duodenalis are major contributors to the burden of gastrointestinal illness in children globally, whereas the stramenopile Blastocystis species has been associated with irritable bowel syndrome and skin disorders. The individual prevalence for any parasite was 28%; Blastocystis sp.: 13%; G. duodenalis: 18%; Cryptosporidium spp.: 1%. Carriage increased up to the age of 10 years and being female increased the odds of Cryptosporidium spp. infection. Conclusion: We detected a larger than expected proportion of asymptomatic cases in the participanting schoolchildren
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