Dysentery Syndrome Research Articles

Etiological Profile of Lower Gastrointestinal Bleeding in Children and Adolescents from Kashmir; A Tale of 5 Years.

Background: Lower gut bleeding is an alarming sign among caregivers. Determining the etiology is of utmost importance for further management. This is the first study conducted in northernmost India. Methods: This cross-sectional study was conducted at the Department of Pediatrics, Government Medical College, Srinagar. This study aimed to describe the etiology of lower gastrointestinal bleeding in the age group of 1-18 years over the past 5 years from June 2017 to June 2022. Results: A total of 310 children presented with hematochezia (53.5%), blood mixed with loose stools for > 2 weeks (39.3%), melena (1.9%), and occult blood in stools (0.3%). The mean age was 5.12 years. The age group of 1-6 years was 73.5 %. The most common findings were rectosigmoid polyps n=104 (33.5%), anal fissure n=47 (15.1%), lymphoid nodular hyperplasia (LNH) n=38 (12.2%), trichuris dysentery syndrome n=30(9.7%), cow's milk protein allergy n=27(8.7%), non-specific colitis n=18(5.8%), solitary rectal ulcer syndrome n=14(4.5%), inflammatory bowel disease n=6 (1.9%),intestinal tuberculosis n=3(0.9%), duodenal dieulafoy lesion 1(0.3%), and blue bleb nevus rubber syndrome n=1(0.3%). 21 patients had a normal colonoscopy. The colonoscopy yield was 93.3 %. Among the colonoscopy-negative patients, 6(1.6%) had Meckel's diverticulum, and 1(0.3%) had a duodenal dieulafoy lesion. Conclusion: Lower GI bleeding most commonly presents as hematochezia, and the most common cause is a rectosigmoid polyp. Colonoscopy is the procedure of choice to evaluate the etiology of lower GI bleeding. Anal fissures, LNH, Trichuris trichiura, and cow's milk protein allergy are other common causes of lower gut bleeding in Kashmir, northernmost India.

Clinical, endoscopic, histopathological characteristics of patients with colorectal polyps - Endoscopy Gastroenterology Center, Hue University of Medicine and Pharmacy Hospital

Background: Colorectal polyps are a relatively common diseases in the group of lower gastrointestinal tract diseases. The prevalence of colorectal polyps ranges from 20 to 50%. Polyps are formed due to excessive hyperplasia of the mucosa and the malignancy rate of colorectal polyps is higher than other sites. Objectives: (1) To describe some clinical and endoscopic features of colorectal polyps; (2) To evaluate the histopathological characteristics and the relationship between histopathology and some clinical and endoscopic features of colorectal polyps. Subjects: The patients aged 16 years old and older who were diagnosed with colon polyps at the Center for Gastroenterology - Endoscopy at Hue University of Medicine and Pharmacy Hospital from April 1st, 2020 to March 30th, 2021. Methods: Cross-sectional, retrospective description. Results: Study on 67 patients who were dianosiged as having colorectal polyps through endoscopy, in which, 48 patients underwent polypectomy and histopathology. The mean age is 55.8 ± 15.7 years old, the most common age group is ≥ 45 years old, male/female is 2/1. The time from symptoms onset to disease detection is usually 6 months to less than 1 year (37.4%). The common clinical symptoms: abdominal pain (83.6%), diarrhea (29.9 %), constipation (28.4%), dysentery syndrome (13.4%), bloody stools (31.3%). The position of polyps: anus (1.5%), rectum (47.8%), sigmoid colon (40.3%), descending colon (31.3%), transverse colon (22.4%), ascending colon (28.4) %), cecum (13.4%). The proportion of patients having ≥ 2 polyps (59.7%), 1 polyp (40.3%). Polyp sizes: 5 - < 10 mm (50.7%), < 5 mm (37.4%), ≥ 10 mm (11.9%). The percentage of sessile polyps is higher than that of pedunculated polyps at each locations. Histopathological types: adenomatous polyps (60.4%), hyperplastic polyps (20.8%), malignant polyps (4.2%). Polyps with dysplasia (64.6%), mild – grade dysplasia (56.3%), severe-grade dysplasia (8.3%). The differences were statistically significant between the grade of dysplasia and the polyp size groups, between the histopathology and the grade of dysplasia (p < 0.05). Conclusions: Colorectal polyps are more common in patients ≥ 45 years old, male are much more of having than female. Abdominal pain, bloody stools are common symptoms. Common polyp phenotypes are sessile polyps, ≥ 2 polyps, 5 - < 10 mm in size, mainly in the rectum. Adenomatous polyps are the most common histopathological type, with the high rate of dysplasia. Key words: clinical, endoscopy, histopathology, colorectal polyps.

Clinical, Endoscopic, Histopathological Characteristics Of Colorectal Polyps In Adults At Gastroenterology – Endoscopy Center, Hue University Of Medicine and Pharmacy Hospital

Background: Colorectal polyps are relatively common diseases in the group of lower gastrointestinal tract diseases. The prevalence of colorectal polyps ranges from 20 to 50%. Polyps are formed due to excessive hyperplasia of the mucosa and the malignancy rate of colorectal polyps is higher than other sites. Target: Describe some clinical, endoscopy and histopathology characteristics. Subjects: The patients aged 16 years old and older who were diagnosed colon polyps at the Center for Gastroenterology - Endoscopy at Hue University of Medicine and Pharmacy Hospital from April 1st, 2020 to April 30th, 2021. Methods: Crosssectional, retrospective description. Results: The mean age was 55.8 ± 15.7 years old, the most common age was ≥ 45 years old, male/female was 2/1. The common clinical symptoms: abdominal pain (83.6%), diarrhea (29.9%), constipation (28.4%), dysentery syndrome (13.4%), bloody stools (31.3%). The position of polyps: anus (1.5%), rectum (47.8%), sigmoid colon (40.3%), descending colon (31.3%), transverse colon (22.4%), ascending colon (28.4)%), cecum (13.4%). The proportion of patients ≥ 2 polyps (59.7%), 1 polyp (40.3%). Polyp sizes: 5 - < 10 mm (50.7%), < 5 mm (37.4%), ≥ 10 mm (11.9%). The percentage of sessile polyps was higher than that of pedunculated polyps at each locations. Histopathological types: adenomatous polyps (60.4%), hyperplastic polyps (35.4%), malignant polyps (4.2%). Polyps with dysplasia (64.6%), mild - grade dysplasia (56.3%), severe-grade dysplasia (8.3%). The differences were statistically significant between the grade of dysplasia and the polyp size groups, between the histopathology and the grade of dysplasia (p < 0.05). Conclusions: Colorectal polyps are more common in patients ≥ 45 years old, male are much more than female. Abdominal pain, bloody stools are common symptoms. Common polyp phenotypes are sessile polyps, ≥ 2 polyps, 5 - < 10 mm in size, mainly in the rectum. Adenomatous polyps are the most common histopathological type, with the high rate of dysplasia Key words: clinical, endoscopy, histopathology, colorectal polyps

Trichuris dysentery syndrome, the neglected tropical disease: a case series

Almost 2 billion people, about a quarter of the world’s population, are infected with soil-transmitted helminths (STH) worldwide. Approximately 270 million preschool children and more than 550 million school-age children live in areas of extensive parasite transmission.1,2 Indonesia is a moderate-to-high-risk area of STH, with an overall mean prevalence of 28.12%. However, the prevalence in Papua is higher.3 A study reported that 50% of school-aged children in Jayapura, Papua, a high-risk area, suffered from STH, with distributions of 48.5% Ascaris lumbricoides, 28.6% Trichuris trichiura, 14.3% hookworm, and 8.6% mixed infection.4

First report and genomic characterization of a bovine-like coronavirus causing enteric infection in an odd-toed non-ruminant species (Indonesian tapir, Acrocodia indica) during an outbreak of winter dysentery in a zoo.

Bovine coronavirus (BCoV) is associated with three distinct clinical syndromes in cattle that is, neonatal diarrhoea, haemorrhagic diarrhoea in adults (the so-called winter dysentery syndrome, WD) and respiratory infections in cattle of different ages. In addition, bovine-like CoVs have been detected in various species including domestic and wild ruminants. However, bovine-like CoVs have not been reported so far in odd-toed ungulates. We describe an outbreak of WD associated with a bovine-like CoV affecting several captive wild ungulates, including Indonesian tapirs (Acrocodia indica) an odd-toed ungulate species (Perissodactyla) which, with even-toed ungulates species (Artiodactyla) form the clade Euungulata. Genomic characterization of the CoV revealed that it was closely related to BCoVs previously reported in America. This case illustrates the adaptability of bovine-like CoVs to new species and the necessity of continued surveillance of bovine-like CoVs in various species.

In silico design of a T-cell epitope vaccine candidate for parasitic helminth infection.

Trichuris trichiura is a parasite that infects 500 million people worldwide, leading to colitis, growth retardation and Trichuris dysentery syndrome. There are no licensed vaccines available to prevent Trichuris infection and current treatments are of limited efficacy. Trichuris infections are linked to poverty, reducing children’s educational performance and the economic productivity of adults. We employed a systematic, multi-stage process to identify a candidate vaccine against trichuriasis based on the incorporation of selected T-cell epitopes into virus-like particles. We conducted a systematic review to identify the most appropriate in silico prediction tools to predict histocompatibility complex class II (MHC-II) molecule T-cell epitopes. These tools were used to identify candidate MHC-II epitopes from predicted ORFs in the Trichuris genome, selected using inclusion and exclusion criteria. Selected epitopes were incorporated into Hepatitis B core antigen virus-like particles (VLPs). Bone marrow-derived dendritic cells and bone marrow-derived macrophages responded in vitro to VLPs irrespective of whether the VLP also included T-cell epitopes. The VLPs were internalized and co-localized in the antigen presenting cell lysosomes. Upon challenge infection, mice vaccinated with the VLPs+T-cell epitopes showed a significantly reduced worm burden, and mounted Trichuris-specific IgM and IgG2c antibody responses. The protection of mice by VLPs+T-cell epitopes was characterised by the production of mesenteric lymph node (MLN)-derived Th2 cytokines and goblet cell hyperplasia. Collectively our data establishes that a combination of in silico genome-based CD4+ T-cell epitope prediction, combined with VLP delivery, offers a promising pipeline for the development of an effective, safe and affordable helminth vaccine.

Pengaruh Perasan Daun Pandan Wangi (Pandanus amaryllifolius Roxb) Terhadap Shigella dysentriae

ABSTRACTDysentriae Shigella is a bacterial species of shigella that occurs in tropical countries, these bacteria are pathogenic gut bacteria are commonly known to cause dysentery. Dysentery is an infection that causes sores that cause ulcers limited dicolon characterized by symptoms known as dysentery syndrome. In user of trimatoprim sulfametaksazol can cause or accelerate the onset of megaloblastosis, leocopenia, or trombostopenia. In regular use, this combination appears to show little toxicity, approximately 75% of these adverse effects involving the skin. ‘Pandan wangi’ (pandanus amaryllifolius roxb) is one of the plants that can be used as a natural antibiotic against shigella dysentriae infection because the content of fragrant pandan leaves include flavonoids, alkaloids, saponins and tannins.This type of research is experimental, while the goal is to determine the effect of ‘pandan wangi’ leaf (pandanus amaryllifolius roxb) juice on shigella dysentriae. Consisting of 7 concentrations and four repetitions. Using dilution method by observing the growth of bacteria shigella dysentriae on ‘pandan wangi’ leaf juice that is characterized by the colonies grown on media Mac Conkey (MC).Data analysis uses Anova with an error or a = 5%. The advanced test uses Tukkey test, Honestly Significant Difference (HSD). After doing the research, the optimal concentration of juice of ‘pandan wangi’ (pandanus amaryllifolius roxb) leaves can inhibit shigella dysentriae is 25% and can kill shigella dysentriae from concentration of 50%. The final conclusion is that there is the effect of ‘pandan wangi’ (pandanus amaryllifolius roxb) leaf juice on shigella dysentriae. Keywords: Pandanus amaryllifolius Roxb leaves, shigella dysentriae.

A study on the antibiotic resistance of Shigella

Background The hospital morbidity caused by Shigella or dysen-tery ranges between 0.3 to 2.9%. Irrational use of antibiotics causesa persistent diarrhea and may lead to drug resistance.Objectives With various kinds of antibiotics available in Indone-sia at the moment, this study aimed to anticipate the kinds of anti-biotics appropriate for shigellosis and to evaluate the clinical spec-trum of dysentery in children in Indonesia.Method The study involved 50 children diagnosed with dysenteryor dysentery-like syndrome, aged 1 to 12 years, who came to fourdifferent hospitals in Jakarta, from November 2001 to April 2002.Parents were asked for their consent. Interviewers recorded de-tails of the children’s history of illness and the physical examina-tions. Stool culture and resistance tests were done.Results Fifty dysentery cases, comprising 30 males and 20 fe-males, 98% aged from 1 to 5 years, came to the four hospitalsduring the study period. Only 24 cases had positive Shigella cul-tures, of which 87% were Shigella flexneri and 17% were Shigellasonnei. The clinical manifestations of shigellosis were bloody stools(83%), mucus in the stool (75%), and watery diarrhea (96%). Fe-ver and tenesmus were absent in 67% and 92% of subjects, re-spectively. Almost 87% of shigellosis cases were resistant tocotrimoxazole; all were sensitive to colistin and most were sensi-tive to nalidixic acid.Conclusion This data suggests that colistin and nalidixic acid aredrugs of choice for dysentery syndrome. The clinical manifesta-tion of dysentery is not always accompanied by bloody stools butmostly incorporates watery diarrhea and mucus in the stool

Faecal egg counts and expulsion dynamics of the whipworm, Trichuris trichiura following self-infection.

More than 400 million humans are estimated to be infected with the intestinal helminth parasite, Trichuris trichiura. The infection is chronic in nature and high-intensity infection can lead to colitis, anaemia, Trichuris Dysentery Syndrome and reduced cognitive performance. Single doses of 400mg albendazole or 500mg mebendazole (MBZ) are used in mass drug administration programmes, but this has been shown to be insufficient. In this study, worm expulsion dynamics are described after MBZ treatment, given as a multi-dose and single-dose treatment in two separate T. trichiura self-infection studies. Worm expulsion dynamics post-treatment showed a similar pattern regardless of the dose regime, with the first worms observed on day 2 and the last worms expelled on days 9 and 13 post-treatment. Establishment of a chronic infection was observed following the inefficient single-dose treatment. The prepatent period was 13-16 weeks in both studies and worms were found to have a lifespan of at least 1 year and 10 months. These self-infection studies provide key information on the chronicity of T. trichiura infections, expulsion dynamics after anthelmintic treatment and the prepatent period, as well as the fecundity of female worms, which was around 18,000 eggs/female per day.

P0056 Treatment of non-metastatic colon adenocarcinomas in Morocco

Background Adenocarcinoma of the colon is a common cancer and the annual incidence is increasing. Treatment is essentially surgical, combined with adjuvant chemotherapy in advanced cases. Methods This is a retrospective study of 100 patients with non-metastatic colon adenocarcinoma, treated at the gastroenterology and oncology centre in Ibn Rushd Hospital, Casablanca, over a period of 5 years from January, 2006, to January, 2010. Diagnosis was made after a histological study of biopsies taken during colonoscopy. Findings One hundred patients were diagnosed with non-metastatic colon adenocarcinoma. The sex ratio was 3:2 (M:F), the average age was 52 years, and approximately 50% of patients were diagnosed after a period of 7 months from the appearance of their first symptoms of rectal bleeding events, melena, and dysentery syndrome. Histologically, non-metastatic colon adenocarcinoma is well-differentiated in 80% of cases. All patients were operated on. The distribution of patients by stage was: 61% classified as stage II, 30% stage III, and 9% stage I. Adjuvant chemotherapy FUFOL, FOLFOX IV, or capecitabine was given in 85% of patients and monitoring without adjuvant therapy in 15%. The immediate follow-up after completion of chemotherapy showed complete remission in 95% of patients and 5% were in disease progression. After a mean follow-up of 30 months, 71% were in remission. 18% had a local or metastatic recurrence treated by second line chemotherapy (FOLFIRI or XELIRI), with remission seen in three patients, stable disease in seven patients, and treatment failure in eight patients. Interpretation The multidisciplinary approach to all stages of the process requires the involvement of various disciplines to give the patient the best quality of care. Adenocarcinoma of the colon is a common cancer and the annual incidence is increasing. Treatment is essentially surgical, combined with adjuvant chemotherapy in advanced cases. This is a retrospective study of 100 patients with non-metastatic colon adenocarcinoma, treated at the gastroenterology and oncology centre in Ibn Rushd Hospital, Casablanca, over a period of 5 years from January, 2006, to January, 2010. Diagnosis was made after a histological study of biopsies taken during colonoscopy. One hundred patients were diagnosed with non-metastatic colon adenocarcinoma. The sex ratio was 3:2 (M:F), the average age was 52 years, and approximately 50% of patients were diagnosed after a period of 7 months from the appearance of their first symptoms of rectal bleeding events, melena, and dysentery syndrome. Histologically, non-metastatic colon adenocarcinoma is well-differentiated in 80% of cases. All patients were operated on. The distribution of patients by stage was: 61% classified as stage II, 30% stage III, and 9% stage I. Adjuvant chemotherapy FUFOL, FOLFOX IV, or capecitabine was given in 85% of patients and monitoring without adjuvant therapy in 15%. The immediate follow-up after completion of chemotherapy showed complete remission in 95% of patients and 5% were in disease progression. After a mean follow-up of 30 months, 71% were in remission. 18% had a local or metastatic recurrence treated by second line chemotherapy (FOLFIRI or XELIRI), with remission seen in three patients, stable disease in seven patients, and treatment failure in eight patients. The multidisciplinary approach to all stages of the process requires the involvement of various disciplines to give the patient the best quality of care.

Extensive persistent Trichuriasis: A case report

Trichuris trichura (whip worm) is one of the most common intestinal parasite of humans in tropical countries. Often asymptomatic in humans, heavy infection can lead to chronic bloody diarrhoea associated with complications like rectal prolapse (particularly in children), appendicitis, colitis and proctitis. Very few cases of extensive Trichuriasis have been reported worldwide. We report a case of a 5-year-old girl who presented with generalized weakness, bleeding per rectum and rectal prolapse of 1 year duration. She was investigated for bleeding per rectum. Colonoscopy performed revealed extensive worm infestation involving the entire colon which was later confirmed as Trichuris trichura (whip worm) by microscopy. Child was diagnosed as Trichuris Dysentery Syndrome (TDS), treated for the same and discharged on improvement of the symptoms. The patient was traced back using the address available from the hospital records as she was not brought to the hospital for further follow up. Although none of her symptoms recurred, her stool microscopy however showed the presence of Trichuris trichura ova even at the end of 2 years indicative of persistent asymptomatic Trichuris trichura infection.

Trichuris dysentery syndrome

Trichuris dysentery syndrome

Trichuris dysentery syndrome: a common cause of chronic iron deficiency anemia in adults in an endemic area (with videos)

There are few published reports of Trichuris dysentery syndrome (TDS) in children. The disease has not been reported in adults. To report the clinical, colonoscopic, and histologic findings of TDS in adults in an endemic area. Case series. Tertiary gastroenterology center. Eighty-four consecutive adult patients with chronic iron deficiency anemia over a 3-year period were investigated. Ten patients had severe Trichuris trichiura infection and received a diagnosis of TDS. Colonoscopy and colonic biopsies. Patients received anthelmintic treatment, and their response was assessed. Ten patients with TDS were studied, including 8 female and 2 male patients with a mean (+/- standard deviation) age of 43 (+/- 15.5) years (range 15-65 years) and a hemoglobin level (+/- standard deviation) of 6.0 +/- 1.5 g/dL (range 4-8 g/dL); the duration (+/- standard deviation) of disease was 2.1 +/- 1.1 years (range 1.5-8.5 years). None of the patients had growth retardation, malnutrition, or immunodeficiency. Abdominal symptoms included abdominal pain, diarrhea, and hematochezia in 1 patient. Nine other patients had no abdominal symptoms. Colonoscopy revealed actively motile T. trichiura worms in large numbers in the right colon in 7 patients, in the ileum in 1, in the left colon in 1, and worms carpeting of the whole colonic mucosa in 1. Associated mucosal changes included petechial lesions, blotchy mucosal hemorrhages, and active mucosal oozing. Biopsy of the colon revealed worm segments with a thick outer cuticle. The posterior segment of the worm contained gravid uterus with numerous characteristic T. trichiura eggs. There was paucity of associated mucosal changes in most of the sections. Similar studies in other endemic areas are lacking. TDS should be considered in all patients in endemic areas with chronic iron deficiency anemia and/or occult blood loss.

Trichuris dysentery syndrome with eosinophilic leukemoid reaction mimicking inflammatory bowel disease

Trichuris dysentery syndrome with eosinophilic leukemoid reaction mimicking inflammatory bowel disease

An analysis of relationship between bacterial dysentery and irritable bowel syndrome

An analysis of relationship between bacterial dysentery and irritable bowel syndrome

The public health significance of Trichuris trichiura.

An estimated 1049 million persons harbour T. trichiura, including 114 million preschool-age children and 233 million school-age children. The prevalence of T. trichiura is high and may reach 95% in children in many parts of the world where protein energy malnutrition and anaemias are also prevalent and access to medical care and educational opportunities is often limited. The Trichuris dysentery syndrome (TDS) associated with heavy T. trichiura, which includes chronic dysentery, rectal prolapse, anaemia, poor growth, and clubbing of the fingers constitutes an important public health problem, as do lighter but still heavy infections, even if not strictly TDS, especially in children. The profound growth stunting in TDS can be reversed by repeated treatment for the infection and, initially, oral iron. However findings from Jamaica strongly suggest that the significant developmental and cognitive deficits seen are unlikely to disappear without increasing the positive psychological stimulation in the child's environment. The severe stunting in TDS now appears likely to be a reaction at least in part to a chronic inflammatory response and concomitant decreases in plasma insulin-like growth factor-1 (IGF-1), increases in tumor necrosis factor-alpha (TNF-alpha) in the lamina propria of the colonic mucosa and peripheral blood (which likely decrease appetite and intake of all nutrients) and a decrease in collagen synthesis. Improvements in cognitive performance have been found after treatment for relatively heavy infections (without chronic dysentery) in school-going children; it is unclear precisely how much T. trichiura interferes with children's ability to access educational opportunities, but treatment of infections whenever possible is obviously sensible. The blood loss that can occur in T. trichiura infection is likely to contribute to anaemia, particularly if the child also harbours hookworm, malaria and/or has a low intake of dietary iron. Community control is important, particularly for the individuals within a population who harbour heavy worm burdens; this means children, with special attention to girls who will experience increased iron requirements and blood loss due to menstruation, pregnancies, and lactation. Mebendazole and albendazole, both of which are on the WHO Essential Drugs List, are very effective against T. trichiura; multiple doses are needed to attain complete parasitological cure in all cases. However the goal of control programmes in endemic areas is morbidity reduction, which follows when intensity of infection is significantly reduced.

Plasma insulin-like growth factor-1, type 1 procollagen, and serum tumor necrosis factor alpha in children recovering from Trichuris dysentery syndrome.

To explore: 1) the relationship between plasma insulin-like growth factor-1 (IGF-1) and other markers of growth; and 2) the effect of serum concentrations of tumor necrosis factor alpha (TNF) on growth variables in children (2-10 years) stunted by Trichuris dysentery syndrome (TDS), recovering cases, and their matched controls. Fourteen patients with TDS were admitted to the Tropical Metabolism Research Unit, treated with albendazole and iron, and then followed with matched controls (n = 28) for 1 year. Anthropometric and biochemical measurements were done on admission and then every 3 months for the year. Plasma IGF-1, the carboxyterminal propeptide of type 1 procollagen, serum TNF, total serum protein, serum albumin, and complete blood count were determined. Low admission plasma levels of IGF-1 in TDS cases were accompanied by high serum levels of TNF, and total serum protein, normal serum albumin, low hemoglobin, reduced collagen synthesis (low plasma carboxyterminal propeptide of type 1 procollagen), and growth failure. These variables improved significantly after treatment. Plasma levels of IGF-1 were significantly related to the Z-scores for height-for-age (r = 0.60, 0.73, 0.68) and weight-for-age (r = 0.69, 0.80, 0.69) of cases and controls, height-for-age (r = 0.51, 0.52, 0.54) and weight-for-age (r = 0.51, 0.52, 0.54) at each measurement throughout the year. Serum levels of TNF were not related to any of the growth variables. These findings may contribute to the understanding of growth failure in children affected by other forms of chronic inflammatory bowel disease.

Fecal occult blood testing on Trichuris-infected primary school children in northeastern peninsular Malaysia.

Stool specimens of 104 primary schoolchildren (mean+/-SD age = 8.2+/-0.3 years) were examined for helminth eggs and for occult blood to investigate the possibility that trichuriasis causes occult intestinal bleeding in the absence of the overt Trichuris dysentery syndrome. A commercially available guaiac test was used to detect fecal occult blood. Sixty-one children had Trichuris infection, 11 of whom had heavy infections (> 10,000 eggs per gram of feces [epg]), and 53 had Ascaris infections. No hookworm infection was detected. Baseline screening yielded only one weakly positive occult blood test result in a child with a light (800 epg) Trichuris infection. Serial stool occult blood testing on the 11 subjects with heavy trichuriasis and 8 uninfected controls yielded a single weakly positive result in the control group. The results provide no evidence that trichuriasis predisposes to significant occult gastrointestinal bleeding in children in the absence of the dysenteric syndrome.

Growth and development four years after treatment for the Trichuris dysentery syndrome

A follow-up study is reported of 18 children 4 y after treatment for the Trichuris dysentery syndrome (TDS) and matched control children. The TDS children were initially severely stunted and had extremely low developmental levels. They showed catch-up in height of 1.9 z-scores even though they remained in very poor environments. Their intelligence quotients, school achievement and cognitive function remained significantly lower than those of the controls. Controlling for their earlier developmental levels, the TDS children showed a small improvement in mental development relative to the controls.

Growth and development four years after treatment for the Trichuris dysentery syndrome

A follow‐up study is reported of 18 children 4 y after treatment for the Trichuris dysentery syndrome (TDS) and matched control children. The TDS children were initially severely stunted and had extremely low developmental levels. They showed catch‐up in height of 1.9 z‐scores even though they remained in very poor environments. Their intelligence quotients, school achievement and cognitive function remained significantly lower than those of the controls. Controlling for their earlier developmental levels, the TDS children showed a small improvement in mental development relative to the controls.