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Status of intestinal parasites infection among primary school children in Kampongcham, Cambodia
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Korean J Parasito > Volume 40(3):2002 > Article
Lee, Bae, Kim, Deung, Ryang, Kim, Im, and Yong: Status of intestinal parasites infection among primary school children in Kampongcham, Cambodia

Abstract

A survey was made to find the extent of intestinal parasite infection in Kampongcham, Cambodia in February 2002. A total of 251 fecal specimens were collected from Tonlebat primary school children and examined by formalin-ether sedimentation technique. The overall infection rate of intestinal parasite was 54.2% (males, 57.3%; females, 50.8%). The infection rate of intestinal helminths by the species were as follows: Ascaris lumbricoides 26.3%, Echinostoma sp. 15.6%, hookworm 6.4%, Opisthorchis sp. 4.0%, Rhabditis sp. 2.4%, and Trichuris trichiura 0.4%. The infection rate of intestinal protozoa were as follows: E. coli 7.6%, G. lamblia 3.2%, I. butschlii 3.2%, and E. histolytica 0.8%. More than two different kinds of parasites were found in 16.7% of the stool samples. All the children infected were treated with albendazole, praziquantel and metronidazole according to parasite species. The results showed that intestinal parasites are highly endemic in this area.

Cambodia has been known as an endemic area for malaria and schistosomiasis (Meek, 1988; Singhasivanon, 1999; Urbani et al., 2002). The infection status of intestinal parasites in Cambodia, however, has not yet been thoroughly investigated. Only several reports show Cambodian refugees infected with intestinal parasites including nematodes, trematodes and protozoa (Nwanyanwu et al., 1989; Lurio et al., 1991; Gyorkos et al., 1992). With aids of a local Korean missionary in Cambodia and a medical service team from Wonju Christian hospital, we performed stool examinations. In February 2002, we collected 251 stool samples from Tonlebat primary school children in Kampongcham, Cambodia. Kampongcham city is located 80 km from Phnom Penh to the northeast. Formalin-ether sedimentation technique revealed intestinal helminth eggs of Ascaris lumbricoides, Trichuris trichiura, hookworm, Rhabditis sp. Echinostoma sp. and Opisthorchis sp., and protozoan cysts of Entamoeba histolytica, Entamoeba coli, Giardia lamblia and Iodamoeba butschlii, respectively. Of the 251 stool specimens, 136 (54.2%) were positives. The positive rates of boys and girls were 57.3% and 50.5%, respectively. Data revealed the highest positive rate as 26.3% for Ascaris lumbricoides, followed by 15.6% for Echinostoma species (Table 1). Multiple parasite infections were found in 16.7% of the stool specimens. There was no cestode infection. The infection rates ranged from 48.7% to 59.6% by the grade, and the highest rate was noticed in second grade schoolchildren. It was interesting to compare trematode infection with their eating habits. In general, they did not consume raw fresh water fish (Story and Harris, 1989), however, are thought to be infected by insufficiently cooked fish. Opisthorchis infection rate was 4.0%. Not only Opisthorchis species but also Echinostoma species were important trematode parasites in need of treatment. Anti-helminthics were sent to Tonlebat primary school after stool examination. The school is located along the Mekong river. Although, many children were swimming in the river during the stool examination we could not find Schistosoma eggs. Considering swimming habits, the area is considered to be no schistosomiasis endemic area.
This survey showed that Tonlebat primary school children are prevalently infected with intestinal parasites, especially trematode such as Echinostoma species. Similar results were also obtained from around the survey area. A periodic survey on the intestinal parasite infections, treatment of infected cases, education of eating habit, and improvement of the sanitations are recommended for the parasite control in Kampongcham city, Cambodia.

ACKNOWLEDGMENTS

We thank the medical service team in Wonju Christian Hospital for stool samples, and Harvest Mission Center in Kampongcham, Cambodia, for its help during our visit to the survey area.

REFERENCES

1. Gyorkos TW, MacLean JD, Viens P, Chheang C, Kokoskin NE. Intestinal parasite infection in the Kampuchean refugee population 6 years after resettlement in Canada. J Infect Dis 1992;166:413-417. PMID: 1634813.
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2. Lurio J, Verson H, Karp S. Intestinal parasites in Cambodians: comparison of diagnostic methods used in screening refugees with implications for treatment of populations with high rates of infestation. J Am Board Fam Pract 1991;4:71-78. PMID: 2028827.

3. Meek SR. Epidemiology of malaria in displaced Khmers on the Thai-Kampuchean border. Southeast Asian J Trop Med Public Health 1988;19:243-252. PMID: 3067373.

4. Nwanyanwu OC, Moore JS, Adams ED. Parasitic infections in Asian refugees in Fort Worth. Tex Med 1989;85:42-45. PMID: 2595611.

5. Singhasivanon P. Mekong malaria, malaria multi-drug resistance and economic development in the greater Mekong subregion of Southeast Asia. Southeast Asian J Trop Med Public Health 1999;30(suppl):i-iv-1-101.

6. Story M, Harris LJ. Food habits and dietary change of Southeast Asian refugee families living in the United States. J Am Diet Assoc 1989;89:800-803. PMID: 2723303.

7. Urbani C, Sinoun M, Socheat D, et al. Epidemiology and control of mekongi schistosomiasis. Acta Trop 2002;82:157-168. PMID: 12020888.
crossref
Table 1.
Prevalence of intestinal parasite infections among Tonlebat primary school children, Kampongcham, Cambodia
No. examined/positive (%) Male
Female
Total
131/75 (57.3) 120/61 (50.8) 251/136 (54.2)
A. lumbricoides 37 (28.4) 29 (24.2) 66 (26.3)
Hookworm 11 (8.3) 5 (4.2) 16 (6.4)
T. trichiura - 1 (0.8) 1 (0.4)
Rhabditis sp. 2 (1.5) 4 (3.3) 6 (2.4)
Echinostomatidae 15 (11.5) 24 (20.0) 39 (15.6)
Opisthorchis sp. 6 (4.6) 4 (3.3) 10 (4.0)
E. histolytica 1 (0.8) 1 (0.8) 2 (0.8)
E. coli 8 (6.1) 11 (9.2) 19 (7.6)
G. lamblia 4 (3.1) 4 (3.3) 8 (3.2)
I. butschlii 5 (3.8) 3 (2.5) 8 (3.2)
Table 2.
Prevalence of intestinal parasite infection by the grade among Tonlebat primary school children, Kampongcham, Cambodia
grade 1
2
3
4
5
6
No. examined/positive (%) 36/21 (58.3) 52/31 (59.6) 39/19 (48.7) 39/19 (48.7) 40/21 (52.5) 45/25 (55.6)
A. lumbricoides 14 (38.9) 17 (32.7) 10 (25.6) 7 (18.0) 10 (25.0) 8 (17.8)
Hookworm 1 (2.8) 1 (1.9) 2 (5.1) 2 (5.1) 2 (5.0) 8 (17.8)
T. trichiura - - 1 (2.6) - - -
Rhabditis sp. 1 (2.8) 2 (3.9) 1 (2.6) - - 2 (4.4)
Echinostomatidae 6 (16.7) 9 (17.3) 6 (15.4) 7 (18.0) 5 (12.5) 6 (13.3)
Opisthorchis sp. 3 (8.3) 3 (5.8) - 1 (2.6) 2 (5.0) 1 (2.2)
E. histolytica - - 1 (2.6) - 1 (2.5) -
E. coli 3 (8.3) 3 (5.8) 1 (2.6) 2 (5.1) 3 (7.5) 7 (15.6)
G. lamblia 1 (2.8) 3 (5.8) - 1 (2.6) 2 (5.0) 1 (2.2)
I. butschlii - 3 (5.8) 1 (2.6) 1 (2.6) 1 (2.5) 2 (4.4)
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