Hymenolepiasis in institutionalized Romanian children

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Background: Parasitic diseases represent an important public health problem. Digestive parasitosis are characterized by high prevalence and a variety of clinical manifestations, being especially frequent in institutionalized children.The aim of the present study was to investigate the prevalence of intestinal parasitic infections in a Romanian Children Care Unit.

Methods: Stool examinations were performed using the iodine staining for the identification of protozoan cysts and the Willis-Hung method for the identification of helminth eggs. Eosinophil values were determined by differential white blood cell count with May Grunwald Giemsa staining.

Results: We investigated 64 institutionalized children aged 2 to 12 years. Parasitic infections were identified in 44 cases (68.7%). Hymenolepis nana (31.2%), Giardia lamblia (28.1%), Blastocytis hominis (7.8%), Entamoeba coli (4.7%), Ascaris lumbricoides (4.7%), and Trichuris trichiura (3.1%) were diagnosed. We have determined associations of two (45.4%) and more than two parasites (18.2%) among the infected children; of the 20 with hymenolepiasis, 11 (55%) had multiple parasitic infections. Clinical and laboratory examinations were conducted to investigate the presence of symptoms and eosinophilia in patients with parasitic infections. Diarrhoea (38.6%), weight loss (47.7%), abdominal pain (25%), nervous disorders (34.1%), cutaneous manifestations (22.7%), fever (9.1%) and respiratory infections (59.1%) were reported in the infected children. Eosinophilia was noted in 27 (61%) of the 44 patients with parasitosis. High eosinophil values were mostly observed among those diagnosed with helminth infections.

Conclusion: Hymenolepis nana infection was reported with an increased frequency among Romanian institutionalized children. The majority of the patients with hymenolepiasis were diagnosed with multiple parasitic infections.