Prevalence and risk factors for intestinal parasitic infections in pregnant women residing in three districts of Bogotá, Colombia Academic Article

journal

  • BMC Public Health

abstract

  • ANTECEDENTES: Las infecciones parasitarias intestinales (IPI) conllevan a una significativa morbilidad y mortalidad en población pediátrica y adulta a nivel mundial. El parasitismo intestinal durante el embarazo es de interés dado que puede afectar la salud de las gestantes y de sus hijos. Este estudio determinó la prevalencia de IPI en mujeres embarazadas viviendo en condiciones subestándar en tres localidades de Bogotá, Colombia. Asociaciones entre la prevalencia y los factores sociodemográficos, del hogar y condiciones de vida fueron evaluadas.MÉTODOS: En un estudio de prevalencia analítica y basado en la comunidad, mujeres embarazadas fueron reclutadas desde tres distritos de Bogotá. Un total de 550 participantes respondieron un cuestionario; 331 de ellas también entregaron muestras coprológicas, 233 entregaron una sola muestra y 98 entregaron dos muestras. Las respuestas del cuestionario fueron asociadas con la presencia de parásitos intestinales, los cuales fueron determinados usando una técnica microscópica combinada estándar que incluyó examen directo y examen por concentración formol-éter. Los resultados fueron verificados a través de un examen suplementario a 48 muestras coprológicas por la técnica cuantitativa de reacción en cadena de polimerasa (qPCR).RESULTADOS: Entre las gestantes quienes vivían en las áreas pobres seleccionadas en Bogotá, la prevalencia general de parasitismo intestinal fue de 41% con un 9% de poliparasitismo. Los parásitos patogénicos estuvieron presentes en el 1.2% de las 331 participantes, incluyendo Giardia lamblia, Ascaris lumbricoides. La más alta prevalencia fue encontrada para parásitos con patogenicidad debatida, incluyendo Blastocystis hominis (25%), Endolimax nana (15%), Entamoeba coli (8%), y Iodamoeba butschlii (2%). Entamoeba histolytica/dispar complex también fue detectada (1.5%). Cuando se comparó un subgrupo de muestras coprológicas usando la técnica microscópica combinada estándar y la qPCR, ésta última detectó una mayor prevalencia general de IPI (58.3%). Mayor prevalencia de infecciones por algún parásito intestinal fue encontrada en los participantes que nunca se habían desparasitado (p=0.01). Mayor pero no estadísticamente significativas asociaciones fueron encontradas entre algún parásito y mujeres que viven con pareja, y poliparasitismo intestinal y pertenecer a un grupo minoritario o no tener lavamanos.CONCLUSIONES: Este es el primer estudio de parasitismo intestinal enfocad en mujeres embarazadas viviendo en pobreza, encontró una alta prevalencia de parásitos intestinal de patogenicidad debatida y confirmó una baja prevalencia de parásitos intestinales patógenos. Estos resultados resaltan la necesidad de intervenciones educativas para interrumpir las rutas de transmisión para la prevalencia de parásitos.
  • BACKGROUND: Intestinal parasitic infections (IPI) lead to significant morbidity and mortality in pediatric and adult populations worldwide. Intestinal parasitism during pregnancy is of interest as it may affect the health of pregnant women and their offspring. This study determined the prevalence of IPI in pregnant women living in substandard conditions in three urban districts of Bogotá, Colombia. Associations between prevalence and sociodemographic factors, housing, and living conditions were also evaluated.METHODS: In a cross-sectional and community-based study, pregnant women were recruited from three districts of Bogotá. A total of 550 participants answered a questionnaire; 331 of these also provided stool samples, with 233 providing one and 98 providing two stool samples. Questionnaire responses were associated with the presence of intestinal parasites, which was determined using a standard combined microscopy technique including direct wet mount and formol-ether concentration. Results were verified by supplementary examination of 48 stool samples by quantitative polymerase chain reaction (qPCR).RESULTS: Among pregnant women who lived in selected poor residential areas in Bogotá, the overall prevalence of intestinal parasitism was 41% with 9% polyparasitism. Pathogenic parasites were present in 1.2% of the 331 participants including Giardia lamblia and Ascaris lumbricoides. Higher prevalence was found for parasites with debated pathogenicity, including Blastocystis hominis (25%), Endolimax nana (15%), Entamoeba coli (8%), and Iodamoeba butschlii (2%). Entamoeba histolytica/dispar complex was also detected (1.5%). When comparing a subset of stool samples using the combined microscopy technique and qPCR, the latter detected a higher 58.3% overall IPI prevalence. Higher prevalence of infections by any intestinal parasite was found in participants who had never been dewormed (p = 0.01). Higher but not statistically significant associations were found between any parasite and women living with a partner, and intestinal polyparasitism and being from a minority group and not having a water sink.CONCLUSIONS: This first study of the prevalence of intestinal parasitism in Bogotá focused on pregnant women living in poverty, found a high prevalence of intestinal parasites of debated pathogenicity, and confirmed a low prevalence of pathogenic intestinal parasites. These results highlight the need for educational interventions to disrupt transmission routes for prevalent parasites.
  • BACKGROUND: Intestinal parasitic infections (IPI) lead to significant morbidity and mortality in pediatric and adult populations worldwide. Intestinal parasitism during pregnancy is of interest as it may affect the health of pregnant women and their offspring. This study determined the prevalence of IPI in pregnant women living in substandard conditions in three urban districts of Bogotá, Colombia. Associations between prevalence and sociodemographic factors, housing, and living conditions were also evaluated.METHODS: In a cross-sectional and community-based study, pregnant women were recruited from three districts of Bogotá. A total of 550 participants answered a questionnaire; 331 of these also provided stool samples, with 233 providing one and 98 providing two stool samples. Questionnaire responses were associated with the presence of intestinal parasites, which was determined using a standard combined microscopy technique including direct wet mount and formol-ether concentration. Results were verified by supplementary examination of 48 stool samples by quantitative polymerase chain reaction (qPCR).RESULTS: Among pregnant women who lived in selected poor residential areas in Bogotá, the overall prevalence of intestinal parasitism was 41% with 9% polyparasitism. Pathogenic parasites were present in 1.2% of the 331 participants including Giardia lamblia and Ascaris lumbricoides. Higher prevalence was found for parasites with debated pathogenicity, including Blastocystis hominis (25%), Endolimax nana (15%), Entamoeba coli (8%), and Iodamoeba butschlii (2%). Entamoeba histolytica/dispar complex was also detected (1.5%). When comparing a subset of stool samples using the combined microscopy technique and qPCR, the latter detected a higher 58.3% overall IPI prevalence. Higher prevalence of infections by any intestinal parasite was found in participants who had never been dewormed (p = 0.01). Higher but not statistically significant associations were found between any parasite and women living with a partner, and intestinal polyparasitism and being from a minority group and not having a water sink.CONCLUSIONS: This first study of the prevalence of intestinal parasitism in Bogotá focused on pregnant women living in poverty, found a high prevalence of intestinal parasites of debated pathogenicity, and confirmed a low prevalence of pathogenic intestinal parasites. These results highlight the need for educational interventions to disrupt transmission routes for prevalent parasites.

publication date

  • 2018/8/29

edition

  • 18

International Standard Serial Number (ISSN)

  • 1471-2458

number of pages

  • 15

start page

  • 1071