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Intestinal parasite screening in internationally adopted children: importance of multiple stool specimens.
Pediatrics. 2011 Sep; 128(3):e613-22.Ped

Abstract

OBJECTIVE

Our goal was to determine the prevalence of intestinal parasites in internationally adopted children, to examine factors associated with infection, and to determine if evaluating multiple stool specimens increases the yield of parasite identification.

METHODS

We evaluated internationally adopted children with at least 1 stool specimen submitted for ova and parasite testing within 120 days after arrival to the United States. In children submitting 3 stool specimens, in which at least 1 specimen was positive for the pathogen studied, we examined whether multiple stool specimens increased the likelihood of pathogen identification.

RESULTS

Of the 1042 children studied, 27% had at least 1 pathogen identified; with pathogen-specific prevalence of Giardia intestinalis (19%), Blastocystis hominis (10%), Dientamoeba fragilis (5%), Entamoeba histolytica (1%), Ascaris lumbricoides (1%), and Hymenolepsis species (1%). The lowest prevalence occurred in South Korean (0%), Guatemalan (9%), and Chinese (13%) children, and the highest prevalence occurred in Ethiopian (55%) and Ukrainian (74%) children. Increasing age was significantly associated with parasite identification, whereas malnutrition and gastrointestinal symptoms were not. Overall, the yield of 1 stool specimen was 79% with pathogen recovery significantly increasing for 2 (92%) and 3 (100%) specimens, respectively (P < .0001). Pathogen identification also significantly increased with evaluation of additional stool specimens for children with and without gastrointestinal symptoms.

CONCLUSIONS

We provide data for evidence-based guidelines for intestinal parasite screening in internationally adopted children. Gastrointestinal symptoms were not predictive of pathogen recovery, and multiple stool specimens increased pathogen identification in this high-risk group of children.

Links

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Authors+Show Affiliations

Staat MA
Division of Infectious Diseases, MLC 7013, International Adoption Center, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, ML 7036, Cincinnati, OH 45229-3039, USA. mary.staat@cchmc.org
Rice M
No affiliation info available
Donauer S
No affiliation info available
Mukkada S
No affiliation info available
Holloway M
No affiliation info available
Cassedy A
No affiliation info available
Kelley J
No affiliation info available
Salisbury S
No affiliation info available

MeSH

AdoptionAge FactorsBlastocystis hominisChildChild, PreschoolFecesFemaleGiardia lambliaGlobal HealthHumansInfantIntestinal Diseases, ParasiticLogistic ModelsMaleMultivariate AnalysisNutritional StatusPrevalence

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21824880

Citation

Staat, Mary Allen, et al. "Intestinal Parasite Screening in Internationally Adopted Children: Importance of Multiple Stool Specimens." Pediatrics, vol. 128, no. 3, 2011, pp. e613-22.
Staat MA, Rice M, Donauer S, et al. Intestinal parasite screening in internationally adopted children: importance of multiple stool specimens. Pediatrics. 2011;128(3):e613-22.
Staat, M. A., Rice, M., Donauer, S., Mukkada, S., Holloway, M., Cassedy, A., Kelley, J., & Salisbury, S. (2011). Intestinal parasite screening in internationally adopted children: importance of multiple stool specimens. Pediatrics, 128(3), e613-22. https://doi.org/10.1542/peds.2010-3032
Staat MA, et al. Intestinal Parasite Screening in Internationally Adopted Children: Importance of Multiple Stool Specimens. Pediatrics. 2011;128(3):e613-22. PubMed PMID: 21824880.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intestinal parasite screening in internationally adopted children: importance of multiple stool specimens. AU - Staat,Mary Allen, AU - Rice,Marilyn, AU - Donauer,Stephanie, AU - Mukkada,Sheena, AU - Holloway,Michol, AU - Cassedy,Amy, AU - Kelley,Jennifer, AU - Salisbury,Shelia, Y1 - 2011/08/08/ PY - 2011/8/10/entrez PY - 2011/8/10/pubmed PY - 2012/4/24/medline SP - e613 EP - 22 JF - Pediatrics JO - Pediatrics VL - 128 IS - 3 N2 - OBJECTIVE: Our goal was to determine the prevalence of intestinal parasites in internationally adopted children, to examine factors associated with infection, and to determine if evaluating multiple stool specimens increases the yield of parasite identification. METHODS: We evaluated internationally adopted children with at least 1 stool specimen submitted for ova and parasite testing within 120 days after arrival to the United States. In children submitting 3 stool specimens, in which at least 1 specimen was positive for the pathogen studied, we examined whether multiple stool specimens increased the likelihood of pathogen identification. RESULTS: Of the 1042 children studied, 27% had at least 1 pathogen identified; with pathogen-specific prevalence of Giardia intestinalis (19%), Blastocystis hominis (10%), Dientamoeba fragilis (5%), Entamoeba histolytica (1%), Ascaris lumbricoides (1%), and Hymenolepsis species (1%). The lowest prevalence occurred in South Korean (0%), Guatemalan (9%), and Chinese (13%) children, and the highest prevalence occurred in Ethiopian (55%) and Ukrainian (74%) children. Increasing age was significantly associated with parasite identification, whereas malnutrition and gastrointestinal symptoms were not. Overall, the yield of 1 stool specimen was 79% with pathogen recovery significantly increasing for 2 (92%) and 3 (100%) specimens, respectively (P < .0001). Pathogen identification also significantly increased with evaluation of additional stool specimens for children with and without gastrointestinal symptoms. CONCLUSIONS: We provide data for evidence-based guidelines for intestinal parasite screening in internationally adopted children. Gastrointestinal symptoms were not predictive of pathogen recovery, and multiple stool specimens increased pathogen identification in this high-risk group of children. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/21824880/full_citation DB - PRIME DP - Unbound Medicine ER -