Abstract
Background Intestinal parasitism in large urban cities is an ongoing public
health challenge. Although most epidemiological studies were concentrating on
children, there is an ongoing concern that adult vulnerable populations are prone
to protozoal and helminthic pathogenic infestations. In pregnant women living
in social inequality settings, this is particularly important as it may affect their
overall health and that of their offspring.
Methods We investigated the prevalence of intestinal parasitic infections in
pregnant women in three districts of Bogotá, the largest city in Colombia. We
undertook a cross-sectional study including questionnaires on sociodemographic
factors and living conditions, in addition to home visits. By examination of stool
samples, we determined the prevalence of intestinal parasites, including protozoa
and helminths that are pathogenic and of debated pathogenicity. The presence of
microorganisms was detected by multiple approaches including direct smears,
concentration techniques, double stool sampling and/or qPCR techniques. Five
hundred and fifty pregnant women from low-income urban areas participated
in this study by answering the questionnaire, with 331 providing in addition a
stool sample, 98 of them providing two stool samples, and 48 of them being
prospectively analyzed for the presence of protozoal and helminthic parasites
with quantitative PCR.
Results The findings revealed an overall 41.4% prevalence of intestinal parasites,
with an unexpected 40.5% predominance of protozoa that are considered
non-pathogenic and/or of debated pathogenicity, withBlastocystis hominis as the
most prevalent parasite (25.1%). The low prevalence of pathogenic parasites was
confirmed with all techniques. Double sampling and qPCR showed highest diagnostic
capacity. Sociodemographic, pregnancy and living conditions analyses in
women infected with any parasite revealed associations with civil status (higher
parasites in married women or those living with someone, P < 0.038) and with
last deworming (higher when deworming was done over a year ago, P < 0.018).
Higher trends were found between intestinal polyparasitism and women from
minority groups and those not having water sinks.
Conclusions This is the first study focused on pregnant women in Bogotá, the
largest city in Colombia that estimates the prevalence and factors associated with
intestinal parasitism in vulnerable populations living in conditions of poverty and
social inequality. Although a low prevalence of pathogenic parasites was found
in pregnant women, a high prevalence of parasites with disputed pathogenicity
was revealed. In Bogotá, the good quality of water for human consumption,
open availability of broad-spectrum anti-parasitic drugs, better educational level
and appropriate sanitary facilities play an important role in the prevention of
pathogenic parasitic infections. However, the high prevalence of non-pathogenic
parasites indicates that fecal-oral contamination continues in these communities.
Accordingly, public health services should emphasize education campaigns to
prevent these contamination routes, particularly in women belonging to minority
groups, those without water sinks and who have not been dewormed recently.
Additionally, public health services could take into account the findings that
double stool sampling may increase diagnostic capacity in these populations, a
cost-effective strategy in middle income countries like Colombia.
Translated title of the contribution | Prevalence of pathogenic and non-pathogenic intestinal parasites in pregnant women living in poverty and social inequality |
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Original language | English |
Article number | 66S |
Pages (from-to) | 382 |
Number of pages | 382 |
Journal | Revue d'Epidemiologie et de Sante Publique |
Volume | 66 |
Issue number | spp 5 |
DOIs | |
State | Published - Jul 2018 |
Event | Congreso europeo de epidemiología - Lyon Convention Centre at the Cité Internationale, Lyon, France Duration: Jul 4 2018 → Jul 6 2018 Conference number: p8-9 http://www.euroepi2018.com/ |
All Science Journal Classification (ASJC) codes
- Medicine(all)
Author Keywords
- Concept