Mukhopadhyay C, Wilson G, Pradhan D, Shivananda P G
Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal.
Southeast Asian J Trop Med Public Health. 2007 Jan;38(1):13-9.
Unlike acute diarrhea, the role of pathogens in persistent diarrhea in children in Nepal is unclear. Protozoal parasites are suspected to be a major cause. The study was carried out to find the association between protozoal agents and persistent diarrhea in children below age 5 years from western Nepal. Stool samples were collected from 253 children with persistent diarrhea, from 155 children with acute diarrhea (disease controls) and from 100 healthy children from the community (normal controls). Of 253 children with persistent diarrhea, 90 (35.5%) had protozoal infections, 63 (24.9%) helminthic infections, 32 (12.6%) had bacterial infections and 16 had mixed infections. Giardia lamblia was the most prevalent (67.7%), followed by Entamaeba histolytica (27.7%). HIV infection and severe malnutrition were associated with Cyclospora cayetanensis and Cryptosporidium spp causing persistent diarrhea. We conclude that stool microscopy should be routinely performed in children with persistent diarrhea since protozoal infections can be cured with effective treatment and control can be achieved by proper health education.
与急性腹泻不同，病原体在尼泊尔儿童持续性腹泻中所起的作用尚不清楚。原生动物寄生虫被怀疑是主要病因。开展这项研究是为了找出尼泊尔西部5岁以下儿童原生动物病原体与持续性腹泻之间的关联。从253名患有持续性腹泻的儿童、155名患有急性腹泻的儿童（疾病对照组）以及100名社区健康儿童（正常对照组）中采集了粪便样本。在253名患有持续性腹泻的儿童中，90名（35.5%）有原生动物感染，63名（24.9%）有蠕虫感染，32名（12.6%）有细菌感染，16名有混合感染。蓝氏贾第鞭毛虫最为常见（67.7%），其次是溶组织内阿米巴（27.7%）。艾滋病毒感染和严重营养不良与导致持续性腹泻的卡耶塔环孢子球虫和隐孢子虫属有关。我们得出结论，对于患有持续性腹泻的儿童应常规进行粪便显微镜检查，因为原生动物感染可以通过有效治疗治愈，并且通过适当的健康教育可以实现控制。
