From the Department of Woman and Child Health and Public Health, Child Health Area, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy.
Istituto of Mibrobiology.
Pediatr Infect Dis J. 2019 Oct;38(10):983-989. doi: 10.1097/INF.0000000000002399.
Intestinal parasitic infections (IPIs) represent one of the leading causes of morbidity in the world. Children involved in international adoptions constitute a special group of subjects with specific problems and specific healthcare needs. Nevertheless, in current literature there are insufficient data on IPI in this subset of children. This study aims to evaluate the prevalence of IPI in a cohort of internationally adopted children and to investigate epidemiologic factors and clinical features related to IPIs.
A retrospective study involving internationally adopted children <18 years old for which results from 3 fecal parasitologic tests were available, evaluated between September 1, 2008 and April 31, 2018 at a tertiary level university hospital in Rome. Univariate and multivariate logistic regression analyses were carried out to identify demographic factors and clinical features associated with IPIs. Two comparisons were performed, the first one according to the positivity of the parasitologic examination of the feces and the second one according to the pathogenicity of the identified strains.
Of 584 children evaluated, 346 (59.3%) had a positive parasitologic examination (143 pathogenic parasites and 203 nonpathogenic parasites) and 238 (40.8%) had a negative parasitologic examination. About 28.9% of children were positive for 2 or more parasites. A statistically significant positive association was found between IPIs and age, macroarea of origin (Africa and Latin America), living in institutions before adoption and vitamin D deficiency (P < 0.05).
Intestinal parasites represent a widespread infection among internationally adopted children, especially in school-age children and those from Latin America and Africa. Importantly, the parasites found in adopted children were not pathogenic in most cases and did not cause significant alterations in growth, major micronutrient deficits or malnutrition.
肠道寄生虫感染（IPIs）是世界上发病率的主要原因之一。参与国际收养的儿童构成了具有特定问题和特定医疗保健需求的特殊人群。然而，在当前的文献中，关于这部分儿童的 IPI 数据不足。本研究旨在评估国际收养儿童中 IPI 的流行率，并调查与 IPI 相关的流行病学因素和临床特征。
这是一项回顾性研究，涉及 2008 年 9 月 1 日至 2018 年 4 月 31 日期间在罗马一所三级大学医院接受评估的年龄<18 岁的国际收养儿童，他们的粪便寄生虫 3 项检查结果均可用。进行单变量和多变量逻辑回归分析，以确定与 IPI 相关的人口统计学因素和临床特征。进行了两次比较，第一次是根据粪便寄生虫检查的阳性结果进行的，第二次是根据鉴定出的菌株的致病性进行的。
在评估的 584 名儿童中，有 346 名（59.3%）粪便寄生虫检查阳性（143 种致病性寄生虫和 203 种非致病性寄生虫），238 名（40.8%）粪便寄生虫检查阴性。约 28.9%的儿童有 2 种或以上寄生虫阳性。IPIs 与年龄、起源地区（非洲和拉丁美洲）、收养前在机构中生活和维生素 D 缺乏呈统计学显著正相关（P<0.05）。
肠道寄生虫在国际收养儿童中广泛存在，尤其是在学龄儿童和来自拉丁美洲和非洲的儿童中。重要的是，在收养儿童中发现的寄生虫在大多数情况下没有致病性，不会导致生长、主要微量营养素缺乏或营养不良的显著改变。
