Growth retardation and severe anemia in children with Trichuris dysenteric syndrome

Abstract

Objective: To document epidemiologic data, clinical manifestations and treatment in hospitalized children with Trichuris dysenteric syndrome from Honduras during 2010–2012. Methods: Severe trichuriasis cases were identified by routine stool examinations from hospitalized patients (12 years old or less). Relevant epidemiologic, clinical and management data were obtained from review of clinical histories in the ward. Results: Of 122 Trichuris infections diagnosed in 11 528 (1.0%) stool samples for all ages, 81 (66.4%) were identified in the age group 2–12 years old, 21 (25.9%) of which were severe (≥100 eggs in 2 mg of feces). Thirteen of those 21 patients collaborated in this study. Patients (9 males and 4 females) were of rural precedence, from large poor or very poor families, chronically parasitized, and between 2 and 12 years old. Dysentery of months duration, severe anemia and stunting were common complaints; clinical characteristics associated with heavy Trichuris infections included egg counts from 232 to 3520 eggs per direct smear, hemoglobin from 3.4 to 10.8 g/dL, eosinophilia up to 43%, severe malnutrition and growth stunting. Orally administered drugs mebendazole, albendazole, metronidazole, nitaxozanide, and piperazine were prescribed at different dosages and duration other than recommended; no cure or egg excretion control was exercised before patient release. A range of 340 to about 10 000 worms were recovered after treatment from 8 patients. Conclusions: This report underlines the need for detailed community studies in trichuriasis morbidity, effective treatment assessment and clinical response in severely malnourished parasitized children.

Keywords

• Anemia
• Honduras
• Stunting
• Trichuris dysentery syndrome