Abstract
A survey was conducted to determine the extent of intestinal parasite infection in Bat Dambang, Cambodia in March 2004. A total of 623 fecal specimens was collected from kindergarten and schoolchildren and examined using the formalin-ether sedimentation technique. The overall infection rate of intestinal parasites was 25.7% (boys, 26.2%; girls, 25.1%), and the infection rates of intestinal helminthes by species were as follows: Echinostoma sp. 4.8%, hookworm 3.4%, Hymenolepis nana 1.3%, and Rhabditis sp. 1.3%. The infection rates of intestinal protozoa were; Entamoeba coli 4.8%, Giardia lamblia 2.9%, Iodamoeba butschlii 1.4%, Entamoeba polecki 1.1%, and Entamoeba histolytica 0.8%. There were no egg positive cases of Ascaris lumbricoides or Trichuris trichiura. All children infected were treated with albendazole, praziquantel, or metronidazole according to parasite species. The results showed that intestinal parasites are highly endemic in Bat Dambang, Cambodia.
-
Key words: Cambodia, intestinal parasites, children
Cambodia is recognized as an endemic area for malaria and schistosomiasis (
Meek, 1988;
Singhasivanon, 1999;
Urbani et al., 2002), but the infection status of intestinal parasites in Cambodia has not been thoroughly investigated. However, several reports show that Cambodian children and refugees are infected with intestinal parasites including nematodes, trematodes, and protozoa (
Nwanyanwu et al., 1989;
Lurio et al., 1991;
Gyorkos et al., 1992;
Lee et al., 2002).
With the aid of a local Korean medical service in Cambodia, we collected 623 stool samples from children at Watkor Kindergarten and from schoolchildren in Bat Dambang, Cambodia in March 2004; Bat Dambang is located about 250 km southeast of Phnom Penh, the capital city of Cambodia.
Formalin-ether sedimentation revealed intestinal helminth eggs of Hookworm,
Rhabditis sp.,
Hymenolepis nana, and
Echinostoma sp., and protozoan cysts of
Entamoeba histolytica,
Entamoeba coli,
Giardia lamblia,
Iodamoeba butschlii, and
Entamoeba polecki. Of the 623 stool specimens, 160 (25.7%) were positive. The positive rates for boys and girls were 26.2% (90/344) and 25.1% (70/279), respectively. Data revealed a highest positive rate (4.8%) for
Echinostoma sp., followed by 3.4% for Hookworm (
Table 1). Multiple parasite infections were found in 9 cases. Infection rates ranged from 10% to 38.2% by school grade; the highest rate was found among third grade of primary schoolchildren. The results of a comparison of trematode infection and eating habits were interesting. In general, children did not consume raw fresh water fish (
Story et al., 1989); however, they were believed to have been infected by inadequately cooked fish.
Echinostoma species are important trematode parasites and require treatment; anti-helminthics were sent to the Watkor primary school after the stool examination.
The school is located along the Steung Sangkae River, which is connected to Tonle Sab Lake. Although many children swam in this river during the stool examination period, we failed to find Schistosoma eggs. Accordingly, in view of their swimming habits, this area is not considered to be a schistosomiasis endemic area.
The present study showed different patterns of intestinal parasite infection compared to the previous survey at Kampongcham (
Lee et al., 2002); this survey showed no cases of
Ascaris lumbricoides,
Trichuris trichiura or
Opisthorchis sp., while egg positive rates of
A. lumbricoides,
T. trichiura, and
Opisthorchis sp. in Kampongcham were 26.3%, 1%, and 10%, respectively. However, children in Bat Dambang were found infected with
E. polecki (1.1%) and
H. nana (1.3%), whereas no cases of
E. polecki or
H. nana were recorded in the Kampongcham survey in 2002 (
Lee et al., 2002). This study identified regional differences in intestinal parasitic infections between in Bat Dambang and in Kampongcham.
Periodic surveys on intestinal parasitic infections, the treatment of infected cases, and education with respect to eating habits and improved sanitation conditions are highly recommended for parasite control in Cambodia.
ACKNOWLEDGEMENTS
We thank the medical service team at Wonju Christian Hospital for collection of stool samples, and the Harvest Mission Center in Cambodia for its cooperation during the visit to the survey area.
References
- 1. Gyorkos TW, MacLean JD, Viens P, Chheang C, Kokoskin-Nelson E. Intestinal parasite infection in the Kampuchean refugee population 6 years after resettlement in Canada. J Infect Dis 1992;166:413-417.
- 2. Lee KJ, Bae YT, Kim DH, et al. Status of intestinal parasites infection among primary school children in Kampongcham, Cambodia. Korean J Parasitol 2002;40:153-155.
- 3. Lurio J, Verson H, Karp S. Intestinal parasites in Cambodians: comparison of diagnostic methods used in screening refugees with implications for treatment of populations with high rates of infestation. J Am Board Fam Pract 1991;4:71-78.
- 4. Meek SR. Epidemiology of malaria in displaced Khmers on the Thai-Kampuchean border. Southeast Asian J Trop Med Public Health 1988;19:243-252.
- 5. Nwanyanwu OC, Moore JS, Adams ED. Parasitic infections in Asian refugees in Fort Worth. Tex Med 1989;85:42-45.
- 6. Singhasivanon P. Mekong malaria. Malaria, multidrug resistance and economic development in the greater Mekong subregion of Southeast Asia. Southeast Asian J Trop Med Public Health 30 1999;30(Suppl 4):i-iv. 1-101.
- 7. Story M, Harris LJ. Food habits and dietary change of Southeast Asian refugee families living in the United States. J Am Diet Assoc 1989;89:800-803.
- 8. Urbani C, Sinoun M, Socheat D, et al. Epidemiology and control of mekongi schistosomiasis. Acta Trop 2002;82:157-168.
Table 1.Prevalences of intestinal parasite infections in Watkor kindergarten children and schoolchildren in Bat Dambang, Cambodia
Table 1.
|
Boy (%) |
Girl (%) |
Total (%) |
|
Echinostomatidae |
7(2.0) |
23(8.2) |
30(4.8) |
|
Hookworm |
13(3.8) |
8(2.9) |
21(3.4) |
|
Rhabditis sp. |
6(1.7) |
2(0.7) |
8(1.3) |
|
Hymenolepsis nana
|
4(1.2) |
4(1.4) |
8(1.3) |
|
Entamoeba coli
|
20(5.8) |
10(3.6) |
30(4.8) |
|
Entamoeba histolytica
|
4(1.2) |
1(0.4) |
5(0.8) |
|
Entamoeba polecki
|
3(0.9) |
4(1.4) |
7(1.1) |
|
Endolimax nana
|
23(6.7) |
17(6.1) |
40(6.4) |
|
Giardia lamblia
|
15(4.4) |
3(1.1) |
18(2.9) |
|
Iodamoeba butschlii
|
5(1.5) |
4(1.4) |
9(1.4) |
Table 2.Prevalences of intestinal parasite infection by school grade among Watkor kindergarten children and schoolchildren in Bat Dambang, Cambodia
Table 2.
|
Grade |
Kindergarden |
Primary school
|
Middle school
|
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
|
No. examined/positive (%) |
20/2 (10.0) |
52/14 (26.9) |
61/13 (21.3) |
89/34 (38.2) |
84/20 (23.8) |
82/16 (19.5) |
67/12 (17.9) |
94/24 (25.5) |
41/14 (34.1) |
33/9 (27.3) |
|
Echinostomatidae |
- |
1(1.9) |
4(6.5) |
6(6.7) |
3(3.6) |
5(6.1) |
3(4.5) |
1(1.1) |
4(9.8) |
3(9.1) |
|
Hookworm |
- |
2(3.8) |
2(3.3) |
5(5.6) |
4(4.8) |
2(2.4) |
- |
3(3.2) |
3(7.3) |
- |
|
Rhabditis sp. |
- |
2(3.8) |
- |
1(1.1) |
1(1.2) |
1(1.2) |
1(1.5) |
1(1.1) |
- |
1(3.0) |
|
Hymenolepsis nana
|
- |
1(1.9) |
- |
2(2.2) |
1(1.2) |
1(1.2) |
- |
2(2.1) |
1(2.4) |
- |
|
Entamoeba coli
|
- |
1(1.9) |
5(8.2) |
7(7.8) |
5(5.9) |
1(1.2) |
4(6.0) |
2(2.1) |
2(4.9) |
3(9.1) |
|
Entamoeba histolytica
|
- |
- |
- |
3(3.4) |
- |
- |
- |
1(1.1) |
- |
1(3.0) |
|
Entamoeba polecki
|
- |
1(1.9) |
1(1.6) |
2(2.2) |
1(1.2) |
1(1.2) |
1(1.5) |
- |
- |
- |
|
Endolimax nana
|
1(5.0) |
5(9.6) |
2(3.3) |
4(4.5) |
2(2.4) |
6(7.3) |
1(1.5) |
13(13.8) |
4(9.8) |
2(6.0) |
|
Giardia lamblia
|
1(5.0) |
3(5.8) |
2(3.3) |
2(2.2) |
3(3.6) |
1(1.2) |
4(6.0) |
1(1.1) |
1(2.4) |
- |
|
Iodamoeba butschlii
|
- |
- |
1(1.6) |
6(6.7) |
1(1.2) |
- |
- |
1(1.1) |
- |
- |
Citations
Citations to this article as recorded by
- Aspects of Genetic Diversity, Host Specificity and Public Health Significance of Single‐Celled Intestinal Parasites Commonly Observed in Humans and Mostly Referred to as ‘Non‐Pathogenic’
Christen Rune Stensvold
APMIS.2025;[Epub] CrossRef - Retrospective and Histopathological Studies of Entamoeba spp. and Other Pathogens Associated with Diarrhea and Wasting in Pigs in Aichi Prefecture, Japan
Tetsuya KOMATSU, Makoto MATSUBAYASHI, Naoko MURAKOSHI, Kazumi SASAI, Tomoyuki SHIBAHARA
Japan Agricultural Research Quarterly: JARQ.2019; 53(1): 59. CrossRef - Prevalence of Hookworm infection and Strongyloidiasis in Cats and Potential Risk Factor of Human Diseases
Blego Sedionoto, Witthaya Anamnart, Hadiyanto, Sudarno, Maryono
E3S Web of Conferences.2018; 31: 06002. CrossRef - Intestinal parasitic infections: Current prevalence and risk factors among schoolchildren in capital area of the Republic of Marshall Islands
Chien-Wei Liao, Ting-Wu Chuang, Ying-Chieh Huang, Chia-Mei Chou, Chia-Lien Chiang, Fei-Peng Lee, Yun-Ting Hsu, Jia-Wei Lin, Kennar Briand, Chia-Ying Tu, Chia-Kwung Fan
Acta Tropica.2017; 176: 242. CrossRef - Prevalence of Intestinal Protozoans among Schoolchildren in Suburban Areas near Yangon, Myanmar
Min-Jae Kim, Bong-Kwang Jung, Jaeeun Cho, Deok-Gyu Kim, Hyemi Song, Keon-Hoon Lee, Seon Cho, Thi Thi Htoon, Htay Htay Tin, Jong-Yil Chai
The Korean Journal of Parasitology.2016; 54(3): 345. CrossRef - Molecular Characterization of Cryptosporidium Species and Giardia duodenalis from Symptomatic Cambodian Children
Catrin E. Moore, Kristin Elwin, Nget Phot, Chanthou Seng, Saroeun Mao, Kuong Suy, Varun Kumar, Johanna Nader, Rachel Bousfield, Sanuki Perera, J. Wendi Bailey, Nicholas J. Beeching, Nicholas P. J. Day, Christopher M. Parry, Rachel M. Chalmers, James S McC
PLOS Neglected Tropical Diseases.2016; 10(7): e0004822. CrossRef - High prevalence of large trematode eggs in schoolchildren in Cambodia
Philipp J. Bless, Fabian Schär, Virak Khieu, Stefanie Kramme, Sinuon Muth, Hanspeter Marti, Peter Odermatt
Acta Tropica.2015; 141: 295. CrossRef - Potentially Zoonotic Helminthiases of Murid Rodents from the Indo-Chinese Peninsula: Impact of Habitat and the Risk of Human Infection
Kittipong Chaisiri, Praphaiphat Siribat, Alexis Ribas, Serge Morand
Vector-Borne and Zoonotic Diseases.2015; 15(1): 73. CrossRef - A survey for potentially zoonotic gastrointestinal parasites of dogs and pigs in Cambodia
Tawin Inpankaew, K. Darwin Murrell, Nongnuch Pinyopanuwat, Chamnan Chhoun, Kuong Khov, Tharin Sem, San Sorn, Sinuon Muth, Anders Dalsgaard
Acta Parasitologica.2015;[Epub] CrossRef - Intestinal Parasite Infections in Symptomatic Children Attending Hospital in Siem Reap, Cambodia
Catrin E. Moore, Phot Nget, Mao Saroeun, Suy Kuong, Seng Chanthou, Varun Kumar, Rachel Bousfield, Johanna Nader, J. Wendi Bailey, Nicholas J. Beeching, Nicholas P. Day, Christopher M. Parry, William A Paxton
PLOS ONE.2015; 10(5): e0123719. CrossRef - Ultrastructural characteristics and molecular identification of Entamoeba suis isolated from pigs with hemorrhagic colitis: implications for pathogenicity
Makoto Matsubayashi, Fumiko Suzuta, Yoshimi Terayama, Kengo Shimojo, Takeshi Yui, Makoto Haritani, Tomoyuki Shibahara
Parasitology Research.2014; 113(8): 3023. CrossRef - The prevalence and diversity of intestinal parasitic infections in humans and domestic animals in a rural Cambodian village
Fabian Schär, Tawin Inpankaew, Rebecca J. Traub, Virak Khieu, Anders Dalsgaard, Wissanuwat Chimnoi, Chamnan Chhoun, Daream Sok, Hanspeter Marti, Sinuon Muth, Peter Odermatt
Parasitology International.2014; 63(4): 597. CrossRef - Prevalence of Intestinal Parasitic Infections Among Rural Inhabitants of Hamadan City, Iran, 2012
Rasool Jafari, Mohammad Fallah, Hossein Yousofi Darani, Hosein Ali Yousefi, Mohammad Ali Mohaghegh, Milad Latifi, Mohammad Sadaghian, Amir Hossein Maghsood
Avicenna Journal of Clinical Microbiology and Infection.2014; 1(2): 21445. CrossRef - Hsp90 Inhibitors as New Leads To Target Parasitic Diarrheal Diseases
Anjan Debnath, Dea Shahinas, Clifford Bryant, Ken Hirata, Yukiko Miyamoto, Grace Hwang, Jiri Gut, Adam R. Renslo, Dylan R. Pillai, Lars Eckmann, Sharon L. Reed, James H. McKerrow
Antimicrobial Agents and Chemotherapy.2014; 58(7): 4138. CrossRef - Zoonoses in South-East Asia: a regional burden, a global threat
Marion Bordier, François Roger
Animal Health Research Reviews.2013; 14(1): 40. CrossRef - Prevalence of Intestinal Parasitic Infection in School Going Children in Amalapuram, Andhra Pradesh, India
Rangaiahagari Ashok, Giddi Suguneswari, Ksbvn Satish, Vedantham Kesavaram
Shiraz E-Medical Journal.2013;[Epub] CrossRef -
Drugs for treating giardiasis
Carlos E Granados, Ludovic Reveiz, Luis G Uribe, Claudia P Criollo
Cochrane Database of Systematic Reviews.2012;[Epub] CrossRef - Genetic Hemoglobin Disorders, Infection, and Deficiencies of Iron and Vitamin A Determine Anemia in Young Cambodian Children
Joby George, Miriam Yiannakis, Barbara Main, Robyn Devenish, Courtney Anderson, Ung Sam An, Sheila M. Williams, Rosalind S. Gibson
The Journal of Nutrition.2012; 142(4): 781. CrossRef - Molecular Identification ofTaeniaTapeworms byCox1Gene in Koh Kong, Cambodia
Hyeong-Kyu Jeon, Tai-Soon Yong, Woon-Mok Sohn, Jong-Yil Chai, Sung-Jong Hong, Eun-Taek Han, Hoo-Gn Jeong, Tep Chhakda, Muth Sinuon, Duong Socheat, Keeseon S. Eom
The Korean Journal of Parasitology.2011; 49(2): 195. CrossRef - Echinostoma revolutumInfection in Children, Pursat Province, Cambodia
Woon-Mok Sohn, Jong-Yil Chai, Tai-Soon Yong, Keeseon S. Eom, Cheong-Ha Yoon, Muth Sinuon, Duong Socheat, Soon-Hyung Lee
Emerging Infectious Diseases.2011; 17(1): 117. CrossRef - Epidemiology and control of human gastrointestinal parasites in children
Michael O Harhay, John Horton, Piero L Olliaro
Expert Review of Anti-infective Therapy.2010; 8(2): 219. CrossRef - Childhood Nephrotic Syndrome in Cambodia: An Association with Gastrointestinal Parasites
Lawrence Copelovitch, Orng Sam Ol, Sarah Taraquinio, Ngoun Chanpheaktra
The Journal of Pediatrics.2010; 156(1): 76. CrossRef - Prevalence of counterfeit anthelminthic medicines: a cross-sectional survey in Cambodia
Mohiuddin Hussain Khan, Junko Okumura, Tey Sovannarith, Nam Nivanna, Manabu Akazawa, Kazuko Kimura
Tropical Medicine & International Health.2010;[Epub] CrossRef - Reassessment of the epidemiology of amebiasis: State of the art
Cecilia Ximénez, Patricia Morán, Liliana Rojas, Alicia Valadez, Alejandro Gómez
Infection, Genetics and Evolution.2009; 9(6): 1023. CrossRef - Molecular epidemiology of amebiasis
Ibne Karim M. Ali, C. Graham Clark, William A. Petri
Infection, Genetics and Evolution.2008; 8(5): 698. CrossRef - The prevalence of intestinal parasites in the province of Izmir, Turkey
Hande Dagci, Özgür Kurt, Mete Demirel, Ipek Östan, Naser Reza Azizi, Aliye Mandiracioglu, Cengiz Yurdagül, Mehmet Tanyüksel, Ece Eroglu, Mucide Ak
Parasitology Research.2008; 103(4): 839. CrossRef - Prevalence of Giardia lamblia with or without diarrhea in South East, South East Asia and the Far East
Hassan H. Dib, Si Qi Lu, Shao Fang Wen
Parasitology Research.2008; 103(2): 239. CrossRef - Parasitic infestation and nutritional status among schoolchildren in Vientiane, Lao PDR
Outavong Phathammavong, Ali Moazzam, Duangphachan Xaysomphoo, Alongkone Phengsavanh, Chushi Kuroiwa
Journal of Paediatrics and Child Health.2007; 43(10): 689. CrossRef
