Letters to the Editor

Indian Pediatrics 1999; 36:521-522

Hemoglobin Levels and Concomitant Intestinal Parasitoses Among Children in and Around Patna

We evaluated the magnitude of intestinal parasites and hemoglobin concentrations among children (upto 12 years of age) of different income groups. Freshly passed stools and finger prick blood were collected from 668 children (337 boys and 331 girls), attending the outpatient Department of our hospital for gastrointestinal and anemia related symptoms during March 1997 to May 1998. Presenting complaints included weakness, pallor, sudden or recurrent pain abdomen, diarrhea, dysentry, fullness of abdomen, loss of or voracious appetite, respiratory infections, grinding of teeth at night and hypopigmented patches.

Within 8 hours of collection, direct fecal examination was done on fresh specimen for ova of helminths and saline iodine staining for detection of protozoa. Parasites were detected, in 485 (72.6%) stool samples. The most prevalent parasites were A. lumbricoides in 107 (22.1 %) followed by E. histolytica in 85 (17.7%), E. vermicularis in 47 (9.7%), hookworm in 36 (7.4%), G. lambia in 73 (15.3%), T. solium in 3 (0.6%), H. nana in 6 (1.3%) and mixed infestations in 126 (25.9%). One hundred and eighty three (27.4%) stool specimens did not reveal any parasites. The prevalence of intestinal parasites in the current series is comparable to earlier reports(2,3), but higher than another series(4). Interestingly, in this series 27% of children who harbored intestinal parasites were from higher income group families.

The overall mean (± SD) hemoglobin concentration (measured by Sahlis hemoglobinometer) in the children was 10.9±1.2 g/dl (n = 668). Children infested with intestinal parasites had a significantly lower hemoglobin concentration (p = 0.005); Hemoglobin Concentration was particularly low with associated hookworm and T. trichiura infections.

As part of protective measures for children against intestinal parasitic infection, improvement in environmental sanitation including provision of septic lavatory for communities is important as is awareness for personal hygiene through sustained health education. Regular health check-ups and periodic screening for parasites and deworming will go a long way in improving the nutritional status and hemoglobin concentration of the children of poor communities.
 

Umesh Kumar,
Sheela Sinha,
Raja Ram Pd. Singh,
S.P. Srivastava,
Department of Pediatrics,
Patna Medical College
and Hospital, Bihar 800 004, India.