Hospitalization of Cuban children for giardiasis: a retrospective study in a paediatric hospital in Havana

Abstract

The medical records of the 185 children who, in 2007, were admitted to the Academic Paediatric Hospital 'Centro Habana', in the Cuban capital of Havana, because of giardiasis were analysed retrospectively. A standardized form was used to collect data on the socio-demographic characteristics, clinical features, laboratory diagnosis, treatment and length of stay of each child. Information on the 15 children who had incomplete medical records was excluded from the data analysis. Of the remaining 170 children, 85 (50.0%) were aged 1-4 years, 97 (57.1%) were male, and 106 (62.4%), 92 (54.1%) and 69 (40.6%) had presented with diarrhoea, vomiting, and/or abdominal pain, respectively. Most (91.2%) of the cases had been diagnosed by the microscopical examination of a duodenal aspirate, and the drugs that had been most used frequently were quinacrine and tinidazole, which had been given to 72 (42.4%) and 62 (36.5%) of the cases, respectively. The mean length of hospital stay was 4.9 days. Such information on the clinical characteristics of giardiasis among children living in an endemic area may be valuable to paediatricians and public-health officials who wish to screen for the disease.

Risk factors forGiardiainfection among hospitalized children in Cuba

“…Infection seemed to occur equally commonly among the girls and boys investigated in the present study. Although similar observations have been made in Brazil (Pereira et al, 2007) and Cuban day-care centres (Nú ñ ez et al, 1999), boys appeared at higher risk of Giardia infection than girls in investigations in the U.S.A. (Yoder and Beach, 2007), Germany (Espelage et al, 2010) and in a recent study in another hospital in Havana (Escobedo et al, 2011).…”

“…Elsewhere in Cuba, Giardia positivity has generally been found to decrease with age, peaking in children aged 2-3 years and decreasing thereafter (Nú ñ ez et al, 1999). In most endemic settings, where children acquire primary infections with Giardia early in their lives and subsequently improve their personal hygiene, the prevalence of Giardia infection might be expected to fall from infanthood (Escobedo et al, 2011). Infection does not necessarily translate into symptomatic disease, however, and the probability that a Giardia infection becomes symptomatic may also be age-related.…”

A report on a case of Giardia duodenalis

“…5 The parasites colonizes the upper part of the small intestine resulting in giardiasis. 6 Studies had shown that Giardia infection in children usually present as chronic diarrhea, weight loss and malabsorption.…”

Care-seeking behaviour and diagnostic processes for symptomatic giardiasis in children attending an academic paediatric hospital

“…When the awareness of Giardia infection among caregivers in Havana, 33,34 its increased prevalence among children, [3][4][5][6][7][8][9] and its occurrence within the community, 2 which may also be a cause of hospitalization, 35,36 are considered, it is not surprising to find that children of mothers who knew other people with Giardia were diagnosed earlier. However, it seems that despite efforts at informing the public about intestinal parasites in Cuba, more information is necessary for addressing the giardiasis.…”

“…1 In Cuba, in the last national survey carried out in 2009, the overall prevalence of Giardia in human population was estimated to be 6.02%; 2 however, higher prevalences have been recorded among young children attending day-care centres 3,4 and primary schools, 5,6 and, according to hospital-based studies, it seems to be that clinical giardiasis is a common reason for hospitalization in paediatric hospitals. [7][8][9] As in other diseases, the diagnosis of giardiasis critically depends on the community's perception of the disease, care-seeking behaviour of individuals, socio-economic factor, and the suspicion index of the health care providers. 10,11 Care-seeking behaviour and diagnostic processes have been studied for several bacterial and parasitic infections, such as sexually transmitted diseases, malaria, and childhood diarrhoea.…”