Risk factors for Fasciola hepatica infection in children: a case–control study

Abstract

We conducted a case-control study to clarify the risk factors for human fascioliasis in the Northern Peruvian Altiplano. Cases (n=61) were individuals who were diagnosed as having chronic fascioliasis by faecal and/or serologic (Fas2-ELISA) studies. Controls (n=61) had negative serologic and coprological results for Fasciola hepatica. We identified an association between fascioliasis and four variables (40 analysed): the habit of drinking alfalfa juice (OR=4.5; 95% CI 1.8-11.1; P<0.001); familiarity with aquatic plants (OR=4.3; 95% CI 1.8-10.6; P<0.001); dog ownership (OR=5; 95% CI 1.7-15.1; P=0.002); and raising more than five sheep (OR=0.3; 95% CI 0.1-0.8; P=0.01). According to clinical presentation and laboratory studies, dizzy spells (P=0.01), history of jaundice (P=0.01), peripheral eosinophilia (P=0.005) and Ascaris lumbricoides in stools (P=0.001) were associated with fascioliasis. The principal exposure factor for F. hepatica infection was drinking alfalfa juice. In conclusion, we suggest that human fascioliasis in Peru should be suspected in patients from livestock-rearing areas, who present with recurrent episodes of jaundice and who have a history of consumption of alfalfa juice or aquatic plants, or who have eosinophilia.

Preliminary antigenic characterisation of an adult worm vomit preparation of Fasciola hepatica by infected human sera

“…It seems that the number of reported human cases is underestimated in many countries, especially where animal fascioliasis is prevalent. The acute disease may mimic a wide spectrum of hepatic and biliary pathology so that the diagnosis may be delayed 17 . As a result of the natural history of the disease, it can become self-limited and, after a few weeks, the patient evolves into an almost asymptomatic stage, clouding the final diagnosis.…”

Fascioliasis and Eosinophilia in the Highlands of Cuzco, Peru and Their Association with Water and Socioeconomic Factors

“…24,25 Testing of one stool specimen probably limited our ability to detect low-intensity infections. Furthermore, Marcos and others 13 described a strong association between eosinophil counts and Fasciola infection in highly endemic areas. Unfortunately, we were unable to perform serologic tests to confirm this finding.…”

“…11,12 A risk factor for Fasciola transmission recognized in a casecontrol study in children from the Peruvian Altiplano is the consumption of raw vegetables (alfalfa juice). 13 Indirect epidemiological information suggests that transmission of Fasciola may be related to water. 14 The objective of this study was to evaluate the epidemiology of Fasciola infection among children in the highlands of Cuzco considering demographic, socioeconomic, and exposure factors as markers of possible transmission routes.…”

Efficacy and tolerability of two single-day regimens of triclabendazole for fascioliasis in Peruvian children

“…. Participants were recruited from a fi eld validation study using a serological test against F. hepatica (37) and a series of coprological-based, longitudinal epidemiological studies (10) (38) .…”