Abstract
Background: Children with chronic liver diseases (CLDs), like immunocompromised
individuals, are susceptible to infection with opportunistic parasites.
Objectives: To identify the frequency of intestinal parasitic infection among children
with CLDs in Assiut Governorate, Egypt, and to correlate this infection with blood
eosinophil count and patients' anthropometric measurements.
Patients and Methods: The present hospital-based case-control study was conducted
on 200 children with CLDs of different etiologies (Cases) and age- and gendermatching 200 children complaining of gastrointestinal symptoms without CLDs as
control patients. All children were investigated for liver function, complete blood count
(CBC) (including differential and absolute eosinophil count), and stool examination.
Infection was correlated to eosinophil count, and participant's weight and height.
Results: Among children with CLDs, the intestinal protozoa identified in order of
frequency were; Giardia lamblia (16.5%), Entamoeba histolytica/dispar (13.5%),
Blastocystis spp. (12%), Cryptosporidium spp. (8%), and microsporidial spores (3%).
Intestinal helminthes identified in order of frequency were; Hymenolepis nana (8%),
Enterobius vermicularis (6%), Ancylostoma doudenale (5%), Ascaris lumbricoides
(3%), Taenia saginata (1.5%), and Schistosoma mansoni (0.5%). As compared to
control patients, incidence of intestinal protozoa in CLDs children was significantly
higher (P <0.001), but there was insignificant difference regarding the incidence of
intestinal helminthes (P = 0.107). The level of blood eosinophils in control patients was
significantly higher than that in CLDs children (P = 0.001). While weight and height of
children were apparently affected by parasitic infections, there was no significant
correlation between intestinal parasitic infection and liver function tests. The prevalence
of parasitic infections in children from rural areas was significantly higher than in those
from urban areas in both groups (P <0.001).
Conclusion: We reported a significant increase in the incidence of intestinal parasites
with a lower eosinophilic immune response in cases with CLDs compared to controls.
However, infection did not correlate with level of liver enzymes. Infection seemed to
negatively affect the weight and height of the studied children