782. Intestinal Parasites in Internationally Adopted Children: Risk Factors and Clinical Predictors
Session: Oral Abstract Session: Travel/Tropical Medicine and Parasitology
Friday, October 21, 2011: 3:30 PM
Room: 204AB
Background: Internationally adopted children are known to be at risk for a number of infectious diseases, especially intestinal parasites. Despite changing trends in international adoption, few studies have explored intestinal parasites in this population in the 21st century. Our objectives were to determine the prevalence of intestinal parasites in recent international adoptees and identify risk factors associated with their acquisition and clinical predictors of their presence.

Methods: Retrospective review of children seen in the Nationwide Children’s Hospital International Adoption Clinic January 1, 2005, through December 31, 2009. Demographic, clinical, and laboratory data were compared between children with and without intestinal parasites.

Results: Of 506 children from 19 countries evaluated during the study period, 484 (96%) had at least one stool sample examined for parasites (ova & parasites or Giardia lamblia & Cryptosporidium antigen detection). At least one parasite was detected in 165 (34%) children, with multiple parasites in 80 (17%). Parasites detected included G. lamblia in 110 (23%) children, Blastocystis hominis in 74 (15%), Hymenolepsis nana in 6 (1%), Trichuria trichuris in 4 (1%), and Dientamoeba fragilis in 4 (1%). Risk factors for acquisition of parasites included adoption from Africa (OR: 11; 95% CI 5.4-24; p<0.01) or Eastern Europe (OR: 3.3; 95% CI: 2.2-5.1; p<0.01) and pre-adoption placement in an orphanage (OR: 6.9; 95% CI: 3.6-13; p<0.01). Children with parasites more often had gastrointestinal symptoms (24 vs 14%; p=0.04) and had lower height-for-age z-scores (-1.2 vs -0.7; p=0.02) than those without parasites. There were no significant differences between the two groups in albumin, absolute eosinophil count, and weight-for-age or weight-for-height z-scores.

Conclusion: The prevalence of intestinal parasites in this study was higher than in previous studies. Although there were statistically significant differences in height and symptoms between those with and without parasites, these were too subtle to have clinical relevance, and there were no differences in other growth parameters or laboratory data. These findings reinforce current recommendations for routine screening of all international adoptees.


Subject Category: T. Travel/tropical medicine and parasitology

Rebecca Wallihan, MD, Department of Pediatrics, Section of Infectious Diseases, Nationwide Children's Hospital (NCH) and The Ohio State University College of Medicine, Columbus, OH, Colby Day, MD, The Ohio State University College of Medicine, Columbus, OH, Rose Knieper, Nationwide Children's Hospital, Columbus, OH and Katalin Koranyi, MD, Department of Pediatrics, Section of Infectious Diseases, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH

Disclosures:

R. Wallihan, None

C. Day, None

R. Knieper, None

K. Koranyi, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.