Prevalence, Age Profile, and Associated Risk Factors for Hymenolepis nana Infection in a Large Population-Based Study in Northern Peru

Percy M. Vilchez Barreto Centro de Salud Global Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú;

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Ricardo Gamboa Centro de Salud Global Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú;

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Saul Santivañez Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú;

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Seth E. O’Neal Centro de Salud Global Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú;
School of Public Health, Oregon Health and Science University and Portland State University, Portland, Oregon;

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Claudio Muro Centro de Salud Global Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú;

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Andrés G. Lescano Emerge, Emerging Infections and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Perú;

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Luz-Maria Moyano Centro de Salud Global Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú;
Epidemiology Unit, Hospital Regional, Tumbes, Peru;

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Guillermo Gonzálvez Enfermedades Transmisibles y Análisis de Salud, Organización Panamericana de la Salud OPS/OMS;

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Hector H. García Centro de Salud Global Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú;
Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru

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for the Cysticercosis Working Group in Perú (CWGP)
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Hymenolepis nana, the dwarf tapeworm, is a common intestinal infection of children worldwide. We evaluated infection and risk factor data that were previously collected from 14,761 children aged 2–15 years during a large-scale program in northern Peru. We found that 1,124 of 14,761 children (7.61%) had H. nana infection, a likely underestimate given that only a single stool sample was examined by microscopy for diagnosis. The strongest association with infection was lack of adequate water (adjusted prevalence ratio [aPR] 2.22, 95% confidence interval [CI] 1.82–2.48) and sanitation infrastructure in the house (aPR 1.94, 95% CI 1.64–2.29). One quarter of those tested did not have a bathroom or latrine at home, which doubled their likelihood of infection. Similarly, one quarter did not have piped public water to the house, which also increased the likelihood of infection. Continued efforts to improve access to basic water and sanitation services will likely reduce the burden of infection in children for this and other intestinal infections.

Author Notes

Address correspondence to Percy M. Vilchez Barreto, Centro de Salud Global Universidad Peruana Cayetano Heredia, Panamericana Norte Km 1275, Tumbes, Perú. E-mails: pvilchez@peruresearch.org or percy.vilchez.b@upch.edu.pe

Financial support: This study was partially funded by research grant number 23981 from the Bill & Melinda Gates Foundation (23981) fund ongoing cysticercosis research by the authors. Lescano is sponsored by the training grant D43 TW007393 awarded by the Fogarty International Center of the U.S. National Institutes of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Authors’ addresses: Percy M. Vilchez Barreto, Ricardo Gamboa, and Claudio Muro, Centro de Salud Global Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú, E-mails: pvilchez@peruresearch.org, rgamboa@peruresearch.org, and claudio.muro@peruresearch.org. Saul Santivañez, Instituto Peruano de parasitologia clinica y experimental, Lima, Perú, E-mail: ssantiv2@jhu.edu. Seth E. O’Neal, School of Public Health, Oregon Health and Science University, and Portland State University, Portland, OR, and Centro de Salud Global Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú, E-mail: oneals@ohsu.edu. Andrés G. Lescano, School of Public Health and Management, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mail: andres.lescano.g@upch.pe. Luz-Maria Moyano, Centro de Salud Global Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú, and Unit of Epidemiology and Environmental, Health Regional Hospital, Tumbes, Perú, E-mail: luzmariamoyano@gmail.com. Guillermo Gonzálvez, Organización Panamericana de la Salud OPS/OMS, Enfermedades Transmisibles y Análisis de Salud, Managua, Nicaragua, E-mail: gonzalvezg@paho.org. Hector H. García, Centro de Salud Global Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú, and Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mail: hgarcia1@jhu.edu.

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