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EPIDEMIOLOGY AND CONTROL OF INTESTINAL PARASITES WITH NITAZOXANIDE IN CHILDREN IN MEXICO

The purpose of this study was to evaluate the efficacy and the tolerance of nitazoxanide in children as a single broad-spectrum antiparasitic agent in the treatment of mixed parasite infections with both intestinal protozoa and helminths. Two hundred seventy-two children (age range = 2–14 years) participated in this study. We systematically surveyed every household head using questionnaires designed to obtain information about household socioeconomic status and hygiene. Parasitic infections were confirmed by three stool examinations using direct smear, Ferreira concentration, and cold acid-fast Kinyoun staining methods. One hundred twenty-one (44%) children tested positive for protozoa such as Giardia lamblia (18%), Entamoeba histolytica/E. dispar (10%), Blastocystis hominis (7%), Cryptosporidium parvum (4%), and Cyclospora cayetanensis (3%), and helminths such as Hymenolepis nana (10%), Trichuris trichiura (6%), and Ascaris lumbricoides (6%). There were also two cases of infection with Enterobius vermicularis. After a complete physical examination was performed, 121 patients received treatment with nitazoxanide. Overall, 84% of the protozoa and 95% of the helminths were completely eliminated from the patients. Nitazoxanide was very well tolerated, with no serious adverse effects reported.

Received March 15, 2002. Accepted for publication November 18, 2002.

Acknowledgments: We thank R. Miranda and A. Romero for critical review of the manuscript; Laboratorios Columbia S.A. de C.V., México, for providing the nitazoxanide; T. Aguirre for invaluable assistance in the field; and A. Gámez, the late G. Hernández, and A. Morales for their outstanding technical assistance.

Authors’ addresses: Elvia Díaz, Unidad de Medicina Familiar 91, Instituto Mexicano del Seguro Social, Av. López Portillo s/n, Coacalco de Berriozabal, CP 55700 Estado de México, México. Jaime Mondragón, Departamento de Ciencias Químicas, Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México, Campo 1, Av. 1° de Mayo s/n, Cuautitlán Izcalli, CP 54740 Estado de México, México. Enrique Ramírez and Rosamaria Bernal, Laboratorio de Parasitología y Micología, Hospital Infantil de México Federico Gómez, Secretaría de Salubridad y Asistencia, Dr. Márquez 162, Col. Doctores CP 06720 México, DF, México.

Reprint requests: Rosamaría Bernal, Laboratorio de Parasitología y Micología, Hospital Infantil de México Federico Gómez, Secretaría de Salubridad y Asistencia, Dr. Márquez 162, Col. Doctores CP 06720 México, DF México. E-mail: rbernal{at}bolivar.usb.mx

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