Socioeconomic Factors Associated with Fasciola hepatica Infection Among Children from 26 Communities of the Cusco Region of Peru

Miguel M. Cabada Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas;
Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco Branch, Peru;

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Maria Luisa Morales Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco Branch, Peru;

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Camille M. Webb Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas;

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Logan Yang School of Medicine, University of Texas Medical Branch, Galveston, Texas;

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Chelsey A. Bravenec School of Medicine, University of Texas Medical Branch, Galveston, Texas;

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Martha Lopez Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco Branch, Peru;

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Ruben Bascope Zoonosis Unit, Direccion Regional de Salud del Cusco, Ministerio de Salud, Cusco, Peru

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A. Clinton White Jr. Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas;

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Eduardo Gotuzzo Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco Branch, Peru;

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Fasciola hepatica is the most widely distributed trematode-affecting humans. The Andes Mountains are highly endemic for fascioliasis. We report results of a cross-sectional study evaluating the epidemiology of Fasciola among children in 26 agricultural communities in the Cusco region of Peru. Children 3 to 16 years old were enrolled in preschools and schools. Blood from participants was tested for complete blood counts, transaminases, and Fasciola antibodies. Stool samples were tested for Fasciola and other parasites. A total of 2,515 children were included in the analysis and the mean age was 9.6 years (±3.6). Ten percent (253) of the children had at least one positive test for Fasciola, 6% had chronic infection, and 0.4% acute infection. The rest of the subjects had only antibodies against Fasciola. The prevalence of infection varied from 0% to 20% between communities. Children with evidence of Fasciola exposure were older, lived at higher altitudes, and had a lower socioeconomic status than children without infection. The logistic regression analysis showed that children from Ancahuasi district, older children, and children with higher measures of poverty were more likely to have Fasciola exposure. Fascioliasis is common in the Cusco region and associated with poverty. However, the distribution varies markedly between communities.

Author Notes

Address correspondence to Miguel M. Cabada, Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, 301 University Bvd., Route 0435, Galveston, TX 77555. E-mail: micabada@utmb.edu

Financial support: This work was supported by the National Institute for Allergy and Infectious Diseases at the National Institutes of Health (grant number 1R01AI104820–01).

Authors’ addresses: Miguel M. Cabada, Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, and Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco Branch, Peru, E-mail: micabada@utmb.edu. Maria Luisa Morales, Martha Lopez, and Eduardo Gotuzzo, Department of Medicine, Alexander von Humboldt Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru, E-mails: malu.morales.fernadez@gmail.com, martlop2000@gmail.com, and eduardo.gotuzzo@upch.pe. Camille M. Webb and A. Clinton White, Jr., Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, E-mails: cmwebbca@utmb.edu and acwhite@utmb.edu. Logan Yang and Chelsey A. Bravenec, School of Medicine, University of Texas Medical Branch, Galveston, TX, E-mails: lryang@utmb.edu and cabraven@utmb.edu. Ruben Bascope, Programa de Control de Enfermedades Zoonoticas, Direccion Regional de Salud Cusco, Cusco, Peru, E-mail: bascopeq@gmail.com.

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