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Fasciola hepatica Infection Risk for Adult Household Members Living with Children with Fascioliasis in Cusco, Peru

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  • 1 Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas;
  • 2 Department of Pediatrics, Hospital Nacional Adolfo Guevara Velasco ESSALUD, Cusco, Peru;
  • 3 Cusco Branch, Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru;
  • 4 School of Medicine, University of Texas Medical Branch, Galveston, Texas

Abstract.

Fasciola hepatica is highly prevalent in the highlands of Peru. School-age children have the greatest risk of infection. Mass treatment of at-risk populations has been proposed to control the infection and prevent complications. However, the decreasing effectiveness of triclabendazole raises concerns regarding this strategy. Previous studies reported aggregation of Fasciola infection among family members. This study aimed to determine the risk of fascioliasis among household members living with Fasciola-infected children identified through school-based testing. We conducted a cross-sectional study including adult members of households where children with and without fascioliasis were identified. Demographic, epidemiological, and socioeconomic information was collected. One blood sample was drawn to test for Fasciola antibodies, and three stool samples were collected for microscopy for Fasciola ova. We tested 326 adults from 213 households. Of these adult subjects, chronic fascioliasis (24 of 326, 7.4%) was the most common helminth infection. Thirty-nine subjects (12.7%) tested positive for Fasciola antibodies. Combining microscopy and serum antibody tests, 13.2% (43 of 326) had evidence of Fasciola infection. One third (104 of 326, 31.9%) of the participants lived with at least one child infected with Fasciola hepatica. Adults with fascioliasis were four times more likely to live with an infected child. Poverty and diet were associated with increased risk of Fasciola infection. Adults with fascioliasis were significantly more likely to live with Fasciola-infected children.

Author Notes

Address correspondence to Miguel M. Cabada, 301 University Blvd. RT 0435, Galveston, TX 77555. E-mail: micabada@utmb.edu

Disclaimer: The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute for Allergy and Infectious Diseases

Financial support: This study was supported by the NIH National Institute for Allergy and Infectious Diseases (grant no. 1R01AI104820-01).

Authors’ addresses: Maria A. Caravedo and Melinda B. Tanabe, Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, E-mails: macarave@utmb.edu and mbtanabe@utmb.edu. Walter Ramirez, Department of Pediatrics, Hospital Nacional Adolfo Guevara Velasco ESSALUD, Cusco, Peru, E-mail: ramirezwalter77@yahoo.com. Maria L. Morales and Martha Lopez, Cusco Branch, Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru, E-mails: maria.morales.f@upch.pe and martlop2000@gmail.com. Claire E. Janes, Brittany A. Bunag, and Katie L. Mixon, School of Medicine, University of Texas Medical Branch, Galveston, TX, E-mails: cejanes@utmb.edu, babunag@utmb.edu, and klmixon@utmb.edu. A. Clinton White Jr. and Miguel M. Cabada, Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, and Cusco Branch, Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru, E-mails: acwhite@utmb.edu and micabada@utmb.edu.

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