Geospatial Analysis of Hymenolepis (Rodentolepis) nana Infection Transmission in Schools among Children in Cusco, Peru

Melinda B. Tanabe Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, Galveston, Texas;

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Maria Caravedo Martinez Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, Galveston, Texas;

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Maria L. Morales UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru;

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Martha Lopez UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru;

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Miguel M. Cabada Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, Galveston, Texas;
UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru;
Sede Cusco—Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru

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Hymenolepis nana is an emergent parasitosis, and the role of schools in infection transmission is unclear. Data from a cross-sectional study evaluating children for H. nana infection in schools in three districts of Anta province in Peru were analyzed. Geospatial information from the children’s residence and school was obtained. A total of 2,961 children were included from 51 different schools. The median age was 9.6 years old (interquartile range [IQR]: 6.8–12.4), 1,479 (50%) were female, and the median H. nana prevalence per school was 15% (IQR: 3.61–24.20). Regression analysis demonstrated that those living in Ancahuasi and Zurite and those with higher poverty score and higher residence altitude were more likely to reside on a hot spot than a cold spot based on residence distribution, whereas being of school age was protective. Children living in low-risk areas (nonhot spots) who were attending schools with higher prevalence of H. nana (≥15%) were less likely to reside in Ancahuasi or Zurite than in Anta, had lower paternal education, and were older than 6 years of age. Our study shows that schools have a role in infection transmission among children in the highlands of Peru.

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Author Notes

Financial support: This work was supported by the National Institute for Allergy and Infectious Diseases at the National Institutes of Health (Grant no. 1R01AI104820). 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.

Disclosures: The authors do not have any relevant disclosures. Part of the work was presented at the Conference of the American Society of Tropical Medicine and Hygiene meeting in 2023 in Chicago, IL.

Current contact information: Melinda B. Tanabe and Maria Caravedo Martinez, Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, Galveston, TX, E-mails: mbtanabe@utmb.edu and alejandra.caravedo@gmail.com. Maria L. Morales and Martha Lopez, UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru, E-mails: maria.morales.f@upch.pe and martlop2000@gmail.com. Miguel M. Cabada, Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, Galveston, TX, UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru, and Sede Cusco—Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru, E-mail: micabada@utmb.edu.

Address correspondence to Miguel M. Cabada, University of Texas Medical Branch, 301 University Blvd., Rt. 0436, Galveston, TX 77555. E-mail: micabada@utmb.edu
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