title: Intestinal parasite infections in symptomatic children attending hospital in Siem Reap, Cambodia.
abstract: BACKGROUND
  Infections with helminths and other intestinal parasites are an important but neglected problem in children in developing countries. Accurate surveys of intestinal parasites in children inform empirical treatment regimens and can assess the impact of school based drug treatment programmes. There is limited information on this topic in Cambodia.
  
  
  METHODS
  In a prospective study of intestinal parasites in symptomatic children attending Angkor Hospital for Children, Siem Reap, Cambodia, April-June 2012, samples were examined by microscopy of a direct and concentrated fecal sample. Two culture methods for hookworm and Strongyloides stercoralis were employed when sufficient sample was received. Demographic, clinical and epidemiological data were collected.
  
  
  RESULTS
  We studied 970 samples from 865 children. The median (inter-quartile range) age of the children was 5.4 (1.9-9.2) years, 54% were male. The proportion of children with abdominal pain was 66.8%, diarrhea 34.9%, anemia 12.7% and malnutrition 7.4%. 458 parasitic infections were detected in 340 (39.3%) children. The most common parasites using all methods of detection were hookworm (14.3%), Strongyloides stercoralis (11.6%) and Giardia lamblia (11.2%). Giardia lamblia was most common in children aged 1-5 years, hookworm and Strongyloides stercoralis were more common with increasing age. Hookworm, Strongloides stercoralis and Giardia lamblia were more common in children living outside of Siem Reap town. In a multivariate logistic regression increasing age was associated with all three infections, defecating in the forest for hookworm infection, the presence of cattle for S. stercoralis and not using soap for handwashing for G. lamblia.
  
  
  CONCLUSIONS
  This study confirms the importance of intestinal parasitic infections in symptomatic Cambodian children and the need for adequate facilities for laboratory diagnosis together with education to improve personal hygiene and sanitation.
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ.
authors.forename: Catrin E
authors.initials: CE
authors.lastname: Moore
authors.affiliation: Angkor Hospital for Children, Tep Vong (Achamean) Road & Oum Chhay Street, Svay Dangkum, Siem Reap, Kingdom of Cambodia.
authors.forename: Phot
authors.initials: P
authors.lastname: Nget
authors.affiliation: Angkor Hospital for Children, Tep Vong (Achamean) Road & Oum Chhay Street, Svay Dangkum, Siem Reap, Kingdom of Cambodia.
authors.forename: Mao
authors.initials: M
authors.lastname: Saroeun
authors.affiliation: Angkor Hospital for Children, Tep Vong (Achamean) Road & Oum Chhay Street, Svay Dangkum, Siem Reap, Kingdom of Cambodia.
authors.forename: Suy
authors.initials: S
authors.lastname: Kuong
authors.affiliation: Angkor Hospital for Children, Tep Vong (Achamean) Road & Oum Chhay Street, Svay Dangkum, Siem Reap, Kingdom of Cambodia.
authors.forename: Seng
authors.initials: S
authors.lastname: Chanthou
authors.affiliation: Angkor Hospital for Children, Tep Vong (Achamean) Road & Oum Chhay Street, Svay Dangkum, Siem Reap, Kingdom of Cambodia.
authors.forename: Varun
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ; Department of Clinical Medicine, Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ.
authors.forename: Rachel
authors.initials: R
authors.lastname: Bousfield
authors.affiliation: Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA.
authors.forename: Johanna
authors.initials: J
authors.lastname: Nader
authors.affiliation: Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA.
authors.forename: J Wendi
authors.initials: JW
authors.lastname: Bailey
authors.affiliation: Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Beeching
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ.
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Day
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine Research Building, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Parry
mesh_terms: D000723:Ancylostomatoidea / Q000302:isolation & purification*; D000818:Animals; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D016829:Giardia lamblia / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D017171:Strongyloides stercoralis / Q000302:isolation & purification*