Background: Chronic kidney disease (CKD) in children is associated with reduced immune responses that predispose them to frequent parasitic infections.
Objective: This present work aimed to determine the prevalence rates of intestinal parasitic infections in children with CKD.
Subjects and methods:
This case-control study was carried out on 136 cases aged 2-18 years, divided into three groups; CKD on hemodialysis, CKD on conservative treatment, and healthy control. This work was carried out from March 2018 to April 2019. Three fecal samples were obtained from each case and samples were subjected to direct wet mount and iodine stained smear, formol ether sedimentation concentration technique, modified Ziehl-Neelsen stain, and stool culture on an agar plate for nematode larvae. Blood samples were examined for anemia and kidney function tests.
Results:
The prevalence rate of parasitic infections was 53% for the hemodialysis group, 51% for CKD on conservative treatment group, and 36% for the control group. The infecting parasites were as follows, Cryptosporidium (13.2%), G. lamblia (2.9%), E. histolytica (5.1%), Entameba coli (5.1%), Blastocystis (9.6%), Cyclospora cayetanensis (1.5%), Strongyloides stercoralis (1.5%), Ascaris lumbercoides (2.2%) and H. nana (3.7%). Mixed infections were reported in 2.9% of the studied groups. 42% of the hemodialysis cases were anemic as well as 63% of the other CKD cases and 23% of the control group. In the infected group, 57% were anemic as well as 28% in the non-infected group.
Conclusion:
The elevated prevalence rate of parasitic infections among the CKD cases was related to their reduced immune responses.