Intestinal Parasites in Children with Lymphohematopoietic Malignancy in Iran, Mashhad

Background: Intestinal parasitic disease can cause serious complications for Immunosuppressed patients. Objectives: This study determines the prevalence of intestinal parasites in children, with lymphohematopoietic malignancy in Mashhad, Iran. Patients and Methods: In this cross-sectional study stool samples were collected from 89 children (53 boys, 36 girls) with lymphohematopoitic malignancies under chemotherapy, between the age of 1 and 18 years (mean age 7.5 years). Three fresh stool samples taken for three consecutive days were examined by direct smear, formalin-ether method, trichrome staining and ELISA test for Giardia lamblia coproantigens. Results: In this study 35.9% of our patients had parasitic infections and the following parasites were identified; G. lamblia (the most prevalent parasite in children) 16 (18%), Entamoeba coli 6 (6.7%) Blastocystis hominis 5 (5.6%) Iodamoeba butschlii 2 (2.2%). Chilomastics mesnili 1 (1.1%), Hymenolepis nana 1 (1.1%) and Enterobius vermicularis 1 (1.1%). Conclusions: With regards to the high incidence of gasterointestinal parasitic diseases and also because of asymptomatic cases of giardiasis, we recommend evaluation of pediatric patients with malignant lymphohematopoitic disease by at least two different diagnostic methods and three rounds of stool examination in order to prevent possible life threatening outcomes. Coproparasitoscopic study for oncologic patients should be performed and anti-parasitic treatment provided before starting chemotherapy to prevent disseminated parasitic infections. The coproantigen-ELISA is especially advantageous in situations where only a single stool sample can be examined.