الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 178 |  |  |
| | | from | 178 | | |
Abstract
Parasitic diseases are one of the major causes of morbidity and mortality in the developing countries. Children are the most common affected population acquiring infection. Clinical severity and outcome of parasitic diseases often depend on innate and acquired host immunity. Impaired or weakened immune system may be due to a number of conditions including diseases (e.g. diabetes mellitus, renal diseases, malignant diseases, hematologic diseases, malnutrition and others), and drugs (e.g. long duration of corticosteroid therapy), may establish a favorable condition for opportunistic parasites to flourish over the host system.
The commonest parasites causing morbidity and/or mortality in the immuno-compromised children are parasites which inhabit the gastrointestinal tract (GIT) (e.g. Cryptosporidium spp., Cyclospora spp., Microspora spp., Isospora belli, Blastocystis spp. and Strongyloides stercoralis), parasites of the reticulo-endothelial cells (e.g. Toxoplasma gondii). Clinical picture ranges from self-limited or mild to moderate disease in immuno-competent children to severe or life threatening disease in immuno-compromised ones.
This was a cross sectional study, applied on 100 children (age ranged from 2-15 years), 80 immuno-compromised patients attended to the outpatients clinics of Pediatric Minia Uni¬versity Hospital, Minia District, and 20 immuno-competent (apparent healthy) children. They divided into five groups, 20 child each; uncontrolled diabetes mellitus (DM) type I (group I), chronic renal diseases (nephrotic syndrome (NS) under chronic steroid therapy and chronic renal failure) (group II), hemolytic anemia (HA) with repeated blood transfusion (group III), moderate to severe malnourished (group IV) and the immuno-competent children group was considered as (group V).
Stool and blood samples were collected from all the study groups. Stool samples were examined by different parasitological techniques; wet mount technique, concentration techniques (Formal-Ether Concentration), staining with Giemsa stain, Modified Ziehl-Neelsen (ZN) stain and Stool culture for nematodes larvae (The Harada-Mori technique).
Serum samples were tested for detection of anti-Toxoplasma gondii (IgM & IgG) antibodies by ELISA technique.
The study revealed the following:
1- The results of examination of stool samples by using wet mount smear showed that out of 100 samples, 70 cases were positive (70%) for different parasitic infections. However, this percent was increased to 83 (83%) when concentration technique was used for negative samples, by using Giemsa stain, the number of positive cases were 88(88%) and 93(93%) by modified Ziehl-Neelsen (ZN). Unfortunately all stool samples were negative for nematodes larvae by culture on Harada- Mori technique.
2- It was found that the number of parasites detected in the immuno-compromised children was higher than the immuno-competent ones. Parasites found among immuno-compromised children were Blastocystis spp. (69 cases 86%), Cryptosporidium spp. (61 cases 76% ), Microspora spp. ( 47 cases 59% ), E. histolytica/ E. dispar ( 41 cases 51% ), Giardia lamblia ( 32 cases 40% ), Cyclospora spp. (30 cases 37.5 % ), E. coli ( 10 cases 12.5 ), Storage mite egg (5 cases 6.25% ) , H.nana egg (4 cases 5% ), Ascaris lumbricoides egg (one case 1.25% ) and S. haematobium egg (one case 1.25% ).
3- Among immuno-competent group, the parasites found were Cryptosporidium spp. (17 cases 72.5%), Blastocystis spp. (13 cases 65%), Cyclospora spp. (4 cases 20%), Microspora spp. (4 cases 20%), E. histolytica/ E. dispar (3 cases 15%) and Giardia lamblia (3 cases15%).
4- Between different immuno-compromised children, it was found that parasitic infection in uncontrolled diabetes mellitus (DM) type I, chronic renal diseases and hemolytic anemia (HA) more compared to children with moderate to severe malnourished children.
5- As regard to ELISA technique, positive Toxoplasma gondii antibodies were detected in 40% of children with uncontrolled diabetes mellitus (DM) type I, 90% of children with chronic renal diseases, 80% of children with hemolytic anemia (HA) with repeated blood transfusion, 50% of malnourished children and 65% of immuno-competent ones.