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Journal of Clinical Microbiology, January 2001, p. 34-42, Vol. 39, No. 1
Division of Parasitic Diseases, National
Center for Infectious Diseases, Centers for Disease Control and
Prevention, Atlanta, Georgia,1 and Peace
Corps Medical Office2 and Universidad
del Valle,3 Guatemala City, Guatemala
Received 8 August 2000/Returned for modification 11 September
2000/Accepted 4 October 2000
We conducted a prospective, longitudinal study in a cohort of 36 Peace Corps volunteers (PCVs) in Guatemala to study the incidence and
natural history of intestinal parasitic infections during the PCVs'
>2-year overseas stay. PCVs collected stool specimens at least monthly
and when ill with gastrointestinal symptoms. Of the 1,168 specimens
tested, 453 (38.8%) were positive for at least one parasite and 48 (4.1%) were positive for a pathogenic parasite. A median interval of
187 days (range, 14 to 752 days) elapsed before the first documented
parasitic infection, and the median intervals from arrival until
subsequent infections (e.g., second or third) were >300 days. The PCVs
had 116 episodes of infection with 11 parasites, including up to 4 episodes per PCV with specific nonpathogens and Blastocystis
hominis. The incidence, in episodes per 100 person-years, was
highest for B. hominis (65), followed by
Entamoeba coli (31), Cryptosporidium
parvum (17), and Entamoeba hartmanni
(17). The PCVs' B. hominis episodes lasted 6,809 person-days (28.7% of the 23,689 person-days in the study), the
E. coli episodes lasted 2,055 person-days (8.7%), and each of the other types of episodes lasted <2% of the person-days in the
study. Gastrointestinal symptoms were somewhat more common and more
persistent, but not significantly so, in association with pathogen
episodes than with B. hominis and nonpathogen episodes. Although infections with pathogenic parasites could account for only a
minority of the PCVs' diarrheal episodes, the continued acquisition of
parasitic infections throughout the PCVs' >2-year stay in Guatemala
suggests that PCVs repeatedly had fecal exposures and thus were at risk
for infections with both parasitic and nonparasitic pathogens
throughout their overseas service.
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.1.34-42.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Multiyear Prospective Study of Intestinal
Parasitism in a Cohort of Peace Corps Volunteers in Guatemala
*
Corresponding author. Mailing address: Centers for
Disease Control and Prevention, Division of Parasitic Diseases,
Mailstop F-22, 4770 Buford Highway N.E., Atlanta, GA 30341-3724. Phone: (770) 488-7772. Fax: (770) 488-7761. E-mail: bxh4{at}cdc.gov.
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