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The percentage of pinworm infected orphan children with enuresis before and after treatment in Iraqi orphanage institute 

The percentage of pinworm infected orphan children with enuresis before and after treatment in Iraqi orphanage institute 

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The prevalence of Enterobiasis and Enuresis were screened in this study, to evaluate the possible relationship between each other, and to investigate age, gender related factors in fifty one orphanage Iraqi children their age (3-12) years, before and after albendazole treatment. The results showed that Enterobius vermicularis is one of the most fre...

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... enuresis was constructed and data on age, gender anal itching, and inflammation was gathered. Data collection was done in cooperation with children nurses. Stool collection by digital (finger) rectal exam technique was done of collecting eggs or worms as described by [8,12], briefly: the position of the child body for this test may be asked to lie on the left side of his chest with right knee and right thigh drawn up and asked him to inhale slowly as insert a lubricated and gloved finger into his anus to collect a stool sample. The sample is placed on a microscope slide and examined as soon as possible [4, 8]. Nocturnal enuresis rates were investigated before and after Albendazole treatment in children with and with no enterobiasis to search for the association between enuresis and pin worm infection. Data collection was done in cooperation with children's nurse. Albendazole (Zentel) , 400 mg was given orally as single dose for the purpose of treatment , all residents living on the same institute were treated also by one-dose of Levamisole (HCL) Katrex as worm expeller.At the end of treatment (after 14 days), stool samples were taken from all of children and examined by microscope. Experimental data were presented in terms of observed numbers and percentage frequencies, and then analysed by Statistical Package for Social Sciences (SPSS 10.01) using the Chi- square test, P value ≤ 0.05 was considered statistically significant. Enterobius vermicularis is one of the most frequently encountered nematodes. It is highly contagious and parasitizing the human intestinal tract. It is known that the transmission of enteroparasites depend on the presence of infected individual , sanitation deficiencies and , principally , the socio economic and cultural condition of the population [13]. The present data showed that the overall prevalence rate of enterobiasis among children from 3-12 years who lived in orphanage institute in Baghdad / Iraq was 84.31% (figure 1) , the number of positive sample were 43 out of 51 child , this results considerd higher than the previous results by Kitvatanachai et al . [14] who got total infectivity rate 15.95 % in Thailand orphanages while other epidemiological studies reported 60% in Egyptian orphanages [15] and 94% in Turkish orphanages [16], the main reason for these high rates of E.vermicularis infection among orphan children inside orphanages may be related to the direct contact between them , especially when this parasites confirmed previously as most prevalent parasite in overcrowded areas or in families with many members [1,16]. E. vermicularis appears a highly successful parasite in countries where the socio-economic and environmental conditions are thought to be less hygienic, it is easily transmitted among family members through inhalation, contaminated hands and fomites [17, 18].Other factors that are often believed to be related to the high transmission of Enterobius vermicularis in this orphanage are the area of the bedroom, the age of children, and behavioral patterns. The results also showed that the infection rate in males 55.81% (24/43) was higher than females 44.18% (19/43) , although there was no significant relation (p ≤ 0.05) between gender and infection rate of enterobiasis (figure 2) , this results was agreed with other previous studies by [14 ,15 ,19] , the non significant differences can be explained as both gender were lived in the same place and had the same chance in playing and eating as well as sharing the same toilets , so the exposure to infectious agent may not varied very much between genders .However, Enterobius vermicularis has been reported to cause pathology in the genital and reproductive system of females [20]. Table (1) showed the age related prevalence of Enterobius vermicularis , the maximum infection rates 43.88% , 20.98 and 20.98 were seen in age group 4 , 5 and 6 years respectively , children infected with pinworm scratch themselves; eggs are picked up under their fingernails and then deposited on toys, books, or back into the mouth, if the child is a thumb-sucker or nail-biter [21]. Results also showed that percentage of asymptomatic infection was 16.27% (7/43) , while the symptomatic infections were seen as following :infection with itching only 25.5% (11/43) , infection with inflammation only 11.62% (5/43) and 46.5% (20/43) was the percentage of infections with itching and inflammation table (2). In this study, we attempted to determine the relationship between enuresis and Enterobius vermicularis infection among Iraqi orphanage children, and up to our knowledge, studies on this relation is limited in Iraq. Nocturnal enuresis rates were investigated before and after Albendazole treatment in children with and with no enterobiasis. The percentage of children who had both pinworm infection and enuresis were 58.82% (30/51) before treatment, while this percentage decreased significantly (p ≤ 0.05) 11.76% (6/51) after treatment with Albendazole Figure 3. Similar association between nocturnal enuresis and pinworm infection revealed by Culha and Duran [22] who investigated that there were a significant decrease of the prevalence of nocturnal enuresis occurred depending on the decrease of the prevalence of Enterobius vermicularis after treatment with mebendazole. Other similar results were reported also by [23, 24], urethral / vaginal reflux has been suggested as cause for enuresis [22]. The results also showed no significant differences (p ≤ 0.05) between female and male in their response to albendazole, the percentage of female who had both enterobiasis and nocturnal enuresis before treatment was 63% (14/22) and 55.17% (16/29) in male, while the percentage became 10.5% (2/19) and 12.5% (4/32) in female and male respectively after treatment (figure 4). our results disagreed with others who demonstrated significant differences between male and female in enuresis after treatment [22] this differences may due to the large number of children that participated in their studies , as well as females may take a very big concerns especially when some investigators initiate their study on vulvovaginitis which may associated with pin worm infection and other pathogenic agents [25 ,26]. Despite medication; enterobiasis has not been eradicated completely in this study this may be that some eggs take more than 14 days to mature. Alternatively , some children re-infected due to nail biting , inadequate hand washing or perianal cleaning. It may be necessary to treat such repeatedly infected children with two to three doses of medication at sequential 14 days intervals. In conclusion our findings revealed that Enterobius vermicularis is a high prevalent parasite among orphanage children, as well as relation between noctournal enuresis and pinworm infection was confirmed in this study. So children with enuresis have to be screened for E.vermicularis infection, especially in orphanages, schools and ...

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... There have been many studies that reported the epidemiological and demographic status of E. vermicularis among the population from different parts of Iraq [16][17][18]. In addition, some other investigators focused on enterobiasis and its relation to enuresis, anaemia, biochemical parameters of the blood, and vitamin deficiencies [19][20][21]. Although several studies were achieved regarding E. vermicularis, updating our knowledge is still needed about its potential influence on the haematological, nutritional status, and immunological status of the host infected with E. vermicularis. ...
... While, it is lower than the result of Hussein (2015) who showed 83.9% infection rate among 124 children aged 4-7 years in Najaf province [27]. It is also lower that the result of Al-Qhadi et al. (2011) who reported 84.3% infection rate among 51 orphan children aged 3-12 years in Baghdad [19]. The variations in infection rates of enterobiasis among different studies are likely due to some effects, including sample size, diagnostic technique used, living conditions, socio-economic situations, spatial changes, and demographic variations [28]. ...
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... The presence of large numbers of adult worms in the bowel can cause abdominal pain, constipation, tenesmus and vaginitis (4,15,16). Some evidence exists that E. vermicularis infestation may be a cause of secondary enuresis (17,18). There have also been reported cases of appendicitis complicated by E. vermicularis infestation (19,20). ...
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... Studies in school children have found different rates of pinworm infection. In Santiago city, Chile, infection rates were 20.9% [4], 0.62% in Taiwan [5], 58.88% in China [6] and, in one orphanage in Iraq, 84.31% [7]. and 65%, in young children [11,14,15], rates higher than the 7% found in Karen hill tribes of NE Thailand [16]. ...
... This study was performed using the Scotch tape technique, a well know, widely used, easy, safe and reliable technique [7,25]. In this study, 31 children were infected with pinworm, just under 8%. ...
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... Several studies were done in Iraq on Enterobius vermicularis. Some of them were deal with the infection effect on some hematological parameters [9,10], others on its effect on enuresis among children [11,12], and some on its prevalence [13,14]. ...
... Ratios recorded by researchers in our country were ranged from small rate ( 1.9%) [13], to moderate (24.9, 37.89, 51.8 %) [10,11,9] or high (84.3, 92.05%) [12,14] This might be because of the dissimilarities between studied cohorts. ...
... This result was agreed with [29] who noted decreased discharged but not complete eradication of the worms, in infected chimpanzees treated with pyrantel pamoate. And disagreed with other researches who found effect with albendazole 400 mg as single dose [12] and with Mebendazole 100 mg [11]. Now it's better to pay more attention to E. vermicularis infection. ...
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Pin worm is a nematode distributed worldwide. It infects all ages and sexes especially children, but the infection is still of a very little of concern. Different diagnostic methods were used for investigating Enterobius vermicularis prevalence in 1020 patients (500 male and 520 female) in Kirkuk city. Stool samples were collected and proceeded for General Stool Examination (GSE).The overall incidence of E. vermicularis was 34.6 %. A rate of 5.3% was detected microscopically, 5.9% by swab method, 26% by cellophane tape and 41% macroscopically by detecting the larva and adult worm with naked eye. The worm was prevalent in all ages. High rate (27%) of infested person has been infected for 7-10 years. Significantly strong relation had appeared between E. vermicularis infection and appendicitis and fallopian tube obstruction. 49.5% of infected individuals had appendicitis and 27.4% had fallopian tube obstruction, a rate of 48.4% of tubular obstructed women were infertile.12.2% of E. vermicularis infected patients had Urinary Tract Infection (UTI). All used anti-helminthic drugs were not effective against the infection. The conclusion is: high percentage of Kirkuk population is infected with E. vermicularis but most of these cases were not diagnosed. E. vermicularis infection can led to appendicitis or tubular obstruction especially in chronic cases. Therefore, parents are recommended to treat their children, especially females as soon as they recognize the infection, to preserve the future complications that might be caused by the worm as fallopian tube obstruction and infertility.