Browsing by Autor "Roberto Passera"

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Determinants of Anemia in Schoolchildren in the Highland Bolivia
(Multidisciplinary Digital Publishing Institute, 2024) Washington R. Cuna; Irazú Contreras; Armando Rodríguez; Roberto Passera; Celeste Rodríguez
Anemia is a health problem of concern among schoolchildren in underprivileged rural regions, where recurrent parasitic infections are common. A cross-sectional study was conducted in 229 schoolchildren in rural highland Bolivia in the department of La Paz, an area with a high prevalence of protozoan and helminth infections, to determine the types and mechanisms of anemia. A substantial proportion of children (40.2%) were found to be anemic based on hemoglobin measurements. No associations were found between low hemoglobin levels and helminth or protozoan infections when evaluating infectious causes of anemia, nor with Giardia lamblia or Blastocystis hominis, which are associated with iron deficiency and nutrient malabsorption and were highly prevalent in this study. The significant association between anemia and hypochromia suggests iron deficiency, aligned with low hemoglobin levels. A total of 39 out of 150 children (26%) had markers consistent with iron deficiency anemia (IDA), 26 out of 127 children (20%) met the criteria for anemia of inflammation (AI). Furthermore, 12 of the 127 tested children (9.4%) met the criteria for mixed AI with IDA according to the soluble transferrin receptor (sTfR)/log ferritin levels, which increased significantly due to overall infections by Hymenolepis nana and Ascaris lumbricoides helminths. The findings highlight the need for integrated public health interventions to address iron nutrition and parasitic infections to effectively prevent anemia in this vulnerable population.
Frequency of Gastrointestinal Parasites, Anemia, and Nutritional Status among Children from Different Geographical Regions of Bolivia
(Hindawi Publishing Corporation, 2023) Ceilan Apaza; Washington R. Cuna; Froilán Brañez; Roberto Passera; Celeste Rodríguez
The study aimed to measure the frequency of occurrence of infections with helminths, protozoa, and risk factors of undernutrition and anemia among schoolchildren from the Bolivian highland (altiplano) and lowland (subtropical) rural regions, with a high frequency of gastrointestinal parasite infections. Cross-sectional data were collected from 790 children, 5-13 years old. Microscopic examination of stool using the Ritchie technique, hemoglobin testing using the HemoCue analyzer, and anthropometric measurements were performed. Over 60% and 20% of children were infected with protozoa and helminth parasites, respectively. Infections caused by pathogenic Hymenolepis nana (15.7-5.2%), Ascaris lumbricoides (41.9-28.5%), Giardia lamblia (30.1-11.2%), Entamoeba histolytica (5.7-0.7%), and nonpathogenic Entamoeba coli (48.9-16%), Blastocystis hominis (40.2-28.5%), Iodamoeba butschli (16.1-2.5%), Chilomastix mesnili (19.2-7.3%), and Entamoeba histolytica/dispar (7.4-5.5%) parasites, were more prevalent in the highlands than the lowlands. Single parasitic infections were more prevalent in the lowlands; polyparasitism of light or heavy intensity predominated in the highlands. A strongly increased risk of anemia and a low prevalence of wasting were determined in children in the highlands. A higher risk for stunting was associated with children of older age, and a low burden of intestinal helminths would prevent wasting in children of highlands. Infections with A. lumbricoides and G. lamblia pathogens in older children were not significant covariates for stunting. Environmental, nutritional, and parasitic factors may predispose to anemia in the highlands. A nutritional intervention and parasite control effort will substantially improve children´s health in the highlands.
Interplay of Gastrointestinal Parasites, Micronutrient Deficiencies, and Anemia in Children from the Bolivian Highlands
(Multidisciplinary Digital Publishing Institute, 2026) Washington R. Cuna; Roberto Passera; Celeste Rodríguez
Children living in resource-limited regions with inadequate environmental sanitation, such as the Bolivian highlands, are affected by parasitic infections that may compromise nutritional status. Objective: This study aimed to assess the prevalence of intestinal parasitic infections and their associations with nutritional status, micronutrient deficiencies, and anemia in school-aged children from La Paz, Bolivia. Methods: A cross-sectional study was conducted among 212 schoolchildren aged 5-13 years in the municipality of La Paz, in highland areas characterized by high poverty levels. Parasitological examination, anthropometric measurements, and biochemical assessment of micronutrients (vitamins A and D, zinc, iron) were performed to evaluate children's health status. Results: Mild malnutrition was more prevalent than moderate-to-severe forms. Micronutrient analysis revealed substantial deficiencies in vitamin A (39%), zinc (25%), and vitamin D (18%). Zinc deficiency was significantly more common in children aged 11-13 years compared to younger age groups (p = 0.034). Intestinal protozoan infections showed significant associations with micronutrient deficiencies. Giardia lamblia infection was associated with both vitamin A (30.9%, p = 0.042) and vitamin D (78.9%, p = 0.001) deficiencies. Blastocystis spp. infection was similarly linked to higher prevalence of vitamin A (35.8%, p = 0.025) and vitamin D (69.7%, p = 0.004) deficiencies. Entamoeba coli infection was significantly associated with vitamin D deficiency (p = 0.021), while Iodamoeba bütschlii infection showed a significant association with zinc status (p = 0.027), with notably lower zinc deficiency prevalence in infected children (7.7%) compared to non-infected children. Among helminth infections, Ascaris lumbricoides was significantly associated with vitamin D deficiency (37%, p = 0.018). Moderate-to-severe anemia was highly prevalent, affecting over half of the children regardless of sex. Wasting (BAZ) was significantly associated with age (p = 0.030), with moderate-to-severe cases most prevalent in children aged 5-7 years and absent in older groups, while mild wasting increased with age. In univariate logistic regression analysis, zinc deficiency emerged as a significant risk factor for anemia (OR = 2.51, 95% CI: 1.19-5.29, p = 0.016). No significant associations were observed between anemia and sex, age group, vitamin A or D status, or anthropometric indicators including underweight, stunting, or wasting. Conclusions: These findings highlight the substantial burden of micronutrient deficiencies, parasitic infections, and anemia among children in this impoverished region, underscoring the urgent need for targeted public health interventions addressing nutritional supplementation, parasite control, and improved sanitation.
Parasitic Effects on the Congenital Transmission of Trypanosoma cruzi in Mother–Newborn Pairs
(Multidisciplinary Digital Publishing Institute, 2024) Ana Gabriela Herrera Choque; Washington R. Cuna; Simona Gabrielli; Simonetta Mattiucci; Roberto Passera; Celeste Rodríguez
Maternal parasitemia and placental parasite load were examined in mother-newborn pairs to determine their effect on the congenital transmission of Trypanosoma cruzi. Parasitemia was qualitatively assessed in mothers and newborns by the microhematocrit test; parasite load was determined in the placental tissues of transmitting and non-transmitting mothers by the detection of T. cruzi DNA and by histology. Compared to transmitter mothers, the frequency and prevalence of parasitemia were found to be increased in non-transmitter mothers; however, the frequency and prevalence of parasite load were higher among the transmitter mothers than among their non-transmitter counterparts. Additionally, serum levels of interferon (IFN)-γ were measured by an enzyme-linked immunosorbent assay (ELISA) in peripheral, placental, and cord blood samples. Median values of IFN-γ were significantly increased in the cord blood of uninfected newborns. The median IFN-γ values of transmitter and non-transmitter mothers were not significantly different; however, non-transmitter mothers had the highest total IFN-γ production among the group of mothers. Collectively, the results of this study suggest that the anti-T. cruzi immune response occurring in the placenta and cord is under the influence of the cytokines from the mother's blood and results in the control of parasitemia in uninfected newborns.
Pro-Inflammatory Cytokine Production in Chagasic Mothers and Their Uninfected Newborns
(American Society of Parasitologists, 2009) Washington R. Cuna; Ana Gabriela Herrera Choque; Roberto Passera; Celeste Rodríguez
The levels of IFN-gamma, TNF-alpha, IL-10, and TGF-beta1 cytokines associated with Trypanosoma cruzi during pregnancy were determined by enzyme-linked immunosorbent assay (ELISA) in serum samples from peripheral, placental, and cord blood of chronic infected mothers with detectable and undetectable parasitemia, and in their uninfected newborns. Compared to uninfected pregnant women and mothers with undetectable parasitemia, the concentrations of IFN-gamma were higher at the 3 sites in mothers with detectable parasitemia. In these mothers and their newborns, the TNF-alpha concentrations were higher in the periphery and cord in comparison to serum samples from non-chagasic pregnant women. TNF-alpha levels were higher in newborns of mothers with detectable parasitemia than in newborns of mothers with undetectable parasitemia. IL-10 and TGF-beta1 levels at the 3 sites were unchanged and diminished, respectively, in samples from infected mothers with patent parasitemia in comparison with uninfected pregnant women. Cytokine concentrations did not change significantly in all samples from mothers with undetectable parasitemia; however, the concentration of TGF-beta1 was significantly reduced in their peripheral samples but significantly higher in the placenta in comparison with uninfected mothers and mothers with detectable parasitemia, respectively. These results suggest that elevated numbers of circulating parasites in vivo elicit production of pro-inflammatory cytokines that control congenital T. cruzi infection.