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Prevalence and Risk Factors for Intestinal Protozoan Infections in Children with Cancer in Taif, Western Saudi Arabia by Yousry Hawash, Ammar Alturkistani, Abdelrahman Yousry, Marwa A. Gowda

Background: Cancer is a category of diseases that cause an individual's immune system to become suppressed. In a case-control study, the current study aims to detect the frequency of intestinal parasites and related risk factors in children with cancer.
Methods: Stool samples were collected from 178 children with cancers (cases) and 150 cancer-free children (controls) who sought treatment for diarrheal episodes at nearby hospitals. Samples were processed by direct smear examination, concentration technique, permanent staining by Lugol's iodine, modified Ziehl-Neelsen, modified trichrome, and chromotrope 2R stains.
Results: The overall prevalence of intestinal parasites was 7.3% (24/328), with non-statistically significant differences between cases (7.8%; 14/178) and controls (6.6%; 10/150). Children with leukemia had a higher infection rate (9%; 9/100) than children with lymphoma (6.9%; 3/43) or solid tumors (5.7%; 2/35). Blastocystis sp. (3.3%) was the most common intestinal parasite found in cases, followed by Cryptosporidium sp. (2.2%), Giardia lamblia (1.6%), and Microsporidia sp. (0.5%). For all parasites, no statistical difference was found between the two groups. (p > 0.05). Male gender, young age, non-bottled water use, travel to parasite-endemic areas, living in an urban area, and infrequent hand washing were all associated with intestinal parasitosis, with non-statistical significance observed between the two groups. In children with cancer, intestinal parasites were found to be significantly associated with chronic (p = 0.04) and severe (p = 0.03) diarrhea.
Conclusions: Children with cancer, particularly those with hematological cancers, should be screened for intestinal parasites on a regular basis and treated for their overall health.

DOI: 10.7754/Clin.Lab.2022.220727