Epidemiology and control of intestinal parasites with nitazoxanide in children in Mexico

The purpose of this study was to evaluate the efficacy and the tolerance of nitazoxanide in children as a single broad-spectrum antiparasitic agent in the treatment of mixed parasite infections with both intestinal protozoa and helminths. Two hundred seventy-two children (age range 2-14 years) participated in this study. We systematically surveyed every household head using questionnaires designed to obtain information about household socioeconomic status and hygiene. Parasitic infections were confirmed by three stool examinations using direct smear, Ferreira concentration, and cold acid-fast Kinyoun staining methods. One hundred twenty-one (44%) children tested positive for protozoa such as Giardia lamblia (18%), Entamoeba histolytica/E. dispar (10%), Blastocystis hominis (7%), Cryptosporidium parvum (4%), and Cyclospora cayetanensis (3%), and helminths such as Hymenolepis nana (10%), Trichuris trichiura (6%), and Ascaris lumbricoides (6%). There were also two cases of infection with Enterobius vermicularis. After a complete physical examination was performed, 121 patients received treatment with nitazoxanide. Overall, 84% of the protozoa and 95% of the helminths were completely eliminated from the patients. Nitazoxanide was very well tolerated, with no serious adverse effects reported.