{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T02:31:47Z","timestamp":1777429907200,"version":"3.51.4"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12,5]]},"abstract":"<jats:p>Tropical anemia can have multiple causes, whether socioeconomic, dietary, or infectious. In the Bolivian Chaco, soil-transmitted helminthiases (STH), malaria, and Chagas disease are potential infectious causes of anemia among school-aged children (SAC). Following years of preventive chemotherapy with mebendazole, the prevalence of STH among SAC living in that area is now negligible, whereas protozoan infections are still highly prevalent (81%); <jats:italic>Hymenolepis nana<\/jats:italic> is the most frequent intestinal helminth (\u223c13%). We present results of hemoglobin (Hb) assessment and the association between parasitic infections and Hb levels of that SAC population. Overall, 511 SAC (girls:boys ratio 1:1, mean age 9.4 years [95% confidence interval {CI}: 9.3\u20139.5]) had Hb levels measured by using a point of care testing (HemoCue<jats:sub>\u00ae<\/jats:sub> Hb 301 System; HemoCue, Angelhome, Sweden). The prevalence of anemia was 23% (117\/511), with mean and median Hb level = 12.2 g\/dL (95% CI: 12.1\u201312.3; range 9.2\u201315.4 g\/dL). By multivariate analysis, <jats:italic>H. nana<\/jats:italic> infection was associated with an increased risk of anemia (odds ratio 2.9, 95% CI: 1.5\u20135.7, <jats:italic>P<\/jats:italic> = 0.002). Two samples (0.5%) were positive for <jats:italic>Trypanosoma cruzi<\/jats:italic> and none for <jats:italic>Plasmodium<\/jats:italic> spp. by polymerase chain reaction of the 439 children tested. Anemia is still a concern among SAC living in the Bolivian Chaco. Our findings call for a greater attention to fecal\u2013oral emerging pathogens, such as <jats:italic>H. nana<\/jats:italic>, and highlight the importance of water, sanitation, and hygiene improvements for disadvantaged population such as those living in the Bolivian Chaco.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0397","type":"journal-article","created":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T07:11:36Z","timestamp":1539069096000},"page":"1598-1601","source":"Crossref","is-referenced-by-count":8,"title":["Hymenolepis nana\u2014An Emerging Intestinal Parasite Associated with Anemia in School Children from the Bolivian Chaco"],"prefix":"10.4269","volume":"99","author":[{"given":"Michele","family":"Spinicci","sequence":"first","affiliation":[{"name":"Dipartimento di Medicina Sperimentale e Clinica, Universit\u00e0 degli Studi di Firenze, Firenze, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Macchioni","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Veterinarie, Universit\u00e0 degli Studi di Pisa, Pisa, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Gabrielli","sequence":"additional","affiliation":[{"name":"Dipartimento di Sanit\u00e0 Pubblica e Malattie Infettive, Universit\u00e0 di Roma Sapienza, Roma, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Rojo","sequence":"additional","affiliation":[{"name":"Escuela de Salud del Chaco Tekove Katu, Gutierrez, Plurinational State of Bolivia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herlan","family":"Gamboa","sequence":"additional","affiliation":[{"name":"Facultad Integral del Chaco, Universidad Aut\u00f3noma Gabriel Ren\u00e9 Moreno, Camiri, Plurinational State of Bolivia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Liz","family":"Villagr\u00e1n","sequence":"additional","affiliation":[{"name":"Hospital B\u00e1sico de Villa Montes, Villa Montes, Plurinational State of Bolivia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yolanda","family":"Vallejos","sequence":"additional","affiliation":[{"name":"Hospital Municipal de Camiri, Camiri, Plurinational State of Bolivia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"Strohmeyer","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Sperimentale e Clinica, Universit\u00e0 degli Studi di Firenze, Firenze, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mimmo","family":"Roselli","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Sperimentale e Clinica, Universit\u00e0 degli Studi di Firenze, Firenze, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella","family":"Cancrini","sequence":"additional","affiliation":[{"name":"Dipartimento di Sanit\u00e0 Pubblica e Malattie Infettive, Universit\u00e0 di Roma Sapienza, Roma, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piero","family":"Olliaro","sequence":"additional","affiliation":[{"name":"Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Montresor","sequence":"additional","affiliation":[{"name":"Department of Control of Neglected Tropical Diseases (NTD), World Health Organization, Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Bartoloni","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Sperimentale e Clinica, Universit\u00e0 degli Studi di Firenze, Firenze, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","author":"WHO","year":"2005"},{"key":"b2","series-title":"PLoS Negl Trop Dis","first-page":"e2912","article-title":"Blood drain: soil-transmitted helminths and anemia in pregnant women","volume":"8","author":"Gyorkos","year":"2014"},{"key":"b3","author":"WHO","year":"2017"},{"key":"b4","series-title":"Trop Med Int Health","first-page":"616","article-title":"Scaling down of a deworming programme among school-age children after a thirty-year successful intervention in the Bolivian Chaco","volume":"23","author":"Spinicci","year":"2018"},{"key":"b5","series-title":"Clin Microbiol Infect","first-page":"426","article-title":"Neglected zoonotic helminths: Hymenolepis nana, Echinococcus canadensis and Ancylostoma ceylanicum","volume":"21","author":"Thompson","year":"2015"},{"key":"b6","author":"WHO","year":"2011"},{"key":"b7","series-title":"Giornale Italiano di Malattie 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