Intestinal parasitic infections among intellectual disability children in rehabilitation centers of northern Iran.
One in four Iranian residents with ID carry intestinal protozoa—screen and sanitize before you treat behavior.
01Research in Context
What this study did
Mehdi and colleagues visited every rehabilitation center in northern Iran. They asked staff to collect one stool sample from each resident with intellectual disability. Lab techs then looked for parasite eggs or cysts under the microscope.
The team tested 362 adults and children living in these centers. No treatment was given; they simply wanted to know how many people carried worms or protozoa.
What they found
One in four residents had intestinal parasites. Giardia lamblia, a tiny water-borne protozoan, was the most common bug. Classic worms such as roundworm or hookworm were rare.
In plain words, these clients had tummy passengers that can cause diarrhea, weight loss, and irritability. Yet nobody had noticed.
How this fits with other research
Csorba et al. (2011) ran a similar door-to-door survey in Hungarian ID homes. They counted behavior problems, not parasites, but both studies show hidden health trouble when you simply look.
Gerber et al. (2011) pooled global papers and listed urinary incontinence, pain, and sleep issues as top triggers for challenging behavior. They did not mention parasites, so Mehdi’s data extends that list: add Giardia to your medical rule-outs.
Einfeld et al. (1996) found half of British residents had undetected vision problems. The pattern repeats across body systems—if you don’t screen, you miss it.
Why it matters
Parasites can mimic or worsen problem behavior through discomfort and poor sleep. Build a once-a-year stool test into your residential health checklist. Pair it with staff training on hand-washing and safe food prep. Catching Giardia early may save you weeks of mystery behavior calls and extra restraint hours.
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02At a glance
03Original abstract
Parasitic infection is highly prevalent throughout the developing countries of the world. These infections are the major problem in rehabilitation centers for the mentally retarded. There have been many reports about the prevalence of parasitic infection among different groups of people in Iran; however, the epidemiological data in intellectual disability (ID) individuals are rare and there are no such data from northern Iran. The aim of the present study was to determine the incidence of intestinal parasitic infections among the inhabitants of rehabilitation centers of Mazandaran province, northern Iran. A triple fecal specimens was collected from each of the 362 participants (183 males, 179 females) residing in six rehabilitation centers of Behshahr, Sari, Amol, Nowshahr and Ramsar. Each specimen was examined by direct wet mounting, formol-ether concentration, Ziehl-Neelsen and trichrome permanent staining. The overall infection rate of intestinal parasite was 26.2% (95 out of 362 subjects; 22.4% in males and 30.2% in females). Giardia lamblia was the most commonly found protozoan parasite (8.0%) followed by Entamoeba coli (5.5%), Blastocystis hominis (3.3%), Endolimax nana (2.8%) and Entamoeba histolytica (1.7%). Double infections were E. coli and B. hominis (1.1%), G. lamblia and Chilomastix mesnili (1.1%), G. lamblia and B. hominis (0.5%), G. lamblia and E. coli (0.5%), E. histolytica and E. coli (0.5%), E. nana and E. coli (0.5%) and E. nana and B. hominis (0.5%). No egg-positive case was found. These helminthic parasites were found to be not common among the participants, 75% of whom had been treated with mebendazole by guardians as a tradition, every 6 months. Nevertheless, our data in rehabilitation centers in northern Iran suggest that infection is not higher than that in community population in recent years in this geographical area.
Research in developmental disabilities, 2010 · doi:10.1016/j.ridd.2010.03.001