Socio-demographic, Clinical and Laboratory Predictors for the Diagnosis of Visceral Larva Migrans in Children - Upper Egypt

Abstract

Visceral larva migrans (VLM) is a worldwide neglected disease, prevalent among children from socio-economically disadvantaged populations in temperate and tropical regions. Infections may go undiagnosed as the required diagnostic tests; serological, molecular and/or imaging examinations are expensive, which may not be affordable or available. We aimed to establish predictors useful in the diagnosis of VLM in children in Upper Egypt. A one year cross-sectional study was conducted at Assiut University Children's Hospital and eighty-one children aged between 6 months to 13 years old (mean± SD 5.7 ± 3.2 years) were eligible to our inclusion criteria, 55.6% of them were males. Socio-demographic risk factors, clinical, laboratory and imaging tests were collected. ELISA (anti-T. canis IgG) results were positive in 60.5%. By using the bivariate analysis, a significant association was found between seropositive ELISA and younger age less than four years (p-value <0.0001), having underground water at their homes (p= 0.004), previous history of parasitic infection (p= 0.003) and positive liver ultrasonographic findings (p=0.001). In a multivariate logistic regression model with positive and negative ELISA results as a dependent factor, younger age (<4 years), history of parasitic infestation and positive liver ultrasonographic findings were found  to be significant predictors, while no significant association with other factors was identified. Thus, clinicians should consider the positive liver ultrasonographic changes with the earlier history of parasitic infection in children under four years as predictors for VLM infection, according to which they should undergo ELISA or other tests to confirm their diagnosis.