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Clinical insight
P R O B E
• V o l . L I I I • N o . 3 • A p r – J u n 2 0 1 4
Breast-feeding Protects Against Infantile Diarrhea
Caused by Intestinal Protozoan Infections
Abdel-Hafeez, et al
Korean J Parasitol
. 2013;51(5):519–524.
A B S T R A C T
This study investigated the effect of
breastfeeding in protection against protozoan
infection in infants with persistent diarrhea. Infants
were classified into 2 groups—161 breastfed infants and
the same number of non-breastfed infants. Microscopic
examinations of stool were done for detection of parasites and
measuring the intensity of infection. Moreover, serum levels of
IgE and TNF-
a
were measured by ELISA.
Cryptosporidium
spp,
Entamoeba histolytica
/
Entamoeba dispar
,
Giardia lamblia
, and
Blastocystis
spp were demonstrated in infants with persistent diarrhea.
The percentage of protozoan infections was significantly lower in
breastfed infants than that in the non-breastfed infants. The levels of
IgE and TNF-
a
were significantly lower in the breastfed group than
in the non-breastfed group. There were significant positive associations
between the serum levels of IgE and TNF-
a
and the intensity of parasite
infection in the breastfed group. It is suggested that breastfeeding has an
attenuating effect on the rate and intensity of parasite infection.
Key Words:
Breastfeeding, infantile diarrhea, protozoan parasites,
hygiene
Introduction
Protozoan parasites such as
Cryptosporidium
spp,
Entamoeba
histolytica
, and
Giardia lamblia
cause
diarrhea, which still remains a leading
cause of morbidity and mortality
among infants in low-income
and middle-income countries. As
infections with parasites, particularly
G lamblia
and
Cryptosporidium
spp,
are the most likely causes of persistent
diarrhea (> 14 days), pediatricians had
strong suspicion from the symptoms
and clinical courses of these infants
that the causes of persistent diarrhea
should be intestinal protozoan
infections (IPI), that is, infections
caused by pathogenic protozoa in the
intestine.
Breastfeeding provides significant
protection against many diseases
including diarrhea in infancy. This is
attributable to a complex of acquired
and innate factors unique to human
milk including immunoglobulins,
oligosaccharides, glycoconjugates,
lactoferrin, antimicrobial compounds,
leukocytes, cytokines, and other
agents. Breastfed infants have a
lower prevalence of gastrointestinal
infections including IPI than
