155

Neotrop. Helminthol., 7(1), 2013

2013 Asociación Peruana de Helmintología e Invertebrados Afines (APHIA)

ISSN: 2218-6425 impreso / ISSN: 1995-1043 on line

SCIENTIFIC NOTE / NOTA CIENTÍFICA

NOTES ON INTESTINAL PARASITIC DISEASES IN ARTISANAL FISHERMEN OF THE

FISHING TERMINAL OF CHORRILLOS (LIMA, PERU)

NOTAS EN LAS ENFERMEDADES PARASITARIAS INTESTINALES EN PESCADORES

ARTESANALES DEL TEMINAL PESQUERO DE CHORRILLOS (LIMA, PERU)

Suggested citation: Zelada-Castro, H, Rodríguez-Borda, J, Flores-Liñan, H, León-Manco, J, Wetzel, EJ & CárdenasCallirgos, J.

Neotropical Helminthology, vol. 7, N°1, jan-jun, pp. 155 - 166.

1 Alberto Hurtado School of Medicine. Cayetano Heredia Peruvian University. Av. Honorio Delgado 430, Urb. Ingeniería, S.M.P. Lima - Peru.

E-mail: henryzc86@hotmail.com

2 Alberto Cazorla Talleri School of Sciences and Philosophy. Cayetano Heredia Peruvian University. Av. Honorio Delgado 430, Urb. Ingeniería, S.M.P. Lima -

Peru. E-mail: hugo.flores@upch.pe

3 Department of Biology, Wabash College, Crawfordsville, IN 47933, Indiana, USA. E-mail: wetzele@wabash.edu

4 Invertebrate Laboratory. Museum of Natural History. Biological Sciences School. Ricardo Palma University. Av. Benavides 5440, Lima 33, Peru.

E-mail: jmcardenasc@gmail.com

1 1 2 2 3

Henry Zelada – Castro , Jenny Rodríguez - Borda , Hugo Flores - Liñan , Jorge León - Manco , Eric J. Wetzel & Jorge

Cárdenas - Callirgos

Resumen

Un estudio coproparasitológico a la población dedicada a la pesca artesanal del Terminal Pesquero de

Chorrillos, Provincia de Lima, Perú, se llevó a cabo con el objetivo de determinar la prevalencia de

enteroparasitosis y su relación con la actividad pesquera. Muestras coprológicas fueron examinadas

por el método de Ritchie y la técnica de sedimentación espontánea en tubo. La prevalencia de

enteroparasitosis fue del 68%. El único protozoo patógeno encontrado fue Giardia intestinalis

(sinónimo de G. lamblia) (Lambl, 1859) Kofoid & Christiansen, 1915, con una prevalencia del 16%,

después los helmintos mencionados Hymenolepis nana (Culbertson, 1.940) y Ascaris lumbricoides

(Linnaeus, 1758), tanto con una prevalencia de 4%. Si bien entre los parásitos comensales se encontró

a Endolimax nana (Wenyon & O'Connor, 1917), llegando a 40%, seguido de Entamoeba coli (Grassi,

1879) con 28% y, finalmente, Iodamoeba butschlii (Prowazek, 1911) con 4%, se recomienda

implementar estrategias de educación para la salud y un seguimiento permanente.

Palabras clave: Giardia - enteroparasitismo - Chorrillos - pescadores - factores de riesgo.

Abstract

A fecal parasitological study of the population performing artisanal fishing of Terminal Pesquero de

Chorrillos (Fishing Terminal of Chorrillos), Province of Lima, Peru, was conducted aiming at

determining the prevalence of endoparasites and their relationship with fishing activity. Fecal samples

were examined by the Ritchie's Method and the Spontaneous Sedimentation in Tube Technique. The

prevalence of endoparasites was 68%. The only pathogenic protozoa found was Giardia intestinalis

(syn. G. lamblia) (Lambl, 1859) Kofoid & Christiansen, 1915 with a 16% prevalence. The helminth

parasites found included Hymenolepis nana (Culbertson, 1940) and Ascaris lumbricoides (Linnaeus,

1758), both with a 4% prevalence. Commensal parasites found included Endolimax nana (Wenyon &

O´Connor, 1917) at a prevalence reaching 40%, followed by Entamoeba coli (Grassi, 1879) with 28%

and finally Iodamoeba butschlii (Prowazek, 1911) with 4%, it is recommended to implement health

education strategies and a permanent monitoring.

Keywords: Giardia - enteroparasitism - Chorrillos - fishermen - risk factors.

156

Parasitic disease in artisanal fishermen Zelada-Casto et al.

Gastrointestinal parasitic disease is common in

our environment mostly due to the deficiencies

in our health system (Contreras et al., 1993) and

the cultural habits of the population, especially

of those living in poor conditions and who

cannot access an adequate health system,

additionally to the environmental characteristics

promoting the transmission of etiologic agents

(Apt, 1987). The access to drinking water

services, an efficient excretion removal system

and a right per capita income, additionally to the

population literacy rate, are characteristics

determining the socio-economic level of the

population and are related to the human

infection with gastrointestinal helminths

(Mehraj et al., 2008).

Human communities dedicated to fishing

activities present socio-cultural aspects

determining the transmission of protozoa and

helminths, especially for those getting oral

transmission through water and contaminated

food and this due to the human behavior habits

which are directly related to the epidemiology of

parasitic infections, such as the case of

contamination due to cysts of Giardia sp. and

oocysts of Cryptosporidium spp., which when

transmitted by fecal contamination cause

diarrhea in the population exposed to a

contaminated environment due to the lack of

access to drinking water services (Macpherson,

2005). This health approach with multifactor

impacts, including environmental, cultural and

social factors, all of them subject to continuous

changes due to the dynamic of the current human

development (Petney, 2001), may be grouped

under the title of poverty ecology, indicating a

context where food safety, health infrastructure

and a comprehensive educational proposal must

be considered (Stillwaggon, 2006) preferably

with the most vulnerable human groups, such as

children (Holland et ál., 1988) and women

(Brabin & Brabin, 1992) and where food habits,

the relationship with the wild fauna and the

ecological characteristics of the marine – coastal

ecosystem play a fundamental role in the

transmission of helminthic zoonoses (Cárdenas-

Callirgos, 2012).

INTRODUCTION Based on the aforementioned, the objective of

this study was established, that is, to conduct a

coproparasitological study in part of the port

population of the Fishing Terminal of Chorrillos

dedicated to artisanal fishing and its likely

relationship to marine helminthic zoonoses

transmitted due to the consumption of marine

products, considering the fishing community as

a risk population since their diet, especially on

the high seas, is based on fish, cephalopods and

marine crustaceans (Cárdenas – Callirgos,

2010); thus, it was expected to find helminth

eggs of parasites developed in the

gastrointestinal tract until reaching sexual

maturity and thus ovoposit. Also, possibly in

some larvae or immature stages, helminthes

cannot adhere themselves to the digestive tract

and thus they cannot sexually develop and are

removed with feces. But also, in some other

cases, helminths get to migrate to other organs

and; therefore, it is necessary to diagnose

through serological or surgical methods

(Tantaleán, 1994; Cabrera & Trillo –

Altamirano, 2004; Cárdenas – Callirgos, 2010),

where we shall also consider that in the case of

fish collected in Chorrillos, it was previously

reported several helminthic larvae with zoonotic

potential and that become into risk factor for the

population of the city of Lima who consume

them without the previous cooking (Tantaleán &

Huiza, 1994; Zelada – Castro et al., 2008).

The study zone was the Fishing Terminal of

Chorrillos located in the District of Chorrillos in

Lima, Peru (12°11'33"S 77°0'23"W) , where the

inhabitants dedicated to artisanal fishing, for

several generations now, sell fresh marine

products, providing such products to several

zones of Lima, particularly to the inhabitants of

the neighboring districts. Prior to the collection

of the fecal sample, meetings and talks to raise

awareness were conducted, which were

addressed to the members of José Olaya

Fishermen's Association and to their relatives. In

these meetings, voluntary participants were

registered who signed an Informed Consent

MATERIALS AND METHODS

Neotrop. Helminthol., 7(1), 2013

where they agreed on their participation in the

study. Therefore, we worked with a randomized

and representative population sample (n = 50)

throughout all seasons of 2007. Human

coproparasitological exams were conducted by

using the direct method with saline and Lugol's

solution and two concentration techniques: The

Ritchie's Method and the Spontaneous

S e d i m e n t a t i o n i n Tu b e Te c h n i q u e

(Concentration Technique by Sedimentation

with no Centrifugation) as per the methods

standardized previously (Navone et al., 2005).

The prevalence of parasitic infection was based

on the number of individuals parasitized by the

number of sampled individuals.

No marine origin helminthic zoonoses were

observed in the results given, although the

presence of other parasitic agents, some with a

probable zoonotic origin, confirms fecal

contamination of possible animal and human

origin in water and food. In Table 1, it is

observed how the six species of parasites

reported are equally distributed presenting a

high prevalence especially for those considered

non pathogenic, where the most prevalent

parasite is Endolimax nana (Wenyon &

O´Connor, 1917) reaching 40%, followed by

Entamoeba coli (Grassi, 1879) with 28% and

finally by Iodamoeba butschlii (Prowazek,

1911) with 4% among the protozoan commensal

parasites. In the case of the pathogens, the most

prevalent was Giardia intestinalis (syn. G.

lamblia) (Lambl, 1859) Kofoid & Christiansen,

1915 with 16% prevalence, followed by

helminths named Hymeno l e p i s nana

(Culbertson, 1940) and Ascaris lumbricoides

(Linnaeus, 1758), both with a 4% prevalence,

observing, in conclusion, that the population

studied reaches a global parasitism equal to

68%.

In Table 2, we may observe that helminths are

only parasitizing female population, while in the

three parasites shared by both genders; it was

observed that men present higher prevalence,

although in the total count, women present a

higher prevalence in global parasitism with

respect to men despite of being represented on a

lower degree.

RESULTS

Table 1. Distribution of enteric species according to their pathogenicity in 50 fishermen of the Fishing Terminal of

Chorrillos, Lima, Peru, 2007 (*).

Etiologic Agent Number of Individuals Parasitized Prevalence (%)

Pathogenic Parasites:

Giardia intestinalis

Hymenolepis nana

Ascaris lumbricoides

Non-Pathogenic or Commensal Parasites:

Entamoeba coli

Endolimax nana

Iodamoeba butschlii

Negative 16 32

Total Parasitized Individuals 34 68

(*) Parasites were divided according to their pathogenicity following the naming conventions of the CDC (Center for Disease

Control and Prevention), USA (Alarcón et al, 2010).

157

Table 2. Enteroparasitism in the Fishing Terminal of Chorrillos, Lima, Peru, 2007: Prevalence of enteroparasitosis

according to the type of etiologic agent and gender.

Etiologic Agent

Prevalence in Men (N)

Prevalence in Women (N)

(n = 32) % (n = 18) %

Entamoeba coli

31.25(10)

22.22 (4)

Endolimax nana

43.75 (14)

33.33 (6)

Iodamoeba butschlii

11.11 (2)

Giardia intestinalis

18.75 (6)

11.11 (2)

Hymenolepis nana

11.11 (2)

Ascaris lumbricoides

11.11 (2)

Negative

37.5 (12)

22.22 (4)

Total Parasitized Individuals 62.5 (20) 77.77 (14)

We may observe in the comparison conducted in

Table 3 that the parasitic richness (number of

parasitic species) of the coastal population

assessed in the group of studies mentioned

equals 22 species distributed in 11 protozoa and

11 helminths (without considering the report of

Taenia sp., where the species are not included

and considering the two species of hookworms:

Necator americanus (Stiles, 1902) and

Ancylostoma duodenale (Dubini, 1843) even

though these cannot be distinguished in the

coprological test).

In almost all of the cases (unless for A.

lumbricoides), our study presents the lowest

prevalence compared to that previously

reported. Some parasites have not been reported

in our study, but the works conducted confirm

their presence in the Peruvian coast, such as

protozoan called: Entamoeba histolytica

(Schaudinn, 1903) / E. dispar Brumpt, 1925;

Chilomastix mesnili (Wenyon 1910) Alexieieff,

1912; Pentatrichomonas hominis (syn.

Trichomonas hominis) (Davaine, 1860)

Wenrich, 1931; Enteromonas hominis da

Fonseca, 1915; Cystoisospora belli (syn.

Isospora belli) (Railliet & Lucet, 1891) Wenyon,

1923; Balantidium coli (Malmstein, 1857) and

Blastocystis hominis Brumpt, 1912; as well as

helminths called Hymenolepis diminuta

(Rudolphi, 1819); Diphyllobothrium pacificum

(Nybelin, 1931); Taenia solium Linnaeus, 1758;

Taenia saginata Goeze, 1782; Trichuris

trichiura Linnaeus, 1771; Strongyloides

stercoralis Bavay, 1876 and Enterobius

vermicularis Linnaeus, 1758. These studies

were selected since these included a wide range

of parasitic agents, including normally

protozoan parasites, and since these were

conducted with coastal populations presenting

e n v i r o n m e n t a l a n d s o c i o e c o n o m i c

characteristics similar to the target population in

our study. This is even the only one study

dedicated only to helminthiasis in the District of

Chorrillos, in Lima.

158

Parasitic disease in artisanal fishermen Zelada-Casto et al.

Neotrop. Helminthol., 7(1), 2013

Table 3. Comparative prevalence chart (%) of enteroparasitism in the different human populations of the coastal

zone of Lima, Peru, based on previously published studies (n = number of patients examined).

Etiologic

Current Study

Iannacone & Alvariño (*)

Contreras et al.

Tantaleán & Atencia

Agent

Chorrillos 2007

Ventanilla 1993 IMT - UNMSM 1993

= 72) (**)

= 143) (**)

= 912)

Entamoeba coli

63.63

78.9

Entamoeba histolytica/

9.79

20.9

E. dispar

Endolimax nana

41.25

75.3

Iodamoeba butschlii

12.5

14.3

Chilomastix mesnili

5.59

13.6

Pentatrichomonas hominis

1.3

Enteromonas hominis

0.3

Giardia intestinalis

30.76

30.6

Cystoisospora belli

0.32

Balantidium coli

2.09

Blastocystis hominis

95.9

Hymenolepis nana

37.5

26.57

13.7

Hymenolepis diminuta

8.3

Diphyllobothrium pacificum -

1.3

6.2

Taenia sp.

0.69

Taenia solium

0.32

Taenia saginata

1.3

Ascaris lumbricoides

15.3

2.09

5.59

Ancylostoma/Necator

0.69

Trichuris trichiura

9.7

4.89

6.5

Strongyloides stercoralis

2.79

2.5

Enterobius vermicularis

31.9

2.09

(*) This study only focused on helminthic infection.

(**) These studies are only based on pediatric population.

Finally, Table 4 shows the community structure

of protozoan and metazoan parasites present in

the human population studied where a certain

similarity with one of the few studies conducted

in artisanal fishermen is discerned, that is to say,

the study conducted in the southern coast of

Peru, in Chala, Arequipa, that even though it

presents 4 non-reported species in our study,

both human populations share 4 protozoan

species and 1 helminthic species. Also, it shall be

mentioned that we had a very similar number of

patients

159

Table 4. Comparative prevalence chart (%) of Enteroparasitism in two artisanal fishermen's populations in the coast

of Peru (n = number of patients examined).

Etiologic Agent Current Study Sisniegas et al. (1997)

Chala - Arequipa

(n = 54)

Entamoeba coli 28 54.76

Entamoeba histolytica -

16.66

Endolimax nana 40 26.19

Iodamoeba butschlii 4 16.66

Chilomastix mesnili - 9.52

Trichomonas hominis

9.52

Giardia intestinalis

26.19

Hymenolepis nana

9.52

Diphyllobothrium pacificum

7.4

Ascaris lumbricoides

Total Parasitized Individuals

As it has been previously stated, very few

researches have been conducted on the

prevalence of parasitic diseases in the artisanal

fishermen's communities. In Table 4, details of

the study conducted in Chala, Arequipa are

presented, where the similarity between the

structures of both parasitic communities would

be related since the human population dedicated

to fishing activity is subjected to the same health

conditions despite the distance of both localities.

Thus, the handling of food would be a

determining factor for understanding the

relevance of the parasitic diseases reported

(Villegas et al., 2012). The research focused on

the assessment of the presence of

diphyllobothriasis, a parasite that could not be

found in this study despite the wide distribution

in the Peruvian coastal population that is used to

consuming raw or semi-raw fish, especially as a

daily food for artisanal fishermen. That is a risk

behavior due to the imminent danger it

represents for people who may be infected with

larvae of zoonotic helminths and even more in

the population of Chorrillos, who participated in

this research. Also, no signs of marine origin

zoonotic infection were found. Particularly, no

cestode infections from the Diphyllobothridae

family were present, which was actually found

in a study conducted in a school population of

Chorrillos (Table 3), where the presence of four

helminths not found in this study was reported

and this probably due to the use of different

diagnostic techniques and since pediatric

population is more sensitive to helminthiasis. In

this same work line, a research was conducted in

family groups of the coastal population of

Riñihue Lake in Chile for assessing the possible

impact of the educational work in the seasonal

distribution due to the presence of human

diphyllobothriasis and its presence in fresh

water fish belonging to this lake related to

gender, size and diet of host fish (Torres et al.,

1998). Finally, in other places, such as in Egypt,

one of the few studies published in human

communities dedicated to the fishing activities

was conducted. This study aimed at assessing

the presence of heterophyiasis (related to several

species of zoonotic trematodes) in tilapias

looking for metacercariae encysted in fish,

finding a prevalence of 13.3% of eggs

characteristic of the Heterophyidae group. Also,

a statistically significant positive co-

DISCUSSION

160

Parasitic disease in artisanal fishermen Zelada-Casto et al.

Neotrop. Helminthol., 7(1), 2013

relationship was found between the fishing

activity and heterophyidae in the population

studied (Lobna et al., 2010).

As it may be observed in Table 1, G. intestinalis

presents 16% prevalence and this flagellum,

parasitizing duodenum, jejunum and the top part

of ileum in human beings, is easily transmitted

from person to person, although it may also be a

zoonosis considering as a reservoir a wide range

of domestic and wild mammals (Roberts &

Janovy, 2005), this being mostly reported in

dogs in Lima (Zarate et al., 2003) and of Callao

(Araujo et al., 2004). The presence of this

parasite was inspected based on the possible

relationship between dogs and kids (Pablo et al.,

2012). This pathogenic parasite was followed in

terms of prevalence by H. nana with 4%, the

only one cestode that during its life cycle, the

intermediary host is optional and where

domestic mice and rats may act as reservoirs

(Roberts & Janovy, 2005); also, its prevalence in

Lima is 5.95% and for the Peruvian coast is

9.95% (Cabrera, 2003), which is higher than that

found in this study. Also, this helminth has been

related in Peru to symptoms such as

constipation, hyporexia and abdominal pain,

finding a statistical significance (p<0.05) only

when relating the presence of the parasite to

diarrhea and not with the rest of the mentioned

symptoms (Romaní et al., 2005). A.

lumbricoides is reported with the same

prevalence, which in the Province of Lima is

6.23% and in the Peruvian coast is 6.58%, being

Oxapampa the province with the highest

prevalence (64.32%) and the Low Jungle being

the geographical region with the highest

prevalence (45.30%) as well, calculating a

national prevalence of 14.5% (Cabrera, 2003).

Finally, its transmission is related to the fecal

contamination and environmental pollution due

to dogs that are sensitive to the infection and

where chicken play an important role since they

act as a paratenic host. Similarly, cockroaches

may transport and disseminate eggs (Roberts &

Janovy, 2005). This verme has important

economic implications for human population,

presenting a negative effect in growth and the

use of nutrients in undernourished children is

associated to intestinal obstruction and other

surgical emergencies endangering life and

causing the need of treatment. This generating

the need of an efficient healthcare system and

expenses for the relatives due to the disease

treatment (Stephenson, 1984).

Among the commensals found in Table 1, E.

nana was the most prevalent parasite with 40%.

This ameba lives in the human large intestine,

mainly close to the cecum and feeds on bacteria.

Although it is not pathogenic, its presence

indicates there is the possibility of colonization

of the host by pathogenic parasites (Roberts &

Janovy, 2005); E. coli presents a 28%

prevalence, this non-pathogenic ameba is more

common than E. histolytica due to its greater

capacity of surviving putrefaction and its

presence is an indicator of health level and the

efficacy of water treatment system (Roberts &

Janovy, 2005); finally, I. butschlii may infect the

large intestine (mainly the area of the cecum

where it feeds from intestinal flora of primates

and pigs), being considered a zoonosis (Roberts

& Janovy, 2005). To sum up, it is observed that

although they do not cause diseases to men,

commensal protozoa are good indicators of

fecal-oral contamination from food and water of

the population studied and of the lack of an

adequate personal hygiene. Thus, infections

inform us on the lack of hygiene in the handling

of water and food in the community of fishermen

of the Fishing Terminal of Chorrillos, presenting

a 68% prevalence of global parasitism, placing

ourselves in the scenario of a multi-parasitic

infection in a community composed of 6 species

of parasites, although probably due to the

number of patients examined and due to the

different techniques used, as well as due to the

socio-cultural risk factors affecting the

population and that may be differentiated from

the factors affecting the population examined in

the previous studies used for comparison as it is

shown in Table 3, it is observed that the

composition of parasitic communities in

previous studies indicates a higher number of

populations of parasitic helminths and protozoa;

therefore, we shall consider that several factors

may be influencing the structure of parasitic

161

communities, such as factors related to

individual hosts (age, anatomy, behavior, diet,

genetic basis, immune response, nutritional

condition, predisposition, physiological

condition, gender, size and social conditions), to

host populations (host social group size,

population density of the hosts, predator - prey

interactions, range of host species, sympatry

with other potential hosts and history), to

environmental characteristics (latitude, season

and habitat characteristics), to evolutionary

backgrounds (age of the species, co-evolution,

geographical barriers, key species, phylogeny of

the host and life cycle of parasites) and finally

considering stochastic factors (size of samples

of hosts, parasitic dispersion patterns,

opportunity and source communities). They

altogether influence on the opportunity of

parasites to infect a host individual (Petney &

Andrews, 1998). It has even been shown that

there is a relationship between the pathogenicity

of the infection and the genetic predisposition of

the human population exposed to the infection as

it has been shown in the studies conducted in

Sudan with respect to Schistosoma mansoni

Sambon 1907 (Dessein et al., 1999) and in ,

Nigeria with respect to A. lumbricoides (Holland

et al., 1992).

One of the factors mentioned is gender and as it

was previously mentioned in Table 2, it is

observed that the prevalence of female

parasitism is 77.77%, while in males it only

reaches 62.5%; therefore, we shall analyze the

factors related to differential parasitism between

different sex persons. Thus, a factor may have

subordinated factors conditioning it. In this case

we may consider the differences attributed to the

level of exposition in men and women to

etiologic agents, which are actually both

etiologic and immunological differences, even

when understanding the effects of sex in the

immune response of the host in its relationship

with the chemotherapy efficacy (Brabin &

Brabin, 1992).

If we analyze some factors influencing on the

presence/absence of certain intestinal parasites

and that may be relevant for the study, it shall be

mentioned that in several researches, the

possibility of a relationship between the

epidemiology of certain parasitic diseases and

the social and ecological factors has been

studied, a relationship that influences on the

target population daily life (Bhattacharya et al.,

1981), as in the case of the studies conducted in

some towns of Reunion Island where

environmental life conditions were assessed, as

well as weather conditions such as rainfall and

altitude, and cultural aspects, such as the diverse

daily habits of inhabitants related to a

differential composition of immigrants (Picot &

Benoist, 1975). Similarly, in a research

conducted in Peru, in Concepción, Puerto

Maldonado, Madre de Dios, 136 people were

parasitologically assessed observing the lack of

adequate hygienic standards, the environmental

characteristics of cultivation lands, the degree of

geographic isolation of family and the different

activities inhabitants conduct according to their

age and sex. These characteristics determine the

transmission patterns of helminthiasis reported

(Mc. Daniel et al., 1979). In Argentina, the

influence of some environmental factors on

parasitic infection was studied. This is a case

where variables such as the material of

construction of houses, the characteristics of

floors and the type of water service showed an

statistically significant association with the

presence of intestinal parasites (Basualdo et al.,

2007). In urban ecosystems, the consequences of

a poor health planning additionally to the

formation of slums and the migration

phenomenon from provinces to the capital, that

is to say, from rural areas to urban areas, causes

consequences such as inadequate houses,

unhealthy water, sewage and problems in waste

management, which encourages the

transmission of diverse infectious diseases,

especially in tropical countries where heavy rain

and a poor drainage system, if these actually

exist, contribute to the transmission of parasitic

disease through contaminated water. Therefore,

social inequality causes that poor population

become sensitive to diverse parasitic diseases

(Herbreteau, 2010). In this context, it is

important to determine in parasitological studies

the risk factors contributing to infection through

an adequate methodology (Alarcón et al., 2010)

and the use of ecological analysis tools in

162

Parasitic disease in artisanal fishermen Zelada-Casto et al.

Neotrop. Helminthol., 7(1), 2013

parasitological studies related to public health

(Iannacone et al., 2006).

As a final comment, it shall be mentioned that

control strategies over intestinal parasitic

diseases shall include a joint effort of

chemotherapy, health education, participative

community, basic sanitation, use of shoes and

epidemiological research, with an adequate

program of monitoring and assessment

(Albonico et al., 1999).

The authors would like to thank the financing

sources composed of the 2007 Francisco Tejada

and Semíramis Reátegui Medicine Promotion

Scholarship of Alberto Hurtado School of

Medicine of Cayetano Heredia Peruvian

University and NIH Fogarty International

Training & Research in Environmental &

Occupational Health (ITREOH) Project 2005 of

Emory University in partnership with Cayetano

Heredia Peruvian University. Similarly, we

would like to thank Manuel Tantaleán Vidaurre,

MD and Guillermo Leguía Puente, MD, from

the School of Veterinary Medicine and

Zootechnics of Cayetano Heredia Peruvian

University for their continuous support. Also,

we would like to thank Víctor La Noire, Manuel

Vílchez, Bertha Dioses, Melinna Raffael,

Paloma Alcázar, Mario Verano, Nancy Carlos,

Charlene Lujan, Bruno Ibañez, Nelly Mostajo

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Authors for Correspondence / Autor para

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Jorge Cárdenas - Callirgos

Invertebrate Laboratory. Museum of Natural

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Peru.

E-mail/ correo electrónico:

jmcardenasc@gmail.com

165

Hugo Flores-Liñán

Alberto Cazorla Talleri School of Sciences and

Philosophy. Cayetano Heredia Peruvian

University. Av. Honorio Delgado 430, Urb.

Ingeniería, S.M.P. Lima -Perú.

E-mail/ correo electrónico:

hugo.flores@upch.pe

166

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