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Background: The prevalence of multi-infections with helminthes, protozoans and Campylobacter spp. in Guatemalan children is a reflection of differences in the risk factors related to pathogen transmission., Methodology: Two hundred and eighty-nine fecal samples were collected from children of the Guatemalan highlands and patterns of pathogen occurrences were evaluated using an immunoassay for Campylobacter spp., a formalin-ether concentration followed by observation of unstained slides for helminthes and trichome stains of fecal smears for protozoans. Specimens were examined microscopically using 100, 400 and 1000x magnification., Results: Prevalence of Ascaris lumbricoides, Campylobacter spp., Giardia duodenalis, Entamoeba histolytica/E. dispar and Trichuris trichiura were 55.1%, 30.8%, 21.5%, 19.8% and 19.4%, respectively. Overall, the prevalence of at least one intestinal pathogen was 85.5%. Multi-infections were found in 43% of the children harboring pathogens., Conclusions: Infections with Campylobacter spp., E. histolytica/E. dispar, T. trichiura and G. duodenalis were closely associated with the presence of co-infection with A. lumbricoides. T. trichiura infection was related to co-infection with A. lumbricoides and Campylobacter spp. Infections with G. duodenalis and T. trichiura were related to co-infections with either Campylobacter spp. or E. histolytica/E. dispar. The prevalence of multi-gastrointestinal infections with helminthes, protozoans and Campylobacter spp. in children was found to be related to age and gender.

A survey was performed to determine if infection with gastrointestinal parasites differs between the rural and urban poor inhabitants of Guatemala. A total of 317 stool samples from children in two towns, one rural and one urban, were examined using the formalin-ether concentration method. The overall prevalence of parasites in infected children was 67%, 20%, 30%, and 22%, respectively for Ascaris lumbricoides, Trichuris trichiura, Giardia duodenalis and Entamoeba histolytica in the rural town of La Mano de Leon and 49%, 14%, 15%, and 21%, respectively in the urban town of Santa Maria de Jesus. Two sub-studies were carried out to determine the effects of (1) gender and (2) age on the rate of parasitic infections. Female children in the 1-to 6-year-olds age group in Santa Maria de Jesus had more infections with A. lumbricoides and T. trichiura when compared to La Mano de Leon. A. lumbricoides was most prevalent in Santa Maria de Jesus. These results propose that accessibility to tourism and trade decreases the risk for the establishment of parasitic diseases in children of Guatemala possibly due to improvements in basic nutrition and availability of health care.

Cryptosporidium parvum is an endemic, zoonotic coccidian parasitosis that is highly prevalent in third-world countries where waterborne fecal contamination of food and drink or person-to-person contact with oocysts are the most common methods of transmission of the enteric protozoan. This type of transmission of the parasite made the villages around Lake Atitlan, Guatemala a unique site to compare environmental risk factors with the level of Cryptosporidium infections in the local residents. The study was carried out in two villages, San Antonio Palopo and Santa Catarina Palopo, located in the highlands above the shores of the lake. Smears from stool specimens of patients with gastroenteritis were processed using Kinyoun's modified acid-fast stain and observed with light microscopy. Of the 100 residents examined from the two villages, 32% had Cryptosporidium infections. Female children had the highest prevalence of infection (44% in San Antonio Palopo and 46% in Santa Catarina Palopo, p<0.05), and they also had significantly higher infection rates than males, 50% vs. 17%, respectively. The prevalence rate was not influenced by the season of the year or by the location of the residents. We found differences in prevalence rates due to age and gender, and we suggest that the high infection rates of specific groups are associated with their exposure to the contaminated water supply from Lake Atitlan.