The Pediatric Infectious Disease Journal  •  Volume 34, Number 2, February 2015

by Ascaris lumbricoides (3.7%) and Entamoeba histolytica/dispar (3.7%). Prevalence of infection by Hymenolepis nana was significantly higher in children younger than 5, whereas prevalence of infection by Taenia spp., Trichuris trichura, A. lumbricoides, E. histolytica/dispar, and hookworms was significantly lower in the young children. Multiple parasitic infections were less common in children younger than 5 (2.8%) than in children between 5 and 14 years of age (4.3%) (P < 0.001). Our findings indicate that the prevalence of intestinal parasites in children younger than 5 was higher than that found in other studies.1 Differences in prevalence might be due to differences in hygiene practices, water supplies, latrine coverage, economic and educational status, and climatic conditions. G. intestinalis was the main intestinal parasitic infection, as demonstrated in other studies.2–4 Multiple intervention strategies could reduce the morbidity of acute diarrhea in young children such as health education, access to a safe water supply and improvement in hygiene.

ACKNOWLEDGMENTS We would like to acknowledge the staff of Gambo Rural Hospital for their cooperation during this study. I.A. was supported by a grant from SEMTSI (Sociedad Española de Medicina Tropical y Salud Internacional), Spain.

Iñaki Alegria, MD

Gambo Rural General Hospital Kore West-Arsi, Ethiopia Department of Pediatrics Hospital General Granollers Barcelona, Spain

Jose M. Ramos, MD, DTM&H1, PhD Gambo Rural General Hospital Kore West-Arsi, Ethiopia Department of Internal Medicine Hospital General Universitario de Alicante Department of Medicine Universidad Miguel Hernández San Juan Campus Alicante, Spain

© 2015 Wolters Kluwer Health

Gabriel Tisiano, BHSc Tafese Yohannes, BHSc Ashenafi Gosa, BHSc Francisco Reyes, MD, DTM&H1

Gambo Rural General Hospital Kore West-Arsi, Ethiopia REFERENCES

1. Abossie A, Seid M. Assessment of the prevalence of intestinal parasitosis and associated risk factors among primary school children in Chencha town, Southern Ethiopia. BMC Public Health. 2014;14:166. 2. Sire JM, Garin B, Chartier L, et al. Communityacquired infectious diarrhoea in children under 5 years of age in Dakar, Senegal. Paediatr Int Child Health. 2013;33:139–144. 3. Mustafa A, Makki A, Siddig O, et al. Baseline burden of rotavirus disease in Sudan to monitor the impact of vaccination. Pediatr Infect Dis J. 2014;33(suppl 1):S23–S27. 4. Abebe A, Teka T, Kassa, et al. Hospital-based surveillance for rotavirus gastroenteritis in children younger than 5 years of age in Ethiopia: 2007–2012. Pediatr Infect Dis J. 2014;33 (suppl 1):S28–S33.

Cesarean Section and Hospitalization for Respiratory Syncytial Virus Infection To the Editors: ristensen et al1 report an association of risk for and duration of hospitalization for


This investigator-driven study was funded by Abbott. The funder had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. No honorarium, grant or other form of payment was given to anyone to produce the manuscript. Netherlands Organization for Health Research and Development (ZonMw), NWO-AGIKO grant 920-03589 (M.O. Blanken). Dr. Bont has received fees for lectures and advisory activities from Abbott International; the other authors indicated they have no financial relationships relevant to this article to disclose. Copyright © 2015 by Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0891-3668/15/3402-0227 DOI: 10.1097/INF.0000000000000612


respiratory syncytial virus (RSV) with birth by cesarean section (CS). We respond to their call for confirmation of this observation by reporting related findings from the ongoing RISK-study, a multicenter prospective birth cohort study investigating risk factors for RSV hospitalization (RSV-H) in late preterms (33–35 weeks gestational age).2 Data of 3328 children were analyzed, including 153 children with RSV-H during the first year. Incidence of CS was 35.3% versus 35.1% among the cases and controls, respectively. Multivariate analysis was performed using similar control variables as Kristensen et al (birth weight, multiple birth, siblings, maternal smoking, birth week and sex), as well as using univariately significant trends (siblings, multiple birth, birth week, family atopy, planned day-care attendance and household of >5 persons). Multiple linear regression after logarithmic transformation was used to investigate CS and length of stay for RSV-H among the cases. Consistently by all analyses, CS was not associated with either risk for RSV-H or length of stay for RSV-H. Kristensen and colleagues have used a population-based national register–based cohort study. Although the prospective birth cohort design of the RISKstudy is different, we were unable to replicate the association of CS with risk for and duration of RSV-H in otherwise healthy late preterms.

Niek B. Achten, BSc Koos Korsten, BSc Maarten O. Blanken, MD, MSc Elisabeth E. Nibbelke, MSc Louis Bont, MD, PhD










Department of Pediatric Immunology and Infectious Diseases University Medical Center Utrecht Utrecht, The Netherlands REFERENCES 1. Kristensen K, Fisker N, Haerskjold A, et al. Caesarean section and hospitalization for respiratory syncytial virus infection: a population based study. Pediatr Infect Dis J. 2014;34: 145–148. 2. Blanken MO, Koffijberg H, Nibbelke EE, et al.; Dutch RSV Neonatal Network. Prospective validation of a prognostic model for respiratory syncytial virus bronchiolitis in late preterm infants: a multicenter birth cohort study. PLoS One. 2013;8:e59161. | 227



Cesarean section and hospitalization for respiratory syncytial virus infection.

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