P3.H149: Delusional Parasitosis? Perceptions of Parasitic Infections Among Ecuadorian Citizens: Insights from an Online Survey

Background: Intestinal parasitic infections (IPIs) are among the most prevalent diseases in the world, affecting an estimated two billion people, predominantly in tropical and subtropical regions. In Ecuador, a significant portion of both rural and urban-marginal populations is impacted, with about 80% and 40% affected respectively. The predominant parasites include soil-transmitted helminths (STH) like Ascaris lumbricoides and Trichuris trichiura, as well as gastrointestinal protists (GP) such as Giardia duodenalis and various Entamoeba species. Although parents of preschool-aged children usually have some knowledge about worm infections, certain cultural beliefs may interfere with effective prevention. This study aims to analyze citizens' perceptions of IPIs and to describe sanitary habits concerning parasitosis.

Methods: We designed an online survey to assess the perceptions of parasitic infections among the Ecuadorian population. The survey was distributed on April 1, 2024, targeting a broad demographic spectrum. Out of approximately 2000 individuals contacted, we received 279 valid responses. Respondents were diverse in age, sex, and education level. We specifically inquired about respondents' familial status, whether their children had ever experienced a parasitic infection, and their practices regarding the treatment of such infections. Furthermore, the survey explored how often participants believed screening and treatment for parasites should occur and asked for their perspectives on what signs and symptoms might suggest a parasitic infection.

Results: Of our 279 person sample, 181 (65%) people were female. The median age was 28 (IQR 23.75), and the majority (79%) had an undergraduate education. 121 (43%) individuals were parents, and from this group 57 (47%) had a child diagnosed with a parasitic infection, most of them treated with anthelmintics (95%). When asked about the frequency of prophylactic treatment to a child, 55% of the sample thought that it should be a minimum of once a year, 28% once every six months, 16% chose only when symptoms appear, and 1% selected “never”. The last question regarded common signs and symptoms that would point out that a child is infected with a parasite. The most common responses were perianal itching and nausea/vomiting, with 61% and 59% respectively. Other interesting responses were craving for junk food (21%), dysuria (11%), and loss of speech (4%).

Conclusion: Many participants incorrectly believed that prophylactic treatment for parasites should be administered regularly, a practice that is not medically recommended. Misconceptions such as the association of parasitic infections with symptoms like craving for junk food and dysuria, which are not recognized as related symptoms in medical literature, were evident. Thus, parasitic infections function as a scapegoat being held responsible for symptoms that are not commonly associated with them. These findings highlight the need for targeted educational interventions that can accurately inform the public about the symptoms of parasitic infections and treatments.