The Fire Under the Ash: Parasitic infections as potential risk factors for Attention Deficit Hyperactivity Disorder (ADHD) in children

Abstract

<title>Abstract</title> Attention deficit hyperactivity disorder (ADHD) represents a mysterious neuropsychiatric alarming concern due to indefinite etiopathogenesis among children. Notably, the studies which investigated the correlation between ADHD and parasitic infections are insufficient. Therefore, this research aimed to assess the correlation between ADHD and some tissue dwelling and intestinal parasitic infections in children. The study was conducted on 200 children, including 100 children suffering from ADHD (Group I) and 100 healthy children as a control group (Group II). All caregivers fulfilled predesigned sociodemographic form and Conners parent rating scale (CPRS-48) questionnaire. Blood samples were collected to determine hemoglobin level as well as relative eosinophilic count. The presence of anti-<italic>Toxoplasma</italic> IgG and anti-<italic>Toxocara</italic> IgG in serum by Enzyme-Linked Immunosorbent Assay (ELISA) was further investigated. Also, micronutrients as zinc, iron, and copper levels were measured.<italic> Schistosoma</italic> antigen was investigated in urine samples. Stool samples were subjected to direct wet smear, concentration technique and modified Ziehl-Neelsen (MZN) staining for coccidian parasites detection.<italic> Cryptosporidium parvum, Giardia lamblia </italic>and<italic> Entamoeba histolytica </italic>antigens were investigated in stool samples. Group I expressed more liability to sociodemographic risk factors, decreased levels of Hb, iron, zinc, and copper with statistically significant difference (<italic>P</italic> &lt; 0.001). Comparison between Group I and Group II regarding the detected parasitic infections exhibited statistically significant difference except<italic> Schistosoma</italic> antigen positivity which expressed no statistical significance.<bold> </bold>The present study concluded that the parasitic infections with their consequences are potential risk factors in children with ADHD indicating that their early diagnosis and treatment may help in ADHD prevention.