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Case report We describe the finding of eggs of this parasite in an asymptomatic 3-year-old child. The child had extremely high IgE values of 1,376 IU/ml. After receiving treatment with Albendazole suspension 400mg/20mL, on the 10th day post-treatment, he showed no H. diminuta eggs in his fecal matter Conclusions Detailed morphological review of Hymenolepis nana-like eggs is recommended to distinguish them from H. diminuta eggs. 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F1000Research 2025, 13 :1119 ( https://doi.org/10.12688/f1000research.155856.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Case Report Revised Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] Zulbey Rivero de Rodriguez 1 , Ader Ponce https://orcid.org/0009-0006-6091-1641 2 , Anthony Vera 2 , Angela Bracho https://orcid.org/0000-0001-5749-9568 1 , Anita Murillo 3 Zulbey Rivero de Rodriguez 1 , Ader Ponce https://orcid.org/0009-0006-6091-1641 2 , [...] Anthony Vera 2 , Angela Bracho https://orcid.org/0000-0001-5749-9568 1 , Anita Murillo 3 PUBLISHED 20 Feb 2025 Author details Author details 1 Biological sciences, Universidad Tecnica de Manabi Facultad de Ciencias de la Salud, Portoviejo, Manabí Province, 130105, Ecuador 2 Laboratory, Vital&Med Clinical Laboratory, Guayaquil, Guayas, Ecuador 3 Laboratorio Clínico, Universidad Estatal del Sur de Manabi Unidad Academica de Ciencias de la Salud, Jipijapa, Manabí Province, Ecuador Zulbey Rivero de Rodriguez Roles: Conceptualization, Investigation, Writing – Original Draft Preparation Ader Ponce Roles: Investigation Anthony Vera Roles: Investigation Angela Bracho Roles: Writing – Review & Editing Anita Murillo Roles: Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Pathogens gateway. Abstract Background The cestode Hymenolepis diminuta is a cosmopolitan parasite, which in the adult stage is usually found in the small intestine of rats and accidentally in humans. Case report We describe the finding of eggs of this parasite in an asymptomatic 3-year-old child. The child had extremely high IgE values of 1,376 IU/ml. After receiving treatment with Albendazole suspension 400mg/20mL, on the 10th day post-treatment, he showed no H. diminuta eggs in his fecal matter Conclusions Detailed morphological review of Hymenolepis nana -like eggs is recommended to distinguish them from H. diminuta eggs. READ ALL READ LESS Keywords Hymenolepis diminuta, asymptomatic condition, Child, Preschool, Ecuador Corresponding Author(s) Zulbey Rivero de Rodriguez ( [email protected] ) Close Corresponding author: Zulbey Rivero de Rodriguez Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2025 Rivero de Rodriguez Z et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Rivero de Rodriguez Z, Ponce A, Vera A et al. Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.12688/f1000research.155856.3 ) First published: 03 Oct 2024, 13 :1119 ( https://doi.org/10.12688/f1000research.155856.1 ) Latest published: 20 Feb 2025, 13 :1119 ( https://doi.org/10.12688/f1000research.155856.3 ) Revised Amendments from Version 2 Only a few minor editorial corrections suggested by a referee were made. Only a few minor editorial corrections suggested by a referee were made. See the authors' detailed response to the review by Amal Sm Sayed See the authors' detailed response to the review by Yukifumi Nawa See the authors' detailed response to the review by Adriana Esteves READ REVIEWER RESPONSES Introduction The cestode Hymenolepis diminuta (Rudolphi 1819, Weinland 1858) is a cosmopolitan parasite, which in the adult stage is usually found in the small intestine of rats and accidentally in humans. Its biological cycle develops with the intervention of an arthropod, which becomes infected by ingesting the eggs of H. diminuta , which are found in the feces of parasitized rats. 1 The mechanism of infection begins when coprophilic arthropods ingest the eggs of H. diminuta which are eliminated in rodent feces and act as obligate intermediate hosts of the cestode. When humans accidentally ingest these infected arthropods, the cysticercoids in the insect’s hemocele develop into adults in the human’s small intestine, where eggs are then produced and expelled in defecation. Human infection through direct ingestion of H. diminuta eggs has not been reported. 2 Several coprophilous arthropods such as fleas, weevils, lepidoptera and beetles have been described as intermediate hosts, 3 as well as different species of beetles of the genera Tribolium and Tenebrio. 4 Experimentally, it has been shown that 90 species of arthropods can serve as intermediate hosts. 5 Although, Joyeux 6 pointed to Tenebrio molitor, Ceratophyllus fasciatus and Xenopsylla cheopis as the usual sources of rat infestation, the beetles of the genus Tribolium are those indicated by the scientific literature, as the most frequent in rats and human infections. The adult cestode of H. diminuta is 20 to 60 cm long, its scolex is rounded and small with four cup-shaped suckers, it has a rostellum without hooks, which is invaginated in a cavity located in the most apical portion of the scolex. The strobilar chain contains three characteristic portions of proglottids: immature, mature, and gravid; The latter, when detached from the strobilus, disintegrates and releases the eggs that are eliminated along with the feces. 7 The eggs are round, yellow, 60 to 80 microns, with a thick outer membrane and a small oncosphere inside, with three pairs of hooks and no polar filaments. 8 Clinically, as in Hymenolepis nana infection, parasitosis can be asymptomatic. In infections with a high parasite load, the most frequent symptoms of H. diminuta hymenolepiasis are digestive, with abdominal pain and diarrhea prevailing; irritability and anal itching may also occur 2 , 3 , 9 and in some cases patients with skin conditions have presented. 10 , 11 It is an uncommon infection in humans; however, the prevalence is high in some places: 7.8% in schoolchildren between 6 and 15 years of age in Magdalena in Cajamarca 12 and 7.1% in the population of Tingo María in Huánuco in Peru. 13 It can be deduced that food, stored in contact with rats and beetles, when consumed constitutes the means of infection, through ingestion of infected beetles. Few cases are reported in adults in the literature 3 and most cases have been described in children, 2 , 9 – 11 , 14 – 17 probably due to ingesting the infected arthropods, without paying attention. However, a 2020 review of H. diminuta 18 states that, out of 130 infections in humans, the age of the infected individuals was: 2.3% infants (≤1 year old), 66.2% children (2 to 9 years), 20% adolescents (10 to 19 years old), and 11.5% were adults (≥ 20 years old). Regarding geographical location, the review by Panti-May et al. 18 reports that human infections with H. diminuta were reported in 80 countries around the world from 1810 to 2018. Most cases were reported in the Americas (n = 815), Southeast Asia (n = 226) and Eastern Mediterranean (n = 210). Three countries exhibited more than 100 records: Costa Rica (n = 320), the United States of America (n = 181), and Brazil (n = 140). In Ecuador, the presence of Hymenolepis spp. has been described 19 in stray dogs on the coastal beaches of Ecuador, Hymenolepis nana and diminuta have also been reported in rodents ( Rattus norvegicus and Rattus rattus ) from the city of Milagro. 20 Only one case has previously been reported of this species in a two-year-old Ecuadorian girl, however, the finding was made in Spain 11 ; This case describes that in 2003 it arrived in that continent and in the first half of 2004 it presented gastrointestinal symptoms, detecting the parasite in feces. In 2007, research by Jacobsen et al. 21 indicated a 1% prevalence of H. diminuta when evaluating 203 samples from children between 12 and 60 months of age; however, no reference was made to clinical or sociodemographic data of the infected children. Since then, no other case of infection in humans has been described in the country, so the case of an asymptomatic child from Portoviejo, Ecuador, is presented. Case report In February 2024, the stool sample of a 3-year-old child was received at the Parasitology laboratory of the Technical University of Manabí. On macroscopic examination, the sample showed a soft, greenish-brown consistency, without mucus, pus, or blood; There are also no obvious food residues. Microscopic examination with physiological saline, showed eggs morphologically compatible with eggs of Hymenolepis diminuta ( Figure 1A,B ). These had their characteristic brown color, large size and absence of polar filaments. They were measured with a micrometer scale, where 4 of them measured 60 microns and 1 measured 70 microns in diameter. In addition to the coproparasitological examination, the Ritchie-Frick concentrate 22 was performed, where no other intestinal parasites were observed, only the eggs of H. diminuta . Figure 1. (A) H. diminuta eggs at 100 × magnification, physiological saline; (B) Eggs of H. diminuta at 400 × magnification, physiological saline. When the father is consulted, he indicates that the child did not have gastrointestinal symptoms and that the stool test was carried out as part of the annual health evaluation that he performs. When reviewing the rest of the tests performed, it was observed in the hematology: Leukocyte count within the reference values: 7.15×102/μl (5.0 to 10.00), but with a decrease in neutrophils: 1.59×102/μl (2.10 to 8.90), an increase in lymphocytes: 4.64×102/μl (1.30 to 4.60) and a slight increase in eosinophils: 5.2% (0.0 to 4.0). Hemoglobin 12.5 g/dl (10.5 to 13.5 g/dl), Hematocrit: 36.0% (32.0 to 40.0%). The results show that, although C-reactive protein was within the reference values: 0.33 mg/L (0.00 to 5.00 mg/L), there was a significant increase in the value of Immunoglobulin E (IgE): 1.376 IU/ml (0.0 to 60.0 IU/ml). To assess the child’s living conditions, his home was visited. The house is in a peri-urban community of the city of Portoviejo (Colón parish). Although Colón is considered an urban parish, the house is in a wooded area of the parish, and in the back has an abundance of intricate trees. In general terms, the house is neat and has the basic services of water, electricity, and septic tank, for the disposal of excreta. There is a chance of rats and mice in the back wooded area, which is ideal for synanthropic animals. During the visit, the presence of beetles (genus Hexodon ) is observed and since there are dogs, the presence of fleas, which have been described as intermediate hosts of H. diminuta , cannot be ruled out. The child received anthelmintic treatment with Albendazole suspension 400 mg/20 mL, 2 bottles, one per day. On the 4th day after treatment, a post-treatment stool examination was performed and eggs were still observed, which were quite altered in their morphology and difficult to identify. Subsequently, 10 days after the end of treatment, the stool examination showed no evolutionary forms of parasites. Discussion Hymenolepis diminuta infection is a cosmopolitan zoonosis that is mainly rural and infrequent in humans. As of 2020, 1,561 published records of H. diminuta infection had been identified in 80 countries 18 ; mainly reported in children. 2 , 9 – 11 , 14 – 17 Although, the child in this case, did not present clinical manifestations and most of his laboratory tests were within the reference ranges, the high IgE value found is remarkable. The child did not suffer from allergies, so this situation was ruled out as the cause of the increase. Helminth infections have been mainly related to blood eosinophilia 23 – 25 and a similar situation has only been reported in terms of increased IgE in a child with H. diminuta in Italy 10 who presented atypical allergic manifestations. 11 In this research, it is pointed out that the infected 2-year-old child presented remitting fever (maximum peak 37.7 °C), abdominal pain, diffuse skin itching, transient chest rash and arthromyalgia and in the same context, the case of the Ecuadorian girl in Spain is presented, who manifested atopic dermatitis, self-limited diarrhea, vomiting and constipation, unlike the current case, there were no allergic manifestations or any symptoms, only the elevation of IgE. Unfortunately, in this case, no information was obtained on the post-treatment IgE values, to evaluate their direct relationship with parasitosis. Allergic symptoms are often present in chronic helminth infections, caused by a constant state of immune activation characterized by a dominant type of Th2 cytokine profiles and high IgE levels. 26 , 27 However, eosinophilia is not usually seen in helminth infections that reside in the lumen of the human intestine, as is the case with H. diminuta. However, helminth infections can affect the expression of an allergic disease and, in certain situations, may be associated with a higher, lower, or no risk of atopic conditions. 28 , 29 Another important point to highlight is the anthelmintic treatment applied, since the literature reports that the first choice anthelmintics are praziquantel and niclosamide, 3 therefore, it has been the treatment of choice in several studies. 9 – 11 , 14 – 17 However, in this case, albendazole was indicated, a treatment also applied in a case reported by Rivero et al. 2 in Venezuela, demonstrating effectiveness in the treatment of parasitosis, as no eggs were observed in successive samples. It is known that first-choice drugs are given in single doses, however, Tena et al. 14 indicated in their study to repeat the dose three times, even increased, until the parasite was eliminated, so albendazole can be considered as an alternative treatment. Conclusions It is feasible to find H. diminuta infection in Ecuadorian children, although in an infrequent way, so the microscopist should be alert to the finding of eggs like those of Hymenolepis nana , but larger and dark brown in fresh preparations. Likewise, medical personnel should not rule out the possibility of this parasitic species in children, mainly under five years of age; even in children without clinical manifestations. The report of this case, aims to alert health personnel about the possibility of finding this cestode in Ecuadorian children, and contribute to the epidemiology of intestinal parasitosis in the country. Ethics and consent Written informed consent for publication of their clinical details and/or clinical images was obtained from the parent relative of the patient. Written informed consent has been obtained from the father of the patient to publish this paper. Informed assent could not be obtained, because the child was too young (3 years old). Data availability No data is associated with this article. Acknowledgements To the Ponce Bazurto family for their collaboration in providing all the necessary information about the case. References 1. Roberts JJ, Schmidt G, Larry S: Roberts’Foundations of Parasitology. 8th ed.McGraw-Hill; 2009; 701. 2. Rivero ZC, Villalobos R, Bracho A, et al. : Infección por Hymenolepis diminuta en un niño del municipio Maracaibo, estado Zulia, Venezuela. Rev. Soc. Venez. Microbiol. 2009; 29 : 133–135. 3. Martínez-Barbabosa I, Gutiérrez-Cárdenas M, Aguilar-Venegas J, et al. : Infección por Hymenolepis diminuta en una estudiante universitaria. Rev. Biomed. 2012; 23 : 61–64. 4. Shostak A: Hymenolepis diminuta infections in tenebrionid beetles as a model system for ecological interactions between helminth parasites and terrestrial intermediate hosts: A review and meta-analysis. J. Parasitol. 2014; 100 (1): 46–58. PubMed Abstract | Publisher Full Text 5. 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PubMed Abstract | Publisher Full Text | Free Full Text 16. Rohela M, Ngui R, Lim YA, et al. : case report of Hymenolepis diminuta infection in a Malaysian child. Trop. Biomed. 2012; 29 (2): 224–230. PubMed Abstract 17. Sinhabahu VP, Perera TM, Samarasinghe S, et al. : A case of Hymenolepis diminuta (rat tape worm) infestation in a child. Ceylon Med. J. 2014; 59 (2): 70–71. PubMed Abstract | Publisher Full Text 18. Panti-May JA, Rodríguez-Vivas RI, García-Prieto L, et al. : Worldwide overview of human infections with Hymenolepis diminuta. Parasitol. Res. 2020; 119 (7): 1997–2004. PubMed Abstract | Publisher Full Text 19. Calvopina M, Cabezas-Moreno M, Cisneros-Vasquez E, et al. : Diversity and prevalence of gastrointestinal helminths of free-roaming dogs on coastal beaches in Ecuador: Potential for zoonotic transmission. Vet. Parasitol. Reg. Stud. Reports. 2023; 40 : 100859. PubMed Abstract | Publisher Full Text 20. Coello-Peralta R, Martínez-Cepeda G, Pinela-Castro D, et al. : Presencia de Hymenolepis nana y diminuta en roedores de la ciudadela las Piñas, Milagro-Ecuador y su riesgo en salud pública. Rev. Mex. Cienc. Pecu. 2020; 11 (4): 961–970. Publisher Full Text 21. Jacobsen K, Ribeiro P, Quist B, et al. : Prevalence of Intestinal Parasites in Young Quichua Children in the Highlands of Rural Ecuador. J. Health Popul. Nutr. 2007; 25 (4): 339–405. 22. Giraldo J, Guatibonza A: Comparación De Sensibilidad Y Especificidad De Dos Técnicas De Diagnóstico Directo: Kato–Katz-Saf Y Ritchie–Frick (Formol-Gasolina) En Examen Coproparasitológico Para La Identificación De Estadios Infectivos De Geohelmintos En Población Infantil. Rev. Fac. Med. 2017; 25 (2): 22–41. PubMed Abstract | Publisher Full Text 23. Steer M, Preston S, Piedrafita D, et al. : The Immune Response to Nematode Infection. Int. J. Mol. Sci. 2023; 24 (3): 2283. PubMed Abstract | Publisher Full Text | Free Full Text 24. Carranza-Rodríguez C, Escamilla-González M, Fuentes-Corripio I, et al. : Helmintosis y eosinofilia en España (1990-2015). Enf. Infecciosas Microbiol. Clín. 2018; 36 (2): 120–136. PubMed Abstract | Publisher Full Text 25. Murillo-Zavala A, Molina-Solorzano A, Peñafiel-Álvarez D: Helmintiasis intestinal, eosinofilia e inmunomodulación parasitaria. Kasmera. 2022; 50 : e5034307. Publisher Full Text 26. Robinson TM, Nelson RG, Boyer JD: Parasitic infection and the polarized Th2 immune response can alter a vaccine-induced immune response. DNA Cell Biol. 2003; 22 : 421–430. PubMed Abstract | Publisher Full Text 27. Palmer LJ, Celedon JC, Weiss ST, et al. : Ascaris lumbricoides is associated with increased risk of childhood asthma and atopy in rural China. Am. J. Respir. Crit. Care Med. 2002; 165 : 1489–1493. PubMed Abstract | Publisher Full Text 28. Cooper PJ, Chico ME, Bland M, et al. : Alllergic symptoms, atopy, and geohelminth infections in a rural area of Ecuador. Am. J. Respir. Crit. 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PubMed Abstract Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 03 Oct 2024 ADD YOUR COMMENT Comment Author details Author details 1 Biological sciences, Universidad Tecnica de Manabi Facultad de Ciencias de la Salud, Portoviejo, Manabí Province, 130105, Ecuador 2 Laboratory, Vital&Med Clinical Laboratory, Guayaquil, Guayas, Ecuador 3 Laboratorio Clínico, Universidad Estatal del Sur de Manabi Unidad Academica de Ciencias de la Salud, Jipijapa, Manabí Province, Ecuador Zulbey Rivero de Rodriguez Roles: Conceptualization, Investigation, Writing – Original Draft Preparation Ader Ponce Roles: Investigation Anthony Vera Roles: Investigation Angela Bracho Roles: Writing – Review & Editing Anita Murillo Roles: Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (3) version 3 Revised Published: 20 Feb 2025, 13:1119 https://doi.org/10.12688/f1000research.155856.3 version 2 Revised Published: 18 Nov 2024, 13:1119 https://doi.org/10.12688/f1000research.155856.2 version 1 Published: 03 Oct 2024, 13:1119 https://doi.org/10.12688/f1000research.155856.1 Copyright © 2025 Rivero de Rodriguez Z et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Rivero de Rodriguez Z, Ponce A, Vera A et al. Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.12688/f1000research.155856.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 18 Nov 2024 Revised Views 0 Cite How to cite this report: Sayed AS. Reviewer Report For: Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.5256/f1000research.174667.r361809 ) The direct URL for this report is: https://f1000research.com/articles/13-1119/v2#referee-response-361809 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 12 Feb 2025 Amal Sm Sayed , Head of Zoonoses Department, Assiut University, Asyut, Assiut Governorate, Egypt Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.174667.r361809 The article is highlights the importance of H.diminuta infection in human and health implications. They provided background on H.diminuta . infection and their epidemiology are sufficient. The case study was well-written and the figures support the results mentioned by the authors. ... Continue reading READ ALL The article is highlights the importance of H.diminuta infection in human and health implications. They provided background on H.diminuta . infection and their epidemiology are sufficient. The case study was well-written and the figures support the results mentioned by the authors. However, some corrections still should be made to improve the article. The correction are provided in the PDF file: https://f1000research.s3.amazonaws.com/linked/708089.h_rev..pdf Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the case presented with sufficient detail to be useful for other practitioners? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Zoonoses, Microbiology, Infectious diseases I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Sayed AS. Reviewer Report For: Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.5256/f1000research.174667.r361809 ) The direct URL for this report is: https://f1000research.com/articles/13-1119/v2#referee-response-361809 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 20 Feb 2025 Zulbey Rivero de Rodriguez , Biological Sciences, Universidad Tecnica de Manabi, Portoviejo, Ecuador 20 Feb 2025 Author Response Greetings, I will proceed to make the text corrections that were suggested. Competing Interests: No competing interests were disclosed. Greetings, I will proceed to make the text corrections that were suggested. Greetings, I will proceed to make the text corrections that were suggested. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 20 Feb 2025 Zulbey Rivero de Rodriguez , Biological Sciences, Universidad Tecnica de Manabi, Portoviejo, Ecuador 20 Feb 2025 Author Response Greetings, I will proceed to make the text corrections that were suggested. Competing Interests: No competing interests were disclosed. Greetings, I will proceed to make the text corrections that were suggested. Greetings, I will proceed to make the text corrections that were suggested. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Esteves A. Reviewer Report For: Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.5256/f1000research.174667.r341287 ) The direct URL for this report is: https://f1000research.com/articles/13-1119/v2#referee-response-341287 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 22 Nov 2024 Adriana Esteves , University of the Republic Uruguay, Montevideo, Montevideo Department, Uruguay Approved VIEWS 0 https://doi.org/10.5256/f1000research.174667.r341287 I have ... Continue reading READ ALL I have no further comments. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Molecular parasitology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Esteves A. Reviewer Report For: Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.5256/f1000research.174667.r341287 ) The direct URL for this report is: https://f1000research.com/articles/13-1119/v2#referee-response-341287 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 03 Oct 2024 Views 0 Cite How to cite this report: Esteves A. Reviewer Report For: Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.5256/f1000research.171080.r331924 ) The direct URL for this report is: https://f1000research.com/articles/13-1119/v1#referee-response-331924 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 04 Nov 2024 Adriana Esteves , University of the Republic Uruguay, Montevideo, Montevideo Department, Uruguay Approved VIEWS 0 https://doi.org/10.5256/f1000research.171080.r331924 The Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child from Rivero and coworkers is very interesting in that it shows an atypical case of a parasitosis in a patient. The data provided in the introduction is correct and ... Continue reading READ ALL The Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child from Rivero and coworkers is very interesting in that it shows an atypical case of a parasitosis in a patient. The data provided in the introduction is correct and very appropriate. Recommendations to the authors: Explain the meaning of “direct ingestion of eggs” I understand that its different from accidentally, but it is difficult to understand a voluntary ingestion. “… probably due to ingesting the infected arthropods without realizing it.” The explanation is not convincing. The indicated period of reports around the world is too long to have an idea of the evolution of the disease. It would be appropriate to indicate, for example, the current prevalence in each country mentioned, or at least some way that allows such old cases to be evidenced by recent ones. What’s the meaning of (ren) at the end of a sentence from the last paragraph of the introduction. IgE data after treatment would be an important input complementing the microscopic evaluation. If you have them, I suggest including them “… unlike the current case. there were no allergic manifestations ….“Typing error, there should be a comma instead of a period. Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the case presented with sufficient detail to be useful for other practitioners? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Molecular parasitology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Esteves A. Reviewer Report For: Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.5256/f1000research.171080.r331924 ) The direct URL for this report is: https://f1000research.com/articles/13-1119/v1#referee-response-331924 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 18 Nov 2024 Zulbey Rivero de Rodriguez , Biological Sciences, Universidad Tecnica de Manabi, Portoviejo, Ecuador 18 Nov 2024 Author Response 1.-When direct ingestion of eggs is indicated, it means ingestion of the eggs as such, not in any other evolutionary way. It means that even if an egg is swallowed, ... Continue reading 1.-When direct ingestion of eggs is indicated, it means ingestion of the eggs as such, not in any other evolutionary way. It means that even if an egg is swallowed, infection has not been described. It is necessary to ingest the cysticercoid found inside an arthropod.If you think it is strictly necessary to explain this better, please let me know. 2.-In the part where it is indicated that children are more susceptible to infection, it was changed without realizing it, because without paying attention to it. 3.- The placement of child(ren) was to indicate the plural of child, but it was changed at once to children 4.-We do not have IgE data from the child after treatment, as far as we know only stool tests were done again (we did them) 5.-Corrected, the period (dot) was removed and a comma was placed 1.-When direct ingestion of eggs is indicated, it means ingestion of the eggs as such, not in any other evolutionary way. It means that even if an egg is swallowed, infection has not been described. It is necessary to ingest the cysticercoid found inside an arthropod.If you think it is strictly necessary to explain this better, please let me know. 2.-In the part where it is indicated that children are more susceptible to infection, it was changed without realizing it, because without paying attention to it. 3.- The placement of child(ren) was to indicate the plural of child, but it was changed at once to children 4.-We do not have IgE data from the child after treatment, as far as we know only stool tests were done again (we did them) 5.-Corrected, the period (dot) was removed and a comma was placed Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 18 Nov 2024 Zulbey Rivero de Rodriguez , Biological Sciences, Universidad Tecnica de Manabi, Portoviejo, Ecuador 18 Nov 2024 Author Response 1.-When direct ingestion of eggs is indicated, it means ingestion of the eggs as such, not in any other evolutionary way. It means that even if an egg is swallowed, ... Continue reading 1.-When direct ingestion of eggs is indicated, it means ingestion of the eggs as such, not in any other evolutionary way. It means that even if an egg is swallowed, infection has not been described. It is necessary to ingest the cysticercoid found inside an arthropod.If you think it is strictly necessary to explain this better, please let me know. 2.-In the part where it is indicated that children are more susceptible to infection, it was changed without realizing it, because without paying attention to it. 3.- The placement of child(ren) was to indicate the plural of child, but it was changed at once to children 4.-We do not have IgE data from the child after treatment, as far as we know only stool tests were done again (we did them) 5.-Corrected, the period (dot) was removed and a comma was placed 1.-When direct ingestion of eggs is indicated, it means ingestion of the eggs as such, not in any other evolutionary way. It means that even if an egg is swallowed, infection has not been described. It is necessary to ingest the cysticercoid found inside an arthropod.If you think it is strictly necessary to explain this better, please let me know. 2.-In the part where it is indicated that children are more susceptible to infection, it was changed without realizing it, because without paying attention to it. 3.- The placement of child(ren) was to indicate the plural of child, but it was changed at once to children 4.-We do not have IgE data from the child after treatment, as far as we know only stool tests were done again (we did them) 5.-Corrected, the period (dot) was removed and a comma was placed Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Nawa Y. Reviewer Report For: Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.5256/f1000research.171080.r331922 ) The direct URL for this report is: https://f1000research.com/articles/13-1119/v1#referee-response-331922 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 28 Oct 2024 Yukifumi Nawa , Khon Kaen University, Khon Kaen, Thailand Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.171080.r331922 General: Although this manuscript is a case report of asymptomatic Hymenoleepis diminuta infection in a child in Ecuador, actual content of this manuscript is a kind of the mixture of a case report and a insufficient review of H. ... Continue reading READ ALL General: Although this manuscript is a case report of asymptomatic Hymenoleepis diminuta infection in a child in Ecuador, actual content of this manuscript is a kind of the mixture of a case report and a insufficient review of H. diminuta infection in general. Thus, as a case report, the entire manuscript is lengthy and wordy with too much of unnecessary reference citation. Specific: Introduction This is a report of an asymptomatic hymenolepiasis case. Thus, this case has little significance/attractive issues in terms of clinical practice. Also, as is mentioned by the authors, H. diminuta infection in humans, especially among children of poor sanitary condition has been sporadically but repeatedly reported from various parts of the world. The only merit/appeal of this case report is the confirmed case of H. diminuta infection in a child in Ecuador, where the presence of such a parasitic disease is ignored by the clinical practitioners in the country. Thus, the first 4 paragraphs of general description of H. diminuta infection should be merged into one short introductory paragraph. Case report The 3 years old boy has received regular health checking and his stool sample was examined in the Parasitology Laboratory. However, his stool was examined only by direct microscopic observation for the saline-diluted specimen (Please give more data as to how much of stool with what degree of saline-dilution). What about other coproparasitological examinations? What about possible co-infection with other intestinal helminths or protozoa? Discussion The same problem as those seen in the Introduction. The Discussion part of the case report should be limited to the findings and the problems and the tasks directly related to the present case. As it stands, the Discussion section of this manuscript contains too much of general information not directly related to this cs. Conclusions As it stands, the Conclusion is too general. Conclusions of the case report should be specific from the observations of this case. Is the background of the case’s history and progression described in sufficient detail? Partly Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Partly Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Partly Is the case presented with sufficient detail to be useful for other practitioners? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Parasitology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Nawa Y. Reviewer Report For: Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.5256/f1000research.171080.r331922 ) The direct URL for this report is: https://f1000research.com/articles/13-1119/v1#referee-response-331922 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 18 Nov 2024 Zulbey Rivero de Rodriguez , Biological Sciences, Universidad Tecnica de Manabi, Portoviejo, Ecuador 18 Nov 2024 Author Response 1.-The reviewer's suggestion is respected, but changes were made to the introduction, as it is considered short enough that it is necessary to eliminate information that is important to provide ... Continue reading 1.-The reviewer's suggestion is respected, but changes were made to the introduction, as it is considered short enough that it is necessary to eliminate information that is important to provide to the reader. 2.- Information on stool tests is included, because if we had the concentrate result and forgot to put that in the article 3.- The discussion further discussed the increase in eosinophils and IgE in cases of H. diminuta, such as this one. It was added that unfortunately there was no data on post-treatment IgE. 4.- Something else is added for conclusion, taking into account the reviewer's suggestion 1.-The reviewer's suggestion is respected, but changes were made to the introduction, as it is considered short enough that it is necessary to eliminate information that is important to provide to the reader. 2.- Information on stool tests is included, because if we had the concentrate result and forgot to put that in the article 3.- The discussion further discussed the increase in eosinophils and IgE in cases of H. diminuta, such as this one. It was added that unfortunately there was no data on post-treatment IgE. 4.- Something else is added for conclusion, taking into account the reviewer's suggestion Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 18 Nov 2024 Zulbey Rivero de Rodriguez , Biological Sciences, Universidad Tecnica de Manabi, Portoviejo, Ecuador 18 Nov 2024 Author Response 1.-The reviewer's suggestion is respected, but changes were made to the introduction, as it is considered short enough that it is necessary to eliminate information that is important to provide ... Continue reading 1.-The reviewer's suggestion is respected, but changes were made to the introduction, as it is considered short enough that it is necessary to eliminate information that is important to provide to the reader. 2.- Information on stool tests is included, because if we had the concentrate result and forgot to put that in the article 3.- The discussion further discussed the increase in eosinophils and IgE in cases of H. diminuta, such as this one. It was added that unfortunately there was no data on post-treatment IgE. 4.- Something else is added for conclusion, taking into account the reviewer's suggestion 1.-The reviewer's suggestion is respected, but changes were made to the introduction, as it is considered short enough that it is necessary to eliminate information that is important to provide to the reader. 2.- Information on stool tests is included, because if we had the concentrate result and forgot to put that in the article 3.- The discussion further discussed the increase in eosinophils and IgE in cases of H. diminuta, such as this one. It was added that unfortunately there was no data on post-treatment IgE. 4.- Something else is added for conclusion, taking into account the reviewer's suggestion Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 03 Oct 2024 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 Version 3 (revision) 20 Feb 25 Version 2 (revision) 18 Nov 24 read read Version 1 03 Oct 24 read read Yukifumi Nawa , Khon Kaen University, Khon Kaen, Thailand Adriana Esteves , University of the Republic Uruguay, Montevideo, Uruguay Amal Sm Sayed , Assiut University, Asyut, Egypt Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Sayed A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 12 Feb 2025 | for Version 2 Amal Sm Sayed , Head of Zoonoses Department, Assiut University, Asyut, Assiut Governorate, Egypt 0 Views copyright © 2025 Sayed A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The article is highlights the importance of H.diminuta infection in human and health implications. They provided background on H.diminuta . infection and their epidemiology are sufficient. The case study was well-written and the figures support the results mentioned by the authors. However, some corrections still should be made to improve the article. The correction are provided in the PDF file: https://f1000research.s3.amazonaws.com/linked/708089.h_rev..pdf Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the case presented with sufficient detail to be useful for other practitioners? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Zoonoses, Microbiology, Infectious diseases I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 20 Feb 2025 Zulbey Rivero de Rodriguez , Biological Sciences, Universidad Tecnica de Manabi, Portoviejo, Ecuador Greetings, I will proceed to make the text corrections that were suggested. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Sayed AS. Peer Review Report For: Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.5256/f1000research.174667.r361809) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-1119/v2#referee-response-361809 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Esteves A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 22 Nov 2024 | for Version 2 Adriana Esteves , University of the Republic Uruguay, Montevideo, Montevideo Department, Uruguay 0 Views copyright © 2024 Esteves A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions I have no further comments. Competing Interests No competing interests were disclosed. Reviewer Expertise Molecular parasitology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Esteves A. Peer Review Report For: Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.5256/f1000research.174667.r341287) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-1119/v2#referee-response-341287 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Esteves A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 04 Nov 2024 | for Version 1 Adriana Esteves , University of the Republic Uruguay, Montevideo, Montevideo Department, Uruguay 0 Views copyright © 2024 Esteves A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child from Rivero and coworkers is very interesting in that it shows an atypical case of a parasitosis in a patient. The data provided in the introduction is correct and very appropriate. Recommendations to the authors: Explain the meaning of “direct ingestion of eggs” I understand that its different from accidentally, but it is difficult to understand a voluntary ingestion. “… probably due to ingesting the infected arthropods without realizing it.” The explanation is not convincing. The indicated period of reports around the world is too long to have an idea of the evolution of the disease. It would be appropriate to indicate, for example, the current prevalence in each country mentioned, or at least some way that allows such old cases to be evidenced by recent ones. What’s the meaning of (ren) at the end of a sentence from the last paragraph of the introduction. IgE data after treatment would be an important input complementing the microscopic evaluation. If you have them, I suggest including them “… unlike the current case. there were no allergic manifestations ….“Typing error, there should be a comma instead of a period. Is the background of the case’s history and progression described in sufficient detail? Yes Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Yes Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Yes Is the case presented with sufficient detail to be useful for other practitioners? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Molecular parasitology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 18 Nov 2024 Zulbey Rivero de Rodriguez , Biological Sciences, Universidad Tecnica de Manabi, Portoviejo, Ecuador 1.-When direct ingestion of eggs is indicated, it means ingestion of the eggs as such, not in any other evolutionary way. It means that even if an egg is swallowed, infection has not been described. It is necessary to ingest the cysticercoid found inside an arthropod.If you think it is strictly necessary to explain this better, please let me know. 2.-In the part where it is indicated that children are more susceptible to infection, it was changed without realizing it, because without paying attention to it. 3.- The placement of child(ren) was to indicate the plural of child, but it was changed at once to children 4.-We do not have IgE data from the child after treatment, as far as we know only stool tests were done again (we did them) 5.-Corrected, the period (dot) was removed and a comma was placed View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Esteves A. Peer Review Report For: Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.5256/f1000research.171080.r331924) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-1119/v1#referee-response-331924 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Nawa Y. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 28 Oct 2024 | for Version 1 Yukifumi Nawa , Khon Kaen University, Khon Kaen, Thailand 0 Views copyright © 2024 Nawa Y. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions General: Although this manuscript is a case report of asymptomatic Hymenoleepis diminuta infection in a child in Ecuador, actual content of this manuscript is a kind of the mixture of a case report and a insufficient review of H. diminuta infection in general. Thus, as a case report, the entire manuscript is lengthy and wordy with too much of unnecessary reference citation. Specific: Introduction This is a report of an asymptomatic hymenolepiasis case. Thus, this case has little significance/attractive issues in terms of clinical practice. Also, as is mentioned by the authors, H. diminuta infection in humans, especially among children of poor sanitary condition has been sporadically but repeatedly reported from various parts of the world. The only merit/appeal of this case report is the confirmed case of H. diminuta infection in a child in Ecuador, where the presence of such a parasitic disease is ignored by the clinical practitioners in the country. Thus, the first 4 paragraphs of general description of H. diminuta infection should be merged into one short introductory paragraph. Case report The 3 years old boy has received regular health checking and his stool sample was examined in the Parasitology Laboratory. However, his stool was examined only by direct microscopic observation for the saline-diluted specimen (Please give more data as to how much of stool with what degree of saline-dilution). What about other coproparasitological examinations? What about possible co-infection with other intestinal helminths or protozoa? Discussion The same problem as those seen in the Introduction. The Discussion part of the case report should be limited to the findings and the problems and the tasks directly related to the present case. As it stands, the Discussion section of this manuscript contains too much of general information not directly related to this cs. Conclusions As it stands, the Conclusion is too general. Conclusions of the case report should be specific from the observations of this case. Is the background of the case’s history and progression described in sufficient detail? Partly Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes? Partly Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment? Partly Is the case presented with sufficient detail to be useful for other practitioners? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Parasitology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 18 Nov 2024 Zulbey Rivero de Rodriguez , Biological Sciences, Universidad Tecnica de Manabi, Portoviejo, Ecuador 1.-The reviewer's suggestion is respected, but changes were made to the introduction, as it is considered short enough that it is necessary to eliminate information that is important to provide to the reader. 2.- Information on stool tests is included, because if we had the concentrate result and forgot to put that in the article 3.- The discussion further discussed the increase in eosinophils and IgE in cases of H. diminuta, such as this one. It was added that unfortunately there was no data on post-treatment IgE. 4.- Something else is added for conclusion, taking into account the reviewer's suggestion View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Nawa Y. Peer Review Report For: Case Report: Hymenolepis diminuta in an asymptomatic Ecuadorian child. [version 3; peer review: 1 approved, 2 approved with reservations] . F1000Research 2025, 13 :1119 ( https://doi.org/10.5256/f1000research.171080.r331922) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. 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Extraction quality varies by source — PMC NXML preserves structure
cleanly, OA-HTML may include some navigation residue, and OA-PDF can
have broken hyphenation. The publisher copy
(via DOI)
is the canonical version.