Abstract
BackgroundIntestinal parasitosis is one of several health concerns about immigrants who travel from endemic to non-endemic regions. Reliable rapid sensitive diagnostic tools, for use in non-endemic regions, are urgently required to enable frequent assessment of immigrant workers in jobs where risk of local transmission is a particular concern (e.g. food-handlers). We assessed the burden of intestinal protozoa in newly arrived immigrants and those applying for renewal of work permits in Qatar (n = 735), by both microscopic examination of stool samples and by Real Time PCR methodology.ResultsPrevalence was considerably higher using RT-PCR compared with coproscopy (Blastocystis hominis: 65.2 vs 7.6%; Giardia duodenalis: 14.3 vs 2.9%; Entamoeba histolytica: 1.6 vs 1.2%). Dientamoeba fragilis was sought only by RT-PCR (prevalence of 25.4%). Prevalence of G. duodenalis was significantly higher in male subjects, associated with blue collar workers and declined over time. Prevalence of B. hominis varied significantly with region of origin of subjects with highest values recorded among African immigrants. Prevalence of D. fragilis also varied with region of origin of subjects, and was lower in young female subjects and in renewal applicants compared with first-time applicants for work permits.ConclusionsWe strongly recommend that, henceforth, intestinal protozoa should be screened by RT-PCR, with a particular focus on frequent assessment of immigrant food-handlers.
Highlights
Intestinal parasitosis is one of several health concerns about immigrants who travel from endemic to non-endemic regions
We identify some remaining problems with this technology and we use data based on RT-polymerase chain reaction (PCR) to assess some of the factors that influence the prevalence of intestinal protozoan infections among immigrants
Relationship between detection of positives by coproscopy and by PCR As assessed by real-time PCR (RT-PCR), the number of detected positives of most species was considerably higher than when detection was based on faecal cyst counts using coproscopy (Table 1)
Summary
Intestinal parasitosis is one of several health concerns about immigrants who travel from endemic to non-endemic regions. It is important that countries that receive immigrants to have monitoring systems for these infections in place [2] This should encompass both assessment of all asymptomatic immigrants on first arrival and regular re-assessment thereafter over appropriate periods of time, especially if home visits occur frequently [3]. Diagnosis of enteric parasitic infections is achieved primarily by the traditional microscopic examination of stool samples (coproscopy). This is still regarded as the gold standard when performed by an experienced and highly skilled microscopist. It is of some concern that currently, there is a world-wide shortage
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