Abstract
Background: Intestinal infections remain a major public health burden in developing countries. Due to social, ecological, environmental, and cultural conditions, Indigenous peoples in Colombia are at particularly high risk. Materials: 137 stool samples were analyzed by microscopy and real-time-Polymerase Chain Reaction (RT-PCR), targeting protozoan parasites (Giardia intestinalis, Entamoeba histolytica, Cryptosporidium spp., and Cyclospora cayetanensis), bacteria (Campylobacter jejuni, Salmonella spp., Shigella ssp./enteroinvasive E. coli (EIEC), Yersinia spp., enterohemorrhagic E. coli (EHEC), enteropathogenic E. coli (EPEC), enterotoxin-producing E. coli (ETEC), enteroaggregative E. coli (EAEC), and Tropheryma whipplei), and helminths (Necator americanus, Strongyloides stercoralis, Ascaris lumbricoides, Ancylostoma spp., Trichuris. trichiura, Taenia spp., Hymenolepis nana, Enterobius vermicularis, and Schistosoma spp.). Microscopy found additional cases of helminth infections. Results: At least one pathogen was detected in 93% of the samples. The overall results revealed protozoa in 79%, helminths in 69%, and bacteria in 41%. G. intestinalis (48%), Necator/hookworm (27%), and EAEC (68%) were the most common in each group. Noteworthy, T. whipplei was positive in 7% and T. trichirua in 23% of the samples. A significant association of one infection promoting the other was determined for G. intestinalis and C. jejuni, helminth infections, and EIEC. Conclusions: The results illustrate the high burden of gastrointestinal pathogens among Indigenous peoples compared to other developing countries. Countermeasures are urgently required.
Highlights
The indigenous tribe called Wiwa lives in retracted areas in the Sierra Nevada de Santa Marta in the northeast of Colombia
To evaluate the average parameters related to size, weight, and growth, the official tables provided by the Organización Mundial de Salud 2006–2007 were used, which are valid for the Colombian population
Seventeen of the positive results for C. cayetanensis occurred in children (59%); 50% of these were in those 1–4 years of age and 50% were in those 5–12 years of age
Summary
According to the Wiwas, gastrointestinal complaints are the leading problem in their communities, causing high morbidity and mortality rates. The Wiwa’s traditional mode of agriculture (top dressing), living together with livestock, and poor drinking water access (rivers and unprotected wells) likely contribute to high infection rates. These kind of infections cause approximately 2 billion diarrhetic episodes worldwide and kill about 5.8 million children (2015) [1]. The main aim was to find evidence for and determine the prevalence and underlying causes of gastrointestinal infections in Wiwa communities for effective countermeasures to be implemented
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