Abstract
Intestinal parasites account for the majority of parasitic diseases, particularly in endemic areas. Most are transmitted via contaminated food. Because of increased immigration and travel, enteric parasitoses are now distributed worldwide. Between May 2006 and December 2008, we examined stool specimens from 5,351 patients (4,695 Italians, 656 non-Italians) for ova and parasites using microscopy, culture techniques, and molecular methods. Stools from 594 patients (11.1%) were contaminated and for all patients samples combined, a total of 700 intestinal parasites were counted. Ninety of the 594 infected patients had more than one parasite in their stools. Parasites causing intestinal disease occurred in 8.8% of patients. The prevalence was over twice as high among non-Italians (26.8% vs 8.9% in Italians, p<0.001) and higher in males (13.0% vs 9.5% in females, p=0.003). Most isolates were pathogenic protozoa, including in decreasing order of frequency: Blastocystis hominis, Giardia intestinalis, Entamoeba histolytica, and Cyclospora cayetanensis. The latter two species tended to be more common in Italians, although not at significant level (3.6% (15/418) vs 1.7% (3/176) in non-Italians, OR: 2.15; 95%CI: 0.60–11.70, p=0.22). Helminthes were found in 28 patients, mainly non-Italians (5.7% (10/176) vs 4.3% (18/418), OR: 1.34; 95%CI: 0.54–3.13, p=0.47). Ascaris lumbricoides and Hymenolepis nana were the most common. Strongyloides stercoralis, Enterobius vermicularis, Taenia spp. and Trichuris trichiura were also found. Intestinal parasites are a serious problem in developing countries, but should not be underestimated in industrialised countries.
Highlights
Enteric parasites are the most common cause of parasitic diseases, and they cause significant morbidity and mortality, in endemic areas [1]
Enteric parasites were more commonly detected in non-Italian patients than in Italians (26.8% (176/656) vs 8.9% (418/4,695); Odds ratios (ORs): 3.01; 95% confidence intervals (CIs): 2.47–3.68, p
The problem is serious in endemic areas with poor sanitation, but parasitic infections are becoming more common in non-endemic areas as a result of intensified immigration and travel [1]
Summary
Enteric parasites are the most common cause of parasitic diseases, and they cause significant morbidity and mortality, in endemic areas [1]. The diseases caused by intestinal parasites, once considered rare phenomena confined to the tropics, are being diagnosed with increased frequency in Europe and other industrialised countries [1]. This trend can be attributed to various factors, including globalisation of the food supply, the increased consumption of fresh foods, increased travel to developing countries, and more intensive immigration originating from these areas. Seafood is a classic example, but the rapid transport of fresh fruits and produce from developing countries has made such products more available to European consumers, and increased their contact with intestinal parasites. In at-risk groups, sexual practices may represent a contributor to the transmission of parasites such as Entamoeba histolytica, Hymenolepis nana and/or Enterobius vermicularis [5]
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