Abstract
BackgroundIn Ghana, Balantidium coli (B. coli) has been identified in vegetables and in pigs, although there is a paucity of data regarding human balantidiosis. This study sought to assess human B. coli infection in Ghana, factors associated with the infection as well as its association with haematological and biochemical parameters.MethodsTwo pig rearing communities in the Ga West Municipality, Ghana, were involved in this study. Stool and blood samples were collected from pig farmers and their exposed household members as well as relevant information on potential associated factors. Eosin-saline wet preparation was done on the same day of stool samples were collected while formol ether concentration technique was performed later. Haematological, biochemical parameters and serum electrolytes were determined using Celltac MEK-6500 K, PKL-125 biochemical analyser, and FT-320 electrolyte analyser, respectively.ResultsThe overall prevalence of balantidiosis was 10.4 %, significantly higher among farmers (21.7 %) than in exposed household members (5.8 %) (x2 = 17.8, p = 0.000025). Of the 43 infected individuals, 20.9 % were co-infected with either Entamoeba histolytica, Giardia lamblia, or Schistosoma mansoni. In B. coli infection, mild to moderate anaemia together with a reduction in levels of platelet, albumin and, sodium, chloride, and bicarbonate ions were observed. However, white blood cells were significantly elevated in infected states. Poor farming practices such as free-range systems, improper disposal of pig faeces, lack of use of protective farming clothing, and unavailability of dedicated farming clothing were found to be associated with B. coli infection status. Finally, frequent diarrhea (OR = 12.30, p = 0.006) with occult blood (OR = 25.94, p < 0.0001) were found to be predictors of B. coli infection.ConclusionsHuman balantidiosis is endemic in Ga West Municipality, Ghana. Individuals living closed to pig rearing communities presenting with frequent diarrhea with occult blood in stool should be screened and treated for balantidiosis to mitigate the clinical consequences of the infection.
Highlights
In Ghana, Balantidium coli (B. coli) has been identified in vegetables and in pigs, there is a paucity of data regarding human balantidiosis
This study reports the findings from the human balantidiosis survey in Ghana and reports for the first time the burden of human balantidiosis in two pig rearing communities in Ghana as well as the identification of probable at-risk groups
Human balantidiosis is endemic in two pig-rearing communities in Ga West Municipality, Ghana, with an overall prevalence of 10.4 %, with direct pig farmers being significantly infected
Summary
In Ghana, Balantidium coli (B. coli) has been identified in vegetables and in pigs, there is a paucity of data regarding human balantidiosis. Data on human balantidiosis, caused by the only known human ciliate, Balantidium coli (B. coli), is lacking in Ghana. Water supply containing pig faeces used for irrigation being the main source of contamination [1]. The presence of parasites in vegetables and in pigs could serve as a source of human infections. B. coli is able to cause ulcers by secreting an enzyme called hyaluronidase. This enzyme is capable of degrading intestinal tissues and facilitates penetration of the mucosa.
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