Blastocystis Research Articles

A case of a combined course of typhoid fever and leptospirosis

Coinfections are becoming increasingly relevant and urgently require research. The development of international tourism has caused the rapid spread of infectious diseases from countries with unfavorable sanitary and hygienic conditions. This article analyzes the clinical case of a patient who recently returned from India and developed a combined course of typhoid fever and leptospirosis due to astrovirus infection and blastocystosis. The disease was characterized by symptoms of enteritis, low-grade fever, and mild intoxication. The patient repeatedly sought medical help. Diagnoses of “acute respiratory viral infection” and “intestinal infection of unknown etiology” were established. Symptomatic therapy was performed without a positive effect; fever and severe asthenic syndrome persisted. The patient was hospitalized on the 18th day of illness with moderate severity. Taking into account clinical, anamnestic, and epidemiological data and laboratory examination results, typhoid fever was diagnosed. A polymerase chain reaction (PCR) test identified astrovirus RNA in the stool, and Blastocystis hominis was detected during stool examination. Despite the ongoing pathogenetic and antibacterial therapy, considering the determination of the pathogen’s sensitivity to antibiotics, the patient’s condition worsened. On day 23 of the illness, jaundice, hemorrhagic syndrome, and signs of acute renal failure were noted. Through in-depth analysis of changes in the clinical and laboratory findings, considering epidemiological history data (stay in a region endemic for leptospirosis), leptospirosis was diagnosed and treated with antibacterial therapy. Complex intensive therapy using extracorporeal treatment methods helped prevent the development of unfavorable outcomes of combined pathology. This clinical case emphasizes that doctors must be wary of imported infections and conduct additional comprehensive investigations of suspected cases.

The Use of Immersion Oil in Parasitology Light Microscopic Examination

Aims: to briefly review the history of application of immersion oil and specifically in some Parasitology Microscopic examination.
 Discussion: One way of increasing the optical resolving power of the microscope is to use immersion liquids between the front lens of the objective and the cover slip. The application of immersion oil in microscopic examination began in the mid-17th century. The principle of immersion oil in microscopic examination is to improve the resolution and clarity of the image by reducing the refractive index mismatch between the specimen and the objective lens. In the context of micro-sized parasitic agent, adding this oil will greatly enhanced visualization and in turn will have a direct impact on improving the characteristic morphological image/appearance, thereby enabling observers to optimize microscopic assessment for parasitological examination. Protozoan parasites such as Plasmodium spp, Entamoeba histolytica, Giardia lamblia, Microsporidia spp., Trichomonas vaginalis, Toxoplasma spp, Trypanosoma spp, Babesia spp, Leishmania spp, Cyclospora cayetanensis, and Blastocystis hominis are some examples of parasitic organisms that should be viewed at great magnification to see detailed morphology; and for that it means you need to add immersion oil.
 Conclusion: The addition of immersion oil in Paarasitology microscopic examination is surely improve optical resolution and clarity of the image and positively support Parasitologist to make correct diagnosis.

Enhancing enteric pathogen detection: implementation and impact of multiplex PCR for improved diagnosis and surveillance

BackgroundSyndromic surveillance of acute gastroenteritis plays a significant role in the diagnosis and management of gastrointestinal infections that are responsible for a substantial number of deaths globally, especially in developing countries. In Lebanon, there is a lack of national surveillance for acute gastroenteritis, and limited data exists regarding the prevalence of pathogens causing diarrhea. The one-year study aims to investigate the epidemiology of common gastrointestinal pathogens and compare our findings with causative agents of diarrhea reported by our study collaborative centers.MethodsA multicenter, cross-sectional study was conducted over a one-year period. A total of 271 samples were obtained from outpatients and inpatients presenting with symptoms of acute gastroenteritis at various healthcare facilities. The samples were then analyzed using Allplex gastrointestinal assay that identifies a panel of enteric pathogens.ResultsOverall, enteropathogens were detected in 71% of the enrolled cases, 46% of those were identified in patients as single and 54% as mixed infections. Bacteria were observed in 48%, parasites in 12% and viruses in 11%. Bacterial infections were the most prevalent in all age groups. Enteroaggregative E. coli (26.5%), Enterotoxigenic E. coli (23.2%) and Enteropathogenic E. coli (20.3%) were the most frequently identified followed by Blastocystis hominis (15.5%) and Rotavirus (7.7%). Highest hospitalization rate occurred with rotavirus (63%), Enterotoxigenic E. coli (50%), Blastocystis hominis (45%) and Enteropathogenic E. coli (43%). Enteric pathogens were prevalent during summer, fall and winter seasons.ConclusionsThe adoption of multiplex real-time PCR assays in the diagnosis of gastrointestinal infections has identified gaps and improved the rates of detection for multiple pathogens. Our findings highlight the importance of conducting comprehensive surveillance to monitor enteric infections. The implementation of a syndromic testing panel can therefore provide healthcare professionals with timely and accurate information for more effective treatment and public health interventions.

Irritable Bowel Syndrome Associated with Blastocystis hominis or Without Relationship to It? A Case-Control Study and Minireview.

Blastocystis hominis (B. hominis) is a protozoan parasite that has a worldwide distribution. Some studies have suggested a link between B. hominis and the development of irritable bowel syndrome (IBS). The objective of this study was to determine the prevalence of B. hominis in patients with IBS compared to healthy individuals. A total of 65 stool samples from patients with IBS and 65 samples from healthy individuals in northern Iran were examined. The samples were tested using various methods including direct smear, formalin ether sedimentation and culture to detect the presence of B. hominis. Additionally, polymerase chain reaction (PCR) was performed on all culture-positive isolates to confirm the results and identify the genotype. B. hominis was detected in 15.38% of IBS patients and 9.2% of the healthy group. The culture in RPMI1640 was found to be better than the formalin ether and direct smear methods. Positive samples were confirmed using the molecular method. No significant difference was observed in the order of B. hominis infection between the two groups. The results of our study indicate that no significant difference was observed in the order of B. hominis infection between IBS patients and healthy groups. Therefore, further study is necessary to determine the potential pathogenic effects of this parasite and its role in causing IBS.

Prevalence of intestinal parasites and comparison of detection techniques for soil-transmitted helminths among newly arrived expatriate labors in Jeddah, Saudi Arabia.

Diversity in clinical signs and symptoms are associated with soil transmitted diseases (STD), which are spread to humans by intestinal worms and transmitted in a variety of ways. There is a need for the present study, which aimed to investigate the prevalence of intestinal parasites and to compare between the common detection techniques for soil-transmitted helminths (STHs) among newly arrived expatriate labors in Jeddah, Saudi Arabia. A total of 188 stool samples were analyzed by macroscopic examination, and microscopic examination using direct iodine smear and the formal ether sedimentation technique. Trichrome and modified Kinyoun's stains were used to confirm the morphology of any detected protozoa stages and oocyst of Cryptosporidium, respectively. A chromatographic immunoassay kit was used for Entamoeba histolytica, Giardia lamblia and Cryptosporidium. In addition, real-time PCR was employed only to identify various STHs. Out of 188, several types of parasites were detected in 35 samples (18.62%), of which some with multiple infections. Nine samples (4.79%) were positive for Entamoeba coli, seven samples (3.72%) for Trichuris trichiura, six samples (3.19%) for Necator americanus, four samples (2.13%) for Strongyloides stercoralis, four samples (2.13%) for Ascaris lumbricoides, four samples (2.13%) for E. histolytica, three samples (1.60%) for Blastocystis hominis and two samples (1.06%) for Ancylostoma duodenale. In comparison between laboratory techniques for STHs, real-time PCR was able to detect the DNA of 19 samples (10.1%) followed by Ritchie sedimentation technique (18, 9.6%), and direct smear (7, 3.7%) (p > 0.05). The high rate of newly arrived foreign workers infected with intestinal parasites could lead to a risk to society. Continuous and regular surveys are needed to deal with the occurrence of intestinal parasitic infections including STHs. To improve the identification of these infections, we recommend a supporting infrastructure for the application of concentration methods and molecular assays.

Intestinal pathogens detected in cockroach species within different food-related environment in Pudong, China

Cockroaches are considered mechanical transmitters of infectious diseases, posing a threat to human health. This study assessed the potential of cockroaches in food-related environments to mechanically transmit intestinal pathogens. Cockroaches captured with traps were placed together into a low temperature refrigerator at − 80° for 2 h. Standard taxonomic keys and Fluorescent quantitative PCR techniques were applied for species identification and digestive tract etiological examination. A total of 360 cockroach traps were placed, with a positive rate of 20.8%, and 266 cockroaches were captured. In general, compared with other places and areas, the degree of infestation of cockroaches was more serious in catering places and kitchens. Blattella germanica were most found in catering places (40.2%), followed by Periplaneta fuliginosa in schools (22.2%). According to the life stage, among the 128 cockroach samples, 23 were positive for nymphs and 13 were positive for adults. There were statistically significant differences in the intestinal pathogen detection rates between nymphs and adults (P < 0.05). A total of eight intestinal pathogens were detected, and enterovirus infections were the main ones, with sapovirus being the most detected in Blattella germanica or nymph. Shiga toxin-producing Escherichia coli (STEC) was the most frequently isolated bacterium. Blastocystis hominis had the highest isolation rate. In contrast, 12 diarrhoeal disease pathogens were isolated, and the viruses and bacteria with the highest frequencies were norovirus and E. coli, respectively; no parasites were found. Blattella germanica and Periplaneta fuliginosa in food-related environments can act as potential vectors for the spread of intestinal pathogens and may pose a significant threat to public health.

Green synthesis of silver and iron oxide nanoparticles mediated photothermal effects on Blastocystis hominis

The evolution of parasite resistance to antiparasitic agents has become a serious health issue indicating a critical and pressing need to develop new therapeutics that can conquer drug resistance. Nanoparticles are novel, promising emerging drug carriers that have demonstrated efficiency in treating many parasitic diseases. Lately, attention has been drawn to a broad-spectrum nanoparticle capable of converting absorbed light into heat via the photothermal effect phenomenon. The present study is the first to assess the effect of silver nanoparticles (Ag NPs) and iron oxide nanoparticles (Fe3O4 NPs) as sole agents and with the combined action of the light-emitting diode (LED) on Blastocystis hominins (B. hominis) in vitro. Initially, the aqueous synthesized nanoparticles were characterized by UV-Vis spectroscopy, zeta potential, and transmission electron microscopy (TEM). The anti-blastocyst efficiency of these NPs was tested separately in dark conditions. As these NPs have a wide absorption spectrum in the visible regions, they were also excited by a continuous wave LED of wavelength band (400–700 nm) to test the photothermal effect. The sensitivity of B. hominis cysts was evaluated using scanning laser confocal microscopy whereas the live and dead cells were accurately segmented based on superpixels and the k-mean clustering algorithm. Our findings showed that this excitation led to hyperthermia that induced a significant reduction in the number of cysts treated with photothermally active NPs. The results of this study elucidate the potential role of photothermally active NPs as an effective anti-blastocystis agent. By using this approach, new therapeutic antiparasitic agents can be developed.

RPA-CRISPR/Cas9-based method for the detection of Toxoplasma gondii: A proof of concept

Toxoplasma gondii is a widespread and specialized intracellular protozoan pathogen that affects one third of the world’ s population, posing a great threat to public health. As the definitive host, cats excrete oocysts and play a crucial role in the transmission of toxoplasmosis. The current diagnostic tools usually require bulky equipment and expertize, which hinders the efficient diagnosis and intervention of Toxoplasma infection in cats. In this study, we combined (RPA) with clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 technique to establish an easier method for the detection of T. gondii oocysts in cat fecal samples. The sensitivity, specificity, and practicability of the established RPA-CRISPR/Cas9 method were evaluated using a lateral flow strip, with the limitation of detection determined at 10 plasmid copies/μL (corresponding to about one oocyst), cross reactivity to none of Giardia lamblia, Cryptosporidium sp., Microsporidium biberi and Blastocystis hominis that also commonly found in cats, and comparable performance in detecting T. gondii in clinical samples to conventional PCR amplification. This RPA-CRISPR/Cas9 method provides an alternative to conventional molecular tools used in the clinical diagnosis of Toxoplasma infection in cats and other animals.

Prevalence and Predictors of Intestinal Parasitic Infections at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from 2019 to 2023: A Retrospective Study.

Parasitic infections are a primary cause of illness worldwide and a public health problem. This study highlighted the prevalence of intestinal parasitic (IP) infections and their updated epidemiologic status from 2019 to 2023 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. A retrospective study was conducted from 2019 to 2023 at King Abdulaziz University Hospital. The laboratory results, socio-demographic information, and the year of data collection were collected from the hospital's parasitology laboratory. The data were analyzed using SPSS version 26. Ethical approval was obtained from the National Committee of Bioethics (NCBE) - King Abdul Aziz City for Science and Technology, with an approval number of 258-22. During the study period, 7673 stool samples were requested for intestinal parasite examination. The prevalence of IP infection from 2019 to 2023 was 212/7673, with a percentage of 2.8%. Infected patients had a mean (SD) age of 37.68 (17.27) years. Most infected patients were females (61%) and from Saudi Arabia (37.1%). Most stool samples were brown (79.1%), and about half were soft (51.7%). 2019 had the highest number of infected cases (28.3%), while the number of cases decreased in 2023 (8.8%), the lowest during five years. The most predominant parasite among study subjects was Blastocystis hominis (48.11%). The prevalence of IP infection is lower than in previous comparable surveys. Maintaining personal hygiene, conducting epidemiological surveillance, and enhancing environmental sanitation can prevent and control infections.

Association of helicobacter pylori and intestinal parasites in the stool samples of patients with dyspeptic complaints

Objective: Helicobacter pylori and infections due to intestinal parasites are quite common in developing countries around the world, in societies with low socioeconomic levels, and in regions with inadequate and unhealthy drinking water and food. Our study aimed to reveal the association of Helicobacter pylori positivity and intestinal parasites (IP) in the stool in patients who came to the hospital due to dyspeptic complaints. Their relationships with age and gender were evaluated. Materials and Methods: Between 01.2018 and 04.2024, 953 patients who were admitted to the hospital with dyspepsia and whose stool samples were taken were examined. The data of patients for whom stool Helicobacter pylori rapid antigen test and IP test were requested were evaluated retrospectively. Results: Of the 953 patients, 396 (41.6%) were male and 557 (58.4%) were female. Patient ages ranged from 18 to 85 years and the average was 38.65∓15,15.64 years. The patients were divided into two age groups. There were 882 (92.5%) patients between the ages of 18-65, and 71 (7.5%) patients between the ages of 66-85. Entamoeba histolytica (E. histolytica) / Entamoeba dispar (E. dispar) in 12 (1.3%) of the patients, Giardia intestinalis (G. intestinalis) in 24 (2.5%), Blastocystis hominis (B. Hominis) in 3 (0.3%) and H. pylori was detected in 128 (13.4%). The relationship between H. pylori and IP was found to be statistically significant. IP was detected in 20.3% of cases in which H. pylori was detected. No relationship was found between gender and H. pylori and IP. No relationship was found between age groups and H. pylori and IP. Conclusion: H. pylori and IP are found quite frequently in the world. In order to better understand the association between them, more comprehensive multi-center studies are needed, in which high-sensitivity methods are used and data can be compared with healthy control groups.

Anemia and intestinal parasites in Mbya Guarani children, Misiones, Argentina.

This study aimed to assess the prevalence of anemia in children of two Guarani communities in Misiones, Argentina, and to analyze its association with socioenvironmental and parasitic factors. This cross-sectional study took place in two villages, Koen Ju and Kaa Poty, and included Mbya Guarani children aged 6 months to 14 years. A multivariable analysis was performed to evaluate the association of anemia with the presence of intestinal parasites. Altogether, 162 children were included in the study: 53.1% were boys, 32.7% had low weight-for-age, and 22.2% low height-for-age. Nearly half (46.9%, n=76) had anemia, which was mainly mild (92.1%), with a few moderate cases (7.9%). Of the 109 children who underwent testing for intestinal parasites, 89 (81.7%) had at least one, and 53 (59.5%) had more than one. The main parasite was Blastocystis hominis (49.5%), followed by Entamoeba coli (47.7%), hookworms (36.7%), and Ascaris lumbricoides (31.5%). In the multivariable analysis, anemia was associated with intestinal parasitosis (adjusted odds ratio [OR] 4.24, 95% confidence interval [CI] 1.08-16.5; p=0.038) and male sex (adjusted OR 2.66; 95% CI 1.08-6.47; p= 0.01). Overall, we found that both anemia and intestinal parasites are common in the pediatric population of the Guarani ethnic group. Intestinal parasites and male sex were associated with the presence of anemia.

Parasitic Contamination of Street Food Samples From School-Based Food Vendors of Dhaka City, Bangladesh

Street food is an old notion that arose from the need of quick access of light food to satisfy hunger. With the mention of street food in Bangladesh, a picture is visualized which includes open stalls with uncovered food, unawareness of vendors about hygienic practices, lack of safe source of water for cleaning and preparing food, increasing pollution in surrounding environment leading to infestation with various parasites and causing diarrhoeal diseases in people. The aim of the present study was to determine the prevalence of parasites in school-based street foods in Dhaka city. A total of 200 food samples were examined containing three representative types of street foods: tamarind water of snacks (79 samples), sliced fruits (71 samples) and fruit juices (50 samples) using Formal-ether concentration technique. Among them, 164 (82%) samples were contaminated with Entamoeba histolytica, Blastocystis hominis, Cystoisospora belli, Diphyllobothrium latum, Hymenolepis diminuta, Hymenolepis nana, Ascaris lumbricoides, Enterobius vermicularis, Trichuris trichiura and Ancylostoma duodenale. C. belli was the most prevalent (38%), followed by A. lumbricoides (33%) and B. hominis (33%). While comparing the parasite prevalence in three types of street foods, the highest prevalence was observed for C. belli (21.5% in tamarind water of snacks, 6.5% in sliced fruits and 10% in fruit juices) followed by A. lumbricoides, B. hominis and D. latum. There were significant associations (p&lt;0.05) among the different food types with B. hominis, C. belli, D. latum and A. lumbricoides positive samples. The study implicates that parasitic contamination of school-based street foods is alarming and it is urgent to take necessary steps to ensure the food safety. Bangladesh J. Zool. 51(2): 217-229, 2023

Prevalence of Blastocystis hominis in patients with diabetes mellitus in Balad City , Salahaddin Province, Iraq

Blastocystis sp. is anaerobic,global, eukaryotic, found in the human gastrointestinal tract. The purpose of the current study is to estimate the prevalence of B. hominis infection in people with diabetes mellitus. This study is conducted on a total of three hundred (300) individuals, ranging between 4 and 70 years, included (150) diabetic group and (150) non diabetic group. Samples are taken between November 2022 and May 2023. The practical portion and the collection of samples have been done in laboratories of General Balad Hospital in Balad City; Salahadin; Iraq. The study include the collection of 2 ml of venous blood, which is used to measure the HbA1c ratio with stool sample. This is used to examine the presence or absence of B.hominis by microscopic examination after it had been cultured. Modified Jones' Medium has reportedly been used for Blastocystis sp. in vitro culture. Only 80 diabetic patients (50 male, 30 female) were infected with B.hominis after the laboratory diagnosis, and only 50 people (13 male, 37 female) among the healthy participants have B.hominis. This study demonstrate that the DM group had a higher prevalence of this protozoan than the non-DM group. Also, it notice that there is a link between the presence of Blastocystis and other participant characteristics (risk factors). Most results in the present study are display a highly significant difference between both genders, residence, source of drinking water and keeping animals (p&lt;0.05),but there is no statistically correlation with infection by this parasite among the classes of age and educational level (p&gt;0.05).

Profiling pathogenic protozoan and their functional pathways in wastewater using 18S rRNA and shotgun metagenomics

Despite extensive research, little is known about the composition of eukaryotic protists in environmental samples. This is due to low parasite concentrations, the complexity of parasite diversity, and a lack of suitable reference databases and standardized protocols. To bridge this knowledge gap, this study used 18S rRNA short amplicon and shotgun metagenomic sequencing approaches to profile protozoan microbial communities as well as their functional pathways in treated and untreated wastewater samples collected from different regions of South Africa. Results demonstrated that protozoan diversity (Shannon index P-value = 0.03) and taxonomic composition (PERMANOVA, P-value = 0.02) was mainly driven by the type of wastewater samples (treated & untreated) and geographic location. However, these WWTPs were also found to contain a core community of protozoan parasites. The untreated wastewater samples revealed a predominant presence of free-living, parasitic, and potentially pathogenic protists typically found in humans and animals, ranging from Alveolata (27 %) phylum (Apicomplexa and Ciliophora) to Excavata (3.88 %) (Discoba and Parasalia) and Amoebozoa (2.84 %) (Entamoeba and Acanthamoeba). Shotgun metagenomics analyses in a subset of the untreated wastewater samples confirmed the presence of public health-importance protozoa, including Cryptosporidium species (3.48 %), Entamoeba hystolitica (6.58 %), Blastocystis hominis (2.91 %), Naegleria gruberi (2.37 %), Toxoplasma gondii (1.98 %), Cyclospora cayetanensis (1.30 %), and Giardia intestinalis (0.31 %). Virulent gene families linked to pathogenic protozoa, such as serine/threonine protein phosphatase and mucin-desulfating sulfatase were identified. Additionally, enriched pathways included thiamine diphosphate biosynthesis III, heme biosynthesis, Methylerythritol 4-Phosphate Pathway, methyl erythritol phosphate (MEP), and pentose phosphate pathways. These findings suggest that protozoan pathogens may possess metabolic and growth potential within WWTPs, posing a severe risk of transmission to humans and animals if inadequately disinfected before release. This study provides a baseline for the future investigation of diverse protozoal communities in wastewater, which are of public health importance.

Identification of Cryptosporidium parvum and Blastocystis hominis subtype ST3 in Cholga mussel and treated sewage: Preliminary evidence of fecal contamination in harvesting area

Cryptosporidium parvum and Blastocystis hominis are foodborne parasites known for causing diarrhea. They accumulate in mussels grown on contaminated water bodies, due to the discharge of treated sewage from sewage treatment plants (STP). Despite this, some countries like Chile do not include these parasites in the control or monitoring of sewage water. The objective of this research was to evaluate the contamination of C. parvum. and B. hominis from treated sewage (disinfected by chlorination) and Cholga mussels in a touristic rural cove from the bay of Concepción. Cholga mussels from commercial stores and a treated sewage sample were analyzed. Cryptosporidium spp. was identified by Ziehl-Neelsen-Staining (ZNS) and C. parvum by direct-immunofluorescence assay (IFA) from ZNS-positive samples. Blastocystis hominis was identified by PCR using locus SSU rDNA. C. parvum and B. hominis subtype ST3 were found in 40% and 45% of Cholga mussel samples, respectively, and both parasites were identified in the treated sewage. Blastocystis hominis SSU rDNA gene alignment from Cholga mussels and treated sewage showed 89% of similarity, indicating that could be the same parasite in both samples. We describe the first evidence of possible contamination with these parasites from treated sewage to Cholga mussel suggesting an environmental contamination with high human risk. Based on these results, further studies will consider all the rural coves and STP from the bay to prevent possible contamination of these parasites.

Frequency of Gastrointestinal Parasites, Anemia, and Nutritional Status among Children from Different Geographical Regions of Bolivia.

The study aimed to measure the frequency of occurrence of infections with helminths, protozoa, and risk factors of undernutrition and anemia among schoolchildren from the Bolivian highland (altiplano) and lowland (subtropical) rural regions, with a high frequency of gastrointestinal parasite infections. Cross-sectional data were collected from 790 children, 5-13 years old. Microscopic examination of stool using the Ritchie technique, hemoglobin testing using the HemoCue analyzer, and anthropometric measurements were performed. Over 60% and 20% of children were infected with protozoa and helminth parasites, respectively. Infections caused by pathogenic Hymenolepis nana (15.7-5.2%), Ascaris lumbricoides (41.9-28.5%), Giardia lamblia (30.1-11.2%), Entamoeba histolytica (5.7-0.7%), and nonpathogenic Entamoeba coli (48.9-16%), Blastocystis hominis (40.2-28.5%), Iodamoeba butschli (16.1-2.5%), Chilomastix mesnili (19.2-7.3%), and Entamoeba histolytica/dispar (7.4-5.5%) parasites, were more prevalent in the highlands than the lowlands. Single parasitic infections were more prevalent in the lowlands; polyparasitism of light or heavy intensity predominated in the highlands. A strongly increased risk of anemia and a low prevalence of wasting were determined in children in the highlands. A higher risk for stunting was associated with children of older age, and a low burden of intestinal helminths would prevent wasting in children of highlands. Infections with A. lumbricoides and G. lamblia pathogens in older children were not significant covariates for stunting. Environmental, nutritional, and parasitic factors may predispose to anemia in the highlands. A nutritional intervention and parasite control effort will substantially improve children´s health in the highlands.

Enteric Protozoan Parasitosis and Associated Factors among Patients with and without Diabetes Mellitus in a Teaching Hospital in Ghana.

Enteric protozoa infections (EPIs) could worsen clinical outcomes in patients with diabetes mellitus and therefore requires prompt and accurate diagnosis and attention. This study aimed to determine the burden of EPIs and their associated factors among patients with and without diabetics at the Komfo Anokye Teaching Hospital (KATH) in Ghana. Again, the diagnostic performance of parasitological techniques routinely used for diagnosis was assessed. A total of 240 participants (made up of 140 patients with diabetes and 100 patients without diabetes) were recruited into the study by simple random sampling from November 2020 to May 2021. Stool samples of participants were collected, along with their demographic information, and examined using the saline direct wet mount (DWM), formol-ether concentration (FEC), and modified Ziehl-Neelsen staining (ZNS) techniques for the presence of enteric protozoans. Enteric protozoa were found among 62/140 (44.3%) diabetic patients and 13/100 (13.0%) nondiabetic patients. The predominant protozoa identified were Cryptosporidium spp. (17.86%) among patients with diabetes and Blastocystis hominis (7.0%) among patients without diabetes. EPI was associated with diabetes mellitus status (AOR = 3.48, 95% CI, 1.55-7.79), having diabetes for more than five years (AOR = 3.83, 95% CI, 1.65-8.86) and having comorbidity (AOR = 2.93, 95% CI, 1.33-6.45). The FEC technique had the highest sensitivity (100.0%), specificity 94.3% (95% CI, 91.35-97.22), and accuracy 95.0% (95% CI, 88.54-98.13) when compared to other techniques for diagnosis. EPIs are a significant health problem among patients with diabetes at KATH, and therefore antiparasitic drugs should be included in their treatment protocols for better health outcomes. Again, the FEC technique has demonstrated better performance in detecting EPIs and is therefore recommended to achieve early and accurate diagnosis of EPIs.

Assessment of host biochemical factors and microbiota interactions and pathogenicity of Blastocystis hominis genotypes: A cross-sectional study

Assessment of host biochemical factors and microbiota interactions and pathogenicity of Blastocystis hominis genotypes: A cross-sectional study

Risk of infection in patients with hidradenitis suppurativa on biologics or other immunomodulators: a systematic review and meta-analysis.

Hidradenitis suppurativa (HS) is a painful skin condition that significantly affects patients' quality of life. Biologic agents, including anti-TNF agents and IL-17 inhibitors, have shown promise as treatment options for HS. However, there is concern about the increased risk of infections associated with these therapies. We conducted a systematic review and meta-analysis following PRISMA and MOOSE guidelines. We searched PubMed and Embase until February 1, 2023. The primary outcome of interest was the incidence of any infectious complications. Secondary outcomes included serious and opportunistic infections in HS patients treated with biologics or other immunomodulators. Twenty-four studies met our inclusion criteria, comprising 1,696 patients. The pooled incidence rate for any infection was 24.2%, primarily consisting of mild respiratory and skin infections. Subgroup analysis based on the mechanism of action (MOA)showed a pooled incidence of 7.77% for anti-IL1, 14.24% for anti-PDE4, and 21.96% for anti-TNF. Notably, patients receiving anti-IL17 had the highest incidence rate of infection at 33.6%, but the relative risk compared to placebo was not significantly elevated (0.99, 95% CI: 0.86-1.14). Serious infections were rare, with pooled incidences of 0.39% for anti-IL17 and 0.03% for anti-TNF. Opportunistic infections were infrequent, with 10 reported cases, including eight oral candidiasis, one cryptosporidiosis, and one Blastocystis hominis infection. The use of biologic therapies in HS patients does not significantly increase the risk of infectious complications. Additionally, the occurrence of serious or opportunistic infections in HS patients treated with biologics appears to be minimal.

Effect of parasite infection on IgE, Anti-TG, Anti-TPO of thyroiditis patients

This study was conducted to investigate parasitic infection's effect on the thyroid gland's functions by hypo- or hyperthyroidism and inflammation by measuring some physiological and immunological indicators. 130 blood and stool samples were collected from both genders, including 80 samples from people with thyroid disorders and 50 samples from healthy people. Anti-TG, anti-TPO and IgE were estimated by using the Cobas e411 device. The general stool examination was carried out to confirm the presence of a parasitic infection and determine the type of parasites. The type of parasites found the most affected were Entamoeba histolytica, Giardia lamblia, Blastocystis hominis, and the last parasite, Cryptosporidium. Anti-TG, anti-TPO, and IgE immunoassays significantly increased hypo and hyperthyroidism cases compared to the control. The increase was higher in parasitic-infected patients than in non-infected patients compared to the control. Results of the infected were as follows: (94.41, 27.96, 361.44) IU/ml and (54.13, 18.48, 308.18) IU/ml, for non-infected (55.46, 18.48, 149.67) IU/ml and (89.56, 20.80, 90.67) IU/ml. Compared to the control (22.3, 7.05, 62.93) IU/ml, respectively. Conclusion: This study showed that infection with a parasite affected the performance of the thyroid gland. Keywords: Parasites; Thyroid Disorders; Anti-TG; Anti-TPO; IgE.