Co-infection Of Intestinal Parasites Research Articles

Investigation of Visceral Leishmaniasis and Coinfection of Intestinal Parasites in HIV-Positive Patients

Objective: Parasitic infections are more frequently observed in immunosuppressed cases, such as those infected with human immunodeficiency virus (HIV). Furthermore, compared to immunocompetent cases, a more severe clinical course is observed in the immunosuppressed patient group. HIV-positive individuals have increased pathogenicity of parasites and may exhibit a wide range of clinical symptoms of varying severity that may result in mortality. Visceral leishmaniasis (VL) is a vector-borne disease and an important opportunistic infection seen in HIV/Acquired Immune Deficiency Syndrome (AIDS) cases, most notably in Southern Europe and Africa, where both infections are endemic. Several parasites namely toxoplasmosis, cryptosporidiosis, isosporiasis, cyclosporiasis, amebiasis, giardiasis, plasmodium, and strongyloidiasis are infections posing significant risk factors for these patient groups. Materials and Methods: In this study, visceral leishmaniasis was investigated serologically in serum samples and parasitic infections were analyzed by conventional methods in fecal samples from HIV-positive cases. Results: 5 of the 42 cases included in the study were female. The mean age of these cases was 38.7 years (19-66). Blastocystis spp was detected in 5 fecal samples obtained from HIV-positive cases. The rK39 dipstick test with serum samples yielded a very weak band in one case, while none of the other tests yielded a positive band. Conclusion: The regional prevalence of these latent infections, which can be subclinical in HIV-positive patients, is important to know. However, the literature lacks sufficient data on the situation in Turkey. In this study, the prevalence of enteric parasitic infections in people with HIV infection in our region was found to be low and VL was not detected.

Helicobacter Pylori and Intestinal Parasites Co-infection in Pregnant Women Attending Antenatal Clinic in a Hospital, South-South Nigeria

Pregnant women are susceptible to severe health problems caused by Helicobacter pylori and intestinal parasitic infections. These conditions include iron deficiency anaemia, hyperemesis gravidarum, gastritis, duodenal ulcers, and maternal morbidity and mortality. These infections usually spread due to poor personal hygiene and socioeconomic conditions. The study aimed to investigate the occurrence of H. pylori and intestinal parasitic infections amongst pregnant women attending the antenatal clinic in Okolobiri, Bayelsa State. We analysed the samples using the H. pylori antibody rapid tests, stool direct wet mounts, formal ether concentration, and saturated sodium chloride floatation. The data revealed that 34% of the women were infected with H. pylori and 20% with intestinal parasites. The highest occurrence of H. pylori infection and intestinal co-infection was in the 26-30 age group. Entamoeba histolytica was the most common type of protozoa present, while Ascaris lumbricoides and Trichuris trichuria were the most common forms of helminth infections. The Chi-square analysis showed a statistically significant difference with respect to age. These results provide essential epidemiological data on the prevalence of H. pylori and intestinal parasitic infections among pregnant women in Okolobri, Bayelsa State. The study highlights the need to screen pregnant women for H. pylori and intestinal parasites to improve antenatal care for both mother and child.

The COVID-19 Severity and Its Association with Intestinal Parasite Coinfection and Urine Biochemical Parameters among COVID-19-Confirmed Patients Admitted to Debre Markos University COVID-19 Center, Northwest Ethiopia.

Though most people with COVID-19 disease show asymptomatic to mild illness, a substantial number of patients are at high risk of developing severe disease and adverse outcomes with long COVID-19 and death. Even though some studies showed that previously existing infections with parasites amend the host's body defenses to increase resistance to infection with SARS-CoV-2, there is limited data in Ethiopia. This study is aimed at determining the COVID-19 disease severity and its association with intestinal parasite coinfection and urine biochemical parameters among COVID-19-confirmed patients admitted at Debre Markos University COVID-19 Center, 2021. A prospective cohort study was conducted on 136 RT-qPCR-confirmed COVID-19 patients admitted at Debre Markos University COVID-19 Center from January 1 to March 30, 2021. Sociodemographic and clinical data were collected by using standardized data collection forms. A urine biochemical test was performed using a dry urine dipstick kit and stool examination using direct wet mount microscopic examination and formalin-ether concentration method. The chi-square test, Fisher exact test, and ordinal logistic regression analysis were computed to assess association with outcome variables using Statistical Package for Social Science software (version 24). A total of 136 COVID-19-confirmed patients participated in this study. The median age of the participants was 48 years. The majority (86 (62.5%)) of them were male in sex. Of the 136 cases, 39 (28.7%) had died. Among the 136 patients, 22 (16.2%) were coinfected with intestinal parasites. COVID-19 patients who have intestinal parasite coinfection had lower odds of developing clinically severe COVID-19 compared to noninfected (AOR = 0.37; 95% CI = 0.147-0.944; P = 0.037). The majority (104 (76.5%)) of them have abnormal urine biochemical results. From the abnormal urine biochemical tests observed, the urine blood, glucose, and ketone tests were positive for 54 (39.7%), 36 (26.5%), and 30 (21.1%) patients, respectively. Among the 31 critical COVID-19 patients, 25 (80.6%) showed abnormal urine biochemical parameters. Age and comorbidity were significantly associated with COVID-19 severity (P < 0.05). Patients with old age and comorbidity had an increased risk of developing severe COVID-19 disease. Patients having SARS-CoV-2 and intestinal parasitic coinfections demonstrated mild COVID-19 disease severity. Abnormal urine biochemical results were common among critical COVID-19 patients. Thus, advanced study on the effect of the interaction among intestinal parasites on COVID-19 clinical severity and its mechanisms is essential.

Is co-infection of intestinal parasites with COVID-19 virus infection affecting its severity?

Is co-infection of intestinal parasites with COVID-19 virus infection affecting its severity?

Prevalence of Intestinal Parasites among Tuberculosis and Non-Tuberculosis Patients Attending Hospitals in Yola, Adamawa State, Nigeria

Tuberculosis and intestinal parasites are mostly affecting poor people. They are in a vicious cycle since one is the risk factor for the other. A hospital based cross-sectional study was carried out on the prevalence and co-infection of intestinal parasites on tuberculosis and non-tuberculosis patients in Specialist Hospital, Jimeta and Federal Medical Centre, Yola, between April-July, 2021. Demographic data was collected using structured questionnaire, while stool samples was collected and processed using wet mount and formol ether concentration technique for the detection of intestinal parasites. Data was analyzed using SPSS Version 26.0 software packages. Chi-squared test at 95% level of significance was used to measure the strength of an association. Out of the 250 participants, 150 (60%) had tuberculosis, while 100 (40%) were non-TB patients. A total of 34 (13.6%) were infected with intestinal parasites: 8.4% of TB patients and 5.2% of non-TB patients were positive for intestinal parasites. There was no statistically significant difference in the prevalence of infection between the patient’s (p&gt;0.05). Ascaris lumbricoides was the highest occurring parasite (4.4%), followed by Schistosoma mansoni and Entamoeba histolytica, both having a prevalence of 2.8% each, Hymenolepsis nana (2.0%), Trichomonas hominis (1.2%) and Entamoeba coli being the least with a prevalence of 0.4%. Age related infection showed that the 21-30 year old had the highest prevalence of infection (4.0%) with the least among the 11-20 year old age group (0.4%). There was a statistically significant difference in the association between the age groups and infection (p&lt;0.05). Males had the higher prevalence of infection (8.4%) compared to their female counterpart (5.2%), there was no statistically significant difference in the association between infection and gender (p&gt;0.05). With respect to patient’s occupation and level of education, those with tertiary education and farmers had the highest prevalence (6.0%, 5.9%), respectively. The prevalence of intestinal parasites was higher in persons with tuberculosis, and there was evidence that tuberculosis increased susceptibility to intestinal parasites in this study. Though the prevalence in this study is low, the lack of knowledge of the mode of transmission of these parasite can lead to further infection of both those already infected and those not infected.

Haemoparasites and Polyparasitism of Intestinal Helminths among Cattle Slaughtered in Selected Abattoirs in Abeokuta, Ogun State.

Background: Haemoparasites and intestinal helminths are significant constraints to livestock production resulting in substantial economic loss, and some helminth parasites of cattle are of serious public health concern. This study investigated the prevalence of haemoparasites and polyparasitism of intestinal helminths amongst cattle slaughtered in two major abattoirs of Abeokuta metropolis and their implications for public health. Methods: Blood and faecal samples were randomly collected from 256 cattle less than two and greater than two years of age. Blood samples were screened for Packed Cell Volume (PCV) using the haematocrit centrifuge technique and parasites were detected by microscopy using a wet mount, buffy coat and stained thin smear. Helminth eggs and oocysts were detected using centrifugal sedimentation and centrifugal faecal flotation method. Results: Results showed prevalence for Trypanosoma spp., Babesia spp., Anaplasma spp. and Theileria spp. to be 8.3%, 27.34%, 20.7% and 0.39%, respectively. For intestinal parasites, the prevalence for Strongyle eggs is 73.82%, Neoascaris vitulorum 0.8%, Fasciola spp. 10.15%, Moniezia spp. 4.3%, Eimeria oocyst 35.94% and Cryptosporidium oocyst was 1.17%. The total prevalence of coinfection of haemoparasite and intestinal helminths was 42.6%. Breed-specific prevalence for co-infection of haemoparasites and intestinal parasites showed 55.96%, 37.6% and 6.4% for White Fulani, Red Bororo and Sokoto Gudali, respectively which was statistically insignificant (p &gt; 0.05). With regards to sex, females had a higher prevalence of 92 (84.4%) of coinfection of haemoparasites and intestinal helminths than males 17 (15.6%), which was statistically significant (p&lt;0.05). Conclusion: This study revealed a high prevalence of haemoparasites and intestinal parasites in cattle slaughtered in Abeokuta, Nigeria. Therefore, the study recommends strict compliance with meat inspection at abattoirs and the need for immediate operationalisation and implementation of a sustainable Preventive One Health intervention to mitigate against the outbreak of zoonoses in Abeokuta.

Magnitude and associated factors of Intestinal Parasitosis and Tuberculosis among Tuberculosis suspected patients attending Kuyu General Hospital, North Shewa, Oromia, Ethiopia.

BackgroundIntestinal parasites and Tuberculosis (TB) co-infection is a major public health problem. The parasitic infection suppresses the cell mediated immunity that protects tuberculosis. Helminthes-induced immune modulation promotes progression to active tuberculosis. However, there is paucity of evidences on the intestinal parasites-tuberculosis co-infection in Ethiopia. This study explores the magnitude and associated factors of intestinal parasitic infection and TB among suspected pulmonary Tuberculosis (PTB) patients.MethodologyA cross-sectional study design was conducted in Kuyu General Hospital from December 2019—March 2020. The socio-demographic data and associated factors were collected by structured questionnaire and then spot-spot sputum and fresh stool samples were collected following standard guidelines and were processed. Descriptive analysis was conducted and reported in frequency and percentage. Bivariate analysis was computed and a multivariable analysis was conducted to provide an adjusted odds ratio (AOR). P-value <0.05 at 95% confidence interval was considered as statistically significant.ResultsThe burden of intestinal parasites was 20.2% (49/ 242) and 6.1% (20/ 242) of them were helminths infections and 14.1% (29/ 242) were protozoa infections. Of 242 patients, 14.9% (36/242) were sputum smear-positive for acid fast-bacilli. Of 36 smear positive patients, 9(25%) had TB–intestinal parasites co-infection. Dwelling in rural areas and having untrimmed fingernails were statistically significantly associated with intestinal parasites. Having a contact history of Tb patients was significantly associated with pulmonary tuberculosis.ConclusionsThe magnitude of intestinal parasites and TB among PTB suspected patients were high. Hookworm infection was the predominant helmenthic infection. It is important to consider screening TB patients for intestinal parasites and treat co-infection properly.

Prevalence of Intestinal Parasites Co-infection and Associated Factors Among Pulmonary Tuberculosis Patients in Adama Town, East Shoa, Oromia, Ethiopia

Tuberculosis and parasitic infections are co-endemic in many parts of the world. The treatments of many patients with tuberculosis are under the influence of Intestinal parasite infection that worsens the progression of this disease. Hence, adequate information on co-infection rate is needed to undertake the integrated prevention and control program. Therefore this study aimed to assess the prevalence of intestinal parasite co-infection and associated factors among pulmonary tuberculosis patients in Adama Town, East shoa, Oromia, Ethiopia. A facility based cross sectional study was conducted from November 2018 up to January 2019 using multi stage random sampling technique. Data on socio-demographic characteristics and potential risk factors for intestinal parasite co-infection was collected by standardized semi structured interviewer administered questionnaire. One gram stool samples for direct saline microscopy, formol-ether concentration technique and modified acid fast staining was collected and processed in accordance to the standard parasitological techniques and procedures at Adama Science and Technology University Higher Health Center Laboratory. Data entry was done by EPI info version 7, and analyzed using SPSS version 22.0. Pearson chi-square and multiple logistic regression models were used to identify associated factors. Overall co-infection rate of intestinal parasites was 75 (21.4%) (95% CI: 17.1-25.4). Protozoans’ account 40 (11.4%) and Helminthes were 35 (10.0%). The predominate isolates were Entamoeba histolytica 30 (40%) and Ascaris lumbricoides12 (16.0%) from protozoans and helminthes, respectively. Eating raw vegetables/ fruits without washing or peeling [AOR]: 5.311 (2.089-13.506), habit of not using soup [AOR]: 11.238 (3.134-40.296) and Body mass index<18.5 kg/m² [AOR]: 15.337 (5.860-40.142) were significant determinants of intestinal parasite among pulmonary tuberculosis patient. In general overall co-infection rate of intestinal parasites in this study was high (21.4%). Therefore, integrating screening and mass deworming of parasite into existing tuberculosis program should be considered.

Malaria and intestinal parasite co-infection and its association with anaemia among people living with HIV in Buea, Southwest Cameroon: A community-based retrospective cohort study

Both malaria and intestinal parasites are endemic in Cameroon, and their co-infection can be of great impact on anaemia among people living with HIV (PLWH). This community-based retrospective cohort study determined the prevalence and association of infections with anaemia in PLWH and HIV-negative individuals in Buea, Cameroon from March to August 2019. The study population comprised of 190 PLWH and 216 consenting HIV-negative individuals from the Buea community. Participants were examined clinically, the collected blood sample was used for malaria parasite (MP) detection, HIV diagnosis and haemoglobin (Hb) measurement while stool samples were examined for the detection of intestinal parasites (IPs). Proportions were compared using Pearson's Chi-square test and association of anaemia with independent variables was evaluated using logistic regression analysis. Out of the 406 participants, MP, IPs and MP/IP co-infection prevalences were 15.5%, 13.0% and 3.0% respectively. PLWH had a higher prevalence of MP (16.3%, P = 0.17), IPs (23.7%, P ˂ 0.001) and MP/IPs co-infection (3.7%, P = 0.04) when compared with HIV-negative participants. Similarly, PLWH had significantly lower mean haemoglobin value (11.10 ± 1.54 g/dL) than their HIV-negative counterparts (12.45 ± 2.06 g/dL). Also, PLWH co-infected with MP and IPs were observed to have a significantly lower mean haemoglobin value (10.6 ± 1.21 g/dL). PLWH had a significantly (P ˂ 0.001) higher prevalence of mild (56.8%), moderate (18.4%) and severe (1.6%) anaemia when compared with HIV-negative counterparts. The significant risk factors associated with anaemia included being febrile (P = 0.03), MP-infected only (P = 0.001), HIV-infected only (P < 0.001), having dual (P < 0.001) or triple-infections (P = 0.03). Malaria and intestinal parasites remain public health concerns among PLWH and anaemia as a serious haematological abnormality gets exacerbated even with the viral load suppression. Hence, routine medical check-ups among PLWH are recommended.

Prevalence Rate of Intestinal Parasites/Malaria Co-Infections and their Associated Risk Factors in Melong and Denzo, Littoral Region- Cameroon)

Objective: To determine the prevalence rate of intestinal parasites/malaria co-infections and their associated risk factors in Melong and Denzo, Littoral region- Cameroon&#x0D; Materials and Methods: Study period was from November 2019-March 2020. Blood samples were collected after informed consent by finger pricking. Stool samples were examined using normal saline and the Kato-Katz technique for the presence and intensity of IPs. Thick blood films were prepared, Giemsa-stained and examined under x100 for the presence of parasites and estimate GMPD. A structured questionnaire was filled out to obtain information on different factors which might predispose participants to become infected. Data was analysed using SPSS version 23 at P&lt;0.05.&#x0D; Results: The overall prevalence of IP was 28.3% (113/400). Entamoeba histolytica was the most prevalent IP 22.0% (88/400) and it was significantly more in Melong (27.7%, 76/274) than in Denzo (9.5%, 12/126), (P=0.001). The overall prevalence of malaria was 66.5% (266/400). The prevalence of malaria was higher in Denzo (79.3%, 100/126) than in Melong (60.5, 166/274), P=0.001. Children ≤5 years recorded the highest (75.4%, 83/110) prevalence of malaria, and the difference between age groups was significant, p=0.016. The overall prevalence of co-infections was 16.3% (65/400). Low access to bed nets, presence of bushes and water bodies, poor drinking water source and lack of personal and community hygiene are the associated risk factors leading to co-infection of malaria and intestinal parasites.&#x0D; Conclusion: Intestinal parasites/malaria co-infections are still a cause of morbidity and mortality in Cameroon; interventions targeting groups at risk will help reduce the burden of these diseases in Melong and Denzo localities.

The immunoglobulin G antibody response to malaria merozoite antigens in asymptomatic children co-infected with malaria and intestinal parasites.

Co-infection with malaria and intestinal parasites is common in children in Africa and may affect their immune response to a malaria parasite infection. Prior studies suggest that co-infections may lead to increased susceptibility to malaria infection and disease severity; however, other studies have shown the reverse. Knowledge on how co-morbidities specifically affect the immune response to malaria antigens is limited. Therefore, this study sought to determine the prevalence of co-infection of malaria and intestinal parasites and its association with antibody levels to malaria merozoite antigens. A cross sectional study was carried out in two villages with high transmission of malaria in Cameroon (Ngali II and Mfou) where mass drug administration (MDA) had been administered at ~6-month intervals (generally with albendazole or mebendazole). Children aged 1-15 years were enrolled after obtaining parental consent. A malaria rapid diagnostic test was used on site. Four (4) ml of peripheral blood was collected from each participant to determine Plasmodium falciparum infections by microscopy, haemoglobin levels and serology. Fresh stool samples were collected and examined by wet mount, Kato-Katz method and modified Ritchie concentration techniques. A Multiplex Analyte Platform assay was used to measure antibody levels. A total of 320 children were enrolled. The prevalence of malaria by blood smear was 76.3% (244/320) and prevalence of malaria and intestinal parasites was 16.9% (54/320). Malaria prevalence was highest in young children; whereas, intestinal parasites (IP+) were not present until after 3 years of age. All children positive for malaria had antibodies to MSP142, MSP2, MSP3 and EBA175. No difference in antibody levels in children with malaria-co infections compared to malaria alone were found, except for antibody levels to EBA-175 were higher in children co-infected with intestinal protozoa (p = 0.018), especially those with Entamoeba histolytica infections (p = 0.0026). Antibody levels to EBA175 were significantly higher in children co-infected with malaria and E. histolytica compared to children infected with malaria alone. It is important to further investigate why and how the presence of these protozoans might modulate the immune response to malaria antigens.

Concurrent infection of intestinal parasites and Helicobacter pylori among school-age children in Central Ethiopia

BackgroundCoinfection of multiple intestinal microbial pathogens plays an important role in individuals harboring these organisms. However, data on magnitude and risk factors are scarce from resource limited settings. ObjectiveWe examined the prevalence and associated risk factors of intestinal parasites and Helicobacter pylori co-infection among young Ethiopian school children. MethodData from a total of 434 Ethiopian school children from the Ziway region were analyzed in the study. Stool antigen and blood serum antibody tests were used to detect H. pylori, while the presence of any intestinal parasites was detected using direct wet mount microscopy and formol-ether concentration techniques. A structured questionnaire was delivered to mothers and legal guardians of the children by an interviewer to collect data relevant demographic and lifestyle factors. Multivariate logistic regression analysis was performed to assess the association of these sociodemographic characteristics with the coinfection of H. pylori and intestinal parasites. ResultsThe prevalence of coinfection with any intestinal parasites and Helicobacter pylori was 23.0% (n = 92/400). Univariate analysis showed an increased risk for co-infection among children whose mothers had non-formal education (COR: 1.917, p < 0.01) and those who had no history of child vaccination (COR: 3.455, p = 0.084). Children aged 10–14 and those who lived in a house that had a flush or ventilated latrine were found at lower odds of coinfection between intestinal parasites and Helicobacter pylori (COR: 0.670, p = 0.382; COR: 0.189, p = 0.108). Multivariate regression analysis showed increased odds of co-infection among children whose mothers had non-formal education (AOR: 1.978, p < 0.01). Maternal education was also associated with a two-fold increase in odds for H. pylori and any protozoa co-infection (AOR: 2.047, p < 0.01). ConclusionOur study shows a moderate prevalence of H. pylori and intestinal parasite co-infection and identified maternal education as a significant risk factor among school children.

A systematic review and meta-analysis on the co-infection of Helicobacter pylori with intestinal parasites: public health issue or neglected correlation?

ABSTRACT The current study was conducted to assess the prevalence and odds ratio (OR) of co-infection of Helicobacter pylori (H. pylori) and intestinal parasites (IPs). English databases were searched. A total of 18 studies including 14 studies with cross-sectional design (a total of 3739 participants) and 4 studies with case-control design (397 patients and 320 controls) met the eligibility criteria. The pooled prevalence of H. pylori, intestinal parasite infections (IPIs), and their co-infections in different populations were 48.3% (95% CI, 34.1–62.8%), 15.4% (95% CI, 10–22.8%), and 11% (95% CI, 6.7–17.6%), respectively. The co-infection of H. pylori and Giardia was 7.6% (95% CI, 4.9–11.7%). Although statistically not significant, the risk of co-infection of H. pylori and IPIs was higher in case group compared to control group (OR, 1.59; 95% CI, 0.77–3.25). The overlaps between H. pylori and IPIs in countries with lower human development index (HDI) and income levels were high.

Intestinal parasites co-infection among tuberculosis patients in Ethiopia: a systematic review and meta-analysis

BackgroundTuberculosis and intestinal parasites are mostly affecting poor people. They are in a vicious since one is the risk factor for the other. However, the comprehensive report on the burden and co-incidence of intestinal parasites and tuberculosis in Ethiopia is scant. This systematic review and meta-analysis aimed to provide abridge conclusive evidence on the intestinal parasite-tuberculosis co-infection in Ethiopia.MethodsA total of 414 articles published in English were searched from both electronic databases (CINAHL, DOAJ, Embase, Emcare, Medline, ProQuest, and PubMed, Science Direct, and Web of Science) and other sources. The qualities of the included studies were assessed using the Joanna Briggs Institute Critical Appraisal tools and the publication bias was measured using the funnel plot and Eggers regression test. Comprehensive meta-analysis (CMA) Version 3.3.07 and Review Manager software were used to estimate pooled prevalence and associations of intestinal parasites and tuberculosis infection.ResultsEleven articles with a total of 3158 tuberculosis patients included in the analysis based on the eligibility criteria. The estimated pooled prevalence of intestinal parasites co-infection was 33% (95% CI: 23.3, 44.3) using the random-effects model. The most common intestinal parasites were Ascaris lumbricoides 10.5% (95% CI: 6.0, 17.5), Hookworm 9.5% (95% CI: 6.10, 14.4), Giardia lamblia 5.7% (95% CI: 2.90, 10.9) and Strongyloides sterocoralis 5.6% (95% CI: 3.3, 9.5). The odds of intestinal parasites infection was higher among tuberculosis patients compared to tuberculosis free individuals (OR = 1.76; 95% CI: 1.17, 2.63). A significant difference was observed among TB patients for infection with intestinal helminths (OR = 2.01; 95% CI: 1.07, 3.80) but not for intestinal protozoans when compared with their counterparts. The odds of multiple parasitic infections was higher among tuberculosis patients (OR = 2.59, 95% CI: 1.90, 3.55) compared to tuberculosis free individuals. However, intestinal parasites co-infection was not associated with HIV status among tuberculosis patients (OR = 0.97; 95% CI: 0.71, 1.32).ConclusionOne-third of tuberculosis patients are co-infected with one or more intestinal parasites, and they are more likely to be infected with intestinal helminths and multiple intestinal parasitic infections compared to TB free individuals. We recommend routine screening of tuberculosis patients for intestinal parasites. The effect of mass deworming on tuberculosis incidence would be important to be considered in future researches.Trial registrationRegistered on PROSPERO with reference number ID: CRD42019135350.

Coinfection of Toxoplasma Gondii and Intestinal Parasites among Elderly Immunocompromised Patients

Introduction: Patients with cancer and hemodialysis are prone to opportunistic infections. The present research aims to examine the frequency of Toxoplasmosis and intestinal parasites in these patients.&#x0D; Methods: In the present cross-sectional study, seventy stool and blood samples from immunocompromised patients (46 hemodialysis and 24 cancer patients) from Guilan Province were collected in 2017-2018. Different tests including direct smear examination and formalin-ether was conducted for the intestinal protozoan parasites. To detect coccidian parasites (e.g. Cryptosporidium spp.) Ziehl Neelsen staining was applied. The anti T.gondii antibodies were detected via ELISA method.&#x0D; Results: Totally 6.52% and 4.16% cases of hemodialysis and cancer patients were positive for intestinal parasite infection respectively. Blastocystis hominis was only intestinal parasite that were detected in these patients. IgG anti-Toxoplasma antibody detected in 35 (76.8%) hemodialysis and 15 (62.5%) cancer patients. IgM antibody were found in 1 elderly hemodialysis patient. Mix infection (Toxoplasmosis and Blastocystis) was observed in 6.52% and 4.16% in hemodialysis and cancer patients respectively.&#x0D; Conclusion: It is recommended to evaluate these patients for intestinal parasitic infections during hemodialysis or chemotherapy sessions. Data showed the high percentage of elderly patients were susceptible to reactivation of chronic Toxoplasmosis. Therefore, in order to refer them for early therapy or other interventions, it is important that elderly hemodialysis and cancer patients with toxoplasma infection be diagnosed and identified.&#x0D;

Assessment of real-time PCR for Helicobacter pylori DNA detection in stool with co-infection of intestinal parasites: a comparative study of DNA extraction methods

BackgroundMany studies reported high prevalence of H. pylori infection among patients co-infected with intestinal parasites. Molecular approach for the DNA detection of those microbes in stool have been proposed. However there are a few reports that evaluated the effect of bead-beating in relation to the H. pylori outcome. Therefore, we developed and evaluated two TaqMan-based real-time PCR (rt-PCR) qualitative assays for the detection of ureC (glmM) and cagA of Helicobacter pylori on DNA extracted by three procedures.ResultsThe two PCRs were analysed on 100 stool samples from patients who were screened for intestinal parasites. Three DNA extraction procedures were used: 1) automation with bead beating, 2) automation without bead beating and 3) hand column. The specificity of the new assays was confirmed by sequencing the PCR products and by the lack of cross-reactivity with other bacteria or pathogens DNA. Rt-PCR assays showed a detection limit of 10^4 bacteria/200 mg stool. The ureC_PCR with bead beating process was compared to conventional stool antigen test (SAT), with 94.12 and 93.75% of respectively sensitivity and specificity. However, the discordant samples were confirmed by DNA sequencing suggesting a potential higher sensitivity and specificity of PCR.ConclusionsOur findings showed that the automation with bead-beating –suggested procedure for intestinal parasitic infections- can reach highly sensitive results in H. pylori detection on stool compared also with SAT. Thus, this work can provide new insights into the practice of a clinical microbiology laboratory in order to optimize detection of gastro-intestinal infections. Further studies are needed to better define the clinical value of this technique.

Intestinal parasites co-infection and associated factors among active pulmonary tuberculosis patients in selected health centers, Addis Ababa, Ethiopia: unmatched case control study

BackgroundIn co-endemic areas, rate of intestinal parasites and tuberculosis (TB) co-infection thought to be high. However, there are limited studies on the epidemiology of this co-infection in Ethiopia. Therefore, the present study aimed to generate evidence on intestinal parasites co-infection rate and associated factors among pulmonary tuberculosis patients (PTB) and their household contacts in Addis Ababa, Ethiopia.MethodsUnmatched case-control study was conducted. Data were collected from 91 PTB patients (cases) and 89 household contacts (controls). Socio-demographic characteristics and associated factors were collected using structured questionnaire. Sputum, stool and blood specimens were collected, processed and examined for PTB, intestinal parasites and Human Immunodeficiency virus anti-body test, respectively. Data were entered and analyzed by Statistical Packages for Social Sciences (SPSS) Version 20. Descriptive statistics, Fisher’s exact test, binary logistic regression, and odds ratio were used. P-value of < 0.05 was considered as statistically significant.ResultsThe infection rate of intestinal parasites based on one stool samples in PTB patients and controls was 22 and 9%, respectively. The difference was statistically significant (COR = 2.85;95% CI = 1.18–6.87). The most prevalent intestinal parasite in PTB patients was Gardia lamblia (8.8%, 8), followed equally by Ascaris lumbricoides, Haymenolopsis nana and Entamoeba histolytica/dispar (4.4%, 4). Co-infection in PTB patients was associated with body mass index (BMI) < 18.5 (AOR = 6.71;95% CI = 1.65–27.25) and dirty material in finger nails (AOR = 8.99;95% CI = 2.46–32.78). There was no variable associated with parasitic infections in controls in our analysis, which might be due to the low prevalence of intestinal parasites’.ConclusionsThere was a statistical significant difference in the infection rate of intestinal parasites in PTB patients compared to healthy household contacts. The consequence of co-infection on developing an active disease, disease severity and treatment efficacy needs to be investigated in future.

Prevalence of Intestinal Parasites and Associated Factors among Pulmonary Tuberculosis Suspected Patients Attending University of Gondar Hospital, Gondar, Northwest Ethiopia

Introduction Intestinal parasitic infections are among the major public health problems in developing countries. Hence, it is significant to explore coinfection with intestinal parasites and pulmonary tuberculosis because coinfection increases the complexity of control and prevention of pulmonary tuberculosis and parasitic diseases. Objective To assess the prevalence of intestinal parasites among pulmonary tuberculosis suspected patients. Method Institutional based cross-sectional study was conducted at University of Gondar Hospital from March to May, 2017. Stool samples were taken from each participant and examined by direct microscopy and concentration technique. Descriptive statistics was performed and chi-square test was used to show the association between variables. P values of <0.05 were considered statistically significant. Results Intestinal parasites were detected in 50 (19.6%) among a total of 256 pulmonary tuberculosis suspected patients who were included in the study, whereas the prevalence of pulmonary tuberculosis was 16.8% (43/256). Pulmonary tuberculosis and intestinal parasite coinfection was detected in 5 (2.0%) of the participants. The most prevalent intestinal parasites infection in this study was Ascaris lumbricoides, 15 (5.85%), followed by Entamoeba histolytica/dispar, 14 (5.46%), and Hookworm, 13 (5.1%). Conclusion The prevalence of intestinal parasites and their coinfection rate with pulmonary tuberculosis among pulmonary tuberculosis suspected patients were considerable.

Co-infection patterns of intestinal parasites in arboreal primates (proboscis monkeys, Nasalis larvatus) in Borneo.

Non-human primates of South-East Asia remain under-studied concerning parasite epidemiology and co-infection patterns. Simultaneously, efforts in conservation demand knowledge of parasite abundance and biodiversity in threatened species. The Endangered proboscis monkey, Nasalis larvatus, a primate flagship species for conservation in Borneo, was investigated in the present study. Habitat loss and fragmentation are among the greatest threats to bachelor and harem groups of this folivorous colobine. Designed as a follow-up study, prevalence and co-infection status of intestinal parasites from N. larvatus in a protected area in Malaysian Borneo were analyzed from fecal samples using a flotation method. For the first time, the intestinal parasite co-infection patterns were examined using quantitative analyses. Overall, 92.3% of fecal samples (N = 652) were positive for helminth eggs. Five helminth groups were detected: (1) trichurids (82.7% prevalence) including Trichuris spp. (82.1%) and Anatrichosoma spp. (1.4%), (2) strongyles (58.9%) including Trichostrongylus spp. (48.5%) and Oesophagostomum/Ternidens spp. (22.8%), (3) Strongyloides fuelleborni (32.7%), (4) Ascaris lumbricoides (8.6%), and (5) Enterobius spp. (5.5%). On average, an individual was co-infected with two different groups. Significant positive associations were found for co-infections of trichurids with strongyles and S. fuelleborni as well as S. fuelleborni with A. lumbricoides and strongyles. This study shows a high prevalence of various gastrointestinal helminths with potential transmission pathways primarily related to soil and with zoonotic relevance in wild proboscis monkeys in their remaining natural habitats. Observed positive associations of trichurids with strongyles and Strongyloides spp. may result from the high prevalence of trichurids. Similarly, positive associations between Strongyloides and Ascaris were found, both of which typically occur predominantly in juvenile hosts. These findings should be considered when proposing conservation actions in altered habitats nearby human settlements and when managing captive populations.

Co-infection of malaria and intestinal parasites among pregnant women in Edo State, Nigeria

Background: Parasitic infection is a cause of maternal and neonatal morbidity and mortality. This study was conducted to determine the co-infection of Plasmodium falciparum and intestinal parasites among the pregnant women in Edo State, Nigeria. Materials and Methods: A total of 601 participants, consisting of 401 pregnant women attending antenatal clinics and 200 non-pregnant controls, were recruited in this study. The blood and stool specimens were collected from each participant. P. falciparum and intestinal parasites were diagnosed using standard techniques. Results: An overall prevalence of 43.1% of co-infection of P. falciparum and intestinal parasites was observed among the pregnant women. P. falciparum parasitaemia prevalence was 24.9%, whereas the prevalence of intestinal parasites was 18.2%. The most common co-infections among the pregnant women were either P. falciparum/Entamoeba histolytica (16.7%) or P. falciparum/Ascaris lumbricoides (16.7%). Pregnancy status, gestational age and anaemia correlated with the co-infection of P. falciparum/intestinal parasites. Conclusion: Measures to reduce P. falciparum/intestinal parasite co-infection and their effect on pregnant women are advocated.