Direct Smear Research Articles

Frequency of Intestinal Parasites in Patients with Diabetes Mellitus Compared with Healthy Controls in Fasa, Fars Province, Iran, 2018

Background: Parasitic diseases are medically important, especially among immunocompromised patients. Recently, diabetes mellitus (DM) has become one of the most important clinical diseases, and the combination of this disease with parasitic infections can result in serious consequences. Objectives: The aim of this study was to evaluate the infection of intestinal parasites in patients with DM and compare them with healthy individuals in Fasa city and surrounding health centers. Methods: In this case-control study a total of 501 patients and healthy individuals (254 patients with DM and 247 healthy controls) referred to health centers in Fasa, Fars province. Fecal specimens of all of these individuals were collected in a special container. These specimens were investigated using direct smear, concentration method, acid-fast and trichrome staining, agar plate cultivation, and Baermann technique. Results: In this study, 254 diabetic patients (50.7%) and 247 (49.3%) healthy controls were included. The age range of these people was between 25 to 89 years old, with an average age of 57.7 ± 10.7. Our findings revealed that the frequency of intestinal parasites in the control group (18.6%) is higher than the patient group (12.6%). Conclusions: Although the frequency of intestinal parasites in the control group was higher than the patient group, this does not reduce the importance of preventative programs for these patients. Considering the significant effect of unpurified water on intestinal parasites, it is better to consider this issue more in health programs.

Strongyloides stercoralis infection in a patient with rheumatoid arthritis and type 2 diabetes mellitus: a case-based review

Strongyloides stercoralis (S. stercoralis), a human intestinal nematode, can lead to hyper/disseminated (HD) infection in patients treated with corticosteroids. Here, we report a case of strongyloidiasis in a 58-year-old female with a history of rheumatoid arthritis (RA) and type 2 diabetes mellitus (T2DM). The patient presented with abdominal pain and gastrointestinal (GI) bleeding. Stool was negative for parasitic agents in the first direct smear examination, and the patient with the probable diagnosis of Helicobacter pylori (H. pylori) infection or Crohn's disease received antibiotics and corticosteroids. Parasitic agents were not detected in further direct stool examinations, and the patient with the diagnosis of pneumonia, chronic kidney disease (CKD), ulcerative colitis, sepsis, and candidiasis received fungal, antibiotic, and corticosteroids medications. Low sensitivity of direct smear and the lack of using two methods in diagnosing intestinal parasitic infections led to delayed detection. In the fourth direct stool examination, rhabditiform larva of S. stercoralis was reported. The treatment of corticosteroids was discontinued and albendazole was started. A literature review was conducted by searching Medline, Embase, Scopus, and Web of Science with the keywords S. stercoralis, strongyloidiasis, RA, and T2DM. Our case indicates that screening S. stercoralis infection in high-risk groups, especially those who are candidates for corticosteroids medications, must be implemented using at least two diagnostic techniques.

Intestinal parasites amongst primary school children attending Ta’al Model Primary School in Lafia Local Government Area of Nasarawa State, Nigeria

Intestinal parasites are a major health challenge in the tropical and sub-tropical regions. The high prevalence of intestinal parasites has been attributed to poverty leading to poor hygiene, inadequate health services and contaminated food and water. A survey of intestinal parasitic infectation was conducted among 200 primary school children of Ta’al Modern Primary School, Bukan-Sidi in Lafia Local Government Area of Nasarawa State, Nigeria. Stool specimens were collected and examined using direct smear method and formol-ether concentration technique. The prevalence of intestinal parasite recorded was 95(47.5%) in the study-area. A total of six intestinal parasites species were identified: Entomoeba histolytica 15(15.8%), Giardia lamblia 14(14.7%) Ascairis lumbicoides 23(24.2%), Hookworm 28(29.5%), Trichuris trichiura 8 (8.4%) and Fasciola hepatica 7(7.4%). Amongst the six intestinal parasites, Hookworm recorded the highest prevalence 28(29.5%). Generally females 54(56.8%) were found to be more infected than males 41(43.1%). It was observed that prevalence of infection decreased with increase in age group of the pupils. The age-group 7-9 years recorded the highest 27(28.4%) prevalence and least 22(23.2%) in age group 13-15. The highest prevalence 23(24.2%) was found amongst primary one pupils and the least 8(8.4%) was in primary six. Statistical analysis using chi-square (x2) showed no significant difference (p>0.05) in the prevalence of infection between sex, age-group and class of pupils. Intestinal parasitic infection can be reduced through public health awareness campaign to improved personal hygiene and environmental sanitation including good water supply.Keywords: Intestinal parasite; infection; primary school children; Nasarawa State

Frequency, associated factors and clinical symptoms of intestinal parasites among tuberculosis and non-tuberculosis groups in Iran: a comparative cross-sectional study.

Co-infection of human tuberculosis (TB) and intestinal parasites infections (IPIs) is a public health problem, especially in low- and middle-income countries. There is no data on this issue in Iran. Therefore, we investigated the prevalence of IPIs among patients with TB in Iran. Stool samples were collected from 161 patients with TB and 181 healthy people (non-TB group). Standard parasitological methods including direct slide smear, formalin-ether concentration, trichrome, modified Ziehl-Neelsen and chromotrope 2R staining techniques were used for detection of intestinal protozoa and helminths. Nested-PCR and sequence analysis were used to identify the genotypes of Cryptosporidium and human-infecting species of microsporidia. Data analysis was performed using SPSS version 16. The frequency of IPIs in the non-TB group (16.5%) was slightly lower than in patients with TB (21.1%), although statistical significance was not observed (OR, 0.74; 95% CI, 0.43-1.27; P= 0.28). Blastocystis (11.8%) was the most common parasite detected in patients with TB. Infection with multiple parasites in the non-TB group (2.2%) was significantly lower than in patients with TB (7.5%) (OR, 0.28; 95% CI, 0.08-0.88; P=0.02). The ova of Taenia spp., Ascaris lumbricoides and Hyamenolepis nana were identified in three patients with TB (1.9%), while only one person (0.5%) in the non-TB group was infected with Enterobius vermicularis. The results of genotyping revealed two C. parvum subtype families (IIa and IId) and three E. bieneusi genotypes (Ebcar4, IH and jLD-1). Our results showed a higher prevalence of IPIs in patients with TB in comparison with non-TB subjects. Moreover, our findings suggest a proper health education program for good personal hygiene habits, and also preventative measures to avoid the acquisition of IPIs in patients with TB.

Expansion of urban cutaneous leishmaniasis into rural areas of southeastern Iran: Clinical, epidemiological and phylogenetic profiles explored using 7SL high resolution melting-PCR analysis.

Cutaneous leishmaniasis (CL) has increased remarkably in Iran and has expanded into new areas. The present study aimed to assess the emerging CL outbreak in southeastern Iran using high resolution melting-polymerase chain reaction (HRM-PCR) and phylogenetic analysis using the 7SL RNA gene marker. A cross-sectional and analytical survey was conducted during a house-to-house census of 11,021 inhabitants in Narmashir County in southeastern Iran in 2016. The cases were detected by direct smear microscopic examination and sequencing and were characterized using the 7SL RNA gene. All age groups and sexes were equally affected. Most were single lesions (70.7%). The hands (55.2%) and face (37.9%) were the main sites of involvement. The disease was more common among illiterate persons. Sequencing and HRM-PCR revealed that Leishmania tropica (accession no. MH632168 Qale-Shahid) was the principal causative agent of anthroponotic CL (ACL) in new areas of expansion. This is the first emergence of ACL in rural areas of Narmashir County. Based on the molecular data, the causative parasite species confirmed to be L. tropica. Sequencing and phylogenetic analysis indicated that a single clone of the organism derived from a single source has spread into the affected villages. Construction of a main road, population movement and recent urbanization in the area are likely the major factors associated with the establishment of this new outbreak. This study was essential to enable the planning of effective therapeutic and prophylactic measures to control the disease.

Favus of Scrotum Due to Trichophyton rubrum in Immunocompetent Patients: A Clinical, Mycological and Ultrastructural Study.

To characterize the clinical and mycological features of favus of scrotum due to Trichophyton rubrum. A single-site prospective study was carried out in an outpatient dermatology clinic. Microscopic examination and fungal culture were done using skin scrapings. Scales on the scrotum were stained with PAS and visualized by microscopy, including in vivo reflectance confocal microscopy (RCM). Two strains were analyzed by RAPD typing. Scutular lesions were fixed for scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Cultures of the scale from the scrotum and/or groin in all patients showed a growth of T. rubrum. T. rubrum strains from scrotum and groins in one patient were demonstrated as the same strain by RAPD typing. The average age of patients was 34.1 ± 12.78years. The mean course was 8.2 ± 5.07days. All the patients received only topical treatment for 2weeks without recurrence. Direct smear, calcofluor-white staining and in vivo RCM study of the scrotal favus in patients showed a massive number of septate branching hyphae, while fewer septate hyphae in scales in the groin. Abundant hyphae were found only in the outer layer of the stratum corneum of the scrotum under SEM and TEM with intact bilateral cell walls, and normal nucleus, liposomes and reticulum. Few distorted hyphae structures, cell wall degeneration, degenerated cytoplasm and the autophagy phenomenon could be seen in scales from groin under TEM. Scrotal favus due to T. rubrum is still a true infection, which most often occurred in immunocompetent patients.

The Role Of Rose (Rapid Onsite Evaluation) On Spinal Lesion Surgery Decision

Introduction: Exposure and instrumentation of the spine must be meticulous and thorough regardless the techniques and approach selected. Management of the whole surgery process should be decided based on the best available evidence whenever possible. ROSE (Rapid Onsite Evaluation) cytology wrap up the surgical decision. Case Description: Fifteen cases comprise of lytic lesions and/or single pathological fractures of the corpus vertebrae will be presented and discuss as to how the surgical techniques and approaches are assisted by ROSE. ROSE cytology was performed in the operating theater during the surgery. Samples were taken after exposure of the minimal lesion using (18–21) G trocar needle or under fluoroscopy guided. Direct smear, air dried fixation, and Diff Quik staining would take about 10 minutes. Pathologist evaluated the specimen and provided the result in about 20 minutes. The overall 30 minutes allowed surgeon to prepare the further steps. Results would be malignant or benign without pursuing further detail diagnostic. Benign results should be categorized as infection, suspicious of granulomatic tuberculosis, or normal host population cells. The cases outcome were 8 normal host population cells advanced for vertebroplasty to fill the porotic bone. Three spondylitis tuberculosis were debrided without unnecessary instrumentation, and four malignant processes were assured to have enough samples for immunohistochemistry evaluation afterward. All ROSE cytology was confirmed accordingly by the histopathology result afterward. Conclusion: ROSE is easy and offers accurate sampling from the lesion itself. It is quick, therefore during surgery surgeon could decide the best management for the patient.

Improved sensitivity of direct microscopy for Mycobacterium tuberculosis in lymph nodes: comparison of fluorescent microscopy and modified bleach method ZN microscopy along with conventional ZN staining method

Background: Extra pulmonary tuberculosis arises as a result of lymphatic spread from a primary focus. Fine needle aspiration cytology has assumed an important role in the evaluation of peripheral lymphadenopathy as a possible minimally invasive alternative to excisional biopsy. In most low-income countries; the only practically available bacteriologic method for diagnosing EPTB is direct smear microscopy for acid fast bacilli from the sample of the lesion. There are various methods of staining and concentration for improving sensitivity of direct microscopy for detection of tubercle bacilli in specimen.Methods: This prospective study was carried out in the Department of Pathology, Subharti Medical College and associated Chattrapati Shivaji Subharti Hospital, Meerut for a period of 2 years from July 2016 - August 2018 in 151 patients with clinical suspicion of TB and significant lymphadenopathy.Results: AFB positivity increased from 40.39% on conventional ZN stain to 48.34% on modified bleach method ZN stain and to 56.29% on Auramine-O fluorescent stain. Taking fluorescent microscopy (Auramine-O) as reference method the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of conventional ZN stain and modified bleach method ZN stain were calculated as 71.8%, 100%, 100%, 73.33%, 84.10% and 85.33%,100%,100% ,84.61% ,92.05%, respectively.Conclusions: The addition of fluorescent microscopy (Auramine-O) and modified bleach method ZN microscopy along with conventional ZN staining method would be an important adjunct to improve the microscopic detection of Mycobacterium tuberculosis in fine-needle aspirates of lymph nodes.

Prevalence and risk factors of intestinal parasite infections in Mazandaran province, North of Iran

BackgroundIntestinal parasitic infections (IPIs) are confirmed as major public health problems, worldwide. Northern Iran is highly endemic area for such infections. This research aimed to study on the prevalence of IPIs among people referred to the health care centers in Mazandaran Province, Northern Iran. MethodsIn this descriptive cross-sectional survey, 984 stool samples were collected during 2015–2016. Fresh stool samples were collected from all individuals and examined by direct slide smear, formalin-ether concentration, trichrome and modified Ziehl-Neelsen staining techniques. The results were analyzed using SPSS version 16 and Chi-square test. ResultsOut of 984 participants, the overall prevalence of IPIs was 12.1% (95 CI, 11.4–12.7; 119/984). The prevalence of protozoa and helminthes infections were 7.9% (95 CI, 7.4–8.3; 109/984) and 5.3% (95 CI, 4.9%–5.5%; 69/984), respectively. The most prevalent protozoan IPs were include Giardia lamblia (3.3%), Entamoeba coli (2%), Blastocystis hominis (1.3%), Entamoeba histolytica/dispar (1.1%), Entamoeba hartmanni (1.1%) and Cryptosporidium spp. (0.6%). Also major helminthic infections were include Trichostrongylus spp. (2.6%), Hookworms (1.7%), Strongyloides stercoralis (1.1%), Hymenolepis nana (0.6%) and Dicrocoelium dendriticum (0.6%). The results of the univariate analysis revealed that residence (rural being [P = 0.017]) and occupation (farmers [0.033]) were statistically significant risk factor for IPIs. ConclusionIn conclusion, we have found, despite persistent improvement in sanitary conditions over the recent years in northern part of Iran, IPIs are still among the main public health problems in this area. Moreover, helminths infection in our study were considerable. Thus, effective control programs are essential to reduce the incidence of IPIs.

A Simple Genotyping Method for Rapid Differentiation of Blastocystis Subtypes and Subtype Distribution of Blastocystis spp. in Thailand.

Blastocystis spp. is one of the most common protozoa of humans and animals worldwide. The genetic diversity of Blastocystis spp. might be associated with a wide range of symptoms. However, the prevalence of each subtype is different in each country. Until now, there is no standard method for subtyping of Blastocystis spp. We developed a sequential restriction fragment length polymorphism (RFLP) analysis for the rapid differentiation of human Blastocystis subtypes. A large-scale study was also conducted to determine the subtype distribution of Blastocystis spp. in Thailand. Stool samples were collected from 1025 school-age students in four regions of Thailand. Blastocystis infections were identified by direct smear, formalin ethyl-acetate concentration technique (FECT), Boeck and Drbohlav’s Locke-Egg-Serum (LES) medium culture, and polymerase chain reaction (PCR) of small-subunit ribosomal DNA (SSU rDNA). Subtypes of Blastocystis spp. were determined by RFLP. Phylogenetic tree of partial SSU rDNA sequences of Blastocystis spp. was constructed using the Maximum Likelihood (ML) method. Out of 1025 students, 416 (40.6%) were positive for Blastocystis spp. Using two steps of RFLP reactions, we could determine subtype one–three among these students. Subtype 3 was the most common subtype (58.72%) in Thai students, followed by subtype 1 (31.2%), and subtype 2 (10.1%). Blastocystis subtype 3 was the most prevalent in all regions of Thailand. The subtype distribution of Blastocystis spp. in Thailand was different from other countries.

Diagnostic value of bronchoalveolar lavage in the subset of patients with negative sputum/smear and mycobacterial culture and a suspicion of pulmonary tuberculosis

BackgroundThe diagnostic value of bronchoalveolar lavage in patients with negative sputum/smear for tuberculous bacilli has been well studied. However, its value in the subset of patients with both negative sputum/smear and culture is seldom reported. MethodsA retrospective study of patients referred for diagnostic bronchoscopy for the suspicion of pulmonary tuberculosis during the period from April 1st, 2015 to March 30th, 2016, and who had negative sputum/smear and culture for tuberculous bacilli. ResultsOne hundred and ninety patients fulfilled the inclusion criteria. Bronchoalveolar lavage detected further 61/190 (32.1%) pulmonary tuberculosis cases. Bronchoalveolar lavage mycobacterial culture and polymerase chain reaction (positive in 60/190 (31.6%) and 58/190 (30.5%) of patients respectively) provided the highest diagnostic yield, whereas direct smear provided the lowest yield. Bronchoalveolar lavage had a sensitivity of 89.7%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 94.6%, and a test accuracy of 96.3% in suspected pulmonary tuberculosis cases with negative sputum/smear and culture. Positive bronchoalveolar lavage yield for tuberculosis was significantly associated with a positive QuantiFERON-TB Gold In-Tube test, positive purified protein derivative skin test, radiological evidence of upper zone abnormality and patient’s origin being from the Indian subcontinent. ConclusionBronchoalveolar lavage should be pursued as a useful diagnostic tool for suspected pulmonary tuberculosis cases when sputum/smear and culture are negative. Its value is higher in the subset of patients with positive QuantiFERON-TB Gold In-Tube test, positive purified protein derivative skin test, upper zone abnormality on radiograph or being from the Indian subcontinent.

Skin cytology for the veterinary nurse

Skin cytology forms an important part of any dermatological investigation and lends itself well to input from the veterinary nurse. Basic diagnostic procedures such as acetate tape impression smears, direct and indirect impression smears and fine needle aspirates can be undertaken with only a minimal amount of equipment and will produce clinical information that can contribute hugely to the successful management of the case. A knowledge of the most important types of cellular infiltrate and pathogens is needed in order to undertake meaningful interpretation of the results.

The detection of gastrointestinal parasites in owned and shelter dogs in Cebu, Philippines.

Background:Gastrointestinal tract (GIT) parasites affect the health of dogs and may also be zoonotic. The prevalence of these parasites has been well studied in several countries, but reports in the Philippines have been limited.Aim:This study generally aimed to detect the presence of common GIT parasites in owned and shelter dogs in Cebu, Philippines.Materials and Methods:A total of 200 fecal samples (130 from owned dogs and 70 from shelter dogs) were collected. Profiles of owned dogs and their owners were obtained. Fecalysis was performed using three methods: Direct smear, sedimentation, and flotation techniques.Results:Majority of the sampled dogs were 5 years old and below that (79.2%), male (64.6%) and of pure breed (53.1%). Among the most common parasites detected were Ancylostoma, Trichuris and Toxocara spp. Statistical analyses revealed a significant association between the presence of parasites and the body score of the dogs (p=0.000), the deworming status (p=0.000), and the rearing practice (contact with other dogs, p=0.000, where it spends its time (p=0.000), plays in the grass (p=0.050), where it defecates (p=0.014), contact with other animals (p=0.000).Conclusion:GIT parasites were detected in owned and shelter dogs in Cebu, Philippines. The results of this study can serve as baseline information about the canine parasitic fauna in the Philippines.

Prevalence, Characteristics, Risk Factors, and Impact of Intestinal Parasitic Infections on School Children in Jeddah, Western Saudi Arabia

Intestinal Parasitic Infections (IPIs) are a major public health problem worldwide, especially among children with a need for periodical evaluation of prevalence and risk factors to adopt an appropriate prevention strategy. This cross-sectional prospective study was conducted to identify prevalence, risk factors, characteristics, and impact of IPIs on school children in different regions of Jeddah, Saudi Arabia. Children were recruited from randomly selected schools. Questionnaires were distributed to students and filled by their parents to collect relevant information about sociodemographic, environmental, and hygienic living conditions. Stool samples and anthropometric measurements as indicators of nutritional status were collected from students who agreed to participate in the study. Fecal samples were examined by direct smear and formol-ether concentration method. Out of 581 collected stool samples, only 31 (5.3%) samples were positive for IPIs especially Blastocystis hominis (10 samples) and Giardia lamblia (six samples). The only two significant risk factors associated with IPIs were drinking water from tanks [odds ratio (OR): 3.35, 95% confidence interval (CI): 1.60–6.99, p = 0.001] and washing hands with only water (OR: 2.63, 95% CI: 1.17–5.93, p = 0.03). There was no significant impact of IPIs on growth parameters or level of children’s academic performance.

Identification of Gardnerella vaginalis and Atopobium vaginae in Women With Bacterial Vaginosis in Northern Iran

Background Bacterial vaginosis is the most common lower genital tract infection among women of reproductive age. Its causative agent is often the bacterium Gardnerella vaginalis, which exists in synergism with other mostly anaerobic bacteria such as Atopobium vaginae, Mobiluncus curtisii, and Megasphaera type I. Methods A total of 211 women, who referred to obstetrics and gynecology clinics in Rasht City for suspected vaginal infections, were tested for possible bacterial vaginosis. The presence of G. vaginalis and A. vaginae was verified by 5 different laboratory methods based on the Amsel criteria. These methods included determination of pH, whiff test, and observation of clue cells in a direct smear. Polymerase chain reaction using specific primers was performed on the extracted DNA from the vaginal specimens. Results Sixty cases of bacterial vaginosis, of the 211 women tested for suspected vaginal infections, were confirmed using Amsel criteria. In 44% (29/66) and 29% (19/66) of these bacterial vaginosis cases, the presence of G. vaginalis and A. vaginae was confirmed by polymerase chain reaction, respectively. Conclusions Gardnerella vaginalis had a very high prevalence in the 18- to 35-year-old women suffering from bacterial vaginosis in this region of Iran. Presumably, these cases were recommended for appropriate treatment, but the wider issue is about prevention in this age group and appropriate public health messages to raise awareness.

What is known about Tritrichomonas foetus infection in cats?

Tritrichomonas foetus is a parasite that has been definitively identified as an agent of trichomonosis, a disease characterized by chronic diarrhea. T. foetus colonizes portions of the feline large intestine, and manifests as chronic and recurrent diarrhea with mucus and fresh blood, which is often unresponsive to common drugs. Diagnosis of a trichomonad infection is made by either the demonstration of the trophozoite on a direct fecal smear, fecal culture and subsequent microscopic examination of the parasite, or extraction of DNA in feces and amplification by the use of molecular tools. T. foetus is commonly misidentified as other flagellate protozoa such as Giardia duodenalis and Pentatrichomonas hominis. Without proper treatment, the diarrhea may resolve spontaneously in months to years, but cats can remain carriers of the parasite. This paper intends to serve as a source of information for investigators and veterinarians, reviewing the most important aspects of feline trichomonosis, such as trichomonad history, biology, clinical manifestations, pathogenesis, world distribution, risk factors, diagnosis, and treatment.

Enteroparasitism and Risk Factors Associated with Clinical Manifestations in Children and Adults of Jalisco State in Western Mexico.

ObjectivesTo determine the prevalence and risk factors associated with intestinal parasites in the population of San Juan Cosala, Jalisco, Mexico.MethodsA total of 277 samples from 104 participants were analysed using direct smear, flotation, formaldehyde/ethyl acetate, and modified Kinyoun’s acid-fast stain methods. The Graham method was applied only for samples from children under 12 years of age for the diagnosis of Enterobius vermicularis.ResultsThe prevalence of parasite infections in the study population was 77.9% including: Entamoeba histolytica/E. dispar/E. moshkovskii/E. bangladeshi (37.5%), Giardia intestinalis (11.5%); commensals: Endolimax nana (44.2%), Entamoeba coli (27.9%), Chilomastix mesnili (6.7%) and Iodamoeba bütschlii, (2.9%); emerging intestinal protozoans: Blastocystis spp. (49%), Cryptosporidium spp. (7.7%) and Cyclospora cayetanensis (2.9%); and helminths: Enterobius vermicularis (18.3%) and Ascaris lumbricoides (5.8%). The results also showed that 58.64% of the studied population presented polyparasitism. A significant association was found between protozoan infections and housewives, and houses that were not built with concrete ceilings, brick walls and cement floors (p < 0.05).ConclusionPolyparasitism was observed in over half the study population. The most prevalent parasite was Blastocystis spp, whilst the prevalence of helminths was less than that of protozoans. The risk factors for infection to intestinal parasites were being a housewife and not having solid brick, cement and concrete materials for house construction.

PREVALENCE OF SOIL-TRANSMITTED HELMINTHIASIS AMONG ELEMENTARY CHILDREN IN SORONG DISTRICT, WEST PAPUA

Soil transmitted helminthiasis are common in the world and cause illness, especially in developing countries. It can cause infection in humans by contact with parasitic eggs or larvae that live in moist and warm soil. Soil-transmitted helminthiasis is often caused by Ascaris lumbricoides, Trichuris trichiura, Ancylostoma duodenale, and Necator americanus. In Indonesia, Soil transmitted helminthiasis prevalence is still high in some places. The tropical climate and high humidity support for the development of worms like in Sorong District, but there was no data. The purpose of this study is to identify the presece of Soil transmitted helminthiasis in primary school children in Sorong District. A cross-sectional study was conducted in two elementary schools located in Sorong District, West Papua, Indonesia. The two elementary schools are SDN 22 in Klain village and SD Inpres 24 in sub-district Mayamuk. Once collected, the pot that has contained stool is given formalin 10%. Stool examinattion using direct smear method to determine the presence of soil transmitted helminthiasis. Researchers get the subject as many as 147 children. The proportion of elementary school children by sex consists of 72 boys (49%) and 75 girls (51%). The prevalence of Soil transmitted helminthiasis as a whole was 30.6% (45/147) with 40.1% (18/45) single infections and 59.9% (27/45) mixed infections. The single infection that most frequent is Trichuris trichiura, then followed by Ascaris lumbricoides. Soil-transmitted helminthiasis mostly found in girl than boy and mostly found in 6-9 years age group. The worm species that infect elementary school children in the district is Ascaris lumbricoides, Trichuris trichiura, Hookworm, and Strongyloides stercoralis. This is probably related with the climate and low sanitation level. To eliminate soil transmitted helminthiasis among elementary school children, in addition to routine treatment also needs intensive counseling about the importance of maintaining personal hygiene and the environment.

Herpes Simplex Virus and Tuberculosis-Associated Encephalitis in Northeast of Iran

Background: Encephalitis is associated with high rates of mortality and morbidity; however, its pathophysiology is yet to be determined. Objectives: A prospective cohort study of patients with clinically diagnosed encephalitis was performed to investigate herpes simplex virus (HSV) or tuberculosis infection in encephalitis patients. Methods: Overall, 114 patients were enrolled according to clinical profile and were tested for the presence of HSV-1 and 2 or tuberculosis using TaqMan real-time PCR method on cerebrospinal fluid (CSF). Results: Thirty patients were clinically diagnosed with HSV infection, whose CSF samples were sent for HSV qRT-PCR test. The results showed that 10 (33.3) subjects were HSV-1 or 2-positive. Out of 84 patients who were tested for tuberculosis encephalitis, and tuberculosis qRT-PCR was carried out on their CSF, 3 (3.6) cases were positive. No significant differences were found in gender and age between HSV or tuberculosis-negative and positive groups. The main symptoms in HSV positive subjects were fever and depressed level of consciousness. No cases of tuberculosis infection were diagnosed in direct CSF smear test. Conclusions: Since infectious encephalitis is a life-threatening problem and tuberculosis and HSV are progressing in the developing countries, health authorities, physicians and researchers should address this problem more seriously © 2019, Author(s). © 2019, Author(s).

Evaluation of Presence of Candida in Complete Denture Wearer in Tissue and Denture Surfaces Using Smear Method

Background: Candidiasis is the most frequent fungal infection of the human oral cavity. Candida albicans is an opportunistic fungal microorganism and normal flora of the oral cavity. While different Candida species can cause infection, 85% of all oral cavity fungal infections are caused by Candida albicans; other types can cause infection less frequently. Aim: This study aims to determine Candida count as an index of fungal contamination in dentures. The results would determine the level of patients’ oral hygiene and can be useful in infection control programs which consequently would assist in the prevention of opportunistic fungal infections, particularly, in elderly people. Methods: In this experimental study, 100 patients with complete denture randomly selected from the city of Ardabil. Before completing the study questionnaires, consent of patient taken by orally and the necessary demographic data were collected to all patients. Samples were collected two times with two-month interval. The samples were stained with Giemsa using the direct smear method and were studied under light microscope. Data were analyzed by statistical methods such as table and graph and Chi-Square test using SPSS.16 software. Results: Out of 100 studied individuals, 53 had Candida (with different frequency), which was directly associated with cigarette smoking (duration of usage and the number of cigarettes used), and also the oral hygiene maintenance. Conclusion: Oral hygiene maintenance, patient’s training, ceasing the smoking habit and controlling systematic diseases can decrease the amount of Candida in the oral cavity. Keywords: Direct smear, complete denture, Candida, prevalence, Smear Method