Intestinal Protozoan Infections Research Articles

Prevalence of intestinal parasitic infections and associated risk factors among schoolchildren in the Plateau Central and Centre-Ouest regions of Burkina Faso.

BackgroundUnsafe drinking water, unimproved sanitation and lack of hygiene pose health risks, particularly to children in low- and middle-income countries. This study aimed to assess the prevalence and risk factors of intestinal parasitic infections in school-aged children in two regions of Burkina Faso.MethodsA cross-sectional survey was carried out in February 2015 with 385 children aged 8–14 years from eight randomly selected schools in the Plateau Central and Centre-Ouest regions of Burkina Faso. Stool samples were subjected to the Kato-Katz and a formalin-ether concentration method for the diagnosis of helminths and intestinal protozoa infections. Urine samples were examined with a urine filtration technique for Schistosoma haematobium eggs. Water samples from community sources (n = 37), children’s households (n = 95) and children’s drinking water cups (n = 113) were analysed for contamination with coliform bacteria and faecal streptococci. Data on individual and family-level risk factors were obtained using a questionnaire. Mixed logistic regression models were employed to determine factors associated with intestinal parasitic infections in schoolchildren.ResultsIntestinal parasitic infections were highly prevalent; 84.7 % of the children harboured intestinal protozoa, while helminth infections were diagnosed in 10.7 % of the children. We found significantly lower odds of pathogenic intestinal protozoa infection (Entamoeba histolytica/E. dispar and Giardia intestinalis) among children from the Plateau Central, compared to the Centre-Ouest region (P < 0.001). Children from households with “freely roaming domestic animals” (P = 0.008), particularly dogs (P = 0.016) showed higher odds of G. intestinalis, and children reporting exposure to freshwater sources through domestic chores had higher odds of S. haematobium infection compared to children without this water contact activity (P = 0.035). Water quality, household drinking water source and storage did not emerge as significant risk factors for intestinal parasitic infections in children.ConclusionsIntestinal protozoa but not helminths were highly prevalent among schoolchildren in randomly selected schools in two regions of Burkina Faso. Our findings call for specific public health measures tailored to school-aged children and rural communities in this part of Burkina Faso. It will be interesting to assess the effect of water, sanitation and hygiene interventions on the transmission of intestinal parasitic infections.Trial registration ISRCTN17968589 (date assigned: 17 July 2015).Electronic supplementary materialThe online version of this article (doi:10.1186/s13071-016-1835-4) contains supplementary material, which is available to authorized users.

Nitazoxanide induces in vitro metabolic acidosis in Taenia crassiceps cysticerci

Nitazoxanide (NTZ) is a broad-spectrum anti-parasitic drug used against a wide variety of protozoans and helminthes. Albendazole, its active metabolite albendazole sulfoxide (ABZSO), is one of the drugs of choice to treat both intestinal and tissue helminth and protozoan infections. However little is known regarding their impact on the metabolism of parasites. The aim of this study was to compare the in vitro effect of NTZ and ABZSO in the glycolysis of Taenia crassiceps cysticerci. The cysticerci were treated with 1.2; 0.6; 0.3 or 0.15 μg/mL of NTZ or ABZSO. Chromatographic and spectrophotometric analyses were performed in the culture medium and in the cysticerci extract. Regarding the glucose concentrations was possible to observe two responses: impair of the uptake and gluconeogenesis. The pyruvate concentrations were increased in the ABZSO treated group. Lactate concentrations were increased in the culture medium of NTZ treated groups. Therefore it was possible to infer that the metabolic acidosis was greater in the group treated with NTZ than in the ABZSO treated group indicating that this is one of the modes of action used by this drug to induce the parasite death.

Intestinal parasite infections and associated risk factors in communities exposed to wastewater in urban and peri-urban transition zones in Hanoi, Vietnam.

BackgroundInfections with intestinal parasites (helminths and intestinal protozoa) are endemic in Southeast Asia and inappropriate management and reuse of wastewater might exacerbate the risk of human infections. In rapidly growing urban settings, little is known about the extent of intestinal parasite infections. We assessed the point-prevalence and risk factors of intestinal parasite infections in population groups differently exposed to wastewater in urban and peri-urban transition zones in Hanoi, the capital of Vietnam.MethodsA cross-sectional survey was carried out between April and June 2014 in people aged ≥ 18 years at risk of wastewater exposure from To Lich River: workers maintaining wastewater treatment facilities; urban farmers reusing wastewater; and urban dwellers at risk of flooding events. For comparison, two peri-urban population groups living in close proximity to the Red River were chosen: farmers using river water for irrigation purposes; and people living in the same communities. A single stool sample was subjected to Kato-Katz and formalin-ether concentration methods for the diagnosis of helminth and intestinal protozoa infections. A questionnaire was administered to determine risk factors and self-reported signs and symptoms.ResultsA total of 681 individuals had complete data records. Highest point-prevalence rates of intestinal parasite infections were observed for peri-urban farmers (30 %). Hookworm and Trichuris trichiura were the predominant helminth species (25 % and 5 %, respectively). Peri-urban farmers were at higher odds of infection with intestinal parasites than any other groups (adjusted odds ratio 5.8, 95 % confidence interval 2.5 to 13.7). Lack of access to improved sanitation and not receiving deworming within the past 12 months were associated with higher infection risk, while higher educational attainment and socioeconomic status were negatively associated with intestinal parasite infections.ConclusionsOur results suggest that exposure to wastewater was not directly associated with infection with helminths and intestinal protozoa in different population groups in Hanoi. These findings might be explained by a high level of awareness of health risks and access to safe sanitary infrastructure in urban areas. The high prevalence rates observed in peri-urban farmers call for specific interventions targeting this population group.Electronic supplementary materialThe online version of this article (doi:10.1186/s13071-016-1809-6) contains supplementary material, which is available to authorized users.

Epizootic amebiasis outbreak in wild black howler monkeys (Alouatta caraya) in a wildlife facility during captivity prior to translocation - Recommendations to wildlife management programs

Óbitos por infecções causadas por protozoários intestinais são indesejáveis para programas de manejo de fauna, exigidos no âmbito do licenciamento ambiental e que demandam a captura e quarentena de primatas não humanos. Exames coproparasitológicos, necroscópicos, microbiológicos e moleculares foram utilizados para a confirmação do diagnóstico de uma severa enterite necrótica que levou a óbito três fêmeas e dois machos de Alouatta (A.) caraya capturados e mantidos em quarentena prévia à translocação. Exames coproparasitológicos revelaram a presença de cistos de Entamoeba (E.) histolytica/dispar (5/5), Entamoeba (E.) coli (5/5) e Giardia (G.) duodenalis (1/5). A avaliação necroscópica revelou áreas de necrose multifocal severa na mucosa e submucosa intestinal. A análise microscópica revelou a presença de estruturas morfologicamente compatíveis com trofozoítos do gênero Entamoeba spp. em todos os indivíduos examinados. Além disso, G. duodenalis (1/5) foi demonstrada pela técnica de Nested PCR. Sugere-se que quando for necessário o cativeiro temporário de primatas, deverão ser adotados protocolos de manejo adequados buscando a destinação imediata dos animais, de moto a mitigar os efeitos negativos do estresse e reduzir o risco da ocorrência de infecções.

A decade of intestinal protozoan epidemiology among settled immigrants in Qatar.

BackgroundThe World Health Organization estimates that about 3.5 billion people worldwide are affected by intestinal parasitic infections. Reports have already emphasized the role of immigrants in outbreaks of parasitic diseases in industrialized countries. With the mass influx of immigrants to Qatar, patent intestinal parasitic infections have been observed. Herein, the prevalence of intestinal protozoan infections was analysed in 29,286 records of subjects referred for stool examination at the Hamad Medical Corporation over the course of a decade (2005 to 2014, inclusive).ResultsOverall prevalence of combined protozoan infections was 5.93 % but there were significant temporal trends, age and sex effects and those arising from the region of origin of the subjects. The most common protozoan was Blastocystis hominis (overall prevalence 3.45 %). Giardia duodenalis, Chilomastix mesnili, Entamoeba coli, Entamoeba hartmanni, Endolimax nana, Iodamoeba butschlii, Entamoeba histolytica/dispar, Cryptosporidium sp. and a single case of Isospora were also detected. The prevalence of combined protozoan infections, G. duodenalis and the non-pathogenic amoebae all declined significantly across the decade. That of B. hominis varied between years but showed no directional trend across years and there was no evidence that prevalence of E. histolyitica/dispar changed significantly. Protozoan infections were observed among all regional groups, but prevalence was higher among subjects from the Arabian Peninsula, Africa and Asia compared to those from the Eastern Mediterranean and Qatar. Prevalence was higher among male subjects in all cases, but age-prevalence profiles differed between the taxa.ConclusionThese results offer optimism that prevalence will continue to decline in the years ahead.

Accuracy of Mobile Phone and Handheld Light Microscopy for the Diagnosis of Schistosomiasis and Intestinal Protozoa Infections in Côte d'Ivoire.

BackgroundHandheld light microscopy using compact optics and mobile phones may improve the quality of health care in resource-constrained settings by enabling access to prompt and accurate diagnosis.MethodologyLaboratory technicians were trained to operate two handheld diagnostic devices (Newton Nm1 microscope and a clip-on version of the mobile phone-based CellScope). The accuracy of these devices was compared to conventional light microscopy for the diagnosis of Schistosoma haematobium, S. mansoni, and intestinal protozoa infection in a community-based survey in rural Côte d’Ivoire. One slide of 10 ml filtered urine and a single Kato-Katz thick smear from 226 individuals were subjected to the Newton Nm1 microscope and CellScope for detection of Schistosoma eggs and compared to conventional microscopy. Additionally, 121 sodium acetate-acetic acid-formalin (SAF)-fixed stool samples were examined by the Newton Nm1 microscope and compared to conventional microscopy for the diagnosis of intestinal protozoa.Principal FindingsThe prevalence of S. haematobium, S. mansoni, Giardia intestinalis, and Entamoeba histolytica/E. dispar, as determined by conventional microscopy, was 39.8%, 5.3%, 20.7%, and 4.9%, respectively. The Newton Nm1 microscope had diagnostic sensitivities for S. mansoni and S. haematobium infection of 91.7% (95% confidence interval (CI) 59.8–99.6%) and 81.1% (95% CI 71.2–88.3%), respectively, and specificities of 99.5% (95% CI 97.0–100%) and 97.1% (95% CI 92.2–99.1%), respectively. The CellScope demonstrated sensitivities for S. mansoni and S. haematobium of 50.0% (95% CI 25.4–74.6%) and 35.6% (95% CI 25.9–46.4%), respectively, and specificities of 99.5% (95% CI 97.0–100%) and 100% (95% CI 86.7–100%), respectively. For G. intestinalis and E. histolytica/E. dispar, the Newton Nm1 microscope had sensitivity of 84.0% (95% CI 63.1–94.7%) and 83.3% (95% CI 36.5–99.1%), respectively, and 100% specificity.Conclusions/SignificanceHandheld diagnostic devices can be employed in community-based surveys in resource-constrained settings after minimal training of laboratory technicians to diagnose intestinal parasites.

Prevalence and Associated Risk Factors of Protozoan Infections among the Tea Estates Workers of Ilam District, Nepal

&lt;strong&gt;Introduction&lt;/strong&gt;: Intestinal protozoan infections continue to remain a global public health challenge, particularly in developing countries. Since diagnosis of these parasites is difficult, prevalence data on intestinal protozoa is scarce. &lt;strong&gt;Objectives&lt;/strong&gt;: To measure the prevalence of intestinal Protozoan Infections and to identify risk factors associated with Protozoan Infections among the tea garden workers in Ilam district of Nepal. &lt;strong&gt;Materials and Methods&lt;/strong&gt;: A Community based cross-sectional study was conducted among tea garden workers in Ilam district of Nepal. Out of 4 tea estates in Ilam District, 2 tea estates (Ilam Municipality and Kanyam) were selected randomly. Out of total 150 tea workers (30 in Ilam Municipality and 120 in Kanyam), 98 workers participated in the study. Semi-structured questionnaire was used and routine examination of stool was done. Collected data was entered in Microsoft excel and analysed. &lt;strong&gt;Results&lt;/strong&gt;: Prevalence of protozoan infections among the Tea Estates workers of Ilam District was 22.4%. &lt;em&gt;Giardia lamblia&lt;/em&gt; was seen higher (12.2%) than &lt;em&gt;Entamoeba histolytica&lt;/em&gt; (10.2%). Regarding ethnicity, the protozoan infection was seen higher among Dalit (40%) than Janajati (18.8%) and Brahmin/Chhetri (11.1%) (P&amp;lt;0.05). The protozoan infections was seen lower who use of soap and water after defecation (6.2%) than those using only water (60%) (P&amp;lt;0.001). The protozoan infections was also seen lower who wear sandals or shoes (17.3%) than those did not wear (47.1%) (P&amp;lt;0.05). The protozoan infection was seen higher among those having the habit of nail biting and thumbs sucking. &lt;strong&gt;Conclusions&lt;/strong&gt;: There is relatively high prevalence of intestinal protozoan infection among the Tea garden workers in Ilam District of Nepal. This obviously suggests that there is possible poor personal hygiene, sanitation, and behavior oriented risk factors which predispose the workers to these parasites.

Epidemiology of Cryptosporidiosis and Giardiasis: What Pediatricians Need to Know

Diarrheal illness in the USA is a significant contributor to adverse morbidity in children and has a major impact economically, including the utilization of healthcare resources. Viral and bacterial pathogens account for the majority of cases that have an infectious cause; however, intestinal protozoan parasites are important but often under-recognized etiologic agents for infectious diarrhea. Cryptosporidium spp. and Giardia lamblia are the most common intestinal protozoal infections in both resource-limited and resource-abundant countries and predominately affect children, usually those between ages 1–9 years and most often in children less than 4 years of age. Both Cryptosporidium and Giardia are ubiquitous in the environment and transmit primarily through the fecal-oral route after ingestion of oocysts/cysts in contaminated water or food or direct person-to-person contact. Both are environmentally hardy. The chlorine-tolerant Cryptosporidium oocysts in particular have led to more diarrheal outbreaks due to treated recreational water exposure than any other pathogen. Despite notifiable diseases in the USA, reporting is very low and thus general awareness of epidemiology and clinical manifestations is limited. Underdiagnosis can further contribute to under-reporting, especially in asymptomatic patients and where specialty consultation and reliable diagnostics are absent. Once a diagnosis of cryptosporidiosis or giardiasis has been confirmed, in addition to appropriate case reporting and treatment considerations, it is essential to provide educational support to children and their parents or caregivers to prevent further transmission of the disease within the household and throughout the community.

Gastrointestinal parasitic infection in diverse species of domestic birds of Manipur, India

Domesticated birds (515) consisting of 185 broiler (Gallusgallusdomesticus), 130 layers (Gallus Sp), 75 free range local chicken (Gallusdomesticus), 40 house pigeon (Columbalivia), 70 ducks (Anasplatyrhynchos) and 15 turkeys (Melleagrisgallopavo) reared in valley districts of Manipur were investigated for intestinal protozoan and helminthic infections. Fresh faecal samples of these birds were examined microscopically by direct wet smear with 2.5% potassium dichromate (K2Cr2O7). Of these 412 (80%) were found to be infected with different species of gastrointestinal parasites. The highest (90.8%) prevalence of these parasitic infections was found in broiler followed by layer (78.5%), duck (75.7%), house pigeon (75%), Turkey (66.7%) and free range local chicken (65.3%), etc. A total of 10 species of intestinal parasites were encountered. Among these, the protozoans Eimeria and Isospora were the most common (68.3%) followed by mixed infection of protozoan and Helminths.

Water Related Health Problems in Central Asia—A Review

The present paper provides an extensive literature review on water related health issues in Central Asia. Even though the per capita amount of available freshwater is substantial in all Central Asian states the uneven distribution in time and space creates problems for water availability. Due to this, the Central Asian economies are developing under increasing water deficiency. The degradation of water supply systems and sewage treatment plants is often severe leading to potentially high water loss rates and inadequate accessibility to safe water supply. In this context, rural areas are the most affected. Low tariffs in combination with absent metering and low collection rates for water fees mean that operation and maintenance costs for basic services of water supply and sanitation are not covered. Unsafe water supply contains both microbiological and non-microbiological contaminants. Helminthiasis and intestinal protozoa infections are of considerable public health importance in Central Asia. Agricultural and industrial pollution is especially affecting downstream areas of Amu Darya and Syr Darya rivers. In large areas copper, zinc, and chromium concentrations in water exceed maximum permissible concentration. Thus, there is an urgent need to strengthen the environmental monitoring system. Small-scale water supply and sanitation systems need to be developed in line with more efficient public spending on these.

Trends in prevalence of soil-transmitted helminth and major intestinal protozoan infections among school-aged children in Nepal.

To assess the trends in prevalence of soil-transmitted helminths (STHs), Entamoeba histolytica and Giardia lamblia among school-aged children in Nepal between 1990 and 2015. Systematic literature search in PubMed, MEDLINE, EMBASE, Google Scholar and local peer-reviewed journals for papers published between 1990 and December 2015. We conducted metaregression and meta-analyses to pool studies where applicable. Thirty-nine studies that examined a total of 14 729 stool specimens were included in the meta-analyses. The metaregression of prevalence of hookworms, roundworm, and whipworm showed a significantly decreasing trend over time. In or after 2004, the pooled prevalence of hookworm infections was 1.53% (95% CI, 0.73-2.59), of roundworm 4.31% (95% CI, 2.52-6.53) and of whipworm 2.89% (95% CI, 1.33-4.97) vs. 16.54% (95% CI, 7.64-27.97) for hookworm, 25.20% (95% CI, 13.59-38.97) for roundworm and 11.54% (95% CI 4.25-21.76) for whipworm in 1993-2003. E. histolytica and G. lamblia had stable prevalence since early 1990s, with a pooled prevalences of 4.12% (95% CI, 2.73-5.77) and 9.40% (95% CI, 7.15-11.92), respectively. The prevalence of G. lamblia was significantly higher in urban areas. We observed a sharp decrease in prevalence of STHs among school-aged children in Nepal in the past decade with prevalences dropping below 5% for STHs with no variation in prevalence in rural and urban areas. However, the prevalence of E. histolytica and G. lamblia remained stable over time. These results suggest that school-based deworming programmes rolled out during the study period had an observable impact on prevalence of STHs.

Prevalence and Risk Factors for Intestinal Protozoan Infections with Cryptosporidium, Giardia, Blastocystis and Dientamoeba among Schoolchildren in Tripoli, Lebanon.

BackgroundIntestinal protozoan infections are confirmed as major causes of diarrhea, particularly in children, and represent a significant, but often neglected, threat to public health. No recent data were available in Lebanon concerning the molecular epidemiology of protozoan infections in children, a vulnerable population at high risk of infection.Methodology and Principal FindingsIn order to improve our understanding of the epidemiology of intestinal pathogenic protozoa, a cross-sectional study was conducted in a general pediatric population including both symptomatic and asymptomatic subjects. After obtaining informed consent from the parents or legal guardians, stool samples were collected in January 2013 from 249 children in 2 schools in Tripoli, Lebanon. Information obtained from a standard questionnaire included demographic characteristics, current symptoms, socioeconomic status, source of drinking water, and personal hygiene habits. After fecal examination by both microscopy and molecular tools, the overall prevalence of parasitic infections was recorded as 85%. Blastocystis spp. presented the highest infection rate (63%), followed by Dientamoeba fragilis (60.6%), Giardia duodenalis (28.5%) and Cryptosporidium spp. (10.4%). PCR was also performed to identify species and genotypes of Cryptosporidium, subtypes of Blastocystis, and assemblages of Giardia. Statistical analysis using a logistic regression model showed that contact with family members presenting gastrointestinal disorders was the primary risk factor for transmission of these protozoa.ConclusionsThis is the first study performed in Lebanon reporting the prevalence and the clinical and molecular epidemiological data associated with intestinal protozoan infections among schoolchildren in Tripoli. A high prevalence of protozoan parasites was found, with Blastocystis spp. being the most predominant protozoans. Although only 50% of children reported digestive symptoms, asymptomatic infection was observed, and these children may act as unidentified carriers. This survey provides necessary information for designing prevention and control strategies to reduce the burden of these protozoan infections, especially in children.

Risk of Intestinal Parasitic Infections in People with Different Exposures to Wastewater and Fecal Sludge in Kampala, Uganda: A Cross-Sectional Study.

BackgroundThere are health risks associated with wastewater and fecal sludge management and use, but little is known about the magnitude, particularly in rapidly growing urban settings of low- and middle-income countries. We assessed the point-prevalence and risk factors of intestinal parasite infections in people with different exposures to wastewater and fecal sludge in Kampala, Uganda.MethodologyA cross-sectional survey was carried out in September and October 2013, enrolling 915 adults from five distinct population groups: workers maintaining wastewater facilities; workers managing fecal sludge; urban farmers; slum dwellers at risk of flooding; and slum dwellers without risk of flooding. Stool samples were subjected to the Kato-Katz method and a formalin-ether concentration technique for the diagnosis of helminth and intestinal protozoa infections. A questionnaire was administered to determine self-reported signs and symptoms, and risk factors for intestinal parasite infections. Univariate and multivariate analyses, adjusted for sex, age, education, socioeconomic status, water, sanitation, and hygiene behaviors, were conducted to estimate the risk of infection with intestinal parasites and self-reported health outcomes, stratified by population group.Principal FindingsThe highest point-prevalence of intestinal parasite infections was found in urban farmers (75.9%), whereas lowest point-prevalence was found in workers managing fecal sludge (35.8%). Hookworm was the predominant helminth species (27.8%). In urban farmers, the prevalence of Trichuris trichiura, Schistosoma mansoni, Ascaris lumbricoides, and Entamoeba histolytica/E. dispar was 15% and above. For all investigated parasites, we found significantly higher odds of infection among urban farmers compared to the other groups (adjusted odds ratios ranging between 1.6 and 12.9). In general, female participants had significantly lower odds of infection with soil-transmitted helminths and S. mansoni compared to males. Higher educational attainment was negatively associated with the risk of intestinal protozoa infections, while socioeconomic status did not emerge as a significant risk factor for any tested health outcome.Conclusions/SignificanceUrban farmers are particularly vulnerable to infections with soil-transmitted helminths, S. mansoni, and intestinal protozoa. Hence, our findings call for public health protection measures for urban farmers and marginalized communities, going hand-in-hand with integrated sanitation safety planning at city level.

Intestinal protozoa infections, associated risk factors and clinical features among children in a low-income tea plantation community in Sri Lanka

Background: Information on associated factors and current health impact on intestinal protozoa infections in tea plantation community in Sri Lanka is insufficient. The purpose of this study was to describe risk factors and clinical manifestations of intestinal protozoa infections among children in a tea plantation community in Sri Lanka. Methods: An interviewer administered structured questionnaire was used to collect data on socio-demographic characteristics and clinical features of children. Protozoa infections were diagnosed by direct wet smears, formal-ether concentration technique and Ziehl-Neelsen staining technique. Results: 489 children aged 1–12 years participated and the overall prevalence of intestinal protozoan infection was 18.4%. Entamoeba coli was the most common intestinal protozoa (16.9%) followed by Blastocystis hominis (1.4%), Iodamoeba buschilli (0.2%), Entamoeba histolytica (0.2%) and Giardia intestinalis (0.2%). Multivariate analysis identified eating unwashed fruits (p=0.003), nail biting (p=0.024) and sucking fingers (p=0.018) as statistically significant factors with intestinal protozoa infections. Conclusions: Health education programs promoting awareness about health and hygiene and improving sanitation facilities are recommended to reduce the morbidity associated with intestinal protozoa infections among this population.

Protozoan Parasites of Rodents and Their Zoonotic Significance in Boyer-Ahmad District, Southwestern Iran.

Backgrounds. Wild rodents are reservoirs of various zoonotic diseases, such as toxoplasmosis, babesiosis, and leishmaniasis. The current study aimed to assess the protozoan infection of rodents in Boyer-Ahmad district, southwestern Iran. Materials and Methods. A total of 52 rodents were collected from different parts of Boyer-Ahmad district, in Kohgiluyeh and Boyer-Ahmad province, using Sherman live traps. Each rodent was anesthetized with ether, according to the ethics of working with animals, and was dissected. Samples were taken from various tissues and stool samples were collected from the contents of the colon and small intestines. Moreover, 2 to 5 mL of blood was taken from each of the rodents and the sera were examined for anti-Leishmania antibodies, by ELISA, or anti-T. gondii antibodies, by modified agglutination test (MAT). DNA was extracted from brain tissue samples of each rodent and PCR was used to identify the DNA of T. gondii. Results. Of the 52 stool samples of rodents studied by parasitological methods, intestinal protozoa infection was seen in 28 cases (53.8%). From 52 rodents, 19 (36.5%) were infected with Trichomonas, 10 (19.2%) with Giardia muris, and 11 (21.2%) with Entamoeba spp. Also, 10 cases (19.2%) were infected with Blastocystis, 3 (5.8%) were infected with Chilomastix, 7 (13.5%) were infected with Endolimax, 1 (1.9%) was infected with Retortamonas, 3 (5.77%) were infected with T. gondii, and 6 (11.54%) were infected with Trypanosoma lewisi. Antibodies to T. gondii were detected in the sera of 5 (9.61%) cases. Results of the molecular study showed T. gondii infection in 3 (5.77%) of the rodents. Findings of this study showed that rodents in Kohgiluyeh and Boyer-Ahmad province, southwestern Iran, are infected with several blood and intestinal parasites; some of them might be potential risks to residents and domestic animals in the region.

A Study of Prevalence of Intestinal Protozoan Infections and Associated Risk Factors among the School Children of Biratnagar Submetropolitan, Eastern Region of Nepal

A Study of Prevalence of Intestinal Protozoan Infections and Associated Risk Factors among the School Children of Biratnagar Submetropolitan, Eastern Region of Nepal

PREVALENCE OF INTESTINAL PROTOZOAN PARASITIC INFECTIONS AMONG PEOPLE ATTENDING SEBHA CENTRAL LABORATORY IN SEBHA, LIBYA: A RETROSPECTIVE STUDY

Intestinal d protozoan parasites are still major public health problems in the world, particularly in developing countries. This retrospective study was conducted using data obtained from the Department of Parasitology of Sebha Central Laboratory in Sebha, Libya. A total of 740 stool samples were recorded from January to December, 2017. All samples were examined by direct wet smears using normal saline and Lugol’s iodine. The objective of this study was to determine the different types of intestinal protozoan in Sebha city. The results were analyzed using SPSS version 20.0, the Chi-square test was used to measure the statistical significant differences at level p&lt;0.05. The overall prevalence rate of protozoan parasitic infections was 10.5% (78/740). Four species of protozoan parasites were detected as single infections: Blastocystis hominis (6.8%; 50/740), Entamoeba histolytica/Entamoeba dispar (2.3%; 17/740), Giardia lamblia (0.9%; 7/740), and Entamoeba coli (0.3%; 2/740). Two samples were obtained with mixed infections: the first by Blastocystis hominis with Entamoeba histolytica/Entamoeba dispar (0.1%; 1/740), and the second by Blastocystis hominis with Giardia lamblia (0.1%; 1/740). Prevalence of protozoan infections was insignificantly (p=0.740) higher in males, 10.9% (43/396) than females (10.2%; 35/344). The prevalence of protozoan infections was highest in the 10-19 years age group (14.1%, 14/99), and lowest in the 30-39 years age group (5.7%; 4/70), with no significant differences between the intestinal protozoan infection and age groups (p=0.641). According to the seasonal variations, the results revealed that the highest rate of infection was in November (20.8%, 11/53), followed by 19.6% in September (9/46), while the lowest infection was 4.3% in July (3/70). No significant differences were detected in the prevalence of infection between the different months (p=0.236).

Metagenomic diagnostics for the simultaneous detection of multiple pathogens in human stool specimens from Côte d'Ivoire: a proof-of-concept study

BackgroundThe intestinal microbiome is a complex community and its role in influencing human health is poorly understood. While conventional microbiology commonly attributes digestive disorders to a single microorganism, a metagenomic approach can detect multiple pathogens simultaneously and might elucidate the role of microbial communities in the pathogenesis of intestinal diseases. We present a proof-of-concept that a shotgun metagenomic approach provides useful information on the diverse composition of intestinal pathogens and antimicrobial resistance profiles in human stool samples. MethodsIn October 2012, we obtained stool specimens from patients with persistent diarrhea in south Côte d'Ivoire. Four stool samples were purposefully selected and subjected to microscopy, multiplex polymerase chain reaction (PCR), and a metagenomic approach. For the latter, we employed the National Center for Biotechnology Information nucleotide database and screened for 36 pathogenic organisms (bacteria, helminths, intestinal protozoa, and viruses) that may cause digestive disorders. We further characterized the bacterial population and the prevailing resistance patterns by comparing our metagenomic datasets with a genome-specific marker database and with a comprehensive antibiotic resistance database. ResultsIn the four patients, the metagenomic approach identified between eight and 11 pathogen classes that potentially cause digestive disorders. For bacterial pathogens, the diagnostic agreement between multiplex PCR and metagenomics was high; yet, metagenomics diagnosed several bacteria not detected by multiplex PCR. In contrast, some of the helminth and intestinal protozoa infections detected by microscopy were missed by metagenomics. The antimicrobial resistance analysis revealed the presence of genes conferring resistance to several commonly used antibiotics. ConclusionsA metagenomic approach provides detailed information on the presence and diversity of pathogenic organisms in human stool samples. Metagenomic studies allow for in-depth molecular characterization such as the antimicrobial resistance status, which may be useful to develop setting-specific treatment algorithms. While metagenomic approaches remain challenging, the benefits of gaining new insights into intestinal microbial communities call for a broader application in epidemiologic studies. Trial registration: ISRCTN86951400.

Effect of sanitation and water treatment on intestinal protozoa infection: a systematic review and meta-analysis

Pathogenic intestinal protozoa infections are responsible for substantial mortality and morbidity, particularly in settings where people lack improved sanitation and safe drinking water. We assessed the relation between access to, and use of, sanitation facilities and water treatment and infection with intestinal protozoa. We did a systematic review and searched PubMed, ISI Web of Science, and Embase from inception to June 30, 2014, without restrictions on language. All publications were examined by two independent reviewers and were included if they presented data at the individual level about access or use of sanitation facilities or water treatment, in combination with individual-level data on human intestinal protozoa infections. Meta-analyses using random effects models were used to calculate overall estimates. 54 studies were included and odds ratios (ORs) extracted or calculated from 2 × 2 contingency tables. The availability or use of sanitation facilities was associated with significantly lower odds of infection with Entamoeba histolytica or Entamoeba dispar (OR 0·56, 95% CI 0·42-0·74) and Giardia intestinalis (0·64, 0·51-0·81), but not for Blastocystis hominis (1·03, 0·87-1·23), and Cryptosporidium spp (0·68, 0·17-2·68). Water treatment was associated with significantly lower odds of B hominis (0·52, 0·34-0·78), E histolytica or E dispar (0·61, 0·38-0·99), G intestinalis (0·63, 0·50-0·80), and Cryptosporidium spp infections (0·83, 0·70-0·98). Availability and use of sanitation facilities and water treatment is associated with lower odds of intestinal protozoa infections. Interventions that focus on water and sanitation, coupled with hygiene behaviour, should be emphasised to sustain the control of intestinal protozoa infections. Swiss National Science Foundation (project numbers PBBSP3-146869 and P300P3-154634), Medicor Foundation, European Research Council (614739-A_HERO).

RETRACTED ARTICLE: Frequency of intestinal protozoan parasites in patients with gastrointestinal disorders in south of Karaj, Iran.

The aim of this study was to describe epi- demiologic characteristics of intestinal protozoan parasites in a population in Karaj, Iran. Out of 2200 patient, 428 stool specimens (19.45 %) were infected with intestinal protozoan parasites. Out of 428 (19.45 %) infected patient with parasite, 366 (16.63) of patients were infected with single parasite and 62 (2.81) were infected with multiple protozoan parasites. The results were shown that maximum infections belonged to Giardia intestinalis, 31.69 % among the patients with multiple infection and 35.48 % among the patients with single infection. Moreover, Entamoeba coli and Blastocystis hominis were the other common parasites. Other protozoan parasites were as follows: Trichomonas hominis, Iodamoeba butschlii and Endolimax nana. Prevalence of Giardia lamblia and E. coli were highest in the B1-12 years age group (P 0.05). A significant dif- ference was found between protozoan parasites and gender (P 0.05). Our result indicated that intestinal protozoan infections are still a major public health challenge in this area.