Intestinal Protozoan Infections Research Articles

Prevalence and risk factors of intestinal protozoan and helminth infections among pulmonary tuberculosis patients without HIV infection in a rural county in P. R. China

Although co-infection of tuberculosis (TB) and intestinal parasites, including protozoa and helminths, in humans has been widely studied globally, very little of this phenomenon is known in China. Therefore, a cross-sectional study was conducted in a rural county of China to investigate such co-infections. Patients with pulmonary TB (PTB) undergoing anti-Mycobacterium tuberculosis (anti-MTB) treatment were surveyed by questionnaires, and their feces and blood specimens were collected for detection of intestinal protozoa and helminths, routine blood examination and HIV detection. The χ2 test and multivariate logistic regression model were used to identify risk factors. A total of 369 patients with PTB were included and all of them were HIV negative. Overall, only 7.3% of participants were infected with intestinal protozoa, among which prevalence of Blastocystis hominis, Entamoeba spp. and Trichomonas hominis were 6.0%, 1.1% and 0.3%, respectively; 7.0% were infected with intestinal helminths, among which prevalence of hookworm, Trichuris trichiura, Ascaris lumbricoides and Clonorchis sinensis were 4.3%, 1.9%, 0.5% and 0.3%, respectively; and 0.5% were simultaneously infected with intestinal protozoa and helminths. Among patients with PTB, body mass index (BMI)≤18 (OR=3.30, 95% CI=1.44–7.54) and raised poultry or livestock (e.g., chicken, duck, pig) (OR=3.96, 95% CI=1.32–11.89) were significantly associated with harboring intestinal protozoan infection, while BMI≤18 (OR=3.32, 95% CI=1.39–7.91), anemia (OR=3.40, 95% CI=1.44–8.02) and laboring barefoot in farmlands (OR=4.54, 95% CI=1.88–10.92) were significantly associated with having intestinal helminth infection. Additionally, there was no significant relationship between duration of anti-MTB treatment and infection rates of intestinal parasites including protozoa and helminths. Therefore, preventing malnutrition, avoiding unprotected contact with reservoirs of protozoa, and improving health education for good hygiene habits, particularly wearing shoes while outdoors, are beneficial in the prevention of intestinal protozoan and helminth infection among patients with PTB.

Asymptomatic intestinal protozoa in school age children in Pategi, Pategi LGA of Kwara state, Nigeria.

Introduction: Intestinal protozoan infection is one of the principal diseases contributing to human illness and suffering in tropical countries with significant morbidity and mortality effect on children. The prevalence of intestinal asymptomatic protozoan infection was assessed (November, 2012 through May, 2013) among school age children in Pategi, Pategi Local Government area of Kwara State, Nigeria.Materials and methods: Four public primary schools with nursery, prebasic and basic sections were used for the study. The age range was from 1 to 15 years old. Seven hundred and forty eight (748) stool specimens were collected and examined for protozoan cysts using the direct wet preparation and formol-ether concentration methods.Results: One hundred and ninety seven (26.3%) of the samples were positive for intestinal protozoan parasite. The distribution of the parasites was E. histolytica/dispar (75.1), E. coli (18.8) and G. lamblia (6.1%). Balantidium coli cyst was not detected in the stool samples of the pupils. Highest prevalence of E. histolytica was observed among Gboke primary school (35.0%), closely followed by Nyamkpan (31.7%) and Sudan Interior Mission (SIM) (5.9%). Though males (28.0%) were more infected than female (24.7%), the difference was not statistically significant (P>0.05) except for G. lamblia infection (P<0.05).Conclusion: The public health implication of asymptomatic carriage in cysts of intestinal protozoan among the children with poor personal hygiene was discussed. The use of mass chemotherapy and integrated measures of parasitic control would be of utmost importance in reducing the level of symptomatic infections among children.Key words: Asymptomatic, amoebiasis, giardiasis, rural area, children.

Prevalence of intestinal protozoan infections among individuals living with HIV/AIDS at Felegehiwot Referral Hospital, Bahir Dar, Ethiopia

HIV infection continues to pose a serious challenge to global health by predisposing patients to opportunistic infections. A cross-sectional study was conducted from December 2012 to February 2013 to assess the enteric protozoan infection status among individuals living with HIV/AIDS in Felegehiwot Referral Hospital, Bahir Dar, northwest Ethiopia. Stool specimens from 399 HIV-positive individuals were examined for the presence of trophozoites, cysts, and oocysts using direct wet mount, formol-ether sedimentation and modified Ziehl-Neelsen techniques. In addition, CD4+ T-cell counts were measured to evaluate the immune status of the study subjects. An overall prevalence of 30.6% enteric protozoan infections was recorded. Pre-ART (antiretroviral treatment) individuals were more infected than patients on ART, although this was not statistically significant (p>0.05). The highest prevalence of enteric protozoan infection was due to Entamoeba histolytica/E. dispar (19.3%), followed by Cryptosporidium spp (5.8%), Giardia lamblia (4.3%), and Isospora belli (1.3%). A CD4+ T-cell count of <200 cells/μl and status of being diarrhoeic were significantly associated with the overall prevalence of enteric protozoan infection. A relatively high prevalence of enteric protozoan infection was observed among individuals living with HIV/AIDS. Routine stool and CD4+ T-cell examinations should be conducted to monitor the status of HIV/AIDS patients.

Asymptomatic intestinal protozoa in school age children in Pategi, Pategi LGA of Kwara state, Nigeria.

Intestinal protozoan infection is one of the principal diseases contributing to human illness and suffering in tropical countries with significant effect of morbidity and mortality on children. The prevalence of intestinal asymptomatic protozoan infection was assessed (November, 2012 through May, 2013) among school age children in Pategi, Pategi Local Government area of Kwara State, Nigeria. Four public primary schools with nursery, prebasic and basic sections were used for the study. The age range was from 1 to 15 years old. Seven hundred and forty eight (748) stool specimens were collected and examined for protozoan cysts using the direct wet preparation and formol-ether concentration methods. One hundred and ninety seven (26.3%) of the samples were positive for intestinal protozoan parasite. The distribution of the parasites was E. histolytica/dispar (75.1), E. coli (18.8) and G. lamblia (6.1%). Balantidium coli cyst was not detected in the stool samples of the pupils. Highest prevalence of E. histolytica was observed among Gboke primary school (35.0%), closely followed by Nyamkpan (31.7%) and Sudan Interior Mission (SIM) (5.9%). Due males (28.0%) were more infection and female (24.7%), the difference was not statistically significant (P>0.05) except for G. lamblia infection (P<0.05). The public health implication of asymptomatic carriage of cyst of intestinal protozoan among low socioeconomic and sanitary standards of environments and children with poor personal hygiene was discussed. The use of mass chemotherapy and integrated measures of parasitic control would be of utmost importance in reducing the level of symptomatic infections among children.

Neglected tropical diseases among the Association of Southeast Asian Nations (ASEAN): overview and update.

The ten member states of the Association of Southeast Asian Nations (ASEAN) constitute an economic powerhouse, yet these countries also harbor a mostly hidden burden of poverty and neglected tropical diseases (NTDs). Almost 200 million people live in extreme poverty in ASEAN countries, mostly in the low or lower middle-income countries of Indonesia, the Philippines, Myanmar, Viet Nam, and Cambodia, and many of them are affected by at least one NTD. However, NTDs are prevalent even among upper middle-income ASEAN countries such as Malaysia and Thailand, especially among the indigenous populations. The three major intestinal helminth infections are the most common NTDs; each helminthiasis is associated with approximately 100 million infections in the region. In addition, more than 10 million people suffer from either liver or intestinal fluke infections, as well as schistosomiasis and lymphatic filariasis (LF). Intestinal protozoan infections are widespread, while leishmaniasis has emerged in Thailand, and zoonotic malaria (Plasmodium knowlesi infection) causes severe morbidity in Malaysia. Melioidosis has emerged as an important bacterial NTD, as have selected rickettsial infections, and leptospirosis. Leprosy, yaws, and trachoma are still endemic in focal areas. Almost 70 million cases of dengue fever occur annually in ASEAN countries, such that this arboviral infection is now one of the most common and economically important NTDs in the region. A number of other arboviral and zoonotic viral infections have also emerged, including Japanese encephalitis; tick-borne viral infections; Nipah virus, a zoonosis present in fruit bats; and enterovirus 71 infection. There are urgent needs to expand surveillance activities in ASEAN countries, as well as to ensure mass drug administration is provided to populations at risk for intestinal helminth and fluke infections, LF, trachoma, and yaws. An ASEAN Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation provides a policy framework for the development of new control and elimination tools. Together with prominent research institutions and universities, the World Health Organization (WHO), and its regional offices, these organizations could implement important public health improvements through NTD control and elimination in the coming decade.

Opportunistic Intestinal Protozoan Infections in HIV/AIDS Patients on Antiretroviral Therapy in the North West Region of Cameroon

Background: In most developing countries, intestinal parasites are the major cause of morbidity and mortality killing millions of patients each year. Hence, this study was undertaken to determine the prevalence of intestinal protozoans in HIV/AIDS patients on ART in three hospitals in the North West region of Cameroon. Methodology: A cross sectional study was carried out in three Hospitals in the North West Region of Cameroon, focusing on HIV/AIDS patients who were enrolled for ART in these Hospitals. A total of 320 HIV/AIDS patients aged 1-70 years, of both sexes (230 females and 90 males) participated in the study. Stool samples were collected and processed using direct wet mount, formol-ether concentration technique and modified Ziehl-Neelson staining techniques. Original Research Article Ntonifor et al.; BMRJ, 7(6): 269-275, 2015; Article no.BMRJ.2015.119 270 Results: Results obtained showed that out of the 320 stool samples examined, 120 (37.5%) were infected with at least one species of intestinal protozoa. Males showed a significantly higher prevalence of 41.1% (37) as compared to the females 36.09% (83). Prevalence was also significantly higher in the rural areas 42.4%, (87) than in the urban areas 28.7%, (33). The age group with the highest prevalence was that of 31-40 years 40.6%, (43). The prevalence for parasite species was 14.4% for Cryptosporidium parvum, 13.4% for Entamoeba coli, 11.3% for Entamoeba histolytica, 7.8% for Microsporidia, 2.2% for Iodamoeba butschlii and 1.9% for Cystoisospora belli. Conclusion: The results indicated that opportunistic intestinal infections are a threat to HIV patients in the studied area. Therefore public health measures should be strongly encouraged to improve the life quality of the patients.

Intestinal protozoal and helminthic infections in immunocompromised patients attending RIMS Hospital, Imphal

Background: Intestinal parasites continue to be a significant health problem among immunocompromised patients in both developed and developing countries. With the increasing numbers of immunocompromised individuals throughout the world, closer examination and detection of intestinal protozoal and helminthic infections in these individuals is highly needed. Objectives: To find out the prevalence of various intestinal protozoal and helminthic infections in immunocompromised individuals and to compare the pattern of their infection depending on sociodemographic characteristics. Materials and Methods: One hundred seventy stool samples of immunocompromised patients were examined by direct wet mount, formol-ether concentration, Modified Kinyoun's acid-fast stain, and Kato-Katz technique. Data analysis was performed by using SPSS version 17 software. Results: Thirty-two intestinal parasites were detected, of which Ascaris lumbricoides was the most frequently detected parasite (5.90%) and the least frequent was Trichuris trichiura (1.18%). Twenty-one parasites were detected in the immunocompromised patients from rural areas. Conclusion: Immunocompromised patients, especially human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients from rural areas, were found to have more intestinal protozoal and helminthic infections compared to urban patients due to low socioeconomic status and poor hygiene conditions.

The intestinal protozoa: emerging impact on global health and development.

To highlight new findings on the relevance of gastrointestinal protozoan infections to global public health in low-income and middle-income countries and suggest new large-scale interventions. New disease burden assessments and epidemiological studies highlight the role of the major intestinal protozoa as important etiologic disease agents in low-income and middle-income countries. Despite their prevalence and adverse health impact, such information has not yet translated to the implementation of large-scale interventions as exist for helminth infections and other neglected tropical diseases. There are also several key research and development questions that must be addressed for intestinal protozoan infections and the potential need for new tools, for example, drugs, diagnostics, and vaccines. Additional studies have identified new and emerging species of intestinal protozoa relevant to global public health such as Dientamoeba fragilis and Blastocystis hominis and how they too might emerge as important gastrointestinal pathogens in the coming years. New and emerging information on intestinal protozoa are reviewed with emphasis on aspects considered relevant to global health policymakers including prospects for scaling up interventions against intestinal protozoan infections in resource-poor countries.

Ovine Coccidiosis: A Case Report

Parasitism in food animal is of great economic importance. Coccidiosis is one of the gastrointestinal parasites that have a high detrimental effect on the sheep industry. A two and a half year-old ram was brought from the northern part of Nigeria into the University Teaching and Research Farm, Federal University of Agriculture, Abeokuta, Nigeria on the 30th December, 2010. About two weeks later, the ram was observed passing diarrheic feces, frequently urinating (4 minutes interval) and mucopurulent nasal discharge. Clinical examination revealed fever, congested mucous membrane, slight dehydration, matted hind-quarter, respiratory distress and lethargy. Based on clinical signs, intestinal protozoan infection and peste de petits ruminants (PPR) were tentatively diagnosed. Initial management which included metronidazole oral, 20% oxytetracycline, 20% tylosin and multivitamins yielded no positive response. Laboratory results revealed presence of heavy coccidian oocyst. The combination of potentiated oral sulphonamide and parenteral sulfadimidine sodium injection proved very effective. This report shows that sheep of any age bracket can present clinical condition of coccidiosis at any season of the year if exposed to factors that favour the incidence of the disease and also that advanced cases of ovine coccidiosis may need combination therapy for effective treatment.

Prevalence of Intestinal Parasitic Infection and Its Side Effect in School Aged Children in Our Local Region

Background: The presence of intestinal protozoal infections and parasites is a common and important health problem in our developed country. Our aim of this study was to determine the prevalence of intestinal parasites and protozoa in primary school children, and relationships between the prevalence and family socio-economic status. Patients and Methods: The study population was randomly selected from two schools (rural and urbans), from April 2013 to September 2014. A total of 132 learners (85 boys and 47 girls) participated in this research. One of the selected school was a college (S1) and the other one was local goverment school (S2). The children weight, z scores, blood hemoglobin level and family properties such as fathers’ employment, etc. have been researched. Parasitological data were collected by analyzing stool samples using Formalin ethyl acetate concentration technique by the department of Biochemistry laboratory in The Goverment Hospital. Symptoms, socio-economic and epidemiologic data were collected by means of a pretested structured questionnaire. Results: Out of 132 learners analyzed, 44.6% stool samples were positive for ova and cysts of which 34.4% were known pathogenic parasites. The most common parasite was Giardia intestinalis followed by Dientamoeba fragilis, and Enterobius vermicularis. Occurrence of Blastocystis hominis, H. nana, Taenia spp, and Fasciola spp is low. Our findings showed that there was a significant difference in parasitic infections between S1 and S2 school. Significant associations between parasitic infections and children’s family educations were observed. The mean hemoglobin concentration was 96 g/L (7 ± 1.1) and the prevalence of parasitic infections was more than 40 in rural area school children (in S1 school). In total, 41.6.2% of children were hungry when they arrived at school from S1. Over 5% of mothers and 12% of fathers were illiterate. Conclusion: Our study results demonstrated that parasitic infections in school children were found to be a common and a severe public health problem. Diarrhea, abdominal pain and weight loss were the main symptoms. Lower socio-economic condition and poor sanitation were the main risk factors. In our opinion, the department of Public Heart Centers should explain the reasons to family for preventing intestinal parasitic disease, and explain hygienic conditions importance, and application of supportive programs for the parents.

Prevalence of Intestinal Parasitic Infection Among Inhabitants and Tribes of Chelgerd, Iran, 2008-2009.

Although a notable development in treating and controlling of parasitic infections in recent years has occurred but, these infections are still counted as important problems in many countries. The aim of this study is to determine the prevalence of intestinal parasitic infections in the inhabitant and tribe populations who were referred to central health care of Chelgerd, Iran. This descriptive cross-sectional study was carried out from April 2008 to October 2009 in Chelgerd, Iran. A total of 655 samples of feces from inhabitants and tribes were collected and each sample was examined by Direct smear, formol- ethyl acetate concentration and Trichorom staining. Out of 655 stool samples, 367(56%) patients revealed at least one intestinal parasite (pathogenic /non-pathogenic protozoa/helminth), 233(67.7%) in tribes and 134(43%) in inhabitants. There was significant difference between infected inhabitants and infected tribes (p=0.001). Although the intestinal parasitic infections were more in female than male it was not statistically significant (p=0.52). There was no significant difference in various age groups. Common intestinal parasitic infections which were detected in both the populations were Giardia intestinalis (28.2%) and Blastocystis hominis (27.5%). We found that the prevalence of intestinal parasitic infections was higher in the tribe than inhabitant populations. Prevalence of intestinal protozoa infections was much higher than the helminthic infections. These findings reflect poor sanitary conditions in this region. They should be educated and provided better facilities to get rid of intestinal parasitic infections.

Malaria and Intestinal Parasite Infections and Co-Infections in Tach Gayint District, South Gondar Zone, Amhara Regional State 2010

To assess the level of intestinal parasite and malaria infection, a total of 806 consenting individuals were randomly selected from Tach Gayint District. The prevalence of malaria, intestinal protozoa and helminth infections and co-infections in the area were determined. The study was conducted in two seasons, November/December, 2008 (after the big rains) and April/May, 2009 (after the small rains). Blood film determination, direct wet mount and concentration techniques were respectively used for diagnosis of malaria and intestinal parasites. The overall prevalence of intestinal parasites was the same in the two seasons, 67.28% November/December) and 67.20% (April/May), indicating lack of variation in intestinal parasite burden during the two dry periods of the year. However, the prevalence of hookworm, S. mansoni and A. lumbricoides were significantly higher in the age groups below 14 years (P 5%). This indicates that malaria control program in the study area was inadequate or was not being properly implemented. Furthermore, he double, triple and quadruple co-infections involving malaria and intestinal parasites were i indications of high burden of parasite infection in the study area. On the whole, the findings of the present study have provided an empirical evidence for the need to implement effective malaria and intestinal parasite control measures in Tach Gayint District.

Effect of deworming on school-aged children's physical fitness, cognition and clinical parameters in a malaria-helminth co-endemic area of Côte d'Ivoire.

BackgroundMalaria and helminth infections are thought to negatively affect children’s nutritional status and to impair their physical and cognitive development. Yet, the current evidence-base is weak. The purpose of this study was to determine the effect of deworming against soil-transmitted helminthiasis and schistosomiasis on children’s physical fitness, cognition and clinical parameters in a malaria-helminth co-endemic setting of Côte d’Ivoire.MethodsWe designed an intervention study with a 5-month follow-up among schoolchildren aged 5–14 years from Niablé, eastern Côte d’Ivoire. In late 2012, a baseline cross-sectional survey was conducted. Finger-prick blood, stool and urine samples were subjected to standardised, quality-controlled techniques for the diagnosis of Plasmodium spp., Schistosoma spp., soil-transmitted helminths and intestinal protozoa infections. Haemoglobin level was determined and anthropometric measurements were taken for appraisal of anaemia and nutritional status. Children underwent memory (digit span) and attention (code transmission) cognitive testing, and their physical fitness and strength were determined (20 m shuttle run, standing broad jump and grip strength test). All children were treated with albendazole (against soil-transmitted helminthiasis) and praziquantel (against schistosomiasis) after the baseline cross-sectional survey and again 2 months later. Five months after the initial deworming, the same battery of clinical, cognitive and physical fitness tests was performed on the same children.ResultsLower scores in strength tests were significantly associated with children with harbouring nutritional deficiencies. Surprisingly, boys infected with Schistosoma mansoni achieved longer jumping distances than their non-infected counterparts. Light-intensity infection with S. mansoni was associated with slightly better aerobic capacity. Deworming showed no effect on haemoglobin levels and anaemia, but children with moderate- to heavy-intensity Schistosoma infection at baseline gained weight more pronouncedly than non-infected children. Interestingly, children with soil-transmitted helminth or Schistosoma infection at baseline performed significantly better in the sustained attention test than their non-infected counterparts at the 5-month follow-up.ConclusionsThis study revealed conflicting results regarding clinical parameters and cognitive behaviour of children after two rounds of deworming. We speculate that potential beneficial effects of deworming are likely to be undermined in areas where malaria is co-endemic and nutritional deficiencies are widespread.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2334-14-411) contains supplementary material, which is available to authorized users.

Recurrent wheezing is associated with intestinal protozoan infections in Warao Amerindian children in Venezuela: a cross-sectional survey.

BackgroundWhile in developed countries the prevalence of allergic diseases is rising, inflammatory diseases are relatively uncommon in rural developing areas. High prevalence rates of helminth and protozoan infections are commonly found in children living in rural settings and several studies suggest an inverse association between helminth infections and allergies. No studies investigating the relationship between parasitic infections and atopic diseases in rural children of developing countries under the age of 2 years have been published so far. We performed a cross-sectional survey to investigate the association of helminth and protozoan infections and malnutrition with recurrent wheezing and atopic eczema in Warao Amerindian children in Venezuela.MethodsFrom August to November 2012, 229 children aged 0 to 2 years residing in the Orinoco Delta in Venezuela were enrolled. Data were collected through standardized questionnaires and physical examination, including inspection of the skin and anthropometric measurements. A stool sample was requested from all participants and detection of different parasites was performed using microscopy and real time polymerase chain reaction (PCR).ResultsWe observed high prevalence rates of atopic eczema and recurrent wheezing, respectively 19% and 23%. The prevalence of helminth infections was 26% and the prevalence of protozoan infections was 59%. Atopic eczema and recurrent wheezing were more frequently observed in stunted compared with non-stunted children in multivariable analysis (OR 4.3, 95% CI 1.3 – 13.6, p = 0.015 and OR 4.5, 95% CI 0.97 – 21.2, p = 0.055). Furthermore, recurrent wheezing was significantly more often observed in children with protozoan infections than in children without protozoan infections (OR 6.7, 95% CI 1.5 – 30.5).ConclusionsHigh prevalence rates of atopic eczema and recurrent wheezing in Warao Amerindian children under 2 years of age were related to stunting and intestinal protozoan infections respectively. Helminth infections were not significantly associated with either atopic eczema or recurrent wheezing.

Prevalence and risk factors for intestinal parasitic infections in a rural community in "consolación del sur" municipality, cuba.

Intestinal parasites are very common infections worldwide and they are responsible for significant public health problems. The World Health Organization estimates that one-third of the world population is infected and some epidemiologic factors related to the transmission have been identified. The purpose of this investigation was to study the prevalence of intestinal parasitic infections in people living in the rural community of "El Canal", Consolación del Sur municipality and the association with some epidemiologic risk factors. All participants were subjected to three methods of parasitological examinations on the stool samples and by immunodiagnostic tests which allow the detection of excretory-secretory antigens of adults with Fasciola hepatica. The global prevalence rate of intestinal parasitic infections (IPIs) was 18%, and 16.7% for protozoan infections, while the rate of helminth infection was lower (5.3%) in the population studied. The univariate analysis identified three factors associated with intestinal pathogenic protozoan infections which include livestock work, drinking water from well\river and eating unwashed fruits\vegetables. The multivariate analysis using introduction test logistic regression ratified the association of these risk factors. Contrary to what have been published in the majority of Cuban studies carried out in rural places, a higher prevalence of protozoan than helminth infection was found. This discrepancy may be explained because the majority of the workers in this rural community were stock-breeders and they are not involved in other agricultural work. The identification of risk factors is important in order to design appropriate strategies for control of IPIs in communities.

A Study on Different Laboratory Methods for Diagnosis of Intestinal Protozoal Infections

This cross sectional study was done from January 2009 to June 2010 in Microbiology department of Dhaka Medical College, Dhaka on different laboratory methods for diagnosis of intestinal protozoal infections and their distribution among selected study population. Of the 375 stool samples evaluated, 103 (27.5%) samples were positive for the intestinal protozoa. The prevalence of G. intestinalis was highest (25.78%) followed by E. histolytica/dispar (8.98%). Other protozoa found were, E. coli (1.56%), B. hominis (1.95%), C. mesnilli (1.17%) and C. parvum (0. 78%). lron-hematoxyline stain showed highest sensitivity for detection of protozoa. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18510 Bangladesh Medical Journal 2011 Vol.40(2): 47-49

Aboriginal Populations and Their Neglected Tropical Diseases

Although Aboriginal people make up a small percentage of the worlds population, they are disproportionately affected by poverty and neglected tropical diseases (NTDs). Unless prioritized, Aboriginal populations may be the last to receive access to essential medicines as part of global NTD elimination efforts. An estimated 370 million people are today classified as belonging to Indigenous or Aboriginal groups [1], [2]. According to Gracey and King, included among the major criteria defining these populations are self-identification as belonging to an Indigenous group historical ties to specified geographic areas and natural resources, frequently followed by external invasion or colonization a distinct culture with beliefs and ceremonies and resolve to maintain ancestral environments and manage their own affairs [1]. However, there is not universal agreement on what constitutes an Aboriginal group, leading in some cases to exclusion or further marginalization [1]. As a whole, Aboriginal populations are disproportionately impoverished, accounting for 15 of global poverty even though they comprise only 5 of the global population [3]. Poverty, especially rural poverty, and its associated poor housing and sanitation, environmental degradation, inadequate or improper nutrition, forced migrations, and lack of access to health care, combine and synergize to create a number of adverse health consequences for Aboriginal populations [1], [2]. These include a spectrum of non-communicable diseases such as diabetes, obesity, hypertension, and cardiovascular disease (frequently related to tobacco consumption), as well as interpersonal violence and suicide often linked to alcohol and drugs [1], [2]. Aboriginal populations are also disproportionately affected by infectious diseases, especially infections of the skin (e.g., impetigo and tungiasis), eye (e.g., trachoma), and ear (e.g., acute and chronic otitis), dental caries, respiratory and urinary tract infections, and diarrheal diseases [1]. Neglected tropical diseases (NTDs) are especially common among Aboriginal populations. Shown in Table 1 are five representative groups of Aboriginal peoples and their major NTDs. The most common NTDs are intestinal helminth and protozoan infections zoonotic parasitic infections neglected bacterial infections such as trachoma, leprosy, and yaws and a number of important vector-borne illnesses, including malaria and dengue. Many, but not all, are included in the list of 17 NTDs as defined by the World Health Organization [4]; others are on the expanded list of diseases as defined by PLOS Neglected Tropical Diseases [5]. Table 1 Major Aboriginal populations and their neglected tropical diseases (NTDs).

Prevalence of intestinal protozoan infestation among primary school children in Urban and peri-urban communities in Kumasi, Ghana

Introduction- Intestinal protozoan infections continue to remain a global public health challenge, particularly in developing countries. Children are greatly prone to these infections via the ingestion of food, water or soil contaminated with the infective stage of these parasites. Objectives- This study focused on establishing the prevalence of intestinal protozoan infection among primary school children aged 5 to 12 years from six communities in the Kumasi metropolis of Ghana. Methods- A total of 2400 children were randomly selected sampled. Stool samples collected from the children were analyzed using the formol-ether concentration technique. The modified Ziehl-Neelsen staining technique was employed in the identification of Cryptosporidium parvum. Results- The overall prevalence of intestinal protozoan identified among the studied school children was 42.9%. Prevalence was significantly higher in males than females with rates of 51.0% (604/1162) and 30.8% (381/1238) respectively. The highest protozoan infestation was Giardia lamblia with a prevalence of 16.8% (195/1162) and 7.8 % (97/1238) in males and females respectively. Three pathogenic strains (Giardia lamblia, Entamoeba histolytica/dispar and Cryptosporidium parvum) and four non-pathogenic species (Entamoeba coli, Endolimax nana, Chilomastix mesnili and Iodamoeba butschlii) were identified in the study. Giardia lamblia and Cryptosporidium parvum recorded prevalence rates of 12.2% and 8.5% respectively. Prevalence was however proportional to age with respect to Endolimax nana and Iodamoeba butschlii infections. Conclusion- There is relatively high prevalence of intestinal protozoan infection among the studied children. This obviously suggests that there are possible household, school based and behaviour oriented risk factors which predispose the children to these parasites.

Prevalence of Intestinal Protozoan Infections among Orang Asli Schoolchildren in Pos Senderut , Pahang , Malaysia

The current study determined the prevalence of intestinal protozoan infections among the Orang Asli schoolchildren in Pos Senderut, Pahang, Malaysia. The overall intestinal protozoan infection rate was 85% (261 out of 307). The highest prevalence rates were due to Entamoeba coli (24.4%), Giardia lamblia (21.8%), Blastocystis hominis (21.2%) and Entamoeba histolytica (15.0%). The prevalence of Iodamoeba butschlii was only 2.9%. Among the positive samples, mixed infection with B. hominis and E. histolytica was 3.3%, B. hominis and G. lamblia was 2.9%, G. lamblia and E. histolytica was 2.0% and triple infections (B. hominis, G. lamblia and E. histolytica) was 1.0 %. The prevalence of the infection was high in all age groups (6-14 years old). Thus, we can conclude that intestinal protozoan infections are still representing a serious public health problem in aboriginal communities, especially among children.

The role of arginine and arginine-metabolizing enzymes during Giardia – host cell interactions in vitro

BackgroundArginine is a conditionally essential amino acid important in growing individuals and under non-homeostatic conditions/disease. Many pathogens interfere with arginine-utilization in host cells, especially nitric oxide (NO) production, by changing the expression of host enzymes involved in arginine metabolism. Here we used human intestinal epithelial cells (IEC) and three different isolates of the protozoan parasite Giardia intestinalis to investigate the role of arginine and arginine-metabolizing enzymes during intestinal protozoan infections.ResultsRNA expression analyses of major arginine-metabolizing enzymes revealed the arginine-utilizing pathways in human IECs (differentiated Caco-2 cells) grown in vitro. Most genes were constant or down-regulated (e.g. arginase 1 and 2) upon interaction with Giardia, whereas inducible NO synthase (iNOS) and ornithine decarboxylase (ODC) were up-regulated within 6 h of infection. Giardia was shown to suppress cytokine-induced iNOS expression, thus the parasite has both iNOS inducing and suppressive activities. Giardial arginine consumption suppresses NO production and the NO-degrading parasite protein flavohemoglobin is up-regulated in response to host NO. In addition, the secreted, arginine-consuming giardial enzyme arginine deiminase (GiADI) actively reduces T-cell proliferation in vitro. Interestingly, the effects on NO production and T cell proliferation could be reversed by addition of external arginine or citrulline.ConclusionsGiardia affects the host’s arginine metabolism on many different levels. Many of the effects can be reversed by addition of arginine or citrulline, which could be a beneficial supplement in oral rehydration therapy.