Modified Ziehl-Neelsen Staining Research Articles

Detection and Molecular Identification of Cryptosporidium Species Among Children with Malignancies

Cryptosporidiosis represents a major health problem worldwide particularly among children. Its diagnosis is still difficult and demands sensitive methods. In Egypt, there is little documentation of infection among children with malignancies. This work was designed to study the infection rate of Cryptosporidium among children with malignancies, compare the performance of modified Ziehl-Neelsen (MZN) stain with nested polymerase chain reaction (PCR) and identify the species subtypes of positive cases. The study was conducted on 100 children with malignancies (leukemia, lymphoma and solid tumors), below 10 years of age, from El-Shatby hospital, Alexandria University. After obtaining the informed consent, their stool samples were collected and examined microscopically following MZN stain for the diagnosis of Cryptosporidium spp. All samples were then subjected to nested PCR. Restriction fragment length polymorphism (RFLP) targeting the Cryptosporidium oocyst wall protein (COWP) gene was applied to positive cases, using restriction enzyme RsaI for digestion of nested PCR products. Out of the 100 examined children, MZN detected higher positive cases compared to nested PCR. Six cases (6%) were diagnosed positive by MZN stain, three of which (3%) were concordantly positive by nested PCR. All positives were among children with acute lymphoblastic leukemia (ALL). Fair agreement was found between the two tests (K = 0.36). Genotyping results revealed that positive samples were of Cryptosporidium parvum (C. parvum) type II. Low Cryptosporidium infection rate was detected among children with malignancies. MZN diagnosed more positive cases compared to nested PCR. C. parvum type II was the identified species among the examined children. Further optimization of PCR steps is needed.

Intestinal parasites among humans and their livestock animals in a rural community in Gharbia governorate, Egypt

Our objective was to study the prevalence of intestinal parasitic infections among humans and their contact livestock animals in a rural community in Gharbia governorate, Egypt. The collected human and livestock animal fecal samples were examined by formol ether sedimentation technique and modified Ziehl-Neelsen stain. Human samples were further examined by the Kato-Katz technique. The total prevalence of intestinal parasites in humans was 52.3%; 7.3% helminths and 45% protozoa. Regarding animals, 29% of livestock animals had protozoan parasites and no helminths were detected. Results revealed that risk factors including drinking tap water and attendance of nurseries, affected the rate of parasitic infection among humans. The infection rate of protozoa was significantly higher among humans (1.5 times) as compared to animals.

Aborte und Totgeburten bei Ziegen unter besonderer Berücksichtigung von Coxiella burnetii

Coxiellosis, caused by the bacterium Coxiella burnetii, is a reportable disease in animals and humans in Switzerland. The number of cases in farm animals and humans has risen continuously in recent years. The aim of this work was to investigate abortions and stillbirths in goats with a focus on C. burnetii, to identify excretory routes which pose a zoonotic risk and the excretion time after an acute infection. Besides the submitted fetuses, does were screened with a serological antibody test. In addition, excretion via milk, faeces and vaginal mucus were investigated in dams with fetuses tested positive for C. burnetii at 14-day intervals.C. burnetii were isolated in 8 cases (3× in the placenta, 2× in the abomasum, 3× in the placenta and abomasum) of 13 examined stillbirths/abortions. Ten abomasums of goat kids and 8 placentas were examined using modified Ziehl-Neelsen staining (ZN) according to Stamp simultaneously with a real-time PCR. Four of 18 samples were false negative using modified ZN staining according to Stamp in contrast to real-time PCR. Seven does had serum antibodies against Coxiella. The excretion of C. burnetii persisted for 63 days in the milk, for 96 days in the vaginal mucus and for 96 respectively 114 days in two does monitored extensively. Intermittent excretion could also be observed in the milk during these 63 days. The present study showed that confirmation of disease, respectively transmission cannot be based on a single test. Only combined serological antibody test and real-time PCR examinations of birth material, milk, feces and vaginal mucus can result in a conclusive diagnosis. In addition, the examination using modified ZN staining according to Stamp is less sensitive and specific than the real-time PCR examination.

IMMOBILE TRAVELLER SYNDROME: A CASE REPORT

SESSION TITLE: Global Case Report Posters SESSION TYPE: Global Case Reports PRESENTED ON: October 18-21, 2020 INTRODUCTION: Apart from Economic class syndrome which is a well established entity in air travel, Pulmonary embolism can also occur due to other modes of long travel (1). We present a case of pulmonary embolism resulted from continuous car travel. CASE PRESENTATION: A 45-year-old male came with minimal productive cough ,breathlessness of modified medical research council (MMRC) grade 2 and mild fever for five days. He was a normotensive and non diabetic. On examination he had fine crackles over right infra scapular region. Laboratory investigations showed mild leucocytosis with polymorph predominance. Metabolic panel was normal. His chest x ray showed right lower zone ill defined airspace opacity. HRCT Chest revealed right lower lobe sub pleural consolidation with reverse halo sign. Sputum gram stain and modified Ziehl Neelsen stain were not contributory. Based on the clinical scenario ,lab parameters and radiological findings, community acquired pneumonia of right lower lobe was diagnosed and Patient was started on oral antibiotics. After three days patient returned with history of an episode of minimal hemoptysis. He was admitted for further evaluation. On detailed history evaluation he accepted he himself drove his car to a city for five hours without break and after finishing his work he drove back continuously for five more hours to his hometown two days before the illness. Pulmonary thromboembolism was suspected and d-dimer was found to be elevated(690 ng/ml). Echocardiogram was normal. CT Pulmonary angiogram(CTPA) confirmed multiple emboli (polo mint sign) in branches of right inferior pulmonary artery with infarction and pleural effusion. Patient was successfully treated with low molecular weight heparin for five days and discharged with warfarin. The etiological work up found out that he was having homocyteinemia and anti platelet drug with vitamin supplements were given. After nine months patient himself discontinued dabigatran for two weeks and came with right sided pleurisy and right thigh swelling. Venous Doppler study confirmed deep vein thrombosis(DVT) of right femoral vein and CTPA confirmed recurrent thromboembolism in right inferior pulmonary artery. Patient was subjected to IVC filter and treated again with low molecular weight heparin. Now he is on warfarin. DISCUSSION: Travel history is essential when suspecting pulmonary embolism.Immobilisation during long travel is a definite risk factor for deep vein thrombosis and pulmonary thromboembolism.Like Economic class syndrome of air travel ,Pulmonary embolism due to other modes of long travel can be called as ‘Immobile Traveller’s Syndrome’(2). When sub pleural consolidation with reverse halo sign is noted in CT chest, Pulmonary infarction must be considered in differential diagnosis. CONCLUSIONS: High index of suspicion is the key for diagnosis pulmonary embolism in peripheral branches because it may mimic pneumonia or pleural effusion. Reference #1: 1.Paolo Feltracco;Stefania Barbieri;Francesca Bertamini;Elisa Michieletto;Carlo Ori; Economy class syndrome: still a recurrent complication of long journeys.European Journal of Emergency Medicine. 14(2):100-103, APR 2007 Reference #2: 2. Gispert P1, Drobnic ME, Vidal R. Economy-class syndrome or Immobile Traveler's syndrome? Arch Bronconeumol. 2006 Jul;42(7):373-5. DISCLOSURES: No relevant relationships by Nagarajan Appusamy, source=Web Response No relevant relationships by Mathanraj Sinnassamy, source=Web Response No relevant relationships by Sivaraja Subramaniam, source=Admin input

Gastrointestinal parasites of domesticated duck (Anas platyrhynchos Linnaeus, 1758) in Chandragiri municipality, Kathmandu, Nepal

Intestinal parasitosis is one of the chief causes of health problems associated with domesticated and free-range ducks particularly in developing countries. Among the various health problems amoebiasis and helminthic infection are still significant among ducks (Anas platyrhynchos Linnaeus, 1758) in Nepal. We report the status of intestinal parasitosis, particularly the prevalence and associated risk factors of gastrointestinal parasites of ducks reared in three different locations (Bishnu-Devi, Kanchan-Basti and Balambu) of Chandragiri Municipality from November 2016 to February 2017 using opportunistic random method. A total of 120 faecal samples collected in clean, dry and screw-capped plastic containers from six different locations were examined for the presence of parasites using formol-ether concentration method and modified Ziehl Neelsen staining technique, sodium chloride floatation and zinc sulphate sedimentation methods. Overall parasite positive rate was 81.67% (98/120). Positive rate of nematodes was highest (74.49%; 73/98) followed by cestodes (52.04%; 51/9) and protozoans (41.84%; 41/98) (P<0.05). A total of 78 (65.00%) samples showed single infections and 20 (16.67%) samples showed mixed infection (χ2 = 5.55; P<0.05). Statistical analysis indicated that locations were insignificantly associated with the infection by gastrointestinal tract parasites in the study areas. A total of eight (8) genera of parasites were identified which include two genera of protozoa, five genera of nematodes and one genera of cestodes. Of these, Ascaridia galli (21.67%) was found to have the highest prevalence and Isospora sp. (6.67%) to be the lowest. Gastrointestinal tract parasites were the major biological constraints contributing tothe low productivity of ducks and hampered the economic benefits obtained from the sector. Improvement of biosecurity measures for household duck farms through educating and motivating household farmers could help mitigate the effects of parasitic infection on production.
 Keywords: Duck, Nematode, Cestode, Kathmandu, Chandragiri

Evaluation of different laboratory techniques for diagnosis of intestinal microsporidiosis in diarrheic children

Background: Microsporidia are a group of obligate intracellular organisms that can infect all animals including man causing disease in both immunocompetent individuals and immunosuppressed patients. The most common microsporidia causing gastrointestinal infection worldwide are Enterocytozoonbieneusi and Encephalitozoonintestinalis. Objectives: The present study was designed with the aim of estimating the rate of microsporidia in diarrheic children and the evaluation of different staining techniques and nested polymerase chain reaction (PCR) for the clinical diagnosis of intestinal microsporidiosis. Subjects and Methods: One hundred and fifty diarrheic stool samples were collected from Abou El-Rich children hospital laboratory. Samples were examined by “Ryan-Blue” modified trichrome stain (MTS), modified ZiehlNeelsen (MZN), acid fast trichrome (AFT) stain, and nested polymerase chain reaction (nPCR). Results:Microsporidium spp. was detected in 12 (8%) of samples using MTS. Compared with the other detection techniques the respective sensitivities and specificities of MZN stain was 100% and 98.57%; nPCR was 80% and 100%; and AFT was 85.71% and 97.87%. Conclusion: Using specific staining techniques as MZN and AFT for diagnosis of intestinal microsporidiosis in diarrheal stool samples are nearly as efficacious as PCR, but even better in some cases with the added advantage of being an inexpensive diagnostic method compared to PCR. Another benefit is the detection of other oocyst forming parasites such as Cryptosporidium, which makes staining techniques very suitable for developing countries

Copro-microscopical and immunological diagnosis of cryptosporidiosis in Egyptian buffalo-calves with special reference to their cytokine profiles.

Cryptosporidiosis is considered to be one of the most devasting gastrointestinal diseases in calves. The aim of this study was to investigate Cryptosporidium parvum infection (C. parvum) in buffalo-calves with both copro-microscopic examination and enzyme linked immunosorbent assay (ELISA) using two C. parvum prepared antigens with regards to their cytokines profile; interferon- γ (IFN-γ), interleukin (IL)-12 and IL-14 to achieve a proper diagnosis. All collected buffalo- calves' fecal samples were examined by modified Ziehl-Neelsen staining technique. ELISA was performed to evaluate the diagnostic accuracy of the two C. parvum prepared antigens; crude whole oocyst (CWO) and crude sonicated oocyst (CSO) in detection of anti-C. parvum IgG in buffalo-calves' sera. As well, concentrations of INF-γ, IL-12 and IL-14 in the buffalo-calves' serum samples were estimated. The results revealed that the overall parasitological incidence of cryptosporidiosis was 40%. However, the serological diagnosis by ELISA assay showed 53.75% and 27.5% when using CWO and CSO antigen, respectively. Also, the diagnostic efficacy parameters of both antigens; CWO and CSO showed a significant high specificity (83.3%) achieved by CSO antigen and a high sensitivity (71.8%) by CWO antigen. The levels of INF-γ, IL-12 and IL-14 were significantly increased in positive Cryptosporidium infected group by both coprological and serological assays followed by the group which was positive for cryptosporidiosis by copro-microscopic examination only. The present study concluded that a combination of coprological and serological examination with reference to the cytokines profile is needed for proper diagnosis of cryptosporidiosis in buffalo-calves.

Prevalence of Intestinal Parasitic Infections among Individuals Referred to the Medical Centers of Coastal Cities, Guilan Province, Northern Iran, 2015-2017

Background: Intestinal parasitic infections (IPIs) are among the major public health problems, especially in developing countries. Northern Iran is highly endemic area for these infections. This study aimed to investigate the prevalence of IPIs among people referred to the medical centers of the coastal cities in Guilan Province, Northern Iran. Methods: In this descriptive cross-sectional survey, 1232 stool samples were collected during 2015-2017. We used a structured questionnaire to obtain socio-demographic characteristics, and stool examination was performed using direct slide smear, formalin-ether concentration, trichrome and modified Ziehl-Neelsen staining techniques. The results were analyzed using SPSS and Chi-square test. Results: The overall prevalence of IPs in our study was 17.8% (219/1232). The most common IP was Blastocystis sp. 154/1232 (12.59%), followed by Giardia lamblia 50/1232 (4.1%) and Entamoeba hartmani 45/1232 (3.7%). Out of the 219 positive patients, 82 (55.14%) and 137 (44.85%) were female and males, respectively. Regarding the socio-demographic variables, educational status (P=0.226), contact with domestic animals and soil (P=0.476), age years (P=0.78), Occupation (0.637) and Gender (P=0.417) were not significantly associated to IPIs. Conclusion: In the past, parasitic infections were more prevalent in different parts of Iran. However, today it has declined indicating a significant improvement in level of individual hygiene, and environmental standards.

Intestinal parasitic infections in children under five in the Central Hospital of Nampula, Northern Mozambique.

Intestinal parasites are known to cause infection in humans worldwide, with higher prevalence in low- and middle- incoming countries. Children are greatly affected leading to malnutrition and subsequently to physical and cognitive development impairment. Despite the scale and importance of this issue, there are few studies conducted in Mozambique concerning parasitic intestinal infections in hospitalized children. To our knowledge this is the first published report with data on this subject from Northern Mozambique. A cross-sectional study was conducted in 2012 and 2013 in 831 children, attending the Central Hospital of Nampula in Northern Mozambique. One single stool sample was obtained from each child. Socio-demographic and clinical data were also obtained. Parasitological analysis of feces was performed through direct examination and Ritchie concentration technique and Giardia duodenalis antigen detection by rapid immunochromatographic test. Modified Ziehl-Neelsen staining was used for coccidia detection. The global prevalence of pathogenic intestinal parasites was 31.6%. G. duodenalis (23.9%) was by far the most prevalent parasite followed by Strongyloides stercoralis (4.1%) and Cryptosporidium sp. (3.4%). Intestinal parasites were more frequent in older children (p = 0.005; aOR = 1.025). This work is one of the few published studies reporting intestinal parasites infection in hospitalized children. The percentage of children affected with G. duodenalis is higher than found in other studies in the African region. This highlights the need of particular attention being given to this intestinal protozoan and its resistance to water treatment, as well as to environmental health and personal hygiene.

Nocardia Infections: Ten Years Experience from a Tertiary Health Care Center in North India (2007-2016).

Nocardia species are important cause of infections in humans but are underreported due to missed diagnosis as well as misdiagnosis. Majority of the literature on these infections consists of case reports or series with few articles describing high number of cases. To study the epidemiology of Nocardia infections in a tertiary care center. This retrospective observational study was done in a tertiary care centre of North India over a period of 10 years (2007-2016). The detection of Nocardia spp. from clinical specimens was done by conventional methods viz. direct microscopy (Gram's stain, modified Ziehl -Neelsen stain [1%], KOH examination) and culture. A total of 25 cases of nocardiosis were diagnosed during the study period. The mean age of the patients was 50.9 years (range 30-72 years) with a male:female ratio of 3:2. The site of disease in these patients included pulmonary (n=18), cutaneous (n=4), perinephric abscess (n=1), ocular (n=1) and bone (n=1). Risk factors associated were underlying lung disease (n=11), smoking (n=7), diabetes (n=5) and steroid therapy (n=4) in pulmonary nocardiosis, iatrogenic (n=1) and leprosy (n=1) in cutaneous nocardiosis, diabetes in perinephric abscess and cataract surgery in ocular nocardiosis. Culture was positive in 12/25 (48%) patients for Nocardia spp. Direct microscopy was positive in 22 patients. We wish to highlight that meticulous observation of KOH wet mount examination helped in clinching the diagnosis of Nocardiosis in 3 cases which were earlier missed by other methods. Good communication with the clinician alongside a meticulous effort in the laboratory is essential for appropriate diagnosis and management of these cases.

Bovine Cryptosporidiosis and the Egyptian Diarrheic Buffalo Calves

The negative impact of diarrhea on livestock health is well known, Cryptosporidium, is one of the protozoan that causes diarrhea in calves especially buffalo calves. Some species of Cryptosporidium represent a zoonotic hazard. This study aimed to distinguish the potential species of Cryptosporidium in affected buffalo calves and evaluate a modified technique to improve the molecular detection and identification of Cryptosporidium. Twenty buffalo calves suffered from diarrhea were enrolled in the study. The enrollment criteria depended on the results of Ziehl–Neelsen stain. Sugar floatation technique was performed followed by oocyst concentration to form a pellet for DNA extraction. Multiplex PCR was performed for identification and differentiation of Cryptosporidium Spp. The results showed a mixed infection in 4 samples; the most common type of Cryptosporidium affecting the examined buffalo calves was C.parvum (10), followed by C.bovis (7 samples) and C.andersoni (6 samples) while no C.reyne was detected in the examined samples. The zoonotic type, C.parvum was found in 50% of the total affected animals. The current study detects three Cryptosporidium spp. namely C.parvum, C. andersoni, and C.bovis linked to diarrhea in the studied buffalo calves. Mixed infection with more than one species of Cryptosporidium was present. Standard detection of oocyte in fecal samples using modified Ziehl-Neelsen stain is a simple way for diagnosis of Cryptosporidium. However, a more sophisticated method is recommended to detect and differentiate the zoonotic species in calves, as they symbolize a crucial source of human infection.

Frequency and Molecular Identification of Cryptosporidium Species among Immunocompromised Patients Referred to Hos-pitals, Central Iran, 2015-16

The purpose of this study was to determine the prevalence and genotype of Cryptosporidium spp. in different groups of immunocompromised patients admitted to the referral hospitals in center of Iran during 2015-2016. This cross-sectional study was conducted on 346 immunocompromised patients (HIV+/AIDS, Lymphoma, Leukemia and organ transplants) in referred hospitals from central parts of Iran including Isfahan, Markazi, Yazd and Chaharmahale Bakhtiari provinces. Stool samples were analyzed for Cryptosporidium species, modified Ziehl-Neelsen staining techniques followed by the semi-nested PCR and DNA sequencing methods. The total rate of Cryptosporidium spp. was 3.46% (12/346) in the patients, however, the prevalence of the parasite, was 4.6% (4/87) in HIV+/AIDS patients, 3.6% (6/168) in patients with blood malignancy and 2.1% (2/91) in organ transplant recipients. The SSU rRNA gene of Cryptosporidium spp. in all microscopic-positive samples was effectively amplified by the semi-nested PCR and DNA sequences, exposed the existence of two Cryptosporidium species, including C. hominis 91.6% (11/12) and C. parvum 8.3% (1/12). The predominance of C. hominis in the present study may be certifies the importance of anthroponotic transmission of cryptosporidiosis in center of Iran.

Longitudinal cerebrospinal fluid assessment in a patient with tuberculous meningitis—A case report

BackgroundDynamic assessment of cerebrospinal fluid (CSF) is essential for diagnosis, treatment, and prognosis of tuberculous meningitis, one of the most severe forms of central nervous system (CNS) infection.Case presentationA 45‐year‐old man sought care as he developed confusion, clonic convulsion, and coma. Longitudinal, comprehensive analyses of cytological, biochemical, and microbial changes in CSF specimen were assessed for this patient. On day 1 of hospitalization, modified Ziehl‐Neelsen staining of CSF identified positive acid‐fast bacilli, cytological analysis revealed neutrophilic‐predominant pleocytosis (neutrophils 77%), and adenosine deaminase (ADA) was substantially elevated. Therefore, tuberculous meningitis was diagnosed and first‐line standard anti‐tuberculosis treatment was initiated. Interestingly, after 7‐day treatment, the patient was greatly improved, and CSF disclosed a dominant percentage of lymphocytes (82%) as well as macrophages engulfing Mycobacterium tuberculosis. Later, the dose of dexamethasone was reduced, large number of neutrophils (57%) was present and protein level was immediately elevated in CSF specimen, indicating a possible relapse of tuberculous meningitis. Since the clinical condition of the patient was not worsening, the patient was stick to reduced dose of dexamethasone and standard anti‐tuberculosis agents. He was discharged from the hospital on day 34, with 1‐year continuation standard anti‐tuberculosis therapy, and was clinically resolved from tuberculous meningitis.ConclusionDetailed analyses of cellular composition, biochemical results, and microbial tests of CSF specimen provide the physician direct evidence of the immune surveillance status during tuberculous meningitis, which facilitates early diagnosis, optimal treatment, and improved prognosis.

Microsporidial stromal keratitis: characterisation of clinical features, ultrastructural study by electron microscopy and efficacy of different surgical modalities

AimsTo report the clinical manifestations, ultrastructure and evaluate the efficacy of therapeutic lamellarkeratectomy (TLK) and penetrating keratoplasty (PK) for microsporidial stromal keratitis (MSK).MethodsFourteen MSK cases between 2009 and 2018 were...

Cryptosporidiosis in HIV-Positive Patients, Bandar Abbas, Iran: A Cross-Sectional Study

Background: Cryptosporidiosis is a parasitic disease caused by a small protozoan of the genus coccidian. It is important in the medical and veterinary area, since it is a zoonotic parasite. Transmission of fecal-oral infections occurs through direct and indirect contact with food and contaminated drinks. Many HIV-positive individuals live in the areas where intestinal parasites are hyperendemic. Objectives: Given the significance of the study associated with opportunistic infectious diseases in this group of patients, we decided to study the prevalence of the parasite in those individuals. Methods: In this descriptive cross-sectional study, we collected a single fecal specimen of 133 HIV-positive patients seeking treatment from the center for Behavioral Disease Counseling of Bandar Abbas, Iran. Stool samples examined by direct, formalin-ether concentration method and modified Ziehl-Neelsen stain for Cryptosporidium spp. Results: The mean age of the patients was 42.15 (ranged 12 - 82 years). No oocyst of cryptosporidium spp. or other intestinal coccidian was found in any of the samples. Only four species including Giardia lamblia, Hymenolepis nana, and both Entamoeba coli and Blastocystis hominis were found in three patients, which indicated less diversity and low frequency of parasitic infection in this study. Conclusions: Monitoring and evaluating the therapeutic process of the patients lead to less infectious diseases, especially those of opportunistic parasites.

Chronicle of migrant hyperinfective Strongyloides stercolaris larvae and associated bacteremia in a patient suffering from Idiopathic Thrombocytopenic Purpura

Background: Strongyloidiasis is a neglected nematode infestation and can lead to hyperinfection syndrome. The onset of strongyloides hyper-infection syndrome is associated with a myriad of seemingly unrelated symptoms including diarrhoea, abdominal pain, urticaria, anaemia, sepsis and acute respiratory distress syndrome. Case report: A 65-year-old female patient presenting with chief complaints of nausea, vomiting, abdominal cramps, diarrhea, fever and cough and was admitted to a teaching hospital on 2nd May 2019. The patient was a diagnosed case of idiopathic thrombocytopenic purpura on Azathioprine (50mg, BD) and oral corticosteroid therapy (Prednisolone 60mg, OD) and was on treatment from the same hospital. The patient developed these symptoms after 23 days of immunosuppressive therapy. Patient was continued with previous medication along with supportive management after admission. Blood and urine sample was received in the department of Microbiology on 3rd May 2019 for culture and sensitivity testing. Urine sample was sterile after 24 hours of aerobic incubation. Escherichia coli grew in blood culture and the isolate was susceptible to gentamicin, amikacin and colistin. Stool sample was received on 6th of May 2019 for routine microscopy. With wet mount preparation of stool specimen, numerous larvae of Strongyloides stercoralis were seen. Modified Ziehl-Neelsen staining was performed and oocysts of Cryptosporidium species were also seen. Wet mount preparation of sputum sample was also performed in which few larvae of S. stercoralis were seen. Conclusion: As corticosteroid is the mainstay of treatment in idiopathic thrombocytopenic purpura an early diagnosis and prompt specific anti-parasitic therapy is required to eradicate these infections

A Study of Indices in Smear Positive Leprosy in Post-Elimination Era: Experience at a Teaching Tertiary Care Centre

Background: Leprosy is an oldest chronic infectious disease known to mankind that predominantly affects the skin and peripheral nerves. Objective: To evaluate the bacteriological and morphological indices in smear positive cases. Materials and Method: Retrospective observational study was undertaken for one year duration on suspected cases of leprosy. Smears were prepared from one from each of the ear lobes by slit and scrap method and one from the site of lesion. Smears were stained with modified Ziehl-Neelsen stain and bacteriological/morphological indices were calculated. Results: Among 345 clinically suspected cases, 160 (46.38%) were multibacillary with male to female ratio 1.9:1 and most of cases from rural area of lower/middle class of third and fourth decade. All the three sites smears were positive in 112 (70%) cases. 66 (41.25%) cases had bacteriological index of 1+ while more than 1000 bacilli, on average, in 1each oil-immersion field (BI 6+) was observed in 1 (0.62%) cases. In 70 (43.75%) cases morphological index was less than 25 while in 14(8.75%) cases it was more than 50. Conclusion: Bacteriological and morphological index is one of the most important tools for diagnosis, classification, monitoring of treatment and disease severity.

Gastrointestinal parasites of dromedary camel (Camelus dromedarius) in Algeria.

Aim:The present study was designed to investigate the prevalence and identification of gastrointestinal parasites in feces samples of dromedary camels (Camelus dromedarius) in Algeria based on microscopic examination.Materials and Methods:A total of 717 fresh fecal samples obtained from 28 farms at Steppe and Northern Sahara regions of Algeria were processed for microscopic examination after concentration by formalin-ether sedimentation and flotation techniques. In addition, microscopic examination of Cryptosporidium spp. was done by modified Ziehl-Neelsen staining and Lugol staining procedure was used for the detection of Giardia cysts.Results:Microscopic examination indicated an infection rate of gastrointestinal parasites of 48.26% (346/717). Protozoan infections were recorded at 17.02% (122/717), whereas helminth infections were recorded at 23.71% (170/717). In addition, mixed infection (protozoans and helminths) was seen at 7.53% (54/717). No correlation was found between infection and age of the animals, nor the consistency of the stool samples; in addition, neither influence of sex nor breed of camels was observed. Eighteen genera of gastrointestinal parasites were revealed; including four genera of protozoa, 12 Nematoda, one Cestoda, and one Trematoda. Strongyloides spp. and Eimeria spp. showed the highest rate of parasitism, while Cooperia spp. was observed with the lowest prevalence. Cryptosporidium spp. was detected in 13 among 717 examined samples (1.81%).Conclusion:The parasite fauna infecting the gastrointestinal tract of the Algerian dromedary is much diversified. The detected parasites in camels are similar to counterparts in other ruminants, posing serious challenge to animal farming. Future studies should be carried out to better understand the epidemiology of these parasitic diseases and their economic and public health impact.

Spectrum of leprosy among suspected cases attending a teaching hospital in Western Rajasthan, India.

Background:Leprosy is a chronic granulomatous infectious disease, which mainly involves skin, peripheral nerves, mucosa of the upper respiratory tract, and eyes. According to National Leprosy Eradication Programme 2017–18 annual report, the annual new case detection rate from Rajasthan is 1.27 per 1 lakh population and prevalence rate is 0.14.Aims and Objective:The main objective of this study was to determine the spectrum of Mycobacterium leprae infections among suspected cases attending a teaching hospital in western Rajasthan, India.Materials and Methods:This is a retrospective study conducted in the Department of Microbiology, in a teaching hospital, western Rajasthan, between the period of January 2017 and April 2019. The records of modified Ziehl–Neelsen staining during the study period were analyzed. The demographic data like age and sex along with clinical diagnosis were also recorded from laboratory register and hospital information system.Results:Out of total 91 suspected cases, 30.77% was microbiologically confirmed cases of leprosy. Out of total positive cases, 71.43% were male and 28.57% were female. A maximum number of positive (50%) were found in the age group of 31–50 years.Conclusion:Present study gives an insight about the spectrum of leprosy in the region. The large number of positive cases signifies that leprosy awareness and programs aimed at elimination need to be more vigorously implemented. To achieve complete eradication from this menace, newer strategies like effective vaccine development and drug-resistance testing should be implemented.

Parasitological detection and associated risk factors of Cryptosporidium in bovines of Karnataka state

The prevalence of Cryptosporidium in cattle and buffalo calves of less than one month age was studied in Karnataka state using modified Ziehl-Neelsen staining method. Associated risk factors viz., age, sex, breed, consistency of dung, rearing systems and season were evaluated for their influence on the prevalence of Cryptosporidium infection. An overall prevalence of 12.20% (40/328) of Cryptosporidium infection was observed with a prevalence rate of 12.84% in cattle calves and 10.91% in buffalo calves. Age wise, three week-old animals were infected more (16.95%) followed by the four week (13.27%), one week (6.90%) and two week (4.41%) old animals. Female animals (13.14%) showed more prevalence than male animals (11.11%). Among the breeds, crossbred animals (15.08%) were infected more compared to non-descript animals (7.75%). Higher prevalence of infection was noticed in diarrhoeic samples (16.41%) followed by formed (10.31%) and semisolid dung samples (7.77%). Rearing system was correlated for its effect on its prevalence rate, in which the free-range animals (12.61%) had a slightly higher prevalence than that of intensively reared animals (11.32%). Season-wise, the higher prevalence of infection was noted in monsoon (14.74%) followed by winter (11.48%), autumn (11.38%) and summer (10.20%).