Modified Ziehl Neelsen Research Articles

Cryptosporidiosis and Associated Risk Factors among Children Attending Paediatric Hospitals in Enugu Metropolis, Enugu State, Nigeria

Cryptosporidiosis is a zoonotic disease caused by infection with protozoan parasite of the genus Cryptosporidium. It is associated with moderate to severe diarrhoea which may eventually lead to death. The parasite impedes growth and development of affected children. A hospital based cross-sectional study was conducted to assess cryptosporidiosis and the associated risk factors among children aged 0-15years attending selected paediatric hospitals in Enugu Metropolis between November 2021 and August 2022. A total of five hundred and fifty stool samples were examined for oocysts of Cryptosporidium species using Formol Ethyl-Acetate sedimentation and modified Ziehl Neelsen’s staining techniques. The overall prevalence of the parasite was 14.4% (79/550). Enugu State University of Science and Technology Teaching Hospital recorded the highest prevalence 32(25.6%) of Cryptosporidium species while St. Patrick Hospital recorded the least 1(1.1%). Public hospitals recorded more infections than private hospitals. The age group ≤ 5years 43(15.8%) recorded the highest prevalence. Males 52(17.1%) were more infected than females 27(10.98%), which was not significant (P>0.05). Children whose parents/caregivers had only primary education 11(26.8%), has the highest prevalence while those whose parents/caregivers had tertiary education 17(8.9%), has the least. Children whose parents/caregivers were farming has the highest prevalence 9(25.0%), while children of civil servants, 40(12.4%) has the least which was not significant (P>0.05). Children living in multifamily residences 48(15.2%) had higher prevalence than those living in private homes, 2(6.3%). Other protozoan parasites identified in the study were Entamoeba histolytica 88(16.1%) and Giardia lamblia 69(12.5%). There were co-infections of Cryptosporidium and Entamoeba histolytica 27(4.9%), Cryptosporidium and Giardia lamblia 21(4.3%) which was not significant (P>0.05). Intervention through health education on good hygiene habits, and provision of clean water and proper disposal of faeces will help reduce cryptosporidiosis among children.

Prevalence of Intestinal Parasites and Associated Risk Factors among Diarrheal Patients Attending Negelle Borena General Hospital: A Case-Control Study.

In tropical countries, intestinal protozoal parasitic infections are among the common infections causing significant morbidity and mortality. Thus, the present study was conducted to assess the status of intestinal protozoal parasitic infections among diarrheal patients attending Negelle Borena General Hospital and investigate the possible risk factors for the infection. A case-control study design was employed in the study. The intestinal protozoal parasites were detected using a wet-mount, stool concentration, and modified Ziehl-Neelsen methods. The crude and adjusted odd ratios were considered to identify the associated risk factors for intestinal protozoal parasitic infections among the study participants. The overall status of parasitic infection was 46.88% in cases and 27.08% in the control groups. The most prevalent protozoal infection was Giardia lamblia (9.38%) and followed by Entamoeba histolytica/dispar (6.25%) in the cases. The highest prevalence of the infection was detected in the age groups that varied from 6 to 10 years in cases (71%). The enteric G. lamblia and E. histolytica/dispar were found to be 33.3% and 9.1%, respectively, in the age groups of 6-10 years in cases. Based on sex, 56.50% and 27.30% of protozoal (parasitic) infections were revealed by females in the cases and control groups, respectively, indicating a significant variation (P < 0.05). The education level (illiteracy), absence of toilet usage, no hand washing after toilet and before eating as significant risk factors for patient's infection with G. lamblia, E. histolytica, and Cryptosporidium spp. (P < 0.05, AOR = 1-14). However, eating raw fruit and vegetables was also found as a major risk factor for E. histolytica (P < 0.05, AOR = 6.2) 40. Moreover, the residence of the patients was also indicated as a plus risk factors for the infection to be occurred by Cryptosporidium spp. in the study participants (P > 0.95, AOR = 0.2). The prevalence of intestinal protozoal parasitic infection showed variation based on age, sex, and educational background of the study participants. Therefore, awareness creating training should be provided to the Negelle area communities so as to minimize the parasitic infection.

Approaches to increase recovery of bacterial and fungal abortion agents in domestic ruminants.

Abortions in domestic ruminants cause significant economic losses to farmers. Determining the cause of an abortion is important for control efforts, but it can be challenging. All available diagnostic methods in the bacteriology laboratory should be employed in every case due to the many limiting factors (autolysis, lack of history, range of samples) that complicate the investigation process. The purpose of this study was to determine whether the recovery of diagnostically significant isolates from domestic ruminant abortion cases could be increased through the use of a combination of the existing aerobic culture andBrucellaselective method with methods that are commonly recommended in the literature reporting abortion investigations. These methods are examination of wet preparations and impression smears stained by the modified Ziehl-Neelsen method, anaerobic, microaerophilic,Leptospira, Mycoplasmaand fungal culture. Samples of placenta and aborted foetuses from 135 routine clinical abortion cases of cattle (n= 88), sheep (n= 25) and goats (n= 22) were analysed by the new combination of methods. In 46 cases, bacteria were identified as aetiological agents and in one case a fungus. Isolation ofBrucellaspecies increased to 7.4% over two years compared with the previous 10 years (7.3%), as well asCampylobacter jejuni(n= 2) andRhizopusspecies (n= 1).Salmonellaspecies (5.9%) andTrueperella pyogenes(4.4%) were also isolated more often. In conclusion, the approach was effective in removing test selection bias in the bacteriology laboratory. The importance of performing an in-depth study on the products of abortion by means of an extensive, combination of conventional culture methods was emphasised by increased isolation ofBrucella abortusand isolation ofC. jejuni. The combination of methods that yielded the most clinically relevant isolates was aerobic, microaerophilic,Brucellaand fungal cultures.

The Presence of Potentially Pathogenic Protozoa in Lettuce (Lactuca sativa) Sold in Markets in the Central Peruvian Andes.

Peru is currently one of the world’s leading culinary destinations, whose world-renowned cuisine uses vegetables, mainly lettuce, as frequent ingredients. Vegetable consumption is promoted worldwide as a part of a healthy diet. However, vegetables, more frequently lettuce, have been implicated as a vehicle of infection for several foodborne parasites. This study aimed to determine the presence of potentially pathogenic parasites in lettuce marketed in the Central Andes of Peru. A total of 75 lettuce samples were collected from the two largest wholesale markets and the main open-air market in Jauja province, in the central Peruvian Andes. The province of provenance (coast vs. highlands), lettuce variety (“curly-leaf”, “iceberg”, and “butter”), and type of market were recorded. The samples were microscopically examined for detection of parasitic life forms using standard parasitological methods including direct slide smear, Lugol’s iodine staining, and Modified Ziehl−Neelsen staining. The overall positivity of parasitic contamination in lettuces was 45.3% (CI 95%: 34−56.6%). Cryptosporidium spp., Isospora belli, Giardia lamblia, Balantidium coli, and Entamoeba spp. were detected in twenty-six (34.7%), six (8%), four (5.3%), two (2.7%), and two (2.7%) lettuces, respectively. I. belli was found in a significantly (p < 0.01) lower proportion in the “butter” variety, and significantly (p < 0.05) higher contamination with G. lamblia was found in lettuce sold at the open-air market. B. coli, G. lamblia, and E. histolytica/E. dispar/E. moshkovskii were detected only in lettuce from the highlands (Tarma province). This study provides important data for health authorities to develop food safety programs. This information is also of interest to the international community because of the increased visibility that Peru has gained as a tourist destination.

Molecular and phylogenetic characterization of Cryptosporidium species in the saffron finch Sicalis flaveola

BackgroundCryptosporidium is the most common protozoan that can infect a wide variety of animals, including mammals and birds. Fecal samples of six saffron finches, Sicalis flaveola, from a commercial establishment were screened for the presence of Cryptosporidium by the modified Ziehl–Neelsen technique and nested PCR of the 18S rRNA gene followed by sequencing of the amplified fragments.ResultsThe species Cryptosporidium galli was identified in all six saffron fiches, in addition to Cryptosporidium andersoni in one of the birds, indicating a mixed infection. Only two birds had feathers that were ruffled and dirty with feces. Concomitant infection with Isospora spp. was observed in all birds.ConclusionsSaffron finches are a possible host of C. andersoni and this is the first report of this species in a captive bird and the third report of parasitism by C. galli in Sicalis flaveola.

Cryptosporidium in human-animal-environment interphase at Adama and Asella areas of Oromia regional state, Ethiopia

BackgroundIn Ethiopia, several studies have reported the occurrence of Cryptosporidium infection in young calves, lambs, and HIV positive patients. However, research on cattle and sheep of all ages, as well as humans, has been limited.MethodsA cross-sectional study was conducted to investigate the occurrence of Cryptosporidium in dairy cattle, sheep, humans, and manure samples. Dairy cattle and sheep were stratified according to their age groups and randomly sampled. Stool samples from volunteered dairy farm workers and rural household members were collected purposefully. A semi-structured questionnaire was also used to collect information about manure handling practices and socio-demographic variables. All collected samples were processed with the sugar floatation technique and the modified Ziehl–Neelsen staining method. Logistic regression was used to analyze the association of risk factors with the occurrence of Cryptosporidium in study subjects (p < 0.05).ResultsThe overall prevalence of Cryptosporidium in dairy cattle, sheep, humans, and manure samples was 20.5%, 14%, 16%, and 13.20%, respectively. Cryptosporidium infection was significantly higher in dairy cattle aged 1–12 months and 13–36 months with odds of 3.48 and 3.07 times higher, respectively, compared to others. Similarly, its occurrence was 2.69 times higher in sheep aged 1–6 months than those above 6 months. And also, a higher average oocyst count (above 10 oocysts) per-field was observed in cattle aged 1–12 months, followed by sheep aged 1–6 months. Furthermore, the likelihood of infection was 13 times greater in farm workers compared to household members of smallholder farmers. In addition, the occurrence of oocysts was 22.8 times higher in manures from dairy cattle than that of sheep. About 16.8% of the study respondents had manure disposal pit, 98.1% of them used manure as fertilizer for crop and vegetable production without any treatment.ConclusionsThe study revealed the occurrence of Cryptosporidium infection in all age groups of dairy cattle and sheep, humans engaged in animal production. Occurrence of Cryptosporidium in manure suggests it potential contamination of environment and water sources.

Parasitic infections as potential risk factors for attention deficit hyperactivity disorder (ADHD) in children.

Attention deficit hyperactivity disorder (ADHD) represents a mysterious neuropsychiatric alarming concern due to indefinite etiopathogenesis among children. Notably, the studies which investigated the correlation between ADHD and parasitic infections are insufficient. Therefore, this research aimed to assess the correlation between ADHD and some tissue dwelling and intestinal parasitic infections in children. The study was conducted on 200 children, including 100 children suffering from ADHD (Group I) and 100 healthy children as a control group (Group II). All caregivers fulfilled predesigned sociodemographic form and Conners parent rating scale (CPRS-48) questionnaire. Blood samples were collected to determine hemoglobin level as well as relative eosinophilic count. The presence of anti-Toxoplasma IgG and anti-Toxocara IgG in serum by Enzyme-Linked Immunosorbent Assay (ELISA) was further investigated. Also, micronutrients as zinc, iron, and copper levels were measured. Schistosoma antigen was investigated in urine samples. Stool samples were subjected to direct wet smear, concentration technique and modified Ziehl-Neelsen (MZN) staining for coccidian parasites detection. Cryptosporidium parvum, Giardia lamblia and Entamoeba histolytica antigens were investigated in stool samples. Group I expressed more liability to sociodemographic risk factors, decreased levels of Hb, iron, zinc, and copper with statistically significant difference (P < 0.001). Comparison between Group I and Group II regarding the detected parasitic infections exhibited statistically significant difference except Schistosoma antigen positivity which expressed no statistical significance. The present study concluded that the parasitic infections with their consequences are potential risk factors in children with ADHD indicating that their early diagnosis and treatment may help in ADHD prevention.

Stall Sanitation Associated with Cryptosporidium sp. Infection on Calf and Cattle Farmer

Increasing the cattle population can increase the amount of the waste. Poor management of cage sanitation has the risk of causing a decrease in the health conditions of cattle farmers, such as: diarrhea, nausea, vomiting, and itching, as many as 50% of cattle with diarrhea are infected with Cryptosporidium sp. The highest infection of Cryptosporidium sp. in cattle found in calves. The calf can excrete 1×1010 oocysts of Cryptosporidium sp. per day. Cryptosporidium sp. also has the potential to cause zoonotic infections that are transmitted from animals to humans. The study aims was to determine the relationship between stall sanitation and Cryptosporidium sp. to calf and cattle farmer. The type of this research was analytic observational with a cross sectional approach conducted in Jatian Village, Pakusari, Jember during October 2021 - March 2022. The primary data was obtained through interviews and observations. The feces of calves and cattle farmer were collected and examined using sedimentation method and modified Ziehl-Neelsen (MZN) staining method. The statistical test used is the chi-square test. The results showed that the prevalence of Cryptosporidium sp. in calves by 14,3% and on cattle farmer by 4,8%. The bivariate analysis showed that that stall location and waste handling were associated with Cryptosporidium for calf (p≤0.05), and there were no variables that were significantly related to infection in cattle farmers (p&gt;0,05). Cryptosporidium sp. in calves and humans can be caused by several factors, such as environmental factors and hosts. Preventive measures such as maintaining a clean environment including cowshed sanitation and personal hygiene need to be taken to reduce the risk of Cryptosporidium infection from calves to humans, and vice versa.

Prevalence of Cryptosporidiosis and It’s Associated Risk Factors Among Human Population in Zakho District, Duhok Province, Kurdistan Region, Iraq

Cryptosporidiosis caused by species belonging to genus Cryptosporidium. Cryptosporidiosis is a zoonotic disease that affects both animals and humans, making it a major public health and veterinary concern. A cross sectional study was performed during the period from August 2021 to March2022, to estimate the prevalence of Cryptosporidium spp. in the human population in order to determine the effect of associated risk factors on the rate of infection in Zakho district, Duhok. Seven hundred Fecal specimens were collected from Zakho General Hospital and two primary schools located in suburban area of Zakho city. The collected stool specimens were examined macroscopically and microscopically using a modified Ziehl–Neelsen staining method. Cryptosporidium infection was found in 87.57% (613/700) of the examined specimens. Males showed slightly higher infection rate than females (88.4% vs. 85.5%) with non-significant difference (P &gt; 0.05). Ages group (31-41 years) showed highest rates, with significant difference (P&lt;0.05). The highest rates of infection were reported among families with 6-10 members, people drinking unfiltered municipal tap water, suburban residents, those with close contacts with domestic animal, and illiterate people. The control of this disease necessitates the improvement of living conditions, providing potable clean water and disseminating health education programs among the community.

Performance of diagnostic assays used to detect Cryptosporidium oocysts in faecal samples of cattle in Kuwait and genotyping of Cryptosporidium species

BackgroudCryptosporidium species are zoonotic protozoan parasites responsible for gastroenteritis in various animals and humans. The diagnosis of Cryptosporidium presents many challenges. This research attempted to match the diagnostic efficiency of the modified Ziehl–Neelsen technique (mZN), immunochromatographic assays (IC), and enzyme-linked immunosorbent assay (ELISA) for the detection of Cryptosporidium in faecal samples of cattle in Kuwait. In addition, polymerase chain reaction (PCR) was utilised to determine the predominant species infecting cattle in Kuwait and correlating the detected species with the results of different diagnostic tests used, the presence or absence of clinical signs, and the age group of the infected cattle.ResultsOf 400 analysed faecal samples, Cryptosporidium positive samples were 23%, 15.25%, and 14% using IC, ELISA, and mZN. IC had the highest sensitivity (74.07%), and mZN had the highest specificity (98.29%) using a composite reference standard (CRS) as a gold standard. The rapid IC test results in high false-positive results of cryptosporidiosis, whereas using mZN alone is insufficient to declare a negative faecal sample. Only 74.5% (35/47) of Cryptosporidium-positive samples by the three assays could be amplified by PCR. This study was the first to genotype Cryptosporidium in Kuwait. Cryptosporidium parvum (n = 26) was the dominant species detected from cattle samples, followed by C. andersoni (n = 6), C. bovis (n = 2), and C. raynae (n = 1). The findings showed a statistically relevant relationship between diarrhoea and the detection of Cryptosporidium spp. in faecal samples of cattle (p-value = 0.0003). Pre-weaned calves were the most vulnerable age group to Cryptosporidium spp. infection (p-value = 0.0007).ConclusionFor screening of Cryptosporidium infection in faecal samples, antigen detection or PCR methods combined with one of the microscopy techniques should be used. Cryptosporidium parvum was the prepoderant Cryptosporidium spp. recovered from cattle samples in Kuwait followed by C. andersoni. Cryptosporidium parvum is a significant risk factor for diarrhoea in pre-weaned calves. However, further study is needed as many other causes of diarrhoea in calves must be ruled out before a diagnosis of Cryptosporidium diarrhoea can be made.

Commonness and Risk Factors Associated with Gastrointestinal Parasitic Infections among Inmates of Port Harcourt Children’s Home

Background: Gastrointestinal parasites are important health problems among most societies.&#x0D; Objectives: Prevalence and risk factors associated with gastrointestinal parasites among inmates of Port Harcourt children home.&#x0D; Methods: This prospective study was carried out in August and September 2019 at the Port Harcourt children home. Fecal samples were collected from 63 healthy looking inmates and examined macroscopically and microscopically (using normal saline and iodine wet mount, formalin-ether sedimentation and modified Ziehl Neelsen staining) methods. Finally, data was analyzed using descriptive statistics and Chi-square (X2) test.&#x0D; Results: Result showed that 74.6% (47/63) of the female and 25.4% (16/63) of the male tested positive for GIPs. Age group 11-15 years had prevalence of 17(44.8%). The common parasites identified were A. lumbricoides 10(15.9%), T. trichiura 7(11.1%) and hookworm (Ancylostoma duodenale) 2(3.2%). The educational level prevalence of 10(52.6%) was observed among the primary level (p&lt;0.05). The risk factors such as: the use of drug in the last three months, hand washing with soap after using the toilet and washing of hands after contact with soil had significance of p&lt;0.05 while putting on foot wear outside the house p&gt;0.05.&#x0D; Conclusion: The distribution of gastrointestinal parasitic infections is high among the children. Necessary treatment intervention safety measures should be routinely carried out to reduce the spread to zero tolerance.

Intestinal Parasitic Infection and Associated Risk Factors among HIV-Infected Patients Seeking Healthcare in a Rural Hospital in Ghana

Background Parasitic infections among human immunodeficiency virus (HIV)-infected patients are common in various regions and populations across the world and have since remained a persistent public health challenge. Sub-Saharan Africa harbors the greatest burden of the infections due to sociodemographic and behavioral factors. However, the prevalence of gastrointestinal parasitic infections among HIV-infected persons has been poorly investigated in Ghana. Aim This study sought to determine the prevalence of gastrointestinal parasitic infections and associated factors in HIV-infected individuals attending the antiretroviral therapy (ART) clinic in St. Mary Theresa Hospital, Dodi Papase. Methods A cross-sectional study was conducted from June 2021 to September 2021 among three hundred and thirty-five HIV-infected individuals in the study area. Sociodemographic and behavioral factors were collected with the aid of a close-ended structured questionnaire. Furthermore, stool samples were collected from each participant and examined for the presence of intestinal parasites by microscopy using direct wet mount, formol-ether concentration, and modified Ziehl–Neelsen (Zn) techniques. Data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 22.0 and Graphpad Prism version 8. Results The prevalence of gastrointestinal parasitic infections was 5.97%. Species-specific prevalence was found to be 2.99% for Giardia lamblia, 1.19% for Ascaris lumbricoides, and 0.90% each for Entamoeba histolytica/dispar and Trichuris trichiura. There was a significant association between participants' educational level and intestinal parasitic infection. In addition, gastrointestinal parasitic infections were not found to be associated with age. Unemployed participants, those with a lower frequency of deworming, and those who do not use water closet toilet facilities were at a higher risk of getting infected. Conclusion The lower infection rate recorded in this study suggests that public health interventions put in place are yielding significant results. Even though the prevalence is low, routine screening of all HIV-infected patients for parasitic infection is recommended to ensure timely, effective treatment and comprehensive care.

Prevalence of Intestinal Parasites in HIV/AIDS-Infected Patients Attending Clinics in Selected Areas of the Eastern Cape

Introduction: Intestinal parasites in HIV and AIDS patients increase the risk of gastroenteritis, adding to the complexity of the virus. According to the literature, their interactions are one of the factors leading to HIV replication and progression of AIDS in Africa. Chronic immunosuppression caused by HIV infection makes people vulnerable to parasitic infections, and this is associated with a CD4+ cell count of less than 100. The study describes the prevalence of intestinal parasites in patients attending HIV/AIDS clinics in certain areas of the Eastern Cape. Methods: A cross-sectional study was conducted among 600 patients from HIV/AIDS clinics in the Eastern Cape. Tambo Municipality and Amatole Municipality were the municipalities covered. These included the Ngangalizwe Community Clinic, Tsolo Gateway Clinic, Idutywa Health Centre, and Nqamakwe Health Centre. The stools of 600 participants were examined using direct wet saline/iodine embedding, formal ether concentration technique, and modified Ziehl–Neelsen methods. Results: The mean age of the study participants was 28.2 years. They were predominantly female (79.9%), mostly single (63.6%), and lived in rural (65.2%) and urban areas (34.8%). The prevalence of intestinal parasites was determined to be 30% (180/600) after screening 600 stool samples. The most frequently detected parasites were Ascaris lumbricoides (55.9%), Balantidium coli (15.1%), Entamoeba coli (11.3%), Diphyllobothrium latum (4.3%), Taenia species (3.8%), Schistosoma mansoni (1.6%), and Cryptosporidium spp. (1.6%). Males were affected more frequently (39.2%) than females (27.9%). The difference was statistically significant (p = 0.017). Among the identified intestinal parasites, A. lumbricoides, B. coli, and Taenia spp. were found at all four sites. Conclusion: This study has shed light on the high burden of intestinal parasites in HIV/AIDS patients in the Eastern Cape. Medication adherence, deworming, and sanitary hygiene practices are needed to enhance the control of infection in the affected communities and hence contribute to the control of the HIV pandemic.

Modified Ziehl–Neelsen staining for Mycobacterium leprae

Modified Ziehl–Neelsen staining for Mycobacterium leprae is a time-tested technique in the evaluation of leprosy. The staining helps to classify clinical types of leprosy into those with low and high bacillary load. It is also useful in assessing the response to therapy, identifying defaulters, and differentiating relapse from late reversal reactions. In this net educational video, we demonstrate the technique of taking an ear lobe smear and performing the modified Ziehl–Neelsen staining for acid fast bacilli.

Prevalence of Cryptosporidium infection in cattle from selected commercial farms and nomadic settlements in Yola, Adamawa State

Cryptosporidium species are apicomplexan parasites commonly associated with diarrhoea in both men and animals. They are of public health importance. The study aimed to determine the occurrence of Cryptosporidium species in cattle in the Yola metropolitan area, Adamawa State, Nigeria. Four hundred and sixteen (416) faecal samples were collected from cattle in commercial farms and nomadic settlements and were analyzed using Modified Ziehl Neelsen (MZN) technique. Twenty-seven (27) positive samples were subjected to nested Polymerase Chain Reaction (PCR) for the amplification of a specific fragment of 18S rRNA gene that was used to detect Cryptosporidium spp. Seventy-three (17.5%) out of 416 samples were positive for Cryptosporidium oocysts by MZN, and 26 (96.0%) out of 27 isolated oocysts of Cryptosporidium detected by MZN were positive by PCR. Commercial farms had a higher prevalence (19.2%) of Cryptosporidium oocysts than the nomadic settlements (15.9%). Based on risk factors, there was a significant association (P&lt;0.05) between the occurrence of Cryptosporidium oocysts and factors such as sex and faecal consistency. At the same time, age, breed, management system, animal source and drinking water source varied insignificantly (P&gt;0.05). This study has shown the occurrence of Cryptosporidium infection in cattle in the Yola metropolis. There should be an awareness campaign among public health workers on the dangers posed by the organism to humans so that the Government would enforce control and preventive measures.

Prevalence and Associated Risk Factors of Endoparasites among Under-Five Children in Debre Tabor Comprehensive Specialized Hospital, Debre Tabor, Northwest Ethiopia: A Cross-Sectional Study.

Many endoparasites are still considered neglected tropical illnesses. The term “endoparasites” refers to infections caused by both helminths and protozoa. In many places in Ethiopia, particularly Debre Tabor, epidemiological data on the prevalence and associated variables of endoparasites among under-five children is unavailable. Thus, the aim of this study was to gather baseline data on the prevalence of endoparasites and their associated variables among under-five children who visited the Debre Tabor comprehensive specialized hospital in Northwest Ethiopia. A hospital-based quantitative cross-sectional study was used. The study was carried out from May 1 to November 30, 2021. Study participants were selected by a systematic sampling technique. The stool specimen was examined for the presence of different stages of intestinal parasites (adult, trophozoite, larvae, cysts, and ova) using direct wet mount, modified formal-ether sedimentation, and modified Ziehl–Neelsen methods. The IBM SPSS statistical package (version 23) was used to enter and analyze the collected data. The data was summarized using frequency tables and a bar chart. The adjusted odds ratio and p value <0.05 were used to declare the final association. In the present study, a total of 258 under-five children and their mothers/guardians were involved in the study, with a response rate of 100%. More than half of the respondents, 137 (53.10%), were females, and 159 (61.63%) were in the age group of 24 to 59 months. The overall prevalence of one or more endoparasites among under-five children was 45 (17.44%). Multivariate logistic regression analysis showed that health supervision, child food freshness, regular trimming of fingernails, and children's playground cleanliness were significantly associated with childhood endoparasites. The present study demonstrated a higher prevalence of endoparasites among under-five children. Health supervision, child food freshness, regular trimming of fingernails, and children's playground cleanliness were significantly associated with endoparasites. Thus, strengthening health education about food, personal, and environmental hygiene for both children and their mothers/guardians is crucial.

Cryptosporidium species in HIV patients in Alexandria, Egypt: distribution and associated clinical findings.

Cryptosporidium sp. cause opportunistic infections in HIV patients. Molecular differentiation provides a better understanding of the epidemiology and clinical variations of cryptosporidiosis. The present work studied the species of Cryptosporidium in HIV patients and their associated demographic and clinical features. The study included 100 adult HIV patients receiving antiretroviral therapy in Egypt. Cryptosporidium infection was diagnosed by modified Ziehl- Neelsen (MZN) stain and PCR amplification of COWP gene. The infecting species were molecularly identified by restriction fragment length polymorphism (RFLP) and DNA sequencing. Data were analyzed using Kappa ( K) agreement, Mann-Whitney U, odds ratio and the 95% confidence interval, Chi-squared and Monte Carlo significance (MCp) tests. The statistical significance was judged at the 5% level. A total of 16 Cryptosporidium positive cases were detected (16%), with good agreement between PCR and MZN ( K = 0.763). Among 11 PCR positive samples, RFLP identified C. hominis in five samples, C. parvum in three samples, C. meleagridis in two samples, and mixed C. hominis and C. meleagridis in one sample. Eight samples were successfully sequenced and the results confirmed the RFLP classification. C. hominis was found mainly in urban residents while C. parvum and C. meleagridis were significantly associated with rural areas (MC p =0.01). Diarrhoea and nausea/vomiting were recorded only in the presence of C. hominis infection while abdominal pain was the main symptom in C. parvum and C. meleagridis infections. Drinking water sources, contact with animals, and CD4+ count were not related to infection with a particular species. In conclusion, infection with Cryptosporidium sp. is common and frequently symptomatic in HIV patients in Egypt. The predominant species, C. hominis, C. parvum, and C. meleagridis show a distinct distribution in urban and rural residents.

Intestinal Parasites in Children up to 14 Years Old Hospitalized with Diarrhea in Mozambique, 2014-2019.

Diarrhea remains a public health problem in Mozambique, even with control strategies being implemented. This analysis aimed to determine the proportion and factors associated with intestinal parasitic infection (IPI) in children up to 14 years old with diarrheal disease, in the southern, central and northern regions of Mozambique. A single diarrheal sample of 1424 children was collected in hospitals and examined using the formol-ether concentration and modified Ziehl–Neelsen techniques to identify intestinal parasites using optical microscopy. Sociodemographic characteristics were obtained by questionnaires. Descriptive statistics and cross-tabulation were performed, and p-values <0.05 were considered statistically significant. A single IPI was detected in 19.2% (273/1424) of the children. Cryptosporidium spp. was the most common parasite (8.1%; 115/1424). Polyparasitism was seen in 26.0% (71/273), with the co-infection of Ascaris lumbricoides and Trichuris trichiura (26.8%; 19/71) being the most common. Age and province were related to IPI (p-value < 0.05). The highest occurrence of IPI was observed in the wet period (October to March), with 21.9% (140/640), compared to the dry period (April to September), with 16.9% (131/776) (p-value = 0.017). Cryptosporidium spp. and the combination of A. lumbricoides/T. trichiura were the main intestinal parasites observed in children hospitalized with diarrhea in Mozambique.

Molecular characterization of algerian strains of Blastocysts sp

RésuméIntroductionBlastocystis sp. est un protozoaire colonisant le tube digestif de l’Homme et de nombreux animaux et il est à ce jour le parasite le plus fréquemment retrouvé dans les selles humaines. Dans certains pays en développement, sa prévalence dans les populations étudiées peut dépasser 50 %. Sur le plan morphologique, les isolats de Blastocystis sp. trouvés chez différents hôtes sont très similaires. Cependant, ces mêmes isolats présentent entre eux une très grande diversité génétique et pas moins de 17 sous-types (ou génotypes) ont déjà été identifiés à partir de données moléculaires. Des études de génotypage ont été réalisées dans de nombreux pays à travers le monde et en particulier dans certains pays du pourtour méditerranéen comme la France, l’Espagne, l’Italie, la Turquie ou l’Égypte. En revanche, très peu de données de génotypage sont disponibles en Algérie. À cet effet, nous avons réalisé la présente étude dont le but était d’identifier et de génotyper Blastocystis dans des échantillons de selles humaines et animales.Patients et méthodesMille huit cent soixante-neuf (1 869) prélèvements de selles appartenant à un personnel de cuisine dans le cadre du contrôle médical périodique, à des sujets pour la fourniture d’un certificat médical requis pour le traitement d’un dossier de visa et à des patients atteints de troubles gastro-intestinaux ont été examinés. À côté des selles humaines, des échantillons d’animaux, dont 10 volailles, 2 bovins et 2 murins ont été examinés. Toutes les selles ont été soumises à un examen microscopique direct complété par des techniques de concentration et une coloration de Ziehl Neelsen modifiée. La caractérisation moléculaire de 39 isolats humains et 14 d’origine animale a été réalisée par le séquençage et les séquences obtenues comparées à celles disponibles auprès de GenBank. Le séquençage n’a été contributif que pour 30 souches humaines et 9 souches animales.RésultatsSur l’ensemble des échantillons humain examinés, 284 étaient positifs (15,19 %) avec une prévalence de 7,38 % pour le Blastocystis. Parmi les 30 souches ayant fait l’objet d’une caractérisation moléculaire, le ST3 était prédominant (15/30, 50 %) suivi de ST1 (10/30, 33,33 %) et en troisième position le ST2 (4/30, 13,33 %). Le ST4 n’a été identifié que chez un seul patient (1/30, 3,33 %). La corrélation entre le statut clinique et le sous-type de Blastocystis identifié a montré que le nombre de ST3 était élevé chez les sujets asymptomatiques (11/15, 73 %) comparativement aux sujets symptomatiques (4/15, 26,66 %), de même pour le sous-type ST1 (7/10, 70 % versus 3/10, 30 %). À l’inverse, le nombre de ST2 était plus élevé chez les sujets présentant des troubles gastro-intestinaux (3/4, 75 %). À côté des souches humaines nous avons génotypé 7 souches aviaires, 2 souches murines et 2 souches bovines. La caractérisation des souches aviaires a révélé 5 ST6 (71,42 %) et 2 ST7 (28, 57 %). Les souches murines et bovines sont identifiées en tant que ST7 et ST6 respectivement.

Comparative diagnostic utility of metagenomic next-generation sequencing, GeneXpert, modified Ziehl-Neelsen staining, and culture using cerebrospinal fluid for tuberculous meningitis: Amulti-center, retrospective study in China.

BackgroundEarly diagnosis of tuberculosis meningitis (TBM) remains a great challenge during clinical practice. The diagnostic efficacies of cerebrospinal fluid (CSF)‐based mycobacterial growth indicator tube (MGIT) culture, modified Ziehl–Neelsen (ZN) staining, Xpert MTB/RIF, and metagenomic next‐generation sequencing (mNGS) for TBM remained elusive.MethodsA total of 216 adult patients with suspicious TBM were retrospectively enrolled in this multi‐cohort study. The diagnostic performances for MGIT, modified ZN staining, Xpert MTB/RIF, and mNGS using CSF samples were evaluated.ResultsUniform clinical case definition classified 88 (40.7%) out of 216 patients as the definite TBM, 5 (2.3%) patients as probable TBM cases, and 24 (11.1%) patients as possible TBM cases. The sensitivities of MGIT, modified ZN staining, Xpert MTB/RIF, and mNGS for TBM diagnosis against consensus uniform case definition for definite TBM were 25.0%, 76.1%, 73.9%, and 84.1%, respectively. Negative predictive values (NPVs) were 66.0%, 85.9%, 84.8%, and 90.1%, respectively. The sensitivities of MGIT, modified ZN staining, Xpert MTB/RIF, and mNGS for TBM diagnosis against consensus uniform case definition for definite, probable, and possible TBM were 18.8%, 57.3%, 55.5%, and 63.2%, respectively. Negative predictive values (NPVs) were 51.0%, 66.4%, 65.6%, and 69.7%, respectively. mNGS combined with modified ZN stain and Xpert could cover TBM cases against a composite microbiological reference standard, yielding 100% specificity and 100% NPV.ConclusionMetagenomic next‐generation sequencing detected TBM with higher sensitivity than Xpert, ZN staining and MGIT culture, but mNGS cannot be used as a rule‐out test. mNGS combined with Xpert or modified ZN staining could enhance the sensitivity of diagnostic tests for TBM.