Stool Parasite Research Articles

Evaluation of the Allplex GI Parasite and Helminth PCR Assay in a Belgian Travel Clinic.

Recently a number of broad-range stool parasite PCR assays have been developed. However, there is ongoing disagreement regarding their diagnostic performance, as various studies have produced contradictory results. In this study, we compared the diagnostic accuracy of the Seegene Allplex GI-Parasite and Allplex GI-Helminth assays (SA) with the conventional methods used at the travel clinic of the Institute of Tropical Medicine (ITM) including microscopy, antigen testing, and molecular detection in order to provide insights into the strengths and limitations of this diagnostic tool which may be crucial to select the most appropriate diagnostic tools for the suspected pathogen. A total of 97 native stool samples from 95 patients with suspected gastrointestinal illness were analyzed, including 26 from a frozen collection and 71 prospectively collected samples. The diagnostic performance of SA was notably superior to the conventional workflow in detecting Dientamoeba fragilis (sensitivity 100% vs. 47.4%) and Blastocystis hominis (sensitivity 95% vs. 77.5%). SA had a comparable performance with the conventional workflow in detecting pathogenic protozoa (sensitivity 90% vs. 95%). In contrast, SA had a much lower diagnostic performance in detecting helminths (59.1%) compared to the conventional workflow (100%). We conclude that the Seegene Allplex GI-Parasite assay may be useful for protozoa screening in low-endemic industrialized countries. However, the Allplex GI-Helminth assay is not recommended due to its suboptimal performance compared to microscopy.

No longer stuck in the past: new advances in artificial intelligence and molecular assays for parasitology screening and diagnosis.

Emerging technologies are revolutionizing parasitology diagnostics and challenging traditional methods reliant on microscopic analysis or serological confirmation, which are known for their limitations in sensitivity and specificity. This article sheds light on the transformative potential of artificial intelligence and molecular assays in the field, promising more accurate and efficient detection methods. Artificial intelligence has emerged as a promising tool for blood and stool parasite review, when paired with comprehensive databases and expert oversight result in heightened specificity and sensitivity of diagnoses while also increasing efficiency. Significant strides have been made in nucleic acid testing for multiplex panels for enteric pathogen. Both multiplex and single target panels for Plasmodium , Babesia , filaria, and kinetoplastids have been developed and garnered regulatory approval, notably for blood donor screening in the United States. Additional technologies such as MALDI-TOF, metagenomics, flow cytometry, and CRISPR-Cas are under investigation for their diagnostic utility and are currently in the preliminary stages of research and feasibility assessment. Recent implementation of artificial intelligence and digital microscopy has enabled swift smear screening and diagnosis, although widespread implementation remains limited. Simultaneously, molecular assays - both targeted and multiplex panels are promising and have demonstrated promise in numerous studies with some assays securing regulatory approval recently. Additional technologies are under investigation for their diagnostic utility and are compelling avenues for future proof-of-concept diagnostics.

Multiplex PCR for gastrointestinal parasites in stool: Benchmarking against direct microscopy and simplex PCR

PurposeTo develop and validate a multiplex conventional PCR assay to simultaneously detect Cryptosporidium spp., Entamoeba histolytica, and Giardia lamblia in diarrheal samples as a rapid, cost-effective, and sensitive diagnostic tool for prevalent co-infections for improved diagnostic accuracy and efficiency in resource-limited settings. MethodsStool samples collected from patients with gastrointestinal symptoms after taking written consent, processed via wet mount, iodine mount, and PCR assays. Cohen's kappa statistical analysis was done to test agreement. ResultAmong 240 patients, 28.75% showed intestinal protozoa via Microscopy; Single-plex and multiplex PCR demonstrated 100% concordance, detecting 27.9%; confirmed by sequencing. Highest parasite positivity was observed in transplant and immunocompromised patients, with moderate to almost perfect agreement between microscopy and molecular methods. ConclusionMultiplex-conventional PCR offers superior sensitivity and specificity over microscopy and 100% concordance with single-plex PCR, enabling rapid, cost-effective diagnosis of multiple parasites from single stool sample. Its adoption could revolutionize parasitic infection management in routine diagnostics.

The epidemiology of intestinal protozoa in the Israeli population based on molecular stool test: a nationwide study.

This study sheds light on the prevalence of stool parasites in Israel. Additionally, this study indicates that the shift from microscope analysis to molecular tests improved protozoa diagnosis.

Reducing Stool Ova and Parasite Testing in Patients Admitted to the Hospital with Acute Diarrhea

Introduction & Background: A significant number of patients are either admitted to the hospital for acute diarrhea or develop diarrhea during their admission. Frequently stool O&P testing is ordered as part of the workup for acute diarrhea when it is not clinically indicated, leading to an increased financial burden on both the patient and the hospital. Aim & Significance: To reduce the overuse of inpatient stool O&P testing by instructing residents on the appropriate criteria for ordering this test in patients with acute diarrhea. Methods & Design: Infectious Disease Society of America and American College of Gastroenterology guidelines for acute diarrheal infections in adults were reviewed and a simplified flowsheet was created based upon their recommendations for indications for Stool O&P testing. The flowsheets were then placed in easy to view locations in the resident work rooms. Baseline data was collected by pulling the number of stool O&P tests ordered by the resident teaching service for the 3 months leading up to the intervention. Data from the same teaching services were pulled once again 3 months after the intervention had been performed. Results: After the intervention, there was an 18% decrease in stool O&P orders placed by the resident teaching services. Discussion: Overutilization of stool O&P testing and the associated financial burden can be reduced by providing education regarding the appropriate indications for ordering this test in patients with acute diarrhea.

Are artefacts misleading the diagnosis of Ascaris lumbricoides in microscopy? Observations.

Stool has multiple components, which include undigested food material, plant, animal products, normal intestinal microbiome, and parasites. Due to the existence of all the elements, stool parasite examination is cumbersome, especially with identification of the eggs of Ascaris lumbricoides. We examined 650 stool samples of pregnant women before anti-helminthic treatment. We found that the prevalence ofAscaris lumbricoideswas 5.4% (95% CI 3.8-7.4, n = 35) by a single observer in microscopy, and the majority (33/35) were identified as decorticated fertilized eggs. The prevalence of Ascaris by molecular methods was 2.6% (95% CI 1.5-4.2%, n = 17). Five samples were positive by both methods. The prevalence of structures resemblingAscariswas 4.6% (95% CI 3.1-6.5, n = 30). Three of the positive samples were confirmed with sequencing. With the subjective nature of microscopy along with the naked eye examination, errors can happen. Hence adequate training and confirmation with molecular techniques for identification of Ascaris lumbricoides are advisable.

Preparing Collared Peccary (Pecari tajacu Linnaeus, 1758) for Reintroduction into the Wild: A Screening for Parasites and Hemopathogens of a Captive Population.

The reintroduction of captive animals to the wild helps restore endangered species, but it risks pathogen transmission, harming wild populations. Such transmission can impact the genetic diversity and long-term viability of these populations. This study assessed parasite diversity and load in captive Pecari tajacu, a species native to the Americas and culturally significant to Brazilian indigenous culture, prior to reintroduction. Samples from 24 peccaries were analyzed for ectoparasites, hemopathogens, and stool parasites with direct and molecular analysis. Findings showed that various parasites were present. Two peccaries (8.3%) were infested by the adult tick Amblyomma sculptum. Six (25.0%) tested positive for Trypanosoma evansi, four (16.7%) for hemobacteria of the family Anaplasmataceae, twelve (50.0%) for hemotropic Mycoplasma, and seven (29.2%) for Leishmania braziliensis. Stool samples indicated multiple parasites, with sixteen (66.7%) peccaries infected by Strongylida order parasites, Spiruridae in three (12.5%), and Ascaris suum in one (4.2%) animal. Cysts of Balantidium sp. were found in twenty (83.3%), Entamoeba polecki in five (20.8%), and Iodamoeba bütschlii in two (8.3%) peccaries. To our current knowledge, this is the first global report of Leishmania braziliensis, Iodamoeba bütschlii, and Entamoeba polecki in P. tajacu, irrespective of the environment, including both captivity and wild conditions. Some of these parasites are common in domestic animals, and others are zoonotic, indicating potential interspecies pathogen transmission.

Prevalence of Intestinal Parasitic Infection Among the 1-15 Years Age Group Children and Its Association with Iron Deficiency Anemia

Background and Objective Intestinal parasitic infection and iron deficiency anaemia are still, a significant public health concern mostly in developing countries. The present study aimed to study the relationships between intestinal parasitic infections and iron deficiency anaemia among the 1-15 years age group of children. There are many helminths, transmitted through the soil like Ascaris lumbricoides (roundworm), Trichiuris trichiura (whipworm), Ancylostoma duodenale, and Necator americanicus (hookworms). These infections are most prevalent among the children Methods: In this study the stool samples were collected fro[i]m above age group children for parasitic infection and Hb, PBF examination was also conducted to rule out the anemia at verto medical lab. There may be chances of IDA because of the nutrition deficiency but if the occult blood positive and parasites in stool, suggestive of anemia due to the blood loss. Results: The sample was collected and processed out of that 19% samples were positive for intestinal parasites. Particularly the Entamoeba coli was 6%, E. histolytica was 2%, Ascaris and Giardia was 7%. Giardia percentage was high and fecal occult blood was positive of all sample containing parasites except Entamoeba coli, the FOB was negative. The patient with intestinal infection usually having low hemoglobin value and peripheral examination populated with predominately microcytic hypochromic picture. Conclusion: The reveals the relationship between the role of intestinal parasites in loss of iron that gives the impact on hemoglobin synthesis revealed in blood film examination. finding proof of IDA. The study also helpful in early diagnosis of IDA through few parameters mentioned in study.
 

B-237 Analytical and Clinical Performance Evaluation of the Panther Fusion® GI Parasite Assay (In Development)

Abstract Background Acute diarrhea from gastrointestinal (GI) infections is the leading cause of outpatient visits, hospitalizations, and loss of quality of life, with an estimated global impact of 500 million illnesses and 230 000 deaths annually. Most GI infections from bacteria, viruses, and parasites present similar symptoms, but successful treatment is dependent on accurate pathogen identification. For identification of parasites, microscopic testing is often used, but is laborious and often results in inconclusive or inaccurate diagnoses. Clinicians now rely on rapid and accurate molecular diagnostics to correctly identify the causative organism, which leads to optimal infection control and appropriate treatment. The Panther Fusion (PF) GI Parasite Assay is a multiplex qualitative real-time PCR assay that addresses the need for accurate and sensitive identification and detection of the most common parasites that are known to cause gastroenteritis: Cryptosporidium, Entamoeba histolytica, Giardia lamblia and Cyclospora cayetanensis. Methods Stool specimens collected in Cary-Blair (CB) are transferred to the AptimaTM Multitest collection tube (Hologic). Multitest tubes are loaded on Panther Fusion where nucleic acid isolation, amplification, and detection are performed. Analytical sensitivity was assessed using cell suspension of Cryptosporidium, Giardia or E. histolytica spiked in negative CB Stool (CBS) matrix and the limit of detection (LoD) was determined using probit. Since Cyclospora cayetanensis cannot be cultured, in-vitro transcribed RNA (IVT) was spiked in CBS matrix for LoD evaluation. Inclusivity was evaluated using cell suspensions for 20 Giardia and 15 E. histolytica strains spiked in CBS matrix. Cryptosporidium inclusivity was evaluated with synthetic nucleic acid. Specificity was evaluated by spiking cells suspensions or synthetic nucleic acid of various microbes in CBS in the presence or absence of GI targets. For clinical performance, 119 archived frozen stool specimens in CB and 40 contrived specimens were tested on Film Array GI Panel (BioFire) and PF GI Parasite Assay and results were compared. Results The LoD for Cryptosporidium, Giardia and E. histolytica was determined to be < 1 cell/mL in the Aptima Multitest tube. For C. cayetanensis, the LoD was found to be 1032 copies/mL. The PF GI Parasite Assay detected 20 strains of Giardia lamblia and 15 E. histolytica strains. In-silico and initial testing of synthetic nucleic acid demonstrated detection of 10 Cryptosporidium species. No cross-reactivity to closely related organisms or other microorganisms commonly found in the gastrointestinal tract was observed, except for cross-reactivity to Entamoeba nuttalli, which rarely infects humans. In testing of clinical remnant specimens, the PF GI Parasite Assay had a 97% PPA (35/36) for Cryptosporidium, 100% PPA (58/58) for Giardia lamblia, 100% PPA (42/42) for E. histolytica (included 40 contrived specimens) and 100% PPA (8/8) for Cyclospora with the Film Array GI Panel. Conclusion The PF GI Parasite Assay demonstrated excellent analytical and clinical performance in the detection and differentiation of Cryptosporidium, Entamoeba histolytica, Giardia lamblia and Cyclospora cayetanensis. Together with its companion Panther Fusion assays that detect bacterial and viral GI pathogens (also in development), this assay will provide a sensitive and accurate molecular tool for the automated detection of parasites in human stool.

Evaluation of the Performance of the Novodiag® Stool Parasites Assay for the Detection of Intestinal Protozoa and Microsporidia.

We aimed to assess the performance of the Novodiag® Stool Parasites (NSP) assay in the diagnosis of the most common intestinal protozoan and microsporidia infections. A panel of 167 selected stool samples was retrospectively analysed with the NSP assay and compared to routine microscopy and qPCR methods for the detection of pathogenic protozoa and microsporidia. Whereas specificity was high for all protozoa and microsporidia, NSP sensitivity was strongly dependent on the comparative method used as reference. When compared to microscopic methods, NSP sensitivity was high (96.7 to 100%) for Blastocystis hominis, Entamoeba histolytica and Cyclospora cayetanensis but was lower for Giardia intestinalis (85.2%) and ≤50% for Cystoisospora belli and Dientamoeba fragilis. In comparison to conventional qPCR, the NSP assay demonstrated lower sensitivity characteristics dependent on parasite loads, reaching 60 to 70% for G. intestinalis, D. fragilis, Cryptosporidium spp. and E. histolytica. Sensitivity was 100% for Enterocytozoon bieneusi, but none of the five samples containing Encephalitozoon spp. were detected. The overall performance of the NSP assay in the diagnosis of gastrointestinal protozoa and microsporidia seems to be better than or equivalent to that observed with microscopic methods but inferior to that obtainable with classical targeted qPCR.

A study on prevalence of Intestinal worm infestation and a comparative analysis between two floatation methods, for demonstrating intestinal parasites in stool (dung) of cattle

Parasitic infections of the gut are difficult to detect. It depends on microscopy and also different concentration techniques. All the concentration techniques may not be good and may not give reproducible results. Though there are some standard solutions giving good results but they are not always affordable in all geographical areas and there are very less solutions able to detect parasitic ova in both soil and faeces. We here report a new concentration technique i.e. sugar-ethanol solution for gut parasites. In this study we compared our novel solution (sugar ethanol) with saturated salt solution by flotation technique in the dung sample of cattle and soil samples around them in rural area of West Bengal. Results were conformable and new sugar-akcohol based solution was superior to Saturated saline. This solution can be used for concentration technique in stool samples.

A Five-Year Retrospective Investigation of the Prevalence of Intestinal Parasites at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia.

Intestinal parasites are responsible for a significant amount of disease and mortality around the world. In developing nations, intestinal parasites are a severe public health issue. Intestinal parasite infections are one of the most common illnesses in the world. They're frequently linked to poor personal and environmental cleanliness, as well as low-quality drinking water. The aim of this study is to investigate the prevalence of intestinal parasites and their shifting trends during a five-year period at Mizan-Tepi University of Teaching Hospital (MTUTH). A cross-sectional retrospective survey using the past five years' (2017 to 2021) clinical records obtained from MTUTH Mizan-Aman town Southern west Ethiopia. Patients with complete age, sex, and stool parasite examination (direct wet mount or concentration techniques) records on the parasitology registration book were included. Data were entered and analysed using a Microsoft Excel sheet. The parasite prevalence was calculated using frequency and percentages. Overall, 17,030 patient records of the past five years were reviewed from the registration books of parasitology laboratory departments at MTUTH and only 546 records were taken for this study. Of these 336 (61.50%) were female and the rest 210 (38.50%) were males. One hundred eighty-two (182) 33.33% of patients had one or more intestinal parasites over five years from 2017 to 2021. From total of 546 patients' records 17.77% in 2017, 18.89% in 2018, 23.44% in 2019, 19.96% in 2020 and 19.96% in 2021 had complete information. Intestinal parasite prevalence was high among patients who visited the Mizan-Tepi University of Teaching Hospital during the five-year period. Helminthes and protozoan parasites prevalence was higher in the 15-45 years age category. In order to avoid intestinal parasite-related disease, strategies other than mass drug administration are required.

Diarrhea don’ts: Reducing inappropriate stool cultures and ova and parasite testing for nosocomial diarrhea

Diarrhea that develops in patients after 72 hours of hospitalization is likely to have a nosocomial or iatrogenic etiology. Testing with stool cultures and stool ova and parasites (O&P) is not recommended. Our goal was to reduce this inappropriate testing within a large, urban safety-net hospital system. This was a quality improvement project. We created a best practice advisory (BPA) within the electronic medical record that fires when a stool culture or O&P order is placed 72 hours after admission for any immunocompetent patient. It states that stool testing is low yield and offers the option to remove the order. We measured weekly counts of stool culture and stool O&P orders pre- and postintervention. We also measured the BPA acceptance rate, the 24-hour stool testing reorder rate, and Clostridioides difficile infection rates. Data were analyzed using Welch tests as well as a quasi-experimental pre- and postintervention interrupted time series regression analysis. Stool culture orders decreased by 24.4% (P < .001). There was a significant level difference and slope difference with linear regression. Five of the 11 hospitals had a significant reduction in stool culture orders. Stool O&P orders decreased by 18.2% (P < .01). Three of the 11 hospitals had a significant reduction in stool O&P orders. Our intervention successfully reduced inappropriate stool testing within a large safety-net hospital system.

Prevalence of Intestinal Coccidia: First Description of Cyclosporidiosis Associated with Diarrhea in Children in Colombia

Background: In Colombia, the studies about the etiology of acute diarrhea disease (ADD) in children by using standard stool culture techniques methods and DNA detection tools for intestinal virus show that viral origin was the most frequent, however still between 16 to 45% of the cases of unknown etiology. Specific staining techniques or high sensitivity molecular methods for the intestinal coccidia Cryptosporidium sp and Cyclospora sp have been not applied in the Colombian studies, for this reason, the current situation of these intestinal coccidia in Colombia as cause of diarrhea is unknown. Objective: To estimate the frequency of Cryptosporidium sp. and Cyclospora sp. and to analyze the association between infection and clinical manifestations on children with acute diarrhea consulting the pediatrics emergency service of a third level Hospital. Methods: An observational descriptive study was performed in 150 children that consulted the emergency service at the Hospital San Juan de Dios in Armenia, Colombia, in the period between April 1st and May 31st of 2022. We applied questionnaires and collected primary data from clinical records of children, as well as stool samples of each child after receiving informed consent from the parents and/or legal guardian of the minors. To identify the pathogenic intestinal coccidia (Cryptosporidium sp. and Cyclospora sp.), we used stool fresh preparations with 1% iodine and stained by a modified Ziehl Nielsen coloration protocol (Kinyoun stain). Samples were examined by expert microbiologists on a light microscope with a 40x objective. Prevalence and odds ratios were estimated. For statistical analysis differences in proportions among groups were compared via the X2 test and Fisher exact test. For non-parametric data, differences of means between two groups were analyzed through a Kruskall-Wallis test. Differences of medians were analyzed via Kruskal-Wallis test for non-parametric variables and analysis of variance (ANOVA) for parametric variables; statistical significance was considered when p ≤ 0.05. Statistical calculations were made by using software factors in Epi Info 7.2 Epi-Info version 3.5.1 (CDC, Atlanta). Results: The prevalence of infection in the children that went to the urgency service was of 19,7% by Cryptosporidium sp. and 10,9% by Cyclospora sp. The 59,2% of children with cryptosporidiosis and 66,6% of children with cyclosporidiosis were hospitalized. There was a statistically significant association between the presence of parasite in stools and fever in cyclosporidiosis (93,3% of children with cyclosporidiosis vs. 56% by other causes, OR 10,7 IC95% 1,3-84; p= 0,004). Conclusions: The study results indicate the need to use specific diagnostic techniques to identify Cryptosporidium sp and Cyclospora sp in children with diarrhea, because they are frequent and are treatable with specific antiparasitic medication. We recommend that its search should be done systematically.

Nematode Toxocara canis as a Probable Epidemic, Sanitary and Hygienic Threat to Public Health in the Southern Region of the Russian Federation

Introduction: According to the World Health Organization, Toxocara canis, a nematode in the order Ascarididia, is an epidemic and epizootic risk factor for humans and animals around the world and in the Russian Federation. Human toxocariasis is one of the commonest parasitic zoonoses with up to 900 million incident cases registered annually in different age and social groups of the population and a global public health problem of our time. Objective: To study the nematode Toxocara canis (Werner, 1782) as a health risk factor for the population of southern regions the Russian Federation. Materials and methods: We estimated the incidence of larval toxocariasis in the population of 10 districts and two cities of Karachay-Cherkessia based on the results of enzyme immunoassay of blood samples of 6,000 people in 2019–2022. The Tiascar diagnostic test kit (2017) was applied showing toxocariasis for the antibody titer ≥ 1:800 and infestation with Toxocara larvae for those of 1:200 and 1:400. The stool ova and parasite test was used to study 600 dog stool samples from the study areas. In addition, 1,200 soil samples were tested for the presence of Toxocara canis eggs. Results: We established that the incidence rate of larval toxocariasis in the population of 10 districts and two cities of Karachay-Cherkessia varied from 2.00 to 5.40 %. Toxocara canis larvae were not found in human feces, since humans are a biological dead end for this species of worms. Toxocara canis infestation rates in feces of dogs ranged from 2.7 ± 0.4 to 6.9 ± 0.8 eggs/g, potentially accounting for a high level of soil contamination with eggs. The current epidemic situation of human toxocariasis in the Karachay-Cherkess Republic is relatively favorable owing to planned preventive measures. Yet, this constituent entity is at risk of the disease in the future since the number of children, adults and migrants with larval toxocariasis shows a dynamic growth throughout the year. Conclusion: Incidence rates of larval toxocariasis in the child population and migrants demonstrate a 2.74–2.78-fold increase during the year. Toxocara canis eggs contaminate 46 to 94 % of soils in different areas of the republic posing high risks of larval toxocariasis for the local population. In terms of canine toxocariasis, the Karachay-Cherkess Republic can be attributed to disadvantaged territories of the North Caucasian Federal District.

Formalin Inactivation of Virus for Safe Downstream Processing of Routine Stool Parasite Examination during the COVID-19 Pandemic.

During the COVID-19 pandemic, the parasitology laboratories dealing with fecal samples for the diagnosis of gastrointestinal parasitic infections are confronting the unsaved virus-containing samples. To allow for safe downstream processing of the fecal samples, a protocol for preparing a fecal smear is urgently needed. Formalin was tested with or without isotonic forms for virus inactivation using porcine epidemic diarrhea virus (PEDV) as a representative, as it belongs to the Coronaviridae family. The results revealed complete inactivation activity of 10% formalin and 10% isotonic formalin on coronavirus after 5 min of treatment at room temperature. Both also inhibited Naegleria fowleri growth after 5 min of treatment at 37 °C without disruption of the structure. In addition to these key findings, it was also found that isotonic formalin could stabilize both red and white blood cells when used as a solution to prepare fecal smears comparable to the standard method, highlighting its value for use instead of 0.9% normal saline solution for the quantification of blood cells without active virus. The 10% isotonic formalin is useful to safely prepare a fecal smear for the diagnosis of parasites and other infections of the gastrointestinal tract during the COVID-19 pandemic.

The Relationship between Helicobacter Pylori and Intestinal Parasites in Patients with Peptic Ulcer

Aim: This study aimed to evaluate the frequency of Helicobacter pylori (H. pylori), risk factors, and co-infection with intestinal parasites in adult patients presenting gastrointestinal complaints. Materials and Methods: The working group of the study consisted of 385 patients with gastrointestinal complaints. A questionnaire including questions aiming to canvass the socio-demographic features, lifestyles, and complaints of the patients was administered to the study population. Cellophane slide method, native-lugol, sedimentation and Modified kinyoun acid-fast methods were used for the diagnosis of parasites in stool, under microscope. The H. pylori antigen was studied in the stool sample taken for the diagnosis of H. pylori.Results: H. pylori positivity was found to be 27.79% in the patients included in the study. 76.6% of those who are positive for H. pylori are women, and the positivity rate was found to be higher at the age of 40 and over (75.7%). The majority of patients with H. pylori positivity expressed being married (73.8%), having middle / low-income (89.7%), having a low educational background (82.2%), living in a village (55.1%), and in a nuclear family (72.2%) (p&amp;lt;0.001). H. pylori positivity was higher in those who used tap water (40.2%) and those who had a vegetable-based diet (75.7%) (p&amp;lt;0.001). The study found a statistically significant correlation between Entamoeba histoloytica and Enterobius vermicularis positivity and H. pylori positivity (p&amp;lt;0.05 p&amp;lt;0.001, respectively). The calculated odds ratio showed that H. pylori positivity was 1.19 times higher in Entamoeba histoloytica positivity and 11.27 times higher in Enterobius vermicularis positivity. Conclusion: Larger and more comprehensive studies should be performed to understand better the epidemiology, clinical effects, treatment, and control of H. pylori co-infection.

Cutaneous Larva Migrans as a frequent problem in travellers.

Dermatological disorders are among the most common complaints of patients seeking medical assistance after returning from trips to tropical countries. Among exotic dermatoses, one of the frequently encountered diagnoses is Cutaneous Larva Migrans (CLM), primarily caused by the nematodes Ancylostoma braziliense and A. caninum. Cats and dogs, which serve as the definitive hosts for these nematodes, excrete with their stool parasite eggs into the environment, where they transform into larvae. Human infection occurs through the invasive form of the larvae, which penetrate the skin, causing itching and the characteristic serpiginous, slightly raised, and enlarging lesion at the site of invasion. Diagnosis is made based on the highly characteristic clinical presentation, although in non-endemic countries, diagnostic errors and delays in initiating effective causal treatment are relatively common. Effective therapy includes oral albendazole and ivermectin. Prevention of CLM involves avoiding skin contact with potentially contaminated soil by wearing shoes and using towels and mats on the beach. Due to the high interest in travel and the risk of importing exotic diseases, it is important to promote knowledge of tropical medicine among healthcare professionals as well as the travellers.

ANSWERS LIE IN THE COMPLETE BLOOD COUNT: A CASE OF EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS PRESENTING WITH ACUTE ST-WAVE ELEVATION MYOCARDIAL INFARCTION

ANSWERS LIE IN THE COMPLETE BLOOD COUNT: A CASE OF EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS PRESENTING WITH ACUTE ST-WAVE ELEVATION MYOCARDIAL INFARCTION

Environmental and behavioural exposure pathways associated with diarrhoea and enteric pathogen detection in 5-month-old, periurban Kenyan infants: a cross-sectional study

ObjectivesThe aim of this study was to test whether household environmental hygiene and behavioural conditions moderated associations between diarrhoea and enteric pathogen detection in infants 5 months of age in...