Parasite Co-infection Research Articles

Concomitant parasite infections influence tuberculosis immunopathology and favor rapid sputum conversion of pulmonary tuberculosis patients

Immunopathology of human tuberculosis (TB) in a subgroup of patients is characterized by aberrantly high concentrations of inflammatory cytokines, for example Interleukin (IL)-6. Concomitant (co-)infections by parasites can affect host immunity, but the impact on immunopathology in TB patients is poorly defined. Here we characterized a group of patients with TB ( n = 76) from Ghana with different protozoan and helminth co-infections. Plasma cytokines were measured at the onset of disease and anti-mycobacterial treatment efficacy was monitored during disease course. A subgroup of TB patients had co-infections with protozoan (n = 19) or helminth (n = 16) parasites. Plasma analyses for candidate cytokines identified lower levels of IL-6 in parasite co-infected patients with TB. Moreover, it took less time for co-infected patients to become sputum-negative for Mycobacterium tuberculosis during treatment. These results indicated an influence of parasite co-infections on immunopathology in TB and suggested positive effects on treatment efficacy.

Intestinal Protozoa, Helminth Infection, and Associated Factors among Tuberculosis Patients and Nontuberculosis Persons in Bobo-Dioulasso City, Burkina Faso.

We report the frequency and associated factors of tuberculosis (TB) and parasite coinfection from newly diagnosed pulmonary TB patients (TB+) and non-TB participants (TB-) from the Regional Tuberculosis Control Center, households, and health facilities in Bobo-Dioulasso from 2019 to 2021. Biological samples were examined for parasite infection using direct microscopy, concentration techniques, and the immunochromatographic rapid test. Data were analyzed using STATA 14. Of a total of 192 participants involved, 95 were TB+ and 97 were non-TB. There was no statistically significant difference in parasitic infections between the two groups, although it was higher in TB+ than TB- (69.5% [66/95] versus 55.7% [54/97]; P = 0.07). Protozoal infection prevalence was significantly higher in patients with TB+ than in those TB- (61.1% versus 37.1%; P = 0.001). Specifically, Entamoeba spp. and Cryptosporidium spp. followed this pattern with 35.8% versus 19.6% (P = 0.01) and 22.1% versus 8.3% (P = 0.007), respectively. Although higher in TB+ patients, helminthiasis frequency was not significantly different between the two groups (23.2% versus 15.5%; P = 0.2). Helminth species were Schistosomia mansoni (17.9% versus 12.4%), Dicrocoelium dendriticum (3.2% versus 1.0%), Enterobius vermicularis (2.1% versus 2.1%), Wuchereria bancrofti (1.1% versus 0.0%), and Hymenolepis nana (1.1% versus 0.0%). Illiteracy (adjusted odds ratio [aOR]: 2.5; 95% CI: 1.0-6.1), smoking (aOR: 2.4; 95% CI: 1.1-5.3), and handwashing after defecation (aOR: 2.4; 95% CI: 1.2-4.7) were associated with parasites. This study reported a high frequency of parasite coinfection in TB patients. These findings suggest the need for adequate health education for behavioral change and systematic diagnosing of parasites in TB patients for better coinfection management.

Prevalence of intestinal parasites and Helicobacter pylori coinfection, and contributing factors among patients with gastrointestinal manifestations at Addis Zemen primary hospital, Northwest Ethiopia

BackgroundThe urease-producing Helicobacter pylori increase the likelihood that pathogenic intestinal protozoa will use the stomach’s increased hydrogen potential to propagate the disease. Coinfections exacerbate the onset and severity of gastrointestinal symptoms. This study aimed to assess the prevalence of intestinal parasites/Helicobacter pylori coinfection and contributing factors in patients with gastrointestinal symptoms at Addis Zemen Primary Hospital, Northwest Ethiopia.MethodsFrom April to July 2023, patients with gastrointestinal problems participated in a cross-sectional study carried out in a hospital. To collect the clinical and sociodemographic data, a questionnaire was employed. Intestinal parasites and Helicobacter pylori were detected using the saline stool wet mount and Helicobacter pylori stool antigen tests, respectively. SPSS version 20 was used to analyze the data and variables with p-values < 0.05 were considered statistically significant.ResultThe study included 384 participants in total, of which 47.3% (182/384) were farmers and 50.3% (193/384) were women. Of the study subjects, 69/384 or approximately 18%, had intestinal parasitic infections. In 12% of cases (46/384), Helicobacter pylori were detected. A coinfection of Helicobacter pylori and intestinal parasites was found in 5.5% (21/384) of the subjects. Multiple logistic regression revealed increased risk of coinfection of Helicobacter pylori and intestinal parasites in patients who drink surface water (AOR: 10.7, p = 0.03) family history of Helicobacter pylori (AOR: 3.3, p = 0.024) and those with untrimmed fingers (AOR: 4.9, p = 0.031).ConclusionsGiardia lamblia and Entamoeba histolytica/dispar/ moshkovskii/ bangladeshi complex are the most common protozoans that cause coinfection with Helicobacter pylori. Drinking surface water, family history of Helicobacter pylori and untrimmed fingers are the contributing factors to intestinal parasites/Helicobacter pylori coinfection.

Co-infection of Liburna oophaga sp. nov. and Ikanecator primus on cuttlefish (Sepia pharaonis) eggs and the effectiveness of peracetic acid as a treatment

The cuttlefish Sepia pharaonis species complex is emerging as a promising set of organisms for research in neuroscience, the behavioral sciences, and commercial aquaculture. At the same time, information about pathogens and diseases that could affect cuttlefish cultivation in intensive aquaculture settings remains limited. Our study has identified two species of parasite, the protozoan Liburna oophaga sp. nov. and the metazoan Ikanecator primus, that co-infect cuttlefish eggs, increasing mortality and reducing hatching rates. L. oophaga sp. nov. is reported here for the first time to enhance mortality during the incubation period by inducing deformity in cuttlefish eggs. We investigated the application of peracetic acid to parasite elimination during cuttlefish egg incubation. When cuttlefish eggs were treated with a peracetic acid containing product (PAA-product); 35 mg/L PAA + 15 mg/L H2O2, L. oophaga on the surfaces of the eggs were eliminated within 10 min. PAA-product; 70 mg/L PAA + 30 mg/L H2O2 was required to achieve the same effect for I. primus. Immersion treatment with PAA-product at 70 mg/L PAA + 30 mg/L H2O2 reduced parasitic load and improved survival of cuttlefish embryos and hatchling size, demonstrating that PAA product can inhibit and control parasitic co-infections in cephalopod culture.

Intestinal parasitic co-infections associated with Helicobacter pylori among paediatric patients with gastrointestinal illness attending a general hospital in southern Ethiopia

BackgroundConcurrent infections or co-infections caused by intestinal parasites and Helicobacter pylori are quite rampant in paediatrics living in endemic areas of sub-Saharan Africa, including Ethiopia, and if left untreated, can result in severe complications and hence must be addressed to ensure their health and well-being.ObjectivesTo determine the prevalence of intestinal parasitic and H. pylori co-infections and associated factors among paediatric patients with gastrointestinal symptoms who attended the Arba Minch General Hospital (AMGH), Arba Minch, southern Ethiopia, from September to November 2020.MethodsA cross-sectional study was conducted among a study population of 299 paediatric patients with gastrointestinal symptoms who visited AMGH. Stool samples were collected and analysed to detect H. pylori and intestinal parasites. A rapid lateral flow chromatographic immunoassay was employed to identify the H. pylori copra antigen, whereas the latter was detected using wet mount saline preparation and formol-ether concentration method. Socio-demographic, clinical, behavioural and other factors were obtained by means of a pre-tested structured questionnaire. Descriptive statistics and logistic regression analysis were done by Statistical Package for Social Service (SPSS) version 25; P values < 0.05 were considered statistically significant.ResultsThe prevalence of Helicobacter pylori and intestinal parasites was 14% (n = 42) and 37.1% (n = 111), respectively, whereas that of the co-infections with these pathogens was 6.4% (n = 19). Giardia lamblia was the most prevailing parasite, 21.4% (n = 64). Informal maternal education [AOR = 5.14; 95% CI: 1.98–15.70] and lack of hand washing practice were significantly associated with the extent of co-infections [AOR = 4.18; 95% CI: 1.36–12.80].ConclusionNearly one in twenty pediatric patients with gastrointestinal symptoms had intestinal parasitic infections and H. pylori co-infections, representing a silent health problem that is to be addressed through effective control strategies. Health administrators should consider the importance of co-infections in clinical diagnosis and planning aimed at its prevention.

Intestinal Parasitic Infections May Be Overlooked Drivers of the Tuberculosis Pandemic.

The burden of tuberculosis (TB) is disproportionate in tropical and subtropical regions, where parasitic coinfections are common. Given the significant geographical overlap between TB and intestinal parasitic infections, it is important to consider the implications of intestinal parasitic infections for the TB pandemic. Intestinal parasitic infections have been theorized to increase vulnerability to TB by altering the inflammatory milieu, inducing undernutrition that blunts the immune response, and affecting drug pharmacokinetics. In this perspective piece, we provide a background of the epidemiological and immunological evidence that links parasitic infections to increased risk of TB progression and worse treatment outcomes. We also identify gaps in our knowledge and call for increased research on TB-parasitic coinfections to ensure action on a potentially widespread TB comorbidity.

Tropheryma whipplei Colonization in Adults and Children: A Prospective Study.

We conducted a prospective cohort study at the IRCCS Sacro Cuore Don Calabria Hospital in Negrar di Valpolicella from 2019 to 2021 to investigate the duration of T. whipplei colonization. In addition, the correlation between persistent colonization and the continent of origin, current treatment regimen, clinical manifestations, and parasite coinfection was evaluated. The cohort included subjects who were tested in a previous study (years 2014-2016) and found to be positive for T. whipplei DNA in fecal samples. Thirty-three subjects were enrolled in a prospective study between 2019 and 2021. Feces, saliva, urine, and blood were collected at baseline and after 12 months. Medical history, current treatment, and symptoms were recorded. Among them, 25% showed persistent intestinal or oral colonization, 50% had no colonization at both visits, and 25% had intermittent colonization. No association was found between persistent T. whipplei colonization and subjects' continent of origin, current treatment regimen, initial clinical manifestations, and parasite coinfection. The longest duration of persistent T. whipplei intestinal colonization exceeded six years, with 11 subjects presenting persistent positivity for more than three years, including 1 minor. Our research was limited by the lack of a strain-specific identification of T. whipplei that made it impossible to distinguish between persistence of the same T. whipplei strain, reinfection from household exposure, or infection by a new strain. Larger prospective studies are needed to further explore the implications of this persistence and determine the key factors influencing the duration of colonization and its potential health impacts.

The Impact of HIV and Parasite Single Infection and Coinfection on Telomere Length: A Systematic Review.

HIV and parasite infections accelerate biological aging, resulting in immune senescence, apoptosis and cellular damage. Telomere length is considered to be one of the most effective biomarkers of biological aging. HIV and parasite infection have been reported to shorten telomere length in the host. This systematic review aimed to highlight work that explored the influence of HIV and parasite single infections and coinfection on telomere length. Using specific keywords related to the topic of interest, an electronic search of several online databases (Google Scholar, Web of Science, Scopus, Science Direct and PubMed) was conducted to extract eligible articles. The association between HIV infection or parasite infection and telomere length and the association between HIV and parasite coinfection and telomere length were assessed independently. The studies reported were mostly conducted in the European countries. Of the 42 eligible research articles reviewed, HIV and parasite single infections were independently associated with telomere length shortening. Some studies found no association between antiretroviral therapy (ART) and telomere length shortening, while others found an association between ART and telomere length shortening. No studies reported on the association between HIV and parasite coinfection and telomere length. HIV and parasite infections independently accelerate telomere length shortening and biological aging. It is possible that coinfection with HIV and parasites may further accelerate telomere length shortening; however, this is a neglected field of research with no reported studies to date.

Telomere Length in a South African Population Co-Infected with HIV and Helminths.

Biological ageing refers to the gradual decrease in physiological functions, resulting in immune senescence, cellular damage and apoptosis. Telomere length is a biomarker of biological ageing. Limited studies have associated shorter telomere length with HIV and parasite single infections, with no studies reporting the association of HIV and parasite co-infection with telomere length. The study aimed to investigate whether telomere length shortening is accelerated in a South African population co-infected with HIV and helminths compared to participants singly infected with either HIV or helminths. Additionally, telomere length data were compared with participants' biochemical and full blood count parameters. A total of 200 participants were in groups of uninfected control, HIV single infection, helminth single infection and HIV and helminth co-infection groups. Relative telomere length (RTL) was determined using Real-Time PCR and associated with biochemical and full blood count parameters using multivariate regression analysis models that were adjusted for confounders. The uninfected control group was used as a reference group. The uninfected control group had the highest mean RTL (1.21 ± 0.53) while the HIV-infected (0.96 ± 0.42) and co-infected (0.93 ± 0.41) groups had similar RTLs, and lastly, the helminth-infected group (0.83 ± 0.33) had the lowest RTL (p = 0.0002). When compared to the uninfected control group, a significant association between RTL and biochemical parameters, including blood iron (β = -0.48), ferritin (β = -0.48), transferrin saturation (β = -0.57), transferrin (β = -0.57), phosphate (β = -0.47), vitamin A (β = -0.49) and C-reactive protein (β = -0.52) were noted in the co-infected group (p < 0.05). In addition, a significant association between RTL and full blood count, including (β = -0.47), haematocrit (β = -0.46), mean corpuscular volume (β = -0.47), lymphocytes (β = -0.45), mean corpuscular haemoglobin concentration (β = -0.45), red cell distribution width (β = -0.47), monocytes (β = -0.45), eosinophils (β = -0.45), basophils (β = -0.44) and transferrin saturation (β = -0.57) were also noted in the co-infected group (p < 0.05). Accelerated biological ageing, as indicated by telomere length shortening, is associated with HIV and helminth co-infections.

Polyparasitism with soil transmitted helminthes and Schistosoma haematobium among school-aged children in Igede land, Benue state, Nigeria

Background: Polyparasitism is widespread in rural communities of the developing world, and it is a serious problem for public health. The aim of this study is to investigate the co-infection of intestinal parasites and urinary schistosomiasis among school-aged children in two local government areas of Benue State. Methods: This study collected 452 stool and urine samples from randomly selected participants and examined them using three techniques - direct wet mount, formol ether concentration, and urine sedimentation. The researchers also utilized questionnaires to assess risk factors associated with the samples. The data was then analyzed using the Chi-square statistical test to identify any significant relationships between the various factors examined. Results: The study found that 29.0% of the 452 randomly selected participants were infected with at least one parasite. 17.3% of the infected were male, while 11.7% were female. 11.7% had multiple infections, with 13.1% in males and 10.2% in females. 15.0% were infected with single parasites, 9.1% had double infections, and 2.7% had triple infections. Schistosoma haematobium was found in 1.8% of participants, with 1.1% in males and 0.7% in females. The most common parasite was Ascaris lumbricoides (6.0%), followed by hookworm (5.8%). The hookworm-Ascaris combination was the most common double infection (4.2%). While males were generally more infected, there was no statistically significant difference between males and females. Similarly, the higher infection rate in Obi (16.2%) compared to Oju (12.8%) was not statistically significant. The 11-15 age group had the highest prevalence of multiple infections (14.2%), but this was not statistically significant across age groups. Conclusion: Aggressive health education and mass drug administration are recommended in the study area. Kewwords: Polyparasitism, Igede, Oju, Obi, Parasites, Soil Transmitted Helminthes (STH), Schistosomiasis, Nigeria

IgG seroprevalence of Toxoplasma gondii and Leishmania infantum in leprosy patients: Implications for screening and management of co-infections

Parasitic co-infections are common in developing countries and can interfere with leprosy treatment, leading to an increased risk of inflammatory leprosy reactions. This study assessed serum immunoglobulin G (IgG) levels against Toxoplasma gondii and Visceral Leishmaniasis (VL) antigens in 270 leprosy patients from Brazilian states. Regarding the respective cut-offs, the prevalence of IgG seropositivity for T. gondii and VL were 21.05 % and 47.36 % in the leprosy-negative group, and 77.7 % and 52.6 % in the leprosy-positive group. Of the 270 leprosy patients, 158 (58.5 %) presented with inflammatory leprosy reactions. Of those, 72 (59.5 %) had neuritis, 35 (48.6 %) had reverse reactions, and 28 (38.9 %) had ENL in both Brazilian states. Leprosy patients with anti-Leishmania IgG seropositivity were 3.25 times more likely to develop neuritis (95 % C.I.: 1.187 - 9.154; p = 0.019). These findings are particularly relevant for clinical settings where both leprosy and parasitic diseases are prevalent and could provide essential guidance for detecting and addressing complications arising from parasitic co-infections in leprosy patients, thereby improving clinical management strategies.

Co-infection of Helicobacter pylori and intestinal parasites in children of selected low-income communities in Lagos State, Nigeria

Helicobacter pylori and intestinal parasites cause gastrointestinal diseases with a high prevalence in children in resource limited developing countries. There is paucity of information in Nigeria on co-infection of H. pylori and intestinal parasites. The study was conducted to determine the prevalence of H. pylori and parasite co-infection in children from selected low-income communities in Lagos, Nigeria. Fecal samples were collected from 151 healthy children aged ≤11 years across six low-income communities in Lagos. H. pylori was detected using stool antigen test and conventional PCR assay, intestinal parasites were detected using formol-ether concentration and nested PCR assay. Structured questionnaires were administered to parents and legal guardians of the children by an interviewer to collect relevant data on demographic and lifestyle factors. The prevalence of H. pylori was 31.79% (48), with a higher prevalence in children aged 2–3 years. The prevalence of intestinal parasites was 21.19% (32) with the lowest frequency found in children aged 8–9 years. The parasites detected include: A. lumbricoides (10.6%), G. intestinalis (7.3%), hookworm (1.99%), E. histolytica (0.66%), S. mansoni (0.66%). There was co-infection prevalence of 10.6% (16) which was associated with the parasites: G. intestinalis (7.3%) and A. lumbricoides (3.97%). Polyparasitism with G. intestinalis and A. lumbricoides was reported in 2 children infected with H. pylori. This study which is the first reported in Lagos established a low prevalence of H. pylori and intestinal parasite co-infection in children and provides better understanding of the epidemiology of H. pylori infection associated with intestinal parasites in Nigeria.

Young male blackcaps with blood parasite coinfections cope with oxidative stress favouring anthocyanin‐rich food during migratory fattening

Parasites may alter host physiology, which may promote behavioural adaptations to counteract their effect. Adaptive feeding may help individuals to cope with infection, especially during physiologically demanding life stages. For instance, migrating birds need fuel for long‐distance flights and repair oxidative damage caused by intense aerobic exercise, and parasites may influence on how individuals balance these needs. Infected birds may face increased oxidative challenges, which could induce them to favour antioxidant defences over other needs, such as fattening. We tested whether migrating birds can adaptively choose food according to their needs, favouring dietary antioxidants to cope with oxidative stress caused by haemosporidian blood parasites during migration. During autumn migration, we mist‐netted young male Eurasian blackcaps Sylvia atricapilla stopping over in central Spain. We placed the birds in cages where they were offered fat and anthocyanin‐enriched food alternatives. We measured preference for each food offer. We tested their infections with haemosporidian parasites by PCR techniques and their parasitaemia by blood smear inspection. We also measured physiological variables that account for nutritional and oxidative status in red blood cells and plasma. We found that birds with multiple infections favoured anthocyanin‐enriched food controlling for an effect of body mass on food preference (lean blackcaps preferred anthocyanins, likely because they are urged to repair oxidative damage upon arrival on stopover with depleted energy reserves). Haemosporidian‐infected birds had a lower antioxidant capacity of plasma, although no effect of infections on oxidative damage was detected, and individuals with more oxidative damage preferred anthocyanin‐enriched food. Our results suggest that haemosporidian infections may increase individual antioxidant needs, which could affect migratory performance if the urge to find dietary antioxidants reduces the rate of fuel consumption.

Investigation of Visceral Leishmaniasis and Coinfection of Intestinal Parasites in HIV-Positive Patients

Objective: Parasitic infections are more frequently observed in immunosuppressed cases, such as those infected with human immunodeficiency virus (HIV). Furthermore, compared to immunocompetent cases, a more severe clinical course is observed in the immunosuppressed patient group. HIV-positive individuals have increased pathogenicity of parasites and may exhibit a wide range of clinical symptoms of varying severity that may result in mortality. Visceral leishmaniasis (VL) is a vector-borne disease and an important opportunistic infection seen in HIV/Acquired Immune Deficiency Syndrome (AIDS) cases, most notably in Southern Europe and Africa, where both infections are endemic. Several parasites namely toxoplasmosis, cryptosporidiosis, isosporiasis, cyclosporiasis, amebiasis, giardiasis, plasmodium, and strongyloidiasis are infections posing significant risk factors for these patient groups. Materials and Methods: In this study, visceral leishmaniasis was investigated serologically in serum samples and parasitic infections were analyzed by conventional methods in fecal samples from HIV-positive cases. Results: 5 of the 42 cases included in the study were female. The mean age of these cases was 38.7 years (19-66). Blastocystis spp was detected in 5 fecal samples obtained from HIV-positive cases. The rK39 dipstick test with serum samples yielded a very weak band in one case, while none of the other tests yielded a positive band. Conclusion: The regional prevalence of these latent infections, which can be subclinical in HIV-positive patients, is important to know. However, the literature lacks sufficient data on the situation in Turkey. In this study, the prevalence of enteric parasitic infections in people with HIV infection in our region was found to be low and VL was not detected.

Ranavirus and helminth parasite co-infection in invasive American bullfrogs in the Atlantic forest, Brazil

Emerging infectious diseases threaten amphibian species across the globe. In Brazil, the American bullfrog (Aquarana catesbeiana) is a highly invasive species that can potentially transmit parasites and pathogens to native amphibians. This is the first assessment of co-infection of Ranavirus and helminth macroparasites in invasive populations of bullfrogs in South America. We collected, measured, and euthanized 65 specimens of A. catesbeiana sampled from 9 sites across three states of Brazil in the Atlantic Forest biome. We collected and identified helminth macroparasites and sampled host liver tissue to test for the presence and load of Ranavirus with quantitative PCR. We documented patterns of prevalence, parasite load, and co-infection with generalized linear mixed models, generalized logistic regressions, and randomization tests. Most individual bullfrogs did not exhibit clinical signs of infection, but the overall Ranavirus prevalence was 27% (95% confidence interval, [CI 17–38]). Bullfrogs were infected with helminth macroparasites from 5 taxa. Co-infection of helminth macroparasites and Ranavirus was also common (21% CI [12–31]). Bullfrog size was positively correlated with total macroparasite abundance and richness, and the best-fitting model included a significant interaction between bullfrog size and Ranavirus infection status. We observed a negative correlation between Ranavirus viral load and nematode abundance (slope = −0.22, P = 0.03). Invasive bullfrogs (A. catesbeiana) in Brazil were frequently infected with both Ranavirus and helminth macroparasites, so adult bullfrogs could serve as reservoir hosts for both pathogens and parasites. However, many macroparasites collected were encysted and not developing. Coinfection patterns suggest a potential interaction between Ranavirus and macroparasites because helminth abundance increased with bullfrog size but was lower in Ranavirus infected individuals. Future studies of bullfrogs in the Atlantic Forest should investigate their potential role in pathogen and parasite transmission to native anurans.

Parasite and bacterial co-infections with Leishmania spp. in dogs

Canine visceral leishmaniasis (CVL) is a major disease affecting dogs and is often associated with other illnesses. In this study, we investigated the distribution of helminths, ectoparasites and bacteria in dogs of an endemic urban area of CVL. A total of 71 dogs, uninfected or naturally infected with Leishmania spp. were studied. Splenic samples were cultured for Leishmania identification, and anti-Leishmania antibodies were measured in the serum. Helminths were diagnosed in the feces using flotation or spontaneous sedimentation techniques. Serum antibodies against six ectoparasite-transmitted pathogens were detected. Microbial growth from eyes, skin, urine, and blood samples were evaluated. To our knowledge, this is the first time that co-infections with Leishmania spp., parasites and bacteria together has been reported. Co-infections with Leishmania were observed in 89% of the animals with helminths and 95% with ectoparasites. Most of the dogs were positive for Ehrlichia spp. and Anaplasma spp. Coagulase-negative Staphylococcus was the most frequently isolated organism. It is found that Leishmania positivity dogs from endemic area in Brazil have a higher rate of co-infections with helminths, ectoparasites and bacteria. Therefore, effective treatment and public measures are needed to contain the spread of canine leishmaniasis and other infections.

Farmed Chinese Perch (Siniperca chuatsi) Coinfected with Parasites and Oomycete Pathogens

Farming Chinese perch in aquaculture systems with artificial diets is a new method and developing trend. This method of raising Chinese perch has led to outbreaks of new diseases. In 2022, a disease outbreak occurred among farmed Chinese perch fed an artificial diet in Jiangxi Province, China, during which 50% of the fish died. The clinical signs exhibited by the diseased Chinese perch included decreased physical vitality, anorexia, emaciation, and dorsal fin ulceration with white cysts and flocs. Coinfection with ciliate parasites and an oomycete was found. No pathogenic bacteria were isolated from the microbial test, and the viral detection results were negative. After morphological and 18S or 28S rDNA sequence clustering analysis, the parasites were identified as Epistylis wuhanensis and Zoothamnium sp., while the oomycete was identified as Achlya klebsiana. This article discusses the interaction between parasitic and oomycete coinfections in Chinese perch from the perspective of the characteristics of Chinese perch raised with an artificial diet. The relationships between parasites, oomycete, and fish were also briefly discussed. This is the first report of the coinfection of Chinese perch with Epistylis wuhanensis, Zoothamnium sp. and Achlya klebsiana.

Helicobacter Pylori and Intestinal Parasites Co-infection in Pregnant Women Attending Antenatal Clinic in a Hospital, South-South Nigeria

Pregnant women are susceptible to severe health problems caused by Helicobacter pylori and intestinal parasitic infections. These conditions include iron deficiency anaemia, hyperemesis gravidarum, gastritis, duodenal ulcers, and maternal morbidity and mortality. These infections usually spread due to poor personal hygiene and socioeconomic conditions. The study aimed to investigate the occurrence of H. pylori and intestinal parasitic infections amongst pregnant women attending the antenatal clinic in Okolobiri, Bayelsa State. We analysed the samples using the H. pylori antibody rapid tests, stool direct wet mounts, formal ether concentration, and saturated sodium chloride floatation. The data revealed that 34% of the women were infected with H. pylori and 20% with intestinal parasites. The highest occurrence of H. pylori infection and intestinal co-infection was in the 26-30 age group. Entamoeba histolytica was the most common type of protozoa present, while Ascaris lumbricoides and Trichuris trichuria were the most common forms of helminth infections. The Chi-square analysis showed a statistically significant difference with respect to age. These results provide essential epidemiological data on the prevalence of H. pylori and intestinal parasitic infections among pregnant women in Okolobri, Bayelsa State. The study highlights the need to screen pregnant women for H. pylori and intestinal parasites to improve antenatal care for both mother and child.

Cystoisospora Belli Infection in HTLV-1 Patients and Progression to Acute T-Cell Leukemia

Cystoisospora belli is a parasite in tropical and subtropical regions. It is transmitted via a direct fecal-oral cycle and is more common in areas with poor sanitation and warm weather. Severe cases have been reported in patients with HIV, organ transplants, and tumors worldwide. People with HTLV-1 are also at risk of persistent parasitic coinfections, such as S. stercoralis and C. belli. We describe a couple of cases of cystoisosporiasis in patients with HTLV-1 infection. The first case is a 45-year-old female who presented chronic watery diarrhea, for which she was diagnosed with C. belli infection. Thus, she was treated with TMP/SMX. An ATL diagnosis was made on the same admission. The second case is a 33-year-old female patient with a previous diagnosis of HTLV-1 who went to the emergency room multiple times due to recurrent watery diarrhea after multiple treatment and prophylaxis schemes. The cases suggest a potential link between C. belli infection in HTLV-1 patients and early development of ATL. Routine modified acid-fast staining should be conducted for C. belli in HTLV-1 patients. Further research is necessary to determine the potential association between this coccidia and HTLV-1.

The COVID-19 Severity and Its Association with Intestinal Parasite Coinfection and Urine Biochemical Parameters among COVID-19-Confirmed Patients Admitted to Debre Markos University COVID-19 Center, Northwest Ethiopia.

Though most people with COVID-19 disease show asymptomatic to mild illness, a substantial number of patients are at high risk of developing severe disease and adverse outcomes with long COVID-19 and death. Even though some studies showed that previously existing infections with parasites amend the host's body defenses to increase resistance to infection with SARS-CoV-2, there is limited data in Ethiopia. This study is aimed at determining the COVID-19 disease severity and its association with intestinal parasite coinfection and urine biochemical parameters among COVID-19-confirmed patients admitted at Debre Markos University COVID-19 Center, 2021. A prospective cohort study was conducted on 136 RT-qPCR-confirmed COVID-19 patients admitted at Debre Markos University COVID-19 Center from January 1 to March 30, 2021. Sociodemographic and clinical data were collected by using standardized data collection forms. A urine biochemical test was performed using a dry urine dipstick kit and stool examination using direct wet mount microscopic examination and formalin-ether concentration method. The chi-square test, Fisher exact test, and ordinal logistic regression analysis were computed to assess association with outcome variables using Statistical Package for Social Science software (version 24). A total of 136 COVID-19-confirmed patients participated in this study. The median age of the participants was 48 years. The majority (86 (62.5%)) of them were male in sex. Of the 136 cases, 39 (28.7%) had died. Among the 136 patients, 22 (16.2%) were coinfected with intestinal parasites. COVID-19 patients who have intestinal parasite coinfection had lower odds of developing clinically severe COVID-19 compared to noninfected (AOR = 0.37; 95% CI = 0.147-0.944; P = 0.037). The majority (104 (76.5%)) of them have abnormal urine biochemical results. From the abnormal urine biochemical tests observed, the urine blood, glucose, and ketone tests were positive for 54 (39.7%), 36 (26.5%), and 30 (21.1%) patients, respectively. Among the 31 critical COVID-19 patients, 25 (80.6%) showed abnormal urine biochemical parameters. Age and comorbidity were significantly associated with COVID-19 severity (P < 0.05). Patients with old age and comorbidity had an increased risk of developing severe COVID-19 disease. Patients having SARS-CoV-2 and intestinal parasitic coinfections demonstrated mild COVID-19 disease severity. Abnormal urine biochemical results were common among critical COVID-19 patients. Thus, advanced study on the effect of the interaction among intestinal parasites on COVID-19 clinical severity and its mechanisms is essential.