Single Stool Specimen Research Articles

Factors Associated with Foodborne Pathogens among Food Handlers: A Case Study of Thika, Kiambu County, Kenya

Increasing risks of infections with foodborne pathogens may occur as a result of poor food handling practices. The present cross-sectional study employed a mixed-methods approach to determine the factors associated with foodborne pathogens among food handlers working in the food establishments in Thika, Kiambu County, Kenya. Random sampling was used to enroll respondents in the survey. A single stool specimen was collected from each study participant. Laboratory analysis of the specimen was done to test the selected foodborne pathogens. Overall, 44 out of the 285 food handlers who took part in the study had at least one food-transmitted pathogen, putting the prevalence of foodborne infections among the food handlers at 15.4% (95% confidence interval (CI) 11.7%–20.1%). The findings from multivariate logistic regression indicated the following protective factors for foodborne pathogens among the studied food handlers: being female (adjusted odds ratio (AOR) 0.098 (95% CI 0.0304–0.315, p < 0.001 )); having a valid medical examination certificate (AOR 0.141 (95% CI 0.141–1. 0.439, p = 0.001 )); not boiling or treating water before serving the water to customers was a risk factor for having infections with foodborne pathogens (AOR 3.043 (95% CI 1.2225–7.577, p = 0.017 )). The presence of foodborne pathogens among the food handlers in the study area potentially highlights the need to address the spread and transmission of foodborne infections in the study area. There is a need to institute appropriate control measures, including regular screening of food handlers for foodborne illnesses in addition to training them on safe food handling practices, hand hygiene practices, and regular monitoring of the food handling practices.

Molecular prevalence of Entamoeba species in a cohort of Egyptians

Background and objective: Intestinal and extraintestinal amebiasis is caused by the protozoan parasite Entamoeba (E.) histolytica, it is of considerable morbidity and mortality in developing countries. E.histoltica complex species includes E.histolytica, E. moshkovskii and E. dispar are morphologically indistinctable. The current study goal was to use molecular assays to detect the true prevalence of E. histolytica complex species among a cohort of Egyptians. Methods: A single stool specimen was collected from 133 patients, examined coproscopically before and after concentration. DNA was extracted from microscopically positive stool specimens for E. histolytica complex species were molecularly idenitified using multiplex PCR. Results: The coroscopic prevalence of intestinal parasites was 51.1% (68/133) of them 30 cases had E.histolytica complex (22.6%; 30/133). Among coproscopically positive samples, E. dispar was the most common parasite (63.3%; 19/30), followed by E. histolytica (23.4%; 7/30) and E. moshkovskii (13.3%; 4/30). There was statistical significance association between sociodemographic characteristics and Entamoeba species in asymptomatic individuals, while in the symptomatic individual, only age groups were stastically significant. Conclusion: E.dispar is the predominant Entamoeba species among studied individuals. There is a need for molecular diagnosis of Entamoeba to determine the true prevalence of E. histolytica and avoid overmedication.

Blastocystis hominis infection in HIV/AIDS children with extraintestinal symptom: a case report

Background: Blastocystis hominis is an intestinal parasite that can induce both intra- and extraintestinal symptoms. This article aims to describe the symptom findings in cases of HIV children co-infected with B. hominis. Case Presentation: A 3-year-old boy with HIV/AIDS came with diarrhea and skin rashes. The direct smear technique, formalin-ethyl acetate concentration technique, Jones medium culture, and trichrome staining were all used to investigate a single stool specimen from this patient. The results of the examination showed B. hominis infection with intensity <5/high power field (HPF). Extraintestinal symptoms such as skin rashes were not seen in this patient after appropriate treatment. Conclusion: B. hominis infection can cause extraintestinal symptoms such as a red rash on the skin. When a patient presents with a skin rash of unknown origin, having their stool tested for parasites is a concern.

Alterations in the Stool Microbiome in Newborns Undergoing Mild Therapeutic Hypothermia after Hypoxic-Ischemic Encephalopathy

Background: Hypoxic-ischemic encephalopathy (HIE) is associated with brain injury in newborns and may lead to disability or death. Mild therapeutic hypothermia (TH) is an effective neuroprotective intervention and an established standard of care in western countries. The gut microbiome, the genomic and physicochemical contribution of the gut microbiota, serves important functions and is increasingly recognized as a major influencer on development. The impact of HIE and TH on the evolving gut microbiota of the newborn remains to be elucidated. Objective: The objective of this study was to carry out an exploratory study on the effects of HIE and TH on the gut microbiome in term neonates. Methods and Results: Stool samples were obtained from 28 newborns with HIE (median age 68 h) undergoing TH on the neonatal unit (HIE TH group), with a follow-on stool sample available for 20 of these babies (median age 151 h). For comparison, a single stool specimen was obtained from 19 healthy newborns on the postnatal ward (median age 34 h). The microbiota composition was determined using established microbial DNA extraction and 16S rRNA gene sequencing methodology. There was no difference in the mode of delivery or the method of feeding the newborns, once established, between the 2 groups. All the infants in the HIE TH group had received antibiotics compared to only one of the controls. A lower α-diversity, quantified by the Shannon diversity index, was noted in the microbiota of the HIE TH group in comparison to the control group. The HIE TH group had a higher mean relative abundance (MRA) of facultative anaerobes and aerobes such as Staphylococcus species and a lower MRA of strict anaerobes, such as members of the Bacteroides genus, compared to the control. Also, there was a significant reduction in the MRA of the genus Bifidobacterium in the HIE TH group. Although the mode of delivery exerts a profound influence on the gut microbiota of the newborn, distance-based redundancy analysis showed that TH may exert an independent influence. This study could not determine the independent contribution of the use of antibiotics or the neonatal intensive care unit environment. Conclusion: In this study, we demonstrate an alteration in the microbiota composition in newborns undergoing TH for HIE.

Intra-specimen and day-to-day variations of Fasciola egg counts in human stools

Intra-specimen and day-to-day variations of Fasciola egg counts in stools were investigated for 16 cases of established fascioliasis. For each case six Kato slides from a single stool sample were examined daily for 5 consecutive days. The results indicated the presence of significant intra-specimen variations in more than one-third of the examined series, while the inter-specimen variation was almost negligible. The sensitivity of the Kato-Katz test for diagnosing Fasciola infection with three Kato slides from the same specimen or on different days ranged from 96.0%-99.1%. The examination of three Kato smears from a single stool specimen, which is more feasible in field studies, would give an accurate diagnosis of fascioliasis. Used as such, the Kato-Katz technique is highly sensitive in the diagnosis of fascioliasis.

Xpert® MTB/RIF assay testing on stool for the diagnosis of paediatric pulmonary TB in Tanzania

Six health facilities in Dar es Salaam, Tanzania. To evaluate the use of stool specimens in the diagnostic workup of paediatric TB using the Xpert® MTB/RIF assay. Between December 2018 and May 2019, we performed a cross-sectional diagnostic study of children aged between 1 month and 14 years with presumptive TB. A single stool specimen was tested using Xpert. The result was compared with the reference microbiological standard for respiratory or gastric specimens tested using Xpert and/or solid culture. The sensitivity, specificity and predictive values of stool Xpert assay were assessed. A total of 225 children with a median age of 2.17 years (IQR 1.16-5.19) were enrolled; 165/225 (73.3%) were aged <5 years. Of 225 children, 8 (3.6%) were diagnosed with TB as they were culture- or Xpert-positive on sputum/gastric aspirate. The stool Xpert assay showed a sensitivity of 62.5% (95% CI 25-92) and specificity of 100% (95% CI 98-100) against the reference standard. Use of the Xpert assay on stool specimens had a moderate sensitivity and high specificity in the diagnosis of pulmonary TB in children. Our data adds to the body of evidence for the use of Xpert assay on stool as a non-respiratory specimen to complement conventional methods used to diagnose the disease.

Concurrent Intestinal Schistosomiasis and Soil-Transmitted Nematode Infections in Primary School Children, Benue State North Central Nigeria

Intestinal schistosomiasis and soil-transmitted nematode (STN) infections are among the major public health problems globally, especially in sub-Saharan Africa, Nigeria inclusive. School-aged children carry the highest burden of both infections with significant morbidities in Nigeria. Data on co-endemicity of these infections especially amongst internally displaced persons (IDP) is scarce. To fill this gap, we performed a school-based cross sectional study in three rural communities in North Central Nigeria in which internally displaced persons co-existed. The study aimed to determine the co-endemicity of Schistosoma mansoni and soil-transmitted nematodes infections among primary school children in six primary schools in Guma Local Government area, Benue State, north central Nigeria. Four hundred and forty three primary school pupils were included in the study between January and March 2018 by using simple random technique. A single stool specimen was collected from each participant, and a portion about 1 gram of each specimen was processed by Kato Katz technique. Of the 443 pupils examined, 219(49.4%) were found positive for the characteristic egg of at least one STN. Of the total children, 46(10.4%) had Schistosoma mansoni infection. Co-infection of atleast one STN and S.mansoni occurred in 21(4.7%) of the 443 pupils sampled. Co-infection of Schistosoma mansoni and Ascaris lumbricoides was observed in 11(23.9%) while Schistosoma mansoni and hookworm occurred in 10(21.7%) of the children. There was higher intensity in the total egg count among the males (51.99±60.67) than the females (48.42±59.89) in both genders. The intensity of egg count was highest in age group 7-9 years (55.27±65.03). The lowest intensity was observed in age group 13-15 (41.47±46.08).Integrated interventions such as health education, school feeding program for improved nutrition and mass chemotherapy is advocated.

Intestinal protozoan infections among children 0-168 months with diarrhea in Mozambique: June 2014 - January 2018.

BackgroundIntestinal parasites such as Cryptosporidium spp., Giardia lamblia and Entamoeba histolytica can cause severe diarrhea, especially among children in developing countries. This study aims to determine the frequency of Cryptosporidium spp., Giardia lamblia and Entamoeba histolytica in children with diarrhea and identify risk factors for infection.MethodologyWe conducted a cross-sectional study in children aged 0–168 months hospitalized with diarrhea in three regions of Mozambique, from June 2014 to January 2018. Following consent, caretakers were interviewed and a single stool specimen was collected from each child to diagnose Cryptosporidium spp., G. lamblia and E. histolytica using commercial immune-enzymatic assay (TechLab, Inc, Blacksburg, VA, USA). Anthropometric data were collected from the clinical reports. Multivariable logistic regression models were built to identify risk factors for Cryptosporidium spp. and G. lamblia infection.ResultsTwenty-one percent of all specimens (212/1008) presented at least one parasitic infection. Cryptosporidium spp. infection was the most common 12.0% (118/985), followed by G. lamblia 9.7% (95/983) and E. histolytica 2.0% (20/1004). Risk factors for infection by Cryptosporidium spp. were: provenience (children from Nampula province showed the highest risk, OR: 8.176; CI: 1.916–34.894; p-value < 0.01); animal contact (children with animal contact had a protective effect OR: 0.627; CI: 0.398–0.986; p-value < 0.05); underweight (children severely underweight showed a risk of 2.309; CI: 1.310–4.069; p-value < 0.05). Risk factors for infection by G. lamblia were: age (group with highest risk, 60–168 months (OR: 2.322; CI: 1.000–5.393, p-value > 0.05)); and living in a household with five or more members (OR: 2.141; CI: 1.286–3.565, p-value < 0.01).ConclusionsParasitic infection is common among children with diarrhea. Routine testing, standard treatment, and assessment for risk exposure of children with diarrhea should be implemented at health facilities in Mozambique.

Diagnostic Performance of Four Fecal Immunochemical Tests for Detecting Advanced Colorectal Neoplasia: Preliminary Results

Abstract Screening programs based on fecal blood testing have been shown in randomized controlled trials to reduce colorectal cancer incidence and mortality. Professional organizations highly recommend screening average-risk patients with fecal immunochemical testing (FIT). Many patients find these stool tests more acceptable than colonoscopy and stool testing may be the preferred option for areas with limited endoscopic resources. However, the diagnostic performance of FIT testing, particularly for CLIA-waived point-of-care (POC) tests, has not been well studied. Purpose: We are comparing the diagnostic accuracy of 4 FIT tests, one automated (AUTO) and 3 POC, for detecting advanced neoplasia (advanced adenomas and carcinomas) using colonoscopy as a gold standard. Methods. We are enrolling subjects ages 50 to 85 at 3 academic medical centers in Iowa, Texas, and North Carolina who were scheduled for a screening or surveillance colonoscopy. Each subject completed 4 different FIT tests on a single stool specimen. Based on colonoscopy results, we calculated sensitivity, specificity, and predictive values. We used PROC GLIMMIX models in SAS to compare sensitivity and specificity across the different tests, accounting for the within-patient correlation. Results: We currently have 641 subjects who completed FIT and colonoscopy. Mean age is 61.2 (±7.5) years, 63% women, 63% non-Hispanic white, and 31% Hispanic. We found advanced neoplasia, including 5 carcinomas, in 68 subjects. The sensitivities for detecting these neoplasia were 3%, 22%, 28%, and 16% (AUTO), respectively. Corresponding positive predictive values were 18%, 21%, 33%, and 24% (AUTO). Specificities were 97%, 89%, 90%, and 94% (AUTO), respectively, and corresponding negative predictive values were 89%, 91%, 92%, and 90% (AUTO). We found statistically significant differences in sensitivity (P &amp;lt; 0.01) and specificity (P &amp;lt; 0.01) across tests. Conclusions: Early data suggest that FIT products may vary in their sensitivity and specificity for detecting advanced colorectal neoplasia. This variability could have important impacts on the effectiveness of efforts to limit the burden of colorectal cancer by increasing population-based screening rates through fecal blood testing.

Intestinal parasitic infections in HIV-1 sero-positive individuals and its correlation with CD4 cell count in a tertiary care teaching hospital, Gujarat.

Background: Opportunistic infections constitute a major health problem in patients infected with HIV. Among these, intestinal parasitic infections are the commonest and are a major cause of morbidity and mortality in HIV positive individuals worldwide. The present study was carried out to identify various intestinal parasites in HIV-1 sero-positive individuals and to correlate these intestinal parasitic infections with CD4 count. Methods and Material: In a cross-sectional prospective study, stool samples of a total of 27 patients were examined for the presence of the enteric parasites using direct saline & iodine wet mount, formal ether concentration technique, modified acid fast staining & Giemsa staining. Data of recent CD4 cell count was obtained from the patients. Results: Out of 58 patients given written consent for participating in the study, only 27 (47%) patients provided stool samples. The prevalence of enteric parasites in HIV-1 sero-positive patients was 7.4%. The parasites detected in our study population were Entamoeba coli (3.7%) and Ancylostoma duodenale (3.7%). Entamoeba coli (3.7%) was detected in the patient with CD4 count less than 200 cells/?L. 96.3% patients were on ART. Intestinal parasites were detected from ART (3.8%) and nae ART (3.8%) patient. Conclusion: Routine examination of stool samples for parasites could significantly benefit the HIV-infected individuals by contributing to reduce morbidity and improve quality of life. However; considering to limited sample size and a single stool specimen received in the present study, a large study is required. Key Messages: Early detection and treatment of intestinal parasitic infections are important to improve the quality of life of HIV sero-positive patients.

Schistosoma mansoni Infections, Undernutrition and Anaemia among Primary Schoolchildren in Two Onshore Villages in Rorya District, North-Western Tanzania.

BackgroundUndernutrition and anaemia remains to be a major public health problem in many developing countries, where they mostly affect children. Intestinal parasitic infections are known to affect both growth and haemoglobin levels. Much has been reported on the impact of geohelminths on anaemia and undernutrition, leaving that of Schistosoma mansoni not well studied. Therefore this study intended to determine the association between S.mansoni infections, anaemia and undernutrition among schoolchildren in Rorya district, Northwestern Tanzania.MethodologyA cross-sectional study was carried among schoolchildren in two onshore villages namely Busanga and Kibuyi in Rorya district. Single stool specimens were collected from 513 randomly selected schoolchildren and processed for microscopic examination using the Kato-Katz method. Nutritional status was determined by anthropometry. Blood samples were also collected and examined for malaria parasites and haemoglobin levels using the Giemsa stain and HaemoCue methods, respectively. A pretested questionnaire was used to collect socio-demographic data and associated factors.ResultsThe prevalence of S. mansoni infection and malaria was 84.02% and 9.16%, respectively. Other parasites found were Ascaris lumbricoides (1.36%) and Hookworm (1.36%). The prevalence of stunting and wasting was 38.21% and 14.42%, respectively. The prevalence of anaemia was 29.43%, whereby 0.58% had severe anaemia. S. mansoni infection was not found to be associated with undernutrition or anaemia (p>0.05). The risk of stunting and wasting increased with increasing age (p<0.001). Anaemia was associated with age, sex and village of residence (p<0.05).ConclusionsS.mansoni, undernutrition and anaemia are highly prevalent in the study area. The observed rates of undernutrition and anaemia were seen not to be associated with S.mansoni infection suggesting possibly being a result of poor dietary nutrients. This study suggests that policy makers should consider Rorya district for inclusion into national schistosomiasis control and school feeding programmes.

Comparison between Kato - Katz Thick Smear and Sedimentation Techniques in Diagnosis of Faecal - Orally Transmitted Helminthes and Other Geohelminthes

Kato-Katz technique is widely used for the diagnosis of Fecal-orally transmitted helminthic infections. It is relatively simple and inexpensive. However, a single slide prepared from a single stool specimen has low sensitivity, particularly in light infections. Therefore, there is a great need for concentration techniques. This study detected an accurate and affordable method for diagnosis of fecal-orally transmitted helminthes and other geohelminthes. The study was carried out on 217 stool samples of different sex and age groups. Stool samples were collected from different urban and rural areas in Sharkia Governorate. Stool samples were examined macroscopically and analyzed by different parasitological techniques: direct wet mount (DWM), Kato-Katz thick smear, spontaneous sedimentation in tube technique (SSTT) and formol ether sedimentation technique (FEC). The results showed that formol ether sedimentation method detected 59 positive samples followed by spontaneous sedimentation in tube technique (48/59 positive samples). FEC showed significant difference when compared to direct wet mount and Kato-Katz thick smear. SSTT also showed significant difference when compared to DWM (P <0.05).The overall prevalence of intestinal helminthes was (29.6%) among studied samples in Sharkia Governorate. The commonest helminthic infection was H. nana (12%) followed by E. vemicularis(10%) then A. lumbricoides (3.7%).

COMPARISON BETWEEN KATO-KATZ THICK SMEAR AND SEDIMENTATION TECHNIQUES IN DIAGNOSIS OF FAECAL-ORALLY TRANSMITTED HELMINTHES AND OTHER GEOHELMINTHES

Kato-Katz technique is widely used for the diagnosis of Fecal-orally transmitted helminthic infections. It is relatively simple and inexpensive. However, a single slide prepared from a single stool specimen has low sensitivity, particularly in light infections. Therefore, there is a great need for concentration techniques. This study detected an accurate and affordable method for diagnosis of fecal-orally transmitted helminthes and other geohelminthes. The study was carried out on 217 stool samples of different sex and age groups. Stool samples were collected from different urban and rural areas in Sharkia Governorate. Stool samples were examined macroscopically and analyzed by different parasitological techniques: direct wet mount (DWM), Kato-Katz thick smear, spontaneous sedimentation in tube technique (SSTT) and formol ether sedimentation technique (FEC). The results showed that formol ether sedimentation method detected 59 positive samples followed by spontaneous sedimentation in tube technique (48/59 positive samples). FEC showed significant difference when compared to direct wet mount and Kato-Katz thick smear. SSTT also showed significant difference when compared to DWM (P <0.05).The overall prevalence of intestinal helminthes was (29.6%) among studied samples in Sharkia Governorate. The commonest helminthic infection was H. nana (12%) followed by E. vemicularis(10%) then A. lumbricoides (3.7%).

Screening for Colorectal Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

Colorectal cancer (CRC) remains a significant cause of morbidity and mortality in the United States. To systematically review the effectiveness, diagnostic accuracy, and harms of screening for CRC. Searches of MEDLINE, PubMed, and the Cochrane Central Register of Controlled Trials for relevant studies published from January 1, 2008, through December 31, 2014, with surveillance through February 23, 2016. English-language studies conducted in asymptomatic populations at general risk of CRC. Two reviewers independently appraised the articles and extracted relevant study data from fair- or good-quality studies. Random-effects meta-analyses were conducted. Colorectal cancer incidence and mortality, test accuracy in detecting CRC or adenomas, and serious adverse events. Four pragmatic randomized clinical trials (RCTs) evaluating 1-time or 2-time flexible sigmoidoscopy (n = 458,002) were associated with decreased CRC-specific mortality compared with no screening (incidence rate ratio, 0.73; 95% CI, 0.66-0.82). Five RCTs with multiple rounds of biennial screening with guaiac-based fecal occult blood testing (n = 419,966) showed reduced CRC-specific mortality (relative risk [RR], 0.91; 95% CI, 0.84-0.98, at 19.5 years to RR, 0.78; 95% CI, 0.65-0.93, at 30 years). Seven studies of computed tomographic colonography (CTC) with bowel preparation demonstrated per-person sensitivity and specificity to detect adenomas 6 mm and larger comparable with colonoscopy (sensitivity from 73% [95% CI, 58%-84%] to 98% [95% CI, 91%-100%]; specificity from 89% [95% CI, 84%-93%] to 91% [95% CI, 88%-93%]); variability and imprecision may be due to differences in study designs or CTC protocols. Sensitivity of colonoscopy to detect adenomas 6 mm or larger ranged from 75% (95% CI, 63%-84%) to 93% (95% CI, 88%-96%). On the basis of a single stool specimen, the most commonly evaluated families of fecal immunochemical tests (FITs) demonstrated good sensitivity (range, 73%-88%) and specificity (range, 90%-96%). One study (n = 9989) found that FIT plus stool DNA test had better sensitivity in detecting CRC than FIT alone (92%) but lower specificity (84%). Serious adverse events from colonoscopy in asymptomatic persons included perforations (4/10,000 procedures, 95% CI, 2-5 in 10,000) and major bleeds (8/10,000 procedures, 95% CI, 5-14 in 10,000). Computed tomographic colonography may have harms resulting from low-dose ionizing radiation exposure or identification of extracolonic findings. Colonoscopy, flexible sigmoidoscopy, CTC, and stool tests have differing levels of evidence to support their use, ability to detect cancer and precursor lesions, and risk of serious adverse events in average-risk adults. Although CRC screening has a large body of supporting evidence, additional research is still needed.

Schistosoma mansoni and soil-transmitted helminths among preschool-aged children in Chuahit, Dembia district, Northwest Ethiopia: prevalence, intensity of infection and associated risk factors.

BackgroundIntestinal schistosomiasis and soil-transmitted helminthiasis are the major public health problems globally. Compared with any other age group, pre-school aged children and school-aged children are the most exposed. There are few studies showing the burden of intestinal schistosomiasis, and soil-transmitted helminthiasis among pre-school aged children in Ethiopia. Hence, this study aimed to assess the prevalence of schistosoma mansoni and soil-transmitted helminths and associated risk factors among preschool aged children of Chuahit and surrounding Kebeles, Northwest Ethiopia.MethodsA community based cross sectional study was conducted from February 2 to March 27 2015. Four hundred one preschool-aged children were included in the study by using two stage cluster sampling technique. Pretested structured questionnaire was employed to collected data via face-to-face interview technique. A single stool specimen was collected, and a portion of the sample was processed by Kato Katz method.ResultsOf the total children, 141 (35.2 %) harbored one or more intestinal helminthes. Schistosoma mansoni was found in 45 (11.2 %) of preschool age children. Ascaris lumbricoides was the predominant isolate, 77 (19.2 %) followed by S. mansoni, 45 (11.2 %). The least parasites isolated were Tania species, 2 (0.5 %). After adjusting for other variables, being mothers who did not have the habit of washing hands after toilet (AOR = 7.3, 95%CI: 2.97–17.95), being occupationally housewife mothers (AOR = 8.9, 95%CI: 2.27–25.4), using protected spring water as a main family source of water (AOR = 3.9, 95%CI: 1.2–12.3) and child habit of not wearing shoe (AOR = 1.91, 95%CI: 1.01–3.64) were significantly associated with high prevalence of soil-transmitted helminthiasis among preschool-age children in Chuahit.ConclusionThe current study showed that relatively higher level of STH and S. mansoni among preschool-aged children in Chuahit. This finding calls for a need of public health education, promotion of women education and provision of safe water to reduce the burden of soil-transmitted intestinal helminthiasis and schistosomiaisis.

Evaluation of efficacy of single stool specimen examination for detection of intestinal parasitic infections in health card applicants

Evaluation of efficacy of single stool specimen examination for detection of intestinal parasitic infections in health card applicants

High prevalence of Schistosoma mansoni and other intestinal parasites among elementary school children in Southwest Ethiopia: a cross-sectional study.

BackgroundIntestinal parasitic infections (IPIs) pose significant public health challenges in school children in developing countries. The aim of this study is to determine prevalence of intestinal parasites among elementary school children in Mizan-Aman town, southwest Ethiopia.MethodsInstitution-based cross-sectional study involving 460 elementary school children in Mizan-Aman Town was conducted from May to June 2013. The school children were selected using multistage sampling technique. Data on demography and predisposing factors of IPIs were collected using pretested questionnaire. Moreover, single stool specimen was examined microscopically after wet mount and formol-ether sedimentation concentration procedures. Infection intensity of Schistosoma mansoni and soil-transmitted helminths (STHs) was estimated using Kato-Katz egg counting method.ResultsAge of the children ranged from 5 to 17 years. Overall, 76.7 % (95%CI: 72.8–80.6) of the children harbored at least one species of intestinal parasite. Eight species of intestinal parasites were detected with S. mansoni (44.8 %) and Ascaris lumbricoides (28.7 %) being predominant. Helminths and pathogenic intestinal protozoa were detected in 73.9 and 7.8 % of the children, respectively. After adjusting for other variables, age between 5 and 9 years (AOR, 2.6, 95%CI, 1.552–4.298), male gender (AOR, 2.1, 95%CI, 1.222–3.526), attending public school (AOR, 0.1, 95%CI, 0.060–0.256), using river/well water (AOR, 2.4, 95%CI, 0.912–6.191), irregular washing of hands before meal (AOR, 0.5, 95%CI, 0.254–0.865), consuming street food (AOR, 2.3, 95%CI, 1.341–3.813) and raw vegetables (AOR, 2.7, 95%CI, 1.594–4.540) were significantly associated with IPIs in the study participants.ConclusionPrevalence of intestinal parasites among the school children was high. Deworming of the school children and continuous follow up is required.

Prevalence of Giardia lamblia in Asymptomatic Patients by Direct Examination and ELISA Methods

Stool samples from 182 asymptomatic patients were collected from two hospitals in Baghdad (Al-Yarmok and Central Child) during the period from the beginning of March to the end of June/2014 and subjected to microscopic and ELISA diagnostic techniques for Giardia lamblia detection; the sensitivity and specificity for ELISA were calculated. Cysts of G. lamblia were observed in 37 and 49 stool samples of asymptomatic patients from a total 182 examined samples with prevalence recorded 20.32, 26.92% by direct examination and ELISA respectively. Of 145 samples showed negative result in microscope examination, 12 samples were positive in ELISA, sensitivity and specificity of ELISA were 75.51 and 100%. Higher prevalence rates were observed in asymptomatic children aged 2-8 years old 27.84% (22+ve/79) in contrast with 26.21% prevalence rate in asymptomatic adults aged 21-57 years old (27+ve /103). According to gender, males showed higher prevalence 28.94% (33+ve/114) while females showed lower prevalence rate 23.52% (16+ve/68). No differences in the level of infection in both age and gender were recorded. Conclusion: The superior sensitivity of the rapid enzyme assay in detecting asymptomatic cases of giardiasis when a single stool specimen is analyzed, the availability of an immunodiagnostic assay which can detect small amounts of antigens in the feces which have a potential tools to improve the diagnosis.

An outbreak of acute gastroenteritis associated with group A Rotavirus in long-term care facility in Slovenia.

In April 2013, an outbreak of acute gastroenteritis was reported in a residential long-term care facility (LTCF) in Ljubljana. We carried out an outbreak investigation to describe the outbreak, identify factors associated with contracting infection and to recommend control measures. We conducted descriptive epidemiology of the outbreak and a case-control study among residents; a case was a resident or staff member of the LTCF with acute diarrhoea and at least one of the following symptoms: fever, vomiting, nausea, fatigue, headache and abdominal pain between 11 and 23 April 2013. Controls had no gastrointestinal symptoms during the outbreak period. Stool specimens were tested for enteric pathogens, including Rotavirus. Of 244, 33 (13.5 %) and 4 of 106 staff (3.8 %) were affected. Twenty-eight (84.8 %; median age 85 years; range 71-95 years) among affected residents and four (100 %; median age 35 years; range 30-45 years) among affected staff were women. The main symptoms besides acute diarrhoea were fatigue (54.1 %) and nausea (45.9 %). The average duration of gastroenteritis symptoms was 3.6 days in residents and 1.3 days in staff. None of the affected persons was hospitalized. Rotavirus group A was detected in a single stool specimen. In the multivariable analysis, being ambulant (aOR = 12.3; 95 % CI: 1.14-133.1), and having more than two comorbidities (aOR = 4.7; 95 % CI: 1.14-19.0) were significantly associated with acute gastroenterocolitis. Contact precautions of affected persons and controlled staff interactions between outbreak ward and unaffected ward are recommended in times of outbreak, with additional effort in targeting mobile residents and those with comorbidities.

Prevalence and risk factors related to intestinal parasites among children in Department of Rio San Juan, Nicaragua

The present study was carried out to assess the prevalence of intestinal parasite infections among children in Department of Rio San Juan (Nicaragua), to explore the extent of polyparasitism, and to identify the risk factors that might favour transmission of these parasites. A coprological study of single stool specimen, collected at random from 382 children (167 boys and 215 girls) aged 2-15 years from two municipalities, and a questionnaire, concerning demographic and epidemiological data on sanitary and behavioural habits, was filled in to identify risk factors. About 93% of the children presented infection. Blastocystis hominis, the most frequently protozoa, and Trichuris trichiura, Ascaris lumbricoides and hookworm, the most prevalent helminths. Polyparasitism (85.4%[326/382]), with the highest percentages detected in females (p=0.001), in the 6-11 year age group (p<0.001) and having a rural background (p<0.001). A firm relationship between any parasite and age (OR=1.2, p=0.036) and rural background (OR=0.3, p=0.027) was detected. Living in rural areas and drinking river water were also positively associated with each of the STH species detected, and walking barefoot was also associated with hookworm infection. Government efforts should be focused on controlling the risk factors associated with these enteroparasites, with health education programmes in rural areas of Nicaragua.