Unwashed Fruits Research Articles

Consuming Blackberry as a Traditional Nutraceutical Resource from an Area with High Anthropogenic Impact

The most serious quality issue of natural resources for human consumption or medicinal purposes is the contamination with pollutants harmful to consumers. Common blackberry (Rubus fruticosus L.) is a sought-after nutraceutical and an important component in herbal medicine in many places around the globe. The present study aims to analyze the level of heavy metal bioaccumulation in blackberry organs, as well as its spatial distribution in two consecutive years immediately after the interruption of the extended activity of the industrial source of pollution. The research was conducted in one of the most polluted areas in Romania and Eastern Europe, within a 26 km radius of the source of pollution. The Pb, Cd, Cu, and Zn concentrations in the leaves, flowers, and unwashed blackberry fruits were analyzed spectrophotometrically through flame atomic absorption spectroscopy (FAAS). The results show that blackberry is an important bioaccumulator of these heavy metals—71% of the Pb concentration values and 100% of the Cd concentration values exceeded the World Health Organization thresholds by up to 29 and 15 times, respectively. Also, the leaves are the largest reservoirs of Pb and Zn (the median values: 51.4 mg/kg dry weight and 105.2 mg/kg d.w., respectively), and the flowers contained the largest quantities of Cd and Cu (2.54 mg/kg d.w. and 11.3 mg/kg d.w., respectively). The Pb concentrations decreased by a power function in relation to the distance from the source of pollution. The implications of these results on the safety of the use of blackberry are discussed. The urgent necessity for food education of the local population which consumes contaminated nutraceutical products is emphasized.

Relationships between the weaning period and the introduction of complementary foods in the transmission of gastrointestinal parasitic infections in children in Honduras.

PurposeThis study was to investigate weaning practices used by mothers when transitioning infants from breast milk to complementary foods and to determine the role these foods have in the transmission of gastrointestinal parasites.Participants and methodsOn average, of the 175 mothers extensively interviewed, 93% said they had breast-fed their infants. Approximately 20.8% of mothers had added some other liquid to their infant’s diet at 3 months, while most mothers had added other liquids at 6 months (39.0%) and >6 months (32.1%). Some mothers expanded food offerings to infants before 3 months. The percentage of mothers who had added other liquids to their infants’ diet was reported by age of the infant: as early as 1 day (2.5%), <1 week (1.9%), first month (3.1%), 3 months (20.8%), 6 months (39.0%), and >6 months (32.1%). These foods included fruit, vegetables, meat, and grains. The maximum age a child was found to be still breastfeeding was 13 years.ResultsForty percent of mothers involved in this survey reported that their children were diagnosed and/or treated for gastrointestinal parasitic infection. Routes of infection of protozoan and helminth parasites likely resulted from contaminated complementary foods and water given to infants while still breast-feeding or from contaminated foods after breast-feeding had been completed. Contaminated water is a likely source of protozoan parasites. Contaminated water was fed to infants, mixed with formula or complementary foods, or used to wash bottles for infant feeding. There was an absence of hand-washing by children and mothers before eating or while preparing foods.ConclusionThe major source of soil-transmitted helminth infections was likely the result of unwashed or uncooked pureed fruit or vegetables used as complementary foods, unpasteurized animal milk, insanitary food storage, poor living conditions with exposed dirt floors, and exposure to roaming domestic animals.

Toxoplasmosis among pregnant women attending antenatal clinic in a health facility in Port Harcourt, Rivers State, Nigeria

Toxoplasmosis is a neglected tropical protozoan disease of public health importance. This study estimated the seroprevalence of toxoplasmosis and the associated risk factors among pregnant women attending the antenatal clinic in the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. Two hundred and thirteen (213) pregnant women antenatal clinic attendees were tested for IgG and IgM toxoplasma antibodies using conventional ELISA technique after ethical clearance and informed consent were obtained. Demographic data were collected using well-structured questionnaires. Out of the 213 subjects examined, 58 (27.2%) were positive consisting of 48 (24%) and 10(5%) positive for IgG and IgM toxoplasma antibodies respectively. The age-groups 25-29 and 30-34 years had higher prevalence rates of 19 (8.9%) and 16 (7.5%) respectively for IgG whereas age-group 35-40 years had the highest 4 (1.9%) for IgM antibodies. The age-group >40 years had the least prevalence for IgG 2 (0.9%) and IgM (0.0%) antibodies. It was observed that toxoplasma antibody IgG, increases with increase in trimesters while the IgM decreases simultaneously. Traders had the highest prevalence for IgG and IgM antibodies for occupation related seroprevalence. The two way anova and mean separation showed that the overall prevalence for IgG was statistically significant ( p 0.05). It also showed that there was no association between the age-group, trimester, occupation and seropositive subjects. Demographic data analysis showed that history of living with pets, eating improperly or unwashed fruits and engagement in gardening and farming were some of the risk factors associated with seropositivity to toxoplasmosis. The inclusion of Toxoplasma gondii test as one of the routine tests carried out in antenatal clinics, and awareness campaign of toxoplasmosis by government and NGOs were advocated. Keywords: Toxoplasma antibodies; seropositivity; pregnant women; Port Harcourt; Nigeria

Effect of Multiple Rounds of Mass Drug Administration under Lymphatic Filariasis Elimination Program on Prevalence of Soil-Transmitted Helminthiasis in One of the Co-endemic Districts of India

Both soil-transmitted helminthiasis and lymphatic filariasis are co-endemic in some districts of India. The study was aimed at comparing the prevalence of soil-transmitted helminthiasis (STH) infection before and after mass drug administration (MDA) given for lymphatic filariasis at Alappuzha. We examined stool samples of 219 children aged between 9 and 10 years from nine schools at Alappuzha, Kerala, in June 2015. The current STH situation was compared with that in the year 1999 (before the institution of MDA) in the same age group in the same district. WHO-recommended Kato-Katz technique was used for STH prevalence estimation. Information regarding socio-demographic variables, sanitation, personal hygiene practices was also recorded. Chi-square test was used to study association of risk factors with STH infection. A total of 79 (36.07%) children were found to be positive for STH infection. Out of all samples positive for Ascaris lumbricoides, 4 (5%) were found co-infected with Trichuris trichiura and none with hookworm. Factors like absence of household latrine, lack of hand washing before meals and practice of consuming unwashed fruits were found to be significantly associated with occurrence of STH infection. Over the years, consecutive rounds of MDA for LF have led to a decline in intestinal worm burden but with little effect on the overall prevalence of STH. Thus, STH control activities working synergistically with the Filarial Elimination Strategy can yield better results in the co-endemic areas with optimum resource utilization.

The Seroprevalence and Risk Factors of Toxoplasmosis Among Female Undergraduate University Students in Saudi Arabia.

Toxoplasma gondii (T. gondii) is a serious public health issue, but limited data has been published to date on the seroprevalence of T. gondii infection in Saudi Arabia. Therefore, this study aimed to establish the seroprevalence and risk factors of T. gondii infection using a sample of females enrolled at a university in Northern Saudi Arabia. Using a cross-sectional research approach, we recruited a convenience sample of 180 healthy females studying at the University of Tabuk between February and June 2016. We used a questionnaire to gather sociodemographic data on the participants to establish the risk factors leading to exposure to toxoplasma. Blood samples were taken from the participants and analyzed to detect T. gondii antibodies (immunoglobulin M and immunoglobulin G) via the enzyme-linked immunosorbent assay technique. Multivariate logistic regression modeling was employed to establish the potential predictor variables for T. gondii infection. Of the 180 participants, 17 (9.4%) were seropositive for T. gondii IgG. None tested positive for IgM antibodies exclusively. The sole variable positively associated with seropositive T. gondii IgG was the participants' consumption of raw, unwashed fruit or vegetables (odds ratio = 3.36, 95% confidence interval: 1.11-10.22). Our findings emphasize the need for higher awareness of toxoplasmosis in Saudi Arabia, specifically knowledge of the way toxoplasma infection occurs so that women can more easily avoid it. Large-scale research is therefore required to inform the design of future public health interventions.

Age-related prevalence of toxoplasmosis among pregnant women in Hatay: Estimation depending on model

Toxoplasmosis, caused by the obligate intracellular protozoan Toxoplasma gondii, is a common parasitic infection affecting approximately one-third of the world population. T.gondii infections are usually acquired by ingesting raw or insufficiently cooked meat and from unwashed fruits and vegetables contaminated with soil or water with cat feces. Primary infection acquired during pregnancy can cause severe congenital abnormalities in the fetus such as neurologic and ocular malformations, abortion, or stillbirth according to the degree of infection. The aim of this study was to estimate the prevalence and rate of seroconversion of T.gondii IgG antibodies in a selected population of pregnant women in Hatay by using a mathematical model. T.gondii-specific serological screening test results of 11.564 pregnant women who have attended the Private Antakya Mosaic Obstetrics and Gynecology Hospital between 01.04.2009 and 31.04.2016 were analysed in the study. The prevalence of T.gondii-specific IgG antibodies in the studied population were found as 48.70% (95% CI, 0.48-0.50). The prevalence of T.gondii-specific IgG antibodies were increased linearly with age in our study population. The relationship between age and prevalence was statistically significant (p< 0.001). The age-specific rate of seroconversion was estimated as 0.8% for T.gondii infection in pregnant women. It was observed that the rate of T.gondii-specific IgG antibodies decreased from 55.12% (95% Cl, 0.52-0.57) detected in 2009 to 42.22% (95% Cl, 0.37-0.46) in 2016. The estimated number of cases carrying the risk of primer T.gondii infection was calculated as 69 in the study population. Our results have suggested that the prevalence of T.gondii-specific antibodies is high among pregnant women in Hatay. Early maternal diagnosis and treatment methods may reduce the risk of transplacental transmission during pregnancy. The on time diagnosis can only be achieved with prenatal serological screening. The knowledge of the incidence and prevalence of toxoplasma infection in pregnant women plays a crucial role in estimating the burden of the disease and evaluating the effectiveness of the public health protection policies including screening programmes. Expanding of training activities, drawing attention to hygiene, taking nutritional precautions and increasing awareness of toxoplasmosis in pregnant women are important to prevent congenital toxoplasmosis or minimize the disease.

Loop-Mediated Isothermal Amplification-Lateral-Flow Dipstick (LAMP-LFD) to detect Toxoplasma gondii oocyst in ready-to-eat salad

The apicomplexan parasite Toxoplasma gondii is the causative agent of toxoplasmosis, a foodborne zoonosis with a global distribution and estimated to cause up to 20% of the total foodborne disease burden in Europe. Association between T. gondii infection and the consumption of unwashed raw fruits and vegetables contaminated with oocysts has been reported and the increasing habit to eat pre-washed ready-to-eat salads poses a new potential risk for consumers. It is therefore important to trace the occurrence of potential contamination with this parasite to guarantee the safety of ready-to-eat vegetables. Detection of T. gondii in vegetables by molecular techniques has been achieved but low sensitivity (PCR) or expensive equipments (qPCR) limit routine applicability. Here, we describe the development and validation of a sensitive and robust method relying on a LAMP assay, targeting the 529 bp locus, to detect T. gondii oocysts down to 25 oocysts/50 g in ready-to-eat baby lettuce. The LAMP has been also adapted for a faster visualization of the result by a lateral flow dipstick chromatographic detection method.

Knowledge, attitude, and practices on intestinal schistosomiasis among primary schoolchildren in the Lake Victoria basin, Rorya District, north-western Tanzania

BackgroundGlobally school-age children, adolescents and young adults bear the highest burden of schistosomiasis. When developing a specific intervention to improve community’s knowledge, attitudes, and practices (KAPs), existing KAPs must be taken into account. Therefore, this study was designed to determine schoolchildren’s KAPs on schistosomiasis in the study area.MethodsA cross-sectional study was conducted in Busanga and Kibuyi villages involving 513 schoolchildren. A pre-tested questionnaire was used to collect socio-demographic data and to assess KAP on schistosomiasis among primary schoolchildren in the study area.ResultsOf the 488 interviewed children, 391 (80.12%) reported to have heard of schistosomiasis, with the majority 289 (73.91%) citing school as the source of this knowledge. Swimming in the lake, worms, witchcraft, and mosquitoes were mentioned to be the cause for intestinal schistosomiasis. Fishing in the lake, drinking unboiled lake water, walking bare footed, and shaking hands were reported to be practices that may lead to contracting schistosomiasis. Only 156 (39.90%) of the study respondents reported to know the signs of intestinal schistosomiasis. Avoiding swimming in the lake, drinking unboiled water and eating unwashed fruits were mentioned as preventive measures. Nearly 85% (412) reported understanding that there was a disease known as schistosomiasis; additionally, 419 (85.86%) considered schistosomiasis as a dangerous disease and 418 (85.66%) believed that schistosomiasis was treatable. Fishermen and schoolchildren were reported to be groups most at risk of schistosomiasis infection. Visiting the lake (for swimming and other gatherings) was a common practice among study participants 471 (96.52%).Nearly 93% (451) of participants mentioned using lake water for domestic chores, and, although 407 (84.61%) reported to own a toilet at home, only 229 (55.31%) reported to always use a toilet for sanitation purposes.Conclusion and recommendationDespite a high rate of awareness among schoolchildren regarding schistosomiasis, there was a persistent gap amongst the children regarding the causes, modes of transmission, symptoms, and preventive measures for the disease. Therefore, an appropriate health education intervention is needed in order to inculcate better knowledge, attitudes, and practices amongst schoolchildren regarding its transmission, control, and prevention as part of a successful schistosomiasis campaign.

Intestinal helminthic infection and anemia among pregnant women attending ante-natal care (ANC) in East Wollega, Oromia, Ethiopia

BackgroundEthiopia is a developing country where intestinal helminthic infections are major public health problems. The burden of intestinal parasites, particularly the soil-transmitted helminths (STHs), is often very high in school children and pregnant women. Anemia, associated with STH, is a major factor in women’s health, especially during pregnancy; it is an important contributor to maternal mortality. The aim of this study was to determine the prevalence of intestinal helminthic infection and anemia among pregnant women attending ANC in East Wollega Zone, Ethiopia.MethodsA cross-sectional study was conducted in five health centers of East Wollega Zone of Oromia Region, Ethiopia between November 2015 and January 2016. The health centers were selected randomly and study participants were enrolled consecutively with proportions from all the health centers. Stool and blood specimens were processed using standard operating procedures in accordance with structured questionnaires. Logistic regression models were applied to assess the association between predictors and outcome variables. P values less than 0.05 were taken as significant levels. Results were presented in tables and figures.ResultsA total of 372 pregnant women were enrolled in this study with a median age of 25 years (range 17–40 years). The total prevalence of intestinal helminths was 24.7% (92/372) with the predominance of Hookworm (15.1%) followed by Ascaris lumbricoides (6.5%). Illiteracy [AOR, 95% CI 2.21 (1.3, 4.8), P = 0.042], absence of latrine [AOR, 95% CI 4.62 (1.7, 8.3), P = 0.013] and regular consumption of raw and/or unwashed fruit [AOR, 95% CI 3.30 (1.2, 6.3), P = 0.011] were significant predictors of intestinal helminthic infection. The overall prevalence of anemia was 17.5% (65/372) where mild anemia accounts for 80% of the total anemia. Anemia was significantly associated with the first trimester of gestation [AOR, 95% CI 2.82 (1.3, 6.2), P = 0.009], previous malaria infection [AOR, 95% CI 2.32 (1.3, 5.3), P = 0.003], failing to take iron supplements regularly [AOR, 95% CI 1.82 (1.1, 4.8), P = 0.022] and infection with intestinal helminths specifically with Hookworm (P = 0.001) and Ascaris lumbricoides (P = 0.022).ConclusionThe prevalence of intestinal helminths and anemia was significantly high in this study. Different socio-demographic, lifestyle and obstetric factors were identified as significant contributors of intestinal helminthic infection and anemia among pregnant women. Therefore, public health measures and intensive antenatal care services are vital to promoting safe pregnancy.

Seroprevalence and Risk Factors of Toxocara canis Infection in Children (2–15 Years Old) Referred to Health Centers of Lorestan Province, Iran

AbstractThis study aims to evaluate the seroprevalence and risk factors for Toxocara canis infection in children (2–15 years old) referred to health centers of Lorestan province, Iran. This cross-sectional study was performed from August 2016 to March 2017 on 316 children. All serum samples were tested using the commercially available anti IgG-Toxocara kit (IBL, Germany) according to manufacturer's instructions. Of the 316 children, 14 (4.4%) tested seropositive for anti-T.canis IgG antibody. The variables used to evaluate association between risk factors and status of anti-T. canis IgG antibodies were age, gender, area of residence, eosinophilia, contact with dogs, and consumption of raw or unwashed vegetables and fruits. Risk factors that were significantly related to T. canis seropositivity included living in rural regions (p = 0.018) and contact with dogs (p = 0.001). However, other demographic and risk factors did not demonstrate any association with T. canis seropositivity. To conclude, we found that T. canis infection is prevalent among children (2–15 years old) referred to health centers of Lorestan province, Iran with an overall seroprevalence rate of 4.4%. These findings may be a warning for health centers to pay special attention to toxocariasis among children (2–15 years old) and design screening programs for its prevention.

Viable microbial loads on citrus carpoplane during packhouse processing and survival of foodborne pathogens in reconstituted postharvest fungicides

AbstractThis study investigated microbial population shifts on citrus carpoplane and the impact of irrigation and packhouse processing water in four commercial farms. Samples included oranges (n = 450) and water (n = 230). Mean microbial concentrations ranging from 1.6 to 3.6 log colony forming units (CFU)/cm2 were detected on unwashed fruit and were reduced at least by 2.0 log CFU/cm2 for bacteria, 0.8 log CFU/cm2 for fungi and 1.3 log CFU/cm2 for yeasts during washing with disinfectants and/or fungicides. Occasional spikes in concentration (mostly for bacteria) were observed following some packing steps including washing, fungicide treatment, waxing, and final packing. Evaluation of Escherichia coli O157:H7 and S. Typhimurium survival in fungicides typically used during packhouse processing showed them to be susceptible to guazatine, imazalil, philabuster, and ortho‐phenyl phenate. Both tested pathogens were able to survive in thiabendazole, fludioxinil and pyremethanil, except for S. Typhimurium in fludioxinil where it died within 4 hr of incubation.Practical applicationsUnderstanding the impact of current intervention strategies on the ecological balance of the citrus carpoplane may provide a more durable approach to reduced losses and spoilage and in developing crop‐specific management systems for food safety assurance. Our study showed process‐by‐process changes in microbial loads naturally present on healthy citrus fruit at harvest. Washing baths containing a sanitizing agent consistently reduced initial microbial loads on the citrus carpoplane. Further, potential survival of E. coli O157:H7 and S. Typhimurium in currently registered commercial postharvest fungicides, was demonstrated. The pesticide fludioxinil was observed to be effective against, S. Typhimurium providing some potential use as a kill step agent, which, however, needs further investigation.

Detection of Echinococcus multilocularis DNA in fruit, vegetable, and mushroom samples collected in the non-endemic territory of the Pomerania province and comparison of the results with data from rural areas of the neighbouring highly endemic Warmia-Masuria province, Poland.

Echinococcus multilocularis is a tapeworm that may cause alveolar echinococcosis (AE), one of the most dangerous parasitic zoonoses. As in the case of some foodborne diseases, unwashed fruits and vegetables contaminated with eggs of E. multilocularis may serve as an important transmission route for this parasite. The aim of this study was to investigate the presence of E. multilocularis DNA in fruit, vegetables, and mushrooms in rural areas of the Pomerania province, Poland (non-endemic territory). In total, 104 environmental fruit, vegetable, and mushroom samples collected in forests, plantations, and kitchen gardens were analysed using nested PCR based on the mitochondrial 12S rRNA gene. E. multilocularis DNA was detected in 6.7 % of the samples tested, which indicated that the environment of the Pomerania province is contaminated with this parasite, creating a potential risk for humans. Therefore, fresh fruit, vegetables, and mushrooms should be washed before consumption. Additionally, the results showed that the level of contamination is significantly lower than in the highly endemic Warmia-Masuria province. The differences in the occurrence of E. multilocularis in the environment of these neighbouring provinces appears to be connected with the general epidemiological situation of these two regions, but further study is required for an exact explanation.

Detection of Specific Antibody Reactivity to Toxocara Larval Excretory-secretory Antigens in Asthmatic Patients (5-15 Years).

Background & Purpose: Humans act as an intermediate host for Toxocara canis and Toxocara cati. Toxocara may be an important risk factor for asthma in humans. The aim of the present study was to evaluate immunoglobulin G (IgG) anti-Toxocara canis antibody, using enzyme-linked immunosorbent assay (ELISA) in asthmatic patients (aged 5-15 years), referring to a clinic of pulmonary diseases in Arak, Iran.Materials & Methods: In this bi-group cross sectional study, serum samples were collected from 110 children with confirmed asthma and 70 children without asthma within one year. IgG anti-Toxocara antibody was detected via ELISA method. The collected data were analyzed, using SPSS.Results: The seroprevalence of antibodies against Toxocara species was estimated at 1.8% (two males) in asmathic children via ELISA method; however, no antibodies against Toxocara canis were detected in the control group. There was no significant correlation between the frequency of antibodies against Toxocara and variables such as age, gender, or place of residence (P>0.05). Moreover, the frequency of antibodies against Toxocara was not significantly correlated with contact with dogs, consumption of unwashed fruits and vegetables, or use of raw/undercooked sheep liver (P>0.05).Conclusion: The present study showed anti-Toxocara antibody in 1.8% of asthmatic children and determined the seroprevalence of toxocariasis in asthmatic children and adolescents in Arak, Iran. Based on the findings, the low rate of infection with Toxocara among asthmatic children may be attributed to acceptable personal hygiene and religious considerations.

Seroprevalence of Toxoplasma gondii IgG and IgM antibodies and associated risk factors in women of child-bearing age in Njinikom, NW Cameroon.

BackgroundToxoplasmosis is a widely distributed zoonotic disease, caused by the protozoan parasite Toxoplasma gondii. T. Infections can result in stillbirths, abortions or congenital defects during pregnancy, as well as toxoplasmic encephalitis in HIV/AIDS patients. This study aimed to determine the seroprevalence and risk factors for T. gondii infection in women seeking antenatal and medical care in the locality of Njinikom, North West of Cameroon.MethodsWe conducted a cross-sectional study from August to December 2014 consecutively enrolling 178 consenting women aged 15 to 49 years attending antenatal care or medical check-ups at the hospital. A questionnaire survey was administered to study participants and potential risk factors for Toxoplasma exposure sought. Venous blood was collected and serum from each participant analysed for T. gondii infection as evidenced by the presence of anti-T. gondii IgG and IgM antibodies detected using the indirect enzyme-linked immunosorbent assay (ELISA) technique. The proportion of anti-T. gondii antibody positivity calculated as the percentage of antibody seropositivity to T. gondii antigens. Predictors of T. gondii infection were analysed by univariate and multivariate regression and association with T. gondii seropositivity assessed. Epi-Info 3.5.4 was used for statistical analyses. A p < 0.05 was considered significant for all analyses.ResultsThe seroprevalence of anti-T. gondii antibodies (IgM or IgG) were 54.5 % (97/178). Among seropositive women, 88.7 % (86/97), 30.9 % (30/97), and 19.6 % (19/97) were respectively seropositive for IgG antibody, IgM antibody and both IgM and IgG antibodies. Among the risk factors evaluated, only the consumption of raw or undercooked meat (p = 0.02) was observed to be an independent risk factor of T. gondii infection. The consumption of unwashed vegetables and fruits was significant (p = 0.01) only with simple logistic regression analysis.ConclusionsOur findings suggest recent T. gondii exposure is high in our study population, and may constitute a significant risk factor for stillbirths, abortions or congenital defects during pregnancy in women attending antenatal care, or toxoplasmic encephalitis in those who are immunosuppressed such as in HIV/AIDS. Education and screening of HIV-positive individuals and pregnant women for T. gondii infection may be important primary prevention strategies in this population.

Fresh fruits, vegetables and mushrooms as transmission vehicles for Echinococcus multilocularis in highly endemic areas of Poland: reply to concerns.

Echinococcus multilocularis is a tapeworm that may cause alveolar echinococcosis (AE), one of the most dangerous parasitic zoonoses. As in the case of other foodborne diseases, unwashed fruits and vegetables, contaminated with dispersed forms of E. multilocularis, may serve as an important transmission route for this parasite. In this article, we reply to the incorrect interpretation of results of our study concerning the detection of E. multilocularis DNA in fresh fruit, vegetable and mushroom samples collected from the highly endemic areas of the Warmia-Masuria Province, Poland, to dispel any doubts. The accusations formulated by the commentators concerning our paper are unfounded; moreover, these commentators demand information which was beyond the purview of our study. Making generalisations and drawing far-reaching conclusions from our work is also unjustified. The majority of positive samples were found in only a few hyperendemic communities; this information corresponds with the highest number of both infected foxes and AE cases in humans recorded in this area. Our findings indicate that E. multilocularis is present in the environment and may create a potential risk for the inhabitants. These people should simply be informed to wash fruits and vegetables before eating. No additional far-reaching conclusions should be drawn from our data. We believe these commentators needlessly misinterpreted our results and disseminated misleading information. Nevertheless, we would like to encourage any readers simply to contact us if any aspects of our study are unclear.

Toxoplasmosis awareness, seroprevalence and risk behavior among pregnant women in the Gampaha district, Sri Lanka

Background: Primary gestational toxoplasmosis can be transmitted to the fetus with deleterious effects on the pregnancy. There is very little information regarding gestational toxoplasmosis in Sri Lanka. This survey was done to determine the prevalence and awareness of toxoplasmosis and to identify risk factors of infection among pregnant women in the Gampaha district, Sri Lanka.Methods: Women attending obstetric clinics at the Colombo North Teaching Hospital in 2014 were tested for Toxoplasma gondii (T. gondii) specific Immunoglobulins G (IgG) and M (IgM) subtypes using the OnSite Toxo IgG/IgM Rapid Test-Dip Strip®. Disease awareness and risk behaviors of the participants were investigated.Results: Of the 293 participants (mean age 27 years, SD ± 5.92), 38% were primigravidae with a mean gestational age of 16.2 weeks (SD 7). The prevalence of anti-T. gondii IgG and IgM antibodies was 12.3% (n = 36) and zero, respectively. Unadjusted and adjusted odds ratios were calculated to determine risk factors of infection (cat-ownership, handling cats, consumption of meat, commercial meals and unwashed raw vegetables and fruits, handling soil and not washing hands after handling soil). On bivariate analysis, eating commercially prepared meals weekly or more was associated with toxoplasma seroprevalence with marginal statistical significance. On multivariate analysis, none of the considered risk factors were significant. Toxoplasma awareness was 4.4% (n = 13); health personnel (46.2%, n = 6) and media (53.8%, n = 7) being sources of information.Conclusions: Health education programs to increase awareness of toxoplasmosis is recommended at antenatal clinics.

SEROPREVALENCE AND RISK FACTORS ASSOCIATED WITH Toxoplasma gondii INFECTION AMONG RURAL COMMUNITIES IN NORTHERN IRAN.

SUMMARYToxoplasmosis is the fourth most common cause of hospitalization and the second cause of death due to food-borne infections. We conducted a cross-sectional study to determine the prevalence, disease awareness and risk factors associated with toxoplasmosis among rural communities in Northern Iran. Data were obtained from serological testing and from participant's questionnaires and were analyzed using a logistic regression. Of the 630 participants, 465 (73.8%), and 12 (1.9%) had IgG and both IgG and IgM anti-Toxoplasma gondii antibodies, respectively. In the logistic regression analysis, T. gondii seropositivity was associated with the following factors: age, occupation, consumption of undercooked meat, and of unwashed raw vegetables or fruits (p < 0.001). Our study showed a high prevalence of T. gondii infection in the general population of Northern Iran. A health program is needed to increase the public awareness of toxoplasmosis, and its associated risk factors.

Intestinal protozoa infections, associated risk factors and clinical features among children in a low-income tea plantation community in Sri Lanka

Background: Information on associated factors and current health impact on intestinal protozoa infections in tea plantation community in Sri Lanka is insufficient. The purpose of this study was to describe risk factors and clinical manifestations of intestinal protozoa infections among children in a tea plantation community in Sri Lanka. Methods: An interviewer administered structured questionnaire was used to collect data on socio-demographic characteristics and clinical features of children. Protozoa infections were diagnosed by direct wet smears, formal-ether concentration technique and Ziehl-Neelsen staining technique. Results: 489 children aged 1–12 years participated and the overall prevalence of intestinal protozoan infection was 18.4%. Entamoeba coli was the most common intestinal protozoa (16.9%) followed by Blastocystis hominis (1.4%), Iodamoeba buschilli (0.2%), Entamoeba histolytica (0.2%) and Giardia intestinalis (0.2%). Multivariate analysis identified eating unwashed fruits (p=0.003), nail biting (p=0.024) and sucking fingers (p=0.018) as statistically significant factors with intestinal protozoa infections. Conclusions: Health education programs promoting awareness about health and hygiene and improving sanitation facilities are recommended to reduce the morbidity associated with intestinal protozoa infections among this population.

Serosurvey of Entamoeba Histolytica Exposure among Tepehuanos Population in Durango, Mexico

The seroepidemiology of Entamoeba histolytica infection in Tepehuanos population in Mexico is largely unknown. This study aimed to study the seroprevalence and correlates of E. histolytica antibodies in Tepehuanos in Durango, Mexico. Through a cross-sectional study, we determined the frequency of E. histolytica IgG antibodies in 156 Tepehuanos people in Durango, Mexico using an enzyme-linked immunoassay. Furthermore, we studied the association of E. histolytica seroprevalence with the socio-demographic, clinical, and behavioral characteristics of the Tepehuanos studied. Forty-four (28.2%) Tepehuanos with mean age of 31.03 ± 16.71 years old had anti- E. histolytica IgG antibodies. Multivariate analysis showed that E. histolytica exposure was positively associated with laborer occupation (Odds ratio=2.77; 95% CI: 1.15, 6.66; p=0.02), and history of lymphadenopathy (Odds ratio=4.97; 95% CI: 1.74, 14.13; p=0.002), and negatively associated with soil contact (Odds ratio=0.13; 95% CI: 0.03, 0.53; p=0.004). Other behavioral characteristics including drinking untreated water or unpasteurized milk, and consumption of unwashed raw vegetables or fruits were not associated with E. histolytica exposure. The seroprevalence of E. histolytica infection in Tepehuanos in Durango is higher thanseroprevalences reported in national surveys. The factors associated with E. histolytica seropositivity reported in the present study might aid for the planning and implementation of effective measures against E. histolytica infection.

Low Seroprevalence of Toxocara Infection in Schizophrenic Inpatients in Durango, Mexico: A Case Control Study

Psychiatric patients have a higher seroprevalence of toxocariasis than general population. However, there is poor knowledge about any specific psychiatric diagnosis associated with toxocariasis. The aim of the study was to determine whether seropositivity to Toxocara was associated with schizophrenia. Through an age and gender-matched case-control seroprevalence study in Durango City, Mexico, 50 schizophrenic inpatients in a public psychiatric hospital and 100 control subjects of the general population were compared for the presence of anti-Toxocara IgG antibodies. One of the 50 (2%) schizophrenic inpatients, and 3 (3%) of the 100 controls were positive for anti-Toxocara IgG antibodies. No statistically significant difference in Toxocara seroprevalence among cases and controls was found (P=0.59). The Toxocara positive schizophrenic patient suffered from paranoid schizophrenia (F20.0) and had a number of putative risk factors for Toxocara exposure including contact with cats, dogs and other animals, worked in agriculture, and consumed undercooked meat, unwashed fruits and vegetables, and untreated water. Results suggest that seroprevalence of Toxocara infection was low and not associated with schizophrenia in psychiatric inpatients in Durango, Mexico. However, further studies to elucidate the association of toxocariasis with schizophrenia are needed.