RESUMEN
BACKGROUND: Tuberculosis (TB) and intestinal helminths are diseases that pose a dual burden on public health in low-income countries. Previous studies have shown that helminths can affect the shedding of bacteria or the bacterial load in the sputum of active TB patients. However, there is limited information on bacterial load in TB patients with helminth infections. OBJECTIVE: This study aimed to compare bacterial load in helminths-infected and non-infected pulmonary tuberculosis patients at selected public health facilities in Jimma zone, Oromia, Ethiopia. METHODS: The study was conducted in Jimma Zone, Oromia, Ethiopia. A facility-based comparative cross-sectional study was employed from August 01, 2020, to January 2021. A total of 124 (55 intestinal helminths-infected and 69 non-infected) newly diagnosed smear-positive pulmonary tuberculosis (PTB) patients were included in the study. A convenience sampling technique was employed to recruit study participants, and a semi-structured questionnaire was used to collect data regarding socio-demographic characteristics and possible risk factors for intestinal helminths co-infection. Stool examination was performed using both wet mount and Kato Katz technique. Additionally, weight and height measurements, sputum, and blood samples were taken to determine body mass index, bacilli load, and diabetic mellitus, respectively. Data were entered into Epi-Data software version 3.1 and analyzed using Statistical Packages for Social Sciences (SPSS) Version 25. A statistically significant difference was defined as a P-value of less than 0.05. RESULTS: Intestinal helminths reduced bacilli load 3 times more than intestinal helminths non-infected PTB (AOR = 3.44; 95% CI; 1.52, 7.79; P = 0.003) However, diabetes mellitus, HIV, drinking alcohol and cigarette smoking were not associated with bacilli load. The rate of co-infection TB with intestinal helminths was 44%. The three most prevalent parasites detected were Trichuris trichiura 29 (66%), hookworm 19 (43%), and Ascaris lumbricoides 11(25%)). Among co-infected patients about 36 (81.8%) had a single parasite infection, and 19 (43.2%) had multiple infections. A body mass index < 18.5 (AOR = 3.26; 95% CI; 1.25, 8.56;P = 0.016) and untrimmed fingernail status (AOR = 3.63; 95%CI;1.32,9.93;P = 0.012) were significantly associated with PTB- intestinal helminth -co-infection. CONCLUSION: Helminth infection was associated with a lower bacilli load compared to helmenths non-infected PTB. The rate of co-infection TB with intestinal helminths was 44%. Trichuris trichiura was the most prevalent helminth. Untrimmed fingernail and a body mass index were associated with PTB-intestinal helminth co-infection.
Asunto(s)
Coinfección , Helmintiasis , Parasitosis Intestinales , Tuberculosis Pulmonar , Humanos , Etiopía/epidemiología , Estudios Transversales , Femenino , Masculino , Helmintiasis/epidemiología , Helmintiasis/complicaciones , Helmintiasis/parasitología , Adulto , Coinfección/epidemiología , Coinfección/parasitología , Coinfección/microbiología , Parasitosis Intestinales/epidemiología , Parasitosis Intestinales/complicaciones , Parasitosis Intestinales/parasitología , Persona de Mediana Edad , Tuberculosis Pulmonar/epidemiología , Tuberculosis Pulmonar/complicaciones , Carga Bacteriana , Adulto Joven , Helmintos/aislamiento & purificación , Animales , Heces/parasitología , Heces/microbiología , Mycobacterium tuberculosis/aislamiento & purificación , Esputo/microbiología , Esputo/parasitología , Adolescente , Instituciones de Salud/estadística & datos numéricos , Factores de Riesgo , Salud PúblicaRESUMEN
Digenetic trematodes form a major group of human parasites, affecting a large number of humans, especially in endemic foci. Over 100 species have been reported infecting humans, including blood, lung, liver and intestinal parasites. Traditionally, trematode infections have been diagnosed by parasitological methods based on the detection and the identification of eggs in different clinical samples. However, this is complicated due to the morphological similarity between eggs of different trematode species and other factors such as lack of sensitivity or ectopic locations of the parasites. Moreover, the problem is currently aggravated by migratory flows, international travel, international trade of foods and changes in alimentary habits. Although efforts have been made for the development of immunological and molecular techniques, the detection of eggs through parasitological techniques remains as the gold standard for the diagnosis of trematodiases. In the present chapter, we review the current status of knowledge on diagnostic techniques used when examining feces, urine, and sputum and also analyze the most relevant characteristics used to identify eggs with a quick key for the identification of eggs.
Asunto(s)
Heces , Trematodos , Infecciones por Trematodos , Humanos , Infecciones por Trematodos/diagnóstico , Infecciones por Trematodos/parasitología , Animales , Heces/parasitología , Esputo/parasitología , Recuento de Huevos de Parásitos/métodosRESUMEN
PURPOSE: Lophomoniasis is a chronic protozoan respiratory disease in humans with main clinical symptoms such as chronic cough, productive sputum, breath shortness, and occasionally hemoptysis. Differentiation diagnosis of lophomoniasis from tuberculosis (TB) and asthma is crucial. METHODS: In this study, 210 participants with suspected TB referred to tuberculosis laboratories in Mazandaran province, northeastern Iran, were enrolled during 2021. All patients showed low grade fever, chronic cough or sputum on referral. Sputum specimens were collected from the participants, and Lophomonas DNA was detected through a conventional genus-specific polymerase chain reaction (PCR). RESULTS: Out of 210 participants, 67 (31.9%) had Lophomonas spp., infection, 38 (18.1%) had TB (Smear and culture-positive), and 20 (9.5%) had both TB and Lophomonas co-infection. CONCLUSION: Based on our results, a relatively high occurrence of Lophomonas infection was found among patients suspected of having TB. Accordingly, due to the high similarity of clinical symptoms between both pulmonary diseases, it is highly recommended to accurately and early diagnose the parasite in the sputum specimen.
Asunto(s)
Esputo , Tuberculosis Pulmonar , Humanos , Irán/epidemiología , Tuberculosis Pulmonar/epidemiología , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/parasitología , Masculino , Femenino , Adulto , Persona de Mediana Edad , Esputo/microbiología , Esputo/parasitología , Reacción en Cadena de la Polimerasa , Anciano , Adulto Joven , Coinfección/parasitología , Coinfección/epidemiología , Coinfección/microbiología , Adolescente , ADN Protozoario/genéticaRESUMEN
Infections with Entamoeba histolytica are seen worldwide and are more prevalent in the tropics. About 90 percent of infections are asymptomatic, and the remaining 10 percent produce a spectrum of clinical syndromes, ranging from dysentery to abscesses of the liver or other organs. Extra-intestinal infection by E. histolytica most often involves liver. Pleuro-pulmonary involvement, seen as the second most common extra-intestinal pattern of infection, is frequently associated with amebic liver abscess. Pulmonary amebiasis occurs in about 2-3 percent of patients with invasive amebiasis. We report herein the case of a 45-year-old male presenting with hepato-pulmonary amebiasis. The diagnosis was established from direct examination of sputum, in which trophozoites of E. histolytica were detected, and by serology. Following treatment with metronidazole and chloroquine, the clinical evolution improved significantly. On regular follow-up visits, the patient was asymptomatic. This case report reiterates the need for collaboration between clinicians and microbiologists for timely diagnosis of such infections.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Entamoeba histolytica/aislamiento & purificación , Absceso Hepático Amebiano/diagnóstico , Enfermedades Pulmonares Parasitarias/diagnóstico , Diagnóstico Diferencial , Absceso Hepático Amebiano/complicaciones , Enfermedades Pulmonares Parasitarias/complicaciones , Estudios Retrospectivos , Esputo/parasitologíaRESUMEN
Stool samples from 409 pre-school and school students, living in six villages of the Cajabamba and Condebamba districts, Cajamarca, Perú, were examined using wet preparations and Lumbreras' method, looking for Paragonimus eggs. Fecal and sputum samples from two children (0.5 percent) of 6 and 8 year-old showed eggs of Paragonimus. One hundred and twenty freshwater crabs, Hypolobocera chilensis eigenmanni, were collected from the Condebamba valley and 21 (17.5 percent) of them were infected with P. mexicanus (syn. P. peruvianus) metacercariae. Our results show the persistence of Paragonimus in human beings and in the main source of infection, the crabs
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Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Animales , Paragonimiasis/epidemiología , Paragonimus/aislamiento & purificación , Braquiuros/parasitología , Enfermedades Endémicas , Heces/parasitología , Encuestas Epidemiológicas , Paragonimiasis/diagnóstico , Paragonimiasis/parasitología , Perú/epidemiología , Prevalencia , Esputo/parasitologíaRESUMEN
We report the observation of acid-fast Cyclospora cayetanensis oocysts in a sputum sample. The patient, a 60 year-old, HIV negative man, was successfully treated for pulmonary tuberculosis during 1997. On February 1998, he was admitted to our center due to loss of weight, cough with purulent expectoration, dysphonia and a radiological picture of pulmonary fibrosis. Bacilloscopic study of sputum (negative for acid-fast bacilli) stained with Ziehl-Neelsen technique showed large (8-10 µm) spherical, acid-fast Cyclospora cayetanensis oocysts. No other pathogens were isolated on cultures from this sample or from laryngeal biopsy. Serial parasitologic studies showed C. cayetanensis and also eggs of Trichuris trichiura, Ascaris lumbricoides and Hymenolepis nana and of Entamoeba coli cysts. The patient lives in the outskirts of Buenos Aires in a brick-made house with potable water and works as builder of sewers. He travelled in several occasions to the rural area of province of Tucumán which has poor sanitary conditions. C. cayetanensis is an emergent agent of diarrhea and as far as we know this is the first time the parasite is observed in respiratory samples.
Asunto(s)
Humanos , Animales , Masculino , Persona de Mediana Edad , Criptosporidiosis/diagnóstico , Cryptosporidium/aislamiento & purificación , Heces/parasitología , Esputo/parasitología , Antiinfecciosos/uso terapéutico , Criptosporidiosis/tratamiento farmacológico , Infecciones Oportunistas/diagnóstico , Infecciones Oportunistas/tratamiento farmacológico , Infecciones Oportunistas/parasitologíaRESUMEN
Durante 41 meses se investigó la presencia de parásitos en una población HIV seropositiva con las características clínicas de los estadíos 3 y 4 según la clasificación de la OMS. Se analizaron 212 muestras fecales de 135 pacientes y 53,33 por ciento de ellos presentaban enteroparásitos. A las heces recolectadas en formol 10 por ciento se les realizó un examen parasitológico directo, una concentración por Ritchie y la tinción de 2 frotis con Safranina 1 por ciento y 2 con Ziehl-Neelsen modificada para identificar Cryptosporidium sp. Las frecuencias detectadas fueron: Cryptosporidium sp. 11,11 por ciento; I. belli 2,96 por ciento; G. lamblia 11,85 por ciento; B. hominis 26,66 por ciento; A. lumbricoides 2,96 por ciento; E. vermicularis 1,48 por ciento; H. nana 0,74 por ciento; E. coli 13,33 por ciento por ciento; E. nana 5,93 por ciento; Ch. mesnilii 2,22 por ciento e I. butschlii 0,74 por ciento; resultando 46 pacientes monoparasitados, 19 b, 5 tri y 2 tetraparasitados. Se procesaron 17 lavados broncoalveolares (LBA) y 194 esputos, recolectados en formal 10 por ciento y centrifugados hasta agotamiento. Con el sedimento se realizaron 10 frotis y se colorearon con azul de toluidina O. La tinción de Groccot Gomori se usó para confirmar los casos dudosos. En el 47 por ciento de los LBA y en 22,68 por ciento de los esputos (E) se diagnosticó P. carinii. Esto representa el 34,68 por ciento. El porcentaje de positividad fue: 30,88 por ciento para los pacientes que remitieron un único esputo; 36,84 por ciento más de uno y 27,276 por ciento para LBA. Por último 7 pacientes enviaron LBA y E, siendo 2 positivos y 2 negativos en ambos materiales, mientras que en 3 pacientes se diagnosticó P. carinii sólo en LBA