Enterocytozoon bieneusi and Encephalitozoon intestinalis (microsporidia) in HIV-positive patients in central Spain.

Microsporidia are fungi-related eukaryotic intracellular parasites that opportunistically infect immunocompromised individuals such as those infected by the human immunodeficiency virus (HIV). Among them, Enterocytozoon bieneusi and Encephalitozoon spp. are the most clinically relevant species. We investigated the occurrence and genetic diversity of microsporidial and protist infections in mostly immunocompetent HIV-positive patients in Madrid, Spain. A structured questionnaire was used to retrieve data on factors potentially associated with an increased risk of infection, including sexual attitudes and sex-risk behaviour. Faecal samples (n = 96) from 81 HIV-positive patients were collected and analysed by molecular (PCR and Sanger sequencing) methods. Two microsporidial pathogens were detected: Ent. bieneusi (2.5%, 95% CI: 0.3-8.6) and Enc.intestinalis (4.9%, 95% CI: 1.4-12.2). The two Ent. bieneusi isolates were identified as zoonotic genotype A. Among protists, Entamoeba dispar was the species most prevalently found (33.3%, 95% CI: 23.2-44.7), followed by Blastocystis spp. (19.8%, 95% CI: 11.7-30.1), Giardia duodenalis (13.6%, 95% CI: 7.0-23.0), and Cryptosporidium spp. and Entamoeba histolytica (2.5%, 95% CI: 0.3-8.6 each). Cyclospora cayetanensis and Cystoisospora belli were not detected. Subtypes ST1 (70.6%, 12/17) and ST3 (29.4%, 5/17) were identified within Blastocystis sp., sub-assemblages AII and BIII (50%, 1/2 each) within G. duodenalis, and Cry. parvum and canine-adapted Cry. canis (50%, 1/2 each) within Cryptosporidium spp. Microsporidial and protist parasites were frequent in well-controlled, mostly immunocompetent HIV-positive patients and should be included in diagnostic algorithms when diarrhoea is present.

Opportunistic microsporidial and protist intestinal infections were relatively common in well-controlled HIV-positive patients in Madrid, Spain. These agents should be suspected and appropriately diagnosed in HIV-positive patients presenting with diarrhoea regardless of their immunological status.

Intestinal parasite infections associated with sociodemographic and seasonal factors in the Western Amazon.

Intestinal parasites are a constant public health problem in the Amazon region, with a high prevalence of cases related to poor sanitary conditions. We investigated the sociodemographic and seasonal factors associated with human intestinal parasite infections in an area of the Western Amazon, Brazil, from September 2017 to August 2019. Data were collected using a database available at the Diagnostic Support Centre (Centro de Apoio ao Diagnóstico, CAD) of the Municipality of Rio Branco, on positive diagnoses for intestinal parasites. Among the 53,200 samples analysed, 18.3% (n = 9712) were positive. Of these, 96.4% (n = 9363) and 3.6% (n = 349) were protozoan and helminthic infections, respectively. Males showed higher odds ratio (OR) for Enterobius vermicularis infection (OR: 2.3) and giardiasis (OR: 1.9) and lower OR for Endolimax nana (OR: 0.9) and Entamoeba coli (OR: 0.9) infections. Individuals aged ≥ 15 presented higher OR for Strongyloides stercoralis (OR: 3.4), hookworms (OR: 2.3), and almost all protozoan infections than younger individuals. In the dry season, the OR for hookworms (OR: 1.5), Iodamoeba butschlii (OR: 1.4), and Endolimax nana (OR: 1.3) infections was higher than that in the rainy season, including a high chance of polyparasitism (OR: 1.6). We concluded that there was a significant difference between the different types of intestinal parasites, particularly protozoa, with high OR in the dry season and for certain groups.

Prevalencia de Entamoeba gingivalis y Trichomonas tenax en adolescentes de edad escolar / Prevalence of Entamoeba gingivalis and Trichomonas tenax in school-age adolescents

Entamoeba gingivalis y Trichomonas tenaxson protozoos que generalmente se encuentran en la cavidad oral de los humanos. E. gingivalis vive en la superficie de los dientes y las encías, bolsas gingivales cerca de la base de los dientes y rara vez en las criptas de las amígdalas. Por lo general, se transmiten por contacto directo de una persona a otra al besarse, rociarse con gotas o compartir utensilios para comer. Se sabe que hasta el 95% de las personas con poca higiene bucal pueden estar infectadas con esta ameba. Por otro lado, Trichomonas tenax es una pequeña tricomona que generalmente se encuentra en la cavidad oral del 5 al 10% de los humanos. Aunque se consideran comensales anaeróbicos no patógenos, el refugio de este protozoo es más común entre personas con mala higiene bucal o enfermedades. Los informes epidemiológicos demostraron variables tasas de prevalencia de la infección por E. gingivalis entre los niños, y su ocurrencia puede variar de acuerdo a la edad, presencia de gingivitis, periodontitis y condiciones inmunosupresoras. Los niños y adolescentes en edad escolar son extremadamente susceptibles a una amplia gama de infecciones gingivales como bacterias y protozoos. El objetivo de este trabajo es determinar la prevalencia de los protozoarios E. gingivalis y T. tenax en adolescentes con edades comprendidas entre 10 y 19 años en una población de 185 pacientes de la ciudad peruana de Huancayo, Perú. La prevalencia fue mayor en la población femenina (14,05%) que en la población masculina (11,35%), con un mayor porcentaje de prevalencia entre las edades de 17 a 19 años (12,43%), pH salival menor a 6,7 y con enfermedades periodentales (16,22%). Los resultados estadísticos demostraron que la edad (p=0,001), pH salival (p=0,024) y diagnóstico de otras patologías periodentales (p<0,001) fueron estadísticamente significativas(AU)

Entamoeba gingivalis and Trichomonas tenax are protozoa that are usually found in the oral cavity of humans. E. gingivalis lives on the surface of the teeth and gums, gum pockets near the base of the teeth, and rarely in the crypts of the tonsils. They are usually spread by direct person-to-person contact through kissing, dousing, or sharing eating utensils. It is known that up to 95% of people with poor oral hygiene may be infected with this amoeba. On the other hand, Trichomonas tenax is a small trichomona that is usually found in the oral cavity of 5-10% of humans. Although they are considered non-pathogenic anaerobic commensals, the harborage of this protozoan is more common among people with poor oral hygiene or disease. Epidemiological reports have shown variable prevalence rates of E. gingivalis infection among children, and its occurrence may vary according to age, presence of gingivitis, periodontitis, and immunosuppressive conditions. School-age children and adolescents are extremely susceptible to a wide range of gingival infections including bacteria and protozoa. The objective of this work is to determine the prevalence of the protozoa E. gingivalis and T. tenax in adolescents between the ages of 10 and 19 in a population of 185 patients from the Peruvian city of Huancayo, Peru. The prevalence was higher in the female population (14.05%) than in the male population (11.35%), with a higher percentage of prevalence between the ages of 17 to 19 years (12.43%), lower salivary pH to 6.7 and with periodontal diseases (16.22%). The statistical results showed that age (p=0.001), salivary pH (p=0.024) and diagnosis of other periodontal pathologies (p<0.001) were statistically significant(AU)

Prevalence and Risk Factors for Intestinal Protozoan Infections in Children with Cancer in Taif, Western Saudi Arabia.

BACKGROUND: Cancer is a category of diseases that cause an individual's immune system to become suppressed. In a case-control study, the current study aims to detect the frequency of intestinal parasites and related risk factors in children with cancer. METHODS: Stool samples were collected from 178 children with cancers (cases) and 150 cancer-free children (controls) who sought treatment for diarrheal episodes at nearby hospitals. Samples were processed by direct smear examination, concentration technique, permanent staining by Lugol's iodine, modified Ziehl-Neelsen, modified trichrome, and chromotrope 2R stains. RESULTS: The overall prevalence of intestinal parasites was 7.3% (24/328), with non-statistically significant differences between cases (7.8%; 14/178) and controls (6.6%; 10/150). Children with leukemia had a higher infection rate (9%; 9/100) than children with lymphoma (6.9%; 3/43) or solid tumors (5.7%; 2/35). Blastocystis sp. (3.3%) was the most common intestinal parasite found in cases, followed by Cryptosporidium sp. (2.2%), Giardia lamblia (1.6%), and Microsporidia sp. (0.5%). For all parasites, no statistical difference was found between the two groups. (p > 0.05). Male gender, young age, non-bottled water use, travel to parasite-endemic areas, living in an urban area, and infrequent hand washing were all associated with intestinal parasitosis, with non-statistical significance observed between the two groups. In children with cancer, intestinal parasites were found to be significantly associated with chronic (p = 0.04) and severe (p = 0.03) diarrhea. CONCLUSIONS: Children with cancer, particularly those with hematological cancers, should be screened for intestinal parasites on a regular basis and treated for their overall health.

Prevalence of Pathogens in Young Children Presenting to Hospital with Diarrhea from Lambaréné, Gabon.

Diarrheal disease is the second most frequent cause of mortality in children younger than 5 years worldwide, causing more than half a million deaths each year. Our knowledge of the epidemiology of potentially pathogenic agents found in children suffering from diarrhea in sub-Saharan African countries is still patchy, and thereby hinders implementation of effective preventative interventions. The lack of cheap, easy-to-use diagnostic tools leads to mostly symptomatic and empirical case management. An observational study with a total of 241 participants was conducted from February 2017 to August 2018 among children younger than 5 years with diarrhea in Lambaréné, Gabon. Clinical and demographic data were recorded, and a stool sample was collected. The samples were examined using a commercial rapid immunoassay to detect Rotavirus/adenovirus, conventional bacterial culture for Salmonella spp., and multiplex real-time PCR for Cryptosporidium spp., Giardia lamblia, Cyclospora cayetanensis, enterotoxigenic Escherichia coli (ETEC), and enteroinvasive Escherichia coli (EIEC)/Shigella. At least one infectious agent was present in 121 of 241 (50%) samples. The most frequently isolated pathogens were EIEC/Shigella and ETEC (54/179; 30.2% and 44/179; 24.6%, respectively), followed by G. lamblia (33/241; 13.7%), Cryptosporidium spp. (31/241; 12.9%), and Rotavirus (23/241; 9.5%). Coinfection with multiple pathogens was observed in 33% (40/121) of the positive cases with EIEC/Shigella, ETEC, and Cryptosporidium spp. most frequently identified. Our results provide new insight into the possible causes of diarrheal disease in the Moyen-Ogooué region of Gabon and motivate further research on possible modes of infection and targeted preventive measures.

[Prevalence of intestinal protozoan infections among rural children in Henan Province from 2014 to 2015].

OBJECTIVE: To investigate the prevalence and influencing factors of intestinal protozoan infections among rural children in Henan Province. METHODS: A total of 104 survey sites were sampled from 35 counties (cities) in Henan Province using the stratified cluster sampling method to investigate the prevalence of intestinal protozoan infections among rural children from 2014 to 2015. The trophozoites and cysts of intestinal protozoa were identified using the iodine staining method and the physiological saline direct smear method (one detection for one stool sample). The prevalence of intestinal protozoan infections was compared among rural children with different characteristics, and the factors affecting intestinal protozoan infections among rural children were identified. RESULTS: The overall prevalence of intestinal protozoan infections was 0.60% (40/6 771) among rural children in Henan Province from 2014 to 2015. There were 7 species of intestinal protozoa identified, and there was no species-specific prevalence (χ2 = 37.732, P = 0.000). No significant differences were found in prevalence of intestinal protozoan infections among rural children in terms of gender (χ2 = 1.793, P = 0.181), age (χ2 = 1.443, P = 0.486), occupation (χ2 = 0.219, P = 0.896) or ecological region (χ2 = 1.700, P = 0.637). In addition, terrain (χ2 = 2.311, P = 0.510), economic level (χ2 = 4.322, P = 0.229), source of drinking water (χ2 = 0.731, P = 0.393), eating raw vegetables (χ2 = 1.134, P = 0.287) and deworming (χ2 = 1.089, P = 0.297) had no remarkable effects on the prevalence of intestinal protozoan infections among rural children in Henan Province; however, the prevalence of intestinal protozoan infections varied significantly among rural children living in regions with different coverage of non-harmless toilets (χ2 = 10.050, P = 0.018). CONCLUSIONS: The prevalence of intestinal protozoan infections is low among rural children in Henan Province.

Rangelia vitalii molecular and histological quantification in tissues comparing crab-eating foxes (Cerdocyon thous) and domestic dogs.

Rangeliosis is a condition transmitted by the tick Amblyomma aureolatum and caused by the protozoan parasite Rangelia vitalii in canids. In domestic dogs, the disease causes a severe hemolytic disease, while in wild canids the piroplasm is often detected without any clinical abnormality. This study aimed to detect and quantify the number of copies of the R. vitalii Hsp70 gene (indirect parasite burden) in several organs of domestic and South American wild canids (Cerdocyon thous and Lycalopex gymnocercus) to elucidate distinct clinical presentations of rangeliosis in these species. A total of seven domestic dogs that died due to rangeliosis and 38 wild foxes were initially included, with all dogs presenting histological and molecular features of rangeliosis, while eight C. thous were positive at the molecular analysis for R. vitalii. Fragments of 22 organs collected from domestic (n = 7) and wild foxes (n = 8) were employed for histological and molecular quantification using real-time polymerase chain reaction aiming at the Hsp70 gene. Histologically, parasitophorous vacuoles were constantly detected in the dogs, while these were detected only in two C. thous. Parasitic burden was significantly higher in the digestive, cardiorespiratory, endocrine, genitourinary, and skeletal-muscle systems of domestic dogs when compared to wild foxes. In the hematopoietic system of wild canids, some organs, such as the lymph nodes and tonsils, presented significantly lower amounts of R. vitalii, while other organs (spleen, bone marrow, and blood) had results similar to those of domestic dogs. Additionally, the central nervous system of both domestic and wild canids presented a similar quantity of R. vitalii. The etiological agent is possibly maintained through an asexual reproductive process (merogony) in both domestic and wild species. Nonetheless, a limited or short-duration schizogony phase occurs in C. thous, which would designate this species as a possible reservoir host for the agent. Dogs, in contrast, would most likely act as accidental hosts, presenting a severe and more pathogenic schizogony phase, resulting in characteristic clinical and pathological rangeliosis.

Intestinal protozoan infections among Egyptian neutropenic patients with acute leukemia.

Several enteric protozoan species are linked to diarrhea in humans, with some causing debilitating illnesses, essentially in immunocompromised and neutropenic patients as in acute leukemias. The aim of this study was to detect intestinal protozoa in Egyptian neutropenic patients with acute leukemia. The study comprised two groups; 40 newly diagnosed neutropenic acute leukemia patients and 30 controls. Stool samples were collected from all participants and subjected to routine microscopic examination, special staining and detection of copro-antigen using rapid diagnostic test (RDT) RIDA®QUICK Entamoeba/ Giardia/ Cryptosporidium Combi. Cases were tested post-chemotherapy at the nadir of neutropenia (absolute neutrophil count ANC<= 0.5x109/L) and 19 cases were also tested initially prior to chemotherapy. Of examined patients, 15/40 (37%) were positive for Blastocystis hominis by wet mount, 10/40 (25%) had microsporidia using modified trichrome stain and only 2 cases (5%) of Cryptosporidium spp. by Ziehl-Neelsen stain. By RDT, 8/40 cases (20%) were positive compared to entirely negative controls. The positive cases included 4 patients with G. intestinalis 2 with Entamoeba and 2 with Cryptosporidium.19/40 cases were tested both pre- and post-chemotherapy. microsporidian spp. was diagnosed in 6/19 cases at the nadir of neutropenia compared to none of the cases pre-chemotherapy and the difference was statistically significant (p= 0.031*). Intestinal protozoa in acute leukemia patients post-chemotherapy are common especially B. hominis. Furthermore, RDT might be helpful for diagnosing intestinal protozoa in acute leukemia. Attention is highly required as intestinal protozoa infection can emerge after chemotherapy such as microsporidia.

Prevalencia de parasitosis intestinal en trabajadores de la florícola Irose de la provincia de Pichincha ­ Cantón Pedro Moncayo 2019 / Prevalence of intestinal parasitosis in workers of the irose florícola of the province of pichincha - Canton Pedro Moncayo

Las infecciones por parásitos intestinales son de ocurrencia constantes y se encuentran asociadas al incumplimiento de las medidas sanitarias por parte de la población. El objetivo de esa investigación fue establecer la prevalencia de parasitosis intestinal por protozoos y helmintos en trabajadores de la florícola iRose de la provincia de Pichincha-Cantón Pedro Moncayo mediante el examen coproparasitario realizado en el mes de agosto de 2019. Correspondió a un estudio transversal, descriptivo y de tipo observacional. La población estuvo integrada por 88 personas, quienes son trabajadores de la florícola iRose, Provincia de Pichincha, cantón Pedro Moncayo, distribuidos de la siguiente manera: 49 trabajadores del sexo masculino y 39 trabajadores del sexo femenino. La técnica de recolección de datos utilizada fue la encuesta y la observación directa y luego de obtener las muestras biológicas, la detección de parásitos intestinales se realizó mediante el método de coproparasitario en muestras heces. Los resultados evidencian presencia de protozoos en un 92.5% de las muestras estudiadas, mientras que el 7.5% presentan helmintos; mientras que el 40% de los estudios revelan quistes de endolimax nana, detectándose en el 25% de la muestra de los trabajadores de sexo masculino y con una presencia del 15% en los trabajadores del sexo femenino. Por lo que se recomienda realizar el examen coproparasitario al menos dos veces al año y paralelamente fortalecer las estrategias de promoción y prevención(AU)

Infections with intestinal parasites are of constant occurrence and are associated with non-compliance with health measures by the population. The objective of this research was to establish the prevalence of intestinal parasitosis by protozoa and helminths in la workers IRose flower farm of the province of Pichincha-Canton Pedro Moncayo through the coproparasitario examination carried out in august 2019. It corresponded to a cross-sectional, descriptive, observational study. The population was composed of 88 people, who are workers of the floricultural iRose, Province of Pichincha, canton Pedro Moncayo, distributed as follows: 49 male and 39 female workers. The data collection technique used was survey and direct observation and after obtaining biological samples, detection of intestinal parasites was performed using the coproparasitario method in fecal samples. The results showed the presence of protozoa in 92.5% of the samples studied, while 7.5% showed helminths; while 40% of studies reveal endolimax nana cysts, being detected in 25% of the sample of male workers and with a presence of 15% in female workers. Therefore, it is recommended to perform the coproparasitario examination less twice a year and in parallel strengthen strategies promotion and prevention(AU)

[Survey of human intestinal protozoal infections in Tibet Autonomous Region, 2015].

OBJECTIVE: To investigate the current prevalence of human intestinal protozoal infections in Tibet Autonomous Region, so as to provide the scientific basis for the development of the future control strategy. METHODS: The study sites were sampled using a stratified cluster random sampling method in different ecological zones and different geographical locations of Tibet Autonomous Region in 2015. Fecal samples were collected from the permanent residents at ages of 3 years and older for the detection of intestinal protozoa cysts and trophozoites. The region-, gender-, age-, occupation- and education level-specific prevalence of human intestinal protozoal infections was estimated and compared. RESULTS: A total of 70 study sites were sampled from 23 counties (districts) in 3 ecological zones of Tibet Autonomous Region in 2015. Among 17 939 subjects surveyed, there were 1 117 residents infected with intestinal protozoa, with a prevalence of 6.23%. There were 9 species of intestinal protozoa identified, and Entamoeba coli (3.59%), Giardia lamblia (0.74%) and Blastocystis hominis (0.72%) were found to have a high in- fection rate. The prevalence of human intestinal protozoal infections was 7.20%, 6.39% and 4.48% in the southern, eastern and northern Tibetan ecological zones, respectively. Among the 23 counties (districts), the highest human prevalence was seen in Baingoin (13.56%) and Amdo counties (12.77%), and there were significant differences in the prevalence of human intestinal pro- tozoal infections among the three ecological zones (χ2 = 33.909, P < 0.01) and 23 counties (districts) (χ2 = 580.511, P < 0.01). There was no gender-specific prevalence of human intestinal protozoal infections (men, 6.08%; women, 6.35%; χ2 = 0.542, P > 0.05); however, there was age-specific human prevalence (χ2 = 44.377, P < 0.01), and a higher prevalence was seen in residents at ages of 60－69 years (8.51%) and 50－59 years (7.67%). In addition, there were occupation- (χ2 = 37.568, P < 0.01) and education level-specific prevalence rates of human intestinal protozoal infections (χ2 = 14.659, P < 0.01), and a higher prevalence was seen in farmers (7.17%) and herdsmen (5.28%), and in residents with a primary school education (6.62% and illiterate resi- dents (6.33%). CONCLUSIONS: The prevalence of human intestinal protozoal infections remains high in Tibet Autonomous Region. The health education pertaining to intestinal parasitic disease control requires to be intensified among farmers and herds- men in rural areas.

Prevalencia de parásitos intestinales en muestras de pacientes atendidos en el Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Argentina, 2018-2019 / Prevalence of intestinal parasites in samples of patients attending the Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Argentina, 2018-2019 / Prevalência de parasitas intestinais em amostras de pacientes atendidos no Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Argentina, 2018-2019

Resumen Se evaluaron retrospectivamente los resultados obtenidos de estudios parasitológicos en muestras de heces y escobillados anales remitidos al Laboratorio de Parasitología y Gastroenterología del Hospital de Pediatría "Prof. Dr. Juan P. Garrahan" de la Ciudad de Buenos Aires, Argentina. El objetivo del trabajo fue conocer la prevalencia de los parásitos intestinales observados en las muestras remitidas a este hospital y su distribución en rangos etarios. En el período comprendido entre mayo de 2018 y abril de 2019 se analizó un total de 4713 muestras pertenecientes a 3311 pacientes, que arrojó un resultado total de 29% de positivos (1371/4713). De los exámenes coproparasitológicos el 30% fueron positivos (1193/4025) y se hallaron huevos de Enterobius vermicularis en el 26% (178/688) de los escobillados anales. En las muestras seriadas de heces se obtuvo un 37% de positividad mientras que en muestras únicas un 21%. En la totalidad de muestras fecales, los enteroparásitos más prevalentes fueron Blastocystis spp. en un 14% (579/4025), Giardia duodenalis 11% (456/4025) y Dientamoeba fragilis 7% (291/4025). Los resultados demostraron diferencias significativas con mayor prevalencia de parásitos intestinales en pacientes en edad escolar comprendidos entre los 6 y 10 años, en relación a los de edad preescolar. En las muestras fecales analizadas se evidenció un predominio de parasitismo de protozoos sobre helmintos, por lo que se debería considerar reforzar el diagnóstico de laboratorio de esas especies mediante técnicas, como coloraciones, que posibiliten su hallazgo y confirmación.

Abstract The results obtained of the coproparasitological studies and anal swab submitted to the laboratory of the Parasitology Section of the Hospital de Pediatría "Prof. Dr. Juan P. Garrahan" of the Buenos Aires City, Argentina, were retrospectively evaluated The aim of this study was to determine the prevalence of intestinal parasites found on the submitted samples and to evaluate their frequency according to the age of the patients. Within the period between May 2018 and April 2019, a total of 4713 samples corresponding to 3311 patients were analyzed and intestinal parasites were present in 29% (1371/4713). In 30% of coproparasitological studies parasite estructures were found (1193/4025) and 26% of anal swab samples were positive for the presence of Enterobius vermicularis eggs (178/688). In serial fecal samples, 37% positive results were obtained, while in single samples, 21%. The most prevalent enteroparasites calculated from the total fecal samples were: Blastocystis spp. with 14% (579/4025), followed by Giardia duodenalis 11% (456/4025) and Dientamoeba fragilis 7% (291/4025). The incidence of intestinal parasites was higher in the group of patients between 6 and 10 years, and the existence of significant differences between proportions of parasitized patients in preschool and school infants, was observed. In the faecal samples analyzed, a greater prevalence of parasitism caused by protozoa than by helminths was evidenced, for which reason it should be considered, reinforcing the laboratory diagnosis using techniques such as stains that allow its finding and confirmation.

Resumo Os resultados obtidos de estudos parasitológicos em amostras fecais e esfregaços anais enviados ao Laboratório de Parasitologia e Gastroenterologia do Hospital de Pediatría "Prof. Dr. Juan P. Garrahan" da Cidade de Buenos Aires, Argentina, foram avaliados retrospectivamente. O objetivo do estudo foi avaliar a prevalência dos parasitas intestinais observados nas amostras enviadas a este hospital e sua distribuição por faixas etárias. Durante o período compreendido entre maio de 2018 a abril de 2019 foram analisadas 4713 amostras, correspondentes a 3311 pacientes, o que deu um resultado total de 29% de positivos (1371/4713). 30% dos exames coproparasitológicos foram positivos (1193/4025) e foram encontrados ovos de Enterobius vermicularis em 26% (178/688) dos esfregaços anais. Nas amostras seriadas fecais foram obtidos 37% de resultados positivos, enquanto que em amostras únicas, 21%. Os enteroparasitas mais prevalentes na totalidade das amostras fecais foram Blastocystis spp. em 14% (579/4025), Giardia duodenalis 11% (456/4025) e Dientamoeba fragilis 7% (291/4025). Os resultados demonstraram diferenças significativas com maior prevalência de parasitas intestinais em pacientes em idade escolar da faixa etária entre 6 e 10 anos, em relação aos da pré-escola. Nas amostras fecais analisadas, evidenciou-se um predomínio de parasitismo por protozoários por sobre helmintos, pelo qual deve ser considerado o reforço do diagnóstico laboratorial dessas espécies por meio de técnicas, como colorações que permitam a sua localização e confirmação.

Molecular prevalence of intestinal parasites infections in children with diarrhea in Franceville, Southeast of Gabon.

BACKGROUND: Pediatric diarrhea caused by a range of pathogens, including intestinal parasites, is one of main causes of death among children under 5 years of age. The distribution of these parasitic infections overlaps in many environmental, socioeconomic and epidemiological settings. Their distribution and prevalence varies from region to region. In the current study, we assess the prevalence of intestinal parasites among pediatric patients with syndromic diarrheal disease living in Franceville, Gabon. METHODS: A cross-sectional study conducted in the Amissa Bongo Regional Hospital and Chinese-Gabonese Friendship Hospital in Franceville, between November 2016 and August 2017, enrolled a total of 100 diarrheic children between 0 and 180 months of age. Parasite detection in stool samples was performed using molecular diagnostic by PCR. Difference in means were tested by Student's t test and ANOVA while principal component analysis was used to determine the correlation between parasite distributions and age groups. RESULTS: The overall prevalence of intestinal parasite infection was 61% (61/100). Hymenolepis sp and Cryptosporidium hominis/parvum were the most common parasites (31 and 19%, respectively), followed by Encephalitozoon intestinalis (15%), Trichuris trichiura (4%), Dientamoeba fragilis (4%), and Enterocytozoon bieneusi (2%). The polyparasitism rate was 19.7%, with 83.3% double and 16.7% triple infections. Protozoan infections (66.7%) were more prevalent than helminths infections (33.3%). Seasonal association of the circulation of intestinal parasite was statistically significant (p = 0.03). Correlations between different parasites was also observed. CONCLUSION: The prevalence of intestinal parasitic infections is highest in diarrheic pediatric children. The prevalence of parasitic infections indicates that protozoa and helminths are the most common parasites in the Franceville environment. This study reinforces the importance of routine examination of diarrheic stool samples for the diagnostic of intestinal parasites. Further analyses are required to better understand the local epidemiology and risk factors associated with the transmission of intestinal parasites in Franceville, Gabon. KEYSWORDS: diarrhea, children, intestinal parasitic infections, molecular diagnostic, Franceville, Gabon.

Changes in the epidemiological profile of intestinal parasites after a school-based large-scale treatment for soil-transmitted helminths in a community in northeastern Brazil: Epidemiological profile after large-scale school-based treatment for STH.

Intestinal parasites cause a significant public health problem worldwide due to the associated morbidities, mainly in infected school-aged children (SAC). The strategy of large-scale deworming in SAC to control the transmission of soil-transmitted helminths (STH) has been advocated by the World Health Organization and was recently adopted in Brazil; however, the long-term effects of mass deworming on the larger parasitological profile have been less studied. After a five-year period of school-based large-scale treatment for STH using an annual single dose of albendazole in a community of Sergipe state, Brazil, a marked reduction in prevalence was observed (15.4%% vs.7.4% for Ascaris sp., 6.0%%  vs. 0.4% for hookworm, and 12.8%%  vs. 4.5%% for Trichuris trichiura), with the exception of Strongyloides stercoralis, which had no statistically significant change in prevalence. There was, however, an increase in the prevalence of intestinal protozoans, specifically Entamoeba histolytica/E. dispar (0.0%% vs. 36.0%), Blastocystis hominis (0.0%%  vs. 40.1%), and Giardia duodenalis (5.6%% vs. 14.5%). Although the findings showed a dramatic reduction in the prevalence of STH after four rounds of preventive chemotherapy, there was an increase in intestinal protozoan infections, indicating a change in the epidemiological profile.

Frequência de enteroparasitos em mulheres não grávidas e seus filhos e grávidas atendidas em uma unidade de saúde / Frequency of enteroparasites in non-pregnant women and their children and pregnant women attended at a public health unit

As infecções parasitárias intestinais são amplamente distribuídas em todo o mundo e a população infantil é a mais afetada. A prevalência das infecções parasitárias intestinais materna e infantil de pacientes atendidos em uma unidade de saúde pública do município de Lagoa Santa, Minas Gerais foi avaliada pela técnica de centrífugo sedimentação em formol-éter. A positividade foi de 41,7% para gestantes, 37,3% para mães e 35,7% em crianças. Endolimax nana (17,1%) e Giardia intestinalis (17,1%) foram os parasitos mais frequentemente detectados em crianças com idade inferior a dois anos e em gestantes (33,3%). Para as mães, G. intestinalis (20,3%) foi o parasito mais prevalente seguido de Entamoeba coli (17%). A infecção simultânea de mãe e filho foi detectada em 7 das 25 crianças infectadas. Apesar das ações de educação em saúde, melhoria no nível educacional e acesso a serviços médicos, a frequência de infecções por endoparasitas permanece alta. A literatura é escassa em relação ao tema e acredita-se que a deficiência na aplicação de medidas de educação sanitária possa fazer com que mães infectadas possam contribuir para a infecção parasitária de seus filhos, assim como os filhos podem ser fonte de infecção para suas mães.

Intestinal parasitic infections are widely distributed throughout the world and children are the most affected population. The objective of the present study was to evaluate the prevalence of parasitic maternal and infant intestinal infection of patients attended at a public health unit in the municipality of Lagoa Santa, Minas Gerais. The centrifugal-sedimentation in formol-ether was the technica used for stool analysis. Positivity was observed in 41.7% for pregnant women, 37.3% for mothers and 35.7% for children. Endolimax nana (17.1%) and Giardia intestinalis (17.1%) were the most frequently detected parasites in children under two-years old and pregnant women (33.3%). For mothers, G. intestinalis (20.3%) was the most prevalent parasite followed by Entamoeba coli (17%). Simultaneous infection of mother and child was detected in 7 of 25 infected children. Despite health educations actions, improvement in educational level, and access to medical services, the frequency of endoparasite infections remains high. Literature is scarce in relation to the present theme and it is believed that infected mothers can contribute for parasitic infection of their kids, just as children can be a source of infection for their mothers.

[Prevalence and influencing factors of intestinal parasitic diseases among rural children in Henan Province].

OBJECTIVE: To understand the epidemic status and influencing factors of intestinal parasitic diseases among rural children in Henan Province. METHODS: According to the Scheme for The National Survey on Current Status of Major Human Parasitic Diseases in China, the survey counties were selected based on the ecological zones and economic levels in Henan Province between 2014 and 2015. Then, the included counties were stratified according to the topography and economic levels. A township was randomly sampled from each stratum, and a village was randomly sampled from each township as the study site. Finally, a total of 104 study sites from 35 counties were enrolled for the survey of intestinal parasitic diseases in children. At least 250 fresh stool samples were collected from each study site for detection of intestinal helminth eggs with the Kato-Katz technique, for the identification of Necator americanus and Ancylostoma duodenale with the fecal culture method, and for the detection of intestinal protozoa trophozoite and cyst with the physiological saline smear and iodine staining techniques. In addition, the Enterobius vermicularis and tapeworm eggs were detected in children aged 3 to 6 years using the adhesive cellophane-tape perianal swab method. RESULTS: The overall prevalence of intestinal parasitic infections was 3.21% (214/6 671) among rural children in Henan Province, and the prevalence of intestinal helminthes (2.62%, 175/6 671) was higher than that of intestinal protozoa (0.60%, 40/6 671). A total of 12 species of intestinal parasites were found, including 4 nematodes species, one trematode species, and 7 protozoa species, and the highest infection was seen in E. vermicularis (2.47%, 161/6 671). Among the four ecological zones in Henan Province, the greatest prevalence of intestinal parasitic infections was detected among children in the Qinba Mountain Ecological Zone (5.85%, 90/1 538). There was no gender-specific difference in the prevalence of intestinal parasitic infections in children (P > 0.05); however, there were age- (χ2 = 32.762, P < 0.05) and education level-specific differences in the prevalence of intestinal parasitic infections in children (χ2 = 67.507, P < 0.05), with the greatest prevalence of E. vermicularis infection seen in all species of intestinal parasites in children at all age groups. Multivariate non-conditional logistic regression analysis showed that high education level, high coverage of harmless toilets, drinking tap water and deworming were protective factors for intestinal parasitic infections in children in Henan Province. The overall prevalence of intestinal parasitic infections appeared a tendency towards a gradual decline among children in Henan Province as compared to the previous two surveys. CONCLUSIONS: The overall prevalence of intestinal parasitic infections shows a tendency towards a remarkable decline among children in Henan Province. E. vermicularis infection should be given a priority for future parasitic disease control activities among rural children in Henan Province.

High prevalence of Pentatrichomonas hominis infection in gastrointestinal cancer patients.

BACKGROUND: Pentatrichomonas hominis is a flagellated protozoan that inhabits the large intestine of humans. Although several protozoans have been proposed to have a role in cancer progression, little is known about the epidemiology of P. hominis infection in cancer patients. METHODS: To determine the prevalence of P. hominis in patients with digestive system malignancies, we collected 195 and 142 fecal samples from gastrointestinal cancer patients and residents without any complaints related to the digestive system, respectively. Each sample was detected for the presence of P. hominis by nested PCR amplifying the internal transcribed spacer (ITS) region and partial 18S rRNA gene. RESULTS: A significantly higher prevalence of P. hominis was found in cancer patients than that in the control population (41.54 vs 9.15%, χ2 = 42.84, df = 1, P < 0.001), resulting in a 6.75-fold risk of gastrointestinal cancers (OR: 6.75, 95% CI: 3.55-12.83, P < 0.001). The highest prevalence of P. hominis infection was detected in small intestine cancer patients (60%, OR: 14.88, 95% CI: 0.82-4.58, P = 0.009) followed by liver (57.14%, χ2 = 10.82, df = 1, P = 0.001) and stomach cancer patients (45.1%, χ2 = 31.95, df = 1, P < 0.001). In addition, phylogenetic analysis provided some evidence supporting that human P. hominis infection might derive from animal sources. CONCLUSIONS: To our knowledge, this study is the first report presenting the high association between P. hominis and gastrointestinal cancers. Nevertheless, whether there is any possible pathological role of P. hominis infection in cancer patients needs to be further elucidated.

Intestinal parasitic infections and associated factors in children of three rural schools in Colombia. A cross-sectional study.

Rural children are one of the populations that are most vulnerable to gastrointestinal parasite infections. Such diseases decrease the quality of life and result in growth and cognitive delays in the long term. This cross-sectional study was conducted to determine the frequency of intestinal parasite infections among rural schoolchildren in the municipality of Apulo, Colombia. A total of 97 stool samples from children aged between 5 and 15 years were collected and examined via direct light microscopy. Microscopic examination was repeated with sediments obtained using a fecal parasite concentrator, and the Kato-Katz test was performed. Frequency of intestinal parasite infection was 100%. Endolimax nana (77.35%), Blastocystis sp. (71.1%), Giardia intestinalis (39.1%), Entamoeba coli (25.7%), and the Entamoeba histolytica/dispar/moshkovskii complex (9.2%) were the most prevalent protozoa. Trichuris trichiura was the most prevalent helminth (12.3%), followed by Enterobius vermicularis (6.15%) and Ascaris lumbricoides (5.1%). Among the analyzed associated factors, consumption of untreated water increased the risk of acquiring pathogenic intestinal parasites. Finally, because G. intestinalis was the most prevalent pathogenic protozoan, molecular analysis was conducted to establish genetic assemblages and subassemblages of Giardia through sequence-based genotyping of the glutamate dehydrogenase, triose phosphate isomerase, and beta-giardin genes. A total of 14 G. intestinalis-positive samples were genotyped, which revealed the presence of subassemblages AI (n = 1), AII (n = 7), BIII (n = 2), BIV (n = 2), and BIII/BIV (n = 1) as well as a mixed subassemblage AII + BIII (n = 1). Our results indicate that gastrointestinal parasite infections in the tested population were mainly caused by suboptimal water quality. Moreover, molecular typing of G. intestinalis suggested contamination of water by animal- and human-derived cysts.

The extent, nature, and pathogenic consequences of helminth polyparasitism in humans: A meta-analysis.

BACKGROUND: Individual helminth infections are ubiquitous in the tropics; geographical overlaps in endemicity and epidemiological reports suggest areas endemic for multiple helminthiases are also burdened with high prevalences of intestinal protozoan infections, malaria, tuberculosis (TB), and human immunodeficiency virus (HIV). Despite this, pathogens tend to be studied in isolation, and there remains a need for a better understanding of the community ecology and health consequences of helminth polyparasitism to inform the design of effective parasite control programs. METHODOLOGY: We performed meta-analyses to (i) evaluate the commonality of polyparasitism for helminth-helminth, helminth-intestinal protozoa, helminth-malaria, helminth-TB, and helminth-HIV co-infections, (ii) assess the potential for interspecies interactions among helminth-helminth and helminth-intestinal protozoan infections, and (iii) determine the presence and magnitude of association between specific parasite pairs. Additionally, we conducted a review of reported health consequences of multiply-infected individuals compared to singly- or not multiply-infected individuals. PRINCIPAL FINDINGS: We found that helminth-helminth and helminth-intestinal protozoan multiple infections were significantly more common than single infections, while individuals with malaria, TB, and HIV were more likely to be singly-infected with these infections than co-infected with at least one helminth. Most observed species density distributions significantly differed from the expected distributions, suggesting the potential presence of interspecies interactions. All significant associations between parasite pairs were positive in direction, irrespective of the combination of pathogens. Polyparasitized individuals largely exhibited lower hemoglobin levels and higher anemia prevalence, while the differences in growth-related variables were mostly statistically insignificant. CONCLUSIONS: Our findings confirm that helminth polyparasitism and co-infection with major diseases is common in the tropics. A multitude of factors acting at various hierarchical levels, such as interspecies interactions at the within-host infra-parasite community level and environmental variables at the higher host community level, could explain the observed positive associations between pathogens; there remains a need to develop new frameworks which can consider these multilevel factors to better understand the processes structuring parasite communities to accomplish their control.

A Comprehensive Retrospective Study: Intestinal Parasites in Human in Van Province

Objective: The aim of present study was to retrospectively determine the prevalence of intestinal parasites in patients, who were referred to Parasitology Laboratory in Van Yüzüncü Yil University, Faculty of Medicine during an 11-year period. Methods: Stool samples of 69633 individuals admitted to the outpatient clinics in the hospital were initially evaluated with native-Lugol, and then by flotation, sedimentation, trichrome staining, modified acid-fast staining and ELISA methods. Results: Twenty-four parasite species were identified in parasite-positive patients. At least one or more parasite species were found in 34.1% of all patients. The most commonly observed parasite was Blastocystis hominis (26.5%). Among pathogen parasites, Giardia intestinalis (G. intestinalis) was detected in 9.3%, Ascaris lumbricoides (A. lumbricoides) was detected in 2.5%, Entamoeba histolytica/Entamoeba dispar in 0.8%, Cystoisospora belli in 0.004%, Fasciola hepatica in 0.04%, Dicrocoelium dendriticum in 0.001%, Strongyloides stercoralis in 0.001% and hookworm in 0.001% of the patients. Conclusion: It was determined that, pathogen parasites such as G. intestinalis and A. lumbricoides were still observed at high rates in Van province, especially in children, and the problem of parasitosis is still continuing, although the prevalence of parasites has declined when compared to the previous years.

Molecular Detection and Epidemiological Features of Selected Bacterial, Viral, and Parasitic Enteropathogens in Stool Specimens from Children with Acute Diarrhea in Thi-Qar Governorate, Iraq.

Knowledge of etiology causes of diarrheal illness is essential for development and implementation of public health measures to prevent and control this disease syndrome. There are few published studies examining diarrhea in children aged <5 years in Iraq. This study aims to investigate the occurrences and epidemiology of selected bacterial (Salmonella spp. and Campylobacter spp.), viral (adenovirus, norovirus GI and GII, and astrovirus), and parasitic (Entamoeba spp. and Giardia spp.) agents in stool samples from 155 child diarrheal cases enrolled between March and August 2017, in a hospital-based cross-sectional study in Thi-Qar, southeastern Iraq. Using molecular techniques and sequence-based characterization, adenovirus was the most frequently detected enteropathogen (53/155 (34.2%)), followed by Salmonella spp. (23/155 (14.8%)), Entamoeba spp. (21/155 (13.5%)), and Campylobacter spp. (17/155 (10.9%)). Mixed infection with Salmonella spp. and Campylobacter spp. was evident, and the same was revealed between various enteric viruses, particularly adenovirus and norovirus. The most frequent co-infection pattern was between adenovirus and Campylobacter spp., in seven cases (7/155 (4.5%)). Whole-genome sequencing-derived typing data for Salmonella isolates (n = 23) revealed that sequence type 49 was the most prevalent in this sample set (15/23 (65.2%)). To the best of our knowledge, this study provides the first report on detection and identification of floR, blaCARB-2, and mphA antimicrobial resistance genes in Salmonella isolated from children in the Middle East region. Logistic regression analysis pointed to few enteropathogen-specific correlations between child age, household water source, and breastfeeding patterns in relation to the outcome of detection of individual enteropathogens. This study presents the first published molecular investigation of multiple enteropathogens among children <5 years of age in Iraq. Our data provide supporting evidence for planning of childhood diarrhea management programs. It is important to build on this study and develop future longitudinal case-control research in order to elaborate the epidemiology of enteropathogens in childhood diarrhea in Iraq.