Prevalence and risk factors for infection with Entamoeba histolytica/dispar/ moshkovskii complex in people living in the slightest and outermost islands of Indonesia

@#Entamoeba histolytica (E. histolytica), the causative agent of amoebiasis, is still a global public health problem that cannot be controlled, especially in tropical and subtropical countries. This study was conducted to obtain information about the incidence of Entamoeba histolytica/dispar/ moshkovskii complex infection and the factors that influence it. The prevalence of infection with the Entamoeba histolytica/dispar/moshkovskii complex and the factors that influence it in people living on the smallest and outermost island of Indonesia, Sabang Island, Aceh Province. This study involved 335 respondents aged > 10 years. Respondents were selected by non-probability sampling technique. Interviews and observations were conducted to identify risk factors. The Entamoeba histolytica/dispar/ moshkovskii complex was identified by direct examination, concentration, and Whitley’s trichrome staining techniques. A Chi-Square test was performed to analyze the correlation of risk factors with the incidence of infection. The prevalence of infection with the Entamoeba histolytica/dispar/ moshkovskii complex in the people of Sabang Island was 26.6% (89/335). Source and adequacy of clean water correlated with the incidence of Entamoeba histolytica/dispar/moshkovskii complex infection. Demographic variables are not correlated with the incidence of infection. However, the group of women aged > 61 years, unemployed, unmarried, and earning less than the regional minimum wage tend to be more likely to be found with Entamoeba histolytica/dispar/moshkovskii complex infections. Thus it can be concluded that the prevalence of infection with the Entamoeba histolytica/dispar/moshkovskii complex on Sabang Island is in the high category. The prevalence of E. histolytica as the causative agent of amoebiasis cannot be explained with certainty because the two identical non-pathogenic Entamoeba species cannot be distinguished by microscopic identification. Sources and adequacy of clean water correlate with the incidence of Entamoeba histolytica/dispar/moshkovskii complex infection in the people of Sabang Island.

Prevalence of Intestinal Parasitic Infections Among Diarrheic Patients from Ahvaz, Southwestern Iran.

BACKGROUND: Intestinal parasitic infections are among the most common infections in humans, particularly in resource-poor communities. Gastrointestinal parasites, specially protozoa, can lead to diarrhea, malabsorption, and anemia. The majority of parasitic diarrhea is caused by Entamoeba histolytica, Giardia duodenalis, and Cryptosporidium spp. The present study aimed to evaluate the prevalence of intestinal parasites among diarrheic patients referred to the Shahid Rajaee Polyclinic, Ahvaz, southwestern Iran. METHODS: A cross-sectional study was conducted to determine the prevalence of intestinal parasites among 250 diarrheic patients using direct smear, formalin-ether concentration, Ziehl-Neelsen and trichrome staining. RESULTS: The results indicated that 34.4% (86/250) of the patients were infected with pathogenic parasites. Giardia duodenalis with an occurrence of 18.8% (47/250) and Cryptosporidium spp. with a frequency of 2.8% (7/250) had the highest and lowest infection rates, respectively. Blastocystis hominis with a frequency of 15.2% (38/250) showed the highest prevalence rate after G. duodenalis. Entamoeba histolytica/dispar was observed in 3 (1.2%) of diarrheic patients. The age group 1-10 years old was the most frequently infected group (27.9%). We could not find a significant association between the source of drinking water and intestinal parasitic infections (p= 0.912). CONCLUSION: This study demonstrated that G. duodenalis was the predominant parasite found among the patients. The results revealed that intestinal parasites were one of the main health problems in the region.

Are immunoenzymatic tests for intestinal protozoans reliable when used on archaeological material?

Intestinal protozoans found in ancient human samples have been studied primarily by microscopy and immunodiagnostic assays. However, such methods are not suitable for the detection of zoonotic genotypes. The objectives of the present study were to utilize immunoenzimatic assays for coproantigen detection of Cryptosporidium sp., Giardia duodenalis, and Entamoeba histolytica/Entamoeba dispar in sixty ancient human and animal samples collected from 14 archaeological sites in South America, and to carry out a critical analysis of G. duodenalis according to results obtained from three diagnostic methodologies: microscopy, immunodiagnostic tests (immunoenzymatic and immunofluorescence), and molecular biology (PCR and sequencing). More than half (31/60) of the samples analyzed using immunoenzymatic tests were positive for at least one of the intestinal protozoans, with 46.6% (28/60) corresponding to G. duodenalis, 26.6% (16/60) to Cryptosporidium sp., and 5% (3/60) to E. histolytica/E. dispar. Cryptosporidium sp. and G. duodenalis coinfection was observed in 15% (9/60) of the samples, whereas all three protozoans were found in 5% (3/60) of samples. In the Northeast Region of Brazil, by immunoenzymatic tests there is evidence that G. duodenlais and Cryptosporidium sp. have infected humans and rodents for at least 7150 years. However, for G. duodenalis, the results from the three diagnostic tests were discordant. Specifically, despite the efficiency of the molecular biology assay in the experimental models, G. duodenalis DNA could not be amplified from the ancient samples. These results raise the following question: Are all ancient samples positive for coproantigen of G. duodenalis by immunoenzymatic tests truly positive? This scenario highlights the importance of further studies to evaluate the sensitivity and specificity of the immunoenzymatic method in the archaeological context.

Molecular and descriptive epidemiology of intestinal protozoan parasites of children and their pets in Cauca, Colombia: a cross-sectional study.

BACKGROUND: Parasitic infections, particularly those caused by protozoa, represent a considerable public health problem in developing countries. Blastocystis, Giardia duodenalis, Cryptosporidium spp. and the Entamoeba complex (Entamoeba histolytica, Entamoeba dispar and Entamoeba moshkovskii) are the most common etiological causes of intestinal parasitic infections. METHODS: We carried out a descriptive cross-sectional study in school-age children attending a daycare institution in commune eight of Popayán, Cauca (Southwest Colombia). A total of 266 fecal samples were collected (258 from children and eight from pets). Blastocystis, G. duodenalis, Cryptosporidium spp. and the Entamoeba complex were identified by microscopy, quantitative real-time PCR (qPCR) and conventional PCR. The concordance of qPCR and microscopy was assessed using the Kappa index. Molecular characterization was conducted to identify Blastocystis subtypes (18S), G. duodenalis assemblages (tpi and gdh) and Cryptosporidium species/subtypes (18S and GP60). Potential associations between intestinal parasitism and sociodemographic factors were examined using bivariate analyses. RESULTS: A total of 258 fecal samples from children were analyzed by microscopy and 255 samples were analyzed by qPCR. The prevalence of Blastocystis was between 25.19% (microscopy) and 39.22% (qPCR), that of G. duodenalis was between 8.14% (microscopy) and 10.59% (qPCR), that of Cryptosporidium spp. was estimated at 9.8% (qPCR), and that of the Entamoeba complex was between 0.39% (conventional PCR) and 0.78% (microscopy). The concordance between microscopy and qPCR was very low. Blastocystis ST1 (alleles 4, 8, and 80), ST2 (alleles 11, 12, and 15), ST3 (alleles 31, 34, 36, 38,57, and 151), and ST4 (alleles 42 and 91), G. duodenalis assemblages AII, BIII, BIV and D, C. parvum subtype IIa and C. hominis subtype IbA9G3R2 were identified. The only identified member of the Entamoeba complex corresponded to E. histolytica. No statistically significant association was identified between parasitic infection and any sociodemographic variable. CONCLUSION: This study revealed the usefulness of molecular methods to depict the transmission dynamics of parasitic protozoa in southwest Colombia. The presence of some of these protozoa in domestic animals may be involved in their transmission.

Prevalence of Dientamoeba fragilis, Giardia duodenalis, Entamoeba histolytica/dispar, and Cryptosporidium spp in Da Nang, Vietnam, detected by a multiplex real-time PCR.

We surveyed the prevalence of Dientamoeba fragilis, Giardia duodenalis, Entamoeba histolytica, Entamoeba dispar, and Cryptosporidium spp in individuals with and without gastrointestinal (GI) symptoms residing in and around Da Nang city, Vietnam. Fecal samples were collected from children (n = 100) and adults (n = 80) with GI symptoms and from healthy individuals (n = 88) reporting no GI symptoms. Parasite detection was performed by multiplex real-time PCR. Overall, except for G. duodenalis, we found a low prevalence (<5%) of D. fragilis and E. dispar and no detection of E. histolytica and C. spp in all participants with GI symptoms. Specifically for D. fragilis this contrasts with findings in European populations of children with GI symptoms showing prevalence up to 73%. Moreover, our results indicate that the prevalence of G. duodenalis is higher in patients with GI symptoms compared to asymptomatic individuals and this difference is most obvious in young patients.

Risk factors for intestinal parasitosis among antiretroviral-treated HIV/AIDS patients in Ethiopia.

Summary A cross-sectional survey was conducted to determine the risk factors associated with intestinal parasitosis in HIV/AIDS patients receiving antiretroviral therapy (ART). Socio-demographic information was collected and faecal samples were analysed from 384 randomly selected patients on ART. Data on CD4+ T-cell counts and World Health Organization clinical staging were obtained from the medical records at the hospital. The overall prevalence of intestinal parasitosis was 56% (95% confidence interval [CI]: 51% to 61%). No opportunistic intestinal parasites or Schistosoma haematobium eggs were detected. Unavailability of latrine and lack of hand washing with soap were associated with Entamoeba histolytica/dispar (adjusted odds ratio [AOR], 2.75; 95% CI: 1.77 to 4.27 and AOR, 2.67; 95% CI: 1.60 to 4.44, respectively) and Giardia lamblia (AOR, 2.08; 95% CI: 1.08 to 3.99 and AOR, 2.46; 95% CI: 1.06 to 5.75, respectively) infections. Intestinal parasitosis was significantly associated with low CD4 cell count (p = 0.002). In contrast, intestinal parasitic infections were not associated (p > 0.05) with the World Health Organization disease staging. In summary, poor personal hygiene and sanitation practice contributed to the high prevalence of intestinal parasitosis. Routine diagnosis for intestinal parasitic infections should be performed in patients attending ART clinics in this setting.

Prevalencia de enteroparásitos y anticuerpos IgG anti-Entamoeba histolytica en indígenas de la comunidad de Toromo, estado Zulia, Venezuela / Prevalence of enteroparasites and IgG antibodies anti-Entamoeba histolytica in the indigenous community of Toromo, Zulia State, Venezuela

Para determinar la seroprevalencia de anticuerpos contra Entamoeba histolytica y la prevalencia de los enteroparásitos en indígenas de la comunidad de Toromo, estado Zulia, Venezuela, se estudiaron 69 individuos de ambos sexos, de 1 a 60 años de edad, en el año 2012. Se recolectaron muestras de heces y suero; a todas las muestras fecales se les realizó examen microscópico con solución fisiológica y lugol, concentración con formol-éter y coloración de Kinyoun; para la detección de anticuerpos IgG anti-Entamoeba histolytica en suero, se empleó una técnica de ELISA comercial. El 98,6% de los individuos estudiados estaban parasitados, predominando el poliparasitismo (88,2%), detectándose asociaciones de hasta 10 especies parasitarias. Entre las especies encontradas están, Ascaris lumbricoides el principal helminto (65%), y Blastocystis sp. (59%) el protozoario más frecuente. Entamoeba histolytica/dispar/moshkovskii se detectó por microscopia en 25 individuos (36% de prevalencia), donde se incluyó un caso de infección por Entamoeba histolytica, por haberse encontrado trofozoítos hematófagos. Se observó una seroprevalencia de anticuerpos contra E. histolytica, del 83%. De los resultados obtenidos, se concluye que existe una elevada seroprevalencia de anticuerpos contra E. histolytica, así como una alta prevalencia de enteroparásitos en la población indígena estudiada.

In order to determine the seroprevalence of antibodies against Entamoeba histolytica and intestinal parasites in the indigenous community of Toromo, Zulia state, Venezuela, 69 individuals of both sexes, from 1 to 60 years of age were studied during the year 2012. Stool and serum samples were collected. Microscopic study of fecal specimens was carried out by saline solution dilution, Lugol staining, formol-ether concentration and Kinyoun’s stain. For determination of anti-Entamoeba histolytica IgG antibodies, a commercial ELISA technique in serum was used; 98.6% of the population were parasitized, predominating the polyparasitism (88.24%) and finding up to 10 different parasite species were associated. The main parasitic species found were: Ascaris lumbricoides (65%), followed by Blastocystis sp. (59%). Entamoeba histolytica/dispar/moshkovskii was detected by microscopy in 25 individuals (36% prevalence), which included a case of infection by Entamoeba histolytica as hematophagous trophozoites were observed. A seroprevalence of 83% for IgG anti-Entamoeba histolytica antibodies in the individuals studied was found. According to the results it is concluded, that there is a high seroprevalence of antibodies against E. histolytica, as well as a high prevalence of intestinal parasites in the indigenous population studied.

Frequência de parasitos intestinais no município de Chapadinha, Maranhão, Brasil / Frequency of intestinal parasites in the municipality of Chapadinha, Maranhão, Brazil

O presente estudo teve como objetivo determinar a frequência dos enteroparasitos em uma população atendida no Laboratório Central do município de Chapadinha. Os testes coproscópicos foram realizados entre janeiro de 2007 e fevereiro de 2008, por meio da técnica de sedimentação espontânea de fezes (Hoffmann, Pons e Janer). Um total de 3.933 amostras foi analisado, sendo 1.301 (33,1por cento) amostras positivas e 2.632 (66,9por cento) negativas. Entamoeba coli, Entamoeba histolytica/dispar, Giardia intestinalis, Endolimax nana, Iodamoeba butschlii, Ascaris lumbricoides, Ancilostomídeos, Enterobius vermicularis, Strongyloides stercoralis e Hymenolepis nana foram as espécies observadas nas análises fecais. Entamoeba histolytica/doispar. Entamoeba coli, Giardia intestinalis e Ascaris lumbricoides foram as espécies mais frequentes.

The frequency of intestinal parasites in the population attended in the CentralLaboratory of the municipality of Chapadinha, state of Maranhão, was assessed. Stool tests were undertaken between January 2007 and February 2008, by means of the spontaneous sedimentation technique (Hoffmann, Pons, and Janer). A total of 3,933 stool samples were analyzed, where 1,302 samples were positive (33.1%) and2,632 were negative (66.9%) for intestinal parasites. Entamoeba coli, Entamoeba histolytica/dispar, Giardia intestinalis, Endolimax nana, Iodamoeba butschlii, Ascaris lumbricoides, Ancilostomídeos, Enterobius vermicularis, Strongyloidesstercoralis and Hymenolepis nana were the observed species. Entamoebahistolytica/dispar, Entamoeba coli, Giardia intestinalis and Ascaris lumbricoides were the most frequent species.

Prevalencia de parásitos intestinales en niños que asisten al Templo Comedor Sagrado Corazón Teresa Benedicta de la Cruz, del barrio Vallejuelos, Medellín, 2007 / Intestinal parasites prevalence in children from "Templo-Comedor Sagrado Corazón Teresa Benedicta de la Cruz",Vallejuelos-Medellín, 2007.

Introducción: los seres humanos estamos expuestos a los parásitos presentes en el medio en quehabitamos, lo que puede plantear un problema de salud pública, especialmente en los países en vías de desarrollo como Colombia. La población más vulnerable es la infantil, especialmente la de comunidades en condiciones socioeconómicas precarias.Objetivo: determinar la prevalencia de parásitos intestinales en los niños que acuden a un templocomedor en un barrio marginal de Medellín.Métodos: en octubre y noviembre de 2007 se hizo un estudio descriptivo transversal, mediante un coprológico directo y por concentración, en 58 de los 150 niños que acuden al templo-comedor; lo anterior se complementó con una encuesta sobre algunas variables sociodemográficas.Resultados: se halló que 54 de los 58 niños (93%) estaban parasitados y que en 48 de ellos (88,9%) losparásitos eran potencialmente patógenos; entre estos predominó Entamoeba histolytica/dispar(46,6%), seguida por Giardia intestinalis (25,9%), Trichuris trichiura (25,9%), Ascaris lumbricoides (24,1%) y Enterobius vermicularis (8,6%). Se halló multiparasitismo en 21 niños (38,8%). En cuanto a la relación entre algunas variables sociodemográficas y la frecuencia de parásitos solo se halló que el hacinamiento en la vivienda se asociaba significativamente con la presencia de Entamoeba histolytica/dispar y de Blastocystis hominis, y la tenencia de mascotas, con la infección por Enterobiusvermicularis.Conclusión: la prevalencia de parasitosis intestinales hallada en este trabajo superó la de otros grupos tanto colombianos como extranjeros. Se discuten las implicaciones de este hallazgo desde el punto de vista de la salud pública.

Introduction: Human beings are exposed to the parasites present in their habitat. This situation poses a public health problem, especially in underdeveloped countries such as Colombia. The pediatric population is the most vulnerable, particularly that of communities in poor socioeconomic conditions.Objective: To determine the prevalence of intestinal parasites in children attending a social aid institution in a poor neighborhood of Medellín, Colombia.Methods: In October and November 2007 a descriptive cross-sectional study was carried out by means of direct and concentration stool examination in 58 out of 150children attending the aforementioned institution. In addition, a survey was made of some socio-demographicvariables.Results: 54 of the 58 children (93%) were infected by intestinal parasites. In 48 of them (88.9%) potentiallypathogen parasites were present, namely: Entamoeba histolytica/dispar (46.6%), Giardia intestinalis (25.9%), Trichuris trichiura (25.9%), Ascaris lumbricoides (24.1%), and Enterobius vermicularis (8.6%). Twenty one children (38.8%) were infected with either 2 or 3 parasites. The only significant associations between socio demographic variables and parasitic infections were as follows:overcrowding was associated with Entamoeba histolytica/dispar and Blastocystis hominis, and thepresence of pets (mostly dogs) in the house was associated with Enterobius vermicularis.Conclusion: Prevalence rate of intestinal parasites was higher in the studied group than in other communities, both Colombian and from other countries. Implicationsof this finding from the public health perspective are discussed.