Unveiling Blastocystis epidemiology in Morocco: subtype diversity among clinical patients with and without gastrointestinal manifestations in the Meknes region.

Blastocystis is an intestinal protist frequently identified in humans and other animals, though its clinical significance remains controversial. This study aimed to determine the prevalence and genetic diversity of Blastocystis in faecal samples from symptomatic (n = 55) and asymptomatic (n = 50) individuals seeking medical care in Meknes, Morocco. Detection of the protist was accomplished through coproparasitological examination and culture in Jones medium. Culture-positive samples were subjected to molecular analyses (PCR and Sanger sequencing) based on sequences of the small subunit ribosomal RNA gene. Epidemiological questionnaires on demographics and potential risk factors were collected from participating patients. The overall Blastocystis infection rate was 51.4% (54/105), with no differences between symptomatic (52.7%, 29/55) and asymptomatic (50.0%, 25/50) individuals. Sequence analyses identified three Blastocystis subtypes, with ST3 being the most prevalent (42.0%), followed by ST1 (34.0%), and ST2 (12.0%). Regarding intra-subtype diversity, allele 4 was found within ST1; alleles 11/12 and alleles 34/36 (alone or in combination) were identified within ST2 and ST3 respectively. Allele 34 in ST3 (40.8%) and allele 4 in ST1 (34.7%) were the most common genetic variants circulating in the surveyed clinical population. A statistically significant association between ST2 and the presence of flatulence was observed. This is the first study assessing the epidemiology and genetic diversity of Blastocystis sp. in the Meknes region, Morocco.

Prevalence of Blastocystis sp. in Morocco: Comparative assessment of three diagnostic methods and characterization of parasite forms in Jones' culture medium.

Blastocystosis is an infection caused by Blastocystis sp., which colonizes the digestive tract of various hosts, including humans, although its pathogenicity is debated. It is crucial to detect and distinguish the different forms of Blastocystis to understand better its impact on human health and its epidemiological evolution. This study evaluated three diagnostic methods on 105 stool samples: direct examination, culture in Jones' medium, and conventional PCR. PCR is considered the gold standard and revealed a high prevalence of Blastocystis (67.62%) compared to direct examination (20.95%) and culture in Jones' medium (51.43%). Although the sensitivity of direct examination and culture was 31% and 76.1%, respectively, their specificity was 100%. No significant risk factors were identified. A statistically significant association was observed between Blastocystis infection and abdominal pain. Microscopic analysis revealed various morphological forms. Molecular diagnosis is an essential tool to determine the true prevalence of Blastocystis, and studying the different forms of this microorganism will contribute to a better understanding of its biological cycle and, therefore, the impact of this emerging infection on human health.

Title: Prévalence de Blastocystis sp. au Maroc : évaluation comparative de trois méthodes de diagnostic et caractérisation des formes parasitaires en milieu de culture Jones. Abstract: La blastocystose est une infection causée par Blastocystis sp., qui colonise le tractus digestif de divers hôtes, y compris l'homme, bien que son pouvoir pathogène soit débattu. Il est crucial de détecter et de distinguer les différentes formes de Blastocystis pour mieux comprendre son impact sur la santé humaine et son évolution épidémiologique. Cette étude a évalué trois méthodes de diagnostic sur 105 échantillons de selles : l'examen direct, la culture en milieu de Jones et la PCR conventionnelle. La PCR, considérée comme méthode de référence, a révélé une prévalence élevée de Blastocystis (67,62 %) par rapport à l'examen direct (20,95 %) et à la culture en milieu de Jones (51,43 %). Bien que la sensibilité de l'examen direct et de la culture soit respectivement de 31 % et 76,1 %, leur spécificité était de 100 %. Aucun facteur de risque significatif n'a été identifié. Une association statistiquement significative a été observée entre l'infection à Blastocystis et les douleurs abdominales. L'analyse microscopique a révélé diverses formes morphologiques. Le diagnostic moléculaire est un outil essentiel pour déterminer la véritable prévalence de Blastocystis, et l'étude des différentes formes de ce microorganisme contribuera à une meilleure compréhension de son cycle biologique et, par conséquent de l'impact de cette infection émergente sur la santé humaine.