Pinworm infection in school children of four districts of Malakand region, Khyber Pakhtunkhwa, Pakistan / Infecção por Pinworm em crianças em idade escolar de quatro distritos da região de Malakand, Khyber Pakhtunkhwa, Paquistão

Illnesses caused by human pinworm remains a pediatric health problem in developing nations including Pakistan. This study aimed to investigate the prevalence of Enterobius vermicularis in school children of four districts in Malakand region, Pakistan. Four hundred faecal specimens were screened from May 2014 to July 2017 using normal saline and Lugol Iodine solution. Twenty three (5.75%) individuals were found infected with E. vermicularis. Five children (1.25%) were infected with only E. vermicularis and eighteen (4.5%) were mixed with other helminths. E. vermicularis 23 (5.75%), hookworm 11 (2.75%), Ascaris lumbricoides 5 (1.25%), Taenia saginata 2 (0.5%) and Trichuris trichuira 4 (1%) were detected. Age wise 5-8 years were more parasitized followed by 13-15 and 9-12 years of age (0.0296, P<0.05). Male children were highly (0.06700, P<0.05) infected than female. Children in Malakand district were found more infected followed by Dir Upper, similar infection rate was noted in children of districts Lower Dir and Swat (0.0192, P<0.05). Children in primary level were highly (0.0013, P<0.05) infected than those of middle and high levels. Enterobiosis is still the most common parasitic diseases in children. Studies on enterobiosis should be conducted time by time to recognize the hazardous of such parasitic infection in remote areas of the country.

As doenças causadas pela traça humana continuam sendo um problema de saúde pediátrica nos países em desenvolvimento, incluindo o Paquistão. Este estudo teve como objetivo investigar a prevalência de Enterobius vermicularis em escolares de quatro distritos na região de Malakand, Paquistão. Quatrocentos espécimes fecais foram selecionados de maio de 2014 a julho de 2017, usando solução salina normal e solução de lugol iodo. Vinte e três (5,75%) indivíduos foram encontrados infectados por E. vermicularis. Cinco crianças (1,25%) foram infectadas apenas com E. vermicularis e dezoito (4,5%) foram misturadas com outros helmintos. Foram detectados E. vermicularis 23 (5,75%), ancilóstomo 11 (2,75%), Ascaris lumbricoides 5 (1,25%), Taenia saginata 2 (0,5%) e Trichuris trichuira 4 (1%). Com relação à idade, 5-8 anos foram mais parasitados, seguidos por 13-15 e 9-12 anos de idade (0,0296, P <0,05). Crianças do sexo masculino foram altamente (0,06700, P <0,05) infectadas do que as do sexo feminino. As crianças no distrito de Malakand foram encontradas mais infectadas, seguidas por Dir Upper, taxa de infecção semelhante foi observada em crianças dos distritos Lower Dir e Swat (0,0192, P <0,05). As crianças do nível primário foram altamente (0,0013, P <0,05) infectadas do que as dos níveis médio e alto. A enterobiose ainda é a doença parasitária mais comum em crianças. Os estudos sobre enterobiose devem ser conduzidos periodicamente para reconhecer a periculosidade dessa infecção parasitária em áreas remotas do país.

Análise parasitológica em estudantes com deficiência intelectual e/ou múltipla (o múltiple) / Parasitological analysis in students with intellectual and/or multiple disabilities

O parasitismo acontece quando há associação de dois seres vivos onde um deles se desenvolve e prejudica de alguma forma o outro ser, chamado hospedeiro (El parasitismo ocurre cuando existe una asociación de dos seres vivos, donde uno de ellos se desarrolla y afecta de algún modo al otro, que se llama huésped). Alguns parasitos como Entamoeba histolytica/Entamoeba dispar, Giardia lamblia, Hymenolepis nana, Taenia solium, Ascaris lumbricoides, Trichuris trichiura e Enterobius vermicularis são transmitidos pela água e/ou (se transmiten por el agua o por) alimentos contaminados e afetam grande parte da população mundial no desempenho (y afectan a una gran parte de la población mundial en el desarrollo) de suas atividades físicas, mentais e sociais, expondo-a a diversas manifestações clínicas que podem gerar elevados níveis (pueden generar altos niveles) de morbidade. Considerando que, aproximadamente, 11% da população brasileira sofrem com algum tipo de deficiência intelectual e/ou múltipla e pouco se tem estudado sobre a ocorrência (y poco se ha estudiado acerca de la existencia) de enteroparasitos nesse grupo populacional, estudos parasitológicos laboratoriais foram realizados em 50 estudantes da Associação de Pais e Amigos dos Excepcionais (APAE) da cidade de São Mateus, Espírito Santo, Brasil. Do total de amostras analisadas 28 (56%) estavam positivas para um ou mais parasitos e comensais, sendo (uno o más parásitos y comensales, siendo) 5 (17.85%) por G. lamblia, 7 (25.00%) por E. histolytica/E. dispar/E. moschkovskii, 11 (39.28%) por Entamoeba coli, 6 (21.43%) por Balantidium coli, 2 (7.14%) por Endolimax nana e 3 (10.7%) por E. vermicularis. Considerando a elevada frequência de indivíduos parasitados torna-se necessário a busca (se hace necesaria la búsqueda) de investimentos em profilaxia e educação higiênico-sanitária, além da realização (además de la realización) constante de exames parasitológicos, garantindo uma melhor (garantizando una mejor) qualidade de vida à população da APAE de São Mateus.

Parasitism occurs when there is an association between two living beings, in which one develops and in some way harms the other being, called host. Some parasites such as Entamoeba histolytica/Entamoeba dispar, Giardia lamblia, Hymenolepis nana, Taenia solium, Ascaris lumbricoides, Trichuris trichiura and Enterobius vermicularis are transmitted by contaminated water and/or food and affect a large number of the world population in their physical, mental and social activities, exposing them to diverse clinical manifestations that can generate high levels of morbidity. Considering that approximately 11% of the Brazilian population suffers from some type of intellectual and/or multiple deficiency and little has been studied about the occurrence of enteroparasites in this population group, laboratory parasitological studies were performed in 50 students of the Associação de Pais e Amigos dos Excepcionais (APAE) of the city of São Mateus, Espírito Santo, Brazil. From the total of the analyzed samples, 28 (56%) were positive for one or more parasites and commensals, of which 5 (17.85%) were positive for G. lamblia, 6 (25.00%) for E. histolytica/E. dispar, 11 (39.28%) for Entamoeba coli, 7 (21.43%) for Balantidium coli, 2 (7.14%) for Endolimax nana and 3 (10.7%) for E. vermicularis. Considering the high prevalence of parasitic infection in this population, it is necessary to seek greater investment in prophylaxis and hygienic-sanitary education, in addition to constantly conducting parasitological examinations that might guarantee a better quality of life for the population of São Mateus APAE.

Is the treatment of Enterobius vermicularis co-infection necessary to eradicate Dientamoeba fragilis infection?

OBJECTIVES: Dientamoeba fragilis is a pathogenic protozoan of the human gastrointestinal tract with a worldwide distribution, which has emerged as an important and misdiagnosed cause of chronic gastrointestinal illnesses such as diarrhea and 'irritable-bowel-like' gastrointestinal disease. Very little research has been conducted on the use of suitable antimicrobial compounds. Furthermore, higher rates of co-infection with Enterobius vermicularis have been described, suggesting that E. vermicularis could influence the treatment of D. fragilis-infected patients. To study this, the treatment of E. vermicularis and D. fragilis co-infected patients was evaluated. METHODS: Forty-nine patients with a D. fragilis infection, including 25 (51.0%) patients co-infected with E. vermicularis, were studied. All of them were treated with metronidazole. Patients with E. vermicularis co-infection and/or an E. vermicularis-positive case in the family were treated with mebendazole. RESULTS: Metronidazole treatment failure was significantly more frequent in patients with E. vermicularis co-infection and in patients with children in the family. CONCLUSIONS: Co-infection with E. vermicularis may act as a factor favoring D. fragilis infection by preventing eradication measures. This suggests that both parasites should be treated simultaneously.

Transmission of Dientamoeba fragilis: pinworm or cysts?

Recently, conflicting evidence has been published on the mode of transmission of the trichomonad Dientamoeba fragilis. Detection of D. fragilis DNA inside Enterobius vermicularis eggs agrees with the prediction of Dobell in 1940 that the eggs of a nematode act as a vector for transmission. However, the identification of a cyst stage of D. fragilis in the stool of rodents infected with a human isolate has also been reported, and this implies a life cycle similar to those of most other intestinal protistan parasites. Herein we discuss the recent data, identify gaps in the experimental evidence, and propose a method for determining which view of the life cycle of this organism is correct.

Enterobius vermicularis infection of the ovary.

Enterobius vermicularis is an intestinal parasite, which may occasionally involve extraintestinal sites including the female genital tract. We report a rare case of ovarian involvement, which presented with chronic right iliac fossa pain in a 31-year-old woman. A transvaginal ultrasound scan was suggestive of a right adnexal dermoid cyst; however, histological examination of the subsequent salpingo-oophorectomy specimen showed an abscess containing viable E. vermicularis ova. E. vermicularis is the most prevalent human nematode worldwide. Its ova are ingested, larvae hatch and mature female worms journey to the perianal region where they lay eggs. Female worms may also migrate from the anus along the female genital tract. Although of low pathogenicity, complications such as infertility or peritonitis may arise.

Dientamoeba fragilis DNA detection in Enterobius vermicularis eggs.

Dientamoeba fragilis is an intestinal protozoan suspected of causing gastrointestinal symptoms, and its mode of transmission is unknown, although first described almost a century ago. A hypothesis is that Enterobius vermicularis is a vector for D. fragilis, and recently, D. fragilis DNA was detected within surface-sterilized eggs of E. vermicularis. Using real-time PCR, we detected D. fragilis DNA in 18 (85%) of 21 samples of E. vermicularis eggs collected from patients harbouring D. fragilis in faeces. This finding supports the hypothesis that E. vermicularis may have an important role in the transmission of D. fragilis.

DNA of Dientamoeba fragilis detected within surface-sterilized eggs of Enterobius vermicularis.

With no evidence of a cyst stage, the mode of transmission of Dientamoeba fragilis, an intestinal protozoon of common occurrence and suggested pathogenicity, is incompletely known. Numerous studies have suggested that eggs of intestinal nematodes, primarily Enterobius vermicularis (pinworm), can serve as vectors for D. fragilis, although attempts to culture D. fragilis from pinworm eggs have been unsuccessful and data from epidemiological studies on D. fragilis/pinworm co-infection have been conflicting. The aim of this study was to investigate whether we could detect D. fragilis DNA from pinworm eggs collected from routine diagnostic samples (cellophane tape) and surface-sterilised by hypochlorite. DNA was extracted from individual eggs and tested by PCR using D. fragilis- and E. vermicularis-specific primers; amplicons were sequenced for confirmation. In cellophane tape samples from 64 patients with unknown D. fragilis status we detected D. fragilis DNA in 12/238 (5%) eggs, and in a patient known to harbour D. fragilis we detected D. fragilis DNA in 39/99 (39%) eggs. The finding of D. fragilis DNA within eggs of E. vermicularis strongly supports the hypothesis of D. fragilis-transmission by pinworm and has implications for antimicrobial intervention as well as control and public health measures.

[Epidemiological characteristics of soil-borne nematodiasis in Xiamen City].

The infection rate of soil-borne nematodes was 6.37% in Xiamen City, 2008, and among which the infection rates of hookworm, Ascaris lumbricoides, Trichuris trichiura and pinworm were 5.97%, 0.29%, 0.09% and 20.13%, respectively. The infection rate of soil-borne nematodes outside the island and that of pinworm in children were still high.

The ambiguous life of Dientamoeba fragilis: the need to investigate current hypotheses on transmission.

Dientamoeba fragilis is an inhabitant of the human bowel and is associated with gastrointestinal illness. Despite its discovery over a century ago, the details of Dientamoeba's life cycle are unclear and its mode of transmission is unknown. Several theories exist which attempt to explain how Dientamoeba may be transmitted. One theory suggests that animals are responsible for the transmission of Dientamoeba. However, reports of Dientamoeba in animals are sporadic and most are not supported by molecular evidence. Another theory suggests that Dientamoeba may be transmitted via the ova of a helminth. Given that the closest relative of Dientamoeba is transmitted via the ova of a helminth, this theory seems plausible. It has also been suggested that Dientamoeba could be transmitted directly between humans. This theory also seems plausible given that other relatives of Dientamoeba are transmitted in this way. Despite numerous investigations, Dientamoeba's mode of transmission remains unknown. This review discusses the strengths and weaknesses of theories relating to Dientamoeba's mode of transmission and, by doing so, indicates where gaps in current knowledge exist. Where information is lacking, suggestions are made as to how future research could improve our knowledge on the life cycle of Dientamoeba.

Relationship between Enterobius vermicularis and the incidence of acute appendicitis.

The objective of this study was to evaluate the relationship between Enterobius vermicularis and the occurrence of acute appendicitis. Over a ten year period of time, all appendix specimens received by the department of pathology were reviewed for pathologic changes and the existence of E. vermicularis. Logistic regression was carried out to determine the odds ratio (OR) of the relationship between E. vermicularis and acute appendicitis. A total of 5048 specimens were reviewed. E. vermicularis was found in 144 (2.9%) cases. After separating by sex and adjusting for age logistic regression analysis showed the OR of E. vermicularis appendiceal infestation was 1.275 (95% CI = 0.42-3.9) for males and 1.678 (95% CI = 0.61-4.65) for females. Age was an independent risk factor for acute appendicitis in males (OR = 1.01, 95% CI = 1.003-1.017) and females (OR = 1.012, 95% CI = 1.005-1.02).

Helminth eggs in raw and treated wastewater in the Islamic Republic of Iran.

To assess the type and load of helminths in wastewater and the quality of treatment, we examined the raw and treated wastewater of 8 wastewater treatment plants (WTP) in Tehran and 2 in Isfahan for the presence of helminth eggs during 2002-2003. Wastewater samples obtained from both inlet and effluent of each treatment plant were examined on several occasions using the modified Bailenger method. Untreated entry wastewater in Tehran WTPs contained a larger variety of helminth eggs than those of Isfahan, as well as higher total egg counts. The helminths identified in the influent of Tehran included Ascaris lumbricoides, hookworms, Enterobius vermicularis, Trichostrongylus spp., Taenia spp., Hymenolepis nana and Dicrocoelium dendriticum, while in Isfahan only A. lumbricoides, Trichostriogylus and H. nana were isolated. After treatment, the number of eggs/L fell to < or = 1 egg/L.

Mitochondrial cytochrome c oxidase subunit 1 gene and nuclear rDNA regions of Enterobius vermicularis parasitic in captive chimpanzees with special reference to its relationship with pinworms in humans.

Sequences of mitochondrial cytochrome c oxidase subunit 1 (CO1) gene, nuclear internal transcribed spacer 2 (ITS2) region of ribosomal DNA (rDNA), and 5S rDNA of Enterobius vermicularis from captive chimpanzees in five zoos/institutions in Japan were analyzed and compared with those of pinworm eggs from humans in Japan. Three major types of variants appearing in both CO1 and ITS2 sequences, but showing no apparent connection, were observed among materials collected from the chimpanzees. Each one of them was also observed in pinworms in humans. Sequences of 5S rDNA were identical in the materials from chimpanzees and humans. Phylogenetic analysis of CO1 gene revealed three clusters with high bootstrap value, suggesting considerable divergence, presumably correlated with human evolution, has occurred in the human pinworms. The synonymy of E. gregorii with E. vermicularis is supported by the molecular evidence.

Respuesta inmune en niños con infección intestinal por giardia lamblia, Cryptosporidium parvum y enterobius vermicularis / Inmune response in children with intestinal parasitic infection for Giardia lamblia, Cryptosporidium parvum and Enterobious vermicularis

El objetivo de este estudio es determinar la respuesta inmune sérica en niños con parasitosis intestinal al diagnóstico y tres meses después sin infección. Fueron recogidas 3036 muestras de 1959 niños y 939 pruebas de cello de 688 niños para investigación parasitaria. De los 155 niños con parásitos, 86 con un único parásito fueron seguidos en este estudio. Veintiséis con Giardia lamblia fueron tratados con tinidazol y metranidazol, cuarente con Enterobius vermicularis con palmoato de prantel y veinte con Cryptosporidium parvum sólo con tratamiento sintomático. Las inmunoglobulinas séricas fueron determinadas mediante nefelometria cinética CD4+ y CD8+ por citometria de flujo y anticuerpos monocionales marcados con fluorescencia. Existe un incremento signficativo de IgA en pacientes con Giardia lamblia y de IgG para Cryptosporidium parvum, entre la fase aguda de parasitación y tres meses después sin infección. No existen diferencias para IgM. Hay un descenso significativo en los tres tipos de parasitación para IgE entre el diagnóstico y tres meses después sin infección. No hemos encontrado diferencias significativas para CD4+, CD8+ y CD4+ / CD8+. Los pacientes con parasitosis intestinal presentan modificaciones inmunológicas significativas en la fase aguda de parasitación. Actualmente, el mecanismo mediante el cual el sistema inmune responde en las personas inmunocompetes es escasamente conocido. La respuesta inmunológica podría reflejar las alteraciones surgidas en la mucosa intestinal en contacto con el parásito (AU)

To determine prospectively plasma levels of immunes response in children with intestinal parasitic infection and three months after without infection. Three thousand thirty-six faecal stool samples were collected form 1959 children, and 939 cello-tape anal swabs form 688 children, were performed for intestinal parasite searching. From 155 children with parasitic infection, 86 were followed during this study. Twenty-six children with Giardi lamblia infection were treated with tinidazoie and metronidazole. Pyrantel palmoate symptomatic treatment. Serum inmune globulin, were determined for kinetic nephelometric, CD4+ and CD8+ for cytometric of flow and monoclonal atibodies marked with fluorescence. There were significant increases of IgA for Giardi lamblia and of IgG for Cryptosporidium parvum. No statistical difference was found for IgM. There were significant differences among the three types of parasites for IgE. There were a decrease significant of IgE among diagnosis and three months without infection for all types of parasites. No statistical difference was found for CD4+ CD8+ and C4/CD8. Patients with intestinal parasitic infection have alteration immunology´s significances. The mechanism with which the immune system of an inmunocompetent host responds to intestinal parasitic infection is still poorly understood. the immune response should reflect he pathology at the intestinal mucous site (AU)

Doença de além-mar: estudos comparativos da oncocercose na América Latina e Africa / Overseas disease: comparative studies of onchocerciasis in Latin America and Africa

Objetiva investigar os aspectos históricos da introduçäo e disseminaçäo da oncocercose na América Latina, e realizar estudos comparativos sobre a história da doença nos dois continentes. A importância que adquiriu acarretou a revalorizaçäo das coleçöes de simuliídeos, cujas espécies brasileiras começaram a ser estudadas por Adolpho Lutz no início do século XX. (AU)

Prevalencia de enteroparasitosis en una escuela urbana en el Municipio San Francisco, Estado Zulia, Venezuela / Prevalence of enteric parasitosis in an urban area school in San Francisco Municipality, Zulia State, Venezuela

El propósito de la investigación es conocer la prevalencia de las enteroparasitosis en una escuela urbana de la parroquia San Francisco. Del total de la población escolar, se escogieron 114 niños, de edades comprendidas entre 5 y 15 años de ambos sexos, donde se les realizó exámenes coproparasitológicos y de recolección de información a través de encuestas epidemiológicas. De los niños seleccionados, 74,56 por ciento reportaron positividad para uno o más enteroparásitos. 40,35 por ciento fueron masculinos y 34,21 por ciento femeninos. Las edades más parasitadas fueron comprendidas entre 8 y 12 años (34,24 por ciento) segudas de 5 a 8 años 30,69 por ciento. Los helmintos más frecuentes fueron: Enterobius vermicularis (45,55 por ciento), Trichus trichuria (27,80 por ciento). Ascaris lumbricoides (23,35 por ciento) e Hymenolepis nana (3,30 por ciento) y los protozoos fueron: Blastocystis hominis (37,28 por ciento), Giardia lamblia (17,79 por ciento). Endolimax nana (16,95 por ciento), Entamoeba coli (15,26 por ciento). El poliparasitismo predominó sobre el monoparasitismo. Las helmintiasis observadas presentaron en su mayoría una infestación leve. Se evidencia acentuados malos hábitos higiénicos en los niños así como en la escuela. Se obtuvo elevada prevalencia parasitaria en la población estudiada. La Enterobiasis fue la helmintiasis más común

Parasitismo intestinal en círculos infantiles / Intestinal parasitism in day cara centers

Resumen: Se estudiaron 1 113 niños asistentes a 5 círculos infantiles del municipio de Santa Clara, Villa Clara; con el propósito de analizar la incidencia de parasitismo intestinal. Se les procesaron las muestras de heces fecales mediante 3 métodos coproparasitológicos; demostrándose que el 42,2 porciento de la muestra estaba parasitada. Las especies más frecuentes fueron la Giardia lamblia, el Enterobius vermicularis y la Entamoeba histolytica, con asociaciones de parásitos en varios casos. Estos son más frecuentes a partir del tercer año de vida. Se resalta la influencia positiva del médico y enfermera de la familia en estas instituciones (AU)