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PloS One 2018Intestinal parasitic infections are a major public health problem in inter-tropical areas. The aim of our study was to describe the situation in Mahajanga, Madagascar...
INTRODUCTION
Intestinal parasitic infections are a major public health problem in inter-tropical areas. The aim of our study was to describe the situation in Mahajanga, Madagascar with a particular focus on two protozoa, Dientamoeba fragilis and Blastocystis sp.
METHODS
This was a prospective study from February to June 2015. Stool samples from symptomatic hospitalized patients and asymptomatic volunteers were submitted to microscopy and molecular assays in order to detect parasites.
RESULTS
A wide panel of intestinal parasites were identified among the 265 included subjects, protozoa being the most prevalent with 72.8% whereas the prevalence of helminths and microsporidia was of 7.9% and 4.5%, respectively. Blastocystis sp. was the most prevalent protozoa (64.5% of the entire cohort) followed by various amoebas (35.5%) and flagellates (27,5%). We only detected subtypes 1, 2 and 3 of Blastocystis sp. Among the patients positive for D. fragilis (9.4%), 23 carried genotype 1 and 1 genotype 2. For the first time, we detected in 4 human stools the DNA of a recently described protozoon, Simplicimonas similis. Interestingly, subjects living in urban areas harbored significantly more different parasitic species than subjects living in rural areas with a correlation between sanitary level of neighborhood and protozoan infection. However, there was no difference in prevalence of digestive symptoms between parasite-free and parasite-infected subjects, except for Giardia intestinalis which had more symptomatic carriers.
DISCUSSION
Our study reveals a high overall parasite prevalence, similar to what had been found in 2003 in the same city and to other prevalence studies conducted in Africa. The poor access of the population to sanitary infrastructures may explain this result. Data from our study provide valuable key for sanitation programs and prevention of fecal-related infectious diseases.
Topics: Adult; Blastocystis; Cities; Dientamoeba; Female; Geography, Medical; Humans; Intestinal Diseases, Parasitic; Madagascar; Male; Phylogeny; Prevalence; Prospective Studies; Protozoan Infections; Rural Population; Sanitation; Urban Population
PubMed: 30304028
DOI: 10.1371/journal.pone.0204576 -
Journal of Travel Medicine Jul 2022Persistent abdominal symptoms (PAS) are the leading cause of post-travel morbidity although there is a paucity of evidence concerning the aetiology of this condition....
BACKGROUND
Persistent abdominal symptoms (PAS) are the leading cause of post-travel morbidity although there is a paucity of evidence concerning the aetiology of this condition. Recently molecular methods for protozoa detection in stool have been introduced. Herein, we describe the clinical aspects and the prevalence of gastrointestinal protozoa in returning travellers with PAS.
METHODS
From 2017 to 2019, clinical information and stool specimens from returning travellers with PAS were analysed for the presence of parasites using the Allplex-GI-Parasite-assay. Stool findings from symptomatic patients without a travel history were used as a comparator.
RESULTS
During the 2-year study, 203 stool specimens from returning travellers were analysed. The median duration of symptoms before seeking care was 6 months, the most common symptoms were fatigue (79.2%), abdominal pain (75.7%) and loose stool (70.8%).Most of travellers had returned from Asia (57.6%), mainly from the Indian-subcontinent and only 52.6% were backpackers. Altogether, 36.9% samples were positive for protozoa, with Blastocystis hominis being the most common (26.6%) in samples, followed by Dientamoeba fragilis (18.7%), Giardia lamblia (3.0%) and Cryptosporidium spp (0.5%). The former two were dominant in all regions. In all cases but one, G. lamblia was acquired, but one were acquired in the Indian subcontinent (odds ratios 16.9; 95% confidence intervals: 1.9-148.3). Entamoeba histolytica was not detected. The demographic characterization of the 1359 non-travellers was comparable with the travellers. Among them D. fragilis was the most common followed by B. hominis, which was significantly less frequent compared among the travellers (16.7% vs 26.6%, P < 0.001). Average Cycle threshold values for each stool parasites were comparable between the two groups.
CONCLUSION
Among returning travellers with PAS, more than one-third were positive for gastrointestinal protozoa. A low rate of giardia was found and no E. histolytica while B. hominis followed by D. fragilis were the dominant findings. Further studies are required to better understand the role of these protozoa in PAS.
Topics: Cryptosporidiosis; Cryptosporidium; Entamoeba histolytica; Feces; Giardia lamblia; Giardiasis; Humans
PubMed: 35134178
DOI: 10.1093/jtm/taac011 -
Journal of Clinical Laboratory Analysis Mar 2016Current practices for ordering stool studies in patients with abdominal and gastrointestinal symptoms are not standardized. We hypothesized that an algorithm involving...
BACKGROUND
Current practices for ordering stool studies in patients with abdominal and gastrointestinal symptoms are not standardized. We hypothesized that an algorithm involving first-line use of a Cryptosporidium/Giardia combination antigen test and stricter use of ova and parasite (O&P) examinations would be clinically and cost effective.
METHODS
In this study, stool O&P test results for pediatric patients in Dallas, Texas, were reviewed. All results obtained between 2009 and 2012 were included. Patient charts were reviewed to determine test results, symptoms, treatment, travel, and past medical history. Using these data, a retrospective modeling study was done to evaluate the utility of a diagnostic algorithm that limits O&P testing to those patients who are immunocompromised or have travelled outside the United States.
RESULTS
Over the 3-year period of this study, we found that the prevalence of gastrointestinal parasitic disease in children was 1.9%. Analysis of the diagnostic algorithm for the judicious use of stool O&P showed that as much as 65% of testing may be unnecessary and could be eliminated.
CONCLUSIONS
Our findings show that the prevalence of pediatric gastrointestinal parasitic disease in Texas may be lower than expected. In addition, these data show that a diagnostic algorithm limiting O&P testing may be both clinically and cost effective in low-prevalence settings. However, such an algorithm would miss a significant number of infections due to Dientamoeba fragilis and Blastocystis hominis.
Topics: Animals; Child; Gastroenteritis; Humans; Intestinal Diseases, Parasitic; Ovum; Parasites
PubMed: 25545819
DOI: 10.1002/jcla.21829 -
Revista de Gastroenterologia Del Peru :... 2016Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder of uncertain etiology. Several studies have proposed the possible role of intestinal parasites... (Review)
Review
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder of uncertain etiology. Several studies have proposed the possible role of intestinal parasites in the pathogenesis of IBS. We aimed to summarize the epidemiological studies that describe a possible link between intestinal parasites and IBS, with special interest in endemic areas for intestinal parasitism such as South America. A comprehensive review of the literature was conducted by using the keywords: irritable bowel syndrome, intestinal parasites, protozoan infection, soil-transmitted helminths and South America. Giardia lamblia may cause IBS symptoms that can persist several years after effective treatment. Dientamoeba fragilis can cause IBS-like symptoms, but low sensitive parasitological techniques may fail to detect it. Entamoeba histolytica can cause a chronic non-dysenteric colitis, but several studies have failed to find an association with IBS. The role of Blastocystis hominis in IBS remains controversial. In addition, epidemiological studies evaluating the effect of soil-transmitted helminths in IBS are scant. Symptoms elicited by intestinal parasites may resemble to those in IBS, especially in endemic areas such as South America, where both the prevalence of IBS and intestinal parasitism are high. Whether these organisms are the cause or contributing factors in IBS remains a subject of study. Routine parasitologicalexamination of stools in individuals who full-fit the criteria for IBS should be included upon initial assessment in endemic countries.
Topics: Endemic Diseases; Humans; Intestinal Diseases, Parasitic; Irritable Bowel Syndrome; Risk Factors; South America
PubMed: 27409092
DOI: No ID Found -
Journal of Infection in Developing... Jan 2018Dientamoeba fragilis, an intestinal trichomonad, occurs in humans with and without gastrointestinal symptoms. Its presence was investigated in individuals referred to...
INTRODUCTION
Dientamoeba fragilis, an intestinal trichomonad, occurs in humans with and without gastrointestinal symptoms. Its presence was investigated in individuals referred to Milad Hospital, Tehran.
METHODOLOGY
In a cross-sectional study, three time-separated fecal samples were collected from 200 participants from March through June 2011. Specimens were examined using traditional techniques for detecting D. fragilis and other gastrointestinal parasites: direct smear, culture, formalin-ether concentration, and iron-hematoxylin staining. The presence of D. fragilis was determined using PCR assays targeting 5.8S rRNA or small subunit ribosomal RNA.
RESULTS
Dientamoeba fragilis, Blastocystis sp., Giardia lamblia, Entamoeba coli, and Iodamoeba butschlii were detected by one or more traditional and molecular methods, with an overall prevalence of 56.5%. Dientamoeba was not detected by direct smear or formalin-ether concentration but was identified in 1% and 5% of cases by culture and iron-hematoxylin staining, respectively. PCR amplification of SSU rRNA and 5.8S rRNA genes diagnosed D. fragilis in 6% and 13.5%, respectively. Prevalence of D. fragilis was unrelated to participant gender, age, or gastrointestinal symptoms.
CONCLUSIONS
This is the first report of molecular assays to screen for D. fragilis in Iran. The frequent finding of D. fragilis via fecal analysis indicated the need to include this parasite in routine stool examination in diagnostic laboratories. As the length of amplification target correlates to the sensitivity of PCR, this assay targeting the D. fragilis 5.8S rRNA gene seems optimal for parasite detection and is recommended in combination with conventional microscopy for diagnosing intestinal parasites.
PubMed: 31628834
DOI: 10.3855/jidc.9643 -
Turkiye Parazitolojii Dergisi Mar 2021Immunocompromised patients are at a greater risk of developing intestinal parasite infections. In this study, we examined the presence of and other intestinal protozoa...
OBJECTIVE
Immunocompromised patients are at a greater risk of developing intestinal parasite infections. In this study, we examined the presence of and other intestinal protozoa in stool samples of immunosuppressed patients.
METHODS
A total of 100 stool samples were obtained from patients receiving chemotherapy because of solid organ tumour with haematological malignancies and those receiving immunosuppressive treatment because of rheumatic diseases, organ transplant patients and patients receiving treatment for HIV-related infections. Stool samples were examined by using the native-lugol method in which the stool concentration, modified Kinyoun acid-fast and trichrome staining methods and parasite presence were analysed. The stool samples were also examined for the presence of and using an indirect fluorescent antibody method.
RESULTS
Intestinal parasites were detected in 12% of all patients. The distribution of intestinal parasites in patients were 7% spp., 2% spp. + , 1% spp. + , 1% spp. + and 1% spp. were detected in 4% of all patients by the IFAT method and in 8% of all patients by calcoflour staining method.
CONCLUSION
In our study, the most prevalent parasite detected in the immunosuppressed patients was spp. The pathogenesis of spp. remains to be controversial, and their role in immunocompromised patients continues to remain unknown. Although these rates detected in our study are similar to the prevalence in the normal population, it is important to study these microorganisms in immunocompromised patients in terms of the associated decreasing morbidity and mortality rates.
Topics: Blastocystis; Dientamoeba; Entamoeba; Feces; Giardia; Hospitals, University; Humans; Immunocompromised Host; Intestinal Diseases, Parasitic; Microsporidia; Prevalence
PubMed: 33685067
DOI: 10.4274/tpd.galenos.2020.6819 -
The Pediatric Infectious Disease Journal Apr 2021Dientamoeba fragilis in children has been associated with gastrointestinal symptoms, like abdominal pain and diarrhea. The mechanism underlying these symptoms in...
BACKGROUND
Dientamoeba fragilis in children has been associated with gastrointestinal symptoms, like abdominal pain and diarrhea. The mechanism underlying these symptoms in children with D. fragilis remains unclear. We hypothesized that concomitant microbial alterations, which have been described in other parasitic infections, may be associated with gastrointestinal symptoms in D. fragilis.
METHODS
In this case-control study performed in 2 centers, 19 children referred to a pediatrician because of gastrointestinal symptoms and with a positive fecal PCR for D. fragilis were included as cases. We included 19 healthy children as controls and matched for age and gender, selected from an existing cohort of 63 children. A PCR for D. fragilis was performed on fecal samples of the 19 controls to assess D. fragilis carriership in this asymptomatic group. Microbiota was analyzed with the IS-pro technique, and the intestinal microbiota composition and diversity were compared between the 2 groups.
RESULTS
Microbiota of children with D. fragilis and gastrointestinal symptoms did not significantly differ in terms of composition and diversity compared with controls, both on phylum and species level. In the asymptomatic controls, a positive fecal PCR for D. fragilis was found in 16 of 19 (84.2%).
CONCLUSION
Intestinal microbiota does not seem to play a key role in the presence of clinical symptoms in children with D. fragilis. The pathogenicity of D. fragilis and pathophysiologic pathways underlying the development of gastrointestinal symptoms remains yet to be clarified.
Topics: Abdominal Pain; Case-Control Studies; Child; Child, Preschool; Cohort Studies; Diarrhea; Dientamoeba; Dientamoebiasis; Feces; Gastrointestinal Diseases; Gastrointestinal Microbiome; Genetic Variation; Humans
PubMed: 33181781
DOI: 10.1097/INF.0000000000002975 -
Food Microbiology Oct 2017To investigate the prevalence of protozoan contamination by Giardia duodenalis, Cryptosporidium spp., Toxoplasma gondii and Cyclospora cayetanensis, in 'ready to eat'...
To investigate the prevalence of protozoan contamination by Giardia duodenalis, Cryptosporidium spp., Toxoplasma gondii and Cyclospora cayetanensis, in 'ready to eat' (RTE) salads on sale in Italy, 648 packages were purchased from industrial and local brands. Nine individual packages from each brand were collected per month, pooled and subjected to microscopy and molecular analyses. Microscopic examination of 864 slides detected Cryptosporidium spp. but also Blastocystis hominis and Dientamoeba fragilis. Molecular tools identified G. duodenalis assemblage A, Cryptosporidium parvum and Cryptosporidium ubiquitum, T. gondii Type I and C. cayetanensis. B. hominis and D. fragilis were also molecularly confirmed. The overall prevalence of each protozoan species was 0.6% for G. duodenalis, 0.8% for T. gondii, 0.9% for Cryptosporidium spp., and 1.3% for C. cayetanensis, while prevalence for B. hominis was 0.5% and for D. fragilis 0.2%. Microscopy and/or molecular tools revealed that 4.2% of the samples were contaminated by at least one protozoan species, and 0.6% of samples presented contamination by two protozoan species, with a number of oocysts ranging from 62 to 554 per g of vegetable matter for T. gondii, and 46 to 1.580 for C. cayetanensis. This is Europe's first large-scale study on the presence of protozoans in packaged salads, and shows that RTE sanitation processes do not guarantee a product free from protozoans of fecal origin.
Topics: Cryptosporidium; Cyclospora; DNA, Protozoan; Fast Foods; Food Contamination; Italy; Toxoplasma; Vegetables
PubMed: 28648295
DOI: 10.1016/j.fm.2017.06.006 -
Journal of Clinical Microbiology Nov 2021Despite the global use of rotavirus vaccines, vaccine breakthrough cases remain a pediatric health problem. In this study, we investigated suspected rotavirus vaccine...
Despite the global use of rotavirus vaccines, vaccine breakthrough cases remain a pediatric health problem. In this study, we investigated suspected rotavirus vaccine breakthrough cases using next-generation sequencing (NGS)-based viral metagenomics ( = 102) and a panel of semiquantitative reverse transcription-PCR (RT-qPCR) ( = 92) targeting known enteric pathogens. Overall, we identified coinfections in 80% of the cases. Enteropathogens such as adenovirus (32%), enterovirus (15%), diarrheagenic Escherichia coli (1 to 14%), astrovirus (10%), spp. (10%), parechovirus (9%), norovirus (9%), Clostridioides (formerly ) difficile (9%), Dientamoeba fragilis (9%), sapovirus (8%), Campylobacter jejuni (4%), and Giardia lamblia (4%) were detected. Except for a few reassortant rotavirus strains, unusual genotypes or genotype combinations were not present. However, in addition to well-known enteric viruses, divergent variants of enteroviruses and nonclassic astroviruses were identified using NGS. We estimated that in 31.5% of the patients, rotavirus was likely not the cause of gastroenteritis, and in 14.1% of the patients, it contributed together with another pathogen(s) to disease. The remaining 54.4% of the patients likely had a true vaccine breakthrough infection. The high prevalence of alternative enteropathogens in the suspected rotavirus vaccine breakthrough cases suggests that gastroenteritis is often the result of a coinfection and that rotavirus vaccine effectiveness might be underestimated in clinical and epidemiological studies.
Topics: Child; Feces; Humans; Prevalence; Real-Time Polymerase Chain Reaction; Rotavirus Vaccines
PubMed: 34586890
DOI: 10.1128/JCM.01236-21 -
Canadian Family Physician Medecin de... Dec 2017To determine the prevalence of intestinal parasites and rates of stool testing compliance, as well as associated patient characteristics, among newly arrived refugees at...
OBJECTIVE
To determine the prevalence of intestinal parasites and rates of stool testing compliance, as well as associated patient characteristics, among newly arrived refugees at the Mosaic Refugee Health Clinic in Calgary, Alta.
DESIGN
Retrospective chart review.
SETTING
Primary care clinic for refugee patients.
PARTICIPANTS
A total of 1390 new refugee patients at the clinic from May 1, 2011, to June 30, 2013.
MAIN OUTCOME MEASURES
Stool ova and parasite test completion and proportion of positive test results.
RESULTS
Of 1390 patients, 74.1% (95% CI 71.7% to 76.4%) completed at least 1 stool ova and parasite test. Among those completing tests, 29.7% (95% CI 26.9% to 32.6%) had at least 1 positive result. Patients aged 6 to 18 years were more likely to have positive test results (38.5%, 95% CI 32.2% to 45.0%) than patients aged 19 to 39 were, as were those last residing in Asia (36.4%, 95% CI 30.4% to 42.8%) or sub-Saharan Africa (30.9%, 95% CI 26.8% to 35.1%), compared with those arriving from the Middle East. and or were the most prevalent parasites. If and are excluded because of their lower potential to cause harm, the overall prevalence was 16.3%.
CONCLUSION
Given the high compliance of patients submitting stool ova and parasite tests and a high prevalence of positive test results in some refugee groups, targeted screening should be considered in newly arrived refugees at greater risk of intestinal parasites.
Topics: Adult; Animals; Canada; Feces; Female; Humans; Intestinal Diseases, Parasitic; Male; Middle Aged; Needs Assessment; Parasite Egg Count; Parasite Load; Parasites; Prevalence; Refugees; Retrospective Studies
PubMed: 29237648
DOI: No ID Found