Inflammatory bowel disease: pathogenetic mechanisms

Abstract Significant progress has been made in the understanding of ulcerative colitis and Crohn's Disease over the last decades.Despite this, the pathogenesis of inflammatory bowel disease (IBD) remains obscure, especially at molecular level. Various contributing factors have been identified so far, but their respective contributions are not entirely clear cut. In this review, we focus on the genetic and environmental factors linked with IBD pathogenesis. We also explore the role of pro-inflammatory cytokines on the molecular pathophysiology of IBD

Prevalence and Intensity of Intestinal Parasitic Infections and Factors Associated with Transmission among School going Children

Objective: To determine the prevalence and intensity of intestinal parasitic infections and factors associated with transmission among primary school going children.Design: Cross-sectional descriptive study.Setting: Muthithi Location situated in Murang'a County; Kenya.Subjects: Multi-stage sampling was used to select 418 children. Stool specimens were examined using Kato-katz technique to determine the number of helminthes eggs per gram of stool and formol ether concentration technique to detect the different protozoan cysts. Data were analysed using Statistical Package format (SPSS version 20.0). Pearson's Chi-square test was used to establish the association between categorical variables. Multivariate analysis was used to determine the factors associated with the infections.Results: The study established that 53.8% (225 out of 418) were infected with one or more of intestinal parasite. Five species of helminthes were identifiedwith prevalence of 11.5%; the predominant helminth parasite identified was Ascaris lumbricoides 9.1% (38 cases). Intestinal protozoan identified in this population was Entamoeba histolytica with prevalence of 42.3% (177 cases). The factors established to be independently associated with presence of intestinal parasitic infection were: age 11-15 years P0.001; use of plain water for hand washing P0.05; eating food without spoon P0.05; consuming raw vegetables P0.001; untrimmed finger nails P0.001 and source of drinking water [river P0.001 and mixed sources (river; well and tap) P0.05]. Conclusion: This study revealed that intestinal parasites still pose a public health problem to school going children. Despite lack of school based deworming programme in this area; treatment combined with health education and other interventions in school age children is recommended as a way of controlling transmission

Indications and Indings at Colonoscopy in Ilorin; Nigeria

Colonoscopy is a safe and effective means of visual inspection of the large bowel from the distal rectum to the caecum. It may be carried out for diagnostic and or therapeutic reasons. There is a paucity of data on this procedure in Nigeria. We; therefore; determined the indications; findings; and diagnostic yield in Nigerians at colonoscopy. Materials and Methods: This was a hospital-based cross-sectional study carried out at the Endoscopy unit of Crescent hospital; Ilorin from January 2010 to May; 2012. The endoscopy register was reviewed; and the biodata; indications and colonoscopic findings were recorded on a pro forma. Results: A total of 103 patients had colonoscopy. Seventy (68.0) were males while 33 (32.0) were females. The indications for colonoscopy were rectal bleeding 41 (39.8); suspected colon cancer 32 (31.1); chronic constipation and chronic diarrhoea nine each (8.7); abdominal/anal pain five (4.9); suspected anorectal cancer and enterocutaneous fistula two each (1.9); faecal incontinence; occult gastrointestinal bleeding; post-colostomy for Hirschsprung disease one each (1.0). Endoscopic findings were normal findings 21 (20.4); diverticulosis 17 (16.5); polyps 16 (15.5); haemorrhoids 16 (15.5); anorectal cancer 13 (12.6); angiodysplasia 12 (11.7); colon cancer eight (7.8); colitis 7 (6.8); anorectal ulcer 4 (3.9); anal warts two (1.9); anal fissure; caecal tumour; faecal impaction and proctitis one each (1.0). The diagnostic yield was 79.6. Conclusions: The commonest indication for colonoscopy was rectal bleeding; while the most frequent pathology was diverticulosis. The diagnostic yield was high

Prevalence and Pattern of Bacteria and Intestinal Parasites among Food Handlers in the Federal Capital Territory of Nigeria

Background: In developing countries; biological contaminants largely bacteria and other parasites constitute the major causes of food-borne diseases often transmitted through food; water; nails; and fingers contaminated with faeces. Accordingly; food-handlers with poor personal hygiene could be potential sources of infections by these micro-organisms. Objective: This study was aimed at determining the prevalence and pattern of bacteria and intestinal parasites among food handlers in the Federal Capital Territory. Materials and Methods: The study was a descriptive one in which a multistage sampling technique was employed to select 168 food handlers of various types. Subjects' stool; urine; and fingernail analyses were carried out and the result scientifically scrutinized. Results: Fingernail bacteria isolates include: E. Coli (1.8); coagulase-negative staphylococcus (17.9); Staphylococcus aureus(7.1); Klebsiella species (2.4); Serratia species (1.2); Serratia species (1.2); Citrobacter species (1.2); and Enterococcus species (1.8). The subjects' stool samples tested positive: For A. lumbricoides (14.9); T. trichuria (1.8); S. starcolaris (3.0); E. histolytica (10.7); G. lambilia (1.8); S. mansoni (1.2); and Taenia species (4.8). Furthermore; 42.3 and 15.5 of the stool specimen tested positive for Salmonella and Shigella species; respectively. Conclusion: Food establishments should screen and treat staff with active illness; and regularly train them on good personal and workplace hygiene practices

Prevalence and Predisposing Factors Regarding Intestinal Parasitic Infections among Rural Primary School Pupils at Minia Governorate; Egypt

About 400 million school-age children are infected with roundworm; whipworm and hookworm worldwide. This study aims to assess prevalence of parasitic infections among rural primary school pupils at Minia Governorate; Egypt; and to identify relevant predisposing factors of the school and pupils to intestinal parasitic infections. A total of 264 pupils out of 1053; aged 6-12 years; were randomly selected for parasitological investigation and the school was inspected on site for sanitary facilities and conditions of hygiene; as well as the conditions of hygiene of the pupils. The pupils were examined for ova; cysts and/or larvae of intestinal parasites using direct wet mount and formal-ether concentration techniques. Inspection of sanitary facilities and the conditions of hygiene of the school; as well pupil's conditions of hygiene; were carried out through observation checklists. Findings revealed the following intestinal parasites: Entamoeba coli (in 19.3of pupils); Ascaris lumbricoides (3.8); Hymenolepiasis nana (12.5); Enterobious vermicularis (5.7) and Giardia lamblia (12.5); with varying percentages between male and female pupils; and a highly statistical association between pupil sex and type of parasites (P0.001). Unapproved sanitary facilities and conditions of hygiene of the school and pupils were observed. Many intestinal parasitic infections among the primary school pupils were found. Unapproved and low inventory school sanitary facilities were observed; in addition to poor conditions of hygiene of pupils which may play a crucial role in these infections. The school facilities and sanitary conditions; especially the quality of water in the toilets; should be improved. Pupils and school personnel have a real need for health education about modes of transmission and preventive methods of intestinal parasitic infections

Prevalence and Predisposing Factors Regarding Intestinal Parasitic Infections among Rural Primary School Pupils at Minia Governorate; Egypt

About 400 million school-age children are infected with roundworm; whipworm and hookworm worldwide. This study aims to assess prevalence of parasitic infections among rural primary school pupils at Minia Governorate; Egypt; and to identify relevant predisposing factors of the school and pupils to intestinal parasitic infections. A total of 264 pupils out of 1053; aged 6-12 years; were randomly selected for parasitological investigation and the school was inspected on site for sanitary facilities and conditions of hygiene; as well as the conditions of hygiene of the pupils. The pupils were examined for ova; cysts and/or larvae of intestinal parasites using direct wet mount and formal-ether concentration techniques. Inspection of sanitary facilities and the conditions of hygiene of the school; as well pupil's conditions of hygiene; were carried out through observation checklists. Findings revealed the following intestinal parasites: Entamoeba coli (in 19.3of pupils); Ascaris lumbricoides (3.8); Hymenolepiasis nana (12.5); Enterobious vermicularis (5.7) and Giardia lamblia (12.5); with varying percentages between male and female pupils; and a highly statistical association between pupil sex and type of parasites (P0.001). Unapproved sanitary facilities and conditions of hygiene of the school and pupils were observed. Many intestinal parasitic infections among the primary school pupils were found. Unapproved and low inventory school sanitary facilities were observed; in addition to poor conditions of hygiene of pupils which may play a crucial role in these infections. The school facilities and sanitary conditions; especially the quality of water in the toilets; should be improved. Pupils and school personnel have a real need for health education about modes of transmission and preventive methods of intestinal parasitic infections

Intestinal Parasitic Infections among Under-Five Children and Maternal Awareness about the Infections in Shesha Kekele; Wondo Genet; Southern Ethiopia

Background: Few studies have reported the magnitude of intestinal parasitic infections among under-five children in tropical countries. Moreover; there is little information on maternal awareness about intestinal parasitosis. Objective: To determine the prevalence of intestinal parasitosis among under-five children; and assess maternal awareness about it in Shesha Kebkele; Wondo Genet; Southern Ethiopia. Methods: A cross-sectional study involving 288 under-five children was conducted and stool samples were collected and examined for intestinal parasites using Kato-Katz and formol-ether concentration methods. In addition; a total of 130 mothers of under-five children were interviewed regarding their awareness about intestinal parasitic infections. Results: Of the 288 children; 245 (85.1) were found infected with one or more intestinal parasites. The prevalence of Trichuris trichiura; Schistosoma mansoni and Ascaris lumbricoides; hookworm; and Hymenolepis nana infections as determined by Kato-Katz were 74.7; 37.2; 25.7; 5.9; and 4.5; respectively. On the other hand; the prevalence of Strongyloides stercoralis; Giardia lamblia; Entamoeba histolytica/dispar; and Entamoeba coli infections as determined by formol-ether concentration method were 0.69; 13.2; 0.35; and 2.1; respectively. Most mothers were reasonably aware of the mode of transmission of ascariasis; amoebiasis and giardiasis while they had very limited knowledge of bilharzia and hookworm transmission. Almost all of the respondents reported that infections with intestinal parasites could cause retardation of growth and death in children unless treated. Conclusion: Intestinal parasitic infections were prevalent in varying magnitude among under-five children in Wondo Genet area; Southern Ethiopia. Mothers in the study area had a fairly good knowledge of the impact of infections but limited knowledge of the mode of transmission of intestinal parasitic infections. Improvement of sanitation and health education are required besides preventive chemotherapy to control worms (except for schistosomiasis in under-five which need treatment on an individual basis) and other intestinal parasitic infections in the area. (Ethiop. J. Health Dev. 2010;24(3):185-190)

Intestinal Parasites in Children Attending Day Care Centers in Jos; Central Nigeria

It is estimated that 3 billion people world wide are infected with intestinal parasites. Morbidity is highest amongst children; infestation causes a threat to the growth and development of the child. The study aims to determine the prevalence of intestinal helminthes in children attending day care centers in Jos metropolis. Ten day care centers were randomly selected from the total number of day care centers. From each centre children were randomly selected for study. Parents of selected children completed a structured questionnaire and stool specimens of the children were analyzed using iodine and saline preparation. : Two hundred and twenty-one children (57.8) of the 384 children studied had intestinal parasites. Ascaris lumbricoides; Ancylostoma duodenale and Trichuris trichura were the commonest parasites found. The relationship between intestinal parasite infestation and diarrhea in past 2 months (X =19.5; df = 1; p 0.001 OR

The impact of Health Education on the Prevalence of Faecalorally Transmitted Parasitic Infections among School Children in a Rural Community in Cameroon

Intestinal parasitic infections (IPIs) are among the most prevalent infections in humans in developing countries and are responsible for considerable morbidity and mortality. Most of them are transmitted by the faecal-oral route. In general; situations involving unhygienic conditions promote transmission [1]. These infections are globally endemic and have been described as constituting the greatest single worldwide cause of illness and disease [2]. They are associated with poor hygiene and lack of access to safe water [3]. Food handlers play an important role in their transmission [4]. Ignorance is also a contributing factor to transmission especially among people living in rural areas where level of awareness is relatively low [5]. Like the majority of the parasitic diseases; these infections are influenced by human behaviour especially their hygienic practices; and failure to take advantage of available screening services or comply with treatment [6]. In Cameroon; IPIs are recognized by the Ministry of Public Health to be an important public healthproblem ranking second to malaria [7]. There has been periodic de-worming in most endemic areas in the country; but studies suggest that there is a high rate of re-infection [8]. A change in hygienic behaviour is advocated to reduce these infections. Health education; especially in rural communities where the level of awareness is quite low and sanitary conditions poor [9] could contribute to the reduction of the prevalence of infection: This issue is addressed in this study. Methods : Ten villages in the South-West Region of Cameroon were grouped in pairs. The grouping was based on the fact that each pair was made of 2 rural communities sharing the same social; geographical and climatic features. The pair comprising Kake II and Barombi-Kang was randomly selected among five. An intervention study was conducted from January 2010 to July 2010 in two primary schools in the 2 selected villages (Kake II and Barombi-kang). They are separated by a distance of about 30 Km. Theformer village served as the experimental school; whilst the latter served as the control (random selection). The two villages are typical African rural communities. There is no pipe-borne water; electricity; or drainage system. Each of the villages has a government primary school; but no secondary school. The inhabitants are farmers practicing peasant farming and petty trading. Prior to the start of this study; permission was sought from the school authorities and parents were informed about the purpose; objectives and benefits of the study; as their involvement was a key factorfor its success. They were made to understand that it was not a school obligation to take part in the study; neither was it a prerequisite for accessing publicly available health facilities. Written informed parental consent forms were distributed one week prior to the beginning of sample collection. An ethical clearance was obtained from the Regional Delegation of Health of the South West Region in Buea (Ref.R11/MPH/SWP/RDPH/FP-R/5341/94)

Prevalence of Intestinal Worm Infections among Primary School Children in Nairobi City; Kenya

Objective: The main objective of the study was to determine the prevalence of total; single and multiple intestinal worm infections among the primary school children in Nairobi City. Methods: A cross-sectional descriptive study was used to determine the status of intestinal worm infections whose subjects were drawn from eight city administrative divisions. Proportional random sampling method to select forty five (45) schools out of 320 public; private and non-formal schools was used. Using the school enrolment register for standard 3 and 4; fifty (50) pupils per school were selected to participate in the study. Quantitative data from the study subjects were collected by use of a structured questionnaire. In addition; stool specimens were collected from each study subject and examined by Kato-Katz laboratory method. Results: The four intestinal worms investigated constituted a total prevalence of 12.9. This prevalence was found to be lower than that in two other previous studies. A. lumbricoides had the highest prevalence and S. mansoni had the lowest. Prevalence of single worm infections constituted 8.6of the total prevalence. Differences in prevalence between males and females were observed only with respect to T. trichiura and hookworm species. Fourteen to sixteen (14-16) and 11-13 years of age groups had the highest total prevalence of 47and 30.6respectively. Differences in prevalence were not found among the school categories with exception of T. trichiura infections. Conclusion: Prevalence of total; single and multi- ple infections showed a downward trend when compared to the previous studies with Ascaris lumbricoides persisting with the highest prevalence

Opportunistic and other Intestinal Parasitic Infections in Aids Patients; HIV Seropositive healthy carriers and HIV seronegative Individuals in SouthWest Ethiopia

Background: Human Immunodeficiency Virus (HIV) infection leads to acquired immunodeficiency syndrome (AIDS) and major causes of morbidity and mortality of such patients are opportunistic infections caused by viral; bacterial; fungal and parasitic pathogens. Objectives: To determine the magnitude of opportunistic and non-opportunistic intestinal parasitic infections among AIDS patients and HIV positive carrier individuals Method: Cross-sectional study was conducted among AIDS patients; HIV positive healthy carriers and HIV negative individuals in Jimma University Hospital; Mother Theresa Missionary Charity Centre; Medan Acts Projects and Mekdim HIV positive persons and AIDS orphans' national association from January to May; 2004. Convenient sampling technique was employed to identify the study subjects and hence a total of 160 subjects were included. A pre-tested structured questionnaire was used to collect socio-demographic data of the patients. Stool samples were examined by direct saline; iodine wet mount; formol-ether sedimentation concentration; oocyst concentration and modified Ziehl-Neelsen staining technique. Results: Out of 160 persons enrolled in this study 100(62.5) (i.e. 65 male and 35 female) were infected with one or more intestinal parasites. The highest rate 36(69.2) of intestinal parasites were observed among HIV/AIDS patients; followed by HIV positive healthy carriers 35 (61.4) of and HIV negative individuals (29(56.9). Isospora belli 2(3.9); Cryptosporidum parvum 8(15.4); Strongyloides stercoralis 6(11.5) and Blastocystis 2(3.9) were found only in HIV/AIDS groups Conclusion: I. belli; C. parvum; S. stercoralis and Blastocystis are the major opportunistic intestinal parasites observed in HIV/AIDS patients. Therefore; early detection and treatment of these parasites are important to improve the quality of life of HIV/AIDS patients with diarrhoea

Perforation traumatique du grele et engagement occasionnel du taenia saginata : a propos de 2 observations. [Lettre]

L'engagement occasionnel de parasites a travers une breche intestinale; en dehors de l'ascaris; est un fait assez rare au Cameroun. La presence intraperitoneale du taenia saginata confirme l'hypothese d'une utilisation accidentelle par le parasite d'une perforation pre-existante. Cette presence ne modifie pas le cours de l'intervention. Le traitement antiparasitaire post-operatoire complete la destruction parasitaire mecanique peroperatoire

Les protozooses intestinales: rappel parasitologique et distribution geographique au Senegal

Les protozooses intestinales sont des affections dues a la presence dans le tube digestif d'animaux unicellulaires; parasites ou saprophytes. Parmi elles; l'amibiase et a moindre degre la giardiase; ont ete longtemps les plus importantes. Mais depuis l'avenement du SIDA; certaines coccidioses intestinales comme la cryptosporidiose et l'isosporose occupent une place preponderante par leur frequence et leur gravite chez les sujets porteurs du virus HIV

Survey of intestinal parasites in Bure area; Illubabor; Southern Ethiopia

Population census and survey of intestinal parasites were conducted in October 1987 in Bure area; Illubabor. Altogether; there were 1063 households comprising 4119 residents; of whom 86.3 percent (3;555) were indigenous and 13.7 percent (564) were newly arrived settlers. Four villages among nine were taken randomly; and all individuals living in a 10 percent sample of households picked by systematic sampling underwent investigation for intestinal parasites. Of these; 8.5 percent (301) indigenous and 13.7 percent (77) settlers provided stool specimens which were collected; processed and examined by the formol-ether-concentration technique. Positive rates for one or more parasites turned out to be 82.7 percent and 67.5 percent among the former and latter respectively; the difference being statistically significant (p0.05). In both population groups combined; ascaris lumbricoides; hookworms; and Entameba coli were the predominant parasites. Multiple infection was common comprising 48.2 percent in indigenous and 53.8 percent in the settler population groups. Preventive and control measures are suggested

Intestinal parasitism among Jiren elementary and junior secondary students in South-Western Ethiopia

A cross-sectional survey on intestinal parasites was conducted in Jiren Elementary et Junior Secondary School; Jimma. A total of 301 stool specimens were collected by systematic random sampling from a total of 1626 population. The stools were examined for ova and parasites by direct saline suspension (wet mount) method. The result showed high prevalence rate of parasitic infection (68.4 percent). A total of 10 species were identified among which Ascaris lumbricoides was the leading (52.2 percent) followed by Trichuris trichiura (18.6 percent); while Schistosoma mansoni was the least (0.3 percent). No statistically significant difference was seen in the prevalence rate of intestinal parasites by sex; (P.0.01). However; there is significant association between water source for drinking and parasitoses; (P;0.01); where; unprotected source of water favouring infection of all infected. Most of the infected children (92.2 percent) were asymptomatic. It is suggested that affective PHC strategies; such as health education in schools; expansion of school health services and chemotherapy with broad spectrum antihelminthics should be implemented

"The in vitro antibacterial activity of ""tazma mar"" honey produced by the stingless bee"

"In 1993 the antibacterial effect of tazma mar was evaluated on Salmonella typhimurium; Salmonella enteritidis; Escherichia coli; Bacillus cereus and Staphylococcus aureus at concentrations of 10; 15 and 20 percent in Brain Heart Infusion Broth. In the absence of ""tazma mar""; the Gram negative test strains reached counts greater than 10 the power of 8 cfu/ml within 12 hours and maintained the count until 48 hours. At 10 percent concentration; S. typhimurium; S. enteritidis and E. coli were not inhibited until 12 hours; but thereafter their number declined faster and complete inhibition was observed at 48 hours. Retarded growth and inhibition was noted at 15 percent and 20 percent concentrations. A more marked growth retardation and inhibition at all concentrations was noted on B. cereus and Staph. aureus. ""Tazma mar"" may be effective to treat food-borne infections at low concentrations."

Soil transmitted helminth infections in three isolated communities in Sierra Leone

The prevalence and intensity of soil transmitted helminths (STH) in three isolated communities in Sierra Leone; Blama (near Bo); York Island Southern Province; and Magbil (Port Loko District) Northern Province was investigated in 1993. Trichuris trichuria prevalence was found to vary most both between and within sites being significantly higher amongst children 5 to 10 years-old. It was the only STH to show a variation with sex at the most heavily infected community; Magbil; where prevalence was significantly higher in males than females. There was no significant difference in overall prevalence of A. lumbricoides and hookworm between the sites. The prevalence and intensity of all three STH peaked either in the 5 to 10; or the 10 to 20 year olds at all three sites

L'actualite sur le traitement des parasitoses intestinales

Les parasitoses intestinales sont frequentes en milieu tropical du fait des conditions socio-economiques et de l'hygiene generale defectueuse. Le medecin; dans sa pratique courante; fait face a ces differentes pathologies. Ce texte presente donc l'attitude therapeutique que doit adopter le medecin face aux parasitoses intestinales les plus frequemment rencontrees

Intensity of intestinal parasite infestation in a small farming village; near Lake Tana; Ethiopia

Of the 806 people in Gebaba Village; 192 were examined for intestinal parasites. The overall prevalence was 61 per cent. The mean intensity of infestation for A. lumbricoides generally fell with age. Of the total nematode egg counts; 41 per cent was harboured by children below 10 years of age. The cure rate with a single dose of levamisole (Ketrax) for A. lumbricoides was 94 per cent and for T. trichiura and Hookworm 100 per cent. The study has an important implication in understanding the epidemiology of intestinal parasites and in the design of community based control programmes