[Intestinal parasites in food handlers region of Tunis: 8502 study stool samples [1998-2008]]

The food handlers control is one of the major measures of the National program against intestinal parasitoses in Tunisia. The collected data allow regular updates of the prevalence and profile of the involved parasitic species and note possible evolutions in time. From 1998 to 2008, 8502 stool samples of food handlers working in Tunis area were examined in the laboratory of Parasitology, Pasteur Institute of Tunis. The mean prevalence of intestinal parasites was 13.5% [1152 positive samples]. The protozoa were the most detected parasites [93% of the species observed]. Among the pathogenic or potentially pathogenic parasites, Dientamoeba fragilis [15.5%] and Giardia intestinalis [7.6%] were the most frequently encountered. Entamoeba [E.] histolytica/dispar was diagnosed in 41 subjects [a prevalence of 0.5%]. Hymenolepis nana was the most frequent helminth [4.5% of the whole parasites]. Therapeutic failures were noticed in 43.8% of infection by this cestode because of the lack of the appropr iate antihelminthic. The identification using PCR of cysts and/or vegetative forms of E. histolytica/dispar revealed the exclusive presence of E. dispar

Contribution of the real time PCR in antenatal diagnosis of congenital toxoplasmosis

The antenatal diagnosis of congenital toxoplasmo-sis rests in Tunisia on ultrasonography coupled with biological explorations. Among these explorations the search of Toxoplasma gondii by means of real time PCR in amniotic fluid is the examination of choice. We report the results of 33 parturients for which the biological examinations allowed to retain the notion of perigravidic or per-gravidic toxoplasmic infection. They were 13 patients having a seroconversion during the pregnancy, 19 having anti-toxoplasmic IgM with a low or intermediate index of avidity and a patient having presented a symptomatic anteconceptional primary infection. The ADN was extracted by means of the Kit [Qiagen]. Genie amplification by PCR TaqMan targeted a portion of 71 pairs of bases of the Bl gene. The PCR was positive among 9 patients [27,3%]. They were a patient having presented a symptomatic toxoplasmosis during the pregnancy, 4 patients having consulted only in the 2nd quarter and for which the index of avidity was intermediate and 4 patients having presented seroconversions of 1st [n=l] of 2nd [n=2] or 3rd trimester. Among these patients, 2 had a medical interruption of pregnancy. The 7 others were put under pyrimethamine sulfadiazine. The neonatal assessment practised at 5 new-born babies was negative in all the cases. The PCR was negative for 24 patients. 18 pregnancies were followed. The neonatal serology was negative. The follow-up of 13 newborn child showed the disappearance of the anti-toxoplasmic IgG between the 6th and 12th month

[Value of screening for intestinal and urinary parasites in non-resident permanent students in Tunisia]

In order to fight digestive and urinary parasitoses, a national program of surveillance has been founded. The screening of these parasitoses among the non permanent resident students in Tunisia [ENRPTS] is one of the main actions of this program. Among 2560 ENRPTS tested in the laboratory of Parasitologie of Institut Pasteur of Tunis, between 1998 and 2002, 674 were infected by parasites, which represents a global prévalence of 26.3%. The intestinal protozoa constitute the majority of parasites identified [87.4%]. Entamoeba histolytica has been isolated in 89 cases, essentially from students from tropical African countries. Urinary bilharziosis has been diagnosed in 25 cases. These results confirm the utility of the control of the ENRPTS. The precocious tracking permits to avoid the introduction and the dissemination of parasites already absent or rare in our country