Comparison between blood smear, histidine-rich protein-2 immunochromatographic test [HRP2-ICT] and nested PCR in malaria diagnosis of clinically suspected cases, Jazan, KSA

Malaria is a major health problem. The efficacy of treatment depends on its early diagnosis using rapid effective diagnostic tests. Correct diagnosis is urgently needed to reduce mortality and morbidity and also to reduce wastage of costly drugs. Comparison of microscopic blood smear examination, with the P. falciparum histidine rich protein 2 immunochromatographic test [HRP2-ICT] and the nested polymerase chain reaction [PCR] in detection of malarial infection in clinically suspected patients. A total of 91 patients attending Jazan General Hospital, Jazan KSA, complaining of a short febrile illness or prolonged undiagnosed pyrexia were investigated for harboring malaria parasites by microscopic Giemsa- stained blood smears, HRP2-ICT and nested PCR. The diagnostic performance of these methods was calculated. Out of the 91 clinically suspected malarial cases, 23 [25.3%] were positive for Plasmodium infection using microscopy, while HRP2-ICT and PCR detected 25 [27.5%] and 29 [31.9%] positive cases, respectively. Patients diagnosed by PCR proved to be 27 [93.1%] P. falciparum-infected and 2 [6.9%] P. vivax-infected. The differences in detection rates of these diagnostic tests were statistically significant [P<0.001]. Sensitivities of PCR, HRP2-ICT and blood smears were 97%, 83% and 77%, respectively. The three methods gave a specificity of 100%. Additionally, HRP2-ICT proved to be more in accord with PCR [K;= 0.8 versus 0.7] than the blood smear. Clinical diagnosis of malaria should not be relied on. Using antigen detection tests and PCR techniques in addition to microscopic blood examination will help to diagnose malaria cases accurately

Molecular diagnosis and genotyping of Dienlamoeba fragilis by polymerase chain reaction compared to microscopy and culture

The diagnosis of D. fragilis by microscopic identification of the parasite in stool is time consuming and relatively insensitive. To evaluate microscopy, culture and PCR for detection of D. fragilis in stool samples and to identify the genotypes of D. fragilis isolates among the study population. A total of 82 fresh human fecal samples were examined by microscopy using Wheatley's trichrome permanent staining, culture using the modified Boeck and Drbohlav medium and PCR targeting the small subunit [SSU] rRNA gene. Additionally, the existence of genetic variation among D. fragilis isolates [proved positive by PCR] was examined by restriction fragment length polymorphism analysis. PCR detected 25 isolates [30.5%], MBD culture detected 24 isolates [29.3%], while microscopy detected 8 isolates [9.8%]. Sensitivities of PCR, culture and microscopy were 92.6%, 88.9% and 29.6%, respectively. The agreement between PCR and culture results was substantial [KA=0.86]. PCR followed by RFLP analysis revealed the existence of two genetic variants among 25 D. fragilis isolates. Genotype I predominated in 23 [92%] samples, while the remaining two isolates corresponded to genotype II. It is recommended to use culture for routine diagnosis of D. fragilis in suspected gastrointestinal cases. Two genetic variants of D. fragilis existed in the Egyptian isolates

In vitro and in vivo effects of Quillaja saponaria on Blastocystis hominis isolates

Blastocystis hominis is a protozoan parasite that inhabits the human intestinal tract. Various epidemiological surveys have recorded 50-60% prevalence in developing countries. Until now, the most commonly recommended drug is metronidazole [MTZ] which can cause undesirable side effects and failures in treatment. To investigate the in vitro and in viva effects of Quillaja saponaria [QS] against clonal cultures of B. hominis and to demonstrate its implemented ultrastructural changes. Two fresh stool isolates of B. hominis were processed for in vitro cultivation using Jones media. In comparison to MTZ, different concentrations of QS were added to assess its lethal dose; QS [500 micro g] was used to assess programmed cell death for both isolates, using transmission electron microscopy [TEM]. Experimental infection of rats was performed to assess QS induced intestinal histopathological changes as compared to treatment with MTZ. With isolate I. QS [1000 micro g/ml] produced a high significant reduction [P

Apolipoprotein E4 effect on development and cognitive function in giardia-infected children

Parasitic infections can seriously affect child development and cognition while the treatment is easy and cheap. To elucidate apolipoprotein [ApoE] and neurodevelopment in children with Giardiasis and the role of ApoE isoforms in childhood cognition and infant development. The present study was performed on 75 Giardia-infected patients [1-9 years] and 45 healthy children control group of similar age and sex.They were subjected to anthropometric measurements. cognitive functioning. developmental assessments and determination of ApoE allelic forms. ApoE genotypes frequency distribution in the studied children was 6. 8, 4, 42, 27 and 33 for E2/2, E2/3. E2/4, E3/3. E3/4 and [4/4, respectively. There were no significant differences regarding demographic and anthropometric measurements as well as cognitive function between ApoE4 carrier and non carrier in children above 4 years; but their scores of performance, part of the intelligence test, and of the frill scale IQs proved to be at the lower normal level. Meanwhile, highly significant differences were observed between ApoE4 carrier and minim carrier regarding developmental assay in children below 4 years. The ApoE4 isoforms have a protective role on cognitive development in children below 4 years sufferring from sole Giartia infection. So, children with ApoE4 negative genotypes should be notified for their susceptibility to cognitive impairment after diarrhea in early infancy and childhood and are advised for careful follow up

Comparison between trichmonas vaginalis symptomatic and asymptomatic isolates effects in intravaginally infected rats

In this study, histopathological and immunohistochemical changes of the posterior vaginal fornix's and upper portion of the vagina were compared on rats infected with symptomatic and asymptomatic human isolates. Eighteen symptomatic and asymptomatic female isolates were used [nine/ each]. Two groups of infected female rats were included in this study [3 rats /isolate]. The results showed that there were no differences between symptomatic and asymptomatic isolates in histopathological changes; T. vaginalis of both isolates adhered to PAS epithelial cells at the surface and traversed under these cells. Both isolates were PAS and cathepsn D positive. By scanning electron microscopy many of T. vaginalis of the isolates adhered to microvilli of the epithelium cells in the same manner. Transmission electron microscopy proved that both isolates used the pseudopodia to adhere to the vagina upper part cells. The experimental infections did not differentiate between symptomatic and asymptomatic human isolates regarding histopathological and immunohistochemical changes

Prevalence and clinical features of Dientamoeba Fragilis infections in patients suspected to have intestinal parasitic infection

The present study was conducted to determine the prevalence and clinical features of dientamoebiasis in patients presumed to be infected with intestinal parasites. A total of 168 patients were examined for D. fragilis using microscopy [after Wheatley's trichrome staining] and culture [using modified Boeck and Drbohlav's medium] D. fragilis trophozoites were detected in 15 samples [8.9%] examined using trichrome staining and in 50 samples [29.8%] by culture method. Other enteric parasites were common in the study population as 48.8% of patients [82/168] were found harboring intestinal parasites. Blastocystis hominis was the most common, identified in 33.3% [56/168] of the samples. Giardia lamblia was detected in 17.9% [30/168] and E. histolytica/E. dispar in 11.9% [20/168]. The symptoms most frequently encountered were diarrhea, abdominal pain and weight loss and fatigue. Diarrhea and abdominal pain were significantly more frequent in patients with dientamoebiasis compared to non pathogenic cases [P<0.05]. Diarrhea was 38.5% of patients infected with D. fragilis compared to 50% of patients infected with G. lamblia, while abdominal pain was encountered with D. fragilis in 41% compared to 33.3% with G. lamblia. These differences were insignificant [P>0.05]

Cervical intraepithelial neoplasia [CIN] and Trichomonas vaginalis infection as revealed by polymerase chain reaction

The impact of sexually transmitted diseases [STDs] on the development of cervical intraepithelial neoplasia [CIN] has been increasingly recognized over the last 25 years. The role of bacterial vaginosis [BV] is the focus of several current investigations, not only in the genesis of CIN but also in the development of other gynecological and obstetric complications. Out of 150 women with vaginitis, 46 were diagnosed as T. vaginalis infection by different methods: wet mount, In-Pouch TV culture and PCR. Pap smear showed that 10 smears had atypical squamous cells of undetermined significance [ASCUS], 2 smears had atypical squamous cells of high grade [ASC-H], 8 smears had squamous intraepithelial lesions of low-grade [SIL-L] in the form of mild dysplasia, 4 smears showed squamous intraepithelial lesions of high-grade [SIL-H] in the form of moderate to severe dysplasia and carcinoma in-situ. So, the early detection and treatment of symptomatic and asymptomatic trichomoniasis minimize the complications of cervical neoplasia