ABSTRACT
A cross sectional study was conducted to determine the extent of intestinal parasitic infection and parasitic causes of diarrhea at a village in Giza governorate. Random sample of houses were chosen from which a total of 202 faecal specimens of preschool age children were collected, clinical history taking and abdominal ultrasonograghic examination were done to them. Evaluation of housing conditions was done. Thirty cases of diarrhea were included in the study to address the parasitic causative agents and to evaluate different parasitological techniques for detection of protozoan infection. Regular stool samples were examined using direct smear, Merthiolate Iodine Formaldehyde and Kato-Katz thick smear techniques. Diarrheic stool was examined using direct smear, modified Ziehi Neelsen, safranin, phenyl auramine staining and coproantigen detection ELISA techniques. The results showed that preschool children were infected by different types of parasites and protozoa. Schistosomiasis and ancylostomiasis were absent. The over all infection rate of intestinal parasites was about 18.8%. Boys infected were insignificantly higher than girls. Infection rates of H. nana and G. lamblia were the highest among other parasites [5% for each infection and 2.5% for the coinfection by the two parasites]. Strongloides stercoralis infection was exceptionally high [3.0%]. Pin worm infestation rate was 17,3%. Cats were the most responsible animal in transmission of infection. The most presenting symptom was abdominal, colic. Ultrasonographic positive cases were 13 [6.4%]; 12 cases with mild splenomegaly and one case with fatty liver. Examination of diarrheic stool samples showed that safranin staining technique could diagnose the case of cyclospora. Modified ZN could diagnose C. parvum. Safranin staining was more efficient than ELISA coproantigen detection in diagnosing E. histolytica and G lamblia infections. Laboratory doctors and clinicians should make use of the suitable techniques in diagnosing cases of parasitic diarrhea in children. Preschool health programs should include training of laboratory personnel, drug availability, health education to children and mothers
Subject(s)
Humans , Male , Female , Child, Preschool , Rural Population , Prevalence , Feces/parasitologyABSTRACT
Chronic liver diseases are disastrous to health. Many factors are associated with their prevalence, hence endemicity. These are mainly infectious, parasitic and toxic. A survey was conducted in a village south to Cairo. Large industries concerned with iron and steel industry, metals smelting, cement manufacturing and electric station were located north to the village. A systematic random sample of houses was selected. All individuals inside the houses were invited to share in the study. Sample size was 84 individuals. Hepatitis markers were done [HBsAg and anti-HCV antibodies]. The levels of some heavy metals were assessed; which were lead, mercury, arsenic, aluminum, manganese, nickel, chromium and cadmium. Levels of some trace elements were assessed. These were copper, iron, selenium and zinc. Aflatoxin B1 was assessed in serum. Assessment of schistosomal circulating antigen and antibodies was carried out. Abdominal ultrasonograghy was done to assess liver condition. Univariate logistic regression analysis was done to assess the association between studied variables and HBsAg or anti-HCV sero-positive subjects. The association between studied variables and bilharzial or fatty liver, diagnosed by ultrasonography, were also assessed. The univariate logistic regression analysis revealed odds ratios at the following results. For HBsAg sero positive subjects, aflatoxin B1, lead, chromium and schistosomal antigen and antibodies were higher than negative ones where odds ratios were; 6.2, 1.6, 1.6, 1.6 and 1.7, respectively. None of the variables showed statistically significant difference. For anti-HCV antibodies sero-positive subjects, aflatoxin Bi and chromium had the highest odds ratios among the studied variables, [odds ratios were 2.5 and 2.4, respectively]. Bilharzial liver showed higher significant positivity of anti-HCV antibodies and insignificant decreased level of zinc than negative ones [odds ratios were 7.2 and 4.5, respectively]. Fatty liver cases showed higher statistically significant positivity of anti-HCV antibodies and chromium than negative ones. Odds ratios were 8.0 and 7.1, respectively. Statistically significant lower level of aflatoxin B1 was shown in fatty liver than normal liver subjects. Multivariate logistic regression analysis for fatty liver showed that only anti-HCV antibodies sero-positivity had statistically significant odds ratio in comparison to chromium level and aflatoxin B1. It is concluded that some heavy metals, and Aflatoxin B1 had a definite association with liver diseases in the area under study. Having anti-HCV antibodies had a relation with fatty liver and with bilharzial liver more than having HBsAg. It is recommended that environmental management to factories nearby the village is urgently needed to decrease exposure to heavy metals. Prevention of hepatitis infection and aflatoxin exposure through different means is also recommended, other wise health care authorities would be confronted with unusual cases of HCC in the nearby future