Substantial progress in the development of A variety of microscopic methods for the diagnosis of intestinal parasitic infections

To assess the efficacy of parasep [a new faecal concentrator method] and potassium hydroxide [10% KOH] solution [as a direct wet mount method] and to re-evaluate other routine procedures conducted in parasitology outpatient of Theodor Bilharz Research Institute [TBRI]. The study also highlights, the prevalence of intestinal parasitic infections especially the newly emerging protozoa and the different staining methods used for their identification. Faecal samples collected from 259 cases were examined by direct mount preparation, once by using saline solution [9% Nacl] and the other by using 10% potassium hydroxide [10% KOH] solution and Merthiolate Iodine formaldehyde concentration method, [MIFC]. Only 100 samples were subjected to examination by parasep [SF] "parasite fecal concentrator". The 259 samples were fixed in methanol and permanently stained by Giemsa stain. Diarrheic stools [70 out of 259 samples] were stained by Modified Ziehl Neelson for diagnosis of coccidian parasites. Only 12 individuals agreed upon performing the analysis on 5 days. Out of 259 samples, 191 had parasites with a percentage rate of 73.74% parasitosis. Wet mount preparation using 9% NacI and 10% KOH solution showed 43.67% and 62.06% positivity rates respectively. The MIFC examination detected 77.5% of intestinal parasites. The parasep proved to be the most efficient technique in diagnosing G. lamblia, where the percentage of parasites detected was 90.9% compared to .63.6% and 45.45% when MIFC and direct methods were used respectively. However, certain parasites require specific techniques for their diagnosis, such as D. fragilis, B. hominis and the coccidian parasites [Cryprosporidium, Cyclospora and Isospora belli]. In our study, all stool samples were fixed with methanol and permanently stained with Giemsa stain. Eight samples were positive for D. Fragilis and 3 samples showed B. homnis, with a prevalence rate of 3.08% and 1.15% respectively. Modified Ziehl Neelson stain was performed on the 70 diarrheic stool samples. Ctyptosporidium was detected in 3 cases and Cyclospora in 2 samples [prevalence rate 4.28% and 2.85% respectively] and B. Hominis was accidentally identified in one sample. Microscopic examination of stool samples is the primary method to diagnose parasitic infection. The limitation of each procedure must be taken into consideration and a combination of direct, concentration method, permanent staining, and MZH will increase the sensitivity of stool microscopy

role of probiotics in controlling giardia intestinalis in experimental animals

Efficacy of Lactobacillus acidophilus [Lactospore] for the control Research Institute Warak of Giardia intestianlis infection was evaluated in hamsters. Each El-Hadar Imbaba hamster was infected orally by 10.000 Giardia lamblia cysts. Animal were divided into five groups: Group A: control infected, untreate group. Group B: infected receiving Metronidazole. Group C: infected and receiving Lactospore. Group D: infected and receiving combination of Metronidazole and Lactospore. Group E: receiving Lactospore 7 days before infection acting as a prophylactic group. Groups B, C and D were given the appmpriate drug, three weeks post infection. Two weeks later stool analysis was performed and cysts/gm stool were counted, after which scarification of all groups took place. There was a highly significant difference between control and all treated groups. The highest percentage of reduction [cure rate] was in group D [98.6%]. followed by group B which gave a reduction rate of [93.8 1%]. The effect of the drugs on the vegetative [trophozoite] forms in the small intestine of sacrificed hamsters was studied. Combination of both drugs [group D] revealed a high significant cure rate [99.32%]. On the other hand when metronidazole and lactospore were given alone a reduction rate of 92.22% and 63.4% respectively was observed. The prophylaxis effect of Lactospore was highly noticed with 93.65% parasite reduction. Assessment of cure was also performed by electron microscopic and histopathological examination of the small intestine, peyer's patches and the spleen. Ultrastructural examination of the small intestine revealed remarkable destruction of the intestinal cell projection by Gardia cyst. Partial healing of the destructeci intestinal cell projection by Metronidazole was obvious, while complete healing could be detected in both groups D and E, Combined treatment with metronidazole and lactospore revealed remarkable activation of lymphocytes and macrophages. This easy flow through the endothelial cells lining the sinus in its way to the lumen to enhance their opportunity to overcome the infection could be detected. Histopathological examination revealed complete healing of the intestinal mucosa after the combined treatment while partial healing of the lining epithelium of the intestine was noticed after metronidazole treatment. The present study proves the efficacy of lactospore as a prophylactic agent for Giardiasis when given 7 days pre infection. This might be of considerable interest in eases of travelers diarrhea. In addition, it can strengthen the effect of metronidazole when both drugs are given together

Epidemiology of Schistosoma mansoni infection and its relationship to snail distribution in a village at the Nile Bank south to Cairo

The relationship between epidemiology of S.mansoni infection and snail distribution at a village, related to Guiza Governorate and lies south to Cairo, was investigated. A systematic random sample of houses was selected. All inhabitants of the houses were invited to share in the study. The Number examined was 704. Urine and stools were examined using Nucleopore filtration and standard Kato-Katz techniques, respectively. Snail collection was done from 35 sites along the water bodies related to the village. Snails collected were examined by cercariae shedding under light. Snail differentiation was done. The results showed that the prevalence of Schistosoma mansoni human infection was 25.1% and GMEC was 2.4 +/- 5.5. Schistosoma haematobium infection was zero percent. Biomphlaria alexandrina snail infection rate was 3.7% with density equal 0.5 +/- 1.3. Bulinus truncatus snail infection rate was zero percent. The pattern of S. mansoni human infection was closely related to snail distribution and infection. Presence of a hybrid species of B.alexandrina and B.glabrata may explain the epidemiological pattern found in the studied village

Incidence of cryptosporidiosis in immunodeficient cancer patients in Egypt

A coproprotozoal study was carried out on 63 patients suffering from malignancy. The majority had cancer of the hemopoietic system. All patients were under chemotherapy and classified into two groups: Group A [33 children] and group B [30 adults], of whom 20 immunocompetent diarrheic patients of matched age and sex were considered as controls. Stool samples were examined by merthiolate iodine-formaldehyde concentration technique [MIF]. Modified Zeihl- Neelsen [ZN] stain was performed for Cryptosporidium oocysts. The detection of Cryptosporidium coproantigen by enzyme-linked immunoassay test [Ridascreen test] was used. Immunoglobulins [IgG, IgM, IgE and IgA], C3, C4 and CD4:CD8 ratio were measured. According to their levels, 25 out of 63 patients had both humoral and cellular immunodeficiency. The incidence of Cryptosporidium in cancer patients was 23.8%, while it was 37.7% and 91% in children and adults immunodeficient patients, respectively. ZN stain was able to diagnose Cryptosporidium in 13 out of 35 immunodeficient cases, while ELISA detected only 11 cases. Cryptosporidium infection in immunodeficient cancer patients had significantly more frequent and prolonged duration of diarrhea than in negative ones

Upgrading of Kato-katz technique for diagnosis of S. Mansoni infection in rural Egypt

Processing of the same stool samples was done using standard Kato-Katz [KK] technique with 41.7 mg of stools and one of the three modifications. These included KK technique using a higher concentration of glycerin for preparation or another stain [negrosin- eosin] with a specified formula instead of the standard malachite green or processing a smaller volume of stools [20 mg]. The results showed that using cumulative infection rate from the two comparable tests as the reference KK with higher concentration of glycerin was more sensitive than standard KK [sensitivities 77.6% and 61.2%, respectively]. Using negrosin-eosin stain showed higher sensitivity [75.0%] in relation to standard KK technique [70.8%]. KK with higher concentration of glycerin showed the same sensitivity as KK with negrosin-eosin stain [85.7%] in relation to others. All comparisons showed statistically insignificant differences. Using 20 mg of stools showed very low sensitivity in relation to standard KK technique [57.9% and 100%, respectively]. The statistical difference was highly significant. All specificities were 100%. Other screening indices showed the same trend of sensitivities. Degree of microscope clarity was optimal with higher concentration of glycerin. Negrosin-eosin showed better visualization of ova than the standard KK. All modifications took only an hour after processing to be examined. KK technique used with any of these modifications is simple, inexpensive, use with either a higher concentration of glycerin or negrosin-eosin stain

Tegumental alteration and immunological changes in murine schistosomiasis mansoni after treatment with artemesia extract

The present work was designed to evaluate the effect of an Egyptian strain of artemesia; namely, Artemesia inculta as a schistosomicidal agent. After infection of mice with 100 cercariae, they were divided according to the duration of infection into group I [22 days] and group II [49 days]; each group was further subdivided into infected control and treated subgroups. Mice in the treated groups received artemesinin in a dose of 800 mg/kg intragastrically 7, 14 and 21 days post infection. The artemesinin extract was found to be more effective in reducing the number of female more than male worms in both hepatic and portomesenteric systems. No obvious changes could be detected on the tegument of both male and female worms in the treated adult group compared with the infected control. These results demonstrated the role of artemether in eliciting a high level of anti- SWAP total IgG and its subclass IgGI that may have a role together with artemether in eliminating schistosomes and share in the damage process on the tegument of juvenile stages but not adult stages