ABSTRACT
Routine diagnosis of intestinal microsporidiosis in clinical diagnostic laboratories relies mostly on detection of microsporidial spores via special staining and microscopic techniques. This paper describes the comparative evaluation of Calcofl uor White M2R method, with modifi ed Gram-chromotrope Kinyoun method as the reference standard. One hundred and six stool samples were examined for the presence of microsporidial spores. Sensitivity, specifi city, positive and negative predictive values of the Calcofl uor White M2R method compared to the reference technique were 95.2%, 4.3%, 78.2% and 20.0%, respectively. The positive predictive value (PPV) was 78.2% and the negative predictive value (NPV) was 20.0%. Despite low specifi city of the CFW method due to its ability to stain chitinous wall of microorganisms, the presence of distinct deep-blue horizontal or equitorial stripes in microsporidial spores in modifi ed Gram-chromotrope Kinyoun would likely reduce the false positive results obtained in the Calcofl uor White M2R. Hence, the simultaneous use of these two methods would give better performance and accuracy for the detection of microsporidial spores in patients with intestinal microsporidiosis.
ABSTRACT
Intestinal microsporidia is an emerging human disease caused by microsporidia. A study was conducted to determine the prevalence of microsporidia in patients with gastro-intestinal symptoms and to examine the clinical manifestations associated with intestinal microsporidiosis. A descriptive cross-sectional study using a well-structured questionnaire; a review of medical records was also undertaken. Positive stool samples were defined as presence of one or more pinkish-violet ovoid structures with a belt-like stripe under high power field (100x) using modified gram-chromotrope stain (MGC). A total of 353 faecal specimens of patients was examined and 100 patients were found to have positive stool samples for microsporidia. The overall prevalence of microsporidia was 28.3%. Acute and chronic diarrhoea were seen in 49.0% and 36.0% patients, respectively. The commonest clinical presentations were diarrhoea (85.0%) with 83.0% of patients having loose or watery stools, vomiting (75.0%), foul-smelling stools (60.0%), nausea (59.0%) and cramping abdominal pain (39.0%). The least common symptoms were fever (15.0%), mucous in stool (5.0%) and blood in stool (4.0%). This study concludes that the prevalence of microsporidia is still high (28.3%) and the majority of patients (93.0%) are symptomatic; the most common gastro-intestinal symptom is diarrhoea with loose or watery stools. Hence, it is recommended that a stool screening for microsporidia be done in selected patients presented with gastrointestinal symptoms.
Subject(s)
FecesABSTRACT
Primary toxoplasmosis is usually subclinical, but in severely immunocompromised patients it may be life-threatening. For this reason, it could be important to monitor situations related to non-noticeable diseases among foreign arrivals in a country. In this study, we aimed to survey toxoplasmosis among migrants from Indian subcontinent to Malaysia. In a prospective, observational study, a serological evaluation on toxoplasmosis among 91 migrants from Indian Subcontinent in Malaysia was conducted in a plantation and a detention camp. We used study subject information sheet for demographic information and venous blood samples for serological study to determine Toxoplasma gondii IgG and IgM antibodies. The control group was composed of 198 local Malaysians working in the same plantation and detention camp. The age of study participants ranged from 19-45 years [geometric mean 29.9]. Except for the Nepalese, none of these migrants from the Indian Subcontinent were positive for IgM. IgG positive rates among the Nepalese, Indians and Pakistani were 46.2%, 6.6% and 5.9% respectively. All workers from Sri Lanka had 0.0% prevalence rate for both IgG and IgM. The prevalence rates of 44.9% was significantly [p <0.001] higher among local Malaysian workers when compared to migrant workers [18.8%]. No significant difference in the prevalence rates was noted among the migrants or local workers when they were grouped according to agricultural and non-agricultural occupations. Our data demonstrate that, with the exception of Nepalese population, there is a low frequency of toxoplasmosis infection among migrants from Indian subcontinent to Malaysia. A routine screening for toxoplasmosis may be indicated for sub-groups of migrants in this country