Detection and Quantification of Gastrointestinal Parasites among Inmates of Social Welfare Homes and Low Socio-economic Areas in Metropolitan Port Harcourt

Background: Detection and quantification of gastrointestinal parasitic infections (GIPIs) causing public health problems among poorer layers of the society are still one of the Neglected Tropical Diseases (NTDs) in developing countries. Objective: The aim of the study was to detect gastrointestinal parasites among inmates of Social Welfare Homes and Low Socioeconomic Areas in Metropolitan Port Harcourt. Methods: A cross-sectional survey was carried out for the evaluation of all the 1500 participants for GIPs among residents of social welfare homes and low socioeconomic areas in Rivers State, Nigeria for a period of one year (July 2019- June 2020). Stool samples were collected from each participant for isolation of GIPs in stool sample. Formol-ether concentration methods and Modified Ziehl-Neelson Staining techniques was used for the isolation and identification of gastrointestinal parasites. Descriptive and Chi square statistical analysis was applied. Results: Out of 1500, 1,381 (92.1%) participants showed negative report, while 119(7.9%) participants were positive for GIPs. Females account for 839 (55.9%) while males were 661 (44.1%). Positivity in males accounted for 9.8% (65/661) and the females had 6.4% (54/839). Age group with high prevalence occurred among 11-15yrs (13.5%)/340. Both variables were statistically significant (p<0.05). Seasonal distribution of GIPs was high during the wet season (p<0.05). Overall, A. lumbricoides was the most predominant gastrointestinal parasites, accounting for 35.3% of the total identified. Others were as follows; T. Trichiura 26.1%, hookworm 21.9%, C. sinensis and S. mansoni 2.5%, tapeworm 1.7%, while H. nana and H. diminuta had 0.8% each. Co-infection of A. lumbricoides + hookworm and hookworm + T. Trichiura recorded 4.2% each. Protozoa species were not identified. Risk factor of the use of toilet papers was found to be statistically significant (p<0.05) among others. Conclusion: We recommend that knowledge of epidemiology and transmission routes of C. sinensis and H. diminuta needs to be improved and effective health education on personal hygiene and mass treatment should be sustainable to control the spread of gastrointestinal parasites.

Intestinal parasitic infections and risk factors among the population in Cambodia

@#Many species of helminths and protozoa caused intestinal parasitic infections (IPIs). It belongs to neglected tropical diseases (NTDs) and remains a major public health problem in several Southeast Asian countries. The present study aimed to investigate the prevalence of IPIs and associated risk factors among the population in Kratie Province in northeastern Cambodia and Phnom Penh is the capital that locates in southern Cambodia. Fecal specimens (n=366) were collected in 10 villages in Kratie Province and Phnom Penh from 2019 to 2021. They were processed using the formalin ethyl-acetate concentration technique (FECT) to investigate parasites at egg and cyst stages and then examined under a light microscope. The results revealed that the prevalence of IPIs among the population in Kratie Province (n=317) and Phnom Penh (n=49) was 16.12% (n=59); of Kratie Province (n=50, 13.66%) and Phnom Penh (n=9, 2.46%), 12.02% (n=44) were helminths and 4.10% (n=15) were protozoa. The parasitic infection rate was higher in males (9.02%) than in females (7.10%) and more likely to be due to helminths (7.38%) than protozoa (1.64%). Prevalence of Opisthorchis viverrini was the highest (5.74%), followed by those of Entamoeba coli (4.10%), hookworm (3.83%), Ascaris lumbricoides (1.10%), Hymenolepis nana (1.09%), Taenia spp. (0.54%), Trichuris trichiura (0.55%), and Enterobius vermicularis (0.27%), respectively. Moreover, O. viverrini infection was the most common infection in the >20-year age group in Kratie Province. In addition, the bivariate and multivariate analyses showed that the association between gender. Gender was a significant risk factor positively associated with O. viverrini and hookworm infections (ORadj=0.318, 95% CI=0.122-0.8270, P=0.019 and ORadj=0.085, 95% CI=0.017-0.436, P=0.003, respectively). In conclusion, the IPIs were highly prevalent, especially O. viverrini and hookworm infections, among the population in Cambodia. These IPIs impact the public health burden but can be prevented by education regarding good sanitary practices in this community.

Perfil epidemiológico das parasitoses intestinais em moradores de uma comunidade da Ilha de Boipeba, Bahia, Brasil / Epidemiological profile of intestinal parasites in residents of a community on the island of Boipeba, Bahia, Brazil

Introdução: as parasitoses intestinais constituem-se um importante problema de saúde pública mundial. Estas infecções são mais prevalentes em regiões tropicais impactando na morbimortalidade e aumento nos custos para o sistema de saúde. Objetivo: avaliar a prevalência das enteroparasitoses e sua associação com as condições socioeconômicas, sanitárias, ambientais e hábitos de vida em uma comunidade costeira do Nordeste brasileiro. Metodologia: estudo epidemiológico, descritivo e transversal, realizado de modo não probabilístico entre março a junho de 2017, com 105 moradores da Ilha de Boipeba, localizada no Sul da Bahia. O exame parasitológico de fezes foi realizado pelos métodos de sedimentação espontânea, Baermann-Moraes e FAUST. Um questionário foi aplicado para avaliar o perfil sociodemográfico da população. Resultados: do total de indivíduos avaliados, 52,4% eram do sexo feminino e 57,1% tinham entre 15 a 59 anos. Todos os indivíduos possuíam água encanada, porém não tratada, enquanto 91,4% referiu ingerir vegetais crus e 45,7% não higienizavam as mãos antes as refeições. Sintomas gastrointestinais foram relatados em 82,8% dos indivíduos e infecções enteroparasitárias foram diagnosticadas em 69,6%. Os parasitos mais frequentemente encontrados foram Ancilostomídeo (18,1%) e Entamoeba coli (43,8%). O principal fator de risco potencial para contrair a infecção por ancilostomídeos foi a não existência de poço artesiano na residência (RP=4,35), enquanto para Trichuris trichiura foi não dispor de pia no banheiro (RP=3,82). Conclusão: a comunidade analisada apresentou elevada prevalência de enteroparasitoses. Os hábitos precários de higiene e de acesso à água tratada, associados às condições ambientais e climáticas do local, podem ter contribuído para a elevada transmissão de geohelmintos observada.

Introduction: Intestinal parasitic infections are an important public health problem worldwide. They are more prevalent in tropical regions impacting in morbidity and mortality and costs for the health system. Objective: To evaluate the prevalence of enteroparasitosis and its association with socioeconomic, sanitary and environmental conditions and lifestyle habits in a coastal community in the Northeast Brazil. Methodology: This is an epidemiological, descriptive and cross-sectional study, carried out in a non-probabilistic manner between March and June 2017, with 105 residents of Boipeba Island in the Southern Bahia. The parasitological examination of feces was carried out by the methods of spontaneous sedimentation, Baermann-Moraes and FAUST. A questionnaire was applied to assess the sociodemographic profile of the population. Results: Of the total of individuals evaluated, 52.4% were female and 57.1% were between 15 and 59 years old. All individuals had piped, but untreated water, while 91.4% reported eating raw vegetables and 45.7% did not wash their hands before meals. Gastrointestinal symptoms were observed in 82.8% individuals and 69.6% were diagnosed with enteroparasitic infections. The most frequent parasites were the hookworm (18.1%) and Entamoeba coli (43.8%). The main potential risk factor for hookworm infection was the non-existence of an artesian well in the residence (PR=4.35) and Trichuris trichiura it was not having a sink in the toilet (PR=3.82). Conclusion: The analyzed community has a high prevalence of enteroparasitosis, in addition to environmental and climatic conditions that contribute to the transmission of these infections.

High prevalence of protozoan infections: a permanent cycle in a brazilian semi-arid peripheric area

In regions where sanitary conditions are poor, prophylactic administration of antiparasitic drugs is common and affects the prevalence of intestinal parasites, in spite of the environmental maintenance of their life cycle. The purpose of this study was to evaluate the prevalence of parasitic infections, patient lifestyles, health conditions and environmental sources of contamination. One hundred seventy two children and adolescents, 5 to 15 years of age of both sexes were analyzed. Data were obtained through epidemiological questionnaires, parasitological examinations using Paratest®, IgG testing for Entamoeba histolytica, and analysis of sources of contamination in living areas. The study detected a prevalence of 45.9% (79/172) parasitic infections, of which 62.0% (49/79) Entamoeba histolytica/E. dispar complex; 46.8% (37/79) Entamoeba coli; 27.8% (22/79) Giardia intestinalis; 12.7% (10/79) Endolimax nana; 10.1% (8/79) Hymenolepis nana; 8.9% (7/79) Ascaris lumbricoides and 2.5% (2/79) Trichuris trichiura. Out of the 49 samples positive for Entamoeba histolytica complex, there was only one case of antibodies to E. histolytica. The children's life habits demonstrated inadequate food hygiene practices. These insufficient sanitary parameters revealed a general lack of information in face of an alarming situation regarding sewage and other sources of environmental contamination in 20% of the areas. The high prevalence of protozoan infections despite chemoprophylaxis, with environmental sources of contamination/risk, inadequate health conditions and the general apathy of the population suggest the ineffectiveness of current preventive practices. Thus, it is advisable that control actions include protozoa as therapeutic targets and, above all, health education as a routine practice to prevent the long-term continuance of this vicious cycle.

Prevalence of Intestinal Parasites in HIV Seropositive Patients Attending an Integrated Counselling and Testing Centre

HIV infection is the most disastrous and invariably fatal disease. Its devastating effect is due to its relentless and eventually complete destruction of the immune system. As a result, people infected with HIV die not due to the virus itself, but rather due to plethora of opportunistic infections that characterize AIDS. Intestinal parasitic infections are a significant cause of morbidity and mortality in patients infected with HIV in which Diarrhoea is one of the most common clinical presentations.1 With this background, a prospective study was carried out to determine the prevalence of intestinal parasites in HIV seropositive patients attending an Integrated Counselling Testing Centre (ICTC) of a tertiary care hospital.METHODSA cross-sectional study was conducted in a tertiary care multispecialty teaching hospital for a period of one year. Stool specimens of 250 HIV seropositive patients above 18 years of age and belonging to all genders, were screened for intestinal parasites in the present study. The stool specimens submitted were processed using direct wet mounts, concentration technique of formol ether, sedimentation and saturated common salt solution, and permanent staining techniques using Modified Acid-Fast staining, Trichrome staining and Modified Trichrome staining methods.RESULTSThe prevalence of intestinal parasites in HIV seropositive patients was found to be 27.6% (69/250). Protozoan parasites were predominant and were detected in 81.15% (56/69), followed by intestinal helminths in 11.59% (8/69) and coccidian parasites in 7.24% (5/69).CONCLUSIONSIntestinal parasites are a common source of infection in HIV seropositive patients. These patients are a threat not only to themselves but also to others in the community as well. Hence routine screening of all HIV seropositive patients is a must in order to prevent and reduce morbidity and mortality in the community.

Environmental Sanitation Factors and human Behaviour Associated with Intestinal Parasitic Infections in Rural Communities of Cameroon

Introduction: Intestinal parasitic infections stillconstitute major public health threats in many areas in Cameroon. To improve control measures, epidemiological data from environmental and human aspects are necessary to draw concrete control strategies to better follow-up the population at risk.Aim of the Study:This study aimed to investigate environmental risk factors related to infections in the Lolodorf health district, a high risk area ofsouth Cameroon. Methods:A total of 325participants who gave their informed consent were recruited for the study. Stool samples were collected and examined microscopicallyin search ofhelminth eggs and Original ResearchArticleprotozoan cysts using the Kato Katz and concentration Formol-ether techniques. Questionnaires were filled by participants to evaluate the risk factors.Results:Overall, 117 (42.9%) among the 325 participants harbored at least one parasite species with 75 (27.5%) having single infections and 42 (15.4%) having multiple infections. Ascaris lumbricoides(11.0%), Trichuris trichiura(26.4%), Hookworms (12.5%),Entamoeba coli(10.6%) and Entamoeba histolytica/Entamoeba dispar(1,5%) were diagnosed. Females were more infected (48.7%;p=0.04) compared to males (35.2%). Infection rate varied significantly according to villages (p=0.001). Univariate analysis revealed the following: gender (48.7%;p= 0.04), agricultural activities (47.7%; p= 0.04) and absence of treatment (50.8%: p=0.02) to be risk factors correlated to infection. Other factors such as age (49.3%), family size (47.8%), absence of toilets (53.5%), irregular use of shoes (48.6%), not wearing shoes (60.0%), irregular hand washing before meals (48.4%) and eating raw food (45.5%) had high infestation rates though with no significance.Multivariate logistic regression analysis showed that people who had never received any treatment had high risks of being infected (p=0.01; OR =0.17; 95% CI= 0.06 to 0.5).Conclusion:Improved sanitation, water supply and regular and extended deworming in the entire communities are fundamental issues in controlling intestinal parasitic infections

Frequência de enteroparasitos em mulheres não grávidas e seus filhos e grávidas atendidas em uma unidade de saúde / Frequency of enteroparasites in non-pregnant women and their children and pregnant women attended at a public health unit

As infecções parasitárias intestinais são amplamente distribuídas em todo o mundo e a população infantil é a mais afetada. A prevalência das infecções parasitárias intestinais materna e infantil de pacientes atendidos em uma unidade de saúde pública do município de Lagoa Santa, Minas Gerais foi avaliada pela técnica de centrífugo sedimentação em formol-éter. A positividade foi de 41,7% para gestantes, 37,3% para mães e 35,7% em crianças. Endolimax nana (17,1%) e Giardia intestinalis (17,1%) foram os parasitos mais frequentemente detectados em crianças com idade inferior a dois anos e em gestantes (33,3%). Para as mães, G. intestinalis (20,3%) foi o parasito mais prevalente seguido de Entamoeba coli (17%). A infecção simultânea de mãe e filho foi detectada em 7 das 25 crianças infectadas. Apesar das ações de educação em saúde, melhoria no nível educacional e acesso a serviços médicos, a frequência de infecções por endoparasitas permanece alta. A literatura é escassa em relação ao tema e acredita-se que a deficiência na aplicação de medidas de educação sanitária possa fazer com que mães infectadas possam contribuir para a infecção parasitária de seus filhos, assim como os filhos podem ser fonte de infecção para suas mães.

Intestinal parasitic infections are widely distributed throughout the world and children are the most affected population. The objective of the present study was to evaluate the prevalence of parasitic maternal and infant intestinal infection of patients attended at a public health unit in the municipality of Lagoa Santa, Minas Gerais. The centrifugal-sedimentation in formol-ether was the technica used for stool analysis. Positivity was observed in 41.7% for pregnant women, 37.3% for mothers and 35.7% for children. Endolimax nana (17.1%) and Giardia intestinalis (17.1%) were the most frequently detected parasites in children under two-years old and pregnant women (33.3%). For mothers, G. intestinalis (20.3%) was the most prevalent parasite followed by Entamoeba coli (17%). Simultaneous infection of mother and child was detected in 7 of 25 infected children. Despite health educations actions, improvement in educational level, and access to medical services, the frequency of endoparasite infections remains high. Literature is scarce in relation to the present theme and it is believed that infected mothers can contribute for parasitic infection of their kids, just as children can be a source of infection for their mothers.

Prevalencia de parasitismo intestinal y sus factores asociados en publicaciones indexadas de colombia: revisión sistemática 2000-2017

Introducción. En Colombia, las parasitosis intestinales constituyen un problema de salud pública poco investigado (o invisibilizado), a pesar de su relevancia como trazador de pobreza. Objetivo. Analizar la prevalencia de parasitismo intestinal y sus factores asociados en publicaciones indexadas de Colombia 1990-2017. Métodos. Revisión sistemática de la literatura científica a partir de la aplicación de un protocolo ex ante de selección de artículos con 40 estrategias, según las fases de identificación, tamización, elección e inclusión de Prisma. Se garantizó la reproducibilidad de la selección de los artículos y la extracción de la información. Se evaluó la calidad metodológica con la guía Strobe. Se estimaron prevalencias generales y específicas según agentes parasitarios, etnia y edad. Resultados. Se incluyeron 20 estudios con 4.226 sujetos, principalmente de Antioquia, niños y población mestiza. La prevalencia general fue 65,9% (IC de 95% = 64,5 - 67,4), con un 38,2% (IC de 95% = 36,3 - 40,0) de poliparasitismo y 19,1% (IC de 95% = 16,2 - 21,9) por especies patógenas. Las infecciones más prevalentes corresponden a Blastocystis hominis con 34,0% (IC de 95 % = 32,5 - 35,6), E. coli 27,4% (IC de 95% = 25,8 - 29,0), E. nana 26,2% (IC de 95% = 24,6 - 27,7) y E. histolytica/dispar/moshkovski 15,1% (IC de 95% = 13,9 - 16,3); mientras que las especies de menor magnitud fueron E. hominis, C. cayatenensis, E. vermicularis y T. hominis. La infección fue 23,6% mayor en niños indígenas en comparación con niños mestizos; en adultos no se registraron diferencias estadísticas según la etnia. Conclusión. Las investigaciones publicadas en revistas indexadas refieren una elevada prevalencia de parasitismo intestinal global, así como la alta frecuencia de algunas especies. Para el caso colombiano, las publicaciones refieren a múltiples factores asociados con la pobreza, las condiciones materiales de vida y los aspectos sociodemográficos; aunque solo se pudo metaanalizar el mayor riesgo de la población de niños e indígenas.

Introduction: In Colombia, intestinal parasitic infections are a public health problem which has little research, even with its relevance as a poverty tracer. Objective: To analyze the prevalence of intestinal parasitism and associated factors in indexed papers in Colombia 1990-2017. Method: Systematic revision of scientific literature through carrying out an ex ante protocol to select articles with 40 strategies, according to identification phases, screening, election and inclusion of prism. Reproducibility of article selection and information extraction was guaranteed. Methodological quality was evaluated with the Strobe guide. General and specific prevalences were estimated according to parasitic agents, ethnicity and age. Results: 20 studies with 4.226 subjects were included, mainly in Antioquia, in Mestizo children. The general preva- lence was 65.9% (CI of 95% = 64.5 - 67.4), with a 38.2% (CI of 95% = 36.340.0) of polyparasitism and 19.1% (CI of 95%=16-2 -21.9) for pathogenic species. Most prevalent infections are Blastocystis hominis with a 34.0% (CI of 95% = 32.5 - 35.6), E. coli 27.4% (CI of 95% = 25.8 - 29.0), E. nana 26.2% (CI of 95% = 24.6 - 27.7) and E. histolytica/dispar/moshkovski 15.1 % (IC of 95% = 13.9 - 16.3); while less species where E. hominis, C. cayatenensis, E. vermicularis y T. hominis. The infection was 23.6% higher in indigenous children, compared to Mestizo children. Adults did not register any statistical difference in terms of ethnicity. Conclusion: Research published in indexed journals show an elevated prevalence of global intestinal parasitism, as well as the high frequency of certain species. In the case of Colombia, papers refer to multiple factors associated to poverty, material life conditions and sociodemographic aspects. It was only possible to metaanalyze the risk of children and indigenous children.

Introdução: na Colômbia, as parasitoses intestinais constituem um problema de saúde pública pouco pesquisado ou invisibilizado, embora sua relêvancia como definidor de pobreza. Objetivo: analisar a prevalência de parasitose intestinal e seus fatores associados em publicações indexadas da Colômbia 1990-2017. Métodos: revisão sistemática da literatura científica a partir da aplicado de um protocolo ex ante de seleção de artigos com 40 estratégias, segundo as fases de identificação, rastreio, escolha e inclusão de Prisma. Foi garantida a reprodutibilidade da seleção dos artigos e a extração da informado. Foi evidenciada a qualidade metodológica com o guia Strobe. Foram estimadas prevalencias gerais e específicas segundo agentes parasitários, etnia e idade. Resultados: foram incluídos 20 estudos com 4.226 sujeitos, principalmente de Antioquia, Colômbia, crianzas e população mestiza. A prevalência geral foi 65,9% (IC de 95% = 64,5 - 67,4), com 38,2% (IC de 95% = 36,3 - 40,0) de poliparasitose e 19,1% (IC de 95% = 16,2 - 21,9) por espécies patógenas. As infecções mais prevalentes correspondem a Blastocystis hominis com 34,0% (IC de 95% = 32,5 - 35,6), E. coli 27,4% (IC de 95% = 25,8 - 29,0), E. nana 26,2% (IC de 95% = 24,6 - 27,7) e E. histolytica/dispar/moshkovski 15,1% (IC de 95% = 13,9 - 16,3); enquanto as espécies de menor magnitude foram E. hominis, C. cayatenensis, E. vermicularis e T. hominis. A infecção foi 23,6% maior em crianzas indígenas em comparação com crianças mestizas; em adultos, nao foram registradas diferenças estatísticas segundo a etnia. Conclusão: as pesquisas publicadas em revistas indexadas referem elevada prevalência de parasitose intestinal global, bem como alta frequência de algumas espécies. Para o caso colombiano, as publicações apresentam múltiplos fatores associados com a pobreza, com as condições materiais de vida e com os aspectos sociodemográficos, embora somente tenha sido materializado o maior risco da população de criançãs e indígenas.

Anemia in Parasitic Infections in Patients Attending a Tertiary Care Hospital

This study showed the importance of intestinal parasitic infections in developing countries, the present study was undertaken to determine the prevalence of intestinal parasitic infections in general population attending the hospital. Methods: A total of 194 individuals of different age groups were included. The study was conducted in the department of Pathology & Microbiology at G.C.R.G. Institute of Medical Sciences, Lucknow. The duration of study was over a period of one year. Results: In our study, 194 total numbers of cases were included and 117 cases had parasitic infections. Conclusion: The study showed that, most of the affected individuals are generally poor, thus malnutrition may be secondary to poverty, and both in turn play a significant role in the prevalence of parasites causing infection and anemia.

Effects of water, sanitation and hygiene (WASH) education on childhood intestinal parasitic infections in rural Dembiya, northwest Ethiopia: an uncontrolled before-and-after intervention study

BACKGROUND@#Soil-transmitted helminthes (STH) infections are among the most common infections worldwide and affect the most deprived communities. Adequate water, sanitation, and hygiene (WASH) prevents environmental contamination, thereby preventing transmission of STH. Cognizant of this, WASH education was implemented in rural Dembiya to reduce intestinal parasitic infections. This study was, therefore, conducted to assess the impacts of the intervention on households' WASH conditions and prevalence of intestinal parasitic infections.@*METHOD@#An uncontrolled before-and-after intervention study was used. Cross-sectional studies were done before and after the intervention. Two hundred twenty-five and 302 under five children were recruited randomly at the baseline and endline, respectively. Data were collected using a structured questionnaire and observational checklists. Direct stool examination and Kato-Katz methods were used to identify parasites in the stool. We used percent point change and prevalence ratio (PR) to see the effects of the intervention on WASH conditions and prevalence of intestinal parasitic infections respectively. Pearson chi-squared and Fisher's exact tests were used to test for statistically significant percentage point changes of WASH conditions. The effect of the intervention on intestinal parasitic infections was statistically tested on the basis of PR with 95% confidence interval (CI).@*RESULTS@#The baseline prevalence of intestinal parasitic infections was 25.8%, and the endline prevalence was 23.8%. The prevalence of intestinal parasitic infections was not significantly decreased at the endline compared with the baseline [PR = 0.92, 95% CI = (0.62, 1.38)]. Ascaris Lumbricoides was the most prevalent parasitic infection both at the baseline and endline. The proportion of children who had good hygienic condition increased from 1.3% at the baseline to 34.4% at the end line (p <  0.05). The percentage of mothers/care givers who washed hands at different pick times was significantly increased from 24.4% at the baseline to 68.2% at the endline (p <  0.001). The proportion of households who practiced home-based water treatment was significantly increased from 7.6% at the baseline to 47% at the endline (p <  0.001). The proportion of households who used sanitary latrine was increased from 32% at the baseline to 49% at the endline (p <  0.05).@*CONCLUSION@#This before-and-after intervention study found that households' WASH performance was significantly improved at the endline compared with the baseline. The endline prevalence of intestinal parasitic infections was slightly lower than the baseline prevalence; however, the reduction was not statistically significant. The local health office needs to strengthen the WASH education program, mobilize the community to construct WASH facilities, and support the community to sustain households' WASH performance.

THE CONCEPTUAL FRAMEWORK: ESTABLISHING HEALTH LITERACY MODULE FOR INDIGENOUS PEOPLE IN MALAYSIA

@#This paper proposed a conceptual model on developing a new Health Literacy Module for Indigenous People in Malaysia. This proposed model could be used as a reference for researchers to develop new strategies to overcome health issues on Indigenous People. The proposed model incorporated three (3) phases which are (i) Phase 1: To determine the Knowledge, Attitude & Practice (KAP) on parasitic infections among Indigenous People, (ii) Phase 2: To develop self-useful kit for Indigenous People according to the needs in Phase 1, (iii) Phase 3: To develop a health literacy module of parasitic infections as a referral for Indigenous People. This research will have a significant contribution to provide an in-depth knowledge on identification of health care problems related to parasitic infections towards the development of health literacy module for Indigenous People. Authors will propose new or adapted or/and adopted tools/products/guidelines to be established based on the findings of this research. The findings are aimed to improve quality of life for Indigenous People in Malaysia

Status of intestinal parasitic infections among rural and urban populations, southwestern Iran

Objective: To evaluate the prevalence and risk factors of intestinal parasitic infections in the urban and rural areas of Shushtar County, southwest Iran. Methods: A total of 1 008 fecal samples were analyzed by direct smear examination, formalin-ether concentration, and Ziehl-Neelsen and trichrome staining; furthermore, PCR was used to distinguish Trichostrongylus and hookworm species based on 28S rRNA gene. Results: Totally, 16.0% cases tested positive, either with a pathogenic or a non-pathogenic parasite. Protozoa were detected in 14.0%, helminths in 1.0%, protozoa and helminth co-infections were detected in 0.3%, and co-infections of two protozoa were detected in 0.7% of cases. The most common protozoa and helminths were Giardia duodenalis (7.7%) and Trichostrongylus spp. (0.5%), respectively. Among five microscopy Trichostrongylus positive cases, Trichostrongylus culbriformis was successfully identified in three isolates by sequencing. In the rural areas, the prevalence of parasitic infection was higher (9.8%) than that in the urban areas (6.2%). A significant association was found between educational level, type of drinking water, animals contact, hand-washing, and clinical symptoms. Conclusions: This study indicates that intestinal parasitic infections remain as a public health priority in Shushtar County. It seems that drinking water and environmental sanitation are the main risk factors of parasitic infections in rural areas.

Status of intestinal parasitic infections among rural and urban populations, southwestern Iran

Objective: To evaluate the prevalence and risk factors of intestinal parasitic infections in the urban and rural areas of Shushtar County, southwest Iran. Methods: A total of 1 008 fecal samples were analyzed by direct smear examination, formalin-ether concentration, and Ziehl-Neelsen and trichrome staining; furthermore, PCR was used to distinguish Trichostrongylus and hookworm species based on 28S rRNA gene. Results: Totally, 16.0% cases tested positive, either with a pathogenic or a non-pathogenic parasite. Protozoa were detected in 14.0%, helminths in 1.0%, protozoa and helminth co-infections were detected in 0.3%, and co-infections of two protozoa were detected in 0.7% of cases. The most common protozoa and helminths were Giardia duodenalis (7.7%) and Trichostrongylus spp. (0.5%), respectively. Among five microscopy Trichostrongylus positive cases, Trichostrongylus culbriformis was successfully identified in three isolates by sequencing. In the rural areas, the prevalence of parasitic infection was higher (9.8%) than that in the urban areas (6.2%). A significant association was found between educational level, type of drinking water, animals contact, hand-washing, and clinical symptoms. Conclusions: This study indicates that intestinal parasitic infections remain as a public health priority in Shushtar County. It seems that drinking water and environmental sanitation are the main risk factors of parasitic infections in rural areas.

Childhood intestinal parasitic infection and sanitation predictors in rural Dembiya, northwest Ethiopia

BACKGROUND@#Intestinal parasites are a common problem in the world. The greater proportion of infections is associated with poor water, sanitation, and hygiene (WASH). This study was conducted to assess intestinal parasites, WASH condition, and their association in rural Dembiya, northwest Ethiopia.@*METHODS@#A cross-sectional study was employed. Two hundred twenty-five children aged 6-59 months were included. Mothers were interviewed using a structured questionnaire, and the living environment was observed using checklists. Kato-Katz technique was used to determine the intensity of parasitic infections. Escherichia coli (E. coli) was used as a biological indicator for drinking water quality. Multivariable binary logistic regression analysis was conducted to identify WASH predictors of parasites on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and p < 0.05.@*RESULTS@#The prevalence of intestinal parasites was 25.8% (95% CI = 20.3-32.0%). Ascaris lumbricoides (78%), hookworm (12%), Hymenolepis nana (7%), Enterobius vermicularis (5%), Schistosoma mansoni (3%), Giardia lamblia (3%), and Trichuris trichiuria (2%) were identified infections. Intestinal parasites were associated with poor child hand washing practice [AOR = 3.86, 95% CI = 1.53, 9.75], unprotected water sources [AOR = 7.79, 95% CI = 3.30, 18.40], access to water below 20 l/c/d [AOR = 3.05, 95% CI = 1.28, 7.23], poor food safety[AOR = 4.33, 95% CI = 1.62, 11.58], and poor sanitation [AOR = 5.01, 95% CI = 1.56, 16.16].@*CONCLUSION@#A. lumbricoides, hookworm, H. nana, E. vermicularis, S. mansoni, G. lamblia, and T. trichiuria were identified. Child hand washing practice, service level of water supply, water sources, food safety, and sanitation were associated with intestinal parasites. WASH promotion is needed to prevent infections.

Hemiparesia súbita secundaria a cisticercosis cerebral: presentación de un caso clínico / Sudden hemiparesis secondary to cerebral cysticercosis: presentation of a clinical case

Introducción: La neurocisticercosis es una infección parasitaria del sistema nervioso central, ocasionada por la etapa larval del parásito Taenia solium. Su prevalencia mundial es de 9,1%. Se presenta a continuación un caso clínico en el que destaca una clínica infrecuente y tamaño de la lesión poco común; caso que fue resuelto con éxito mediante neurocirugía. Presentación del caso: Hombre de 48 años, residente en localidad rural, consultó por cuadro súbito de hemiparesia derecha de predominio crural, posteriormente con aumento de paresia braquial ipsilateral. Al examen físico destacó síndrome piramidal derecho. Se estudió con Tomografía Computarizada que evidenció quiste frontal izquierdo con compresión del área motora, sugerente de lesión parasitaria. Resonancia Nuclear Magnética de Cerebro (RNMC) informó proceso expansivo quístico fronto-parietal parasagital izquierdo de 5 x 5,5 cm, con efecto de masa. Por tamaño, tipo de lesión y clínica se decidió realizar cirugía abierta con extirpación total y biopsia que informó cisticercosis cerebral. El paciente evolucionó con recuperación total de su déficit motor posterior a la cirugía. Discusión: La neurocisticercosis se encuentra dentro de los diagnósticos diferenciales de lesiones quísticas encefálicas. Su clínica es inespecífica, manifestándose comúnmente con convulsiones y cefalea. La RNMC permite el diagnóstico y localización de las lesiones. El tratamiento es médico, quirúrgico o combinado. Generalmente, el manejo se basa en antiepilépticos y antiparasitarios sistémicos, sin embargo en este caso, se decidió el manejo quirúrgico que llevó a una mejoría total del paciente, lo que avala la cirugía precoz como principal medida en lesiones de este tipo

Introduction: Neurocysticercosis is a parasitic infection of the central nervous system, caused by the larval stage of the parasite Taenia solium. Its worldwide prevalence is 9.1%. We present below a clinical case with an infrequent clinical and uncommon lesion size, with surgical resolved. Case report: A 48 year old man, who was a resident of a rural locality, consulted for sudden hemiparesis on the right side of the crural predominance, subsequently with increased ipsilateral brachial paresis. Physical examination highlighted right pyramidal syndrome. It was studied with Computed Axial Tomography that showed left frontal cyst with compression of the motor area, suggestive of parasite lesion. Brain Nuclear Magnetic Resonance (BNMR) reported left parasagittal fronto-parietal cystic expansive process of 5 x 5.5 cm, with mass effect. By size, type of lesion and clinic it was decided to perform open surgery with total extirpation and biopsy that reported cerebral cysticercosis. The patient evolved with complete recovery of motor deficit after surgery. Discussion: Neurocysticercosis is a differential diagnosis of brain cystic lesions. Its clinic is non-specific, commonly manifesting with seizures and headache. The RNMC allows the diagnosis and location of the lesions. The treatment is medical, surgical or combined. Usually, the management is based on antiepileptics and systemic antiparasitic, however in this case, it was decided the surgical management that led to the total improvement of the patient, which guarantees the early surgery as the main measure in lesions of this type

Urticaria crónica espontánea: revisión de la literatura / Spontaneous chronic urticaria: A literature review

Resumen: la urticaria crónica espontánea es una enfermedad que produce gran compromiso en la calidad de vida del paciente y de la que aún se desconocen, en gran parte, los mecanismos fisiopatológicos asociados, ya que no son generalizables en todos los individuos. Existen factores intrínsecos y extrínsecos implicados en el desarrollo y persistencia de la enfermedad, los cuales pueden actuar de forma individual o coexistente. En esta revisión se proponen algunos cambios en la clasificación actual de la enfermedad, donde se incluye una subdivisión dentro de la urticaria crónica denominada urticaria crónica mixta, la cual hace referencia a los casos donde coexisten factores intrínsecos y extrínsecos para la aparición de la enfermedad en el mismo individuo. Algunos procesos infecciosos virales, bacterianos y parasitarios se han asociado en el desarrollo o severidad de los síntomas de la urticaria crónica en un subgrupo de pacientes, por lo tanto, son incluidos como factores extrínsecos del individuo dentro de las urticarias crónicas inducibles no físicas. Estas modificaciones son propuestas con el fin de optimizar el diagnóstico y manejo de los pacientes con urticaria crónica mixta. (AU)

Abstract: Chronic spontaneous urticaria is a disease that produces a great compromise in patient's quality of life. The associated pathophysiological mechanisms are still largely unknown because they are not generalizable to all individuals. There are intrinsic and extrinsic factors involved in the development and persistence of the disease that can act individually or coexist. In this review are proposing some changes in the current classification of the disease, which includes a subdivision into the chronic urticaria called mixed chronic urticaria that makes reference to cases where intrinsic and extrinsic factors coexist for the onset of the disease in the same individual. Some viral, bacterial and parasite infectious processes have been associated with the development or severity of chronic urticaria symptoms in a subgroup of patients, therefore, they are included as extrinsic factors to the individual within chronic inducible urticaria non-physical. These modifications are proposed in order to optimized the diagnosis and treatment of patients with chronic spontaneous urticaria. (AU)

Infective Dermatoses in Genital Region - Prevalence in Children of 1-18 Years Age.

Background: Dermatoses are a wide-spread health problem among children though not responsible for mortalities but for morbidities. Present survey was conducted to determine the prevalence of skin diseases, which are infectious origin in children of age group 1-18 years. Methods: This is a hospital based, Cross Sectional Study from November 2011- July 2013. 173 children were screened, General and Systemic examination, details of cutaneous lesions were noted and after examination provisional diagnosis of infectious genital dermatoses were made. Results: Infective Genital dermatoses were seen in 173 (86.5%) of the total cases. Among Infectious dermatoses, parasitic infections (50.2%) were commoner than fungal (26.5%), bacterial (19%) and viral infections(4%).Genital scabies was found to be the most common dermatoses among all the other types (43%). Tinea cruris was found to be the most common fungal infection (7.5%) followed by candidal intertrigo (6.0%).Among viral infections. Molluscum contagiosum was more frequently found (2.5%) than viral warts (0.5%) and pityriasis rosea (0.5%). Conclusion: To decrease the incidence of infectious dermatoses important thing to maintain is hygiene. Health education should give to parents or guardians of children about Hygienic measures, sexual behavior and need of seeking medical advice.

Spectrum of chronic small bowel diarrhea with malabsorption in Indian subcontinent: is the trend really changing?

BACKGROUND/AIMS: This study aimed to document the recent etiological spectrum of chronic diarrhea with malabsorption and also to compare features that differentiate tropical sprue from parasitic infections, the two most common etiologies of malabsorption in the tropics. METHODS: We analyzed 203 consecutive patients with malabsorption. The etiological spectrum and factors that differentiated tropical sprue from parasitic infections were analyzed. RESULTS: The most common etiology was tropical sprue (n=98, 48.3%) followed by parasitic infections (n=25, 12.3%) and tuberculosis (n=22, 10.8%). Other causes were immunodeficiency (n=15, 7.3%; 12 with human immunodeficiency virus and 3 with hypogammaglobulinemia), celiac disease (n=11, 5.4%), Crohn's disease (n=11, 5.4%), small intestinal bacterial overgrowth (n=11, 5.4%), hyperthyroidism (n=4, 1.9%), diabetic diarrhea (n=4, 1.9%), systemic lupus erythematosus (n=3, 1.4%), metastatic carcinoid (n=1, 0.5%) and Burkitt's lymphoma (n=1, 0.5%). On multivariate analysis, features that best differentiated tropical sprue from parasitic infections were larger stool volume (P=0.009), severe weight loss (P=0.02), knuckle hyperpigmentation (P=0.008), low serum B12 levels (P=0.05), high mean corpuscular volume (P=0.003), reduced height or scalloping of the duodenal folds on endoscopy (P=0.003) and villous atrophy on histology (P=0.04). Presence of upper gastrointestinal (GI) symptoms like bloating, nausea and vomiting predicted parasitic infections (P=0.01). CONCLUSIONS: Tropical sprue and parasitic infections still dominate the spectrum of malabsorption in India. Severe symptoms and florid malabsorption indicate tropical sprue while the presence of upper GI symptoms indicates parasitic infections.

Medical treatment of tropical parasitic diseases

In Korea, patterns of parasitic infections have notably changed during the past few decades. The soil-transmitted helminthiases and water-borne protozoan infections, which had been prevalent, became negligible, while parasitic zoonosis including pet-associated infections, food-borne helminthiases, and imported tropical endemic diseases have increasingly been detected. People who travel abroad and those who have immigrated from other countries might suffer from endemic tropical diseases. Except for a few entities, which invoked acute febrile illness (malaria) and diarrhea (giardiasis and amoebiasis), most helminthic and protozoan infections did not provoke acute symptoms. Those infections progress slowly, but can sometimes result in fatal clinical consequences. Diverse tropical endemic diseases are prevalent in several continents/countries according to different natural environments (climate and humidity), socioeconomic status, and traditional cultural background. Those diseases might be acquired through different routes of infection. Travelers who have returned to Korea from overseas and immigrants should undergo a careful differential diagnosis. Information on countries and duration of travel/residence, food habits, underlying medical history, prophylactics received, exposure to harmful environments (insect bites, contaminated food or water), and swimming in freshwater is valuable. This article briefly overviews the epidemiology, pathophysiology, clinical manifestations, diagnosis, and specific chemotherapeutics of the tropical endemic diseases that are important in Korea.