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.

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

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.

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.

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.

Surveillance of human intestinal parasitic diseases in Nanping City from 2014 to 2018 / 中国血吸虫病防治杂志

Objective To investigate the status of human intestinal parasitic diseases in Nanping City from 2014 to 2018, so as to provide reference for the development of the effective control measures. Methods Administrative villages were selected using the two-stage cluster sampling in Nanping City from 2014 to 2018, and surveillance of human intestinal parasitic diseases was performed in 5 administrative villages in each county (district) of Nanping City. Intestinal parasitic infections were detected using a modified Kato-Katz thick smear method (two smears for a single stool sample) in villagers, and the hookworm species was differentiated. In addition, the eggs of Enterobius vermicularis were detected using the adhesive tape method in children aged 3 to 6 years. Results A total of 6 317 villagers were detected in Nanping City from 2014 to 2018, and the overall prevalence of human intestinal parasitic infections was 2.15%. There was year- (χ2 = 10.53, P < 0.05) and gender-specific prevalence of human intestinal parasitic infections in Nanping City during the study period (χ2 = 17.00, P < 0.01). The prevalence of human intestinal parasitic infections increased with age, and there was age-specific prevalence of human intestinal parasitic infections in Nanping City (χ2 = 102.62, P < 0.01). A total of 945 children at ages of 3 to 6 years were detected, and the prevalence of E. vermicularis infection was 3.28%. Conclusions The prevalence of human intestinal parasitic infections is at a low level in Nanping City from 2014 to 2018, and the infection mainly occurs in villagers of advanced age and low education levels. Further comprehensive measures are required to control intestinal parasitic infections in key populations.

Prevalence and influencing factors of intestinal parasitic diseases among rural children in Henan Province / 中国血吸虫病防治杂志

Objective To understand the epidemic status and influencing factors of intestinal parasitic diseases among rural children in Henan Province. Methods According to the Scheme for The National Survey on Current Status of Major Human Parasitic Diseases in China, the survey counties were selected based on the ecological zones and economic levels in Henan Province between 2014 and 2015. Then, the included counties were stratified according to the topography and economic levels. A township was randomly sampled from each stratum, and a village was randomly sampled from each township as the study site. Finally, a total of 104 study sites from 35 counties were enrolled for the survey of intestinal parasitic diseases in children. At least 250 fresh stool samples were collected from each study site for detection of intestinal helminth eggs with the Kato-Katz technique, for the identification of Necator americanus and Ancylostoma duodenale with the fecal culture method, and for the detection of intestinal protozoa trophozoite and cyst with the physiological saline smear and iodine staining techniques. In addition, the Enterobius vermicularis and tapeworm eggs were detected in children aged 3 to 6 years using the adhesive cellophane-tape perianal swab method. Results The overall prevalence of intestinal parasitic infections was 3.21% (214/6 671) among rural children in Henan Province, and the prevalence of intestinal helminthes (2.62%, 175/6 671) was higher than that of intestinal protozoa (0.60%, 40/6 671). A total of 12 species of intestinal parasites were found, including 4 nematodes species, one trematode species, and 7 protozoa species, and the highest infection was seen in E. vermicularis (2.47%, 161/6 671). Among the four ecological zones in Henan Province, the greatest prevalence of intestinal parasitic infections was detected among children in the Qinba Mountain Ecological Zone (5.85%, 90/1 538). There was no gender-specific difference in the prevalence of intestinal parasitic infections in children (P > 0.05); however, there were age- (χ2 = 32.762, P < 0.05) and education level-specific differences in the prevalence of intestinal parasitic infections in children (χ2 = 67.507, P < 0.05), with the greatest prevalence of E. vermicularis infection seen in all species of intestinal parasites in children at all age groups. Multivariate non-conditional logistic regression analysis showed that high education level, high coverage of harmless toilets, drinking tap water and deworming were protective factors for intestinal parasitic infections in children in Henan Province. The overall prevalence of intestinal parasitic infections appeared a tendency towards a gradual decline among children in Henan Province as compared to the previous two surveys. Conclusions The overall prevalence of intestinal parasitic infections shows a tendency towards a remarkable decline among children in Henan Province. E. vermicularis infection should be given a priority for future parasitic disease control activities among rural children in Henan Province.

Epidemiological features and changing patterns of intestinal parasitic diseases in Jiangxi Province / 中国血吸虫病防治杂志

Objective To understand the epidemiological features and changing patterns of intestinal parasitic diseases in Jiangxi Province from 1989 to 2014, so as to provide scientific evidence for formulating the preventive and control strategy for intestinal parasitic diseases. Methods The data regarding the status of intestinal parasitic diseases in Jiangxi Province were captured from the 1989 national survey on the distribution of human parasites in China and the 2014 national survey on major human parasitic diseases in China, and the status of human intestinal parasite infections was compared between the two surveys in Jiangxi Province. Results The prevalence rate of human intestinal parasite infections was 79.59% and 9.64% in Jiangxi Province in 1989 and 2014, with a decline rate of 87.89% during the 25-year period (χ2 = 30 870.5, P < 0.01). There were 24 and 20 species of human intestinal parasites detected in Jiangxi Province in 1989 and 2014, respectively, with totally 26 species detected during the two surveys. In Jiangxi Province, the 3 most highly prevalent human intestinal parasites included Ascaris lumbricoides (71.06%), hookworm (17.61%) and Enterobius vermicularis (17.59%) in 1989, and E. vermicularis (13.73%), hookworm (4.66%), whipworm (0.95%) in 2014. A higher rate of human intestinal parasite infections was found in females than in males in both surveys in Jiangxi Province (P < 0.01), and the prevalence of human intestinal parasite infections reduced by 82.50% to 95.31% in different age groups in Jiangsu Province during the 25-year period. Conclusions The prevalence of human intestinal parasite infections shows a remarkable decline tendency in Jiangxi Province, and soil-transmitted nematodes remain the main species of human intestinal parasites in Jiangxi Province.

Investigation on human intestinal parasitic diseases in ecological regions of Qinba Mountains in Henan Province in 2015 / 中国血吸虫病防治杂志

Objective To understand and analyze the epidemic status of human intestinal parasitic diseases in the ecological region of the Qinba Mountains in Henan Province, so as to provide the evidence for the control of the diseases in this region. Methods According to the methods of National Survey Scheme on Major Human Parasitic Diseases, 26 survey spots were selected in 8 counties (cities) in ecological regions of Qinba Mountains in Henan Province in 2015. After collecting the human fecal samples, the eggs of intestinal helminthes were detected with the modified Kato-Katz thick smear method, the species of Ancylostoma of the hookworm egg-positive samples were identified with the tube fecal culture method, the eggs of Enterobius vermicularis were detected by using the adhesive tape method in children aged 3 to 6 years, and the cyst and trophozoite of intestinal protozoa were examined by iodine staining. The infections of intestinal parasites in different populations and the related influencing factors were analyzed. Results Totally 6 706 residents were recruited in this study, 8 kinds of parasites were found including 3 species of helminthes and 5 species of protozoans. The overall infection rate of intestinal parasites was 3.39%, covering 2.92% for helminthes and 0.49% for protozoans. The infection rate of E. vermicularis in children aged 3 to 6 years was 3.93%. The 3 identified helminthes were Ascaris lumbricoides, E. vermicularis, and Dicrocoelium dendriticum, with the highest infection rate of E. vermicularis (2.68%, χ2 = 306.362, P < 0.05). The 5 identified protozoans were Entamoeba hartmani, E. coli, Endolimax nana, Giardia lamblia, and Blastocystis hominis, and the infection rate of E. nana was the highest (χ2 = 23.842, P < 0.05). Among the 8 counties (cities), the highest infection rate of helminthes, mainly with Enterobius infection, existed in Ruyang County, and the infection rate of protozoans in Xin’an County was the highest, mainly with E. nana infection. There was a significant difference in the infection rates of helminthes and protozoans among the 8 counties (cities) (helminthes: χ2 = 357.525, P < 0.05; protozoans: χ2 = 38.795, P < 0.05). There was no significant difference in the helminth infection rate between males and females ( χ2 = 0.034, P > 0.05), but the protozoan infection rate of the males was higher than that of the females ( χ2 = 12.946, P < 0.05). The helminth infection rate of the 0-9 years old group was the highest ( χ2 = 62.600, P < 0.05), up to 6.60%, mainly with E. vermicularis infection. There was no significant difference in the infection rate of intestinal parasites among nationalities ( χ2 = 0.212, P > 0.05). The helminth infection rate of preschool children was the highest and up to 8.43%, mainly with E. vermicularis infection. The infection of A. lumbricoides was mainly happened among farmers, with the infection rate of 0.31%. There was a significant difference in the helminth infection rate among different occupations (χ2 = 84.333, P < 0.05). The intestinal parasites infection rate of the illiterate population was the highest and up to 7.63%, there was a significant difference among the populations with different educational levels (χ2 = 72.013, P < 0.05). The helminth infection rate of plain areas was higher than that of valley and hill ( χ2 = 11.690, P < 0.05). The helminth infection rate of people with low-income was the highest and up to 10.32% (χ2 = 244.999, P < 0.05). The protozoan infection rate of people with middle-income was the highest, who had the annual per capita net income of 6 000 to 7 999 Yuan ( χ2 = 24.749, P < 0.05). The helminth infection rate of people drinking well water was much higher than that of people drinking tap water (χ2 = 62.255, P < 0.05). The protozoan infection rate of people without insect repellent was higher than that of people with insect repellent (χ2 = 5.235, P < 0.05). Conclusions The infection rates of human intestinal parasites in the ecological region of the Qinba Mountains in Henan Province have decreased sharply. E. vermicularis infection in children should be the main point of prevention and treatment of parasitic diseases in the future.

Investigation on human intestinal parasitic diseases in ecological regions of Qinba Mountains in Henan Province in 2015 / 中国血吸虫病防治杂志

Objective To understand and analyze the epidemic status of human intestinal parasitic diseases in the ecological region of the Qinba Mountains in Henan Province, so as to provide the evidence for the control of the diseases in this region. Methods According to the methods of National Survey Scheme on Major Human Parasitic Diseases, 26 survey spots were selected in 8 counties (cities) in ecological regions of Qinba Mountains in Henan Province in 2015. After collecting the human fecal samples, the eggs of intestinal helminthes were detected with the modified Kato-Katz thick smear method, the species of Ancylostoma of the hookworm egg-positive samples were identified with the tube fecal culture method, the eggs of Enterobius vermicularis were detected by using the adhesive tape method in children aged 3 to 6 years, and the cyst and trophozoite of intestinal protozoa were examined by iodine staining. The infections of intestinal parasites in different populations and the related influencing factors were analyzed. Results Totally 6 706 residents were recruited in this study, 8 kinds of parasites were found including 3 species of helminthes and 5 species of protozoans. The overall infection rate of intestinal parasites was 3.39%, covering 2.92% for helminthes and 0.49% for protozoans. The infection rate of E. vermicularis in children aged 3 to 6 years was 3.93%. The 3 identified helminthes were Ascaris lumbricoides, E. vermicularis, and Dicrocoelium dendriticum, with the highest infection rate of E. vermicularis (2.68%, χ2 = 306.362, P < 0.05). The 5 identified protozoans were Entamoeba hartmani, E. coli, Endolimax nana, Giardia lamblia, and Blastocystis hominis, and the infection rate of E. nana was the highest (χ2 = 23.842, P < 0.05). Among the 8 counties (cities), the highest infection rate of helminthes, mainly with Enterobius infection, existed in Ruyang County, and the infection rate of protozoans in Xin’an County was the highest, mainly with E. nana infection. There was a significant difference in the infection rates of helminthes and protozoans among the 8 counties (cities) (helminthes: χ2 = 357.525, P < 0.05; protozoans: χ2 = 38.795, P < 0.05). There was no significant difference in the helminth infection rate between males and females ( χ2 = 0.034, P > 0.05), but the protozoan infection rate of the males was higher than that of the females ( χ2 = 12.946, P < 0.05). The helminth infection rate of the 0-9 years old group was the highest ( χ2 = 62.600, P < 0.05), up to 6.60%, mainly with E. vermicularis infection. There was no significant difference in the infection rate of intestinal parasites among nationalities ( χ2 = 0.212, P > 0.05). The helminth infection rate of preschool children was the highest and up to 8.43%, mainly with E. vermicularis infection. The infection of A. lumbricoides was mainly happened among farmers, with the infection rate of 0.31%. There was a significant difference in the helminth infection rate among different occupations (χ2 = 84.333, P < 0.05). The intestinal parasites infection rate of the illiterate population was the highest and up to 7.63%, there was a significant difference among the populations with different educational levels (χ2 = 72.013, P < 0.05). The helminth infection rate of plain areas was higher than that of valley and hill ( χ2 = 11.690, P < 0.05). The helminth infection rate of people with low-income was the highest and up to 10.32% (χ2 = 244.999, P < 0.05). The protozoan infection rate of people with middle-income was the highest, who had the annual per capita net income of 6 000 to 7 999 Yuan ( χ2 = 24.749, P < 0.05). The helminth infection rate of people drinking well water was much higher than that of people drinking tap water (χ2 = 62.255, P < 0.05). The protozoan infection rate of people without insect repellent was higher than that of people with insect repellent (χ2 = 5.235, P < 0.05). Conclusions The infection rates of human intestinal parasites in the ecological region of the Qinba Mountains in Henan Province have decreased sharply. E. vermicularis infection in children should be the main point of prevention and treatment of parasitic diseases in the future.

Surveillance of human intestinal parasitic diseases in Nanping City from 2014 to 2018 / 中国血吸虫病防治杂志

Objective To investigate the status of human intestinal parasitic diseases in Nanping City from 2014 to 2018, so as to provide reference for the development of the effective control measures. Methods Administrative villages were selected using the two-stage cluster sampling in Nanping City from 2014 to 2018, and surveillance of human intestinal parasitic diseases was performed in 5 administrative villages in each county (district) of Nanping City. Intestinal parasitic infections were detected using a modified Kato-Katz thick smear method (two smears for a single stool sample) in villagers, and the hookworm species was differentiated. In addition, the eggs of Enterobius vermicularis were detected using the adhesive tape method in children aged 3 to 6 years. Results A total of 6 317 villagers were detected in Nanping City from 2014 to 2018, and the overall prevalence of human intestinal parasitic infections was 2.15%. There was year- (χ2 = 10.53, P < 0.05) and gender-specific prevalence of human intestinal parasitic infections in Nanping City during the study period (χ2 = 17.00, P < 0.01). The prevalence of human intestinal parasitic infections increased with age, and there was age-specific prevalence of human intestinal parasitic infections in Nanping City (χ2 = 102.62, P < 0.01). A total of 945 children at ages of 3 to 6 years were detected, and the prevalence of E. vermicularis infection was 3.28%. Conclusions The prevalence of human intestinal parasitic infections is at a low level in Nanping City from 2014 to 2018, and the infection mainly occurs in villagers of advanced age and low education levels. Further comprehensive measures are required to control intestinal parasitic infections in key populations.

Prevalence and influencing factors of intestinal parasitic diseases among rural children in Henan Province / 中国血吸虫病防治杂志

Objective To understand the epidemic status and influencing factors of intestinal parasitic diseases among rural children in Henan Province. Methods According to the Scheme for The National Survey on Current Status of Major Human Parasitic Diseases in China, the survey counties were selected based on the ecological zones and economic levels in Henan Province between 2014 and 2015. Then, the included counties were stratified according to the topography and economic levels. A township was randomly sampled from each stratum, and a village was randomly sampled from each township as the study site. Finally, a total of 104 study sites from 35 counties were enrolled for the survey of intestinal parasitic diseases in children. At least 250 fresh stool samples were collected from each study site for detection of intestinal helminth eggs with the Kato-Katz technique, for the identification of Necator americanus and Ancylostoma duodenale with the fecal culture method, and for the detection of intestinal protozoa trophozoite and cyst with the physiological saline smear and iodine staining techniques. In addition, the Enterobius vermicularis and tapeworm eggs were detected in children aged 3 to 6 years using the adhesive cellophane-tape perianal swab method. Results The overall prevalence of intestinal parasitic infections was 3.21% (214/6 671) among rural children in Henan Province, and the prevalence of intestinal helminthes (2.62%, 175/6 671) was higher than that of intestinal protozoa (0.60%, 40/6 671). A total of 12 species of intestinal parasites were found, including 4 nematodes species, one trematode species, and 7 protozoa species, and the highest infection was seen in E. vermicularis (2.47%, 161/6 671). Among the four ecological zones in Henan Province, the greatest prevalence of intestinal parasitic infections was detected among children in the Qinba Mountain Ecological Zone (5.85%, 90/1 538). There was no gender-specific difference in the prevalence of intestinal parasitic infections in children (P > 0.05); however, there were age- (χ2 = 32.762, P < 0.05) and education level-specific differences in the prevalence of intestinal parasitic infections in children (χ2 = 67.507, P < 0.05), with the greatest prevalence of E. vermicularis infection seen in all species of intestinal parasites in children at all age groups. Multivariate non-conditional logistic regression analysis showed that high education level, high coverage of harmless toilets, drinking tap water and deworming were protective factors for intestinal parasitic infections in children in Henan Province. The overall prevalence of intestinal parasitic infections appeared a tendency towards a gradual decline among children in Henan Province as compared to the previous two surveys. Conclusions The overall prevalence of intestinal parasitic infections shows a tendency towards a remarkable decline among children in Henan Province. E. vermicularis infection should be given a priority for future parasitic disease control activities among rural children in Henan Province.

Epidemiological features and changing patterns of intestinal parasitic diseases in Jiangxi Province / 中国血吸虫病防治杂志

Objective To understand the epidemiological features and changing patterns of intestinal parasitic diseases in Jiangxi Province from 1989 to 2014, so as to provide scientific evidence for formulating the preventive and control strategy for intestinal parasitic diseases. Methods The data regarding the status of intestinal parasitic diseases in Jiangxi Province were captured from the 1989 national survey on the distribution of human parasites in China and the 2014 national survey on major human parasitic diseases in China, and the status of human intestinal parasite infections was compared between the two surveys in Jiangxi Province. Results The prevalence rate of human intestinal parasite infections was 79.59% and 9.64% in Jiangxi Province in 1989 and 2014, with a decline rate of 87.89% during the 25-year period (χ2 = 30 870.5, P < 0.01). There were 24 and 20 species of human intestinal parasites detected in Jiangxi Province in 1989 and 2014, respectively, with totally 26 species detected during the two surveys. In Jiangxi Province, the 3 most highly prevalent human intestinal parasites included Ascaris lumbricoides (71.06%), hookworm (17.61%) and Enterobius vermicularis (17.59%) in 1989, and E. vermicularis (13.73%), hookworm (4.66%), whipworm (0.95%) in 2014. A higher rate of human intestinal parasite infections was found in females than in males in both surveys in Jiangxi Province (P < 0.01), and the prevalence of human intestinal parasite infections reduced by 82.50% to 95.31% in different age groups in Jiangsu Province during the 25-year period. Conclusions The prevalence of human intestinal parasite infections shows a remarkable decline tendency in Jiangxi Province, and soil-transmitted nematodes remain the main species of human intestinal parasites in Jiangxi Province.

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.

Caracterización clínico epidemiológica del parasitismo intestinal en pacientes jóvenes / Clinical epidemiological characterization of intestinal parasitism in young patients

Introducción: entre las enfermedades infecciosas, las producidas por parásitos intestinales constituyen un importante problema de salud para el hombre. Objetivo: caracterizar clínica y epidemiológicamente el parasitismo intestinal en pacientes jóvenes. Métodos: se realizó un estudio observacional, descriptivo y transversal en la consulta externa del Hospital Militar Docente Dr Mario Muñoz Monroy; el universo de estudio estuvo representado por todos los pacientes jóvenesa tendidos durante el período de noviembre de 2013 a octubre de 2014 con el diagnóstico clínico y microbiológico de parasitosis intestinal. Resultados: existió un predominio del sexo masculino con un 91 por ciento, siendo el grupo etario más afectado el de 17 a 22 años para un 60,7 por ciento. El 19,6 por ciento de los enfermos procedían del municipio Calimete. El dolor abdominal, seguido de las diarreas fueron los síntomas más referidos por los pacientes para un 96,4 por ciento y 94,6 por ciento, respectivamente. La Giardia lamblia fue el parásito más identificado en las muestras con un 51,7 por ciento, seguido del Enterobius vermicularis en un 28,6 por ciento. La mayoría de los enfermos no acostumbra a lavar los alimentos antes de su ingestión en un 83,9 por ciento de los casos estudiados, ni practican el lavado de manos previo representando el 69,6 por ciento. Conclusiones: el mayor porcentaje de pacientes enfermos procede del área rural. Los malos hábitos higiénicos-dietéticos constituyen los principales factores de riesgo(AU)

Introduction: Among the infectious diseases, those produced by intestinal parasites are a major health problem. Objective: To characterize the clinical and epidemiological aspects of intestinal parasitism in young patients. Methods: An observational, descriptive and cross-sectional study was carried out in the external consultation of the Military Teaching Hospital Dr Mario Muñoz Monroy; the universe was represented by all the young patients treated from November 2013 to October 2014 with the clinical and microbiological diagnosis of intestinal parasitosis. Results: There was a predominance of males with 91 percent, the most affected age group being 17 to 22 years old for 60.7 percent. 19.6 percent of the patients came from Calimete municipality. Abdominal pain and diarrhea were the most commonly reported symptoms for 96.4 percent and 94.6 percent, respectively. Giardia lamblia was the most identified parasite in the samples with 51.7 percent, followed by Enterobius vermicularis in 28.6 percent. The majority of patients do not usually wash their food prior to their ingestion in 83.9 percent of the cases, nor do they practice previous hand washing, representing 69.6 percent. Conclusions: The highest percentage of sick patients comes from the rural area. Bad hygienic-dietary habits are the main risk factors(AU)

Study on Intestinal Parasitic Infections in Muslim community of Janakpurdham, Nepal

Background and Objectives: Intestinal parasitic infection is an important public health problem in Nepal because of its high morbidity and mortality. The distribution and prevalence of the various intestinal parasites species depend on social, geographical, economical and inhabitant customs. Therefore, the present study was designed to determine the burden of intestinal parasitic infections and its relation with sanitary practices and socio-demographic characteristics in Muslim community of Janakpurdham, Nepal.Material and Methods: A total of 161 stool samples were collected in dry, clean and screw capped plastic container and were preserved with 10% formalin. The stool samples were examined by direct microscopy and confirmed by concentration methods. Modified Ziehl Neelsen (ZN) staining was performed for the detection of coccidian parasites. P- value < 0.05 was considered as statistically significant.Results: The incidence of intestinal parasitic infection was 63.35% (male = 57.84% vs. female = 42.15%) (p = 0.321). The positive cases of parasitic infection were found to be slightly higher in less than 10 years (35.29%) than others. Hookworm (10%) and G. lamblia (28%) infection was marginally higher than other helminthic and protozoan infection. The highest number of positive cases of parasitic infection was found in those who didn’t wash their hands before meal, defecates stool haphazardly in open area, didn’t wash their hands after toilet, didn’t trim their nail, in larger family, with low income and in housewives which was found to be statistically significant (p = <0.05).Conclusion: The health status was found poor among Nepalese Muslim people. Routine periodic screening of parasitic infection among people, changing behavior, public educations on improved personal and environmental hygiene are the fundamental principle in the control of infection.

Infección por Hymenolepis nana en una comunidad indígena del estado Bolívar, Venezuela / Hymenolepis nana infection in an indigenous community from Bolívar State, Venezuela

Introducción: la himenolepiosis es una parasitosis intestinal causada por el género Hymenolepis. De las dos especies que pueden afectar al hombre, H. nana es la más común. Su distribución es cosmopolita, pero más frecuente en regiones tropicales. Objetivos: en junio de 2014 se realizó un estudio transversal para determinar la prevalencia de himenolepiosis en habitantes de la comunidad indígena Itopoicon del estado Bolívar, Venezuela. Métodos: fueron evaluadas 136 muestras fecales procedentes de igual número de personas, mediante las técnicas de examen directo, Kato, Willis y sedimentación espontánea. Se llenó una ficha de control de cada participante con datos de identificación y clínico-epidemiológicos de interés. Resultados: un total de 118 habitantes (86,8 por ciento) resultaron parasitados. De ellos, 26 (19,1 por ciento) tenían infección por helmintos intestinales, siendo Hymenolepis nana el helminto más comúnmente diagnosticado con 19 casos (14 por ciento). De los 19 casos de himenolepiosis, 17 ocurrieron en niños y dos en adultos, siendo la diferencia estadísticamente significativa (x2= 14,26 g.l.= 7 p< 0,05). Con relación al género no se observaron diferencias estadísticamente significativas (p> 0,05). Se determinó una amplia variedad de manifestaciones clínicas (generales, toxico-alérgico o intestinales) en los habitantes con H. nana. Conclusiones: se determinó una elevada prevalencia (14 por ciento) de infección por H. nana en una comunidad indígena del estado Bolívar, Venezuela, siendo ambos géneros afectados por igual pero con un predominio en los niños menores de 10 años. La mayoría de los casos presentó sintomatología(AU)

Introduction: hymenolepiasis is an intestinal parasitic disease caused by the genus Hymenolepis. Of the two species affecting humans, H. nana is the most common. Its distribution is cosmopolitan, but more frequent in tropical regions. Objectives: a cross-sectional study was conducted in June 2014 to determine the prevalence of hymenolepiasis among dwellers from the indigenous community of Itopoicon, Bolívar State, Venezuela. Methods: evaluation was performed of 136 stool samples from an equal number of persons using the techniques known as direct examination, Kato, Willis and spontaneous sedimentation. A control card was filled in for each participant, containing identification details and data of clinical and epidemiological interest. Results: a total 118 inhabitants (86.8 percent) were positive for parasites. Of these, 26 (19.1 percent) had intestinal helminth infection, Hymenolepis nana being the most commonly diagnosed helminth with 19 cases (14 percent). Of the 19 cases of hymenolepiasis, 17 were children and 2 were adults, the difference being statistically significant (2= 14.26 g.l. = 7 p< 0.05). No statistically significant differences were found with respect to gender (p> 0.05). A wide range of clinical manifestations (general, toxic and allergic or intestinal) were found among people with H. nana. Conclusions: ahigh prevalence (14 percent) of H. nana infection was found in an indigenous community from Bolívar State in Venezuela. Both sexes are equally affected, but there is a predominance of children under 10 years of age. Most cases were symptomatic(AU)

Intestinal Parasitic Infections among HIV/AIDS Patients with Diarrhoea at Rural Tertiary Care Teaching Hospital Of Maharashtra.

Background and Objective: Opportunistic intestinal parasites usually cause mild and self- limiting infections in immunocompetent individuals but in the case of people living with HIV/AIDS (PLHA) they cause severe, chronic or frequent gastrointestinal disease. The spectrum of intestinal parasites causing infections in PLHA varies from country to country and region to region within the country. Therefore it is very necessary to know the relative frequencies of specific intestinal parasites causing diarrhoea in PLHA in different regions of the country to devise appropriate management strategies. The present study was conducted with an aim to document the prevalence pattern of various intestinal parasites in PLHA in rural tertiary care teaching hospital of Maharashtra. Methods: Stool samples collected from HIV infected individuals with diarrhoea were screened for the presence of intestinal parasites by standard parasitological protocol. Results and Interpretation: The incidence of HIV infection was high in age group 26-35 years followed by 16-25 years age group. The incidence of HIV infection was high in males as compared to females. Out of 124 stool samples screened, 44 (35.48%) showed presence of intestinal parasites. Cryptosporidium parvum followed by Entamoebahistolytica and Isospora belli were the most common intestinal parasite. Conclusion: Opportunistic intestinal parasitic infections still pose as a problem in rural parts of India. This underscores the importance of screening of stool samples of PLHA. It can be also suggested that along with prompt diagnosis and treatment of opportunistic infection, clean potable water supply, improved sanitation and health education is necessary for preventing opportunistic infection in PLHA.