The Effect of the COVID-19 Pandemic Process on the Incidence of Intestinal Parasites; Aydin Province Example

OBJECTIVE: The Coronavirus disease-2019 (COVID-19) pandemic, which started in our country in March 2020, has caused a sudden and dramatic change in our habits. As a result of the pandemic measures directly effective in the transmission of parasites, it has become important to investigate the possible effect of the COVID-19 pandemic process on the incidence of intestinal parasites. METHODS: In order to examine the situation before and after the pandemic, all stool and cellophane tape test results examined from March 11, 2018 to March 11, 2022 in Aydin Adnan Menderes University Faculty of Medicine Parasitology Laboratory were evaluated retrospectively. The relationship between the socio-demographic characteristics of the cases, the distribution of the months and years of diagnosis and the prevalence of parasites were also evaluated. RESULTS: Of the 13,036 stool samples examined, 67.42% belong to the pre-pandemic and 32.58% belong to the post-pandemic period. In total, 1.959 stool samples were positive for at least one parasite, of which 71.41% were from the pre-pandemic. Blastocystis spp. was the most frequently detected parasite both before (14.63%) and after the pandemic (12.59%). Of the 3.194 cellophane tape examined, 72.32% belonged to the pre-pandemic and 27.68% post-pandemic period, and Enterobius vermicularis eggs were detected in 246 (7.70%) of all. The majority of E. vermicularis positive samples (82.11%) were belonged to the pre-pandemic period. The number and positivity rates of stool and cellophane tape samples examined in the post-pandemic period showed a significant decrease (p<0.05). CONCLUSION: It was observed that the incidence of intestinal parasites decreased significantly during the COVID-19 pandemic. Important developments in terms of public health, such as measures such as social distance and quarantine during the pandemic process, increased sensitivity to personal hygiene, and informing the public through various tools during the pandemic, are thought to be the reason for the decrease in the prevalence of intestinal parasites.

The effect of compliance to Hand hygiene during COVID-19 on intestinal parasitic infection and intensity of soil transmitted helminthes, among patients attending general hospital, southern Ethiopia: Observational study.

BACKGROUND: Intestinal parasitic infection (IPIs) is one of the major health problems in Sub -Saharan Africa where water, sanitation and hygiene practices are inadequate. Taking into account the national level implementation of intensive hand hygiene against COVID-19 pandemic and general protective effect this study assessed its effect on intestinal parasite. OBJECTIVE: This study aim to investigate the effect of compliance to hand hygiene practice on the prevalence of intestinal parasitic infection (IPIs) and intensity of Soil transmitted helminthes (STH) among patients attending tertiary care hospital in southern Ethiopia. METHODS: Observational study was conducted from June to September 2021. Data on socio demographic, hand hygiene practice and intestinal parasite (prevalence and intensity of helminthic infection) was collected from randomly selected and consented patients. Compliance to hand hygiene practice was assessed using pre-tested questionnaire. Fresh stool sample from each participant was examined by direct wet mount, concentration and Ziehl-Neelson (ZN) staining technique to detect intestinal parasite. Intensity of STH measurements was done through direct egg-count per gram using Kato Katz methods. Data analysis was done using SPSS version 25. Odds ratio with 95% confidence interval was used to measure association and p-value <0.05 was considered as statistically significant. RESULTS: The study population (N = 264) consisted of 139(52.65%) male and 125 (47.34%) female with the mean ages of 36 ±16.12(±SD). The proportion of good compliance to hand hygiene during COVID-19 to was 43.93% (95%CI: 37% to 47) and prevalence of intestinal parasite was 26.14% (95%CI:21.2% to 31.75) comprising 23.48% intestinal protozoa and 6.43% of soil transmitted helminthic infection. Gardia lamblia, Entamoeba histolytica/dispar, Ascaris lumbricoides were the common parasite in the study area with prevalence of 15.53%, 6.44%, and 1.52% respectively. Prevalence of intestinal parasite among participants with good compliance to hand hygiene group and poor compliance to hand hygiene were (14.65% vs. 35.13%)(AOR: 0.48,95%CI:0.13 to 0.68) (p = 0.002) implying that good compliance to hand hygiene can reduce the risk of IPIs by 52%. Moreover significantly lower odds of intestinal protozoa among good compliance to hand hygiene group than the control (OR:0.38; (95%CI: 0.20 to 0.71);P = 0.001. However, no significant difference in the odds of intensity of STH infection in good compliance hand hygiene and poor compliance group. The result of this study also confirmed the association between intestinal parasitic infections and younger /adolescent age, education status, habit of eating raw vegetable and figure nail status. CONCLUSION: Good hand hygiene compliance during COVID-19 significantly associated with reduction of intestinal parasitic infection. This finding highlights the secondary protective effect of improved hand hygiene against IPIs and suggest it can used in augmenting the existing parasitic control strategies in the study setting.

The Impact of COVID-19 Pandemic on Access to Healthcare: The Experience of the Diagnostic Parasitology Laboratory of Ege University

Objective: Beyond the Coronavirus disease-2019 (COVID-19) itself, the pandemic influenced healthcare settings in all aspects. It is aimed to demonstrate the effect of the pandemic on access to the healthcare setting in the parasitology direct diagnosis laboratory. Methods: Stool parasitological examination results were obtained retrospectively from the laboratory information system. Data belonging to the one-year of pandemic, lock-down and gradual normalization periods and their time equivalents were compared retrospectively. Results: During pandemic, parasites were detected in 529 of 2.233 samples. Parasites were detected in 58 of the 178 samples during the lock-down period and 471 of the 2.055 samples in the gradual normalization period. Incidence of Cryptosporidium spp. increased during the pandemic and lock-down periods. Incidence of Blastocystis spp. decreased during the pandemic and gradual normalization periods. Incidence of Giardia intestinalis decreased during the pandemic and gradual normalization periods. Incidence of Entamoeba histolytica/dispar increased during the pandemic and gradual normalization periods Incidence of Cyclospora spp. increased during the pandemic and gradual normalization periods. Incidence of Enterobius vermicularis decreased during the pandemic and gradual normalization periods and no case was seen during the lock-down period. Conclusion: Although the incidence of parasites gives the impression that COVID-19 does not cause weakness in the fight against intestinal parasitic diseases, there may be parasitic infections with a similar frequency in the society that cannot access the laboratory. It is predicted that the effects of this vulnerability may lead to an increase in the incidence of parasites in postpandemic period.

Investigation of Intestinal and Blood Parasites in People Returning to Turkey with a History of Traveling Abroad During the Pandemic

Objective: To investigate intestinal and blood parasites in people who have a history of traveling abroad during the Coronavirus disease-2019 pandemic and returning to Turkey. Methods: In this study, 104 patients with gastrointestinal system and/or fever complaints who had traveled abroad during the pandemic period and returned to Turkey were included. Parasitic agents were investigated by taking blood and stool samples from the patients. Additionally, urine samples were obtained from patients with hematuria or dysuria with the suspicion of schistosomiasis. A direct microscopic examination, the Crypto-Giardia immunochromatographic test, and ELISA methods were used in the examination of the stool samples. In order to detect Plasmodium species, blood samples were examined by preparing both the rapid diagnostic test and thick drop and thin smear preparations. Results: One or more parasite species were detected in 38 (38.5%) of 104 patients included in the study. While intestinal parasites were detected in 16 (32%) of 50 patients who traveled to Iran and 16 (33.3%) of 48 patients who traveled to Northern Iraq, blood parasites were not found. Schistosoma mansoni was detected in all 5 of the patients with a history of traveling to Sudan. Plasmodium falciparum was detected in 1 patient who traveled to the African continent. Conclusion: It is vital to take precautions to prevent parasitic diseases, such as malaria and schistosomiasis, during travels to African countries. During travels to neighboring countries of Turkey, such as Northern Iraq and Iran, hygiene should be paid attention to, so as to prevent contracting intestinal parasitic diseases. In addition, it was concluded that people who plan to travel abroad should have information about the endemic parasitic diseases of the country that they are going to.

Intestinal parasitic infections among patients referred to hospitals affiliated to Shiraz University of Medical Sciences, southern Iran: a retrospective study in pre- and post-COVID-19 pandemic.

Intestinal parasitic infections (IPIs) are still a serious public health problem worldwide, particularly in developing countries. The COVID-19 pandemic has affected people's lifestyles and quality of life. Besides, the prevalence of IPIs is directly associated with environmental sanitation, overcrowding, and personal hygiene. Therefore, the current study aimed to determine the prevalence of IPIs among patients referred to hospitals affiliated to Shiraz University of Medical Sciences by reviewing the available data of hospital information system database in the pre- and post-COVID-19 pandemic. The total data of 13,686 patients referred to hospitals affiliated to Shiraz University of Medical Sciences, southern Iran were collected from March 2019 to March 2021. The overall prevalence of IPIs was found to be 4.4%, and Blastocystis spp. was the most common parasite. The prevalence of protozoan parasites (4.4%) was significantly higher than helminthic parasites (0.04%, P < 0.001). A significant association was observed between IPIs with age, gender, and year (P < 0.05). The prevalence of IPIs among those referred to hospitals before the COVID-19 pandemic was higher than those referred to hospitals during the COVID-19 pandemic (5.8% vs 2.8%), and the differences were statistically significant (P < 0.001). The odds of infection among people investigated during the COVID-19 pandemic was about 40% lower than those investigated before the COVID-19 pandemic (AOR: 0.60, 95% CI: 0.49-0.73, P < 0.001). Our results showed that the prevalence of IPIs has decreased during the COVID-19 pandemic. Improved sanitation, personal hygiene, and health education can be effective in reducing parasitic infections in the COVID-19 pandemic.

Shift in parasitic infections during the Corona pandemic: a hospital-based retrospective study.

The Corona pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) calls on the Saudi government to take action to control the infection. The government closed borders, prohibited travel, limited outdoor movements, and told primary and secondary care facilities to reduce all regular non-urgent health services. It is not known whether these measures have impacted the prevalence of parasitic intestinal infections. This study has therefore been carried out to investigate this issue. Dataset of 217 stool samples submitted to the King Faisal Medical Complex (KFMC) Microbiology Laboratory in Taif, Saudi Arabia for parasitological examination during the pandemic (January-June 2020) and 649 samples submitted during the corresponding months of the previous year (January-June 2019) were extracted and analyzed. Overall, 24.1% (209/866) of samples were parasitespositives; 26.6% (173/649) before and 16.5% (36/217) during the pandemic, with 79% reduction. There was a significant difference in gender-parasitism between the two periods where the majority of parasitism were for males (p<0.001). Infections were frequent in patients aged 5- 14 years both before (84/649; 12.9%) and during (12/217; 5.5%) the pandemic, with significant difference observed between the two cohorts (p<0.002). Moreover, the majority of infected patients were non-Saudi (67.9%; 142/209), with a significant difference in nationality reported, (p=0.024). Protozoa were identified in 21.8% (189) of all samples investigated, of which, Blastocystis hominis, Entamoeba coli, Giardia lamblia, Entamoeba histolytica/dispar and Cryptosporidium species were identified in 6.1% (53), 5.4% (47), 5.0% (44), 2.8% (25), and 2.3% (20), respectively. Helminths were diagnosed in 2.3% (20/866) of samples. Eggs of hookworm, Ascaris, Taenia spp, and Hymenolepis nana were detected in 0.9% (8), 0.5% (5), 0.3% (3) and 0.4% (4), respectively. In parallel with our research hypothesis, a substantial decrease in the burden of intestinal parasitic infections was recorded with the lock-down measures taken during the Corona pandemic.