Clinical varieties of Toxocariasis canis in Children's Hospital, Mansoura University: is it an underestimated problem?

Human toxocariasis is a worldwide parasitic disease. Children are more frequently infected because of the closer contact with contaminated soil and relatively frequent geophagia. Toxocariasis in children has variable modes of presentation but clinical diagnosis is difficult. Various clinical phenotypes of toxocariasis in symptomatic children attending Children's Hospital Mansoura University were studied. A total of 480 children were included in the study with mean age 7.24 +/- 4.22 years, 61.9% were boys and 200 age-sex-matched healthy controls. Patients were examined clinically, and the anti-Toxocara antibodies in the blood of children were performed by ELISA using T. canis larval excretory-secretory products as antigen. Eosinophils level in peripheral blood was measured. Sero-positive cases were 12 % of patients and only 3.5% of controls. Statistical analysis showed a significant association between infection and male sex (P <0.001). Sero-positive children were older than the sero-negative (P <0.001). Eosinophilia was detected in 86.2% of sero-positive children. Sero-positivity and degree of eosinophilia were more frequently detected among patients with allergy (bronchial asthma and urticaria). Degree of eosinophilia was found to be positively correlated to the optical density (OD) ELISA of anti-Toxocara IgG.

Helminthes of synanthropic rodents (Rodentia: Muridae) from Dakahlia and Menoufia, Egypt.

A cross-sectional survey was conducted to monitor and compare the prevalence of helminthes in rodents from Dakahlia and Menoufia governorates. The domestic rodents (271) were Rattus norvegicus, Rattus rattus frugivorous, Rattus r. alexandrinus, & Mus musculus. The overall prevalence of helminthes was 52.8%. In Dakahlia, 72/145 rats (49.6%) were infected. The highest prevalence of infection was in R. r. frugivorous 43 (60.4%), then R. r. alexandrinus 44 (47.7%), R. norvegicus 38 (44.7%), and the lowest was M. musculus 20 (40%). In Menoufia, 71/126 rats (56.3%) were infected. The highest prevalence of infection was in R. r. frugivorous 36 (77.7%), then M. musculus 27 (48.1%), R. norvegicus 23 (47.8%), and the lowest was in R. r. alexandrinus 40 (47.5%). A total of 24 species of helminthes (11 trematodes, 4 cestodes & 10 nematodes) were identified among the 271 rodents. The commonest trematode was Mesostephanus aegypticus followed by Stictodora tridactyla. The commonest cestode was Hymenolepis diminuta followed by Taenia taeniaformis. The commonest nematode was Capillaria hepatica followed by Trichurus muris. Given the zoonotic potential of rodents' parasites and since several residential, commercial, and agricultural sites exist in the examined geographic areas, the potential health risk should not be ignored.

Echinococcosis granulosus/hydatidosis an endemic zoonotic disease in Egypt.

The hydatidosis patients were collected from Mansoura University's Hospitals and Dakahlia Public Health Hospitals. The patients were divided into three groups: GI: 74 patients with surgically confirmed cystic echinococcosis (CE), GII: 45 patients with other parasitic infections, GIII: 30 healthy parasite-free individuals. All were subjected to questionnaire and full clinical examination, imaging investigation, routine laboratory examination, and serum samples for antibody against CE by the specific ELISA. The hydatidosis was higher in females but without statistically significant difference (p = 0.309). There was no age predilection difference regarding hydatidosis infection. However, the hydatidosis granulosus was significantly higher in the shepherd followed by the farmers. All the questionnaires were positively correlated to hydatidosis infection except the availability of clean domestic water and personal knowledge about hydatidosis gave negative correlations. The ELISA-OD correlated positively with the imaging investigation (mainly U S stage). The sensitivity of ELISA was 86.7% and specificity was 81.4%. The results were evaluated regarding the local and regional data on echinococcosis/hydatidosis.

Echinococcosis (zoonotic hydatidosis) in street dogs in urban and rural areas, Dakahlia Governorate, Egypt.

A total of one hundred and ninety street dogs were captured from urban area, Mansoura district and three hundreds and fifty from rural area, Met El-Korama and adjacent villages (Manshet El-Badawy, Talka Center). The overall prevalence of Echinoccocus granulosus was 5%, with a worm burden ranging from 4 to 1010 (mean = 421). The prevalence was 6% in rural locality and 3.2% in urban locality. E. granulosus in dogs was significantly higher in rural areas but, without significant difference in puppies and males. The overall sensitivity was 61.5% and specificity was 97.5%. Apart from E. granulosus, dogs were also, infected with Taenia sp., Diplydium caninum, Toxocara canis, Trichurus vulpis and Ancylostoma caninum. The major cross-reactions were with Taenia sp., and D. caninum. Significantly, no correlation was found between ELISA on dogs' sera and E. granulosus burden.

Host-induced phenotypic differences in Egyptian Heterophyes heterophyes (Digenea: Heterophyidae).

A comparative morphometric study identified host-related variations in Heterophyes heterophyes. In one study, variations in adult H. heterophyes obtained from different definitive hosts were examined. Significant differences were in size and dimensions of body organs of adults collected from dogs, cats and albino-rats experimentally infected with encysted metacercariae (EMC) from mullet (Mugil cephalus). Hypotheses on the sources of host-dependent variations were interpreted in terms of adaptation to conditions created by the host. In a second study, comparative morphometric analysis of adults recovered from puppies experimentally fed on EMC isolated from five sympatric fish species was done. No significant differences were in adults H. heterophyes recovered from puppies feed on EMC of different fishes. Constancy in morphological characters of adults reared in the same host, independent of a change of fish was seen. So, the variations depend upon host species where worms develop, and host selection may determine the worm morphology and phenotypic plasticity.

Natural infection of fresh and brackish water fish with heterophyid encysted metacercariae in Dakahlia Governorate, Egypt.

The encysted metacercariae (EMC) of heterophyids in the fish species; Mugil caphalus, M. capito, M. auratus, Oreochromis n. niloticus (=Tilapia nilotica), and Tilapia zillii trapped brackish and fresh water fishes were isolated by the artificial digestion method and identified. The EMC by morphometric analysis proved to be seven phenotypical distinct types. Cross-matched seven groups of clean laboratory bred puppies each was experimentally infected with a distinct EMC type. The recovered adult flukes were compatible to seven species of six genera of family Heterophyidae. These were Heterophyes heterophyes, H. aequalis, Pygidiopsis genata, Haplorchis yokogawai, Prohemostomumn vivax, Phagicola sp. and Stictodora sp. The EMC of the seven heterophyids were recovered from all the brackish water fishes, M. caphalus, M. capito, M. auratus, O. niloticus and T. zillii. On the other hand, the EMC of P. genata, Haplorchis yokogawai and Phagicola sp. were recovered only from the fresh water fish, O. niloticus and T. zillii. All the EMC was re-described and photographed.

Hydatidosis granulosus in Egyptian slaughtered animals in the years 2000-2005.

Hydatidosis was investigated among camels, sheep, goats, and pigs in Egyptian official abattoirs, from August 2000 to August 2005, and among cows and buffaloes were in Mansoura official abattoirs, in the year 2005. One hundred randomly chosen animals of each species were subjected to serologic and histopathologic examinations for infections. The overall five years hydatidosis prevalence was 2.53%, 0.3% & 0.68% in camels, sheep & goats, and pigs respectively. The 2005 year prevalence in cows and buffaloes was 6.4% in Mansoura. There was a significant difference between animals regarding liver infection, but the difference was highly significant for lung infection. A highly significant difference in hydatid cysts size was between pigs and other animals species (p< 0.000) and a significant difference between macroscopic findings in pigs and camels (p=0.018). A high significant difference was between histopathology in all animals species except pigs and sheep & goats (p=0.089). IHAT showed highly significant difference between camels and other animals species (p<0.000). A significant histopathologic positive correlation was between positive IHAT and fertility (Pearson correlation =0.148, p=0.003). The results were photographed and discussed.

Cytokines and immunoglobulin-E in certain parasitic diseases.

Ninety Egyptian patients were classified into 7 groups, 6 with different parasitic infection and 10 normal controls. Forty patients with different schistosomiasis stages (1, 2 & 3) with compensated but the last one (stage 4) of decompansated schistosomiasis. Gs3 & 4 of mixed infections with schistosomiasis and HCV & HBV respectively. The last 3 patients groups were infected with toxoplasmosis, filariasis and hymenolepiasis nana. IL2, IL4 & Ig E levels were measured. The results showed significant increase in IL2 (P < 0.05), (P < 0.01), P < 0.01) & (P < 0.001) among stages (1, 2, 3 & 4) versus control respectively. In chronic schistosomiasis with HCV & HBV, significance was P = < 0.001 & P < 0.05 respectively, among toxoplasmosis, filariasis and hymenolepiasis patients, it was P = < 0.001, 0.05 & 0.01 respectively. The IL 4 level showed highly significant increase (P< 0.001) among stage 1, 2, Gs 2, 3 & 6. There was significant increase (P < 0.01) with stage 3 in Gs 4 & 5 but, without significance (P > 0.05) increased in decompensate schistosomiasis patients. IgE level and test of significance versus controls were given and results were discussed.