A demographic survey on the prevalence of gastrointestinal parasites based on socioeconomic determinants in Pakistan.

INTRODUCTION: The present study was conducted to investigate prevalence of intestinal parasites and the risk factors related to socio-demographic characteristics of patients admitted in pathology ward, General Hospital, Gujranwala. METHODOLOGY: 318 stool samples were collected from patients and examined under light microscope by using wet mount technique. While socio-demographic information was collected in the form of a questionnaire. RESULTS: The results showed seven (n = 7) species of intestinal parasites were prevalent in stool samples of patients. Among them, four (n = 4) were helminth and three (n = 3) were protozoan parasites causing single and mixed infections. Overall prevalence of intestinal parasites was 78.3% (n = 249/318) considering both male and female patients. Highest prevalence was recorded for A. lumbricoides (n = 125, 39.3%) followed by H. nana (n = 10, 3.1%), S. stercoralis and T. saginata (n = 6, 1.9%). Among protozoan parasites, higher prevalence was recorded in G. lamblia (n = 23, 7.2%) followed by E. histolytica (n = 21, 6.6%). Among single infections, the most prevalent parasite was A. lumbricoides and less prevalent parasites were S. stercoralis and T. saginata. The factors that had significant effect (p < 0.05) on prevalence of parasitic species were contaminated water, food, soil, and surrounding environment. CONCLUSIONS: The present study determined that the parasite helminth (A. lumbricoides, H. nana, S. stercoralis, T. saginata) and protozoan (G. lamblia and E. histolytica) are common that pose an important public health concern in Pakistan.

First report of Echinococcus canadensis (G6/G7) by sequence analysis from the Khyber Pakhtunkhwa province of Pakistan.

Cystic echinococcosis (CE) is a zoonotic parasitic disease that can result in human and animal health problems globally. Although the disease is known to be endemic in Asia and the Middle East, there are few epidemiological studies on CE in Pakistan. The purpose of the present study was to identify the Echinococcus granulosus sensu lato species and genotypes contributing to human CE cases in the Khyber Pakhtunkhwa (KPK) province of Pakistan. A total of fifty-six formalin fixed paraffin embedded (FFPE) CE cyst samples of human origin were collected from the Pathology Department, Rehman Medical Institute (RMI), KPK for the years 2012-2017. Cyst samples came from the liver (26/56; 46.4%), lungs (3/56; 5.3%), spleen (3/56; 5.3%), pelvis (1/56; 1.8%), breast (1/56; 1.8%), and thigh (1/56; 1.8%). The organ location for 21 of the cysts was not recorded. World Health Organization-Informal Working Group on Echinococcosis (WHO-IWGE) ultrasound-based cyst staging was available for 17 of the 26 (65.4%) hepatic cysts. Five of these cysts (29.4%) were CE3 (transitional), nine (52.9%) were CE4 (inactive), and three (17.6%) were CE5 (inactive). Most of the cysts were obtained from CE patients that were ethnically Afghan Pashtuns (44/56; 78.6%), while 12.5% (7/56) were from patients that were Pakistani Pashtuns. The majority (41/56; 73.2%) of patients reported having close interactions with dogs. Using 12SrRNA primers, 33 cyst samples were identified as being caused by E. granulosus sensu stricto (s.s.). Mitochondrially encoded cytochrome C oxidase 1 (mt-CO1) was evaluated for the remaining 23 samples. PCR product was obtained from six of these 23 samples. Of these six samples, one was identified as Echinococcus canadensis (G6/7). Haplotype analysis showed high haplotype and low nucleotide diversity for the mt-CO1 gene. There were 26 polymorphic sites for the mt-CO1 sequence, of which 65.3% (17/26) were parsimony informative. The E. canadensis mt-CO1 haplotype network consisted of 11 haplotypes, with a main central haplotype. In conclusion, it appears that E. granulosus s.s. and E. canadensis (G6/7) are circulating in the northwestern region of Pakistan. Further molecular epidemiological studies are needed to explore the local genetic diversity of the parasite.

Knowledge, attitude & practices (KAPs) regarding rabies endemicity among the community members, Pakistan.

INTRODUCTION: Rabies is one of the most neglected tropical diseases in numerous regions of the world. Annually, 60,000 deaths have been reported, mostly in Asia and Africa. Dogs are responsible for approximately 99% of human deaths due to rabies. Consequently, incidences of canine bites are increased yet rabies continues to remain a neglected disease in Pakistan. The objective of the study was to investigate the Knowledge, Attitude and Practices (KAP) for rabies, among the participants from urban and rural population of Rawalpindi and Islamabad, Pakistan. METHODS: Data was collected by conducting household based cross-sectional survey over a period of 5 months (from January 2018 to May 2018). Quantitative data was collected in the form of questionnaires to investigate awareness and knowledge of rabies among the participants. The questionnaire compromised of socio-demographic features and degree of KAP with respect to rabies management and control. RESULTS: A total sample size of 434 participants responded in the study. Among them, 89.4% were found to have heard about rabies, 38.7% have no knowledge of signs and symptoms, 93.3% knew that infected dogs are the major cause of spreading rabies and 77.6% considered that the vaccination of animals is important for prevention of rabies. However, only 39.8% actively seek medical treatment at a hospital if bitten by a dog. From the 434 participants 61 reported dog bites, of which 68.8% (42/61) were male and 49.1% (30/61) belonged to age group of 6-25 years. CONCLUSION: This study concludes that respondents have relatively limited knowledge, inconsistent attitude and poor practices towards rabies prevention and control. There is a high need of imparting knowledge to the population from multidisciplinary programs for effective management and prevention of rabies.

Knowledge, attitudes and practices related to cystic echinococcosis endemicity in Pakistan.

BACKGROUND: Cystic echinococcosis (CE) is a human and animal health problem in many endemic areas worldwide. It is considered a neglected zoonotic disease caused by the larval form (hydatid cyst) of Echinococcus spp. tapeworm. There are limited studies on echinococcosis in Pakistan. METHODS: A cross-sectional survey was conducted to find out recent knowledge, attitudes and practices on the occurrence of cystic echinococcosis in butchers and dog owners in both urban and rural areas of Rawalpindi/Islamabad regions, Pakistan. The quantitative data was collected in the form of questionnaires to investigate the knowledge and awareness of CE among community members and their routine practices that  were behind the factors involved in hydatid cyst infection. The practices and infrastructure of abattoirs/butcher shops and their role in transmission of cystic echinococcosis were also evaluated in the present study. RESULTS: The participants involved in the study were dog owners and people who kept animals. A total of 400 people were interviewed and 289 questionnaires were received. The results showed that only 4.1% of people have heard about the disease, and 58.1% were closely associated with dogs. Sixty-three percent of dogs in study area were consuming uncooked organs (e.g. liver, lung, etc.) of slaughtered animals, while 100% of dogs at butcher shops were consuming uncooked organs. Home slaughtering was common in 20.06%. Among butchers, 32.3% had heard about zoonoses and 7.61% knew about CE. The statistical analysis showed that there was highly significant difference (P < 0.05) among most of the practices that were associated with the prevalence of CE. CONCLUSIONS: It  was concluded from the present study that, the knowledge and awareness of CE among people of Rawalpindi/Islamabad were low. Because of dogs and poor knowledge of CE among community members and butchers, the transmission of echinococcosis is facilitated. Therefore, there is urgent need to strengthen awareness and health education among people, as well as proper practices related to the CE not only in the study area, but also in other areas of Pakistan.

Academic influence of institutes in field of schistosomiasis control and re-search in China / 中国血吸虫病防治杂志

Objective To assess the academic influence of schistosomiasis control and research institutions in China. Meth-ods The papers (including original articles and reviews) pertaining to schistosomiasis in Science Citation Index Expanded (SCIE)of Web of Science(WOS)during the period from 2002 to 2012 were searched. The number of published papers,h index and citation frequencies of the papers of Chinese institutes and authors were analyzed by a bibliometric method,and the academic influences of the institutes and authors were assessed according to the number of published papers and h index. In addition,the scientific knowledge network map was plotted by using the CiteSpace II software to analyze the inter-institution academic collabora-tion network. Results From 2002 to 2012,totally 610 papers pertaining to schistosomiasis were published by Chinese scholars, accounted for 16.7%of the published papers in global,and the quantity increased year by year. The number of published papers and h index of the National Institute of Parasitic Diseases(NIPD),China Center for Disease Control and Prevention(China CDC) were 114 and 27,respectively,both of which were ranked at the first position among all the Chinese institutes,and in the academ-ic collaboration network,the NIPD played a central and dominate part. Xiao-Nong Zhou with the h index of 17 became the out-standing academic leader in the research field of schistosomiasis control. Conclusions Both number of published papers in SCIE and h index of the Chinese institutes for schistosomiasis control are far inferior to the leading institutions in the world. It suggests that when strengthening the research and control of schistosomiasis,we should pay an attention to the output and sharing of the control experience and achievements.

Cluster analysis of cystic echinococcosis in Non Tibetan Plateau regions / 中国血吸虫病防治杂志

Objective To understand the endemic characteristics and regularity of cystic echinococcosis by evaluating and classifying its endemic situation in Non Tibetan Plateau regions,so as to provide the evidence for formulating effective preventive and control measures. Methods The prevalence data of cystic echinococcosis in 174 counties(cities,districts,banners)in Non Tibetan Plateau regions from a national survey were collected and analyzed by the sample cluster method in 2012. Results The 174 counties(cities,districts,banners)could be classified into 4 clusters by spatial distribution. The first cluster with human high prevalence rate,low infection rate of livestock,and positive rate of dog stool antigen included 3 counties. The second cluster with high infection rate of livestock,low prevalence rate of human,and positive rate of dog stool antigen included 20 counties(cit-ies). The third cluster with high positive rate of dog stool antigen,low prevalence rate of human,and low infection rate of livestock included 39 counties(cities,districts,banners). The fourth cluster with low rates of the above 3 indices included the rest 112 counties. Conclusions The results of the cluster analysis conform to the current epidemiological status of cystic echinococcosis in the Non Tibetan Plateau regions. The epidemiological characteristics and geographical distributions of the four area types will pro-vide a basis for the classified management and guidance of cystic echinococcosis control in these areas.