Worldwide prevalence of emerging parasite Blastocystis in immunocompromised patients: A systematic review and meta-analysis.

BACKGROUND: Blastocystis is one of the most common pathogens of the human intestine, caused by an emerging parasite, which can lead to severe symptoms and even death in immunocompromised patients. We aimed to determine the global prevalence of Blastocystosis infection in people with immunodeficiency. A systematic literature search was conducted on Web of Science, Scopus, Google scholar, Science Direct and MEDLINE databases to select all observational studies reporting the prevalence of Blastocystosis infection in Worldwide, based on different diagnostic methods in immunocompromised patients of any age and published from inception to February 2019. Pooled estimates and 95% confidence intervals (95% CIs) were calculated using random effects models and in addition, the I2 statistic was calculated. The geographic distribution of studies was evaluated and the diagnosis of Blastocystis was compared by various techniques. Electronic databases were reviewed for Blastocystosis infection in HIV/AIDS, cancer and other immunocompromised patients, and meta-analyses were conducted to calculate the overall estimated prevalence. Total68 eligible studies were included. The estimated pooled prevalence rate of Blastocystosis infection in immunocompromised patients was overall 10% (95% CI, 7-13%; I2 96.04%) (P < 0.001), of whom 21% [18-25] were in Australia, 12% [4-24] in America, 11% [6-17] in Europe and 10% [5-15], 7% [3-13] in Asia and Africa, respectively. It was calculated that the estimated pooled prevalence rate of Blastocystosis infection in immunocompromised patients was overall 10% and the prevalence estimates ranged from 0.44 to 72.39. Also, overall the prevalence of parasites co-infection in immunocompromised patients was detected as 0.024%. Our finding showed that immunocompromised people show a high prevalence of Blastocystosis infection compared to the control population. Adequate information on the prevalence rate is still missing from many countries. However, current information underscore that Blastocystis should not be neglected.

Impact of Helicobacter pylori Eradication Therapy on Platelet Counts in Patients With Chronic Idiopathic Thrombocytopenic Purpura.

This study was a before and after clinical evaluation of Helicobacter pylori eradication on platelet counts in a group of 23 patients with chronic Idiopathic (Autoimmune) thrombocytopenic purpura (CITP). H. pylori infection was identified in patients by a (13)C-urea breath test and confirmed by an H. pylori stool antigen test. Eradication was conducted in patients testing positive. Infected (n = 10) and uninfected (n = 13) patient groups did not differ with respect to age, gender, history of previous splenectomy, treatment with anti-D, current treatment with corticosteroids, or initial platelet counts. H pylori eradication was successful in eight infected CITP patients, with two patients not responsive to treatment. Compared to the uninfected group, patients in the infected group who responded to eradication therapy had significantly increased platelet counts after six months (56.2 ± 22.2 vs. 233 ± 85.6 ×10(3) million cells/L; P < 0.01), whereas platelet counts in the non-responding patients and uninfected group did not differ after this period of time. H. pylori eradication promotes significant platelet count improvement in patients with CITP. Thus, all patients with CITP should be tested and treated for H. pylori infections.