Safeguarding health on every plate: Intestinal parasitic infection survey of food handlers in a tertiary care centre.

Food borne infections pose significant public health problem, especially in developing countries of the world. A continuous surveillance to ensure the health of the personnel involved in preparation of the hospital food is important as they can be a source of spreading the infections and possible outbreaks. We analysed the data of the prevalence of intestinal parasitic infections in food handlers in our tertiary care centre from 2018 to 2022 and 6.8% were observed to harbour intestinal parasites during the period. This signifies the importance of routine screening, and the need of awareness and education of the food handlers in hospitals.

Prevalence and contributing factors of intestinal parasitic infections among school children with malnutrition in Hetauda, Nepal: A cross-sectional study.

Background and Aims: With existing undernutrition in the developing world, the prevalence of obesity is increasing rapidly. Some studies reported an association of intestinal parasitic infection (IPIs) with undernutrition while few recent studies reported an inverse association of IPIs with overweight and obesity. This study evaluated the comparative risk and associated factors of IPIs among under (body mass index [BMI] < 18.5), normal (BMI: 18.5-24.9) and overweight (BMI > 24.9) school-aged adolescents. Methods: A total of 105 fecal samples were collected, with 35 samples from each group. The collected samples were tested for the presence of intestinal parasites via concentration method, and the parasites were identified morphologically. Results: Overall prevalence of IPIs was 5.71% with 3 protozoa viz Giardia lamblia (2.86%), Entamoeba histolytica (1.90%) and Endolimax nana (0.95%). Univariate and multivariable regression analysis indicated none of the nutritional, socioeconomic status, demographic, lifestyle and behavioral characteristics were significantly associated with the prevalence of overall IPIs. Yet, significant numbers of male reported undernutrition and elevated risk of IPIs in this study population. Conclusion: Despite low prevalence of IPIs in this study, risk of IPIs is attributable to individual differences in behavior like "not using soap for hand washing". Relatively elevated malnutrition with risky hygiene behaviors, male adolescents appeared as risky cluster of school age population.

Intestinal Parasitic Infections in People Referring to the Central Laboratory of Meshkin Shahr County, Ardabil Province, Iran.

Background: Intestinal parasitic infections are still a considerable global public health problem. We aimed to determine the frequency of intestinal parasitic infections among people referring to the central laboratory of Meshkin Shahr City, Ardabil Province, Iran. Methods: In this cross-sectional survey, 460 fecal samples were collected randomly from persons referred to the central laboratory of Meshkin Shahr City, from January to June 2022. The samples were examined by direct wet-mount, Trichrome and modified Ziehl-Neelsen staining, formalin ethyl acetate sedimentation, and agar plate culture. Results: The frequency of intestinal parasites was 15.7% (72 out of 460 cases), with some people with numerous intestinal parasites. The frequency of protozoan infections (13.9%) was higher than the helminthic infections (2.6%). Blastocystis spp. (8.1%) was the most prevalent detected intestinal protozoan. Entamoeba coli (5.7%), Dicrocoelium dendriticum (2.2%), Giardia lamblia (1.5%), Fasciola spp. (0.2%), and Hymenolepis nana (0.2%) were other detected parasites. Conclusion: In- spite of betterment of the health condition in Iran and reduction of parasitic infection, intestinal parasitic infections are still a considerable public health issue in some parts of Iran.

Enteric parasites and associated factors in cancer patients in Nepal.

Infection with intestinal parasites is widespread worldwide, especially in developing countries. Intestinal parasites are a major cause of diarrhea in both immunocompetent and immunocompromised people, but cancer patients are more prone to infection. This study aimed to investigate the prevalence and risk factors of intestinal parasitic infections (IPIs) among cancer patients undergoing chemotherapy at Nepal Cancer Hospital and Research Center (NCHRC) in Nepal. One hundred individuals were selected with a convenience sampling strategy. The stool samples were examined by direct wet mount, sedimentation, flotation, and acid-fast methods to determine the prevalence and intensity of IPIs in this population. The overall prevalence of IPIs was 8% (4% protozoan and 4% helminths). Altogether, three species of intestinal parasites were detected. Cryptosporidium (4%) was predominant followed by Trichuris trichiura (2%) and Ancylostoma duodenale (2%). Multivariable regression analysis revealed that "not using soap for handwashing" was significantly associated with the prevalence of overall IPIs. None of the other evaluated risk factors indicated an association with IPIs infection. In this study, the IPIs were attributable to individual hygiene behaviors, but not to nutritional status or socio-demographic characteristics. Yet, significant numbers of males reported anemia and undernutrition in this study population.

The spectrum of parasitic infections with emphasis on the clinico-epidemiological characteristics and risk factors among immunocompromised and immunocompetent patients at a university hospital in Northern India.

Introduction: Intestinal parasitic infections pose a substantial threat to public health and are a huge burden to the economic development of a developing country. We aimed to identify the spectrum of intestinal parasitic infections with an emphasis on demographic and clinical characteristics observed among immunocompromised and immunocompetent patients. Materials and Methods: This observational study was performed in the Parasitology section of the Department of Microbiology from January 2022 to July 2022. A total of 2628 stool samples were obtained from patients presenting with chief complaints of abdominal pain, distension, vomiting, and foul-smelling feces. All the clinical and diagnostic data of the patients enrolled in the above-mentioned period were extracted from the ward files, hospital electronic records, and laboratory registers. Result: A total of 2628 stool samples were sent to the Parasitology section of the Department of Microbiology. Out of the above-mentioned samples, 70 (70/2628, 2.66%) samples yielded gastrointestinal parasites on microscopic examination. The mean age of the patients included in our cohort study was 32.53 ± 16.21 years with a male predominance of 72.86% (51/70, 72.86%). The most common gastrointestinal parasite identified from stool samples was Giardia lamblia (61/70, 87.14%). All cases of opportunistic gastrointestinal infection caused by Cryptosporidium spp. (4/70, 5.71%) in our study cohort were found to infest the immunocompromised patients. Conclusion: This study determines the spectrum of intestinal parasitic infections among the immunocompromised and immunocompetent individuals and guides physicians in starting appropriate anti-parasitic treatment along with the instillation of strict hand hygiene techniques.

Intestinal parasitic infections and risk analysis among urban refugees in the Klang Valley, Malaysia.

BACKGROUND: Global studies show intestinal parasitic infections (IPIs) have been introduced and spread with refugee inflows from low to high socio-economic countries. However, there is relatively limited information on the prevalence of infections among the community. METHODS: A 2-year cross-sectional study was conducted to determine the prevalence and associated risk factors for infections among urban refugees in the Klang Valley, Malaysia. A total of 418 faecal samples were collected and examined by microscopy. RESULTS: Faecal screening revealed moderate levels (32.3%) of infections in the community. Three nematode (Ascaris lumbricoides, Trichuris trichiura and hookworm) and three protozoan species (Entamoeba, Giardia and Cryptosporidium) were recorded, with the highest prevalence being A. lumbricoides (20.6%) followed by T. trichiura (10.3%), while other infections were <5%. Statistical analysis found that young males with less education were more likely to be infected with helminths. Additionally, living near waste disposal sites, the presence of stray animals, eating with bare hands, bare footedness, poor handwashing practices and no anthelmintic treatment constituted significant risk factors for helminth infections. Protozoan infections were linked to drinking tap water or from water dispensers and poor handwashing practices. CONCLUSIONS: These findings emphasize the importance of health education in addition to introduction of biannual anthelmintic treatment to promote community health and well-being.

Magnitude and Determinants of Intestinal Parasites among Children under Five in Ethiopia During 2010-2023: A Systematic Review and Meta-Analysis.

Background: Intestinal parasitic infection (IPI) poses a serious public health threat across the globe, particularly in children in low- and middle-income countries like Ethiopia. This study was to provide pooled estimates for the individually available data on IPI and its predictors among children under five in Ethiopia. Methods: Cochrane's Q, I2, sensitivity analysis, funnel plot, Begg's, and Egger's regression tests were used to check heterogeneity and publication bias. A random-effects model was used to calculate the pooled burden of IPI among children under five. Results: The pooled prevalence of IPI among children under five was 28.27% (95% CI = 20.52-36.03%). Of these, single and mixed infections contribute to 28.02% and 0.25%. Intestinal parasites were significantly associated with eating raw fruits and vegetables [AO = 3.21, 95% CI = 1.11, 5.31]. Conclusion: Under the present scenario, the IPI ranges from 17.78 to 40.05%, and the IPI is higher in community-based studies of children under five.

Prevalence of intestinal parasites during pre- and post-COVID-19 pandemic at a tertiary care center in Lebanon.

INTRODUCTION: Intestinal parasitic infections (IPIs) are a major medical and public health problem, especially in developing countries. This study aimed at comparing the prevalence and types of IPI during pre- and post-COVID-19 pandemics, and with data reported in Lebanon a decade ago. METHODOLOGY: Stool specimen results from a total of 4,451 and 4,158 patients were examined using the concentration method during the pre-covid (2017-2018) and post-covid (2020-2021) pandemic periods, respectively. Demographic information related to patient's age and gender was recorded. RESULTS: The overall positive detected parasites among the total tested in these two periods were 589 (13.2%) and 310 (7.5%), respectively. The protozoa accounted for most parasites (e.g., Blastocystis hominis, Entamoeba coli (E. coli), Entamoeba histolytica, and Giardia lamblia). Only B. hominis and E. coli showed significant differences; B. hominis was more prevalent in the post-covid period (33.5%) whereas E. coli in the pre-covid phase (44.5%). Among gender, E. histolytica was higher in males during the post-covid period (13.3% vs. 6.3%). Regarding age, adults (between 26 and 55 years) had the highest prevalence, with a noticeable decrease among the elderly in the post-covid time. Compared to the previous decade, the prevalence of B. hominis and E. coli remained higher, and that of E. histolytica and G. lamblia was almost the same. CONCLUSIONS: These findings indicate an overall reduction in the prevalence of IPI during the post-covid period, though IPIs persistence remains high. This highlights the need for enhancing public health awareness efforts to improve hygiene and sanitation to reduce parasitic prevalence in Lebanon.

Investigating intestinal parasitic infections with emphasis on molecular identification of Strongyloides stercoralis and Trichostrongylus colubriformis in north of Iran.

Currently, parasitic infections are one of the important health problems in the world, especially in developing countries. This study aims to investigate intestinal parasites with an emphasis on molecular identification through the analysis of mitochondrial COX1 and ITS2 gene sequences of Strongyloides stercoralis (S. stercoralis) and Trichostrongylus spp. in north of Iran. Five hundred forty stool samples were collected from medical diagnostic laboratories affiliated with Mazandaran University of Medical Sciences in Sari city, north of Iran. First, all the samples were examined using direct smear, formalin-ether sedimentation, and trichrome staining technique. Suspected samples of Strongyloides larvae were cultured in agar plate. Then, DNA was extracted from samples containing Trichostrongylus spp. eggs and Strongyloides larvae. To amplify DNA, PCR was performed and the samples with a sharp band in electrophoresis were sequenced by Sanger method. Overall, the prevalence of parasitic infections in the study population was 5.4%. The highest and the lowest level of infection was observed with Trichostrongylus spp. and S. stercoralis at 3% and 0.2%, respectively. No traces of live Strongyloides larvae were seen in the culture medium of the agar plate. The six isolates obtained from the amplification of the ITS2 gene of Trichostrongylus spp. were sequenced, all of which were Trichostrongylus colubriformis. The sequencing results of COX1 gene indicated S. stercoralis. In the present study, the prevalence of intestinal parasitic infections in north of Iran has relatively decreased that its main reason can be due to the coronavirus epidemic and compliance with health principles. However, the prevalence of Trichostrongylus parasite was relatively high that it requires special attention to apply appropriate control and treatment strategies in this field.

Burden of intestinal parasitic infections and associated factors among pregnant women in East Africa: a systematic review and meta-analysis.

BACKGROUND: The ultimate goal of preventing intestinal parasites among pregnant women is to reduce maternal and newborn morbidity and mortality. Numerous primary studies were conducted in East Africa presented intestinal parasite infection and associated factors among pregnant women. However, the pooled finding is not known. Therefore, this review aimed to identify the pooled prevalence of intestinal parasite infection and its determinants among pregnant women in East Africa. METHODS: Articles published from 2009 to 2021 were searched in PubMed, Web of Science, EMBASE, and HINARI databases. The search for unpublished studies such as thesis and dissertations was checked in Addis Ababa University and Africa Digital Library. PRISMA checklist was used to report the review. Articles published in the English Language were considered. The data were extracted by two authors using data extraction checklists on Microsoft excel. Heterogeneity among the included studies was checked using I2 statistics on forest plots. Sensitivity and sub-group analyses were conducted to assess the presence of primary studies, and study characteristics responsible for the observed heterogeneity. RESULTS: Of the 43 identified articles, about 23 articles were removed due to duplications. Then, by assessing the abstracts and full texts, four articles were removed because they failed to meet the eligibility criteria. Finally, 16 articles were included in the systematic and meta-analysis.The pooled prevalence of intestinal parasites among pregnant women in East Africa was 38.54 (28.77, 48.32). In this study, variables like residing in rural areas (OR: 3.75; CI: 1.15,12.16), availability of latrine(OR: 2.94; 95% CI: 2.22, 3.91), eating raw fruits/vegetables (OR: 2.44; 95% CI: 1.16, 5.11). and sources of water as unprotected sources (OR: 2.20; 95% CI: 1.11,4.35) show statistically significant association with the increased burden of intestinal parasites among pregnant women. CONCLUSION: The burden of intestinal parasite infection among pregnant women in East Africa was high. Therefore, efforts should be made in deworming pregnant women at the community and institutional level by stakeholders to reduce the burden of intestinal parasite infections and related complications.

An Epidemiological Survey of Intestinal Parasitic Infection and the Socioeconomic Status of the Ethnic Minority People of Moken and Orang Laut.

Ethnic minority groups are often subjected to exclusion, social and healthcare marginalization, and poverty. There appears to be important linkages between ethnic minority groups, poor socioeconomic status, and a high prevalence of parasitic infection. Data regarding the prevalence and health effects of IPIs are necessary in the development and implementation of targeted prevention and control strategies to eradicate intestinal parasitic infection in the high-risk population. Thus, we investigated for the first time the intestinal parasitic infection status (IPIs), the socioeconomic status, and sanitary condition in the communities of Moken and Orang Laut, the ethnic minority peoples living on the coast of southwest Thailand. A total of 691 participants participated in the present study. The information concerning socioeconomic status and sanitary condition of the study population was obtained by personal interviews using a picture questionnaire. Stool samples were collected and examined for intestinal parasitic infection using direct wet smear and formalin-ethyl acetate concentration techniques. The results revealed that 62% of the study population were infected with one or more types of intestinal parasites. The highest prevalence of intestinal parasitic infections was found in the 11-20-year-old age range group. A statistically significant difference of IPIs among the three communities were observed (p < 0.0001). There was a statistical difference concerning 44 multiple infections of soil-transmitted helminths (STHs) (p < 0.001), whereas no statistically significant difference in multiple infections of protozoa was observed (p > 0.55). The results also displayed the significant difference in socioeconomic status and sanitary condition among the Moken living in Ranong and Phang Nga and the Orang Laut living in the Satun province (p < 0.001). Our study found no direct association between parasitic infection status and ethnic/geographic features; however, socioeconomic status is the key factor associated with prevalence of intestinal parasitic infection, with the observation that the higher prevalence of IPIs is due to a low socioeconomic status, consequently leading to poor hygiene and sanitation practices. The picture questionnaire played a major role in information gathering, especially from those of low or no education. Lastly, data pertaining to the species of the parasites and the mode of transmission assisted in the identification of group-specific vulnerabilities and shortcomings that can be utilized in education and corrected to reduce the prevalence of infection in the study areas.

Mono-Parasitic and Poly-Parasitic Intestinal Infections among Children Aged 36-45 Months in East Nusa Tenggara, Indonesia.

The prevalence of intestinal parasitic infection remains high in developing countries, especially because of geographic and socio-demographic factors. This study aimed to evaluate intestinal parasitic infection, as well as its risk factors, among children aged 36-45 months in a rural area (North Kodi) and an urban area (Kupang) of East Nusa Tenggara, Indonesia. Anthropometry, socio-demographic factors and personal hygiene practices were assessed. A total of 214 children participated in the study, and 200 stool samples were collected for intestinal parasite examination. Approximately 30.5% (61/200) of the children were infected with one or more intestinal parasites (67.2%; 41/61 being mono-parasitic infections and 32.8%; 20/61 being poly-parasitic infections). A total of 85 intestinal parasites were detected, consisting of 35.3% (30/85) protozoa and 64.7% (55/85) helminths. The predominant protozoa were Giardia lamblia (43%; 13/30) and Blastocystis spp. (33.3%; 10/30), whereas the predominant helminths were Trichuris trichiura (50.9%; 28/55) and Ascaris lumbricoides (43.6%; 24/55). Moreover, intestinal parasitic infection was associated with rural area (OR 4.5; 95%CI 2.3-8.6); the absence of treatment with deworming drugs (OR 2.56; 95%CI 1.3-5.0); sanitation facilities without a septic tank (OR 4.3; 95%CI 2.1-8.5); unclean water as a source of drinking water (OR 4.67; 95%CI 2.4-9.4); no handwashing practice after defecation (OR 3.2; 95%CI 1.4-7.3); and stunted children (OR 4.4; 95%CI 2.3-8.3). In conclusion, poly-parasitic infections were common in this study. Poor personal hygiene practice and sanitation factors contributed to the high prevalence of intestinal parasitic infection in 36-45-month-old children in East Nusa Tenggara, Indonesia.

Status of Intestinal Parasitic Infections in a Tertiary Care Center.

BACKGROUND: Intestinal parasitic infections (IPIs) are diseases of serious public health concern in low- and middle-income countries, including Nepal. Such infections can cause growth retardation and increased susceptibility to other parasitic infections. Hence, this study aims to assess the prevalence of IPIs among the patients attending a tertiary care hospital in central Nepal. METHODS: Clinical and laboratory records of patients, whose stool samples were collected and transported to the Department of Clinical Microbiology, KIST Medical College and Teaching Hospital, during 2 years (January 2019 and December 2020) were examined for parasitological findings, by conventional microscopy using normal saline and iodine preparation. RESULTS: Out of 3,146 patients included in the study, 411 (13.1%) patients (median age[IQR]: 27[12-45]) were infected with the intestinal parasites. Patients of different age groups, such as 20-30 years (16.1%), 10-20 years (14.1%), and 30-40 years (13.3%) were mostly infected. Infection was more common in females (221/1572, 14.1%) than males (190/1574, 12.1%). There were 373 (90.8%) cases of IPIs due to Entamoeba histolytica, 34 (8.3%) cases due to Giardia lamblia, and 4 (0.9%) cases due to helminths. The prevalence of IPI in the first and second years was 14.5% (260/1794) and 11.2% (151/1352), respectively. IPIs were more common in summer (n=87, 12.8%) and spring(n=81, 10.8%). CONCLUSIONS: Present study showed a declined prevalence of helminth infection. However, a higher rate of protozoan infection indicated the water source contamination with fecal matters and therefore urgencies for awareness among the public about hygienic practices.

Trends of intestinal parasites among the patients attended at Yabelo General Hospital, Borena Zone, Southern Ethiopia.

Objectives: Intestinal parasitic infections (IPIs) still cause a major public health problem in developing countries. The most affected populations are those with low socioeconomic status, lack of latrines, inadequate water supply, and poor hygiene like in pastoralist community areas in Ethiopia. Therefore, the study assessed the trends of intestinal parasites among the patients attended at Yabelo General Hospital, Southern Ethiopia, from 2019 to 2021. Methods: This retrospective study was conducted on 6108 patients and recorded data from Yabelo General Hospital, which were extracted using a checklist. The complete data of sex, age, and laboratory stool examination result in the record book were included in the study. The data were double-entered using EpiData version 3 and exported to the Statistical Package for Social Sciences version 16 for analysis. The associated factors were analyzed using chi-square and a p-value <0.05 was considered statistically significant. The results were presented in tables, pie charts, and graphs. Results: The overall prevalence of intestinal parasites among the patients who attended Yabelo General Hospital was 48%. Of these, 37.8% (2310) were intestinal protozoa, and 10.2% (624) were intestinal helminths. The study indicates that 59% of patients aged above 45 years were seen infected with intestinal parasites. Of the total suspected patients, 2% (123) were found to have mixed parasite infections. The most reported parasites were Entamoeba histolytica/Entamoeba Dispar 22.6%, Giardia lamblia 15.3%, and Ascaris lumbricoides 1.8%. The trend analysis of intestinal parasites revealed that the overall prevalence declined from 55% in 2019 to 42.3% in 2021. Conclusion: The prevalence of IPI was high among patients seen at Yabelo General Hospital. The analysis showed that the prevalence declined from 2019 to 2021. To sustain the decrease in prevalence, all intestinal parasite prevention measures should be continuously exercised in the area.

Intestinal Parasitic Infection and Nutritional Status in Children under Five Years Old: A Systematic Review.

Intestinal parasitic infections are common infectious diseases causing many health problems and impaired growth and physical development.. Children under five years old are the most vulnerable to infections, due to their immature immunity and feeding and exploratory behaviours. This systematic review aimed to assess the relationship between intestinal parasitic infections and undernutrition among children under 5 years old. Fifteen studies met the inclusion and exclusion criteria and were classified as high-quality studies. Twelve parasites were reported, including Ascaris lumbricoides, Cryptosporodium spp., Entamoeba histolytica, Enterobius vermicularis, Giardia lamblia, hookworm, Hymenolepis nana, Strongyloides sterocalis, Taenia spp. and Trichuris trichuria. Ascariasis is the most reported infection, with a prevalence ranging from 10.77% in Ethiopia to 57.14% in Malaysia, and is correlated with stunting (OR 2.17 (95% CI 1.14, 4.13), p = 0.02). Giardiasis is the second most reported infection, with a prevalence ranging from 4.43% in Ethiopia to 66.33% in the Central African Republic, and is related to an increased risk of stunting (OR 2.34 (95% CI 1.07, 5.10), p = 0.03)), wasting (OR 2.90 (95% CI 1.12, 7.49, p = 0.03)), and being underweight (OR 1.53 (95% CI 1.02, 2.29, p = 0.04)). The third and fourth most prevalent infections are T. trichiura and hookworm infections. Intestinal parasitic infections can occur very early in life and cause significant growth retardation. It is important to understand the prevalence and effects of infection based on the parasite species in order to implement therapeutic interventions and prevention controls.

Prevalence of Intestinal Parasitic Infections and Associated Risk Factors Among Schoolchildren in Ibb Governorate, Southwest Yemen: A Cross-Sectional Study.

Introduction: Intestinal parasitic infections (IPIs) among schoolchildren are important public health problem, especially in developing countries, and monitoring of such infections and associated risk factors are necessary for intervention strategies. In line with this view, the aim of this study was to determine the prevalence of IPIs and associated risk factors among schoolchildren in Ibb governorate, southwest Yemen. Methods: A cross-sectional study was carried out during February to April 2020 on 600 schoolchildren selected from 6 districts of Ibb governorate. Fecal specimens were examined using saline and iodine wet mount and formal-ether concentration techniques. Socio-demographic data were collected using pre-designed, structured questionnaires. The results were analyzed using SPSS for Windows version 25 (SPSS Inc., Chicago, IL, USA). Results: Out of 600 participants, the overall prevalence of IPIs was 66.3% (398/600). The prevalence rate of protozoan infections (56.3%, 338/600) was largely higher than helminthic infections (10%, 60/600). The most common intestinal parasite was E. histolytica/dispar (28.5%, 171/600). S. mansoni infection showed higher infection rate in males (5.3%) than in females (0.4%), with statistically significant difference (P = 0.001). Univariate analysis showed that the age was only significantly associated with protozoan infections, with statistically significant differences (P = 0.002). Regarding to clinical symptoms, the presence of IPIs was significantly associated with diarrhea, dysentery, and abdominal pain. Conclusion: The present study revealed that there was a relatively high prevalence of IPIs, especially protozoan parasites, in schoolchildren of the study area, with E. histolytica/dispar being the most prevalent parasite. The results showed that age was only significantly associated with IPIs. According to the results of this study, IPIs are still among the main public health problems in the study area. Thus, effective prevention and control strategies are important to reduce the incidence of IPIs in this area of the country.

Prevalence and Risk Factors of Intestinal Parasitic Infection in Under-Five Children With Malnutrition: A Hospital Based Cross-Sectional Study.

Background: Intestinal parasitic infections (IPIs) and malnutrition in under-five children contribute substantially to developing countries' childhood morbidity and mortality. This study assessed the prevalence and profile of IPI in under-five children and compared them with nutritional status and other socioeconomic factors. Methods: Anthropometric indices were used for checking the nutritional status of under-five children. Malnutrition was graded into four grades (I-IV) based on the Indian Academy of Pediatrics advocated Weight-for-Age criteria. Children whose Height-for-Age and Weight-for-Height were <-2, standard deviations were regarded as stunted and wasted, respectively. Stool samples were examined by direct wet mount (normal saline and iodine) and formol-ethyl acetate concentration technique to detect parasitic cyst and ova. Stool smears were made directly from the specimen and after concentration and stained by kinyoun's stain. Subsequently, the association of undernutrition was assessed with intestinal IPI using the Chi-square test. Results: The overall prevalence of Grade I, II, III, and IV malnutrition was 52%, 31.7%, 12.2%, and 4.1% while stunting and wasting IPIs were present in 60.2% and 36.6%, respectively. IPIs were present in 47.2%, and 11.4% showed polyparasitism. Soil-transmitted helminths were found to be the commonest (Ascaris lumbricoides: 21.1%; Trichuris trichiura: 13.0%; and hookworms: 8.1%) followed by the intestinal protozoa (Enterobius vermicularis: 7.3, Giardia lamblia: 6.5, and Cryptosporidium spp.: 2.4%). Increasing age upto 5 years, improper excreta disposal, low level of maternal education, and a higher number of childrenin the family were predictors of IPIs. The prevalence of IPI was significantly associated with Grade II and III undernutrition, stunting, and wasting. Individually, Ascaris and hookworms contributed significantly to stunting and cryptosporidium spp. to wasting. Conclusion: Prevalence of IPI in malnourished under-five children is high. Joint nutritional interventional strategies, early diagnosis/treatment of under-five children, and increased awareness among masses are imperative to break the vicious cycle of malnutrition and parasitic diseases.

Soil-transmitted helminthes and Schistosoma mansoni infections among primary school children at Ambasame primary school, North-West Ethiopia: a cross-sectional study.

BACKGROUND: Schistosomiasis and soil-transmitted helminthiasis (STHs) are the major public health problem in the world especially in school age children. Therefore, this study aimed to determine the burden of soil transmitted helminths and Schistosoma mansoni among Ambesame primary school children, North-West Ethiopia. METHOD: A cross sectional study was carried out at Ambasame primary school children from March to May, 2019. Study participants were selected using systematic random sampling technique. Socio-demographic characteristics and other factors were collected using structured questionnaire. Moreover, stool samples were examined microscopically using wet mount and formol ether concentration techniques. Data were entered and analyzed using SPSS version 20. Logistic regression analysis was done to investigate the association between dependent and independent variables. P-value less than 0.05 was considered as statistically significant. RESULT: The overall prevalence of intestinal parasites was 117(31.2%). The prevalence of soil-transmitted helminthes and S.mansoni was 110 (29.3%) using formol ether concentration technique. The most predominant parasite was S. mansoni (10.7%), followed by hookworm (5.6%). Multivariate logistic regression analysis revealed that, helminthic infection was associated with children less than 7 years of age (P-value = 0.019, AOR = 3.29, 95% CI (1.21-8.91)); fathers who are able to read and write (P-value< 0.001, AOR = 5.4, 95% CI (2.37-12.33)); absence of latrine (P-value = 0.016, AOR = 12.96, 95% CI (1.60-104.87)) and untrimmed nail (P-value = 0.043, AOR = 2.09, 95% CI (1.02-4.27)). CONCLUSION: This study revealed that the prevalence of intestinal helminthes among Ambasame primary school children was relatively high. The lower educational status of father, absence of latrine and untrimmed finger nail showed statistically significant association with intestinal helminthic infection. This indicates the school community, health offices and other stakeholders should plan a strategy to tackle problems associated with sanitary condition. Furthermore, Health policy makers, healthcare workers and health extension workers should enhance their effort of awareness creation for school children, parents, school community about personal hygiene, environmental sanitation, intestinal parasites transmission, prevention and control. Moreover, mass deworming of school children and periodic screening for parasitic infection should be done.

Intestinal Parasitic Infections Among Pediatric Patients in a Metropolitan City of Bangladesh With Emphasis on Cryptosporidiosis.

Introduction Gastrointestinal parasitic infections are one of the global health concerns in developing countries like Bangladesh. Among them, Cryptosporidium spp. plays an essential role in causing diarrhea, malnutrition, and poor cognitive function, especially in children. This study was conducted to identify the frequency of Cryptosporidium cases and other parasitic agents.  Methods A cross-sectional observational study was conducted among 219 hospitalized children with diarrhea. The conventional microscopic technique was applied for parasitic detection. Particular staining (modified Ziehl-Neelsen) procedure was performed to identify oocysts of Cryptosporidium spp. A polymerase chain reaction (PCR) was performed to determine the SSU rRNA and gp60 gene of Cryptosporidium.  Results Cysts of Giardia duodenalis (2.3%), ova of Ascaris lumbricoides (1.4%,), Trichuris trichiura (0.5%), and both A. lumbricoides and T. trichiura (0.9%) were identified in samples through wet mount preparation. The distribution of Cryptosporidium spp. as detected by the staining method and nested PCR was 1.4% and 4.1%, respectively.  Conclusion Factors independently associated with Cryptosporidium infection are unsafe water, lack of regular hand washing, and insufficiency of exclusive breastfeeding. This study reports, presumably for the first time, the detection of Cryptosporidium oocysts in Chattogram metropolitan city of Bangladesh.

Risk factors associated with intestinal pathogenic parasites in schoolchildren.

Diseases caused by intestinal parasites impose a substantial burden on population of middle income countries including Pakistan. This research was aimed to assess the risk factors for intestinal parasites in school children of Malakand, Pakistan. Two hundred and eighty eight students were enrolled between February and June 2016. Out of the total enrolled 184 were agreed to collect stool specimens. A questionnaire was also used to collect the data on socio-demographic and socio-economic characteristics of the participants. All the students were guided to collect at least 10gof their own stool specimens. Each of the stool specimens was diagnosed for the presence of any stage of helminth or protozoal parasites. Formal ether concentration method and wet mount techniques were applied. One way ANOVA was used for calculation of P value when it was less than 0.05 which was considered significant. Eighty two percent of the participants were found infected with one species of parasite while 69.9% of the participants were infected with more than one species of intestinal parasites. The most prevalent parasite was hook worm 33.4% (n = 99/296) followed by Taenia saginata 28.7% (n = 85/296), Ascaris lumbricoides 27.7% (n = 82/296), Hymenolepis nana 6.08% (n = 18/296), Entamoeba histolytica 3.37% (n = 10/296) and least for each Enterobius vermicularis and Fasciola hepatica 0.37% (n = 1/296). Previously used drugs, level in school, ages, weight and upper arm circumference were the most significantly (P < 0.05) related factors for the occurrence of intestinal parasite infection. Present research endorsed that risk factors play a key role in the transmission of parasitic diseases. Lack of safe water supply, using raw vegetables, animal keeping, which should be considered for sustainable strategies in the control of these infections preferably in remote parts of the world.