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A parasitological study of Pulau Pinang and Pulau Perhentian Kechil, off Trengganu, West Malaysia. I. Malaria and filariasis

Yap LF, Ramachandran CP, Balasingam E

Med J Malaya, 1968 Dec;23(2):118-22.
PMID: 4240821
Matched MeSH terms: Intestinal Diseases, Parasitic/epidemiology
Intestinal parasites in hemodialysis patients from developing countries: A systematic review and meta-analysis

Taghipour A, Olfatifar M, Rostami A, Foroutan M, Vasigala V, Norouzi M

Hemodial Int, 2020 01;24(1):12-21.
PMID: 31804770 DOI: 10.1111/hdi.12796

Intestinal parasitic infection (IPI) is the main cause of gastrointestinal complications in hemodialysis patients due to their impaired immune systems. We conducted a systematic review and meta-analysis to evaluate the prevalence and odds ratio (OR) of IPIs in this population. Relevant eligible studies were identified by searching the PubMed, Science Direct, Scopus, Web of Science, and Google scholar databases up to January 30, 2019. A random-effects meta-analysis model was used to estimate the pooled prevalence, OR, and 95% confidence intervals (CI). Twenty-two studies, from Turkey, Iran, Brazil, Egypt, Saudi Arabia, Pakistan, and Malaysia met eligibility criteria for analysis, and included 11 using a case-control design (980 patients and 893 controls) and 11 studies using a cross-sectional design (a total of 1455 participants). Cross-sectional studies suggested that the pooled prevalence of IPIs in hemodialysis patients was 24% (95% CI, 14-36%; 307/1455). In studies using a case-control design, the pooled prevalence of IPIs in hemodialysis patients (30%, 330/980) was found to be significantly higher than controls (10%, 115/893) (OR, 3.40; 95%CI, 2.37-4.87). With respect to the parasites, Cryptosporidium spp. (OR, 4.49; 95%CI, 2.64-7.64) and Blastocystis sp. (OR, 4.03; 95%CI, 1.20-13.51) were significantly higher in hemodialysis patients compared to the controls. The current study revealed a high prevalence of IPIs in hemodialysis patients from countries in which the baseline prevalence of parasitic infection is high. We recommend that periodic screenings for IPIs in such countries should be incorporated into the routine clinical care of hemodialysis patients.

Matched MeSH terms: Intestinal Diseases, Parasitic/parasitology*
An unceasing problem: soil-transmitted helminthiases in rural Malaysian communities

Al-Mekhlafi MS, Atiya AS, Lim YA, Mahdy AK, Ariffin WA, Abdullah HC, et al.

Southeast Asian J Trop Med Public Health, 2007 Nov;38(6):998-1007.
PMID: 18613540

Despite great development in socioeconomic status throughout 50 years of independence, Malaysia is still plagued with soil-transmitted helminthiases (STH). STH continue to have a significant impact on public health particularly in rural communities. In order to determine the prevalence of STH among rural Orang Asli children and to investigate the possible risk factors affecting the pattern of this prevalence, fecal samples were collected from 292 Orang Asli primary schoolchildren (145 males and 147 females) age 7-12 years, from Pos Betau, Kuala Lipis, Pahang. The samples were examined by Kato-Katz and Harada Mori techniques. Socioeconomic data were collected using pre-tested questionnaires. The overall prevalence of ascariasis, trichuriasis, and hookworm infections were 67.8, 95.5 and 13.4%, respectively. Twenty-nine point eight percent of the children had heavy trichuriasis, while 22.3% had heavy ascariasis. Sixty-seven point seven percent of the children had mixed infections. Age > 10 years (p = 0.016), no toilet in the house (p = 0.012), working mother (p = 0.040), low household income (p = 0.033), and large family size (p = 0.028) were identified as risk factors for ascariasis. Logistic regression confirmed low income, no toilet in the house and working mother as significant risk factors for ascariasis. The prevalence of STH is still very high in rural Malaysian communities. STH may also contribute to other health problems such as micronutrient deficiencies, protein-energy malnutrition and poor educational achievement. Public health personnel need to reassess current control measures and identify innovative and integrated ways in order to reduce STH significantly in rural communities.

Matched MeSH terms: Intestinal Diseases, Parasitic*
Prevalence of intestinal parasites among members of the public in Kuala Lumpur, Malaysia

Jamaiah I, Rohela M

Southeast Asian J Trop Med Public Health, 2005 Jan;36(1):68-71.
PMID: 15906644

A total of 246 stool samples were collected from the public who participated in a Medical Fair held at the University Malaya Medical Center. The stools were examined for intestinal parasites using the formalin-ether concentration technique. The overall infection rate was 6.9% (17 out of 246), with Trichuris trichiura being the most common parasite (4.5%), followed by Ascaris lumbricoides (0.8%), Clonorchis sinensis (0.8%), hookworm (0.4%), and Entamoeba histolytica (0.4%). None of these participants showed any clinical symptoms. The highest infection rate was among the Chinese 7.7% (13 out of 169), followed by the Malays 7.0% (3 out of 43) and Indians 3.3% (1 out of 30). The highest infection rate was in the age group 16-30 years, which was 9% (6 out of 67). The two cases of clonorchiasis were from two Chinese women aged 28 and 66 years. The 28-year-old Chinese woman was born in Malaysia and had never left the country, while the older woman was also born in Malaysia but had visited Hong Kong as a tourist on two occasions. Both enjoyed eating raw fresh water fish with porridge.

Matched MeSH terms: Intestinal Diseases, Parasitic/epidemiology*
Fulltext Enterobius vermicularis infection among children aged 1-8 years in a rural area in Malaysia

Norhayati M, Hayati MI, Oothuman P, Azizi O, Fatmah MS, Ismail G, et al.

Southeast Asian J Trop Med Public Health, 1994 Sep;25(3):494-7.
PMID: 7777914

The infection rate and relationship of enterobiasis with socio-economic status were determined in children aged 1-8 years, living in a rural area in Malaysia. Of the 178 subjects 40.4% were infected with Enterobius vermicularis. The distribution of enterobiasis among these children were analyzed in relation to age groups and sex. The rate of infection was significantly higher in older children (5-7 years). The association of enterobiasis with other factors studied such as number of persons per house, household income per months and mother's employment status were not significant. The sensitivity of three successive days anal swabs compared to a single swab was found to be statistically significant.

Matched MeSH terms: Intestinal Diseases, Parasitic/epidemiology*
Fulltext Blastocystis hominis infection, a cause of human diarrhea

Sinniah B, Rajeswari B

Southeast Asian J Trop Med Public Health, 1994 Sep;25(3):490-3.
PMID: 7777913

Blastocystis hominis has long been described as a non pathogenic protozoan parasite until recently when claims have been made that it can result in pathogenic conditions. Of the 729 stool samples (614 from survey and 115 from pediatric wards) examined, 18.1% of them were found to be positive for one or more intestinal protozoan cyst. The commonest was Giardia intestinalis (8.4%) Followed by Entamoeba coli (7.1%) and Entamoeba histolytica (5.1%) in the normal children without symptoms of diarrhea. When diarrheic stools were examined, the commonest parasite encountered was Giardia (20.4%), followed by E. coli (15.9%) and E. histolytica (9.7%). Blastocystis was observed in 4.4% of the children who had diarrhea and 1.1% among the children taken from the normal population in the rural areas.

Matched MeSH terms: Intestinal Diseases, Parasitic/epidemiology*
Fulltext Review of sarcocystosis in Malaysia

Kan SP, Pathmanathan R

Southeast Asian J Trop Med Public Health, 1991 Dec;22 Suppl:129-34.
PMID: 1822870

Sarcocystis is a tissue coccidian with an obligatory two-host life cycle. The sexual generations of gametogony and sporogony occur in the lamina propria of the small intestine of definitive hosts which shed infective sporocysts in their stools and present with intestinal sarcocystosis. Asexual multiplication occurs in the skeletal and cardiac muscles of intermediate hosts which harbor Sarcocystis cysts in their muscles and present with muscular sarcocystosis. In Malaysia, Sarcocystis cysts have been reported from many domestic and wild animals, including domestic and field rats, moonrats, bandicoots, slow loris, buffalo, and monkey, and man. The known definitive hosts for some species of Sarcocystis are the domestic cat, dog and the reticulated python. Human muscular sarcocystosis in Malaysia is a zoonotic infection acquired by contamination of food or drink with sporocysts shed by definitive hosts. The cysts reported in human muscle resembled those seen in the moonrat, Echinosorex gymnurus, and the long-tailed monkey, Macaca fascicularis. While human intestinal sarcocystosis has not been reported in Malaysia so far, it can be assumed that such cases may not be infrequent in view of the occurrence of Sarcocystis cysts in meat animals, such as buffalo. The overall seroprevalence of 19.8% reported among the main racial groups in Malaysia indicates that sarcocystosis (both the intestinal and muscular forms) may be emerging as a significant food-borne zoonotic infection in the country.

Matched MeSH terms: Intestinal Diseases, Parasitic/epidemiology*
Intestinal parasitism in a Kampong on Pulau Pangkor, West Malaysia

Nawalinski T, Roundy LM

Southeast Asian J Trop Med Public Health, 1978 Sep;9(3):440-1.
PMID: 749228
Matched MeSH terms: Intestinal Diseases, Parasitic/epidemiology*
Wintergreen oil: a novel method in Wheatley's trichrome staining technique

Salleh FM, Anuar TS, Yasin AM, Moktar N

J Microbiol Methods, 2012 Oct;91(1):174-8.
PMID: 22986100 DOI: 10.1016/j.mimet.2012.08.004

Permanent staining of faecal smears by Wheatley's trichrome technique has been used by many scientists for the detection of parasites in the past and it was found to be highly sensitive. This study was conducted to evaluate the use of Wintergreen oil in comparison with xylene in Wheatley's trichrome staining technique, as the reference technique. In a blind comparison study, 500 collected faecal samples from aboriginal communities were examined. Wintergreen oil was found to be more superior than xylene as a clearing agent in the Wheatley's trichrome staining of polyvinyl alcohol-fixed faecal smears for the identification of intestinal protozoa. Elimination of toxic, carcinogenic, and fire hazards makes Wintergreen oil the preferred choice in routine parasitology examinations.

Matched MeSH terms: Intestinal Diseases, Parasitic/diagnosis*
Soil-transmitted helminthiasis: a critical but neglected factor influencing school participation of Aboriginal children in rural Malaysia

Ahmed A, Al-Mekhlafi HM, Azam MN, Ithoi I, Al-Adhroey AH, Abdulsalam AM, et al.

Parasitology, 2012 May;139(6):802-8.
PMID: 22310239 DOI: 10.1017/S003118201100237X

Soil-transmitted helminthiasis (STH), among the most common neglected tropical diseases, is a major public health problem in Malaysia with a possible impact on the nutritional status and school participation of rural children. This study was carried out among Aboriginal schoolchildren, living in an endemic area for STH in Malaysia, to determine the possible relationship between intestinal helminthiasis and school absenteeism. We also evaluated whether successful treatment of the infection will affect school attendance among the subjects. Stool analysis revealed that more than 90% of the subjects were infected with at least 1 helminth species, with Ascaris lumbricoides and Trichuris trichiura infections being most prevalent. Infection of moderate-to-heavy worm burdens, low level of fathers' education and anaemia were identified as the significant predictors of high absenteeism among the subjects (P<0·05). Following treatment of the infected children, it was found that school absenteeism was reduced significantly (P<0·01). In conclusion, STH continues to have significant impacts on public health, particularly in rural communities with a negatively significant effect on the school participation of Aboriginal children. A school-based de-worming programme should be introduced and incorporated in the current educational assistance targeted towards the Aboriginal communities, under the auspices of the government.

Matched MeSH terms: Intestinal Diseases/epidemiology*; Intestinal Diseases/parasitology; Intestinal Diseases/prevention & control; Intestinal Diseases, Parasitic
Nutritional status of refugee children entering DeKalb County, Georgia

Shah AY, Suchdev PS, Mitchell T, Shetty S, Warner C, Oladele A, et al.

J Immigr Minor Health, 2014 Oct;16(5):959-67.
PMID: 23828627 DOI: 10.1007/s10903-013-9867-8

This study determines the nutritional status among refugee children entering one of the largest resettlement counties in the United States and identifies differences between incoming populations. Medical records of all newly arriving pediatric refugees (0-18 years) entering DeKalb County, Georgia between October 2010 and July 2011 were reviewed. Refugee children were grouped as African, Bhutanese, or Burmese (resettling from either Thailand or Malaysia) for comparative analysis. Approximately one in five refugees were anemic or malnourished, while a quarter had stool parasites, and nearly half had dental caries. African refugees had the highest anemia but the lowest underweight prevalence (p < 0.05). Compared to Burmese resettling from Malaysia, Burmese children from Thailand had a higher prevalence of anemia, underweight, and stool parasites (p < 0.05). Clinicians should use CDC medical screening guidelines for newly arriving pediatric refugees, as well as ensure proper nutritional support and follow-up care.

Matched MeSH terms: Intestinal Diseases, Parasitic/ethnology; Intestinal Diseases, Parasitic/epidemiology
Fulltext Intestinal parasitic infections among children in central Albania

Sejdini A, Mahmud R, Lim YA, Mahdy M, Sejdini F, Gjoni V, et al.

Ann Trop Med Parasitol, 2011 Apr;105(3):241-50.
PMID: 21801503 DOI: 10.1179/136485911X12987676649584

Although intestinal parasitic infections (IPI) among children remain a global issue, the current information on such infections in Albanian children is very limited. A cross-sectional study of the IPI in 321 children living in the Albanian counties of Tirana (152) and Elbasan (169) was therefore conducted in 2008, with a pre-tested standard questionnaire employed to gather the relevant personal and clinical data. Using formalin-ether concentration and permanent stains, stool samples were examined microscopically for the ova, cysts and oocysts of any parasites. The overall prevalence of IPI was 19% (61 of 321), with protozoan infections (11·5%) apparently more common than infections with soil-transmitted helminths (STH; 8·1%). Giardia duodenalis was the parasite most frequently detected (10·9%), followed by hookworm (5·6%), Ascaris lumbricoides (1·9%), Trichuris trichiura (0·6%), Cryptosporidium (0·3%) and Entamoeba histolytica/dispar (0·3%). The results of a univariate analysis indicated that the children from Tirana county were significantly more likely to be found infected with STH compared with the children from Elbasan county (12·5% v. 4·1%; P=0·006). Children sampled in the community were also more likely to be found STH-positive than the children sampled as they attended hospitals and health clinics (10·5% v. 6·0%) but this difference did not reach statistical significance. The children found STH-positive were five times more likely to be suffering from diarrhoea than the other children checked in clinical settings (P=0·004) and were also more likely to be suffering from abdominal pain (P=0·054) and/or diminished appetite (P=0·016).

Matched MeSH terms: Intestinal Diseases, Parasitic/complications; Intestinal Diseases, Parasitic/epidemiology*
Anaemia and iron deficiency anaemia among aboriginal schoolchildren in rural Peninsular Malaysia: an update on a continuing problem

Al-Mekhlafi MH, Surin J, Atiya AS, Ariffin WA, Mahdy AK, Abdullah HC

Trans R Soc Trop Med Hyg, 2008 Oct;102(10):1046-52.
PMID: 18617209 DOI: 10.1016/j.trstmh.2008.05.012

A cross-sectional study to determine the current prevalence of anaemia and iron deficiency anaemia (IDA) and to investigate the possible risk factors for IDA was carried out on 241 aboriginal schoolchildren (120 boys, 121 girls) aged 7-12 years and living in remote areas in Pos Betau, Pahang, Malaysia. Haemoglobin (Hb) level was measured and serum iron status was assessed by serum ferritin (SF), serum iron (SI) and total iron binding capacity measurements. Socioeconomic data were collected using pre-tested questionnaires. All children were screened for intestinal parasitic infections. Overall, 48.5% (95% CI 42.3-54.8) of children were anaemic (Hb<12 g/dl). The prevalence of IDA was 34% (95% CI 28.3-40.2), which accounted for 70.1% of the anaemia cases. The prevalence of IDA was significantly higher in females than males. Low levels of mothers' education and low household income were identified as risk factors for IDA. Severe trichuriasis also found to be associated with low SF and SI. Logistic regression confirmed low levels of mothers' education and gender as significant risk factors for IDA. Improvement of socioeconomic status and health education together with periodic mass deworming should be included in public health strategies for the control and prevention of anaemia and IDA in this population.

Matched MeSH terms: Intestinal Diseases, Parasitic/ethnology; Intestinal Diseases, Parasitic/epidemiology
Epidemiology of gastro-intestinal nematodes of sheep in wet tropical conditions in Malaysia

Cheah TS, Rajamanickam C

Trop Anim Health Prod, 1997 Aug;29(3):165-73.
PMID: 9316233

A study on the seasonal variations in the population structure of Haemonchus contortus and Trichostronglyus colubriformis was conducted for a period of 12 months in a typical large scale sheep farm on improved pasture in Peninsular Malaysia which has a wet tropical climate. Successive groups of helminth-free tracer lambs were grazed for 4 weeks together with naturally infected sheep and were necropised for worm counts 2 weeks after their removal from the pasture. The monthly populations of H. contortus fluctuated slightly except in May and August during which more worms were found in the tracer animals. The numbers of T. colubriformis were comparatively high from October to December 1992 and again in March 1993, low during April and June 1992. Small numbers of hypobiotic larvae of H. contortus were detected in the tracer animals. Development and survival of infective larvae of H. contortus and T. colubriformis on pasture were investigated by spreading faeces containing eggs on grass plots in October 1993, February and May 1994. Development of the eggs to the infective larvae occurred within one week and their survival times were 7 weeks in the 3 experiments. The potential for control by rotational grazing is discussed.

Matched MeSH terms: Intestinal Diseases, Parasitic/epidemiology; Intestinal Diseases, Parasitic/veterinary*
Diverticular disease of the large bowel in Singapore. An autopsy survey

Lee YS

Dis Colon Rectum, 1986 May;29(5):330-5.
PMID: 3084185

One thousand fourteen consecutive large intestines were removed at autopsy from persons over the age of 14 years and examined for diverticular disease. Diverticulosis was encountered in 194 patients (19 percent). The lesion appeared early in life, after the second decade. Men were affected more frequently than women before the age of 60 years. Chinese men had significantly more diverticular disease than Malayan men (P less than 0.01) and Indian men (P less than 0.02). Chinese men also had significantly more diverticular disease than Chinese women. There was a predominance of right colon involvement, with the disease affecting especially the ascending colon and cecum. This pattern was observed in all three major ethnic groups, and in both the Singapore-born and foreign-born Singaporeans. The cause of right-sided diverticulosis is unknown. It appears that, while adoption of the western diet may influence the prevalence of diverticular disease, the site of predilection is determined more by racial or genetic predisposition. All diverticula examined histologically were false, including 39 (20 percent) solitary diverticula. The distribution of solitary diverticula was similar to that of multiple diverticulosis. It is suggested that solitary and multiple diverticulosis are part of the spectrum of the same disease.

Matched MeSH terms: Intestinal Diseases/epidemiology; Intestinal Diseases/pathology*
Copro-molecular identification of intestinal nematode infections in a rural community in East Malaysia

Hassan NA, Thodsapol A, Lim YAL, Wan Sulaiman WY, Sidi Omar SFN, Umsakul K, et al.

Parasitol Int, 2021 Feb;80:102237.
PMID: 33144195 DOI: 10.1016/j.parint.2020.102237

Soil-transmitted helminth (STH) infections are the most common intestinal parasitic infections of medical importance in humans. The infections are widely distributed throughout tropical and subtropical countries, particularly among disadvantaged and underprivileged communities. In Malaysia, STH infections is highly prevalent, especially among the indigenous groups. However, species identification through molecular studies is still lacking. Using molecular techniques, this study was conducted to identify STH species that infect humans. Faecal samples were collected from three Iban tribal longhouses in the rural area of Sarikei Division, Sarawak. Positive faecal samples by microscopy were subjected to PCR and sequenced for species identification. Based on the microscopy examination, the most prevalent STH infection was Ascaris, followed by hookworm and Trichuris. All microscopy-positive samples were then PCR-amplified. The amplicons were sequenced, aligned, and compared with other sequences in the GenBank database. The results showed that Ascaris lumbricoides was the predominant STH species, followed by Trichuris trichiura, Ancylostoma duodenale, and Necator americanus. Our findings were contradictory to past studies, as we showed that A. duodenale was more abundant than N. americanus. Socioeconomic improvement and health education programs should be included in the management and prevention of public health strategies against STH.

Matched MeSH terms: Intestinal Diseases, Parasitic/epidemiology*; Intestinal Diseases, Parasitic/parasitology
Fulltext Detection of selected intestinal helminths and protozoa at Hospital Universiti Sains Malaysia using multiplex real-time PCR

Basuni M, Mohamed Z, Ahmad M, Zakaria NZ, Noordin R

Trop Biomed, 2012 Sep;29(3):434-42.
PMID: 23018507

Intestinal parasites are the causative agents of a number of important human infections in developing countries. The objective of this study was to determine the prevalence of selected helminths and protozoan infections among patients admitted with gastrointestinal disorders at Hospital Universiti Sains Malaysia, Kelantan, Malaysia using multiplex real-time PCR. In addition microscopic examination was also performed following direct smear, zinc sulphate concentration and Kato-Katz thick smear techniques; and the presence of protozoan parasites was confirmed using trichrome and acid-fast stains. Of the 225 faecal samples analysed, 26.2% were positive for intestinal parasites by the multiplex real-time PCR, while 5.3% were positive by microscopy. As compared to microscopy, the multiplex real-time PCR detected 5.8 and 4.5 times more positives for the selected helminth and protozoan infections respectively. Among the selected helminths detected in this study, hookworm was the most prevalent by real-time PCR, while Ascaris lumbricoides was detected the most by microscopy. Meanwhile, among the selected protozoa detected in this study, Entamoeba histolytica was the most prevalent by real-time PCR, however microscopy detected equal number of cases with E. histolytica and Giardia lamblia. This study showed that real-time PCR can be used to obtain a more accurate prevalence data on intestinal helminths and protozoa.

Matched MeSH terms: Intestinal Diseases, Parasitic/epidemiology; Intestinal Diseases, Parasitic/parasitology*
Fulltext Neglected Intestinal Parasites, Malnutrition and Associated Key Factors: A Population Based Cross-Sectional Study among Indigenous Communities in Sarawak, Malaysia

Rajoo Y, Ambu S, Lim YA, Rajoo K, Tey SC, Lu CW, et al.

PLoS One, 2017;12(1):e0170174.
PMID: 28095446 DOI: 10.1371/journal.pone.0170174

Intestinal parasitic infections (IPIs) have been recognized as one of the most significant causes of illness among disadvantaged communities. Many studies have been conducted on the prevalence of IPIs in Malaysia. However, these studies mostly focused on the indigenous groups in Peninsular Malaysia. The present study was conducted to provide the current baseline data on prevalence of IPIs, anaemia, malnutrition and associated risk factors among the indigenous communities in Sarawak, situation at northwest Borneo island of Malaysia. A cross sectional study was conducted among the longhouses communities. Stool samples were obtained and examined for the presence of IPIs using microscopy technique. Haemoglobin measurement was done using a portable haemoglobin analyzer. Malnutrition (i.e., stunting, underweight and wasting) was assessed using the WHO Anthro software. Statistical analysis was carried out using SPSS software. A total of 341participants took part in this study. The overall prevalence of IPIs was 57.5%. Multivariate analysis indicated that the absence of toilets (OR = 1.6; 95% CI = 1.1-2.7; p = 0.002) and close contact with animals (OR = 1.8; 95% CI = 1.3-2.9; p = 0.027) as significant predictors for IPIs. The incidence of anaemia was 36.4%. The incidence of underweight, wasting and stunting were 22.2%, 5.6% and 35.4%, respectively. Multivariate analysis demonstrated that low level of parental education attainment (OR = 1.9; 95% CI = 1.2-3.0; p = 0.006) was identified as significant predictor for anaemia. The incidence of wasting was significantly associated with mild anaemia (OR = 1.2; 95% CI = 0.9-1.7; p = 0.024). Low household income was identified as significant predictor for stunting (OR = 2.1; 95% CI = 9.8-22.2; p = 0.001) and underweight (OR = 1.9; 95% CI = 5.6-18.7; p = 0.037), respectively. Essentially, the present study highlighted that intestinal parasitic infections, anaemia and malnutrition are still prevalent among rural indigenous community in Sarawak. Improvement of socioeconomic status, periodic mass deworming, iron supplementation and health education program should be included in the control and prevention of public health strategies.

Matched MeSH terms: Intestinal Diseases, Parasitic/epidemiology*; Intestinal Diseases, Parasitic/parasitology
Fulltext Occurrence of enteric parasitic infections among HIV-infected individuals and its relation to CD4 T-cell counts with a special emphasis on coccidian parasites at a tertiary care centre in South India

Swathirajan CR, Vignesh R, Pradeep A, Solomon SS, Solomon S, Balakrishnan P

Indian J Med Microbiol, 2017 Jan-Mar;35(1):37-40.
PMID: 28303816 DOI: 10.4103/ijmm.IJMM_16_164

CONTEXT: Diarrhoea is one of the major complications occurring in over 90% of HIV-infected individuals in developing countries. Coccidian group of parasites, being opportunistic pathogens, have been implicated as the most common causative agents of diarrhoea among HIV-infected population.

AIMS: The aim was to study the magnitude of parasitic diarrhoea with special context to coccidian parasitic infections in HIV-infected individuals and their association with the patient's immunological status measured by CD4 T-cell counts.

SETTINGS AND DESIGN: This investigation was performed between January 2002 and December 2014 at a tertiary HIV care centre in Chennai, South India.

MATERIALS AND METHODS: Stool samples were collected and microscopically observed for parasites using direct, formal-ether-concentrated wet mounts and modified acid-fast staining for coccidian parasites. CD4 T-cell counts were done by FACScount.

STATISTICAL ANALYSIS USED: All statistical analyses were performed using GraphPad Prism software, version 5.0, andP < 0.05 was considered statistically significant.

RESULTS: Coccidian parasitic infection accounted for about 23.4% of parasitic infections, and of these, Cystoisospora belli was observed to be the most common cause of diarrhoea (88.8%), followed by Cryptosporidium spp. (9.9%) and Cyclospora spp. (1.3%). Trend analysis of coccidian aetiology during the study period revealed a significant rise in the positivity of C. belli and Cryptosporidium spp. (P = 0.001). Among the HIV patients with CD4+ T-cell counts <200 cells/μL, Cryptosporidium infection was most common (90%), followed by infection with C. belli(61.4%).

CONCLUSIONS: Coccidian parasites continue to be the most common aetiological agent of diarrhoea among patients with HIV. The increasing trend of positivity of both cystoisosporiasis and cryptosporidiosis over the study period and the high positivity of cryptosporidiosis in patients with lower CD4+ T-cell counts are issues of serious concern. The findings call for the need for the early diagnosis of coccidian parasites and appropriate intervention among HIV-infected patients.

Matched MeSH terms: Intestinal Diseases, Parasitic/epidemiology*; Intestinal Diseases, Parasitic/parasitology
Fulltext Factors associated with high prevalence of intestinal protozoan infections among patients in Sana'a City, Yemen

Alyousefi NA, Mahdy MA, Mahmud R, Lim YA

PLoS One, 2011;6(7):e22044.
PMID: 21789210 DOI: 10.1371/journal.pone.0022044

BACKGROUND: Intestinal protozoan diseases in Yemen are a significant health problem with prevalence ranging from 18% to 27%. The present study is a cross-sectional study aimed at determining the factors associated with the high prevalence of intestinal protozoan infections among patients seeking health care in Sana'a City, the capital of Yemen.
METHODOLOGY/PRINCIPAL FINDINGS: Stool samples were collected from 503 patients aged between 1 and 80 years old; 219 were males and 284 females. Biodata were collected via pretested standard questionnaire. Faecal samples were processed and examined for (oo)cysts or ova using a wet mount preparation after formal-ether concentration technique. Cryptosporidium oocysts were detected using the Ziehl-Neelsen staining technique. The overall prevalence of intestinal protozoan infections was 30.9%. Infection rates of Giardia duodenalis, Entamoeba histolytica/dispar and Cryptosporidium were 17.7%, 17.1% and 1%, respectively. Other parasites detected included Ascaris lumbricoides (2.4%), Schistosoma mansoni (0.3%), Hymenolepis nana (1.4%) and Enterobius vermicularis (0.4%). Multivariate analysis using forward stepwise logistic regression based on intestinal protozoan infections showed that contact with animals (OR = 1.748, 95% CI = 1.168-2.617) and taking bath less than twice a week (OR = 1.820, 95% CI = 1.192-2.779) were significant risk factors of protozoan infections.
CONCLUSIONS/SIGNIFICANCE: This present study indicated that intestinal protozoan infections are still a public health problem in Yemen, with Giardia and Entamoeba infections being most common. Statistical analysis indicated that low personal hygiene and contact with animals were important predictors for intestinal protozoan infections. As highlighted in this study, in order to effectively reduce these infections, a multi-sectoral effort is needed. Preventive measures should include good hygienic practices, good animal husbandry practices, heightened provision of educational health programs, health services in all governorates including rural areas. Furthermore, it is also essential to find radical solutions to the recent water crises in Yemen.

Matched MeSH terms: Intestinal Diseases, Parasitic/epidemiology*; Intestinal Diseases, Parasitic/parasitology

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