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Rare occurrence of Blastocystis in sea turtles and insects (cockroaches, houseflies, and crickets) from several states in Peninsular Malaysia

Muhammad Hafiz S, Attah AO, Mohd Salleh S, Rusli MU, Farah Haziqah MT

Trop Biomed, 2024 Sep 01;41(3):363-369.
PMID: 39548791 DOI: 10.47665/tb.41.3.017

Blastocystis a single-celled eukaryotic protist, is known to inhabit the intestines of various hosts, including humans, and has been implicated in a wide spectrum of symptoms, ranging from gastrointestinal issues to skin disorders, thereby establishing its status as an emerging infectious agent. In this study, the prevalence of Blastocystis infection was investigated in insects, including cockroaches, houseflies, and crickets, as well as sea turtles. Additionally, the genotypic characteristics of the isolated Blastocystis strains were examined, and the evolutionary relationships between Blastocystis species found in sea turtles, and animals/humans were determined. Microscopic techniques and molecular methods were utilized in this study. The results showed that four out of 90 insects (4.44%) and one out of 13 sea turtles (7.7%) were infected by Blastocystis. Furthermore, detailed observations revealed the presence of characteristic morphological features, such as vacuolar forms in the cockroach, cricket and sea turtle samples and binary fission from cockroach samples, indicative of Blastocystis' mode of reproduction. While the ST8 of Blastocystis in sea turtles were successfully identified, no subtyping was achieved for the infected insects. This study not only establishes the occurrence of Blastocystis infection in sea turtles but also uncovers its ability to infect insects, suggesting a potential reservoir role for these organisms. Overall, this research emphasizes the significance of comprehending the prevalence, genotypic diversity, and evolutionary relationships of Blastocystis across various hosts. Such insights are instrumental in developing effective control measures and public health interventions to mitigate the associated symptoms and prevent future outbreaks.

Matched MeSH terms: Blastocystis Infections/epidemiology
Elevated levels of urinary hyaluronidase in humans infected with intestinal parasites

Chandramathi S, Suresh K, Kuppusamy UR

Ann Trop Med Parasitol, 2010 Jul;104(5):449-52.
PMID: 20819313 DOI: 10.1179/136485910X12743554760423
Matched MeSH terms: Blastocystis Infections/epidemiology
Blastocystis hominis in high-rise flat dwellers in Kuala Lumpur, Malaysia

Suresh K, Salim HR, Jamaiah I, Anuar AK

Trans R Soc Trop Med Hyg, 2001 10 3;95(4):377-8.
PMID: 11579877
Matched MeSH terms: Blastocystis Infections/epidemiology*
Blastocystis in animal handlers

Rajah Salim H, Suresh Kumar G, Vellayan S, Mak JW, Khairul Anuar A, Init I, et al.

Parasitol Res, 1999 Dec;85(12):1032-3.
PMID: 10599928

The present study investigated whether people working closely with animals were at higher risk of getting infected with Blastocystis hominis. The prevalence of the parasite was determined in two population groups, i.e., animal handlers and normal healthy individuals who did not work with animals. In all, 105 stool samples were collected from animal handlers from 2 local research institutions, a local zoo, and a local abattoir and 163 stool samples were collected from normal healthy individuals residing in high-rise flats in the city. The in vitro culture method used in the study detected that 41% of 105 animal handlers and 17% of 163 flat-dwellers in the city were positive for Blastocystis. This statistically significant finding (P = 0.0000313) shows that people who work closely with animals do stand at risk of acquiring Blastocystis infection.

Matched MeSH terms: Blastocystis Infections/epidemiology*
Prevalence and subtype distribution of Blastocystis sp. in cattle from Pahang, Malaysia

Kamaruddin SK, Mat Yusof A, Mohammad M

Trop Biomed, 2020 Mar 01;37(1):127-141.
PMID: 33612724

Blastocystis sp. is a common enteric protozoan parasite found in humans and various type of animal worldwide. Recently, genotypic distribution of Blastocystis sp. was revealed in insects, rodents, avian and mammals, which exposed its potential of transmiting the infections to human. However, very little information on current level of Blastocystis sp. infection were reported in cattle from Malaysia. Herein, a total of 120 stool samples of cattles were collected. While the potential risk of infection such as age, gender, body score, diarrheic condition of the cattle were noted, the management of the farms was also recorded. All stool sample were cultured, but 80 samples were selected for PCR sequencing analysis. The cultivation and microscopic examination revealed only 25% of the cattle (30/120) were infected with Blastocystis sp.. But, 43.8% of the cattle (35/80) were found positive upon PCR sequencing. The study also found that age, body score condition, diarrheic condition and certain farm were associated with the infection (p<0.05). Six subtypes (STs) that were discovered during the study were ST10 (21.3%;17/35), ST5 (8.8%;7/35), ST3 (7.5%;6/35), ST1 (2.5%;2/35), ST4 (2.5%;2/35) and ST14 (1.3%;1/35). Thus, moderate infections of Blastocystis sp. and variants in the genotypic distributions of the cattle suggest its potential for zoonotic transmission. Therefore, this findings could be helpful for further understanding the parasite, which assist studies of its pathogenicity.

Matched MeSH terms: Blastocystis Infections/epidemiology
Fulltext Prevalence of Blastocystis in animals from domesticated surroundings

Chuong LS, Suresh K, Mak JW, Init I, Kathijah O

Southeast Asian J Trop Med Public Health, 1996 Dec;27(4):850-2.
PMID: 9253897
Matched MeSH terms: Blastocystis Infections/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: Blastocystis Infections/epidemiology*
Fulltext Subtype distribution of Blastocystis isolates in Sebha, Libya

Abdulsalam AM, Ithoi I, Al-Mekhlafi HM, Al-Mekhlafi AM, Ahmed A, Surin J

PLoS One, 2013;8(12):e84372.
PMID: 24376805 DOI: 10.1371/journal.pone.0084372

BACKGROUND: Blastocystis is a genetically diverse and a common intestinal parasite of humans with a controversial pathogenic potential. This study was carried out to identify the Blastocystis subtypes and their association with demographic and socioeconomic factors among outpatients living in Sebha city, Libya.
METHODS/FINDINGS: Blastocystis in stool samples were cultured followed by isolation, PCR amplification of a partial SSU rDNA gene, cloning, and sequencing. The DNA sequences of isolated clones showed 98.3% to 100% identity with the reference Blastocystis isolates from the Genbank. Multiple sequence alignment showed polymorphism from one to seven base substitution and/or insertion/deletion in several groups of non-identical nucleotides clones. Phylogenetic analysis revealed three assemblage subtypes (ST) with ST1 as the most prevalent (51.1%) followed by ST2 (24.4%), ST3 (17.8%) and mixed infections of two concurrent subtypes (6.7%).
BLASTOCYSTIS: ST1 infection was significantly associated with female (P = 0.009) and low educational level (P = 0.034). ST2 was also significantly associated with low educational level (P= 0.008) and ST3 with diarrhoea (P = 0.008).
CONCLUSION: Phylogenetic analysis of Libyan Blastocystis isolates identified three different subtypes; with ST1 being the predominant subtype and its infection was significantly associated with female gender and low educational level. More extensive studies are needed in order to relate each Blastocystis subtype with clinical symptoms and potential transmission sources in this community.

Matched MeSH terms: Blastocystis Infections/epidemiology*
Genetic diversity of caprine Blastocystis from Peninsular Malaysia

Tan TC, Tan PC, Sharma R, Sugnaseelan S, Suresh KG

Parasitol Res, 2013 Jan;112(1):85-9.
PMID: 22961236 DOI: 10.1007/s00436-012-3107-3

Blastocystis sp. is a common intestinal parasite found in humans and animals. The possibility of zoonotic transmission to humans from livestock especially goats led us to investigate the genetic diversity of caprine Blastocystis sp. obtained from five different farms in Peninsular Malaysia. Moreover, there is a lack of information on the prevalence as well as genetic diversity of Blastocystis sp. in goat worldwide. Results showed that 73/236 (30.9 %) of the goats were found to be positive for Blastocystis infection. The most predominant Blastocystis sp. subtype was ST1 (60.3 %) followed by ST7 (41.1 %), ST6 (41.1 %), and ST3 (11.0 %) when amplified by PCR using sequenced-tagged site (STS) primers. Four farms had goats infected only with ST1 whereas the fifth showed mixed infections with multiple STs. The proximity of the fifth farm to human dwellings, nearby domesticated animals and grass land as opposed to a sterile captive environment in the first four farms may account for the multiple STs seen in the fifth farm. Since ST1, ST3, ST6 and ST 7 were previously reported in human infection worldwide in particular Malaysia, the potential of the zoonotic transmission of blastocystosis should not be disregarded. The implications of different farm management systems on the distribution of Blastocystis sp. STs are discussed.

Matched MeSH terms: Blastocystis Infections/epidemiology
Drinking water is a significant predictor of Blastocystis infection among rural Malaysian primary schoolchildren

Abdulsalam AM, Ithoi I, Al-Mekhlafi HM, Ahmed A, Surin J, Mak JW

Parasitology, 2012 Jul;139(8):1014-20.
PMID: 22444778 DOI: 10.1017/S0031182012000340

Blastocystis infection has a worldwide distribution especially among the disadvantaged population and immunocompromised subjects. This study was carried out to determine the prevalence and the association of Blastocystis infection with the socio-economic characteristics among 300 primary schoolchildren, living in rural communities in Lipis and Raub districts of Pahang state, Malaysia. Stool samples were collected and examined for the presence of Blastocystis using direct smear microscopy after in vitro cultivation in Jones' medium. The overall prevalence of Blastocystis infection was found to be as high as 25.7%. The prevalence was significantly higher among children with gastrointestinal symptoms as compared to asymptomatic children (x2 =4.246; P=0.039). Univariate and multivariate analyses showed that absence of a piped water supply (OR=3.13; 95% CI=1.78, 5.46; P<0.001) and low levels of mothers' education (OR=3.41; 95% CI=1.62, 7.18; P<0.01) were the significant predictors of Blastocystis infection. In conclusion, Blastocystis is prevalent among rural children and the important factors that determine the infection were the sources of drinking water and mothers' educational level. Interventions with provision of clean water supply and health education especially to mothers are required.

Matched MeSH terms: Blastocystis Infections/epidemiology*
Fulltext Blastocystis infection in Malaysia: evidence of waterborne and human-to-human transmissions among the Proto-Malay, Negrito and Senoi tribes of Orang Asli

Anuar TS, Ghani MK, Azreen SN, Salleh FM, Moktar N

Parasit Vectors, 2013;6:40.
PMID: 23433099 DOI: 10.1186/1756-3305-6-40

Blastocystis has been described as the most common intestinal parasite in humans and has an increased impact on public health. However, the transmission of this parasite has not been conclusively determined.

Matched MeSH terms: Blastocystis Infections/epidemiology*
Fulltext Predominance of Blastocystis sp. Infection among School Children in Peninsular Malaysia

Nithyamathi K, Chandramathi S, Kumar S

PLoS One, 2016;11(2):e0136709.
PMID: 26914483 DOI: 10.1371/journal.pone.0136709

BACKGROUND: One of the largest cross-sectional study in recent years was carried out to investigate the prevalence of intestinal parasitic infections among urban and rural school children from five states namely Selangor, Perak, Pahang, Kedah and Johor in Peninsula Malaysia. This information would be vital for school authorities to influence strategies for providing better health especially in terms of reducing intestinal parasitism.
METHODS AND PRINCIPAL FINDINGS: A total of 3776 stool cups was distributed to 26 schools throughout the country. 1760 (46.61%) responded. The overall prevalence of intestinal parasitic infection in both rural and urban areas was 13.3%, with Blastocystis sp (10.6%) being the most predominant, followed by Trichuris trichiura (3.4%), Ascaris lumbricoides (1.5%) and hook worm infection (0.9%). Only rural school children had helminthic infection. In general Perak had the highest infection (37.2%, total, n = 317), followed by Selangor (10.4%, total, n = 729), Pahang (8.6%, total, n = 221), Kedah (6.2%, total, n = 195) and Johor (3.4%, total, n = 298). School children from rural schools had higher infection (13.7%, total, n = 922) than urban school children (7.2%, total, n = 838). Subtype (ST) 3 (54.3%) is the most predominant ST with persons infected with only ST1 and ST3 showing symptoms. Blastocystis sp infection significantly associated with low household income, low parent's education and presence of symptoms (p<0.05).
CONCLUSION: It is critical that we institute deworming and treatment to eradicate the parasite especially in rural school children.

Matched MeSH terms: Blastocystis Infections/epidemiology*
Prevalence and subtypes of Blastocystis among migrant workers from different working sectors in Peninsular Malaysia

Sahimin N, Meor Termizi FH, Rajamanikam A, Mohd Nazri NA, Govind SK, Mohd Zain SN

Parasitol Res, 2020 Oct;119(10):3555-3558.
PMID: 32875397 DOI: 10.1007/s00436-020-06865-3

Blastocystis sp. is a common enteric parasite of humans and animals associated with inadequate sanitation and poor personal hygiene. Over the years, the Malaysian thriving economy has been facilitated largely by migrant workers from developing countries, and there is concern that diseases endemic to their countries may be imported. Therefore, this study aimed to determine the current status of Blastocystis infection as well as subtypes (STs) from fecal samples among migrant workers in Selangor and Kuala Lumpur, Malaysia. Overall, almost a third of the study cohort (30.9%; n = 68/220) screened were infected with Blastocystis sp. predominantly with ST3 (54.5%; n = 12), followed by ST1 (36.4%; n = 8) and ST2 (9.1%; n = 2). Infection levels was almost similar among the different sectors; manufacturing (32.8%), domestic service (32.3%), and food service (27.3%) with common symptoms for infection included stomach and abdominal pain or discomfort and diarrhea (48.5%; n = 33). None of the socio-demographic risk factors evaluated were significant. Therefore, this study warrants continuous monitoring as well as understanding the impact of transmission among the migrant community with the local population especially those involved in food service sector.

Matched MeSH terms: Blastocystis Infections/epidemiology*
Fulltext Current status of Blastocystis sp. in animals from Southeast Asia: a review

Rauff-Adedotun AA, Mohd Zain SN, Farah Haziqah MT

Parasitol Res, 2020 Nov;119(11):3559-3570.
PMID: 32951145 DOI: 10.1007/s00436-020-06828-8

Blastocystis is the most frequently observed eukaryotic gastrointestinal symbiont in humans and animals. Its low host specificity and zoonotic potential suggest that animals might serve as possible reservoirs for transmission. The prevalence and subtype distributions of Blastocystis sp. in animal populations in Southeast Asia, a hotspot for zoonotic diseases, are reviewed. Recommendations for future research aimed at understanding the zoonotic role of Blastocystis are also included. Seven countries have, so far, reported Blastocystis infection in various animals, such as livestock, poultry, companion animals, and non-human primates. Pigs were the most studied animals, and there were records of 100% prevalence in pigs, cattle, and ostriches. Using polymerase chain reaction (PCR)-based approaches, twelve Blastocystis sp. subtypes (STs), namely ST1, ST2, ST3, ST4, ST5, ST6, ST7, ST8, ST9, ST10, ST12, and ST14 have been recognised infecting animals of Southeast Asia. ST1 and ST5 were the most frequently identified, and Malaysia observed the most diverse distribution of subtypes. Further investigations on Blastocystis sp. in various animal hosts, using adequate sample sizes and uniform detection methods, are essential for a better understanding of the distribution of this organism. Detailed genome studies, especially on STs shared by humans and animals, are also recommended.

Matched MeSH terms: Blastocystis Infections/epidemiology
Fulltext Prevalence, predictors and clinical significance of Blastocystis sp. in Sebha, Libya

Abdulsalam AM, Ithoi I, Al-Mekhlafi HM, Khan AH, Ahmed A, Surin J, et al.

Parasit Vectors, 2013;6:86.
PMID: 23566585 DOI: 10.1186/1756-3305-6-86

BACKGROUND: Blastocystis sp. has a worldwide distribution and is often the most common human intestinal protozoan reported in children and adults in developing countries. The clinical relevance of Blastocystis sp. remains controversial. This study was undertaken to determine the prevalence of Blastocystis infection and its association with gastrointestinal symptoms among outpatients in Sebha city, Libya.
METHODS: A total of 380 stool samples were collected from outpatients attending the Central Laboratory in Sebha, Libya for routine stool examination. The presence of Blastocystis sp. was screened comparing light microscopy of direct smears against in vitro cultivation. Demographic and socioeconomic information were collected with a standardized questionnaire.
RESULTS: The us (OR = 2.2; 95% CI = 1.02, 4.70) as significant predictors of Blastocystis infection among this population. In those who had only Blastocystis infection but no other gastrointestinal parasitic infections, the prevalence of gastrointestinal symptoms was higher compared to those without Blastocystis infection (35.3% vs 13.2%; x² = 25.8; P < 0.001). The most common symptoms among these patients were abdominal pain (76.4%), flatulence (41.1%) and diarrhoea (21.5%).overall prevalence of Blastocystis infection was 22.1%. The prevalence was significantly higher among patients aged ≥18 years compared to those aged < 18 years (29.4% vs 9.9%; x² = 19.746; P < 0.001), and in males compared to females (26.4% vs 17.5%; x² = 4.374; P = 0.036). Univariate analysis showed significant associations between Blastocystis infection and the occupational status (P = 0.017), family size (P = 0.023) and educational level (P = 0.042) of the participants. Multiple logistic regression analysis confirmed that the age of ≥ 18 years (OR = 5.7; 95% CI = 2.21; 9.86) and occupational stat
CONCLUSIONS: Blastocystis sp. is prevalent and associated with gastrointestinal symptoms among communities in Sebha city, Libya. Age and occupational status were the significant predictors of infection. However, more studies from different areas in Libya are needed in order to delineate the epidemiology and clinical significance of this infection.

Matched MeSH terms: Blastocystis Infections/epidemiology*
Predominance of Blastocystis sp. subtype 4 in rural communities, Nepal

Lee IL, Tan TC, Tan PC, Nanthiney DR, Biraj MK, Surendra KM, et al.

Parasitol Res, 2012 Apr;110(4):1553-62.
PMID: 22076050 DOI: 10.1007/s00436-011-2665-0

Blastocystis sp. is a common intestinal parasite. To date, there have been sporadic and scanty studies on Blastocystis sp. carried out in rural communities in Nepal. We surveyed the prevalence of Blastocystis sp. and its possible associated risk factors, and reported the predominant Blastocystis sp. subtype in two rural communities, Bolde Phediche and Bahunipati, in Nepal. Human faecal samples were collected from 241 participants, cultured using in vitro cultivation and examined for Blastocystis sp. The presence of Blastocystis sp. in faecal samples was further confirmed by polymerase chain reaction (PCR) and subsequently genotyped using subtype-specific sequence tagged site (STS) primers. There were 26.1% (63/241) of the participants that were infected by Blastocystis sp. We detected 84.1% (53/63) of Blastocystis sp. subtype 4 infections in these rural communities. The unusually high prevalence of Blastocystis sp. subtype 4 can be attributed to the rearing of family-owned animals in barns built close to their houses. Eighty one percent (51/63) of the Blastocystis sp. infected participants drank not boiled or unfiltered water. The present study revealed that Blastocystis sp. could pose a health concern to the communities and travellers to the hilly area in Nepal. Infection may be transmitted through human-to-human, zoonotic and waterborne transmissions. We provide recommendations to ensure good public health practices.

Matched MeSH terms: Blastocystis Infections/epidemiology*

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