Human cryptosporidiosis in Iran: a systematic review and meta-analysis

A large-scale study on the prevalence of intestinal parasites in patients referred to medical laboratories in Urmia, Northwest Iran

INTRODUCTION

Intestinal parasitic infections (IPIs), caused by helminths and protozoans, are among the most prevalent infections in humans in developing countries. This study aimed to determine the prevalence of IPIs in patients referred to three educational and medical centers affiliated with Urmia University of Medical Sciences in Urmia.

MATERIALS AND METHODS

In this cross-sectional study, 2845 stool samples, including 2174 (76.4%) males and 671 (23.6%) females, were collected from patients referred to Imam Khomeini and Shahid Motahhari hospitals and Shahid Nikkhah Health Center in Urmia, Northwest Iran, from January 2020 to February 2022. The microscopic examination for IPIs was carried out using the wet mount method, and the hard-to-identify samples were stained by trichrome for accurate identification of protozoa. For diagnosis of infections by coccidian parasites modified Ziehl-Neelsen (mZN) staining was used.

RESULTS

Based on the results, two hundred nine intestinal parasites were identified in 184 out of 2845 (6.5%) patients of which 136 out of 2174 males (6.3%) and 48 out of 671 females (7.2%) were positive. Some patients had tested positive for multiple protozoa. The observed intestinal protozoa are as follows: Blastocystis spp. 118 (4.1%), Endolimax Nana 42 (1.5%), Entamoeba coli 24 (0.8%), Giardia lamblia 13 (0.5%), Cryptosporidium spp. 6 (0.2%), Iodamoeba butschlii 3 (0.1%), Chilomastix mesnili 2 (0.1%), and an accidentally detected helminthic infection Enterobius vermicularis 1 (0.05%).

CONCLUSION

According to the results, the most prevalent IPIs in West Azerbaijan Province are caused by Blastocystis spp., and Giardia lamblia. Most intestinal protozoa observed in the study were nonpathogenic and commensal, which shows water or food contamination in the area. Thus, medical technologists in the parasitology section must be trained and aware of IPIs in medical laboratories.

Prevalence of Cryptosporidium infection in children from China: a systematic review and meta-analysis

Cryptosporidium is an important zoonotic pathogen that causes diarrhea in humans and animals, and a leading cause of diarrhea morbidity and mortality in children under 5 years old. However, the meta-analysis of Cryptosporidium infection in children in China has not been published. We searched the databases for articles published on the prevalence of Cryptosporidium infection in children in China since the inception of these databases to 31 October 2022. The prevalence of Cryptosporidium infection in children was estimated using a random effects model. The results showed that 111 datasets from 24 provinces were selected for the final quantitative analysis. The estimated pooled Cryptosporidium infection prevalence in children in China was 2.9% (3300/126,381). The highest prevalence rate was in southwestern China (4.8%, 365/7766). Subgroup analysis indicated that the Cryptosporidium infection rate in children aged < 3 years (4.9%, 330/8428) was significantly higher than that in children aged 3-6 years (2.5%, 609/26,080) and >6 years (2.6%, 647/27,586). Six Cryptosporidium species were detected in children in China from the selected studies. C. hominis was the dominant species (77.1%, 145/188) and the proportions of subgenotype IaA14R4 of C. hominis was highest (42.8%, 62/145). The findings suggest that Chinese children is in a low level of Cryptosporidium infection, however, the geographical distribution of the infection is extensive. We suggest that measures should be taken to ensure the healthy growth of Chinese children by improving the water environment, increasing public health facilities, strengthening children's health education, and developing sound Cryptosporidium infection control programs.

Prevalence and molecular analysis of Cryptosporidium spp. collected from surface water

Cryptosporidium is an obligate intracellular parasite reported from all over the world. This protozoan infects a wide range of animals as well as humans. Cryptosporidium parvum and Cryptosporidium hominis are the most prevalent infecting species with mild and self-limiting infection in healthy people. The protozoan oocyst is resistant to common water purifiers. Based on emerging evidence, Cryptosporidium is one of waterborne parasites considered a major public health problem in developing and developed countries. In this study, 42 samples were collected from 14 rivers in the catchment area of Lake Urmia in northwest of Iran. Moreover, amplification of SSU rRNA gene was performed, and polymerase chain reaction products were sequenced. The results of sequencing and comparing the sequences with those in the GenBank revealed that all the 17 positive samples were C. parvum, a zoonotic species and one of the most frequent human-infecting species. Considering these data, it is highly important to inhibit the spread of this protozoan by treating livestock and preventing human and animal effluents from entering the water.

High prevalence of Cryptosporidium infection in Iranian patients suffering from colorectal cancer

The present investigation was designed to study the prevalence of cryptosporidiosis in the colorectal cancer patients compared to the healthy subjects. The present descriptive case-control study was performed on 174 subjects including 87 healthy people and 87 patients with colorectal cancer attending to general hospitals in Lorestan Province, Western Iran, during October 2019–August 2020. A fresh stool specimen was collected from each subject in a sterile labeled container. The collected stool samples were concentrated using the sucrose flotation method and then prepared for Ziehl-Neelsen staining for microscopic examination. All samples were also tested using the Nested-PCR assays by amplifying the 18S rRNA gene for the presence of Cryptosporidium DNA. Demographic and possible risk factors such as age, gender, residence, agriculture activity, history of contact with livestock, consumption unwashed fruits/vegetables, and hand washing before eating were investigated in all the studied subjects using a questionnaire. Of the 87 patients with colorectal cancer, 37 (42.5%) had Cryptosporidium infection. A significant difference (p < 0.001) in the prevalence of Cryptosporidium spp. infections among the participants in the case and control (11, 12.6%) groups was observed. We found that cryptosporidiosis was not linked with age, gender, hand washing, agriculture activity, and history of contact with livestock in the colorectal patients. However, residence in urban areas was significantly associated with the prevalence of cryptosporidiosis. The 18 s rRNA gene of Cryptosporidium in 48 samples was successfully amplified by the Nested-PCR. Based on the obtained findings, Cryptosporidium spp. infections were observed significantly more frequently in the patients with colorectal cancer in comparison with the healthy individuals. It is suggested to carry out similar studies in various parts of Iran with larger sample sizes and further parasitological tests.

Cryptosporidium infection in cattle and humans in Ethiopia: A systematic review and meta-analysis

Cryptosporidium is an intracellular coccidian parasite causing gastrointestinal disturbances resulting in diarrhoea in humans and animals. It is more frequently detected in calves and early childhood, and one of the major causes of mortality in low-income countries. National estimates of Cryptosporidium infection rate in cattle and humans are lacking in Ethiopia. Therefore, this systematic review and meta-analysis estimated the prevalence and assess the risk factors of Cryptosporidium infection in cattle and humans over 20 years. Article searches were made using PubMed, HINARI, Research Gates, AJOLs and Google Scholar databases. Studies that met the inclusion criteria under the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist were used. Random effects models and Inverse Variance Index were used to calculate the pooled prevalence of cryptosporidiosis and heterogeneity among studies, respectively. A total of 23 eligible studies published between 2000 and 2020 were selected for this study. The estimated pooled prevalence of cryptosporidiosis was found to be 16.2% and 11% in cattle and humans, respectively. Ten Cryptosporidium species were documented with cattle and human-based studies. C. andersoni, C. parvum, C. bovis and C. ryanae were the reported species in cattle. Similarly, in humans, seven types of Cryptosporidium species (such as C. parvum, C. hominis, C. viatorum, C. felis, C. meleagridis, C. canis and C. xiaoi) were recorded. C. parvum and C. hominis were the dominant and responsible species for human illness. Using gp60 gene locus analysis, various zoonotic C. parvum subgenotypes were determined in humans; but it was limited in anthroponotic C. hominis. In conclusion, the overall prevalence of Cryptosporidium infection in cattle and humans was high and linked with several risk factors. Thus, there is a need for further epidemiological and genetic diversity studies, and awareness of creations on the disease to provide strategies that mitigate the disease in cattle and humans.

Global prevalence of Cryptosporidium spp. in cats: A systematic review and meta-analysis

The One-Health approach highlights that the health of human populations is closely connected to the health of animals and their shared environment. Cryptosporidiosis is an opportunistic zoonotic disease considering as global public health concern. Cats are considered as one of potential host for transmitting the Cryptosporidium spp. infection to humans. A random-effects meta-analysis model was used to estimate the overall and the subgroup-pooled prevalence of Cryptosporidium spp. across studies, and the variance between studies (heterogeneity) were quantified by I² index. Eighty articles (including 92 datasets), from 29 countries met eligibility criteria for analysis. The pooled global prevalence (95% CI) of Cryptosporidium spp. in cats was 6% (4-8%), being highest in Africa 14% (0-91%) and lowest in South and Central America 4% (3-7%) countries. Considering the detection methods, the pooled prevalence was estimated to be 26% (1-67%) using serological detection methods, 6% (3-10%) using coproantigen detection methods, 5% (3-7%) using molecular detection methods, and 4% (3-7%) using microscopic detection methods. The highest prevalence of Cryptosporidium spp. was found in stray cats 10% (5-17%), while pet (domestic) cats 4% (3-7%) had the lowest prevalence. These results emphasize the role of cats as reservoir hosts for human-infecting Cryptosporidium spp. Prevention and control of this zoonosis in cats should receive greater attention by health officials and health policymakers, especially in countries where prevalence are highest.

Prevalence of Cryptosporidium Infection in the Global Population: A Systematic Review and Meta-analysis

BACKGROUND

Cryptosporidium is a protozoan parasite that can infect both humans and animals and cause cryptosporidiosis. We aimed to estimate the global prevalence of Cryptosporidium infection.

METHODS

In this study, Web of Science, Medline and PubMed were searched for relative articles, published between January 1, 1960 and January 1, 2018. Included articles were restricted to English language and that sample size of articles was not less than 50. Studies with no information on the study period, location, method of diagnosis, sample size and number of infected people were excluded. Studies about outbreak, laboratory report or immunocompromised population were excluded as well. The quality of the included publications was assessed. The prevalence of cryptosporidiosis was estimated by DerSimonian-Laird random-effects model, after converting by the Freeman-Tukey type double arcsine transformation.

FINDINGS

From 13,064 publications selected by literature search, 221 studies were included in the meta-analysis. The global pooled prevalence of Cryptosporidium infection was 7.6 % (95% CI: 6.9-8.5). The highest estimated prevalence of Cryptosporidium infection was in Mexico (69.6%, 95% CI 66.3-72.8), Nigeria (34.0%, 95% CI 12.4-60.0), Bangladesh (42.5%, 95% CI 36.1-49.0) and Republic of Korea (8.3%, 95% CI 4.4-13.2) among general residents, patients, school children and healthy population, respectively. The estimated prevalence was high in people from low-income country, people with gastrointestinal symptoms, people younger than 5 years old and residents not living in urban areas.

CONCLUSIONS

These estimates indicate the substantial prevalence of Cryptosporidium infection in the world, which may provide a theoretical basis for the formulation of the prevention strategy about Cryptosporidium.

Global prevalence of Cryptosporidium infection in rodents: A systematic review and meta-analysis

The One-Health approach implies that the health of people is connected to the health of animals and the environment. Rodents, which are abundant and widespread, have been considered the major reservoirs of Cryptosporidium infection in humans and other animals. However, there is a paucity of information about global patterns of occurrence of Cryptosporidium in rodents. This systematic review and meta-analysis aimed to estimate the pooled global prevalence of Cryptosporidium infection and associated risk factors in rodents. International databases (PubMed, Web of Science, Scopus, and Google scholar) were systematically searched to identify relevant studies. A random-effects meta-analysis model was used to estimate the overall and the subgroup-pooled prevalence of Cryptosporidium across studies, and the variance between studies (heterogeneity) were quantified by I2 index. The data were classified according to WHO-region, type of diagnostic methods, different kinds of rodents, and specific risk factors, including geographical and climate parameters. Eighty-four articles (including 92 datasets), from 29 countries met eligibility criteria for analysis. The pooled global prevalence (95% CI) of Cryptosporidium infection in rodents was 17% (13-20%), being highest in North American and Caribbean regions 27% (16-40%) and lowest in South American 5% (0-16%) countries. Considering the detection methods, the pooled prevalence was estimated to be 25% (13-39%) using coproantigen detection methods, 17% (13-23%) using molecular detection methods, and 14% (9-20%) using microscopic detection methods. The highest prevalence of Cryptosporidium was found in muskrats 47% (27-68%), while Meriones persicus 1% (0-3%) had the lowest prevalence. These results emphasize the role of rodents as reservoir hosts for human-infecting Cryptosporidium. This highlights the need for an increased focus on implementing affordable, appropriate control programs to reduce the public health threat of cryptosporidiosis as a zoonosis of global importance.

Frequency, associated factors and clinical symptoms of intestinal parasites among tuberculosis and non-tuberculosis groups in Iran: a comparative cross-sectional study

BACKGROUND

Co-infection of human tuberculosis (TB) and intestinal parasites infections (IPIs) is a public health problem, especially in low- and middle-income countries. There is no data on this issue in Iran. Therefore, we investigated the prevalence of IPIs among patients with TB in Iran.

METHODS

Stool samples were collected from 161 patients with TB and 181 healthy people (non-TB group). Standard parasitological methods including direct slide smear, formalin-ether concentration, trichrome, modified Ziehl-Neelsen and chromotrope 2R staining techniques were used for detection of intestinal protozoa and helminths. Nested-PCR and sequence analysis were used to identify the genotypes of Cryptosporidium and human-infecting species of microsporidia. Data analysis was performed using SPSS version 16.

RESULTS

The frequency of IPIs in the non-TB group (16.5%) was slightly lower than in patients with TB (21.1%), although statistical significance was not observed (OR, 0.74; 95% CI, 0.43-1.27; P= 0.28). Blastocystis (11.8%) was the most common parasite detected in patients with TB. Infection with multiple parasites in the non-TB group (2.2%) was significantly lower than in patients with TB (7.5%) (OR, 0.28; 95% CI, 0.08-0.88; P=0.02). The ova of Taenia spp., Ascaris lumbricoides and Hyamenolepis nana were identified in three patients with TB (1.9%), while only one person (0.5%) in the non-TB group was infected with Enterobius vermicularis. The results of genotyping revealed two C. parvum subtype families (IIa and IId) and three E. bieneusi genotypes (Ebcar4, IH and jLD-1).

CONCLUSION

Our results showed a higher prevalence of IPIs in patients with TB in comparison with non-TB subjects. Moreover, our findings suggest a proper health education program for good personal hygiene habits, and also preventative measures to avoid the acquisition of IPIs in patients with TB.

Cryptosporidium infection among people living with HIV/AIDS in Ethiopia: a systematic review and meta-analysis

Studies on the prevalence of Cryptosporidium infection in People Living with HIV/AIDS (PLWHA) are inconsistent and heterogeneous. Therefore, this systematic review with meta-analysis was performed to assess the burden of the infection relative to the proportion of CD4 + T cell count among PLWHA in Ethiopia. Articles published before 15 May 2019, have been retrieved for this systematic review using five databases; PubMed, Scopus, Web of Science, Google Scholar and ProQuest, supplemented by the search for gray literature. The overall pooled prevalence and pooled Odds Ratio (OR) with their 95% Confidence Intervals (CI) were estimated using STATA 14 statistical Software. Of the 255 studies retrieved, 31 were considered for the final analysis. As many as 8,645 Ethiopians infected with HIV were included in the final quantitative synthesis. The overall pooled prevalence estimate of Cryptosporidium infection among PLWHA in Ethiopia was 11% (95%CI: 0.09-0.13). HIV-infected people with low CD4 + T cell count (CD4 < 200 cells/mm3) were 13.07 times more likely to become infected with Cryptosporidium than those with high CD4 + T cell count (CD4 > 500 cells/mm3) (OR: 13.07 (95%CI: 6.38-26.75). Cryptosporidium infection in PLWHA in Ethiopia showed decreasing patterns in 2001-2010, 2011-2014, and in 2015-2019, 14.6% (95%CI: 0.076-0.217), 12.71% (95%CI: 0.086-0.167) and 6.7% (95%CI: 0.044-0.090), respectively (p < 0.001). Though the pattern of Cryptosporidium infection in HIV-infected Ethiopians showed a declining trend; it remains a considerable problem that requires improvement in routine screening for Cryptosporidium in HIV-infected people, particularly with poor or declining CD4 + T cell count.

Impacts of flood on health of Iranian population: Infectious diseases with an emphasis on parasitic infections

Background

Outbreaks of infectious diseases are the major concern after flooding. Flood makes people displacement which would be more complicated with inadequate sanitation. Settling in crowded shelters in absence of clean water and inaccessibility to health care services makes people more vulnerable to get infection. This review aimed to discuss about potential undesirable outcomes of flooding occurred in 2019 in Iran.

Methods

A comprehensive search was carried out in databases including PubMed, Google scholar, Scopus, Science Direct, Iran medex, Magiran and SID (Scientific information database) from 2000 to 2019. All original descriptive articles on flood were concerned. Related articles on flood disturbance were considered. Also, publication of red cross society was considered as only reliable reference in evaluation of consequences of flood occurred in 2019 in Iran.

Results

Flooding in Iran, was started in March 2019 and lasted to April 2019. Flood affected 31 provinces and 140 rivers burst their banks, and southwestern Iran being hit most severely. According the reports of international federation of red cross society, 3800 cities and villages were affected by the floods with 65,000 destroyed houses and 114,000 houses partially damaged. Also 70 hospitals or health care centers with 1200 schools were damaged along with many infrastructures including 159 main roads and 700 bridges.

Conclusions

Considering 365,000 displaced persons and estimation of mentioned damages, it was one of the greatest natural disaster during the last 20 years. Various risk factors in favor of infectious diseases such as overcrowding, disruption of sewage disposal, poor standards of hygiene, poor nutrition, negligible sanitation and human contact among refugees provide suitable conditions for increased incidence of infectious diseases after flooding and also cause epidemics.More attention is needed to provide hygienic situation for people after natural disasters including flood.

scFv against HSP60 of Strongyloides sp. and Its Application in the Evaluation of Parasite Frequency in the Elderly

The present study is aimed at evaluating serological method using scFv anti-Strongyloides sp. and reporting the frequencies of the results with conventional parasitological technique (faeces) in elderly individuals. Among 112 elderly individuals (≥60 years of age), 14.28% were positive for at least one enteroparasite, with one individual positive for S. stercoralis. Sera were evaluated for the presence of anti-Strongyloides sp. antibodies using total or detergent fraction extracts of Strongyloides venezuelensis, which presented positivity rates of 19.64% and 10.71%, respectively. An anti-HSP60 single-chain variable fragment from Strongyloides sp. was used to detect parasite antigens, with 5.36% (6 individuals) of ELISA-positive individuals returning a positive result. While the serological test indicates previous or recent infection and may be limited by antigen purification, the anti-HSP60 method reflects the presence of Strongyloides sp. immune complexes and exhibits greater sensitivity and specificity. Our results demonstrate the variable occurrence of enteroparasites in elderly individuals residing in long-term nursing homes and validate a novel epidemiological tool to describe infection cases by Strongyloides sp.

Prevalence and genotyping identification of Cryptosporidium in adult ruminants in central Iran

Background

Apicomplexan parasites of the genus Cryptosporidium infect a wide range of animal species as well as humans. Cryptosporidium spp. can cause life threatening diarrhea especially in young animals, children, immunocompromised patients and malnourished individuals. Asymptomatic cryptosporidial infections in animals can also occur, making these animals potential reservoirs of infection.

Methods

In the present study, a molecular survey of Cryptosporidium spp. in ruminants that were slaughtered for human consumption in Yazd Province, located in central Iran was conducted. Faeces were collected per-rectum from 484 animals including 192 cattle, 192 sheep and 100 goats. DNA was extracted from all samples and screened for Cryptosporidium by PCR amplification of the 18S rRNA gene. Positives were Sanger sequenced and further subtyped by sequence analysis of the 60 kDa glycoprotein (gp60) locus.

Results

In total, Cryptosporidium spp. were detected in 22 animals: C. andersoni and C. bovis in seven and two cattle faecal samples, respectively, C. ubiquitum in five sheep, and C. xiaoi in six sheep and two goat samples, respectively. To our knowledge, this study provides for the first time, molecular information concerning Cryptosporidium species infecting goats in Iran, and is also the first report of C. ubiquitum and C. xiaoi from ruminants in Iran.

Conclusion

The presence of potentially zoonotic species of Cryptosporidium in ruminants in this region may suggest that livestock could potentially contribute to human cryptosporidiosis, in particular among farmers and slaughterhouse workers, in the area. Further molecular studies on local human populations are required to more accurately understand the epidemiology and transmission dynamics of Cryptosporidium spp. in this region.

Association between Cryptosporidium infection and cancer: A systematic review and meta-analysis

The link between cryptosporidiosis and cancer has been suggested by some epidemiological studies. This systematic review and meta-analysis was conducted to further understand this relationship. In the current study, six electronic databases were reviewed for Cryptosporidium infection in cancer patients. We used random effects model and 95% confidence intervals (CI) to determine the overall odds ratio (OR). Heterogeneity was calculated with Cochran's Q test and I²statistic. In total, 19 studies involving 3562 individuals with case-control (nine) and cross-sectional (ten) designs were included in our project. The pooled overall random effect favored a statistically significant increased risk of Cryptosporidium infection in cancer patients compared with non-cancer individuals [OR = 3.3; 95% CI: 2.18-4.98]. The overall heterogeneity was medium (χ² = 25.77; I² = 30.2%, P = .11). The pooled ORs in case-control and cross-sectional studies were [OR = 5.60; 95% CI: 3.43-9.13; χ² = 5.51; I² = 0.00%, P = .70] and [OR = 2.08; 95% CI: 1.18-3.67; χ² = 13.69; I² = 34.3, P = .13], respectively. T-value and P-value were 0.54 and 0.57 based on the results of Harbord's modified's regression test. In summary, this meta-analysis demonstrates that Cryptosporidium infection is associated with cancer. Also, it found that study design and year of publication are the specific sources of heterogeneity. Further studies should be carried out to investigate the impact of Cryptosporidium infection in the onset or development of cancer in the future.

Epidemiology of Cryptosporidium infection in different hosts in Nigeria: A meta-analysis

Cryptosporidium is a medical and veterinary significant protozoan parasite that infects all classes of vertebrates. Environmental contamination with infective oocyst increases the risk of transmission to susceptible host. Estimates of Cryptosporidium prevalence in humans and animals are lacking in Nigeria, therefore a systematic review and meta-analysis were performed to understand the epidemiology of the disease over a period of 30 years using publications from EMBASE, Ovid MEDLINE, Web of Science, AJOL and Google Scholar databases. Studies that met the inclusion criteria of Cryptosporidium infections under the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist were analysed. Point estimates prevalence and subgroup analyses based on potential risk factors and diagnostic techniques were evaluated at 95% confidence interval (CI). A total of 64 eligible studies published between 1987 and 2017 were selected for meta-analysis. The prevalence of Cryptosporidium infection using quality effects model among human, cattle, sheep, goat, pigs, laboratory animals and birds was estimated as 15.0, 26.1, 16.6, 26.0, 20.1, 9.0 and 7.2%, respectively. The high report of C. parvum subtype family IIc indicates the importance of anthroponotic transmission of Cryptosporidium in Nigeria. Heterogeneity of subgroup (regions, species) and risk factors (HIV status, age, gender, faecal type) analyses were determined. The pooled prevalence of Cryptosporidium spp. in different hosts were high and linked with several risk factors such as environmental contamination and animal contact. There is need for increased awareness on the prevalence of the disease to provide strategies that mitigate the disease in humans and animals.

Distribution of Cryptosporidium parvum gp60 subtypes in calf herds of Saxony, Germany

Cryptosporidiosis is a common protozoan parasitic infection that causes diarrhoea in neonatal calves. The high shedding of environmentally resistant oocysts facilitates outbreaks of cryptosporidiosis in humans. In total, 58 farms (512 calves) in Germany (Saxony and Brandenburg) were visited three times each. Faecal samples of pre-weaned calves were microscopically examined for oocysts of Cryptosporidium spp. using Heine staining and were scored with regard to their consistency. Overall, 88.9% of calves tested microscopically positive for Cryptosporidium spp. in at least one sample, and the excretion of oocysts was significantly (P < 0.01) associated with a higher faecal score (diarrhoea). After DNA extraction from pooled farm isolates, 47 samples were successfully subtyped by sequence analysis of the 60 kDa glycoprotein gene (gp60). All isolates belonged to subtype family IIa. IIaA15G2R1 was the most common subtype (present on 66% of the farms), followed by IIaA16G3R1 (13%). Subtypes IIaA14G1R1, IIaA14G2R1, IIaA1612R1, IIaA16G2R1, IIaA17G1R1, IIaA17G2R1, IIaA17G4R1 and IIaA19G2R1 were found sporadically. This is the first description of gp60 subtype IIaA17G4R1 in cattle in Germany.

Intestinal parasite infections in dogs affected by multicentric lymphoma and undergoing chemotherapy

Prevalence and species composition of intestinal parasites were evaluated in dogs affected by high-grade multicentric lymphoma and undergoing chemotherapy and in control healthy dogs. Obtained data were statistically analyzed. The overall prevalence of intestinal parasite infections was 33.3%. In lymphoma dogs, the prevalence of protozoa infections (46.7%) was significantly higher (p < 0.05) than that of helminth infections (6.7%) and Giardia duodenalis, Cryptosporidium spp., Neospora caninum, Cystoisospora ohioensis-complex, Entamoeba sp. and Spirocerca lupi were identified. In the control group, only 3/15 dogs (20%) were found positive and no statistically significant differences emerged regarding helminth (hookworms and Toxocara canis) and protozoa (G. duodenalis) infections. Results from this study may suggest a potential higher prevalence of opportunistic intestinal protozoa, including some potentially zoonotic species, in dogs affected by high-grade multicentric lymphoma, emphasizing the need to monitor lymphoma-affected dogs for these protozoa, especially those undergoing chemotherapy.

Occurrence, genotyping, and health risk of Cryptosporidium and Giardia in recreational lakes in Tianjin, China

Cryptosporidium and Giardia are critical parasites in the etiology of diarrhea worldwide, and often cause waterborne outbreaks. The presence of Cryptosporidium and Giardia in recreational lakes was investigated with molecular characterization, and a comprehensive quantitative microbial risk assessment (QMRA) of protozoan infections was performed, considering multiple exposure pathways, differences in age, sex, and disease severity, and the genotypes of the protozoa. Forty-three (82.7%) and 51 (98.1%) water samples were positive for Cryptosporidium oocysts and Giardia cysts, respectively, with average counts of 3.65 oocysts/10 L and 12.58 cysts/10 L, respectively. Six Cryptosporidium species and three Giardia lamblia assemblages were confirmed with molecular analyses. The protozoan concentration was significantly associated with water turbidity, but not with the total coliform numbers. Swimming in the lakes entailed the highest incidence risk of 5.72 × 10^-4 per person per year (pppy) (95% confidence interval (CI): 0.03-43.33 × 10^-4) for Cryptosporidium and 4.04 × 10^-4 pppy (95% CI: 0.01-32.66 × 10^-4) for Giardia, whereas wading entailed the lowest risk (2.20 × 10^-4 and 1.70 × 10^-4 pppy, respectively). The annual burdens attributable to recreational-water-associated cryptosporidiosis and giardiasis were 3.44 (95% CI: 0.04-23.51) and 1.81 (95% CI: 0.01-12.96) disability-adjusted life years per 1,000,000 individuals per year, respectively. Children were more likely to have an individual disease burden than adults, and males were more likely than females. Sensitivity analysis highlighted the great importance of controlling the proportion of exposed individuals and reducing the frequency of exposure. The methodology and results of this study will allow us to better evaluate and reduce the burden of Cryptosporidium and/or Giardia infections associated with recreational water use in China and other countries.

Cryptosporidium infection in children with cancer undergoing chemotherapy: how important is the prevention of opportunistic parasitic infections in patients with malignancies?

Cryptosporidiosis is a relatively uncommon disease in healthy individuals but could be potentially worrisome in immunocompromised patients. This study aimed to evaluate Cryptosporidium infection in children with cancer undergoing chemotherapy. A case-control study was conducted in 132 children with cancer undergoing chemotherapy and 132 non-cancer controls. The modified Ziehl-Neelsen (MZN) staining and polymerase chain reaction methods were used for the detection of Cryptosporidium parasite. All positive isolates were sequenced for phylogenetic analysis. Statistical analysis was performed using the SPSS version 16 and Fisher exact test. The rate of cryptosporidiosis in children with cancer undergoing chemotherapy was 3.8%, which was higher than that of the control group. Other intestinal parasites detected in patients with cancer included Giardia lamblia (3%), Entamoeba coli (1.5%), and Chilomastix mesnili (0.8%). In the control group, only two (1.5%) cases were positive for G. lamblia. No significant difference was observed between the gender, age, residency, contact with domestic animals, stool appearance, neutropenia, chemotherapy period, and type of malignancy with regard to cryptosporidiosis. Phylogenetic analysis revealed that Cryptosporidium parvum isolates in this study relied on a branch that represents similar sequences from Iran and other countries. Although the rate of Cryptosporidium infection was relatively higher in children with cancer undergoing chemotherapy compared to the control group, any statistically significant difference has not been found between them. These findings should not be contrary to the need for healthcare to prevent opportunistic parasitic infections in malignant and immunocompromised patients.

In silico identification and validation of a novel hypothetical protein in Cryptosporidium hominis and virtual screening of inhibitors as therapeutics

Computational approaches to predict structure/function and other biological characteristics of proteins are becoming more common in comparison to the traditional methods in drug discovery. Cryptosporidiosis is a major zoonotic diarrheal disease particularly in children, which is caused primarily by Cryptosporidium hominis and Cryptosporidium parvum. Currently, there are no vaccines for cryptosporidiosis and recommended drugs are ineffective. With the availability of complete genome sequence of C. hominis, new targets have been recognized for the development of effective and better drugs and/or vaccines. We identified a unique hypothetical protein (TU502HP) in the C. hominis genome from the CryptoDB database. A three-dimensional model of the protein was generated using the Iterative Threading ASSEmbly Refinement server through an iterative threading method. Functional annotation and phylogenetic study of TU502HP protein revealed similarity with human transportin 3. The model is further subjected to a virtual screening study form the ZINC database compound library using the Dock Blaster server. A docking study through AutoDock software reported N-(3-chlorobenzyl)ethane-1,2-diamine as the best inhibitor in terms of docking score and binding energy. The reliability of the binding mode of the inhibitor is confirmed by a complex molecular dynamics simulation study using GROMACS software for 10 ns in the water environment. Furthermore, antigenic determinants of the protein were determined with the help of DNASTAR software. Our findings report a great potential in order to provide insights in the development of new drug(s) or vaccine(s) for treatment and prophylaxis of cryptosporidiosis among humans and animals.