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Molaei S, Asfaram S, Mashhadi Z, Mohammadi-Ghalehbin B, Iranpour S. Insights into parasites and COVID-19 co-infections in Iran: a systematic review. Trans R Soc Trop Med Hyg 2024; 118:350-358. [PMID: 38288655 DOI: 10.1093/trstmh/trae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 11/28/2023] [Accepted: 01/23/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND It is well-documented that using immunosuppressive drugs such as corticosteroids or cytokine blockers in treating coronavirus disease 2019 (COVID-19) increases the risk of co-infections. Here we systematically summarized the cases of COVID-19-associated parasitic infections (CAPIs) in Iran. METHODS From 19 February 2020 to 10 May 2023, all studies on Iranian patients suffering from CAPIs were collected from several databases using a systematic search strategy. RESULTS Of 540 records, 11 studies remained for data extraction. In this research, most of the studies were related to Lophomonas and Toxoplasma. Of 411 cases of CAPIs, toxoplasmosis (385 [93.7%]) had the highest rate of infection among Iranian patients, followed by blastocystosis (15 [3.6%]), fascioliasis (4 [0.97%]), leishmaniasis (3 [0.7%]), lophomoniasis (3 [0.7%]) and strongyloidiasis (1 [0.2%]). In general, Blastocystis enhanced diarrhoea in patients with COVID-19. Lophomonas, Toxoplasma and Strongyloides increased the severity of COVID-19, but Fasciola decreased its intensity. Patients with a history of cutaneous leishmaniasis showed mild symptoms of COVID-19. Also, patients with a prior history of hydatid cysts were not affected by COVID-19. CONCLUSIONS Due to the similar symptoms of some parasitic diseases and COVID-19 and immunosuppressive treatment regimens in these patients that may cause the reactivation or recurrence of parasitic infections, early diagnosis and treatment are required.
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Affiliation(s)
- Soheila Molaei
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
| | - Shabnam Asfaram
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
| | - Zahra Mashhadi
- School of Medicine, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
| | - Behnam Mohammadi-Ghalehbin
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
- Department of Microbiology and Immunology, School of Medicine, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
| | - Sohrab Iranpour
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
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Asadi P, Zarei Z, Mohebali M, Alizadeh Z, Najafi F, Izadi *S, Heidari Z. Intestinal Parasitic Infections in People Referring to the Central Laboratory of Meshkin Shahr County, Ardabil Province, Iran. IRANIAN JOURNAL OF PARASITOLOGY 2024; 19:105-112. [PMID: 38654952 PMCID: PMC11033542 DOI: 10.18502/ijpa.v19i1.15217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/04/2023] [Indexed: 04/26/2024]
Abstract
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.
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Affiliation(s)
- Pooria Asadi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zabihollah Zarei
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Alizadeh
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Najafi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - *Shahrokh Izadi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Heidari
- Zoonoses Research Center (ZRC), Ardabil University of Medical Sciences, Ardabil, Iran
- Department of Medical Microbiology, Parasitology and Immunology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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Zeinali S, Rezgi M, Gholinejad M, Jafari R. A large-scale study on the prevalence of intestinal parasites in patients referred to medical laboratories in Urmia, Northwest Iran. BMC Gastroenterol 2023; 23:322. [PMID: 37730548 PMCID: PMC10510251 DOI: 10.1186/s12876-023-02947-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023] Open
Abstract
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.
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Affiliation(s)
- Shiva Zeinali
- Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran
- Department of Parasitology and Mycology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Mahsa Rezgi
- Department of Parasitology and Mycology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Morteza Gholinejad
- Department of Parasitology and Mycology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasool Jafari
- Department of Parasitology and Mycology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Research Institute, Urmia University of Medical Sciences, Urmia, Iran.
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Taghipour A, Pirestani M, Hamidi Farahani R, Barati M. The Frequency of Intestinal Parasitic Infections in COVID-19 Patients: A Case-Control Study in Tehran, Capital of Iran. J Trop Med 2023; 2023:5359823. [PMID: 37719419 PMCID: PMC10504051 DOI: 10.1155/2023/5359823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/04/2023] [Accepted: 09/04/2023] [Indexed: 09/19/2023] Open
Abstract
The present study was done to evaluate the prevalence of intestinal parasitic infections (IPIs) in patients with COVID-19 in health care centers (Imam Reza and Golestan hospitals), Tehran, capital of Iran. By designing a matched case-control study, 200 fecal samples were collected for each of the COVID-19 patients and healthy individuals. Nasopharyngeal/oropharyngeal swab samples were collected from all participants for the diagnosis of COVID-19. RNA extraction was performed, and then real time reverse-transcription polymerase chain reaction (rRT-PCR) assay was applied to detect viral RNA. Considering the lung complications, 25%> lung complications was detected in 49 patients, 25-49% in 42 patients, and 50%≤ in 109 patients. Fecal samples were examined using different parasitological techniques. After nested-PCR, sequencing was applied to identify Cryptosporidium spp. and microsporidia spp. A relatively lower prevalence of IPIs was detected among control group (7.5%), than in COVID-19 patients (13%), though not significant (P=0.13). The most prevalent parasite among patients was Blastocystis sp. (6%). Also, 13.76% of IPIs were detected in inpatients with more than 50% lung complication. As well, a remarkably significant difference in IPIs was observed among diarrheic COVID-19 patients, in comparison with nondiarrheic patients (P < 0.00001). Moreover, the isolated sequences in the present study belonged to C. parvum subtype IIa and Enterocytozoon bieneusi genotypes D and Peru 8. In conclusion, more epidemiological and clinical research studies are needed to better understand the status and interaction of IPI in COVID-19 in Iran and other countries.
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Affiliation(s)
- Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Majid Pirestani
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ramin Hamidi Farahani
- Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Mohammad Barati
- Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran
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Amoak D, Dhillon S, Antabe R, Sano Y, Luginaah I. Factors Associated with Deworming Medication Utilization among Pregnant Women in Benin: Evidence from the Demographic and Health Survey. Trop Med Infect Dis 2023; 8:tropicalmed8030166. [PMID: 36977167 PMCID: PMC10053996 DOI: 10.3390/tropicalmed8030166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
Deworming medication utilization is a useful strategy to reduce the burden of anemia among pregnant women. Yet, we know very little about the prevalence and correlates of deworming medication utilization among pregnant women in sub-Saharan Africa, including Benin. To address this void in the literature, we used the 2017–2018 Benin Demographic and Health Survey and applied logistic regression analysis to explore the demographic, socioeconomic, and healthcare factors associated with deworming medication utilization in Benin. We found that deworming medication coverage was 65% at the national level. We observed that women aged 35–49 years were less likely to use deworming medication compared to those aged 15–24 years (OR = 0.79, p < 0.01). Compared to Christian women, Muslim women (OR = 0.70, p < 0.01) and women of other religions (OR = 0.51, p < 0.01) were also less likely to use deworming medication. Moreover, women with lower levels of education and household wealth, as well as unemployed women, were less likely to use deworming medication in comparison to their educated, richer, and employed counterparts. Women who visited ANC fewer than eight times were also less likely to use deworming medication compared to their counterparts who did so eight times or more (OR = 0.65, p < 0.001). Based on these findings, we discussed several implications for policymakers.
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Affiliation(s)
- Daniel Amoak
- Department of Geography and Environment, Western University, London, ON N6A 5C2, Canada
| | - Satveer Dhillon
- Department of Geography and Environment, Western University, London, ON N6A 5C2, Canada
| | - Roger Antabe
- Department of Health and Society, University of Toronto Scarborough, Scarborough, ON M1C 1A4, Canada
| | - Yujiro Sano
- Department of Sociology and Anthropology, Nipissing University, North Bay, ON P1B 8L7, Canada
- Correspondence:
| | - Isaac Luginaah
- Department of Geography and Environment, Western University, London, ON N6A 5C2, Canada
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Investigating the Potential Effects of COVID-19 Pandemic on Intestinal Coccidian Infections. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.3.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
New infectious agents pose a global threat to the healthcare system, and studies are conducted to estimate their health and epidemiological outcomes in the long run. The SARS-CoV-2 virus, which has caused the COVID-19 disease, was formerly assumed to be a respiratory virus; however, it can have serious systemic effects, affecting organs such as the gastrointestinal tract (GIT). Viral RNA was reported in the stool in a subset of patients, indicating another mode of transmission and diagnosis. In COVID-19, prolonged GIT symptoms, especially diarrhea, were associated with reduced diversity and richness of gut microbiota, immunological dysregulation, and delayed viral clearance. Intestinal coccidian parasites are intracellular protozoa that are most typically transmitted to humans by oocysts found in fecally contaminated food and water. Their epidemiological relevance is coupled to opportunistic infections, which cause high morbidity and mortality among immunocompromised individuals. Among immunocompetent people, intestinal coccidia is also involved in acute diarrhea, which is usually self-limiting. Evaluating the available evidence provided an opportunity to carefully consider that; the COVID-19 virus and coccidian protozoan parasites: namely, Cryptosporidium spp., Cyclospora cayetanensis, and Isospora belli, could mutually influence each other from the microbiological, clinical, diagnostic, and elimination aspects. We further systemically highlighted the possible shared pathogenesis mechanisms, transmission routes, clinical manifestations, parasite-driven immune regulation, and intestinal microbiota alteration. Finally, we showed how this might impact developing and developed countries prevention and vaccination strategies. To the best of our knowledge, there is no review that has discussed the reciprocal effect between coccidian parasites and COVID-19 coinfection.
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Rega S, Melese Y, Geteneh A, Kasew D, Eshetu T, Biset S. Intestinal Parasitic Infections Among Patients Who Visited Woldia Comprehensive Specialized Hospital's Emergency Department Over a Six-Year Period, Woldia, Ethiopia: A Retrospective Study. Infect Drug Resist 2022; 15:3239-3248. [PMID: 35761976 PMCID: PMC9233484 DOI: 10.2147/idr.s369827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background Despite ongoing intensive public health intervention efforts, intestinal parasitic infections (IPIs) remain a major public health problem in developing countries, including Ethiopia. Having updated epidemiological data focusing on the top common IPIs that cause emergency visits is crucial for implementing area-specific and evidence-based intervention strategies. Hence, this study aimed to determine the prevalence of IPIs in Woldia Comprehensive Specialized Hospital's (WCSH) emergency laboratory over a six-year period. Methods An institutional-based retrospective study was conducted to assess the prevalence of IPIs over a six-year period (2014-2019) using a recorded saline wet-mount stool sample examination result in the laboratory logbook at WCSH's emergency department. Results In this study, of the total of 11,281 clinically suspected individuals who were requested for stool sample examination, 3908 (34.6%) individuals were diagnosed with IPs. The majority of confirmed cases were caused by protozoan parasites (32.9%), followed by helminth infections (1.7%). A slight fluctuating trend in the prevalence of IPs was observed in the six-year study period, with the highest prevalence documented in the year of 2014 (41.3%) and the lowest in 2017 (28.0%). Entamoeba histolytica/dispar and Giardia lamblia accounts for 95% of the IPs. The prevalence of protozoan infection was significantly higher in females (p-value = 0.0101), while H. nana (p-value =0.0138) and E. vermicularis (p-value = 0.0201) infections were higher in males. The highest and the lowest IP prevalence were reported in the age groups of 45-54 years (40%) and under five years (25.6%), respectively. Conclusion and Recommendations In the study area, nearly one-third of patients with emergency visits due to gastrointestinal symptoms were infected with IPs. This underlines the severity of the problem in the study area, which requires a collaborative effort of concerned bodies to minimize the burden of IP to the level where it is no longer a public health threat.
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Affiliation(s)
- Solomon Rega
- Department of Medical Laboratory Science, Woldia Comprehensive Specialized Hospital, Woldia, Ethiopia
| | - Yimer Melese
- Department of Medical Laboratory Science, Dessie Health Science College, Dessie, Ethiopia
| | - Alene Geteneh
- Department of Medical Laboratory Science, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Desie Kasew
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tegegne Eshetu
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sirak Biset
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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