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Aziz AFE, Roshidi N, Muhammad Hanif MDH, Tye GJ, Arifin N. Giardia lamblia Immunoassay: Systematic review and meta-analysis. Clin Chim Acta 2024; 561:119839. [PMID: 38964570 DOI: 10.1016/j.cca.2024.119839] [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: 05/09/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/06/2024]
Abstract
Immunoassays are important tools in diagnosing giardiasis, though there are several controversies inherent in the existing methods. We conducted a systematic review and meta-analysis to assess the pooled diagnostic accuracy of immunoassays in detecting the gastrointestinal disease-causing parasite Giardia lamblia. Our comprehensive search, which included PubMed, Scopus, and ScienceDirect from 2000 up until 2023, resulted in 34 studies reporting the performance of 24 different immunoassays. The overall pooled sensitivity and specificity of immunoassays and subgroup analyses were determined. Notably, ImmunoCardSTAT® and RIDASCREEN® Giardia were the most used assays (n = 6 studies each). They exhibited sensitivity and specificity of 84 % and 99 % and 93 % and 99 %, respectively. Sub-group analysis on the type of immunoassays (without the case-control studies) showed that commercial ELISA had higher sensitivity (96 %) compared to a commercial immunochromatographic (88 %), which justifies the difference of sensitivity between ImmunoCardSTAT® and RIDASCREEN® Giardia. However, the applicability between these two in clinical settings, replacing the gold standard, should be considered including the time, equipment requirement, and budget. Samples from symptomatic patients showed higher sensitivity (92 %) compared to asymptomatic patients (79 %). Overall, immunoassays can be a practical replacement for the current gold standard, but more information should be gathered regarding the cost of providing more conclusive suggestions on these findings.
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Affiliation(s)
- Ahmad Fudail Eiyad Aziz
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang 11800, Malaysia
| | - Norhamizah Roshidi
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang 11800, Malaysia
| | | | - Gee Jun Tye
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang 11800, Malaysia
| | - Norsyahida Arifin
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Penang 11800, Malaysia.
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Pouryousef A, Fararouei M, Sarkari B. Antigen-Based Diagnosis of Human Giardiasis: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PARASITOLOGY 2023; 18:140-154. [PMID: 37583633 PMCID: PMC10423904 DOI: 10.18502/ijpa.v18i2.13180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/10/2023] [Indexed: 08/17/2023]
Abstract
Background We aimed to present a systematic review and meta-analysis of studies that used antigen-based assays for the diagnosis of human giardiasis. Methods All the related published literature cited within PubMed, ISI web of science, Google Scholar, Embase, and Scopus, were searched up to December 2021. The search terms, both as MeSH terms and text words, were "Giardia", "Giardia lamblia", "Giardia intestinalis", "giardiasis", combined with "diagnosis", "antigen detection", serodiagnosis, or serological diagnosis. The required data was extracted from the papers. Pooled estimates of sensitivity and specificity were obtained and forest plots and summary receiver operating characteristics (SROC) plots were used to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results The search of databases found 1683 papers, of which 46 articles fulfilled our eligibility criteria. The sensitivity of antigen-based methods for the diagnosis of human giardiasis ranged from 45% (95% CI: 31-59%) to 100% (95% CI: 100-100%) and the pooled estimate of sensitivity was 92% (95% CI: 90-93%). The pooled estimated specificity was 97% (95% CI: 96-98%), ranged from 81% (95% CI: 68-89%) to 100% (95% CI: 98-100%). The summary estimate of PPV and NPV were 92 % (95% CI: 90-93%) and 97% (95% CI: 96-98%) respectively. Comparing the performance of the antigen detection assays by region revealed a significant difference in the assay's performances in different regions of the world. Conclusion The antigen-based detection methods have acceptable and satisfactory performance in the diagnosis of human giardiasis. The task ahead is to identify more specific target antigens and design simpler, cheaper, and more sensitive methods for the diagnosis of this common worldwide-distributed parasitic infection.
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Affiliation(s)
- Ali Pouryousef
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Fararouei
- HIV/AIDS Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahador Sarkari
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Circulating IL-6, IL-10, and TNF-alpha and IL-10/IL-6 and IL-10/TNF-alpha ratio profiles of polyparasitized individuals in rural and urban areas of gabon. PLoS Negl Trop Dis 2022; 16:e0010308. [PMID: 35421083 PMCID: PMC9041759 DOI: 10.1371/journal.pntd.0010308] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 04/26/2022] [Accepted: 03/06/2022] [Indexed: 11/20/2022] Open
Abstract
Malaria, blood-borne filarial worms and intestinal parasites are all endemic in Gabon. This geographical co-distribution leads to polyparasitism and, consequently, the possibility of immune-mediated interactions among different parasite species. Intestinal protozoa and helminths could modulate antimalarial immunity, for example, thereby potentially increasing or reducing susceptibility to malaria. The aim of the study was to compare the cytokine levels and cytokine ratios according to parasitic profiles of the population to determine the potential role of co-endemic parasites in the malaria susceptibility of populations. Blood and stool samples were collected during cross-sectional surveys in five provinces of Gabon. Parasitological diagnosis was performed to detect plasmodial parasites, Loa loa, Mansonella perstans, intestinal helminths (STHs) and protozoan parasites. Nested PCR was used to detect submicroscopic plasmodial infection in individuals with negative blood smears. A cytometric bead array was used to quantify interleukin (IL)-6, IL-10 and tumour necrosis factor (TNF)-α in the plasma of subjects with different parasitological profiles. Median IL-6 and IL-10 levels and the median IL-10/TNF-α ratio were all significantly higher among individuals with Plasmodium (P.) falciparum infection than among other participants (p<0.0001). The median TNF-α level and IL-10/IL-6 ratio were higher in subjects with STHs (p = 0.09) and P. falciparum-intestinal protozoa co-infection (p = 0.04), respectively. IL-6 (r = -0.37; P<0.01) and IL-10 (r = -0.37; P<0.01) levels and the IL-10/TNF-α ratio (r = -0.36; P<0.01) correlated negatively with age. Among children under five years old, the IL-10/TNF-α and IL-10/IL-6 ratios were higher in those with intestinal protozoan infections than in uninfected children. The IL-10/TNF-α ratio was also higher in children aged 5–15 years and in adults harbouring blood-borne filariae than in their control counterparts, whereas the IL-10/IL-6 ratio was lower in those aged 5–15 years with filariae and intestinal parasites but higher in adults with intestinal parasitic infections. Asymptomatic malaria is associated with a strong polarization towards a regulatory immune response, presenting high circulating levels of IL-10. P. falciparum/intestinal protozoa co-infections were associated with an enhanced IL-10 response. Immunity against malaria could differ according to age and carriage of other parasites. Helminths and intestinal protozoa can play a role in the high susceptibility to malaria currently observed in some areas of Gabon, but further investigations are necessary. The current epidemiological transition of malaria observed in Gabon included, for example, a shift in the at-risk population from children aged less than 5 years old to older children aged 5–15 years. Another consequence was the increasing number of cases of infection among adults. In view of these findings, it is important to explain this phenomenon of epidemiological modification of malaria in Gabon. Intestinal parasites and blood filariasis are endemic in Gabon. These parasites are described to alter the malaria immune response and can be implicated in the susceptibility of individuals to malaria. In Gabon, malaria presents a heterogeneous repartition. Thus, in the present study, we investigated the role of co-endemic parasitosis in the alteration of the malarial immune response by comparing Th1 (IL-6 and TNF-α) and Th2/Treg (IL-10) cytokine production between mono- and co-parasitized individuals in many localities with different epidemiological patterns of malaria. Microscopic analyses and rapid antigenic tests were performed for malaria diagnosis. The nested PCR technique was used to demonstrate the submicroscopic parasitaemia of Plasmodium sp. Then, once groups with different parasitological profiles were constituted, IL-6, IL-10 and TNF-α levels were measured in the plasma of individuals. Th2/Th1 ratios, which can indicate the level of susceptibility of individuals to malaria, were calculated. We observed that there was no interaction between Plasmodium sp. and co-endemic parasites in the present study. However, the high Th2/Th1 cytokine ratio among patients with intestinal protozoa seems to suggest that these intestinal parasites could also play a role in susceptibility to malaria as they do for helminths.
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O'Leary JK, Sleator RD, Lucey B. Cryptosporidium spp. diagnosis and research in the 21 st century. Food Waterborne Parasitol 2021; 24:e00131. [PMID: 34471706 PMCID: PMC8390533 DOI: 10.1016/j.fawpar.2021.e00131] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/06/2021] [Accepted: 08/17/2021] [Indexed: 01/01/2023] Open
Abstract
The protozoan parasite Cryptosporidium has emerged as a leading cause of diarrhoeal illness worldwide, posing a significant threat to young children and immunocompromised patients. While endemic in the vast majority of developing countries, Cryptosporidium also has the potential to cause waterborne epidemics and large scale outbreaks in both developing and developed nations. Anthroponontic and zoonotic transmission routes are well defined, with the ingestion of faecally contaminated food and water supplies a common source of infection. Microscopy, the current diagnostic mainstay, is considered by many to be suboptimal. This has prompted a shift towards alternative diagnostic techniques in the advent of the molecular era. Molecular methods, particularly PCR, are gaining traction in a diagnostic capacity over microscopy in the diagnosis of cryptosporidiosis, given the laborious and often tedious nature of the latter. Until now, developments in the field of Cryptosporidium detection and research have been somewhat hampered by the intractable nature of this parasite. However, recent advances in the field have taken the tentative first steps towards bringing Cryptosporidium research into the 21st century. Herein, we provide a review of these advances.
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Affiliation(s)
- Jennifer K. O'Leary
- Department of Biological Sciences, Munster Technological University, Bishopstown Campus, Cork, Ireland
| | - Roy D. Sleator
- Department of Biological Sciences, Munster Technological University, Bishopstown Campus, Cork, Ireland
| | - Brigid Lucey
- Department of Biological Sciences, Munster Technological University, Bishopstown Campus, Cork, Ireland
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Alharbi A, Toulah FH, Wakid MH, Azhar E, Farraj S, Mirza AA. Detection of Giardia lamblia by Microscopic Examination, Rapid Chromatographic Immunoassay Test, and Molecular Technique. Cureus 2020; 12:e10287. [PMID: 33047079 PMCID: PMC7541033 DOI: 10.7759/cureus.10287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Giardia lamblia is a pathogenic intestinal flagellate transmitted by the ingestion of contaminated water or food with the cyst stage of the parasite. Giardiasis can cause severe acute diarrhea and malabsorption or may persist as a chronic infection. Effective treatment and control measures depend on proper laboratory diagnosis using diagnostic methods with high sensitivity and specificity. Objective To compare the sensitivity and specificity of direct smear, Ritchie sedimentation technique, two brands of rapid chromatographic immunoassay test, and real-time polymerase chain reaction (PCR) for the detection of G. lamblia in clinical human fecal samples. Materials and methods Unpreserved 100 stool specimens were collected in clean plastic containers and labeled with the patient’s information and examined through light microscopy, immunochromatographic test (ICTs), and real-time PCR. Results Out of 100 fresh stool samples obtained from workers analyzed, real-time PCR targeting the SSU rRNA gene was able to detect Giardia deoxyribonucleic acid (DNA) in (42) samples followed by ImmunoCard STAT! (31) samples (Meridian Bioscience, Germany), direct smear (23) samples, CerTest (19) samples (Biotec, Zaragoza, Spain), and Ritchie technique (17) samples. Real-time PCR was the most sensitive for the diagnosis of G. lamblia in comparison to the other techniques. Conclusions All the techniques investigated were sensitive for the detection of G. lamblia in stool samples. Further studies are recommended using multiplex real-time PCR assay in order to increase the possibility of the presence or absence of the infection.
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Affiliation(s)
- Amjad Alharbi
- Faculty of Science for Girls, Department of Biology, King Abdulaziz University, Jeddah, SAU
| | - Fawzia H Toulah
- College of Science, Department of Biology, University of Jeddah, Jeddah, SAU
| | - Majed H Wakid
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Sciences, King Abdulaziz University, Jeddah, SAU.,Special Infectious Agents Unit, King Fahd Medical Research Center, Jeddah, SAU
| | - Esam Azhar
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Sciences, King Abdulaziz University, Jeddah, SAU.,Special Infectious Agents Unit, King Fahd Medical Research Center, Jeddah, SAU
| | - Suha Farraj
- Special Infectious Agents Unit, King Fahd Medical Research Center, Jeddah, SAU
| | - Ahmed A Mirza
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Sciences, King Abdulaziz University, Jeddah, SAU
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Manouana GP, Lorenz E, Mbong Ngwese M, Nguema Moure PA, Maiga Ascofaré O, Akenten CW, Amuasi J, Rakotozandrindrainy N, Rakotozandrindrainy R, Mbwana J, Lusingu J, Byrne N, Melhem S, Zinsou JF, Adegbite RB, Hogan B, Winter D, May J, Kremsner PG, Borrmann S, Eibach D, Adegnika AA. Performance of a rapid diagnostic test for the detection of Cryptosporidium spp. in African children admitted to hospital with diarrhea. PLoS Negl Trop Dis 2020; 14:e0008448. [PMID: 32658930 PMCID: PMC7377516 DOI: 10.1371/journal.pntd.0008448] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 07/23/2020] [Accepted: 06/02/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cryptosporidium is a protozoan parasite that causes mild to severe diarrhoeal disease in humans. To date, several commercial companies have developed rapid immunoassays for the detection of Cryptosporidium infection. However, the challenge is to identify an accurate, simple and rapid diagnostic tool for the estimation of cryptosporidiosis burden. This study aims at evaluating the accuracy of CerTest Crypto, a commercialized rapid diagnostic test (RDT) for the detection of Cryptosporidium antigens in the stool of children presenting with diarrhoea. METHODS A cross-sectional study was conducted in four study sites in Sub-Saharan Africa (Gabon, Ghana, Madagascar, and Tanzania), from May 2017 to April 2018. Stool samples were collected from children under 5 years with diarrhoea or a history of diarrhoea within the last 24 hours. All specimens were processed and analyzed using CerTest Crypto RDT against a composite diagnostic panel involving two polymerase chain reaction (PCR) tests (qPCR and RFLP-PCR,) as the gold standard. RESULTS A total of 596 stool samples were collected. Evaluation of the RDT yielded a very low overall sensitivity of 49.6% (confidence interval (CI) 40.1-59.0), a specificity of 92.5% (CI 89.8-94.7), positive predictive value of 61.3% (CI 50.6-71.2), and negative predictive value of 88.5% (85.3-91.1) when compared to the composite reference standard of qPCR and RFLP-PCR for the detection of Cryptosporidium species. Moreover, the performance of this test varied across different sites. CONCLUSION The weak performance of the studied RDT suggests the need to carefully evaluate available commercial RDTs before their use as standard tools in clinical trials and community survey of Cryptosporidium infections in pediatric cohorts.
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Affiliation(s)
- Gédéon Prince Manouana
- Centre de Recherches Médicales de Lambaréné
- German Center for Infection Research (DZIF), African partner institution, CERMEL, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Eva Lorenz
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, Germany
| | - Mirabeau Mbong Ngwese
- Centre de Recherches Médicales de Lambaréné
- German Center for Infection Research (DZIF), African partner institution, CERMEL, Gabon
| | | | - Oumou Maiga Ascofaré
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | | | - John Amuasi
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | | | | | - Joyce Mbwana
- National Institute for Medical Research (NIMR) & University of Copenhagen, Denmark
| | - John Lusingu
- National Institute for Medical Research (NIMR) & University of Copenhagen, Denmark
| | - Natalie Byrne
- Centre de Recherches Médicales de Lambaréné
- German Center for Infection Research (DZIF), African partner institution, CERMEL, Gabon
| | - Sophia Melhem
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
| | - Jeannot Frejus Zinsou
- Centre de Recherches Médicales de Lambaréné
- German Center for Infection Research (DZIF), African partner institution, CERMEL, Gabon
| | - Roméo Bayodé Adegbite
- Centre de Recherches Médicales de Lambaréné
- German Center for Infection Research (DZIF), African partner institution, CERMEL, Gabon
| | - Benedikt Hogan
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
| | - Doris Winter
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
| | - Jurgen May
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
| | - Peter Gottfried Kremsner
- Centre de Recherches Médicales de Lambaréné
- German Center for Infection Research (DZIF), African partner institution, CERMEL, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), partner site Tübingen, Germany
| | - Steffen Borrmann
- Centre de Recherches Médicales de Lambaréné
- German Center for Infection Research (DZIF), African partner institution, CERMEL, Gabon
| | - Daniel Eibach
- Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
- German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Germany
| | - Ayola Akim Adegnika
- Centre de Recherches Médicales de Lambaréné
- German Center for Infection Research (DZIF), African partner institution, CERMEL, Gabon
- Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), partner site Tübingen, Germany
- * E-mail:
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Oyegue-Liabagui SL, Ndjangangoye NK, Kouna LC, Lekolo GM, Mounioko F, Kwedi Nolna S, Lekana-Douki JB. Molecular prevalence of intestinal parasites infections in children with diarrhea in Franceville, Southeast of Gabon. BMC Infect Dis 2020; 20:350. [PMID: 32414337 PMCID: PMC7226932 DOI: 10.1186/s12879-020-05071-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 05/04/2020] [Indexed: 01/30/2023] Open
Abstract
Background Pediatric diarrhea caused by a range of pathogens, including intestinal parasites, is one of main causes of death among children under 5 years of age. The distribution of these parasitic infections overlaps in many environmental, socioeconomic and epidemiological settings. Their distribution and prevalence varies from region to region. In the current study, we assess the prevalence of intestinal parasites among pediatric patients with syndromic diarrheal disease living in Franceville, Gabon. Methods A cross-sectional study conducted in the Amissa Bongo Regional Hospital and Chinese-Gabonese Friendship Hospital in Franceville, between November 2016 and August 2017, enrolled a total of 100 diarrheic children between 0 and 180 months of age. Parasite detection in stool samples was performed using molecular diagnostic by PCR. Difference in means were tested by Student’s t test and ANOVA while principal component analysis was used to determine the correlation between parasite distributions and age groups. Results The overall prevalence of intestinal parasite infection was 61% (61/100). Hymenolepis sp and Cryptosporidium hominis/parvum were the most common parasites (31 and 19%, respectively), followed by Encephalitozoon intestinalis (15%), Trichuris trichiura (4%), Dientamoeba fragilis (4%), and Enterocytozoon bieneusi (2%). The polyparasitism rate was 19.7%, with 83.3% double and 16.7% triple infections. Protozoan infections (66.7%) were more prevalent than helminths infections (33.3%). Seasonal association of the circulation of intestinal parasite was statistically significant (p = 0.03). Correlations between different parasites was also observed. Conclusion The prevalence of intestinal parasitic infections is highest in diarrheic pediatric children. The prevalence of parasitic infections indicates that protozoa and helminths are the most common parasites in the Franceville environment. This study reinforces the importance of routine examination of diarrheic stool samples for the diagnostic of intestinal parasites. Further analyses are required to better understand the local epidemiology and risk factors associated with the transmission of intestinal parasites in Franceville, Gabon. Keyswords diarrhea, children, intestinal parasitic infections, molecular diagnostic, Franceville, Gabon.
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Affiliation(s)
- Sandrine Lydie Oyegue-Liabagui
- Ecole Doctorale Régionale d'Afrique Centrale en Infectiologie Tropicale (ECODRAC), Université des Sciences et Techniques de Masuku, BP 876, Franceville, Gabon. .,Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon.
| | - Nal Kennedy Ndjangangoye
- Ecole Doctorale Régionale d'Afrique Centrale en Infectiologie Tropicale (ECODRAC), Université des Sciences et Techniques de Masuku, BP 876, Franceville, Gabon.,Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon
| | - Lady Charlene Kouna
- Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon
| | - Gwladys Mirlande Lekolo
- Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon
| | - Franck Mounioko
- Laboratoire d'Ecologie Vectoriel, Institut de Recherche en Ecologie Tropicale, BP 13354, Libreville, Gabon
| | - Sylvie Kwedi Nolna
- Capacity for Leadership Excellence And Research (CLEAR, Inc.), Yaoundé, Cameroon
| | - Jean Bernard Lekana-Douki
- Unité d'Evolution, Epidémiologie et Résistance Parasitaire (UNEEREP), Centre International de Recherches Médicales de Franceville (CIRMF), BP 769, Franceville, Gabon.,Département de Parasitologie-Mycologie Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, BP 4009, Libreville, Gabon
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Utami WS, Murhandarwati EH, Artama WT, Kusnanto H. Cryptosporidium Infection Increases the Risk for Chronic Diarrhea Among People Living With HIV in Southeast Asia: A Systematic Review and Meta-Analysis. Asia Pac J Public Health 2020; 32:8-18. [PMID: 32037854 PMCID: PMC7750677 DOI: 10.1177/1010539519895422] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We conducted a systematic review research and meta-analysis to reveal the
relationship between the risk of chronic diarrhea and
Cryptosporidium infection in people living with HIV in
Southeast Asia. We performed online peer-reviewed literature research from
January 2005 to December 2017, which included PubMed, Science Direct, ProQuest,
EBSCO, Cochrane, and Web of Science databases. Calculation of size effects in
the meta-analysis was performed by STATA 13.0 software to estimate relative
risks (RRs) with 95% confidence intervals (CIs) for any associations. Seven
cross-sectional research articles were recruited in this study based on the
inclusion and exclusion criteria. Our analysis revealed a significant
relationship between cryptosporidiosis and the risk of chronic diarrhea in
people living with HIV, with RR = 1.325; 95% CI = 1.157 to 1.517; and
P < .000. Our results suggested that cryptosporidiosis
increases the risk of chronic diarrhea, and low CD4+ lymphocyte cell
counts aggravate the degree of diarrhea. Therefore, clinicians should be more
aware in treating HIV-positive people, especially those with low CD4+
cell counts, and we suggest that Cryptosporidium laboratory
examinations be conducted immediately.
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Bitilinyu-Bangoh J, Voskuijl W, Thitiri J, Menting S, Verhaar N, Mwalekwa L, de Jong DB, van Loenen M, Mens PF, Berkley JA, Bandsma RHJ, Schallig HDFH. Performance of three rapid diagnostic tests for the detection of Cryptosporidium spp. and Giardia duodenalis in children with severe acute malnutrition and diarrhoea. Infect Dis Poverty 2019; 8:96. [PMID: 31775877 PMCID: PMC6882336 DOI: 10.1186/s40249-019-0609-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 11/14/2019] [Indexed: 02/01/2023] Open
Abstract
Background There is significant need for accurate diagnostic tools for Cryptosporidium spp. and Giardia duodenalis infections in resource limited countries where diarrhoeal disease caused by these parasites is often prevalent. The present study assessed the diagnostic performance of three commercially available rapid diagnostic tests (RDTs) based on faecal-antigen detection for Cryptosporidium spp. and/or G. duodenalis infections in stool samples of children admitted with severe acute malnutrition (SAM) and diarrhoea. An established multiplex PCR was used as reference test. Methods Stool samples from children with SAM and diarrhoea enrolled in a randomized controlled trial (registered at clinicaltrials.gov/ct2/show/NCT02246296) in Malawi (n = 175) and Kenya (n = 120) between December 2014 and December 2015 were analysed by a multiplex PCR for the presence of Cryptosporidium spp., G. duodenalis or Entamoeba histolytica parasite DNA. Cryptosporidium-positive samples were species typed using restriction fragment length polymorphism analysis. A sub-sample of the stool specimens (n = 236) was used for testing with three different RDTs. Diagnostic accuracy of the tests under evaluation was assessed using the results of PCR as reference standard using MedCalc software. Pearson Chi-square test and Fisher’s exact test were used to determine (significant) difference between the number of cryptosporidiosis or giardiasis cases found by PCR in Malawi and Kenya. The overall diagnostic accuracy of each RDT was calculated by plotting a receiver operating characteristic (ROC) curve for each test and to determine the area under the curve (AUC) using SPSS8 software. Results Prevalence of Cryptosporidium spp. by PCR was 20.0 and 21.7% in Malawi and Kenya respectively, mostly C. hominis. G. duodenalis prevalence was 23.4 and 5.8% in Malawi and Kenya respectively. E. histolytica was not detected by PCR. RDT testing followed the same pattern of prevalence. RDT sensitivities ranged for cryptosporidiosis from 42.9 to 76.9% and for G. duodenalis from 48.2 to 85.7%. RDT specificities ranged from 88.4 to 100% for Cryptosporidium spp. and from 91.2 to 99.2% for G. duodenalis infections. Based on the estimated area under the curve (AUC) values, all tests under evaluation had an acceptable overall diagnostic accuracy (> 0.7), with the exception of one RDT for Cryptosporidium spp. in Malawi. Conclusions All three RDTs for Cryptosporidium spp. and Giardia duodenalis evaluated in this study have a moderate sensitivity, but sufficient specificity. The main value of the RDTs is within their rapidness and their usefulness as screening assays in surveys for diarrhoea.
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Affiliation(s)
- Joseph Bitilinyu-Bangoh
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.,Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Wieger Voskuijl
- College of Medicine, Department of Paediatrics and Child Health, University of Malawi, Blantyre, Malawi.,Global Child Health Group, Emma Children's Hospital, Amsterdam University Medical Centres, Amsterdam, The Netherlands.,The Childhood Acute Illness and Nutrition Network (CHAIN), Nairobi, Kenya
| | - Johnstone Thitiri
- The Childhood Acute Illness and Nutrition Network (CHAIN), Nairobi, Kenya.,KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Sandra Menting
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - Nienke Verhaar
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | | | - Daisy B de Jong
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - Merlin van Loenen
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - Petra F Mens
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - James A Berkley
- The Childhood Acute Illness and Nutrition Network (CHAIN), Nairobi, Kenya.,KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Robert H J Bandsma
- The Childhood Acute Illness and Nutrition Network (CHAIN), Nairobi, Kenya.,Translational Medicine Program, Hospital for Sick Children, Toronto, Canada
| | - Henk D F H Schallig
- Academic Medical Centre, Department of Medical Microbiology, Parasitology Unit, Amsterdam University Medical Centres, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.
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10
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Deltombe C, Lefebvre M, Morio F, Boutoille D, Imbert BM, Le Pape P, Raffi F, Hourmant M. Cryptosporidiosis and microsporidiosis as causes of diarrhea in kidney and/or pancreas transplant recipients. Med Mal Infect 2019; 50:407-413. [PMID: 31472993 DOI: 10.1016/j.medmal.2019.07.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 07/10/2018] [Accepted: 07/11/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Gastrointestinal disorders in solid organ recipients may have various origins including cryptosporidiosis and microsporidiosis. The prevalence of these infections is poorly known in solid organ transplant (SOT) patients in industrialized countries. METHODS We prospectively assessed the infectious causes of diarrhea in SOT patients. Secondary objectives were to gain further insight into the main characteristics of cryptosporidiosis, and to assess risk factors for this infection. All adult kidney and/or pancreas recipients presenting with diarrhea and admitted to our facility between May 1, 2014 and June 30, 2015 were enrolled. A stool sample was analyzed using a standardized protocol including bacteriological, virological, and parasitological investigations. Data related to clinical symptoms, immunosuppression, and environmental potential risk factors were collected through a self-administered questionnaire and computerized medical records. RESULTS Out of 73 enrolled patients, 36 had infectious diarrhea (49.3%). Viruses ranked first (17/36), followed by parasites and fungi (11/17). Cryptosporidiosis was the most common parasitic disease (n=6 patients). We observed four microsporidiosis cases. The estimated prevalence of cryptosporidiosis and microsporidiosis in this cohort was 3.7 and 2.40/00, respectively. No significant risk factor for cryptosporidiosis or microsporidiosis, neither environmental nor immunological, could be evidenced. CONCLUSION Both cryptosporidiosis and microsporidiosis represent a significant cause of diarrhea in kidney transplant recipients.
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Affiliation(s)
- C Deltombe
- Institute for Transplantation, Urology and Nephrology (ITUN) Nantes University Hospital, 44000 Nantes, France.
| | - M Lefebvre
- Infectious Diseases Department and CIC 1413, Inserm, Nantes University Hospital, 44000 Nantes, France
| | - F Morio
- Parasitology and Medical Mycology Laboratory, Nantes University Hospital, 44000 Nantes, France
| | - D Boutoille
- Infectious Diseases Department and CIC 1413, Inserm, Nantes University Hospital, 44000 Nantes, France
| | - B M Imbert
- Virology Department, Nantes University Hospital, 4000 Nantes, France
| | - P Le Pape
- Parasitology and Medical Mycology Laboratory, Nantes University Hospital, 44000 Nantes, France
| | - F Raffi
- Infectious Diseases Department and CIC 1413, Inserm, Nantes University Hospital, 44000 Nantes, France
| | - M Hourmant
- Institute for Transplantation, Urology and Nephrology (ITUN) Nantes University Hospital, 44000 Nantes, France
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11
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Rapid diagnostic tests relying on antigen detection from stool as an efficient point of care testing strategy for giardiasis and cryptosporidiosis? Evaluation of a new immunochromatographic duplex assay. Diagn Microbiol Infect Dis 2019; 93:33-36. [DOI: 10.1016/j.diagmicrobio.2018.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/11/2018] [Accepted: 07/18/2018] [Indexed: 11/21/2022]
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12
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Hooshyar H, Rostamkhani P, Arbabi M, Delavari M. Giardia lamblia infection: review of current diagnostic strategies. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2019; 12:3-12. [PMID: 30949313 PMCID: PMC6441489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Giardiasis has a global distribution and it is a common cause of diarrhea in both children and adults and is transmitted via the fecal-oral route through direct or indirect ingestion of cysts. The laboratory diagnosis of Giardia spp. is mainly based on demonstration of microscopic cyst or trophozoite in stool samples but several immunological-based assays and molecular methods are also available for giardiasis diagnosis. The aim of this study was to conduct a review of the applied methods in medical laboratory and to highlight pitfalls and challenges of them for diagnosis of giardiasis. In this article we have evaluated the Giardia diagnostic methods with a broad review of literature, electronic databases and books. The search has covered the articles and some textbooks that have published up to 2018. It has been concluded that traditional microscopy combination with stool concentration method should still be held in the routine medical laboratory due to economical and high sensitivity and immunological-based assay and molecular methods which are recommended to use as a complementary test to the traditional technique.
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13
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Widespread occurrence of Cryptosporidium infections in patients with HIV/AIDS: Epidemiology, clinical feature, diagnosis, and therapy. Acta Trop 2018; 187:257-263. [PMID: 30118699 DOI: 10.1016/j.actatropica.2018.08.018] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/06/2018] [Accepted: 08/12/2018] [Indexed: 01/02/2023]
Abstract
Cryptosporidium infection is a serious threat for HIV/AIDS patients, causing severe diarrhea and even death. The overall prevalence of Cryptosporidium in HIV/AIDS patients was calculated as approximately 8.69% (7,799/89,724), with higher prevalence observed in individuals with diarrhea, individuals with low CD4+ T-lymphocyte counts, and antiretroviral therapy-naïve individuals. Cryptosporidium infection was not significantly associated with patient age or gender, national development levels, or continent of residence. Over the period from 2007 to 2017, Cryptosporidium prevalence was 10.09% (3,282/32,517); this figure was higher than that observed in each of the previous observation periods (1985-1995 and 1996-2006), suggesting that the prevalence of cryptosporidiosis has been increasing over time in HIV/AIDS patients. Ten Cryptosporidium species and genotypes have been identified from 1,252 isolates, with C. hominis, C. parvum, and C. meleagridis accounting for 93.53% of infections. Five subtypes each of C. hominis (Ia, Ib, Id, Ie, and If), C. parvum (IIa to IIe), and C. meleagridis (IIIa to IIIe) have been described by sequence analyses of the 60-kDa glycoprotein (gp60) gene. Variation in the clinical manifestations observed in HIV/AIDS patients might be attributed to infection by different Cryptosporidium species, genotypes and subtypes, as well as different sites of infection. New molecular and immunological diagnostic techniques are in development or already commercially available. High-throughput screening methods for development of new or repurposed therapeutics as well as novel parasite genetic manipulation strategies offer hope for improving human cryptosporidiosis therapies. Painstaking efforts by researchers as well as support from governments and funding agencies will be required to make lasting achievements in this field.
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14
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M’bondoukwé NP, Kendjo E, Mawili-Mboumba DP, Koumba Lengongo JV, Offouga Mbouoronde C, Nkoghe D, Touré F, Bouyou-Akotet MK. Prevalence of and risk factors for malaria, filariasis, and intestinal parasites as single infections or co-infections in different settlements of Gabon, Central Africa. Infect Dis Poverty 2018; 7:6. [PMID: 29378644 PMCID: PMC5789590 DOI: 10.1186/s40249-017-0381-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 12/13/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Malaria, filariasis, and intestinal parasitic infections (IPIs) are common and frequently overlap in developing countries. The prevalence and predictors of these infections were investigated in three different settlements (rural, semi-urban, and urban) of Gabon. METHODS During cross-sectional surveys performed from September 2013 to June 2014, 451 individuals were interviewed. In addition, blood and stool samples were analysed for the presence of Plasmodium, filarial roundworm, intestinal protozoan, and helminth infections. RESULTS Intestinal parasitic infections (61.1%), including intestinal protozoa (56.7%) and soil-transmitted helminths (STHs) (22.2%), predominated, whereas Plasmodium falciparum (18.8%), Loa loa (4.7%), and Mansonella perstans (1.1%) were less prevalent. Filariasis and STHs were mainly found in rural settlements, whereas a higher plasmodial infection prevalence rate was observed in the periurban area. The most common IPI was blastocystosis (48.6%), followed by ascaridiasis (13.7%), trichuriasis (11.8%), amoebiasis (9.3%), giardiasis (4.8%), and strongyloidiasis (3.7%). Hookworm was detected in one adult from rural Dienga. Adults had a higher prevalence of Blastocystis hominis and STHs, whereas Giardia duodenalis was more frequently observed among children aged below 5 years (P < 0.01). The polyparasitism rate was 41.5%, with 7.0% Plasmodium-IPIs and 1.8% Plasmodium-STH co-infections. The multivariate analysis showed that living in a suburban area, belonging to the age group of 5-15 years, having none or a secondary education, or having an open body water close to home were significant risk factors for malaria (P ≤ 0.01). For STH infections, identified risk factors were drinking untreated water and living in a rural area (P ≤ 0.04). No significant predictors were identified for IPIs and malaria-IPI co-infection. CONCLUSIONS This study reports a high prevalence of IPIs and intestinal protozoa, but a low rate of malaria-IPI co-infections in the study sites. Improvements in the living conditions of the population such as adequate water supply and proper health education and sanitation should be integrated into control strategies for malaria, STHs, and IPIs.
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Affiliation(s)
- Noé Patrick M’bondoukwé
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Eric Kendjo
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Denise Patricia Mawili-Mboumba
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Jeanne Vanessa Koumba Lengongo
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Christelle Offouga Mbouoronde
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
| | - Dieudonné Nkoghe
- International Center for Medical Research of Franceville, Franceville, Gabon
| | - Fousseyni Touré
- International Center for Medical Research of Franceville, Franceville, Gabon
| | - Marielle Karine Bouyou-Akotet
- Department of Parasitology-Mycology, Faculty of Medicine, University of Health Sciences, P.O. Box 4009, Libreville, Gabon
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15
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Humbert P, Guichard A, Bennani I, Chiheb S. [Giardia duodenalis and its involvement in skin diseases]. Ann Dermatol Venereol 2017; 144:676-684. [PMID: 28965699 DOI: 10.1016/j.annder.2017.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 02/01/2017] [Accepted: 08/07/2017] [Indexed: 10/18/2022]
Abstract
BACKGOUND Over the last thirty years, the scientific community has become increasingly interested in the intestinal flora, whether commensal or pathogenic, and its impact on other organs. In dermatology, the correlation between intestinal microbial agents and cutaneous lesions is well established. Giardia duodenalis, an intestinal parasite, has been particularly widely studied. The aim of this work is to provide a review of studies demonstrating the involvement of G. duodenalis in various forms of dermatosis. PATIENTS AND METHODS The data were obtained by an English-language literature search of Medline, PubMed and Google Scholar for the period 1975-2015. Among the thirty case reports since 1976, we selected the twenty most objective and clinically relevant. RESULTS AND DISCUSSION This review demonstrates that intestinal giardiasis may be an etiological factor, either alone or in combination with other agents, of various dermatoses through inflammatory and allergic mechanisms or intestinal hyperpermeability. The mucocutaneous lesions are varied: urticaria, angioedema, atopic dermatitis, erythema nodosum, Wells syndrome, among others. The role and origin of the infection are often unknown, and it is thus difficult to determine the interval between parasite infestation and the onset of skin lesions. Consequently, a fecal examination to identify G. duodenalis should be considered in chronic urticaria or angioedema, and where atopic dermatitis occurs in adulthood without any specific etiology. Therapeutic test should be done in every suspicion.
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Affiliation(s)
- P Humbert
- Service de dermatologie, centre d'études et de recherche sur le tégument (CERT), centre d'investigation clinique (CIC BT506), université de Franche-Comté, centre hospitalier universitaire Besançon, Inserm UMR1098, SFR FED 4234 IBCT, 25030 Besançon, France; Fondation Cheikh Khalifa Mohammed VI, Casablanca, Maroc.
| | - A Guichard
- Service de dermatologie, centre d'études et de recherche sur le tégument (CERT), centre d'investigation clinique (CIC BT506), université de Franche-Comté, centre hospitalier universitaire Besançon, Inserm UMR1098, SFR FED 4234 IBCT, 25030 Besançon, France
| | - I Bennani
- Fondation Cheikh Khalifa Mohammed VI, Casablanca, Maroc
| | - S Chiheb
- Fondation Cheikh Khalifa Mohammed VI, Casablanca, Maroc; Faculté de médecine et de pharmacie, université Hassan II, Casablanca, Maroc
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16
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PCR-based verification of positive rapid diagnostic tests for intestinal protozoa infections with variable test band intensity. Acta Trop 2017. [PMID: 28634143 DOI: 10.1016/j.actatropica.2017.06.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Stool-based rapid diagnostic tests (RDTs) for pathogenic intestinal protozoa (e.g. Cryptosporidium spp. and Giardia intestinalis) allow for prompt diagnosis and treatment in resource-constrained settings. Such RDTs can improve individual patient management and facilitate population-based screening programmes in areas without microbiological laboratories for confirmatory testing. However, RDTs are difficult to interpret in case of 'trace' results with faint test band intensities and little is known about whether such ambiguous results might indicate 'true' infections. In a longitudinal study conducted in poor neighbourhoods of Port Elizabeth, South Africa, a total of 1428 stool samples from two cohorts of schoolchildren were examined on the spot for Cryptosporidium spp. and G. intestinalis using an RDT (Crypto/Giardia DuoStrip; Coris BioConcept). Overall, 121 samples were positive for G. intestinalis and the RDT suggested presence of cryptosporidiosis in 22 samples. After a storage period of 9-10 months in cohort 1 and 2-3 months in cohort 2, samples were subjected to multiplex PCR (BD Max™ Enteric Parasite Panel, Becton Dickinson). Ninety-three percent (112/121) of RDT-positive samples for G. intestinalis were confirmed by PCR, with a correlation between RDT test band intensity and quantitative pathogen load present in the sample. For Cryptosporidium spp., all positive RDTs had faintly visible lines and these were negative on PCR. The performance of the BD Max™ PCR was nearly identical in both cohorts, despite the prolonged storage at disrupted cold chain conditions in cohort 1. The Crypto/Giardia DuoStrip warrants further validation in communities with a high incidence of diarrhoea.
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Ryan U, Paparini A, Oskam C. New Technologies for Detection of Enteric Parasites. Trends Parasitol 2017; 33:532-546. [DOI: 10.1016/j.pt.2017.03.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/13/2017] [Accepted: 03/13/2017] [Indexed: 12/21/2022]
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18
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Squire SA, Ryan U. Cryptosporidium and Giardia in Africa: current and future challenges. Parasit Vectors 2017; 10:195. [PMID: 28427454 PMCID: PMC5397716 DOI: 10.1186/s13071-017-2111-y] [Citation(s) in RCA: 165] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/24/2017] [Indexed: 12/15/2022] Open
Abstract
Cryptosporidium and Giardia are important causes of diarrhoeal illness. Adequate knowledge of the molecular diversity and geographical distribution of these parasites and the environmental and climatic variables that influence their prevalence is important for effective control of infection in at-risk populations, yet relatively little is known about the epidemiology of these parasites in Africa. Cryptosporidium is associated with moderate to severe diarrhoea and increased mortality in African countries and both parasites negatively affect child growth and development. Malnutrition and HIV status are also important contributors to the prevalence of Cryptosporidium and Giardia in African countries. Molecular typing of both parasites in humans, domestic animals and wildlife to date indicates a complex picture of both anthroponotic, zoonotic and spill-back transmission cycles that requires further investigation. For Cryptosporidium, the only available drug (nitazoxanide) is ineffective in HIV and malnourished individuals and therefore more effective drugs are a high priority. Several classes of drugs with good efficacy exist for Giardia, but dosing regimens are suboptimal and emerging resistance threatens clinical utility. Climate change and population growth are also predicted to increase both malnutrition and the prevalence of these parasites in water sources. Dedicated and co-ordinated commitments from African governments involving "One Health" initiatives with multidisciplinary teams of veterinarians, medical workers, relevant government authorities, and public health specialists working together are essential to control and prevent the burden of disease caused by these parasites.
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Affiliation(s)
- Sylvia Afriyie Squire
- School of Veterinary and Life Sciences, Murdoch University, Perth, Australia
- Council for Scientific and Industrial Research, Animal Research Institute, Accra, Ghana
| | - Una Ryan
- School of Veterinary and Life Sciences, Murdoch University, Perth, Australia
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