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Soares FA, Suzuki CTN, Sabadini E, Falcão AX, de Oliveira Baccin A, de Melo LCV, Gomes JF. Laboratory validation of the automated diagnosis of intestinal parasites via fecal sample processing for the recovery of intestinal parasites through the dissolved air flotation technique. Parasit Vectors 2024; 17:368. [PMID: 39215369 PMCID: PMC11363502 DOI: 10.1186/s13071-024-06434-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Techniques for diagnosing intestinal parasites need technological advancements in the preanalytical (collection/processing) and analytical (detection) stages. The dissolved air flotation (DAF) technique effectively recovers parasites from processed feces for routine diagnosis. Artificial intelligence (AI) is a practical and affordable alternative to modernize the analysis stage of microscopy images and generates high efficiency in the parasitological examination of feces. METHODS The objective of this study was to standardize a laboratory protocol for stool processing using the DAF technique in conjunction with an automated diagnosis of intestinal parasites (DAPI) system. A total of 400 samples were obtained to perform the tests with the use of DAF to verify the recovery of the parasites as a function of the chemical reagent (polymer and surfactant), the volume of the flotation tube, and standardization of smear assembly on a microscopy slide, with automated analysis by DAPI. The DAF protocol that obtained the most satisfactory results in terms of parasite recovery (P < 0.05) and slide positivity was compared with the Three Fecal Test (TF-Test) protocol with manual (microscopists) and automated (DAPI) evaluation. We compared the sensitivity with the modified TF-Test technical protocol and the diagnostic agreement with the gold standard (Kappa) result. RESULTS There was no significant difference in the parasite recovery between the 10 ml and 50 ml tubes (P > 0.05). The surfactants showed a range of parasite recoveries between 41.9% and 91.2% in the float supernatant. We obtained a maximum positivity of 73% of the assembled slides when we applied DAF processing with 7% CTAB surfactant and 57% positivity with the modified TF-Test technique. Regarding diagnostic performance, the TF-Test-modified and DAF techniques used in fecal processing for subsequent computerized analysis by AI presented sensitivities of 86% and 94%, with kappa agreements of 0.62 and 0.80 (substantial), respectively. CONCLUSIONS The DAF protocol defined in this study and the DAPI system are innovative processes for parasite recovery and fecal debris elimination that are favorable for effectively detecting pathogenic structures in laboratory diagnosis.
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Affiliation(s)
- Felipe Augusto Soares
- School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil.
- Laboratory of Image Data Science (LIDS), Institute of Computing (IC), Universidade Estadual de Campinas, Campinas, SP, Brazil.
| | | | - Edvaldo Sabadini
- Department of PhysicalChemistry, Institute of Chemistry, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Alexandre Xavier Falcão
- Laboratory of Image Data Science (LIDS), Institute of Computing (IC), Universidade Estadual de Campinas, Campinas, SP, Brazil
| | | | | | - Jancarlo Ferreira Gomes
- School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
- Laboratory of Image Data Science (LIDS), Institute of Computing (IC), Universidade Estadual de Campinas, Campinas, SP, Brazil
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Kalavani S, Matin S, Rahmanian V, Meshkin A, Bahadori Mazidi B, Taghipour A, Abdoli A. Prevalence of Giardia duodenalis among African children: A systematic review and meta-analysis. Parasite Epidemiol Control 2024; 26:e00365. [PMID: 39070059 PMCID: PMC11277988 DOI: 10.1016/j.parepi.2024.e00365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/30/2024] [Accepted: 07/01/2024] [Indexed: 07/30/2024] Open
Abstract
Background Giardia duodenalis (G. duodenalis) is one of the major causes of diarrhea among children. We performed a systematic review and meta-analysis to assess the prevalence of G. duodenalis and associated risk factors among African children. Methods We searched online databases (PubMed, Scopus, and Web of Science) as well as the Google Scholar search engine for studies measured the prevalence of G. duodenalis among African children, published between 1 January 2000 and 15 March 2022. Due to high heterogeneity among the included studies, a random-effects meta-analysis model was employed to estimate pooled prevalence and 95% confidence intervals (CI). Results A total of 114 articles from 29 African countries met the inclusion criteria. The pooled prevalence of G. duodenalis infection among African children was estimated as 18.3% (95% CI: 16.5-20.2). The highest and lowest pooled prevalence of G. duodenalis infection were estimated in Niger and Cameroon as 65.1% (55-75.2) and 0.08% (0.02-1.05), respectively. Considering the type of study population, the highest prevalence was related to, iron-deficient children 65.2% (61.3-69.1), handicapped children 30.4% (18.3-42.4), HIV infected children 25.7% (11.2-40.2) and displaced children 20.2% (16.5-23.9). Conclusions Giardiasis is common among African children, hence, prevention and control scheme of this protozoan in children should be considered by health officials and health policymakers, especially in African countries where prevalence is highest.
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Affiliation(s)
- Sara Kalavani
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Sara Matin
- Pediatric Department, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Vahid Rahmanian
- Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| | - Ahmad Meshkin
- Student Committee of Medical Education Development, Education Development Center, Gerash University of Medical Sciences, Gerash, Iran
| | - Bahareh Bahadori Mazidi
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
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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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Menezes SA, Tasca T. Extracellular vesicles in parasitic diseases - from pathogenesis to future diagnostic tools. Microbes Infect 2024; 26:105310. [PMID: 38316376 DOI: 10.1016/j.micinf.2024.105310] [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: 11/08/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/07/2024]
Abstract
Parasitic diseases are still a major public health problem especially among individuals of low socioeconomic status in underdeveloped countries. In recent years it has been demonstrated that parasites can release extracellular vesicles that participate in the host-parasite communication, immune evasion, and in governing processes associated with host infection. Extracellular vesicles are membrane-bound structures released into the extracellular space that can carry several types of biomolecules, including proteins, lipids, nucleic acids, and metabolites, which directly impact the target cells. Extracellular vesicles have attracted wide attention due to their relevance in host-parasite communication and for their potential value in applications such as in the diagnostic biomarker discovery. This review of the literature aimed to join the current knowledge on the role of extracellular vesicles in host-parasite interaction and summarize its molecular content, providing information for the acquisition of new tools that can be used in the diagnosis of parasitic diseases. These findings shed light to the potential of extracellular vesicle cargo derived from protozoan parasites as novel diagnostic tools.
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Affiliation(s)
- Saulo Almeida Menezes
- Faculdade de Farmácia e Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre 90610-000, RS, Brazil.
| | - Tiana Tasca
- Faculdade de Farmácia e Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre 90610-000, RS, Brazil.
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Zhao Z, Cao S, Sun M, Yang Q, Huang T, Yang X, Li J, Zhang X, Li X, Wang X, Jiang W, Gong P. Rapid visual detection of Giardia duodenalis in faecal samples using an RPA-CRISPR/Cas12a system. Parasitol Res 2024; 123:176. [PMID: 38573530 DOI: 10.1007/s00436-024-08197-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/24/2024] [Indexed: 04/05/2024]
Abstract
Giardiasis is a common intestinal infection caused by Giardia duodenalis, which is a major economic and health burden for humans and livestock. Currently, a convenient and effective detection method is urgently needed. CRISPR/Cas12a-based diagnostic methods have been widely used for nucleic acid-based detection of pathogens due to their high efficiency and sensitivity. In this study, a technique combining CRISPR/Cas12a and RPA was established that allows the detection of G. duodenalis in faecal samples by the naked eye with high sensitivity (10-1 copies/μL) and specificity (no cross-reactivity with nine common pathogens). In clinical evaluations, the RPA-CRISPR/Cas12a-based detection assay detected Giardia positivity in 2% (1/50) of human faecal samples and 47% (33/70) of cattle faecal samples, respectively, which was consistent with the results of nested PCR. Our study demonstrated that the RPA-CRISPR/Cas12a technique for G. duodenalis is stable, efficient, sensitive, specific and has low equipment requirements. This technique offers new opportunities for on-site detection in remote and poor areas.
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Affiliation(s)
- Zhiteng Zhao
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Songgao Cao
- Pingdu People's Hospital, Qingdao, 266700, People's Republic of China
| | - Min Sun
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Qiankun Yang
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Taojun Huang
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Xing Yang
- Integrated Laboratory of Pathogenic Biology, College of Preclinical Medicine, Dali University, Dali, Yunnan, 671003, People's Republic of China
| | - Jianhua Li
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Xichen Zhang
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Xin Li
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Xiaocen Wang
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China
| | - Weina Jiang
- Department of Pathology, Qingdao Municipal Hospital, Qingdao, Shandong Province, 266071, People's Republic of China.
| | - Pengtao Gong
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonosis Research of the Ministry of Education, Institute of Zoonosis, and College of Veterinary Medicine, Jilin University, Changchun, 130062, People's Republic of China.
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Kalavani S, Matin S, Rahmanian V, Meshkin A, Taghipour A, Abdoli A. Prevalence of Giardia duodenalis among Asian children: a systematic review and meta-analysis. Int Health 2024; 16:133-143. [PMID: 37204774 PMCID: PMC10911531 DOI: 10.1093/inthealth/ihad037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/04/2023] [Accepted: 04/28/2023] [Indexed: 05/20/2023] Open
Abstract
Giardia duodenalis is one of the major causes of diarrhea among children. We performed a systematic review and meta-analysis to assess the prevalence of G. duodenalis and associated risk factors among Asian children. We searched online databases (PubMed, Scopus and Web of Science) and Google Scholar search engine for studies published from 1 January 2000 to 15 March 2022 that measured the prevalence of G. duodenalis among Asian children. Accordingly, the pooled prevalence and 95% CIs were estimated using a random-effects meta-analysis model for the included studies. A total of 182 articles from 22 Asian countries met the inclusion criteria. The pooled prevalence of G. duodenalis infection among Asian children was estimated as 15.1% (95% CI 14.1 to 16%). The highest and lowest pooled prevalence values of G. duodenalis infection were estimated for Tajikistan and China as 26.4% (95% CI 22.9 to 30%) and 0.6% (95% CI 0.001 to 1.02%), respectively. The infection had a higher prevalence in males than in females (OR=1.24; 95% CI 1.16 to 1.31; p<0.001), which was statistically significant. Giardiasis is common among Asian children, hence, a prevention and control scheme of this protozoan in children should be considered by health officials and health policymakers, especially in Asian countries where the prevalence is highest.
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Affiliation(s)
- Sara Kalavani
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Sara Matin
- Department of Pediatrics, Jahrom University of Medical Sciences, Jahrom
| | - Vahid Rahmanian
- Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| | - Ahmad Meshkin
- Student Committee of Medical Education Development, Education Development Center, Gerash University of Medical Sciences, Gerash, Iran
| | - Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
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Vicente B, Freitas AD, Freitas M, Midlej V. Systematic Review of Diagnostic Approaches for Human Giardiasis: Unveiling Optimal Strategies. Diagnostics (Basel) 2024; 14:364. [PMID: 38396402 PMCID: PMC10887752 DOI: 10.3390/diagnostics14040364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
Giardiasis, caused by the protozoan Giardia intestinalis, affects around 400 million people worldwide, emphasizing the critical need for accurate diagnosis to enhance human health, especially in children. Prolonged giardiasis in childhood can lead to intellectual deficits and other complications. A variety of diagnostic tools, including microscopic, immunological, and molecular methods, are available for detecting G. intestinalis infection. Choosing the most suitable method can be challenging due to the abundance of options. This systematic review assesses the reliability and applicability of these diagnostic modalities. Utilizing the Dimensions and Wordart platforms for data analysis, we focus on relevant literature addressing diagnostic methods for human giardiasis. Microscopic techniques, particularly Ritchie's method, emerge as the primary choice, followed by enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). PCR's limited use is attributed to its high cost and infrastructure challenges in developing nations. In conclusion, our analysis supports microscopic methods as the gold standard for giardiasis diagnosis. However, in cases where symptoms persist despite a negative diagnosis, employing more sensitive diagnostic approaches is advisable.
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Affiliation(s)
- Bruno Vicente
- Laboratório de Biologia Estrutural, Instituto Oswaldo Cruz—Fiocruz, Rio de Janeiro 21040-900, Brazil; (B.V.); (A.D.F.); (M.F.)
- Programa de Pós-Graduação em Biologia Celular e Molecular, Instituto Oswaldo Cruz—Fiocruz, Rio de Janeiro 21040-900, Brazil
| | - Anna De Freitas
- Laboratório de Biologia Estrutural, Instituto Oswaldo Cruz—Fiocruz, Rio de Janeiro 21040-900, Brazil; (B.V.); (A.D.F.); (M.F.)
- Programa de Pós-Graduação em Biologia Parasitária, Instituto Oswaldo Cruz—Fiocruz, Rio de Janeiro 21040-900, Brazil
| | - Marcus Freitas
- Laboratório de Biologia Estrutural, Instituto Oswaldo Cruz—Fiocruz, Rio de Janeiro 21040-900, Brazil; (B.V.); (A.D.F.); (M.F.)
| | - Victor Midlej
- Laboratório de Biologia Estrutural, Instituto Oswaldo Cruz—Fiocruz, Rio de Janeiro 21040-900, Brazil; (B.V.); (A.D.F.); (M.F.)
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Kanski S, Weber K, Busch K. [Feline and canine giardiosis: An Update]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2023; 51:411-421. [PMID: 38056479 DOI: 10.1055/a-2191-1723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Giardia duodenalis is a facultative pathogenic intestinal parasite. Giardiosis in dogs and cats may appear with or without clinical signs. Typical signs include diarrhea with or without vomiting. The prevalence in young animals is high and may amount to up to 50%. There are 8 different genotypes (A - H), which are called assemblages. Assemblages C and D are most common in dogs and assemblage F most frequent in cats. However, animals may also be infected with the zoonotically effective assemblages A and B or exhibit mixed infections. The immunofluorescence test (IFA), the enzyme-linked immunosorbent assay (ELISA) and fecal centrifugation using zinc sulphate solution are currently recommended as diagnostic methods. Polymerase chain reaction (PCR) may be used to determine the corresponding assemblage. Approved treatments for giardiosis include fenbendazole and metronidazole. In addition, undertaking specific hygiene measures is warranted. Only animals showing clinical signs or those living in the same household with high-risk patients (e. g. immunosuppressed humans) are recommended to receive medication. The aim of treatment is clinical improvement of the diseased dogs and cats. Frequently, complete elimination of Giardia is not attained.
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Affiliation(s)
- Sabrina Kanski
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
| | - Karin Weber
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
| | - Kathrin Busch
- Medizinische Kleintierklinik, Ludwig-Maximilians-Universität München
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Tawana M, Onyiche TE, Ramatla T, Thekisoe O. A 'One Health' perspective of Africa-wide distribution and prevalence of Giardia species in humans, animals and waterbodies: a systematic review and meta-analysis. Parasitology 2023; 150:769-780. [PMID: 37246558 PMCID: PMC10478065 DOI: 10.1017/s0031182023000513] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/03/2023] [Accepted: 05/09/2023] [Indexed: 05/30/2023]
Abstract
Giardiasis, caused by Giardia duodenalis, is a leading cause of diarrhoea in resource-poor countries. To gain a better insight into the epidemiology of Giardia in Africa, we undertook a robust study to comprehend the distribution and prevalence of Giardia infection in humans, animals and their dispersal in the environment. Our protocol was registered with PROSPERO (registration number CRD42022317653). Deep literature search from 5 electronic databases, namely, AJOL, Google scholar, PubMed, ScienceDirect and Springer Link was performed using relevant keywords. Meta-analysis was performed using a random-effects model and heterogeneity among studies was evaluated using Cochran's Q and the I2-statistic. More than 500 eligible studies published from 1 January 1980 until 22 March 2022 were retrieved. In humans, exactly 48 124 Giardia spp. infection cases were registered from the 494 014 stool samples examined resulting in a pooled prevalence estimate (PPE) of 8.8% using microscopy. Whereas copro-antigen tests and molecular diagnostic methods generated PPE of 14.3 and 19.5%, respectively, with HIV+ subjects and those with diarrhoeatic stool having infection rates of 5.0 and 12.3%, respectively. The PPE of Giardia spp. infection in animals using molecular methods was 15.6%, which was most prevalent in pigs (25.2%) with Nigeria registering the highest prevalence at 20.1%. The PPE of Giardia spp. contamination from waterbodies was 11.9% from a total of 7950 samples which were detected using microscopy, with Tunisia documenting the highest infection rate of 37.3%. This meta-analysis highlights the necessity of ‘One Health’ approach for consolidated epidemiological studies and control of giardiasis in the African continent.
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Affiliation(s)
- Mpho Tawana
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom 2531, South Africa
| | - ThankGod E. Onyiche
- Department of Veterinary Parasitology and Entomology, University of Maiduguri, Maiduguri, Nigeria
| | - Tsepo Ramatla
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom 2531, South Africa
| | - Oriel Thekisoe
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom 2531, South Africa
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Dong C, Liu Z, Li X. Development of a chemiluminescence assay for detection of Giardia lamblia in canine stool samples. Vet Parasitol 2023; 316:109899. [PMID: 36804682 DOI: 10.1016/j.vetpar.2023.109899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/13/2023] [Accepted: 02/11/2023] [Indexed: 02/16/2023]
Abstract
Our Giardia chemiluminescence assay (GCA) detected Giardia antigens in a dose-dependent manner with a limit of detection at 0.46 ng/mL and a signal-to-baseline ratio at 475. In a study of 30 clinic collected canine stool samples, samples were identified as Giardia positive or negative by a standard Giardia II ELISA (TechLab), the GCA had sensitivity of 93.8 % and specificity of 92.9 %. Study on the set of 16 Giardia positive samples showed that all samples displayed higher signal-to-baseline ratio in GCA than they did in a colorimetric ELISA. A dilution analysis of antigen titer showed that for all positive samples, antigen titers in GCA were equal or higher than those in ELISA. The GCA system of chemiluminescence has shown improved capability in detecting Giardia antigens and provided a valid alternative method for researchers and for laboratories.
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Harvey TV, Carvalho JPDS, Aquino MCCD, Oliveira BCM, Barros LDD, Fehlberg HF, Rocha CMBMD, Albuquerque GR. Giardiasis in children and dogs, and the first report of assemblage E in dogs from northeastern Brazil. REVISTA BRASILEIRA DE PARASITOLOGIA VETERINARIA = BRAZILIAN JOURNAL OF VETERINARY PARASITOLOGY : ORGAO OFICIAL DO COLEGIO BRASILEIRO DE PARASITOLOGIA VETERINARIA 2023; 32:e012222. [PMID: 36820730 DOI: 10.1590/s1984-29612023010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/15/2022] [Indexed: 02/22/2023]
Abstract
Diagnosis is crucial for controlling giardiasis. We determined the prevalence and genetically characterize isolates of Giardia duodenalis of children and dogs from rural communities in northeastern Brazil. G. duodenalis cysts were concentrated by centrifugal flotation/sedimentation. Molecular characterization was carried out using the loci ssu-rRNA, bg, tpi, and gdh. By parasitological techniques, Giardia spp. infection was detected in 72/192 children (37.5%; 95% CI: 30.6%-44.7%) and 24/139 dogs (17.3%; 95% CI: 11.4%-24.6%). By molecular analysis, infection was detected in 60/141 children (42.5%; 95% CI: 34.3%-51.2%) and 26/92 dogs (28.3%; 95% CI: 19.4%-38.6%). The total prevalence of giardiasis was 54.9% in children (106/193; 95% CI: 47.1%-61.6%) and 32.9% in dogs (47/143; 95% CI: 25.2%-41.2%). Zoonotic assemblages A and B of G. duodenalis were detected in children, and assemblage E of G. duodenalis was detected in one child and two dogs. Parallel use of parasitological and molecular techniques proved to be a more effective strategy for detecting giardiasis in children and dogs from endemic areas.
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Affiliation(s)
- Tatiani Vitor Harvey
- Programa de Pós-graduação em Ciência Animal, Laboratório de Parasitologia Veterinária, Departamento de Ciências Agrárias e Ambientais, Universidade Estadual de Santa Cruz - UESC, Ilhéus, BA, Brasil
| | - Jamille Pinto Dos Santos Carvalho
- Programa de Pós-graduação em Ciência Animal, Laboratório de Parasitologia Veterinária, Departamento de Ciências Agrárias e Ambientais, Universidade Estadual de Santa Cruz - UESC, Ilhéus, BA, Brasil
| | | | - Bruno César Miranda Oliveira
- Departamento de Apoio, Produção e Saúde Animal, Faculdade de Medicina Veterinária, Universidade Estadual Paulista - UNESP, Araçatuba, SP, Brasil
| | - Luiz Daniel de Barros
- Laboratório de Protozoologia Animal, Departamento de Medicina Veterinária Preventiva, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - Hllytchaikra Ferraz Fehlberg
- Programa de Pós-graduação em Ciência Animal, Laboratório de Parasitologia Veterinária, Departamento de Ciências Agrárias e Ambientais, Universidade Estadual de Santa Cruz - UESC, Ilhéus, BA, Brasil
| | | | - George Rego Albuquerque
- Programa de Pós-graduação em Ciência Animal, Laboratório de Parasitologia Veterinária, Departamento de Ciências Agrárias e Ambientais, Universidade Estadual de Santa Cruz - UESC, Ilhéus, BA, Brasil
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12
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Saleh NE, Sharaf HM, Elnemr HI, Elzeiny SM, Ali KM, Nabih N. Intestinal Giardiasis in Children Undergoing Upper Endoscopy for Unexplained Gastrointestinal Symptoms: Implication for Diagnosis. Fetal Pediatr Pathol 2023; 42:18-29. [PMID: 35302404 DOI: 10.1080/15513815.2022.2053013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Giardia lamblia is a flagellated protozoan causing diarrheal outbreaks worldwide. Microscopic stool examination is widely used. We conducted this study to explore intestinal giardiasis in children undergoing upper endoscopy for unexplained gastrointestinal symptoms. METHODS The study included 160 children undergoing upper endoscopy for unexplained gastrointestinal symptoms (patients) and 90 children as controls. We collected stool samples for microscopic examination and ELISA coproantigen detection from all participants. We examined duodenal biopsies for patients. RESULTS In patients, stool examination revealed Giardia in 23.8% and coproantigen detection was positive in 37.5%. Endoscopic duodenal biopsies revealed Giardia trophozoites in 5% of patients, in addition to various pathological changes. CONCLUSION Giardiasis was significantly higher (P = 0.001) in children with unexplained gastrointestinal complaints than the controls. Diagnosis by coproantigen detection was superior to microscopic stool examination, with a sensitivity of 90.9%. Duodenal biopsies examination confirmed the infection in fewer cases but added other diagnostic information.
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Affiliation(s)
- Nora E Saleh
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Hend M Sharaf
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Hossam I Elnemr
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Sherine M Elzeiny
- Department of Pediatric Medicine, Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Khadiga M Ali
- Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Nairmen Nabih
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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13
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The Importance of Endoscopy with Biopsy: Real-World Evidence of Gastrointestinal Involvement in Primary Immunodeficiency in Two Main Northern Italian Centres. Biomedicines 2023; 11:biomedicines11010170. [PMID: 36672678 PMCID: PMC9855427 DOI: 10.3390/biomedicines11010170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Inborn errors of immunity (IEI) represent a heterogeneous group of diseases in which the true prevalence of GI involvement is not well-known. This study evaluates the prevalence of lower GI manifestations in patients with common variable immunodeficiency (CVID), analysing the histologic findings in colonic samples and assessing any correlations with biochemical abnormalities. MATERIALS AND METHODS A retrospective study was performed by collecting the data of IEI adult patients followed up at two main Northern Italian centres. Demographic and clinical data, and blood tests were collected. A colonoscopy with multiple biopsies in standard sites, in addition to a biopsy for any macroscopic lesion, was performed. The gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS) and the short Inflammatory Bowel Disease Questionnaire (sIBDQ) were used to assess GI symptoms. RESULTS 141 patients were included: 121 (86.5%) with CVID, 17 (12.1%) with IgG subclass deficiency, and 2 (1.4%) with X-linked agammaglobulinemia. Of the patients, 72 (51%) complained of GI symptoms. No differences were seen between patients receiving or not IgRT. GI infections were found in 9 patients (6.4%). No significant correlations were found between gut infections and symptoms or leukocyte infiltrates. Colonoscopy alterations were present in 79 patients (56%), and the most common were colon polyps (42%). Microscopical abnormalities were seen in 60 histologic samples (42.5%) and the most frequent was nodular lymphoid hyperplasia (40%). A leukocyte infiltrate was present in 67 samples (47.5%), and the most common was a lymphocyte infiltrate (33%). No correlation was found between GI symptoms and macroscopic alterations, whereas a positive correlation between symptoms and microscopic alterations was detected. CONCLUSIONS GI symptoms and microscopic alterations in colon samples are closely related; hence, it is important to carry out serial colonic biopsies in every CVID patient, even in the absence of macroscopic lesions.
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14
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Noaman EA, Nayel M, Salama A, Mahmoud MA, El-Kattan AM, Dawood AS, Abd El-Hamid IS, Elsify A, Mousa W, Elkhtam A, Zaghawa A. Enteric protozoal infections in camels: Etiology, epidemiology, and future perspectives. GERMAN JOURNAL OF VETERINARY RESEARCH 2023; 3:1-17. [DOI: 10.51585/gjvr.2023.1.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Camels have great potential as a safety valve for current and future food security for pastoralists, agropastoralists, and urban populations. Enteric protozoal diseases are important causes of economic losses in camels; however, they are poorly concerned globally. The most common members of enteric protozoa are Balantidium, Eimeria, Giardia, and Cryptosporidium. Some of them threaten human health as humans can be infected by consuming food or water contaminated with camel feces, particularly in poor communities with inadequate sanitation and low-quality healthcare facilities. For these reasons, a comprehensive and careful investigation was conducted on some enteric protozoal diseases of camels to present an updated insight into the etiology, epidemiology, and future trends in diagnosing and controlling camel enteric protozoa. Future studies on the camel enteric protozoa should be carried out to develop advanced diagnostic approaches in diverse farm animal species. Moreover, the protozoan zoonotic potential should be considered to secure human health.
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15
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Fusaro C, Chávez-Romero YA, Prada SLG, Serrano-Silva N, Bernal JE, González-Jiménez FE, Sarria-Guzmán Y. Burden and Epidemiology of Human Intestinal Giardia duodenalis Infection in Colombia: A Systematic Review. Trop Med Infect Dis 2022; 7:tropicalmed7100325. [PMID: 36288066 PMCID: PMC9608748 DOI: 10.3390/tropicalmed7100325] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/05/2022] [Accepted: 10/12/2022] [Indexed: 11/23/2022] Open
Abstract
The genus Giardia is a unicellular protozoan able to parasitize both humans and animals. Cysts of Giardia can be found in soil samples, aquatic environments, food, and any surface that gets in contact with the feces of parasitized animals. The aim of this systematic review was to analyze the burden and epidemiology of Giardia infection in Colombia summarizing recent scientific reports and existing knowledge and to identify knowledge gaps that may be addressed in future investigations. This work follows the guidelines established by "Preferred Reporting Items for Systematic Reviews and Meta-Analyzes" (PRISMA). Published scientific literature from 1 January 2010 to 18 September 2022 was searched in six electronic scientific databases using the search terms: "Giardia" OR "Giardiasis" AND "Colombia". Twenty-three scientific articles were performed in 22 departments of Colombia at rural, urban, and a combination of rural and urban contexts. The prevalence of Giardia in the Colombian population was between 0.9 and 48.1% when the samples were analyzed with classical microscopy; the range of Giardia prevalence was even bigger (4.2-100%) when qPCR and nested PCR were used. The dominant Giardia assemblages found in Colombia were A and B, and most frequent subassemblages were AII, BIII, and BIV.
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Affiliation(s)
- Carmine Fusaro
- Facultad de Ingenierías, Universidad de San Buenaventura, Cartagena de Indias 130010, Colombia
| | - Yosef A. Chávez-Romero
- Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Santa Cruz 90640, Mexico
| | | | - Nancy Serrano-Silva
- Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Correspondence: (N.S.-S.); (Y.S.-G.); Tel.: +52-5556224827 (N.S.-S.); +57-5-5894093 (Y.S.-G.)
| | - Jaime E. Bernal
- Facultad de Medicina, Universidad del Sinú, Cartagena de Indias 130011, Colombia
| | | | - Yohanna Sarria-Guzmán
- Facultad de Ingeniería y Ciencias Básicas, Fundación Universitaria del Área Andina, Valledupar 200005, Colombia
- Correspondence: (N.S.-S.); (Y.S.-G.); Tel.: +52-5556224827 (N.S.-S.); +57-5-5894093 (Y.S.-G.)
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16
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Kamyingkird K, Phoosangwalthong P, Klinkaew N, Leelanupat A, Kengradomkij C, Chimnoi W, Rungnirundorn T, Nimsuphan B, Inpankaew T. Detection of Giardia duodenalis Zoonotic Assemblages AI and BIV in Pet Prairie Dogs (Cynomys ludovicanus) in Bangkok, Thailand. Animals (Basel) 2022; 12:ani12151949. [PMID: 35953937 PMCID: PMC9367409 DOI: 10.3390/ani12151949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
Giardia is a flagellate protozoa that can be transmitted via direct contact and by consuming contaminated water. It is pathogenic in humans and various other animals, including exotic pets. Pet prairie dogs are popular in Thailand, but they have not been investigated regarding giardiasis. Giardia infection was measured, and genetic characterization was performed to investigate the zoonotic potential of Giardia carried by pet prairie dogs. In total, 79 fecal samples were examined from prairie dogs visiting the Kasetsart University Veterinary Teaching Hospital during 2017–2021. Simple floatation was conducted. Two Giardia-positive samples were submitted for DNA extraction, PCR targeting the Giardiassu rRNA, tpi and gdh genes was performed, and genetic characterization using sequencing analysis was conducted. Risk factors associated with Giardia infection were analyzed. Giardia infection was found in 11 out of the 79 pet prairie dogs (13.9%). Giardia infection was significantly higher in male prairie dogs (p = 0.0345). Coccidia cysts (12.7%), the eggs of nematodes (6.3%), and amoeba cysts (2.5%) were also detected. Genetic characterization of the two Giardia-positive samples revealed that they were G. duodenalis assemblage A, sub-genotypes AI and assemblage B, and sub-genotype BIV, the zoonotic assemblages. This was the first report of Giardia infection in pet prairie dogs in Bangkok, Thailand. The results revealed that these pet prairie dogs in Thailand were infected with zoonotic assemblages of G. duodenalis sub-genotype AI, which might have been derived from animal contaminants, whereas sub-genotype BIV might have been derived from human contaminants. Owners of prairie dogs might be at risk of giardiasis or be the source of infection to their exotic pets.
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Affiliation(s)
- Ketsarin Kamyingkird
- Department of Parasitology, Faculty of Veterinary Medicine, Kasetsart University, Lad Yao, Chatuchak, Bangkok 10900, Thailand; (K.K.); (P.P.); (N.K.); (A.L.); (C.K.); (W.C.)
| | - Pornkamol Phoosangwalthong
- Department of Parasitology, Faculty of Veterinary Medicine, Kasetsart University, Lad Yao, Chatuchak, Bangkok 10900, Thailand; (K.K.); (P.P.); (N.K.); (A.L.); (C.K.); (W.C.)
| | - Nutsuda Klinkaew
- Department of Parasitology, Faculty of Veterinary Medicine, Kasetsart University, Lad Yao, Chatuchak, Bangkok 10900, Thailand; (K.K.); (P.P.); (N.K.); (A.L.); (C.K.); (W.C.)
| | - Alisara Leelanupat
- Department of Parasitology, Faculty of Veterinary Medicine, Kasetsart University, Lad Yao, Chatuchak, Bangkok 10900, Thailand; (K.K.); (P.P.); (N.K.); (A.L.); (C.K.); (W.C.)
| | - Chanya Kengradomkij
- Department of Parasitology, Faculty of Veterinary Medicine, Kasetsart University, Lad Yao, Chatuchak, Bangkok 10900, Thailand; (K.K.); (P.P.); (N.K.); (A.L.); (C.K.); (W.C.)
| | - Wissanuwat Chimnoi
- Department of Parasitology, Faculty of Veterinary Medicine, Kasetsart University, Lad Yao, Chatuchak, Bangkok 10900, Thailand; (K.K.); (P.P.); (N.K.); (A.L.); (C.K.); (W.C.)
| | - Teerapat Rungnirundorn
- Exotic Clinic, Kasetsart University Veterinary Teaching Hospital, Chatuchak, Bangkok 10900, Thailand;
| | - Burin Nimsuphan
- Department of Parasitology, Faculty of Veterinary Medicine, Kasetsart University, Lad Yao, Chatuchak, Bangkok 10900, Thailand; (K.K.); (P.P.); (N.K.); (A.L.); (C.K.); (W.C.)
- Correspondence: (B.N.); (T.I.)
| | - Tawin Inpankaew
- Department of Parasitology, Faculty of Veterinary Medicine, Kasetsart University, Lad Yao, Chatuchak, Bangkok 10900, Thailand; (K.K.); (P.P.); (N.K.); (A.L.); (C.K.); (W.C.)
- Correspondence: (B.N.); (T.I.)
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17
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Savarino E, Zingone F, Barberio B, Marasco G, Akyuz F, Akpinar H, Barboi O, Bodini G, Bor S, Chiarioni G, Cristian G, Corsetti M, Di Sabatino A, Dimitriu AM, Drug V, Dumitrascu DL, Ford AC, Hauser G, Nakov R, Patel N, Pohl D, Sfarti C, Serra J, Simrén M, Suciu A, Tack J, Toruner M, Walters J, Cremon C, Barbara G. Functional bowel disorders with diarrhoea: Clinical guidelines of the United European Gastroenterology and European Society for Neurogastroenterology and Motility. United European Gastroenterol J 2022; 10:556-584. [PMID: 35695704 PMCID: PMC9278595 DOI: 10.1002/ueg2.12259] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/20/2022] [Indexed: 11/23/2022] Open
Abstract
Irritable bowel syndrome with diarrhoea (IBS‐D) and functional diarrhoea (FDr) are the two major functional bowel disorders characterized by diarrhoea. In spite of their high prevalence, IBS‐D and FDr are associated with major uncertainties, especially regarding their optimal diagnostic work‐up and management. A Delphi consensus was performed with experts from 10 European countries who conducted a literature summary and voting process on 31 statements. Quality of evidence was evaluated using the grading of recommendations, assessment, development, and evaluation criteria. Consensus (defined as >80% agreement) was reached for all the statements. The panel agreed with the potential overlapping of IBS‐D and FDr. In terms of diagnosis, the consensus supports a symptom‐based approach also with the exclusion of alarm symptoms, recommending the evaluation of full blood count, C‐reactive protein, serology for coeliac disease, and faecal calprotectin, and consideration of diagnosing bile acid diarrhoea. Colonoscopy with random biopsies in both the right and left colon is recommended in patients older than 50 years and in presence of alarm features. Regarding treatment, a strong consensus was achieved for the use of a diet low fermentable oligo‐, di‐, monosaccharides and polyols, gut‐directed psychological therapies, rifaximin, loperamide, and eluxadoline. A weak or conditional recommendation was achieved for antispasmodics, probiotics, tryciclic antidepressants, bile acid sequestrants, 5‐hydroxytryptamine‐3 antagonists (i.e. alosetron, ondansetron, or ramosetron). A multinational group of European experts summarized the current state of consensus on the definition, diagnosis, and management of IBS‐D and FDr.
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Affiliation(s)
- Edoardo Savarino
- Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Fabiana Zingone
- Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Brigida Barberio
- Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Giovanni Marasco
- Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Filiz Akyuz
- Department of Gastroenterology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | - Hale Akpinar
- Department of Internal Medicine, Dokuz Eylül University School of Medicine, Izmir, Turkey
| | - Oana Barboi
- Department of Gastroenterology, 'Grigore T. Popa' University of Medicine and Pharmacy, Iasi, Romania.,Institute of Gastroenterology and Hepatology, 'Saint Spiridon' Hospital, Iasi, Romania
| | - Giorgia Bodini
- Gastrointestinal Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Serhat Bor
- Division of Gastroenterology, Ege University School of Medicine, Izmir, Turkey
| | | | - Gheorghe Cristian
- Fundeni Clinical Institute Center of Gastroenterology and Hepatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Maura Corsetti
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.,Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Antonio Di Sabatino
- First Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Anca Mirela Dimitriu
- Center of Gastroenterology and Hepatology, Fundeni Clinical Institute, University of Medicine and Pharmacy, Bucharest, Romania
| | - Vasile Drug
- Department of Gastroenterology, 'Grigore T. Popa' University of Medicine and Pharmacy, Iasi, Romania.,Institute of Gastroenterology and Hepatology, 'Saint Spiridon' Hospital, Iasi, Romania
| | - Dan L Dumitrascu
- 2nd Department of Internal Medicine, 'Iuliu Hatieganu' University of Medicine and Farmacy, Cluj-Napoca, Romania
| | - Alexander C Ford
- Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Leeds Institute of Medical Research at St. James's Sciences, University of Leeds, Leeds, UK
| | - Goran Hauser
- Department of Gastroenterology, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Radislav Nakov
- Department of Gastroenterology, Tsaritsa Yoanna University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Nisha Patel
- Imperial College Healthcare NHS Trust, Institute of Global Health Innovation, St Mary's Hospital Campus, London, UK
| | - Daniel Pohl
- Department of Gastroenterology, University Hospital Zurich, Zurich, Switzerland
| | - Cătălin Sfarti
- Department of Gastroenterology, 'Grigore T. Popa' University of Medicine and Pharmacy, Iasi, Romania.,Institute of Gastroenterology and Hepatology, 'Saint Spiridon' Hospital, Iasi, Romania
| | - Jordi Serra
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Badalona, Spain.,Digestive System Research Unit, University Hospital Vall d'Hebron, Barcelona, Spain.,Department of Medicine, Autonomous University of Barcelona, Badalona, Spain
| | - Magnus Simrén
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alina Suciu
- Center of Gastroenterology and Hepatology, Fundeni Clinical Institute, University of Medicine and Pharmacy, Bucharest, Romania
| | - Jan Tack
- Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
| | - Murat Toruner
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
| | - Julian Walters
- Division of Digestive Diseases, Department of Metabolism, Digestion, and Reproduction, Faculty of Medicine, Imperial College London, London, UK.,Department of Gastroenterology, Division of Medicine and Integrated Care, Imperial College Healthcare NHS Trust, London, UK
| | - Cesare Cremon
- Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giovanni Barbara
- Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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18
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Global prevalence of Giardia duodenalis in cattle: A systematic review and meta-analysis. Prev Vet Med 2022; 203:105632. [DOI: 10.1016/j.prevetmed.2022.105632] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/14/2022] [Accepted: 03/24/2022] [Indexed: 12/15/2022]
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19
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Soares FA, Martins Dos Santos B, Rosa SL, Loiola SHN, Suzuki CTN, Sabadini E, Bresciani KDS, Falcão AX, Gomes JF. Dissolved air flotation as potential new mechanism for intestinal parasite diagnosis in feces. Acta Trop 2021; 224:106137. [PMID: 34562419 DOI: 10.1016/j.actatropica.2021.106137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 08/17/2021] [Accepted: 09/15/2021] [Indexed: 01/08/2023]
Abstract
The parasitological examination of feces is recommended for the laboratory diagnosis of intestinal parasites due to its practicality, low-cost, and moderate diagnostic sensitivity. Dissolved Air Flotation (DAF) is an efficient technical principle used in other areas to separate dispersed solids. This study sought the preliminary evaluation of a proof-of-concept prototype as a tool for detecting species of parasites by adjusting DAF. Two DAF prototype units were developed to evaluate microbubbles' generation amidst fecal suspension and parasites' capture. For this evaluation, samples were screened and processed by the TF-Test technique (Control) and simultaneously by DAF device. The dimensional and attachment characteristics in the formation of the microbubbles were evaluated, and the percentage of parasitic recovery in floated and not-floated regions compared by Student's t-test. The second prototype unit proved to be more efficient in forming microbubbles with diameters between 34 and 170µm. The flotation tests showed a recovery of 73.27%, 58.12%, 37.85%, and 91.89% for Ascaris lumbricoides, Hymenolepis diminuta, Giardia duodenalis, and Strongyloides stercoralis, respectively. This study confirmed the selective interaction between microbubbles and parasite eggs and larvae during the flotation process using the DAF principle for the first time through imaging.
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Affiliation(s)
- Felipe Augusto Soares
- School of Medical Sciences, University of Campinas, Campinas, São Paulo 13083-889, Brazil; Laboratory of Image Data Science (LIDS), Institute of Computing (IC), University of Campinas, Campinas, São Paulo, Brazil.
| | - Bianca Martins Dos Santos
- School of Medical Sciences, University of Campinas, Campinas, São Paulo 13083-889, Brazil; Laboratory of Image Data Science (LIDS), Institute of Computing (IC), University of Campinas, Campinas, São Paulo, Brazil
| | - Stefany Laryssa Rosa
- School of Medical Sciences, University of Campinas, Campinas, São Paulo 13083-889, Brazil; Laboratory of Image Data Science (LIDS), Institute of Computing (IC), University of Campinas, Campinas, São Paulo, Brazil
| | - Saulo Hudson Nery Loiola
- School of Medical Sciences, University of Campinas, Campinas, São Paulo 13083-889, Brazil; Laboratory of Image Data Science (LIDS), Institute of Computing (IC), University of Campinas, Campinas, São Paulo, Brazil
| | - Celso Tetsuo Nagase Suzuki
- Laboratory of Image Data Science (LIDS), Institute of Computing (IC), University of Campinas, Campinas, São Paulo, Brazil; ImmunoCamp Science and Technology, Vinhedo, São Paulo, Brazil
| | - Edvaldo Sabadini
- Department of Physical-Chemistry, Institute of Chemistry, University of Campinas, Campinas, São Paulo, Brazil
| | | | - Alexandre Xavier Falcão
- Laboratory of Image Data Science (LIDS), Institute of Computing (IC), University of Campinas, Campinas, São Paulo, Brazil
| | - Jancarlo Ferreira Gomes
- School of Medical Sciences, University of Campinas, Campinas, São Paulo 13083-889, Brazil; Laboratory of Image Data Science (LIDS), Institute of Computing (IC), University of Campinas, Campinas, São Paulo, Brazil
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20
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Liu X, Guo J, Li Y, Wang B, Yang S, Chen W, Wu X, Guo J, Ma X. SERS substrate fabrication for biochemical sensing: towards point-of-care diagnostics. J Mater Chem B 2021; 9:8378-8388. [PMID: 34505606 DOI: 10.1039/d1tb01299a] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Rapid technology development and economic growth have brought attention to public health issues, such as food safety and environmental pollution, which creates an ever-increasing demand for fast and portable sensing technologies. Portable surface-enhanced Raman spectroscopy (SERS) capable of various analyte detection with low concentration in a convenient manner shows advantages in sensing technology including enhanced diagnostic precision, improved diagnostic efficiency, reduced diagnostic cost, and alleviation of patient pain, which emerges as a promising candidate for point-of-care testing (POCT). SERS detection technology based on different nanostructures made of noble metal-based nanomaterials can increase the sensitivity of Raman scattering by 6-8 orders of magnitude, making Raman based trace detection possible, and greatly promote the application scenarios of portable Raman spectrometers. In this perspective, we provide an overview of fundamental knowledge about the SERS mechanism including chemical and electromagnetic field enhancement mechanisms, the design and fabrication of SERS substrates based on materials, progress of using SERS for POCT in biochemical sensing and its clinical applications. Furthermore, we present the prospective of developing new nanomaterials with different functionalities for advanced SERS substrates, as well as the future advancement of biomedical sensing and clinical potential of SERS technology.
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Affiliation(s)
- Xiaojia Liu
- Sauvage Laboratory for Smart Materials, School of Materials Science and Engineering, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, China. .,Shenzhen Bay Laboratory, No. 9 Duxue Road, Shenzhen 518055, China
| | - Jiuchuan Guo
- School of Information and Communication Engineering, University of Electronic Science and Technology of China, Chengdu 611731, P. R. China.
| | - Yang Li
- School of Materials Engineering, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Bo Wang
- School of Materials Engineering, Shanghai University of Engineering Science, Shanghai 201620, China
| | - Shikun Yang
- Sauvage Laboratory for Smart Materials, School of Materials Science and Engineering, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, China. .,Shenzhen Bay Laboratory, No. 9 Duxue Road, Shenzhen 518055, China
| | - Wenjun Chen
- Sauvage Laboratory for Smart Materials, School of Materials Science and Engineering, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, China. .,Shenzhen Bay Laboratory, No. 9 Duxue Road, Shenzhen 518055, China
| | - Xinggui Wu
- CloudMinds, Inc., Shenzhen Bay Science and Technology Ecological Park, Nanshan District, Shenzhen 100022, China.
| | - Jinhong Guo
- School of Information and Communication Engineering, University of Electronic Science and Technology of China, Chengdu 611731, P. R. China.
| | - Xing Ma
- Sauvage Laboratory for Smart Materials, School of Materials Science and Engineering, Harbin Institute of Technology (Shenzhen), Shenzhen 518055, China. .,Shenzhen Bay Laboratory, No. 9 Duxue Road, Shenzhen 518055, China
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21
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Comparative analysis of routine parasitological methods for recovery of cysts, molecular detection, and genotyping of Giardia duodenalis. Eur J Clin Microbiol Infect Dis 2021; 40:2633-2638. [PMID: 34059933 DOI: 10.1007/s10096-021-04280-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/23/2021] [Indexed: 10/21/2022]
Abstract
In order to improve the diagnosis of giardiasis, fecal samples (high/medium/low concentration of cysts) were processed by the parasitological methods used in the routine: Faust, Lutz e Ritchie modified (replacement of formaldehyde by distilled water). The cysts were quantified; the DNA was extracted and amplified by semi-nested PCR (GDH gene). Fifteen clinical samples were analyzed to validate the study by PCR-RFLP. The results showed that the parasite was only detected and genotyped correctly when samples from children with high, medium, and low parasitic load, belonging to genotype AII, were processed by the modified Ritchie method, different from what was observed for the other methods used in laboratory routine (Faust and Lutz). The modified Ritchie method proved to be more suitable, recovering a greater number of cysts from samples, regardless of parasitic load, which reduces the chance of false negative results and has epidemiological repercussions since individuals with low parasite load are usually asymptomatic and the main disseminators of this infection.
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22
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Conners EE, Miller AD, Balachandran N, Robinson BM, Benedict KM. Giardiasis Outbreaks - United States, 2012-2017. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:304-307. [PMID: 33661866 PMCID: PMC7948938 DOI: 10.15585/mmwr.mm7009a2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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23
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Sursal N, Simsek E, Yildiz K. FELINE GIARDIASIS IN TURKEY: PREVALENCE AND GENETIC AND HAPLOTYPE DIVERSITY OF GIARDIA DUODENALIS BASED ON THE β-GIARDIN GENE SEQUENCE IN SYMPTOMATIC CATS. J Parasitol 2021; 106:699-706. [PMID: 33120408 DOI: 10.1645/19-183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Giardia duodenalis is a common zoonotic protozoan parasite with a broad host distribution. The main objectives of the present study were to determine the prevalence of giardiasis and to reveal the genetic and haplotype diversity of G. duodenalis in symptomatic cats in Turkey. Fecal samples were collected from cats (n = 102) with diarrhea that were admitted to different pet clinics in the Central Anatolia region of Turkey. All samples were analyzed by microscopic examination (ME), rapid immunochromatographic test (ICT), and PCR targeting the β-giardin (bg) loci of the parasite. Phylogenetic, haplotype, and network analyses of G. duodenalis based on the bg gene were carried out. Overall, G. duodenalis was detected in 70/102 (68.6%) of the cats with diarrhea by ME (38/102, 37.3%), ICT (51/102, 50%), and PCR (30/102, 29.4%). According to sequence analyses of the bg gene region, all isolates were identified as G. duodenalis assemblage B. Haplotype analyses revealed 2 known and 8 novel haplotypes for G. duodenalis assemblage B. This study provides first prevalence and genetic and haplotype diversity data on G. duodenalis assemblage B from cats in Turkey.
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Affiliation(s)
- Neslihan Sursal
- Department of Parasitology, Faculty of Veterinary Medicine, Aksaray University, Aksaray, Turkey
| | - Emrah Simsek
- Department of Preclinical Sciences, Faculty of Veterinary Medicine, Erciyes University, Kayseri, Turkey
| | - Kader Yildiz
- Department of Parasitology, Faculty of Veterinary Medicine, Kirikkale University, Kirikkale, Turkey
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24
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Pacheco FTF, de Carvalho SS, Santos SA, das Chagas GMT, Santos MC, Santos JGS, da Costa-Ribeiro H, Ribeiro TCM, de Mattos ÂP, Gomes MA, Soares NM, Teixeira MCA. Specific IgG and IgA Antibody Reactivities in Sera of Children by Enzyme-Linked Immunoassay and Comparison With Giardia duodenalis Diagnosis in Feces. Ann Lab Med 2021; 40:382-389. [PMID: 32311851 PMCID: PMC7169635 DOI: 10.3343/alm.2020.40.5.382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 01/05/2020] [Accepted: 03/31/2020] [Indexed: 01/03/2023] Open
Abstract
Background Giardia duodenalis is conventionally diagnosed in fecal samples using parasitological methods. However, sensitivity is poor when only a single sample is analyzed, due to intermittent excretion of cysts in feces. Alternatively, the serum antibodies to G. duodenalis can be used for parasite diagnosis and epidemiological studies to determine previous exposure. We compared the rate of G. duodenalis infection between serum anti-Giardia IgG and IgA antibodies and fecal examination in Brazilian children. Methods Fecal and serum samples were tested from 287 children at a clinical laboratory and from 187 children at daycare centers. Fecal samples were processed using conventional parasitological methods and coproantigen detection for Giardia diagnosis. Serum samples were tested using an in-house ELISA for detection of anti-Giardia IgG and IgA. Results G. duodenalis was found in 8.2% (N=39) of the 474 children analyzed. The sensitivity and specificity of ELISA were 80.0% and 90.0% for IgG and 80.0% and 83.3% for IgA, respectively. The total positivity rate of anti-Giardia IgG and IgA in the sera was 13.9% (N=66) and 23.6% (N=112). The agreement between the positivity of specific antibodies and the detection of G. duodenalis in feces was moderate for ELISA-IgG, kappa index (95% CI)=0.543 (0.422–0.664), and mild for ELISA-IgA, kappa index (95% CI)=0.283 (0.162–0.404). Among the children infected with other enteroparasites, 11.6% (N=10) and 24.4% (N=21) showed reactivity to anti-Giardia IgG and to IgA, respectively. This cross-reactivity was more frequent in samples from children infected with Endolimax nana and Entamoeba coli. Conclusions The higher frequency of specific antibody reactivity compared with G. duodenalis diagnosis in feces could reflect continuous exposure of children to G. duodenalis infection, resulting in long-lasting immunological memory and/or cross-reactivity with other intestinal amoebas.
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Affiliation(s)
- Flávia Thamiris Figueiredo Pacheco
- Department of Clinical and Toxicological Analysis, Pharmacy College, Salvador, Brazil.,Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | | | - Samara Alves Santos
- Department of Clinical and Toxicological Analysis, Pharmacy College, Salvador, Brazil
| | | | | | | | | | | | | | - Maria Aparecida Gomes
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Neci Matos Soares
- Department of Clinical and Toxicological Analysis, Pharmacy College, Salvador, Brazil
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25
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Capewell P, Krumrie S, Katzer F, Alexander CL, Weir W. Molecular Epidemiology of Giardia Infections in the Genomic Era. Trends Parasitol 2020; 37:142-153. [PMID: 33067130 DOI: 10.1016/j.pt.2020.09.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 12/19/2022]
Abstract
Giardia duodenalis is a major gastrointestinal parasite of humans and animals across the globe. It is also of interest from an evolutionary perspective as it possesses many features that are unique among the eukaryotes, including its distinctive binucleate cell structure. While genomic analysis of a small number of isolates has provided valuable insights, efforts to understand the epidemiology of the disease and the population biology of the parasite have been limited by the molecular tools currently available. We review these tools and assess the impact of affordable and rapid genome sequencing systems increasingly being deployed in diagnostic settings. While these technologies have direct implications for public and veterinary health, they will also improve our understanding of the unique biology of this fascinating parasite.
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Affiliation(s)
- Paul Capewell
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G61 1QH, UK
| | - Sarah Krumrie
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G61 1QH, UK
| | - Frank Katzer
- Moredun Research Institute, Pentlands Science Park, Edinburgh, EH26 0PZ, UK
| | - Claire L Alexander
- Scottish Parasitology Diagnostic and Reference Laboratories, Glasgow, G31 2ER, UK
| | - William Weir
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G61 1QH, UK.
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26
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Dixon BR. Giardia duodenalis in humans and animals - Transmission and disease. Res Vet Sci 2020; 135:283-289. [PMID: 33066992 DOI: 10.1016/j.rvsc.2020.09.034] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/25/2020] [Accepted: 09/29/2020] [Indexed: 02/07/2023]
Abstract
Giardia duodenalis is a protozoan parasite infecting the upper intestinal tract of humans, as well as domestic and wild animals worldwide. Transmission of giardiasis occurs through the faecal-oral route, and may be either direct (i.e., person-to-person, animal-to-animal or zoonotic) or indirect (i.e., waterborne or foodborne). While asymptomatic infections are common in both humans and animals, a wide range of enteric symptoms have been reported, along with extra-intestinal and post-infectious complications. A definitive diagnosis of giardiasis is generally made by detection of cysts in stool specimens through microscopical examination of wet mounts, or through the use of permanent or fluorescent antibody stains. More recently, molecular methods have become popular for diagnosis and for testing environmental samples. Symptomatic giardiasis is often treated to reduce the duration of symptoms, to prevent complications, and to minimize transmission of the parasite to other hosts. Direct faecal-oral transmission of giardiasis can be largely controlled thorough improved hygiene and sanitation. In the case of waterborne transmission, a multiple barrier approach, including limiting access of people and animals to watersheds and reservoirs, and treatment using flocculation, filtration and disinfection, is necessary to minimize the risk. Since foodborne transmission is often associated with the consumption of fresh produce, a number of control measures can be taken during pre- and post-harvest, as well as at the food handler/consumer level to minimize the risk of contamination, or for removing or inactivating parasites. Good husbandry and farm management practices are important in controlling the spread of giardiasis in livestock and companion animals.
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Affiliation(s)
- Brent R Dixon
- Bureau of Microbial Hazards, Food Directorate, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, Ontario K1A 0K9, Canada.
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27
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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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Jangra M, Dutta U, Shah J, Thapa BR, Nada R, Gupta N, Sehgal R, Sharma V, Khurana S. Role of Polymerase Chain Reaction in Stool and Duodenal Biopsy for Diagnosis of Giardiasis in Patients with Persistent/Chronic Diarrhea. Dig Dis Sci 2020; 65:2345-2353. [PMID: 31955285 DOI: 10.1007/s10620-019-06042-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 12/31/2019] [Indexed: 12/09/2022]
Abstract
BACKGROUND Giardia duodenalis is a common cause of chronic diarrhea especially in tropical countries. Diagnosis is based on microscopy (three stool samples) for trophozoites/cysts. Role of stool or duodenal biopsy PCR as a diagnostic method needs to be defined. We conducted a prospective study to determine the diagnostic characteristics of G. duodenalis stool and duodenal biopsy PCR in comparison to stool microscopy (reference standard). Later, we compared other techniques with stool PCR, considering it as new reference standard and characterized the type of Giardia assemblage. METHODS G. duodenalis stool nested PCR was first evaluated using 40 positive controls and 50 negative controls considering stool microscopy as reference standard. Patients with chronic diarrhea (n = 100) were evaluated by stool microscopy and nested PCR. In 30 patients in whom upper gastrointestinal endoscopy was performed, duodenal biopsy samples were obtained and evaluated by histopathology, imprint cytology, and nested PCR. The type of Giardia assemblage was detected by assemblage-specific PCR. RESULTS Stool nested PCR was found to have sensitivity and specificity of 100% and 94%, respectively, compared to stool microscopy. In patients with chronic diarrhea, 48% had evidence of Giardia infection. Stool microscopy detected 65%, stool PCR detected an additional 27%, and duodenal biopsy PCR detected an additional 8% of cases. The commonest assemblage found was assemblage B. Clinical and demographic characteristics were similar in patients harboring either assemblage A or B. CONCLUSION Stool PCR is more sensitive than stool microscopy. By utilizing stool microscopy, stool nested PCR, and duodenal biopsy PCR in sequential manner, diagnostic yield can be increased.
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Affiliation(s)
- Monika Jangra
- Department of Medical Parasitology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, India
| | - Usha Dutta
- Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Jimil Shah
- Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - B R Thapa
- Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ritambhra Nada
- Histopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nalini Gupta
- Cytological and Gynaecological Pathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rakesh Sehgal
- Department of Medical Parasitology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, India
| | - Vishal Sharma
- Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sumeeta Khurana
- Department of Medical Parasitology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, India.
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29
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Molina-Gonzalez SJ, Bhattacharyya T, AlShehri HR, Poulton K, Allen S, Miles MA, Arianitwe M, Tukahebwa EM, Webster B, Russell Stothard J, Bustinduy AL. Application of a recombinase polymerase amplification (RPA) assay and pilot field testing for Giardia duodenalis at Lake Albert, Uganda. Parasit Vectors 2020; 13:289. [PMID: 32505215 PMCID: PMC7275508 DOI: 10.1186/s13071-020-04168-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 06/02/2020] [Indexed: 02/08/2023] Open
Abstract
Background Giardia duodenalis is a gastrointestinal protozoan causing 184 million cases of giardiasis worldwide annually. Detection is by microscopy or coproantigen assays, although sensitivity is often compromised by intermittent shedding of cysts or trophozoites, or operator expertise. Therefore, for enhanced surveillance field-applicable, point-of-care (POC), molecular assays are needed. Our aims were to: (i) optimise the recombinase polymerase amplification (RPA) assay for the isothermal amplification of the G. duodenalis β-giardin gene from trophozoites and cysts, using published primer and probes; and (ii) perform a pilot field validation of RPA at a field station in a resource-poor setting, on DNA extracted from stool samples from schoolchildren in villages around Lake Albert, Uganda. Results were compared to an established laboratory small subunit ribosomal RNA (SSU rDNA) qPCR assay with additional testing using a qPCR targeting the triose phosphate isomerase (tpi) DNA regions that can distinguish G. duodenalis of two different assemblages (A and B), which are human-specific. Results Initial optimisation resulted in the successful amplification of predicted RPA products from G. duodenalis-purified gDNA, producing a double-labelled amplicon detected using lateral flow strips. In the field setting, of 129 stool samples, 49 (37.9%) were positive using the Giardia/Cryptosporidium QuikChek coproantigen test; however, the RPA assay when conducted in the field was positive for a single stool sample. Subsequent molecular screening in the laboratory on a subset (n = 73) of the samples demonstrated better results with 21 (28.8%) RPA positive. The SSU rDNA qPCR assay resulted in 30/129 (23.3%) positive samples; 18 out of 73 (24.7%) were assemblage typed (9 assemblage A; 5 assemblage B; and 4 mixed A+B). Compared with the SSU rDNA qPCR, QuikChek was more sensitive than RPA (85.7 vs 61.9%), but with similar specificities (80.8 vs 84.6%). In comparison to QuikChek, RPA had 46.4% sensitivity and 82.2% specificity. Conclusions To the best of our knowledge, this is the first in-field and comparative laboratory validation of RPA for giardiasis in low resource settings. Further refinement and technology transfer, specifically in relation to stool sample preparation, will be needed to implement this assay in the field, which could assist better detection of asymptomatic Giardia infections.![]()
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Affiliation(s)
- Sandra J Molina-Gonzalez
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.,London Centre for Neglected Tropical Disease Research, London, UK
| | - Tapan Bhattacharyya
- London Centre for Neglected Tropical Disease Research, London, UK. .,Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK.
| | - Hajri R AlShehri
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK.,Ministry of Health, Asir District, Abha, Kingdom of Saudi Arabia
| | - Kate Poulton
- London Centre for Neglected Tropical Disease Research, London, UK.,Natural History Museum Parasites and Vectors Division, Life Sciences Department, London, UK
| | - Stephen Allen
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Michael A Miles
- London Centre for Neglected Tropical Disease Research, London, UK.,Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
| | - Moses Arianitwe
- Vector Control Division, Ministry of Health, Kampala, Uganda
| | | | - Bonnie Webster
- London Centre for Neglected Tropical Disease Research, London, UK.,Natural History Museum Parasites and Vectors Division, Life Sciences Department, London, UK
| | - J Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Amaya L Bustinduy
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.,London Centre for Neglected Tropical Disease Research, London, UK
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30
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Soares FA, Benitez ADN, dos Santos BM, Loiola SHN, Rosa SL, Nagata WB, Inácio SV, Suzuki CTN, Bresciani KDS, Falcão AX, Gomes JF. A historical review of the techniques of recovery of parasites for their detection in human stools. Rev Soc Bras Med Trop 2020; 53:e20190535. [PMID: 32491097 PMCID: PMC7269538 DOI: 10.1590/0037-8682-0535-2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/30/2020] [Indexed: 11/22/2022] Open
Abstract
Since the early 20th century, the detection of intestinal parasites has improved with the development of several techniques for parasitic structures recovery and identification, which differ in sensitivity, specificity, practicality, cost, and infrastructure demand. This study aims to review, in chronological order, the stool examination techniques and discuss their advantages, limitations, and perspectives, and to provide professionals and specialists in this field with data that lays a foundation for critical analysis on the use of such procedures. The concentration procedures that constitute the main techniques applied in routine research and in parasitological kits are a) spontaneous sedimentation; b) centrifugation-sedimentation with formalin-ethyl acetate; and c) flotation with zinc sulfate solution. While selecting a technique, one should consider the purpose of its application and the technical-operational, biological, and physicochemical factors inherent in the procedures used in stool processing, which may restrict its use. These intrinsic limitations may have undergone procedural changes driven by scientific and technological development and by development of alternative methods, which now contribute to the improvement of diagnostic accuracy.
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Affiliation(s)
- Felipe Augusto Soares
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
| | | | | | | | - Stefany Laryssa Rosa
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
| | - Walter Bertequini Nagata
- Universidade Estadual Paulista, Faculdade de Medicina Veterinária, Departamento de Apoio, Produção e Saúde Animal, Araçatuba, SP, Brasil
| | - Sandra Valéria Inácio
- Universidade Estadual Paulista, Faculdade de Medicina Veterinária, Departamento de Apoio, Produção e Saúde Animal, Araçatuba, SP, Brasil
| | | | - Katia Denise Saraiva Bresciani
- Universidade Estadual Paulista, Faculdade de Medicina Veterinária, Departamento de Apoio, Produção e Saúde Animal, Araçatuba, SP, Brasil
| | | | - Jancarlo Ferreira Gomes
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
- Universidade Estadual de Campinas, Instituto de Computação, Campinas, SP, Brasil
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31
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Diarrhoea associated with gastrointestinal parasites in grazing sheep. Vet Parasitol 2020; 282:109139. [PMID: 32447149 DOI: 10.1016/j.vetpar.2020.109139] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 11/22/2022]
Abstract
Diarrhoea is a common, widespread and frustrating reality for sheep enterprises in most sheep producing regions globally and of particular concern in Australia as the major risk factor for breech flystrike. Parasitic disease has long been recognised as an important factor in diarrhoea in sheep, particularly the gastrointestinal nematodes (Trichostrongylus and Teladorsagia species). This review focuses on the role of parasitic infections in causing diarrhoea in sheep, with emphasis on the epidemiology of diarrhoea outbreaks related to worms and opportunities to manage the risk of diarrhoea outbreaks in sheep related to parasitic infections. Parasitic nematodes damage the gastrointestinal tract via a complex relationship between direct impacts from worms, such as physical changes to the gut mucosa, and indirect effects largely associated with the host response. Diarrhoea associated with large worm burdens is most efficiently managed through integrated parasite management programs. Despite some limitations, measuring faecal worm egg counts remains a mainstay for assessing the contribution of worms to outbreaks of diarrhoea in sheep. Larval hypersensitivity scouring is emerging as a significant cause of worm-related diarrhoea in sheep without large adult worm burdens in some geographic locations. The syndrome describes a heightened inflammatory response to the ingestion of trichostrongylid infective larvae seen in the gut of sheep with diarrhoea, and is most effectively addressed through selecting sheep for low breech soiling ('dag scores'), as worm resistant sheep may show an increased propensity for diarrhoea, even with low rates of larval challenge. Importantly, dag should be considered as a separate trait to WEC in breeding indexes. Outbreaks of diarrhoea in young sheep are often multifactorial, and co-infections with nematodes and other infectious agents associated with diarrhoea are common. This presents challenges for the field investigation of diarrhoea in grazing sheep.
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Abstract
Cryptosporidium and Giardia are ubiquitous protozoan parasites that infect a broad range of vertebrate hosts, including domestic and wild animals as well as humans. Both parasites are of medical and veterinary importance. Infections with Cryptosporidium and Giardia in ruminants are associated with diarrhea outbreaks, mainly in young animals. Ruminants are potential sources of infection for humans because some species of Cryptosporidium and assemblages of Giardia duodenalis have been isolated from both ruminants and humans. Knowledge of these parasites has greatly expanded in the last 2 decades from simple microscopic observations of organisms to the knowledge acquired from molecular tools.
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Affiliation(s)
- Monica Santin
- Environmental Microbial and Food Safety Laboratory, Beltsville Agricultural Research Center, Agricultural Research Service, US Department of Agriculture, BARC-East, Building 173, 10300 Baltimore Avenue, Beltsville, MD 20705, USA.
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Codrean A, Dumitrascu DL, Codrean V, Tit DM, Bungau S, Aleya S, Rus M, Fratila O, Nistor-Cseppento DC, Aleya L, Negrut N. Epidemiology of human giardiasis in Romania: A 14 years survey. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 705:135784. [PMID: 31791758 DOI: 10.1016/j.scitotenv.2019.135784] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/02/2019] [Accepted: 11/25/2019] [Indexed: 06/10/2023]
Abstract
Giardia spp. is the most common intestinal protozoan (causing gastrointestinal illness) and the most frequent cause of parasitic gastroenteritis in humans and animals worldwide. The aim of this study was to highlight new data in a specific area regarding clinical presentation and epidemiological prevalence over a long period of time. Patients (a total number of 54,623 patients) admitted in a tertiary center for infectious diseases serving a county for a period of 14 years were tested for infection with Giardia. Positive cases were recorded through analyzing the clinical complaints, the month of incidence and the demographic area from which the patients came from. Longitudinal trends have been evaluated. The incidence of giardiasis among the tested patients was 4.47%. A decreasing trend was observed regarding the annual incidence. Patients between the ages of 15 and 44 presented most commonly giardiasis, especially those from urban areas and women. The most common symptoms are loss of appetite (71.24%) and abdominal pain (69.07%). The highest monthly incidence was quoted in July (10.65%), August (10.49%) and June (10.20%). This epidemiological study allows a better knowledge of the infection with Giardia spp. It gives the long-term changes in demographic characteristics of the infected patients in a specific area and the monthly incidence.
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Affiliation(s)
- Adriana Codrean
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | - Dan L Dumitrascu
- 2nd Medical Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Victor Codrean
- Faculty of Environmental Protection, University of Oradea, Oradea, Romania
| | - Delia Mirela Tit
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | - Selim Aleya
- Faculty of Medecine, Université de Franche-Comté, Besançon, France
| | - Marius Rus
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | - Ovidiu Fratila
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | - Delia Carmen Nistor-Cseppento
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
| | - Lotfi Aleya
- Chrono-environnement CNRS 6249, Université de Franche-Comté, Besançon, France.
| | - Nicoleta Negrut
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania
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Improvement in cyst recovery and molecular detection of Giardia duodenalis from stool samples. Mol Biol Rep 2019; 47:1233-1239. [PMID: 31813130 DOI: 10.1007/s11033-019-05224-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/04/2019] [Indexed: 10/25/2022]
Abstract
Molecular detection of Giardia duodenalis by polymerase chain reaction (PCR) is difficult in faecal samples due to inhibitors that contaminate DNA preparations, or due to low cyst concentrations. In order to eliminate inhibitors, improve cyst recovery and molecular detection of G. duodenalis, different types of water, distillates (MDs), deionized (MDz), injection (MI) or Milli-Q® (MM) were used instead of formaldehyde (F) in the laboratory routine method (Ritchie). Cysts were isolated from faecal samples with low cyst concentrations (< 1 cyst/field), medium (1-2 cysts/field) or high (> 2 cysts/field). Cyst recovery was improved using all water types (MDs, MDz, MI, MM) compared to formaldehyde. At all cyst concentrations, the use of MM consistently showed the greatest recovery of G. duodenalis cysts . DNA samples from recovered cysts were tested for the glutamate dehydrogenase (GDH) and β-giardin (βg) genes. The use of Milli-Q® water allowed to detect both genes in all cyst concentrations, including low. The method processed with the other types of water amplified these genes at high and medium cyst concentrations. GDH and βg genes were not detected when the sample was processed with formaldehyde. These experimental results were confirmed in clinical samples. The results suggest that Milli-Q® water provides the highest cyst recovery from stool samples and, correspondingly, the highest sensitivity for detecting G. duodenalis by microscopy or PCR for GDH and βg genes, even at low concentration of cysts.
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Carrasco-Labra A, Lytvyn L, Falck-Ytter Y, Surawicz CM, Chey WD. AGA Technical Review on the Evaluation of Functional Diarrhea and Diarrhea-Predominant Irritable Bowel Syndrome in Adults (IBS-D). Gastroenterology 2019; 157:859-880. [PMID: 31351880 DOI: 10.1053/j.gastro.2019.06.014] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The evaluation of patients with chronic watery diarrhea represents a diagnostic challenge for clinicians because organic causes, including inflammatory bowel disease, microscopic colitis, and chronic infection, must be differentiated from functional diarrhea and diarrhea-predominant irritable bowel syndrome. The purpose of this review is to summarize the available evidence on the usefulness of diagnostic tests in such patients. METHODS We searched MEDLINE and EMBASE via OVID, from 1978 until April 2017. We included diagnostic test accuracy studies reporting on the use of fecal and blood tests for the evaluation of adult patients with functional diarrhea, including irritable bowel syndrome. We assessed the risk of bias of included studies using a modified version of the Quality Assessment of Diagnostic Accuracy Studies II, and the certainty in the evidence using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. We calculated pooled sensitivity and specificity, and the proportion of patients with true and false positive and negative results. We evaluated the following tests: erythrocyte sedimentation rate, C-reactive protein, fecal lactoferrin, fecal calprotectin, serologic tests for celiac disease, tests for bile acid diarrhea, the commercially available version of anti-cytolethal distending toxin B and anti-vinculin antibodies, and tests for Giardia infection. We did not evaluate breath tests for small intestinal bacterial overgrowth, as they are not part of a standard diarrhea workup. RESULTS Thirty-eight studies proved eligible to evaluate 1 or more of these tests. Erythrocyte sedimentation rate and C-reactive protein were similar at discriminating organic from functional disease, with sensitivity and specificity, respectively, of 0.54-0.78 and 0.46-0.95 for erythrocyte sedimentation rate and 0.73 and 0.78 for C-reactive protein. Among fecal tests, fecal calprotectin in a range of 50-60 μg/g (pooled sensitivity 0.81; 95% confidence interval [CI], 0.75-0.86; pooled specificity 0.87; 95% CI, 0.78-0.92) and fecal lactoferrin in a range of 4.0-7.25 μg/g (pooled sensitivity 0.79; 95% CI, 0.73-0.84; pooled specificity 0.93; 95%CI 0.63-0.99) presented the lowest proportion of false-negative results (low certainty in the evidence). Among tests for celiac disease, IgA tissue transglutaminase presented the best diagnostic test accuracy (sensitivity range, 0.79-0.99; specificity range, 0.90-0.99) with moderate certainty in the evidence. Among tests for bile acid diarrhea, the 75selenium homotaurocholic acid test performed better than serum fibroblast growth factor 19 and 7α-hydroxy-4-cholesten-3-one, but is not available in the United States. There was insufficient evidence to recommend serologic tests for irritable bowel syndrome at this time. There are several good diagnostic tests for Giardia infection. CONCLUSIONS Moderate to low certainty in the evidence indicates that available fecal and blood tests may play a role in the diagnostic workup of adult patients with functional diarrhea. At the moment, no tests are available to reliably rule in irritable bowel syndrome.
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Affiliation(s)
- Alonso Carrasco-Labra
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Oral and Craniofacial Health Science, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lyubov Lytvyn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Yngve Falck-Ytter
- Division of Gastroenterology, Case Western Reserve University, Cleveland, Ohio; Veterans Affairs Medical Center and University Hospitals of Cleveland, Cleveland, Ohio
| | - Christina M Surawicz
- Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
| | - William D Chey
- Division of Gastroenterology, Department of Medicine, Michigan Medicine, Ann Arbor, Michigan
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Miambo RD, Laitela B, Malatji MP, De Santana Afonso SM, Junior AP, Lindh J, Mukaratirwa S. Prevalence of Giardia and Cryptosporidium in young livestock and dogs in Magude District of Maputo Province, Mozambique. ACTA ACUST UNITED AC 2019; 86:e1-e6. [PMID: 31478737 PMCID: PMC6739555 DOI: 10.4102/ojvr.v86i1.1709] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/04/2019] [Accepted: 02/11/2019] [Indexed: 11/01/2022]
Abstract
BACKGROUND Giardia and Cryptosporidium species are significant zoonotic parasites of humans and domesticated animals. OBJECTIVES The study aimed to determine the prevalence of Giardia and Cryptosporidium in livestock and dogs of the Magude District. METHOD The flotation technique (Willis), modified Ziehl-Neelsen (mZN) and direct and indirect immunofluorescence (DIF and IIF) techniques were applied to determine the prevalence of Giardia and Cryptosporidium species in faecal samples of dog pups (156), goat kids (60) and calves (480) from the Magude District of Mozambique from February to September 2015. RESULTS Using Willis, IIF and DIF, the prevalence of Giardia in calves was 0%, 8.1%, and 6.0%; in dogs 0.6%, 8.3% and 5.7% and for goats 0% and 13.3% (IIF was not performed), respectively. The prevalence of Cryptosporidium in calves using Willis, mZN, IIF and DIF was 0%, 3.8%, 4.7% and 0.4% and in dogs 0%, 0.6%, 6.4% and 0.6%, respectively. The parasite was not detected in goats. CONCLUSION Results from the present study showed that IIF performed better diagnosis of Giardia and Cryptosporidium, and that the mZN can be used as an alternative for Cryptosporidium because of the high cost of IIF. There is a need for identification of genotypes or subtypes of these parasites through application of molecular techniques in order to determine their zoonotic potential, and we advocate a 'one health' approach in the control and prevention of these parasites.
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Affiliation(s)
- Regina D Miambo
- Department of Para-Clinics, Faculty of Veterinary Medicine, Eduardo Mondlane University, Maputo, Mozambique; and, School of Life Science, College of Agriculture, Engineering and Science, University of KwaZulu-Natal, Westville, South Africa.
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Thompson RCA, Ash A. Molecular epidemiology of Giardia and Cryptosporidium infections - What's new? INFECTION GENETICS AND EVOLUTION 2019; 75:103951. [PMID: 31279819 DOI: 10.1016/j.meegid.2019.103951] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/30/2019] [Accepted: 07/02/2019] [Indexed: 12/22/2022]
Abstract
New information generated since 2016 from the application of molecular tools to infections with Giardia and Cryptosporidium is critically summarised. In the context of molecular epidemiology, nomenclature, taxonomy, in vitro culture, detection, zoonoses, population genetics and pathogenicity, are covered. Whole genome sequencing has had the greatest impact in the last three years. Future advances will provide a much better understanding of the zoonotic potential of both parasites, their diversity and how this is linked to pathogenesis in different hosts.
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Affiliation(s)
- R C A Thompson
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA 6150, Australia.
| | - A Ash
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA 6150, Australia
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Chen D, Zou Y, Li Z, Wang SS, Xie SC, Shi LQ, Zou FC, Yang JF, Zhao GH, Zhu XQ. Occurrence and multilocus genotyping of Giardia duodenalis in black-boned sheep and goats in southwestern China. Parasit Vectors 2019; 12:102. [PMID: 30867035 PMCID: PMC6417273 DOI: 10.1186/s13071-019-3367-1] [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: 10/02/2018] [Accepted: 02/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Giardia duodenalis is an important intestinal protozoan infecting both humans and animals, causing significant public health concern and immeasurable economic losses to animal husbandry. Sheep and goats have been reported as common reservoirs of G. duodenalis, but only a limited amount of information is available for native breeds of these small ruminants in China. The present study investigated the prevalence and multilocus genotypes of G. duodenalis in black-boned sheep and goats, two important native breeds in Yunnan Province, southwestern China. METHODS Fecal samples were collected from 336 black-boned goats and 325 black-boned sheep from five counties (Meishui, Shanshu, Shilin, Yongsheng and Nanping) of Yunnan Province and the genomic DNA was extracted from these feces. The prevalence of G. duodenalis was determined by the nested PCR targeting the β-giardin (bg) gene. The assemblages and multilocus genotypes (MLGs) were investigated based on analyses of three genetic loci, i.e. bg, glutamate dehydrogenase (gdh) and triosephosphate isomerase (tpi). RESULTS Giardia duodenalis infection was detected in both black-boned sheep and goats, and the prevalence of G. duodenalis in black-boned sheep (21.8%, 71/325) was significantly higher (χ2 = 36.63, df = 1, P < 0.001) than that in black-boned goats (4.8%, 16/336). Significant differences in prevalence were also observed in goats and sheep from different counties (χ2 = 39.83, df = 4, P < 0.001) and age groups (χ2 = 97.33, df = 3, P < 0.001). Zoonotic assemblage A and animal-specific assemblage E were identified in both black-boned sheep and goats with the latter as the predominant assemblage. Based on sequences obtained from the three genetic loci (bg, gdh and tpi), 16 MLGs were obtained in black-boned sheep and goats, including 15 MLGs in assemblage E and one MLG in assemblage A. CONCLUSIONS Our results not only extended the host range of G. duodenalis, but also revealed high genetic variations in G. duodenalis assemblages. The findings of the present study also provide baseline data for preventing and controlling G. duodenalis infection in black-boned sheep and goats in Yunnan Province.
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Affiliation(s)
- Dan Chen
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730046, Gansu, People's Republic of China.,College of Veterinary Medicine, Northwest A&F University, Yangling, 712100, Shaanxi, People's Republic of China
| | - Yang Zou
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730046, Gansu, People's Republic of China
| | - Zhao Li
- Key Laboratory of Veterinary Public Health of Higher Education of Yunnan Province, College of Veterinary Medicine, Yunnan Agricultural University, Kunming, 650201, Yunnan, People's Republic of China
| | - Sha-Sha Wang
- College of Veterinary Medicine, Northwest A&F University, Yangling, 712100, Shaanxi, People's Republic of China
| | - Shi-Chen Xie
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730046, Gansu, People's Republic of China
| | - Lian-Qin Shi
- Key Laboratory of Veterinary Public Health of Higher Education of Yunnan Province, College of Veterinary Medicine, Yunnan Agricultural University, Kunming, 650201, Yunnan, People's Republic of China
| | - Feng-Cai Zou
- Key Laboratory of Veterinary Public Health of Higher Education of Yunnan Province, College of Veterinary Medicine, Yunnan Agricultural University, Kunming, 650201, Yunnan, People's Republic of China
| | - Jian-Fa Yang
- Key Laboratory of Veterinary Public Health of Higher Education of Yunnan Province, College of Veterinary Medicine, Yunnan Agricultural University, Kunming, 650201, Yunnan, People's Republic of China
| | - Guang-Hui Zhao
- College of Veterinary Medicine, Northwest A&F University, Yangling, 712100, Shaanxi, People's Republic of China.
| | - Xing-Quan Zhu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730046, Gansu, People's Republic of China. .,Jiangsu Co-innovation Center for the Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University College of Veterinary Medicine, Yangzhou, 225009, Jiangsu, People's Republic of China.
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Corleto VD, Di Marino VP, Galli G, Antonelli G, Coluccio C, Di Cerbo A, Uccini S, Annibale B. Improving basic skills in celiac-like disease diagnosis: a case report. BMC Gastroenterol 2018; 18:162. [PMID: 30390626 PMCID: PMC6215663 DOI: 10.1186/s12876-018-0894-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 10/23/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The diagnosis of Coeliac disease (CD) requires a combination of sign/symptoms, positivity of specific antibodies and duodenal histological evidence of villous atrophy. Duodenal villous atrophy, despite representing the CD landmark, is not specific since it is found in many gastrointestinal disorders. Giardiasis is one of the most common human intestinal protozoan infestations in industrialized countries whose histological duodenal mucosa damage could mimic that of CD. The present report shows how a wise clinical and laboratory assessment led us shortly to a correct diagnosis. CASE PRESENTATION A 42-year-old outpatient woman without previous significant gastrointestinal diseases, was referred with dyspeptic symptoms, fatigue and mild diarrhea from 4 months. Her first investigations including immunoglobulin A (IgA) anti-tissue transglutaminase antibodies (anti-tTG) and stool parasitological and cultural analysis were negative. An esophagogastroduodenoscopy (EGDS) showed no mucosal alteration. But histology demonstrated a Helicobacter Pylori (HP) pan-gastritis while duodenal mucosa showed villous atrophy consistent with a diagnosis of CD Marsh type 3b. While on gluten-free diet (GFD) the patient didn't experience any improvement of symptoms. Duodenal biopsies were then reviewed showing the presence of trophozoites of Giardia on the luminal surface of the duodenal wall and at the same time, a second stool examination revealed the presence of trophozoites and cysts of Giardia. Treated with metronidazole, 500 mg twice daily for 6 days the patient reduced diarrhea after few days. After about 2 months of GFD she was invited to discontinue it. At the same time stool examination was repeated with negative results. She subsequently performed eradication for Hp with triple therapy (Pylera®). Around 6 months later, the patient did not complain any gastrointestinal symptoms. Serological tests were normal and at a follow-up EGDS, duodenal mucosa had normal histology with normal finger-like villi and absence of Giardia trophozoites. CONCLUSION This case report shows how CD diagnosis can sometimes be manifold. Intestinal villous atrophy alone may not automatically establish a diagnosis of CD. In the present case the clinical scenario could be fully explained by giardiasis. Indeed, different diagnostic tools and a multi-step approaches have been used to determine the final correct diagnosis.
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Affiliation(s)
- Vito Domenico Corleto
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
- grid.7841.aDigestive Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Vincenza Patrizia Di Marino
- grid.7841.aPaedriatic Allergology, Allergology Unit, “Policlinico Umberto I” University Hospital, “Sapienza” University of Rome, Rome, Italy
| | - Gloria Galli
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
| | - Giulio Antonelli
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
| | - Chiara Coluccio
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
| | - Arcangelo Di Cerbo
- grid.7841.aPathology Unit, Azienda Ospedaliera Sant’Andrea, “Sapienza” University of Rome, Rome, Italy
| | - Stefania Uccini
- grid.7841.aPathology Unit, Azienda Ospedaliera Sant’Andrea, “Sapienza” University of Rome, Rome, Italy
| | - Bruno Annibale
- grid.7841.aGastroenterology and Gastrointestinal Endoscopy Unit, Sant’Andrea University Hospital, “Sapienza” University of Rome, Rome, Italy
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Ryan U, Hijjawi N, Feng Y, Xiao L. Giardia: an under-reported foodborne parasite. Int J Parasitol 2018; 49:1-11. [PMID: 30391227 DOI: 10.1016/j.ijpara.2018.07.003] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 11/26/2022]
Abstract
Foodborne zoonotic pathogens are a serious public health issue and result in significant global economic losses. Despite their importance to public health, epidemiological data on foodborne diseases including giardiasis caused by the enteric parasite, Giardia duodenalis, are lacking. This parasite is estimated to cause ∼28.2 million cases of diarrhoea each year due to contamination of food, but very few foodborne outbreaks have been documented due to the limitations of current detection as well as surveillance methods. The current method for the recovery of Giardia cysts from food matrices using immunomagnetic separation requires further standardisation and cost reduction before it can be widely used. It also should incorporate downstream molecular procedures for genotyping, and traceback and viability analyses. Foodborne giardiasis can be potentially controlled through improvements in national disease surveillance systems and the establishment of Hazard Analysis and Critical Control Point interventions across the food chain. Studies are needed to assess the true prevalence and public health impact of foodborne giardiasis.
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Affiliation(s)
- Una Ryan
- School of Veterinary and Life Sciences, Vector- and Water-Borne Pathogen Research Group, Murdoch University, Murdoch, Western Australia 6150, Australia.
| | - Nawal Hijjawi
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, The Hashemite University PO Box 150459, Zarqa 13115, Jordan
| | - Yaoyu Feng
- College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China
| | - Lihua Xiao
- College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China
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Adeyemo FE, Singh G, Reddy P, Stenström TA. Methods for the detection of Cryptosporidium and Giardia: From microscopy to nucleic acid based tools in clinical and environmental regimes. Acta Trop 2018; 184:15-28. [PMID: 29395034 DOI: 10.1016/j.actatropica.2018.01.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 12/21/2017] [Accepted: 01/22/2018] [Indexed: 01/18/2023]
Abstract
The detection and characterization of genotypes and sub genotypes of Cryptosporidium and Giardia is essential for their enumeration, surveillance, prevention, and control. Different diagnostic methods are available for the analysis of Cryptosporidium and Giardia including conventional phenotypic tools that face major limitations in the specific diagnosis of these protozoan parasites. The substantial advancement in the development of genetic signature based molecular tools for the quantification, diagnosis and genetic variation analysis has increased the understanding of the epidemiology and preventive measures of related infections. The conventional methods such as microscopy, antibody and enzyme based approaches, offer better detection results when combined with advanced molecular methods. Gene based approaches increase the precision of identification, for example, many signatures detected in environmental matrices represent species/genotype that are not infectious to humans. This review summarizes the available methods and the advantages and limitations of advance detection techniques like nucleic acid-based approaches for the detection of viable oocysts and cysts of Cryptosporidium and Giardia along with the conventional and widely accepted detection techniques like microscopy, antibody and enzyme based ones. This technical article also encourages the wide application of molecular methods in genetic characterization of distinct species of Cryptosporidium and Giardia, to adopt necessary preventive measures with reliable identification and mapping the source of contamination.
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Affiliation(s)
- Folasade Esther Adeyemo
- SARChI Chair, Institute for Water and Wastewater Technology (IWWT), Durban University of Technology, P.O. Box 1334, Durban, 4000, South Africa
| | - Gulshan Singh
- SARChI Chair, Institute for Water and Wastewater Technology (IWWT), Durban University of Technology, P.O. Box 1334, Durban, 4000, South Africa.
| | - Poovendhree Reddy
- Department of Community Health Studies, Faculty of Health Sciences, Durban University of Technology, P.O. Box 1334, Durban, 4000, South Africa
| | - Thor Axel Stenström
- SARChI Chair, Institute for Water and Wastewater Technology (IWWT), Durban University of Technology, P.O. Box 1334, Durban, 4000, South Africa
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Uiterwijk M, Nijsse R, Kooyman FNJ, Wagenaar JA, Mughini-Gras L, Koop G, Ploeger HW. Comparing four diagnostic tests for Giardia duodenalis in dogs using latent class analysis. Parasit Vectors 2018; 11:439. [PMID: 30064472 PMCID: PMC6069568 DOI: 10.1186/s13071-018-3014-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 07/13/2018] [Indexed: 11/10/2022] Open
Abstract
Background To accurately diagnose giardiosis in dogs, knowledge of diagnostic test characteristics and expected prevalence are required. The aim of this work was to estimate test characteristics (sensitivity and specificity) of four commonly used diagnostic tests for detection of Giardia duodenalis in dogs. Methods Fecal samples from 573 dogs originating from four populations (household dogs, shelter dogs, hunting dogs and clinical dogs) were examined with centrifugation sedimentation flotation (CSF) coproscopical analysis, direct immunofluorescence assay (DFA, Merifluor Cryptosporidium/Giardia®), a rapid enzyme immunochromatographic assay (IDEXX SNAP Giardia®) and qPCR (SSU rDNA) for presence of G. duodenalis. Bayesian latent class analysis was used to determine test performance characteristics and to estimate G. duodenalis prevalence of each of the four dog populations. Results All tests were highly specific. IDEXX SNAP Giardia® showed the highest specificity (99.6%) and qPCR the lowest (85.6%). The sensitivities were much more variable, with qPCR showing the highest (97.0%) and CSF the lowest (48.2%) sensitivity. DFA was more sensitive than IDEXX SNAP Giardia®, but slightly less specific. Prevalences of G. duodenalis differed substantially between populations, with the hunting dogs showing the highest G. duodenalis prevalence (64.9%) and the household dogs the lowest (7.9%). Conclusions This study identifies qPCR as a valuable screening tool because of its high sensitivity, whereas methods using microscopy for cyst identification or cyst wall detection should be used in situations where high specificity is required. G. duodenalis is a prevalent gastro-intestinal parasite in Dutch dogs, especially in dogs living in groups (hunting and shelter dogs) and clinical dogs. Electronic supplementary material The online version of this article (10.1186/s13071-018-3014-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mathilde Uiterwijk
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,Present address: National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control (CIb), Bilthoven, The Netherlands
| | - Rolf Nijsse
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Frans N J Kooyman
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Jaap A Wagenaar
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,Wageningen Bioveterinary Research, Lelystad, The Netherlands
| | - Lapo Mughini-Gras
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control (CIb), Bilthoven, The Netherlands
| | - Gerrit Koop
- Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Harm W Ploeger
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
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Mohapatra S, Singh DP, Alcid D, Pitchumoni CS. Beyond O&P Times Three. Am J Gastroenterol 2018; 113:805-818. [PMID: 29867172 DOI: 10.1038/s41395-018-0083-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 02/23/2018] [Indexed: 12/11/2022]
Abstract
Although examination of the stool for ova and parasites times three (O&P ×3) is routinely performed in the United States (US) for the evaluation of persistent and/or chronic diarrhea, the result is almost always negative. This has contributed to the perception that parasitic diseases are nearly non-existent in the country unless there is a history of travel to an endemic area. The increasing number of immigrants from third-world countries, tourists, and students who present with symptoms of parasitic diseases are often misdiagnosed as having irritable bowel syndrome or inflammatory bowel disease. The consequences of such misdiagnosis need no explanation. However, certain parasitic diseases are endemic to the US and other developed nations and affect both immunocompetent and immunocompromised patients. Testing for parasitic diseases either with O&P or with other diagnostic tests, followed by the recommended treatment, is quite rewarding when appropriate. Most parasitic diseases are easily treatable and should not be confused with other chronic gastrointestinal (GI) disorders. In this review, we critically evaluate the symptomatology of luminal parasitic diseases, their differential diagnoses, appropriate diagnostic tests, and management.
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Affiliation(s)
- Sonmoon Mohapatra
- Department of Internal Medicine, Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA. Department of Infectious Diseases, Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA. 3Department of Gastroenterology, Hepatology and Clinical Nutrition Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA
| | - Dhruv Pratap Singh
- Department of Internal Medicine, Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA. Department of Infectious Diseases, Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA. 3Department of Gastroenterology, Hepatology and Clinical Nutrition Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA
| | - David Alcid
- Department of Internal Medicine, Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA. Department of Infectious Diseases, Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA. 3Department of Gastroenterology, Hepatology and Clinical Nutrition Saint Peter's University Hospital - Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA
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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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CURRIE SL, STEPHENSON N, PALMER AS, JONES BL, ALEXANDER CL. Under-reporting giardiasis: time to consider the public health implications. Epidemiol Infect 2017; 145:3007-3011. [PMID: 28879824 PMCID: PMC9152757 DOI: 10.1017/s0950268817001959] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/07/2017] [Accepted: 08/10/2017] [Indexed: 11/07/2022] Open
Abstract
Giardiasis is a treatable disease, caused by the flagellated protozoan parasite, Giardia duodenalis (G. duodenalis). It is one of the most common enteric parasites found globally to cause gastrointestinal disturbances, and infections may result in long-term irritable bowel syndrome-like symptoms. It is a common misconception that giardiasis is associated with foreign travel, which results in locally acquired cases in the UK being underdiagnosed. This report highlights the findings from one large Scottish Health Board, arising from a change in testing methodology, which resulted in the screening of all stools submitted for enteric investigations for G. duodenalis. Previous selection criteria were restricted to patients with a travel history to specific regions of the world, or on the basis of certain clinical details. In this report, clinical details were recorded from samples shown to be positive using two methods: an ELISA-based antigen detection assay and microscopy. Clinical details were assessed for a total of 28 laboratory-confirmed positive cases against the original selection criteria. Twenty-six cases (93%) would have been excluded from Giardia testing if the previous selection criteria had been applied. Although nine cases stated foreign travel, only two had been to regions deemed to be 'high risk'. Therefore, those seven cases that travelled to perceived 'low-risk' regions would have been excluded from testing for this reason. This summary highlights the need for significant improvements to the selection criteria for Giardia testing. Laboratories should be encouraged towards the testing of all routinely submitted stools for this neglected pathogen to ensure cases that are acquired locally are properly identified and treated effectively.
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Affiliation(s)
- S. L. CURRIE
- Scottish Parasite Diagnostic and Reference Laboratory, Glasgow, Scotland, UK
| | - N. STEPHENSON
- Department of Microbiology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, Scotland, UK
| | - A. S. PALMER
- Gastrointestinal and Zoonoses Section, Health Protection Scotland, Glasgow, Scotland, UK
| | - B. L. JONES
- Scottish Parasite Diagnostic and Reference Laboratory, Glasgow, Scotland, UK
| | - C. L. ALEXANDER
- Scottish Parasite Diagnostic and Reference Laboratory, Glasgow, Scotland, UK
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Pathogens of Food Animals: Sources, Characteristics, Human Risk, and Methods of Detection. ADVANCES IN FOOD AND NUTRITION RESEARCH 2017; 82:277-365. [PMID: 28427535 DOI: 10.1016/bs.afnr.2016.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Pathogens associated with food production (livestock) animals come in many forms causing a multitude of disease for humans. For the purpose of this review, these infectious agents can be divided into three broad categories: those that are associated with bacterial disease, those that are associated with viruses, and those that are parasitic in nature. The goal of this chapter is to provide the reader with an overview of the most common pathogens that cause disease in humans through exposure via the food chain and the consequence of this exposure as well as risk and detection methods. We have also included a collection of unusual pathogens that although rare have still caused disease, and their recognition is warranted in light of emerging and reemerging diseases. These provide the reader an understanding of where the next big outbreak could occur. The influence of the global economy, the movement of people, and food makes understanding production animal-associated disease paramount to being able to address new diseases as they arise.
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