Diagnostic performance of direct wet mount microscopy in detecting intestinal helminths among pregnant women attending ante-natal care (ANC) in East Wollega, Oromia, Ethiopia

Schistosoma mansoni and soil-transmitted helminth infections among schoolchildren living along the shore of Lake Hawassa, southern Ethiopia

BACKGROUND

Schistosoma mansoni and soil-transmitted helminth (STH) infections are major public health problems in areas with poor sanitation and limited access to water. In Ethiopia, there is limited data available for monitoring the efficacy of interventions aimed at reducing helminth infections. Therefore, we assessed the prevalence of S. mansoni and STH infections, as well as factors associated with this prevalence, among schoolchildren and compared the findings with those of earlier studies. We also evaluated the diagnostic agreement between two parasitological methods.

METHODS

A cross-sectional study involving 363 schoolchildren from three rural primary schools located along the shore of Lake Hawassa, Sidama Regional State, southern Ethiopia, was conducted in October and November 2023. The schoolchildren were selected using a systematic random sampling technique. Socio-demographic data were collected using pre-structured questionnaires. A single stool sample was collected from each study participant and processed using direct wet mount (DM) microscopy and the formol-ether concentration technique (FECT) to detect helminth ova.

RESULTS

The overall prevalence of helminths was 59.8%, with 36.6% of participating children having a single infection and 23.1% having multiple infections. Schistosoma mansoni and STHs were present in 33.9% and 38.8% of children, respectively. The STHs included Ascaris lumbricoides (28.9% of children), Trichuris trichiura (10.7%), hookworms (5.2%) and Strongyloides stercoralis (2.8%). Diagnostic agreement between the DM microscopy method and FECT was substantial [kappa (κ) = 0.710] for the detection of Hymenolepis nana and almost perfect (κ = 0.827) for the dection of A. lumbricoides, but only fair for the detection of other detected helminths. Children at Finchawa primary school had a lower prevalence of S. mansoni infection [adjusted odds ratio (AOR) 0.31; 95% confidence interval (CI) 0.13-0.76] than those at St Paul's Tullo Catholic primary school. STH infections were more common among children who sometimes (vs. always) washed their hands before meals (AOR 1.89; 95% CI 1.01-3.54) and those who regularly played with soil (AOR 2.56; 95% CI 1.47-4.46).

CONCLUSIONS

This study showed a reduction in STH infections from a high prevalence in 2015 to a moderate prevalence at the present time, despite a similar moderate prevalence of S. mansoni infection. Thus, it is crucial to intensify deworming interventions to reduce the burden of helminths in the study area. Additionally, there is a need to enhance the capacity of clinical laboratories to perform FECT in Ethiopian clinical settings where DM is often employed to diagnose helminths.

Evaluation of the diagnostic techniques in the detection of hookworm infestation among school children in Ethiopia: Cross-sectional study design

Background

Hookworm infestation is an important public health concern especially in regions with poor sanitation and limited resources. In healthcare institutions in Ethiopia, wet mount microscopy with low performance has been used as the sole diagnostic technique. Sensitive diagnostic methods are essential for the proper identification of hookworm infection in national strategies for hookworm prevention and management. Thus, the objective of the article was to evaluate the performance of diagnostic techniques in the detection of hookworm infestation among school children in the Gozamin district, Northwest Ethiopia.

Methods

A cross-sectional study with 530 school children was conducted from February to April 2022 in Ethiopia. The study participants were selected by using systematic random sampling technique. Direct wet mount (DWM), Richie's, Kato-Katz (KK), and spontaneous tube sedimentation (STS) diagnostic techniques were utilized to process the stool samples. The data were entered into the Epi-data version 4.2 and the data was analyzed using SPSS version 25.0. The sensitivity, specificity, predictive values and test efficiency of the test were calculated with respect to the Composite Reference Standard (CRS) as the reference method. The degree of agreement with the methods of diagnosis was assessed by the Kappa value.

Results

The overall prevalence of hookworm was 34.9 %. The detection rate of STS, Richie's, KK and DWM techniques in hookworm detection was 30.2 %, 27.0 %, 22.3 % and 15.1 %, respectively. The sensitivity and test efficiency of STS to detect hookworm were 86.5 % and 95.3 %, for Richie's 77.3 % and 92.1 %, for KK 63.8 % and 87.4 %, for DWM method 43.2 % and 80.2 %, respectively. The agreement of STS, Richie's, KK and DWM techniques with CRS were perfect (κ = 0.893), perfect (κ = 0.816), substantial (κ = 0.696) and moderate (κ = 0.498), respectively in detecting hookworm parasites.

Conclusion

The prevalence of hookworm among school children was high. The STS method is superior to other methods for detecting hookworm infections. The Richie's technique was more successful in detecting the hookworm parasite than the KK and DWM techniques. It is important to implement the STS technique in routine diagnostic methods and in endemic areas of hookworm infection because it cheaper, easy to perform, and identifies a wide range of parasitic species.

The burden and trend of intestinal parasitosis among women at Berekum, Ghana: a 9-year retrospective study

BACKGROUND

Intestinal parasitic infections (IPIs) are serious global public health issues, especially in low and middle-income countries. These parasites can cause high morbidity and mortality, especially in immunocompromised individuals, and can easily be transmitted by consumption of contaminated food or water or by penetration of skin and mucous membranes.

METHODS

We retrospectively analyzed all archived data from stool examination reports at the Parasitology Unit of Precise Health Diagnostic Services, Berekum for the prevalence and trends of parasitic infections spanning a period of 9 years (2013-2021). The data was retrieved and exported to IBM SPSS v.26 for statistical analysis. Descriptive data was summarized as proportions and presented in tables and charts. Pearson Chi-Square test (χ2) or Fisher's exact test was used to test for a statistical association between demographic factors and intestinal parasitic infections. P value was significant at < 0.05.

RESULTS

A total of 9,217 records of stool examinations were retrieved. Almost half (48.45%) of the data were from patients aged between 20 and 29 years. An overall prevalence of intestinal parasitic infections of 21.20% was observed in this study. Patients aged 70 to 79 had the highest prevalence of the IPIs (44.44%). The parasites recovered in this study were intestinal flagellates, Entamoeba coli, Hookworm, Entamoeba histolytica/dispar, Ascaris lumbricoides, Enterobius vermicularis, Strongyloides stercoralis and Hymenolepis nana. The intestinal flagellates had the highest prevalence (98.31%) compared to the other intestinal parasites recovered. Intestinal parasitic infections had the highest prevalence in the year 2020 (28.56%) and lowest in 2018 (11.78%).

CONCLUSION

An overall prevalence of 21.20% of intestinal parasitic infection was found. The majority of the parasites reported were intestinal flagellates (98.31%). The trend analysis revealed that the overall prevalence fluctuated across the entire period from 2013 to 2021.

Prevalence of intestinal parasites in Erbil, Iraq

Background

Infections with intestinal parasites are the major cause of infectious disease globally and have been described as a public health issue in developing countries.

Objective

This study aimed to determine prevalence of intestinal parasitic infections and their associated factors among the population of Erbil province in Iraq over the period 2011-2021.

Methods

The results of 614455 stool examinations of all public health facilities of the province were collected from the register in the directorate of preventive health affairs and the data were analyzed.

Result

The overall prevalence of intestinal parasitic infections was 4.24 % in the province. The total number of reported cases of intestinal parasites decreased from 4352 for 2011 to 1728 for 2018 and then increased to 2014 cases for 2021. Nearly half of the intestinal parasitic infections were detected among age group of 15 to 44 years. The prevalence of intestinal parasitic infections was higher in males (65.73 %) than females (34.27 %). The prevalence of intestinal parasitic infections was 9 0.47 % for protozoan infections, while the rate of helminth infection was lower (9 .53 %). Entamoeba histolytica/dispar were the most common parasite (60.92 %) followed by Giardia lamblia (29.54 %) and Enterobius vermicularis (8.56 %). Prevalence of infection with intestinal parasites was lowest in March and highest in February.

Conclusion

In spite of that intestinal parasitic infection rates appear to be decreasing, intestinal parasitic infection remains an important health problem in the province. Therefore, there is still a need for prevention efforts in the community.

Design of a Protocol for Soil-Transmitted Helminths (in Light of the Nematode Toxocara canis) DNA Extraction from Feces by Combining Commercially Available Solutions

One of the main challenges for the mass introduction of the molecular diagnostics of soil-transmitted helminths (STHs) into clinical practice is the lack of a generally recognized effective method for isolating parasitic DNA from fecal samples. In the present study, we assessed the effects of various pretreatment procedures on the efficiency of removing PCR inhibitors and extracting Toxocara canis DNA from feces. We evaluated the effectiveness of four destructive methods (bead beating, the action of temperature-dependent enzymes, freeze-heat cycles, and incubation in a lysis buffer) on the integrity of T. canis eggs and the efficiency of DNA extraction. Also, we evaluated the effects of prewashes and the use of commercial concentrators on DNA extraction from fecal samples contaminated with T. canis eggs. A bead beating procedure was sufficient to destroy the T. canis eggs, while the effects of enzymes and freeze-heat cycles did not lead to a significant destruction of the eggs or the release of Toxocara DNA. Helminth DNA isolation protocols that do not include a bead beating step are not preferred. The preconcentration of STH eggs from feces using a commercial concentrator and subsequent washing can significantly increase the yield of DNA from STHs and reduce PCR inhibition.

Investigation of intestinal parasites by conventional and molecular methods in children with gastrointestinal system complaints

Intestinal parasitic infections are a global health problem that causes morbidity and mortality, especially in children living in rural areas. In this study, stool samples of pediatric patients with gastrointestinal complaints were examined by conventional and molecular methods to determine the prevalence of intestinal parasites. A total of 100 pediatric patients with gastrointestinal complaints and 50 healthy children were included in the study. Stool samples were collected from each child and examined by direct microscopic examination (native-Lugol method), formol-ethyl acetate concentration technique, Kinyoun's acid-fast staining, and Wheatley trichrome staining methods. Real-time PCR was used for the detection of Blastocystis spp. and D. fragilis in the stool samples. Sanger sequencing was used to identify Blastocystis spp. subtypes. One or more intestinal parasites were found in 12% (n = 100) of the patient group and 1% (n = 50) of the control group using conventional techniques. By using real-time PCR, Blastocystis spp. was discovered in 14% (14/100) of the patient group and 8% (4/50) of the control group. There was no significant difference in the frequency of Blastocystis spp. between the two groups. The most prevalent Blastocystis subtype was ST1 and the most frequent allele was a2 among the samples successfully amplified and sequenced. D. fragilis was detected in 17% (17/100) of the patient group and 8% (4/50) of the control group by real-time PCR. The prevalence of D. fragilis was not significantly different between the patient and control groups, as well. Blastocystis spp. and D. fragilis were found in high prevalence in pediatric patients with gastrointestinal complaints in this study. Although the role of these protists as a pathogen in humans is still controversial, it is supposed to the presence of the parasites are associated with gastrointestinal disorders such as diarrhea, abdominal pain, nausea, and vomiting. More case-control studies are needed to understand the pathogenic or commensal role of these parasites on the intestinal microbiota, especially in both patients with gastrointestinal disorders and healthy individuals.

Advantages and Limitations of Microscopy and Molecular Detections for Diagnosis of Soil-transmitted Helminths: An Overview

World Health Organization (WHO) reported that over 1.5 billion people are infected by soil-transmitted helminths (STH) worldwide in sub-Saharan Africa, the United States of America, China, and East Asia. Heavy infections and polyparasitism are associated with higher morbidity rates, and the patients are exposed to increased vulnerability to other diseases. Therefore, accurate diagnosis followed by mass treatment for morbidity control is necessary.STH diagnosis commonly involves the microscopic observation of the presence of the STH eggs and larvae in the faecal samples. Furthermore, molecular approaches are increasingly utilised in monitoring and surveillance as they show higher sensitivity. Their capability to differentiate hookworm species is an advantage over the Kato-Katz technique. This review discusses the advantages and limitations of microscopy and various molecular tools used for STH detection.

Comparison of Intestinal Parasites in Native and Refugee Patients Admitted to a Territory Hospital in Turkey

OBJECTIVE

This study aimed to evaluate the distribution of intestinal parasites in refugee and native patients who applied to a territory hospital in Turkey.

METHODS

A total of 17911 patients who were admitted to our hospital between January 2018 and January 2019 were evaluated retrospectively in terms of intestinal parasites. The patients' stool samples were investigated for the existence of intestinal parasites by direct wet mount preparation, formalin ether concentration technique and cellophane tape method. The data obtained were compared between patient groups according to the examination method.

RESULTS

The overall prevalence of E. vermicularis in refugee children was found twice higher than that in native patients and the most common symptom was abdominal pain in these patients. Intestinal parasite detection rates were significantly higher in the stool concentration method than in the direct wet mount examination. Cutaneous complaints and protein energy malnutrition/growth retardation were the most common clinical conditions besides gastrointestinal symptoms in patients with intestinal parasitosis.

CONCLUSION

In our study, the prevalence of Blastocystis sp. in refugees was found to be higher than in the normal population. Intestinal parasitic infections should be investigated with proper diagnostic methods especially in children with PEM/GR and cutaneous symptoms in addition to gastrointestinal problems.

Modified Nonnutrient Agar Plate Culture for the Diagnosis of Strongyloides stercoralis and Hookworm Infections in La-Ngu District, Satun Province, Southern Thailand

Due to the low prevalence and light intensity of Strongyloides stercoralis (S. stercoralis, Ss) and hookworm (HW) in Thailand, an increase in the efficacy of detection with the appropriate diagnosis is needed. This cross-sectional survey is aimed at using modified nonnutrient agar plate culture (mNNAPC) to assess the prevalence of S. stercoralis and hookworm infections and to report intestinal parasitic infections in La-Ngu villagers, Satun Province in Southern Thailand. We used wet smear, modified Harada-Mori filter paper culture (mHMFPC), and mNNAPC to investigate 204 villagers (4 villages) between August 2016 and January 2017. The combination of mHMFPC and mNNAPC raised the prevalence of S. stercoralis and hookworm infections among the study population from 3.4% and 1.0% to 6.9% and 2.5%, respectively. There were no significant differences between demographic characteristics and these infections (p < 0.05). Three types of protozoal infections, Blastocystis spp. (2.9%), Entamoeba histolytica-like (0.5%), and Giardia duodenalis (0.5%), and 3 species of helminthic infections, S. stercoralis (6.9%) (14 cases), hookworm 2.5%, and Enterobius vermicularis 0.5%, were demonstrated in this area. The mNNAPC showed the highest efficacy in detecting both parasites (Ss 92.9% and HW 80%), whereas the wet smear detected none.

Comparison of Molecular and Parasitological Methods for Diagnosis of Human Trichostrongylosis

Human trichostrongyliasis is a zoonotic disease that is prevalent among rural populations in some countries. This study was performed to evaluate various parasitological methods and polymerase chain reaction (PCR) for the diagnosis of human trichostrongyliasis. A total of 206 fresh stool samples were collected from residents of endemic villages of Northern Iran. All samples were examined using conventional parasitological methods, including wet mount, formalin ethyl acetate concentration (FEAC), agar plate culture (APC), Harada-Mori culture (HMC), and Willis, along with the PCR technique. Among the total of 206 individuals examined, 72 people (35%) were found infected with Trichostrongylus species using combined parasitological methods. By considering the combined results of parasitological methods as the diagnostic gold standard, the Willis technique had a sensitivity of 91.7% compared with 52.8% for the APC, 40.3% for the HMC, 37.5% for FEAC, and 5.6% for the wet mount technique. The diagnostic specificity of all the parasitological methods was 100%. Furthermore, the PCR method detected Trichostrongylus spp. DNA in 79 fecal samples (38.3%) with a sensitivity of 97.2% and a specificity of 93.3%. According to the current findings, the Willis method was more sensitive than are the other parasitological methods in the diagnosis of human trichostrongyliasis. However, the PCR assay was more sensitive and more reliable in the detection of human trichostrongyliasis in comparison with the parasitological methods.

Prevalence and risk factors of human Balantidium coli infection and its association with haematological and biochemical parameters in Ga West Municipality, Ghana

Background

In Ghana, Balantidium coli (B. coli) has been identified in vegetables and in pigs, although there is a paucity of data regarding human balantidiosis. This study sought to assess human B. coli infection in Ghana, factors associated with the infection as well as its association with haematological and biochemical parameters.

Methods

Two pig rearing communities in the Ga West Municipality, Ghana, were involved in this study. Stool and blood samples were collected from pig farmers and their exposed household members as well as relevant information on potential associated factors. Eosin-saline wet preparation was done on the same day of stool samples were collected while formol ether concentration technique was performed later. Haematological, biochemical parameters and serum electrolytes were determined using Celltac MEK-6500 K, PKL-125 biochemical analyser, and FT-320 electrolyte analyser, respectively.

Results

The overall prevalence of balantidiosis was 10.4 %, significantly higher among farmers (21.7 %) than in exposed household members (5.8 %) (x² = 17.8, p = 0.000025). Of the 43 infected individuals, 20.9 % were co-infected with either Entamoeba histolytica, Giardia lamblia, or Schistosoma mansoni. In B. coli infection, mild to moderate anaemia together with a reduction in levels of platelet, albumin and, sodium, chloride, and bicarbonate ions were observed. However, white blood cells were significantly elevated in infected states. Poor farming practices such as free-range systems, improper disposal of pig faeces, lack of use of protective farming clothing, and unavailability of dedicated farming clothing were found to be associated with B. coli infection status. Finally, frequent diarrhea (OR = 12.30, p = 0.006) with occult blood (OR = 25.94, p < 0.0001) were found to be predictors of B. coli infection.

Conclusions

Human balantidiosis is endemic in Ga West Municipality, Ghana. Individuals living closed to pig rearing communities presenting with frequent diarrhea with occult blood in stool should be screened and treated for balantidiosis to mitigate the clinical consequences of the infection.

Intestinal parasitic infections and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Intestinal parasitic infections (IPIs) are public health problems widely distributed in the world and cause significant morbidity and mortality; many of which occur among women of reproductive age. IPIs caused by helminthes and protozoan parasites are common among pregnant women. Data on the national pooled prevalence of intestinal parasites and associated factors during pregnancy is not documented well in Ethiopia. This review aims at summarizing evidences on the burden of IPIs and associated factors among pregnant women in Ethiopia.

METHODS

Published and unpublished studies were thoroughly searched at MEDLINE/PubMed, EMBASE, Google Scholar, CINAHL, Cochrane library and Science Direct. In addition, repositories of Addis Ababa, Gondar and Jimma Universities were searched. Eligible studies were selected following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. The pooled prevalence of intestinal parasites and summary odds ratios (ORs) were determined with 95 % confidence intervals (CI). Sub-groups analyses were done based on study region, types of parasites, methods of stool examination and study setting. The statistical analyses were performed using STATA version 14.0 software.

RESULTS

Among 168 retrieved studies, 31 studies with a total population of 12,118 pregnant women were included. The estimated pooled prevalence of IPIs among pregnant women in Ethiopia was 27.32 % (95 % CI: 20.61, 33.87 %). In the subgroup analysis, Oromia and Amhara regions had the highest prevalence with a 29.78 % (95 % CI: 15.97, 43.60) and 29.63 % (95 % CI: 15.37, 43.89); respectively. In addition, studies conducted in the community showed higher prevalence than institution based studies (49.93 % Vs 24.84 %; respectively). The most prevalent type of intestinal parasite identified were Hookworm followed by Ascaris lumbricoides with a pooled prevalence of 11.2 and 10.34 %, respectively. In our analysis; residence, being bare footed, lack of hand washing habit and eating uncooked/raw vegetables were significantly associated with IPIs among pregnant women in Ethiopia.

CONCLUSIONS

Prevalence of IPIs during pregnancy is relatively high in Ethiopia. Poor hygienic practices were identified as risk factors. Based on our finding, targeted preventive measures shall be considered so as to prevent morbidity and mortality due to IPIs.

Burden of intestinal parasitic infections among pregnant women in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Comprehensive nationwide data on prevalence and distribution of intestinal parasites (IPIs) among pregnant women are lacking. Therefore, the aim of this study was to provide pooled prevalence estimate, prevalence in different regions and species-specific IPIs among pregnant women in Ethiopia.

METHODS

The search was carried out in Medline via PubMed, Scopus, Science Direct, Web of Science and Google Scholar on published and unpublished data between 2008 and Sep 2020 for studies describing rate of IPIs among pregnant women in Ethiopian. A random-effects model and forest plots to estimate pooled effect size and effect of each study with their confidence interval (CI) were used to provide a visual summary of the data. We conducted meta-regression to understand the source of heterogeneity and pooled the prevalence using 'metaprop' command using STATA software version 14.

RESULTS

A total of 3149 of the 9803 pregnant women were infected with one or more species of IPIs resulted in an overall prevalence of 29% (95% CI 22-37%). The prevalence estimate varied among studies with considerable heterogeneity (χ² = 2069.19, p < 0.001 I² = 98.84). The prevalence of IPIs was 36% (95% CI 22-50%) in Oromia region, 29% (95% CI 10-47%) in Amhara region, 24% (95% CI 17-32%) in southern nation, nationality and people region, 24% (95% CI 22-27%) in Tigray region and 24% (95% CI 20-29%) in Addis Ababa city. Hookworms with pooled prevalence estimate of 10% (95% CI 8-13%) followed by Ascaris lumbricoides 10% (95% CI 7-13%), and Entamoeba histolytica/dispar 6% (95% CI 4-8%) were the three common species of IPIs identified in this group of population.

CONCLUSION

The prevalence of IPIs among pregnant women is relatively high in comparison to other general population. Hookworms and Ascaris lumbricoides were the most dominant species of intestinal helminths, whereas Entamoeba histolytica/dispar was the dominant intestinal protozoa among pregnant women in Ethiopia.

Evaluation of Hookworm Diagnosis Techniques from Patients in Debre Elias and Sanja Districts of the Amhara Region, Ethiopia

BACKGROUND

Inappropriate diagnosis could intimidate the prevention and control of hookworm infection. Thus, this study was aimed at evaluating the performance of hookworm diagnosis methods.

METHODS

An institution-based cross-sectional study was conducted from patients in Debre Elias and Sanja districts of the Amhara region, Ethiopia, from November 2019 to January 2020. The study subjects were selected conveniently. After the data was entered into Statistical Package for the Social Sciences (SPSS), sensitivity, specificity, predictive values, test accuracy, and agreement of the different hookworm diagnosis methods, namely, test tube flotation technique (TFT), McMaster (MM), formol-ether concentration (FEC), Kato-Katz (KK), and direct wet mount microscopy (DWMM), were calculated by using SPSS software. The composite reference standard (CRS) was used as the gold standard method. The kappa (κ) test was used to measure the level of agreement between diagnosis tests.

RESULT

A total of 389 stool samples were collected from patients in the study. The overall prevalence of hookworm was 63.24%. The test tube flotation technique (TFT) was found to be the highest both in terms of sensitivity and diagnostic accuracy (100%). McMaster (MM) was the second most sensitive test (68.7%), followed by FEC (44.3%) and KK (38.2%). On the other hand, DWMM had the lowest sensitivity (37.4%), and its diagnostic accuracy was also the least (60%). Only TFT had a perfect agreement (agreement = 100%, kappa = 1) with the CRS. The sensitivity of DWMM, KK, and FEC showed a kind of linear function with the intensity of infection, but TFT and MM methods were not affected by the infection intensity.

CONCLUSION

Hookworm is still a public health problem in the study area. TFT is by far more sensitive than MM, FEC, KK, and DWMM techniques.

Prevalence of cryptosporidiosis among children with diarrhoea under five years admitted to Kosti teaching hospital, Kosti City, Sudan

Background

Cryptosporidiosis is a disease caused by infection with an intestinal coccidian parasite Cryptosporidium. Cryptosporidium species are the second leading cause of diarrheal disease and death in children in developing countries. Until now, no data have been available or published on its prevalence among children with diarrhea in Sudan. Therefore, this paper was designed to determine the prevalence rate of Cryptosporidium among children with diarrhea under 5 years who were admitted to Kosti Teaching Hospital.

Methods

A hospital-based cross-sectional study including children under 5 years old admitted to the pediatric section of the hospital between September 2020 and December 2020. A total of one-hundred and fifty stool samples were collected. All stool samples were examined using the modified Ziehl Neelsen (mZN) staining technique and then examined microscopically for Cryptosporidium infection.

Results

A total of 150 children were examined out of which 70 presented with diarrhea. A greater prevalence of 19/70 (27.1%) of Cryptosporidium was observed in children with diarrhea than children without diarrhea 7/80 (8.8%). There was a significant relationship between the prevalence of Cryptosporidium and the presence of diarrhea in children under 5 years in the Kosti Teaching Hospital(P < 0.05). It was found that a higher prevalence was registered among children using piped-water sources for drinking.

Conclusions

The overall prevalence of parasite detected was 17.3% among children admitted to Kosti Teaching Hospital. The prevalence rate of the infection among Children with diarrhoea was 27.1%. Studying the prevalence rate of cryptosporidiosis among diarrheic children may predict their health status, leading to a better diagnosis, treatment, and, therefore, patients’ status improvement.

Evaluation of Wet Mount and Concentration Techniques of Stool Examination for Intestinal Parasites Identification at Debre Markos Comprehensive Specialized Hospital, Ethiopia

Background

Intestinal parasitic infection has serious medical and public health impacts in developing countries. Intestinal parasites were under reported via direct wet mount method due to its poor sensitivity. So, the selection of a more sensitive and reliable diagnostic method is essential.

Objective

The aim of the study was to evaluate the diagnostic performance of wet mount and concentration techniques of stool examination for intestinal parasites identification.

Methods

A cross-sectional study among 797 pregnant women was conducted from October 2018 to February 2019 at Debre Markos Comprehensive Specialized Hospital. The study participants were selected by using a systematic random sampling technique. Stool sample was processed by using Wet Mount (WM) and Formol-Ether Concentration (FEC) techniques. Data was entered into Epi-data version 3.1 and analysis using SPSS version 20.0. The sensitivity, specificity, positive predictive value, and negative predictive value were determined against the combined result as “Gold” standard. Kappa value was determined to estimate the agreement of the diagnostic methods.

Results

The overall prevalence of intestinal parasites (IP) was 35.2% with a combined method. By using WM and FEC the prevalence of IP was 13.1% and 25.7%, respectively. The sensitivity and negative predictive value of WM method were 37.1% and 74.6%, and for FEC method 73.5% and 87.5%, respectively. Test efficiency of direct WM and FEC were 77.9% and 90.7%, respectively. The agreement of WM and FEC techniques with combined technique were moderate (κ=0.434) and perfect (κ=0.783), respectively.

Conclusion

The prevalence of intestinal parasites was under-reported by wet mount technique. The diagnostic performance of FEC technique for the diagnosis of intestinal parasites in pregnant women was notably high as compared to WM technique in the present study. Therefore, the WM and FEC combined method should be used as a routine diagnostic technique for the diagnosis of intestinal parasites identification.

Inverse association between dengue, chikungunya, and Zika virus infection and indicators of household air pollution in Santa Rosa, Guatemala: A case-control study, 2011-2018

BACKGROUND

Dengue, chikungunya, and Zika viruses are increasingly important public health problems. Burning vegetation, leaves, and other plant products have been shown to be effective mosquito repellents for their vector, Aedes spp., but there has been scant research on whether firewood cooking smoke in households influences mosquito populations or mosquito-borne diseases. About 2.9 billion people worldwide use biomass fuel for household cooking and heating, resulting in an estimated 1.6 million deaths annually from household air pollution (HAP)-related diseases. Global health agencies now encourage households to transition from biomass to clean fuels, but it is unclear whether such interventions may actually increase risk for mosquito-borne diseases. This retrospective case-control study evaluated associations between arboviral infections and cooking with firewood in Santa Rosa, Guatemala.

METHOD

Vigilancia Integrada Comunitaria (VICo) was a prospective public health surveillance system for bacterial, parasitic, and viral causes of diarrheal, neurological, respiratory, and febrile illnesses in hospitals and clinics in the department of Santa Rosa, Guatemala. Enrolled VICo in-patients and out-patients during 2011-2018 were interviewed using standardized questionnaires on demographics and household characteristics. Blood and stool specimens were collected and tested to identify the etiologies presenting symptoms. Cases were defined as laboratory-positive for dengue, chikungunya, or Zika virus infections. Controls were laboratory-positive for bacterial and viral diarrheal illnesses (e.g., Salmonella, Shigella, Campylobacter, Escherichia coli, rotavirus, norovirus, sapovirus, or astrovirus). Cooking with firewood, kitchen location, stove type, and firewood cooking frequency were the independent exposure variables. Logistic regression models were used to analyze unadjusted and adjusted associations between arboviral infections and exposures of interest.

RESULT

There were 311 arboviral cases and 1,239 diarrheal controls. Arboviral infections were inversely associated with cooking with firewood in the main house (AOR: 0.22; 95% CI: 0.08-0.57), cooking with firewood on an open hearth (AOR: 0.50; 95% CI: 0.33-0.78), and cooking with firewood ≥5 times per week (AOR: 0.54; 95% CI: 0.36-0.81), adjusting for age, sex, ethnicity, socioeconomic status index, number of people per household, community population density, community elevation, recruitment location, season, and admission year.

CONCLUSION

Several primary determinants of HAP exposure were inversely associated with arboviral infections. Additional studies are needed to understand whether interventions to reduce HAP might actually increase risk for mosquito-borne infectious diseases, which would warrant improved education and mosquito control efforts in conjunction with fuel interventions.

Intestinal parasitic infections and associated factors among mentally disabled and non-disabled primary school students, Bahir Dar, Amhara regional state, Ethiopia, 2018: a comparative cross-sectional study

Background

Intestinal parasitic infections are still common in low-income countries including Ethiopia, particularly in children due to low-quality drinking water, poor personal and environmental sanitation. Disabled individuals are excluded from most academic, economic, social and cultural opportunities, they are among the poorest and most marginalized of the whole world’s people.

The aim of this study was to assess the prevalence of intestinal parasitic infections and associated factors among mentally disabled and non-disabled students at primary schools in Bahir Dar city, Amhara regional state, Ethiopia, 2018.

Methods

A school-based Comparative cross-sectional study design was conducted from November 1–30, 2018. A total of 418 study participants, 104 mentally disabled and 314 non-disabled students were recruited through a simple random sampling technique. The collected data were coded, entered and cleaned with EpiData version 3.1 and analyzed using SPSS version 23. Multivariable logistic regression was conducted to identify factors associated with intestinal parasitic infections. The adjusted odds ratio with a 95% Confidence interval at a 5% level of significance was used to measure the strength of association.

Results

The mean age of study participants was 14.05 ± 3.66 and 11.96 ± 2.94 for mentally disabled students and non-disabled students. Prevalence of parasitic infection was 56.70% (n = 59) for mentally disabled students whereas 41.10%(n = 129) for non-disabled students. Unclean fingernails [AOR = 2.42; 1.40,4.17], health checkups [AOR = 1.87;1.16,3.02], hand washing with water only [AOR = 2.48; 1.49,4.12], cooking and sanitation source of water [AOR = 4.40;2.32,8.36], Grade [ (1–4)] [AOR = 2.27;1.41,3.67], sex [AOR = 1.64;1.03,2.63] and Family size> = 7 [AOR = 2.74;1.25,5.99] were variables which showed statistically significant association with intestinal parasitic infections.

Conclusion

The prevalence of intestinal parasitic infection was higher among mentally disabled students than non-disabled students. Unclean fingernails, health checkups, hand washing habits, source of water, family size, sex and Grade of students have had a statistically significant association with intestinal parasitic infections. Periodic medicinal treatment was needed twice a year for mentally disabled and once a year for non-disabled students.

Electronic supplementary material

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Modified Harada-Mori and simple wet mount to determine hookworm infections in Yo Island urban area, Songkhla, Southern Thailand

BACKGROUND

Hookworm was a previously dominant parasitic infection in Southern Thailand. The changing population to an aging society in Yo Island has never been investigated for intestinal parasites. This study aimed to estimate the prevalence of hookworm and intestinal parasitic infections on Yo Island, a small island in Songkhla Province of southern Thailand.

METHODS

A cross-sectional study was conducted among volunteers aged 15 and above to give one stool sample that was screened by wet mount for intestinal parasites and the modified Harada-Mori culture (mHMFPC) which is adapted from HMFPC, using local plastic bag containers instead of test tubes for hookworm detection.

RESULTS

Two hundred forty-seven volunteers (females = 160) gave one stool. The highest participation was in age group higher than 60 years. Most were Buddhism (89.1%), agriculturist (71.4%), non-education (87.9%), and income lower than 9000 baht (50.2%). The prevalence of intestinal parasites was 13/247 (5.3%) of which 6/247 (2.4%) were positive for hookworm species Necator americanus. One volunteer was coinfected with hookworm and Strongyloides stercoralis and another with Endolimax nana and Blastocystis hominis. The mHMFPC detected more positive stool samples than wet mount and wet mount: 5 vs. 2.

CONCLUSIONS

Parasite prevalence was low in this urban community of mostly low-income village dwellers. The mHMFPC appeared better at detecting hookworm but numbers were small. Combined techniques are suitable for field use.

Hymenolepiasis in a Pregnant Woman: A Case Report of Hymenolepis nana Infection

Hymenolepiasis is an infection caused by Hymenolepis nana (H. nana) and H. diminuta (H. diminuta). Hymenolepiasis is prevalent throughout the world with human infections with H. nana being frequently reported in the literature as compared to H. diminuta. Hymenolepiasis is more frequent among children, and most human infections remain asymptomatic and self-limited. Symptoms including abdominal pain, diarrhea, and vomiting are frequently noted in the cases of heavy infections. We report a case of hymenolepiasis caused by H. nana in a pregnant woman.