Prevalence of intestinal opportunistic parasites infections in the University hospital of Bobo-Dioulasso, Burkina Faso

Intestinal Protozoa, Helminth Infection, and Associated Factors among Tuberculosis Patients and Nontuberculosis Persons in Bobo-Dioulasso City, Burkina Faso

We report the frequency and associated factors of tuberculosis (TB) and parasite coinfection from newly diagnosed pulmonary TB patients (TB+) and non-TB participants (TB-) from the Regional Tuberculosis Control Center, households, and health facilities in Bobo-Dioulasso from 2019 to 2021. Biological samples were examined for parasite infection using direct microscopy, concentration techniques, and the immunochromatographic rapid test. Data were analyzed using STATA 14. Of a total of 192 participants involved, 95 were TB+ and 97 were non-TB. There was no statistically significant difference in parasitic infections between the two groups, although it was higher in TB+ than TB- (69.5% [66/95] versus 55.7% [54/97]; P = 0.07). Protozoal infection prevalence was significantly higher in patients with TB+ than in those TB- (61.1% versus 37.1%; P = 0.001). Specifically, Entamoeba spp. and Cryptosporidium spp. followed this pattern with 35.8% versus 19.6% (P = 0.01) and 22.1% versus 8.3% (P = 0.007), respectively. Although higher in TB+ patients, helminthiasis frequency was not significantly different between the two groups (23.2% versus 15.5%; P = 0.2). Helminth species were Schistosomia mansoni (17.9% versus 12.4%), Dicrocoelium dendriticum (3.2% versus 1.0%), Enterobius vermicularis (2.1% versus 2.1%), Wuchereria bancrofti (1.1% versus 0.0%), and Hymenolepis nana (1.1% versus 0.0%). Illiteracy (adjusted odds ratio [aOR]: 2.5; 95% CI: 1.0-6.1), smoking (aOR: 2.4; 95% CI: 1.1-5.3), and handwashing after defecation (aOR: 2.4; 95% CI: 1.2-4.7) were associated with parasites. This study reported a high frequency of parasite coinfection in TB patients. These findings suggest the need for adequate health education for behavioral change and systematic diagnosing of parasites in TB patients for better coinfection management.

Cryptosporidium spp. prevalence in the general population in Guinea: first large-scale screening study

Cryptosporidium is a leading cause of diarrheal mortality in children in Africa and Asia. Despite the public health significance of this parasite, its molecular epidemiology and circulation in Guinea remain poorly understood. Therefore, this study aimed to determine the prevalence and genotype distribution of Cryptosporidium in the Guinean general population. To achieve this, fecal samples were collected from 834 individuals, both with and without digestive disorders, at two hospitals in Conakry. The presence of the parasite in the stool samples was detected using nested PCR targeting the SSU rDNA gene, followed by sequencing of the PCR products for genotyping of the isolates. The PCR-based prevalence was 0.12% for the whole cohort, and 0.2% among adults. The low frequency of Cryptosporidium observed in the current study is thus consistent with the prevalence of this parasite already reported in certain other African countries. The species identified in the positive samples was Cryptosporidium hominis. This study is the first to report the prevalence of Cryptosporidium in the general population of Guinea. Given the potential of this parasite to cause life-threatening diarrhea, further studies are needed to clarify the epidemiology of Cryptosporidium in this country.

Immunological and Haematological Relevance of Helminths and Mycobacterium tuberculosis Complex Coinfection among Newly Diagnosed Pulmonary Tuberculosis Patients from Bobo-Dioulasso, Burkina Faso

The effect of helminthiasis on host immunity is a neglected area of research, particularly in tuberculosis (TB) infection. This study aimed to evaluate the effect of helminthiasis on immunological and haematological parameters in newly diagnosed TB patients in Bobo-Dioulasso. After all biological analyses, we formed three subpopulations: group 1 (n = 82), as control, were participants without helminthic or Mycobacterium tuberculosis complex infection (Mtb-/Helm-), group 2 (n = 73) were TB patients without helminthic infection (Mtb+/Helm-), and group 3 (n = 22) were TB patients with helminthic infection (Mtb+/Helm+). The proportion of helminth coinfection was 23.16% (22/95) in TB patients, and Schistosoma mansoni infection was found in 77.3% (17/22) cases of helminthiasis observed in this study. A low CD4 T cell count and a low CD4:CD8 ratio were significantly associated with concomitant infection with helminths and the Mtb complex (Mtb+/Helm+) compared to the other groups (p < 0.05). However, there was no statistically significant difference in the CD8 median among the three participating groups (p > 0.05). Lymphopenia, monocytosis, thrombocytosis, and hypochromic microcytic anaemia were the haematological defects observed in the Mtb+/Helm+ and Mtb+/Helm- patients. Exploring these types of immune-haematological biomarkers would be a valuable aid in diagnosing and a better follow-up and monitoring of the tuberculosis-helminthiasis coinfection.

Prevalence and associated factors of intestinal parasitic infections among HIV clients attending Masaka Regional Referral Hospital, Uganda

Introduction

infection with Human Immune deficiency Virus (HIV) increases the risk of opportunistic infections, which aggravates life-long complications. We report the prevalence and the associated factors of intestinal parasites among HIV infected clients attending anti-retroviral therapy (ART) clinic at Masaka Regional Referral Hospital, in Uganda.

Methods

this was a cross-sectional study that purposefully enrolled 410 HIV infected clients. Stool samples were macroscopically assessed, and analyzed using wet preparations, Formol ether concentration and Modified Ziehl Neelsen (ZN) techniques to identify cysts and ova of intestinal parasites. Further, a questionnaire was used to obtain data on socio-demographic, hygiene and immunologic markers. Logistic regression analysis was used to determine the associated factors of intestinal parasitic infection.

Results

of the 410 adult HIV sero-positive clients enrolled, 58.0% (238/410) were females. Participants mean age was 26.8 years, (range of 18-59 years). The prevalence of intestinal parasites was 49/410 (11.95%; 95% confidence interval: 10.3 - 14.7). Intestinal parasites isolated were Giardia lamblia (N=10, 20.4%), strongloides stercolaris (N=4, 8.2%), and modified ZN showed Cryptosporidium species (N=35, 71.4%). Hand washing, history of not deworming in the previous 1 year, deteriorating HIV clinical stage and unprotected open water sources were the associated factors.

Conclusion

this study reports a high prevalence of opportunistic intestinal parasites. As these are neglected tropical infections, early detection and exploration of the associated factors is key to their proper management.

Updates on the worldwide burden of amoebiasis: A case series and literature review

BACKGROUND

Amoebiasis is an intestinal and tissue parasitic infection caused by the protozoan Entamoeba histolytica. Despite significant medical importance and worldwide dispersion, little is known about the epidemiology and distinct geographical distribution of various clinical forms of amoebiasis in the world. In this study, we present an amoebiasis case series referred to Avicenne Hospital (Bobigny, France) from 2010 to 2022 followed by an overview of the released literature to explore diverse clinico-pathology of amoebiasis and to update the actual epidemiological situation of this parasitosis worldwide.

METHODS

The referred patients underwent a combination of clinical and parasitological examinations and imaging. The study was followed by an overview of released literature performed based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline.

RESULTS

A total of 15 patients with amoebiasis were diagnosed with an average age of 48.5 years old at the occurrence time of infection. Men (78%) were the most affected patients. Most of the cases were reported following a trip to endemic regions, such as Mali, India, Nepal, Algeria, Cameroon or Congo. All of the processed patients exhibited a hepatic amoebiasis. Amoebic abscess was observed in all cases with an average size of 6.3 cm. Of these patients, seven cases (46.7%) benefited from drainage following a risk of rupture or superinfection of the abscess. A compilation of findings extracted from 390 scientific publications via seven major medical databases, allowed us to update the main epidemiological and clinical events that has led to the current worldwide expansion of amoebiasis. We presented a clinical and epidemiological overview of the amoebiasis accompanied with a worldwide illustrative map displaying the current distribution of known amoebiasis foci in each geographical ecozone of Asia, Europe, Africa, Americas, and Australia.

CONCLUSIONS

Although Metropolitan France is not known as an endemic region of amoebiasis, amoebic liver abscess was the most frequent clinical form observed among our 15 patients processed. Most of infected patients had a history of travel to or lived-in endemic areas before arriving in France.

Rejuvenating the human gut microbiome

Industrial advances have caused significant loss of diversity in our gut microbiome, potentially increasing our susceptibility to many diseases. Recently, rewilding the human gut microbiome - that is, bringing it back to an ancestral or preindustrial state (e.g., by transplanting stool material from donors in nonindustrial societies) - has been hotly debated from medical, ethical, and evolutionary perspectives. Here we propose an alternative solution: rejuvenating the human gut microbiome by stool banking and autologous fecal microbiota transplantation, that is, collecting the hosts' stool samples at a younger age when they are at optimal health, and cryopreserving the samples in a stool bank for the hosts' own future use. In this article we discuss the motivation, applications, feasibility, and challenges of this solution.

Prevalence of Giardiasis and Entamoeba Species in Two of the Six Governorates of Kuwait

Intestinal parasitic infections are a global concern owing to elevated rates of morbidity and mortality in many parts of the world. Increased rates of intestinal parasitic infections are observed in developing and low-income countries. In Kuwait, many expatriates and foreigners hail from endemic countries, thus increasing the rate and risk factor of infection. This retrospective study is aimed at assessing the prevalence of Giardia lamblia and Entamoeba sp. in stool samples handled by two of Kuwait's general hospitals during the period from January 2018 to July 2019: Mubarak Al Kabeer (serving Hawalli governorate population) and Aladan hospitals (serving Mubarak Al Kabeer governorate population) serving 27% of total Kuwait population with Kuwaitis making up only 32%. A total of 9,653 samples were tested for consistency and the availability of any parasitic particles using visual, direct wet mount, and concentration method. Statistical analysis was implemented using SPSS statistical program, at p < 0.05. Of all the 9,653 tested stool samples, 74 were positive for G. lamblia or Entamoeba sp. This represented a mere 1% rate of infection and showed no significant correlation to the prevalence of intestinal parasite infections in Kuwait. On the other hand, comparing the rate of infection in different seasons revealed an increased rate of infection during spring compared to other seasons (p = 0.03). Findings revealed low rates of intestinal parasitic infection within the two governorates of Kuwait representing no statistical significance to the distribution of the investigated parasites in Kuwait. This may be attributed to improved living conditions and healthcare. Elevated infection rates in spring in relation to other seasons raised the importance of increasing public awareness during camping season for maintaining proper personal hygiene and waste management to contain and decrease the rate on infection.

Soil-transmitted helminths, intestinal protozoa and Clonorchis sinensis infections in southeast China

BACKGROUND

Extensive parasitic diseases epidemiology in Zhejiang province has not been carried out since the second national survey in 2004. Therefore, dynamics in prevalence and infection pattern of the major intestinal parasites should be explored.

METHODS

The distribution of three parasites including soil-transmitted helminths (STH), intestinal protozoa and C. sinensis in Zhejiang from 2014 to 2015 were explored. Kato-Katz technique was used for STH and C. sinensis detection, whereas transparent adhesive paper anal swab was used for pinworm detection, and iodine smear was used for protozoa detection. A questionnaire survey on alimentary habits and sanitary behaviors was conducted in half of the studied counties.

RESULTS

This study recruited 23,552 participants: 19,935 from rural and 3617 from urban area. Overall prevalence of intestinal helminth infections was 1.80%. In this study, seven helminth species were identified including A. duodenale, N. americanus, Trichuris trichiura, Ascaris lumbricoides, C. sinensis, Fasciolopsis buski and pinworm. The average prevalence of STH infection was 1.71%: 1.94% in rural and 0.44% in urban area. Hookworm was the most prevalent infection at 1.58%: 1.79% in rural and 0.44% in urban area. Prevalence varied considerably in the studied counties. Prevalence was highest in Yongkang county at 10.25%. Only 2.79% of children from rural area were infected with pinworm. A proportion of 0.40% of rural participants were infected with protozoa, whereas Endolimax nana was the most prevalent at 0.23%. C. sinensis showed infection only in one man. Awareness on C. sinensis was 24.47% in rural and 45.96% in urban area, respectively.

CONCLUSIONS

Prevalence of STH and protozoa infections declined considerably whereas C. sinensis infections remained few in Zhejiang province compared with the prevalence reported in previous large scale surveys (19.56% for national STH infection in 2004, 18.66% and 4.57% for provincial STH and protozoa infection, respectively in 1999). The findings of this study showed that hookworm, mainly N. americanus remained a parasitic threat to population health, mainly in the central and western Zhejiang. Therefore, more health education regarding fertilization and farming habits is necessary in rural areas. The awareness concerning hookworm infection should be reinforced.

Prevalence and genetic characteristics of Blastocystis hominis and Cystoisospora belli in HIV/AIDS patients in Guangxi Zhuang Autonomous Region, China

Blastocystis hominis and Cystoisospora belli are considered to be common opportunistic intestinal protozoa in HIV/AIDS patients. In order to investigate the prevalence and genetic characteristics of B. hominis and C. belli in HIV/AIDS patients, a total of 285 faecal samples were individually collected from HIV/AIDS patients in Guangxi, China. B. hominis and C. belli were investigated by amplifying the barcode region of the SSU rRNA gene and the internal transcribed spacer 1 (ITS-1) region of the rRNA gene, respectively. Chi-square test or Fisher’s exact test were conducted to assess the risk factors related to B. hominis and C. belli infection. The prevalence of B. hominis and C. belli was 6.0% (17/285) and 1.1% (3/285) respectively. Four genotypes of B. hominis were detected, with ST3 (n = 8) and ST1 (n = 6) being predominant, followed by ST6 (n = 2) and ST7 (n = 1). Females had a statistically higher prevalence of B. hominis (11.6%) than males (4.2%). The statistical analysis also showed that the prevalence of B. hominis was significantly associated with age group and educational level. Our study provides convincing evidence for the genetic diversity of B. hominis, which indicates its potential zoonotic transmission and is the first report on the molecular characteristics of C. belli in HIV/AIDS patients in China.

Prevalence of intestinal parasitic infections and associated factors among patients attending at Sanja Primary Hospital, Northwest Ethiopia: An institutional-based cross-sectional study

BACKGROUND

Intestinal Parasitic Infections are the most prevalent diseases in the world, predominantly in developing countries. It is estimated that more than two billion people are affected globally, mostly in tropical and sub-tropical parts of the world. Ethiopia is one of the countries in Africa with a high prevalence of intestinal parasites. However, there is a limited study conducted in the study area. Hence, this study was to assess the prevalence and associated factors of intestinal parasitosis among patients attending at Sanja Primary Hospital, Northwest Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted at Sanja Primary Hospital from January 1 to August 20, 2019. Stool samples were collected from 1240 study participants and analyzed by direct wet mount and formal ether concentration techniques. Furthermore, sociodemographic and explanatory variables were collected using a face-to-face interview. Data were entered into Epi data version 4.4.2.1 and transferred to SPSS version 23 for analysis. Bivariate and multivariate binary logistic regression models were fitted to identify associated factors of intestinal parasitic infections. Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) was considered to ascertain the significance of the association.

RESULTS

The overall prevalence of intestinal parasitic infection was 52.9% (95% CI: 50.2%-55.5%). Entamoeba histolytica/dispar (21.5%) was the leading cause of intestinal parasitosis followed by Hookworm species (13.3%). Furthermore, the rate of double and triple parasitic infections was observed in 6.1% and 0.5% of study participants respectively. Being Illiterate (AOR: 2.87, 95% CI: 1.06-7.47, p = 0.038), swimming habits of more than 4 times a month (AOR = 2.91, 95% CI 1.62-5.24, p< 0.001) and not washing hands before a meal (AOR: 3.92, 95% CI: 1.74-8.83, p = 0.001) were the key factors significantly associated with intestinal parasitic infection.

CONCLUSIONS

The present study showed that the prevalence of intestinal parasitosis is high in the study area. Therefore, there is a need for an integrated control program, including improving personal, environmental sanitation and health education should be given to have a lasting impact on transmission.

Intestinal parasitic infections and associated factors among people living with HIV/AIDS in Ethiopia: A systematic review and meta-analysis

Background

Intestinal parasitic infections are major public health problems throughout the world, particularly in people living with HIV/AIDS. People living with HIV/AIDS are vulnerable groups for a variety of diseases, hence they are easily affected by opportunistic and non-opportunistic intestinal parasites due to the weakening of their immunity. Therefore, this study aimed to estimate the pooled prevalence and factors associated with intestinal parasitic infections among people living with HIV/AIDS in Ethiopia.

Methods

Articles were identified through search engines in the online electronic databases PubMed/MEDLINE, EMBASE, HINARI, CINAHL, Cochrane Library, Google Scholar, and reference lists of previous studies following the PRISMA Protocol. Studies conducted between 2003 and 2020 with English language were included in this study. This review included papers with having high-quality NOS scores. Meta-analysis was computed using STATA version 11 software. Heterogeneity was assessed using the Cochrane Q-test and I² test statistics. Subgroup and sensitivity analysis was employed with evidence of heterogeneity. Publication bias was determined using the funnel plot and Egger’s regression test statistic.

Results

This study included a total of twenty-two cross-sectional studies with 5,833 study participants. The mean age of the study participants was 35 years old. The pooled prevalence of intestinal parasitic infection among people living with HIV/AIDS in Ethiopia was 39.15% (95%CI: 32.34, 45.95). The pooled prevalence of intestinal parasitic infections among people living with HIV/AIDS who had taking ART and who had not to start ART was found to be 28.27% (95%CI 22.47, 34.06) and 41.63% (95%CI: 28.75, 54.52) respectively. Unavailability of latrine (AOR: 4.87, (95% CI: 2.39, 9.92)), CD4+ T cell count <200cells/μl ((AOR: 3.53, (95%CI: 1.98, 6.27)), and having a history of diarrhea (AOR: 4.79 (95%CI: 1.53, 14.99) were factors significantly associated with intestinal parasitic infections.

Conclusion

In this study, the overall pooled prevalence of intestinal parasitic infections among HIV/AIDS patients in Ethiopia was relatively high. CD4+ T-cell count <200cells/μl, unavailability of a latrine, and history of diarrhea were significantly associated with intestinal parasitic infections. Therefore, the policymakers and health care professionals could give special attention to the presence of latrines, early detection and treatment of intestinal parasitic infections, and early initiation of ART drugs.

Prevalence of Intestinal Parasitic Infections and Associated Risk Factors among the First-Cycle Primary Schoolchildren in Sasiga District, Southwest Ethiopia

Intestinal parasitic infections (IPIs) have been major public health burdens in low-income countries like Ethiopia. Studies in different areas of Ethiopia have shown a high prevalence of IPIs in poor families. A similar study has not been conducted in Sasiga District given that the area is possibly at high-risk of IPIs due to the prevailing risk factors. This study is aimed at assessing the prevalence of IPIs and associated risk factors among schoolchildren in Sasiga District, southwest Ethiopia. A school-based cross-sectional study was conducted from December 2018 to March 2019 to estimate the prevalence of IPIs and associated risk factors among the study participants. A total of 383 children were selected using resident-type and grade-level stratified systematic random sampling technique. Stool samples were examined microscopically using direct wet mount and formal-ether concentration techniques. A structured questionnaire was used to get information on the associated risk factors. Data were analyzed using SPSS version 20 and p value of ≤0.05 was taken as statistically significant. The overall prevalence of IPIs among the children was 62.4% (239/383). Single, double, and triple infections were 49.9%, 10.7%, and 1.83%, respectively. Residence, family income, place of defecation, source of drinking water, shoe-wearing habit, handwashing habit after toilet use, ways of waste disposal, and cleanliness of fingernail were the most important predictors of IPIs (p < 0.05). Ascaris lumbricoides (22.7% (87/383)) and hookworms (20.6% (79/383)) were the most prevalent parasites, followed by Entamoeba histolytica (8.1%), Trichuris trichiura (7.6%), Giardia intestinalis (6.5%), Hymenolepis nana (5.7%), and Schistosoma mansoni (4.4%), in that order. Sasiga District primary schoolchildren are likely at a high burden of IPIs. Intensive health education on personal hygiene and environmental sanitation is needed.

Cystoisospora belli infections in humans: the past 100 years

Cystoisospora belli is a coccidian parasite of humans, with a direct fecal-oral transmission cycle. It is globally distributed, but mainly found in tropical and subtropical areas. Many cases of C. belli infections have been reported in patients with HIV, and in patients undergoing immunosuppressive therapy for organ transplants or those treated for tumours worldwide. Unsporulated or partially sporulated oocysts of C. belli are excreted in feces. When sporulated oocysts in contaminated water or food are ingested, asexual and sexual stages of C. belli are confined to the epithelium of intestines, bile ducts and gallbladder. Monozoic tissue cysts are present in extra-intestinal organs (lamina propria of the small and large intestine, lymph nodes, spleen, and liver) of immunosuppressed humans. However, a paratenic host has not been demonstrated. Cystoisospora belli infections can be persistent, lasting for months, and relapses are common; the mechanism of relapse is unknown. Recently, the endogenous stages of C. belli were re-examined and attention was drawn to cases of misidentification of non-protozoal structures in the gallbladder of patients as C. belli. Here, we review all aspects of the biology of C. belli, including morphology, endogenous stages, prevalence, epidemiology, symptoms, diagnosis and control.

A road less travelled: Clinical comparison of HIV seropositive and seronegative patients with cystoisosporiasis - An 11-year experience from a tertiary care centre in Northern India

Background

Cystoisospora is a well-known opportunistic enteric parasite among human immunodeficiency virus (HIV) seropositive patients but there is a paucity of data among HIV negative patients. This study investigated Cystosporiasis on both HIV positive and negative patients, with or without diarrhea, presenting to a tertiary care and super specialty center of northern India.

Methodology

Oocysts of Cystoisospora were detected on light microscopy, by modified Kinyoun staining of stool specimens, over an 11-year study period.

Results

Of the 10,233 stool specimens evaluated, Cystoisospora was detected in 64 patients, 37 (57.81%) of whom were HIV positive. Year-wise analysis showed an overall declining trend of cystoisosporiasis. Maximum cases were detected in May and June in HIV positive patients and February and September among HIV negative patients. Among HIV positive patients, the mean CD4 count was 152.04 ± 81.12cells/μL, mean absolute eosinophil count (AEC) was 229.16 ± 175.62 cells/μL and 12.5% patients had mild eosinophilia. Tuberculosis was the most common co-morbidity. Dual infections of Cystoisospora with Cryptosporidium and Giardia were also seen. Among HIV negative patients, eight had primary autoimmune disorders, seven were solid organ transplant recipients and the rest had chronic bowel diseases. The mean AEC was 485.47 ± 414.88 cells/μL, with 14.81% patients showing mild and 11.11% showing marked eosinophilia. Dual infection with Giardia was seen. Recurrent cystoisosporiasis was noted, despite cotrimoxazole treatment in a single case.

Conclusion

The epidemiology of cystoisosporiasis differs between HIV seropositive and seronegative patients in terms of year-wise and month-wise trends, co-infections and most importantly, AECs.

Occurrence of Cryptosporidium spp. and Cystoisospora belli among adult patients with diarrhoea in Maputo, Mozambique

Infections with Cryptosporidium spp. and Cystoisospora belli are important causes of diarrhoea in HIV patients. Nevertheless, information concerning these two parasites is scarce in many African countries, including Mozambique. In this study occurrence of Cryptosporidium spp. and C. belli was investigated by microscopy of stool specimens from 108 adult diarrhoeal patients, most with a confirmed HIV diagnosis. The Cryptosporidium isolates were further characterized by molecular methods. Cryptosporidium and C. belli oocysts were found in 8.3% (9/108), and 25.0% (27/108) of the study participants, respectively. Species identification was possible for all Cryptosporidium isolates with available DNA. The following Cryptosporidium species were detected (number of cases within parentheses): C. parvum (3), C. hominis (3), C. felis (1), and C. hominis/C. parvum (1). Subtyping targeting the gp60 gene revealed two C. hominis isolates with subtype IaA23R3, one C. parvum isolate with IIcA5G3d, and one with IIeA12G1. In summary the occurrence of C. hominis and anthroponotic subtypes of C. parvum indicates that the main route of Cryptosporidium transmission in the present study population was human to human (direct or via food and water). The high prevalence of C. belli highlights the need for early diagnosis of this parasite, for which a treatment exists.

Cryptosporidium and Giardia in Africa: current and future challenges

Cryptosporidium and Giardia are important causes of diarrhoeal illness. Adequate knowledge of the molecular diversity and geographical distribution of these parasites and the environmental and climatic variables that influence their prevalence is important for effective control of infection in at-risk populations, yet relatively little is known about the epidemiology of these parasites in Africa. Cryptosporidium is associated with moderate to severe diarrhoea and increased mortality in African countries and both parasites negatively affect child growth and development. Malnutrition and HIV status are also important contributors to the prevalence of Cryptosporidium and Giardia in African countries. Molecular typing of both parasites in humans, domestic animals and wildlife to date indicates a complex picture of both anthroponotic, zoonotic and spill-back transmission cycles that requires further investigation. For Cryptosporidium, the only available drug (nitazoxanide) is ineffective in HIV and malnourished individuals and therefore more effective drugs are a high priority. Several classes of drugs with good efficacy exist for Giardia, but dosing regimens are suboptimal and emerging resistance threatens clinical utility. Climate change and population growth are also predicted to increase both malnutrition and the prevalence of these parasites in water sources. Dedicated and co-ordinated commitments from African governments involving "One Health" initiatives with multidisciplinary teams of veterinarians, medical workers, relevant government authorities, and public health specialists working together are essential to control and prevent the burden of disease caused by these parasites.

In vitro efficacy of latex and purified papain from Carica papaya against Strongyloides venezuelensis eggs and larvae

Latex from Carica papaya is rich in bioactive compounds, especially papain, which may help to control parasitic diseases. This study evaluated the efficacy of latex from C. papaya and purified papain against Strongyloides venezuelensis. The Egg Hatching Test (EHT) and the Larval Motility Test (LMT) using fresh and frozen latex (250mg/mL), lyophilized latex (34mg/mL), and purified papain (2.8 mg/mL) were performed. Albendazole (0.025 mg/mL) and ivermectin (316 ppm) were used as positive controls. EHT and LMT were carried out through the incubation of each solution with S. venezuelensis eggs or larvae (± 100 specimens), and results were analyzed after 48h (EHT) or 24, 48, and 72h (LMT). EHT showed that latex preparations at higher concentrations (1:10 to 1:100) resulted in partial or complete destruction of eggs and larvae inside the eggs. The result from the 1:1,000 dilution was similar to the positive control. LMT showed effectiveness in all the tested dilutions compared to negative controls. Purified papain showed a dose-dependent response in the EHT. Purified papain (2.8 mg/ mL) showed similar results to lyophilized latex at 1:1,000 in the EHT. Latex and purified papain from C. papaya were effective against S. venezuelensis eggs and larvae in vitro, suggesting their potential use as an alternative treatment for strongyloidiasis.

Prevalence of intestinal parasitic infections and associated risk factors among schoolchildren in the Plateau Central and Centre-Ouest regions of Burkina Faso

Background

Unsafe drinking water, unimproved sanitation and lack of hygiene pose health risks, particularly to children in low- and middle-income countries. This study aimed to assess the prevalence and risk factors of intestinal parasitic infections in school-aged children in two regions of Burkina Faso.

Methods

A cross-sectional survey was carried out in February 2015 with 385 children aged 8–14 years from eight randomly selected schools in the Plateau Central and Centre-Ouest regions of Burkina Faso. Stool samples were subjected to the Kato-Katz and a formalin-ether concentration method for the diagnosis of helminths and intestinal protozoa infections. Urine samples were examined with a urine filtration technique for Schistosoma haematobium eggs. Water samples from community sources (n = 37), children’s households (n = 95) and children’s drinking water cups (n = 113) were analysed for contamination with coliform bacteria and faecal streptococci. Data on individual and family-level risk factors were obtained using a questionnaire. Mixed logistic regression models were employed to determine factors associated with intestinal parasitic infections in schoolchildren.

Results

Intestinal parasitic infections were highly prevalent; 84.7 % of the children harboured intestinal protozoa, while helminth infections were diagnosed in 10.7 % of the children. We found significantly lower odds of pathogenic intestinal protozoa infection (Entamoeba histolytica/E. dispar and Giardia intestinalis) among children from the Plateau Central, compared to the Centre-Ouest region (P < 0.001). Children from households with “freely roaming domestic animals” (P = 0.008), particularly dogs (P = 0.016) showed higher odds of G. intestinalis, and children reporting exposure to freshwater sources through domestic chores had higher odds of S. haematobium infection compared to children without this water contact activity (P = 0.035). Water quality, household drinking water source and storage did not emerge as significant risk factors for intestinal parasitic infections in children.

Conclusions

Intestinal protozoa but not helminths were highly prevalent among schoolchildren in randomly selected schools in two regions of Burkina Faso. Our findings call for specific public health measures tailored to school-aged children and rural communities in this part of Burkina Faso. It will be interesting to assess the effect of water, sanitation and hygiene interventions on the transmission of intestinal parasitic infections.

Trial registration

ISRCTN17968589 (date assigned: 17 July 2015).

Electronic supplementary material

The online version of this article (doi:10.1186/s13071-016-1835-4) contains supplementary material, which is available to authorized users.

Major parasitic diseases of poverty in mainland China: perspectives for better control

Significant progress has been made in the prevention, control, and elimination of human parasitic diseases in China in the past 60 years. However, parasitic diseases of poverty remain major causes of morbidity and mortality, and inflict enormous economic costs on societies.In this article, we review the prevalence rates, geographical distributions, epidemic characteristics, risk factors, and clinical manifestations of parasitic diseases of poverty listed in the first issue of the journal Infectious Diseases of Poverty on 25 October 2012. We also address the challenges facing control of parasitic diseases of poverty and provide suggestions for better control.