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Liu X, Zhang C, Li T, Xia X, Xu Y, Hu J, Zhang L, Wang L, Qi M. Occurrence and genotyping of Enterocytozoon bieneusi in flying squirrels (Trogopterus xanthipes) from China. Parasite 2024; 31:37. [PMID: 38963405 PMCID: PMC11223590 DOI: 10.1051/parasite/2024037] [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: 03/09/2024] [Accepted: 06/12/2024] [Indexed: 07/05/2024] Open
Abstract
Enterocytozoon bieneusi is an obligate intracellular microsporidian parasite with a worldwide distribution. As a zoonotic pathogen, E. bieneusi can infect a wide range of wildlife hosts through the fecal-oral route. Although the feces of flying squirrels (Trogopterus xanthipes) are considered a traditional Chinese medicine (as "faeces trogopterori"), no literature is available on E. bieneusi infection in flying squirrels to date. In this study, a total of 340 fresh flying squirrel fecal specimens from two captive populations were collected in Pingdingshan city, China, to detect the prevalence of E. bieneusi and assess their zoonotic potential. By nested PCR amplification of the ITS gene, six specimens tested positive, with positive samples from each farm, with an overall low infection rate of 1.8%. The ITS sequences revealed three genotypes, including known genotype D and two novel genotypes, HNFS01 and HNFS02. Genotype HNFS01 was the most prevalent (4/6, 66.7%). Phylogenetic analysis showed that all genotypes clustered into zoonotic Group 1, with the novel genotypes clustering into different subgroups. To our knowledge, this is the first report of E. bieneusi infection in flying squirrels, suggesting that flying squirrels could act as a potential reservoir and zoonotic threat for E. bieneusi transmission to humans in China.
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Affiliation(s)
- Xuehan Liu
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology Xinxiang 453003 Henan PR China
| | - Chi Zhang
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology Xinxiang 453003 Henan PR China
| | - Tiantian Li
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology Xinxiang 453003 Henan PR China
| | - Xiaojing Xia
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology Xinxiang 453003 Henan PR China
| | - Yanzhao Xu
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology Xinxiang 453003 Henan PR China
| | - Jianhe Hu
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology Xinxiang 453003 Henan PR China
| | - Longxian Zhang
- Postdoctoral Research Base, College of Veterinary Medicine, Henan Agricultural University Zhengzhou 450046 PR China
| | - Lei Wang
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology Xinxiang 453003 Henan PR China
| | - Meng Qi
- College of Animal Science and Technology, Tarim University Alar 843300 Xinjiang PR China
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Ahmed SAA, Mohamed SF, El-Mahallawy HS, Quattrocchi A, Karanis P. Gastrointestinal parasitic infections: Prevalence and risk factors in West Ismailia, Arab Republic of Egypt. Gut Pathog 2024; 16:29. [PMID: 38898500 PMCID: PMC11186246 DOI: 10.1186/s13099-024-00622-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND This study aimed to determine the prevalence of gastrointestinal parasites (GIP) in the rural community of West Ismailia and its associated risk factors. Human infection by GIP is natural and expected. There are few records concerning parasitic infection in the rural areas of the Ismailia Governorate. METHODS From 520 individuals, sociodemographic and risk factors information were retrieved. Fecal samples were collected, concentrated, and tested for GIP infection using a microscopic examination. RESULTS The West Ismailia study population had a 40.4% prevalence of GIP infection, including single and concomitant parasite infections. The most common cause of GIP infection was protists (38%). Entamoeba sp., Blastocystis sp., and G. duodenalis were the most common parasites. Poly-parasitism was prevalent within the West Ismailia region. Age, abdominal symptoms, perianal itching, ownership of numerous animal species, exposure to turbid water, previous parasitic infection (PPI), and non-treatment reception of PPI were all considered significant factors associated with GIP infection. Specific individuals from the same family have been observed to have identical GIP. CONCLUSION GIP infection remains underestimated in rural areas. Periodic screening and treatment for GIP infection in children and public education on GIP hazards and prevention, focusing on personal hygiene, are recommended. Family members of affected individuals should be screened and treated for GIP.
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Affiliation(s)
| | - Samar Farag Mohamed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, 41522, Egypt
| | - Heba Sayed El-Mahallawy
- Department of Zoonoses, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, 41522, Egypt
| | - Annalisa Quattrocchi
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, 24005, CY-1700, Cyprus
| | - Panagiotis Karanis
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, 24005, CY- 1700, Cyprus.
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Scavuzzo CM, Campero MN, Maidana RE, Oberto MG, Periago MV, Porcasi X. Spatial patterns of intestinal parasite infections among children and adolescents in some indigenous communities in Argentina. GEOSPATIAL HEALTH 2024; 19. [PMID: 38804692 DOI: 10.4081/gh.2024.1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/01/2024] [Indexed: 05/29/2024]
Abstract
Argentina has a heterogeneous prevalence of infections by intestinal parasites (IPs), with the north in the endemic area, especially for soil-transmitted helminths (STHs). We analyzed the spatial patterns of these infections in the city of Tartagal, Salta province, by an observational, correlational, and cross-sectional study in children and adolescents aged 1 to 15 years from native communities. One fecal sample per individual was collected to detect IPs using various diagnostic techniques: Telemann sedimentation, Baermann culture, and Kato-Katz. Moran's global and local indices were applied together with SaTScan to assess the spatial distribution, with a focus on cluster detection. The extreme gradient boosting (XGBoost) machine-learning model was used to predict the presence of IPs and their transmission pathways. Based on the analysis of 572 fecal samples, a prevalence of 78.3% was found. The most frequent parasite was Giardia lamblia (30.9%). High- and low-risk clusters were observed for most species, distributed in an east-west direction and polarized in two large foci, one near the city of Tartagal and the other in the km 6 community. Spatial XGBoost models were obtained based on distances with a minimum median accuracy of 0.69. Different spatial patterns reflecting the mechanisms of transmission were noted. The distribution of the majority of the parasites studied was aligned in a westerly direction close to the city, but the STH presence was higher in the km 6 community, toward the east. The purely spatial analysis provides a different and complementary overview for the detection of vulnerable hotspots and strategic intervention. Machine-learning models based on spatial variables explain a large percentage of the variability of the IPs.
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Affiliation(s)
- Carlos Matías Scavuzzo
- Human Nutrition Research Center, School of Nutrition, Faculty of Medical Sciences, National University of Córdoba, Córdoba; Mario Gulich Institute for Higher Space Studies, National University of Córdoba, National Commission of Space Activities, Falda del Cañete, Córdoba; National Council for Scientific and Technical Research, Buenos Aires; Mundo Sano Foundation, Buonos Aires.
| | - Micaela Natalia Campero
- Human Nutrition Research Center, School of Nutrition, Faculty of Medical Sciences, National University of Córdoba, Córdoba; Mario Gulich Institute for Higher Space Studies, National University of Córdoba, National Commission of Space Activities, Falda del Cañete, Córdoba; National Council for Scientific and Technical Research, Buenos Aires.
| | - Rosana Elizabeth Maidana
- Human Nutrition Research Center, School of Nutrition, Faculty of Medical Sciences, National University of Córdoba, Córdoba.
| | - María Georgina Oberto
- Human Nutrition Research Center, School of Nutrition, Faculty of Medical Sciences, National University of Córdoba, Córdoba.
| | - María Victoria Periago
- National Council for Scientific and Technical Research, Buenos Aires; Mundo Sano Foundation, Buonos Aires.
| | - Ximena Porcasi
- Mario Gulich Institute for Higher Space Studies, National University of Córdoba, National Commission of Space Activities, Falda del Cañete, Córdoba.
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Figueiredo AM, Santín M, Köster PC, Dashti A, Maloney JG, Torres RT, Fonseca C, Mysterud A, Carvalho J, Hipólito D, Rossa M, Palmeira JD, González-Barrio D, Calero-Bernal R, Carmena D. Molecular detection and characterization of Blastocystis in herbivore livestock species in Portugal. Vet Parasitol 2024; 327:110147. [PMID: 38364349 DOI: 10.1016/j.vetpar.2024.110147] [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: 10/25/2023] [Revised: 02/03/2024] [Accepted: 02/08/2024] [Indexed: 02/18/2024]
Abstract
Blastocystis is a ubiquitous intestinal protist in humans and animals worldwide. The traditional livestock free-roaming raising system in rural communities increases the risk of infection with contact with a wider range of pathogens transmitted via the faecal-oral route associated with that wildlife-livestock-human interface. However, no studies have been conducted to determine the occurrence and subtype distribution of Blastocystis in livestock in Portugal. Here, we collected 180 faecal samples from herbivore livestock (cattle, goats, horses, and sheep) in different regions of the country to investigate Blastocystis prevalence and subtype diversity using PCR and next-generation amplicon sequencing. Blastocystis was present in 40.6% (73/180; 95% CI: 33.31-48.11) of the samples (goats, 81.0%; sheep, 60.9%; cattle, 32.2%). None of the horse samples were Blastocystis-positive. Eighteen subtypes were detected (ST1-ST3, ST5-ST7, ST10, ST13, ST14, ST21, ST23-ST26, ST30, ST42-ST44). Mixed infections were detected in 97.3% of the Blastocystis-positive samples. Potentially zoonotic subtypes were identified in 75.0%, 96.4%, and 100% of the Blastocystis-positive specimens collected from cattle, sheep, and goats, respectively. These results demonstrate that cattle, sheep, and goats harbour a high diversity of Blastocystis subtypes in the study regions. Importantly, our data provide novel molecular evidence strongly suggesting that some Blastocystis STs/ST subgroups may have differential host specificity.
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Affiliation(s)
- Ana M Figueiredo
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal; Centre for Ecological and Evolutionary Synthesis, Department of Biosciences, University of Oslo, Blindern, Oslo, Norway
| | - Mónica Santín
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA.
| | - Pamela C Köster
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Majadahonda, Spain; Faculty of Health Sciences, Alfonso X El Sabio University (UAX), Villanueva de la Cañada, Madrid, Spain; Faculty of Medicine, Alfonso X El Sabio University (UAX), Villanueva de la Cañada, Madrid, Spain
| | - Alejandro Dashti
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Majadahonda, Spain
| | - Jenny G Maloney
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, MD, USA
| | - Rita T Torres
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Carlos Fonseca
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal; ForestWISE - Collaborative Laboratory for Integrated Forest & Fire Management, Vila Real, Portugal
| | - Atle Mysterud
- Centre for Ecological and Evolutionary Synthesis, Department of Biosciences, University of Oslo, Blindern, Oslo, Norway
| | - João Carvalho
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Dário Hipólito
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal; Veterinary Biology Unit, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Mariana Rossa
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Josman D Palmeira
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - David González-Barrio
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Majadahonda, Spain
| | - Rafael Calero-Bernal
- SALUVET, Animal Health Department, Faculty of Veterinary Sciences, Complutense University of Madrid, Madrid, Spain
| | - David Carmena
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Majadahonda, Spain; CIBER Infectious Diseases (CIBERINFEC), Health Institute Carlos III, Madrid, Spain.
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Zhao W, Ren G, Wang L, Xie L, Wang J, Mao J, Sun Y, Lu G, Huang H. Molecular prevalence and subtype distribution of Blastocystis spp. among children who have diarrheia or are asymptomatic in Wenzhou, Zhejiang Province, China. Parasite 2024; 31:12. [PMID: 38450718 PMCID: PMC10918642 DOI: 10.1051/parasite/2024012] [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: 12/27/2023] [Accepted: 02/11/2024] [Indexed: 03/08/2024] Open
Abstract
Blastocystis sp., a significant zoonotic parasite with a global distribution, was the focus of this study, which aimed to investigate its prevalence and genetic diversity among diarrheic and asymptomatic children in Wenzhou, China. We collected 1,032 fecal samples from Yuying Children's Hospital, Wenzhou, China, comprising 684 from children with diarrhea and 348 from asymptomatic children. Genomic DNA extracted from these samples was used to detect Blastocystis spp. by PCR, targeting the small subunit ribosomal RNA gene. Subsequently, a phylogenetic tree was constructed, applying the maximum likelihood method. Blastocystis spp. were detected in 67 (6.5%) of the fecal samples. The prevalence rate of Blastocystis spp. in diarrheic children (8.8%; 60/684) was significantly higher than that in asymptomatic children (2.0%; 7/348) (χ 2 = 17.3, p < 0.001). Sequence analysis of the SSU rRNA gene identified five known Blastocystis spp. subtypes, ST1 (n = 12), ST2 (n = 5), ST3 (n = 35), ST4 (n = 12), and ST7 (n = 3). ST1 and ST3 were present in both diarrheic and asymptomatic children, while ST2, ST4, and ST7 were exclusive to diarrheic children. Intra-subtype genetic polymorphisms were identified, comprising four variations in ST1 (ST1-1 to ST1-4), five in ST3 (ST3-1 to ST3-5), two in ST4 (ST4-1 and ST4-2), and two in ST7 (ST7-1 and ST7-2). Notably, ST1-2 to ST1-4, ST3-3 to ST3-5, and ST7-1 and ST7-2 represent newly identified variations. The composition and genetic characteristics of subtypes among children in this region suggest various sources of infection, including human-to-human and animal-to-human transmission.
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Affiliation(s)
- Wei Zhao
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Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University Wenzhou Zhejiang 325035 China
| | - Guangxu Ren
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Department of Pathogenic Biology, Hainan Medical University, Haikou, Hainan, China; Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University Haikou Hainan China;
Key Laboratory of Tropical Translational Medicine of the Ministry of Education, Hainan Medical University Haikou 571199 China
| | - Long Wang
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Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University Wenzhou Zhejiang 325035 China
| | - Lisha Xie
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Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University Wenzhou Zhejiang 325035 China
| | - Jiayang Wang
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Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University Wenzhou Zhejiang 325035 China
| | - Jialiang Mao
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Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University Wenzhou Zhejiang 325035 China
| | - Yanbin Sun
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Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University Wenzhou Zhejiang 325035 China
| | - Gang Lu
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Department of Pathogenic Biology, Hainan Medical University, Haikou, Hainan, China; Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University Haikou Hainan China;
Key Laboratory of Tropical Translational Medicine of the Ministry of Education, Hainan Medical University Haikou 571199 China
| | - Huicong Huang
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Department of Parasitology, School of Basic Medical Sciences, Wenzhou Medical University Wenzhou Zhejiang 325035 China
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Cheng Z, Wu S, Pan H, Lu X, Liu Y, Yang L. Cortinarius and Tomentella Fungi Become Dominant Taxa in Taiga Soil after Fire Disturbance. J Fungi (Basel) 2023; 9:1113. [PMID: 37998918 PMCID: PMC10672602 DOI: 10.3390/jof9111113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
Fungi have important ecological functions in the soil of forests, where they decompose organic matter, provide plants with nutrients, increase plant water uptake, and improve plant resistance to adversity, disease, and disturbance. A forest fire presents a serious disturbance of the local ecosystem and can be considered an important component affecting the function of ecosystem biomes; however, the response of soil fungi to fire disturbance is largely unknown. To investigate the effects of fire disturbance on the community composition and diversity of soil fungi in a taiga forest, we collected soil from plots that had undergone a light, moderate, and heavy fire 10 years previously, with the inclusion of a fire-free control. The present soil fungi were characterized using Illumina MiSeq technology, and the sequences were analyzed to identify differences in the community composition and diversity in response to the changed soil physicochemical properties. The results showed that the Chao1 index, which characterizes the alpha diversity of the fungi, did not change significantly. In contrast, the Shannon index increased significantly (p < 0.05) and the Simpson index decreased significantly (p < 0.05) following a light or heavy fire disturbance compared to the control. The relative abundance of Basidiomycota was significantly higher in the soil of the fire sites than that in the control (p < 0.01), and the relative abundance of Ascomycota was significantly lower (p < 0.01). The results of principal coordinates analyses (PCoAs) showed that fire disturbance highly significantly affected the beta diversity of soil fungi (p < 0.001), while the results of canonical correlation analysis (CCA) indicated that the available nitrogen (AN), moisture content (MC), pH, available potassium (AK), and total nitrogen (TN) contents of the soil significantly affected the compositional structure and diversity of the soil fungal communities. The results of functional prediction showed that the majority of the detected soil fungi were symbiotrophs, followed by saprotrophs and saprotroph-symbiotrophs, with ectomycorrhiza being the dominant functional taxon. Fire disturbance significantly reduced the relative abundance of ectomycorrhiza (p < 0.05). This study illustrates that fire disturbance alters the structural composition, diversity, dominance, and relative abundance of the guilds of soil fungal communities in taiga forest, and strongly affected the beta diversity of soil fungi, with AN, MC, pH, AK, and TN being the most important factors affecting their community structure. The results may provide a useful reference for the restoration and rehabilitation of taiga forests after fire disturbance.
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Affiliation(s)
- Zhichao Cheng
- Key Laboratory of Biodiversity, Institute of Natural Resources and Ecology, Heilongjiang Academy of Sciences, Harbin 150040, China; (Z.C.); (H.P.); (X.L.)
- Heilongjiang Huzhong National Nature Reserve, Daxing’anling 165038, China
| | - Song Wu
- Science and Technology Innovation Center, Institute of Scientifc and Technical Information of Heilongjiang Province, Harbin 150028, China;
| | - Hong Pan
- Key Laboratory of Biodiversity, Institute of Natural Resources and Ecology, Heilongjiang Academy of Sciences, Harbin 150040, China; (Z.C.); (H.P.); (X.L.)
| | - Xinming Lu
- Key Laboratory of Biodiversity, Institute of Natural Resources and Ecology, Heilongjiang Academy of Sciences, Harbin 150040, China; (Z.C.); (H.P.); (X.L.)
| | - Yongzhi Liu
- Heilongjiang Huzhong National Nature Reserve, Daxing’anling 165038, China
| | - Libin Yang
- Key Laboratory of Biodiversity, Institute of Natural Resources and Ecology, Heilongjiang Academy of Sciences, Harbin 150040, China; (Z.C.); (H.P.); (X.L.)
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Sandoval-Ramírez T, Seco-Hidalgo V, Calderon-Espinosa E, Garcia-Ramon D, Lopez A, Calvopiña M, Guadalupe I, Chico M, Mejia R, Chis Ster I, Cooper PJ. Epidemiology of giardiasis and assemblages A and B and effects on diarrhea and growth trajectories during the first 8 years of life: Analysis of a birth cohort in a rural district in tropical Ecuador. PLoS Negl Trop Dis 2023; 17:e0011777. [PMID: 37983257 PMCID: PMC10695370 DOI: 10.1371/journal.pntd.0011777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/04/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND There are limited longitudinal data on the acquisition of Giardia lamblia infections in childhood using molecular assays to detect and type assemblages, and measure effects of infections on diarrhea risk and childhood growth. METHODS We analysed stool samples from a surveillance sample within a birth cohort in a rural district in tropical Ecuador. The cohort was followed to 8 years of age for the presence of G. lamblia in stools by quantitative PCR and A and B assemblages by Taqman assay or Sanger sequencing. We explored risk factors associated with infection using generalized estimating equations applied to longitudinal binary outcomes, and longitudinal panel data analysis to estimate effects of infection on diarrhea and growth trajectories. RESULTS 2,812 stool samples collected between 1 month and 8 years of age from 498 children were analyzed and showed high rates of infection: 79.7% were infected at least once with peak prevalence (53.9%) at 5 years. Assemblage B was accounted for 56.8% of genotyped infections. Risk factors for infection included male sex (P = 0.001), daycare attendance (P<0.001), having a household latrine (P = 0.04), childhood (P<0.001) and maternal soil-transmitted helminth (P = 0.029) infections, and exposures to donkeys (age interaction P = 0.034). G. lamblia was associated with increased risk of diarrhea (per episode, RR 1.03, 95% CI 1.01-1.06, P = 0.011) during the first 3 years of life and a transient impairment of weight (age interaction P = 0.017) and height-for-age (age interaction P = 0.025) trajectories between 1 and 4 years of age. There was no increased risk of either assemblage being associated with outcomes. CONCLUSION Our data show a relatively high edemicity of G. lamblia transmission during childhood in coastal Ecuador, and evidence that infection is associated with a transiently increased risk of diarrhea during the first 3 years of life and impairment of weight and height between 1 and 4 years.
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Affiliation(s)
- Tannya Sandoval-Ramírez
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
- Grupo de Investigación en Sanidad Animal y Humana GISAH, Departamento de Ciencias de la Vida y la Agricultura, Universidad de las Fuerzas Armadas ESPE, Quito, Ecuador
| | - Victor Seco-Hidalgo
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
| | | | - Diana Garcia-Ramon
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Andrea Lopez
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Manuel Calvopiña
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
| | - Irene Guadalupe
- Fundación Ecuatoriana Para la Investigación en Salud, Quito, Ecuador
| | - Martha Chico
- Fundación Ecuatoriana Para la Investigación en Salud, Quito, Ecuador
| | - Rojelio Mejia
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Irina Chis Ster
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Philip J. Cooper
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
- Fundación Ecuatoriana Para la Investigación en Salud, Quito, Ecuador
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