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Siti Farah Norasyikeen SO, Ngui R, Syaza Zafirah AR, Md Zoqratt MZH, Eng WWH, Ayub Q, Amin Nordin S, Narcisse Mary Sither Joseph V, Musa S, Lim YAL. Study on intestinal parasitic infections and gut microbiota in cancer patients at a tertiary teaching hospital in Malaysia. Sci Rep 2024; 14:13650. [PMID: 38871760 DOI: 10.1038/s41598-024-59969-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/17/2024] [Indexed: 06/15/2024] Open
Abstract
Intestinal parasitic infections (IPIs) can lead to significant morbidity and mortality in cancer patients. While they are unlikely to cause severe disease and are self-limiting in healthy individuals, cancer patients are especially susceptible to opportunistic parasitic infections. The gut microbiota plays a crucial role in various aspects of health, including immune regulation and metabolic processes. Parasites occupy the same environment as bacteria in the gut. Recent research suggests intestinal parasites can disrupt the normal balance of the gut microbiota. However, there is limited understanding of this co-infection dynamic among cancer patients in Malaysia. A study was conducted to determine the prevalence and relationship between intestinal parasites and gut microbiota composition in cancer patients. Stool samples from 134 cancer patients undergoing active treatment or newly diagnosed were collected and examined for the presence of intestinal parasites and gut microbiota composition. The study also involved 17 healthy individuals for comparison and control. Sequencing with 16S RNA at the V3-V4 region was used to determine the gut microbial composition between infected and non-infected cancer patients and healthy control subjects. The overall prevalence of IPIs among cancer patients was found to be 32.8%. Microsporidia spp. Accounted for the highest percentage at 20.1%, followed by Entamoeba spp. (3.7%), Cryptosporidium spp. (3.0%), Cyclospora spp. (2.2%), and Ascaris lumbricoides (0.8%). None of the health control subjects tested positive for intestinal parasites. The sequencing data analysis revealed that the gut microbiota diversity and composition were significantly different in cancer patients than in healthy controls (p < 0.001). A significant dissimilarity was observed in the bacterial composition between parasite-infected and non-infected patients based on Bray-Curtis (p = 0.041) and Jaccard (p = 0.021) measurements. Bacteria from the genus Enterococcus were enriched in the parasite-infected groups, while Faecalibacterium prausnitzii reduced compared to non-infected and control groups. Further analysis between different IPIs and non-infected individuals demonstrated a noteworthy variation in Entamoeba-infected (unweighted UniFrac: p = 0.008), Cryptosporidium-infected (Bray-Curtis: p = 0.034) and microsporidia-infected (unweighted: p = 0.026; weighted: p = 0.019; Jaccard: p = 0.031) samples. No significant dissimilarity was observed between Cyclospora-infected groups and non-infected groups. Specifically, patients infected with Cryptosporidium and Entamoeba showed increased obligate anaerobic bacteria. Clostridiales were enriched with Entamoeba infections, whereas those from Coriobacteriales decreased. Bacteroidales and Clostridium were found in higher abundance in the gut microbiota with Cryptosporidium infection, while Bacillales decreased. Additionally, bacteria from the genus Enterococcus were enriched in microsporidia-infected patients. In contrast, bacteria from the Clostridiales order, Faecalibacterium, Parabacteroides, Collinsella, Ruminococcus, and Sporosarcina decreased compared to the non-infected groups. These findings underscore the importance of understanding and managing the interactions between intestinal parasites and gut microbiota for improved outcomes in cancer patients.
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Affiliation(s)
- Sidi Omar Siti Farah Norasyikeen
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
- Department of Paraclinical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Malaysia
| | - Romano Ngui
- Department of Paraclinical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Malaysia.
| | - Ab Rahman Syaza Zafirah
- Department of Paediatrics, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | | | - Wilhelm Wei Han Eng
- Monash University Malaysia Genomics Facility, Monash University Malaysia, 47500, Subang Jaya, Malaysia
| | - Qasim Ayub
- Monash University Malaysia Genomics Facility, Monash University Malaysia, 47500, Subang Jaya, Malaysia
| | - Syafinaz Amin Nordin
- Department of Microbiology, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | | | - Sabri Musa
- Department of Children's Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Yvonne Ai Lian Lim
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
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Hernanz Lobo A, Berzosa Sánchez A, Escolano L, Pérez Muñoz S, Gerig N, Sainz T, Mellado Peña MJ, García López Hortelano M. International Adoption of Children with Special Needs in Spain. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040690. [PMID: 37189939 DOI: 10.3390/children10040690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 05/17/2023]
Abstract
International adoption has declined in recent years, although the adoption of children with special needs has arisen. We aim to describe our experience in the international adoption of children with special needs and to analyze the concordance between the pathologies included in pre-adoption reports and the diagnosis made upon arrival. We conducted a retrospective descriptive study including internationally adopted children with special needs evaluated at a reference Spanish unit between 2016 and 2019. Epidemiological and clinical variables were collected from medical records, and pre-adoption reports were compared to established diagnoses following their evaluation and complementary tests. Fifty-seven children were included: 36.8% females, a median age of 27 months [IQR:17-39], mostly coming from China (63.2%) and Vietnam (31.6%). The main pathologies described in the pre-adoption reports were congenital surgical malformations (40.3%), hematological (22.6%), and neurological (24.6%). The initial diagnosis that motivated the international adoption via special needs was confirmed in 79% of the children. After evaluation, 14% were diagnosed with weight and growth delay, and 17.5% with microcephaly, not previously reported. Infectious diseases were also prevalent (29.8%). According to our series, the pre-adoption reports of children with special needs appear accurate, with a low rate of new diagnoses. Pre-existing conditions were confirmed in almost 80% of cases.
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Affiliation(s)
- Alicia Hernanz Lobo
- Pediatric Infectious Diseases Department, Gregorio Marañón University Hospital, 28007 Madrid, Spain
- Gregorio Marañón Research Health Institute (IiSGM), Translational Research in Pediatric Infectious Diseases (RITIP), 28007 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, 28040 Madrid, Spain
| | - Arantxa Berzosa Sánchez
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Medicine Faculty, Complutense University of Madrid, 28040 Madrid, Spain
- Department of Pediatrics, Clínico San Carlos Hospital, Clínico San Carlos Research Health Institute (IdISSC), 28040 Madrid, Spain
| | - Lucía Escolano
- Department of Pediatrics, La Paz University Hospital, 28046 Madrid, Spain
| | - Sara Pérez Muñoz
- Department of Pediatrics, Torrejon Hospital, 28850 Madrid, Spain
| | - Nathalia Gerig
- Department of Pediatrics, La Paz University Hospital, 28046 Madrid, Spain
| | - Talía Sainz
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Pediatrics, Infectious and Tropical Diseases, Paediatrics, La Paz University Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain
- La Paz Hospital and La Paz Research Institute (IdiPAZ), Translational Research in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Medicine Faculty, Autónoma University of Madrid, 28049 Madrid, Spain
| | - María Jose Mellado Peña
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Pediatrics, Infectious and Tropical Diseases, Paediatrics, La Paz University Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain
- La Paz Hospital and La Paz Research Institute (IdiPAZ), Translational Research in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Medicine Faculty, Autónoma University of Madrid, 28049 Madrid, Spain
| | - Milagros García López Hortelano
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFECC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Pediatrics, Infectious and Tropical Diseases, Paediatrics, La Paz University Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain
- La Paz Hospital and La Paz Research Institute (IdiPAZ), Translational Research in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Medicine Faculty, Autónoma University of Madrid, 28049 Madrid, Spain
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Elmehy DA, Elmansory BM, Gamea GA, Abdelhai DI, Abd-Elsalam SM, Salamah AM, Ata DS, Mahmoud EF, Ibrahim HA, Salama AM. Parasitic infections as potential risk factors for attention deficit hyperactivity disorder (ADHD) in children. J Parasit Dis 2023; 47:82-92. [PMID: 36910322 PMCID: PMC9998788 DOI: 10.1007/s12639-022-01542-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 10/12/2022] [Indexed: 11/27/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) represents a mysterious neuropsychiatric alarming concern due to indefinite etiopathogenesis among children. Notably, the studies which investigated the correlation between ADHD and parasitic infections are insufficient. Therefore, this research aimed to assess the correlation between ADHD and some tissue dwelling and intestinal parasitic infections in children. The study was conducted on 200 children, including 100 children suffering from ADHD (Group I) and 100 healthy children as a control group (Group II). All caregivers fulfilled predesigned sociodemographic form and Conners parent rating scale (CPRS-48) questionnaire. Blood samples were collected to determine hemoglobin level as well as relative eosinophilic count. The presence of anti-Toxoplasma IgG and anti-Toxocara IgG in serum by Enzyme-Linked Immunosorbent Assay (ELISA) was further investigated. Also, micronutrients as zinc, iron, and copper levels were measured. Schistosoma antigen was investigated in urine samples. Stool samples were subjected to direct wet smear, concentration technique and modified Ziehl-Neelsen (MZN) staining for coccidian parasites detection. Cryptosporidium parvum, Giardia lamblia and Entamoeba histolytica antigens were investigated in stool samples. Group I expressed more liability to sociodemographic risk factors, decreased levels of Hb, iron, zinc, and copper with statistically significant difference (P < 0.001). Comparison between Group I and Group II regarding the detected parasitic infections exhibited statistically significant difference except Schistosoma antigen positivity which expressed no statistical significance. The present study concluded that the parasitic infections with their consequences are potential risk factors in children with ADHD indicating that their early diagnosis and treatment may help in ADHD prevention.
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Affiliation(s)
- Dalia A. Elmehy
- Department of Medical Parasitology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Basma M. Elmansory
- Department of Medical Parasitology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ghada A. Gamea
- Department of Medical Parasitology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Dina I. Abdelhai
- Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Abeer M. Salamah
- Department of Pediatrics, Faculty of Medicine, Kafr El Shiekh University, Kafr El Shiekh, Egypt
| | - Dina S. Ata
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Eman F. Mahmoud
- Department of Physiology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Hoda A. Ibrahim
- Department of Medical Biochemistry, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Amina M. Salama
- Department of Medical Parasitology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Elmehy D, Elmansory BM, Gamea GA, Abdelhai DI, Abd-elsalam SM, Salamah AM, Ata DS, Mahmoud EF, Ibrahim HA, Salama AM. The Fire Under the Ash: Parasitic infections as potential risk factors for Attention Deficit Hyperactivity Disorder (ADHD) in children.. [DOI: 10.21203/rs.3.rs-1983187/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
Attention deficit hyperactivity disorder (ADHD) represents a mysterious neuropsychiatric alarming concern due to indefinite etiopathogenesis among children. Notably, the studies which investigated the correlation between ADHD and parasitic infections are insufficient. Therefore, this research aimed to assess the correlation between ADHD and some tissue dwelling and intestinal parasitic infections in children. The study was conducted on 200 children, including 100 children suffering from ADHD (Group I) and 100 healthy children as a control group (Group II). All caregivers fulfilled predesigned sociodemographic form and Conners parent rating scale (CPRS-48) questionnaire. Blood samples were collected to determine hemoglobin level as well as relative eosinophilic count. The presence of anti-Toxoplasma IgG and anti-Toxocara IgG in serum by Enzyme-Linked Immunosorbent Assay (ELISA) was further investigated. Also, micronutrients as zinc, iron, and copper levels were measured. Schistosoma antigen was investigated in urine samples. Stool samples were subjected to direct wet smear, concentration technique and modified Ziehl-Neelsen (MZN) staining for coccidian parasites detection. Cryptosporidium parvum, Giardia lamblia and Entamoeba histolytica antigens were investigated in stool samples. Group I expressed more liability to sociodemographic risk factors, decreased levels of Hb, iron, zinc, and copper with statistically significant difference (P < 0.001). Comparison between Group I and Group II regarding the detected parasitic infections exhibited statistically significant difference except Schistosoma antigen positivity which expressed no statistical significance. The present study concluded that the parasitic infections with their consequences are potential risk factors in children with ADHD indicating that their early diagnosis and treatment may help in ADHD prevention.
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