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Aydemir S, Barlik F, Yürektürk Ş, Saygin M, Hakan Ünlü A, Ekici A, Yilmaz H. Prevalence of Blastocystis infection in humans in Türkiye: a systematic review and meta-analysis. Microb Pathog 2024:106876. [PMID: 39182858 DOI: 10.1016/j.micpath.2024.106876] [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: 03/20/2024] [Revised: 07/01/2024] [Accepted: 08/20/2024] [Indexed: 08/27/2024]
Abstract
Although Blastocystis, a protozoan, is commonly found in all species of animals and in humans, there remains a lack of clear information about its epidemiology and routes of transmission. The aim of this meta-analysis study was to determine the changes in Blastocystis prevalence and subtype distribution in humans in Türkiye according to geographical regions. Databases were searched using the Web of Science, PubMed, Scopus, EBSCO, and TRDizin to identify studies on the prevalence of Blastocystis in humans in Türkiye published from 2009 to 2023. As a result of this systematic search, 117 of 730 articles were included in the meta-analysis. The pooled prevalence of human Blastocystis infection in Türkiye was 13.08%. The prevalence of the pool was higher in the Black Sea region, which is the most humid region in Türkiye, than in other regions. Blastocystis subtypes were identified in a total of 885 positive samples. The most common subtypes (ST) in Türkiye were ST3, ST1 and ST2, respectively. In addition to these ST4, ST5, ST6 and ST7 were also detected in humans in Türkiye. In conclusion, the prevalence of Blastocystis in humans is high in Türkiye, especially in the Black Sea region.
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Affiliation(s)
- Selahattin Aydemir
- Van Yüzüncü Yıl University, Faculty of Medicine, Department of Parasitology, Van, Türkiye
| | - Fethi Barlik
- Van Yüzüncü Yıl University, Van Health Services Vocational School, Van, Türkiye
| | - Şehriban Yürektürk
- Van Yüzüncü Yıl University, Van Health Services Vocational School, Van, Türkiye
| | - Murat Saygin
- Van Yüzüncü Yıl University, Faculty of Medicine, Department of Parasitology, Van, Türkiye
| | - Ahmet Hakan Ünlü
- Van Yüzüncü Yıl University, Vocational School of Gevas, Division of Veterinary, Van, Türkiye
| | - Abdurrahman Ekici
- Van Yüzüncü Yıl University, Faculty of Medicine, Department of Parasitology, Van, Türkiye.
| | - Hasan Yilmaz
- Van Yüzüncü Yıl University, Faculty of Medicine, Department of Parasitology, Van, Türkiye
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Boutahar M, Belaouni M, Ibrahimi A, Eljaoudi R, Aanniz T, Er-Rami M, Köster PC, Dashti A, Carmena D. Unveiling Blastocystis epidemiology in Morocco: subtype diversity among clinical patients with and without gastrointestinal manifestations in the Meknes region. Parasitol Res 2024; 123:273. [PMID: 39017986 DOI: 10.1007/s00436-024-08288-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 07/06/2024] [Indexed: 07/18/2024]
Abstract
Blastocystis is an intestinal protist frequently identified in humans and other animals, though its clinical significance remains controversial. This study aimed to determine the prevalence and genetic diversity of Blastocystis in faecal samples from symptomatic (n = 55) and asymptomatic (n = 50) individuals seeking medical care in Meknes, Morocco. Detection of the protist was accomplished through coproparasitological examination and culture in Jones medium. Culture-positive samples were subjected to molecular analyses (PCR and Sanger sequencing) based on sequences of the small subunit ribosomal RNA gene. Epidemiological questionnaires on demographics and potential risk factors were collected from participating patients. The overall Blastocystis infection rate was 51.4% (54/105), with no differences between symptomatic (52.7%, 29/55) and asymptomatic (50.0%, 25/50) individuals. Sequence analyses identified three Blastocystis subtypes, with ST3 being the most prevalent (42.0%), followed by ST1 (34.0%), and ST2 (12.0%). Regarding intra-subtype diversity, allele 4 was found within ST1; alleles 11/12 and alleles 34/36 (alone or in combination) were identified within ST2 and ST3 respectively. Allele 34 in ST3 (40.8%) and allele 4 in ST1 (34.7%) were the most common genetic variants circulating in the surveyed clinical population. A statistically significant association between ST2 and the presence of flatulence was observed. This is the first study assessing the epidemiology and genetic diversity of Blastocystis sp. in the Meknes region, Morocco.
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Affiliation(s)
- Mounia Boutahar
- Human Pathology, Biomedicine and Environment Laboratory, Faculty of Science and Technology of Fez, B.P. 2202 - Route d'Imouzzer, Fez, Morocco.
| | - Mourad Belaouni
- Parasitology-Mycology Laboratory, Moulay Ismaïl Military Hospital, Meknes, Morocco
| | - Azeddine Ibrahimi
- Biotechnology Lab (MedBiotech), Bioinova Research Center, Rabat Medical & Pharmacy School, Mohammed V University in Rabat, 10100, Rabat, Morocco
- Mohammed VI Center for Research & Innovation (CM6), 10000, Rabat, Morocco
- Mohammed VI University of Health Sciences, 20000, Casablanca, Morocco
| | - Rachid Eljaoudi
- Biotechnology Lab (MedBiotech), Bioinova Research Center, Rabat Medical & Pharmacy School, Mohammed V University in Rabat, 10100, Rabat, Morocco
- Mohammed VI Center for Research & Innovation (CM6), 10000, Rabat, Morocco
- Emergency Department, Military Hospital Mohammed V, 10000, Rabat, Morocco
| | - Tarik Aanniz
- Biotechnology Lab (MedBiotech), Bioinova Research Center, Rabat Medical & Pharmacy School, Mohammed V University in Rabat, 10100, Rabat, Morocco
| | - Mohammed Er-Rami
- Parasitology-Mycology Laboratory, Moulay Ismaïl Military Hospital, Meknes, Morocco
- Human Pathology, Biomedicine and Environment Laboratory, Faculty of Medicine and Pharmacy, Fez, Morocco
| | - Pamela C Köster
- Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, 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
- Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - David Carmena
- Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
- CIBER Infectious Diseases (CIBERINFEC), Madrid, Spain
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Asghari A, Yousefi A, Mohammadi MR, Badali R, Shamsi L, Köseoğlu AE, Abbaszadeh A, Shams M, Mohammadi-Ghalehbin B. Comparative molecular epidemiology, subtype distribution, and zoonotic potential of Blastocystis sp. in Equus animals (horses, donkeys, and mules) in northwestern Iran. Comp Immunol Microbiol Infect Dis 2024; 106:102124. [PMID: 38262257 DOI: 10.1016/j.cimid.2024.102124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/31/2023] [Accepted: 01/03/2024] [Indexed: 01/25/2024]
Abstract
A total of 500 fecal samples were collected from Equus animals in six different cities (Ardabil, Namin, Nir, Meshginshahr, Germi, and Khalkhal) of Ardabil Province, northwestern Iran, with 200 samples from horses, 200 from donkeys, and 100 from mules. Of the horse samples, 100 were from racing horses under special monitoring and care, while the remaining 100 were from non-racing horses, including those used for herding or in rural areas. All fecal samples were examined for the presence of Blastocystis sp. using PCR amplification of the SSU rRNA gene's barcode region after DNA extraction. The molecular prevalence of Blastocystis infection in Equus animals was 7.6% (38/500). Blastocystis was more common in horses [11.5% (23/200)] than in donkeys [5.5% (11/200)] and mules [4% (4/100)] (P > 0.05). Compared to racing horses [3% (3/100)], non-racing/rural horses [20% (20/100)] exhibited a substantially higher prevalence of Blastocystis (P < 0.05). The prevalence of Blastocystis in diarrheal samples and younger animals was remarkably higher than in formed samples and older animals, respectively (P < 0.05). No significant difference in Blastocystis infection prevalence was found between the genders of examined animals (P > 0.05). In Equus animals, 38 Blastocystis isolates included eight STs: ST10 [31.6% (12/38)], ST1 [21.1% (8/38)], ST2 [15.8% (6/38)], ST3 [10.5% (4/38)], ST4 [7.9% (3/38)], ST7 [5.2% (2/38)], ST14 [5.2% (2/38)], and ST6 [2.6% (1/38)]. These results suggest that Equus animals act as a proper reservoir for numerous Blastocystis STs, consequently playing a crucial part in the spread of this protozoan infection to humans, animals, and water reservoirs.
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Affiliation(s)
- Ali Asghari
- Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Amirhosein Yousefi
- Department of Pharmaceutical Biotechnology, University of Pavia, Pavia, Italy
| | - Mohammad Reza Mohammadi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Roya Badali
- Department of Pharmaceutical Biotechnology, University of Pavia, Pavia, Italy
| | - Laya Shamsi
- Department of Pathobiology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Ahmet Efe Köseoğlu
- Department of Molecular Biology and Genetics, Faculty of Engineering and Natural Sciences, Biruni University, 34010, Istanbul, Turkey
| | - Amir Abbaszadeh
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Morteza Shams
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
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Feng X, Xin L, Zhang B, Wang Z, Meng Z, Yu F, Qi M. Molecular characterization of Blastocystis spp. in Hotan Black chickens in southern Xinjiang. J Eukaryot Microbiol 2024; 71:e13012. [PMID: 37975433 DOI: 10.1111/jeu.13012] [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: 09/07/2023] [Revised: 11/07/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
To determine the infection status and assess the zoonotic potential of Blastocystis spp. in Hotan Black chickens in southern Xinjiang, China, fecal samples were collected from 617 chickens on 18 large-scale farms. The presence of Blastocystis spp. was determined using polymerase chain reaction based on the small subunit rRNA (SSU rRNA) locus. The results revealed an overall infection rate of 26.3% (162/617). Samples from Farm 1 in Luopu County showed the highest infection rate (76.3%, 29/38). The highest and lowest infection rates were detected in the <30-day (34.4%, 43/125) and > 90-day age groups (12.4%, 11/89), respectively. The infection rate decreased with increasing age. Statistical analysis showed significant differences in the infection rates of Blastocystis spp. among the different sampling sites (p < 0.05) and age groups (p < 0.05). Four Blastocystis spp. subtypes (ST6, ST7, ST10, and ST23) were identified. The infection rates of the zoonotic subtypes, ST6 and ST7, were 3.2% (20/617) and 22.2% (137/617), respectively. The presence of Blastocystis spp. and zoonotic subtypes provided evidence for the potential transmission of this pathogen between Hotan Black chickens and humans, especially in animal handlers in this area.
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Affiliation(s)
- Xinwei Feng
- College of Animal Science and Technology, Tarim University, Xinjiang, China
- Tarim Animal Disease Diagnosis and Control Engineering Laboratory of Xinjiang Production and Construction Corps, Xinjiang, China
| | - Luyao Xin
- College of Animal Science and Technology, Tarim University, Xinjiang, China
- Tarim Animal Disease Diagnosis and Control Engineering Laboratory of Xinjiang Production and Construction Corps, Xinjiang, China
| | - Bowen Zhang
- College of Animal Science and Technology, Tarim University, Xinjiang, China
- Tarim Animal Disease Diagnosis and Control Engineering Laboratory of Xinjiang Production and Construction Corps, Xinjiang, China
| | - Zhichao Wang
- College of Animal Science and Technology, Tarim University, Xinjiang, China
- Tarim Animal Disease Diagnosis and Control Engineering Laboratory of Xinjiang Production and Construction Corps, Xinjiang, China
| | - Zhu Meng
- College of Animal Science and Technology, Tarim University, Xinjiang, China
- Tarim Animal Disease Diagnosis and Control Engineering Laboratory of Xinjiang Production and Construction Corps, Xinjiang, China
| | - Fuchang Yu
- College of Animal Science and Technology, Tarim University, Xinjiang, China
- Tarim Animal Disease Diagnosis and Control Engineering Laboratory of Xinjiang Production and Construction Corps, Xinjiang, China
| | - Meng Qi
- College of Animal Science and Technology, Tarim University, Xinjiang, China
- Tarim Animal Disease Diagnosis and Control Engineering Laboratory of Xinjiang Production and Construction Corps, Xinjiang, China
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Zhang J, Fu Y, Bian X, Han H, Dong H, Zhao G, Li J, Li X, Zhang L. Molecular identification and genotyping of Blastocystis sp. in sheep and goats from some areas in Inner Mongolia, Northern China. Parasitol Int 2023; 94:102739. [PMID: 36787864 DOI: 10.1016/j.parint.2023.102739] [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: 09/15/2022] [Revised: 01/28/2023] [Accepted: 02/06/2023] [Indexed: 02/14/2023]
Abstract
Blastocystis sp. is a kind of unicellular intestinal commensal which is widely distributed in humans and animals, and frequently found in the people who are in close contact with animals. To investigate the prevalence and evaluate the zoonotic potential of Blastocystis sp. in sheep and goats from Inner Mongolia, China, a total of 1037 samples were collected from them, and subjected to nested PCR amplification based on the small subunit ribosomal RNA (SSU rRNA) gene of Blastocystis sp. The sanger sequencing was used for Blastocystis sp. subtype identification. The results indicated that the average infection rate of Blastocystis sp. was 10.70% [95CI: 8.82%-12.58%] (111/1037), including 11.30% [95CI: 7.96%-14.64%] for sheep (39/345) and 10.40% [95CI: 8.13%-12.67%] for goats (72/692). Five Blastocystis subtypes (ST5, ST10, ST14, ST21 and ST26) were identified in the present study. Among them, ST10 was the most dominant subtype in sheep and goats, accounting for 70.27% (78/111) of the total identified positive samples. This is the first report regarding Blastocystis sp. subtypes ST21 and ST26 in goats in China. This study has provided a detail epidemiological data on the prevalence and subtypes distribution of Blastocystis sp. in sheep and goats in Inner Mongolia, China. Our results indicated that sheep and goats could be reservoir host for multiple Bastocystis subtypes, including the zoonotic subtypes. Further studies among humans, livestock and wild animals are needed to better understand their role in the spread of Blastocystis sp.
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Affiliation(s)
- Junchen Zhang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, PR China; International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450046, PR China; Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, Zhengzhou 450046, PR China
| | - Yin Fu
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, PR China; International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450046, PR China; Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, Zhengzhou 450046, PR China
| | - Xiaokun Bian
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, PR China; International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450046, PR China; Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, Zhengzhou 450046, PR China
| | - Han Han
- Norman Bethune Health Science Center of Jilin University, Changchun 130021, Jinlin Province, PR China
| | - Heping Dong
- College of Veterinary Medicine, Northwest A&F University, Yangling 712100, PR China.
| | - Guanghui Zhao
- College of Veterinary Medicine, Northwest A&F University, Yangling 712100, PR China.
| | - Junqiang Li
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, PR China; International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450046, PR China; Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, Zhengzhou 450046, PR China.
| | - Xiaoying Li
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, PR China; International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450046, PR China; Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, Zhengzhou 450046, PR China
| | - Longxian Zhang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, PR China; International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450046, PR China; Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, Zhengzhou 450046, PR China.
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Distribution and Phylogenetic Analysis of Subtypes and Alleles of Blastocystis sp. in the Stool Samples Collected from Patients with Gastrointestinal Complaints in İzmir, Turkey. Acta Parasitol 2023:10.1007/s11686-023-00665-2. [PMID: 36806111 DOI: 10.1007/s11686-023-00665-2] [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: 10/07/2022] [Accepted: 01/19/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE Blastocystis sp. is one of the most prevalent intestinal protozoa found in humans and many other animals. The present study aimed to examine the distribution and genetic diversity of Blastocystis sp. in stool samples from patients with gastrointestinal complaints in İzmir, Turkey. METHODS All stool samples of 439 patients with gastrointestinal complaints were examined by native-Lugol and trichrome staining. To investigate the presence of Blastocystis sp. in stool samples, DNA was isolated, and PCR was performed with the barcode region in the SSU rRNA gene. PCR positive samples were sequenced to identify subtypes and alleles of Blastocystis sp. RESULTS The prevalence of Blastocystis sp. was found to be 16.6% (73/439) in patients with gastrointestinal complaints in İzmir, Turkey. Three different Blastocystis sp. subtypes were identified. ST3 (28/55; 51.0%) was the most common subtype followed by ST2 (19/55; 34.5%) and ST1 (8/55; 14.5%). Itching and diarrhea were the most prominent clinical symptoms in Blastocystis sp. positive patients. When clinical symptoms and subtypes were compared, diarrhea was found in 62.5%, 47.4%, and 46.4% of patients with ST1, ST2, and ST3 subtypes, respectively. In addition, itching was found in 37.5%, 32.1%, and 21.1% of patients with ST1, ST3, and ST2, respectively. Six distinct alleles were identified by allele analysis of Blastocystis 18S rRNA gene: allele 4 for ST1, alleles 9, 11, and 12 for ST2, and alleles 34 and 36 for ST3. In this study, Blastocystis sp. was detected in 16 of 21 districts, including the central and rural districts of İzmir. Although ST1 was detected in central districts, it was not found in rural districts. CONCLUSION This study provides comprehensive data on the prevalence and molecular epidemiology of the genetic diversity at the level of subtypes and alleles of Blastocystis sp. in different districts of İzmir province in Turkey. To the best of our knowledge, this is the first study which evaluates the distribution of subtypes and alleles of Blastocystis sp. according to PCR and SSU rRNA gene sequencing in patients with gastrointestinal complaints in different districts of İzmir province in Turkey.
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Zhang K, Qin Z, Qin H, Wang Y, Wang L, Fu Y, Hou C, Ji C, Yuan Y, Zhang L. First detection of Blastocystis sp. in migratory whooper swans ( Cygnus cygnus) in China. One Health 2023; 16:100486. [PMID: 36683961 PMCID: PMC9846003 DOI: 10.1016/j.onehlt.2023.100486] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/07/2023] [Accepted: 01/07/2023] [Indexed: 01/11/2023] Open
Abstract
Blastocystis is a usual intestinal protist that always found in humans and various animals. Currently, the prevalence of Blastocystis in the migratory whooper swan (Cygnus cygnus) is unknown. In our research, we aimed to determine the occurrence, prevalence, subtype distribution and dynamic transmission mechanisms of Blastocystis in the migratory whooper swan in China. We also assessed the zoonotic potential of Blastocystis isolates, as well as possible routes of transmission and impact of this organism on One Health perspective. Fecal samples (n = 770) were collected from whooper swans inhabiting the Sanmenxia Swan Lake National Urban Wetland Park, China. The overall prevalence of Blastocystis was 11.6% (89/770). We identified 9 subtypes of Blastocystis sp., including 5 zoonotic subtypes [ST1 (Cakir et al., 2019 (8)), ST4 (Selma and Karanis, 2011 (4)), ST5 (Stensvold et al., 2009 (1)), ST6 (Fare et al., 2019 (5)) and ST7(58)] and 3 host-specific subtypes [ST10 (Zhao et al., 2018 (7)), ST14 (Tan et al., 2010 (2)), ST23 (Wang et al., 2018 (3)), and ST25 (Stensvold et al., 2009 (1))]. Subtypes ST4, ST5, ST6, ST10, ST14, ST23, and ST25 were first identified in the whooper swan. Among these subtypes, ST23 and ST25 were identified in birds for the first time, indicating that these subtypes are expanding their host range. So far, this is the first research reporting on the prevalence and subtypes distribution of Blastocystis in the migratory whooper swan in China. The findings obtained in this study will provide new insights into the genetic diversity and transmission routes of Blastocystis, and the possible public health concerns posed by this organism.
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Affiliation(s)
- Kaihui Zhang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, PR China,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450002, Henan Province, PR China,Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, PR China
| | - Ziyang Qin
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, PR China,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450002, Henan Province, PR China,Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, PR China
| | - Huikai Qin
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, PR China,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450002, Henan Province, PR China,Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, PR China
| | - Yinlin Wang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, PR China,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450002, Henan Province, PR China,Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, PR China
| | - Luyang Wang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, PR China,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450002, Henan Province, PR China,Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, PR China
| | - Yin Fu
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, PR China,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450002, Henan Province, PR China,Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, PR China
| | - Changjiang Hou
- Sanmenxia Management Office of Henan Yellow River Wetland National Nature Reserve, Sanmenxia 472000, PR China
| | - Chenxiao Ji
- Sanmenxia Management Office of Henan Yellow River Wetland National Nature Reserve, Sanmenxia 472000, PR China
| | - Yuan Yuan
- Sanmenxia Management Office of Henan Yellow River Wetland National Nature Reserve, Sanmenxia 472000, PR China
| | - Longxian Zhang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, PR China,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou 450002, Henan Province, PR China,Key Laboratory of Quality and Safety Control of Poultry Products (Zhengzhou), Ministry of Agriculture and Rural Affairs, PR China,Corresponding author at: College of Veterinary Medicine, Henan Agricultural University, No. 15 Longzihu University Area, Zhengzhou New District, Zhengzhou 450046, PR China.
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Ali SH, Ismail MAM, El-Badry AA, Abu-Sarea EY, Dewidar AM, Hamdy DA. An Association Between Blastocystis Subtypes and Colorectal Cancer Patients: A Significant Different Profile from Non-cancer Individuals. Acta Parasitol 2022; 67:752-763. [PMID: 35067864 PMCID: PMC8784229 DOI: 10.1007/s11686-021-00508-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/09/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE Blastocystis is a common enteric human parasite of non-conclusive pathogenicity which may be determined by subtype (ST) variation. Colorectal cancer (CRC) is considered one of the primary causes of cancer mortality. Blastocystis ST7 has been shown to reduce beneficial intestinal microbiota and may exacerbate CRC. This study assessed the possible association between Blastocystis STs and CRC in comparison to non-cancer patients. MATERIAL AND METHODS A total of 200 fecal samples were obtained from CRC (100) and non-CRC (100) individuals attending Beni-Suef University Hospital, Egypt. Blastocystis was searched for in all samples using microscopy and culturing. Positive subculture samples were genetically sequenced and subtyped using conventional polymerase chain reaction (PCR). Blastocystis STs were determined by sequencing and a phylogenetic tree was created. Related patient characteristics and tumor stages were analyzed for association with presence of Blastocystis. RESULTS Blastocystis was identified in 52% and 42% of CRC and non-cancer individuals, respectively. ST1, 2, and 3 were isolated from both cancer and non-cancer individuals; however, for the first time, ST7 was only isolated from CRC stool samples with significant association. Associated patient characteristics were evaluated as predictors. CONCLUSION Blastocystosis is highly prevalent in CRC patients, predominantly in the latest CRC grades and stages. To the best of our knowledge, this is the first study to report the identification of Blastocystis ST7 in CRC patients. To determine whether certain STs of Blastocystis are associated with CRC would require further research, including the role played by gut microbiota.
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Affiliation(s)
- Shaimaa H. Ali
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Mousa A. M. Ismail
- Department of Medical Parasitology, College of Medicine, Cairo University, Giza, Egypt
| | - Ayman A. El-Badry
- Department of Microbiology-Medical Parasitology Section, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Enas Y. Abu-Sarea
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Ahmad M. Dewidar
- Department of Oncology, College of Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Doaa A. Hamdy
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni Suef, Egypt
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Relationship Among Blastocystis, the Firmicutes/Bacteroidetes Ratio and Chronic Stress in Mexican University Students. Curr Microbiol 2022; 79:72. [PMID: 35067729 PMCID: PMC8784498 DOI: 10.1007/s00284-021-02756-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 12/21/2021] [Indexed: 11/17/2022]
Abstract
The role played by Blastocystis in humans has been a subject of discussion due to its intestinal effects and modifications in the intestinal microbiota. We aimed to analyze the relationship between Blastocystis subtypes ST1-4 and 7, the Firmicutes to Bacteroidetes ratio (F/B ratio) of fecal microbiota, and chronic stress in university students. This study had a cross-sectional design with a sample of 202 students. We analyzed fecal and hair samples, and stress inventories were applied to the students. The results showed a frequency of Blastocystis-colonized students of 52.97%. Regarding fecal microbiota, a median RAU of 0.801 for Firmicutes and 0.82 of Bacteroidetes were obtained, with an F/B ratio of 0.83. A low F/B ratio (66.04%) was more frequent in Blastocystis-colonized students, whereas a high F/B ratio (68.09%) (p = < 0.0001) was found in the Blastocystis-non-colonized. Only Blastocystis ST3 did not significantly correlate with a low F/B ratio (p = 0.290). The ST4 was associated with lower values of cortisol (p = 0.030), psychological stress (p = 0.040), and lower frequency of constipation (p = 0.010). Only two students with the ST1 had abdominal pain (p = 0.007). Our results suggest that colonization by Blastocystis subtypes can modify the intestinal microbiota due to a decreased ratio between the two most representative phyla (F/B). Also, the results of this study show that ST4 colonization is related to a lower level of chronic stress.
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Prevalence of Blastocystis infection in free-range Tibetan sheep and Tibetan goats in the Qinghai-Tibetan Plateau in China. One Health 2021; 13:100347. [PMID: 34820500 PMCID: PMC8600063 DOI: 10.1016/j.onehlt.2021.100347] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/30/2021] [Accepted: 11/07/2021] [Indexed: 12/03/2022] Open
Abstract
Blastocystis is one of the most common enteric parasites in humans and domestic animals. For Tibetan sheep and Tibetan goats, the traditional grazing methods still occupy a dominant position, and the close contact between humans and domestic animals increases the risk of infection by Blastocystis between herdsmen and livestock. However, less pertinent information is available for Tibetan sheep or Tibetan goats. In this study, 880 fecal specimens from Tibetan sheep and Tibetan goats were collected from 6 sampling sites in Tibet to test for Blastocystis using the polymerase chain reaction and sequencing analysis of the partial SSU rRNA gene. The infection rate of Blastocystis was 8.55% for Tibetan sheep (53/620) and 8.46% for Tibetan goats (22/260). The genetic analysis of 53 positive samples from Tibetan sheep identified 4 known subtypes (ST4, ST5, ST10, and ST14). Four known subtypes (ST1, ST5, ST6, and ST10) were identified in Tibetan goats. ST10 was the dominant subtype in Tibetan sheep and Tibetan goats, accounting for 65.33% (49/75) of total subtypes. ST1, ST4, ST5, and ST6 were recognized as belonging to zoonotic subtypes. This report provides a detailed data on the prevalence and subtype distribution of Blastocystis in Tibetan sheep and Tibetan goats in Tibet, which enriches the epidemiological data of Blastocystis infection in Tibetan sheep and Tibetan goats in China. Our results indicated that Tibetan sheep and Tibetan goats can be infected with multiple Blastocystis subtypes, including zoonotic subtypes. More research is needed among humans, livestock and wild animals in Tibet to better understand their role in the spread of Blastocystis. And, One Health measures need to be taken to control and prevent its zoonotic transmission. Tibetan sheep and Tibetan goats were examined the Blastocystis for the first time. Subtypes ST4, ST5, ST10, ST14 in Tibetan sheep and subtypes ST1, ST5, ST6, ST10 in Tibetan goats were identified separately. Four potential zoonotic subtypes (ST1, ST4, ST5, ST6) were detected in this article.
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Asghari A, Sadeghipour Z, Hassanipour S, Abbasali Z, Ebrahimzadeh-Parikhani H, Hashemzaei M, Alimardani V, Hatam G. Association between Blastocystis sp. infection and immunocompromised patients: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:60308-60328. [PMID: 34528202 DOI: 10.1007/s11356-021-16187-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/23/2021] [Indexed: 06/13/2023]
Abstract
The significance of opportunistic infections in immunocompromised patients and the enigmatic pathogenicity of Blastocystis directed us to conduct the first global systematic review and meta-analysis on Blastocystis prevalence, odds ratios (ORs), and subtypes distribution in various immunocompromised patients (HIV/AIDS, cancer and hemodialysis patients, as well as transplant recipients). The systematic searching procedure was done in Web of Science, PubMed, Scopus, and Google Scholar databases for relevant published literature until November 11, 2020. Random-effects model was utilized to calculate the weighted estimates and 95% confidence intervals (95% CIs). The computed pooled prevalence of Blastocystis inferred from 118 papers (128 datasets) on immunocompromised patients was 10.3% (95% CI: 8.7-12.2%), with 16.1% (95% CI: 11.3-22.2%), 12.5% (95% CI: 8.5-18%), 8.4% (95 % CI: 6.6-10.6%), and 6% (95% CI: 2.6-13.3%) for hemodialysis patients, cancer patients, HIV/AIDS patients, and transplant recipients, respectively. Based on 50 case-control studies (54 datasets), the highest ORs were associated with cancer [2.81 (95% CI: 1.24-6.38, P = 0.013)] and hemodialysis patients [2.78 (95% CI: 1.19-6.48, P = 0.018)]. The most frequent subtype being found in immunocompromised patients was ST3 [41.7% (95% CI: 31.4-52.7%)], followed by ST1 [31.7% (95% CI: 23.2-41.8%)] and ST2 [23.1% (95% CI: 14.8-34.1%)]. Also, the weighted frequency of Blastocystis in various subgroups (publication year, WHO regions, geographical distribution, continents, and country income) was analyzed separately. In total, the results of the present meta-analysis highlighted that one's immunodeficiency status is probably associated with an increased Blastocystis infection, underpinning strict preventive measures to be taken.
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Affiliation(s)
- Ali Asghari
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zeinab Sadeghipour
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Abbasali
- Department of Medical Parasitology and Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Hasan Ebrahimzadeh-Parikhani
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Hashemzaei
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Alimardani
- Department of Pharmaceutical Nanotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholamreza Hatam
- Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Sarzhanov F, Dogruman-Al F, Santin M, Maloney JG, Gureser AS, Karasartova D, Taylan-Ozkan A. Investigation of neglected protists Blastocystis sp. and Dientamoeba fragilis in immunocompetent and immunodeficient diarrheal patients using both conventional and molecular methods. PLoS Negl Trop Dis 2021; 15:e0009779. [PMID: 34613993 PMCID: PMC8494357 DOI: 10.1371/journal.pntd.0009779] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/30/2021] [Indexed: 02/07/2023] Open
Abstract
Introduction The clinical significance of Blastocystis sp. and Dientamoeba fragilis in patients with gastrointestinal symptoms is a controversial issue. Since the pathogenicity of these protists has not been fully elucidated, testing for these organisms is not routinely pursued by most laboratories and clinicians. Thus, the prevalence of these organisms and the subtypes of Blastocystis sp. in human patients in Turkey are not well characterized. This study aimed to determine the prevalence of Blastocystis sp. and D. fragilis in the diarrheic stool samples of immunodeficient and immunocompetent patients using conventional and molecular methods and to identify Blastocystis sp. subtypes using next generation sequencing. Material and methods Individual stool specimens were collected from 245 immunodeficient and 193 immunocompetent diarrheic patients between March 2017 and December 2019 at the Gazi University Training and Research Hospital in Ankara, Turkey. Samples were screened for Blastocystis sp. and D. fragilis by conventional and molecular methods. Molecular detection of both protists was achieved by separate qPCRs targeting a partial fragment of the SSU rRNA gene. Next generation sequencing was used to identify Blastocystis sp. subtypes. Results The prevalence of Blastocystis sp. and D. fragilis was 16.7% and 11.9%, respectively as measured by qPCR. The prevalence of Blastocystis sp. and D. fragilis was lower in immunodeficient patients (12.7% and 10.6%, respectively) compared to immunocompetent patients (21.8% and 13.5%, respectively). Five Blastocystis sp. subtypes were identified and the following subtype distribution was observed: ST3 54.4% (n = 37), ST2 16.2% (n = 11), ST1 4.4% (n = 3), ST6 2.9% (n = 2), ST4 1.5% (n = 1), ST2/ST3 11.8% (n = 8) and ST1/ST3 8.8% (n = 6). There was no statistically significant difference in the distribution of Blastocystis sp. subtypes between immunocompetent and immunodeficient patients. Conclusion and recommendation Our findings demonstrated that Blastocystis sp. and D. fragilis are commonly present in immunocompetent and immunodeficient patients with diarrhea. This study is the first to use next generation sequencing to address the presence of Blastocystis sp. mixed subtypes and intra-subtype variability in clinical samples in Turkey. Blastocystis sp. and Dientamoeba fragilis are single-cell parasites of the human intestine which are common worldwide and reported in cases with gastrointestinal symptoms. However, the role of Blastocystis sp. and D. fragilis in patients with gastrointestinal symptoms is still controversial because their presence is not always associated with symptoms. As some intestinal parasitic infections can cause severe illness in immunocompromised individuals careful consideration of intestinal protist infection is warranted. However, testing for Blastocystis sp. and D. fragilis is not routinely carried out by most laboratories and clinicians. Therefore, this study aimed to determine the prevalence of Blastocystis sp. and D. fragilis in immunocompetent and immunosuppressed patients with diarrhea by conventional and molecular methods. Both Blastocystis sp. and D. fragilis were detected more frequently by quantitative polymerase chain reaction than by conventional methods. Next generation sequencing was used to characterize the diversity and frequency of Blastocystis sp. subtypes and mixed subtypes in patients in Turkey. Five Blastocystis sp. subtypes (ST1, ST2, ST3, ST4 and ST6) were detected. ST3 was the most frequent subtype in both immunocompetent and immunosuppressed patients. Mono-infections were more common than mixed subtype infections. Our findings showed that Blastocystis sp. and D. fragilis are commonly present in immunocompetent and immunodeficient patients with diarrhea.
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Affiliation(s)
- Fakhriddin Sarzhanov
- Division of Medical Parasitology, Department of Medical Microbiology, School of Medicine, Gazi University, Ankara, Turkey
- Akhmet Yassawi International Kazakh-Turkish University, Faculty of Medicine, Turkestan, Kazakhstan
| | - Funda Dogruman-Al
- Division of Medical Parasitology, Department of Medical Microbiology, School of Medicine, Gazi University, Ankara, Turkey
- * E-mail: ,
| | - Monica Santin
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, Maryland, United States of America
| | - Jenny G. Maloney
- Environmental Microbial and Food Safety Laboratory, Agricultural Research Service, United States Department of Agriculture, Beltsville, Maryland, United States of America
| | - Ayse Semra Gureser
- Department of Medical Microbiology, School of Medicine, Hitit University, Corum, Turkey
| | - Djursun Karasartova
- Department of Medical Microbiology, School of Medicine, Hitit University, Corum, Turkey
| | - Aysegul Taylan-Ozkan
- Department of Medical Microbiology, School of Medicine, Hitit University, Corum, Turkey
- Department of Medical Microbiology, Faculty of Medicine, TOBB- University of Economics and Technology, Ankara, Turkey
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Popruk S, Adao DEV, Rivera WL. Epidemiology and subtype distribution of Blastocystis in humans: A review. INFECTION GENETICS AND EVOLUTION 2021; 95:105085. [PMID: 34530156 DOI: 10.1016/j.meegid.2021.105085] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 12/19/2022]
Abstract
Blastocystis is a commonly encountered gastrointestinal protozoan in humans and animals with uncertain pathogenicity. Despite its potential public health impact, epidemiological data regarding the prevalence and molecular subtype (ST) distribution of Blastocystis have been rarely reported. Among Blastocystis STs, ST1-ST4 are common in humans, including healthy and immunodeficient populations. According to the Chi-squared (χ2) association based on the data compiled for this cross-sectional study, the presence of ST1 is associated with asymptomatic infection, whereas the presence of ST4 is associated with symptomatic infection. However, cross-sectional studies cannot clarify the potential pathogenicity of Blastocystis, unlike in vivo and in vitro studies. Poor hygiene, poor sanitation and zoonotic transmission are possible factors associated with high Blastocystis prevalence, although this protozoan may be part of the normal healthy human gastrointestinal microbiota. This review covers the prevalence, STs and distribution of Blastocystis infection in humans. Thus, future epidemiological and subtyping studies could reveal new STs in humans as well as possible associations of STs with disease, drug resistance and related mechanisms such as protease activity. These associations with proper ST identification may facilitate the control of potential threats to host health, including the direct pathogenic effects of Blastocystis or alterations of the gastrointestinal microbiome.
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Affiliation(s)
- Supaluk Popruk
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok 10400, Thailand
| | - Davin Edric V Adao
- Pathogen-Host-Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City 1101, Philippines
| | - Windell L Rivera
- Pathogen-Host-Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City 1101, Philippines.
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Asghari A, Sadrebazzaz A, Shamsi L, Shams M. Global prevalence, subtypes distribution, zoonotic potential, and associated risk factors of Blastocystis sp. in domestic pigs (Sus domesticus) and wild boars (Sus scrofa): A systematic review and meta-analysis. Microb Pathog 2021; 160:105183. [PMID: 34517066 DOI: 10.1016/j.micpath.2021.105183] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/02/2021] [Accepted: 09/06/2021] [Indexed: 12/30/2022]
Abstract
The intestinal parasite Blastocystis sp. is a widely distributed protist among humans and various animal hosts, with significant prevalence in developing countries. Due to the zoonotic nature of its subtypes (STs), we aimed at global estimation of the prevalence, STs distribution, zoonotic potential, and associated risk factors of Blastocystis sp. infection in domestic pigs (Sus domesticus) and wild pigs/wild boars (Sus scrofa). The study was designed and conducted in 2021 via searching articles in PubMed, Scopus, Google Scholar, and Web of Science databases, based on the PRISMA checklist, and meta-analysis was done using a random-effects model to calculate the weighted estimates and 95% confidence intervals (95% CIs). Totally, 43 papers (47 datasets) reported data on 7977 examined pigs in 24 countries with a total prevalence of 50.9% (95% CI: 42.8-59%). In details, prevalence was higher among domestic pigs [52.4% (95% CI: 43.9-60.7%)] than wild boars [31.2% (95% CI: 11.2-62%)], but is poorly statistically supported as far as the CIs largely overlap. Out of 28 reported STs, nine (ST1-ST7, ST10, and ST15) were reported from domestic pigs, while six (ST1, ST3-ST5, ST8, and ST15) had been isolated from wild boars. Among nine zoonotic STs (ST1-ST8, and ST12), all were identified in examined swine populations, except for ST12. As well, ST1 and ST5 were probably the most frequently circulating STs among these animals. In addition, male and older pigs showed higher Blastocystis sp. infection. Altogether, Blastocystis epidemiology and the distribution of its related STs in pigs is still open to question and requires more extensive studies, especially in the neglected regions of the world.
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Affiliation(s)
- Ali Asghari
- Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Alireza Sadrebazzaz
- Razi Vaccine & Serum Research Institute, Agricultural Research, Education and Extension Organization, Mashhad, Iran.
| | - Laya Shamsi
- Department of Pathobiology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.
| | - Morteza Shams
- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran.
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Investigation of Isolated Blastocystis Subtypes from Cancer Patients in Turkey. Acta Parasitol 2021; 66:584-592. [PMID: 33387270 DOI: 10.1007/s11686-020-00322-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/28/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE It is not clear that Blastocystis remains without damage to the digestive tract or has a pathogenic effect in relation to subtypes in immunocompromised people, such as cancer patients. The present study aimed to investigate the frequency and subtype distribution of Blastocystis in cancer patients who were followed-up and treated in the Oncology clinic of Firat University Hospital and to determine the clinical signs of infected sufferers. METHODS 201 patients aged ≥ 18 with a diagnosis of cancer were enrolled in this cross-sectional study. Patients' stool samples were examined between September 2017 and August 2019 by native-Lugol, trichrome staining. Microscopy-positive stool samples were subjected to DNA isolation and subtyped by Sequence Tagged Site (STS)-PCR analysis. The symptoms and demographic characteristics of the patients were also evaluated. RESULTS Totally, 29 (14.4%) samples were positive for Blastocystis after all methods. 15 (51.7%) out of 29 samples were successfully subtyped by the sequenced-tagged site(STS)-PCR, while 14 (48.3%) could not be typed. Three subtypes of Blastocystis were detected: ST3 (40%), ST2 (33%), ST1 (20%), and one mixed infections with ST1/ST2 (6%). There was no statistically significant difference in terms of clinical findings and demographic characteristics. CONCLUSION The outcomes of our study promote the idea that Blastocystis could be an asymptomatic and harmless commensal organism. However, more comprehensive molecular and clinical studies are needed to fully determine the pathogenicity and epidemiology of Blastocystis in cancer patients.
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Sarzhanov F, Köster PC, Dogruman-Al F, Bailo B, Dashti A, Demirel-Kaya F, Carmena D. Detection of enteric parasites and molecular characterization of Giardia duodenalis and Blastocystis sp. in patients admitted to hospital in Ankara, Turkey. Parasitology 2021; 148:550-561. [PMID: 32981546 PMCID: PMC10950376 DOI: 10.1017/s0031182020001821] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/10/2020] [Accepted: 09/18/2020] [Indexed: 11/06/2022]
Abstract
This epidemiological study assesses the occurrence of enteric parasites in 4303 patients attended at two public hospitals in Ankara (Turkey) during 2018-2019. Microscopy was used as a screening test. Giardia duodenalis was also identified using a commercial ELISA for the detection of parasite-specific coproantigens. Giardia-positive samples by microscopy/ELISA were confirmed by real-time PCR and characterized using a multilocus genotyping scheme. Blastocystis sp. was genotyped in a sample subset. Blastocystis sp. (11.1%, 95% CI 11.4‒14.8%) and G. duodenalis (1.56%, 95% CI 1.22‒1.96) were the most prevalent pathogens found. Cryptosporidium spp., Entamoeba histolytica and intestinal helminths were only sporadically (<0.5%) found. For G. duodenalis, sequence (n = 30) analyses revealed the presence of sub-assemblages AII (23.3%), discordant AII/AIII (23.3%) and mixed AII + AIII (6.7%) within assemblage A, and BIII (10.0%), BIV (3.3%) and discordant BIII/BIV (23.3%) within assemblage B. Two additional sequences (6.7%) were assigned to the latter assemblage but sub-assemblage information was unknown. No associations between G. duodenalis assemblages/sub-assemblages and sociodemographic and clinical variables could be demonstrated. For Blastocystis sp., sequence (n = 6) analyses identified subtypes ST1, ST2 and ST3 at equal proportions. This is the first molecular characterization of G. duodenalis based on MLG conducted in Turkey to date.
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Affiliation(s)
- Fakhriddin Sarzhanov
- Department of Medical Microbiology, School of Medicine, Gazi University, 06490Ankara, Turkey
- Faculty of Medicine, Akhmet Yassawi International Kazakh-Turkish University, 161200Turkestan, Kazakhstan
| | - Pamela Carolina Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain
| | - Funda Dogruman-Al
- Section of Medical Parasitology, Department of Medical Microbiology, School of Medicine, Gazi University, 06490Ankara, Turkey
| | - Begoña Bailo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain
| | - Alejandro Dashti
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain
| | - Filiz Demirel-Kaya
- Medical Microbiology Laboratory, Ankara Education and Research Hospital, Health Science University, 06230Ankara, Turkey
| | - David Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain
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Angelici MC, Walochnik J, Calderaro A, Saxinger L, Dacks JB. Free-living amoebae and other neglected protistan pathogens: Health emergency signals? Eur J Protistol 2020; 77:125760. [PMID: 33340850 DOI: 10.1016/j.ejop.2020.125760] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 10/25/2020] [Accepted: 11/13/2020] [Indexed: 02/08/2023]
Abstract
Protistan parasites have an undisputed global health impact. However, outside of a few key exceptions, e.g. the agent of malaria, most of these infectious agents are neglected as important health threats. The Symposium entitled "Free-living amoebae and neglected pathogenic protozoa: health emergency signals?" held at the European Congress of Protistology in Rome, July 2019, brought together researchers addressing scientific and clinical questions about some of these fascinating organisms. Topics presented included the molecular basis of pathogenicity in Acanthamoeba; genomics of Naegleria fowleri; and epidemiology of poorly diagnosed enteric protistan species, including Giardia, Cryptosporidium, Blastocystis, Dientamoeba. The Symposium aim was to excite the audience about the opportunities and challenges of research in these underexplored organisms and to underline the public health implications of currently under-appreciated protistan infections. The major take home message is that any knowledge that we gain about these organisms will allow us to better address them, in terms of monitoring and treatment, as sources of future health emergencies.
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Affiliation(s)
| | - Julia Walochnik
- Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Adriana Calderaro
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Lynora Saxinger
- Division of Infectious Diseases, Department of Medicine, University of Alberta, Alberta, Canada
| | - Joel B Dacks
- Division of Infectious Diseases, Department of Medicine, University of Alberta, Alberta, Canada; Institute of Parasitology, Biology Centre, Czech Academy of Sciences České Budějovice, Czech Republic.
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Deng Y, Zhang S, Ning C, Zhou Y, Teng X, Wu X, Chu Y, Yu Y, Chen J, Tian L, Wang W. Molecular Epidemiology and Risk Factors of Blastocystis sp. Infections Among General Populations in Yunnan Province, Southwestern China. Risk Manag Healthc Policy 2020; 13:1791-1801. [PMID: 33061712 PMCID: PMC7532910 DOI: 10.2147/rmhp.s269664] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/03/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Blastocystis is a common enteric parasite of controversial pathogenic roles in human diseases. Although the prevalence of Blastocystis infections has been investigated in a diverse range of populations, there is little knowledge on the molecular epidemiology and risk factors of Blastocystis infections among general populations in southeastern China. MATERIALS AND METHODS A total of 507 individuals were randomly selected in Yunnan province, China from July 2016 to March 2017. Stool specimens were sampled for detection of Blastocystis sp. using PCR assay, and the risk factors of Blastocystis infections were identified. Blastocystis isolates were subtyped, and the associations of Blastocystis infections and subtypes with clinical manifestations were examined. RESULTS The overall detection rate of Blastocystis sp. was 9.47% (95% CI: 7.13-12.44%). Toilet type (OR = 3.248, 95% CI: 1.245-8.473), anemia (OR = 2.601, 95% CI: 1.245-8.473) and type of daily drinking water (OR = 3.11, 95% CI: 1.557-6.213) were identified as risk factors of Blastocystis infections; however, Blastocystis infections showed no associations with clinical symptoms. Four subtypes (ST1 to ST4) were characterized in Blastocystis isolates, in which ST3 was predominant (4.73%, 95% CI: 3.2-6.94%), followed by ST1 (3.16%, 95% CI: 1.95-5.07%), ST4 (1.38%, 95% CI: 0.07-2.82%) and ST2 (0.2%, 95% CI: 0-1.11%). In addition, ST1 subtype infection was found to correlate with anemia (OR = 4.66, 95% CI: 1.631-14.314). CONCLUSIONS There is a high prevalence of Blastocystis infections among general populations in Yunnan province, southwestern China, and toilet type, anemia and type of daily drinking water are risk factors of Blastocystis infections. ST3 is the dominant subtype of Blastocystis sp. characterized, and ST1 correlates with anemia. Improving hygiene conditions, developing healthy lifestyles and intensifying health education programs are strongly recommended to reduce the prevalence and transmission potential of Blastocystis infections.
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Affiliation(s)
- Yao Deng
- Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, Jiangsu Province, People's Republic of China
| | - Shunxian Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Chaoqun Ning
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Yongkang Zhou
- The First Clinical Medical College of Lanzhou University, Lanzhou 730000, Gansu Province, People's Republic of China
| | - Xuejiao Teng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Xiuping Wu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Yanhong Chu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Yingfang Yu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Jiaxu Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Liguang Tian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasites and Vector Biology, WHO Collaborating Center for Tropical Diseases, Chinese Center for Tropical Diseases Research, Shanghai 200025, People's Republic of China
| | - Wei Wang
- Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, Jiangsu Province, People's Republic of China
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19
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Wang R, Zhang Y, Jiang Y, Xing J, Tao D, Qi M. First Report of Blastocystis Infection in Pigs from Large Farms in Xinjiang, China. J Eukaryot Microbiol 2020; 67:642-647. [PMID: 32623806 DOI: 10.1111/jeu.12816] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/16/2020] [Accepted: 06/25/2020] [Indexed: 11/28/2022]
Abstract
Blastocystis is a common intestinal protozoan in humans and various animals worldwide. A few studies have reported the genetic characterization of Blastocystis in pigs in China, but no epidemiological data are available from the Xinjiang Uygur Autonomous Region. In this study, 801 fecal samples were collected from seven scale pig farms in Xinjiang and tested by polymerase chain reaction and sequence analysis of the partial SSU rRNA gene. The average infection rate of Blastocystis was 21.7% (174/801), with 7.1% in preweaning piglets, 10.0% in postweaning piglets, 31.8% in fattening pigs, and 41.9% in sows (χ2 = 104.89; P < 0.01). Blastocystis subtypes ST1 (7/174), ST3 (2/174), and ST5 (165/174) were identified, with subtype ST5 being predominant in each of the pig farms and in each of the age groups. ST3 and ST5 were identified in preweaning piglets, and ST1, ST3, and ST5 were identified in postweaning piglets. In contrast, only the subtype ST5 was observed in fattening pigs and sows. Genetic polymorphisms were observed at the intrasubtype level, including two variations of ST1 (ST1A, ST1B), and seven of ST5 (ST5A to ST5G), by sequence alignment analysis and phylogenetic analysis. More studies are needed to elucidate the transmission and public health significance of Blastocystis in pigs in various areas.
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Affiliation(s)
- Rongjun Wang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, Henan, 450046, China
| | - Ying Zhang
- College of Animal Science, Tarim University, Alar, Xinjiang, 843300, China
| | - Yuxi Jiang
- College of Animal Science, Tarim University, Alar, Xinjiang, 843300, China
| | - Jinming Xing
- College of Animal Science, Tarim University, Alar, Xinjiang, 843300, China
| | - Dayong Tao
- College of Animal Science, Tarim University, Alar, Xinjiang, 843300, China
| | - Meng Qi
- College of Animal Science, Tarim University, Alar, Xinjiang, 843300, China
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20
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Bahrami F, Babaei E, Badirzadeh A, Riabi TR, Abdoli A. Blastocystis, urticaria, and skin disorders: review of the current evidences. Eur J Clin Microbiol Infect Dis 2020; 39:1027-1042. [PMID: 31873864 DOI: 10.1007/s10096-019-03793-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 12/05/2019] [Indexed: 12/17/2022]
Abstract
Blastocystis is one of the most common intestinal protozoan parasites worldwide, which is linked to cutaneous lesions and urticaria. In a setting of systematic review, the data on the association of Blastocystis infection with cutaneous lesions were searched in order to summarize the main clinical symptoms, diagnostic methods, treatment, and outcome of the patients. The search identified 28 eligible articles, including 12 cross-sectional studies and 16 case reports/case series (including 23 cases). A diverse spectrum of skin symptoms, mainly urticaria, rash, and itching, was reported from the studies. Of the 23 infected cases with the skin symptoms, gastrointestinal symptoms were reported from the 16 cases, whereas 7 cases with urticaria had asymptomatic infection. The most frequent subtypes were ST1, ST2, and ST3, respectively. Metronidazole, paromomycin, and tinidazole were the most prescribed drugs in patients with single Blastocystis infection. Notably, urticaria and other cutaneous symptoms of all treated patients were resolved after treatment. In conclusion, this study indicates that Blastocystis infection can be a neglected cause of urticaria and skin disorders. Since the treatment of Blastocystis infection is simple, screening and treatment of this infection should be considered in patients with urticaria and other skin disorders.
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Affiliation(s)
- Fares Bahrami
- Zoonoses Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Erfan Babaei
- Department of Immunology & Hematology, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Alireza Badirzadeh
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Rezaei Riabi
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Abdoli
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom, Iran.
- Zoonoses Research Center, School of Medicine, Jahrom University of Medical Sciences, 74148-46199, Ostad Motahari Ave, Jahrom, Iran.
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21
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Qi M, Wei Z, Zhang Y, Zhang Q, Li J, Zhang L, Wang R. Genetic diversity of Blastocystis in kindergarten children in southern Xinjiang, China. Parasit Vectors 2020; 13:15. [PMID: 31924261 PMCID: PMC6954523 DOI: 10.1186/s13071-020-3890-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/04/2020] [Indexed: 12/02/2022] Open
Abstract
Background Blastocystis is one of the most common intestinal parasites in humans and various animals worldwide. Few studies are available regarding the genetic characterization of Blastocystis infections in humans in China. Methods In the present study, 609 fecal samples were collected from two- to six-year-old kindergarten children in southern Xinjiang and were examined by polymerase chain reaction (PCR). Results The infection rate of Blastocystis was 14.3% (87/609); no significant difference was observed among counties and between sexes. Blastocystis subtypes ST1 (n = 38), ST2 (n = 8), and ST3 (n = 41) were identified by sequence analysis of the small subunit ribosomal RNA gene. Genetic polymorphisms were observed at the intra-subtype level, including seven variations for ST1 (ST1A to ST1G), four for ST2 (ST2A to ST2D), and two for ST3 (ST3A and ST3B); with ST1F and ST2B being new variations. Conclusions ST1 and ST3 are the two common Blastocystis subtypes in the study area. More extensive studies in both humans and animals in different regions are needed to better characterize the transmission of Blastocystis.
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Affiliation(s)
- Meng Qi
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, Henan, People's Republic of China.,College of Animal Science, Tarim University, Alar, 843300, Xinjiang, People's Republic of China
| | - Zilin Wei
- College of Animal Science, Tarim University, Alar, 843300, Xinjiang, People's Republic of China
| | - Ying Zhang
- College of Animal Science, Tarim University, Alar, 843300, Xinjiang, People's Republic of China
| | - Qiyuan Zhang
- College of Animal Science, Tarim University, Alar, 843300, Xinjiang, People's Republic of China
| | - Juanfeng Li
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, Henan, People's Republic of China
| | - Longxian Zhang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, Henan, People's Republic of China.
| | - Rongjun Wang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, Henan, People's Republic of China.
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22
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Gong B, Liu X, Wu Y, Xu N, Xu M, Yang F, Tong L, Zhou K, Cao J, Liu A, Shen Y. Prevalence and subtype distribution of Blastocystis in ethnic minority groups on both sides of the China-Myanmar border, and assessment of risk factors. ACTA ACUST UNITED AC 2019; 26:46. [PMID: 31343971 PMCID: PMC6658150 DOI: 10.1051/parasite/2019046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 07/16/2019] [Indexed: 11/14/2022]
Abstract
Blastocystis is one of the most common intestinal parasites in humans worldwide. To understand its prevalence and to explore the risk factors for Blastocystis in humans in developing countries, a molecular epidemiological investigation of Blastocystis was conducted in ethnic minority groups on both sides of the China-Myanmar border. A total of 461 fecal specimens were collected from 289 Yao people in China and 172 Wa people in Myanmar, together with a questionnaire for each participant. Based on sequence analysis of the partial small subunit of ribosomal RNA (SSU rRNA) gene (barcode region or 260 bp region), an average prevalence of 6.29% (29/461) was observed, with 4.50% (13/289) in Yao people and 9.30% (16/172) in Wa people. Twenty-two Blastocystis isolates were successfully subtyped by sequence analysis of the barcode region. Three subtypes were identified: ST1 (n = 7), ST3 (n = 13) and ST4 (n = 2). A statistical difference in the prevalence of Blastocystis was only observed between children (12.37%, 12/97) and adults (4.95%, 16/323), and between not washing hands (11.02%, 14/127) and washing hands (4.76%, 15/315) after using toilets, emphasizing the importance and necessity of health education in people in the investigated areas, especially in children.
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Affiliation(s)
- Baiyan Gong
- Department of Parasitology, Harbin Medical University, Harbin, 150081 Heilongjiang, PR China
| | - Xiaohua Liu
- Department of Parasitology, Harbin Medical University, Harbin, 150081 Heilongjiang, PR China
| | - Yanchen Wu
- Department of Parasitology, Harbin Medical University, Harbin, 150081 Heilongjiang, PR China
| | - Ning Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, MOH, Shanghai 200025, PR China
| | - Meng Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, MOH, Shanghai 200025, PR China
| | - Fengkun Yang
- Department of Parasitology, Harbin Medical University, Harbin, 150081 Heilongjiang, PR China
| | - Lei Tong
- Department of Parasitology, Harbin Medical University, Harbin, 150081 Heilongjiang, PR China
| | - Kexin Zhou
- Department of Parasitology, Harbin Medical University, Harbin, 150081 Heilongjiang, PR China
| | - Jianping Cao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, MOH, Shanghai 200025, PR China
| | - Aiqin Liu
- Department of Parasitology, Harbin Medical University, Harbin, 150081 Heilongjiang, PR China
| | - Yujuan Shen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, MOH, Shanghai 200025, PR China
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