Intestinal parasitic infections among inhabitants of Karaj City, Tehran province, Iran in 2006-2008

Prevalence and subtyping of Blastocystis sp. in ruminants in Southwestern, Iran

Blastocystis is the most common gastrointestinal protozoan parasite of humans and many vertebrates. This study was carried out to investigate the prevalence and determination subtype (ST) of Blastocystis in domestic ruminants of Shahrekord County, southwestern Iran. In this descriptive cross-sectional study, 330 ruminant fecal samples (107 cows, 115 sheep, and 108 goats) were evaluated by parasitological methods (direct wet mount microscopic examination and formalin-ether concentration), Giemsa staining, In vitro xenic culture (The modified Dobell and Laidlaw culture method), polymerase chain reaction, and sequencing from 2018 to 2019, then data were analyzed using SPSS software version 21. The overall Blastocystis positive in ruminants was 14.2% and the frequency of Blastocystis sp. in cattle, sheep, and goats were 0.93%, 17.4%, and 24.1% respectively. Molecular diagnosis techniques revealed that ruminants were infected with four STs (genotypes) of Blastocystis including ST5(21.3%), ST7(2.1%), ST10(17.1%) and ST14(57.4%). Also, the STs identified in cows were ST10, and the observed STs in sheep were ST5 (40%), ST7 (3%), ST10 (5%), ST14 (45%), and one unknown subspecies. Goats were infected by ST5 (7.7%), ST10 (23.1%), and ST14 (69.2%). In this study, ST14 was identified as the most common subtype of Blastocystis sp. that was not common between humans and livestock, meanwhile, ST5 and ST7 are common between humans and animals accounted 21.3% and 2.1% of the positive cases, respectively, and reinforces the hypothesis that ruminants are reservoirs of blastocystosis in humans.

Intestinal Parasitic Infections in People Referring to the Central Laboratory of Meshkin Shahr County, Ardabil Province, Iran

Background

Intestinal parasitic infections are still a considerable global public health problem. We aimed to determine the frequency of intestinal parasitic infections among people referring to the central laboratory of Meshkin Shahr City, Ardabil Province, Iran.

Methods

In this cross-sectional survey, 460 fecal samples were collected randomly from persons referred to the central laboratory of Meshkin Shahr City, from January to June 2022. The samples were examined by direct wet-mount, Trichrome and modified Ziehl-Neelsen staining, formalin ethyl acetate sedimentation, and agar plate culture.

Results

The frequency of intestinal parasites was 15.7% (72 out of 460 cases), with some people with numerous intestinal parasites. The frequency of protozoan infections (13.9%) was higher than the helminthic infections (2.6%). Blastocystis spp. (8.1%) was the most prevalent detected intestinal protozoan. Entamoeba coli (5.7%), Dicrocoelium dendriticum (2.2%), Giardia lamblia (1.5%), Fasciola spp. (0.2%), and Hymenolepis nana (0.2%) were other detected parasites.

Conclusion

In- spite of betterment of the health condition in Iran and reduction of parasitic infection, intestinal parasitic infections are still a considerable public health issue in some parts of Iran.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Prevalence and Associated Risk Factors of Human Intestinal Helminths Parasitic Infections in Ethiopia: A Systematic Review and Meta-Analysis

Background

Intestinal helminth infections are still public health problems in tropical and subtropical countries including Ethiopia. This review and meta-analysis aimed to produce the pooled prevalence and associated risk factors of human intestinal helminth parasitic infections (HIHPIs) in Ethiopia.

Methods

Articles written in English were searched from online databases. Sixty-seven studies were included. Meta-analysis was computed using STATA version 14.

Result

The pooled prevalence of HIHPIs was (33.35%, 95% CI: 28.85%, 37.86%). Ascaris lumbricoides (10.84%, 95% CI: 9.34, 12.34), hookworm spp. (8.89%, 95% CI: 7.75, 10.04), Schistosoma mansoni (4.22%, 95% CI: 3.64, 4.81), Trichuris trichiura (2.51%, 95% CI: 2.17, 2.86), Hymenolepis nana (2.29%, 95% CI: 1.96, 2.63), Taenia species (1.01%, 95% CI: 0.80, 1.22), Strongyloides stercoralis (1.17%, 95% CI: 0.92, 1.41), and Enterobius vermicularis(0.71%, 95% CI: 0.52, 0.90) were recorded. Handwashing before food (OR: 5.22,95% CI: 3.49, 6.94), handwashing after toilet (OR: 3.03, 95%; CI: 1.01, 5.05), age (OR: 1.66, 95% CL. 1.09, 2.23), open defecation (OR: 2.42, 95% CI: 1.60, 3.24), eating raw and unwashed vegetables/fruits (OR: 1.98, 95%; CI: 1.30, 2.66), maternal education (OR: 1.81, 95% CI: 0.91, 2.72), family income (OR: 2.00, 95% CI: 0.87, 3.31), source of drinking water (OR: 3.12, 95% CI: 1.96, 4.27), swimming/contact with river water (OR: 1.90, 95% CI: 1.11, 2.69), barefoot (OR: 3.28, 95% CI: 1.67, 4.88), playing with soil (OR: 2.64, 95% CI: 1.40, 3.88), and family size (OR: 3.75, 95% CI: 2.03, 5.46) were factors associated with HIHPIs in Ethiopia. High heterogeneity of the prevalence of HIHPIs was observed among the studies within and among regions (I2 > 99.6% and P ≤ 0.001).

Conclusion

HIHPIs in Ethiopia were significantly high. Therefore, special attention should be given by all stakeholders to minimize HIHPIs in Ethiopia.

Prevalence and Associated Risk Factors of Intestinal Parasitic Infections among Patients Visiting a Referral Hospital in Tehran Province, Iran

BACKGROUND

Intestinal parasitic infections (IPIs) are still considered a public health problem of mankind, particularly in immunocompromised patients. We aimed to determine the prevalence of IPIs with an emphasis on immunocompromised patients in a referral hospital in Tehran Province, Iran.

METHODS

In this cross-sectional study, 442 fecal specimens were collected randomly from patients, referred to Baqiyatallah Hospital in Tehran Province, Iran from May to September 2020. The collected specimens were examined using wet-mount, trichrome and modified Ziehl-Neelsen staining, formalin-ether concentration, and agar plate culture.

RESULTS

The prevalence of IPIs was found 17.0% (95% CI: 13.6-20.8%). The prevalence of protozoan parasites (16.3%; 95% CI: 13.0-20.1%) was significantly higher than helminthic parasites (0.7%; 95% CI: 0.1-2.0%). Blastocystis spp., Giardia lamblia, and Entamoeba coli were the most common intestinal protozoan with a prevalence of 12.2%, 1.6%, and 1.4%, respectively. E. histolytica/E. dispar/E. moshkovskii, Iodamoeba bütschlii, Cryptosporidium spp., Chilomastix mesnili as protozoan species and Hymenolepis nana, Dicrocoelium dendriticum, and Ascaris lumbricoides as helminthic species were the other detected parasites. Multiple logistic regression revealed a significant association of IPIs infections with stool consistency and the status of immune system.

CONCLUSION

The prevalence of IPIs among the patients who are immunocompromised was significantly higher than immunocompetent patients (P< 0.05). Periodic stool examinations for screening of IPIs should be included as a part of routine medical check-up in these patients.

Intestinal parasitic infections among patients referred to hospitals affiliated to Shiraz University of Medical Sciences, southern Iran: a retrospective study in pre- and post-COVID-19 pandemic

Intestinal parasitic infections (IPIs) are still a serious public health problem worldwide, particularly in developing countries. The COVID-19 pandemic has affected people's lifestyles and quality of life. Besides, the prevalence of IPIs is directly associated with environmental sanitation, overcrowding, and personal hygiene. Therefore, the current study aimed to determine the prevalence of IPIs among patients referred to hospitals affiliated to Shiraz University of Medical Sciences by reviewing the available data of hospital information system database in the pre- and post-COVID-19 pandemic. The total data of 13,686 patients referred to hospitals affiliated to Shiraz University of Medical Sciences, southern Iran were collected from March 2019 to March 2021. The overall prevalence of IPIs was found to be 4.4%, and Blastocystis spp. was the most common parasite. The prevalence of protozoan parasites (4.4%) was significantly higher than helminthic parasites (0.04%, P < 0.001). A significant association was observed between IPIs with age, gender, and year (P < 0.05). The prevalence of IPIs among those referred to hospitals before the COVID-19 pandemic was higher than those referred to hospitals during the COVID-19 pandemic (5.8% vs 2.8%), and the differences were statistically significant (P < 0.001). The odds of infection among people investigated during the COVID-19 pandemic was about 40% lower than those investigated before the COVID-19 pandemic (AOR: 0.60, 95% CI: 0.49-0.73, P < 0.001). Our results showed that the prevalence of IPIs has decreased during the COVID-19 pandemic. Improved sanitation, personal hygiene, and health education can be effective in reducing parasitic infections in the COVID-19 pandemic.

Prevalence and Risk Factors Associated with Intestinal Parasitic Infection among Primary School Children in Dera District, Northwest Ethiopia

BACKGROUND

Globally, over 600 million school children are living with intestinal parasites. The prevalence of intestinal parasitic infections (IPIs) among school children in Ethiopia and the Amhara region is 52% and 51%, respectively. The present study aimed to determine the prevalence and associated risk factors of IPIs among primary school children in Dera district, Northwest Ethiopia.

METHODS

A school-based cross-sectional study was conducted from December 2019 to February 2020. The study used a structured pretested questionnaire and stool tests to obtain epidemiological and disease data. Data were analyzed using appropriate univariate and multivariable logistic regression methods by statistical package for social science (SPSS) version 25.0.

RESULTS

Of the 382 students who were examined for IPIs, 238 (62.3%) (61.8% males, 62.8% females) were positive for one or more IPIs. One hundred thirty-six (35.6%), 98 (25.7%), and 4 (1.05%) were single, double, and triple infections, respectively. Out of the nine species of IPIs detected, Entamoeba sp. was the predominant species (29.6%) followed by hookworm (21.7%), Schistosoma mansoni (11.3%), Taenia sp. (9.2%), Giardia lamblia (5.2%), and Ascaris lumbricoides, Hymenolepis nana, and Enterobius vermicularis (4.2%) each, and Trichuris trichiura (0.5%). Family size greater than five (AOR = 1.8; 95% CI: 1.004, 3.13), open field school waste disposal (AOR = 15.88; 95% CI: 1.91, 132.1), and lack of knowledge about intestinal parasitic infection (AOR = 1.8; 95% CI: 1.1, 3.2) were the independent risk factors associated with the overall prevalence of IPIs.

CONCLUSIONS

The prevalence of intestinal parasitic infection was high in the Dera district. Health education, extending school-based deworming, and mass treatments are recommended.

Spatial Distribution of Common Pathogenic Human Intestinal Protozoa in Iran: A Systematic Review

Background:

Pathogenic intestinal protozoa are considered as a serious public health problem in developing countries. This study aimed to elucidate the overall prevalence and spatial distribution of three common human pathogenic intestinal protozoan infections in Iran.

Methods:

Six English and Persian databases were explored for published papers on the prevalence of Entamoeba histolytica/dispar, Giardia lamblia, and Cryptosporidium spp. in the general population of Iran from 2000 to 2015. All eligible data were collected using a pre-designed data extraction form, and the overall prevalence was estimated using a random-effects meta-analysis model. We used ArcMap for mapping the prevalence of the studied protozoa and clustering analysis.

Results:

Altogether, 118 eligible papers from 24 provinces of Iran were included and analyzed. The weighted prevalence of E. histolytica/dispar, G. lamblia, and Cryptosporidium spp. infection among Iranian general population were calculated 1.3% (95% CI 1.1–1.5%), 10.6% (95% CI 9.6–11.5%) and 2% (95% CI 1.5–2.5%), respectively.

Conclusion:

Our findings indicated human intestinal protozoan infections caused by E. histolytica/dispar, G. lamblia, and Cryptosporidium spp. have still public health importance in some parts of Iran.

Prevalence and Associated Risk Factors of Human Intestinal Protozoan Parasitic Infections in Ethiopia: A Systematic Review and Meta-Analysis

Background

Human intestinal protozoan parasitic infections (HIPPIs) are a series of public health problems in developing countries like Ethiopia. The overall prevalence of HIPPIs in Ethiopia is not known. Therefore, this systematic review and meta-analysis study is aimed at determining the overall prevalence of HIPPIs in Ethiopia.

Methods

Articles written in English were searched from online public databases. Searching terms used were "prevalence," "intestinal protozoan parasite," "associated factors," and "Ethiopia." We used Stata version 14 for meta-analysis and Cochran's Q test statistics and the I ² test for heterogeneity.

Result

A total of 286 articles were reviewed, but only 45 of them fulfilled the inclusion criteria. The pooled prevalence of HIPPIs in Ethiopia was 25.01% (95% CI: 20.08%-29.95%) where Entamoeba histolytica/dispar is the most prevalent (14.09%, 95% CI: 11.03%-17.14%) followed by Giardia lamblia (10.03%, 95% CI: 7.69%-12.38%) and Cryptosporidium spp. (5.93%, 95% CI: 2.95%-8.91%). This meta-analysis showed that family size (OR: 3.7, 95% CI: 1.45-5.85), source of drinking water (OR: 3.33, 95% CI: 1.30-5.36), open field defecation (OR: 2.91, 95% CI: 1.60-4.21), handwashing habit (OR: 2.82, 95% CI: 2.01-3.63), playing with soil (OR: 2.15, 95% CI: 1.01-3.29), the habit of eating raw vegetables (OR: 1.77, 95% CI: 1.03-2.51), and fingernail trimming (OR: 1.70, 95% CI: 0.89-2.25) were strongly associated with the HIPPIs in Ethiopia. High heterogeneity on the prevalence of HIPPIs was observed among studies within and among regions (I ² > 99% and P ≤ 0.01).

Conclusion

The prevalence of HIPPIs was significantly high among the Ethiopian population. Family size, source of drinking water, open field defecation, handwashing habit, the habit of eating raw vegetables, and fingernail trimming habits were significantly associated with HIPPIs.

The Frequency of the Intestinal Parasites Giardia Lamblia and Entamoeba Histolytica in Pediatric Diarrhea Specimens from Central Iran

Introduction:

Intestinal parasitic infections, particularly those caused by Giardia lamblia, are among the major health problems that exist worldwide, especially in developing countries. This study aimed to investigate the prevalence of the intestinal parasites Giardia lamblia and Entamoeba histolytica that were isolated from samples of infectious diarrhea in pediatric patients from Central Iran.

Methods:

This descriptive cross-sectional study included 230 samples of infectious diarrhea that were collected from May 2015 to February 2016. Direct observation, the formalin-ether sedimentation method and the technique using the Polymerase Chain Reaction (PCR) of β-giardin and EH primers were used for the identification of Giardia lamblia and Entamoeba histolytica.

Results:

Out of 230 samples of infectious diarrhea, five cases (2.1%) of Giardia lamblia and no cases (0%) of Entamoeba histolytica were identified using the formalin-ether sedimentation method and the same result were obtained using PCR technique. Of the five patients who had Giardia lamblia, three (60%) were male and two (40%) were female. The most common clinical symptoms in these patients were stomach ache and diarrhea (100%) and mucus in the stool (80%).

Conclusion:

Giardia lamblia was introduced as a parasitic agent causing diarrhea from Central Iran. The results indicate that pediatricians and, even more importantly, experts in laboratories should pay special attention to the identification of this parasite to treat the patients as effectively and as quickly as possible.

Prevalence and associated risk factors of human intestinal parasitic infections: a population-based study in the southeast of Kerman province, southeastern Iran

Background

Determination of the prevalence and distribution pattern of intestinal parasites is a fundamental step to set up an effective control program to improve the health status. This study aimed to determine the prevalence of intestinal parasitic infections and associated risk factors among inhabitants of Rudbar-e Jonub county, southeast of Kerman province, southeastern Iran.

Methods

In this cross-sectional study, 861 stool specimens were collected from inhabitants of Rudbar-e Jonub county through a multistage cluster sampling method in 2018. The collected specimens were examined by parasitological methods including, direct wet-mounting (for the fresh specimens with a watery consistency), formalin-ethyl acetate sedimentation and agar plate culture.

Results

The prevalence of intestinal parasites was 34.2% (95% CI 30.1 to 38.2). The prevalence of protozoan parasites 32.3% (95% CI 28.4 to 36.5) was significantly higher than helminthic parasites 3.2% (95% CI 2.1 to 4.7). Blastocystis sp. (13.3%), Entamoeba coli (11.4%) and Giardia lamblia (10.6%) as protozoan parasite and Hymenolepis nana (2.4%) as helminthic parasite were the most common detected intestinal parasites in the study. Entamoeba histolytica/dispar (1.5%), Iodamoeba bütschlii (1.0%), Chilomastix mesnili (0.5%), Entamoeba hartmanni (0.4%), Enterobius vermicularis (0.3%) and Ascaris lambercoides (0.3%) were other detected parasites. Multiple logistic regression revealed a significant association of intestinal parasitic infections with source of drinking water and residency status (rural/urban). Multiple infections with 2 or 3 parasitic agents constituted 22.7% of 295 infected cases.

Conclusions

This study revealed a high prevalence of intestinal protozoan infections among inhabitants of Rudbar-e Jonub county. Intestinal parasites especially protozoans remain a challenging public health problem wherever sanitation and health measures are limited in Iran.

The Prevalence of Intestinal Parasitic Infections in Ahvaz, Southwest of Iran, during 2007-2017

BACKGROUND

Intestinal parasitic infections (IPIs) are frequently considered one of the public health problems worldwide. Therefore, we aimed to evaluate the prevalence of IPIs among patients.

METHODS

In this Retrospective cross-sectional study, 50000 stool samples (24551 males) were collected among males and females referred to Naft Hospital of Ahvaz, southern Iran during 2007-2017. At first, the collected specimens were macroscopically observed for the presence of trophozoites, eggs, cysts using the procedure of direct as well as the method of formalin-ether concentration.

RESULTS

Of 50000 samples, 2878 (5.75%) cases were positive for IPIs that 1426 and 1452 cases were observed in the males and females, respectively. Giardia lamblia with 887 (1.774%) cases, Blastocystis hominis with 784 (1.568%) cases, Entamoeba histolytica/dispar with 685 (1.37%) cases, E. coli with 357 (0.714%) cases, Trichomonas hominis with 43 (0.086%) cases, Chilomastix mesnili with 40 (0.08%) cases, Hymenolepis nana with 38 (0.076%) cases, Lodamoeba butschlii with 25 (0.05%) cases, Endolimax nana with 18 (0.036%) cases, Taenia saginata proglottid with one (0.002%) case were found.

CONCLUSION

Our finding showed a relatively high prevalence of IPIs among people referred to Naft Hospital of Ahvaz, southern Iran during 2007-2017.

Fatty acid and retinol-binding protein: A novel antigen for immunodiagnosis of human strongyloidiasis

The tenacious human parasitic helminth Strongyloides stercoralis is a significant health problem worldwide. The current lack of a definitive diagnostic laboratory test to rule out this infection necessitates designing more specific diagnostic methods. Fatty acid and retinol-binding protein (FAR) plays a crucial role in the development and reproduction of nematodes. We generated a recombinant form of this protein and determined its applicability for immunodiagnosis of S. stercoralis. The L3 form of S. stercoralis was harvested and used for RNA extraction and cDNA synthesis. The coding sequence of S. stercoralis FAR (SsFAR) was cloned into pET28a(+) vector, expressed in E. coli BL21 and purified. ELISA and immunoblotting were employed to determine the specificity and sensitivity of rSsFAR using a set of defined sera. In addition, we analyzed the phylogenetic relationship of SsFAR with different FAR sequences from other nematodes. The cloned SsFAR had an open reading frame of 447 bp encoding 147 amino acids, with a deduced molecular mass of 19 kD. The SsFAR amino acid sequence was 93% identical to FAR of S. ratti. For differential immunodiagnosis of strongyloidiasis, rSsFAR exhibited 100% sensitivity and 97% specificity. However, cross-reactivity with FAR proteins of other parasites, namely Toxocara canis and Echinococcus granulosus, was noted. Our results provide a novel approach for immunodiagnosis of S. stercoralis infections using rSsFAR with reliable sensitivity and specificity.

Giardia lamblia assemblages A and B isolated from symptomatic and asymptomatic persons in Hamadan, west of Iran

Giardia is a very abundant organism bringing about diarrhoea in human beings. The focus of this analysis was the detection of Giardia lamblia assemblages in human stool specimens in Hamadan, west of Iran, as well as the association between obtained assemblages and clinical symptoms. Faecal samples of 4066 individuals admitted to the medical and health care facilities in Hamadan were inspected microscopically for the existence of Giardia cysts/trophozoites, and the clinical symptoms of the patients were recorded. The DNA of positive samples was isolated from and the nucleotide sequences of both glutamate dehydrogenase (gdh) (n = 15) and triose phosphate isomerase (tpi) (n = 8) genes were analyzed. In direct microscopy, a total of sixty-four samples (1.6%), were considered as positive for G. lamblia cysts or trophozoites. The sequence analysis showed that 18 out of 23 sequenced isolates (78.2%) were assemblage A and 5 (21.7%) were assemblage B. Clinical symptoms were observed in 44.4% and 40% of patients with assemblages A and B, respectively. Overall, the predominant assemblage A detected in the tested samples along with bioinformatics analysis suggest a potential zoonotic transmission in the region of the study. Although advanced analyses are necessary to understand the foundation and path of the infection, it seems that more sanitary regulations regarding contact with livestock and pet animals are essential.

Epidemiology of taeniosis, cysticercosis and trichinellosis in Iran: A systematic review

BACKGROUND

The aim of this review was to establish the current epidemiology of taeniosis, cysticercosis and trichinellosis among humans and animals in Iran by carrying out a comprehensive assessment of published articles reporting on these foodborne zoonotic diseases across the country.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used in the search for relevant published articles reporting on cysticercosis, taeniosis and trichinellosis in Iran using a number of appropriate key words. The search was conducted through PubMed, Web of Science, Google Scholar, SpringerLink, SCOPUS, WHOLIS, FAO and CDC. Published scientific articles including journals, books and book chapters reporting on cysticercosis, taeniosis and trichinellosis in Iran for the period between 1967 and 2018 were selected.

RESULTS

A total of 37 articles met the search criteria and were incorporated in this review. Of these, 10 (27%) reported on human taeniosis, 15 (40.5%) on cysticercosis (10 on Taenia saginata and five on Taenia spp. cysticercosis) and 12 (32.5%) on trichinellosis. T. saginata was implicated in all human taeniosis cases. All Taenia spp. cysticercosis cases were reported among domesticated pigs and wild animals. A case of neurocysticercosis was reported in a male patient at Shohada Hospital in Tehran. Eleven (91.7%) of the 12 studies reported on trichinellosis among wild animals, while one (8.3%) study detected anti-Trichinella IgG in 8 (2.2%) of the 364 at-risk human beings tested. Nevertheless, most of these studies were carried out in northern Iran.

CONCLUSION

This review found T. saginata to be the most prevalent and of greater economic and public health significance in Iran. However, T. solium and Trichinella spp. were of little significance to human health. More studies should focus on other regions besides northern Iran.

Prevalence of Intestinal Parasites among Rural Residents of Takestan in North-West of Iran

BACKGROUND

Intestinal parasites are one of the health challenges in developing countries. Decreasing the prevalence of intestinal parasitic infections (IPIs) is one of the main aims of health services in these countries. This study was designed to determine the current status of IPIs in rural residents of Takestan a town located in North West of Iran.

METHODS

A total of 2280 rural residents of Takestan were randomly selected. Data were collected through questionnaire by interviews and laboratory findings obtained by microscopic examination of stool sample including wet smear and formalin ethyl-acetate concentration. A P<0.05 was considered significant, statistically.

RESULTS

In total, 8.7% (199/2280) of participants were positive for at least one intestinal parasite. The prevalence of polyparasitism was 0.7% in study population. Hymenolepis nana was the only helminthic infection which was detected (1/2280). Blastocystis, Entamoeba coli, and Giardia lamblia were the most common IPIs with prevalence of 3.6%, 2.9%, and 1.6%, respectively. Statistically, the prevalence of IPIs showed significant differences among villages (P<0.01) and age groups (P<0.001), and also habit of eating raw vegetables (P<0.005), whereas, the difference was insignificant in terms of sex, education level, and occupation.

CONCLUSION

The prevalence of IPIs in rural residents of the study area is considerably low and this reduction was very impressive about helminthic infections.

Impacts of human development index and climate conditions on prevalence of Blastocystis: A systematic review and meta-analysis

Blastocystis is a prevalent eukaryotic microorganism that has been frequently reported from the stool samples of human and animals, all over the world. The prevalence of this parasite has close correlation with the climate and hygiene situation of studied populations. For the current study, English and Persian databases were searched for the following terms: "Blastocystis hominis", "Blastocystis sp.", "Intestinal Parasites", "Prevalence" and "Iran". In order to data analysis and assess the possibility of publication bias, STATA v11 and Begg's Funnel plot were employed respectively. From 605 searched cases, 86 publications met our criteria for the analysis. The pooled prevalence of Blastocystis was 9.1% (95%CI: 8.2%, 10.1%). The results represented that the prevalence of the parasite using molecular techniques or cultivation followed by molecular techniques (20.89%) was higher than only microscopical examination (8.96%). The prevalence rate of Blastocystis according to human development index was 7.6%, 7.2%, 11.9%, 13.4%, and 3.3% for ranks 1 to 5, respectively. This is the first study signifying the prevalence of Blastocystis regarding the human development index and climate conditions. The findings represented that although human development index, low levels of socioeconomic situations together with appropriate climate such as sufficient humidity and high temperature increase the chance of transmission of Blastocystis in a society.

Amoebiasis in Iran: a systematic review and meta-analysis

A comprehensive meta-analysis study was performed to estimate the reliable national prevalence and molecular epidemiology of amoebiasis in Iran. Nine English and Persian databases were searched to achieve the relevant studies. Pooled estimates were generated and meta-regression was performed. We identified 71 eligible articles involving 330 930 subjects from 25 provinces to be included in the final analysis. Moreover, 17 studies compromising 462 polymerase chain reaction (PCR)-positive isolates performed molecular analysis to inter-species differentiation. The pooled prevalence of Entamoeba infection among Iranian population was about 1% (95% CI 0.8-2.0%). Moreover, regarding Human Development Index (HDI), a higher prevalence was observed in undeveloped provinces. Out of 462 PCR-positive isolates, 83% (95% CI 69-94%) and 12% (95% CI 3-24%) were Entamoeba dispar, Entamoeba histolytica, respectively. In subgroup analysis based on molecular results, in general, population prevalence of Entamoeba dispar and E. histolytica were 91% (95% CI 80-99%) and 7%, (95% CI 0-19%), respectively, while prevalence of these species in patients with gastrointestinal disorders were 75% (95% CI 45-96%) and 18% (95% CI 1-43%), respectively. Our findings indicate the low burden of amoebiasis in Iran. E. dispar, that is mostly non-pathogenic, was identified as most prevalent species. Nevertheless, we suggest more public health interventions in areas with lower HDI.

Rodent-borne diseases and their public health importance in Iran

Background

Rodents are reservoirs and hosts for several zoonotic diseases such as plague, leptospirosis, and leishmaniasis. Rapid development of industry and agriculture, as well as climate change throughout the globe, has led to change or increase in occurrence of rodent-borne diseases. Considering the distribution of rodents throughout Iran, the aim of this review is to assess the risk of rodent-borne diseases in Iran.

Methodology/Principal finding

We searched Google Scholar, PubMed, Science Direct, Scientific Information Database (SID), and Magiran databases up to September 2016 to obtain articles reporting occurrence of rodent-borne diseases in Iran and extract information from them. Out of 70 known rodent-borne diseases, 34 were reported in Iran: 17 (50%) parasitic diseases, 13 (38%) bacterial diseases, and 4 (12%) viral diseases. Twenty-one out of 34 diseases were reported from both humans and rodents. Among the diseases reported in the rodents of Iran, plague, leishmaniasis, and hymenolepiasis were the most frequent. The most infected rodents were Rattus norvegicus (16 diseases), Mus musculus (14 diseases), Rattus rattus (13 diseases), Meriones persicus (7 diseases), Apodemus spp. (5 diseases), Tatera indica (4 diseases), Meriones libycus (3 diseases), Rhombomys opimus (3 diseases), Cricetulus migratorius (3 diseases), and Nesokia indica (2 diseases).

Conclusions/Significance

The results of this review indicate the importance of rodent-borne diseases in Iran. Considering notable diversity of rodents and their extensive distribution throughout the country, it is crucial to pay more attention to their role in spreading infectious diseases for better control of the diseases.

This review showed that approximately half of the known rodent-borne diseases have been reported in Iran, half of which were reported both in humans and rodents. Most of the diseases were bacterial and parasitic. Plague, leishmaniasis, and hymenolepiasis were the most frequent diseases among rodent populations. Also, this review showed that among the rodent species, three commensal ones—R. norvegicus, M. musculus, and R. rattus—play an important role in the transmission of diseases to humans in Iran. Considering repeated reports of many of these diseases in humans and rodents, and the notable diversity and extensive distribution of rodents throughout Iran, it is crucial to pay adequate attention to rodents as a source of zoonotic infectious diseases in the country.

Intestinal parasite infections in a rural community of Rio de Janeiro (Brazil): Prevalence and genetic diversity of Blastocystis subtypes

Background

Intestinal parasitic infections are considered a serious public health problem and widely distributed worldwide, mainly in urban and rural environments of tropical and subtropical countries. Globally, soil-transmitted helminths and protozoa are the most common intestinal parasites. Blastocystis sp. is a highly prevalent suspected pathogenic protozoan, and considered an unusual protist due to its significant genetic diversity and host plasticity.

Methodology/main findings

A total of 294 stool samples were collected from inhabitants of three rural valleys in Rio de Janeiro, Brazil. The stool samples were evaluated by parasitological methods, fecal culture, nested PCR and PCR/Sequencing. Overall prevalence by parasitological analyses was 64.3% (189 out of 294 cases). Blastocystis sp. (55.8%) was the most prevalent, followed by Endolimax nana (18.7%), Entamoeba histolytica complex (7.1%), hookworm infection (7.1%), Entomoeba coli (5.8%), Giardia intestinalis (4.1%), Iodamoeba butchilii (1.0%), Trichuris trichiura (1.0%), Pentatrichomonas hominis (0.7%), Enterobius vermicularis (0.7%), Ascaris lumbricoides (0.7%) and Strongyloides stercoralis (0.7%). Prevalence of IPIs was significantly different by gender. Phylogenetic analysis of Blastocystis sp. and BLAST search revealed five different subtypes: ST3 (34.0%), ST1 (27.0%), ST2 (27.0%), ST4 (3.5%), ST8 (7.0%) and a non-identified subtype.

Conclusions/significance

Our findings demonstrate that intestinal parasite infection rates in rural areas of the Sumidouro municipality of Rio de Janeiro, Brazil are still high and remain a challenge to public health. Moreover, our data reveals significant genetic heterogeneity of Blastocystis sp. subtypes and a possible novel subtype, whose confirmation will require additional data. Our study contributes to the understanding of potential routes of transmission, epidemiology, and genetic diversity of Blastocystis sp. in rural areas both at a regional and global scale.

Intestinal parasitic infections among expatriate workers in various occupations in Sharjah, United Arab Emirates

Intestinal parasitic infections are prevalent throughout many countries. This study aimed to determine the prevalence of intestinal parasite carriers among 21,347 expatriate workers, including food handlers and housemaids attending the public health center laboratory in Sharjah, UAE. Stool sample collection was performed throughout the period between January and December 2013. All samples were examined microscopically. Demographic data were also obtained and analyzed. Intestinal parasites were found in 3.3% (708/21,347) of the studied samples (single and multiple infections). Among positive samples, six hundred and eighty-three samples (96.5%) were positive for a single parasite: Giardia lamblia (257; 36.3%) and Entamoeba histolytica/Entamoeba dispar (220; 31.1%), respectively, whereas mono-infections with helminths accounted for 206 (29.1%) of the samples. Infection rates with single worms were: Ascaris lumbricoides (84; 11.9%), Hookworm (34; 4.8%), Trichuris trichiura (33; 4.7%), Taenia spp. (27; 3.81%), Strongyloides stercoralis (13; 1.8%), Hymenolepis nana (13; 1.8%), and Enterobius vermicularis (2; 0.28%), respectively. Infections were significantly associated with gender (x² = 14.18; p = 0.002) with males as the most commonly infected with both groups of intestinal parasites (protozoa and helminths). A strong statistical association was noted correlating the parasite occurrence with certain nationalities (x²= 49.5, p <0.001). Furthermore, the study has also found a strong statistical correlation between parasite occurrence and occupation (x²= 15.60; p = 0.029). Multiple infections were not common (3.5% of the positive samples), although one individual (0.14%) had four helminth species, concurrently. These findings emphasized that food handlers with different pathogenic parasitic organisms may pose a significant health risk to the public.

Intestinal parasitic infections in different groups of immunocompromised patients in Kashan and Qom cities, central Iran

INTRODUCTION

Intestinal parasitic infections (IPIs) are important causes of morbidity and mortality in patients with immunocompromising conditions.

OBJECTIVE

The aim of this study was to determine the prevalence of IPIs in different groups of immunocompromised patients, including hemodialysis patients (HD), renal transplant recipients (RTR), cancer and HIV/AIDS patients in comparison with healthy individuals in two central cities of Iran (Kashan and Qom).

METHODS

In this case-control study, the stool samples of 135 HD, 50 RTR, 60 cancer patients, 20 HIV/AIDS patients and 120 healthy subjects were tested using direct-smear, formol-ether concentration, Ziehl-Neelsen staining and Agar plate method.

RESULTS

The overall infection rate was 11.7% (31/265) in patient groups and 0% (0/120) in the control group. The frequency of parasites was 25% in HIV/AIDS patients, 11.9% (16/135) in HD, 12.0% (6/50) in RTR and 6.7% (4/60) in cancer patients. Blastocystis hominis (4.2%) and Giardia lamblia (3.0%) were the most prevalent parasites in patient groups. The infection rate was significantly higher in male (17.6%) than female (5.4%) patients (p = .002), but no statistically significant association was observed according to the age and educational levels.

CONCLUSIONS

This study showed a high prevalence of IPIs in immunocompromised patients. The results of this study suggest that periodic stool examinations for screening of IPIs should be included as a part of routine medical care in these patients.

Prevalence and risk factors of intestinal protozoan infections: a population-based study in rural areas of Boyer-Ahmad district, Southwestern Iran

BACKGROUND

Parasitic infections are still a significant health problem in rural areas in developing countries including Iran. There is no recent population-based data about the prevalence of human intestinal parasites in most rural areas of Iran. The current study aimed to determine the prevalence of intestinal protozoan infection in inhabitants of rural areas of Boyer-Ahmad district, Southwestern Iran.

METHODS

A total of 1025 stool samples were collected from the inhabitant of 50 randomly selected villages in Boyer-Ahmad Township. The stool samples were evaluated by parasitological methods including, direct wet-mounting, formalin ethyl acetate concentration, zinc sulfate floatation, and Trichrome permanent stain for detection of protozoan infections. Diarrheic samples were further evaluated with a modified Ziehl-Neelsen staining method for detection of coccidian parasites.

RESULTS

The prevalence of both pathogenic and nonpathogenic intestinal parasites in the population was 37.5% (385 out of 1025 cases), some individual with multiple infections. Giardia lamblia was detected in 179 (17.46%), Blastocystis hominis in 182 (17.76%), Entamoeba histolytica/dispar in 9 (0.87%), Endolimax nana in 216 (21.07%), Entamoeba coli in 151 (14.73%), Ioedamoeba butschlii in 45 (4.39%), Chillomastix mesnili in 22 (2.14%), Trichomonas hominis in 2 (0.19%) and Dientamoeba fragillis in 2 (0.19%) of cases. Multivariate logistic regression revealed significant associations between protozoan infection (pathogenic protozoa) and contact with animals (OR yes/no = 2.22, p < 0.001) and educational status (OR higher/illiterate = 0.40, P = 0.01).

CONCLUSION

Findings of this study demonstrated that protozoan infection rate in rural areas of southwestern Iran is still high and remained as a challenging health problem in these areas.

Zoonotic intestinal protozoan of the wild boars, Sus scrofa, in Persian Gulf's coastal area (Bushehr province), Southwestern Iran

Aim:

Wild boars, Sus scrofa, are potential reservoirs of many zoonotic diseases, and there are a possibility of transmission of the zoonotic diseases from these animals to humans and also domestic animals. This study aimed to evaluate the protozoan contamination of wild boars in the Persian Gulf’s coastal area (Bushehr Province), southwestern Iran.

Materials and Methods:

A total of 25 crossbred boars were collected during a course of vertebrate pest control in Bushehr province, in 2013. Samples were collected from the gastrointestinal tracts of each boar in 5% formalin, Bouin’s solution, sodium acetate-acetic acid-formalin, and polyvinyl alcohol fixatives. Fixed stool smears examined by trichrome and Ziehl–Neelsen staining.

Results:

Each of the 25 wild boars was infected with at least one of the intestinal protozoans. The rate of contamination with intestinal protozoan was 64% for Balantidium coli, 76% for Iodamoeba sp., 52% for Entamoeba polecki, 44% for Blastocystis sp. and 8% for Chilomastix sp. No intestinal coccidian was detected in studied boars when the stool samples were evaluated by Ziehl–Neelsen staining method.

Conclusion:

Findings of this study demonstrated that wild boars in the Persian Gulf coastal area are contaminated by many protozoans, including zoonotic protozoan, which poses a potential risk to locals as well as the domestic animals of the area.

Contribution of environmental media to cryptosporidiosis and giardiasis prevalence in Tehran: a focus on surface waters

The occurrences of Cryptosporidium and Giardia in surface sources of drinking water in Tehran were monitored, using US EPA method 1623.1. The prevalence ratios (PR) of positive samples among other media (animal's stools, vegetables, and human's stools) were also estimated from literature data. The density of Giardia and Cryptosporidium in water samples were 0.129 ± 0.069 cysts/L and 0.005 ± 0.002 oocysts/L, respectively. Estimated PR in vegetables, animal stools, surface waters, and human stools were 6.65, 20.42, 21.05, and 4.28 % for Cryptosporidium and 6.46, 17.13, 73.68, and 15.65 % for Giardia, respectively. These reveal the importance of surface waters' and animal stools' roles in the prevalence of cryptosporidiosis and giardiasis in Tehran's population. Giardia's prevalence in untreated surface waters in Tehran was found 3.5 times as much as Cryptosporidium while this found 2.3 times on a global scale. Moreover, the prevalence of giardiasis to cryptosporidiosis infections in Tehran's human population was 3.65. These values could be a clue to attribute the infections to the occurrence of parasites in surface waters. Significant (p < 0.05) associations were observed between rainfalls and presence of Giardia (r = 0.62) and Cryptosporidium (r = 0.60) in surface waters. In autumn, rainfalls can increase the parasites occurrences in surface waters. Significant (p < 0.05) difference on the density of parasites was found between some seasons using Kruskal-Wallis and multiple comparison tests. A significant correlation (r = 0.86) between Giardia and Cryptosporidium densities also confirms the common sources of pollution in surface waters. Findings suggest that untreated surface waters in Tehran may be a potential route of human exposure to protozoan parasites.

Bacterial assessment of food handlers in Sari City, Mazandaran Province, north of Iran

Food handlers with poor personal hygiene could be potential sources of infection due to pathogenic bacteria. This study was designed to determine the prevalence of bacterial infestation among the food handlers attending the public health center laboratory in Sari, northern Iran for annual check-up. This study was performed from September 2013 to August 2014. Stool samples, fingernail specimens of both hands and nasal swabs were collected from 220 male and female food handlers of different jobs, aged between 17-65 years. The samples were cultured on bacteriological culture media and bacterial species were identified following standard procedures. A structured questionnaire was used to record sociodemographic and behavioral data analysis of the food handlers. Of the total 220 subjects examined, 62.2% showed positive culture for different bacterial species from their fingernail contents, 65.4% were found to be harboring Staphylococcus aureus in their nostrils and 0.9% tested positive for Shigella boydii from stool samples. Staphylococcus aureus was the predominant bacteria isolated from fingernail specimens (46%), followed by Escherichia coli (29.2%), Coliforms (18.2%) and Pseudomonas aeruginosa (6.6%). This study showed a statistically significant difference in the rate of bacterial infestation between different occupational categories (p=0.04). Butchers showed the highest prevalence of bacteria (86.6%) in their fingernail contents, followed by fast food workers (76.5%), bakers (73.5%), chicken store workers (73%), school cafeterias staff (53.3%), restaurant workers (46.9%) and fruit/vegetables sellers (42.5%). The highest rate of nasal carrier for Staphylococcus aureus was observed among chicken store workers 14/17(20.8%). These findings indicate the need for intensive training/retraining and health education of all food service employees and strengthening the existing screening methods to control the problem of bacterial infestation in food handlers.

PREVALENCE, RISK FACTORS AND SYMPTOMS ASSOCIATED TO INTESTINAL PARASITE INFECTIONS AMONG PATIENTS WITH GASTROINTESTINAL DISORDERS IN NAHAVAND, WESTERN IRAN

We studied the prevalence of intestinal parasites (IPs), their risk factors and associated symptoms among patients with gastrointestinal disorders. A total of 1,301 participants aged 22 days-90 years were enrolled in this study. We used a structured questionnaire to obtain socio-demographic and stool examination to investigate intestinal parasite infections. Data analysis was performed using SPSS16. The overall prevalence of intestinal parasites (IPs) was 32.2% (419/1,301). Three hundred and fifty nine cases/1,301 (27.6%) were infected with a single parasite and 60/1,301 cases (4.6%) presented polyparasitism. The most common IP was Blastocystis sp. 350/1,301 (26.9%), followed by Entamoeba coli 38/1,301 (2.92%), Giardia lamblia 30/1,301 (2.3%) and Cryptosporidium spp. 17/1,301 (1.3%). Regarding the socio-demographic variables, educational status (p = 0.001), contact with domestic animals and soil (p = 0.02), age above 15 years (p = 0.001) and seasons (p = 0.001) were significantly associated to intestinal parasitic infections. Concerning clinical characteristics, the presence of IPs was significantly associated to diarrhea (OR = 1.57; CI 95% = 1.24-1.98; p < 0.001) and dysentery (OR = 1.94; CI 95% = 1.03-3.66; p < 0.04). Our findings suggest that IPs are one of the main causal agents of gastrointestinal disorders. Improving the knowledge on local risk factors such as poverty, low level of education, poor sanitation, contact with soil and contact with domestic animal is warranted.

Prevalence of intestinal parasites among food handlers of Sari, Northern Iran

Parasitic infection is highly prevalent throughout the developing countries of the world. Food handlers are a potential source of infection for many intestinal parasites and other enteropathogenic infections as well. The aim of this study was to determine the prevalence of intestinal parasite carriers among food handlers attending the public health center laboratory in Sari, Northern Iran for annual check-up. The study was performed from August 2011 through February 2012. Stool samples were collected from 1041 male and female food handlers of different jobs aged between 18 to 63 years and were examined following standard procedures. Sociodemographic, environmental and behavioral data analysis of the food handlers were recorded in a separate questionnaire. Intestinal parasites were found in 161 (15.5%) of the studied samples. Seven species of protozoan or helminth infections were detected. Most of the participants were infected with Giardia lamblia (53.9%) followed by Blastocystis hominis (18%), Entamoeba coli (15.5%), Entamoeba histolytica/dispar (5.5%), Cryptosporidium sp. (3.1%), Iodamoeba butschlii (3.1%) and Hymenolepis nana (1.9%) as the only helminth infection. The findings emphasized that food handlers with different pathogenic organisms may predispose consumers to significant health risks. Routine screening and treatment of food handlers is a proper tool in preventing food-borne infections.

Prevalence of Strongyloides stercoralis and Other Intestinal Parasites among Institutionalized Mentally Disabled Individuals in Rasht, Northern Iran

BACKGROUND

We aimed to determine the status of strongyloidiasis in mentally disabled population in the institutional places in Rasht City, the capital of Guilan Province, northern Iran.

METHODS

This cross-sectional study was conducted in 8 institutions for mentally retarded population in Rasht in 2013. Before collecting the samples, a questionnaire was filled out for each participant by an expert person. A single stool sample was obtained from each of the 173 subjects and examined using direct wet mount, formalin-ether concentration technique and agar plate culture method.

RESULTS

A total of 173 mentally disabled individuals aged 2-57 (25.69±11.56) yr old were studied. Stool examination showed that 51 (29.5%) cases were infected with at least one parasite. Of 173 studied cases only 10 (5.8%) individuals were infected with pathogenic parasites, of which 2 (1.2%) cases were infected with Strongyloides stercoralis and 8 (4.6%) with Giardia lamblia. On the other hand, 42 (24.3%) of the studied population were infected with non-pathogenic intestinal protozoa such as Blastocystis hominis (n=29, 16.8%), Entamoeba coli (n=16, 9.2%) and Endolimax nana (n=4, 2.3%). Mixed protozoal infections were observed in 8 (4.6%) individuals.

CONCLUSION

The prevalence rate of S. stercoralis in mentally disabled individuals in Rasht was somewhat higher than those of normal population of the province. The same picture was seen when the prevalence of G. lamblia and non-pathogenic protozoa in normal and mentally disabled populations were compared.

Epidemiology of Human Fascioliasis and Intestinal Helminthes in Rural Areas of Boyer-Ahmad Township, Southwest Iran; A Population Based Study

BACKGROUND

Fascioliasis, caused by Fasciola hepatica and F. gigantica, is one of the most important plant and water borne disease in Iran. This study aimed to determine the prevalence of fascioliasis and intestinal helminthes in inhabitants of rural areas of Boyer-Ahmad in Kohgiluyeh and Boyer-Ahmad province in Southwest of Iran.

METHODS

Stool samples (1025) were collected from inhabitant of 50 randomly selected villages in Boyer-Ahmad Township. Samples were evaluated with modified Telemann and formalin-ethyl acetate methods. Blood samples of Fasciola positive cases were assessed with ELISA and Western blotting. DNA was extracted from Fasciola eggs from stool of positive individuals and evaluated by molecular (PCR) method and the PCR products were sequenced and analyzed.

RESULTS

Of the 1025 participants, 473 (46.1%) were male and 552 (53.9%) were female. The mean age of the subjects was 20.25 (±15.86) years. Fasciola eggs were detected in stools of two cases (0.19%). Blood samples were obtained from the Fasciola positive cases and their infection was further confirmed by ELISA and Western blotting. Molecular analysis revealed that both cases are infected with F. hepatica. Furthermore, seven of participants (0.68%) were found to be infected with H. nana, 4 cases (0.39%) with E. vermicularis, and one case (0.09%) with Trichuris trichiura.

CONCLUSION

Findings of this study showed that Boyer-Ahmad district is one of the endemic areas of human fascioliasis in Iran. The study also documented that the rate of helminthic infections in rural areas of the district has drastically declined over the past years.

Prevalence of Intestinal Parasitic Infection Among Inhabitants and Tribes of Chelgerd, Iran, 2008-2009

INTRODUCTION

Although a notable development in treating and controlling of parasitic infections in recent years has occurred but, these infections are still counted as important problems in many countries.

AIM

The aim of this study is to determine the prevalence of intestinal parasitic infections in the inhabitant and tribe populations who were referred to central health care of Chelgerd, Iran.

MATERIALS AND METHODS

This descriptive cross-sectional study was carried out from April 2008 to October 2009 in Chelgerd, Iran. A total of 655 samples of feces from inhabitants and tribes were collected and each sample was examined by Direct smear, formol- ethyl acetate concentration and Trichorom staining.

RESULTS

Out of 655 stool samples, 367(56%) patients revealed at least one intestinal parasite (pathogenic /non-pathogenic protozoa/helminth), 233(67.7%) in tribes and 134(43%) in inhabitants. There was significant difference between infected inhabitants and infected tribes (p=0.001). Although the intestinal parasitic infections were more in female than male it was not statistically significant (p=0.52). There was no significant difference in various age groups. Common intestinal parasitic infections which were detected in both the populations were Giardia intestinalis (28.2%) and Blastocystis hominis (27.5%).

CONCLUSIONS

We found that the prevalence of intestinal parasitic infections was higher in the tribe than inhabitant populations. Prevalence of intestinal protozoa infections was much higher than the helminthic infections. These findings reflect poor sanitary conditions in this region. They should be educated and provided better facilities to get rid of intestinal parasitic infections.

Prevalence of Strongyloides stercoralis and other intestinal parasitic infections among mentally retarded residents in central institution of southern Iran

OBJECTIVE

To determine the prevalence of intestinal parasitic infections among mentally retarded residents of rehabilitation center of Bandar Abbas, Hormozgan province, southern Iran.

METHODS

A cross-sectional study was carried out in central rehabilitation institute of Hormozgan province in summer 2010. Fecal samples of all 133 residents (72 males, 61 females) aged 3-52, were collected in triplicate. Specimens were examined by direct smear, formalin-ether concentration techniques and stained by permanent Trichrome, Ziehl-Neelsen stains. Statistical analysis was conducted by SPSS 13.5.

RESULTS

Intestinal parasitic infections were seen in 48.5% (64 out of 133 subjects: 53.4% in males and 46.6% in females). Strongyloides stercoralis with 17.3% showed the highest incidence followed by Entamoeba coli (9.8%), Blastocystis hominis (7.5%), Giardia lamblia (2.3%), Endolimax nana (2.3%), Hymenolepis nana (0.8%), Oxyuris vermicularis (0.8%), and Chilomasix mesnili (0.8%). Double infections were found to be as: Strongyloides stercoralis + Giardia lamblia (2.3%), Entamoeba coli + Giardia lamblia (1.5%), Entamoeba coli + Blastocystis hominis (1.5%), Oxyuris vermicularis + Entamoeba coli (0.8%), Strongyloides stercoralis + Entamoeba coli (0.8%), respectively.

CONCLUSIONS

Our findings reveal that strongyloidiasis is a common disease among mentally retarded population in southern Iran.

Prevalence of Enterobius vermicularis amongst kindergartens and preschool children in Mazandaran Province, North of Iran

Enterobiasis (oxyuriasis) is probably the most common helminth, which infects humans. Amongst different age groups, prevalence of Enterobius vermicularis in children is high compared to adults. Oxyuriasis is one of the most significant parasitic diseases of children. This nematode in children can result in loss of appetite, insomnia, grinding of the teeth, restlessness, endometritis, abdominal cramps, diarrhea and etc. Due to important complications of this parasite, the objective of the current study was to determine the prevalence of enterobiasis in kindergarten and preschool children of Amol, Mazandaran Province, North of Iran. A total number of 462 children from 32 kindergartens of Amol were examined for the prevalence of E. vermicularis infection, 2013. Adhesive cello-tape anal swab method was trained to parents for sampling. In addition, a questionnaire was designed and filled out to collect demographic information for each individual. Data were analyzed using Chi square test and multivariate logistic regression for each risk factor. The overall prevalence of E. vermicularis infection was 7.1 % (33). Although infection with E. vermicularis in girls 7.9 % was higher compared to boys 6.3 %, there was no significant difference between gender and age (p > 0.05) whereas binary logistic regression showed significant difference between enterobiasis and age (p < 0.05). The findings indicated that the prevalence of E. vermicularis in kindergarten and preschool children is relatively high and still is an important health problem and should not be underestimated due to being highly contagious infection. Therefore, educational programs and mass treatment should be carried out in order to reduce infection incidence in this area and regular parasitological test and attention to personal hygiene in kindergarten and preschool is of great importance.

Strongyloidiasis--an insight into its global prevalence and management

BACKGROUND

Strongyloides stercoralis, an intestinal parasitic nematode, infects more than 100 million people worldwide. Strongyloides are unique in their ability to exist as a free-living and autoinfective cycle. Strongyloidiasis can occur without any symptoms or as a potentially fatal hyperinfection or disseminated infection. The most common risk factors for these complications are immunosuppression caused by corticosteroids and infection with human T-lymphotropic virus or human immunodeficiency virus. Even though the diagnosis of strongyloidiasis is improved by advanced instrumentation techniques in isolated and complicated cases of hyperinfection or dissemination, efficient guidelines for screening the population in epidemiological surveys are lacking.

METHODOLOGY AND RESULTS

In this review, we have discussed various conventional methods for the diagnosis and management of this disease, with an emphasis on recently developed molecular and serological methods that could be implemented to establish guidelines for precise diagnosis of infection in patients and screening in epidemiological surveys. A comprehensive analysis of various cases reported worldwide from different endemic and nonendemic foci of the disease for the last 40 years was evaluated in an effort to delineate the global prevalence of this disease. We also updated the current knowledge of the various clinical spectrum of this parasitic disease, with an emphasis on newer molecular diagnostic methods, treatment, and management of cases in immunosuppressed patients.

CONCLUSION

Strongyloidiasis is considered a neglected tropical disease and is probably an underdiagnosed parasitic disease due to its low parasitic load and uncertain clinical symptoms. Increased infectivity rates in many developed countries and nonendemic regions nearing those in the most prevalent endemic regions of this parasite and the increasing transmission potential to immigrants, travelers, and immunosuppressed populations are indications for initiating an integrated approach towards prompt diagnosis and control of this parasitic disease.

Prevalence of intestinal parasites among food handlers in Western Iran

Parasitic infection is one of the problems that affect human health, especially in developing countries. In this study, all of the fast food shops, restaurants, and roast meat outlets of Khorramabad (Western Iran) and all the staff employed by them, some 210 people, were selected through a census and their stools were examined for the presence of parasites. The parasitological tests of direct wet-mount, Lugol's iodine staining, formaldehyde-ether sedimentation and Trichrome staining techniques were performed on the samples. The data was analyzed with a chi-square test and logistic regression was selected as the analytical model. The results showed 19 (9%) stool specimens were positive for different intestinal parasites. These intestinal parasites included Giardia lamblia 2.9%, Entamoeba coli 4.3%, Blastocystis sp. 1.4%, and Hymenolepis nana 0.5%. There was a significant difference between the presence of a valid health card, awareness of transmission of intestinal parasites, participation in training courses in environmental health with intestinal parasites (p < 0.05). No statistically significant difference was found between the rate of literacy and gender among patients infected with intestinal parasites (p > 0.05). To control parasitic infection in food handlers, several strategies are recommended such as stool examinations every three months, public education, application of health regulations, controlling the validity of health cards and training on parasitic infection transmission. In this regard, the findings of the present study can be used as a basis to develop preventive programs targeting food handlers because the spread of disease via them is a common problem worldwide.

Soil-transmitted helminth infections and associated risk factors in three Orang Asli tribes in Peninsular Malaysia

Currently, information on prevalence of soil-transmitted helminth (STH) infections among different tribes of Orang Asli (aboriginal) is scarce in Malaysia. The present study is a cross-sectional study aimed at determining the factors associated with the prevalence of STH infections among the Proto-Malay, Negrito and Senoi tribes. Faecal samples were collected from 500 participants and socioeconomic data was collected via pre-tested questionnaire. All samples were processed using formalin-ether sedimentation and Wheatley's trichrome staining. Trichuris trichiura (57%) was the most common STH seen among the participants, followed by Ascaris lumbricoides (23.8%) and hookworm (7.4%). Trichuriasis and ascariasis showed an age-dependency relationship; significantly higher rates were observed among Senois who aged <15 years. Likewise, Negritos also showed an age-dependency association with ascariasis affecting mainly the under 15 years old individuals. Multivariate logistic regression model indicated the following predictors of trichuriasis among these communities; being aged <15 years, consuming raw vegetables, belonging to a large household members (≥8) and earning low household income (<RM500). Meanwhile, ascariasis was significantly related to participants being aged <15 years and earning low household income. Two risk factors were found to be associated with hookworm infection; consuming raw vegetables and eating contaminated fresh fruits.

Intestinal parasitic infection among school children in Golestan province, Iran

Infections by intestinal parasites are a major public health problem worldwide, especially among children in developing countries. It causes nutritional deficiencies and anaemia. As, the prevalence ofparasitic infection is different among various population, there is a need for periodical prevalence evaluation to an appropriate control strategy. The goal in this study was to determine the prevalence of intestinal parasitic infections in primary school children living in Gorgan, north of Iran. A cross-sectional survey was conducted on 800 schoolchildren aged 8-12 years of Gorgan city, capital of Golestan province, located in the north of Iran in 2011. Three stool specimens were collected from each student. Specimens were examined with direct wet and formalin ethyl acetate method. Data were analyzed with SPSS version 16 software. A total of 800 schoolchildren were screened. Nearly one third of students (28.8%) were infected with one or more intestinal parasites. The most common parasite were Giardia intestinalis (9.9%; 79/800) and H. nana (1.5%; 12/800), respectively. The data showed that Children living in crowded family (> or = 3) were more susceptible to infection also take care of animals in house helps to transmission of parasite infections as there was a significant association between that and rates of parasite infections (p-value < 0.05). The prevalence of infection was also much more common in those students whose parents were less educated. A high percentage of school children were infected to intestinal parasites, so, intervention programs including health education and environmental sanitation are required.

Prevalence of intestinal parasites in a population in Eghbalieh city from Qazvin Province, Iran

Intestinal parasitic infections are endemic worldwide and have been described as constituting the greatest single worldwide cause of illness and disease. The prevalence of Intestinal parasitic infections was estimated to be 5.92 %. Entamoeba coli was the most common parasite followed by Giardia lamblia and Blastocystis hominis. About 5.15 % of samples contained a single parasite and 0.76 % contained multiple parasites. In this study, the prevalence of intestinal parasites especially helminthic infections was low. The study aimed to estimate prevalence of intestinal parasites in Eghbalieh city from Qazvin Province, Iran.

Food and drinking water hygiene and intestinal protozoa in deployed German soldiers

This report analyzes the occurrence of Cryptosporidium spp., E. histolytica, and G. intestinalis in stool of returnees from military deployments and the impact of hygiene precautions. Between 2007 and 2010, stool samples of 830 returnees that were obtained 8-12 weeks after military deployments in Afghanistan, Uzbekistan, the Balkans, Democratic Republic of the Congo/Gabonese Republic, and Sudan and 292 control samples from non-deployed soldiers were analyzed by PCR for Cryptosporidium spp., E. histolytica, G. intestinalis, and the commensal indicator of fecal contamination E. dispar. Data on hygiene precautions were available. The soldiers were questioned regarding gastrointestinal and general symptoms. Among 1122 stool samples, 18 were positive for G. intestinalis, 10 for E. dispar, and no-one for Cryptosporidium spp. and E. histolytica. An increased risk of acquiring chronic parasitic infections in comparison with non-deployed controls was demonstrated only for G. intestinalis in Sudan, where standardized food and drinking water hygiene precautions could not be implemented. Standard food and drinking water hygiene precautions in the context of screened military field camps proved to be highly reliable in preventing food-borne and water-borne chronic infections and colonization by intestinal protozoa, leading to detection proportions similar to those in non-deployed controls.