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Golomazou E, Mamedova S, Eslahi AV, Karanis P. Cryptosporidium and agriculture: A review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 916:170057. [PMID: 38242460 DOI: 10.1016/j.scitotenv.2024.170057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/22/2023] [Accepted: 01/08/2024] [Indexed: 01/21/2024]
Abstract
Cryptosporidiosis is a significant contributor to global foodborne and waterborne disease burden. It is a widespread cause of diarrheal diseases that affect humans and animals worldwide. Agricultural environments can become a source of contamination with Cryptosporidium species through faecal material derived from humans and animals. This review aims to report the main findings of scientific research on Cryptosporidium species related to various agricultural sectors, and highlights the risks of cryptosporidiosis in agricultural production, the contamination sources, the importance of animal production in transmission, and the role of farmed animals as hosts of the parasites. Agricultural contamination sources can cause water pollution in groundwater and different surface waters used for drinking, recreational purposes, and irrigation. The application of contaminated manure, faecal sludge management, and irrigation with inadequately treated water are the main concerns associated with foodborne and waterborne cryptosporidiosis related to agricultural activities. The review emphasizes the public health implications of agriculture concerning the transmission risk of Cryptosporidium parasites and the urgent need for a new concept in the agriculture sector. Furthermore, the findings of this review provide valuable information for developing appropriate measures and monitoring strategies to minimize the risk of infection.
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Affiliation(s)
- Eleni Golomazou
- Department of Ichthyology and Aquatic Environment - Aquaculture Laboratory, School of Agricultural Sciences, University of Thessaly, Fytokou str., 38446 Volos, Greece
| | - Simuzer Mamedova
- Institute of Zoology, Ministry of Science and Education Republic of Azerbaijan, Baku, Azerbaijan & Department of Life Sciences, Khazar University, Baku, Azerbaijan
| | - Aida Vafae Eslahi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Panagiotis Karanis
- University of Cologne, Medical Faculty and University Hospital, 50931 Cologne, Germany; University of Nicosia Medical School, Department of Basic and Clinical Sciences, Anatomy Centre, 2408 Nicosia, Cyprus.
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Daniels ME, Pradhan A, Odagiri M, Jenkins MW. Waterborne exposure during non-consumptive domestic use of surface water: a population study across WASH service levels in rural India. JOURNAL OF WATER AND HEALTH 2023; 21:751-762. [PMID: 37387340 PMCID: wh_2023_309 DOI: 10.2166/wh.2023.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Exposure to pathogens from domestic use of surface water is understudied. In many low- and middle-income countries, surface water is used for hygiene, sanitation, amenity, and recreational purposes. In this study, self-reported use of and structured observations at community ponds were collected to measure waterborne exposure across water and sanitation service levels in a rural population of Khorda District, India. Overall, 86% of households (n = 200) reported using ponds on a regular basis. Among observed people (n = 765), 82% put water into their mouth at least once, with a median frequency of five occurrences per visit. Reported and observation data were combined to estimate the proportion (p) of the population that put water in their mouth at least once per day, and their mean daily rate of oral exposure (OE). These were highest for individuals with neither safely managed water nor basic sanitation access (p = 93%, OE = 14 day-1), but still high among those with both (p = 67%, OE = 6 day-1). The results suggest widespread exposure to waterborne pathogens in settings where non-potable surface water bodies continue to be used for domestic purposes, even among households with access to safely managed drinking water.
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Affiliation(s)
- Miles E Daniels
- Institute of Marine Sciences, Fisheries Collaborative Program, University of California, Santa Cruz, CA 95060, USA E-mail:
| | - Ashirbad Pradhan
- Regional Resource Centre for RMNCH + A, Saheed Laxman Nayak Medical College and Hospital, Koraput, Odisha, India; United Nations Children's Fund (UNICEF), Bhubaneswar, Odisha, India
| | | | - Marion W Jenkins
- Department of Civil and Environmental Engineering, University of California, Davis, CA 95616, USA
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Ballard AM, Laramee N, Haardörfer R, Freeman MC, Levy K, Caruso BA. Measurement in the study of human exposure to animal feces: A systematic review and audit. Int J Hyg Environ Health 2023; 249:114146. [PMID: 36868140 PMCID: PMC10044406 DOI: 10.1016/j.ijheh.2023.114146] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/31/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Human exposure to animal feces is increasingly recognized as an important transmission route of enteric pathogens. Yet, there are no consistent or standardized approaches to measurement of this exposure, limiting assessment of the human health effects and scope of the issue. OBJECTIVE To inform and improve approaches to the measurement of human exposure to animal feces, we audited existing measurement in low- and middle-income countries. METHODS We systematically searched peer-reviewed and gray literature databases for studies with quantitative measures of human exposure to animal feces and we classified measures in two ways. First, using a novel conceptual model, we categorized measures into three 'Exposure Components' identified a priori (i.e., Animal, Environmental, Human Behavioral); one additional Component (Evidence of Exposure) inductively emerged. Second, using the exposure science conceptual framework, we determined where measures fell along the source-to-outcome continuum. RESULTS We identified 1,428 measures across 184 included studies. Although studies overwhelmingly included more than one single-item measure, the majority only captured one Exposure Component. For example, many studies used several single-item measures to capture the same attribute for different animals, all of which were classified as the same Component. Most measures captured information about the source (e.g. animal presence) and contaminant (e.g. animal-sourced pathogens), which are most distal from exposure on the source-to-outcome continuum. DISCUSSION We found that measurement of human exposure to animal feces is diverse and largely distal from exposure. To facilitate better assessment of the human health effects of exposure and scope of the issue, rigorous and consistent measures are needed. We recommend a list of key factors from the Animal, Environmental, and Human Behavioral Exposure Components to measure. We also propose using the exposure science conceptual framework to identify proximal measurement approaches.
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Affiliation(s)
- April M Ballard
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA.
| | - Nicholas Laramee
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Regine Haardörfer
- Department of Behavioral, Social and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Matthew C Freeman
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Karen Levy
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
| | - Bethany A Caruso
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA; Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
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Derx J, Kılıç HS, Linke R, Cervero-Aragó S, Frick C, Schijven J, Kirschner AKT, Lindner G, Walochnik J, Stalder G, Sommer R, Saracevic E, Zessner M, Blaschke AP, Farnleitner AH. Probabilistic fecal pollution source profiling and microbial source tracking for an urban river catchment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159533. [PMID: 36270368 DOI: 10.1016/j.scitotenv.2022.159533] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/10/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
We developed an innovative approach to estimate the occurrence and extent of fecal pollution sources for urban river catchments. The methodology consists of 1) catchment surveys complemented by literature data where needed for probabilistic estimates of daily produced fecal indicator (FIBs, E. coli, enterococci) and zoonotic reference pathogen numbers (Campylobacter, Cryptosporidium and Giardia) excreted by human and animal sources in a river catchment, 2) generating a hypothesis about the dominant sources of fecal pollution and selecting a source targeted monitoring design, and 3) verifying the results by comparing measured concentrations of the informed choice of parameters (i.e. chemical tracers, C. perfringensspores, and host-associated genetic microbial source tracking (MST) markers) in the river, and by multi-parametric correlation analysis. We tested the approach at a study area in Vienna, Austria. The daily produced microbial particle numbers according to the probabilistic estimates indicated that, for the dry weather scenario, the discharge of treated wastewater (WWTP) was the primary contributor to fecal pollution. For the wet weather scenario, 80-99 % of the daily produced FIBs and pathogens resulted from combined sewer overflows (CSOs) according to the probabilistic estimates. When testing our hypothesis in the river, the measured concentrations of the human genetic fecal marker were log10 4 higher than for selected animal genetic fecal markers. Our analyses showed for the first-time statistical relationships between C. perfringens spores (used as conservative microbial tracer for communal sewage) and a human genetic fecal marker (i.e. HF183/BacR287) with the reference pathogen Giardia in river water (Spearman rank correlation: 0.78-0.83, p < 0.05. The developed approach facilitates urban water safety management and provides a robust basis for microbial fate and transport models and microbial infection risk assessment.
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Affiliation(s)
- Julia Derx
- Institute of Hydraulic Engineering and Water Resources Management, TU Wien, Austria.
| | - H Seda Kılıç
- Institute of Hydraulic Engineering and Water Resources Management, TU Wien, Austria
| | - Rita Linke
- Institute of Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics 166/5/3, TU Wien, Austria
| | - Sílvia Cervero-Aragó
- Institute for Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Austria
| | - Christina Frick
- Vienna City Administration, Municipal Department 39, Division of Hygiene, Vienna, Austria
| | - Jack Schijven
- Utrecht University, Faculty of Geosciences, Department of Earth Sciences, Utrecht, the Netherlands; National Institute for Public Health and the Environment, Department of Statistics, Informatics and Modelling, Bilthoven, the Netherlands
| | - Alexander K T Kirschner
- Institute for Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Austria; Division Water Quality and Health, Department of Pharmacology, Physiology, and Microbiology, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | - Gerhard Lindner
- Institute of Hydraulic Engineering and Water Resources Management, TU Wien, Austria
| | - Julia Walochnik
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Austria
| | - Gabrielle Stalder
- Research Institute of Wildlife Ecology, Department of Interdisciplinary Life Sciences, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Regina Sommer
- Institute for Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Austria
| | - Ernis Saracevic
- Institute for Water Quality and Resource Management, TU Wien, Vienna, Austria
| | - Matthias Zessner
- Institute for Water Quality and Resource Management, TU Wien, Vienna, Austria
| | - Alfred P Blaschke
- Institute of Hydraulic Engineering and Water Resources Management, TU Wien, Austria
| | - Andreas H Farnleitner
- Institute of Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics 166/5/3, TU Wien, Austria.; Division Water Quality and Health, Department of Pharmacology, Physiology, and Microbiology, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
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Awais MM, Ihsan-Ul-Haq H, Akhtar M, Anwar MI, Shirwany ASAK, Razzaq A, Ahmad S. Copro-ELISA-based prevalence and risk determinants of giardiasis in cattle and sheep populations raised by socio-economically deprived urban nomadic communities located in and around Multan, Punjab-Pakistan. BIOL RHYTHM RES 2022. [DOI: 10.1080/09291016.2022.2156180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Mian Muhammad Awais
- One Health Research Laboratory, Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - Hafiz Ihsan-Ul-Haq
- One Health Research Laboratory, Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - Masood Akhtar
- One Health Research Laboratory, Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - Muhammad Irfan Anwar
- One Health Research Laboratory, Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - Abdul Sammad Ali Khan Shirwany
- One Health Research Laboratory, Department of Pathobiology, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - Abdul Razzaq
- Animal Sciences Division, Pakistan Agricultural Research Council, Islamabad, Pakistan
| | - Sibtain Ahmad
- Livestock and Dairy Development Department, Directorate of Multan Division, Multan, Pakistan
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Fusaro C, Chávez-Romero YA, Prada SLG, Serrano-Silva N, Bernal JE, González-Jiménez FE, Sarria-Guzmán Y. Burden and Epidemiology of Human Intestinal Giardia duodenalis Infection in Colombia: A Systematic Review. Trop Med Infect Dis 2022; 7:tropicalmed7100325. [PMID: 36288066 PMCID: PMC9608748 DOI: 10.3390/tropicalmed7100325] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/05/2022] [Accepted: 10/12/2022] [Indexed: 11/23/2022] Open
Abstract
The genus Giardia is a unicellular protozoan able to parasitize both humans and animals. Cysts of Giardia can be found in soil samples, aquatic environments, food, and any surface that gets in contact with the feces of parasitized animals. The aim of this systematic review was to analyze the burden and epidemiology of Giardia infection in Colombia summarizing recent scientific reports and existing knowledge and to identify knowledge gaps that may be addressed in future investigations. This work follows the guidelines established by "Preferred Reporting Items for Systematic Reviews and Meta-Analyzes" (PRISMA). Published scientific literature from 1 January 2010 to 18 September 2022 was searched in six electronic scientific databases using the search terms: "Giardia" OR "Giardiasis" AND "Colombia". Twenty-three scientific articles were performed in 22 departments of Colombia at rural, urban, and a combination of rural and urban contexts. The prevalence of Giardia in the Colombian population was between 0.9 and 48.1% when the samples were analyzed with classical microscopy; the range of Giardia prevalence was even bigger (4.2-100%) when qPCR and nested PCR were used. The dominant Giardia assemblages found in Colombia were A and B, and most frequent subassemblages were AII, BIII, and BIV.
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Affiliation(s)
- Carmine Fusaro
- Facultad de Ingenierías, Universidad de San Buenaventura, Cartagena de Indias 130010, Colombia
| | - Yosef A. Chávez-Romero
- Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Santa Cruz 90640, Mexico
| | | | - Nancy Serrano-Silva
- Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Correspondence: (N.S.-S.); (Y.S.-G.); Tel.: +52-5556224827 (N.S.-S.); +57-5-5894093 (Y.S.-G.)
| | - Jaime E. Bernal
- Facultad de Medicina, Universidad del Sinú, Cartagena de Indias 130011, Colombia
| | | | - Yohanna Sarria-Guzmán
- Facultad de Ingeniería y Ciencias Básicas, Fundación Universitaria del Área Andina, Valledupar 200005, Colombia
- Correspondence: (N.S.-S.); (Y.S.-G.); Tel.: +52-5556224827 (N.S.-S.); +57-5-5894093 (Y.S.-G.)
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Gizaw Z, Yalew AW, Bitew BD, Lee J, Bisesi M. Effects of local handwashing agents on microbial contamination of the hands in a rural setting in Northwest Ethiopia: a cluster randomised controlled trial. BMJ Open 2022; 12:e056411. [PMID: 35568490 PMCID: PMC9109095 DOI: 10.1136/bmjopen-2021-056411] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 04/26/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of handwashing with water and wood ash in reducing faecal contamination of the hands. DESIGN A cluster randomised controlled trial was employed with two arms: handwashing with water and wood ash versus handwashing with water alone. SETTING Rural households of East Dembiya District, Central Gondar Zone, Amhara National Regional State, Ethiopia. PARTICIPANTS 440 mothers and caregivers of children younger than 5 years assigned (1:1, 220 in each group) in clusters, with buffer zones between each cluster. INTERVENTION Health education on effective handwashing was given to the intervention and control groups. Participants in the intervention group used wood ash of the same quantity (ie, one closed palm). OUTCOME MEASURES The primary outcome was microbial contamination of the hands, measured by means of Escherichia coli counts before and after handwashing. RESULTS At baseline, 75.9% and 67.7% of the participants in the intervention and control groups, respectively, had dirt on their fingernails, and the hands of all participants in both groups were contaminated with E. coli. The mean E. coli counts recovered at baseline were 3.07 log10 colony forming unit (CFU)/swab in the intervention group and 3.03 log10 CFU/swab in the control group, while at endline it was 1.4 log10 CFU/swab in the intervention group and 3.02 log10 CFU/swab in the control group. The mean E.coli counts was reduced by 1.65 log10 due to the intervention (difference-in-differences: β= -1.65, 95% CI= -1.84 to -1.46). CONCLUSION Two-thirds of the swab samples tested positive for E. coli after handwashing with water and wood ash, which indicates wood ash is not very effective in terms of completely removing micro-organisms on the hands. However, wood ash was significantly better than water alone in reducing the concentration of faecal coliform organisms on the hands. Local health authorities should primarily promote handwashing with soap. However, in the absence of soap, use of wood ash over water alone might be appropriate. TRIAL REGISTRATION NUMBER PACTR202011855730652.
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Affiliation(s)
- Zemichael Gizaw
- Department of Environmental and Occupational Health and Safety, University of Gondar, Gondar, Ethiopia
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- Global One Health Initiative (GOHi), the Ohio State University, Columbus, Ohio, USA
| | | | - Bikes Destaw Bitew
- Department of Environmental and Occupational Health and Safety, University of Gondar, Gondar, Ethiopia
| | - Jiyoung Lee
- Division of Environmental Health Sciences, The Ohio State University, Columbus, Ohio, USA
- Department of Food Science and Technology, The Ohio State University, Columbus, Ohio, USA
| | - Michael Bisesi
- Division of Environmental Health Sciences, The Ohio State University, Columbus, Ohio, USA
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Floyd JR, Kwoba E, Mwangi T, Okotto-Okotto J, Wanza P, Wardrop N, Yu W, Wright JA. A spatiotemporal analysis of cattle herd movement in relation to drinking-water sources: implications for Cryptosporidium control in rural Kenya. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:34314-34324. [PMID: 35038102 PMCID: PMC9076705 DOI: 10.1007/s11356-021-17888-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 11/27/2021] [Indexed: 06/14/2023]
Abstract
Given the increasing evidence that domestic contact with livestock is a risk factor for child diarrhoea in low- and middle-income countries, there have been calls for greater quantification of human-livestock contact in such countries. This study aimed to quantify seasonality in cattle proximity to domestic water sources and household compounds and develop a preliminary landscape model of faecal deposition by cattle. A total of 120 cattle in smallholder herds in the Asembo area of Siaya County, Kenya, were tracked over 1 week in April 2018 to July 2018 and November 2018 to February 2019 using GPS tracking devices. Dung deposition and behaviour were observed among 33 cattle from these herds over 185.4 hours. Mean cattle home ranges were small at 3.78 km2 and 5.85 km2 in the wet and dry seasons, respectively. There were significant differences between seasons in home range size, distance travelled from the household, and time spent tethered, but not in the time spent at domestic water sources or home range overlap with other herds. On average, 0.76 dung deposition events/hour were observed, with higher frequency in bulls. Variation in cattle proximity to household compounds and water sources did not account for seasonal variation in child diarrhoea in this population. The preliminary landscape model of faecal deposition by cattle could be further developed to inform interventions for safe separation of livestock and people, such as fencing and separate water troughs.
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Affiliation(s)
- Jessica R Floyd
- School of Geography and Environmental Science, University of Southampton, Building 44, Highfield, Southampton, SO17 1BJ, UK.
| | - Emmah Kwoba
- Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-1400, Kisian campus, Kisumu-Busia Highway, Kisumu, Kenya
| | - Thumbi Mwangi
- Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-1400, Kisian campus, Kisumu-Busia Highway, Kisumu, Kenya
| | - Joseph Okotto-Okotto
- Victoria Institute for Research on Environment and Development (VIRED) International, P.O. Box 6423-40103, off Nairobi Road, Rabuor, Kenya
| | - Peggy Wanza
- Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-1400, Kisian campus, Kisumu-Busia Highway, Kisumu, Kenya
| | - Nicola Wardrop
- School of Geography and Environmental Science, University of Southampton, Building 44, Highfield, Southampton, SO17 1BJ, UK
| | - Weiyu Yu
- School of Geography and Environmental Science, University of Southampton, Building 44, Highfield, Southampton, SO17 1BJ, UK
| | - Jim A Wright
- School of Geography and Environmental Science, University of Southampton, Building 44, Highfield, Southampton, SO17 1BJ, UK
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Gizaw Z, Yalew AW, Bitew BD, Lee J, Bisesi M. Fecal indicator bacteria along multiple environmental exposure pathways (water, food, and soil) and intestinal parasites among children in the rural northwest Ethiopia. BMC Gastroenterol 2022; 22:84. [PMID: 35220951 PMCID: PMC8882269 DOI: 10.1186/s12876-022-02174-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 02/21/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Children in low-resource settings are exposed to multiple risk factors for enteropathogens. However, the probability of exposures may be different across exposure pathways. Accordingly, this study was conducted to assess environmental exposures of children to intestinal parasites in the east Dembiya district of Ethiopia. METHODS A cross-sectional study was conducted for 372 households with children aged 24-59 months. The potential for external exposure of children to intestinal parasites was assessed by determining the presence of fecal indicator organism (Escherichia coli (E. coli)) in drinking water at point of use, ready-to-eat foods, and courtyard soil from children's outdoor play areas. For internal exposure assessment, ova of parasites in stool samples was detected using wet mount and Kato-Katz techniques to estimate exposure to intestinal parasites. The external and internal exposure assessments were also complemented using questionnaire and spot-check observations to assess behaviors that result in high risk of exposure. Individual and community-level predictors of intestinal parasites were identified using a multilevel logistic regression model. Statistically significant variables were identified on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value < 0.05. RESULTS Ova of one or more intestinal parasites was detected among 178 (47.8%) (95% CI 42.8, 52.6%) of the children. The most common intestinal parasites were A. lumbricoides (20.7%) and S. mansoni (19.1%). Furthermore, E. coli was detected in 69.1% of drinking water samples at point of use, 67.5% of ready-to-eat food samples, and 83.1% of courtyard soil samples from children's outdoor play areas. Exposure of children to intestinal parasites among children in the studied region was associated with poor hand hygiene of mothers (AOR 1.98, 95% CI (1.07, 3.66), poor hand hygiene of children (AOR 3.20, 95% CI (1.77, 5.77), mouthing of soil contaminated materials (AOR 2.31, 95% CI (1.26, 4.24), open defecation practices (AOR 2.22, 95% CI (1.20, 4.10), limited access to water (AOR 2.38, 95% CI (1.13, 5.01), water contamination (AOR 2.51, 95% CI (1.31, 4.80), food contamination (AOR 3.21, 95% CI (1.69, 6.09), and soil contamination (AOR 2.56, 95% CI (1.34, 4.90). CONCLUSION An extensive E. coli contamination of water, foods, and courtyard soil was found in the studied region and the potential sources of contamination were open defecation practices, unhygienic disposal of wastes, poor animal husbandry and keeping practices, and poor water and food safety measures at household level. Moreover, fecal contamination of water, foods, and soil linked to exposure of children to intestinal parasites in the studied region. Thus, it is critical to implement individual-level interventions (such as latrine utilization, hand hygiene promotion, food safety, home-based water treatment, and containment of domestic animals), plus community-level interventions (such as protecting water sources from contamination, source-based water treatment, and community-driven sanitation).
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Affiliation(s)
- Zemichael Gizaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- Global One Health Initiative (GOHi), The Ohio State University, Columbus, OH USA
| | | | - Bikes Destaw Bitew
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Jiyoung Lee
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210 USA
- Department of Food Science and Technology, The Ohio State University, Columbus, OH USA
| | - Michael Bisesi
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210 USA
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Beard DK, Bristol S, Cosby K, Davis A, Manning C, Perry L, Snapp L, Toy A, Wheeler K, Young J, Staker B, Arakaki TL, Abendroth J, Subrahamanian S, Edwards TE, Myler PJ, Asojo OA. Crystal structure of a hypothetical protein from Giardia lamblia. Acta Crystallogr F Struct Biol Commun 2022; 78:59-65. [PMID: 35102894 PMCID: PMC8805217 DOI: 10.1107/s2053230x21013595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/23/2021] [Indexed: 11/17/2022] Open
Abstract
Giardiasis is the most prevalent diarrheal disease globally and affects humans and animals. It is a significant problem in developing countries, the number one cause of travelers' diarrhea and affects children and immunocompromised individuals, especially HIV-infected individuals. Giardiasis is treated with antibiotics (tinidazole and metronidazole) that are also used for other infections such as trichomoniasis. The ongoing search for new therapeutics for giardiasis includes characterizing the structure and function of proteins from the causative protozoan Giardia lamblia. These proteins include hypothetical proteins that share 30% sequence identity or less with proteins of known structure. Here, the atomic resolution structure of a 15.6 kDa protein was determined by molecular replacement. The structure has the two-layer αβ-sandwich topology observed in the prototypical endoribonucleases L-PSPs (liver perchloric acid-soluble proteins) with conserved allosteric active sites containing small molecules from the crystallization solution. This article is an educational collaboration between Hampton University and the Seattle Structural Genomics Center for Infectious Disease.
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Affiliation(s)
- Dylan K. Beard
- Department of Chemistry and Biochemistry, Hampton University, 100 William R. Harvey Way, Hampton, VA 23668, USA
| | - Seonna Bristol
- Department of Chemistry and Biochemistry, Hampton University, 100 William R. Harvey Way, Hampton, VA 23668, USA
| | - Kayla Cosby
- Department of Chemistry and Biochemistry, Hampton University, 100 William R. Harvey Way, Hampton, VA 23668, USA
| | - Amber Davis
- Department of Chemistry and Biochemistry, Hampton University, 100 William R. Harvey Way, Hampton, VA 23668, USA
| | - Courtney Manning
- Department of Chemistry and Biochemistry, Hampton University, 100 William R. Harvey Way, Hampton, VA 23668, USA
| | - Lionel Perry
- Department of Chemistry and Biochemistry, Hampton University, 100 William R. Harvey Way, Hampton, VA 23668, USA
| | - Lauren Snapp
- Department of Chemistry and Biochemistry, Hampton University, 100 William R. Harvey Way, Hampton, VA 23668, USA
| | - Arian Toy
- Department of Chemistry and Biochemistry, Hampton University, 100 William R. Harvey Way, Hampton, VA 23668, USA
| | - Kayla Wheeler
- Department of Chemistry and Biochemistry, Hampton University, 100 William R. Harvey Way, Hampton, VA 23668, USA
| | - Jeremy Young
- Department of Chemistry and Biochemistry, Hampton University, 100 William R. Harvey Way, Hampton, VA 23668, USA
| | - Bart Staker
- Seattle Structural Genomics Center for Infectious Disease (SSGCID), Seattle, Washington, USA
- Center for Infectious Disease Research, formerly Seattle Biomedical Research Institute, 307 Westlake Avenue North Suite 500, Seattle, WA 98109, USA
| | | | - Jan Abendroth
- Seattle Structural Genomics Center for Infectious Disease (SSGCID), Seattle, Washington, USA
| | - Sandhya Subrahamanian
- Seattle Structural Genomics Center for Infectious Disease (SSGCID), Seattle, Washington, USA
- Center for Infectious Disease Research, formerly Seattle Biomedical Research Institute, 307 Westlake Avenue North Suite 500, Seattle, WA 98109, USA
| | - Thomas E. Edwards
- Seattle Structural Genomics Center for Infectious Disease (SSGCID), Seattle, Washington, USA
- Center for Infectious Disease Research, formerly Seattle Biomedical Research Institute, 307 Westlake Avenue North Suite 500, Seattle, WA 98109, USA
| | - Peter J. Myler
- Center for Infectious Disease Research, formerly Seattle Biomedical Research Institute, 307 Westlake Avenue North Suite 500, Seattle, WA 98109, USA
| | - Oluwatoyin A. Asojo
- Department of Chemistry and Biochemistry, Hampton University, 100 William R. Harvey Way, Hampton, VA 23668, USA
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11
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Development and evaluation of a molecular based protocol for detection and quantification of Cryptosporidium spp. In wastewater. Exp Parasitol 2022; 234:108216. [DOI: 10.1016/j.exppara.2022.108216] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 01/13/2022] [Accepted: 01/21/2022] [Indexed: 12/19/2022]
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12
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Kashyap G, Sindhoora K, Singh S, Banerjii PS, Gupta D, Kumar P, Singh R, Singh V. Occurrence and diagnosis of cryptosporidiosis in cattle calves with clinical diarrhoea. BIOL RHYTHM RES 2021. [DOI: 10.1080/09291016.2019.1603687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Gayatri Kashyap
- Division of Pathology, Indian Veterinary Research Institute, Bareilly, India
| | - K Sindhoora
- Division of Pathology, Indian Veterinary Research Institute, Bareilly, India
| | - Shailendra Singh
- Division of Pathology, Indian Veterinary Research Institute, Bareilly, India
| | - P S Banerjii
- Division of Parasitology, Indian Veterinary Research Institute, Bareilly, India
| | - Deepanshu Gupta
- Division of Physiology, Indian Veterinary Research Institute, Bareilly, India
| | - Pawan Kumar
- Division of Pathology, Indian Veterinary Research Institute, Bareilly, India
| | - Rajendra Singh
- Division of Pathology, Indian Veterinary Research Institute, Bareilly, India
| | - Vidya Singh
- Division of Pathology, Indian Veterinary Research Institute, Bareilly, India
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13
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Utaaker KS, Chaudhary S, Kifleyohannes T, Robertson LJ. Global Goat! Is the Expanding Goat Population an Important Reservoir of Cryptosporidium? Front Vet Sci 2021; 8:648500. [PMID: 33748221 PMCID: PMC7977713 DOI: 10.3389/fvets.2021.648500] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/08/2021] [Indexed: 12/03/2022] Open
Abstract
Goats are a primary or additional income source for many families in resource-poor areas. Although often considered inferior to other livestock, the resilience of goats and their ability to thrive in a range of environments means that that they are of particular value. Furthermore, goats emit less methane than other livestock species. In these same areas, it is well-documented that cryptosporidiosis has a substantial impact on infant morbidity and mortality, as well as reducing child growth and development. As Cryptosporidium also causes diarrheal disease in goats, the question arises whether goats may represent a reservoir of infection to humans. Epidemiological studies regarding the potential for transmission of Cryptosporidium between goats and humans have largely concluded that Cryptosporidium species infecting goats are not zoonotic. However, these studies are mostly from developed countries, where goat husbandry is smaller, management routines differ greatly from those of developing countries, contact between goats and their owners is more limited, and cryptosporidiosis has less impact on human health. In this article, background information on goat husbandry in different countries is provided, along with information on Cryptosporidium prevalence among goats, at both the species and sub-species levels, and the potential for zoonotic transmission. The intention is to indicate data gaps that should be filled and to increase awareness of the role of goats as providers for low-income families, often living in areas where cryptosporidiosis is endemic and where appropriate baseline interventions could have a positive impact, regardless of species of goat or parasite.
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Affiliation(s)
| | - Suman Chaudhary
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Tsegabirhan Kifleyohannes
- Parasitology, Department of Paraclinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Oslo, Norway.,Department of Veterinary Basic and Diagnostic Sciences, College of Veterinary Medicine, Mekelle University, Mekelle, Ethiopia
| | - Lucy Jane Robertson
- Parasitology, Department of Paraclinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Oslo, Norway
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14
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Effect of Inter-Observer Variation on the Association between Contamination Hazards and the Microbiological Quality of Water Sources: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249192. [PMID: 33317003 PMCID: PMC7764753 DOI: 10.3390/ijerph17249192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/26/2020] [Accepted: 12/02/2020] [Indexed: 11/29/2022]
Abstract
Sanitary risk inspection protocols are often used to identify contamination hazards at water sources; however, different observers sometimes struggle to record hazards consistently. This study aimed to assess the effect of inter-observer variation in hazard observations on the strength of relationships between observed hazards and the bacterial contamination of water sources, particularly relationships with animal-related hazards. In a longitudinal study, five surveyors independently recorded hazards at 93 water sources used by 234 households in Siaya County, Kenya, in both wet and dry seasons. One surveyor collected samples from sources for subsequent Escherichia coli and intestinal enterococci testing. The relationship between each surveyor’s hazard observations and high bacterial contamination was examined using logistic regression. After controlling for water source type and preceding rainfall; percentage scores for animal-related hazards were significantly related to high contamination with enterococci and E. coli for one surveyor (odds ratio 1.02; 95% confidence intervals 1.00–1.03 for both parameters), but not for the remaining four surveyors. The relationship between observed contamination hazards and the microbiological contamination of water sources is sensitive to variation in hazard recording between surveyors. Sanitary risk protocols should be designed to enable robust and consistent observation of hazards.
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15
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de Aquino MCC, Inácio SV, Rodrigues FDS, de Barros LD, Garcia JL, Headley SA, Gomes JF, Bresciani KDS. Cryptosporidiosis and Giardiasis in Buffaloes ( Bubalus bubalis). Front Vet Sci 2020; 7:557967. [PMID: 33330686 PMCID: PMC7673452 DOI: 10.3389/fvets.2020.557967] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/16/2020] [Indexed: 11/13/2022] Open
Abstract
Cryptosporidium spp. and Giardia duodenalis infect the gastrointestinal tracts of animals and humans. Both parasite groups are distributed worldwide and cause significant economic losses in animal productivity. Infected hosts presenting with and without clinical manifestations can eliminate infective forms of these protozoa, which are particularly important to One Health. Compared to the published research on cattle, relatively few studies have examined the epidemiology of cryptosporidiosis and giardiasis in buffaloes. This short review describes the global occurrence of Cryptosporidium spp. and G. duodenalis in buffaloes, including the molecular techniques employed for the identification of species/assemblages and genotypes of these protozoa. Genetic analyses of isolates of G. duodenalis and Cryptosporidium spp. from various sources (environmental, animal, and human) have been performed to investigate their epidemiology. In buffaloes, the species Cryptosporidium parvum, Cryptosporidium ryanae, Cryptosporidium bovis, and Cryptosporidium suis-like have been characterized, as well as assemblages A and E of G. duodenalis. We demonstrate that buffaloes can be infected by species of Cryptosporidium spp. and G. duodenalis assemblages with zoonotic potential. Epidemiological studies that utilize molecular biology techniques represent an important resource for efforts to control and prevent the spread of these protozoans.
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Affiliation(s)
| | - Sandra Valéria Inácio
- School of Veterinary Medicine Araçatuba, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Fernando de Souza Rodrigues
- Laboratory of Animal Protozoology, Department of Preventive Veterinary Medicine, State University of Londrina, Londrina, Brazil
| | - Luiz Daniel de Barros
- Laboratory of Animal Protozoology, Department of Preventive Veterinary Medicine, State University of Londrina, Londrina, Brazil
| | - João Luis Garcia
- Laboratory of Animal Protozoology, Department of Preventive Veterinary Medicine, State University of Londrina, Londrina, Brazil
| | - Selwyn Arlington Headley
- Comparative Pathology Shared Resources Laboratory, Masonic Cancer Center, University of Minnesota, Saint Paul, MN, United States.,Laboratory of Animal Pathology, Department of Preventive Veterinary Medicine, State University of Londrina, Londrina, Brazil
| | - Jancarlo Ferreira Gomes
- School of Medical Sciences, University of Campinas, São Paulo, Brazil.,Laboratory of Image Data Science, Institute of Computing, University of Campinas, São Paulo, Brazil
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16
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Trajano Gomes da Silva D, Ebdon J, Okotto-Okotto J, Ade F, Mito O, Wanza P, Kwoba E, Mwangi T, Yu W, Wright JA. A longitudinal study of the association between domestic contact with livestock and contamination of household point-of-use stored drinking water in rural Siaya County (Kenya). Int J Hyg Environ Health 2020; 230:113602. [PMID: 32911124 PMCID: PMC7607227 DOI: 10.1016/j.ijheh.2020.113602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/20/2020] [Accepted: 08/05/2020] [Indexed: 11/08/2022]
Abstract
Background Emerging evidence suggests close domestic proximity of livestock and humans may lead to microbiological contamination of hands, objects, food and water supplies within domestic environments, adversely impacting public health. However, evidence quantifying the relationship between livestock, domestic animals, humans and microbiological contamination of household stored water remains limited. Aim This longitudinal study aimed to examine the relationship between domestic contact with livestock and domestic animals on microbiological contamination of household Point-of-Use (POU) stored drinking water in rural Kenya and assess the influence of choice of faecal indicator on such associations. Methodology A survey was performed in 234 households in Siaya county, Kenya, to observe presence of livestock (cattle, goats, poultry) and domestic animals (cats, dogs) in household compounds, alongside other risk factors for contamination of POU stored drinking water such as sanitation, storage conditions and hygiene practices. Samples from water sources (e.g. piped, spring/wells, boreholes, surface and rainwater) and from POU storage containers were tested for E. coli and intestinal enterococci. Livestock-related risk factors for water contamination were examined through multinomial regression, controlling for confounders. Results Rainwater was the main POU water source and was found to be highly susceptible to contamination. Multivariate analysis showed greater risk of gross (>100 CFU/100 mL) water contamination (with E. coli) for households where goats were observed, and/or where poultry roosted in proximity to stored household water (relative risk RR = 2.71; p = 0.001 and RR = 2.02; p = 0.012 respectively). Presence of a poultry coop was also associated with elevated intestinal enterococci densities (RR = 4.46; p = 0.001). Associations between contamination and livestock risk factors were thus similar for both bacteria groups, but E. coli counts declined more rapidly following collection from surface waters than enterococci counts (p = 0.024). Conclusion The presence of livestock (particularly goats) and poultry within household compounds increases POU water contamination risk, suggesting the need for improved interventions to address cross-contamination within rural domestic settings. Within Siaya county, more effective community education is needed to raise awareness of POU water quality protection, particularly of rainwater. Poultry and goats are risk factors for household stored water contamination. Poultry are risk factors for both enterococci and E. coli contamination. Attenuation of enterococci in household stored water is lower than for E. coli. Residual free chlorine is mostly too low to prevent stored water recontamination.
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Affiliation(s)
- Diogo Trajano Gomes da Silva
- School of Environment and Technology, University of Brighton, Cockcroft Building, Lewes Road, Brighton, BN2 4GJ, UK.
| | - James Ebdon
- School of Environment and Technology, University of Brighton, Cockcroft Building, Lewes Road, Brighton, BN2 4GJ, UK
| | - Joseph Okotto-Okotto
- Victoria Institute for Research on Environment and Development (VIRED) International, P.O. Box 6423-40103, Off Nairobi Road, Rabour, Kisumu, Kenya
| | - Frederick Ade
- Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Oscar Mito
- Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Peggy Wanza
- Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Emmah Kwoba
- Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Thumbi Mwangi
- Centre for Global Health Research, Kenya Medical Research Institute, P.O. Box 1578-40100, Kisumu, Kenya
| | - Weiyu Yu
- School of Geography and Environmental Science, University of Southampton, Building 44, Highfield, Southampton, SO17 1BJ, UK
| | - Jim A Wright
- School of Geography and Environmental Science, University of Southampton, Building 44, Highfield, Southampton, SO17 1BJ, UK
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17
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Shrivastava AK, Mohakud NK, Panda S, Patra SD, Kumar S, Sahu PS. Major enteropathogens in humans, domestic animals, and environmental soil samples from the same locality: prevalence and transmission considerations in coastal Odisha, India. Epidemiol Health 2020; 42:e2020034. [PMID: 32512665 PMCID: PMC7644938 DOI: 10.4178/epih.e2020034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/24/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Regions with limited sanitation facilities have higher rates of infections with various enteric pathogens. It is therefore important to identify different hosts and their relative contribution to pathogen shedding into the environment, and to assess the subsequent health risks to humans.
METHODS In this study, human faecal (n=310), animal faecal (n=150), and environmental (soil) samples (n=40) were collected from the same locality and screened for selected enteric pathogens by immunochromatography and/or polymerase chain reaction.
RESULTS At least 1 microbial agent was detected in 49.0%, 44.7%, and 40.0% of the samples from human, animals, and soil, respectively. Among humans, rotavirus was predominantly detected (17.4%) followed by enteropathogenic Escherichia coli (EPEC) (15.4%), Shigella (13.8), and Shiga toxin-producing E. coli (STEC) (9.7%). Among animals, STEC was detected most frequently (28.0%), and EPEC was the major enteric pathogen detected in soil (30.0%). The detection rate of rotavirus was higher among younger children (≤2 years) than among older children. Single infections were more commonly detected than multiple infections in humans (p<0.01), unlike the observations in animal and soil samples. For diarrhoeagenic E. coli and Shigella, most of the human and animal isolates showed close relatedness, suggesting possible cross-infection between humans and domesticated animals in the area studied.
CONCLUSIONS The present study provides an improved understanding of the distribution of major enteric pathogens coexisting in humans and animals in the region, thereby suggesting a high potential for possible transmission among livestock and communities residing in the studied locality.
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Affiliation(s)
- Arpit Kumar Shrivastava
- Infection Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, India
| | - Nirmal Kumar Mohakud
- Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology (KIIT) University, Bhubaneswar, India
| | - Swagatika Panda
- Infection Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, India
| | - Saumya Darshana Patra
- Infection Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, India
| | - Subrat Kumar
- Infection Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, India
| | - Priyadarshi Soumyaranjan Sahu
- Infection Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, India.,Department of Microbiology and Immunology, Medical University of the Americas, Nevis, West Indies
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18
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Fuhrmeister E, Ercumen A, Pickering AJ, Jeanis KM, Crider Y, Ahmed M, Brown S, Alam M, Sen D, Islam S, Kabir MH, Islam M, Rahman M, Kwong LH, Arnold BF, Luby SP, Colford JM, Nelson KL. Effect of Sanitation Improvements on Pathogens and Microbial Source Tracking Markers in the Rural Bangladeshi Household Environment. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:4316-4326. [PMID: 32167305 PMCID: PMC7144219 DOI: 10.1021/acs.est.9b04835] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 03/11/2020] [Accepted: 03/13/2020] [Indexed: 05/19/2023]
Abstract
Diarrheal illnesses from enteric pathogens are a leading cause of death in children under five in low- and middle-income countries (LMICs). Sanitation is one way to reduce the spread of enteric pathogens in the environment; however, few studies have investigated the effectiveness of sanitation in rural LMICs in reducing pathogens in the environment. In this study, we measured the impact of a sanitation intervention (dual-pit latrines, sani-scoops, child potties delivered as part of a randomized control trial, WASH Benefits) in rural Bangladeshi household compounds by assessing prevalence ratios, differences, and changes in the concentration of pathogen genes and host-specific fecal markers. We found no difference in the prevalence of pathogenic Escherichia coli, norovirus, or Giardia genes in the domestic environment in the sanitation and control arms. The prevalence of the human fecal marker was lower on child hands and the concentration of animal fecal marker was lower on mother hands in the sanitation arm in adjusted models, but these associations were not significant after correcting for multiple comparisons. In the subset of households with ≥10 individuals per compound, the prevalence of enterotoxigenic E. coli genes on child hands was lower in the sanitation arm. Incomplete removal of child and animal feces or the compound (versus community-wide) scale of intervention could explain the limited impacts of improved sanitation.
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Affiliation(s)
- Erica
R. Fuhrmeister
- Department
of Civil and Environmental Engineering, University of California, Berkeley, California 94720, United States
| | - Ayse Ercumen
- School
of Public Health, University of California, Berkeley, California 94720, United States
- Department
of Forestry and Environmental Resources, North Carolina State University, Raleigh, North Carolina 27695, United States
| | - Amy J. Pickering
- Civil
and Environmental Engineering, Tufts University, Medford, Massachusetts 02153, United States
| | - Kaitlyn M. Jeanis
- Department
of Civil and Environmental Engineering, University of California, Berkeley, California 94720, United States
| | - Yoshika Crider
- Energy
and Resources Group, University of California, Berkeley, California 94720, United States
| | - Mahaa Ahmed
- Department
of Civil and Environmental Engineering, University of California, Berkeley, California 94720, United States
| | - Sara Brown
- Department
of Civil and Environmental Engineering, University of California, Berkeley, California 94720, United States
| | - Mahfuja Alam
- Infectious
Disease Division, International Centre for
Diarrhoeal Disease Research Bangladesh, Dhaka 1212, Bangladesh
| | - Debashis Sen
- Infectious
Disease Division, International Centre for
Diarrhoeal Disease Research Bangladesh, Dhaka 1212, Bangladesh
| | - Sharmin Islam
- Infectious
Disease Division, International Centre for
Diarrhoeal Disease Research Bangladesh, Dhaka 1212, Bangladesh
| | - Mir Himayet Kabir
- Infectious
Disease Division, International Centre for
Diarrhoeal Disease Research Bangladesh, Dhaka 1212, Bangladesh
| | - Mahfuza Islam
- Infectious
Disease Division, International Centre for
Diarrhoeal Disease Research Bangladesh, Dhaka 1212, Bangladesh
| | - Mahbubur Rahman
- Infectious
Disease Division, International Centre for
Diarrhoeal Disease Research Bangladesh, Dhaka 1212, Bangladesh
| | - Laura H. Kwong
- Department
of Civil and Environmental Engineering, Stanford University, Stanford, California 94305, United States
| | - Benjamin F. Arnold
- School
of Public Health, University of California, Berkeley, California 94720, United States
| | - Stephen P. Luby
- Woods
Institute for the Environment, Stanford
University, Stanford, California 94305, United States
| | - John M. Colford
- School
of Public Health, University of California, Berkeley, California 94720, United States
| | - Kara L. Nelson
- Department
of Civil and Environmental Engineering, University of California, Berkeley, California 94720, United States
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19
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Berhe B, Mardu F, Tesfay K, Legese H, Adhanom G, Haileslasie H, Gebremichail G, Tesfanchal B, Shishay N, Negash H. More Than Half Prevalence of Protozoan Parasitic Infections Among Diarrheic Outpatients in Eastern Tigrai, Ethiopia, 2019; A Cross-Sectional Study. Infect Drug Resist 2020; 13:27-34. [PMID: 32021317 PMCID: PMC6954853 DOI: 10.2147/idr.s238493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 12/19/2019] [Indexed: 12/13/2022] Open
Abstract
Background Protozoan infections remain a major public health concern in Ethiopia, which causes malnutrition, protein and iron deficiencies, increment of health costs, hospitalization and long-term deleterious effects. In Tigrai, particularly, in the study area, there are limited literatures on the prevalence of protozoa and associated factors among diarrheic outpatients. Thus, aimed to determine the prevalence and associated factors of protozoan infections among diarrheic outpatients in Eastern Tigrai. Methods Health facility-based cross-sectional study was conducted in Eastern Tigrai, Ethiopia from April to October 2019 among diarrheic outpatient in health facilities of Adigrat. Four hundred one eighteen study participants were included consecutively. The stool samples were examined via direct wet mount following formal-ether concentration technique. Both interviewer based and self-administrated questionnaires were used to collect demographic data and factors associated with protozoan infections. Data were analyzed and computed using BM SPSS statistics version 22.0. P-value=0.05 at 95% confidence interval declared statistically significant. Results Out of 418 diarrheic outpatients, the overall prevalence of protozoan infection was 59.3% (248/418). A higher percentage of intestinal protozoan infection was recorded for females 130 (31.1%). Using well water as a source of drinking, poor hand washing habits before eating, not home latrine, dirty and untrimmed fingernails were the most important risk factors identified. E. histolytica complex and Giardia duodenalis were the most predominant protozoan infections detected among diarrheic outpatients. Conclusion The present study showed that diarrheic outpatients in the study area were heavily infected with protozoan parasitic infection. E. histolytica complex and Giardia duodenalis were the most predominant protozoans detected among diarrheic outpatients. Using well water as a source of drinking, poor handwashing habit before eating, not having home latrine, dirty and untrimmed fingernails were most important risk factors identified. So, cooperative action and health education on preventive measure are needed to reduce protozoan infections in Tigrai, particularly in the study area. The present study showed that diarrheic outpatients in the study area were heavily infected with protozoan parasitic infection.
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Affiliation(s)
- Brhane Berhe
- Unite of Medical Parasitology and Entomology, Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Tigrai, Ethiopia
| | - Fitsum Mardu
- Unite of Medical Parasitology and Entomology, Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Tigrai, Ethiopia
| | - Kebede Tesfay
- Unite of Medical Parasitology and Entomology, Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Tigrai, Ethiopia
| | - Haftom Legese
- Unite of Medical Microbiology, Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Tigrai, Ethiopia
| | - Gebre Adhanom
- Unite of Medical Microbiology, Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Tigrai, Ethiopia
| | - Hagos Haileslasie
- Unite of Hematology and Immuno-Hematology, Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Tigrai, Ethiopia
| | - Gebremedhin Gebremichail
- Unite of Hematology and Immuno-Hematology, Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Tigrai, Ethiopia
| | - Brhane Tesfanchal
- Unite of Clinical Chemistry, Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Tigrai, Ethiopia
| | - Niguse Shishay
- Unite of Immunology, Department of Medical Laboratory Science, Adigrat University, Adigrat, Tigrai, Ethiopia
| | - Hadush Negash
- Unite of Medical Microbiology, Department of Medical Laboratory Science, College of Medicine and Health Science, Adigrat University, Adigrat, Tigrai, Ethiopia
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20
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Fuhrmeister E, Ercumen A, Pickering AJ, Jeanis KM, Ahmed M, Brown S, Arnold BF, Hubbard AE, Alam M, Sen D, Islam S, Kabir MH, Kwong LH, Islam M, Unicomb L, Rahman M, Boehm AB, Luby SP, Colford JM, Nelson KL. Predictors of Enteric Pathogens in the Domestic Environment from Human and Animal Sources in Rural Bangladesh. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2019; 53:10023-10033. [PMID: 31356066 PMCID: PMC6727619 DOI: 10.1021/acs.est.8b07192] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 07/24/2019] [Accepted: 07/29/2019] [Indexed: 05/19/2023]
Abstract
Fecal indicator organisms are measured to indicate the presence of fecal pollution, yet the association between indicators and pathogens varies by context. The goal of this study was to empirically evaluate the relationships between indicator Escherichia coli, microbial source tracking markers, select enteric pathogen genes, and potential sources of enteric pathogens in 600 rural Bangladeshi households. We measured indicators and pathogen genes in stored drinking water, soil, and on mother and child hands. Additionally, survey and observational data on sanitation and domestic hygiene practices were collected. Log10 concentrations of indicator E. coli were positively associated with the prevalence of pathogenic E. coli genes in all sample types. Given the current need to rely on indicators to assess fecal contamination in the field, it is significant that in this study context indicator E. coli concentrations, measured by IDEXX Colilert-18, provided quantitative information on the presence of pathogenic E. coli in different sample types. There were no significant associations between the human fecal marker (HumM2) and human-specific pathogens in any environmental sample type. There was an increase in the prevalence of Giardia lamblia genes, any E. coli virulence gene, and the specific E. coli virulence genes stx1/2 with every log10 increase in the concentration of the animal fecal marker (BacCow) on mothers' hands. Thus, domestic animals were important contributors to enteric pathogens in these households.
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Affiliation(s)
- Erica
R. Fuhrmeister
- Department
of Civil and Environmental Engineering, University of California, Berkeley, California 94720, United States
| | - Ayse Ercumen
- School
of Public Health, University of California, Berkeley, California 94720, Unites States
- Department
of Forestry and Environmental Resources, North Carolina State University, Raleigh, North Carolina 27695, United States
| | - Amy J. Pickering
- Civil
and Environmental Engineering, Tufts University, Medford, Massachusetts 02153, United States
| | - Kaitlyn M. Jeanis
- Department
of Civil and Environmental Engineering, University of California, Berkeley, California 94720, United States
| | - Mahaa Ahmed
- Department
of Civil and Environmental Engineering, University of California, Berkeley, California 94720, United States
| | - Sara Brown
- Department
of Civil and Environmental Engineering, University of California, Berkeley, California 94720, United States
| | - Benjamin F. Arnold
- School
of Public Health, University of California, Berkeley, California 94720, Unites States
| | - Alan E. Hubbard
- School
of Public Health, University of California, Berkeley, California 94720, Unites States
| | - Mahfuja Alam
- Infectious
Disease Division, International Centre for
Diarrhoeal Disease Research Bangladesh, Dhaka, 1212, Bangladesh
| | - Debashis Sen
- Infectious
Disease Division, International Centre for
Diarrhoeal Disease Research Bangladesh, Dhaka, 1212, Bangladesh
| | - Sharmin Islam
- Infectious
Disease Division, International Centre for
Diarrhoeal Disease Research Bangladesh, Dhaka, 1212, Bangladesh
| | - Mir Himayet Kabir
- Infectious
Disease Division, International Centre for
Diarrhoeal Disease Research Bangladesh, Dhaka, 1212, Bangladesh
| | - Laura H. Kwong
- Department
of Civil and Environmental Engineering, Stanford University, Stanford, California 94305, United States
| | - Mahfuza Islam
- Infectious
Disease Division, International Centre for
Diarrhoeal Disease Research Bangladesh, Dhaka, 1212, Bangladesh
| | - Leanne Unicomb
- Infectious
Disease Division, International Centre for
Diarrhoeal Disease Research Bangladesh, Dhaka, 1212, Bangladesh
| | - Mahbubur Rahman
- Infectious
Disease Division, International Centre for
Diarrhoeal Disease Research Bangladesh, Dhaka, 1212, Bangladesh
| | - Alexandria B. Boehm
- Department
of Civil and Environmental Engineering, Stanford University, Stanford, California 94305, United States
| | - Stephen P. Luby
- Woods
Institute for the Environment, Stanford
University, Stanford, California 94305, United States
| | - John M. Colford
- School
of Public Health, University of California, Berkeley, California 94720, Unites States
| | - Kara L. Nelson
- Department
of Civil and Environmental Engineering, University of California, Berkeley, California 94720, United States
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21
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Stokdyk JP, Spencer SK, Walsh JF, de Lambert JR, Firnstahl AD, Anderson AC, Rezania LIW, Borchardt MA. Cryptosporidium Incidence and Surface Water Influence of Groundwater Supplying Public Water Systems in Minnesota, USA. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2019; 53:3391-3398. [PMID: 30895775 DOI: 10.1021/acs.est.8b05446] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Regulations for public water systems (PWS) in the U.S. consider Cryptosporidium a microbial contaminant of surface water supplies. Groundwater is assumed free of Cryptosporidium unless surface water is entering supply wells. We determined the incidence of Cryptosporidium in PWS wells varying in surface water influence. Community and noncommunity PWS wells ( n = 145) were sampled ( n = 964) and analyzed for Cryptosporidium by qPCR and immunofluorescence assay (IFA). Surface water influence was assessed by stable isotopes and the expert judgment of hydrogeologists using site-specific data. Fifty-eight wells (40%) and 107 samples (11%) were Cryptosporidium-positive by qPCR, and of these samples 67 were positive by IFA. Cryptosporidium concentrations measured by qPCR and IFA were significantly correlated ( p < 0.001). Cryptosporidium incidence was not associated with surface water influence as assessed by stable isotopes or expert judgment. We successfully sequenced 45 of the 107 positive samples to identify species, including C. parvum (41), C. andersoni (2), and C. hominis (2), and the predominant subtype was C. parvum IIa A17G2R1. Assuming USA regulations for surface water-supplied PWS were applicable to the study wells, wells positive for Cryptosporidium by IFA would likely be required to add treatment. Cryptosporidium is not uncommon in groundwater, even when surface water influence is absent.
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Affiliation(s)
- Joel P Stokdyk
- USGS Upper Midwest Water Science Center, 2615 Yellowstone Drive , Marshfield , Wisconsin 54449 , United States
| | - Susan K Spencer
- USDA-Agricultural Research Service, Environmentally Integrated Dairy Management Research Unit, 2615 Yellowstone Drive , Marshfield , Wisconsin 54449 , United States
| | - James F Walsh
- Minnesota Department of Health , 625 Robert St. N , St. Paul , Minnesota 55164 , United States
| | - Jane R de Lambert
- Minnesota Department of Health , 625 Robert St. N , St. Paul , Minnesota 55164 , United States
| | - Aaron D Firnstahl
- USGS Upper Midwest Water Science Center, 2615 Yellowstone Drive , Marshfield , Wisconsin 54449 , United States
| | - Anita C Anderson
- Minnesota Department of Health , 625 Robert St. N , St. Paul , Minnesota 55164 , United States
| | - Lih-In W Rezania
- Minnesota Department of Health , 625 Robert St. N , St. Paul , Minnesota 55164 , United States
| | - Mark A Borchardt
- USDA-Agricultural Research Service, Environmentally Integrated Dairy Management Research Unit, 2615 Yellowstone Drive , Marshfield , Wisconsin 54449 , United States
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22
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Johri M, Sylvestre MP, Koné GK, Chandra D, Subramanian SV. Effects of improved drinking water quality on early childhood growth in rural Uttar Pradesh, India: A propensity-score analysis. PLoS One 2019; 14:e0209054. [PMID: 30620737 PMCID: PMC6324831 DOI: 10.1371/journal.pone.0209054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 11/27/2018] [Indexed: 12/17/2022] Open
Abstract
Context Recent randomised controlled trials in Bangladesh and Kenya concluded that household water treatment, alone or in combination with upgraded sanitation and handwashing, did not reduce linear growth faltering or improve other child growth outcomes. Whether these results are applicable in areas with distinct constellations of water, sanitation and hygiene (WaSH) risks is unknown. Analysis of observational data offers an efficient means to assess the external validity of trial findings. We studied whether a water quality intervention could improve child growth in a rural Indian setting with higher levels of circulating pathogens than the original trial sites. Methods We analysed a cross-sectional dataset including a microbiological measure of household water quality. All households accessed water from an improved source. We applied propensity score methods to emulate a randomised trial investigating the hypothesis that receipt of drinking water meeting Sustainable Development Goal (SDG) 6.1 quality standards for absence of faecal contamination leads to improved growth. Growth outcomes (stunting, underweight, wasting, and their corresponding Z-scores) were assessed in children 12–23 months of age. For each outcome, we estimated the mean and 95% confidence interval of the absolute risk difference between treatment groups. Findings Of 1088 households, 442 (40.62%) received drinking water meeting SDG 6.1 standards. The adjusted risk of child underweight was 7.4% (1.3% to 13.4%) lower among those drinking water satisfying SDG 6.1 norms than among controls. Evidence concerning the relationship of drinking water meeting SDG 6.1 norms to length-for-age and weight-for-age was inconclusive, and there was no apparent relationship with stunting or wasting. Conclusions In contexts characterised by high pathogen transmission, water quality improvements have the potential to reduce the proportion of underweight children, but are unlikely to impact stunting or wasting. Further research is required to assess how these modelled benefits can best be achieved in real world settings.
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Affiliation(s)
- Mira Johri
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Québec, Canada
- Département d’administration de la santé, École de santé publique, Université de Montréal, Montreal, Canada
- * E-mail:
| | - Marie-Pierre Sylvestre
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Québec, Canada
- Département de médicine sociale et préventive, École de santé publique, Université de Montréal, Montreal, Canada
| | - Georges Karna Koné
- Abt associates, Health finance and governance (FHG) Project, Port-au-Prince, Haiti
| | - Dinesh Chandra
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, Québec, Canada
- Independent consultant, New Delhi, India
| | - S. V. Subramanian
- Harvard Center for Population and Development Studies, Cambridge MA, United States of America
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Korajkic A, McMinn BR, Harwood VJ. Relationships between Microbial Indicators and Pathogens in Recreational Water Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2842. [PMID: 30551597 PMCID: PMC6313479 DOI: 10.3390/ijerph15122842] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 12/10/2018] [Accepted: 12/11/2018] [Indexed: 11/16/2022]
Abstract
Fecal pollution of recreational waters can cause scenic blight and pose a threat to public health, resulting in beach advisories and closures. Fecal indicator bacteria (total and fecal coliforms, Escherichia coli, and enterococci), and alternative indicators of fecal pollution (Clostridium perfringens and bacteriophages) are routinely used in the assessment of sanitary quality of recreational waters. However, fecal indicator bacteria (FIB), and alternative indicators are found in the gastrointestinal tract of humans, and many other animals and therefore are considered general indicators of fecal pollution. As such, there is room for improvement in terms of their use for informing risk assessment and remediation strategies. Microbial source tracking (MST) genetic markers are closely associated with animal hosts and are used to identify fecal pollution sources. In this review, we examine 73 papers generated over 40 years that reported the relationship between at least one indicator and one pathogen group or species. Nearly half of the reports did not include statistical analysis, while the remainder were almost equally split between those that observed statistically significant relationships and those that did not. Statistical significance was reported less frequently in marine and brackish waters compared to freshwater, and the number of statistically significant relationships was considerably higher in freshwater (p < 0.0001). Overall, significant relationships were more commonly reported between FIB and pathogenic bacteria or protozoa, compared to pathogenic viruses (p: 0.0022⁻0.0005), and this was more pronounced in freshwater compared to marine. Statistically significant relationships were typically noted following wet weather events and at sites known to be impacted by recent fecal pollution. Among the studies that reported frequency of detection, FIB were detected most consistently, followed by alternative indicators. MST markers and the three pathogen groups were detected least frequently. This trend was mirrored by reported concentrations for each group of organisms (FIB > alternative indicators > MST markers > pathogens). Thus, while FIB, alternative indicators, and MST markers continue to be suitable indicators of fecal pollution, their relationship with waterborne pathogens, particularly viruses, is tenuous at best and influenced by many different factors such as frequency of detection, variable shedding rates, differential fate and transport characteristics, as well as a broad range of site-specific factors such as the potential for the presence of a complex mixture of multiple sources of fecal contamination and pathogens.
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Affiliation(s)
- Asja Korajkic
- National Exposure Research Laboratory, Office of Research and Development, United States Environmental Protection Agency, 26 West Martin Luther King Drive, Cincinnati, OH 45268, USA.
| | - Brian R McMinn
- National Exposure Research Laboratory, Office of Research and Development, United States Environmental Protection Agency, 26 West Martin Luther King Drive, Cincinnati, OH 45268, USA.
| | - Valerie J Harwood
- Department of Integrative Biology, University of South Florida, 4202 East Fowler Ave, SCA 110, Tampa, FL 33620, USA.
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24
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Thakur R, Singh BB, Jindal P, Aulakh RS, Gill JPS. The Clean India Mission: Public and animal health benefits. Acta Trop 2018; 186:5-15. [PMID: 29949730 DOI: 10.1016/j.actatropica.2018.06.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/21/2018] [Accepted: 06/23/2018] [Indexed: 12/20/2022]
Abstract
The Clean India Mission is a national campaign that aims for complete elimination of open defecation from the country. In India, 564 million people do not have access to toilets and defecate in the open environment. The 'Millennium development goals' have given increased weightage to elimination of open defecation for improving health, nutrition and productivity of developing country populations. The Indian economy bears an estimated annual total loss (in terms of health, education, access time and tourism) of US$ 54 billion due to lack of toilets, poor hygiene and over US$ 38.5 billion in treatment costs for diseases occurring due to poor hygiene. Out of 1415 human pathogens, at least more than 10% of pathogens are transmitted through the faecal-oral route. The practice of open defecation helps pathogens persist in the environment and cause diseases. This review focuses on the current status and harms of open defecation, as well as the public and animal health benefits of implementing 'The Clean India Mission' in India.
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Affiliation(s)
- Rashmi Thakur
- School of Public Health & Zoonoses, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, 141004, Punjab, India
| | - Balbir Bagicha Singh
- School of Public Health & Zoonoses, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, 141004, Punjab, India.
| | - Prateek Jindal
- School of Public Health & Zoonoses, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, 141004, Punjab, India
| | - Rabinder Singh Aulakh
- School of Public Health & Zoonoses, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, 141004, Punjab, India
| | - Jatinder Paul Singh Gill
- School of Public Health & Zoonoses, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, 141004, Punjab, India
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25
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Shrestha A, Schindler C, Odermatt P, Gerold J, Erismann S, Sharma S, Koju R, Utzinger J, Cissé G. Intestinal parasite infections and associated risk factors among schoolchildren in Dolakha and Ramechhap districts, Nepal: a cross-sectional study. Parasit Vectors 2018; 11:532. [PMID: 30268160 PMCID: PMC6162948 DOI: 10.1186/s13071-018-3105-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/10/2018] [Indexed: 12/19/2022] Open
Abstract
Background Infections with soil-transmitted helminths and pathogenic intestinal protozoa pose a considerable public health burden, particularly in low- and middle-income countries, including Nepal. We assessed the extent of intestinal parasite infections among schoolchildren in two districts of Nepal and determined underlying risk factors. Methods A cross-sectional survey was conducted between March and May 2015 in the districts of Dolakha and Ramechhap, Nepal. A total of 708 children, aged 8–16 years from 16 purposively selected schools, were enrolled. Each child provided a single stool sample that was subjected to a suite of copro-microscopic diagnoses for intestinal protozoa and helminths. Drinking water samples from different sources at schools (n = 29), community places (n = 43) and households (n = 562) were analysed for contamination with thermotolerant coliforms (TTC). A questionnaire was administered to determine individual- and household-level risk factors of intestinal parasite infections. Self-reported symptoms were assessed and a clinical examination was undertaken by a physician. Haemoglobin was measured and used as a proxy for anaemia. Mixed logistic regression models were applied to investigate associations. Results The overall prevalence of intestinal parasite infections was 39.7%. Trichuris trichiura (30.9%), Giardia intestinalis (30.5%) and hookworm (30.2%) were the predominant intestinal parasite infections. Children from households lacking soap for handwashing were at higher odds of intestinal parasite infections than children who had soap [adjusted odds ratio (aOR) 1.81; 95% confidence interval (CI): 1.13–2.89; P = 0.01]. Children from households without freely roaming domestic animals showed lower odds of G. intestinalis compared to children from households with freely roaming animals (aOR 0.52; 95% CI: 0.33–0.83; P = 0.01). One out of three (31.0%) children suffered from fever and 22.4% had watery diarrhoea within a two-week recall period. Anaemia was diagnosed in 23.6% of the children. Water contamination with TTC showed no clear association with intestinal parasite infection. Conclusions Intestinal parasites are common among schoolchildren in the two surveyed districts of Nepal. An important risk factor was lack of soap for handwashing. Our findings call for efforts to control intestinal parasite infection and emphasis should be placed on improvements in water, sanitation and hygiene interventions. Trial registration ISRCTN17968589 (date assigned: 17 July 2015). Electronic supplementary material The online version of this article (10.1186/s13071-018-3105-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Akina Shrestha
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland.,Kathmandu University, School of Medical Sciences, P.O. Box 11008, Kathmandu, Nepal
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Peter Odermatt
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Jana Gerold
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Séverine Erismann
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Subodh Sharma
- Kathmandu University, School of Science, Aquatic Ecology Centre, P.O. Box 6250, Dhulikhel, Nepal
| | - Rajendra Koju
- Kathmandu University, School of Medical Sciences, P.O. Box 11008, Kathmandu, Nepal
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Guéladio Cissé
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland. .,University of Basel, P.O. Box, CH-4003, Basel, Switzerland.
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26
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Zhong Z, Tu R, Ou H, Yan G, Dan J, Xiao Q, Wang Y, Cao S, Shen L, Deng J, Zuo Z, Ma X, Zhou Z, Liu H, Yu S, Ren Z, Hu Y, Peng G. Occurrence and genetic characterization of Giardia duodenalis and Cryptosporidium spp. from adult goats in Sichuan Province, China. PLoS One 2018; 13:e0199325. [PMID: 29912930 PMCID: PMC6005483 DOI: 10.1371/journal.pone.0199325] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 06/05/2018] [Indexed: 11/19/2022] Open
Abstract
Giardia duodenalis and Cryptosporidium spp. are common gastrointestinal protozoa in mammals. Many studies have been conducted on the distribution of G. duodenalis and Cryptosporidium spp. genotypes in sheep and cattle. However, in China, information about molecular characterization and genetic analysis of G. duodenalis and Cryptosporidium spp. in goats is limited. In this study, 342 fecal samples from adult goats were collected from 12 farms in Sichuan Province, China. The occurrence of G. duodenalis and Cryptosporidium spp. in adult goats was 14.9% (51/342) and 4.7% (16/342), respectively. All G. duodenalis were identified as assemblage E, with two novel genotypes (assemblages E17 and E18) being detected at the beta-giardin (bg) locus. Based on three loci-beta-giardin (bg), triose phosphate isomerase (tpi), and glutamate dehydrogenase (gdh)-multilocus sequence typing revealed three novel multilocus genotypes (MLGs) of assemblage E (MLG-E1, E2, E3 (sc)). Small Subunit (SSU) rRNA-based PCR identified two Cryptosporidium species, namely C. xiaoi (11/16) and C. suis (5/16). This study is not only the first to report C. suis infection in adult goats in China but is also the first to use the MLG approach to identify G. duodenalis in adult goats.
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Affiliation(s)
- Zhijun Zhong
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Rui Tu
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Hongping Ou
- Chengdu Agricultural College, Sichuan, P.R. China
| | - Guangwen Yan
- College of Animal Science, Xichang University, Xichang, P.R. China
| | - Jiaming Dan
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Qicheng Xiao
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Ya Wang
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Suizhong Cao
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Liuhong Shen
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Junliang Deng
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Zhicai Zuo
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Xiaoping Ma
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Ziyao Zhou
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Haifeng Liu
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Shumin Yu
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Zhihua Ren
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Yanchun Hu
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
| | - Guangneng Peng
- Key Laboratory of Animal Disease and Human Health of Sichuan Province, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, P.R. China
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27
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Mugala L, Siwila J, Saasa N, Pandey GS. Prevalence of Cryptosporidium spp. oocysts in dogs in Lusaka district of Zambia. Vet World 2018; 11:585-589. [PMID: 29915495 PMCID: PMC5993767 DOI: 10.14202/vetworld.2018.585-589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/03/2018] [Indexed: 11/16/2022] Open
Abstract
AIM Cryptosporidium is one of the causes of diarrheal illness in man and animals worldwide and is zoonotic. The study aimed to determine the prevalence and risk factors associated with fecal shedding of Cryptosporidium oocysts in dogs in Lusaka district of Zambia. MATERIALS AND METHODS A cross-sectional study was conducted in Lusaka district of Zambia during 2015-2016. A total of 390 dogs (243 males and 147 females) aged 2 months-13 years were enrolled. Fecal samples were collected and stained using modified Ziehl-Neelsen and Auramine O staining techniques and examined microscopically for oocysts. RESULTS Overall, the prevalence of Cryptosporidium oocysts infection was 5.9% (23/390; 95% confidence interval: 3.9-8.7). Prevalence among male dogs and female dogs was 5.3% and 6.8%, respectively. Older dogs had a relatively higher infection rate compared to the younger puppies. There was a statistically significant difference in infection between nondescript breed and pure breeds with prevalence being higher in nondescript dog breeds. Water source was also significantly associated with Cryptosporidium infection. CONCLUSION Cryptosporidium infections are common, especially among the nondescript breed of domestic dogs in Lusaka district of Zambia. Further studies to characterize the common species are warranted.
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Affiliation(s)
- Lamson Mugala
- Department of Applied and Health Sciences, Biomedical Section, Evelyn Hone College of Applied Arts and Commerce, Lusaka, Zambia
| | - Joyce Siwila
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, P. O. Box, 32379, Lusaka, Zambia
| | - Ngonda Saasa
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, P. O. Box, 32379, Lusaka, Zambia
| | - Girja Shanker Pandey
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, P. O. Box, 32379, Lusaka, Zambia
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Delahoy MJ, Wodnik B, McAliley L, Penakalapati G, Swarthout J, Freeman MC, Levy K. Pathogens transmitted in animal feces in low- and middle-income countries. Int J Hyg Environ Health 2018; 221:661-676. [PMID: 29729998 PMCID: PMC6013280 DOI: 10.1016/j.ijheh.2018.03.005] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/20/2018] [Accepted: 03/14/2018] [Indexed: 02/04/2023]
Abstract
Animals found in close proximity to humans in low-and middle-income countries (LMICs) harbor many pathogens capable of infecting humans, transmissible via their feces. Contact with animal feces poses a currently unquantified-though likely substantial-risk to human health. In LMIC settings, human exposure to animal feces may explain some of the limited success of recent water, sanitation, and hygiene interventions that have focused on limiting exposure to human excreta, with less attention to containing animal feces. We conducted a review to identify pathogens that may substantially contribute to the global burden of disease in humans through their spread in animal feces in the domestic environment in LMICs. Of the 65 potentially pathogenic organisms considered, 15 were deemed relevant, based on burden of disease and potential for zoonotic transmission. Of these, five were considered of highest concern based on a substantial burden of disease for which transmission in animal feces is potentially important: Campylobacter, non-typhoidal Salmonella (NTS), Lassa virus, Cryptosporidium, and Toxoplasma gondii. Most of these have a wide range of animal hosts, except Lassa virus, which is spread through the feces of rats indigenous to sub-Saharan Africa. Combined, these five pathogens cause close to one million deaths annually. More than half of these deaths are attributed to invasive NTS. We do not estimate an overall burden of disease from improperly managed animal feces in LMICs, because it is unknown what proportion of illnesses caused by these pathogens can be attributed to contact with animal feces. Typical water quantity, water quality, and handwashing interventions promoted in public health and development address transmission routes for both human and animal feces; however, sanitation interventions typically focus on containing human waste, often neglecting the residual burden of disease from pathogens transmitted via animal feces. This review compiles evidence on which pathogens may contribute to the burden of disease through transmission in animal feces; these data will help prioritize intervention types and regions that could most benefit from interventions aimed at reducing human contact with animal feces.
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Affiliation(s)
- Miranda J Delahoy
- Department of Environmental Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Breanna Wodnik
- Department of Environmental Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Lydia McAliley
- Department of Environmental Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Gauthami Penakalapati
- Department of Environmental Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Jenna Swarthout
- Department of Environmental Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Matthew C Freeman
- Department of Environmental Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA
| | - Karen Levy
- Department of Environmental Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA 30322, USA.
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Berhe B, Bugssa G, Bayisa S, Alemu M. Foodborne intestinal protozoan infection and associated factors among patients with watery diarrhea in Northern Ethiopia; a cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2018; 37:5. [PMID: 29499754 PMCID: PMC5834838 DOI: 10.1186/s41043-018-0137-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 02/24/2018] [Indexed: 05/14/2023]
Abstract
BACKGROUND Intestinal protozoa are parasites transmitted by consumption of contaminated water and food and mainly affect children and elder people and cause considerable health problems. They are the leading causes of outpatient morbidity due to diarrhea in the developing countries. So, assessing water and food source of diarrheal patients and identifying the main associated factors for transmission of protozoan parasitic infections help for effective control measures of protozoan infections. Hence, the current study was aimed at determining the prevalence of foodborne intestinal protozoa infections and associated factors among diarrheic patients in North Ethiopia. METHODS A health facility based cross-sectional study was conducted among 223 patients with watery diarrhea in four selected government health facilities in North Ethiopia from November 2016-June 2017. A structured questionnaire was used to collect data on socio-demography of study participants and factors associated with foodborne protozoa infections. The diarrheic stool samples were collected, transported, and processed using direct wet mount, formal-ether concentration and modified ZiehlNeelson staining methods. The data were analyzed using SPSS version 21 and descriptive statistics, bi-variate, and multivariate logistic regressions were computed. P-value < 0.05 at 95% confidence interval was considered statistically significant. RESULTS The overall prevalence of foodborne protozoa infection was 101 (45.3%). The predominant protozoa species identified was Entamoeba histolytica/dispar 55 (24.7%), followed by Giardia intestinalis 25 (11.2%) and Cryptosporidium species 5 (2.2%). The highest proportion of protozoa infection was observed among males (23.3%) and the age group 15-24 years (13.5%). Statistically significant associations were observed between foodborne protozoan infection and not using any type of recipe to decontaminate salads and fruits (AOR = 2.64, 95 CI: 1.34-5.19, P = 0.005) and using vinegar as a decontaminant (AOR = 2.83, 95 CI: 1.24-6.48, P = 0.014). Eating out (meals at a restaurant) on the other hand was found to be protective for foodborne protozoan infection (AOR = 0.43, 95 CI: 0.23-0.78, P = 0.006). CONCLUSION Our study revealed that foodborne protozoa infections are of public health significance in the study area. Vinegar, which is frequently used as a recipe for decontaminating salads and fruits, is inversely related to foodborne protozoa parasite infection .
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Affiliation(s)
- Birhane Berhe
- Department of Bio-Medical Laboratory Science, College of Health Science, Adigrat University, Adigrat, Ethiopia
| | - Gessessew Bugssa
- Department of Medical Parasitology and Entomology, Institute of Biomedical Sciences, College of Health Science, Mekelle University, Mekelle, Ethiopia
| | - Sena Bayisa
- Department of Medical Parasitology and Entomology, Institute of Biomedical Sciences, College of Health Science, Mekelle University, Mekelle, Ethiopia
| | - Megbaru Alemu
- Department of Medical Microbiology, Immunology and Parasitology, Bahir Dar University, Mekelle, Ethiopia
- Department of Microbiology, Immunology and Parasitology, Bahir Dar University, PO Box 79, Bahir Dar, Ethiopia
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Daniels ME, Smith WA, Jenkins MW. Estimating Cryptosporidium and Giardia disease burdens for children drinking untreated groundwater in a rural population in India. PLoS Negl Trop Dis 2018; 12:e0006231. [PMID: 29377884 PMCID: PMC5805363 DOI: 10.1371/journal.pntd.0006231] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 02/08/2018] [Accepted: 01/10/2018] [Indexed: 01/26/2023] Open
Abstract
Background In many low-income settings, despite improvements in sanitation and hygiene, groundwater sources used for drinking may be contaminated with enteric pathogens such as Cryptosporidium and Giardia, which remain important causes of childhood morbidity. In this study, we examined the contribution of diarrhea caused by Cryptosporidium and Giardia found in groundwater sources used for drinking to the total burden of diarrheal disease among children < 5 in rural India. Methodology/Principal findings We studied a population of 3,385 children < 5 years of age in 100 communities of Puri District, Odisha, India. We developed a coupled quantitative microbial risk assessment (QMRA) and susceptible-infected-recovered (SIR) population model based on observed levels of Cryptosporidium and Giardia in improved groundwater sources used for drinking and compared the QMRA-SIR estimates with independently measured all-cause (i.e., all fecal-oral enteric pathogens and exposure pathways) child diarrhea prevalence rates observed in the study population during two monsoon seasons (2012 and 2013). We used site specific and regional studies to inform assumptions about the human pathogenicity of the Cryptosporidium and Giardia species present in local groundwater. In all three human pathogenicity scenarios evaluated, the mean daily risk of Cryptosporidium or Giardia infection (0.06–1.53%), far exceeded the tolerable daily risk of infection from drinking water in the US (< 0.0001%). Depending on which protozoa species were present, median estimates of daily child diarrhea prevalence due to either Cryptosporidium or Giardia infection from drinking water was as high as 6.5% or as low as < 1% and accounted for at least 2.9% and as much as 65.8% of the all-cause diarrhea disease burden measured in children < 5 during the study period. Cryptosporidium tended to account for a greater share of estimated waterborne protozoa infections causing diarrhea than did Giardia. Diarrhea prevalence estimates for waterborne Cryptosporidium infection appeared to be most sensitive to assumptions about the probability of infection from ingesting a single parasite (i.e. the rate parameter in dose-response model), while Giardia infection was most sensitive to assumptions about the viability of parasites detected in groundwater samples. Conclusions/Significance Protozoa in groundwater drinking sources in rural India, even at low concentrations, especially for Cryptosporidium, may account for a significant portion of child diarrhea morbidity in settings were tubewells are used for drinking water and should be more systematically monitored. Preventing diarrheal disease burdens in Puri District and similar settings will benefit from ensuring water is microbiologically safe for consumption and consistent and effective household water treatment is practiced. Water, sanitation, and hygiene (WASH) interventions aimed at reducing exposure to enteric pathogens have produced mixed health impacts, with some interventions finding no significant difference in health outcomes between intervention and control groups. While there are many explanations why individual WASH interventions may not achieve improved health outcomes, one reason is an incomplete understanding of the conditions that favor perpetuation and transmission of enteric pathogens in a given population and region. In this study, we developed a set of diarrhea-causing disease transmission models using measurements of drinking water contamination and child diarrhea over the same time period in the same study population. Using the disease transmission models, we examined how much of the observed diarrhea in children was due to waterborne transmission of enteric pathogens in a program in rural India that improved household sanitation but failed to produce improvements in child health. We focused on the role of two enteric protozoal pathogens, Cryptosporidium and Giardia, and diarrhea rates among children < 5 years of age in these communities. We found that Cryptosporidium and Giardia infections from drinking water contaminated with these enteric protozoa may have together caused as much as 65.8% (IQR 63.4–68.2%) or as little as 2.9% (IQR 2.3–3.4%) of the observed diarrhea in children depending on modeling assumptions about which protozoa species were present. These findings suggest implementing a single barrier, such as only sanitation, to disrupt the multiple pathways of fecal-oral transmission of enteric pathogens, rather than multiple barriers, such as sanitation and safe drinking water, may lead some interventions to fall short of achieving measurable health improvements. Finally, our research suggests that Cryptosporidium and Giardia may cause significant amounts of child diarrhea morbidity even at low levels of concentration when present in improved drinking water sources and their measurement should be including in community drinking water quality monitoring programs.
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Affiliation(s)
- Miles E. Daniels
- Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California at Davis, Davis, California United States of America
- Department of Institute of Marine Sciences, University of California at Santa Cruz, Santa Cruz, California, United States of America, Affiliated with: Fisheries Ecology Division, Southwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, Santa Cruz, California, United States of America
- * E-mail:
| | - Woutrina A. Smith
- Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California at Davis, Davis, California United States of America
| | - Marion W. Jenkins
- Department of Civil and Environmental Engineering, University of California at Davis, Davis, California, United States of America
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Kalantari N, Ghaffari S, Bayani M. Cryptosporidium spp. infection in Iranian children and immunosuppressive patients: A systematic review and meta-analysis. CASPIAN JOURNAL OF INTERNAL MEDICINE 2018; 9:106-115. [PMID: 29732026 PMCID: PMC5912216 DOI: 10.22088/cjim.9.2.106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 06/21/2017] [Accepted: 07/03/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cryptosporidiosis is an important cause of diarrhea in children and immunosuppressive patients. The current study was intended to evaluate the prevalence rate of Cryptosporidium infection and clarify the epidemiological characteristics of the infection in both children and immunosuppressive patients in Iran. METHODS Five English electronic databases including PubMed, Google Scholar, Science Direct, Scopus and Cochrane, and two Persian language databases Magiran and Scientific Information Database were searched. Additionally, reports from the Iranian congresses of parasitology and graduate student thesis dissertations were assessed manually. RESULTS Out of 1856 studies from the literature search, our search resulted in a total of 27 articles published from 1991 to 2016. These include 14 reports on cryptosporidiosis in children and 13 papers regarding immunosuppressive patients. 8520 children and 2015 immunosuppressed cases were evaluated. Oocysts of Cryptosporidium were found in 3.8% and 8% children cases and immunosuppressed patients, respectively. There was a relatively high variation in the prevalence estimates among different studies, and the Q statistics was high among articles regarding children (p<0.0001) and also between records regarding immunosuppressed patients (p<0.0001). Findings showed that the prevalence rates of Cryptosporidium infection are significantly higher in children under 5 years (P=0.00). CONCLUSIONS In summary, the present study provides a comprehensive view of the epidemiology of Cryptosporidium in children and immunosuppressive patients in Iran. Furthermore, a multidisciplinary and multicenter study to evaluate the real prevalence of Cryptosporidium infection and to determine its risk factors using an adequate sample size and standardized methods is highly recommended.
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Affiliation(s)
- Narges Kalantari
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Salman Ghaffari
- Department of Parasitology and Mycology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Masomeh Bayani
- Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran
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Garcia LS, Arrowood M, Kokoskin E, Paltridge GP, Pillai DR, Procop GW, Ryan N, Shimizu RY, Visvesvara G. Practical Guidance for Clinical Microbiology Laboratories: Laboratory Diagnosis of Parasites from the Gastrointestinal Tract. Clin Microbiol Rev 2018; 31:e00025-17. [PMID: 29142079 PMCID: PMC5740970 DOI: 10.1128/cmr.00025-17] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This Practical Guidance for Clinical Microbiology document on the laboratory diagnosis of parasites from the gastrointestinal tract provides practical information for the recovery and identification of relevant human parasites. The document is based on a comprehensive literature review and expert consensus on relevant diagnostic methods. However, it does not include didactic information on human parasite life cycles, organism morphology, clinical disease, pathogenesis, treatment, or epidemiology and prevention. As greater emphasis is placed on neglected tropical diseases, it becomes highly probable that patients with gastrointestinal parasitic infections will become more widely recognized in areas where parasites are endemic and not endemic. Generally, these methods are nonautomated and require extensive bench experience for accurate performance and interpretation.
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Affiliation(s)
| | - Michael Arrowood
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Foodborne, Waterborne, and Environmental Diseases, Waterborne Disease Prevention Branch, Atlanta, Georgia, USA
| | - Evelyne Kokoskin
- Public Health Ontario, Ottawa, Ontario, Canada
- Public Health Laboratories-Ottawa, Ottawa, Ontario, Canada
| | | | - Dylan R Pillai
- Calgary Laboratory Services, Diagnostic and Scientific Centre, Calgary, Alberta, Canada
| | - Gary W Procop
- Enterprise Test Utilization and Pathology Consultative Services, Cleveland, Ohio, USA
- Molecular Microbiology, Parasitology, and Mycology Laboratories, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
| | - Norbert Ryan
- Bacteriology and Parasitology, Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute, Melbourne, Victoria, Australia
| | | | - Govinda Visvesvara
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Foodborne, Waterborne, and Environmental Diseases, Waterborne Disease Prevention Branch, Atlanta, Georgia, USA
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Utaaker KS, Myhr N, Bajwa RS, Joshi H, Kumar A, Robertson LJ. Goats in the city: prevalence of Giardia duodenalis and Cryptosporidium spp. in extensively reared goats in northern India. Acta Vet Scand 2017; 59:86. [PMID: 29273058 PMCID: PMC5741913 DOI: 10.1186/s13028-017-0354-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 12/14/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Various characteristics of goats mean they are highly suitable livestock for backyard rearing by people with limited resources. They are a popular livestock choice in India, where they are often kept to supplement an already scarce income. In these settings, hygiene and sanitation standards tend to be low, and weakens the interface between humans and animals, thus reducing the barrier between them and thereby increasing the likelihood that zoonotic and anthroponotic infections will occur. RESULTS This study reports an investigation of the occurrence of Cryptosporidium spp. and Giardia duodenalis in goats being reared in different settings in urban and peri-urban areas in northern India, and addressed the zoonotic potential of these important protozoan parasites shed from goats living close to humans. The overall prevalence of G. duodenalis was 33.8 and 0.5% for Cryptosporidium spp.; the relatively low prevalence of cryptosporidiosis may reflect that most samples were derived from adult animals. The prevalence of G. duodenalis excretion was found to be similar to that reported in other studies. However, although other studies have reported a predominance of non-zoonotic Assemblage E in goats, in this study potentially zoonotic Assemblages predominated [Assemblage A (36%) and Assemblage B (32%)]. CONCLUSIONS The results of this study indicate that in this area where goats and humans are living in close proximity, there may be sharing of intestinal parasites, which can be detrimental for both host species.
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Praharaj I, Revathy R, Bandyopadhyay R, Benny B, Azharuddin Ko M, Liu J, Houpt ER, Kang G. Enteropathogens and Gut Inflammation in Asymptomatic Infants and Children in Different Environments in Southern India. Am J Trop Med Hyg 2017; 98:576-580. [PMID: 29231154 PMCID: PMC5929183 DOI: 10.4269/ajtmh.17-0324] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Children in poor environmental conditions are exposed early and often to enteric pathogens, but within developing countries, heterogeneity in enteropathogen exposure in different settings and communities is rarely addressed. We tested fecal samples from healthy infants and children from two different environments in the same Indian town for gut enteropathogens and biomarkers of gut inflammation. A significantly higher proportion of infants and children from a poor semi-urban neighborhood (93%) had one or more enteropathogens than those from a medical college campus (71.7%). Infants and children from the poor neighborhood had an average of 3.3 (95% confidence interval [CI]: 2.9-3.7) enteropathogens compared with an average of 1.4 (95% CI: 1.0-1.7) enteropathogens in campus infants/children. Viral and bacterial infections, including enteroviruses, adenoviruses, Campylobacter spp., and diarrhegenic Escherichia coli were more common and fecal biomarkers of inflammation were higher in the poor neighborhood. The findings demonstrate significant difference in the asymptomatic carriage of gut enteropathogens and gut inflammatory biomarkers in infants and children from two different environments within the same town in south India.
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Affiliation(s)
- Ira Praharaj
- Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - R Revathy
- Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rini Bandyopadhyay
- Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Blossom Benny
- Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mohammed Azharuddin Ko
- Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Jie Liu
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia
| | - Eric R Houpt
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia
| | - Gagandeep Kang
- Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
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Penakalapati G, Swarthout J, Delahoy MJ, McAliley L, Wodnik B, Levy K, Freeman MC. Exposure to Animal Feces and Human Health: A Systematic Review and Proposed Research Priorities. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2017; 51:11537-11552. [PMID: 28926696 PMCID: PMC5647569 DOI: 10.1021/acs.est.7b02811] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/07/2017] [Accepted: 09/19/2017] [Indexed: 05/19/2023]
Abstract
Humans can be exposed to pathogens from poorly managed animal feces, particularly in communities where animals live in close proximity to humans. This systematic review of peer-reviewed and gray literature examines the human health impacts of exposure to poorly managed animal feces transmitted via water, sanitation, and hygiene (WASH)-related pathways in low- and middle-income countries, where household livestock, small-scale animal operations, and free-roaming animals are common. We identify routes of contamination by animal feces, control measures to reduce human exposure, and propose research priorities for further inquiry. Exposure to animal feces has been associated with diarrhea, soil-transmitted helminth infection, trachoma, environmental enteric dysfunction, and growth faltering. Few studies have evaluated control measures, but interventions include reducing cohabitation with animals, provision of animal feces scoops, controlling animal movement, creating safe child spaces, improving veterinary care, and hygiene promotion. Future research should evaluate: behaviors related to points of contact with animal feces; animal fecal contamination of food; cultural behaviors of animal fecal management; acute and chronic health risks associated with exposure to animal feces; and factors influencing concentrations and shedding rates of pathogens originating from animal feces.
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Affiliation(s)
- Gauthami Penakalapati
- Department of Environmental
Health, Emory University, Atlanta, Georgia 30322 United States
| | - Jenna Swarthout
- Department of Environmental
Health, Emory University, Atlanta, Georgia 30322 United States
| | - Miranda J. Delahoy
- Department of Environmental
Health, Emory University, Atlanta, Georgia 30322 United States
| | - Lydia McAliley
- Department of Environmental
Health, Emory University, Atlanta, Georgia 30322 United States
| | - Breanna Wodnik
- Department of Environmental
Health, Emory University, Atlanta, Georgia 30322 United States
| | - Karen Levy
- Department of Environmental
Health, Emory University, Atlanta, Georgia 30322 United States
| | - Matthew C. Freeman
- Department of Environmental
Health, Emory University, Atlanta, Georgia 30322 United States
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Wardrop NA, Hill AG, Dzodzomenyo M, Aryeetey G, Wright JA. Livestock ownership and microbial contamination of drinking-water: Evidence from nationally representative household surveys in Ghana, Nepal and Bangladesh. Int J Hyg Environ Health 2017; 221:33-40. [PMID: 29031736 PMCID: PMC5739303 DOI: 10.1016/j.ijheh.2017.09.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 09/20/2017] [Accepted: 09/30/2017] [Indexed: 02/03/2023]
Abstract
Owning livestock can increase the risk of drinking-water contamination. Large livestock were associated with water contamination in Ghana and Bangladesh. Poultry were associated with drinking-water contamination in Bangladesh. Livestock were not significantly correlated with water contamination in Nepal. Livestock excreta should be considered for the prevention of water contamination.
Background Current priorities for diarrhoeal disease prevention include use of sanitation and safe water. There have been few attempts to quantify the importance of animal faeces in drinking-water contamination, despite the presence of potentially water-borne zoonotic pathogens in animal faeces. Objectives This study aimed to quantify the relationship between livestock ownership and point-of-consumption drinking-water contamination. Methods Data from nationally representative household surveys in Nepal, Bangladesh, and Ghana, each with associated water quality assessments, were used. Multinomial regression adjusting for confounders was applied to assess the relationship between livestock ownership and the level of drinking-water contamination with E. coli. Results Ownership of five or more large livestock (e.g. cattle) was significantly associated with drinking-water contamination in Ghana (RRR = 7.9, 95% CI = 1.6 to 38.9 for medium levels of contamination with 1–31cfu/100 ml; RRR = 5.2, 95% CI = 1.1–24.5 for high levels of contamination with >31cfu/100 ml) and Bangladesh (RRR = 2.4, 95% CI = 1.3–4.5 for medium levels of contamination; non-significant for high levels of contamination). Ownership of eight or more poultry (chickens, guinea fowl, ducks or turkeys) was associated with drinking-water contamination in Bangladesh (RRR = 1.5, 95% CI = 1.1–2.0 for medium levels of contamination, non-significant for high levels of contamination). Conclusions These results suggest that livestock ownership is a significant risk factor for the contamination of drinking-water at the point of consumption. This indicates that addressing human sanitation without consideration of faecal contamination from livestock sources will not be sufficient to prevent drinking-water contamination.
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Affiliation(s)
- Nicola A Wardrop
- Geography and Environment, University of Southampton, Southampton, Hampshire, UK.
| | - Allan G Hill
- Social Sciences, University of Southampton, Southampton, Hampshire, UK.
| | - Mawuli Dzodzomenyo
- Ghana School of Public Health, University of Ghana, Legon, Accra, Ghana.
| | - Genevieve Aryeetey
- Ghana School of Public Health, University of Ghana, Legon, Accra, Ghana.
| | - Jim A Wright
- Geography and Environment, University of Southampton, Southampton, Hampshire, UK.
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Majorin F, Torondel B, Routray P, Rout M, Clasen T. Identifying Potential Sources of Exposure Along the Child Feces Management Pathway: A Cross-Sectional Study Among Urban Slums in Odisha, India. Am J Trop Med Hyg 2017; 97:861-869. [PMID: 28749766 PMCID: PMC5590566 DOI: 10.4269/ajtmh.16-0688] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Child feces represent a particular health risk to children due to increased prevalence of enteric agents and a higher risk of exposure owing to exploratory behaviors of young children. The safe management of such feces presents a significant challenge, not only for the 2.4 billion who lack access to improved sanitation, but also due to unhygienic feces collection and disposal and poor subsequent handwashing practices. We assessed potential sources of fecal exposure by documenting child feces management practices in a cross-sectional study of 851 children < 5 years of age from 694 households in 42 slums in two cities in Odisha, India. No preambulatory children and only 27.4% of ambulatory children defecated directly in the latrine. Children that did not defecate in a latrine mainly defecated on the ground, whether they were preambulatory or ambulatory. Use of diapers (1.2%) or potties (2.8%) was low. If the feces were removed from the ground, the defecation area was usually cleaned, if at all, only with water. Most children’s feces were disposed of in surrounding environment, with only 6.5% deposited into any kind of latrine, including unimproved. Handwashing with soap of the caregiver after child feces disposal and child anal cleaning with soap after defecation was also uncommon. While proper disposal of child feces in an improved latrine still represents a major challenge, control of the risks presented requires attention to the full range of exposures associated to the management of child feces, and not simply the place of disposal.
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Affiliation(s)
- Fiona Majorin
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Belen Torondel
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Parimita Routray
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Manaswini Rout
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas Clasen
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.,Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Abstract
CONTEXT Cryptosporidium spp. is a zoonotic infection, now being recognized as a significant cause of diarrhea in both immunocompetent and immunocompromised hosts. However, there still exist significant knowledge gaps in its estimated global burden, epidemiology, diagnosis and management. EVIDENCE ACQUISITION A semi-systematic search was performed across PubMed to select studies on epidemiological burden of cryptosporidium diarrhea using the following keywords- ['crytosporidiosis' OR 'cryptosporidium'] AND ['diarrhea' OR 'diarrhoea']. Articles were included if participants were 'Humans', belonged to pediatric (0-18 y) age group, and were published after 1990. The results were compiled separately for acute and persistent diarrhea. RESULTS Cryptosporidium spp is commonly detected in stools of both cases (acute/ persistent diarrhea) and asymptomatic controls. The prevalence is higher in children with diarrhea than non-diarrheal controls (1.7-35% vs 0.3-15%); varying widely across different studies. The positivity rate is higher in younger children (<2 years) suffering from diarrhea. The main symptoms associated with cryptosporidiosis include fever, vomiting and abdominal pain with propensity for prolonged duration of diarrhea. It predisposes to malnutrition, which is also a risk factor for cryptosporidiosis. The prevalence is higher in HIV positive patients; certain socio-demographic factors play a more important role than mere geographical distribution for infection. CONCLUSION The high positivity rates during both acute and persistent diarrhea highlights the need to suspect this infection even in immunocompetent children.
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Murugesan M, Ganesan SK, Ajjampur SS. Cryptosporidiosis in children in the Indian subcontinent. Trop Parasitol 2017; 7:18-28. [PMID: 28459011 PMCID: PMC5369269 DOI: 10.4103/tp.tp_2_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cryptosporidiosis is a leading cause of diarrheal disease among children under two in developing countries. Previous estimates have shown a high burden of cryptosporidial diarrhea in children from Sub-Saharan Africa and South Asia. Asymptomatic cryptosporidial infections which go undetected and untreated have been shown to result in significant malnutrition. In this review, we carried out a literature search of studies published on cryptosporidiosis in children in the Indian subcontinent from 1983 to 2016. Of the 154 publications identified, 54 were included for final analysis with both hospital-based and community-based studies. There were wide variations in reported prevalence rates from hospital studies and highlight the need to be carry out these studies with uniform sampling and molecular tools for detection, especially in countries with a dearth of information. Community-based studies, however, showed similarities in spite of differences in when (the late 1990s up until recently) and where (South India or Bangladesh) they were conducted. When more sensitive detection methods were used, cryptosporidial diarrhea accounted for 7%–9% of all diarrhea episodes and 20%–30% of children in these cohorts experienced at least one cryptosporidial diarrheal episode. High rates of asymptomatic infections with increased detection by serology and multiple infections (symptomatic and asymptomatic) were also documented in all cohorts. This overview brings to light the high burden of disease associated with cryptosporidiosis in children in the subcontinent and the gaps in knowledge to be addressed.
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Affiliation(s)
- Malathi Murugesan
- Division of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - Santhosh Kumar Ganesan
- Division of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sitara Sr Ajjampur
- Division of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
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Shrivastava AK, Kumar S, Mohakud NK, Suar M, Sahu PS. Multiple etiologies of infectious diarrhea and concurrent infections in a pediatric outpatient-based screening study in Odisha, India. Gut Pathog 2017; 9:16. [PMID: 28400860 PMCID: PMC5387278 DOI: 10.1186/s13099-017-0166-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 03/27/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND There are multiple etiologies responsible for infectious gastroenteritis causing acute diarrhea which are often under diagnosed. Also acute diarrhea is one of the major causes of morbidity and mortality among children less than 5 years of age. METHODS In our study, fecal samples (n = 130) were collected from children (<5 years) presenting with symptoms of acute diarrhea. Samples were screened for viral, bacterial, and parasitic etiologies. Rotavirus and Adenovirus were screened by immunochromatographic tests. Diarrheagenic Escherichia coli (EPEC, EHEC, STEC, EAEC, O157, O111), Shigella spp., Salmonella spp., Vibrio cholera, Cryptosporidium spp., and Giardia spp. were detected by gene-specific polymerase chain reaction. RESULTS Escherichia coli was detected to be the major etiological agent (30.07%) followed by Rotavirus (26.15%), Shigella (23.84%), Adenovirus (4.61%), Cryptosporidium (3.07%), and Giardia (0.77%). Concurrent infections with two or more pathogens were observed in 44 of 130 (33.84%) cases with a predominant incidence particularly in <2-year-old children (65.90%) compared to children of 2-5 years age group (34.09%). An overall result showed significantly higher detection rates among children with diarrhea in both combinations of two as well as three infections concurrently (p = 0.004915 and 0.03917, respectively). CONCLUSION Suspecting possible multiple infectious etiologies and diagnosis of the right causative agent(s) can aid in a better pharmacological management of acute childhood diarrhea. It is hypothesized that in cases with concurrent infections the etiological agents might be complementing each other's strategies of pathogenesis resulting in severe diarrhea that could be studied better in experimental infections.
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Affiliation(s)
- Arpit Kumar Shrivastava
- Infection Biology Laboratory, School of Biotechnology, KIIT University, Bhubaneswar, Odisha 751024 India
| | - Subrat Kumar
- Infection Biology Laboratory, School of Biotechnology, KIIT University, Bhubaneswar, Odisha 751024 India
| | - Nirmal Kumar Mohakud
- Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha 751024 India
| | - Mrutyunjay Suar
- Infection Biology Laboratory, School of Biotechnology, KIIT University, Bhubaneswar, Odisha 751024 India
| | - Priyadarshi Soumyaranjan Sahu
- Infection Biology Laboratory, School of Biotechnology, KIIT University, Bhubaneswar, Odisha 751024 India.,Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha 751024 India.,Divisions of Pathology, School of Medicine, International Medical University, 57000 Kuala Lumpur, Malaysia
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41
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Debenham JJ, Tysnes K, Khunger S, Robertson LJ. Occurrence of Giardia, Cryptosporidium, and Entamoeba in wild rhesus macaques ( Macaca mulatta) living in urban and semi-rural North-West India. INTERNATIONAL JOURNAL FOR PARASITOLOGY-PARASITES AND WILDLIFE 2017; 6:29-34. [PMID: 28229045 PMCID: PMC5312650 DOI: 10.1016/j.ijppaw.2016.12.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 12/03/2016] [Accepted: 12/12/2016] [Indexed: 11/19/2022]
Abstract
Giardia duodenalis, Cryptosporidium spp., and Entamoeba spp. are intestinal protozoa capable of infecting a range of host species, and are important causes of human morbidity and mortality. Understanding their epidemiology is important, both for public health and for the health of the animals they infect. This study investigated the occurrence of these protozoans in rhesus macaques (Macaca mulatta) in India, with the aim of providing preliminary information on the potential for transmission of these pathogens between macaques and humans. Faecal samples (n = 170) were collected from rhesus macaques from four districts of North-West India. Samples were analysed for Giardia/Cryptosporidium using a commercially available direct immunofluorescent antibody test after purification via immunomagnetic separation. Positive samples were characterised by sequencing of PCR products. Occurrence of Entamoeba was investigated first by using a genus-specific PCR, and positive samples further investigated via species-specific PCRs for Entamoeba coli, Entamoeba histolytica, Entamoeba dispar and Entamoeba moshkovskii. Giardia cysts were found in 31% of macaque samples, with all isolates belonging to Assemblage B. Cryptosporidium oocysts were found in 1 sample, however this sample did not result in amplification by PCR. Entamoeba spp. were found in 79% of samples, 49% of which were positive for E. coli. Multiplex PCR for E. histolytica, E. dispar and E. moshkovskii, did not result in amplification in any of the samples. Thus in 51% of the samples positive at the genus specific PCR, the Entamoeba species was not identified. This study provides baseline information on the potential for transmission of these zoonotic parasites at the wildlife-human interface. Intestinal protozoa in wild rhesus macaques (n = 170) in India investigated. Cryptosporidium oocysts identified in only one sample. No zoonotic Entamoeba detected, but Entamoeba coli and unknown Entamoeba spp. Giardia duodenalis cysts detected in approximately 30% samples. Only Assemblage B Giardia, even when exposure to Assemblages A and E in calves.
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Affiliation(s)
- John J Debenham
- The Norwegian University of Life Sciences (NMBU), Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Ullevålsveien 72, 0033 Oslo, Norway
| | - Kristoffer Tysnes
- The Norwegian University of Life Sciences (NMBU), Faculty of Veterinary Medicine, Department Food Safety and Infection Biology, Ullevålsveien 72, 0033 Oslo, Norway
| | - Sandhya Khunger
- Postgraduate Institute of Medical Education & Research, Chandigarh, Department of Medical Parasitology, 160012 Chandigarh, India
| | - Lucy J Robertson
- The Norwegian University of Life Sciences (NMBU), Faculty of Veterinary Medicine, Department Food Safety and Infection Biology, Ullevålsveien 72, 0033 Oslo, Norway
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Schurer JM, Mosites E, Li C, Meschke S, Rabinowitz P. Community-based surveillance of zoonotic parasites in a 'One Health' world: A systematic review. One Health 2016; 2:166-174. [PMID: 28616494 PMCID: PMC5462647 DOI: 10.1016/j.onehlt.2016.11.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 11/01/2016] [Indexed: 11/17/2022] Open
Abstract
The One Health (OH) concept provides an integrated framework for observing and improving health issues involving human, animal, and environmental factors, and has been applied in particular to zoonotic disease problems. We conducted a systematic review of English and Chinese language peer-reviewed and grey literature databases to identify zoonotic endoparasite research utilizing an OH approach in community-based settings. Our review identified 32 articles where specimens collected simultaneously from all three OH domains (people, animals, and the environment) were assessed for endoparasite infection or exposure. Study sites spanned 23 countries, and research teams brought together an average of seven authors from two countries. Surveillance of blood-borne and gastrointestinal protozoa were most frequently reported (19 of 32; 59%), followed by trematodes, nematodes, and cestodes. Laboratory techniques varied greatly between studies, and only 16 identified parasites using Polymerase Chain Reaction (PCR) in all three OH domains. Our review identified important gaps in parasitology research operating under an OH framework. We recommend that investigators working in the realm of zoonotic disease strive to evaluate all three OH domains by integrating modern molecular tools as well as techniques provided by economists and social scientists.
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Affiliation(s)
- JM Schurer
- Department of Veterinary Microbiology, University of Saskatchewan, 52 Campus Drive, Saskatoon S7N 5B4, Canada
- Department of Environmental and Occupational Health Sciences, University of Washington, 1959 Pacific Street, Seattle 98195, United States
- Corresponding author at: 52 Campus Drive, Saskatoon S7N 5B4, Canada.52 Campus DriveSaskatoonS7N 5B4Canada
| | - E Mosites
- Paul G. Allen School for Global Animal Health, Washington State University, P.O. Box 647090, Pullman 99164-7090, United States
| | - C Li
- Irma Lerma Rangel College of Pharmacy, Texas A & M University, 1010 West Ave B, Kingsville 78363, United States
| | - S Meschke
- Department of Environmental and Occupational Health Sciences, University of Washington, 1959 Pacific Street, Seattle 98195, United States
| | - P Rabinowitz
- Department of Environmental and Occupational Health Sciences, University of Washington, 1959 Pacific Street, Seattle 98195, United States
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Odagiri M, Schriewer A, Daniels ME, Wuertz S, Smith WA, Clasen T, Schmidt WP, Jin Y, Torondel B, Misra PR, Panigrahi P, Jenkins MW. Human fecal and pathogen exposure pathways in rural Indian villages and the effect of increased latrine coverage. WATER RESEARCH 2016; 100:232-244. [PMID: 27192358 PMCID: PMC4907306 DOI: 10.1016/j.watres.2016.05.015] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 05/02/2016] [Accepted: 05/03/2016] [Indexed: 05/14/2023]
Abstract
Efforts to eradicate open defecation and improve sanitation access are unlikely to achieve health benefits unless interventions reduce microbial exposures. This study assessed human fecal contamination and pathogen exposures in rural India, and the effect of increased sanitation coverage on contamination and exposure rates. In a cross-sectional study of 60 villages of a cluster-randomized controlled sanitation trial in Odisha, India, human and domestic animal fecal contamination was measured in community tubewells and ponds (n = 301) and via exposure pathways in homes (n = 354), using Bacteroidales microbial source tracking fecal markers validated in India. Community water sources were further tested for diarrheal pathogens (rotavirus, adenovirus and Vibrio cholerae by quantitative PCR; pathogenic Escherichia coli by multiplex PCR; Cryptosporidium and Giardia by immunomagnetic separation and direct fluorescent antibody microscopy). Exposure pathways in intervention and control villages were compared and relationships with child diarrhea examined. Human fecal markers were rarely detected in tubewells (2.4%, 95%CI: 0.3-4.5%) and ponds (5.6%, 95%CI: 0.8-10.3%), compared to homes (35.4%, 95%CI: 30.4-40.4%). In tubewells, V. cholerae was the most frequently detected pathogen (19.8%, 95%CI: 14.4-25.2%), followed by Giardia (14.8%, 95%CI: 10.0-19.7%). In ponds, Giardia was most often detected (74.5%, 95%CI: 65.7-83.3%), followed by pathogenic E. coli (48.1%, 95%CI: 34.8-61.5%) and rotavirus (44.4%, 95%CI: 34.2-54.7%). At village-level, prevalence of fecal pathogen detection in community drinking water sources was associated with elevated prevalence of child diarrhea within 6 weeks of testing (RR 2.13, 95%CI: 1.25-3.63) while within homes, higher levels of human and animal fecal marker detection were associated with increased risks of subsequent child diarrhea (P = 0.044 and 0.013, respectively). There was no evidence that the intervention, which increased functional latrine coverage and use by 27 percentage points, reduced human fecal contamination in any tested pathway, nor the prevalence of pathogens in water sources. In conclusion, the study demonstrates that (1) improved sanitation alone may be insufficient and further interventions needed in the domestic domain to reduce widespread human and animal fecal contamination observed in homes, (2) pathogens detected in tubewells indicate these sources are microbiologically unsafe for drinking and were associated with child diarrhea, (3) domestic use of ponds heavily contaminated with multiple pathogens presents an under-recognized health risk, and (4) a 27 percentage point increase in improved sanitation access at village-level did not reduce detectable human fecal and pathogen contamination in this setting.
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Affiliation(s)
- Mitsunori Odagiri
- Dept. of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA, USA
| | - Alexander Schriewer
- Dept. of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA, USA
| | - Miles E Daniels
- Dept. of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Stefan Wuertz
- Dept. of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA, USA; Singapore Centre for Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, 60 Nanyang Drive, Singapore; School of Civil and Environmental Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore
| | - Woutrina A Smith
- Dept. of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Thomas Clasen
- Dept. of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Wolf-Peter Schmidt
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Yujie Jin
- Dept. of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA, USA
| | - Belen Torondel
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Pravas R Misra
- Asian Institute of Public Health, Bhubaneswar, Odisha, India
| | - Pinaki Panigrahi
- Dept. of Epidemiology, Center for Global Health and Development, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA; Dept. of Pediatrics, Center for Global Health and Development, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Marion W Jenkins
- Dept. of Civil and Environmental Engineering, University of California, Davis, One Shields Avenue, Davis, CA, USA; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
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44
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Daniels M, Smith WA, Schmidt WP, Clasen T, Jenkins MW. Modeling Cryptosporidium and Giardia in Ground and Surface Water Sources in Rural India: Associations with Latrines, Livestock, Damaged Wells, and Rainfall Patterns. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2016; 50:7498-507. [PMID: 27310009 PMCID: PMC5058636 DOI: 10.1021/acs.est.5b05797] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 04/12/2016] [Accepted: 06/16/2016] [Indexed: 05/25/2023]
Abstract
Surface and groundwater contamination with fecal pathogens is a public health concern especially in low-income settings where these sources are used untreated. We modeled observed Cryptosporidium and Giardia contamination in community ponds (n = 94; 79% contaminated), deep tubewells (DTWs) (n = 107; 17%), and shallow tubewells (STWs) (n = 96; 19%) during the 2012 and 2013 monsoon seasons (June-August) in 60 villages in Puri District, India to understand sources and processes of contamination. Detection of Cryptosporidium and/or Giardia in a tubewell was positively associated with damage to the well pad for DTWs, the amount of human loading into pour-flush latrine pits nearby (≤15 m) for STWs, and the village literacy rate (for Giardia in STWs). Pond concentration levels were positively associated with the number of people practicing open defecation within 50 m and the sheep population for Cryptosporidium, and with the village illiteracy rate for Giardia. Recent rainfall increased the risk of Cryptosporidium in STWs (an extreme event) and ponds (any), while increasing seasonal rainfall decreased the risk of Giardia in STWs and ponds. Full latrine coverage in this setting is expected to marginally reduce pond Cryptosporidium contamination (16%) while increasing local groundwater protozoal contamination (87-306%), with the largest increases predicted for Cryptosporidium in STWs.
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Affiliation(s)
- Miles
E. Daniels
- Department
of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, One Shields Avenue, Davis, California 95616, United States
| | - Woutrina A. Smith
- Department
of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, One Shields Avenue, Davis, California 95616, United States
| | - Wolf-Peter Schmidt
- Faculty
of Infectious and Tropical Diseases, London
School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, U.K.
| | - Thomas Clasen
- Faculty
of Infectious and Tropical Diseases, London
School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, U.K.
- Rollins
School of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - Marion W. Jenkins
- Faculty
of Infectious and Tropical Diseases, London
School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, U.K.
- Department
of Civil and Environmental Engineering, University of California, Davis, One Shield Avenue, Davis, California 95616, United States
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