Exploring Blastocystis genetic diversity in rural schoolchildren from Colombia using next-generation amplicon sequencing reveals significant associations between contact with animals and infection risk

Blastocystis colonization among inland and forest periphery Negritos in Malaysia: The crucial role of sanitation and hygiene practices

There has been an increasing trend in the study of Blastocystis due to its ubiquitous nature, and potential impact on human health. In Malaysia, its prevalence among the undeserved indigenous Orang Asli (OA) population varies widely from 1.7 %- 80.0 %. These huge differences were suggested to be attributed to disparities in living standards, including sanitation and access to treated water status. We investigated the prevalence, risk factors, and subtypes of Blastocystis among the OA Negritos residing in forest periphery villages and the inland jungle settings. A cross-sectional study was conducted involving 259 participants and their stool samples were screened microscopically for intestinal parasites and molecular techniques for Blastocystis. Risk factors including the type of village category and Blastocystis subtypes were identified. Of the 259 participants, 40 (15.4 %) were found to be colonized with Blastocystis. Prevalence was higher in the inland (17/81; 21.0 %) than in forest periphery villages (23/178; 12.9 %), but the difference was not statistically significant (P = 0.096). Among the 40 positive individuals, 31 (77.5 %) were co-infected with soil-transmitted helminths (STH). Multivariate analysis identified the unavailability of a household latrine (P < 0.001), infrequent washing hands after defecation (P = 0.005), having other household members positive with Blastocystis (P = 0.003), individuals from the Bateq subtribe (P = 0.011), and living in inland villages (P = 0.033) as significant predictors of Blastocystis colonization. Three subtypes were identified: ST1, ST2 and ST3 (the most predominant). We highlighted the critical role of hygiene and sanitation practices in the transmission dynamics of Blastocystis rather than type of village category or development status among OA. Continuous health practices, particularly on proper hygienic practices, should be emphasized especially concerning parasites transmitted via the fecal-oral route.

Free-Ranging Wolves (Canis lupus) are Natural Reservoirs of Intestinal Microeukaryotes of Public Health Significance in Southwestern Europe

INTRODUCTION

Intestinal microeukaryote parasites are major contributors to the burden of diarrhoea in humans and domestic animals, but their epidemiology in wildlife is not fully understood. We investigated the frequency, genetic diversity and zoonotic potential of protists of animal and public health significance in free-ranging grey wolf (Canis lupus) populations in south-western Europe.

METHODS

Individually formed faecal samples collected from necropsied wolves or scat trails in Italy (n = 47), Portugal (n = 43) and Spain (n = 225) during the period 2011-2023 were retrospectively analysed using molecular (PCR and Sanger sequencing) methods. Complementary epidemiological data were gathered when available.

RESULTS

Giardia duodenalis was the most frequent microeukaryote found (40.3%, 127/315; 95% CI: 34.9-46.0), followed by Cryptosporidium spp. (3.5%, 11/315; 95% CI: 1.8-6.2), Enterocytozoon bieneusi and Encephalitozoon spp. (1.6%, 5/315; 95% CI: 0.5-3.7 each). Blastocystis was not identified in any of the faecal samples analysed. Sequence analyses confirmed the presence of canine-adapted assemblage D within G. duodenalis (n = 7). Three Cryptosporidium species were identified, namely canine-adapted C. canis (n = 9), zoonotic C. parvum (n = 1) and primarily anthroponotic C.hominis (n = 1). Genotyping tools enabled the identification of subtype family XXe2 within C. canis. Among microsporidia, the canine-adapted genotype PtEb IX was identified within E. bieneusi. Two samples were confirmed as Enc. intestinalis and three more as Enc. cuniculi genotype IV. This is the first record of Enc. intestinalis and Enc. cuniculi in the grey wolf globally.

CONCLUSIONS

Silent carriage of intestinal microeukaryotes seems common in free-ranging grey wolves in southwestern Europe. Wolves can contribute to environmental contamination through the transmission stages (cysts, oocysts, spores) of species/genotypes potentially infective to humans. Individuals in close contact with wolf carcasses or their faecal material may be at potential risk of infection by microeukaryotic pathogens.

Global Prevalence and Subtype Distribution of Blastocystis sp. in Rodent Populations: A Systematic Review and Meta-Analysis

BACKGROUND

The present systematic review and meta-analysis aimed to gather and analyse global data on the prevalence, subtypes (STs) distribution and zoonotic potential of Blastocystis sp. in rodents.

METHODS

A systematic literature search was performed across multiple databases (PubMed, Scopus, Web of Science and ProQuest) for studies published by 23 July 2024. The analysis included 34 studies/78 datasets, comprising 5661 samples from various rodent species across 15 countries. Statistical analyses were performed using comprehensive meta-analysis (CMA) software, employing a random-effects model to estimate pooled prevalence and 95% confidence intervals (CIs) and the I2 index for assessing heterogeneity.

RESULTS

This review found that 16% (95% CI: 12.6%-20.2%) of rodents worldwide were infected with Blastocystis sp. Voles and squirrels exhibited the highest infection rates at 29.8% (95% CI: 14.7%-51%) and 28.8% (95% CI: 14.4%-49.2%), whereas civets and porcupines had the lowest rates at 9.5% (95% CI: 6.6%-13.6%) and 7.1% (95% CI: 3.3%-14.7%), respectively. The findings indicated that rodents can host various Blastocystis sp. STs (ST1-ST8, ST10, ST13, ST15, ST17), with several (ST1-ST8 and ST10) having zoonotic potential. Globally, ST4, ST5, ST1 and ST3 were the most commonly reported STs in rodents. China and the UK showed the highest ST diversity in rodents, with 10 (ST1-ST7, ST10, ST13, ST17) and 7 (ST1-ST5, ST10, ST15) distinct STs, respectively. ST6, ST7 and ST13 were unique to China, whereas ST15 was found only in the United Kingdom. Squirrels, rats, mice and voles had the highest ST diversity of Blastocystis sp., with 8, 7, 5 and 5 distinct STs, respectively. Notably, ST6 and ST13 were unique to squirrels, ST7 only appeared in rats, and ST15 was found only in voles. Most ST1, ST3-ST5 and ST17 came from Asia. ST6, ST7 and ST13 were also isolated there, whereas ST15 was only found in Europe. ST17 was reported in Africa, ST4 and ST17 in North America, and ST1-ST3 and ST8 in South America.

CONCLUSIONS

This review emphasizes the widespread presence of Blastocystis sp. in rodent populations globally, underscoring the need for continued surveillance and research into its zoonotic potential.

A cross-sectional survey of Blastocystis sp. and Dientamoeba fragilis in non-human primates and their caregivers in Czech zoos

Intestinal protists in the gut microbiome are increasingly studied, but their basic epidemiology is not well understood. We explored the prevalence, genetic diversity, and potential zoonotic transmission of two protists colonizing the large intestine - Blastocystis sp. and Dientamoeba fragilis - in 37 species of non-human primates (NHPs) and their caregivers in six zoos in the Czech Republic. We analyzed 179 fecal samples (159 from NHPs, 20 from humans) by qPCR. Blastocystis sp. was detected in 54.7% (98/179) of samples, in 24 NHP species and in 57.2% of NHP samples (prevalence ranged between 36 and 80%), and in 35% of human samples (prevalence ranged between 0 and 67%). Using next generation amplicon sequencing, nine Blastocystis subtypes (ST1-ST5, ST7, ST8, and two novel subtypes) were identified. The two new Blastocystis subtypes (named ST47 and ST48) were described using Nanopore sequencing to produce full-length reference sequences of the small subunit ribosomal RNA gene. Some subtypes were shared between NHPs and their caregivers, suggesting potential zoonotic transmission. Mixed subtype colonization was frequently observed, with 52% of sequenced samples containing two or more subtypes. Dientamoeba was found only in NHPs with a prevalence of 6%. This study emphasizes the critical role of molecular diagnostics in epidemiological and transmission studies of these protists and calls for further research to better understand their impact on public health.

Asymptomatic carriage of intestinal protists is common in children in Lusaka Province, Zambia

BACKGROUND

PCR-based screenings on the presence of diarrhoea-causing intestinal protist species are limited in Zambia, resulting in inaccurate current prevalence and epidemiological data. Sensitive PCR-based methods are particularly well suited for detecting subclinical infections in apparently healthy carriers.

METHODOLOGY

In this prospective cross-sectional study, we investigated the occurrence of the most common intestinal protists in an apparently healthy paediatric population (5-18 years) in Lusaka Province, Zambia. We collected single stool samples (n = 256) and epidemiological questionnaires on demographics, behavioural habits, drinking water and toilet access from participating children. We used PCR for the initial screening of samples for the presence of intestinal protist species and Sanger and next-generation sequencing for genotyping. We conducted statistical analyses to assess the association of the gathered variables with an increased likelihood of the investigated pathogens.

PRINCIPAL FINDINGS

Blastocystis sp. was the most prevalent intestinal protist found (37.9%, 97/256; 95% CI: 31.9-44.1), followed by Giardia duodenalis (30.9%, 79/256; 95% CI: 25.3-36.90), Entamoeba dispar (13.3%, 34/256; 95% CI: 9.4-18.1), and Cryptosporidium spp. (4.3%, 11/256, 95% CI: 2.2-7.6). Entamoeba histolytica was not detected. Based on Sanger sequencing results, subtypes ST2 (44.3%, 43/97), ST1 (35.1%, 34/97), and ST3 (20.6%, 20/97) were identified within Blastocystis sp. and assemblages B (71.0%), A+B (16.1%), and A (12.9%) within G. duodenalis. Cryptosporidium parvum (81.8%) and C. hominis (18.2%) were the only two Cryptosporidium species found. Living in the Kafue District was positively associated with higher infection rates by G. duodenalis and Blastocystis sp. Schoolchildren living in Chongwe District were more likely to be infected by Cryptosporidium spp.

CONCLUSIONS/SIGNIFICANCE

Intestinal protist infection/colonization is a common finding in apparently healthy children in Lusaka Province, Zambia. Asymptomatic carriers may play an underestimated role as spreaders of gastrointestinal parasitic infections. This study improves our current understanding of the epidemiology of diarrhoea-causing protists in Zambia and sub-Saharan Africa and indicates that the role of asymptomatic carriers of gastrointestinal parasites in transmission should be further explored.

Molecular detection and characterization of Blastocystis in herbivore livestock species in Portugal

Blastocystis is a ubiquitous intestinal protist in humans and animals worldwide. The traditional livestock free-roaming raising system in rural communities increases the risk of infection with contact with a wider range of pathogens transmitted via the faecal-oral route associated with that wildlife-livestock-human interface. However, no studies have been conducted to determine the occurrence and subtype distribution of Blastocystis in livestock in Portugal. Here, we collected 180 faecal samples from herbivore livestock (cattle, goats, horses, and sheep) in different regions of the country to investigate Blastocystis prevalence and subtype diversity using PCR and next-generation amplicon sequencing. Blastocystis was present in 40.6% (73/180; 95% CI: 33.31-48.11) of the samples (goats, 81.0%; sheep, 60.9%; cattle, 32.2%). None of the horse samples were Blastocystis-positive. Eighteen subtypes were detected (ST1-ST3, ST5-ST7, ST10, ST13, ST14, ST21, ST23-ST26, ST30, ST42-ST44). Mixed infections were detected in 97.3% of the Blastocystis-positive samples. Potentially zoonotic subtypes were identified in 75.0%, 96.4%, and 100% of the Blastocystis-positive specimens collected from cattle, sheep, and goats, respectively. These results demonstrate that cattle, sheep, and goats harbour a high diversity of Blastocystis subtypes in the study regions. Importantly, our data provide novel molecular evidence strongly suggesting that some Blastocystis STs/ST subgroups may have differential host specificity.

Molecular Prevalence and Subtypes Distribution of Blastocystis spp. in Humans of Latin America: A Systematic Review

Blastocystis spp. are among the few enteric parasites with a prevalence that can reach up to approximately 80% in communities of developing countries. This systematic review updates and summarizes available literature on the molecular prevalence and subtype distribution of Blastocystis spp. in Latin American people. This work follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The literature revised covers from 1 January 2015 to 6 October 2023 in seven different scientific databases, and the material was selected through inclusion and exclusion criteria. According to data found in the 36 selected articles, the prevalence of Blastocystis spp. in Latin America ranged between 5.8% (Bolivian rural communities) and 94.0% (Colombian general public). Generally, genomic DNA was extracted from approximately 200 mg fecal sediments using commercial kits, such as the QIAamp Stool Mini Kit (QIAGEN, Hilden, Germany) or the Norgen Stool DNA Isolation Kit (Norgen Biotek Corporation, Thorold, ON, Canada). Subtype-specific primers (such as the couple of primers BhRDr-RD5) developed from unique sequences of the SSU rRNA gene were applied to Blastocystis subtyping. Ten specific subtypes (STs) were found as well as various mixed infections, and the most circulating Blastocystis STs were in the order ST3, ST1, ST2, and ST4. The most recent data about Blastocystis spp. molecular epidemiology and the STs in communities of Latin America are limited to studies from specific countries. Novel scientific data from the other countries are required to obtain a complete picture and truly understand the distribution and prevalence of Blastocystis spp. and the STs.

Blastocystis genetic diversity in animal and human samples from different departments of Colombia using complete sequencing of the 18S rRNA gene (SSU rRNA) by Oxford Nanopore Technologies (ONT)

Blastocystis is an intestinal microeukaryote that has raised attention due to its wide distribution in animals and humans. The risk of zoonotic circulation primarily arises from close contact with infected animals. Therefore, the following study aimed to evaluate the diversity and frequency of Blastocystis subtypes in Colombian human and animal samples using complete sequencing of the 18S rRNA gene. For this purpose, 341 human stool samples and 277 animal fecal samples (from cattle, sheep, goat, pigs, cats, and dogs), were collected from different Colombian regions and analyzed using PCR-based detection and full-length 18S SSU rRNA gene Next-Generation Sequencing (NGS). Among the 618 samples from both hosts, humans and animals, the results revealed widespread Blastocystis frequency, with 48.09% (n = 164) in humans and 31.4% (n = 87) detection in animals. Dogs, cats, sheep, pigs, and wild animals tested positive, aligning with global prevalence patterns. Also, 29 human samples and 23 animal samples were sequenced using ONT technology from which 11 long-read unique sequences were generated and cluster with their compared reference sequences. The subtype distribution varied within hosts, detecting ST1 and ST3 in both human and animal samples. Subtypes ST5, ST10, ST14, ST15, ST21, ST24, ST25 and ST26 were limited to animals hosts, some of which are considered to have zoonotic potential. On the other hand, ST2 was found exclusively in human samples from Bolivar region. Mixed infections occurred in both animal and humans, 60.86% and 27.58% respectively. Moreover, to our knowledge, this is the first study in Colombia identifying ST15 in pigs and ST25 in sheep. The subtypes (STs) identified in this study indicate that certain animals may serve as reservoirs with the potential for zoonotic transmission. The identification of zoonotic subtypes highlights the use of Next Generation Sequencing as the depth and resolution of the sequences increases providing insights into STs of medical and veterinarian significance. It also reveals the coexistence of diverse subtypes among hosts. Further research is essential for understanding transmission dynamics, health implications, and detection strategies for Blastocystis occurrence in animals and humans, mainly associated to the role of animals as reservoirs and their close interaction with humans.