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Rodrigues JGM, Miranda GS, Camelo GMA, Rodrigues VF, Silva JKAO, Gouveia CBG, Porto WJN, Wanderley FS, Geiger SM, Negrão-Corrêa DA. Modifications to the parasitological technique of Rugai increase the diagnostic sensitivity for strongyloidiasis. Parasitol Res 2024; 123:101. [PMID: 38233532 DOI: 10.1007/s00436-023-08111-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/29/2023] [Indexed: 01/19/2024]
Abstract
Strongyloidiasis is a neglected tropical disease caused mainly by Strongyloides stercoralis, a nematode that can persist for decades in the human host with a very low parasitic burden and without specific symptoms. Hence, it is difficult to diagnose and control. Larval concentration and culture methods with fecal samples show higher sensitivity for the diagnosis of Strongyloides-infected individuals; however, these techniques are not routinely used, primarily due to the challenges associated with processing a substantial volume of fecal samples. In the current study, we comparatively evaluated the sensitivity and applicability of modifications made to the Rugai parasitological method for the diagnosis of strongyloidiasis in fecal samples of experimentally infected rats and in 68 individuals from an urban community close to Maceió, Brazil. The presence and quantity of parasite larvae in the feces were comparatively evaluated using different parasitological techniques. In the experimental model, we demonstrated that the modified Rugai technique (RMOD) allowed for significantly higher recovery of larvae than the original Rugai technique (RO). Moreover, the sediment was cleaner and easier to evaluate using optical microscopy. Compared to other parasitological techniques, such as agar-plate culture (A-PC) and spontaneous sedimentation (SS), the RMOD technique showed higher sensitivity in the detection of larvae in all infected groups and presented comparatively better performance, especially in rats with a low parasite burden. In the human population, among the 68 stool samples evaluated, Strongyloides larvae were detected in the feces of six individuals with an estimated prevalence of 8.82%. However, the performance of each parasitological method was remarkably different. SS identified Strongyloides larvae in only two individuals and A-PC in three, whereas RMOD was able to identify six infected individuals, resulting in sensitivities of 33.3%, 50%, and 100%, respectively. In conclusion, the modifications introduced to the Rugai technique resulted in improved sensitivity for the detection of Strongyloides spp. infections, especially in stool samples with a low parasite burden, in comparison with other routinely used parasitological techniques.
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Affiliation(s)
- João Gustavo Mendes Rodrigues
- Institute of Biological Sciences, Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Guilherme Silva Miranda
- Institute of Biological Sciences, Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Department of Biology, Federal Institute of Education, Science and Technology of Maranhão, São Raimundo das Mangabeiras, Brazil
| | - Genil Mororó Araújo Camelo
- Institute of Biological Sciences, Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Vanessa Fernandes Rodrigues
- Institute of Biological Sciences, Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Caio Brandão Goes Gouveia
- Institute of Biological Sciences, Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Flaviana Santos Wanderley
- Laboratory of Parasitic Infectious Diseases, State University of Health Sciences of Alagoas, Maceió, Brazil
| | - Stefan Michael Geiger
- Institute of Biological Sciences, Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Buonfrate D, Bradbury RS, Watts MR, Bisoffi Z. Human strongyloidiasis: complexities and pathways forward. Clin Microbiol Rev 2023; 36:e0003323. [PMID: 37937980 PMCID: PMC10732074 DOI: 10.1128/cmr.00033-23] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/11/2023] [Indexed: 11/09/2023] Open
Abstract
Strongyloidiasis is a World Health Organization neglected tropical disease usually caused by Strongyloides stercoralis, a parasitic worm with a complex life cycle. Globally, 300-600 million people are infected through contact with fecally contaminated soil. An autoinfective component of the life cycle can lead to chronic infection that may be asymptomatic or cause long-term symptoms, including malnourishment in children. Low larval output can limit the sensitivity of detection in stool, with serology being effective but less sensitive in immunocompromise. Host immunosuppression can trigger catastrophic, fatal hyperinfection/dissemination, where large numbers of larvae pierce the bowel wall and disseminate throughout the organs. Stable disease is effectively treated by single-dose ivermectin, with disease in immunocompromised patients treated with multiple doses. Strategies for management include raising awareness, clarifying zoonotic potential, the development and use of effective diagnostic tests for epidemiological studies and individual diagnosis, and the implementation of treatment programs with research into therapeutic alternatives and medication safety.
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Affiliation(s)
- Dora Buonfrate
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Richard S. Bradbury
- School of Health and Life Sciences, Federation University Australia, Berwick, Victoria, Australia
| | - Matthew R. Watts
- Centre for Infectious Diseases and Microbiology, Institute of Clinical Pathology and Medical Research – New South Wales Health Pathology and Sydney Institute for Infectious Diseases, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Zeno Bisoffi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
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Banjong D, Pongking T, Tran NTD, Pinlaor S, Dangtakot R, Intuyod K, Anutrakulchai S, Cha’on U, Pinlaor P. Slight Changes in the Gut Microbiome in Early-stage Chronic Kidney Disease of Unknown Etiology. Microbes Environ 2023; 38:ME22097. [PMID: 37635077 PMCID: PMC10522841 DOI: 10.1264/jsme2.me22097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/23/2023] [Indexed: 08/29/2023] Open
Abstract
Gut dysbiosis and changes in short-chain fatty acids (SCFAs) occur in end-stage chronic kidney disease (CKD); however, the degree of these changes in the gut microbiome and serum SCFA profiles in the early stages of CKD, particularly in CKD of unknown etiology (CKDu), is unclear. We herein investigated the gut microbiome and SCFA profiles of early-stage CKD patients (CKD stages 1-3) in a community in Khon Kaen Province, Thailand. Seventy-two parasite-free participants were distributed among a healthy control group (HC, n=18) and three patient groups (an underlying disease group [UD, n=18], early-stage CKD with underlying disease [CKD-UD, n=18], and early-stage CKD of unknown etiology, [CKDu, n=18]). Fecal DNA was individually extracted and pooled for groups of six individuals (three pools in each group) to examine the composition of the gut microbiome using next-generation sequencing. A SCFA ana-lysis was performed on serum samples from each individual using gas chromatography-mass spectrometry. The results revealed that microbial abundance differed between the healthy group and all patient groups (UD, CKD-UD, and CKDu). [Eubacterium]_coprostanoligenes_group was more abundant in the CKDu group than in the HC and CKD-UD groups. Furthermore, serum concentrations of acetate, a major SCFA component, were significantly lower in all patient groups than in the HC group. The present results indicate that minor changes in the gut microbiome and a significant decrease in serum acetate concentrations occur in early-stage CKDu, which may be important for the development of prevention strategies for CKD patients.
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Affiliation(s)
- Ditsayathan Banjong
- Biomedical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Thatsanapong Pongking
- Biomedical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Na T. D. Tran
- Faculty of Medical Laboratory Science, Danang University of Medical Technology and Pharmacy, Danang, Vietnam
| | - Somchai Pinlaor
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Rungtiwa Dangtakot
- Faculty of Medical Technology, Nakhonratchasima College, Nakhon Ratchasima, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Kitti Intuyod
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Ubon Cha’on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
| | - Porntip Pinlaor
- Center for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in Northeastern Thailand, Khon Kaen, Thailand
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Strongyloides stercoralis infection induces gut dysbiosis in chronic kidney disease patients. PLoS Negl Trop Dis 2022; 16:e0010302. [PMID: 36067216 PMCID: PMC9481163 DOI: 10.1371/journal.pntd.0010302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 09/16/2022] [Accepted: 08/09/2022] [Indexed: 11/19/2022] Open
Abstract
Background Strongyloides stercoralis infection typically causes severe symptoms in immunocompromised patients. This infection can also alter the gut microbiota and is often found in areas where chronic kidney disease (CKD) is common. However, the relationship between S. stercoralis and the gut microbiome in chronic kidney disease (CKD) is not understood fully. Recent studies have shown that gut dysbiosis plays an important role in the progression of CKD. Hence, this study aims to investigate the association of S. stercoralis infection and gut microbiome in CKD patients. Methodology/Principal findings Among 838 volunteers from Khon Kaen Province, northeastern Thailand, 40 subjects with CKD were enrolled and divided into two groups (S. stercoralis-infected and -uninfected) matched for age, sex and biochemical parameters. Next-generation technology was used to amplify and sequence the V3-V4 region of the 16S rRNA gene to provide a profile of the gut microbiota. Results revealed that members of the S. stercoralis-infected group had lower gut microbial diversity than was seen in the uninfected group. Interestingly, there was significantly greater representation of some pathogenic bacteria in the S. stercoralis-infected CKD group, including Escherichia-Shigella (P = 0.013), Rothia (P = 0.013) and Aggregatibacter (P = 0.03). There was also a trend towards increased Actinomyces, Streptococcus and Haemophilus (P > 0.05) in this group. On the other hand, the S. stercoralis-infected CKD group had significantly lower representation of SCFA-producing bacteria such as Anaerostipes (P = 0.01), Coprococcus_1 (0.043) and a non-significant decrease of Akkermansia, Eubacterium rectale and Eubacterium hallii (P > 0.05) relative to the uninfected group. Interesting, the genera Escherichia-Shigella and Anaerostipes exhibited opposing trends, which were significantly related to sex, age, infection status and CKD stages. The genus Escherichia-Shigella was significantly more abundant in CKD patients over the age of 65 years and infected with S. stercoralis. A correlation analysis showed inverse moderate correlation between the abundance of the genus of Escherichia-Shigella and the level of estimated glomerular filtration rate (eGFR). Conclusions/Significance Conclusion, the results suggest that S. stercoralis infection induced gut dysbiosis in the CKD patients, which might be involved in CKD progression. Human strongyloidiasis is caused by a soil-transmitted helminth, Strongyloides stercoralis, which typically causes severe symptoms in immunocompromised individuals. This infection can also alter the gut microbiota and is often found in areas where chronic kidney disease (CKD) is common. However, the relationship between S. stercoralis and the gut microbiome in CKD is not known. This is the first study to investigate the gut microbiota of CKD patients with and without S. stercoralis using high-throughput sequencing of the V3–V4 region of the 16S rRNA gene. Infection with S. stercoralis was associated with reduced gut microbial diversity. In addition, infection with this nematode led to reduced abundance of SCFA-producing bacteria and enrichment of pathogenic bacteria. In particular, there were significant differences in abundance of the beneficial genus Anaerostipes (a decrease) and the pathogenic taxon Escherichia-Shigella (an increase) in CKD patients infected with S. stercoralis relative to controls. In the infected group, the representation of Escherichia-Shigella was significantly higher in patients over the age of 65 years. There was a significant inverse moderate correlation of Escherichia-Shigella with the estimated glomerular filtration rate (eGFR).
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Buonfrate D, Tamarozzi F, Paradies P, Watts MR, Bradbury RS, Bisoffi Z. The diagnosis of human and companion animal Strongyloides stercoralis infection: Challenges and solutions. A scoping review. ADVANCES IN PARASITOLOGY 2022; 118:1-84. [PMID: 36088083 DOI: 10.1016/bs.apar.2022.07.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Strongyloidiasis is the infection caused by soil-transmitted nematodes of Strongyloides species, infecting humans and some animals. Strongyloides stercoralis is the species with most clinical and epidemiological relevance in humans and dogs, due to its high prevalence and its capacity of inducing a life-threatening hyperinfection. Diagnosis of strongyloidiasis is challenging, due to the absence of a single reference standard test with high sensitivity and specificity, which also hampers the estimation of the accuracy of other diagnostic tests. In this chapter, we review the deployment and performance of the parasitological, immunological, molecular tests for the diagnosis of strongyloidiasis in humans and in dogs. Further, we comment the available evidence from genotyping studies that have addressed the zoonotic potential of S. stercoralis. Finally, we discuss the use of different diagnostic methods in relation to the purpose (i.e., screening, individual diagnosis, inclusion in a clinical trial) and the setting (endemic/non-endemic areas) and report the accuracy figures reported by systematic reviews on either parasitological, serological or molecular techniques published in literature.
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Affiliation(s)
- Dora Buonfrate
- Department of Infectious Tropical diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy.
| | - Francesca Tamarozzi
- Department of Infectious Tropical diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Paola Paradies
- Department of Emergency and Organs Transplantation, Veterinary Section, Campus of Veterinary Medicine, University of Bari, Bari, Italy
| | - Matthew R Watts
- Centre for Infectious Diseases and Microbiology, Institute of Clinical Pathology and Medical Research - New South Wales Health Pathology and Sydney Institute for Infectious Diseases, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Richard S Bradbury
- School of Health and Life Sciences, Federation University Australia, Berwick, VC, Australia
| | - Zeno Bisoffi
- Department of Infectious Tropical diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy; Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Yingklang M, Chaidee A, Dangtakot R, Jantawong C, Haonon O, Sitthirach C, Hai NT, Cha’on U, Anutrakulchai S, Kamsa-ard S, Pinlaor S. Association of Strongyloides stercoralis infection and type 2 diabetes mellitus in northeastern Thailand: Impact on diabetic complication-related renal biochemical parameters. PLoS One 2022; 17:e0269080. [PMID: 35639713 PMCID: PMC9154194 DOI: 10.1371/journal.pone.0269080] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/13/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Several studies have demonstrated that helminth infections provide a degree of protection against Type 2 diabetes mellitus (T2DM). However, the relationship between Strongyloides stercoralis infection and T2DM has scarcely been investigated and the protective effect of infection against development of diabetic complications is unclear. In this study, we aimed to investigate the relationship between S. stercoralis infection and T2DM in a rural area of Khon Kaen Province, Thailand. The impact of S. stercoralis infection on diabetic complication-related kidney function biochemical parameters and body-mass index (BMI) was also assessed. METHODOLOGY Using a cross-sectional study design, S. stercoralis infection and T2DM assessments were conducted between October 2020 and May 2021. Associations between S. stercoralis infection, T2DM, and socioeconomic factors were analyzed using multivariable logistic regression analyses. Diabetic complication-related biochemical parameters relating largely to kidney function (estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR), serum creatinine, uric acid, alanine transaminase (ALT), and low-density lipoprotein cholesterol (LDL-C)) and BMI of participants with and without T2DM were compared between groups with or without S. stercoralis infection. RESULTS One hundred and seven out of 704 individuals (15.20%) were positive for S. stercoralis, and 283 people were diagnosed with T2DM. Of those with T2DM, 11.31% (32/283) were infected with S. stercoralis and of those without T2DM, 17.82% (75/421) were infected with S. stercoralis. Multivariate analysis revealed that T2DM was inversely correlated with S. stercoralis infection (Adjusted OR = 0.49; 95% CI: 0.30, 0.78; p = 0.003), while male, increasing age, lower education level, and alcohol intake were positively associated with infection. Those infected with S. stercoralis had lower eGFR levels and higher ALT and UACR levels than those in the uninfected group. CONCLUSION This finding indicates that S. stercoralis infection was inversely associated with T2DM in northeastern Thailand, but participants infected with S. stercoralis had lower eGFR levels and higher ALT and UACR levels. Infection with S. stercoralis might lead to worse complication-related renal biochemical parameters.
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Affiliation(s)
- Manachai Yingklang
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Apisit Chaidee
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Rungtiwa Dangtakot
- Department of Medical Technology, Faculty of Allied Health Science, Nakhon Ratchasima College, Nakhon Ratchasima, Thailand
| | - Chanakan Jantawong
- Department of Medical Technology, Faculty of Allied Health Science, Nakhon Ratchasima College, Nakhon Ratchasima, Thailand
| | - Ornuma Haonon
- Department of Medical Technology, Faculty of Allied Health Science, Nakhon Ratchasima College, Nakhon Ratchasima, Thailand
| | - Chutima Sitthirach
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nguyen Thi Hai
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Parasitology, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Ubon Cha’on
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Supot Kamsa-ard
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Somchai Pinlaor
- Chronic Kidney Disease Prevention in The Northeastern Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Unterköfler MS, Eipeldauer I, Merz S, Pantchev N, Hermann J, Brunthaler R, Basso W, Hinney B. Strongyloides stercoralis infection in dogs in Austria: two case reports. Parasit Vectors 2022; 15:168. [PMID: 35570317 PMCID: PMC9107779 DOI: 10.1186/s13071-022-05270-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/29/2022] [Indexed: 12/02/2022] Open
Abstract
Background Strongyloides stercoralis is endemic in tropical and subtropical regions, but reports of infections in central and northern Europe have been recently increasing. Infections occur mainly in humans and dogs. In dogs, both dog-adapted and zoonotic S. stercoralis genotypes seem to occur. Clinical manifestations mainly include gastrointestinal and respiratory signs. The severity of the disease can vary greatly and depends on the immune status of the host. The infection is potentially fatal in immunosuppressed individuals, either medically induced or due to an underlying disease, in which hyperinfections and disseminated infections with extraintestinal parasite dissemination may occur. Methods Diagnosis was based on coproscopy, including flotation and the Baermann funnel technique, histology of small intestinal biopsies and molecular analysis of mitochondrial cytochrome oxidase subunit I (COI) and hypervariable regions I and IV (HVR I and HVR IV) of the nuclear 18S rDNA loci. Results Two independent cases of severe canine S.stercoralis infection in Austria are presented. In both cases, S. stercoralis was detected in histological sections of the small intestine and with the Baermann funnel technique. Molecular analysis revealed strains with zoonotic potential. Case 1 was a 1-year-old female French bulldog with a long history of respiratory and gastrointestinal signs, severe emaciation and apathy before S.stercoralis infection was diagnosed. Treatment with moxidectin (2.5 mg/kg body weight [BW], oral route) did not eliminate the infection, but treatment with ivermectin (0.2 mg/kg BW, subcutaneously) was successful. Case 2 consisted of two 2-month-old Pomeranian puppies, one female and one male, from a litter of four, which died soon after presenting dyspnoea and haemorrhagic diarrhoea (female) or torticollis (male); S.stercoralis infection was first diagnosed post-mortem. Conclusion More attention should be paid to this nematode because although it appears to be rare in Austria, it is easily overlooked on standard coproscopy unless a Baermann funnel technique is used, and even then, it can be missed. Moxidectin is not always successful in eliminating the infection, and treatment with ivermectin should be considered in cases of infection. Graphical Abstract ![]()
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Affiliation(s)
| | - Iris Eipeldauer
- Institute of Parasitology, University of Veterinary Medicine Vienna, Vienna, Austria
| | | | | | - Josef Hermann
- Veterinary Practice Dipl.Tzt. Josef Hermann, Trautmannsdorf, Austria
| | - René Brunthaler
- Institute of Pathology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Walter Basso
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Barbara Hinney
- Institute of Parasitology, University of Veterinary Medicine Vienna, Vienna, Austria
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Modified Nonnutrient Agar Plate Culture for the Diagnosis of Strongyloides stercoralis and Hookworm Infections in La-Ngu District, Satun Province, Southern Thailand. J Parasitol Res 2022; 2022:1117400. [PMID: 35371565 PMCID: PMC8975711 DOI: 10.1155/2022/1117400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
Due to the low prevalence and light intensity of Strongyloides stercoralis (S. stercoralis, Ss) and hookworm (HW) in Thailand, an increase in the efficacy of detection with the appropriate diagnosis is needed. This cross-sectional survey is aimed at using modified nonnutrient agar plate culture (mNNAPC) to assess the prevalence of S. stercoralis and hookworm infections and to report intestinal parasitic infections in La-Ngu villagers, Satun Province in Southern Thailand. We used wet smear, modified Harada-Mori filter paper culture (mHMFPC), and mNNAPC to investigate 204 villagers (4 villages) between August 2016 and January 2017. The combination of mHMFPC and mNNAPC raised the prevalence of S. stercoralis and hookworm infections among the study population from 3.4% and 1.0% to 6.9% and 2.5%, respectively. There were no significant differences between demographic characteristics and these infections (p < 0.05). Three types of protozoal infections, Blastocystis spp. (2.9%), Entamoeba histolytica-like (0.5%), and Giardia duodenalis (0.5%), and 3 species of helminthic infections, S. stercoralis (6.9%) (14 cases), hookworm 2.5%, and Enterobius vermicularis 0.5%, were demonstrated in this area. The mNNAPC showed the highest efficacy in detecting both parasites (Ss 92.9% and HW 80%), whereas the wet smear detected none.
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NGUYEN HT, HONGSRICHAN N, INTUYOD K, PINLAOR P, YINGKLANG M, CHAIDEE A, SENGTHONG C, PONGKING T, DANGTAKOT R, BANJONG D, ANUTRAKULCHAI S, CHA’ON U, PINLAOR S. Investigation of gut microbiota and short-chain fatty acids in <i>Strongyloides stercoralis</i>-infected patients in a rural community. BIOSCIENCE OF MICROBIOTA, FOOD AND HEALTH 2022; 41:121-129. [PMID: 35854692 PMCID: PMC9246423 DOI: 10.12938/bmfh.2021-054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 03/05/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Hai Thi NGUYEN
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Nuttanan HONGSRICHAN
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Kitti INTUYOD
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Porntip PINLAOR
- Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Manachai YINGKLANG
- Department of Fundamentals of Public Health, Faculty of Public Health, Burapha University, Chonburi 20131, Thailand
| | - Apisit CHAIDEE
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Chatchawan SENGTHONG
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Thatsanapong PONGKING
- Science Program in Biomedical Science, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Rungthiwa DANGTAKOT
- Department of Medical Technology, Faculty of Allied Health Sciences, Nakhonratchasima college, Nakhon Ratchasima, 30000, Thailand
| | - Ditsayathan BANJONG
- Science Program in Biomedical Science, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Sirirat ANUTRAKULCHAI
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Ubon CHA’ON
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Somchai PINLAOR
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
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Wattanawong O, Iamsirithaworn S, Kophachon T, Nak-ai W, Wisetmora A, Wongsaroj T, Dekumyoy P, Nithikathkul C, Suwannatrai AT, Sripa B. Current status of helminthiases in Thailand: A cross-sectional, nationwide survey, 2019. Acta Trop 2021; 223:106082. [PMID: 34364893 DOI: 10.1016/j.actatropica.2021.106082] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 12/15/2022]
Abstract
Helminthiases are common neglected tropical diseases in Thailand, thus regular surveillance is necessary for their control. During fiscal year 2019, the Thailand Ministry of Public Health carried out a cross-sectional nationwide survey in people of all age groups from the 12 Regional Health Offices in 76 provinces of Thailand. Multi-stage cluster random sampling design was employed to assess the prevalence of helminth infections and certain behavioural risk factors. A total of 16,187 stool samples and demographic data were obtained from the participants. Stool examination was done and parasite eggs/lavae were identified microscopically by experienced technicians. Positive stool samples for Opisthorchis viverrini, hookworms, or Ascaris lumbricoides were further quantified and expressed in eggs per gram feces (EPG). The results revealed an overall prevalence of helminthic infections of 9.79% with over 14 species identified. The highest prevalence was hookworms (4.47%) followed by O. viverrini (2.2%) with mean infection intensities of 222.7 EPG and 120.9, respectively. The majority of the infections were low intensity (97.4% for hookworms and 99.1% for O. viverrini). Similarly for A. lumbricoides, 93.9% of the positive cases were low infections. Two major helminthiases caused by hookworms and O. viverrini were highlighted in this report. While the liver fluke was highly endemic in Northeast Thailand, the hookworms were prevalent in the southmost region of the country. Association with demographic characteristics and risk behaviors of the two parasites were analyzed and presented in this study. Overall, this countrywide survey provides basic information of the current status of helminth infections in Thailand. Moreover, the data clearly indicates a dramatic reduction of O. viverrini prevalence likely due to extensive control activities under the national campaign against the liver fluke over the past five years.
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Braseth AL, Elliott DE, Ince MN. Parasitic Infections of the Gastrointestinal Track and Liver. Gastroenterol Clin North Am 2021; 50:361-381. [PMID: 34024446 PMCID: PMC11095845 DOI: 10.1016/j.gtc.2021.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Parasites have coevolved with humans. Several of them colonize the human body and establish a symbiotic relationship. Other parasites cause severe and lethal diseases. Prevalence of parasitic infections is decreased in highly industrialized countries, largely due to enforced hygienic practices. In contrast, parasites cause significant morbidity and mortality in parts of the world with barriers to effective public hygiene. Some parasites have emerged as potent pathogens in specific patient populations, such as immune suppressed individuals, regardless of sanitation. This article reviews common parasites encountered in clinical practice and, in the setting of host-parasite symbiosis, discusses their immune regulatory role.
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Affiliation(s)
- Annie L Braseth
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, IA 52242, USA
| | - David E Elliott
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa, Carver College of Medicine, 4546 JCP, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - M Nedim Ince
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Iowa, Carver College of Medicine, 4546 JCP, 200 Hawkins Drive, Iowa City, IA 52242, USA.
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12
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Sengthong C, Yingklang M, Intuyod K, Hongsrichan N, Pinlaor S. An optimized agar plate culture improves diagnostic efficiency for Strongyloides stercoralis infection in an endemic community. Parasitol Res 2020; 119:1409-1413. [PMID: 32086591 DOI: 10.1007/s00436-020-06626-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 02/14/2020] [Indexed: 02/05/2023]
Abstract
We aimed to compare the efficacy of modified agar plate fecal culture (mAPC) and standard agar plate culture (sAPC) for diagnosis of Strongyloides stercoralis infection in a community at Khon Kaen Province, Thailand. Fecal samples were collected from participants individually (n = 1076) and were tested using these two methods. Modified APC and sAPC detected 129 (11.99%) and 91 (8.46%) infected individuals, respectively. Thirty-eight participants were negative according to sAPC, but positive for mAPC. Moreover, in the participants who were positive for both methods, the number of worm developmental stages obtained was higher for mAPC than for sAPC. Our study suggests that mAPC is an effective and useful tool for S. stercoralis diagnosis and can be applied for mass-screening in community and/or control programs.
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Affiliation(s)
- Chatchawan Sengthong
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Medical Technology Unit of Bangkatum Hospital, Phitsanulok, 65110, Thailand.,Chronic Kidney Disease Prevention in the Northeastern Thailand, Khon Kaen, 40002, Thailand
| | - Manachai Yingklang
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Chronic Kidney Disease Prevention in the Northeastern Thailand, Khon Kaen, 40002, Thailand
| | - Kitti Intuyod
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Chronic Kidney Disease Prevention in the Northeastern Thailand, Khon Kaen, 40002, Thailand
| | - Nuttanan Hongsrichan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Chronic Kidney Disease Prevention in the Northeastern Thailand, Khon Kaen, 40002, Thailand
| | - Somchai Pinlaor
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. .,Chronic Kidney Disease Prevention in the Northeastern Thailand, Khon Kaen, 40002, Thailand.
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