Concurrent infection of intestinal parasites and Helicobacter pylori among school-age children in Central Ethiopia

Co-infection of intestinal protozoa and intestinal parasites with Helicobacter pylori among HIV AIDS patients at Jimma Medical Center, Ethiopia

BACKGROUND

Human Immunodeficiency Viruses (HIV) infected people are at increased chance of immunocompromission. In combination with this immunocompromission, the incidence of co-infection with intestinal parasites, intestinal protozoal and Helicobacter pylori can be escalated by different factors including similar mode of transmission, poor economic status, synergistic pathogenesis, and geographic topography of more than two organisms. A large number of world population is either affected or at risk of infection from diversified intestinal parasites, intestinal protozoal and H. pylori.

OBJECTIVE

The study determined the prevalence of H. pylori with intestinal parasites and intestinal protozoal co-infection among HIV positive individuals and factors associated to the co-infection at Jimma University Medical Center (JUMC); Jimma, Ethiopia.

MATERIALS AND METHODS

This cross-sectional study included 384 HIV positive patients using consecutive sampling technique. Stool sample was examined using normal saline to diagnosis intestinal parasites and with lugol's Iodine for active motile intestinal protozoa and the stool sample was concentrated by formalin-ethyl acetate and stained with Kinyoun-modified acid-fast stain to stain coccidian protozoa H. pylori was diagnosed by antigen test using Wondfo one Step H. pylori feces test.

RESULT

In this study, gender distribution was 177(46.1 %) males and 207(53.9 %) females. About 179 were between 10 and 20 years. The prevalence of H. pylori, intestinal parasites and intestinal protozoal infection among HIV positive individuals were 27.6 % 24.4 % and 6.5 % respectively. The overall prevalence of both intestinal parasites and intestinal protozoal co-infection with H. pylori was 20.7 %. Positive associations of co-infection with source of drinking water, animal contact, finger nail trimming, economic status and shoe-wearing habits as significant variables.

CONCLUSION AND RECOMMENDATION

A notable co-infection involving H. Pylori alongside intestinal parasites and intestinal protozoa was identified. It was acknowledged that the sanitary and socio-economic conditions could serve as potential risk factors associated with co-infection. Enhancing hygiene and sanitation practices is essential to interrupt the transmission pathways of intestinal parasites, H. Pylori, and intestinal protozoa, particularly for individuals with weakened immune systems, including those living with AIDS.

Prevalence of intestinal parasites and Helicobacter pylori co-infection in people with gastrointestinal symptoms in Africa: a systematic review and meta-analysis

BACKGROUND

Gastrointestinal infections caused by intestinal parasites and Helicobacter pylori are significant public health issues in Africa, where poor sanitation and limited access to healthcare contribute to high disease burden. Since there was no previous pooled data regarding the intestinal parasites and Helicobacter pylori co-infections among gastrointestinal symptomatic patients in the African context, this review aimed to determine the overall prevalence of intestinal parasites and Helicobacter pylori co-infection in people with gastrointestinal symptoms in Africa.

METHODS

The current review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards and registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42024598993). A comprehensive search was conducted across electronic databases: PubMed, Medline, EMBASE, Google Scholar, Web of Science, Science Direct, and African Journals Online. The data was extracted using Microsoft Excel 2010 and analyzed using STATA version 11.0 Software. A random-effects model was used to calculate the pooled effect size of outcome variables across studies, with a 95% confidence interval. The I2 statistic was employed to assess heterogeneity. A funnel plot and Egger's test were used to identify publication bias. A p-value < 0.05 indicated statistically significant publication bias.

RESULTS

The combined prevalence of intestinal parasites and H. pylori co-infections was 31.03% (95% CI: 18.66-43.39) with significant heterogeneity (I2 = 98.9%, p = 0.000). The Subgroup analysis revealed that Egypt and Ethiopia had the highest and lowest rates of intestinal parasites and H. pylori co-infection respectively at 39.84% (95% CI: 27.79-51.88%), and 5.86% (95% CI: 4.10-7.62). Moreover, the adjusted Egger's regression test did not reveal any publication bias (p = 0.116).

CONCLUSION

This meta-analysis shows a significant prevalence of intestinal parasites and H. pylori co-infection in Africans with gastrointestinal symptoms. The coexistence of these diseases creates diagnostic and therapeutic problems. Thus, the findings underscore need for targeted interventions and further research is needed to develop effective control strategies to reduce the impact of these illnesses on public health in Africa.

Concomitant Infection of Helicobacter pylori and Intestinal Parasites: Burden, Sociodemographic and Clinical Characteristics in Hospitalized Children and Adolescents in Northern Lebanon

Background

Helicobacter pylori and intestinal parasites are well-known for their high prevalence in children, especially in developing countries. However, their concomitant infections are poorly documented. In this study, we aimed to evaluate the association between intestinal parasites and H. pylori among hospitalized children and adolescents with upper gastrointestinal complaints in Northern Lebanon.

Methods

A cross-sectional study was conducted involving 297 hospitalized pediatric patients, aged between 1 and 15 years, who presented with gastrointestinal symptoms. The socio-demographic, lifestyle, and gastrointestinal characteristics of all participants were analyzed. Fresh stool samples were collected and screened for the presence of intestinal parasites and H. pylori infections.

Results

6.4% of the patients were positive for intestinal parasitic infections, 5.4% were positive for H. pylori infection, and 11.8% were co-infected. The results of the Chi-square test showed that H. pylori infection is significantly associated with parasitic infection but not with a particular species. The most frequent coinfection was H. pylori-Entamoeba histolytica (77.1%). Moreover, H. pylori infection was associated with overcrowding and infrequent washing of vegetables before eating. The prevalence of co-infections increased in patients of mothers with a primary educational level or less. In regards to clinical characteristics, our findings showed a statistically significant relationship between i) gastric reflux and H. pylori, and ii) severe diarrhea and parasitic infection.

Conclusion

Our data highlighted the association between H. pylori and intestinal parasitic infections. Thus, H. pylori detection could be taken into consideration while screening for parasitic infections in children and adolescents.

Prevalence, Predictors, and Treatment Outcomes of Anemia in Vietnamese School-Age Children With Helicobacter pylori Infection

Background A growing number of studies suggest that anemia caused by Helicobacter pylori (H. pylori) infection is prevalent in developing countries. A combination of H. pylori eradication and iron supplementation may be effective in treating iron deficiency anemia (IDA) caused by H. pylori infection. The aim of this study is to assess the prevalence, risk factors, and treatment outcomes of anemia in Vietnamese school-age children infected with H. pylori Methods A cross-sectional study was conducted from April 2023 to April 2024 involving 112 dyspeptic children from 5 to 16 years old who were admitted to Can Tho Children's Hospital, Vietnam. H. pylori infection was diagnosed with a positive histopathology combined with a rapid urease test. A bivariate and multivariate logistic regression model was used to identify independent variables associated with anemia in H. pylori-infected children. Results The prevalence of anemia and IDA (iron deficiency anemia) among H . pylori-infected children were 28.6% and 53.1%, respectively. The risk factor for anemia was age group from 11 to 16 years of age (OR: 3.24; CI 95%:1.21- 8.70). Iron supplementation (OR: 0.14; CI 95%:0.03 - 0.66) and periodic deworming (OR: 0.29; CI 95%: 0.10-0.89) were protective factors against anemia. After H. pyroli eradication and iron supplementation, all hematological parameters were increased among 32 anemic patients. Hemoglobin increased from 9.9 ±2.1 to 11.9±2.1 g/dL (p<0.001), mean corpuscular hemoglobin increased from 25.1 ± 4.1 to 28.0 ± 3.3 pg (P=0.003), and ferritin (IQR) increased from 16.7 (9.5-45.2) to 27.0 (15.1-47.0) µg/L (p<0.001). Conclusion Anemia in Vietnamese school-age children infected with H. pylori is prevalent. Taking iron supplements and periodic deworming reduces the risk of anemia. H. pylori eradication therapy plus oral iron supplementation will improve iron status in H. pylori-infected children.

Intestinal parasitic co-infections associated with Helicobacter pylori among paediatric patients with gastrointestinal illness attending a general hospital in southern Ethiopia

BACKGROUND

Concurrent infections or co-infections caused by intestinal parasites and Helicobacter pylori are quite rampant in paediatrics living in endemic areas of sub-Saharan Africa, including Ethiopia, and if left untreated, can result in severe complications and hence must be addressed to ensure their health and well-being.

OBJECTIVES

To determine the prevalence of intestinal parasitic and H. pylori co-infections and associated factors among paediatric patients with gastrointestinal symptoms who attended the Arba Minch General Hospital (AMGH), Arba Minch, southern Ethiopia, from September to November 2020.

METHODS

A cross-sectional study was conducted among a study population of 299 paediatric patients with gastrointestinal symptoms who visited AMGH. Stool samples were collected and analysed to detect H. pylori and intestinal parasites. A rapid lateral flow chromatographic immunoassay was employed to identify the H. pylori copra antigen, whereas the latter was detected using wet mount saline preparation and formol-ether concentration method. Socio-demographic, clinical, behavioural and other factors were obtained by means of a pre-tested structured questionnaire. Descriptive statistics and logistic regression analysis were done by Statistical Package for Social Service (SPSS) version 25; P values < 0.05 were considered statistically significant.

RESULTS

The prevalence of Helicobacter pylori and intestinal parasites was 14% (n = 42) and 37.1% (n = 111), respectively, whereas that of the co-infections with these pathogens was 6.4% (n = 19). Giardia lamblia was the most prevailing parasite, 21.4% (n = 64). Informal maternal education [AOR = 5.14; 95% CI: 1.98-15.70] and lack of hand washing practice were significantly associated with the extent of co-infections [AOR = 4.18; 95% CI: 1.36-12.80].

CONCLUSION

Nearly one in twenty pediatric patients with gastrointestinal symptoms had intestinal parasitic infections and H. pylori co-infections, representing a silent health problem that is to be addressed through effective control strategies. Health administrators should consider the importance of co-infections in clinical diagnosis and planning aimed at its prevention.

Gaita Örneklerinde Helicobacter pylori Antijen Pozitifliği ile İntestinal Parazit Birlikteliğinin Araştırılması

Aim: Helicobacter pylori and intestinal parasitic infections are commonly seen, especially in areas with low socioeconomic status and poor hygiene conditions. H. pylori and Giardia duodenalis can be commonly found in patients with upper gastrointestinal system complaints. It is thought that the urease activity of H. pylori may help intestinal parasites pass into the intestines without being affected by the acidic environment of the stomach. In this study, it was aimed to investigate the association of H. pylori and intestinal parasites (IP) in patients with gastrointestinal system complaints. Material and Method: A total of 408 patients, who were admitted to our hospital with gastrointestinal complaints between 2018 and 2020 and whose H. pylori rapid antigen test was studied simultaneously with intestinal parasite examination in the stool, were evaluated retrospectively. Results: Out of 408 patients whose stool samples were examined, one or more intestinal parasites were detected in 80 (19.6%), and H. pylori antigen test was positive in 65 (15.9%). While there was no statistically significant difference between H. pylori positivity and age groups, the rate of IP detection was found to be significantly higher in children aged 6-18 years. The most prevalent IP was Blastocystis sp. in 74 (18.1%) patients. Intestinal parasite and H. pylori antigen co-positivity in stool samples was detected in eight patients and it was not found statistically significant. Conclusion: H. pylori and intestinal parasites are common all over the world. The relationship between H. pylori and IP is still controversial, and more studies that are comprehensive are needed to understand the association of H. pylori and IP, especially in patients with upper gastrointestinal system complaints.

Helicobacter pylori Pathogenicity Islands and Giardia lamblia Cysteine Proteases in Role of Coinfection and Pathogenesis

Helicobacter pylori is a well-known human-specific stomach pathogen that infects more than half of the world’s population. The infection with this bacterium can cause a variety of gastrointestinal problems, including chronic gastritis, peptic ulcers, and even cancer. H. pylori is a highly infectious bacterium. H. pylori causes an increase in gastric mucosa pH or gastric mucosa intestinal metaplasia. These modifications in the stomach environment are necessary for G. lamblia colonization to occur. Giardia lamblia is a flagellate protozoan parasite that can cause giardiasis in humans and other mammals. It dwells in the duodenum and upper jejunum. Globally, over 280 million cases of human giardiasis are predicted to occur each year. Simultaneous human colonization by G. lamblia and H. pylori is a typical occurrence since the viruses’ predisposing factors are similar in both groups. Giardiasis is a parasitic infection that affects both children and adults worldwide. Infection with Giardia is more common in underdeveloped countries. Globally, more than 200 million cases of giardiasis are detected each year. In contrast, the presence of G. lamblia in the host body triggers an immunological response comparable to that of H. pylori, with lymphocytes strongly polarized towards Th1. As a result, their combined presence exacerbates host tissue damage. The major goal of this seminar is to describe the pathophysiology, immunology, and clinical aspects of G. lamblia and H. pylori coinfection using a comprehensive search of PubMed, Lancet, and Google Scholar sources. Upper gastrointestinal problems such as upper abdominal pain, abdominal bloating, nausea, vomiting, epigastric pain/burning, and belching are all caused by both organisms. Differentiation by physical examination is impossible in people infected with both bacteria. For this coinfection distinction, a laboratory diagnosis is required. G. lamblia and H. pylori, when present together, have a synergistic effect on the host and can cause serious damage. As a result, researchers should delve deeper into the mechanics underlying this potential microbial interaction.