Prevalence of Parasitic Contamination of Raw Vegetables in Villages of Qazvin Province, Iran

Fresh Leafy Vegetables and Parasitic Contamination: Practical Solutions

This study aimed at investigating the parasitic contamination of fresh leafy vegetables in Tehran, Iran, during 2020-2021. A cross-sectional study was conducted and 180 fresh leafy vegetables (including leek, watercress, mint, spring onion, radish, basil, parsley, lettuce, and spinach) were collected randomly in the five regions of Tehran, Iran. Each 200-g sample was soaked with tap water containing detergent, and the obtained sediment was centrifuged and examined for parasitic stages using a light microscope. The overall rate of parasitic contamination was 19.4%, with Trichostrongylus and Toxocara eggs being the most prevalent parasites (3.9%) and the highest rate of parasitic contamination was observed in spinach (40%), whereas no contamination was found in spring onions. Except for radish, other vegetable samples had multiple parasitic infections. Due to the contamination of vegetables, it is necessary to have a suitable method to reduce the parasites. Consequently, policymakers should safeguard public health by consistently monitoring contaminants in food and prioritizing education and research on methods to mitigate their presence in the food chain.

Parasitic Contamination of Fresh Leafy Green Vegetables Sold in Northern Lebanon

Contaminated, raw or undercooked vegetables can transmit parasitic infections. Here, we investigated parasitic contamination of leafy green vegetables sold in local markets in the Tripoli district, Lebanon, during two consecutive autumn seasons (2020-2021). The study involved the microscopic examination of 300 samples of five different types of vegetables (60 samples per type) and used standardized qualitative parasitological techniques for some protozoa and helminths. The results showed that 16.7% (95% interval for p: 12.6%, 21.4%) (50/300) of the vegetable samples were contaminated with at least one parasite. The most frequently detected parasite was Blastocystis spp. (8.7%; 26/300); this was followed in frequency by Ascaris spp. (3.7%; 11/300). Among the different vegetable types, lettuce (23.3%; 14/60) was the most contaminated, while arugula was the least contaminated (11.7%; 7/60). The statistical analysis did not reveal any significant association between the prevalence of parasitic contamination and the investigated risk factors, which included collection date, vegetable type, market storage status, and wetness of vegetables at the time of purchase (p > 0.05). The high prevalence of parasitic contamination also suggested the potential presence of other microbial pathogens. These findings are important because leafy green vegetables are preferentially and heavily consumed raw in Lebanon. Thus, implementing effective measures that target the farm-to-fork continuum is recommended in order to reduce the spread of intestinal pathogens.

Microbial pollution in inland recreational freshwaters of Quetta, Pakistan: an initial report

Parasitic contamination of surface waters, especially recreational waters, is a serious problem for under-developed nations like Pakistan, where numerous outbreaks of parasitic diseases are reported each year. In the current study, parasitic presence in two surface waters (Hanna Lake and Wali-Tangi Dam) of Quetta was monitored quarterly for 1 year. The methodology involved the pre-concentration of the water samples and the subsequent preparation for the microscopic search of parasites. Physico-chemical and bacteriological variables were also studied. Wet staining, modified Trichrome staining, and modified acid-fast staining methods were used to identify various parasitic forms (cysts, oocysts, eggs, trophozoites). Collectively 11 parasitic elements (10 in Lake and 8 in Dam) belonging to 10 species were recorded, many of which are potential human pathogens. The species identified include Trichomonas sp., Isospora sp., Balantidium coli, Cryptosporidium sp., Entamoeba spp., amoebas, Microsporidium sp., Endolimax nana, Ascaris lumbricoides, and Giardia spp. Parasitic contamination remained persistent in both locations throughout the year independent of physico-chemical parameters (temperature, EC, pH, turbidity, and DO) and bacterial concentration of water. Reliance on bacterial presence for monitoring of recreational waters can be a risk for tourists. Entamoeba spp. and A. lumbricoides may be used for surface water monitoring in these waters.

Altayb H. Frequency of parasitic infections in Arachishypogaea L (groundnuts), Citrulluslanatus seeds (watermelon seeds), and Ziziphusspina-christi (nabag) sold by street vendors in Khartoum State, Sudan: a cross-sectional study

Background: Plant products, including seeds are an important source of vitamins, minerals, proteins, and energy. This study aimed to assess parasitic contaminations in roasted groundnuts, nabag, and tasali (watermelon seeds) sold by street vendors in Khartoum State, Sudan. Methods: The frequency of parasitic contaminations among all crop products was detected by washing the plants with saline, and then conducting an examination using a formal ether concentration technique (FECT), followed by a saturated sugar floatation technique. Results: The detected parasites belonged to two species: Entamoeba histolytica (33.3%) and Giardia lamblia (15.6%). No helminthic parasites were detected. Mixed contamination of the mentioned parasites was also observed (11.1%). The most contaminated crop was nabag, followed by groundnut, and finally tasali. Conclusion: No relation was established between the positivity of samples for parasites and crop type, Khartoum State city, or  seller sex. FECT was more sensitive than the saturated sugar floatation technique as a detection method.

The prevalence of foodborne parasites in raw vegetables in Iran: a comprehensive systematic review and meta-analysis

Foodborne parasites in raw vegetables could cause parasitic infections in humans. An effective approach to the reduction of pathogenic microorganisms in vegetables involves identifying the main sources of contamination and the ecology of the involved microorganisms. This review aimed to evaluate the prevalence of foodborne parasites in raw vegetables in Iran. According to the reviewed studies, the prevalence rate of Ascaris spp., Giardia spp., Toxocara spp., Fasciola, Trichuris, Cryptosporidium, Dicrocoeliasis, Taenia spp., and Entamoeba histolytica was 6 % (95 % CI: 5-8 %), 6 % (95 % CI: 5-7 %), 6 % (95 % CI: 4-7 %), 2 % (95 % CI: 1-2 %), 1 % (95 % CI: 1-2 %), 10 % (95 % CI: 6-15 %), 2 % (95 % CI: 1-3 %), 5 % (95 % CI: 4-6 %), and 3 % (95 % CI: 2-4 %), respectively. According to the standard deviation map, Ilam province was one of the high-risk areas in terms of food-borne parasites in raw vegetables (3 SD < prevalence < 4 SD). Given the key role of raw vegetables in human parasitic contamination, governments must implement more stringent programs for effective wastewater treatment, preventing domestic and wild animals from entering farms, not using human and animal manure on farms, using ready-to-eat packaged vegetables, food safety training for households, implementation of GMP and HACCP in the factory vegetable packaging are required in this regard, especially in the high-risk areas of Iran, such as Ilam province.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40201-021-00714-w.

Altayb H. Frequency of parasitic infections in Arachishypogaea L (groundnuts), Citrulluslanatus seeds (watermelon seeds), and Ziziphusspina-christi (nabag) sold by street vendors in Khartoum State, Sudan: a cross-sectional study

Background: Plant products, including seeds are an important source of vitamins, minerals, proteins, and energy. This study aimed to assess parasitic contaminations in roasted groundnuts, nabag, and tasali (watermelon seeds) sold by street vendors in Khartoum State, Sudan. Methods: The frequency of parasitic contaminations among all crop products was detected by washing the plants with saline, and then conducting an examination using a formal ether concentration technique (FECT), followed by a saturated sugar floatation technique. Results: The detected parasites belonged to two species: Entamoeba histolytica (33.3%) and Giardia lamblia (15.6%). No helminthic parasites were detected. Mixed contamination of the mentioned parasites was also observed (11.1%). The most contaminated crop was nabag, followed by groundnut, and finally tasali. Conclusion: No relation was established between the positivity of samples for parasites and crop type, Khartoum State city, or  seller sex. FECT was more sensitive than the saturated sugar floatation technique as a detection method.

Echinococcoses in Iran, Turkey, and Pakistan: Old Diseases in the New Millennium

Echinococcosis is considered a cosmopolitan zoonosis caused by different species of small taeniid tapeworms of the genus Echinococcus and is regarded as a neglected zoonosis. Cystic and alveolar echinococcoses are endemic diseases of Tibetan, Pamir, and Iranian plateaus. All of the countries within the Iranian plateau are affected by echinococcosis. Pakistan, Turkey, and Iran are the three most populous countries of the region, in which echinococcosis is highly endemic. The three neighboring countries share strong cultural and socioeconomic ties. The present study aimed to provide a broad review of the status of cystic and alveolar echinococcosis, summarizing the current knowledge about geographical distribution, molecular epidemiology, and transmission dynamics of Echinococcus granulosus sensu lato and Echinococcus multilocularis in this region. Additionally, we aimed to understand disease burden and risk factors as basic requirements for establishing a surveillance system and planning prevention and control programs. A considerable body of information is available on different aspects of echinococcosis in this region; however, several information and research gaps need to be filled before planning control programs. None of the countries in the region have an elaborate echinococcosis control program. Effective control programs require multi/intersectoral coordination within a One Health approach with a long-term political and administrative commitment and enhanced international collaboration among the three countries.

Zoonotic parasitic organisms on vegetables: Impact of production system characteristics on presence, prevalence on vegetables in northwestern Iran and washing methods for removal

Fresh vegetables are essential components of a healthy and nutritious diet, but if consumed raw without proper washing and/or disinfection, can be important agents of transmission of enteric pathogens. This study aimed to determine the prevalence of zoonotic parasites on vegetables freshly harvested and "ready to eat" vegetables from greengrocers and markets in northwestern Iran. In addition, the effect of cropping system and season on contamination levels were assessed as well as the efficacy of washing procedures to remove parasites from the vegetables. A total of 2757 samples composed of field (n = 1, 600) and "ready to eat" (n = 1157) vegetables were analyzed. Vegetables included leek, parsley, basil, coriander, savory, mint, lettuce, cabbage, radish, dill, spinach, mushroom, carrot, tomato, cucumber and pumpkin. Normal physiological saline washings from 200 g samples were processed using standard parasitological techniques and examined microscopically. A total of 53.14% of vegetable samples obtained from different fields and 18.23% of "ready to eat" vegetables purchased from greengrocers and markets were contaminated with different parasitic organisms including; Entamoeba coli cysts, Giardia intestinalis cysts, Cryptosporidium parvum oocysts, Fasciola hepatica eggs, Dicrocoelium dendriticum eggs, Taenia spp. eggs, Hymenolepis nana eggs, Ancylostoma spp. eggs, Toxocara cati eggs, Toxocara canis eggs, Strongyloides stercoralis larvae, and Ascaris lumbricoides eggs. In both field and "ready to eat" vegetables, the highest parasitic contamination was observed in lettuce with a rate of 91.1% and 55.44%, respectively. The most common parasitic organism was Fasciola hepatica. A seasonal difference in contamination with parasitic organisms was found for field and "ready to eat" vegetables (P < 0.05). There was a significant difference in the recovery of parasitic organisms depending on the washing method with water and dishwashing liquid being the least effective. Proper washing of vegetables is imperative for a healthy diet as the results of this study showed the presence of zoonotic parasites from field and ready to eat vegetables in Iran.

Checklist of digenean trematodes of Iran

Digeneans are an important class of trematodes which infect variety of animals ranging from vertebrates (mainly final hosts) to invertebrates (mainly as intermediate hosts). Additionally, some of these parasites are zoonotic and one health importance. Diversity of digeneans in Iran and reports of several zoonotic cases show the importance of these parasites in this country. This is the checklist of digenean parasites reported from Iran representing a total of 118 species, from 105 genera, 43 families, 21 subfamilies, and 3 orders that are reported from 139 species of different hosts including humans. Some of the most important final number of families, genera, and species reported in Iran fauna include: Fasciolidae, Genus: Fasciola, Fasciola gigantica, Fasciola hepatica, Family: Dicrocoeliidae, Genus: Dicrocoelium, Dicrocoelium dendriticum, Family: Diplostomidae, Genus: Diplostomum, Diplostomum spathaceum, Family: Heterophyidae, Genus: Haplorchis, Haplorchis taichui, Family: Notocotylidae, Genus: Notocotylu, Notocotylus aegyptiacus, Family: Bucephalidae, Genus: Rhipidocotyle, Rhipidocotyle illense.

The survival and dispersal of Taenia eggs in the environment: what are the implications for transmission? A systematic review

Taenia spp. are responsible for a substantial health and economic burden in affected populations. Knowledge of the fate of the eggs of Taenia spp. in the environment and of other factors facilitating the transmission of eggs to intermediate hosts is important for the control/elimination of infections caused by Taenia spp. The aim of this systematic review was to summarize current knowledge of the factors influencing the survival and dispersal of Taenia spp. eggs in the environment. Publications retrieved from international databases were systematically reviewed. Of the 1465 papers initially identified, data were ultimately extracted from 93 papers. The results of this systematic review indicate that survival is favoured at moderate temperatures (0–20 °C). Humidity seems to affect the survival of Taenia spp. eggs more than temperature. Under field circumstances, Taenia spp. eggs have been found to survive for up to 1 year. Taenia spp. eggs are commonly found on vegetables (0.9–30%) and in soil and water samples (0–43%), with their presence posing a risk to the consumer. Invertebrates may act as transport hosts, transferring the infection to an intermediate host, but the importance of this route of transmission is still open to question. Wastewater treatment systems are not capable of entirely eliminating Taenia spp. eggs. Access to surface water and the use of sewage sludge as fertilizer on pastures are important risk factors for bovine cysticercosis. Although information on the survival and spread of Taenia spp. eggs is available, in general the data retrieved and reviewed in this article were old, focused on very specific geographical regions and may not be relevant for other areas or not specific for different Taenia spp. Furthermore, it is unknown whether egg survival differs according to Taenia sp. Future studies are necessary to identify sustainable methods to identify and inactivate parasite eggs in the environment and reduce their spread.

Prevalence of Cryptosporidium and Giardia in vegetables in Iran: a nineteen-years meta-analysis review

Cryptosporidium and Giardia are two major protozoa reported from vegetables and environment. The prevalence of these parasites supposes to be different regarding the climate zones. This review aimed to evaluate the prevalence of Cryptosporidium and Giardia in vegetables according to the major climate zones in Iran. The results showed pooled prevalence 7% (95% CI: 2%, 14%) and 4% (95% CI: 3%, 6%) for Cryptosporidium spp., and Giardia spp., respectively. The prevalence of Giardia spp. in mountain, desert and semi-desert, and Mediterranean regions was 4% (95% CI: 2%, 6%), 5% (95% CI: 3%, 8%) and 7% (95% CI: 1%, 18%), respectively. Cryptosporidium spp. was reported 8% (95% CI: 0%, 65%), 6% (95% CI: 0%, 18%) and 4% (95% CI: 0%, 77%) from mountain, desert and semi-desert, and Mediterranean climate zones, respectively. This review suggests the higher prevalence of Giardia and Cryptosporidium in Mediterranean and mountain regions, respectively.

A systematic review and meta-analysis of Hymenolepis nana in human and rodent hosts in Iran: A remaining public health concern

Hymenolepis nana, as a neglected zoonotic helminth, naturally occurs in both humans and rodents. Herein, a systematic review and meta-analysis was carried out to estimate pooled prevalence of H. nana infection among human and rodent hosts for the first time in Iran. PubMed, Web of Science, Scopus, and Embase databases (English articles) and SID and Magiran databases (Persian articles) were systematically searched for relevant studies published from inception till May 24, 2020. Chi² and I² index were used to assess the heterogeneity of the included studies. Publication bias was assessed using Egger's intercept and visual inspection of the funnel plot. Pooled prevalence was estimated using random-effects model with 95 % confidence interval (CI) and depicted as a forest plot. STATA software was used for analysis. The overall pooled prevalence estimate of H. nana in humans included 1.2 % (95 % CI = 1.0-1.4%). Subgroup analysis revealed 2.2 % (95 % CI = 1.8-2.6%) and 0.5 % (95 % CI = 0.3 to 0.8 %) of H. nana infection among school children and food handlers, respectively. In terms of rodent hosts, the overall pooled prevalence of H. nana infection included 13 % (95 % CI = 9.3-16.6%). Subgroup analysis revealed the highest rate of the infection was in Rattus spp. (19.6 %; 95 % CI = 10.6-28.6%), a genus with synanthropic behavior. It seems, despite the advancement in sanitation infrastructure and hygiene status, the H. nana infection compares to other helminthic diseases remains a challenging public health problem in Iran.

Detection of human intestinal protozoan parasites in vegetables and fruits: a review

Diarrheal diseases caused by intestinal protozoan parasites are a major food-borne public health problem across the world. Vegetables and fruits provide important nutrients and minerals, but are also common sources of some food-borne human pathogenic microorganisms. The contamination of raw vegetables and fruits with human pathogenic parasites are now a global public health threat, despite the health benefits of these foods in non-pharmacological prophylaxes against diseases. A large number of reports have documented the contamination of vegetables or fruits with human pathogenic microorganisms. In this paper, we reviewed the contamination and detection methods of human pathogenic intestinal protozoans that are frequently recovered from raw vegetables and fruits. The protozoan parasites include Cryptosporidium spp., Giardia duodenalis, Cyclospora cayetanensis, Entamoeba spp., Toxoplasma gondii, Balantioides coli, Blastocystis sp., Cystoisospora belli and Enterocytozoon bieneusi. The risk factors involved in the contamination of vegetables and fruits with parasites are also assessed.

Intestinal Parasite Detection in Assorted Vegetables in the United Arab Emirates

Objectives

Consuming raw vegetables presents a considerable risk to the public and is the chief mode of transmission of intestinal parasites. We sought to assess the degree of parasitic contaminations on selected vegetables in the UAE.

Methods

A total of 218 fresh vegetable samples were collected randomly from different farms and local supermarkets between February 2017 and January 2018. After washing and centrifugation, the sediment was examined microscopically for parasitic forms.

Results

Protozoa cysts and helminths eggs were detected in 15.1% (33/218) of samples. The most detected parasites were Entamoeba complex (E. histolytica/E. dispar/E. moshkovskii) (30.3%), Entamoeba coli (18.2%), Trichuris trichiura (12.1%), Strongyloides stercoralis (12.1%), Ascaris lumbricoides egg (9.1%), Endolimax nana cyst and Enterobius vermicularis egg (6.1% each), and Giardia lamblia and Hymenolepis nana (3.0% each). We found no significant association between the vegetable type and the parasite occurrence (p > 0.050). Moreover, parasite incidence was independent of the vegetable type (p > 0.050).

Conclusions

The study highlights the potential of raw produce serving as a major source of foodborne disease outbreaks and its role in the transmission of intestinal parasitic infections. Public education on the safe handling of raw vegetables is recommended.

Detection methods and prevalence of transmission stages of Toxoplasma gondii, Giardia duodenalis and Cryptosporidium spp. in fresh vegetables: a review

One of the ways of human parasitic infection is the accidental ingestion of vegetables contaminated with parasites, which represents a major human health hazard. This non-exhaustive review aims to evaluate studies carried out on five types of vegetables (lettuce, parsley, coriander, carrot and radish) since 2000, particularly the methods used for recovery, concentration, detection and identification of protozoan parasites such as Toxoplasma gondii, Giardia duodenalis and Cryptosporidium spp., and the results of each work. Various studies have determined the presence of pathogenic parasites in fresh vegetables with different rates; this variation in rate depends particularly on the detection method used which is related to each parasite and each vegetable type. The variation in parasitic prevalence in food could be due to different factors such as the geographical location, the size of analysed samples and the methods used for parasite detection.

An Additional Asset for the FLOTAC Technique: Detection of Gastrointestinal Parasites in Vegetables

INTRODUCTION

Gastrointestinal parasites are considered amongst the most important threats to veterinary and human health worldwide. The transmission of these parasitic diseases usually involves the accidental ingestion of oocysts, cysts, eggs, and larvae, whose detection is generally achieved by classical coproparasitological methods, based on sedimentation and/or flotation techniques. These procedures might be inefficient or display a low sensitivity when performed on food matrices. This study aimed to assess the value of the FLOTAC technique for the detection of different parasitic stages of gastrointestinal parasites of domestic animals in fresh lettuce.

MATERIAL AND METHODS

Samples (n = 100) were purchased from public markets located in the metropolitan region of Recife (Brazil).

RESULTS

A total of 79% scored positive for eggs and/or cysts of gastrointestinal parasites. Protozoa and nematodes were detected in 32% (32/100) and 64% (64/100) of samples, respectively, with cysts of the genus Entamoeba (32%) and eggs of nematodes of the order Strongylida (30%) being the most frequently diagnosed.

CONCLUSIONS

The findings herein reported demonstrate that the FLOTAC technique can be successfully applied for recovering food-borne parasites of medical and veterinary concern in food matrices.

Fruit and vegetable contamination with medically important helminths and protozoans in Tarcha town, Dawuro zone, South West Ethiopia

Background: Fresh vegetables supply the body with essential supplements. The consumption of raw vegetables and fruits are among the ways for transmission of intestinal parasitic organisms to human beings. This study was aimed at detecting the parasitic contamination in fresh vegetables sold at the central open-aired market of Tarcha town, Ethiopia.

Methods: A total of 270 fresh vegetables and fruit samples were collected from the main market of Tarcha town during August 1, 2017–August 22, 2017. The samples were microscopically examined for detection of medically important parasites after washing with 500 mL normal saline and 24-hr sedimentation of the washing solution followed by centrifuging at 2000 g for 5 mins. After centrifugation, the supernatant was decanted leaving the sediment. Finally, the sediment was examined under a light microscope for protozoans and helminths worms.

Results: Of the 270 fresh vegetable and fruit samples, 115 (42.6%) were found positive for intestinal parasites. A high level of contamination in fresh vegetable and fruit samples was recorded in cabbage 71.1% (32/45) while tomato was the least contaminated 24.4% (11/45). The identified medically important parasites were Entamoeba histolytica/dispar, Giardia intestinalis, Ascaris lumbricoides, Hymenolepis nana, Toxocara spp, Hymenolepis diminuta, and Cystoisospora belli. The most predominant parasite encountered was Ascaris lumbricoides (16.7%) whereas Cystoisospora belli (2.6%) the least detected. All of the vegetables and fruits that were contaminated were with more than one parasite species. A statistically significant association between the type of vegetables and the presence of parasites was also observed (p=0.002).

Conclusion: This study has shown that fruits and vegetables which are sold in the study area are highly contaminated with medically important parasites. Fruits and vegetables sold in the study area may play a role in the transmission of intestinal parasitic infections to humans. Effective and comprehensive prevention measures should be taken to ensure food safety. Relevant bodies should work on addressing the issue of high rate of vegetable and fruit contamination in the study area.

Good manufacturing practices of minimally processed vegetables reduce contamination with pathogenic microorganisms

Consumption of ready-to-eat (RTE) vegetables is quick, easy and healthy, especially when eaten without cooking. However, they might be a source of foodborne pathogenic microorganisms. The objective of this study was to evaluate the microbiological and parasitological contamination of fresh RTE vegetables produced in agroindustries in the Federal District of Brazil (FD), and to correlate contamination with good manufacturing practices (GMP). One hundred and three samples of RTE vegetables were collected from six agroindustries for microbiology and parasitology analyses and correlate with GMP; 54 samples were collected from three hypermarkets for parasitological evaluation. None of the samples analyzed were positive for Salmonella sp. and for thermotolerant coliforms, but they were contaminated with total coliforms. All analyzed samples were contaminated with at least one species of enteroparasistes or commensals, which were identified as Ascaris sp., Balantidium coli, Entamoeba histolytica/dispar, Hookworm, Strongyloides sp., Trichuris sp., Entamoeba sp., eggs and larvae of Nematoda, insects and fungi. Agroindustries that adopted GMP showed less contamination with helminths. RTE vegetables sold in hypermarkets of the FD are unfit for human consumption. It is important to guide farmers in the FD on the need to adopt good practices in the production and processing of vegetables to reduce the microbial contamination.

Prevalence of parasitic contamination of raw vegetables in Nakhon Si Thammarat province, southern Thailand

Background

Soil-transmitted helminth (STH) infections are major public health problems in poor and developing countries that require fecal contamination of the environment for transmission. The consumption of raw vegetables without proper washing is one of the main routes of intestinal parasite acquisition. Therefore, this study was designed to detect the prevalence of intestinal parasitic contamination in commonly consumed raw vegetables sold in three central open-air markets in Nakhon Si Thammarat province, southern Thailand.

Methods

A total of 265 fresh vegetable samples consisting of peppermint, lettuce, coriander, leek, gotu kola, celery, Chinese cabbage, culantro, Thai basil, and Chinese morning glory were purchased from three central open-air markets in the Mueang, Thasala and Sichon districts from December 2016 to March 2017. Each sample was washed with physiological saline, shaken for 15 min, and then allowed to sediment. Finally, sedimentation was performed via the sedimentation concentration technique and examined using light microscopy for the detection of pathogenic parasites.

Results

The overall prevalence of parasitic contamination was 35.1% (93/265). The most predominant parasite was hookworms (42.9%), followed by Strongyloides stercoralis (10.6%), Trichuris trichiura (2.6%), Ascaris lumbricoides (2.6%), and Toxocara spp. (2.6%). The highest level of contamination was found in celery, with a prevalence rate of 63.3% (19/30), while the lowest contamination level was found in Chinese morning glory, with a prevalence rate of 2.0% (2/30). The prevalence of intestinal parasite contamination in Mueang district (51.5%) was significantly higher than that in Thasala district (17.9%) and Sichon district (30.6%) (P < 0.001).

Conclusion

The results of the present study demonstrate that consumption of vegetables with parasite contamination in this area represents a potential route for the transmission of parasitic infection, particularly hookworm infection. Therefore, it is necessary for health authorities to educate consumers about the proper washing of vegetables prior to consumption. Preventive methods such as wearing gloves and washing hands after handling vegetables should also be advocated to sellers who are at risk of acquiring STH infections via skin penetration.

Giardia: an under-reported foodborne parasite

Foodborne zoonotic pathogens are a serious public health issue and result in significant global economic losses. Despite their importance to public health, epidemiological data on foodborne diseases including giardiasis caused by the enteric parasite, Giardia duodenalis, are lacking. This parasite is estimated to cause ∼28.2 million cases of diarrhoea each year due to contamination of food, but very few foodborne outbreaks have been documented due to the limitations of current detection as well as surveillance methods. The current method for the recovery of Giardia cysts from food matrices using immunomagnetic separation requires further standardisation and cost reduction before it can be widely used. It also should incorporate downstream molecular procedures for genotyping, and traceback and viability analyses. Foodborne giardiasis can be potentially controlled through improvements in national disease surveillance systems and the establishment of Hazard Analysis and Critical Control Point interventions across the food chain. Studies are needed to assess the true prevalence and public health impact of foodborne giardiasis.

No molecular epidemiological evidence supporting household transmission of zoonotic Giardia duodenalis and Cryptosporidium spp. from pet dogs and cats in the province of Álava, Northern Spain

The role of pet dogs and cats as suitable source of human infections by the diarrheagenic protozoan parasites Giardia duodenalis and Cryptosporidium spp. has been a topic of intense debate for long time and still remains a largely unsolved problem. In this cross-sectional molecular epidemiological survey we attempted to investigate whether zoonotic (or zooanthroponotic) disease transmission was occurring among humans and domestic dogs and cats sharing the same spatial and temporal setting in both rural and urban areas of the province of Álava, Northern Spain. A total of 268 (including 179 human, 55 canine, and 34 feline) individual faecal specimens were obtained from 63 family households during February-March and November-December 2014. Detection of G. duodenalis cysts and Cryptosporidium spp. oocysts was achieved by direct fluorescence microscopy (DFAT) and PCR-based methods targeting the small subunit (SSU) ribosomal RNA gene of the parasites. Giardia-positive isolates were subsequently sub-genotyped at the glutamate dehydrogenase (GDH) and β-giardin (BG) genes. Overall, G. duodenalis infections were identified in 3.4% (6/179) of humans, 29% (16/55) of dogs, and 5.9% (2/34) of cats, respectively. Cryptosporidium spp. infections were detected in 1.1% (2/179) of humans, 5.5% (3/55) of dogs, and 8.8% (3/34) of cats, respectively. Simultaneous infections in human and canine/feline hosts by G. duodenalis or Cryptosporidium spp. were only demonstrated in a single household in which a cat and its owner tested positive for Cryptosporidium by DFAT, but this result could not be confirmed by SSU-PCR. Infections were homogeneously distributed among the studied human or animal populations irrespectively of their sex, age group, or geographical region of origin. Inadequate washing of raw vegetables and fruits was the only risk factor significantly associated to a higher likelihood of having human giardiosis/cryptosporidiosis. Molecular characterization of G. duodenalis isolates revealed the presence of sub-assemblage BIV in a single human isolate. All dog (n=3) and cat (n=2) isolates successfully genotyped were assigned to canine- and feline-specific assemblages C and F, respectively. No mixed assemblage or sub-assemblage infections could be demonstrated. Regarding Cryptosporidium, C. canis was found infecting dogs (n=2), and C. felis a single cat. Attempts to amplify and characterize Cryptosporidium human isolates failed repeatedly. Our results suggest that pet dogs and cats do not seem to play a significant role as suitable reservoirs of human giardiosis or cryptosporidiosis in the province of Álava. We conclude, therefore, that zoonotic transmission of giardiosis or cryptosporidiosis among pet dogs and cats and their owners in this geographical region is very likely a rare event.

Parasitic contamination of raw vegetables and fruits collected from selected local markets in Arba Minch town, Southern Ethiopia

Background

One way that people get infected with intestinal parasites is through the consumption of contaminated vegetables and fruits. This study aimed at determining the prevalence and predictors of parasitic contamination of fruits and vegetables collected from four local markets in Arba Minch town, Southern Ethiopia.

Methods

A cross-sectional study was conducted from 1 to 21 September 2014 to determine the level of parasitic contamination of fruits and vegetables sold in Arba Minch town. A total of 360 samples of different types of fruits and vegetables were soaked in physiological saline, followed by vigorous shaking with the aid of a mechanical shaker for 15 minutes and then examined using the sedimentation concentration technique.

Results

Out of the 360 samples examined, 196 (54.4%) were contaminated with at least one type of parasite. Ascaris lumbricoides (20.83%) was the most frequently detected parasite and Isospora belli (3.06%) was the least frequently detected one. It was also observed that decreased parasitic contamination was significantly associated with washing the products before displaying it for selling (P < 0.001).

Conclusions

The findings of this study provide evidence that there is a potentially high risk of acquiring parasitic infections from the consumption of raw vegetables and fruits in Arba Minch, Ethiopia. The authors believe that an effort should be made by the relevant bodies to reduce the rate of contamination of products with medically important parasites by educating the vendors and the community.

Electronic supplementary material

The online version of this article (doi:10.1186/s40249-016-0226-6) contains supplementary material, which is available to authorized users.

Fresh fruits, vegetables and mushrooms as transmission vehicles for Echinococcus multilocularis in highly endemic areas of Poland: reply to concerns

Echinococcus multilocularis is a tapeworm that may cause alveolar echinococcosis (AE), one of the most dangerous parasitic zoonoses. As in the case of other foodborne diseases, unwashed fruits and vegetables, contaminated with dispersed forms of E. multilocularis, may serve as an important transmission route for this parasite. In this article, we reply to the incorrect interpretation of results of our study concerning the detection of E. multilocularis DNA in fresh fruit, vegetable and mushroom samples collected from the highly endemic areas of the Warmia-Masuria Province, Poland, to dispel any doubts. The accusations formulated by the commentators concerning our paper are unfounded; moreover, these commentators demand information which was beyond the purview of our study. Making generalisations and drawing far-reaching conclusions from our work is also unjustified. The majority of positive samples were found in only a few hyperendemic communities; this information corresponds with the highest number of both infected foxes and AE cases in humans recorded in this area. Our findings indicate that E. multilocularis is present in the environment and may create a potential risk for the inhabitants. These people should simply be informed to wash fruits and vegetables before eating. No additional far-reaching conclusions should be drawn from our data. We believe these commentators needlessly misinterpreted our results and disseminated misleading information. Nevertheless, we would like to encourage any readers simply to contact us if any aspects of our study are unclear.

A tale of two communities: intestinal polyparasitism among Orang Asli and Malay communities in rural Terengganu, Malaysia

Background

Intestinal parasitic infections (IPIs) are still major health problems in many developing countries including Malaysia, particularly in the poor and socioeconomically deprived rural and remote communities in Peninsular Malaysia. This study was conducted to determine the prevalence of IPIs and to identify the key factors associated with intestinal polyparasitism as well as to evaluate the knowledge, attitude and practices (KAP) on IPIs among rural Orang Asli and Malay communities in Terengganu, Malaysia.

Methods

A cross-sectional study was conducted among 340 participants (165 Orang Asli and 175 Malay) aged ≤ 15 years from the Hulu Terengganu and Kemaman districts of Terengganu. Faecal samples were examined for the presence of intestinal parasites by using direct smear, formalin-ether sedimentation, trichrome stain, modified Ziehl Neelsen stain, in vitro cultivation in Jones’ medium, Kato Katz and Harada Mori techniques. Demographic, socioeconomic, environmental and behavioural information of the participants and their KAP for IPIs were collected by using a pre-tested questionnaire.

Results

Overall, 149 (90.3 %) Orang Asli and 43 (24.6 %) Malay children were infected by at least one parasite species. The overall prevalences of intestinal polyparasitism among the Orang Asli and Malay were 68.5 % (113/165) and 14.3 % (25/175), respectively. Multiple logistic regression analysis showed that using unsafe water supply as a source for drinking water, the presence of domestic animals, not wearing shoes when outside, not washing vegetables before consumption, not washing hands after playing with soil, indiscriminate defecation and the low level of mother’s education were the key risk factors for intestinal polyparasitism among the Orang Asli, while working mothers and the presence of domestic animals were the risk factors among the Malay children. Almost all the Malays were well aware about the IPIs while Orang Asli respondents had a poor level of related awareness.

Conclusions

This study demonstrates that IPIs are highly prevalent in rural Terengganu, Malaysia. Community awareness about IPIs was found to be imperative in protecting Malay children from these infections. An integrated control programme for the prevention and control of IPIs is highly recommended for these communities, with a special emphasis on the Orang Asli population.

Standardization of a method for the detection of helminth eggs and larvae in lettuce

Despite reports that food-borne parasitic infections have been increasing worldwide, the methodologies employed to detect food contamination by helminths are still largely based on methodologies used to detect these pathogens in feces and water. This study sought to improve the diagnosis of parasitic contaminants in lettuce by standardizing a method for detecting helminth eggs and larvae and estimating their percentage of recovery. Sanitized lettuces were artificially contaminated with different amounts of Ascaris suum and hookworm eggs and larvae. To standardize the method, we tested liquid extractors, vegetable washing steps, and spontaneous sedimentation times. Higher percentages of egg and larvae recovery were obtained using 1 M glycine as the liquid extractor, manual shaking for 3 min and 2 h of sedimentation. Five different levels of artificial contamination (ten replicates each; n = 50) were tested using these standardized conditions, yielding an average recovery of 62.6 % (±20.2), 51.9 % (±20.0), and 50.0 % (±27.3) for A. suum eggs, hookworm eggs, and larvae, respectively. Tests were performed with a different matrix to evaluate the performance of the method. Furthermore, collaborative analytical studies performed by different laboratories produced satisfactory results. The method for the identification of helminth eggs and larvae proposed in this study proved to be simpler and more efficient than previously published procedures, thereby demonstrating its potential contribution to health surveillance and epidemiological studies.

Parasitic contamination of fresh vegetables sold at central markets in Khartoum state, Sudan

Background

Fresh vegetables are considered as vital nutrients of a healthy diet as they supply the body with essential supplements. The consumption of raw vegetables is the main way for transmission of intestinal parasitic organisms. This study was aimed at detecting the parasitic contamination in fresh vegetables sold in two central open-aired markets in Khartoum state, Sudan.

Methods

In this prospective cross-sectional study, a total of 260 fresh vegetable samples and 50 water samples used to sprinkle vegetable(s) were collected from two central open-aired markets (namely; Elshaabi and Central markets) during November 2011 to May 2012. The samples were microscopically examined for detection of parasitic life forms using standardized parasitological techniques for protozoans and helminthes worms.

Results

Of the 260 fresh vegetable samples, 35 (13.5 %) were microscopically positive for intestinal parasites whereas 7/50 (14 %) of water samples used to sprinkle vegetable(s) were found positives. Remarkably, high level of contamination in fresh vegetable samples was recorded in lettuce (Lactuca sativa) 36.4 % (4/11) while cayenne pepper (Capsicum annuum) and cucumber (Cucumis sativus) were not contaminated. The identified protozoans and helminthes were Entamoeba histolytica/dispar, Entamoeba coli, Giardia lamblia, Ascaris lumbricoides, Strongyloides stercoralis, T. trichiura and hookworms. The most predominant parasite encountered was E. histolytica/dispar (42.9 %) whereas both T. trichiura and A. lumbricoides (2.9 %) were the least detected parasites. None of the fresh vegetables had single parasitic contamination. The highest percentages found in water samples used to sprinkle vegetable(s) was for Strongyloides larvae 60 % (3/5). It is worth-mentioned that the rate of contamination in Elshaabi market was higher compared with Central market. However, there was no significant correlation between the type of vegetables and existence of parasites in both markets and a high significant relationship was observed between the type of parasite and total prevalence in fresh vegetables (p = 0.000).

Conclusion

The study has identified a moderate rate of fresh vegetables contaminated with protozoan and helminthes. Contaminated fresh vegetables in central markets of Khartoum state may play a significant role in transmission of intestinal parasitic infections to humans, and the water used by greengrocers to sprinkle vegetable(s) can be implicated in vegetable contamination.

Parasitic contamination of commonly consumed fresh leafy vegetables in benha, egypt

This study evaluated the degree of parasitic contamination of vegetables which are commercialized and consumed fresh in Benha, Egypt. It included 530 vegetables: lettuce, watercress, parsley, green onion, and leek. Vegetables were collected randomly from markets within Benha. Samples were washed in saline, and the resulting washing solution was filtered and centrifuged to concentrate the parasitic stages. Sediments and supernatants were examined by iodine and modified Ziehl-Neelsen stained smears. Intestinal parasites were detected in 157/530 (29.6%) samples. Giardia lamblia cysts were the most prevalent parasite (8.8%) followed by Entamoeba spp. cysts (6.8%), Enterobius vermicularis eggs (4.9%), various helminth larvae (3.6%), Hymenolepis nana eggs (2.8%), Hymenolepis diminuta eggs (2.1%), and Ascaris lumbricoides eggs (0.6%). The highest contaminated vegetable was lettuce (45.5%) followed by watercress (41.3%), parsley (34.3%), green onion (16.5%), and leek (10.7%). These results indicate a significant seasonal variation (P < 0.05), with highest prevalence in summer (49%) and the lowest in winter (10.8%). These findings provide evidence for the high risk of acquiring parasitic infection from the consumption of raw vegetables in Benha, Egypt. Effective measures are necessary to reduce parasitic contamination of vegetables.

Molecular epidemiology of amoebiasis in Malaysia: highlighting the different risk factors of Entamoeba histolytica and Entamoeba dispar infections among Orang Asli communities

Currently, species-specific information on Entamoeba infections is unavailable in Malaysia and is restricted worldwide due to the re-description of pathogenic Entamoeba histolytica and non-pathogenic Entamoeba dispar and Entamoeba moshkovskii. Therefore, this cross-sectional study was conducted to provide the first known documented data on the true prevalence of these three species in western Malaysia using a molecular method. Another aim of this study was to determine the association of potential risk factors associated with each Entamoeba sp. A total of 500 stool samples from three Orang Asli tribes were randomly collected. The overall prevalence of E. histolytica, E. dispar and E. moshkovskii determined by microscopy was 18.6% (93/500). Molecular analysis revealed that while most Entamoeba-positive individuals were infected with E. dispar (13.4%), followed by E. histolytica (3.2%) and E. moshkovskii (1.0%), the present findings show low prevalence rates of mixed infections with E. histolytica and E. dispar (2%), E. dispar and E. moshkovskii (1.2%) and association infections of E. histolytica, E. dispar and E. moshkovskii (0.4%). Logistical regression analysis indicates that the dynamics of the transmission of the three Entamoeba spp. was different. Of six statistically significant variables observed in the univariate analysis, three were retained as significant risk factors for E. histolytica infection in the logistical regression model. These factors were (i) not washing hands after playing with soil or gardening (Odds ratio (OR)=4.7; 95% confidence level (CI)=1.38, 16.14; P=0.013), (ii) indiscriminate defecation in the river or bush (OR=5.7; 95% CI=1.46, 21.95; P=0.012) and (iii) close contact with domestic animals (OR=5.4; 95% CI=1.36, 2.51; P=0.017). However, subjects with family members who were infected with E. histolytica/E. dispar/E. moshkovskii (OR=3.8; 95 CI=2.11, 6.86; P<0.001) and those who consumed raw vegetables (OR=1.8; 95% CI=1.01, 3.23; P=0.047) were more likely to be infected with E. dispar. On the other hand, no associated factor was identified with E. moshkovskii infection. Nevertheless, diarrhoea (P=0.002) and other gastroenteritis symptoms (P<0.001) were only associated with E. histolytica infection. The present study provides new insight into the distribution and risk factors of E. histolytica, E. dispar and E. moshkovskii infections among Orang Asli communities in Malaysia. Identifying the different risk factors of E. histolytica and E. dispar infections will help in the planning specific strategies in the control and prevention of each infection in the communities. Moreover, it emphasises the need for molecular methods to determine the species-specific prevalence of Entamoeba spp.

Al-Mekhlafi H, Abdul Ghani MK, Osman E, Mohd Yasin A, Nordin A, Nor Azreen S, Md Salleh F, Ghazali N, Bernadus M, Moktar N. Prevalence and risk factors associated with Entamoeba histolytica/dispar/moshkovskii infection among three Orang Asli ethnic groups in Malaysia

BACKGROUND

Entamoeba histolytica/Entamoeba dispar/Entamoeba moshkovskii infection is still prevalent in rural Malaysia especially among Orang Asli communities. Currently, information on prevalence of this infection among different ethnic groups of Orang Asli is unavailable in Malaysia. To contribute to a better comprehension of the epidemiology of this infection, a cross-sectional study aimed at providing the first documented data on the prevalence and risk factors associated with E. histolytica/E. dispar/E. moshkovskii infection was carried out among three Orang Asli ethnic groups (Proto-Malay, Negrito, and Senoi) in selected villages in Negeri Sembilan, Perak, and Pahang states, Malaysia.

METHODS/FINDINGS

Faecal samples were examined by formalin-ether sedimentation and trichrome staining techniques. Of 500 individuals, 8.7% (13/150) of Proto-Malay, 29.5% (41/139) of Negrito, and 18.5% (39/211) of Senoi were positive for E. histolytica/E. dispar/E. moshkovskii, respectively. The prevalence of this infection showed an age-dependency relationship, with higher rates observed among those aged less than 15 years in all ethnic groups studied. Multivariate analysis confirmed that not washing hands after playing with soils or gardening and presence of other family members infected with E. histolytica/E. dispar/E. moshkovskii were significant risk factors of infection among all ethnic groups. However, eating with hands, the consumption of raw vegetables, and close contact with domestic animals were identified as significant risk factors in Senoi.

CONCLUSIONS

Essentially, the findings highlighted that E. histolytica/E. dispar/E. moshkovskii parasites are still prevalent in Malaysia. Further studies using molecular approaches to distinguish the morphologically identical species of pathogenic, E. histolytica from the non-pathogenic, E. dispar and E. moshkovskii are needed. The establishment of such data will be beneficial for the public health authorities in the planning and implementation of specific prevention and control strategies of this infection in different Orang Asli ethnic groups in Malaysia.

Risk factors for Entamoeba histolytica infection in an agricultural community in Hanam province, Vietnam

BACKGROUND

Entamoeba histolytica is an important protozoan intestinal infection in resource-poor settings, including Vietnam. The study objective was to assess risk factors of E. histolytica infection in a community in Vietnam, where wastewater and human excreta are used in agriculture. A case-control study was conducted among residents of Hanam province, Northern Vietnam. Cases (n = 46) infected with E. histolytica and non-infected controls (n = 138) were identified in a cross-sectional survey among 794 randomly selected individuals and matched for age, sex and place of residence. Potential risk factors including exposure to human and animal excreta and household wastewater were assessed with a questionnaire.

RESULTS

People from households with an average socio-economic status had a much higher risk of E. histolytica infection (odds ratio [OR]=4.3, 95% confidence interval [CI]: 1.3-14.0) compared with those from households with a good socioeconomic status. Those individuals who never or rarely used soap for hand washing had a 3.4 times higher risk for infection (OR=3.4, 95% CI: 1.1-10.0), compared to those who used always soap. In contrast, none of the factors related to use of human or animal excreta was statistically significant associated with E. histolytica infection. People having close contact with domestic animals presented a greater risk of E. histolytica infection (OR = 5.9, 95% CI: 1.8-19.0) than those without animal contact. E. histolytica infection was not associated with direct contact with Nhue river water, pond water and household's sanitary conditions, type of latrine or water source used.

CONCLUSIONS

Our study suggests that in settings where human and animal excreta and Nhue River water are intensively used in agriculture, socio-economic and personal hygiene factors determine infection with E. histolytica, rather than exposure to human and animal excreta in agricultural activities.