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Asadi P, Zarei Z, Mohebali M, Alizadeh Z, Najafi F, Izadi *S, Heidari Z. Intestinal Parasitic Infections in People Referring to the Central Laboratory of Meshkin Shahr County, Ardabil Province, Iran. IRANIAN JOURNAL OF PARASITOLOGY 2024; 19:105-112. [PMID: 38654952 PMCID: PMC11033542 DOI: 10.18502/ijpa.v19i1.15217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/04/2023] [Indexed: 04/26/2024]
Abstract
Background Intestinal parasitic infections are still a considerable global public health problem. We aimed to determine the frequency of intestinal parasitic infections among people referring to the central laboratory of Meshkin Shahr City, Ardabil Province, Iran. Methods In this cross-sectional survey, 460 fecal samples were collected randomly from persons referred to the central laboratory of Meshkin Shahr City, from January to June 2022. The samples were examined by direct wet-mount, Trichrome and modified Ziehl-Neelsen staining, formalin ethyl acetate sedimentation, and agar plate culture. Results The frequency of intestinal parasites was 15.7% (72 out of 460 cases), with some people with numerous intestinal parasites. The frequency of protozoan infections (13.9%) was higher than the helminthic infections (2.6%). Blastocystis spp. (8.1%) was the most prevalent detected intestinal protozoan. Entamoeba coli (5.7%), Dicrocoelium dendriticum (2.2%), Giardia lamblia (1.5%), Fasciola spp. (0.2%), and Hymenolepis nana (0.2%) were other detected parasites. Conclusion In- spite of betterment of the health condition in Iran and reduction of parasitic infection, intestinal parasitic infections are still a considerable public health issue in some parts of Iran.
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Affiliation(s)
- Pooria Asadi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zabihollah Zarei
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Alizadeh
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Najafi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - *Shahrokh Izadi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Heidari
- Zoonoses Research Center (ZRC), Ardabil University of Medical Sciences, Ardabil, Iran
- Department of Medical Microbiology, Parasitology and Immunology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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Legge H, Pullan RL, Sartorius B. Improved household flooring is associated with lower odds of enteric and parasitic infections in low- and middle-income countries: A systematic review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002631. [PMID: 38039279 PMCID: PMC10691699 DOI: 10.1371/journal.pgph.0002631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/27/2023] [Indexed: 12/03/2023]
Abstract
Enteric and parasitic infections such as soil-transmitted helminths cause considerable mortality and morbidity in low- and middle-income settings. Earthen household floors are common in many of these settings and could serve as a reservoir for enteric and parasitic pathogens, which can easily be transmitted to new hosts through direct or indirect contact. We conducted a systematic review and meta-analysis to establish whether and to what extent improved household floors decrease the odds of enteric and parasitic infections among occupants compared with occupants living in households with unimproved floors. Following the PRISMA guidelines, we comprehensively searched four electronic databases for studies in low- and middle-income settings measuring household flooring as an exposure and self-reported diarrhoea or any type of enteric or intestinal-parasitic infection as an outcome. Metadata from eligible studies were extracted and transposed on to a study database before being imported into the R software platform for analysis. Study quality was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale. In total 110 studies were eligible for inclusion in the systematic review, of which 65 were eligible for inclusion in the meta-analysis after applying study quality cut-offs. Random-effects meta-analysis suggested that households with improved floors had 0.75 times (95CI: 0.67-0.83) the odds of infection with any type of enteric or parasitic infection compared with household with unimproved floors. Improved floors gave a pooled protective OR of 0.68 (95CI: 0.58-0.8) for helminthic infections and 0.82 OR (95CI: 0.75-0.9) for bacterial or protozoan infections. Overall study quality was poor and there is an urgent need for high-quality experimental studies investigating this relationship. Nevertheless, this study indicates that household flooring may meaningfully contribute towards a substantial portion of the burden of disease for enteric and parasitic infections in low- and middle-income settings.
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Affiliation(s)
- Hugo Legge
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Rachel L. Pullan
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Benn Sartorius
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Department of Health Metric Sciences, University of Washington, Seattle, Washington, United States of America
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Razanajatovo IM, Andrianomiadana L, Habib A, Randrianarisoa MM, Razafimanjato H, Rakotondrainipiana M, Andriantsalama P, Randriamparany R, Andriamandimby SF, Vonaesch P, Sansonetti PJ, Lacoste V, Randremanana RV, Collard JM, Heraud JM. Factors Associated with Carriage of Enteropathogenic and Non-Enteropathogenic Viruses: A Reanalysis of Matched Case-Control Data from the AFRIBIOTA Site in Antananarivo, Madagascar. Pathogens 2023; 12:1009. [PMID: 37623969 PMCID: PMC10459613 DOI: 10.3390/pathogens12081009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 08/26/2023] Open
Abstract
Environmental Enteric Dysfunction (EED) is an associate driver of stunting in poor settings, and intestinal infections indirectly contribute to the pathophysiology underlying EED. Our work aimed at assessing whether enteric viral carriage is determinant to stunting. A total of 464 healthy and asymptomatic children, aged 2 to 5 years, were recruited, and classified as non-stunted, moderately stunted, or severely stunted. Among the recruited children, 329 stool samples were obtained and screened for enteric and non-enteric viruses by real-time polymerase chain reaction. We statistically tested for the associations between enteric viral and potential risk factors. Approximately 51.7% of the stool samples were positive for at least one virus and 40.7% were positive for non-enteric adenoviruses. No statistical difference was observed between virus prevalence and the growth status of the children. We did not find any statistically significant association between viral infection and most of the socio-demographic risk factors studied, except for having an inadequate food quality score or an over-nourished mother. In addition, being positive for Ascaris lumbricoides was identified as a protective factor against viral infection. In conclusion, we did not find evidence of a direct link between stunting and enteropathogenic viral carriage in our population.
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Affiliation(s)
- Iony Manitra Razanajatovo
- Virology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (I.M.R.); (H.R.); (S.F.A.); (V.L.)
| | - Lova Andrianomiadana
- Experimental Bacteriology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar (A.H.); (J.-M.C.)
| | - Azimdine Habib
- Experimental Bacteriology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar (A.H.); (J.-M.C.)
| | - Mirella Malala Randrianarisoa
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (M.M.R.); (M.R.); (P.A.); (R.R.); (R.V.R.)
| | - Helisoa Razafimanjato
- Virology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (I.M.R.); (H.R.); (S.F.A.); (V.L.)
| | - Maheninasy Rakotondrainipiana
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (M.M.R.); (M.R.); (P.A.); (R.R.); (R.V.R.)
| | - Prisca Andriantsalama
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (M.M.R.); (M.R.); (P.A.); (R.R.); (R.V.R.)
| | - Ravaka Randriamparany
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (M.M.R.); (M.R.); (P.A.); (R.R.); (R.V.R.)
| | - Soa Fy Andriamandimby
- Virology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (I.M.R.); (H.R.); (S.F.A.); (V.L.)
| | - Pascale Vonaesch
- Department of Fundamental Microbiology, University of Lausanne, 1002 Lausanne, Switzerland;
- Unité de Pathogénie Microbienne Moléculaire, Institut Pasteur, 75015 Paris, France
| | | | - Vincent Lacoste
- Virology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (I.M.R.); (H.R.); (S.F.A.); (V.L.)
| | - Rindra Vatosoa Randremanana
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (M.M.R.); (M.R.); (P.A.); (R.R.); (R.V.R.)
| | - Jean-Marc Collard
- Experimental Bacteriology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar (A.H.); (J.-M.C.)
| | - Jean-Michel Heraud
- Virology Unit, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar; (I.M.R.); (H.R.); (S.F.A.); (V.L.)
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Vonaesch P, Billy V, Mann AE, Morien E, Habib A, Collard JM, Dédé M, Kapel N, Sansonetti PJ, Parfrey LW. The eukaryome of African children is influenced by geographic location, gut biogeography, and nutritional status. MICROLIFE 2023; 4:uqad033. [PMID: 37680753 PMCID: PMC10481997 DOI: 10.1093/femsml/uqad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/17/2023] [Indexed: 09/09/2023]
Abstract
Eukaryotes have historically been studied as parasites, but recent evidence suggests they may be indicators of a healthy gut ecosystem. Here, we describe the eukaryome along the gastrointestinal tract of children aged 2-5 years and test for associations with clinical factors such as anaemia, intestinal inflammation, chronic undernutrition, and age. Children were enrolled from December 2016 to May 2018 in Bangui, Central African Republic and Antananarivo, Madagascar. We analyzed a total of 1104 samples representing 212 gastric, 187 duodenal, and 705 fecal samples using a metabarcoding approach targeting the full ITS2 region for fungi, and the V4 hypervariable region of the 18S rRNA gene for the overall eukaryome. Roughly, half of all fecal samples showed microeukaryotic reads. We find high intersubject variability, only a handful of taxa that are likely residents of the gastrointestinal tract, and frequent co-occurrence of eukaryotes within an individual. We also find that the eukaryome differs between the stomach, duodenum, and feces and is strongly influenced by country of origin. Our data show trends towards higher levels of Fusarium equiseti, a mycotoxin producing fungus, and lower levels of the protist Blastocystis in stunted children compared to nonstunted controls. Overall, the eukaryome is poorly correlated with clinical variables. Our study is of one of the largest cohorts analyzing the human intestinal eukaryome to date and the first to compare the eukaryome across different compartments of the gastrointestinal tract. Our results highlight the importance of studying populations across the world to uncover common features of the eukaryome in health.
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Affiliation(s)
- Pascale Vonaesch
- Unité de Pathogénie Microbienne Moléculaire, Institut Pasteur, 25-28 Rue du Dr Roux, 75015 Paris, France
| | - Vincent Billy
- Departments of Botany and Zoology, and Biodiversity Research Centre, University of British Columbia, 3200-6270 University Boulevard, V6T1Z4 Vancouver, Canada
| | - Allison E Mann
- Departments of Botany and Zoology, and Biodiversity Research Centre, University of British Columbia, 3200-6270 University Boulevard, V6T1Z4 Vancouver, Canada
| | - Evan Morien
- Departments of Botany and Zoology, and Biodiversity Research Centre, University of British Columbia, 3200-6270 University Boulevard, V6T1Z4 Vancouver, Canada
| | - Azimdine Habib
- Unité de Bactériologie Expérimentale, Institut Pasteur de Madagascar, BP1274 Ambatofotsikely Avaradoha 101 Antananarivo, Madagascar
| | - Jean-Marc Collard
- Unité de Bactériologie Expérimentale, Institut Pasteur de Madagascar, BP1274 Ambatofotsikely Avaradoha 101 Antananarivo, Madagascar
| | - Michel Dédé
- Laboratoire d’Analyse médicale, Institut Pasteur de Bangui, Avenue De Independence Bangui, 923 Central African Republic
| | - Nathalie Kapel
- Laboratoire de Coprologie Fonctionnelle, Assistance Publique- Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, 47-83 Bd de l’Hôpital, 75013 Paris, France
| | - Philippe J Sansonetti
- Unité de Pathogénie Microbienne Moléculaire, Institut Pasteur, 25-28 Rue du Dr Roux, 75015 Paris, France
| | - Laura Wegener Parfrey
- Departments of Botany and Zoology, and Biodiversity Research Centre, University of British Columbia, 3200-6270 University Boulevard, V6T1Z4 Vancouver, Canada
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Razafiarimanga ZN, Yao YBK, Rajerison M, Randriamampianina LJ, Rahelinirina S, Rakotoarison R, Alexandra B, Elisoa H, Pascal H, Ronan J. Risk factors for intestinal parasite portage in an informal suburb on the West coast of Madagascar. Parasite Epidemiol Control 2022; 19:e00267. [PMID: 36065443 PMCID: PMC9440058 DOI: 10.1016/j.parepi.2022.e00267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 06/21/2022] [Accepted: 08/15/2022] [Indexed: 10/31/2022] Open
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Stunted children display ectopic small intestinal colonization by oral bacteria, which cause lipid malabsorption in experimental models. Proc Natl Acad Sci U S A 2022; 119:e2209589119. [PMID: 36197997 PMCID: PMC9573096 DOI: 10.1073/pnas.2209589119] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Environmental enteric dysfunction (EED) is an inflammatory syndrome postulated to contribute to stunted child growth and to be associated with intestinal dysbiosis and nutrient malabsorption. However, the small intestinal contributions to EED remain poorly understood. This study aimed to assess changes in the proximal and distal intestinal microbiota in the context of stunting and EED and to test for a causal role of these bacterial isolates in the underlying pathophysiology. We performed a cross-sectional study in two African countries recruiting roughly 1,000 children aged 2 to 5 years and assessed the microbiota in the stomach, duodenum, and feces. Upper gastrointestinal samples were obtained from stunted children and stratified according to stunting severity. Fecal samples were collected. We then investigated the role of clinical isolates in EED pathophysiology using tissue culture and animal models. We find that small intestinal bacterial overgrowth (SIBO) is extremely common (>80%) in stunted children. SIBO is frequently characterized by an overgrowth of oral bacteria, leading to increased permeability and inflammation and to replacement of classical small intestinal strains. These duodenal bacterial isolates decrease lipid absorption in both cultured enterocytes and mice, providing a mechanism by which they may exacerbate EED and stunting. Further, we find a specific fecal signature associated with the EED markers fecal calprotectin and alpha-antitrypsin. Our study shows a causal implication of ectopic colonization of oral bacterial isolated from the small intestine in nutrient malabsorption and gut leakiness in vitro. These findings have important therapeutic implications for modulating the microbiota through microbiota-targeted interventions.
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Vonaesch P, Winkel M, Kapel N, Nestoret A, Barbot-Trystram L, Pontoizeau C, Barouki R, Rakotondrainipiana M, Kandou K, Andriamanantena Z, Andrianonimiadana L, Habib A, Rodriguez-Pozo A, Hasan M, Vigan-Womas I, Collard JM, Gody JC, Djorie S, Sansonetti PJ, Randremanana RV. Putative Biomarkers of Environmental Enteric Disease Fail to Correlate in a Cross-Sectional Study in Two Study Sites in Sub-Saharan Africa. Nutrients 2022; 14:nu14163312. [PMID: 36014817 PMCID: PMC9412633 DOI: 10.3390/nu14163312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/07/2022] [Accepted: 08/10/2022] [Indexed: 11/30/2022] Open
Abstract
Environmental enteric dysfunction (EED) is an elusive, inflammatory syndrome of the small intestine thought to be associated with enterocyte loss and gut leakiness and lead to stunted child growth. To date, the gold standard for diagnosis is small intestine biopsy followed by histology. Several putative biomarkers for EED have been proposed and are widely used in the field. Here, we assessed in a cross-sectional study of children aged 2–5 years for a large set of biomarkers including markers of protein exudation (duodenal and fecal alpha-1-antitrypsin (AAT)), inflammation (duodenal and fecal calprotectin, duodenal, fecal and blood immunoglobulins, blood cytokines, C-reactive protein (CRP)), gut permeability (endocab, lactulose-mannitol ratio), enterocyte mass (citrulline) and general nutritional status (branched-chain amino acids (BCAA), insulin-like growth factor) in a group of 804 children in two Sub-Saharan countries. We correlated these markers with each other and with anemia in stunted and non-stunted children. AAT and calprotectin, CRP and citrulline and citrulline and BCAA correlated with each other. Furthermore, BCAA, citrulline, ferritin, fecal calprotectin and CRP levels were correlated with hemoglobin levels. Our results show that while several of the biomarkers are associated with anemia, there is little correlation between the different biomarkers. Better biomarkers and a better definition of EED are thus urgently needed.
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Affiliation(s)
- Pascale Vonaesch
- Unité de Pathogénie Microbienne, Institut Pasteur, 25-28 Rue du Dr Roux, 75015 Paris, France
- Department of Fundamental Microbiology, University of Lausanne, Campus UNIL-Sorge, 1015 Lausanne, Switzerland
- Human and Animal Health Unit, Swiss Tropical and Public Health Institute & University of Basel, Kreuzstrasse 2, 4123 Allschwil, Switzerland
- Correspondence:
| | - Munir Winkel
- Department of Fundamental Microbiology, University of Lausanne, Campus UNIL-Sorge, 1015 Lausanne, Switzerland
| | - Nathalie Kapel
- Service de Coprologie Fonctionnelle, Hôpital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, 47-83 boulevard de l’Hôpital, 75013 Paris, France
| | - Alison Nestoret
- Service de Coprologie Fonctionnelle, Hôpital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, 47-83 boulevard de l’Hôpital, 75013 Paris, France
| | - Laurence Barbot-Trystram
- Service de Coprologie Fonctionnelle, Hôpital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, 47-83 boulevard de l’Hôpital, 75013 Paris, France
| | - Clément Pontoizeau
- Laboratoire de biochimie métabolique, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, 149 Rue de Sèvres, 75015 Paris, France
| | - Robert Barouki
- Laboratoire de biochimie métabolique, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, 149 Rue de Sèvres, 75015 Paris, France
| | - Maheninasy Rakotondrainipiana
- Unité d’Epidémiologie et de Recherche Clinique, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
| | - Kaleb Kandou
- Unité d’Epidémiologie, Institut Pasteur de Bangui, Bangui BP 923, Central African Republic
| | - Zo Andriamanantena
- Unité d’Immunologie des Maladies Infectieuses, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
| | - Lova Andrianonimiadana
- Unité de Bactériologie Expérimentale, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
| | - Azimdine Habib
- Unité de Bactériologie Expérimentale, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
| | - Andre Rodriguez-Pozo
- Unité de Pathogénie Microbienne, Institut Pasteur, 25-28 Rue du Dr Roux, 75015 Paris, France
- Cytometry and Biomarkers Unit of Technology and Service, Institut Pasteur and Université Paris Cité, 25-28 Rue du Dr Roux, 75015 Paris, France
| | - Milena Hasan
- Cytometry and Biomarkers Unit of Technology and Service, Institut Pasteur and Université Paris Cité, 25-28 Rue du Dr Roux, 75015 Paris, France
| | - Inès Vigan-Womas
- Unité d’Immunologie des Maladies Infectieuses, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
| | - Jean-Marc Collard
- Unité de Bactériologie Expérimentale, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
| | | | - Serge Djorie
- Unité d’Epidémiologie, Institut Pasteur de Bangui, Bangui BP 923, Central African Republic
| | - Philippe J. Sansonetti
- Unité de Pathogénie Microbienne, Institut Pasteur, 25-28 Rue du Dr Roux, 75015 Paris, France
| | - Rindra Vatosoa Randremanana
- Unité d’Epidémiologie et de Recherche Clinique, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
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Tokijoh NI, Bakar AA, Othman N, Noordin R, Saidin S. Assessing the prevalence and risk factors associated with Entamoeba complex infection among the Orang Asli school children in Perak, Malaysia through molecular approach. Parasitol Int 2022; 91:102638. [PMID: 35926695 DOI: 10.1016/j.parint.2022.102638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/04/2022] [Accepted: 07/28/2022] [Indexed: 10/16/2022]
Abstract
This study performed a cross-sectional investigation on the prevalence of Entamoeba complex infection comprising Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii and their associated risk factors among the Orang Asli school children in three districts in Perak, Malaysia. Stool samples collected from 544 school children aged between 7 and 12 years old were examined through the nested multiplex PCR assay. The univariate and multivariate regression analyses were then carried out to determine the risk factor associated with Entamoeba complex infection. The overall prevalence of Entamoeba complex infections (E. histolytica, E. dispar and E. moshkovskii) was 21.3% (116/544). Most positive school children were infected with E. moshkovskii (10.7%; 58/544), followed by E. dispar (9.0%; 49/544) and E. histolytica (5.0%; 27/544). Not washing their hands after using the toilet was identified as the only significant risk factor for E. histolytica. The significant risk factors associated with E. moshkovskii infection included children within the age of 10-12 years old, with high BMI, living with working and non-educated mothers, no toilet in the house, not washing their hands after using the toilet, and fever. On the other hand, drinking water from the river, well, and rain was associated with a decreased risk of E. dispar infection. In conclusion, this study showed a high prevalence of Entamoeba spp. infections among the Orang Asli school children in Perak, Malaysia. Addressing the identified risk factors coupled with a holistic approach in breaking the transmission of Entamoeba complex can help improve their quality of life.
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Affiliation(s)
- Nur Insyirah Tokijoh
- Department of Biology, Faculty of Science and Mathematics, Universiti Pendidikan Sultan Idris, 35900 Tanjung Malim, Perak, Malaysia
| | - Adibah Abu Bakar
- Department of Biology, Faculty of Science and Mathematics, Universiti Pendidikan Sultan Idris, 35900 Tanjung Malim, Perak, Malaysia.
| | - Nurulhasanah Othman
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800 USM, Penang, Malaysia.
| | - Rahmah Noordin
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800 USM, Penang, Malaysia
| | - Syazwan Saidin
- Department of Biology, Faculty of Science and Mathematics, Universiti Pendidikan Sultan Idris, 35900 Tanjung Malim, Perak, Malaysia.
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Randrianarisoa MM, Rakotondrainipiana M, Randriamparany R, Andriantsalama PV, Randrianarijaona A, Habib A, Robinson A, Raharimalala L, Hunald FA, Etienne A, Collard JM, Randrianirina F, Barouki R, Pontoizeau C, Nestoret A, Kapel N, Sansonetti P, Vonaesch P, Randremanana RV. Factors associated with anaemia among preschool- age children in underprivileged neighbourhoods in Antananarivo, Madagascar. BMC Public Health 2022; 22:1320. [PMID: 35810292 PMCID: PMC9271242 DOI: 10.1186/s12889-022-13716-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anaemia occurs in children when the haemoglobin level in the blood is less than the normal (11 g/dL), the consequence is the decrease of oxygen quantity in the tissues. It is a prevalent public health problem in many low-income countries, including Madagascar, and data on risk factors are lacking. We used existing data collected within the pathophysiology of environmental enteric dysfunction (EED) in Madagascar and the Central African Republic project (AFRIBIOTA project) conducted in underprivileged neighbourhoods of Antananarivo to investigate the factors associated with anaemia in children 24 to 59 months of age. METHODS Children included in the AFRIBIOTA project in Antananarivo for whom data on haemoglobin and ferritin concentrations were available were included in the study. Logistic regression modelling was performed to identify factors associated with anaemia. RESULTS Of the 414 children included in this data analysis, 24.4% were found to suffer from anaemia. We found that older children (adjusted OR: 0.95; 95% CI: 0.93-0.98) were less likely to have anaemia. Those with iron deficiency (adjusted OR: 6.1; 95% CI: 3.4-11.1) and those with a high level of faecal calprotectin (adjusted OR: 2.5; 95% CI: 1.4-4.4) were more likely to have anaemia than controls. CONCLUSIONS To reduce anaemia in the children in this underprivileged area, more emphasis should be given to national strategies that improve children's dietary quality and micronutrient intake. Furthermore, existing measures should be broadened to include measures to reduce infectious disease burden.
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Affiliation(s)
- Mirella Malala Randrianarisoa
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Maheninasy Rakotondrainipiana
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Ravaka Randriamparany
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Prisca Vega Andriantsalama
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Anjasoa Randrianarijaona
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Azimdine Habib
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Annick Robinson
- Centre Hospitalier Universitaire Mère Enfant de Tsaralalana, rue Patrice Lumumba, Rue Mabizo S, 101, Antananarivo, Madagascar
| | - Lisette Raharimalala
- Centre de Santé Maternelle et Infantile de Tsaralalana, Lalana Andriantsilavo, 101, Antananarivo, Madagascar
| | - Francis Allen Hunald
- Service de Chirurgie pédiatrique, Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, BP 4150, Ampefiloha, 101, Antananarivo, Madagascar
| | - Aurélie Etienne
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Jean-Marc Collard
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar.,The Center for Microbes, Development and Health, Institut Pasteur of Shanghai/Chinese Academy of Sciences, Shanghai, China
| | - Frédérique Randrianirina
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar
| | - Robert Barouki
- Laboratoire de Biochimie Métabolomique et Protéomique, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Clement Pontoizeau
- Laboratoire de Biochimie Métabolomique et Protéomique, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Alison Nestoret
- Service de Coprologie Fonctionnelle, Hôpital Salpétrière Paris, Paris, France
| | - Nathalie Kapel
- Service de Coprologie Fonctionnelle, Hôpital Salpétrière Paris, Paris, France
| | - Philippe Sansonetti
- Unité de Pathogénie Microbienne, Institut Pasteur, 25-28 Rue du Dr Roux, Paris, France
| | - Pascale Vonaesch
- Unité de Pathogénie Microbienne, Institut Pasteur, 25-28 Rue du Dr Roux, Paris, France.,Department of Fundamental Microbiology, University of Lausanne, Campus UNIL-Sorge, 1015, Lausanne, Switzerland
| | - Rindra Vatosoa Randremanana
- Institut Pasteur de Madagascar, Unité Epidémiologie et de Recherche Clinique, BP 1274, Ambatofotsikely, 101, Antananarivo, Madagascar.
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10
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Andriamanantena Z, Randrianarisaona F, Rakotondrainipiana M, Andriantsalama P, Randriamparany R, Randremanana R, Randrianirina F, Novault S, Duffy D, Huetz F, Hasan M, Schoenhals M, Sansonetti PJ, Vonaesch P, Vigan-Womas I. Changes in Systemic Regulatory T Cells, Effector T Cells, and Monocyte Populations Associated With Early-Life Stunting. Front Immunol 2022; 13:864084. [PMID: 35720335 PMCID: PMC9202423 DOI: 10.3389/fimmu.2022.864084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
Stunting and environmental enteric dysfunction (EED) may be responsible for altered gut and systemic immune responses. However, their impact on circulating immune cell populations remains poorly characterized during early life. A detailed flow cytometry analysis of major systemic immune cell populations in 53 stunted and 52 non-stunted (2 to 5 years old) children living in Antananarivo (Madagascar) was performed. Compared to age-matched non-stunted controls, stunted children aged 2-3 years old had a significantly lower relative proportion of classical monocytes. No significant associations were found between stunting and the percentages of effector T helper cell populations (Th1, Th2, Th17, Th1Th17, and cTfh). However, we found that HLA-DR expression (MFI) on all memory CD4+ or CD8+ T cell subsets was significantly lower in stunted children compared to non-stunted controls. Interestingly, in stunted children compared to the same age-matched non-stunted controls, we observed statistically significant age-specific differences in regulatory T cells (Treg) subsets. Indeed, in 2- to 3-year-old stunted children, a significantly higher percentage of memory Treg, whilst a significantly lower percentage of naive Treg, was found. Our results revealed that both innate and adaptive systemic cell percentages, as well as activation status, were impacted in an age-related manner during stunting. Our study provides valuable insights into the understanding of systemic immune system changes in stunted children.
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Affiliation(s)
- Zo Andriamanantena
- Immunology of Infectious Diseases Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | | | | | - Prisca Andriantsalama
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Ravaka Randriamparany
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Rindra Randremanana
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | | | - Sophie Novault
- Cytometry and Biomarkers Unit of Technology and Service, Université de Paris, Institut Pasteur, Paris, France
| | - Darragh Duffy
- Translational Immunology Lab, Department of Immunology, Université de Paris, Institut Pasteur, Paris, France
| | - François Huetz
- Antibodies in Therapy and Pathology Unit, Institut Pasteur, Paris, France
| | - Milena Hasan
- Cytometry and Biomarkers Unit of Technology and Service, Université de Paris, Institut Pasteur, Paris, France
| | - Matthieu Schoenhals
- Immunology of Infectious Diseases Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | | | - Pascale Vonaesch
- Institut Pasteur, Molecular Microbial Pathogenesis Unit, Paris, France
| | - Inès Vigan-Womas
- Immunology of Infectious Diseases Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar,*Correspondence: Inès Vigan-Womas,
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