Prevalence of intestinal parasitic infections and their relation with socio-economic factors and hygienic habits in Tehran primary school students

Temporal and spatial patterns of Trichuris trichiura eggs: a potential threat to human health in Pakistan

This study investigates the presence of Trichuris trichiura eggs in soil samples collected from urban areas in Lahore, Pakistan. A total of 3600 soil samples were collected over two years from Lahore's urban regions. The detection of helminth eggs in these samples was performed using sodium hypochlorite (NaOCl) as a diagnostic technique. The study reveals an overall prevalence rate of T. trichiura at 0.97 % (35 out of 3600) in the contaminated soil samples from Lahore's slum areas. When analyzing the data by geographical areas, the study found the highest prevalence of T. trichiura in Allama Iqbal Town (1.83 %, 11 out of 600), followed by Samanabad (1.16 %, 7 out of 600), Wapda Town (1.00 %, 6 out of 600), Gulberg (1.00 %, 6 out of 600), and Cantt (0.50 %, 3 out of 600). Conversely, Valencia Town had the lowest prevalence rate at 0.33 % (2 out of 600). However, these variations in prevalence rates were not statistically significant (p = 0.117). Prevalence rates of T. trichiura's eggs varied significantly across different sampling seasons (p>0.001). In autumn, a total of 900 soil samples were collected, with 19 samples (2.11 %) testing positive for T. trichiura. This rate was notably higher compared to the prevalence rates observed in winter, spring, and summer, which were 0.66 %, 0.22 %, and 0.88 %, respectively. Regarding the sampling months, the study observed a significantly higher prevalence during September (3.33 %, 10 out of 300), followed by October (2.33 %, 7 out of 300), and August (1.33 %, 4 out of 300). Prevalence rates gradually decreased in other months, ranging from 1 % to 0.33 % (3 to 1 out of 300), with no parasite detection in March (0 %, 0 out of 300) (p < 0.001). This research underscores soil contamination due to fecal waste and highlights public unawareness of parasite biology, driven by open defecation practices.

Distribution of the Intestinal Parasites According to Species and Gender in Patients Presented to the Microbiology Laboratory in a Tertiary Hospital, in Somalia Between January 2018 and October 2022

Purpose

In this study, it was aimed to determine the 5-year prevalence of intestinal parasites in patients admitted to the Microbiology laboratory of a tertiary hospital in Somalia. Intestinal parasites; Types of patients, age and sex of the patients, and the distribution by years were examined.

Patients and Methods

Stool samples were examined using wet preparation, native lugol and trichrome staining methods. Statistical analysis was performed using IBM SPSS V23 software and a P value of <0.05 was considered statistically significant. Tables and figures were used to show the results.

Results

One or more parasites were detected in 6766 of 56,824 stool samples examined. It was observed that Giardia lamblia had a higher prevalence than other parasites (60.84%) in a five-year period. Entamoeba histolytica (33.07%) second rank and Ascaris lumbricoides (3.18%) third rank according to their prevalence. When the distribution of the parasite population by gender is evaluated; no statistically significant difference was found (p = 0.235). When the frequency of parasites was evaluated according to age groups, it was seen that the prevalence of parasites between the ages of 0-15 was higher (45.5%) compared to other age groups. A statistically significant difference was found between the distribution of parasite groups according to age groups (p < 0.001).

Conclusion

Considering the effects of intestinal parasites on public health, it is still considered to be an important health problem for developing countries. It is thought that the frequency of parasitic diseases in society will decrease with the education of individuals, effective diagnosis, treatment, and implementation of preventive measures.

Prevalence of soil-transmitted helminths and associated risk factors among primary school children in Kandahar, Afghanistan: A cross-sectional analytical study

BACKGROUND

Soil-transmitted helminth (STH) infections are global health problem, especially in low-income countries. Main objectives of this study were to estimate the prevalence and intensity of STH and its risk factors among school children in Kandahar city of Afghanistan.

METHODOLOGY/PRINCIPAL FINDINGS

This was a school-based cross-sectional analytical study, with data collected during eight-month-period (May-December, 2022) from 6- and 12-years old school children in Kandahar city, Afghanistan. All the stool samples were examined by saline wet mount method and Kato-Katz technique. Data were analyzed by using descriptive statistics, Chi square test, and multivariate logistic regression. A total of 1275 children from eight schools of Kandahar city were included in this study. Mean age of these children was 8.3 years with 53.3% boys. The overall prevalence of any intestinal parasitic infection was 68.4%. The overall prevalence of STH infection was 39.1%, with Ascaris lumbricoides (29.4%) as the most prevalent STH species. Mean intensity of overall STH infection was 97.8. Multivariate logistic regression revealed playing barefoot (AOR 1.6, 95% CI 1.1-2.2), not washing hands after defecating and before eating (AOR 1.3, 95% CI 1.0-1.7), having untrimmed nails (AOR 1.4, 95% CI 1.1-1.8), and belonging to poor families (AOR 1.3, 95% CI 1.0-1.7) as the risk factors associated with the predisposition of school children for getting STH in Kandahar city of Afghanistan.

CONCLUSIONS/SIGNIFICANCE

There is high prevalence of STH among school children of Kandahar city in Afghanistan. Most of the risk factors are related to poverty, decreased sanitation, and improper hygiene. Improvement of socioeconomic status, sanitation, and health education to promote public awareness about health and hygiene together with periodic mass deworming programs are better strategies for the control of STH infections in Afghanistan.

Individual and Community-Level Risk Factors for Giardiasis in Children under Five Years of Age in Pakistan: A Prospective Multi-Regional Study

OBJECTIVES

This study aimed to estimate the prevalence of Giardia lamblia infection and identify associated risk factors at both individual and community levels in a pediatric population in different agroecological zones of Khyber Pakhtunkhwa, Pakistan.

METHODS

A community-based cross-sectional study was conducted from March to December 2022. Using stratified sampling, 1026 households were recruited from nine agroecological zones. Stool samples were collected from 1026 children up to the age of five years and processed for detection of Giardia using a commercial ELISA kit. Data on potential risk factors were collected using a pre-structured questionnaire. A multivariable logistic regression model was used to identify risk factors associated with giardiasis.

RESULTS

The study found that the prevalence of giardiasis in the study area was 3.31%. Children aged 13-24 months were found to be at higher risk for giardiasis. Illiterate mothers and fathers attending daycare institutions/kindergartens, mothers not practicing hand washing during critical times, households with companion animals, and homes where stray dogs/cats enter were identified as predictors of giardiasis at the individual level. Children living in sub-mountain valleys use un-piped water, inadequate domestic water storage vessels, drink un-boiled or unfiltered water, live near rubbish heaps or un-paved streets/pathways, and have unimproved latrine facilities were identified as risk factors of giardiasis at the community level.

CONCLUSIONS

The study highlights the need for integrated intervention approaches at both individual and community levels to reduce the incidence of giardiasis in Khyber Pakhtunkhwa, Pakistan. Interventions aimed at promoting behavioral change and providing safe and adequate water sources, combined with individual-level interventions such as hand washing and awareness of giardiasis prevention methods, would be critical to addressing this health concern. Inter-sectoral collaboration between the health sector and other sectors would also be necessary to achieve meaningful progress in reducing the incidence of giardiasis in resource-limited areas.

Malaria, gastrointestinal parasite infection and nutritional status among febrile children In Accra, Ghana

Introduction

Malaria and intestinal parasite infection are common in developing countries. These Parasites causes anaemia and malnutrition mostly in children. For this reason, it is important to study these infections and their effects in order to monitor interventions to control them. This study aims to determine prevalence of malaria and intestinal parasite infections and their association with nutritional status among febrile children in Accra, Ghana.

Methods

The study was conducted among febrile children aged 6 months to 5 years attending three health facilities in Accra from May to October, 2022. A total of 315 children were selected for the study. Anthropometric measurement was done for each participant. Blood and stool samples were collected for investigation. Thick and thin blood smears stained with 10% Giemsa were prepared and examined for Plasmodium parasite using microscopy. Stool samples were processed using direct wet mount and formalin-ether concentration method and examined for intestinal parasites using microscopy. Haemoglobin concentration was measured using automatic haematology analyzer.

Results

A total of 24% (76/315) were positive for malaria. Plasmodium falciparum accounted for 77.6% (59/76) of parasitaemia, whereas Plasmodium malariae was 22.4% (17/76). Prevalence of intestinal parasite infection was 10.7% (34/315). Giardia lamblia accounted for 17/315 (5.3%) of the entire children, followed by Ascaris lumbricoides 8/315 (2.5%), Hookworm 6/315 (1.9%) and Trichuris trichiura 3/315 (0.9%). A total of 15/315 (5%) of the participants had co-infection of malaria and intestinal parasite infection. Prevalence of anaemia, malnutrition, stunting, wasting and underweight were (72%), (30.7%), (16.2%), (24.4%) and (57.1%) respectively. Malaria was significantly associated with anaemia (p = 0.000) and underweight (p = 0.013). Ascaris lumbricoides was significantly associated with wasting (p = 0.010). Giardia lamblia was significantly association with malnutrition (p = 0.000) and Stunting (p = 0.000), whereas Hookworm was found to be significantly associated with anaemia (p = 0.021).

Conclusion

Prevalence of IPI in this study was less than previously reported, most likely due to regular deworming of most of the children. However, Malaria and intestinal parasitic infection were significantly associated with anaemia and malnutrition including wasting, stunting, and underweight.

Prevalence of Intestinal Parasites among Immunocompromised Patients, Children, and Adults in Sana'a, Yemen

Intestinal parasite infection (IPI) is still a very important public health issue. The severity of the parasitic disease has been reported as a high infection in immunocompromised patients and children. Hence, this study aimed to investigate the prevalence of intestinal parasites among immunocompromised patients and children with various gastrointestinal system complications in Sana'a city, Yemen, with different variables, including genus and age, and explore the risk factors associated with parasitic intestinal infections. The study socioeconomic data and certain behavioral and environmental risk factors and stool samples were collected from immunocompromised adult and children's patients, including children (one to eight years old), pregnant women, diabetes mellitus patients, cancer patients, HIV patients, and older adults. Out of 436 fecal samples, the overall prevalence rate of IPIs among immunocompromised patients and children in Sana'a was 51.8%. In contrast, the rate of infection in children (26.1%) was higher than that in old patients (25.7%) and in females (38.5%) and higher than that in males (13.3%). The protozoa (44.5%) have been shown more than intestinal helminths (7.3%) in samples, and the most common intestinal protozoan was Giardia lamblia and Entamoeba histolytica (13.8% and 12.8%), respectively. The most common intestinal helminthiasis was Hymenolepis nana with 1.8%. Concluding that the rate of infection was high for several reasons, including lack of commitment to hygiene as not handwashing after using the toilet (88.9%), eating uncovered food (56.3%), poor sanitation as lack of water sources (59.5%), reduced health education, and presence of other family members infected by parasites (61.3%). Interventions are required to reduce intestinal parasites, including health education on personal hygiene for patients, increasing awareness, and improving the environment and healthcare system.

Gender equity in vision care seeking behavior among caregivers: evidence from a randomized controlled trial in rural China

Background

Despite rising incomes and rapid economic growth, there remains a significant gender gap in health outcomes among rural children in China. This study examines whether the gender gap in child health is related to the behavior of caregivers when seeking healthcare, and whether healthcare subsidies help to bridge the gender gap in rural health outcomes.

Methods

Focusing on vision care specifically, we draw on data from a randomized controlled trial of 13,100 children in Gansu and Shaanxi provinces in China that provided subsidized eyeglasses to myopic children in one set of schools (henceforth, referred to as the treatment schools) and provided prescription information but not subsidized eyeglasses to myopic children in another set of schools (control schools).

Results

The baseline results reveal that while female students generally have worse vision than male students, they are significantly less likely than male students to be taken by their caregivers to a vision exam. The experimental results indicate, however, that caregivers respond positively to both health information and subsidized healthcare, regardless of the gender of their children. When prescription information is paired with a subsidy voucher for healthcare (a free pair of eyeglasses), the uptake rate rises dramatically.

Conclusions

The gender gap in healthcare can be minimized by implementing subsidized healthcare policies.

Trial registration

The protocol for this study was approved in full by Institutional Review Boards at Stanford University (Palo Alto, California, USA) and the Zhongshan Ophthalmic Center of Sun Yat-sen University (ZOC, Guangzhou, China). Permission was received from local Boards of Education in each region and from the principals of all schools. The principles of the Declaration of Helsinki were followed throughout. The original trial (Registration site: http://isrctn.org. Registration number: ISRCTN03252665) was designed to study the effect of providing free spectacles on children’s educational performance. The original trial was retrospectively registered on 09/25/2012.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12939-022-01625-4.

Cross-sectional study on intestinal parasite infections in different ecological zones of the Department of La Paz, Bolivia

We performed a cross-sectional parasitological survey to assess the prevalence of protozoa and helminth infection among 275 school-age children (SAC) living in rural and peri-urban areas located in different ecological zones of the Department of La Paz, Bolivia. Public health activities for the control of STH, based on the biannual administration of mebendazole to preschool and school children are implemented at national level since 1986.

We found an overall prevalence of 82.2% for intestinal parasites, including protozoa (80%) and helminths (23.3%). Blastocystis and Entamoeba coli were the most prevalent protozoa (found in 44% and 20.7% of the SAC enrolled); as for helminths, Ascaris lumbricoides and Hymenolepis nana were diagnosed in 14.5% and 3.3% of the children, respectively, followed by Trichuris trichiura 1.4%, Enterobius vermicularis 1.4%, Strongyloides stercoralis 0.7% and hookworms 0.7%.

Molecular characterization of Blastocystis positive samples evidenced three different subtypes (ST1, ST2, ST3) highlighting the risk of transmission also from animal reservoir. We found a significant difference in the distribution of intestinal parasitic infection (IPIs) by ecological zone (44/74. 59% in Andean highlands, 94/170, 88% in tropical lowlands and 88/94, 94% in the Yungas, p < 0.001). Access to potable water (OR 0.1 95%CI 0.02–0.5, p = 0.004) and the habit of boiling drinking water (OR 0.3, 95% CI 0.2–0.7, p = 0.004) showed an independent association with a lower risk of all IPIs and STHs, respectively. The very low prevalence of STH infections of moderate heavy intensity demonstrate that periodical deworming has been successful in reducing the morbidity due to these parasites, however the high prevalence of protozoa demonstrate that sanitation is still problematic and there is a relevant contamination of the environment with human faeces.

Significant efforts are still needed to reduce IPIs transmission and to improve health and sanitation in this area.

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In the Department of La Paz, the current overall STH among school-age children prevalence is high (17.1%), with a patchy distribution throughout the region.

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The prevalence of STH infections of moderate and heavy intensity shows that the morbidity due to these parasites has not been eliminated yet.

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The preventive chemotherapy coverage should be significantly improved in all the at-risk populations, and strategy of PC delivery should be tailored to local conditions.

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Updated epidemiological information is crucial to inform policy for STH control.

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Significant efforts are still needed to reduce transmission and to improve health and sanitation in this area. Interventions should be inspired by the WASH principles, endorsed by the WHO.

Fasciola hepatica Infection Risk for Adult Household Members with Children with Fascioliasis in Cusco, Peru

Fasciola hepatica is highly prevalent in the highlands of Peru. School-age children have the greatest risk of infection. Mass treatment of at-risk populations has been proposed to control the infection and prevent complications. However, the decreasing effectiveness of triclabendazole raises concerns regarding this strategy. Previous studies reported aggregation of Fasciola infection among family members. This study aimed to determine the risk of fascioliasis among household members living with Fasciola-infected children identified through school-based testing. We conducted a cross-sectional study including adult members of households where children with and without fascioliasis were identified. Demographic, epidemiological, and socioeconomic information was collected. One blood sample was drawn to test for Fasciola antibodies, and three stool samples were collected for microscopy for Fasciola ova. We tested 326 adults from 213 households. Of these adult subjects, chronic fascioliasis (24 of 326, 7.4%) was the most common helminth infection. Thirty-nine subjects (12.7%) tested positive for Fasciola antibodies. Combining microscopy and serum antibody tests, 13.2% (43 of 326) had evidence of Fasciola infection. One third (104 of 326, 31.9%) of the participants lived with at least one child infected with Fasciola hepatica. Adults with fascioliasis were four times more likely to live with an infected child. Poverty and diet were associated with increased risk of Fasciola infection. Adults with fascioliasis were significantly more likely to live with Fasciola-infected children.

Prevalence of intestinal parasitic infection and its associated factors among primary school students in Ethiopia: A systematic review and meta-analysis

Introduction

Intestinal parasitic infection are a major public health concern affecting both children and adolescents in Ethiopia. The aim of this systematic review and meta-analysis was to determine pooled prevalence and associated factors of intestinal parasitic infection in this target group.

Method

We systematically retrieved available articles on the prevalence of intestinal parasitic infection following database searches using PubMed, Scopus, Cochrane Library, and Science Direct between March 1 and May 27, 2020. Two authors independently extracted all relevant data using a standardized Microsoft Excel data extraction form. Heterogeneity among included studies was assessed with the Higgins I² tests. The pooled estimates and associated factors were assessed with a random-effects model using Stata/se Version 14.

Result

We retrieved 30 eligible articles with a pooled sample size of 14,445 primary school children with response rate of 97.8%. Entamoeba spp (16.11%), Ascaris lumbricoides (13.98%), hookworm (12.51%) and Giardia lamblia (9.98%) are the top causes of intestinal parasitic infection among primary school children in Ethiopia. The pooled prevalence for at least one intestinal parasitic infection was 46.09 (95% CI: 38.50, 53.68). Heterogeneity was assessed by doing subgroup analysis by study province/region. Thus, the highest prevalence of 66.6% (95% CI: 55.5, 77.7) occurred in Tigray region, which was followed by Southern Nations, Nationalities, and Peoples’ Region at 50.8% (95% CI: 33.1, 68.5). No latrine availability (OR = 4.39: 2.50,7.73), no fingernail hygiene (OR = 2.37: 1.67, 3.35), open defecation (OR = 1.67:1.64,4.36), no formal maternal education (OR = 2.02: 1.18,3.47), rural residence (OR = 1.88: 1.46, 2.41), no habit of wearing shoes (OR = 2.66: 1.79, 3.96), non-pipe source of drinking water (OR = 1.99: 1.42,2.76), no regular hand washing practices (OR = 3.45:1.85,6.47), and no habit of washing fruits and vegetables (OR = 1.59:1.01,2.49) were associated with parasitic infection.

Conclusions

The prevalence of intestinal parasitic infection was high (46%). Attention should be given to promoting personal hygiene, latrine utilization, wearing shoes, avoiding eating raw food, creating awareness for those mothers who lack formal education. Moreover, future research ideally will expand on the topic by conducting research in regions which have no prior research.

Intestinal parasitic infections are distributed virtually with high prevalence rates in many regions, especially in low and middle income countries which intimately linked to age group, poverty and inadequate access to water, sanitation and hygiene. It is now a day’s one of the neglected tropical disease. We had searched different individual studies on intestinal parasitic infections to generate the pooled effect and recommend for the concerned body. We head included 30 different articles with a sample size of 14,445 and we have found a pooled prevalence of 46.09%. This finding indicates the prevalence of parasitic infection was almost near to half. Therefore every concerned body should give emphasize to prevent and control parasitic infection infestation.

High prevalence of intestinal parasite infestations among stunted and control children aged 2 to 5 years old in two neighborhoods of Antananarivo, Madagascar

BACKGROUND

This study aimed to compare the prevalence of intestinal parasite infestations (IPIs) in stunted children, compared to control children, in Ankasina and Andranomanalina Isotry (two disadvantaged neighborhoods of Antananarivo, Madagascar), to characterize associated risk factors and to compare IPI detection by real-time PCR and standard microscopy techniques.

METHODOLOGY/PRINCIPAL FINDINGS

Fecal samples were collected from a total of 410 children (171 stunted and 239 control) aged 2-5 years. A single stool sample per subject was examined by simple merthiolate-iodine-formaldehyde (MIF), Kato-Katz smear and real-time PCR techniques. A total of 96.3% of the children were infested with at least one intestinal parasite. The most prevalent parasites were Giardia intestinalis (79.5%), Ascaris lumbricoides (68.3%) and Trichuris trichiura (68.0%). For all parasites studied, real-time PCR showed higher detection rates compared to microscopy (G. intestinalis [77.6% (n = 318) versus 20.9% (n = 86)], Entamoeba histolytica [15.8% (n = 65) versus 1.9% (n = 8)] and A. lumbricoides [64.1% (n = 263) versus 50.7% (n = 208)]). Among the different variables assessed in the study, age of 4 to 5 years (AOR = 4.61; 95% CI, (1.35-15.77)) and primary and secondary educational level of the mother (AOR = 12.59; 95% CI, (2.76-57.47); AOR = 9.17; 95% CI, (2.12-39.71), respectively) were significantly associated with IPIs. Children drinking untreated water was associated with infestation with G. intestinalis (AOR = 1.85; 95% CI, (1.1-3.09)) and E. histolytica (AOR = 1.9; 95% CI, (1.07-3.38)). E. histolytica was also associated with moderately stunted children (AOR = 0.37; 95% CI, 0.2-0.71). Similarly, children aged between 4 and 5 years (AOR = 3.2; 95% CI (2.04-5.01)) and living on noncemented soil types (AOR = 1.85; 95% CI, (1.18-2.09)) were associated with T. trichiura infestation.

CONCLUSIONS/SIGNIFICANCE

The prevalence of IPIs is substantial in the studied areas in both stunted and control children, despite the large-scale drug administration of antiparasitic drugs in the country. This high prevalence of IPIs warrants further investigation. Improved health education, environmental sanitation and quality of water sources should be provided.

Intestinal protozoa in hospitalized under-five children with diarrhoea in Nampula - a cross-sectional analysis in a low-income setting in northern Mozambique

Background

In Mozambique, infection by intestinal parasites is reported all over the country. However, infection in children with diarrhoea is mostly focused in the southern region of Mozambique. This work aims to determine the frequency and potential risk factors for infection by Cryptosporidium spp., Giardia lamblia, and Entamoeba histolytica in children under-five years hospitalized with diarrhoea in Hospital Central de Nampula, northern Mozambique.

Methods

A cross-sectional hospital-based surveillance was conducted between March 2015 and January 2018 in children admitted with diarrhoea in Hospital Central de Nampula. Sociodemographic information was obtained through semi-structured interviews applied to the children’s caregivers. A single stool sample was collected from each child to detect antigens from Cryptosporidium spp., G. lamblia, and E. histolytica using an immune-enzymatic technique. Crude and adjusted odds ratios (with 95% Confidence Intervals) were obtained by logistic regression models to identify factors associated with infection by Cryptosporidium spp. and G. lamblia.

Results

The median age and interquartile intervals of our sample population was 12 months (8–20). Intestinal protozoa were detected in 21.4% (59/276). Cryptosporidium spp. was the most common protozoa (13.9% - 38/274), followed by G. lamblia (9.1% - 25/274) and E. histolytica (0.4% - 1/275). Children with illiterate caregiver’s (p-value = 0.042) and undernourished (p-value = 0.011) were more likely to be infected by Cryptosporidium spp. G. lamblia was more common in children living in households with more than four members (p-value = 0.039). E. histolytica was detected in an eleven month’s child, co-infected with Cryptosporidium spp. and undernourished.

Conclusion

Cryptosporidium spp. and Giardia lamblia were the most common pathogenic intestinal protozoa detected in children with diarrhoea hospitalized in the Hospital Central de Nampula. Our findings obtained highlight the importance of exploring the caregiver’s education level, children’s nutritional status for infections with Cryptosporidium spp., and living conditions, namely crowded households for infections with G. lamblia in children younger than five years.

Development of a Decision-Making Approach for Mass Deworming Campaigns on Intestinal Parasites among Primary School Children in Egypt

Intestinal parasitic infections are widespread and cause considerable morbidity. Although mortality from such infections is low, most intestinal parasitic infections interfere with nutrition, growth, development and cognitive progress of children, in addition to interference with productivity and quality of life of adults.   Study Aim: Reduction of intestinal parasites prevalence among primary school children.   Methods: this is a three-phased study; Desk review on current prevention and control methods including mass deworming in the light of global guidelines. Cross-sectional field study on 522 school children from 8 Governorates, and interviews with 168 members of the health team running the deworming campaign at these Governorates in 2017. Development of decision making approach to guide future consideration of mass deworming campaigns   Results: National mass deworming campaigns were effective in reducing prevalence of intestinal worms among primary school children in Egypt, and provided a nationwide awareness on the issue. However, unless these campaigns are combined with sustainable measures of clean drinking water, sewage disposal in schools and households the success of these campaigns in reducing intestinal worms' prevalence will be transient.   Conclusion and Recommendations: The national mass deworming campaigns ranged an alarm bell in the community about dangers of intestinal parasites. However, it's recommended to include other susceptible groups like preschool children, adolescent girls and women of childbearing age while focusing the deworming only on infected individuals. It's also recommended to convert the deworming campaigns into a program to ensure sustainability of resources and continuous monitoring and evaluation of intestinal parasitic burden among populations at risk.   Key Words: Intestinal Parasites – Primary School Children – Mass Deworming Campaigns – Egypt

Spatial Distribution of Common Pathogenic Human Intestinal Protozoa in Iran: A Systematic Review

Background:

Pathogenic intestinal protozoa are considered as a serious public health problem in developing countries. This study aimed to elucidate the overall prevalence and spatial distribution of three common human pathogenic intestinal protozoan infections in Iran.

Methods:

Six English and Persian databases were explored for published papers on the prevalence of Entamoeba histolytica/dispar, Giardia lamblia, and Cryptosporidium spp. in the general population of Iran from 2000 to 2015. All eligible data were collected using a pre-designed data extraction form, and the overall prevalence was estimated using a random-effects meta-analysis model. We used ArcMap for mapping the prevalence of the studied protozoa and clustering analysis.

Results:

Altogether, 118 eligible papers from 24 provinces of Iran were included and analyzed. The weighted prevalence of E. histolytica/dispar, G. lamblia, and Cryptosporidium spp. infection among Iranian general population were calculated 1.3% (95% CI 1.1–1.5%), 10.6% (95% CI 9.6–11.5%) and 2% (95% CI 1.5–2.5%), respectively.

Conclusion:

Our findings indicated human intestinal protozoan infections caused by E. histolytica/dispar, G. lamblia, and Cryptosporidium spp. have still public health importance in some parts of Iran.

Parasitic risk factors in migrant horticultural families from Bolivia settled in the rural area of La Plata, Buenos Aires, Argentina

Objective

The aims were to diagnose intestinal parasites in migrant horticultural families in the rural area of La Plata, and assess factors that increase the risk of parasitic infection.

Materials and methods

Serial stool samples and anal swabs of 350 individuals were processed using sedimentation and flotation techniques. Socio-sanitary and environmental characteristics were surveyed using a semi-structured questionnaire. A generalized linear model was used to assess the change in parasitic prevalence with different predictor variables.

Results

Of all examined individuals, 79.1% were parasitized, and 12 parasites were identified. Blastocystis sp. (58.9%), Entamoeba coli (26.3%), Enterobius vermicularis (26.0%), and Giardia lamblia (24.0%) were the most prevalent species. Risk factors were age group (<12 years), sampling site, and a basic education of parents.

Conclusion

The high prevalence of intestinal parasites in horticultural families is associated with inadequate environmental sanitation, a limited access to education, and insufficient hygienic habits. An increase in parasitological references in integrated studies (human, animal and environmental health) would result in an understanding of the parasitic etiology, and the development of effective actions for the control of intestinal parasites.

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La Plata Horticultural area is the most important region for vegetable production in Argentina.

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79.1% of analyzed farming population was parasitized and the species found indicate an inadequate environmental sanitation.

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An increase in parasitological references in integrated studies could mitigate the effect of intestinal parasitoses.

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.

Prevalence and associated risk factors of intestinal helminthic infections in children from Lorestan province, Western Iran

BACKGROUND

Intestinal helminthic infections are among the most important global socioeconomic and health problems. This study aimed to estimate the frequency of intestinal parasites in 366 children aged 2 to 15 years referred to the main pediatric health center of Lorestan Province, Iran.

METHODS

Microscopic analysis was performed on 366 stool samples. We applied direct smear, scotch tape, and formol-ether methods. Moreover, a questionnaire was filled in by parents or guardians of the children.

RESULTS

The results showed that 36 children (9.8%) were infected with at least one or more intestinal parasites. The most prevalent parasites were Enterobius vermicularis (6.8%), Hymenolepis nana (1.9%), and Ascaris lumbricoides (0.55%), in the order of their appearance. Statistical analysis showed that several risk factors were significantly associated with the prevalence intestinal helminthic parasites, including male sex (OR = 2.9; 95% CI: 1.2-6.2; p < 0.05), residing in rural regions (OR = 4.2; 95% CI: 2.1-10.6; p < 0.001), no handwashing habit before eating (OR = 5.2; 95% CI: 2.2-12.5; p < 0.001), and consuming raw or unwashed vegetables and fruits (OR = 4.8; 95% CI: 2.3-11.2; p < 0.001).

CONCLUSION

The present study showed a high overall frequency of intestinal helminthic infections among the children in Lorestan province, Iran. The results of the risk factor analysis suggest that improving environmental hygiene and health education would be important for effective control of intestinal parasitic infections.

Report of Giardia assemblages and giardiasis in residents of Guilan province-Iran

Giardia duodenalis is considered a highly diverse organism that infects a variety of mammalian hosts. Giardiasis is a significant public health problem in Iran. The purpose of this study was to investigate the occurrence of Giardia duodenalis (G. lamblia, G. intestinalis) infections in humans residing in the Guilan province of Iran. Stool samples were collected during 12 months from 8356 individuals that had been referred to certain hospitals in the capital city of Rasht in the Guilan province, of which 4126 were males and 4230 were females. The samples were separated into three groups according to patient age: group A 1-9 years old (n = 483); group B 10-19 years old (n = 491); and group C greater than 20 years old (n = 7382). The wet mount technique was performed directly on 8356 fecal samples for microscopy. Samples were examined using a saline and iodine direct smear technique in order to confirm the presence of G. duodenalis. The results indicated that 2.5% (206/8356) of the samples were identified as positive for G. duodenalis. A total of 30% of the infected patients (n = 62) had no symptoms. In symptomatic cases, the most common symptoms (46%, n = 95) were abdominal cramps and bloating. Twenty-four percent of patients (n = 50) had cramps, bloating, nausea, and diarrhea. Sixty positive samples were sent for G. duodenalis genotyping based on the amplification of the gdh gene. Forty-one PCR products were successfully selected and sequenced, where 38 (92.6%) samples were identified as genotype A/subgenotype II and in three samples (7.4%) genotype B/subgenotype IV. Genotype A-II had a dominant prevalence as compared to the genotype B-IV samples that were identified in the study. Based on the samples provided by the regional teaching hospitals and subsequent sample analysis, the authors concluded that assemblage A-II is most likely the most common Giardia subgroup infection in the Guilan region. Assemblages have been reported in both humans and animals; however, further studies need to investigate the role of domestic animals and water reservoirs as potential sources of Giardia infection in the Guilan region.

Prevalence and associated risk factors of human intestinal parasitic infections: a population-based study in the southeast of Kerman province, southeastern Iran

Background

Determination of the prevalence and distribution pattern of intestinal parasites is a fundamental step to set up an effective control program to improve the health status. This study aimed to determine the prevalence of intestinal parasitic infections and associated risk factors among inhabitants of Rudbar-e Jonub county, southeast of Kerman province, southeastern Iran.

Methods

In this cross-sectional study, 861 stool specimens were collected from inhabitants of Rudbar-e Jonub county through a multistage cluster sampling method in 2018. The collected specimens were examined by parasitological methods including, direct wet-mounting (for the fresh specimens with a watery consistency), formalin-ethyl acetate sedimentation and agar plate culture.

Results

The prevalence of intestinal parasites was 34.2% (95% CI 30.1 to 38.2). The prevalence of protozoan parasites 32.3% (95% CI 28.4 to 36.5) was significantly higher than helminthic parasites 3.2% (95% CI 2.1 to 4.7). Blastocystis sp. (13.3%), Entamoeba coli (11.4%) and Giardia lamblia (10.6%) as protozoan parasite and Hymenolepis nana (2.4%) as helminthic parasite were the most common detected intestinal parasites in the study. Entamoeba histolytica/dispar (1.5%), Iodamoeba bütschlii (1.0%), Chilomastix mesnili (0.5%), Entamoeba hartmanni (0.4%), Enterobius vermicularis (0.3%) and Ascaris lambercoides (0.3%) were other detected parasites. Multiple logistic regression revealed a significant association of intestinal parasitic infections with source of drinking water and residency status (rural/urban). Multiple infections with 2 or 3 parasitic agents constituted 22.7% of 295 infected cases.

Conclusions

This study revealed a high prevalence of intestinal protozoan infections among inhabitants of Rudbar-e Jonub county. Intestinal parasites especially protozoans remain a challenging public health problem wherever sanitation and health measures are limited in Iran.

Molecular epidemiology of Blastocystis spp. in children referred to Qods hospital in northwest of Iran

Blastocystis sp. is a polymorphic intestinal parasite in humans and animals. The parasite has a worldwide distribution, especially in developing countries with poor sanitation, exposure to animals, and improper disposal systems. The aim of this study was to identify the subtypes of Blastocystis sp. among children of Qazvin, northwest Iran. Totally, 864 stool samples were collected from the children referred to Qods hospital in Qazvin, Iran. Fecal specimens were investigated by formalin-ethyl acetate concentration method and trichrome staining as well as cultivation of all samples in clotted fetal bovine medium. DNA extraction of culture-positive specimens and PCR amplification of 18S ribosomal RNA gene region was performed. The sequences detected were compared with reference genes in the GenBank, and the sequences further deposited in the GenBank database. Data analysis was performed by Chi square test while a p value of < 0.05 was considered as significant. Of 864 isolates, 4.1% (36/864) were positive for Blastocystis sp. with infection rate insignificantly higher among the females than males. The highest infection rate was estimated at 6.8% in 6-9 years old age group with abdominal pain as the most common (33%) gastrointestinal sign. No statistically significant difference was found between the variables and Blastocystis infection. Molecular analysis clarified the presence of three subtypes of Blastocystis including ST1 (56%), ST2 (28%), and ST3 (16%) of among specimens with ST1 as the predominant subtype. A significant association between intestinal signs and the subtypes was not found. Considering ST1 as the predominant subtype, it seems that zoonotic transmission is a main route of human infections with Blastocystis sp. in the area studied.

Cryptosporidium spp., prevalence, molecular characterisation and socio-demographic risk factors among immigrants in Qatar

BACKGROUND

The World Health Organization WHO has estimated that in developed countries, up to 30% of the population may suffer from foodborne diseases each year, and that in developing countries up to 2 million deaths per annum can be attributed to cryptosporidiosis. Reports have already emphasized the role of immigrants in outbreaks of parasitic diseases especially those working in food processing industries.

METHODOLOGY/PRINCIPAL FINDINGS

Herein we assessed Cryptosporidium spp. infections among immigrants in Qatar with a special focus on food handlers and housemaids. The overall prevalence of Cryptosporidium spp. by q-PCR among 839 asymptomatic subjects was 4.5%. Based on the Gp60 gene, the majority of isolates were identified as C. parvum subtype IIdA20G1b. The positive sample for C. hominis was subtyped as IeA12G3T3. Seven mixed infections were also identified (four C. parvum + C. hominis, and three C. parvum + C. meleagridis). The prevalence of Cryptosporidium spp. did not differ significantly between the sexes or age classes but varied significantly between subjects affiliated to different religions with the lowest prevalence among the Muslims. Multifactorial analysis retained also marked significance with education, income, and a house contents index.

CONCLUSIONS/SIGNIFICANCE

Our results contribute to a better understanding of the epidemiology of cryptosporidiosis and the risk factors associated with the likelihood of carrying this infection among immigrant workers from developing countries.

Blastocystis spp. and Giardia intestinalis co-infection profile in children suffering from acute diarrhea

Giardia intestinalis and Blastocystis spp. are two common zoonotic intestinal parasites responsible for the majority of diarrheic cases, especially in children. The study was planned to determine the impact role of both Giardia and Blastocystis co-infection in children up to 12 years old with acute diarrhea in Beni-Suef, Egypt. Also, to estimate the general prevalence rates and risk factors associated with intestinal parasitic infections. Stool samples collected from 125 children, within a period of 7 months, were examined using direct wet mount and trichrome stain in comparison to in vitro culture on Jones medium (for detecting Blastocystis spp.) and Immunochromatography techniques (for detecting Giardia). At least one type of intestinal parasites was harbored in 72% of the studied children, single infection constituted 37.6% while, 34.4% were polyparasitized children. The predominant parasites involved were Blastocystis spp.(53.6%), followed by Giardia intestinalis (27.2%). Co-infection between both parasites was recorded in 20% of cases. Two risk factors were significantly associated with higher risk of Giardia-Blastocystis co-infection including age category (5-7 years) and family size (≥ 6 members) by univariate analysis (P = 0.004, 0.009 respectively) and also by the multivariate model (OR = 0.526, 0.336). Abdominal pain was the only gastrointestinal manifestation associated with the co-infection using the univariate analysis (P = 0.0427). The present study detects a high prevalence of intestinal parasitic infection; in particular, Giardia-Blastocystis co-infection in diarrheic young children (up to 12 years) in Beni-Suef Governorate, Egypt and recommends further subtypes identification of both parasites.

Socioeconomic Factors Associated with Fasciola hepatica Infection Among Children from 26 Communities of the Cusco Region of Peru

Fasciola hepatica is the most widely distributed trematode-affecting humans. The Andes Mountains are highly endemic for fascioliasis. We report results of a cross-sectional study evaluating the epidemiology of Fasciola among children in 26 agricultural communities in the Cusco region of Peru. Children 3 to 16 years old were enrolled in preschools and schools. Blood from participants was tested for complete blood counts, transaminases, and Fasciola antibodies. Stool samples were tested for Fasciola and other parasites. A total of 2,515 children were included in the analysis and the mean age was 9.6 years (±3.6). Ten percent (253) of the children had at least one positive test for Fasciola, 6% had chronic infection, and 0.4% acute infection. The rest of the subjects had only antibodies against Fasciola. The prevalence of infection varied from 0% to 20% between communities. Children with evidence of Fasciola exposure were older, lived at higher altitudes, and had a lower socioeconomic status than children without infection. The logistic regression analysis showed that children from Ancahuasi district, older children, and children with higher measures of poverty were more likely to have Fasciola exposure. Fascioliasis is common in the Cusco region and associated with poverty. However, the distribution varies markedly between communities.

Prevalence of intestinal helminth infections in Jiangsu Province, eastern China; a cross-sectional survey conducted in 2015

Background

Intestinal helminth infections are a serious public health problem in developing countries. Jiangsu, an eastern coastal province of China, has an environment conducive to the transmission of intestinal parasites, and suffered human infection rates of 71.75% in 1990. Due to comprehensive anti-transmission measures undertaken throughout the province in the 1990s, the prevalence had decreased to 9.28% in 2002. In order to assess the current epidemic situation for intestinal parasitic infections in Jiangsu province, a province-wide cross-sectional survey was carried out in 2015.

Methods

Surveys were conducted in two main settings; rural (for soil-transmitted parasites) and urban (for Clonorchis sinensis), selected through stratified random sampling. Human infection rates were evaluated through the detection of helminth eggs or cysts (oocysts or trophozoites) of intestinal protozoa in fecal samples by microscopy. Secondary intermediate and reservoir hosts were surveyed for C. sinensis infection. Questionnaires were completed by each participant to evaluate knowledge, attitude and practice of soil-transmitted parasite and C. sinensis avoidance.

Results

115 out of 30153 participants (0.38%) had intestinal helminths or protozoa. There were eight species of helminth detected and the most common parasite was the hookworm Ancylostoma duodenale. In rural settings, there were significant differences in infection rates between participants of differing economic status. In urban settings, only four cases of C. sinensis infection were detected. However, secondary intermediate and reservoir hosts were found to harbor parasites. The questionnaire survey revealed that 38.42% participants were not aware of how humans become infected by hookworms. Knowledge and awareness of C. sinensis was similarly low, with 53.22% participants combining the use of chopping boards for raw and cooked food items when preparing meals.

Conclusions

The prevalence of intestinal parasitic infections in Jiangsu Province in eastern China has decreased from 71.57% in 1990 to 0.38% in 2015. Control measures should now focus on parasitic infections in the elderly and in children, health promotion and the development of alternative detection methods.

Electronic supplementary material

The online version of this article (10.1186/s12879-019-4264-0) contains supplementary material, which is available to authorized users.

Prevalence of Intestinal Parasitic Infestation Among Expatriate Workers

Background

Parasitic infestations of the gastrointestinal tract remain a common problem in third-world countries. Poverty, illiteracy, poor hygiene, scarcity of potable water, as well as the hot and humid tropical climate, are all contributing factors associated with intestinal parasitic infestation.

Objective

This cross-sectional study aims to evaluate the prevalence of intestinal parasitic infestation amongst expatriate workers in Benghazi City, Libya.

Patients and methods

A total of 250 stool samples (200 male and 50 female) were randomly collected between October 2017 to April 2018 from expatriate workers in Benghazi City, Libya. The samples examined were used to detect the presence of intestinal parasitic infestation while the study utilized a pre-tested structure. Cases were matched based on demographic parameters, such as age, gender, and nationality, while the history of diarrhea was recorded using direct smear microscopy for the detection of intestinal parasitic infestation.

Results

Of the 250 immigrants looking for work, 95 (38%) were found to be infested with two or more intestinal parasites. The protozoa included: Blastocystis hominis, Giardia lamblia, Entamoeba histolytica, Entamoeba dispar, and Cryptosporidium parvum (47.4%, 38.9%, 17.9%, 17.9%, and 4.2%, respectively); the non-pathogenic protozoa included the prevalence of Entamoeba coli (E. coli), which is 12.6%, and the helminth Ascaris lumbricoidesis 1.1%.

Conclusion

The prevalence of parasitic infection was relatively high (38%) and was affected by individual hygiene. Therefore, comprehensive healthcare education aimed at reducing parasitic infestation is needed.

Cross-sectional epidemiological investigations of Giardia lamblia in children in Pakistan

BACKGROUND

The prevalence of Giardia lamblia in Pakistani children is currently unknown. The aim here was to evaluate the prevalence and risk factors of Giardia lamblia in children exhibiting diarrhea.

DESIGN AND SETTING

Cross-sectional study at different district healthcare hospitals in Pakistan.

METHODS

A total of 800 samples were collected from children aged 0-10 years. Information regarding personal data, demographic data and supposed risk factors was collected through a structured questionnaire. Giardia lamblia was detected through direct microscopy and antigens through the enzyme-linked immunosorbent assay (ELISA).

RESULTS

The prevalence of Giardia lamblia was 2.75% through direct microscopy and inflated to 9.5% through ELISA. The demographic factors positively associated with occurrences of giardiasis were age (P = 0.035; odds ratio, OR = 1.96; 95% confidence interval, CI = 1.094-3.533), mother's educational level (P = 0.031; OR = 2.67; 95% CI = 1.186-6.045) and father's educational level (P = 0.004; OR = 3.56; 95% CI = 1.612-7.899). Similarly, among the supposed risk factors, rural residency (P = 0.032; OR = 1.76; 95% CI = 1.098- 2.851), absence of proper sewerage system (P = 0.000; OR = 6.60; 95% CI = 4.029-10.841) and unavailability of safe drinking water (P = 0.000; OR = 4.08; 95% CI = 2.207-7.547) were the factors strongly connected with giardiasis. Abdominal discomfort was a prominent clinical sign with 46% frequency.

CONCLUSION

Various risk factors were associated with occurrences of Giardia, thus emphasizing the importance of parents' education, safe drinking water and proper sewerage systems for Pakistani children's health.

Impacts of human development index and climate conditions on prevalence of Blastocystis: A systematic review and meta-analysis

Blastocystis is a prevalent eukaryotic microorganism that has been frequently reported from the stool samples of human and animals, all over the world. The prevalence of this parasite has close correlation with the climate and hygiene situation of studied populations. For the current study, English and Persian databases were searched for the following terms: "Blastocystis hominis", "Blastocystis sp.", "Intestinal Parasites", "Prevalence" and "Iran". In order to data analysis and assess the possibility of publication bias, STATA v11 and Begg's Funnel plot were employed respectively. From 605 searched cases, 86 publications met our criteria for the analysis. The pooled prevalence of Blastocystis was 9.1% (95%CI: 8.2%, 10.1%). The results represented that the prevalence of the parasite using molecular techniques or cultivation followed by molecular techniques (20.89%) was higher than only microscopical examination (8.96%). The prevalence rate of Blastocystis according to human development index was 7.6%, 7.2%, 11.9%, 13.4%, and 3.3% for ranks 1 to 5, respectively. This is the first study signifying the prevalence of Blastocystis regarding the human development index and climate conditions. The findings represented that although human development index, low levels of socioeconomic situations together with appropriate climate such as sufficient humidity and high temperature increase the chance of transmission of Blastocystis in a society.

Amoebiasis in Iran: a systematic review and meta-analysis

A comprehensive meta-analysis study was performed to estimate the reliable national prevalence and molecular epidemiology of amoebiasis in Iran. Nine English and Persian databases were searched to achieve the relevant studies. Pooled estimates were generated and meta-regression was performed. We identified 71 eligible articles involving 330 930 subjects from 25 provinces to be included in the final analysis. Moreover, 17 studies compromising 462 polymerase chain reaction (PCR)-positive isolates performed molecular analysis to inter-species differentiation. The pooled prevalence of Entamoeba infection among Iranian population was about 1% (95% CI 0.8-2.0%). Moreover, regarding Human Development Index (HDI), a higher prevalence was observed in undeveloped provinces. Out of 462 PCR-positive isolates, 83% (95% CI 69-94%) and 12% (95% CI 3-24%) were Entamoeba dispar, Entamoeba histolytica, respectively. In subgroup analysis based on molecular results, in general, population prevalence of Entamoeba dispar and E. histolytica were 91% (95% CI 80-99%) and 7%, (95% CI 0-19%), respectively, while prevalence of these species in patients with gastrointestinal disorders were 75% (95% CI 45-96%) and 18% (95% CI 1-43%), respectively. Our findings indicate the low burden of amoebiasis in Iran. E. dispar, that is mostly non-pathogenic, was identified as most prevalent species. Nevertheless, we suggest more public health interventions in areas with lower HDI.

Epidemiology of intestinal parasite infections in three departments of south-central Côte d'Ivoire before the implementation of a cluster-randomised trial

Hundreds of millions of people are infected with helminths and intestinal protozoa, particularly children in low- and middle-income countries. Preventive chemotherapy is the main strategy to control helminthiases. However, rapid re-infection occurs in settings where there is a lack of clean water, sanitation and hygiene. In August and September 2014, we conducted a cross-sectional epidemiological survey in 56 communities of three departments of south-central Côte d'Ivoire. Study participants were invited to provide stool and urine samples. Stool samples were examined for helminth and intestinal protozoa infections using the Kato-Katz technique and a formalin-ether concentration method. Urine samples were subjected to a filtration method for the diagnosis of Schistosoma haematobium. Information on sociodemographic characteristics, knowledge, attitude, practices and beliefs with regard to hygiene, sanitation and intestinal parasitic diseases were collected using a questionnaire administered to household heads. Multivariable logistic regression models were employed to analyse associations between parasite infections and risk factors. Overall, 4,305 participants had complete parasitological and questionnaire data. Hookworm was the predominant helminth species (21.2%), while Ascaris lumbricoides, Trichuris trichiura, Schistosoma mansoni and S. haematobium showed prevalences below 10%. Infections with pathogenic intestinal protozoa (e.g. Entamoeba histolytica/E. dispar and Giardia intestinalis) were similarly prevalent in the three departments. Hookworm infection was associated with open defecation and participants' age and sex. Entamoeba coli infection was negatively associated with the use of tap water at home (odds ratio (OR) = 0.66; p = 0.032). Disposal of garbage in close proximity to people's home was positively associated with G. intestinalis (OR = 1.30; p = 0.015). Taken together, helminth and intestinal protozoa infections affected a considerable proportion of rural dwellers in south-central Côte d'Ivoire at the onset of a cluster-randomised intervention trial. Our results will serve as baseline to monitor the effect of a package of interventions, including preventive chemotherapy, sanitation and health education on re-infection with helminths and intestinal protozoa.

TRIAL REGISTRATION

ISRCTN53102033 (date assigned: 26 March 2014).

The role of family size, employment and education of parents in the prevalence of intestinal parasitic infections in school children in Accra

INTRODUCTION

Intestinal parasitic infections (IPIs) in school children are a public health problem in most developing countries.

METHODS AND PRINCIPAL FINDINGS

A cross sectional survey was conducted from May to July 2016 with school children living in overcrowded urban slums in Accra, Ghana. A simple random sample of 300 children aged 2-9 years was collected. The study used structured pre-tested questionnaire and stool tests to obtain information on epidemiological, sanitation habits, employment and education status of parents and children. Data were analysed using appropriate descriptive, univariate and multivariable logistic tools of analyses. The mean age of participants was 6.9 years and 49% were males and 51.3% were females. Giardia lamblia was found in males (10.95%) and females (7.79%). Very low prevalences for Schistosoma mansoni, Ascaris lumbricoides, Taenia species, and Entamoeba coli were detected. Whilst children from mothers (62.2%) and fathers (55.6%) with no education were often infected, a few children from fathers (22.2%) and mothers (6.7%) with no jobs were infected. Most of the infected children's (93.7%) parents did not have any knowledge of IPIs. The educational and employment status of the mothers [p = 1.0 and p = 0.422] was not significant, however, the family size was a predisposing factor (p = 0.031) for parasitic infections.

CONCLUSIONS

Intestinal parasites were prevalent in children from overcrowded families and with no knowledge of IPIs. Educative programmes on IPIs, improving hygiene, and application of supportive programmes to elevate socioeconomic conditions may help reduce the burden of intestinal parasite carriage in children.

Relationship between socioeconomic status and gastrointestinal infections in developed countries: A systematic review and meta-analysis

BACKGROUND

The association between socioeconomic status (SES) and health is well-documented; however limited evidence on the relationship between SES and gastrointestinal (GI) infections exists, with published studies producing conflicting results. This systematic review aimed to assess the association between SES and GI infection risk, and explore possible sources of heterogeneity in effect estimates reported in the literature.

METHODS

MEDLINE, Scopus, Web of Science and grey literature were searched from 1980 to October 2015 for studies reporting an association between GI infections and SES in a representative population sample from a member-country of the Organisation for Economic Co-operation and Development. Harvest plots and meta-regression were used to investigate potential sources of heterogeneity such as age; level of SES variable; GI infection measurement; and predominant mode of transmission. The protocol was registered on PROSPERO: CRD42015027231.

RESULTS

In total, 6021 studies were identified; 102 met the inclusion criteria. Age was identified as the only statistically significant potential effect modifier of the association between SES and GI infection risk. For children, GI infection risk was higher for those of lower SES versus high (RR 1.51, 95% CI;1.26-1.83), but there was no association for adults (RR 0.79, 95% CI;0.58-1.06). In univariate analysis, the increased risk comparing low and high SES groups was significantly higher for pathogens spread by person-to-person transmission, but lower for environmental pathogens, as compared to foodborne pathogens.

CONCLUSIONS

Disadvantaged children, but not adults, have greater risk of GI infection compared to their more advantaged counterparts. There was high heterogeneity and many studies were of low quality. More high quality studies are needed to investigate the association between SES and GI infection risk, and future research should stratify analyses by age and pathogen type. Gaining further insight into this relationship will help inform policies to reduce inequalities in GI illness in children.

Prevalence of anemia and associated factors among school children in Gondar town public primary schools, northwest Ethiopia: A school-based cross-sectional study

Background

Anemia is a global public health problem affecting 305 million school children (SC) worldwide. It has deleterious effects in SC, including lower school achievement due to impaired cognitive development and physical growth, fatigue and poor attention span, and increased morbidity because of reduced resistance to infection. Hence, the aim of this study was to assess the prevalence and associated factors of anemia among SC attending public primary schools in Gondar town, northwest Ethiopia.

Methods

A school-based cross sectional study was conducted on a total of 523 SC aged from 6–14 years old. Multi-stage sampling followed by systematic random sampling techniques were employed to select study participants. Data on socio-demographic and socio-economic characteristics, and dietary status of children were collected using pre-tested structured questionnaire through face-to-face interview of children’s caregivers. Anthropometric measurements were taken. Hemoglobin (Hb) concentration was determined by using HemoCue 301+analyser. Stool and blood samples were collected in the school premises, and examined for intestinal and hemoparasites, respectively. Data were entered into Epi Info version 3.5.3 and transferred to SPSS version 20 for analysis. Bivariate and multivariate binary logistic regression models were fitted to identify associated factors of anemia. P-value < 0.05 was considered as statistically significant.

Result

Of the total SC participated in the study, 269 (51.4%) were males. The median (inter quartile range (IQR)) age was 12 (10–13) years, and 332 (63.5%) of them were in the age group 11–14 years. About 81 (15.5%; 95%CI: 12.4%, 18.7%) of them were anemic: 56 (69.1%) and 25 (38.9%) of them were mildly and moderately anemic, respectively. Low maternal education (AOR = 2.30; 95%CI: 1.11, 4.78), stunting (AOR = 2.22; 95%CI: 1.30, 3.80), severe food insecurity (AOR = 5.11; 95%CI: 1.53, 17.13), and soil-transmitted helminthic (STH) infection (AOR = 7.13; 95%CI: 3.16, 16.86) were found significantly associated with anemia.

Conclusion

Anemia among SC was found to be a mild public health problem. It was strongly associated with low maternal education, food insecurity, stunting and intestinal helminthic infection. Focused policies and strategies towards the above factors should be designed to reduce anemia among SC.

Prevalence and Risk Factors of Intestinal Parasite Infection among Schoolchildren in the Peripheral Highland Regions of Huanuco, Peru

Objectives

Schoolchildren in developing countries are at greater risk of intestinal parasitic infections. This study aimed to estimate the prevalence and assess the risk factors of intestinal parasite infection among schoolchildren in rural areas of Peru.

Methods

A volunteer team from the Korea International Cooperation Agency (KOICA) conducted a campaign for parasite eradication called “Chao parasitos” at five schools in the peripheral highland regions of Huanuco in October 2013. The study collected questionnaires and stool samples from children of participating schools. Entamoeba coli, Iodamoeba buschii, and Chilomastix mesnil were classified as nonpathogenic parasites.

Results

The overall prevalence of intestinal parasite infection in the students was 100% (185/185). Among them, 25.9% (48/185) were infected only with nonpathogenic parasites whereas 74.1% (137/185) were infected with at least one pathogenic parasite. Ascaris lumbricoides was the most commonly detected (37.3%, 69/185), followed by Giardia lamblia (15.1%, 28/185) and I. buschii (11.9%, 22/185). Among lifestyle practices associated with parasitic infection, the rate of washing hands before meals was significantly lower in the students with pathogenic parasites compared to those with nonpathogenic parasites (77.4%, 106/137 vs. 93.8%, 45/48, p = 0.025).

Conclusion

The prevalence of intestinal parasite was 100%. Both personal hygiene and water supply facilities are required to eradicate parasite infection in rural areas of Peru.

Enteroparasitoses and Toxocarosis Affecting Children from Mar del Plata City, Argentina

This study evaluated the existence of enteroparasitoses and toxocarosis in children of peripheral (PC) and urban communities (UC) from Mar del Plata city (Argentina) and their associations with socio-environmental conditions. A Parasite Vulnerability Index (PVI) was elaborated using variables such as overcrowding, floor type, drinking water source, wastewater disposal, solid waste disposal, presence of animals and schooling level. The PC evidenced statistically significant higher frequencies of families with high (38.9%) and medium (55.5%) PVI, while in the UC low PVI (93%) was the most frequent. A statistically significant higher frequency of PC children was parasitized (30.2 vs. 14.5%; χ ² Pearson = 5.21; P < 0.05), presented higher parasite frequencies, specific richness, parasitic loads, and they also evidenced polyparasitism. The Multiple Correspondence Analysis (MCA) showed associations between PC-parasitized children, overcrowding and contact with pets and farm animals. The ELISA test to the specified determination of Toxocara canis IgG was reactive in a statistically significant higher proportion of PC children than the UC (55 vs. 8.5%; χ ² = 30.5; P < 0.01). The MCA associated PC reactive children, not adequate hand washing, moderate and hypereosinophilia and contact with pets and farm animals. Deficient socio-environmental conditions became children more vulnerable to get enteroparasitoses and toxocarosis in the PC than in the UC.

Intestinal parasitic infections in different groups of immunocompromised patients in Kashan and Qom cities, central Iran

INTRODUCTION

Intestinal parasitic infections (IPIs) are important causes of morbidity and mortality in patients with immunocompromising conditions.

OBJECTIVE

The aim of this study was to determine the prevalence of IPIs in different groups of immunocompromised patients, including hemodialysis patients (HD), renal transplant recipients (RTR), cancer and HIV/AIDS patients in comparison with healthy individuals in two central cities of Iran (Kashan and Qom).

METHODS

In this case-control study, the stool samples of 135 HD, 50 RTR, 60 cancer patients, 20 HIV/AIDS patients and 120 healthy subjects were tested using direct-smear, formol-ether concentration, Ziehl-Neelsen staining and Agar plate method.

RESULTS

The overall infection rate was 11.7% (31/265) in patient groups and 0% (0/120) in the control group. The frequency of parasites was 25% in HIV/AIDS patients, 11.9% (16/135) in HD, 12.0% (6/50) in RTR and 6.7% (4/60) in cancer patients. Blastocystis hominis (4.2%) and Giardia lamblia (3.0%) were the most prevalent parasites in patient groups. The infection rate was significantly higher in male (17.6%) than female (5.4%) patients (p = .002), but no statistically significant association was observed according to the age and educational levels.

CONCLUSIONS

This study showed a high prevalence of IPIs in immunocompromised patients. The results of this study suggest that periodic stool examinations for screening of IPIs should be included as a part of routine medical care in these patients.

Intestinal parasitic infections in Iranian preschool and school children: A systematic review and meta-analysis

Parasitic infections are a serious public health problem because they cause anemia, growth retardation, aggression, weight loss, and other physical and mental health problems, especially in children. Numerous studies have been performed on intestinal parasitic infections in Iranian preschool and school children. However, no study has gathered and analyzed this information systematically. The aim of this study was to provide summary estimates for the available data on intestinal parasitic infections in Iranian children. We searched 9 English and Persian databases, unpublished data, abstracts of scientific congresses during 1996-2015 using the terms intestinal parasite, Giardia, Cryptosporidium, Enterobiusvermicularis, oxyure, school, children, preschool, and Iran. We conducted meta-analysis using STATA, and for all statistical tests, p-value less than 0.05was considered significant. Among the 68,532 publications searched as a result, 103 were eligible for inclusion in the study. The prevalence rate of intestinal parasitic infections was 38% (95% CI- 33%, 43%). Prevalence of protozoa, helminthic intestinal infections, and non-pathogenic parasites was 16.9%, 9.48%, and 18.5%, respectively, which affected 14.27% males and 15.3% females. The rate of infection in preschool and school children was 38.19% and 43.37% respectively. Giardia, Enterobiusvermicularis and Entamoeba coli were the most common among protozoa, helminthic, and non-pathogenic infections (15.1%, 16.5%, and 7.1%, respectively). The data analyses indicated that the prevalence of intestinal parasitic infection is decreasing in Iranian preschool and school children. Improvement of sanitation, personal hygiene, increased awareness of people, seasonal variations, and health education can be effective in reducing parasitic infections in different communities.

Prevalence of intestinal parasitic infection among primary school children in southern Iran

A cross-sectional study was carried out to determine the prevalence of intestinal parasites in primary school children in Bandar Abbas, southern Iran during January to March 2016. Single stool samples were collected from 1465 participants by clean stool cup. The questionnaire was prepared on the basis of demographic characteristics. The diagnosis was made on the basis of the direct wet mount, formalin-ether concentration, and Ziehl-Neelsen and trichrome stained slides. Out of the 1465 school children examined, six species of intestinal parasites were identified with an overall prevalence of 95 positive students (6.5%). Prevalence of protozoan infections (6.2%) was significantly higher than helminth infections (0.3%). The most common protozoan species were Giardia lamblia (n = 42, 2.9%) and Blastocystis hominis (n = 31, 2.1%). Only two cases of Hymenolepis nana and two cases of Enterobius vermicularis were detected. The prevalence of parasitic infections was higher in boys (n = 52, 7%) than girls (n = 41, 5.7%), but the difference was not significant. The parasitic infections were higher among the children whose parent's education was less than high school diploma (p = 0.000), and there was also a significant association between the parents' jobs and the intensity of parasitic infection. The prevalence of intestinal parasites, compared to the previous studies in this area, was significantly lower; that is mainly due to an increase in the quality of life and parents' education as well as the accessibility to health services. The most prevalent intestinal parasite was G. lamblia; therefore, it is recommended that more emphasis is applied to controlling and preventing this parasitic infection by washing hands, particularly before each meal course.

School-based prevalence of intestinal parasitic infections and associated risk factors in rural communities of Sana'a, Yemen

Yemen is a developing country overwhelmed with a triad of poverty, diseases and social conflicts. Moreover, the majority of its population live in rural communities and suffer from intestinal parasitic infections (IPIs). Therefore, the present school-based, cross-sectional survey aimed to detect the prevalence of such infections and associated risk factors among schoolchildren in the rural communities of Bani Alharith, Hamdan and Bani Hushaysh districts of Sana'a, north of Yemen. Socio-demographic data and certain behavioral risk factors as well as stool samples were collected from 1218 schoolchildren from ten randomly schools in the study area. Fresh stool samples were examined for parasites by direct saline and iodine preparations and after concentration with formol-ether technique. The overall prevalence of IPIs was 54.8%, with a higher frequency of protozoal than helminthic infections (37.6 vs. 17.2%, respectively). Parasite species recovered were Entameba histolytica (21.5%), Giardia lamblia (16.1%), Ascaris lumbricoides (8.3%), Hymenolepis nana (5.3%), Schistosoma mansoni (2.6%), Trichuris trichiura (0.5%) and Enterobius vermicularis (0.4%). Univariate analysis showed that the male gender and illiteracy of fathers and/or mothers were the socio-demographic factors significantly associated with higher infection rates. The illiteracy of mothers was also confirmed as an independent risk factor by multivariable analysis. On the other hand, not washing hands before eating, not washing fruits and vegetables before consumption, eating uncovered food and not clipping fingernails were the risk behaviors significantly associated with higher infection rates, with the last three ones being confirmed as independent risk factors. Therefore, control measures should include regular treatment of protozoal infections and deworming of schoolchildren, promotion of hygiene in rural schools through health education programs, regular inspection of schoolchildren for personal hygiene practices and the provision of a healthy school infrastructure.

Factors Associated with Gastrointestinal Parasitic Infections among Young Population in Northeast Brazil

Background. Intestinal parasitic infections constitute a major public health problem that is frequently associated with poverty, inadequate sanitation, and the nutritional status of the population. Objective. The aim of the present study is to investigate the possible association of parasitic infections, sanitary conditions, hygiene practices, and the nutritional and socioeconomic status of a poor youth population. Methods. A cross-sectional study was conducted with 367 children and adolescents inhabiting a substandard settlement in the urban area of Maceió (Alagoas State, Brazil). Data collection included socioeconomic status, anthropometric measurements, fecal sample examinations, and laboratory blood analysis. The identification of factors associated with gastrointestinal parasitic infections was undertaken through bi- and multivariate analyses. Results. Stool sample analysis obtained from 300 individuals revealed that 204 (68%) were infected with at least one parasite species and of these 130 (63.7%) were polyparasitized. No significant associations were identified between low height for age (stunted), parasitic infections, and polyparasitism. There was also no association between family income and parasitosis. However, low socioeconomic status proved to be a potential risk factor for parasitic infections. Conclusion. Actions must be taken to improve sanitation, housing, and environmental conditions in order to eliminate the risk factors for parasitic infections, and thereby guarantee a better quality of life for this population.

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.

Helminth infections among long-term-residents and settled immigrants in Qatar in the decade from 2005 to 2014: temporal trends and varying prevalence among subjects from different regional origins

BACKGROUND

Travel and migration from developing regions, where tropical diseases are common, to more developed industrialised nations can contribute to the introduction and subsequent spread of infections. With its rapidly expanding economy, Qatar has attracted vast numbers of immigrant workers in the last two decades, often from countries with poor socio-economic levels. Many used to arrive with patent intestinal parasitic infections.

METHODS

We analysed the prevalence of helminth infections in a dataset of 29,286 records of subjects referred for stool examination at the Hamad Medical Corporation over the course of a decade (2005 to 2014, inclusive).

RESULTS

Overall prevalence of combined helminth infections was low (1.86 %) but there were significant temporal trends, age and sex effects and those arising from the region of origin of the subjects. The most common helminths were hookworms (overall prevalence 1.22 %), which accounted for 70.1 % of cases, and therefore patterns for combined helminth infections were largely driven by hookworms. In both cases, and also in Trichuris trichiura and Ascaris lumbricoides, prevalence peaked in 2008, since when prevalence has been steadily falling. Helminth infections were largely concentrated among subjects from five Asian countries (Nepal, Bangladesh, Sri Lanka, India and Pakistan), and there was a highly biased prevalence in favour of male subjects in all cases. Prevalence of all three nematodes peaked in age class 7 (mean age 25.5 years, range = 20-29) and there were significant interactions between region of origin, sex of subjects and prevalence of hookworms.

CONCLUSION

These results offer optimism that prevalence will continue to decline in the years ahead, especially if control is targeted at those most at risk of carrying infections.

Practical parasitology courses and infection with intestinal parasites in students

Students who are working in research or educational laboratories of parasitology, as well as health care workers providing care for patients, are at the risk of becoming infected with parasites through accidental exposure. The main purpose of this study was to identify potential positive cases of intestinal parasitic infections among students who took practical parasitology courses compared with students who did not take any practical parasitology courses in Lorestan University of Medical Sciences, Khorramabad, Iran, in 2013-2014. A total of 310 subjects from various majors were invited to voluntarily participate in the study. Various demographic data were collected using questionnaires. Three stool samples were collected from each individual on alternate days. Saline wet mounts (SWM), formalin-ether sedimentation test (FEST), Sheather floatation test (SHFT) and trichrome and modified Ziehl-Neelsen staining methods were used to diagnose the presence of intestinal parasites. The prevalence rate of intestinal parasites (IPs) among the students was 11.93%. There was a significant difference between majors in the infection with IPs (P<0.05). The most frequently observed IPs were Blastocystis hominis (4.51%) and Giardia intestinalis (3.54%). The results of this study showed that the transmission of pathogenic parasites in the educational course of practical parasitology could occur and must be taken into careful consideration.

Patterns and Risk Factors of Soil-Transmitted Helminthiasis Among Orang Asli Subgroups in Peninsular Malaysia

A cross-sectional study was conducted to provide comprehensive data on the patterns and associated risk factors of soil-transmitted helminth (STH) infections among five Orang Asli subgroups in Peninsular Malaysia. The overall prevalence of STH infections was 59.9% (95% confidence interval [CI] = 56.1-63.7%). Trichuris trichiura (54.3%; 95% CI = 50.4-58.2%) was the predominant species followed by Ascaris lumbricoides (26.7%; 95% CI = 23.3-30.1%) and hookworm (9.1%; 95% CI = 6.9-11.3%). This study showed diversity for STH infections by subgroup with poverty and personal sanitary behavior as important risk factors for infection. Risk profile analyses indicating that Orang Kuala subgroup who has a generally well-developed infrastructure and better quality of life had a low rate of infection. There is a need for poverty reduction and promotion of deworming programs along with mass scale campaigns to create awareness about health and hygiene to reduce STH infections.