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Taghipour A, Pirestani M, Hamidi Farahani R, Barati M. The Frequency of Intestinal Parasitic Infections in COVID-19 Patients: A Case-Control Study in Tehran, Capital of Iran. J Trop Med 2023; 2023:5359823. [PMID: 37719419 PMCID: PMC10504051 DOI: 10.1155/2023/5359823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/04/2023] [Accepted: 09/04/2023] [Indexed: 09/19/2023] Open
Abstract
The present study was done to evaluate the prevalence of intestinal parasitic infections (IPIs) in patients with COVID-19 in health care centers (Imam Reza and Golestan hospitals), Tehran, capital of Iran. By designing a matched case-control study, 200 fecal samples were collected for each of the COVID-19 patients and healthy individuals. Nasopharyngeal/oropharyngeal swab samples were collected from all participants for the diagnosis of COVID-19. RNA extraction was performed, and then real time reverse-transcription polymerase chain reaction (rRT-PCR) assay was applied to detect viral RNA. Considering the lung complications, 25%> lung complications was detected in 49 patients, 25-49% in 42 patients, and 50%≤ in 109 patients. Fecal samples were examined using different parasitological techniques. After nested-PCR, sequencing was applied to identify Cryptosporidium spp. and microsporidia spp. A relatively lower prevalence of IPIs was detected among control group (7.5%), than in COVID-19 patients (13%), though not significant (P=0.13). The most prevalent parasite among patients was Blastocystis sp. (6%). Also, 13.76% of IPIs were detected in inpatients with more than 50% lung complication. As well, a remarkably significant difference in IPIs was observed among diarrheic COVID-19 patients, in comparison with nondiarrheic patients (P < 0.00001). Moreover, the isolated sequences in the present study belonged to C. parvum subtype IIa and Enterocytozoon bieneusi genotypes D and Peru 8. In conclusion, more epidemiological and clinical research studies are needed to better understand the status and interaction of IPI in COVID-19 in Iran and other countries.
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Affiliation(s)
- Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Majid Pirestani
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ramin Hamidi Farahani
- Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Mohammad Barati
- Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran
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Chatterjee R, Mondal T, Barik G, Ghosh S, Pramanik N, Maji A, Ghosh T. Multiple protozoal infections in a single immunocompromised patient: A case report. Trop Parasitol 2023; 13:121-125. [PMID: 37860609 PMCID: PMC10583785 DOI: 10.4103/tp.tp_31_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/28/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2023] Open
Abstract
Immunocompromised patients with human immunodeficiency virus (HIV) infection are prone to multiple infections, of which parasitic infections are an important cause. Parasitic protozoal infections - both by common and rare protozoa are documented in such patients. Here, we report a rare and interesting case of five protozoal infections affecting a single HIV-infected person at the same time of initial presentation. A 64-years-male came to us with complaints of chronic diarrhea for 6 months. He was investigated and found to be positive for HIV I. His stool examination revealed cysts of Entameba histolytica and Giardia lamblia and oocysts of Cryptosporidium species and Cystoisospora species. His toxoplasma IgG was also positive in high titer. The patient was medically diagnosed and was treated with medications as clinically prescribed - antiretroviral therapy was initiated and he was discharged in due course. A total of five protozoal infections were documented affecting a single person - newly diagnosed immunocompromised male, which by sheer qualitative count of patient case histories, indeed is a rare case reported in the medical literature.
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Affiliation(s)
- Rupak Chatterjee
- Department of Tropical Medicine, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Tanusree Mondal
- Department of Community Medicine, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Gautam Barik
- Department of Microbiology, Calcutta Medical College, Kolkata, West Bengal, India
| | - Subhoroop Ghosh
- Department of Microbiology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Netai Pramanik
- Department of Tropical Medicine, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Ardhendu Maji
- Department of Microbiology, Protozoology Unit, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Tapashi Ghosh
- Department of Microbiology, Helminthology Unit, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
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Ali MI, Wahab WMAE, Hassan A, Ryan U, Xiao L, Arafa WM, Hamdy DA. Detection of unusual Cryptosporidium parvum subtype in patients with gastrointestinal cancer in Egypt. Parasitol Res 2023; 122:597-606. [PMID: 36539638 DOI: 10.1007/s00436-022-07761-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
While the importance of cryptosporidiosis in immunocompromised persons is well known, the prevalence of Cryptosporidium spp. in cancer patients is not clear. The current study was designed to assess the occurrence and genetic characteristics of Cryptosporidium spp. in patients with gastrointestinal (GI) cancer in Egypt. Stool samples were collected from 100 patients with GI malignancies and 20 healthy individuals without any GI manifestations (control group). They were screened by microscopy and the immunochromatographic RIDA®QUICK Cryptosporidium kit. Subtyping of Cryptosporidium spp. was conducted by sequence analysis of the glycoprotein 60 (gp60) locus. Sociodemographic, environmental data and information on GI symptoms, cancer types, and clinical treatment were obtained via a questionnaire. By microscopy and RIDA®QUICK, only 7% (7/100) of GI cancer patients were positive for Cryptosporidium, compared with 40% (40/100) by gp60 nPCR. No positives were obtained from the control group. Male sex (P = 0.02) and younger age (P = 0.004) were major Cryptosporidium risk factors for infection. The occurrence of Cryptosporidium was also significantly more frequent (P = 0.003) in watery stool samples. Sequence analysis of the gp60 amplicons (~ 400 bp) identified a novel C. parvum subtype with nine TCA repeats and eleven ACATCA repeats. A formal subtype designation could not be made due to the short sequence length. More studies should be conducted to verify the common occurrence of this unusual C. parvum subtype and establish its genetic identity.
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Ghoshal U, Kalra SK, Tejan N, Ranjan P, Dey A, Nityanand S. Prevalence and Genetic Characterization of Cryptosporidium and Microsporidia Infecting Hematological Malignancy Patients. Acta Parasitol 2021; 66:508-516. [PMID: 33188485 DOI: 10.1007/s11686-020-00307-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/23/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the prevalence of Cryptosporidium and Microsporidia, associated risk factors and species identification in patients with haematological malignancies (HM). METHODS A total of 148 consecutive patients with HM and 101 healthy subjects were evaluated for Cryptosporidium and Microsporidia using modified Kinyoun and modified Trichrome staining. Clinical, demographic and laboratory parameters were studied. The species of Cryptosporidium and Microsporidia were studied using PCR-RFLP. RESULTS Of 148 HM patients initially screened, 47 were excluded from the final analysis due to inadequate clinical records. Patients with HM [n = 101, 63 (62.4%) male] more often had Cryptosporidium than healthy subjects [n = 101, 65 (74.4%) male] [3/101 (3%) vs. 0/101 (0%), p = 0.02]. Two of 101 (2%) HM patients and none of the healthy subjects had Microsporidia (p = 0.155). Diarrhea was more prevalent in HM patients with Cryptosporidium than those without [3, 100% vs. 39/96, 40.62%; p = 0.04). Both patients infected with Microsporidia presented with persistent diarrhea and fever. Cryptosporidium hominis was identified in all the three HM patients. Enterocytozoon bieneusi was identified in one HM patient infected with Microsporidia, which was classified as genotype Ind2. CONCLUSION Cryptosporidium and Microsporidia may infect HM patients leading to overwhelming diarrhea. The commonest species of Cryptosporidium and Microsporidia found to infect HM patients are C. hominis and E. bieneusi.
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Affiliation(s)
- Ujjala Ghoshal
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareili road, Lucknow, UP, 226014, India.
| | - Sonali K Kalra
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareili road, Lucknow, UP, 226014, India
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, PO Sultanpur, Distt., Solan, HP, 173229, India
| | - Nidhi Tejan
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareili road, Lucknow, UP, 226014, India
| | - Prabhat Ranjan
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareili road, Lucknow, UP, 226014, India
| | - Asmita Dey
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareili road, Lucknow, UP, 226014, India
| | - Soniya Nityanand
- Department of Haematology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareili road, Lucknow, UP, 226014, India
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Salehi Kahyesh R, Alghasi A, Haddadi S, Sharhani A. Intestinal Parasites Infection in Children with Cancer in Ahvaz, Southwest Iran. Interdiscip Perspect Infect Dis 2020; 2020:8839740. [PMID: 33424965 DOI: 10.1155/2020/8839740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 11/24/2020] [Accepted: 12/11/2020] [Indexed: 11/25/2022] Open
Abstract
Background Infection with intestinal parasites is widespread worldwide, especially in developing countries. Intestinal parasites are known as one of the leading causes of diarrhea in both immunocompetent and immunocompromised subjects, but cancer patients are highly susceptible to contamination, and it can be deadly for them. This study aimed to estimate the prevalence of intestinal parasites in immunocompromised patients in Ahvaz. Material and Methods. In this descriptive cross-sectional pilot case-control study, fecal samples were collected from 52 children with malignancies hospitalized in Baqaei2 hospital in Ahvaz. A questionnaire including demographic information, type of cancer, type of gastrointestinal symptoms, and laboratory diagnosis was completed for each patient. The collected specimens were examined by direct smear, Logul staining, and concentration. Result The 52 stool samples were collected, 46% were female and 54% male. The age range of children enrolled in the study was from 4 months to 16 years. Of these stool samples, 38.38% were infected with a variety of parasitic intestinal infections (helminths and protozoa). In this study, protozoan parasites, Blastocystis (23%), Chilomastix mesnili (1.92%), Endolimax nana (7.7%), and Entamoeba coli (1.92%), and helminth infection, Strongyloides stercoralis (3.84%), were observed and statistical analysis showed that there was a significant relationship between gastrointestinal symptoms and parasitic infection in children with cancer. Conclusion Blastocystis and Endolimax nana are the most prevalent gastrointestinal parasitic protozoans that infect individuals admitted to Baqaei2 Hospital of Ahvaz, Iran. Since parasitic intestinal infections in immunocompromised patients lead to fatal diarrhea, children with parasitic infections must be carefully identified and treated.
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Mohebali M, Keshavarz H, Abbaszadeh Afshar MJ, Hanafi-Bojd AA, Hassanpour G. Spatial Distribution of Common Pathogenic Human Intestinal Protozoa in Iran: A Systematic Review. Iran J Public Health 2021; 50:69-82. [PMID: 34178765 PMCID: PMC8213612 DOI: 10.18502/ijph.v50i1.5073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
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.
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Affiliation(s)
- Mehdi Mohebali
- Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran.,Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Keshavarz
- Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran.,Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ahmad Ali Hanafi-Bojd
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Hassanpour
- Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran.,Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Najafi-asl M, Faraji H, Hosseini Teshnizi S, Sharifi-sarasiabi K. Prevalence and Molecular Genotyping of Cryptosporidium Spp. in Diarrheic Patients from Bandar Abbas City, Southern Iran. Jundishapur J Microbiol 2020; 13. [DOI: 10.5812/jjm.102706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Cryptosporidium species are recognized as one of the most important gastrointestinal pathogens of humans and livestock. Objectives: This study aimed to determine the prevalence and sub-genotypes of Cryptosporidium spp. among diarrheic patients in Bandar Abbas City, Iran. Methods: Diarrheic fecal samples were collected from 170 patients in three hospitals of Bandar Abbas, Iran, from October 2018 to May 2019. Initial parasitological identification of Cryptosporidium spp. was performed by modified Ziehl-Neelsen (ZN) staining. For molecular analysis, the positive specimens and the suspected ones of Cryptosporidium spp. were evaluated by sequence analysis of the 60-kDa glycoprotein gene (gp60). The collected data were analyzed using SPSS software and the relationship between the variables and the presence of Cryptosporidium spp. assessed by the chi-square test. To assess the degree of agreement between PCR and ZN staining, Cohen’s kappa-index was applied. Results: Of the 170 diarrheic patients, 98 (57.6%) were male, and 72 (42.4%) were female. Prevalence of Cryptosporidium spp. by parasitological examination was 1.8% (3/170). However, using PCR, Cryptosporidium spp. was detected in 12% (6/50) of the positive microscopically samples (3 samples) and 47 suspected specimens. Sequence analysis of the gp60 gene showed that all of the positive isolates were Cryptosporidium parvum in which all subtypes belonged to allele family IId. Two distinct nucleotide sequences obtained from this study were deposited in GenBank under the accession numbers MN820453 and MN820454. Conclusions: The predominance of C. parvum (subtype family IId) in this study emphasizes the importance of zoonotic Cryptosporidium transmission in Bandar Abbas, Southern Iran.
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Utami WS, Murhandarwati EH, Artama WT, Kusnanto H. Cryptosporidium Infection Increases the Risk for Chronic Diarrhea Among People Living With HIV in Southeast Asia: A Systematic Review and Meta-Analysis. Asia Pac J Public Health 2020; 32:8-18. [PMID: 32037854 PMCID: PMC7750677 DOI: 10.1177/1010539519895422] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We conducted a systematic review research and meta-analysis to reveal the
relationship between the risk of chronic diarrhea and
Cryptosporidium infection in people living with HIV in
Southeast Asia. We performed online peer-reviewed literature research from
January 2005 to December 2017, which included PubMed, Science Direct, ProQuest,
EBSCO, Cochrane, and Web of Science databases. Calculation of size effects in
the meta-analysis was performed by STATA 13.0 software to estimate relative
risks (RRs) with 95% confidence intervals (CIs) for any associations. Seven
cross-sectional research articles were recruited in this study based on the
inclusion and exclusion criteria. Our analysis revealed a significant
relationship between cryptosporidiosis and the risk of chronic diarrhea in
people living with HIV, with RR = 1.325; 95% CI = 1.157 to 1.517; and
P < .000. Our results suggested that cryptosporidiosis
increases the risk of chronic diarrhea, and low CD4+ lymphocyte cell
counts aggravate the degree of diarrhea. Therefore, clinicians should be more
aware in treating HIV-positive people, especially those with low CD4+
cell counts, and we suggest that Cryptosporidium laboratory
examinations be conducted immediately.
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Mahmoudi M, Hazrati Tappeh K, Abasi E, Aminpour A. Utility of Different Diagnostic Tools for Detection of Cryptosporidium in Children with Diarrhea. Arch Pediatr Infect Dis 2019; 8. [DOI: 10.5812/pedinfect.92033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Firoozi Z, Sazmand A, Zahedi A, Astani A, Fattahi-Bafghi A, Kiani-Salmi N, Ebrahimi B, Dehghani-Tafti A, Ryan U, Akrami-Mohajeri F. Prevalence and genotyping identification of Cryptosporidium in adult ruminants in central Iran. Parasit Vectors 2019; 12:510. [PMID: 31666095 PMCID: PMC6822396 DOI: 10.1186/s13071-019-3759-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 10/22/2019] [Indexed: 12/22/2022] Open
Abstract
Background Apicomplexan parasites of the genus Cryptosporidium infect a wide range of animal species as well as humans. Cryptosporidium spp. can cause life threatening diarrhea especially in young animals, children, immunocompromised patients and malnourished individuals. Asymptomatic cryptosporidial infections in animals can also occur, making these animals potential reservoirs of infection. Methods In the present study, a molecular survey of Cryptosporidium spp. in ruminants that were slaughtered for human consumption in Yazd Province, located in central Iran was conducted. Faeces were collected per-rectum from 484 animals including 192 cattle, 192 sheep and 100 goats. DNA was extracted from all samples and screened for Cryptosporidium by PCR amplification of the 18S rRNA gene. Positives were Sanger sequenced and further subtyped by sequence analysis of the 60 kDa glycoprotein (gp60) locus. Results In total, Cryptosporidium spp. were detected in 22 animals: C. andersoni and C. bovis in seven and two cattle faecal samples, respectively, C. ubiquitum in five sheep, and C. xiaoi in six sheep and two goat samples, respectively. To our knowledge, this study provides for the first time, molecular information concerning Cryptosporidium species infecting goats in Iran, and is also the first report of C. ubiquitum and C. xiaoi from ruminants in Iran. Conclusion The presence of potentially zoonotic species of Cryptosporidium in ruminants in this region may suggest that livestock could potentially contribute to human cryptosporidiosis, in particular among farmers and slaughterhouse workers, in the area. Further molecular studies on local human populations are required to more accurately understand the epidemiology and transmission dynamics of Cryptosporidium spp. in this region.
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Affiliation(s)
- Zohre Firoozi
- Zoonotic Diseases Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.,Department of Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Alireza Sazmand
- Department of Pathobiology, Faculty of Veterinary Sciences, Bu-Ali Sina University, Hamedan, Iran
| | - Alireza Zahedi
- Vector and Water-Borne Pathogens Research Group, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, 6150, Australia
| | - Akram Astani
- Zoonotic Diseases Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.,Department of Microbiology Sciences, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Ali Fattahi-Bafghi
- Department of Parasitology, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Narges Kiani-Salmi
- Zoonotic Diseases Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.,Department of Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Behnam Ebrahimi
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Arefeh Dehghani-Tafti
- Department of Biostatics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Una Ryan
- Vector and Water-Borne Pathogens Research Group, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, 6150, Australia
| | - Fateme Akrami-Mohajeri
- Zoonotic Diseases Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. .,Department of Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
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Kalantari N, Gorgani-Firouzjaee T, Ghaffari S, Bayani M, Ghaffari T, Chehrazi M. Association between Cryptosporidium infection and cancer: A systematic review and meta-analysis. Parasitol Int 2020; 74:101979. [PMID: 31472267 DOI: 10.1016/j.parint.2019.101979] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 08/24/2019] [Accepted: 08/27/2019] [Indexed: 02/08/2023]
Abstract
The link between cryptosporidiosis and cancer has been suggested by some epidemiological studies. This systematic review and meta-analysis was conducted to further understand this relationship. In the current study, six electronic databases were reviewed for Cryptosporidium infection in cancer patients. We used random effects model and 95% confidence intervals (CI) to determine the overall odds ratio (OR). Heterogeneity was calculated with Cochran's Q test and I2statistic. In total, 19 studies involving 3562 individuals with case-control (nine) and cross-sectional (ten) designs were included in our project. The pooled overall random effect favored a statistically significant increased risk of Cryptosporidium infection in cancer patients compared with non-cancer individuals [OR = 3.3; 95% CI: 2.18-4.98]. The overall heterogeneity was medium (χ2 = 25.77; I2 = 30.2%, P = .11). The pooled ORs in case-control and cross-sectional studies were [OR = 5.60; 95% CI: 3.43-9.13; χ2 = 5.51; I2 = 0.00%, P = .70] and [OR = 2.08; 95% CI: 1.18-3.67; χ2 = 13.69; I2 = 34.3, P = .13], respectively. T-value and P-value were 0.54 and 0.57 based on the results of Harbord's modified's regression test. In summary, this meta-analysis demonstrates that Cryptosporidium infection is associated with cancer. Also, it found that study design and year of publication are the specific sources of heterogeneity. Further studies should be carried out to investigate the impact of Cryptosporidium infection in the onset or development of cancer in the future.
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El-Badry AA, El Sayed SS, Hussein RR, Said YM, Al-Antably AS, Hassan MA. Intestinal parasitism in pediatric oncology children receiving chemotherapy: unexpected low prevalence. Heliyon 2019; 5:e02228. [PMID: 31453397 DOI: 10.1016/j.heliyon.2019.e02228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 04/25/2019] [Accepted: 08/01/2019] [Indexed: 11/29/2022] Open
Abstract
Background Children with underlying malignancies and those on chemotherapy are at risk for having intestinal parasitic infections, which can lead to a severe course and death. This cross-sectional study was done to assess the copro-parasitological and copro-molecular prevalence of entero-parasites in children with malignancies and those on chemotherapy. Procedure Stool samples were collected from 137 Egyptian hospitalized cancerous children with different malignancies in the National Cancer Institute, and receiving chemotherapy. Faecal samples were examined microscopically. Genomic copro-DNA was extracted from fecal samples and amplified by 3 separate nPCR assays targeting Cryptosporidium, G. intestinalis and Entamoeba histolytica complex. Result The overall prevalence of enteroparasites was 6.6 % (9 cases). Only Giardia copro-DNA was encountered in 2 (1.4%) faecal samples of patients. Coproscopy detected parasites in 7 cases: Blastocystis spp. in 5 cases (3.6%), Hymenolepis nana in 1 case (0.7%) and Ascaris lumbericoides in 1 case (0.7%). Conclusion Low prevalence may be due to patient's use of prophylactic anti-parasitic and anti-fungal drugs, a standard protocol, basic hygienic practices and good nursing all of which are preventive against enteroparasites transmission. Among studied variables only diarrhoeic individuals who had a solid tumor, and soft/liquid stool with mucus and blood were predictors of intestinal parasitism.
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Sahimin N, Douadi B, Yvonne Lim AL, Behnke JM, Mohd Zain SN. Distribution of Giardia duodenalis (Assemblages A and B) and Cryptosporidium parvum amongst migrant workers in Peninsular Malaysia. Acta Trop 2018; 182:178-184. [PMID: 29501402 DOI: 10.1016/j.actatropica.2018.02.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 02/26/2018] [Accepted: 02/28/2018] [Indexed: 02/08/2023]
Abstract
The influx of low skilled workers from socioeconomically deprived neighbouring countries to Malaysia has raised concerns about the transmission of communicable gastrointestinal diseases such as giardiasis and cryptosporidiosis to the local population. Therefore, a cross sectional study was conducted to investigate the prevalence of both diseases and the genetic diversity of these pathogens in the migrant population. Microscopic examination of faecal samples from 388 migrant workers involved in five working sectors were screened and 10.8% (n = 42) were found to be positive with Giardia spp. and 3.1% (n = 12) with Cryptosporidium spp. infections. PCR amplicons at the triosephosphate isomerase (tpi) gene were successfully obtained for Giardia duodenalis from 30 (30/388; 7.73%) samples with assemblages AII and B in 13 (13/30; 43.3%) and 17 (17/30; 56.7%) positive samples, respectively. Nine samples (9/388; 2.3%) were identified as Cryptosporidium parvum using PCR-RFLP analysis. Country of origin, duration of residence in Malaysia and working sectors significantly influenced G. duodenalis assemblage AII infections amongst the targeted population. Meanwhile, C. parvum infection was significantly associated with those working in the food service sector. Despite the low presence of pathogenic G. duodenalis and C. parvum in the study population, the results highlight the risk of anthroponotic foodborne and waterborne transmission and therefore call for implementation of control strategies through improvements in personal hygiene and sanitation standards.
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Kalantari N, Ghaffari S, Bayani M. Cryptosporidium spp. infection in Iranian children and immunosuppressive patients: A systematic review and meta-analysis. Caspian J Intern Med 2018; 9:106-115. [PMID: 29732026 PMCID: PMC5912216 DOI: 10.22088/cjim.9.2.106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 06/21/2017] [Accepted: 07/03/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cryptosporidiosis is an important cause of diarrhea in children and immunosuppressive patients. The current study was intended to evaluate the prevalence rate of Cryptosporidium infection and clarify the epidemiological characteristics of the infection in both children and immunosuppressive patients in Iran. METHODS Five English electronic databases including PubMed, Google Scholar, Science Direct, Scopus and Cochrane, and two Persian language databases Magiran and Scientific Information Database were searched. Additionally, reports from the Iranian congresses of parasitology and graduate student thesis dissertations were assessed manually. RESULTS Out of 1856 studies from the literature search, our search resulted in a total of 27 articles published from 1991 to 2016. These include 14 reports on cryptosporidiosis in children and 13 papers regarding immunosuppressive patients. 8520 children and 2015 immunosuppressed cases were evaluated. Oocysts of Cryptosporidium were found in 3.8% and 8% children cases and immunosuppressed patients, respectively. There was a relatively high variation in the prevalence estimates among different studies, and the Q statistics was high among articles regarding children (p<0.0001) and also between records regarding immunosuppressed patients (p<0.0001). Findings showed that the prevalence rates of Cryptosporidium infection are significantly higher in children under 5 years (P=0.00). CONCLUSIONS In summary, the present study provides a comprehensive view of the epidemiology of Cryptosporidium in children and immunosuppressive patients in Iran. Furthermore, a multidisciplinary and multicenter study to evaluate the real prevalence of Cryptosporidium infection and to determine its risk factors using an adequate sample size and standardized methods is highly recommended.
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Affiliation(s)
- Narges Kalantari
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Salman Ghaffari
- Department of Parasitology and Mycology, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Masomeh Bayani
- Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran
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Saki J, Asadpouri R. Molecular Characterization of Cryptosporidium Species Isolated from Cattle in Southwest of Iran. Jundishapur J Microbiol 2017; 11. [DOI: 10.5812/jjm.59371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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16
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Mahmoudi MR, Ongerth JE, Karanis P. Cryptosporidium and cryptosporidiosis: The Asian perspective. Int J Hyg Environ Health 2017; 220:1098-1109. [PMID: 28760503 DOI: 10.1016/j.ijheh.2017.07.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 07/17/2017] [Accepted: 07/17/2017] [Indexed: 12/11/2022]
Abstract
This review discusses findings of Cryptosporidium and cryptosporidiosis research in Asia and highlights the current situation of Cryptosporidium epidemiology, genetic diversity and distribution, and transmission throughout Asia taking into account all the available papers published for Cryptosporidium research in Asian countries since 2000. This effort will facilitate future research approaches and further developments in the understanding of Cryptosporidium epidemiology in Asia. The intent is to contribute to improvement in protection measures for mitigating the burden associated with this illness in the future.
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Affiliation(s)
- Mohammad-Reza Mahmoudi
- Department of Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Jerry E Ongerth
- Civil, Mining, and Environmental Engineering, University of Wollongong, Wollongong, Australia.
| | - Panagiotis Karanis
- State Key Laboratory of Plateau Ecology and Agriculture, Qinghai University, Center of Biomedicine and Infectious Diseases (CBID), Academy of Animal Science and Veterinary Medicine, Qinghai University, Xining 810016, China.
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Berahmat R, Mahami-Oskouei M, Rezamand A, Spotin A, Aminisani N, Ghoyounchi R, Madadi S. Cryptosporidium infection in children with cancer undergoing chemotherapy: how important is the prevention of opportunistic parasitic infections in patients with malignancies? Parasitol Res. 2017;116:2507-2515. [PMID: 28730516 DOI: 10.1007/s00436-017-5560-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/12/2017] [Indexed: 12/20/2022]
Abstract
Cryptosporidiosis is a relatively uncommon disease in healthy individuals but could be potentially worrisome in immunocompromised patients. This study aimed to evaluate Cryptosporidium infection in children with cancer undergoing chemotherapy. A case-control study was conducted in 132 children with cancer undergoing chemotherapy and 132 non-cancer controls. The modified Ziehl-Neelsen (MZN) staining and polymerase chain reaction methods were used for the detection of Cryptosporidium parasite. All positive isolates were sequenced for phylogenetic analysis. Statistical analysis was performed using the SPSS version 16 and Fisher exact test. The rate of cryptosporidiosis in children with cancer undergoing chemotherapy was 3.8%, which was higher than that of the control group. Other intestinal parasites detected in patients with cancer included Giardia lamblia (3%), Entamoeba coli (1.5%), and Chilomastix mesnili (0.8%). In the control group, only two (1.5%) cases were positive for G. lamblia. No significant difference was observed between the gender, age, residency, contact with domestic animals, stool appearance, neutropenia, chemotherapy period, and type of malignancy with regard to cryptosporidiosis. Phylogenetic analysis revealed that Cryptosporidium parvum isolates in this study relied on a branch that represents similar sequences from Iran and other countries. Although the rate of Cryptosporidium infection was relatively higher in children with cancer undergoing chemotherapy compared to the control group, any statistically significant difference has not been found between them. These findings should not be contrary to the need for healthcare to prevent opportunistic parasitic infections in malignant and immunocompromised patients.
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Tavalla M, Kord E, Abdizadeh R, Asgarian F. Molecular Study of Cryptosporidium spp. in Dogs from Southwest of Iran. Jundishapur J Microbiol 2017; In press. [DOI: 10.5812/jjm.43412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Berahmat R, Spotin A, Ahmadpour E, Mahami-Oskouei M, Rezamand A, Aminisani N, Ghojazadeh M, Ghoyounchi R, Mikaeili-Galeh T. Human cryptosporidiosis in Iran: a systematic review and meta-analysis. Parasitol Res 2017; 116:1111-28. [PMID: 28110441 DOI: 10.1007/s00436-017-5376-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 01/12/2017] [Indexed: 01/20/2023]
Abstract
Cryptosporidiosis caused by Cryptosporidium spp. is an important parasitic disease that can be life-threatening for children and immunocompromised patients. This systematic review and meta-analysis was designed to determine the prevalence rate of Cryptosporidium infection and related risk factors among the Iranian general population. We searched electronic databases including Google Scholar, PubMed, Science Direct, Scopus and Proquest for articles in English and SID, Magiran, IranMedex, and IranDoc for articles in Persian. Out of 4816 studies identified in the electronic search, 94 articles were eligible for inclusion in the systematic review and meta-analysis. The prevalence rate of cryptosporidiosis by using the random effect model among children, healthy people, and gastroenteritis and immunocompromised patients in Iran was estimated as 3.65, 2.94, 1.29, and 4.54%, respectively. Findings of a phylogenetic analysis inferred by gp60 and 18S ribosomal RNA markers indicated that most of the infection rate belonged to C. parvum (particularly subtype IIaA15G2R1) and C. hominis among understudied groups. The present study is the first systematic review and meta-analysis providing a comprehensive view of the prevalence of human cryptosporidiosis and its related risk factors in Iran. It seems that the awareness of Cryptosporidium prevalence, risk factors, and disease complications may be required for developing effective strategies to prevent infection.
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Anejo-Okopi JA, Okojokwu JO, Ebonyi AO, Ejeliogu EU, Isa SE, Audu O, Akpakpan EE, Nwachukwu EE, Ifokwe CK, Ali M, Lar P, Oguche S. Molecular characterization of cryptosporidium in children aged 0- 5 years with diarrhea in Jos, Nigeria. Pan Afr Med J 2016; 25:253. [PMID: 28293369 PMCID: PMC5337289 DOI: 10.11604/pamj.2016.25.253.10018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 09/22/2016] [Indexed: 11/11/2022] Open
Abstract
Introduction Cryptosporidium is an important cause of diarrhea in children and immune-compromised individuals. Recent advances in molecular diagnostics have led to the discovery of subtype families that are thought to be more commonly associated with diarrhea. We aimed to isolate and characterize Cryptosporidium spp among children with diarrhea in Jos, Nigeria. Methods Stool samples were collected from165 children aged 0-5 years with diarrhea. Cryptosporidium oocysts were examined by wet mount preparation, using formalin ether and a modified acid fast staining method. DNA was extracted from positive samples using QIAamp DNA stool mini kit and PCR-RFLP assay was carried out after quantification. Genotyping and phylogenetic analysis were done to determine the subtype families and their relatedness. Results From the 165 children studied, 8 (4.8%) were infected with Cryptosporidium. PCR-RFLP assay and genotype characterization found the following Cryptosporidium species: C. hominis 6 (75%) and C. parvum 2 (25.0%), with family subtypes Id-5, Ie-1 and IIa-1, IId-1 respectively.The most common species was C. hominis and the frequent subtype was C. hominis-Id 5 (62.5%). Conclusion Cryptosporidium is not an uncommon cause of diarrhea in children, with C. hominis being the dominant species. Also C. hominis Id is the commonest sub-family subtype. Put together, zoonotic species may be an important cause of diarrhea in children aged 0-5 years in Jos, Nigeria.
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Affiliation(s)
- Joseph Aje Anejo-Okopi
- Department of Microbiology, University of Jos, Jos, Nigeria; AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Jos, Nigeria
| | | | - Augustine Odo Ebonyi
- AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Jos, Nigeria; Department of Pediatrics, University of Jos, Jos, Nigeria
| | - Emeka Uba Ejeliogu
- AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Jos, Nigeria; Department of Pediatrics, University of Jos, Jos, Nigeria
| | - Samson Ejiji Isa
- AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Jos, Nigeria; Department of Medicine, University of Jos, Jos, Nigeria
| | - Onyemocho Audu
- Department of Epidemiology and Community Health, College of Health Sciences, Benue State University, Makurdi, Nigeria
| | - Edoama Edet Akpakpan
- Department of Biological Science, Federal University, Otuoke, Bayelsa State, Nigeria
| | | | | | - Murna Ali
- Department of Microbiology, University of Jos, Jos, Nigeria
| | - Patricia Lar
- Department of Microbiology, University of Jos, Jos, Nigeria
| | - Stephen Oguche
- AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Jos, Nigeria; Department of Pediatrics, University of Jos, Jos, Nigeria
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Saki J, Foroutan-Rad M, Asadpouri R. Molecular Characterization of Cryptosporidium spp. in Wild Rodents of Southwestern Iran Using 18s rRNA Gene Nested-PCR-RFLP and Sequencing Techniques. J Trop Med 2016; 2016:6834206. [PMID: 27956905 DOI: 10.1155/2016/6834206] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/05/2016] [Accepted: 10/26/2016] [Indexed: 11/18/2022] Open
Abstract
Background. Rodents could act as reservoir for Cryptosporidium spp. specially C. parvum, a zoonotic agent responsible for human infections. Since there is no information about Cryptosporidium infection in rodents of Ahvaz city, southwest of Iran, hence, this survey was performed to determine the prevalence and molecular characterization of Cryptosporidium spp. in this region. Materials and Methods. One hundred rodents were trapped from different regions of Ahvaz city. Intestine contents and fecal specimens of rodents were studied using both microscopy examination to identify oocyst and nested-polymerase chain reaction (PCR) technique for 18s rRNA gene detection. Eventually restriction fragment length polymorphism (RFLP) method using SspI and VspI restriction enzymes was carried out to genotype the species and then obtained results were sequenced. Results. Three out of 100 samples were diagnosed as positive and overall prevalence of Cryptosporidium spp. was 3% using both modified Ziehl-Neelsen staining under light microscope and nested-PCR (830 bp) methods. Afterwards, PCR-RFLP was performed on positive samples and C. parvum pattern was identified. Finally PCR-RFLP findings were sequenced and presence of C. parvum was confirmed again. Conclusions. Our study showed rodents could be potential reservoir for C. parvum. So an integrated program for control and combat with them should be adopted and continued.
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