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Muadica AS, Köster PC, Dashti A, Bailo B, Hernández-de-Mingo M, Balasegaram S, Carmena D. Molecular Diversity of Giardia duodenalis, Cryptosporidium spp., and Blastocystis sp. in Symptomatic and Asymptomatic Schoolchildren in Zambézia Province (Mozambique). Pathogens 2021; 10:255. [PMID: 33668348 PMCID: PMC7996272 DOI: 10.3390/pathogens10030255] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 11/24/2022] Open
Abstract
Infections by the protist enteroparasites Giardia duodenalis, Cryptosporidium spp., and, to a much lesser extent, Blastocystis sp. are common causes of childhood diarrhoea in low-income countries. This molecular epidemiological study assesses the frequency and molecular diversity of these pathogens in faecal samples from asymptomatic schoolchildren (n = 807) and symptomatic children seeking medical attention (n = 286) in Zambézia province, Mozambique. Detection and molecular characterisation of pathogens was conducted by polymerase chain reaction (PCR)-based methods coupled with Sanger sequencing. Giardia duodenalis was the most prevalent enteric parasite found [41.7%, 95% confidence interval (CI): 38.8‒44.7%], followed by Blastocystis sp. (14.1%, 95% CI: 12.1‒16.3%), and Cryptosporidium spp. (1.6%, 95% CI: 0.9‒2.5%). Sequence analyses revealed the presence of assemblages A (7.0%, 3/43) and B (88.4%, 38/43) within G. duodenalis-positive children. Four Cryptosporidium species were detected, including C. hominis (30.8%; 4/13), C. parvum (30.8%, 4/13), C. felis (30.8%, 4/13), and C. viatorum (7.6%, 1/13). Four Blastocystis subtypes were also identified including ST1 (22.7%; 35/154), ST2 (22.7%; 35/154), ST3 (45.5%; 70/154), and ST4 (9.1%; 14/154). Most of the genotyped samples were from asymptomatic children. This is the first report of C. viatorum and Blastocystis ST4 in Mozambique. Molecular data indicate that anthropic and zoonotic transmission (the latter at an unknown rate) are important spread pathways of diarrhoea-causing pathogens in Mozambique.
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Affiliation(s)
- Aly S. Muadica
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain; (A.S.M.); (P.C.K.); (A.D.); (B.B.); (M.H.-d.-M.)
- Departamento de Ciências e Tecnologia, Universidade Licungo, 106 Quelimane, Zambézia, Mozambique
| | - Pamela C. Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain; (A.S.M.); (P.C.K.); (A.D.); (B.B.); (M.H.-d.-M.)
| | - Alejandro Dashti
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain; (A.S.M.); (P.C.K.); (A.D.); (B.B.); (M.H.-d.-M.)
| | - Begoña Bailo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain; (A.S.M.); (P.C.K.); (A.D.); (B.B.); (M.H.-d.-M.)
| | - Marta Hernández-de-Mingo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain; (A.S.M.); (P.C.K.); (A.D.); (B.B.); (M.H.-d.-M.)
| | - Sooria Balasegaram
- Field Epidemiology Services, National Infection Service, Public Health England, London SE1 8UG, UK;
| | - David Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, 28220 Madrid, Spain; (A.S.M.); (P.C.K.); (A.D.); (B.B.); (M.H.-d.-M.)
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Muadica AS, Balasegaram S, Beebeejaun K, Köster PC, Bailo B, Hernández-de-Mingo M, Dashti A, Dacal E, Saugar JM, Fuentes I, Carmena D. Risk associations for intestinal parasites in symptomatic and asymptomatic schoolchildren in central Mozambique. Clin Microbiol Infect 2020; 27:624-629. [PMID: 32505583 DOI: 10.1016/j.cmi.2020.05.031] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Chronic infections by enteric parasites including protist and helminthic species produce long-term sequelae on the health status of infected children. This study assesses potential associations linked with enteric parasite infections in symptomatic and asymptomatic children in Zambézia province, Mozambique. METHODS In this prospective cross-sectional study, stool samples and epidemiological questionnaires on demographics and risk associations were collected from symptomatic children (n = 286) from clinical settings and asymptomatic (n = 807) children from 17 schools and creches aged 3‒14 years. We detected enteric parasites using PCR-based methods. We calculated prevalence (adjusted for age, sex, house construction, drinking water, and latrine use) and odds ratios (ORs) for risk associations with logistic regression, after adjusting for district, neighbourhood and symptoms. RESULTS Numbers and adjusted prevalence (95% confidence intervals in parentheses) for the symptomatic and asymptomatic populations were Giardia duodenalis 120, 52% (22-82), 339, 42% (25-59); followed by Strongyloides stercoralis 52, 14% (9‒20), 180, 20% (15-25). Risk associations for G. duodenalis included drinking untreated river/spring water, OR 2.91 (1.80-4.70); contact with ducks, OR 14.96 (2.93‒76.31); dogs, OR 1.92 (1.04-3.52); cats, OR 1.73 (1.16-2.59), and a relative with diarrhoea, OR 2.59 (1.54‒4.37). Risk associations for S. stercoralis included having no latrine, OR 2.41 (1.44-4.02); drinking well water, OR 1.82 (1.02-3.25), and increasing age, OR 1.11 (1.04-1.20). CONCLUSIONS We found a high prevalence of intestinal parasites regardless of the children's symptoms. Drinking well or river water, domestic animals, and latrine absence were contributing factors of human infections.
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Affiliation(s)
- A S Muadica
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain; Departamento de Ciências e Tecnologia, Universidade Licungo, Quelimane, Zambézia, Mozambique
| | - S Balasegaram
- Field Epidemiology Services, National Infection Service, Public Health England, London, UK
| | - K Beebeejaun
- Field Epidemiology Services, National Infection Service, Public Health England, London, UK
| | - P C Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - B Bailo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - M Hernández-de-Mingo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - A Dashti
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - E Dacal
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - J M Saugar
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - I Fuentes
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - D Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Majadahonda, Madrid, Spain.
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Paulos S, Köster PC, de Lucio A, Hernández-de-Mingo M, Cardona GA, Fernández-Crespo JC, Stensvold CR, Carmena D. Occurrence and subtype distribution of Blastocystis
sp. in humans, dogs and cats sharing household in northern Spain and assessment of zoonotic transmission risk. Zoonoses Public Health 2018; 65:993-1002. [DOI: 10.1111/zph.12522] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 08/07/2018] [Accepted: 08/09/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Silvia Paulos
- Microbiology Service; Quirón Madrid University Hospital; Madrid Spain
| | - Pamela C. Köster
- Parasitology Reference and Research Laboratory; National Centre for Microbiology, Carlos III Health Institute; Madrid Spain
| | - Aida de Lucio
- Parasitology Reference and Research Laboratory; National Centre for Microbiology, Carlos III Health Institute; Madrid Spain
| | - Marta Hernández-de-Mingo
- Parasitology Reference and Research Laboratory; National Centre for Microbiology, Carlos III Health Institute; Madrid Spain
| | | | - Juan C. Fernández-Crespo
- Sub-Direction of Public Health of Álava, Department of Health; Basque Government; Vitoria-Gasteiz Spain
| | - Christen R. Stensvold
- Department of Bacteria, Parasites and Fungi; Statens Serum Institut; Copenhagen Denmark
| | - David Carmena
- Parasitology Reference and Research Laboratory; National Centre for Microbiology, Carlos III Health Institute; Madrid Spain
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Seguí R, Muñoz-Antoli C, Klisiowicz DR, Oishi CY, Köster PC, de Lucio A, Hernández-de-Mingo M, Puente P, Toledo R, Esteban JG, Carmena D. Prevalence of intestinal parasites, with emphasis on the molecular epidemiology of Giardia duodenalis and Blastocystis sp., in the Paranaguá Bay, Brazil: a community survey. Parasit Vectors 2018; 11:490. [PMID: 30165880 PMCID: PMC6117969 DOI: 10.1186/s13071-018-3054-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [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: 05/02/2018] [Accepted: 08/10/2018] [Indexed: 12/22/2022] Open
Abstract
Background Intestinal protozoan parasites are major contributors to the global burden of gastrointestinal disease causing significant socioeconomic consequences. Children living in resource-poor settings with restricted access to water and sanitary services are particularly at risk of these infections. Methods A prospective, community-based, cross-sectional survey was conducted in Paraná (southern Brazil) between May 2015 and May 2016. A total of 766 stool samples were individually collected from volunteers (male/female ratio: 0.99; age range: 0–76 years) and used for investigating the presence of intestinal helminth and protozoan species by routine microscopic procedures including the Kato-Katz and modified Ritchie concentration methods and the Ziehl-Neelsen stain technique. Quantitative real-time PCR confirmed microscopy-positive samples for Giardia duodenalis and the assemblages and sub-assemblages determined by multilocus sequence-based genotyping of the glutamate dehydrogenase (gdh) and β-giardin (bg) genes of the parasite. Identification of Blastocystis subtypes was carried out by amplification and sequencing of a partial fragment of the small-subunit ribosomal RNA gene (SSU rDNA) of this heterokont microorganism. Results Overall, 46.1% (353/766) of the participants were infected/colonised by at least one intestinal parasite/commensal species. Protozoan and helminth species were detected in 42.7% and 10.1% of the surveyed population, respectively. Blastocystis sp. (28.2%), Endolimax nana (14.9%), and Giardia duodenalis (11.0%) were the most prevalent species found among protozoans and Ascaris lumbricoides (5.0%), Trichuris trichiura (4.6%) and hookworms (1.0%) among helminths. A total of 38 G. duodenalis-positive samples were genotyped at gdh and bg markers, revealing the presence of the sub-assemblages AII (47.4%), AII/AIII (2.6%), BIII (5.3%), BIV (26.3%) and BIII/BIV (13.1%). Two samples (5.3%) were only identified as assemblage B. AII was predominantly found in females aged 5–9 years and was associated with a higher likelihood of reporting gastrointestinal symptoms. A total of 102 Blastocystis-positive samples were successfully subtyped at the SSU rRNA gene revealing the presence of ST1 (36.3%), ST2 (15.7%), ST3 (41.2%), ST4 (2.9%), ST6 (1.0%) and ST8 (2.9%). Conclusions Data presented here indicate that enteric parasites still represent a pressing health concern in Paraná, Brazil, probably due to sub-optimal water, sanitation and hygiene conditions. A mostly anthroponotic origin is suspected for G. duodenalis and Blastocystis sp. infections. Electronic supplementary material The online version of this article (10.1186/s13071-018-3054-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Raimundo Seguí
- Department of Pharmacy, Pharmaceutical Technology and Parasitology, Parasitology Area, Faculty of Pharmacy, Valencia University, Avda. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - Carla Muñoz-Antoli
- Department of Pharmacy, Pharmaceutical Technology and Parasitology, Parasitology Area, Faculty of Pharmacy, Valencia University, Avda. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain.
| | - Debora R Klisiowicz
- Department of Basic Pathology, Biological Sciences Area, Paraná Federal University, Av. Cel. Francisco H. dos Santos 100, Curitiba, 19031, Brazil
| | - Camila Y Oishi
- Department of Basic Pathology, Biological Sciences Area, Paraná Federal University, Av. Cel. Francisco H. dos Santos 100, Curitiba, 19031, Brazil
| | - Pamela C Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain
| | - Aida de Lucio
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain
| | - Marta Hernández-de-Mingo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain
| | - Paula Puente
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain
| | - Rafael Toledo
- Department of Pharmacy, Pharmaceutical Technology and Parasitology, Parasitology Area, Faculty of Pharmacy, Valencia University, Avda. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - José G Esteban
- Department of Pharmacy, Pharmaceutical Technology and Parasitology, Parasitology Area, Faculty of Pharmacy, Valencia University, Avda. Vicent Andrés Estellés s/n, 46100, Burjassot, Valencia, Spain
| | - David Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid, Spain.
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Dacal E, Saugar JM, de Lucio A, Hernández-de-Mingo M, Robinson E, Köster PC, Aznar-Ruiz-de-Alegría ML, Espasa M, Ninda A, Gandasegui J, Sulleiro E, Moreno M, Salvador F, Molina I, Rodríguez E, Carmena D. Prevalence and molecular characterization of Strongyloides stercoralis, Giardia duodenalis, Cryptosporidium spp., and Blastocystis spp. isolates in school children in Cubal, Western Angola. Parasit Vectors 2018; 11:67. [PMID: 29378626 PMCID: PMC5789528 DOI: 10.1186/s13071-018-2640-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/11/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Human infections by the gastrointestinal helminth Strongyloides stercoralis and the enteric protozoans Giardia duodenalis, Cryptosporidium spp. and Blastocystis spp. are not formally included in the list of 20 neglected tropical diseases prioritised by the World Health Organization. Although largely underdiagnosed and considered of lower public health relevance, these infections have been increasingly demonstrated to cause significant morbidity and even mortality globally, particularly among children living in resource-poor settings. METHODS In this cross-sectional survey the prevalence, frequency and molecular diversity of S. stercoralis, G. duodenalis, Cryptosporidium spp. and Blastocystis spp. were investigated in a school children population in the province of Benguela (Angola). A total of 351 stool samples were collected during January to June 2015. The presence of S. stercoralis and G. duodenalis was confirmed by qPCR methods. Giardia duodenalis assemblages and sub-assemblages were determined by multilocus sequence-based genotyping of the glutamate dehydrogenase and β-giardin genes of the parasite. Detection and identification of Cryptosporidium and Blastocystis species and subtypes was carried out by amplification and sequencing of a partial fragment of the small-subunit ribosomal RNA gene of both protozoan. Analyses of risk factors potentially associated with the transmission of these pathogens were also conducted. RESULTS Prevalences of S. stercoralis, G. duodenalis, Cryptosporidium spp., and Blastocystis spp. were estimated at 21.4% (95% CI: 17.1-25.7%), 37.9% (95% CI: 32.8-43.0%), 2.9% (95% CI: 1.1-4.5%) and 25.6% (95% CI: 21.18-30.2%), respectively. Overall, 64.1% (225/351) of the children were infected by at least one of the pathogens investigated. Sequence analyses of the 28 G. duodenalis isolates that were successfully genotyped allowed the identification of sub-assemblages AI (14.3%), AII (14.3%), BIII (7.1%) and BIV (25.0%). Discordant typing results AII/AIII and BIII/BIV were identified in 7.1% and 14.3% of the isolates, respectively. A total of five additional isolates (17.9%) were identified as assemblage B. Three Cryptosporidium species including C. hominis (70%), C. parvum (20%) and C. canis (10%) were found circulating in the children population under study. A total of 75 Blastocystis isolates were assigned to the subtypes ST1 (30.7%), ST2 (30.7%), ST3 (36.0%), ST5 (1.3%) and ST7 (1.3%), respectively. Children younger than seven years of age had significantly higher risk of infections by protozoan enteropathogens (PRR: 1.35, P < 0.01), whereas being underweight seemed to have a protective effect against these infections (PRR: 0.74, P = 0.005). CONCLUSIONS The burden of disease attributable to human strongyloidiasis, giardiosis, cryptosporidiosis and blastocystosis in Angola is considerably higher than initially estimated in previous surveys. Surveillance and control of these infections should be jointly tackled with formally considered neglected tropical diseases in order to maximize effort and available resources. Our data also demonstrate the added value of using molecular diagnostic methods in high transmission areas.
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Affiliation(s)
- Elena Dacal
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | - José M. Saugar
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | - Aida de Lucio
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | - Marta Hernández-de-Mingo
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | - Elena Robinson
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | - Pamela C. Köster
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | | | - Mateu Espasa
- 0000 0001 0675 8654grid.411083.fMicrobiology Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Passeig de la Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Arlette Ninda
- Hospital Nossa Senhora da Paz, Cubal, Benguela, Angola
| | - Javier Gandasegui
- 0000 0001 2180 1817grid.11762.33Biomedical Research Institute of Salamanca - Research Center for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain
| | - Elena Sulleiro
- 0000 0001 0675 8654grid.411083.fMicrobiology Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Passeig de la Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | | | - Fernando Salvador
- 0000 0001 0675 8654grid.411083.fInfectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Passeig de la Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Israel Molina
- 0000 0001 0675 8654grid.411083.fInfectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Passeig de la Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Esperanza Rodríguez
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
| | - David Carmena
- 0000 0000 9314 1427grid.413448.eParasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220 Majadahonda, Madrid Spain
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Adell-Aledón M, Köster PC, de Lucio A, Puente P, Hernández-de-Mingo M, Sánchez-Thevenet P, Dea-Ayuela MA, Carmena D. Occurrence and molecular epidemiology of Giardia duodenalis infection in dog populations in eastern Spain. BMC Vet Res 2018; 14:26. [PMID: 29357850 PMCID: PMC5778629 DOI: 10.1186/s12917-018-1353-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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] [Received: 08/11/2017] [Accepted: 01/16/2018] [Indexed: 01/23/2023] Open
Abstract
Background Giardia duodenalis is one of the most common enteric parasites in domestic animals including dogs. Young animals are more prone to the infection, with clinical manifestations ranging from asymptomatic to acute or chronic diarrhoea. Dogs are primarily infected by canine-specific (C-D) assemblages of G. duodenalis. However, zoonotic assemblages A and B have been increasingly documented in canine isolates, raising the question of whether and to which extent dogs can act as natural reservoirs of human giardiosis. Methods In this cross-sectional epidemiological survey we assessed the molecular diversity of G. duodenalis in dogs in the province of Castellón, Eastern Spain. A total of 348 individual faecal samples from sheltered (n = 218), breeding (n = 24), hunting (n = 68), shepherd (n = 24), and pet (n = 14) dogs were collected between 2014 and 2016. Detection of G. duodenalis cysts in faecal material was carried out by direct fluorescence microscopy as a screening test, whereas a qPCR targeting the small subunit ribosomal RNA gene of the parasite was subsequently used as a confirmatory method. Results Giardia duodenalis was detected in 36.5% (95% CI: 31.6–41.7%) of dogs. No significant differences in prevalence rates could be demonstrated among dogs according to their sex and geographical origin, but breeding (45.8%; 95% CI: 27.9–64.9%) and sheltered (40.4%; 95% CI: 34.1–47.0%) dogs harboured significantly higher proportions of G. duodenalis. Multi-locus sequence-based genotyping of the glutamate dehydrogenase and β-giardin genes of G. duodenalis allowed the characterization of 35 canine isolates that were unambiguously assigned to assemblages A (14.3%), B (22.9%), C (5.7%), and D (37.1%). A number of inter-assemblage mixed infections including A + B (11.4%), A + D (2.9%), and A + B + D (5.7%) were also identified. Conclusions Data presented here are strongly indicative of high infection pressures in kennelled animals. Zoonotic sub-assemblages AII, BIII, and BIV were responsible for a considerable proportion of the G. duodenalis infections detected, but very few of the genotypes identified have been previously documented in Spanish human populations. Although possible, zoonotic transmission between dogs and humans seems an infrequent event in this Spanish region. Electronic supplementary material The online version of this article (10.1186/s12917-018-1353-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Manuel Adell-Aledón
- CEU Cardenal Herrera University, C/ Grecia, 31, 12006, Castellón de la Plana, Castellón, Spain
| | - Pamela C Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain
| | - Aida de Lucio
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain
| | - Paula Puente
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain
| | - Marta Hernández-de-Mingo
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain
| | - Paula Sánchez-Thevenet
- CEU Cardenal Herrera University, C/ Grecia, 31, 12006, Castellón de la Plana, Castellón, Spain
| | | | - David Carmena
- CEU Cardenal Herrera University, C/ Grecia, 31, 12006, Castellón de la Plana, Castellón, Spain. .,Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Ctra. Majadahonda-Pozuelo Km 2, 28220, Majadahonda, Madrid, Spain.
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7
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Azcona-Gutiérrez JM, de Lucio A, Hernández-de-Mingo M, García-García C, Soria-Blanco LM, Morales L, Aguilera M, Fuentes I, Carmena D. Molecular diversity and frequency of the diarrheagenic enteric protozoan Giardia duodenalis and Cryptosporidium spp. in a hospital setting in Northern Spain. PLoS One 2017; 12:e0178575. [PMID: 28617836 PMCID: PMC5472271 DOI: 10.1371/journal.pone.0178575] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 05/15/2017] [Indexed: 11/18/2022] Open
Abstract
Background Human giardiosis and cryptosporidiosis are caused by the enteric protozoan parasites Giardia duodenalis and Cryptosporidium spp. Both pathogens are major contributors to the global burden of diarrhoeal disease, affecting primarily children and immunodebilitated individuals in resource-poor settings. Giardiosis and cryptosporidiosis also represent an important, often underestimate, public health threat in developed countries. In Spain only limited information is currently available on the epidemiology of these infections. Molecular data on the diversity, frequency, geographical distribution, and seasonality of G. duodenalis assemblages/sub-assemblages and Cryptosporidium species/sub-genotypes are particularly scarce. Methods A longitudinal molecular epidemiological survey was conducted between July 2015 to September 2016 in patients referred to or attended at the Hospital San Pedro (La Rioja, Northern Spain) that tested positive for G. duodenalis (N = 106) or Cryptosporidium spp. (N = 103) by direct microscopy and/or a rapid lateral flow immunochromatographic assay. G. duodenalis infections were subsequently confirmed by real-time PCR and positive isolates assessed by multi-locus sequence genotyping of the glutamate dehydrogenase and β-giardin genes of the parasite. Cryptosporidium species and sub-genotypes were investigated at the 60 kDa glycoprotein or the small subunit ribosomal RNA genes of the parasite. Sociodemographic and clinical parameters of infected patients were also gathered and analysed. Principal findings Out of 90 G. duodenalis-positive isolates by real-time PCR a total of 16 isolates were successfully typed. AII (44%, 7/16) was the most prevalent sub-assemblage found, followed by BIV (31%, 5/16) and BIII (19%, 3/16). A discordant genotype result AII/AIII was identified in an additional (6%, 1/16) isolate. No mixed infections A+B were detected. Similarly, a total of 81 Cryptosporidium spp. isolates were successfully typed, revealing the presence of C. hominis (81%, 66/81) and C. parvum (19%, 15/81). Obtained GP60 sequences were assigned to sub-type families Ib (73%, 59/81) within C. hominis, and IIa (7%, 6/81) and IId (2%, 2/81) within C. parvum. A marked inter-annual variation in Cryptosporidium cases was observed. Conclusions Human giardiasis and cryptosporidiosis are commonly identified in patients seeking medical care in Northern Spain and represent a more important health concern than initially thought. Assemblage A within G. duodenalis and sub-genotype IbA10G2 within C. hominis were the genetic variants of these parasite species more frequently found circulating in the population under study. Molecular data presented here seem to suggest that G. duodenalis and Cryptosporidium infections arise through anthroponotic rather than zoonotic transmission in this Spanish region.
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Affiliation(s)
| | - Aida de Lucio
- Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | | | | | | | - Lucía Morales
- Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - María Aguilera
- Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - Isabel Fuentes
- Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain
| | - David Carmena
- Parasitology Service, National Centre for Microbiology, Majadahonda, Madrid, Spain
- * E-mail:
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