Breast cancer knowledge and practices amongst women in Algeria

PURPOSE

The present study aims at investigating how Algerian women feel about Breast Cancer (BC) and Breast Self-Examination (BSE) in terms of knowledge and attitude and to determine the factors associated with performing BSE and its reluctance.

METHODS

We carried out a cross-sectional survey between October 14, 2021 and November 14, 2022, targeting Algerian females aged more than 18 years and living in the country using a self-administered questionnaire.

RESULTS

A total of 436 participants were involved in this study among which 41.28% were aged between 21 and 30 years and 34.86% were aged between 31 and 40 years. The average level of correct responses with regard to knowledge about BC was estimated at 51.31%, whereas it was 32.93% concerning knowledge about BC risk factors. Family history was the less reported incriminating factor for developing BC among the asked women (7.34%). Concerning alarming signs of BC, the current study revealed that Algerian women were less knowledgeable about breast dimpling-puckering (44.27%), breast inward traction (50.23%), breast redness (54.13%), and nipple position change (54.13%). In terms of belief in the utility of BSE in the early detection of BC, almost all the participants (97.98%) were convinced of its utility, whereas 96.33% of them showed an interest in learning more about it. In what concerns the early screening tests, approximately, four-fifth of the participant (77.52%) heard about them, while 94.72% believed that its early detection could reduce the disease's severity and mortality.

CONCLUSION

These findings revealed an insufficient level of knowledge concerning BC, especially in regard to its risk factors and some alarming signs as well as a lack of knowledge about BSE and other BC screening tests; hence the necessity of awareness campaigns about this disease that should target categories with the lowest level of knowledge.

Further insight into the genetic diversity of Entamoeba coli and Entamoeba hartmanni

Despite the species' wide distribution, studies of the genetic diversity within Entamoeba coli and Entamoeba hartmanni remain limited. In the present study, we provide further insight into the genetic diversity of both species based on analysis of partial nuclear small subunit ribosomal DNA sequences generated from human fecal DNAs from samples collected in Africa, South America, and Europe. Reinforcing the previous recognition that E. coli is a species complex, our data confirm the existence of the two subtypes, ST1 and ST2, previously identified plus, potentially, a new subtype, ST3. While ST1 appears to be genetically quite homogenous, ST2 shows a substantial degree of intrasubtype diversity. ST2 was more common in samples collected outside Europe, whereas ST1 showed no geographical restriction. The potentially novel subtype is represented to date exclusively by sequences from South American and African samples. In contrast to previous reports, our new data also indicate substantial variation in E. hartmanni that could also support the establishment of subtypes within this species. Here, however, no links were identified between subtype and geographical origin.

Prevalence and Clinical Manifestations of Giardia intestinalis and Other Intestinal Parasites in Children and Adults in Algeria

Giardia intestinalis is one of the most common causes of parasite-induced diarrhea, abdominal pain, flatulence, and malabsorption. Yet, data on the epidemiology of G. intestinalis infections in North Africa are limited. The purpose of this study was to carry out a retrospective survey on the level of intestinal parasitism with a particular emphasis on G. intestinalis in children and adults in Algiers, Algeria. A total of 2,054 individuals from outpatient clinics or hospitalized at Beni-Messous University Hospital of Algiers undergoing stool microscopy for ova and parasites were included. The overall parasite infection rate was 28%. In the 567 parasite-positive samples, Blastocystis was found most frequently (57.3%), followed in frequency by Endolimax nana (41.0%), Entamoeba histolytica/dispar (19.6%), G. intestinalis (17.1%), Entamoeba coli (13.9%), Chilomastix mesnili (1.0%), Iodamoeba bütschlii (0.7%), Entamoeba hartmanni (0.5%), and Cryptosporidium spp. (0.2%). Intestinal parasites were generally more common in adults than in children, except for Giardia, which was more common in children (P = 0.0001). Giardia infection was independent of gender (P = 0.94). Compared with other intestinal parasitic infections, clinical manifestations, such as abdominal pain (P = 0.28) and diarrhea (P = 0.82), were found not to be significantly linked to Giardia infection. In conclusion, G. intestinalis is common in individuals referred to the University Hospital of Beni-Messous with digestive symptoms, particularly so in children. However, in our study, intestinal symptoms appeared not to be more linked to Giardia than to other intestinal parasites.

Molecular Characterization of Giardia duodenalis in Children and Adults Sampled in Algeria

The molecular epidemiology of giardiasis in Africa remains unclear. A study was carried out across four hospitals in Algeria. A total of 119 fecal samples from 55 children, 37 adults, and 27 individuals of undetermined age, all scored positive for intestinal parasites by microscopy, and were screened by real-time PCR for Giardia. Molecular characterization of Giardia was performed by assemblage-specific PCR and PCR targeting the triose phosphate isomerase gene (tpi). Of the 119 samples, 80 (67%) were Giardia-positive by real-time PCR. For 48 moderately-highly real-time PCR-positive samples, tpi genotyping assigned 22 samples to Assemblage A and 26 to Assemblage B. Contrary to Assemblage A, Assemblage B exhibited substantial genetic diversity and allelic heterozygosity. Assemblage-specific PCR proved to be specific for discriminating Assemblage A or B but not as sensitive as tpi genotyping. We confirmed that real-time PCR is more sensitive than microscopy for detecting Giardia in stool samples and that robust amplification and sequencing of the tpi gene is feasible when moderate-to-strongly real-time PCR-positive samples are used. This study is one of the few performed in Africa providing genotyping data on Giardia infections in humans. Both assemblages A and B were commonly seen and not associated with specific sociodemographic data.

Occurrence and molecular characterization of Giardia duodenalis in lambs in Djelfa, the central steppe of Algeria

Little is known of the prevalence and genetic identity of Giardia duodenalis in sheep in Algeria. The present study aimed at characterizing G. duodenalis in lambs up to 6 months of age in Djelfa, Algeria. A total of 346 fecal specimens were collected from 28 farms and screened for G. duodenalis cysts by zinc sulfate flotation microscopy, and positive specimens were confirmed using a direct immunofluorescence assay. Microscopy-positive specimens were analyzed by PCR and sequence analysis of the triosephosphate isomerase and glutamate dehydrogenase genes to determine G. duodenalis assemblages. Coprological examination indicated that the overall infection rate was 7.0% (24/346). Lambs under 3 months of age had higher infection rate (18/197, 9.0%) than older (6/149, 4.0%) animals, and animals with diarrhea (7/44, 16.0%) had higher infection rate than animals without diarrhea (17/302, 5.6%). PCR sequence analyses of the 15 G. duodenalis isolates revealed the presence of assemblages A in 6 isolates, assemblage E in 7 isolates, and both in 2 isolates. Assemblage A was only found in pre-weaned lambs with diarrhea, while assemblage E was mostly found in post-weaned lambs without diarrhea. The assemblage E isolates from sheep were genetically related to those from cattle in Algeria, while assemblage A isolates were from a well-known subtype prevalent in humans. Data generated from the study improve our understanding of the transmission of G. duodenalis in Algeria.

Differentiation of Blastocystis and parasitic archamoebids encountered in untreated wastewater samples by amplicon-based next-generation sequencing

Background

Application of next-generation sequencing (NGS) to genomic DNA extracted from sewage offers a unique and cost-effective opportunity to study the genetic diversity of intestinal parasites. In this study, we used amplicon-based NGS to reveal and differentiate several common luminal intestinal parasitic protists, specifically Entamoeba, Endolimax, Iodamoeba, and Blastocystis, in sewage samples from Swedish treatment plants.

Materials and methods

Influent sewage samples were subject to gradient centrifugation, DNA extraction and PCR-based amplification using three primer pairs designed for amplification of eukaryotic nuclear 18S ribosomal DNA. PCR products were sequenced using ILLUMINA® technology, and resulting sequences were annotated to species and subtype level using the in-house BION software, sequence clustering, and phylogenetic analysis.

Results

A total of 26 samples from eight treatment plants in central/southern Sweden were analysed. Blastocystis sp. and Entamoeba moshkovskii were detected in all samples, and most samples (n = 20) were positive for Entamoeba coli. Moreover, we detected Entamoeba histolytica, Entamoeba dispar, Entamoeba hartmanni, Endolimax nana, and Iodamoeba bütschlii in 1, 11, 4, 10, and 7 samples, respectively. The level of genetic divergence observed within E. nana and E. moshkovskii was 20.2% and 7.7%, respectively, across the ~400-bp region studied, and two clades of E. moshkovskii were found. As expected, Blastocystis sp. subtypes 1–4 were present in almost all samples; however, ST8 was present in 10 samples and was the only subtype not commonly found in humans that was present in multiple samples.

Conclusions

Entamoeba and Blastocystis were identified as universal members of the “sewage microbiome”. Blastocystis sp. ST8, which has been rarely reported in humans, was a very common finding, indicating that a hitherto unidentified but common host of ST8 contributed to the sewage influent. The study also provided substantial new insight into the intra-generic diversity of Entamoeba and Endolimax.

Prevalence of Cryptosporidium spp. in farmed animals from steppe and high plateau regions in Algeria

This study was conducted to investigate the prevalence of Cryptosporidium spp. and associated potential risk factors in farmed animals from different steppe and high plateau regions in Algeria. A total of 289, 254 and 149 faecal samples of cattle, sheep and dromedary camels respectively, and tracheas of 135 broiler chickens were screened for the presence of Cryptosporidium spp. by formalin-ether concentration method and modified Ziehl-Neelsen staining. Overall, Cryptosporidium spp. was detected in 36.7%, 15%, 8.9% and 2% of examined cattle, sheep, broiler chickens and dromedary camels. In cattle, the highest prevalence was observed in the neonatal calves (52.6%) and the presence of Cryptosporidium spp. was significantly associated with diarrhoea. Ovine cryptosporidiosis was found in more of 80% of sampled farms and lambs aged between 1-6 months (20.3%), followed by neonatal lambs (18.7%) were the most infected. Cryptosporidium excretion in sheep was not associated with presence of diarrhoea. The presence of cryptosporidia in broiler chickens showed a higher rate in birds aged of 16-24 days (30%) than in those of 35-44 days (3.5%). None of broiler chickens more than 44 days was found to be positive for Cryptosporidium. Cryptosporidium in dromedary camels was reported in three females aged more than 6 months, which did not show any signs of diarrhoea at the time of sampling. Cryptosporidium prevalence was not affected by sex in all studied animal species. The results of the present study provide the first data on the prevalence of Cryptosporidium spp. in dromedary camels and broiler chickens from steppe and high plateau regions in Algeria.