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Intestinal parasites in Dakahlia governorate, with different techniques in diagnosing protozoa.

A total of 3180 patients attending Mansoura University Hospitals' Clinics, were subjected to stool examination by direct wet smear, formol-ether concentration, original formol-tween concentration, modified formol-tween concentration, modified Sheather's sugar floatation, Potassium hydroxide concentration and Gomori's Trichrome stain, and modified Kinyoun's acid-fast stain, and Ryan's Trichrome blue stain for Microsporidia. The intestinal helminthes in a descending order of abundance were: S. mansoni (5.3%), Fasciola sp. (4.8%), H. heterophyes (4.2%), Hymenolepis nana (3.9%), Trichostrongylus sp. (2.6%), A. lumbricoides (1.8%), Strongyloides stercoralis (1.5%), H. diminuta (1.4%), Taenia saginata (1.1%), E. vermicularis (by smear; 1.1 %), T. trichura (0.7%) and lastly A. duodenale (0.1%). The intestinal protozoa in a descending order of abundance were Blastocystis hominis (22.4%), Giardia lamblia (19.6%), Entamoeba histolytica/E.dispar (19%), Iodamoeba butschlii (16%), Cryptosporidium parvum (14.3%), E. coli (9.7%), Isospora hominis (7.7%), Endolimax nana (6.9%), E. hartmani (5.9%), Dientamoeba fragilis (5.1%), Chilomastix mesnili (5.1%), Trichomonas hominis (4.2%), Cyclospora cayetanensis (4.2%), Microsporidia spores (3.2%), Enteromonas hominis (1.9%) and Embadomonas intestinalis (1.3%). The results were discussed.

Animals↗

[Incidence of intestinal parasites in municipal sanitary workers in Malatya].

The incidence of intestinal parasites is closely related to such factors as the socio-economic level of the society, nutritional and hygienic habits, climate, environmental conditions, infrastructure and degree of literacy. In this study, the municipal sanitary workers who are regarded as a high risk group in Malatya were examined for intestinal parasites. Cellophane slides and fecal samples from 241 workers were examined and intestinal parasites were found in 93 (39.0%). The most common parasite was Entamoeba coli (34). Other parasites detected include Enterobius vermicularis (32), Giardia intestinalis (22), Blastocystis hominis (8), Iodamoeba butschlii (5), Entamoeba histolytica (2), Taenia sp. (2), Chilomastix mesnili (2), Dientamoeba fragilis (2), Entamoeba hartmanni (1), Trichomonas intestinalis (1) Hymenolepis nana (1), and Ascaris lumbricoides (1). A training seminary was conducted in order to inform all the workers about means of protection. The workers were given suitable treatment and were called for control after a month. The examinations revealed a significant decrease in the incidence rate of parasites (qui-square test in dependent samples P<0.05). It was concluded that offering training seminaries for certain occupational groups under risk is efficient in terms of protection.

Adult↗

Parasitic diarrhea.

This article reviews the biology, epidemiology, and clinical management of amebiasis, giardiasis, and cryptosporidiosis as well as the less common intestinal protozoa, Dientamoeba fragilis, Isospora belli, Balantidium coli, and Blastocystis hominis.

Diarrhea↗

[Protozoological stool examinations from 1980 to 1985 in the East German district of Rostock].

Between 1980 and 1985 a total of 17,290 faecal specimens were examined for intestinal Protozoa at the Institute of Hygiene, District of Rostock, GDR. The samples were taken from GDR citizens travelling to tropical or semitropical regions, from foreigners from these regions visiting Rostock District, and from the local population. Intestinal Protozoa were found in 5.78%, 20.80% and 6.43%, respectively. 9 different species were diagnosed: Entamoeba coli, E. hartmanni, E. histolytica, Endolimax nana, Jodamoeba buetschlii, Giardia lamblia, Dientamoeba fragilis, Chilomastix mesnili, Trichomonas hominis.

Entamoebiasis↗

Human cysticercosis and intestinal parasitism amongst the Ekari people of Irian Jaya.

A random sample of 242 people showed that 42 had palpable cysts of Taenia solium. Faecal examination recovered eggs of T. solium in seven (3%), while Trichuris (83%), Ascaris (83%), hookworms (76%), Strongyloides stercoralis (10%) and Strongyloides sp. (29%), Entamoeba histolytica (14%), Entamoeba coli (22%), Entamoeba hartmanni (7%), Entamoeba polecki (7%), Balantidium coli (9%) and Dientamoeba fragilis (21%) were the most common other intestinal parasites encountered. ELISA tests, using antigens prepared from adults and eggs of T. solium and from cysticerci of T. saginata were not very sensitive, the last diagnosing less than half of known positives while still retaining good specificity.

Adolescent↗

Sulfasalazine-induced colitis complicating idiopathic ulcerative colitis.

A diagnosis of idiopathic ulcerative colitis was made in a previously healthy 9-year-old boy. Symptoms persisted despite therapy with sulfasalazine, 50 mg/kg daily, but they eventually responded to treatment with parenteral nutrition and prednisone, 40 mg daily. Metronidazole was also given to eradicate persistent Dientamoeba fragilis from the stools. The symptoms resolved over 3 weeks, and the daily dose of prednisone was tapered. On two subsequent occasions a challenge with sulfasalazine caused an immediate recurrence of loose, blood-streaked stools and of nonspecific histologic features of ulcerative colitis, which resolved when the sulfasalazine was discontinued.

Child↗

Intestinal parasites in metropolitan Toronto day-care centres.

In 1981, 900 children (aged 3 months to 10 years) and 146 staff attending 22 day-care centres in metropolitan Toronto chosen at random provided a stool specimen in a survey for intestinal parasites. Of the children, 4% to 36% were infected in 20 of 22 centres. Overall, 19% of the children and 14% of the staff had intestinal parasites: 8.6% and 4.0% respectively had Dientamoeba fragilis, and 7.8% and 2.0% respectively had Giardia lamblia. The highest prevalence of dientamebiasis was in the 7- to 10-year-olds, whereas giardiasis was detected most frequently in the 6-year-olds. Infection with intestinal parasites was not correlated with age, sex, duration in the day-care centre, dog ownership, travel history, gastrointestinal symptoms or the proportion of children in the day-care centre who were born in less developed countries. Immigrant children and children of parents born in industrialized countries (including Canada) were more likely to be infected than were children born in Canada of parents from the developing world. Dientamebiasis was associated with cat ownership. Thus, intestinal protozoa--in particular, D. fragilis and G. lamblia--are endemic in Toronto day-care centres.

Canada↗

Intestinal protozoan infections: prevalence in the San Francisco Bay Area.

A sample of 415 members of the Kaiser Foundation Health Plan (KFHP) were tested for intestinal protozoa. This parasite survey group was found to be comparable in age distribution, sex and ethnic background with the membership at large. Gastrointestinal complaints were no more numerous in this group than in a large series of KFHP members taking multiphasic examinations. Because KFPH membership included, at the time of the survey, approximately 27 percent of all residents of the San Francisco Bay Area, the membership may be considered approximately representative of the entire area. Fourteen percent of persons were found to be infected with one or more intestinal protozoan parasites, while 5.5 percent harbored potentially pathogenic sorts. Entamoeba histolytica was found in 0.7 percent of those surveyed, Giardia lamblia in 1.7 percent and Dientamoeba fragilis in 3.1 percent.

Adolescent↗

[Frequency and significance of parasitic infections in refugees from vietnam (author's transl)].

In the course of the medical care which is provided for the refugees from Southeast Asia 100 persons were tested for intestinal parasites (helminths and protozoa). In addition serum samples were obtained from 72 of these and tested in several tests (CFT, FAT, IHA and SFT) using antigens of Entamoeba histolytica, Leishmania donovani, Toxoplasma gondii, Schistosoma spp., Fasciola hepatica, Echinococcus spp., Trichinella spiralis and Litomosoides carinii. In 49 persons infections with one, two or even three species of intestinal helminths were detected (helminthic index: 63%). In detail the following infection-rates were found: Ascaris lumbricoides 41%, Trichuris trichiura 11%, Ancylostoma spp. 10% and Clonorchis sinensis 1%. Besides infections with apathogenic protozoa (Entamoeba coli, Entamoeba hartmani, Dientamoeba fragilis, Endolimax nana, Jodamoeba buetschlii and Blastocystis hominis) infections with Entamoeba histolytica were found in 3% and with Lamblia intestinalis in 4%. The results of the serological tests did not reveal any acute infection with any of the extraintestinal parasites mentioned above, although some of the low titres may reflect old infections. In particular it is surprising that none of the sera reacted against Toxoplasma gondii in dilutions higher than 1 : 16. The results are discussed with respect to risks for the health of the refugees themselves and of the indigenous population.

Austria↗

[Comparison of intestinal parasite infestation indexes among HIV positive and negative populations].

This study was carried out on two groups of patients treated at the José de San Martín Clinical Hospital. One group was composed of 82 HIV-seropositive patients with no signs of diarrhea, and another one of 300 patients, not suspected of HIV infection, was considered as "control population". Stool samples were collected from each patient and examined for intestinal parasites. These determinations were carried out at the Department of Clinical Biochemistry, in the same Hospital. Three specimens were obtained from each patient and processed in an identical form. Concentration methods, a direct smear technique after centrifugation and the trichrome staining procedure were performed on each sample. The HIV-positive group was found to harbor a higher proportion of intestinal parasites. Outstanding differences between both groups in percentages of parasitoses were observed. Species found in a significantly higher percentage among HIV seropositive patients were: Entamoeba histolytica (26.5%), Iodamoeba bütschlii (16.9%), Dientamoeba fragilis (25.3%), Blastocystis hominis (51.8%), Cryptosporidium sp. (7.2%), and probably Isospora belli (1.2%). No significant differences in percentages of Giardia lamblia, Entamoeba coli, Chilomastix mesnili and helminths were observed between both groups. Within the HIV-positive group, a higher proportion of infestation due to E. histolytica and I. bütschlii was observed in homosexuals-bisexuals than in intravenous drug addicts or heterosexuals.

AIDS-Related Opportunistic Infections↗

Amebiasis and "nonpathogenic" intestinal protozoa.

Infection with single or multiple species of intestinal protozoa is common in humans and can result in either asymptomatic colonization or symptoms of intestinal disease. Entamoeba histolytica serves as a paradigm for invasive colonic protozoal infection. The key to diagnosis and treatment of amebiasis is knowledge of the epidemiologic risk factors and clinical manifestations, a rational approach to diagnosis, and an understanding of the sites of action and uses of anti-amebic drugs. This knowledge of treatment provides a context for consideration of intestinal infection with less common protozoan pathogens such as Dientamoeba fragilis and Balantidium coli and 'nonpathogenic' protozoa such as Blastocystis hominis and Entamoeba coli.

AIDS-Related Opportunistic Infections↗

Enteropathogens associated with diarrhea among military personnel during Operation Bright Star 96, in Alexandria, Egypt.

This study investigated the microbial causes of diarrheal disease among U.S. troops deployed near Alexandria, Egypt, during October 1995. Bacterial causes associated with 19 cases of diarrhea included: enterotoxigenic Escherichia coli (ETEC), 42% (21% heat-stable, 11% heat-labile, and 11% heat-stable/ heat-labile producers); enteropathogenic E. coli (5.3%); and enteroadherent E. coli (42%). Four cases of diarrhea were associated with enteroaggregative E. coli based on probe analysis for enteroaggregative heat-stable enterotoxin 1. Protozoan causes included; Entamoeba histolytica (11%), E. hartmanni (5%), E. nana (5%), Blastocystis hominis (5%), Chilomastix mesnili (11%), Dientamoeba fragilis (5%), Entamoeba coli (5%), and Cryptosporidium (5%). Shigella, Aeromonas, Plesiomonas, Vibrio, Campylobacter, and Salmonella were not detected. Of the eight ETEC cases, one was colonization factor antigen (CFA)/I only, one was both CFA/I and CFA/III, three were CFA/II, two were CFA/IV, and two were CFA-negative. Antibiograms of the ETEC and enteroadherent E. coli strains showed that all isolates were susceptible to norfloxacin, ciprofloxacin, and nalidixic acid but resistant to ampicillin, tetracycline, chloramphenicol, and sulfamethoxazole.

Ampicillin Resistance↗

[Immunofluorescent diagnosis of Entamoeba histolytica trophocoites in preserved stool specimens of patients (author's transl)].

A fixative and examination technique is described for identification of Entamoeba histolytica trophocoites in faeces with the aid of the indirect immunofluorescence technique. Magnaforms in bloody-dysenteric specimens and Minutaforms in spontaneous or saline purged specimens give equally good fluorescence. The specifity of the rabbit antiserum against axenically grown E. hist. is good: There is strong positive reaction only with trophocoites of E. hist. Weak crossreactions are encountered with trophocoites of E. coli, E. hartmanni and E. polecki. Negative reactions are encountered with trophocoites of Endolimax nana, Jodamoeba bāutschlii, and Dientamoeba fragilis. Amebic cysts, flagellates, leucocytes, epithelial cells and Blastocytis give negative reactions, too.

Animals↗

Observations on the intestinal protozoa infecting man in Rhodesia.

Humans in Rhodesia harbour a wide range of intestinal protozoa. Of the species included, Entamoeba histolytica, Entamoeba coli and Giardia lamblia have previously been recorded. Other species which are either rarely reported or which have previously never been reported from this country, include Trichomonas hominis, Chilomastix mesnili, Enteromonas hominis, Retortamonas intestinalis, Balantidum coli,Entamoeba hartmanni,Entamoeba histolytica Laredo. Endolimax nana, Dientamoeba fragilis and Isospora belli. The importance in Rhodesia of these species, and especially of E. histolytica, is discussed.

Balantidiasis↗

A SAMPLE SURVEY OF SELECTED AREAS IN AND NEAR LITTLE ROCK, ARKANSAS, TO ASSESS THE PREVALENCE OF ENTAMOEBA HISTOLYTICA.

Laboratory confirmed clinical amoebiasis was diagnosed among more than 50 persons by the University of Arkansas Medical Center from 1965 to 1961. The presence of this number of patients prompted an investigation into the prevalence of Entamoeba histolytica in four selected areas in and around Little Rock, Arkansas. The results of the study, using a sample survey technique, showed that it is possible to have a seemingly large number of clinically significant cases of amoebiasis in a population without a high prevalence of the parasite. Evidence was also obtained of the beneficial effects of improvements in sanitary facilities, as reflected in the lower amoebic prevalence rate in a 0-4-year age-group from one of the four areas surveyed in which a piped, indoor city-water supply and sewage facilities had been installed six years previously.

Amebiasis↗