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Prevalence of pathogenic Escherichia coli and parasites in infants with diarrhoea in Kumasi, Ghana.

OBJECTIVES: To determine the relative frequencies and prevalence rates of pathogenic Escherichia coli and intestinal parasites in hospitalised infants (0-5 years) in Kumasi. DESIGN: A prospective descriptive study of screening 162 (83 males and 79 females) infants with diarrhoea and 122(64 males and 58 females) non-diarrhoeal infants controls for pathogens (E. coli and intestinal parasites) by standard microbiological methods. SETTING: Komfo Anokye Teaching Hospital and Maternal and Child Hospital, Kumasi, Ghana. RESULTS: From the 162 in the diarrhoeal group 96(59.6%) pathogens, and from the 122 in the control group, eight (6.6%) pathogens were isolated. Enteropathogenic E. coli (EPEC) was the most frequently detected pathogen, accounting for 24(14.8%) of the findings in the diarrhoeal group, five (4.1%) in the non-diarrhoeal control group. Of the 26 EPEC isolates, there were nine serotypes with the three dominant ones being 0125 (6), 0119 (5), and 026 (15). Other agents isolated included Ascaris lumbricoides 18(11.1%) and two (1.6%), Cryptosporidium 13(8.0%) and one (0.8%) for diarrhoeal and non-diarrhoeal infants respectively. The following were detected only in diarrhoeal stools. Giardia lamblia, six (3.7%); Trichomonas hominis, three (1.9%); Trichuris trichiura one (0.6%) and hookworm, one (0.6%). CONCLUSION: From this study, EPEC and Cryptosporidium may be considered as important diarrhoeagenic pathogens and it is hoped that provision of potable water and good sanitation may decrease diarrhoeas in infants caused by these agents.

Case-Control Studies↗

Presumptive fenbendazole toxicosis in North American porcupines.

CASE DESCRIPTION: 4 North American porcupines were evaluated because of diarrhea or neutropenia (or both) that developed after treatment with fenbendazole for intestinal parasites. CLINICAL FINDINGS: Complete blood cell count abnormalities included severe neutropenia in all affected porcupines and mild anemia in some of them. In 2 porcupines, postmortem findings included bone marrow hypoplasia and intestinal crypt cell necrosis. TREATMENT AND OUTCOME: Affected porcupines received supportive care including fluid supplementation and broad-spectrum antimicrobials. The 2 surviving animals recovered after 9 to 33 days of treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Fenbendazole is an anthelminthic that may be used in an extralabel manner for the treatment of intestinal parasitism in wildlife species. The drug inhibits mitosis and can affect rapidly dividing cell lines, such as those in the bone marrow and intestinal crypt mucosa. Fenbendazole may not be an appropriate anthelminthic choice in North American porcupines.

Animals↗

Epidemiological studies on gastro-intestinal nematode parasites of sheep: the seasonal number of generations and succession of species.

Monthly post mortem worm counts were carried out from June to September on grazing lambs, in association with faecal egg counts and pasture larval counts. Similar patterns were recorded by all three methods, and egg counts proved to be a reliable reflection of worm burden over this period. A succession of species was recorded, in particular Ostertagia spp and Nematodirus spp in June; Haemonchus contortus in July; Trichostrogylus virinus in August; T axei, T colubriformis and Cooperia curticei in September. A new explanation for this succession is given, based on the overwintering capabilities and freeliving development time of individual species.

Animals↗

Spatial distribution on pasture of infective larvae of the gastro-intestinal nematode parasites of sheep.

The horizontal distributions of infective larvae on pasture grazed by sheep have been investigated. Using Taylor's Power Law it was found that larvae had a more aggregated distribution in September than August, the Law index of aggregation being 1.97 and 1.89 for the 2 months, respectively. However, at each time the degree of aggregation remained fairly constant for a range of spacings between points from 5 to 30 m. These results suggest that Taylor's Power Law could be used as a basis for devising an efficient pasture sampling strategy. More data are required, however, to determine the extent to which aggregation of the larvae varies with time of the year.

Analysis of Variance↗

Parasitic infections among Southeast Asian labourers in Taiwan: a long-term study.

Parasitic infections have been reported to be relatively common among the Southeast Asian labourers in Taiwan. This study, conducted in 1992-6, was designed to determine the temporal changes of the prevalence. Faecal specimens were examined by the formalin-ethyl acetate sedimentation technique and blood samples screened using the quantitative buffy coat technique and confirmed by Giemsa stained blood smear. The overall prevalence of intestinal parasitic infections was 10.3%. The annual prevalence decreased from 33.3% in 1992-3 to 4.6% in 1995-6. The Thai (12.0%) and Indonesian (11.1%) had a higher prevalence than the Malaysian (6.7%) and Filipinos (5.9%). Opisthorchis viverrini was the most important parasite in the Thai and Trichuris trichiura in the remaining groups. Moreover, no blood parasites were found in the labourers. The dramatic temporal decline in the intestinal parasitic infections suggests that limiting the entry of infected persons, periodic follow-ups, and immediate treatment of sporadic cases are necessary in preventing transmission of non-indigenous parasites through large population change.

Adult↗

Biomedical survey in North Samar Province, Philippine Islands.

A biomedical survey was carried out in North Samar Province, Philipines to update information on the prevalence of parasitic and other infectious diseases. A total of 1,394 stool specimens, 1,859 blood smears and 1,274 sera were collected from persons living in 8 barrios. Stools were examined for intestinal parasites, bloods smears for malaria and filariasis and sera tested for antibodies to Schistosoma japonicum, Entamoeba histolytica, Toxoplasma gondii, influenza A and B, and Japanese encephalitis virus. The prevalence rates for intestinal parasites were: Trichuris trichiura 90%, Ascaris lumbricoides 78%, hookworm 65%, Schistosoma japonicum 15%, Strongyloides stercoralis 1%, Entamoeba coli 16%, Endolimax nana 6%, entamoeba histolytica 5%, Giardia lamblia 3%, Entaemoeba hartmanii 1%, Chilomastix mesnili 1%. No malaria was found but microfilariae of Wuchereria bancrofti were detected in 4% of the blood smears; the MfD50 was 12.9. The circumoval precipitin test (COPT) was used to detect antibodies to Schistosoma japonicum and 65% of 994 sera was considered positive. The indirect hemagglutination test (IHA) was used for detecting antibodies to Entamoeba histolytica and Toxoplasma gondii and 5% and 3% of 1,274 sera tested were positive at titers equal to or greater than 1:128 and 1:256, respectively. Hemagglutination inhibition tests (HI) were used to detect antibodies to Influenza A2HK68, Influenza A2HK68, Influenza B2T62 and Japanese encephalitis virus and 72%, 12% and 78%, respectively, of 1201 sera were considered positive at titers equal to or greater than 1:20.

Adolescent↗

Parasites of man in remote areas of Central and South Sulawesi, Indonesia.

A biomedical survey was conducted in 10 villages in remote, high mountain valleys of Central and South Sulawesi, Indonesia to learn whether Oriental schistosomiasis was endemic and to determine the prevalences of other intestinal parasites, malaria and filariasis in those areas. Although persons with Oriental schistosomiasis were found in three villages of South Sulawesi, follow-up inquiries revealed that these had recently migrated from a known schistosomiasis area in Central Sulawesi. Other intestinal parasites diagnosed were Ascaris lumbricoides (14%), Trichuris trichiura (7%), hookworm (68%), Entamoeba histolytica (3%), Entamoeba coli (17%), and Giardia lamblia (5%). Enterobius vermicularis, Strongyloides stercoralis, Trichostrongylus sp., Physaloptera sp., Diphyllobothrium sp. heterophyid, echinostome and dicrocoelid-like termatodes, Endolimax nana and Chilomastix mesnili were detected infrequently. Malaria parasitemias due to Plasmodium falciparum, P. vivax and P. malariae were detected in 4% of the sampled populations, Malayan filariasis was diagnosed in 21% of the subjects examined.

Adolescent↗

Health status of Ethiopian refugees in the United States.

The health status of 239 Ethiopian refugees in the United States was evaluated. Over 70 per cent were males 15-30 years old. Positive PPDs (purified protein derivative of tuberculin) were observed in 72 per cent and 3.4 per cent had abnormal chest x-rays. One patient had active tuberculosis. Other laboratory abnormalities included: intestinal parasites (36.7 per cent), anemia (14.9 per cent), eosinophilia (14 per cent), positive syphilis serology (7.5 per cent), and hepatitis B surface antigenemia (9.4 per cent). The most prevalent intestinal parasites were Giardia lamblia, Trichuris trichiura, and Schistosoma mansoni.

Adolescent↗

Microbes and microbial toxins: paradigms for microbial-mucosal interactions. VI. Entamoeba histolytica: parasite-host interactions.

The protozoan intestinal parasite Entamoeba histolytica remains a significant cause of morbidity and mortality worldwide. E. histolytica causes two major clinical syndromes, amebic colitis and amebic liver abscess. Recent advances in the development of in vitro and in vivo models of disease, new genetic approaches, the identification of key E. histolytica virulence factors, and the recognition of crucial elements of the host response to infection have led to significant insights into the pathogenesis of amebic infection. E. histolytica virulence factors include 1) a surface galactose binding lectin that mediates E. histolytica binding to host cells and may contribute to amebic resistance to complement, 2) amebapores, small peptides capable of lysing cells, which may play a role in killing intestinal epithelial cells, hepatocytes, and host defense cells, and 3) a family of secreted cysteine proteinases that play a key role in E. histolytica tissue invasion, evasion of host defenses, and parasite induction of gut inflammation. Amebae can both lyse host cells and induce their suicide through programmed cell death. The host response is also an important factor in the outcome of infection, and neutrophils may play a key role in contributing to the tissue damage seen in amebiasis and in controlling amebic infection.

Animals↗

[The effect of parasites on enteric bacterial flora].

In this paper, the intestinal bacterial flora is described and the functions of permanent bacterial flora and its individual members is discussed. The pertinent publications about the factors which effects the bacterial flora and specially relations between intestinal parasites and bacterial flora is reviewed. Among these parasites giardia, amoebae, B. coli and Ascaris may change bacterial population by causing malabsorption syndromes. Some drugs used in treatment of parasitic infestations may have harmful effects on normal intestinal bacterial flora. In parasitic diseases the probable floral changes could be looked for and taken into the consideration for a successful treatment of the patients.

Bacteria↗

[Coprologic survey in Bilharzia infected children of the Adzope region (Ivory Coast)].

During a stool examination survey on 174 bilharzia attained children living in a rural area of Ivory Coast, 93% were found to have intestinal parasites mainly Entamoeba coli, Necator americanus and Ascaris lumbricoides. The prevalence of the cysts of Entamoeba histolytica (4,7%) is lower than the one found in France (7%). Concerning the other intestinal parasites, their respective occurrence have been compared with those noted in other regions of Ivory Coast and of Africa.

Adolescent↗

Gastrointestinal parasitic infection in healthy Jamaican carriers of HTLV-I.

A subsample (1.6%; n = 13,260) of a healthy Jamaican population of food-handlers, studied by Murphy et al. (1991), who were serologically positive (n = 99) or negative (n = 113) for HTLV-I was investigated for intestinal parasitic infection using coprological methods. Helminth infection included Ascaris lumbricoides (2.8%), Trichuris trichiura (7.1%) and hookworms (6.1%). Entamoeba coli was found in 21.8% of samples, while E. hartmanni, Giardia lamblia, Endolimax nana, Iodamoeba bütschlii and Chilomastix mesnili each occurred in less than 10% of responders. T. trichiura displayed a higher prevalence (10.6 vs 3%) (chi 2 = 4.623; P = 0.03) in the HTLV-I negative group. G. lamblia was detected more frequently among HTLV-I carriers compared to controls (9.1 and 3.5%, respectively), but the association was not statistically significant (chi 2 = 2.825; P = 0.09). Infection with intestinal parasites is likely to occur independent of HTLV-I status: however, possible HTLV-I-induced immunosuppression may lead to higher intensity infections of certain organisms thus facilitating easier detection using parasitological methods. The immunomodulatory potential of HTLV-I infection in the aetiology of non-malignant diseases requires further investigation.

Analysis of Variance↗

Correlations between intestinal parasitosis, physical growth, and psychomotor development among infants and children from rural Nicaragua.

The correlations between malnutrition, parasitosis (especially helminth infections), and child development are complex, and studies of these interrelationships will allow health agencies to maximize screening and intervention strategies for developing countries. We examined these correlations in a cross-sectional program in Carazo State, Nicaragua. Nine hundred sixty-one children in two age strata (ages 0-24 months and ages 2-10 years) from one urban and three rural communities were screened for intestinal parasites (direct smear and ZnSO4 flotation), malnutrition, and developmental delays. Nutritional status was determined as weight-for-age (WFA), weight-for-height (WFH), and height-for-age (HFA). Developmental status (normal, suspect) was determined for the four subtests of the Denver II Screening Test. The prevalence of malnutrition was 14.6% (WFA), 8.4% (WFH), and 36.3% (HFA). Parasitosis was more prevalent in children less than 24 months of age with low HFA, whereas in older children low WFA was more closely associated with parasitic infections. Ascaris and Trichuris were more prevalent in malnourished children. On the Denver II, suspect test results in all four categories (language, social, gross motor, and fine motor) were associated with low WFA, and suspect language tests were associated with both intestinal parasites (P = 0.0003) and Ascaris infection in particular (P = 0.044). Developmental disabilities are a significant and frequently undetected health problem in developing countries, and malnutrition associated with intestinal helminth infections may be an important contributory factor for these disabilities.

Body Height↗

An investigation into the riboflavin status of young Egyptians from the oasis with glucose-6-phosphate dehydrogenase deficiency.

The erythrocytic glutathione reductase activity was studied among 40 normal and G 6 PD-deficient males without or with intestinal parasitic infection. The results showed that the incidence of vitamin B2 deficiency was significantly higher (chi 2 P less than 0.05) among G 6 PD deficient subjects compared to corresponding incidence obtained with normal. Intestinal parasitism led to deterioration of the B2-status among both the normals and the subjects with G 6 PD deficiency.

Adolescent↗

The characterization of intraepithelial lymphocytes, lamina propria leukocytes, and isolated lymphoid follicles in the large intestine of mice infected with the intestinal nematode parasite Trichuris muris.

Despite a growing understanding of the role of cytokines in immunity to the parasitic helminth Trichuris muris, the local effector mechanism culminating in the expulsion of worms from the large intestine is not known. We used flow cytometry and immunohistochemistry to characterize the phenotype of large intestinal intraepithelial lymphocytes (IEL) and lamina propria leukocytes (LPL) from resistant and susceptible strains of mouse infected with T. muris. Leukocytes accumulated in the epithelium and lamina propria after infection, revealing marked differences between the different strains of mouse. In resistant mice, which mount a Th2 response, the number of infiltrating CD4+, CD8+, B220+, and F4/80+ IEL and LPL was generally highest around the time of worm expulsion from the gut, at which point the inflammation was dominated by CD4+ IEL and F4/80+ LPL. In contrast, in susceptible mice, which mount a Th1 response, the number of IEL and LPL increased more gradually and was highest after a chronic infection had developed. At this point, CD8+ IEL and F4/80+ LPL were predominant. Therefore, this study reveals the local immune responses underlying the expulsion of worms or the persistence of a chronic infection in resistant and susceptible strains of mouse, respectively. In addition, for the first time, we illustrate isolated lymphoid follicles in the large intestine, consisting of B cells interspersed with CD4+ T cells and having a central zone of rapidly proliferating cells. Furthermore, we demonstrate the organogenesis of these structures in response to T. muris infection.

Animals↗