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PubMed2003

Thick stool smear wet mount examination: a new approach in stool microscopy.

Microscopic examination of a wet mount of the stool has been the standard practice for the laboratory diagnosis of intestinal parasitic infections. Here we describe a novel method of stool microscopy of 80 stool samples, 31 (38.75%) were positive by the new thick stool smear wet mount method, whereas the corresponding figure for the conventional method using lacto-phenol cotton blue was 16 (20%). The difference was found to be statistically significant (P < 0.04 by McNemar's test). The thick stool smear wet mount procedure promises to be superior to the direct wet mount method in the detection of the intestinal parasites.

Feces↗
PubMed1984

Intestinal protozoa in homosexual men of the San Francisco Bay area: prevalence and correlates of infection.

To compare the prevalence of intestinal parasitic infection in male homosexuals selected from other sources with the levels previously reported from clinic-derived populations, various homosexual groups of the San Francisco Bay Area were checked by means of stool examination and questionnaires for prevalence of intestinal parasites and for related sexual behavioral patterns during a 3-year period. The prevalence of Entamoeba histolytica (28.6%) was similar to that reported in other studies, whereas that of Giardia lamblia was lower. Infection with E. histolytica was correlated significantly with a prior history of syphilis or gonorrhea (P less than 0.0001), with the number of sexual partners in the preceding 12-month period (P less than 0.0001), and with the reported frequency of oral-anal sexual contact (P less than 0.001). Giardial infection was also significantly related to oral-anal sex (P less than 0.001). No relation was seen between the presence or absence of gastrointestinal symptoms and infection with pathogenic protozoa. Factors associated with parasitic infection differed little from those found in previous studies, although significance levels were considerably higher because of the larger size of our study group.

Adult↗
PubMedDate not supplied

Preventive health care and screening of Latin American immigrants in the United States.

BACKGROUND: The Central and South American immigrant population in the United States is large and growing. A review of the preventive health care needs of this population has not previously been done but would be helpful to clinicians caring for immigrants in this country. METHODS: Using MEDLINE, the literature related to immigrants and their health status was searched, using the key words "immigrant," "refugee," "South/Central/Latin America," "health status," "screening," "nutrition," "parasites," "stomach/gastric cancer," "children," and "psychological." The American Statistics Index and Index to International Statistics were also resources. The available literature was reviewed and led to the recommendations in this article. RESULTS: Screening strategies for Latin American immigrants are discussed for intestinal parasites, tuberculosis, hepatitis B, schistosomiasis, leprosy, American trypanosomiasis (Chagas disease), malaria, human immunodeficiency virus (HIV) infection, cervical and gastric cancer, sickle cell trait, malnutrition, iron-deficiency anemia, incomplete immunizations, dental problems, psychological problems, impairment in the elderly, alcohol use, smoking, physical inactivity, and hypertension. There are not enough data to evaluate fully the screening strategies for most of these conditions, but recommendations are offered based on current knowledge. CONCLUSIONS: Screening is recommended for intestinal parasites and schistosomiasis, tuberculosis, hepatitis B in prenatal patients, leprosy in immigrants from high-risk areas, yearly Papanicolaou smears, malnutrition, iron-deficiency anemia, incomplete immunizations, dental problems, history of violence, and depression. Screening for sickle cell trait in prenatal patients from South America and universal hepatitis B screening are less clearly indicated but could be appropriate. Screening for American trypanosomiasis (Chagas disease), malaria, and gastric cancer is not recommended. Screening for HIV infection, functional impairment in the elderly, alcohol use, cigarette smoking, physical inactivity, and hypertension should be the same as for the general population.

Central America↗
PubMed1980

Epidemiologic studies among Amerindian populations of Amazonia. III. Intestinal parasitoses in newly contacted and acculturating villages.

The prevalences of intestinal parasites among the residents of three South American Indian villages in the process of acculturation were compared with those found in earlier unpublished surveys in two newly contracted village.s Although one individual in an acculturating village harbored 11 different intestinal parasites, in general the average number of different parasitic species carried per person was somewhat higher in the newly contacted villages. Helminth egg counts, performed on direct smears of each specimen from one newly contacted village, were low. There were no sex-associated differences in prevalences. The overall prevalences, unadjusted for age, were among the highest recorded for Amerindians. No Taenia species were present. Balantidium coli was present in two acculturating villages, concomitant with the beginning of agricultural practices which include raising swine. No cases of moderate or severe protein-calorie malnutrition was observed in any of the villages during the surveys. These limited data provide a baseline for future comparisons and, perhaps, a glimpse into the past.

Acculturation↗
PubMed1994

Intestinal parasitoses in the Kandy area, Sri Lanka.

The prevalence of intestinal protozoa and geohelminths was assessed among two diverse populations in the Kandy area: adults attending medical outpatients clinics at the Teaching Hospital Peradeniya, and pre-school children in low-cost housing areas within the Kandy Municipality. In addition to a brief history and examination, a fresh stool sample was obtained and examined by direct smears in saline and iodine, and by formol-ether concentration. The children's stool samples were also examined for Cryptosporidium by cold Ziehl-Neelsen staining. A total of 192 stool samples from the adult outpatients (101 males, age range 15-82 years, mean 51.4 years) and 354 samples from the pre-school children (age range 1-72 months, mean 30 months) were examined. Entamoeba histolytica was not seen in any of the samples; Giardia cysts and Cryptosporidium oocysts were seen in three and one sample respectively from the pre-school children. The overall prevalence of geohelminth infections was 21.3% among the adults and 24.5% among the children. Ascaris lumbricoides was the predominant species in both populations. Comparison of the rate of intestinal parasite infection among 37 adult patients patients with non-specific abdominal complaints, with the rate among 37 matched controls with no abdominal complaints showed no significant difference (16% and 19% respectively). This suggests that the presence of abdominal pain or diarrhea was unrelated to the presence of intestinal parasites in the adult study population. Although the techniques used were not highly sensitive, the absence of E. histolytic probably reflects a true decline in the prevalence of this parasite in Sri Lanka.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Influence of regular tick and helminth control on productivity of small ruminants in the Lolgorien area, Narok district, Kenya.

Forty-five indigenous goats (one to two years old) and 45 indigenous sheep (six to eight months old) were exposed to natural tick and gastro-intestinal parasite challenge. All animals were born and reared in a pastoral husbandry system. Throughout the study they were housed at night under improved hygienic conditions and grazed during daytime with the flock from which they originated. Improvement of hygienic conditions reduced mortality. Control of intestinal parasites increased liveweight gain (LWG) in both species and reduced mortality most noticeably in sheep. Regular tick control had a negative influence on LWG in goats over one year old but a positive influence on LWG on young sheep. This, however, was of marginal economic benefit compared to a substantial benefit of helminth control.

Animal Husbandry↗
PubMed1990

[Intestinal myiasis in Macao].

Six cases of intestinal myiasis were diagnosed in Macao from January 1987 to August 1989, during a survey of intestinal parasites in inhabitants and on stool routine examination in hospitalized patients. The species of flies identified were Stomoxys calcitrans in 4 cases and Megalesia (Megalesia) insulana in 2 cases, M. insulana being a new record in mainland of China. During the survey of intestinal parasites 1889 human fecal samples were collected from Chinese inhabitants. 45 samples were collected on September 2 and 15 samples on September 11, 1987 in an aged home. Among them 4 samples were found to have some moving larvae, which were later identified morphologically as S. calcitrans. All these four cases were old ladies living in the aged home and they complained of mild diarrhea and abdominal pain. The fifth case was a patient with dermatosis, who had an eosinophil count of 18%. On stool examination, eggs of Clonorchis sinensis and larvae of flies were found. These larvae were cultured in food stuff containing wheat bran (100g), milk powder (18g) and water (200ml) at 30 degrees C. Within a week these larvae became pupa from which hatched adult flies identified as M. insulana which were known to be distributed in the Philippines and Hawaii but not found in the mainland of China before. 3 months later the stool from the patient was re-examined, about 200 larvae were counted in 5 ml of feces, the fly species being the same. The sixth patient was a pediatric case, again in his stool sample larvae of flies were found which were identified as M. insulana after culture. M. insulana is distributed in the Philippines, Hawaii, etc. Since a great amount of fruits was constantly imported from the Philippines and Hawaii, it remains to be confirmed whether M. insulana is imported into Macao through fruits.

Aged↗
PubMed1970

"Primary" pulmonary hypertension, eosinophilia, and filariasis in Ceylon.

;Primary' pulmonary hypertension, which is rare in western countries, was found to be relatively common in Ceylon. The clinical and haemodynamic features were studied. There were two distinct types of the disease, malignant and benign. Patients with the malignant form of the disease had a rapidly progressive illness of short duration and an invariably fatal outcome. Those with the benign form gave a long history and, in spite of severe pulmonary hypertension, were only slightly disabled. They seemed to tolerate the disease better. An important factor which determined the clinical course of the disease was the patency of the foramen ovale. This appeared to act as a safety valve permitting a right-to-left shunt in times of stress. The foramen ovale was closed in all patients with the malignant type. The therapeutic implications of this need further study. Many patients with ;primary' pulmonary hypertension had an unusually high eosinophil count (normal range for Ceylon, 0-500 per cu.mm.). Patients in hospitals often have higher counts ranging from 0-1000 per cu.mm. due to intestinal parasitic infestation. Patients with ;primary' pulmonary hypertension were found to have a significantly higher mean eosinophil count than age-matched, sex-matched controls admitted to the Cardiology Unit with chronic rheumatic heart disease and congenital heart disease. The higher count was not due to intestinal parasitic infestation, and none of the other known causes of a raised eosinophil count were present. Four patients had eosinophil counts over 3,000 per cu.mm., the range commonly associated with tropical pulmonary eosinophilia, a disease caused by filariasis. These patients did not manifest any of the symptoms of tropical pulmonary eosinophilia. Patients with ;primary' pulmonary hypertension were examined for evidence of filariasis (clinical, haematological, and serological). Volunteers from among patients with tropical pulmonary eosinophilia and symptom-free patients positive for Wuchereria bancrofti microfilaria were similarly tested and also catheterized for evidence of pulmonary hypertension. The results of these investigations and their significance are discussed. The geographical incidence of ;primary' pulmonary hypertension and filariasis was similar. Filarial worms are known to cause pulmonary hypertension in animals. There is sufficient evidence to suspect that the same may be true in humans. This may explain the high incidence of the disease in Ceylon and its unusually high prevalence among men.

Adolescent↗
PubMed2005

Identification of novel genes in intestinal tissue that are regulated after infection with an intestinal nematode parasite.

Infection of resistant or susceptible mice with Trichuris muris provokes mesenteric lymph node responses which are polarized towards Th2 or Th1, respectively. These responses are well documented in the literature. In contrast, little is known about the local responses occurring within the infected intestine. Through microarray analyses, we demonstrate that the gene expression profile of infected gut tissue differs according to whether the parasite is expelled or not. Genes differentially regulated postinfection in resistant BALB/c mice include several antimicrobial genes, in particular, intelectin (Itln). In contrast, analyses in AKR mice which ultimately progress to chronic infection provide evidence for a Th1-dominated mucosa with up-regulated expression of genes regulated by gamma interferon. Increases in the expression of genes associated with tryptophan metabolism were also apparent with the coinduction of tryptophanyl tRNA synthetase (Wars) and indoleamine-2,3-dioxygenase (Indo). With the emerging literature on the role of these gene products in the suppression of T-cell responses in vitro and in vivo, their up-regulated expression here may suggest a role for tryptophan metabolism in the parasite survival strategy.

Animals↗
PubMed1998

[Health examination of children from the Democratic Sahara Republic (North West Africa) on vacation in Spain].

OBJECTIVE: We present results of a global health evaluation of groups of children from the Democratic Sahara Republic who came to Spain for vacation. PATIENTS AND METHODS: Clinical and analytical tests of 242 Sahara children from refugee camps in Tindouf (Algeria) that were adopted temporarily by Spanish families between July 1993 and July 1997 are reported. We have used standard groups graphics from the World Health Organization. RESULTS: The results were as follows: sex, 53% girls; mean age, 11.1 +/- 1.6 years and age range, 7-16 years (mode 11). Sixty percent of the children had a weight lower than the 10th percentile and 28% less than the 3rd percentile. Fifty-one percent of the children had a height lower than the 10th percentile and 32% less than the 3rd percentile. The corporal mass was lower than the 10th percentile in 19% and less than the 3rd percentile in 8%. The mean hemoglobin was 12.7 +/- 1.2 gr/dl (17% Hb < 12), iron 66 +/- 32 micrograms/dl (23% Fe < 40), and ferritin 28 +/- 24 ngr/ml (26% Fe < 12). Between 1 and 3 intestinal parasites were found in 75% of the children. Isolated were: Entamoeba coli (38%), Blastocystis hominis (22%), Lamblia (18%), Endolimax nana (17%), Hymenolepis nana (11%), and Oxiuros (5%). Sixteen percent of the children had dental caries and 54% dental malocclusion. Ophthalmological problems were found in 28%, generally myopia. Mantoux > 9 mm was found in 5%. Other pathologies included: 5 kyphoscoliosis, 2 cardiopathies, 2 poliomyelitis sequels, 1 gastric ulcer, 1 epilepsy, 1 spherocytosis and 1 euthyroid goiter. Those with weight in p < 3 and/or functional murmur had Hb < 12 in 61% of the cases and Fe < 40 in 48%. CONCLUSIONS: Anamnesis is difficult because of ignorance of the pathological antecedents and date of birth. For physical exploration and collection of parasites they were extremely modest. Feeding and conditions of life would explain low weight and height percentiles, ferropenic anemia and intestinal parasite rates. It would be better to give anti-parasite drugs and systematic ferroprofilaxis as routine and perform blood tests only in those with weight p < 3.

Adolescent↗
PubMed1980

Altered lysophospholipase B responsiveness in lactating mice infected with intestinal nematode parasites.

Lactating and nulliparous outbred Swiss (CF-1 strain) mice were infected at 12-16 weeks of age with Nippostrongylus brasiliensis or Trichinella spiralis. Lysophospholipase B levels in the intestinal tissue and faecal pellets were greatly in infected lactating mice in contrast to infected nulliparous mice. Correlated with these depressions in lysophospholipase levels were markedly reduced numbers of bone-marrow eosinophils in infected lactating mice. Although the peak levels of lysophospholipase in the intestinal tissues occurred in both nulliparous and lactating mice by days 9 and 14 after infection with N. brasiliensis and T. spiralis, respectively, lactating mice had significantly lower lysophospholipase peak levels than nulliparous mice. The peak of luminal levels of the enzyme coincided with peak levels of the enzyme in the intestinal tissues and with the expulsion of the majority of the worms from the small intestines of nulliparous mice. However, lactation delayed the temporal relation between the peak of lysophospholipase levels in the intestinal lumen and worm expulsion. These results suggest that lactation depressed the levels of the enzyme and interfered with its release into the intestinal lumen.

Animals↗
PubMedDate not supplied

Intestinal helminthiasis and anaemia in youngsters from Matriz da Luz, district of São Lourenço da Mata, state of Pernambuco, Brazil.

A group of youngsters (4-18 years old) in northeast Brazil was studied to establish the prevalence of anaemia and intestinal parasitism, as well as to analyze the correlation between them. Two criteria were used to determine the state of anaemia, the level of haemoglobin and the mean of corpuscular volume. The first was considered a single criterion and the second an associated criteria, used in an attempt to correlate anaemia with iron deficiency. The prevalence of intestinal parasitism was 93%, while the prevalence of anaemia was 43.1% and 16.1% according to the criteria employed (single or associated respectively). Anaemia was significantly associated with both sex and age. No significant statistical difference was observed when the association was made between each parasite and anaemia even with those more related to anaemia.

Adolescent↗
PubMed1999

Decline in total serum IgE after treatment for tuberculosis.

BACKGROUND: Infection with Mycobacterium tuberculosis induces a type-1 immune response, whereas intestinal parasites elicit a type-2 response. Given that type-1 and type-2 responses inhibit each other, we investigated if M tuberculosis downregulates serum IgE, a marker of a type-2 response. METHODS: A prospective study was done in the Western Cape Province of South Africa, where tuberculosis and intestinal-parasite infection are common. Total serum IgE was determined for 37 controls and for 33 adolescent patients at presentation with tuberculosis and after successful completion of treatment. IgE specific for ascaris and allergens were measured in a subset of these individuals. Mantoux skin tests were done on 35 controls and on 31 patients at diagnosis. FINDINGS: Total IgE concentrations were high in controls (mean 313 kU/L) and in patients before treatment (mean 457 kU/L, p=0.085) and declined in all patients following successful treatment (mean 175 kU/L, p<0.0001). Posttreatment IgE concentrations did not differ from concentrations in controls. Ascaris-specific IgE was lower in controls (mean 1.73 kU/L) than in patients before treatment (4.62 kU/L, p=0.023) and was 2.39 kU/L in patients after treatment (p=0.0625). Tuberculin induration correlated inversely with IgE in patients but not in controls. INTERPRETATION: Infection with M tuberculosis as such is not incompatible with a prominent IgE response. IgE concentrations decreased after successful treatment of tuberculosis, showing that IgE concentrations in human beings can be downregulated under these circumstances, presumably due to enhancement of a type-1 response.

Adolescent↗
PubMed1998

Eosinophilia, anemia and parasitism in a rural region of northwest Thailand.

Parasitic infections are prevalent in Thailand. The parasites' relationship with anemia and eosinophilia has been rarely reported due to limited health care access, especially in rural areas. We studied the prevalence and relationship between eosinophilia, anemia and parasitism in 169 Thai-Karens from Mae Lamung and Mae Chan subdistricts, Umphang district, Tak Province, using an automated complete blood counter, and microscopic examination for intestinal parasites and microfilaria. In Mae Chan, 5 individuals were microfilaremic, 72% of individuals examined were infected with at least one kind of intestinal parasites, and 50% were anemic, with normal mean red cell volume (MCV). In Mae Lamung, 46% were parasitized (Triteeraprapab et al, 1997) but none were microfilaremic or anemic. In both populations, eosinophilia was prevalent (77%). Hookworm infection was found to be significantly associated with eosinophilia, but not anemia nor microcytosis of red cells.

Adolescent↗
PubMed1998

Different patterns of intestinal helminth infection among young workers in urban and rural areas of Alexandria Governorate, Egypt.

The process of urbanisation taking place in most developing countries is creating favourable conditions for an increase in prevalence of infections, especially with intestinal parasites, in the marginal areas of the towns. The present study was implemented in 1996 to assess the varying prevalence and intensity of infection among young workers in urban and rural areas of the same Governorate (Alexandria, Egypt). The sample comprised 408 male subjects, 8 to 19 years of age, in various occupations: 308 from urban areas, 67 from an industrialised village close to the desert, and 33 from a rural village. A quantitative diagnosis of intestinal helminth infections was made using the Kato-Katz technique, with a double reading of each slide. The results showed a higher prevalence (> 50%) and intensity of infection (indirectly measured as number of eggs per gram of faeces) than in previous studies. Furthermore, a higher prevalence and intensity of infection with Ascaris lumbricoides and Trichuris trichiura was detected in urban districts, as compared to rural areas. This difference was statistically significant. High crowding index, latrine shared with other families and no piped water inside the household, were more common in urban areas as compared with rural settlements and also associated with a higher intensity of infection by soil-transmitted helminths. The trend toward urbanisation seems to have caused deterioration of living conditions and sanitation standards in some areas of Alexandria city, with the most vulnerable people experiencing an increase in intestinal parasitic infections.

Adolescent↗
PubMedDate not supplied

[Intestinal parasitosis in canteen employees: a quadrennial study].

Giardia Lamblia is the flagellated protozoan of intestinal-tract more frequently diagnosed. This disease is well known all over the world, particularly in hot countries and under precarious hygienic-environmental conditions. In Italy the rate of infestation is around 8%. The giardiasis affects people of every age. The disease can be transmitted either by direct contagion or through the ingestion of food contaminated by cysts. Some A.A. believe that in the last years real epidemics in adults occurred, due to the current changing in the habits of life, in particular as regards food and the use of canteens. The italian law demands the competent sanitary authorities to prepare diagnostical procedures for sanitary checks, to be carried out for consignment and renewal of the employment card and for periodical checks on production, manipulation, transport and sale-staff. In a quadrenniale study (1985-1988) the A.A. estimate the incidence of the intestinal parasites and they evaluate the real danger and risks deriving from the contamination of food, by checking 160 canteen-men working in a know metal-mechanical industry in our country, through periodical parasitological stool examination. The parasitological stool exam was carried out bright and after enrichment by Ritchie's method. The Giardia Lamblia, that certainly is the ++intestinal parasite more often isolated in our country, has been observed with varying frequency during the examined period from 1.9% to 5.6%. In 4 years, 38% of these patients, even undergoing specific therapy, has shown relapsing and recurrent infestations both in the following year and later.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2002

Parasitic infections in Thai workers that pursue overseas employment: the need for a screening program.

Stool examination is a requirement of the screening program for Thai workers seeking overseas employment. We report on the prevalence of intestinal parasitic infections among these workers; the stool examination results of 2,213 Thai workers who visited the Out-patients Department of the King Chulalongkorn Memorial Hospital between September 2000 and January 2001 were analysed. One hundred and thirty-five (6.1%) were found to be infected with 1 or 2 species of parasite. There were 54 (40%), 47 (34.8%), and 25 (18.5%) cases infected with nematodes, platyhelminths and protozoa, respectively. The commonest parasite was Opisthorchis viverrini (28.9%). Most nematode infections were due to Strongyloides stercoralis (19.2%); most protozoal infections were due to Giardia lamblia (17.0%). Mixed infections were found in 9 cases. Not unexpectedly, the rate of intestinal parasitic infection among Thai workers remains high. Screening for the parasitic infections among these workers can help to decrease their rate of rejection by the countries in which overseas employment is sought.

Employment↗
PubMed1996

Protozoal colonization of the intestinal tract in institutionalized Romanian children.

To determine the prevalence of intestinal parasitic infections in 92 Romanian children institutionalized at Colentina Hospital (Bucharest, Romania) and at the Dystrophic Center (Vidra, Romania), medical charts were reviewed and complete physical examinations were performed. The nutritional status of each child was evaluated, and their sera were tested for the presence of antibodies to human immunodeficiency virus (HIV) and Cryptosporidium. Fecal samples were collected in 10% formalin and examined by an immunofluorescent assay and by trichrome staining for intestinal parasites. At least one protozoan was identified in 77% of the fecal specimens examined. Giardia lamblia (72% of cases), Cryptosporidium parvum (12%), and Entamoeba coli (4%) were the only parasites identified. Stepwise logistic regression revealed that the only factors predictive of giardia colonization were normal nutritional status (P < .01) and HIV seropositivity (P < .02), while cryptosporidium colonization was only associated with where the children lived (P < .01). Seventy-three percent of the children had IgA and/or IgG antibodies to Cryptosporidium in their sera. The presence of these antibodies was strongly associated with the severity of symptoms present in the HIV-infected children (P < .01). Protozoal colonization of the intestinal tract is common in institutionalized Romanian children and may play a role in causing morbidity and mortality in this high-risk group of children.

AIDS-Related Opportunistic Infections↗