Objective
To generate estimates of the global prevalence and incidence of urogenital infection with chlamydia, gonorrhoea, trichomoniasis and syphilis in women and men, aged 15–49 years, in 2016.

Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016.

The soil-transmitted threadworm, Strongyloides stercoralis, is one of the most neglected among the so-called neglected tropical diseases (NTDs). We reviewed studies of the last 20 years on S. stercoralis's global prevalence in general populations and risk groups.; A literature search was performed in PubMed for articles published between January 1989 and October 2011. Articles presenting information on infection prevalence were included. A Bayesian meta-analysis was carried out to obtain country-specific prevalence estimates and to compare disease odds ratios in different risk groups taking into account the sensitivities of the diagnostic methods applied. A total of 354 studies from 78 countries were included for the prevalence calculations, 194 (62.4%) were community-based studies, 121 (34.2%) were hospital-based studies and 39 (11.0%) were studies on refugees and immigrants. World maps with country data are provided. In numerous African, Asian and South-American resource-poor countries, information on S. stercoralis is lacking. The meta-analysis showed an association between HIV-infection/alcoholism and S. stercoralis infection (OR: 2.17 BCI: 1.18-4.01; OR: 6.69; BCI: 1.47-33.8), respectively.; Our findings show high infection prevalence rates in the general population in selected countries and geographical regions. S. stercoralis infection is prominent in several risk groups. Adequate information on the prevalence is still lacking from many countries. However, current information underscore that S. stercoralis must not be neglected. Further assessments in socio-economic and ecological settings are needed and integration into global helminth control is warranted.

https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0002288&type=printable

Strongyloides stercoralis: Global Distribution and Risk Factors.

Summary: Globally, the number of immunosuppressed people increases each year, with the human immunodeficiency virus (HIV) pandemic continuing to spread unabated in many parts of the world. Immunosuppression may also occur in malnourished persons, patients undergoing chemotherapy for malignancy, and those receiving immunosuppressive therapy. Components of the immune system can be functionally or genetically abnormal as a result of acquired (e.g., caused by HIV infection, lymphoma, or high-dose steroids or other immunosuppressive medications) or congenital illnesses, with more than 120 congenital immunodeficiencies described to date that either affect humoral immunity or compromise T-cell function. All individuals affected by immunosuppression are at risk of infection by opportunistic parasites (such as the microsporidia) as well as those more commonly associated with gastrointestinal disease (such as Giardia). The outcome of infection by enteric protozoan parasites is dependent on absolute CD4+ cell counts, with lower counts being associated with more severe disease, more atypical disease, and a greater risk of disseminated disease. This review summarizes our current state of knowledge on the significance of enteric parasitic protozoa as a cause of disease in immunosuppressed persons and also provides guidance on recent advances in diagnosis and therapy for the control of these important parasites.

https://cmr.asm.org/content/cmr/22/4/634.full.pdf

Clinical Significance of Enteric Protozoa in the Immunosuppressed Human Population

Ever since its first description in 1918, Dientamoeba fragilis has struggled to gain recognition as a significant pathogen. There is little justification for this neglect, however, since there exists a growing body of case reports from numerous countries around the world that have linked this protozoal parasite to clinical manifestations such as diarrhea, abdominal pain, flatulence, and anorexia. A number of studies have even incriminated D. fragilis as a cause of irritable bowel syndrome, allergic colitis, and diarrhea in human immunodeficiency virus patients. Although D. fragilis is most commonly identified using permanently stained fecal smears, recent advances in culturing techniques are simplifying as well as improving the ability of investigators to detect this organism. However, there are limitations in the use of cultures since they cannot be performed on fecal samples that have been fixed. Significant progress has been made in the biological classification of this organism, which originally was described as an ameba. Analyses of small-subunit rRNA gene sequences have clearly demonstrated its close relationship to Histomonas, and it is now known to be a trichomonad. How the organism is transmitted remains a mystery, although there is some evidence that D. fragilis might be transmitted via the ova of the pinworm, Enterobius vermicularis. Also, it remains to be answered whether the two distinct genotypes of D. fragilis recently identified represent organisms with differing virulence.

Emerging from Obscurity: Biological, Clinical, and Diagnostic Aspects of Dientamoeba fragilis

Dientamoeba fragilis is a protozoan that inhabits the human gut. It is approximately 100 years since Dientamoeba's discovery and first description when it was described as a rare and harmless commensal. Since then it has struggled to gain recognition as a pathogen despite the evidence supporting its pathogenicity. Dientamoeba remains neglected, probably due to the misconceptions that it is uncommon and non-pathogenic. Usually, carriage of Dientamoeba is associated with symptoms such as abdominal pain and diarrhea. Moreover, antimicrobial therapy followed by resolution of symptoms coincides with the eradication of Dientamoeba. This manuscript reviews the scientific literature relating to Dientamoeba's prevalence and pathogenicity. While much of the evidence supporting its pathogenicity is only circumstantial, it is apparent that most researchers agree that Dientamoeba is pathogenic. Therefore, in symptomatic patients who harbor Dientamoeba and no other pathogen, Dientamoeba should be considered as the etiological agent and treated as such.

A review of Dientamoeba fragilis carriage in humans: Several reasons why this organism should be considered in the diagnosis of gastrointestinal illness

The prevalence of intestinal parasitoses by protozoans and helminths was determined in an aboriginal community located 6 km from Tartagal, province of Salta, Argentina. The age of the inhabitants studied ranged from 1 to 49 years old. A total of 112 stool samples were collected in sodium acetate-acetic acid- formalin solution (SAF). Each sample was obtained in three different days, alternatively. Ritchie biphasic concentration method and Faust flotation technique were applied. For survey of Enterobius vermicularis, 68 samples were collected during six consecutive days using anal swabs. For the diagnosis of Dientamoeba fragilis, the modified trichrome Gomori-Wheatley staining technique was used. One hundred and six (94.6%) subjects resulted positive for enteric parasites. Forty-four (41.5%) individuals were positive for four or more parasites. The parasites more frequently found were, among the protozoans Blastocystis hominis (58.9%), Entamoeba coli (51.8%), Giardia lamblia (27.7%) and Entamoeba histolytica/E. dispar (24.1%). Among the helminths, the most frequent were hookworms (58.0%), Hymenolepis nana (31.2%) and Strongyloides stercoralis (24.1%). This is the first time that Entamoeba histolytica/E. dispar (24.1%) and Dientamoeba fragilis (2.7%) have been registered in the suburbs of Tartagal. This study reveals how intestinal parasitoses constitute a critical problem of public health in aboriginal communities like the one examined, where the lack of adequate sanitation conditions and unsuitable supply of water coexist.

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Investigación de parásitos intestinales en una comunidad aborigen de la provincia de Salta

The objectives of this study were to conduct a prevalence survey of trichomoniasis in pregnant women and to evaluate the utility of different methods for its diagnosis. A total of 597 vaginal exudates from pregnant women who were examined at the Hospital de Clinicas in Buenos Aires, Argentina from 1 August 2005 to 31 January 2007, were prospectively and consecutively evaluated. The investigation of Trichomonas vaginalis was made by different microscopic examinations, and culture on liquid medium. The sensitivity and specificity of the microscopic examinations were assessed considering culture on liquid medium as the "gold standard". The prevalence of T. vaginalis obtained by culture on liquid medium was 4.0% (24/597). The prevalence of T. vaginalis obtained by direct wet smear, prolonged May-Grunwald Giemsa staining, and sodium acetate-formalin (SAF)/methylene blue staining-fixing technique was 1.8%, 2.3% and 2.5%, respectively. The sensitivity of the direct wet smear was 45.8%, that of the prolonged May-Grunwald Giemsa staining was 58.3%, and that of the SAF/methylene blue method was 62.5%. Considering the 3 microscopic examinations altogether, the sensitivity rose to 66.7% and the specificity was 100% for all of them. This is the first time that the prevalence data of T. vaginalis by culture in pregnant women are published in Argentina. Due to the low sensitivity obtained by microscopy in asymptomatic pregnant women, the use of the liquid medium is recommended during pregnancy, in order to provide an early diagnosis and treatment.

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Prevalence and Comparison of Diagnostic Methods for Trichomonas vaginalis Infection in Pregnant Women in Argentina

This study was carried out on two groups of patients treated at the Jose de San Martin 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 butschlii (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. butschlii was observed in homosexuals-bisexuals than in intravenous drug addicts or heterosexuals.

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

RESUMEN Dientamoeba fragilis es un protozoariointestinal humano. Su prevalencia mundial oscilaaproximadamente entre 1,4% y 19%. Muy pocose sabe actualmente sobre su virulencia,patogenicidad, modo de transmision; y no se haidentificado aun un estadio quistico. Un amplioespectro de sintomas gastrointestinales ha sidodescrito en un gran numero de pacientesinfectados: diarrea, flatulencia, colicos, y perdidade peso, entre otros. La asociacion simultaneaentre las infecciones causadas por D. fragilis y Enterobius vermicularis llevo a Burrows ySwerdlow en 1956 a especular sobre el probablerol de los huevos de E. vermicularis en larestriccion de uno de los cuatro pacientes (calles1, 2 y 3) y los productos de PCR de la cepa controlde D. fragilis , obtenidos luego del tratamientocon la misma enzima (calles 4, 5 y 6). (Figura3). Una “semi-nested” PCR con los “primers”DF5 y TRD3 genero un producto de PCR finalque contenia cinco sitios de restriccion para Hinf I.Cinco fragmentos de restriccion (597 pb, 209pb, 127 pb, 87 pb y 76 pb) se muestran en laFigura 3, calle 2. Otra “semi-nested” PCR sedesarrollo con la combinacion de los “primers”TRD5 y DF3. El producto de PCR obtenido nocontenia ningun sitio de restriccion para

/pdf/dientamoeba-fragilis-tecnicas-moleculares-para-dilucidar-su-1b7jbrnr24.pdf

Dientamoeba fragilis: Técnicas moleculares para dilucidar su modo de transmisión

Objective: To study the rates of lower genital tract infections (Candida spp., bacterial vaginosis (BV), Trichomonas vaginalis), during pregnancy. Material and methods: Two hundred and twenty three vaginal swab specimens from pregnant women who attended the Obstetrics Section at the Hospital of Clinics from August 1, 2005 to January 15, 2006, were prospectively and consecutively examined. The diagnosis of Candida spp. was made by microscopic wet smear examination with saline solution and potassium hydroxide at 10% and culture (Sabouraud agar and blood agar). The diagnosis of BV was made using the Nugent ́s score (≥ 7) and the presence of three or more of the following criteria described by Amsel: presence of clue-cells in the microscopic examination, pH ≥ 4.5, fishy odor test positive and thin, homogeneous vaginal discharge. The investigation of T. vaginalis was made by Artemisa medigraphic en línea

/pdf/prevalencia-de-infecciones-vaginales-en-embarazadas-2k7hzhmvyq.pdf

Claudia Gatta

Papers

Investigación de parásitos intestinales en una comunidad aborigen de la provincia de Salta

Prevalence and Comparison of Diagnostic Methods for Trichomonas vaginalis Infection in Pregnant Women in Argentina

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

Dientamoeba fragilis: Técnicas moleculares para dilucidar su modo de transmisión

Prevalencia de infecciones vaginales en embarazadas sintomáticas y asintomáticas