Strongyloides stercoralis in the immunocompromised population

Prevalence of intestinal parasitic pathogens among hiv-positive individuals in iran: 180

This study was carried out to determine the presence of intestinal parasites and their correlation with CD4 + T-cell counts and demographics among human immunodeficiency virus (HIV)-positive patients in Benin City, Nigeria. Stool specimens from 2,000 HIV-positive patients and 500 controls (HIV-negative individuals) were examined for ova, cysts, or parasites, using standard procedures. In addition, patient’s blood samples were analyzed for CD4 counts by flow cytometry. An overall prevalence rate of 15.3% was observed among HIVpositive patients while 6.2% was noted among non-HIV subjects. HIV status was a significant (P<0.0001) risk factor for acquiring intestinal parasitic infections. Male gender, CD4 count <200 cell/ml, and diarrhea were significantly associated with an increased prevalence of intestinal parasitic infections among HIVpositive patients. The level of education, occupation, and source of water among HIV patients significantly (P<0.0001) affected the prevalence of intestinal parasitic infections. Ascaris lumbricoides was the most predominant parasite in both HIV-positive patients and controls. A CD4 count <200 cells/ml was significantly associated with only Isospora belli and Cryptosporidium infections. The presence of pathogenic intestinal parasites such as A. lumbricoides, hookworm, Giardia intestinalis, Entamoeba histolytica, Trichuris trichiura, and Taenia species among HIV-infected persons should not be neglected. Cryptosporidium species and I. belli were the opportunistic parasites observed in this study. Routine screening for intestinal parasites in HIV-positive patients is advocated. Keywords: intestinal parasites; HIV; CD4 count; Demographics; Benin City (Published: 29 October 2010) Citation: Libyan J Med 2010, 5 : 5506 - DOI: 10.3402/ljm.v5i0.5506

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Prevalence of intestinal parasitic infections among HIV patients in Benin City, Nigeria

This study investigated the occurrence of free-living amoebae (FLA) in immunodeficiency wards of hospitals in Tehran, Iran. A total of 70 dust and biofilm samples from wards serving transplant, pediatric (malignancies), HIV, leukemia and oncology patients of five university hospitals were collected and examined for the presence of FLA using culturing and molecular approaches. Based on the morphology of the amoebae in plate cultures, primer sets were applied for molecular identification of Acanthamoeba, vahlkampfiid amoebae and Hartmannella. Out of 70 samples, 37 (52.9%) were positive for FLA. Acanthamoeba belonged to the T4 genotype was the most prevalent isolate. Presence of the T4 genotype on medical instruments, including an oxygen mask in an isolation room of an immunodeficiency pediatric ward, should be of concern for health authorities. Acanthamoeba T5 genotypes, Hartmannella vermiformis, and Vahlkampfia avara were also present. These results highlight a clear need for greater attention to improved disinfection, especially where susceptible patients, such as those who are immune-suppressed, are served. To our knowledge, this is the first report of these FLA in immunodeficiency wards in Iran, and also the first to identify Acanthamoeba T5, Hartmannella, and Vahlkampfia in moist habitats, such as biofilms, in this country.

Potentially pathogenic free-living amoebae isolated from hospital wards with immunodeficient patients in Tehran, Iran

Echinococcus granulosus genotypes in livestock of Iran indicating high frequency of G1 genotype in camels.

The aim of this study was to verify the occurrence of intestinal parasitic infections in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in Iran in comparison with non-HIV individuals. Methods: A total of HIV+/AIDS patients (Group I) and 1220 clinically healthy individuals (Group II) were submitted to coproparasitological examination from 2003 to 2005. Results: The overall prevalence of intestinal parasites in group I and group II was 11.4% and 11.6%, respectively, without significant difference between two groups. The prevalence of infection for each helminth and pathogenic protozoan, in every group, was as follows: Group I: Blastocystis hominis (6.1%); Giardia lamblia (4.2%); Cryptosporidium spp. (0.9%); Isospora belli (0.26%); Strongyloides stercoralis (0.26%); Hymenolepis nana (0.13%); and Rhabditis axei (0.13%). Group II: Blastocystis hominis (6.5%); Giardia lamblia (4.1%); Strongyloides stercoralis (0.33%); Hymenolepis nana (0.16%); and Trichostrongylus sp. (0.16%). Although the prevalence of infection for extracellular parasites was not statistically different be- tween two groups, however, the infection rates for enteric coccidians including Cryptosporidium spp. and I. belli were significantly higher in patients at AIDS stage than Group II. Conclusion: The results emphasize the needs for especial consideration of enteropathogenic intracellular coccidians in immunocompromised patients.

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A Comparative Analysis of Intestinal Parasitic Infections between HIV+/AIDS Patients and Non-HIV Infected Individuals

Background: Strongyloides stercoralis is a common parasitic nematode in Iran, especially in north of the country. The early diagnosis and treatment of S. stercoralis is crucial to prevent complicated cases of strongyloidiasis. The value of the preference of agar plate culture, in detection of S. stercoralis compared to formalin ether concentration method, reported in different studies in the world is variable from 1.6 to 6 times. Therefore, the current study was performed to evaluate the efficacy of agar plate on some isolates from north of Iran.
Methods: Nine hundred stool samples were randomly collected from rural areas of Mazandaran Province, northern Iran. All samples were examined by agar plate culture, formalin ether concentration and direct smear.
Results: Agar plate was 2 times superior to formalin ether; however, it showed some false negative results, too. The direct method could only detect cases of hyperinfection strongyloidosis. 
Conclusion: On the whole, combination of agar plate culture and formalin ether concentration is recommended to obtain higher efficacy.

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An Evaluation on the Efficacy of Agar Plate Culture for Detection of Strongyloides stercoralis

Background: Cystic hydatid disease is an important zoonosis, affecting humans and animals and is a significant public health and economic problem throughout the world and Iran. Since extraction of DNA from the parasite is a primary and crucial step which has a principal effect on PCR results, in the current study five simple methods for DNA extraction from protoscoleces of Echinococcus granulosus were applied and compared with each other. Methods: After collecting hydatid cysts from an abattoir, DNA samples were extracted from two cyst isolates from sheep, two from goats and two from camels using five different methods involving the use of glass beads, mechanical grinder, freeze-thaw, boiling and crushing. For all DNA samples extracted, one PCR assay based on amplifying rDNA-ITS1 region was performed and amplicons resolved on 1.5% agarose gels. Results: The methods were compared regarding to DNA and PCR bands, time and cost effectiveness and laborious amount. The target DNA was successfully amplified from all samples using all methods produced an expected band size. All methods showed some advantages and disadvantages in PCR gels. The boiling method, which was the most time and cost effectiveness method, achieved the thickest bands in the PCR following grinder, crushing, freeze-thaw and glass beads. Conclusion: Boiling and crushing methods were the most suitable methods regarding their amplicon quality, easiness, quickness and cost effectiveness.

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F Zahabioun

Papers

A Comparative Analysis of Intestinal Parasitic Infections between HIV+/AIDS Patients and Non-HIV Infected Individuals

An Evaluation on the Efficacy of Agar Plate Culture for Detection of Strongyloides stercoralis

Comparison of Five Simple Methods for DNA Extraction from Echinococcus granulosus Protoscoleces for PCR-Amplification of Ribosomal DNA