RESUMEN
Objetivos. Blastocystis hominis (B. hominis) es uno de los parásitos intestinales más frecuentemente aislados en el ser humano. Puede producir sintomatología gastrointestinal o, en la mayoría de los casos, permanecer asintomático. Existen dudas sobre el carácter patógeno del parásito. El objetivo de este estudio fue analizar las características clínicas y epidemiológicas de la parasitación por B. hominis, con y sin otras coparasitaciones. Pacientes y métodos. Estudio observacional retrospectivo de aislamientos de B. hominis en heces, desde octubre del 2004 hasta marzo del 2016 en una Unidad de Medicina Tropical. Se revisó a todos los pacientes con parasitación exclusiva, o no, por B. hominis. Resultados. Se estudió a 3.070 pacientes. En 570 (18%) se diagnosticó infección por B. hominis, de los que en 245 (43%) representó el único aislamiento; 325 (57%) presentaron otras coparasitaciones (Entamoeba hystolitica o dispar, Strongyloides stercoralis, uncinarias y Schistosoma sp.). El síntoma principal fue dolor abdominal (41,8%). En un 31,2% el parásito se detectó en el cribado de enfermedades importadas en pacientes asintomáticos. De los que recibieron tratamiento con metronidazol, un 78,2% mejoró y en el 82,6% los parásitos se negativizaron. Conclusiones. La parasitación por B. hominis es una de las enfermedades más frecuentes en nuestra Unidad de Medicina Tropical. La mayoría de los pacientes están asintomáticos o bien la clínica puede ser atribuida a otras parasitaciones. En aquellos casos en los que persisten los síntomas sin poder ser atribuidos a otras causas, es recomendable un tratamiento específico
Objectives. Blastocystis hominis (B. hominis) is one of the most common intestinal parasites isolated in humans. The parasite can cause gastrointestinal symptoms or, in most cases, remain asymptomatic. There are issues concerning the parasite's pathogenic character. The aim of this study was to analyse the clinical and epidemiological characteristics of the parasite infection by B. hominis, with or without other parasitic co-infections. Patients and methods. An observational retrospective study was conducted of B. hominis isolates in faeces from October 2004 to March 2016 in a tropical medicine unit. We reviewed all patients with a parasite infection, exclusively or not by B. hominis. Results. We studied 3070 patients, 570 (18%) of whom were diagnosed with B. hominis infection, which was the only isolate in 245 (43%) of the 570 patients. A total of 325 (57%) patients presented other parasitic co-infections (Entamoeba histolytic or Entamoeba dispar, Strongyloides stercoralis, hookworm and Schistosoma spp.). The main symptom was abdominal pain (41.8%). In 31.2% of cases, the parasite was detected in the imported diseases screening of asymptomatic patients. Of those who underwent treatment with metronidazole, 78.2% improved. The parasite was neutralised in 82.6% of the patients. Conclusions. Parasite infection by B. hominis is one of the most common diseases in our tropical medicine unit. Most patients are asymptomatic, or their symptoms can be attributed to other parasite infections. In those cases in which symptoms persist without being able to attribute them to other causes, a specific treatment is recommended
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Parasitosis Intestinales/epidemiología , Infecciones por Blastocystis/epidemiología , Blastocystis hominis/aislamiento & purificación , Metronidazol/uso terapéutico , Dolor Abdominal/etiología , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico , Estudios Retrospectivos , Parasitosis Intestinales/tratamiento farmacológico , Anamnesis/métodos , Parasitosis Intestinales/orina , Esquistosomiasis/orina , Microfilarias , Microfilarias/parasitología , España/epidemiología , Heces/parasitologíaRESUMEN
BACKGROUND: More than 1 billion people are currently infected with soil-transmitted helminths and schistosomes. The global strategy to control helminthiases is the regular administration of anthelmintic drugs to at-risk populations. However, rapid re-infection occurs in areas where hygiene, access to clean water, and sanitation are inadequate. METHODOLOGY: In July 2011, inhabitants from two villages and seven hamlets of the Taabo health demographic surveillance system in south-central Côte d'Ivoire provided stool and urine samples. Kato-Katz and ether-concentration methods were used for the diagnosis of Schistosoma mansoni, soil-transmitted helminths (Ascaris lumbricoides, Trichuris trichiura, and hookworm), and intestinal protozoa. Urine samples were subjected to a filtration method for the diagnosis of Schistosoma haematobium. A questionnaire was administered to households to obtain information on knowledge, attitude, practice, and beliefs in relation to hygiene, sanitation, and defecation behavior. Logistic regression models were employed to assess for associations between questionnaire data and parasitic infections. PRINCIPAL FINDINGS: A total of 1,894 participants had complete data records. Parasitological examinations revealed prevalences of hookworm, S. haematobium, T. trichiura, S. mansoni, and A. lumbricoides of 33.5%, 7.0%, 1.6%, 1.3% and 0.8%, respectively. Giardia intestinalis and Entamoeba histolytica/E. dispar were detected in 15.0% and 14.4% of the participants, respectively. Only one out of five households reported the presence of a latrine, and hence, open defecation was common. Logistic regression analysis revealed that age, sex, socioeconomic status, hygiene, and defecation behavior are determinants for helminths and intestinal protozoa infections. CONCLUSIONS/SIGNIFICANCE: We found that inadequate sanitation and hygiene behavior are associated with soil-transmitted helminths and intestinal protozoa infections in the Taabo area of south-central Côte d'Ivoire. Our data will serve as a benchmark to monitor the effect of community-led total sanitation and hygiene education to reduce the transmission of helminthiases and intestinal protozoa infections.
Asunto(s)
Entamoeba histolytica , Giardia lamblia , Helmintiasis/epidemiología , Helmintos , Parasitosis Intestinales/epidemiología , Adolescente , Adulto , Distribución por Edad , Animales , Niño , Preescolar , Côte d'Ivoire/epidemiología , Defecación , Exposición a Riesgos Ambientales , Heces/parasitología , Femenino , Alfabetización en Salud , Helmintiasis/parasitología , Helmintiasis/transmisión , Helmintiasis/orina , Humanos , Higiene , Parasitosis Intestinales/parasitología , Parasitosis Intestinales/transmisión , Parasitosis Intestinales/orina , Masculino , Prevalencia , Población Rural , Saneamiento , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Oxidative stress has been implicated as an important pathogenic factor in the pathophysiology of various life-threatening diseases such as cancer, cardiovascular diseases and diabetes. It occurs when the production of free radicals (generated during aerobic metabolism, inflammation, and infections) overcome the antioxidant defences in the body. Although previous studies have implied that oxidative stress is present in serum of patients with parasitic infection there have been no studies confirming oxidative stress levels in the Malaysian population infected with intestinal parasites. Three biochemical assays namely hydrogen peroxide (H2O2), lipid peroxidation (LP) and advanced oxidative protein product (AOPP) assays were carried out to measure oxidative stress levels in the urine of human subjects whose stools were infected with parasites such as Blastocystis hominis, Ascaris, Trichuris, hookworm and microsporidia. The levels of H2O2, AOPP and LP were significantly higher (P<0.001, P<0.05 and P<0.05 respectively) in the parasite-infected subjects (n=75) compared to the controls (n=95). In conclusion, the study provides evidence that oxidative stress is elevated in humans infected by intestinal parasites. This study may influence future researchers to consider free radical-related pathways to be a target in the interventions of new drugs against parasitic infection and related diseases.
Asunto(s)
Parasitosis Intestinales , Infecciones por Nematodos , Estrés Oxidativo , Infecciones por Protozoos , Animales , Humanos , Peróxido de Hidrógeno/orina , Parasitosis Intestinales/parasitología , Parasitosis Intestinales/fisiopatología , Parasitosis Intestinales/orina , Peroxidación de Lípido , Malondialdehído/orina , Infecciones por Nematodos/parasitología , Infecciones por Nematodos/fisiopatología , Infecciones por Nematodos/orina , Oxidación-Reducción , Proteínas/metabolismo , Infecciones por Protozoos/parasitología , Infecciones por Protozoos/fisiopatología , Infecciones por Protozoos/orinaRESUMEN
We measured enteric parasitic infection prevalence and the effect of treatment on human immunodeficiency virus (HIV) RNA levels to assess their importance to HIV primary care in resource-limited settings. Adults in Lilongwe, Malawi, were evaluated, treated, and followed-up for parasitic and HIV infections. Of 389 patients, 266 (68%) were HIV infected. Helminth infections were more common in HIV-uninfected than in HIV-infected patients (39% vs. 17%). Among HIV-infected patients, helminth infections were associated with higher CD4 cell counts but not with higher HIV RNA levels. Successful treatment of parasitic infections had no effect on HIV RNA levels. Although common, parasitic infections did not impact HIV RNA levels.
Asunto(s)
Infecciones por VIH/epidemiología , Infecciones por VIH/virología , VIH-1/aislamiento & purificación , Helmintiasis/epidemiología , Parasitosis Intestinales/epidemiología , Adulto , Albendazol/administración & dosificación , Albendazol/uso terapéutico , Atención Ambulatoria , Antihelmínticos/administración & dosificación , Antihelmínticos/uso terapéutico , Antiprotozoarios/administración & dosificación , Antiprotozoarios/uso terapéutico , Recuento de Linfocito CD4 , Heces/parasitología , Femenino , Infecciones por VIH/sangre , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , VIH-1/genética , Helmintiasis/sangre , Helmintiasis/complicaciones , Helmintiasis/tratamiento farmacológico , Helmintiasis/parasitología , Helmintiasis/orina , Humanos , Parasitosis Intestinales/sangre , Parasitosis Intestinales/complicaciones , Parasitosis Intestinales/tratamiento farmacológico , Parasitosis Intestinales/parasitología , Parasitosis Intestinales/orina , Malaui/epidemiología , Masculino , Área sin Atención Médica , Metronidazol/administración & dosificación , Metronidazol/uso terapéutico , Praziquantel/administración & dosificación , Praziquantel/uso terapéutico , ARN Viral/análisis , Carga Viral , Esparcimiento de VirusRESUMEN
Eosinophils, eosinophil cationic protein (ECP), eosinophil-derived neurotoxin (EDN/EPX), myeloperoxidase (MPO) and IgE were measured in blood, serum and/or urine in Schistosoma haematobium- and Onchocerca volvulus-infected Guineans and O. volvulus- and S. haematobium-negative Guineans coinfected or infected with intestinal nematodes. The number of eosinophils and levels of eosinophil granule proteins but not of MPO were found to be strongly elevated in all Africans as compared to European controls. The highest serum ECP and serum and urinary EDN/EPX levels were observed in the hyperreactive form of onchocerciasis (sowda). Onchocerciasis patients and O. volvulus-negative Africans coinfected or infected with intestinal nematodes (hookworm and/or Ascaris lumbricoides) revealed higher serum granule protein concentrations and/or absolute eosinophil counts and urinary ECP than those without nematode infections. Statistical differences between both sections were found for the absolute eosinophil counts and for serum EDN/EPX and IgE in generalized onchocerciasis, and for urinary ECP in sowda, indicating stimulation of the eosinophil potential of O. volvulus-positive patients by coexistent hookworm infection. This worm species, in contrast to A. lumbricoides, causes especially high eosinophil counts and EDN/EPX and IgE levels. From these results it is concluded that in nematode diseases, ECP and EDN/EPX levels reflect the degree of antigenic stimulation, eosinophil activation and eosinophil turnover rates. Serum ECP and serum and urinary EDN/EPX may, therefore, serve as parameters to monitor helminth infection. Urinary ECP may be a marker of eosinophiluria secondary to urogenital manifestation of S. haematobium. It is elevated in hyperreactive onchocerciasis activated by intestinal nematodes.
Asunto(s)
Proteínas Sanguíneas/análisis , Eosinófilos , Parasitosis Intestinales/complicaciones , Infecciones por Nematodos/complicaciones , Oncocercosis/complicaciones , Proteínas/análisis , Ribonucleasas , Esquistosomiasis Urinaria/metabolismo , Adolescente , Adulto , Animales , Proteínas en los Gránulos del Eosinófilo , Neurotoxina Derivada del Eosinófilo , Femenino , Humanos , Inmunoglobulina E/sangre , Parasitosis Intestinales/sangre , Parasitosis Intestinales/orina , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Infecciones por Nematodos/sangre , Infecciones por Nematodos/orina , Onchocerca volvulus/inmunología , Oncocercosis/sangre , Oncocercosis/orina , Peroxidasa/metabolismo , Schistosoma haematobium/inmunología , Esquistosomiasis Urinaria/sangre , Esquistosomiasis Urinaria/orinaRESUMEN
The Comede health care center for political refugees received 4,414 first arrivals from 70 African, Asian and South American countries in 1989. Many arrived from areas where intestinal parasitic infections are endemic, and where infections by nematodes (Ancyclostoma duodenale, Necator americanus, Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis), trematodes (Schistosoma hematobium, Schistosoma stercoralis) and protozoa (Entamoeba coli) cause significant morbidity. The question that arises is whether we should screen stools and urine only in the case of African refugees, or treat all refugees empirically (mass treatment program). We carried out a retrospective study of 1,425 patients seen for the first time in the Comede from August 1, 1989 to December 31, 1989. Three-quarters of the subjects were men and the mean age was 29 years. 63.2% of the subjects were from 28 African countries, 18.6% from 8 Asian countries, 10% from 5 South American countries and the West Indies, and 6.4% from 4 countries of the Mediterranean basin. 4 countries of the Mediterranean basin. All the subjects were asked to provide stool and urine specimens at the Paris City Laboratory, which were examined using the merthiolate iodo formol direct methods, two concentration methods (MIF and Kato) and Baermann's technique. Patients with infestations were prescribed appropriate treatment at a second visit, compliance with which was good (86%). The prevalence of intestinal parasite infections was 60%. Albendazole was given to 44% of patients, while 45% of African patients were given praziquantel and 2.7% tinidazole.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Parasitosis Intestinales/prevención & control , Tamizaje Masivo/métodos , Refugiados , Adulto , África/etnología , Asia/etnología , Protocolos Clínicos , Centros Comunitarios de Salud/organización & administración , Análisis Costo-Beneficio , Árboles de Decisión , Costos de los Medicamentos , Heces/parasitología , Femenino , Humanos , Parasitosis Intestinales/etnología , Parasitosis Intestinales/parasitología , Parasitosis Intestinales/orina , Masculino , Tamizaje Masivo/economía , Paris/epidemiología , Prevalencia , Estudios Retrospectivos , Sensibilidad y Especificidad , América del Sur/etnologíaRESUMEN
Leucine aminopeptidase activity and total protein concentration was estimated in the fresh early morning sample of urine of twenty five normal adult subjects, twenty four cases with active urinary bilharziasis, eleven cases with active intestinal bilharziasis, ten cases with mixed bilharzial infection (urinary and intestinal), fourteen bilharzial cases with clinical hepatosplenomegaly of bilharzial etiology, thirteen bilharzial cases with clinical hepatosplenomegaly and ascites, and twelve cases with cancer bladder of bilharzial etiology. It was found that there is a significant increase in LAP activity in the urine of all groups of patients studied. Again this increase ran parallel to the course of the disease in bilharzial cases. Urine protein concentration was found to be increased significantly in all groups of bilharzial cases studied with the highest value in urine of patients with cancer bladder of bilharzial etiology. However no direct correlation was found between urinary LAP level and protein concentration either within the individual cases or within the different groups.
Asunto(s)
Leucil Aminopeptidasa/orina , Esquistosomiasis/enzimología , Adulto , Hepatomegalia/enzimología , Hepatomegalia/orina , Humanos , Parasitosis Intestinales/enzimología , Parasitosis Intestinales/orina , Masculino , Proteinuria , Esplenomegalia/enzimología , Esplenomegalia/orina , Neoplasias de la Vejiga Urinaria/enzimología , Neoplasias de la Vejiga Urinaria/orina , OrinaRESUMEN
Arylsulfatase A and B in urine have been estimated in 18 normal subjects and 50 bilharziasis patients. The bilharziasis patients were divided into two groups according to the type of infeciton. Those with bilharziasis haematobian type of infection and those with the bilharziasis mansoni type. Each group was further subdivided into subgroups according to the severity and progress of the disease. The activities of arylsulfatase A and B were significantly elevated in all the groups of patients studied and it is evident that there is a progressive increase with the progress of the disease in both types of bilharziasis infections (the haematobian and mansoni types). Liver dysfunction consequent of bilharzial infestation appears to take part in the mechanism of induction of the bilharzial bladder cancer.