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Parasitology Research

, Volume 110, Issue 4, pp 1553–1562 | Cite as

Predominance of Blastocystis sp. subtype 4 in rural communities, Nepal

  • I. L. Lee
  • T. C. Tan
  • P. C. Tan
  • D. R. Nanthiney
  • M. K. Biraj
  • K. M. Surendra
  • K. G. SureshEmail author
Original Paper

Abstract

Blastocystis sp. is a common intestinal parasite. To date, there have been sporadic and scanty studies on Blastocystis sp. carried out in rural communities in Nepal. We surveyed the prevalence of Blastocystis sp. and its possible associated risk factors, and reported the predominant Blastocystis sp. subtype in two rural communities, Bolde Phediche and Bahunipati, in Nepal. Human faecal samples were collected from 241 participants, cultured using in vitro cultivation and examined for Blastocystis sp. The presence of Blastocystis sp. in faecal samples was further confirmed by polymerase chain reaction (PCR) and subsequently genotyped using subtype-specific sequence tagged site (STS) primers. There were 26.1% (63/241) of the participants that were infected by Blastocystis sp. We detected 84.1% (53/63) of Blastocystis sp. subtype 4 infections in these rural communities. The unusually high prevalence of Blastocystis sp. subtype 4 can be attributed to the rearing of family-owned animals in barns built close to their houses. Eighty one percent (51/63) of the Blastocystis sp. infected participants drank not boiled or unfiltered water. The present study revealed that Blastocystis sp. could pose a health concern to the communities and travellers to the hilly area in Nepal. Infection may be transmitted through human-to-human, zoonotic and waterborne transmissions. We provide recommendations to ensure good public health practices.

Keywords

Irritable Bowel Syndrome Faecal Sample Rural Community Hand Hygiene Open Defecation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Böhm-Gloning B, Knobloch J, Walderich B (1997) Five subgroups of Blastocystis hominis from symptomatic and asymptomatic patients revealed by restriction site analysis of PCR-amplified 16S-like rDNA. Trop Med Int Health 2:771–778PubMedCrossRefGoogle Scholar
  2. Chandramathi S, Suresh K, Kuppusamy UR (2010) Solubilized antigen of Blastocystis hominis facilitates the growth of human colorectal cancer cells, HCT116. Parasitol Res 106:941–945. doi: 10.1007/s00436-010-1764-7 PubMedCrossRefGoogle Scholar
  3. Dogruman-Al F, Dagci H, Yoshikawa H, Kurt Ö, Demirel M (2008) A possible link between subtype 2 and asymptomatic infections of Blastocystis hominis. Parasitol Res 103:685–689. doi: 10.1007/s00436-008-1031-3 PubMedCrossRefGoogle Scholar
  4. Dogruman-Al F, Kustimur S, Yoshikawa H, Tuncer C, Simsek Z et al (2009) Blastocystis subtypes in irritable bowel syndrome and inflammatory bowel disease in Ankara, Turkey. Mem Inst Oswaldo Cruz 104:724–727. doi: 10.1590/S0074-02762009000500011 PubMedCrossRefGoogle Scholar
  5. Domínguez-Márquez MV, Guna R, Muñoz C, Gómez-Muñoz MT, Borrás R (2009) High prevalence of subtype 4 among isolates of Blastocystis hominis from symptomatic of a health district of Valencia (Spain). Parasitol Res 105:949–945. doi: 10.1007/s00436-009-1485-y PubMedCrossRefGoogle Scholar
  6. El-Shazly AM, Abdel-Magied AA, El-Beshbishi SN, El-Nahas HA, Fouad MA et al (2005) Blastocystis hominis among symptomatic and asymptomatic individuals in Talkha Center, Dakahlia Governorate, Egypt. J Egypt Soc Parasitol 35:653–666PubMedGoogle Scholar
  7. Eroglu F, Koltas IS (2010) Evaluation of the transmission mode of Blastocystis hominis by using PCR method. Parasitol Res 107:841–845PubMedCrossRefGoogle Scholar
  8. Giacometti A, Cirioni O, Fiorentini A, Fortuna M, Scalise G (1999) Irritable bowel syndrome in patients with Blastocystis hominis infection. Eur J Clin Microbiol Infect Dis 18:436–439PubMedCrossRefGoogle Scholar
  9. Hussein EM, Hussein AM, Eida MM, Atwa MM (2008) Pathophysiological variability of different genotypes of human Blastocystis hominis Egyptian isolates in experimentally infected rats. Parasitol Res 102:853–60. doi: 10.1007/s00436-007-0833-z PubMedCrossRefGoogle Scholar
  10. Jones MS, Whipps CM, Ganac RD, Hudson NR, Boroom K (2009) Association of Blastocystis subtype 3 and 1 with patients from an Oregon community presenting with chronic gastrointestinal illness. Parasitol Res 104:341–345. doi: 10.1007/s00436-008-1198-7 PubMedCrossRefGoogle Scholar
  11. Kaneda Y, Horiki N, Cheng XJ, Fujita Y, Maruyama M et al (2001) Ribodemes of Blastocystis hominis isolated in Japan. AmJTrop Med Hyg 65:393–396Google Scholar
  12. Katsarou-Katsari A, Vassalos CM, Tzanetou K, Spanakos G, Papadopoulou C (2008) Acute urticaria associated with amoeboid forms of Blastocystis sp. subtype 3. Acta Dermatol Venereol 88:80–81. doi: 10.2340/00015555-0338 CrossRefGoogle Scholar
  13. Kaya S, Cetin ES, Aridogan BC, Arikan S, Demirci M (2007) Pathogenicity of Blastocystis hominis, a clinical reevaluation. Turk Parazitol Derg 31:184–187Google Scholar
  14. Leelayoova S, Siripattanapipong S, Thathaisong U, Naaglor T, Taamasri P et al (2008) Drinking water: a possible source of Blastocystis spp. subtype 1 infection in schoolchildren of a rural community in Central Thailand. AmJTrop Med Hyg 79:401–406Google Scholar
  15. Li LH, Zhang XP, Lv S, Zhang L, Yoshikawa H et al (2007) Cross-sectional surveys and subtype classification of human Blastocystis isolates from four epidemiological settings in China. Parasitol Res 102:83–90. doi: 10.1007/s00436-007-0727-0 PubMedCrossRefGoogle Scholar
  16. Menounos PG, Spanakos G, Tegos N, Vassalos CM, Papadopoulou C (2008) Direct detection of Blastocystis sp. in human faecal samples and subtype assignment using single strand conformational polymorphism and sequencing. Mol Cell Probes 22:24–29. doi: 10.1016/j.mcp.2007.06.007 PubMedCrossRefGoogle Scholar
  17. Ministry of Tourism and Civil Aviation, Tourism Statistic. Available at: http://www.tourism.gov.np/tourismstatistics.php. Accessed January 8, 2010
  18. Ozyurt M, Kurt O, Molbak K, Nielsen HV, Haznedaroglu T et al (2008) Molecular epidemiology of Blastocystis infections in Turkey. Parasitol Int 57:300–306. doi: 10.1016/j.parint.2008.01.004 PubMedCrossRefGoogle Scholar
  19. Pasqui AL, Savini E, Saletti M, Guzzo C, Puccetti L et al (2004) Chronic urticaria and Blastocystis hominis infection: a case report. Eur Rev Med Pharmacol Sci 8:117–120PubMedGoogle Scholar
  20. Pegelow K, Gross R, Pietrzik K, Lukito W, Richards AL et al (1997) Parasitological and nutritional situation of school children in the Sukaraja district, West Java, Indonesia. Southeast Asian J Trop Med Public Health 28:173–190PubMedGoogle Scholar
  21. Rene BA, Stensvold CR, Badsberg JH, Nielsen HV (2009) Subtype analysis of Blastocystis isolates from Blastocystis cyst excreting patients. AmJTrop Med Hyg 80:588–592Google Scholar
  22. Scicluna SM, Tawari B, Clark CG (2006) DNA barcoding of Blastocystis. Protist 157:77–85. doi: 10.1016/j.protis.2005.12.001 PubMedCrossRefGoogle Scholar
  23. Sherchand JB, Larsson S, Shrestha MP (1996) Intestinal parasites in children and adults with and without abdominal discomfort from the Kathmandu area of Nepal. Trop Gastroenterol 17:15–22PubMedGoogle Scholar
  24. Shlim DR, Hoge CW, Rajah R, Rabold JG, Echeverria P (1995) Is Blastocystis hominis a cause of diarrhea in travelers? A prospective controlled study in Nepal. Clin Infect Dis 21:97–101PubMedCrossRefGoogle Scholar
  25. Souppart L, Sanciu G, Cian A, Wawrzyniak I, Delbac F et al (2009) Molecular epidemiology of human Blastocystis isolates in France. Parasitol Res 105:413–421. doi: 10.1007/s00436-009-1398-9 PubMedCrossRefGoogle Scholar
  26. Souppart L, Moussa H, Cian A, Sanciu G, Poirier P et al (2010) Subtype analysis of Blastocystis isolates 5 from symptomatic patients in Egypt. Parasitol Res 106:505–511. doi: 10.1007/s00436-009-1693-5 PubMedCrossRefGoogle Scholar
  27. Stensvold R, Brillowska-Dabrowska A, Nielsen HV, Arendrup MC (2006) Detection of Blastocystis hominis in unpreserved stool specimens by using polymerase chain reaction. J Parasitol 92:1081–1087PubMedCrossRefGoogle Scholar
  28. Stensvold CR, Arendrup MC, Jespersgaard C, Molbak K, Nielsen HV (2007) Detecting Blastocystis using parasitologic and DNA-based methods: a comparative study. Diagn Microbiol Infect Dis 59:303–307. doi: 10.1016/j.diagmicrobio.2007.06.003 PubMedCrossRefGoogle Scholar
  29. Stensvold CR, Lewis HC, Hammerum AM, Porsbo LJ, Nielsen SS et al (2009) Blastocystis: unravelling potential risk factors and clinical significance of a common but neglected parasite. Epidemiol Infect 137:1655–1663. doi: 10.1007/s00436-009-1551-5 PubMedCrossRefGoogle Scholar
  30. Suresh KG, Smith H (2004) Comparison of methods for detecting Blastocystis hominis. Eur J Clin Microbiol Infect Dis 23:509–511. doi: 10.1007/s10096-004-1123-7 PubMedCrossRefGoogle Scholar
  31. Tan KSW (2008) New insights on classification, identification, and clinical relevance of Blastocystis spp. Clin Microbiol Rev 21:639–665. doi: 10.1128/CMR.00022-08 PubMedCrossRefGoogle Scholar
  32. Tan TC, Suresh KG, Smith HV (2008) Phenotypic and genotypic characterisation of Blastocystis hominis isolates implicates subtype 3 as a subtype with pathogenic potential. Parasitol Res 104:85–93. doi: 10.1007/s00436-008-1163-5 PubMedCrossRefGoogle Scholar
  33. Tan TC, Ong SC, Suresh KG (2009) Genetic variability of Blastocystis sp. isolates obtained from cancer and HIV/AIDS patients. Parasitol Res 102:1283–1286. doi: 10.1007/s00436-009-1551-5 CrossRefGoogle Scholar
  34. Thathaisong U, Worapong J, Mungthin M, Tan-Ariya P, Viputtigul K et al (2003) Blastocystis isolates from a pig and a horse are closely related to Blastocystis hominis. J Clin Microbiol 41:967–975PubMedCrossRefGoogle Scholar
  35. Termmathurapoj S, Leelayoova S, Aimpun P, Thathaisong U, Nimmanon T et al (2004) The usefulness of short-term in vitro cultivation for the detection and molecular study of Blastocystis hominis in stool specimens. Parasitol Res 93:445–447. doi: 10.1007/s00436-004-1157-x PubMedCrossRefGoogle Scholar
  36. Vassalos CM, Spanakos G, Vassalou E, Papadopoulou C, Vakalis N (2010) Differences in clinical significance and morphologic features of Blastocystis sp subtype 3. Am J Clin Pathol 133:251–258. doi: 10.1309/AJCPDOWQSL6E8DMN PubMedCrossRefGoogle Scholar
  37. Valsecchi R, Leghissa P, Greco V (2004) Cutaneous lesions in Blastocystis hominis infection. Acta Derm Venereol 84:322–323. doi: 10.1080/00015550410025949 PubMedCrossRefGoogle Scholar
  38. Wong KHS, Ng GC, Lin RTP, Yoshikawa H, Taylor MB et al (2008) Predominance of subtype 3 among Blastocystis isolates from a major hospital in Singapore. Parasitol Res 102:663–670. doi: 10.1007/s00436-007-0808-0 PubMedCrossRefGoogle Scholar
  39. Yakoob J, Jafri W, Jafri N, Khan R, Islam M et al (2004) Irritable bowel syndrome: in search of an etiology: role of Blastocystis hominis. AmJTrop Med Hyg 70:383–385Google Scholar
  40. Yakoob J, Jafri W, Beg MA, Abbas Z, Naz S et al (2010) Irritable bowel syndrome: is associated with genotypes of Blastocystis hominis. Parasitol Res 106:1033–1038. doi: 10.1007/s00436-010-1761-x PubMedCrossRefGoogle Scholar
  41. Yan Y, Su S, Lai R, Liao H, Ye J et al (2006) Genetic variability of Blastocystis hominis isolates in China. Parasitol Res 99:597–601. doi: 10.1007/s00436-006-0186-z PubMedCrossRefGoogle Scholar
  42. Yan Y, Su S, Ye J, Lai X, Lai R (2007) Blastocystis sp. subtype 5: a possibly zoonotic genotype. Parasitol Res 101:1527–1532. doi: 10.1007/s00436-007-0672-y PubMedCrossRefGoogle Scholar
  43. Yoshikawa H, Abe N, Iwasawa M, Kitano S, Nagano I et al (2000) Genomic analysis of Blastocystis hominis strains isolated from two long-term health care facilities. J Clin Microbiol 38:1324–1330PubMedGoogle Scholar
  44. Yoshikawa H, Wu Z, Kimata I, Iseki M, Ali IKMD et al (2004) Polymerase chain reaction-based genotype classification among human Blastocystis hominis populations isolated from different countries. Parasitol Res 94:22–29. doi: 10.1007/s00436-003-0995-2 CrossRefGoogle Scholar
  45. Yoshikawa H, Wu Z, Pandey K, Pandey BD, Sherchnad JB et al (2009) Molecular characterization of Blastocystis isolates from children and rhesus monkeys in Kathmandu, Nepal. Vet Parasitol 160:295–300. doi: 10.1016/j.vetpar.2008.11.029 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • I. L. Lee
    • 1
  • T. C. Tan
    • 1
  • P. C. Tan
    • 1
  • D. R. Nanthiney
    • 1
  • M. K. Biraj
    • 2
  • K. M. Surendra
    • 3
  • K. G. Suresh
    • 1
    Email author
  1. 1.Department of Parasitology, Faculty of MedicineUniversity MalayaKuala LumpurMalaysia
  2. 2.Department of Community ProgrammesDhulikhel Hospital Kathmandu University HospitalKathmanduNepal
  3. 3.Department of MicrobiologyKathmandu University School of Medical SciencesKathmanduNepal

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