Abstract
To determine the prevalence of endoparasites and their association with diarrhea, a survey was conducted in the Southern Province of Zambia that used conventional and molecular techniques applied to stool and urine samples from school-age children (n=93). Almost half of the stools (49.5%) were diarrhetic. The overall prevalence of Endolimax nana, Schistosoma haematobium, Blastocystis hominis, Giardia lamblia, Cryptosporidium parvum, Encephalitozoon intestinalis, and Strongyloides stercoralis was 64.3, 59.1, 53.8, 19.4, 8.6, 8.6, and 1.1%, respectively. Only the associations between infection with B. hominis and E. nana with diarrhea were statistically significant. Although B. hominis and E. nana are considered to be nonpathogenic organisms, this study demonstrated that they can be associated with diarrhea in children when they occur at high prevalence and intensity. This survey supports the recent evidence that B. hominis and E. nana infections are associated with deficient sanitation and low hygiene standards and can contribute to diarrhea in children in developing countries.
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Ash LR, Orihel TC (1987) Parasites: a guide to laboratory procedures and identification. American Society of Clinical Parasitologists, Chicago
Ashford RW, Atkinson EA (1992) Epidemiology of Blastocystis hominis in Papua New Guinea: age prevalence and associations with other parasites. Ann Trop Med Parasitol 86:129–136
Baggaley R, Sulwe J, Chilala M, Mashambe C (1997) HIV-related stress at school and at home in Zambia. AIDS Anal Afr 7:14–15
Boreham PF, Stenzel DJ (1993) The current status of Blastocystis hominis. Parasitol Today 9:251
Burnstein SL, Liakos S (1983) Parasitic rheumatism presenting as rheumatoid arthritis. J Rheumatol 10:514–515
Carrascosa M, Martinez J, Perez-Castrillon JL (1996) Hemorrhagic proctosigmoiditis and Blastocystis hominis infection. Ann Intern Med 15:278–279
Cerva L, Kliment V (1978) Contribution to the problem of the so-called nonpathogenic amoebae in the intestine of man. Folia Parasitol 25:367–370
Chevallier E (1994) AIDS, children, families: how to respond? Glob AIDSnews 4:18–19
Curtis J, Sleisenger MH (1973) Infectious and parasitic diseases. In: Sleisenger MH, Fordtrain JS (eds) Gastrointestinal disease. WB Saunders, Philadelphia pp 1369–1405
Diaz E, Mondragon J, Ramirez E, Bernal R(2003) Epidemiology and control of intestinal parasites with nitazoxanide in children in Mexico. Am J Trop Med Hyg 68:384–385
Fitzerald O, D'Farrel TT (1954) Chronic diarrhea due to Endolimax nana infestation. Ir J Med Sci 6:467–468
Graczyk TK, Bosco-Nizeyi J, DaSilva AJ, Moura INS, Pieniazek NJ, Cranfield, MR Lindguist, HDA (2002) A single genotype of Encephalitozoon intestinalis infects free-ranging gorillas and people sharing their habitats, Uganda. Parasitol Res 88:926–931
Graczyk TK, Grimes BH, Knight R, DaSilva AJ, Pieniazek NJ, Veal DA (2003) Combined FISH and mAb detection of Cryptosporidium parvum and Giardia lamblia carried by synanthropic flies. Am J Trop Med Hyg 68:228–232
Graczyk TK, Conn DB, Lucy F, Minchin D, Tamang L, Moura LNS, DaSilva, AJ (2004) Human waterborne parasites in zebra mussels (Dreissena polymorpha) from the Shannon River drainage, Ireland. Parasitol Res 93:389–391
Guignard S, Arienti H, Freyre L, Lujan H, Rubinstein H (2000) Prevalence of enteroparasites in a residence for children in the Cordoba Province, Argentina. Eur J Epidemiol 16:287–293
Healy GR, Garcia LS (1995) Intestinal and urogenital protozoa. In: Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH (eds) Manual of clinical microbiology. ASM Press, Washington DC, pp 1204–1228
Hussain R, Jafri W, Zuberi S, Baqai R, Abrar N, Ahmed A, Zaman V (1997) Significantly increased IgG2 subclass antibody levels to Blastocystis hominis in patients with irritable bowel syndrome. Am J Trop Med Hyg 56:301–306
Iqbal J, Hira PR, Al-Ali F, Philip R (2001) Cryptosporidiosis in Kuwaiti children: seasonality and endemicity. Clin Microbiol Infect 7:261–266
Jiang JB, He JG (1993) Taxonomic status of Blastocystis hominis. Parasitol Today 9:2–3
Kain KC, Noble MA, Freeman HJ, Barteluk RL (1987) Epidemiology and clinical features associated with Blastocystis hominis infection. Diagn Microbiol Infect Dis 8:235–244
Lima AAM, Guerrant RL (1992) Persistent diarrhea in children: epidemiology, risk factors, pathophysiology, nutritional impact, and management. Epidemiol Rev 14:222–242
Long HY, Handschack A, Konig W, Ambrosch A (2001) Blastocystis hominis modulates immune responses and cytokine release in colonic epithelial cells. Parasitol Res 87:1029–1030
Navarrete N, Torres P (1994) Prevalence of infection by intestinal helminthes and protozoa in school children from a coastal locality in the province of Valdivia, Chile. Bol Chil Parasitol 49:79–80
Ndhlovu Z, Ryon JJ, Griffin DE, Monze M, Kasolo F, Moss WJ (2004) CD4+ and CD8+ T-lymphocyte subsets in Zambian children. J Trop Pediatr 50:94–97
Nigro L, Larocca L, Massarelli L, Patamia I, Minniti S, Palermo F, Cacopardo B (2003) A placebo-controlled treatment trial of Blastocystis hominis infection with metronidazole. J Travel Med 10:128–130
Nimri L, Batchoun R (1994) Intestinal colonization of symptomatic and asymptomatic school children with Blastocystis hominis. J Clin Microbiol 32:2865–2866
Rivero-Rodriguez Z, Chourio-Lozano G, Diaz I, Cheng R, Rucson G (2000) Intestinal parasites in school children at a public institution in Maracai municipality, Venezuela. Invest Clin 41:37–57
Saksirisampant W, Nuchprayoon S, Wiwanitkit V, Yenthakam S, Ampavasiri A (2003) Intestinal parasitic infestations among children in an orphanage in Pathum Thai province. J Med Assoc Thai 86(suppl 2):S263–S270
Stauffer JQ, Levine WL (1974) Chronic diarrhea related to Endolimax nana response to treatment with metronidazole. Am J Dig Dis 19:59–63
Swerdlow MA, Burrows RB (1955) Dientamoeba fragilis, an intestinal pathogen. JAMA 158:176–178
Walderich B, Bernauer S, Renner M, Knobloch J, Burchard GD (1998) Cytopathic effects of Blastocystis hominis on Chinese hamster ovary (CHO) and adenocarcinoma HT 29 cell cultures. Trop Med Intl Health 3:385–390
WHO (1995) The treatment of diarrhea: a manual for physicians and senior health workers. Bull World Health Org/CDR/95.3:1–47
WHO (1998). Persistent diarrhea in children in developing countries: memorandum from WHO meeting. Bull World Health Org 66:709–717
Wolfe MS (2000) Miscellaneous intestinal protozoa. In: Strickland GT (ed) Hunter's tropical medicine and emerging infectious diseases. WB Saunders, Philadelphia, pp 603–610
Yakoob J, Jafri W, Jafri N, Khan R, Islam M, Beg MA, Zaman V (2004) Irritable bowel syndrome: in search of an etiology: role of Blastocystis hominis. Am J Trop Med Hyg 70:383–385
Zaman V (1996) Blastocystis hominis. In: Weatherall DJ, Ledingham JGG, Warrell D (eds) Oxford Texbook of Medicine 3rd edn. Oxford University Press, Oxford
Zierdt CH (1991) Blastocystis hominis: past and future. Microbiol Rev 4:61–79
Zierdt CH (1993) Taxonomic status of Blastocystis hominis: reply. Parasitol Today 9:18
Acknowledgements
We thank Zambian health officials and employees of The Malaria Institute at Macha, Zambia, for facilitating this study. The study was supported by the Johns Hopkins Malaria Research Institute, Baltimore, MD, USA.
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Graczyk, T.K., Shiff, C.K., Tamang, L. et al. The association of Blastocystis hominis and Endolimax nana with diarrheal stools in Zambian school-age children. Parasitol Res 98, 38–43 (2005). https://doi.org/10.1007/s00436-005-0003-0
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DOI: https://doi.org/10.1007/s00436-005-0003-0