Tropical Parasitology最新文献

An 84-year-old female from rural Rajasthan presented with an intertrochanteric fracture of the right femur. On the 2^nd postoperative day, a resident doctor observed the passage of worms in her urine in the indwelling catheter. She had a history of renal calculi for which she was successfully treated surgically 1 year ago. The catheter was collected and sent for microbiological examination. The suspected worm was examined both macroscopically and microscopically. There were very intriguing findings on microscopic examination and are discussed below.

Background: Malaria remains a significant public health challenge in rural Iraq, particularly among children who are vulnerable due to poor nutrition and limited healthcare access. The aim of the study was to investigate the relationship between malaria and inflammatory biomarker levels in children, with a focus on the impact of nutritional deficiencies, anemia, and hematological disorders on disease progression and severity.

Methodology: This case-control study (August 2023-February 2025) included 150 children with malaria and 50 controls aged 5-8 years in rural Iraq. Ethical approval and parental consent were obtained. Blood samples were collected in gel and EDTA tubes, processed, and stored at -80°C. C-reactive protein (CRP), interleukin (IL-6), and tumor necrosis factor-alpha (TNF-α) were measured through the enzyme-linked immunosorbent assay, while hemoglobin was measured via complete blood count. Linear device, while iron, zinc, vitamin D, and ferritin were analyzed using the Cobas e411.

Results: The study showed significant differences in inflammatory markers between the malaria and control groups. CRP (18.4 vs. 5.2 mg/L; P < 0.001), IL-6 (10.2 vs. 3.1 pg/mL; P < 0.001), and TNF-α (12.5 vs. 4.0 pg/mL; P < 0.001) were elevated in malaria patients. Hemoglobin (9.8 vs. 12.5 g/dL; P < 0.001) and iron levels (45.3 vs. 90.2 μg/dL; P < 0.001) were lower, while ferritin levels were higher (30.0 vs. 100.0 ng/mL; P < 0.001). Malnutrition was more prevalent in the malaria group (65% vs. 15%; P < 0.001), as were anemia (70% vs. 20%; P < 0.001) and blood disorders (40% vs. 10%; P < 0.001). Zinc and vitamin D levels were also significantly reduced in malaria patients (P < 0.001).

Conclusion: This study reveals that malaria profoundly affects inflammation, nutrition, and blood health, with elevated CRP, IL-6, and TNF-α levels, common anemia, and disrupted iron metabolism. Zinc and vitamin D deficiencies were frequent. About 65% had severe malnutrition, 70% anemia, and 40% other blood disorders. Findings stress integrated nutritional and anti-inflammatory care and call for further biomarker research.

Background: Malaria remains a significant global health concern as a parasitic infectious disease. The recurrence of malaria presents a considerable challenge in the worldwide efforts to eliminate the disease. Riau Province, recognized as one of the regions with a relatively high incidence of malaria, is set to achieve certification for malaria elimination across all districts by the year 2024. Despite this progress, malaria cases continue to be reported, with an increase observed until now. The persistence of recurrent malaria can be attributed to several factors, including limitations in diagnostic capabilities, treatment challenges such as drug resistance, inadequate therapeutic interventions, and issues related to dosing and treatment evaluation regimens.

Materials and methods: This study uses a descriptive retrospective approach. This study will overview recurrent malaria in Riau Province between 2019 and 2022. While recurrent malaria episodes were observed, this study could not definitively differentiate between relapse and reinfection. The research data were obtained from the Directorate of Communicable Disease Prevention and Control at the Riau Provincial Health Office, covering the period from 2019 to 2022.

Results: Between 2019 and 2022, Riau Province reported 4622 malaria cases. Among these, 232 recurrent malaria cases were identified, and 100% of them occur after 28 days. We were unable to distinguish between cases of relapse and those of reinfection. Most of these cases were reported by the Panipahan Community Health Center in Rokan Hilir Regency. Of the recurrent malaria cases, 220 (94.83%) were caused by Plasmodium vivax, 11 (4.74%) by Plasmodium falciparum, and one case involved a mixed infection. The most commonly used diagnostic method to establish the diagnosis is the rapid diagnostic test (69%). The study found that most cases occurred in male genders, aged 19-59 years, with the majority working as civil servants. All malaria cases received treatment according to the standards, but 73.45% did not receive a complete after-treatment evaluation.

Conclusion: Malaria relapse is a significant challenge in malaria elimination efforts in Riau Province.

Stakeholders meet on "Diagnosis of Endemic Haemoptysis" was conducted on September 14, 2024 at All India Institute of Medical Sciences, Guwahati, Assam, India during the 18^th National Conference of Indian Academy of Tropical Parasitology. This programme was of national importance since endemic hemoptysis caused by Paragonimus westermanii and related species is a public health problem in North-eastern states of India because of exotic food habit of the inhabitants. Experts in Paragonimiasis infection across India attended this meeting. The objective was to frame the guidelines on the identification and detection of P. westermanii with reference to conventional diagnostic and molecular methods. The recommendations of the panel were released as the declaration on the diagnosis of endemic haemoptysis and were circulated to various administrative and scientific bodies in India as reference policy document on the diagnosis of the same.

Background: Chronic/persistent diarrhea due to parasites is emerging. However, majority of the studies document the causes of acute diarrhea. This cross-sectional study was undertaken to determine the occurrence of intestinal parasites in persistent/chronic diarrhea.

Materials and methods: A single diarrheal stool sample from adults with diarrhea >2 weeks were collected for wet mount examination. Patients with prior intake of antiparasitic agents, with cytomegalovirus (CMV), fungal, and bacterial causes of diarrhea, and those with multiple comorbidities were excluded. Modified acid-fast staining was performed for oocysts. Polymerase chain reaction (PCR) for CMV was performed to exclude CMV diarrhea. PCR for Giardia lamblia, Ancylostoma duodenale, Ascaris, Cryptosporidium spp., Strongyloides stercoralis, and Entamoeba spp. was performed through multiplex and nested multiplex protocols, respectively. Results were statistically analyzed using Chi-square and analysis of variance.

Results: A total of 204 cases of chronic/persistent diarrhea, 115 (56.4%) males and 89 (43.6%) females with a mean age of 38.93 ± 16.0 years were studied. Majority (134, 65.7%) had diarrhea with inflammatory bowel disease (IBD) (P = 0.001). Cysts of Entamoeba spp. (Entamoeba histolytica) in 8 (3.9%) and 12 (5.8%) while cysts of G. lamblia were detected in 8 (3.9%) and 10 (4.9%) through microscopy and PCR, respectively. The detection of parasites was significantly higher with PCR (P = 0.0001). None of the samples showed the presence of helminths.

Conclusions: The study revealed 10.7% (E. histolytica, 5.8% and G. lamblia, 4.9%) occurrence of parasitic infections in adults with persistent/chronic diarrhea. It was significantly associated with IBD. The combination of both methods can increase the accuracy of detection.

Parasitic infections pose a significant public health challenge, particularly in tropical and subtropical regions, where they affect nearly a quarter of the global population. These infections can lead to various health issues, including malnutrition, anemia, and increased susceptibility to other diseases, thereby hindering development efforts. The World Health Organization highlights that a significant proportion of neglected tropical diseases are parasitic, underscoring the need for improved diagnostic methods. Early microscopy and staining techniques laid the groundwork for identifying parasites, paving the way for modern diagnostic approaches. Serodiagnostics have progressed from early 20^th-century tests to more advanced techniques, such as enzyme-linked immunosorbent assays and immunoblot. However, challenges remain, such as cross-reactivity and the difficulty in distinguishing between past and current infections. Currently, molecular diagnostics, utilizing technologies such as polymerase chain reaction, multiplex assays, and next-generation sequencing are increasingly used to improve sensitivity and specificity in detecting parasites. In the years to come, there is a growing emphasis on integrating artificial intelligence and deep learning, particularly convolutional neural networks, which are revolutionizing parasitic diagnostics by enhancing detection accuracy and efficiency. Innovative imaging technologies are enabling faster identification of parasites and addressing traditional diagnostic limitations. However, challenges persist, including the need for diverse datasets and infrastructure support in low-resource settings. Continued research and development are essential to overcome these obstacles and ensure better global health outcomes in the face of evolving parasitic threats.

Background: Giardia lamblia (G. lamblia) is a common enteric parasite linked to gastrointestinal illnesses, particularly diarrhea, with its prevalence influenced by various factors.

Aims and objectives: This study aimed to detect and genotype G. lamblia in diarrheal patients using real-time PCR with assemblage-specific primers, and to assess associations with potential risk factors.

Materials and methods: A total of 332 stool samples were collected and examined microscopically. Genotyping was performed on positive samples using real-time PCR targeting the tpi and gdh genes.

Results: G. lamblia was detected in 50 samples (15%), with single and mixed infections each accounting for 7.5%. The tpi gene was successfully amplified in all microscopically positive samples, revealing that mixed assemblages A&B (46%) were the most common, followed by assemblage B (32%) and assemblage A (22%). The gdh gene was amplified in 96% of samples, showing a similar pattern: mixed assemblages (42%), assemblage B (36%), and assemblage A (18%). Additionally, dual peaks in the gdh gene suggest genetic variability that may assist in subtyping. Assemblage distribution based on the tpi gene was significantly associated with age, residence, and animal contact but not with gender, water source, or clinical symptoms.

Conclusion: Real-time PCR effectively detected and genotyped G. lamblia, with a high prevalence of mixed assemblages A&B. The observed genetic variability highlights the importance of molecular tools in understanding Giardia transmission dynamics and supporting targeted public health interventions.