scholarly journals Screening for Parasitic Infection and Tuberculosis in Immunosuppressed and Pre-Immunosuppressed Patients: An Observational Study

2021 ◽  
Vol 6 (3) ◽  
pp. 170
Author(s):  
Luisa Carnino ◽  
Jean-Marc Schwob ◽  
Dionysios Neofytos ◽  
Maria Lazo-Porras ◽  
François Chappuis ◽  
...  

Reactivation of latent tuberculosis infection (LTBI) or latent parasitic infection (LPI) during drug-induced immunosuppression can have serious consequences. The Division of tropical and humanitarian medicine of the Geneva University Hospitals runs a specific consultation for parasitic screening of immunosuppressed or pre-immunosuppressed patients. We sought to determine the seroprevalence of LTBI and LPI in such patients and explore its relationship with country of origin or previous travel in a retrospective, single-centre observational study from 2016 to 2019. Demographic data, travel history, ongoing treatments and results of the parasitological (Strongyloides stercoralis, Trypanosoma cruzi, Echinococcus multilocularis, Entamoeba histolytica and Leishmania spp.) and TB screening were collected to calculate LPI or LTBI prevalence. Risk factors for LTBI and strongyloidiasis were analysed using Poisson regression with robust variance. Among 406 eligible patients, 24/353 (6.8%) had LTBI, 8/368 (2.2%) were positive for Strongyloides stercoralis infection, 1/32 (3.1%) was positive for Entamoeba histolytica and 1/299 (0.3%) was positive for Leishmaniasis. No cases of Trypanosoma cruzi (0/274) or Echinococcus multilocularis (0/56) infection were detected. Previous travel to or originating from high-prevalence countries was a risk factor for LTBI (PR = 3.4, CI 95%: 1.4–8.2 and 4.0, CI 95%: 1.8–8.9, respectively). The prevalence of serological Strongyloidiasis in immunosuppressed patients is lower in comparison to those without immunosuppression (PR = 0.1, CI 95%: 0.01–0.8). In conclusion, screening before immunosuppression needs to be individualized, and LTBI and LPI need to be ruled out in patients who originate from or have travelled to high-prevalence countries. The sensitivity of strongyloidiasis serology is reduced following immunosuppression, so an algorithm combining different tests or presumptive treatment should be considered.

2020 ◽  
Vol 31 (5) ◽  
pp. 398-401
Author(s):  
Sophie A Ross ◽  
Hannah Pintilie ◽  
James Hatcher ◽  
Olamide Dosekun ◽  
Graham S Cooke ◽  
...  

Strongyloides stercoralis is a common parasitic infection in tropical and subtropical areas which may result in fatal hyperinfection syndrome in immunosuppressed patients. Infection occurs through skin or mucous membrane contact with material contaminated with infected human faeces. Sexual transmission of other gastrointestinal infections has been observed in men who have sex with men (MSM), with human immunodeficiency virus (HIV) a known risk factor. We present a case series of strongyloidiasis in seven HIV-positive MSM living in a non-endemic area. We found high rates of concomitant sexually transmitted infection and chemsex drug use, suggesting high-risk sexual behaviour.


2007 ◽  
Vol 40 (6) ◽  
pp. 631-634 ◽  
Author(s):  
José Ivan Albuquerque Aguiar ◽  
Alessandra Queiroga Gonçalves ◽  
Fernando Campos Sodré ◽  
Severino dos Ramos Pereira ◽  
Márcio Neves Bóia ◽  
...  

A parasitological survey was carried out among Terena Indians living in the Tereré settlement in the municipality of Sidrolândia, State of Mato Grosso do Sul, Brazil. Single samples of feces from 313 Indians were processed by means of the spontaneous sedimentation method. In the population studied, 73.5% were infected with at least one intestinal parasite or commensal. Protozoa predominated. Blastocystis hominis (40.9%), Entamoeba coli (33.2%) and Entamoeba histolytica/Entamoeba dispar (31.6%) were the most common. Bivariate analysis showed that females were generally more infected and presented higher rates of infection by Entamoeba histolytica/Entamoeba dispar and Entamoeba coli. Males were more infected by hookworms and Strongyloides stercoralis than females. The precarious sanitary conditions of the Tereré settlement are probably a contributory factor towards the high prevalence of intestinal protozoa.


Author(s):  
J Lakhani Sucheta ◽  
Dhruba Hari Chandi ◽  
J Lakhani Som

Introduction: In developing countries, immunosuppressive patients are at greater risk of parasitic infection which may cause morbidity and mortality. Socio-economic and environmental factors including lack of health hygiene in close contact with infected reservoir animal which plays an important role. Aim: To determine the prevalence of parasitic infections and their association with socio-demographic status. Materials and Methods: This was a cross-sectional study which was carried out at tertiary care hospital located in Central East India. Total 120 stool samples were collected from the immunosuppressive patients and were processed using direct wet mount preparation with saline and Lugol, formalin-ether concentration and Modified Ziehl-Neelsen stain. Different socio-demographic parameters were recorded. Statistical analysis was done using Graph Pad Prism version 8 Chi-square test. The p-value ≤0.05 was considered as statistically significant Results: Out of total 120 patients, 20 (16.7%) were found to be infected. Majority of the population were males (66.7%). Among the total positive samples, 75% (15) showed the presence of Protozoa in which 10 samples had Entamoeba histolytica. The presence of Helminths was found in 25% (5), in which three samples showed Ascaris lumbricoides and two had Taenia species (10%). Conclusion: The prevalence of parasitic infection among immunosuppressive patients in the present study was 16.7%. Entamoeba histolytica was the most commonly observed parasite. There was no significant association between prevalence of parasitic infections and socio-demographic data variables.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A160-A161
Author(s):  
Darin Ryujin ◽  
Krishna Sundar ◽  
Allyson Gilles

Abstract Introduction Sleep-disordered breathing in Native Hawaiians and Pacific Islanders (NHPIs), its relationship to type 2 diabetes mellitus (DM), chronic renal, and heart disease, is not well known. NHPIs comprise only 1.3% of Utah’s population, but have the highest rates of DM and deaths due to diabetic kidney disease in Utah. This study assessed the nature of sleep-disordered breathing, its association with demographic variables, and comorbidities, and adherence patterns to positive airway pressure (PAP) therapy. Methods University of Utah sleep clinics patient databases from 2014 were evaluated to identify NHPIs using first/last names. Electronic medical records were reviewed to confirm patient ethnic origin, demographic data, and comorbidities. The most recent PAP downloads were obtained. Results Of 106 NHPIs were identified, data available for 104 patients (71 males, 33 females) was analyzed. Mean age of males was 47 + 13 years and females 48±13 years. Prevalence rates of obesity were 13% (female 9%, male 15%) with BMI≥30, 33% (female 24%, male 23%) with BMI≥35, and 49% (female 58%, Male 23%) with BMI≥40). Majority of patients had severe OSA (61% males with AHI≥30; 39% females with ≥ 30), with overall mean AHI of 47±38. A high prevalence of comorbidities was noted: 61% hypertension (male 58%; female 67%), diabetes 54% (male 48%, female 67%), renal disease 20% (male 21%, female 18%), coronary artery disease 13% (male 14%, female 9%), and congestive heart failure 13% (male 15%, female 9%). Prevalence of lung disease was low 13% (male 9%, female 18%). Conclusion NHPIs evaluated for sleep-disordered breathing have high rates of obesity, severe OSA, and concerning comorbidities. PAP adherence in this group was poor compared to overall adherence for patients seen in University of Utah sleep clinics (~70%). Further research is required to assess the relationships between OSA, associated comorbidities, and disease outcomes. Addressing low rates of PAP adherence in this population may afford opportunities to improve health outcomes. Support (if any) n/a


2006 ◽  
Vol 130 (12) ◽  
pp. 1792-1798 ◽  
Author(s):  
Francesco Rivasi ◽  
Silvio Pampiglione ◽  
Renzo Boldorini ◽  
Loredana Cardinale

Abstract Context.—Strongyloidiasis is a worldwide parasitic infection affecting approximately 75 million people. In Italy, it was more prevalent in the past among rural populations of irrigated areas. Objective.—To determine the histopathologic alterations of the gastric and duodenal mucosa associated with the presence of Strongyloides stercoralis parasites. Design.—Fifteen cases of strongyloidiasis were observed in immunocompromised patients during a recent 6-year period in Italy. S stercoralis was found histologically in gastric biopsies (10 cases), in a gastrectomy (1 case), and in duodenal biopsies (9 cases). In 5 cases the parasite was present both in gastric and duodenal biopsies. Four patients were affected by lymphoma, 2 by multiple myeloma, 2 by gastric carcinoma, 1 by chronic myeloid leukemia, 1 by sideroblastic anemia, 1 by colorectal adenocarcinoma, 1 by chronic idiopathic myelofibrosis, 1 by chronic gastritis, 1 by gastric ulcers, and 1 by rheumatoid arthritis in corticosteroid therapy. No patient was affected by human immunodeficiency virus infection. Strongyloidiasis was not clinically diagnosed. Results.—Histologic examination revealed several sections of S stercoralis larvae, many eggs, and some adult forms. All the parasites were located in the gastric and/or the duodenal crypts. Eosinophils infiltrating into the lamina propria were found in all cases; their intensity was correlated with the intensity of the infection. Conclusions.—Histologic diagnosis of strongyloidiasis must be taken into consideration when examining both gastric and duodenal biopsies in immunocompromised patients, to avoid the development of an overwhelming infection of the parasite, which is dangerous for the life of the patient.


Author(s):  
Mohammad Hashem Hashempur ◽  
Seyed Hamdollah Mosavat ◽  
Mojtaba Heydari ◽  
Mesbah Shams

Abstract Background Despite growing demand for medicinal plants, there is little data about their use by patients with dyslipidemia. We aimed to determine the prevalence, pattern, and associated factors for the use of medicinal plants among patients with dyslipidemia. Methods A 17-item semi-structured questionnaire was filled out by 195 patients with dyslipidemia in a cross-sectional study carried out in two academic endocrinology clinics in Shiraz, Iran. The questionnaire comprised of three main domains of demographic data (6 questions), clinical data (2 of them), and data related to the use of medicinal plants (totally 9 questions). Results A total of 77.4% of patients took medicinal plants. The most common medicinal herbs used by dyslipidemic patients were Zataria multiflora, Cinnamomum zeylanicum, and Zingiber officinale. Duration of dyslipidemia was significantly longer in herbal users than non-herbal users (p=0.04). Patients believing that concomitant use of conventional drugs and herbal preparations had synergic positive effects in addition to those persuaded that herbal preparations possessed less side effects, were significantly more likely to use medicinal plants (p=0.008 and 0.005, respectively). Additionally, most of the medicinal herb users (87.4%) changed neither the pattern nor the dosage of their medications all during herbal preparations use. Conclusions This study demonstrated a high prevalence of medicinal plants’ use among patients with dyslipidemia, which was associated with the duration of dyslipidemia, patients’ viewpoints about herbal preparations’ synergic positive effects, and their fewer side effects.


Author(s):  
Jun Kobayashi ◽  
Hideo Hasegawa ◽  
Archimedes A. Forli ◽  
Nancy F. Nishimura ◽  
Ademar Yamanaka ◽  
...  

A parasitological survey was carried out on 222 inhabitants of five farms in Holambra, located 30 km north of Campinas, São Paulo, Brazil, on October 1992. Approximately 70% of the inhabitants were found to be infected with at least one species of intestinal parasite. The positive rates of 6 helminths and 7 protozoan species detected are as follows: 5.4% Ascaris lumbricoides; 8.6% Trichuris trichiura; 19.8% Necator americanus; 10.4% Strongyloides stercoralis; 14% Enterobius vermicularis; 0.9% Hymenolepis nana; 3.2% Entamoeba histolytica; 2.7% E. hartmanni; 9.9% E. coli; 14.0% Endolimax nana; 2.3% Iodamoeba butschlii; 10.4% Giardia lamblia; 37.8% Blastocystis hominis. The positive rates of helminth infection were generaly higher in the younger-group under 16 years-old than those in the elder group aged 16 or more, whereas the infection rates of protozoan species were higher in the elder group. The infection rate of Strongyloides was found to be 10.4% by a newly developed sensitive method (an agarplate culture methods).


Author(s):  
Arcelia González-García ◽  
Claudia Hernández-Salas ◽  
Rosa Maria Martínez-Ortiz ◽  
Lilia González-Martínez

Introduction: Nowadays in our state, intestinal parasitic diseases are still endemic, with a greater frequency in rural and mountainous urban areas. After the years have elapsed since the last national survey, it was necessary to carry out a new survey to know the prevalence rates of intestinal parasitosis and to compare the results obtained between both studies. Such knowledge would be of great value in developing health strategies and designing intestinal parasitic infection control programs. Objective: to determine the current prevalence rates of intestinal parasites, to compare the results with those of the survey obtained. Methods: a random cross-sectional descriptive study was carried out during the months of December 2018 to March 2019 in a random sample of both sexes from the population of urban communities and the province of Zacatecas, Zac. Each one had a stool sample collected that was analyzed by the direct examination method, the Willis concentration technique, and the Kato-Katz examination; A questionnaire was also applied to them. Results: when comparing the results of the national and state surveys of intestinal parasitic infections carried out in 2009 and 2018, it was found that, in general, infections by parasites decreased, both helminths and pathogenic protozoa, although those infected with commensals increased their frequency in that of 2019. There was also a decrease in the frequency of infections by all species of soil-transmitted helminths, Trichuris trichiura, Ascaris lumbricoides, ancylostomideos, and Strongyloides stercoralis, as well as by the pathogenic protozoa Giardia lamblia and Entamoeba histolitica. Conclusions: when comparing the results of national and state surveys of intestinal parasite infections carried out in 2018 and 2019, it was found that in general the frequencies of infections with intestinal parasites decreased. The finding in both studies of a higher frequency of infection with parasites or commensals in the group aged 5 to 14 years (school age), supports the recommendation to place emphasis on control programs for intestinal parasites in this age group.


Author(s):  
Khalid Astitene ◽  
Hassan Aguenaou ◽  
Laila Lahlou ◽  
Amina Barkat

Aim: After a traumatic event, the person can develop post-traumatic stress disorder (PTSD), the purpose of the study is to assess the prevalence of PTSD in adolescents in public middle schools of the prefecture of Salé in Morocco and study anxiety and depression which are the comorbid disorders of the PTSD. The survey was carried out from March to June 2017. Methods: 523 students were selected by the cross-sectional method from fifteen schools that were randomly selected, the age of the students vary between 12 and 17 years. For the survey, standardized questionnaires (the socio-demographic data, the Life Events Checklist, the CPTS-RI (Children's Post Traumatic Stress Reaction Index), the STAIY (State Trait Inventory Anxiety Form Y) and the CDI (Children Depression Inventory) were used which were filled in by the students. Results: The prevalence of PTSD was 70.4% in the students who have PTSD. We found that the prevalence in boys was 46.74%, while in girls it was 53.26%. In addition to that, 81% of students found to be anxious and 51.8% of students have depression. Conclusion: There is a high prevalence of post traumatic stress disorder among adolescents, there are practical implications for the support and care of these adolescents.


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