Prevalence and Associated Risk Factors of Intestinal Parasitic Infections among Pregnant Women Attending Antenatal Care in Yifag Health Center, Northwest Ethiopia

Background. A cross-sectional study was conducted from November 2019 to March 2020 to determine the prevalence and associated risk factors of intestinal parasitic infections (IPIs) among pregnant women attending antenatal care (ANC) at Yifag Health Center. Methods. The data were collected by a questionnaire interview technique and collecting the stool samples from each pregnant woman. Wet-mount and formol-ether concentration techniques were applied to identify the IPIs. Data were analyzed using SPSS, version 25, and P -values < 0.05 were considered statistically significant. Results. Out of the total 280 pregnant women who were selected using a simple random sampling technique, 277 participated in the questionnaire survey and gave stool samples (a response rate of 98.9%). The prevalence of IPIs among pregnant women was 53.4% (95% CI: 47.37, 59.42). Taenia species (18.1%) was the predominant parasite followed by Giardia lamblia (12.6%), Entamoeba histolytica/dispar (9.4%), hookworms (9%), Ascaris lumbricoides (4%), Schistosoma mansoni (3.2%), Hymenolepis nana (0.7%), Strongyloides stercoralis (0.4%), and Enterobius vermicularis (0.4%). Eating raw vegetables (AOR = 2.721; 95% CI: 1.266, 5.849; P = 0.010 ) and poor personal hygiene (AOR = 4.015; 95% CI: 1.456, 11.07; P = 0.007 ) were associated risk factors for G. lamblia, while eating raw meat (AOR = 2.477; 95% CI: 1.252, 4.902; P = 0.009 ) for Taenia species infections. The prevalence of intestinal parasites was high and still a health burden to the pregnant women in the study area. We recommend avoiding eating raw meat, strengthening sanitation and hygiene programs, and routine deworming of pregnant mothers to reduce the burden of IPIs among pregnant women.

Intestinal Parasite Infestation in HIV Infected Patients in Tertiary Care Center

Every year, the number of people living with HIV rises as a consequence of advanced infections and the positive effects of highly active antiretroviral therapy (HAART). Gastrointestinal involvement is common, with 90% of patients seeking treatment for gastrointestinal problems as their HIV infection progresses. Nonetheless, identifying and characterization of infectious agents is important for patient management by excluding a clinical diagnosis and determining appropriate treatment, as well as determining public healthcare policy for true pathogen prevalence and yielding epidemiological risk factors for specific infections. The aim of this study is to evaluate the prevalence of symptomatic or asymptomatic intestinal parasitic infection among HIV or AIDS patients. For this study with 80 HIV seropositive patients being recruited from various wards and the Integrated Counseling and Testing Center (ICTC) affiliated to the microbiology department. Patients with acute and chronic diarrhea with abdominal disorder were taken as symptomatic whereas patients without these clinical complaints and who came for routine investigations were taken as asymptomatic. Firstly stool samples were analyzed by macroscopically for the presence of mucus, blood, larvae, segments of tapeworm and adult worms. The consistencies of stool were also recorded such as formed, watery or soft or loose with odor and color. It was examined microscopically after macroscopically for protozoan cysts and trophozoites, helminthic ova and larvae, as wet mount preparation by saline and iodine preparation as well as formal ether concentrated. For the detection of intestinal coccidian parasites, smears were prepared from stool samples and a modified Ziel-Nelseen (MZN) stain was also performed. Stool samples with the detection of parasites were informed for treatment. The prevalence of intestinal parasite was 23.75% with asymptomatic and symptomatic groups having a prevalence of 16.98% and 37.04% respectively. Out of total patients, 56.25% were male and 43.75% were female. Among the male patients, 11 (13.75%) were positive for an intestinal parasitic infection and 8 (10%) were positive among females. The age distribution data revealed that the age group 21-40 years old had the highest number of intestinal parasites, followed by 41-60, 61-80, and 0-20 years old. The most intestinal parasites were found in the young and middle-aged patients, according to this study. Different parasites were identified as Entamoeba histolytica, Taenia species, Ascaris lumbricoides, Cryptosporidium parvum and Isospora with one protozoan, two coccidian parasites and two helminthes. The most common parasite was Taenia species 6 (7.5%) followed by Entamoeba histolytica 5 (6.3%) and Cryptosporidium parvum 5 (6.3%). Intestinal parasitic infection is not uncommon in HIV seropositive patients. This study underscores the need for early diagnosis and treatment of these intestinal parasites in both symptomatic and asymptomatic HIV patients.

Interlinks between Wildlife and Domestic Cycles of Echinococcus spp. in Kenya

Effective conservation and management of wildlife in the current changing world, call for incorporation of infectious zoonotic diseases surveillance systems, among other interventions. One of such diseases is echinococcosis, a zoonotic disease caused by Echinococcus species. This disease exists in two distinct life cycle patterns, the domestic and wildlife cycles. To investigate possible inter-links between these cycles in Kenya, 729 fecal samples from wild carnivores and 406 from domestic dogs (Canis lupus familiaris) collected from Maasai Mara and Samburu National Reserves were analyzed. Taeniid eggs were isolated by zinc chloride sieving-flotation method and subjected to polymerase chain reaction of nicotinamide adenine dehydrogenase subunit 1 (NAD1). Subsequent amplicons were sequenced, edited and analyzed with GENtle VI.94 program. The samples were further subjected to molecular identification of specific host species origin. All sequences obtained were compared with those in Gene-bank using Basic Local Alignment Search Tool (BLAST). The study found that there were 74 taeniid positive samples, 53 from wild carnivores and 21 from domestic dogs. In wildlife, mixed infections with Echinococcus and Taenia species were identified and these included E. granulosus sensu stricto, E. felidis, T. canadensis G6/7, Taenia hydatigena, T. multiceps, and T. saginata. Domestic dogs harbored Echinococcus and Taenia species similar to wild carnivores including E. granulosus G1–3, E. felidis, T. multiceps, T. hydatigena, and T. madoquae. Taenia species of nine taeniid eggs were not identified. Majority of genotypes were found in hyena (Crocuta crocuta) fecal samples. Distribution of Echinococcus and Taenia spp. varied with hosts. Mixed infections of Echinococcus spp, T. multiceps and T. hydatigena in a single animal were common. There seemed to be existence of interactions between the two cycles, although public health consequences are unknown. The presence of T. saginata in hyena suggests scavenging of human fecal matter by the animal. In addition, presence of T. multiceps, T hydatigena, T madoquae and T. saginata in the two cycles suggested possible human exposure to these parasites. The results are important in drawing up of strategies and policies towards prevention and control of Echinococcosis and other Taenia related parasitic infections, especially in endemic areas given their potential risk to public and socio- economic livelihood.