The relation between Entamoeba histolytica and anemia has lately had much attention. The aim of this study was to determine the possible correlation between anemia and parasitic intestinal infection with E.histolytica in children from Baghdad-Iraq. This study was conducted from October 2018 to April 2019 in different hospitals, primary health care centers, and primary schools. Eighty-one children participated in this study and their ages were between 1 and 12 years. The participants were divided into two groups based on their general microscopic stool examination. The first group was diagnosed as E.histolytica infected group (n=47), while no pathogens were detected in the stool samples of the second group which was considered as a healthy control (n=34). Blood samples were taken from all subjects and tested for haemoglobin level, serum ferritin, serum iron, total binding iron capacity (TBIC) and mean corpuscular volume (MCV). Nutritional status was also evaluated for all children aged ≥5 years old. Results showed that the prevalence of anemia was higher in children infected with E.histolytica compared with the control subjects. Anemia was largely reported among children aged 1-3 years for both E.histolytica infected children and control subjects. The results also illustrated that both haemoglobin and iron levels were significantly (p˂0.05) lower in E.histolytica infected children compared with control subjects, while non-significant differences (p˃0.05) were observed in the level of ferritin between E.histolytica infected children and control subjects, although the ferritin was lower in E.hisolytica infected group. The results showed that both gender and age are significantly related to low serum iron levels in both infected and control groups. Significant relationshipswere also noticed between each of the anemia types and the nutritional status with the E.histolytca infection. Microcytic anemia as well as high records of severe malnutrition were observed in the majority of E. histolytica infected children These findings indicate that anemia is more expected to be present in children infected with E.histolytica. Therefore, efforts should be focused on health education of populations at high risk of both anemia and E.histolytica.
Parasitic infections are associated with low education, wars and migration, absence of animal control and poor sanitation. Infections like visceral and cutaneous leishmaniasis (VL and CL), trichomoniasis, toxoplasmosis, malaria, echinococcosis and schistosomiasis are all spread worldwide and have harmful effects on individuals and societies. The aim of this survey was to identify the possible association of these infections with spatial distribution (province/governorate) and patient demographics (age and gender). According to the data collected from the Iraqi National CDC from 2019 to 2020, the predominant parasitic infections in both years were trichomoniasis and CL, followed by echinococcosis, VL and toxoplasmosis. Iraq is malaria and schistosomiasis free. The highest incidence rate of trichomoniasis was in Duhouk (2019) and Al-Dewaniya (2020) and majority of CL cases were in Diala in both 2019 and 2020. The number of echinococcosis cases was the highest in Thi-Qar (2019) and in Nineveh (2020). VL mostly affected Al-Dewaniya (2019) and Thi-Qar (2020). Toxoplasmosis scored the highest incidence rate in Basra in 2019 and 2020. All infections were higher in 2019 than in 2020, except for CL. As for age groups: echinococcosis, toxoplasmosis and trichomoniasis were higher in age group 15 – 44 years, while VL and CL was most common in 0-14 years juveniles in both years. Females were more affected than males by echinococcosis, toxoplasmosis, and trichomoniasis, while VL and CL affected males more often in the years included in this study.
The relation between anemia and inflammatory immune response has lately had much attention. This research was conducted from October 2018 until April 2019, including (110) children below 12 years from both gender in some Hospitals, Primary Health care centers, Public Primary Schools and Kindergarten in Baghdad, Iraq. The objective of this study is to determine the possible correlation between iron deficiency anemia and inflammatory immune response among children infected with Entamoeba histolytica or Giardia lamblia. Blood samples were taken from all groups to measure hemoglobin level, serum iron, total iron binding capacity (TIBC), mean corpuscular volume (MCV), and mean corpuscular hemoglobin concentration (MCHC), while the inflammatory related immune response was evaluated by measuring IL-6 and ferritin. Student T-Test was used to compare between means. The results showed that both hemoglobin and iron concentrations were significantly (P) ˂ 0.01 lower in infected children compared with control, as well as both IL-6 and ferritin levels were significant where (P) ˂0.05 amplified among infected children compared to control. Microcytic hypochromic anemia was observed in the majority of infected children, while normocytic normochromic RBCs was recorded in the majority of control children.
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