Blastocystis hominis as a contributing risk factor for development of iron deficiency anemia in pregnant women

Abstract

Intestinal parasitic infection increases the risk of developing iron deficiency anemia (IDA) during pregnancy. The objective of this study was to assess Blastocystis hominis as a contributing risk factor for development of IDA in pregnant women. A total of 200 fecal specimens from 120 pregnant women with IDA (mean Hb = 9.6 g/dl), and 80 non-anemic controls were examined for Blastocystis. Fecal specimens were examined by the formalin/ethyl-acetate concentration technique, iron hematoxylin staining, modified Ziehl-Neelsen acid-fast staining, and by the in vitro cultivation technique for Blastocystis. Frequency of Blastocystis infection, detected microscopically and by the in vitro culture technique, was significantly higher in IDA study group (n = 48; 40%) compared to non-anemic controls (n = 5; 6.3%; P < 0.0001), and 26.5% (n = 53) in all study subjects. Among the 48 cases, Blastocystis without other intestinal parasitic infections was detected in 41 cases (34.2%), while seven cases (5.8%) with Blastocystis were coinfected with other intestinal parasites which included Giardia and Cryptosporidium (1.7% each), and Entamoeba sp., Ascaris, and Trichuris (0.8% each). The mean Hb level of the 48 Blastocystis-infected cases was 9.2 g/dl (mild anemia). While the other 72 IDA cases with no infection had mean Hb of 10.0 g/dl (mild anemia), with a significant difference in mean Hb level between Blastocystis-infected and the non-infected IDA cases (P < 0.0001). Furthermore, among the 48 Blastocystis-infected IDA cases, the mean Hb of the 41 Blastocystis-infected cases without other intestinal parasitic co-infection was 9.1 g/dl (mild anemia), while the mean Hb level of the 7 Blastocystis-infected cases with other intestinal parasitic co-infection was 8.7 g/dl (moderate anemia). Findings of the current study showed that B. hominis infection contributes to the development of IDA in pregnant women. Hence, parasitological diagnostic tests are recommended in routine examination at all antenatal clinics.

<p>Molecular Epidemiology and Risk Factors of Blastocystis sp. Infections Among General Populations in Yunnan Province, Southwestern China</p>

“…infection has been identified as a contributing factor to the pathogenesis of iron deficiency anemia in pregnant women. 40 In this study, we found a correlation between ST1 subtype infection and anemia (P = 0.008); however, the predominant ST3 subtype, ST2 or ST4 all had no associations with anemia. This is different from previous findings in pregnant women reporting no correlation between Blastocystis subtypes and anemia.…”

Prevalence and risk factors for intestinal parasitic infections in pregnant women residing in three districts of Bogotá, Colombia

“…Colombian studies in school children identified this parasite as common, with over 50% prevalence [ 21 , 39 ]. Despite its debated pathogenicity, Blastocystis hominis has been reported to cause or be associated with abdominal pain and diarrhea [ 76 ], hematological abnormalities [ 77 ], pregnancy-related anemia [ 78 ], and immunosuppression [ 79 ]. Additionally, Ramirez et al [ 80 ] reported that 72% of children positive for Blastocystis hominis were asymptomatic, with just 11% showing abdominal pain and 2% diarrhea.…”

Subtype analysis of Blastocystis spp. isolated from domestic mammals and poultry and its relation to transmission to their in-contact humans in Ismailia governorate, Egypt.

“…among humans in contact with animals was 35.7%, which was in accordance with previous reports of human blastocystosis in Egypt, regardless of the state of contact with animals. A prevalence of 22.4% was reported among subjects from Dakahlia governorate [38] , while it was 33.3% among patients complaining of GIT symptoms [39] and 26.5% among pregnant women [40] . The situation was quite similar in other developing countries: a prevalence of 41% was reported among animal handlers from Malaysia [27] , 26.1% in subjects from rural communities in Nepal [41] and 37.2% in Thailand [42] .…”