Intestinal parasites in hemodialysis patients from developing countries: A systematic review and meta‐analysis

Abstract

Intestinal parasitic infection (IPI) is the main cause of gastrointestinal complications in hemodialysis patients due to their impaired immune systems. We conducted a systematic review and metaanalysis to evaluate the prevalence and odds ratio (OR) of IPIs in this population. Relevant eligible studies were identified by searching the PubMed, Science Direct, Scopus, Web of Science, and Google scholar databases up to January 30, 2019. A random-effects meta-analysis model was used to estimate the pooled prevalence, OR, and 95% confidence intervals (CI). Twenty-two studies, from Turkey, Iran, Brazil, Egypt, Saudi Arabia, Pakistan, and Malaysia met eligibility criteria for analysis, and included 11 using a case-control design (980 patients and 893 controls) and 11 studies using a cross-sectional design (a total of 1455 participants). Cross-sectional studies suggested that the pooled prevalence of IPIs in hemodialysis patients was 24% (95% CI, 14-36%; 307/1455). In studies using a case-control design, the pooled prevalence of IPIs in hemodialysis patients (30%, 330/980) was found to be significantly higher than controls (10%, 115/893) (OR, 3.40; 95%CI, 2.37-4.87). With respect to the parasites, Cryptosporidium spp. (OR, 4.49; 95%CI,) and Blastocystis sp. (OR, 4.03; 95%CI,) were significantly higher in hemodialysis patients compared to the controls. The current study revealed a high prevalence of IPIs in hemodialysis patients from countries in which the baseline prevalence of parasitic infection is high. We recommend that periodic screenings for IPIs in such countries should be incorporated into the routine clinical care of hemodialysis patients.

Molecular characterization of Cryptosporidium spp. obtained from fecal samples of immunosuppressed patients from Brazil

“…Several studies have investigated the incidence of opportunistic enteric parasites in immunosuppressed populations, particularly in people with HIV/AIDS. However, information regarding Cryptosporidium infection in kidney failure and transplant patients remains scant 33 . The fact that Cryptosporidium spp.…”

Intestinal parasitic infections among hemodialysis Sudanese patients.

“…In our present paper, a high prevalence of parasites was detected by modified ZN staining technique and was found to be 50 (44.6%) and by formol-ether concentration technique was found to be 32 (39%) (Table 1). Previous studies showed high prevalence of intestinal parasites among hemodialysis patients of different populations [7,8,34]. This may be due to low socio-economic status associated with poor sanitation, inadequate hygiene habits, drinking of untreated water, malnutrition and immunocompromised, leading to the onset of enteroparasitosis.…”

“…In developing countries continue a noteworthy cause of morbidity and mortality, it is estimated that 3.5 billion people are affected and 450 million are ill as a result of these infections and majority being children [3][4][5][6]. In other estimation, about one-quarter of world's population is infected and about 80% of all deaths annually are due to infectious and parasitic diseases in developing countries [7,8]. The reason behind the high prevalence of these infections is closely correlated to lack, poor environmental cleanliness, and destitute health services [9,10].…”

State-of-the-Art Techniques for Diagnosis of Medical Parasites and Arthropods

“…Nowadays, parasitic diseases are responsible for significant morbidity and mortality in both tropical and subtropical regions [ 2 ]. Globally, there are approximately 3.5 billion cases of intestinal parasitic infections [ 3 ]. In Thailand, the prevalence of parasitic infections has steadily decreased due to improved sanitation and personal hygiene.…”