Mapping gut parasitism patterns in a cohort of Egyptians

Abstract

In developing countries, the prevalence of intestinal parasitic infection is still significant, particularly due to geographical and socioeconomic variables. The objective of this study was to map the distribution pattern of intestinal parasitic infection in a cohort of the Egyptian population, as well as to assess associated risk factors. A cross-sectional hospital-based study was conducted on 386 patients. A single fecal specimen was collected from the study individual and examined microscopically for the detection of parasitic infection. DNA was extracted from all samples and utilized to amplify Entamoeba histolytica complex species, Cryptosporidium species, Giardia intestinalis assemblages, and Blastocystis species using PCRs. Typing of Cryptosporidium species and Giardia intestinalis assemblages was performed using restriction enzymes RasI and HaeIII respectively. While Blastocystis spp. subtypes (ST) were identified through sequencing of PCR products and phylogenetic analysis. 59.6% (230/386) of the study patients were infected with one or more intestinal parasites, 87.4%; 201/230 of patients had mono-parasitic infections, and 12.6%; 29/230 had multiple-parasitic infections (P < 0.0001). The predominant protozoa were Blastocystis, followed by Entamoeba histolytica complex, and Giardia intestinalis both as mono-parasites and as part of multiple parasites. Molecular assays showed that Blastocystis ST3, Entamoeba dispar, Giardia intestinalis assemblage B, and Cryptosporidium hominis were the most prevalent species. Intestinal parasitic infection was significantly associated with age, gender, residence, and water source. Multi-parasitism showed that residency in a rural area was a risk factor (OR 4.49; 95% CI 1.51–13.37; P = 0.007). Egyptians residing in rural areas have a high prevalence of intestinal multi-parasitism. Therefore, to lessen the prevalence and effects of these infections in this group, effective and sustainable control methods, providing health education focusing on good personal hygiene habits, and providing a safe drinking water supply should be implemented.

Gastrointestinal parasitic infections: Prevalence and risk factors in West Ismailia, Arab Republic of Egypt

“…In contrast to protists infection (37.9%), the prevalence of helminths was comparatively low at 2.5%. This finding was consistent with previous GIP prevalence studies conducted in ARE [ 32 , 33 , 42 ] and other regions [ 43 ]. The reduction in the prevalence of intestinal helminths could be attributed to the implementation of anti-helminthic community-based control programs [ 47 ].…”

“…Forty percent of the 520 individuals examined in this study were infected with at least one parasite. The observed prevalence rate was comparatively lower than those previously documented in other regions of ARE, including Gharbia governorate (46.2%) [ 31 ], Zagazig district (56%) [ 42 ], and Cairo (59.6%) [ 32 ]. Nevertheless, it surpassed the prevalence among school students in Aswan (31%) [ 33 ].…”

Molecular Prevalence and Subtypes Distribution of Blastocystis spp. in Humans of Latin America: A Systematic Review

“…These results are consistent with other reports from several geographic regions worldwide that principally identified the subtypes ST1 to ST9 [ 91 , 92 , 93 , 94 , 95 , 96 ]. According to Nemati et al [ 11 ], the first three, ST1, ST2, and ST3, are the most frequent STs among human subjects in the Asian continent.…”

“…Some studies in developing countries reported the following Blastocystis spp. prevalence and the dominant ST: Algeria, 7.4%—ST3 [ 98 ]; Angola, 25.6%—ST3 [ 99 ]; Azerbaijan, 45.1%—ST3 [ 100 ]; Cambodia, 55.2%—ST1 [ 101 ]; Egypt, 47.8%—ST3 [ 91 ]; India, 27.0%—ST3 [ 102 ]; Jordan, 15.0%—ST3 [ 100 ]; Malaysia, 18.5%—ST3 [ 103 ]; Nigeria, 55.5%—ST1 [ 100 ], the Philippines, 13.0%—ST3 [ 104 ]; Qatar, 71.1%—ST3 [ 26 ]; Saudi Arabia, 68.6%—ST3 [ 105 ]; Senegal, 51.7%—ST2 [ 106 ]; Sudan, 47.5%—ST1 [ 100 ]; Tanzania, 61.0%—ST1 [ 107 ]; Turkey, 24.6%—ST3 [ 94 ].…”

Molecular Epidemiology and Genetic Diversity of the Enteric Protozoan Parasite Blastocystis sp. in the Northern Egypt Population

“…Indeed, in these latter studies, the parasite frequency was determined via direct microscopy of fecal smears or after in vitro cultivation of stool samples, which are conventional detection methods known to significantly underestimate the true incidence of the parasite compared to molecular assays [52,53]. Recently, the prevalence of 64.0% and 37.3% have been recorded by PCR for two limited cohorts of Egyptians [54,55], but either almost all or all PCR products obtained in these surveys were not sequenced to confirm the presence of the parasite. Overall, the prevalence observed in our Egyptian cohort was similar to that determined, for instance, in large groups of individuals in West Africa, like in Senegal (80.4%) [5] or Guinea (78.0%) [6].…”