Prevalence and Associated Risk Factors of Intestinal Parasitic Infections among Patients Visiting a Referral Hospital in Tehran Province, Iran

Abstract

Background: Intestinal parasitic infections (IPIs) are still considered a public health problem of mankind, particularly in immunocompromised patients. We aimed to determine the prevalence of IPIs with an emphasis on immunocompromised patients in a referral hospital in Tehran Province, Iran.
 Methods: In this cross-sectional study, 442 fecal specimens were collected randomly from patients, referred to Baqiyatallah Hospital in Tehran Province, Iran from May to September 2020. The collected specimens were examined using wet-mount, trichrome and modified Ziehl-Neelsen staining, formalin-ether concentration, and agar plate culture.
 Results: The prevalence of IPIs was found 17.0% (95% CI: 13.6-20.8%). The prevalence of protozoan parasites (16.3%; 95% CI: 13.0-20.1%) was significantly higher than helminthic parasites (0.7%; 95% CI: 0.1-2.0%). Blastocystis spp., Giardia lamblia, and Entamoeba coli were the most common intestinal protozoan with a prevalence of 12.2%, 1.6%, and 1.4%, respectively. E. histolytica/E. dispar/E. moshkovskii, Iodamoeba bütschlii, Cryptosporidium spp., Chilomastix mesnili as protozoan species and Hymenolepis nana, Dicrocoelium dendriticum, and Ascaris lumbricoides as helminthic species were the other detected parasites. Multiple logistic regression revealed a significant association of IPIs infections with stool consistency and the status of immune system.
 Conclusion: The prevalence of IPIs among the patients who are immunocompromised was significantly higher than immunocompetent patients (P< 0.05). Periodic stool examinations for screening of IPIs should be included as a part of routine medical check-up in these patients.

Intestinal Parasitic Infections in People Referring to the Central Laboratory of Meshkin Shahr County, Ardabil Province, Iran

“…Based on our findings, the frequency of IPIs in the age group 60–69 years was 26.1% higher than in other age groups, possibly due to the low personal hygiene and education level of older people and lack of awareness of the transmission of IPIs. Nevertheless, there was no significant correlation between the frequency of IPIs and age groups, consistent with other reported studies ( 13 , 16 ).…”

“…According to our knowledge, this research was the first attempt to illustrate the frequency of IPIs in this area. This finding was similar to a study performed in Tehran in which the prevalence of IPIs was reported as 17% among patients visiting a referral hospital ( 16 ). In addition, the prevalence of the intestinal parasite in people referred to different medical laboratories in Babol was 12.1% ( 17 , 18 ).…”

“…The prevalence of helminth infections in Iran has decreased dramatically in recent years, while some helminths with direct fecal-oral transmission, such as H. nana and Enterobius vermicularis , remain common in some parts of the country ( 36 ). Despite the human cases of dicrocoeliasis reported in the northern regions of Iran, the D. dendriticum infections reported in the current study were pseudo infections due to consuming contaminated livestock liver ( 16 ). The low rate of intestinal helminth infections in Meshkin Shahr is consistent with the findings of recent reports from other regions of Iran ( 16 , 25 ).…”

“…Despite the human cases of dicrocoeliasis reported in the northern regions of Iran, the D. dendriticum infections reported in the current study were pseudo infections due to consuming contaminated livestock liver ( 16 ). The low rate of intestinal helminth infections in Meshkin Shahr is consistent with the findings of recent reports from other regions of Iran ( 16 , 25 ).…”

“…The frequency of intestinal parasites showed no significant correlation with educational level or occupation, although the highest frequency was found among retired participants, 22.2% ( 16 , 18 ).…”