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Burden of major diarrheagenic protozoan parasitic co-infection among amoebic dysentery cases from North East India: a case report

Published online by Cambridge University Press:  23 June 2015

JOYOBRATO NATH
Affiliation:
Department of Zoology, Gurucharan College, Silchar, Assam, India Department of Biotechnology, Assam University, Silchar, Assam, India
GULZAR HUSSAIN
Affiliation:
Department of Zoology, Gurucharan College, Silchar, Assam, India
BABY SINGHA
Affiliation:
Department of Zoology, Gurucharan College, Silchar, Assam, India
JAISHREE PAUL
Affiliation:
School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
SANKAR KUMAR GHOSH*
Affiliation:
Department of Biotechnology, Assam University, Silchar, Assam, India
*
*Corresponding author. Department of Biotechnology, Assam University, Silchar 788011, India. E-mail: drsankarghosh@gmail.com

Summary

Intestinal diarrheagenic polyparasitic infections are among the major public health concerns in developing countries. Here we examined stool specimens by microscopy, DNA dot blot and polymerase chain reaction (PCR) to evaluate the co-infection of four principal protozoans among amoebic dysentery cases from Northeast Indian population. The multiplex PCR confirmed Entamoeba histolytica (8·1%), Entamoeba dispar (4·8%) and mixed infection of both the parasites (3·4%) in 68 of 356 stool specimens that were positive in microscopy and/or HMe probe based DNA dot blot screening. The prevailing parasite that co-exists with E. histolytica was Giardia duodenalis (34·1%), followed by Enterocytozoon bieneusi (22·0%), Cryptosporidium parvum (14·6%) and Cyclospora cayetanensis (7·3%, P = 0·017). Symptomatic participants (odds ratio (OR) = 4·07; 95% confidence interval (CI) = 1·06, 15·68; P = 0·041), monsoon season (OR = 7·47; 95% CI = 1·40, 39·84; P = 0·046) and participants with family history of parasitic infection (OR = 4·50; 95% CI = 1·16, 17·51; P = 0·030) have significant association with overall co-infection rate. According to molecular consensus, comprehensive microscopy yielded 3·4% (12/356) false-negative and 7·6% (27/356) false-positive outcome, suggesting an improved broad-spectrum PCR-based diagnostic is required to scale down the poor sensitivity and specificity as well as implementation of integrated control strategy.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2015 

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References

REFERENCES

Alyousefi, N. A., Mahdy, M. A., Mahmud, R. and Lim, Y. A. (2011). Factors associated with high prevalence of intestinal protozoan infections among patients in Sana'a City, Yemen. PLoS ONE 6, e22044.Google Scholar
Daniel, W. W. (1999). Biostatistics: A Foundation for Analysis in the Health Science, 7th Edn. John Wiley & Sons, New York, USA.Google Scholar
Elwin, K., Chalmers, R. M., Roberts, R., Guy, E. C. and Casemore, D. P. (2001). Modification of a rapid method for the identification of gene-specific polymorphisms in Cryptosporidium parvum and its application to clinical and epidemiological investigations. Applied and Environmental Microbiology 67, 55815584.CrossRefGoogle ScholarPubMed
Emile, N., Bosco, N. J. and Karine, B. (2013). Prevalence of intestinal parasitic infections and associated risk factors among Kigali Institute of Education students in Kigali, Rwanda. Tropical Biomedicine 30, 718726.Google Scholar
Feng, Y. and Xiao, L. (2011). Zoonotic potential and molecular epidemiology of Giardia species and giardiasis . Clinical Microbiology Reviews 24, 110140.Google Scholar
Fotedar, R., Stark, D., Beebe, N., Marriot, D., Ellis, J. and Harkness, J. (2007). PCR detection of Entamoeba histolytica, Entamoeba dispar and Entamoeba moshkovskii in stool samples from Sydney, Australia. Journal of Clinical Microbiology 45, 10351037.CrossRefGoogle ScholarPubMed
Fotedar, R., Stark, D., Marriott, D., Ellis, J. and Harkness, J. (2008). Entamoeba moshkovskii infections in Sydney, Australia. European Journal Clinical Microbiology and Infectious Disease 27, 133137.CrossRefGoogle ScholarPubMed
Gelaw, A., Anagaw, B., Nigussie, B., Silesh, B., Yirga, A., Alem, M., Endris, M. and Gelaw, B. (2013). Prevalence of intestinal parasitic infections and risk factors among schoolchildren at the University of Gondar Community School, Northwest Ethiopia: a cross-sectional study. BMC Public Health 13, 304.CrossRefGoogle ScholarPubMed
Gibson, A. K., Raverty, S., Lambourn, D. M., Huggins, J., Magargal, S. L. and Grigg, M. E. (2011). Polyparasitism is associated with increased disease severity in Toxoplasma gondii-infected marine sentinel species. PLoS Neglected Tropical Diseases 5, e1142.Google Scholar
Goodgame, R. (2003). Emerging causes of traveler's diarrhea: Cryptosporidium, Cyclospora, Isospora, and Microsporidia . Current Infectious Disease Reports 5, 6673.Google Scholar
Hamzah, Z., Petmitr, S., Mungthin, M., Leelayoova, S. and Chavalitshewinkoon-Petmitr, P. (2006). Differential detection of Entamoeba histolytica, Entamoeba dispar and Entamoeba moshkovskii by a single-round PCR assay. Journal of Clinical Microbiology 44, 31963200.Google Scholar
Haque, R., Mondal, D., Kirkpatrick, B. D., Akther, S., Farr, B. M., Sack, R. B. and Petri, W. A. Jr. (2003). Epidemiologic and clinical characteristics of acute diarrhea with emphasis on Entamoeba histolytica infections in preschool children in an urban slum of Dhaka, Bangladesh. American Journal of Tropical Medicine and Hygiene 69, 398405.Google Scholar
Herbinger, K. H., Fleischmann, E., Weber, C., Perona, P., Loscher, T. and Bretzel, G. (2011). Epidemiological, clinical, and diagnostic data on intestinal infections with Entamoeba histolytica and Entamoeba dispar among returning travelers. Infection 39, 527535.CrossRefGoogle ScholarPubMed
Liu, H., Shen, Y., Yin, J., Yuan, Z., Jiang, Y., Xu, Y., Pan, W., Hu, Y. and Cao, J. (2014). Prevalence and genetic characterization of Cryptosporidium, Enterocytozoon, Giardia and Cyclospora in diarrheal outpatients in China. BMC Infectious Diseases 14, 25.Google Scholar
Lopez, A. S., Bendik, J. M., Alliance, J. Y., Roberts, J. M., da Silva, A. J., Moura, I. N., Arrowood, M. J., Eberhard, M. L. and Herwaldt, B. L. (2003). Epidemiology of Cyclospora cayetanensis and other intestinal parasites in a community in Haiti. Journal of Clinical Microbiology 41, 20472054.Google Scholar
Mahbubani, M. H., Bej, A. K., Perlin, M. H., Schaefer, F. W. III, Jakubowski, W. and Atlas, R. M. (1992). Differentiation of Giardia duodenalis from other Giardia spp. by using polymerase chain reaction and gene probes. Journal of Clinical Microbiology 30, 7478.Google Scholar
Mirelman, D., Nuchamowitz, Y. and Stolarsky, T. (1997). Comparison of use of enzyme-linked immunosorbent assay-based kits and PCR amplification of rRNA genes for simultaneous detection of Entamoeba histolytica and E. dispar . Journal of Clinical Microbiology 35, 24052407.CrossRefGoogle ScholarPubMed
Mirzaei, M. (2007). Prevalence of Cryptosporidium sp. infection in diarrheic and non-diarrheic humans in Iran. Korean Journal of Parasitology 45, 133137.CrossRefGoogle ScholarPubMed
Nath, J., Banyal, N., Gautam, D. S., Ghosh, S. K., Singha, B. and Paul, J. (2014). Systematic detection and association of Entamoeba species in stool samples from selected sites in India. Epidemiology and Infection 4, 112.Google Scholar
Nguhiu, P. N., Kariuki, H. C., Magambo, J. K., Kimani, G., Mwatha, J. K., Muchiri, E., Dunne, D. W., Vennervald, B. J. and Mkoji, G. M. (2009). Intestinal polyparasitism in a rural Kenyan community. East African Medical Journal 86, 272278.Google Scholar
Ngui, R., Ishak, S., Chuen, C. S., Mahmud, R. and Lim, Y. A. L. (2011). Prevalence and risk factors of intestinal parasitism in rural and remote West Malaysia. PLoS Neglected Tropical Diseases 5, e974.Google Scholar
Ngui, R., Angal, L., Fakhrurrazi, S. A., Lian, Y. L., Ling, L. Y., Ibrahim, J. and Mahmud, R. (2012). Differentiating Entamoeba histolytica, Entamoeba dispar and Entamoeba moshkovskii using nested polymerase chain reaction (PCR) in rural communities in Malaysia. Parasites and Vectors 5, 187.Google Scholar
Noor Azian, M. Y., San, Y. M., Gan, C. C., Yusri, M. Y., Nurulsyamzawaty, Y., Zuhaizam, A. H., Maslawaty, M. N., Norparina, I. and Vythilingam, I. (2007). Prevalence of intestinal protozoa in an aborigine community in Pahang, Malaysia. Tropical Biomedicine 24, 5562.Google Scholar
Parija, S. C. and Khairnar, K. (2005). Entamoeba moshkovskii and Entamoeba dispar-associated infections in Pondicherry, India. Journal of Health, Population and Nutrition 23, 292295.Google Scholar
Pavie, J., Menotti, J., Porcher, R., Donay, J. L., Gallien, S., Sarfati, C., Derouin, F. and Molina, J. M. (2012). Prevalence of opportunistic intestinal parasitic infections among HIV-infected patients with low CD4 cells counts in France in the combination antiretroviral therapy era. International Journal of Infectious Diseases 16, e677e699.CrossRefGoogle ScholarPubMed
Potters, L. and Van Esbroeck, M. (2010). Negative staining technique of Heine for the detection of Cryptosporidium spp: a fast and simple screening technique. Open Parasitology Journal 4, 14.Google Scholar
Pritt, B. S. and Clark, C. G. (2008). Amebiasis. Mayo Clinic Proceedings 83, 11541159.Google Scholar
Srivastva, S., Bhattacharya, S. and Paul, J. (2005). Species and strain-specific probes derived from repetitive DNA for distinguishing Entamoeba histolytica and Entamoeba dispar . Experimental Parasitology 110, 303308.Google Scholar
Tanyuksel, M. and Petri, W. A. Jr. (2003). Laboratory diagnosis of amebiasis. Clinical Microbiology Reviews 16, 713729.CrossRefGoogle ScholarPubMed
Tengku, S. A. and Norhayati, M. (2011). Public health and clinical importance of amebiasis in Malaysia: a review. Tropical Biomedicine 28, 194222.Google Scholar
Verweij, J. J., Blange, R. A., Templeton, K., Schinkel, J., Brienen, E. A., van Rooyen, M. A., van Lieshout, L. and Polderman, A. M. (2004). Simultaneous detection of Entamoeba histolytica, Giardia lambia, and Cryptosporidium parvum in fecal samples by using multiplex real-time PCR. Journal of Clinical Microbiology 42, 12201223.Google Scholar
Wegayehu, T., Adamu, H. and Petros, B. (2013). Prevalence of Giardia duodenalis and Cryptosporidium species infections among children and cattle in North Shewa Zone, Ethiopia. BMC Infectious Diseases 13, 419.Google Scholar
WHO/PAHO/UNESCO Report (1997). A consultation with experts on amebiasis, Mexico City, Mexico 28–29 January. Epidemiological Bulletin 18, 1314.Google Scholar
World Health Organization (1998). Control of Tropical Diseases. WHO, Geneva, Switzerland.Google Scholar
World Health Organization (2002). Prevention and control of intestinal parasite infections. WHO Technical Report Series 749, Geneva, Switzerland.Google Scholar
Ximenez, C., Moran, P., Rojas, L., Valadez, A. and Gomez, A. (2009). Reassessment of the epidemiology of amebiasis: state of the art. Infection, Genetics and Evolution 9, 10231032.Google Scholar