Feline patent Toxoplasma-like coccidiosis among feral cats (Felis catus) in Doha city, Qatar and its immediate surroundings

Doha city has a high feral cat population and studies of hospital records in Doha have shown that human toxoplasmosis also occurs. Clearly, there is a need to understand the role of cats as vectors of human toxoplasmosis in the city and as a first step we assessed the extent of patent Toxoplasma-like coccidial infections among feral cats. Oocysts in cat faeces were detected between June 2008 and April 2010, from a range of locations radiating out of the city centre in concentric semi circular/elliptic rings and by north, west and south divisions within each of the rings. In total 4,652 cats were sampled and overall prevalence of oocysts was 9.1%. Prevalence was 10.1% in the first summer, and then dropped to 8.4% in the following winter and further to 6.8% in the next summer before rising to 10.6% in the final winter of the study; this interaction between annual period and season was significant. There were also significant changes in prevalence across each of the consecutive months of the study, but no clear pattern was evident. Prevalence did not vary significantly by city sector and there was no difference in prevalence between the host sexes. We conclude therefore, that despite minor and significant perturbations, the prevalence of patent Toxoplasma-like coccidial infections among cats in Doha is remarkably stable throughout the year, across years and spatially within the city’s districts.Qatar National Research Funds Student grant UREP 05 – 060 – 3 – 01

Intestinal Parasitic Infections among Long-Term-Residents and Settled Immigrants in Qatar in the Period 2005 to 2011

Abstract. The expanding economy of Qatar in the last two decades has attracted immigrants, often from countries with poor socio-economic levels. Many arrive with patent intestinal parasitic infections, and recent analyses have indicated consistently rising trends in the prevalence of some infections. Here, we examined 18,563 hospital records of subjects in Qatar seeking medical assistance for a variety of ailments, combining data from 2009 to 2011 with the earlier dataset from 2005 to 2008 to enable trends to be identified across a 7-year period. We found that 8.6% were infected with one or more species of parasites, however in contrast to the earlier period (2005–2008), in the latter 3 years there were falling trends of prevalence providing some optimism that parasitic infections among the resident immigrants have begun to decline. We identified also geographic regions from which resident workers still maintain a relatively high prevalence of helminth infections despite their long-term residence in Qatar.This publication was made possible by a grant from Qatar National Research Fund (QRNF) at Qatar Foundation through National Priorities Research Program (NPRP) (Project No. NPRP 4-1283-3-327

Seroprevalence and epidemiological correlates of Toxoplasma gondii infections among patients referred for hospital-based serological testing in Doha, Qatar

Background. The city of Doha in Qatar has a high density of feral cats and there is a high risk of toxoplasmosis for the resident human population. No data currently exist for the prevalence of infection with Toxoplasma gondii in the city. Methods. We analysed the serological response to Toxoplasma gondii of 1625 subjects referred for routine hospital based serological tests in Doha, Qatar. Prevalence of current/recent infection was assessed through an enzyme-linked immunosorbent assay (ELISA) for the presence of specific anti-T. gondii IgM antibodies, and previous history of infection through IgG. Results. Overall prevalence of IgG responses was 29.8% and this did not differ between the sexes nor between the three years of the study although there was a marked age effect. Among children less than 1 year old prevalence was 22.9%, but then dropped to 45 years). The prevalence of IgG antibody also varied significantly with region of origin, with higher rates for subjects from Africa, followed by those from the Eastern Mediterranean or Asia and lowest rates for subjects from the Arabian Peninsula. No IgM antibodies were detected in any subjects younger than 19 years, but prevalence increased to plateau at 7 - 9% in subjects aged over 20 years, and also varied with region of origin. In this case prevalence was highest among subjects from the Arabian Peninsula and least among those from Asia. Prevalence of IgM was higher among male subjects but did not vary between the three years of the study. Conclusion. Although these data are based on a selected subset of the population, they nevertheless provide the first evidence that toxoplasmosis is endemic in Qatar in the human population, and that both age and region of origin play a role in the epidemiology of the infection. Concerns relating to the role of high density of feral cats in sustaining the infection were highlighted

Toxoplasma gondii Seropositivity and Co-Infection with TORCH Pathogens in High-Risk Patients from Qatar

Testing of patients who are deemed to be at high risk for TORCH pathogens, e.g., pregnant women, their fetuses, neonates, and acquired immunodeficiency syndrome (AIDS) patients, is important so that specific treatment can be initiated. This study included 1,857 such patients between 2005 and 2008. Logistic regression was used to evaluate factors associated with Toxoplasma gondii seropositivity. Among 823 women of childbearing age, 35.1% and 5.2% tested positive for T. gondii IgG and IgM, respectively. Three infants ≤ 6 months of age (0.8% of 353) were congenitally infected. Factors associated with T. gondii IgG seropositivity included older age, East Mediterranean or African nationality, positive cytomegalovirus (CMV) and herpes simplex virus (HSV)-1 serostatus, and negative rubella IgG results. The decreasing prevalence of IgM antibodies between 2005 and 2008 suggested that exposure to T. gondii from food or environmental sources declined over this period in Qatar. Population-based studies of newborns would be helpful to accurately estimate incidence of congenital toxoplasmosis

Monospecific helminth and arthropod infections in an urban population of brown rats from Doha, Qatar

Parasitic infections were studied for the first time in an urban population of brown rats (Rattus norvegicus) from Doha. Only one species of helminth was found, the cestode Hymenolepis diminuta, and one ectoparasite, the flea Xenopsylla astia, from a sample size of 136 rats (52 males and 84 females). The prevalence of H. diminuta was 17.6%, increasing with host age but not in relation to host sex nor season of capture. Host age was a key factor in influencing abundance of infection, although there was a significant three-way interaction with season and host sex arising through heavy infections in juvenile male rats in the summer. The prevalence of X. astia was 45.6%, although both prevalence and abundance of infestations were season and host age dependent. In the winter prevalence and abundance were similar in both host age and sex groups, but in the summer both parameters of infestation were markedly higher among juveniles compared with adults. We found evidence for some association between these two species: H. diminuta was more prevalent among rats with fleas than among those without, although this association was season-, and independently sex- and age-dependent. There were no quantitative interactions and reasons for this are discussed in relation to the foraging and breeding behaviour of the brown rat in Qatar

Monospecific helminth and arthropod infections in an urban population of brown rats from Doha, Qatar

Parasitic infections were studied for the first time in an urban population of brown rats (Rattus norvegicus) from Doha. Only one species of helminth was found, the cestode Hymenolepis diminuta, and one ectoparasite, the flea Xenopsylla astia, from a sample size of 136 rats (52 males and 84 females). The prevalence of H. diminuta was 17.6%, increasing with host age but not in relation to host sex nor season of capture. Host age was a key factor in influencing abundance of infection, although there was a significant three-way interaction with season and host sex arising through heavy infections in juvenile male rats in the summer. The prevalence of X. astia was 45.6%, although both prevalence and abundance of infestations were season and host age dependent. In the winter prevalence and abundance were similar in both host age and sex groups, but in the summer both parameters of infestation were markedly higher among juveniles compared with adults. We found evidence for some association between these two species: H. diminuta was more prevalent among rats with fleas than among those without, although this association was season-, and independently sex- and age-dependent. There were no quantitative interactions and reasons for this are discussed in relation to the foraging and breeding behaviour of the brown rat in Qatar

Comparison of intestinal parasitic infection in newly arrived and resident workers in Qatar

Abstract Background: The rapid growth of Qatar in the last two decades has been associated with an enormous expansion of building programs in its cities and in the provision of new service industries. This in turn has attracted a large influx of immigrant workers seeking employment in jobs associated with food handling, domestic service and the building industry. Many of these immigrants come from countries in the tropics and subtropics where intestinal parasitic infections are common. Methods: We analyzed intestinal parasitic infections recorded in 2008 among immigrant and long-term resident workers in Doha city, Qatar (n = 1538). Stool examinations were carried out at the Hamad Medical Corporation and at the Medical Commission in Doha using standard procedures. Results: Overall, 21.5% of subjects were infected with at least one of the species recorded (8 helminth and 4 protozoan species; the highest prevalence was for hookworms = 8.3%) and there were strong regional effects on prevalence of helminths, with subjects from North East Africa and Nepal showing particularly high prevalence. Most helminths declined in prevalence in subjects that acquired residency status in Qatar, especially among female subjects, but there was a marked exception among male Nepalese workers, who continued to harbour helminth infections (notably hookworms) after they became residents. Contrary to all other regional groups the prevalence of Giardia duodenalis was higher among Nepalese residents compared with new arrivals, while Blastocystis hominis infections were more common among residents of all regions, and especially among North East Africans. Conclusions: Our analysis has identified male Nepalese workers as a particular risk group continuing to harbour hookworm infection and G. duodenalis as residents, and subjects from North East Africa are as particularly likely to acquire B. hominis infection after settling in the country. These conclusions have important implications for the health authorities in QatarQatar National Research Fund (QRNF) NPRP Grant# 4-1283-3-32

Helminth infections among long-term residents and settled immigrants in Qatar in the decade from 2005 to 2014: temporal trends and varying prevalence among subjects from different regional origins

Background: Travel and migration from developing regions, where tropical diseases are common, to more developed industrialised nations can contribute to the introduction and subsequent spread of infections. With its rapidly expanding economy, Qatar has attracted vast numbers of immigrant workers in the last two decades, often from countries with poor socio-economic levels. Many used to arrive with patent intestinal parasitic infections. Methods: We analysed the prevalence of helminth infections in a dataset of 29,286 records of subjects referred for stool examination at the Hamad Medical Corporation over the course of a decade (2005 to 2014, inclusive). Results: Overall prevalence of combined helminth infections was low (1.86 %) but there were significant temporal trends, age and sex effects and those arising from the region of origin of the subjects. The most common helminths were hookworms (overall prevalence 1.22 %), which accounted for 70.1 % of cases, and therefore patterns for combined helminth infections were largely driven by hookworms. In both cases, and also in Trichuris trichiura and Ascaris lumbricoides, prevalence peaked in 2008, since when prevalence has been steadily falling. Helminth infections were largely concentrated among subjects from five Asian countries (Nepal, Bangladesh, Sri Lanka, India and Pakistan), and there was a highly biased prevalence in favour of male subjects in all cases. Prevalence of all three nematodes peaked in age class 7 (mean age 25.5 years, range = 20–29) and there were significant interactions between region of origin, sex of subjects and prevalence of hookworms. Conclusion: These results offer optimism that prevalence will continue to decline in the years ahead, especially if control is targeted at those most at risk of carrying infections.Qatar National Research Fund (QRNF) at Qatar Foundation for supporting this study through the National Priorities Research Program (NPRP) (Project No. NPRP 4-1283-3-327)

Prevalence and risk factors of intestinal protozoan infection among symptomatic and asymptomatic populations in rural and urban areas of southern Algeria

Background: Intestinal parasitic infections are amongst the most common infections worldwide and have been identified as one of the most significant causes of morbidity and mortality among disadvantaged populations. This comparative cross-sectional study was conducted to assess the prevalence of intestinal protozoan infections and to identify the significant risk factors associated with intestinal parasitic infections in Laghouat province, Southern Algeria. Methods: A comparative cross-sectional study was conducted, involving 623 symptomatic and 1654 asymptomatic subjects. Structured questionnaires were used to identify environmental, socio demographic and behavioral factors. Stool specimens were collected and examined using direct wet mount, formalin-ether concentration, xenic in vitro culture and staining methods. Results: A highly significant difference of prevalence was found between symptomatic (82.3%) and asymptomatic subjects (14.9%), with the majority attributable to protozoan infection. The most common species in the symptomatic subjects were Blastocystis spp. (43.8%), E. histolytica/dispar (25.4%) and Giardia intestinalis (14.6%) and more rarely Enterobius vermicularis (02.1%), Teania spp. (0.6%) and Trichuris trichiura (0.2%), while in asymptomatic population Blastocystis spp. (8%), Entamoeba coli (3.3%) and Entamoeba histolytica/dispar (2.5%) were the most common parasites detected with no case of helminth infection. Multivariate log-linear analysis showed that contact with animals was the main risk factor for transmission of these protozoa in both populations. Furthermore, living in rural areas was significantly associated with combined protozoan infection in the asymptomatic population, whereas, in the symptomatic population an increasing trend of protozoan infection was detected in the hot season. In addition, Blastocystis spp. and G. intestinalis infection were found to be associated with host sex and contact with animals across the study period. Conclusions: Based on these results, several strategies are recommended in order to effectively reduce these infections including good animal husbandry practices, health education focused on good personal hygiene practices and adequate sanitation