Prevalence and Risk Factors of Intestinal Parasitism in Rural and Remote West Malaysia

Intestinal parasitic infections (IPIs) are among the most prevalent human afflictions; these infections still have major impact on the socioeconomic and public health of the bottom billion of the world's poorest people. Although Malaysia has a thriving economy, IPIs are still very much prevalent and causing major health problems among the poor and in deprived communities especially in rural and remote areas. A comprehensive study is paramount to determine the current prevalent and factors closely linked to IPIs so that effective control measures can be instituted. In view of this, we conducted this study to provide detailed data of the existing status of IPIs among 716 participants living in rural and remote areas in Peninsular Malaysia. The establishment of such data is beneficial for the public health service to justify and facilitate the reassessment of control strategies and policies in terms of reducing intestinal parasitism. With effective control measures in place, these communities (especially children) will have a greater opportunity for a better future in terms of health and educational achievement and eventually will be at par socially and economically with urban communities in Malaysia

High Seroprevalence of Echinococossis, Schistosomiasis and Toxoplasmosis among the Populations in Babati and Monduli Districts, Tanzania.

BackgroundThe neglected tropical diseases, echinococcosis, schistosomiasis and toxoplasmosis are all globally widespread zoonotic diseases with potentially harmful consequences. There is very limited data available on the prevalence of these infections, except for schistosmiasis, in underdeveloped countries. This study aimed to determine the seroprevalence of Echinococcus multilocularis, Schistosoma mansoni, and Toxoplasma gondii antibodies in populations from the Monduli and Babati districts in Tanzania.MethodsA total of 345 blood samples were collected from 160 and 185 randomly selected households from Babati and Monduli districts, Tanzania between February and May of 2012 and analyzed them using the enzyme linked immunosorbent assay. The antibodies were determined using the NovaLisa® Toxoplasma gondii IgG, NovaLisa® Schistosoma Mansoni IgG, NovaLisa® Echinococcus IgG and NovaLisa® Toxoplasma gondii IgM kits (Novatec, Germany).ResultsThe seropositivity estimated for E. multilocularis, S. mansoni, and T. gondii IgG was 11.3% (95% confidence interval (CI): 7.96 - 14.6), 51.3% (95% CI: 46.0 - 56.5), and 57.68% (95% CI: 52.5 - 62.9), respectively. The seropositivity for T. gondii IgM was 11.3% (95% CI: 7.96 - 14.6). Living in the Monduli district was found to be the main risk factor for IgG seropositivity for both schistosomiasis (OR =1.94; 95% CI: 1.23 - 3.08; p =0.005) and toxoplasmosis (OR =2.09; 95% CI: 1.31-3.33; p =0.002).ConclusionsThese results suggest that restricting disease transmission, implementing control measures, and introducing training projects to increase public awareness are imperative, particularly for the Monduli district

Prevalence and associated factors of Schistosomiasis among children in Yemen: implications for an effective control programme

BACKGROUND Schistosomiasis, one of the most prevalent neglected tropical diseases, is a life-threatening public health problem in Yemen especially in rural communities. This cross-sectional study aims to determine the prevalence and associated risk factors of schistosomiasis among children in rural Yemen. METHODS/FINDINGS Urine and faecal samples were collected from 400 children. Urine samples were examined using filtration technique for the presence of Schistosoma haematobium eggs while faecal samples were examined using formalin-ether concentration and Kato Katz techniques for the presence of S. mansoni. Demographic, socioeconomic and environmental information were collected via a validated questionnaire. Overall, 31.8% of the participants were found to be positive for schistosomiasis; 23.8% were infected with S. haematobium and 9.3% were infected with S. mansoni. Moreover, 39.5% of the participants were anaemic whereas 9.5% had hepatosplenomegaly. The prevalence of schistosomiasis was significantly higher among children aged >10 years compared to those aged ≤ 10 years (P<0.05). Multivariate analysis confirmed that presence of other infected family member (P<0.001), low household monthly income (P = 0.003), using unsafe sources for drinking water (P = 0.003), living nearby stream/spring (P = 0.006) and living nearby pool/pond (P = 0.002) were the key factors significantly associated with schistosomiasis among these children. CONCLUSIONS/SIGNIFICANCE This study reveals that schistosomiasis is still highly prevalent in Yemen. These findings support an urgent need to start an integrated, targeted and effective schistosomiasis control programme with a mission to move towards the elimination phase. Besides periodic drug distribution, health education and community mobilisation, provision of clean and safe drinking water, introduction of proper sanitation are imperative among these communities in order to curtail the transmission and morbidity caused by schistosomiasis. Screening and treating other infected family members should also be adopted by the public health authorities in combating this infection in these communities

Cryptosporidiosis among birds and bird handlers at Zoo

Abstract. This study was carried out at the Malaysian National Zoo to ascertain, not only the current prevalence rate in the birds, but also to determine the association between cryptosporidiosis in birds and the bird handlers. A total of 116 fecal samples from 71 species of birds were collected from six different locations in Zoo Negara, and eight fecal samples from bird handlers were also sampled. Results showed that the prevalence of Cryptosporidium oocysts in birds and bird handlers were 3.4% and 12.5%, respectively. The birds that were positive for cryptosporidiosis were Wreathed Hornbill (Aceros undulatus) and Great Currasow (Crax rubra) from the aviary, Bushy-crested Hornbill (Anorrhinus galeritus) from the bird house, and the Common Peafowl (Pavo cristatus) from the lake. Birds at the lake showed the highest percentage (12.5%) of positivity, followed by birds at the aviary (5.4%) and the birdhouse (2.8%). Result of the present study seemed to indicate that cryptosporidiosis might be spreading to other species of birds and to other locations in the zoo, which was not previously documented. This study also suggested the probable association of cryptosporidiosis among birds and their bird handlers. However, conclusions can only be drawn after the confirmation of speciation found in birds and bird handlers through molecular identification

Seroprevalence of toxocariasis among Orang Asli (Indigenous people) in Malaysia using two immunoassays

Toxocariasis is a zoonotic helminthic infection of humans caused by the dog roundworm (Toxocara canis) or cat roundworm (Toxocara cati). There are two main human syndromes: visceral larva migrans (VLM), which are characterized by symptoms associated with major organs and ocular larva migrans (OLM), in which pathological effects on the host are restricted to the eye and the optic nerve. The present study evaluated the seroprevalence of toxocariasis among the Orang Asli with an IgG4-ELISA using recombinant antigens (rTES-26, rTES-30 and rTES-120) and an IgG-ELISA commercial kit (Cypress Diagnostic, Belgium). A total of 188 serum samples were analyzed using IgG4-ELISA recombinant antigens while 83 were tested using IgG-ELISA. Overall, 9 out of 188 (4.8) samples were positive with the former assay: rTES-26 (2.7) and rTES-30 (2.1); and 63 out of 83 (75.9) were positive with the IgG-ELISA. In general, the seroprevalence of toxocariasis among males (9.5) was higher compared to females (1). Children below 12 years (6.3) have higher seroprevalence rate compared to adults (1.2). Out of 59 IgG positive samples, 56 (94.9) were also positive with soil-transmitted helminth (STH) infections which may indicate high false positivity. None of the IgG4-ELISA positive samples were positive with STH infections. Of 9 positive samples with IgG4-ELISA, 7 were also positive with IgG-ELISA giving the probability of true cases. The present finding indicated that exposure to Toxocara infection is not unusual among Malaysian aborigines, and it affects both sexes and all age groups. As a prevention strategy, more effective public health programmes to promote better understanding on the consequences of toxocariasis among the Orang Asli communities are deemed necessary

ParaSitic iNFEctiON: a rEcUrriNg PHENOmENON iN maLaYSia

Abstract. A total of 255 patients including 179 (70.2%) of non-HIV and 76 (29.8%) HIV-infected patients were recruited in this descriptive study. The subjects was significantly found to be male Chinese (157; 61.6% vs 74; 47.1%) followed by female Malays (98; 38.4% vs 35; 35.7%) (p&lt;0.05). The majority of subjects (124; 48.6%) were in the age group of 21-39 years, however, no statistical difference was found between the various age groups (p&gt;0.05). Overall seroprevalence of latent Toxoplasma infection was 82/183 (44.8%) being; 3 (3.7%) positive for IgM, 74 (90.2%) for IgG, and 5 (6.1%) for IgG and IgM antibodies. The prevalence was more relatively found in the Chinese (28; 15.3%) and Malays (27; 14.8%) than others (p&lt;0.05). While, 23/76 (30.3%) of HIV-positive patients were shown Toxoplasma seropositivity. The majority of these subjects (138/181; 76.2%) were significantly asymptomatic (p = 0.000), while the others were clinically evident cases of toxoplasmosis. Of this, 37 patients were included in differential diagnosis relating to ocular diseases and only 4 patients were confirmed as having ocular toxoplasmosis. Toxoplasmic encephalitis (TE) was based on presumptive diagnosis, particularly found in 5 patients with AIDS. Seventeen patients were clinically diagnosed as having malaria being; 8 for P. vivax, 4 for P. falciparum, 3 for P. malariae, and 2 for mixed infections. All cases resolved satisfactorily after treatment with antimalarial drugs. Other important emerging parasitic diseases were also detected in these patients including amebiasis (2), blastocystosis (1), cryptosporidiosis (1), filariasis (1), and giardiasis (2) during the time of this study

Plasmodium knowlesi reinfection in human

To the Editor: In 2004, a large number of patients infected with Plasmodium knowlesi (simian malarial species) were reported in Sarawak, Malaysia (1). P. knowlesi infection was also reported in Peninsular Malaysia (2). Here we report a case of human P. knowlesi reinfection. Phylogenetic sequence analysis shows that the first and second infections were caused by different strains of P. knowlesi

Dirofilaria causing eye infection in a patient from Malaysia

Human dirofilariasis caused by Dirofilaria immitis and Dirofilaria repens have been reported in Malaysia. This is the fourth reported case of dirofilariasis caused by D. repens. The patient was a Chinese male from Kuching Sarawak, Malaysia who presented with a one day history of redness and itchiness over the temporal aspect of his left eye. A worm was seen and later removed from beneath the conjunctiva under local anesthesia and based on the morphological characteristics, it was identified as an immature Dirofilaria repens

Prevalence of cryptosporidiosis in HIV-infected patients in Kajang Hospital, Selangor

A total of 66 fecal specimens obtained from patients infected with human immunodeficiency virus (HIV) from Kajang Hospital were screened for Cryptosporidium oocysts. The fecal specimens were concentrated using the formalin ethyl acetate concentration technique, stained with modified Ziehl-Neelsen and confirmed with immunofluorescence stain. It was established that 2 (3.0) were positive for Cryptosporidium. The two cases involved a Chinese local man (with diarrhea) and an Indonesian foreigner (without diarrhea). A higher index of suspicion for clinical cryptosporidiosis in HIV patients, including those with chronic weight loss with or without diarrhea, is recommended. In addition, laboratory testing for Cryptosporidium in HIV-infected patients is highly recommended in order to have a better understanding of the epidemiology and management of the disease in Malaysia

Intestinal myiasis in a Malaysian patient caused by larvae of Clogmia albipunctatus (Diptera: Psychodidae)

Clogmia albipunctatus (Duckhouse) is a cosmopolitan fly belonging to the family Psychodidae and is one of the medically important insects associated with urban environments ( Smith and Thomas 1979 ). Psychodid larvae can cause myiasis in humans through infestation of healthy or traumatized tissues ( Hall and Smith 1993 ). Human myiasis can be presented in various forms with cutaneous myiasis the most common form ( Tu et al. 2007 ). Other infestation sites include nasal, aural, pulmonary, ophthalmic cavities, body cavities, and the gastrointestinal and urogenital systems ( Tu et al. 2007 , El-Badry et al. 2014 ). Intestinal myiasis may result from accidental ingestion of larvae. Subsequently, this form of myiasis presents symptoms such as nausea, vomiting, abdominal pain and distention, loss of appetite, weight loss, and episodic diarrhea ( Ramana 2012 ). This is the second reported case of human intestinal myiasis in Malaysia caused by larvae of C. albipunctatus . Microscopic examination revealed the structure of the larvae and DNA barcoding established the species identity