Cross-sectional study of parasitic causes of diarrhea in patients visiting a university hospital in Jeddah, Saudi Arabia
Keywords:
Diarrhea, Intestinal parasites, Cardiovascular disorders, Ziehl-Neelsen stainAbstract
Diarrhea is considered a global health problem and a major mortality cause in children less than 5 years of age. Infectious diarrhea is usually associated with morbidity in the form of intestinal dysfunction and malnutrition. One of the major causes of diarrhea is intestinal parasitic infections. In this study, we investigate the parasitic causes of diarrhea in patients visiting King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia during 2014. A total of 627 stool samples was received during 2014 at the Parasitology lab for stool analysis. Samples were analyzed using the formalin-ethyl acetate concentration technique and a direct smear was performed for all diarrheic samples. A thick smear was prepared from all diarrheic specimens and permanently stained with a modified Ziehl-Neelsen staining procedure to look for the presence of Cryptosporidium. Four hundred and eighty (76.6%) specimens were negative for intestinal parasites and 88 (14%) non-diarrheic specimens were positive for intestinal parasites. Fifty-nine (9.4%) specimens were diarrheic and 30 of them had intestinal parasites. The most frequent parasites seen in diarrheic samples were Giardia lamblia (28.8%) and Entamoeba histolytica (10.2%). Cryptosporidium was found in only 2 (3.4%) diarrheic specimens. The Results of this work recommend the establishment of a high standard sewage system to provide a better quality of life.
Downloads
References
Patel, K. & Thillainayagam, A.V. (2009). Diarrhoea. Medicine, 37(1): 23–27.
Thapar, N. & Sanderson, I.R. (2004). Diarrhoea in children: an interface between developing and developed countries. Lancet, 363(9409): 641–653. https://doi.org/10.1016/S0140-6736(04)15599-2.
Hamilton, A.C. & Auron, M. (2013). Diarrhea. Hospital Medicine Clinics, 2(2): e277-e246.
Tinuade, O., John, O., Saheed, O., Oyeku, O., Fidelis, N. & Olabisi, D. (2006). Parasitic Etiology of childhood diarrhea. Indian J. Pediatr., 73(12): 1081–1084. https://doi.org/10.1007/BF02763049.
Mukhopadhyay, C., Wilson, G., Pradhan, D. & Shivananda, P.G. (2007). Intestinal protozoal infestation profile in persistent diarrhea in children below age 5 years in western Nepal. Southeast Asian J. Trop. Med. Public Health, 38(1): 13–19.
Platts-Mills, J.A., Liu, J. & Houpt, E.R. (2013). New concepts in diagnostics for infectious diarrhea. Mucosal Immunol., 6(5): 876–885. https://doi.org/10.1038/mi.2013.50.
Swierczewski, B.E., Odundo, E.A., Koech, M.C., Ndonye, J.N., Kirera, R.K., Odhiambo, C.P., Cheruiyot, E.K., Wu, M.T., Lee, J.E., Zhang, C. & Oaks, E.V. (2013). Surveillance for enteric pathogens in a case-control study of acute diarrhea in Western Kenya. Trans. R. Soc. Trop. Med. Hyg., 107(2): 83–90. https://doi.org/10.1093/trstmh/trs022.
Fagundes-Neto, U. (2013). Persistent diarrhea: still a serious public health problem in developing countries. Curr. Gastroenterol. Rep., 15(9): 345. https://doi.org/10.1007/s11894-013-0345-1.
AL-Kubaisy, W., AL-Talib, H., Al-khateeb, A. & Shanshal, M.M. (2014). Intestinal parasitic diarrhea among children in Baghdad--Iraq. Trop. Biomed., 31(3): 499–506.
Dinesen, L. & Harbord, M. (2013). Acute diarrhoea. Medicine, 41(2): 104–107. https://doi.org/10.1016/j.mpmed.2012.11.007.
Qadri, S.M. (1990). Infectious diarrhea: Managing a misery that is still worldwide. Postgrad. Med., 88(5): 169–184. https://doi.org/10.1080/00325481.1990.11716399.
Klein, E.J., Boster, D.R., Stapp, J.R., Wells, J.G., Qin, X., Clausen, C.R., Swerdlow, D.L., Braden, C.R. & Tarr, P.I. (2006). Diarrhea etiology in a Children's Hospital Emergency Department: a prospective cohort study. Clin. Infect. Dis., 43(7): 807–813. https://doi.org/10.1086/507335.
Kaiser, L. & Surawicz, C.M. (2012). Infectious causes of chronic diarrhoea. Best. Pract. Res. Clin. Gastroenterol., 26(5): 563–571. https://doi.org/10.1016/j.bpg.2012.11.001.
Rim, H.J., Chai, J.Y., Min, D.Y., Cho, S.Y., Eom, K.S., Hong, S.J., Sohn, W.M., Yong, T.S., Deodato, G., Standgaard, H., Phommasack, B., Yun, C.H. & Hoang, E.H. (2003). Prevalence of intestinal parasite infections on a national scale among primary schoolchildren in Laos. Parasitol. Res., 91(4): 267–272. https://doi.org/10.1007/s00436-003-0963-x.
Mahdi, N.K. & Ali, N.H. (2004). Cryptosporidiosis and other intestinal parasitic infections in patients with chronic diarrhea. Saudi Med. J., 25(9): 1204–1207.
Dib, H.H., Lu, S.Q. & Wen, S.F. (2008). Prevalence of Giardia lamblia with or without diarrhea in South East, South East Asia and the Far East. Parasitol. Res., 103(2): 239–251. https://doi.org/10.1007/s00436-008-0968-6.
Haque, R., Mondal, D., Karim, A., Molla, I.H., Rahim, A., Faruque, A.S., Ahmad, N., Kirkpatrick, B.D., Houpt, E., Snider, C. & Petri, W.A., Jr (2009). Prospective case-control study of the association between common enteric protozoal parasites and diarrhea in Bangladesh. Clin. Infect. Dis., 48(9): 1191–1197. https://doi.org/10.1086/597580.
Mousa, K.M., Abdel-Tawab, A.H., Khalil, H.H. & El-Hussieny, N.A. (2010). Diarrhea due to parasites particularly Cryptosporidium parvum in great Cairo, Egypt. J. Egypt. Soc. Parasitol., 40(2): 439–450.
Shah, M., Tan, C.B., Rajan, D., Ahmed, S., Subramani, K., Rizvon, K. & Mustacchia, P. (2012). Blastocystis hominis and Endolimax nana Co-Infection Resulting in Chronic Diarrhea in an Immunocompetent Male. Case Rep. Gastroenterol., 6(2): 358–364. https://doi.org/10.1159/000339205.
Kurniawan, A., Dwintasari, S.W., Connelly, L., Nichols, R.A., Yunihastuti, E., Karyadi, T. & Djauzi, S. (2013). Cryptosporidium species from human immunodeficiency-infected patients with chronic diarrhea in Jakarta, Indonesia. Ann. Epidemiol., 23(11): 720–723. https://doi.org/10.1016/j.annepidem.2013.07.019.
Dash, M., Padhi, S., Panda, P. & Parida, B. (2013). Intestinal protozoans in adults with diarrhea. N. Am. J. Med. Sci., 5(12): 707–712. https://doi.org/10.4103/1947-2714.123261.
Hegazi, M.A., Patel, T.A. & El-Deek, B.S. (2013). Prevalence and characters of Entamoeba histolytica infection in Saudi infants and children admitted with diarrhea at 2 main hospitals at South Jeddah: a re-emerging serious infection with unusual presentation. Braz. J. Infect. Dis., 17(1): 32–40. https://doi.org/10.1016/j.bjid.2012.08.021.
Hawash, Y., Dorgham, L., Al-Hazmi, A.S. & Al-Ghamdi, M.S. (2014). Prevalence of Cryptosporidium-associated diarrhea in a high altitude-community of Saudi Arabia detected by conventional and molecular methods. Korean J. Parasitol., 52(5): 479–485. https://doi.org/10.3347/kjp.2014.52.5.479.
Nazeer, J.T., El Sayed Khalifa, K., von Thien, H., El-Sibaei, M.M., Abdel-Hamid, M.Y., Tawfik, R.A. & Tannich, E. (2013). Use of multiplex real-time PCR for detection of common diarrhea causing protozoan parasites in Egypt. Parasitol. Res., 112(2): 595–601. https://doi.org/10.1007/s00436-012-3171-8.
Mukherjee, A.K., Chowdhury, P., Rajendran, K., Nozaki, T. & Ganguly, S. (2014). Association between Giardia duodenalis and coinfection with other diarrhea-causing pathogens in India. Biomed Res. Int., in press.
Cheesbrough, M. (1991). Medical laboratory manual for tropical countries. 2nd edition. ELBS with Tropical Health technology/Butterworth-Heinemann, Cambridge.
Casemore, D.P., Armstrong, M. & Sands, R.L. (1985). Laboratory diagnosis of cryptosporidiosis. J. Clin. Pathol., 38(12): 1337–1341. https://doi.org/10.1136/jcp.38.12.1337.
Zakai, H.A. (2004). Intestinal parasitic infections among primary school children in Jeddah, Saudi Arabia. J. Egypt. Soc. Parasitol., 34(3): 783–790.
Zakai, H.A. & Barnawi, H.I. (2014). Prevalence of Cryptosporidium and Giardia lamblia in Water Samples from Jeddah and Makkah Cities. J. Adv. Lab. Res. Biol., 5(1): 12–17.
Norman, G., Pedley, S. & Takkouche, B. (2010). Effects of sewerage on diarrhoea and enteric infections: a systematic review and meta-analysis. Lancet Infect. Dis., 10(8): 536–544. https://doi.org/10.1016/S1473-3099(10)70123-7.
Ben Ayed, L., Schijven, J., Alouini, Z., Jemli, M. & Sabbahi, S. (2009). Presence of parasitic protozoa and helminth in sewage and efficiency of sewage treatment in Tunisia. Parasitol. Res., 105(2): 393–406. https://doi.org/10.1007/s00436-009-1396-y.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2015 The author(s) retains the copyright of this article.
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
