Prevalence of Intestinal Parasites among Rural Inhabitants of Fouman, Guilan Province, Northern Iran with Emphasis on Strongyloides stercoralis
Abstract
Background: Intestinal parasitic infections (IPIs) are among the most important etiologies of gastrointestinal disorders in developing countries. The present study was performed to determine the prevalence of IPIs in rural inhabitants of Fouman, northern Iran.
Methods: Overall, 31 villages were randomly selected during 2015-2016. Stool samples were collected from 1500 inhabitants aged 2-87. The samples were examined by direct wet smear, formalin ethyl-acetate concentration and agar plate culture. Trichrome staining and modified acid-fast staining were used as confirmatory tests for intestinal amoeba and flagellates and cryptosporidium spp., respectively. Data were analyzed with Chi-Square and Fisher exact tests using SPSS.
Results: 8.06% of participants were positive for at least one intestinal parasite. The prevalence of mixed parasitic infections was 0.87%. The most prevalent IPIs were caused by Trichostrongylus spp. (3.13%), followed by Strongyloides stercoralis (1.5%), Giardia lamblia (1.3%), and Entamoeba coli (1.0%), Blastocystis hominis (0.86%), E. histolytica/dispar (0.53%), Endolimax nana (0.26%), Iodamoeba butschlii (0.13%), Trichuris trichiura (0.07%), Enterobius vermicularis (0.07%), Hook worm (0.07%) and E. hartmani (0.07%). Statistically, the prevalence of IPIs showed significant differences regarding the age groups, education status, occupation (P<0.001), and the habit of eating raw vegetables (P<0.007), whereas, the differences were insignificant with regard to sex (P=0.924) and water supply (P=0.088).
Conclusion: The prevalence of IPIs, especially soil-transmitted helminthes (STHs) has sharply decreased in northern Iran. Excluding Trichostrongylus spp. and S. stercoralis, other intestinal parasites only produce a marginal and unnoticeable health problem in this area, today.
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2. Robertson LJ, van der Giessen JW, Batz MB et al. Have foodborne parasites finally become a global concern? Trends Parasitol. 2013;29(3):101-3.
3. de Silva NR, Brooker S, Hotez PJ et al. Soil-transmitted helminth infections: updating the global picture. Trends Parasitol. 2003;19(12):547-51.
4. Escobedo AA, Almirall P, Alfonso M et al. Treatment of intestinal protozoan infections in children. Arch Dis Child. 2009;94(6):478-82.
5. Haque R. Human intestinal parasites. J Health Popul Nutr. 2007;25(4):387-91.
6. Matthys B, Bobieva M, Karimova G et al. Prevalence and risk factors of helminths and intestinal protozoa infections among children from primary schools in western Tajikistan. Parasit Vectors. 2011;4:195.
7. Okyay P, Ertug S, Gultekin B et al. Intestinal parasites prevalence and related factors in school children, a western city sample-Turkey. BMC Public Health.2004;4:64.
8. Dorny P, Praet N, Deckers N et al. Emerging food-borne parasites. Vet Parasitol. 2009;163(3):196-206.
9. Macpherson CN, Gottstein B, Geerts S. Parasitic food-borne and water-borne zoonoses. Rev Sci Tech. 2000;19(1):240-58.
10. Hotez PJ, Brindley PJ, Bethony JM et al. Helminth infections: the great neglected tropical diseases. J Clin Invest. 2008;118(4):1311-21.
11. Ahmadi M, Kia EB, Rezaeian M et al. Prevalence of Strongyloides stercoralis and other intestinal parasites in rehabilitation centers in Mazandaran province, northern Iran. J Mazandaran Univ Med Sci. 2015;25(130):1-7.
12. Asmar M, Ashrafi K, Amintahmasbi H, et al. Prevalence of intestinal parasitic infections in urban areas of Bandar Anzali, Northern Iran. J Guilan University Med Sci, 2013; 22(88):18-25.
13. Rokni MB. The present status of human helminthic diseases in Iran. Ann Trop Med Parasitol. 2008;102(4):283-95.
14. Saeidinia A, Tavakoli I, Naghipour MR, et al.. Prevalence of Strongyloides stercoralis and other intestinal parasites among institutionalized mentally disabled individuals in Rasht, northern Iran. Iran J Parasitol. 2016;11(4):527-33.
15. Ashrafi K, Tahbaz A, Rahmati B. Strongyloides stercoralis: The Most prevalent parasitic cause of eosinophilia in Gilan province,northern Iran. Iran J Parasitol. 2010;5(3):40-7.
16. Sharifdini M, Ghanbarzadeh L, Kouhestani-Maklavani N, et al. Prevalence and molecular aspects of human hookworms in Guilan province, northern Iran.Iran J Parasitol. 2017;12(3):374-381.
17. Kazemi Rad L, Mohammadi H. Climate change assessment in Gilan province, Iran. Intl J Agri Crop Sci. 2015;8(2):86-93.
18. Sharifdini M, Mirhendi H, Ashrafi K et al. Comparison of Nested Polymerase Chain Reaction and Real-Time Polymerase Chain Reaction with parasitological methods for detection of Strongyloides stercoralis in human fecal samples. Am J Trop Med Hyg. 2015;93(6):1285-91.
19. Sharifdini M, Kia EB, Ashrafi K et al. An analysis of clinical characteristics of Strongyloides stercoralis in 70 indigenous patients in Iran. Iran J Parasitol. 2014;9(2):155-62.
20. Inatomi S, Kamo H, Otsuru M et al. Ova and larvae of the common helminthes of man. In: Yamaguchi T, Editor. A colour atlas of clinical parasitology. Tokyo: Wolf Medical Publication, 1981.
21. Alemi AA, Arfaa F. Prevalence of intestinal helminthiasis in the rural area of gilan province (caspian littoral). Iran J Public Health. 1978;7(1):25-34.
22. Mehryar A. Primary health care and the rural poor in the islamic republic of iran. scaling up poverty reduction: A Global Learning Process and Conference Shanghai, May 25-7, 2004.
23. Iran - Literacy rate 2016. https://www.indexmundi.com/facts/iran/literacy-rate
24. Asmar M, Milaninia A, Amir-Khani A, et al. Seroepidemiological investigation of fascioliasis in northern Iran. Med J Islamic Repub Iran. 1991;5(1–2):23–7.
25. Sarkari B, Hosseini G, Motazedian MH, et al. Prevalence and risk factors of intestinal protozoan infections: a population-based study in rural areas of Boyer-Ahmad district, Southwestern Iran. BMC Infect Dis. 2016;16(1):703.
26. Barkhori Mahni M, Rezaeian M, Kia EB, et al. Prevalence of intestinal parasitic infections in Jiroft, Kerman province, Iran. Iran J Parasitol. 2016;11(2):232-8.
27. Kiani H, Haghighi A, Rostami A, et al. Prevalence, risk factors and symptoms associated to intestinal parasite infections among patients with gastrointestinal disorders in Nahavand, western Iran. Rev Inst Med Trop Sao Paulo. 2016;58:42.
28. Daryani A, Sharif M, Nasrolahei M, et al. Epidemiological survey of the prevalence of intestinal parasites among schoolchildren in Sari, northern Iran. Trans R Soc Trop Med Hyg. 2012;106(8):455-9.
29. Pestehchian N, Nazari M, Haghighi A, et al. Prevalence of intestinal parasitic infection among inhabitants and tribes of Chelgerd, Iran, 2008-2009. J Clin Diagn Res. 2015;9(5):1-4.
30. Sharifdini M, Heidari Z, Hesari Z, et al. Molecular phylogenetics of Trichostrongylus species (Nematoda: Trichostrongylidae) from humans of Mazandaran province, Iran. Korean J Parasitol. 2017;55(3):279-85.
31. Sharifdini M, Derakhshani S, Alizadeh SA, et al. Molecular identification and phylogenetic analysis of human Trichostrongylus species from an endemic area of Iran. Acta Trop. 2017;176:293-299.
32. Ashrafi K, Sharifdini M, Heidari Z, et al. Zoonotic transmission of Teladorsagia circumcincta and Trichostrongylus species in Guilan province, northern Iran: molecular and morphological characterizations. BMC Infect Dis. 2020;20(1):28.
33. Ghanbarzadeh L, Saraei M, Kia EB, et al. Clinical and haematological characteristics of human trichostrongyliasis. J Helminthol. 2019;93(2):149-53
34. Ashrafi K, Tahbaz A, Sharifdini M, et al. Familial Trichostrongylus infection misdiagnosed as acute fascioliasis. Emerg Infect Dis. 2015;21(10):1869-70.
35. Boonjaraspinyo S, Boonmars T, Kaewsamut B, et al. A cross-sectional study on intestinal parasitic infections in rural communities, northeast Thailand. Korean J Parasitol. 2013;51(6):727-34.
36. Kia EB, Mahmoudi M, Zahabiun F, et al. An evaluation on the efficacy of agar plate culture for detection of Strongyloides stercoralis. Iran J Parasitol. 2007;2(1):29-34.
37. Sharifdini M, Keyhani A, Eshraghian MR, et al. Molecular diagnosis of strongyloidiasis in a population of an endemic area through nested-PCR. Gastroenterol Hepatol Bed Bench.2018;11(1):68-74.
38. Sharifdini M, Hesari A, Mahdavi SA, et at. Strongyloides stercoralis hyperinfection in an unconscious diabetic patient with dermatomyositis. Indian J Pathol Microbiol. 2018;61(1):109-12.
39. Saraei M, Hosseinbigi B, Shahnazi M, et al. Fatal Strongyloides hyper-infection in a patient with myasthenia gravis. Infection. 2014;42(6):1039-42.
40. Schad GA, Hellman ME, Muncey DW. Strongyloides stercoralis: hyperinfection in immunosuppressed dogs. Exp Parasitol. 1984;57(3):287-96.
41. Siddiqui AA, Berk SL. Diagnosis of Strongyloides stercoralis infection. Clin Infect Dis. 2001; 33 (7): 1040–7.
42. Pocaterra LA, Ferrara G, Peñaranda R, et al. Improved Detection of Strongyloides stercoralis in Modified Agar Plate Cultures. Am J Trop Med Hyg. 2017;96(4):863-5.
2. Robertson LJ, van der Giessen JW, Batz MB et al. Have foodborne parasites finally become a global concern? Trends Parasitol. 2013;29(3):101-3.
3. de Silva NR, Brooker S, Hotez PJ et al. Soil-transmitted helminth infections: updating the global picture. Trends Parasitol. 2003;19(12):547-51.
4. Escobedo AA, Almirall P, Alfonso M et al. Treatment of intestinal protozoan infections in children. Arch Dis Child. 2009;94(6):478-82.
5. Haque R. Human intestinal parasites. J Health Popul Nutr. 2007;25(4):387-91.
6. Matthys B, Bobieva M, Karimova G et al. Prevalence and risk factors of helminths and intestinal protozoa infections among children from primary schools in western Tajikistan. Parasit Vectors. 2011;4:195.
7. Okyay P, Ertug S, Gultekin B et al. Intestinal parasites prevalence and related factors in school children, a western city sample-Turkey. BMC Public Health.2004;4:64.
8. Dorny P, Praet N, Deckers N et al. Emerging food-borne parasites. Vet Parasitol. 2009;163(3):196-206.
9. Macpherson CN, Gottstein B, Geerts S. Parasitic food-borne and water-borne zoonoses. Rev Sci Tech. 2000;19(1):240-58.
10. Hotez PJ, Brindley PJ, Bethony JM et al. Helminth infections: the great neglected tropical diseases. J Clin Invest. 2008;118(4):1311-21.
11. Ahmadi M, Kia EB, Rezaeian M et al. Prevalence of Strongyloides stercoralis and other intestinal parasites in rehabilitation centers in Mazandaran province, northern Iran. J Mazandaran Univ Med Sci. 2015;25(130):1-7.
12. Asmar M, Ashrafi K, Amintahmasbi H, et al. Prevalence of intestinal parasitic infections in urban areas of Bandar Anzali, Northern Iran. J Guilan University Med Sci, 2013; 22(88):18-25.
13. Rokni MB. The present status of human helminthic diseases in Iran. Ann Trop Med Parasitol. 2008;102(4):283-95.
14. Saeidinia A, Tavakoli I, Naghipour MR, et al.. Prevalence of Strongyloides stercoralis and other intestinal parasites among institutionalized mentally disabled individuals in Rasht, northern Iran. Iran J Parasitol. 2016;11(4):527-33.
15. Ashrafi K, Tahbaz A, Rahmati B. Strongyloides stercoralis: The Most prevalent parasitic cause of eosinophilia in Gilan province,northern Iran. Iran J Parasitol. 2010;5(3):40-7.
16. Sharifdini M, Ghanbarzadeh L, Kouhestani-Maklavani N, et al. Prevalence and molecular aspects of human hookworms in Guilan province, northern Iran.Iran J Parasitol. 2017;12(3):374-381.
17. Kazemi Rad L, Mohammadi H. Climate change assessment in Gilan province, Iran. Intl J Agri Crop Sci. 2015;8(2):86-93.
18. Sharifdini M, Mirhendi H, Ashrafi K et al. Comparison of Nested Polymerase Chain Reaction and Real-Time Polymerase Chain Reaction with parasitological methods for detection of Strongyloides stercoralis in human fecal samples. Am J Trop Med Hyg. 2015;93(6):1285-91.
19. Sharifdini M, Kia EB, Ashrafi K et al. An analysis of clinical characteristics of Strongyloides stercoralis in 70 indigenous patients in Iran. Iran J Parasitol. 2014;9(2):155-62.
20. Inatomi S, Kamo H, Otsuru M et al. Ova and larvae of the common helminthes of man. In: Yamaguchi T, Editor. A colour atlas of clinical parasitology. Tokyo: Wolf Medical Publication, 1981.
21. Alemi AA, Arfaa F. Prevalence of intestinal helminthiasis in the rural area of gilan province (caspian littoral). Iran J Public Health. 1978;7(1):25-34.
22. Mehryar A. Primary health care and the rural poor in the islamic republic of iran. scaling up poverty reduction: A Global Learning Process and Conference Shanghai, May 25-7, 2004.
23. Iran - Literacy rate 2016. https://www.indexmundi.com/facts/iran/literacy-rate
24. Asmar M, Milaninia A, Amir-Khani A, et al. Seroepidemiological investigation of fascioliasis in northern Iran. Med J Islamic Repub Iran. 1991;5(1–2):23–7.
25. Sarkari B, Hosseini G, Motazedian MH, et al. Prevalence and risk factors of intestinal protozoan infections: a population-based study in rural areas of Boyer-Ahmad district, Southwestern Iran. BMC Infect Dis. 2016;16(1):703.
26. Barkhori Mahni M, Rezaeian M, Kia EB, et al. Prevalence of intestinal parasitic infections in Jiroft, Kerman province, Iran. Iran J Parasitol. 2016;11(2):232-8.
27. Kiani H, Haghighi A, Rostami A, et al. Prevalence, risk factors and symptoms associated to intestinal parasite infections among patients with gastrointestinal disorders in Nahavand, western Iran. Rev Inst Med Trop Sao Paulo. 2016;58:42.
28. Daryani A, Sharif M, Nasrolahei M, et al. Epidemiological survey of the prevalence of intestinal parasites among schoolchildren in Sari, northern Iran. Trans R Soc Trop Med Hyg. 2012;106(8):455-9.
29. Pestehchian N, Nazari M, Haghighi A, et al. Prevalence of intestinal parasitic infection among inhabitants and tribes of Chelgerd, Iran, 2008-2009. J Clin Diagn Res. 2015;9(5):1-4.
30. Sharifdini M, Heidari Z, Hesari Z, et al. Molecular phylogenetics of Trichostrongylus species (Nematoda: Trichostrongylidae) from humans of Mazandaran province, Iran. Korean J Parasitol. 2017;55(3):279-85.
31. Sharifdini M, Derakhshani S, Alizadeh SA, et al. Molecular identification and phylogenetic analysis of human Trichostrongylus species from an endemic area of Iran. Acta Trop. 2017;176:293-299.
32. Ashrafi K, Sharifdini M, Heidari Z, et al. Zoonotic transmission of Teladorsagia circumcincta and Trichostrongylus species in Guilan province, northern Iran: molecular and morphological characterizations. BMC Infect Dis. 2020;20(1):28.
33. Ghanbarzadeh L, Saraei M, Kia EB, et al. Clinical and haematological characteristics of human trichostrongyliasis. J Helminthol. 2019;93(2):149-53
34. Ashrafi K, Tahbaz A, Sharifdini M, et al. Familial Trichostrongylus infection misdiagnosed as acute fascioliasis. Emerg Infect Dis. 2015;21(10):1869-70.
35. Boonjaraspinyo S, Boonmars T, Kaewsamut B, et al. A cross-sectional study on intestinal parasitic infections in rural communities, northeast Thailand. Korean J Parasitol. 2013;51(6):727-34.
36. Kia EB, Mahmoudi M, Zahabiun F, et al. An evaluation on the efficacy of agar plate culture for detection of Strongyloides stercoralis. Iran J Parasitol. 2007;2(1):29-34.
37. Sharifdini M, Keyhani A, Eshraghian MR, et al. Molecular diagnosis of strongyloidiasis in a population of an endemic area through nested-PCR. Gastroenterol Hepatol Bed Bench.2018;11(1):68-74.
38. Sharifdini M, Hesari A, Mahdavi SA, et at. Strongyloides stercoralis hyperinfection in an unconscious diabetic patient with dermatomyositis. Indian J Pathol Microbiol. 2018;61(1):109-12.
39. Saraei M, Hosseinbigi B, Shahnazi M, et al. Fatal Strongyloides hyper-infection in a patient with myasthenia gravis. Infection. 2014;42(6):1039-42.
40. Schad GA, Hellman ME, Muncey DW. Strongyloides stercoralis: hyperinfection in immunosuppressed dogs. Exp Parasitol. 1984;57(3):287-96.
41. Siddiqui AA, Berk SL. Diagnosis of Strongyloides stercoralis infection. Clin Infect Dis. 2001; 33 (7): 1040–7.
42. Pocaterra LA, Ferrara G, Peñaranda R, et al. Improved Detection of Strongyloides stercoralis in Modified Agar Plate Cultures. Am J Trop Med Hyg. 2017;96(4):863-5.
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| Issue | Vol 15 No 1 (2020) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijpa.v15i1.2531 | |
| Keywords | ||
| ntestinal parasites Prevalence Strongyloides stercoralis Trichostrongylus Iran | ||
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How to Cite
1.
SHARIFDINI M, GHANBARZADEH L, BARIKANI A, SARAEI M. Prevalence of Intestinal Parasites among Rural Inhabitants of Fouman, Guilan Province, Northern Iran with Emphasis on Strongyloides stercoralis. Iran J Parasitol. 2020;15(1):91-100.
