1. Giardia duodenalis infection among rural communities in Yemen: A community-based assessment of the prevalence and associated risk factors
Hesham M. AL-MEKHLAFI ; Hesham M. AL-MEKHLAFI ; Hesham M. AL-MEKHLAFI
Asian Pacific Journal of Tropical Medicine 2017;10(10):987-995
Objective To investigate the prevalence and risk factors of Giardia infection among rural communities among rural communities in Yemen. Methods In this cross-sectional study, a total of 605 stool samples were collected and screened for the presence of Giardia duodenalis (G. duodenalis) cysts and/or trophozoites by using three different diagnostic methods: direct smear, formalin-ether sedimentation, and trichrome staining. A pre-tested questionnaire was used to collect information on the demographic, socioeconomic, behavioural and environmental characteristics of the participants. Results Overall, 28.1% (170/605) of the participants were infected by G. duodenalis. The prevalence was significantly higher among male participants compared to female (P = 0.034); however, it was not significant among different age groups (P > 0.05). Univariate and multivariate analyses identified four variables as the significant key risk factors of Giardia infection among the sampled communities. These are, in addition to being of the male gender, using unsafe water sources for drinking water, not washing hands after defecation, presence of other family members infected with Giardia, and close contact with domestic animals. Conclusions The study reveals that Giardia infection is still prevalent among rural communities in Yemen. The provision of clean and safe drinking water, proper sanitation, and health education regarding personal hygiene practices, particularly handwashing, as well as identifying and treating infected family members is imperative and these interventions should be considered in a strategy to control intestinal parasites among these communities in order to curtail the transmission and morbidity caused by G. duodenalis.
2. Prevalence and risk factors of Blastocystis infection among underprivileged communities in rural Malaysia
Nabilah Amelia MOHAMMAD ; Tengku Shahrul ANUAR ; Hesham M. AL-MEKHLAFI ; Hesham M. AL-MEKHLAFI ; Norhayati MOKTAR ; Tengku Shahrul ANUAR
Asian Pacific Journal of Tropical Medicine 2017;10(5):491-497
Objectives To determine the prevalence and risk factors of Blastocystis among underprivileged communities living in rural Malaysia. Methods This cross-sectional study was conducted among 253 participants aged between 1 and 85 years. Stool samples were examined using Wheatley's trichrome stain after in-vitro cultivation in Jones' medium to detect the presence of Blastocystis. Information pertaining to the demography, socioeconomic and environment were collected using pre-validated questionnaires. Results The total prevalence of Blastocystis infection was 40.7%. The multiple logistic regression analysis revealed that age ≥15 years (OR = 2.72; 95% CI = 1.47–5.04) and presence of infected family members (OR = 8.56; 95% CI = 4.47–16.38) were the significant risk factors associated with blastocystosis in these communities. Conclusions Blastocystosis is revealed through this study to be still prevalent among Orang Asli communities in rural Malaysia. The two main approaches that should be implemented by the public health authority in battling this infection would be the screening of other family members and giving treatment to the infected individuals. Moreover, it is imperative for health education on good personal and food hygiene practices are provided in order to reduce the morbidity and transmission of Blastocystis infection among the Orang Asli in their communities meaningfully.
3.Different Clinical Outcomes of Entamoeba histolytica in Malaysia: Does Genetic Diversity Exist?.
Tengku Shahrul ANUAR ; Hesham M AL-MEKHLAFI ; Mohamed Kamel ABDUL GHANI ; Siti Nor AZREEN ; Fatmah Md SALLEH ; Nuraffini GHAZALI ; Mekadina BERNADUS ; Norhayati MOKTAR
The Korean Journal of Parasitology 2013;51(2):231-236
The present study was conducted to investigate the clinical outcomes of Entamoeba histolytica infection in symptomatic and asymptomatic Orang Asli (aborigine) communities in Malaysia. Examination was performed on 500 stool samples obtained from Orang Asli communities in 3 different states using formalin-ether concentration, trichrome staining, and single-round PCR techniques. Out of 500 stool samples, single infection of E. histolytica, Entamoeba dispar, and Entamoeba moshkovskii was identified in 3.2%, 13.4%, and 1%, respectively. In addition, 10 samples had mixed infections with E. histolytica and E. dispar. Six samples containing E. dispar were also positive for E. moshkovskii, and only 2 samples had E. histolytica in association with E. dispar and E. moshkovskii. Seventeen E. histolytica-positive samples were from symptomatic subjects, whereas the remaining 11 samples came from asymptomatic subjects. These findings suggest a predominant distribution of pathogenic potential of E. histolytica strains in this community. Therefore, further studies on genotyping of E. histolytica is required, to find out association between E. histolytica genotype and the outcome of the infection.
Adolescent
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Adult
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Asymptomatic Diseases
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Child
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Child, Preschool
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Coinfection/parasitology/pathology
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Entamoeba/*classification/isolation & purification/*pathogenicity
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Entamoebiasis/parasitology/*pathology
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Feces/parasitology
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Female
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*Genetic Variation
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Humans
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Malaysia
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Male
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Middle Aged
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Treatment Outcome