Soil-transmitted helminth (STH) infestations are among the most prevalent neglected tropical diseases, especially in low- and middle-income countries. Helminth co-infestations are not uncommon in countries with a high prevalence of STH. We report a case of a 29 -year-old lady with mental retardation and learning difficulties who presented with severe hypochromic microcytic anaemia and severe malnutrition, and diagnosed with concomitant Trichuris trichiura and Ancylostoma duodenale infestations. STH infestations can cause prolonged morbidity, but in our patient, infestations had led to complications of malnutrition and severe weight loss, thus inevitably leading to death.

Aims: Respiratory tract infections (RTIs) among Malaysian pilgrims are caused by exposure to zoonotic-potential respiratory pathogens, symptomatically and asymptomatically affected by rigorous pilgrimage rituals, overcrowding and other stressors. This study aimed to determine the prevalence, virulence and antibiotic resistance genes of selected zoonotic respiratory pathogens using polymerase chain reaction (PCR) assays among Hajj pilgrims from Kelantan state, Malaysia. Methodology and results: Throat swab specimens were obtained from 189 Kelantan Hajj pilgrims in 2016 and examined by PCR for the identification of respiratory pathogens. Thirteen samples (6.88%) were positive for Streptococcus pneumoniae and four (2.11%) were positive for Klebsiella pneumoniae. All the samples were negative for Influenza A virus, MERS-CoV and Mycobacterium bovis. One sample was positive for S. pneumoniae virulence lytA gene. One sample was positive for K. pneumoniae virulence magA and K2A genes respectively, and three samples were positive for K. pneumoniae rmpA genes. Ten and seven samples were positive for S. pneumoniae mefA and pbpA antibiotic resistance genes respectively. Two samples were positive for K. pneumoniae blaKPC and blaOXA-48 antibiotic resistance genes. Conclusion, significance and impact of study This work provided insight into the existence of zoonotic respiratory pathogens inducing Hajj RTIs in Kelantan pilgrims. It showed promising findings for zoonotic studies in Hajj settings. The findings could be relevant in potential control measures for the management of zoonotic infections among Hajj pilgrims.
Respiratory Tract Infections ; Polymerase Chain Reaction ; Bacterial Zoonoses