Current status of intestinal parasitic infections among inhabitants of the Ghazni and Parwan provinces, Afghanistan

Abstract

Background. The prevalence rates of food-and waterborne parasitic infections in Afghanistan are unknown. Cases of invasive diseases found in Afghans are rarely laboratory-confirmed. Objectives. The aim of the study was to present the current status of intestinal parasitic infections in Afghan inhabitants on the example of patients hospitalized in two healthcare facilities in eastern Afghanistan. Material and methods. Fecal samples were collected from 548 patients (children aged 1-17 years and adults) with internal complaints, treated in Ghazni Provincial Hospital (Afghan civilian medical center, Ghazni province, 180 south-west of Kabul) and in Bagram Korean Hospital (Korean military medical center for Afghan patients, Parwan province, 60 km north of Kabul) between 2013 and 2014. One to three stool specimens from Afghan patients were fixed in 10% formalin, transported to the Military Institute of Medicine in Poland and tested by light microscopy using three diagnostic methods (direct smear in Lugol's solution, decantation in distilled water and Fül-leborn's flotation). Results. Intestinal parasites were found in 144/386 of tested patients from the Ghazni province (37.3% infected, mainly with Ascaris lumbricoides, Giardia intestinalis, Hymenolepis nana) and in 49/162 patients from the Parwan province (30.2% infected, mainly with G. intestinalis, A. lumbricoides, H. nana). Conclusions. The rates of intestinal parasitic infections among Afghans are high. The wide range of the detected parasites (protozoa, nematodes, cestodes) should result in the introduction of general screening to be conducted regularly among inhabitants of Afghanistan and the application of targeted antiparasitic chemotherapy aiming to eliminate intestinal helminths and protozoa from the local community.

First detection and genotyping of Giardia intestinalis in stool samples collected from children in Ghazni Province, eastern Afghanistan and evaluation of the PCR assay in formalin-fixed specimens

“…Using real-time PCR, we detected DNA of G. intestinalis in 21.2% of samples. Results of microscopic investigations performed earlier (Korzeniewski et al 2017 ) on this group of children showed a prevalence of this parasite of 17.9%. Of the investigated samples, 38 positive samples were confirmed by both methods applied.…”

“…In four samples, both assemblages were detected. A comparison of this data with the results of a microscopic investigation performed earlier (Korzeniewski et al 2017 ) is shown in Table 2 .…”

“…Studies performed by the scientists from different international military medical services in 2002 and researchers from WHO in 2003 showed high rates of parasitic infections among inhabitants of Afghanistan (Scheid and Thoma 2004 ; Gabrielli et al 2005 ). More recently, our team performed microscopic examinations for intestinal parasitic infections on a large number of inhabitants, especially schoolchildren, of Ghazni Province (Korzeniewski et al 2014 , 2015a , b , 2016 , 2017 ). Faecal material was collected by Polish medical staff and diagnosticians working at the Forward Operating Base in Ghazni, with the aim of detecting and controlling intestinal parasitic infections in the local population.…”

“…The aim of this action was to prepare the scheme of deworming for the local population. Based on a microscopic screening study of this material, we showed a high prevalence of intestinal parasites in these populations (Korzeniewski et al 2014 , 2015a , b , 2016 , 2017 ). Examination of 777 children hospitalised in the Ghazni Province Hospital performed in 2012–2013 showed the presence of intestinal parasitic infection in 40.2% of them, with a predominance of A. lumbricoides and G. intestinalis (17.2 and 16.7%) (Korzeniewski et al 2014 ).…”

Prevalence and associated risk factors of soil-transmitted helminth infections in Kandahar, Afghanistan

“…Diagnosis is mostly made on clinical basis without any laboratory confirmation. The insecurity and shortage of medical staff at all levels of the healthcare system hinders the implementation of epidemiological surveillance [ 15 ]. Healthcare system in Afghanistan is mostly dependent of international humanitarian aid [ 16 ].…”