Determining intestinal parasitic infections (IPIs) in inmates from Kajang Prison, Selangor, Malaysia for improved prison management

Abstract

BackgroundThe prison management in Malaysia is proactively seeking to improve the health status of the prison inmates. Intestinal parasitic infections (IPIs) are widely distributed throughout the world and are still gaining great concern due to their significant morbidity and mortality among infected humans. In Malaysia, there is a paucity of information on IPIs among prison inmates. In order to further enhance the current health strategies employed, the present study aims to establish firm data on the prevalence and diversity of IPIs among HIV-infected and non-HIV-infected individuals in a prison, an area in which informed knowledge is still very limited.MethodsSamples were subjected to microscopy examination and serological test (only for Strongyloides). Speciation for parasites on microscopy-positive samples and seropositive samples for Strongyloides were further determined via polymerase chain reaction. SPSS was used for statistical analysis.ResultsA total of 294 stool and blood samples each were successfully collected, involving 131 HIV positive and 163 HIV negative adult male inmates whose age ranged from 21 to 69-years-old. Overall prevalence showed 26.5 % was positive for various IPIs. The IPIs detected included Blastocystis sp., Strongyloides stercoralis, Entamoeba spp., Cryptosporidium spp., Giardia spp., and Trichuris trichiura. Comparatively, the rate of IPIs was slightly higher among the HIV positive inmates (27.5 %) than HIV negative inmates (25.8 %). Interestingly, seropositivity for S. stercoralis was more predominant in HIV negative inmates (10.4 %) compared to HIV-infected inmates (6.9 %), however these findings were not statistically significant. Polymerase chain reaction (PCR) confirmed the presence of Blastocystis, Strongyloides, Entamoeba histolytica and E. dispar.ConclusionsThese data will enable the health care providers and prison management staff to understand the trend and epidemiological situations in HIV/parasitic co-infections in a prison. This information will further assist in providing evidence-based guidance to improve prevention, control and management strategies of IPIs co-infections among both HIV positive and HIV negative inmates in a prison environment.

Prevalence of Intestinal Parasitic Infections among Inmates of the New-bell Central Prison, Cameroon

“…The overall IPIs prevalence in New-Bell central prison was lower than reports from Nigerian prisons namely the Keffi prison in 2006 [7], the Owerri prison [8], as well as the Ouagadougou prison in Burkina-Faso [6] and the Shewa Robit prison in Ethiopia [11] where IPIs prevalence was always over 70%. Prevalence of IPIs in the New-Bell central prison was however higher than recent report from inmates in the Kajang prison, Selangor, Malaysia where in 2015 an overall 26.5% IPIs prevalence was reported among inmates [12]. These differences may not be due to laboratory techniques used since the studies undergone in Nigerian prisons, the Burkina-Faso prison and Ethiopia combined fresh mount and formol-ether concentration.…”

“…Such combination may likely result to development of clinical symptoms. Such intestinal polyparasitic infections were also reported in stool samples from inmates in the Nigerian prison [7], the Ethiopian prison [11] and the Malaysian prison [12].…”

“…This study aimed to establish the biodiversity, prevalence and identify main risk factors of intestinal protozoa and helminthe infections among inmates of the New-Bell central prison in Douala, Cameroon. Intestinal parasites recorded in this study belonged to protozoan and helminthes namely E. histolytica/dispar, E. coli, G. intestinalis, Chilomastix mesnili, [12]. Concerning helminthe infections, a greater diversity was reported in 2014 in the Jos prison in Nigeria [9] and the Shewa Robit prison in Ethiopia [11] with an additional occurrence of hookworm, S. stercoralis and Taenia sp.…”

“…Hygiene-related intestinal parasitic infections data made available in prisons from some African countries indicated high overall prevalence of IPIs always over 70% at Ouagadougou [6], some Nigerian prisons namely Keffi prison, Owerri prison and Jos Central Prison [7,8,9,10] and Ethiopia [11]. In Kajang Prison, Selangor, Malaysia an overall 26.5% IPIs prevalence was reported among inmates [12]. Depending on the laboratory diagnostic techniques used, intestinal parasite found in stool samples in either studies belonged to various protozoa and/or helminthes species and were recovered singly or in combination.…”

The laboratory diagnosis of Strongyloides stercoralis

“…the 18S rRNA small subunit (SSU); the internal transcribed spacer region 1 (ITS-1); the 28S rRNA gene; or the cyclooxygenase gene (cox1) 19,[23][24][25][26][27][28][29][30][32][33][34][35][36][37] . Published sensitivities and specificities for…”