Diagnostics of intestinal parasites in light microscopy among the population of children in eastern Afghanistan

Abstract

Objectives. The Afghans, living in poor socioeconomic conditions, are estimated to be a community with a high rate of intestinal parasitic infections. The aim of the study was to estimate the prevalence and species of intestinal parasites among children's population in eastern Afghanistan and to present the methods of optimizing the techniques for identification of pathogens in light microscopy. The research was carried out as a part of humanitarian project Capacity building of health care system in Ghazni Province. Materials and method. The study involved 500 children aged 7-18 attending the Share Kona and the Khuija Ali High Schools in Ghazni, eastern Afghanistan in the period November 2013-April 2014. Three stool samples were collected from each patient at 2-day intervals, the samples were fixed in 10% formalin, transported to the Military Institute of Medicine in Poland, where they were pooled and examined using five different diagnostic methods in light microscopy (direct smear in Lugol's solution, Fülleborne's flotation, decantation in distilled water, Kato-Miura thick smear, and DiaSys/PARASYS sedimentation system). Results. Pathogenic intestinal parasites were detected in 217 patients (43.4%), with the most common Ascaris lumbricoides (35.3%), Giardia intestinalis (31.1%), and Hymenolepis nana (15.7%). The use of direct smear method allowed for the detection of intestinal parasites in 161 individuals. The application of four following testing methods has improved the detection rates of infected patients by 11.2%. Conclusions. The variety of detected intestinal pathogens in examined children's population has required the use of combination of multiple diagnostic methods in light microscopy, and finally improved the detection rates of intestinal parasites and helped eliminate infections with nematodes, cestodes, trematodes, and protozoa using appropriate treatment in the study population.

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

“…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 ).…”

“…Prior to the investigations of Giardia strains in the Afghan schoolchildren, we evaluated the effect of 10% buffered formalin fixative on the detection of G. intestinalis DNA using real-time PCR and nested PCR. Human faecal sample containing cysts of G. intestinalis , selected from a population of polish children investigated previously in the Epidemiology and Tropical Medicine Department in Gdynia, Military Institute of Medicine in Warsaw for the presence of intestinal parasites (Korzeniewski et al 2016 ), was used in the performed experiments. Light microscopy was used to confirm the presence of G. intestinalis cysts as well as to count them.…”

“…The examined students were representative of children inhabiting eastern Afghanistan. Stool samples collected from the children were placed in sterile plastic vessels, fixed in 10% formalin and transported to the Military Institute of Medicine in Poland, where they were investigated microscopically for the presence of intestinal parasites (Korzeniewski et al 2016 ). Simultaneously, a part of each sample was placed in a 2-mL sterile tube and analysed at the Department of Tropical Parasitology, Medical University of Gdańsk, Poland, using molecular detection methods as described below.…”

Health of Special Immigrant Visa holders from Iraq and Afghanistan after arrival into the United States using Domestic Medical Examination data, 2014–2016: A cross-sectional analysis

“…Studies in Iraqi populations report a high overall prevalence of gastrointestinal infections with estimates up to 64% of the population, and commonly reported parasites include Blastocystis (32%-36%) [8,38], Giardia (28%-45%) [8,[38][39][40][41], and Entamoeba (23%) [39]. In Afghan populations, overall prevalence of intestinal parasites as high as 39% has been noted [42], and commonly reported parasites include Giardia (15%-59%) [42][43][44] and Ascaris (20%-35%) [41]. Blastocystis was found in 15% of Polish soldiers returning from peacekeeping missions in both Afghanistan and Iraq; the infections were presumably contracted in these regions [45].…”