High Prevalence of Intestinal Pathogens in Indigenous in Colombia

Abstract

Background: Intestinal infections remain a major public health burden in developing countries. Due to social, ecological, environmental, and cultural conditions, Indigenous peoples in Colombia are at particularly high risk. Materials: 137 stool samples were analyzed by microscopy and real-time-Polymerase Chain Reaction (RT-PCR), targeting protozoan parasites (Giardia intestinalis, Entamoeba histolytica, Cryptosporidium spp., and Cyclospora cayetanensis), bacteria (Campylobacter jejuni, Salmonella spp., Shigella ssp./enteroinvasive E. coli (EIEC), Yersinia spp., enterohemorrhagic E. coli (EHEC), enteropathogenic E. coli (EPEC), enterotoxin-producing E. coli (ETEC), enteroaggregative E. coli (EAEC), and Tropheryma whipplei), and helminths (Necator americanus, Strongyloides stercoralis, Ascaris lumbricoides, Ancylostoma spp., Trichuris. trichiura, Taenia spp., Hymenolepis nana, Enterobius vermicularis, and Schistosoma spp.). Microscopy found additional cases of helminth infections. Results: At least one pathogen was detected in 93% of the samples. The overall results revealed protozoa in 79%, helminths in 69%, and bacteria in 41%. G. intestinalis (48%), Necator/hookworm (27%), and EAEC (68%) were the most common in each group. Noteworthy, T. whipplei was positive in 7% and T. trichirua in 23% of the samples. A significant association of one infection promoting the other was determined for G. intestinalis and C. jejuni, helminth infections, and EIEC. Conclusions: The results illustrate the high burden of gastrointestinal pathogens among Indigenous peoples compared to other developing countries. Countermeasures are urgently required.

Seasonal Differences in Cyclospora cayetanensis Prevalence in Colombian Indigenous People

“…The study was conducted to assess the effects of seasonality on the colonization or infection with C. cayetanensis in an indigenous population in the remote Colombian territories. While high endemicity during the rainy season has previously been described [ 1 ], a follow-up assessment about 4 years later in the dry season demonstrated a reduced but still relevant colonization rate.…”

“…The study was conducted as an epidemiological follow-up assessment in indigenous people living in a remote region of tropical Colombia, where a high baseline colonization rate with C. cayetanensis in the rainy season was known from a previous cross-sectional study [ 1 ]. Four years after this first assessment, a second stool sample collection was conducted in the dry season to assess the dimension of seasonal effects on the colonization rate with C. cayetanensis .…”

“…Animals live close together with the population, having access to hygiene-related infrastructures of the houses like kitchens. Furthermore, climate conditions favor infectious diseases, too, as humidity and temperatures are high, supporting the multiplication of microbial pathogens [ 1 ]. Such conditions are also optimal for the developmental cycle of Cyclospora cayetanensis, a protozoan parasite from the phylum coccidia causing enteric human disease [ 2 ].…”

“…Studies on the epidemiology of C. cayetanensis can best be performed in endemic areas, e.g., in Central and South American countries [ 1 , 36 , 37 ], where fecal–oral transmission via food sources [ 38 ] even beyond specific outbreak situations [ 39 ] is likely. In the assessment presented here, the effects of seasonality on the prevalence of C. cayetanensis infections or colonization was investigated.…”

“…In the assessment presented here, the effects of seasonality on the prevalence of C. cayetanensis infections or colonization was investigated. In detail, we compare the C. cayetanensis prevalence in stool samples of Colombian indigenous people in a high endemicity setting as observed in the rainy season [ 1 ] with the prevalence as assessed four years later in the dry season. By doing so, the period prevalence and the background colonization shall be assessed.…”