Prevalence of Intestinal Parasitism and Associated Symptomatology Among Hemodialysis Patients

Abstract

SUMMARYIntestinal parasites are an important cause of morbidity and mortality. Immunocompromised individuals may develop more severe forms of these infections. Taking into account the immunity impairment in patients suffering from chronic renal failure (CRF), we will determine the prevalence and associated symptoms of intestinal parasites in these patients. Controls without CRF were used for comparison. Stool samples were collected and processed for microscopic identification of parasites using the Formalin-ether concentration method. For Cryptosporidium diagnosis, the ELISA technique was used. One hundred and ten fecal samples from hemodialysis patients were analyzed, as well as 86 from a community group used as control group. A result of 51.6% of intestinal parasites was observed in hemodialysis patients and 61.6% in the control group. Cryptosporidium and Blastocystis were the most common infections in patients with CRF (26.4% and 24.5%, respectively). Blastocystis was the most common infection in the control group (41.9%), however no individual was found positive for Cryptosporidium. Among the CRF patients, 73.6% were symptomatic, 54.3% of these tested positive for at least one parasite, in contrast to 44.8% in asymptomatic patients (p = 0.38). The most common symptoms in this group were flatulence (36.4%), asthenia (30.0%) and weight loss (30.0%). In the control group, 91.9% were symptomatic, 60.8% of these tested positive for at least one parasite, in contrast to 71.4% in asymptomatic patients (p = 0.703). A significant difference between the two groups was observed with regard to symptoms, with bloating, postprandial fullness, and abdominal pain being more frequent in the control group than in the hemodialysis group (all p < 0.05). Comparing symptomatic with asymptomatic, there was no association in either group between symptoms or the prevalence of parasitic infection, nor with the type of parasite or with multiple parasitic infections. Patients with chronic renal failure are frequent targets for renal transplantation, which as well as the inherent immunological impairment of the disease itself, results in immunosuppression by medication. For this reason, carriers of intestinal parasites with pathogenic potential can develop serious clinical complications influencing the success of transplantation. This fact, coupled with the high prevalence of intestinal parasites and the dissociation between symptoms and infection in CRF patients, suggests that the stool test should be incorporated in routine propedeutics. Furthermore, preventive measures for the acquisition of parasites through the fecal-oral contamination route should be introduced.

Intestinal Parasites in Diabetes Mellitus Patients in the Limbe and Buea Municipalities, Cameroon

“…9 Diabetic patients have been reported to be immunocompromised. 1,[10][11][12] Intestinal parasites have gained increasing attention as important opportunistic pathogens responsible for clinically important infections in immunosuppressed patients.…”

Incidence of Some Intestinal Parasites among Diabetic Patients Suffering from Gastroenteritis

“…Even in the some countries where education excel and adequate sanitation conditions, some of these parasites had an important role in causing diseases in specific groups such as immune-compromised individuals (Fantry, 2002), organ diseases such as diabetes (Nazligul et al, 2001), among renal failure patients (Gil et al, 2013).…”

Cryptosporidiosis in Iranian Farm Workers and Their Household Members: A Hypothesis about Possible Zoonotic Transmission

“…It is worth discussing this as it probably represents a further risk factor for transmission especially if this was shown to be in young children from which transmission is likely to occur. Although prevalence of asymptomatic careers in this study was reported as high as 75%, this range may be variable by species of Cryptosporidium , the general health condition of human host for example being immunocompromised such as HIV positive and kidney transplant patients, the prevalence of positive calves and animal and previous outbreaks in that geographical region [46–49]. …”