Intestinal protozoan and helminthic infections among hemodialysis and cancer patients

Parasitol Res. 2020 Sep;119(9):3053-3059. doi: 10.1007/s00436-020-06774-5. Epub 2020 Jul 8.

Abstract

Intestinal parasitic infections (IPIs) can be a severe threat to immunocompromised patients. This is particularly true for those undergoing chemotherapy and hemodialysis. The present research is aimed at identifying intestinal parasites that might be present in immunocompromised patients. In this cross-sectional study 1040 stool samples were collected from March to September 2017. Six hundred and forty-one stool samples from immunocompromised patients (279 samples from hemodialysis patients and 362 samples from chemotherapy patients) and 399 samples from the control group were collected in Guilan province, Iran. The samples were tested by direct, formalin-ether methods for protozoa and ova of intestinal parasites and Ziehl-Neelsen staining methods for coccidian parasites such as Cryptosporidium species. The overall parasitic infection rate was highest (15%) in hemodialysis patients and 11.3% in chemotherapy patients, whereas the lowest rate was observed (7.3%) in the control group. The infectivity rates were statistically significant (P = 0.008) when compared with the control group. The parasites found were Blastocystis hominis (8.9% of the cases), Entamoeba coli (1.6%), Iodamoeba butschlii (0.8%), Endolimax nana (0.6%), Chilomastix mesnili (0.5%), Strongyloides stercoralis (0.5%), and Taenia species (0.15%), whereas Giardia lamblia was detected only in the control group. There was not a correlation between prevalence of parasites with age or education levels of the infected individuals. Results of the present study suggest that periodic stool examinations in special parasitological laboratories should be included as part of routine and general medical care.

Keywords: Chemotherapy; Dialysis; Iran; Parasites; Prevalence.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Cross Infection / parasitology*
  • Cross-Sectional Studies
  • Feces / parasitology
  • Female
  • Helminthiasis / immunology
  • Helminthiasis / parasitology*
  • Helminths / classification
  • Helminths / isolation & purification*
  • Humans
  • Immunocompromised Host
  • Intestinal Diseases, Parasitic / parasitology
  • Intestines / parasitology*
  • Iran / epidemiology
  • Male
  • Middle Aged
  • Neoplasms / immunology
  • Neoplasms / parasitology*
  • Parasites / classification
  • Parasites / genetics
  • Parasites / isolation & purification*
  • Prevalence
  • Renal Dialysis / adverse effects*
  • Young Adult