Parasites, Hosts and Diseases

"diarrhea"

Brief Communications

Association between Sociodemographic Factors and Diarrhea in Children Under 5 Years in Rwanda: Umuhoza Claudine, Ju Yeong Kim, Eun-Min Kim, Tai-Soon Yong; Korean J Parasitol 2021;59(1):61-65.
Published online February 19, 2021; DOI: https://doi.org/10.3347/kjp.2021.59.1.61

Abstract
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Diarrheal disease is the second leading cause of mortality and morbidity in children under 5 years old worldwide, and is the most common cause of malnutrition in sub-Saharan Africa. In Rwanda, diarrhea is the third leading cause of death in children under 5 years old. This study examined the association between sociodemographic factors and diarrhea in children under 5 years using the data of 7,474 households in the 2014-2015 Rwanda Demographic and Health Survey. Overall prevalence of diarrhea in this study was 12.7% in children. An increased risk for diarrhea was found for children aged 12-23 months (odds ratio (OR)=4.514), those with a low economic status (OR=1.64), those from the Western province (OR=1.439), those with poorly-educated mothers (OR=5.163), and those with families engaged in agricultural activities (OR=1.624). In conclusion, sociodemographic factors significantly affect the risk of developing diarrhea in children under 5 years in Rwanda. Designing and implementing health education promoting awareness of early interventions and rotavirus vaccination are essential to reduce diarrheal diseases for the Rwandan community.

Citations

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Prevalence of diarrheal diseases and associated factors among under five children in Africa: A meta-analysis
Eshetu Abera Worede, Asmamaw Malede, Hailemariam Feleke, Geziew Abere, Eyayaw Addissu Demeke, Jember Azanaw, Hope Onohuean
PLOS One.2025; 20(7): e0326501. CrossRef
Diarrhea among children under-five: Comparing risk factors in urban and rural areas in Indonesia
Diah Yunitawati, Marizka Khairunnisa, Donny Kristanto Mulyantoro, Hadi Ashar, Leny Latifah
Clinical Epidemiology and Global Health.2025; 35: 102136. CrossRef
Diarrhea in Yemeni children under five: A multi-level analysis of population-based surveys, 1991–2022
Zahir M. Tag, Laith J. Abu-Raddad, Hiam Chemaitelly, Qu Cheng
PLOS Neglected Tropical Diseases.2025; 19(7): e0013297. CrossRef
Acute gastroenteritis and associated factors among under-five children visiting public hospitals in Jigjiga City, Somali Region, Ethiopia: a hospital-based cross-sectional study
Mahlet Ameha Getahun, Liyew Mekonnen Ayehubizu, Abdirahman Mohamed Ahmed, Seid Yimam Ali, Ahmed Moumin Abdilahi, Mekonin Meskelu Shegere
BMJ Open.2025; 15(9): e099998. CrossRef
Prevalence of diarrheal disease and its determinants among children under five in East Africa: systematic review and meta-analysis
Bantie Getnet Yirsaw, Muluemebet Kassa Mezen, Aychew Kassa Belete, Fasiledes Fetene Asfaw, Shumye Tamrie Yerie, Ashenafi Kalayu Nega, Birhan Ambachew Taye
BMC Infectious Diseases.2025;[Epub] CrossRef
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Hira Hameed, Aummara Rafique, Nadia Tariq, Rubina Zulfiqar, Sohail Aslam, Ainur Zholdabeskova
Journal of Rawalpindi Medical College.2025;[Epub] CrossRef
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International Journal of Environmental Health Research.2025; : 1. CrossRef
Diarrheal disease and associated factors among children aged 6 to 59 months in Oda Bultum District, Eastern Ethiopia: a community-based cross-sectional study
Zewudalem Getachew, Nega Asefa, Tigist Gashaw, Abdi Birhanu, Adera Debella, Bikila Balis, Usmael Jibro, Sina Tolera, Aboma Motuma, Mulugeta Gamachu, Alemayehu Deressa, Fethia Mohammed, Moti Tolera, Addis Eyeberu, Lemma Demissie Regassa, Ibsa Mussa
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Spatial disparity and associated factors of diarrhea among under-five children in Rwanda: a multilevel logistic regression analysis
Abiyu Abadi Tareke, Sebwedin Surur Jemal, Getahun Dejene Yemane, Hamdi Fekredin Zakaria, Enyew Woretaw Shiferaw, Anaclet Ngabonzima
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Tomas Getahun, Dejene Hailu, Ondari D Mogeni, Edlawit Mesfin Getachew, Biruk Yeshitela, Yeonji Jeon, Abel Gedefaw, Samuyel Ayele Abebe, Ermiyas Hundito, David Mukasa, Geun Hyeog Jang, Gi Deok Pak, Deok Ryun Kim, Yeshambel Worku Demlie, Mukemil Hussen, Mek
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Abdulaziz Kebede Kassaw, Ayana Alebachew Muluneh, Ebrahim Msaye Assefa, Ali Yimer
Frontiers in Public Health.2024;[Epub] CrossRef
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Jember Azanaw, Asmamaw Malede, Hailemariam Feleke Yalew, Eshetu Abera Worede
BMC Public Health.2024;[Epub] CrossRef
Diarrhea and its associated factors among children aged under five years in Madagascar, 2024: a multilevel logistic regression analysis
Gebeyehu Lakew, Amlaku Nigusie Yirsaw, Eyob Ketema Bogale, Getnet Alemu Andarge, Demis Getachew, Eyob Getachew, Abiyu Abadi Tareke
BMC Public Health.2024;[Epub] CrossRef
Prevalence and spatiotemporal distribution of rotavirus diarrhea among children younger than five years old in Lagos, Nigeria
Ebelechukwu Eugenia Afocha, Bamidele Abiodun Iwalokun, Mopelola Anotu Deji-Agboola, Babatunde Ayorinde James, Taiwo Abayomi Banjo, Festus Adu, Oliver Chukwujekwu Ezechi, Richard Adegbola, Babatunde Lawal Salako
Journal of Immunoassay and Immunochemistry.2023; 44(2): 117. CrossRef
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Didier Gbebangi-Manzemu, Véronique Muyobela Kampunzu, Hortense Malikidogo Vanzwa, Mupenzi Mumbere, Gaspard Mande Bukaka, Bibi Batoko Likele, Emmanuel Tebandite Kasai, Benoit Mbiya Mukinayi, Serge Tonen-Wolyec, Nestor Ngbonda Dauly, Jean Pierre Alworong’a
BMC Pediatrics.2023;[Epub] CrossRef
Impact of access to improved water and sanitation on diarrhea reduction among rural under-five children in low and middle-income countries: a propensity score matched analysis
Mehari Woldemariam Merid, Adugnaw Zeleke Alem, Dagmawi Chilot, Daniel Gashaneh Belay, Anteneh Ayelign Kibret, Melaku Hunie Asratie, Yadelew Yimer Shibabaw, Fantu Mamo Aragaw
Tropical Medicine and Health.2023;[Epub] CrossRef
Clinical Epidemiology Features and Risk Factors for Acute Diarrhea Caused by Rotavirus A in Vietnamese Children
Dang Van Chuc, Dang Phuong Linh, Dang Viet Linh, Pham Van Linh, Lavjay Butani
International Journal of Pediatrics.2023; 2023: 1. CrossRef
SOCIOECONOMIC FACTORS ASSOCIATED WITH DIARRHEA AMONG CHILDREN UNDER FIVE YEARS IN INDONESIA
Miftahatur Rizqiyah Kurniawati, Erni Astutik
Jurnal Berkala Epidemiologi.2023; 11(2): 170. CrossRef
Pooled prevalence and associated factors of diarrhea among under-five years children in East Africa: A multilevel logistic regression analysis
Abiyu Abadi Tareke, Ermias Bekele Enyew, Bayley Adane Takele, Khin Thet Wai
PLOS ONE.2022; 17(4): e0264559. CrossRef
Global burden and trends of rotavirus infection-associated deaths from 1990 to 2019: an observational trend study
Yuxia Du, Can Chen, Xiaobao Zhang, Danying Yan, Daixi Jiang, Xiaoxiao Liu, Mengya Yang, Cheng Ding, Lei Lan, Robert Hecht, Changtai Zhu, Shigui Yang
Virology Journal.2022;[Epub] CrossRef
Productive uses of electricity at the energy-health nexus: Financial, technical and social insights from a containerized power system in Rwanda
Samuel B. Miles, Jessica Kersey, Emiliano Cecchini, Daniel M. Kammen
Development Engineering.2022; 7: 100101. CrossRef
Global Burden and Trends of Rotavirus Infection-Associated Death from 1990 to 2019: An Observational Trend Study
Yuxia Du, Can Chen, Xiaobao Zhang, Danying Yan, Daixi Jiang, Xiaoxiao Liu, Mengya Yang, Cheng Ding, Lei Lan, Robert Hecht, Changtai Zhu, Shigui Yang
SSRN Electronic Journal .2022;[Epub] CrossRef
The Role of Household Flooring on Childhood Diarrhea Among Children 0 to 23 Months of Age in Ethiopia: A Nationally Representative Cross-Sectional Study Using a Multi-Level Mixed Effect Analysis
Biniyam Sahiledengle, Abera Kumie, Daniel Atlaw, Yohannes Tekalegn, Demelash Woldeyohannes, Demisu Zenbaba, Tadesse Awoke
Environmental Health Insights.2021;[Epub] CrossRef
Recent emergence and outbreak of rotavirus gastroenteritis in Samoa
Lawal Olatunde Olayemi, Vicky Yemoh, Alec Ekeroma
Asian Pacific Journal of Tropical Medicine.2021; 14(11): 479. CrossRef

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Outbreak of Cyclosporiasis in Korean Travelers Returning from Nepal: Da-Won Ma, Myoung-Ro Lee, Bora Ku, Shin-Hyeong Cho, Sang-Eun Lee; Korean J Parasitol 2020;58(5):589-592.
Published online October 22, 2020; DOI: https://doi.org/10.3347/kjp.2020.58.5.589

Abstract
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Cyclospora cayetanensis is an apicomplexan protozoan and is one of the most common pathogens causing chronic diarrhea worldwide. Eight stool samples with diarrheal symptom out of 18 Korean residents who traveled to Nepal were obtained, and examined for 25 enteropathogens including 16 bacterial species, 5 viral species, and 4 protozoans in stool samples as causative agents of water-borne and food-borne disease. Only C. cayetanensis was detected by nested PCR, and 3 PCR-positive samples were sequenced to confirm species identification. However, the oocysts of C. cayetanensis in fecal samples could not be detected by direct microscopy of the stained sample. As far as we know, this is the first report of a group infection with C. cayetanensis from a traveler visiting Nepal, and the second report of a traveler’s diarrhea by C. cayetanensis imported in Korea.

Citations

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Food Safety in Developing Countries: Common Foodborne and Waterborne Illnesses, Regulations, Organizational Structure, and Challenges of Food Safety in the Context of Nepal
Deepak Subedi, Madhav Paudel, Sandesh Poudel, Niranjan Koirala
Food Frontiers.2025; 6(1): 86. CrossRef
Imported parasitic diseases in the Republic of Korea: status and issues
Jong-Yil Chai
Journal of the Korean Medical Association.2025; 68(1): 52. CrossRef
Cyclospora and Cyclosporiasis: The Nepalese Perspective
Pitambar Dhakal, Junqiang Li, Bishnu Maya K.C., Yin Fu, Yuancai Chen, Longxian Zhang
Zoonoses.2024;[Epub] CrossRef
Cyclospora cayetanensis: A Perspective (2020–2023) with Emphasis on Epidemiology and Detection Methods
Sonia Almeria, Leonor Chacin-Bonilla, Jenny G. Maloney, Monica Santin
Microorganisms.2023; 11(9): 2171. CrossRef
Waterborne transmission of protozoan parasites: a review of worldwide outbreaks – an update 2017–2022
Pavlina Bourli, Aida Vafae Eslahi, Ourania Tzoraki, Panagiotis Karanis
Journal of Water and Health.2023; 21(10): 1421. CrossRef
Waterborne protozoan outbreaks: An update on the global, regional, and national prevalence from 2017 to 2020 and sources of contamination
Jun-Yang Ma, Man-Yao Li, Ze-Zheng Qi, Ming Fu, Tian-Feng Sun, Hany M. Elsheikha, Wei Cong
Science of The Total Environment.2022; 806: 150562. CrossRef
Review on Cyclosporiasis Outbreaks and Potential Molecular Markers for Tracing Back Investigations
Junqiang Li, Feifei Xu, Md Robiul Karim, Longxian Zhang
Foodborne Pathogens and Disease.2022; 19(12): 796. CrossRef

4,749 View
99 Download
7 Web of Science
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Molecular Detection and Subtyping of Human Blastocystis and the Clinical Implications: Comparisons between Diarrheal and Non-diarrheal Groups in Korean Populations: Moon-Ju Kim, Eun Jeong Won, Soo Hyun Kim, Jong Hee Shin, Jong-Yil Chai; Korean J Parasitol 2020;58(3):321-326.
Published online June 26, 2020; DOI: https://doi.org/10.3347/kjp.2020.58.3.321

Abstract
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Blastocystis has recently been recognized as the most common eukaryotic microbe of the human gut. We investigated the prevalence of Blastocystis and their subtypes in diarrheal and non-diarrheal groups and the associated clinical parameters. A total of 324 stool samples were obtained from 196 diarrheal and 128 non-diarrheal subjects. Blastocystis subtypes were determined by sequencing the small subunit ribosomal DNA (SSU rRNA) gene. Demographic, clinical and laboratory data were collected and analyzed by diarrhea and Blastocystis status. The overall rate of Blastocystis positivity was 9.0% (29/324) but was significantly higher in the non-diarrheal group (18.0% vs. 3.1%, P<0.0001). Of the 6 Blastocystis-positive diarrheal patients, 3 (50.0%), none (0.0%), 2 (33.3%), and 1 (16.7%) were infected with subtypes ST1, ST2, ST3, and multiple subtypes, respectively. Of the 23 Blastocystis-positive non-diarrheal patients, 4 (17.4%), 1 (4.3%), and 18 (78.3%) were infected with subtypes ST1, ST2, and ST3, respectively. Blastocystis was less common in the diarrheal than the non-diarrheal group (odds ratio, 0.144; 95% confidence interval, 0.057?0.365, P<0.001). Of the 3 subtypes, ST3 was more frequently observed in the non-diarrheal than diarrheal group (78.3% vs. 33.3%, P=0.0341). Collectively, Blastocystis was found in both the diarrheal and non-diarrheal groups and ST3 was the most common subtype in Korea.

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Access Microbiology .2025;[Epub] CrossRef
A Systematic Review about the Efficacy of Antiparasitic Agents in the Treatment of Blastocystis Species
Özlem Ulusan Bağcı, Gülay Aral Akarsu
Acta Parasitologica.2025;[Epub] CrossRef
Molecular Prevalence of Blastocystis sp. from Patients with Diarrhea in the Republic of Korea
Ji-Young Kwon, Jong-Hoon Choi, Hee-Il Lee, Jung-Won Ju, Myoung-Ro Lee
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Subtype Distribution of Blastocystis spp. in Patients with Gastrointestinal Symptoms in Northern Spain
Cristina Matovelle, Joaquín Quílez, María Teresa Tejedor, Antonio Beltrán, Patricia Chueca, Luis Vicente Monteagudo
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Systematic Review and Meta-Analysis: Epidemiology of Human Blastocystis spp. Infection in Malaysia
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Ayşe Semra Gureser, Djursun Karasartova, Fakhiriddin Sarzhanov, Nezahat Kosar, Aysegul Taylan-Ozkan, Funda Dogruman-Al
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Folia Parasitologica.2022;[Epub] CrossRef
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Junqiang Li, Haiju Dong, Md Robiul Karim, Xianli Yang, Liqin Chao, Shuai Liu, Hairong Song, Longxian Zhang
European Journal of Protistology.2021; 79: 125796. CrossRef
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Case Report

Necrotizing Enteritis Caused by Pharyngostomum cordatum Infection in a Stray Cat: Ji-Hyeon Kim, Kyunghyun Lee, Woon-Mok Sohn, Ha-Young Kim, Yu-Ran Lee, Eun-Jin Choi, ByungJae So, Ji-Youl Jung; Korean J Parasitol 2019;57(1):17-20.
Published online February 26, 2019; DOI: https://doi.org/10.3347/kjp.2019.57.1.17

Abstract
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A stray female cat of unknown age, presenting bright red watery diarrhea, was submitted to the Animal and Plant Quarantine Agency for diagnosis. In the small intestines extracted from the necropsied cat, numerous white oval-shaped organisms were firmly embedded in the mucosa and there was thickening of intestinal wall. Histopathological analysis revealed severe necrotizing enteritis, together with atrophied intestinal villi, exfoliated enterocytes, and parasitic worms. Recovered worms were identified as Pharyngostomum cordatum by morphological observation and genetic analysis. Although P. cordatum is known to occur widely in Korea, this is the first clinical description of an infection by P. cordatum causing severe feline enteritis.

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The Korean Journal of Parasitology.2021; 59(3): 303. CrossRef

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Brief Communication

Epidemiological Survey on Eimeria spp. Associated with Diarrhea in Pre-weaned Native Korean Calves: Hyeon-Cheol Kim, Changyoung Choe, SuHee Kim, Joon-Seok Chae, Do-Hyeon Yu, Jinho Park, Bae-Keun Park, Kyoung-Seong Choi; Korean J Parasitol 2018;56(6):619-623.
Published online December 31, 2018; DOI: https://doi.org/10.3347/kjp.2018.56.6.619

Abstract
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Bovine coccidiosis is one of the most important parasitic diseases affecting calf productivity. Here, we investi- gated the prevalence of Eimeria spp. in pre-weaned native Korean calves and determined the correlation between diar- rhea and Eimeria spp. Fecal samples were collected from individual calves (288 normal and 191 diarrheic) in 6 different farms. Of the 479 samples, Eimeria oocysts were detected in 124 calves (25.9%). Five Eimeria spp. were identified; E. zuernii (18.8%) was the most prevalent, followed by E. auburnensis (12.5%), E. bovis (7.5%), E. subspherica (5.8%), and E. bukidnonensis (1.0%). A significant correlation was observed between diarrhea and mixed infection with more than 2 Eimeria spp. (odds ratio [OR]=2.21; 95% confidence interval [CI]: 1.09-4.49; P=0.03) compared to single infection (OR = 1.29; 95% CI: 0.77-2.15; P = 0.33). Of the 5 Eimeria spp. identified, E. subspherica (95% CI: 1.24-5.61; P = 0.01) and E. bukidnonensis (95% CI: 825.08-1,134.25; P = 0.00) strongly increased the risk of diarrhea by 2.64-fold and 967.39-fold, respectively, compared to other species. Moreover, mixed infection with E. auburnensis and E. bukidnonensis was significantly associated with diarrhea (OR = 2,388.48; 95% CI: 1,009.71-5,650.00; P < 0.00) in pre-weaned native Korean calves. This is the first report to demonstrate the importance of E. bukidnonensis associated with diarrhea in pre-weaned native Korean calves. Further epidemiological studies should investigate the prevalence of E. bukidnonensis and the association between E. bukidnonensis and diarrhea.

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Original Articles

Development of Molecular Diagnosis Using Multiplex Real-Time PCR and T4 Phage Internal Control to Simultaneously Detect Cryptosporidium parvum, Giardia lamblia, and Cyclospora cayetanensis from Human Stool Samples: Ji-Hun Shin, Sang-Eun Lee, Tong Soo Kim, Da-Won Ma, Shin-Hyeong Cho, Jong-Yil Chai, Eun-Hee Shin; Korean J Parasitol 2018;56(5):419-427.
Published online October 31, 2018; DOI: https://doi.org/10.3347/kjp.2018.56.5.419

Abstract
PDF

This study aimed to develop a new multiplex real-time PCR detection method for 3 species of waterborne protozoan parasites (Cryptosporidium parvum, Giardia lamblia, and Cyclospora cayetanensis) identified as major causes of traveler’s diarrhea. Three target genes were specifically and simultaneously detected by the TaqMan probe method for multiple parasitic infection cases, including Cryptosporidium oocyst wall protein for C. parvum, glutamate dehydrogenase for G. lamblia, and internal transcribed spacer 1 for C. cayetanensis. Gene product 21 for bacteriophage T4 was used as an internal control DNA target for monitoring human stool DNA amplification. TaqMan probes were prepared using 4 fluorescent dyes, FAMTM, HEXTM, Cy5TM, and CAL Fluor Red® 610 on C. parvum, G. lamblia, C. cayetanensis, and bacteriophage T4, respectively. We developed a novel primer-probe set for each parasite, a primer-probe cocktail (a mixture of primers and probes for the parasites and the internal control) for multiplex real-time PCR analysis, and a protocol for this detection method. Multiplex real-time PCR with the primer-probe cocktail successfully and specifically detected the target genes of C. parvum, G. lamblia, and C. cayetanensis in the mixed spiked human stool sample. The limit of detection for our assay was 2×10 copies for C. parvum and for C. cayetanensis, while it was 2×103 copies for G. lamblia. We propose that the multiplex real-time PCR detection method developed here is a useful method for simultaneously diagnosing the most common causative protozoa in traveler’s diarrhea.

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High Frequency of Enteric Protozoan, Viral, and Bacterial Potential Pathogens in Community-Acquired Acute Diarrheal Episodes: Evidence Based on Results of Luminex Gastrointestinal Pathogen Panel Assay: Yousry A. Hawash, Khadiga A. Ismail, Mazen Almehmadi; Korean J Parasitol 2017;55(5):513-521.
Published online October 31, 2017; DOI: https://doi.org/10.3347/kjp.2017.55.5.513

Abstract
PDF

Infectious diarrhea is endemic in most developing countries. We aimed to investigate the protozoan, viral, and bacterial causes of acute diarrhea in Taif, Saudi Arabia. A cross-sectional prospective 1-year study was conducted on 163 diarrheal patients of various ages. Stool samples were collected, 1 per patient, and tested for 3 protozoa, 3 viruses, and 9 bacteria with the Luminex Gastrointestinal Pathogen Panel. Overall, 53.4% (87/163) of samples were positives (20.8% protozoa, 19.6% viruses, 2.8% bacteria, and 9.8% mixed). Rotavirus (19.6%), Giardia duodenalis (16.5%), and Cryptosporidium spp. (8.5%) were the mostly detected pathogens. Adenovirus 40/41 (4.2%), Salmonella (3%), Shiga toxin-producing Escherichia coli (3%), and Entamoeba histolytica (2.4%) were also detected. Norovirus GI/II, Vibrio cholerae, Yersinia enterocolitica, and Clostridium difficile toxin A/B were not detected in any patients. All pathogens were involved in coinfections except E. histolytica. Giardia (5.5%) and rotavirus (3%) were the most commonly detected in co-infections. Enterotoxigenic E. coli (2.4%), Campylobacter spp. (2.4%), E. coli 0157 (1.8%), and Shigella spp. (1.2%) were detected in patients only as co-infections. Infections were more in children 0-4 years, less in adults <40 years, and least >40 years, with statistically significant differences in risk across age groups observed with rotavirus (P<0.001), Giardia (P=0.006), and Cryptosporidium (P=0.036) infections. Lastly, infections were not significantly more in the spring. This report demonstrates the high burden of various enteropathogens in the setting. Further studies are needed to define the impact of these findings on the clinical course of the disease.

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Brief Communication

Prevalence of Enteric Protozoan Oocysts with Special Reference to Sarcocystis cruzi among Fecal Samples of Diarrheic Immunodeficient Patients in Iran: Mahmoud Agholi, Shahrbanou Naderi Shahabadi, Mohammad Hossein Motazedian, Gholam Reza Hatam; Korean J Parasitol 2016;54(3):339-344.
Published online June 30, 2016; DOI: https://doi.org/10.3347/kjp.2016.54.3.339

Abstract
PDF

The genus Sarcocystis is not usually considered as an important enteric pathogen in immune compromised patients. It might be expected that species for which humans are the final host (Sarcocystis hominis and Sarcocystis suihominis as well as possibly others) would be encountered increasingly often in immunodeficient persons. This study aimed to address how to detect and differentiate Sarcocystis oocysts and/or sporocysts from enteric protozoans in the diarrheal samples of immunodeficient patients in Shiraz, Iran. Diarrheal samples of 741 immunodeficient patients with recurrent persistent or chronic diarrhea were examined by microscopy and molecular biological analysis. Oocysts-positive samples were 68 Cryptosporidium spp., 9 Cystoisospora belli (syn. Isospora belli), 2 Cyclospora cayetanensis, and 15 microsporidia (Enterocytozoon bieneusi). Sarcocystis-like sporocysts found from a woman were identified as Sarcocystis cruzi through 18S rDNA amplification and phylogenetic analysis. To the best of our knowledge, this is the first report of S. cruzi from a human.

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Original Articles

Intestinal Parasitosis in Relation to Anti-Retroviral Therapy, CD4+ T-cell Count and Diarrhea in HIV Patients: Shehla Khalil, Bijay Ranjan Mirdha, Sanjeev Sinha, Ashutosh Panda, Yogita Singh, Anju Joseph, Manorama Deb; Korean J Parasitol 2015;53(6):705-712.
Published online December 31, 2015; DOI: https://doi.org/10.3347/kjp.2015.53.6.705

Abstract
PDF

Intestinal parasitic infections are one of the major causes of diarrhea in human immunodeficiency virus (HIV) seropositive individuals. Antiretroviral therapy has markedly reduced the incidence of many opportunistic infections, but parasite-related diarrhea still remains frequent and often underestimated especially in developing countries. The present hospital-based study was conducted to determine the spectrum of intestinal parasitosis in adult HIV/AIDS (acquired immunodeficiency syndrome) patients with or without diarrhea with the levels of CD4+ T-cell counts. A total of 400 individuals were enrolled and were screened for intestinal parasitosis. Of these study population, 200 were HIV seropositives, and the remaining 200 were HIV uninfected individuals with or without diarrhea. Intestinal parasites were identified by using microscopy as well as PCR assay. A total of 130 (32.5%) out of 400 patients were positive for any kinds of intestinal parasites. The cumulative number of parasite positive patients was 152 due to multiple infections. A significant association of Cryptosporidium (P<0.001) was detected among individuals with CD4+ T-cell counts less than 200 cells/μl.

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Prevalence of Cryptosporidium-Associated Diarrhea in a High Altitude-Community of Saudi Arabia Detected by Conventional and Molecular Methods: Yousry Hawash, Laila Sh. Dorgham, Ayman S. Al-Hazmi, Mohammed S. Al-Ghamdi; Korean J Parasitol 2014;52(5):479-485.
Published online October 22, 2014; DOI: https://doi.org/10.3347/kjp.2014.52.5.479

Abstract
PDF

Cryptosporidium diarrhea represents a relevant clinical problem in developing countries. In Al-Taif, a city of Saudi Arabia that lies at an altitude of an around 2 km above the sea level, Cryptosporidium infection seems to be undiagnosed in nearly all clinical laboratories. Furthermore, nothing was published regarding Cryptosporidium-associated diarrhea in this area. The
objective
s of this research were to (1) determine the Cryptosporidium prevalence among patients with diarrhea and (2) to estimate the performances of 3 different diagnostic methods. Total 180 diarrheal fecal samples, 1 sample per patient, were collected between January and August 2013. Samples were screened for Cryptosporidium with modified Zeihl Neelsen (ZN) microscopy, RIDA® Quick lateral flow (LF) immunotest, and a previously published PCR. The Cryptosporidium prevalence rate was 9.4% (17/180), 10% (18/180), and 11.6% (21/180) by microscopy, LF, and PCR test, respectively. Infection was significantly (P=0.004) predominant among children <5 years (22%) followed by children 5-9 years (11.1%). Although infection was higher in males than in females (16.2% males and 8.5% females), the difference was not statistically significant (P=0.11). Compared to PCR, the sensitivity of microscopy and the LF test were 80.9%, 85.7%, respectively. To conclude, high Cryptosporidium-associated diarrhea was found in this area especially in children ≤9 years. The PCR test showed the best performance followed by the LF test and ZN staining microscopy. The primary health care providers in Al-Taif need to be aware of and do testing for this protozoon, particularly for children seen with diarrhea.

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Intestinal Parasitic Infections Among Pediatric Patients in a Metropolitan City of Bangladesh With Emphasis on Cryptosporidiosis
Nusrat Jahan Nipa, Nasima Aktar, Hasina M Hira, Farhana Akter, Dilshad Jahan, Salequl Islam, Ayukafangha Etando, Adnan Abdullah, Kona Chowdhury, Rahnuma Ahmad, Ahsanul Haq, Mainul Haque
Cureus.2022;[Epub] CrossRef
Cryptosporidium and Cryptosporidiosis: The Perspective from the Gulf Countries
Shahira A. Ahmed, Panagiotis Karanis
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Foodborne intestinal protozoan infection and associated factors among patients with watery diarrhea in Northern Ethiopia; a cross-sectional study
Birhane Berhe, Gessessew Bugssa, Sena Bayisa, Megbaru Alemu
Journal of Health, Population and Nutrition.2018;[Epub] CrossRef
Human cryptosporidiosis in Iran: a systematic review and meta-analysis
Reza Berahmat, Adel Spotin, Ehsan Ahmadpour, Mahmoud Mahami-Oskouei, Azim Rezamand, Nayyereh Aminisani, Morteza Ghojazadeh, Roghayeh Ghoyounchi, Tahereh Mikaeili-Galeh
Parasitology Research.2017; 116(4): 1111. CrossRef
Cryptosporidium and Giardia Infections in Children
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High Frequency of Enteric Protozoan, Viral, and Bacterial Potential Pathogens in Community-Acquired Acute Diarrheal Episodes: Evidence Based on Results of Luminex Gastrointestinal Pathogen Panel Assay
Yousry A. Hawash, Khadiga A. Ismail, Mazen Almehmadi
The Korean Journal of Parasitology.2017; 55(5): 513. CrossRef
Assessment of microscopic and molecular tools for the diagnosis and follow-up of cryptosporidiosis in patients at risk
Y. Le Govic, K. Guyot, G. Certad, A. Deschildre, R. Novo, C. Mary, B. Sendid, E. Viscogliosi, L. Favennec, E. Dei-Cas, E. Fréalle, E. Dutoit
European Journal of Clinical Microbiology & Infectious Diseases.2016; 35(1): 137. CrossRef
Genetic characterization of Cryptosporidium in animal and human isolates from Jordan
Nawal Hijjawi, Rami Mukbel, Rongchang Yang, Una Ryan
Veterinary Parasitology.2016; 228: 116. CrossRef

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13 Web of Science
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Breast-Feeding Protects Infantile Diarrhea Caused by Intestinal Protozoan Infections: Ekhlas Hamed Abdel-Hafeez, Usama Salah Belal, Manal Zaki Mohamed Abdellatif, Koji Naoi, Kazumi Norose; Korean J Parasitol 2013;51(5):519-524.
Published online October 31, 2013; DOI: https://doi.org/10.3347/kjp.2013.51.5.519

Abstract
PDF

This study investigated the effect of breast-feeding in protection against protozoan infection in infants with persistent diarrhea. Infants were classified into 2 groups; 161 breast-fed infants and the same number of non-breast-fed infants. Microscopic examinations of stool were done for detection of parasites and measuring the intensity of infection. Moreover, serum levels of IgE and TNF-α were measured by ELISA. Cryptosporidium spp., Entamoeba histolytica/Entamoeba dispar, Giardia lamblia, and Blastocystis sp. were demonstrated in infants with persistent diarrhea. The percentage of protozoan infections was significantly lower in breast-fed infants than that in the non-breast-fed infants. The levels of IgE and TNF-α were significantly lower in the breast-fed group than in the non-breast-fed group. There were significant positive associations between the serum levels of IgE and TNF-α and the intensity of parasite infection in the breast-fed group. It is suggested that breast-feeding has an attenuating effect on the rate and intensity of parasite infection.

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Case Reports

Isospora belli Infection with Chronic Diarrhea in an Alcoholic Patient: Min Jae Kim, Woo Ho Kim, Hyun-Chae Jung, Jee-Won Chai, Jong-Yil Chai; Korean J Parasitol 2013;51(2):207-212.
Published online April 25, 2013; DOI: https://doi.org/10.3347/kjp.2013.51.2.207

Abstract
PDF

Chronic diarrhea with a 35 kg weight loss (75 kg to 40 kg) occurred during 2 years in an alcoholic patient was diagnosed with Isospora belli infection in the Republic of Korea. The patient, a 70-year old Korean male, had been a heavy drinker for more than 30 years. He was admitted to the Seoul National University Hospital because of long-standing diarrhea and severe weight loss. He had an increased white blood cell (WBC) count with high peripheral blood eosinophilia (36.8-39.9%) and lowered protein and albumin levels but without any evidence of immunosuppression. A parasitic infection was suspected and fecal examination was repeated 3 times with negative results. Peroral endoscopy with mural biopsy was performed in the upper jejunum. The biopsy specimens revealed villous atrophy with loss of villi together with various life cycle stages of I. belli, including trophozoites, schizonts, merozoites, macrogamonts, and microgamonts. The patient was treated successfully with oral doses of trimethoprim 160-320 mg and sulfamethoxazole 800-1,600 mg daily for 4 weeks. A follow-up evaluation at 2.5 years later revealed marked improvement of body weight (68 kg), increased protein and albumin levels, and normal WBC count with low eosinophils (3.1%). This is the first clinical case of isoporiasis with demonstration of various parasitic stages in the Republic of Korea.

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Masashi Ohno, Osamu Inatomi, Takayuki Imai, Kenichiro Takahashi, Shigeki Bamba, Keiji Konishi, Masaya Sasaki, Ryoji Kushima, Akira Andoh
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Daniel J. Rowan, Samar Said, Audrey N. Schuetz, Bobbi S. Pritt
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J. P. Dubey, S. Almeria
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David Oddó, Gonzalo P. Méndez, Yasmina Retamal, Aarón Oddó
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Indian Journal of Medical Microbiology.2018; 36(4): 508. CrossRef
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Sze-Ann Woon, Rongchang Yang, Una Ryan, Peter Boan, David Prentice
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First Report of Feline Intestinal Trichomoniasis Caused by Tritrichomonas foetus in Korea: Sun Lim, Sang-Ik Park, Kyu-Sung Ahn, Dae-Sung Oh, Jae-Sook Ryu, Sung-Shik Shin; Korean J Parasitol 2010;48(3):247-251.
Published online September 16, 2010; DOI: https://doi.org/10.3347/kjp.2010.48.3.247

Abstract
PDF

Feline intestinal tritrichomoniasis by Tritrichomonas foetus was first recognized in USA in 1999 and has so far been reported from UK, Norway, Switzerland, and Australia, but not from the Far East Asian countries. In November 2008, 2 female and male littermate Siamese cats, 6-month old, raised in a household in Korea were referred from a local veterinary clinic with a history of chronic persistent diarrhea. A direct smear examination of fecal specimens revealed numerous trichomonad trophozoites which were isolated by the fecal culture in InPouch™ TF-Feline medium. A PCR testing of the isolate based on the amplification of a conserved portion of the T. foetus internal transcribed spacer (ITS) regions (ITS1 and ITS2) and the 5.8S rRNA gene, and the molecular sequencing of the PCR amplicons confirmed infection with T. foetus. This is the first clinical case of feline intestinal trichomoniasis caused by T. foetus in Korea.

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Didem PEKMEZCİ, Gökmen Zafer PEKMEZCİ, Ümit ÖZCAN, Duygu DALGIN, Mehmet TÜTÜNCÜ
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Jody L Gookin, Katherine Hanrahan, Michael G Levy
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F. Veronesi, A.L. Gazzonis, E. Napoli, E. Brianti, A. Santoro, S.A. Zanzani, E. Olivieri, M. Diaferia, S. Giannetto, M.G. Pennisi, M.T. Manfredi
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Original Article

Prevalence of Cryptosporidium sp. infection in diarrheic and non-diarrheic humans in Iran: Mohammad Mirzaei; Korean J Parasitol 2007;45(2):133-137.
Published online June 20, 2007; DOI: https://doi.org/10.3347/kjp.2007.45.2.133

Abstract
PDF

For evaluation of the prevalence of Cryptosporidium sp. infection in diarrheic and non-diarrheic humans in Iran, fecal specimens from diarrheic (n = 129) and non-diarrheic humans (n = 271) were collected and examined for the presence of Cryptosporidium sp. oocysts. The presence of Cryptosporidium sp. oocysts was determined by Ziehl-Neelsen acid-fast staining. Humans were grouped according to their age as follows: younger than 15, 16-25, 26-35, 36-50, and over 51 years. The results showed that the overall prevalence of infection in all 400 samples was 10.8%, but the prevalence (25.6%) in diarrheic humans was higher than that (3.7%) in non-diarrheic humans. Oocysts of Cryptosporidium sp. were detected in the feces of 21.4%, 9.3%, 8.8%, 6.7% and 5.7% of different age groups, respectively. The intensity of oocysts was significantly higher in diarrheic humans than in non-diarrheic ones. There was a significant association between Cryptosporidium sp. infection and occurrence of diarrhea (P < 0.05). The results indicate that Cryptosporidium sp. infection is prevalent in diarrheic humans in Iran.

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Brief Communication

Prevalence of diarrhea caused by Cryptosporidium parvum in non-HIV patients in Jeollanam-do, Korea: Jong-Kyu Lee, Hyeon-Je Song, Jae-Ran Yu; Korean J Parasitol 2005;43(3):111-114.
Published online September 20, 2005; DOI: https://doi.org/10.3347/kjp.2005.43.3.111

Abstract
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The present study investigated the prevalence rate of Cryptosporidium parvum as a cause of diarrhea. We examined 942 stools of unidentified reasons occurring in patients in whom no immunosuppression had been detected. We examined the stools for Cryptosporidium parvum via modified acid-fast staining. The clinical records of all of the positive patients were then analyzed. Nine (1%) of the stools among the 942 diarrheal patients were positive for C. parvum. The positive rate in the males was 1.1% (6/522) and the positive rate of the females was 0.7% (3/420). Age distribution revealed that the highest positive rates were in patients in their sixties, with a positive rate of 2.5% (4/158). In the clinical tests, levels of c-reactive protein, erythrocyte sedimentation rates, and neutrophil proportions were normally increased in the peripheral blood, whereas the lymphocyte proportion exhibited a tendency towards decrease. The pathological findings were compatible with an inflammatory reaction in the host.

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