Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
PLoS One. 2011;6(7):e22044. doi: 10.1371/journal.pone.0022044. Epub 2011 Jul 18.
Intestinal protozoan diseases in Yemen are a significant health problem with prevalence ranging from 18% to 27%. The present study is a cross-sectional study aimed at determining the factors associated with the high prevalence of intestinal protozoan infections among patients seeking health care in Sana'a City, the capital of Yemen.
METHODOLOGY/PRINCIPAL FINDINGS: Stool samples were collected from 503 patients aged between 1 and 80 years old; 219 were males and 284 females. Biodata were collected via pretested standard questionnaire. Faecal samples were processed and examined for (oo)cysts or ova using a wet mount preparation after formal-ether concentration technique. Cryptosporidium oocysts were detected using the Ziehl-Neelsen staining technique. The overall prevalence of intestinal protozoan infections was 30.9%. Infection rates of Giardia duodenalis, Entamoeba histolytica/dispar and Cryptosporidium were 17.7%, 17.1% and 1%, respectively. Other parasites detected included Ascaris lumbricoides (2.4%), Schistosoma mansoni (0.3%), Hymenolepis nana (1.4%) and Enterobius vermicularis (0.4%). Multivariate analysis using forward stepwise logistic regression based on intestinal protozoan infections showed that contact with animals (OR = 1.748, 95% CI = 1.168-2.617) and taking bath less than twice a week (OR = 1.820, 95% CI = 1.192-2.779) were significant risk factors of protozoan infections.
CONCLUSIONS/SIGNIFICANCE: This present study indicated that intestinal protozoan infections are still a public health problem in Yemen, with Giardia and Entamoeba infections being most common. Statistical analysis indicated that low personal hygiene and contact with animals were important predictors for intestinal protozoan infections. As highlighted in this study, in order to effectively reduce these infections, a multi-sectoral effort is needed. Preventive measures should include good hygienic practices, good animal husbandry practices, heightened provision of educational health programs, health services in all governorates including rural areas. Furthermore, it is also essential to find radical solutions to the recent water crises in Yemen.
在也门，肠道原生动物病是一个严重的健康问题，其患病率在 18%至 27%之间。本研究是一项横断面研究，旨在确定在也门首都萨那市寻求医疗保健的患者中肠道原生动物感染高发的相关因素。
方法/主要发现：收集了 503 名年龄在 1 至 80 岁之间的患者的粪便样本；其中男性 219 人，女性 284 人。通过预测试的标准问卷收集了生物数据。使用湿片制备法和甲醛-乙醚浓缩技术对粪便样本进行处理，并检查（oo）卵囊或卵。使用齐尔-尼尔森染色技术检测隐孢子虫卵囊。肠道原生动物感染的总患病率为 30.9%。十二指肠贾第鞭毛虫、溶组织内阿米巴/迪斯帕和隐孢子虫的感染率分别为 17.7%、17.1%和 1%。检测到的其他寄生虫包括蛔虫（2.4%）、曼氏血吸虫（0.3%）、细粒棘球绦虫（1.4%）和蛲虫（0.4%）。基于肠道原生动物感染的向前逐步逻辑回归多变量分析表明，与动物接触（OR = 1.748，95%CI = 1.168-2.617）和每周洗澡次数少于两次（OR = 1.820，95%CI = 1.192-2.779）是原生动物感染的显著危险因素。
结论/意义：本研究表明，肠道原生动物感染仍然是也门的一个公共卫生问题，其中贾第鞭毛虫和溶组织内阿米巴感染最为常见。统计分析表明，个人卫生水平低和与动物接触是肠道原生动物感染的重要预测因素。正如本研究强调的那样，为了有效减少这些感染，需要多部门共同努力。预防措施应包括良好的卫生习惯、良好的畜牧业实践、加强提供教育健康计划、在所有省份包括农村地区提供卫生服务。此外，还必须找到也门最近水资源危机的根本解决方案。
