Huruy Kahsay, Kassu Afework, Mulu Andargachew, Worku Netsanet, Fetene Teshome, Gebretsadik Simon, Biadglegne Fantahun, Belyhun Yeshambel, Muche Abebe, Gelaw Aschalew, Anagaw Belay, Yifru Sisay, Wondie Yemataw, Bekele Assegedech, Tiruneh Moges, Reissig Dieter, Moges Feleke
Department of Medical Laboratory Technology, College of Medicine and Health Sciences, University of Gondar, Ethiopia.
BMC Res Notes. 2011 Oct 31;4:472. doi: 10.1186/1756-0500-4-472.
Diarrheal diseases are the major causes of morbidity and mortality in developing world. Understanding the etiologic agents of diarrheal diseases and their association with socio-demographic characteristics of patients would help to design better preventive measures. Thus, this study was aimed to determine the prevalence of intestinal parasites and enteropathogenic bacteria in diarrheic patients.
A cross-sectional study involving 384 consecutive diarrheal patients who visited Gondar teaching hospital, Gondar, Ethiopia from October 2006 to March 2007 was conducted. Stool specimens were collected and examined for intestinal parasites and enteropathogenic bacteria following standard parasitological and microbiological procedures.
Intestinal parasites were diagnosed in 36.5% of the patients. The most frequently encountered protozoan parasite was Entamoeba histolytica/dispar (7.3%) followed by Giardia lamblia (5.0%), Cryptosporidium parvum (1.8%) and Isospora belli (1.3%). The dominant helminthic parasite identified was Ascaris lumbricoides (5.5%) followed by Strongyloides stercoralis and Schistosoma mansoni (3.1% each), hookworm infection (1.8%), and Hymenolepis species (1.3%). Multiple infections of intestinal parasites were also observed in 6.3% of the patients. Among the enteropathogenic bacteria Shigella and Salmonella species were isolated from 15.6% and 1.6%, respectively, of the patients. Escherichia coli O57:H7 was not found in any of the stool samples tested. Eighty eight percent and 83.3% of the Shigella and Salmonella isolates were resistant to one or more commonly used antibiotics, respectively.Intestinal parasitosis was higher in patients who live in rural area, in patients who were washing their hands after visiting toilet either irregularly with soap and without soap or not at all, in patients who used well and spring water for household consumption, and in patients who had nausea (P < 0.05). Statistically significant associations were also observed between Shigella infections and patients who were using well and spring water for household consumption, and patients who had dysentery and mucoid stool (P < 0.05).
The high prevalence of intestinal parasites and Shigella species in diarrheic patients calls for institution of appropriate public health intervention measures to reduce morbidity and mortality associated with these diseases. The rational use of antibiotics should also be practiced.
腹泻病是发展中国家发病和死亡的主要原因。了解腹泻病的病原体及其与患者社会人口学特征的关联，将有助于设计更好的预防措施。因此，本研究旨在确定腹泻患者肠道寄生虫和肠道致病菌的患病率。
对2006年10月至2007年3月期间连续就诊于埃塞俄比亚贡德尔教学医院的384例腹泻患者进行了一项横断面研究。按照标准的寄生虫学和微生物学程序收集粪便标本，并检测肠道寄生虫和肠道致病菌。
36.5%的患者被诊断出患有肠道寄生虫。最常见的原生动物寄生虫是溶组织内阿米巴/迪斯帕内阿米巴（7.3%），其次是蓝氏贾第鞭毛虫（5.0%）、微小隐孢子虫（1.8%）和贝氏等孢球虫（1.3%）。鉴定出的主要蠕虫寄生虫是蛔虫（5.5%），其次是粪类圆线虫和曼氏血吸虫（各3.1%）、钩虫感染（1.8%）和膜壳绦虫属（1.3%）。6.3%的患者还观察到肠道寄生虫多重感染。在肠道致病菌中，分别从15.6%和1.6%的患者中分离出志贺菌属和沙门菌属。在所检测的任何粪便样本中均未发现大肠杆菌O57:H7。分别有88%和83.3%的志贺菌和沙门菌分离株对一种或多种常用抗生素耐药。生活在农村地区的患者、上厕所后不定期用肥皂或不用肥皂洗手或根本不洗手的患者、使用井水和泉水作为家庭用水的患者以及有恶心症状的患者肠道寄生虫感染率较高（P<0.05）。在使用井水和泉水作为家庭用水的患者以及患有痢疾和黏液便的患者中，也观察到志贺菌感染与患者之间具有统计学意义的关联（P<0.05）。
腹泻患者中肠道寄生虫和志贺菌属的高患病率要求采取适当的公共卫生干预措施，以降低与这些疾病相关的发病率和死亡率。还应合理使用抗生素。
