Incani Renzo Nino, Ferrer Elizabeth, Hoek Denise, Ramak Robbert, Roelfsema Jeroen, Mughini-Gras Lapo, Kortbeek Titia, Pinelli Elena
Laboratorio de Investigaciones en Bilharzia, Departamento de Parasitología, Facultad de Ciencias de la Salud, Universidad de Carabobo, Campus Carabobo, Valencia, Venezuela.
Instituto de Investigaciones Biomédicas "Dr. Francisco J. Triana Alonso" (BIOMED) and Departamento de Parasitología, Facultad de Ciencias de la Salud, Universidad de Carabobo, Sede Aragua, Maracay, Venezuela.
Acta Trop. 2017 Mar;167:64-70. doi: 10.1016/j.actatropica.2016.12.014. Epub 2016 Dec 19.
A cross-sectional study was carried out to determine the prevalence and diagnostic performance of microscopy and real time PCR (RT-PCR) for 14 intestinal parasites in a Venezuelan rural community with a long history of persistent intestinal parasitic infections despite the implementation of regular anthelminthic treatments. A total of 228 participants were included in this study. A multiplex RT-PCR was used for the detection of Dientamoeba fragilis, Giardia intestinalis, Cryptosporidium sp. and a monoplex RT-PCR for Entamoeba histolytica. Furthermore, a multiplex PCR was performed for detection of Ascaris lumbricoides, Strongyloides stercoralis, Necator americanus and Ancylostoma duodenale. Combined microscopy-PCR revealed prevalences of 49.3% for A. lumbricoides, 10.1% for N. americanus (no A. duodenale was detected), 2.0% for S. stercoralis, 40.4% for D. fragilis, 35.1% for G. intestinalis, and 7.9% for E. histolytica/dispar. Significant increases in prevalence at PCR vs. microscopy were found for A. lumbricoides, G. intestinalis and D. fragilis. Other parasites detected by microscopy alone were Trichuris trichiura (25.7%), Enterobius vermicularis (3.4%), Blastocystis sp. (65.8%), and the non-pathogenic Entamoeba coli (28.9%), Entamoeba hartmanni (12.3%), Endolimax nana (19.7%) and Iodamoeba bütschlii (7.5%). Age- but no gender-related differences in prevalences were found for A. lumbricoides, T. trichiura, G. intestinalis, and E. histolytica/dispar. The persistently high prevalences of intestinal helminths are probably related to the high faecal pollution as also evidenced by the high prevalences of non-pathogenic intestinal protozoans. These results highlight the importance of using sensitive diagnostic techniques in combination with microscopy to better estimate the prevalence of intestinal parasites, especially in the case of D. fragilis trophozoites, which deteriorate very rapidly and would be missed by microscopy. In addition, the differentiation between the pathogenic E. histolytica and the non-pathogenic E. dispar can be attained. However, microscopy remains an important diagnostic tool since it can detect other intestinal parasites for which no PCR is available.
在委内瑞拉一个农村社区开展了一项横断面研究，以确定显微镜检查和实时荧光定量聚合酶链反应（RT-PCR）对14种肠道寄生虫的感染率及诊断效能。尽管定期进行驱虫治疗，但该社区长期存在肠道寄生虫持续感染的情况。本研究共纳入228名参与者。采用多重RT-PCR检测脆弱双核阿米巴、肠贾第虫、隐孢子虫属，采用单重RT-PCR检测溶组织内阿米巴。此外，采用多重PCR检测蛔虫、粪类圆线虫、美洲板口线虫和十二指肠钩口线虫。显微镜检查与PCR联合检测显示，蛔虫感染率为49.3%，美洲板口线虫感染率为10.1%（未检测到十二指肠钩口线虫），粪类圆线虫感染率为2.0%，脆弱双核阿米巴感染率为40.4%，肠贾第虫感染率为35.1%，溶组织内阿米巴/迪斯帕内阿米巴感染率为7.9%。蛔虫、肠贾第虫和脆弱双核阿米巴的PCR检测感染率显著高于显微镜检查。仅通过显微镜检查检测到的其他寄生虫有鞭虫（25.7%）、蛲虫（3.4%）、芽囊原虫（65.8%）以及非致病性的大肠内阿米巴（28.9%）、哈氏内阿米巴（12.3%）、微小内蜒阿米巴（19.7%）和布氏嗜碘阿米巴（7.5%）。蛔虫、鞭虫、肠贾第虫和溶组织内阿米巴/迪斯帕内阿米巴的感染率在年龄上存在差异，但在性别上无差异。肠道蠕虫持续的高感染率可能与高粪便污染有关，非致病性肠道原生动物的高感染率也证明了这一点。这些结果突出了使用敏感诊断技术并结合显微镜检查以更好地估计肠道寄生虫感染率的重要性，特别是对于脆弱双核阿米巴滋养体，其迅速退化，显微镜检查可能会漏检。此外，还可以区分致病性溶组织内阿米巴和非致病性迪斯帕内阿米巴。然而，显微镜检查仍然是一项重要的诊断工具，因为它可以检测到没有PCR检测方法的其他肠道寄生虫。
