Institute of Food Safety, Animal Health and Environment BIOR, 1076 Riga, Latvia.
Faculty of Biology, University of Latvia, 1004 Riga, Latvia.
Medicina (Kaunas). 2022 Mar 24;58(4):471. doi: 10.3390/medicina58040471.
: Protozoan parasites- and -are important causes of diarrhea with an underestimated short-term burden on childhood growth and wellbeing in children under five years of age. The main transmission routes for both parasites are food and drinking water; transmission from person to person; and, due to their zoonotic nature, from domestic or wild animals to humans. The aims of the present study were to summarize the officially reported human cases of cryptosporidiosis and giardiasis in Latvia and to assess the occurrence of and in children within a prospective prevalence study. : The number of officially reported cases of cryptosporidiosis and giardiasis in the time period of 2000-2020 was collected from the Centre for Disease Prevention and Control of Latvia. Data from a clinical diagnostic laboratory were included in the study in the period from 1 January 2008 to 31 December 2018. Additionally, a prospective study was performed, and fecal samples were collected from unique 0-17-year-old patients from January to February 2021 and tested using fluorescent microscopy. : Overall, during the 20-year period, 71 cases (mean per year = 9) of cryptosporidiosis and 1020 (mean per year = 34) cases of giardiasis were officially reported in Latvia. Meanwhile, within the prospective study, we found 35 (6.0%; 95%CI 4.3-8.1) and 42 (7.2%; 95%CI 5.3-9.6) cases. : Here, we provide clear proof that both and are underdiagnosed in Latvia, which could also be true for neighboring Baltic and European countries, where a low number of cases are officially reported. Therefore, we highlight the hypothesis that the actual number of cryptosporidiosis and giardiasis human cases in the Baltic states is higher than that officially reported, including in Latvia.
原生动物寄生虫——隐孢子虫和贾第虫——是导致 5 岁以下儿童腹泻的重要原因，它们对儿童的短期生长和健康造成了被低估的负担。这两种寄生虫的主要传播途径是食物和饮用水；人与人之间的传播；以及由于其人畜共患的性质，从家养或野生动物传播给人类。本研究的目的是总结拉脱维亚官方报告的隐孢子虫病和贾第虫病的人类病例，并评估前瞻性患病率研究中儿童隐孢子虫病和贾第虫病的发生情况。
在 2000 年至 2020 年期间，从拉脱维亚疾病预防和控制中心收集了官方报告的隐孢子虫病和贾第虫病病例数。本研究还包括了来自临床诊断实验室的数据，时间为 2008 年 1 月 1 日至 2018 年 12 月 31 日。此外，还进行了一项前瞻性研究，从 2021 年 1 月至 2 月，收集了独特的 0-17 岁患者的粪便样本，并使用荧光显微镜进行了检测。
总体而言，在 20 年期间，拉脱维亚官方报告了 71 例（年平均=9）隐孢子虫病和 1020 例（年平均=34）贾第虫病。与此同时，在前瞻性研究中，我们发现了 35 例（6.0%；95%CI 4.3-8.1）和 42 例（7.2%；95%CI 5.3-9.6）隐孢子虫病。
在这里，我们提供了明确的证据，证明在拉脱维亚，隐孢子虫病和贾第虫病都被漏诊了，这种情况在波罗的海和欧洲邻国也可能存在，因为这些国家官方报告的病例数量较少。因此，我们提出了一个假设，即波罗的海国家的隐孢子虫病和贾第虫病实际人类病例数高于官方报告的数量，包括拉脱维亚。
