Elmahallawy Ehab Kotb, Gareh Ahmed, Ghallab Marwa M I, Köster Pamela C, Dashti Alejandro, Aboelsoued Dina, Toaleb Nagwa Ibrahim, Alzaylaee Hind, Gonzálvez Moisés, Saleh Amira A, Alhegaili Alaa S, Eldehn Ahmed Fathy, Hernández-Castro Carolina, Bailo Begoña, González-Barrio David, Carmena David
Department of Zoonoses, Faculty of Veterinary Medicine, Sohag University, Sohag, Egypt.
Departamento de Sanidad Animal, Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), Universidad de Córdoba, Córdoba, Spain.
Front Public Health. 2024 Apr 5;12:1377123. doi: 10.3389/fpubh.2024.1377123. eCollection 2024.
Giardiosis remains one of the most prevalent enteric parasitic infections globally. Earlier molecular-based studies conducted in Egypt have primarily focused on paediatric clinical populations and most were based on single genotyping markers. As a result, there is limited information on the frequency and genetic diversity of infections in individuals of all age groups.
Individual stool samples ( = 460) from outpatients seeking medical care were collected during January-December 2021 in Kafr El-Sheikh governorate, northern Egypt. Initial screening for the presence of was conducted by coprological examination. Microscopy-positive samples were further confirmed by real-time PCR. A multilocus sequence typing approach targeted amplification of the glutamate dehydrogenase (), beta- (), and triose phosphate isomerase () genes was used for genotyping purposes. A standardised epidemiological questionnaire was used to gather basic sociodemographic and clinical features of the recruited patients.
cysts were observed in 5.4% (25/460, 95% CI: 3.6-7.9) of the stool samples examined by conventional microscopy. The infection was more frequent in children under the age of 10 years and in individuals presenting with diarrhoea but without reaching statistical significance. Stool samples collected during the winter period were more likely to harbour . All 25 microscopy-positive samples were confirmed by real-time PCR, but genotyping data was only available for 56.0% (14/25) of the isolates. Sequence analyses revealed the presence of assemblages A (78.6%, 11/14) and B (21.4%, 3/14). All assemblage A isolates were identified as sub-assemblage AII, whereas the three assemblage B sequences belonged to the sub-assemblage BIII. Patients with giardiosis presenting with diarrhoea were more frequently infected by the assemblage A of the parasite.
This is one of the largest epidemiological studies evaluating infection in individuals of all age groups in Egypt. Our molecular data suggest that infections in the surveyed population are primarily of anthropic origin. However, because assemblages A and B are zoonotic, some of the infections identified can have an animal origin. Additional investigations targeting animal (domestic and free-living) and environmental (water) samples are warranted to better understand the epidemiology of giardiosis in Egypt.
贾第虫病仍然是全球最普遍的肠道寄生虫感染之一。埃及早期基于分子的研究主要集中在儿科临床人群，且大多数基于单一基因分型标记。因此，关于所有年龄组个体感染的频率和遗传多样性的信息有限。
2021年1月至12月期间，在埃及北部卡夫尔谢赫省收集了寻求医疗护理的门诊患者的个体粪便样本（n = 460）。通过粪便学检查对贾第虫的存在进行初步筛查。显微镜检查呈阳性的样本通过实时PCR进一步确认。采用多位点序列分型方法，靶向扩增谷氨酸脱氢酶（gdh）、β-微管蛋白（tub）和磷酸丙糖异构酶（tpi）基因用于基因分型。使用标准化的流行病学问卷收集招募患者的基本社会人口统计学和临床特征。
通过传统显微镜检查，在5.4%（25/460，95%CI：3.6 - 7.9）的粪便样本中观察到贾第虫囊肿。感染在10岁以下儿童和出现腹泻的个体中更常见，但未达到统计学意义。冬季收集的粪便样本更有可能携带贾第虫。所有25个显微镜检查呈阳性的样本均通过实时PCR确认，但基因分型数据仅适用于56.0%（14/25）的分离株。序列分析显示存在A群（78.6%，11/14）和B群（21.4%，3/14）。所有A群分离株均被鉴定为AII亚群，而三个B群序列属于BIII亚群。出现腹泻的贾第虫病患者更常被该寄生虫的A群感染。
这是埃及评估所有年龄组个体贾第虫感染的最大规模流行病学研究之一。我们的分子数据表明，被调查人群中的贾第虫感染主要源于人类。然而，由于A群和B群是人畜共患病原体，一些已鉴定的感染可能来自动物。有必要针对动物（家养和自由生活）和环境（水）样本进行进一步调查，以更好地了解埃及贾第虫病的流行病学。
