Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-29T22:26:54.745Z Has data issue: false hasContentIssue false
  • English
  • Français

Drinking water is a significant predictor of Blastocystis infection among rural Malaysian primary schoolchildren

Published online by Cambridge University Press:  23 March 2012

AWATIF M. ABDULSALAM ,
INIT ITHOI ,
HESHAM M. AL-MEKHLAFI ,
ABDULHAMID AHMED ,
JOHARI SURIN  and
JOON-WAH MAK
AWATIF M. ABDULSALAM
Affiliation:
Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
INIT ITHOI*
Affiliation:
Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
HESHAM M. AL-MEKHLAFI
Affiliation:
Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
ABDULHAMID AHMED
Affiliation:
Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
JOHARI SURIN
Affiliation:
Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
JOON-WAH MAK
Affiliation:
School of Postgraduate Studies and Research, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia
*
*Corresponding author: Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. Tel: +6 03 79674767. Fax: +6 03 79674754. E-mail: [email protected], [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

Blastocystis infection has a worldwide distribution especially among the disadvantaged population and immunocompromised subjects. This study was carried out to determine the prevalence and the association of Blastocystis infection with the socio-economic characteristics among 300 primary schoolchildren, living in rural communities in Lipis and Raub districts of Pahang state, Malaysia. Stool samples were collected and examined for the presence of Blastocystis using direct smear microscopy after in vitro cultivation in Jones' medium. The overall prevalence of Blastocystis infection was found to be as high as 25·7%. The prevalence was significantly higher among children with gastrointestinal symptoms as compared to asymptomatic children (x2=4·246; P=0·039). Univariate and multivariate analyses showed that absence of a piped water supply (OR=3·13; 95% CI=1·78, 5·46; P<0·001) and low levels of mothers’ education (OR=3·41; 95% CI=1·62, 7·18; P<0·01) were the significant predictors of Blastocystis infection. In conclusion, Blastocystis is prevalent among rural children and the important factors that determine the infection were the sources of drinking water and mothers' educational level. Interventions with provision of clean water supply and health education especially to mothers are required.

Keywords

Blastocystispredictorsdrinking waterschoolchildrenMalaysia
Type
Research Article
Information
Parasitology , Volume 139 , Issue 8 , July 2012 , pp. 1014 - 1020
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Al-Mekhlafi, M. H., Surin, J., Atiya, A. S., Ariffin, W. A., Mahdy, M. A. K. and Abdullah, H. C. (2008). Pattern and predictors of soil-transmitted helminth re-infection among Aboriginal schoolchildren in rural peninsular Malaysia. Acta Tropica 107, 200–204.CrossRefGoogle Scholar
Azman, J., Init, I. and Wan Yusoff, W. S. (2009). Occurrence of Giardia and Cryptosporidium oocysts in the river water of two recreational areas in Selangor, Malaysia. Tropical Biomedicine 26, 289–302.Google ScholarPubMed
Baldo, E. T., Belizario, V. Y., De Leon, W. U., Kong, H. H. and Chung, D. I. (2004). Infection status of intestinal parasites in children living in residential institutions in Metro Manila, the Philippines. Korean Journal of Parasitology 42, 67–70.CrossRefGoogle ScholarPubMed
Baldursson, S. and Karanis, P. (2011). Waterborne transmission of protozoan parasites: review of worldwide outbreaks – an update 2004–2010. Water Research 45, 6603–6614.CrossRefGoogle ScholarPubMed
Boeke, C. E., Mora-Plazas, M., Forero, Y. and Villamor, E. (2010). Intestinal protozoan infections in relation to nutritional status and gastrointestinal morbidity in Colombian schoolchildren. Journal of Tropical Pediatrics 56, 299–306.CrossRefGoogle Scholar
Cook, D. M., Swanson, R. C., Eggett, D. L. and Booth, G. M. (2009). A retrospective analysis of prevalence of gastrointestinal parasites among schoolchildren in the Palajunoj Valley of Guatemala. Journal of Health, Population and Nutrition 27, 31–41.CrossRefGoogle Scholar
Daryani, A., Barmaki, N., Ettehad, G. H., Sharif, M., Nemati, A. and Ziaei, H. (2006). A cross-sectional study of Blastocystis hominis in primary schoolchildren, Northwest Iran. International Journal of Tropical Medicine 1, 53–57.Google Scholar
Eroglu, F. and Koltas, I. S. (2010). Evaluation of the transmission mode of B. hominis by using PCR method. Parasitology Research 107, 841–845.CrossRefGoogle ScholarPubMed
Galantowicz, B. B., Illueca, M. D., Levy, J., Rayburn, J. L. and Weinstock, D. J. (1993). Neonatal Blastocystis hominis diarrhea. Pediatric Infectious Disease Journal 12, 345–346.CrossRefGoogle ScholarPubMed
Gamboa, M. I., Navone, G. T., Orden, A. B., Torres, M. F., Castro, L. E. and Oyhenart, E. E. (2011). Socio-environmental conditions, intestinal parasitic infections and nutritional status in children from a suburban neighborhood of La Plata, Argentina. Acta Tropica 118, 184–189.CrossRefGoogle ScholarPubMed
Hakim, S. L., Gan, C. C., Malkit, K., Azian, M. N., Chong, C. K., Shaari, N., Zainuddin, W., Chin, C. N., Sara, Y. and Lye, M. S. (2007). Parasitic infections among Orang Asli (Aborigine) in the Cameron Highlands, Malaysia. Southeast Asian Journal of Tropical Medicine and Public Health 38, 415–419.Google Scholar
Horiki, N., Kaneda, Y., Maruyama, M., Fujita, Y. and Tachibana, H. (1999). Intestinal blockage by carcinoma and Blastocystis hominis infections. The American Journal of Tropical Medicine and Hygiene 60, 400–402.CrossRefGoogle Scholar
Hu, K. C., Lin, C. C., Wang, T. E., Liu, C. Y., Chen, M. J. and Chang, W. H. (2008). Amoebic liver abscess or is it? Gut 57, 627.CrossRefGoogle ScholarPubMed
Ithoi, I. (1999). Immunology and molecular studies of Blastocystis hominis isolates from symptomatic and asymptomatic patients. Ph.D. thesis. University of Malaya, Kuala Lumpur, Malaysia.Google Scholar
Ithoi, I., Azman, J., Mak, J. W., Wan Yusoff, W. S. and Rohela, M. (2011). Occurrence of Blastocystis in water of two rivers from recreational areas in Malaysia. Journal of Parasitology Research 2011, doi: 10.1155/2011/123916.CrossRefGoogle ScholarPubMed
Janarthanan, S., Khoury, N. and Antaki, F. (2011). An unusual case of invasive Blastocystis hominis infection. Endoscopy 43, E185–E186.CrossRefGoogle ScholarPubMed
Karanis, P., Kourenti, C. and Smith, H. (2007). Waterborne transmission of protozoan parasites: a worldwide review of outbreaks and lessons learnt. Journal of Water and Health 5, 1–38.CrossRefGoogle ScholarPubMed
Kaya, S., Cetin, E. S., Aridogan, B. C., Arikan, S. and Demirci, M. (2007). Pathogenicity of Blastocystis hominis, a clinical re-evaluation. Acta parasitologica Turcica 31, 184–187.Google Scholar
Kurniawan, A., Karyadi, T., Dwintasari, S. W., Sari, I. P., Yunihastuti, E., Djauzi, S. and Smith, H. V. (2009). Intestinal parasitic infections in HIV/AIDS patients presenting with diarrhoea in Jakarta, Indonesia. Transactions of the Royal Society of Tropical Medicine and Hygiene 103, 892–898.CrossRefGoogle ScholarPubMed
Leder, K., Hellard, M. E., Sinclair, M. I., Fairley, C. K., Wolfe, R. (2005). No correlation between clinical symptoms and Blastocystis hominis in immunocompetent individuals. Journal of Gastroenterology and Hepatology 20, 1390–1394.CrossRefGoogle ScholarPubMed
Leelayoova, S., Siripattanapipong, S., Thathaisong, U., Naaglor, T., Taamasri, P., Piyaraj, P. and Mungthin, M. (2008). Drinking water: a possible source of Blastocystis spp. subtype 1 infection in schoolchildren of a rural community in central Thailand. The American Journal of Tropical Medicine and Hygiene 79, 401–406.CrossRefGoogle ScholarPubMed
Li, L. H., Zhou, X. N., Du, Z. W., Wang, X. Z., Wang, L. B., Jiang, J. Y., Yoshikawa, H., Steinmann, P., Utzinger, J., Wu, Z., Chen, J. X., Chen, S. H. and Zhang, L. (2007). Molecular epidemiology of human Blastocystis in a village in Yunnan province, China. Parasitology International 56, 281–286.CrossRefGoogle Scholar
Menon, B. S., Abdullah, M., Mahamud, F. and Singh, B. (1999). Brief report: Intestinal parasites in Malaysian children with cancer. Journal of Tropical Pediatrics 45, 241–242.CrossRefGoogle Scholar
Moe, K. T., Singh, M., Howe, J., Ho, L. C., Tan, S. W., Ng, G. C., Chen, X. Q. and Yap, E. H. (1996). Observations on the ultrastructure and viability of the cystic stage of Blastocystis hominis from human feces. Parasitology Research 82, 439–444.CrossRefGoogle ScholarPubMed
Nimri, L. F. (1993). Evidence of an epidemic of Blastocystis hominis infections in preschool-children in Northern Jordan. Journal of Clinical Microbiology 31, 2706–2708.CrossRefGoogle ScholarPubMed
Nimri, L. and Batchoun, R. (1994). Intestinal colonization of symptomatic and asymptomatic schoolchildren with Blastocystis hominis. Journal of Clinical Microbiology 32, 2865–2866.CrossRefGoogle ScholarPubMed
Noor Azian, M. Y., San, Y. M., Gan, C. C., Yusri, M. Y., Nurulsyamzawaty, Y., Zuhaizam, A. H., Maslawaty, M. N., Norparina, I. and Vythilingam, I. (2007). Prevalence of intestinal protozoa in an aborigine community in Pahang, Malaysia. Tropical Biomedicine 24, 55–62.Google Scholar
Okyay, P., Ertug, S., Gultekin, B., Onen, O. and Beser, E. (2004). Intestinal parasites prevalence and related factors in school children, a western city sample-Turkey. BMC Public Health 4, 64.CrossRefGoogle ScholarPubMed
Qadri, S. M., al-Okaili, G. A. and al-Dayel, F. (1989). Clinical significance of Blastocystis hominis. Journal of Clinical Microbiology 27, 2407–2409.CrossRefGoogle ScholarPubMed
Rayan, P., Verghese, S. and McDonnell, P. (2010). Geographical location and age affects the incidence of parasitic infestations in schoolchildren. Indian Journal of Pathology and Microbiology 53, 498–504.CrossRefGoogle Scholar
Sinniah, B. and Rajeswari, B. (1994). Blastocystis hominis infection, a cause of human diarrhea. Southeast Asian Journal of Tropical Medicine and Public Health 25, 490–493.Google ScholarPubMed
Sohail, M. R. and Fischer, P. R. (2005). Blastocystis hominis and travelers. Travel Medicine and Infectious Disease 3, 33–38.CrossRefGoogle ScholarPubMed
Stenzel, D. J. and Boreham, P. F. (1996). Blastocystis hominis revisited. Clinical Microbiology Reviews 9, 563–584.CrossRefGoogle ScholarPubMed
Sun, T., Katz, S., Tanenbaum, B. and Schenone, C. (1989). Questionable clinical significance of Blastocystis hominis infection. American Journal of Gastroenterology 84, 1543–1547.Google ScholarPubMed
Taamasri, P., Mungthin, M., Rangsin, R., Tongupprakarn, B., Areekul, W. and Leelayoova, S. (2000). Transmission of intestinal blastocystosis related to the quality of drinking water. Southeast Asian Journal of Tropical Medicine and Public Health 31, 112–117.Google Scholar
Tan, K. S., Mirza, H., Teo, J. D., Wu, B. and Macary, P. A. (2010). Current views on the clinical relevance of Blastocystis spp. Current Infectious Disease Reports 12, 28–35.CrossRefGoogle ScholarPubMed
Tan, K. S. W. (2004). Blastocystis in humans and animals: new insights using modern methodologies. Veterinary Parasitology 126, 121–144.CrossRefGoogle ScholarPubMed
Tan, K. S. W. (2008). New insights on classification, identification, and clinical relevance of Blastocystis spp. Clinical Microbiology Reviews 21, 639–665.CrossRefGoogle ScholarPubMed
Tasova, Y., Sahin, B., Koltas, S. and Paydas, S. (2000). Clinical significance and frequency of Blastocystis hominis in Turkish patients with hematological malignancy. Acta Medica Okayama 54, 133–136.Google ScholarPubMed
Yaicharoen, R., Ngrenngarmlert, W., Wongjindanon, N., Sripochang, S. and Kiatfuengfoo, R. (2006). Infection of Blastocystis hominis in primary schoolchildren from Nakhon Pathom province, Thailand. Tropical Biomedicine 23, 117–122.Google ScholarPubMed
Yoshikawa, H., Abe, N. and Wu, Z. (2004). PCR-based identification of zoonotic isolates of Blastocystis from mammals and birds. Microbiology 150, 1147–1151.CrossRefGoogle ScholarPubMed
Yoshikawa, H., Wu, Z., Nagano, I. and Takahashi, Y. (2003). Molecular comparative studies among Blastocystis isolates obtained from humans and animals. Journal of Parasitology 89, 585–594.CrossRefGoogle ScholarPubMed
Yoshikawa, H., Wu, Z., Pandey, K., Pandey, B. D., Sherchand, J. B., Yanagi, T. and Kanbara, H. (2009). Molecular characterization of Blastocystis isolates from children and rhesus monkeys in Kathmandu, Nepal. Veterinary Parasitology 160, 295–300.CrossRefGoogle ScholarPubMed
Zaman, V., Howe, J. and Ng, M. (1995). Ultrastructure of Blastocystis hominis cysts. Parasitology Research 81, 465–469.CrossRefGoogle ScholarPubMed