Investigation on common infection of diarrhea-causing parasitic protozoa in Shanghai during 2015—2019

doi:10.12140/j.issn.1000-7423.2021.06.020

Abstract

Abstract:

To understand common infection status of diarrhea-causing parasitic protozoa in residents of Shanghai Municipality, a survey was carried out through selecting 1-2 general hospitals from five districts, including Changning, Hongkou, Minhang, Jiading and Pudong New District, as surveillance sites in 2015—2019. Fecal samples were collected from diarrhea patients (defecation for more than three times within 24 h, with abnormal feces appearance), who visited the surveillance site hospital, based on the principle of sampling from both urban and the suburb districts. Using the methods of direct smear with saline, iodine staining, acid-fast staining and coproantigen immuno-chromatography, the fecal samples were examined for Entamoeba histolytica, Giardia lamblia and Cryptosporidium, and analyzing the infection status. The results showed that a total of 6 984 fecal samples were collected from diarrhea patients and examined etiologically, of them 9 were found positive, with an overall infection rate of 0.13% (9/6 984) in 2015—2019. Among the positives, 4 were infected with E. histolytica, 2 were G. lamblia and 3 were Cryptosporidium. The positive rates in each year were 0.08% (1/1 207), 0.40% (5/1 254), 0.13% (2/1 506), 0 (0/1 509) and 0.07% (1/1 508), respectively. Among the 6 984 patients with diarrhea, the age group of 30-40 years (1 370) had 4 cases of protozoa infection; of 3 345 males, 4 were found protozoa positive, while from 3 639 females, 5 were positive; there were 2, 2, 2, 3 positive cases were detected in districts of Changning, Hongkou, Minhang, and Jiading, whereas no positive cases were detected in Pudong New District. Protozoan coproantigen fast test strip detected 31 positives, with an overall positive rate of 0.44% (31/6 984), which was significantly different from the findings by pathogen examination (χ² = 12.13,P < 0.01). The positive rate of parasitic protozoa was found at a considerably low level, maintaining at low prevalence and in scattering distribution in Shanghai. Therefore, it is urged to carry on health education, and to strengthen continuous and effective surveillance; applying combined approaches of etiology, immunology, and molecular biology for improving the detection rate.

Key words: Diarrhea, Parasitic protozoon, Infection, Shanghai City

CLC Number:

R531

WANG Zhen-yu, ZHANG Yao-guang, MA Xiao-jiang, JIANG Li, HE Yan-yan, ZHU Qian, PAN Hao. Investigation on common infection of diarrhea-causing parasitic protozoa in Shanghai during 2015—2019[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2021, 39(6): 759-763.

Figures/Tables 2

References 23

[1]	Wu GL. Human parasitology[M]. 4th Ed. Beijing: People’s Medical Publishing House, 2013: 115-122, 144- 145, 185-188. (in Chinese)
	(吴观陵. 人体寄生虫学[M]. 4版. 北京: 人民卫生出版社, 2013: 115-122, 144- 145, 185-188.)
[2]	Wu J, Zhang J, Wang QH, et al. Diagnostic criteria for bacillary and amoebic dysentery WS/T 287—2008[S]. Beijing: Ministry of Health of the People’s Republic of China, 2008. (in Chinese)
	(吴疆, 张锦, 王勤环, 等. 细菌性和阿米巴性痢疾诊断标准 WS/T 287—2008[S]. 北京: 中华人民共和国卫生部, 2008.)
[3]	Cao JP, Shen YJ, Guan YY, et al. Diagnosisof cryptosporidiosis WS/T 487—2016[S]. Beijing: National Health and Family Planning Commission of the People’s Republic of China, 2016. (in Chinese)
	(曹建平, 沈玉娟, 官亚宜, 等. 隐孢子虫病的诊断 WS/T 487—2016[S]. 北京: 中华人民共和国国家卫生和计划生育委员会, 2016.)
[4]	Li J, Wang H, Wang R, et al. Giardia duodenalis infectionsin humans and other animals in China[J]. Front Microbiol, 2017, 8: 2004. doi: 10.3389/fmicb.2017.02004
[5]	Xu N, Yin JH, Shen YJ, et al. Advances in molecular epidemiology of Cryptosporidium and Giardia lamblia[J]. Chin J Parasitol Parasit Dis, 2018, 36(6): 661-672. (in Chinese)
	(徐宁, 尹建海, 沈玉娟, 等. 隐孢子虫和蓝氏贾第鞭毛虫分子流行病学研究进展[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(6): 661-672.)
[6]	Checkley W, White AC, Jaganath D, et al. A review of theglobal burden, novel diagnostics, therapeutics, and vaccinetargets for Cryptosporidium[J]. Lancet Infect Dis, 2015, 15(1): 85-94. doi: 10.1016/S1473-3099(14)70772-8 pmid: 25278220
[7]	Al-Mekhlafi HM, Al-Maktari MT, Jani R, et al. Burden of Giardia duodenalis infection and its adverse effects on growth of school children in rural Malaysia[J]. PLoS Negl Trop Dis, 2013, 7(10): e2516. doi: 10.1371/journal.pntd.0002516
[8]	Wanyiri JW, Kanyi H, Maina S, et al. Cryptosporidiosis inHIV/AIDS patients in Kenya: clinical features, epidemiology,molecular characterization and antibody responses[J]. Am JTrop Med Hyg, 2014, 91(2): 319-328.
[9]	Stanley SL. Amoebiasis[J]. Lancet, 2003, 361(9362): 1025-1034. pmid: 12660071
[10]	Jiang ZX, Xu LQ, Yu SH, et al. The infection of Entamoeba histolytica in China[J]. Chin J Parasit Dis Control, 1997, 10(4): 264-268. (in Chinese)
	(蒋则孝, 许隆祺, 余森海, 等. 中国溶组织内阿米巴感染的状况[J]. 中国寄生虫病防治杂志, 1997, 10(4): 264-268.)
[11]	Zhang XP, He YY, Wang ZY, et al. Investigation on Cryptosporidium infections in diarrhea patients from the general hospitals in Shanghai[J]. Chin Trop Med, 2016, 16(12): 1183-1186. (in Chinese)
	(张小萍, 何艳燕, 王真瑜, 等. 上海市综合性医院腹泻患者隐孢子虫感染状况调查[J]. 中国热带医学, 2016, 16(12): 1183-1186.)
[12]	The National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention. Report on the national survey of important human parasitic diseases in China (2015)[M]. Beijing: People’s Medical Publishing House, 2018: 48. (in Chinese)
	(中国疾病预防控制中心寄生虫病预防控制所. 2015年全国人体重点寄生虫病现状调查报告[M]. 北京: 人民卫生出版社, 2018: 48.)
[13]	Zhang XP, He YY, Wang ZY, et al. Investigation on Entamoeba histolytica infection in diarrhea patients from general hospitals in Shanghai City[J]. Chin J Schisto Control, 2015, 27(6): 600-603. (in Chinese)
	(张小萍, 何艳燕, 王真瑜, 等. 上海市综合性医院腹泻患者中溶组织内阿米巴感染现状调查[J]. 中国血吸虫病防治杂志, 2015, 27(6): 600-603.)
[14]	Chen SH, Zhang YN, Li H, et al. Analysis on parasitic infection of clinical samples from hospitals in Shanghai during 2011—2013[J]. Chin J Parasitol Parasit Dis, 2014, 32(6): 446-451. (in Chinese)
	(陈韶红, 张永年, 李浩, 等. 2011—2013年上海临床医院送检样品寄生虫检测结果分析[J]. 中国寄生虫学与寄生虫病杂志, 2014, 32(6): 446-451.)
[15]	Song P, Li H, Guo J, et al. Laboratory detection of parasitic infections in clinical samples from hospitals in Shanghai during 2014—2017[J]. Chin J Parasitol Parasit Dis, 2018, 36(5): 489-494. (in Chinese)
	(宋鹏, 李浩, 郭俭, 等. 2014—2017年上海市临床医院送检样品寄生虫检测结果分析[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(5): 489-494.)
[16]	Sun XD, Deng Y, Wang J, et al. A survey on the prevalence of amoebiasis in Western China near the China-Myanmar border[J]. J Pathog Biol, 2012, 7(1): 56-57, 84. (in Chinese)
	(孙晓东, 邓艳, 王剑, 等. 中缅边境(西段)阿米巴病流行现状调查[J]. 中国病原生物学杂志, 2012, 7(1): 56-57, 84.)
[17]	Wang QQ, Cao ZG, Li QY, et al. Epidemiological research progress of human cryptosporidiosis[J]. J Trop Dis Parasitol, 2015, 13(2): 120-124. (in Chinese)
	(王庆权, 操治国, 李启扬, 等. 人体隐孢子虫病流行病学研究进展[J]. 热带病与寄生虫学, 2015, 13(2): 120-124.)
[18]	国家卫生健康委员会. 中华人民共和国卫生行业标准: 肠道原虫检测碘液染色涂片法 WS/T 634—2018[S]. 北京: 中国标准出版社, 2019. (in Chinese)
	(National Health Commission of the People’s Republic of China. Hygiene & Health Standard of the People’s Republic of China: Detection of intestinal protozoa Iodine staining smear method. WS/T 634—2018[S]. Beijing: Standards Press of China, 2019.)
[19]	Liu CX, Zhao JX, Yin JG. Research advances in diagnosis and treatment of cryptosporidiosis[J]. Infect Dis Inf, 2015, 28(3): 133-136, 148. (in Chinese)
	(刘彩霞, 赵继学, 尹继刚. 隐孢子虫病诊断和治疗研究进展[J]. 传染病信息, 2015, 28(3): 133-136, 148.)
[20]	Yang B, Cheng XJ. Aiding serology in diagnosing amebiasis[J]. J Pathog Biol, 2009, 4(11): 875, 877. (in Chinese)
	(杨彬, 程训佳. 血清学试验对阿米巴病诊断的辅助作用[J]. 中国病原生物学杂志, 2009, 4(11): 875, 877.)
[21]	Lu Y, Chen JX, Zhang YN, et al. Identification of Entamoeba histolytica by FTA-nested pcr[J]. Chin J Zoonoses, 2016, 32(2): 128-132. (in Chinese)
	(卢艳, 陈家旭, 张永年, 等. FTA-巢式PCR方法鉴定溶组织内阿米巴原虫的初步研究[J]. 中国人兽共患病学报, 2016, 32(2): 128-132.)
[22]	Li J, Huang DN, Zhang XM, et al. Establishment of a two-step duplex fluorescence quantitative PCR method for simultaneous detection of Giardia lamblia and Cryptosporidium parvum[J]. Chin J Zoonoses, 2020, 36(1): 32-39. (in Chinese)
	(李佳, 黄达娜, 张晓敏, 等. 蓝氏贾第鞭毛虫和微小隐孢子虫双重荧光定量PCR两步法检测技术的建立[J]. 中国人兽共患病学报, 2020, 36(1): 32-39.)
[23]	Chen SH, Ai L, Tian LG, et al. Investigation and fecal specimens detection of cryptozoite and other protozoon infection from patients with diarrhea[J]. Chin J Zoonoses, 2012, 28(8): 815-819. (in Chinese)
	(陈韶红, 艾琳, 田利光, 等. 腹泻病人隐孢子虫及其他原虫感染粪样检测分析[J]. 中国人兽共患病学报, 2012, 28(8): 815-819.)