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 Table of Contents  
ORIGINAL ARTICLE
Year : 2014  |  Volume : 2  |  Issue : 2  |  Page : 113-116

Study of the prevalence of intestinal parasitic infections in a tertiary care hospital located in central India


Department of Microbiology, Sri Aurobindo Institute of Medical Sciences Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India

Date of Web Publication18-Aug-2014

Correspondence Address:
Trupti Bajpai
Department of Microbiology, Sri Aurobindo Institute of Medical Sciences Medical College and Post Graduate Institute, Indore - 453 555, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2347-9019.139070

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  Abstract 

Background: Intestinal parasitic infections are important public health problems, especially in the developing countries like India. The prevalence of different parasitic diseases depends upon social, environmental, and economic factors. Aim: To evaluate the year-wise, gender-wise, and age-wise prevalence of intestinal parasites among the patients visiting a tertiary care hospital located in central India. Materials and Methods: The present study was conducted in the microbiology section of central laboratory located in our hospital. All the stool samples received in the laboratory were macroscopically and microscopically examined. The parasite prevalence data collected from June 2007 to May 2012 was evaluated retrospectively. Results: Out of the total 7,215 samples evaluated, 1,004 (13.9%) samples were found to be positive for least one parasite. A total of 969 (13.4%) samples had protozoan parasite and 35 (0.4%) samples had helminthes. Among these, the 670 (9.2%) samples had a single parasite, 278 (3.8%) had dual infection, 51 (0.7%) had triple, and 5 (0.07%) had quadruple infection. Discussion: The parasite prevalence gradually declined from the year 2007 (17.5%) to 2012 (11.7%). The rate of infection was found to be high in males (15.6%) as compared to females (12%) as influenced by day to day activity. More of the infected patients were found to be among age groups 21-30 years as affected by food habits and higher exposure of young adults to contaminated environments. Conclusions: The prevalence of intestinal parasitic infections has though declined year after year due to increased awareness, improved health and sanitary practices, and availability of potable water in our place; still negative reports can be increased by personal implementation of these practices by every individual from rural as well as from urban areas.

Keywords: Helminthes, intestinal parasite, protozoa, stool specimen


How to cite this article:
Singh T, Bhatambare GS, Deshmukh AB, Bajpai T, Srivastava I, Patel KB. Study of the prevalence of intestinal parasitic infections in a tertiary care hospital located in central India. Int J Health Syst Disaster Manage 2014;2:113-6

How to cite this URL:
Singh T, Bhatambare GS, Deshmukh AB, Bajpai T, Srivastava I, Patel KB. Study of the prevalence of intestinal parasitic infections in a tertiary care hospital located in central India. Int J Health Syst Disaster Manage [serial online] 2014 [cited 2022 Jan 24];2:113-6. Available from: https://www.ijhsdm.org/text.asp?2014/2/2/113/139070


  Introduction Top


Intestinal parasitic infections have always been an important medical and public health issue in tropics, especially in developing countries like India. According to the World Health Organization (WHO), more than one billion (almost 15-20%) of the world's population is chronically infected with parasites. [1] The overall prevalence of intestinal parasites have been reported in the range of 11.3-90% by several authors in India. [2],[3] The risk factors for the greater prevalence of such infections in India include humid climate, malnutrition, insanitary environment, improper and unsafe sewage and human waste disposal, and low standards of personal hygiene. While low socio-economic status, scarcity of potable drinking water, and impoverished health services further aids to the prevailing problem. [4],[5],[6],[7],[8]

Parasitic infections cause detrimental effects on the physical growth of the general population and leads to poor cognitive performance in children. [8] It manifests with asymptomatic carrier state, [9] gastrointestinal symptoms, or surgical problems. [10],[11] Symptoms presented by the patients usually depend on the host immune system, the degree of malnutrition, and environmental load. [12] Therefore, it is essential to know the burden of intestinal parasitic infections in the Indian community. The data on their prevalence help the clinicians in the diagnosis and management of the patients. Our retrospective study, will thereby report a detailed analysis of the prevalence of potentially pathogenic intestinal parasites among the various patients visiting a tertiary care hospital located in Central India.


  Materials and Methods Top


The present descriptive and retrospective study was carried out in the Microbiology section of the central laboratory located in a 1,200 bedded tertiary care hospital located in central India. The study protocol was approved by the institutional ethical committee. The study was conducted to determine the prevalence of intestinal parasitic infections among the suspected patients. The parasitic distribution was also evaluated according to sex and age of the patients.

Stool sample of the out patients and admitted patients suspected of parasitic infections were included in the study. The 5-year (June 2007-May 2012) data were retrospectively analyzed. A total of 7215 fresh stool samples collected in a labelled, screw-capped, plastic, wide-mouth containers were subjected to macroscopic (naked-eye examination of color, consistency, nature of feces, proglottidsof Taenia, presence of adult worms), and microscopic (cysts and trophozoites of protozoa and ova of helminthes) examination by saline and Lugol's iodine preparation examined under 100x and 400x magnifications. Processing of specimen was done within 1-2 hours of collection. Protozoa and helminthes were identified according to morphological details. [13]


  Results Top


A total of 7,215 stool specimen were examined during the study period. Out of these, 1,004 (13.9%) samples were positive for one or more than one parasite. Polyparasitism was detected in 334 (4.6%) patients while 670 (9.2%) samples had a single parasitic infection. Dual infection was seen in 278 (3.8%) samples, triple infection in 51 (0.7%), and quadruple infection was observed in 05 (0.07%) samples [Table 1]. Year-wise distribution of parasitic prevalence has been enumerated in [Table 2]. The overall prevalence of protozoa and helminthic infection has been described in [Table 3]. The gender-wise prevalence and age-wise distribution of intestinal parasites have been evaluated in [Table 4].
Table 1: Prevalence of intestinal parasites among the stool samples

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Table 2: Prevalence of intestinal parasites in 5-year period (June 2007-May 2012)

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Table 3: Gender-based prevalence of intestinal parasites

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Table 4: Age-based prevalence of intestinal parasites

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  Discussion Top


Out of the total 7,215 samples examined during the study, 1,004 (13.9%) samples were found to carry at least one parasite. The prevalence percent was quite low as compared to findings of Marothi et al., (21.4%), Parameshwarappa et al., (27.6%), Prakash et al., (38.1%), Rao et al., (59.5%), Chandrashekhar and Nagesha (68%), Hegde and Patel (90.6%), Kang et al., (97.4%) [1],[5],[7],[14],[15],[16],[17] and was found to be consistent with those of Ramesh et al. (12.5%), Khubnani et al., (15.9%), Sethi et al., (7.3-15.5%), Khurana et al., (14.6%), and Ngrenngarmlert et al. (13.6%) [2],[18] while it was more than the findings made by Davane et al. (6.63%) This may be probably due to difference in time, place and methods of examination used. [8]

A list of eight pathogenic parasites and one non pathogenic parasite identified in our study and their percentage prevalence has been enumerated in [Table 2]. Poly parasitism, observed in our case was found in 334 (4.6%) patients [Table 1]. This value ranges in between 4.3-72.7% according to studies done by several authors [10] and was higher than those by Marothi et al. (1.1%). [7] Dual infections were seen in 278 (3.8%) out of 7,215 patients that was again higher than the study performed by Marothi et al., (1%) [7] and lower than the study by Parameshwarappa et al., (5.5%). [5] Triple infection was shown by 51 (0.7%) cases which was found to be 0.1% and 0.2% according to studies by Marothi et al., and Parameshwarappa et al., [5],[7] We also encountered quadruple infection though in only 05 (0.06%) samples. Studies reveal that presence of one intestinal parasite may increase the susceptibility to infections with other intestinal pathogens. [4]

The overall prevalence of intestinal parasite showed gradual decline from the year 2007 (17.5%) to 2012 (11.7%) with a slight rise in 2008 (13.8%) [Table 1]. The protozoan infection was seen in 969 (96.5%) out of 1004 positive samples with only 35 (3.4%) samples carrying helminthes. It was also found to be high in most of the studies [5],[7] including our study. However, it was against the study by Davane et al., (Protozoa: 32.4%; Helminths: 78.5%) and Ngrenngarmlert et al., (Protozoa: 8.5%; Helminths: 10.3%). [2],[8] In our case, 306 (4.2%) out of 7,215 samples were also diagnosed for the presence of non pathogenic cysts of Entamoeba coli. Such factors are indicative of consumption of contaminated, unsafe drinking water and prevalence of unhygienic conditions. [1],[3],[4],[5],[7],[8] The predominant helminth parasite in our study was Hymenolepis nana (14,1.4%) followed by Ascarislumbricoides (08;0.8%). However, it was Enterobiusvermicularis in case of study by Raza et al., (2.2%). [3] Ascarislumbricoides in case of Ngrenngarmlert et al., (3.3%) and Marothi et al., (2.8%). [2],[8] This can be attributed to the fact that geographical distribution of intestinal parasites is influenced by the requirement of suitable hosts and favorable environmental conditions. [3]

In our study, the rate of infection was higher in males (15.6%) as compared to females (12%) [Table 3]. The results were similar to those of Rao et al., [14] but were inconsistent with the study by Marothi et al., [7] while Patel et al., reported similar rates in both the sexes. [19] That means, the results relate to daily activities of an individual like methods of defecation and habitats rather than type of gender. If the age factor is considered, most of the infected cases in our study were in 21 to 30 years of age-group followed by 1-10 years [Table 4]. This can be attributed to food habits, more outdoor activity and exposure to contaminated surroundings of young adult population that also include the migrants in our place, especially from rural areas for the purpose of education and job. This allows easy spread of parasites from carrier migrant workers harboring intestinal parasites. [2],[3]

To conclude, the parasitic infections are still prevailing in our community. Though not life-threatening, chronic parasitic infections can impair physical and mental growth of children and general development of individuals. This prevalence may be because of malnutrition and unhygienic conditions especially among patients visiting the hospital from rural areas. However, the declining prevalence of intestinal parasites year after year from 2007 to 2012 suggests that it is due to increased awareness and improvement of sanitary practices, personal hygiene, safe drinking water supply, patients' early treatment seeking behavior and health education, especially among patients visiting our hospital from urban areas.

In order to further alleviate this prevailing health problem, there is a need of educational health program, periodic de-worming exercise in primary schools, reduction of source of infection by therapeutic measures, and regular community and hospital survey to estimate prevalence of particular parasites among people.


  Acknowledgement Top


The authors wish to thank the Chairman and the Dean of Sri Aurobindo Institute of Medical Sciences and PG Institute, Indore (M.P) India for providing laboratory facilities and the healthy working atmosphere during the endeavor. The authors truly appreciate the help provided by the technical staff of the department during the study period.

 
  References Top

1.Montresor A, Crompton DWT, Hall A, Bundy DAP, Savioli L. Guidelines for the evaluation of soil transmitted helminthiasis and schistosomiasis at community level. Geneva: World Health Organization; WHO/CTC/SIP/98.  Back to cited text no. 1
    
2.Kang G, Mathew MS, Rajan DP, Daniel JD, Mathan MM, Mathan VI, et al. Prevalence of intestinal parasites in rural Southern Indians. Trop Med Int Health 1998;3:70-5.  Back to cited text no. 2
    
3.Marothi Y, Singh B. Prevalence of intestinal parasites at Ujjain, Madhya Pradesh, India: Five-year study. Afr J Microbiol Res 2011;5:2711-4.  Back to cited text no. 3
    
4.Raza HH, Sami RA. Epidemiological study of gastrointestinal parasites among different sexes, occupations and age groups in Sulaimani district. J Duhok Univ 2008;12:317-23.  Back to cited text no. 4
    
5.Kaur R, Rawat D, Kakkar M, Uppal B, Sharma VK. Intestinal parasites in children with diarrhea in Delhi, India. Southeast Asian J Trop Med Public Health 2002;33:725-9.  Back to cited text no. 5
    
6.Parameshwarappa KD, Chandrakanth C, Sunil B. The prevalence of intestinal parasitic infestations and the evaluation of different concentration techniques of stool examination. J Clin Diagn Res 2012;6:1188-91.  Back to cited text no. 6
    
7.Ngrenngarmlert W, Kritsirwuthinan K, Nilmanee N. Prevalence of intestinal parasitic infections among Myanmar workers in Bangkok and SamutSakhon. Asia J Public Health 2012;3:53-8.  Back to cited text no. 7
    
8.Davane MS, Suryawanshi NM, Deshpande KD. A prevalence study of intestinal parasitic infections in a rural hospital. Int J Recent Trends Sci Technol 2012;2:1-3.  Back to cited text no. 8
    
9.Ogunlesi T, Okeniyi J, Oseni S, OyelamiO, Njokanma F, Dedeke O. Parasitic etiology of childhood diarrhea. Indian J Paediatr 2006;73:1081-4.  Back to cited text no. 9
    
10.Vizer G, Patai A, Dobronte Z. Endoscopic treatment of cholestasis caused by Ascaris lumbricoides. Orv Hetil 2001;142:681-3.  Back to cited text no. 10
    
11.Chirdan LB, Yusufu LM, Ameh EA, Shehu SM. Meckel′s diverticulitis due to Tinea saginata: Case report. East Afr Med J 2001;78:107-8.  Back to cited text no. 11
    
12.Stephenson LS, Latham MC, Adams EJ, Kinoti SN, Pertet A. Physical fitness, growth and appetite of Kenyan schoolboys with hookworm, Trichuris trichiura and Ascaris lumbricoides infections are improved four months after a single dose of albendazole. J Nutr 1993;123;1036-46.  Back to cited text no. 12
    
13.Cheesbrough M. Medical laboratory manual for tropical countries. Vol. 1. Microbiology. 985.  Back to cited text no. 13
    
14.Rao VG, Aggrawal MC, Yadav R, Das SK, Sahare LK, Bondley MK, et al. Intestinal parasitic infections, anaemia and undernutrition among tribal adolescents of Madhya Pradesh. Indian J Community Med 2003;27:26-9.  Back to cited text no. 14
    
15.Chandrasedhar MR, Nagesha CN. Intestinal helminthic infestation in children. Ind. J. Pathol. Microbiol 2003;46:492-94.  Back to cited text no. 15
    
16.Prakash O, Tandon BN. Intestinal parasites with special reference to Entamoebahistolytica complex as reveled by routine concentration and cultural examination of stool samples from patients with gastrointestinal symptoms. Indian J Med Res 1966;54:10-4.  Back to cited text no. 16
    
17.Hedge GR, Patel JC. Prevalence of intestinal parasitic infestation in rural area. J Postgrad Med 1986;32:225-8.  Back to cited text no. 17
    
18.Sethi S, Sehgal R, Malla N, Dudey ML, Mahajan RC. Changing trends of intestinal parasitic infections in Chandigarh (Northern India): Hospital based study. Indian J Med Microbiol 2000;18:106-9.  Back to cited text no. 18
    
19.Patel JC. Ten year study of stool samples with particular reference to intestinal parasites. J Postgrad Med 1986;32:219-24.  Back to cited text no. 19
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]


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