Printer Friendly

The prevalence of intestinal protozoa in patients referred to Tabriz Imam Reza hospital from January 2010 to December 2010.


Intestinal parasitic infections are among the major diseases of concern to public health throughout the world [39]. Some of the parasite species responsible are associated with severe morbidity often resulting in mortality, particularly in less developed tropical and subtropical countries [39,40]. Amoebiasis, giardiasis, ascariasis, hookworm infection, and trichuriasis are among the most common intestinal parasitic infections worldwide and are closely related to socio-economic status, poor sanitation, inadequate medical care and absence of safe drinking water supplies [5,17,19,38,39]. Intestinal parasitic infections are still a serious public health problem in the world, especially in developing countries [28]. The fecal oral route is significant in the transmission of parasite infections to humans via poor personal hygiene [24], environmental conditions like contamination of soil and water sources with human feces [20]. Infection with intestinal parasite as a major problem has been recognized to spread within institutions for the mentally retarded because of inadequate personal hygiene and lack of toilet training [21]. Mentally retarded individuals are usually placed in institutions during childhood or adolescent and are highly debilitated patients who require care and treatment especially for infectious diseases [7]. Several surveys of institutions for the mentally retarded in the world have reported a wide range of prevalence (20-60%) of intestinal parasitism [41]. A prevalence rate of 7.3% was found among individuals with mental retardation in New York State [35]. Few epidemiological surveys performed in mentally retarded centers in Iran revealed a different prevalence of intestinal parasitic infection [16,29]. An investigation was undertaken to determine the prevalence of parasitic diseases in intellectual disability persons in rehabilitation centers of Mazandaran province, northern Iran.

Methods and materials

This descriptive study--cross over records and information was conducted in Tabriz Imam Reza Hospital. Patients that referred to this hospital in the first period January 2010 until December 2010 send for fecal examination by a physician were evaluate. Methods of this survey was a case of patient records were examined and information about the results that obtained by fecal examination. A triple stool sample of each individual in three consecutive days was collected in P.V.A. and 10% formalin preservative and submitted to parasitology laboratory of Tabriz Islamic Azad University. The diagnosis was made on direct wet mount, formol-ether concentration, and with confirmation of positive stool specimens on Ziehl-Neelsen and trichrome stained slides. Statistical analysis was carried out using Chi square test.

Results and discussion

The 12-month period in 2515 number of fecal samples was referred to our center. Total of 57 numbers (2.26%) infestation by intestinal parasites were observed. The highest rate of infection related to Entamoeba histolytica cysts 20 cases (0.79%). Many other protozoa including Entamoeba histolytica trophozoaits 2 cases (0.07%), Giardia cysts in 15 cases (0.59%), Giardia trophozoaites 1 (0.03%) Entamoeba coli cysts 8 (0.31%) Endolimax nana cysts 11 cases (0.43%), respectively.


Intestinal parasitic infections are common major problem closely related to poverty, inadequate sanitation, and insufficient health care and overcrowding [4]. They cause significant morbidity among residents of mental institutions [3,12,37]. Previous reports have revealed that many institutions for mentally retarded patients have problem with endemic amebiasis and giardiasis [26,27,34]. In addition many of non-pathogenic parasites were frequently detected from fecal specimens of mentally retarded [31,36,42]. The presence of non-pathogenic protozoa could indicate a fecal contamination of the environment; in fact residents who had nonpathogenic parasites are more likely to be infected by pathogenic parasites [37]. According to recent reports in general populations in different parts of Iran, the prevalence rate of the intestinal helminth infections, were 0-3.6% [1,2,8,11,13,30,33]. It should be mentioned that in the recent years the prevalence of intestinal parasites, particularly of helminthic infections showed significant decrease, which can be explained as follows: (a) substitution of untreated human excrement with chemical fertilizer, (b) installation and operation of reliable sewage system, (c) education on disinfecting vegetables before use, and (d) implementation of health educational programmes specially in Iran. As a result of the aforementioned intervention, helminth eggs were not observed in any of the stool samples in this study. Another reason for a low prevalence of helminthic infection was routine drug therapy with mebendazole undertaken in all rehabilitation centers under study and as a result the prevalence rate of helminthic infection in this survey was null, which corresponds with previous relevant reports from Iran. We found a 26.2% intestinal protozoan infection and no helminth eggs among the mentally retarded subjects in northern Iran, which is in accord with the results of a study by Sargeaunt et al [32] in South East England that showed 24.7% protozoa infection in patients in a group of mental hospitals and also reported no helminth in any specimen due to regular de-worming of the patients. Kasssem et al [14] in a study among children admitted to Ibne Sina hospital in Libya reported no intestinal helminth parasites. A study among inhabitants of rehabilitation centers of Tehran, Iran, revealed 59.4% prevalence rate of infection [29]. In another report, Mahyar et al. [16] showed 56.6% prevalence rate in mentally retarded children of Qazvin, Iran. The prevalence rate of the intestinal parasitic infections in mentally retarded individuals in the world, were 76.67% in Egypt [18], 30% in Abha, Saudi Arabia [25], 7.3% in New York [35], 53.8% and 23% in Italy [6,9,], 35.7% in Korea [15]. Recent reports in Iran, showed a prevalence rate of intestinal parasites between 18.4 and 29.75% in general populations [10,13,22,23,33]. When the data of the current study were compared with those of the reports of the recent years in different groups of people in Iran, no significant difference between infection rates in ID persons of northern Iran with the normal populations was observed. The minor differences in the prevalence rate reported in different studies may be due to different groups of study populations and the years in which those surveys were performed.


[1.] Asghari, G.H., M. Nateghpour and M. Rezaian, 2002. Prevalence of intestinal parasites in the inhabitants of Islam-Shahr district. Journal of School of Public Health and Institute of Public Health Research, 3: 67-74.

[2.] Baghaei, M., P. Daneshvar Farzanegan, M. Mirlohi and M. Mahmoodi, 2001. Intestinal parasitic prevalence in rural area children, Mobarakeh, Isfahan. Journal of Research in Medical Sciences, 3: 104-107.

[3.] Braun, T., T. Fekete and A. Lynch, 1988. Strongyloidiasis in an institution for mentally retarded adults. Archives of Internal Medicine, 148: 634-636.

[4.] Crompton, D.W. and L. Savioli, 1993. Intestinal parasitic infections and urbanization. Bulletin of the World Health Organization, 71: 1-7.

[5.] Gamboa, M.I., J.A. Basualdo, M.A. Cordoba, B.C. Pezzani, M.C. Minvielle, H.B. Lathitte, 2003. Distribution of intestinal parasitoses in relation to invironmental and sociocultural parameters in La Plata Argentina. J. Helminthol., 77: 15-20.

[6.] Gatti, S., R. Lopes, C. Cevini, B. Ijaoba, A. Bruno, A.M. Bernuzzi, et al. 2000. Intestinal parasitic infections in an institution for the mentally retarded. Annals of Tropical Medicine and Parasitology, 94, 453-460.

[7.] Geller, H.M., R.K. Eyman and H.F. Dingman, 1964. Infectious disease in a hospital for the mentally retarded. American Journal of Public Health, 54: 1810-1816.

[8.] Ghahremanloo, M. and M. Hasanjani, 2001. Survey of prevalence of intestinal parasites in elementary schools in Eastern Bandpay district in Babol. Journal of Babol University of Medical Sciences, 2: 47-51.

[9.] Giacometti, A., O. Irioni, M. Balducci, D. Drenaggi, M. Quarta, M. De Federicis, et al. 1997. Epidemiologic features of intestinal parasitic infections in Italian mental institutions. European Journal of Epidemiolology, 13: 825-830.

[10.] Haghighi, A., A. Salimi, M. Nazemalhosseini, B. Kazemi, M. Rostami Nejad and S. Rasti, 2009. Frequency of enteric protozoan parasites among patients with gastrointestinal complaints in medical centers of Zahedan, Iran. Transactions of the Royal Society of Tropical Medicine and Hygiene, 103: 452-454.

[11.] Heidari, A. and M. Rokni, 2003. Prevalence of intestinal parasites among children in day care centers in Damghan-Iran. Iranian Journal of Public Health, 32: 31-34.

[12.] Huminer, D., K. Symon, F.I. Groskop, D. Pietrushka, I. Kremer, P.M. Schantz, et al. 1992. Seroepidemiologic study of toxocariasis and strongyloidiasis in institutionalized mentally retarded adults. American Journal of Tropical Medicine and Hygiene, 46: 278-281.

[13.] Jalalian, M., M. Rezaiian, E.B. Kia, J. Massoud, M. Mahdavi and M.B. Rokni, 2004. Relationship between serum IgE and intestinal parasites. Iranian Journal of Public Health, 33: 18-21.

[14.] Kasssem, H.H., H.A. Zaed and G.A. Sadaga, 2007. Intestinal parasitic infection among children and neonatus admitted to Ibn-Sina hospital, Sirt, Libya. Journal of the Egyptian Society of Parasitology, 37: 371-380.

[15.] Lee, J., G.M. Park, D.H. Lee, S.J. Park and T.S. Yong, 2000. Intestinal parasite infection at an institution for the handicapped in Korea. The Korean Journal of Parasitology, 38: 179-181.

[16.] Mahyar, A., M.M. Daneshi, H. Saghafi and M. Rezaai, 2000. Intestinal parasitic in mentally retarded children of Qazvin, Iran. The Journal of Qazvin University of Medical Sciences, 14: 64-70.

[17.] Merid, Y., M. Hegazy, G. Kekete, S. Teklemariam, 2001. Intestinal helminthic infection among children at Lake Awassa Area, South Ethiopia. Ethiopian J. Health Dev., 15: 31-38.

[18.] Mohamed, N.H., S.A. Salem, M.E. Azab, M.A. Bebars, H.M. Khattab, A.M. Kamal, et al. 1991. Parasitic infections associated with mental retardation in Egypt. Journal of the Egyptian Society of Parasitology, 21: 319-331.

[19.] Montresor, A., D.W.T. Crompton, A. Hall, D.A. Bundy, L. Savioli, 1998. Guidelines for the Evaluation of Soil-Transmitted Helminthiasis and Schistosomiasis at Community Level. World Health Organization, Geneva (WHO/CTD/SIP/98.1).

[20.] Muttalib, M.A., M. Huq, J.A. Huq and N. Suzuki, 1983. Soil pollution with Ascaris ova in three villages of Bangladesh. Yokogawa, collected paper on the control of soil transmitted helminthiasis, vol. 11. Tokyo: APCO. pp: 66-71.

[21.] Naiman, H.L., L. Sekla and W.L. Albritton, 1980. Giardiasis and other intestinal parasitic infections in a Manitoba residential school for the mentally retarded. Canadian Medical Association Journal, 122: 185-188.

[22.] Nematian, J., A. Gholamrezanezhad and E. Nematian, 2008. Giardiasis and other intestinal parasitic infections in relation to anthropometric indicators of malnutrition: A large, population based survey of schoolchildren in Tehran. Annals of Tropical Medicine and Parasitology, 102: 209-214.

[23.] Niyyati, M., M. Rezaeian, F. Zahabion, R. Hajarzadeh and E.B. Kia, 2009. A survey on intestinal parasitic infections in patients referred to a hospital in Tehran. Pakistan Journal of Medical Sciences, 25: 87-90.

[24.] Okey, P., S. Ertug, B. Gultekin, O. Onen and E. Baser, 2004. Intestinal parasites prevalence and related factors in school children, a western city sample-Turkey. BMC Public Health 4 p. 64, doi:10.1186/1471-2458r-r4-64.

[25.] Omar, M.S., M.E. al-Awad and A.A. al-Madani, 1991. Giardiasis and amoebiasis infections in three Saudi closed communities. Journal of Tropical Medicine and Hygiene, 94: 57-60.

[26.] Ong, S.L., M.Y. Cheng, K.H. Liu, S.Y. Lee, L.P. Chow, T.L. Cheng, et al. 1995. Parasitic infection in a psychiatric institution in Taiwan, with special reference to Entamoeba histolytica. Epidemiology Bulletin, 11: 107-110.

[27.] Ong, S.L., M.Y. Cheng, K.h. Liu and C.B. Horng, 1996. Use of theproSpec T microplate enzyme immunoassay for the detection of pathogenic and non-pathogenic Entamoeba histolytica in fecal specimens. Transactions of the Royal Society of Tropical Medicine and Hygiene, pp: 248-249.

[28.] Quihua, L., M.E. Valencia, D.W.T. Crompton, S. Phillips, P. Hagan, G. Morales, et al. 2006. Role of the employment status and education of mothers in the prevalence of intestinal parasitic infections in Mexican rural schoolchildren. BMC Public Health, 6, 225 doi:10.1186/1471-2458r-r6 225.

[29.] Rohanni, S., 1994. Intestinal parasite infection in mentally retarded population of rehabilitation centers of Tehran, Iran. The Journal of Medical School of Shahid Beheshty University of Medical Sciences, 1: 20-28.

[30.] Rohanni, S., A. Athari and H. Kianian, 2001. Prevalence of intestinal parasites in villages of Sari. The Journal of Zanjan University of Medical Sciences &Health Services, 34: 33-40.

[31.] Rolston, K.V.I., R. Winans and S. Rodrigyez, 1989. Blastocystis hominis: Pathogen or not? Reviews of Infectious Diseases, 11: 661-662.

[32.] Sargeaunt, P.G., M. Aimls and M. Williams, 1982. A study of intestinal protozoa including non-pathogenic Entamoeba histolytica from patients in a group of mental hospitals. American Journal of Public Health, 72: 178-180.

[33.] Sayyari, A.A., F. Imanzadeh, S.A. Bagheri Yazdi, H. Karami and M. Yaghoobi, 2005. Prevalence of intestinal parasitic infections in the Islamic Republic of Iran. Eastern Mediterranean Health Journal, 11: 377-383.

[34.] Scaglia, M., S. Gatti, A. Bruno, C. Cevini, L. Marchi, P.G. Sargeaunt, et al. 1991. Autochthonous amoebiasis in institutionalized mentally-retarded patients:

[35.] Schupf, N., M. Ortiz, D. Kapell, M. Kiely and R.D. Rudelli, 1995. Prevalence of intestinal parasit infections among individuals with mental retardation in New York State. Mental Retardation, 33: 84-89.

[36.] Sheehan, D.J., B.G. Raucher and J.C. McKitirick, 1986. Association of Blastocystis hominis with signs and symptoms of human disease. Journal of Clinical Microbiology, 24: 548-550.

[37.] Thacker, S.B., A.M. Kimball, M. Wolfe, K. Choi and L. Gilmore, 1981. Parasitic disease control in a residential facility for the mentally retarded: Failure of selected isolation procedure. American Journal of Public Health, 71: 303-305.

[38.] Tshikuka, J.G., M.E. Scott, K. Gray-Donald, 1995. Ascaris lumbricoides infection and environmental risk factors in an urban African setting. Ann. Med. Parasitol., 89: 505-514.

[39.] World Health Organization, 1987. Prevention and control of intestinal parasitic infections. WHO Techl. Rep. Ser., 749: 1-86.

[40.] World Health Organization, 1999. Removing Obstacles to Healthy Development. Geneva, World Health Organization.

[41.] Yoeli, M., H. Most, J. Hammond and G.P. Scheinesson, 1972. Parasitic infections in a closed community. Transactions of the Royal Society of Tropical Medicine & Hygiene, 65: 764-776.

[42.] Zierdt, C.H., 1989. Blastocystis hominis as a human pathogen. Reviews of Infectious Diseases, 11: 661.

Milad Anvarian

Young researchers club, Tabriz Branch, Islamic Azad University, Tabriz, Iran.

Corresponding Author

Milad Anvarian, Young researchers club, Tabriz Branch, Islamic Azad University, Tabriz, Iran.

E-mail: Tel: +98 935 890 3710
COPYRIGHT 2011 American-Eurasian Network for Scientific Information
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2011 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:Original Article
Author:Anvarian, Milad
Publication:Advances in Environmental Biology
Article Type:Report
Geographic Code:7IRAN
Date:Jun 1, 2011
Previous Article:The effect of thyme essential oils (Thymus vulgaris) in the vaccination reactions on broiler chicks.
Next Article:Regression analysis of factors influencing the adoption of genetically modified crops in Iran.

Terms of use | Copyright © 2017 Farlex, Inc. | Feedback | For webmasters