Prevalence of, and Factors Associated with Intestinal Parasites in Multinational Expatriate Workers in Al Ain City, United Arab Emirates: An Occupational Cross-Sectional Study

Abstract

To estimate the prevalence of, and identify factors associated with intestinal parasites (IPs) in expatriate workers in the United Arab Emirates (UAE). All expatriate workers (N = 115) in a conveniently selected workplace in the industrial district of Al Ain city were invited to participate in a cross-sectional study. Consenting workers completed an interviewer-led questionnaire and self-collected stool samples. Stool samples were microscopically and molecularly screened for the presence of IPs. Univariate and multivariate analyses were conducted. Overall, 102 (88.7%) workers participated in the survey and 84.3% provided stool samples. Over three-quarters (79.4%) of workers were living in labour accommodation, 76.0% were sharing a bedroom with ≥ 4 workers, 80.2% were sharing a toilet with > 5 other people. Fifteen species of IPs were identified. Microscopically, 17.4% of the screened stool samples were positive for at least one parasite. Entamoeba species was the most common (8.1%) followed by Cryptosporidium species (3.5%). Thirty-six (41.8%) of the tested stool samples were positive for at least one parasite by molecular testing. The most prevalent parasite was Cryptosporidium species (16.3%) followed by Enterobius vermicularis (14.0%) and Ascaris lumbricoides (5.8%). Overall, 47.8% of the tested expatriate workers were positive for at least one IP, microscopically or molecularly. Educational attainment was negatively associated with being positive for at least one IP. IPs were very common amongst expatriate workers in Al Ain city. Efficacious and cost-effective public health interventions are required to reduce the burden of, and prevent the onward transmission of IPs in the UAE.

Keywords: Communicable diseases; Infectious disease transmission; One health; Parasitic intestinal diseases; Transients and migrants; United Arabia Emirates.

Fig. 1

Helminthes eggs and protozoan cysts identified under microscope in tested stool samples. aHookworm, bTrichruis trichiura, cTaenia species egg identified in a stool using wet mount with iodine. dCryptosporidium species

Fig. 2

Agarose gel electrophoresis (2%) shows PCR products of intestinal parasites. Lanes 1 and 9: 50 basepair (pb) DNA ladder, lane 2: A. lumbricoides, lane 3: E. vermicularis, lane 4: T. saginata, lane 5: Gardia lamblia, lane 6: Trichuris trichuria, lane 7: Cryptosporidium spp. lane 8: Taenia solium, lane 10: Entamoeba spp.