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. 2021 Aug 30;21(1):888.
doi: 10.1186/s12879-021-06615-5.

Prevalence and risk factors of intestinal protozoan infection among symptomatic and asymptomatic populations in rural and urban areas of southern Algeria

Soumia Sebaa  1 , Jerzy M Behnke  2 , Djamel Baroudi  3 , Ahcene Hakem  1   4 , Marawan A Abu-Madi  5
Affiliations

Prevalence and risk factors of intestinal protozoan infection among symptomatic and asymptomatic populations in rural and urban areas of southern Algeria

Soumia Sebaa et al. BMC Infect Dis. .

Abstract

Background: Intestinal parasitic infections are amongst the most common infections worldwide and have been identified as one of the most significant causes of morbidity and mortality among disadvantaged populations. This comparative cross-sectional study was conducted to assess the prevalence of intestinal protozoan infections and to identify the significant risk factors associated with intestinal parasitic infections in Laghouat province, Southern Algeria.

Methods: A comparative cross-sectional study was conducted, involving 623 symptomatic and 1654 asymptomatic subjects. Structured questionnaires were used to identify environmental, socio demographic and behavioral factors. Stool specimens were collected and examined using direct wet mount, formalin-ether concentration, xenic in vitro culture and staining methods.

Results: A highly significant difference of prevalence was found between symptomatic (82.3%) and asymptomatic subjects (14.9%), with the majority attributable to protozoan infection. The most common species in the symptomatic subjects were Blastocystis spp. (43.8%), E. histolytica/dispar (25.4%) and Giardia intestinalis (14.6%) and more rarely Enterobius vermicularis (02.1%), Teania spp. (0.6%) and Trichuris trichiura (0.2%), while in asymptomatic population Blastocystis spp. (8%), Entamoeba coli (3.3%) and Entamoeba histolytica/dispar (2.5%) were the most common parasites detected with no case of helminth infection. Multivariate log-linear analysis showed that contact with animals was the main risk factor for transmission of these protozoa in both populations. Furthermore, living in rural areas was significantly associated with combined protozoan infection in the asymptomatic population, whereas, in the symptomatic population an increasing trend of protozoan infection was detected in the hot season. In addition, Blastocystis spp. and G. intestinalis infection were found to be associated with host sex and contact with animals across the study period.

Conclusions: Based on these results, several strategies are recommended in order to effectively reduce these infections including good animal husbandry practices, health education focused on good personal hygiene practices and adequate sanitation.

Keywords: Algeria; Animal contact; Asymptomatic; Intestinal parasites; Rural areas; Symptomatic; Temporal changes.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig. 1
Fig. 1
A Geographic map of Algeria, B Geographic map of Laghouat province showing the origin of the patients (UA urban areas, RA rural areas). Maps source: https://d-maps.com/carte.php?num_car=189308&lang=fr
Fig. 2
Fig. 2
Prevalence of combined protozoan infection by host age class in POPULATION 1 and 2
Fig. 3
Fig. 3
Prevalence of combined protozoan infection by year and season in POPULATION 1 (A) and 2 (B). Note that no data were collected in the autumn of 2018
Fig. 4
Fig. 4
Prevalence of G. intestinalis infections by year and season in POPULATION 2
Fig. 5
Fig. 5
Prevalence of G. intestinalis in male and female subjects with or without animals in POPULATION 2
Fig. 6
Fig. 6
Prevalence of Blastocystis spp. in subjects with or without animals during the 4 years of the study, in POPULATION 1
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