Prevalence of Intestinal Parasitic Infections among Patients Referring to Medical Diagnostic Laboratories, Kashan, Central Iran, 2015-2018

INTRODUCTION Intestinal parasitic infections are among the most common human infections worldwide and are considered as critical health indicators of a community, especially in developing countries [1]. According to the World Health Organization (WHO) report, more than two billion people in the world are infected with intestinal parasitic infections [2-3]. More than 1.5 billion (24%) of the world's population are estimated to be infected with parasitic infections such as Ascaris lumbricoides, hookworms and Trichuris trichiura [4]. These infections are widespread mainly in tropical and subtropical regions. The highest incidences are reported from developing countries, more in sub-Saharan Africa, North and South America, China, and East Asia, where people are struggling with health problems, insufficient water supply, rapid population growth and other economic and social problems [4-6]. The most prominent pathogenic protozoa of human intestine are Giardia intestinalis, Entamoeba histolytica/Entamoeba dispar, Dientamoeba fragilis and Blastocystis sp. [3, 6]. Giardia intestinalis is one of the most common etiological agents of parasitic diarrhea in humans and animals. This parasite has a global distribution, and it is estimated that 280 million people are affected by this parasite worldwide [7]. The global prevalence of this protozoon in human has been estimated to be about 8 to 30% in developing countries and 1 to 8% in developed countries [8]. In Iran, like other developing countries, parasitic diseases in communities are considered as one of the critical health issues. Infection rates of giardiasis in different regions of Iran have been reported to be between 1.2%-38% [9]. Amoebiasis is the third leading cause of death by parasitic diseases around the world. According to WHO report, E. histolytica has infected 50 million people around the world and has contributed to about in 90-110 thousand deaths each year [10]. Blastocystis spp. are considered as common intestinal parasites in the world and were traced in the human and many animals intestine [11]. The prevalence of this parasite in developed countries ranges from 0.5% to 23% [12] while in some developing countries it exceeds to more than 60% [13-14]. In a systematic review study, the average rate of Blastocystis infection was reported to be 3% in Iran [15]. Dientamoeba fragilis is another most common intestinal parasites in humans with a global distribution; its prevalence varies from 0.9% to 82.9% in different countries, Introduction: Intestinal parasitic infections are among the most common diseases worldwide and are significant indicators of the health status of communities, especially in developing countries. This study aims to determine the prevalence of intestinal parasites infection in patients referring to Kashan diagnostic laboratories from July 2015 to August 2018. Methods: This crosssectional study was carried out on 6921 patients referring to medical diagnostic laboratories, Kashan, central Iran. Fecal specimens were examined by direct smear and formalin-ether concentration methods. The results together with risk factors including sex, age were recorded and analyzed by descriptive statistics using SPSS 16 software. Results: Out of the 6921 individuals examined, 3636 (52.5%) were male and 3285 (47.5%) were female. Microscopy revealed the prevalence of parasitic infection by 4.96% (4.96 ± 0.5). Totally 5.1% of males and 4.6% of females had intestinal parasite infections. No significant association was seen between sex, seasons, and parasite infections. Rate of infection to intestinal parasites were Blastocystis spp. (3.06%), Entamoeba coli (0.95%), Giardia intestinalis (0.59%), Iodamoeba butschlii (0.23%), Endolimax nana (0.20%), Entamoeba hartmanni (0.20%), Dientamoeba fragilis (0.14%), Chilomastix mesnili (0.07%), Entamoeba histolytica/Entamoeba dispar (0.05%) and Hymenolepis nana (0.01%) was the only intestinal worm that observed in one individual. The results showed that 4.48% of the examined individuals were infected with one parasite, 0.39% with two and 0.08% with 3 or more parasites. Conclusion: The prevalence of intestinal parasites in our study was lower than those from other areas of Iran and other countries, indicating an increase in health status as well as public awareness of infectious diseases. J Med Microbiol Infec Dis, 2018, 6 (2-3): 62-66.