Changing trend in prevalence of intestinal parasites in patients attending a tertiary care hospital in Lucknow

Background: Intestinal parasitic infections are one of the commonest causes of morbidity in third world countries including, India. The aim of this study was to determine the prevalence of common intestinal parasitic infections in relation to demographic details of patients, attending a tertiary care hospital in Lucknow. Materials and Methods: A retrospective study was conducted from 1 January 2014 to 31 December 2014 in the Department of Microbiology, of Integral Institute of Medical Sciences and Research, Dasauli, Kursi road, Lucknow. A total of 755 samples from patients attending the OPD and IPD of the hospital with gastrointestinal symptoms were included in the study. Results: Out of total 755 samples, 133 (17.6%) samples were found to be positive for at least one parasite. Entamoeba histolytica was the most common parasite (9.3%) followed by Blastocystis hominis (3.3%), Giardia lambia (3%), Ascaris lumbricoides (1.3%), Ancylostoma duodenale (0.4%) and Hymenolepis nana (0.3%). Infection was more common in males (10%) than females (7.55%), 21-40 yrs. age group (40%). Conclusion: Intestinal parasitic infection is quite high and intestinal protozoa are more common than helminths in our study. We are first to report high prevalence of B. hominis in stool samples from North India. This study emphasizes the need to study further the reasons behind decrease in prevalence of helminthic intestinal parasites along with health education, good sanitation, personal hygiene, and health awareness to decrease prevalence of intestinal protozoa. Introduction Intestinal parasitic infections are globally endemic and constitute major public health problem, especially in the tropical and subtropical regions (1,2). They are widely prevalent in third world countries due to poor sanitation, inadequate personal hygiene, low level of education and lack of awareness about safe drinking water (3). According to the World Health Organization (WHO), more than one billion (almost 15-20%) of the world's population is chronically infected with parasites (4). In India overall prevalence rate of intestinal parasitic infection ranges from 12.5% to 66% with varying prevalence rate for individual parasite (5,6). Globally, the intestinal parasitic infections such as soil-transmitted helminth (STH) and protozoa infections have been recognized as one of the most significant causes of illnesses and diseases especially among disadvantaged communities (7). In India prevalence of the protozoa infections is higher than that of helminths with E. histolytica leading with a prevalence of 43.9% (8). Amoebiasis, Giardiasis, Ascariasis, Hookworm infection, and Trichuriasis are among the most common intestinal parasitic Indian Journal of Basic and Applied Medical Research, March 2015: Vol.-4, Issue2, P. 560-567 561 www.ijbamr.com P ISSN: 2250-284X, E ISSN: 2250-2858 infections worldwide. These infections are responsible for high levels of morbidity and mortality, nutritional deficiencies including iron deficiency anemia, seizures, portal hypertension, chronic diarrhea and impaired physical development in children (9, 10, 11). The aim of this study was to determine the prevalence of common intestinal parasitic infection in relation to demographic, socioeconomic status as well as the seasons of the year in patients attending an upcoming tertiary care hospital in North Lucknow. Materials and Methods: A retrospective study was conducted during the period of 1 January 2014 to 31 December 2014 in the Department of Microbiology laboratory of Integral Institute of Medical Sciences and Research, Dasauli, Kursi road, Lucknow. The study was approved by the Institutional Ethical Committee. A total of 755 stool samples from patients having complaints of gastrointestinal symptoms attending Integral Institute of Medical Sciences and Research hospital were processed. All samples were subjected to routine macroscopic and microscopic examination. Macroscopic examination included colour, consistency, presence of mucus / pus / blood / any parasite. Microscopic examination was done by normal saline and Lugol’s iodine wet mount preparation after Formol Ether sedimentation technique and observed under low (10x) and high (40x) power. The mounts were screened for any protozoan trophozoite / cyst and helminthic ova which were identified on the basis of their characteristic morphological features. Results A total of 755 stool samples were analyzed, out of which, 133 samples were found to be positive for parasitic infections, with a prevalence rate of 17.6%. Among positive samples Entamoeba histolytica was found to be the most common parasite in 70 (9.3%) cases, followed by Blastocystis hominis in 25 (3.3%), Giardia lamblia in 23 (3%), Ascaris lumbricoides in 10 (1.3%), Ancyclostoma duodenale in 3 (0.4%) and Hymenolepis nana in only 2 (0.3%) cases (Table 1, Figure 1). Parasitic infections were more common in male patients (10%) compared to their female (7.55%) counterparts. Statistically significant difference was found in male female distribution of E. histolytica was seen (p<0.05) (Table 2). In different age groups 21-40 years group (6%) was most commonly affected followed by 5-20 years, 41-60 years, 0-5 years and lastly >60 yrs, with a prevalence rate of 3.8, 3.2, 3 and 1.6% respectively (Table 3). Indian Journal of Basic and Applied Medical Research Is now with IC value 5.09 Indian Journal of Basic and Applied Medical Research, March 2015: Vol.-4, Issue2, P. 560-567 561 www.ijbamr.com P ISSN: 2250-284X, E ISSN: 2250-2858 Table 1: Prevalence of intestinal parasites in positive stool samples Name of parasite N (%) E.histolytica 70 (9.3)