Abstract Strongyloides stercoralis is an intestinal nematode that usually causes mild or asymptomatic chronic infection in immunocompetent individuals but can result in fatal hyperinfection or dissemination in immunocompromised hosts. Gastric involvement is rare and underreported. We present two histologically confirmed cases of S. stercoralis infection involving the upper gastrointestinal (GI) tract – one in an immunocompetent and the other in an immunocompromised patient. The first involved duodenal and gastric mucosa, and the second showed gastric strongyloidiasis in a patient on corticosteroids. Both highlight the diagnostic value of endoscopic biopsy and the differences in presentation between immune states. Strongyloides infection of the stomach and duodenum, though rare, should be considered in chronic GI symptoms even without overt immunosuppression. Early detection by endoscopic biopsy and timely treatment are vital to prevent fatal outcomes.
Abstract Filariasis is an infectious disease caused by various parasitic roundworms and remains a significant global health issue, especially in tropical regions such as India. The disease primarily affects the lymphatic system, commonly impacting the lower limbs, retroperitoneal tissues, spermatic cord, and epididymis. Here, we present a rare case in which microfilariae coexist with a follicular variant of papillary carcinoma in the right thyroid lobe of a young female. Microfilariae were incidentally detected on fine-needle aspiration cytology and confirmed by quantitative buffy coat examination. The patient was treated with diethylcarbamazine followed by definitive surgical management for thyroid carcinoma. This case highlights the importance of keeping a high index of suspicion for filariasis in endemic regions, even in cystic or neoplastic thyroid lesions, and emphasizes the role of cytology in diagnosis.
Abstract Background: Malaria, a devastating disease primarily caused by five Plasmodium species in humans, continues to pose a significant global health challenge, particularly in sub-Saharan Africa. The parasite’s ability to evade the host immune system through antigenic variation is a major obstacle to malaria control. Genes responsible for this variation are concentrated in subtelomeric regions of chromosomes, with chromosome 4 being a notable locus for such genes. This study presents a comparative genomic analysis of chromosome 4 across the five human-infecting Plasmodium species: Plasmodium falciparum, Plasmodium malariae, Plasmodium ovale, Plasmodium vivax , and Plasmodium knowlesi . Methodology: The complete nucleotide sequences of chromosome 4 for the five Plasmodium species were retrieved from the National Center for Biotechnology Information GenBank database. We performed a comprehensive bioinformatic analysis to compare their genomic features. This included calculation of GC content and sequence length, de novo gene prediction using AUGUSTUS, functional annotation of predicted genes through Basic Local Alignment Search Tool against the PlasmoDB database, and gene ontology (GO) enrichment analysis. Phylogenetic relationships were inferred using Multiple Alignment using Fast Fourier Transform for multiple sequence alignment and PhyML for maximum likelihood tree construction. Results: Our analysis revealed significant differences in the genomic landscape of chromosome 4 among the five species. P. knowlesi exhibited the highest GC content (39.65%) and gene density, with 192 predicted genes. In contrast, P. ovale had the smallest chromosome 4 and the lowest gene count. Phylogenetic analysis confirmed that the common ancestor of P. falciparum, P. vivax, P. malariae , and P. ovale diverged from the lineage leading to P. knowlesi . We identified a set of conserved genes across all five species, as well as species-specific genes, including some known virulence factors such as the var and rifin gene families in P. falciparum . GO analysis of the predicted genes revealed enrichment for terms related to pathogenesis and immune evasion. Conclusion: This comparative genomic study provides a detailed profile of chromosome 4 in human Plasmodium species, highlighting both conserved and species-specific features. These findings offer valuable insights into the evolutionary dynamics of this chromosome and its role in host–parasite interactions. The identification of species-specific genes and their functional annotation may pave the way for the development of novel, targeted interventions, such as species-specific vaccines and antimalarial drugs.
Abstract Background: Intestinal parasitic infections, particularly soil-transmitted helminths (STH), remain a major public health concern in tropical and subtropical regions. Data from Northeast India are limited. Objective: The objective of this study was to determine the prevalence, age distribution, and seasonal trends of intestinal parasites among patients attending a secondary-to-mid-tertiary care hospital in Nagaland. Materials and Methods: A retrospective analysis of stool samples collected from January 2019 to December 2022 was performed. Samples were examined macroscopically and microscopically using saline and Lugol’s iodine wet mounts after formol-ether concentration. Data were analyzed using Microsoft Excel and SPSS. Results: A total of 2166 stool samples were analyzed. Overall prevalence of intestinal parasitic infections was 7.8% (169/2166), with Ascaris lumbricoides (36.3%) and Taenia spp. (31.5%) being the most common. Highest prevalence was observed in the 11–15 years of age group (14.7%). A. lumbricoides infections peaked during the winter months (November–March). Coinfections were observed in two patients. Conclusion: Although hospital-based data may underestimate community prevalence, this study highlights the persistent presence of intestinal parasites in Northeast India, with school-aged children at higher risk. Findings highlight the need for community-based surveillance.
Abstract Hookworm as a cause of anemia in the postmenopausal women has been often neglected and only evaluated for when all other causes have been excluded. Here, we report a series of four cases of severe anemia needing blood transfusions due to hookworm infection in postmenopausal women who presented at a tertiary care hospital in Northeast India. These cases highlight the problem of hookworm infection in this age group who are otherwise not regarded as vulnerable group and not prioritized in national deworming program. There is a need to recognize hookworm as the cause of anemia for the early diagnosis of infection and prevention of severe consequence.
Abstract Introduction: Scabies is a skin disease that presents a variety of symptoms. Untreated scabies can lead to significant complications and negatively impact the affected quality of patient life. This study aims to describe the clinical characteristics of scabies and assess the efficacy of various treatment therapies. Materials and Methods: The study was conducted in Hanoi and Lai Chau with 65 patients who had been diagnosed with scabies from September 2023 to June 2024. Patients underwent examination, categorization, and treatment with diethyl phthalate (DEP) topical and a 5% permethrin spray. The patient’s treatment outcomes were assessed following a period of 4 weeks. Results: The proportion of patients diagnosed with scabies was 65 (0.8%) out of 8110 people suffering from dermatological illnesses. Scabies afflicted males and females in a 2:1 ratio, with the majority of cases (60%) in the 20–49 age range and 4.6% among those under 10 years old. Moderate and mild cases were found in 40% and 47.7% of patients, respectively, with only 12.3% being severe cases. Scabies lesions were most usually detected in the interdigital spaces and on the palms (95.4%), the belly and around the waist (75.4%), external genitalia (72.3%), and the pubic area with interdigital spaces (66.2%); other afflicted locations varied from 1.5% to 30.8%. All lesions were vesicular, with 40% exhibiting scaliness, and other lesion types ranged from 4.6% to 9.2%. 96.9% of patients experienced moderate to severe itching, with 81.5% experiencing it at night. The treatment results revealed a 47.7% clinical improvement when treated with DEP, compared to 79.8% with permethrin 5%. There were no negative effects from any scabies drugs. Conclusions: Scabies affects around 0.8% of the population in Northern Vietnam, a common dermatological disease that causes lesions to form as blisters on the hands and between the fingers, causing itching in those affected. Permethrin 5% is a more effective scabies therapy than DEP.
Abstract Background/Objectives: Opisthorchis viverrini , a foodborne zoonotic trematode endemic to Southeast Asia, is a major cause of cholangiocarcinoma and an environmental public health concern. Its transmission relates to aquatic ecosystems, waterborne diseases, and health–environment interactions. This study assessed prevalence and distribution in freshwater cyprinid fish from Nakhon Nayok, Thailand, using polymerase chain reaction (PCR)-based diagnostics. Materials and Methods: A total of 359 fish representing five cyprinid species were collected from four districts. Tissue samples (gills, scales, and flesh) underwent enzymatic digestion for metacercarial recovery, followed by deoxyribonucleic acid extraction. Species-specific PCR targeting a 330 bp fragment was conducted, and products were visualized by agarose gel electrophoresis. Results: Among the 359 fish, Henicorhynchus siamensis was most common (27.6%), followed by Barbodes schwanenfeldi (25.9%), Barbodes gonionotus (24.5%), Trichopodus trichopterus (10.6%), and Anabas testudineus (11.4%). PCR revealed species- and tissue-specific infections: H. siamensis showed the highest prevalence (15.2% scales, 9.1% flesh, and 6.1% gills), T. trichopterus moderate (12.9% gills, 6.5% scales), and B. gonionotus low (2.3%), while none were detected in A. testudineus or B. schwanenfeldi . Ban Na showed the highest positivity (28%), followed by Ongkharak (12%) and Pak Phli (5%), with none in Mueang. Conclusion: This study highlights species- and region-specific variations of O. viverrini infection in freshwater fish from Nakhon Nayok. PCR provided reliable early detection, supporting molecular tools for surveillance and targeted public health interventions in opisthorchiasis control.
Background and Objective:Tuberculosis (TB), caused by Mycobacterium tuberculosis, ranks among the deadliest communicable diseases, significantly contributing to global mortality and morbidity. By weakening the immune system, TB increases susceptibility to intestinal parasites like Cryptosporidium spp. These intestinal parasitic infections (IPIs) are widespread, especially in regions with poor sanitation and inadequate hygiene. The problem is particularly acute in developing countries like India, where the co-infection rate of TB and IPIs is notably high. The primary purpose of this study was to investigate the potential for co-infection and its impact on both diseases. Methods:This prospective observational study was carried out in the Department of Microbiology at Christian Medical College and Hospital, Ludhiana, Punjab, India, from September 2022 to August 2023. It included 115 sputum smear-positive TB patients; stool samples were collected from 92 of these individuals. The collected samples underwent both macroscopic and microscopic examinations to assess the prevalence of IPIs. Results:TB with IP co-infection was detected in 27.17% of the patients, with Cryptosporidium oocysts being the most frequent finding. The age group of 61-70 years had the highest prevalence of TB with Cryptosporidium spp. (41.17%). Cryptosporidium spp. prevalence was higher in urban areas (33.33%) compared to rural areas (5%). TB with Cryptosporidium spp. coinfection was more prevalent among patients with diabetes (31.43%). Conclusion:The simultaneous occurrence of TB and IPIs like Cryptosporidium spp. can severely weaken the immune system. It is important to screen all TB patients for IPIs to effectively identify and manage these dual infections to improve treatment outcomes, reduce health risks, and enhance overall patient care strategies.
Introduction:Visceral Leishmaniasis (VL), caused by Leishmania donovani, is a fatal disease, necessitating an effective vaccine. This study aims to develop a vaccine by evaluating the combination of recombinant kinesin protein (rKIN) with Bacille Calmette-Guerin (BCG) as an adjuvant against experimental VL. Materials and Methods:The immune response was analyzed against the purified rKIN of L. donovani with and without BCG adjuvant by using BALB/C mice. Mice were divided into 6 groups comprising of 6 animals in each group for the vaccine intramuscularly. All 6 Groups were immunized either with BCG, rKIN, or combination of the two, with different doses. Saline was used as negative control. Each group was further divided into 2 subgroups. One subgroup of animals from each group was challenged with L. donovani promastigotes 1 × 106 cells/100 μl per animal. The extent of protection was evaluated by estimating the reduction in the number of parasites in the spleen, quantity of nitric oxide (NO), reactive oxygen species (ROS) in the peritoneal cells, and production of cytokines in blood serum. Results:Significant parasite reduction (70%-90%) was observed in the spleens of groups receiving rKIN (50µg or 100µg) with BCG. NO and ROS production increased by 60%-95% and 70%-90%, respectively. The 100µg rKIN with BCG group demonstrated substantial protection (P < 0.001) with upregulated interferon-gamma (IFN-γ), tumor necrosis factor, interleukin-2 (IL-2), and downregulated IL-4, IL-10, and IL-17. Statistical analysis confirmed significant differences (P < 0.001) between vaccinated and control groups. Conclusions:The combination of 100µg rKIN with BCG shows potential as a vaccine candidate against VL.
Giardiasis is increasingly recognized as a systemic illness beyond its classical intestinal manifestations. This study aimed to characterize systemic manifestations across age groups by evaluating hematological, hepatic, and iron profiles. A retrospective cross-sectional analysis was conducted on 105 giardiasis cases in a tertiary center between 2022 and 2024, stratified by age. All infants exhibited reduction in packed cell volume, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH); adolescents showed significant MCV reduction (P = 0.018); young adults displayed reduced MCH (P = 0.019). Elevated bilirubin is observed in children (P = 0.025) and adolescents (P = 0.009). Most striking was iron metabolism dysregulation in 100% adults aged 18-60 years. The study also showed a male predominance (70.5%), with a seasonal peak during the monsoon period. These findings indicate that giardiasis causes age-specific systemic effects, with iron metabolism disruption in adults emerging as a key treatment focus.
Context: Toxoplasmosis is a zoonotic infectious disease caused by Toxoplasma gondii ( T. gondii ). This infection can lead to important manifestations in children with placental transmission. Toxoplasmosis can be avoided by simple hygiene measures, and prenatal care is important for pregnant women. Aim: This study aimed to investigate knowledge about toxoplasmosis and practices that prevent this infection among pregnant women. Materials and Methods: The study was conducted in 19 selected primary healthcare units in the district of Abidjan, Côte d’Ivoire. A completed survey form was administered to each woman after obtaining informed consent. The questionnaire included items on the parasite T. gondii , transmission modes, symptoms, diagnosis, treatment, and prevention and control strategies. Results: Pregnant women were unaware of toxoplasmosis and its effects; only 8% indicated that they had heard or seen information about toxoplasmosis. Among pregnant women, 7% owned a cat, and 13.51% of them cleaned up their cat’s droppings. Gardening was practiced by 8%. Seroprevalence of toxoplasmosis was 52%. The main risk factors for contamination were lack of knowledge about toxoplasmosis and consumption of undercooked meat, raw milk, and untreated water. Conclusion: This is the first study regarding the knowledge and practice of toxoplasmosis in pregnant women in Côte d’Ivoire. Poor knowledge regarding T. gondii infection and practices among pregnant women was found. Educational interventions are highly needed for pregnant women prenatally. This information could help reduce the vertical transmission of Toxoplasma infection during pregnancy.
Gallbladder ascariasis is an uncommon manifestation of ascaris lumbricoides infection, typically seen in the endemic regions. Even rarer is the concurrent presence of Löffler's syndrome. We report the two cases - the first, a 92-year-old male, presented with typical biliary colic and was diagnosed with gallbladder ascariasis. The second, a 38-year-old female, presented with respiratory symptoms and was found to have ground-glass opacities on high-resolution computed tomography and peripheral eosinophilia, later associated with gallbladder ascariasis on imaging. Both cases were managed conservatively with anthelminthic therapy and supportive care. This series highlights both the hepatobiliary and pulmonary presentations of ascaris lumbricoides infection.
A 7-year-old boy presented to the paediatric out-patient department with complaints of abdominal pain and fever for the past 6-7 days. On clinical examination, the child was febrile, with no evidence of hepatosplenomegaly. He was admitted for further evaluation and management and was started on intravenous ceftriaxone, paracetamol, pantoprazole, and Ringer lactate. Baseline laboratory investigations revealed normocytic, normochromic red blood cells with leukocytosis and a left shift, along with the presence of a few activated lymphocytes. The total leukocyte count was 16.3 × 10³/µL. Haemoglobin level was 9.2 g/dL, and the platelet count was markedly reduced at 35,000/µL. Inflammatory markers were significantly elevated, with a C-reactive protein (CRP) level of 144.8 mg/L. Liver function tests were within normal limits. Peripheral blood smear examination was performed in view of thrombocytopenia and persistent fever, which revealed unusual microscopic findings. These findings and their clinical significance are discussed below.
Microsporidia are obligate intracellular, primitive eukaryotic parasites that infect a diverse array of vertebrate and invertebrate hosts. Phylogenetic studies have demonstrated their close relationship to fungi, though they possess unique structural and genomic features. With approximately 220 genera and 1,700 species identified, they exhibit considerable diversity in host range and pathogenic potential. These organisms are widely distributed across humans, animals, and environmental reservoirs, and are increasingly recognized as clinically significant pathogens. They are particularly associated with disease in immunocompromised populations, such as those with advanced HIV infection, organ or bone marrow transplant recipients, and individuals receiving immunomodulatory therapies. However, recent reports have also documented infections in immunocompetent individuals, emphasizing their growing clinical relevance. The clinical manifestations of microsporidiosis are heterogeneous, ranging from chronic gastrointestinal illness to ocular, respiratory, and systemic involvement. Diagnosis primarily relies on microscopic detection of spores in clinical specimens like stool and body fluids. Advanced methods such as molecular assays, immunofluorescence, and electron microscopy enable species-level identification. Therapeutically, albendazole is effective against many microsporidial species, particularly those belonging to the genus Encephalitozoon. However, species such as Enterocytozoon bieneusi and Vittaforma often respond poorly. Effective management depends on early recognition, improved access to diagnostics, and restoration of immune function. Intensified research into host-pathogen interactions and treatment modalities is essential to address the growing burden of microsporidiosis. This review highlights the emerging significance of microsporidia as opportunistic pathogens, emphasizing their epidemiology, host interactions, diagnostic strategies, and current therapeutic challenges in both immunocompromised and immunocompetent populations.
Objective: Leishmania major , the primary causative agent of cutaneous leishmaniasis, presents significant challenges for vaccine development due to antigenic diversity and the limitations of current therapeutic approaches. Therefore, this study aimed to use immunoinformatics computational approaches to identify novel vaccine candidates against leishmaniasis. Materials and Methods: We implemented a comprehensive multi-stage computational filtering strategy to systematically evaluate the complete L. major proteome (8,038 proteins) for membrane-associated vaccine candidates. Using integrated antigenicity prediction VaxiJen v2.0, subcellular localization analysis combining UniProt annotations and DeepLoc 2.0 predictions, dual allergenicity assessment using AllerTOP v2.0 and AllergenFP v1.0, and extensive conservation analysis were conducted across five Leishmania species ( L. donovani, L. infantum , L. braziliensi s, L. guyanensis , and L. mexicana ) with human homology screening. Results: The screening achieved a 321-fold enrichment, identifying 25 nonallergenic membrane-associated proteins with high antigenic potential and optimal safety profiles. These candidates have not been previously investigated as vaccine targets, representing an expansion of the existing therapeutic repertoire. Conservation analysis revealed distinct strategic categories: seven proteins demonstrated >90% identity across multiple Leishmania species, suggesting broad-spectrum vaccine potential, while eight showed moderate conservation (>80%), indicating region-specific utility. Functional characterization revealed diverse membrane proteins, including novel adhesion molecules, transport proteins, and uncharacterized surface antigens. Critical safety assessment confirmed minimal human protein similarity (<35% identity), significantly reducing autoimmunity risks. Conclusion: The bioinformatics data support the substantial untapped potential within parasitic proteomes and validate systematic computational screening as a potential strategy for vaccine development. The conservation patterns identified provide clear strategic guidance for developing either pan- Leishmania vaccines for broad-spectrum protection or species-specific formulations for targeted regional use. However, additional in silico and wet lab synthesis of the vaccine has to be conducted to confirm the potential of the protein candidates.
