Background: The control of mosquito-borne diseases is challenged by biosafety concerns and the emergence of insecticide resistance. Herbal agents and nano pesticides offer promising approaches to ecofriendly vector control strategies. Objective: To evaluate the larvicidal efficacy of curcumin (Cur), and ivermectin (IVM) nanoparticles (NPs) against C. pipiens larvae, with special emphasis on morphological effects and the effect on oxidative stress. Material and Methods: Third instar C. pipiens larvae were exposed to different concentrations of Cur- NP and IVM-NP. Larval mortality was recorded over time, while morphological alterations were examined microscopically. Oxidative stress e.g., catalase (CAT) and peroxidase (POD) activities were assessed to investigate the underlying mechanism of larval mortality. Results: The IVM-NP achieved 100% mortality at a concentration of LC50 = 47.56 ppm within four days. The Cur-NP produced 100% mortality at a concentration of LC50 = 406.15 ppm within six days. Morphological deformities such as tilted head orientation and loss of setae were observed in Cur-NP-treated larvae. Moreover, there was a significant reduction in oxidative stress enzymes; CAT and POD activity in both treatment groups. Conclusion: These results highlight the significant efficiency of nano formulations of IVM and CUR as larvicidal agents, proposing them as potential candidates for the control of C. pipiens.
Background: Iron deficiency anemia (IDA) in children is often aggravated by intestinal parasites such as Blastocystis spp., with a debated pathogenic role. Objective: To assess the clinical, demographic, and hematological features of iron-deficient children with and without blastocystosis. Patients and Methods: This cross-sectional study included 240 children with IDA. Collected stool samples were examined microscopically by direct wet technique and by two staining methods: Giemsa and modified Ziehl-Neelsen (ZN). Blood samples were analyzed for hematological indices and serum ferritin levels. Results: Blastocystis cystic forms were detected in 135 cases (56.3%) aged 7-15 y (P<0.0001) residing in rural areas. Gastrointestinal (GIT) symptoms were exclusive for Blastocystis-positive cases (P<0.0001), in addition to significant lower total leukocyte counts (33.3%) and lymphopenia (66.7% vs. 50.5%; P=0.01) than non-infected patients. Leukocytosis was markedly higher in the Blastocystis-negative group (P<0.0001). Elevated eosinophil levels (>5%) were observed in 16.7% of all patients, frequently among Blastocystis-positive cases (22.2%) compared to non-infected individuals (9.5%, P<0.0001). Ferritin levels were significantly reduced among Blastocystis-positive children (P<0.0001). Iron deficiency anemia (12-30 ng/ml) and severe IDA (<12 ng/ml) were more prevalent among Blastocystis-positive children, whether infected by Blastocystis alone (72.3% and 12.0%, respectively) or with coinfections (51.9% and 9.6%, respectively). Conclusion: Blastocystosis is significantly linked to hematological abnormalities and IDA in children in rural areas. Its association with co-infections suggests a pathogenic role that warrants routine parasitic screening and integrated management in pediatric IDA cases.
Background: The commercially available therapeutic agents against cyclosporiasis are limited, and associated with serious side effects, low efficiency and high recurrence rate. Chitosan nanoparticles (CS-NPs) which showed promising therapeutic, immunomodulatory, and antioxidant activities were not previously investigated in treatment of cyclosporiasis. Objective: The current research evaluates the efficacy of low molecular weight (LMW)-CS-NPs against experimental cyclosporiasis in immunosuppressed mice. Material and Methods: Seven days oral regimen of 30 mg/kg of LMW-CS-NPs was applied starting from the 6th day post infection (dpi). Using a randomized controlled experimental study, the therapeutic effects of LMW-CS-NPs were compared to the traditional treatment with co-trimoxazole. In addition to parasitological, ultrastructural, and histopathological studies, glutathione (GSH), malondialdehyde (MDA) and IFN-gamma levels in mice' sera, were determined. Results: Results demonstrated statistically significant reductions in the oocyst count, with absence of recurrence, even after cessation of LMW-CS-NPs-treatment. Scanning electron microscopy (SEM) examination revealed markedly-mutilated LMW-CS-NPs-treated oocysts. Moreover, restored villus architecture, improved host antioxidant status, and enhanced immune response were documented in LMW-CS-NPs-treated group. Moreover, LMW-CS-NPs therapy mitigated MDA, and restored GSH. On the other hand, immunological assessment documented that LMW-CS-NPs achieved the highest IFN-gamma level. Conclusion: The evidence gathered herein highlighted, for the first time, LMW-CS-NPs as a promising safe non-expensive alternative treatment for cyclosporiasis.
Background: Use of the therapeutic drug co-trimoxazole (sulfamethoxazole/trimethoprim) against acute toxoplasmosis is limited highlighting the need for new, effective and secure treatments. Natural products gained significant attention as effective and potentially safer alternatives for the treatment of parasitic diseases. Objective: To assess the potential efficacy of Origanum vulgare extract (Oregano) for the treatment of T. gondii (RH strain)-experimentally infected mice, in comparison to co-trimoxazole. Material and Methods: Four groups of Swiss albino male mice were included in the study, (12 mice in each): non-infected, infected non-treated, co-trimoxazole treated, and oregano treated. Treatment was started on the 1st day post infection (dpi) and mice were sacrificed at the 7th day. Therapeutic effects were evaluated by conducting parasitological, and histopathological studies. To assess cytotoxicity, liver enzymes were determined. To explore the potential mechanism of action, cyclooxygenase 2 (COX-2) immunohistochemical staining of liver tissues was performed. Results: Treatment with oregano extract or co-trimoxazole significantly exhibited anti-T. gondii effects compared to the untreated as evidenced by reduced tachyzoite counts in the peritoneal fluid, reduced mortality rate, improved histopathological changes of liver, spleen and brain tissues, and reduced COX-2 immunohistochemical staining in liver sections. Additionally, oregano extract presented a noticeable improvement in liver enzyme levels. Conclusion: From the results obtained, the potential therapeutic efficacy of oregano extract against acute toxoplasmosis was concluded.
Background: Toxoplasmosis seropositivity rate is variable in different populations and regions and is influenced by some demographic and lifestyle factors. Objective: To determine the seropositivity rate of toxoplasmosis and its correlation with certain demographic factors and some immunological measures in Duhok Province, Iraq. Subjects and Methods: This cross-sectional study was conducted from May 2024 to June 2025 among 600 participants, aged 22-60 y of both genders, in Duhok Province, Iraq. Anti-Toxoplasma IgG and IgM antibodies, as well as the serum pro-inflammatory cytokines (IL-1 beta, IL-6, IL-18, TNF-alpha), and the anti-inflammatory cytokines (IL-4, IL-10), were determined using ELISA. Results: Overall seropositivity rate was 39.17% (IgG 31.67%, IgM 7.5%). Significant (P<0.001) associations for both IgM and IgG antibodies were found with gender, residence, education level and occupation. While significant (P<0.001) differences for IgG antibodies were found among age group 31-40 y, married individuals, and AB+ blood group. Elevated mean concentrations of several key inflammatory and regulatory cytokines specifically IL-6, IL-10, and IL-18 were found to be significantly (P<0.001) higher in the seropositive population vs. the seronegative (control). Conversely, IL-1 beta and IL-4 levels were significantly (P<0.001) lower in the seropositive group. While TNF-alpha level was almost equal in both groups. Conclusion: Monitoring serum cytokine profiles offers an accurate indicator to assess the dynamic pathoimmunological landscape of toxoplasmosis, facilitating tailored therapeutic interventions and improved patient management for both genders.
Background: Nitazoxanide (NTZ) is the sole drug commonly used to treat cryptosporidiosis. However, it is less effective in immunocompromised patients and drug resistance was recorded. Objective: To assess the therapeutic efficacy of Cassia fistula extract on immunocompromised mice infected with Cryptosporidium spp. compared to NTZ. Material and Methods: Fifty pathogens free mice were categorized into five equal groups designated as a negative control and four Cryptosporidium infected groups: positive control, NTZ treated, C. fistula treated, and combined NTZ/C. fistula treated. All mice were euthanized on 21st day post infection (dpi). To assess therapeutic effects, oocyst counts in stool were calculated on 7th, 11th, 14th, 17th and 21st dpi, while microscopic examination of histopathological changes, and determination of cyclooxygenase-2 (COX2) expression in ileal and lung tissues were performed at 21st dpi. Results: Nitazoxanide induced a high reduction% in oocysts count whether alone (70.4%, 70.7%, 75%, and 78.7%) or combined with C. fistula extract (82.1%, 82.2%, 85.1%, and 88.1%) on days 11, 14, 17 and 21 dpi, respectively. Extract alone achieved better improvement in histopathological examination in ileal tissue (restoration of villous/crypt ratio, decreased ulceration and sloughing of villi, and increased goblet cells) and lung tissue (decreased dysplasia, congestion and inflammation with remarkable improvement of interstitial inflammation, hyperplasia of bronchial mucosa, pulmonary hemorrhage, and restoration of normal alveolar structure). Amelioration in histopathological changes in C. fistula treated groups than in NTZ monotherapy group could be explained by downregulation of COX2 expression in ileal and lung tissues. Overall, the best results were obtained with combined treatment. Conclusion: Combined therapy has dual antiparasitic and anti-inflammatory effects offering a superior therapeutic strategy against cryptosporidiosis.
Background: Available drugs for treatment of cryptosporidiosis aren't efficient for either malnourished children or immunocompromised patients. Searching for an effective therapeutic protocol in such cases is mandatory. Objective: To explore the therapeutic potential of Artemether (ART) on immunosuppressed mice experimentally infected with Cryptosporidium spp., when used as monotherapy and in combination regimens with Nitazoxanide (NTZ) and/or Ivermectin (IVM). Material and Methods: This study was conducted on male Swiss albino mice, immunosuppressed by dexamethasone then orally infected by Cryptosporidium oocysts. Mice were randomly divided into seven groups: G1 (control untreated); G2 (NTZ-treated); G3 (ART-treated), G4 (IVM-treated); G5 (ART+IVMtreated); G6 (ART+NTZ-treated); G7 (ART+NTZ+IVMs-treated). Drug efficacy was assessed by oocysts counts in stool and intestinal content at different intervals, and histopathological examination of ileal tissue. Results: Mice treated with ART showed significant oocyst count reduction in stool and intestinal samples, as compared with control group. However, its effect was potentiated when used in combination with both NTZ and IVM (G7). In addition, restoration of normal histological structure, inflammation reduction and decrease of oocysts count within the ileal tissue were obvious in mice receiving the triple protocol despite using half the recommended therapeutic doses. Conclusion: Our study suggests the potential synergism effects for treating cryptosporidiosis in immunocompromised patients. Further studies are recommended to explore the mechanism of that synergism.
Parasitic intestinal infections can present by chronic or persistent diarrhea in children and may lead to severe nutritional, metabolic, and systemic complications even when routine stool examinations are initially negative. Clinical consideration is important because parasitic infections are frequently overlooked due to nonspecific clinical presentations and false-negative initial investigations. Delayed diagnosis can result in growth failure, electrolyte disturbances, protein-losing enteropathy, and long-term morbidity, particularly in children living in low-resource settings. Early recognition and targeted evaluation are therefore essential to prevent serious complications. Two such sporadic pediatric cases from Upper Egypt are worth mentioning. An 8-year-old girl complaining for one year from chronic bloody diarrhea, mild abdominal pain, eosinophilia, and recurrent symptoms despite standard antibacterial therapy, suggesting an overlooked parasitic etiology. A 13-year-old boy with persistent diarrhea complicated by severe malnutrition (BMI 13.9 kg/m2), electrolyte imbalance, hypoalbuminemia, edema, and protein-losing enteropathy, highlighting the profound systemic impact of prolonged enteric infection.
Background: Cryptosporidiosis is an opportunistic parasitic disease targeting young children and immunocompromised individuals. Nitazoxanide (NTZ) has limited efficacy in these patients. Proton pump inhibitors were successfully evaluated as alternative therapy in treatment of several parasitic diseases. Objective: To evaluate the therapeutic efficacy of Vonoprazan (Vono) compared to NTZ against cryptosporidiosis in experimentally immunosuppressed mice. Material and Methods: Fifty male Swiss Albino mice were immunosuppressed by dexamethasone. Mice were divided into 5 equal groups; GI: neither infected nor treated (normal control); GII: infected, non-treated (positive control); GIII: infected and treated with NTZ; GIV: infected and treated with Vono, GV: infected and treated with Vono/NTZ. Drugs' efficacy was evaluated using parasitological, histopathological and serological parameters. The latter included assessment of proinflammatory cytokine (TNF-alpha), and oxidative stress marker (malondialdehyde, MDA). Results: The highest reduction in Cryptosporidium oocysts count was achieved in Vono/NTZ treated group (82.6%) followed by NTZ treated group (65.7%). The lowest levels of TNF-alpha, and MDA were observed in Vono/NTZ treated group followed by Vono treated group. However, NTZ treated group showed the highest MDA and TNF-alpha levels. Combined group showed the best improvement of histopathological changes in the small intestine and lungs in comparison to that induced by either NTZ or Vono alone. Conclusion: Combining Vono with NTZ is a promising regimen for cryptosporidiosis with significant impact on antioxidant and anti-inflammatory effects.
Background: Irritable bowel syndrome (IBS) is a common gut-brain disorder of unclear origin, though growing evidence links itto intestinal parasites. However, whether these infections cause IBS or are merely incidental remains uncertain, especially in affected regions. Objective: This case-control study aimed to determine the frequency and clinical impact of intestinal parasites in IBS patients versus healthy controls and to evaluate the therapeutic effect of targeted antiparasitic treatment on IBS symptomatology. Subjects and Methods: A total of 200 participants (100 IBS patients diagnosed by Rome IV criteria and 100 matched controls) were enrolled. To assess epidemiological impact, and clinical outcome, clinical evaluation and comprehensive stool analysis were performed for all subjects. Patients and control with confirmed intestinal parasites received standard antiparasitic therapy. Parasitological and clinical followups were conducted post-treatment to assess clearance and symptom evolution. Results: Intestinal parasites frequency was significantly higher in the IBS cohort (36%) compared to controls (14%) (P<0.005). Blastocystis spp. was the most common pathogen (24% in IBS vs. 9% in controls), followed by E. histolytica/dispar (8% vs. 5%). Post-treatment evaluation demonstrated effective parasitological clearance, reducing the infection rate in the IBS group to 4%. Clinically, targeted antiparasitic treatment led to significant improvement in 63.8% of treated IBS patients, while symptoms remained unchanged in 33.3%. In contrast, one patient (2.9%) progressed to watery diarrhea. Conclusion: This study demonstrates a significant association between intestinal parasitic infections and IBS. Routine microscopic screening is recommended in patients with IBS in endemic areas, as targeted antiparasitic treatment can improve clinical outcome.
