Intestinal parasite infections among internal war refugees and inhabitants of the Ternopil region, Western Ukraine

Background: The armed aggression of the Russian Federation against Ukraine resulted in the destruction of the country's infrastructure and a decline in the standard of living for many citizens (e.g. shortages of electricity and safe drinking water, limited access to healthcare, living in unsuitable cold basements). A lot of Ukrainians living in the eastern, southern and central parts of the country were forced to flee their homes. The aim of this study was to assess the prevalence of intestinal parasite infections among internal war refugees and residents of Ternopil, a city in Western Ukraine, in response to the worsening of the epidemiological situation in the country.Materials and methods: Parasitological diagnostics was carried out in June 2023 and involved 127 adult Ukrainian citizens aged 19-80 years old, including 80 internal war refugees (most of the participants came from Donetsk, Luhansk, Dnipro, Kherson regions) and 47 residents of Ternopil region, Western Ukraine. Surveys and parasitological examination of stool samples by three different light microscopy testing methods (direct smear, decantation, flotation) were performed. The samples were then tested for the presence of Giardia intestinalis intestinal protozoa by molecular tests (reverse transcription polymerase chain reaction [RT-PCR]) and immunochromatographic rapid diagnostic tests (RDTs).Results: All RT-PCR and RDT tests to detect Giardia intestinalis were found to be negative. The examination of faecal samples taken from 127 patients showed no infections with nematodes, cestodes or trematodes. The examinations only revealed infections with potentially pathogenic Blastocystis spp.: 18/80 infections in the population of internal war refugees (22.5%) and 7/47 infections among residents of the Ternopil region (14.9%). Survey results demonstrated frequent use of antibiotics and antiparasitic drugs without physician advise or prescription: 43.9% of the study participants (n = 127) were taking antibiotics, and 25.2% were taking antiparasitic drugs during the period of 3 months prior to the study. Conclusions: An absence of intestinal parasite pathogens was detected in the studied population. The authors may explain it by the fact, that many Ukrainian patients have unlimited access to antimicrobial drugs (drugs sold without a valid prescription and taken without consultation with a physician), which could have contributed to the low incidence of intestinal parasite infections.