Human intestinal parasites in Mahajanga, Madagascar: The kingdom of the protozoa

• Published in: PloS one Vol. 13; no. 10; p. e0204576
• Main Authors: Greigert, Valentin, Abou-Bacar, Ahmed, Brunet, Julie, Nourrisson, Céline, Pfaff, Alexander W, Benarbia, Leila, Pereira, Bruno, Randrianarivelojosia, Milijaona, Razafindrakoto, Jean-Louis, Solotiana Rakotomalala, Rivo, Morel, Eugène, Candolfi, Ermanno, Poirier, Philippe
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 10.10.2018; Public Library of Science (PLoS)
• Subjects: Adult; Amoeba; Analysis; Biology and Life Sciences; Blastocystis; Cities; Deoxyribonucleic acid; Diagnosis; Dientamoeba - genetics; DNA; Female; Flagellates; Genotypes; Geography, Medical; Giardia; Human health and pathology; Humans; Infections; Infectious diseases; Intestinal Diseases, Parasitic - diagnosis; Intestinal Diseases, Parasitic - epidemiology; Intestinal parasites; Intestine; Life Sciences; Madagascar - epidemiology; Male; Medicine and Health Sciences; Microbiology and Parasitology; Microscopy; Microsporidia; Parasites; Parasitic diseases; Parasitology; Patients; Phylogeny; Prevalence; Prospective Studies; Protozoa; Protozoan Infections - diagnosis; Protozoan Infections - epidemiology; Public health; Rural areas; Rural Population; Sanitation; Urban areas; Urban Population; Madagascar; Cities; France
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0204576

Intestinal parasitic infections are a major public health problem in inter-tropical areas. The aim of our study was to describe the situation in Mahajanga, Madagascar with a particular focus on two protozoa, Dientamoeba fragilis and Blastocystis sp. This was a prospective study from February to June 2015. Stool samples from symptomatic hospitalized patients and asymptomatic volunteers were submitted to microscopy and molecular assays in order to detect parasites. A wide panel of intestinal parasites were identified among the 265 included subjects, protozoa being the most prevalent with 72.8% whereas the prevalence of helminths and microsporidia was of 7.9% and 4.5%, respectively. Blastocystis sp. was the most prevalent protozoa (64.5% of the entire cohort) followed by various amoebas (35.5%) and flagellates (27,5%). We only detected subtypes 1, 2 and 3 of Blastocystis sp. Among the patients positive for D. fragilis (9.4%), 23 carried genotype 1 and 1 genotype 2. For the first time, we detected in 4 human stools the DNA of a recently described protozoon, Simplicimonas similis. Interestingly, subjects living in urban areas harbored significantly more different parasitic species than subjects living in rural areas with a correlation between sanitary level of neighborhood and protozoan infection. However, there was no difference in prevalence of digestive symptoms between parasite-free and parasite-infected subjects, except for Giardia intestinalis which had more symptomatic carriers. Our study reveals a high overall parasite prevalence, similar to what had been found in 2003 in the same city and to other prevalence studies conducted in Africa. The poor access of the population to sanitary infrastructures may explain this result. Data from our study provide valuable key for sanitation programs and prevention of fecal-related infectious diseases.