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Objective: To describe the environmental conditions and the parasitic infection status of Xukuru-Kariri individuals living in the municipality of Caldas, state of Minas Gerais, Brazil., Methods: A cross-sectional study was carried out in March 2009. Sociodemographic and environmental data were collected through interviews. Water and fecal samples were collected for determination of environmental contamination and parasitic infection status., Results: The Xukuru-Kariri population living in Caldas included 86 people divided into 22 families. Of 22 heads of household, 81.8% had low schooling (not higher than elementary education). Of 26 water samples collected for microbiological analysis, 77.0% were positive for total coliforms and 4.0% for Escherichia coli. Residents of 27.3% of households defecated in the open. Trash was scattered in the yard of 54.5% of households. Fecal samples were collected from 60 individuals, with parasitic infection in 66.6%. The following prevalence rates were recorded: Entamoeba histolytica/dispar, 6.7%; Entamoeba coli, 60.0%; Endolimax nana, 1.8%; and Giardia duodenalis, 6.6%., Conclusions: The people included in this study faced environmental characteristics that contributed to their health vulnerability. Health actions as well as the implementation of public policies to provide sanitation, with quality water and adequate collection and treatment of human and household waste, are essential to prevent environmental degradation and improve the quality of life of these individuals.

This study provides a comprehensive epidemio-clinical picture of sporadic, domestically acquired cases of amoebiasis, cryptosporidiosis and giardiasis in one Canadian community based on patient symptom, outcome and exposure data from an enhanced surveillance system. It yields valuable data for estimating the burden of those diseases including the proportion of bloody diarrhoea, hospitalization, and disease duration. Age differences were observed by incidence rate and for some clinical information and exposures to risk factors. For each of the three diseases, the animal/environment-to-person route was the most common possible main transmission route according to the exposure reported, whereas the person-to-person route was the least common. Exposure was higher for the 10-24 years age group of giardiasis cases for swimming in recreational waters (79%) and attending a barbeque (50%). Therefore, comparisons between groups of cases or extrapolation of results when estimating the burden of illness should be adjusted for age.

The use of wastewater and excreta in agriculture constitutes an important source of spread Salmonella strains and protozoan infections into the environment. This practice has been used in El Azzouzia (the wastewater-spreading area of Marrakesh city, Morocco) for several years. The available circumstantial evidence gained from epidemiological and microbiological investigations suggests that the use of untreated wastewater causes an excess of protozoan infections among children living in El Azzouzia (72%) compared with those from a control area (45%). The pathogenic protozoan infections observed were giardiasis (39%) and amoebiasis (28%). For Salmonella infection, 21.34% of the exposed children were infected, while this rate did not exceed 1.14% in the control group. The serogroups B and C were the most commonly isolated. The sewage farming children are therefore more exposed to detectable risk from pathogenic micro-organisms than the control children.

The present study addresses the impact of wastewater reuse in agriculture on the transmission of protozoan and helminthic infections. For this purpose, an epidemiological study was carried out on two populations of children totalling 608 individuals for protozoan infections and 528 for helminthic infections. Each population comprised an exposed group living in the wastewater spreading area of Marrakech and a control group. Results showed that 72% of the exposed group had protozoan infections. This rate did not exceed 45% in the control group. The pathogenic protozoan infections observed were giardiasis and amoebiasis. Regarding helminthic infections, 73% of the exposed children were infected compared with 30% of the control group. The risk attributable to wastewater reuse in the transmission of pathogenic protozoan and helminthic infections was 41% and 43%, respectively. Children of the spreading area are therefore more exposed to detectable risks from parasitic helminths and protozoa than the control children.

In two cases there was simultaneous or sequential occurrence of amebiasis, shigellosis, and giardiasis in male homosexuals. Enteric pathogens may, under the proper conditions, be venereally transmitted. In particular, the sexual practices of male homosexuals, most significantly, oral-anal contact, appear to provide the necesseary link for transmission. Evidence suggests that this is a growing problem.

Stool specimens from 89 high-risk, sexually active homosexual men were screened for enteric protozoal cysts. Patients whose specimens contained nonpathogenic cysts were investigated further by examination of fresh purged specimens. A total of 27 of the initial specimens (30%) contained protozoal cysts. Twenty-three patients (26%) harbored pathogens. There were 18 cases (20%) of amebiasis and 11 cases (12%) of giardiasis. Six men (7%) had concurrent amebiasis and giardiasis. The presence of infections correlated with a history of anilingus but not with place of birth, travel, or history of symptoms. The exceptionally high rate of prevalence of intestinal protozoal infection in this population suggests that enteric protozoal infections are important among sexually transmitted diseases.

This paper focuses on the growing incidence of the "new" sexually transmitted parasitic enteric diseases: amebiasis and giardiasis. Two major behavioral factors influence transmission of these diseases in the gay community: 1) oral-rectal and oral-genital sexual contact and 2) multiple sexual partners. Pathogenesis, clinical signs and symptoms and complications associated with these diseases are also discussed. Although many patients present with severe symptoms, approximately 50 percent of infected patients are asymptomatic. The diagnostic procedures include a fresh purged stool examination, nonpurged warm stool examinations, and/or cold stool specimens. The serologic tests (serum precipitin and hemagglutination) are of value only in severely symptomatic invasive disease. Different treatment regimens and their side effects are discussed. Drugs used in the treatment of the enteric diseases include diiodohydroxyquin, metronidazole, furamide, and paromomycin. Only 60 to 70 percent of patients with the disease are cured, and 30 to 40 percent of patients require multiple courses of therapy. Test-of-cure examinations, ideally consisting of one or two purged stool specimens, are necessary in follow-up management.

A study on the prevalence of intestinal parasites in a group of homosexual men, attending a sexually-transmitted diseases clinic in Glasgow, was undertaken. Of 118 men examined over an eight-month period, four, one of whom had symptoms of dysentery, were found to be infected with Entamoeba histolytica. Cysts of Iodamoeba buetschlii were also found in the stool of one of these men. A further two patients had giardiasis, and 11 men had enterobiasis. The importance of an awareness of these conditions is discussed.