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Background: In the last decade, several cases of cutaneous leishmaniasis (CL) have been recorded by the provincial health center of Mazandaran Province, northern Iran. However, there is no documented report of autochthonous CL in the province yet. Case Presentation: The patient, a 59-year-old female, known case of diabetes mellitus, lived in therural area of Kiasar district (in theeastern part of the Mazandaran) with 5 skin lesions suspected of having vasculitis, without ahistory of traveling to the endemic areas of CL,was admitted to Imam Khomeini teaching hospital, Sari. To rule out CL, fine needle aspiration(FNA)procedure was used aseptically for the patient. Laboratory investigations showed Leishman bodies (amastigotes) by direct smear preparation, and species identification confirmed Leishmania major (L. major) by polymerase chain reaction (PCR)molecular method. Accordingly, this is the first documented report of autochthonous CL in Mazandaran Province. Conclusion: Overall, due to the abundance of probable rodent reservoir hosts and confirmation of infectionof sandflies (Phlebotomus papatasi) withL. major in the Kiasar district, where our patient was livingthere, it seems that CL emerged in the eastern part of the province. Therefore, further studies on rodents and sandflies fauna in terms of emerging leishmanial infection in the area is recommended.

Inadequate latrine and water source cause transmission of intestinal parasitic infection, particularly in children. There is a lack information about it and it is needed to be investigated. This study aimed to compare the prevalence of intestinal parasitic infection, the use of latrine and clean water source in elementary school children at coastal and non-coastal areas in Sumenep District, Indonesia. An analytic observational study with cross sectional design was conducted in Dasuk Timur Elementary School located at coastal area, and Kolor II Elementary School at non-coastal area, Sumenep district, in January 2020. Intestinal parasites in students’ stools were identified by microscopic examination using wet direct smear stained with lugol. The use of latrine and water sources were analyzed with questionnaire. A total of 68 children stools were collected from both elementary schools. Worm infections were not found. Thirty-one children (31/44, 70.5%) from Dasuk Timur Elementary School and eight children (8/24, 33.3%) from Kolor II Elementary School were infected with intestinal protozoan and significant difference (P=0.003, Chi-square test). Blastocystis hominis was highly found in stools of Dasuk Timur Elementary School’s students (31/44, 70.5%) and significantly different from Kolor II Elementary School’s students (P

Intestinal helminthiasis affects schoolchildren causing diseases. In this study, five copromicroscopicmethods (3 traditional and 2 recent; Formaline-ether concentration method (FECM),Kato-Katz, direct smear, McMaster and mini-FLOTAC with two flotation solutions NaCl Z 75 single & 7 mixed infections.Enterobius vermicularis was the commonest one (11%) followed by Hymenolepis nana(9.75%) and the least one was Schistosoma mansoni (1.5%). The most sensitive method wasmini-FLOTAC ZnSO4 while the least one was direct smear, but without a significant difference.Scotch adhesive tape method had the best efficacy for E. vermicularis diagnosis. No significantdifference was found for egg per gram (EPG) values of the counting techniques. H.nana was associated with anemia and underweight. Rural residence, unwashed fruits, and vegetables,unwashed hands before eating and after defecation were the risk factors. Sharing underwearand water canal contact were specifically associated with E. vermicularis and S. mansonirespectively. The better diagnostic performance were mini-FLOTAC and McMaster methods.

Eimeria is an apicomplex protozoon which affects many species of birds, domestic and wild animals including deer. This is the first study in Iraq that was designed for diagnosis Eimeria spp. in deer using traditional methods. Eighty fecal samples of Fallow deer (Damadama) were collected in different provinces in the middle part of Iraq during December 2018 to the end of September 2019. Samples were examined by direct smear and flotation with Sheather's solution. The total infection rate with Eimeria spp. was 70% (56/80), in which higher infection rate was observed in female deer (78%, 39/50). The results also showed that Fawn at age

Direct stool examination is the gold standard technique for diagnosing intestinal parasitic infection.Stool examination by stained smear, concentration techniques and sometimes culture are thecommonly used. The sensitivity of direct smear is low and requires repeated smears. Formalinethylacetate concentration method is more sensitive, but time consuming. Midi-Parasep® concentratoris a new diagnostic tool used as a routine stool examination for intestinal parasitic infectionsworldwide. There’s a lack of reports which evaluate the efficacy of Midi-Parasep® procedurein areas of limited diagnostic facilities and poor resource settings. Therefore, our currentstudy represents the first report that assessed the Midi-Parasep® technique by comparing its performanceto other economic standard measures like modified Ridley-Allen and formol detergentconcentration techniques for detection of intestinal parasites in human stool samples. We examined306 fecal samples using Midi-Parasep fecal parasite concentrator, modified Ridley-Allenconcentration and formol detergent concentration techniques. The best over-all sensitivity(71.7%) was obtained for Midi-Parasep technique followed by formol detergent concentration(66.7%) then modified Ridley-Allen technique (51.7%). Regarding, helminths parasites, the mostsensitive was formol detergent concentration technique (70%), followed by the Midi-Parasep technique (60%), and Modified Ridley-Allen technique (33.3%). Referring to the intestinal protozoa,midi-Parasep technique had the highest sensitivity (83.3%), followed by modified Ridley-Allen procedure (70%) then formol detergent concentration technique (63.3%).

Introducción: Los parques están contaminados por heces de perro y las personas tienen contacto con formas parasitarias en estas áreas con césped, el objetivo del presente trabajo fue determinar la presencia de Giardia lamblia en muestras de heces de canes recolectadas en los parques de la ciudad de Cochabamba. Metodología: Se realizó un estudio descriptivo de corte transversal y prospectivo en 4 parques de Cochabamba; Lincoln, Demetrio Canelas, Ex Combatientes, y La Torre de febrero a mayo del 2019, la población de estudio estuvo conformada por 107 muestras de heces de canes y posteriormente se procesaron por el método de frotis directo simple. Resultados: El 56% no se observaron parásitos, 29% otros parásitos y el 15% se identificó quistes de Giardia lamblia. Discusión: Los parques de Cochabamba están contaminados con Giardia lamblia. Siendo una fuente importante de zoonosis, lo cual se correlaciona con datos de estudios que reportan elevadas tasas de giardiasis en niños Perros. Conflictos de InteresesLos autores declaramos no tener conflictos de interés para el presente estudio.

Bronchial asthma is a chronic inflammatory disorder of the airways characterized by airway hyper responsiveness and reversible airflow obstruction that fluctuates over time. Parasitic infection is one of the environmental factors associated with a small increase in bronchial asthmatic risk. In the present study, 200 stool samples were collected from patients suffering from bronchial asthma and 200 stool samples from non-asthmatic healthy volunteers as control group. The samples were preserved in 10% formalin and examined macroscopically, microscopically by direct smear & formol ether sedimentation techniques. It was found that 12/200 cases (6%) were infected with Ascaris lumbricoides in asthmatic group and 2/200 cases (1%) in control (P = 0.007) illustrating significant difference between cases and control group indicating a role of Ascaris lumbricoides as a risk factor for bronchial asthma.

Lobomycosis is a disease that is endemic to the Amazon rainforest and is caused by the still uncultured fungus Lacazia loboi. This disease occurs in loggers, farmers, miners, fishermen, and persons living near coastal rivers of this region. We report 6 soldiers in Colombia in whom lobomycosis developed after military service in the Amazon area. The patients had nodular and keloid-like lesions on the face, neck, trunk, and limbs. The duration of illness ranged from 2 years to 15 years. The initial diagnosis was leishmaniasis on the basis of clinical manifestations and direct smear results, but biopsies confirmed the final diagnosis of lobomycosis. Treatment with surgical excision, itraconazole and clofazimine was satisfactory. However, the follow-up time was short. Healthcare professionals responsible for the diagnosis and treatment of skin diseases need to be able to recognize the clinical signs of lobomycosis and differentiate them from those of cutaneous leishmaniasis.

In recent years, cytopathology has established itself as an independent diagnostic modality to guide clinical management in many different settings. The application of molecular techniques to cytological samples to identify prognostic and predictive biomarkers has played a crucial role in achieving this goal. While earlier studies have demonstrated that single biomarker testing is feasible on cytological samples, currently, this provides only limited and increasingly insufficient information in an era where an increasing number of biomarkers are required to guide patient care. More recently, multigene mutational assays, such as next-generation sequencing (NGS), have gained popularity because of their ability to provide genomic information on multiple genes. The cytopathologist plays a key role in ensuring success of NGS in cytological samples by influencing the pre-analytical steps, optimizing preparation types and adequacy requirement in terms of cellularity and tumor fraction, and ensuring optimal nucleic acid extraction for DNA input requirements. General principles of the role and potential of NGS in molecular cytopathology in the universal healthcare (UHC) European environment and examples of principal clinical applications were discussed in the workshop that took place at the 30th European Congress of Pathology in Bilbao, European Society of Pathology, whose content is here comprehensively described.

Background and aims: Cutaneous leishmaniasis is a major health issue in many parts of Iran. Diagnosis of cutaneous leishmaniasis in a non-endemic area is not as simple as that in endemic foci. The management and treatment of this disease are global dilemmas. The purpose of this study was to identify Leishmania species isolated from human cutaneous leishmaniasis lesions in patients referred to health centers of Golestan province, Iran. Methods: Cutaneous leishmaniasis patients with suspected lesions were clinically examined. History of journey to the endemic areas of zoonotic cutaneous leishmaniasis and/or anthroponotic cutaneous leishmaniasis and the characteristics of their lesion(s) were recorded. Diagnosis of the lesion was done by using direct smear microscopy and conventional polymerase chain reaction. Results: Out of 360 patients, 202 (57.4 %) were male and 158 (42.8 %) were female. A total of 360 samples were selected from different cities. The number of infected samples in the cities is as follows: Azad Shahr [3 (1.5%)], Aq Qala [11 (5.7%)], Ali Abad [4 (2.1%)], Bandar Turkmen [3 (1.5%)], Bandar Gaz [2 (1%)], Ramian [3 (1.5%)], Kalaleh [23 (12.1%)], Kord koy [1 (0.5%)], Galikesh [7 (3.7 %)], Gomishan [12 (3.6 %)], Gorgan [13 (6.8 %)], Gonbad Qabus [99 (52.1 %)], Marave Tappe [7 (3.6%)] and Minoodasht [2 (1%)]. In the molecular investigations, 186 (96.8%) samples were observed to acquire rural cutaneous leishmaniasis, 4 (2.1%) to acquire urban cutaneous leishmaniasis and 170 (47.2%) to be uninfected. Conclusion: Although history of visiting endemic areas is an important factor to be considered in diagnosis, parasitological confirmation is necessary for the initiation of treatment.

Introduction: Tuberculosis diagnostic, using microscopic examination of direct smear of acid-fast bacili (AFB) from the spectrum of lung tuberculosis suspect is still important criteria today, but the sensitivity of this method is low enough, especially in the samples which contain a small number of bacteria. Culture is stronger, but it takes long time, high cost, and it is not conducted in all laboratories. BTA microscopic examination can use direct smear and concentration method. Staining technique which is usually used in microscopic examination is Ziehl Neelsen. The sensitivity of direct smear method tends to be low and can be increased by using concentration method because bacteria can be easily found. Objective of the research: The objective of the research was to find out the effectiveness of direct smear examination of AFB , and concentration method was compared with culture. Materials and Method: The samples consisted of 60 sputum samples from the patients of lung tuberculosis suspects who visited BP4 Medan and from private practices of tuberculosis specialists, and the samples had fulfilled inclusive criteria. Microscopic examination of acid-fast bacilli using direct smear and concentration method with Petroff method, using Ziehl Neelsen staining and culture with Lowenstein Jensen was conducted. Then we performed diagnostic test for direct smear and concentration method to compare it with culture. Result of the research: AFB examination with concentration method had sensitivity of 68.75%, specificity of 82.14%, the value of positive prediction of 81,48%, the value of negative prediction of 69.70%, ratio of positive likelihood of 3.85, and ratio of negative likelihood of 0.38, compared with culture method examination in finding BTA in sputum of lung tuberculosis suspects. The result of microscopic examination of direct smear method had the sensitivity of 59.38%, specificity of 92.68%, the value of positive prediction of 90.48%, the value of negative prediction of 66.67%, ratio of positive likelihood of 8.31, and ratio of negative likelihood of 0.44, compared with culture method examination in finding BTA in sputum of lung tuberculosis suspects. Conclusion: The ability of acid-fast bacilli examination of concentration methodsin diagnosis oflung tuberculosisis 9.37% higher thanthe directsmear but direct smear method gives bigger clinical benefit in diagnosing lung tuberculosis, compared with concentration method

Background & Objective: Urine cytology is an important diagnostic method for urinary tract cancers (especially carcinomas), which is suitable for follow-up of residual urothelial tumors after surgery of malignant bladder tumors. In this study, for the first time, liquid-based cytology (LBC) was used in cervical cytology. Compared to direct smear cytology (DSC), LBC reduced background elements (including cellular debris, inflammatory cells, and blood cells), provided better cell preservation, and had a higher satisfaction rate. In this study, we performed two different methods (DSC and LBC) to detect bladder lesions; also, we determined the sensitivity and specificity of these methods.Methods: A total of 146 samples were taken from patients with suspected bladder cancer and processed for direct smear and LBC. In both methods, findings were reported according to the Paris System. Then, patients underwent cystoscopy and biopsy. Next, the accuracy of cytology methods was evaluated according to biopsy reports. The sensitivity and specificity of these methods were also calculated.Results: Credit indices obtained for the direct smear method included sensitivity (62.5%), specificity (89%), positive predictive value (89.5%), and negative predictive value (91.5%). For LBC methods, credit indices included sensitivity (85.7%), specificity (99%), positive predictive value (96%), and negative predictive value (96%). Agreement between the two methods was statistically significant (P0.05).Conclusion: This study showed that LBC has higher sensitivity and specificity than the direct smear.

Cameline filarosis is an important parasitic disease having an economic impact on the camel industry around the world. However, there has been no study on filarosis in Bactrian camels of Mongolia. Therefore, the aim of the present study was to detect and identify microfilariae of Deraiophoronema evansi (D. evansi) in Bactrian camels from three provinces, located in southern and southwestern Mongolia. Blood samples were obtained from 400 healthy two-humped camels of different ages and both sexes. All blood samples were analysed using a variety of diagnostic techniques. Microfilariae were detected in 30 Bactrian camels (7.5%) by the Knott technique, while 13 Bactrian camels (3.3%) tested positive in a direct smear test. D. evansi was detected in 18 Bactrian camels (4.5%) by PCR assay. Prevalence was shown to be high among Bactrian camels in the age group up to 5 years, while the lowest positive results were obtained for Bactrian camels in the 5–10-year age group and the over 10-year age group. To confirm the morphological identification, D. evansi–COI gene sequences were subjected to phylogenetic analyses. The D. evansi–COI gene sequences from Mongolian two-humped camels were identical to sequences from Iranian one-humped camels and were clustered together with these sequences in the phylogeny. This is the first report of molecular detection and identification of microfilariae of D. evansi in Bactrian camels of Mongolia.

Background: Blastocystis spp. is known as one of the few intestinal parasites, prevalent in more than 5% and 30 - 60% of the population in industrialized and developing countries, respectively. In this respect, immunocompromised individuals, such as patients undergoing chemotherapy or those with malignancies, are at risk of the clinical symptoms of Blastocystis infection; however, the given condition is often self-limiting in healthy individuals. Objectives: The current study aimed at evaluating the prevalence of Blastocystis infection in children with malignancies receiving chemo drugs. Methods: The current descriptive, cross-sectional study was conducted on 52 stool specimens collected from patients with cancer admitted to the Oncology Ward of Shahid Baqaei 2 Hospital, Ahvaz, Iran, for six months. A standardized questionnaire was filled out for all cases. Each specimen was also prepared using direct smear, the Lugol iodine staining, and the formalin-ether condensation method. Results: Blastocystis spp. was detected in 21.1% of the cases among them, 11.5% demonstrated gastrointestinal symptoms; therefore, a significant relationship was observed between Blastocystis infection and gastrointestinal symptoms. Conclusion: Patients undergoing chemotherapy should be screened for opportunistic parasitic infections such as Blastocystis to avoid potentially life-threatening outcomes. Besides, further studies are required to identify the subtypes of Blastocystis.

The current study was conducted at Wasit province, Iraq during the period from 28 October 2020 to28 December 2020. The study included one hundred stool samples taken from questionable patients ofEntamoeba histolytica and Helicobacter pylori. Samples were collected from patient attended to GeneralHospital of Martyr Fairuz at Hay district , Saeed Health center and Hospital of Al-Kut. All samples havebeen checked using direct smear lugol’s iodine stain for Entamoeba histolytica and dipstick for Helicobacterpylori. The result showed that 40 samples (40%) out of 100 patients were gave positive by rapid test cassette;females 23 (23%) positive samples and males 17(17%). While 14 samples (14%)out of 100 samples werepositive for Entamoeba histolytica. The highest infection in females 8(8%) and the lowest in males 6(6%).The result showed 10 samples (10%) out of 100 patients positive for both E. histolytica and H. pylori. Thehighest infection was recorded in females 6(6%) and the lowest in males 4(4%).The highest infection of H.pylori in age group (39 and more) years ; females recorded 6(6%) and malesrecorded 6(6%), while the lowest infection in group (>1) years old ; females recorded 1(1%) and malesrecorded 1(1%). The infection rate of Entamoeba histolytica was highest in age group (1-13) years old ;females was recorded 1(1%) and males was recorded 4(4%) , while the lowest in age group (26-39) years old; females recorded 1(1%) while males without infection. Infection with both E.histolytica and H.pylori wasrecorded the highest in group (39 and more) years old ; females was recorded 3(3%) and males was recorded2(2%) while the group (>1) years old do not recorded infections.

Cutaneous leishmaniosis in Iraq has 2 forms, zoonotic cutaneous leishmaniasis (ZCL), which is mainlycaused by Leishmania major, and anthroponotic cutaneous leishmaniasis (ACL), which is mainly causedby Leishmania tropica . Twenty skin samples were taken from suspected patients with CL and checked forLeishmania amastigote, during the period from October 2019 to February 2020 in Al-Karamah teachinghospital of Kut city, Iraq. The highest infection 100% using Giemsa- smeared and 75% using Nested PCRmethods. Totally 20 patients aged from (1- 20) years old. Thecurrent study 12(60%) were brought on Leishmania major and 4(20%) Leishmania tropica using NestedPCR method . In present study the direct smear could be considered a good test for testing the cutaneousLeishmaniasis but Nested PCR assay was more touchy than parasitological technique in diagnosis ofLeishmania species in skin lesions. L.major is the main species responsible of cutaneous leishmaniasis inareas of Wasit Province.

Introduction: Giardia lamblia infection can cause impaired absorption of nutrients and affects to the nutritional status that has not yet fully investigated in Indonesia. This study aimed to investigate the comparison of prevalence of Giardia lamblia infection and nutritional status of elementary students in Mandangin island and Mojo village where were different condition. Methods: An analytical observational study with cross sectional design was conducted in Mandangin island in July 2017 and Mojo village in June 2018 by informed consent. Stools of elementary students were collected for Giardia lamblia identification under a light microscope using direct smear method. Nutritional status of students were determined by body mass index (BMI), and categorized as severe underweight, underweight, healthyweight, overweight, and obese. Results: Forty-five stools samples were collected from elementary students in Mandangin island and 55 stools samples in Mojo village. Prevalence of Giardia lamblia infection without symptoms was higher in elementary students in Mandangin island than Mojo village (28,9%, 13/45 and 1,8%, 1/55, respectively). Giardiasis prevalence in Mandangin island was significantly difference with Mojo village (pl0.0001, chi square-test). Nutritional status of students in both study sites showed dominant healthy-weight that were 73.3% (34/55) in Mandangin island and 61.8% (33/45) in Mojo village. Giardiasis was commonly observed in students with healthy- weight and it was higher in Mandangin island (8/33, 24.2%) than Mojo village (1/34, 2.9%). Conclusion: Asymptomatic giardiasis was highly found in elementary students in Mandangin island and commonly observed in students with healthy-weight from both 3 regions. It suggested that asymptomatic giardiasis might not affect to the nutrition status of students.

The current study was carried out during the period between November/2018 and March/2019. The studywas aiming to investigate the types and proportions of intestinal parasites among children who visited theprimary health care center in the city of Khanaqin - Diyala governorate. The total number of specimensexamined, during the course of study, was 805 stool specimens. These specimens were taken from childrenin the age range 1-10 years, and direct smear was the method used for the investigation of the intestinalparasites existence. The results showed that 156 children were infected with intestinal parasitic infections.These infections were categorized as four types of Protozoa and one type of intestinal Helminthes. Theincidence ratio of intestinal parasitic infection was 19.373%, where the percentages of parasites consideredin the current study have found to be 62.179% for the Entamoebahistolytica followed by 12.820% for theGiardia lamblia, 12.820 of Entamoebacoli, and 3.205% for the Iodomoebabutschillii. Moreover, the studyhas reported one type of Helminthes represented by the Entrobiusvermicularis with occurrence ratio of6.410%.

Background Intestinal schistosomiasis is still a public health problem in Burundi. Since 2008, annual mass drug administration with praziquantel has been rolled out in 11 endemic districts. The national programme relies on school-based surveys with kato-katz to monitor the impact of mass drug administration. We explored whether routine data on intestinal schistosomiasis as determined by direct fecal smears at health centre level could be used. Methods From the Burundian National Health Information System, we collected routine incidence data on intestinal schistosomiasis as determined by direct smear examination in all 45 sanitary districts during 2011–2015. A temporal trends analysis was performed using a mixed negative binomial regression. Sanitary districts with mass drug administration campaigns with praziquantel (n = 11) were compared with those without (n = 34). In addition, prevalence data on intestinal schistosomiasis based on kato-katz results from a school-based national mapping in 2014 were compared with the incidence data in health centres based on direct smear results, in the same 45 sanitary districts. Results In the 11 sanitary districts applying mass drug administration with praziquantel, the incidence rate decreased significantly for the years 2014 (β2014 = − 0.826, P = 0.010) and 2015 (β2015 = − 1.294, P < 0.001) and for the five-year period (β = − 0.286, P < 0.001), whereas in the 34 districts where mass drug administration was not delivered, there was no significant decrease over time (β = − 0.087, P = 0.219). In most of the 45 sanitary districts, the low prevalence based on kato-katz in school children was confirmed by low incidence rates based on direct smears in the health centres. Conclusions National Health Information System surveillance data, based on routinely collected direct smear results at health centre level, may be able to monitor the impact of mass drug administration with praziquantel on intestinal schistosomiasis in Burundi. Control and elimination of intestinal schistosomiasis call for integration of adequate diagnosis and treatment into routine activities of primary health care facilities, as recommended by the World Health Organization since more than 20 years. When moving towards elimination, more sensitive tests, such as the point-of-care circulating cathodic antigen assay are desirable.

Se estudió a una mujer de 19 años, con embarazo de cuatro meses, que presentaba cuatro úlceras cutáneas de tres meses de evolución, diagnosticadas por biopsia como leishmaniasis cutánea. El frotis directo y la leishmanina fueron negativos.Dado que todos los medicamentos usuales para la leishmaniasis cutánea están contraindicados en el embarazo, la paciente no recibió tratamiento, aunque curó espontáneamente durante el embarazo. Se cree que la leishmaniasis cutánea no tiene peligro para la mujer embarazada y que no hay transmisión de la madre al feto en el humano, aunque se ha detectado en animales en condiciones experimentales.La paciente tuvo un parto sin complicaciones y la condición de salud tanto de ella como de su hijo era normal a los dos años de seguimiento.