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Intestinal protozoa and helminths in ulcerative colitis and the influence of anti-parasitic therapy on the course of the disease.
- Source :
-
Acta tropica [Acta Trop] 2021 Jan; Vol. 213, pp. 105755. Date of Electronic Publication: 2020 Nov 11. - Publication Year :
- 2021
-
Abstract
- Purpose: The aim of this study is to determine the prevalence of intestinal helminths and protozoa in patients with ulcerative colitis (UC) and to estimate the influence of the anti-parasitic therapy on the course of the disease.<br />Methods: The study was conducted at the Research Institute of Epidemiology, Microbiology and Infectious Diseases and Coloproctology Department of the Republic Clinical Hospital №1 of the Ministry of Health of the Republic of Uzbekistan. One hundred UC patients and 200 healthy individuals were examined by triple coproscopy. Additionally, 20, 25 and 22 UC patients with Blastocystis infection were treated with nitazoxanide (1.0 g/day), mesalazine (1.5-2 g/day) or a combination of nitazoxanide (1.0 g/day) and mesalazine (≥1.5-2 g/day) for 14 consecutive days, respectively. Parasitological, clinical and endoscopic examinations were conducted before therapy, immediately after and 6 and 12 weeks after therapy completion.<br />Results: The overall prevalence of helminths in UC patients and control individuals was not significantly different: 14±3.4% and 8.5±1.9%, respectively (OR: 1.7524; 95% CI: 0.8258 to 3.7186; P=0.1). Giardia lamblia was the most prevalent parasite in both groups, but the difference compared to the control was insignificant (OR: 0.4565; 95% CI: 0.2020 to 1.0318; P=0.05). A significantly higher prevalence of Blastocystis sp., Chilomastix mesnili and Iodamoeba butschlii in UC patients compared to control individuals was found (P<0.0005): 65.0%, 14.0% and 22.0%, respectively. During all follow-up periods, the clinical response and clinical remission were not statistically different between the groups (P>0.05). Mucosal healing immediately and 6 weeks after therapy with a combination of nitazoxanide with mesalazine was significantly better than with a monotherapy of nitazoxanide, respectively (P<0.05). UC patients treated with a combination of nitazoxanide with mesalazine showed better mucosal healing than in patients treated with a monotherapy of mesalazine (P>0.05).<br />Conclusions: Diagnosis of Blastocystis sp. should be introduced in the complex examination of UC patients. Further clinical studies are necessary for assessment of the efficiency of anti-Blastocystis therapy in UC patients.<br /> (Copyright © 2020. Published by Elsevier B.V.)
- Subjects :
- Adult
Animals
Anti-Inflammatory Agents, Non-Steroidal administration & dosage
Antiparasitic Agents administration & dosage
Blastocystis drug effects
Blastocystis Infections parasitology
Colitis, Ulcerative parasitology
Drug Therapy, Combination
Female
Giardia lamblia drug effects
Humans
Male
Mesalamine administration & dosage
Mesalamine therapeutic use
Middle Aged
Nitro Compounds administration & dosage
Nitro Compounds therapeutic use
Prevalence
Thiazoles administration & dosage
Thiazoles therapeutic use
Treatment Outcome
Young Adult
Anti-Inflammatory Agents, Non-Steroidal therapeutic use
Antiparasitic Agents therapeutic use
Blastocystis isolation & purification
Blastocystis Infections drug therapy
Colitis, Ulcerative drug therapy
Giardia lamblia isolation & purification
Intestines parasitology
Subjects
Details
- Language :
- English
- ISSN :
- 1873-6254
- Volume :
- 213
- Database :
- MEDLINE
- Journal :
- Acta tropica
- Publication Type :
- Academic Journal
- Accession number :
- 33188747
- Full Text :
- https://doi.org/10.1016/j.actatropica.2020.105755