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This cross-sectional study was carried to determine the prevalence of intestinal parasitic infections among mentally handicapped individuals in Alexandria, Egypt, in the period from December 2012 till November 2013. The study was conducted on 200 institutionalized and non-institutionalized mentally handicapped individuals. Fresh stool samples were subjected to different stains including; trichrome for detecting intestinal protozoa, modified acid fast stain for intestinal coccidia and quick hot gram chromotrope stain for Microsporidia. Also they were processed by Kato-Katz and formol ethyl acetate techniques for intestinal helminths. Additionally, blood samples were collected for measuring hemoglobin levels. Out of 200 mentally handicapped individuals, 87 (43.5%) were infected. The infection rates were 44.6% and 42.6% for non-institutionalized and institutionalized people, respectively. Regarding gender, 46.7% and 38.5% were reported for the males and females respectively. The most common parasites detected were: Cryptosporidium sp. (23.5%), microsporidia (15%), Giardia lamblia (8.5%), Dientamoeba fragilis (8%), Cyclospora cyatanensis (7.5%), Blastocystis hominis (6.5%), Entamoeba histolytica (5.5%) and Entamoeba coli (2.5%). Rates for Isospora belli and Enterobius vermicularis were estimated to be 1.5% for each, while lower rate was reported for Iodamoeba butschlii (1.0%). Prevalence of infections among mentally handicapped individuals are indications for several risk factors, including improper sanitary hygiene and illiteracy about personal hygiene. Therefore, frequent investigations, health care and medical intervention are needed.
The aim of the study was to present the past and actual prevalence of Entamoeba histolytica and other intestinal protozoa in Poznań Province. Although in Poland there are only few accurate data concerning the prevalence of intestinal protozoa, the results of some studies were found reliable. In a survey conducted in 1958 in an orphanage in Poznań (Kasprzak and Karlewiczowa) the intestinal protozoa were found with high prevalence (Table 1). After six years this prevalence decreased considerably (Karlewiczowa and Kasprzak, 1964). Because at the same time such a decrease in intestinal protozoa prevalence, especially that in Entamoeba coli, was observed in the whole population of the Poznań Province, long-term surveys were undertaken. The diagnosing of intestinal protozoa in faeces of 4165 persons, performed at more points in time in the period of 1963 to 1986 in the Poznań Province, were conducted by the same highly skilled staff. Decreasing rates of infection were seen for each amoeba species at nearly each point in time, particularly in the first eight years of observation (Table 2). By using the "amoebic index" and "amoebic prevalence rate" in assessing epidemiological factors (acc. WHO, 1969), the considerable reduction in both indices should be accounted for the improvement of the sanitation and socio-economic status in our country. After the Second World War some Polish authors expressed the fear that after returning to the country, the Polish soldiers who had fought in the endemic regions of invasive amoebiasis, infected with E. histolytica, would constitute sources for spreading amoebiasis and that the disease would be a nucleus of a new, hitherto unknown, social calamity in Poland. Fortunately, the fear did not come true. Although in this country the infection with amoebae, also with E. histolytica, decreased considerably after several years, unfortunately, some opinions still prevail, being the source of an amoebo-mania in the medical staff and corresponding amoebophobia in the patients.
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