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Prevalence of helminth eggs in raw vegetables consumed in Burdur, Turkey
... Fresh produce, if consumed with no or minimal preparation, has been implicated in several studies as a potential vehicle of transmission. Indeed, several protozoal cysts (Entamoeba hystolytica/Entamoeba dispar, Giardia intestinalis, Entamoeba coli, Balantidium coli, Blastocystis spp.), oocysts (Cryptosporidium parvum, Cyclospora spp., Isospora belli, Toxoplasma spp.) and helminth eggs and larvae (Strongyloides spp, Trichuris trichiura, Enterobius vermicularis, Fasciola hepatica, Ascaris lumbricoides, Toxocara spp., Hymenolepis diminuta, Taenia spp.) have been documented in Nigeria (4,9), Sudan (5), Libya (7), Cameroon (8), India (10), Ethiopia (6,11), Egypt (12,13), Ghana (14), Malaysia (15), Iran (16), South Korea (17), Türkiye (18)(19)(20)(21)(22), Italy (23), Switzerland (24), Poland (25), Brazil (26), and Canada (27). To our knowledge, there are several studies conducted on helminthic contamination of fresh vegetables and fruits in Türkiye (18)(19)(20)(21)(22). ...
... Indeed, several protozoal cysts (Entamoeba hystolytica/Entamoeba dispar, Giardia intestinalis, Entamoeba coli, Balantidium coli, Blastocystis spp.), oocysts (Cryptosporidium parvum, Cyclospora spp., Isospora belli, Toxoplasma spp.) and helminth eggs and larvae (Strongyloides spp, Trichuris trichiura, Enterobius vermicularis, Fasciola hepatica, Ascaris lumbricoides, Toxocara spp., Hymenolepis diminuta, Taenia spp.) have been documented in Nigeria (4,9), Sudan (5), Libya (7), Cameroon (8), India (10), Ethiopia (6,11), Egypt (12,13), Ghana (14), Malaysia (15), Iran (16), South Korea (17), Türkiye (18)(19)(20)(21)(22), Italy (23), Switzerland (24), Poland (25), Brazil (26), and Canada (27). To our knowledge, there are several studies conducted on helminthic contamination of fresh vegetables and fruits in Türkiye (18)(19)(20)(21)(22). However, there is no study performed to determine the parasitic contamination of vegetables specifically in İzmir province. ...
... Overall protozoal and helminthic contamination rate (26.2%) of fresh unwashed or pre-washed vegetables in our study was relatively higher than 13.5% in Khartuom, Sudan (5), 6.3% in Burdur, Türkiye (18), and 11.0% in Maiduguri, Northeastern Nigeria (33). However, it was lower than the rates found in the majority of studies such as 31.7% in Egypt (15), 59.7% in Iran (16), 54.4% in Ethiopia (11), 56.25% in Nigeria (9), and 58% in Libya (7). ...
Objective:
Fresh vegetables are an important part of a healthy and nutrient-rich diet but the consumption of raw vegetables without proper washing is the main way for transmission of parasites. This study was aimed at determining the rate of parasitic contamination in prewashed fresh vegetables sold at randomly selected 10 retail markets which is the last step to reach the consumer in İzmir, Türkiye.
Methods:
A total of 80 samples selected from eight types of vegetables including tomato, spinach, lettuce, rocket, mint, parsley, dill, and cucumber were examined for parasitic agents microscopically by sedimentation method after washing samples with normal saline. Statistical analysis was performed using SPSS software version 20.0.
Results:
Protozoan cysts, helminth eggs, and larvae were detected in 21 (26.2%) of 80 samples from eight different vegetable species. Rhabditidiform larvae 18.7%, Blastocystis spp. 5%, Toxocara spp. 2.5%; Ascaris spp., Fasciola spp., Entamoeba histolytica/ Entamoeba dispar and hooked worms were found in 1.2%. Spinach and mint samples were contaminated with parasites significantly more than other fresh vegetable samples (p<0.008, odds ratio =80.0; p<0.017, odds ratio =46.6 respectively). Cruznema spp., a plant nematode, was found at the highest rate according to the results of culture, polymerase chain reaction and sequencing, respectively.
Conclusion:
In this study, the parasitic contamination was found in approximately one of the four vegetables sold in randomly selected markets in İzmir. These findings show that vegetables sold in local markets can cause parasitic infections if they are consumed without adequate washing and awareness should be raised on this issue. In addition, it was concluded that morphological examinations should be confirmed by molecular studies and sequencing as much as possible in order to avoid misdiagnosis of rhabditidiform larvae.
... In these studies, various helminth species were detected, such as Ascaris lumbricoides, Toxocara spp., Taenia spp., Enterobius vermicularis, Hymenolepis nana, and Trichuris spp. (Adamu et al., 2012;Adanir & Tasci, 2013;Amaechi et al., 2016;Avcioğlu et al., 2011;Bekele et al., 2017;El Bakri et al., 2020;Erdoğrul & Şener, 2005;Fallah et al., 2012;Hajipour et al., 2021;Ismail, 2016;Kozan et al., 2005;Rodrigues et al., 2020;Ulukanligil et al., 2001;Vizon et al., 2019;Yavari et al., 2019). ...
... But, the identification of parasites using microscopic techniques is based on only morphological features, especially egg morphology. Microscopic diagnostic methods are not eligible for identification of the species in the genus of Toxocara or Taenia/ Echinococcus since these species have similar egg morphology (Adanir & Tasci, 2013;Bekele et al., 2017;Fallah et al., 2012;Kozan et al., 2005). According to researchers, species discrimination of eggs in the genus of Toxocara or Taenia/Echinococcus is done by using molecular methods, like polymerase chain reaction (PCR) (Adanir & Tasci, 2013;Li et al., 2007;Trachsel et al., 2007). ...
... Microscopic diagnostic methods are not eligible for identification of the species in the genus of Toxocara or Taenia/ Echinococcus since these species have similar egg morphology (Adanir & Tasci, 2013;Bekele et al., 2017;Fallah et al., 2012;Kozan et al., 2005). According to researchers, species discrimination of eggs in the genus of Toxocara or Taenia/Echinococcus is done by using molecular methods, like polymerase chain reaction (PCR) (Adanir & Tasci, 2013;Li et al., 2007;Trachsel et al., 2007). ...
Raw vegetables are the source of vitamins, minerals, proteins, and fibers that protect the human body against diseases. On the other hand, these may become sources of parasitic pathogens, which affect human health. This study aimed to assess the presence of helminth species in raw vegetables consumed in Sivas with microscopic and molecular techniques. The study material consisted of 120 vegetable samples (lettuce, parsley, peppermint, rockets, cress, and carrots) obtained from greengrocers, supermarkets, street vendors, and wholesalers. Toxocara spp. eggs, T. leonina eggs, and Rhabditiform larvae were detected in vegetable samples with
a prevalence of 5.83%, 3.33%, and 24.17%, respectively. Toxocara spp.
eggs were identified as T. canis using polymerase chain reaction. This is
the first molecular detection of T. canis eggs in raw vegetables in Turkey.
This study revealed that vegetables sold in Sivas are contaminated with
helminth eggs or larvae. Therefore, people should take the necessary
hygiene precaution, such as washing or sanitizing, before consuming
these vegetables.
... A. lumbricoides eggs have been reported in numerous studies carried out in Türkiye. It has been reported that Ascaris lumbricoides eggs were found in 1% of 203 unwashed samples in a study conducted in Ankara [6], 2% in 199 unwashed samples in Bursa [19], 1.8% in 111 samples in Burdur [20], and 11% [21] in 100 food samples in Şanlıurfa. ...
... In a study conducted in Burdur, A. lumbricoides eggs were mostly found in lettuce (9.09%) and parsley (7.69%) [20]. In contrast, we observed the highest rate of Ascaris lumbricoides eggs in arugula (33.3%), lettuce (25%), mint (16.6%), and less frequently in spring onions (8.3%) and purslane (8.3%). ...
This research was performed on a total of 120 vegetables, with 12 samples taken from each available Eskişehir district markets. In this study, we aimed to determine the presence of contamination from helminth eggs in 10 types of vegetables: carrot, lettuce, parsley, arugula, cress, fresh onion, mint, cucumber, dill, and purslane. 200 g of material from each collected sample was prepared for the helminthological examination. The prepared samples were examined for helminth eggs with a light microscope that could be identified at 40x magnification. The data were analyzed using SPSS 16 software. Helminth eggs were detected in 20 (16.6%) vegetable samples. According to the research, the highest rate of helminth eggs was observed in spring onion (66.6%), while the lowest rate was found in mint (16.6%) and purslane (16.6%). Ascaris lumbricoides eggs were found in 11 (9.1%) of the samples, and strongyle type eggs in 9 (7.5%). In this study, we observed that infectious forms of parasites can contaminate many foods and potentially infect people after consumption if these foods are not washed well. The aim of this study was to assess the presence of helminth eggs in raw vegetables, which are commonly consumed produce sold in street markets in Eskişehir, Türkiye.
... It is interesting to note that leafy vegetables, particularly lettuce, were found more contaminated with parasites. Other studies also reported lettuce contamination (Adamu et al., 2012;Adanir and Tasci, 2013;Eraky et al., 2014;Ordoňez et al., 2016;Ferreira et al., 2018;Vizon et al., 2019). Parasite contamination of lettuce can be attributed to its broad and large surface area which allows more contact with contaminated soil and water. ...
... Several studies also reported contaminated lettuce with parasites that could come from faeces of livestock or animal manure fertilizers (Gupta et al., 2009;Adamu et al., 2012;Adanir and Tasci, 2013;Maikai et al., 2013;Eraky et al., 2014;Adenusi et al., 2015;Luz et al., 2017;Woldetsadik et al., 2017). Variation in the prevalence of parasite contamination in vegetables can be attributed to the state of the vegetables before the examination (pre-washed or unwashed) and/or post-harvest practices. ...
Fresh vegetables are an important part of a healthy diet, however, they can also be agents of transmission of intestinal parasites. This study aimed to evaluate the presence of parasite contamination in vegetable farms as a source of transmission in selected rural communities in Laguna, Philippines. A total of 168 vegetable, 55 soil and 15 water samples collected from four selected farms and a reference farm were processed through various standard parasitological techniques. Of these, 17.3% of vegetables, 47.3% soil and 73.3% water samples were found contaminated with parasites’ eggs or cysts. Interestingly, leafy vegetables, such as lettuce, were found to be more contaminated. Results showed that strongylids/hookworms (egg/larva) showed the highest prevalence in farm soil (38.2%) and vegetable (13.1%); other helminth parasite eggs were also recovered such as Toxocara sp., Ascaris sp., Trichiuris, Trichostrongylus sp. and protozoan cysts of Balantidium coli. Cryptosporidium sp. oocysts of and Giardia sp. cysts were observed in all water samples in the farms. Furthermore, results revealed that some farming practices such as the use of improperly treated animals manure as fertilizers, unhygienic practice of farmers and sanitation issues were factors that contribute to parasite contamination in the farms. These findings have implications on food safety in poor-resource communities posing public health risks. Recommendations were discussed in the study for the control and prevention of parasite contamination at the farm level.
... However, vegetables can be contaminated with enteric bacteria, viruses and zoonotic parasites. Several surveys in different parts of the world have shown that vegetables can be agents for transmission of protozoan cysts and oocysts (e.g., Entamoeba, Cyclospora, Toxoplasma and Isospora) and helminth eggs and larvae (e.g., Hymenolepsis, Taenia, Fasciola, Toxocara, Ascaris, Trichostrongylus and hookworms) (Dvuong et al., 2006) with the consumption of raw vegetables playing a major epidemiological role in the transmission of food-borne parasitic zoonoses such as Giardiasis, Strongyloidiasis, Fascioliasis, Fasciolopsiasis and Echinococcosis (Abougrain et al., 2010;Adamu et al., 2012;Adanir and Tasci, 2013;Adenusi et al., 2015;De La Vega-Miranda et al., 2012;Duedu et al., 2014;El Said Said, 2012;Eraky et al., 2014;Erdogřul and Ş ener, 2005;Kozan et al., 2005;Maikai et al., 2012b;Monge and Arias, 1996;2012;2012;Omowaye and Toluhi 2011;Samaliev and Mohamedova, 2011;Santos et al., 2012). Intestinal parasite infection as a cause of malnutrition/growth stunting is well documented and is caused by a decline in food intake and/or an increase in nutrient wastage (Stephenson, 1994). ...
... The percent of vegetables directly harvested with parasitic organisms (53.14%; 845/1600) was higher than that reported in other studies from Iran (36.8% (Asadpour et al., 2016);) and from other countries such as West Bengal, India (44.2%; (Gupta et al., 2009), although lower than reported elsewhere in Iran (65% (Gharavi et al., 2002);). In regards to market vegetables, the results in this study (18.2%) also were higher and lower than that reported for other studies in Iran and other countries (Adanir and Tasci, 2013;Asadpour et al., 2016;Balarak et al., 2016). Reasons for differences in the percent of vegetables with parasitic organisms might be due to differences in the vegetables assessed in each study, season of the study and methods of parasite recovery used in the studies (Maikai et al., 2012a). ...
Fresh vegetables are essential components of a healthy and nutritious diet, but if consumed raw without proper washing and/or disinfection, can be important agents of transmission of enteric pathogens. This study aimed to determine the prevalence of zoonotic parasites on vegetables freshly harvested and “ready to eat” vegetables from greengrocers and markets in northwestern Iran. In addition, the effect of cropping system and season on contamination levels were assessed as well as the efficacy of washing procedures to remove parasites from the vegetables. A total of 2757 samples composed of field (n = 1, 600) and “ready to eat” (n = 1157) vegetables were analyzed. Vegetables included leek, parsley, basil, coriander, savory, mint, lettuce, cabbage, radish, dill, spinach, mushroom, carrot, tomato, cucumber and pumpkin. Normal physiological saline washings from 200 g samples were processed using standard parasitological techniques and examined microscopically. A total of 53.14% of vegetable samples obtained from different fields and 18.23% of “ready to eat” vegetables purchased from greengrocers and markets were contaminated with different parasitic organisms including; Entamoeba coli cysts, Giardia intestinalis cysts, Cryptosporidium parvum oocysts, Fasciola hepatica eggs, Dicrocoelium dendriticum eggs, Taenia spp. eggs, Hymenolepis nana eggs, Ancylostoma spp. eggs, Toxocara cati eggs, Toxocara canis eggs, Strongyloides stercoralis larvae, and Ascaris lumbricoides eggs. In both field and “ready to eat” vegetables, the highest parasitic contamination was observed in lettuce with a rate of 91.1% and 55.44%, respectively. The most common parasitic organism was Fasciola hepatica. A seasonal difference in contamination with parasitic organisms was found for field and “ready to eat” vegetables (P < 0.05). There was a significant difference in the recovery of parasitic organisms depending on the washing method with water and dishwashing liquid being the least effective. Proper washing of vegetables is imperative for a healthy diet as the results of this study showed the presence of zoonotic parasites from field and ready to eat vegetables in Iran.
... and Taenia spp.), soil-transmitted helminths (Ascaris lumbricoides, Toxocara spp., Trichuris trichiura, and hookworms), and protozoa such as Giardia intestinalis, Cryptosporidium spp., and Toxoplasma gondii considerably affect people's health. Many studies have reported that the consumption of raw foodstuffs irrigated by water that is polluted by human and animal manure could cause severe zoonosis, and it has recently been demonstrated that fruits and vegetables sold in retail markets are responsible for the transmission of numerous human parasitic infections (2,3,7,20,33,44,49). In Tunisia, the environment is seriously contaminated by several pathogenic helminth eggs, such as Toxocara spp., Echinococcus granulosus, and hookworms (12,13,39). ...
... The annual human surgical incidence averages 12.7 per 100,000 inhabitants (15), and the environment is seriously contaminated with E. granulosus eggs, from 8.3 to 41.3% depending on the region (13,39). Previously, the source of infection for human cystic echinococcosis has always been attributed to the ingestion of eggs via contaminated fruits, vegetables, and water (2) or to direct contact with contaminated dog coat (18). However, the low prevalence of E. granulosus eggs observed on unwashed vegetables supports the hypothesis that they might be of minor importance in the epidemiology of cystic echinococcosis in Tunisia. ...
Foodborne diseases continue to represent an important threat to public health in many parts of the world and are particularly widespread in developing countries. They are essentially acquired through an oro-fecal route via the consumption of uncooked fruits and vegetables. This study evaluated the parasitological contamination of vegetables for sale to humans in Tunisian retail markets. A total of 240 samples of fresh vegetables were examined for helminth eggs and protozoan cysts and oocysts (collectively, (oo)cysts) contamination. The parasitic elements (helminth eggs and protozoan (oo)cysts) were concentrated by sucrose flotation and identified by microscopic examination. The molecular identification of Echinococcus granulosus eggs was carried out using PCR. Helminth eggs and protozoan (oo)cysts eggs were found in 12.5% of the unwashed vegetables, and the most common parasites observed in vegetables were coccidian oocysts (4.1%), Toxocara spp. (2.5%), hookworm (2.1%), and Taenia spp. (1.25%) eggs, followed by Pseudolimax butschlii (1.6%) and Entamoeba coli (1.6%) protozoan cysts. Furthermore, parasite contamination differed significantly from one city to another. Taeniid eggs were identified by PCR as E. granulosus sensu stricto (s.s.) (genotype G1). To our knowledge, this study highlights for the first time in Tunisia that fresh vegetables for sale in markets are contaminated with helminths and protozoan cysts, which are potentially pathogenic for humans. The control of these pathogens is in part a question of sanitary education, especially for retail vendors, and in part of improvement in hygiene measures throughout the food production chain, from the field to the consumer.
Highlights:
... Previous studies in other developing countries, including Iran, Iraq, Nigeria, Pakistan, and Egypt, indicated higher parasitic contamination than in the present study [22][23]. However, studies conducted in developing regions such as Saudi Arabia [24] and Turkey [25] indicated lower parasitic contamination. Differences between percentages may be due to differences in the living standards of the communities, cultivation methods, climatic changes, and pre-post-harvesting care. ...
Intestinal parasitic infections in Sri Lanka have received little attention due to their perceived low prevalence. Consuming raw vegetables without proper washing is one of the main ways to transmit intestinal parasitic infections. Therefore, this study investigated the contamination of parasites in vegetables. A cross-sectional study was conducted from August 2023 to January 2024 at fifty selected open markets in ten cities (Ragama, Miriswatta, Kirillawala, Kadawatha, Balummahara, Kiribathgoda, Peliyagoda, Weliweriya, Imbulgoda and Gampaha) in Gampaha District, Sri Lanka. Four vegetable types, namely Centella asiatica (Gatu kola) [n = 162], Ipomoea aquatica (Kankun) [n = 150], Alternanthera sessilis (Mukunuwenna) [n = 160] and Lactuca sativa (Lettuce) [n = 148] that are consumed either raw or half cooked were selected. Approximately 50 g of each vegetable was taken randomly at each sampling attempt. Each sample was dipped in the Tween 20 (5%) in a shaker for 15 minutes, followed by sedimentation overnight and centrifugation (2000 × g for 15 min). Both supernatant and sediment were examined under a light microscope to detect parasitic stages. The overall prevalence of parasitic contamination in the samples was 21.29% (n = 132). Centella asiatica indicated the highest contamination (37.65% [61/162]). Lactuca sativa had the lowest contamination (2.02% [3/148]). Parasites including protozoan (Entamoeba histolytica, Giardia lamblia, Toxoplasma gondii, Blastocystis hominis, Paramphistomum spp and Balantidium coli) and helminths (Ascaris spp., Hymenolepis spp., Strongyloides stercoralis, Trichuris spp, Taenia spp, Toxocara canis and hookworms) were detected. Blastocystis hominis was the most predominant (4.68%; n = 29). Toxocara sp, G. lamblia and Eimeria sp were identified as least abundant (0.77%; n = 5). Every sample contained at least one parasitic contamination. A significant difference between the type of vegetables and the existence of parasites was identified (P = 0.008). The parasitic stages identified could cause infections among people with poor food hygienic/ preparation practices. Therefore, health authorities must educate consumers on precautionary measures to prevent re-emerging intestinal parasitic infections in Sri Lanka.
... Animales domésticos como los perros son hospedadores de una variedad de parásitos que pueden afectar a los seres humanos. Dado que la vía fecal-oral es la forma más común de transmisión de parásitos, el consumo de vegetales crudos irrigados con agua contaminada por heces de animales parasitados o la ingestión de agua contaminada puede impactar directamente en la salud humana (6,7) . ...
Introducción. Cajamarca es una región peruana que enfrenta desafíos importantes en la calidad de vida y prácticas de higiene de gran parte de su población. La falta de programas educativos sólidos en salud e inocuidad alimentaria es evidente en áreas rurales de la región. Objetivo. Determinar la prevalencia de parásitos intestinales mediante la observación de huevos en heces de niños escolares de un centro poblado ubicados en el valle de Cajamarca. Materiales y Métodos. Se recolectaron muestras fecales de 117 niños de una institución educativa y se procesaron mediante el método de concentración por flotación solución saturada de sulfato de zinc. Resultados. Se observaron huevos fecales de helmintos en 73 escolares (62,39% [IC 95%: 53,62 – 71,17]). El sexo de los escolares estuvo asociado con la presencia de casos positivos a parásitos (p<0,05), con una mayor prevalencia en niñas. Los escolares de mayor edad fueron los más afectados, pero no mostraron asociación estadística (p>0,05). La mayor cantidad de escolares estuvieron infectados con Ascaris lumbricoides (54,70%), seguido de Taenia spp (3,42%). Además, se observaron tres casos de coexistencia de A. lumbricoides con Taenia spp (2,56%), y un caso de A. lumbricoides con Trichuris spp y Trichuris spp con Taenia spp (0,85%). Conclusión. La prevalencia de parásitos entéricos en escolares del centro poblado evaluado fue alta, destacando la necesidad de mejorar las prácticas de higiene y los programas educativos en salud, especialmente enfocados en los niños.
... The parasite life cycle is completed in two hosts, the definitive host, the dogs and other members of family Canidae in which the adult stage inhabit their intestine, and the intermediate hosts including many ruminants such as sheep, goats, cattle, camel etc., in these hosts the larval stage lives in visceral organs Karamian et al. 2017;Mulinge et al. 2018). Intermediate hosts are infected by ingesting the infective eggs released with dog feces that contaminate the pasture (Adanir and Tasci 2013;. The dogs and other carnivores acquire infection by eating infected organs from slaughtered animals such as the liver and lungs containing fertile cysts (Otero-Abad and Torgerson 2013; Craig et al. 2017). ...
Echinococcus granulosus sensu lato species complex is the parasite responsible for cystic echinococcosis (CE), which has a worldwide distribution. This study involved the prevalence of cystic echinococcosis in sheep and cattle slaughtered at Zakho abattoirs from February 2020 to January 2021, in which 21565 animals were slaughtered. They included 14547 sheep and 7018 cattle. The total rate of infection was 1.18% (255/21565), with the highest rate (1.34%) in sheep and the lowest (0.85%) in cattle. Among infected sheep, 45.64% of the cysts were seen in both the liver and lungs, 32.82% in the liver and 21.53% in the lungs. While among infected cattle, 76.66% of the cysts were found in both the liver and the lungs, 16.66% in the liver and 6.66% in lungs. Concerning animal gender, females of sheep and cattle showed the highest infection rate as compared to males (37.01 and 83.33% versus 0.49 and 0.71%), respectively. Regarding the yearly prevalence of CE, sheep showed the highest rate of infection throughout the year with a peak during April which was 4.43%, while the highest rate of infection in cattle was during August (2.63%). According to cyst types, sheep CE showed the highest rate (63.04%) of fertility, followed by cattle (14.29%). While the highest rate (77.77%) of sterile cysts were in cattle. Furthermore, 16.67% of sheep cysts and 7.95% of cattle cysts were calcified. Sheep cysts are characterized by the highest rate of protoscolices viability than cattle cysts (58.36 vs 27.36%). These results showed that the prevalence of CE infection is lower than that previously reported in the same regions of Iraq, but the disease is still present and there is the possibility of its transmission to sheep and cattle which play an important role in the life cycle and transmission of this zoonotic disease to definitive host and from them to humans and other susceptible intermediate hosts.
... These infections share soil and food-borne transmission as major variables in their human population predominance because they discharge their eggs/ larvae in the feces of infected hosts, contaminating food or polluting soil due to unhealthy hygienic practices (Chelkeba et al., 2022) Gastrointestinal diseases are abundantly seen in developing countries where contaminated water, poor sanitation, poor hygiene, and civil wars contribute to their prevalence which has a great impact on global health (Mandeville et al., 2009). Studies all over the world have shown that many species of enteric helminths and protozoa can infect humans who consume contaminated, improperly washed fruits and vegetables (Al-Shawa and Mwafy, 2007; Adanir and Tasci, 2013;Ismail, 2016). Intestinal parasites such as Cryptosporidium spp., Giardia lamblia, Entamoeba histolytica, Ascaris lumbricoides, hookworms, Enterobius vermicularis, Trichuris trichiura, Toxocara spp., Hymenolepis spp., Taenia spp., Fasciola spp., and members of the family trichostrongylidae could infect humans as a result of consumption of contaminated, uncooked, or improperly washed vegetables (Kozan et al., 2007). ...
... Improper hygiene practices among agricultural workers during harvesting can transfer parasites from their hands to the vegetables [10]. Additionally, contaminated equipment or surfaces can contribute to cross-contamination [4,11]. If vegetables are not thoroughly washed before consumption, parasite eggs or cysts may remain on the surface and can be ingested, leading to infection [12]. ...
Introduction: Intestinal parasite infections pose a significant public health concern in many developing countries, including Ghana. Inadequate sanitation and poor hygiene practices contribute to the transmission of these parasites, with contaminated food being a common route of infection. This research article investigates the prevalence of gastrointestinal parasite infections in ready-to-eat vegetables sold in selected markets in Ashanti region, Ghana. Methods: A cross-sectional study was conducted, and vegetable samples were collected from various vendors in the markets. The samples were examined for the presence of intestinal parasites using standard laboratory techniques. The findings of this study shed light on the potential risks associated with consuming contaminated vegetables and highlight the importance of food safety measures in reducing the burden of intestinal parasite infections in the region. Results: 22.7% (68/300) of the sampled vegetables were contaminated with intestinal parasites. The common intestinal parasites were Entamoeba histolytica (9.7%, 29/300), followed by both Ascaris lumbricoides and Giardia lamblia at 4.3% (13/300) and Ancylostoma duodenale at 3.0% (9/300). The prevalence of Enterobium vermicularis infections was 1.7% (5/300). However, Trichuris trichiura and Strongyloides stercoralis infections was 0.7% (2/300). The least common intestinal parasites were Isospora belli and Taenia sp. (0.3%, 1/300). Entamoeba histolytica was the only parasite detected in all vegetable type while Ascaris lumbricoides was detected in all vegetable types except cucumber. Conclusion: our study highlights the need for heightened awareness, improved food safety practices, and tailored interventions to address the risks associated with the consumption of fresh vegetables.
... Examination of vegetables in Kenya in 2008 revealed a higher contamination of 65.5% as reported by (Nyarango et al., 2008). A study done in Khorramabad Iran by (Ezatpour et al., 2013) reported a contamination rate of 79% while a lower rate of contamination was observed in Riyadh Saudi Arabia which recorded 16.2% (Al-megrm., 2010) and in Turkey 6.3% (Adanir & Tasci., 2013). The high prevalence recorded in this sturdy may be due to the fact that the study was conducted during rainy season where water body was washing human and animal excreta into farmlands where vegetables were cultivated awaiting harvest or may be due to the improper handling of the vegetables by farmers or transporters and vegetable sellers who use contaminated water to wash their vegetables in order to keep it fresh to attract buyers. ...
Vegetables serves is a rich source of minerals and roughages that are essential for maintenance of good health and prevention of diseases but can as well serve as a source of parasitic pathogens to man. Intestinal parasites are known to cause significant morbidity and mortality worldwide particularly in underdeveloped countries such as Nigeria. The rate of consumption of raw and undercooked vegetable which can serve as a means of transmission of intestinal parasite to people is high especially in Jos. This study was to determine parasitic contamination of commonly consumed vegetables sold in two markets in Jos South LGA. A total of 260 samples of fresh vegetables; Tomato, Carrot, Lettuce, Cabbage and Spinach were purchased from vendors and examined for parasitic contamination using ordinary centrifugation method. Out of 260 samples examined, 215 (82.69%) were contaminated with at least one type of parasite. Strongyloides stercoralis, Entamoeba coli, Entamoeba histolytica, Ascaris lumbricoides, Hookworm, Giardia lamblia, Taenia species, Enterobius vermicularis, and Mite accounted for 72.02%, 13.10%, 6.15%, 3.97%, 3.77%, 0.40% and 0.20% respectively in this study. Lettuce, Spinach, Cabbage, Carrot and Tomatoes accounted for 28.13, 22.18%, 21.15%, 15.61%, and 12.94% respectively with overall parasitic prevalence of 82.69%. Strongyloides stercoralis is the most prevalent parasite seen while Taenia specie, Enterobius vermicularis, and Mite are the least parasites seen. Lettuce has the highest contamination rate of 137 (28.13%) followed by Spinach 108 (22.18%) while Tomatoes 63 (12.94%) had the least contamination. The findings of the study suggest that there is potential high risk of acquiring parasitic infection from consumption of raw and undercooked vegetables sold in Jos South LGA, Plateau State. There should be proper washing and cooking of these vegetables before consumption since they can serve as source of transmission of parasites to man when eaten raw or undercooked.
... A técnica de sedimentação espontânea é bastante utilizada na rotina de pesquisa parasitológica, pois apresenta baixo custo, fácil execução (não necessitando do uso de centrifugação), além da possibilidade de detectar um amplo espectro de agentes parasitários (ADANIR; TASCI, 2013;BRAUER et al., 2016). A análise técnica consistiu em cinco etapas: de início, foram colocadas aproximadamente duas gramas (2g) de fezes em um frasco Borrel ou Backer, com cerca de 5mL de água e os excrementos da amostra foram triturados com bastão de vidro. ...
Esta pesquisa destina-se à realização de análises físico-químicas, microbiológicas e parasitológicas da água da Lagoa Mundaú em Maceió com enfoque em infecções por parasitas intestinais que constituem um relevante problema de saúde, estas patologias estão correlacionadas com a falta de saneamento básico e hábitos de higiene precários, corroborando, assim, com a alta taxa de contaminação por enteroparasitoses, principalmente em crianças. O objetivo deste estudo foi realizar análises físico-químicas da água e um levantamento das parasitoses intestinais mais comuns em crianças que frequentam o Centro de Recuperação e Educação Nutricional (CREN), o qual atende crianças das comunidades da Vila Emater e Sururu de Capote.
... This finding has been supported by other researchers where Ascaris lumbricoides was the predominant parasite detected [37,38]. However, a lower rate of contamination of vegetables samples with A. lumbricoides eggs was recorded (1.8%) of total examined samples in Turkey [39]. Also, in Iran, as it was found to be 2.5% in Jiruft [40]. ...
Fresh and raw vegetables may play a significant role in transmission of intestinal parasitic infections to humans. Therefore, this study was conducted to estimate the level of parasitic contamination in vegetables which are consumed raw in Aden governorate, Yemen. This is a descriptive analytic cross-sectional study in which six local markets were randomly selected. A total of 216 fresh vegetable samples including parsley (Petroselinum sativum), watercress (Nasturtium officinale), lettuce (Lactuca sativa), leek (Allium porrum), green onion (Allium cepa), and tomatoes (Solanum Lycopersicum) were purchased from the selected markets and analysed using direct and iodine wet mount smear preparation. Modified Ziehl–Neelsen staining and Zinc sulphate flotation method were also used. Smears were examined by under the light microscope. Out of 216 vegetable samples, 166 (76.9%) were contaminated with one or more parasites. Parsley was the most contaminated (97.2%), followed by watercress (94.4%), lettuce (88.9%), leek (80.6%), green onion (77.8%), whereas the least contamination rate was in tomato (22.2%). Statistically significant difference in parasitic contamination rate was found between different types of vegetables (P < 0.05). The most common parasite was Ascaris lumbricoides 75 (24.4%), followed by cyst of Entamoeba histolytica/dispar 64 (20.9%), and Entamoeba coli 52 (16.8%). Significant difference was reported in prevalence rate between different parasitic species (????< 0.05). Vegetable samples collected from Dar Saad market, show the highest contamination rate (94.4%) while vegetables collected from Al Mansura market showed the lowest contamination rate(50.0%). However, the parasitic contamination rates were not significantly different for samples collected from different markets. This study highlighted the importance of raw vegetables as the potential source of transmission for intestinal parasites to humans. Prevention methods such as proper washing or cooking of vegetables before consumption should be conveyed to consumers. In addition, comprehensive health education and hygienic practices, including washing hands after handling vegetables, should be provided to sellers and consumers.
... Echinococcus granulosus, parasitizes canids (definitive hosts) where the adult inhabits small intestine and herbivores act as the intermediate hosts for the parasitic larval stage (metacestode) which is most commonly found in lungs and liver [3]. Human contamination occurs following the ingestion of eggs through contaminated food, essentially vegetables and water [4] or by direct contact with contaminated dogs that retain eggs on their coat [5] leading to cystic echinococcosis. The post-mortem examination of organs of intermediate host were also examined in the present study for the presence of hydatid cyst and organ wise incidence of hydatidosis was also reported. ...
... The pathogenicity of these Raillietina species results in loss of nutrition, weight loss, slow growth, reduced egg production, and unacceptable egg and meat quality. These effects could lead to severe economic losses in the absence of food safety and control processing for parasite diagnosis and sterilization (Adanir and Tasci, 2013;Lalthanpuii and Lalchhandama, 2020). ...
Chickens and ducks are important sources of essential proteins and nutrition for global consumption, especially their eggs and meat. Tapeworm infections in chickens and ducks are the cause of serious poultry health and economic problems in the processing of livestock and food production systems. Raillietina are cosmopolitan in distribution and are possibly the most common tapeworm parasites. There are three important species regarding avian infection, with different pathogenicity, including Raillietina echinobothrida, R. tetragona, and R. cesticillus. Co-infection diagnosis of these tapeworms using morphological analysis can be performed, but this is time-consuming and complicated. Therefore, this study aimed to develop a triplex PCR for the detection and discrimination of three Raillietina species. The triplex PCR assay specifically amplified target DNAs with no inter-specific interference and produced a specific band for each species. According to the specificity test, there was no cross-amplification with the DNA template of related parasites and their hosts. The lowest detectable DNA concentrations were evaluated and provided sensitivities of 0.5 pg/μL for R. echinobothrida, 5 pg/μL for R. tetragona, 50 fg/μL for R. cesticillus, and 5 pg/μL for the combination of DNA from all three species. Simultaneous detection limits of egg capsules and gravid proglottids was also performed, with and without feces. The interference of feces in the reaction was related to a decrease in sensitivity, but simultaneous detection of three Raillietina species in amounts lower than one gravid proglottid and ten egg capsules was still successful. Thus, this study is the first triplex PCR assay for Raillietina detection and can be utilized as an alternative diagnostic tool for the detection and discrimination of R. echinobothrida, R. tetragona, and R. cesticillus infection in poultry through the verification of fecal specimens. In addition, it could improve the performance of specific treatments and promote veterinary healthcare.
... Some studies have shown that raw vegetables play a role in spreading parasitic food-borne diseases (Blackburn & McClure 2002; Eraky et al. 2014). Several studies have also shown that people are more susceptible to intestinal worms and protozoa by eating fruits or vegetables (Al-Shawa & Mwafy 2007;Adanir & Tasci 2013;Ismail 2016). Researches have revealed that the reason for this phenomenon may be that vegetables are polluted by wastewater during irrigation or directly contaminated by animals and humans during harvesting, packaging, transportation, processing, distribution, and sales (Amoah et al. 2007;Gabre & Shakir 2016). ...
Cryptosporidium and Giardia are globally recognized protozoa that directly cause human diarrhea. Their transmission route mainly involves drinking contaminated water, thus needing proper water treatment to avoid human infection. At present, there is a lack of review on the infection status and control measures of the two protozoa. Hence, this article summarizes and compares the infection status and the role of drinking water in transmitting the Cryptosporidium and Giardia in some key countries in Asia, Africa, Europe, and the Americas. With collected data, this review offers recommendations for sanitary control and provides theoretical support for the application of drinking water treatment projects. HIGHLIGHTS
Need to strengthen preventive measures of Giardia and Cryptosporidium in animals.;
Improve sanitation facilities, pay attention to non-core areas, and avoid concentrated outbreaks.;
Reasonable selection of testing methods according to the needs and conditions of each country.;
The water treatment process parameters need to be reasonably selected according to the natural water quality conditions.;
... In Egypt the rate of parasitic contamination in vegetable samples was the highest in summer (49%) and the lowest was in winter (10.8%) [29]. The excretion of parasite's eggs to environment by human or animals is high in warm seasons compared to cold seasons [37]. Another study in Hanoi, Vietnam, ...
... To determine helminth eggs presence in irrigation water, preparation step is conducted before analysis. After removing all the floating dirt in the overnight settled sample, the resulting precipitate will be prepared for analysis [6]. Quantitative measure and analysis of helminth eggs was done by Bailinger method with some modification based on existing laboratories condition using Mc Master slide [7,8]. ...
Water as vital needs to our life must be fulfilled. Increasing population tends to water scarcity causes by the high demand and limited source. Water reuse is one of the solutions to face the challenge. Helminth eggs is one of the parameters for water reuse recommended by WHO. Previous studies have shown that there are helminth eggs presence in irrigation water and wastewater system in Indonesia, thus the possibility of disease by helminth eggs presence. This study was conducted to give an advice about the importance of helminth eggs assessment in Indonesia for better water reuse and prevent disease like soil-transmitted helminthiases. To detect the presence of helminth eggs in water, adaptations from several existing methods is required. Indonesia needs an exact method to determine the presence of helminth eggs. Government, institutions, and society have to collaborate to prevent the existence of helminth eggs for the water reuse purpose in the future. This can lead to increase quality of health and environment aspects.
... The overall prevalence rate of parasitic contamination in this study supports the findings from Egypt [21], Nigeria [22] and Sudan [7] but was lower than previous findings elsewhere [16,23,24]. Nonetheless, it was observed to be higher when compared to a study from Turkey [25] and India [26]. These differences could be attributed to variations in environmental and climatic conditions, sanitary conditions, laboratory techniques employed and types of vegetable sampled which are instrumental in the transmission of parasitic diseases. ...
Aims: Vegetables are usually exposed to parasitic ova, larvae or oocyst during cultivation, irrigation, storage, transportation or while processing for consumption. Consumption of raw, unwashed and improperly cooked vegetables is considered a risk factor for transmission of intestinal parasites. This study assessed the parasitic contamination of vegetables and also determined factors associated with parasitic contamination of vegetables in selected markets in Calabar, Cross River State. Place and Duration of Study: Sample: Markets within Calabar, Cross River State, Nigeria between September and October, 2018. Methodology: A pre-tested semi-structured questionnaire was used for collecting data on factors associated with parasitic contamination of vegetables. 300 vegetable samples were purchased and processed from three different markets in Calabar for examination of parasitic contamination using direct wet mount and zinc sulphate floatation techniques. Results: 15.7% (47/300) of the vegetables sampled were positive for at least one parasite. The species and stages of parasites detected were larvae of Strongyloides, ova of Trichuris trichiura and Hookworm, and cysts of Entamoeba histolytica and Giardia lamblia. Larvae of Strongyloides (11.3%) were the most frequently detected followed by ova of T. trichiura (1.7%) and Hookworm (1.7%) (P = 0.000). Among the five vegetable types sampled, waterleaf (40%) had the highest level of parasitic contamination followed by pumpkin (21.7%). Washing vegetables before display and the means of display were significantly associated with parasitic contamination (P = 0.000). Conclusion: Prevention of contamination is important in reducing food-borne parasitic infections and can be achieved through improved personal hygiene practices of farmers, vendors and consumers, proper washing of vegetables and improved sanitary conditions especially around markets where these vegetables are sold.
... In comparison with other studies, the 14.6% prevalence of parasitic infestation is relatively moderate. There are different reports about the prevalence of parasitic contamination of raw consumed vegetables in Iran and other regions of the world such as Kenya (65.5%) (17), Libya (58%) (6), Egypt (31.7%) (14), Nigeria (3.5%) (5), Iraq (49.79%) (18), and Turkey (6.3%) (19). Klapec and Borecka reported that the rate of geohelminths eggs on vegetables and fruits from conventional and organic farms was 34.7% and 18.9%, respectively, in south-eastern Poland (20). ...
... Several studies from different parts of the world such as Turkey [10], Sudan [2], Ethiopia [5], Iran [11], Ghana [4] have confirmed that fruits and vegetables serve as the major medium of transmission of helminths eggs (Ascaris lumbricoides, Trichura trichuris, hookworm, Strongyloides spp. larva), protozoan cysts (Entamoeba spp., Giardia spp.). ...
Aim: Parasitic contaminations are major public health problems more, especially in developing countries. The consumption of fresh fruits or vegetables which are not adequately washed serves as one of the major channels through which humans being getting infected. The study was carried out to determine parasitic contamination of commonly consumed fruits and vegetables sold in two selected markets in Katagum region of Bauchi State, northeast Nigeria. Place and Duration of Study: The study was carried out in two selected local markets, namely, Azare central market and Gadau central market of Katagum region, from July to October 2019. Methodology: A total of 175 fresh fruits and vegetable samples consisting of banana, mango, orange, cabbage and spinach were purchased from two selected local markets. 200g of each fruit and vegetable sample was washed separately in normal physiological saline for detaching the helminths and protozoan's parasites assumed to be associated with the products. After 24 hours Original Research Article Abubakar et al.; SAJP, 4(4): 36-43, 2020; Article no.SAJP.58772 37 sedimentation of the washing solution, 15 ml of the sediment was centrifuged and further prepared for microscopic examination. Results: The overall prevalence of parasitic contamination was 23.4%. The most frequently detected helminths parasite eggs were Ascaris lumbricoides (7.4%), followed by Taenia spp (6.3%), hookworms (2.9%), Fasciola spp (1.7%), Hymenolepis diminuta, Hymenolepis hana (1.1%) and Strongyloides spp. larva (0.6%). Among the protozoa, the cysts of Entamoeba spp. (1.7%) were the most commonly detected, followed by Giardia spp. (0.6%). The highest level of contamination was found in cabbage, with a prevalence rate of 37.1%, while the lowest contamination level was found in mango and spinach, with a prevalence rate of 17.1%. The occurrence of parasite contamination in Gadau central market (23%) was statistically significant than that of Azare central market (18%) (χ 2 =12.46, df=1, p=0.00). Conclusion: The findings of this study show that the consumption of fresh fruits and vegetables with parasite contamination in this area represents a potential agent for the transmission of these parasites to humans. Therefore, health authorities must sensitize farmers, vendors, and consumers on the dangers associated with the consumption of contaminated fruits and vegetables. The principle of personal hygiene, such as the washing of the fruits and vegetables before eating, should be advocating the inhabitant of this region as this will drastically help reduced parasitic contamination.
... This facilitates adherence to surfaces of vegetables, herbs and fruits. Accordingly, contamination of different vegetables has been described, such as lettuce, carrots, potato, zucchini, spinach, cucumber or cress (Abougrain et al. 2010;Adanir and Tasci 2013;Fallah et al. 2012;Klapec and Borecka 2012), some of which are commonly consumed raw. ...
The zoonotic dog roundworm Toxocara canis infects not only a broad range of canids as definitive hosts, but also affects humans as paratenic hosts after accidental infection. In humans, clinical apparent toxocarosis (or toxocariasis) is classified into four different syndromes: visceral larva migrans (VLM), ocular larva migrans (OLM), neurotoxocarosis (NT) and covert toxocarosis. Symptoms range from abdominal pain to irreversible blindness or meningitis and cognitive disorders. Nevertheless, toxocarosis is a neglected zoonotic disease, which is often undiagnosed. Until today, the parasite remains enigmatic in many aspects. This chapter aims to summarise key characteristics of the biology of T. canis, risk factors that lead to human infection, clinical presentation and relevance of human toxocarosis and possibilities of control and prevention measures. Further research efforts as well as raising public awareness for this zoonotic dog parasite are essential to improve the control of this challenging zoonotic infection.
... 8,26 Much lower percentages of E. vermicularis contamination were reported from Accra, Ghana (2%), 21 Benha, Eg ypt (4.9%), 27 Burdur, Turkey (0.9%). 28 G. lamblia cysts were detected in 3.0% of the fresh produce with lettuce found to be the only vegetable contaminated with this parasitic protozoan [ Table 2]. Other studies reported somewhat similar contamination rates. ...
Objectives: Consuming raw vegetables presents a considerable risk to the public
and is the chief mode of transmission of intestinal parasites. We sought to
assess the degree of parasitic contaminations on selected vegetables in the UAE.
Methods: A total of 218 fresh vegetable samples were collected randomly from different
farms and local supermarkets between February 2017 and January 2018. After washing
and centrifugation, the sediment was examined microscopically for parasitic forms.
Results: Protozoa cysts and helminths eggs were detected in 15.1% (33/218) of samples.
The most detected parasites were Entamoeba complex (E. histolytica/E. dispar/E.
moshkovskii) (30.3%), Entamoeba coli (18.2%), Trichuris trichiura (12.1%), Strongyloides
stercoralis (12.1%), Ascaris lumbricoides egg (9.1%), Endolimax nana cyst and Enterobius
vermicularis egg (6.1% each), and Giardia lamblia and Hymenolepis nana (3.0% each). We
found no significant association between the vegetable type and the parasite occurrence
(p > 0.050). Moreover, parasite incidence was independent of the vegetable type
(p > 0.050). Conclusions: The study highlights the potential of raw produce serving
as a major source of foodborne disease outbreaks and its role in the transmission of
intestinal parasitic infections. Public education on the safe handling of raw vegetables
is recommended.
... 8,26 Much lower percentages of E. vermicularis contamination were reported from Accra, Ghana (2%), 21 Benha, Eg ypt (4.9%), 27 Burdur, Turkey (0.9%). 28 G. lamblia cysts were detected in 3.0% of the fresh produce with lettuce found to be the only vegetable contaminated with this parasitic protozoan [ Table 2]. Other studies reported somewhat similar contamination rates. ...
Objectives:
Consuming raw vegetables presents a considerable risk to the public and is the chief mode of transmission of intestinal parasites. We sought to assess the degree of parasitic contaminations on selected vegetables in the UAE.
Methods:
A total of 218 fresh vegetable samples were collected randomly from different farms and local supermarkets between February 2017 and January 2018. After washing and centrifugation, the sediment was examined microscopically for parasitic forms.
Results:
Protozoa cysts and helminths eggs were detected in 15.1% (33/218) of samples. The most detected parasites were Entamoeba complex (E. histolytica/E. dispar/E. moshkovskii) (30.3%), Entamoeba coli (18.2%), Trichuris trichiura (12.1%), Strongyloides stercoralis (12.1%), Ascaris lumbricoides egg (9.1%), Endolimax nana cyst and Enterobius vermicularis egg (6.1% each), and Giardia lamblia and Hymenolepis nana (3.0% each). We found no significant association between the vegetable type and the parasite occurrence (p > 0.050). Moreover, parasite incidence was independent of the vegetable type (p > 0.050).
Conclusions:
The study highlights the potential of raw produce serving as a major source of foodborne disease outbreaks and its role in the transmission of intestinal parasitic infections. Public education on the safe handling of raw vegetables is recommended.
... The prevalence of Toxocara spp. ova has been reported as 1.48% and 2.7% in Turkey [157,158] and 18.3% in Iraq [159], as the neighbors of Iran. The weighted prevalence of Toxocara spp. ...
Background
Toxocariasis is one of the neglected zoonosis with considerable public health importance around the world. The current study aimed to elucidate the overall prevalence of Toxocara infection in human and definitive hosts and also the contamination of soil and raw vegetables with the ova of these parasites, in Iran, using systematic review and meta-analysis.Methods
Six English and Persian databases were explored from 2000 to 2017 using the terms toxocariasis, Toxocara spp., visceral larva migrans, Iran, epidemiology, and prevalence. This meta-analysis conducted using STATA, and for all statistical tests, a p value less than 0.05 was considered significant. The random-effects model was used to the report of the pooled prevalence with a 95% confidence interval (CI).ResultsThe pooled prevalence of toxocariasis in human was calculated as 11% (95% CI 8–13%). In terms of definitive hosts, the pooled prevalence of Toxocara infection in dogs and cats were calculated as 17% (95% CI 14–20%) and 37% (95% CI 26–48%), respectively. Also, the pooled prevalence of Toxocara spp. eggs in the soil and raw vegetable samples were calculated as 18% (95% CI 13–23%) and 2% (95% CI 1–3%), respectively.Conclusions
The results of current study demonstrate that toxocariasis should be taken more seriously by health authorities. Implementing an appropriate control program is necessary to reduce the incidence of this disease in Iran.
... On the other hand, it is higher than that reported in similar studies done in other part of Nigeria (Agbalaka et al., 2019;Luka et al., 2016). Similar reports have also been made in some part of the world which include Ghana (Dankwa et al., 2018), Ethiopia (Tefera et al., 2014), Sudan (Mohamed et al., 2016), Iran (Rostami et al., 2016), Thailand (Punsawad et al., 2019), Brazil (Luz et al., 2017) and Turkey (Adanir and Tasci, 2013). Several studies have shown that the use of untreated water to irrigate vegetables in Nigeria and other under developing countries is one of the major factors responsible for STH contamination (Alemu et al., 2019). ...
Consumption of raw vegetables provides essential nutrient to humans. However, eating these vegetables raw without proper washing serve as one of the major factors responsible for high morbidity and mortality globally. The present study aimed to evaluate the prevalence of soil-transmitted helminths (STH) parasites in commonly used vegetables in Jama'are Town, north east Nigeria. A total of 150 fresh raw vegetable samples were obtained from various markets within the study area. Each sample was divided into two groups; unwashed and washed with traditional method. The samples were examined using sedimentation concentration technique and data obtained were analyzed using Chi square in SPSS version 24. The overall prevalence of STH parasites was 22.6%. The unwashed vegetables (29.3%) had more STH contamination than the washed vegetables (16.0%). There was a significantly difference between the occurrence of STH parasites between unwashed and washed vegetables (χ2=14.21, P=0.001). Spinach (26.6%) had the highest prevalence, followed by cabbage, lettuce and carrot which all have 23.3% contamination while green pepper had the least contamination. For the unwashed, spinach (8%) had the highest prevalence while green paper (4.0%) has the least. There was no significant difference between the occurrence of STH parasite and the vegetable types (χ2=4.200, P=0.380). For the washed, cabbage and lettuce (4%) harboured more contamination while spinach, carrot and green paper (2.6%) have the least. Similarly, there was no significant difference between the occurrence of STH parasite and the vegetable types (χ2=3.00, P=0.558). The overall prevalence of STH infections in all the vegetables were as follows: hookworms (30.3%), Ascaris lumbricoides and Strongyloides (21.2%), Taenia sp. and Trichuris trichiura (15.2%). The results of the present study provide evidence that vegetables are potential risk factor for transmission of STH infection to human in Jama'are Metropolis, Bauchi State. Therefore, it is indispensable for retailers and consumers to proper wash their vegetables before consumption as this is necessary to reduce STH contamination.
... On the other hand, it is higher than that reported in similar studies done in other part of Nigeria (Agbalaka et al., 2019;Luka et al., 2016). Similar reports have also been made in some part of the world which include Ghana (Dankwa et al., 2018), Ethiopia (Tefera et al., 2014), Sudan (Mohamed et al., 2016), Iran (Rostami et al., 2016), Thailand (Punsawad et al., 2019), Brazil (Luz et al., 2017) and Turkey (Adanir and Tasci, 2013). Several studies have shown that the use of untreated water to irrigate vegetables in Nigeria and other under developing countries is one of the major factors responsible for STH contamination (Alemu et al., 2019). ...
Consumption of raw vegetables provides essential nutrient to humans. However, eating these vegetables raw without proper washing serve as one of the major factors responsible for high morbidity and mortality globally. The present study aimed to evaluate the prevalence of soil-transmitted helminths (STH) parasites in commonly used vegetables in Jama'are Town, north east Nigeria. A total of 150 fresh raw vegetable samples were obtained from various markets within the study area. Each sample was divided into two groups; unwashed and washed with traditional method. The samples were examined using sedimentation concentration technique and data obtained were analyzed using Chi square in SPSS version 24. The overall prevalence of STH parasites was 22.6%. The unwashed vegetables (29.3%) had more STH contamination than the washed vegetables (16.0%). There was a significantly difference between the occurrence of STH parasites between unwashed and washed vegetables (χ2=14.21, P=0.001). Spinach (26.6%) had the highest prevalence, followed by cabbage, lettuce and carrot which all have 23.3% contamination while green pepper had the least contamination. For the unwashed, spinach (8%) had the highest prevalence while green paper (4.0%) has the least. There was no significant difference between the occurrence of STH parasite and the vegetable types (χ2=4.200, P=0.380). For the washed, cabbage and lettuce (4%) harboured more contamination while spinach, carrot and green paper (2.6%) have the least. Similarly, there was no significant difference between the occurrence of STH parasite and the vegetable types (χ2=3.00, P=0.558). The overall prevalence of STH infections in all the vegetables were as follows: hookworms (30.3%), Ascaris lumbricoides and Strongyloides (21.2%), Taenia sp. and Trichuris trichiura (15.2%). The results of the present study provide evidence that vegetables are potential risk factor for transmission of STH infection to human in Jama'are Metropolis, Bauchi State. Therefore, it is indispensable for retailers and consumers to proper wash their vegetables before consumption as this is necessary to reduce STH contamination.
... [38] Lower rate of contamination in the Middle-East were detected in Riyadh, Saudi Arabia (16.2%) [39] and Turkey (6.3%). [40] However several other factors may contribute to the differences observed in the contamination rate these may include geographical location, types and number of samples examined, methods used for detection of the intestinal parasite, type of water used for irrigation, postharvesting handling methods of such vegetables which are different from one country to another. ...
BACKGROUND: Vegetables are vital for good health but can serve as a means of transmission of parasitic pathogens to man. JUSTIFICATION: There is increase consumption of vegetables due to general awareness of the health benefits. This research intends to explore suggestive management strategies and control in handling vegetables to reduce or if possible eliminate food borne parasites. AIM AND OBJECTIVE: The study was to determine parasitic contamination of fresh vegetables with objective to determine the prevalence of parasites of medical importance in vegetables sold in Jos market. METHODOLOGY: A total of 575 samples of fresh vegetables; Lettuce, Cabbage, Carrot, Spinach, Green Pepper, Cucumber, Beetroot, Tomatoes, Garden egg, and Green bean; were bought from sellers from May-June 2016 and examined for helminthes eggs, larva and cysts using wet mount and concentration techniques. RESULT: Hookworm, Ascaris lumbricoides, Trichuris trichuria, Strongyloides stercoralis, cyst of Entamoeba histolytica and Giardia lambia accounted for 7.3%, 8.1%, 4.8%, 58.1%, 9.7% and 12.1% respectively. Cucumber, carrot, cabbage beetroot, spinach, lettuce, green pepper, green beans, garden egg and tomatoes had 0%, 26.7%, 31.7%, 5.7%, 40%, 53.3%, 6.7%, 6.7%, 13.3% and 25% respectively with overall prevalence of 21.6% and strongyloides stercoralis was most prevalent and Trichuris trichiura least prevalent found in cabbage and tomatoes. Lettuce has the highest contamination rate 32(53.3%), followed by spinach 24(40%) while beetroot had the least (5.7%). CONCLUSION: Vegetables in Jos Metropolis are contaminated with parasites. There should be proper washing as they could serve as source of transmission of parasites when eaten raw or undercooked.
... The results of the present study showed that, as indicated in Table ( (El-Said, 2012) in Egypt (Alexandria) was (31.7%) and was higher than recorded (Anna, 2013) in the city of Diwaniyah, where it reached (11.77%) and also higher than the ratio recorded by (Omowaye & Falola, 2012) in Nigeria, which amounted to (4.6%) in its study of various types of vegetables and also higher than the proportion of (AL- Binali et al., 2006) in the Kingdom of Saudi Arabia, which amounted to (7.8%), which used tap water in the washing vegetables and the percentage of contamination of vegetables with parasitic eggs and concentric stages was (27.2%) in the case of saline solution in the washing of vegetables and higher than the study (Adanir & Tasci, 2013). in Turkey, (6.3%) (Balarak et al., 2016) in Tabriz, Iran (19.5%), and (Sylvia et al., 2016). in Egypt and it is lower than in Nigeria (71.2%), in South Nigeria (73.5%), ...
The study included the detection of parasites that contaminate the fruit and vegetables in Samarra city, were collected randomly from the local markets of Samarra for the period between November 2017 and February 2018 at 250 gm of each type. The vegetables included Lactuca sativa, Beta vulgaris, Lycoperson esculentum, Cucumis sativus, Daucus carota, Raphanus sativus and Apium graveolens. The fruit included grape Vitis vinifera, Pyrus communis and apple Pyrus malus. The samples were placed in plastic cysts, separately labeled and transferred to the laboratory to diagnosis eggs and worms during the six hours of the collecting. The results showed that the total percentage of contamination of vegetables 34.2% and 35% of fruits. Three types of eggs worms were isolated, and two types of protoza included Ascaaris lumbricoid egg (0.7%) on vegetables, (2.4%) Hymenolepis nana egg on vegetables, (6.6%) on fruit, Echinococcus granulosus egg on vegetables (0.7%) and Entamoeba histolytica cyst for (22.1%) on vegetables, (20%) for fruit and Giardia lamblia for(6.4%) on vegetables and(8.3%) on the fruit, this study showed that the cucumber Cucumis sativis and Lactuca sativa (55%) and (50%) respectively, while the fruits was the highest grape by 45%. The results showed significant differences in the percentage of contamination of vegetables and fruits at the level of P <0.05 where significant differences in infection with Entamoeba histolytica and Giardia lamblia between the fruits and vegetables did not show significant differences.
... The prevalence documented in Mexico 26.5% (Chable et al., 2015;Bangladesh 22.4% (Mahmud et al., 2014;Iran 19.1% (Kohansal et al., 2017) was lower than all other studies conducted. Helminths reported in this study may be transmittable through the consumption of uncooked vegetables irrigated by water polluted by human feces and/or ingestion of faecally contaminated soil (Adanir and Tascl, 2013). ...
Data on environmental contamination of the parasites of zoonotic importance is scarce in Pakistan. Soil contamination with feces of dogs hide infective stages of the parasite represents a health-risk to humans. This study was aimed to assess the eggs of gastrointestinal parasites of stray dogs and household dogs in lower Dir district, Pakistan with special consideration to those that can be spread to humans. One hundred and fifty two stool specimens from (stray dogs=90 and household dogs=62) were collected. The helminth eggs were processed by direct smear method and centrifugation techniques and identified by microscopic examination. Of the total examined dogs 26.8% (n=41 /152) were found to be infected with one or more intestinal parasites. The intestinal helminths detected were Dipylidium caninum (n =18, 11.8%), followed by Toxocara canis (n =16, 10.5%), Taenia spp., (n=10, 6.57%) Ancylostoma caninum (n=6, 3.94), Toxascaris spp., Capillaria spp., and Trichuris vulpis (n=2, 1.31% each) in order of their prevalence. Pattern of infection revealed that 27 (65.8%) dogs have single, 13(31.7%) double and 1(2.43%) triple infection. The stray dogs were highly infected 34.4% (n=31) than house hold dogs 16.1% (n=10). The prevalence of infection with intestinal parasites was significantly different among these two groups (p = 0.0097). This study highlight a severe environmental contamination by frequent parasitic stages infectious to humans. There is a higher risk of zoonotic transmission from dogs which indicate an immediate need for the controlling of these parasites and educating the public to take wise action relating to the parasites and pets.
... Interestingly, the prevalence of helminthic contamination in the current study was significantly higher than the previously published papers in Turkey, Sudan, and Nigeria. In a survey conducted by Adanir and Tasci in Turkey, the egg of helminths was seen in 6.3% of vegetable samples collected from bazaar (30). After that, Adenusi et al., observed only 8.44% of collected samples contaminated with helminthic eggs (31). ...
Aim:
This study aimed to investigate the presence of oocyst of Cryptosporidium sp., and egg of soil-transmitted helminths in market vegetables in the north of Iran.
Background:
Fecal-oral transmission via consumption of contaminated food is the main route of transmission of intestinal parasites. Concerning the high risk of contamination of vegetable with intestinal parasites, raw consumption of crops can enhance the chance of transmission of intestinal parasites.
Methods:
In this study, we collected 34 pre-washed vegetable samples including spinach, mint, parsley, oregano, chives, savory, radish, coriander, basil and tarragon from local markets in Tonekabon City, North of Iran. All vegetable samples were washed using sterile PBS. Parasitological examinations, including direct examination and staining with Lugol's iodine and modified Ziehl-Neelsen were performed on the pellet resulted from the washing process.
Results:
The findings showed that 14/34 (41.17%) of collected samples were contaminated with at least one parasite. Eggs of Toxocara sp., Ascaris sp., Fasciola sp., Toxoascarisleonine, Trichuris sp. and Enterobius together with free-living larvae, amoeba cyst, cyst of Entamoebacoli and oocyst of Cryptosporidium sp., were observed among the positive samples. Furthermore, statistical analysis indicated that there was no significant correlation between parasitic contamination of vegetables and seasonal changes.
Conclusion:
This study signifies that some parasites due to their resistant cell wall usually remain in an environment with the harsh condition and thus, consumption of raw vegetables increases the risk of transmission of them.
... The results of the present study showed that, as indicated in Table ( (El-Said, 2012) in Egypt (Alexandria) was (31.7%) and was higher than recorded (Anna, 2013) in the city of Diwaniyah, where it reached (11.77%) and also higher than the ratio recorded by (Omowaye & Falola, 2012) in Nigeria, which amounted to (4.6%) in its study of various types of vegetables and also higher than the proportion of (AL- Binali et al., 2006) in the Kingdom of Saudi Arabia, which amounted to (7.8%), which used tap water in the washing vegetables and the percentage of contamination of vegetables with parasitic eggs and concentric stages was (27.2%) in the case of saline solution in the washing of vegetables and higher than the study (Adanir & Tasci, 2013). in Turkey, (6.3%) (Balarak et al., 2016) in Tabriz, Iran (19.5%), and (Sylvia et al., 2016). in Egypt and it is lower than in Nigeria (71.2%), in South Nigeria (73.5%), ...
The study included the detection of parasites that contaminate the fruit and vegetables in Samarra city, were collected randomly from the local markets of Samarra for the period between November 2017 and February 2018 at 250 gm of each type. The vegetables included Lactuca sativa, Beta vulgaris, Lycoperson esculentum, Cucumis sativus, Daucus carota, Raphanus sativus and Apium graveolens. The fruit included grape Vitis vinifera, Pyrus communis and apple Pyrus malus. The samples were placed in plastic cysts, separately labeled and transferred to the laboratory to diagnosis eggs and worms during the six hours of the collecting. The results showed that the total percentage of contamination of vegetables 34.2% and 35% of fruits. Three types of eggs worms were isolated, and two types of protoza included Ascaaris lumbricoid egg (0.7%) on vegetables, (2.4%) Hymenolepis nana egg on vegetables, (6.6%) on fruit, Echinococcus granulosus egg on vegetables (0.7%) and Entamoeba histolytica cyst for (22.1%) on vegetables, (20%) for fruit and Giardia lamblia for(6.4%) on vegetables and(8.3%) on the fruit, this study showed that the cucumber Cucumis sativis and Lactuca sativa (55%) and (50%) respectively, while the fruits was the highest grape by 45%. The results showed significant differences in the percentage of contamination of vegetables and fruits at the level of P <0.05 where significant differences in infection with Entamoeba histolytica and Giardia lamblia between the fruits and vegetables did not show significant differences.
... To detect the presence of helminth eggs in the sample, water samples were allowed to settle overnight. For vegetable samples, 100 grams of water spinach were washed with mixing in 1 liter of 0.95% saline solution (Adanir and Tasci, 2013). For soil samples, 1 liter of distilled water was added in 100 grams of soil. ...
The high prevalence of helminth infection in Indonesia had encouraged the government to issue the Regulation of the Minister of Health concerning the Prevention of Soil-transmitted Helminths in 2017. Researches on the presence of helminth eggs in the environment, in soil and water as a media for transmitting the disease, are very few. Aim: The aim was conducted to investigate the potential presence of helminth eggs causing STH infections in two urban agricultural areas in northern and southern part of Bandung City. Methodology and results: Samples of water from the inlet and plantation area, as well as soil and water spinach produced by both regions, were collected and analyzed for the presence of helminth eggs using modified Bailinger methods. The number of helminth eggs of 1–119 eggs/L in water, soil, and vegetable samples. Conclusion, significance, and impact study: The results confirmed that the irrigation water used in both areas has been contaminated by feces. The average number of fecal coli exceeds the allowable value for the irrigation water source based on the Grade 4 of water quality criteria in Indonesia. Variations in the number of helminth eggs found in the samples can be caused by environmental conditions such as temperature, humidity, and soil types. The presence of helminth eggs in irrigation water and land samples exceeds the value recommended by WHO (2006) in the guidelines for the safe use of wastewater for agriculture. It can lead to an increased risk of helminth infection to consumers, agricultural workers, as well as residents around the farmland.
... Ali Mohamed and colleagues in Sudan showed that from 250 vegetable samples, 35 (13.5%) were contaminated with parasites (34). In another study in Turkey performed by Adanir et al, eggs of helminthic parasites were observed in 7/111 (6.3%) of raw vegetables that were randomly collected from bazaar (35). The lower prevalence of parasites in these studies compared with our study is probably related to the place of sampling. ...
Aim
The aim of the present study was to simultaneously investigate parasitic contamination of treated wastewater and downstream vegetable farms that are irrigated with treated sewage, during a year.
Background
(Oo) Cysts and eggs of parasites are resistant to most of routine wastewater treatment process. Irrigation of vegetables farms with either treated wastewater or illegally use of raw wastewaters enhances the risk of contamination with enteric pathogens.
Methods
The treated wastewater samples were taken after chlorination from a wastewater treatment plant located at the south of Tehran. In addition, 60 vegetable samples (5 samples from each farm) were collected from the selected downstream farms that routinely used treated wastewater for irrigation of crops. Parasitological tests were performed using Ziehl–Neelsen, conventional lugol’s iodine staining and direct microscopical examination.
Results
Parasites including free living larvae, eggs of Toxoascaris leonina, egg of Toxocara sp. Trichuris sp, Trichostrongylus sp and amoeboid trophozoite were seen in 5/12 (41.7%) of vegetable samples gathered during a year. There was no statistically significant correlation between the season and parasitic contamination of the vegetables (P= 1). Furthermore, parasitic contamination was observed in 7/12 (53.8%) of treated wastewater samples. The correlation between season and parasitic contamination of treated wastewater was evaluated that the results showed a higher contamination of treated wastewater in spring and autumn (P<0.05). Fisher’s exact test also showed that there was no significant correlation between parasitic contaminations of vegetable samples and treated wastewater according to seasonal change.
Conclusion
The results showed parasites in both treated wastewater plant and downstream crops farms that suggests the public health importance of the quality of water resources that routinely used for irrigation of vegetable farms.
Gastrointestinal (GI) parasitism is one of the major threats to the livestock population. GI parasites steal nutrients from their hosts, which can result in direct and indirect damage, and in severe cases death of the hosts. To combat infection by GI parasites, different deworming strategies are used which definitely decrease the worm load. In addition, appropriate pasture management can also effectively control exposure to and reinfection with parasites. Pasture efficiency depends on many factors, including quantity and quality of forages, grazing, natural conditions and grazing types. Effective pasture management systems help to optimize not only animal productivity but also the containment of parasitism. This chapter highlights pasture management, its types and how different management strategies play a role in minimizing the magnitude of parasitism in field conditions. It also covers the suitability of various strategies in different geoclimatic zones and seasonal conditions, which will help the farming community to implement appropriate pasture management strategies according to their needs and climatic conditions.
Parasitic infections are one of the major One Health threats in developing countries. Early and accurate diagnosis of
the infection is pivotal for the estimate of the disease burden and devising appropriate treatment and control strategies.
Parasites are diagnosed by simple conventional tools such as microscopy. Many protozoa, e.g. Babesia, Plasmodium
and Trypanosoma, can be detected easily through stained preparation by microscopy. However, even with trained
technicians, this tool exhibits lower sensitivity and specificity (may be due to low parasite number). Microscopy along
with parasite culturing can improve the issue of low sensitivity and specificity and has been used for the diagnosis of
trypanosomiasis and leishmaniasis. Serological tools such as ELISA offer a promising tool but their use alone is associated with increased false results, particularly where antigens from different parasites exhibit cross reactivity. With the
advent of molecular biology, other sensitive and specific techniques are being devised for the early detection of different
parasitic pathogens. Nowadays, customized approaches of conventional polymerase chain reaction are being developed
with improved sensitivity and specificity that can therefore effectively address the problems encountered with traditional
diagnostic tools. Moreover, advancements in proteomics and biosensing are offering promising solutions in parasite
diagnostics for the near future. This chapter details conventional and advanced tools for parasite diagnosis with case
scenarios in the developing world.
Parasites induce multiple pathological changes in their human and animal hosts. In this chapter, the pathophysiology of parasitic infections and their clinical symptoms are discussed. Pathways for pathology of parasitic infections might be associated directly (e.g. intestinal blockage and damage by the helminths) or indirectly (e.g. loss of production through reduced feed intake or reduced feed conversion ratio). Similarly, haemoprotozoa are discussed to study their effects on blood (cell count, anaemia, etc.). Nematodes and cestodes are discussed for their special association with the gastrointestinal (GI) tracts of their hosts. Parasites mostly cause production and economic losses in livestock by affecting their GI functions, feed intake, efficiency of feed conversion into protein mass and energy metabolism. In this chapter, we describe the pathogenic interventions of numerous parasitic infections of livestock along with their prevalent genera and species in developing countries. Information on the harmful impacts of these parasites will aid future researchers in developing measures to combat them. This chapter has concentrated the essence of multiple studies related to parasitic infection pathology.
Iraq is an endemic country for cystic echinococcosis (CE). This disease is zoonotic infection with a widespread distribution among livestock and humans. The adult parasite inhabits the small intestine of dogs especially stray dogs, their eggs are excreted with the feces to the environment. The objective of this study was to evaluate the prevalence of Taeniid eggs and other intestinal parasites in the feces of stray dogs collected from different location of Zakho city. The study was conducted during the period from March 2020 to March 2021, in which 160 fecal samples of stray dogs were collected from soil surface of 10 different location in Zakho city. The feces were examined by direct wet mount and flotation technique to detect the presence of parasitic eggs and then the data were statistically analyzed. The overall, rate of infection was 46.25% (74/160) of examined fecal samples. The most frequently detected eggs were of Taeniid spp. constituting 23.13% (37/160) of the examined stool samples, with the highest rate (42.86%) being in samples collected from the areas around Zakho abattoir. Furthermore, other parasites recorded in this study, were Oxyurid spp. larvae (8.13%) and eggs of Dipylidium caninum (5%), Stronglodies stercoralis (5%), Toxocara spp. (4.38%) and Hymenolepis nana (0.63%).
This study aimed to investigate the helminth egg contamination of raw vegetables grown in Afyonkarahisar. The material of the study consisted of 508 randomly selected vegetable samples, including lettuce, parsley, carrot, green onion, spinach, cress, arugula, mint, dill, and purslane, which were collected from the field between October 2018 and September 2019. According to the relevant literature, the sediments obtained after the proper washing procedure were examined under a light microscope for helminth eggs. According to the results, Taenia/Echinococcus eggs were found in 2 (0.39%) vegetable samples, including 1 lettuce and 1 dill. Toxocara spp. eggs were found in 2 (0.39%) vegetable samples, including 1 lettuce and 1 mint. Toxascaris leonina eggs were found in 1 (0.2%) rocket sample, and hookworm/strongylid eggs were found in 58 samples (11.42%), including 4 lettuce, 6 parsley, 3 carrots, 18 green onions, 2 spinach, 9 cresses, 4 garden rocket, 6 mint, and 6 purslanes. Moreover, Dicrocoelium spp. eggs were detected in 2 (3,63%) carrots and 1 (2,04%) rocket, Moniezia spp. eggs were detected 2 (3.63% ) carrots, Fasciola spp.eggs were detected in 1 (2.08%) green onion. This study concluded that some vegetables sold and consumed raw in Afyonkarahisar bazaars are contaminated with helminth eggs, which are a risk to public health. It was agreed that these vegetables should be thoroughly washed and consumed in accordance with hygiene standards, otherwise serious health problems may arise.
Helminth eggs are one of the microbial parameters that must be removed from water and sludge for its safe reuse. Detection and removal of these eggs is one of the most challenging and difficult tasks in the present time. Authorities are giving very little attention to the potential threat possessed by these eggs. The increasing abundance of various parasites in water is a raising concern for its reuse. This is mainly due to the negligence in detection and the inefficiency of wastewater treatment methods in treating and removal of these species of eggs. The proper identification of helminth eggs and development of its effective removal techniques is crucial in the recent time. This paper helps in summarizing the basics of helminth eggs and its classifications along with the contamination caused in fruits and vegetables. The review also provides an overview of advanced diagnostic and treatment methods available for the safe detection and removal of helminth species. Efficient and effective detection and treatment technologies will be helpful in eradicating these species making the water and sludge safe for reuse.
The cestode family Taeniidae consists of the genera Echinococcus and Taenia, both of which include zoonotic tapeworms of serious public health importance. Various environmental matrices have been identified from which parasite transmission to animals and humans can occur, and many techniques for detecting taeniid eggs in different environments have been developed. However, the majority lack appropriate validation, and standardized egg isolation procedures are absent. This hampers interstudy comparisons and poses a challenge for future researchers when deciding which technique to implement for assessing taeniid egg contamination in a particular matrix. Therefore, the aim of this systematic review was to present an overview of the detection methods for taeniid eggs in the environment, to discuss and compare them, and to provide recommendations for future studies. In total, 1814 publications were retrieved from scientific databases, and, ultimately, data were systematically reviewed from 90 papers. The results provide an overview of numerous diagnostic tests for taeniid egg detection in (or on) water, food, soil, insects, objects, and air. These tools could be categorized as either conventional (light microscopy), molecular, or immunodetection tools. The relatively cheap microscopy techniques often lack sensitivity and are unable to identify a taeniid egg at the genus level. Nevertheless, several records ascribed a genus, or even species, to taeniid eggs that had been detected by light microscopy. Molecular and immunodetection tools offer better specificity, but still rely on the preceding egg recovery steps that also affect overall sensitivity. Finally, the majority of the methods lacked any attempt at performance evaluation and standardization, especially at the earlier stages of the analysis (e.g., sampling strategy, storage conditions, egg recovery), and viability was rarely addressed. As such, our review highlights the need for standardized, validated detection tools, that not only assess the extent of environmental contamination, but also the egg genus or species, and address viability.
No Brasil, mais da metade dos municípios não possuem plano de saneamento básico. Essa situação atinge, de fato, a população socioeconomicamente mais carente, ocasionando o aparecimento de doenças por ingestão de alimentos crus ou mal lavados. O presente estudo teve por objetivo analisar a presença de parasitos, coliformes totais e termotolerantes em alfaces (Lactuca sativa) comercializadas em feiras livres em Jequié, Bahia. Entre os meses de agosto a outubro de 2019, as amostras foram obtidas aleatoriamente em três feiras livre, as análises foram realizadas pelo método de centrifugação simples e a pesquisa de coliformes utilizou o Método do Número Mais Provável. As amostras de alface analisadas nas feiras livres, 62,5% apresentaram contaminação por Ancilostomídeo, sendo a morfologia predominante larva e, em apenas uma amostra foi encontrado um ovo; além disso, foi possível constatar que 90,9% das amostras analisadas foram positivas para coliformes termotolerantes. A presença de Ancilostomídeo assim como a elevada contagem de coliformes termotolerantes em amostras de alfaces obtidas em feiras livres no município de Jequié, sinaliza a necessidade da implementação e adoção de medidas profiláticas durante o processo de comercialização das hortaliças.
Foodborne parasites in raw vegetables could cause parasitic infections in humans. An effective approach to the reduction of pathogenic microorganisms in vegetables involves identifying the main sources of contamination and the ecology of the involved microorganisms. This review aimed to evaluate the prevalence of foodborne parasites in raw vegetables in Iran. According to the reviewed studies, the prevalence rate of Ascaris spp., Giardia spp., Toxocara spp., Fasciola, Trichuris, Cryptosporidium, Dicrocoeliasis, Taenia spp., and Entamoeba histolytica was 6 % (95 % CI: 5-8 %), 6 % (95 % CI: 5-7 %), 6 % (95 % CI: 4-7 %), 2 % (95 % CI: 1-2 %), 1 % (95 % CI: 1-2 %), 10 % (95 % CI: 6-15 %), 2 % (95 % CI: 1-3 %), 5 % (95 % CI: 4-6 %), and 3 % (95 % CI: 2-4 %), respectively. According to the standard deviation map, Ilam province was one of the high-risk areas in terms of food-borne parasites in raw vegetables (3 SD < prevalence < 4 SD). Given the key role of raw vegetables in human parasitic contamination, governments must implement more stringent programs for effective wastewater treatment, preventing domestic and wild animals from entering farms, not using human and animal manure on farms, using ready-to-eat packaged vegetables, food safety training for households, implementation of GMP and HACCP in the factory vegetable packaging are required in this regard, especially in the high-risk areas of Iran, such as Ilam province.
Supplementary information:
The online version contains supplementary material available at 10.1007/s40201-021-00714-w.
Taenia spp. are responsible for a substantial health and economic burden in affected populations. Knowledge of the fate of the eggs of Taenia spp. in the environment and of other factors facilitating the transmission of eggs to intermediate hosts is important for the control/elimination of infections caused by Taenia spp. The aim of this systematic review was to summarize current knowledge of the factors influencing the survival and dispersal of Taenia spp. eggs in the environment. Publications retrieved from international databases were systematically reviewed. Of the 1465 papers initially identified, data were ultimately extracted from 93 papers. The results of this systematic review indicate that survival is favoured at moderate temperatures (0–20 °C). Humidity seems to affect the survival of Taenia spp. eggs more than temperature. Under field circumstances, Taenia spp. eggs have been found to survive for up to 1 year. Taenia spp. eggs are commonly found on vegetables (0.9–30%) and in soil and water samples (0–43%), with their presence posing a risk to the consumer. Invertebrates may act as transport hosts, transferring the infection to an intermediate host, but the importance of this route of transmission is still open to question. Wastewater treatment systems are not capable of entirely eliminating Taenia spp. eggs. Access to surface water and the use of sewage sludge as fertilizer on pastures are important risk factors for bovine cysticercosis. Although information on the survival and spread of Taenia spp. eggs is available, in general the data retrieved and reviewed in this article were old, focused on very specific geographical regions and may not be relevant for other areas or not specific for different Taenia spp. Furthermore, it is unknown whether egg survival differs according to Taenia sp. Future studies are necessary to identify sustainable methods to identify and inactivate parasite eggs in the environment and reduce their spread.
Graphical Abstract
Monitoring parasitic contamination in raw vegetables used in salads is an important measure in controlling the occurrence of gastroenterological diseases, which may be life-threatening. This study aimed to inspect the parasitological contamination of some raw vegetables used in salads. Eight commonly consumed vegetable types were purchased from street vendors in the city markets. Vegetables were washed and the sediments were obtained for microscopic examination. Genomic DNA was isolated from contaminated samples. Our result showed that 34.4% of the studied samples were contaminated with one or more species of parasites. Lettuce was the most commonly contaminated vegetable type (29.5%), while tarragon leaves showed the lowest level of contamination (2.3%). The risk of contamination was significantly higher in lettuce samples in comparison with the other samples studied. Giardia duodenalis was the most prevalent parasite detected (38.6%) and was abundantly found in lettuce isolates (23.5%). Molecular typing revealed that all Giardia samples found in the contaminated specimens belonged to Assemblage B. Blastocystis spp. were the second most prevalent parasite in samples (29.5%), they were frequently detected in lettuce leaves (30.8%). Other parasites were found in low frequencies. The high level of parasitic contamination found in our study indicates an urgent need to identify the sources of contamination and to monitor irrigation water and ensure its cleanliness.
Amphistomiasis, a neglected trematode infection of ruminants, has recently come up as an important reason for economic losses. The aim of this study was to determine the prevalence of bovine amphistomiasis and associated risk factors such as: age, gender, breed, season, water source, pastureland and grazing system. Between January 2016 and 2017, a total of 1,000 faecal samples and 1,000 rumens of cattle were collected from slaughterhouse of Zabol, Iran ante‐mortem and post‐mortem, respectively, and examined. The overall prevalence was 34.6% and 19.5% in terms of amphistome adults and eggs respectively. The identified amphistome species and their prevalence were Paramphistomumcervi (13.3%), Cotylophoroncotylophorum (19.5%), Gastrothylaxcrumenifer (5.9%) and Carmyeriusspatiosus (2.7%). The correlation between prevalence and season, age, breed, water source, pastureland and grazing system was significant (p < .0001). The presented information about the prevalence of amphistomes of cattle and individual and management risk factors can be used to design appropriate control measures.
Contamination of soil with helminth eggs in the samples of fields, kitchen gardens, yards and composts in rural areas of Lodz district (Poland) was investigated. In this study, helminth eggs were found in 60–100 % of field samples, in 20–100 % of yards samples, in 0–20 % of kitchen gardens samples and in 10–100 % of composts. The highest average density of helminth eggs in 100 g of soil was detected in composts (44.0), then fields (28.5) and yards (18.0). In samples taken from kitchen gardens the average density of eggs was 0.4/100/g of soil. The comparison of frequency of positive samples from fields, kitchen gardens and yards did not exhibit significant difference (p > 0.05). The soil samples of fields contained mainly eggs of Ascaris spp. (87.7 %), less frequently Toxocara spp. (7.7 %) and Trichuris spp. (3.5 %). In samples from yards among detected eggs the most often were Toxocara spp. (73.9 %), and there were statistically significant differences in comparison with fields (7.7 %) and composts (0.3 %). The highest prevalence of eggs with moving larva was noted in yards (25.6 %), which differ statistically significantly from analogous value for fields (p < 0.05) and composts (p < 0.0001).
These results showed a considerable infestation of soil with geohelminth eggs of the examined rural areas of Lodz district which is a potential source of antropozoonosis.
Fresh vegetables are an important part of a healthy diet. In recent years there has been an increase in the number of reported cases of food-borne illness linked to fresh vegetables. The consumption of raw vegetables is a major way in the transmission of parasitic contaminations. The goal of this study was to determine the parasitological contamination of vegetables sold at markets and obtained from gardens. A total of 141 samples from different vegetables were randomly selected from the markets and gardens (markets: 96; gardens: 45) and then were examined by a concentration method. Each sample was washed with water, allowing sedimentation at room temperature for 24 h. Five ml of sediment were centrifuged at 3000 rpm for 5 min. Sediment was examined in lugol stained slides through light microscopy. Fifty percent (48/96) of markets vegetables and 71% (32/45) of gardens vegetables were contaminated with different parasites. Prevalences of pathogenic parasites in vegetables of markets and gardens were 25% and 29%, respectively. Parasites detected were Giardia cysts (7%), Dicrocoelium eggs (6%), Fasciola eggs (5%) and Ascaris eggs (2%). In regard to results of this study, the importance of vegetables in the transmission of intestinal parasites in stressed, and it is necessary to improve the sanitary conditions of these kinds of food.
The objectives of this study were to evaluate the contamination by eggs of Toxocara in sandy areas or grass lawns of outdoor recreation areas that are used by children, and the frequency of seroprevalence in children, from three cities of fewer than 45,000 inhabitants in Paraná, Brazil. From May 2005 to December 2007, five samples were taken from each of 13 sandy sites and 18 grass lawns, all from plazas and public schools. Blood samples from children aged 0-12 years were analysed by immunoassay for anti-Toxocara IgG. The soil samples were processed by floatation and sedimentation. Eggs of Toxocara spp. were present in 44.7% (38/85) of the samples from grassed areas and in 21.4% (15/70) of the sand samples. The lawns were 2.16 times more contaminated than the sand (P = 0.0009). However, the epidemiological variables showed no statistically significant difference between seropositive (36.8%; 130/353), and seronegative children. The rate of seropositivity was higher in children aged 0-5 years (P = 0.03), who were 1.94 times more likely to develop persistent wheezing (P = 0.02).
This study was conducted to determine the control of helminth egg contamination of raw vegetables by washing. A total of 199 unwashed and 199 washed lettuce, parsley, carrots, dill, rocket, and green-peppers, provided by a catering service in Bursa, Turkey, between March and June 2009, were subjected to helminth egg count under light microscopy. Helminth eggs were detected in six (3.0%) unwashed samples and not in any washed samples (p<0.01). Ascaris lumbricoides and Toxocara spp. were detected in four (2.0%) and two (1.0%) unwashed vegetables, respectively, mostly among leafy vegetables such as lettuce and parsley. Our data confirm that washing procedures before consumption of raw vegetables regardless of the providers' sanitation should be performed to avoid transmission of helminths.
Intestinal parasite infections have been known to compromise the quality of human life since prehistoric times. Throughout the ages, human civilizations have fought against parasitism, including intestinal parasites. During the second half of the last century, the focus of disease-combating efforts moved to other imminent public health issues, under the notion that the fight against infectious diseases had been won. However, the disease incidence data indicate that these diseases continue to wreak havoc on human productivity across the globe. Lately, chemotherapeutic intervention has been stressed for the control of intestinal parasitic infections. In this paper we evaluate the need for a holistic approach to address this issue and make recommendations for this cause.
The burden of diseases caused by food-borne pathogens remains largely unknown. Importantly data indicating trends in food-borne infectious intestinal disease is limited to a few industrialised countries, and even fewer pathogens. It has been predicted that the importance of diarrhoeal disease, mainly due to contaminated food and water, as a cause of death will decline worldwide. Evidence for such a downward trend is limited. This prediction presumes that improvements in the production and retail of microbiologically safe food will be sustained in the developed world and, moreover, will be rolled out to those countries of the developing world increasingly producing food for a global market. In this review evidence is presented to indicate that the microbiological safety of food remains a dynamic situation heavily influenced by multiple factors along the food chain from farm to fork. Sustaining food safety standards will depend on constant vigilance maintained by monitoring and surveillance but, with the rising importance of other food-related issues, such as food security, obesity and climate change, competition for resources in the future to enable this may be fierce. In addition the pathogen populations relevant to food safety are not static. Food is an excellent vehicle by which many pathogens (bacteria, viruses/prions and parasites) can reach an appropriate colonisation site in a new host. Although food production practices change, the well-recognised food-borne pathogens, such as Salmonella spp. and Escherichia coli, seem able to evolve to exploit novel opportunities, for example fresh produce, and even generate new public health challenges, for example antimicrobial resistance. In addition, previously unknown food-borne pathogens, many of which are zoonotic, are constantly emerging. Current understanding of the trends in food-borne diseases for bacterial, viral and parasitic pathogens has been reviewed. The bacterial pathogens are exemplified by those well-recognized by policy makers; i.e. Salmonella, Campylobacter, E. coli and Listeria monocytogenes. Antimicrobial resistance in several bacterial food-borne pathogens (Salmonella, Campylobacter, Shigella and Vibrio spp., methicillin resistant Staphylcoccus aureas, E. coli and Enterococci) has been discussed as a separate topic because of its relative importance to policy issues. Awareness and surveillance of viral food-borne pathogens is generally poor but emphasis is placed on Norovirus, Hepatitis A, rotaviruses and newly emerging viruses such as SARS. Many food-borne parasitic pathogens are known (for example Ascaris, Cryptosporidia and Trichinella) but few of these are effectively monitored in foods, livestock and wildlife and their epidemiology through the food-chain is poorly understood. The lessons learned and future challenges in each topic are debated. It is clear that one overall challenge is the generation and maintenance of constructive dialogue and collaboration between public health, veterinary and food safety experts, bringing together multidisciplinary skills and multi-pathogen expertise. Such collaboration is essential to monitor changing trends in the well-recognised diseases and detect emerging pathogens. It will also be necessary understand the multiple interactions these pathogens have with their environments during transmission along the food chain in order to develop effective prevention and control strategies.
We examined samples of irrigation water and vegetables from kitchen gardens in Campinas, Brazil. The bacterial analysis condemned 22.3% of the vegetable samples, and the parasitological examination condemned 14.5%. The criteria established by the Brazilian legislation condemned 11.8% of the irrigation water samples. Parasites were significantly more frequent in vegetables in the rainy season, while excessive fecal coliforms were more frequent in the dry season. A proper monitoring of the irrigation water supply is important to avoid the contamination of vegetables.
The objective of the study was to determine and compare the current level of exposure of the Ghanaian urban population to hazardous pesticide and fecal coliform contamination through the consumption of fresh vegetables produced in intensive urban and periurban smallholder agriculture with informal wastewater irrigation. A total of 180 vegetable samples (lettuce, cabbage, and spring onion) were randomly collected under normal purchase conditions from 9 major markets and 12 specialized selling points in 3 major Ghanaian cities: Accra, Kumasi and Tamale. The samples were analyzed for pesticide residue on lettuce leaves, total and fecal coliforms, and helminth egg counts on all three vegetables. Chlopyrifos (Dursban) was detected on 78% of the lettuce, lindane (Gamalin 20) on 31%, endosulfan (Thiodan) on 36%, lambda-cyhalothrin (Karate) on 11%, and dichloro-diphenyl-trichloroethane on 33%. Most of the residues recorded exceeded the maximum residue limit for consumption. Vegetables from all 3 cities were fecally contaminated and carried fecal coliform populations with geometric mean values ranging from 4.0 x 10(3) to 9.3 x 10(8) g(-1) wet weight and exceeded recommended standards. Lettuce, cabbage, and spring onion also carried an average of 1.1, 0.4, and 2.7 helminth eggs g(-1), respectively. The eggs were identified as those of Ascaris lumbricoides, Ancylostoma duodenale, Schistosoma heamatobium, and Trichuris trichiura. Because many vegetables are consumed fresh or only slightly cooked, the study shows that intensive vegetable production, common in Ghana and its neighboring countries, threatens public health from the microbiologic and pesticide dimensions. Standard recommendations to address this situation (better legislations, law enforcement, or integrated pest management) often do not match the capabilities of farmers and authorities. The most appropriate entry point for risk decrease that also addresses postharvest contamination is washing vegetables before food preparation at the household or "chop" bar (street restaurant).
A total of 46 wastewater samples (untreated: 24 and treated: 22), 35 soil samples and 172 vegetable samples were collected from the wastewater-irrigated area of Titagarh to assess its contamination level with intestinal helminth. 83.3% of raw wastewater, 68.2% of treated wastewater, 68.6% of soil and 44.2% of vegetables in the study area were found to be positive for helminth ova. Vegetables grown in this area were found positive for Ascaris lumbricoides (36%), Trichuris trichiura (1.7%) and hookworms (6.4%). A. lumbricoides was the most predominant species observed in all the samples. Of all the vegetables examined, Pudina was most commonly contaminated followed by Lettuce, Spinach, Coriander, Celery and Parsley. High percentage of viable-stage intestinal helminth egg positive vegetable samples grown in the wastewater-irrigated study area may pose serious public health hazards.
The presence of helminth eggs on raw vegetables, including lettuce, parsley, green onions, cucumbers, carrots, red cabbage, tomatoes, rockets (Eruca sativa), and green-peppers from wholesalers in Ankara, Turkey was determined. A total of 203 unwashed and 406 washed samples were assayed by light microscopy. Helminth eggs were detected in 12 (5.9%) of 203 unwashed samples and not in any washed samples (p<0.05).Helminth eggs detected in unwashed samples included Taenia spp. (3.5%), Toxocara spp. (1.5%), and Ascaris lumbricoides (1.0%) eggs. Taenia spp. eggs were recovered to be highest number (n=130), followed by Toxocara spp. eggs (n=21). Approximately 11% of unwashed lettuce and parsley was contaminated compared with only 2.5% of carrot samples. No helminth eggs were detected in red cabbage, rockets, tomatoes or green-peppers.These results highlight the potential for transmission of helminth eggs by unwashed salad vegetables in Turkey and the importance of properly washing/disinfecting raw vegetables before consumption.
Trichinellosis, one of the most widespread helminthic zoonoses, is still endemic in most countries of the European Union. In the past few years, advanced biotechnology has been used to re-examine the taxonomy, epidemiology and life cycles of aetiological agents, providing additional information on the main factors contributing to the maintenance of these parasites in Nature. The old concept that pigs and rats are the main hosts of Trichinella spiralis, as still reported in many books, has been re-evaluated thoroughly. In this review, Edoardo Pozio summarizes the epidemiology and ecology of human and animal trichinellosis, quantifies the economic impact of this zoonosis and suggests methods of controlling this infection that would result in a great reduction in costs.
BackgroundFresh vegetables are an important part of a healthy diet. Raw vegetables can be agent of transmission of intestinal parasites. The aim of the present study was to determine the parasitological contamination of salad vegetables sold at wholesale and retail markets in Tripoli-Libya.MethodsA total of 126 samples of salad vegetables obtained from wholesale and retail markets were examined for helminth eggs and Giardia spp. cysts of using standard methods.ResultsOf the 36 tomato, 36 cucumber, 27 lettuce, and 27 cress samples examined eggs of Ascaris spp. were detected in 19%, 75%, 96% and 96%, respectively; eggs of Toxocara cati in 11%, 14%, 48% and 41%; eggs of Toxocara canis in 3%, 8%, 37% and 33%; and eggs of Taenia/Echinococcus spp. in 6%, 25%, 33% and 30%, respectively. Cysts of Giardia spp. were detected in 3%, 19%, 4% and 11%, respectively.ConclusionParasitological contamination of raw salad vegetables sold in wholesale and retail markets in Tripoli may pose a health risk to consumers of such products.
The author discusses the significance of helminth and schistosome infections in exacerbating nutritional problems in many countries, and advocates population-wide treatment where there is clear evidence that this would yield substantial gains in the quality of life.
The Global Burden of Disease caused by the 3 major intestinal nematodes is an estimated 22·1million disability-adjusted life-years (DALYs) lost for hookworm, 10·5million for Ascarislumbricoides, 6·4million for Trichuristrichiura, and 39·0million for the three infections combined (as compared with malaria at 35·7million) (World Bank, 1993; Chan etal. 1994); these figures illustrate why some scarce health care resources must be used for their control. Strongyloidesstercoralis is the fourth most important intestinal worm infection; its nutritional implications are discussed, and the fact that its geographic distribution needs further study is emphasized. Mechanisms underlying the malnutrition induced by intestinal helminths are described. Anorexia, which can decrease intake of all nutrients in tropical populations on marginal diets, is likely to be the most important in terms of magnitude and the probable major mechanism by which intestinal nematodes inhibit growth and development. We present a revised and expanded conceptual framework for how parasites cause/aggravate malnutrition and retard development in endemic areas. Specific negative effects that a wide variety of parasites may have on gastrointestinal physiology are presented. The synergism between Trichuris and Campylobacter, intestinal inflammation and growth failure, and new studies showing that hookworm inhibits growth and promotes anaemia in preschool (as well as school-age) children are presented. We conclude by presenting rationales and evidence to justify ensuring the widest possible coverage for preschool-age children and girls and women of childbearing age in intestinal parasite control programmes, in order to prevent morbidity and mortality in general and specifically to help decrease the vicious intergenerational cycle of growth failure (of low-birth-weight/intrauterine growth retardation and stunting) that entraps infants, children and girls and women of reproductive age in developing areas.
To determine the degree of contamination caused by parasites in commonly used leafy vegetables in Abha, Kingdom of Saudi Arabia (KSA).
We carried out the study in the Department of Clinical Microbiology and Parasitology, King Khalid University, Abha, KSA, during the period September 2004 to May 2005. Five commonly used leafy vegetables, namely, green onion, radish, watercress, lettuce and leek, were washed each in water and Tris-buffer-saline (TBS). The washing solution was then centrifuged and the sediments were examined for parasites.
The use of TBS for the extraction, significantly increased the isolation rate (27.2%) of the parasites compared with the use of tap water (7.8%) (z=4.72 p<0.001). The prevalence of the parasites was 28% in green onion, 25% in radish, 17% in watercress, 17% in lettuce, and 13% in leek. The parasites were more common in the months of September to December. Ankylostoma duodenale, Entameba coli, Ascaris lumbricoides and Blastocystis hominis were the most common isolated parasites. We encountered 12 genera of parasites during the study and the least common was iodamoeba butschlii.
The study shows that parasites are common in leafy vegetables and the use of tap water does little to remove them. The public health implications of our findings will be communicated to the Aseer regional health authorities for appropriate community health education and other necessary actions.
To investigate the epidemiology of human toxocariasis a field survey was carried out at homes of 194 children (80 of rural and 114 of urban origin) with diagnosed disease from central Poland. A questionnaire referring to the possible risk factors was directed to their parents. Overall contamination rate of soil by Toxocara eggs was 27.5% in rural and 21.1% in urban environment in the households examined, with difference not significant (chi2=1.08, p=0.2986). In rural settlements 29.3% of yards surrounding houses were found contaminated, whereas in urban 25.0% of family gardens, 26.4% of private yards and 10.7% of public sandpits were positive. Frequency of positive samples differs only for rural yards and urban sandpits (chi2=3.85, p=0.0499). The study showed a high risk of reinfection for the ill children in sites of their residence. Despite diagnosed toxocariasis kids were not adequately supervised by their parents with no measures undertaken to avoid further infection. These data present strong need for educational programs which should be implemented for prevention of Toxocara infections in children.
Prevalence of helminth para-sites found on vegetables sold in Maiduguri, Northeastern Nigeria. Food Control, 25, 23e26 The prevalence of parasites in commonly used leafy vegetables in South Western Saudi Arabia The global war against intestinal parasites-should we use a holistic approach
- N B Adamu
- J Y Adamu
- D Mohammed
- A M Al-Binali
- C S Bello
- K Shewy
- S E Abdulla
Adamu, N. B., Adamu, J. Y., & Mohammed, D. (2012). Prevalence of helminth para-sites found on vegetables sold in Maiduguri, Northeastern Nigeria. Food Control, 25, 23e26. Al-Binali, A. M., Bello, C. S., El-Shewy, K., & Abdulla, S. E. (2006). The prevalence of parasites in commonly used leafy vegetables in South Western Saudi Arabia. Saudi Medical Journal, 27(5), 613e616. Alum, A., Rubino, J. R., & Ijaz, M. K. (2010). The global war against intestinal parasites-should we use a holistic approach? International Journal of Infectious Diseases, 14, e732ee738.