IJMABHR International Journal of Medical and All Body Health ResearchIJMABHR 2582-8940 Anfo Publication House 166 Parasitic diarrheal agents among people in Erbil city Al-DaoodyAhmed A Kh. AliFattma A HussenBashdar Mahmud SaeedMaawa Smko SabahHelen Wshiar PirbalHiba Yaseen KamalKamal Iqdam MohammedFirdows Sidqi Medical Department of Microbiology, College of Health Sciences, Hawler Medical University, Kurdistan Region, Erbil, Iraq Department of Clinical Analysis, College of Pharmacy, Hawler Medical University, Kurdistan Region, Erbil, Iraq 2023 4 1 49 53 20022023 23032023 CC BY-NC-SA 4.0

Background: The intestinal parasites of Entamoeba histolytica and Giardia lamblia are among the major causes of diarrhea throughout the world. Despite the remarkable development of diagnostic methods for parasitic diseases and the continuous awareness of their treatment and control, which led to a clear reduction in the spread of these diseases in a number of developed and industrial countries. However, parasitic diseases of all types continue to be a major health problem in many countries. Objective: This study was performed to investigate the prevalence and risk of E. histolytica and G. lamblia in Erbil City. Results: Out of (12944) samples examined, 1086 (8.39%) were positive by direct microscopic examination, the parasitic species found in the fecal sample were E. histolytica (74.40%), G. lamblia (25.23%). The prevalence rate of parasitic infection among females (12.87%) was higher than males (7.97%) with a statistically significant difference. According to months the result showed no significant difference, but the highest rate of infection was recorded in May (9.81%) and lowest rate was observed in January (6.62%). Nanakaly Hospital, showed the higher percentage of infection (38.71), while percentage of infection decreased to (8.24%) in Public health laboratory. Double infection with intestinal protozoa were also recorded in (0.37%). Conclusion: According to our study throughout the year, E. histolytica has the highest rate followed by G. lamblia with female being more commonly infected. Also the single infections were more commonly observed while double infections were rare.

 DiarrheaStool examinationEntamoeba histolyticaGiardia lambliaIntestinal protozoa References MCMahan ZH, Dupont HL. The history of acute infectious diarrhoea management from poorly focused empiricism to fluid therapy and modern pharmacotherapy. Aliment Pharmacol Ther. 2007; 25(7):759-69. Hodges K, Gill R. Infectious diarrhea: Cellular and molecular mechanisms. Gut Microbes. 2010; 1(1):4-21. doi: 10.4161/gmic.1.1.11036. PMID: 21327112; PMCID: PMC3035144. Talley NJ, Zinsmeister AR, Van Dyke C, Melton LJ. Epidemiology of colonic symptoms and the irritable bowel syndrome. Gastroentero. 1991; 101:927-934. Farthing M, Salam MA, Lindberg G, Dite P, Khalif I, Salazar-Lindo E, et al. Acute diarrhea in adults and children: a global perspective. Journal of clinical gastroenterology. 2013; 47(1):12-20. Pawlowski SW, Warren CA, Guerrant R. Diagnosis and treatment of acute or persistent diarrhea. Gastroentero. 2009; 136:1874-1886. Navaneethan U, Giannella RA. Definition, epidemiology, pathophysiology, clinical classification, and differential diagnosis of diarrhea. In Diarrhea. Humana Press, Totowa, NJ, 2010, 1-31. Othman N, Noordin R, Saidin S. Update on laboratory diagnosis of amoebiasis. European Journal of Clinical Microbiology & Infectious Diseases, 2019, 38(1). Müller N, Von Allmen N. Recent insights into the mucosal reactions associated with Giardia lamblia infections. International journal for parasitology. 2005; 35(13):1339-1347. Bdir S, Adwan G. Prevalence of intestinal parasitic infections in Jenin Governorate, Palestine: a 10-year retrospective study. Asian Pac J Trop Med. 2010; 3(9):745-7. Patel PK, Khandekar R. Intestinal parasitic infections among school children of the Dhahira Region of Oman. Saudi Med J. 2006; 27(5):627-32. Minetti C, Chalmers RM, Beeching NJ, Probert C, Lamden K. Giardiasis. BMJ. 2016; 27:355-i5369. Lanata CF. Studies of food hygiene and diarrhoeal disease. Int J Environ Health Res. 2003; 13 (Sup l):S175-International Journal of Medical and All Body Health Research www.allmedicaljournal.com 183. Stephen W. Amoebiasis and Giardiasis. Medic. 2005; 33(8):47-50. Bartelt LA, Sartor RB. Advances in understanding Giardia: determinants and mechanisms of chronic sequelae. F1000Prime Reports. 2015; 7(62):62. Garcia LS, Arrowood M, Kokoskin E, Paltridge GP, Pillai DR, Procop GW, et al. Practical guidance for clinical microbiology laboratories: laboratory diagnosis of parasites from the gastrointestinal tract. Clinical microbiology reviews. 2018; 31(1):e00025-17. Lien TH, Chang MH, Wu JF, Chen HL, Lee HC, Chen AC, Tiao MM, et al. Effects of the infant stool color card screening program on 5‐year outcome of biliary atresia in Taiwan. Hepatology. 2011; 53(1):202-208. Kasirga E. Cocuklarda sindirim sistemi hastaliklarinin tani ve izleminde diski incelemelerinin yeri/The importance of stool tests in diagnosis and follow-up of gastrointestinal disorders in children. Turkish Pediatrics Archive. 2019; 54(3):141-149. Vandenberg O, Van Laethem Y, Souayah H, Kutane WT, Van Gool T, Dediste A. Improvement of routine diagnosis of intestinal parasites with multiple sampling and SAF- fixative in the triple-faeces-test. Acta gastro-enterologica belgica. 2006; 69(4):361-366. Evangelopoulos A, Legakis N and Vakalis N. Microscopy, PCR and ELISA applied to the epidemiology of amoebiasis in Greece. Parasitology international. 2001; 50(3):185-189. El-Mohammady H, Mansour A, Shaheen HI, Henien NH, Motawea MS, et al. Increase in the detection rate of viral and parasitic enteric pathogens among Egyptian children with acute diarrhea. The Journal of Infection in Developing Countries. 2012; 6(11):774-781. Yilmaz H, Abdullah A. Prevalence of Intestinal parasites (Entamoeba sp. and Giardia lamblia) in Duhok and Erbil cities. Northern Iraq. J Microbiol Exp. 2017; 4(6):00132. Saida LA. Epidemiological study of intestinal parasites among population of Erbil city, Kurdistan. Iraq. J Raparin Univ. 2016; 3:75-86. Al-Daoody AAK, Ali FA, Sadiq LB, Mamand AS, Ismail RS, Muhammed HF. Investigation of Intestinal Protozoan Infection among Food-Handlers in Erbil City, Iraq. Plant Archives. 2021; 21(Sup1):1367-1372. Bayoumi, et al. Intestinal parasitic infections in school students in Malakal city, Upper Nile State, South Sudan. SOJ Microbiol Inf Dis. 2016; 4(1):1-5. Al Alkeem F, Loney T, Aziz F, Blair I, Sonnevend A and Sheek-Hussein M. Prevalence and factors associated with infectious intestinal diseases in Ras Al Khaimah, United Arab Emirates, 2017: A population-based cross-sectional study. International Journal of Infectious Diseases. 2019; 85:188-194. Okyay P, Ertug S, Gultekin B, Onen O and Beser E. Intestinal parasites prevalence and related factors in school children, a western city sample-Turkey. BMC public health. 2004; 4(1):1-6. Damen JG, Cosmas EU, Damak CA. Intestinal Parasitosis among Food Handlers in Jos, North Central Nigeria. Danish Journal of Agriculture and Animal Sciences. 2015; 2:53-58. Amer OS, Al-Malki ES, Waly MI, AlAgeel A, Lubbad MY. Prevalence of intestinal parasitic infections among patients of king fahd medical city in riyadh region, Saudi arabia: A 5-year retrospective study. Journal of parasitology research, 2018. Hussein RA, Shaker MJ, Majeed HA. Prevalence of intestinal parasitic infections among children in Baghdad City. Journal of College of Basic Education. 2011; 71:130-147. Amer OH, Ashankyty IM, Haouas NAS. Prevalence of intestinal parasite infections among patients in local public hospitals of Hail, Northwestern Saudi Arabia. Asian Pacific journal of tropical medicine. 2016; 9(1):44-48. Al-Daoody AAK, Ismail SM, Ezadin ZY, Ahmad DK. Prevalence of Giardia lamblia among residents of hawler, Soran and Chamchamal Cities, North of Iraq. Pak-Euro Journal of Medical and Life Sciences. 2020; 3(2):28-36. AlAyyar RM, AlAqeel AA, AlAwadhi MS. Prevalence of Giardiasis and Entamoeba Species in Two of the Six Governorates of Kuwait. Journal of Parasitology Research, 2022. Al-Daoody AAK, Younes MR, Ali WR, Hamad KM. Prevalence of Hymenolepis nana in Erbil City-North of Iraq. International Journal of Research Studies in Science, Engineering and Technology. 2017; 4(11):16-21. Jaran AS. Prevalence and seasonal variation of human intestinal parasites in patients attending hospital with abdominal symptoms in northern Jordan. EMHJ-Eastern Mediterranean Health Journal. 2016; 22(10):756-760. Hussein RA, Al-bashier NT, Mohamed AA. Identification of Giardia lambila, genotype isolates from children with diarrhea. Iraqi Journal of Medical Sciences. 2016; 14(2):182-190. Mehraj V, Hatcher J, Akhtar S, Rafique G and Beg MA. Prevalence and factors associated with intestinal parasitic infection among children in an urban slum of Karachi. PloS one. 2008; 3(11):e3680.