Intestinal Parasitic Infections among Egyptian Patients with Chronic Liver Diseases at Zagazig University Hospital
2021
Background and study aim: Regarding the increased number of chronic liver diseases (CLD) patients suffering from many manifestations e.g. diarrhea, this withdrew our attention to try to find a relation between CLD and parasitic infections in those patients.
Patients and Methods: A case-control study was performed on 190 participants suffering from gastrointestinal complaints especially diarrhea attending Gastroenterology and Hepatology Outpatient Clinics at Zagazig University Hospital, divided into 2 groups GI: 95 CLD patients. GII: 95 non-CLD Control group patients. Cases underwent clinical, abdominal ultrasonographic, and laboratory liver function assessments. Also, collected patients’ stool samples were microscopically examined using iodine, Trichrome and Modified Ziehl-Neelsen stains. To confirm accurate diagnosis to parasitic infections causing diarrhea, RIDA-ELISA for Cryptosporidium spp. and Giardia lamblia copro-antigens detections was performed.
Results: Parasitic infections among both studied groups were (47%), comprising (58%) in CLD and (36%) in non-CLD as follow: Cryptosporidium (28%, 14%), Giardia (15%, 12%), mixed (5%, 3%), E.histolytica spp. (5%, 4%), Blastocystis hominis (3%, 1%) and H. nana (1%, 2%) respectively. The sensitivity, specificity, PPV, NPP and accuracy of ELISA regarding Giardia and Cryptosporidium infections were (100% and 89.6%, 97.5% and 100%, 87.9% and 100%, 100% and 96.6%, 97.9% and 98.4%) respectively. In GI, most giardial cases had normal ALT and AST levels (74%, 63%), but elevated in cryptosporidial infection (59%, 66%) respectively, with statistically significant difference.
Conclusion: Presence of intestinal parasitic infections; mainly Cryptosporidia and Giardia protozoa among CLD patients was striking when compared to diarrheic non-CLD control group and this may be attributed to impaired immune status.
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