Infection with Blastocystis spp. and its association with enteric infections and environmental enteric dysfunction among slum-dwelling malnourished adults in Bangladesh

• Published in: PLoS neglected tropical diseases Vol. 15; no. 8; p. e0009684
• Main Authors: Fahim, Shah Mohammad, Gazi, Md. Amran, Hasan, Md. Mehedi, Alam, Md. Ashraful, Das, Subhasish, Mahfuz, Mustafa, Rahman, M. Masudur, Haque, Rashidul, Sarker, Shafiqul Alam, Ahmed, Tahmeed
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 01-08-2021; Public Library of Science (PLoS)
• Subjects: Adults; Anemia; Biology and Life Sciences; Biomarkers; Blastocystis; Body mass; Body mass index; Body size; Complications and side effects; Disease; Drinking water; E coli; Endoscopy; Feces; Gastrointestinal diseases; Giardia; Health aspects; Households; Infections; Intestine; Intestines; Irritable bowel syndrome; Laboratories; Malnutrition; Medicine and Health Sciences; Microbiota; Parasitic diseases; Pathogenesis; Pathogens; Poor; Proteins; Protista; Regression analysis; Research and Analysis Methods; Risk factors; Slums; Sociodemographics; Statistics; Stocking density; Strains; Trichuris trichiura; Tropical climate; Tropical diseases; Variables; Bangladesh; Minnesota; United States > US; Germany
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0009684

Background Blastocystis spp. (Blastocystis) is a widely distributed gastrointestinal protist frequently reported in countries with tropical and sub-tropical climate. We sought to determine the factors associated with Blastocystis infection and investigate its role on biomarkers of intestinal health among slum-dwelling malnourished adults in Bangladesh. Methodology Total 524 malnourished adults with a body mass index [less than or equal to]18.5 kg/m.sup.2 were included in this analysis. Presence of Blastocystis in feces was evaluated by TaqMan Array Card assays. Principal findings Blastocystis was tested positive in 78.6% of the participants. Prevalence of infection with atypical strains of enteropathogenic Escherichia coli (aEPEC) (56% vs. 38%, p<0.001), and Trichuris trichiura (28% vs. 15%, p-value = 0.02) was significantly greater in adults with Blastocystis, while Giardia intestinalis was significantly lower (8% vs. 14%, p-value = 0.04) in Blastocystis positive adults. Malnourished adults who were living in households with high crowding index (aOR = 2.18; 95% CI = 1.11, 4.65; p-value = 0.03), and infected with aEPEC (aOR = 2.14; 95% CI = 1.35, 3.44; p-value = 0.001) and Trichuris trichiura (aOR = 1.97; 95% CI = 1.08, 3.77; p = 0.03) were more likely to be infected with Blastocystis. A significant negative relationship was observed between Blastocystis and fecal concentrations of alpha-1 antitrypsin ([beta] = -0.1; 95% CI = -1.7, -0.1; p-value<0.001) and Reg1B ([beta] = -3.6; 95% CI = -6.9, -3.0; p-value = 0.03). Conclusions The study findings suggest that the presence of Blastocystis in human intestine influences gut health and may have potential pathogenic role in presence of other pathogens.