Academic journal article Iranian Journal of Public Health

Epidemiology of Human Fascioliasis and Intestinal Helminthes in Rural Areas of Boyer-Ahmad Township, Southwest Iran; A Population Based Study

Academic journal article Iranian Journal of Public Health

Epidemiology of Human Fascioliasis and Intestinal Helminthes in Rural Areas of Boyer-Ahmad Township, Southwest Iran; A Population Based Study

Article excerpt


More than a billion people worldwide are infected by intestinal helminthes (1). The main species that infect humans are Ascaris lumbricoides, Trichuris trichiura and hookworms (Necator americanus and Ancylostoma duodenale) (1).

Intestinal helminthes are widely distributed in developing countries, where control measures are often difficult to implement. Intestinal helminthes induce a wide range of symptoms including diarrhea, abdominal pain, general malaise and weakness and impair the nutritional status of infected individuals.

More than intestinal helminthes, fascioliasis is a serious health and veterinary problem in few countries of the world, including Iran (2). While animal fascioliasis is common in livestock in most areas of Iran, human fascioliasis is also a health problem in few areas of the country (3-4). Human fascioliasis has emerged as a serious problem in the Northern Province of Guilan in Iran during the past decades. This province experienced two outbreaks of human fascioliasis in 1987, affecting more than 10,000 people, and in 1997, affecting several thousands of people (3). Cases of human fascioliasis have also been reported from other provinces of Iran including Kohgiluyeh and Boyer-Ahmad in the southwest of the country (4). Our recent study revealed a seroprevalence rate of 1.86% for human fascioliasis in this province (4). In north of the country, Ashrafi et al. reported a prevalence of 0.4% and 1.2% for human fascioliasis in rural areas by parasitological and serological methods, respectively (5).

The current study was conducted to assess the prevalence and intensity of fascioliasis and intestinal helminthes in rural areas of Boyer-Ahmad district, southwest Iran.

Materials and Methods

Study area

This cross-sectional study was conducted between June 2014 and December 2014, in Boyer-Ahmad Township in Kohgiluyeh and Boyer-Ahmad province, Southwest Iran. The province has geographical coordinates between latitudes 30-9° to 31-27° N. and longitudes 49-55° to 51-42° E. It has a moderate and cool climate. Boyer-Ahmad Township is located in a cold region and has a cold winters and temperate summers. Snow and rainfall (mean annual rainfall of 600 mm) are plentiful in this region. Ground covered with pastures, including wild pistachio, tulips and oak forests. Climate and socio-economic conditions make the people to depend more on animal husbandry and agriculture for their livelihood. Local people traditionally consume high levels of wild freshwater plants such as Nasturtium microphyllum (local name Bakaloo), Mentha logifolia (local name, Pooneh) and spearmint. Moderate temperatures and large pasture for ruminants provide appropriate conditions for transmission and establishment of parasitic helminthes, including cystic echinococcosis and fascioliasis in this area (4, 6).

Sample collecting

Approval for the study was obtained from the Institutional Ethics Committees of the Shiraz University of Medical Sciences. All participants were counseled about the study and they were requested to provide informed consent. Confidentiality of the details of the participants was guaranteed.

Stool samples were collected from 1025 villagers (with 84816 populations) in 50 randomly selected villages in Boyer-Ahmad Township. Sample size was calculated based on the population living in the study area and also the prevalence of helminthic infection reported in previous study (7). A questionnaire was used to obtain demographic information as well as information on participants' education, occupation, sanitation and water supply facilities, and eating of freshwater vegetables.

Stool samples were evaluated with formol-ethyl acetate sedimentation technique and the sedimentary materials were examined by conventional light microscope for helminthes' ova. Formol-ethyl acetate technique was performed by dissolving one gram of stool sample in 7 ml of 10% formalin and passing through a pad of four layers of clearing gauze. …

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