Entameba histolytica causes amebiasis, which includes both intestinal and extraintestinal amebiasis. E. histolytica causes 34 million to 50 million symptomatic cases of amebiasis worldwide every year, causing 40 thousand to 100 thousand deaths annually. E. histolytica, the pathogenic species of amebae is indistinguishable in its cyst and trophozoite stages from those of E. moshkovskii, a free-living ameba, and E. dispar, a non-invasive ameba, by microscopy, except in cases of invasive disease, where E. histolytica trophozoite may contain ingested red blood cells, but such a finding is rarely seen. This leads to a confusing scenario for the definite identification and differentiation of E. histolytica from E. moshkovskii and E. dispar by conventional microscopy, in the diagnosis of intestinal amebiasis. The advent of molecular methods such as multiplex PCR and real time PCR have facilitated a better and accurate diagnosis of E. histolytica, E. moshkovskii, and E. dispar in stool, urine, saliva, and other specimens. Multiplex PCR for the diagnosis of amebic liver abscess, using urine and saliva as clinical specimens, has been used, and the results have been encouraging. Real-time PCR is a new and a very attractive methodology for laboratory diagnosis of amebiasis, because of its characteristics that eliminate post-PCR analysis, leading to a shorter turnaround time. Microarray-based approaches represent an attractive diagnostic tool for the detection and identification of amebae in clinical and epidemiological investigations. Development of vaccines against amebiasis is still in its infancy. However, in recent years, progress has been made in the identification of possible vaccine candidates, the route of application, and the understanding of the immune response, which is required for protection against amebiasis. Thus, it is just a matter of time, and hopefully, amebiasis vaccine for human trials will be available in the next few years.

Toxplasmosis is an important zoonotic disease caused by protozoan parasite Toxoplasma gondii. The disease affects one-third of the total world population. Transmission of the disease is mainly by ingestion of food or water contaminated with oocysts. Congenital toxoplasmosis occurs from the transplacental passage of the parasite from mother to fetus. In most adults it does not cause serious illness, but it can cause blindness and mental retardation in congenitally infected children, and it is a devastating disease in immunocompromised individuals. Diagnosis of toxoplasmosis can be established by the direct detection of the parasite or by serological methods. The most commonly used and effective therapeutic regimen is the combination of pyrimethamine with sulfadiazine and folinic acid. This article provides an overview and update on transmission, diagnosis, management, and prevention of toxoplasmosis.

Human Immunodeficiency Virus (HIV) infection causes progressive damage to both limbs of the immune system, which results in a plethora of opportunistic infections. Among the various opportunistic infections, gastrointestinal infections are very common in HIV / Acquired Immunodeficiency Syndrome (AIDS). Opportunistic spore-forming protozoal parasites, namely, Cryptosporidium parvum, Isospora belli, Cyclospora cayetanensis, and Microsporidia, play a major role in causing chronic diarrhea, accompanied with weight loss, in patients with HIV / AIDS. The purpose of this review is to discuss the salient microbiological, clinical, and diagnostic aspects of important enteric spore-forming opportunistic parasites in HIV / AIDS.

Background: Cysticercosis is the most common differential diagnosis for epilepsy. The present study was carried out to assess the serological response among patients with epileptic seizures visiting JIPMER Hospital Puducherry. Materials and Methods: A total of 934 serum samples were collected from patients with epileptic seizures. A standardized questionnaire was designed to obtain information on the demographic, socioeconomic, environmental, and behavioral characteristics related to the transmission of infection. An enzyme-linked immunosorbent assay (ELISA) was used to detect the anti-Taenia solium larval stage IgG antibodies. Samples found reactive and inconclusive by ELISA were further tested by the enzyme immunotransfer blot (EITB). Results: The frequency of antibodies in the serum samples of the above-mentioned population was 16.2% by EITB. Anti-Taenia solium larval stage antibodies were detected in serum samples of 163 patients, out of which 27 (16.56%) patients belonged to the 0 - 15-year age group, 82 (50.30%) patients were in the 16 - 40-year age group, and 52 (31.90%) patients were above 41 years, respectively. Although the sera from males had higher OD values than those from females, the difference was not statistically significant. Out of 163 seropositive by ELISA, 152 (93.25%) were found to be positive by EITB. Out of the 152, 61 (40.13%) were farmers and 79 (51.97%) were office or factory workers. Conclusions: In conclusion, the results indicate a probable endemic situation and a high prevalence of cysticercosis in patients with epileptic seizures. Living in poor sanitary conditions seems to be an important factor related to human cysticercosis in Puducherry and the neighboring districts of Tamil Nadu.

Background: Under the National Vector Borne Disease Control Program, the Enhanced Malaria Control Project (EMCP) with World Bank assistance was implemented in India, in the eastern state of Orissa. Aims: This article tries to analyze the possible reasons for the poor performance of EMCP in a few states of India. Settings and Design: The eastern state of India is taken as a case study for looking into systemic, human resource, and logistics related issues that could explain the poor performance of EMCP in a few states of India. Materials and Methods: Field visits were made to some selected EMCP areas in the state of Orissa. Operational issues-related implementation of various components of the project were scrutinized. Statistical analysis: Not Applicable. Results: While the project was highly successful in a few states of India, it had limited success in some states. It was learnt that the honorarium meant for Fever Treatment depot [FTD] work was divided among all the malaria workers. In high-risk areas, presumptive radical treatment was being carried on by malaria workers for every case of fever. Using Rapid Diagnostic Tests (RDTs) in such areas seemed to have no relevance. The laboratory technician ignored malaria work, due to a high work load and no additional incentive. In the Primary Health Centers (PHCs) the Medical officers had either not visited the village under indoor residual spray or symbolically visited only five to six houses. Cement tanks had to be built for larvivorus fish breeding. However, they had not been mad. Conclusions: The success of a public health program is dependent more on project implementation, management, monitoring, and evaluation of project activities than the volume of financial resource allocation.

Background: Strongyloidiasis is endemic in many tropical and subtropical countries and reports from northeast India are very few. Aim: A community-based study was carried out in Assam, India, to find out the occurrence of Strongyloides stercoralis. Materials and Methods: Stool samples were obtained from 198 randomly selected individuals from the community. Samples were processed using direct microscopy with formal-ether concentration methods. Results and Conclusion: Seventeen numbers of samples showed the presence of Strongyloides stercoralis (8.5%). A total of 105 (53%) individuals were positive for at least one intestinal parasite. The other intestinal parasites detected were Ascaris lumbricoides (33.3%), Trichuris trichiura (9.1%), hookworm (7.1%), Enterobius vermicularis (1.5%), and Giardia cyst (1.5%). Five out of 17 individuals positive for S.stercoralis had associated gastrointestinal, respiratory, and/or cutaneous symptoms.The present study although not exhaustive for true prevalence calls for attention in the backdrop of high malnutrition and pulmonary tuberculosis.

Background : Cystic echinococcosis (CE) being more common in rural areas, the collection of serum may not always be possible or may be hazardous in untrained hands . The alternative, noninvasive samples like saliva and urine which are non invasive and easy to collect need to be evaluated for diagnosis of CE. Aim: The aim of this study was to evaluate hydatid antigen detection by ELISA in urine and saliva samples by comparing them with antigen detection in serum for diagnosis of CE. Materials and Methods : Serum, saliva and urine samples were collected from 25 clinically and radiologically diagnosed CE patients, 25 clinically suspected cases of CE, 15 other parasitic disease controls and 25 healthy controls. Hydatid antigen detection was done in these samples by Enzyme linked immunosorbent assay using hyperimmune serum raised in rabbits immunized with hydatid antigen. Results and Conclusions : The sensitivity of ELISA for antigen detection in serum, saliva and urine was found to be 40%, 24% and 52% respectively. Urine showed significantly higher (p<0.05) sensitivity than that of saliva samples but not significantly higher (p>0.05) than that of serum samples. The specificity was highest for serum (92.5%) followed by saliva (87.5%) and urine (80%). There was no significant difference in antigen detection in patients with single vs multiple cysts. There was no significant difference in antigen detection in patients with hepatic vs extrahepatic cysts in serum or saliva samples but antigen positivity in urine was significantly higher (p<0.05) in hepatic cysts than that in extrahepatic cysts. The results showed that biological fluids like urine and saliva may be used as an alternative or as an adjunct to serum samples by virtue of their noninvasive, easy collection and similar sensitivity and specificity.

An 8-year-old male child of Tuensang District, Nagaland, India, attended Civil Hospital, Tuensang, complaining of cough, fever, headache, and inability to move right arm since one month. On clinical suspicion of tubercular meningitis, anti-tubercular therapy was initiated and the patient was referred to the Naga Hospital Authority. A brain computed tomography scan revealed an isodense area with surrounding edema on the left parietal lobe, which was diagnosed as tuberculoma and the anti-tubercular therapy was continued. As there was no sign of clinical improvement on completion of the three-month-ATD regimen, the patient was investigated for paragonimiasis. Laboratory investigations revealed peripheral blood eosinophilia, raised ESR, Paragonimus egg-positive sputum, and positive Enzyme-linked immunosorbent assay (ELISA) and ID tests for paragonimiasis. The Bacillus Calmette-Guιrin (BCG) test and Acid Fast Bacilli (AFB) sputum smears were negative. Chest roentgenogram showed no abnormal findings. A final diagnosis of pulmonary paragonimiasis associated with cerebral paragonimiasis was made. The patient responded to praziquantel therapy. Cerebral paragonimiasis is a serious extrapulmonary form of paragonimiasis, sometimes life-threatening, but curable with praziquantel. It should be included in the differential diagnosis of cerebral granulomatous and other space-occupying lesions.