Cryptosporidiosis is a major etiology of persistent and chronic diarrhea in children and immunocompromised patients. In addition, it is also one of the important pathogens causing zoonotic or waterborne outbreaks. A number of conventional and molecular tests are available, but each test is riddled with few limitations. Further, there is a need to develop point of care tests and multiplexed tests for simultaneous detection of multiple pathogens.

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Background: Stool microscopy and concentration techniques are the two most important and necessary aspects of diagnostic parasitology. In an era when there is increased disease burden due to intestinal parasites, an early and appropriate diagnosis is warranted. Direct microscopy is usually labor intensive and tedious. Materials and Methods: Thirty-two fresh fecal specimens from patients presenting with eosinophilia and/or anemia (hemoglobin levels <10 g%), HIV-positive patients, and in patients clinically suspected of harboring parasites, were collected for the study. All the positive samples were processed by both the standard methodology, i.e., formalin-ethyl acetate sedimentation technique and Mini Parasep^® SF method, by the standard operating procedure of our laboratory and the manufacturer's instruction. Stool pellet concentrates were subjected to saline/iodine wet mount, modified acid fast staining for intestinal coccidian parasites and trichrome staining for Blastocystis hominis. The average number of organisms counted in 0.5 ml of pellet was used for comparison of the two techniques. Results: The morphology of eggs was maintained in both the techniques; however, the wet mount prepared from the sedimentation technique had more background fecal debris in comparison to the Parasep^® technique. The parasite yield was equal for both the techniques while Mini parasep had the advantage of less distortion of parasite morphology. Conclusion: We found that Parasep^® offered a better parasitic yield, a better workflow capacity, and a reduced turnaround time, which would further benefit resource-restrained laboratories and those with a high sample turnover.

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Introduction: Urinary schistosomiasis caused by Schistosoma haematobium is common in some parts of Lusaka Province, Zambia, where water contact activity is high and sanitation is poor. We conducted a longitudinal study in Ng'ombe Compound of Lusaka, between 2007 and 2015, to observe the prevalence and intensity of S. haematobium infection among community primary school children, before and after receiving a single dose of praziquantel. Materials and Methods: A total of 975 (445 females and 530 males) pupils, aged 9–16 years, were tested for S. haematobium at baseline. After mass treatment with praziquantel in 2010, 1570 pupils (785 females and 785 males), aged 9–15 years, were examined for S. haematobium eggs, from 2011 to 2015. Results: At baseline, 279 out of 975 of the children were infected, with light infections constituting 84.9% and 15.1% classified as heavy infection. After mass treatment with praziquantel, the prevalence rate dropped, slightly, to 20.3% (63 out of 310) in 2011. However, it increased the following years up to 38% (133 out of 350) in 2015, with prevalence rates higher in males than females. The average number of heavy infection cases increased to 24.3% (120 out of 494) after treatment, reducing cases of light infections to 75.7% (374 out of 494). Conclusion: This study revealed that mass treatment with a single dose of praziquantel was not sufficient to significantly reduce the transmission of schistosomiasis. Further studies will need to evaluate whether multiple praziquantel treatments will be more therapeutically effective in limiting future incidences.

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Background: Blastocystis was identified almost a century ago, yet its biology and pathogenicity status in humans is obscure. Studies on Blastocystis in India are scanty and are mostly microscopy based. This study compared three detection modalities to determine their efficiency in the identification of Blastocystis in human feces. Materials and Methods: A total of 279 stool samples were screened using microscopy, culture (Jones' medium), and polymerase chain reaction (PCR)-based methods. Among the three, PCR is considered the gold standard test for detection of Blastocystis, as it helps to authenticate the sensitivity, specificity, and kappa agreement obtained by the other two tests. The morphological features of Blastocystis were recorded at 24, 48, and 72 h. After positive morphological identification, ten samples were cultured on Löwenstein–Jensen (LJ) medium and Locke's egg slant medium. Results: The sensitivity and specificity determined on the basis of microscopy were 36.2% and 99.4%, respectively. On the other hand, Jones' medium showed 67.6% sensitivity and 100% specificity. Further, we documented various morphological and reproductive features of Blastocystis using various staining techniques on cultures positive in Jones' medium. In addition, we also found that LJ medium was not equally efficacious as Jones' medium in assisting the growth of Blastocystis. Conclusions: Although molecular diagnosis is a necessary tool for understanding the true epidemiology of Blastocystis, in laboratories devoid of molecular detection facilities, stool microscopy in conjunction with stool culture on Jones' medium could serve as the best alternative tool for the detection of Blastocystis.

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Background: Malaria is a serious disease and still remains a public health problem in many parts of Nigeria. Objectives: The aim of this study was to describe malaria transmission trends and analyzed the impact of climatic factors on malaria transmission in the highlands of Plateau State, Central Nigeria. Methods: The study was a retrospective survey which used archival data of climate parameters and medical case records on malaria. Rainfall, relative humidity, and temperature data were obtained from the nearest weather stations to the study locations from 1980 to 2015. Data on reported malaria cases were collected from general hospitals in the selected local government areas (LGAs) from 2003 to 2015. Generalized Additive Models were used to model trends in malaria incidences over time, and it is lagged association with climatic factors. Results: The results show a significant cyclical trend in malaria incidence in all the study areas (P < 0.001). The association between monthly malaria cases and mean monthly temperature, rainfall, and relative humidity show significant association at different time lags and locations. Conclusion: Our findings suggest that climatic factors are among the major determinants of malaria transmission in the highlands of Plateau state except in Jos-North LGA where the low model deviance explained (35.4%) could mean that there are other important factors driving malaria transmission in the area other than climatic factors.

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Background: Filariasis is a major health problem in India. Despite the high prevalence, microfilariae are rarely found in cytology smears. Most of the cases are incidentally found, solely or in association with other pathologies. Aims and Objectives: The study was undertaken to analyze the prevalence and cytology findings of cases of incidentally found microfilariae in cytology smears (fine-needle aspiration cytology [FNAC]/body fluids) from different body parts. Materials and Methods: This was a retrospective study over 5 years, where the cases of microfilariae in aspirates from swelling of different locations and body fluids were reviewed, and clinic-pathological data were analyzed. Results and Analysis: Out of 16,738 cases of FNAC and 882 cases of fluid cytology, 22 cases (0.124%) of incidental finding of microfilaria were documented in cytology smears. The cases were diagnosed from lymph nodes (5 cases), skin and soft tissue (4 cases), scrotal (4 cases), breast (3 cases), thyroid (2 cases), and pleural fluid (2 cases). We found eosinophilia in 15 cases (68.18%) of filarial lesions. We found two cases of incidental findings of microfilariae in association with malignant lesions. Conclusion: Filariasis should be considered as differential diagnosis of swelling of lymph nodes, skin, soft tissue, inguinoscrotal region, and other sites as well. Careful screening of cytology smears may help in detection of incidental cases in the association of other pathologies.

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Enterobius vermicularis (EV), an intestinal nematode, causes lesions at ectopic sites also. Although lesions are fully curable with antihelminthic drugs, patients may require surgical intervention in clinically unsuspected cases to arrive at correct diagnosis and appropriate treatment. Accurate diagnosis of these lesions on fine needle aspiration cytology (FNAC) has an advantage of avoiding unwanted surgery. To the best of our literature search, there are few case reports of EV diagnosed on cytology, but none of them describes the various stages of development of eggs and hatching of larvae. Dealing cytopathologist should be cognizant of them as parasite can be present in any of these forms/stages. Recently, we came across an interesting case of young boy who presented with perineal nodule and on FNAC from the lesion showed EV larvae and its eggs in various stages of hatching and development. The patient responded to antihelminthic treatment (AHT). Morphological clues with a review of cytological literature are discussed.

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Malaria is one of the very common causes of fever in the Indian subcontinent with significant morbidity and mortality. In endemic areas, malaria infection may manifest with a variety of systemic complications ranging from mild to the life-threatening condition including atypical presentations and sometimes a clinical dilemma. We herein report a case of 35-year-old male laborer with complaints of fever, headache, and altered consciousness whose presentation was as case of clinical meningitis, developed acute hepatitis, kidney injury, and necrotizing pancreatitis. Later on, he diagnosed to have mixed malaria infection and improved well to antimalarial drugs with supportive management. In malaria, acute necrotizing pancreatitis is a rare and potentially fatal complication. We also accomplish a systematic review of literature for reports of acute pancreatitis due to Plasmodium infection. This report highlights the occurrence of several rare complications and systematic review of literature for acute pancreatitis due to malaria.

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Lymphatic leishmaniasis is a rare parasitic disease even in endemic region. It is usually associated with visceral and post-kala-azar dermal leishmaniasis. Leishmaniasis is being increasingly recognized in association with immunodeficient patients (HIV/AIDS). However, leishmanial lymphadenitis has been rarely diagnosed by fine-needle aspiration cytology (FNAC) of epitrochlear lymph node in an HIV patient. Cytological features of leishmanial lymphadenitis in an HIV-reactive patient have been rarely addressed in previous literature. We present the FNAC of a case of leishmanial lymphadenitis in epitrochlear lymph node in the case of an HIV-reactive patient with visceral leishmaniasis.

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Cystic hydatidosis caused by Echinococcus granulosus is a rare disease which mainly involves the liver and lungs. In 1%–2% cases, it may affect the brain. Primary multiple hydatid cysts of the brain are very rare. A 14-year-old girl presented with a history of headache and altered sensorium. Computed tomography scan and magnetic resonance imaging showed multicystic intraventricular lesions and patient was operated by neurosurgeon. Multiple cysts were removed. Antihelminthic medication was started, and patient was discharged with full recovery of neurological function. Hydatid cyst must be considered as a differential diagnosis of cystic space-occupying lesions of the brain. Surgery and antihelminthic drugs will help to get rid of infection.

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