PREVALENCE OF INTESTINAL PROTOZOA AND HELMINTHIC PA RASITIC INFECTIONS IN ADULT POPULATION OF PUDUCHERRY

INFECTIONS IN ADULT POPULATION OF PUDUCHERRY NAMRATA K. BHOSALE , MUNUSWAMY SANGEETHA 2 & JOSHY M. EASOW 3 Assistant Professor, Department of Microbiology, Ma hatma Gandhi Medical College & Research Institute,  Sri Balaji Vidyapeeth (Deemed-to-be-University), Po ndicherry, India MD Microbiology, Mahatma Gandhi Medical College & R esearch Institute, Sri Balaji Vidyapeeth (Deemed-to-be-University), Po ndicherry, India 3 Professor & Head, Microbiology, Mahatma Gandhi Medi cal College & Research Institute, Sri Balaji Vidyapeeth (Deemed-to-be-University), Po ndicherry, India ABSTRACT


INTRODUCTION
In India, one third of the populations were mostly affected by the intestinal parasites viz., Entamoeba histolytica, Entamoeba dispar, Ascaris, Trichuris trichiura, and Hook worm (Kang et al. 1988:6). Increasing burden of helminthic infection in India due to the unhygienic personnel, overcrowding and water scarcity. Infection may pose major health problem among humans and induces severity of the disease ( Bartelt et al., 2013:1). In the late 19 th century, the true prevalence of pathogenic intestinal parasites was recorded among South Indian population (Kang et al. 1998:6). Prevalence of intestinal parasitic infections in different states which ranges from 5.56% to 90%and most of them were filed high in rural areas than the urban (Mathuria et al., 2017:4;Mareeswaran et al., 2018:5). Parasitic infection is almost exists in every states of India in which it has been documented by several studies (Rituparna, et al. 2017 Helminths and Protozoal parasites such as Ascaris lumbricoides, hookworm, Enterobius vermicularis, Entamoeba histolytica and Giardia lamblia are commonly found in the intestines of humans, which yielded high morbidity mostly in child population (Kaur et al. 2002:5). Our main objective of the study is to determine the prevalence of intestinal parasites among clinically suspected patients who are attending our tertiary care teaching hospital.

MATERIALS & METHODS
This prospective and laboratory investigative study was carried out in the Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Puducherry. This study was conducted during the period of January 2018-January 2019. Totally 571 stool samples were collected from the patients who had suspicion of parasitic infections and they sent to the Parasitology laboratory for routine diagnostic testing like saline and iodine wet mount followed by formal ether concentration technique. Patients who are attending our hospital are from rural and urban areas.
Inclusion Criteria: patients with diarrhoea and other gastrointestinal tract infections like nausea, vomiting etc.
Exclusion Criteria: Improperly labelled samples, Samples with incomplete requisition forms and previously treated with antihelminthic drugs.

Processing of Stool Samples
Patients was educated to collect the samples in clean, wide, leak proof labelled containers provided by the laboratory with pinch of stool sample and asked the patients to avoid to full fill the containers till the rim. After collecting the samples, they were screened with Microscopic examination of Lugol'siodine and saline wet mounts for the presence of ova, larvae and cysts of parasites. Formal-Ether concentration technique will be performed for cases which had high clinical suspicion but were negative by the above mentioned tests. Modified acid fast staining will then be performed for all the samples for detection of intestinal coccidian parasites on methanol fixed stool smears.

STATISTICAL ANALYSIS
Percentages were calculated for Categorical variables. Mean and Standard deviation with 95% confidence interval was calculated for the patients' age. The fisher's exact test will be used to determine the statistical significance between rural and urban patients who had positive for intestinal parasitic infections.    (Saurabh K, et al. 2017:4), Chandigarh (Sehgal R, et al. 2010:4), Bihar (Rituparna B, et al. 2017:5) and Puducherry (Manochitra K, et al. 2016:8). But low prevalent in Uttarkhand (Kotian S, et al. 2014:4) and New

Mean
Delhi (Kaur R, et al. 2002:5). But in the contrast, the present study shows hookworm infections are more prevalent in the region of Puducherry and neighbouring Tamil Nadu state. Primarily an retrospective study was carried out in Puducherry with overall positivity is about 22.21% (Manochitra K, et al. 2016:8)but in our study projected a low prevalence 7.70% when compared to the above study. Coccidian parasites are absent in our stool samples. According to Kotian et al., G. lamblia and Hymenolepis nana were the most common parasites found in the targeted population. There was increase of intestinal parasitic infections among rural than urban population in two health centres of Anakaputhur and Padappai of Kancheepuram district (Mareeswaran et al., 2018:5). But in contrast, the present study shows that urban patients were mostly affected than the rural patients.

CONCLUSIONS
Microscopy is highly helpful and cost effective for diagnosing intestinal parasitic infections from stool samples.
The study which mainly focuses on adult population of Puducherry and yielded that the urban populations are mostly infected with intestinal parasites. This may be due to improper hygienic conditions and large number of populations in a