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Global prevalence of intestinal protozoan contamination in vegetables and fruits: A systematic review and meta-analysis
Get PDFEnvironmental contamination of vegetables and fruits with intestinal protozoan trophozoites, cysts and oocysts is a means of transmitting parasitic agents of public health importance. The purpose of this systematic review and meta-analysis was to determine the global prevalence of intestinal protozoan parasite contamination in vegetables and fruits. Several databases (Web of Science, PubMed, Scopus, ProQuest and Google Scholar) were searched for literature published up to August 2021. Pooled prevalence was determined using the meta-package in R (version 3.6.1). Out of 90,404 publications, 189 articles (202 datasets) met the inclusion criteria. Among these, 183 investigations documented protozoan contamination in vegetables and 20 in fruits. The pooled prevalence (95% confidence interval) was 20% (16%–24%) for vegetables and 13% (7%–21%) for fruits. The highest pooled prevalence was found in South-East Asian WHO region 37% (6%–76%). The most prevalent protozoan parasite in vegetables was Cryptosporidium spp. (11%, 7%–15%). As well, Entamoeba histolytica was the most common agent found in fruits (9%, 4%–14%). Furthermore, the unwashed samples had the highest pooled prevalence of contamination (22%, 3%–49%). Our data suggest a possible risk of protozoan infection in humans via unwashed vegetables and fruits. Accidental ingestion of protozoa occurs through consumption of contaminated vegetables and fruits that have been improperly washed and prepared under poor sanitation. Using sanitary irrigation water, consuming properly cleaned and cooked vegetables, and practicing good hygiene can all assist to reduce the risk of protozoa infection
Contributing Factors for Calcium Changes During Hospitalization in COVID-19: A Longitudinal Study
Get PDFAbstract
Background: Hypocalcemia is highly prevalent in Coronavirus disease 2019 (COVID-19). There is limited evidence about the course
and roles of different parameters in the occurrence of new or worsening hypocalcemia.
Objectives: This prospective longitudinal study was conducted on hospitalized COVID-19 patients in Qazvin, Iran, in 2021.
Methods: Serum levels of calcium, albumin, parathormone (PTH), 25(OH)D (vitamin D), magnesium, and phosphate were assessed
on the first day (time one), as well as fourth to sixth days (time two) of hospitalization. Paired t-test, McNemar’s test, and multivariate
logistic regression test were used to compare data at two times and evaluating the independent roles of different variables in the
occurrence or worsening of hypocalcemia.
Results: Out of a total of 123 participants, 102 patients completed the study. The mean serum calcium level significantly decreased
from 8.32 ± 0.52 mg/dL to 8.02 ± 0.55 mg/dL at time two compared to time one (P < 0.001). Also, we witnessed new or worsening
hypocalcemia at time two in 44 (55%) patients with normal serum calcium or mild hypocalcemia at time one (P < 0.001). The PTH
level decreased from 42.17±27.20 pg/mL to 31.28±23.42 pg/mL (P < 0.001). The decrease in albumin and PTH levels was an independent significant factor in the occurrence or worsening of hypocalcemia at time two (OR = 1.27; 95% CI: 1.10 - 1.46; P = 0.001 for each 1
g/L decrement albumin and OR = 1.29; 95% CI: 1.03 - 1.62; P = 0.026 for each 10 pg/mL decrement PTH). Vitamin D deficiency or changes
during hospitalization did not have a significant role in new or worsening hypocalcemia.
Conclusions: Decreased PTH secretion and hypoalbuminemia have significant roles in the occurrence of new or worsening hypocalcemia during hospitalization due to COVID-19.
Keywords: Hypocalcemia, COVID-19, Parathormone, Vitamin
