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Extensive Multiparasitism in a Village of Yunnan Province, People’s Republic of China, Revealed by a Suite of Diagnostic Methods

Intestinal multiparasitism, the accuracy of different diagnostic techniques, and the influence of sampling effort were studied among 215 individuals in a Bulang village, Yunnan province, People’s Republic of China. Behavioral, demographic, and socioeconomic data were obtained by questionnaire. Multiple stool specimens were examined by the Kato–Katz, Koga agar plate, Baermann, and ether–concentration methods. Eight helminth and 7 protozoa species were diagnosed. The prevalence of each of the 3 main soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) exceeded 85%. Blastocystis hominis was the most prevalent intestinal protozoan (20.0%). Over 80% of the individuals harbored 3 or more intestinal parasites concurrently. The infection intensities were predominantly light for hookworm and T. trichiura but moderate for A. lumbricoides. Examination of 3 instead of 1 stool specimen increased the sensitivity of helminth diagnosis, most notably for hookworm. Intestinal multiparasitism is rampant in this rural part of Yunnan province and calls for control measures.

Received December 13, 2007. Accepted for publication February 9, 2008.

Acknowledgments: We are grateful to the participants and local authorities of Nongyang village and acknowledge the dedication of the local staff. The authors thank the team of Hanspeter Marti at the Swiss Tropical Institute for the diagnosis of intestinal protozoa.

Financial support: P.S. is supported by the Commission for Research Partnership with Developing Countries (through the SDC-sponsored program "Jeunes Chercheurs"), the Janggen-Pöhn-Stiftung (through a personal stipend for the final year of his Ph.D.), and the Freiwillige Akademische Gesellschaft, Basel. J.U. is financially supported by the Swiss National Science Foundation (grant PPOOB-102883). X.N.Z. received a grant from the Chinese Ministry of Science and Technology through its support of the Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health (grant 2005DKA21104).

^* Address correspondence to Jürg Utzinger, Department of Public Health and Epidemiology, Swiss Tropical Institute, P.O. Box, CH-4002 Basel, Switzerland. E-mail: juerg.utzinger{at}unibas.ch

Authors’ addresses: Peter Steinmann and Jürg Utzinger, Department of Public Health and Epidemiology, Swiss Tropical Institute, P.O. Box, CH-4002 Basel, Switzerland. Zun-Wei Du, Li-Bo Wang, Xue-Zhong Wang, and Jin-Yong Jiang, Helminthiasis Division, Yunnan Institute of Parasitic Diseases, 6 Xiyuan Road, Simao 665000, People’s Republic of China. Lan-Hua Li and Xiao-Nong Zhou, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, 207 Rui Jin Er Road, Shanghai 200025, People’s Republic of China. Hanspeter Marti, Department of Medical and Diagnostic Services, Swiss Tropical Institute, P.O. Box, CH-4002 Basel, Switzerland.

Reprint requests: Jürg Utzinger, Department of Public Health and Epidemiology, Swiss Tropical Institute, P.O. Box, CH-4002 Basel, Switzerland, Tel: 41-61-284-8129, Fax: 41-61-284-8105, E-mail: juerg.utzinger{at}unibas.ch.