Prevalence and molecular identification of protozoan parasites in cancer patients in Jordan

Abstract

Introduction: Parasitic infections are prevalent in developing countries, and cancer patients with weakened immune systems are particularly vulnerable. This study examined the prevalence of protozoan parasites among cancer patients.

Methodology: A total of 300 stool and heparinized plasma samples were collected from cancer patients at the King Hussien Cancer Center (KHCC). Cryptosporidium, Giardia duodenalis, and Blastocystis were detected by microscopy. Immunodiagnostic tests included electrochemiluminescence immunoassay (ECLIA) for Toxoplasma gondii IgG and IgM antibodies in plasma samples, and the ImmunoCard STAT Cryptosporidium/Giardia Kit for G. duodenalis and Cryptosporidium detection in stool. DNA extraction from stool samples was followed by nested polymerase chain reaction (PCR) to confirm the presence of intestinal parasites.

Results: Toxoplasma gondii, Cryptosporidium, G. duodenalis, and Blastocystis were detected. T. gondii was found in 22% of patients via IgG antibodies and in 2.7% via IgM, with the highest IgG seropositivity in multiple myeloma and uterine cancer patients (50%), and the highest IgM seropositivity in multiple myeloma patients (12.5%). The prevalence of Cryptosporidium varied depending on the detection method: 8.3% by microscopy, 11% by immunodiagnostic tests, and 12.3% by PCR. The highest infection rate was among colorectal cancer (CRC) patients. Giardia duodenalis was detected at rates of 1.7% by microscopy, 2.0% by immunodiagnostic testing, and 0.7% by PCR. Blastocystis was most prevalent in CRC patients, with detection rates of 31.0% by microscopy and 48.3% by PCR.

Conclusions: This study highlights the significance of protozoan parasitic infections among cancer patients, emphasizing the need for screening and management to improve patient outcomes.