G. lamblia and H. pylori infections among mentally challenged individuals in rehabilitation centers in Alexandria, Egypt

INTRODUCTION: Concomitant infections with pathogens are common, particularly when there are shared modes of infection or when one pathogen promotes the other. Residence among closed-type care institutions may pose an additional risk of such infections. Mentally challenged patients in rehabilitation centers constitute one of the special needs groups exposed to parasitic infections, including giardiasis. Several studies reported concomitant infection with G. lamblia and H. pylori worldwide and in Egypt; however, the co-existence of these two pathogens among mentally challenged individuals remains unexplored. The present study aimed to study the prevalence and association between G. lamblia and H. pylori among mentally challenged patients in rehabilitation centers in Alexandria, Egypt. METHODOLOGY: 200 individuals admitted to four mental rehabilitation centers in the period from June 2013 to January 2014, who guardians gave informed consent, were recruited. Stool samples were collected and subjected to trichrome stain for G. lamblia and to antigen detection for H. pylori. RESULTS: The overall prevalence rates of G. lamblia and H. pylori were 8.5% and 24.0%, respectively. Monoinfection rates were 5.5% for G. lamblia and 21.0% for H. pylori, while concomitant infection with both species was detected in only 3.0% of cases. However, individuals who were H. pylori-positive were about two times more likely to be infected with G. lamblia than those who were H. pylori-negative (12.5% vs. 7.2%). CONCLUSIONS: Mentally challenged individuals in Alexandria harbouring H. pylori are about two times more likely to be exposed to G. lamblia. Large-scale studies are recommended to confirm this association.