{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:56:34Z","timestamp":1791395794730,"version":"4.3.3"},"reference-count":34,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2020,1,25]],"date-time":"2020-01-25T00:00:00Z","timestamp":1579910400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,25]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>The aim of the present study is to perform a retrospective analysis of the prevalence of intestinal parasitic infections among the Bulgarian population over the period 2015 \u2013 2017. The study involved all Bulgarians and foreign nationals residing in the country who had been tested for intestinal protozoa and helminths. A total of 23,785 infections have been revealed, of which 17,712 (74.47 %) were helminth and 6,073 (25.53 %) protozoan invasions. Enterobiasis was found to be the most prevalent among patients infected with intestinal helminths (81.75 %), while giardiasis (62.05 %) was the most common among those diagnosed with protozoan infections. In spite of improved living conditions and increasing public health awareness, parasitic diseases in general, and intestinal parasitic infections in particular, still represent a significant part of the overall morbidity in Bulgaria, thus posing a major issue for the public health care system.<\/jats:p>","DOI":"10.2478\/helm-2020-0002","type":"journal-article","created":{"date-parts":[[2020,1,26]],"date-time":"2020-01-26T04:30:45Z","timestamp":1580013045000},"page":"12-18","source":"Crossref","is-referenced-by-count":15,"title":["Prevalence of intestinal parasitic infections among the Bulgarian population over a three year period (2015 \u2013 2017)"],"prefix":"10.2478","volume":"57","author":[{"given":"R.","family":"Harizanov","sequence":"first","affiliation":[{"name":"National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria, Department of Parasitology and Tropical Medicine , Yanko Sakazov Blvd. 26, 1504 Sofia , Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Rainova","sequence":"additional","affiliation":[{"name":"National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria, Department of Parasitology and Tropical Medicine , Yanko Sakazov Blvd. 26, 1504 Sofia , Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Tsvetkova","sequence":"additional","affiliation":[{"name":"National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria, Department of Parasitology and Tropical Medicine , Yanko Sakazov Blvd. 26, 1504 Sofia , Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Kaftandjiev","sequence":"additional","affiliation":[{"name":"National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria, Department of Parasitology and Tropical Medicine , Yanko Sakazov Blvd. 26, 1504 Sofia , Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Borisova","sequence":"additional","affiliation":[{"name":"National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria, Department of Parasitology and Tropical Medicine , Yanko Sakazov Blvd. 26, 1504 Sofia , Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Ivanova","sequence":"additional","affiliation":[{"name":"National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria, Department of Parasitology and Tropical Medicine , Yanko Sakazov Blvd. 26, 1504 Sofia , Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Videnova","sequence":"additional","affiliation":[{"name":"National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria, Department of Parasitology and Tropical Medicine , Yanko Sakazov Blvd. 26, 1504 Sofia , Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2020,1,25]]},"reference":[{"key":"2026042808561574783_j_helm-2020-0002_ref_001_w2aab2b8ab1b7b1ab2ab1Aa","doi-asserted-by":"crossref","unstructured":"Alum, A., Rubino, J.R., Ijaz, M.K. (2010): The global war against intestinal parasites \u2013 should we use a holistic approach? Int. J. Infect. Dis., 14(9): e732 \u2013 738. DOI: 10.1016\/j.ijid.2009.11.036","DOI":"10.1016\/j.ijid.2009.11.036"},{"key":"2026042808561574783_j_helm-2020-0002_ref_002_w2aab2b8ab1b7b1ab2ab2Aa","doi-asserted-by":"crossref","unstructured":"Baldursson, S., Karanis, P. (2011): Waterborne transmission of protozoan parasites: Review of worldwide outbreaks \u2013 An update 2004 \u2013 2010. Water Res., 45(20): 6603 \u2013 6614. DOI: 10.1016\/j.watres.2011.10.013","DOI":"10.1016\/j.watres.2011.10.013"},{"key":"2026042808561574783_j_helm-2020-0002_ref_003_w2aab2b8ab1b7b1ab2ab3Aa","doi-asserted-by":"crossref","unstructured":"Betancourt, W.Q., Rose, J.B. (2004): Drinking water treatment processes for removal of Cryptosporidium and Giardia. Vet. Parasitol., 126(1 \u2013 2): 219 \u2013 234. DOI: 10.1016\/j.vetpar.2004.09.002","DOI":"10.1016\/j.vetpar.2004.09.002"},{"key":"2026042808561574783_j_helm-2020-0002_ref_004_w2aab2b8ab1b7b1ab2ab4Aa","doi-asserted-by":"crossref","unstructured":"Bethony. J, Brooker, S., Albonico, M., Geiger, S.M., Loukas, A., Diemert, D., Hotez PJ. (2006): Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet, 367(9521): 1521 \u2013 1532. DOI: 10.1016\/S0140-6736(06)68653-4","DOI":"10.1016\/S0140-6736(06)68653-4"},{"key":"2026042808561574783_j_helm-2020-0002_ref_005_w2aab2b8ab1b7b1ab2ab5Aa","doi-asserted-by":"crossref","unstructured":"Brooker, S.J., Bundy, D.A.P. (2014): Soil-transmitted Helminths (Geohelminths). In: Farar, J., Hotez, P.J., Junghanss, T., Kang, G., Lalloo, D.G., White, N.J. (Eds) Manson\u2019s Tropical Diseases. Elsevier Saunders. pp. 766 \u2013 776","DOI":"10.1016\/B978-0-7020-5101-2.00056-X"},{"key":"2026042808561574783_j_helm-2020-0002_ref_006_w2aab2b8ab1b7b1ab2ab6Aa","doi-asserted-by":"crossref","unstructured":"Choy, S. H., Al-Mekhlafi, H. M., Mahdy, M. A., Nasr, N. N., Sulaiman, M., Lim, Y. A., Surin, J. (2014). Prevalence and associated risk factors of Giardia infection among indigenous communities in rural Malaysia. Sci. Rep., 4: 6909. DOI:10.1038\/srep06909","DOI":"10.1038\/srep06909"},{"key":"2026042808561574783_j_helm-2020-0002_ref_007_w2aab2b8ab1b7b1ab2ab7Aa","doi-asserted-by":"crossref","unstructured":"Das, A.K. (2014): Hepatic and biliary ascariasis. J Glob Infect Dis, 6(2): 65 \u2013 72. DOI: 10.4103\/0974-777X.132042","DOI":"10.4103\/0974-777X.132042"},{"key":"2026042808561574783_j_helm-2020-0002_ref_008_w2aab2b8ab1b7b1ab2ab8Aa","doi-asserted-by":"crossref","unstructured":"Dawson, D. (2005): Foodborne protozoan parasites. Int. J. Food Microbiol., 103(2): 207 \u2013 227. DOI: 10.1016\/j.ijfood micro.2004.12.032","DOI":"10.1016\/j.ijfoodmicro.2004.12.032"},{"key":"2026042808561574783_j_helm-2020-0002_ref_009_w2aab2b8ab1b7b1ab2ab9Aa","unstructured":"Dori, G.U., Tullu, K.D., Ali, I., Hirko, A., Mekuria, G. (2011): Prevalence of hookworm infection and its association with anemia among patients visiting Fenan Medical Center, East Wollega Zone, Ethiopia. Ethiop. Med. J., 49(3): 265 \u2013 271"},{"key":"2026042808561574783_j_helm-2020-0002_ref_010_w2aab2b8ab1b7b1ab2ac10Aa","doi-asserted-by":"crossref","unstructured":"Dudlova, A., Juris, P., Jurisova, S., Jarcuska, P., Krecmery, V. (2016): Epidemiology and geographical distribution of gastrointestinal parasitic infection in humans in Slovakia. Helmintologia, 53(4): 309 \u2013 317. DOI: 10.1515\/helmin-2016-0035","DOI":"10.1515\/helmin-2016-0035"},{"key":"2026042808561574783_j_helm-2020-0002_ref_011_w2aab2b8ab1b7b1ab2ac11Aa","doi-asserted-by":"crossref","unstructured":"Fletcher, S., Caprarelli, G., Merif, J., Andresen, D., Hal, S.V., Stark, D., Ellis, J. (2014): Epidemiology and geographical distribution of enteric protozoan infections in Sydney, Australia. J Public Health Res, 3(2): 298. DOI: 10.4081\/jphr.2014.298","DOI":"10.4081\/jphr.2014.298"},{"key":"2026042808561574783_j_helm-2020-0002_ref_012_w2aab2b8ab1b7b1ab2ac12Aa","doi-asserted-by":"crossref","unstructured":"Graczyk, T.K., Shif, C.K., Tamang, L., Munsaka, F., Beitin, A.M., Moss, W.J. (2005): The association of Blastocystis hominis and Endolimax nana with diarrheal stools in Zambian school-age children. Parasitol. Res., 98(1): 38 \u2013 43. DOI: 10.1007\/s00436-005-0003-0","DOI":"10.1007\/s00436-005-0003-0"},{"key":"2026042808561574783_j_helm-2020-0002_ref_013_w2aab2b8ab1b7b1ab2ac13Aa","unstructured":"Harizanov, R., Rainova, I., Kaftandjiev, I., Jordanova, D., Marinova, I. (2013): Soil \u2013 transmitted helminth infections in Bulgaria: a retrospective study of some epidemiological features. Probl Inf Parasit Dis, 41: 32 \u2013 35"},{"key":"2026042808561574783_j_helm-2020-0002_ref_014_w2aab2b8ab1b7b1ab2ac14Aa","doi-asserted-by":"crossref","unstructured":"Hatam-Nahavandi, K., Mahvi, A.H., Mohebali, M., Keshavarz, H., Mobedi, I., Rezaeian, M. (2015): Detection of parasitic particles in domestic and urban wastewaters and assessment of removal efficiency of treatment plants in Tehran, Iran. J Environ Heal Sci Eng., 13(1): 4. DOI: 10.1186\/s40201-015-0155-5","DOI":"10.1186\/s40201-015-0155-5"},{"key":"2026042808561574783_j_helm-2020-0002_ref_015_w2aab2b8ab1b7b1ab2ac15Aa","doi-asserted-by":"crossref","unstructured":"Hotez, P.J., Gurwith, M. (2011): Europe\u2019s neglected infections of poverty. Int. J. Infect. Dis., 15(9): e611 \u2013 619. DOI: 10.1016\/j. ijid.2011.05.006","DOI":"10.1016\/j.ijid.2011.05.006"},{"key":"2026042808561574783_j_helm-2020-0002_ref_016_w2aab2b8ab1b7b1ab2ac16Aa","doi-asserted-by":"crossref","unstructured":"Karanis, P., Sotiriadou, I., Kartashev, V., Kourenti, C., Tsvetkova, N., Stojanova, K. (2006): Occurrence of Giardia and Cryptosporidium in water supplies of Russia and Bulgaria. Environ. Res., 102(3): 260 \u2013 271","DOI":"10.1016\/j.envres.2006.05.005"},{"key":"2026042808561574783_j_helm-2020-0002_ref_017_w2aab2b8ab1b7b1ab2ac17Aa","doi-asserted-by":"crossref","unstructured":"Kumar, T., Onichandran, S., Lim, Y.A.L., Sawangjaroen, N., Ithoi, I., Andiappan, H., Salibay, C.C., Dungca, J.Z., Chye, T.T., Sulaiman, W.Y., Ling, Lau Y, Nissapa torn, V. (2014): Comparative study on waterborne parasites between Malaysia and Thailand: A new insight. Am. J. Trop. Med. Hyg., 90(4): 682 \u2013 689. DOI: 10.4269\/ajtmh.13-0266","DOI":"10.4269\/ajtmh.13-0266"},{"key":"2026042808561574783_j_helm-2020-0002_ref_018_w2aab2b8ab1b7b1ab2ac18Aa","doi-asserted-by":"crossref","unstructured":"Lamberton, P.H., Jourdan, P.M. (2015): Human Ascariasis -Diagnostics Update. Curr Trop Med Rep, 2(4): 189 \u2013 200. DOI: 10.1007\/s40475-015-0064-9","DOI":"10.1007\/s40475-015-0064-9"},{"key":"2026042808561574783_j_helm-2020-0002_ref_019_w2aab2b8ab1b7b1ab2ac19Aa","doi-asserted-by":"crossref","unstructured":"Mehraj, V., Hatcher, J., Akhtar, S., Rafique, G., Beg M.A. (2008): Prevalence and factors associated with intestinal parasitic infection among children in an urban slum of Karachi. PLoS One, 3(11): e3680. DOI: 10.1371\/journal.pone.0003680","DOI":"10.1371\/journal.pone.0003680"},{"key":"2026042808561574783_j_helm-2020-0002_ref_020_w2aab2b8ab1b7b1ab2ac20Aa","doi-asserted-by":"crossref","unstructured":"Norman, F.F., P\u00e9rez de Ayala, A., P\u00e9rez-Molina, J.A., Monge-Maillo, B., Zamar\u00f3n, P., L\u00f3pez-V\u00e9lez, R. (2010): Neglected tropical diseases outside the tropics. PLoS Negl Trop Dis, 4(7): e762. DOI: 10.1371\/journal.pntd.0000762","DOI":"10.1371\/journal.pntd.0000762"},{"key":"2026042808561574783_j_helm-2020-0002_ref_021_w2aab2b8ab1b7b1ab2ac21Aa","doi-asserted-by":"crossref","unstructured":"Ostan, I., Kilimcio \u011flu, A.A., Girgi nkarde\u015fler, N., Ozyurt, B.C., Limoncu, M.E., Ok U.Z. (2007): Health inequities: lower socio-economic conditions and higher incidences of intestinal parasites. BMC Public Health, 7: 342. DOI: 10.1186\/1471-2458-7-342","DOI":"10.1186\/1471-2458-7-342"},{"key":"2026042808561574783_j_helm-2020-0002_ref_022_w2aab2b8ab1b7b1ab2ac22Aa","doi-asserted-by":"crossref","unstructured":"Pullan, R.L., Gething, P.W., Smith, J.L., Mwandawiro, C.S., Sturock, H.J.W., Gitonga, C.W., Hay, S.I., Brooker S. (2011): Spatial modelling of soil-transmitted helminth infections in Kenya: a disease control planning tool. PLoS Negl Trop Dis, 5(2): e975. DOI: 10.1371\/journal.pntd.0000958","DOI":"10.1371\/journal.pntd.0000958"},{"key":"2026042808561574783_j_helm-2020-0002_ref_023_w2aab2b8ab1b7b1ab2ac23Aa","doi-asserted-by":"crossref","unstructured":"Rainova, I., Harizanov, R., Kaftandjiev, I., Tsvetkova, N., Mikov, O., Kaneva E. (2018): Human parasitic diseases in Bulgaria in between 2013 \u2013 2014. Balkan Med J, 35(1): 61 \u2013 67. DOI: 10.4274\/ balkanmedj.2017.0167","DOI":"10.4274\/balkanmedj.2017.0167"},{"key":"2026042808561574783_j_helm-2020-0002_ref_024_w2aab2b8ab1b7b1ab2ac24Aa","doi-asserted-by":"crossref","unstructured":"Rechel, B., Blackburn, C.M., Spencer, N.J., Rechel, B. (2009): Access to health care for Roma children in Central and Eastern Europe: findings from a qualitative study in Bulgaria. Int J Equity Health, 8: 24. DOI: 10.1186\/1475-9276-8-24","DOI":"10.1186\/1475-9276-8-24"},{"key":"2026042808561574783_j_helm-2020-0002_ref_025_w2aab2b8ab1b7b1ab2ac25Aa","doi-asserted-by":"crossref","unstructured":"Savioli, L., Smith, H., Thompson, A. (2006): Giardia and Cryptosporidium join the neglected diseases initiative. Trends Parasitol., 22(5): 203 \u2013 208. DOI: 10.1016\/j.pt.2006.02.015","DOI":"10.1016\/j.pt.2006.02.015"},{"key":"2026042808561574783_j_helm-2020-0002_ref_026_w2aab2b8ab1b7b1ab2ac26Aa","doi-asserted-by":"crossref","unstructured":"Scanlan, P.D., Stensvold, C.R., Rajili\u0107-Stojanovi\u0107, M., Heilig , H.G., De Vos, W.M., O\u2019Toole, P.W., Cotter, P.D. (2014): The microbial eukaryote Blastocystis is a prevalent and diverse member of the healthy human gut microbiota. FEMS Microbiol Ecol, 90(1): 326 \u2013 330. DOI: 10.1111\/1574-6941","DOI":"10.1111\/1574-6941.12396"},{"key":"2026042808561574783_j_helm-2020-0002_ref_027_w2aab2b8ab1b7b1ab2ac27Aa","doi-asserted-by":"crossref","unstructured":"Smith, H.V., Cacci\u00f2, S.M., Cook, N., Nichols, R.A.B., Tait, A. (2007): Cryptosporidium and Giardia as foodborne zoonoses. Vet. Parasitol., 149(1 \u2013 2): 29 \u2013 40. DOI: 10.1016\/j.vetpar.2007.07.015","DOI":"10.1016\/j.vetpar.2007.07.015"},{"key":"2026042808561574783_j_helm-2020-0002_ref_028_w2aab2b8ab1b7b1ab2ac28Aa","doi-asserted-by":"crossref","unstructured":"Speich, B., Croll, D., Fuerst, T., Utzinger, J., Keiser J. (2016): Effect of sanitation and water treatment on intestinal protozoa infection: a systematic review and meta-analysis. Lancet Infect Dis, 16(1): 87 \u2013 99. DOI: 10.1016\/S1473-3099(15)00349-7","DOI":"10.1016\/S1473-3099(15)00349-7"},{"key":"2026042808561574783_j_helm-2020-0002_ref_029_w2aab2b8ab1b7b1ab2ac29Aa","doi-asserted-by":"crossref","unstructured":"Stuckler, D., Basu, S., Suhrcke, M., Coutts, A., McKee, M. (2009): The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis. Lancet, 374(9686): 315 \u2013 323. DOI: 10.1016\/S0140-6736(09)61124-7.","DOI":"10.1016\/S0140-6736(09)61124-7"},{"key":"2026042808561574783_j_helm-2020-0002_ref_030_w2aab2b8ab1b7b1ab2ac30Aa","doi-asserted-by":"crossref","unstructured":"Vandenberg, O., Peek, R., Souayah, H., Dediste, A., Buset, M., Scheen, R., Retore, P., Zissis, G., van Gool, T. (2006): Clinical and microbiological features of dientamoebiasis in patients suspected of suffering from a parasitic gastrointestinal illness: a comparison of Dientamoeba fragilis and Giardia lamblia infections. Int. J. Infect. Dis., 10(3): 255 \u2013 261. DOI: 10.1016\/j.ijid.2005.05.011","DOI":"10.1016\/j.ijid.2005.05.011"},{"key":"2026042808561574783_j_helm-2020-0002_ref_031_w2aab2b8ab1b7b1ab2ac31Aa","unstructured":"WHO Expert Committee. (1987): Public health significance of intestinal parasitic infections. Bull. World Health Organ., 65(5): 575 \u2013 588"},{"key":"2026042808561574783_j_helm-2020-0002_ref_032_w2aab2b8ab1b7b1ab2ac32Aa","unstructured":"WHO. (2016) Framework for control and prevention of soil-transmitted helminthiases in the WHO European Region 2016 \u2013 2020. Copenhagen, WHO Regional Office for Europe, 24 pp."},{"key":"2026042808561574783_j_helm-2020-0002_ref_033_w2aab2b8ab1b7b1ab2ac33Aa","doi-asserted-by":"crossref","unstructured":"Yakoob, J., Jafri, W., Beg, M.A., Abbas, Z., Naz, S., Islam, M., Khan, R. (2010): Irritable bowel syndrome: is it associated with genotypes of Blastocystis hominis. Parasitol. Res., 106: 1033 \u2013 1038. DOI: 10.1007\/s00436-010-1761-x","DOI":"10.1007\/s00436-010-1761-x"},{"key":"2026042808561574783_j_helm-2020-0002_ref_034_w2aab2b8ab1b7b1ab2ac34Aa","doi-asserted-by":"crossref","unstructured":"Yang, D., Zhao, W., Zhang, Y., Liu, A. (2017): Prevalence of Hymenolepis nana and H. diminuta from Brown Rats Rattus norvegicus in Heilongjiang Province, China. Korean J. Parasitol., 55(3): 351 \u2013 355. DOI: 10.3347\/kjp.2017.55.3.351","DOI":"10.3347\/kjp.2017.55.3.351"}],"container-title":["Helminthologia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/content.sciendo.com\/view\/journals\/helm\/57\/1\/article-p12.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/reference-global.com\/pdf\/10.2478\/helm-2020-0002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T17:00:33Z","timestamp":1777395633000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.2478\/helm-2020-0002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,25]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1,25]]},"published-print":{"date-parts":[[2020,1,25]]}},"alternative-id":["10.2478\/helm-2020-0002"],"URL":"https:\/\/doi.org\/10.2478\/helm-2020-0002","relation":{},"ISSN":["1336-9083"],"issn-type":[{"value":"1336-9083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,25]]}}}