{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:40:09Z","timestamp":1787071209649,"version":"build-2736575974"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"\n Background:<\/jats:title>\n Chronic\/persistent diarrhea due to parasites is emerging. However, majority of the studies document the causes of acute diarrhea. This cross-sectional study was undertaken to determine the occurrence of intestinal parasites in persistent\/chronic diarrhea.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n A single diarrheal stool sample from adults with diarrhea >2 weeks were collected for wet mount examination. Patients with prior intake of antiparasitic agents, with cytomegalovirus (CMV), fungal, and bacterial causes of diarrhea, and those with multiple comorbidities were excluded. Modified acid-fast staining was performed for oocysts. Polymerase chain reaction (PCR) for CMV was performed to exclude CMV diarrhea. PCR for\n Giardia lamblia, Ancylostoma duodenale, Ascaris, Cryptosporidium<\/jats:italic>\n spp\n ., Strongyloides stercoralis,<\/jats:italic>\n and\n Entamoeba<\/jats:italic>\n spp. was performed through multiplex and nested multiplex protocols, respectively. Results were statistically analyzed using Chi-square and analysis of variance.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 204 cases of chronic\/persistent diarrhea, 115 (56.4%) males and 89 (43.6%) females with a mean age of 38.93 \u00b1 16.0 years were studied. Majority (134, 65.7%) had diarrhea with inflammatory bowel disease (IBD) (\n P<\/jats:italic>\n = 0.001). Cysts of\n Entamoeba<\/jats:italic>\n spp. (\n Entamoeba histolytica<\/jats:italic>\n ) in 8 (3.9%) and 12 (5.8%) while cysts of\n G. lamblia<\/jats:italic>\n were detected in 8 (3.9%) and 10 (4.9%) through microscopy and PCR, respectively. The detection of parasites was significantly higher with PCR (\n P<\/jats:italic>\n = 0.0001). None of the samples showed the presence of helminths.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n \n The study revealed 10.7% (\n E. histolytica,<\/jats:italic>\n 5.8% and\n G. lamblia<\/jats:italic>\n , 4.9%) occurrence of parasitic infections in adults with persistent\/chronic diarrhea. It was significantly associated with IBD. The combination of both methods can increase the accuracy of detection.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/tp.tp_54_24","type":"journal-article","created":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T19:00:20Z","timestamp":1761418820000},"page":"99-103","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Parasitic causes of persistent\/chronic diarrhea in adults attending the tertiary care hospital, North India"],"prefix":"10.4103","volume":"15","author":[{"given":"Sandhya","family":"Chaurasiya","sequence":"first","affiliation":[{"name":"Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shruti","family":"Kaushal","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vandana","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Upasna","family":"Kumari","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, Central University of South Bihar, Gaya, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anurag","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuhina","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.ijmmb.2021.10.001","article-title":"Chronic diarrhea and parasitic infections: Diagnostic challenges","volume":"39","author":"Khurana","year":"2021","journal-title":"Indian J Med Microbiol"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1056\/NEJMra1207777","article-title":"Enteropathogens and chronic illness in returning travelers","volume":"368","author":"Ross","year":"2013","journal-title":"N Engl J Med"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1002\/ibd.20633","article-title":"Helminths and the IBD hygiene hypothesis","volume":"15","author":"Weinstock","year":"2009","journal-title":"Inflamm Bowel 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diseases: Current scenario and future needs","volume":"25","author":"Mom\u010dilovi\u0107","year":"2019","journal-title":"Clin Microbiol Infect"},{"key":"R14-20260420","first-page":"109","article-title":"A perspective on infectious etiology of chronic diarrhoea in India","volume":"9","author":"Taneja","year":"2017","journal-title":"J Dis Glob Health"},{"key":"R15-20260420","first-page":"211","article-title":"Microorganisms and parasites in chronic infective diarrhea","volume":"36","author":"Simadibrata","year":"2004","journal-title":"Acta Med Indones"},{"key":"R16-20260420","first-page":"1","article-title":"The etiological profile of chronic organic non-bloody diarrhea in India: Emergence of inflammatory bowel disease as a dominant cause","volume":"43","author":"Daga","year":"2024","journal-title":"Indian J Gastroenterol"},{"key":"R17-20260420","first-page":"S362","article-title":"S0721 intestinal parasitism in patients with inflammatory bowel disease","volume":"115","author":"Kroner","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"R18-20260420","doi-asserted-by":"crossref","first-page":"e00025","DOI":"10.1128\/CMR.00025-17","article-title":"Practical guidance for clinical microbiology laboratories: Laboratory diagnosis of parasites from the gastrointestinal tract","volume":"31","author":"Garcia","year":"2018","journal-title":"Clin Microbiol Rev"},{"issue":"Suppl 2","key":"R19-20260420","doi-asserted-by":"crossref","first-page":"S122","DOI":"10.1093\/clinids\/16.Supplement_2.S122","article-title":"Diarrhea in helminthic infections","volume":"16","author":"Genta","year":"1993","journal-title":"Clin Infect Dis"},{"key":"R20-20260420","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/1742-6405-10-7","article-title":"Prevalence of intestinal parasites and associated risk factors among HIV\/AIDS patients with pre-ART and on-ART attending dessie hospital ART clinic, Northeast Ethiopia","volume":"10","author":"Missaye","year":"2013","journal-title":"AIDS Res Ther"},{"key":"R21-20260420","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.3390\/microorganisms8071078","article-title":"Cytomegalovirus and inflammatory bowel diseases (IBD) with a special focus on the link with ulcerative colitis (UC)","volume":"8","author":"Jentzer","year":"2020","journal-title":"Microorganisms"}],"container-title":["Tropical 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