title: "Freezing" parasites in pre-Himalayan region, Himachal Pradesh: Experience with mini-FLOTAC.
abstract: BACKGROUND
  Helminths and protozoa infections pose a great burden especially in developing, countries, due to morbidity caused both by acute and chronic infections. Data on distribution of intestinal parasitic infections among the native and expatriates populations in Himachal Pradesh are scarce. The aim of our survey was to analyze the intestinal parasitic burden in communities from Dharamsala, Kangra district, in clinical and public health settings. We also field-tested the mini- FLOTAC, an innovative diagnostic device.
  
  
  METHODS
  Subjects referring to the Tibetan Delek Hospital for abdominal discomfort and all children of the Tibetan Primary School in Dharamsala were screened for intestinal parasitic infections with direct smear, formol-ether concentration (FEC) method and mini-FLOTAC, their clinical history was recorded, and correlations between clinical symptoms and infections analyzed.
  
  
  RESULTS
  152 subjects were screened for intestinal parasites, of which 72 subjects in the outpatients department (OPD) (36 expatriates and 36 natives) and 80 in the school. 60% of schoolchildren and 57% of OPD patients were found positive for any infection, the most represented were protozoa infections (50%), whereas helminthic infections accounted only for 13% and 20% in OPD patients and schoolchildren, respectively. The most prevalent among helminths was Ascaris lumbricoides (11%). Giardia intestinalis was more present among schoolchildren than the OPD patients (20% vs 6%) and E. histolytica/dispar was more prevalent among the OPD patients (42%) than the school children (23%). Correlations were found between nausea and loose or watery stools and parasitic infections, particularly in expatriates, whereas schoolchildren, despite being as infected as adults, were completely asymptomatic. Mini-FLOTAC detected higher number of helminth infections whereas FEC method was more accurate for the diagnosis of protozoa.
  
  
  CONCLUSIONS
  This study presents an accurate snapshot of intestinal parasitic infections in Dharamsala, and their high prevalence calls for more awareness and control measures. Mini-FLOTAC is a promising and simple technique for the diagnosis of helminth infections.
authors.affiliation: Laboratory of Microbiology, San Raffaele Hospital, Milan, Italy. Electronic address: beatrice.barda@gmail.com.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Barda
authors.affiliation: Section of Veterinary Parasitology and Parasitic Diseases, University of Naples Federico II, Naples, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Ianniello
authors.affiliation: Emerging Pathogens Unit, San Raffaele Scientific Institute, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Salvo
authors.affiliation: Tibetan Delek Hospital, Dharamsala, India.
authors.forename: Tsetan
authors.initials: T
authors.lastname: Sadutshang
authors.affiliation: Section of Veterinary Parasitology and Parasitic Diseases, University of Naples Federico II, Naples, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Rinaldi
authors.affiliation: Section of Veterinary Parasitology and Parasitic Diseases, University of Naples Federico II, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cringoli
authors.affiliation: Laboratory of Microbiology, San Raffaele Hospital, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Burioni
authors.affiliation: Ivo de Carneri Foundation, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Albonico
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010271:Parasites / Q000302:isolation & purification; D018609:Tibet / Q000453:epidemiology
keywords: Helminths; Himachal Pradesh; Intestinal parasites; Protozoa; STH