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Background  Diarrhoea is the second leading cause of illness and death in developing countries and the second commonest cause of death due to infectious diseases among children under five in such countries. Parasites, as well as bacterial and viral pathogens, are important causes of diarrhoea. However, parasitic infections are sometimes overlooked, leading after a period of time to an uncertain aetiology. In this paper we report the prevalence of  Giardia lamblia ,  Entamoeba histolytica  and  Cryptosporidium  sp. in and around Kolkata.    Findings  A hospital-based laboratory surveillance study was conducted among the patients admitted between November 2007 and October 2008 to the Infectious Diseases (ID) Hospital (Population = 1103) with diarrhoeal complaints. Of the 1103 samples collected, 147 were positive for  Giardia lamblia , 84 for  Cryptosporidium  sp. and 51 for  Entamoeba histolytica . For all these parasites there was a high rate of mixed infection with common enteric viruses and bacteria such as Rotavirus,  Vibrio cholerae  and  Shigella  sp. There were also cases of co-infection with all other diarrheogenic pathogens. The age group ≥ 5 years had the highest prevalence of parasites whereas the age group >5 – 10 years was predominantly infected with  Giardia lamblia  (p =< 0.001; Odds ratio (OR) = 3.937; 95% Confidence interval (CI) = 1.862 – 8.326) and with all parasites (p = 0.040; OR = 2.043; 95% CI = 1.033 – 4.039). The age group >10 – 20 years could also be considered at risk for  G. lamblia  (p = 0.009; OR = 2.231; 95% CI = 1.223 – 4.067). Month-wise occurrence data showed an endemic presence of  G. lamblia  whereas  Cryptosporidium  sp. and  E. histolytica  occurred sporadically. The GIS study revealed that parasites were more prevalent in areas such as Tangra, Tiljala and Rajarhat, which are mainly slum areas. Because most of the population surveyed was in the lower income group, consumption of contaminated water and food could be the major underlying cause of parasitic infestations.    Conclusion  This study provides important information on the occurrence and distribution of three important intestinal parasites and indicates their diarrheogenic capacity in Kolkata and surrounding areas.

Hospital-based surveillance of enteric parasites in Kolkata