PROBLEMS of Infectious and Parasitic Diseases <p><strong>"PROBLEMS of Infectious and Parasitic Diseases"</strong> <span id="result_box" class="" lang="en">is <span class="">a <a href="" target="_blank" rel="noopener">peer-reviewed</a> medical journal of scientific papers covering research on microbiological diagnostics of human infectious diseases. It is published by</span></span><span id="result_box" class="" lang="en"> <a href="" target="_blank" rel="noopener">National Centre of Infectious and Parasitic Diseases</a>, in English on paper and in digital form with periodicity three issues annualy</span>.</p> <p style="text-align: justify;"><strong><span class="" lang="en"><span class="">ISSN: 0204-9155</span></span></strong></p> National Centre of Infectious and Parasitic Diseases en-US PROBLEMS of Infectious and Parasitic Diseases 0204-9155 Public Knowledge, Attitudes, and Practices towards COVID-19 Pandemic among Egyptian Citizens: A Descriptive Study <p><strong>Background:</strong> Coronavirus disease 2019 (COVID-19) pandemic has been transmitted rapidly worldwide and is recognized as a main threat to human health in 2020. The best methods to prevent its spread are to know about it and act accordingly.<br /><strong>Aim:</strong> This study aimed to assess the knowledge, attitudes, and practices to respond to COVID-19 among a sample of Egyptian citizens.<br /><strong>Methods:</strong> A community-based cross-sectional online survey was conducted on 501 Egyptian citizens during the early phase of the epidemic.<br /><strong>Results:</strong> The study included 501 participants. Females account for 49.9% (n=250) .Most of the<br />participants (n=380, 75.8%) were between 21- 40 years old. of Transmission modes were recognized by 96% (n=481). The signs and symptoms were identified by 90.8% (n=455). About 91% (n=453) knew that all ages were liable to get infected with COVID-19 and 96% (n=481) knew that the elderly were more prone to develop severe disease. Almost all of the participants (99%, n=494) claimed that they kept hand washing, while only 56.7% mentioned regular use of hand antiseptics. Avoiding contact with symptomatic persons was reported by 97.6% (n=490) and 91.6% (n=459) said they were putting on face masks in crowded places. The concept of remote work was accepted by 89.4% (n=448) and 97.6% (n=489) believed that preventive measures could reduce the risk of catching the infection. Almost all the participants (98.4%, n= 493) would like to know more about the disease. <br /><strong>Conclusion:</strong> Most of the studied sample of Egyptian citizens were knowledgeable about COVID-19, positive in their attitudes, and have appropriate practices regarding COVID-19 pandemic. However, these observations should be generalized with caution due to the limited size of the sample, and the representativeness of low socioeconomic citizens.<br /><strong>Recommendations:</strong> Health education programs should be implemented among Egyptian citizens to maintain appropriate and updated knowledge and practices and keep positive attitudes towards COVID-19.</p> Dina Ali Mona Hamed Lobna El-Korashi Copyright (c) 2020 PROBLEMS of Infectious and Parasitic Diseases 2020-12-17 2020-12-17 48 3 5 15 Mortality rate and prognostic factors for poor outcome in HIV-infected Bulgarian patients with Pneumocystis pneumonia over a 3-year period <p><strong>Background: </strong>In spite of the use of combination antiretroviral therapy and specific prophylaxis, Pneumocystis pneumonia remains one of the most common AIDS-defining disease with high mortality rate.</p> <p>The aim of this study is to analyze the cases of pneumocystis pneumonia over a three-year period by means of assessing the mortality rate and the prognostic factors for the outcome of the disease. </p> <p><strong>Material and methods</strong>: Epidemiological, clinical, laboratory and demographic data were analyzed for 13 HIV-infected patients with proved pneumocystis pneumonia, hospitalized at the AIDS Department over the period January 2017–December 2019. For data processing we used different methods of descriptive statistics.</p> <p><strong>Results:</strong> All presented patients have extremely severe immune deficiency and other opportunistic infections or AIDS-related diseases. The diagnosis of pneumocystis pneumonia was confirmed with PCR in 76.9% of the patients and with Giemsa staining for cysts and trophozoites in 23,1% of the patients. Most of our patients are male (84,6%) and the leading mechanism of HIV infection is unprotected homosexual contact. The mean age of the patients presented is 37.4 ± 10.27. Our results showed high PJP mortality (46.3 %), despite the applied etiological therapy.</p> <p><strong>Conclusions:</strong> <em>Pneumocystis jirovecii </em>pneumonia (PJP) continues to be a life-threatening infection in HIV-infected patients with severe immune suppression. PJP mortality continues to be high, and there is a statistically significant dependence on age, male sex, low CD 4 T+ cell count, high viral load of HIV, low blood albumin, and the number and severity of comorbidities.</p> Nina Yancheva Dimitar Strashimirov Maria Nikolova Ivailo Alexiev Aleksandra Ivanova Nina Tsvetkova Copyright (c) 2020 PROBLEMS of Infectious and Parasitic Diseases 2020-12-17 2020-12-17 48 3 16 20 First cases of culture proven Legionnaires’ disease in Bulgaria <p><strong>Background.</strong> <em>Legionella pneumophila</em> is the most common cause of the potentially fatal Legionnaires’ disease with worldwide increasing incidence reports. The bacterium is fastidious and slow growing and most laboratories do not perform culture.</p> <p><strong>Aim.</strong> To present results from the first culture proven cases of Legionnaires’ disease in Bulgaria.</p> <p><strong>Materials and methods. </strong>Ten lower respiratory tract materials from 10 patients were cultured for legionellae with GVPC supplement. Identification was based on growth characteristics, latex agglutination and monoclonal typing. </p> <p><strong>Results</strong>. Seven <em>L.pneumophila </em>strains (serogroup1 and serogroup6) were isolated. Five belong to monoclonal sub-types Allentown/France, Knoxville and Philadelphia. One culture positive sputum was received at the lab 5 days after sampling. Other materials were plated on the day of sampling, but three of them were obtained long after specific therapy was started and remain negative on culture. Five from the ten patients were with fatal outcome. Three were reported to ELDSNet in real-time as travel-associated.</p> <p><strong>Conclusions</strong>. Isolation of legionellae from patients remains the diagnostic ‘gold standard’. The use of selective supplement designed for water samples had no obvious impact on our results in contrast with late sampling. Isolates were from the most frequent reported <em>L. pneumophila </em>serogroups and five of them – from the virulence-associated Pontiac sub-groups. Legionnaires’ disease is still underdiagnosed in Bulgaria. Clinicians must be encouraged to send appropriate and timely obtained respiratory materials. This should happen even in cases with other positive microbiological results, since co-infection with viral, fungal or other bacterial pulmonary pathogens might be of importance for patients’ treatment and health.</p> Iskra Tomova Rumiana Nenova Copyright (c) 2020 PROBLEMS of Infectious and Parasitic Diseases 2020-12-17 2020-12-17 48 3 21 25 APPLICATION OF PCR METHOD FOR DETECTION AND SPECIES IDENTIFICATION OF TOXOCARA SPP. <p>The ascaridoid nematodes of dogs and cats <em>T. canis</em> and <em>T. cati</em> are with widespread distribu-tion and causative agents of a disease in human and animals named Toxocariasis. Human dis-ease has several clinical forms with different clinical manifestation such as visceral, ocular, neurotoxocariasis and covert toxocariasis. The morphological methods used to differentiate the two species, especially to identify eggs or larvae, can lead to inaccurate diagnosis. This requires the use of more reliable methods, such as PCR, for identification of <em>Toxocara</em> species.</p> <p>The aim of our research is to develop in our conditions a PCR method for species identification of <em>Toxocara</em> and to determine its applicability on different stages of parasites.</p> <p>The method used by Khademvatan et al. (2013), we performed with some modifications in different forms of <em>Toxocara</em> - eggs, larvae and adult parasites. We used species-specific oligonucleotide primers from the ITS2 gene sequence of the ribosomal DNA - Tcan1/NC2 for <em>T. canis</em> and Tcat1/NC2 for <em>T. cati</em>.</p> <p>The presence of a band with a size of 380 bp, specific for <em>T. canis</em>, was found for all stages of the studied parasite.</p> <p>The described method will allow species differentiation of Toxocariasis causative agents and improve the diagnosis of the disease, as well as determine the actual spread and reservoirs of these parasites.</p> Eleonora Kaneva Nina Tsvetkova Iskra Raynova Copyright (c) 2020 PROBLEMS of Infectious and Parasitic Diseases 2020-12-17 2020-12-17 48 3 26 30 DYNAMICS OF THE ETIOLOGICAL STRUCTURE OF SALMONELLOSIS IN BULGARIA AND SENSITIVITY TO ANTI‐BACTERIAL AGENTS FOR THE PERIOD 2016 – 2019 <p><strong>Background</strong><strong>.</strong> In recent years, some features of salmonellosis have been noted: an increase in morbidity all around the world, which is accompanied by an increase in the number of isolated serotypes from humans, animals and food; an increase in sporadic diseases and multi-countries <em>Salmonella</em> outbreaks.</p> <p><strong>Material and methods. </strong>For the period 2016 - 2019 in the National Reference Laboratory for Enteric Infections, Pathogenic Cocci and Diphtheria <strong>2 696</strong> <em>Salmonella</em> isolates from all over the country have been confirmed. All of the strains were epidemiologically and microbiologically examined, and tested for antimicrobial resistance.</p> <p><strong>Results.</strong> Salmonellosis is caused by several dominant for Bulgaria serotypes - is for <em>S.Enteritidis</em> and <em>S.Typhimurium</em> take the leading place, followed by <em>Salmonella</em> 1,2,5,12: i: -, Infantis, Paratyphi B Java, Kottbus, Corvallis, Derby, Dublin.</p> <p><strong>Conclusions.</strong> Given the widespread transfer of <em>Salmonella </em>through the exchange of food and animals, and international tourism, the microbial landscape of salmonellosis is becoming more diverse, though the leadership of S. Enteritidis and <em>S.</em> Typhimurium has been maintained in the recent years, both worldwide and Bulgaria.</p> Maria Pavlova Galin Kamenov Ekaterina Alexandrova Valeri Velev Todor Kantardjiev Copyright (c) 2020 PROBLEMS of Infectious and Parasitic Diseases 2020-12-17 2020-12-17 48 3 31 35 THE ROLE OF BIRDS IN THE TRANSMISSION OF LYME DISEASE <p>During the vast distances in migration, sometimes through thousands of kilometers, the birds carry ticks very far away from their nesting sites. Up to this moment 136 species of hard ticks Ixodidae have been frequently found on birds. Larvae, nymphs and adults of 25 species of the genus <em>Ixodes</em>, parasitize on birds. By transporting of ticks infected with <em>B. burgdorferi</em> s.l., the birds introduce the infection indirectly to new geographical regions. Once imported, the spirochetes may adapt to the local ecological areas and reservoir hosts. Migratory birds which carry <em>Borrelia</em> spp. in their tissues or blood, are able to infect the ticks in the new area. This determines the reservoir competence of the birds and their participation in the ecology and the epidemiology of the Lyme disease. The selective transmission of <em>Borrelia garinii</em> from birds to ticks is detected; as well that migratory birds are able to carry Lyme disease as a latent infection for several months.</p> Nadya Ivanova Aleksandrova Copyright (c) 2020 PROBLEMS of Infectious and Parasitic Diseases 2020-12-17 2020-12-17 48 3 36 42