Ce travail de recherche porte sur le développement d'une plateforme microfluidique de type laboratoire sur puce pour la mesure du pouvoir infectieux d'agents pathogènes présents dans l'eau. La principale fonction étudiée dans ce manuscrit est la concentration de parasites en suspension dans un liquide. La manipulation des microparticules est basée sur l'emploi de forces électrocinétiques. Une analyse numérique en deux et trois dimensions apporte des informations qualitatives. Elle permet également d'extraire les valeurs géométriques clés des électrodes employées pour la concentration des microparticules. Ces premiers résultats théoriques sont confirmés expérimentalement à l'aide de deux dispositifs contenant une grande variété de concentrateurs. A partir des éléments théoriques et expérimentaux, nous concevons un concentrateur optimisé. Il est intégré dans un dispositif employant la technique de déplacement de goutte par électromouillage sur diélectrique (EWOD). Ce système est employé selon trois modes : concentrateur, extracteur et séparateur. Des oocystes de Cryptosporidium et des kystes de Giardia lambia sont utilisés pour la caractérisation du dispositif. Enfin, des résultats préliminaires de cultures cellulaires sur des surfaces fonctionnalisées à l'échelle de la centaine de micromètres permettent d'envisager le développement d'une plateforme microfluidique complète d'analyse du pouvoir infectieux d'agents pathogènes du genre Cryptosporidium.

L’augmentation des interactions entre humains et animaux sauvages en lisière des habitats naturels pourrait faciliter la transmission d’agents pathogènes entre les humains et les différentes espèces animales d’un écosystème et ainsi favoriser l’émergence de maladies. Nous avons effectué une étude transversale portant sur l’infection par Giardia et Cryptosporidium chez les humains, les animaux domestiques, les rongeurs et les lémuriens au sein de l’écosystème de Ranomafana, Madagascar. Des échantillons de fèces ont étés collectés de manière non invasive chez des personnes volontaires, des mammifères domestiques et des rongeurs introduits habitant trois villages situés en lisière du Parc National de Ranomafana (PNR) ainsi que quatre espèces de lémuriens (Propithecus edwardsii, Prolemur simus, Eulemur rubriventer et Microcebus rufus) du PNR. Des analyses coproscopiques par la technique d’immunofluorescence directe ont été réalisées afin de détecter la présence de Cryptosporidium et Giardia. Leur prévalence a été estimée et certaines variables reliées à l’infection par les parasites ont été identifiées. Cryptosporidium et Giardia ont été détectés avec une prévalence estimée à 22,9 % et 13,6 % respectivement chez les humains. La prévalence de ces deux parasites variait de 0 % à 60 % chez les animaux domestiques et les rongeurs au sein des villages. L’espèce hôte, l’âge ainsi que la co-infection par un autre protozoaire sont les seules variables associées à l’infection par Cryptosporidium et Giardia dans cet écosystème tandis qu’aucune association avec une coinfection par un ordre de nématode n’a été détecté. De plus, Cryptosporidium a été détecté chez 10,5 % des lémuriens du PNR. Cette étude documente pour la première fois la présence de Cryptosporidium chez deux espèces de lémuriens du PNR. Par contre, Giardia n’a pas été détecté dans les échantillons issus de lémuriens du PNR. / Increasing human activities in the vicinities of natural habitats may facilitate the emergence and transmission of diseases between humans and domestic animals and wildlife species. We conducted a cross-sectional study investigating the prevalence of Giardia and Cryptosporidium, two ubiquitous and potentially zoonotic protozoan parasites in various populations of humans and animals from the Ranomafana National Park ecosystem (RNP), Madagascar. Fecal samples were obtained non-invasively from human volunteers, domestic animals and introduced rodents inhabiting three villages in the vicinity of the national park and from four species of free-ranging lemurs (Propithecus edwardsi, Prolemur simus, Eulemur rubriventer and Microcebus rufus) from the RNP. Samples were analyzed using the direct immunofluorescence technique. Prevalences of Giardia and Cryptosporidium were estimated and variables associated with infections by the protozoa were identified. Cryptosporidium and Giardia were detected with a prevalence of 22.9 % and 13.6 % in humans respectively. The prevalences of these two parasites varied from 0 % to 60 % in domestic animals and introduced rodents from the villages. Species, age category and co-infection with the other protozoan were significantly associated with the infection by Cryptosporidium and Giardia in this ecosystem, whereas coinfections by different helminths order were not significantly associated with Cryptosporidium or Giardia. Moreover, Cryptosporidium was detected in 10.5 % of lemurs sampled from the RNP. This study reports for the first time the occurrence of Cryptosporidium in two species of lemurs from the RNP. Giardia was not detected in fecal samples from lemurs inhabiting the RNP.

Foodborne illnesses are a significant public health challenge in the United States, with an estimated 9.4 million illnesses annually attributed to the consumption of contaminated food, of which 59% are estimated to be caused by viruses, 39% by bacteria and 2% by parasites. Timely detection and identification of the pathogens causing foodborne outbreaks is vital for the implementation of outbreak control strategies, allowing public health officials to prevent additional illnesses and maintain confidence in the food supply. Public health laboratories employ a variety of traditional and molecular testing techniques to identify foodborne outbreak etiologic agents. One technology is the Luminex XMap® microsphere system, which is also marketed as the Bio-Plex™ 200. This platform has a multiplexing capability with the potential to simultaneously detect up to 100 targets in one reaction. The studies described here show that the combination of two Bio-Plex assays with real-time virus assays and one extraction method provides a flexible foodborne outbreak screening algorithm that potentially identifies an outbreak-associated pathogen on the first day of specimen submission and aids in focusing confirmatory laboratory testing. In these studies, two microsphere-based assays were designed for use on the Bio-Plex 200 system as screening assays for the detection of four enteric protozoa (Giardia intestinalis, Cyclospora cayetanensis, Cryptosporidium parvum, Entamoeba histolytica) and six virulence determinants of shiga toxin-producing Escherichia coli (STEC), enterotoxigenic Escherichia coli (ETEC), enteroinvasive Escherichia coli (EIEC) and Shigella spp. Precision and limits of detections were established for both assays. The sensitivity and specificity of the protozoan assay as compared to reference methods ranged from 81.25% to 100% for most targets, while sensitivity for the E. histolytica target was 42.86%. Sensitivity and specificity for the bacterial assay was 100% as compared to reference methods. However, cross-reactivity of the protozoan assay E. histolytica target with E. dispar and of the bacterial assay uidA target with enteropathogenic E. coli strains was noted. Additionally, real-time detection of norovirus and rotavirus nucleic acids extracted with the QIAamp DNA Stool Mini Kit was statistically comparable to detection when extracted with the Ambion® MagMAX™-96 Viral RNA Isolation Kit combined with the KingFisher® Magnetic Particle Processor.

Diversos estudos têm demonstrado que a pesquisa de microrganismos em águas de esgoto representa um importante parâmetro de avaliação e caracterização de possíveis agentes patogênicos circulantes numa determinada população e suas possíveis implicações à saúde pública. O presente trabalho teve por objetivos pesquisar nas águas de esgoto da cidade de São Paulo a ocorrência do protozóario emergente, Cryptosporidium spp, comparando-se duas técnicas de concentração, uma vez que não existem estudos relacionados a presença deste patógeno neste município, e determinar à presença de Salmonella spp e seus sorotipos nestas amostras. Para isto foram realizadas coletas semanais nos períodos de Julho à Dezembro de 1998, sendo doze realizadas em uma estação elevatória e doze em um córrego receptor de esgoto no município de São Paulo, aonde foi também determinada a poluição de origem fecal através da densidade de E.coli. Para determinação dos oocistos de Cryptosporidium as amostras foram concentradas por “floculação e precipitação do carbonato de cálcio" (Vesey et alii, 1993) e através da técnica da “membrana filtrante" (Aldom et alii, 1995) com posterior identificação e confirmação por imunofluorescência direta e contraste de fase, respectivamente. A determinação de Salmonella foi realizada segundo “Stantard Methods of Water and Wastewater 19th ed.". Para a determinação de coliformes totais e E. coli utilizou-se a técnica de tubos múltiplos, empregando substrato cromogênico e fluorogênico (Colilert 18, Iddex). Os resultados obtidos da análise de 24 amostras indicaram que 100% destas foram positivas tanto para a presença dos oocistos de Cryptosporidium sp quanto para o isolamento de Salmonella sp. O número de oocistos detectados variou de 0 a 1.200 e de 0 a 1.400 oocistos/L nas amostras de águas de esgoto e córrego respectivamente. Foram isoladas um total de 221cepas de Salmonella. Entre os sorotipos prevalentes encontrados estão S. panama, S. agona, S.infantis, S.hadar, S.onakan e S.braenderup. Os resultados verificaram a circulação de Salmonella spp e Cryptosporidium spp no meio ambiente estudado em São Paulo, podendo se constituir em importante fonte de disseminação destes patógenos no meio aquático e na comunidade. / A lot of studies have shown the value on researching in sewage several pathogenic microorganisms to determine possible enteropathogens that are present in communities and the risks for public health. The aims of this study were to determine the occurrence and the levels of Cryptosporidium spp and Salmonella spp in sewage and wastewater in São Paulo since there is no recent studies of this pathogens in sewage of this city. A total of twenty four samples were collected weekly from July to December of 1998 in an effluent sewage station (12) and a river (12) that receives a domestic discharge of São Paulo city. The detection of Cryptosporidium oocysts was made using two procedures for concentration by flocculation (Vesey et alii, 1993) and by membrane filtration (Aldom & Chagla, 1995), and oocysts were identified by direct immunofluorescence assay and the presence was confirmed by phase contrast microscopy. Salmonella isolation was made using membrane filtration method (Martins, 1979). The results showed the occurrence of Cryptosporidium sp and Salmonella spp in 100% of samples. A total of 221 strains of Salmonella were isolated and among the prevalent serotypes were detected S. panama, S. agona, S.infantis, S.hadar, S.onakan e S.braenderup. The presence of Salmonella and Cryptosporidium in environmental samples studied in São Paulo can represent a possible source for dissemination of these pathogens in aquatic evironment and community.

Diversos estudos têm demonstrado que a pesquisa de microrganismos em águas de esgoto representa um importante parâmetro de avaliação e caracterização de possíveis agentes patogênicos circulantes numa determinada população e suas possíveis implicações à saúde pública. O presente trabalho teve por objetivos pesquisar nas águas de esgoto da cidade de São Paulo a ocorrência do protozóario emergente, Cryptosporidium spp, comparando-se duas técnicas de concentração, uma vez que não existem estudos relacionados a presença deste patógeno neste município, e determinar à presença de Salmonella spp e seus sorotipos nestas amostras. Para isto foram realizadas coletas semanais nos períodos de Julho à Dezembro de 1998, sendo doze realizadas em uma estação elevatória e doze em um córrego receptor de esgoto no município de São Paulo, aonde foi também determinada a poluição de origem fecal através da densidade de E.coli. Para determinação dos oocistos de Cryptosporidium as amostras foram concentradas por “floculação e precipitação do carbonato de cálcio” (Vesey et alii, 1993) e através da técnica da “membrana filtrante” (Aldom et alii, 1995) com posterior identificação e confirmação por imunofluorescência direta e contraste de fase, respectivamente. A determinação de Salmonella foi realizada segundo “Stantard Methods of Water and Wastewater 19th ed.”. Para a determinação de coliformes totais e E. coli utilizou-se a técnica de tubos múltiplos, empregando substrato cromogênico e fluorogênico (Colilert 18, Iddex). Os resultados obtidos da análise de 24 amostras indicaram que 100% destas foram positivas tanto para a presença dos oocistos de Cryptosporidium sp quanto para o isolamento de Salmonella sp. O número de oocistos detectados variou de 0 a 1.200 e de 0 a 1.400 oocistos/L nas amostras de águas de esgoto e córrego respectivamente. Foram isoladas um total de 221cepas de Salmonella. Entre os sorotipos prevalentes encontrados estão S. panama, S. agona, S.infantis, S.hadar, S.onakan e S.braenderup. Os resultados verificaram a circulação de Salmonella spp e Cryptosporidium spp no meio ambiente estudado em São Paulo, podendo se constituir em importante fonte de disseminação destes patógenos no meio aquático e na comunidade. / A lot of studies have shown the value on researching in sewage several pathogenic microorganisms to determine possible enteropathogens that are present in communities and the risks for public health. The aims of this study were to determine the occurrence and the levels of Cryptosporidium spp and Salmonella spp in sewage and wastewater in São Paulo since there is no recent studies of this pathogens in sewage of this city. A total of twenty four samples were collected weekly from July to December of 1998 in an effluent sewage station (12) and a river (12) that receives a domestic discharge of São Paulo city. The detection of Cryptosporidium oocysts was made using two procedures for concentration by flocculation (Vesey et alii, 1993) and by membrane filtration (Aldom & Chagla, 1995), and oocysts were identified by direct immunofluorescence assay and the presence was confirmed by phase contrast microscopy. Salmonella isolation was made using membrane filtration method (Martins, 1979). The results showed the occurrence of Cryptosporidium sp and Salmonella spp in 100% of samples. A total of 221 strains of Salmonella were isolated and among the prevalent serotypes were detected S. panama, S. agona, S.infantis, S.hadar, S.onakan e S.braenderup. The presence of Salmonella and Cryptosporidium in environmental samples studied in São Paulo can represent a possible source for dissemination of these pathogens in aquatic evironment and community.

Use of tubular anaerobic digesters to treat livestock waste in developing countries has energy, agricultural, health, social and environmental benefits. However, careful use of digester effluent as a soil amendment is required due to the potential presence of protozoan parasites Cryptosporidium parvum and Giardia lamblia. This research investigated the performance of four tubular digesters in the Monteverde region of Costa Rica. High (>75%) volatile solids and BOD5 removal efficiencies were observed, which was attributed to the formation of a biologically active floccular sludge layer. Computational fluid dynamics (CFD) and bioprocess models were developed to evaluate the transport and transformation mechanisms in the digesters. The CFD model estimated a mean liquid hydraulic residence time (HRT) of 23 days and the bioprocess model estimated an average mean cell residence time (MCRT) of 115 days. Cryptosporidium parvum and Giardia lamblia inactivation studies were performed in the laboratory under conditions similar to the environmental conditions observed in the field tubular digesters. The environmental conditions included: ambient temperatures (21-24°C), neutral pH and total ammonia nitrogen (TAN) concentrations below 250 mg NH4+-N/L. Inactivation rate constants for Cryptosporidium parvum and Giardia lamblia were 0.056 and 0.726 day-1, respectively. An (oo)cysts solid-liquid phase distribution study indicated that 70% of both (oo)cysts adhered to biosolids. A tubular digester model was used to estimate the concentration of viable (oo)cysts in the digester effluents. (Oo)cysts adhesion to solids, total solids concentration in the digester and HRT were the main factors contributing to the modeled effluent concentration of viable (oo)cysts. Since the model predicted presence of viable (oo)cysts in the tubular digester effluent, a quantitative microbial risk assessment (QMRA) model was developed to estimate the risk of infection from exposure to raw livestock waste and tubular digester effluents in two rural communities in Costa Rica. The risk of infection from Cryptosporidium parvum and Giardia lamblia was assessed for occupational and public exposure pathways; fomite and soil contamination and crop contamination from runoff. Results from the QMRA indicated that the concentration of (oo)cysts in the raw livestock waste, inactivation rates at the various exposure pathways and the treatment of livestock waste were the main contributing factors to the risk of infection. This research indicated that treatment of livestock waste in tubular digesters significantly decreased the risk of infection to below WHO’s acceptable individual annual risk of infection (10-4). This is the first study to combine mathematical modeling with field studies to determine the physical and biological processes in tubular digesters. This is also the first study to combine mathematical models with field and laboratory studies to determine the concentration of (oo)cysts in tubular digester effluents and to predict the risk of infection from Cryptosporidium parvum and Giardia lamblia if tubular digester effluent is used as a soil amendment.

Cryptosporidium is a genus of apicomplexan unicellular epicellular parasite with worldwide distribution causing watery diarrhea in humans and animals. The life cycle is completed in one host, where Cryptosporidium parasitizing epithelial cells of gastrointestinal tract and in birds can cause disease of respiratory or urogenital tract. Course of disease depends on condition of immune system. For immunodeficient individuals could be life threatening. One of problems especially in developing countries is early and correct diagnostic, particularly no effective treatment currently exist. The aim of this thesis was to compare efficiency of immunochromatographic tests in samples stored under different conditions. The comparison of sensitivity and specificity of these tests with molecular and microscopic techniques was also performed. Additionaly, suitability of immunochromatographic tests for detection of active infection during prepatent period was evaluated. The theoretic part includes general information about Cryptosporidium. Its taxonomy, cycle of evolution or transmission and course of disease. Using of immunochromatographic test is also mentioned. No differences in sensitivity of used immunochromatographic tests was observed in this thesis. The detection rate for most of tests was 200 oocyst per sample. The presence of coproantigen is depend upon presence of oocysts in a sample. False negative results of immunochromatographic assays was caused by i) low concentration of oocysts in a sample (sensitivity) or ii) antibodies in used test don´t react with antigen of Cryptosporidium spp. (specificity). Results of this thesis show that combination of immunochromatographic tests and other techniques is convenient. During prepatent period is not possible to detect specific DNA, antigen or oocysts of Cryptosporidium. The active infection could not be distinguish from passage of oocysts using of immunochromatographic assays even if PCR is also used.

Soil amended with manure has been implicated as a source of produce contamination leading to foodborne gastrointestinal-disease outbreaks. While current composting guidelines require temperatures ≥ 55°C for 3 days to destroy bacterial pathogens, these requirements have not been evaluated for all pathogens. Investigation of parasite survival in manure required development of a flow cytometry method integrating the cell-impermeant viability dye SytoX for simultaneous quantification and viability assessment of Cryptosporidium and Giardia oocysts/cysts. Further studies will be required to apply this method to investigate thermal reduction in parasites. Studies conducted with bacterial pathogens indicated that E. coli O157:H7 survived longer than other pathogens at 50°C to 55°C. Listeria monocytogenes survived significantly better in chicken manure compared to cow manure at 50°C to 55°C. Results suggest composting guidelines are adequate for bacterial pathogen reduction; however, testing for E. coli O157 along with Salmonella may increase confidence in compost safety.

PhD (Microbiology) / Department of Microbiology / Background: Diarrheal diseases have a major effect on human health, Globally; it is second only to pneumonia as a leading cause of death among children under five. They are due to a variety of infectious and non-infectious agents; including Entamoeba spp. Entamoeba histolytica is an invasive enteric protozoan parasite that causes amebiasis. Amebiasis is frequent in communities without clean water and poor sanitation, which include low-income South African populations in Giyani and Pretoria. In these populations, the amount of diarrhea caused by Entamoeba histolytica inclusive of all ages, sexes and HIV status is uncertain. Diagnosis of the parasite is usually by microscopy. However, microscopy lacks sensitivity and specificity, therefore it is not reliable. Fortunately, molecular diagnostic tests have been developed to detect different Entamoeba species in humans. It is known that the parasite E. histolytica causes asymptomatic and symptomatic diseases. However, the transition from colonization to disease is still unclear. While parasite and host factors, as well as environmental conditions influence the infection outcome, there is currently no clear explanation of wide variation in the presentation of the disease. This could suggest that there are other factors affecting the disease outcome. A better understanding of these factors as well as their role in disease remains target objectives of modern scientists and it will definitely help in the fight against the disease. In spite of the emerging evidence that the host microbiome, parasite burden and the inflammatory response contribute to the virulence of E. histolytica, their roles have never been defined in developing regions such as Giyani and Pretoria. In addition, the present study hypothesized that co-infections with E. histolytica and secretion of extracellular vesicles/exosomes have a significant impact on the virulence of E. histolytica. Little has been explored or elucidated about responses triggered by other enteropathogens/ameba interplay that could be important in the induction of tissue invasion and disease and also how E. histolytica/enteropathogens interplay in these infections has not been determined. Therefore, the knowledge of this interplay could help in understanding how this modifies disease manifestations by modulating pathogen virulence and the host response. The use of secretion systems is an essential biological process exploited by pathogenic microorganisms to promote survival and spread of the pathogen, which in turn exacerbate the infection. The study of extracellular vesicles (EVs) released by pathogens is a new and exciting field that may realistically contribute to a better understanding of the pathogenic process of E. histolytica and provide alternate control strategies. Aim and objective of the study: The overall aim of the study was to determine the impact of enteric pathogens and secreted extracellular vesicles on amebic virulence and the outcome of infection. This aim was addressed in through a series of six primary objectives, which were: a. To investigate the distribution and prevalence of protozoan parasites in South Africa. b. To investigate novel species of Entamoeba circulating in the South African population. ix c. To elucidate the impact of gut microbiota and immune response during amebic infection. d. To determine the role of Entamoeba histolytica macrophage inhibitory factor (EhMIF) during amebic infection. e. To investigate the impact of co-infections on the outcome of amebiasis. f. To determine the presence of secreted extracellular vesicles/exosomes in Entamoeba histolytica. Brief methodology and results: A modified and validated Taqman qPCR assay (with taqman probes and genus specific primers) was used for amplification and target detection. This assay was used to investigate the distribution and prevalence of protozoan parasites (Cryptosporidium spp and Giardia lamblia) in South Africa, the assay was considered superior for this project because it is more sensitive than conventional PCR and it can be used to detect multiple infection targets. This assay allows fast, accurate, and quantitative detection of a broad spectrum of enteropathogens and is well suited for surveillance or clinical purposes. A total of 484 stool samples collected from diarrheal and non-diarrheal patients from rural and urban communities of South Africa were studied. The overall prevalence of parasites (Giardia lamblia and Cryptosporidium spp) in rural and urban patients were found to be 49% (112/227) and 21% (54/257) respectively (p= < 0.0001). The distribution of specific pathogens in rural areas was Cryptosporidium spp (20%) and Giardia lamblia (14%). Our findings showed no significant difference in parasitic infections between gender and the age of the participants (Chapter 3). The discovery of novel species is of great importance to human health. We have recently discovered stools positive for Entamoeba organisms by microscopy but PCR negative for known Entamoeba species. This led to the hypothesis that novel species of Entamoeba are present in the South African population. A comprehensive assay was used which included probes to identify Entamoeba bangladeshi from diarrheal and non-diarrheal participants. A sensitive qPCR assays and amplicon sequencing was used to detect Entamoeba spp, Prevotella copri and Enterobacteriaceae. Interestingly, E. bangladeshi was identified in the South African population. Entamoeba was present in 27% (E. histolytica 8.5% (41/484), E. dispar 8% (38/484), and E. bangladeshi 4.75% (23/484) E. moshkovskii was not detected in the present study. We were also able to observe changes in the host microbiome and the parasite burden associated with E. histolytica infections in S. African diarrhea cases versus asymptomatic controls but not with E. bangladeshi or E. dispar. In E. histolytica positive samples the level of both parasite and P. copri were lower in non-diarrheal samples (p=0.0034) (Chapter 4). There is accumulating evidence that the inflammatory response contributes to injury. Little is known about the key parasite mediators of host mucosal immunopathology. This study hypothesized that migration inhibitory factor (MIF) mediates the destructive host inflammatory response seen in amebic colitis. To determine the role of EhMIF during amebic infection, we used a genetic approach to test the effect of EhMIF on mucosal inflammation. We found that EhMIF induces IL-8 secretion from intestinal epithelial cells. Mice treated with antibodies that specifically block EhMIF had reduced chemokine expression and neutrophil infiltration in the mucosa. In addition to antibody-mediated neutralization, mice infected with parasites overexpressing EhMIF had increased chemokine expression, neutrophil influx and mucosal damage. We also found that the concentration of EhMIF correlated with the level of intestinal inflammation in persons with intestinal amebiasis. Together, our results reveal a novel parasite mediator of mucosal inflammation and support MIF homologs as potential immunomodulatory targets (Chapter 5). To investigate the impact of co-infections on the outcome of amebiasis, we analyzed the co-occurence of E. histolytica with other enteropathogens known to cause diarrheal infections, such as Shigella/EIEC (IpaH), Campylobacter (cadf), Enterotoxigenic E. coli (STh), Norovirus GII and Adenovirus (Hexon). The results were compared with those obtained with E. histolytica that were not interacted with enteropathogens and with E. histolytica interacted with enteropathogens. The impact of multiple infections on the outcome of the infection was compared between nondiarrheal and diarrheal stool samples. It was found that co-infections with two pathogens were associated with diarrhea compared to single infections. Moreover, Norovirus GII, Campylobacter (Cadf) and co-infections were associated with diarrhea in the study population. This study did not show any significant impact of pathogens co-infecting with E. histolytica on the outcome of amebic infection (Chapter 6). The presence of secreted extracellular vesicles/Exosomes in Entamoeba histolytica was determined by using the Pathogenic ameba strains (HM-1:IMSS or HM-1:IMSS (Sub-strain-US) from petri’s lab to purify exosomes using the commercially available kit to isolate exosomes (total exosomes isolation kit). Our study for the first time revealed that E. histolytica does secrete Evs. This finding increases the appreciation that all organisms are likely to secrete these EVs (Chapter 7). However, the impact of these EVs on the pathogenesis of E. histolytica needs further investigations. Conclusion: This study has contributed significantly to our knowledge on infectious diarrhea and the diversity of Entamoeba species by providing new data on the rate and prevalence of Entamoeba diarrheal infections and their distribution in the South African population. Our study describes for the first time the presence of E. bangladeshi in the South African population. Furthermore, our results reveal a novel parasite mediator of mucosal inflammation and support MIF homologs as potential immunomodulatory targets. This study also, for the first time revealed that E. histolytica does secrete EVs. The results from this work will undoubtedly open an exciting research to establish a deeper understanding of the function and role of these vesicles in amebic infection. We encourage public health interventions like health education programs and improvement of sanitation and hygiene in these populations. Molecular diagnostics should be used for specific diagnostic in clinical settings. / NRF

In dieser Arbeit wird eine neue Methode der Vitalitätsbestimmung von Cryptosporidium parvum-Oozysten beschrieben. Die gereinigten Oozysten wurden in einer HCT-8-zelllinie kultiviert und mittels IFAT ausgewertet. Um eine genaue Quantifizierung der fluoreszierenden Flächen vornehmen zu können, wurden die Bilder einer Bildanalysesoftware zugeführt und analysiert. Die Menge eingesäter Oozysten korrelierte signifikant mit den gemessenen Flächen intrazellulärer Entwicklungsstadien. In diesem System wurden verschiedene Feldisolate vergleichend getestet sowie die Vitalität thermisch inaktivierter Oozysten bestimmt.