Abstract

Acute diarrheal disease (ADD) caused by parasites and Tuberculosis (TB) remain major public health concerns in vulnerable indigenous communities with limited access to sanitation, safe water, and healthcare, and where humans, animals and the environment interact closely. Using a One Health framework, this study investigated TB and Intestinal parasites in human, animal and environmental samples from 15 Wayuu indigenous communities in Manaure, La Guajira. A total of 190 samples, including human sputum and feces, animal milk and feces, soil and drinking water, were analyzed according to sample type, preservation suitability, and availability using parasitological concentration techniques, qPCR for helminth detection, metatranscriptomic sequencing, Xpert ® MTB/RIF assay, and mycobacterial culture. Mycobacterium tuberculosis was detected in 8.3% of human sputum samples, with no evidence of rifampicin resistance, whereas Mycobacterium bovis was not detected in animal milk. Human fecal samples analyzed by microscopy showed Blastocystis sp. and the Entamoeba histolytica/Entamoeba dispar complex (38.8% each), followed by Giardia (19.4%), Hymenolepis nana and Trichuris trichiura (5.1% each) and Hymenolepis diminuta (1%). Commensal parasites were also identified, with Entamoeba coli (46.9%) being the most frequent species, indicating inadequate sanitary conditions and poor hygiene practices. Co-infections were common in humans (60.2%). In animal fecal samples, strongylids (66.7%), amoebas (16.7%) and Giardia (8.3%) were observed. Giardia sp. was detected in 2.38% of soil samples by microscopy, supporting environmental circulation, whereas no parasites were detected in water sediments. Multiplex qPCR detected Trichuris trichiura DNA in human feces and Trichuris spp. DNA in soil and sheep fecal samples. Metatranscriptomic analysis of 22 human fecal samples revealed a high diversity and frequency of parasitic protozoa (90.9%), with Blastocystis spp. being the most frequent (81.8%). Additionally, reads of free-living amoebae, including Acanthamoeba spp. (10%) and Naegleria spp. (5%) were detected in community drinking water sources. These findings suggest active transmission of TB and parasitic-associated ADD in Wayuu communities and highlight the need for integrated surveillance and culturally appropriate interventions focused on sanitation, hygiene, veterinary services and community health education to improve the living and health conditions of these vulnerable populations.

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