Prevalence of soil-transmitted helminth infections in HIV patients: a systematic review and meta-analysis

Comparative Evaluation of Deep Learning Models for Diagnosis of Helminth Infections

(1) Background: Helminth infections are a widespread global health concern, with Ascaris and taeniasis representing two of the most prevalent infestations. Traditional diagnostic methods, such as egg-based microscopy, are fraught with challenges, including subjectivity and low throughput, often leading to misdiagnosis. This study evaluates the efficacy of advanced deep learning models in accurately classifying Ascaris lumbricoides and Taenia saginata eggs from microscopic images, proposing a technologically enhanced approach for diagnostics in clinical settings. (2) Methods: Three state-of-the-art deep learning models, ConvNeXt Tiny, EfficientNet V2 S, and MobileNet V3 S, are considered. A diverse dataset comprising images of Ascaris, Taenia, and uninfected eggs was utilized for training and validating these models by performing multiclass experiments. (3) Results: All models demonstrated high classificatory accuracy, with ConvNeXt Tiny achieving an F1-score of 98.6%, followed by EfficientNet V2 S at 97.5% and MobileNet V3 S at 98.2% in the experiments. These results prove the potential of deep learning in streamlining and improving the diagnostic process for helminthic infections. The application of deep learning models such as ConvNeXt Tiny, EfficientNet V2 S, and MobileNet V3 S shows promise for efficient and accurate helminth egg classification, potentially significantly enhancing the diagnostic workflow. (4) Conclusion: The study demonstrates the feasibility of leveraging advanced computational techniques in parasitology and points towards a future where rapid, objective, and reliable diagnostics are standard.

Strongyloidiasis

Strongyloidiasis is a neglected tropical disease caused primarily by the roundworm Strongyloides stercoralis. Strongyloidiasis is most prevalent in Southeast Asia and the Western Pacific. Although cases have been documented worldwide, global prevalence is largely unknown due to limited surveillance. Infection of the definitive human host occurs via direct skin penetration of the infective filariform larvae. Parasitic females reside in the small intestine and reproduce via parthenogenesis, where eggs hatch inside the host before rhabditiform larvae are excreted in faeces to begin the single generation free-living life cycle. Rhabditiform larvae can also develop directly into infectious filariform larvae in the gut and cause autoinfection. Although many are asymptomatic, infected individuals may report a range of non-specific gastrointestinal, respiratory or skin symptoms. Autoinfection may cause hyperinfection and disseminated strongyloidiasis in immunocompromised individuals, which is often fatal. Diagnosis requires direct examination of larvae in clinical specimens, positive serology or nucleic acid detection. However, there is a lack of standardization of techniques for all diagnostic types. Ivermectin is the treatment of choice. Control and elimination of strongyloidiasis will require a multifaceted, integrated approach, including highly sensitive and standardized diagnostics, active surveillance, health information, education and communication strategies, improved water, sanitation and hygiene, access to efficacious treatment, vaccine development and better integration and acknowledgement in current helminth control programmes.

Pattern and Prevalence of Intestinal Helminthiasis among Human Immunodeficiency Virus-Infected Children at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State

BACKGROUND

Children infected with the human immunodeficiency virus (HIV) may be more prone to helminthic infestation because they have depleted immunity, which increases their susceptibility to infection and infestations, even with minimally pathogenic organisms such as helminths.

AIM

The prevalence and pattern of intestinal helminthiasis among children living with HIV attending the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu.

PATIENTS AND METHODS

A cross-sectional study in which 70 HIV-infected children were consecutively recruited from the Pediatric HIV clinic and matched for age and sex with 70 children recruited from the children outpatient clinic (CHOP) of UNTH Ituku-Ozalla. Stool samples of study participants were collected and analyzed using the Kato-Katz method and subsequently examined under the microscope for helminths' eggs and larvae. The worm intensity was determined using the theoretical analytic sensitivity (TAS) of 24 eggs per gram (EPG) to obtain the number of eggs per gram of feces. The CD4+ count, which describes the severity of immunosuppression in HIV-positive children was determined using the PARTEC Cyflow counter for the CD4+ lymphocyte count, whereas HIV screening was performed using the rapid diagnostic tests for HIV (Determine, Statpack and Unigold). Data were analyzed using IBM SPSS.

RESULTS

The prevalence of intestinal helminthiasis among HIV-infected and non-infected children was 27.1% and 12.9%, respectively (P = 0.038). HIV-positive children were more likely to have intestinal helminthiasis than HIV-negative children (odds ratio [OR] =2.525, 95% confidence interval [CI]: 1.052-6.063). Ascaris lumbricoides was the predominant helminthic species in both HIV-infected and non-infected groups; however, there was no statistical significance between intestinal helminthic species and HIV status (P = 0.655) but the severity of intestinal helminthiasis was significantly associated with decreasing CD4+ count (P = 0.028). The risk factors for intestinal helminthic infestation examined were similar in both HIV-positive and HIV-negative children (P > 0.05).

CONCLUSION

There was a significantly higher prevalence of helminthic infestation among HIV-infected children compared to their HIV-negative counterparts. The severity of intestinal helminthiasis was significantly associated with decreasing CD4+ count.