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Kishino M, Hida A, Chadeka EA, Inoue M, Osada-Oka M, Matsumoto S, Njenga SM, Hamano S, Nagi S. Association between diet quality and risk of stunting among school-aged children in Schistosoma mansoni endemic area of western Kenya: a cross-sectional study. Trop Med Health 2024; 52:12. [PMID: 38233936 DOI: 10.1186/s41182-023-00566-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/16/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Healthy eating habits are essential for improving nutritional status and strengthening immunity against infectious diseases. This study examined the relationship between diet quality and stunting in school-aged children in an infectious disease-endemic area of western Kenya. METHODS This cross-sectional study included 260 school-aged children (age 9-17 years) enrolled in primary schools in Mbita Sub-county, western Kenya. The nutritional status was assessed using anthropometric measurements. Dietary intake was measured using food frequency questionnaires and evaluated using the Food Pyramid (FP) score, which indicates adherence to the Kenyan food-based dietary guideline. Information on the children's age, sex, maternal education, and household wealth index was collected using a household-based questionnaire. Infections with the predominant parasites, such as Schistosoma (S.) mansoni, were detected via microscopy. The trend associations of the FP score with food group intake were examined to characterize the dietary intake of this population. Logistic regression analysis was performed to investigate the relationship between stunting and FP score tertiles, adjusted for sociodemographic and economic indicators and parasitic infection status. RESULTS Among the studied schoolchildren, 15.0% exhibited stunting, while 76.2% were infected with S. mansoni. The mean FP score was 25.6 out of 50 points. A higher FP score was characterized by a high intake of roots and tubers, dairy products, pulses, and fruits and a low intake of cereals and animal-source foods. The analysis revealed a trend: a lower risk of stunting was evident in groups with elevated FP scores (p for trend = 0.065). However, these trend associations were observable among subjects with either negative or light S. mansoni infection (p for trend = 0.016). CONCLUSIONS A higher quality diet, as evaluated by FP scores, was associated with a low risk of stunting among school-aged children. Notably, this association seemed to weaken in the presence of a high burden of S. mansoni infection. It highlights the importance of enhancing dietary quality through the promotion of diverse nutrient-dense foods alongside effective S. mansoni infection control for improved growth. This study contributes fundamental knowledge for understanding the diet-malnutrition relationship in areas endemic for S. mansoni infection.
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Affiliation(s)
- Madoka Kishino
- Department of Food and Nutritional Science, Graduate School of Applied Bioscience, Tokyo University of Agriculture, Tokyo, Japan
| | - Azumi Hida
- Department of Nutritional Science, Faculty of Applied Bioscience, Tokyo University of Agriculture, Tokyo, Japan.
| | - Evans A Chadeka
- Nagasaki University Institute of Tropical Medicine (NUITM) - Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Manabu Inoue
- Kyokuto Pharmaceutical Industrial Co., Ltd, Tokyo, Japan
| | - Mayuko Osada-Oka
- Food Hygiene and Environmental Health Division of Applied Life Science, Graduate School of Life and Environmental Sciences, Kyoto Prefectural University, Kyoto, Japan
| | - Sohkichi Matsumoto
- Department of Bacteriology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Laboratory of Tuberculosis, Institute of Tropical Disease, Universitas Airlangga, Surabaya, East Java, Indonesia
- Hokkaido University Institute for Vaccine Research and Development, Kita 20, Nishi 10, Kita-ku, Sapporo, Japan
| | - Sammy M Njenga
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Shinjiro Hamano
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Sachiyo Nagi
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
- Department of Hygiene and Public Health, Tokyo Women's Medical University, Tokyo, Japan.
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Mathewson JD, van der Spek L, Mazigo HD, Kabona G, de Vlas SJ, Nshala A, Rood EJJ. Enabling targeted mass drug administration for schistosomiasis in north-western Tanzania: Exploring the use of geostatistical modeling to inform planning at sub-district level. PLoS Negl Trop Dis 2024; 18:e0011896. [PMID: 38227610 PMCID: PMC10817176 DOI: 10.1371/journal.pntd.0011896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/26/2024] [Accepted: 01/02/2024] [Indexed: 01/18/2024] Open
Abstract
INTRODUCTION Schistosomiasis is a parasitic disease in Tanzania affecting over 50% of the population. Current control strategies involve mass drug administration (MDA) campaigns at the district level, which have led to problems of over- and under-treatment in different areas. WHO guidelines have called for more targeted MDA to circumvent these problems, however a scarcity of prevalence data inhibits decision makers from prioritizing sub-district areas for MDA. This study demonstrated how geostatistics can be used to inform planning for targeted MDA. METHODS Geostatistical sub-district (ward-level) prevalence estimates were generated through combining a zero-inflated poisson model and kriging approach (regression kriging). To make predictions, the model used prevalence survey data collected in 2021 of 17,400 school children in six regions of Tanzania, along with several open source ecological and socio-demographic variables with known associations with schistosomiasis. RESULTS The model results show that regression kriging can be used to effectively predict the ward level parasite prevalence of the two species of Schistosoma endemic to the study area. Kriging was found to further improve the regression model fit, with an adjusted R-squared value of 0.51 and 0.32 for intestinal and urogenital schistosomiasis, respectively. Targeted treatment based on model predictions would represent a shift in treatment away from 193 wards estimated to be over-treated to 149 wards that would have been omitted from the district level MDA. CONCLUSIONS Geostatistical models can help to support NTD program efficiency and reduce disease transmission by facilitating WHO recommended targeted MDA treatment through provision of prevalence estimates where data is scarce.
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Affiliation(s)
- Jake D. Mathewson
- Kit-Royal Tropical Institute, Epidemiology, Center for Applied Spatial Epidemiology (CASE), Amsterdam, The Netherlands
| | - Linda van der Spek
- Kit-Royal Tropical Institute, Epidemiology, Center for Applied Spatial Epidemiology (CASE), Amsterdam, The Netherlands
| | - Humphrey D. Mazigo
- School of Medicine, Department of Medical Parasitology & Entomology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - George Kabona
- Ministry of Health, National Neglected Tropical Diseases Control Programme, Dodoma, Tanzania
| | - Sake J. de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Ente J. J. Rood
- Kit-Royal Tropical Institute, Epidemiology, Center for Applied Spatial Epidemiology (CASE), Amsterdam, The Netherlands
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Winarti C, Widaningrum, Widayanti SM, Setyawan N, Qanytah, Juniawati, Suryana EA, Widowati S. Nutrient Composition of Indonesian Specialty Cereals: Rice, Corn, and Sorghum as Alternatives to Combat Malnutrition. Prev Nutr Food Sci 2023; 28:471-482. [PMID: 38188078 PMCID: PMC10764230 DOI: 10.3746/pnf.2023.28.4.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/21/2023] [Accepted: 09/01/2023] [Indexed: 01/09/2024] Open
Abstract
Stunted growth (stunting) caused by malnutrition is a growing concern in Indonesia. The nutritional composition of cereals is important information for improving people's nutrition. This research aimed to comparatively study the nutritional values of several Indonesian local cereal crops and provide a nutritional database for promoting local food with the aim of combating malnutrition. The cereals investigated included varieties of rice, corn, and sorghum. The nutritional analysis included ash, protein, fat, carbohydrates, dietary fiber, essential amino acids, vitamins, and minerals. A purposive sampling method was performed by collecting five lots from each sampling area and forming composite samples by combining 1∼2 kg of each sample, then mixed before laboratory analysis. The results showed that colored rice, colored corn and sorghum, contain richer essential nutrients, dietary fiber, and essential amino acids compared to white rice and corn. The highest protein content was found in sorghum (13.26%), followed by corn (9.18%), and rice (8.0%). The highest energy value was also found in sorghum (380.5 kcal/100 g), followed by corn (379.9 kcal/100 g), and rice (362.1 kcal/100 g). The same sequence was seen for the mineral contents, where the zinc and iron contents were 1.57 and 2.39 mg/100 g, respectively for sorghum; 1.36 and 0.79 mg/100 g for corn; and 0.93 and 0.58 mg/100 g for rice. Accordingly, it can be concluded that sorghum has the highest nutritional value and therefore potential for combating malnutrition, while corn and rice are also highly nutritious and can be grown locally in order to combat malnutrition.
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Affiliation(s)
- Christina Winarti
- Research Center for Agroindustry, National Research and Innovation Agency (BRIN), Soekarno Integrated Science Center, Bogor 16911, Indonesia
| | - Widaningrum
- Research Center for Agroindustry, National Research and Innovation Agency (BRIN), Soekarno Integrated Science Center, Bogor 16911, Indonesia
| | - Siti Mariana Widayanti
- Research Center for Agroindustry, National Research and Innovation Agency (BRIN), Soekarno Integrated Science Center, Bogor 16911, Indonesia
| | - Nurdi Setyawan
- Research Center for Food Process and Technology, National Research and Innovation Agency (BRIN), Yogyakarta 55861, Indonesia
| | - Qanytah
- Research Center for Agroindustry, National Research and Innovation Agency (BRIN), Soekarno Integrated Science Center, Bogor 16911, Indonesia
| | - Juniawati
- Indonesian Agency for Agriculture Instrument Standardization (IAAIS), Bogor 16114, Indonesia
| | - Esty Asriyana Suryana
- Indonesian Agency for Agriculture Instrument Standardization (IAAIS), Bogor 16114, Indonesia
| | - S Widowati
- Research Center for Agroindustry, National Research and Innovation Agency (BRIN), Soekarno Integrated Science Center, Bogor 16911, Indonesia
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Piazzesi A, Putignani L. Impact of helminth-microbiome interactions on childhood health and development-A clinical perspective. Parasite Immunol 2023; 45:e12949. [PMID: 36063358 DOI: 10.1111/pim.12949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/26/2022] [Accepted: 09/01/2022] [Indexed: 12/01/2022]
Abstract
Humans have co-existed with parasites for virtually the entirety of our existence as a species. Today, nearly one third of the human population is infected with at least one helminthic species, most of which reside in the intestinal tract, where they have co-evolved alongside the human gut microbiota (GM). Appreciation for the interconnected relationship between helminths and GM has increased in recent years. Here, we review the evidence of how helminths and GM can influence various aspects of childhood development and the onset of paediatric diseases. We discuss the emerging evidence of how many of the changes that parasitic worms inflict on their host is enacted through gut microbes. In this light, we argue that helminth-induced microbiota modifications are of great importance in both facing the global challenge of overcoming parasitic infections, and in replicating helminthic protective effects against inflammatory diseases. We propose that deepening our knowledge of helminth-microbiota interactions will uncover novel, safer and more effective therapeutic strategies in combatting an array of childhood disorders.
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Affiliation(s)
- Antonia Piazzesi
- Multimodal Laboratory Medicine Research Area, Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Lorenza Putignani
- Department of Diagnostic and Laboratory Medicine, Unit of Microbiology and Diagnostic Immunology, Unit of Microbiomics and Multimodal Laboratory Medicine Research Area, Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Barbosa FA, Nardelli MJ, Cançado GGL, Silva CF, Osório FMF, Melo RFQ, Taranto DOL, Ferrari TCA, Couto CA, Faria LC. Sarcopenia, body composition and factors associated with variceal gastrointestinal bleeding and splenectomy in hepatosplenic schistosomiasis mansoni. Trans R Soc Trop Med Hyg 2022; 116:1145-1153. [PMID: 35748511 DOI: 10.1093/trstmh/trac052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 05/01/2022] [Accepted: 06/02/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Sarcopenia is a common complication of cirrhosis and an important predictor of morbimortality. We aimed to determine the prevalence of sarcopenia and its associated factors in hepatosplenic schistosomiasis (HSS) as well as to evaluate whether muscle mass and function are associated with variceal upper gastrointestinal bleeding (VUGIB) and previous splenectomy in subjects without other liver diseases. METHODS We conducted a cross-sectional study including adults with HSS who underwent clinical, biochemical, anthropometric, muscle strength and physical performance evaluations and were submitted to bioelectrical impedance analysis and abdominal ultrasound. Sarcopenia was diagnosed according to the 2019 European consensus criteria. RESULTS A total of 66 patients with HSS (62.1% male; mean age 48.8±8.6 y) were included. Overall, six subjects (9.1%) were diagnosed with probable sarcopenia and none had confirmed sarcopenia. Fat-free body mass index (BMI) was independently associated with VUGIB (odds ratio 0.701 [95% confidence interval 0.51 to 0.96]; p=0.025). Compared with patients who did not undergo surgery, individuals who underwent esophagogastric devascularization combined with splenectomy (EGDS) had higher serum lipid levels, fat percentage and frequency of metabolic syndrome, with lower skeletal muscle mass index and hand grip strength. CONCLUSIONS HSS mansoni seems not to cause sarcopenia. However, a lower fat-free BMI was associated with previous VUGIB and the subgroup of patients who underwent EGDS presented higher lipid levels, fat percentage and frequency of metabolic syndrome and lower muscle mass and function.
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Affiliation(s)
- Fernanda A Barbosa
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Mateus J Nardelli
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Guilherme G L Cançado
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil.,Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil.,Hospital da Polícia Militar de Minas Gerais, Rua Pacífico Mascarenhas, s/n-Santa Efigênia, Belo Horizonte, Minas Gerais, 30110-013, Brazil
| | - Catherine F Silva
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Fernanda M F Osório
- Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Rodolfo F Q Melo
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Daniela O L Taranto
- Serviço de Diagnóstico por Imagem, Hospital das Clínicas da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 110 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Teresa C A Ferrari
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil.,Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Claudia A Couto
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil.,Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
| | - Luciana C Faria
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil.,Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte, Minas Gerais, 30130-100, Brazil
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Kasambala M, Mduluza T, Vengesai A, Mduluza-Jokonya T, Jokonya L, Midzi H, Makota RB, Mutemeri A, Maziti E, Dube-Marimbe B, Chibanda D, Mutapi F, Mukaratirwa S. Effect of Schistosoma haematobium infection on the cognitive functions of preschool age children and benefits of treatment from an endemic area in Zimbabwe. BMC Infect Dis 2022; 22:809. [PMID: 36316647 PMCID: PMC9620666 DOI: 10.1186/s12879-022-07784-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/14/2022] [Indexed: 11/26/2022] Open
Abstract
Background Schistosomiasis is known to affect the cognitive functions of children, however, but there is paucity of information on its impact on early childhood development in developing countries where the disease is endemic. This study aimed at determining the effects of schistosomiasis due to Schistosoma haematobium on early childhood development in children below 5 years old from Murewa District, Zimbabwe, including the benefits of treatment. Methods Preschool age children (PSAC) under the age of 5 years were screened at baseline and at 6 months post-treatment for S. haematobium infections diagnosed using the urine filtration method. Cognitive domains were assessed using the Griffith Mental Developmental Scales III on 136 PSAC. Multivariate logistic regression was used to determine the level of association between S. haematobium infection and performance in the cognitive domains adjusting for confounding factors (i.e. nutrition, hemoglobin levels, gender and age). Median Development Quotient scores of each cognitive domain at baseline and at 6 months post-treatment were compared and quantified. Results After adjusting for confounding factors, PSAC infected with S. haematobium had greater odds of having lower scores in the Foundation of Learning Domain (OR = 3.9, p = 0.008), Language and Communication Domain (OR = 3.2, p = 0.017), Eye-Hand Coordination Domains (OR = 10.7, p = 0.001), Personal-Social-Emotional Domain (19.3, p = 0.001) and in the Overall General Development Domain (7.2, p = 0.011). Improvement of cognitive performance was observed at 6 months post treatment in the following Domains; Language and Communication Domain (p = 0.003), Eye-Hand Coordination Domain (p = 0.02) and General Development Domain (p = 0.006). Conclusion The study showed that S. haematobium infection in PSAC is associated with lower cognitive scores in the Foundation of Learning, Language and Communication, Eye-Hand Coordination, Personal-Social-Emotional and in the Overall General Development domains. Our results strengthen the call for inclusion of PSAC in routine deworming programs for the control of urinary schistosomiasis and the need to develop locally validated tools to monitor early child development in endemic areas where resources are limited.
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Affiliation(s)
- Maritha Kasambala
- grid.16463.360000 0001 0723 4123School of Life Sciences, University of KwaZulu-Natal, KwaZulu-Natal, Durban, South Africa ,grid.13001.330000 0004 0572 0760Department of Biological Sciences and Ecology, University of Zimbabwe, Mt Pleasant, P.O. Box MP 167, Harare, Zimbabwe
| | - Takafira Mduluza
- grid.13001.330000 0004 0572 0760Department of Biotechnology and Biochemistry, University of Zimbabwe, Mt Pleasant, P.O. Box MP 167, Harare, Zimbabwe ,grid.16463.360000 0001 0723 4123School of Medicine and Medical Sciences, University of KwaZulu-Natal, KwaZulu-Natal, Durban, South Africa
| | - Arthur Vengesai
- grid.13001.330000 0004 0572 0760Department of Biotechnology and Biochemistry, University of Zimbabwe, Mt Pleasant, P.O. Box MP 167, Harare, Zimbabwe ,grid.442709.c0000 0000 9894 9740Department of Biochemistry, Faculty of Medicine, Midlands State University, Senga Road, Gweru, Zimbabwe
| | - Tariro Mduluza-Jokonya
- grid.13001.330000 0004 0572 0760Department of Biotechnology and Biochemistry, University of Zimbabwe, Mt Pleasant, P.O. Box MP 167, Harare, Zimbabwe
| | - Luxwell Jokonya
- grid.13001.330000 0004 0572 0760Department of Surgery, College of Health Sciences, University of Zimbabwe, Mt Pleasant, P.O. Box MP 167, Harare, Zimbabwe
| | - Herald Midzi
- grid.13001.330000 0004 0572 0760Department of Biotechnology and Biochemistry, University of Zimbabwe, Mt Pleasant, P.O. Box MP 167, Harare, Zimbabwe
| | - Rutendo Birri Makota
- grid.13001.330000 0004 0572 0760Department of Biological Sciences and Ecology, University of Zimbabwe, Mt Pleasant, P.O. Box MP 167, Harare, Zimbabwe
| | - Arnold Mutemeri
- grid.13001.330000 0004 0572 0760Department of Psychiatry, College of Health Sciences, University of Zimbabwe, Mt Pleasant, P.O. Box MP 167, Harare, Zimbabwe
| | - Emmanuel Maziti
- grid.13001.330000 0004 0572 0760Department of Psychiatry, College of Health Sciences, University of Zimbabwe, Mt Pleasant, P.O. Box MP 167, Harare, Zimbabwe
| | - Bazondlile Dube-Marimbe
- grid.13001.330000 0004 0572 0760Department of Psychiatry, College of Health Sciences, University of Zimbabwe, Mt Pleasant, P.O. Box MP 167, Harare, Zimbabwe
| | - Dixon Chibanda
- grid.13001.330000 0004 0572 0760Department of Psychiatry, College of Health Sciences, University of Zimbabwe, Mt Pleasant, P.O. Box MP 167, Harare, Zimbabwe
| | - Francisca Mutapi
- grid.4305.20000 0004 1936 7988Institute for Immunology and Infection Research and Centre for Immunity, Infection and Evolution, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, King’s Buildings, Charlotte Auerbach Rd, EH9 3JT Edinburgh, UK
| | - Samson Mukaratirwa
- grid.16463.360000 0001 0723 4123School of Life Sciences, University of KwaZulu-Natal, KwaZulu-Natal, Durban, South Africa ,grid.412247.60000 0004 1776 0209One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, West Indies Saint Kitts And Nevis
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Al-Niaeemi BH, Ahmed NM, Kharofa WA. Parasitic contamination of some fresh and collected vegetables from Mosul City markets. BIONATURA 2022. [DOI: 10.21931/rb/2022.07.03.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The current study specifies the rate of spreading the parasites in fresh vegetables sold in shops located on the left and right sides of the city of Mosul. 600 samples were collected, 300 for each side left and right, with 15 samples of each Lettuce, Celery, Pepper, Tomatoes, Onions and Carrots. Results showed significant differences in the rates of contaminating variables with intestinal parasites at probability level (p<0.05) on both sides, where it was noticed that the percentage of contamination on the right side (39%) was higher than the one on the left side(26%). The results also showed that fresh vegetables are contaminated with three types of intestinal parasites: Entamoeba histolytica, Giardia Lamblia, Entamoeba coli, and four types of intestinal worms as follows: Ascaris lumbricoides, Trichuris trichura, Hymenolypis nana, Enterobius Vermiculoris. The highest contamination percentage with intestinal protozoa was found with Entamoeba histolytica parasite (67%) on the left side. On the right side, the percentage of contamination was Entamoeba histolytica (50%) in each of the tomato plants and coriander., and the highest percentage of contamination with intestinal worms was by Ascaris lumbricoides worm on the left side (40%) and in the right side (29%). Also shown from the results, the percentage of single contamination in the fresh vegetables was higher than the double and triple contamination. The single contamination was found with a percentage of (82-95%) on both sides, respectively and also noticed in the current study, the leafy vegetables (lettuce and celery) and Tomato, which are the most vegetables contaminated with parasites in both sides in comparison with the rest types of vegetables.
Keywords Contamination; intestinal parasites, vegetables; left and right sides
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Affiliation(s)
- Bushra H. Al-Niaeemi
- Ph.D. Assistant professor of Parasitology-Department of Basic Nursing Science, College of Nursing, University of Mosul, Mosul, Iraq
| | - Najwa M. Ahmed
- M.Sc. Lecturer of Parasitology-Department of Basic Nursing Science, College of Nursing, University of Mosul, Mosul, Iraq
| | - Wahda A. Kharofa
- Ph.D. Assistant professor of Parasitology-Department of Anatomy, College of Medicine, University of Mosul, Mosul, Iraq
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Kadji Fassi JB, Boukeng Jatsa H, Membe Femoe U, Greigert V, Brunet J, Cannet C, Kenfack CM, Gipwe Feussom N, Tienga Nkondo E, Abou-Bacar A, Pfaff AW, Kamgang R, Kamtchouing P, Tchuem Tchuenté LA. Protein undernutrition reduces the efficacy of praziquantel in a murine model of Schistosoma mansoni infection. PLoS Negl Trop Dis 2022; 16:e0010249. [PMID: 35839247 PMCID: PMC9328564 DOI: 10.1371/journal.pntd.0010249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 07/27/2022] [Accepted: 06/28/2022] [Indexed: 01/03/2023] Open
Abstract
Background Undernutrition and schistosomiasis are public health problems and often occur in low and middle-income countries. Protein undernutrition can alter the host-parasite environment system and aggravate the course of schistosomiasis. This study aimed to assess the impact of a low-protein diet on the efficacy of praziquantel. Methodology/Principal findings Thirty-day-old mice were fed with a low-protein diet, and 40 days later, they were individually infected with fifty Schistosoma mansoni cercariae. A 28-day-treatment with praziquantel at 100 mg/kg for five consecutive days followed by distilled water begins on the 36th day post-infection. Mice were sacrificed on the 64th day post-infection. We determined the parasitological burden, liver and intestine histomorphometry, liver injury, and immunomodulation parameters. Praziquantel treatment of infected mice fed with a standard diet (IN-PZQ) resulted in a significant reduction of worm and egg burdens and a normalization of iron and calcium levels. The therapy also improved schistosomiasis-induced hepatopathy and oxidative stress. The anti-inflammatory and immunomodulatory activities of praziquantel were also significant in these mice. When infected mice receiving the low-protein diet were treated with praziquantel (ILP-PZQ), the body weight loss and hepatomegaly were not alleviated, and the worm and liver egg burdens were significantly higher than those of IN-PZQ mice (P < 0.001). The treatment did not reduce the increased activities of ALT and γ-GGT, the high malondialdehyde concentration, and the liver granuloma volume. The iron and calcium levels were not ameliorated and differed from those of IN-PZQ mice (P < 0.001 and P < 0.05). Moreover, in these mice, praziquantel treatment did not reverse the high level of IL-5 and the low mRNA expression of CCL3/MIP-1α and CXCL-10/IP-10 induced by S. mansoni infection. Conclusion/Significance These results demonstrated that a low-protein diet reduced the schistosomicidal, antioxidant, anti-inflammatory, and immunomodulatory activities of praziquantel. Almost 90% of people requiring schistosomiasis preventive chemotherapy in 2018 lived in sub-Saharan Africa. Besides, 205.3 million children under five years suffer and die of undernutrition in low- and middle-income countries. The physiopathology of schistosomiasis mansoni involves liver damage, oxidative stress, and perturbation of the immune response. These disturbances are intensified by undernutrition. Praziquantel is used to treat schistosomiasis, but its efficacy on the comorbidity of S. mansoni infection and undernutrition has not been investigated. We conducted this study to assess the effectiveness of praziquantel on S. mansoni infection in mice fed with a low-protein diet. We recorded growth retardation, hepatomegaly, and high worm and egg burdens in mice fed with a low-protein diet and treated with PZQ. Moreover, the treatment did not reverse the liver function injury, oxidative stress, high iron level, and low calcium level. The proinflammatory cytokine IL-5 was still high, and the gene expression of some macrophage-associated chemokines was reduced. Therefore, this study demonstrated that in a murine model of a low-protein diet, the efficacy of praziquantel on S. mansoni infection was reduced. It also underlines the importance of targeting protein deficiency and malnutrition in populations living in schistosomiasis endemic areas for efficient disease control.
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Affiliation(s)
- Joseph Bertin Kadji Fassi
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
| | - Hermine Boukeng Jatsa
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
- * E-mail:
| | - Ulrich Membe Femoe
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
- Institute of Parasitology and Tropical Diseases, Dynamic Host-Pathogen Interactions, University of Strasbourg, Strasbourg, France
| | - Valentin Greigert
- Institute of Parasitology and Tropical Diseases, Dynamic Host-Pathogen Interactions, University of Strasbourg, Strasbourg, France
| | - Julie Brunet
- Institute of Parasitology and Tropical Diseases, Dynamic Host-Pathogen Interactions, University of Strasbourg, Strasbourg, France
| | - Catherine Cannet
- Laboratory of Histomorphometry, Institute of Legal Medicine, University of Strasbourg, Strasbourg, France
| | - Christian Mérimé Kenfack
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
| | - Nestor Gipwe Feussom
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
| | - Emilienne Tienga Nkondo
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
| | - Ahmed Abou-Bacar
- Institute of Parasitology and Tropical Diseases, Dynamic Host-Pathogen Interactions, University of Strasbourg, Strasbourg, France
| | - Alexander Wilhelm Pfaff
- Institute of Parasitology and Tropical Diseases, Dynamic Host-Pathogen Interactions, University of Strasbourg, Strasbourg, France
| | - René Kamgang
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
| | - Pierre Kamtchouing
- Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
| | - Louis-Albert Tchuem Tchuenté
- Centre for Schistosomiasis and Parasitology, Yaoundé, Cameroon
- Laboratory of Parasitology and Ecology, Department of Animal Biology and Physiology, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
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9
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Mulindwa J, Namulondo J, Kitibwa A, Nassuuna J, Nyangiri OA, Kimuda MP, Boobo A, Nerima B, Busingye F, Candia R, Namukuta A, Ssenyonga R, Ukumu N, Ajal P, Adriko M, Noyes H, de Dood CJ, Corstjens PLAM, van Dam GJ, Elliott AM, Matovu E. High prevalence of Schistosoma mansoni infection and stunting among school age children in communities along the Albert-Nile, Northern Uganda: A cross sectional study. PLoS Negl Trop Dis 2022; 16:e0010570. [PMID: 35895705 PMCID: PMC9359559 DOI: 10.1371/journal.pntd.0010570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/08/2022] [Accepted: 06/08/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Knowing the prevalence of schistosomiasis is key to informing programmes to control and eliminate the disease as a public health problem. It is also important to understand the impact of infection on child growth and development in order to allocate appropriate resources and effort to the control of the disease. METHODS We conducted a survey to estimate the prevalence of schistosomiasis among school aged children in villages along the Albert-Nile shore line in the district of Pakwach, North Western Uganda. A total of 914 children aged between 10-15 years were screened for Schistosoma mansoni using the POC-CCA and Kato Katz (KK) techniques. The infection intensities were assessed by POC-CCA and KK as well as CAA tests. The KK intensities were also correlated with POC-CCA and with CAA intensity. Anthropometric measurements were also taken and multivariate analysis was carried out to investigate their association with infection status. RESULTS The prevalence of schistosomiasis using the POC-CCA diagnostic test was estimated at 85% (95% CI: 83-87), being highest amongst children living closer to the Albert-Nile shoreline. Visual scoring of the POC-CCA results was more sensitive than the Kato Katz test and was positively correlated with the quantified infection intensities by the CAA test. The majority of the children were underweight (BMI<18.5), and most notably, boys had significantly lower height for age (stunting) than girls in the same age range (p < 0.0001), but this was not directly associated with S. mansoni infection. CONCLUSION High prevalence of S. mansoni infection in the region calls for more frequent mass drug administration with praziquantel. We observed high levels of stunting which was not associated with schistosomiasis. There is a need for improved nutrition among the children in the area.
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Affiliation(s)
- Julius Mulindwa
- Department of Biochemistry and Sports Sciences, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - Joyce Namulondo
- Department of Biotechnical and Diagnostic Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Anna Kitibwa
- Department of Biotechnical and Diagnostic Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Jacent Nassuuna
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Oscar Asanya Nyangiri
- Department of Biotechnical and Diagnostic Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Magambo Phillip Kimuda
- Department of Biotechnical and Diagnostic Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Alex Boobo
- Department of Biotechnical and Diagnostic Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Barbara Nerima
- Department of Biochemistry and Sports Sciences, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - Fred Busingye
- Vector Borne & NTD Control Division, Ministry of Health, Kampala, Uganda
| | - Rowel Candia
- Vector Borne & NTD Control Division, Ministry of Health, Kampala, Uganda
| | - Annet Namukuta
- Vector Borne & NTD Control Division, Ministry of Health, Kampala, Uganda
| | - Ronald Ssenyonga
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - Noah Ukumu
- Pakwach District Local Government, District Health Office, Pakwach, Uganda
| | - Paul Ajal
- Pakwach District Local Government, District Health Office, Pakwach, Uganda
| | - Moses Adriko
- Vector Borne & NTD Control Division, Ministry of Health, Kampala, Uganda
| | - Harry Noyes
- Centre for Genomic Research, University of Liverpool, Liverpool, United Kingdom
| | - Claudia J. de Dood
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Paul L. A. M. Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Govert J. van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Alison M. Elliott
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Enock Matovu
- Department of Biotechnical and Diagnostic Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
- * E-mail:
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Al-Haidari SA, Mahdy MAK, Al-Mekhlafi AM, Al Murisi WMS, Thabit AAQ, Al-Amad MA, Al-Shamahi H, Bahashwan OS, Al Serouri A. Intestinal schistosomiasis among schoolchildren in Sana'a Governorate, Yemen: Prevalence, associated factors and its effect on nutritional status and anemia. PLoS Negl Trop Dis 2021; 15:e0009757. [PMID: 34547034 PMCID: PMC8454980 DOI: 10.1371/journal.pntd.0009757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 08/24/2021] [Indexed: 11/18/2022] Open
Abstract
Intestinal schistosomiasis is a neglected tropical disease, causing morbidity and mortality in tropical and subtropical countries. Despite the frequent implementation of mass drug administration with praziquantel, the reinfection with Schistosoma mansoni is still common in Yemen. In addition, there is a scarcity of information on the impact of S. mansoni on nutritional status and anemia among schoolchildren. The present study aimed to determine prevalence and risk factors of intestinal schistosomiasis and investigate its impact on nutritional status and anemia among schoolchildren in Sana’a Governorate, Yemen. It was conducted in 2018 on 445 schoolchildren aged 5–15 years. Biodata, socio-economic, demographic, behavioral and environmental data were collected using a standard questionnaire. S. mansoni was identified and quantified by microscopic examination of Kato-Katz fecal smear. Hemoglobin concentration and anthropometric measurements were estimated using standard methods. The prevalence of S. mansoni was higher in Al-Haimah Al-Dakheliah (33.9%) than Bani Mater (1.4%). Household without tap water (Adjusted Odds Ratio (AOR) = 2.9, 95% Confidence interval (CI): 1.12, 7.55, P = 0.028) was the independent risk factor of the infection. The prevalence of wasting and stunting was 25.0% (95%CI: 21.2%, 29.2%) and 45.8% (95%CI: 41.2%, 50.5%), respectively. The prevalence of underweight among schoolchildren aged 5–10 years was 27.3% (95%CI: 21.9%, 33.4%). The prevalence of anemia was 31.7% (95%CI: 27.5%, 36.2%) with 0.5%, 21.1% and 10.1% being severe, moderate and mild anemia, respectively. S. mansoni (AOR = 4.1, 95%CI: 2.16, 7.84, P < 0.001) and early adolescence (AOR = 6.8, 95%CI: 4.26, 10.82, P < 0.001) were independent predictors of stunting among schoolchildren. The early adolescent schoolchildren (AOR = 3.1, 95%CI: 1.86, 4.97, P < 0.001) and children from families with low (AOR = 2.1, 95%CI: 1.01, 4.15, P = 0.046) or moderate wealth (AOR = 2.3, 95%CI: 1.11, 4.77, P = 0.026) were significantly more wasted. Early adolescence (AOR = 1.8, 95%CI:1.14, 2.78, P = 0.011), female (AOR = 1.6, 95%CI: 1.03, 2.43, P = 0.038) and Al-Haimah Al-Dakheliah District (AOR = 3.4, 95%CI: 1.20, 9.55, P = 0.021) were independent risk factors for anemia. The study findings indicate highly focal prevalence of schistosomiasis in Sana’a Governorate with a public health significance that varies from low to high risk. Approximately half of schoolchildren were stunted, which was associated with S. mansoni infection and early adolescence. One quarter of schoolchildren were wasted with early adolescent schoolchildren and children from poor families being at high risk of wasting. Anemia was a moderate public health threat affecting the female and the early adolescent schoolchildren. The study suggests the implementation of control measures to combat schistosomiasis and integrated diseases control programmes to improve the health status of schoolchildren in Sana’a Governorate. The present study aimed to determine prevalence and risk factors of intestinal schistosomiasis and investigate its impact on nutritional status and anemia among schoolchildren in Sana’a Governorate, Yemen. It was conducted in 2018 on 445 schoolchildren aged 5–15 years. Information was collected using a standard questionnaire. S. mansoni was identified by microscopic examination of Kato-Katz fecal smear. Hemoglobin concentration and anthropometric measurements were estimated using standard methods. The prevalence of S. mansoni was highly focal (1.4–33.9%). Schoolchildren living in households without tap water had significantly high infection rate of S. mansoni. The prevalence of wasting, stunting, underweight and anemia among schoolchildren was 25.0%, 45.8%, 27.3% and 31.7%, respectively. Although S. mansoni was significantly associated with stunting, no significant association was found between S. mansoni and wasting, underweight or anemia. The stunting was higher among early adolescent than young schoolchildren. The early adolescent schoolchildren and children from families with low or moderate wealth were significantly more wasted than schoolchildren from families with high wealth. Schoolchildren in the early adolescence, being female or living in Al-Haimah Al-Dakheliah District were at high risk of anemia. The study suggests implementation of control measures to combat schistosomiasis and integrated diseases control programmes to improve the health status of schoolchildren in Sana’a Governorate.
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Affiliation(s)
- Sami Ahmed Al-Haidari
- Department of Parasitology, Faculty of Medicine, Sana’a University, Sana’a, Yemen
- Diseases Control & Surveillance, Ministry of Public Health and Population, Sana’a, Yemen
| | - Mohammed A. K. Mahdy
- Department of Parasitology, Faculty of Medicine, Sana’a University, Sana’a, Yemen
- * E-mail:
| | | | | | | | | | - Hassan Al-Shamahi
- Department of Medical Microbiology, Faculty of Medicine, Sana’a University, Sana’a, Yemen
| | - Othman Saeed Bahashwan
- Field Epidemiology Training Programme, Ministry of Public Health and Population, Sana’a, Yemen
| | - Abdulwahed Al Serouri
- Field Epidemiology Training Programme, Ministry of Public Health and Population, Sana’a, Yemen
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Abstract
While disease and outbreaks are mainly clonal for bacteria and other asexually reproducing organisms, sexual reproduction in schistosomes and other helminths usually results in unique individuals. For sexually reproducing organisms, the traits conserved in clones will instead be conserved in the group of organisms that tends to breed together, the population. While the same tools are applied to characterize DNA, how results are interpreted can be quite different at times (see another article in this collection, http://www.asmscience.org/content/journal/microbiolspec/10.1128/microbiolspec.AME-0002-2018). It is difficult to know what the real effect any control program has on the parasite population without assessing the health of this population, how they respond to the control measure, and how they recover, if they do. This review, part of the Microbiology Spectrum Curated Collection: Advances in Molecular Epidemiology of Infectious Diseases, concentrates on one approach using pooled samples to study schistosome populations and shows how this and other approaches have contributed to our understanding of this parasite family's biology and epidemiology. *This article is part of a curated collection.
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12
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Das S, Alam MA, Mahfuz M, Arifeen SE, Ahmed T. Relative contributions of the correlates of stunting in explaining the mean length-for-age z-score difference between 24-month-old stunted and non-stunted children living in a slum of Dhaka, Bangladesh: results from a decomposition analysis. BMJ Open 2019; 9:e025439. [PMID: 31366637 PMCID: PMC6678062 DOI: 10.1136/bmjopen-2018-025439] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Using MAL-ED (Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health) Bangladesh birth cohort data, we sought to measure the relative contributions of the most predictive correlates of stunting to mean length-for-age z (LAZ) score difference between stunted and non-stunted children at 24 months of age. SETTING Dhaka, Bangladesh PARTICIPANTS: 211 slum-dwelling children enrolled within 17 days of their birth. VARIABLES AND METHOD The explanatory variables were identified from the following groups: maternal characteristics, birth characteristics, macronutrient intake, socioeconomic status, morbidity and serum micronutrient level. At step 1, predictive correlates of stunting were identified longitudinally (from 9 to 24 months of age) using generalized estimating equations (GEE) model. Then, the relative contributions of the most predictive correlates of stunting to mean LAZ score difference between stunted and non-stunted children at 24 months of age was measured using Blinder-Oaxaca decomposition analysis RESULTS: The GEE multivariable model identified maternal height, birth weight, people per room, gender, having separate room for kitchen and energy intake as the most predictive correlates of stunting. At 24 months, mean LAZ score difference between stunted and non-stunted children was 1.48. The variable by variable decomposition of the LAZ gap identified maternal height (coefficient: -3.04; 95% CI: 0.35 to -6.44), birth weight (coefficient: -0.21; 95% CI: 0.88 to -1.30), people per room (coefficient: 0.31; 95% CI: 0.92 to -0.30) and energy intake (coefficient: -0.12; 95% CI: 0.22 to -0.46) as the top most factors responsible for the mean LAZ score difference between stunted and non-stunted children at 24 months of age. CONCLUSIONS The relative contributions of maternal height and birth weight to LAZ gap signifies that improvement in nutritional status of a women during her adolescence and pregnancy would have an impact on birth weight of her offspring, and ultimately, on linear growth of the child.
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Affiliation(s)
- Subhasish Das
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Ashraful Alam
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mustafa Mahfuz
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shams El Arifeen
- Maternal and Child Health Division (MCHD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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13
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Getachew T, Argaw A. Intestinal helminth infections and dietary diversity score predict nutritional status of urban schoolchildren from southern Ethiopia. BMC Nutr 2017. [DOI: 10.1186/s40795-017-0128-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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14
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Adeniran AA, Mogaji HO, Aladesida AA, Olayiwola IO, Oluwole AS, Abe EM, Olabinke DB, Alabi OM, Ekpo UF. Schistosomiasis, intestinal helminthiasis and nutritional status among preschool-aged children in sub-urban communities of Abeokuta, Southwest, Nigeria. BMC Res Notes 2017; 10:637. [PMID: 29183397 PMCID: PMC5706406 DOI: 10.1186/s13104-017-2973-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Accepted: 11/22/2017] [Indexed: 12/16/2022] Open
Abstract
Objective Schistosomiasis and intestinal helminthiasis are major public health problems with school-aged children considered the most at-risk group. Pre-school aged children (PSAC) are excluded from existing control programs because of limited evidence of infections burden among the group. We assessed the prevalence of infections and effect on nutritional status of preschool aged children in Abeokuta, Southwestern Nigeria. Results A community-based cross-sectional study involving 241 children aged 0–71 months was conducted in 4 sub-urban communities of Abeokuta. Urine and faecal samples were collected for laboratory diagnosis for parasites ova. Nutritional status determined using age and anthropometric parameters was computed based on World Health Organization 2006 growth standards. Data were subjected to descriptive statistics analysis, Chi square, t-test and ANOVA. Of 167 children with complete data, 8 (4.8%) were infected with Schistosoma haematobium; Schistosoma mansoni 6 (3.6%); Taenia species 84 (50.3%); Ascaris lumbricoides 81 (48.5%) and hookworm 63 (37.7%). Overall, 46.7% of the children were malnourished, 39.5% stunted, 22.8% underweight and 11.4% exhibiting wasting/thinness. Mean values of anthropometric indices were generally lower in children with co-infection than those with single infection. We observed low level of schistosomiasis but high prevalence of intestinal helminthiasis and poor nutritional status that calls for inclusion of PSAC in control programs. Electronic supplementary material The online version of this article (10.1186/s13104-017-2973-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Hammed Oladeji Mogaji
- Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
| | - Adeyinka A Aladesida
- Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
| | - Ibiyemi O Olayiwola
- Department of Nutrition and Dietetics, Federal University of Agriculture, Abeokuta, Nigeria
| | - Akinola Stephen Oluwole
- Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
| | | | - Dorcas B Olabinke
- Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
| | - Oladimeji Michael Alabi
- Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
| | - Uwem Friday Ekpo
- Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
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Abstract
The global impact of childhood malnutrition is staggering. The synergism between malnutrition and infection contributes substantially to childhood morbidity and mortality. Anthropometric indicators of malnutrition are associated with the increased risk and severity of infections caused by many pathogens, including viruses, bacteria, protozoa, and helminths. Since childhood malnutrition commonly involves the inadequate intake of protein and calories, with superimposed micronutrient deficiencies, the causal factors involved in impaired host defense are usually not defined. This review focuses on literature related to impaired host defense and the risk of infection in primary childhood malnutrition. Particular attention is given to longitudinal and prospective cohort human studies and studies of experimental animal models that address causal, mechanistic relationships between malnutrition and host defense. Protein and micronutrient deficiencies impact the hematopoietic and lymphoid organs and compromise both innate and adaptive immune functions. Malnutrition-related changes in intestinal microbiota contribute to growth faltering and dysregulated inflammation and immune function. Although substantial progress has been made in understanding the malnutrition-infection synergism, critical gaps in our understanding remain. We highlight the need for mechanistic studies that can lead to targeted interventions to improve host defense and reduce the morbidity and mortality of infectious diseases in this vulnerable population.
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Munisi DZ, Buza J, Mpolya EA, Angelo T, Kinung'hi SM. The Efficacy of Single-Dose versus Double-Dose Praziquantel Treatments on Schistosoma mansoni Infections: Its Implication on Undernutrition and Anaemia among Primary Schoolchildren in Two On-Shore Communities, Northwestern Tanzania. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7035025. [PMID: 29094048 PMCID: PMC5637830 DOI: 10.1155/2017/7035025] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/08/2017] [Accepted: 08/21/2017] [Indexed: 12/16/2022]
Abstract
Administering more than one treatment may increase Praziquantel cure and egg reduction rates, thereby hastening achievement of schistosomiasis transmission control. A total of 431 S. mansoni-infected schoolchildren were randomized to receive either a single or repeated 40 mg/kg Praziquantel dose. Heights, weights, and haemoglobin levels were determined using a stadiometer, weighing scale, and HemoCue, respectively. At 8 weeks, cure rate was higher on repeated dose (93.10%) compared to single dose (68.68%) (p < 0.001). The egg reduction rate was higher on repeated dose (97.54%) compared to single dose (87.27%) (p = 0.0062). Geometric mean egg intensity was lower among those on repeated dose (1.30 epg) compared to single dose (3.18 epg) (p = 0.036) but not at 5 (p > 0.05) and 8 (p > 0.05) months with no difference in reinfection rate. No difference in the prevalence of stunting was observed between the two treatment regimens (p > 0.05) at 8 months, but there was an increase in the prevalence of wasting among those on repeated dose (p < 0.001). There was an increase in the mean haemoglobin levels at 8 months with no difference between the two arms (p > 0.05). To achieve reduction of transmission intensity and disease control in highly endemic areas, repeated treatments alone may not be sufficient. This trial was registered with PACTR201601001416338.
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Affiliation(s)
- David Z. Munisi
- Department of Global Health and Bio-Medical Sciences, School of Life Sciences and Bio-Engineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), P.O. Box 447, Arusha, Tanzania
- Department of Bio-Medical Sciences, School of Medicine and Dentistry, College of Health Sciences, University of Dodoma, P.O. Box 259, Dodoma, Tanzania
| | - Joram Buza
- Department of Global Health and Bio-Medical Sciences, School of Life Sciences and Bio-Engineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), P.O. Box 447, Arusha, Tanzania
| | - Emmanuel A. Mpolya
- Department of Global Health and Bio-Medical Sciences, School of Life Sciences and Bio-Engineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), P.O. Box 447, Arusha, Tanzania
| | - Teckla Angelo
- Department of Global Health and Bio-Medical Sciences, School of Life Sciences and Bio-Engineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), P.O. Box 447, Arusha, Tanzania
| | - Safari M. Kinung'hi
- National Institute for Medical Research (NIMR), Mwanza Research Centre, Isamilo Road, P.O. Box 1462, Mwanza, Tanzania
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Musuva R, Shen Y, Wei X, Binder S, Ivy JA, Secor WE, Montgomery SP, King CH, Mwinzi PNM. Change in children's school behavior after mass administration of praziquantel for Schistosoma mansoni infection in endemic areas of western Kenya: A pilot study using the Behavioral Assessment System for Children (BASC-2). PLoS One 2017; 12:e0181975. [PMID: 28746403 PMCID: PMC5528892 DOI: 10.1371/journal.pone.0181975] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 07/10/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Schistosomiasis is a parasite-related chronic inflammatory condition that can cause anemia, decreased growth, liver abnormalities, and deficits in cognitive functioning among children. METHODOLOGY/PRINCIPAL FINDINGS This study used the Behavior Assessment System for Children (BASC-2) to collect data on thirty-six 9-12 year old school-attending children's behavioral profiles in an Schistosoma mansoni-endemic area of western Kenya, before and after treatment with praziquantel for S. mansoni infection. BASC-2 T scores were significantly reduced post-treatment (p < 0.05) for each of the 'negative' behavior categories including externalizing problems (hyperactivity, aggression, and conduct problems that are disruptive in nature), internalizing problems (anxiety, depression, somatization, atypicality, and withdrawal), school problems (academic difficulties, included attention problems and learning problems), and the composite behavioral symptoms index (BSI), signifying improved behavior. While the observed improvement in the 'positive' behavior category of adaptive skills (adaptability, functional communication, social skills, leadership, and study skills) was not statistically significant, there were significant improvements in two adaptive skills subcategories: social skills and study skills. CONCLUSION/SIGNIFICANCE Results of this study suggest that children have better school-related behaviors without heavy S. mansoni infection, and that infected children's behaviors, especially disruptive problem behaviors, improve significantly after praziquantel treatment.
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Affiliation(s)
- Rosemary Musuva
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Ye Shen
- Department of Epidemiology & Biostatistics, University of Georgia, Athens, Georgia, United States of America
| | - Xianjue Wei
- Department of Epidemiology & Biostatistics, University of Georgia, Athens, Georgia, United States of America
| | - Sue Binder
- Schistosomiasis Consortium for Operational Research and Evaluation, University of Georgia, Athens, Georgia, United States of America
| | - Julianne A. Ivy
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - W. Evan Secor
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Susan P. Montgomery
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Charles H. King
- Schistosomiasis Consortium for Operational Research and Evaluation, University of Georgia, Athens, Georgia, United States of America
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Pauline N. M. Mwinzi
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
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Tickell KD, Walson JL. Nutritional Enteric Failure: Neglected Tropical Diseases and Childhood Stunting. PLoS Negl Trop Dis 2016; 10:e0004523. [PMID: 27124296 PMCID: PMC4849571 DOI: 10.1371/journal.pntd.0004523] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Kirkby D Tickell
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Judd L Walson
- Departments of Global Health, Pediatrics, Medicine, and Epidemiology, University of Washington, Seattle, Washington, United States of America
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Zoni AC, Catalá L, Ault SK. Schistosomiasis Prevalence and Intensity of Infection in Latin America and the Caribbean Countries, 1942-2014: A Systematic Review in the Context of a Regional Elimination Goal. PLoS Negl Trop Dis 2016; 10:e0004493. [PMID: 27007193 PMCID: PMC4805296 DOI: 10.1371/journal.pntd.0004493] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 02/04/2016] [Indexed: 12/11/2022] Open
Abstract
Background In 2012 the World Health Assembly adopted resolution WHA65.21 on elimination of schistosomiasis, calling for increased investment in schistosomiasis control and support for countries to initiate elimination programs. This study aims to analyze prevalence and intensity of Schistosoma mansoni infection in children in Latin America and the Caribbean countries and territories (LAC), at the second administrative level or lower. Methodology A systematic review of schistosomiasis prevalence and intensity of infection was conducted by searching at PubMed, LILACS and EMBASE. Experts on the topic were informally consulted and institutional web pages were reviewed (PAHO/WHO, Ministries of Health). Only SCH infection among children was registered because it can be a ‘proxi-indicator’ of recent transmission by the time the study is conducted. Principal Findings One hundred thirty two full-text articles met the inclusion criteria and provided 1,242 prevalence and 199 intensity of infection data points. Most of them were from Brazil (69.7%). Only Brazil published studies after 2001, showing several 'hot spots' with high prevalence. Brazil, Venezuela, Suriname and Saint Lucia need to update the epidemiological status of schistosomiasis to re-design their national programs and target the elimination of Schistosoma mansoni transmission by 2020. In Antigua and Barbuda, Dominican Republic, Guadeloupe, Martinique, Montserrat and Puerto Rico schistosomiasis transmission may be interrupted. However the compilation of an elimination dossier and follow-up surveys, per WHO recommendations, are needed to verify that status. Hence, the burden of subtle SCH chronic infection may be still present and even high in countries that may have eliminated transmission. Heterogeneity in the methodologies used for monitoring and evaluating the progress of the schistosomiasis programs was found, making cross-national and chronological comparisons difficult. Conclusions There is a need for updating the schistosomiasis status in the historically endemic countries and territories in LAC to address the required public health interventions for control and elimination programs or to verify the elimination of transmission of Schistosoma mansoni. Improved reporting and standardization of the monitoring and evaluation methodologies used are recommended, while using available WHO guidelines. Meeting a regional elimination goal will require additional and improved epidemiological data by age group and sex. Schistosomiasis (Schistosoma spp) is an intestinal parasitic infection that causes anaemia, stunted growth, impaired cognition, and decreased physical fitness among other pathological effects. Currently, the control of schistosomiasis relies principally on mass drug administration of praziquantel. In addition, the implementation of further interventions such as snail (intermediate host) control, improving access to safe water and sanitation are required to achieve elimination of transmission in humans. An updated epidemiological situation will help countries to design tailor-made interventions enabling a step-up in prevention and control measures with the goal of elimination of transmission of this disease by 2020. In the region of the Americas, Schistosoma mansoni is the only species present that infect humans. This systematic review shows that in this region there is a need for re-mapping the schistosomiasis epidemiological situation in certain areas and countries in order to implement and optimize the best public health interventions needed to interrupt transmission or verify elimination of transmission. The methodology for monitoring and evaluating schistosomiasis control programs are well defined by current WHO guidelines. However, further investigations and guidelines on suitable tools for monitoring and evaluating schistosomiasis elimination programs and criteria and procedures for validating the elimination are required, and are currently being undertaken by WHO.
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Affiliation(s)
| | - Laura Catalá
- Pan American Health Organization/World Health Organization, Washington, D.C., United States of America
- * E-mail: ;
| | - Steven K. Ault
- Pan American Health Organization/World Health Organization, Washington, D.C., United States of America
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Bresnahan KA, Tanumihardjo SA. Undernutrition, the acute phase response to infection, and its effects on micronutrient status indicators. Adv Nutr 2014; 5:702-11. [PMID: 25398733 PMCID: PMC4224207 DOI: 10.3945/an.114.006361] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Infection and undernutrition are prevalent in developing countries and demonstrate a synergistic relation. Undernutrition increases infection-related morbidity and mortality. The acute phase response (APR) is an innate, systemic inflammatory reaction to a wide array of disruptions in a host's homeostasis, including infection. Released from immune cells in response to deleterious stimuli, proinflammatory cytokines act on distant tissues to induce behavioral (e.g., anorexia, weakness, and fatigue) and systemic effects of the APR. Cytokines act to increase energy and protein requirements to manifest fever and support hepatic acute phase protein (APP) production. Blood concentrations of glucose and lipid are augmented to provide energy to immune cells in response to cytokines. Additionally, infection decreases intestinal absorption of nutrients and can cause direct loss of micronutrients. Traditional indicators of iron, zinc, and vitamin A status are altered during the APR, leading to inaccurate estimations of deficiency in populations with a high or unknown prevalence of infection. Blood concentrations of APPs can be measured in nutrition interventions to assess the time stage and severity of infection and correct for the APR; however, standardized cutoffs for nutrition applications are needed. Protein-energy malnutrition leads to increased gut permeability to pathogens, abnormal immune cell populations, and impaired APP response. Micronutrient deficiencies cause specific immune impairments that affect both innate and adaptive responses. This review describes the antagonistic interaction between the APR and nutritional status and emphasizes the need for integrated interventions to address undernutrition and to reduce disease burden in developing countries.
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Mekonnen Z, Meka S, Zeynudin A, Suleman S. Schistosoma mansoni infection and undernutrition among school age children in Fincha'a sugar estate, rural part of West Ethiopia. BMC Res Notes 2014; 7:763. [PMID: 25348748 PMCID: PMC4216851 DOI: 10.1186/1756-0500-7-763] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 10/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parasitic infection like schistosomiasis is known to exert a negative effect on nutritional status of school-aged children. However, studies associating parasitic infections with undernutrition are scarce. Thus, this study was primarily to document the association between Schistosoma mansoni infection and undernutrition among school-aged children in a rural setting of Fincha'a Sugar Estate, Ethiopia. METHODS A cross-sectional study was conducted on a total of 453 school-aged children (5-18 years). Stool specimen was collected and examined using the standard Kato-katz technique. Children's height-for-Age Z-score (HAZ) and Body mass index-for-Age Z- score (BAZ) was determined. Z-Scores for each nutritional index were compared with the WHO child growth standards reference values. Children were considered stunted or wasted as HAZ or BAZ falls below -2 standard deviations, respectively. RESULT The overall prevalence of Schistosoma mansoni infection was 53.2%. Out of the total school children examined, 11.5% and 13.2% were stunted and wasted, respectively. Multivariate logistic regression analysis was done to determine the relationship between Schistosoma mansoni infection and nutritional status controlling for other factors. Accordingly, stunting was not significantly associated while wasting was negatively associated with Schistosoma mansoni infection. Paternal occupation was the best predictor of stunting and wasting such that, unemployed fathers have 4.28 (95% CI; 2.13, 8.63) (p < 0.001) and 3.83, 95% CI; 1.89, 7.79) (p < 0.001) chance of having stunted and wasted children, respectively. CONCLUSION Schistosoma mansoni infection is highly prevalent in the study area. The high prevalence of wasting, and moderate level of stunting among study subjects in this study area indicate that they are affected by both infection and undernutrition. Therefore, regular preventive chemotherapy against S. mansoni and other control measures are recommended. Moreover, possibilities of synchronized nutritional rehabilitation and creation of employment opportunities to the families should be looked for.
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Affiliation(s)
- Zeleke Mekonnen
- />Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
| | - Selima Meka
- />Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
| | - Ahmed Zeynudin
- />Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
| | - Sultan Suleman
- />Department of Pharmacy, College of Public Health and Medical Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia
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Papier K, Williams GM, Luceres-Catubig R, Ahmed F, Olveda RM, McManus DP, Chy D, Chau TNP, Gray DJ, Ross AGP. Childhood malnutrition and parasitic helminth interactions. Clin Infect Dis 2014; 59:234-43. [PMID: 24704723 DOI: 10.1093/cid/ciu211] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is evidence to support that nutritional deficiency can reduce the body's immune function, thereby decreasing resistance to disease and increasing susceptibility to intestinal parasites. METHODS A cross-sectional survey was carried out on 693 school-aged children from 5 schistosomiasis-endemic villages in Northern Samar, the Philippines. Data on dietary intake, nutritional status, and intestinal parasitic infection were collected. RESULTS The prevalence of stunting, thinness, and wasting was 49.2%, 27.8%, and 59.7% of all children. The proportion of children infected with Schistosoma japonicum (15.6%, P = .03) and hookworm (22.0%, P = .05) were significantly lower among children who met the recommended energy and nutrient intake (RENI) for total calories. The percentage of children infected with Trichuris trichiura was highest among children who did not meet the RENI for energy (74.1%, P = .04), iron (73.4%, P = .01), thiamine (74.0%, P = .00), and riboflavin (73.3%, P = .01). Susceptibility to having 1 or more parasitic infections was significantly associated with poor intake of energy (P = .04), thiamine (P = .02), and riboflavin (P = .01).The proportion of stunted children was significantly higher among children who did not meet the RENI for energy (68.9%, P = .002), protein (54.0%, P = .004), or niacin (30.8%, P = .02) and for those infected with hookworm (31.8%, P = .0002). After adjusting for potential confounders, protein intake less than the RENI (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.03-2.14), and hookworm infection (OR, 1.77; 95% CI, 1.22-2.55) were the major predictors of stunting. CONCLUSIONS The results support the hypothesis that poor nutrient intake may increase susceptibility to parasitic diseases and together they negatively affect childhood nutritional status.
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Affiliation(s)
- Keren Papier
- Department of Public Health, School of Medicine, Griffith University, Gold Coast Campus and
| | - Gail M Williams
- School of Population Health, University of Queensland, Brisbane, Australia
| | - Ruby Luceres-Catubig
- Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, the Philippines
| | - Faruk Ahmed
- Department of Public Health, School of Medicine, Griffith University, Gold Coast Campus and
| | - Remigio M Olveda
- Department of Health, Research Institute for Tropical Medicine, Muntinlupa City, the Philippines
| | | | - Delia Chy
- Municipal Office of Health, Palapag, Northern Samar, the Philippines
| | - Thao N P Chau
- Discipline of Public Health, Flinders University, Adelaide
| | - Darren J Gray
- School of Population Health, University of Queensland, Brisbane, Australia
| | - Allen G P Ross
- Griffith Health Institute, Griffith University, Gold Coast Campus, Australia
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Sady H, Al-Mekhlafi HM, Mahdy MAK, Lim YAL, Mahmud R, Surin J. Prevalence and associated factors of Schistosomiasis among children in Yemen: implications for an effective control programme. PLoS Negl Trop Dis 2013; 7:e2377. [PMID: 23991235 PMCID: PMC3749985 DOI: 10.1371/journal.pntd.0002377] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 07/04/2013] [Indexed: 11/18/2022] Open
Abstract
Background Schistosomiasis, one of the most prevalent neglected tropical diseases, is a life-threatening public health problem in Yemen especially in rural communities. This cross-sectional study aims to determine the prevalence and associated risk factors of schistosomiasis among children in rural Yemen. Methods/Findings Urine and faecal samples were collected from 400 children. Urine samples were examined using filtration technique for the presence of Schistosoma haematobium eggs while faecal samples were examined using formalin-ether concentration and Kato Katz techniques for the presence of S. mansoni. Demographic, socioeconomic and environmental information were collected via a validated questionnaire. Overall, 31.8% of the participants were found to be positive for schistosomiasis; 23.8% were infected with S. haematobium and 9.3% were infected with S. mansoni. Moreover, 39.5% of the participants were anaemic whereas 9.5% had hepatosplenomegaly. The prevalence of schistosomiasis was significantly higher among children aged >10 years compared to those aged ≤10 years (P<0.05). Multivariate analysis confirmed that presence of other infected family member (P<0.001), low household monthly income (P = 0.003), using unsafe sources for drinking water (P = 0.003), living nearby stream/spring (P = 0.006) and living nearby pool/pond (P = 0.002) were the key factors significantly associated with schistosomiasis among these children. Conclusions/Significance This study reveals that schistosomiasis is still highly prevalent in Yemen. These findings support an urgent need to start an integrated, targeted and effective schistosomiasis control programme with a mission to move towards the elimination phase. Besides periodic drug distribution, health education and community mobilisation, provision of clean and safe drinking water, introduction of proper sanitation are imperative among these communities in order to curtail the transmission and morbidity caused by schistosomiasis. Screening and treating other infected family members should also be adopted by the public health authorities in combating this infection in these communities. Schistosomiasis remains one of the most serious and prevalent diseases worldwide. Despite intensive control efforts by the government and international bodies, schistosomiasis is the second cause of death, after malaria, in Yemen, with an estimated 3 million cases. We screened 400 children in rural areas of five provinces in Yemen for the presence of schistosomiasis. Overall, 31.8% of the children were found to be positive for schistosomiasis; 23.8% were infected by Schistosoma haematobium, and 9.3% were infected by S. mansoni. The study identified the presence of other family members infected with schistosomiasis, low household monthly income, using unsafe water supply as a source for drinking water, living nearby stream/spring and/or pool/pond as the key factors significantly associated with schistosomiasis in these communities. Innovative and integrated control measures to control this infection should be implemented among this population. Periodic school-based and community-based drug distribution, health education, provision of clean and safe drinking water, introduction of proper sanitation will help to reduce the prevalence and morbidity of schistosomiasis among these communities.
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Affiliation(s)
- Hany Sady
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hesham M. Al-Mekhlafi
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
- * E-mail:
| | - Mohammed A. K. Mahdy
- Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
- Research Department, University of Science and Technology, Sana'a, Yemen
| | - Yvonne A. L. Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rohela Mahmud
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Johari Surin
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Association between intestinal helminth infections and underweight among school children in Tikur Wuha Elementary School, Northwestern Ethiopia. J Infect Public Health 2013; 6:125-33. [DOI: 10.1016/j.jiph.2012.11.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 11/09/2012] [Accepted: 11/30/2012] [Indexed: 11/18/2022] Open
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Geiger SM, Jardim-Botelho A, Williams W, Alexander N, Diemert DJ, Bethony JM. Serum CCL11 (eotaxin-1) and CCL17 (TARC) are serological indicators of multiple helminth infections and are driven by Schistosoma mansoni infection in humans. Trop Med Int Health 2013; 18:750-60. [PMID: 23496801 DOI: 10.1111/tmi.12095] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate systemic serum cytokine and chemokine markers for inflammation and Th1/Th2 responses in relation to multiple helminth infections, parasite burden and/or nutritional status of individuals. METHODS In a longitudinal study, stool samples from 210 individuals from an area highly endemic for Ascaris lumbricoides, Necator americanus and Schistosoma mansoni were examined before and 12 months after clearance of parasites by chemotherapy. On both occasions, the presence of mono- or multiple infections and intensities of infection were compared with nutritional parameters and with serum cytokines or chemokines as markers for inflammatory, regulatory or Th1- or Th2-type immune responses. RESULTS Before treatment, we were not able to associate any altered nutritional parameters with increased inflammatory responses, and highest intensities of infection were found in eutrophic participants with multiple infections. In contrast, major changes in serum Th2-type chemokine levels were measured in individuals infected with intestinal helminths and/or S. mansoni, and resulted in significantly higher CCL11 and CCL17 concentrations, both before treatment and after reinfection. CONCLUSIONS The driving force for these elevated type 2 serum chemokine concentrations was an S. mansoni infection and faecal egg counts significantly correlated with serum IL-10 concentrations.
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Affiliation(s)
- Stefan M Geiger
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Belo Horizonte, Brazil.
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The association between multiple intestinal helminth infections and blood group, anaemia and nutritional status in human populations from Dore Bafeno, southern Ethiopia. J Helminthol 2013; 88:152-9. [DOI: 10.1017/s0022149x12000855] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractIn this cross-sectional study, the associations between helminth infections and ABO blood group, anaemia and undernutrition were investigated in 480 febrile outpatients who visited Dore Bafeno Health Centre, southern Ethiopia, in December 2010. Stool specimens were processed using the Kato–Katz method and examined for intestinal helminth infections. Haemoglobin level was measured using a HemoCue machine and blood group was determined using an antisera haemagglutination test. Nutritional status of the study participants was assessed using height and weight measurements. Among the study participants, 50.2% were infected with intestinal helminths. Ascaris lumbricoides (32.7%), Trichuris trichiura (12.7%), Schistosoma mansoni (11.9%) and hookworm (11.0%) were the most frequently diagnosed helminths. The odds of infection and mean eggs per gram of different intestinal helminth species were comparable between the various blood groups. Among individuals who were infected with intestinal helminth(s), the mean haemoglobin level was significantly lower in individuals harbouring three or more helminth species and blood type AB compared to cases with double or single helminth infection and blood type O, respectively. The odds of being underweight was significantly higher in A. lumbricoides and T. trichiura infected individuals of age ≤ 5 and ≥ 20 years, respectively, when compared to individuals of the matching age group without intestinal helminths. In conclusion, infection with multiple intestinal helminths was associated with lower haemoglobin level, which was more severe in individuals with blood type AB. Future studies should focus on mechanisms by which blood group AB exacerbates the helminth-related reduction in mean haemoglobin level.
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Souza SS, Barbosa LM, Guimarães IC, Blank WA, Reis RB, Reis MG, Blanton RE, Andrade ZA. Genetic population structure of cercariae from an urban foci of Schistosoma mansoni, Brazil. Am J Trop Med Hyg 2012; 87:843-9. [PMID: 22949518 PMCID: PMC3516259 DOI: 10.4269/ajtmh.2012.11-0641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 07/29/2012] [Indexed: 11/07/2022] Open
Abstract
Rapid urbanization in Brazil has meant that many persons from rural areas where Schistosoma mansoni is endemic have migrated to cities. Discovery of a focus of active transmission in the city of Salvador prompted a citywide survey for active and potential transmission sites. Cercariae shed from infected snails collected from four locations were used to determine how these samples were related and if they were representative of the parasite population infecting humans. Each cercarial collection was greatly differentiated from the others, and diversity was significantly lower when compared with eggs from natural human infections in one site. Egg samples collected 7 years apart in one neighborhood showed little differentiation (Jost's D = 0.01-0.03). Given the clonal nature of parasite reproduction in the snail host and the short-term acquisition of parasites, cercariae from collections at one time point are unlikely to be representative of the diversity in the human population.
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Affiliation(s)
- Samaly S Souza
- Gonçalo Moniz Research Centre, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.
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Samuels AM, Matey E, Mwinzi PNM, Wiegand RE, Muchiri G, Ireri E, Hyde M, Montgomery SP, Karanja DMS, Secor WE. Schistosoma mansoni morbidity among school-aged children: a SCORE project in Kenya. Am J Trop Med Hyg 2012; 87:874-82. [PMID: 22987651 DOI: 10.4269/ajtmh.2012.12-0397] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Schistosomiasis control programs aim to reduce morbidity but are evaluated by infection prevalence and intensity reduction. We present baseline cross-sectional data from a nested cohort study comparing indicators of morbidity for measuring program impact. Eight hundred twenty-two schoolchildren 7-8 years of age from Nyanza Province, Kenya, contributed stool for diagnosis of Schistosoma mansoni and soil-transmitted helminths (STH) and blood smears for malaria, and were evaluated for anemia, quality of life, exercise tolerance, anthropometry, and ultrasound abnormalities. Schistosoma mansoni, STH, and malaria infection prevalence were 69%, 25%, and 8%, respectively. Only anemia and S. mansoni infection (adjusted odds ratio [aOR] = 1.70; confidence interval [CI] = 1.03-2.80), and hepatomegaly and heavy S. mansoni infection (aOR = 2.21; CI = 1.19-4.11) were associated. Though anemia and hepatomegaly appeared most useful at baseline, additional morbidity indicators may be sensitive longitudinal measures to evaluate schistosomiasis program health impact.
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Affiliation(s)
- Aaron M Samuels
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Opara KN, Udoidung NI, Opara DC, Okon OE, Edosomwan EU, Udoh AJ. The Impact of Intestinal Parasitic Infections on the Nutritional Status of Rural and Urban School-Aged Children in Nigeria. Int J MCH AIDS 2012; 1:73-82. [PMID: 27621960 PMCID: PMC4948163 DOI: 10.21106/ijma.8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Intestinal parasitic infection and undernutrition are still major public health problems in poor and developing countries. The objective of this study was to assess the relationship between intestinal parasitic infection and nutritional status in 405 primary school children from rural and urban areas of Akwa Ibom State, Nigeria. METHODS This cross-sectional survey in 2009 obtained anthropometric data, height-for-age (HA), weight-for-height (WH) and weight-for-age (WA) Z-scores from each child and fecal samples were also collected and screened for intestinal parasites using standard parasitological protocols. RESULTS The prevalence of infection with any intestinal parasite was 67.4%. A total of six intestinal parasites were detected; hookworm (41.7%) had the highest prevalence. The prevalence of intestinal parasites and undernutrition was significantly higher in rural than in urban children (P<0.001). The prevalence of stunting (HAZ < -2), underweight (WAZ < -2) and wasting (WHZ < -2) for rural and urban children were 42.3% vs. 29.7%; underweight 43.2% vs. 29.6% and wasting 10.9% vs. 6.4%, respectively. With respect to nutritional indicators, the infected children had significantly (P<0.05) higher z-scores than the uninfected children. Multivariate logistic regression analysis showed that only Hookworm and Ascaris lumbricoides were each significantly (P<0.05) associated with stunting, wasting, and underweight. CONCLUSIONS AND PUBLIC HEALTH IMPLICATIONS Since intestinal parasitic infections are associated with malnutrition, controlling these parasites could increase the physical development and well-being of the affected children.
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Affiliation(s)
- Kenneth N Opara
- Department of Zoology, University of Uyo, Uyo, Akwa Ibom State, Nigeria
| | - Nsima I Udoidung
- Department of Zoology, University of Uyo, Uyo, Akwa Ibom State, Nigeria
| | - Dominic C Opara
- Department of Community Health, University of Uyo, Uyo, Nigeria
| | - Okpok E Okon
- Department of Zoology and Environmental Biology, University of Calabar, Cross River State, Nigeria
| | - Evelyn U Edosomwan
- Department of Animal and Environmental Biology, University of Benin, Benin City. Nigeria
| | - Anietie J Udoh
- Department of Zoology, University of Uyo, Uyo, Akwa Ibom State, Nigeria
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Werneck GL, Hasselmann MH, Gouvêa TG. Panorama dos estudos sobre nutrição e doenças negligenciadas no Brasil. CIENCIA & SAUDE COLETIVA 2011; 16:39-62. [DOI: 10.1590/s1413-81232011000100009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Accepted: 04/15/2010] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste artigo é revisar a literatura acerca da relação entre nutrição e doenças infecciosas negligenciadas em populações brasileiras, focalizando especificamente a doença de Chagas, a malária, a esquistossomose e a leishmaniose visceral. A revisão da literatura foi realizada em janeiro de 2010 a partir de um levantamento bibliográfico nas bases SciELO, LILACS e Medline. Foram captados 293 resumos; dentre estes, 66 foram selecionados para leitura de texto completo e 43 incluídos na revisão. A presente revisão salienta a relevância dos estudos nutricionais no campo da Saúde Coletiva para melhor compreensão dos aspectos envolvidos no risco e prognóstico de malária, esquistossomose, leishmaniose visceral e doença de Chagas. Evidencia-se também certo desbalanceamento na literatura sobre o tema, com muito mais estudos experimentais do que estudos em populações humanas. Ainda que os primeiros sejam essenciais para esclarecer os mecanismos fisiopatológicos subjacentes à relação entre déficits nutricionais e estas doenças, estudos bem delineados em populações humanas são fundamentais para que o conhecimento científico se traduza em ações efetivas para o controle de doenças negligenciadas.
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Parasites and poverty: the case of schistosomiasis. Acta Trop 2010; 113:95-104. [PMID: 19962954 DOI: 10.1016/j.actatropica.2009.11.012] [Citation(s) in RCA: 398] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Revised: 07/10/2009] [Accepted: 11/23/2009] [Indexed: 11/21/2022]
Abstract
Simultaneous and sequential transmission of multiple parasites, and their resultant overlapping chronic infections, are facts of life in many underdeveloped rural areas. These represent significant but often poorly measured health and economic burdens for affected populations. For example, the chronic inflammatory process associated with long-term schistosomiasis contributes to anaemia and undernutrition, which, in turn, can lead to growth stunting, poor school performance, poor work productivity, and continued poverty. To date, most national and international programs aimed at parasite control have not considered the varied economic and ecological factors underlying multi-parasite transmission, but some are beginning to provide a coordinated approach to control. In addition, interest is emerging in new studies for the re-evaluation and recalibration of the health burden of helminthic parasite infection. Their results should highlight the strong potential of integrated parasite control in efforts for poverty reduction.
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Blank WA, Reis EAG, Thiong'o FW, Braghiroli JF, Santos JM, Melo PRS, Guimarães ICS, Silva LK, Carmo TMA, Reis MG, Blanton RE. Analysis of Schistosoma mansoni population structure using total fecal egg sampling. J Parasitol 2010; 95:881-9. [PMID: 20049994 DOI: 10.1645/ge-1895.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Many parasite populations are difficult to sample because they are not uniformly distributed between several host species and are often not easily collected from the living host, thereby limiting sample size and possibly distorting the representation of the population. For the parasite Schistosoma mansoni, we investigated the use of eggs, in aggregate, from the stools of infected individuals as a simple and representative sample. Previously, we demonstrated that microsatellite allele frequencies can be accurately estimated from pooled DNA of cloned S. mansoni adults. Here, we show that genotyping of parasite populations from reproductively isolated laboratory strains can be used to identify these specific populations based on characteristic patterns of allele frequencies, as observed by polyacrylamide gel electrophoresis and automated sequencer analysis of fluorescently labeled PCR products. Microsatellites used to genotype aggregates of eggs collected from stools of infected individuals produced results consistent with the geographic distribution of the samples. Preferential amplification of smaller alleles, and stutter PCR products, had negligible effect on measurement of genetic differentiation. Direct analysis of total stool eggs can be an important approach to questions of population genetics for this parasite by increasing the sample size to thousands per infected individual and by reducing bias.
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Affiliation(s)
- Walter A Blank
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio 44106, USA
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Mupfasoni D, Karibushi B, Koukounari A, Ruberanziza E, Kaberuka T, Kramer MH, Mukabayire O, Kabera M, Nizeyimana V, Deville MA, Ruxin J, Webster JP, Fenwick A. Polyparasite helminth infections and their association to anaemia and undernutrition in Northern Rwanda. PLoS Negl Trop Dis 2009; 3:e517. [PMID: 19753110 PMCID: PMC2737105 DOI: 10.1371/journal.pntd.0000517] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Accepted: 08/20/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Intestinal schistosomiasis and soil-transmitted helminth (STH) infections constitute major public health problems in many parts of sub-Saharan Africa. In this study we examined the functional significance of such polyparasite infections in anemia and undernutrition in Rwandan individuals. METHODS Three polyparasite infection profiles were defined, in addition to a reference profile that consisted of either no infections or low-intensity infection with only one of the focal parasite species. Logistic regression models were applied to data of 1,605 individuals from 6 schools in 2 districts of the Northern Province before chemotherapeutic treatment in order to correctly identify individuals who were at higher odds of being anaemic and/or undernourished. FINDINGS Stunted relative to nonstunted, and males compared to females, were found to be at higher odds of being anaemic independently of polyparasite infection profile. The odds of being wasted were 2-fold greater for children with concurrent infection of at least 2 parasites at M+ intensity compared to those children with the reference profile. Males compared to females and anaemic compared to nonanaemic children were significantly more likely to be stunted. None of the three polyparasite infection profiles were found to have significant effects on stunting. CONCLUSION The present data suggest that the levels of polyparasitism, and infection intensities in the Rwandan individuals examined here may be lower as compared to other recent similar epidemiological studies in different regions across sub-Saharan Africa. Neither the odds of anaemia nor the odds of stunting were found to be significantly different in the three-polyparasite infection profiles. However, the odds of wasting were higher in those children with at least two parasites at M+ intensity compared to those children with the reference profile. Nevertheless, despite the low morbidity levels indicated in the population under study here, we recommend sustainable efforts for the deworming of affected populations to be continued in order to support the economic development of the country.
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Affiliation(s)
| | | | - Artemis Koukounari
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
- * E-mail:
| | | | | | - Michael H. Kramer
- TRAC Plus - Center for Treatment and Research on AIDS, Malaria, Tuberculosis and Other Epidemics, Kigali, Rwanda
| | | | | | - Vianney Nizeyimana
- TRAC Plus - Center for Treatment and Research on AIDS, Malaria, Tuberculosis and Other Epidemics, Kigali, Rwanda
| | - Marie-Alice Deville
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Josh Ruxin
- Access Project, Kigali, Rwanda
- The Earth Institute, Columbia University, New York, New York, United States of America
| | - Joanne P. Webster
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Alan Fenwick
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
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Kloos H, Correa-Oliveira R, Quites HF, Souza MC, Gazzinelli A. Socioeconomic studies of schistosomiasis in Brazil: a review. Acta Trop 2008; 108:194-201. [PMID: 18694715 PMCID: PMC2650274 DOI: 10.1016/j.actatropica.2008.07.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2007] [Revised: 06/24/2008] [Accepted: 07/11/2008] [Indexed: 10/21/2022]
Abstract
This review finds considerable evidence that socioeconomic status has significantly influenced the transmission, spread and treatment of schistosomiasis in Brazil. High infection rates persist among both the rural and urban poor. Rural living, poor housing and water supplies and low educational level were major factors in schistosomiasis occurrence among agricultural populations. In urban areas, prevailing living conditions in shantytowns and labor migrations from and periodic return movements to rural areas were predictive of schistosomiasis. The risk of the establishment of new transmission foci exists in both rural and urban areas, conferred by and affecting poorer people. Associations between schistosomiasis and socioeconomic parameters, persisting inequities in health services accessibility, prevailing health impacts of schistosomiasis, and the ongoing decentralization of health services point to opportunities and strategies for focused interventions aimed at promoting health-enhancing behavior and living conditions and improving access to health care. The authors call for multidisciplinary studies to better examine the complexities of the socioeconomic environment in relation to schistosomiasis and for economic programs to reduce prevailing socioeconomic inequalities.
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Affiliation(s)
- Helmut Kloos
- Department of Epidemiology and Biostatistics, University of California Medical Center, San Francisco, CA 94143-0560, USA
| | - Rodrigo Correa-Oliveira
- Laboratório de Immunologia Celular e Molecular, Centro de Pesquisas René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Andrea Gazzinelli
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Hotez PJ, Brindley PJ, Bethony JM, King CH, Pearce EJ, Jacobson J. Helminth infections: the great neglected tropical diseases. J Clin Invest 2008; 118:1311-21. [PMID: 18382743 DOI: 10.1172/jci34261] [Citation(s) in RCA: 964] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Helminths are parasitic worms. They are the most common infectious agents of humans in developing countries and produce a global burden of disease that exceeds better-known conditions, including malaria and tuberculosis. As we discuss here, new insights into fundamental helminth biology are accumulating through newly completed genome projects and the nascent application of transgenesis and RNA interference technologies. At the same time, our understanding of the dynamics of the transmission of helminths and the mechanisms of the Th2-type immune responses that are induced by infection with these parasitic worms has increased markedly. Ultimately, these advances in molecular and medical helminth biology should one day translate into a new and robust pipeline of drugs, diagnostics, and vaccines for targeting parasitic worms that infect humans.
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Affiliation(s)
- Peter J Hotez
- Department of Microbiology, Immunology, and Tropical Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC 20037, USA.
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Jardim-Botelho A, Brooker S, Geiger SM, Fleming F, Souza Lopes AC, Diemert DJ, Corrêa-Oliveira R, Bethony JM. Age patterns in undernutrition and helminth infection in a rural area of Brazil: associations with ascariasis and hookworm. Trop Med Int Health 2008; 13:458-67. [PMID: 18312476 PMCID: PMC2735762 DOI: 10.1111/j.1365-3156.2008.02022.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the nutritional status of individuals from a rural area of Brazil, and associations with helminth infections in an age-stratified sample. METHOD A total of 1113 individuals aged from 6 months to 83 years from the rural community of Americaninhas in Minas Gerais were investigated. Assessments comprised anthropometric measurements of weight, height and body composition, examining faecal samples for helminth eggs, and peripheral blood assays for albumin, haemoglobin and ferritin concentrations. RESULTS Ten percent of the participants were underweight, 12.8% were overweight and 28.3% of the children and adolescents were stunted. 11.6% had low lean body mass and 28.8% had low fat body mass. Hypoalbuminaemia was seen in 5.5%, anaemia in 12.5% and iron deficiency in 13.1%, although the prevalence of these two indices increased with age. Multivariate analysis showed that, after controlling for age, sex and socio-economic status, stunting was significantly associated with Ascaris lumbricoides infection among children and adolescents, whereas low body mass was significantly associated with hookworm infection among adults and the elderly. CONCLUSIONS Helminth infections are associated with undernutrition in endemic populations, with important differences between the effects of hookworm and A. lumbricoides on age-related nutritional status.
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Affiliation(s)
- Anne Jardim-Botelho
- Instituto René Rachou, Fundação Oswaldo Cruz (FIOCUZ), Belo Horizonte, Minas Gerais, Brazil
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Abstract
OBJECTIVES To summarize new knowledge on the range of disease due to chronic schistosomiasis and examine the debilitating burden of both light and heavy infection; to outline goals of disease prevention, including current age-targeted strategies and more extended programmes aimed at preventing transmission. METHODS A systematic search of 2004-2007 papers via PUBMED and related databases using 'schistosom' and disability- or treatment-related subject headings. Reports were independently reviewed for inclusion. RESULTS Sixty-eight papers met review objectives. These suggest new evidence for a causative link between schistosome infection, antiparasite inflammation, and risk for anaemia, growth stunting and undernutrition in affected populations, as well as exacerbation of co-infections and impairment of cognitive development and work capacity. Formal quality-of-life assessment defines a significant 9.5-24% disability with the most aggressive schistosome species, Schistosoma japonicum. DISCUSSION Schistosomiasis represents a serious but under-recognized disease burden for many developing countries. Infection (and not intensity of infection) should be considered the defining feature of morbidity formation. Links between infection and long-term disabilities reduce the chances of combating rural poverty. Changes in our appreciation of schistosomiasis-related disease burden means it is no longer appropriate to leave infected persons untreated, and newer approaches to control should focus on preventing transmission.
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Affiliation(s)
- Charles H King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine 10900 Euclid Avenue, Cleveland, Ohio 44106-7286, USA.
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