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Soultani M, Bartlett AW, Mendes EP, Hii SF, Traub R, Palmeirim MS, Lufunda LMM, Colella V, Lopes S, Vaz Nery S. Estimating Prevalence and Infection Intensity of Soil-Transmitted Helminths Using Quantitative Polymerase Chain Reaction and Kato-Katz in School-Age Children in Angola. Am J Trop Med Hyg 2024; 110:1145-1151. [PMID: 38688261 PMCID: PMC11154060 DOI: 10.4269/ajtmh.23-0821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/31/2024] [Indexed: 05/02/2024] Open
Abstract
Quantitative polymerase chain reaction (qPCR) is gaining recognition in soil-transmitted helminth (STH) diagnostics, especially for Strongyloides stercoralis and differentiating hookworm species. However, sample preservation and DNA extraction may influence qPCR performance. We estimated STH prevalence and infection intensity by using qPCR in schoolchildren from Huambo, Uige, and Zaire, Angola, and compared its performance with that of the Kato-Katz technique (here termed Kato-Katz). Stool samples from 3,063 children (219 schools) were preserved in 96% ethanol and analyzed by qPCR, of which 2,974 children (215 schools) had corresponding Kato-Katz results. Cluster-adjusted prevalence and infection intensity estimates were calculated by qPCR and Kato-Katz, with cycle threshold values converted to eggs per gram for qPCR. Cohen's kappa statistic evaluated agreement between qPCR and Kato-Katz. DNA extraction and qPCR were repeated on 191 (of 278) samples that were initially qPCR negative but Kato-Katz positive, of which 112 (58.6%) became positive. Similar prevalence for Ascaris lumbricoides (37.5% versus 34.6%) and Trichuris trichiura (6.5% versus 6.1%) were found by qPCR and Kato-Katz, respectively, while qPCR detected a higher hookworm prevalence (11.9% versus 2.9%). The prevalence of moderate- or high-intensity infections was higher by Kato-Katz than by qPCR. Agreement between qPCR and Kato-Katz was very good for A. lumbricoides, moderate for T. trichiura, and fair for hookworm. Strongyloides stercoralis prevalence was 4.7% (municipality range, 0-14.3%), and no Ancylostoma ceylanicum was detected by qPCR. Despite suboptimal performance, presumably due to fixative choice, qPCR was fundamental in detecting S. stercoralis and excluding zoonotic A. ceylanicum. Further evaluations on sample fixatives and DNA extraction methods are needed to optimize and standardize the performance of qPCR.
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Affiliation(s)
- Muzhgan Soultani
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Adam W. Bartlett
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Elsa P. Mendes
- National Directorate of Public Health, Ministry of Health, Luanda, Angola
| | - Sze Fui Hii
- Faculty of Science, University of Melbourne, Parkville, Australia
| | - Rebecca Traub
- Faculty of Science, University of Melbourne, Parkville, Australia
| | - Marta S. Palmeirim
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Vito Colella
- Faculty of Science, University of Melbourne, Parkville, Australia
| | | | - Susana Vaz Nery
- Kirby Institute, University of New South Wales, Sydney, Australia
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Gaidhane S, Gaidhane A, Khatib MN, Telrandhe S, Patil M, Saxena D, Bhardwaj P, Choudhari S, Zahiruddin QS. Estimation of the Parasitic Burden of Soil-Transmitted Helminths Among Pregnant Women in the Maharashtra State of India Using qPCR: A Community-Based Study. Indian J Community Med 2024; 49:157-164. [PMID: 38425985 PMCID: PMC10900441 DOI: 10.4103/ijcm.ijcm_249_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 11/01/2023] [Indexed: 03/02/2024] Open
Abstract
Background Soil-transmitted helminth (STH) infections are widespread in developing countries with inadequate sanitation facilities. These infections can lead to malnutrition, anemia, and other complications that can negatively impact both the mother's and fetus's health during pregnancy. This study aimed to estimate the burden of STH by Kato-Katz microscopy and quantitative polymerase chain reaction (qPCR) in pregnant women from rural India. The diagnostic accuracy of these two methods was also compared. Material and Methods A community-based cross-sectional study was conducted in rural areas of Wardha district of Maharashtra state. We randomly selected and interviewed 688 pregnant women. A total of 534 (77.61%) participants gave stool samples. Two containers (60 mL) labeled with a unique identification number were given to pregnant women to collect stool samples for Kato-Katz microscopy and qPCR. Stool specimens were transported to an accredited lab and examined within 24 hours. Suitable examinations were conducted to compare sensitivity between two tests. Results The results are presented for 534 participants who gave stool samples. The prevalence of any STH by Kato-Katz stool microscopy was 6.55% (95%CI 4.46-12.19), and that by qPCR was 20.41 (95%CI 17.53-29.40). The sensitivity of Kato-Katz microscopy was 29.17% compared to sensitivity of 90.83% by qPCR (P = 0.001). Pregnant women with STH infection have a significantly lower weight gain during pregnancy, and the majority were either mild or moderate anemic compared to those without STH. Conclusion The study highlighted significant differences in prevalence of STH among pregnant women by Kato-Katz microscopy and qPCR. The sensitivity of qPCR for detecting STH was higher than that of Kato-Katz microscopy.
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Affiliation(s)
- Shilpa Gaidhane
- Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Abhay Gaidhane
- Centre of One Health, School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Mahalaqua Nazli Khatib
- Global Evidence Synthesis Initiative, Division of Evidence Synthesis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Shital Telrandhe
- Global Health Academy, Centre of Early Childhood Development - Stepping Stones Project, Wardha, Maharashtra, India
| | - Manoj Patil
- Global Health Consortium Public Health and Research, School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Deepak Saxena
- i Health Consortium, Department of Epidemiology, Indian Institute of Public Health, Gandhinagar, Gujarat, India
| | - Pankaj Bhardwaj
- School of Public Health (SPH), Department of Community Medicine and Family Medicine, AIIMS, Jodhpur, Rajasthan, India
| | - Sonali Choudhari
- School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Quazi S. Zahiruddin
- South Asia Infant Feeding Research Network (SAIFRN), School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
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Phillips AE, Ower AK, Mekete K, Liyew EF, Maddren R, Mengistu B, Anjulo U, Chernet M, Dunn JC, Mohammed H, Belay H, Gidey B, Tasew G, Tadesse G, Salasibew M, Tollera G, Anderson R. Baseline soil-transmitted helminth and schistosome infection in the Geshiyaro project, Ethiopia: A unique transmission interruption project using biometric fingerprinting for longitudinal individual analysis. PLoS Negl Trop Dis 2023; 17:e0011589. [PMID: 37851666 PMCID: PMC10615263 DOI: 10.1371/journal.pntd.0011589] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/30/2023] [Accepted: 09/07/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The Geshiyaro project aims to assess the feasibility of interrupting transmission of soil-transmitted helminths (STH) and schistosome (SCH) infection in the Wolaita zone of southern Ethiopia through high coverage community-wide mass drug administration (MDA), in combination with improved water, sanitation, and hygiene services and behaviour change communication delivered through the existing health care infrastructure. To accurately measure treatment coverage a population census was conducted enrolling individuals with biometric fingerprinting and barcoded ID cards. This paper details the baseline census and parasitology surveys conducted before the start of any interventions. METHODS The census was conducted in five of the 15 Wolaita districts between October 2018 and December 2019, enrolling all consenting participants from every household. Simultaneously, a cross-sectional parasitology survey was conducted in 130 out of 361 randomly selected communities from all 15 districts, with 100 individuals across all age groups (infant to adult) per community providing stool and urine for analysis by duplicate Kato-Katz and a point-of-care circulating cathodic antigen (POC-CCA) to test for Schistosoma mansoni and STH, and microhaematuria and urine filtration for Schistosoma haematobium. Of the 130 communities, 30 were randomly selected for annual, longitudinal parasitological monitoring, with 150 randomly selected individuals from infant to adult providing two days of stool and urine samples for analysis by the same diagnostic tests per community. RESULTS In total 97,919 households participated in the baseline census enrolling 466,071 individuals, with parasitological data obtained from 10,785 people. At baseline, 15.5% were infected with at least one STH species, with Ascaris lumbricoides (9.5%), followed by hookworm (7.2%) and Trichuris trichiura (1.8%). Substantial heterogeneity in STH prevalence was observed between communities ranging from 0% to 61% where most infections were low intensity. Schistosoma mansoni infection was the dominant schistosome infection (0.85% by Kato-Katz and 13.3% by POC-CCA trace negative and 21.5% trace positive), with few Schistosoma haematobium infections identified (2.77% haematuria positive and 0.13% positive by urine filtration). CONCLUSIONS While the national control program in Ethiopia has made good progress in reducing prevalence of STH and SCH in Wolaita since it was launched in 2015, there remain areas of persistent infection suggesting the existence of environmental or behavioural risk factors that contribute to ongoing transmission. This project aims to identify the most efficient intervention strategies to reduce community burden and reach interruption of transmission.
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Affiliation(s)
- Anna E. Phillips
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary’s Campus, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - Alison K. Ower
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary’s Campus, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | | | | | - Rosie Maddren
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary’s Campus, London, United Kingdom
| | - Birhan Mengistu
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary’s Campus, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - Ufaysa Anjulo
- Children’s Investment Fund Foundation, London, United Kingdom
| | - Melkie Chernet
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Julia C. Dunn
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary’s Campus, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | | | - Habtamu Belay
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Geremew Tasew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | - Roy Anderson
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary’s Campus, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
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Nguemnang Kamdem C, Soubgwi Fogue P, Zebaze Tiofack AA, Mezajou Mewamba E, Tekeu Mengoue LE, Womeni MH, Simo G. Assessment of the capacity of Whatman filter papers as support to store stools for the molecular diagnostic testing of soil-transmitted helminthiasis. J Microbiol Methods 2023; 213:106824. [PMID: 37717625 DOI: 10.1016/j.mimet.2023.106824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/19/2023]
Abstract
Storage of stools for the detection of soil-transmitted helminths (STH) remains challenging for the molecular diagnostic testing of STH infections. This study aimed to overcome this challenge by assessing the capacity of Whatman filter papers to store stools for the molecular detection of STHs. Stool samples were collected from school-aged children of soil-transmitted helminthiasis endemic areas of Cameroon and then, analysed using Kato Katz technique. For this study, 128 and 40 stool samples respectively with and without STH eggs were analysed. From each sample, 10, 20, 40 and 80 mg of stool were weighted and spread on 6 grades of Whatman filter papers that were stored at room temperature from one to ten weeks. DNA was extracted from spread stool using CTAB based-method. The amount of stool to spread on filter papers and the grade of filter paper offering good storage were determined by amplifying specific DNA fragments of Ascaris lumbricoides. The capacity of filter papers to store stool samples for several weeks before the molecular detection of STH species was assessed by amplifying specific DNA fragments of different STHs. The amplification rates of A. lumbricoides were significantly higher (P < 0.0001) for 10 and 20 mg of stored stools. Stools spread on Whatman paper grade 2 yielded the highest amplification rate of 100% for A. lumbricoides, T. trichiura and hookworm. PCR revealed STH infections in all the 128 spread stools carrying STH eggs. It also revealed Necator americanus and Ancylostoma duodenale respectively in 10 and 13 of 15 spread stools contained hookworm eggs. PCR confirmed the co-infections of these hookworm species as well as that of A. lumbricoides and Trichuris trichiura in 7 spread stools. Out of 40 stools without STH eggs, PCR revealed that 5 (12.5%) and 9 (22.5%) had respectively A. lumbricoides and T. trichiura infections. The amplification rate of each STH species was 100% from one to 8 weeks and decreased to 86.7% after 10 weeks of storage. This study highlighted the capacity of filter papers to store stools for the molecular detection of STHs. Storing stools on these papers will enable to monitor and evaluate control programs and ensure post-elimination surveillance.
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Affiliation(s)
- Cyrille Nguemnang Kamdem
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Pythagore Soubgwi Fogue
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Auvaker Arnol Zebaze Tiofack
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Estelle Mezajou Mewamba
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Loic Edmond Tekeu Mengoue
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Macaire Hilaire Womeni
- Unité de Recherche de Biochimie, des plantes Médicinales, des Sciences alimentaires et Nutrition, University of Dschang, Dschang, Cameroon
| | - Gustave Simo
- Molecular Parasitology and Entomology Unit, Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon.
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Tong Y, Tang L, Xia M, Li G, Hu B, Huang J, Wang J, Jiang H, Yin J, Xu N, Chen Y, Jiang Q, Zhou J, Zhou Y. Identifying determinants for the seropositive rate of schistosomiasis in Hunan province, China: A multi-scale geographically weighted regression model. PLoS Negl Trop Dis 2023; 17:e0011466. [PMID: 37440524 DOI: 10.1371/journal.pntd.0011466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Schistosomiasis is of great public health concern with a wide distribution and multiple determinants. Due to the advances in schistosomiasis elimination and the need for precision prevention and control, identifying determinants at a fine scale is urgent and necessary, especially for resource deployment in practice. Our study aimed to identify the determinants for the seropositive rate of schistosomiasis at the village level and to explore their spatial variations in local space. METHODOLOGY The seropositive rates of schistosomiasis were collected from 1714 villages or communities in Human Province, and six spatial regression models including ordinary least squares (OLS), spatial lag model (SLM), spatial error model (SEM), geographically weighted regression (GWR), robust GWR (RGWR) and multiscale GWR (MGWR) were used to fit the data. PRINCIPAL/FINDINGS MGWR was the best-fitting model (R2: 0.821, AICc:2727.092). Overall, the nearest distance from the river had the highest mean negative correlation, followed by proportion of households using well water and the annual average daytime surface temperature. The proportions of unmodified toilets showed the highest mean positive correlation, followed by the snail infested area, and the number of cattle. In spatial variability, the regression coefficients for the nearest distance from the river, annual average daytime surface temperature and the proportion of unmodified toilets were significant in all villages or communities and varied little in local space. The other significant determinants differed substantially in local space and had significance ratios ranging from 41% to 70%, including the number of cattle, the snail infested area and the proportion of households using well water. CONCLUSIONS/SIGNIFICANCE Our study shows that MGWR was well performed for the spatial variability of schistosomiasis in Hunan province. The spatial variability was different for different determinants. The findings for the determinants for the seropositive rate and mapped variability for some key determinants at the village level can be used for developing precision intervention measure for schistosomiasis control.
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Affiliation(s)
- Yixin Tong
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Ling Tang
- Hunan Institute for Schistosomiasis Control, Yueyang, China
| | - Meng Xia
- Hunan Institute for Schistosomiasis Control, Yueyang, China
| | - Guangping Li
- Hunan Institute for Schistosomiasis Control, Yueyang, China
| | - Benjiao Hu
- Hunan Institute for Schistosomiasis Control, Yueyang, China
| | - Junhui Huang
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Jiamin Wang
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Honglin Jiang
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Jiangfan Yin
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Ning Xu
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Qingwu Jiang
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
| | - Jie Zhou
- Hunan Institute for Schistosomiasis Control, Yueyang, China
| | - Yibiao Zhou
- Fudan University School of Public Health, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Ministry of Education, Shanghai, China
- Fudan University Center for Tropical Disease Research, Shanghai, China
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Hughes A, Ng-Nguyen D, Clarke NE, Dyer CEF, Hii SF, Clements ACA, Anderson RM, Gray DJ, Coffeng LE, Kaldor JM, Traub RJ, Vaz Nery S. Epidemiology of soil-transmitted helminths using quantitative PCR and risk factors for hookworm and Necator americanus infection in school children in Dak Lak province, Vietnam. Parasit Vectors 2023; 16:213. [PMID: 37370075 DOI: 10.1186/s13071-023-05809-x] [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: 12/24/2022] [Accepted: 05/14/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Soil-transmitted helminth (STH) infection is driven by a complex interaction of demographic, socioeconomic and behavioural factors, including those related to water, sanitation and hygiene (WASH). Epidemiological studies that measure both infection and potential risk factors associated with infection help to understand the drivers of transmission in a population and therefore can provide information to optimise STH control programmes. METHODS During October and November 2019, we conducted a cross-sectional survey of the prevalence and intensity of STH infection and associated risk factors among 7710 primary-school-age children from 64 primary schools across 13 districts in Dak Lak province, Vietnam. Quantitative PCR (qPCR) was used to detect and quantify STH infections. RESULTS The predominant STH species was the hookworm Necator americanus (overall cluster-adjusted prevalence of 13.7%), and its prevalence was heterogeneously distributed across surveyed schools (0% to 56.3%). All other STH species had a prevalence of less than 1%. Using mixed-effects logistic regression, we found that the adjusted odds ratio (aOR) was significantly higher for both infection and moderate-to-heavy-intensity infection with N. americanus among children from multiple ethnic minority groups, compared to children from the majority group (Kinh). Adjusted odds of infection with N. americanus were also higher in children who reported practising open defecation at school (aOR 1.42, 95% CI 1.05, 1.93, P = 0.02) and in those who had an unimproved household water supply (aOR 1.28, 95% CI 1.04, 1.57, P = 0.02). Conversely, children with a flushing household toilet had a reduced risk of infection (aOR 0.58, 95% CI 0.47, 0.70, P < 0.01), as did those whose primary female carer attended secondary (aOR 0.65, 95% CI 0.51, 0.84, P < 0.01) or tertiary education (aOR 0.39, 95% CI 0.24, 0.63, P < 0.01). CONCLUSIONS This study is the largest reported prevalence survey of STH infections conducted using qPCR as a diagnostic technique. The findings of higher adjusted odds of infection amongst ethnic minority children highlight that STH control programmes may not be reaching certain population groups and that additional culturally appropriate approaches may be required. Additionally, the associations between specific WASH factors and infection indicate potential programmatic targets to complement preventive chemotherapy programmes.
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Affiliation(s)
- Angus Hughes
- School of Population Health, University of New South Wales, Sydney, Australia.
| | - Dinh Ng-Nguyen
- Faculty of Animal Sciences and Veterinary Medicine, Tay Nguyen University, Buon Ma Thuot, Dak Lak, Vietnam
| | - Naomi E Clarke
- The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, Australia
| | - Clare E F Dyer
- The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, Australia
| | - Sze Fui Hii
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Australia
| | - Archie C A Clements
- Faculty of Health Sciences, Curtin University, Perth, Australia
- Telethon Kids Institute, Perth, Australia
| | - Roy M Anderson
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Darren J Gray
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - John M Kaldor
- The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, Australia
| | - Rebecca J Traub
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Australia
| | - Susana Vaz Nery
- Faculty of Animal Sciences and Veterinary Medicine, Tay Nguyen University, Buon Ma Thuot, Dak Lak, Vietnam
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Ding X, Yang Y, Zhang Y, Zhang Q, Mao F, Dai Y. Establishment of a Simple and Rapid Nucleic Acid Detection Method for Hookworm Identification. Pathogens 2023; 12:pathogens12040630. [PMID: 37111516 PMCID: PMC10142964 DOI: 10.3390/pathogens12040630] [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: 02/23/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
Hookworm infection is one of the most common neglected tropical diseases and is mainly found in tropical and subtropical areas. Two species of human hookworm are distributed in China, i.e., Ancylostoma duodenale (AD) and Necator americanus (NA). BACKGROUND Traditional microscopic technology such as the Kato-Katz method is not suitable for hookworm diagnosis due to the rapid degeneration of fragile hookworm eggs or for species identification of hookworm infection. The aim of the present study was to establish and evaluate a novel nucleic acid detection method based on recombinase-aided isothermal amplification (RAA) for the detection of hookworm infections and species identification. METHODS Based on the specific target gene sequences of hookworms (5.8S rRNA for AD and ITS2 for NA, respectively), we designed and synthesized amplification primers and fluorescence probes referring to the principle of the fluorescence recombinase-aided amplification (RAA) technique. RESULTS Each assay provided specific amplification of larval DNA from AD and NA by fluorescence RAA, and the detection limits in plasmids reached 102 copies and 10 copies, respectively. Genomic DNA of two hookworm species was successfully detected at a concentration of 0.1 pg/μL, revealing a high detection sensitivity. No positive amplification occurred for genomic DNA from crossed hookworm species and genomic DNA from Cryptosporidium, Giardia lamblia, Strongyloides stercoralis, Schistosoma japonicum, Ascaris lumbricoides, and Clonorchis sinensis, revealing a satisfactory specificity. Fecal sample detection results demonstrated a similar efficacy to the Kato-Katz method; however, it had a greater sensitivity than the larvae culture method. CONCLUSION A simple and rapid nucleic acid method was successfully established based on RAA, which improved the detection efficacy and species identification for human hookworm infections.
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Affiliation(s)
- Xin Ding
- Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Key Laboratory of Jiangsu Province on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China
| | - Yougui Yang
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Yingshu Zhang
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Qiang Zhang
- Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Key Laboratory of Jiangsu Province on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China
| | - Fanzhen Mao
- Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Key Laboratory of Jiangsu Province on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China
| | - Yang Dai
- Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Key Laboratory of Jiangsu Province on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
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Advantages and Limitations of Microscopy and Molecular Detections for Diagnosis of Soil-transmitted Helminths: An Overview. Helminthologia 2022; 59:321-340. [PMID: 36875683 PMCID: PMC9979072 DOI: 10.2478/helm-2022-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 10/31/2022] [Indexed: 02/05/2023] Open
Abstract
World Health Organization (WHO) reported that over 1.5 billion people are infected by soil-transmitted helminths (STH) worldwide in sub-Saharan Africa, the United States of America, China, and East Asia. Heavy infections and polyparasitism are associated with higher morbidity rates, and the patients are exposed to increased vulnerability to other diseases. Therefore, accurate diagnosis followed by mass treatment for morbidity control is necessary.STH diagnosis commonly involves the microscopic observation of the presence of the STH eggs and larvae in the faecal samples. Furthermore, molecular approaches are increasingly utilised in monitoring and surveillance as they show higher sensitivity. Their capability to differentiate hookworm species is an advantage over the Kato-Katz technique. This review discusses the advantages and limitations of microscopy and various molecular tools used for STH detection.
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Mesquita SG, Lugli EB, Matera G, Fonseca CT, Caldeira RL, Webster B. Development of real-time and lateral flow recombinase polymerase amplification assays for rapid detection of Schistosoma mansoni. Front Microbiol 2022; 13:1043596. [PMID: 36466644 PMCID: PMC9716991 DOI: 10.3389/fmicb.2022.1043596] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/17/2022] [Indexed: 11/19/2022] Open
Abstract
Background Accurate diagnosis followed by timely treatment is an effective strategy for the prevention of complications together with reducing schistosomiasis transmission. Recombinase Polymerase Amplification (RPA) is a simple, rapid, sensitive, and specific isothermal method with low resource needs. This research aimed at the development and optimisation of a real-time (RT) and a lateral flow (LF) RPA assay for the detection of Schistosoma mansoni. Methodology Recombinase Polymerase Amplification reactions were performed at full- (as recommended) and half-volumes (to reduce costs), with RT or LF detection systems targeting the S. mansoni mitochondrial minisatellite region. The specificity was assessed using gDNA from other Schistosoma species, helminths co-endemic with S. mansoni, human stool, and urine, and Biomphalaria snail hosts. The analytical sensitivity was evaluated using serial dilutions of gDNA, synthetic copies of the target, and single eggs. The ability of both assays to detect the S. mansoni DNA in human urine and stool samples was also tested. The long-term stability of the RT-RPA reagents was evaluated by storing the reaction components in different temperature conditions for up to 3 weeks. Results The RT- and the LF-RPA (SmMIT- and SmMIT-LF-RPA, respectively) presented similar results when used full- and half-volumes, thus the latter was followed in all experiments. The SmMIT-RPA was 100% specific to S. mansoni, able to detect a single egg, with a limit of detection (LOD) of down to 1 fg of gDNA and one synthetic copy of the target. The assay was able to detect S. mansoni DNA from stool containing 1 egg/g and in spiked urine at a concentration of 10 fg/μl. SmMIT-RPA reagents were stable for up to 3 weeks when kept at 19°C, and 2 weeks when stored at 27°C. The SmMIT-LF-RPA cross-reacted with Clinostomidae, presented the LOD of 10 fg and one synthetic copy of the target, being able to detect a single egg and 1 egg/g in a stool sample. The LOD in spiked urine samples was 10 pg/μl. Conclusion The half-volume SmMIT-RPA is a promising method to be used in the field. It is specific, sensitive, robust, and tolerant to inhibitors, with a long-term stability of the reaction components and the real-time visualisation of results.
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Affiliation(s)
- Silvia Gonçalves Mesquita
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil,Wolfson Wellcome Laboratories, Department of Science, Natural History Museum, London, United Kingdom
| | - Elena Birgitta Lugli
- Wolfson Wellcome Laboratories, Department of Science, Natural History Museum, London, United Kingdom
| | - Giovanni Matera
- Department of Health Sciences, Unit of Microbiology, University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Cristina Toscano Fonseca
- Grupo de Pesquisa em Biologia e Imunologia Parasitária, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Roberta Lima Caldeira
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil,*Correspondence: Bonnie Webster, ; Roberta Lima Caldeira,
| | - Bonnie Webster
- Wolfson Wellcome Laboratories, Department of Science, Natural History Museum, London, United Kingdom,*Correspondence: Bonnie Webster, ; Roberta Lima Caldeira,
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Phillips AE, Ower AK, Mekete K, Liyew EF, Maddren R, Belay H, Chernet M, Anjulo U, Mengistu B, Salasibew M, Tasew G, Anderson R. Association between water, sanitation, and hygiene access and the prevalence of soil-transmitted helminth and schistosome infections in Wolayita, Ethiopia. Parasit Vectors 2022; 15:410. [DOI: 10.1186/s13071-022-05465-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 09/03/2022] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
The Geshiyaro project is a 5-year intervention to assess the impact of community- and school-based water, sanitation, and hygiene (WaSH) interventions on reducing infection with soil-transmitted helminths (STH) and schistosome parasites in combination with deworming in Wolayita zone, Ethiopia.
Methods
A population-based, cross-sectional census and parasitological mapping activity was conducted between 2018 and 2019. Individuals in the census were identified using either a registered study ID card or biometric fingerprint to enable linkage of their household WaSH data with baseline STH and schistosome prevalence for risk analysis.
Results
Prevalence of STH was 15.5% for any STH species, 9.47% for Ascaris lumbricoides, 1.78% for Trichuris trichiura, and 7.24% for hookworm. Intestinal schistosomiasis (Schistosoma mansoni) infection prevalence was 0.85% by Kato Katz, 21.6% by POC-CCA trace positive (Tr +), and 13.3% trace negative (Tr-). Microhaematuria was 2.77%, with 0.13% of people examined with S. haematobium eggs detected by urine filtration. At the household level, increased (> 30 min) time taken to collect drinking water, sharing a latrine, and lack of handwashing facilities were all associated with a greater risk of A. lumbricoides, hookworm, and S. mansoni infection. Not disposing of infant stool at the household and clothes washing/recreational freshwater contact were significantly associated with higher risk of schistosomiasis infection. Aggregating WaSH data at the community level showed odds of A. lumbricoides, hookworm, and T. trichiura infection were significantly lower as both community sanitation coverage and access to improved drinking water improved.
Conclusions
The principal finding of this study is that lack of access to WaSH, such as improved drinking water and shared toilet and hand-washing facilities, were linked to an increased risk of infection with STH and schistosome parasites. These associations are difficult to establish at an individual household level because of wide variability in access between houses but are detectable when coverage is aggregated at the community level. Maintenance of WaSH facilities as well as increased access within the whole community is important in influencing the community-wide prevalence of infection with STH and schistosome parasites.
Graphical Abstract
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Grolimund CM, Bärenbold O, Utzinger J, Keiser J, Vounatsou P. Modeling the effect of different drugs and treatment regimen for hookworm on cure and egg reduction rates taking into account diagnostic error. PLoS Negl Trop Dis 2022; 16:e0010810. [PMID: 36194622 PMCID: PMC9595538 DOI: 10.1371/journal.pntd.0010810] [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: 08/10/2021] [Revised: 10/25/2022] [Accepted: 09/12/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Hookworm infections, caused by Ancylostoma duodenale and Necator americanus, are of considerable public health importance. The World Health Organization recommends preventive chemotherapy as the key strategy for morbidity control. Meta-analyses have been conducted to estimate treatment efficacy of available drugs and drug combinations. However, in most studies, the relation between the diagnostic error and infection intensity have not been considered, resulting in an overestimation of cure rates (CRs). METHODOLOGY A Bayesian model was developed to compare the 'true' CR and egg reduction rate of different treatment regimens for hookworm infections taking into account the error of the recommended Kato-Katz thick smear diagnostic technique. It was fitted to the observed egg count data which was linked to the distribution of worms, considered the day-to-day variation of hookworm egg excretion and estimated the infection intensity-dependent sensitivity. The CR was obtained by defining the prevalence of infection at follow-up as the probability of having at least one fertilized female worm. The model was applied to individual-level egg count data available from 17 treatments and six clinical trials. PRINCIPAL FINDINGS Taking the diagnostic error into account resulted in considerably lower CRs than previously reported. Overall, of all treatments analyzed, mebendazole administered in six dosages of 100 mg each was the most efficacious treatment with a CR of 88% (95% Bayesian credible interval: 79-95%). Furthermore, diagnostic sensitivity varied with the infection intensity and sampling effort. For an infection intensity of 50 eggs per gram of stool, the sensitivity is close to 60%; for two Kato-Katz thick smears it increased to approximately 76%. CONCLUSIONS/SIGNIFICANCE Our model-based estimates provide the true efficacy of different treatment regimens against hookworm infection taking into account the diagnostic error of the Kato-Katz method. Estimates of the diagnostic sensitivity for different number of stool samples and thick smears are obtained. To accurately assess efficacy in clinical trials with the Kato-Katz method, at least two stool samples on consecutive days should be collected.
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Affiliation(s)
- Carla M. Grolimund
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Oliver Bärenbold
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Penelope Vounatsou
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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PrayGod G, Filteau S, Range N, Ramaiya K, Jeremiah K, Rehman AM, Krogh-Madsen R, Friis H, Faurholt-Jepsen D. The association of Schistosoma and geohelminth infections with β-cell function and insulin resistance among HIV-infected and HIV-uninfected adults: A cross-sectional study in Tanzania. PLoS One 2022; 17:e0262860. [PMID: 35077485 PMCID: PMC8789133 DOI: 10.1371/journal.pone.0262860] [Citation(s) in RCA: 2] [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: 04/18/2021] [Accepted: 01/06/2022] [Indexed: 01/15/2023] Open
Abstract
Objectives Data on the role of helminths on diabetes in Africa are limited. We investigated whether Schistosoma and geohelminth infections are associated with β-cell function and insulin resistance among adults. Methods A cross-sectional study was conducted among adults during 2016–2017. Demography, Schistosoma and geohelminth infections, HIV and insulin data were collected. Insulin during an oral glucose tolerance test (fasting, 30, and 120-min), overall insulin secretion index, insulinogenic index, HOMA-β, and HOMA-IR were main outcome measures for β-cell function and insulin resistance, respectively. Generalized estimating equations and generalized linear models assessed the association of Schistosoma and geohelminth infections with outcome measures separately by HIV status. Outcomes were presented as marginal means with 95% CI. Results Data were obtained for 1718 participants. Schistosoma infection was associated with higher 30-min insulin (24.2 mU/L, 95% CI: 6.9, 41.6) and overall insulin secretion index (13.3 pmol/L/mmol/L; 3.7, 22.9) among HIV-uninfected participants but with lower fasting insulin (-0.9 mU/L; -1.6, -0.2), 120-min insulin (-12.0 mU/L; -18.9, -5.1), and HOMA-IR (-0.3 mmol/L; -0.6, -0.05) among HIV-infected participants not yet on antiretroviral therapy (ART). Among HIV-infected participants not on ART, geohelminth infection was associated with lower fasting insulin (-0.9 mU/L; -1.6, -0.2), 120-min insulin (-9.1 mU/L; -17.3, -1.0), HOMA-β (-8.9 mU/L)/(mmol/L; -15.3, -2.6) and overall insulin release index (-5.1 pmol/L/mmol/L; -10.3, 0.02), although this was marginally significant. There was no association among those on ART. Conclusions Schistosoma infection was associated with higher β-cell function among HIV-uninfected participants whereas Schistosoma and geohelminth infections were associated with reduced β-cell function among HIV-infected participants not on ART.
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Affiliation(s)
- George PrayGod
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
- * E-mail:
| | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Nyagosya Range
- Muhimbili Research Centre, National Institute for Medical Research, Dar es Saalam, Tanzania
| | | | - Kidola Jeremiah
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
| | - Andrea M. Rehman
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Rikke Krogh-Madsen
- Centre for Physical Activity Research, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Moser W, Batil AA, Ott R, Abderamane M, Clements R, Wampfler R, Poppert S, Steinmann P, Allan F, Greter H. High prevalence of urinary schistosomiasis in a desert population: results from an exploratory study around the Ounianga lakes in Chad. Infect Dis Poverty 2022; 11:5. [PMID: 34991728 PMCID: PMC8740043 DOI: 10.1186/s40249-021-00930-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Researching a water-borne disease in the middle of the Sahara desert might not seem the most relevant concern. However, nomadic Sahelian pastoralists health concerns regarding their livestock and anecdotal reports about trematode infections of Fasciola spp. and Schistosoma spp. in desert-raised animals justified an exploratory study focusing on the lakes of Ounianga in Northern Chad. The aim was to test whether trematode parasites such as Schistosoma spp. occur in human populations living around the Sahara desert lakes of Ounianga Kebir and Ounianga Serir in northern Chad. METHODS The study was carried out in January 2019 and comprised of three components. First, a cross sectional survey based on a random sample drawn from the population to detect infections with S. haematobium and S. mansoni; second, focus group discussions exploring disease priorities, access to health and health seeking behaviour; and third, surveying water contact sites for intermediate host snails. Samples of trematode parasites and snails were confirmed on species level by molecular genetic methods. For parasitological and malacological surveys descriptive statistics were performed. Qualitative data analysis included the full review of all transcripts, followed by a descriptive and explorative thematic analysis. RESULTS Among 258 participants, the overall S. haematobium prevalence using urine filtration was 39.2% [95% confidence interval (CI): 33.5-45.1%], with 51.5% of the infected suffering from heavy infection. The intermediate host snail of S. haematobium (Bulinus truncatus) occurred at water contact sites near both study villages, revealing the potential for local transmission. Although a positive S. mansoni point-of-care circulating cathodic antigen (POC-CCA) test result was obtained from 8.6% (95% CI 5.7-12.8%) of the samples, no intermediate host snails of S. mansoni were found, and the relevance of S. mansoni remains uncertain. Qualitative findings underline the importance of morbidity caused by urinary schistosomiasis, and the lack of access to diagnostics and treatment as a major health concern. CONCLUSIONS This research revealed a high prevalence of urinary schistosomiasis in the population living around the lakes of Ounianga in the Sahara, a United Nations Educational, Scientific and Cultural Organization (UNESCO) world heritage site in Chad. Despite the high public health importance of the associated morbidity expressed by the population, there is no access to diagnostics and treatment. Further work is needed to develop and test a context-adapted intervention.
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Affiliation(s)
- Wendelin Moser
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Rebekka Ott
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Ruth Clements
- Department of Life Sciences, Natural History Museum, London, UK
| | - Rahel Wampfler
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sven Poppert
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fiona Allan
- Department of Life Sciences, Natural History Museum, London, UK
| | - Helena Greter
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
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Mationg MLS, Williams GM, Tallo VL, Olveda RM, Aung E, Alday P, Reñosa MD, Daga CM, Landicho J, Demonteverde MP, Santos ED, Bravo TA, Bieri FA, Bedford A, Li Y, Clements ACA, Steinmann P, Halton K, Stewart DE, McManus DP, Gray DJ. "The Magic Glasses Philippines": a cluster randomised controlled trial of a health education package for the prevention of intestinal worm infections in schoolchildren. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 18:100312. [PMID: 35024651 PMCID: PMC8671727 DOI: 10.1016/j.lanwpc.2021.100312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/01/2021] [Accepted: 09/01/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Soil-transmitted helminths (STH) cause substantial disease and disability globally. Health education has proven complementary to school-based drug administration programs for STH control. We determined the generalizability of the impact of "The Magic Glasses" health education package for STH prevention in schoolchildren in Laguna province, the Philippines, having previously shown its positive impact in China. METHODS We conducted a cluster-randomised controlled trial, in schoolchildren, aged 9-10 years, across 40 schools over one year. Schools were randomly assigned either to the "Magic Glasses Philippines" health education intervention package (consisting of a cartoon video, classroom discussions, drawing and essay competition) complementing the standard health education activities of the Philippines Departments of Health and Education, or to a control group, which involved only the standard health education activities. The primary trial outcomes were the proportion of STH infected schoolchildren and their knowledge, attitude and behaviour of STH assessed in both groups at baseline and through two follow-up surveys undertaken immediately prior to the semi-annual national mass administration of albendazole. The outcomes between the study arms were compared using generalized estimating equation models, accounting for clustering at the school level. The trial is registered with Australian New Zealand Clinical Trials Registry number: ACTRN12616000508471. FINDINGS At follow-up assessments, the mean knowledge and behaviour scores in the intervention group were, respectively, 5·3 (95% confidence interval [CI]:4·2-6·5; p=<0.001) and 1·1 (95% CI: 0·4-1·7; p=0.002) percentage points higher than the control group. There was no overall effect on helminth infections (any STH; adjusted odds ratio [aOR]:1·0; 95% CI: 0·8-1·3; p=0·856), Ascaris lumbricoides; aOR:1·0; 95% CI: 0·7-1·6; p=0·894, or Trichuris trichiura; aOR:1·7; 95% CI: 0·9-1·6; p=0·315) but sub-group analysis showed a 60% reduction in the odds of any STH infection resulting from the "Magic Glasses" intervention in schools with a baseline prevalence ≤15% (aOR: 0·4; 95% CI: 0·2-0·7; p=0·001). INTERPRETATION The health-education package demonstrated a modest but statistically significant impact on the students' overall STH knowledge and changes in their behaviour but was only effective in preventing STH infections in intervention schools where the baseline prevalence was ≤15%. FUNDING National Health and Medical Research Council, Australia, and the UBS-Optimus Foundation, Switzerland.
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Affiliation(s)
- Mary Lorraine S Mationg
- Research School of Population Heath, The Australian National University, Canberra, Australia
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Gail M Williams
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Veronica L Tallo
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Remigio M Olveda
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Eindra Aung
- Research School of Population Heath, The Australian National University, Canberra, Australia
- St Vincent's Clinical School, University of New South Wales, Sydney, Australia
| | - Portia Alday
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Mark Donald Reñosa
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Chona Mae Daga
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Jhoys Landicho
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Maria Paz Demonteverde
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Eunice Diane Santos
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Thea Andrea Bravo
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Franziska Angly Bieri
- Research School of Population Heath, The Australian National University, Canberra, Australia
| | - Andrew Bedford
- Research School of Population Heath, The Australian National University, Canberra, Australia
| | - Yuesheng Li
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Hunan Institute of Parasitic Diseases, World Health Organization Collaborating Centre for Research and Control on Schistosomiasis in Lake Region, Yueyang, China
| | | | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kate Halton
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Donald E Stewart
- Research School of Population Heath, The Australian National University, Canberra, Australia
- School of Medicine, Griffith University, Brisbane, Australia
| | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Darren J Gray
- Research School of Population Heath, The Australian National University, Canberra, Australia
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Walson JL. Establishing control and breaking transmission: the importance of accurately classifying cure following treatment for soil-transmitted helminths. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 16:100288. [PMID: 34881372 PMCID: PMC8551819 DOI: 10.1016/j.lanwpc.2021.100288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
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Verweij JJ. Validation and maintaining laboratory developed molecular tests compliant with ISO15189 for diagnosis of intestinal parasitic infections. Expert Rev Mol Diagn 2021; 22:595-601. [PMID: 34424112 DOI: 10.1080/14737159.2021.1971974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Although, in the past few decades molecular diagnostics of parasitic infections have been accepted as first-line diagnostics, laboratories tend to be reluctant of introducing nucleic acid based tests as they dread the validation of laboratory developed tests (LDTs) compliant with ISO1589. AREAS COVERED This paper describes how to set tailor-made performance characteristics for the validation of laboratory developed tests (LDTs) for the molecular diagnosis of intestinal parasitic infections complying with the ISO 15189 guidelines. Then, just as important, maintaining these tests by daily monitoring, external quality assessment schemes, and reassessment of the test set-up. EXPERT OPINION Tailoring performance characteristics for the validation of LDTs defining criteria that make sense and actually leading to a process of continuous quality improvement in the day-to-day practice of a diagnostic laboratory. It is essential or even obligatory to modify these characteristics, skip, or to add additional characteristics based on personal or changing insights fitted for a specific setting.
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Affiliation(s)
- Jaco J Verweij
- Microvida Laboratory for Medical Microbiology and Immunology, ElisabethTweesteden Hospital, Tilburg, The Netherlands
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The role of diagnostic technologies to measure progress toward WHO 2030 targets for soil-transmitted helminth control programs. PLoS Negl Trop Dis 2021; 15:e0009422. [PMID: 34081694 PMCID: PMC8174700 DOI: 10.1371/journal.pntd.0009422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Palmeirim MS, Specht S, Scandale I, Gander-Meisterernst I, Chabicovsky M, Keiser J. Preclinical and Clinical Characteristics of the Trichuricidal Drug Oxantel Pamoate and Clinical Development Plans: A Review. Drugs 2021; 81:907-921. [PMID: 33929716 PMCID: PMC8144136 DOI: 10.1007/s40265-021-01505-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2021] [Indexed: 12/31/2022]
Abstract
Soil-transmitted helminths (Ascaris lumbricoides, hookworm and Trichuris trichiura) infect about one-fifth of the world's population. The currently available drugs are all highly efficacious against A. lumbricoides. However, they are only moderately efficacious against hookworm and poorly efficacious against T. trichiura. Oxantel, a tetrahydropyrimidine derivative discovered in the 1970s, has recently been brought back to our attention given its high efficacy against T. trichiura infections (estimated 76% cure rate and 85% egg reduction rate at a 20 mg/kg dose). This review summarizes the current knowledge on oxantel pamoate and its use against T. trichiura infections in humans. Oxantel pamoate acts locally in the human gastrointestinal tract and binds to the parasite's nicotinic acetylcholine receptor (nAChR), leading to a spastic paralysis of the worm and subsequent expulsion. The drug is metabolically stable, shows low permeability and low systemic bioavailability after oral use. Oxantel pamoate was found to be safe in humans, with only a few mild adverse events reported. Several clinical trials have investigated the efficacy of this drug against T. trichiura and suggest that oxantel pamoate is more efficacious against T. trichiura than the currently recommended drugs, which makes it a strong asset to the depleted drug armamentarium and could help delay or even prevent the development of resistance to existing drugs. We highlight existing data to support the use of oxantel pamoate against T. trichiura infections.
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Affiliation(s)
- Marta S Palmeirim
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, P.O. Box, 4002, Basel, Switzerland
- University of Basel, P.O. Box, 4003, Basel, Switzerland
| | - Sabine Specht
- Drugs for Neglected Diseases Initiative, 15 Chemin Louis-Dunant, 1202, Geneva, Switzerland
| | - Ivan Scandale
- Drugs for Neglected Diseases Initiative, 15 Chemin Louis-Dunant, 1202, Geneva, Switzerland
| | | | - Monika Chabicovsky
- MC Toxicology Consulting GmbH, Siebensterngasse 31/8, 1070, Vienna, Austria
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, P.O. Box, 4002, Basel, Switzerland.
- University of Basel, P.O. Box, 4003, Basel, Switzerland.
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Budiapsari PI, Swastika IK, Masyeni S. Prevalence of Soil-transmitted Helminths Infection in Students of Klungkung, Bali, after Mass Treatment with AlbendazolePrevalence of Soil-transmitted Helminths Infection in Students of Klungkung, Bali, after Mass Treatment with Albendazole. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The success of the anti-helminth mass treatment use Albendazole makes detection of soil transmitted helminth infections even more difficult to do microscopically. It is hoped that the molecular method was able to help increase the detectability of Soil Transmitted Helminth infection. The research aimed is to evaluate effectiveness of Albendazole administration in Bali, to identify the presence of β-tubulin gene as molecular diagnosis of STHs infection among children who treated by Albendazole. This study is a cross-sectional study that recruits elementary school children aged 6-12 years as subjects. Stool examination was carried out using the Kato-Katz technique, then followed by a molecular method using the B-tubulin gene as the target gene. The results showed that only 1 sample out of 140 examined using Kato-Katz was positive for Trichuris trichiura. 30 samples were then extracted from the faeces and performed Polymerase Chain Reaction. A total of 4 positive samples detected the B-tubulin Ascaris lumbricoides gene and 1 positive sample of the B-tubulin Trichuris trichiura gene. In conclusion, albendazole is still effective to treat STH infection, the molecular method has a higher detectability than the microscopic method.
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Autier B, Gangneux JP, Robert-Gangneux F. Evaluation of the Allplex™ GI-Helminth(I) Assay, the first marketed multiplex PCR for helminth diagnosis. ACTA ACUST UNITED AC 2021; 28:33. [PMID: 33812465 PMCID: PMC8019563 DOI: 10.1051/parasite/2021034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/18/2021] [Indexed: 11/20/2022]
Abstract
Molecular biology has been gaining more importance in parasitology. Recently, a commercial multiplex PCR assay detecting helminths was marketed: the Allplex™ GI-Helminth(I) Assay. It targets Ancylostoma spp., Ascaris spp., Enterobius vermicularis, Hymenolepis spp., Necator americanus, Strongyloides spp., Taenia spp. and Trichuris trichiura, but also the two most common microsporidia genera in human health, i.e. Enterocytozoon spp. and Encephalitozoon spp. This study aimed to evaluate and compare the Allplex™ GI-Helminth(I) Assay to classical diagnostic methods, based on a cohort of 110 stool samples positive for helminths (microscopy) or for microsporidia (PCR). Samples were stored at −80 °C until analysis by the Allplex™ GI-Helminth(I) Assay. False-negatives were re-tested with bead-beating pretreatment. Without mechanical lysis, concordance and agreement between microscopy and Allplex™ GI-Helminth(I) Assay ranged from 91% to 100% and from 0.15 to 1.00, respectively depending on the target. Concordance was perfect for Taenia spp. (n = 5) and microsporidia (n = 10). False-negative results were observed in 54% (6/13), 34% (4/11) and 20% (7/35) of cases, for hookworms, E. vermicularis and Strongyloides spp. detection, respectively. For these targets, pretreatment improved the results, but only slightly. Trichuris trichiura detection was critically low without pretreatment, as only 9% (1/11) of the samples were positive, but detection reached 91% (10/11) with bead-beating pretreatment. Mechanical lysis was also needed for Ascaris spp. and Hymenolepis spp. to reduce false-negative results from 1/8 to 1/21, respectively, to none for both. Overall, with an optimized extraction process, the Allplex™ GI-Helminth(I) Assay allows the detection of numerous parasites with roughly equivalent performance to that of microscopy, except for hookworms.
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Affiliation(s)
- Brice Autier
- Université de Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMRS 1085, 35000 Rennes, France
| | - Jean-Pierre Gangneux
- Université de Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMRS 1085, 35000 Rennes, France
| | - Florence Robert-Gangneux
- Université de Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMRS 1085, 35000 Rennes, France
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Keller L, Patel C, Welsche S, Schindler T, Hürlimann E, Keiser J. Performance of the Kato-Katz method and real time polymerase chain reaction for the diagnosis of soil-transmitted helminthiasis in the framework of a randomised controlled trial: treatment efficacy and day-to-day variation. Parasit Vectors 2020; 13:517. [PMID: 33059756 PMCID: PMC7558729 DOI: 10.1186/s13071-020-04401-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/09/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Accurate, scalable and sensitive diagnostic tools are crucial in determining prevalence of soil-transmitted helminths (STH), assessing infection intensities and monitoring treatment efficacy. However, assessments on treatment efficacy comparing traditional microscopic to newly emerging molecular approaches such as quantitative Polymerase Chain Reaction (qPCR) are scarce and hampered partly by lack of an established diagnostic gold standard. METHODS We compared the performance of the copromicroscopic Kato-Katz method to qPCR in the framework of a randomized controlled trial on Pemba Island, Tanzania, evaluating treatment efficacy based on cure rates of albendazole monotherapy versus ivermectin-albendazole against Trichuris trichiura and concomitant STH infections. Day-to-day variability of both diagnostic methods was assessed to elucidate reproducibility of test results by analysing two stool samples before and two stool samples after treatment of 160 T. trichiura Kato-Katz positive participants, partially co-infected with Ascaris lumbricoides and hookworm, per treatment arm (n = 320). As negative controls, two faecal samples of 180 Kato-Katz helminth negative participants were analysed. RESULTS Fair to moderate correlation between microscopic egg count and DNA copy number for the different STH species was observed at baseline and follow-up. Results indicated higher sensitivity of qPCR for all three STH species across all time points; however, we found lower test result reproducibility compared to Kato-Katz. When assessed with two samples from consecutive days by qPCR, cure rates were significantly lower for T. trichiura (23.2 vs 46.8%), A. lumbricoides (75.3 vs 100%) and hookworm (52.4 vs 78.3%) in the ivermectin-albendazole treatment arm, when compared to Kato-Katz. CONCLUSIONS qPCR diagnosis showed lower reproducibility of test results compared to Kato-Katz, hence multiple samples per participant should be analysed to achieve a reliable diagnosis of STH infection. Our study confirms that cure rates are overestimated using Kato-Katz alone. Our findings emphasize that standardized and accurate molecular diagnostic tools are urgently needed for future monitoring within STH control and/or elimination programmes.
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Affiliation(s)
- Ladina Keller
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Chandni Patel
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Sophie Welsche
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Tobias Schindler
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Eveline Hürlimann
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
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