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Kepha S, Mazigo HD, Odiere MR, Mcharo C, Safari T, Gichuki PM, Omondi W, Wakesho F, Krolewiecki A, Pullan RL, Mwandawiro CS, Oswald WE, Halliday KE. Exploring factors associated with Trichuris trichiura infection in school children in a high-transmission setting in Kenya. IJID Reg 2024; 11:100352. [PMID: 38634069 PMCID: PMC11021359 DOI: 10.1016/j.ijregi.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/11/2024] [Accepted: 03/12/2024] [Indexed: 04/19/2024]
Abstract
Objectives Kenya has implemented a national school-based deworming program, which has led to substantial decline in the prevalence of soil-transmitted helminths (STHs), although some pockets of infections remain. To effectively design an STH control program that leads to significant reductions of Trichuris trichiura, there is a need to understand the drivers of persistent infection despite ongoing treatment programs. Methods This study was conducted between July and September 2019 at the south coast of Kenya, using a two-stage sampling design. First, a school-based cross-sectional survey was conducted in 2265 randomly selected school children from selected schools in areas known to be endemic for T. trichiura. After this, we conducted a nested case-control study wherein all children positive for T. trichiura (142) were matched to 148 negative controls based on age and village. A household survey was then conducted with all household members of cases and controls. In addition, a subsample of 116 children found to be infected with T. trichiura were followed up to assess the efficacy of albendazole at day 21 post-treatment. The predictors of presence of T. trichiura were investigated through multilevel logistic regression, considering clustering of infection. Results Overall, 34.4% of the children were infected with at least one STH species; T. trichiura was the most common (28.3%), 89.1% of those with T. trichiura had light-intensity infections. The prevalence of T. trichiura was significantly higher in male children and was positively associated with younger age and number of people infected with T. trichiura in a household. The parasitological cure rate and egg reduction rate of T. trichiura were 35% and 51%, respectively. Other STHs identified were hookworm (9.6%) and Ascaris lumbricoides (5.7%). Conclusions T. trichiura remains a significant public health challenge in the study area with albendazole treatment efficacy against the parasite, remaining lower than the World Health Organization-recommended thresholds. Because of the observed focal transmission of T. trichiura in the current area, control efforts tailored to local conditions and targeting lower implementation units should be used to achieve optimal results on transmission.
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Affiliation(s)
- Stella Kepha
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Humphrey D. Mazigo
- Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania
| | - Maurice R. Odiere
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Carlos Mcharo
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Th'uva Safari
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Paul M. Gichuki
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Wykcliff Omondi
- Division of Vector Borne and Neglected Tropical Diseases, Ministry of Health, Nairobi, Kenya
| | - Florence Wakesho
- Division of Vector Borne and Neglected Tropical Diseases, Ministry of Health, Nairobi, Kenya
| | - Alejandro Krolewiecki
- Universidad Nacional de Salta, Instituto de Investigaciones de Enfermedades Tropicales/CONICET, Oran, Salta, Argentina
| | - Rachel L. Pullan
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Charles S. Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - William E. Oswald
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Katherine E. Halliday
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Tadesse G, Wuletaw Y, Mekete K, Sime H, Yard E, Appleby L, Grimes J, Dejene N, Gardiner I, Kazienga A, Abbeddou S, French M, Levecke B, Drake L. Investigating the effect of a school-based WASH intervention on soil-transmitted helminth and schistosome infections and nutritional status of school children in Ethiopia: a quasi-experimental study. Parasit Vectors 2024; 17:130. [PMID: 38486228 PMCID: PMC10938701 DOI: 10.1186/s13071-024-06155-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 01/22/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The impact of access to improved water, sanitation and hygiene (WASH) and health education on large-scale deworming programs aimed at controlling soil-transmitted helminth (STH) and schistosome (SCH) infections has not been well studied. We assessed the additional impact of improved WASH infrastructure and health education at schools on STH and SCH infections in Ethiopia. METHODS The study used a quasi-experimental design under which 30 schools were assigned to either an intervention (15 schools) or control (15 schools) arm. Both arms received a standard deworming treatment and lunch. In the intervention arm, improved WASH and health education were provided. At three consecutive time points (baseline in 2013, 2014 and 2015), the prevalence and intensity of STH and SCH infections and the nutritional status [hemoglobin concentrations and physical growth (height and weight)] were determined. To verify whether interventions were successfully implemented, the WASH status at school and the student knowledge, attitudes and practices related to WASH (WASH-KAP) were recorded. Differences in metrics between arms at baseline (2013) and follow-up (2015) were assessed both within and between the arms. RESULTS A significant increase in scores for both the school WASH and student KAP was found in the intervention arm, indicating successful implementation of the intervention. The prevalence of any STH infection was significantly reduced in the intervention arm but not in the control arm (F = 4.486, p = 0.034). There was a significantly greater reduction in the intensity of infection of hookworm and Ascaris lumbricoides compared to baseline in both arms. The intervention did not affect school children's height-for-age z-score (intervention arm * time coef = 0.12, p = 0.400) and body mass index-for-age z-scores (intervention * time coef = - 0.06, p = 0.526). Hemoglobin concentrations increased significantly more in the control than the intervention arm (coef = - 0.16, p = 0.006). CONCLUSIONS Although the intervention did increase school WASH and student WASH-KAP, our study found poor evidence of the additional benefit of improved WASH and health education to deworming and school food programs on parasite re-infection and the health outcomes of children.
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Affiliation(s)
- Gemechu Tadesse
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Yonas Wuletaw
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Heven Sime
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Elodie Yard
- Partnership for Child Development, London, UK
| | | | - Jack Grimes
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London, UK
| | | | | | - Adama Kazienga
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Bruno Levecke
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Mationg MLS, Williams GM, Tallo VL, Olveda RM, McManus DP, Stewart DE, Gray DJ. A review of health education activities targeting schoolchildren for the control of soil-transmitted helminthiasis in Southeast Asia, with emphasis upon the Magic Glasses approach. Adv Parasitol 2024; 123:1-22. [PMID: 38448146 DOI: 10.1016/bs.apar.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Soil-transmitted helminths continue to be a serious problem causing disease and morbidity globally. Children, mostly school-aged, are more at risk of these infections. The main strategy for control remains to be the mass drug administration (MDA) of antihelminthic drugs. With the limitation of MDA to prevent re-infection, the need for additional approaches such as hygiene education and improvements in water, sanitation and hygiene (WASH) infrastructure are required. Although the importance of health education as a crucial component of an integrated approaches to STH control is highlighted, this component has often been disregarded because the other more complex solutions have been the focus of most studies and programmes. We performed literature searches from four bibliographic databases - Scopus, PubMed, Web of Science and Cochrane Library - to determine availability of studies on the impact of health education interventions targeting STH infections on schoolchildren in Southeast Asia. Our review found only three studies that evaluated health education interventions targeting children. The current lack of evidence in this area suggests the need for more studies assessing the impact of health education intervention for STH control. A successful health education programme for STH called "The Magic Glasses" has been developed targeting schoolchildren in China and the Philippines. This public health intervention displayed significant impact in terms of improving knowledge, attitude and practices, reducing prevalence of STH infections in schoolchildren and encouraging compliance to MDA. This article details the successes and benefits of the Magic Glasses programme as a promising control tool for STH in the Southeast Asian region.
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Affiliation(s)
- Mary Lorraine S Mationg
- National Center for Epidemiology and Population Health, Australian National University, Canberra; QIMR Berghofer Medical Research Institute, Brisbane
| | | | | | | | | | - Donald E Stewart
- School of Medicine and Dentistry, Griffith Health, Griffith University
| | - Darren J Gray
- QIMR Berghofer Medical Research Institute, Brisbane.
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Le B, Clarke NE, Legrand N, Nery SV. Effectiveness of ivermectin mass drug administration in the control of soil-transmitted helminth infections in endemic populations: a systematic review and meta-analysis. Infect Dis Poverty 2024; 13:16. [PMID: 38369483 PMCID: PMC10874526 DOI: 10.1186/s40249-024-01185-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/01/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Current soil-transmitted helminth (STH) control guidelines endorse the use of albendazole or mebendazole for school-based targeted preventive chemotherapy (PC), yet their reduced efficacy against Strongyloides stercoralis and Trichuris trichiura presents significant limitations. Emerging evidence indicates that community-wide PC [or mass drug administration (MDA)] using ivermectin, commonly used in other neglected tropical disease (NTD) control programs, may play an important role in controlling these parasites. We conducted a systematic review and meta-analysis to evaluate the effectiveness of ivermectin PC in reducing STH prevalence in endemic populations. METHODS We searched Pubmed, EMBASE, and Web of Science on February 14, 2023, for studies that investigated the effectiveness of ivermectin PC, either alone or in combination with other anthelmintic drugs, on STH infections, and provided a measure of STH prevalence before and after PC. We calculated pooled prevalence reductions for each STH using random-effects meta-analyses. Our protocol is available on PROSPERO (registration number CRD42023401219). RESULTS A total of 21 were eligible for the systematic review, of which 15 were eligible for meta-analysis. All studies delivered ivermectin through MDA. The pooled prevalence reduction of S. stercoralis following MDA with ivermectin alone was 84.49% (95% CI 54.96-94.66) across five studies and 81.37% (95% CI 61.62-90.96) across seven studies with or without albendazole. The prevalence reduction of T. trichiura was 49.93% (95% CI 18.23-69.34) across five studies with ivermectin alone, and 89.40% (95% CI 73.66-95.73) across three studies with the addition of albendazole. There was high heterogeneity for all syntheses (I2 > 65%). CONCLUSIONS This study underscores the key role of ivermectin-based MDA in addressing limitations in current global STH guidelines in terms of limited efficacy against S. stercoralis and T. trichiura. Based on these findings, revising international STH guidelines to include ivermectin is a promising option to progress the control and eventual elimination of STHs and other NTDs.
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Affiliation(s)
- Brandon Le
- The Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia.
| | - Naomi E Clarke
- The Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia
| | - Nicolas Legrand
- The Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia
| | - Susana Vaz Nery
- The Kirby Institute, University of New South Wales, Level 6, Wallace Wurth Building, Sydney, NSW, 2052, Australia
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Nacife MBPESL, Siqueira LMV, Barbosa KF, Vianna VN, Masioli CZ, da Silva JC, Zicker F, Coelho PMZ, Katz N, Machado-Coelho GLL. Prevalence of helmintic infections in Brazilian Maxakali indigenous: a repeated cross-sectional design. Int J Equity Health 2024; 23:18. [PMID: 38302951 PMCID: PMC10832216 DOI: 10.1186/s12939-024-02105-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/13/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND The prevalence of intestinal parasites is known to be high among Amerindian populations; further, there are serious problems in the healthcare of these populations in Brazil. The Maxakali, located in the northeastern region of Minas Gerais, Brazil, is an indigenous group that still preserves many of its cultural aspects. This study aimed to compare the positivity rate of schistosomiasis and soil-transmitted helminths in this ethnic group in epidemiological surveys conducted in 1972 and 2014. METHODS Stool parasitological examinations were performed by the Kato-Katz technique during both periods in this population. In 2014, the parasitological diagnosis was also realized with the TF-Test® technique. RESULTS In 1972, 270 inhabitants were examined. The positivity rates were 67.4% for Schistosoma mansoni, 72.9% for hookworms, 43.7% for Ascaris lumbricoides, and 23.7% for Trichuris trichiura. In 2014, 545 individuals were examined, and the positivity rates obtained were 45.7% for S. mansoni, 22.8% for hookworms, 0.6% for A. lumbricoides, and 2.8% for T. trichiura. CONCLUSIONS The comparison of the parasitological surveys conducted in 1972 and 2014, indicates that the indigenous Maxakali remained neglected by the health and indigenous protection authorities during these four decades. The infection rate observed in 2014 for schistosomiasis and hookworm remains high, considering the current epidemiological view of these diseases in the Brazilian population.
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Affiliation(s)
- Maria Beatriz Pena E Silva Leite Nacife
- Universidade Federal de Ouro Preto, Escola de Medicina, Laboratório de Epidemiologia, Rua Dois s/n, sala 203, Campus Universitário Morro do Cruzeiro, Ouro Preto, Minas Gerais, CEP 35402-145, Brasil
| | | | - Keila Furbino Barbosa
- Universidade Federal de Ouro Preto, Escola de Medicina, Laboratório de Epidemiologia, Rua Dois s/n, sala 203, Campus Universitário Morro do Cruzeiro, Ouro Preto, Minas Gerais, CEP 35402-145, Brasil
| | - Valeska Natiely Vianna
- Universidade Federal de Ouro Preto, Escola de Medicina, Laboratório de Epidemiologia, Rua Dois s/n, sala 203, Campus Universitário Morro do Cruzeiro, Ouro Preto, Minas Gerais, CEP 35402-145, Brasil
| | - Cássio Zumerle Masioli
- Universidade Federal de Ouro Preto, Escola de Medicina, Laboratório de Epidemiologia, Rua Dois s/n, sala 203, Campus Universitário Morro do Cruzeiro, Ouro Preto, Minas Gerais, CEP 35402-145, Brasil
| | - Jaime Costa da Silva
- Ministério da Saúde, Distrito Sanitário Especial Indígena/Minas Gerais-Espírito Santo, Belo Horizonte, Minas Gerais, Brasil
| | | | | | - Naftale Katz
- Fundação Oswaldo Cruz, Instituto René Rachou, Belo Horizonte, Minas Gerais, Brasil
| | - George Luiz Lins Machado-Coelho
- Universidade Federal de Ouro Preto, Escola de Medicina, Laboratório de Epidemiologia, Rua Dois s/n, sala 203, Campus Universitário Morro do Cruzeiro, Ouro Preto, Minas Gerais, CEP 35402-145, Brasil.
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Makaula P, Kayuni SA, Mamba KC, Bongololo G, Funsanani M, Juziwelo LT, Musaya J, Furu P. Mass drug administration campaigns: comparing two approaches for schistosomiasis and soil-transmitted helminths prevention and control in selected Southern Malawi districts. BMC Health Serv Res 2024; 24:11. [PMID: 38172854 PMCID: PMC10765822 DOI: 10.1186/s12913-023-10489-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Mass drug administration is one of the key interventions recommended by WHO to control certain NTDs. With most support from donors, health workers distribute antihelminthic drugs annually in Malawi. Mean community coverage of MDA from 2018 to 2020 was high at 87% for praziquantel and 82% for albendazole. However, once donor support diminishes sustaining these levels will be challenging. This study intended to compare the use of the community-directed intervention approach with the standard practice of using health workers in delivery of MDA campaigns. METHODS This was a controlled implementation study carried out in three districts, where four health centres and 16 villages in each district were selected and randomly assigned to intervention and control arms which implemented MDA campaigns using the CDI approach and the standard practice, respectively. Cross-sectional and mixed methods approach to data collection was used focusing on quantitative data for coverage and knowledge levels and qualitative data to assess perceptions of health providers and beneficiaries at baseline and follow-up assessments. Quantitative and qualitative data were analyzed using IBM SPSS software version 26 and NVivo 12 for Windows, respectively. RESULTS At follow-up, knowledge levels increased, majority of the respondents were more knowledgeable about what schistosomiasis was (41%-44%), its causes (41%-44%) and what STH were (48%-64%), while knowledge on intermediate host for schistosomiasis (19%-22%), its types (9%-13%) and what causes STH (15%-16%) were less known both in intervention and control arm communities. High coverage rates for praziquantel were registered in intervention (83%-89%) and control (86%-89%) communities, intervention (59%-79) and control (53%-86%) schools. Costs for implementation of the study indicated that the intervention arm used more resources than the control arm. Health workers and community members perceived the use of the CDI approach as a good initiative and more favorable over the standard practice. CONCLUSIONS The use of the CDI in delivery of MDA campaigns against schistosomiasis and STH appears feasible, retains high coverages and is acceptable in intervention communities. Despite the initial high costs incurred, embedding into community delivery platforms could be considered as a possible way forward addressing the sustainability concern when current donor support wanes. TRIAL REGISTRATION Pan-African Clinical Trials Registry PACTR202102477794401, date: 25/02/2021.
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Affiliation(s)
- Peter Makaula
- Research for Health Environment and Development, P.O. Box 345, Mangochi, Malawi.
- Malawi Liverpool Wellcome Research Programme, Private Bag 30096, Blantyre 3, Malawi.
| | - Sekeleghe Amos Kayuni
- Malawi Liverpool Wellcome Research Programme, Private Bag 30096, Blantyre 3, Malawi
- Medical Aid Society of Malawi (MASM) Medi Clinics Limited, Area 12 Medi Clinic, P.O. Box 31659, Lilongwe 3, Malawi
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | | | - Grace Bongololo
- Research for Health Environment and Development, P.O. Box 345, Mangochi, Malawi
| | - Mathias Funsanani
- Research for Health Environment and Development, P.O. Box 345, Mangochi, Malawi
| | - Lazarus Tito Juziwelo
- Ministry of Health, Community Health Sciences Unit, National Schistosomiasis and Soil-Transmitted Helminths Control Programme, Private Bag 65, Lilongwe, Malawi
| | - Janelisa Musaya
- Malawi Liverpool Wellcome Research Programme, Private Bag 30096, Blantyre 3, Malawi
- Department of Pathology, Kamuzu University of Health Sciences, Private Bag 360, Blantyre 3, Malawi
| | - Peter Furu
- Department of Public Health, Global Health Section, University of Copenhagen, 5 Øster Farimagsgade, 1014, Copenhagen K, Denmark.
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Le B, Clarke NE, Hii SF, Byrne A, Khattak A, Lake S, Lazu E, Wickham S, Wand H, Olsen N, Zendejas-Heredia PA, Sokana O, Romani L, Engelman D, Nasi T, Boara D, Kaldor J, Steer A, Traub R, Nery SV. Effectiveness of one and two doses of ivermectin mass drug administration in reducing the prevalence and intensity of soil-transmitted helminth (STH) infections in Western Province, Solomon Islands: a cluster-randomised, before-after analysis. Lancet Reg Health West Pac 2024; 42:100942. [PMID: 38357395 PMCID: PMC10865046 DOI: 10.1016/j.lanwpc.2023.100942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/23/2023] [Accepted: 10/09/2023] [Indexed: 02/16/2024]
Abstract
Background Ivermectin mass drug administration (MDA) is effective for controlling onchocerciasis and scabies, with evidence supporting its role in some species of soil-transmitted helminth (STH) infections. In the context of RISE, a cluster-randomised trial for scabies, this study evaluated the effectiveness of ivermectin MDA in reducing STH burden in the Western Province of Solomon Islands. Methods Twenty villages were randomised 1:1 to receive ivermectin MDA as one dose (IVM-1) or two doses (IVM-2) for scabies. The effectiveness of one and two doses in reducing STH prevalence and intensity was evaluated before (May 2019) and 21 months after (February 2021) MDA in May 2019. All residents aged 12 months or older in the study villages were eligible to participate and provide stool specimens. Species-specific STH infection and intensity were assessed using quantitative PCR. We compared prevalence and intensity of infection between baseline and 21 months in each intervention arm individually using cluster-level analysis (adjusted for clustering) and individual-level analysis (adjusted for sex, age, and clustering). The primary outcomes were the prevalence risk difference (RD) from the cluster-level analysis, and the change in adjusted odds of infection from the individual-level analysis. Secondary outcomes included change in incident rates of mean eggs per gram (epg) of stool from baseline to 21 months, relative risk difference in prevalence and relative change in odds of infection between arms at 21 months. Sex data (male/female) were self-reported. Findings Overall, STH infection was assessed in 830 participants from 18 villages at baseline and 1172 from 20 villages at follow-up. Females represented 58% (n = 478) of the sample at baseline and 59% (n = 690) at follow-up. We observed a reduction in Strongyloides spp. prevalence following two doses of ivermectin MDA in the cluster-level analysis from 7.0% (32/458 participants) to 1.2% (8/674 participants), corresponding to a RD of -0.07 (95% CI -0.14 to -0.01, p = 0.036), and in the individual-level analysis (OR 0.11, 95% CI 0.04-0.33, p < 0.001). T. trichiura prevalence decreased following one dose from 19.4% (74/372 participants) to 11.7% (56/505 participants) (OR 0.44, 95% CI 0.26-0.73, p = 0.0040), while egg count reduced in both arms (IVM-1: IRR 0.28, 95% CI 0.11-0.70, p = 0.0070; IVM-2: IRR 0.18, 95% CI 0.08-0.40, p < 0.001), in the individual-level analysis. We did not detect a significant difference in effect measures between the one- and two-dose arms for any species after 21 months. Interpretation Our study highlights the long-term benefits of ivermectin MDA in reducing the burden of Strongyloides spp. and T. trichiura. STH control programs should leverage the geographical overlap of NTDs, existing drug distribution channels, and broad-spectrum agents. Funding The National Health and Medical Research Council of Australia.
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Affiliation(s)
- Brandon Le
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Naomi E. Clarke
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Sze Fui Hii
- The University of Melbourne, Melbourne, Australia
| | - Aisling Byrne
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Alam Khattak
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Susanna Lake
- Murdoch Children's Research Institute, Melbourne, Australia
| | | | | | - Handan Wand
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Nick Olsen
- Stats Central, University of New South Wales, Sydney, Australia
| | | | - Oliver Sokana
- Ministry of Health & Medical Services, Honiara, Solomon Islands
| | - Lucia Romani
- The Kirby Institute, University of New South Wales, Sydney, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Titus Nasi
- Ministry of Health & Medical Services, Honiara, Solomon Islands
| | | | - John Kaldor
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Andrew Steer
- Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Susana Vaz Nery
- The Kirby Institute, University of New South Wales, Sydney, Australia
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Ng'etich AI, Amoah ID, Bux F, Kumari S. Anthelmintic resistance in soil-transmitted helminths: One-Health considerations. Parasitol Res 2023; 123:62. [PMID: 38114766 PMCID: PMC10730643 DOI: 10.1007/s00436-023-08088-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
The One-Health approach recognizes the intricate connection between human, animal, and environmental health, and that cooperative effort from various professionals provides comprehensive awareness and potential solutions for issues relating to the health of people, animals, and the environment. This approach has increasingly gained appeal as the standard strategy for tackling emerging infectious diseases, most of which are zoonoses. Treatment with anthelmintics (AHs) without a doubt minimizes the severe consequences of soil-transmitted helminths (STHs); however, evidence of anthelmintic resistance (AR) development to different helminths of practically every animal species and the distinct groups of AHs is overwhelming globally. In this regard, the correlation between the application of anthelmintic drugs in both human and animal populations and the consequent development of anthelmintic resistance in STHs within the context of a One-Health framework is explored. This review provides an overview of the major human and animal STHs, treatment of the STHs, AR development and drug-related factors contributing towards AR, One-Health and STHs, and an outline of some One-Health strategies that may be used in combating AR.
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Affiliation(s)
- Annette Imali Ng'etich
- Institute for Water and Wastewater Technology, Durban University of Technology (DUT), Durban, South Africa
| | - Isaac Dennis Amoah
- Institute for Water and Wastewater Technology, Durban University of Technology (DUT), Durban, South Africa
- Department of Environmental Science, University of Arizona, Tucson, AZ, USA
| | - Faizal Bux
- Institute for Water and Wastewater Technology, Durban University of Technology (DUT), Durban, South Africa
| | - Sheena Kumari
- Institute for Water and Wastewater Technology, Durban University of Technology (DUT), Durban, South Africa.
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Dyer CE, Ng-Nguyen D, Clarke NE, Hii SF, Nguyen HQ, Nguyen VAT, Nguyen TV, Nguyen TV, Ngo TT, Herath HD, Wand H, Coffeng LE, Marshall JC, Gray DJ, Anderson RM, Clements AC, Kaldor JM, Traub RJ, Vaz Nery S. Community-wide versus school-based targeted deworming for soil-transmitted helminth control in school-aged children in Vietnam: the CoDe-STH cluster-randomised controlled trial. Lancet Reg Health West Pac 2023; 41:100920. [PMID: 37860203 PMCID: PMC10583164 DOI: 10.1016/j.lanwpc.2023.100920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 09/15/2023] [Indexed: 10/21/2023]
Abstract
Background Soil-transmitted helminth (STH) infection control programs typically consist of school-based preventive chemotherapy (PC) targeted to school-aged children. STH reservoirs in untreated community members contribute to ongoing transmission in children. The CoDe-STH (Community Deworming against STH) trial, conducted in Dak Lak province, Vietnam, between October 2019 and November 2020, aimed to determine whether community-wide mass drug administration (MDA) is more effective than school-based targeted PC in reducing STH prevalence and intensity in children. Methods In this two-arm cluster randomised controlled trial, 64 primary schools were randomly assigned 1:1 to receive either school-based targeted PC ("school arm") or community-wide MDA ("community arm"). A single dose of albendazole 400 mg was used for deworming. The primary outcome was hookworm prevalence in schoolchildren, measured using quantitative real-time PCR. We also measured infection intensity for Necator americanus only, using qPCR cycle threshold (Ct) values converted into eggs per gram of faeces (EPG). Analysis was by intention to treat. The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000309189). Findings The analysis included 4955 children in the school arm and 5093 children in the community arm. N. americanus was the dominant STH species. The relative reduction in hookworm prevalence was not significantly different between the school arm (30.1%, 95% confidence interval [CI] 20.5-36.9) and the community arm (34.6%, 95% CI 19.9-49.4). Due to lower baseline prevalence than expected, the study was underpowered to detect a difference in prevalence reduction between the study arms. The community arm showed significantly greater relative reduction in N. americanus infection intensity (56.0%, 95% CI 39.9-72.1) compared to the school arm (3.4%, 95% CI -24.7 to 31.4). The community arm also showed greater relative reduction in prevalence of moderate-to-heavy intensity (≥2000 EPG) N. americanus infections (81.1%; 95% CI 69.7-92.6) compared to the school arm (39.0%, 95% CI 13.7-64.2). Interpretation Although no impact was seen on overall prevalence, community-wide MDA was more effective in lowering N. americanus infection intensity in schoolchildren compared to school-based targeted PC, measured 12 months after one round of albendazole deworming with high coverage. Funding National Health and Medical Research Council, Australia (APP1139561).
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Affiliation(s)
- Clare E.F. Dyer
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Dinh Ng-Nguyen
- Faculty of Animal Sciences and Veterinary Medicine, Tay Nguyen University, Dak Lak, Vietnam
| | - Naomi E. Clarke
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Sze Fui Hii
- Faculty of Science, Melbourne Veterinary School, The University of Melbourne, Melbourne, Vic, Australia
| | - Hieu Quoc Nguyen
- Faculty of Animal Sciences and Veterinary Medicine, Tay Nguyen University, Dak Lak, Vietnam
| | - Van-Anh Thi Nguyen
- Faculty of Animal Sciences and Veterinary Medicine, Tay Nguyen University, Dak Lak, Vietnam
| | - Thai Van Nguyen
- Faculty of Animal Sciences and Veterinary Medicine, Tay Nguyen University, Dak Lak, Vietnam
| | - Trong Van Nguyen
- Faculty of Animal Sciences and Veterinary Medicine, Tay Nguyen University, Dak Lak, Vietnam
| | - Tam Thi Ngo
- Centers for Disease Control and Prevention, Dak Lak, Vietnam
| | - H.M.P. Dilrukshi Herath
- Faculty of Science, Melbourne Veterinary School, The University of Melbourne, Melbourne, Vic, Australia
| | - Handan Wand
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Luc E. Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Darren J. Gray
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Roy M. Anderson
- Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Archie C.A. Clements
- Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Telethon Kids Institute, Perth, WA, Australia
- Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
| | - John M. Kaldor
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Rebecca J. Traub
- Faculty of Science, Melbourne Veterinary School, The University of Melbourne, Melbourne, Vic, Australia
| | - Susana Vaz Nery
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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10
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Okoyo C, Minnery M, Orowe I, Owaga C, Campbell SJ, Wambugu C, Olick N, Hagemann J, Omondi WP, McCracken K, Montresor A, Medley GF, Fronterre C, Diggle P, Mwandawiro C. Model-based geostatistical design and analysis of prevalence for soil-transmitted helminths in Kenya: Results from ten-years of the Kenya national school-based deworming programme. Heliyon 2023; 9:e20695. [PMID: 37829802 PMCID: PMC10565763 DOI: 10.1016/j.heliyon.2023.e20695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 10/14/2023] Open
Abstract
Background Kenya is endemic for soil-transmitted helminths (STH) with over 6 million children in 27 counties currently at-risk. A national school-based deworming programme (NSBDP) was launched in 2012 with a goal to eliminate parasitic worms as a public health problem. This study used model-based geostatistical (MBG) approach to design and analyse the impact of the NSBDP and inform treatment strategy changes. Methods A cross-sectional study was used to survey 200 schools across 27 counties in Kenya. The study design, school selection and analysis followed the MBG approach which incorporated historical data on treatment, morbidity and environmental covariates to efficiently predict the helminths prevalence in Kenya. Results Overall, the NSBDP geographic area prevalence for any STH was estimated to sit between 2 % and <10 % with a high predictive probability of >0.999. Species-specific thresholds were between 2 % and <10 % for Ascaris lumbricoides, 0 % to <2 % for hookworm, and 0 % to <2 % for Trichuris trichiura, all with high predictive probability of >0.999. Conclusions Based on the World Health Organization guidelines, STH treatment requirements can now be confidently refined. Ten counties may consider suspending treatment and implement appropriate surveillance system, while another 10 will require treatment once every two years, and the remaining seven will require treatment once every year.
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Affiliation(s)
- Collins Okoyo
- School of Mathematics, University of Nairobi, Nairobi, Kenya
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya
- Department of Epidemiology, Statistics and Informatics (DESI), Kenya Medical Research Institute, Nairobi, Kenya
| | - Mark Minnery
- Deworm the World, Evidence Action, Washington DC, United States
| | - Idah Orowe
- School of Mathematics, University of Nairobi, Nairobi, Kenya
| | | | | | - Christin Wambugu
- Division of Adolescent and School Health (DASH), Ministry of Health, Nairobi, Kenya
| | - Nereah Olick
- School Health, Nutrition and Meals Unit (SHNMU), Ministry of Education, Nairobi, Kenya
| | - Jane Hagemann
- Deworm the World, Evidence Action, Washington DC, United States
| | - Wyckliff P. Omondi
- Division of Vector Borne and Neglected Tropical Diseases (DVBNTD), Ministry of Health, Nairobi, Kenya
| | - Kate McCracken
- Deworm the World, Evidence Action, Washington DC, United States
| | - Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Graham F. Medley
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Claudio Fronterre
- Centre for Health Informatics, Computing and Statistics (CHICAS), Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Peter Diggle
- Centre for Health Informatics, Computing and Statistics (CHICAS), Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Charles Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya
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11
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Dorkenoo AM, Phillips AE, Klein L, Lack F, Ataba E, Yakpa K, Tagba AE, Assoti BE, Sossou E, Tchalim M, Datagni G, Seim A, Milord MD, Kassankogno Y. Progress from morbidity control to elimination as a public health problem of schistosomiasis and the status of soil-transmitted helminth infection in Togo: a second impact assessment after ten rounds of mass drug administration. Parasit Vectors 2023; 16:314. [PMID: 37667301 PMCID: PMC10478252 DOI: 10.1186/s13071-023-05882-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 07/14/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Due to the burden of schistosomiasis (SCH) and soil-transmitted helminths (STH), Togo Ministry of Health launched a program for Preventive Chemotherapy Neglected Tropical Diseases (PC-NTDs) in 2009, initiating integrated mass drug administration (MDA) the following year for the three PC-NTDs: SCH, STH and onchocerciasis. Significant reduction of infection across the country was noted in 2015 during the first impact assessment, following 5 years of high-coverage MDA implemented at the sub-district level for SCH and district level for STH. After another 5 years of effective MDA, a second survey was conducted in 2021 to re-evaluate the situation of SCH and STH. METHODS A cross-section of school-aged children was taken across ten districts of Togo. A total of 302 schools in 92 sub-districts were sampled, with 24 school-aged children per school resulting in 7248 children surveyed. Urine samples were tested by haemastix® for Schistosoma haematobium, with urine filtration for the presence of eggs conducted on haematuria-positive samples. Stool samples were collected in a subset of 34 sub-districts in seven out of the ten surveyed districts, where STH and Schistosoma mansoni endemicity was high during the 2015 impact assessment. Duplicate (two) Kato-Katz analysis was performed for each stool sample. Sociodemographic and school-level water, sanitation and hygiene information was also collected. RESULTS Overall, SCH prevalence was 5.90% (95% CI: 5.4-6.5), with 5.09% (95% CI: 4.64-5.67) for S. haematobium and 2.56% (95% CI: 1.98-3.29) for S. mansoni. STH prevalence was 19.7% (95% CI: 18.2-21.4), with 19.6% (95% CI: 18.1-21.3) hookworm, 0.08% (95% CI: 2.2-5.8) Trichuris trichiura and 0.04% (95% CI: 0.01-0.33) Ascaris lumbricoides. Compared to baseline, a significant reduction in both SCH (22.2% to 5.90%) and STH (29.2% t0 19.7%) prevalence was observed. Children aged 5-9 years were less infected than older peers aged 10-14 years: 4.76% vs. 7.53% (P < 0.01) for SCH and 17.2% vs. 23.0% (P < 0.01) for STH. CONCLUSIONS After 10 years of high coverage integrated MDA, Togo has achieved low prevalence SCH infection through the sub-district MDA implementation with considerable infection heterogeneity within sub-districts. As STH infection has not reached a level where the infections are not a public health problem, the sub-district treatment strategy could also be adopted in addition to improvement of treatment coverage among preschool age children and hygiene and sanitation practices.
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Affiliation(s)
- Ameyo M Dorkenoo
- National Program for the Control of NTDs, Ministry of Health, Public Hygiene and Universal Health Coverage, Lomé, Togo.
- Department of Biological and Basic Sciences, Faculty of Health Sciences, University of Lomé, Lomé, Togo.
| | | | - Luke Klein
- Family Health International 360, Washington, DC, USA
| | - Fiali Lack
- Centre Hospitalier Universitaire Sylvanus Olympio, Ministry of Health, Public Hygiene and Universal Health Coverage, Lomé, Togo
| | - Essoham Ataba
- Programme National de Lute Contre le Paludisme, Ministry of Health, Public Hygiene and Universal Health Coverage, Lomé, Togo
| | - Kossi Yakpa
- Programme National de Lute Contre le Paludisme, Ministry of Health, Public Hygiene and Universal Health Coverage, Lomé, Togo
| | - Atna-Edi Tagba
- Centre Hospitalier Universitaire Sylvanus Olympio, Ministry of Health, Public Hygiene and Universal Health Coverage, Lomé, Togo
| | - Bozi-Esso Assoti
- Centre Hospitalier Universitaire Sylvanus Olympio, Ministry of Health, Public Hygiene and Universal Health Coverage, Lomé, Togo
| | - Efoe Sossou
- Centre Hospitalier Universitaire Sylvanus Olympio, Ministry of Health, Public Hygiene and Universal Health Coverage, Lomé, Togo
| | - Mawèké Tchalim
- National Program for the Control of NTDs, Ministry of Health, Public Hygiene and Universal Health Coverage, Lomé, Togo
| | | | - Anders Seim
- Health and Development International, Fjellstrand, Norway
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12
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Neto AFR, Di Christine Oliveira YL, de Oliveira LM, La Corte R, Jain S, de Lyra Junior DP, Fujiwara RT, Dolabella SS. Why Are We Still a Worm World in the 2020s? An Overview of Risk Factors and Endemicity for Soil-Transmitted Helminthiasis. Acta Parasitol 2023; 68:481-495. [PMID: 37531011 DOI: 10.1007/s11686-023-00701-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 07/18/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Soil-transmitted helminthiasis (STH) is one of the most common chronic infections in developing countries associated with poor socioeconomic and sanitary conditions. The main objective of this overview was to evaluate the influence of environmental factors, risk factors related to the host, and control strategies on the prevalence of STH in different regions of the world. METHODS LILACS, PubMed, Web of Knowledge, Embase, the Cochrane Library, and Clinical Trials (gray literature) databases were used to obtain the systematic reviews published until December 2020. The methodological quality of systematic reviews was assessed using the standard criteria recommended by AMSTAR. RESULTS The initial results of the bibliographic search identified 1448 articles, of which 66 studies were read in full and 16 met the inclusion criteria. All the reviews included in this overview associated variations in the global prevalence of STH with at least one of the factors related to the environment, host, and/or control strategies. Climate, temperature, soil moisture, precipitation, mass drug administration, lack of access to water, sanitation and hygiene (WASH), and non-use of footwear were considered the main factors associated with the prevalence of STH. Socioeconomic factors, low educational level, and wearing shoes were universal factors related to prevalence, regardless of the location studied. CONCLUSION The combination of environmental factors, with factors associated with hosts that predispose infection and reinfection of helminths, as well as the adoption of control strategies based on the treatment of target populations instead of the entire population, influenced the prevalence of STH in all the continents evaluated.
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Affiliation(s)
- Adelson Ferreira Ramos Neto
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | | | - Luciana Maria de Oliveira
- Department of Morphology, Center of Biology and Health Sciences, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - Roseli La Corte
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - Sona Jain
- Postgraduate Program in Industrial Biotechnology, Tiradentes University, Aracaju, SE, 49010-390, Brazil
| | | | - Ricardo Toshio Fujiwara
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Silvio Santana Dolabella
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil.
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil.
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13
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Sumboh JG, Agyenkwa-Mawuli K, Schwinger E, Donkor IO, Akorli JEB, Dwomoh D, Ashong Y, Osabutey D, Ababio FO, Koram KA, Humphries D, Cappello M, Kwofie SK, Wilson MD. Investigating Environmental Determinants of Soil-Transmitted Helminths Transmission using GPS Tracking and Metagenomics Technologies. medRxiv 2023:2023.07.17.23292808. [PMID: 37503260 PMCID: PMC10371187 DOI: 10.1101/2023.07.17.23292808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Background The Global Health community aims to eliminate soil-transmitted helminth (STH) infections by 2030. Current preventive methods such as Mass Drug Administration, WASH practices, and health education needs to be complimented to halt transmission. We tracked the movement of hookworm-infected and non-infected persons and investigated soil factors in the places they frequented within an endemic community to further understand the role of human movement and sources of infections. Methods 59 positive and negative participants wore GPS tracking devices for 10 consecutive days and their movement data captured in real time. The data was overlaid on the community map to determine where each group differentially spent most of their time. Soil samples were collected from these identified sites and other communal places. Physical and chemical properties were determined for each sample using standard methods and helminth eggs cultured into larvae using the Baermann technique. Bivariate and multivariate analyses were used to determine associations between larvae counts and soil factors. Helminth species were identified with metagenomic sequencing and their distributions mapped to sampling sites in the community. Results The study found that there was no significant difference in the average larvae counts in soil between sites assessed by infected and non-infected participants (P=0.59). However, soil factors, such as pH, carbon and sandy-loamy texture were associated with high larvae counts (P<0.001) while nitrogen and clay content were associated with low counts(P<0.001). The dominant helminth species identified were Panagrolaimus superbus (an anhydrobiotic helminth), Parastrongyloides trichosuri (a parasite of small mammals), Trichuris trichuria (whipworm), and Ancylostoma caninum (dog hookworm). Notably, no Necator americanus was identified in any soil sample. Conclusion This study provides important insights into the association between soil factors and soil-transmitted helminths. These findings contribute to our understanding of STH epidemiology and support evidence-based decision-making for elimination strategies.
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Affiliation(s)
- Jeffrey Gabriel Sumboh
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana. Legon, Accra, Ghana
| | - Kwasi Agyenkwa-Mawuli
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana. Legon, Accra, Ghana
| | - Eyram Schwinger
- Department of Mathematics, University of Ghana. Legon, Accra, Ghana
| | - Irene Owusu Donkor
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana. Legon, Accra, Ghana
| | - Jewelna E. B. Akorli
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana. Legon, Accra, Ghana
| | - Duah Dwomoh
- Department of Biostatistics, School of Public Health, University of Ghana. Legon, Accra, Ghana
| | - Yvonne Ashong
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana. Legon, Accra, Ghana
| | - Dickson Osabutey
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana. Legon, Accra, Ghana
| | - Felix Owusu Ababio
- Soil Research Institute, Council for Scientific and Industrial Research, Accra, Ghana
| | - Kwadwo Ansah Koram
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana. Legon, Accra, Ghana
| | - Debbie Humphries
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, United States of America
| | - Michael Cappello
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, United States of America
| | - Samuel K. Kwofie
- School of Biomedical Engineering, Faculty of Engineering, University of Ghana. Legon, Accra, Ghana
| | - Michael D. Wilson
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana. Legon, Accra, Ghana
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14
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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15
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Xu Y, Wang Y, Wang L, Kong X, Yan G, Li Y, Bu C, Zhang B. The prevalence of soil transmitted helminths and its influential factors in Shandong Province, China: an analysis of surveillance data from 2016 to 2020. Infect Dis Poverty 2023; 12:54. [PMID: 37217956 DOI: 10.1186/s40249-023-01100-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/04/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Soil-transmitted helminths (STHs) were previously endemic in Shandong Province, China. This study aimed to analyze the STHs prevalence trend and the natural, social, and human cognitive and behavioural factors influencing the discrepancies between high and low infection levels from 2016 to 2020 in Shandong Province in eastern China. METHODS STHs surveillance data of Shandong Province from 2016 to 2020 were obtained from China Information Management System for Prevention and Control of Parasitic Diseases. STHs infections were detected by modified Kato-Katz method. Comprehensive information on the natural and social factors, STHs-related knowledge and behaviours were collected through questionnaire surveys. Retrospective spatial scan analysis was performed using SaTScan v10.1 to evaluate any identified spatial clusters of STHs infection for statistical significance and Bayes discriminant analysis was used to discriminate the high or low infection groups of the villages. RESULTS In total, 72,160 participants were involved in our survey from 2016 to 2020. The overall STHs prevalence rate was 1.13%, with the eastern region of Shandong Province having the highest rate (2.02%). The predominant species was T. trichiura, with the prevalence rate of 0.99% and the ≥ 70-year age group possessed the highest rate of 2.21%. The STHs prevalence rate showed an annual linear downward trend from 2016 to 2020 ([Formula: see text] = 127.600, P < 0.001). Respondents aged ≥ 60 years had the lowest awareness level of STHs-related prevention knowledge (all P < 0.05), and were the most likely to adopt the practice of fertilizing with fresh stool (χ2 = 28.354, P < 0.001). Furthermore, the southern region demonstrated the highest temperature and rainfall level and the lowest GNP and annual net income per capita (all P < 0.05). CONCLUSIONS There is a remarkable declining in STHs prevalence in Shandong Province from 2016 to 2020. However, the prevalence rates of STHs especially T. trichiura in the southern and eastern regions were still high, and the elderly were more susceptible to be infected with STHs owning to their low awareness level of STHS-related prevention knowledge and high adoption rate of dangerous production and living behaviours. Integrated approaches of health education, environment improvement and behaviour change should be strengthened to obtain a further reduction of STHs prevalence in China.
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Affiliation(s)
- Yan Xu
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, No.11 Taibai Middle Road, Rencheng District, Jining City, 272033, Shandong Province, People's Republic of China
| | - Yongbin Wang
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, No.11 Taibai Middle Road, Rencheng District, Jining City, 272033, Shandong Province, People's Republic of China
| | - Longjiang Wang
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, No.11 Taibai Middle Road, Rencheng District, Jining City, 272033, Shandong Province, People's Republic of China
| | - Xiangli Kong
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, No.11 Taibai Middle Road, Rencheng District, Jining City, 272033, Shandong Province, People's Republic of China
| | - Ge Yan
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, No.11 Taibai Middle Road, Rencheng District, Jining City, 272033, Shandong Province, People's Republic of China
| | - Yuejin Li
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, No.11 Taibai Middle Road, Rencheng District, Jining City, 272033, Shandong Province, People's Republic of China
| | - Cancan Bu
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, No.11 Taibai Middle Road, Rencheng District, Jining City, 272033, Shandong Province, People's Republic of China
| | - Benguang Zhang
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, No.11 Taibai Middle Road, Rencheng District, Jining City, 272033, Shandong Province, People's Republic of China.
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Mukutmoni M, Liza FT, Parvin RA, Nath TC. Perceptions and practices of urban slum-dwelling women concerning soil-transmitted helminths infections in Bangladesh: A cross-sectional study. Parasite Epidemiol Control 2023; 21:e00291. [PMID: 36875174 PMCID: PMC9982025 DOI: 10.1016/j.parepi.2023.e00291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 02/04/2023] [Accepted: 02/15/2023] [Indexed: 02/19/2023] Open
Abstract
Introduction Soil-transmitted helminths (STH) infections are still attributed to a significant part of mortality and disabilities in developing nations. This study aimed at exploring the perceptions and practices concerning STH and to assess the associated risk of infections among slum-dwelling women of Dhaka South City Corporations (DSCC), Bangladesh. Materials and methods A cross-sectional study was conducted in two selected slums (Malibagh and Lalbagh) of DSCC, Bangladesh, from September 2020 to February 2021. A total of 206 women participants were requested to provide stool samples, followed by a semi-structured questionnaire survey. Parasitological assessment was done by the formol-ether concentration (FEC) technique. Data were analyzed using descriptive statistics, and p-value < 0.05 was considered as statistically significant. An adjusted odds ratio (AOR) with a 95% confidence interval (95% CI) was estimated using logistic regression analysis to examine the association between explanatory and outcome factors. Results In total, 36 (17.5%) STH infections were observed out of 206 examined participants. Among the STH, Trichuris trichiura showed the highest prevalence (10.7%), followed by Ascaris lumbricoides (5.3%). Lack of formal education, overcrowded living, large family sizes, and using shared toilets were significantly associated with STH infections. Irregular nail cutting (AOR = 3.12), irregular soap usage after toilet (AOR = 2.98), wearing no shoes (AOR = 4.64), and failing to teach kids to wash their hands (AOR = 3.87) were revealed as practice concerns linked to high STH prevalence. Women, who had never heard about STH (AOR = 2.42) and had no misconceptions regarding STH (AOR = 1.94) were positively related to STH infection in this study. Conclusion Slum-dwelling women in Bangladesh still had a substantial infection of STH. Most of the communities under study were unaware of parasite infection and its negative effects on health. Revision of the policy of ongoing anthelmintic distribution programs and widespread health education programs are recommended aimed at controlling STH.
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Affiliation(s)
| | | | | | - Tilak Chandra Nath
- Department of Parasitology, Sylhet Agricultural University, Sylhet, Bangladesh
- Corresponding author.
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Imalele EE, Braide EI, Emanghe UE, Effanga EO, Usang AU. Soil-transmitted helminth infection among school-age children in Ogoja, Nigeria: implication for control. Parasitol Res 2023; 122:1015-1026. [PMID: 36882536 DOI: 10.1007/s00436-023-07809-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/01/2023] [Indexed: 03/09/2023]
Abstract
The study aimed at assessing the prevalence and risk factors of soil-transmitted helminthiases among school-aged children in Ogoja Local Government Area, Cross River State. Fecal samples were collected from 504 participants and analyzed using the Kato-Katz technique and modified Baermann technique for identifying larvae of Strongyloides. A total of 232 (46.0%) samples were positive for soil-transmitted helminths. The overall prevalence of Ascaris lumbricoides, hookworm, Trichuris trichiura, and Strongyloides stercoralis were 14.1%, 16.5%, 2.6%, and 12.9% respectively. The prevalence of infections were higher among males (46.6%) than females (45.4%). Overall, parasitic infection was higher in the 5-7-year age group (65.6%) than in the other age groups (p = 0.000). Infection intensities of A. lumbricoides (84.00 EPG) (p = 0.044) and T. trichiura (96.00 EPG) (p = 0.041) were higher in school-age children aged 14-16 years. A. lumbricoides and hookworm co-infection (8.7%) was the most common mixed infection and was significantly higher in males than females. School-aged children who did not have prior knowledge about soil-transmitted helminth infections, the habit of drinking water without boiling, open defecation, use of pit latrine, and children who did not have toilet facilities in school were significantly associated with soil-transmitted helminthiases. There was a significant relationship between washing hands after using the toilet, the habit of putting on footwear outside the house, and soil-transmitted helminth infection. In addition to preventive chemotherapy, control measures should focus on health education, providing clean drinking water, proper disposal of human excreta and sewage, and environmental hygiene.
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Affiliation(s)
- Edema Enogiomwan Imalele
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Calabar, Calabar, Cross River State, Nigeria.
| | - Ekanem Ikpi Braide
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Calabar, Calabar, Cross River State, Nigeria
| | - Ubleni Etta Emanghe
- Department of Medical Microbiology/Parasitology, University of Calabar, Calabar, Cross River State, Nigeria
| | - Emmanuel Offiong Effanga
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Calabar, Calabar, Cross River State, Nigeria
| | - Anok Ukam Usang
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Calabar, Calabar, Cross River State, Nigeria
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Mazigo HD, Zinga MM, Kepha S, Yard E, McRee-Mckee K, Kabona G, Ngoma DD, Nshala A. Precision and geographical prevalence mapping of schistosomiasis and soil-transmitted helminthiasis among school-aged children in selected districts of north-western Tanzania. Parasit Vectors 2022; 15:492. [PMID: 36581956 PMCID: PMC9801628 DOI: 10.1186/s13071-022-05547-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 10/18/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The identification and mapping of at-risk populations at a lower administrative level than the district are prerequisites for the planning, resource allocation and design of impactful control intervention measures. Thus, the objective of the current study was to conduct sub-district precision mapping of soil-transmitted helminthiasis (STH) and schistosomiasis in 29 districts of north-western Tanzania using the current recommended World Health Organization criteria. METHODS A cross-sectional survey was conducted in 145 schools between March and May 2021. A urine filtration technique was used for the quantification of Schistosoma haematobium eggs, whereas quantification of Schistosoma mansoni and STH eggs was done using the Kato-Katz technique. Microhaematuria was examined using a urine dipstick. RESULTS The overall prevalences of any STH and schistosome infections were 9.3% [95% confidence interval (95%CI) 8.6-9.9] and 14.6% (95%CI 13.9-15.4), respectively. The overall prevalence of S. mansoni was 8.7% (95%CI 8.1-9.3), and 36.4%, 41.6%, and 21.9% of the children had low, moderate, and heavy infections, respectively. The overall prevalence of S. haematobium was 6.1% (95%CI 5.5-6.5), and 71.7% and 28.3% of the infected children had light and heavy intensity infections, respectively. The prevalence of microhaematuria was 7.3% (95%CI 6.7-7.8), with males having the highest prevalence (8.4%, P < 0.001). The prevalences of Trichuris trichiura, Ascaris lumbricoides and hookworm were, respectively, 1.3% (95%CI 0.1-1.5), 2.9% (95%CI 2.5-3.3) and 6.2% (95%CI 5.7-6.7). Most of the children infected with STH had light to moderate intensities of infection. The overall prevalence of co-infection with STH and schistosomiasis was 19.1%. The prevalence of schistosomiasis (P < 00.1) and STH (P < 0.001) varied significantly between schools and sub-districts. Schistosoma mansoni and S. haematobium were observed in 60 and 71 schools, respectively, whereas any STH was observed in 49 schools. In schools where schistosomiasis was observed, prevalence was < 10% in 90.8% of them, and ranged from ≥ 10% to < 50% in the other 9.2%. In schools where any STH was observed, the prevalence was < 10% in 87.7% of them. CONCLUSIONS The data reported here show that schistosomiasis and STH are widely distributed around Lake Victoria. In most of the schools where schistosomiasis and STH occurred the transmission thresholds were low. These data are important and need to be taken into consideration when decisions are made on the implementation of the next round of mass chemotherapies for schistosomiasis and STH in Tanzania.
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Affiliation(s)
- Humphrey D. Mazigo
- grid.411961.a0000 0004 0451 3858School of Medicine, Department of Medical Parasitology, Catholic University of Health and Allied Sciences, 1464, Mwanza, Tanzania
| | - Maria M. Zinga
- grid.411961.a0000 0004 0451 3858School of Medicine, Department of Medical Parasitology, Catholic University of Health and Allied Sciences, 1464, Mwanza, Tanzania
| | - Stella Kepha
- grid.33058.3d0000 0001 0155 5938Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | | | | | - George Kabona
- grid.415734.00000 0001 2185 2147National Neglected Tropical Diseases Control Programme, Ministry of Health, 743, Dodoma, Tanzania
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Roll A, Saxena M, Orlan E, Titus A, Juvekar SK, Gwayi-Chore MC, Avokpaho E, Chabi F, Togbevi CI, Belou Elijan A, Nindi P, Walson JL, Ajjampur SSR, Ibikounlé M, Kalua K, Aruldas K, Means AR. Policy stakeholder perspectives on barriers and facilitators to launching a community-wide mass drug administration program for soil-transmitted helminths. Glob Health Res Policy 2022; 7:47. [PMID: 36461087 PMCID: PMC9716752 DOI: 10.1186/s41256-022-00281-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 11/18/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Recent evidence suggests that soil-transmitted helminth (STH) transmission interruption may be feasible through community-wide mass drug administration (cMDA) that deworms community members of all ages. A change from school-based deworming to cMDA will require reconfiguring of STH programs in endemic countries. We conducted formative qualitative research in Benin, India, and Malawi to identify barriers and facilitators to successfully launching a cMDA program from the policy-stakeholder perspective. METHODS We conducted 40 key informant interviews with policy stakeholders identified as critical change agents at national, state/district, and sub-district levels. Participants included World Health Organization country office staff, implementing partners, and national and sub-national government officials. We used the Consolidated Framework for Implementation Research to guide data collection, coding, and analysis. Heat maps were used to organize coded data and differentiate perceived facilitators and barriers to launching cMDA by stakeholder. RESULTS Key facilitators to launching a cMDA program included availability of high-quality, tailored sensitization materials, and human and material resources that could be leveraged from previous MDA campaigns. Key barriers included the potential to overburden existing health workers, uncertainty of external funding to sustain a cMDA program, and concerns about weak intragovernmental coordination to implement cMDA. Cross-cutting themes included the need for rigorous trial evidence on STH transmission interruption to gain confidence in cMDA, and implementation evidence to effectively operationalize cMDA. Importantly, if policy stakeholders anticipate a cMDA program cannot be sustained due to cost and human resource barriers in the long term they may be less likely to support the launch of a program in the short term. CONCLUSIONS Overall, policy stakeholders were optimistic about implementing cMDA primarily because they believe that the tools necessary to successfully implement cMDA are already available. Policy stakeholders in this study were cautiously optimistic about launching cMDA to achieve STH transmission interruption and believe that it is feasible to implement. However, launching cMDA as an alternative policy to school-based deworming will require addressing key resource and evidence barriers. Trial registration This study was registered in the U.S. National Library of Medicine Clinical Trials registry (NCT03014167).
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Affiliation(s)
- Amy Roll
- grid.34477.330000000122986657Department of Global Health, University of Washington, Seattle, WA USA
| | - Malvika Saxena
- grid.11586.3b0000 0004 1767 8969The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Elizabeth Orlan
- grid.34477.330000000122986657Department of Global Health, University of Washington, Seattle, WA USA
| | - Angelin Titus
- grid.11586.3b0000 0004 1767 8969The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Sanjay Kamlakar Juvekar
- grid.46534.300000 0004 1793 8046Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Marie-Claire Gwayi-Chore
- grid.34477.330000000122986657Department of Global Health, University of Washington, Seattle, WA USA
| | | | - Félicien Chabi
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Bénin
| | | | | | | | - Judd L. Walson
- grid.34477.330000000122986657Department of Global Health, University of Washington, Seattle, WA USA ,grid.34477.330000000122986657Departments of Medicine, Pediatrics, and Epidemiology, University of Washington, Seattle, WA USA
| | - Sitara S. R. Ajjampur
- grid.11586.3b0000 0004 1767 8969The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Moudachirou Ibikounlé
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Bénin ,grid.412037.30000 0001 0382 0205Centre de Recherche pour la lutte contre les Maladies Infectieuses Tropicales (CReMIT/TIDRC), Université d’Abomey-Calavi, Godomey, Bénin
| | - Khumbo Kalua
- Blantyre Institute for Community Outreach, Blantyre, Malawi
| | - Kumudha Aruldas
- grid.11586.3b0000 0004 1767 8969The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Arianna Rubin Means
- grid.34477.330000000122986657Department of Global Health, University of Washington, Seattle, WA USA
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Ouédraogo JCRP, Anto F, Addo-Lartey AA. Factors determining preventive chemotherapy uptake against soil-transmitted helminthiasis among school-age children in Ghana. Parasitol Res 2022; 121:3641-3651. [PMID: 36264508 DOI: 10.1007/s00436-022-07691-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 10/11/2022] [Indexed: 11/26/2022]
Abstract
By 2020, the World Health Organization and the Ghana Neglected Tropical Diseases programme intended to treat 75% and 100% of school-age children, respectively, during preventative chemotherapy (PCT), to control soil-transmitted helminths. The performance of PCT was assessed, and the factors associated with albendazole uptake in 2019 were determined. This study comprised secondary data (2019 PCT) and a community-based cross-sectional study conducted among 352 children aged from 7 to 14 years and enrolled with their caregivers. Logistic regression was used to determine the factors hindering or favouring the PCT uptake. According to surveillance data (2019 PCT), Krachi East Municipal reported coverage of 83% in schools and 40.9% for all children between 5 and 14 years. The cross-sectional data showed that the median child age was 11 years (IQR: 9-12). There was no gap in the estimates for coverage and uptake, which were both 90.9% (95%CI: 87.4-93.5%). Christians made up the majority of the caregivers (87.5%), and 48.0% had completed secondary or higher education. After controlling for potential confounders, caregiver religion (aOR = 0.07 95%CI: 0.01-0.36) and the perception of a child's PCT risk (aOR = 0.33 95%CI: 0.13-0.84) were the significant barriers of PCT uptake, whereas the child's age (aOR = 1.49 95%CI: 1.19-1.88) and the perception of a child's PCT's benefit (aOR = 10.26 95%CI: 2.57-40.95) were the significant facilitators among children 7-14 years old. Although the performance of PCT was high, the national treatment target was not attained. Intensive and focused health education is therefore needed to improve positive perceptions towards PCT for school-age children.
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Affiliation(s)
- Jean Claude Romaric Pingdwindé Ouédraogo
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Accra, Ghana
- Département de Médecine Et Pharmacopée Traditionnelles, Pharmacie (MEPHATRA-PH), Institut de Recherche en Sciences de La Santé (IRSS), Ouagadougou, Burkina Faso
| | - Francis Anto
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Accra, Ghana
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Geleto GE, Kassa T, Erko B. Epidemiology of soil-transmitted helminthiasis and associated malnutrition among under-fives in conflict affected areas in southern Ethiopia. Trop Med Health 2022; 50:44. [PMID: 35818081 PMCID: PMC9275057 DOI: 10.1186/s41182-022-00436-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/02/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Globally, there were about 50.8 million internally displaced people in 2020, of whom 42% were in sub-Saharan Africa. In areas where there are conflicts, the humanitarian emergency makes infectious disease management extremely complex. Soil-transmitted helminths (STHs) are among the most common infections globally including in Ethiopia that thrives during complex emergencies. However, with regards to STHs, studies in the context of conflict areas have not been documented in Ethiopia. METHODS In southern Ethiopia, a community-based cross-sectional study design was employed. Simple random sampling method was used to enroll a total of 405 under-fives. Structured questionnaire was used to collect data. Kato-Katz technique was used to examine stool specimens for Ascaris lumbricoides, Trichuris trichiura and hookworm spp. The Z-score for stunting, wasting and underweight were computed using the World Health Organization anthroprocedures. RESULTS The respective prevalence of soil-transmitted helminths infection and malnutrition was 67.4% (273) and 54.2% (219). Ascaris lumbricoides was the predominant helminth parasite with a prevalence of 90%, followed by T. trichiura (12%) and hookworm spp. (5%). STHs infection was significantly associated with under-nutrition (AOR: 1.88, CI 1.22-2.90) and internal displacement (AOR: 3.08, CI 1.17-8.09). Infection with A. lumbricoides was associated with both stunting and wasting (AOR: 3.04, CI 1.48-6.26) and (AOR: 3.51, CI 1.79-6.91), respectively. CONCLUSIONS Both soil-transmitted helminths and malnutrition were important public health problems among under-fives in the present conflict affected areas. Internal displacement, unimproved water, absence of latrine and sanitary services were among significant determinants for STH infections.
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Affiliation(s)
- Gosa Ebrahim Geleto
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
- Lideta Sub-City Health Office, Addis Ababa, Ethiopia.
| | - Tesfu Kassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Eneanya OA, Gankpala L, Goss CW, Momolu AT, Nyan ES, Gray EB, Fischer K, Curtis K, Bolay FK, Weil GJ, Fischer PU. Community-based trial assessing the impact of annual versus semiannual mass drug administration with ivermectin plus albendazole and praziquantel on helminth infections in northwestern Liberia. Acta Trop 2022; 231:106437. [PMID: 35405102 PMCID: PMC9168441 DOI: 10.1016/j.actatropica.2022.106437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/10/2022] [Accepted: 03/28/2022] [Indexed: 11/30/2022]
Abstract
Mass drug administration (MDA) with ivermectin plus albendazole was more effective for clearing bancroftian filariasis than it was for onchocerciasis or hookworm. Semiannual MDA was no more effective than annual MDA for reducing prevalences of W. bancrofti, O. volvulus, or hookworm infections. Decreases in bancroftian filariasis prevalence were achieved despite unavoidable interruptions in our study related to the 2014 West Africa Ebola epidemic and the 2020 SARS-CoV-2 pandemic. Neglected Tropical Disease elimination programs in areas coendemic for lymphatic filariasis and onchocerciasis should focus on delivering high quality annual MDA with high coverage and compliance and not try to stretch limited resources to deliver semiannual MDA. MDA with praziquantel had little impact on Schistosoma mansoni infection in the heavily infected area.
We assessed the impact of three annual vs five semiannual rounds of mass drug administration (MDA) with ivermectin plus albendazole followed by praziquantel for the control or elimination of lymphatic filariasis (LF), onchocerciasis, soil-transmitted helminth (STH) infections and schistosomiasis in Lofa County, Liberia. The study started in 2012 and was interrupted in 2014 during the Ebola virus outbreak. Repeated cross-sectional surveys were conducted in individuals 5 years and older to measure infection markers. Wuchereria bancrofti antigenemia prevalences decreased from 12.5 to 1.2% (90% reduction) and from 13.6 to 4.2% (69% reduction) one year after three rounds of annual or five rounds of semiannual MDA, respectively. Mixed effects logistic regression models showed decreases in odds of antigenemia positivity were 91 and 74% at that time in the annual and semiannual treatment zones, respectively (p < 0.001). Semiannual MDA was slightly more effective for reducing Onchocerca volvulus microfiladermia prevalence and at follow-up 3 were 74% (from 14.4 to 3.7%) and 83% (from 23.6 to 4.5%) in the annual and semiannual treatment zones, respectively. Both treatment schedules had similar beneficial effects on hookworm prevalence. Thus, annual and semiannual MDA with ivermectin and albendazole had similar beneficial impacts on LF, onchocerciasis, and STH in this setting. In contrast, MDA with praziquantel had little impact on hyperendemic Schistosoma mansoni in the study area. Results from a long-term follow-up survey showed that improvements in infection parameters were sustained by routine annual MDA provided by the Liberian Ministry of Health after our study endpoint.
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Affiliation(s)
- Obiora A Eneanya
- Department of Medicine, Infectious Diseases Division, Washington University School of Medicine, St. Louis, MO, United States
| | - Lincoln Gankpala
- Division of Public Health and Medical Research, National Public Health Institute of Liberia, Charlesville, Liberia
| | - Charles W Goss
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, United States
| | - Aaron T Momolu
- Division of Public Health and Medical Research, National Public Health Institute of Liberia, Charlesville, Liberia
| | - Enoch S Nyan
- Division of Public Health and Medical Research, National Public Health Institute of Liberia, Charlesville, Liberia
| | - Emmanuel B Gray
- Ministry of Health of Liberia, C.B. Dunbar Hospital, Gbarnga, Liberia
| | - Kerstin Fischer
- Department of Medicine, Infectious Diseases Division, Washington University School of Medicine, St. Louis, MO, United States
| | - Kurt Curtis
- Department of Medicine, Infectious Diseases Division, Washington University School of Medicine, St. Louis, MO, United States
| | - Fatorma K Bolay
- Division of Public Health and Medical Research, National Public Health Institute of Liberia, Charlesville, Liberia
| | - Gary J Weil
- Department of Medicine, Infectious Diseases Division, Washington University School of Medicine, St. Louis, MO, United States
| | - Peter U Fischer
- Department of Medicine, Infectious Diseases Division, Washington University School of Medicine, St. Louis, MO, United States.
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Bartlett AW, Sousa-Figueiredo JC, van Goor RC, Monaghan P, Lancaster W, Mugizi R, Mendes EP, Nery SV, Lopes S. Burden and factors associated with schistosomiasis and soil-transmitted helminth infections among school-age children in Huambo, Uige and Zaire provinces, Angola. Infect Dis Poverty 2022; 11:73. [PMID: 35752864 DOI: 10.1186/s40249-022-00975-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/17/2022] [Indexed: 12/04/2022] Open
Abstract
Background Schistosomiasis and soil-transmitted helminths (STHs) contribute high disease burdens amongst the neglected tropical diseases (NTDs) and are public health problems in Angola. This study reports the prevalence, intensity and risk factors for schistosomiasis and STH infection in Huambo, Uige and Zaire provinces, Angola, to inform a school-based preventive chemotherapy program. Methods A two-stage cluster design was used to select schools and schoolchildren to participate in parasitological and water, sanitation and hygiene (WASH) surveys across Huambo, Uige, and Zaire provinces. Point-of-care circulating cathodic antigen and urinalysis rapid diagnostic tests (RDTs) were used to determine the prevalence of Schistosoma mansoni and S. haematobium, respectively. Kato-Katz was used to identify and quantify STH species and quantify and compare with RDTs for S. mansoni. Urine filtration was used to quantify and compare with RDTs for S. haematobium. Descriptive statistics were used for prevalence and infection intensity of schistosomiasis and STH infection. Performance of RDTs was assessed through specificity and Cohen’s Kappa agreement with microscopy. A multivariate regression analysis was used to determine demographic and WASH factors associated with schistosomiasis and STH infection. Results A total 575 schools and 17,093 schoolchildren participated in the schistosomiasis survey, of which 121 schools and 3649 schoolchildren participated in the STH survey. Overall prevalence of S. mansoni was 21.2% (municipality range 0.9–74.8%) and S. haematobium 13.6% (range 0–31.2%), with an overall prevalence of schistosomiasis of 31.4% (range 5.9–77.3%). Overall prevalence of Ascaris lumbricoides was 25.1% (range 0–89.7%), hookworm 5.2% (range 0–42.6%), and Trichuris trichiura 3.6% (range 0–24.2%), with an overall prevalence of STH infection of 29.5% (range 0.8–89.7%). Ecological zone and ethnicity were factors associated with schistosomiasis and STH infection, with older age and female sex additional risk factors for S. haematobium. Conclusions Most municipalities met World Health Organization defined prevalence thresholds for a schistosomiasis preventive chemotherapy program. A STH preventive chemotherapy program is indicated for nearly all municipalities in Uige and select municipalities in Huambo and Zaire. The association between ecological zone and ethnicity with schistosomiasis and STH infection necessitates further evaluation of home and school environmental, sociodemographic and behavioural factors to inform targeted control strategies to complement preventive chemotherapy programs. Supplementary Information The online version contains supplementary material available at 10.1186/s40249-022-00975-z.
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Raj E, Calvo-Urbano B, Heffernan C, Halder J, Webster JP. Systematic review to evaluate a potential association between helminth infection and physical stunting in children. Parasit Vectors 2022; 15:135. [PMID: 35443698 PMCID: PMC9022337 DOI: 10.1186/s13071-022-05235-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/10/2022] [Indexed: 01/02/2023] Open
Abstract
Background Despite considerable public health efforts over the past 20 years, childhood stunting (physical and/or cognitive) levels globally remain unacceptably high—at 22% amongst children under 5 years old in 2020. The aetiology of stunting is complex and still largely unknown. Helminths can cause significant mortality and morbidity and have often been cited as major causative agents for stunting, although their actual role in childhood stunting remains unclear. Our aim was to systematically review the current evidence to help support or refute the hypothesis that helminths cause physical stunting in children. Methods Inclusion criteria were as follows: infected with (and/or exposed to) helminths (soil-transmitted helminths, schistosomes or food-borne trematodes), children, pregnant or breastfeeding women as study participants (children included infants 0–1 year old, preschool-age children 1–5 years and school-age children > 5 years old), anthelmintic treatment intervention, stunting-related variables reported (e.g. height, height-for-age z-score, birth weight), helminth infection reported in relation to stunting, any geographic location, any date, peer-reviewed literature only. Exclusion criteria were: non-primary research, study protocols, studies with no new data, non-English language papers and animal (non-human) helminth studies. Seven databases were searched on 28 May 2021. Risk of bias was assessed for included studies and GRADE was used for studies included in RCT subgroup meta-analyses (in preschool-age children and pregnant women). This systematic review was registered with PROSPERO (CRD42021256201). Results Eighty studies were included in the analyses. No significant overall evidence was found in support of the hypothesis that helminths cause physical stunting in children, although there was some association with wasting. Conclusions Whilst analyses of the available literature to date failed to support a direct association between helminth infection and childhood stunting, there was significant heterogeneity between studies, and many had follow-up periods which may have been too short to detect impacts on growth. Most apparent was a lack of available data from key demographic groups wherein one may predict the greatest association of helminth infection with stunting—notably that of infants, preschool-age children, and pregnant or nursing women. Thus this review highlights the urgent need for further targeted empirical research amongst these potentially most vulnerable demographic groups. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-022-05235-5.
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Affiliation(s)
- E Raj
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, UK.
| | - B Calvo-Urbano
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, UK.,London Centre for Neglected Tropical Disease Research, Imperial College Faculty of Medicine, W2 1PG, London, UK
| | - C Heffernan
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, UK.,London International Development Centre, London, WC1A 2NS, UK
| | - J Halder
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, UK.,London Centre for Neglected Tropical Disease Research, Imperial College Faculty of Medicine, W2 1PG, London, UK
| | - J P Webster
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Hertfordshire, AL9 7TA, UK. .,London Centre for Neglected Tropical Disease Research, Imperial College Faculty of Medicine, W2 1PG, London, UK.
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Chelkeba L, Mekonnen Z, Emana D, Jimma W, Melaku T. Prevalence of soil-transmitted helminths infections among preschool and school-age children in Ethiopia: a systematic review and meta-analysis. Glob Health Res Policy 2022; 7:9. [PMID: 35307028 PMCID: PMC8935818 DOI: 10.1186/s41256-022-00239-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 01/24/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There is a lack of comprehensive national data on prevalence, geographical distribution of different species, and temporal trends in soil-helminthiasis (STHs). Therefore, this study aimed to provide a summary and location of the available data on STHs infection among preschool and school-age children in Ethiopia. METHODS The search was carried out in Medline via PubMed, Scopus, Science Direct, Web of Science, and Google Scholar on data published between 1997 to February 2020 for studies describing the rate of STHs infection among preschool and school-age in Ethiopian. We followed the Patient, Intervention, Comparison, and Outcome (PICO) approach to identify the studies. Meta-regression was performed to understand the trends and to summarize the prevalence using the "metaprop" command using STATA software version 14.0 RESULTS: A total of 29,311 of the 61,690 children examined during the period under review were infected with one or more species of intestinal parasites yielding an overall prevalence of 48% (95% CI: 43-53%). The overall pooled estimate of STHs was 33% (95% CI: 28-38%). The prevalence was 44% (95% CI: 31-58%) in SNNPR, 34% (95% CI: 28-41%) in Amhara region, 31% (95% CI: 19-43%) in Oromia region and 10% (95% CI: 7-12%) in Tigray region. Soil-transmitted helminths infection rate has been decreasing from 44% (95% CI: 30-57%) pre-Mass Drug Administration (MDA) era (1997-2012) to 30% (95% CI: 25-34%) post-MDA (2013-2020), although statistically not significant (p = 0.45). A lumbricoides was the predominant species with a prevalence of 17%. CONCLUSION Southern Nations Nationalities and Peoples Region, Amhara, and Oromia regions carry the highest-burden and are categorized to Moderate Risk Zones (MRZ) and therefore, requiring MDA once annually with Albendazole or Mebendazole. The prevalence of STHs decreased after MDA compared to before MDA, but the decline was not statistically significant. A. lumbricoides was the predominant species of STHs among preschool and school-age children in Ethiopia. The high prevalence of STHs observed in this review, underscores the need for better control and prevention strategies in Ethiopia.
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Affiliation(s)
- Legese Chelkeba
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College Health Sciences, Black Lion Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zeleke Mekonnen
- Department of Parasitology, School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Daniel Emana
- Department of Parasitology, School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Worku Jimma
- Department of Information Science, College of Natural Sciences, Jimma University, Jimma, Ethiopia
| | - Tsegaye Melaku
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.
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Mazibuko XI, Chimbari M. The effect of schistosomiasis and soil-transmitted helminths on expressive language skills among African preschool children. BMC Infect Dis 2022; 22:264. [PMID: 35303827 PMCID: PMC8931967 DOI: 10.1186/s12879-022-07260-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/09/2022] [Indexed: 11/29/2022] Open
Abstract
Background Schistosomiasis and soil transmitted helminths (STH) have been associated with compromised child development. We determined the effect of schistosomiasis and STH on expressive language skills among isiZulu speaking preschool children focusing on the variables: age, gender, school and stunting. Methods We quantitatively compared the performance of a cohort of infected and non-infected children using a 2 phased approach. In phase 1 infected children were treated with praziquantel and matched with non-infected children and both groups were tested for expressive language performance. In phase 2 both groups of children were re-tested for expressive language skills using a similar but modified test. The participants were 106 preschool children between the age of 4 and 6 years, 11 months. The Developmental Language Test was adapted as a linguistically and culturally appropriate tool for assessing isiZulu expressive language skills. Results The overall performance of the children in phases 1 and 2 were statistically similar. There was significant Pearson’s correlation of expressive language skills to age (0.002, P < 0.01), schistosomiasis i.e. vocabulary 1 (0.024, P < 0.05) and narrative skills (0.001, P < 0.01) and soil-transmitted helminths i.e. vocabulary 1 (0.006, P < 0.05), colours (0.029, P < 0.05) and narrative skills (0.001, P < 0.01) in phase 2 with small to high Cohen’s d effect size for various language subtests. Conclusion We concluded that even mild schistosomiasis and STH may compromise the performance of preschool children on expressive language. However poor ability in following instructions may have contributed to general poor performance across the two groups tested. Diet, school effect and stunting did not influence the performance of the children on expressive language. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07260-2.
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Affiliation(s)
- Xolisile I Mazibuko
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal UKZN, George Campbell Building, Howard College Campus, 4001, Durban, South Africa.
| | - Moses Chimbari
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal UKZN, George Campbell Building, Howard College Campus, 4001, Durban, South Africa
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Abstract
Intestinal nematode infections caused by soil-transmitted helminths (STH), such as the roundworm Ascaris lumbricoides, the whipworm Trichuris trichiura, and the hookworms Ancylostoma duodenale, and Necator americanus, infect more than 1 billion people throughout the world. School-aged children tend to harbor the greatest numbers of intestinal worms, and as a result, experience more adverse health consequences, such as poor growth, anemia, and cognitive decline. Clinicians should maintain a high degree of suspicion in endemic areas when patients present with surgical abdomens, particularly children. Current antihelminthic drugs are moderately effective, but reinfection is possible. Global efforts are needed to eradicate STH infections.
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Affiliation(s)
- Angela F Veesenmeyer
- Department of Child Health, University of Arizona College of Medicine-Phoenix, Pediatric Infectious Disease, Valleywise Health Medical Center, 2601 East Roosevelt Street, Phoenix, AZ 85008, USA.
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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. Lancet Reg Health West Pac 2022; 18:100312. [PMID: 35024651 PMCID: PMC8671727 DOI: 10.1016/j.lanwpc.2021.100312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Lowe C, Sarma H, Kelly M, Kurscheid J, Laksono B, Amaral S, Stewart D, Gray D. Association of soybean-based food with the prevalence of anaemia among reproductive-aged men and women in rural Central Java, Indonesia. Public Health Nutr 2021; 25:1-9. [PMID: 34957940 PMCID: PMC9991750 DOI: 10.1017/s1368980021005000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/08/2021] [Accepted: 12/21/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the association between soybean consumption and anaemic status in Central Java, Indonesia. DESIGN As part of an overarching sanitation improvement intervention in Central Java, Indonesia, we conducted a cross-sectional study in four rural villages. The study consisted of a 24-h food recall, anthropometric measurements, blood Hb measurement and stool sampling to test for soil-transmitted helminth (STH) infection status. A binary logistic regression model was fitted to test the association between soybean consumption and anaemic status after adjusting for socio-demographic factors, STH infection, dietary diversity and anthropometric status. SETTING This study took place in four rural villages of Wonosobo regency, Central Java, Indonesia. PARTICIPANTS Participants were rural villagers aged between 15 and 49 years. RESULTS A total sample size of 763 was attained, of which 231 were anaemic. The prevalence of anaemia was 30·2 % among men and women of reproductive age, and highest among young males. Consumption of soybean was high (79·8 %). After adjusting for covariates, the protective association between soybean consumption and anaemia was statistically significant (AOR = 0·53, 95 % CI = 0·30, 0·95, P < 0·05). There was a positive association with anaemia among underweight (AOR = 2·75, 95 % CI = 1·13, 6·69, P < 0·05) and those with high diet diversity (AOR = 1·40, 95 % CI = 1·00, 1·97, P < 0·05). CONCLUSIONS Our results were consistent with studies from other countries finding a protective association between soybean consumption and anaemia. This association appeared stronger for tofu than for tempeh. The prevalence of anaemia in rural Central Java is relatively consistent with nation-wide statistics indicating that interventions targeting anaemia are still largely required.
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Affiliation(s)
- Callum Lowe
- Australian National University, Acton2601, Australia
| | | | - Matthew Kelly
- Australian National University, Acton2601, Australia
| | - Johanna Kurscheid
- Australian National University, Acton2601, Australia
- Swiss Tropical and Public Health Institute, Basel4051, Switzerland
| | - Budi Laksono
- Universitas Diponegoro, Semarang50275, Indonesia
| | | | - Donald Stewart
- Australian National University, Acton2601, Australia
- Griffith University, South Brisbane, QLD, Australia
| | - Darren Gray
- Australian National University, Acton2601, Australia
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Akosah-Brempong G, Attah SK, Hinne IA, Abdulai A, Addo-Osafo K, Appiah EL, Osei MM, Afrane YA. Infection of Plasmodium falciparum and helminths among school children in communities in Southern and Northern Ghana. BMC Infect Dis 2021; 21:1259. [PMID: 34920721 PMCID: PMC8680042 DOI: 10.1186/s12879-021-06972-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 12/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background Infections of Plasmodium species, Schistosoma species and soil-transmitted helminths (STH) inflict a significant burden on children mostly in deprived communities in Ghana. Despite the deployment of malaria vector control and the annual Mass Drug Administration by National Control Programmes, these infections still pose major public health concerns in Ghana. Some remote communities which are hard-to-reach are not covered by MDA campaigns which is a major challenge to meeting elimination targets. Adequate data is necessary for formulating policies and strengthening interventions to mitigate transmission. This study assessed the infection burden of Plasmodium, Schistosoma species and STH infections among school children in communities in Southern and Northern Ghana. Method School children living in communities in Southern (Ada Foah, Pediatorkope, Tuanikope) and Northern (Kpalsogu) Ghana were enrolled in a cross-sectional study. A total of 493 (241 males and 252 females) school children aged (2–15 years) were enrolled in the study. Stool samples were collected to screen for Schistosoma mansoni and STH infections using the formol-ether concentration technique and urine samples were also collected to screen for S. haematobium using the routine urine examination method. Plasmodium parasitaemia was determined from thick and thin finger-prick blood samples. Results Overall, the prevalence of P. falciparum, S. mansoni, S. haematobium, Trichuris trichiura and hookworm infections were 17.2% (95%CI 12.8–19.7), 22.6% (95%CI 25.2–32.7), 1.6% (95%CI 0.89–5.2), 1.2% (95%CI 0.78–4.8) and 1.2% (95%CI 0.78–4.8) respectively. Plasmodium falciparum infection was generally widespread in all the study sites with Ada Foah recording the highest prevalence (35.3%) and Kpalsogu recording the lowest (5.8%). Schistosoma mansoni was present in only two Southern communities with Tuanikope recording the highest prevalence of 70.3% as against 51.5% recorded in Pediatorkope. A total of 4.5% (95% CI 2.82–10.8) of the children were co-infected with P. falciparum, Schistosoma species and STHs. This occurred only in the Southern communities; of which combination of P. falciparum and S. mansoni were predominant (1.4%). Conclusion A relatively low burden of parasites co-infection among children only in the Southern communities was detected. However, there were a high prevalence of single infections of P. falciparum and S. mansoni in those communities. Control measures for the helminths needs to be restarted in the island communities with a high burden of S. mansoni infections and that of Plasmodium needs to be scaled up in Ada Foah where P. falciparum infections were high.
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Affiliation(s)
- G Akosah-Brempong
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - S K Attah
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - I A Hinne
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - A Abdulai
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - K Addo-Osafo
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - E L Appiah
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - M-M Osei
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - Y A Afrane
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana.
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Feng Y, Yu K, Chen H, Zhang X, Lu Q, Wang X, Zhang X, Yao L, Ruan W. Soil-transmitted helminths, intestinal protozoa and Clonorchis sinensis infections in southeast China. BMC Infect Dis 2021; 21:1195. [PMID: 34837987 PMCID: PMC8626871 DOI: 10.1186/s12879-021-06879-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/15/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Extensive parasitic diseases epidemiology in Zhejiang province has not been carried out since the second national survey in 2004. Therefore, dynamics in prevalence and infection pattern of the major intestinal parasites should be explored. METHODS The distribution of three parasites including soil-transmitted helminths (STH), intestinal protozoa and C. sinensis in Zhejiang from 2014 to 2015 were explored. Kato-Katz technique was used for STH and C. sinensis detection, whereas transparent adhesive paper anal swab was used for pinworm detection, and iodine smear was used for protozoa detection. A questionnaire survey on alimentary habits and sanitary behaviors was conducted in half of the studied counties. RESULTS This study recruited 23,552 participants: 19,935 from rural and 3617 from urban area. Overall prevalence of intestinal helminth infections was 1.80%. In this study, seven helminth species were identified including A. duodenale, N. americanus, Trichuris trichiura, Ascaris lumbricoides, C. sinensis, Fasciolopsis buski and pinworm. The average prevalence of STH infection was 1.71%: 1.94% in rural and 0.44% in urban area. Hookworm was the most prevalent infection at 1.58%: 1.79% in rural and 0.44% in urban area. Prevalence varied considerably in the studied counties. Prevalence was highest in Yongkang county at 10.25%. Only 2.79% of children from rural area were infected with pinworm. A proportion of 0.40% of rural participants were infected with protozoa, whereas Endolimax nana was the most prevalent at 0.23%. C. sinensis showed infection only in one man. Awareness on C. sinensis was 24.47% in rural and 45.96% in urban area, respectively. CONCLUSIONS Prevalence of STH and protozoa infections declined considerably whereas C. sinensis infections remained few in Zhejiang province compared with the prevalence reported in previous large scale surveys (19.56% for national STH infection in 2004, 18.66% and 4.57% for provincial STH and protozoa infection, respectively in 1999). The findings of this study showed that hookworm, mainly N. americanus remained a parasitic threat to population health, mainly in the central and western Zhejiang. Therefore, more health education regarding fertilization and farming habits is necessary in rural areas. The awareness concerning hookworm infection should be reinforced.
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Affiliation(s)
- Yan Feng
- Department of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Kegen Yu
- Department of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Hualiang Chen
- Department of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Xuan Zhang
- Department of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Qiaoyi Lu
- Department of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Xiaoxiao Wang
- Department of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China
| | - Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, NewYork, 10029, USA
| | - Linong Yao
- Department of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China.
| | - Wei Ruan
- Department of Infectious Disease Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China.
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Candela E, Goizueta C, Periago MV, Muñoz-Antoli C. Prevalence of intestinal parasites and molecular characterization of Giardia intestinalis, Blastocystis spp. and Entamoeba histolytica in the village of Fortín Mbororé (Puerto Iguazú, Misiones, Argentina). Parasit Vectors 2021; 14:510. [PMID: 34598722 PMCID: PMC8485468 DOI: 10.1186/s13071-021-04968-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/18/2021] [Indexed: 11/12/2022] Open
Abstract
Background Intestinal parasites (IPs) are widely distributed worldwide and are one of the major contributors to gastrointestinal disease. Their prevalence is associated with poor access to water, sanitation and hygiene (WASH). The objective of this study was to identify the prevalence of IPs, including soil-transmitted helminths (STH), and their relation to socioeconomic characteristics, as well as a first approach to molecularly characterize the types of Giardia intestinalis, Blastocystis spp. and Entamoeba histolytica present in an indigenous community from Puerto Iguazú, Misiones, Argentina. Methods A cross-sectional study was conducted in the rural settlement of Fortin Mbororé between January and March 2018. Socioeconomic variables, household characteristics, and stool and blood samples were collected. Standard coprological techniques were used to analyze stool samples, and a complete hemogram was performed on the blood samples. Giardia intestinalis microscopy-positive samples were genetically typed by the β-giardin (bg) gene. Molecular identification of Blastocystis spp. subtypes and E. histolytica were carried out by amplification and sequencing of a partial fragment of the small subunit ribosomal RNA gene (SSU rDNA). Results The overall prevalence of IPs was 92.7%, with 72.0% specifically for hookworm. IPs were significantly more prevalent in preschool- and school-age children (P < 0.05). No formal education (P = 0.035), the presence of unimproved floors (P = 0.001) and overcrowding (P = 0.005) were significantly associated with IP infection. Hookworm was associated with anemia (P = 0.019). Molecular characterization revealed the presence of E. histolytica sub-assemblages AII (12.5%), AIII (87.5%) and BIV (100%); one case of sub-assemblage D for G. intestinalis; and the presence of subtypes ST1 (14.8%), ST2 (14.8%) and ST3 (70.4%) of Blastocystis spp. Conclusions Protozoans detected in this study are transmitted mainly through water contaminated with fecal matter, evidencing the need to improve the quality of water and sanitation for the inhabitants of Fortín Mbororé. Molecular characterization showed that domestic animals can be implicated in the zoonotic transmission of G. intestinalis and Blastocystis spp. to humans. A hyperendemic area for STH was found, with hookworm prevalence greater than 50%. Therefore, improvements in WASH as well as mass deworming programs need to be implemented in this area to control and decrease the prevalence of IPs in general and STH in particular. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04968-z.
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Affiliation(s)
- Ernesto Candela
- Parasitology Section, Department of Pharmacy Pharmaceutical Technology and Parasitology, School of Pharmacy, University of Valencia, Burjassot-Valencia, Spain
| | | | - M Victoria Periago
- Mundo Sano Foundation, Buenos Aires, Argentina. .,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
| | - Carla Muñoz-Antoli
- Parasitology Section, Department of Pharmacy Pharmaceutical Technology and Parasitology, School of Pharmacy, University of Valencia, Burjassot-Valencia, Spain
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Gandasegui J, Grau-Pujol B, Cambra-Pelleja M, Escola V, Demontis MA, Cossa A, Jamine JC, Balaña-Fouce R, van Lieshout L, Muñoz J, Martínez-Valladares M. Improving stool sample processing and pyrosequencing for quantifying benzimidazole resistance alleles in Trichuris trichiura and Necator americanus pooled eggs. Parasit Vectors 2021; 14:490. [PMID: 34563247 PMCID: PMC8466976 DOI: 10.1186/s13071-021-04941-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 08/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is an urgent need for an extensive evaluation of benzimidazole efficacy in humans. In veterinary science, benzimidazole resistance has been mainly associated with three single-nucleotide polymorphisms (SNPs) in the isotype-1 β-tubulin gene. In this study, we optimized the stool sample processing methodology and resistance allele frequency assessment in Trichuris trichiura and Necator americanus anthelmintic-related SNPs by pyrosequencing, and standardized it for large-scale benzimidazole efficacy screening use. METHODS Three different protocols for stool sample processing were compared in 19 T. trichiura-positive samples: fresh stool, egg concentration using metallic sieves with decreasing pore size, and egg concentration followed by flotation with saturated salt solution. Yield of each protocol was assessed by estimating the load of parasite DNA by real-time PCR. Then, we sequenced a DNA fragment of the β-tubulin gene containing the putative benzimidazole resistance SNPs in T. trichiura and N. americanus. Afterwards, resistant and susceptible-type plasmids were produced and mixed at different proportions, simulating different resistance levels. These mixtures were used to compare previously described pyrosequencing assays with processes newly designed by our own group. Once the stool sample processing and the pyrosequencing methodology was defined, the utility of the protocols was assessed by measuring the frequencies of putative resistance SNPs in 15 T. trichiura- and 15 N. americanus-positive stool samples. RESULTS The highest DNA load was provided by egg concentration using metallic sieves with decreasing pore size. Sequencing information of the β-tubulin gene in Mozambican specimens was highly similar to the sequences previously reported, for T. trichiura and N. americanus, despite the origin of the sample. When we compared pyrosequencing assays using plasmids constructs, primers designed in this study provided the most accurate SNP frequencies. When pooled egg samples were analysed, none of resistant SNPs were observed in T. trichiura, whereas 17% of the resistant SNPs at codon 198 were found in one N. americanus sample. CONCLUSIONS We optimized the sample processing methodology and standardized pyrosequencing in soil-transmitted helminth (STH) pooled eggs. These protocols could be used in STH large-scale screenings or anthelmintic efficacy trials.
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Affiliation(s)
- Javier Gandasegui
- Instituto de Ganadería de Montaña (CSIC-Universidad de León), Grulleros, León, Spain.,Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de León, Campus de Vegazana, León, Spain
| | - Berta Grau-Pujol
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação Em Saúde de Manhiça (CISM), Maputo, Mozambique.,Fundación Mundo Sano, Buenos Aires, Argentina
| | - María Cambra-Pelleja
- Instituto de Ganadería de Montaña (CSIC-Universidad de León), Grulleros, León, Spain.,Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de León, Campus de Vegazana, León, Spain
| | - Valdemiro Escola
- Centro de Investigação Em Saúde de Manhiça (CISM), Maputo, Mozambique
| | | | - Anelsio Cossa
- Centro de Investigação Em Saúde de Manhiça (CISM), Maputo, Mozambique
| | | | | | - Lisette van Lieshout
- Departement of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - José Muñoz
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - María Martínez-Valladares
- Instituto de Ganadería de Montaña (CSIC-Universidad de León), Grulleros, León, Spain. .,Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de León, Campus de Vegazana, León, Spain.
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Mao FZ, Chen YY, Xu XZ, Ni BX, Jin XL, Dai Y, Cao J. Multi-intervention integrated deworming strategy for sustained control of soil-transmitted helminths infections: a case study in Jiangsu Province, China. Infect Dis Poverty 2021; 10:116. [PMID: 34507609 PMCID: PMC8434715 DOI: 10.1186/s40249-021-00903-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/02/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Soil-transmitted helminths (STH) infections still present a global health problem. Mass drug administration (MDA) is a widely applied strategy to reduce morbidity and mortality caused by STH. Yet, this approach has some shortcomings. In this study, we analyzed the impact of a multi-intervention integrated deworming approach including MDA, health education (HE), and environmental sanitation improvements (ESI) for sustained STH control in Jiangsu Province of China that was applied from 1989 to 2019. METHODS Data, including infection rate of STH, medications used, coverage of the medication, non-hazardous lavatory rate, and household piped-water access rate in rural areas, and actions related to HE and ESI were collected (from archives) and analyzed in this retrospective descriptive study. Pearson's correlation analysis was applied to test correlations. RESULTS There was a dramatic decline in the infection rate of STH from 1989 (59.32%) to 2019 (0.12%). From 1995 to 1999, MDA and HE were recommended in rural areas. A negative correlation was observed between infection rate and medication from 1994 to 1998 (r = - 0.882, P = 0.048). From 2000 to 2005, targeted MDA was given to high-risk populations with HE continuously promoting good sanitation behaviors. From 2006 to 2014, targeted MDA + HE and ESI were used to consolidate the control effect. ESI was strengthened from 2006, and a negative correlation was observed between the coverage rate of the non-hazardous lavatory and the infection rate from 2006 to 2019 (r = - 0.95, P < 0.001). The targeted MDA was interrupted in 2015, while continuous efforts like HE and ESI contributed in sustaining STH control. CONCLUSIONS Multi-intervention integrated deworming strategy contributes to the reduction of STH infections. This approach is a valuable example of how different interventions can be integrated to promote durable STH control.
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Affiliation(s)
- Fan-Zhen Mao
- National Health Commission (NHC) Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, 214064, People's Republic of China
| | - Yu-Ying Chen
- Center for Global Health, Nanjing Medical University, Nanjing City, Jiangsu Province, 211166, People's Republic of China
| | - Xiang-Zhen Xu
- National Health Commission (NHC) Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, 214064, People's Republic of China
| | - Bi-Xian Ni
- National Health Commission (NHC) Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, 214064, People's Republic of China
| | - Xiao-Lin Jin
- National Health Commission (NHC) Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, 214064, People's Republic of China
| | - Yang Dai
- National Health Commission (NHC) Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, 214064, People's Republic of China.
- Center for Global Health, Nanjing Medical University, Nanjing City, Jiangsu Province, 211166, People's Republic of China.
| | - Jun Cao
- National Health Commission (NHC) Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory On Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi City, Jiangsu Province, 214064, People's Republic of China.
- Center for Global Health, Nanjing Medical University, Nanjing City, Jiangsu Province, 211166, People's Republic of China.
- Public Health Research Center, Jiangnan University, Wuxi City, Jiangsu Province, 214064, People's Republic of China.
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Sangare M, Berthe A, Dolo H, Diabaté AF, Konipo FDN, Soumaoro L, Doumbia SS, Coulibaly ME, Diarra L, Sanogo Y, Atsou KM, Diallo AA, Coulibaly SY, Keita M, Doumbia S, Coulibaly YI. Evaluation of mass drug administration for schistosomiasis and soil-transmitted helminths in school-aged children in Bankass, Mali. Int J Infect Dis 2021; 112:196-201. [PMID: 34481965 DOI: 10.1016/j.ijid.2021.08.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/20/2021] [Accepted: 08/26/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND In 2004, Mali implemented mass drug administration (MDA) aimed at controlling schistosomiasis and soil-transmitted helminths. Despite several rounds of MDA, the health district of Bankass reported low coverage (64.8%) for praziquantel and albendazole in 2017, meaning that this district was still facing challenges in accomplishing the targeted 75% coverage. This study aimed to explore the barriers and gaps that hindered MDA implementation in Bankass. METHODS A cross-sectional study was performed. Questionnaires were administrated to all school-aged children in randomly selected villages. Technical directors of community health centers and community drug distributors in the selected villages were included in the interviews. RESULTS A total of 2128 children and 52 health workers were interviewed. Coverage rates were 93.51% (1990/2128) for praziquantel and 95.25% (2027/2128) for albendazole. Among the untreated children, 31.63% (31/98) reported being unaware of the campaign and 26.53% (26/98) were unable to reach the distribution points. Most of the health workers suggested increasing incentives. CONCLUSION The data showed satisfactory coverage >90%, in contrast with lower rates initially reported by the district health information system. These results raise concerns about the reliability of programmatic data and highlight the importance of population-based surveys for the evaluation of control interventions.
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Affiliation(s)
- Moussa Sangare
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali.
| | - Adama Berthe
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Housseini Dolo
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Abdoul Fatao Diabaté
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Fatoumata Dite Nènè Konipo
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Lamine Soumaoro
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Salif Seriba Doumbia
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Michel Emmanuel Coulibaly
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Lamine Diarra
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Yacouba Sanogo
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Kueshivi Midodji Atsou
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Abdallah Amadou Diallo
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Siaka Yamoussa Coulibaly
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | | | - Seydou Doumbia
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali
| | - Yaya Ibrahim Coulibaly
- International Center for Excellence in Research Mali (ICER-Mali), University of Sciences, Techniques, and Technologies of Bamako (USTTB), Bamako, Mali; Dermatology Hospital of Bamako, Bamako, Mali
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Bradbury RS, Lane M, Arguello I, Handali S, Cooley G, Pilotte N, Williams JM, Jameson S, Montgomery SP, Hellmann K, Tharp M, Haynie L, Galloway R, Brackin B, Kirmse B, Stempak L, Byers P, Williams S, Faruque F, Hobbs CV. Parasitic Disease Surveillance, Mississippi, USA. Emerg Infect Dis 2021; 27:2201-2204. [PMID: 34287125 PMCID: PMC8314824 DOI: 10.3201/eid2708.204318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Surveillance for soil-transmitted helminths, strongyloidiasis, cryptosporidiosis, and giardiasis was conducted in Mississippi, USA. PCR performed on 224 fecal samples for all soil-transmitted helminths and on 370 samples for only Necator americanus and Strongyloides stercoralis identified 1 S. stercoralis infection. Seroprevalences were 8.8% for Toxocara, 27.4% for Cryptosporidium, 5.7% for Giardia, and 0.2% for Strongyloides parasites.
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Fergus CA, Pearson G. Opportunities and disconnects in the use of primary research on schistosomiasis and soil-transmitted helminths for policy and practice: results from a survey of researchers. J Public Health Policy 2021. [PMID: 34234277 DOI: 10.1057/s41271-021-00294-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 11/21/2022]
Abstract
Even with efforts to facilitate use of evidence in health policy and practice, limited attention has been paid to researchers' perspectives on use of their research in informing public health policy and practice at local, national, and global levels. We conducted a systematic literature search to identify published primary research related to schistosomiasis or soil-transmitted helminths, or both. We then surveyed corresponding authors. Results indicate differences by locations of authors and in conduct of research, especially for research conducted in low- and middle-income countries. Our findings exemplify disparities in research leadership discussed elsewhere. Researchers' perspectives on the use of their work suggest limited opportunities and 'disconnects' that hinder their engagement with policy and other decision-making processes. These findings highlight a need for additional efforts to address structural barriers and enable engagement between researchers and decision-makers.
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Sirima C, Bizet C, Hamou H, Červená B, Lemarcis T, Esteban A, Peeters M, Mpoudi Ngole E, Mombo IM, Liégeois F, Petrželková KJ, Boussinesq M, Locatelli S. Soil-transmitted helminth infections in free-ranging non-human primates from Cameroon and Gabon. Parasit Vectors 2021; 14:354. [PMID: 34225777 PMCID: PMC8259424 DOI: 10.1186/s13071-021-04855-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Zoonotic diseases are a serious threat to both public health and animal conservation. Most non-human primates (NHP) are facing the threat of forest loss and fragmentation and are increasingly living in closer spatial proximity to humans. Humans are infected with soil-transmitted helminths (STH) at a high prevalence, and bidirectional infection with NHP has been observed. The aim of this study was to determine the prevalence, genetic diversity, distribution and presence of co-infections of STH in free-ranging gorillas, chimpanzees and other NHP species, and to determine the potential role of these NHP as reservoir hosts contributing to the environmental sustenance of zoonotic nematode infections in forested areas of Cameroon and Gabon. METHODS A total of 315 faecal samples from six species of NHPs were analysed. We performed PCR amplification, sequencing and maximum likelihood analysis of DNA fragments of the internal transcribed spacer 2 (ITS2) nuclear ribosomal DNA to detect the presence and determine the genetic diversity of Oesophagostomum spp., Necator spp. and Trichuris spp., and of targeted DNA fragments of the internal transcribed spacer 1 (ITS1) to detect the presence of Ascaris spp. RESULTS Necator spp. infections were most common in gorillas (35 of 65 individuals), but also present in chimpanzees (100 of 222 individuals) and in one of four samples from greater spot-nosed monkeys. These clustered with previously described type II and III Necator spp. Gorillas were also the most infected NHP with Oesophagostomum (51/65 individuals), followed by chimpanzees (157/222 individuals), mandrills (8/12 samples) and mangabeys (7/12 samples), with O. stephanostomum being the most prevalent species. Oesophagostomum bifurcum was detected in chimpanzees and a red-capped mangabey, and a non-classified Oesophagostomum species was detected in a mandrill and a red-capped mangabey. In addition, Ternidens deminutus was detected in samples from one chimpanzee and three greater spot-nosed monkeys. A significant relative overabundance of co-infections with Necator and Oesophagostomum was observed in chimpanzees and gorillas. Trichuris sp. was detected at low prevalence in a gorilla, a chimpanzee and a greater spot-nosed monkey. No Ascaris was observed in any of the samples analysed. CONCLUSIONS Our results on STH prevalence and genetic diversity in NHP from Cameroon and Gabon corroborate those obtained from other wild NHP populations in other African countries. Future research should focus on better identifying, at a molecular level, the species of Necator and Oesophagostomum infecting NHP and determining how human populations may be affected by increased proximity resulting from encroachment into sylvatic STH reservoir habitats.
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Affiliation(s)
- C Sirima
- Institut de Recherche Pour Le Développement (IRD), UMI 233-TransVIHMI-INSERM U1175-University of Montpellier, Montpellier, France
| | - C Bizet
- Institut de Recherche Pour Le Développement (IRD), UMI 233-TransVIHMI-INSERM U1175-University of Montpellier, Montpellier, France
| | - H Hamou
- Institut de Recherche Pour Le Développement (IRD), UMI 233-TransVIHMI-INSERM U1175-University of Montpellier, Montpellier, France
| | - B Červená
- Institute of Vertebrate Biology, Czech Academy of Sciences, Květná 8, 603 65, Brno, Czech Republic.,Department of Pathology and Parasitology, Faculty of Veterinary Medicine, University of Veterinary Sciences Brno, Brno, Czech Republic
| | - T Lemarcis
- Institut de Recherche Pour Le Développement (IRD), UMI 233-TransVIHMI-INSERM U1175-University of Montpellier, Montpellier, France
| | - A Esteban
- Institut de Recherche Pour Le Développement (IRD), UMI 233-TransVIHMI-INSERM U1175-University of Montpellier, Montpellier, France
| | - M Peeters
- Institut de Recherche Pour Le Développement (IRD), UMI 233-TransVIHMI-INSERM U1175-University of Montpellier, Montpellier, France
| | - E Mpoudi Ngole
- Projet Prévention du Sida Au Cameroun (PRESICA) and Virology Laboratory IMPM/IRD, Yaoundé, Cameroon
| | - I M Mombo
- Centre Interdisciplinaire de Recherches Médicales de Franceville, BP 769, Franceville, Gabon
| | - F Liégeois
- Institut de Recherche Pour Le Développement (IRD), Maladies Infectieuses Et Vecteurs : Écologie, Génétique, Évolution et Contrôle (MIVEGEC), IRD 224-CNRS 5290-University of Montpellier, Montpellier, France
| | - K J Petrželková
- Institute of Vertebrate Biology, Czech Academy of Sciences, Květná 8, 603 65, Brno, Czech Republic.,Biology Centre, Institute of Parasitology, Czech Academy of Sciences, Ceske Budejovice, Czech Republic
| | - M Boussinesq
- Institut de Recherche Pour Le Développement (IRD), UMI 233-TransVIHMI-INSERM U1175-University of Montpellier, Montpellier, France
| | - S Locatelli
- Institut de Recherche Pour Le Développement (IRD), UMI 233-TransVIHMI-INSERM U1175-University of Montpellier, Montpellier, France. .,Institut de Recherche Pour Le Développement (IRD), Maladies Infectieuses Et Vecteurs : Écologie, Génétique, Évolution et Contrôle (MIVEGEC), IRD 224-CNRS 5290-University of Montpellier, Montpellier, France.
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Mationg MLS, Tallo VL, Williams GM, Gordon CA, Clements ACA, McManus DP, Gray DJ. The control of soil-transmitted helminthiases in the Philippines: the story continues. Infect Dis Poverty 2021; 10:85. [PMID: 34118990 PMCID: PMC8196932 DOI: 10.1186/s40249-021-00870-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/27/2021] [Indexed: 03/30/2023] Open
Abstract
Background Soil-transmitted helminth (STH) infections have long been an important public health concern in the Philippines. In this review, we describe the current status of STH infections there and highlight the control efforts undertaken to reduce STH burden. Main text A nationwide STH mass drug administration (MDA) programme was started in 2006 but the overall STH prevalence remains stubbornly high across the Philippines, ranging from 24.9% to 97.4%. The continued increase in the prevalence may have been due to the challenges related to MDA implementation which include the lack of people’s awareness about the importance of regular treatment, misconceptions about the MDA strategy, lack of confidence on the drugs used, fear of adverse events and general distrust of government programs. There are existing water, sanitation and hygiene (WASH) programmes implemented in communities [e.g., Community-Led Total Sanitation (CLTS) program and providing toilet bowls and provision of subsidy for latrine construction] and schools [e.g., WASH in School (WINS) program], but sustained implementation is required to achieve expected outcomes. Although WASH in general is being taught in schools, integration of STH as a disease and community problem in the current public elementary school curriculum is still inadequate. The Integrated Helminth Control Program (IHCP) currently implemented in the country, which is focused on improved sanitation and personal hygiene, health education and preventive chemotherapy, will require continuous appraisal. The sustainability of this programme still continues to be a challenge. Conclusions Despite the major efforts to control STH infections for almost two decades in the Philippines, persistently high STH prevalence has been reported across the country, which is likely due to suboptimal MDA coverage and limitations in WASH and health education programs. Sustainable delivery of integrated control approaches will continue to play a pivotal role in the control and elimination of STH in the Philippines. Graphic abstract ![]()
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Affiliation(s)
- Mary Lorraine S Mationg
- Department of Global Health, Research School of Population Health, The Australian National University, Building 62 Mills Rd, Acton ACT, Canberra, 2601, Australia. .,Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines.
| | - Veronica L Tallo
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Gail M Williams
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Catherine A Gordon
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Darren J Gray
- Department of Global Health, Research School of Population Health, The Australian National University, Building 62 Mills Rd, Acton ACT, Canberra, 2601, Australia
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Campillo JT, Awaca-Uvon NP, Tambwe JP, Kuyangisa-Simuna G, Vlaminck J, Weil GJ, Boussinesq M, Chesnais CB, Pion SDS. A strong effect of individual compliance with mass drug administration for lymphatic filariasis on sustained clearance of soil-transmitted helminth infections. Parasit Vectors 2021; 14:310. [PMID: 34103096 PMCID: PMC8186172 DOI: 10.1186/s13071-021-04814-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The impact of semiannual mass drug administration (MDA) with albendazole (ALB; 400 mg) alone on lymphatic filariasis (LF) and soil-transmitted helminth (STH) infections was assessed during two trials conducted from 2012 to 2018 in the Republic of Congo and the Democratic Republic of Congo. The collected data were analyzed to evaluate the effect of compliance with ALB treatment on STH infections. METHODS STH infections were diagnosed with duplicate Kato-Katz thick smears and the results are reported as eggs per gram of stool. All subjects with at least two STH infection assessments were included in the analyses. We used parametric survival models to assess the influence of compliance with ALB treatment on the probability of (i) achieving sustained clearance of an STH infection, and (ii) acquiring an STH infection during the follow-up. RESULTS Out of 2658 subjects included in the trials, data on 202 participants (701 person-years; PY) with hookworm infection, 211 (651 PY) with Ascaris lumbricoides infection and 270 (1013 PY) with Trichuris trichiura infection were available to calculate the probability of achieving sustained clearance of infection. The effect of ALB was dose related for all three STH. For hookworm, the time required for sustained clearance was longer (4.3 years, P < 0.001) for participants who took zero doses per year and shorter (3.4 years, P = 0.112) for participants who took two doses per year compared to those who took one dose per year (3.7 years). For Ascaris, the time required to obtain sustained clearance followed the same pattern: 6.1 years (P < 0.001) and 3.2 years (P = 0.004) vs 3.6 years for, zero, two and one dose per year, respectively. For Trichuris, less time was required for sustained clearance (4.2 years, P < 0.001) for fully compliant participants, i.e. those who took two doses per year, than for those who only took one dose per year (5.0 years). ALB was more effective in achieving sustained clearance of STH infection in subjects with light baseline infection intensities compared to those with higher egg counts. CONCLUSION Our results illustrate the importance of MDA compliance at the level of the individual with respect to the STH benefit provided by semiannual ALB MDA, which is used for the elimination of LF in Central Africa.
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Affiliation(s)
- Jérémy T Campillo
- TransVIHMI, Université Montpellier, Institut de Recherche pour le Développement (IRD), INSERM, Montpellier, France
| | - Naomi P Awaca-Uvon
- Ministère de La Santé Publique, Kinshasa, Democratic Republic of the Congo
| | - Jean-Paul Tambwe
- Ministère de La Santé Publique, Kinshasa, Democratic Republic of the Congo
| | | | - Johnny Vlaminck
- Department of Virology, Parasitology and Immunology, Ghent University, Merelbeke, Belgium
| | - Gary J Weil
- Washington University School of Medicine, St. Louis, MO, USA
| | - Michel Boussinesq
- TransVIHMI, Université Montpellier, Institut de Recherche pour le Développement (IRD), INSERM, Montpellier, France
| | - Cédric B Chesnais
- TransVIHMI, Université Montpellier, Institut de Recherche pour le Développement (IRD), INSERM, Montpellier, France
| | - Sébastien D S Pion
- TransVIHMI, Université Montpellier, Institut de Recherche pour le Développement (IRD), INSERM, Montpellier, France.
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Gerber M, Lang C, Beckmann J, du Randt R, Gall S, Seelig H, Long KZ, Ludyga S, Müller I, Nienaber M, Nqweniso S, Pühse U, Steinmann P, Utzinger J, Walter C. How are academic achievement and inhibitory control associated with physical fitness, soil-transmitted helminth infections, food insecurity and stunting among South African primary schoolchildren? BMC Public Health 2021; 21:852. [PMID: 33941121 PMCID: PMC8091717 DOI: 10.1186/s12889-021-10779-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular fitness has been associated with both executive function and academic achievement in multiple cohort studies including children and adolescents. However, research is scarce among children from low- and middle-income countries. Hence, this paper focuses on South African primary schoolchildren living in marginalized areas and examines if academic achievement and inhibitory control can be explained by children's age, socioeconomic status, soil-transmitted helminth infections, food insecurity, stunting, grip strength, and cardiorespiratory fitness. METHODS The sample of this cross-sectional study consisted of 1277 children (48% girls, mean age: 8.3 years). Data were assessed via questionnaires, stool samples, anthropometric measurements, 20 m shuttle run test, grip strength test, Flanker task, and school grades. Data were analysed with mixed linear regression models with random intercepts for school classes, separately for boys and girls. RESULTS Higher socioeconomic status was most closely associated with academic achievement among boys (p < 0.05), whereas higher levels of cardiorespiratory fitness and not being stunted explained most variance in academic achievement in girls (p < 0.05). Higher age turned out to be associated with better performance in the Flanker task (p < 0.01). Additionally, in boys, higher grip strength was associated with better information processing and inhibitory control of attention (p < 0.01), whereas in girls, higher cardiorespiratory fitness levels were positively associated with these cognitive abilities (p < 0.05). CONCLUSIONS Academic performance has been shown to be compromised in schoolchildren living in marginalised areas, compared to schoolchildren in less disadvantaged parts of South Africa. The present study suggests that cardiorespiratory fitness and grip strength are two potentially modifiable factors that are associated with children's academic achievement and cognitive performance, and that should be targeted in future school-based interventions.
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Affiliation(s)
- Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, St. Jakob-Turm, Birsstrasse 320B, 4052, Basel, Switzerland.
| | - Christin Lang
- Department of Sport, Exercise and Health, University of Basel, St. Jakob-Turm, Birsstrasse 320B, 4052, Basel, Switzerland
| | - Johanna Beckmann
- Department of Sport, Exercise and Health, University of Basel, St. Jakob-Turm, Birsstrasse 320B, 4052, Basel, Switzerland
| | - Rosa du Randt
- Nelson Mandela University, Port Elizabeth, South Africa
| | - Stefanie Gall
- Department of Sport, Exercise and Health, University of Basel, St. Jakob-Turm, Birsstrasse 320B, 4052, Basel, Switzerland
| | - Harald Seelig
- Department of Sport, Exercise and Health, University of Basel, St. Jakob-Turm, Birsstrasse 320B, 4052, Basel, Switzerland
| | - Kurt Z Long
- Nelson Mandela University, Port Elizabeth, South Africa
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, St. Jakob-Turm, Birsstrasse 320B, 4052, Basel, Switzerland
| | - Ivan Müller
- Department of Sport, Exercise and Health, University of Basel, St. Jakob-Turm, Birsstrasse 320B, 4052, Basel, Switzerland
| | | | | | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, St. Jakob-Turm, Birsstrasse 320B, 4052, Basel, Switzerland
| | - Peter Steinmann
- Nelson Mandela University, Port Elizabeth, South Africa
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Jürg Utzinger
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Cheryl Walter
- Nelson Mandela University, Port Elizabeth, South Africa
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Aw JYH, Clarke NE, Mayfield HJ, Lau CL, Richardson A, Vaz Nery S. Novel statistical approaches to identify risk factors for soil-transmitted helminth infection in Timor-Leste. Int J Parasitol 2021; 51:729-739. [PMID: 33798561 PMCID: PMC8378505 DOI: 10.1016/j.ijpara.2021.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/31/2020] [Accepted: 01/03/2021] [Indexed: 12/02/2022]
Abstract
We compared logistic regression, recursive partitioning and Bayesian networks to identify risk factors for STH infection. Logistic regression identified fewest variables associated with STH infections compared with the two alternative methods. Recursive partitioning identified more demographic and WASH variables, and Bayesian networks more environmental variables. Model performance was similar across all three statistical techniques. Recursive partitioning can identify at-risk population subgroups, while Bayesian networks can run real-time scenarios.
Soil-transmitted helminths (STHs) are parasitic intestinal worms that infect almost a fifth of the global population. Sustainable control of STHs requires understanding the complex interaction of factors contributing to transmission. Identifying risk factors has mainly relied on logistic regression models where the underlying assumption of independence between variables is not always satisfied. Previously demonstrated risk factors including water, sanitation and hygiene (WASH) access and behaviours, and socioeconomic status are intrinsically linked. Similarly, environmental factors including climate, soil and land attributes are often strongly correlated. Alternative methods such as recursive partitioning and Bayesian networks can handle correlated variables, but there are no published studies comparing these methods with logistic regression in the context of STH risk factor analysis. Baseline cross-sectional data from school-aged children in the (S)WASH-D for Worms study were used to compare risk factors identified from modelling the same data using three different statistical techniques. Outcomes of interest were infection with Ascaris spp. and any hookworm species (Necator americanus, Ancylostoma duodenale, and Ancylostoma ceylanicum). Mixed-effects logistic regression identified the fewest risk factors. Recursive partitioning identified the most WASH and demographic risk factors, while Bayesian networks identified the most environmental risk factors. Recursive partitioning produced classification trees that visualised potentially at-risk population sub-groups. Bayesian networks helped visualise relationships between variables and enabled interactive modelling of outcomes based on different scenarios for the predictor variables of interest. Model performance was similar across all techniques. Risk factors identified across all techniques were vegetation for Ascaris spp., and cleaning oneself with water after defecating for hookworm. This study adds to the limited body of evidence exploring alternative data modelling approaches in identifying risk factors for STH infections. Our findings suggest these approaches can provide novel insights for more robust interpretation.
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Affiliation(s)
- Jessica Yi Han Aw
- Research School of Population Health, Australian National University, Canberra, Australia.
| | - Naomi E Clarke
- Research School of Population Health, Australian National University, Canberra, Australia; Kirby Institute, University of New South Wales, Sydney, Australia
| | - Helen J Mayfield
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Colleen L Lau
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Alice Richardson
- Statistical Consulting Unit, Australian National University, Canberra, Australia
| | - Susana Vaz Nery
- Kirby Institute, University of New South Wales, Sydney, Australia
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Stracke K, Adisakwattana P, Phuanukoonnon S, Yoonuan T, Poodeepiyasawat A, Dekumyoy P, Chaisiri K, Roth Schulze A, Wilcox S, Karunajeewa H, Traub RJ, Jex AR. Effective low-cost preservation of human stools in field-based studies for helminth and microbiota analysis. Int J Parasitol 2021; 51:741-748. [PMID: 33774039 DOI: 10.1016/j.ijpara.2021.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 12/19/2022]
Abstract
Molecular studies of gastrointestinal infections or microbiotas require either rapid sample processing or effective interim preservation. This is difficult in remote settings in low-income countries, where the majority of the global infectious disease burden exists. Processing or freezing of samples immediately upon collection is often not feasible and the cost of commercial preservatives is prohibitive. We compared fresh freezing (the 'gold standard' method), with low-cost chemical preservation in (i) a salt-based buffer consisting of DMSO, EDTA and NaCl (DESS) or (ii) 2.5% potassium dichromate (PD), for soil-transmitted helminth detection and microbiota characterisation in pre-school and school-aged children from north-western Thailand. Fresh frozen samples were frozen at -20°C on collection and maintained at -80°C within ~3 days of collection until molecular analysis, with international shipping on dry ice. In contrast, chemically preserved samples were collected and stored at ~4°C, transported on wet ice and only stored at -20°C on arrival in Australia ~8 weeks after collection, with international shipping on wet ice. DESS and PD provided better sensitivity for STH diagnosis, estimating higher infection rates (>80% for Ascaris lumbricoides and >60% for Trichuris trichiura; versus 56% and 15% for these parasites in fresh frozen samples) and egg abundance (inferred as gene copy number estimates). All methods performed similarly for microbiota preservation, showing no significant differences in alpha-diversity based on overall richness or inverted Simpson's Index. All three methods performed similarly for RNA and protein preservation in a small subset of samples. Overall, DESS provided the best performance, with the added benefit of being non-toxic, compared with PD, hence making it particularly applicable for studies in remote and resource-poor settings.
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Affiliation(s)
- Katharina Stracke
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Department of Medical Biology, The Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Poom Adisakwattana
- Department of Helminthology, Faculty for Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Suparat Phuanukoonnon
- Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Tippayarat Yoonuan
- Department of Helminthology, Faculty for Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Akkarin Poodeepiyasawat
- Department of Helminthology, Faculty for Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Paron Dekumyoy
- Department of Helminthology, Faculty for Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kittipong Chaisiri
- Department of Helminthology, Faculty for Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Stephen Wilcox
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Harin Karunajeewa
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Department of Medicine - Western Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca J Traub
- Faculty for Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Aaron R Jex
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Faculty for Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Sumbele IUN, Otia OV, Bopda OSM, Ebai CB, Kimbi HK, Nkuo-Akenji T. Polyparasitism with Schistosoma haematobium, Plasmodium and soil-transmitted helminths in school-aged children in Muyuka-Cameroon following implementation of control measures: a cross sectional study. Infect Dis Poverty 2021; 10:14. [PMID: 33597042 PMCID: PMC7890808 DOI: 10.1186/s40249-021-00802-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 01/29/2021] [Indexed: 01/04/2023] Open
Abstract
Background Despite the ubiquity of polyparasitism, its health impacts have been inadequately studied. The aim of this study was to determine the prevalence and determinants of polyparasitism with Schistosoma haematobium, Plasmodium and soil-transmitted helminths (STH) following sustained control measures, as well as evaluate the outcomes and clinical correlates of infection in school-aged children (SAC) living in the schistosomiasis endemic focus of Muyuka-Cameroon. Methods In a cross-sectional study, urine, blood and stool samples were each collected from SAC (4–14 years) selected at random between March and June 2015. Microhaematuria in urine was detected using reagent strip and S. haematobium ova by filtration/microscopy methods. Plasmodium was detected using Giemsa-stained blood films and complete blood count was obtained using an auto-haematology analyser. STH in stool was detected by the Kato-Katz method. Categorical and continuous variables were compared as required, Kappa value estimated and the adjusted odds ratio (aOR) in the multivariate analysis was used to evaluate association of the risk factors with infection. Results Out of the 638 SAC examined, single infection was prevalent in 33.4% while polyparasitism was 19.9%. Prevalence of S. haematobium + Plasmodium was 7.8%; S. haematobium + STH was 0.8%; Plasmodium + STH was 0.8%; while S. haematobium + Plasmodium + STH was 0.9%. Higher preponderance of S. haematobium + Plasmodium infection occurred in females, those from Likoko, did not use potable water, practiced bathing in stream and carried out open defecation than their equivalents. However, being female (aOR = 2.38, P = 0.009) was the only significant risk factor identified. Anaemia was a common morbidity (74.3%) with a slight agreement with microscopy in predicting S. haematobium and Plasmodium infections. The sensitivity and specificity of haematuria (13.0%) in predicting S. haematobium infection was 46.5% and 100% with a moderate agreement with microscopy. Co-infection with S. haematobium and malaria parasite was significantly associated with threefold odds of history of fever in the last three days. Conclusions Polyparasitism is a public health problem in Muyuka with females most at risk. Anaemia prevalence is exacerbated in co- and triple-infections and together with a history of fever are of value in predicting polyparasitism.![]()
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Affiliation(s)
- Irene Ule Ngole Sumbele
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon. .,Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
| | - Ofon Vitalis Otia
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
| | - Orelien Sylvain Mtopi Bopda
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Sciences, University of Buea, Buea, Cameroon
| | - Calvin Bisong Ebai
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Science, University of Bamenda, Bambili, Cameroon
| | - Helen KuoKuo Kimbi
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon.,Department of Medical Laboratory Science, University of Bamenda, Bambili, Cameroon
| | - Theresa Nkuo-Akenji
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
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Maddren R, Phillips A, Ower A, Landeryou T, Mengistu B, Anjulo U, Firdawek E, Negussu N, Anderson R. Soil-transmitted helminths and schistosome infections in Ethiopia: a systematic review of progress in their control over the past 20 years. Parasit Vectors 2021; 14:97. [PMID: 33546757 PMCID: PMC7866680 DOI: 10.1186/s13071-021-04600-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 01/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Ethiopia has set the ambitious national targets of eliminating soil-transmitted helminths (STH) and schistosomiasis (SCH) as public health problems by 2020, and breaking their transmission by 2025. This systematic review was performed to provide insight into the progress made by the national STH and SCH control programme purposed with reaching these targets. Methods Studies published on STH and SCH in Ethiopia were searched for using Web of Science, PubMed, Scopus, and the resulting references of selected studies. Prevalence and intensity were analysed, stratified by region, age, and diagnostics. Results A total of 231 papers published between 2000 and 2020 were included. Over the past two decades, Trichuris trichiura (TT) infection has shown the most statistically significant decrease (93%, p < 0.0001), followed by Schistosoma mansoni (SM) (69%, p < 0.0001), Ascaris lumbricoides (AL) (67%, p < 0.0001) and Schistosoma haematobium (83%, p = 0.038) infections. Geographically, parasite burden has only consistently shown a significant reduction in the Southern Nations, Nationalities and Peoples’ Region of Ethiopia, where AL, TT, hookworm and SM significantly decreased by 80% (p = 0.006), 95% (p = 0.005), 98% (p = 0.009) and 87% (p = 0.031), respectively. Prevalence of STH was highest among adults across all species, contrary to typical age-infection profiles for TT and AL that peak among school-aged children. Expanding treatment to the whole community would target reservoirs of adult and preschool-aged infection within the community, assisting Ethiopia in reaching their national transmission break targets. There was substantial heterogeneity in diagnostic methods used across studies, the majority of which predominantly used single-slide Kato–Katz. This low slide frequency provides poor diagnostic sensitivity, particularly in low endemic settings. Conclusion The prevalence of STH and SCH in Ethiopia has decreased over time due to the strategic use of anthelmintics. Both standardising and increasing the sensitivity of the diagnostics used, alongside the ubiquitous use of parasite intensity with prevalence, would enable a more accurate and comparable understanding of Ethiopia’s epidemiological progress. Further work is needed on community-wide surveillance in order to understand the burden and subsequent need for treatment among those outside of the standard school-based control program. ![]()
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Affiliation(s)
- Rosie Maddren
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK.
| | - Anna Phillips
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Alison Ower
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Toby Landeryou
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Birhan Mengistu
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Ufaysa Anjulo
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Ewnetu Firdawek
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Nebiyu Negussu
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Roy Anderson
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
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Patel C, Keller L, Welsche S, Hattendorf J, Sayasone S, Ali SM, Ame SM, Coulibaly JT, Hürlimann E, Keiser J. Assessment of fecal calprotectin and fecal occult blood as point-of-care markers for soil-transmitted helminth attributable intestinal morbidity in a case-control substudy conducted in Côte d'Ivoire, Lao PDR and Pemba Island, Tanzania. EClinicalMedicine 2021; 32:100724. [PMID: 33554091 PMCID: PMC7851339 DOI: 10.1016/j.eclinm.2021.100724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Infections with soil-transmitted helminths (STHs) may result in chronic inflammatory disorders affecting the human host. The objective of this study was to evaluate Fecal Calprotectin (FC) and Fecal Occult Blood (FOB) in individuals infected and non-infected with STHs to identify potential intestinal morbidity markers. METHODS Stool from participants diagnosed positive for Trichuris trichiura and concomitant STH infections from three countries was used to perform FC and FOB point-of-care assays. Simultaneously, identified STH negative participants underwent FC and FOB testing as controls. Potential associations between test results and determinants were analyzed using multivariable logistic regression. FINDINGS In total, 1034 T. trichiura infected cases (mostly light infections) and 157 STH negative controls were tested for FC and FOB. Among all participants tested, 18·5% had ≥ 50 µg/g FC concentration, while 14 (1·2%) were positive for FOB. No statistically significant association was found between T. trichiura infection or Ascaris lumbricoides co-infection and FC concentration, while an inverse association (odds ratio (OR): 0·45, 95% credible intervals (CrI): 0·26, 0·75) was found between hookworm co-infection and FC concentration. In Lao PDR, the proportion of participants in the ≥ 50 µg/g FC category was significantly higher in the oldest age category compared to the 5-11 years group (OR: 3·31, 95% CrI: 1·62, 7·24). Too few participants were found positive for FOB to derive any conclusions. INTERPRETATION Studies are needed to better understand the relationship between intestinal morbidity and STH infections. Suitable, standardized, low-cost markers of STH attributable morbidity to better monitor the impact of STH control interventions are necessary. FUNDING BMGF (OPP1153928).
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Affiliation(s)
- Chandni Patel
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Ladina Keller
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sophie Welsche
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jan Hattendorf
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Somphou Sayasone
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of International Program for Health in the Tropics, Lao Tropical and Public Health Institute, Vientiane, Lao People's Democratic Republic
| | - Said M. Ali
- Public Health Laboratory Ivo de Carneri, Chake Chake, Pemba, Zanzibar, Tanzania
| | - Shaali M. Ame
- Public Health Laboratory Ivo de Carneri, Chake Chake, Pemba, Zanzibar, Tanzania
| | - Jean Tenena Coulibaly
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
- Department of Research and Development, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Eveline Hürlimann
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jennifer Keiser
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Chen YD, Li HZ, Xu LQ, Qian MB, Tian HC, Fang YY, Zhou CH, Ji Z, Feng ZJ, Tang M, Li Q, Wang Y, Bergquist R, Zhou XN. Effectiveness of a community-based integrated strategy to control soil-transmitted helminthiasis and clonorchiasis in the People's Republic of China. Acta Trop 2021; 214:105650. [PMID: 32805214 DOI: 10.1016/j.actatropica.2020.105650] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 08/02/2020] [Accepted: 08/03/2020] [Indexed: 01/25/2023]
Abstract
Soil-transmitted helminthiases (STHs) are caused by a group of intestinal nematode infections due to poor hygiene and environments, and clonorchiasis is a food-borne trematode (FBT) infection caused by ingestion of raw freshwater fish. Both are endemic in the People's Republic of China. To explore a suitable control strategy, integrated interventions were applied between 2007 and 2009 in ten pilot counties (eight for the STHs and two for clonorchiasis). Drug administration was used for treatment and complementary efforts to improve the situation based on health education, provision of clean water and sanitation were carried out. Significant achievements were gained as reflected by a drastic decrease in prevalence these infections were demonstrated. The overall prevalence of STHs and clonorchiasis decreased from 35.9% to 7.8% and from 41.4% to 7.0%, respectively. The reduction of prevalence and high cost-effectiveness were documented supporting large-scale application of this integrated intervention in China and elsewhere.
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Affiliation(s)
- Ying-Dan Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Tropical Diseases, Shanghai 200025, China
| | - Hua-Zhong Li
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Long-Qi Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Tropical Diseases, Shanghai 200025, China
| | - Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Tropical Diseases, Shanghai 200025, China
| | - Hong-Chun Tian
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Yue-Yi Fang
- Guangdong Center for Disease Control and Prevention, Guangzhou 510300, China
| | - Chang-Hai Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Tropical Diseases, Shanghai 200025, China
| | - Zhuo Ji
- Heilongjiang Center for Disease Control and Prevention, Haerbin 150030, China
| | - Zi-Jian Feng
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Meng Tang
- Danling Center for Disease Control and Prevention, Danling 620200, China
| | - Qun Li
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Yu Wang
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | | | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Tropical Diseases, Shanghai 200025, China.
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Lynn MK, Morrissey JA, Conserve DF. Soil-Transmitted Helminths in the USA: a Review of Five Common Parasites and Future Directions for Avenues of Enhanced Epidemiologic Inquiry. Curr Trop Med Rep 2021; 8:32-42. [PMID: 33552843 PMCID: PMC7847297 DOI: 10.1007/s40475-020-00221-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2020] [Indexed: 12/01/2022]
Abstract
Purpose of Review The aim of this review is to present a comprehensive look at five intestinal soil-transmitted helminths (STHs) of global health importance that may continue to plague low-income and rural areas of the USA and argue the need for enhanced surveillance of these infections, which primarily affect the nation’s most vulnerable groups. Recent Findings Human STH infections in middle- and high-income countries are at particular risk for being undiagnosed; as common symptoms are non-specific, differentials require a high index of clinical suspicion, and cases are concentrated in areas of poverty where access to care is limited. Although autochthonous STHs are thought to be rare in the USA, infections were once common in the American South and Appalachia and robust epidemiologic surveillance is limited post 1980s. However, recent community studies and case reports from small-scale farms and areas of high rural or inner-city poverty reveal the potential for persisting helminth infections in distinct populations of the country. Summary STHs are among the most common neglected tropical diseases globally causing significant morbidity in underserved communities and contributing to the continuation of cycles of poverty within vulnerable populations. Due to possible severe disease sequalae and their ability to perpetuate poverty and poverty-associated health outcomes within already vulnerable groups, it is vital that surveillance for these infections is enhanced to bolster health equity in the USA.
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Affiliation(s)
- Mary K Lynn
- Laboratory of Vector-Borne and Zoonotic Diseases, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Josephine A Morrissey
- Laboratory of Vector-Borne and Zoonotic Diseases, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Donaldson F Conserve
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
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49
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Hardwick RJ, Werkman M, Truscott JE, Anderson RM. Stochastic challenges to interrupting helminth transmission. Epidemics 2021; 34:100435. [PMID: 33571786 DOI: 10.1016/j.epidem.2021.100435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 07/27/2020] [Accepted: 01/10/2021] [Indexed: 01/29/2023] Open
Abstract
Predicting the effect of different programmes designed to control both the morbidity induced by helminth infections and parasite transmission is greatly facilitated by the use of mathematical models of transmission and control impact. In such models, it is essential to account for the many sources of uncertainty - natural, or otherwise - to ensure robustness in prediction and to accurately depict variation around an expected outcome. In this paper, we investigate how well the standard deterministic models match the predictions made using individual-based stochastic simulations. We also explore how well concepts which derive from deterministic models, such as 'breakpoints' in transmission, apply in the stochastic world. Employing an individual-based stochastic model framework we also investigate how transmission and control are affected by the migration of infected people into a defined community. To give our study focus we consider the control of soil-transmitted helminths (STH) by mass drug administration (MDA), though our methodology is readily applicable to the other helminth species such as the schistosome parasites and the filarial worms. We show it is possible to theoretically define a 'stochastic breakpoint' where much noise surrounds the expected deterministic breakpoint. We also discuss the concept of the 'interruption of transmission' independent of the 'breakpoint' concept where analyses of model behaviour illustrate the current limitations of deterministic models to account for the 'fade-out' or transmission extinction behaviour in simulations. Our analysis of migration confirms a relationship between the critical infected human migration rate scale (i.e., order of magnitude) per unit of time and the death rate of infective stages that are released into the free-living environment. This relationship is shown to determine the likelihood that control activities aim at chemotherapeutic treatment of the human host will eliminate transmission. The development of a new stochastic simulation code for STH in the form of a publicly-available open-source python package which includes features to incorporate many population stratifications, different control interventions including mass drug administration (with defined frequency, coverage levels and compliance patterns) and inter-village human migration is also described.
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Affiliation(s)
- Robert J Hardwick
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, St. Mary's Campus, Imperial College London, London WC2 1PG, UK; The DeWorm3 Project, the Natural History Museum of London, London SW7 5BD, UK; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK.
| | - Marleen Werkman
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, St. Mary's Campus, Imperial College London, London WC2 1PG, UK; The DeWorm3 Project, the Natural History Museum of London, London SW7 5BD, UK; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK
| | - James E Truscott
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, St. Mary's Campus, Imperial College London, London WC2 1PG, UK; The DeWorm3 Project, the Natural History Museum of London, London SW7 5BD, UK; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, St. Mary's Campus, Imperial College London, London WC2 1PG, UK; The DeWorm3 Project, the Natural History Museum of London, London SW7 5BD, UK; MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, UK
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50
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Truscott JE, Hardwick RJ, Werkman M, Saravanakumar PK, Manuel M, Ajjampur SSR, Ásbjörnsdóttir KH, Khumbo K, Witek-McManus S, Simwanza J, Cottrell G, Houngbégnon P, Ibikounlé M, Walson JL, Anderson RM. Forecasting the effectiveness of the DeWorm3 trial in interrupting the transmission of soil-transmitted helminths in three study sites in Benin, India and Malawi. Parasit Vectors 2021; 14:67. [PMID: 33472677 PMCID: PMC7818558 DOI: 10.1186/s13071-020-04572-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/29/2020] [Indexed: 11/17/2022] Open
Abstract
Background The DeWorm3 project is an ongoing cluster-randomised trial assessing the feasibility of interrupting the transmission of soil-transmitted helminths (STH) through mass drug administration (MDA) using study sites in India, Malawi and Benin. In this article, we describe an approach which uses a combination of statistical and mathematical methods to forecast the outcome of the trial with respect to its stated goal of reducing the prevalence of infection to below 2%. Methods Our approach is first to define the local patterns of transmission within each study site, which is achieved by statistical inference of key epidemiological parameters using the baseline epidemiological measures of age-related prevalence and intensity of STH infection which have been collected by the DeWorm3 trials team. We use these inferred parameters to calibrate an individual-based stochastic simulation of the trial at the cluster and study site level, which is subsequently run to forecast the future prevalence of STH infections. The simulator takes into account both the uncertainties in parameter estimation and the variability inherent in epidemiological and demographic processes in the simulator. We interpret the forecast results from our simulation with reference to the stated goal of the DeWorm3 trial, to achieve a target of \documentclass[12pt]{minimal}
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\begin{document}$$\le 2\%$$\end{document}≤2% prevalence at a point 24 months post-cessation of MDA. Results Simulated output predicts that the two arms will be distinguishable from each other in all three country sites at the study end point. In India and Malawi, measured prevalence in the intervention arm is below the threshold with a high probability (90% and 95%, respectively), but in Benin the heterogeneity between clusters prevents the arm prevalence from being reduced below the threshold value. At the level of individual study arms within each site, heterogeneity among clusters leads to a very low probability of achieving complete elimination in an intervention arm, yielding a post-study scenario with widespread elimination but a few ‘hot spot’ areas of persisting STH transmission. Conclusions Our results suggest that geographical heterogeneities in transmission intensity and worm aggregation have a large impact on the effect of MDA. It is important to accurately assess cluster-level, or even smaller scale, heterogeneities in factors which influence transmission and aggregation for a clearer perspective on projecting the outcomes of MDA control of STH and other neglected tropical diseases. ![]()
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Affiliation(s)
- James E Truscott
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK. .,MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary's Campus, London, W2 1PG, UK. .,The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK.
| | - Robert J Hardwick
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK
| | - Marleen Werkman
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Malathi Manuel
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Sitara S R Ajjampur
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Kristjana H Ásbjörnsdóttir
- The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK.,Departments of Global Health, Medicine (Infectious Disease), Pediatrics and Epidemiology, University of Washington, Seattle, WA, USA
| | - Kalua Khumbo
- Blantyre Institute for Community Outreach, University of Malawi, College of Medicine, Blantyre, Malawi
| | - Stefan Witek-McManus
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - James Simwanza
- Blantyre Institute for Community Outreach, University of Malawi, College of Medicine, Blantyre, Malawi
| | - Gilles Cottrell
- Institut de Recherche pour le Développement, MERIT, Université de Paris, Paris, France
| | - Parfait Houngbégnon
- Institut de Recherche Clinique du Benin, Université d'Abomey-Calavi, Cotonou, Benin
| | - Moudachirou Ibikounlé
- Institut de Recherche Clinique du Benin, Université d'Abomey-Calavi, Cotonou, Benin.,Département de Zoologie, Faculté des Sciences et Techniques, Université d'Abomey-Calavi, Cotonou, Benin
| | - Judd L Walson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK.,Departments of Global Health, Medicine (Infectious Disease), Pediatrics and Epidemiology, University of Washington, Seattle, WA, USA
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary's Campus, London, W2 1PG, UK.,The DeWorm3 Project, The Natural History Museum, London, SW7 5BD, UK
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