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Turner HC, Truscott JE, Fleming FM, Hollingsworth TD, Brooker SJ, Anderson RM. Cost-effectiveness of scaling up mass drug administration for the control of soil-transmitted helminths: a comparison of cost function and constant costs analyses. Lancet Infect Dis 2016; 16:838-846. [PMID: 26897109 DOI: 10.1016/s1473-3099(15)00268-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 07/11/2015] [Accepted: 08/11/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND The coverage of mass drug administration (MDA) for neglected tropical diseases, such as the soil-transmitted helminths (STHs), needs to rapidly expand to meet WHO's 2020 targets. We aimed to compare use of a cost function to take into account economies of scale to the standard method of assuming a constant cost per treatment when investigating the cost and cost-effectiveness of scaling up a STH MDA programme targeting Ascaris lumbricoides. METHODS We fitted a cost function describing how the costs of MDA change with scale to empirical cost data and incorporated it into a STH transmission model. Using this cost function, we investigated the consequences of taking into account economies of scale on the projected cost-effectiveness of STH control, by comparison with the standard method of assuming a constant cost per treatment. The cost function was fitted to economic cost data collected as part of a school-based deworming programme in Uganda using maximum likelihood methods. We used the model to investigate the total reduction in the overall worm burden, the total number of prevalent infection case-years averted, and the total number of heavy infection case-years averted. For each year, we calculated the effectiveness as the difference between the worm burden or number of cases and the number in absence of treatment. FINDINGS When using the cost function, the cost-effectiveness of STH control markedly increased as the programme was scaled up. By contrast, the standard method (constant cost per treatment) undervalued this and generated misleading conclusions. For example, when scaling up control in the projected district from 10% to 75% coverage of at-risk school-age children, the cost-effectiveness in terms of prevention of heavy burden infections was projected to increase by over 70% when using the cost function, but decrease by 18% when assuming a constant cost per treatment. INTERPRETATION The current exclusion of economies of scale in most economic analyses must be addressed if the most cost-effective policies for the control of neglected tropical diseases are to be formulated. These findings are also relevant to other large-scale disease interventions. FUNDING GlaxoSmithKline, Bill & Melinda Gates Foundation, Partnership for Child Development, and Wellcome Trust.
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Affiliation(s)
- Hugo C Turner
- London Centre for Neglected Tropical Disease Research, London, UK; Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK.
| | - James E Truscott
- London Centre for Neglected Tropical Disease Research, London, UK; Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK
| | - Fiona M Fleming
- London Centre for Neglected Tropical Disease Research, London, UK; Schistosomiasis Control Initiative, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK
| | - T Déirdre Hollingsworth
- Mathematics Institute, University of Warwick, Coventry, UK; School of Life Sciences, University of Warwick, Coventry, UK
| | - Simon J Brooker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, London, UK
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Muñoz-Antoli C, Pavón A, Marcilla A, Toledo R, Esteban JG. Prevalence and risk factors related to intestinal parasites among children in Department of Rio San Juan, Nicaragua. Trans R Soc Trop Med Hyg 2014; 108:774-82. [PMID: 25344696 DOI: 10.1093/trstmh/tru160] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The present study was carried out to assess the prevalence of intestinal parasite infections among children in Department of Rio San Juan (Nicaragua), to explore the extent of polyparasitism, and to identify the risk factors that might favour transmission of these parasites. METHODS A coprological study of single stool specimen, collected at random from 382 children (167 boys and 215 girls) aged 2-15 years from two municipalities, and a questionnaire, concerning demographic and epidemiological data on sanitary and behavioural habits, was filled in to identify risk factors. RESULTS About 93% of the children presented infection. Blastocystis hominis, the most frequently protozoa, and Trichuris trichiura, Ascaris lumbricoides and hookworm, the most prevalent helminths. Polyparasitism (85.4%[326/382]), with the highest percentages detected in females (p=0.001), in the 6-11 year age group (p<0.001) and having a rural background (p<0.001). A firm relationship between any parasite and age (OR=1.2, p=0.036) and rural background (OR=0.3, p=0.027) was detected. Living in rural areas and drinking river water were also positively associated with each of the STH species detected, and walking barefoot was also associated with hookworm infection. CONCLUSIONS Government efforts should be focused on controlling the risk factors associated with these enteroparasites, with health education programmes in rural areas of Nicaragua.
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Affiliation(s)
- C Muñoz-Antoli
- Departamento Parasitología, Facultad Farmacia, Universidad Valencia, Avda, Vicent Andrés Estellés s/n, 46100 Burjassot-Valencia, Spain
| | - A Pavón
- Departamento Bionálisis Clínico, Instituto Politécnico de la Salud (IPS-Polisal), Universidad Nacional Autónoma de Nicaragua, Managua, Nicaragua
| | - A Marcilla
- Departamento Parasitología, Facultad Farmacia, Universidad Valencia, Avda, Vicent Andrés Estellés s/n, 46100 Burjassot-Valencia, Spain
| | - R Toledo
- Departamento Parasitología, Facultad Farmacia, Universidad Valencia, Avda, Vicent Andrés Estellés s/n, 46100 Burjassot-Valencia, Spain
| | - J G Esteban
- Departamento Parasitología, Facultad Farmacia, Universidad Valencia, Avda, Vicent Andrés Estellés s/n, 46100 Burjassot-Valencia, Spain
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Tefera T, Mebrie G. Prevalence and predictors of intestinal parasites among food handlers in Yebu Town, southwest Ethiopia. PLoS One 2014; 9:e110621. [PMID: 25329050 PMCID: PMC4201565 DOI: 10.1371/journal.pone.0110621] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 09/15/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND As a result of urbanization, eating and drinking from food service establishments is becoming a common practice in developing countries like Ethiopia, which increases the chances of food borne diseases. The health status and hygiene practices of food handlers are the major determinants of food contamination. In developing countries where there are poor regulatory systems for food hygiene, food handlers are often appointed without screening for possible infections associated with poor hygiene like intestinal parasites. OBJECTIVE This study aimed at determining the prevalence and predictors of intestinal parasites and assessing the hygiene practices among food handlers in Yebu Town, southwest Ethiopia. METHODS A cross-sectional study was conducted among a total of 118 food handlers in Yebu Town in January 2011. Fresh stool specimens were collected and processed using both direct wet mount and Formol ether concentration techniques. RESULTS The overall prevalence of intestinal parasites among the study subjects was 44.1% (52/118). Ascaris lumbricoides and hookworm spp were the predominant parasites identified from the stool of study participants. Age above 35 years (AOR: 4.8, 95% CI: 1.1, 21.8), no regular practice of washing hands before a meal (AOR: 7.8, 95% CI: 2.8, 24.8), and untrimmed finger nail (AOR: 14.7, 95% CI: 2.8, 75.4) were independent predictors of intestinal parasitic infection among the food handlers. CONCLUSION The present study showed high prevalence of intestinal parasites among the study subjects. The study also revealed poor personal hygiene like poor practice of hand washing and poor finger nail hygiene. Therefore, much has to be done to improve the personal hygiene of the food handlers. Pre-placement and periodic screening of food handlers for parasites and prompt treatment, and health education on regular trimming or cleaning of fingernails would be the way forward for prevention of food borne diseases.
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Affiliation(s)
- Tamirat Tefera
- Department of Medical Laboratory Sciences and Pathology, College Of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
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Chen J, Chen GW, Wang MZ, Chen HF, Lin MZ, Ke XM, Guo ZN. [Epidemiological characteristics of soil-borne nematodiasis in Xiamen City]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2012; 24:109-110. [PMID: 22590884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The infection rate of soil-borne nematodes was 6.37% in Xiamen City, 2008, and among which the infection rates of hookworm, Ascaris lumbricoides, Trichuris trichiura and pinworm were 5.97%, 0.29%, 0.09% and 20.13%, respectively. The infection rate of soil-borne nematodes outside the island and that of pinworm in children were still high.
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Affiliation(s)
- Jian Chen
- Xiamen Center for Disease Control and Prevention, Fujian Province, Xiamen 361021, China
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Valencia CA, Fernández JA, Cucunubá ZM, Reyes P, López MC, Duque S. Correlation between malaria incidence and prevalence of soil-transmitted helminths in Colombia: an ecologic evaluation. Biomedica 2010; 30:501-508. [PMID: 21713354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Accepted: 06/23/2010] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Recent studies have suggested an association between the soil-transmitted helminth infections and malaria incidence. However, published evidence is still insufficient and diverging. Since 1977, new ecologic studies have not been carried out to explore this association. Ecologic studies could explore this correlation on a population level, assessing its potential importance on public health. OBJECTIVES The aim of this evaluation is to explore the association between soil-transmitted helminths prevalence and malaria incidence, at an ecologic level in Colombia. MATERIALS AND METHODS Using data from the National Health Survey, which was carried out in 1980 in Colombia, we calculated Spearman correlation coefficients between the prevalence of: Ascaris lumbricoides, Trichuris trichiura and hookworm, with the 1980 malaria incidence data of the same year provided from the Colombian Malaria National Eradication Service. A robust regression analysis with least trimmed squares was performed. RESULTS Falciparum malaria incidence and Ascaris lumbricoides prevalence had a low correlation (R²= 0.086) but this correlation was stronger into the clusters of towns with prevalence of Ascaris lumbricoides infection above 30% were only included (R²= 0.916). CONCLUSION This work showed an ecologic correlation in Colombia between malaria incidence and soil-transmitted helminths prevalence. This could suggest that either there is an association between these two groups of parasites, or could be explained by the presence of common structural determinants for both diseases.
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Affiliation(s)
- Carlos Andrés Valencia
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C, Colombia
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Mehraj V, Hatcher J, Akhtar S, Rafique G, Beg MA. Prevalence and factors associated with intestinal parasitic infection among children in an urban slum of Karachi. PLoS One 2008; 3:e3680. [PMID: 18997865 PMCID: PMC2577067 DOI: 10.1371/journal.pone.0003680] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Accepted: 10/18/2008] [Indexed: 12/01/2022] Open
Abstract
Background Intestinal parasitic infections are endemic worldwide and have been described as constituting the greatest single worldwide cause of illness and disease. Poverty, illiteracy, poor hygiene, lack of access to potable water and hot and humid tropical climate are the factors associated with intestinal parasitic infections. The study aimed to estimate prevalence and identify factors associated with intestinal parasitic infections among 1 to 5 years old children residing in an urban slum of Karachi Pakistan. Methods and Principal Findings A cross sectional survey was conducted from February to June 2006 in Ghosia Colony Gulshan Town Karachi, Pakistan. A simple random sample of 350 children aged 1–5 years was collected. The study used structured pre-tested questionnaire, anthropometric tools and stool tests to obtain epidemiological and disease data. Data were analyzed using appropriate descriptive, univariate and multivariable logistic regression methods. The mean age of participants was 2.8 years and 53% were male. The proportions of wasted, stunted and underweight children were 10.4%, 58.9% and 32.7% respectively. The prevalence of Intestinal parasitic infections was estimated to be 52.8% (95% CI: 46.1; 59.4). Giardia lamblia was the most common parasite followed by Ascaris lumbricoides, Blastocystis hominis and Hymenolepis nana. About 43% children were infected with single parasite and 10% with multiple parasites. Age {Adjusted Odds Ratio (aOR) = 1.5; 95% CI: 1.1; 1.9}, living in rented households (aOR = 2.0; 95% CI: 1.0; 3.9) and history of excessive crying (aOR = 1.9; 95% CI: 1.0; 3.4) were significantly associated with intestinal parasitic infections. Conclusions Intestinal parasites are highly prevalent in this setting and poverty was implicated as an important risk factor for infection. Effective poverty reduction programmes and promotion of deworming could reduce intestinal parasite carriage. There is a need for mass scale campaigns to create awareness about health and hygiene.
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Affiliation(s)
- Vikram Mehraj
- Department of Pathology & Microbiology, Aga Khan University, Karachi, Pakistan
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- Unité Mixte de Recherche 6236, Centre National de la Recherche Scientifique, Faculté de Médecine, Université de la Méditerranée, Marseille, France
| | - Juanita Hatcher
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Saeed Akhtar
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Ghazala Rafique
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Mohammad Asim Beg
- Department of Pathology & Microbiology, Aga Khan University, Karachi, Pakistan
- * E-mail:
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Knopp S, Mohammed KA, Simba Khamis I, Mgeni AF, Stothard JR, Rollinson D, Marti H, Utzinger J. Spatial distribution of soil-transmitted helminths, including Strongyloides stercoralis, among children in Zanzibar. Geospat Health 2008; 3:47-56. [PMID: 19021108 DOI: 10.4081/gh.2008.231] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A programme periodically distributing anthelminthic drugs to school-aged children for the control of soiltransmitted helminthiasis was launched in Zanzibar in the early 1990s. We investigated the spatial distribution of soiltransmitted helminth infections, including Strongyloides stercoralis, in 336 children from six districts in Unguja, Zanzibar, in 2007. One stool sample per child was examined with the Kato-Katz, Koga agar plate and Baermann methods. The point prevalence of the different helminth infections was compared to the geological characteristics of the study sites. The observed prevalences for Trichuris trichiura, Ascaris lumbricoides, hookworm and S. stercoralis were 35.5%, 12.2%, 11.9% and 2.2%, respectively, with considerable spatial heterogeneity. Whilst T. trichiura and hookworm infections were found in all six districts, no A. lumbricoides infections were recorded in the urban setting and only a low prevalence (2.2%) was observed in the South district. S. stercoralis infections were found in four districts with the highest prevalence (4.0%) in the West district. The prevalence of infection with any soil-transmitted helminth was highest in the North A district (69.6%) and lowest in the urban setting (22.4%). A. lumbricoides, hookworm and, with the exception of the North B district, S. stercoralis infections were observed to be more prevalent in the settings north of Zanzibar Town, which are characterized by alluvial clayey soils, moist forest regions and a higher precipitation. After a decade of large-scale administration of anthelminthic drugs, the prevalence of soil-transmitted helminth infections across Unguja is still considerable. Hence, additional measures, such as improving access to adequate sanitation and clean water and continued health education, are warranted to successfully control soil-transmitted helminthiasis in Zanzibar.
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Affiliation(s)
- Stefanie Knopp
- Department of Public Health and Epidemiology, Swiss Tropical Institute, P.O. Box, CH-4002 Basel, Switzerland
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Motazedian H, Mehrabani D, Tabatabaee SHR, Pakniat A, Tavalali M. Prevalence of helminth ova in soil samples from public places in Shiraz. East Mediterr Health J 2006; 12:562-5. [PMID: 17333794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
To determine the prevalence of helminth eggs in public places and children's playgrounds, 112 soil samples were collected in 26 sites in Shiraz, southern Islamic Republic of Iran, during September 2002-September 2003. Toxocara cati ova were found in 7 (6.3%) samples, 2 had Ascaris lumbricoides ova, 3 had larvae morphologically similar to Strongyloides stercoralis. Coccidia oocysts were also observed in 4 samples. No contamination was observed during the dry season.
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Affiliation(s)
- H Motazedian
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Islamic Republic of Iran.
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Williams-Blangero S, Corrêa-Oliveira R, Vandeberg JL, Subedi J, Upadhayay RP, Rai DR, Jha B, Blangero J. Genetic influences on plasma cytokine variation in a parasitized population. Hum Biol 2005; 76:515-25. [PMID: 15754969 DOI: 10.1353/hub.2004.0062] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The soil-transmitted helminths are the most common helminthic infections, affecting about one-fourth of the world's population. There is a significant genetic component to susceptibility to infection with these organisms. Substantial changes in plasma cytokine levels are associated with helminthic infections, and there may be significant genetic components to this cytokine variation. Six plasma cytokine levels were assessed for 367 members of a single pedigree from the Jirel population of eastern Nepal. This population experiences moderate rates of infection with geohelminths. Sex, age, helminthic infection, infection with Giardia, and presence of a household latrine were considered as covariates in all analyses of the cytokine data. The analyses of the single Jirel pedigree revealed significant heritabilities for IFN-gamma (h2 = 0.654+/-0.096), TNF-alpha (h2 = 0.458+/-0.101), IL-2 (h2 = 0.583+/-0.101), IL-4 (h2 = 0.700+/-0.095), IL-5 (h2 = 0.676+/-0.087), and IL-10 (h2 = 0.597+/-0.093). The ratios of IL-4 to IFN-gamma and of IL-10 to IFN-gamma were used as indicators of the degree of type 2 bias in immunological response; analyses of these variables indicated that approximately 40-60% of the variation (h2 = 0.400-0.577) in these derived measures of relative type 2/type 1 response is due to genetic factors.
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Affiliation(s)
- Sarah Williams-Blangero
- Department of Genetics, Southwest Foundation for Biomedical Research, San Antonio, TX 78245-0549, USA
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Ulukanligil M, Seyrek A. Demographic and parasitic infection status of schoolchildren and sanitary conditions of schools in Sanliurfa, Turkey. BMC Public Health 2003; 3:29. [PMID: 12952553 PMCID: PMC200976 DOI: 10.1186/1471-2458-3-29] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [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: 05/13/2003] [Accepted: 09/03/2003] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The design and development of school health programmes will require information at demographic characteristics of schoolchildren and the major health burdens of the school-age group, the opportunities for intervention and the appropriateness of the available infrastructure. This study aims to analyse demographic and parasitic infections status of schoolchildren and sanitary conditions of schools in Sanliurfa province of south-eastern Turkey. METHOD Three primary schools were randomly selected in the shantytown, apartment and rural districts. A total of 1820 schoolchildren between 7-14 years age were took part to the survey of whom 1120 (61.5%) were boys and 700 (38.4%) were girls. A child form (including child's name, sex, age, school grade and parasitic infections) and school survey form (including condition of water supply, condition of latrines, presence of soaps on the basins and presence of garbage piles around to the schools) were used for demographic, parasitic and sanitary surveys. Stool samples were examined by cellophane thick smear technique for the eggs of intestinal helminths. RESULTS The demographic survey showed that number of schoolchildren was gradually decreased as their age's increase in shantytown school. The sex ratio was proportional until the second grade, after which the number of females gradually decreased in children in shantytown and rural schools while, in apartment area, schoolchildren was proportionally distributed between age groups and gender even the high-grade students. The prevalence of helminthic infections was %77.1 of the schoolchildren in shantytown, 53.2% in apartment district and 53.1% of rural area. Ascaris lumbricoides was the most prevalent species and followed by Trichuris trichiura, Hymenolepis nana and Taenia species in three schools. Sanitation survey indicated that the tap water was limited in shantytown school, toilet's sanitation was poor, available no soaps on lavatories and garbage piles were accumulated around the schools in shantytown and rural area, while, the school in apartment area was well sanitised. CONCLUSIONS These results indicated that burden of parasitic infections and poor sanitation conditions constituted public health importance among to the shantytown schoolchildren. School health programmes including deworming and sanitation activities through the health education and improvement of sanitation conditions in the schools have a potential to better health and education for schoolchildren. These programmes also offer the potential to reach significant numbers of population in the shantytown schools with high level of absenteeism.
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Affiliation(s)
- Mustafa Ulukanligil
- Harran University Medical School, Department of Microbiology, Sanliurfa, Turkey
| | - Adnan Seyrek
- Harran University Medical School, Department of Microbiology, Sanliurfa, Turkey
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Carneiro FF, Cifuentes E, Tellez-Rojo MM, Romieu I. The risk of Ascaris lumbricoides infection in children as an environmental health indicator to guide preventive activities in Caparaó and Alto Caparaó, Brazil. Bull World Health Organ 2002; 80:40-6. [PMID: 11884972 PMCID: PMC2567625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE To develop an environmental health indicator for use as a basis for developing preventive measures against Ascaris lumbricoides infection in children from the rural municipalities of Caparaó and Alto Caparaó, in Minas Gerais, Brazil. METHODS A cross-sectional survey was conducted between May and September 1998 among 1171 children under 14 years of age living in 588 dwellings selected from 11 communities. Trained interviewers used a questionnaire to identify risk factors for infection (socioeconomic, sanitation and hygiene variables) and collected stool samples from each child for parasitological tests. RESULTS The overall prevalence of A. lumbricoides infection was 12.2%. The results showed the protective effects of availability of water in the washbasin and better hygiene, sanitation and socioeconomic status; the interactive effect of crowding was five times larger in households without water in the washbasin than in those having water. There was a statistically significant association between infection and children's age. CONCLUSION The environmental health indicator, which incorporated the most significant biological, environmental and social factors associated with the risk of A. lumbricoides infection in children from these communities, should contribute to the development of surveillance tools and health protection measures in this population.
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Affiliation(s)
- Fernando Ferreira Carneiro
- Centro Mineiro de Estudos Epidemiológicos e Ambientais, Belo Horizonte, Minas Gerais, 31 310 580, Brazil.
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Affiliation(s)
- S Pukrittayakamee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Pradhan L, Sahu KL. Ascaris lumbricoides: unusual exit. Indian Pediatr 1998; 35:371. [PMID: 9770896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- L Pradhan
- Government Hospital, Udala, Dist. Mayurbhanj, Orissa
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Hadju V, Stephenson LS, Abadi K, Mohammed HO, Bowman DD, Parker RS. Improvements in appetite and growth in helminth-infected schoolboys three and seven weeks after a single dose of pyrantel pamoate. Parasitology 1996; 113 ( Pt 5):497-504. [PMID: 8893536 DOI: 10.1017/s0031182000081579] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Appetite and growth were studied in primary schoolboys (6-10 years) infected with Ascaris lumbricoides (86%) and Trichuris trichiura (100%) who received a single dose of pyrantel pamoate (which has little or no effect on Trichuris trichiura) or a placebo. Boys were examined, allocated at random by descending Ascaris egg count to pyrantel (PR, n = 36) or placebo (PL, n = 36) groups, treated, and re-examined 3 and 7 weeks later. The 2 groups did not differ significantly before treatment in helminth infections, appetite, or growth. Three and 7 weeks after treatment, the PR group exhibited significantly greater increases than did the PL group in weight (0.2 kg and 0.4 kg more, respectively) and percentage weight-for-age (0.6% and 1.7% points more, respectively). Appetite increased significantly in the PR group at 3 and 7 weeks (P < 0.0005 and P < 0.01, respectively) but not in the PL group. The prevalence and intensity of A. lumbricoides infection were greatly reduced in the PR group at 3 and 7 weeks (both P < 0.0001) but not in the PL group. We conclude that treatment with pyrantel pamoate may improve appetite and growth in school children in areas where A. lumbricoides infections and poor growth are highly prevalent.
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Affiliation(s)
- V Hadju
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA
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Adams EJ, Stephenson LS, Latham MC, Kinoti SN. Physical activity and growth of Kenyan school children with hookworm, Trichuris trichiura and Ascaris lumbricoides infections are improved after treatment with albendazole. J Nutr 1994; 124:1199-206. [PMID: 8074755 DOI: 10.1093/jn/124.8.1199] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Growth, activity, appetite and intestinal helminth infections were compared for 55 Kenyan primary school children with hookworm (93% prevalence), T. trichiura (84% prevalence) and A. lumbricoides (29% prevalence) before and 9 wk after treatment with three 400-mg doses of albendazole (Zentel) or placebo. Fecal samples were examined for helminth eggs using a modified Kato technique. Activity was measured during free-play with motion recorders on the dominant thigh. Children rated their appetites on a 5-point scale. After baseline measurements, children were randomly allocated to the albendazole-treated (n = 28) and placebo (n = 27) groups, treated, and re-examined 9 wk later. At follow-up, egg counts were significantly lower than at baseline in the albendazole-treated group (P < or = 0.002), and gains in activity, reported appetite and most indices of growth were significantly greater for the albendazole-treated group than for the placebo group. We conclude that treatment of undernourished school children for intestinal helminth infections with albendazole may improve growth and appetite and increase spontaneous physical activity.
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Affiliation(s)
- E J Adams
- Program in International Nutrition, Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853-6301
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