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Marques MVA, Lopes BC, Silvério THR, von Sperling M, Neves TDA. Persistence of pathogens and bacterial community dynamics in tropical soil after application of raw sewage. Sci Rep 2023; 13:13435. [PMID: 37596413 PMCID: PMC10439161 DOI: 10.1038/s41598-023-40718-0] [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: 04/04/2023] [Accepted: 08/16/2023] [Indexed: 08/20/2023] Open
Abstract
The objective of this work was to evaluate the persistence of faecal indicators and pathogenic organisms (Salmonella spp., Escherichia coli and viable helminth eggs) and the structure/diversity of bacterial communities in soil receiving raw sewage (RS) for an extended period of application (3 uninterrupted years). In the experimental design, three treatments were defined: (1) Control soil, characterized by the analysis of a composite sample collected in an area of similar soil, but not a recipient of RS (TSC); (2) Soil receiving conventional mineral fertilization, and furrow irrigation with supply water (TW); and (3) Fertirrigated soil with RS applied by furrows (TF). The results of persistence of pathogenic organisms and indicators in TF indicated a sanitary quality similar to the control soil (TSC), thus potentially bringing low risks of contamination with pathogens present in the soil. The presence of viable helminth eggs was not identified in any treatment studied, because of its low concentration in the raw sewage of the studied system. The TW, TF and TSC treatments had 34.8% of bacterial diversity in common. The bacterial composition of the soil showed a predominance of the Proteobacteria phylum in all treatments studied; however, TF was the one with the highest relative abundance of this phylum (44.8%).
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Affiliation(s)
- Marcus Vinícius Araújo Marques
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais (Universidade Federal de Minas Gerais), Belo Horizonte, Minas Gerais, Brazil.
| | - Bruna Coelho Lopes
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais (Universidade Federal de Minas Gerais), Belo Horizonte, Minas Gerais, Brazil
| | - Thiago Henrique Ribeiro Silvério
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais (Universidade Federal de Minas Gerais), Belo Horizonte, Minas Gerais, Brazil
| | - Marcos von Sperling
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais (Universidade Federal de Minas Gerais), Belo Horizonte, Minas Gerais, Brazil
| | - Thiago de Alencar Neves
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais (Universidade Federal de Minas Gerais), Belo Horizonte, Minas Gerais, Brazil
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Lee MR, Shin HE, Back SO, Lee YJ, Lee HI, Ju JW. Status of Helminthic Infections in Residents around River Basins in the Republic of Korea for 10 Years (2011-2020). Korean J Parasitol 2022; 60:187-193. [PMID: 35772737 PMCID: PMC9256286 DOI: 10.3347/kjp.2022.60.3.187] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/17/2022] [Indexed: 11/28/2022]
Abstract
The positive rate of Clonorchis sinensis is the highest among intestinal parasites in the Republic of Korea (Korea). More than 1.2 million people were at risk of C. sinensis infection in Korea in 2012. An intensive control program is being implemented for residents of the 5 major river basins to reduce helminthic infections, including C. sinensis infection. This study evaluated the continuous intensive control program for parasitic diseases including clonorchiasis in areas near the 5 major river basins in Korea over the past 10 years (2011–2020). A total of 335,020 fecal samples (one sample per resident) prepared by the modified sedimentation technic were microscopically examined. Those who expelled helminth eggs were treated with anthelmintics through local health centers and re-examined 3 months later. The overall positive rate of helminths egg was 7.1%. The annual positive rates were dramatically decreased from 14.4% (2011) to 5.9% (2020). The egg positive rate was highest in C. sinensis (5.3%), followed by heterophyid flukes (1.5%) and Trichuris trichiura (0.2%). The prevalence of C. sinensis was significantly higher in males (7.6%) than in females (3.7%), and the highest in the 50–59 years (7.0%) age group. Our results are beneficial to establish prevention and control policies against helminthiases including clonorchiasis in endemic areas in this country.
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Kubas EA, Fischer JR, Hales EN. Endoparasitism of Golden Retrievers: Prevalence, risk factors, and associated clinicopathologic changes. PLoS One 2022; 17:e0263517. [PMID: 35180232 PMCID: PMC8856576 DOI: 10.1371/journal.pone.0263517] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 01/20/2022] [Indexed: 11/17/2022] Open
Abstract
Endoparasitism is a common disease in dogs throughout their lifetime despite the widespread availability of inexpensive diagnostic tests and effective treatments. The consequences of host parasite interactions in otherwise apparently healthy dogs remains largely unknown. This cross-sectional study used complete blood count, serum biochemistry, and fecal flotation data collected from 3,018 young dogs (<3 years of age) enrolled within the Morris Animal Foundation Golden Retriever Lifetime Study (GRLS) to determine the prevalence of endoparasitism and compare bloodwork values of parasite positive and negative participants using logistic regression. Variables including age, gender, reproductive status, and geographic region at the time of evaluation were assessed to identify potential associations. To the authors’ knowledge, a comprehensive assessment of clinicopathological changes associated with endoparasite infection in a large cohort has not been completed in the recent decade. The overall prevalence of endoparasitism was 6.99% (211/3018). Dogs who were parasite positive had statistically lower albumin (P = 0.004), lower RBC count (P = 0.01), higher neutrophil count (P = 0.002), and higher platelet count (P <0.001) as compared to parasite negative dogs. It was also concluded that dogs living in rural areas were more likely to have endoparasites than those living in suburban areas. Epidemiological data is crucial for the design and monitoring of prevention and control strategies. Identification of endoparasites by fecal testing is an essential tool to identify susceptible and resistant animals that can act as spreaders and reservoirs of intestinal parasites thereby enabling appropriate therapy and reducing the risk of new infection to animals and humans. Further epidemiological studies are needed to prevent, monitor, and develop new strategies to control endoparasites.
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Affiliation(s)
- Elizabeth A. Kubas
- Department of Internal Medicine, Veterinary Specialty Hospital, San Diego, CA, United States of America
- * E-mail:
| | - Julie R. Fischer
- Department of Internal Medicine, Veterinary Specialty Hospital, San Diego, CA, United States of America
| | - Erin N. Hales
- Morris Animal Foundation, Denver, CO, United States of America
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Gebrezgabiher G, Yewhalaw D, Ayana M, Hailu A, Mekonnen Z. Impact of ivermectin mass drug administration on burden of soil-transmitted helminths in onchocerciasis control and elimination programs, Yeki district, southwest Ethiopia. PLoS One 2022; 17:e0263625. [PMID: 35143567 PMCID: PMC8830686 DOI: 10.1371/journal.pone.0263625] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/21/2022] [Indexed: 11/18/2022] Open
Abstract
Community-directed treatment with ivermectin (CDTi) is the primary strategy employed to control and eliminate human onchocerciasis in Ethiopia. After long-term mass distribution for onchocerciasis, ivermectin is expected to have additional benefits beyond the envisioned targets by reducing the burden of other co-endemic parasitic infections as to STHs. To date, studies focused on the collateral impact of CDTi on STH in Ethiopia are scanty. Two community-based cross-sectional surveys (baseline in 1997 and post-CDTi in 2017) were conducted to evaluate the impact of long-term CDTi employed to control and eliminate onchocerciasis on the burden of STH infections in Yeki district of southwest Ethiopia. Stool samples were collected and examined using Ritchie`s concentration and Kato-Katz techniques in the baseline and current study, respectively. Overall, 188(38.3%, 95% Confidence interval (CI) 34.1–42.7%) individuals were positive at least for any of the STH species from 491 study participants in the post-CDTi. The prevalence of A. lumbricoides, hookworms, and T. trichiura was 11.2% (95% CI 8.7–14.3%), 16.3% (95% CI 13.3–19.8%), and 29.9% (95% CI 26.1–34.1%), respectively. Individuals aged 5–9 years had a significantly higher prevalence of A. lumbricoides (Adjusted odds ratio (AOR) 6.5, 95% CI 1.7–25.4), T. trichuria (AOR 8, 95% CI 2.6–25.1), and any STH infection (AOR 5, 95% CI 1.7–14.7) than those of ≥ 51 years. Also, significantly higher prevalences of T. trichuria infection were observed in individuals aged 10–14 years (AOR 4.1, 95% CI 1.7–9.9), 15–20 years (AOR 3.1, 95% CI 1.2–8.1), 21–30 years (AOR 2.4, 95% CI 1.1–5.5), and 31–40 years (AOR 3.2, 95% CI 1.3–7.5) compared with those of ≥ 51 years. The prevalence of A. lumbricoides was significantly higher in males (AOR 0.5, 95% CI 0.3–0.9). Of the 491 study participants, only data from 400 individuals who had not been involved in a mass drug administration (MDA) with other STH anthelmintics were considered in the comparative analysis. Before CDTi, the prevalence of A. lumbricoides, T. trichiura, hookworm, and any STH infection was 47.1% (95% CI 41.6–52.7%), 3.3% (95% CI 1.8–5.9%), 37.9% (95% CI 32.7–43.5%), and 58.8% (95% CI 53.2–64.1%), respectively. Long-term CDTi considerably reduced the prevalences of A. lumbricoides and hookworm by 76.2% and 56.9%, respectively (p < 0.001). Nonetheless, CDTi did not affect the prevalence of T. trichiura infection and, in contrast, it was significantly higher in the current study (P < 0.001). Overall post-CDTi prevalence of any STH infection was considerably lower than reported in the baseline (p < 0.001). It is evidenced that long-term CDTi for onchocerciasis control and elimination had additional benefits by reducing the prevalence of STH infections specifically of A. lumbricoides and hookworm, but had no impact on infections with T. trichuria. Our finding of additional health benefits of large-scale ivermectin administration taking it will aid to increase positive engagement and sustain participation of communities during MDA campaigns, and strengthen governmental and non-governmental organizations (NGOs) support for the undergoing national onchocerciasis elimination program.
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Affiliation(s)
- Gebremedhin Gebrezgabiher
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- College of Veterinary Medicine, Samara University, Samara, Ethiopia
- * E-mail:
| | - Delenasaw Yewhalaw
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center, Jimma University, Jimma, Ethiopia
| | - Mio Ayana
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Asrat Hailu
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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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, Li Y, Clements ACA, Steinmann P, Halton K, Stewart DE, McManus DP, Gray DJ. Soil-transmitted helminth infections and nutritional indices among Filipino schoolchildren. PLoS Negl Trop Dis 2021; 15:e0010008. [PMID: 34936644 PMCID: PMC8694453 DOI: 10.1371/journal.pntd.0010008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/05/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022] Open
Abstract
Background Soil-transmitted helminth (STH) infections are still prevalent among schoolchildren in the Philippines. We evaluated the risk factors associated with STH and the relationship between STH and nutritional indices among schoolchildren aged 9–10 years in Laguna province, the Philippines. Methods We used the baseline data from 40 schools enrolled in a randomised controlled trial of the Magic Glasses Philippines health education package. Data on demographic and socio-economic variables, and STH related knowledge, attitudes and practices, were obtained through a questionnaire. Stool samples were collected and assessed for STH egg presence using the Kato-Katz technique. Haemoglobin levels and height and weight of study participants were also determined. The generalized estimating equations approach was used to construct logistic regression models to assess STH-associated risk factors, and the association between any STH infection and anaemia, child stunting, wasting and being underweight. The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12616000508471). Findings Among 1,689 schoolchildren, the prevalence of any STH was 23%. The prevalence of anaemia, stunting, being underweight and wasting was 13%, 20.2%, 19% and 9.5%, respectively. Age, socio-economic status, rural/urban classification of schools and knowledge of STH were significant risk factors for acquiring a STH infection. Moreover, infections with any STH were significantly associated with stunting (P = <0.001) and being underweight (P = <0.003), but not wasting (P = 0.375) or anaemia (P = 0.462) after controlling for confounding covariates. Conclusion The study findings emphasise the need for sustainable deworming in tandem with other measures such as the provision of health education, improvements in sanitation and hygiene, and nutritional programs in order to control STH infections and improve morbidity outcomes in schoolchildren. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12616000508471). Soil-transmitted helminth (STH) infections continue to be high among schoolchildren in the Philippines despite the conduct of semi-annual nationwide school-based mass drug administration (MDA) program more than a decade ago. In this cross-sectional survey, we assess the prevalence of STH, the risk factors associated with infection, and the impact of STH on nutritional indices among schoolchildren in Laguna province, the Philippines. Our results show that STH prevalence (23%) remains above the World Health Organization (WHO) target of < 20% for morbidity control. The prevalences of stunting (20.2%), being underweight (19%) or wasting (9.5%) are high and are still regarded as public health problems according to WHO criteria, but low anaemia prevalence (13%) was observed. Age, socio-economic status, rural/urban classification of schools and knowledge of STH were significant risk factors for STH infections. Moreover, infections with STH were significantly associated with stunting and being underweight but not wasting or anaemia after controlling for key confounders. Sustainable deworming in tandem with other measures such as the provision of health education, improvements in sanitation and hygiene, and nutritional programs, are needed to control intestinal worm infections and improve morbidity outcomes in schoolchildren.
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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
- * E-mail: (MLSM); (DJG)
| | - 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
| | - 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
- * E-mail: (MLSM); (DJG)
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Chis Ster I, Niaz HF, Chico ME, Oviedo Y, Vaca M, Cooper PJ. The epidemiology of soil-transmitted helminth infections in children up to 8 years of age: Findings from an Ecuadorian birth cohort. PLoS Negl Trop Dis 2021; 15:e0009972. [PMID: 34797823 PMCID: PMC8641893 DOI: 10.1371/journal.pntd.0009972] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 12/03/2021] [Accepted: 11/03/2021] [Indexed: 12/11/2022] Open
Abstract
Background There are few prospective longitudinal studies of soil-transmitted helminth (STH) infections during early childhood. We studied the epidemiology of and risk factors for soil-transmitted helminth infections from birth to 8 years of age in tropical Ecuador. Methods 2,404 newborns were followed to 8 years of age with periodic stool sample collections. Stool samples were collected also from household members at the time of the child’s birth and examined by microscopy. Data on social, environmental, and demographic characteristics were collected by maternal questionnaire. Associations between potential risk factors and STH infections were estimated using generalized estimated equations applied to longitudinal binary outcomes for presence or absence of infections at collection times. Results Of 2,404 children, 1,120 (46.6%) were infected with at least one STH infection during the first 8 years of life. The risk of A. lumbricoides (16.2%) was greatest at 3 years, while risks of any STH (25.1%) and T. trichiura (16.5%) peaked at 5 years. Factors significantly associated with any STH infection in multivariable analyses included age, day-care (OR 1.34, 95% CI 1.03–1.73), maternal Afro-Ecuadorian ethnicity (non-Afro vs. Afro, OR 0.55, 95% CI 0.43–0.70) and lower educational level (secondary vs. illiterate, OR 0.31, 95% CI 0.22–0.45)), household overcrowding (OR 1.53, 95% CI 1.21–1.94)), having a latrine rather than a water closet (WC vs. latrine, OR 0.77, 95% CI 0.62–0.95)), and STH infections among household members (OR 2.03, 95% CI 1.59–2.58)). T. trichiura was more associated with poverty (high vs. low socioeconomic status, OR, 0.63, 95% CI 0.40–0.99)] and presence of infected siblings in the household (OR 3.42, 95% CI 2.24–5.22). Conclusion STH infections, principally with A. lumbricoides and T. trichiura, peaked between 3 and 5 years in this cohort of children in tropical Ecuador. STH infections among household members were an important determinant of infection risk and could be targeted for control and elimination strategies. Soil-transmitted helminths (STH) cause significant morbidity among children in low and middle-income countries (LMICs). We followed a birth cohort to 8 years of age in a rural area of coastal Ecuador and showed almost half acquired STH infections during childhood. The dominant STH parasites in this setting in children were Ascaris lumbricoides and Trichuris trichiura and infections peaked in frequency between 3 and 5 years of age. Risk of infection during childhood was associated with markers of marginalisation (Afro-Ecuadorian ethnicity and low educational level), household poverty (overcrowding and poor sanitation), and STH infections among other household members. There was evidence of a reduction in STH infection risk across all ages in study households over the calendar time course of this longitudinal study in parallel with improvements in living conditions, a period of economic growth, and increased government support for those living in extreme poverty. Our data indicate that targeting anthelmintic treatment at members of STH-infected households is likely to reduce the risk of infection in young children.
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Affiliation(s)
- Irina Chis Ster
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Hamzah F. Niaz
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Martha E. Chico
- Fundacion Ecuatoriana Para La Investigacion en Salud, Quito, Ecuador
| | - Yisela Oviedo
- Fundacion Ecuatoriana Para La Investigacion en Salud, Quito, Ecuador
| | - Maritza Vaca
- Fundacion Ecuatoriana Para La Investigacion en Salud, Quito, Ecuador
| | - Philip J. Cooper
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
- Fundacion Ecuatoriana Para La Investigacion en Salud, Quito, Ecuador
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
- * E-mail:
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Grau-Pujol B, Martí-Soler H, Escola V, Demontis M, Jamine JC, Gandasegui J, Muchisse O, Cambra-Pellejà M, Cossa A, Martinez-Valladares M, Sacoor C, Van Lieshout L, Cano J, Giorgi E, Muñoz J. Towards soil-transmitted helminths transmission interruption: The impact of diagnostic tools on infection prediction in a low intensity setting in Southern Mozambique. PLoS Negl Trop Dis 2021; 15:e0009803. [PMID: 34695108 PMCID: PMC8568186 DOI: 10.1371/journal.pntd.0009803] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 04/12/2021] [Revised: 11/04/2021] [Accepted: 09/09/2021] [Indexed: 11/19/2022] Open
Abstract
World Health Organization goals against soil-transmitted helminthiases (STH) are pointing towards seeking their elimination as a public health problem: reducing to less than 2% the proportion of moderate and heavy infections. Some regions are reaching WHO goals, but transmission could rebound if strategies are discontinued without an epidemiological evaluation. For that, sensitive diagnostic methods to detect low intensity infections and localization of ongoing transmission are crucial. In this work, we estimated and compared the STH infection as obtained by different diagnostic methods in a low intensity setting. We conducted a cross-sectional study enrolling 792 participants from a district in Mozambique. Two stool samples from two consecutive days were collected from each participant. Samples were analysed by Telemann, Kato-Katz and qPCR for STH detection. We evaluated diagnostic sensitivity using a composite reference standard. By geostatistical methods, we estimated neighbourhood prevalence of at least one STH infection for each diagnostic method. We used environmental, demographical and socioeconomical indicators to account for any existing spatial heterogeneity in infection. qPCR was the most sensitive technique compared to composite reference standard: 92% (CI: 83%- 97%) for A. lumbricoides, 95% (CI: 88%- 98%) for T. trichiura and 95% (CI: 91%- 97%) for hookworm. qPCR also estimated the highest neighbourhood prevalences for at least one STH infection in a low intensity setting. While 10% of the neighbourhoods showed a prevalence above 20% when estimating with single Kato-Katz from one stool and Telemann from one stool, 86% of the neighbourhoods had a prevalence above 20% when estimating with qPCR. In low intensity settings, STH estimated prevalence of infection may be underestimated if based on Kato-Katz. qPCR diagnosis outperformed the microscopy methods. Thus, implementation of qPCR based predictive maps at STH control and elimination programmes would disclose hidden transmission and facilitate targeted interventions for transmission interruption.
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Affiliation(s)
- Berta Grau-Pujol
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic—University of Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Mundo Sano Foundation, Buenos Aires, Argentina
- * E-mail:
| | - Helena Martí-Soler
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic—University of Barcelona, Barcelona, Spain
| | - Valdemiro Escola
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Maria Demontis
- Department of Parasitology, Centre of Infectious Diseases, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | | | - 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
| | - Osvaldo Muchisse
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Maria Cambra-Pellejà
- 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
| | - Anelsio Cossa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Maria Martinez-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
| | - Charfudin Sacoor
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Lisette Van Lieshout
- Department of Parasitology, Centre of Infectious Diseases, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Jorge Cano
- Expanded Special Project for Elimination of NTDs, World Health Organization Regional Office for Africa, Brazzaville, The Republic of the Congo
| | - Emanuele Giorgi
- Centre for Health Informatics, Computing and Statistics, Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, United Kingdom
| | - Jose Muñoz
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic—University of Barcelona, Barcelona, Spain
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Chen YD, Qian MB, Zhu HH, Zhou CH, Zhu TJ, Huang JL, Li ZJ, Li SZ, Zhou XN. Soil-transmitted helminthiasis in China: A national survey in 2014-2015. PLoS Negl Trop Dis 2021; 15:e0009710. [PMID: 34665821 PMCID: PMC8555824 DOI: 10.1371/journal.pntd.0009710] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 10/29/2021] [Accepted: 08/05/2021] [Indexed: 11/18/2022] Open
Abstract
Background Based on two national surveys, the prevalence of soil-transmitted helminthiasis (STH) in China had decreased from 53.58% in 1988–1992 to 19.56% in 2001–2004. To update the epidemiology and characteristics of STH in China, a third national survey was implemented in 2014–2015. Methodology/Principal findings This survey covered rural areas in 31 provinces in mainland of China. Multiple-stage stratified cluster sampling was employed, which included three levels (provinces, ecozones and economical levels). Stool samples were collected and the Kato-Katz method was applied for helminth eggs detection. Samples with hookworm eggs were selected and hatched to differentiate the species based on larval morphology. Between June 2014 and May 2015, a total of 484,210 participants from 604 counties were enrolled. The weighted prevalence of STH overall was 4.49% (95% confidential interval (CI): 2.45%-6.53%), including 2.62% (95% CI: 0.86%-4.38%) hookworm infections, 1.36% (95% CI: 0.49%-2.23%) ascariasis, and 1.02% (95% CI: 0.15%-1.89%) trichuriasis. The estimated population infected was 29.12 million (95% CI: 15.88 million-42.32 million) for all STH; 16.97 million (95% CI: 5.57 million-28.39 million) for hookworm infections; 8.83 million (95% CI: 3.18 million-14.45 million) for ascariasis; and 6.60 million (95% CI: 0.97 million-12.25 million) for trichuriasis. Overall, the prevalence of ascariasis and trichuriasis was relatively high in children, while hookworm infections were more common in the older population, especially those over 60. STH was highly prevalent in western China, and moderately in central areas, but low in eastern and northern regions. Out of 3,579 hookworm cases with species differentiation, 479 cases (13.38%) were infected with only Ancylostoma spp., 2,808 cases (78.46%) with only Necator americanus, and another 292 cases (8.16%) with both species. Conclusions/Significance This survey demonstrated the continuous decrease of STH in rural China. However, endemicity still prevails in the western areas of the country. Hookworm, especially N. americanus, is becoming the predominant species. Older farmers in western China should be prioritized for control due to the high prevalence of hookworm. Soil-transmitted helminthiasis (STH) had decreased significantly in China based on the two national surveys implemented in 1988–1992 and 2001–2004, respectively. In 2014–2015, an updated national survey on STH was implemented in rural China. This survey covered rural areas of 31 provinces in mainland of China and multiple-stage stratified cluster sampling was employed. Stool samples were collected and examined for helminth eggs. Totally, 484,210 villagers from 604 counties in 31 provinces participated in the survey. The adjusted prevalence of STH was 4.49%, and that of hookworm infections, ascariasis, trichuriasis was 2.62%, 1.36%, 1.02%, respectively. The estimated population with STH was 29.12 million, while that with hookworm infections, ascariasis, trichuriasis was 16.97 million, 8.83 million, 6.60 million, respectively. Children showed a high prevalence in ascariasis and trichuriasis, while the older population had a high prevalence of hookworm infections. STH was still highly prevalent in western parts, moderately in central areas, and low in eastern and northern regions. Further efforts are needed to control STH in China.
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Affiliation(s)
- Ying-Dan Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
- National Center for International Research on Tropical Diseases, Shanghai, China
| | - Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
- National Center for International Research on Tropical Diseases, Shanghai, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui-Hui Zhu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
- National Center for International Research on Tropical Diseases, Shanghai, China
| | - Chang-Hai Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
- National Center for International Research on Tropical Diseases, Shanghai, China
| | - Ting-Jun Zhu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
- National Center for International Research on Tropical Diseases, Shanghai, China
| | - Ji-Lei Huang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
- National Center for International Research on Tropical Diseases, Shanghai, China
| | - Zhong-Jie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
- National Center for International Research on Tropical Diseases, Shanghai, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China
- NHC Key Laboratory of Parasite and Vector Biology, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
- National Center for International Research on Tropical Diseases, Shanghai, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- * E-mail:
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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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Menaldi SL, Dinakrisma AA, Thio HB, Rengganis I, Oktaria S. Unusual presentations of a severe type 2 leprosy reaction mimicking sepsis induced by helminth infection. PLoS Negl Trop Dis 2021; 15:e0009453. [PMID: 34314436 PMCID: PMC8315541 DOI: 10.1371/journal.pntd.0009453] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We describe an unusual case of type 2 leprosy reaction (T2R) with septic shock–like features induced by helminth infection in a 31-year-old Moluccan male patient with a history of completed treatment of WHO multidrug therapy (MDT)–multibacillary (MB) regimen 2 years before admission. During the course of illness, the patient had numerous complications, including septic shock, anemia, and disseminated intravascular coagulation (DIC). Nevertheless, antibiotic therapies failed to give significant results, and the source of infection could not be identified. Helminth infection was subsequently revealed by endoscopic examination followed by parasitological culture. Resolution of symptoms and normal level of organ function–specific markers were resolved within 3 days following anthelmintic treatment. This report demonstrated the challenge in the diagnosis and treatment of severe T2R. Given that helminth infections may trigger severe T2R that mimics septic shock, health professionals need to be aware of this clinical presentation, especially in endemic regions of both diseases.
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Affiliation(s)
- Sri Linuwih Menaldi
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- * E-mail: (SLM); (IR)
| | | | - Hok Bing Thio
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Iris Rengganis
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- * E-mail: (SLM); (IR)
| | - Salma Oktaria
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, the Netherlands
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Kwong LH, Sen D, Islam S, Shahriar S, Benjamin-Chung J, Arnold BF, Hubbard A, Parvez SM, Islam M, Unicomb L, Rahman MM, Nelson K, Colford JM, Luby SP, Ercumen A. Effect of sanitation improvements on soil-transmitted helminth eggs in courtyard soil from rural Bangladesh: Evidence from a cluster-randomized controlled trial. PLoS Negl Trop Dis 2021; 15:e0008815. [PMID: 34319986 PMCID: PMC8351931 DOI: 10.1371/journal.pntd.0008815] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 08/09/2021] [Accepted: 06/24/2021] [Indexed: 11/19/2022] Open
Abstract
Improved sanitation has been hypothesized to reduce soil-transmitted helminth (STH) infections by reducing the prevalence and concentration of STH eggs/larvae in soil. We evaluated the effect of a randomized sanitation program (providing households with an improved dual-pit latrine, tools for child/animal feces management, and behavioral messaging) on reducing the prevalence and concentration of STH eggs in soil from household courtyards. We collected soil samples from 1405 households enrolled in the sanitation intervention (n = 419) and control (n = 914) groups of a cluster-randomized controlled trial (WASH Benefits) in rural Bangladesh approximately 2 years after the initiation of the interventions. We analyzed samples for Ascaris lumbricoides, Trichuris trichiura, and hookworm eggs by microscopy. We estimated prevalence ratios (PR) and egg count ratio (ECR) to compare the prevalence of STH eggs and arithmetic and geometric mean egg counts for STH eggs per gram of soil in the sanitation and control arms. Among intervention households, latrines achieved high and sustained user uptake by adults while child open defecation remained common and most households did not dispose of child feces hygienically. In courtyard soil from control households, the prevalence of any STH eggs was 75.7% and the prevalence of any larvated STH eggs was 67.3%. A. lumbricoides was detected in 63.0% of control samples and T. trichiura in 55.7% of control samples; hookworm was not detected in any sample. In the control arm, the arithmetic mean egg count for any STH was 3.96 eggs/dry gram, while the geometric mean was 1.58 eggs/dry gram. There was no difference between the intervention and control groups in the prevalence of any STH eggs (PR = 0.98 (95% CI: 0.91, 1.05)) or mean egg counts (ECR = 0.08 (95% CI: -0.10, 0.26) for geometric mean and 0.07 (95% CI: -0.22, 0.37) for arithmetic mean). Adjusted models gave similar results. A compound-level sanitation intervention that provided improved latrines and tools for disposal of child and animal feces did not have an impact on STH eggs in soil. In order to effectively reduce the prevalence and concentration of STH eggs in the environment, sustained, widespread use of sanitation strategies to isolate and hygienically dispose of child and animal feces may need to complement traditional strategies for containment of adult human feces. Trial Registration: NCT01590095.
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Affiliation(s)
- Laura H. Kwong
- Woods Institute for the Environment, Stanford University, Stanford, California, United States of America
| | - Debashis Sen
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sharmin Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sunny Shahriar
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Jade Benjamin-Chung
- School of Public Health, University of California, Berkeley, California, United States of America
| | - Benjamin F. Arnold
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California, United States of America
| | - Alan Hubbard
- School of Public Health, University of California, Berkeley, California, United States of America
| | - Sarker Masud Parvez
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mahfuza Islam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Leanne Unicomb
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md. Mahbubur Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Kara Nelson
- Department of Civil Engineering, University of California, Berkeley, California, United States of America
| | - John M. Colford
- School of Public Health, University of California, Berkeley, California, United States of America
| | - Stephen P. Luby
- Woods Institute for the Environment, Stanford University, Stanford, California, United States of America
| | - Ayse Ercumen
- Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, North Carolina, United States of America
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Khadra A, Ezzariai A, Kouisni L, Hafidi M. Helminth eggs inactivation efficiency by sludge co-composting under arid climates. Int J Environ Health Res 2021; 31:530-537. [PMID: 31554408 DOI: 10.1080/09603123.2019.1671960] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/19/2019] [Indexed: 06/10/2023]
Abstract
Primary sludge (PS) from the wastewater treatment plants is constituted of organic matter and other nutrients that could be reused as soil fertilizers. However, primary sludge amendment is hampered due to the presence of pathogens that could be responsible for several infections in various ways depending on the prevalence of the human sources. This study investigates helminth eggs (HE) removal and inactivation efficiency by co-composting. So, PS was mixed with date palm waste as a bulking material at a 1:1 volume ratio. The C/N ratio decreased from 25:1 to 12:1 and temperatures above 50ºC were observed since 33 days. The initial concentration of HE eggs in the PS is 135.9 per 10 g DR. Microscopic examination of the PS, according to the Bailenger method, showed the presence of nematodes and Cestodes represented by: Ascaris lombricoïde, Ancylostomes duodenale, Trichuris trichiura, Capilaria spp, Hymenolepis nana, Taenia saginata, and Ascaris lombricoïde. After 60 days of co-composting, the charge of parasites was reduced to 18 eggs per 10 g per DR. The viability of ascaris eggs was examined using a light microscope and the percentage of the embryonated eggs was determined. No viable eggs were observed in the final compost. The result corroborates the WHO guidelines for the application of the composted sewage sludge safely for agriculture purposes.
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Affiliation(s)
- Ahmed Khadra
- Ecology and Environment laboratory Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
| | | | - Lamfeddal Kouisni
- Agrobiosciences Program, University Mohammed VI Polytechnic (UM6P), Benguerir, Morocco
| | - Mohamed Hafidi
- Ecology and Environment laboratory Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco
- Agrobiosciences Program, University Mohammed VI Polytechnic (UM6P), Benguerir, Morocco
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Keller L, Welsche S, Patel C, Sayasone S, Ali SM, Ame SM, Hattendorf J, Hürlimann E, Keiser J. Long-term outcomes of ivermectin-albendazole versus albendazole alone against soil-transmitted helminths: Results from randomized controlled trials in Lao PDR and Pemba Island, Tanzania. PLoS Negl Trop Dis 2021; 15:e0009561. [PMID: 34191812 PMCID: PMC8277064 DOI: 10.1371/journal.pntd.0009561] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/13/2021] [Accepted: 06/14/2021] [Indexed: 12/13/2022] Open
Abstract
Background Preventive chemotherapy is the cornerstone of soil-transmitted helminth (STH) control. Long-term outcomes and adequate treatment frequency of the recently recommended albendazole-ivermectin have not been studied to date. Methodology/principal findings Double-blind randomized controlled trials were conducted in Lao PDR, Pemba Island, Tanzania and Côte d’Ivoire between 2018 and 2020 to evaluate the efficacy and safety of ivermectin-albendazole versus albendazole-placebo in Trichuris trichiura-infected individuals aged 6 to 60. In the framework of this study, in Lao PDR 466 and 413 participants and on Pemba Island, 558 and 515 participants were followed-up six and 12 months post-treatment, respectively. From each participant at least one stool sample was processed for Kato-Katz diagnosis and cure rates (CRs), egg reduction rates (ERRs) and apparent reinfection rates were calculated. If found helminth-positive at six months, participants were re-treated according to their allocated treatment. Long-term outcomes against T. trichiura based on CRs and ERRs of ivermectin-albendazole compared to albendazole were significantly higher at six months in Lao PDR (CR, 65.8 vs 13.4%, difference; 52.4; 95% CI 45.0–60.0; ERRs, 99.0 vs 79.6, difference 19.4; 95% CI 14.4–24.4) and Pemba Island (CR, 17.8 vs 1.4%, difference; 16.4; 95% CI 11.6–21.0; ERRs, 84.9 vs 21.2, difference 63.8; 95% CI 50.6–76.9) and also at 12 months in Lao PDR (CR, 74.0 vs 23.4%, difference; 50.6; 95% CI 42.6–61.0; ERRs, 99.6 vs 91.3, difference 8.3; 95% CI 5.7–10.8) and Pemba Island (CR, 19.5 vs 3.4%, difference; 16.1; 95% CI 10.7–21.5; ERRs, 92.9 vs 53.6, difference 39.3; 95% CI 31.2–47.4) respectively. Apparent reinfection rates with T. trichiura were considerably higher on Pemba Island (100.0%, 95% CI, 29.2–100.0) than in Lao PDR (10.0%, 95% CI, 0.2–44.5) at 12 months post-treatment for participants treated with albendazole alone. Conclusions/significance The long-term outcomes against T. trichiura of ivermectin-albendazole are superior to albendazole in terms of CRs and ERRs and in reducing infection intensities. Our results will help to guide decisions on how to best use ivermectin-albendazole in the context of large-scale PC programs tailored to the local context to sustainably control STH infections. Trial registration ClinicalTrials.gov registered with clinicaltrials.gov, reference: NCT03527732, date assigned: 17 May 2018. Around 1.5 billion people are infected with the gastrointestinal dwelling nematodes, the so-called soil-transmitted helminths (STHs). Especially chronic high-intensity infections with these parasites can cause substantial morbidity in endemic regions. Preventive chemotherapy, which is the regular administration of a single dose of an anthelmintic drug to at-risk populations, aims to reduce morbidity by lowering the prevalence and intensity of STH infections. Due to the suboptimal efficacy of these recommended single dose monotherapies, particularly against Trichuris trichiura, the use of drug combinations with dissimilar modes of action may enhance treatment efficacy. In double-blind randomized controlled trials in Lao PDR and on Pemba Island, Tanzania, we examined the long-term outcomes of ivermectin-albendazole versus albendazole alone, against T. trichiura. We assessed the infection status, apparent reinfections, new infections and the change of infection intensity for the three major STH species six and 12 months post-treatment. The long-term outcomes (in terms of cure and egg-reduction rates) of the ivermectin-albendazole combination therapy against T. trichiura were significantly higher than that of albendazole alone at all-time points and in both countries. Bi-annual treatment intervals using the ivermectin-albendazole combination might be necessary to sustainably decrease transmission of STH infections.
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Affiliation(s)
- Ladina Keller
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sophie Welsche
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Chandni Patel
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Somphou Sayasone
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, 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
| | - Jan Hattendorf
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Eveline Hürlimann
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jennifer Keiser
- Medical Parasitology and Infection Biology, Helminth Drug Development Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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Webb CM, Morales ML, Lopez M, Baca-Turpo B, Arque E, White AC, Cabada MM. Stunting in pre-school and school-age children in the Peruvian highlands and its association with Fasciola infection and demographic factors. PLoS Negl Trop Dis 2021; 15:e0009519. [PMID: 34153050 PMCID: PMC8248620 DOI: 10.1371/journal.pntd.0009519] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/01/2021] [Accepted: 05/30/2021] [Indexed: 11/18/2022] Open
Abstract
Fascioliasis is a zoonotic trematode infection that is endemic in the highlands of Peru. Chronic fascioliasis can be asymptomatic and remain undiagnosed for years. Chronic malnutrition in children, as manifested by stunting, leads to delayed cognitive development and lost productivity. We hypothesized that fascioliasis is among the factors associated with stunting in children from endemic areas. We conducted a cross-sectional study among children attending pre-school and school in 26 communities in the Anta province in the Cusco region of Peru. We conducted interviews to collect information on demographic, socioeconomic, and medical history. Blood was collected and tested for complete cell count and FAS2 ELISA for Fasciola antibodies. Three stool samples per participant were tested for parasites by Kato-Katz and Lumbreras rapid sedimentation methods. Chronic fascioliasis was determined by the presence of ova in stool. Children's height, weight, and age were recorded and used to calculate height for age Z scores (HAZ). Three thousand children participated in the study. Nine percent (264) of children had at least one positive test for Fasciola infection, 6% (164) had chronic fascioliasis, and 3% (102) had only positive antibody tests. The median HAZ was -1.41 (IQR: -2.03 to -0.81) and was similar in males and females. Twenty six percent (776) of children had stunting with HAZ < -2. Children with chronic fascioliasis had a lower median HAZ than children without Fasciola (-1.54 vs. -1.4, p = 0.014). History of treatment for malnutrition, history of treatment for anemia, having other helminths in stool, lower socioeconomic score, living at a higher elevation, and fewer years of schooling of both parents were associated with a lower HAZ score. In a multiple regression analysis, older age and a lower socioeconomic score were associated with a lower HAZ score. While fascioliasis and other helminths were associated with lower HAZ, they were not independent of the socioeconomic score.
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Affiliation(s)
- Camille M. Webb
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Maria Luisa Morales
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Martha Lopez
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Benicia Baca-Turpo
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Eulogia Arque
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - A. Clinton White
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Miguel M. Cabada
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
- * E-mail:
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van Dijk J. Using worm egg count data to detect and counter trends in equine helminth abundance. Vet Rec 2021; 188:e272. [PMID: 33666990 DOI: 10.1002/vetr.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Jan van Dijk, RCVS specialist in veterinary parasitology, describes how data can be used to both increase understanding of trends in equine helminth abundance and drive better treatment of individual horses.
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Ajjampur SSR, Kaliappan SP, Halliday KE, Palanisamy G, Farzana J, Manuel M, Abraham D, Laxmanan S, Aruldas K, Rose A, Kennedy DS, Oswald WE, Pullan RL, Galagan SR, Ásbjörnsdóttir K, Anderson RM, Muliyil J, Sarkar R, Kang G, Walson JL. Epidemiology of soil transmitted helminths and risk analysis of hookworm infections in the community: Results from the DeWorm3 Trial in southern India. PLoS Negl Trop Dis 2021; 15:e0009338. [PMID: 33930024 PMCID: PMC8184002 DOI: 10.1371/journal.pntd.0009338] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/07/2021] [Accepted: 03/29/2021] [Indexed: 12/17/2022] Open
Abstract
Since 2015, India has coordinated the largest school-based deworming program globally, targeting soil-transmitted helminths (STH) in ~250 million children aged 1 to 19 years twice yearly. Despite substantial progress in reduction of morbidity associated with STH, reinfection rates in endemic communities remain high. We conducted a community based parasitological survey in Tamil Nadu as part of the DeWorm3 Project—a cluster-randomised trial evaluating the feasibility of interrupting STH transmission at three geographically distinct sites in Africa and Asia—allowing the estimation of STH prevalence and analysis of associated factors. In India, following a comprehensive census, enumerating 140,932 individuals in 36,536 households along with geospatial mapping of households, an age-stratified sample of individuals was recruited into a longitudinal monitoring cohort (December 2017-February 2018) to be followed for five years. At enrolment, a total of 6089 consenting individuals across 40 study clusters provided a single adequate stool sample for analysis using the Kato-Katz method, as well as answering a questionnaire covering individual and household level factors. The unweighted STH prevalence was 17.0% (95% confidence interval [95%CI]: 16.0–17.9%), increasing to 21.4% when weighted by age and cluster size. Hookworm was the predominant species, with a weighted infection prevalence of 21.0%, the majority of which (92.9%) were light intensity infections. Factors associated with hookworm infection were modelled using mixed-effects multilevel logistic regression for presence of infection and mixed-effects negative binomial regression for intensity. The prevalence of both Ascaris lumbricoides and Trichuris trichiura infections were rare (<1%) and risk factors were therefore not assessed. Increasing age (multivariable odds ratio [mOR] 21.4, 95%CI: 12.3–37.2, p<0.001 for adult age-groups versus pre-school children) and higher vegetation were associated with an increased odds of hookworm infection, whereas recent deworming (mOR 0.3, 95%CI: 0.2–0.5, p<0.001) and belonging to households with higher socioeconomic status (mOR 0.3, 95%CI: 0.2–0.5, p<0.001) and higher education level of the household head (mOR 0.4, 95%CI: 0.3–0.6, p<0.001) were associated with lower odds of hookworm infection in the multilevel model. The same factors were associated with intensity of infection, with the use of improved sanitation facilities also correlated to lower infection intensities (multivariable infection intensity ratio [mIIR] 0.6, 95%CI: 0.4–0.9, p<0.016). Our findings suggest that a community-based approach is required to address the high hookworm burden in adults in this setting. Socioeconomic, education and sanitation improvements alongside mass drug administration would likely accelerate the drive to elimination in these communities. Trial Registration:NCT03014167. Approximately 1 in 5 people in India are infected with soil transmitted helminths (STH), leading to anaemia and malnutrition. To tackle this large burden of infection, the government of India launched one of the world’s largest school-based deworming programs in 2015 aiming to deworm all pre-school and school-aged children between 1 to 19 years of age twice yearly on the National Deworming Days. Deworming programs, including those in India, are focused on pre-school aged children, school aged children and women of reproductive age group. However, prevailing environmental and socioeconomic conditions, including poor sanitation, can contribute to high rates of reinfection from untreated adults and children. The DeWorm3 Project is a cluster-randomised trial evaluating the feasibility of interrupting STH transmission with community wide deworming of all individuals aged one to 99 years of age or older. As part of the study, we conducted a parasitological survey in the Deworm3 trial site in rural Tamil Nadu. Here we present the factors associated with STH infection and burden in these communities.
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Affiliation(s)
- Sitara S. R. Ajjampur
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
- * E-mail:
| | | | - Katherine E. Halliday
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- The DeWorm3 Project, University of Washington, Seattle, Washington, United States of America
| | - Gokila Palanisamy
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Jasmine Farzana
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Malathi Manuel
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Dilip Abraham
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Selvi Laxmanan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Kumudha Aruldas
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Anuradha Rose
- Department of Community Medicine, Christian Medical College, Vellore, India
| | - David S. Kennedy
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - William E. Oswald
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Rachel L. Pullan
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sean R. Galagan
- The DeWorm3 Project, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Kristjana Ásbjörnsdóttir
- The DeWorm3 Project, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Roy M. Anderson
- School of Public Health, Faculty of Medicine, Imperial College, London, United Kingdom
| | - Jayaprakash Muliyil
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Rajiv Sarkar
- Indian Institute of Public Health, Shillong, India
| | - Gagandeep Kang
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Judd L. Walson
- The DeWorm3 Project, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Medicine (Infectious Diseases) and Pediatrics, University of Washington, Seattle, Washington, United States of America
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Vlaminck J, Lagatie O, Dana D, Mekonnen Z, Geldhof P, Levecke B, Stuyver LJ. Identification of antigenic linear peptides in the soil-transmitted helminth and Schistosoma mansoni proteome. PLoS Negl Trop Dis 2021; 15:e0009369. [PMID: 33909616 PMCID: PMC8081252 DOI: 10.1371/journal.pntd.0009369] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/07/2021] [Indexed: 11/18/2022] Open
Abstract
The scientific community identified non stool-based biomarkers as the way forward to support soil-transmitted helminth (STH; Ascaris lumbricoides, Trichuris trichiura and the hookworms Ancylostoma duodenale and Necator americanus) and schistosome (S. mansoni and S. haematobium) deworming programs. This support is needed in making the decision of whether or not to stop preventive chemotherapy intervention efforts and to ultimately transition towards a post-intervention surveillance phase. We applied a two-step micro-array approach to identify antigenic linear epitopes in the STH and S. mansoni proteomes. In a first experiment, we identified antigenic peptides by applying sera from 24 STH and/or S. mansoni infected Ethiopian children on a high-density peptide microarray containing 3.3 million peptides derived from the complete STH and S. mansoni proteomes. A second array experiment with 170,185 peptides that were recognized in the first array was designed to identify non-specific antibody reactivity by applying sera from 24 healthy individuals from Belgium (a non-endemic country). From this array testing cascade, several peptides were identified for STH but none of them appeared to be unique for one species. We therefore concluded that for STH, none of the peptides revealed to be sufficiently sensitive or species specific. For S. mansoni, some promising peptides were identified prompting future investigation. Based on these results, it is unlikely that linear epitopes would be highly useful in detecting species-specific antibody responses to STH in endemic communities. For S. mansoni, one particular peptide of the micro-exon gene 12 (MEG-12) protein deserves further research. In addition, this study emphasizes the need of well-characterized biobanks for biomarker discovery, particularly when the integration of multiple disease programs is envisioned. Today, infections with intestinal (roundworms, whipworm and hookworms) and blood-dwelling worms (schistosomes) are traditionally diagnosed by demonstrating worm eggs in stool. This current practice comes with some important challenges, including but not limited to the low-throughput and the need of skilled operators. Especially in the context of monitoring and evaluation, there is a need for alternative tools. Therefore, one of the recommendations of the scientific community was to develop tests that are based on the detection of antibodies in blood, which reflect the natural immune response of the host to worm-specific components or antigens. In the present study, we screened the antigenicity of all the peptides that build up the proteome of intestinal and blood-dwelling worms. For intestinal worms, our results revealed that the antibody response to these peptides was either not unique for the worm species or absent in infected subjects. For blood-dwelling worms, the findings were less sobering, with a number of peptides inducing an antibody response that was only observed in infected subjects.
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Affiliation(s)
- Johnny Vlaminck
- Department of Virology, Parasitology, Immunology and Physiology, Ghent University, Merelbeke, Belgium
| | - Ole Lagatie
- Global Public Health R&D, Janssen Pharmaceutica NV, Beerse, Belgium
- * E-mail:
| | - Daniel Dana
- Department of Virology, Parasitology, Immunology and Physiology, Ghent University, Merelbeke, Belgium
- School of Laboratory Science, Faculty of health science, Institute of health, Jimma University, Jimma, Ethiopia
| | - Zeleke Mekonnen
- School of Laboratory Science, Faculty of health science, Institute of health, Jimma University, Jimma, Ethiopia
| | - Peter Geldhof
- Department of Virology, Parasitology, Immunology and Physiology, Ghent University, Merelbeke, Belgium
| | - Bruno Levecke
- Department of Virology, Parasitology, Immunology and Physiology, Ghent University, Merelbeke, Belgium
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von Huth S, Thingholm LB, Kofoed PE, Bang C, Rühlemann MC, Franke A, Holmskov U. Intestinal protozoan infections shape fecal bacterial microbiota in children from Guinea-Bissau. PLoS Negl Trop Dis 2021; 15:e0009232. [PMID: 33657123 PMCID: PMC7959362 DOI: 10.1371/journal.pntd.0009232] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 03/15/2021] [Accepted: 02/11/2021] [Indexed: 12/24/2022] Open
Abstract
Intestinal parasitic infections, caused by helminths and protozoa, are globally distributed and major causes of worldwide morbidity. The gut microbiota may modulate parasite virulence and host response upon infection. The complex interplay between parasites and the gut microbiota is poorly understood, partly due to sampling difficulties in remote areas with high parasite burden. In a large study of children in Guinea-Bissau, we found high prevalence of intestinal parasites. By sequencing of the 16S rRNA genes of fecal samples stored on filter paper from a total of 1,204 children, we demonstrate that the bacterial microbiota is not significantly altered by helminth infections, whereas it is shaped by the presence of both pathogenic and nonpathogenic protozoa, including Entamoeba (E.) spp. and Giardia (G.) lamblia. Within-sample diversity remains largely unaffected, whereas overall community composition is significantly affected by infection with both nonpathogenic E. coli (R2 = 0.0131, P = 0.0001) and Endolimax nana (R2 = 0.00902, P = 0.0001), and by pathogenic E. histolytica (R2 = 0.0164, P = 0.0001) and G. lamblia (R2 = 0.00676, P = 0.0001). Infections with multiple parasite species induces more pronounced shifts in microbiota community than mild ones. A total of 31 bacterial genera across all four major bacterial phyla were differentially abundant in protozoan infection as compared to noninfected individuals, including increased abundance of Prevotella, Campylobacter and two Clostridium clades, and decreased abundance of Collinsella, Lactobacillus, Ruminococcus, Veillonella and one Clostridium clade. In the present study, we demonstrate that the fecal bacterial microbiota is shaped by intestinal parasitic infection, with most pronounced associations for protozoan species. Our results provide insights into the interplay between the microbiota and intestinal parasites, which are valuable to understand infection biology and design further studies aimed at optimizing treatment strategies.
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Affiliation(s)
- Sebastian von Huth
- Cancer and Inflammation Research, Department of Molecular Medicine, University of Southern Denmark, Denmark
| | - Louise B. Thingholm
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Germany
| | - Poul-Erik Kofoed
- Department of Pediatrics, Kolding Hospital, Denmark
- Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau
| | - Corinna Bang
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Germany
| | - Malte C. Rühlemann
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian Albrechts University of Kiel, Germany
| | - Uffe Holmskov
- Cancer and Inflammation Research, Department of Molecular Medicine, University of Southern Denmark, Denmark
- * E-mail:
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Ntonifor HN, Chewa JS, Oumar M, Mbouobda HD. Intestinal helminths as predictors of some malaria clinical outcomes and IL-1β levels in outpatients attending two public hospitals in Bamenda, North West Cameroon. PLoS Negl Trop Dis 2021; 15:e0009174. [PMID: 33651792 PMCID: PMC7924769 DOI: 10.1371/journal.pntd.0009174] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 09/16/2020] [Accepted: 01/24/2021] [Indexed: 11/19/2022] Open
Abstract
This study aimed at determining the impact of intestinal helminths on malaria parasitaemia, anaemia and pyrexia considering the levels of IL-1β among outpatients in Bamenda. A cohort of 358 consented participants aged three (3) years and above, both males and females on malaria consultation were recruited in the study. At enrolment, patients’ axillary body temperatures were measured and recorded. Venous blood was collected for haemoglobin concentration and malaria parasitaemia determination. Blood plasma was used to measure human IL-1β levels using Human ELISA Kit. The Kato-Katz technique was used to process stool samples. Five species of intestinal helminths Ascaris lumbricoides (6.4%), Enterobius vermicularis (5.0%), Taenia species (4.2%), Trichuris trichiura (1.1%) and hookworms (0.8%) were identified. The overall prevalence of Plasmodium falciparum and intestinal helminths was 30.4% (109/358) and 17.6% (63/358) respectively. The prevalence of intestinal helminths in malaria patients was 17.4% (19/109). Higher Geometric mean parasite density (GMPD ±SD) (malaria parasitaemia) was significantly observed in patients co-infected with Enterobius vermicularis (5548 ± 2829/μL, p = 0.041) and with Taenia species (6799 ± 4584/μL, p = 0.020) than in Plasmodium falciparum infected patients alone (651 ± 6076/ μL). Higher parasitaemia of (1393 ± 3031/μL) and (3464 ± 2828/μL) were recorded in patients co-infected with Ascaris lumbricoides and with hookworms respectively but the differences were not significant (p > 0.05). Anaemia and pyrexia prevalence was 27.1% (97/358) and 33.5% (120/358) respectively. Malaria patients co-infected with Enterobius vermicularis and Ascaris lumbricoides had increased risk of anaemia (OR = 13.712, p = 0.002 and OR = 16.969, p = 0.014) respectively and pyrexia (OR = 18.07, p = 0.001 and OR = 22.560, p = 0.007) respectively than their counterparts. Increased levels of IL-1β were significantly observed in anaemic (148.884 ± 36.073 pg/mL, t = 7.411, p = 0.000) and pyretic (127.737 ± 50.322 pg/mL, t = 5.028, p = 0.000) patients than in non-anaemic (64.335 ± 38.995pg/mL) and apyretic patients (58.479 ± 36.194pg/mL). Malaria patients co-infected with each species of intestinal helminths recorded higher IL-1β levels (IL-1β > 121.68 ± 58.86 pg/mL) and the overall mean (139.63 ± 38.33pg/mL) was higher compared with levels in malaria (121.68 ± 58.86 pg/mL) and helminth (61.78 ± 31.69pg/mL) infected patients alone. Intestinal helminths exacerbated the clinical outcomes of malaria in the patients and increased levels of IL-1β were observed in co-infected patients with anaemia, pyrexia and higher parasitaemia. Malaria and intestinal helminthiasis are endemic parasitic diseases in Sub Sahara Africa including Cameroon that has been associated with poverty. Humans are co-infected with these diseases. Intestinal helminths have been reported to improve or exacerbate malaria severities in co-infected patients. The precise mechanism through which they exert this is not well elucidated but there are speculations about possible immunological implications. It is therefore crucial to understand the mechanism how these neglected tropical disease (helminthiasis) impact malaria severities to develop robust integrated public health intervention strategies and treatment protocols that can effectively manage these diseases in endemic zones. In this study, we focused on the impact of these helminths on malaria parasitaemia, anaemia and pyrexia. We examined each patient for malaria and helminth infections while also measuring their haemoglobin concentrations and body temperatures. We found out that patients infected with intestinal helminths had increased risk of malaria infection and exacerbated malaria parasitaemia, anaemia and pyrexia in co-infected patients. We also observed that increased levels of IL-1β were higher in these co-infected patients than in patients infected with malaria parasite or helminths alone. Our study is informative about the possible involvement of intestinal helminths with the immune responses of the host that consequently affects malaria severity.
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Affiliation(s)
- Helen Ngum Ntonifor
- Department of Biological Sciences, Faculty of Science, University of Bamenda, Bambili, North West Region, Cameroon
- * E-mail:
| | - Julius Suh Chewa
- Department of Biological Sciences, Faculty of Science, University of Bamenda, Bambili, North West Region, Cameroon
| | - Mahamat Oumar
- Department of Biological Sciences, Faculty of Science, University of Bamenda, Bambili, North West Region, Cameroon
| | - Hermann Desire Mbouobda
- Department of Biology, Higher Teachers Training College, University of Bamenda, Bambili, North West Region, Cameroon
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Farrant O, Marlais T, Houghton J, Goncalves A, Teixeira da Silva Cassama E, Cabral MG, Nakutum J, Manjuba C, Rodrigues A, Mabey D, Bailey R, Last A. Prevalence, risk factors and health consequences of soil-transmitted helminth infection on the Bijagos Islands, Guinea Bissau: A community-wide cross-sectional study. PLoS Negl Trop Dis 2020; 14:e0008938. [PMID: 33326420 PMCID: PMC7773412 DOI: 10.1371/journal.pntd.0008938] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/24/2020] [Revised: 12/30/2020] [Accepted: 10/30/2020] [Indexed: 11/19/2022] Open
Abstract
Soil-transmitted helminths (STH) are endemic and widespread across Sub-Saharan Africa. A community wide soil-transmitted helminth (STH) prevalence survey was performed on the island of Bubaque in Guinea-Bissau using both Kato-katz microscopy and qPCR methodology. Predictors of infection and morbidity indicators were identified using multivariable logistic regression, and diagnostic methods were compared using k statistics. Among 396 participants, prevalence of STH by microscopy was 23.2%, hookworm was the only species identified by this method and the mean infection intensity was 312 eggs per gram. qPCR analysis revealed an overall prevalence of any STH infection of 47.3%, with the majority A. duodenale (32.3%), followed by N. americanus (15.01%) and S. stercoralis (13.2%). A. lumbricoides, and T. trichiura infections were negligible, with a prevalence of 0.25% each. Agreement between diagnostic tests was k = 0.22, interpreted as fair agreement, and infection intensity measured by both methods was only minimally correlated (Rs = -0.03). STH infection overall was more common in females and adults aged 31-40. STH infection was associated with open defaecation, low socio-economic status and further distance to a water-source. The prevalence of anaemia (defined as a binary outcome by the WHO standards for age and sex) was 69.1%, and 44.2% of children were malnourished according to WHO child growth standards. Hookworm infection intensity by faecal egg count showed no statistically significant association with age (Rs 0.06) but S. Stercoralis infection intensity by qPCR cycle threshold was higher in pre-school aged children (Rs = 0.30, p-value 0.03) There was no statistically significant association between STH infection and anaemia (OR 1.0 p = 0.8), stunting (OR 1.9, p-value 0.5) and wasting (OR 2.0, p-value 0.2) in children. This study reveals a persistent reservoir of STH infection across the community, with high rates of anaemia and malnutrition, despite high-coverage of mebendazole mass-drug administration in pre-school children. This reflects the need for a new strategy to soil-transmitted helminth control, to reduce infections and ultimately eliminate transmission.
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Affiliation(s)
- Olivia Farrant
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Tegwen Marlais
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Joanna Houghton
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Adriana Goncalves
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | - Jose Nakutum
- Region Sanitaria Bolama-Bijagós, Bubaque, Guinea Bissau
| | | | | | - David Mabey
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Robin Bailey
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Anna Last
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Keller L, Patel C, Welsche S, Schindler T, Hürlimann E, Keiser J. Performance of the Kato-Katz method and real time polymerase chain reaction for the diagnosis of soil-transmitted helminthiasis in the framework of a randomised controlled trial: treatment efficacy and day-to-day variation. Parasit Vectors 2020; 13:517. [PMID: 33059756 PMCID: PMC7558729 DOI: 10.1186/s13071-020-04401-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [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: 07/01/2020] [Accepted: 10/09/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Accurate, scalable and sensitive diagnostic tools are crucial in determining prevalence of soil-transmitted helminths (STH), assessing infection intensities and monitoring treatment efficacy. However, assessments on treatment efficacy comparing traditional microscopic to newly emerging molecular approaches such as quantitative Polymerase Chain Reaction (qPCR) are scarce and hampered partly by lack of an established diagnostic gold standard. METHODS We compared the performance of the copromicroscopic Kato-Katz method to qPCR in the framework of a randomized controlled trial on Pemba Island, Tanzania, evaluating treatment efficacy based on cure rates of albendazole monotherapy versus ivermectin-albendazole against Trichuris trichiura and concomitant STH infections. Day-to-day variability of both diagnostic methods was assessed to elucidate reproducibility of test results by analysing two stool samples before and two stool samples after treatment of 160 T. trichiura Kato-Katz positive participants, partially co-infected with Ascaris lumbricoides and hookworm, per treatment arm (n = 320). As negative controls, two faecal samples of 180 Kato-Katz helminth negative participants were analysed. RESULTS Fair to moderate correlation between microscopic egg count and DNA copy number for the different STH species was observed at baseline and follow-up. Results indicated higher sensitivity of qPCR for all three STH species across all time points; however, we found lower test result reproducibility compared to Kato-Katz. When assessed with two samples from consecutive days by qPCR, cure rates were significantly lower for T. trichiura (23.2 vs 46.8%), A. lumbricoides (75.3 vs 100%) and hookworm (52.4 vs 78.3%) in the ivermectin-albendazole treatment arm, when compared to Kato-Katz. CONCLUSIONS qPCR diagnosis showed lower reproducibility of test results compared to Kato-Katz, hence multiple samples per participant should be analysed to achieve a reliable diagnosis of STH infection. Our study confirms that cure rates are overestimated using Kato-Katz alone. Our findings emphasize that standardized and accurate molecular diagnostic tools are urgently needed for future monitoring within STH control and/or elimination programmes.
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Affiliation(s)
- Ladina Keller
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Chandni Patel
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Sophie Welsche
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Tobias Schindler
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Eveline Hürlimann
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
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Rabiu OR, Dada-Adegbola H, Kosoko AM, Falade CO, Arinola OG, Odaibo AB, Ademowo OG. Contributions of malaria, helminths, HIV and iron deficiency to anaemia in pregnant women attending ante-natal clinic in SouthWest Nigeria. Afr Health Sci 2020; 20:1035-1044. [PMID: 33402949 PMCID: PMC7751510 DOI: 10.4314/ahs.v20i3.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Iron deficiency is a dominant source of anaemia in many settings. To evaluate the key cause of anaemia in the study area, the prevalence of anaemia due to major public health diseases was compared with anaemia due to iron deficiency. METHODS Pregnant women were recruited from ante-natal (n=490) and HIV clinics (n=217) with their personal data documented using a questionnaire. Microscopy of Giemsa-stained thick smears was used for detection of malaria parasites while helminths in stools were detected using direct smear method. Haematocrit values were determined by capillary method. Serum ferritin levels were determined using enzyme-linked immunosorbent assay. Data was analysed using SPSS version 22.0. RESULTS The mean age of the recruited women was 28.6±5.4 years old. There were 68.1% cases of anaemia of which 35.5% was due to infections only predominantly HIV and malaria, 14.9% from unknown sources while anaemia due to iron deficiency only was 7.1%. CONCLUSION It can safely be inferred that malaria and HIV predispose to anaemia than iron deficiency in the study area. Although pregnant women are dewormed and given IPTp for helminths and malaria treatment respectively, there should be complementary routine malaria screening at ANC visits for those with HCT values <33% and those infected with HIV.
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Affiliation(s)
- Olawunmi R Rabiu
- Department of Zoology, University of Ibadan, Ibadan, Nigeria
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Biological Sciences, Mountain Top University, Km 12, Lagos-Ibadan Expressway, Ogun State, Nigeria
| | - Hannah Dada-Adegbola
- Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ayokulehin M Kosoko
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Biochemistry, University of Ibadan, Ibadan, Nigeria
- Department of Biochemistry, Federal University of Agriculture, Abeokuta, Ogun State, Nigeria
| | - Catherine O Falade
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Nigeria
| | - Olatunbosun G Arinola
- Immunology Unit, Department of Chemical Pathology, College of Medicine, University of Ibadan, Nigeria
| | | | - Olusegun G Ademowo
- Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Pharmacology and Therapeutics, University of Ibadan, Ibadan, Nigeria
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González Quiroz DJ, Agudelo Lopez SDP, Arango CM, Acosta JEO, Bello Parias LD, Alzate LU, Hernández Castro C, Medina Lozano AP, Sepúlveda Vergara GD, Giraldo AM, Trujillo-Trujillo J, Pernett Bolaño IDC, Cuellar Segura CM, Arbeláez Montoya MP. Prevalence of soil transmitted helminths in school-aged children, Colombia, 2012-2013. PLoS Negl Trop Dis 2020; 14:e0007613. [PMID: 32678821 PMCID: PMC7390406 DOI: 10.1371/journal.pntd.0007613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 02/09/2016] [Revised: 07/29/2020] [Accepted: 07/08/2019] [Indexed: 11/20/2022] Open
Abstract
Background This study aims to establish the prevalence of soil-transmitted helminth (STH) intestinal infections, nutritional status, and anemia in school children aged 7 to 10 years old in the biogeographic provinces of Colombia in 2012–2013. STH prevalence in the country has not been described within the last 30 years and it is needed in order to establish policies its control in the country. Methodology National Survey of STH in school-aged children with a multistage stratified probability sampling was conducted. The overall prevalence and intensity of STH infection, as well as for each parasite, (A. lumbricoides, T. trichiura and hookworms) were calculated for the country and for each of the nine biogeographic provinces. Principal findings Stool samples were collected from 6045 children in eight out of nine biogeographic provinces. The combined prevalence of STH in the country was 29.6%. T. trichiura was the most prevalent helminth (18.4%), followed by A. lumbricoides (11.3%), and hookworms (6.4%). For A. lumbricoides and hookworms, the highest prevalence values were found in the Amazonía province (58.0% and 35.7%, respectively). Regarding STH intensity, most cases showed moderate intensity (41.3%) for A. lumbricoides, and light intensity, for T. trichiura and hookworms. The national prevalence of anemia in school-aged children was 14.2%, lowest in the Nor-Andina province (3.5%), and highest in the Territorios Insulares oceánicos del Caribe province (45.1%). Significance Colombia has a moderate risk of STH infection in school-aged populations, with considerable variation in the prevalence values among the biogeographic provinces. Like any public health issue, this problem should be handled with a comprehensive approach that involves deworming programs and strategies for STH control according to the specific epidemiological and socioeconomic conditions and sanitation service coverage in each biogeographic province. The program should be further supported by intersectoral action to improve living conditions, particularly the excreta disposal, promoted at municipality levels. STH infection (infection by A. lumbricoides, T. trichiura, and hookworms) are endemic in Colombia; however, its prevalence in the country has not been described within the last 30 years. This study determines the prevalence and intensity of STH infections, nutritional status, and anemia in children, using multistage stratified probability sampling. The prevalence result of all STH at national level was 29.6%. T. trichiura was the most prevalent (18.4%), followed by A. lumbricoides (11.3%), and hookworms (6.4%). Comparing the biogeographic provinces (eco-epidemiological zones), Amazonía had the highest STH prevalence. A large spatial variation was found in STH prevalence by province. The study shows that STH infection remains a national public health problem, which requires intervention through nationwide strategies using a comprehensive inter-programmatic approach and prioritizing high-risk areas. These strategies should aim at improving the living conditions associated with the infection while being supported by large-scale anthelmintic chemotherapy.
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Affiliation(s)
- David José González Quiroz
- Epidemiology Group, National School of Public Health, University of Antioquia, Medellin, Colombia
- * E-mail:
| | | | - Catalina María Arango
- Epidemiology Group, National School of Public Health, University of Antioquia, Medellin, Colombia
| | | | - León Darío Bello Parias
- Epidemiology Group, National School of Public Health, University of Antioquia, Medellin, Colombia
| | - Leonardo Uribe Alzate
- Epidemiology Group, National School of Public Health, University of Antioquia, Medellin, Colombia
| | | | | | | | - Adriana Molina Giraldo
- Epidemiology Group, National School of Public Health, University of Antioquia, Medellin, Colombia
| | | | - Ivet Del Carmen Pernett Bolaño
- Knowledge Management Group, Epidemiology and Demography Department, Ministry of Health and Social Protection, Bogotá, Colombia
| | - Claudia Milena Cuellar Segura
- Knowledge Management Group, Epidemiology and Demography Department, Ministry of Health and Social Protection, Bogotá, Colombia
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Cools P, van Lieshout L, Koelewijn R, Addiss D, Ajjampur SSR, Ayana M, Bradbury RS, Cantera JL, Dana D, Fischer K, Imtiaz R, Kabagenyi J, Lok J, McCarthy J, Mejia R, Mekonnen Z, Njenga SM, Othman N, Shao H, Traub R, Van Esbroeck M, Vercruysse J, Vlaminck J, Williams SA, Verweij JJ, van Hellemond JJ, Levecke B. First international external quality assessment scheme of nucleic acid amplification tests for the detection of Schistosoma and soil-transmitted helminths, including Strongyloides: A pilot study. PLoS Negl Trop Dis 2020; 14:e0008231. [PMID: 32544158 PMCID: PMC7319349 DOI: 10.1371/journal.pntd.0008231] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 08/26/2019] [Revised: 06/26/2020] [Accepted: 03/17/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Nucleic acid amplification tests (NAATs) are increasingly being used as diagnostic tools for soil-transmitted helminths (STHs; Ascaris lumbricoides, Trichuris trichiura, Necator americanus, Ancylostoma duodenale and A. ceylanicum), Strongyloides stercoralis and Schistosoma in human stool. Currently, there is a large diversity of NAATs being applied, but an external quality assessment scheme (EQAS) for these diagnostics is lacking. An EQAS involves a blinded process where test results reported by a laboratory are compared to those reported by reference or expert laboratories, allowing for an objective assessment of the diagnostic performance of a laboratory. In the current study, we piloted an international EQAS for these helminths (i) to investigate the feasibility of designing and delivering an EQAS; (ii) to assess the diagnostic performance of laboratories; and (iii) to gain insights into the different NAAT protocols used. METHODS AND PRINCIPAL FINDINGS A panel of twelve stool samples and eight DNA samples was validated by six expert laboratories for the presence of six helminths (Ascaris, Trichuris, N. americanus, Ancylostoma, Strongyloides and Schistosoma). Subsequently this panel was sent to 15 globally dispersed laboratories. We found a high degree of diversity among the different DNA extraction and NAAT protocols. Although most laboratories performed well, we could clearly identify the laboratories that were poorly performing. CONCLUSIONS/SIGNIFICANCE We showed the technical feasibility of an international EQAS for the NAAT of STHs, Strongyloides and Schistosoma. In addition, we documented that there are clear benefits for participating laboratories, as they can confirm and/or improve the diagnostic performance of their NAATs. Further research should aim to identify factors that explain poor performance of NAATs.
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Affiliation(s)
- Piet Cools
- Laboratory of Parasitology, Ghent University, Merelbeke, Belgium
| | - Lisette van Lieshout
- Leiden University Medical Center, Leiden, The Netherlands
- Dutch Foundation for Quality Assessment in Medical Laboratories, Nijmegen, The Netherlands
| | - Rob Koelewijn
- Dutch Foundation for Quality Assessment in Medical Laboratories, Nijmegen, The Netherlands
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - David Addiss
- The Task Force for Global Health, Decatur, Georgia, United States of America
| | | | | | - Richard S. Bradbury
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | | | - Kerstin Fischer
- Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Rubina Imtiaz
- Children Without Worms, Decatur, Georgia, United States of America
| | - Joyce Kabagenyi
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - James Lok
- University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - James McCarthy
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Rojelio Mejia
- Baylor College of Medicine, Houston, Texas, United States of America
| | | | | | | | - Hongguang Shao
- University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | | | | | - Jozef Vercruysse
- Laboratory of Parasitology, Ghent University, Merelbeke, Belgium
| | - Johnny Vlaminck
- Laboratory of Parasitology, Ghent University, Merelbeke, Belgium
| | - Steven A. Williams
- Smith College, Northampton, Massachusetts, United States of America
- University of Massachusetts, Amherst, Massachusetts, United States of America
| | | | - Jaap J. van Hellemond
- Dutch Foundation for Quality Assessment in Medical Laboratories, Nijmegen, The Netherlands
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Bruno Levecke
- Laboratory of Parasitology, Ghent University, Merelbeke, Belgium
- * E-mail:
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Rodrigues AC, da Silva MDC, Pereira RÂS, Pinto LC. Prevalence of contamination by intestinal parasites in vegetables (Lactuca sativa L. and Coriandrum sativum L.) sold in markets in Belém, northern Brazil. J Sci Food Agric 2020; 100:2859-2865. [PMID: 31953861 DOI: 10.1002/jsfa.10265] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 07/09/2019] [Accepted: 01/17/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Previous studies have recorded a high prevalence of intestinal parasites in lettuce (Lactuca sativa L.) and coriander (Coriandrum sativum L.) destined for human consumption. This study determined the prevalence of contamination by intestinal parasites in these two plants sold in two street markets and two supermarkets in the city of Belém, northern Brazil. RESULTS A total of 200 plant samples were analyzed (100 of each species). The samples were collected randomly between August and October 2018, examined by the spontaneous sedimentation method with two washes, and stored for 24 h. The analysis found that 89% (89/100) of the lettuce samples and 86% (86/100) of the coriander samples were contaminated. Polyparasitism was more frequent in lettuce, but monoparasitism predominated in the coriander. A total of 226 intestinal parasites were found in the lettuce, with a predominance of non-pathogenic parasites in the supermarket samples and more pathogenic parasites in the samples from street markets. In the coriander samples, 172 intestinal parasites were identified, with a predominance of pathogenic parasites in samples from both types of market. In the case of the protozoans, the most prevalent species was Endolimax nana, followed by Blastocystis hominis, in both vegetables. In the helminths, hookworms predominated in the lettuce, and Trichuris trichiura in the coriander. CONCLUSIONS These results highlight the need for the monitoring of parasite contamination in vegetables destined for human consumption. Public health initiatives should include educational campaigns on the importance of disinfecting vegetables prior to consumption. © 2020 Society of Chemical Industry.
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Affiliation(s)
| | | | | | - Laine Celestino Pinto
- Department of Biomedicine, Centro Universitário Metropolitano da Amazônia, Belém, Brazil
- Laboratory of Experimental Neuropathology, Biological Science Institute, Federal University of Pará, Belém, Brazil
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Guedes L, Borba VH, Camacho M, Neto J, Dias O, Iñiguez AM. African helminth infection out of Africa: Paleoparasitological and paleogenetic investigations in Pretos Novos cemetery, Rio de Janeiro, Brazil (1769-1830). Acta Trop 2020; 205:105399. [PMID: 32081659 DOI: 10.1016/j.actatropica.2020.105399] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 04/11/2019] [Revised: 02/10/2020] [Accepted: 02/14/2020] [Indexed: 02/06/2023]
Abstract
Pretos Novos cemetery (PNC), Rio de Janeiro, Brazil (1769-1830) was created exclusively to bury enslaved Africans who died upon arrival at the city or before being sold in the slave market. The PNC site may be unique in the Americas in allowing the study of African parasite infections acquired in Africa. We aimed to identify parasites infecting PNC individuals through paleoparasitological and paleogenetic analyses. The bodies had been dismembered, placed in mass graves, and burned, and most human remains collected from the site are highly fragmented and show extensive degradation. Sacrum and pelvic sediments were collected from five individuals along with seven samples of sediment from other areas of the body, as controls. Samples were submitted to three parasitological techniques and, in paleogenetic analysis, to four molecular targets. Larvae, mites, pollen grains, and structure suggestive of plants and fungus were observed, but we found no evidence of helminth infection. Ascaris sp. cytb sequence was recovered in one individual. We emphasize that, even with the extensive degradation of PNC human remains and the process of curation of samples, it was possible to recover helminth aDNA. The origin of PNC individuals confirms that these infections were brought to Brazil from western and central Africa during the colonial era.
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Affiliation(s)
- Lucélia Guedes
- LABTRIP, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (LABTRIP/IOC/FIOCRUZ). Avenida Brasil, 4365, Pavilhão Rocha Lima, Manguinhos, Rio de Janeiro, CEP: 21045-900, Brazil
| | - Victor Hugo Borba
- LABTRIP, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (LABTRIP/IOC/FIOCRUZ). Avenida Brasil, 4365, Pavilhão Rocha Lima, Manguinhos, Rio de Janeiro, CEP: 21045-900, Brazil
| | - Morgana Camacho
- LABTRIP, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (LABTRIP/IOC/FIOCRUZ). Avenida Brasil, 4365, Pavilhão Rocha Lima, Manguinhos, Rio de Janeiro, CEP: 21045-900, Brazil
| | - Jandira Neto
- Instituto de Arqueologia Brasileira (IAB). Estr. Cruz Vermelha, 45 - Vila Santa Teresa, Belford Roxo, Rio de Janeiro, CEP: 26193-415, Brazil
| | - Ondemar Dias
- Instituto de Arqueologia Brasileira (IAB). Estr. Cruz Vermelha, 45 - Vila Santa Teresa, Belford Roxo, Rio de Janeiro, CEP: 26193-415, Brazil
| | - Alena Mayo Iñiguez
- LABTRIP, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (LABTRIP/IOC/FIOCRUZ). Avenida Brasil, 4365, Pavilhão Rocha Lima, Manguinhos, Rio de Janeiro, CEP: 21045-900, Brazil.
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Cao Y, Yang Y, Duszynski DW, Zhu Y, Shang G, Hou C, Zhang T, Bian J. PREVALENCE AND PARASITE COMPOSITION OF GASTROINTESTINAL PARASITES IN THE ENDANGERED TIBETAN ANTELOPE ( PANTHOLOPS HODGSONII) FROM THE CALVING GROUND OF HOH XIL NATURE WORLD HERITAGE SITE, QINGHAI, CHINA. J Wildl Dis 2020; 56:372-377. [PMID: 31750770] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Our objective was to provide baseline information on the gastrointestinal parasites of the female Tibetan antelope (Pantholops hodgsonii) on its calving ground at the Zhuonai Lake region, in the Hoh Xil Nature World Heritage site, Qinghai, China. On 3 July 2018, 238 freshly deposited fecal samples were collected from the calving grounds and analyzed by flotation technique to recover eggs, oocysts, and nematode larvae. All fecal samples demonstrated the presence of gastrointestinal parasites: 93% (221/238) had nematodes, 36% (86/238) had cestodes, and 99% (235/238) had coccidian oocysts. For each Tibetan antelope, mean (SD) parasite species richness was 3.4 (1.3). Coinfections with five parasite genera were found in 19% (45/238) of fecal samples. These results showed that prevalence of Trichostrongylus, Marshallagia, and Eimeria infections in these Tibetan antelopes were sufficiently high to suggest long-term monitoring be implemented because the climate there is becoming warmer and moisture is increasing, both presumably due to the influence of global warming which, in turn, may be contributing to increased infection risks with these parasites.
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Affiliation(s)
- Yifan Cao
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Chinese Academy of Sciences, Xining 810008, People's Republic of China
- Qinghai Key Laboratory of Animal Ecological Genomics, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining 810008, People's Republic of China
| | - Yuangang Yang
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Chinese Academy of Sciences, Xining 810008, People's Republic of China
- University of the Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Donald W Duszynski
- Biology Professor Emeritus, 76 Homesteads Rd., Placitas, New Mexico 87043, USA
| | - Yahui Zhu
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Chinese Academy of Sciences, Xining 810008, People's Republic of China
- Qinghai Key Laboratory of Animal Ecological Genomics, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining 810008, People's Republic of China
| | - Guozhen Shang
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Chinese Academy of Sciences, Xining 810008, People's Republic of China
- University of the Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Chu Hou
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Chinese Academy of Sciences, Xining 810008, People's Republic of China
- University of the Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Tongzuo Zhang
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Chinese Academy of Sciences, Xining 810008, People's Republic of China
- Qinghai Key Laboratory of Animal Ecological Genomics, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining 810008, People's Republic of China
| | - Jianghui Bian
- Key Laboratory of Adaptation and Evolution of Plateau Biota, Chinese Academy of Sciences, Xining 810008, People's Republic of China
- Qinghai Key Laboratory of Animal Ecological Genomics, Northwest Institute of Plateau Biology, Chinese Academy of Sciences, Xining 810008, People's Republic of China
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DOKMAIKAW AMORNRAT, SUNTARAVITUN PISIT. Prevalence of Parasitic Contamination of Cockroaches Collected from Fresh Markets in Chachoengsao Province, Thailand. Kobe J Med Sci 2020; 65:E118-E123. [PMID: 32201426 PMCID: PMC7447098] [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] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 10/28/2019] [Indexed: 06/10/2023]
Abstract
Cockroaches are the greatest potential mechanical vector of various pathogenic microorganisms. This study aimed to determine the prevalence and species type of human pathogenic parasite infestations on the external body surface of the cockroaches. A total of 450 cockroaches collected from three fresh markets were identified in three species belonging to Periplaneta americana, Periplaneta brunnea and Periplaneta australasiae. Helminth and protozoan species were identified by using a direct wet smear technique and modified acid-fast staining technique. The overall prevalence rate of parasitic infestation on the external body surface of cockroaches was 46.4% (209/450). The number of cockroaches infested with protozoa was 44.7% (99/209) and helminths was 44.0% (92/209), while 8.6% (18/209) were infested by both protozoan and helminth parasites. A total of 272 parasite specimens belonging to 16 species were found: ten species of protozoan were identified as Cryptosporidium spp. (15.4%), Entamoeba histolytica/E. dispar (8.5%), Cyclospora spp. (7.0%), Blastocystis hominis (6.6%), Cystoisospora belli (6.6%), Endolimax nana (4.0%), Entamoeba coli (2.2%), Chilomastix mesnili (1.5%), Balantidium coli (1.1%) and Iodamoeba butschlii (1.1%); six species of helminths included Toxocara spp. (8.5%), Trichuris trichiura (6.3%), Ascaris lumbricoides (5.9%), Taenia spp. (5.1%), Strongyloides stercoralis (4.4%), and hookworm (2.2%). Unidentified species of the helminths were isolated, namely nematode larva (9.9%) and helminth eggs (3.7%). Our results show that the cockroaches collected from fresh markets are potential mechanical vectors of several protozoan and helminth species.
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Affiliation(s)
- AMORNRAT DOKMAIKAW
- Department of Public Health, Faculty of Science and Technology, Rajabhat Rajanagarindra University, Chachoengsao, Thailand
| | - PISIT SUNTARAVITUN
- Department of Public Health, Faculty of Science and Technology, Rajabhat Rajanagarindra University, Chachoengsao, Thailand
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Souza LSD, Guilherme E, Gul S, Andrade AMFD, Santos FGDA. First report of Davaneidae and Strongylida parasitizing Ramphocelus carbo (Aves: Passeriformes: Thraupidae) in the southwest of the Brazilian Amazon region. Rev Bras Parasitol Vet 2020; 29:e016719. [PMID: 32049145 DOI: 10.1590/s1984-29612019105] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/25/2019] [Indexed: 06/10/2023]
Abstract
In Brazil, species of the genus Ramphocelus with the presence of various endoparasites have already been reported. Coccidia have been the parasites most frequently found. All species of this genus have similar habitats and ecological niches, which makes parasite transmission easy. The aim of this study was to diagnose the presence of endoparasites in fecal samples from specimens of Ramphocelus carbo that were caught in the Cazumbá-Iracema Extractive Reserve (Cazumbá Resex), in the State of Acre. The specimens (n = 30) were caught in mist nets arranged in different ecosystems of the Reserve. After identification, the bird specimens were placed in cloth bags for a maximum of 30 minutes to collect feces. Among the 22 samples collected, 63.63% (n = 14) were positive for endoparasites. The coccidia were the parasites most frequently. Helminths belonging to Ascaridiidae (Nematoda), Strongylida (Nematoda) and Davaneidae (Cestoda) were recorded for the first time in R. carbo in the State of Acre. Parasites belonging to Strongylida and Davaneidae were recorded for the first time in a species of Ramphocelus. These findings add information on the parasitic fauna of wild birds, since in the Amazon region there are few studies on this subject.
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Affiliation(s)
| | - Edson Guilherme
- Laboratório de Ornitologia, Universidade Federal do Acre - UFAC, Rio Branco, AC, Brasil
- Centro de Ciências Biológicas e da Natureza, Universidade Federal do Acre - UFAC, Rio Branco, AC, Brasil
| | - Saba Gul
- Programa de Pós-graduação em Biologia Parasitária, Instituto Oswaldo Cruz - FIOCRUZ, Manguinhos, Rio de Janeiro, RJ, Brasil
| | - Angela Maria Fortes de Andrade
- Programa de Pós-graduação em Sanidade e Produção Animal Sustentável na Amazônia Ocidental, Universidade Federal do Acre - UFAC, Rio Branco, AC, Brasil
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Toychiev A, Mirzoeva M, Davis N, Islamova J, Osipova S. Pityriasis alba: Possible associations with intestinal helminths and pathogenic protozoa. Int J Clin Pract 2020; 74:e13441. [PMID: 31633268 DOI: 10.1111/ijcp.13441] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/22/2019] [Accepted: 10/16/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The aetiology of pityriasis alba (PA) remains uncertain, and children are at risk for PA and intestinal parasites. AIM To determine the prevalence of intestinal parasites in PA patients and to evaluate their possible role in PA pathogenesis. METHODS Overall, 180 PA patients and 100 healthy individuals were enrolled. Intestinal parasites were diagnosed by triple coproscopy, and the total serum Immunoglobulin E (IgE) levels were determined by ELISA. PA patients with intestinal parasites were treated with conventional antiparasitic drugs. Patient response to antiparasitic therapy was evaluated after 6 weeks. RESULTS The prevalence of intestinal parasites in PA patients and controls was 60 ± 3.6% and 32 ± 4.6%, respectively (P < .0001). Regardless of the parasite species among the PA patients and control individuals, the total IgE levels were significantly higher in PA patients (P ≤ .05). The highest values of IgE were found in PA patients with Hymenolepis nana (641.7 ± 46.3 IU/mL). The total IgE level in PA patients with parasites decreased after antiparasitic therapy, but the reduction was only significant in patients with H. nana (P < .05). Complete disappearance of hypopigmented patches was observed after the elimination of H. nana, Giardia lamblia and Enterobius vermicularis in 65 ± 10.6%, 48.7 ± 8.0% and 33.3 ± 8.2% of cases, respectively. In total, a positive clinical response to antiparasitic therapy was achieved in 60 ± 4.7% of infected PA patients. CONCLUSION A positive clinical response to antiparasitic therapy indicates the role of intestinal parasites in PA pathogenesis. Parasitological examination is justified by the recovery of 60 ± 4.7% of infected PA patients after the elimination of intestinal parasites.
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Affiliation(s)
- Abdurakhim Toychiev
- Department of Immunology of Parasitic Diseases, the Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan
| | - Mexriniso Mirzoeva
- Department of Infectious Diseases, Bukhara state medical institute, Bukhara, Uzbekistan
| | - Nikolay Davis
- Department of Immunology of Parasitic Diseases, the Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan
| | - Jannat Islamova
- Department of Pharmacology and Toxicology, the Institute of the Chemistry of Plant Substances named acad. S. Yu. Yunusov, Tashkent, Uzbekistan
| | - Svetlana Osipova
- Department of Immunology of Parasitic Diseases, the Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent, Uzbekistan
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Corrêa LL, Takemoto RM, Ueta MT, Adriano EA. New records and prevalence of metazoan parasites of fish in the southeastern Brazilian region. Ann Parasitol 2020; 66:27–37. [PMID: 32198993 DOI: 10.17420/ap6601.235] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Hoplias aff. malabaricus is abundant in the Mogi-Guaçu River. The aim of this study was to perform an inventory of the species of metazoan that parasite this species of fish taken from oxbow lakes of the Mogi-Guaçu River. The Mann-Whitney test was used to statistically analyze the possible influence of the sex of the host on the group with the highest parasite richness and the greatest abundance of parasites. Simpson’s diversity index was used to determine parasite diversity among the zoological groups of parasites of H. aff. malabaricus with the highest index. A total of 78 specimens of H. aff. malabaricus were examined. Among the zoological groups of metazoans found, the phylum Nematoda had the greatest number of species. Among these, the larval stage of Contracaecum sp. was most abundant. The sex of the host had a significant effect, with parasites more abundant in female fish (Z(U)=0.043; p<0.05). The digenean Parspina argentinensis, the nematodes Procamallanus (S.) iheringi, Rhabdochona acuminata and Hysterothylacium sp. and copepods Vaigamus sp. and Lernaea cyprinacea have not previously been recorded as parasites of H. aff. malabaricus.
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Affiliation(s)
- Lincoln Lima Corrêa
- Universidade Federal do Oeste do Pará-UFOPA-Instituto de Ciências e Tecnologia das Águas-ICTA, Rua Vera Paz, S/n – Campus Tapajós Bairro Salé, CEP 68040-255, Santarém, PA, Brazil
| | - Ricardo Massato Takemoto
- Laboratório de Ictioparasitologia, Núcleo de Pesquisas em Limnologia, Ictiologia e Aquicultura - Nupélia, Bloco G-90. Av. Colombo, 5790, 87020-900 Maringá, PR, Brazil
| | - Marlene Tiduko Ueta
- Departamento de Biologia Animal, Instituto de Biologia, Universidade Estadual de Campinas (UNICAMP), Caixa Postal 6109, CEP 13083-970 Campinas, SP, Brazil
| | - Edson Aparecido Adriano
- Departamento de Ciências Biológicas, Universidade Federal de São Paulo (UNIFESP), Rua Professor Artur Riedel, 275, Jardim Eldorado, CEP 09972-270 Diadema, SP, Brazil
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Abstract
Parasites are transferred between domestic and wild animals, when host animals come in contact with each other, particularly while grazing the same pastures, or when using same water bodies for drinking. Chances of parasite transmission and adaptation are high when hosts are genetically related. Afghan urial (Ovis vignei blanfordi), Suleiman markhor (Capra falconeri jerdoni) and Chiltan wild goat (C. aegagrus chialtanensis) are wild kin of domestic sheep and goats, sharing numerous parasitic diseases with each other. The present study was conducted in 2014–2015, to determine parasitic infections of Suleiman markhor and Afghan urial of Torghar Game Reserve, and the endemic wild goat of Chiltan National Park. For comparison, parasites of domestic small ruminants of these areas were also studied. A total of 11 species of helminth and 20 species of protozoa were recorded. Highly prevalent helminth among wild ruminants were Trichuris spp., Nematodirus spp., Protostrongylus rufescens and Moniezia benedeni, while highly prevalent Eimeria were E. arloingi and E. ninakohlyakimovae in caprines and E. ovinoidalis in urial. Chiltan wild goats were also found infected with Entamoeba spp. A short tabulated review of the helminth and protozoan parasites of wild sheep and goats of Pakistan, India, Iran and Turkey has been presented.
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Affiliation(s)
- Sher Ahmed
- Department of Biology, Federal Government Degree College, Quetta, Pakistan
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Sulieman Y, Zakaria MA, Pengsakul T. Prevalence of intestinal helminth parasites of stray dogs in Shendi area, Sudan. Ann Parasitol 2020; 66:115–118. [PMID: 32199004 DOI: 10.17420/ap6601.246] [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: 06/10/2023]
Abstract
Three hundred and sixty fecal samples of stray dogs were collected between July and December 2018, from open grounds of Shendi city and two suburbs (Gulia and Musiab), River Nile State, Sudan, and were examined for helminthic infections. The results showed 43 (11.9%) of the samples were positive for at least one species of helminth. A total of four helminth species were identified, including two nematodes (Ancylostoma caninum and Trichuris vulpis) and two cestodes (Dipylidium caninum and Taenia spp.). Taenia spp. was found to be the most common helminth infection in stray dogs (6.7%) followed by D. caninum (3.1%), while the least was the nematode, A. caninum (0.8%). The prevalence of infection among stray dogs in the suburbs was found to be higher than those in the city; however, there was no statistical significance (P = 0.07). In conclusion, stray dogs in Shendi area were found to be harboring several important zoonotic helminthes such as A. caninum and Taenia spp.; this shows the necessity of stray dog population management in this area as they present a health risk to the community.
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Affiliation(s)
- Yassir Sulieman
- Department of Zoology, Faculty of Science and Technology, University of Shendi, Shendi, Sudan
| | - Mohamed A. Zakaria
- Department of Biology, Faculty of Education, University of Nyala, Nyala, Sudan
| | - Theerakamol Pengsakul
- Faculty of Medical Technology, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Erkenswick GA, Watsa M, Gozalo AS, Dudaie S, Bailey L, Muranda KS, Kuziez A, Parker PG. A multiyear survey of helminths from wild saddleback (Leontocebus weddelli) and emperor (Saguinus imperator) tamarins. Am J Primatol 2019; 81:e23063. [PMID: 31692027 PMCID: PMC7029814 DOI: 10.1002/ajp.23063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 05/03/2019] [Revised: 09/10/2019] [Accepted: 09/20/2019] [Indexed: 11/08/2022]
Abstract
The establishment of baseline data on parasites from wild primates is essential to understand how changes in habitat or climatic disturbances will impact parasite-host relationships. In nature, multiparasitic infections of primates usually fluctuate temporally and seasonally, implying that the acquisition of reliable data must occur over time. Individual parasite infection data from two wild populations of New World primates, the saddleback (Leontocebus weddelli) and emperor (Saguinus imperator) tamarin, were collected over 3 years to establish baseline levels of helminth prevalence and parasite species richness (PSR). Secondarily, we explored variation in parasite prevalence across age and sex classes, test nonrandom associations of parasite co-occurrence, and assess the relationship between group size and PSR. From 288 fecal samples across 105 individuals (71 saddleback and 34 emperor tamarins), 10 parasite taxa were identified by light microscopy following centrifugation and ethyl-acetate sedimentation. Of these taxa, none were host-specific, Dicrocoeliidae and Cestoda prevalences differed between host species, Prosthenorchis and Strongylida were the most prevalent. Host age was positively associated with Prosthenorchis ova and filariform larva, but negatively with cestode and the Rhabditoidea ova. We detected no differences between expected and observed levels of co-infection, nor between group size and parasite species richness over 30 group-years. Logistic models of individual infection status did not identify a sex bias; however, age and species predicted the presence of four and three parasite taxa, respectively, with saddleback tamarins exhibiting higher PSR. Now that we have reliable baseline data for future monitoring of these populations, next steps involve the molecular characterization of these parasites, and exploration of linkages with health parameters.
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Affiliation(s)
- Gideon A. Erkenswick
- Department of Biology, University of Missouri-St. Louis,
One University Blvd., Saint Louis, MO 63121, USA
- Field Projects International, 7331 Murdoch Ave, Saint
Louis, MO 63119, USA
| | - Mrinalini Watsa
- Department of Biology, University of Missouri-St. Louis,
One University Blvd., Saint Louis, MO 63121, USA
- Field Projects International, 7331 Murdoch Ave, Saint
Louis, MO 63119, USA
| | - Alfonso S. Gozalo
- Comparative Medicine Branch, National Institute of Allergy
and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892,
USA
| | - Shay Dudaie
- Department of Biology, University of Missouri-St. Louis,
One University Blvd., Saint Louis, MO 63121, USA
| | - Lindsey Bailey
- Department of Biology, University of Missouri-St. Louis,
One University Blvd., Saint Louis, MO 63121, USA
| | - Kudakwashe S. Muranda
- Department of Biology, University of Missouri-St. Louis,
One University Blvd., Saint Louis, MO 63121, USA
| | - Alaa Kuziez
- Department of Biology, University of Missouri-St. Louis,
One University Blvd., Saint Louis, MO 63121, USA
| | - Patricia G. Parker
- Department of Biology, University of Missouri-St. Louis,
One University Blvd., Saint Louis, MO 63121, USA
- WildCare Institute, Saint Louis Zoo, One Government Dr.,
Saint Louis, MO 63110, USA
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Ayana M, Cools P, Mekonnen Z, Biruksew A, Dana D, Rashwan N, Prichard R, Vlaminck J, Verweij JJ, Levecke B. Comparison of four DNA extraction and three preservation protocols for the molecular detection and quantification of soil-transmitted helminths in stool. PLoS Negl Trop Dis 2019; 13:e0007778. [PMID: 31658264 PMCID: PMC6837582 DOI: 10.1371/journal.pntd.0007778] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 02/07/2019] [Revised: 11/07/2019] [Accepted: 09/12/2019] [Indexed: 12/27/2022] Open
Abstract
Background A DNA extraction and preservation protocol that yields sufficient and qualitative DNA is pivotal for the success of any nucleic acid amplification test (NAAT), but it still poses a challenge for soil-transmitted helminths (STHs), including Ascaris lumbricoides, Trichuris trichiura and the two hookworms (Necator americanus and Ancylostoma duodenale). In the present study, we assessed the impact of different DNA extraction and preservativation protocols on STH-specific DNA amplification from stool. Methodology and principal findings In a first experiment, DNA was extracted from 37 stool samples with variable egg counts for T. trichiura and N. americanus applying two commercial kits, both with and without a prior bead beating step. The DNA concentration of T. trichiura and N. americanus was estimated by means of qPCR. The results showed clear differences in DNA concentration across both DNA extraction kits, which varied across both STHs. They also indicated that adding a bead beating step substantially improved DNA recovery, particularly when the FECs were high. In a second experiment, 20 stool samples with variable egg counts for A. lumbricoides, T. trichiura and N. americanus were preserved in either 96% ethanol, 5% potassium dichromate or RNAlater and were stored at 4°C for 65, 245 and 425 days. DNA was extracted using the DNeasy Blood & Tissue kit with a bead beating step. Stool samples preserved in ethanol proved to yield higher DNA concentrations as FEC increased, although stool samples appeared to be stable over time in all preservatives. Conclusions The choice of DNA extraction kit significantly affects the outcome of NAATs. Given the clear benefit of bead beating and our validation of ethanol for (long-term) preservation, we recommend that these aspects of the protocol should be adopted by any stool sampling and DNA extraction protocol for downstream NAAT-based detection and quantification of STHs. DNA-based tools are increasingly being used for the diagnosis of intestinal worm infections in both clinical and research laboratories. However, recovering DNA from intestinal worm eggs in stool remains a challenge since this DNA is protected by a very rigid egg shell. Furthermore, stool contains inhibitors that can affect test results and these should be removed during DNA extraction. Prior to DNA extraction, samples are often preserved, but the impact of the type of preservatives and the duration of preservation remains poorly studied. In the present study, we assessed the impact of four DNA extraction and three preservation protocols on the downstream performance of a DNA-based diagnostic tool for intestinal worms. We found significant differences in DNA recovery across the DNA and preservation protocols, but DNA from worm eggs in stool proved to be stable over time in all preservatives.
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Affiliation(s)
- Mio Ayana
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Sciences, Ghent University, Ghent, Belgium
| | - Piet Cools
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Sciences, Ghent University, Ghent, Belgium
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Abdissa Biruksew
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Daniel Dana
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Sciences, Ghent University, Ghent, Belgium
| | - Nour Rashwan
- Institute of Parasitology, McGill University, Montreal, Quebec, Canada
| | - Roger Prichard
- Institute of Parasitology, McGill University, Montreal, Quebec, Canada
| | - Johnny Vlaminck
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Sciences, Ghent University, Ghent, Belgium
| | - Jaco J. Verweij
- Laboratory for Medical Microbiology and Immunology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Bruno Levecke
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Sciences, Ghent University, Ghent, Belgium
- * E-mail:
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Sarirah M, Wijayanti MA, Murhandarwati EEH. Comparison of mini-flotac and Kato-Katz methods for detecting soil-transmitted helminth eggs in 10% formalin preserved stools stored >=12 months. Trop Biomed 2019; 36:677-686. [PMID: 33597489] [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: 06/12/2023]
Abstract
In Soil-Transmitted Helminth (STH) control programs, microscopic examination is applied as a standard method for detecting the presence and the number of STH eggs. The time limitations of fresh specimen processing, especially for an accurate quantitative diagnosis, cause the specimen processing to be delayed or should be performed at a referral laboratory. This deferment requires preservatives to keep the stool integrity without reducing the accuracy. The aims of this study were: 1) to compare the proportion of positive samples and the intensity of A. lumbricoides, T. trichiura, and hookworm infection based on the examination of fresh samples and stool preserved by 10% formalin for >12 months and 2) to determine the most reliably accurate between Kato-Katz and mini-FLOTAC methods in detecting A. lumbricoides, T. trichiura, and hookworm eggs in preserved stools both qualitatively and quantitatively. Seventy-eight (78) stool samples were examined by mini-FLOTAC, and KatoKatz methods. Proportion of positive samples of A. lumbricoides, T. trichiura, and hookworms in fresh and in >=12 months 10% formalin preserved stools had no significant difference. Helminths density (eggs per gram of stool/EPG) in fresh samples was fewer compared to EPG in preserved samples (p <0.05) which leads to a lower proportion of moderate and high level groups in fresh stools samples compared to those in preserved samples (p <0.05). In preserved samples, as qualitative method, mini-FLOTAC detected more A. lumbricoides and T. trichiura eggs than Kato-Katz, while hookworm eggs were detected more by Kato-Katz than the miniFLOTAC. As a quantitative detection, Kato-Katz showed higher calculation of STH EPG than mini-FLOTAC. Using 10% formalin preservation for stool samples, the STH eggs' morphology could still be well identified. Homogenization process and low number of samples tested, were acknowledged as the limitation of this study.
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Affiliation(s)
- M Sarirah
- Graduate Student of Master Program in Biomedical Science, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako Sekip Utara, Yogyakarta, 55281, Indonesia
| | - M A Wijayanti
- Departement of Parasitology Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako Sekip Utara, Yogyakarta 55281, Indonesia
| | - E E H Murhandarwati
- Departement of Parasitology Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako Sekip Utara, Yogyakarta 55281, Indonesia
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Ediriweera DS, Gunawardena S, Gunawardena NK, Iddawela D, Kannathasan S, Murugananthan A, Yahathugoda C, Pathmeswaran A, Diggle PJ, de Silva N. Reassessment of the prevalence of soil-transmitted helminth infections in Sri Lanka to enable a more focused control programme: a cross-sectional national school survey with spatial modelling. Lancet Glob Health 2019; 7:e1237-e1246. [PMID: 31331809 PMCID: PMC6688098 DOI: 10.1016/s2214-109x(19)30253-0] [Citation(s) in RCA: 9] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 04/19/2019] [Accepted: 05/20/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND In Sri Lanka, deworming programmes for soil-transmitted helminth infections became an integral part of school health in the 1960s, whereas routine antenatal deworming with mebendazole started in the 1980s. A 2003 national soil-transmitted helminth survey done among schoolchildren found an overall prevalence of 6·9%. In our study, we aimed to reassess the national prevalence of soil-transmitted helminth infections to enable implementation of a more focused control programme that targets smaller administrative areas at risk of continued transmission. METHODS We did a cross-sectional, school-based, national survey using multistage stratified cluster sampling, covering all nine provinces as well as populations at high risk of soil-transmitted helminth infections living in urban slums and in plantation-sector communities. Our study population was children aged 5-7 years attending state schools. Faecal samples were collected and analysed with duplicate modified Kato-Katz smears. We modelled the risk of soil-transmitted helminth infection using generalised linear mixed-effects models, and we developed prevalence maps to enable informed decision making at the smallest health administrative level in the country. FINDINGS Between Jan 23 and May 9, 2017, we recruited 5946 children from 130 schools; 4276 (71·9%) children provided a faecal sample for examination. National prevalence of soil-transmitted helminth infection was 0·97% (95% CI 0·63-1·48) among primary schoolchildren. Prevalence in the high-risk communities surveyed was higher than national prevalence: 2·73% (0·75-6·87) in urban slum communities and 9·02% (4·29-18·0) in plantation sector communities. Our prevalence maps showed that the lowest-level health administrative regions could be categorised into low risk (prevalence <1%), high risk (prevalence >10%), or intermediate risk (1-10%) areas. INTERPRETATION Our survey findings indicate that the national prevalence of soil-transmitted helminth infection has continued to decline in Sri Lanka. On the basis of WHO guidelines, we recommend discontinuation of routine deworming in low-risk areas, continuation of annual deworming in high-risk areas, and deworming once every 2 years in intermediate-risk areas, for at least 4 years. FUNDING Task Force for Global Health and WHO.
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Affiliation(s)
- Dileepa Senajith Ediriweera
- Centre for Health Informatics, Biostatistics and Epidemiology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
| | - Sharmini Gunawardena
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Devika Iddawela
- Department of Parasitology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Selvam Kannathasan
- Department of Parasitology, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
| | - Arumugam Murugananthan
- Department of Parasitology, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
| | - Channa Yahathugoda
- Department of Parasitology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | | | - Peter John Diggle
- Centre for Health Informatics, Computing and Statistics, University of Lancaster, Lancaster, UK
| | - Nilanthi de Silva
- Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
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La Hoz RM, Morris MI. Intestinal parasites including Cryptosporidium, Cyclospora, Giardia, and Microsporidia, Entamoeba histolytica, Strongyloides, Schistosomiasis, and Echinococcus: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019; 33:e13618. [PMID: 31145496 DOI: 10.1111/ctr.13618] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [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: 05/15/2019] [Accepted: 05/20/2019] [Indexed: 01/08/2023]
Abstract
These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of intestinal parasites in the pre- and post-transplant period. Intestinal parasites are prevalent in the developing regions of the world. With increasing travel to and from endemic regions, changing immigration patterns, and the expansion of transplant medicine in developing countries, they are increasingly recognized as a source of morbidity and mortality in solid-organ transplant recipients. Parasitic infections may be acquired from the donor allograft, from reactivation, or from de novo acquisition post-transplantation. Gastrointestinal multiplex assays have been developed; some of the panels include testing for Cryptosporidium, Cyclospora, Entamoeba histolytica, and Giardia, and the performance is comparable to conventional methods. A polymerase chain reaction test, not yet widely available, has also been developed to detect Strongyloides in stool samples. New recommendations have been developed to minimize the risk of Strongyloides donor-derived events. Deceased donors with epidemiological risk factors should be screened for Strongyloides and recipients treated if positive as soon as the results are available. New therapeutic agents and studies addressing the optimal treatment regimen for solid-organ transplant recipients are unmet needs.
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Affiliation(s)
- Ricardo M La Hoz
- Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Michele I Morris
- Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida
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Blersch R, Archer C, Suleman E, Young C, Kindler D, Barrett L, Henzi SP. Gastrointestinal Parasites of Vervet Monkeys ( Chlorocebus pygerythrus) in a High Latitude, Semi-Arid Region of South Africa. J Parasitol 2019; 105:630-637. [PMID: 31424324] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
Given a changing climate and large-scale human migration, understanding infectious diseases in wildlife and the factors that drive the spread of these diseases is becoming increasingly important. Owing to the close phylogenetic relationship between nonhuman primates and humans, primate parasites are of particular interest due to the potential for zoonotic disease transmission and for the study of social transmission within gregarious social groups. There is a wide range of social and environmental factors that influence the prevalence and transmission of pathogens, and identifying these, and their effects, is crucial to understanding the population-level consequences of climate change for animals that live in obligate social groups. Here we investigated gastrointestinal parasite species richness and used fecal egg counts to estimate worm intensities in 3 vervet monkey troops (Chlorocebus pygerythrus) in a high latitude, semi-arid region of South Africa. This region is characterized by unpredictable rainfall and temperature extremes in summer and winter. We identified the gastrointestinal parasites in the population and explored potential demographic predictors, namely sex and troop membership, of parasite species richness and estimated intensity. Additionally, we assessed whether there was short-term intra-individual, inter-sample consistency in egg counts. Six species of gastrointestinal helminths were identified from 3 study troops, with egg counts ranging from 0 eggs/g to 1,100 eggs/g. Neither age nor sex predicted species richness or estimated intensity. This population had the highest prevalence of parasites with an insect vector compared with all other vervet populations studied, and distinctively high prevalences of Trichostrongylus sp. (71%) and Ternidens sp. (27%). Additionally, we found intra-individual egg count consistency in the short term (mean: 32 days).
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Affiliation(s)
- Rosemary Blersch
- 1 Department of Psychology, University of Lethbridge, Lethbridge, AB T1K 6T5, Canada
- 2 Applied Behavioral Ecology and Ecosystems Research Unit, The University of South Africa, Florida, 1079, South Africa
| | - Colleen Archer
- 3 Pollution Research Group, University of KwaZulu-Natal, Durban, 4041, South Africa
| | - Essa Suleman
- 4 National Zoological Garden, South African National Biodiversity Institute, P.O. Box 754, Pretoria, 0001, South Africa
- 5 Biosciences, Council for Scientific and Industrial Research (CSIR), Brummeria, Pretoria, 0001, South Africa
| | - Christopher Young
- 1 Department of Psychology, University of Lethbridge, Lethbridge, AB T1K 6T5, Canada
- 2 Applied Behavioral Ecology and Ecosystems Research Unit, The University of South Africa, Florida, 1079, South Africa
- 6 Endocrine Research Laboratory, Department of Anatomy and Physiology, Faculty of Veterinary Science, University of Pretoria, Pretoria, 0110, South Africa
| | - Duodané Kindler
- 4 National Zoological Garden, South African National Biodiversity Institute, P.O. Box 754, Pretoria, 0001, South Africa
| | - Louise Barrett
- 1 Department of Psychology, University of Lethbridge, Lethbridge, AB T1K 6T5, Canada
- 2 Applied Behavioral Ecology and Ecosystems Research Unit, The University of South Africa, Florida, 1079, South Africa
| | - S Peter Henzi
- 1 Department of Psychology, University of Lethbridge, Lethbridge, AB T1K 6T5, Canada
- 2 Applied Behavioral Ecology and Ecosystems Research Unit, The University of South Africa, Florida, 1079, South Africa
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Cools P, Vlaminck J, Albonico M, Ame S, Ayana M, José Antonio BP, Cringoli G, Dana D, Keiser J, Maurelli MP, Maya C, Matoso LF, Montresor A, Mekonnen Z, Mirams G, Corrêa-Oliveira R, Pinto SA, Rinaldi L, Sayasone S, Thomas E, Verweij JJ, Vercruysse J, Levecke B. Diagnostic performance of a single and duplicate Kato-Katz, Mini-FLOTAC, FECPAKG2 and qPCR for the detection and quantification of soil-transmitted helminths in three endemic countries. PLoS Negl Trop Dis 2019; 13:e0007446. [PMID: 31369558 PMCID: PMC6675048 DOI: 10.1371/journal.pntd.0007446] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [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: 02/13/2019] [Accepted: 05/07/2019] [Indexed: 12/20/2022] Open
Abstract
Background Because the success of deworming programs targeting soil-transmitted helminths (STHs) is evaluated through the periodically assessment of prevalence and infection intensities, the use of the correct diagnostic method is of utmost importance. The STH community has recently published for each phase of a deworming program the minimal criteria that a potential diagnostic method needs to meet, the so-called target product profiles (TPPs). Methodology We compared the diagnostic performance of a single Kato-Katz (reference method) with that of other microscopy-based methods (duplicate Kato-Katz, Mini-FLOTAC and FECPAKG2) and one DNA-based method (qPCR) for the detection and quantification of STH infections in three drug efficacy trials in Ethiopia, Lao PDR, and Tanzania. Furthermore, we evaluated a selection of minimal diagnostic criteria of the TPPs. Principal findings All diagnostic methods showed a clinical sensitivity of ≥90% for all STH infections of moderate-to-heavy intensities. For infections of very low intensity, only qPCR resulted in a sensitivity that was superior to a single Kato-Katz for all STHs. Compared to the reference method, both Mini-FLOTAC and FECPAKG2 resulted in significantly lower fecal egg counts for some STHs, leading to a substantial underestimation of the infection intensity. For qPCR, there was a positive significant correlation between the egg counts of a single Kato-Katz and the DNA concentration. Conclusions/Significance Our results indicate that the diagnostic performance of a single Kato-Katz is underestimated by the community and that diagnostic specific thresholds to classify intensity of infection are warranted for Mini-FLOTAC, FECPAKG2 and qPCR. When we strictly apply the TPPs, Kato-Katz is the only microscopy-based method that meets the minimal diagnostic criteria for application in the planning, monitoring and evaluation phase of an STH program. qPCR is the only method that could be considered in the phase that aims to seek confirmation for cessation of program. Trial registration ClinicalTrials.gov NCT03465488 To control the burden caused by intestinal worms, the World Health Organization recommends large-scale deworming programs where anti-worm drugs are administered to at-risk populations. The decision to scale down drug distribution is based on the periodically assessment of prevalence and intensity of infections using a standard diagnostic method. Today, the scientific community strongly doubts whether this method can be used throughout the program. This is in particular when it fails to detect infections of low intensity, and hence may result in prematurely stopping the distribution of drugs. We compared the diagnostic performance of alternative diagnostic methods in three drug efficacy trials in two African and one Asian country. The diagnostic methods were based on demonstration of worm eggs or worm DNA in stool. We also checked the results with minimal diagnostic criteria which have been recently been proposed by the scientific community. Our results indicate that of all diagnostic methods based on demonstration of worm eggs, only the current standard method fulfills the diagnostic criteria for planning, monitoring and evaluation phases of deworming program. Furthermore, we showed that DNA-based methods could be considered in the phase that aims to seek confirmation for cessation of the deworming program.
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Affiliation(s)
- Piet Cools
- Department of Virology, Parasitology and Immunology, Ghent University, Merelbeke, Belgium
| | - Johnny Vlaminck
- Department of Virology, Parasitology and Immunology, Ghent University, Merelbeke, Belgium
| | - Marco Albonico
- Center for Tropical Diseases, Sacro Cuore Don Calabria Hospital, Negrar, Italy
- Department of Life Sciences and Systems Biology, University of Turin, Italy
| | - Shaali Ame
- Public Health Laboratory-Ivo de Carneri, Chake Chake, United Republic of Tanzania
| | - Mio Ayana
- Jimma University Institute of Health, Jimma University, Jimma, Ethiopia
| | | | - Giuseppe Cringoli
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | - Daniel Dana
- Jimma University Institute of Health, Jimma University, Jimma, Ethiopia
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Maria P. Maurelli
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | - Catalina Maya
- Engineering Institute of National Autonomous University of Mexico, Mexico City, Mexico
| | - Leonardo F. Matoso
- Laboratory of Molecular and Cellular Immunology, Research Center René Rachou—FIOCRUZ, Belo Horizonte, Brazil
| | - Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Zeleke Mekonnen
- Jimma University Institute of Health, Jimma University, Jimma, Ethiopia
| | | | - Rodrigo Corrêa-Oliveira
- Laboratory of Molecular and Cellular Immunology, Research Center René Rachou—FIOCRUZ, Belo Horizonte, Brazil
| | - Simone A. Pinto
- Laboratory of Molecular and Cellular Immunology, Research Center René Rachou—FIOCRUZ, Belo Horizonte, Brazil
| | - Laura Rinaldi
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy
| | - Somphou Sayasone
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane, Lao People’s Democratic Republic
| | | | - Jaco J. Verweij
- Laboratory for Medical Microbiology and Immunology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - Jozef Vercruysse
- Department of Virology, Parasitology and Immunology, Ghent University, Merelbeke, Belgium
| | - Bruno Levecke
- Department of Virology, Parasitology and Immunology, Ghent University, Merelbeke, Belgium
- * E-mail:
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Stracke K, Clarke N, Awburn CV, Vaz Nery S, Khieu V, Traub RJ, Jex AR. Development and validation of a multiplexed-tandem qPCR tool for diagnostics of human soil-transmitted helminth infections. PLoS Negl Trop Dis 2019; 13:e0007363. [PMID: 31206520 PMCID: PMC6597125 DOI: 10.1371/journal.pntd.0007363] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 10/25/2018] [Revised: 06/27/2019] [Accepted: 04/05/2019] [Indexed: 11/30/2022] Open
Abstract
Soil-transmitted helminths (STH) are a major cause of morbidity in tropical developing countries with a global infection prevalence of more than one billion people and disease burden of around 3.4 million disability adjusted life years. Infection prevalence directly correlates to inadequate sanitation, impoverished conditions and limited access to public health systems. Underestimation of infection prevalence using traditional microscopy-based diagnostic techniques is common, specifically in populations with access to benzimidazole mass treatment programs and a predominance of low intensity infections. In this study, we developed a multiplexed-tandem qPCR (MT-PCR) tool to identify and quantify STH eggs in stool samples. We have assessed this assay by measuring infection prevalence and intensity in field samples of two cohorts of participants from Timor-Leste and Cambodia, which were collected as part of earlier epidemiological studies. MT-PCR diagnostic parameters were compared to a previously published multiplexed qPCR for STH detection. The MT-PCR assay agreed strongly with qPCR data and showed a diagnostic specificity of 99.60–100.00% (sensitivity of 83.33–100.00%) compared to qPCR and kappa agreement exceeding 0.85 in all tests. In addition, the MT-PCR has the added advantage of distinguishing Ancylostoma spp. species, namely Ancylostoma duodenale and Ancylostoma ceylanicum. This semi-automated platform uses a standardized, manufactured reagent kit, shows excellent run-to-run consistency/repeatability and supports high-throughput detection and quantitation at a moderate cost. Soil-transmitted helminthiases are among the most prevalent and damaging neglected tropical diseases and have a significant global health impact. Accurate identification and quantitation of STH infection is a cornerstone of effective control. Direct observation and counting of eggs in faeces is the current gold-standard method for diagnosis of infection. This approach is time consuming and has poor sensitivity. As ongoing oral benzimidazole therapy across many endemic regions leads to a reduction in STH prevalence and intensity, these sensitivity limitations become an increasingly relevant issue, particularly with respect to monitoring treatment efficacy, identifying reductions in parasite transmission, and accurately quantifying infection burden in discrete populations in middle-income countries. PCR-based detection has long been proposed as an alternative approach to STH diagnosis and many protocols, including quantitative PCR-based methods, have been developed. However, these methods are largely bespoke and use non-standardized reagents that can greatly impact on the transferability and relative consistency of their performance. In the current study, we evaluate an automated, commercially-produced molecular diagnostic tool for validation of the major soil-transmitted helminths, including Ascaris lumbricoides, Trichuris trichiura, Necator americanus, Ancylostoma duodenale and Ancylostoma ceylanicum, and evaluate its performance in comparison to an established multiplexed qPCR using faecal samples from endemic settings.
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Affiliation(s)
- Katharina Stracke
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- * E-mail:
| | - Naomi Clarke
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Camille V. Awburn
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Susana Vaz Nery
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Virak Khieu
- National Center for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - 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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Mubanga C, Mwape KE, Phiri IK, Trevisan C, Zulu G, Chabala C, van Damme I, Schmidt V, Dorny P, Gabriël S. Progress on the development of rapid diagnostic tests for foodborne neglected zoonotic helminthiases: A systematic review. Acta Trop 2019; 194:135-147. [PMID: 30946810 DOI: 10.1016/j.actatropica.2019.03.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 12/26/2018] [Revised: 02/15/2019] [Accepted: 03/31/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Foodborne Neglected Zoonotic Helminths (FNZH) are parasites of both economic and public health importance. They include Taenia solium, Echinococcus granulosus sensu lato, Echinococcus multilocularis and Foodborne trematodes (FBT). FNZH are earmarked for major interventions for control, elimination and eradication. This systematic review highlights the progress towards development of rapid tests for the diagnosis of FNZH since 2010 when they were listed as neglected tropical diseases. METHODOLOGY A systematic search was conducted in three databases, World of Science, Embase and PubMed using the same search phrase. The search produced 480 hits. Three studies from back referencing were included. Only 22 of these met the inclusion criteria. Data was extracted from these and presented qualitatively. RESULTS Twenty-five rapid diagnostic tests were found to have been developed since 2010, eight for diagnosis of T. solium infections, eight for echinococcosis and nine for FBT infections. The rapid tests for diagnosing T. solium infections included six antibody detecting and two antigen detecting tests. They constitute a combination among them, with some tests providing qualitative, others quantitative results. Similarly, seven out of the eight rapid tests developed for Echinococcus infections were antibody detecting tests save for one loop mediated isothermal amplification test. All of them were qualitative tests. For FBT infections, nine rapid tests were described; two antibody and one nucleic acid detecting test for diagnosis of Fascioliasis; three nucleic acid detecting tests for Opisthorchiasis; one antibody detecting test for Paragonimiasis; and for Clonorchiasis, one antibody and one nucleic acid detecting test. The FBT infection rapid tests were all qualitative in nature. Most of these tests have not undergone field evaluation in endemic areas where they will be used most. CONCLUSION This review describes the development and evaluation of rapid diagnostic tests, while highlighting the need for in depth validations of the tools to determine how well they can perform in endemic areas.
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Affiliation(s)
- Chishimba Mubanga
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.
| | - Kabemba E Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Isaac K Phiri
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Gideon Zulu
- Provincial Medical Office, Ministry of Health, Kasama, Zambia
| | - Chishala Chabala
- Children's Hospital, University Teaching Hospitals, Lusaka, Zambia
| | - Inge van Damme
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Veronika Schmidt
- Centre for Global Health, Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany; Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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do Nascimento Ramos IC, Ramos RAN, Giannelli A, Lima VFS, Cringoli G, Rinaldi L, de Carvalho GA, Alves LC. An Additional Asset for the FLOTAC Technique: Detection of Gastrointestinal Parasites in Vegetables. Acta Parasitol 2019; 64:423-425. [PMID: 31069644 DOI: 10.2478/s11686-019-00059-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 08/16/2018] [Accepted: 03/29/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Gastrointestinal parasites are considered amongst the most important threats to veterinary and human health worldwide. The transmission of these parasitic diseases usually involves the accidental ingestion of oocysts, cysts, eggs, and larvae, whose detection is generally achieved by classical coproparasitological methods, based on sedimentation and/or flotation techniques. These procedures might be inefficient or display a low sensitivity when performed on food matrices. This study aimed to assess the value of the FLOTAC technique for the detection of different parasitic stages of gastrointestinal parasites of domestic animals in fresh lettuce. MATERIAL AND METHODS Samples (n = 100) were purchased from public markets located in the metropolitan region of Recife (Brazil). RESULTS A total of 79% scored positive for eggs and/or cysts of gastrointestinal parasites. Protozoa and nematodes were detected in 32% (32/100) and 64% (64/100) of samples, respectively, with cysts of the genus Entamoeba (32%) and eggs of nematodes of the order Strongylida (30%) being the most frequently diagnosed. CONCLUSIONS The findings herein reported demonstrate that the FLOTAC technique can be successfully applied for recovering food-borne parasites of medical and veterinary concern in food matrices.
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Affiliation(s)
| | - Rafael Antonio Nascimento Ramos
- Academic Unit of Garanhuns, Federal Rural University of Pernambuco, Av. Bom Pastor, s/n, Boa Vista, Garanhuns, Pernambuco, CEP 55292-270, Brazil.
| | | | | | - Giuseppe Cringoli
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Naples, Italy
| | - Laura Rinaldi
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, Naples, Italy
| | - Gílcia Aparecida de Carvalho
- Academic Unit of Garanhuns, Federal Rural University of Pernambuco, Av. Bom Pastor, s/n, Boa Vista, Garanhuns, Pernambuco, CEP 55292-270, Brazil
| | - Leucio Câmara Alves
- Department of Veterinary Medicine, Federal Rural University of Pernambuco, Recife, Brazil
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Bangert M, Bancalari P, Mupfasoni D, Mikhailov A, Gabrielli AF, Montresor A. Provision of deworming intervention to pregnant women by antenatal services in countries endemic for soil-transmitted helminthiasis. PLoS Negl Trop Dis 2019; 13:e0007406. [PMID: 31083673 PMCID: PMC6532928 DOI: 10.1371/journal.pntd.0007406] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 08/28/2018] [Revised: 05/23/2019] [Accepted: 04/23/2019] [Indexed: 11/21/2022] Open
Abstract
Background The World Health Organization has recently reemphasized the importance of providing preventive chemotherapy to women of reproductive age in countries endemic for soil-transmitted helminthiasis as they are at heightened risk of associated morbidity. The Demographic and Health Surveys (DHS) Program is responsible for collecting and disseminating accurate, nationally representative data on health and population in developing countries. Our study aims to estimate the number of pregnant women at risk of soil-transmitted helminthiasis that self-reported deworming by antenatal services in endemic countries that conducted Demographic and Health Surveys. Methodology/Principal findings The number of pregnant women living in endemic countries was extrapolated from the United Nations World Population Prospects 2015. National deworming coverage among pregnant women were extracted from Demographic and Health Surveys and applied to total numbers of pregnant women in the country. Sub-national DHS with data on self-reported deworming were available from 49 of the 102 endemic countries. In some regions more than 73% of STH endemic countries had a DHS. The DHS report an average deworming coverage of 23% (CI 19–28), ranging from 2% (CI 1–3) to 35% (CI 29–40) in the different regions, meaning more than 16 million pregnant women were dewormed in countries surveyed by DHS. The deworming rates amongst the 43 million pregnant women in STH endemic countries not surveyed by DHS remains unknown. Conclusions/Significance These estimates will serve to establish baseline numbers of deworming coverage among pregnant women, monitor progress, and urge endemic countries to continue working toward reducing the burden of soil-transmitted helminthiasis. The DHS program should be extended to STH-endemic countries currently not covering the topic of deworming during pregnancy. Soil-transmitted helminths are intestinal worms that cause significant suffering among the poorest communities in the world. They are transmitted via contaminated water, food or soil, all of which result from poor sanitation. Children and women of reproductive age are at heightened risk of related morbidities such as malnutrition, cognitive impairment and anaemia. Pregnant women are particularly susceptible to severe maternal and neonatal complications. Deworming drugs are cheap, safe, and effective in reducing morbidity related to soil-transmitted helminthiasis. Large scale drug administration campaigns have distributed donated medicines to children in endemic countries, but women of reproductive age are currently not well covered. Yet, demographic surveys show that they are being treated for soil-transmitted helminthiasis through health care services. This study provides estimates for the number of pregnant women at risk of soil-transmitted helminthiasis being dewormed by antenatal services in endemic countries conducting Demographic Health Surveys. These estimates mark the preliminary reference point for deworming coverage among pregnant women in endemic countries, and will thus prove useful for tracking overall progress in the ongoing effort to eliminate neglected tropical diseases.
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Affiliation(s)
- Mathieu Bangert
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Pilar Bancalari
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Denise Mupfasoni
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Alexei Mikhailov
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Albis F. Gabrielli
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
- * E-mail:
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Ercumen A, Benjamin-Chung J, Arnold BF, Lin A, Hubbard AE, Stewart C, Rahman Z, Parvez SM, Unicomb L, Rahman M, Haque R, Colford JM, Luby SP. Effects of water, sanitation, handwashing and nutritional interventions on soil-transmitted helminth infections in young children: A cluster-randomized controlled trial in rural Bangladesh. PLoS Negl Trop Dis 2019; 13:e0007323. [PMID: 31050672 PMCID: PMC6519840 DOI: 10.1371/journal.pntd.0007323] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [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: 09/25/2018] [Revised: 05/15/2019] [Accepted: 03/22/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Soil transmitted helminths (STH) infect >1.5 billion people. Mass drug administration (MDA) effectively reduces infection; however, there is evidence for rapid reinfection and risk of potential drug resistance. We conducted a randomized controlled trial in Bangladesh (WASH Benefits, NCT01590095) to assess whether water, sanitation, hygiene and nutrition interventions, alone and combined, reduce STH in a setting with ongoing MDA. METHODOLOGY/PRINCIPAL FINDINGS In 2012-2013, we randomized 720 clusters of 5551 pregnant women into water treatment, sanitation, handwashing, combined water+sanitation+handwashing (WSH), nutrition, nutrition+WSH (N+WSH) or control arms. In 2015-2016, we enrolled 7795 children, aged 2-12 years, of 4102 available women for STH follow-up and collected stool from 7187. We enumerated STH infections with Kato-Katz. We estimated intention-to-treat intervention effects on infection prevalence and intensity. Participants and field staff were not blinded; laboratory technicians and data analysts were blinded. Prevalence among controls was 36.8% for A. lumbricoides, 9.2% for hookworm and 7.5% for T. trichiura. Most infections were low-intensity. Compared to controls, the water intervention reduced hookworm by 31% (prevalence ratio [PR] = 0.69 (0.50,0.95), prevalence difference [PD] = -2.83 (-5.16,-0.50)) but did not affect other STH. Sanitation improvements reduced T. trichiura by 29% (PR = 0.71 (0.52,0.98), PD = -2.17 (-4.03,-0.38)), had a similar borderline effect on hookworm and no effect on A. lumbricoides. Handwashing and nutrition interventions did not reduce any STH. WSH and N+WSH reduced hookworm prevalence by 29-33% (WSH: PR = 0.71 (0.52,0.99), PD = -2.63 (-4.95,-0.31); N+WSH: PR = 0.67 (0.50,0.91), PD = -3.00 (-5.14,-0.85)) and marginally reduced A. lumbricoides. Effects on infection intensity were similar. CONCLUSIONS/SIGNIFICANCE In a low-intensity infection setting with MDA, we found modest but sustained hookworm reduction from water treatment and combined WSH interventions. Impacts were more pronounced on STH species with short vs. long-term environmental survival. Our findings suggest possible waterborne transmission for hookworm. Water treatment and sanitation improvements can augment MDA to interrupt STH transmission. TRIAL REGISTRATION NCT01590095.
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Affiliation(s)
- Ayse Ercumen
- Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC, United States of America
- School of Public Health, University of California Berkeley, Berkeley, CA, United States of America
| | - Jade Benjamin-Chung
- School of Public Health, University of California Berkeley, Berkeley, CA, United States of America
| | - Benjamin F. Arnold
- School of Public Health, University of California Berkeley, Berkeley, CA, United States of America
| | - Audrie Lin
- School of Public Health, University of California Berkeley, Berkeley, CA, United States of America
| | - Alan E. Hubbard
- School of Public Health, University of California Berkeley, Berkeley, CA, United States of America
| | - Christine Stewart
- Department of Nutrition, University of California, Davis, CA, United States of America
| | - Zahidur Rahman
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Sarker Masud Parvez
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Leanne Unicomb
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mahbubur Rahman
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Rashidul Haque
- Infectious Disease Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - John M. Colford
- School of Public Health, University of California Berkeley, Berkeley, CA, United States of America
| | - Stephen P. Luby
- Infectious Diseases & Geographic Medicine, Stanford University, Stanford, CA, United States of America
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Truscott JE, Dunn JC, Papaiakovou M, Schaer F, Werkman M, Littlewood DTJ, Walson JL, Anderson RM. Calculating the prevalence of soil-transmitted helminth infection through pooling of stool samples: Choosing and optimizing the pooling strategy. PLoS Negl Trop Dis 2019; 13:e0007196. [PMID: 30897089 PMCID: PMC6445468 DOI: 10.1371/journal.pntd.0007196] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 09/26/2018] [Revised: 04/02/2019] [Accepted: 01/29/2019] [Indexed: 12/31/2022] Open
Abstract
Prevalence is a common epidemiological measure for assessing soil-transmitted helminth burden and forms the basis for much public-health decision-making. Standard diagnostic techniques are based on egg detection in stool samples through microscopy and these techniques are known to have poor sensitivity for individuals with low infection intensity, leading to poor sensitivity in low prevalence populations. PCR diagnostic techniques offer very high sensitivities even at low prevalence, but at a greater cost for each diagnostic test in terms of equipment needed and technician time and training. Pooling of samples can allow prevalence to be estimated while minimizing the number of tests performed. We develop a model of the relative cost of pooling to estimate prevalence, compared to the direct approach of testing all samples individually. Analysis shows how expected relative cost depends on both the underlying prevalence in the population and the size of the pools constructed. A critical prevalence level (approx. 31%) above which pooling is never cost effective, independent of pool size. When no prevalence information is available, there is no basis on which to choose between pooling and testing all samples individually. We recast our model of relative cost in a Bayesian framework in order to investigate how prior information about prevalence in a given population can be used to inform the decision to choose either pooling or full testing. Results suggest that if prevalence is below 10%, a relatively small exploratory prevalence survey (10-15 samples) can be sufficient to give a high degree of certainty that pooling may be relatively cost effective.
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Affiliation(s)
- James E. Truscott
- The DeWorm3 Project, Department of Life Sciences, Natural History Museum, London, United Kingdom
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Julia C. Dunn
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Marina Papaiakovou
- The DeWorm3 Project, Department of Life Sciences, Natural History Museum, London, United Kingdom
- Parasites & Vectors, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Fabian Schaer
- The DeWorm3 Project, Department of Life Sciences, Natural History Museum, London, United Kingdom
- Parasites & Vectors, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Marleen Werkman
- The DeWorm3 Project, Department of Life Sciences, Natural History Museum, London, United Kingdom
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - D. Timothy J. Littlewood
- The DeWorm3 Project, Department of Life Sciences, Natural History Museum, London, United Kingdom
- Parasites & Vectors, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Judd L. Walson
- The DeWorm3 Project, Department of Life Sciences, Natural History Museum, London, United Kingdom
- Parasites & Vectors, Department of Life Sciences, Natural History Museum, London, United Kingdom
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Roy M. Anderson
- The DeWorm3 Project, Department of Life Sciences, Natural History Museum, London, United Kingdom
- Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, United Kingdom
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Steinbaum L, Mboya J, Mahoney R, Njenga SM, Null C, Pickering AJ. Effect of a sanitation intervention on soil-transmitted helminth prevalence and concentration in household soil: A cluster-randomized controlled trial and risk factor analysis. PLoS Negl Trop Dis 2019; 13:e0007180. [PMID: 30742614 PMCID: PMC6386409 DOI: 10.1371/journal.pntd.0007180] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 07/03/2018] [Revised: 02/22/2019] [Accepted: 01/22/2019] [Indexed: 12/19/2022] Open
Abstract
Improved sanitation has been associated with a reduced prevalence of soil-transmitted helminth (STH) infection and has been hypothesized to prevent fecal contamination from spreading throughout the household environment. We evaluated the effect of providing households with a pit latrine with a plastic slab and drophole cover, child feces management tools, and associated behavioral messaging on reducing STH eggs in household soil. We collected soil samples from 2107 households (898 control and 1209 improved sanitation intervention households) that were enrolled in the WASH Benefits cluster randomized controlled trial in rural Kenya and performed a post-intervention analysis after two years of intervention exposure. Following a pre-specified analysis plan, we combined all households that received the sanitation intervention into one group for comparison to control households. The prevalence of STH eggs in soil was 18.9% in control households and 17.0% in intervention households. The unadjusted prevalence ratio of total STH eggs in the intervention groups compared to the control group was 0.94 (95% CI: 0.78-1.13). The geometric mean concentration was 0.05 eggs/g dry soil in control households and intervention households. Unadjusted and adjusted models gave similar results. We found use of a shared latrine, presence of a roof over the sampling area, and the number of dogs owned at baseline was associated with an increased prevalence of STH eggs in soil; the presence of a latrine that was at least 2 years old and a latrine with a covered drophole was associated with a reduction in the prevalence of STH eggs in soil. Soil moisture content was also associated with an increased prevalence of STH eggs in soil. Our results indicate that an intervention designed to increase access to improved latrines and child feces management tools may not be enough to impact environmental occurrence of STH in endemic areas where latrine coverage is already high.
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Affiliation(s)
- Lauren Steinbaum
- Civil and Environmental Engineering, Stanford University, Stanford, California, United States of America
- Epidemiology and Biostatistics, University of Georgia, Athens, Georgia, United States of America
| | - John Mboya
- Innovations for Poverty Action, Nairobi, Kenya
| | - Ryan Mahoney
- Innovations for Poverty Action, New Haven, Connecticut, United States of America
| | - Sammy M. Njenga
- Eastern and Southern Africa Center of International Parasite Control, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Clair Null
- Innovations for Poverty Action, New Haven, Connecticut, United States of America
- Mathematica, Washington, D.C., United States of America
| | - Amy J. Pickering
- Civil and Environmental Engineering, Stanford University, Stanford, California, United States of America
- Civil and Environmental Engineering, Tufts University, Medford, Massachusetts, United States of America
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Appleby LJ, Tadesse G, Wuletawu Y, Dejene NG, Grimes JET, French MD, Teklu A, Moreda B, Negussu N, Kebede B, Yard E, Gardiner I, Drake LJ. Integrated delivery of school health interventions through the school platform: Investing for the future. PLoS Negl Trop Dis 2019; 13:e0006449. [PMID: 30703087 PMCID: PMC6354954 DOI: 10.1371/journal.pntd.0006449] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] [Indexed: 11/25/2022] Open
Abstract
School health and nutrition (SHN) programmes are recognized as a significant contributor to both health and education sector goals. The school system offers an ideal platform from which to deliver basic health interventions that target the most common health conditions affecting school-age children (SAC) in low-income countries, leading to improved participation and learning outcomes. However, governments require evidence to cost, design, and implement these programmes. In Ethiopia, prevalent health conditions affecting SAC's education participation and learning outcomes include infection with soil-transmitted helminths (STHs), hunger, and malnutrition. In recognition of the multiple issues affecting the health and education of SAC, the government has taken a proactive approach, coordinating an integrated SHN programme designed to be implemented in partnership and monitored and financed through a single, integrated mechanism. The programme, known as the Enhanced School Health Initiative (ESHI), integrates three complimentary health interventions: deworming; school feeding; and provision of a water, sanitation, and hygiene (WASH) package in schools, which in delivery aim to maximize the benefits of each of the individual components. Operational research surrounding the ESHI programme includes both qualitative and quantitative analyses. Here, we present an overview of the ESHI programme and its genesis. We also introduce three additional supporting papers that provide in-depth analyses of key findings, including the baseline situational analysis, the costs, and community perceptions of the programme. The findings from ESHI provide initial evidence to develop an understanding of the related costs and synergies of integrating multiple health interventions onto a single platform. The work has translated into strengthened institutional capacity and improved cross-sectoral coordination. The government is now committed to supporting 25 million school children in Ethiopia through SHN. The ESHI model serves as a reference point for other countries looking to scale up targeted SHN interventions.
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Affiliation(s)
- Laura J. Appleby
- Partnership for Child Development, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
- * E-mail: (LJA); (LJD)
| | - Gemechu Tadesse
- Department of Bacterial, Parasitic and Zoonotic Diseases, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yonas Wuletawu
- Department of Bacterial, Parasitic and Zoonotic Diseases, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Nigussie G. Dejene
- Partnership for Child Development, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Jack E. T. Grimes
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Michael D. French
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Askale Teklu
- United Nations World Food Programme, Addis Ababa, Ethiopia
| | | | | | | | - Elodie Yard
- Partnership for Child Development, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Iain Gardiner
- Partnership for Child Development, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Lesley J. Drake
- Partnership for Child Development, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
- * E-mail: (LJA); (LJD)
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Scheer S, Mascarenhas CS, Macedo MRPD, Muller G. Helminths Assemblage of the bare-faced ibis, Phimosus infuscatus (Lichtenstein, 1823) (Pelecaniformes: Threskiornithidae), in southern Brazil. Rev Bras Parasitol Vet 2019; 28:40-46. [PMID: 30810665 DOI: 10.1590/s1984-29612019001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 01/03/2019] [Indexed: 06/09/2023]
Abstract
Birds act as hosts for a variety of parasites, many of these are unreported. The literature provides scant information on the helminth fauna of Phimosus infuscatus. The presence of helminths were investigate in 28 birds from Pelotas, Capão do Leão, and Rio Grande in Rio Grande do Sul. The preparation and identification of helminths followed protocols. Prevalence (P%), mean intensity of infection (MII), and mean abundance (MA) were estimated. The following helminths were found: Hystrichis acanthocephalicus , Dioctophyme renale (larva), Porrocaecum heteropterum , Baruscapillaria sp., Aproctella carinii , Paradeletrocephalus minor, and Cyathostoma sp. (Nematoda); Echinostomatidae gen. sp., Tanaisia valida, and Athesmia sp. (Trematoda: Digenea) and Megalacanthus sp. (Cestoda). The most prevalent species were H. acanthocephalicus, P. heteropterum, Megalacanthus sp., and Echinostomatidae gen. sp. and Megalacanthus sp. had the highest MII and MA. There was a significant difference in the prevalence of H. acantocephalicus between female and male bird hosts. We report Echinostomatidae gen. sp., T. valida, Athesmia sp., Cyathostoma sp., A. carinii, P. minor, D. renale (larva), Baruscapillaria sp., and Megalacanthus sp. for the first time in P. infuscatus in Brazil.
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Affiliation(s)
- Simone Scheer
- Laboratório de Parasitologia de Animais Silvestres - LAPASIL, Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brasil
| | - Carolina Silveira Mascarenhas
- Laboratório de Parasitologia de Animais Silvestres - LAPASIL, Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brasil
| | - Márcia Raquel Pegoraro de Macedo
- Laboratório de Parasitologia de Animais Silvestres - LAPASIL, Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brasil
| | - Gertrud Muller
- Laboratório de Parasitologia de Animais Silvestres - LAPASIL, Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brasil
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Hamaidi-Chergui F, Errahmani MB, Ouahchia C. Occurrence and removal of protozoan cysts and helminth eggs in the Médéa sewage treatment plant (south-east of Algiers). Ann Parasitol 2019; 65:139-144. [PMID: 31376343 DOI: 10.17420/ap6502.193] [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: 06/10/2023]
Abstract
One of the most important quality characteristics associated with wastewater reuse in discharging in water bodies is the microbial quality. This study aimed to determine the efficiency of Médéa wastewater treatment plant (conventional activated sludge system) in the removal of protozoan cysts and parasitic eggs. This study was carried out during four months and samples were collected at weekly intervals from influent and effluent of the wastewater plant. In order to determine the concentration of ova, samples were analyzed according to Bailenger method. The wastewater treatment plant (WWTP) of Médéa has removed 88.9–100% of parasite eggs and more than 95% of protozoan cysts.
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Affiliation(s)
- Fella Hamaidi-Chergui
- Biotechnology, Environment and Health Laboratory, Department of Biology (BPC), University Blida 1, BP 270, Route de Soumâa, Blida, Algeria
| | | | - Celia Ouahchia
- Biotechnology, Environment and Health Laboratory, Department of Biology (BPC), University Blida 1, BP 270, Route de Soumâa, Blida, Algeria
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