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Legge H, Kazungo K, Muli S, Elson L, Mwongeli J, Halliday KE, Ochwal V, Oswald W, Dreibelbis R, Njomo D, Mwandawiro C, Fillinger U, Pullan R, Kepha S. Identifying Potential Determinants of Faecal Contamination on Domestic Floors in Three Settings in Rural Kenya: A Mixed Methods Analysis. Environ Health Insights 2024; 18:11786302241246454. [PMID: 38737960 PMCID: PMC11088304 DOI: 10.1177/11786302241246454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/21/2024] [Indexed: 05/14/2024]
Abstract
Observational evidence suggests that household floors may be an important domain for the transmission of enteric and parasitic infections. However, little work has been done to investigate how household floors can become contaminated with human and animal faeces. This study uses a mixed methods approach to postulate the proximal and distal determinants of household floor contamination with faeces in groups of rural villages in 3 counties in Kenya (Bungoma, Kwale and Narok). Quantitative data was collected through a household census and analysed descriptively and using mixed effects logistic regression models. Qualitative data was collected through unstructured observations of daily routines and in-depth interviews. These data were analysed thematically with case memos produced for routine activities that were hypothesised to be determinants of floor contamination. Possible proximal determinants of floor contamination included; (1) animal contact with floors; (2) child faeces disposal, and; (3) floor cleaning routines. Distal determinants are suggested to be rooted in the socioeconomic, environmental, and cultural context in which households were located and included; (1) the type and number of animals owned by households; (2) presence/absence of dedicated shelters for housing animals at night, which impacted whether sleeping or cooking areas were exposed to animals; (3) Accessibility of inside spaces to poultry and other roaming animals; (4) ownership of an improved floor; (5) ability of animals to access neighbours compounds; (6) seasonal changes in weather. These results will be of use in identifying the contexts in which faecal contamination of domestic floors may be contributing towards transmission of enteric and parasitic infections and in designing effective interventions to prevent this exposure.
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Affiliation(s)
- Hugo Legge
- London School of Hygiene & Tropical Medicine, UK
| | - Karisa Kazungo
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | - Sharon Muli
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | - Lynne Elson
- KEMRI-Wellcome Trust, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK
| | - Jacinta Mwongeli
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | | | - Victoria Ochwal
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | - William Oswald
- London School of Hygiene & Tropical Medicine, UK
- Global Health Division, International Development Group, RTI International, Research Triangle Park, NC, USA
| | | | - Doris Njomo
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Charles Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Ulrike Fillinger
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | | | - Stella Kepha
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
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Maddren R, Collyer B, Phillips AE, Rayment Gomez S, Abtew B, Anjulo U, Tadele D, Sharma A, Tamiru A, Liyew EF, Chernet M, Anderson RM. Patterns of individual compliance with anthelmintic treatment for soil-transmitted helminth infections in southern Ethiopia over six rounds of community-wide mass drug administration. Trans R Soc Trop Med Hyg 2024; 118:304-312. [PMID: 37965994 PMCID: PMC11062190 DOI: 10.1093/trstmh/trad079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/05/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND The mainstay of soil-transmitted helminth (STH) control is repeated mass drug administration (MDA) of anthelmintics to endemic populations. Individual longitudinal compliance treatment patterns are important for identifying pockets of infected individuals who remain untreated and serve as infection reservoirs. METHODS The Geshiyaro Project censused the study population in Wolaita, Ethiopia at baseline in 2018. Individual longitudinal compliance was recorded for six rounds of community-wide MDA (cMDA). The probability distribution of treatment frequency was analysed by age and gender stratifications. Probabilities of transmission interruption for different compliance patterns were calculated using an individual-based stochastic model of Ascaris lumbricoides transmission. RESULTS The never-treated (0.42%) population was smaller than expected from a random positive binomial distribution. The observed compliance frequency was well described by the beta-binomial distribution. Preschool-age children (odds ratio [OR] 10.1 [95% confidence interval {CI} 6.63 to 15.4]) had the highest never-treated proportion of the age groups. Conversely, school-age children (SAC) and adults (OR 1.03 [95% CI 0.98 to 1.09]) had the highest always-treated proportion of the age groups. CONCLUSIONS The study reports the largest dataset of individual longitudinal compliance to cMDA for STH control. Clear pattens are shown in the age-dependent distribution of individual compliance behaviour. The impact of compliance on the probability of elimination is significant, highlighting the importance of recording the full frequency distribution, not just the never-treated proportion.
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Affiliation(s)
- R Maddren
- Imperial College London, St Mary's Campus, Praed Street, London W2 1NY, UK
| | - B Collyer
- Imperial College London, St Mary's Campus, Praed Street, London W2 1NY, UK
| | - A E Phillips
- FHI360, 359 Blackwell Street, Suite 200, Durham, NC, USA
| | - S Rayment Gomez
- Imperial College London, St Mary's Campus, Praed Street, London W2 1NY, UK
| | - B Abtew
- Imperial College London, St Mary's Campus, Praed Street, London W2 1NY, UK
| | - U Anjulo
- Federal Ministry of Health, 1234 Sudan Street, Addis Ababa, Ethiopia
| | - D Tadele
- Simprints, Cambridge CB1 2FH, UK
| | - A Sharma
- Simprints, Cambridge CB1 2FH, UK
| | - A Tamiru
- Federal Ministry of Health, 1234 Sudan Street, Addis Ababa, Ethiopia
| | - E Firdawek Liyew
- Ethiopian Public Health Institute, Swaziland Street, 2PWJ P8C, Addis Ababa, Ethiopia
| | - M Chernet
- Ethiopian Public Health Institute, Swaziland Street, 2PWJ P8C, Addis Ababa, Ethiopia
| | - R M Anderson
- Imperial College London, St Mary's Campus, Praed Street, London W2 1NY, UK
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Rubagumya SL, Nzalawahe J, Misinzo G, Mazigo HD, Briet M, Misko VR, De Malsche W, Legein F, Justine NC, Basinda N, Mafie E. Evaluation of Lab-on-a-Disc Technique Performance for Soil-Transmitted Helminth Diagnosis in Animals in Tanzania. Vet Sci 2024; 11:174. [PMID: 38668441 PMCID: PMC11054913 DOI: 10.3390/vetsci11040174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/30/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
Soil-transmitted helminth (STH) infections are caused by roundworms, hookworms, whipworms, and thread worms. Accurate diagnosis is essential for effective treatment, prevention, and control of these infections. This study evaluates a new diagnostic method called Single-image Parasite Quantification (SIMPAQ), which uses a lab-on-a-disc (LoD) technique to isolate STH eggs into a single imaging zone for digital analysis. The study evaluates the purification performance of the SIMPAQ technique for detecting STH eggs in animal samples. This was a cross-sectional study conducted among 237 pigs and 281 dogs in the Morogoro region in Tanzania. Faecal samples were collected and processed with the LoD technique, as well as flotation and McMaster (McM) methods for comparison purposes. The overall prevalence of STH infections was high as per the LoD technique (74%), followed by McM (65.44%) and flotation (65.04%). Moreover, the overall performance of the LoD technique, using McM as the gold standard, was 93.51% (sensitivity), 60.89% (specificity), 81.91% (PPV), and 83.21% (NPV). The LoD technique exhibited high prevalence, sensitivity, and NPV, which demonstrates its value for STH egg detection and its crucial role in the era of accurate STH diagnosis, promoting proper management of the infection.
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Affiliation(s)
- Sarah L. Rubagumya
- Department of Microbiology, Immunology and Parasitology, College of Health and Allied Sciences, St. Joseph University in Tanzania, Dar es Salaam P.O. Box 11007, Tanzania
| | - Jahashi Nzalawahe
- Department of Veterinary Microbiology, Parasitology and Biotechnology, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro P.O. Box 3019, Tanzania; (J.N.); (G.M.); (E.M.)
| | - Gerald Misinzo
- Department of Veterinary Microbiology, Parasitology and Biotechnology, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro P.O. Box 3019, Tanzania; (J.N.); (G.M.); (E.M.)
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro P.O. Box 3297, Tanzania
| | - Humphrey D. Mazigo
- Department of Medical Parasitology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.D.M.); (N.C.J.); (N.B.)
| | - Matthieu Briet
- µFlow Group, Department of Chemical Engineering, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (M.B.); (V.R.M.); (F.L.)
| | - Vyacheslav R. Misko
- µFlow Group, Department of Chemical Engineering, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (M.B.); (V.R.M.); (F.L.)
| | - Wim De Malsche
- µFlow Group, Department of Chemical Engineering, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (M.B.); (V.R.M.); (F.L.)
| | - Filip Legein
- µFlow Group, Department of Chemical Engineering, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (M.B.); (V.R.M.); (F.L.)
| | - Nyanda C. Justine
- Department of Medical Parasitology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.D.M.); (N.C.J.); (N.B.)
| | - Namanya Basinda
- Department of Medical Parasitology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.D.M.); (N.C.J.); (N.B.)
| | - Eliakunda Mafie
- Department of Veterinary Microbiology, Parasitology and Biotechnology, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro P.O. Box 3019, Tanzania; (J.N.); (G.M.); (E.M.)
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Labana RV, Borda MCNM, Campo RTA, Ocampo MAV. The Interplay Between Household Risk Perception of Parasitic Infections and Water, Sanitation, and Hygiene (WASH) Practices: Evidence From an Urban Poor Community in the Philippines. Cureus 2024; 16:e57532. [PMID: 38707156 PMCID: PMC11067986 DOI: 10.7759/cureus.57532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Parasitic diseases pose challenges in impoverished urban settlements with limited access to clean water, proper hygiene, and sanitation (WASH). This study assesses WASH practices and risk perceptions of parasitic infections among households in the Bataan Shipyard and Engineering Corporation (BASECO) Compound in Manila, an urban poor community in the Philippines. METHODS A cross-sectional study design was employed to collect data through a self-administered questionnaire. Descriptive statistical analysis was performed to assess the sociodemographic profile, household WASH practices, and respondents' risk perception of parasitic infections. Linear regression analysis was utilized to examine the relationship between these variables. RESULTS A survey was conducted with 363 households, of which 237 (65.3%) used distilled and purified water from the water refilling stations in the community for drinking. Meanwhile, 120 households (33.10%) consumed tap water. Boiling water was a commonly used method (n=146; 56.60%) for treating drinking water. Most households had flush toilets with septic tanks (n=244; 67.20%), water sources for handwashing (n=307; 84.57%) and soap for handwashing (n=356; 98.10%). On average, they washed their hands 6-10 times daily (n=159; 43.80%). Most households were aware that drinking untreated water (n=318; 87.6%), improper food washing (n=309; 85.1%), using contaminated water sources (n=301; 82.9%), and consuming raw or undercooked meat (n=298; 82.1%) could lead to parasitic infections. 316 respondents (87.1%) identified diarrhea as the most common symptom of parasitic infection. Relationships were found between access to drinking water and the number of household members (B=0.191; p-value=0.001), personal hygiene and the respondents' knowledge of parasitic infections (B=0.112; p-value=0.047), and the overall WASH score with household income (B=0.105; p-value=0.045). CONCLUSIONS The WASH conditions in BASECO, Manila need improvement. Factors associated with their WASH practices include risk perception of parasitic diseases, socioeconomic disparity, and household overcrowding. These factors play a crucial role in identifying areas for improvement and promoting health policies for urban poor communities in the Philippines.
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Affiliation(s)
- Ryan V Labana
- Center for Integrated Community Science Research, Research Institute for Science and Technology, Polytechnic University of the Philippines, Manila, PHL
- Department of Biology, College of Science, Polytechnic University of the Philippines, Manila, PHL
| | - Ma Cate Nicole M Borda
- Department of Biology, College of Science, Polytechnic University of the Philippines, Manila, PHL
| | - Ryan Toribio A Campo
- Department of Biology, College of Science, Polytechnic University of the Philippines, Manila, PHL
| | - Maria Antonia V Ocampo
- Department of Biology, College of Science, Polytechnic University of the Philippines, Manila, PHL
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Reddy A, Khadanga S, Gupta PK, Tadepalli K. The Burden of Protozoal and Helminth Intestinal Infections and Related Risk Factors Among the Households of Migrant Construction Workers in Bhopal. Cureus 2024; 16:e58413. [PMID: 38756280 PMCID: PMC11098528 DOI: 10.7759/cureus.58413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
There are a few existing gaps and paucity of literature from Southeast Asia on the prevalence of intestinal parasitic infections among migrant construction workers. The present cross-sectional study was conducted to address this gap among migrant construction workers and their households in Bhopal. The study design included an interview questionnaire survey prior to the enrollment of participants and stool sample collection. The stool samples were processed according to the study protocol of macroscopy, occult blood testing, microscopy techniques combined with modified acid-fast, and sedimentation techniques. Participants were deemed positive if they exhibited microscopic findings in one out of three stool samples per recruit. We recommended clinical consultation for these cases and provided a report. Direct therapeutic intervention was not part of the study. The total recruits were 361. The predominant age group was young, i.e., aged 21 to 30 years (122/361, 33.8%), with the majority of females (55.2%). Most workers were occupied with work of digging soil (47.4%). The majority of participants (93.1%) practiced open field defecation (OFD). The prevalence of intestinal parasitic infections among migrant workers and households was 36.9% (133/361). Monoinfection was 88.7%, with 41% from Entamoeba histolytica/Entamoeba dispar. Monoinfection with Hymenolepis nana (10.2%) was a predominant helminth. The most common coinfection observed was of Giardia intestinalis with Ancylostoma duodenale (26.7%). Hand washing was the only independent predictor with an odds ratio of 3.6. Migrant behavior of the construction workers and their households was the major reason for not reaching the benefits of deworming schemes for children and vulnerability to intestinal parasitic infections.
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Affiliation(s)
- Akhila Reddy
- Preliminary Medicine, United Health Services, New York, USA
| | - Sagar Khadanga
- Internal Medicine, All India Institute of Medical Sciences, Bhopal, IND
| | | | - Karuna Tadepalli
- Microbiology, All India Institute of Medical Sciences, Bhopal, IND
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Agrawal R, Pattnaik S, Kshatri JS, Kanungo S, Mandal N, Palo SK, Pati S. Prevalence and correlates of soil-transmitted helminths in schoolchildren aged 5 to 18 years in low- and middle-income countries: a systematic review and meta-analysis. Front Public Health 2024; 12:1283054. [PMID: 38577281 PMCID: PMC10991833 DOI: 10.3389/fpubh.2024.1283054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/01/2024] [Indexed: 04/06/2024] Open
Abstract
Background According to the Global Burden of Disease (GBD) 2019 report, up to 1.5 million disability-adjusted life years (DALYs) are lost due to soil-transmitted helminths (STHs), and 5.9 million people are at risk of acquiring STHs. Regions with the highest prevalence of STH infections include Sub-Saharan Africa, China, South America, and Asia. While there are numerous fragmented studies on STH, comprehensive information on the prevalence and geographic distribution of different species, as well as their regional variations in the context of STHs is limited. The present systematic review and meta-analysis study attempts to provide a summary of the prevalence, geographical variation, and determinants of STHs among schoolchildren aged 5 to 18 years. Methods An extensive literature search was carried out using PubMed, Embase, Cinhal, and Psychinfo for studies published between 1999 and 2022 that reported the rate of STH infection in school-going children aged 5-18 years. A random effects model was employed in this meta-analysis due to expected heterogeneity. Subgroup analysis was carried out based on sex and STH species because of expected geographical variation. Results A total of 19,725 of the 49,630 children examined were infected with STH, yielding an overall pooled prevalence of 37.16% (95% CI: 29.74-44.89). The prevalence was highest in the Western Pacific region at 50.41% (95% CI: 33.74-67.04) followed by Europe at 39.74% (95% CI: 20.40-61.0) and Africa at 37.10% (95% CI: 26.84-47.95). Ascaris lumbricoides was found to be the most prevalent helminth with a prevalence of 24.07% (95% CI: 17.07-31.83). Conclusion The Western Pacific region is classified as a High-risk Zone (HRZ), while Southeast Asia, Africa, Europe, and the Eastern Mediterranean are classified as moderate-risk zones (MRZs). We found a 12% reduction in the pooled prevalence of STH infection from 1999 to 2012. Ascaris lumbricoides was the predominant species among schoolchildren. Mass Drug Administration (MDA) of Albendazole tablets and improved water, sanitation, and hygiene (WASH) practices are effective in controlling and preventing STH. Ensuring their implementation and access is crucial to addressing the problem. Systematic review registration https://www.crd.york.ac.uk/prospero/#loginpage, CRD42022333341.
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Perera DJ, Koger-Pease C, Paulini K, Daoudi M, Ndao M. Beyond schistosomiasis: unraveling co-infections and altered immunity. Clin Microbiol Rev 2024; 37:e0009823. [PMID: 38319102 PMCID: PMC10938899 DOI: 10.1128/cmr.00098-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
Schistosomiasis is a neglected tropical disease caused by the helminth Schistosoma spp. and has the second highest global impact of all parasites. Schistosoma are transmitted through contact with contaminated fresh water predominantly in Africa, Asia, the Middle East, and South America. Due to the widespread prevalence of Schistosoma, co-infection with other infectious agents is common but often poorly described. Herein, we review recent literature describing the impact of Schistosoma co-infection between species and Schistosoma co-infection with blood-borne protozoa, soil-transmitted helminths, various intestinal protozoa, Mycobacterium, Salmonella, various urinary tract infection-causing agents, and viral pathogens. In each case, disease severity and, of particular interest, the immune landscape, are altered as a consequence of co-infection. Understanding the impact of schistosomiasis co-infections will be important when considering treatment strategies and vaccine development moving forward.
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Affiliation(s)
- Dilhan J. Perera
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Cal Koger-Pease
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Kayla Paulini
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Mohamed Daoudi
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Momar Ndao
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Canada
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Means AR, List K, Roll A, Gwayi-Chore MC, Dolley S, Schünemann HJ, Norman TC, Walson JL. Participatory development of a target policy profile to support soil-transmitted helminth elimination. Front Health Serv 2024; 3:1310694. [PMID: 38313331 PMCID: PMC10836137 DOI: 10.3389/frhs.2023.1310694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/21/2023] [Indexed: 02/06/2024]
Abstract
Introduction Soil-transmitted helminths (STH) are parasitic worms that infect nearly a quarter of the world's population, particularly those living in communities without access to adequate water, sanitation, and housing. Emerging evidence suggests that it may be possible to interrupt transmission of STH by deworming individuals of all ages via community-wide MDA (cMDA), as opposed to only treating children and other focal populations. Transitioning from a policy of STH control to STH elimination in targeted areas would require a fundamental shift in STH policy and programming. This policy change would require updated guidance to support countries as they adapt their current approaches for STH surveillance, supply chain management, community mobilization, and core programmatic activities in pursuit of STH elimination. There is an opportunity to engage with key stakeholders, such as program implementers and implementation partners, to understand what evidence they need to confidently adopt a new policy guideline and to deliver guideline adherent management at scale. Methods We aimed to engage with STH stakeholders to develop a Target Policy Profile (TPoP), a single document that describes optimal characteristics and evidence requirements that STH stakeholders prioritized in future potential STH transmission interruption efforts. Steps in TPoP development included a scoping review and key informant interviews (KIIs), which were used to design a two-stage Delphi technique to identify and verify TPoP components. Results The scoping review resulted in 25 articles, and 8 experts participated in KII's. Twenty respondents completed the first Delphi survey and 10 respondents completed the second. This systematic effort resulted in a net of 3 key information domains (background/context, clinical considerations, and implementation considerations) encompassing 24 evidence categories (examples include evidence regarding safety and adverse events, implementation feasibility, or evidence dissemination). For each evidence category, STH stakeholders reviewed, endorsed, or revised a range of options for how the evidence could be presented. Discussion This information can be used by guideline committees or global policy makers prior to convening guideline advisory groups. The TPoP tool may also speed the process of stakeholder consensus building around guidelines, accelerating progress towards implementing evidence-based policy at scale.
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Affiliation(s)
- Arianna Rubin Means
- Department of Global Health, University of Washington, Seattle, WA, United States
- The DeWorm3 Project, University of Washington, Seattle, WA, United States
| | - Kellie List
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Amy Roll
- Department of Global Health, University of Washington, Seattle, WA, United States
- The DeWorm3 Project, University of Washington, Seattle, WA, United States
| | - Marie-Claire Gwayi-Chore
- Department of Global Health, University of Washington, Seattle, WA, United States
- The DeWorm3 Project, University of Washington, Seattle, WA, United States
| | - Shawn Dolley
- Open Global Health, Arlington, VA, United States
| | - Holger J. Schünemann
- Departmentof Health Research Methods, Evidence, and Impact, and of Medicine, McMaster University, Hamilton, ON, Canada
- McMaster GRADE Centre & Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Thea C. Norman
- Bill & Melinda Gates Foundation, Seattle, WA, United States
| | - Judd L. Walson
- Department of Global Health, University of Washington, Seattle, WA, United States
- The DeWorm3 Project, University of Washington, Seattle, WA, United States
- Departments of Medicine, Pediatrics, and Epidemiology, University of Washington, Seattle, WA, United States
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Bradbury RS, Streit A. Is strongyloidiasis a zoonosis from dogs? Philos Trans R Soc Lond B Biol Sci 2024; 379:20220445. [PMID: 38008118 PMCID: PMC10676807 DOI: 10.1098/rstb.2022.0445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/29/2023] [Indexed: 11/28/2023] Open
Abstract
Strongyloides stercoralis infection remains a major veterinary and public health challenge globally. This chronic and potentially lifelong disease has fatal outcomes in immunosuppressed people and dogs. Currently, the role of dogs in the transmission cycle of human strongyloidiasis remains enigmatic. While zoonotic transmission to humans from companion animals has been proposed, this has not been confirmed. Modern molecular methods have allowed greater opportunity to explore the genotypes of S. stercoralis in dogs and humans. Work thus far has demonstrated that at least two distinct lineages exist, one apparently confined to canine hosts and one found in canine, feline, human and non-human primate hosts. Although genotyping of dog and human isolates from the same village has demonstrated identical genotypes in both species, coprophagia of human waste by dogs confounds interpretation. It remains unclear if dogs act as a zoonotic reservoir for human infection, or vice versa, or if this occurs only in some regions of the world and not in others. These questions must be answered before effective control strategies for strongyloidiasis can be instituted. This review explores the evidence for and against cross-species transmission of S. stercoralis between dogs and humans and summarizes future directions for research in this area. This article is part of the Theo Murphy meeting Issue 'Strongyloides: omics to worm-free populations'.
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Affiliation(s)
- Richard S. Bradbury
- School of Health and Life Sciences, Federation University, Melbourne, Victoria 3806, Australia
| | - Adrian Streit
- Department for Integrative Evolutionary Biology, Max Planck Institute for Biology Tübingen, Tübingen, 72076, Germany
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Genanew B, Getu F, Walle M, Hailu A. Anemia among malaria patients with and without soil-transmitted helminths in Arba Minch town health facilities: A comparative cross-sectional study. Medicine (Baltimore) 2024; 103:e36835. [PMID: 38181246 PMCID: PMC10766214 DOI: 10.1097/md.0000000000036835] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/12/2023] [Indexed: 01/07/2024] Open
Abstract
Anemia is one of the severe clinical outcomes associated with concomitant infection of malaria and soil-transmitted helminths (STH). Since STH infections mostly share similar geographical areas with malaria, the influence of co-infections on the epidemiology and course of Anemia deserves greater consideration to assess the impact of interventions, the adequacy of strategies implemented, and the progress made in the fight against Anemia. So, this study was done to investigate Anemia among STH-negative malaria patients and malaria patients co-infected with single or multiple STHs, in 3 health facilities of Arba Minch, 2020 to 2021. An institutional-based comparative cross-sectional study was conducted at 3 Governmental Health Institutions, Arba Minch, and southern Ethiopia from November 2020 to February 2021 on a total of 321 malaria-positive study participants. Thick and thin blood films were prepared for microscopic examination of malaria parasites and identification of species. A malaria parasite count was done to determine the intensity of the infection. A stool wet mount was done to identify STHs. Kato-Katz was done for microscopic quantitative examination of STHs. A complete blood cell count was done to determine hemoglobin level. Socio-demographic data were collected using a questionnaire. Data were analyzed using SPSS version 25. Independent samples t test and one-way analysis of variance were done. Anemia magnitude in this study was 38.3% and it was higher in malaria with multiple STH co-infection groups (55.1%). Malaria parasite density was significantly higher in malaria with multiple STHs co-infected study participants F (2, 318) = 20.075. It increased with the increasing intensity of hookworm, Trichuris trichiura, and several co-infecting helminth species. But it decreased with increasing intensity of Ascaris lumbricoides. The mean hemoglobin concentration of malaria with multiple STHs co-infection study participants was significantly lower than mono malaria-infected and malaria with single STHs co-infection study participants. The management of malaria should take account of STH infections and optimal modalities of treatment should be devised. Anti-helminthic treatments of malaria patients through regular, inexpensive, single-dose, and highly effective drugs must be seriously considered to protect the population from exacerbation of Anemia by intestinal helminth infections.
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Affiliation(s)
- Birhanu Genanew
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Fasil Getu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Jigjiga University, Jijiga, Ethiopia
| | - Muluken Walle
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Jigjiga University, Jijiga, Ethiopia
| | - Asrat Hailu
- Department of Medical Microbiology, Immunology, and Parasitology (DMIP), School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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Maddren R, Anderson RM. Measuring heterogeneities in soil-transmitted helminth transmission and control. Trends Parasitol 2024; 40:45-59. [PMID: 38087679 DOI: 10.1016/j.pt.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/08/2023] [Accepted: 11/08/2023] [Indexed: 01/06/2024]
Abstract
The global effort over the past decade to control soil-transmitted helminths (STH) has resulted in communities with endemic infection reaching low prevalence levels suitable for the validation of elimination as a public health problem (EPHP), defined by the World Health Organisation (WHO) as <2% of infections classified as moderate or heavy intensity. The spatial scale in which this is validated is currently undefined. As the burden of STH infection decreases, the degree of aggregation of infection within individuals in a population increases. Identifying these remaining pockets of infection requires fine-scale monitoring and evaluation (M&E) programmes that are rarely implemented within current national neglected tropical disease (NTD) control. This review examines various heterogeneities that characterise the epidemiology of STH infections, and discusses their impact on control policy formulation.
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Affiliation(s)
- Rosie Maddren
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK.
| | - Roy M Anderson
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
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12
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Gaidhane S, Gaidhane A, Khatib MN, Telrandhe S, Patil M, Saxena D, Bhardwaj P, Choudhari S, Zahiruddin QS. Estimation of the Parasitic Burden of Soil-Transmitted Helminths Among Pregnant Women in the Maharashtra State of India Using qPCR: A Community-Based Study. Indian J Community Med 2024; 49:157-164. [PMID: 38425985 PMCID: PMC10900441 DOI: 10.4103/ijcm.ijcm_249_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 11/01/2023] [Indexed: 03/02/2024] Open
Abstract
Background Soil-transmitted helminth (STH) infections are widespread in developing countries with inadequate sanitation facilities. These infections can lead to malnutrition, anemia, and other complications that can negatively impact both the mother's and fetus's health during pregnancy. This study aimed to estimate the burden of STH by Kato-Katz microscopy and quantitative polymerase chain reaction (qPCR) in pregnant women from rural India. The diagnostic accuracy of these two methods was also compared. Material and Methods A community-based cross-sectional study was conducted in rural areas of Wardha district of Maharashtra state. We randomly selected and interviewed 688 pregnant women. A total of 534 (77.61%) participants gave stool samples. Two containers (60 mL) labeled with a unique identification number were given to pregnant women to collect stool samples for Kato-Katz microscopy and qPCR. Stool specimens were transported to an accredited lab and examined within 24 hours. Suitable examinations were conducted to compare sensitivity between two tests. Results The results are presented for 534 participants who gave stool samples. The prevalence of any STH by Kato-Katz stool microscopy was 6.55% (95%CI 4.46-12.19), and that by qPCR was 20.41 (95%CI 17.53-29.40). The sensitivity of Kato-Katz microscopy was 29.17% compared to sensitivity of 90.83% by qPCR (P = 0.001). Pregnant women with STH infection have a significantly lower weight gain during pregnancy, and the majority were either mild or moderate anemic compared to those without STH. Conclusion The study highlighted significant differences in prevalence of STH among pregnant women by Kato-Katz microscopy and qPCR. The sensitivity of qPCR for detecting STH was higher than that of Kato-Katz microscopy.
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Affiliation(s)
- Shilpa Gaidhane
- Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Abhay Gaidhane
- Centre of One Health, School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Mahalaqua Nazli Khatib
- Global Evidence Synthesis Initiative, Division of Evidence Synthesis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Shital Telrandhe
- Global Health Academy, Centre of Early Childhood Development - Stepping Stones Project, Wardha, Maharashtra, India
| | - Manoj Patil
- Global Health Consortium Public Health and Research, School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Deepak Saxena
- i Health Consortium, Department of Epidemiology, Indian Institute of Public Health, Gandhinagar, Gujarat, India
| | - Pankaj Bhardwaj
- School of Public Health (SPH), Department of Community Medicine and Family Medicine, AIIMS, Jodhpur, Rajasthan, India
| | - Sonali Choudhari
- School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
| | - Quazi S. Zahiruddin
- South Asia Infant Feeding Research Network (SAIFRN), School of Epidemiology and Public Health, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
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13
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Iqbal S, Abid J, Akram S, Shah HBU, Farooq U, Ahmad AMR. Zinc status or supplementation and its relation to soil-transmitted helminthiasis in children: A systematic review. Parasite Immunol 2024; 46:e13015. [PMID: 37846743 DOI: 10.1111/pim.13015] [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: 06/01/2023] [Revised: 09/19/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023]
Abstract
Soil-transmitted helminths (STHs) parasitic infection is known as one of the most common infections around the world affecting more than a quarter of the world's population. The relationship between STH infections and micronutrient deficiencies are closely related and often coexist among the affected population. The study, therefore, aimed to summarise the available literature focusing on the effect of zinc status/deficiency or supplementation on STH infection or reinfection in children. For this purpose, we adopted a systematic approach and searched the existing literature on PubMed, Scopus, and Cochrane Library databases. A search term was entered to retrieve the available data. A total of 12 articles were included in this review after applying the inclusion/exclusion criteria. Most of the included studies reported a lower zinc status in children affected with any parasitic infection. Regarding the effect of zinc status and supplementation on parasitic infection in children, we found only a few studies (n = 4) with inconsistent result findings. This review reported that children infected with STH have lower zinc levels; however, a limited number of studies showed the effect of zinc supplements on the risk of STH warrants the need for further studies in this regard.
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Affiliation(s)
- Sehar Iqbal
- College of Pharmacy, Al-Ain University, Abu Dhabi, United Arab Emirates
| | - Juweria Abid
- Department of Nutrition & Dietetics, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Sajeela Akram
- Department of Human Nutrition & Dietetics, University of Chakwal, Chakwal, Pakistan
| | | | - Umar Farooq
- Department of Nutrition & Dietetics, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Abdul Momin Rizwan Ahmad
- Department of Nutrition & Dietetics, National University of Medical Sciences, Rawalpindi, Pakistan
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Mazigo HD, Justine NC, Bhuko J, Rubagumya S, Basinda N, Zinga MM, Ruganuza D, Misko VR, Briet M, Legein F, De Malsche W. High Specificity but Low Sensitivity of Lab-on-a-Disk Technique in Detecting Soil-Transmitted Helminth Eggs among Pre- and School-Aged Children in North-Western Tanzania. Trop Med Infect Dis 2023; 9:5. [PMID: 38276635 PMCID: PMC10818991 DOI: 10.3390/tropicalmed9010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
An estimated 1.5 billion people are infected with soil-transmitted helminths (hookworms, Ascaris lumbricoides and Trichuris trichiura). These infections are targeted for elimination by the World Health Organization (WHO) by 2030, with the main interventions being mass drug administration using albendazole or mebendazole. Tanzania is one of the endemic countries; it has been implementing MDA to school-aged children for more than a decade and the infection prevalence and intensity of infection have declined. Thus, at this point, the monitoring and evaluation of infection prevalence and intensity of infections, and assessing drug efficacy is crucial and requires accurate diagnostic tests. The currently used standard diagnostic test, the Kato-Katz (KK) technique, has several limitations and the WHO is calling for the development and evaluation of new diagnostic tests. The Lab-on-a-disk (LOD) was developed and tested in the endemic areas of north-western Tanzania to evaluate its sensitivity and specificity using KK and the formol-ether concentration technique. The results showed that when using a duplicate KK slide, the LOD had a sensitivity and specificity of 37.2% (95% CI: 30.7-43.9) and 67.3% (95% CI: 63.1-71.3%). Using four KK slides as a standard technique, the overall sensitivity and specificity were 37.7% (95% CI: 33.1-42.6) and 70.7% (95% CI: 65.5-75.6). The LOD attained high specificity but low sensitivity especially in detecting eggs of Trichuris trichiura. The LOD technique has potential as a promising diagnostic test, but its sensitivity still requires improvement.
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Affiliation(s)
- Humphrey D. Mazigo
- Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (N.C.J.); (J.B.); (M.M.Z.); (D.R.)
| | - Nyanda C. Justine
- Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (N.C.J.); (J.B.); (M.M.Z.); (D.R.)
| | - Jeffer Bhuko
- Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (N.C.J.); (J.B.); (M.M.Z.); (D.R.)
| | - Sarah Rubagumya
- Department of Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, Chuo Kikuu, Morogoro P.O. Box 3000, Tanzania;
| | - Namanya Basinda
- Department of Community Medicine, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
| | - Maria M. Zinga
- Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (N.C.J.); (J.B.); (M.M.Z.); (D.R.)
| | - Deodatus Ruganuza
- Department of Medical Parasitology and Entomology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (N.C.J.); (J.B.); (M.M.Z.); (D.R.)
| | - Vyacheslav R. Misko
- µFlow Group, Department of Bioengineering Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (V.R.M.); (M.B.); (F.L.)
| | - Matthieu Briet
- µFlow Group, Department of Bioengineering Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (V.R.M.); (M.B.); (F.L.)
| | - Filip Legein
- µFlow Group, Department of Bioengineering Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (V.R.M.); (M.B.); (F.L.)
| | - Wim De Malsche
- µFlow Group, Department of Bioengineering Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (V.R.M.); (M.B.); (F.L.)
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Bradbury RS, Martin L, Malloch L, Martin M, Williams JM, Patterson K, Sanders C, Singh G, Arguello I, Rodriguez E, Byers P, Haynie L, Qvarnstrom Y, Hobbs CV. Surveillance for Soil-Transmitted Helminths in High-Risk County, Mississippi, USA. Emerg Infect Dis 2023; 29:2533-2537. [PMID: 37987591 PMCID: PMC10683803 DOI: 10.3201/eid2912.230709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
Recent reports of hookworm infection in Alabama, USA, has prompted surveillance in Mississippi, given the states' similar environmental conditions. We collected stool specimens from 277 children in Rankin County, Mississippi. Kato-Katz microscopic smear, agar plate culture, and quantitative PCR indicated no soil-transmitted helminths. Nevertheless, further surveillance in other high-risk Mississippi counties is warranted.
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Poole C, Barker T, Bradbury R, Capone D, Chatham AH, Handali S, Rodriguez E, Qvarnstrom Y, Brown J. Cross-Sectional Study of Soil-Transmitted Helminthiases in Black Belt Region of Alabama, USA. Emerg Infect Dis 2023; 29:2461-2470. [PMID: 37987581 PMCID: PMC10683802 DOI: 10.3201/eid2912.230751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
We conducted a cross-sectional study to determine the prevalence of soil-transmitted helminthiases (STH) in areas of rural Alabama, USA, that have sanitation deficits. We enrolled 777 children; 704 submitted stool specimens and 227 a dried blood spot sample. We microscopically examined stool specimens from all 704 children by using Mini-FLOTAC for helminth eggs. We tested a subset by using molecular techniques: real-time PCR analysis for 5 STH species, TaqMan Array Cards for enteric helminths, and digital PCR for Necator americanus hookworm. We analyzed dried blood spots for Strongyloides stercoralis and Toxocara spp. roundworms by using serologic testing. Despite 12% of our cohort reporting living in homes that directly discharge untreated domestic wastewater, stool testing for STH was negative; however, 5% of dried blood spots were positive for Toxocara spp. roundworms. Survey data suggests substantial numbers of children in this region may be exposed to raw sewage, which is itself a major public health concern.
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Sprecher VP, Coulibaly JT, Hürlimann E, Hattendorf J, Keiser J. Efficacy and Safety of Moxidectin-Albendazole and Ivermectin-Albendazole Combination Therapy Compared to Albendazole Monotherapy in Adolescents and Adults Infected with Trichuris trichiura: A Randomized, Controlled Superiority Trial. Clin Infect Dis 2023; 77:1294-1302. [PMID: 37357904 DOI: 10.1093/cid/ciad387] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/18/2023] [Accepted: 06/21/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND The currently recommended benzimidazole monotherapy is insufficiently effective to control infection with the soil-transmitted helminth Trichuris trichiura. Ivermectin-albendazole combination has shown promising, but setting-dependent efficacy, with therapeutic underperformance in Côte d'Ivoire. We evaluated whether moxidectin-albendazole could serve as an alternative to albendazole monotherapy in Côte d'Ivoire. METHODS In this community-based, randomized, placebo-controlled, parallel-group superiority trial, individuals aged 12-60 years were screened for T. trichiura eggs in their stool using quadruplicate Kato-Katz thick smears. Diagnostically and clinically eligible participants were randomly assigned (1:1:1) to receive single oral doses of moxidectin (8 mg) and albendazole (400 mg), ivermectin (200 µg/kg) and albendazole (400 mg), or albendazole (400 mg) and placebo. The primary outcome was proportion cured, ie, cure rate (CR), assessed at 2-3 weeks post-treatment. Safety endpoints were assessed pre-treatment and at 3 and 24 hours post-treatment. RESULTS For the 210 participants with primary outcome data, we observed CRs of 15.3% in the moxidectin-albendazole arm and 22.5% in the ivermectin-albendazole arm, which did not differ significantly from the CR of 13.4% in the albendazole arm (differences: 1.8%-points [95% confidence interval: -10.1 to 13.6] and 9.1%-points [-3.9 to 21.8], respectively). Most common adverse events were abdominal pain (range across arms: 11.9%-20.9%), headache (4.7%-14.3%), and itching (5.8%-13.1%), which were predominantly mild and transient. CONCLUSIONS All therapies showed similar low efficacy in treating trichuriasis in Côte d'Ivoire. Alternative treatment options need to be evaluated, and further analyses should be conducted to understand the lack of enhanced activity of the combination therapies in Côte d'Ivoire. CLINICAL TRIALS REGISTRATION NCT04726969.
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Affiliation(s)
- Viviane P Sprecher
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jean T Coulibaly
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Eveline Hürlimann
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jan Hattendorf
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Candela E, Goizueta C, Sandon L, Muñoz-Antoli C, Periago MV. The Relationship Between Soil-Transmitted Helminth Infections and Environmental Factors in Puerto Iguazú, Argentina: Cross-Sectional Study. JMIR Public Health Surveill 2023; 9:e41568. [PMID: 37934580 PMCID: PMC10664009 DOI: 10.2196/41568] [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: 07/31/2022] [Revised: 07/26/2023] [Accepted: 09/19/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Soil-transmitted helminths (STHs) are widely distributed throughout the world. Various factors, including the environment, socioeconomic characteristics, and access to water and sanitation, play an important role in the spread and persistence of these parasites within communities. They, in turn, affect the growth and development of members of the community, especially children. Studies in the northern provinces of Argentina have shown variable prevalence of STHs, but the factors associated with their presence have not been completely elucidated. OBJECTIVE This cross-sectional study aimed to identify the socioeconomic and environmental factors related to STH infection in indigenous villages located in Puerto Iguazú (Misiones), Argentina. METHODS Between 2018 and 2019, stool samples were collected from individuals ≥1 year residing in 3 villages: Mini-Marangatú, Yriapú, and Fortín Mbororé. Standard parasitological methods were used to determine STH prevalence. Standardized questionnaires were used to assess participants' habits, customs, and household characteristics, and environmental data were obtained through satellite imagery. Multilinear regression with Akaike information criterion stepwise variables was used to explore relevant associations. RESULTS A total of 342 individuals from the 3 villages participated in this study. The prevalence of STHs varied across villages: 89.6% (43/48), in Mini-Marangatú, 80.8% (101/125) in Yriapú, and 68.5% (115/169) in Fortín Mbororé. Notably, there was a significant difference in hookworm infection among the villages (P=.02). The analysis highlighted the significant influence of specific environmental factors on STH presence and spatial distribution, particularly in relation to hookworm infection. Vegetation patterns represented by the Vegetation Heterogeneity Index, created ad hoc for this study, emerged as a critical factor, with 2 significant predictors related to it (P=.002 and P=.004) alongside impervious surface density with a significant predictor (P<.001). The multilinear regression model yielded a high F test score (F108=4.75, P<.001), indicating a strong fit (R2=0.5465). Furthermore, socioeconomic factors, including walking barefoot in houses with dirt floors and overcrowding, were significantly correlated with hookworm infection intensity (P<.001 and P=.001, respectively). We also used the multilinear regression model to calculate hookworm infection intensity (F110=21.15, P<.001; R2=0.4971). CONCLUSIONS Our study underscores the complexity of STH transmission, as villages with similar living conditions and environmental characteristics displayed varied STH prevalence and spatial distribution. Specific environmental factors, such as vegetation pattern and impervious surface density, played major roles in STH presence, demonstrating the crucial relationship between environmental factors and hookworm infection distribution. Moreover, our findings emphasize the significant influence of socioeconomic factors on hookworm infection intensity. By gaining insights into this complex interplay, our research contributes to a better understanding of STH transmission characteristics, thereby informing targeted public health interventions for effective control.
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Affiliation(s)
- Ernesto Candela
- Department of Pharmacy Pharmaceutical Technology and Parasitology, Universitat de València, Burjassot, Spain
| | | | | | - Carla Muñoz-Antoli
- Department of Pharmacy Pharmaceutical Technology and Parasitology, Universitat de València, Burjassot, Spain
| | - Maria Victoria Periago
- Mundo Sano Foundation, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
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Meleko A, Turgeman DB, Caplan N, Baum S, Zerai NK, Zaadnoordijk W, Bruck M, Sabar G, Bentwich Z, Golan R. High prevalence of soil-transmitted helminths and schistosomiasis among primary schoolchildren in Southwest Ethiopia: the need for health strategies alongside mass drug administration. Int Health 2023:ihad083. [PMID: 37935041 DOI: 10.1093/inthealth/ihad083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/24/2023] [Accepted: 09/01/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Soil-transmitted helminths (STH) and schistosomiasis remain widely prevalent in Ethiopia. The aim of this study was to evaluate the prevalence of STH and schistosomiasis among schoolchildren in Gidi Bench district (Southern Nations, Nationalities, and People's Republic, Southwest Ethiopia) and the association with knowledge and health-related behaviors. METHODS A cross-sectional study was conducted. Stool samples, analyzed by the Kato-Katz technique and a knowledge, attitudes and practices questionnaire, were collected. RESULTS Out of 611 participants (mean age 12.8±3.1 y), 129 (21.1%) were infected with schistosomiasis and 382 (62.5%) had STH. More than 30% (n=195, 31.9%) were infected with a single intestinal parasite, while 138 (22.6%) and 47 (7.7%) were infected with two or three parasitic infections, respectively. Boys and those who did not participate in school clubs had higher infection rates (p=0.05). Lower parasitic infection was associated with using a latrine when available, washing hands and vegetables and wearing shoes regularly. Higher rates of infection were found among those who reported swimming and washing cloths and utensils in the river regularly. CONCLUSIONS Schistosomiasis and STH were highly prevalent among schoolchildren in Gidi Bench district. Infection rates were associated with gender, lack of knowledge on parasitic infections and unhealthy behaviors. Findings from this study may assist in decision making regarding disease prevalence and methods of control alongside mass drug administration.
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Affiliation(s)
- Asrat Meleko
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
- Department of Public Health, Mizan Tepi University College of Medicine and Health Sciences, Tepi, 5160, Ethiopia
| | | | - Naomi Caplan
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
| | - Sarit Baum
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
| | | | | | - Michal Bruck
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
| | - Galia Sabar
- The Department of Middle Eastern and African History, Tel Aviv University, Tel Aviv-Yafo P.O. Box 39040, Israel
| | - Zvi Bentwich
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
- Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev, Beer Sheva P.O. Box 653, Israel
| | - Rachel Golan
- NALA, Carlebach 29, Tel Aviv-Yafo 6713224, Israel
- Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer Sheva P.O. Box 653, Israel
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Collyer BS, Truscott JE, Mwandawiro CS, Njenga SM, Anderson RM. How important is the spatial movement of people in attempts to eliminate the transmission of human helminth infections by mass drug administration? Philos Trans R Soc Lond B Biol Sci 2023; 378:20220273. [PMID: 37598700 PMCID: PMC10440163 DOI: 10.1098/rstb.2022.0273] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/02/2023] [Indexed: 08/22/2023] Open
Abstract
Human mobility contributes to the spatial dynamics of many infectious diseases, and understanding these dynamics helps us to determine the most effective ways to intervene and plan surveillance. In this paper, we describe a novel transmission model for the spatial dynamics of hookworm, a parasitic worm which is a common infection across sub-Saharan Africa, East Asia and the Pacific islands. We fit our model, with and without mobility, to data obtained from a sub-county in Kenya, and validate the model's predictions against the decline in prevalence observed over the course of a clustered randomized control trial evaluating methods of administering mass chemotherapy. We find that our model which incorporates human mobility is able to reproduce the observed patterns in decline of prevalence during the TUMIKIA trial, and additionally, that the widespread bounce-back of infection may be possible over many years, depending on the rates of people movement between villages. The results have important implications for the design of mass chemotherapy programmes for the elimination of human helminth transmission. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'.
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Affiliation(s)
- Benjamin S. Collyer
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London, London W2 1PG, UK
| | - James E. Truscott
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London, London W2 1PG, UK
| | | | - Sammy M. Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Roy M. Anderson
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London, London W2 1PG, UK
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21
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Bartlett AW, Mendes EP, Dahmash L, Peliganga LB, Lufunda LMM, Direito A, Mwinzi PN, Eulogio P, Lopes S, Nery SV. Knowledge, attitudes, practices and acceptability of a school preventive chemotherapy programme for schistosomiasis and soil-transmitted helminths control in Angola. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220430. [PMID: 37598703 PMCID: PMC10440166 DOI: 10.1098/rstb.2022.0430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 06/28/2023] [Indexed: 08/22/2023] Open
Abstract
Schistosomiasis and soil-transmitted helminth (STH) control programs require target population engagement, assessed through knowledge, attitudes and practices (KAP) surveys. We report the results of a KAP survey of Angolan schoolchildren supported by a school preventive chemotherapy (PC) programme, without or with a school water, sanitation and hygiene (WASH) programme (PC+/WASH- and PC+/WASH+, respectively); and schoolchildren without a school PC or WASH program (PC-/WASH-). Schoolchildren from PC+/WASH- (N = 218), PC+/WASH+ (N = 250) and PC-/WASH- (N = 254) schools were interviewed. Descriptive statistics were used to report demographics and survey responses. Chi-square or Fisher's exact test was used to compare PC+/WASH- schoolchildren with (i) PC+/WASH+ and (ii) PC-/WASH- schoolchildren. A lower proportion of PC+/WASH- schoolchildren used latrines and a higher proportion practised open defecation at school compared with PC+/WASH+ schoolchildren. A lower proportion of PC+/WASH- schoolchildren always washed their hands after toileting and before meals at school compared with PC+/WASH+ schoolchildren. However, the PC+/WASH- schoolchildren reported better toileting and handwashing practices at school compared to PC-/WASH- schoolchildren. Over 90% of PC+ schoolchildren agreed with schistosomiasis and STH control and accepted schoolteacher PC delivery. Expanding the integration of both school PC and WASH programs will improve health behaviours relevant to reduce the risk of schistosomiasis and STHs in schoolchildren. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'.
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Affiliation(s)
- Adam W. Bartlett
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia, 2052
| | - Elsa P. Mendes
- National Directorate of Public Health, Ministry of Health, Luanda, Angola
| | | | - Luis B. Peliganga
- National Directorate of Public Health, Ministry of Health, Luanda, Angola
| | | | | | - Pauline N. Mwinzi
- Expanded Special Project for Elimination of Neglected Tropical Diseases, Brazzaville, Congo
| | - Pablo Eulogio
- National Directorate of Public Health, Ministry of Health, Luanda, Angola
| | - Sergio Lopes
- National Directorate of Public Health, Ministry of Health, Luanda, Angola
| | - Susana Vaz Nery
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia, 2052
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Halwiindi H, Chooka L, Phiri MM, Tapisha B, Masenga SK, Mudenda J, Chimfwembe K, Mugode M, Hamooya BM. Reach and uptake of mass drug administration for worm infections through health facility-, school-, and community-based approaches in two districts of Zambia: a call for scale-up. Epidemiol Infect 2023; 151:e183. [PMID: 37288508 PMCID: PMC10644052 DOI: 10.1017/s0950268823000912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 05/11/2023] [Accepted: 05/31/2023] [Indexed: 06/09/2023] Open
Abstract
Helminthiases cause significant health deficiencies among children. Mass administration of anthelminthic drugs has had significant results to counter these effects. We assessed the effects on and determinants of treatment coverage of community-directed treatment among children in Zambia, using cross-sectional survey data, and using chi-square test and multilevel mixed-effects model. Of 1,416 children, 51.5% were males and 48.5% were females, while 52.7%, were school-age, and 47.3% were preschool-age. Overall treatment coverage was 53.7% (95% confidence interval (CI) 51.1, 56.4). More preschool-age children were treated compared to school-age ones, 65.2% versus 43.4%, P < 0.001. Similarly, more children under community-directed intervention were treated compared to regular mass drug administration (65.2% versus 51.1 %, P < 0.001). Treatment among school-age participants was associated with being male (Adjusted Odds Ratio (AOR 1.83, 95%CI 1.23-2.72), receiving community-directed treatment (AOR 5.53; 95%CI 3.41-8.97), and shorter distance to health facility (AOR 2.20; 95%CI 1.36-3.56). Among preschool-aged participants, treatment was associated with being residents of Siavonga district (AOR 0.03; 95%CI 0.01-0.04) and shorter distance to health facility (AOR 0.35; 95%CI 0.21-0.59). Community-directed treatment can be used to increase treatment coverage, thereby contribute to 2030 vision of ending epidemics of neglected tropical diseases.
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Affiliation(s)
| | - Lubombo Chooka
- School of Public Health, University of Zambia, Lusaka, Zambia
| | - Masauso Moses Phiri
- School of Medicine, Department of Pathology and Microbiology, University of Zambia, Lusaka, Zambia
| | - Buumba Tapisha
- School of Public Health, University of Zambia, Lusaka, Zambia
| | - Sepiso K. Masenga
- School of Medicine and Health Sciences, Mulungushi University, Livingstone, Zambia
| | - Jolezya Mudenda
- School of Medicine, Department of Pathology and Microbiology, University of Zambia, Lusaka, Zambia
| | | | - Mwitwa Mugode
- School of Public Health, University of Zambia, Lusaka, Zambia
| | - Benson M. Hamooya
- School of Medicine and Health Sciences, Mulungushi University, Livingstone, Zambia
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Rayment Gomez S, Maddren R, Liyew EF, Chernet M, Anjulo U, Tamiru A, Mengitsu B, Forbes K, Collyer B, Salasibew M, Anderson R. Predisposition to soil-transmitted helminth reinfection after four rounds of mass drug administration: results from a longitudinal cohort in the Geshiyaro project, a transmission elimination feasibility study in the Wolaita zone of southern Ethiopia. Trans R Soc Trop Med Hyg 2023:7080902. [PMID: 36939014 DOI: 10.1093/trstmh/trad007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/01/2023] [Accepted: 02/23/2023] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND Current WHO strategies for reaching soil-transmitted helminths (STH) elimination as a public health problem excludes treating certain adult populations in endemic areas, creating infection reservoirs that drive 'bounce back' of STH infection to pretreatment levels post-mass drug administration (MDA). Predisposition is a widespread, but poorly understood phenomena among helminth infections where individuals are predisposed to reinfection after repeated treatments. METHODS This analysis uses Geshiyaro project data, an STH control programme exploring transmission interruption by community-wide MDA and enhanced water, sanitation and hygiene during 2019-2023. Parasitological survey data from longitudinal cohorts are analysed using Kendall's Tau-b rank correlation to assess the evidence for predisposition to light or heavy infection between four consecutive rounds of MDA. RESULTS Correlation analyses revealed the strongest evidence for predisposition to heavy or light Ascaris lumbricoides infection was between survey 1 and 2 (Tau-b 0.29; p<0.001). Overall patterns were not observed for Trichuris trichiura or hookworm infections, however, some significant and notable correlations were recorded for some stratifications and time points. CONCLUSIONS Evidence for predisposition in endemic settings in southern Ethiopia with low STH prevalence suggests that more targeted approaches to MDA in those predisposed to infection may be a sensible control strategy if cheap, point of care diagnostics are available.
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Affiliation(s)
- Santiago Rayment Gomez
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London W2 1NY, UK
| | - Rosie Maddren
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London W2 1NY, UK
| | - Ewnetu Firdawek Liyew
- Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ayat Zone 8, Ethiopia
| | - Melkie Chernet
- Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ayat Zone 8, Ethiopia
| | - Ufaysa Anjulo
- Disease Prevention and Health Promotion Core Process, Ministry of Health, Wolaita, Ethiopia
| | - Adugna Tamiru
- Disease Prevention and Health Promotion Core Process, Ministry of Health, Wolaita, Ethiopia
| | - Birhan Mengitsu
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London W2 1NY, UK
| | - Kathryn Forbes
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London W2 1NY, UK
| | - Benjamin Collyer
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London W2 1NY, UK
| | | | - Roy Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London W2 1NY, UK
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Alade T, Ta-Tang TH, Nassar SA, Akindele AA, Capote-Morales R, Omobami TB, Berzosa P. Prevalence of Schistosoma haematobium and Intestinal Helminth Infections among Nigerian School Children. Diagnostics (Basel) 2023; 13. [PMID: 36832247 DOI: 10.3390/diagnostics13040759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/03/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
Schistosomiasis and soil-transmitted helminthiases (STH) are two parasitic diseases mainly affecting school children. The purpose of this study was to estimate the current prevalence and infection intensity, in addition to the associations of these infections with age and sex, in children aged 4-17 years living in Osun State, Nigeria. From each participant (250 children), one urine and one stool sample were taken for the study, for the microscopic detection of eggs or larvae in faeces by means of the Kato-Katz method and eggs in filtrated urine. The overall prevalence of urinary schistosomiasis was 15.20%, with light infection. The intestinal helminthic species identified (and their prevalence) were S. stercoralis (10.80%), S. mansoni (8%), A. lumbricoides (7.20%), hookworm (1.20%), and T. trichiura (0.4%), all of them being classified as light infections. Single infections (67.95%) are more frequent than multiple infections (32.05%). With this study, schistosomiasis and STH are still endemic in Osun State, but with a light to moderate prevalence and light infection intensity. Urinary infection was the most prevalent, with higher prevalence in children over 10 years. The >10 years age group had the highest prevalence for all of the intestinal helminths. There were no statistically significant associations between gender and age and urogenital or intestinal parasites.
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Kabatende J, Barry A, Mugisha M, Ntirenganya L, Bergman U, Bienvenu E, Aklillu E. Efficacy of Single-Dose Albendazole for the Treatment of Soil-Transmitted Helminthic Infections among School Children in Rwanda-A Prospective Cohort Study. Pharmaceuticals (Basel) 2023; 16:139. [PMID: 37259291 PMCID: PMC9964298 DOI: 10.3390/ph16020139] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 09/13/2023] Open
Abstract
Mass drug administration (MDA) of single-dose albendazole to all at-risk populations as preventive chemotherapy (deworming) is recommended by WHO to halt transmission of soil-transmitted helminth (STH) in endemic countries. We assessed the effectiveness of single-dose albendazole against STH infection in the western province of Rwanda, where STH prevalence remains high despite the implementation of preventive chemotherapy for over a decade. Two weeks before the scheduled MDA, 4998 school children (5-15 years old) were screened for STH infections (Ascaris lumbricoides, Trichuris trichiura, and hookworm), and 1526 children who tested positive for at least one type of STH parasite were enrolled and received single-dose albendazole (400 mg) through MDA. A follow-up stool exam was performed at three weeks post-treatment using Kato-Katz. Efficacy was assessed by cure rate (CR), defined as the proportion of children who became egg-free, and egg reduction rates (ERRs) at three weeks post-treatment. The CR and ERR for hookworms (CR = 96.7%, ERR = 97.4%) was above, and for Ascaris lumbricoides (CR = 95.1%, ERR = 94.6%) was borderline compared with the WHO efficacy threshold (CR and ERR ≥ 95%). However, the CR and ERR for T. trichiura (CR = 17.6% ERR = 40.3%) were below the WHO threshold for efficacy (CR and ERR ≥ 50%). Having moderate-to-heavy infection intensity and coinfection with another type of STH parasites were independent risk factors for lower CR and ERR against Trichirus trichiura (p < 0.001). Single-dose albendazole used in the MDA program is efficacious for the treatment and control for hookworms and Ascaris lumbricoides infections but not effective for Trichirus trichiura. An alternative treatment regimen is urgently needed to prevent, control, and eliminate STH as a public health problem.
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Affiliation(s)
- Joseph Kabatende
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, 14186 Stockholm, Sweden
| | - Abbie Barry
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, 14186 Stockholm, Sweden
| | - Michael Mugisha
- College of Medicine and Health Sciences, University of Rwanda, KK 737, Kigali P.O. Box 4285, Rwanda
| | - Lazare Ntirenganya
- Rwanda Food and Drugs Authority, Nyarutarama Plaza, KG 9 Avenue, Kigali P.O. Box 1948, Rwanda
| | - Ulf Bergman
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, 14186 Stockholm, Sweden
| | - Emile Bienvenu
- Rwanda Food and Drugs Authority, Nyarutarama Plaza, KG 9 Avenue, Kigali P.O. Box 1948, Rwanda
| | - Eleni Aklillu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, 14186 Stockholm, Sweden
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Ellwanger JH, Cavallero S. Editorial: Soil-transmitted helminth infections from a One Health perspective. Front Med (Lausanne) 2023; 10:1167812. [PMID: 37113612 PMCID: PMC10126391 DOI: 10.3389/fmed.2023.1167812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Affiliation(s)
- Joel Henrique Ellwanger
- Laboratory of Immunobiology and Immunogenetics, Postgraduate Program in Genetics and Molecular Biology (PPGBM), Department of Genetics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- *Correspondence: Joel Henrique Ellwanger
| | - Serena Cavallero
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
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Muacevic A, Adler JR, S M, K V, Mathew T, SS M. Prevalence of Geohelminthic Infection and Its Risk Factors Among School Children in Thiruvananthapuram, Kerala, India. Cureus 2023; 15:e34116. [PMID: 36843715 PMCID: PMC9946816 DOI: 10.7759/cureus.34116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 01/25/2023] Open
Abstract
Introduction Geohelminthic infections are the most common infections worldwide and affect the poorest and most deprived communities. School-age children typically have the highest intensity of worm infection. Currently, information on the prevalence of geohelminthic infestations among schoolchildren is scarce in Kerala. As a result, it would be worthwhile to investigate the prevalence and risk factors of a geohelminthic infestation among schoolchildren in Kerala's Thiruvananthapuram district. Materials and methods A community-based cross-sectional study was conducted among 454 primary school children (5-10 years) in the Thiruvananthapuram district. Samples were selected by stratified multi-stage sampling, and the data were collected using a pre-tested, semi-structured questionnaire. The stool examination was performed for each study subject, and the data were recorded. Results The overall prevalence of geohelminthic infections was 9.69% (95% confidence interval: 5.62-14.61), with Ascaris (A.) lumbricoides accounting for 5.7%, Trichuris (T.) trichiura accounting for 3.3%, and hookworm accounting for 0.7%. Children residing in rural areas (odds ratio (OR): 40.16; 95% confidence interval (CI): 5.28-305.3), studying in government schools (OR: 3.06 with 95% CI: 1.55-6.05), and using piped water as a source of drinking water (OR: 1.96; 95% CI: 1.01-3.77) were found to be significant and had emerged as risk factors for geohelminthic infestation. Children wearing footwear while playing outside (OR: 0.77; 95% CI: 0.39-1.5) and having personal hygiene class in school (OR: 0.34; 95% CI: 0.14-0.83) were found to be significant and had emerged as protective factors for geohelminthic infestations. Conclusion The prevalence of geohelminthic infestations among schoolchildren in this study was 9.7%. The individual species prevalence of A. lumbricoides, T. trichiura, and hookworm were 5.7%, 3.3%, and 0.7%, respectively. In addition to geohelminthic infestation, this study discovered a prevalence of 0.9% with Enterobius vermicularis. The factors found to be significantly associated with geohelminthic infestation after doing multivariate analysis were children belonging to government schools, residing in rural areas, and using piped water as a source of drinking water.
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28
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Miswan N, Singham GV, Othman N. Advantages and Limitations of Microscopy and Molecular Detections for Diagnosis of Soil-transmitted Helminths: An Overview. Helminthologia 2022; 59:321-40. [PMID: 36875683 DOI: 10.2478/helm-2022-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 10/31/2022] [Indexed: 02/05/2023] Open
Abstract
World Health Organization (WHO) reported that over 1.5 billion people are infected by soil-transmitted helminths (STH) worldwide in sub-Saharan Africa, the United States of America, China, and East Asia. Heavy infections and polyparasitism are associated with higher morbidity rates, and the patients are exposed to increased vulnerability to other diseases. Therefore, accurate diagnosis followed by mass treatment for morbidity control is necessary.STH diagnosis commonly involves the microscopic observation of the presence of the STH eggs and larvae in the faecal samples. Furthermore, molecular approaches are increasingly utilised in monitoring and surveillance as they show higher sensitivity. Their capability to differentiate hookworm species is an advantage over the Kato-Katz technique. This review discusses the advantages and limitations of microscopy and various molecular tools used for STH detection.
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Ihnacik L, Šmigová J, Šoltys J, Bobíková D, Kuzevičová Ž, Kuzevič Š, Schusterová I, Papajová I. The survey of soil-transmitted helminth species abundance in Slovakia with an emphasis on parameters important for their distribution. Front Med (Lausanne) 2022; 9:1043313. [PMID: 36465912 PMCID: PMC9712972 DOI: 10.3389/fmed.2022.1043313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/03/2022] [Indexed: 01/03/2024] Open
Abstract
Soil-transmitted helminths (STH) can be easily dispensable in socially disadvantaged groups. The Roma people represent the group most at risk in Slovakia. This study aimed to investigate the occurrence of STH infections in minorities living with animals under low hygienic conditions and on contaminated soil. Subsequently, we identified the risk assessment factors of the STH transmissions based on parasitological results. In our study, STHs were predominantly found among the Roma communities living in unsanitary conditions. The prevalence of Ascaris lumbricoides among the majority was 0.79%, and Trichuris trichiura was 0.05 %. On the contrary, a community-based cross-sectional survey across eastern Slovakia also found a prevalence of 22.28 and 3.47% for A. lumbricoides and T. trichiura among the Roma population. Inhabitants that belong to the Roma minority had a 37.12 infection OR times higher than non-Roma inhabitants. The Roma people living in the countryside have a 2.23-fold higher chance of getting infected with STH than Roma living in the city. Therefore, soil and domestic animals were also examined for the presence of the STH eggs to show the environmental burden. In general, the presence of STH eggs was confirmed in 26.26% of the soil examined samples. The detailed description is as follows: eggs of Toxocara spp., Trichuris spp., eggs from the family Ancylostomatidae, and Toxascaris leonina. Ascaris eggs were detected only in the soil from localities with low hygienic standards. The probability of contracting the STH eggs in segregated settlements was 15.94 times higher compared to urban or rural areas. In addition to humans, dogs can also be a source of STH eggs in the soil. The STH eggs were confirmed in 43.55% of dog droppings. The most interesting finding was that the eggs of the genus Ascaris were up to 7.93% of dog droppings from localities with a low hygienic standard were positive. This study revealed that climatic factors and the WASH conditions influenced the distribution of STHs to variable degrees. In addition, ethnicity and sanitation were crucial factors in the distribution of STH infection in eastern Slovakia.
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Affiliation(s)
- Lukáš Ihnacik
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Slovakia
- Department of Public Veterinary Medicine and Animal Welfare, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovakia
| | - Júlia Šmigová
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Slovakia
| | - Jindřich Šoltys
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Slovakia
| | - Diana Bobíková
- Faculty of Mining, Ecology, Process Control, and Geotechnologies, Technical University of Košice, Košice, Slovakia
| | - Žofia Kuzevičová
- Faculty of Mining, Ecology, Process Control, and Geotechnologies, Technical University of Košice, Košice, Slovakia
| | - Štefan Kuzevič
- Faculty of Mining, Ecology, Process Control, and Geotechnologies, Technical University of Košice, Košice, Slovakia
| | - Ingrid Schusterová
- Faculty of Medicine, East Slovak Institute of Cardiovascular Diseases, Košice, Slovakia
| | - Ingrid Papajová
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Slovakia
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Yeung S, Bharwada Y, Bhasker S, Boggild A. Strongyloidiasis: what every gastroenterologist needs to know. Ther Adv Chronic Dis 2022; 13:20406223221137499. [PMID: 36407019 PMCID: PMC9666874 DOI: 10.1177/20406223221137499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/20/2022] [Indexed: 04/28/2024] Open
Abstract
Strongyloidiasis is caused by the intestinal roundworm, Strongyloides stercoralis, which has the potential for fatal outcome. It may present with vague gastrointestinal symptoms and mimic gastrointestinal diseases such as inflammatory bowel disease, and as such, it should be in the purview of the gastroenterologist. While strongyloidiasis is generally asymptomatic or produces mild symptoms in patients with an intact immune system, individuals who are immunocompromised may develop life-threatening disease through hyperinfection syndrome and disseminated disease. The worm has a complex lifecycle and is able to autoinfect its host, thereby allowing indefinite persistence even decades after initial infection. This leads to cases where travelers, and those who lived in endemic countries, may present years after travel. With its features of prolonged infection, relatively high global prevalence, and potential for fatal outcomes, it is imperative for all clinicians to be aware of this disease. Owing to its involvement with the gastrointestinal system, however, we will outline salient points about strongyloidiasis for the gastroenterologist.
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Affiliation(s)
- Sabrina Yeung
- Department of Internal Medicine, McMaster
University, Hamilton, ON, Canada
| | - Yashvi Bharwada
- Department of Internal Medicine, University of
Manitoba, Winnipeg, MB, Canada
| | - Shveta Bhasker
- Institute of Health Policy, Management and
Evaluation, Dalla Lana School of Public Health, University of Toronto,
Toronto, ON, Canada
| | - Andrea Boggild
- Tropical Disease Unit, Division of Infectious
Diseases, Toronto General Hospital, 200 Elizabeth Street, 13EN-218, Toronto,
ON M5G 2C4, Canada
- Department of Medicine, University of Toronto,
Toronto, ON, Canada
- Institute of Medical Science, University of
Toronto, Toronto, ON, Canada
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Koehler S, Springer A, Issel N, Klinger S, Wendt M, Breves G, Strube C. Effects of adult Ascaris suum and their antigens (total and trans-cuticular excretory-secretory antigen, cuticular somatic antigen) on intestinal nutrient transport in vivo. Parasitology 2022; 150:1-34. [PMID: 36274629 PMCID: PMC10090646 DOI: 10.1017/s0031182022001512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/20/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
Ascaris suum constitutes a major problem in commercial pig farming worldwide. Lower weight gains in infected pigs probably result from impaired nutrient absorption. This study investigated intestinal nutrient transport in 4 groups of 6 pigs each, which were inoculated with 30 living adult A. suum , or antigen fractions consisting of (1) total excretory–secretory (ES) antigens of adult worms, (2) ES antigens secreted exclusively from the parasites' body surface (trans-cuticular ES) and (3) cuticular somatic antigens of A. suum , compared to placebo-treated controls. Three days after inoculation into the gastrointestinal tract, glucose, alanine and glycyl-l -glutamine transport was measured in the duodenum, jejunum and ileum using Ussing chambers. Transcription of relevant genes [sodium glucose cotransporter 1 (SGLT1), glucose transporter 1 (GLUT1), GLUT2, hypoxia-inducible factor 1-alpha (Hif1α ), interleukin-4 (IL-4), IL-13, signal transducer and activator of transcription 6 (STAT6), peptide transporter 1 (PepT1)] and expression of transport proteins [SGLT1, phosphorylated SGLT1, GLUT2, Na+/K+-ATPase, amino acid transporter A (ASCT1), PepT1] were studied. Although no significant functional changes were noted after exposure to adult A. suum , a significant downregulation of jejunal GLUT1, STAT6, Hif1α and PepT1 transcription as well as ileal GLUT2 and PepT1 expression indicates a negative impact of infection on transport physiology. Therefore, the exposure period of 3 days may have been insufficient for functional alterations to become apparent. In contrast, A. suum antigens mainly induced an upregulation of transport processes and an increase in transcription of relevant genes in the duodenum and jejunum, possibly as a compensatory reaction after a transient downregulation. In the ileum, a consistent pattern of downregulation was observed in all inoculated groups, in line with the hypothesis of impaired nutrient transport.
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Affiliation(s)
- Sarina Koehler
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Andrea Springer
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Nicole Issel
- Institute for Physiology and Cell Biology, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Stefanie Klinger
- Institute for Physiology and Cell Biology, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Michael Wendt
- Clinic for Swine, Small Ruminants, Forensic Medicine and Ambulatory Service, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Gerhard Breves
- Institute for Physiology and Cell Biology, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Christina Strube
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Hanover, Germany
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Abstract
Ancylostoma ceylanicum hookworms are zoonotic parasites that can infect humans. To detect autochthonous transmission, we analyzed human fecal samples collected in 2000. Multiparallel quantitative PCR detected infection in persons who had never traveled outside Ecuador. These data indicate human transmission of A. ceylanicum in the Americas, although endemicity remains unknown.
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Zendejas-Heredia PA, Colella V, Macpherson MLA, Sylvester W, Gasser RB, Macpherson CNL, Traub RJ. Ancylostoma ceylanicum Hookworms in Dogs, Grenada, West Indies. Emerg Infect Dis 2022; 28:1870-1872. [PMID: 35997602 PMCID: PMC9423915 DOI: 10.3201/eid2809.220634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Ancylostoma ceylanicum hookworms are recognized agents of human infection in the Asia-Pacific region. We investigated prevalence of zoonotic hookworm infections in dogs in Grenada in 2021; 40.8% were infected by hookworms, including Ancylostoma ceylanicum. Surveillance of this parasite in dogs and humans is needed in tropical/subtropical countries in the Americas.
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Affiliation(s)
| | - Vito Colella
- These authors contributed equally to this article
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34
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Donkoh ET, Berkoh D, Fosu-Gyasi S, Boadu WIO, Raji AS, Asamoah S, Otabil KB, Otoo JE, Yeboah MT, Aganbire BA, Adobasom-Anane AG, Adams SK, Debrah O. Evidence of reduced academic performance among schoolchildren with helminth infection. Int Health 2022; 15:309-317. [PMID: 35713982 PMCID: PMC9384326 DOI: 10.1093/inthealth/ihac044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/18/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background Soil-transmitted helminths (STHs) pose a formidable health risk to school-age children in resource-limited settings. Unfortunately, mass deworming campaigns have been derailed since the onset of the coronavirus disease 2019 pandemic. The present study assessed the cross-sectional associations between STHs, nutritional status and academic performance of schoolchildren in the Banda District of Ghana. Methods Schoolchildren (5–16 y of age; n=275) were recruited through both school and household visits by community health workers using a multistage cluster sampling technique. In addition to school microscopy, anthropometric records were also taken. Results The prevalence of geohelminthiasis was 40.4% (95% confidence interval 34.6 to 46.2). STHs targeted for elimination by the World Health Organization and national programmes were detected among schoolchildren. Children with intestinal parasite infection (53.7 [standard deviation {SD} 11.5]) had lower mean academic scores compared with uninfected children (59.6 [SD 16.9]) (p=0.034). In multiple regression analysis, intestinal parasite infection status and z-scores for weight-for-age showed a collective significant effect on the academic score (F1117=8.169, p<0.001, R2=0.125). Conclusions Schoolchildren with STHs had poorer academic performance compared with uninfected children, despite their nutritional status. In addition to school feeding programmes, school-based mass drug administration campaigns may be critical for improving learning outcomes in young schoolchildren.
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Affiliation(s)
- Emmanuel T Donkoh
- Screen and Treat Research Group, Center for Research in Applied Biology, University of Energy and Natural Resources, Sunyani, Ghana
| | - Dorice Berkoh
- Screen and Treat Research Group, Center for Research in Applied Biology, University of Energy and Natural Resources, Sunyani, Ghana
| | - Samuel Fosu-Gyasi
- Screen and Treat Research Group, Center for Research in Applied Biology, University of Energy and Natural Resources, Sunyani, Ghana
| | - Wina I Ofori Boadu
- Department of Medical Diagnostics, Faculty of Allied Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Abdul S Raji
- Screen and Treat Research Group, Center for Research in Applied Biology, University of Energy and Natural Resources, Sunyani, Ghana
| | - Samuel Asamoah
- Department of Medical Laboratory Science, University of Energy and Natural Resources, Sunyani, Ghana
| | - Kenneth B Otabil
- Netrodis Research Group, Center for Research in Applied Biology, University of Energy and Natural Resources, Sunyani, Ghana
| | - John E Otoo
- Ghana Health Service, Bono Regional Health Directorate, Sunyani, Ghana
| | - Michael T Yeboah
- Ghana Health Service, Bono Regional Health Directorate, Sunyani, Ghana
| | | | - Austin G Adobasom-Anane
- Screen and Treat Research Group, Center for Research in Applied Biology, University of Energy and Natural Resources, Sunyani, Ghana
| | - Simon K Adams
- Ghana Health Service, Bono Regional Health Directorate, Sunyani, Ghana
| | - Oksana Debrah
- Department of Medical Laboratory Science, University of Cape Coast, Cape Coast, Ghana
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Kura K, Truscott JE, Collyer BS, Phillips A, Garba A, Anderson RM. The observed relationship between the degree of parasite aggregation and the prevalence of infection within human host populations for soil-transmitted helminth and schistosome infections. Trans R Soc Trop Med Hyg 2022; 116:1226-1229. [PMID: 35474017 PMCID: PMC9717363 DOI: 10.1093/trstmh/trac033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Soil-transmitted helminths (STH) and schistosome parasites are highly aggregated within the human population. The probability distribution of worms per person is described well by the negative binomial probability distribution with aggregation parameter, k, which varies inversely with parasite clustering. The relationship between k and prevalence in defined populations subject to mass drug administration is not well understood. METHODS AND RESULTS We use statistical methods to estimate k using two large independent datasets for STH and schistosome infections from India and Niger, respectively, both of which demonstrate increased aggregation of parasites in a few hosts, as the prevalence of infections declines across the dataset. CONCLUSIONS A greater attention needs to be given in monitoring and evaluation programmes to find and treat the remaining aggregates of parasites.
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Affiliation(s)
- Klodeta Kura
- Corresponding author: Tel: +44 (0)20 7594 2755; E-mail:
| | - James E Truscott
- London Centre for Neglected Tropical Disease Research, London W2 1PG, UK,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London, London W2 1PG, UK,MRC Centre for Global Infectious Disease Analysis
| | - Benjamin S Collyer
- London Centre for Neglected Tropical Disease Research, London W2 1PG, UK,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London, London W2 1PG, UK,MRC Centre for Global Infectious Disease Analysis
| | - Anna Phillips
- FHI 360, 1825 Connecticut Avenue NW, Washington DC 20009
| | | | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, London W2 1PG, UK,Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Mary's Campus, Imperial College London, London W2 1PG, UK,MRC Centre for Global Infectious Disease Analysis
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36
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Wangchuk P, Anderson D, Yeshi K, Loukas A. Identification of Small Molecules of the Infective Stage of Human Hookworm Using LCMS-Based Metabolomics and Lipidomics Protocols. ACS Infect Dis 2021; 7:3264-3276. [PMID: 34767348 DOI: 10.1021/acsinfecdis.1c00428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Hookworm infections affect millions of people worldwide and are responsible for impaired mental and physical growth in children, and anemias. There is no vaccine, and increasing anthelmintic drug resistance in nematodes of domestic animals, and reduced drug cure rates in nematode infections of humans is alarming. Despite this looming health problem, there is a significant knowledge gap in terms of nonproteinaceous "excretory/secretory products" (ESPs) and how they orchestrate a parasitic existence. In the current study, we have conducted the first metabolomic and lipidomic analysis of the infective third-stage filariform larvae (L3) of the predominant human hookworm Necator americanus using liquid chromatography-mass spectrometry. Altogether, we have identified a total of 645 small molecules that were mainly produced through amino acid and glycerophospholipid metabolism. Putatively, 495 metabolites were unique to the somatic tissue extract, and 34 metabolites were present only in the ESP component. More than 21 novel mass features with nitrogen and sulfur functional groups were detected in the ESP component for the first time from helminths. While this study could not establish the biological functions of the metabolites identified, literature searches revealed that these metabolites possess various biological properties, including anti-inflammatory activities. These metabolites are likely used by the parasite upon exposure to a host to facilitate skin penetration, passage through different tissues, and immune regulation in the small bowel. Overall, the results presented herein offer significant insight into the metabolome of N. americanus L3 and have the potential to instigate future work to establish biomarkers of infection. This area urgently needs attention, given the lack of sensitive point-of-care diagnostic tools.
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Affiliation(s)
- Phurpa Wangchuk
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Building E4, McGregor Road, Smithfield, Cairns, Queensland 4878, Australia
| | - Dovile Anderson
- Monash Institute of Pharmaceutical Sciences, Monash University, Royal Parade, Parkville, Victoria 3052, Australia
| | - Karma Yeshi
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Building E4, McGregor Road, Smithfield, Cairns, Queensland 4878, Australia
| | - Alex Loukas
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Building E4, McGregor Road, Smithfield, Cairns, Queensland 4878, Australia
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Schneider-Crease IA, Blackwell AD, Kraft TS, Emery Thompson M, Maldonado Suarez I, Cummings DK, Stieglitz J, Snyder-Mackler N, Gurven M, Kaplan H, Trumble BC. Helminth infection is associated with dampened cytokine responses to viral and bacterial stimulations in Tsimane forager-horticulturalists. Evol Med Public Health 2021; 9:349-359. [PMID: 34868595 PMCID: PMC8634526 DOI: 10.1093/emph/eoab035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 10/19/2021] [Indexed: 02/07/2023] Open
Abstract
Background Soil-transmitted helminths (STHs) and humans share long co-evolutionary histories over which STHs have evolved strategies to permit their persistence by downregulating host immunity. Understanding the interactions between STHs and other pathogens can inform our understanding of human evolution and contemporary disease patterns. Methodology We worked with Tsimane forager-horticulturalists in the Bolivian Amazon, where STHs are prevalent. We tested whether STHs and eosinophil levels—likely indicative of infection in this population—are associated with dampened immune responses to in vitro stimulation with H1N1 and lipopolysaccharide (LPS) antigens. Whole blood samples (n = 179) were treated with H1N1 vaccine and LPS and assayed for 13 cytokines (INF-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12p70, IL-13, GM-CSF and TNF-ɑ). We evaluated how STHs and eosinophil levels affected cytokine responses and T helper (Th) 1 and Th2-cytokine suite responses to stimulation. Results Infection with Ascaris lumbricoides was significantly (P ≤ 0.05) associated with lower response of some cytokines to H1N1 and LPS in women. Eosinophils were significantly negatively associated with some cytokine responses to H1N1 and LPS, with the strongest effects in women, and associated with a reduced Th1- and Th2-cytokine response to H1N1 and LPS in women and men. Conclusions and implications Consistent with the ‘old friends’ and hygiene hypotheses, we find that STHs were associated with dampened cytokine responses to certain viral and bacterial antigens. This suggests that STH infections may play an essential role in immune response regulation and that the lack of STH immune priming in industrialized populations may increase the risk of over-reactive immunity. Lay Summary: Indicators of helminth infection were associated with dampened cytokine immune responses to in vitro stimulation with viral and bacterial antigens in Tsimane forager-horticulturalists in the Bolivian Amazon, consistent with the ‘old friends’ and hygiene hypotheses.
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Affiliation(s)
| | - Aaron D Blackwell
- Department of Anthropology, Washington State University, Pullman, WA, USA
| | - Thomas S Kraft
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, USA
| | | | | | | | | | - Noah Snyder-Mackler
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA.,School of Life Sciences, Arizona State University, Tempe, AZ, USA
| | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Hillard Kaplan
- Economic Science Institute, Chapman University, Orange, CA, USA
| | - Benjamin C Trumble
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA.,School of Life Sciences, Arizona State University, Tempe, AZ, USA.,School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
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Oliveira LM, Oliveira YLDC, Oliveira YLM, Ramos ACS, Andrade GF, Sá VL, Geraldi RM, Pinheiro CS, Bueno LL, Fujiwara RT, Dolabella SS. Intestinal polyparasitism and levels of mucosal anthelmintic SIgA in children from endemic areas in Northeastern Brazil. Parasite Immunol 2021; 44:e12899. [PMID: 34861047 DOI: 10.1111/pim.12899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/20/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022]
Abstract
Interactions between parasites during co-infections are often complex and can impact immunization and treatment programmes, as well as disease outcomes and morbidity. However, little is known about these interactions and the mechanisms involved. In this study, a coproparasitological survey was carried out in school-age children living in endemic areas of parasitic infection in the state of Sergipe, Northeastern Brazil. Anti-helminth-specific and total secretory immunoglobulin-A (SIgA) levels were measured in stool and saliva samples and were compared in children presenting monoparasitism, polyparasitism (helminths and/or intestinal protozoa) and no infections. The survey showed that protozoa were more prevalent than helminths, and that there was a high frequency of polyparasitism in the studied population, mainly from combinations of protozoan species. Although less frequent, combinations between species of protozoa and helminths were also observed. The levels of salivary SIgA in these co-infected individuals were lower than the average observed in infections with helminths alone. Although the children participating in this survey were asymptomatic, and it was, therefore, not possible to evaluate the impact of salivary SIgA reduction on the diseases, and the study highlights the need for further investigations of co-infections by intestinal parasites and the effects on immune response induced by the interactions between different parasites.
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Affiliation(s)
- Luciana M Oliveira
- Postgraduate Program in Parasite Biology, Universidade Federal de Sergipe, São Cristóvão, Brazil.,Department of Morphology, Universidade Federal de Sergipe, São Cristovão, Brazil
| | - Yvanna L D C Oliveira
- Postgraduate Program in Pharmaceutical Sciences, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | - Yrna L M Oliveira
- Postgraduate Program in Parasite Biology, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | - Anne Caroline S Ramos
- Postgraduate Program in Parasite Biology, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | - Gabriela F Andrade
- Department of Morphology, Universidade Federal de Sergipe, São Cristovão, Brazil
| | - Vitor L Sá
- Department of Morphology, Universidade Federal de Sergipe, São Cristovão, Brazil
| | - Ricardo M Geraldi
- Department of Morphology, Universidade Federal de Sergipe, São Cristovão, Brazil
| | - Carina S Pinheiro
- Department of Biointeraction, Institute of Health Sciences, Universidade Federal da Bahia, Salvador, Brazil
| | - Lilian L Bueno
- Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo T Fujiwara
- Postgraduate Program in Parasite Biology, Universidade Federal de Sergipe, São Cristóvão, Brazil.,Department of Parasitology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Silvio S Dolabella
- Postgraduate Program in Parasite Biology, Universidade Federal de Sergipe, São Cristóvão, Brazil.,Department of Morphology, Universidade Federal de Sergipe, São Cristovão, Brazil
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Koehler S, Springer A, Issel N, Klinger S, Wendt M, Breves G, Strube C. Ascaris suum Nutrient Uptake and Metabolic Release, and Modulation of Host Intestinal Nutrient Transport by Excretory-Secretory and Cuticle Antigens In Vitro. Pathogens 2021; 10:pathogens10111419. [PMID: 34832575 PMCID: PMC8618387 DOI: 10.3390/pathogens10111419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Abstract
Ascaris suum, the most important pig parasite, also infects humans as a zoonotic pathogen. Malabsorption upon infection probably results from impaired nutrient transport, presumably mediated by the parasite’s excretory-secretory (ES) or cuticle somatic (CSO) antigens. The present study investigated the electrogenic transport (ΔIsc) of glucose, alanine and the dipeptide glycyl-l-glutamine (glygln), as well as glucose net flux rates in pig jejunal tissue after in vitro exposure to adult A. suum total ES or CSO antigens in Ussing chambers. ΔIsc of glucose, alanine and glucose net flux rate were significantly decreased after one hour of exposure to total ES antigen. In contrast, CSO antigens increased the transport of glygln. Additionally, nutrient uptake and ES antigen pattern were compared in culture medium from untreated adult worms and those with sealed mouth and anal openings. Untreated worms completely absorbed glucose, while cuticular absorption in sealed worms led to 90% reduction. Amino acid absorption was 30% less effective in sealed worms, and ammonia excretion decreased by 20%. Overall, the results show that A. suum total ES antigen rapidly impairs nutrient transport in vitro. Future studies confirming the results in vivo, narrowing down the ES components responsible and investigating underlying molecular mechanisms are needed.
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Affiliation(s)
- Sarina Koehler
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (S.K.); (A.S.)
| | - Andrea Springer
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (S.K.); (A.S.)
| | - Nicole Issel
- Institute for Physiology and Cell Biology, University of Veterinary Medicine Hannover, 30173 Hannover, Germany; (N.I.); (S.K.); (G.B.)
| | - Stefanie Klinger
- Institute for Physiology and Cell Biology, University of Veterinary Medicine Hannover, 30173 Hannover, Germany; (N.I.); (S.K.); (G.B.)
| | - Michael Wendt
- Clinic for Swine, Small Ruminants and Forensic Medicine, University of Veterinary Medicine Hannover, 30173 Hannover, Germany;
| | - Gerhard Breves
- Institute for Physiology and Cell Biology, University of Veterinary Medicine Hannover, 30173 Hannover, Germany; (N.I.); (S.K.); (G.B.)
| | - Christina Strube
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (S.K.); (A.S.)
- Correspondence: ; Tel.: +49-511-953-8711
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Byrne A, Rosário A, da Conceição Ferreira M, de Jesus Trovoada Dos Santos M, Rollinson D, Vaz Nery S. Progress towards control and elimination of neglected tropical diseases targeted by preventive chemotherapy in São Tomé e Príncipe. Trans R Soc Trop Med Hyg 2021; 116:446-453. [PMID: 34718820 PMCID: PMC8574488 DOI: 10.1093/trstmh/trab153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 09/07/2021] [Accepted: 09/13/2021] [Indexed: 11/13/2022] Open
Abstract
The São Tomé e Príncipe government is committed to achieving neglected tropical disease (NTD) control and elimination as a public health problem by 2025. In 2014, the Ministry of Health led a national survey to determine the prevalence of soil-transmitted helminths (STHs) and schistosomiasis across the country. Following this survey, a preventive chemotherapy (PC) campaign with mebendazole and praziquantel reached 31 501 school-age children in 2015. A follow-up 2017 survey to determine the impact of the intervention showed success in controlling schistosomiasis, as no infections were found, but limited impact on STHs, with prevalence similar to pretreatment levels. The survey also investigated the prevalence of a third NTD, lymphatic filariasis (LF), which was found to be endemic in the country. Since then the Ministry of Health has developed the Strategic Plan for the Fight Against Neglected Tropical Diseases 2019-2025 and identified gaps to be addressed. This narrative review systematises the existing literature reporting on the epidemiology of NTDs for which there are PC programs in São Tomé e Príncipe. PubMed was searched for relevant papers that measured the prevalence of LF, schistosomiasis and STHs. Additionally, data provided by the Ministry of Health surveys were analysed. Finally, we discuss current NTD control, including the impact of the coronavirus disease 2019 pandemic and identify priorities for program strengthening and operational research.
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Affiliation(s)
- Aisling Byrne
- Kirby Institute, University of New South Wales, Sydney, NSW 1466, Australia
| | - Alzira Rosário
- Programa de Controlo de Doenças Tropicais Negligenciadas, Ministério da Saúde, Rua Patrice Lumumba, São Tomé, São Tomé & Príncipe
| | | | | | - David Rollinson
- Global Schistosomiasis Alliance, Natural History Museum, London SW7 5BD, UK
| | - Susana Vaz Nery
- Kirby Institute, University of New South Wales, Sydney, NSW 1466, Australia
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Kaliappan S, Ramanujam K, Manuel M, Farzana J, Janagaraj V, Laxmanan S, Muliyil J, Sarkar R, Kang G, Walson J, Ajjampur S. Soil-transmitted helminth infections after mass drug administration for lymphatic filariasis in rural southern India. Trop Med Int Health 2021; 27:81-91. [PMID: 34704320 DOI: 10.1111/tmi.13697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Targeted deworming is the current strategy for control of morbidity associated with soil-transmitted helminths (STH) among at-risk populations: preschool-aged children, school-aged children and women of childbearing age. We report the prevalence and intensity of STH in a district after lymphatic filariasis (LF) mass drug administration (MDA) in southern India where albendazole was co-administered from 2001. METHODS Children aged 2 to 15 years and adults (defined as ≥15 years) in a rural administrative block of Tamil Nadu were recruited using a probability proportional to size method. Stool samples were screened and eggs per gram (EPG) determined by Kato-Katz method. Multilevel logistic regression (MLR) and multilevel negative binomial regression (MNBR) analyses were used to identify factors associated with infection and intensity, respectively. RESULTS Of 862 participants who provided samples, 60 (7.0%; 95% confidence interval (CI): 5.3-8.7) were positive for STH with a predominance of hookworm infections (n = 57, 6.6%; 95% CI: 5.0-8.3). Increasing age (odds ratio (OR): 1.09; 95% CI: 1.04-1.15) and regular usage of the toilet (OR: 0.32; 95% CI: 0.12-0.88) were independently associated with hookworm infection and age was significantly associated with increasing intensity of hookworm infection (infection intensity ratio (IIR): 1.28; 95% CI: 1.19-1.37). A brief review of STH prevalence in endemic settings before and after the stoppage of LF MDA indicated that, in most settings, a substantial reduction in STH prevalence is seen. CONCLUSION Community-wide MDA in all age groups in these post-LF MDA districts with low prevalence and light intensity infections could result in transmission interruption of STH.
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Affiliation(s)
- Saravanakumar Kaliappan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Karthikeyan Ramanujam
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Malathi Manuel
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Jasmine Farzana
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Venkateshprabhu Janagaraj
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Selvi Laxmanan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Jayaprakash Muliyil
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Rajiv Sarkar
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Gagandeep Kang
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Judd Walson
- Departments of Global Health, Medicine (Infectious Disease), Paediatrics & Epidemiology, University of Washington, Seattle, Washington, USA
| | - Sitara Ajjampur
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
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Voinot M, Bonilla R, Sousa S, Sanchís J, Canhão-Dias M, Romero Delgado J, Lozano J, Sánchez-Andrade R, Sol Arias M, Madeira de Carvalho L. Control of Strongyles in First-Season Grazing Ewe Lambs by Integrating Deworming and Thrice-Weekly Administration of Parasiticidal Fungal Spores. Pathogens 2021; 10:1338. [PMID: 34684288 DOI: 10.3390/pathogens10101338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/13/2021] [Accepted: 10/13/2021] [Indexed: 11/29/2022] Open
Abstract
Parasiticidal fungi have been used in several in vivo experiments in livestock farms worldwide, constituting an effective tool for the biocontrol of gastrointestinal parasites in grazing animals. In the first year of study, two groups of eight first-season pasturing ewe lambs infected by strongyles were dewormed with albendazole, and then, the test group received an oral dose of 106 chlamydospores of Mucor circinelloides and 106 Duddingtonia flagrans individually and thrice a week from mid-September to May (FS1), while the control group remained without fungi (CT1). In the second year, two new groups of first-season grazing ewe lambs were treated with ivermectin and subjected to the same experimental design (FS2 and CT2, respectively). The anthelmintic efficacy was 96.6% (CT1), 95.6% (FS1), 96.1% (CT2), and 95.1% (FS2). The counts of strongyle egg output increased in the control groups (CT1 and CT2) throughout the study and reached numbers higher than 600 eggs per gram of feces (EPG), while in FS1 and FS2, they were <250 EPG. The values of red blood cell parameters registered for CT1 and CT2 were lower than those of the reference standards, while a significant increment was recorded in FS1 and FS2, and values within the physiological range were attained. It is concluded that integrating efficient anthelminthic deworming with rotational pasturing and the regular intake of chlamydospores of M. circinelloides and D. flagrans provides a helpful strategy for maintaining low levels of strongyle egg output in first-season grazing ewe lambs and improves their health status.
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Waindok P, Kann S, Aristizabal A, Dib JC, Strube C. Toxocara Seroprevalence and Risk Factor Analysis in Four Communities of the Wiwa, an Indigenous Tribe in Colombia. Microorganisms 2021; 9:microorganisms9081768. [PMID: 34442846 PMCID: PMC8401469 DOI: 10.3390/microorganisms9081768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 01/06/2023] Open
Abstract
The life of the indigenous Wiwa tribe in northeast Colombia is characterized by lacking access to clean drinking water and sanitary installations. Furthermore, free-roaming domestic animals and use of yucca and/or manioc as a primary food source favor the transmission of soil-transmitted helminths, e.g., Toxocara canis and Toxocara cati, the roundworms of dogs and cats. Infection may result in the clinical picture of toxocarosis, one of the most common zoonotic helminthoses worldwide. To estimate the Toxocara seroprevalence in four different villages of the Wiwa community, serum samples from 483 inhabitants were analyzed for anti-Toxocara-antibodies. Overall, 79.3% (383/483) of analyzed samples were seropositive. Statistically significant differences were observed between the four villages, as well as age groups (adults > adolescents > children), while sex had no effect. The high seropositivity rate demonstrates the risk of zoonotic roundworm infections and potential clinical disease in vulnerable indigenous inhabitants.
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Affiliation(s)
- Patrick Waindok
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, 30559 Hanover, Germany;
| | - Simone Kann
- Medical Mission Institute, 97074 Würzburg, Germany;
| | - Andrés Aristizabal
- Tropical Health Foundation, Santa Marta 470003, Colombia; (A.A.); (J.C.D.)
| | - Juan Carlos Dib
- Tropical Health Foundation, Santa Marta 470003, Colombia; (A.A.); (J.C.D.)
- Departement of Medicine, Universidad del Norte, Barranquilla 081001, Colombia
| | - Christina Strube
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, 30559 Hanover, Germany;
- Correspondence: ; Tel.: +49-511-9538711
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Khurana S, Singh S, Mewara A. Diagnostic Techniques for Soil-Transmitted Helminths - Recent Advances. Res Rep Trop Med 2021; 12:181-196. [PMID: 34377048 PMCID: PMC8349539 DOI: 10.2147/rrtm.s278140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 07/01/2021] [Indexed: 12/26/2022] Open
Abstract
Soil-transmitted helminth (STH) infections (hookworms, Trichuris, Ascaris) and Strongyloides spp. are associated with a substantial global burden and high morbidity. Sensitive and specific methods for diagnosis of these infections are essential for mapping the burden in communities, accurate assessment of infection levels, to guide interventions and monitoring the success of STH control programs. Despite considerable progress to control STH over several decades, we are still far from identifying a fully adequate diagnostic test. Conventional microscopy-based methods such as direct Kato–Katz smear or mounts after stool centrifugation/flotation-based concentration techniques have been the mainstay of diagnosis, especially in resource-poor countries where these infections abound. However, recently, these are being adapted to closed, easy to perform, digital formats, thereby improving the sensitivity as well as applicability in a remote, resource-limited setting. The use of image analysis systems to identify and quantify helminth eggs, with potential adaptation to smartphones, is also promising. Antibody detection tests have a limited role mostly in the case of Strongyloides hyperinfection. Coproantigen detection tests have been developed and used in veterinary practice for detection of STH, but these have not been evaluated for use in humans. More sensitive molecular diagnostics, including assays developed with new bioinformatic tools and techniques such as polymerase chain reaction (PCR), quantitative PCR (qPCR) and loop-mediated amplification assay, can help in the clear and precise assessment of STH burden during elimination phase and are of immense value for diagnosis in areas with low endemicity and in travelers to endemic regions. Moreover, the molecular techniques will help detect new species that may emerge. Sample preservation and efficient DNA extraction are critical and significantly affect the efficiency of molecular diagnostic tests. In addition to the diagnosis of clinical or asymptomatic infection in humans, detection of STH eggs in environmental samples is imperative to boost STH control efforts. Overall the diagnostic performance, cost-effectiveness, ease of performance, rapidity and in-field applicability of any test should be considered when choosing from the various diagnostic assays in areas with different endemicity, in addition to striving towards the development of novel technologies and optimization of existing methods.
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Affiliation(s)
- Sumeeta Khurana
- Department of Medical Parasitology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shreya Singh
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Abhishek Mewara
- Department of Medical Parasitology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Eyayu T, Wubie A, Kiros T, Tiruneh T, Damtie S, Sema M, Abebaw A, Chanie ES, Workineh L. Prevalence of Intestinal Parasitosis and Its Associated Factors Among Children Aged 6 to 59 months Attending Mekane Eyesus Primary Hospital, Northcentral Ethiopia. Glob Pediatr Health 2021; 8:2333794X211036605. [PMID: 34377745 PMCID: PMC8326614 DOI: 10.1177/2333794x211036605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/14/2021] [Indexed: 11/17/2022] Open
Abstract
Background. Intestinal parasites are still a serious public health problem and important cause of morbidity and mortality all over the world, particularly in developing countries. Unfortunately, pre-school children are more susceptible to infection. However, information is scarce in the study area. Thus, this study aimed to assess the prevalence of intestinal parasitosis and associated factors among children aged 6 to 59 months in Northcentral Ethiopia. Methods. An institutional-based cross-sectional study was carried out at Mekane Eyesus primary hospital from June 10 to November 30, 2020. Stool samples were collected from 322 children and examined by using direct wet mount and formal ether concentration techniques. The data were entered and analyzed using EPI Info v7 and SPSS v23 statistical software, respectively. Both bivariable and multivariable logistic analysis was carried out and potential associated factors were identified based on adjusted odds ratio with 95% confidence interval and P-value <.05. Results. The prevalence of intestinal parasitosis was 18.0% (95% CI: 14.0%-22.0%). A total of 4 parasites were examined and the dominant parasite was E. histolytica/dispar (8.1%) followed by A. limbricoide (4.7%). Children with irregular trimming of fingernails (AOR = 3.14, 95% CI: 1.59-6.21), and child who have habit of eating unwashed fruits/vegetables (AOR = 3.80, 95% CI: 1.14-12.82) were strongly associated with IPIs. Conclusions. Protozoa parasites are most common cause of diseases in children. The study identified some preventable and modifiable factors to address the prevalence of IPIs. Additionally, improving mothers/guardians awareness about source of infection and mode of transmission is necessary.
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Affiliation(s)
- Tahir Eyayu
- Debre Tabor University, Debre Tabor, Ethiopia
| | | | | | | | | | - Meslo Sema
- Debre Tabor University, Debre Tabor, Ethiopia
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Kositz C, Bradley J, Hutchins H, Last A, D'Alessandro U, Marks M. Broadening the range of use cases for ivermectin - a review of the evidence. Trans R Soc Trop Med Hyg 2021; 116:201-212. [PMID: 34323283 DOI: 10.1093/trstmh/trab114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 11/12/2022] Open
Abstract
Ivermectin is a broad-spectrum antiparasitic agent that interferes with glutamate-gated chloride channels found in invertebrates but not in vertebrate species. Mass drug administration (MDA) with ivermectin-based regimes has been a mainstay of elimination efforts targeting onchocerciasis and lymphatic filariasis for more than 3 decades. More recently, interest in the use of ivermectin to control other neglected tropical diseases (NTDs) such as soil-transmitted helminths and scabies has grown. Interest has been further stimulated by the fact that ivermectin displays endectocidal efficacy against various Anopheles species capable of transmitting malaria. Therefore there is growing interest in using ivermectin MDA as a tool that might aid in the control of both malaria and several NTDs. In this review we outline the evidence base to date on these emerging indications for ivermectin MDA with reference to clinical and public health data and discuss the rationale for evaluating the range of impacts of a malaria ivermectin MDA on other NTDs.
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Affiliation(s)
- Christian Kositz
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - John Bradley
- MRC International Statistics and Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Harry Hutchins
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Anna Last
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.,Hospital for Tropical Diseases, Mortimer Market Capper Street, WC1E 6JB, London, UK
| | - Umberto D'Alessandro
- Disease Control and Elimination, Medical Research Council Unit Gambia at London School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, The Gambia
| | - Michael Marks
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.,Hospital for Tropical Diseases, Mortimer Market Capper Street, WC1E 6JB, London, UK
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Okoyo C, Campbell SJ, Minnery M, Owaga C, Onyango N, Medley G, Mwandawiro C. Prevalence and Correlation Analysis of Soil-Transmitted Helminths Infections and Treatment Coverage for Preschool and School Aged Children in Kenya: Secondary Analysis of the National School Based Deworming Program Data. Front Public Health 2021; 9:645522. [PMID: 34336756 PMCID: PMC8322119 DOI: 10.3389/fpubh.2021.645522] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Soil-transmitted helminths (STH) are among the most common parasitic infections globally, disproportionately affecting children. Treatment of STH in Kenya is often targeted at preschool (PSAC) and school aged (SAC) children delivered through annual mass drug administration (MDA) in primary schools. Understanding group-specific prevalence and dynamics between treatment and coverage is critical for continued treatment success. This study aims to provide detailed information on group-specific infection prevalence and relative reductions (RR), and their relationships with treatment coverage over time. Additionally, it aims to quantify the correlation between the observed school level infection prevalence and treatment coverage. Methods: Secondary analysis of existing data collected between 2012 and 2018 by the monitoring and evaluation (M&E) program of the National School-Based Deworming (NSBD) program was used. The M&E program conducted surveys utilizing cross-sectional study design, at four survey time points, in a nationally-representative sample of schoolchildren across counties in Kenya. In each participating school, the program randomly sampled 108 children per school, of both groups. Infection prevalence was estimated using binomial regression, RR in prevalence using multivariable mixed effects model, statistical correlations using structural equation modeling, and change-point-analysis using the binary segmentation algorithm. Results: Overall, STH prevalence for PSAC was 33.7, 20.2, 19.0, and 17.9% during Year 1 (Y1), Year 3 (Y3), Year 5 (Y5), and Year 6 (Y6) surveys, respectively with an overall RR of 46.9% (p = 0.001) from Y1 to Y6. Similarly, overall STH prevalence for SAC was 33.6, 18.4, 14.7, and 12.5% during Y1, Y3, Y5, and Y6 surveys, respectively with an overall RR of 62.6% (p < 0.001). An overall (all time points) significant but very weak negative correlation was found between treatment coverage and undifferentiated STH prevalence (r = -0.144, p = 0.002) among PSAC but not in SAC. Further, we observed inter-county heterogeneity variation in infection prevalence, RR, as well as correlations. Conclusion: The analysis showed that after six rounds of MDA, prevalence of STH has significantly declined among both groups of children, however not to a point where it is not a public health problem (below 1%). The analysis, additionally established an overall significant but weak negative correlation between treatment coverage and prevalence, indicating that the current treatment coverage might not be sufficient to drive the overall STH prevalence to below 1%. These findings will allow STH control programs in Kenya to make decisions that will accelerate the attainment of STH elimination as a public health problem.
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Affiliation(s)
- Collins Okoyo
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya.,School of Mathematics, College of Biological and Physical Sciences, University of Nairobi, Nairobi, Kenya
| | - Suzy J Campbell
- Deworm the World, Evidence Action, Washington, DC, United States
| | - Mark Minnery
- Deworm the World, Evidence Action, Washington, DC, United States
| | | | - Nelson Onyango
- School of Mathematics, College of Biological and Physical Sciences, University of Nairobi, Nairobi, Kenya
| | - Graham Medley
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Charles Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
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Asfaw MA, Hailu C, Beyene TJ. Evaluating Equity and Coverage in Mass Drug Administration for Soil-Transmitted Helminth Infections among School-Age Children in the Hard-to-Reach Setting of Southern Ethiopia. Pediatric Health Med Ther 2021; 12:325-333. [PMID: 34267576 PMCID: PMC8275865 DOI: 10.2147/phmt.s316194] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/17/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Soil-transmitted helminth (STH) infections are prevalent in most developing countries, including Ethiopia, with school-age children (SAC) at high risk of infection. In Ethiopia, despite substantial progress being made on mass drug administration (MDA) coverage for STH infections, its implementation is facing challenges in hard-to-reach areas. This study thus aimed at assessing equity and coverage in MDA and identifying factors associated with drug coverage for STH infections among SAC in the hard-to-reach setting of southern Ethiopia. METHODS A community-based cross-sectional survey was conducted in the North Ari district, South Omo Zone in July 2019. Sample size was estimated following WHO drug-coverage evaluation guidelines. Factors associated with drug uptake for STH infections were identified using multivariate logistic regression. RESULTS Of 956 SAC participating in this study, the overall MDA coverage for STH was found to be 27.5% (95% CI 24.7%-30.5%). The odds of having taken drugs were highest among school-enrolled children and in those who knew the purpose of MDA: about about double their counterparts. In contrast, the odds of drug uptake were lower by 69% among those who had got informed only when the drugs delivered and by 92% among those who needed to travel >30 minutes to reach drug-distribution points than their counterparts. CONCLUSION Achieving effective and equitable MDA coverage is facing serious challenges in the hard-to-reach setting of southern Ethiopia. The very low (27.5%) and inequitable MDA coverage found in this study are associated with school nonenrollment, inaccessibility, and lack of information, awareness, and mobilization. Social mobilization should be scaled up to inform and create awareness in the community ahead of MDA. Further, school-based deworming in settings with low school enrollment needs a modified strategy to reach those in need of drugs.
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Affiliation(s)
- Mekuria Asnakew Asfaw
- Collaborative Research and Training Centre for NTDs, Arba Minch University, Arba Minch, Ethiopia
| | - Chernet Hailu
- Jimma University, Faculty of Public Health, Department of Epidemiology, Jimma, Ethiopia
| | - Tariku J Beyene
- Center for Surgical Outcomes Research, Research Institute at Nationwide Children’s Hospital, Columbus, OH, 43015, USA
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Grau-Pujol B, Cuamba I, Jairoce C, Cossa A, Da Silva J, Sacoor C, Dobaño C, Nhabomba A, Mejia R, Muñoz J. Molecular Detection of Soil-Transmitted Helminths and Enteric Protozoa Infection in Children and Its Association with Household Water and Sanitation in Manhiça District, Southern Mozambique. Pathogens 2021; 10:pathogens10070838. [PMID: 34357988 PMCID: PMC8308871 DOI: 10.3390/pathogens10070838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/26/2021] [Accepted: 06/30/2021] [Indexed: 11/16/2022] Open
Abstract
Intestinal parasite infections can have detrimental health consequences in children. In Mozambique, soil-transmitted helminth (STH) infections are controlled through mass drug administration since 2011, but no specific control program exists for enteric protozoa. This study evaluates STH and protozoan infections in children attending healthcare in Manhiça district, Southern Mozambique, and its association with water and sanitation conditions. We conducted a cross-sectional study in children between 2 and 10 years old in two health centers (n = 405). A stool sample and metadata were collected from each child. Samples were analyzed by multi-parallel real-time quantitative PCR (qPCR). We fitted logistic regression-adjusted models to assess the association between STH or protozoan infection with household water and sanitation use. Nineteen percent were infected with at least one STH and 77.5% with at least one enteric protozoon. qPCR detected 18.8% of participants with intestinal polyparasitism. Protected or unprotected water well use showed a higher risk for at least one protozoan infection in children (OR: 2.59, CI: 1.01-6.65, p-value = 0.010; OR: 5.21, CI: 1.56-17.46, p-value = 0.010, respectively) compared to household piped water. A high proportion of children had enteric protozoan infections. Well consumable water displayed high risk for that.
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Affiliation(s)
- Berta Grau-Pujol
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic—University of Barcelona, 08036 Barcelona, Spain; (C.D.); (J.M.)
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; (I.C.); (C.J.); (A.C.); (C.S.); (A.N.)
- Mundo Sano Foundation, Buenos Aires 1535, Argentina
- Correspondence: ; Tel.: +34-9322-75400
| | - Inocencia Cuamba
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; (I.C.); (C.J.); (A.C.); (C.S.); (A.N.)
| | - Chenjerai Jairoce
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; (I.C.); (C.J.); (A.C.); (C.S.); (A.N.)
| | - Anelsio Cossa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; (I.C.); (C.J.); (A.C.); (C.S.); (A.N.)
| | - Juliana Da Silva
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA;
| | - Charfudin Sacoor
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; (I.C.); (C.J.); (A.C.); (C.S.); (A.N.)
| | - Carlota Dobaño
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic—University of Barcelona, 08036 Barcelona, Spain; (C.D.); (J.M.)
| | - Augusto Nhabomba
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique; (I.C.); (C.J.); (A.C.); (C.S.); (A.N.)
| | - Rojelio Mejia
- Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX 77030, USA;
| | - Jose Muñoz
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic—University of Barcelona, 08036 Barcelona, Spain; (C.D.); (J.M.)
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50
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Mather W, Hutchings P, Budge S, Jeffrey P. Association between water and sanitation service levels and soil-transmitted helminth infection risk factors: a cross-sectional study in rural Rwanda. Trans R Soc Trop Med Hyg 2021; 114:332-338. [PMID: 32052038 DOI: 10.1093/trstmh/trz119] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/25/2019] [Accepted: 10/30/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Soil-transmitted helminth (STH) infections are one of the most prevalent neglected tropical diseases in the world. Drug treatment is the preferred method for infection control yet reinfection occurs rapidly, so water and sanitation represent important complementary barriers to transmission. METHODS A cross-sectional study was conducted to observe STH risk factors in rural Rwandan households in relation to the Sustainable Development Goal for water and sanitation service levels. Survey and observation data were collected from 270 households and 67 water sources in rural Rwanda and were processed in relation to broader risk factors identified from the literature for the role of water and sanitation in STH infection pathways. RESULTS A significant association between higher water and sanitation service levels and lower STH infection risk profiles was found for both water and sanitation. However, variability existed within service level classifications. CONCLUSIONS Greater granularity within service level assessments is required to more precisely assess the efficacy of water and sanitation interventions in reducing STH infection risks.
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Affiliation(s)
- William Mather
- Cranfield Water Science Institute, Cranfield University, Cranfield, Bedfordshire, MK43 0AL, UK
| | - Paul Hutchings
- Cranfield Water Science Institute, Cranfield University, Cranfield, Bedfordshire, MK43 0AL, UK
| | - Sophie Budge
- Cranfield Water Science Institute, Cranfield University, Cranfield, Bedfordshire, MK43 0AL, UK
| | - Paul Jeffrey
- Cranfield Water Science Institute, Cranfield University, Cranfield, Bedfordshire, MK43 0AL, UK
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