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Scientific Reports Jul 2023Soil-transmitted Helminth (STH) infections have been found associated with people living with human immunodeficiency virus (HIV) but little is known about the overall... (Meta-Analysis)
Meta-Analysis
Soil-transmitted Helminth (STH) infections have been found associated with people living with human immunodeficiency virus (HIV) but little is known about the overall burden of STH coinfection in HIV patients. We aimed to assess the burden of STH infections among HIV patients. Relevant databases were systematically searched for studies reporting the prevalence of soil-transmitted helminthic pathogens in HIV patients. Pooled estimates of each helminthic infection were calculated. The odds ratio was also determined as a measure of the association between STH infection and the HIV status of the patients. Sixty-one studies were finally included in the meta-analysis, consisting of 16,203 human subjects from all over the world. The prevalence of Ascaris lumbricoides infection in HIV patients was found to be 8% (95% CI 0.06, 0.09), the prevalence of Trichuris trichiura infection in HIV patients was found to be 5% (95% CI 0.04, 0.06), the prevalence of hookworm infection in HIV patients was found to be 5% (95% CI 0.04, 0.06), and prevalence of Strongyloides stercoralis infection in HIV patients was found to be 5% (95% CI 0.04, 0.05). Countries from Sub-Saharan Africa, Latin America & Caribbean and Asia were identified with the highest burden of STH-HIV coinfection. Our analysis indicated that people living with HIV have a higher chance of developing Strongyloides stercoralis infections and decreased odds of developing hookworm infections. Our findings suggest a moderate level of prevalence of STH infections among people living with HIV. The endemicity of STH infections and HIV status both are partially responsible for the burden of STH-HIV coinfections.
Topics: Animals; Humans; Prevalence; HIV; Soil; HIV Infections; Helminthiasis; Ascariasis; Hookworm Infections; Helminths; Strongyloidiasis; Coinfection; Feces; Ascaris lumbricoides
PubMed: 37422549
DOI: 10.1038/s41598-023-38030-y -
Cureus May 2024People with visual impairments and blindness face challenges in performing regular tasks such as maintaining proper sanitation, which makes them vulnerable to intestinal...
INTRODUCTION
People with visual impairments and blindness face challenges in performing regular tasks such as maintaining proper sanitation, which makes them vulnerable to intestinal parasitic infections.
AIMS AND OBJECTIVES
This study aims to examine the prevalence and distribution of intestinal parasitic infections in children and adolescents with ocular diseases and to assess if the lockdown during the COVID-19 pandemic affected these rates.
METHODS
This retrospective, hospital record-based study was conducted among children and adolescents attending the Regional Institute of Ophthalmology in Kolkata, India. It involved routine stool examinations as part of their treatment during 2019-2020. Early morning stool specimens were collected and brought to the institute laboratory in containers. Stools were examined under a microscope for cysts, ova, parasites, and adult worms. Findings were recorded in the laboratory record book. These data were then extracted into a spreadsheet and analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York).
RESULTS
The prevalence of intestinal parasitic infections was 8.59% (59 out of 687 patients). Among those 59 positive cases, , , , , spp., , and were detected in 27 (45.8%), 15 (25.4%), 8 (13.6%), 6 (10.2%), 3 (5.1%), 2 (3.4%), and 1 (1.7%) patients, respectively. The positivity rate of stool samples was higher from September and thereafter from January to March. The sample positivity rate was higher post-pandemic and lockdown, but not statistically significant (11.5% vs. 5.3%; χ²=4.044, df=1, p=0.44).
CONCLUSION
was the most commonly observed intestinal parasite in children and adolescents with ocular disease in our setting. Seasonal variation was noted with higher case positivity at the end of the rainy season and thereafter in winter. Therefore, we propose to strengthen the routine deworming program during this period in Eastern India. Higher sample positivity after the pandemic may be attributed to school closures during the lockdown period, which might have caused some children to miss their routine deworming medication.
PubMed: 38864043
DOI: 10.7759/cureus.60152 -
PLoS Neglected Tropical Diseases Mar 2024Control efforts of soil-transmitted helminthiases rely primarily on large scale administration of anthelminthic drugs. The assessment of drug efficacies and... (Clinical Trial)
Clinical Trial
BACKGROUND
Control efforts of soil-transmitted helminthiases rely primarily on large scale administration of anthelminthic drugs. The assessment of drug efficacies and understanding of drug behavior is pivotal to the evaluation of treatment successes, both in preventive chemo-therapy programs as well as in research of novel treatment options. The current WHO guidelines recommend an interval of 14-21 days between the treatment and follow-up, yet no in-depth analysis of egg excretion patterns of Trichuris trichiura after treatment has been conducted to date.
METHODS
Within the framework of a multi-country trial to assess the efficacy and safety of albendazole-ivermectin combination therapy vs albendazole monotherapy against T. trichiura infections, we conducted a study collecting daily stool samples over the period of 28 days post-treatment in 87 participants in Pak Khan, Lao PDR. Egg counts were derived by duplicate Kato-Katz on-site for T. trichiura, hookworm and Ascaris lumbricoides and stool sample aliquots were subsequently analyzed by qPCR for the detection of T. trichiura infections. Sensitivity and specificity was calculated for each day separately using data derived by Kato-Katz to determine the optimal timepoint at which to assess drug efficacy.
RESULTS
Egg excretion patterns varied across treatment arms. For T. trichiura, only the albendazole-ivermectin treatment led to a considerable reduction in mean egg counts, whereas both treatments reduced hookworm egg counts and A. lumbricoides were cleared in all participants after day 7. For T. trichiura, we found sensitivity to be highest at days 18 and 22 when using egg counts as outcome and days 19 and 24 when using qPCR. Specificity was high (>0.9) from day 14 onwards. For hookworm, the highest sensitivity and specificity were found at days 17 and 25, respectively.
CONCLUSIONS
Based on our study, the ideal time period to assess drug efficacy for soil-transmitted helminth infections would be between day 18 and 24. The current WHO recommendation of 14 to 21 days is likely to yield acceptable outcome measures for soil-transmitted helminth infections.
TRIAL REGISTRATION
NCT03527732.
Topics: Animals; Humans; Albendazole; Ancylostomatoidea; Anthelmintics; Feces; Helminthiasis; Ivermectin; Soil; Trichuriasis; Trichuris
PubMed: 38517907
DOI: 10.1371/journal.pntd.0012073 -
Infection and Drug Resistance 2023In this study, it was aimed to determine the 5-year prevalence of intestinal parasites in patients admitted to the Microbiology laboratory of a tertiary hospital in...
Distribution of the Intestinal Parasites According to Species and Gender in Patients Presented to the Microbiology Laboratory in a Tertiary Hospital, in Somalia Between January 2018 and October 2022.
PURPOSE
In this study, it was aimed to determine the 5-year prevalence of intestinal parasites in patients admitted to the Microbiology laboratory of a tertiary hospital in Somalia. Intestinal parasites; Types of patients, age and sex of the patients, and the distribution by years were examined.
PATIENTS AND METHODS
Stool samples were examined using wet preparation, native lugol and trichrome staining methods. Statistical analysis was performed using IBM SPSS V23 software and a P value of <0.05 was considered statistically significant. Tables and figures were used to show the results.
RESULTS
One or more parasites were detected in 6766 of 56,824 stool samples examined. It was observed that had a higher prevalence than other parasites (60.84%) in a five-year period. (33.07%) second rank and (3.18%) third rank according to their prevalence. When the distribution of the parasite population by gender is evaluated; no statistically significant difference was found (p = 0.235). When the frequency of parasites was evaluated according to age groups, it was seen that the prevalence of parasites between the ages of 0-15 was higher (45.5%) compared to other age groups. A statistically significant difference was found between the distribution of parasite groups according to age groups (p < 0.001).
CONCLUSION
Considering the effects of intestinal parasites on public health, it is still considered to be an important health problem for developing countries. It is thought that the frequency of parasitic diseases in society will decrease with the education of individuals, effective diagnosis, treatment, and implementation of preventive measures.
PubMed: 37933295
DOI: 10.2147/IDR.S434214 -
PLoS Neglected Tropical Diseases Apr 2024Infections caused by soil-transmitted helminths (STHs) are the most prevalent neglected tropical diseases and result in a major disease burden in low- and middle-income...
BACKGROUND
Infections caused by soil-transmitted helminths (STHs) are the most prevalent neglected tropical diseases and result in a major disease burden in low- and middle-income countries, especially in school-aged children. Improved diagnostic methods, especially for light intensity infections, are needed for efficient, control and elimination of STHs as a public health problem, as well as STH management. Image-based artificial intelligence (AI) has shown promise for STH detection in digitized stool samples. However, the diagnostic accuracy of AI-based analysis of entire microscope slides, so called whole-slide images (WSI), has previously not been evaluated on a sample-level in primary healthcare settings in STH endemic countries.
METHODOLOGY/PRINCIPAL FINDINGS
Stool samples (n = 1,335) were collected during 2020 from children attending primary schools in Kwale County, Kenya, prepared according to the Kato-Katz method at a local primary healthcare laboratory and digitized with a portable whole-slide microscopy scanner and uploaded via mobile networks to a cloud environment. The digital samples of adequate quality (n = 1,180) were split into a training (n = 388) and test set (n = 792) and a deep-learning system (DLS) developed for detection of STHs. The DLS findings were compared with expert manual microscopy and additional visual assessment of the digital samples in slides with discordant results between the methods. Manual microscopy detected 15 (1.9%) Ascaris lumbricoides, 172 (21.7%) Tricuris trichiura and 140 (17.7%) hookworm (Ancylostoma duodenale or Necator americanus) infections in the test set. Importantly, more than 90% of all STH positive cases represented light intensity infections. With manual microscopy as the reference standard, the sensitivity of the DLS as the index test for detection of A. lumbricoides, T. trichiura and hookworm was 80%, 92% and 76%, respectively. The corresponding specificity was 98%, 90% and 95%. Notably, in 79 samples (10%) classified as negative by manual microscopy for a specific species, STH eggs were detected by the DLS and confirmed correct by visual inspection of the digital samples.
CONCLUSIONS/SIGNIFICANCE
Analysis of digitally scanned stool samples with the DLS provided high diagnostic accuracy for detection of STHs. Importantly, a substantial number of light intensity infections were missed by manual microscopy but detected by the DLS. Thus, analysis of WSIs with image-based AI may provide a future tool for improved detection of STHs in a primary healthcare setting, which in turn could facilitate monitoring and evaluation of control programs.
Topics: Child; Animals; Humans; Artificial Intelligence; Soil; Microscopy; Resource-Limited Settings; Feces; Trichuris; Helminthiasis; Helminths; Ascaris lumbricoides; Ancylostomatoidea; Prevalence
PubMed: 38602896
DOI: 10.1371/journal.pntd.0012041 -
Heliyon Oct 2023Kenya is endemic for soil-transmitted helminths (STH) with over 6 million children in 27 counties currently at-risk. A national school-based deworming programme (NSBDP)...
Model-based geostatistical design and analysis of prevalence for soil-transmitted helminths in Kenya: Results from ten-years of the Kenya national school-based deworming programme.
BACKGROUND
Kenya is endemic for soil-transmitted helminths (STH) with over 6 million children in 27 counties currently at-risk. A national school-based deworming programme (NSBDP) was launched in 2012 with a goal to eliminate parasitic worms as a public health problem. This study used model-based geostatistical (MBG) approach to design and analyse the impact of the NSBDP and inform treatment strategy changes.
METHODS
A cross-sectional study was used to survey 200 schools across 27 counties in Kenya. The study design, school selection and analysis followed the MBG approach which incorporated historical data on treatment, morbidity and environmental covariates to efficiently predict the helminths prevalence in Kenya.
RESULTS
Overall, the NSBDP geographic area prevalence for any STH was estimated to sit between 2 % and <10 % with a high predictive probability of >0.999. Species-specific thresholds were between 2 % and <10 % for 0 % to <2 % for hookworm, and 0 % to <2 % for , all with high predictive probability of >0.999.
CONCLUSIONS
Based on the World Health Organization guidelines, STH treatment requirements can now be confidently refined. Ten counties may consider suspending treatment and implement appropriate surveillance system, while another 10 will require treatment once every two years, and the remaining seven will require treatment once every year.
PubMed: 37829802
DOI: 10.1016/j.heliyon.2023.e20695 -
BMJ Case Reports Jun 2024Rarer causes of acute pancreatitis may be considered in certain settings, such as parasitism in endemic regions. This report describes a pregnant female (second...
Rarer causes of acute pancreatitis may be considered in certain settings, such as parasitism in endemic regions. This report describes a pregnant female (second trimester) in her 20s who presented with 3-day steady epigastric pain radiating to the back and passage of worm from the mouth. She was diagnosed with mild acute pancreatitis, given a significantly elevated serum lipase and absence of organ failures. Fecalysis showed ova; hence, she was treated with mebendazole. Plain MR cholangiopancreatography showed an 842 mL necrotic pancreatic fluid collection and tubular flow void foci within the gallbladder and duodenum consistent with helminthiasis. The patient was managed conservatively in the absence of indications for drainage. The abdominal pain remarkably improved, and she underwent eventual vacuum-assisted delivery to a healthy term baby 4 months after the bout of acute pancreatitis.
Topics: Humans; Female; Ascariasis; Pregnancy; Pancreatitis, Acute Necrotizing; Animals; Ascaris lumbricoides; Pregnancy Complications, Parasitic; Adult; Mebendazole; Abdominal Pain; Cholangiopancreatography, Magnetic Resonance
PubMed: 38862191
DOI: 10.1136/bcr-2024-260316 -
Scientific Reports Jan 2024Assessment of risk factors of intestinal helminths and anaemia in various geographical regions is important for the development of appropriate control strategies. This...
Assessment of risk factors of intestinal helminths and anaemia in various geographical regions is important for the development of appropriate control strategies. This study aimed at determining the risk factors associated with intestinal helminths and anaemia in Melong, Cameroon. A total of 325 participants were recruited in this study between September-December 2021. Faecal samples were examined using the formol-ether sedimentation technique while haemoglobin level was measured using a HemoCue spectrometer. Data on demographic and behavioural factors was collected and used to determine the risk factors using a pretested structured questionnaire and analysed using SPSS. The overall prevalence of intestinal helminths was 24.6% (80/325). Helminths recovered from the study included hookworm (16%; 52/325), Schistosoma mansoni (10.8% 35/325) Ascaris lumbricoides (1.9%; 6/325), and Trichuris trichiura (0.6%; 2/325) with 15 participants having multiple infections (4.6%). The geometric mean egg density was 77epg and ranged from 20 to 560 epg of faeces. Males and age group ≤ 5 years had the highest parasite intensity (248epg). The overall prevalence of anaemia was 33.5% (109/325). Anaemia was significantly (p = 0.001) high at 48.8% (39/80) in those infected with intestinal parasites compared to non-infected individuals. Age group of 31-45 years; [3.42(1.05-11.21)] and > 65 years [6.21(1.75-12.47)], poor knowledge [0.41(0.67-6.07)], no regular deworming [0.70(1.76-21.96)], mud floors toilet [6.18(1.61-23.79)], toilets made of sticks [16.5(4.24-64.31)], and participants who did not have stomach/abdominal pains [0.22(0.07-0.67)] were significant predictors of helminth infections. Age group < 15 years [2.58(1.09-6.11)], geophagia [3.69(1.91-9.33)], hookworm infection [3.26(1.49-7.11)], S. mansoni [1.72 (1.16-3.41)] and those with multiple infections [1.76(1.04-2.88)] were identified as risk factors for anaemia. Risk factors identified in this study can be used to improve the control mechanism put in place by the government.
Topics: Male; Humans; Adult; Middle Aged; Child, Preschool; Adolescent; Cameroon; Helminthiasis; Intestinal Diseases, Parasitic; Anemia
PubMed: 38182648
DOI: 10.1038/s41598-023-46446-9 -
Parasites & Vectors Mar 2024The impact of access to improved water, sanitation and hygiene (WASH) and health education on large-scale deworming programs aimed at controlling soil-transmitted...
Investigating the effect of a school-based WASH intervention on soil-transmitted helminth and schistosome infections and nutritional status of school children in Ethiopia: a quasi-experimental study.
BACKGROUND
The impact of access to improved water, sanitation and hygiene (WASH) and health education on large-scale deworming programs aimed at controlling soil-transmitted helminth (STH) and schistosome (SCH) infections has not been well studied. We assessed the additional impact of improved WASH infrastructure and health education at schools on STH and SCH infections in Ethiopia.
METHODS
The study used a quasi-experimental design under which 30 schools were assigned to either an intervention (15 schools) or control (15 schools) arm. Both arms received a standard deworming treatment and lunch. In the intervention arm, improved WASH and health education were provided. At three consecutive time points (baseline in 2013, 2014 and 2015), the prevalence and intensity of STH and SCH infections and the nutritional status [hemoglobin concentrations and physical growth (height and weight)] were determined. To verify whether interventions were successfully implemented, the WASH status at school and the student knowledge, attitudes and practices related to WASH (WASH-KAP) were recorded. Differences in metrics between arms at baseline (2013) and follow-up (2015) were assessed both within and between the arms.
RESULTS
A significant increase in scores for both the school WASH and student KAP was found in the intervention arm, indicating successful implementation of the intervention. The prevalence of any STH infection was significantly reduced in the intervention arm but not in the control arm (F = 4.486, p = 0.034). There was a significantly greater reduction in the intensity of infection of hookworm and Ascaris lumbricoides compared to baseline in both arms. The intervention did not affect school children's height-for-age z-score (intervention arm * time coef = 0.12, p = 0.400) and body mass index-for-age z-scores (intervention * time coef = - 0.06, p = 0.526). Hemoglobin concentrations increased significantly more in the control than the intervention arm (coef = - 0.16, p = 0.006).
CONCLUSIONS
Although the intervention did increase school WASH and student WASH-KAP, our study found poor evidence of the additional benefit of improved WASH and health education to deworming and school food programs on parasite re-infection and the health outcomes of children.
Topics: Child; Animals; Humans; Sanitation; Soil; Nutritional Status; Water; Ethiopia; Helminths; Hygiene; Schistosoma; Hemoglobins
PubMed: 38486228
DOI: 10.1186/s13071-024-06155-2 -
PloS One 2024Intestinal parasitic infections (IPIs) are major public health problems in developing countries. This study was conducted to determine the prevalence and associated risk...
Intestinal parasitic infections (IPIs) are major public health problems in developing countries. This study was conducted to determine the prevalence and associated risk factors of IPIs at Debarq Primary Hospital in northwest Ethiopia. A health facility-based cross-sectional study was conducted from March 2022 to June 2022. The study participants were recruited from patients who visited Debarq Primary Hospital during the study period. Stool samples were collected from each participant and examined for intestinal parasites using direct wet-mount and formal-ether concentration techniques. Socio-demographic data were collected using a structured questionnaire. Out of 422 individuals examined, 33.64% were infected with at least one intestinal parasite species. Entamoeba histolytica/dispar, Giardia intestinalis, Ascaris lumbricoides, and hookworm were found in 12.79%, 8.53%, 7.10%, and 1.65% of the participants, respectively. Double and triple parasite infections were found in 2.37% and 0.23% of the participants, respectively. A habit of eating unwashed vegetables (Adjusted odds ratio (AOR) = 9.98, 95% confidence interval (CI) = 2.68-37.14) and low income (AOR = 6.66, 95% CI = 1.87-23.70) were associated with increased odds of IPIs. Participants with a habit of hand washing after using the toilet had 0.05 (95% CI = 0.13-0.22) lower odds of IPIs than those who did not. In conclusion, IPIs are common among Debarq Primary Hospital patients and are associated with factors such as low income, not washing hands after using the toilet, and eating unwashed vegetation, necessitating control and prevention efforts in the study area that include health education and the provision and use of sanitary facilities.
Topics: Humans; Ethiopia; Prevalence; Cross-Sectional Studies; Intestinal Diseases, Parasitic; Risk Factors; Hospitals
PubMed: 38451932
DOI: 10.1371/journal.pone.0298767