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Infectious Diseases 2020Soil-transmitted helminths (STH) are still major health problems in resource-poor countries. Despite several epidemiological studies were available in Ethiopia,... (Review)
Review
BACKGROUND
Soil-transmitted helminths (STH) are still major health problems in resource-poor countries. Despite several epidemiological studies were available in Ethiopia, summarized data on the prevalence of STH among school-aged children (SAC) is lacking in the country.
OBJECTIVE
This study was aimed to summarize the existing published studies of STH among SAC children in Ethiopia.
METHODS
The search was carried out in open access databases such as Science Direct, Scopus, and PubMed Central which reported STH in Ethiopia. Open access articles published between 2000 and 2019 were included in this meta-analysis. The pooled prevalence was determined using a random-effect model while heterogeneities between studies were evaluated by test.
RESULTS
A total of 46 338 children (Male = 23 374 and Female = 22 964) were included in the 70 eligible studies for this meta-analysis. The pooled prevalence of STH among SAC was 33.4%; 95% CI, 29.3% to 37.7% in Ethiopia. (19.9%; 95% CI, 17.2%-22.6%) was the most prevalent STH followed by (12.4%; 95% CI, 10.6%-14.1%), and hookworm (7.9%; 95% CI, 6.9%-8.9%) infection in the country. High prevalence of STH was observed in Oromia (42.5%; 95% CI, 31.6%-53.4%) followed by SNNPR (38.3%; 95% CI, 27.7%-48.8%) and Amhara (32.9%; 95% CI, 27.0%-38.8%) regional states. High heterogeneity on the prevalence of STH was observed across studies within and among regions ( > 96% and < .001).
CONCLUSION
This review showed that more than one-third of the Ethiopian SAC were infected with STH. The high prevalence of STH observed in this review highlight the needs of improved control and prevention strategies in Ethiopia.
PubMed: 33088182
DOI: 10.1177/1178633720962812 -
BMC Infectious Diseases Jul 2020Tuberculosis and intestinal parasites are mostly affecting poor people. They are in a vicious since one is the risk factor for the other. However, the comprehensive... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Tuberculosis and intestinal parasites are mostly affecting poor people. They are in a vicious since one is the risk factor for the other. However, the comprehensive report on the burden and co-incidence of intestinal parasites and tuberculosis in Ethiopia is scant. This systematic review and meta-analysis aimed to provide abridge conclusive evidence on the intestinal parasite-tuberculosis co-infection in Ethiopia.
METHODS
A total of 414 articles published in English were searched from both electronic databases (CINAHL, DOAJ, Embase, Emcare, Medline, ProQuest, and PubMed, Science Direct, and Web of Science) and other sources. The qualities of the included studies were assessed using the Joanna Briggs Institute Critical Appraisal tools and the publication bias was measured using the funnel plot and Eggers regression test. Comprehensive meta-analysis (CMA) Version 3.3.07 and Review Manager software were used to estimate pooled prevalence and associations of intestinal parasites and tuberculosis infection.
RESULTS
Eleven articles with a total of 3158 tuberculosis patients included in the analysis based on the eligibility criteria. The estimated pooled prevalence of intestinal parasites co-infection was 33% (95% CI: 23.3, 44.3) using the random-effects model. The most common intestinal parasites were Ascaris lumbricoides 10.5% (95% CI: 6.0, 17.5), Hookworm 9.5% (95% CI: 6.10, 14.4), Giardia lamblia 5.7% (95% CI: 2.90, 10.9) and Strongyloides sterocoralis 5.6% (95% CI: 3.3, 9.5). The odds of intestinal parasites infection was higher among tuberculosis patients compared to tuberculosis free individuals (OR = 1.76; 95% CI: 1.17, 2.63). A significant difference was observed among TB patients for infection with intestinal helminths (OR = 2.01; 95% CI: 1.07, 3.80) but not for intestinal protozoans when compared with their counterparts. The odds of multiple parasitic infections was higher among tuberculosis patients (OR = 2.59, 95% CI: 1.90, 3.55) compared to tuberculosis free individuals. However, intestinal parasites co-infection was not associated with HIV status among tuberculosis patients (OR = 0.97; 95% CI: 0.71, 1.32).
CONCLUSION
One-third of tuberculosis patients are co-infected with one or more intestinal parasites, and they are more likely to be infected with intestinal helminths and multiple intestinal parasitic infections compared to TB free individuals. We recommend routine screening of tuberculosis patients for intestinal parasites. The effect of mass deworming on tuberculosis incidence would be important to be considered in future researches.
TRIAL REGISTRATION
Registered on PROSPERO with reference number ID: CRD42019135350 .
Topics: Ancylostomatoidea; Animals; Ascaris lumbricoides; Coinfection; Ethiopia; Feces; Female; Giardia lamblia; Humans; Intestinal Diseases, Parasitic; Male; Prevalence; Risk Factors; Tuberculosis
PubMed: 32664873
DOI: 10.1186/s12879-020-05237-7 -
Journal of Environmental Management Apr 2021The pathogen concentration in human excreta needs to be managed appropriately, but a predictive approach has yet to be implemented due to a lack of kinetics models for... (Meta-Analysis)
Meta-Analysis Review
The pathogen concentration in human excreta needs to be managed appropriately, but a predictive approach has yet to be implemented due to a lack of kinetics models for pathogen inactivation that are available under varied environmental conditions. Our goals were to develop inactivation kinetics models of microorganisms applicable under varied environmental conditions of excreta matrices and to identify the appropriate indicators that can be monitored during disinfection processes. We conducted a systematic review targeting previous studies that presented time-course decay of a microorganism and environmental conditions of matrices. Defined as a function of measurable factors including treatment time, pH, temperature, ammonia concentration and moisture content, the kinetic model parameters were statistically estimated using hierarchical Bayesian modeling. The inactivation kinetics models were constructed for Escherichia coli, Salmonella, Enterococcus, Ascaris eggs, bacteriophage MS2, enterobacteria phage phiX174 and adenovirus. The inactivation rates of a microorganism were predicted using the established model. Ascaris eggs were identified as the most tolerant microorganisms, followed by bacteriophage MS2 and Enterococcus. Ammonia concentration, temperature and moisture content were the critical factors for the Ascaris inactivation. Our model predictions coincided with the current WHO guidelines. The developed inactivation kinetics models enable us to predict microbial concentration in excreta matrices under varied environmental conditions, which is essential for microbiological risk management in emerging resource recovery practices from human excreta.
Topics: Ammonia; Bayes Theorem; Environmental Microbiology; Humans; Levivirus; Temperature
PubMed: 33582482
DOI: 10.1016/j.jenvman.2021.112088 -
Food and Waterborne Parasitology Sep 2020Waterborne parasitic diseases form one of common and important public health and economic problems in low- and middle-income countries, though little is known on the...
Waterborne parasitic diseases form one of common and important public health and economic problems in low- and middle-income countries, though little is known on the burden and patterns of these diseases in most regions. This systematic scoping review informs on the prevalence and pattern of waterborne parasitic infections in eastern Africa from 1st of January 1941 to 31st of December 2019. The review found limited number of published studies on waterborne parasitic diseases, though 13 of the 15 studied countries in eastern Africa provided one or more published report(s) totalling 47 reports. Focus of studies was mainly on schistosomiasis where 44.8% of the 47 retrieved studies reported it. Other frequently reported diseases were giardiasis (23.4% of reports), soil-transmitted helminths (23.4%) and amoebiasis (21.3%). Rarely reported diseases were malaria, cryptosporidiosis, isosporiasis, dracunculiasis and trichomoniasis. Based on parasitological examinations, schistosomiasis prevalence ranged from 17 to 33% in Burundi, 1.9 to 73.9% in Ethiopia, 2.1 to 18% in Kenya, 7.2 to 88.6% in Uganda, 22.9 to 86.3% in Tanzania, 27.2 to 65.8% in Somalia, 15 to >50% in Mauritius, 2.4% in Eritrea and 5.0 to 93.7% in Madagascar. Amoebiasis prevalence was 4.6-15,3% (Ethiopia), 5.9-58.3% (Kenya), 54.5% (Rwanda), 0.7-2.7% (Sudan), 19.93% (Uganda) and 4.5-5.0% (Seychelles). Giardiasis prevalence was 0.6-55.0% (Ethiopia), 16.6% (Kenya), 3.6% (Rwanda), 21.1% (Sudan), 40.7% (Uganda), 45.0% (Eritrea) and 3.3-6.0% (Seychelles). Soil-transmitted helminths prevalence was 41.7-52.4% (Ethiopia), 32.4-40.7% (Kenya), 9997 cases (Rwanda), 85.0% (Somalia), 4.7% (Madagascar) and 1.1-84% (Seychelles), , and hookworms were the most common helminths detected. Malaria prevalence was 2.9-4.31% (Ethiopia), an annual episode of 9 million people (Sudan), 13.0% (Tanzania), 146 hospital cases (Madagascar), 1.4-2.0% (Seychelles) and <5.0% in Djibouti. It is also observed that >50% of the populations in eastern Africa region lack improved drinking water sources or sanitation facilities. This may account for the observed high prevalence of the diseases. The author also suggests likely underestimation of the prevalence as most waterborne parasitic diseases are neglected and cases likely only recorded and left unpublished in health facilities. Thus for a thorough mapping of burdens of these diseases, grey literature, including hospital records must be reviewed while interventions focusing on improved water and sanitation are likely to reduce the burden considerably.
PubMed: 32995583
DOI: 10.1016/j.fawpar.2020.e00089 -
Journal of Epidemiology and Global... May 2024Soil-transmitted helminthic (STH) infections are the leading cause of stunting among children. To lessen the burden, the World Health Organization (WHO) recommended a...
BACKGROUND
Soil-transmitted helminthic (STH) infections are the leading cause of stunting among children. To lessen the burden, the World Health Organization (WHO) recommended a periodic deworming program through the use of single-dose therapy in the endemic regions. Therefore, the purpose of this study was to synthesize evidence about the efficacy of anthelminthic drugs against STH infections among preschool and school-age children.
METHODS
The Preferred Reposting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria were followed in this study. Relevant electronic databases, including PubMed, Scopus, Embase, DOAJ, Science Direct, the WHO Clinical Trials.gov library, Google Scholar, and AJOL databases, were searched for relevant publications. Randomized controlled trials (RCTs) and non-randomized interventional studies focused on the efficacy of albendazole and mebendazole against STHs in children were included in the study. Review Manager was used to analyze the data. A random effects model was used to obtain the pooled estimated efficacy. To evaluate heterogeneity, the I test and Cochrane Q (χ) were employed. The risk of publication bias was investigated using Egger's test and the funnel plot. The protocol of this review was registered at the PROSPERO international prospective register of systematic reviews (CRD42023401196).
RESULTS
Of the 69 publications selected for the systematic review, 66 with complete data were included in the meta-analysis. Single doses of albendazole and mebendazole have shown satisfactory efficacy [egg reduction rate (ERR)] against Ascaris lumbricoides [95.54% (95% CI: 88.75-102.34%) and 98.69% (95% CI: 97.68-99.65%), respectively. The effectiveness of these two drugs against Trichuris trichiura and hookworms was comparatively low (< 80% ERR), except for albendazole, which showed high ERRs [93.44% (95%CI: 92.39-94.49%)] against hookworms. The cure rate (CR) of albendazole against T. trichiura, A. lumbricoides, and hookworms were 50.8%, 91.3%, and 78.32%, respectively. Likewise, mebendazole showed CRs of 48.15%, 92.8%, and 49.32% against T. trichiura, A. lumbricoides, and hookworms, respectively. Subgroups such as studies conducted after 2000, diagnostic type (McMaster), and longer follow-up weeks significantly reduced the efficacy of the two drugs against T. trichura. While the combination of albendazole or mebendazole with other drugs and RCT showed significantly improved efficacy against T. trichura. The count of eggs per gram of stool (EPG) was identified as one of the variables that negatively and significantly influenced the efficacy of albendazole or mebendazole against A. lumbricoides.
CONCLUSION
Despite the wide range of ERRs and CR reported in the different articles included in this review, the pooled estimated efficacy of albendazole and mebendazole against STHs falls in the satisfactory category of WHO recommendations. Further evaluation of the combination of anthelminthic drugs as a preventive chemotherapy option and routine drug efficacy testing are necessary to prevent the emergence and widespread use of drug-resistant STHs.
PubMed: 38696109
DOI: 10.1007/s44197-024-00231-7 -
Food Microbiology May 2021Regarding preparing and serving foods, food handlers have an influential role in the spreading of foodborne infections. Due to the great potential to cause foodborne... (Meta-Analysis)
Meta-Analysis
Regarding preparing and serving foods, food handlers have an influential role in the spreading of foodborne infections. Due to the great potential to cause foodborne infections, intestinal parasites (IPs) are considered a significant public health problem in today's societies. In Iran, despite several regional reports, national data on IPs prevalence in food handlers are lacking. The aim of the present study, therefore, is to estimate the pooled prevalence of IPs infections and associated pooled odds ratio of educational level among food handlers in Iran. PubMed, Web of Science, Scopus, Embase, and Google Scholar databases (international) and SID and Magiran databases (national) were systematically searched for studies that reporting the prevalence of IPs in food handlers in Iran, published between 2000 and 2020. Pooled prevalence was estimated using a random-effects model with a 95% confidence interval (CI) and depicted as a forest plot, while heterogeneity was evaluated using Cochran's Q-test. The overall pooled prevalence estimate for IPs was 19.3% (95% CI = 14.9-23.7%). Prevalence of the protozoan parasites (20%, 95% CI = 13.7-26.3%) was significantly higher than that of the helminthic parasites (1.6%, 95% CI = 1.1-2.0%). Giardia lamblia (5.2%), Entamoeba coli (5.0%), and Blastocystis spp. (4.4%), as protozoan parasites, and Ascaris lumbricoides (1.4%), Enterobius vermicularis (0.9%), and Hymenolepis nana (0.5%), as helminthic parasites, were the most commonly reported species. Food handlers with low educational levels were 20% more exposed to IPs infection, compared to those with high educational levels (OR = 1.21, 95% CI = 0.88 to 1.65). The prevalence of IPs infections among food handlers in Iran is significant. Besides taking into account this epidemiologic information, a holistic approach, including periodic stool screening, health education, and treatment of infected food handlers, will help in the control of these infections in Iran.
Topics: Animals; Feces; Food Handling; Food Safety; Food Services; Humans; Intestinal Diseases, Parasitic; Iran; Parasites; Prevalence
PubMed: 33397621
DOI: 10.1016/j.fm.2020.103703 -
PLoS Neglected Tropical Diseases Aug 2019In South Asia, hundreds of millions of people are infected with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura). However,...
BACKGROUND
In South Asia, hundreds of millions of people are infected with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura). However, high-resolution risk profiles and the estimated number of people infected have yet to be determined. In turn, such information will assist control programs to identify priority areas for allocation of scarce resource for the control of soil-transmitted helminth infection.
METHODOLOGY
We pursued a systematic review to identify prevalence surveys pertaining to soil-transmitted helminth infections in four mainland countries (i.e., Bangladesh, India, Nepal, and Pakistan) of South Asia. PubMed and ISI Web of Science were searched from inception to April 25, 2019, without restriction of language, study design, and survey date. We utilized Bayesian geostatistical models to identify environmental and socioeconomic predictors, and to estimate infection risk at high spatial resolution across the study region.
PRINCIPAL FINDINGS
A total of 536, 490, and 410 georeferenced surveys were identified for A. lumbricoides, hookworm, and T. trichiura, respectively. We estimate that 361 million people (95% Bayesian credible interval (BCI) 331-395 million), approximately one-quarter of the South Asia population, was infected with at least one soil-transmitted helminth species in 2015. A. lumbricoides was the predominant species. Moderate to high prevalence (>20%) of any soil-transmitted helminth infection was predicted in the northeastern part and some northern areas of the study region, as well as the southern coastal areas of India. The annual treatment needs for the school-age population requiring preventive chemotherapy was estimated at 165 million doses (95% BCI: 146-185 million).
CONCLUSIONS/SIGNIFICANCE
Our risk maps provide an overview of the geographic distribution of soil-transmitted helminth infection in four mainland countries of South Asia and highlight the need for up-to-date surveys to accurately evaluate the disease burden in the region.
Topics: Ancylostomatoidea; Animals; Ascariasis; Ascaris lumbricoides; Asia; Bangladesh; Bayes Theorem; Databases, Factual; Helminthiasis; Helminths; Hookworm Infections; Humans; India; Nepal; Pakistan; Prevalence; Risk Factors; Socioeconomic Factors; Soil; Trichuriasis; Trichuris
PubMed: 31398200
DOI: 10.1371/journal.pntd.0007580 -
Veterinary Medicine and Science Nov 2021Food handlers regardless of whether preparing or serving food, play key roles in the transmission of food-borne infections. This study aimed to evaluate the prevalence... (Meta-Analysis)
Meta-Analysis Review
Food handlers regardless of whether preparing or serving food, play key roles in the transmission of food-borne infections. This study aimed to evaluate the prevalence of intestinal parasitic infections in food handlers in Iran. In the present study, a comprehensive literature search was carried out in electronic databases, including PubMed, Scopus, Google Scholar, Science Direct, Magiran, Scientific Information Database (SID), Iran Medex and Iran Doc, to identify all the published studies from 2000 to 31st April 2019. A total of 25 articles from different regions of Iran were identified and fulfilled our eligibility criteria. Totally, 140,447 cases were examined and 1163 cases were infected with intestinal parasites. Of all cases, 19,516 were male and 5901 were female with 1163 and 652 infected cases, respectively. The overall prevalence of intestinal parasitic infections was evaluated 14.0% [95% CI: 11.0-17.0%]. It is revealed that protozoan, such as Giardia lamblia, with prevalence of 41.0% [95% CI: 25.0-59.0%], Blastosystis hominis with 28.0% [95% CI: 15.0-44.0%] and Entamoeba coli with 22.0% [95% CI: 16.0-29.0%] had the highest prevalence while, Dientamoeba fragilis 5.0% [95% CI: 4.0-7.0%], Iodamoeba bütschlii 5.0% [95% CI: 2.0-8.0%], Chilomastix mesnili 5.0% [95% CI: 2.0-9.0%] and Endolimax nana with 3.0% [95% CI: 1.0-7.0%], were less prevalent. Infection with Ascaris lumbricoides7.0% [95% CI: 0.0-29.0%] was more prevalent helminth followed with Enterobius vermicularis 3.0% [95% CI: 1.0-5.0%], Hymenolepis nana 2.0% [95% CI: 1.0-3.0%], Taenia spp. 2.0% [95% CI: 0.0-7.0%] and Trichuris trichiura 1.0% [95% CI: 0.0-1.0%]. The high prevalence of commensal parasites, such as Entamoeba coli, which does not need cure is indicating the importance of personal hygiene in food handlers. Our results revealed the high prevalence of intestinal parasitic infection in food handlers in Iran. Monitoring programs to prevent and controlling of transmission to individuals are needed.
Topics: Animals; Feces; Female; Intestinal Diseases, Parasitic; Iran; Male; Prevalence
PubMed: 34358411
DOI: 10.1002/vms3.590 -
Parasites & Vectors Feb 2021Ethiopia has set the ambitious national targets of eliminating soil-transmitted helminths (STH) and schistosomiasis (SCH) as public health problems by 2020, and breaking...
BACKGROUND
Ethiopia has set the ambitious national targets of eliminating soil-transmitted helminths (STH) and schistosomiasis (SCH) as public health problems by 2020, and breaking their transmission by 2025. This systematic review was performed to provide insight into the progress made by the national STH and SCH control programme purposed with reaching these targets.
METHODS
Studies published on STH and SCH in Ethiopia were searched for using Web of Science, PubMed, Scopus, and the resulting references of selected studies. Prevalence and intensity were analysed, stratified by region, age, and diagnostics.
RESULTS
A total of 231 papers published between 2000 and 2020 were included. Over the past two decades, Trichuris trichiura (TT) infection has shown the most statistically significant decrease (93%, p < 0.0001), followed by Schistosoma mansoni (SM) (69%, p < 0.0001), Ascaris lumbricoides (AL) (67%, p < 0.0001) and Schistosoma haematobium (83%, p = 0.038) infections. Geographically, parasite burden has only consistently shown a significant reduction in the Southern Nations, Nationalities and Peoples' Region of Ethiopia, where AL, TT, hookworm and SM significantly decreased by 80% (p = 0.006), 95% (p = 0.005), 98% (p = 0.009) and 87% (p = 0.031), respectively. Prevalence of STH was highest among adults across all species, contrary to typical age-infection profiles for TT and AL that peak among school-aged children. Expanding treatment to the whole community would target reservoirs of adult and preschool-aged infection within the community, assisting Ethiopia in reaching their national transmission break targets. There was substantial heterogeneity in diagnostic methods used across studies, the majority of which predominantly used single-slide Kato-Katz. This low slide frequency provides poor diagnostic sensitivity, particularly in low endemic settings.
CONCLUSION
The prevalence of STH and SCH in Ethiopia has decreased over time due to the strategic use of anthelmintics. Both standardising and increasing the sensitivity of the diagnostics used, alongside the ubiquitous use of parasite intensity with prevalence, would enable a more accurate and comparable understanding of Ethiopia's epidemiological progress. Further work is needed on community-wide surveillance in order to understand the burden and subsequent need for treatment among those outside of the standard school-based control program.
Topics: Cross-Sectional Studies; Ethiopia; Feces; Helminthiasis; Humans; Prevalence; Schistosomiasis; Soil; World Health Organization
PubMed: 33546757
DOI: 10.1186/s13071-021-04600-0 -
Journal of Travel Medicine Mar 2020Gestational helminth infections are correlated to adverse outcomes including maternal anaemia; as such, treatment is recommended. However, little published high-quality... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Gestational helminth infections are correlated to adverse outcomes including maternal anaemia; as such, treatment is recommended. However, little published high-quality data exist around the efficacy, safety and tolerability of anti-helminthics in pregnancy. We therefore conducted a systematic review and synthesized the available data on maternal outcomes following gestational treatment of intestinal nematodes to help guide clinical decision-making.
METHODS
Five electronic databases were searched for studies reporting the efficacy, safety or tolerability of anti-helminthic drugs for gestational treatment of intestinal nematodes. Studies were systematically screened followed by data extraction. Trial quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. We conducted a narrative synthesis followed by meta-analyses using random effects models as appropriate. Data were summarized using qualitative and quantitative measures for specific parasitic infections as well as efficacy and safety of anti-parasitic agents. Outcomes of interest included maternal anaemia, minor adverse outcomes, pregnancy loss, pre-mature delivery, prevalence of infection and cure rate.
RESULTS
Twenty-three studies were included. Gestational treatment with albendazole had cure rates up to 90% for hookworm and Ascaris, but only 50% for Trichuris. Mebendazole had an overall cure rate of ≤ 70% for Ascaris, hookworm and Trichuris. Pooled relative risk reduction of hookworm prevalence at delivery with albendazole compared to placebo was 90% (95% confidence interval, 0.09-0.15; n = 2; I2 = 0%). Rate of pregnancy loss and haemoglobin concentration did not differ between albendazole or mebendazole vs placebo, and rates of pre-term delivery were similar in albendazole-treated pregnant women vs controls. Ivermectin demonstrated a cure rate of 29% for hookworm and 56% for Trichuris in pregnant women. No serious adverse events were attributable to any drug studied.
CONCLUSIONS
With increased international travel and migration of vulnerable populations, practitioners will encounter nematode infections in pregnant patients. Our analysis supports that albendazole in pregnancy has high cure rates for soil-transmitted helminths and is safe for the mother.
Topics: Albendazole; Animals; Anthelmintics; Female; Helminthiasis; Helminths; Humans; Pregnancy; Soil; Travel-Related Illness
PubMed: 31641774
DOI: 10.1093/jtm/taz079