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Tropical Medicine and Infectious Disease Dec 2023An estimated 1.5 billion people are infected with soil-transmitted helminths (hookworms, and ). These infections are targeted for elimination by the World Health...
An estimated 1.5 billion people are infected with soil-transmitted helminths (hookworms, and ). 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 . The LOD technique has potential as a promising diagnostic test, but its sensitivity still requires improvement.
PubMed: 38276635
DOI: 10.3390/tropicalmed9010005 -
The American Journal of Tropical... Mar 2024Zoonotic human infections with Ancylostoma ceylanicum have recently been reported in the Americas. We used archived human stool samples to study the geographic...
Geographic Distribution of Human Infections with Zoonotic Ancylostoma ceylanicum and Anthropophilic Hookworms in Ecuador: A Retrospective Analysis of Archived Stool Samples.
Zoonotic human infections with Ancylostoma ceylanicum have recently been reported in the Americas. We used archived human stool samples to study the geographic distribution of human infections with A. ceylanicum and anthropophilic hookworms in different geoclimatic regions (coastal, Andean, and Amazon) of Ecuador. We analyzed retrospectively archived human stool samples from five studies previously screened for hookworm infection by microscopy, of which four included hookworm-positive samples only and one involved hookworm-negative samples to increase geographic distribution of sampling. Stools were analyzed using multi-parallel quantitative polymerase chain reaction (qPCR) assays to detect Necator americanus, Ancylostoma duodenale, A. ceylanicum, Ascaris lumbricoides, Trichuris trichiura, and Strongyloides stercoralis. Sequencing was done for the A. ceylanicum cox1 gene. A total of 132 samples were analyzed, of which 69 (52.3%) were from hookworm-positive and 63 (47.7%) from hookworm-negative individuals by microscopy. Overall, 82.6% of microscopy-positive samples and 33.3% of microscopy-negative samples were positive for hookworm by qPCR. Of microscopy-positive samples, 36.2% were A. ceylanicum, 37.7% A. duodenale, and 33.3% N. americanus, whereas equivalent proportions for microscopy-negative samples were 1.6%, 31.7%, and 1.6%, respectively. Ancylostoma duodenale was the most widely dispersed geographically, followed by N. americanus. Ancylostoma ceylanicum was least dispersed but was detected in coastal and Amazon regions. In conclusion, human infections with A. ceylanicum, A. duodenale, and N. americanus were detected in different geoclimatic regions of Ecuador. Additional studies are required to further define the epidemiology of human A. ceylanicum infections, but the potentially widespread presence of this helminth in human populations in Ecuador has implications for hookworm control strategies.
Topics: Animals; Humans; Ancylostoma; Ancylostomatoidea; Ancylostomiasis; Retrospective Studies; Ecuador; Hookworm Infections; Zoonoses; Feces
PubMed: 38266286
DOI: 10.4269/ajtmh.23-0469 -
Infectious Diseases of Poverty Jan 2024Mass drug administration (MDA) program of albendazole to at-risk populations as preventive chemotherapy is the core public health intervention to control...
Reduced efficacy of single-dose albendazole against Ascaris lumbricoides, and Trichuris trichiura, and high reinfection rate after cure among school children in southern Ethiopia: a prospective cohort study.
BACKGROUND
Mass drug administration (MDA) program of albendazole to at-risk populations as preventive chemotherapy is the core public health intervention to control soil-transmitted helminths (STHs). Achieving this goal relies on drug effectiveness in reducing the parasite reservoirs in the community and preventing reinfection. We assessed the efficacy of albendazole against STH parasite infection and reinfection status after cure.
METHODS
A total of 984 schoolchildren infected with at least one type of STH parasite (hookworm, Ascaris lumbricoides, Trichuris trichiura) in southern Ethiopia were enrolled and received albendazole and praziquantel in MDA campaign conducted from January to March 2019. Stool exams at week-4 and at week-8 of post-MDA were done using Kato Katz technique. The primary outcome was efficacy assessed by cure rate (CR) and fecal egg reduction rates (ERRs) at four weeks of post-MDA. The secondary outcome was reinfection status defined as parasite egg positivity at eight weeks among those who were cured at 4 weeks of post-MDA. Group comparisons in CR and related factors were assessed with chi-square or Fisher's exact tests. Predictors of CR were examined through univariate and multivariate regression analyses.
RESULTS
The overall CR and ERR for hookworm infection were 97.2% (95% CI 94.6-99.4) and 97.02%, respectively. The overall CR and ERR for A. lumbricoides were 71.5% (95% CI 68.3-74.6) and 84.5% respectively. The overall CR and ERR and for T. trichiura were 49.5% (95% CI 44.8-54.2) and 68.3%, respectively. The CR among moderate T. trichiura infection intensity was 28.6%. Among children cured of hookworm, A. lumbricoides and T. trichiura at week 4 post-MDA, 4.6%, 18.3% and 52.4% became reinfected at week-8 post-MDA, respectively. Significantly lower CR (36.6%) and higher reinfection after cure (60.6%) among A. lumbricoides and T. trichiura coinfected children than A. lumbricoides only (CR = 69.6%, reinfection rate = 15.1%) or T. trichiura only infected children (CR = 55.6%, reinfection rate = 47.1%) was observed. Pre-treatment coinfection with ≥ two types of STH parasites was significantly associated with re-infection after cure.
CONCLUSION
Albendazole MDA is efficacious against hookworm but has reduced efficacy against A. lumbricoides and is not effective against T. trichiura. The low drug efficacy and high reinfection rate after cure underscore the need for alternative treatment and integration of other preventive measures to achieve the target of eliminating STHs as a public health problem by 2030.
Topics: Child; Animals; Humans; Ascaris lumbricoides; Trichuris; Albendazole; Ethiopia; Prospective Studies; Reinfection; Coinfection
PubMed: 38246985
DOI: 10.1186/s40249-024-01176-6 -
Helminthologia Dec 2023Rhesus macaques ( are distributed across Nepal in close association with humans and with a high probability of sharing of soil-transmitted intestinal helminth parasites....
Rhesus macaques ( are distributed across Nepal in close association with humans and with a high probability of sharing of soil-transmitted intestinal helminth parasites. This study was carried out to determine the prevalence, richness and risk factors of gastrointestinal (GI) helminth parasites among rhesus macaques and humans in the Daunne Forest area, a community managed forest in the central mid-hills of Nepal. A total of 190 fecal samples, including 120 samples from rhesus macaques residing around the Daunne Devi Temple and in the surrounding forest, and 70 from local people, were microscopically examined by direct wet mount, floatation and sedimentation methods. Seasonal and age-sex based variations in helminth parasite prevalence were analyzed. Among the rhesus macaques, the total parasite prevalence was 39.2 %. sp. accounted for the highest prevalence (19.17 %) followed by sp. (13.33 %), hookworm (10.83 %) and sp. (4.17 %). Among the humans, (11.3 %) was the only parasite detected. The Sorenson's coefficient of similarity of GI parasites between the macaques and local people at the generic level was 0.4. Mean parasite richness for the macaques was 1.21 ± 0.41 (SD) per infected sample. Parasite prevalence in the summer season (41.4 %) was higher than in the winter season (36 %). Adult macaques (41.67 %) had higher GI parasite prevalence than the young (30.77 %) and infants (27.27 %). Among the adult macaques, the prevalence rate was significantly higher (=0.005) in females (52.46 %) than in males (22.86 %). Our results indicate that the temple rhesus macaques have a high prevalence of GI helminth parasites and could pose a potential zoonotic risk. As such, the need for routine monitoring and an effective management strategy is essential.
PubMed: 38222485
DOI: 10.2478/helm-2023-0037 -
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 -
Medicine Jan 2024Anemia is one of the severe clinical outcomes associated with concomitant infection of malaria and soil-transmitted helminths (STH). Since STH infections mostly share...
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.
Topics: Humans; Animals; Soil; Cross-Sectional Studies; Coinfection; Helminths; Anemia; Health Facilities; Human Growth Hormone; Hemoglobins
PubMed: 38181246
DOI: 10.1097/MD.0000000000036835 -
Tropical Medicine and Health Jan 2024Soil-transmitted helminth (STH) infections are a public health concern in endemic areas. For efficient control, the epidemiology of the disease needs to be monitored....
BACKGROUND
Soil-transmitted helminth (STH) infections are a public health concern in endemic areas. For efficient control, the epidemiology of the disease needs to be monitored. This report assesses the prevalence, incidence, post-treatment infection (PTI) rate, and risk factors for STH infections in two rural areas of Gabon.
METHOD
In this longitudinal and prospective study, participants aged six to 30 years from the vicinity of Lambaréné and selected households using a simple randomization process were included and followed in two consecutive periods of six and nine months. Stool samples were obtained at the beginning and the end of each follow-up phase (FUP). The Kato-Katz technique was used for the detection of STH eggs, while the Harada-Mori technique and coproculture were used for the detection of larvae in stool processed within a maximum of four hours of collection. Prevalence was determined at the three main time points of the study, incidence was assessed during the two study phases, and PTI was defined as an infection detected nine months post-treatment.
RESULTS
A total of 262 participants were included. The overall prevalence of STH infections was 42% (95%CI: 34-50) and 44% (95%CI: 37-51) at baseline for the six and nine month FUPs, respectively. Trichuris trichiura was the most prevalent species at each time point of assessment. The cumulative incidence of STH at the 6- and 9-month follow-ups was 18% (95%CI: 12-27) and 35% (95%CI: 27-43), respectively, while the incidence rates were 41 (95%CI: 28-55) and 56 (95%CI: 46-67) per 100 person-years, respectively. The PTI rates at the 9-month follow-up for T. trichiura, hookworm, and Ascaris lumbricoides were 58% (95%CI: 41-74), 31% (95%CI: 11-59) and 18% (95%CI: 5-40), respectively. The STH infection intensity was generally light.
CONCLUSION
The prevalence level of STH infection is moderate in the vicinity of Lambaréné, with T. trichiura being the most prevalent species. Our results reveal a rapid spread of the disease in the population mainly following intervention, particularly for trichuriasis, and therefore call for the full implementation of the World Health Organization's recommendations in the area. Trial registration clinicaltrials.gov Identifier NCT02769013. Registered 21 April 2016, https://clinicaltrials.gov/study/NCT02769013.
PubMed: 38163912
DOI: 10.1186/s41182-023-00567-z -
Archives of Academic Emergency Medicine 2024The simultaneous occurrence of intestinal ascariasis and appendicitis presents a challenge in diagnosing pediatric abdominal emergencies due to overlapping symptoms. We...
The simultaneous occurrence of intestinal ascariasis and appendicitis presents a challenge in diagnosing pediatric abdominal emergencies due to overlapping symptoms. We present the case of an 8-year-old boy who experienced acute abdominal pain, characterized by a severe cramp in the mid and lower right abdomen, with pain rated 7 out of 10, a mild fever, and continuous nausea. The initial evaluation suggested appendicitis, supported by an Alvarado score of 9. However, ultrasonography did not conclusively confirm appendicitis but revealed an Ascaris worm in the ileum. This finding highlights the importance of careful diagnostic processes that combine clinical assessment with imaging techniques, while being mindful of their limitations. Surgical exploration confirmed retrocecal appendicitis coexisting with an Ascaris lumbricoides infection. The treatment involved surgical removal of the affected appendix and pharmacological expulsion of the parasitic worm using albendazole, which proved effective. This report emphasizes the consideration of ascariasis in diagnosing appendicitis, particularly in areas where intestinal parasites are common. It also demonstrated the improved diagnostic accuracy achieved through clinical scoring and imaging, thus reducing the risk of missing dual pathologies in young patients with acute abdominal pain.
PubMed: 38162385
DOI: 10.22037/aaem.v12i1.2187 -
Helminthologia Sep 2023Intestinal parasitic infections in pregnant women have been associated with severe adverse outcomes such as anemia, low birth weight, and mother and fetus morbidity and...
BACKGROUND
Intestinal parasitic infections in pregnant women have been associated with severe adverse outcomes such as anemia, low birth weight, and mother and fetus morbidity and mortality. This study aimed to determine the prevalence of intestinal parasitic infection and its associated risk factors among pregnant women in Taiz, Yemen.
METHODS
A cross-sectional study was conducted between July 2022 and January 2023. Sociodemographic and other explanatory variables were obtained via face-to-face interviews using a structured questionnaire. The wet-mount and formol-ether concentration techniques were applied to identify the IPIs. Data were analyzed using SPSS, version 20, and p-values < 0.05 were considered statistically significant. An analysis of descriptive statistics and multivariate logistic regression was conducted. A p-value < 0.05 was deemed statistically significant. The study included a total of 393 pregnant women.
RESULTS
Of the 393 pregnant women screened for intestinal parasites, 144 (36.6 %) had at least one parasite. The most common intestinal parasite was Giardia lamblia (12.2 %), followed by (10.9 %), (7.4 %), (14.3 %), and (1.8 %). Being a farmer (AOR = 2.7, 95% CI: 1.69-4.26, p = 0:003) and drinking from unsafe water wells, streams, rain, and dams (AOR = 2:6, 95% CI: 1.68-4.25, p ≤ 0:001) were significantly associated with IPIs.
CONCLUSION
Pregnant women in the study area still face a severe health burden due to intestinal parasitic infection. Therefore, it is recommended that health education should be improved, and safe tap water should be provided to pregnant women to reduce the incidence of IPIs.
PubMed: 38152474
DOI: 10.2478/helm-2023-0022 -
Heliyon Dec 2023Rapid diagnosis of urogenital schistosomiasis caused by requires an accurate and timely assay, especially for low-intensity infection cases and in non-endemic areas....
Rapid diagnosis of urogenital schistosomiasis caused by requires an accurate and timely assay, especially for low-intensity infection cases and in non-endemic areas. The mitochondrial cytochrome oxidase 1 (cox1) gene fragment of was selected as detection target as this short fragment, which can be rapidly sequenced and yet possess good diagnostic resolution. A pair of primers and a fluorescent probe were designed according to the principle of recombinase-aided amplification (RAA), which was subsequently optimized and applied as an -specific RAA assay. Its diagnostic performance was validated for sensitivity and specificity in comparison to microscopy-based egg counting after urine filtration. The RAA assay could detect as little as 10 copies/μL of recombinant plasmid, and no cross-reactions were observed with , , , or . This test can be conducted at 39 °C and the whole RAA reaction can be completed within 20 min. The validation of the RAA assay showed that it had 100 % consistency with urine-egg microscopy, as it does not require an elaborate reading tool, is simple to use, and should be useful for field diagnostics and point-of-care applications.
PubMed: 38144328
DOI: 10.1016/j.heliyon.2023.e23031