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Infectious Diseases in Obstetrics and... 2024Toxocariasis is an important health problem caused by the parasitic species () and (). Prevalence of toxocariasis in pregnant women as a vulnerable population is... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Toxocariasis is an important health problem caused by the parasitic species () and (). Prevalence of toxocariasis in pregnant women as a vulnerable population is doubly important, and the aim of this study is to estimate the overall prevalence of toxocariasis infection in pregnant women according to the available reports.
METHODS
The present study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklists. A systematic search was carried out in international scientific databases (Google Scholar, Web of Science, ScienceDirect, Scopus, and PubMed) between 1990 and 2023. The overall prevalence of parasitic infection was estimated with a random-effects model. All analyses (overall prevalence, heterogeneity, publication bias, and sensitivity analysis) were performed with comprehensive meta-analysis (V2.2, Bio stat) software.
RESULTS
Amid the final eleven included studies, based on the random-effects model, the estimation of the pooled prevalence of spp. was 20.8% (95% CI, 9.8-38.7%). The association between the risk factors of toxocariasis and the prevalence of the disease was not statistically significant.
CONCLUSIONS
In the present study, significant prevalence was reported; however, considering the limited number of studies, it seems that the actual prevalence of the disease is higher. Therefore, it seems necessary to monitor this health problem in pregnant women.
Topics: Humans; Female; Pregnancy; Toxocariasis; Animals; Toxocara; Seroepidemiologic Studies; Pregnancy Complications, Parasitic; Prevalence; Toxocara canis
PubMed: 38682081
DOI: 10.1155/2024/1943353 -
Frontiers in Public Health 2024According 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),... (Meta-Analysis)
Meta-Analysis
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). 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. 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.
Topics: Animals; Child; Humans; Ascaris lumbricoides; Developing Countries; Helminthiasis; Helminths; Prevalence; Soil; Child, Preschool; Adolescent
PubMed: 38577281
DOI: 10.3389/fpubh.2024.1283054 -
Acta Parasitologica Mar 2024In the present study, we performed a systematic review and meta-analysis to assess the global and regional seroprevalence of Toxocara spp. and associated risk factors... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
In the present study, we performed a systematic review and meta-analysis to assess the global and regional seroprevalence of Toxocara spp. and associated risk factors among children.
METHODS
The present systematic review and meta-analysis was followed based on the Preferred Reporting. Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. We searched the online databases (PubMed, Scopus, and Web of Science) and Google Scholar search engine for studies that measured seroprevalence of Toxocara spp. among children, published between 1 January 2000 and 15 January 2022. Accordingly, the pooled seroprevalence and 95% confidence intervals (CI) were estimated using a random-effects meta-analysis model.
RESULTS
A total of 65 articles from 22 countries met the inclusion criteria. The global seroprevalence of Toxocara spp. infection among children was estimated as 25% (95% CI 22-29). Meta-regression analysis showed that the type of population studied (p = 0.002) and year of publication (p = 0.044) it may be the source of heterogeneity. The highest and lowest pooled seroprevalence of Toxocara spp. infection were estimated in Thailand and Colombia as 58.2% (95% CI 50.9-65.5) and 7.04% (95% CI 3.05-11.3), respectively. Male gender was associated with a higher risk of Toxocara spp. compared to females, and this association was statistically significant (OR = 1.24; 95% CI 1.09-1.41, p = 0.001). However, residing in rural areas did not show a statistically significant increase in risk compared to living in urban areas (OR = 1.39; 95% CI 0.88-2.21, p = 0.143).
CONCLUSION
Toxocariasis is common among children, hence, prevention and control scheme of this helminth in children should be considered by health officials and health policymakers, especially in developing countries, where seroprevalence is highest.
Topics: Animals; Child; Humans; Global Health; Risk Factors; Seroepidemiologic Studies; Toxocara; Toxocariasis
PubMed: 38195773
DOI: 10.1007/s11686-023-00772-0 -
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 -
Transactions of the Royal Society of... Nov 2023The aberrant migration of Ascaris lumbricoides may cause extra-intestinal ascariasis (EIA) involving hepato-biliary-pancreatic (HBP) or other extra-gastro-intestinal... (Meta-Analysis)
Meta-Analysis
The aberrant migration of Ascaris lumbricoides may cause extra-intestinal ascariasis (EIA) involving hepato-biliary-pancreatic (HBP) or other extra-gastro-intestinal (EGI) organs. We performed a systematic review and meta-analysis to study the risk factors and clinical presentations of EIA, and differences in HBP and EGI ascariasis. Medline, Web of Science and Embase were searched for cases of EIA in the English language from India. From 1204 articles, 86 studies (105 cases) were included. The majority of the cases involved the HBP system (78%). Among HBP ascariasis, the most commonly involved site was the bile duct (53.6%). Females had 11.3 times higher odds (95% CI 2.852 to 44.856; p=0.001) of HBP ascariasis, while the pediatric population had lower odds (OR=0.323). Previous gallbladder disease was significantly associated with HBP ascariasis in adults (p=0.046), while a significantly higher number of cases of EGI ascariasis were observed among pediatric patients (p=0.003). Ocular symptoms occurred exclusively in the pediatric population (p=0.017). Overall, death was reported in 3.8% of patients (n=4). This review emphasizes the importance of the complications of EIA. It encourages future research into issues such as the reasons of higher gall bladder ascariasis in females and the implications of Ascaris-related complications following biliary tract interventions. It also suggests considering Ascaris as a differential diagnosis for airway obstuction in intubated critically ill patients.
Topics: Adult; Animals; Female; Child; Humans; Ascariasis; Ascaris lumbricoides; Intestines; Gastrointestinal Tract; India
PubMed: 37264906
DOI: 10.1093/trstmh/trad033 -
Acta Tropica Mar 2023It has been tested and proven that vaccination is still the best strategy to combat infectious diseases. However, to date, there are still no vaccines against human... (Review)
Review
It has been tested and proven that vaccination is still the best strategy to combat infectious diseases. However, to date, there are still no vaccines against human soil-transmitted helminthic diseases, despite their high prevalence globally, particularly in developing countries and rural areas with tropical climates and poor sanitation. The development of vaccines against helminths is riddled with obstacles. Helminths have a complex life cycle, multiple stages within the same host with stage-specific antigen expression, and the ability to regulate host immune reactions to evade the immune response. These elements contribute to the main challenge of helminthic vaccines: the identification of effective vaccine candidates. Therefore, this article reviews the current progress and potential future direction of soil-transmitted helminthic vaccines, particularly against Trichuris trichiura, Ascaris lumbricoides, Strongyloides stercoralis, Necator americanus and Ancylostoma duodenale. The study design employed was a systematic review, using qualitative meta-summary synthesis. Preclinical studies and clinical trials on the development of protein subunit vaccines against the five soil-transmitted helminths were searched on PubMed and Scopus. Effectiveness was indicated by a reduction in worm burden or larval output, an increase in specific IgG levels, or an increase in cytokine production. Our findings show that only the hookworm vaccine against N. americanus is in the clinical trial phase, while the rest is still in exploratory research and pre-clinical development phase.
Topics: Animals; Humans; Soil; Hookworm Infections; Ascaris lumbricoides; Ancylostomatoidea; Necator americanus; Vaccines; Helminthiasis; Feces
PubMed: 36586174
DOI: 10.1016/j.actatropica.2022.106796 -
PLoS Neglected Tropical Diseases Oct 2022Soil-transmitted helminths (STH) infect 1.5 billion people and countless animals worldwide. In Australian Indigenous communities, STH infections have largely remained... (Meta-Analysis)
Meta-Analysis
Soil-transmitted helminths (STH) infect 1.5 billion people and countless animals worldwide. In Australian Indigenous communities, STH infections have largely remained endemic despite control efforts, suggesting reservoirs of infection may exist. Dogs fulfil various important cultural, social and occupational roles in Australian Indigenous communities and are populous in these settings. Dogs may also harbour zoonotic STHs capable of producing morbidity and mortality in dogs and humans. This review provides an overview of human and zoonotic STH infections, identifies the Australian Indigenous locations affected and the parasite species and hosts involved. The meta-analysis provides estimates of individual study and pooled true prevalence of STH infections in Australian Indigenous communities and identifies knowledge gaps for further research on zoonotic or anthroponotic potential. A systematic literature search identified 45 eligible studies documenting the presence of Strongyloides stercoralis, Trichuris trichiura, Ancylostoma caninum, Ancylostoma duodenale, Ancylostoma ceylanicum, undifferentiated hookworm, and Ascaris lumbricoides. Of these studies, 26 were also eligible for inclusion in meta-analysis to establish true prevalence in the light of imperfect diagnostic test sensitivity and specificity by Rogan-Gladen and Bayesian methods. These studies revealed pooled true prevalence estimates of 18.9% (95% CI 15.8-22.1) for human and canine S. stercoralis infections and 77.3% (95% CI 63.7-91.0) for canine A. caninum infections indicating continued endemicity, but considerably more heterogenous pooled estimates for canine A. ceylanicum infections, and A. duodenale, undifferentiated hookworm and T. trichiura in humans. This review suggests that the prevalence of STHs in Australian Indigenous communities has likely been underestimated, principally based on imperfect diagnostic tests. Potential misclassification of hookworm species in humans and dogs due to outdated methodology, also obscures this picture. High-quality contemporary studies are required to establish current true prevalence of parasite species in all relevant hosts to guide future policy development and control decisions under a culturally sound One Health framework.
Topics: Humans; Dogs; Animals; Soil; Bayes Theorem; Australia; Helminths; Ascaris lumbricoides; Trichuris; Helminthiasis; Hookworm Infections; Ancylostomatoidea; Ancylostoma; Zoonoses; Prevalence; Feces
PubMed: 36279298
DOI: 10.1371/journal.pntd.0010895 -
Frontiers in Public Health 2022Toxocariasis, a neglected parasitic zoonosis with worldwide distribution, has been reportedly associated to different risk factors in several epidemiological and... (Meta-Analysis)
Meta-Analysis
Toxocariasis, a neglected parasitic zoonosis with worldwide distribution, has been reportedly associated to different risk factors in several epidemiological and meta-analysis studies. However, dog and cat contact (environmental and animal exposure) as isolated associated risk factor for children and adults remains to be fully established. Accordingly, the present meta-analysis has aimed to directly assess dog and cat contact for toxocariasis seropositivity in under-18 and adult persons, using a survey strategy of PubMed/Medline, Embase, Scopus and Scielo Databases, from January 2009 to December 2021. A meta-analysis model of random effects was applied to estimate (OR) with 95% Confidence Interval (CI). The statistical heterogeneity was evaluated by the Cochran Q-Test and values. A total of 41 transversal studies ( = 20.515 individuals) from different geographic regions (classified by the World Health Organization) were included herein. In overall, 1,882/13,496 (13.95%; 95% IC = 13.4-14.5) youngers and 513/7.019 (7.3%; 95% CI = 6.7-7.9) adults in contact with dogs or cats were serologically reagent for anti- antibodies. Association of dog and cat contact was observed only in youngers, with both dogs (OR = 1.53; < 0.0001) and cats (OR = 1.64; = 0.0001). In addition, association of dog and contact and serology was statistically significant in populations of Americas (OR = 1.37; 95% CI = 1.1-1.7), Middle East (OR = 2.9; 95% CI = 1.6-5.1) and West Pacific (OR = 1.6; 95% IC = 1.3-1.9). In conclusion, contact with dogs and cats, particularly by younger individuals and in regions such as Americas, Middle East, and West Pacific, should be always a public health concern for toxocariasis. Moreover, dogs and cats should be periodically dewormed, washed and hair cleaned prior to contact with youngers. Finally, robust statistical results herein may serve as basis for future strategies and preventive measures for safer dog and cat contact.
Topics: Adult; Animals; Cat Diseases; Cats; Child; Dog Diseases; Dogs; Humans; Risk Factors; Toxocara; Toxocariasis; United States
PubMed: 35836995
DOI: 10.3389/fpubh.2022.854468 -
The Cochrane Database of Systematic... Jun 2022It is estimated that 1.5 billion people are infected with soil-transmitted helminths (STHs) worldwide. Re-infection occurs rapidly following deworming, and interruption... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
It is estimated that 1.5 billion people are infected with soil-transmitted helminths (STHs) worldwide. Re-infection occurs rapidly following deworming, and interruption of transmission is unlikely without complementary control efforts such as improvements in water, sanitation, and hygiene (WASH) access and behaviours.
OBJECTIVES
To assess the effectiveness of WASH interventions to prevent STH infection.
SEARCH METHODS
We used standard, extensive Cochrane search methods. The latest search date was 19 October 2021.
SELECTION CRITERIA
We included interventions to improve WASH access or practices in communities where STHs are endemic. We included randomized controlled trials (RCTs), as well as trials with an external control group where participants (or clusters) were allocated to different interventions using a non-random method (non-RCTs). We did not include observational study designs. Our primary outcome was prevalence of any STH infection. Prevalence of individual worms was a secondary outcome, including for Ascaris lumbricoides, Trichuris trichiura, hookworm (Ancylostoma duodenale or Necator americanus), or Strongyloides stercoralis. Intensity of infection, measured as a count of eggs per gram of faeces for each species, was another secondary outcome.
DATA COLLECTION AND ANALYSIS
Two review authors independently reviewed titles and abstracts and full-text records for eligibility, performed data extraction, and assessed risk of bias using the Cochrane risk of bias assessment tool for RCTs and the EPOC tool for non-RCTs. We used a random-effects meta-analysis to pool study estimates. We used Moran's I² statistic to assess heterogeneity and conducted subgroup analyses to explore sources of heterogeneity. We assessed the certainty of the evidence using the GRADE approach.
MAIN RESULTS
We included 32 studies (16 RCTs and 16 non-RCTs) involving a total of 52,944 participants in the review. Twenty-two studies (14 RCTs (16 estimates) and eight non-RCTs (11 estimates)) reported on our primary outcome, prevalence of infection with at least one STH species. Twenty-one studies reported on the prevalence of A lumbricoides (12 RCTs and 9 non-RCTs); 17 on the prevalence of T trichiura (9 RCTs and 8 non-RCTs); 18 on the prevalence of hookworm (10 RCTs and 8 non-RCTs); and one on the prevalence of S stercoralis (1 non-RCT). Sixteen studies measured the intensity of infection for an individual STH type. Ten RCTs and five non-RCTs reported on the intensity of infection of A lumbricoides; eight RCTs and five non-RCTs measured the intensity of infection of T trichiura; and eight RCTs and five non-RCTs measured the intensity of hookworm infection. No studies reported on the intensity of infection of S stercoralis. The overall pooled effect estimates showed that the WASH interventions under study may result in a slight reduction of any STH infection, with an odds ratio (OR) of 0.86 amongst RCTs (95% confidence interval (CI) 0.74 to 1.01; moderate-certainty evidence) and an OR of 0.71 amongst non-RCTs (95% CI 0.54 to 0.94; low-certainty evidence). All six of the meta-analyses assessing individual worm infection amongst both RCTs and non-RCTs had pooled estimates in the preventive direction, although all CIs encapsulated the null, leaving the possibility of the null or even harmful effects; the certainty of the evidence ranged from very low to moderate. Individual studies assessing intensity of infection showed mixed evidence supporting WASH. Subgroup analyses focusing on narrow specific subsets of water, sanitation, and hygiene interventions did very little to elucidate which interventions might be better than others. Data on intensity of infection (e.g. faecal egg count) were reported in a variety of ways across studies, precluding the pooling of results for this outcome. We did not find any studies reporting adverse events resulting from the WASH interventions under study or from mass drug administration (MDA).
AUTHORS' CONCLUSIONS
Whilst the available evidence suggests that the WASH interventions under study may slightly protect against STH infection, WASH also serves as a broad preventive measure for many other diseases that have a faecal oral transmission route of transmission. As many of the studies were done in addition to MDA/deworming (i.e. MDA was ongoing in both the intervention and control arm), our data support WHO recommendations for implementation of improvements to basic sanitation and adequate access to safe water alongside MDA. The biological plausibility for improved access to WASH to interrupt transmission of STHs is clear, but WASH interventions as currently delivered have shown impacts that were lower than expected. There is a need for more rigorous and targeted implementation research and process evaluations in order that future WASH interventions can better provide benefit to users. Inconsistent reporting of the intensity of infection underscores the need to define the minimal, standard data that should be collected globally on STHs to enable pooled analyses and comparisons.
Topics: Animals; Ascaris lumbricoides; Humans; Hygiene; Observational Studies as Topic; Sanitation; Soil; Water
PubMed: 35726112
DOI: 10.1002/14651858.CD012199.pub2 -
Parasitology Dec 2021Ascariasis is the most prevalent helminth infection in the world and leads to significant, life-long morbidity, particularly in young children. Current efforts to...
Ascariasis is the most prevalent helminth infection in the world and leads to significant, life-long morbidity, particularly in young children. Current efforts to control and eradicate ascariasis in endemic regions have been met with significant challenges including high-rates of re-infection and potential development of anthelminthic drug resistance. Vaccines against ascariasis are a key tool that could break the transmission cycle and lead to disease eradication globally. Evolution of the vaccine pipeline has progressed, however no vaccine product has been brought to human clinical trials to date. Advancement in recombinant protein technology may provide the first step in generating an vaccine as well as a pan-helminthic vaccine ready for human trials. However, several roadblocks remain and investment in new technologies will be important to develop a successful human vaccine that is critically needed to prevent significant morbidity in -endemic regions around the world.
Topics: Animals; Ascariasis; Ascaris; Humans; Vaccine Development; Vaccines
PubMed: 35586777
DOI: 10.1017/s0031182021001347