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International Journal of Environmental... Dec 2018We aimed to evaluate the evidence on screening and treatment for two parasitic infections-schistosomiasis and strongyloidiasis-among migrants from endemic countries...
Effectiveness of Screening and Treatment Approaches for Schistosomiasis and Strongyloidiasis in Newly-Arrived Migrants from Endemic Countries in the EU/EEA: A Systematic Review.
We aimed to evaluate the evidence on screening and treatment for two parasitic infections-schistosomiasis and strongyloidiasis-among migrants from endemic countries arriving in the European Union and European Economic Area (EU/EEA). We conducted a systematic search of multiple databases to identify systematic reviews and meta-analyses published between 1 January 1993 and 30 May 2016 presenting evidence on diagnostic and treatment efficacy and cost-effectiveness. We conducted additional systematic search for individual studies published between 2010 and 2017. We assessed the methodological quality of reviews and studies using the AMSTAR, Newcastle⁻Ottawa Scale and QUADAS-II tools. Study synthesis and assessment of the certainty of the evidence was performed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We included 28 systematic reviews and individual studies in this review. The GRADE certainty of evidence was low for the effectiveness of screening techniques and moderate to high for treatment efficacy. Antibody-detecting serological tests are the most effective screening tests for detection of both schistosomiasis and strongyloidiasis in low-endemicity settings, because they have higher sensitivity than conventional parasitological methods. Short courses of praziquantel and ivermectin were safe and highly effective and cost-effective in treating schistosomiasis and strongyloidiasis, respectively. Economic modelling suggests presumptive single-dose treatment of strongyloidiasis with ivermectin for all migrants is likely cost-effective, but feasibility of this strategy has yet to be demonstrated in clinical studies. The evidence supports screening and treatment for schistosomiasis and strongyloidiasis in migrants from endemic countries, to reduce morbidity and mortality.
Topics: Cost-Benefit Analysis; Endemic Diseases; European Union; Humans; Mass Screening; Schistosomiasis; Serologic Tests; Strongyloidiasis; Transients and Migrants
PubMed: 30577567
DOI: 10.3390/ijerph16010011 -
Tropical Medicine and Infectious Disease May 2018Strongyloidiasis is a helminth infection that remains under-researched despite its ability to cause significant illness. Women and children may be at particular risk of... (Review)
Review
Strongyloidiasis is a helminth infection that remains under-researched despite its ability to cause significant illness. Women and children may be at particular risk of health consequences from this parasite. This systematic literature review aims to examine research on the long-term health effects that strongyloidiasis has in pregnant women and children. We conducted a structured search using multiple databases to collect all primary studies discussing health effects of strongyloidiasis in the aforementioned groups. The review included 20 results: 16 primary studies and four case reports. The methodological quality of studies was substandard, and there was substantial heterogeneity to the statistical analysis and outcomes assessed in the literature. Statistically significant associations were found between strongyloidiasis and low birth weight, as well as wasting. No links were found between strongyloidiasis and anaemia. Due to testing methods used in the studies, the prevalence of in these studies was probably under-estimated. Current research is suggestive that strongyloidiasis has long-term adverse health effects on the offspring of infected mothers and in chronically-infected children. Data analysis was hindered by both methodological and statistical flaws, and as such, reliable conclusions regarding the health impacts could not be formed.
PubMed: 30274446
DOI: 10.3390/tropicalmed3020050 -
Parasitology Feb 2019Parasites reside inside or outside their hosts and get host nutrition and blood. Here, we have emphasized economic losses in cattle caused by parasitic diseases due to...
Parasites reside inside or outside their hosts and get host nutrition and blood. Here, we have emphasized economic losses in cattle caused by parasitic diseases due to ecto- and endo- parasites (flies, ticks, mites and helminths). We have outlined different methods/models including economic evaluation techniques and dynamic analysis as a major class, used for the calculation of economic losses caused by parasites in cattle. According to already conducted studies, a decrease in production is mentioned in quantity and percentage while financial losses are expressed in the form of account with respect to per head, herd or for the specific study area. The parasites cause the reduced production and financial losses due to control, treatment and mortality costs. We calculated the average decrease in milk production and organ condemnation as 1.16 L animal-1 day-1 and 12.95%, respectively, from overall cattle parasitic infections. Moreover, the average calculated financial and percentage losses were US$ 50.67 animal-1 year-1 and 17.94%, respectively. Economically important parasitic diseases mentioned here are caused by specific spp. of protozoans and helminths according to data collected from the literature. Protozoan diseases include tick-borne diseases, coccidiosis, neosporosis, trypanosomiasis and cryptosporidiosis. Losses due to tick-borne infections were encountered for decreased milk production, mortality, treatment and control. Losses from coccidiosis were due to decreased weight gain, treatment costs and mortality. While abortion losses were encountered in neosporosis. Trypanosomiasis caused losses due to a decrease in milk yield. Moreover, only diagnostic (conventional or molecular techniques) cost was taken into account for cryptosporidiosis. Economically important nematode parasites are Oesophagostomum spp., Cooperia spp., Trichostrongylus spp., Strongyloides spp., Ostertagia spp. and Haemonchus placei. Due to the zoonotic importance of echinococcosis, Echinococcus granulosus is the most economically important cestode parasite. Losses caused by echinococcosis were due to organ condemnation, carcass weight loss and decreases hide value, milk production and fecundity. While, fascioliasis is one of the most economically important trematodal disease, which causes cirrhosis of the liver due to parasite migration, and thus, the organ becomes inedible. So, it would be helpful for farmers and researchers to approach these methods/models for calculation of parasitic losses and should adopt suitable measures to avoid long-term economic losses.
Topics: Animals; Cattle; Cattle Diseases; Cost-Benefit Analysis; Ectoparasitic Infestations; Helminthiasis, Animal; Models, Economic; Parasitic Diseases, Animal; Software; Stochastic Processes
PubMed: 30068403
DOI: 10.1017/S0031182018001282 -
Infectious Diseases of Poverty Jul 2018Soil transmitted helminth (STH) infections still remain a notable health problem in resource-limited countries due to difficulties in the implementation of control... (Review)
Review
BACKGROUND
Soil transmitted helminth (STH) infections still remain a notable health problem in resource-limited countries due to difficulties in the implementation of control measures. In Nigeria for instance, despite several community-based and provincial reports, national data on prevalence, burdens and risk zones (RZs) for STH infections are lacking.
METHODS
The present study employed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to determine the prevalence, distribution and RZs for STH infections among Nigerian children through a meta-analysis of data published between 1980 and 2015. Pooled prevalence estimate (PPE) was determined by the random-effects model while heterogeneity was evaluated using the Cochran's Q-test.
RESULTS
A total of 18 901 of the 34 518 Nigerian children aged 0-17 years examined across 19 Nigerian states during the period under review were infected with one or more species of STHs. The overall PPE for STH infections was 54.8% (95% CI: 54.2-55.3). PPEs for sub-groups ranged between 13.2% (95% CI: 11.5-15.1) and 80.9% (95% CI: 80.0-81.7). Highest PPEs for STH infections were observed among children within community settings (59.0%, 95% CI: 57.7-60.4) and school-aged children (54.9%, 95% CI: 54.3-55.5). Ascaris lumbricoides was the most prevalent species (44.6%, 95% CI: 44.0-45.2). Over 36% (15/41) of the studies were published from south-western Nigeria. South-western region was the only high risk zone (HRZ) for STH infections while the rest of the regions were low risk zones (LRZs).
CONCLUSIONS
STH infections involving Ascaris lumbricoides, Strongyloides stercoralis, Trichuris trichiura and hookworms are highly prevalent across Nigeria. Strategic use of anthelmintics, health education and adequate sanitation, taking into account this epidemiologic information will help in the control of these infections in Nigeria.
Topics: Animals; Child Health; Helminthiasis; Helminths; Humans; Nigeria; Prevalence; Soil
PubMed: 29983115
DOI: 10.1186/s40249-018-0451-2 -
Infectious Diseases of Poverty May 2018The livestock industry plays a vital role in the economy of Nigeria. It serves as a major source of income and livelihood for majority of Nigerians who are rural... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The livestock industry plays a vital role in the economy of Nigeria. It serves as a major source of income and livelihood for majority of Nigerians who are rural settlers and contributes about 5.2% to the National Gross Domestic Product (GDP). Helminths however, cause economic losses due to reductions in milk production, weight gain, fertility and carcass quality. Zoonotic helminths of livestock origin cause health problems in humans.
METHODS
Using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, the prevalence and distribution of helminths of veterinary and zoonotic importance in Nigerian ruminants were determined in a meta-analysis of data published between 1970 and 2016. Data were stratified based on regions, hosts, study periods, sample sizes and study types while helminths were phylogenetically grouped into cestodes, nematodes and trematodes.
RESULTS
Data from 44 studies reported across 19 Nigerian states revealed an overall pooled prevalence estimate (PPE) of 7.48% (95% CI: 7.38-7.57) for helminths of veterinary and zoonotic importance from a total of 320 208 ruminants. We observed a significant variation (P < 0.001) between the PPEs range of 1.90% (95% CI: 1.78-2.02) and 60.98% (95% CI: 58.37-63.55) reported across different strata. High heterogeneity (99.78, 95% CI: 7.38-7.57) was observed. Strongyloides papillosus was the most prevalent (Prev: 32.02%, 95% CI: 31.01-33.11), while, Fasciola gigantica had the widest geographical distribution.
CONCLUSIONS
Helminths of veterinary and zoonotic importance are prevalent in ruminants and well distributed across Nigeria. Our findings show that helminths of ruminants may also be possible causes of morbidity in humans and economic losses in the livestock industry in Nigeria. High heterogeneity was observed within studies and the different strata. Good agricultural practices on farms, standard veterinary meat inspection and adequate hygiene and sanitation in abattoirs, farms and livestock markets need to be implemented in Nigeria in order to reduce the economic, public health and veterinary threats due to these helminths.
Topics: Animals; Helminthiasis, Animal; Helminths; Livestock; Nigeria; Prevalence; Ruminants; Zoonoses
PubMed: 29807540
DOI: 10.1186/s40249-018-0438-z -
PLoS Neglected Tropical Diseases Feb 2018Strongyloides stercoralis infection is a neglected tropical disease which can lead to severe symptoms and even death in immunosuppressed people. Unfortunately, its... (Review)
Review
BACKGROUND
Strongyloides stercoralis infection is a neglected tropical disease which can lead to severe symptoms and even death in immunosuppressed people. Unfortunately, its diagnosis is hampered by the lack of a gold standard, as the sensitivity of traditional parasitological tests (including microscopic examination of stool samples and coproculture) is low. Hence, alternative diagnostic methods, such as molecular biology techniques (mostly polymerase chain reaction, PCR) have been implemented. However, there are discrepancies in the reported accuracy of PCR.
METHODOLOGY
A systematic review with meta-analysis was conducted in order to evaluate the accuracy of PCR for the diagnosis of S. stercoralis infection. The protocol was registered with PROSPERO International Prospective Register of Systematic Reviews (record: CRD42016054298). Fourteen studies, 12 of which evaluating real-time PCR, were included in the analysis. The specificity of the techniques resulted high (ranging from 93 to 95%, according to the reference test(s) used). When all molecular techniques were compared to parasitological methods, the sensitivity of PCR was assessed at 71.8% (95% CI 52.2-85.5), that decreased to 61.8% (95% CI 42.0-78.4) when serology was added among the reference tests. Similarly, sensitivity of real-time PCR resulted 64.4% (95% CI 46.2-77.7) when compared to parasitological methods only, 56.5% (95% CI 39.2-72.4) including serology.
CONCLUSIONS
PCR might not be suitable for screening purpose, whereas it might have a role as a confirmatory test.
Topics: Animals; DNA, Helminth; Databases, Factual; Humans; Meta-Analysis as Topic; Molecular Diagnostic Techniques; RNA, Ribosomal, 18S; Real-Time Polymerase Chain Reaction; Sensitivity and Specificity; Strongyloides stercoralis; Strongyloidiasis
PubMed: 29425193
DOI: 10.1371/journal.pntd.0006229 -
Transplantation Proceedings Mar 2017Syndrome of inappropriate anti-diuretic hormone (SIADH) has been reported to be associated with systemic Strongyloides stercoralis. Here, we report a case of a stem cell... (Review)
Review
Syndrome of Inappropriate Anti-Diuretic Hormone Secretion Secondary to Strongyloides stercoralis Infection in an Allogeneic Stem Cell Transplant Patient: A Case Report and Literature Review.
Syndrome of inappropriate anti-diuretic hormone (SIADH) has been reported to be associated with systemic Strongyloides stercoralis. Here, we report a case of a stem cell transplant (SCT) recipient who developed severe SIADH secondary to systemic S Stercoralis. The SIADH resolved quickly after treating the systemic S Stercoralis with ivermectin. A systematic review of the literature was performed by PubMed, Scopus, and Cochrane database search. Only eight cases of S Stercoralis in allogeneic SCT recipients have been previously reported. To our knowledge, ours is the first reported case of SIADH secondary to S Stercoralis infection in an allogeneic SCT recipient. Prior to transplantation, even if asymptomatic, patients from endemic regions should be screened with strongyloides immunoglobulin (Ig)G serology. Pretransplantation eosinophilia should be evaluated by screening multiple stool samples for ova and parasites. Transplant candidates with positive serology or stool tests can be treated pretransplantation to eradicate infection. Patients at risk for S Stercoralis who develop nonspecific gastrointestinal complaints, rash, pulmonary infiltrates, or gram-negative bacteremia or meningitis may have S Stercoralis hyperinfection syndrome. Our case indicates that the development of SIADH may be an additional clue to this diagnosis. Appropriate diagnostic studies, including repeat stool and other body fluid sampling, should be expedited and ivermectin therapy initiated rapidly to prevent significant morbidity and mortality.
Topics: Aged; Animals; Antinematodal Agents; Duodenal Diseases; Eosinophilia; Humans; Immunoglobulin G; Inappropriate ADH Syndrome; Ivermectin; Male; Opportunistic Infections; Postoperative Complications; Stem Cell Transplantation; Strongyloides stercoralis; Strongyloidiasis; Transplantation, Homologous
PubMed: 28219601
DOI: 10.1016/j.transproceed.2016.12.012 -
Acta Tropica Aug 2016Gastrointestinal (GI) nematode infections are a major health challenge affecting productive and reproductive performance of sheep and goats in Ethiopia. However, there... (Meta-Analysis)
Meta-Analysis
Gastrointestinal (GI) nematode infections are a major health challenge affecting productive and reproductive performance of sheep and goats in Ethiopia. However, there is no comprehensive summary on the occurrence and distribution of the infection at national level. This systematic review provides pooled prevalence estimates and assesses potential predictors of the nematode infections in small ruminants, i.e. helpful in planning interventions or control strategies. The review used 50 animal level datasets retrieved from 24 manuscripts. The studies used data collected from 9407 sheep and 3478 goats. A meta-analytical approach was employed to analyze Effect size (ES). The reported GI nematodes represented eleven genera affecting sheep and goats including: Haemonchus, Trichostrongylus, Teladorsagia/Ostertagia, Strongyloides, Bunostomum, Nematodirus, Chabertia, Trichuris, Cooperia, Skrjabinema and Oesophagostomum. The GI nematodes pooled prevalence estimate in the random effect model was 75.8% (95% CI: 69.6, 80.8). The subgroup analysis revealed significant (p<0.05) differences in the prevalence between different regions and type of diagnostic methods used. 'Postmortem technique' and 'eastern part of the country' were associated with higher GI nematode prevalence and accounted for 68.1% of the between studies heterogeneity. In light of the high parasitic prevalence in all agro-ecologies, the need for strategic intervention is recommended. Meanwhile, data need to be generated for some of the regions where dependable survey reports are lacking.
Topics: Animals; Communicable Diseases; Ethiopia; Haemonchus; Nematoda; Nematode Infections; Prevalence; Sheep; Sheep Diseases
PubMed: 27154584
DOI: 10.1016/j.actatropica.2016.04.016 -
International Journal of Cancer Jun 2016Only three helminths (Schistosoma haematobium, Opisthorchis viverrini and Clonorchis sinensis) are directly associated with carcinogenesis in humans whereas the role of... (Review)
Review
Only three helminths (Schistosoma haematobium, Opisthorchis viverrini and Clonorchis sinensis) are directly associated with carcinogenesis in humans whereas the role of other parasites in cancer remains unclear. This study aimed to perform a systematic review to identify recent insights in the role of other parasite infections in carcinogenesis. We conducted systematic searches of MEDLINE and EMBASE on July 2015. Our primary outcome was the association between parasitic infections and carcinogenesis. Out of 1,266 studies, 19 were selected for detailed evaluation (eight for helminths and 11 for protozoa). The mechanisms of helminth-induced cancer included chronic inflammation, sustained proliferation, modulation of the host immune system, reprogramming of glucose metabolism and redox signaling, induction of genomic instability and destabilization of suppressor tumor proteins, stimulation of angiogenesis, resisting cell death, and activation of invasion and metastasis. In addition to the current knowledge, the following parasites were found in cancers or tumors: Echinococcus, Strongyloides, Fasciola, Heterakis, Platynosomum and Trichuris. Additional parasites were found in this systematic review that could potentially be associated with cancers or tumors but further evidence is needed to elaborate a cause-effect relationship.
Topics: Animals; Carcinogenesis; Clonorchiasis; Humans; Neoplasms; Opisthorchiasis
PubMed: 26840624
DOI: 10.1002/ijc.30028 -
The Cochrane Database of Systematic... Jan 2016Strongyloidiasis is a gut infection with Strongyloides stercoralis which is common world wide. Chronic infection usually causes a skin rash, vomiting, diarrhoea or... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Strongyloidiasis is a gut infection with Strongyloides stercoralis which is common world wide. Chronic infection usually causes a skin rash, vomiting, diarrhoea or constipation, and respiratory problems, and it can be fatal in people with immune deficiency. It may be treated with ivermectin or albendazole or thiabendazole.
OBJECTIVES
To assess the effects of ivermectin versus benzimidazoles (albendazole and thiabendazole) for treating chronic strongyloides infection.
SEARCH METHODS
We searched the Cochrane Infectious Diseases Group Specialized Register (24 August 2015); the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE (January 1966 to August 2015); EMBASE (January 1980 to August 2015); LILACS (August 2015); and reference lists of articles. We also searched the metaRegister of Controlled Trials (mRCT) using 'strongyloid*' as a search term, reference lists, and conference abstracts.
SELECTION CRITERIA
Randomized controlled trials of ivermectin versus albendazole or thiabendazole for treating chronic strongyloides infection.
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted data and assessed risk of bias in the included trials. We used risk ratios (RRs) with 95% confidence intervals (CIs) and fixed- or random-effects models. We pooled adverse event data if the trials were sufficiently similar in their adverse event definitions.
MAIN RESULTS
We included seven trials, enrolling 1147 participants, conducted between 1994 and 2011 in different locations (Africa, Southeast Asia, America and Europe).In trials comparing ivermectin with albendazole, parasitological cure was higher with ivermectin (RR 1.79, 95% CI 1.55 to 2.08; 478 participants, four trials, moderate quality evidence). There were no statistically significant differences in adverse events (RR 0.80, 95% CI 0.59 to 1.09; 518 participants, four trials, low quality evidence).In trials comparing ivermectin with thiabendazole, there was little or no difference in parasitological cure (RR 1.07, 95% CI 0.96 to 1.20; 467 participants, three trials, low quality evidence). However, adverse events were less common with ivermectin (RR 0.31, 95% CI 0.20 to 0.50; 507 participants; three trials, moderate quality evidence).In trials comparing different dosages of ivermectin, taking a second dose of 200 μg/kg of ivermectin was not associated with higher cure in a small subgroup of participants (RR 1.02, 95% CI 0.94 to 1.11; 94 participants, two trials).Dizziness, nausea, and disorientation were commonly reported in all drug groups. There were no reports of serious adverse events or death.
AUTHORS' CONCLUSIONS
Ivermectin results in more people cured than albendazole, and is at least as well tolerated. In trials of ivermectin with thiabendazole, parasitological cure is similar but there are more adverse events with thiabendazole.
Topics: Albendazole; Animals; Anthelmintics; Humans; Ivermectin; Randomized Controlled Trials as Topic; Strongyloides stercoralis; Strongyloidiasis; Thiabendazole
PubMed: 26778150
DOI: 10.1002/14651858.CD007745.pub3