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PLoS Neglected Tropical Diseases Nov 2023Neglected tropical diseases (NTDs) affect most impoverished communities in developing countries, like Myanmar in Southeast Asia. NTDs have been understudied and...
BACKGROUND
Neglected tropical diseases (NTDs) affect most impoverished communities in developing countries, like Myanmar in Southeast Asia. NTDs have been understudied and underreported in Myanmar.
METHODS
A systematic review of published and grey literature (1900-2023) on neglected tropical diseases (NTDs) in Myanmar was conducted. The literature search included five international databases: PubMed, EMBASE, Ovid Global Health, and Web of Science Core Collection and one national database: the Myanmar Central Biomedical Library (locally published papers and grey literature). The selection criteria included articles with all types of study designs of current or previous infections conducted in humans, that reported NTDs, recognised by WHO, US CDC, and listed in PLoS NTDs. We included melioidosis and rickettsioses which we consider also meet the definition of an NTD.
RESULTS
A total of 5941 records were retrieved and screened, of which, 672 (11%) met the selection criteria and were included in this review. Of the included articles, 449 (65%) were published after 2000 and 369 (55%) were from two regions (Yangon and Mandalay) of Myanmar. Of the included articles, 238 (35%) reported bacterial NTDs, 212 (32%) viral NTDs, 153 (23%) helminth NTDs, 25 (4%) protozoal NTDs and 39 (6%) reported more than one aetiology. Based on reported frequency in descending order, the bacterial NTDs were leprosy, Escherichia coli enteritis, salmonellosis, cholera, shigellosis, melioidosis, leptospirosis and rickettsioses; the viral NTDs were dengue, chikungunya and Japanese encephalitis virus (JEV) infection; the protozoal NTDs were amoebiasis, giardiasis and leishmaniasis, and the helminth NTDs were ascariasis, trichuriasis, hookworm disease, filariasis and strongyloidiasis.
CONCLUSION
This review summarises NTDs reported in Myanmar over the past 100 years. The findings suggest that most NTDs are likely to be under reported, especially from the majority of the country which is far from academic centres. Research capacity building together with strengthening of laboratory systems would lead to better understanding of the true burden of NTDs in Myanmar.
TRIAL REGISTRATION
PROSPERO registration ID: CRD42018092627.
Topics: Animals; Humans; Myanmar; Melioidosis; Ascariasis; Helminths; Neglected Diseases; Tropical Medicine; Encephalitis, Japanese; Rickettsia Infections
PubMed: 37910592
DOI: 10.1371/journal.pntd.0011706 -
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 -
Le Infezioni in Medicina 2022Intestinal helminthiasis are a common public health problem in developed and developing countries. It is thought that they can influence pregnancy by causing gestational... (Review)
Review
Intestinal helminthiasis are a common public health problem in developed and developing countries. It is thought that they can influence pregnancy by causing gestational anemia. The aim of this study was to determine if there is a relationship between helminth infection and gestational anemia. A structured review of scientific literature was conducted through active search in the electronic databases MEDLINE and LILACS until December 2021, following 2020 PRISMA statement. The studies were reviewed independently by two authors, extracting the most relevant information from each study. Cross-sectional studies, case-control and ecological studies were included, with no date or language limit. Randomized clinical trials were excluded. A total of 38 studies were included in the systematic review. The study populations of all studies belonged to low- and middle-income countries: 28 studies from Africa, 6 from Asia, 3 from Latin America and 1 from Oceania. Overall, the average prevalence of gestational anemia among the included studies was 40% (95% CI 34-46%). Hookworm was the predominant species detected in most studies (19/38; 50%), followed by (15/38; 39.5%). Gestational anemia was positively associated with (OR 1.86, 95% CI 1.12-3.08) and hookworms (OR 3.09, 95% CI 1.99-4.78). Prevalence of malaria was not associated with the magnitude of the effect of hookworm on anemia risk during meta-regression (p=0.5182). The results of this review indicate that there is a statistically significant association between helminthiasis and gestational anemia. Although hookworm is the main species associated with the outcome, prevalence of malaria was not associated with the magnitude of the effect of hookworm on anemia risk. The impact of other species needs to be defined given the expected bias that arises from polyparasitism when defining comparison groups.
PubMed: 36908393
DOI: 10.53854/liim-3101-6 -
Cureus Dec 2022is the most common type of helminth infection in humans. It affects more than one billion of the world's population. Children living in developing nations are prone to... (Review)
Review
is the most common type of helminth infection in humans. It affects more than one billion of the world's population. Children living in developing nations are prone to ascariasis, presenting with obstructive biliary illnesses. Migration of worms through the major duodenal papilla to the hepatobiliary system leads to symptoms of biliary colic and complications along the biliary tree. In April 2022, we performed a systematic review of case reports to identify and examine cases of gallbladder ascariasis worldwide. A methodical search using PubMed, Semantic Scholar, ScienceDirect, and Directory of Open Access Journals yielded 2773 studies. After duplicate removal, title, abstract, and content screening, retrieval, and quality assessment, 13 studies met the criteria for this systematic review of case reports. The cases and results from these 13 studies revealed gallbladder ascariasis in different age groups worldwide. This systematic review discusses ascariasis, explicitly highlighting its presence in the gallbladder, symptomatic presentation, laboratory/imaging findings, complications, and approach to management.
PubMed: 36654632
DOI: 10.7759/cureus.32545 -
Tropical Medicine and Infectious Disease Nov 2022Intestinal parasitic infections are common infectious diseases causing many health problems and impaired growth and physical development.. Children under five years old... (Review)
Review
Intestinal parasitic infections are common infectious diseases causing many health problems and impaired growth and physical development.. Children under five years old are the most vulnerable to infections, due to their immature immunity and feeding and exploratory behaviours. This systematic review aimed to assess the relationship between intestinal parasitic infections and undernutrition among children under 5 years old. Fifteen studies met the inclusion and exclusion criteria and were classified as high-quality studies. Twelve parasites were reported, including , spp., , , , hookworm, , , spp. and . Ascariasis is the most reported infection, with a prevalence ranging from 10.77% in Ethiopia to 57.14% in Malaysia, and is correlated with stunting (OR 2.17 (95% CI 1.14, 4.13), = 0.02). Giardiasis is the second most reported infection, with a prevalence ranging from 4.43% in Ethiopia to 66.33% in the Central African Republic, and is related to an increased risk of stunting (OR 2.34 (95% CI 1.07, 5.10), = 0.03)), wasting (OR 2.90 (95% CI 1.12, 7.49, = 0.03)), and being underweight (OR 1.53 (95% CI 1.02, 2.29, = 0.04)). The third and fourth most prevalent infections are and hookworm infections. Intestinal parasitic infections can occur very early in life and cause significant growth retardation. It is important to understand the prevalence and effects of infection based on the parasite species in order to implement therapeutic interventions and prevention controls.
PubMed: 36422922
DOI: 10.3390/tropicalmed7110371 -
Global prevalence of Ascaris infection in humans (2010-2021): a systematic review and meta-analysis.Infectious Diseases of Poverty Nov 2022Ascariasis is one of the most important neglected tropical diseases of humans worldwide. The epidemiology of Ascaris infection appears to have changed with improvements... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Ascariasis is one of the most important neglected tropical diseases of humans worldwide. The epidemiology of Ascaris infection appears to have changed with improvements in sanitation and mass drug administration, but there is no recent information on prevalence worldwide. Here, we performed a systematic review and meta-analysis to assess the global prevalence of human Ascaris infection from 2010 to 2021.
METHODS
We searched MEDLINE/PubMed, and Scopus databases for studies measuring prevalence of Ascaris infection, published between 1 January 2010 and 1 January 2022. We included studies of the general human population in endemic regions, which used accepted coprodiagnostic methods, and excluded studies of people with occupations with an increased risk or probability of ascariasis and/or specific diseases other than ascariasis. We applied random-effects models to obtain pooled prevalence estimates for six sustainable development goal regions of the world. We extrapolated the prevalence estimates to the global population in 2020, to estimate the number of individuals with Ascaris infection. We conducted multiple subgroup and meta-regression analyses to explore possible sources of heterogeneity, and to assess relationships between prevalence estimates and demographic, socio-economic, geo-climatic factors.
RESULTS
Of 11,245 studies screened, we analysed 758 prevalence estimates for a total number of 4,923,876 participants in 616 studies from 81 countries. The global prevalence estimated was 11.01% (95% confidence interval: 10.27-11.78%), with regional prevalences ranging from 28.77% (7.07-57.66%) in Melanesia (Oceania) to 1.39% (1.07-1.74%) in Eastern Asia. We estimated that ~ 732 (682-782) million people harboured Ascaris worldwide in 2021. The infected people in Latin America and the Caribbean region had a higher prevalence of high intensity infection (8.4%, 3.9-14.1%). Prevalence estimates were higher in children, and people in rural communities or in countries or regions with lower income and human development indices. There was a trend for a higher prevalence in regions with increasing mean annual relative humidity, precipitation and environmental temperature.
CONCLUSIONS
Our findings indicate that, despite a renewed commitment by some communities or authorities to control ascariasis, a substantial portion of the world's human population (> 0.7 billion) is infected with Ascaris. Despite the clinical and socioeconomic importance of ascariasis, many past routine surveys did not assess the intensity of Ascaris infection in people. We propose that the present findings might stimulate the development of customised strategies for the improved control and prevention of Ascaris infection worldwide.
Topics: Humans; Child; Ascariasis; Prevalence; Rural Population; Latin America
PubMed: 36401308
DOI: 10.1186/s40249-022-01038-z -
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 -
PloS One 2020The effect of nutritional supplements on the re-infection rate of species-specific soil-transmitted helminth infections in school-aged children remains complex and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The effect of nutritional supplements on the re-infection rate of species-specific soil-transmitted helminth infections in school-aged children remains complex and available evidence on the subject matter has not been synthesized.
METHODS
The review included randomised controlled trials (RCTs) and cluster RCTs investigating food supplements on school-aged children between the age of 4-17 years. A search for RCTs was conducted on eight databases from inception to 12th June 2019. Cochrane Risk of Bias tool was used to assess the risk of bias in all included studies. Meta-analysis and narrative synthesis were conducted to describe and analyze the results of the review. Outcomes were summarized using the mean difference or standardized mean difference where appropriate.
RESULTS
The search produced 1,816 records. Six studies met the inclusion criteria (five individually RCTs and one cluster RCT). Four studies reported data on all three STH species, while one study only reported data on Ascaris lumbricoides infections and the last study reported data on only hookworm infections. Overall, the risk of bias in four individual studies was low across most domains. Nutritional supplementation failed to statistically reduce the re-infection rates of the three STH species. The effect of nutritional supplements on measures of physical wellbeing in school-aged children could not be determined.
CONCLUSIONS
The findings from this systematic review suggest that nutritional supplements for treatment of STH in children should not be encouraged unless better evidence emerges. Conclusion of earlier reviews on general populations may not necessarily apply to children since children possibly have a higher re-infection rate.
Topics: Ascariasis; Child; Dietary Supplements; Humans; Micronutrients; Randomized Controlled Trials as Topic; Soil; Trichuriasis; Vitamins
PubMed: 32790693
DOI: 10.1371/journal.pone.0237112 -
The Cochrane Database of Systematic... Apr 2020Ascaris lumbricoides is a common infection, and mainly affects children living in low-income areas. Water and sanitation improvement, health education, and drug... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Ascaris lumbricoides is a common infection, and mainly affects children living in low-income areas. Water and sanitation improvement, health education, and drug treatment may help break the cycle of transmission, and effective drugs will reduce morbidity.
OBJECTIVES
To compare the efficacy and safety of anthelmintic drugs (albendazole, mebendazole, ivermectin) for treating people with Ascaris infection.
SEARCH METHODS
We searched the Cochrane Infectious Disease Group Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, three other databases, and reference lists of included studies, without language restrictions, up to 4 July 2019.
SELECTION CRITERIA
Randomized controlled trials (RCT) that compared albendazole, mebendazole, and ivermectin in children and adults with confirmed Ascaris infection.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed studies for inclusion, assessed risk of bias, and extracted data from the included trials. A third review author checked the quality of data extraction. We used the Cochrane 'Risk of bias' assessment tool to determine the risk of bias in included trials. We used risk ratios (RRs) with 95% confidence intervals (CIs) to compare dichotomous outcomes in treatment and control groups. We used the fixed-effect model for studies with low heterogeneity and the random-effects model for studies with moderate to high heterogeneity. We assessed the certainty of the evidence using the GRADE approach. We used the control rate average to provide illustrative cure rates in the comparison groups.
MAIN RESULTS
We included 30 parallel-group RCTs, which enrolled 6442 participants from 17 countries across Africa, Asia, Central America and the Caribbean, and South America. Participants were from 28 days to 82 years of age, recruited from school, communities, and health facilities. Twenty studies were funded or co-funded by manufacturers, while 10 studies were independent of manufacturer funding. Twenty-two trials had a high risk of bias for one or two domains (blinding, incomplete outcome data, selective reporting). Single dose of albendazole (four trials), mebendazole (three trials) or ivermectin (one trial) was compared to placebo. Parasitological cure at 14 to 60 days was high in all the studies (illustrative cure of 93.0% in the anthelmintic group and 16.1% in the placebo group; RR 6.29, 95% CI 3.91 to 10.12; 8 trials, 1578 participants; moderate-certainty evidence). Single dose of albendazole is as effective as multiple doses of albendazole (illustrative cure of 93.2% with single dose, 94.3% with multiple doses; RR 0.98, 95% CI 0.92 to 1.05; 3 trials, 307 participants; high-certainty evidence); or as single dose of mebendazole (illustrative cure of 98.0% with albendazole, 96.9% with mebendazole; RR 1.01, 95% CI 1.00 to 1.02; 6 trials, 2131 participants; high-certainty evidence). Studies did not detect a difference between a single dose of albendazole and a single dose of ivermectin (cure rates of 87.8% with albendazole, 90.2% with ivermectin; RR 0.99, 95% CI 0.91 to 1.08; 3 trials, 519 participants; moderate-certainty evidence). Across all the studies, failure after single dose of albendazole ranged from 0.0% to 30.3%, mebendazole from 0.0% to 22.2%, and ivermectin from 0.0% to 21.6%. The egg reduction rate (ERR) measured up to 60 days after the treatment was high in all treated groups, regardless of the anthelmintic used (range 96% to 100%). It was not possible to evaluate parasitological cure by classes of infection intensity. No included trials reported complication or serious adverse events. Other adverse events were apparently similar among the compared anthelmintic groups (moderate- to low-certainty evidence). The most commonly reported other adverse events were nausea, vomiting, abdominal pain, diarrhoea, headache, and fever.
AUTHORS' CONCLUSIONS
Single-dose of albendazole, mebendazole, and ivermectin all appeared effective against Ascaris lumbricoides infection, yielding high parasitological cure and large reductions in eggs excreted, with no differences detected between them. The drugs appear to be safe to treat children and adults with confirmed Ascaris infection. There is little to choose between drugs and regimens in terms of cure or adverse events.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Albendazole; Animals; Anthelmintics; Ascariasis; Ascaris lumbricoides; Child; Child, Preschool; Humans; Infant; Ivermectin; Mebendazole; Middle Aged; Parasite Egg Count; Placebos; Randomized Controlled Trials as Topic; Young Adult
PubMed: 32289194
DOI: 10.1002/14651858.CD010599.pub2 -
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