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AIDS Research and Therapy May 2024Intestinal parasitic infections (IP) are a major source of morbidity in people living with Human immunodeficiency virus (HIV), particularly in resource-limited settings,...
Magnitude of intestinal parasitic infections and its determinants among HIV/AIDS patients attending at antiretroviral treatment centers in East and West Gojam Zones, Northwest, Ethiopia: institution based cross-sectional study.
BACKGROUND
Intestinal parasitic infections (IP) are a major source of morbidity in people living with Human immunodeficiency virus (HIV), particularly in resource-limited settings, mostly as a result of high viral load. Hence, this study aimed to investigate the magnitude of intestinal parasitic infections and its determinants among patients with HIV/AIDS attending public health facilities in East and West Gojam Zones in Ethiopia.
METHODS
Institution-based cross-sectional study was conducted on 327 people living with HIV visiting public health facilities from December 2022 to May 2023. A simple random sampling technique was used to recruit participants. Face-to-face interviews were used to collect socio-demographics and determinants. The fresh stool was collected from each patient, transported, and tested in accordance with laboratory standard operating procedures of wet mount, formol-ether concentration technique, and modified acid-fast staining. Data were entered and analyzed in the statistical package for Social Science (SPSS) version 20. A 95% CI with p-value < 0.05 was considered statistically significant.
RESULTS
The overall prevalence of IP in patients with HIV/AIDS was 19.3% (63/327). Hookworm was the most identified parasite 33.3% (21/63) followed by E.histolytica 17% (11/63) and G.lamblia 14.3% (9/63). Parasitic infections were significantly higher among viral load > 1000cps/ml (p = 0.035), WHO stage 4 (p = 0.002), CD4 < 200 cell/mm (p = 0.001), and bare foot walking (p = 0.001).
CONCLUSION
IP infections are moderately high among patients with HIV/AIDS in the study area. The proportion of parasites was greatly affected by high viral load, WHO stage 4, CD4 < 200 cell/mm, and being barefoot; this gives valuable insight to health professionals, health planners and community health workers. As a result, viral load monitoring, and WHO stage controlling were periodically assessed in patients with HIV/AIDS. Health education, awareness creation, routine stool examination, and environmental hygiene were regularly advocated to increase the life of patients with HIV/AIDS.
Topics: Humans; Ethiopia; Cross-Sectional Studies; Male; Female; Adult; Intestinal Diseases, Parasitic; HIV Infections; Middle Aged; Young Adult; Prevalence; Adolescent; Feces; Viral Load; Acquired Immunodeficiency Syndrome; Risk Factors
PubMed: 38755680
DOI: 10.1186/s12981-024-00618-3 -
Kansas Journal of Medicine 2024
PubMed: 38694171
DOI: 10.17161/kjm.vol17.21609 -
Journal of Microbiology, Immunology,... Jun 2024
Topics: Humans; Taiwan; Enoplida Infections; Capillaria; Animals; Male; Intestinal Diseases, Parasitic; Middle Aged; Intestines; Female; Adult
PubMed: 38693030
DOI: 10.1016/j.jmii.2024.04.007 -
POCUS Journal 2024Larva migrans is a cutaneous parasitic infection that occurs when an immature hookworm larva inadvertently penetrates the dermis of a human, typically on the...
Larva migrans is a cutaneous parasitic infection that occurs when an immature hookworm larva inadvertently penetrates the dermis of a human, typically on the extremities. Traditionally, a clinical diagnosis is made when a tortuous/serpiginous eruption is seen superficially in the skin with complaints of intense pruritus. Point of care ultrasound (POCUS) is a useful diagnostic tool for soft tissue complaints in the emergency department (ED). We describe a case of an 18-year-old woman who presented to the ED with foot pruritis four days after walking on the beach barefoot. POCUS examination revealed several motile structures in the dermis of the patient's foot, confirming our suspicion of cutaneous larva migrans. The patient was then placed on an oral anthelmintic and her symptoms resolved shortly after.
PubMed: 38681149
DOI: 10.24908/pocus.v9i1.17470 -
IJID Regions Jun 2024Kenya has implemented a national school-based deworming program, which has led to substantial decline in the prevalence of soil-transmitted helminths (STHs), although...
OBJECTIVES
Kenya has implemented a national school-based deworming program, which has led to substantial decline in the prevalence of soil-transmitted helminths (STHs), although some pockets of infections remain. To effectively design an STH control program that leads to significant reductions of there is a need to understand the drivers of persistent infection despite ongoing treatment programs.
METHODS
This study was conducted between July and September 2019 at the south coast of Kenya, using a two-stage sampling design. First, a school-based cross-sectional survey was conducted in 2265 randomly selected school children from selected schools in areas known to be endemic for . After this, we conducted a nested case-control study wherein all children positive for (142) were matched to 148 negative controls based on age and village. A household survey was then conducted with all household members of cases and controls. In addition, a subsample of 116 children found to be infected with were followed up to assess the efficacy of albendazole at day 21 post-treatment. The predictors of presence of were investigated through multilevel logistic regression, considering clustering of infection.
RESULTS
Overall, 34.4% of the children were infected with at least one STH species; was the most common (28.3%), 89.1% of those with had light-intensity infections. The prevalence of was significantly higher in male children and was positively associated with younger age and number of people infected with in a household. The parasitological cure rate and egg reduction rate of were 35% and 51%, respectively. Other STHs identified were hookworm (9.6%) and (5.7%).
CONCLUSIONS
remains a significant public health challenge in the study area with albendazole treatment efficacy against the parasite, remaining lower than the World Health Organization-recommended thresholds. Because of the observed focal transmission of in the current area, control efforts tailored to local conditions and targeting lower implementation units should be used to achieve optimal results on transmission.
PubMed: 38634069
DOI: 10.1016/j.ijregi.2024.03.007 -
Health Science Reports Apr 2024Soil-transmitted helminths are one of the most prevalent causes of both intellectual and physical disability in the world. Albendazole (ALB) is a drug recommended for...
Efficacy of 400 mg albendazole against soil-transmitted helminthes among Salgy Primary School Children, Dembia district, Northwest Ethiopia, 2020. "Uncontrolled experimental study".
BACKGROUND AND AIMS
Soil-transmitted helminths are one of the most prevalent causes of both intellectual and physical disability in the world. Albendazole (ALB) is a drug recommended for mass treatment of the high burden of soil-transmitted helminths in schoolchildren, particularly in developing countries. However, some researchers have reported that the efficacy of albedazole against soil-transmitted helminths is inconsistent. Monitoring the programs is crucial to evaluating the effectiveness of 400 mg of ALB against soil-transmitted helminths, as well as any changes in its therapeutic efficacy. Thus, the purpose of this study was to evaluate ALB effectiveness in treating soil-transmitted helminthes in Salgy Primary School Children.
METHODS
An uncontrolled experimental study was conducted at Salgy Primary School Children, Northwest Ethiopia, from March to May 2020. A total of 439 schoolchildren were enrolled and screened for soil-transmitted helminths by stratified proportionate systematic random sampling to get 228 positive schoolchildren. Students in grades one through eight were grouped based on their educational attainment. Using the Kato-Katz thick smear technique, the selected stool sample collected from school children was examined using the Kato-Katz thick smear technique to determine the cure and egg reduction rates. The statistical package for social science software, version 20, was used to analyze the data. To determine the relationship between CR (cure rate) and ERR (egg reduction rate) by age, a chi-square test ( ) was employed and significance was considered at A 95% confidence interval and Value ( < 0.05).
RESULTS
A 400 mg single dosage of ALB showed a 99.35% CR and a 97.30% egg reduction rate against . Additionally, a 400 mg dose of ALB showed a 95.75% CR and an 82.07% egg reduction rate, suggesting questionable effectiveness against hookworm infections. showed a decreased efficacy, with a 43.53% CR and a 23.12% egg reduction rate.
CONCLUSION
A single dose of 400 mg ALB is effective (satisfactory), doubtful, and unsatisfactory against , hookworm, and infections, respectively. Further studies using different brands, doses, and routes will be needed to treat hookworm and infections successfully by using a larger sample size.
PubMed: 38633736
DOI: 10.1002/hsr2.2041 -
PLoS Neglected Tropical Diseases Apr 2024Infections caused by soil-transmitted helminths (STHs) are the most prevalent neglected tropical diseases and result in a major disease burden in low- and middle-income...
BACKGROUND
Infections caused by soil-transmitted helminths (STHs) are the most prevalent neglected tropical diseases and result in a major disease burden in low- and middle-income countries, especially in school-aged children. Improved diagnostic methods, especially for light intensity infections, are needed for efficient, control and elimination of STHs as a public health problem, as well as STH management. Image-based artificial intelligence (AI) has shown promise for STH detection in digitized stool samples. However, the diagnostic accuracy of AI-based analysis of entire microscope slides, so called whole-slide images (WSI), has previously not been evaluated on a sample-level in primary healthcare settings in STH endemic countries.
METHODOLOGY/PRINCIPAL FINDINGS
Stool samples (n = 1,335) were collected during 2020 from children attending primary schools in Kwale County, Kenya, prepared according to the Kato-Katz method at a local primary healthcare laboratory and digitized with a portable whole-slide microscopy scanner and uploaded via mobile networks to a cloud environment. The digital samples of adequate quality (n = 1,180) were split into a training (n = 388) and test set (n = 792) and a deep-learning system (DLS) developed for detection of STHs. The DLS findings were compared with expert manual microscopy and additional visual assessment of the digital samples in slides with discordant results between the methods. Manual microscopy detected 15 (1.9%) Ascaris lumbricoides, 172 (21.7%) Tricuris trichiura and 140 (17.7%) hookworm (Ancylostoma duodenale or Necator americanus) infections in the test set. Importantly, more than 90% of all STH positive cases represented light intensity infections. With manual microscopy as the reference standard, the sensitivity of the DLS as the index test for detection of A. lumbricoides, T. trichiura and hookworm was 80%, 92% and 76%, respectively. The corresponding specificity was 98%, 90% and 95%. Notably, in 79 samples (10%) classified as negative by manual microscopy for a specific species, STH eggs were detected by the DLS and confirmed correct by visual inspection of the digital samples.
CONCLUSIONS/SIGNIFICANCE
Analysis of digitally scanned stool samples with the DLS provided high diagnostic accuracy for detection of STHs. Importantly, a substantial number of light intensity infections were missed by manual microscopy but detected by the DLS. Thus, analysis of WSIs with image-based AI may provide a future tool for improved detection of STHs in a primary healthcare setting, which in turn could facilitate monitoring and evaluation of control programs.
Topics: Child; Animals; Humans; Artificial Intelligence; Soil; Microscopy; Resource-Limited Settings; Feces; Trichuris; Helminthiasis; Helminths; Ascaris lumbricoides; Ancylostomatoidea; Prevalence
PubMed: 38602896
DOI: 10.1371/journal.pntd.0012041 -
Journal of Tropical Medicine 2024This study determines the incidence of common viral and helminth coinfections with malaria in the tertiary care hospital set up in southern Khyber Pakhtunkhwa, Pakistan.
INTRODUCTION
This study determines the incidence of common viral and helminth coinfections with malaria in the tertiary care hospital set up in southern Khyber Pakhtunkhwa, Pakistan.
MATERIALS AND METHODS
The multidimensional research included malaria patients admitted to different hospitals of district Kohat during January and December 2021. Stool samples and blood were assembled from the patients. Giemsa-stained microscopy-positive samples were processed by the immunochromatography technique (ICT) to identify species. Common viral infections such as viral hepatitis (A, B, and C), HIV, and dengue (DENV) were analyzed by ICT kits while SARS-CoV-2 was confirmed through real-time PCR. Furthermore, the intestinal helminths were identified using the Kato-Katz thick smear method.
RESULTS
Among 1278 patients, 548 were diagnosed with malaria, 412 (75.2%) were positive for infection, 115 (21%) for , and 21 (3.8%) for mixed malaria infection (), with a higher incidence among males (65.2%) than females (34.8%). Coinfection with helminths was positive in 215 (39.3%) malaria patients. The most common infections were caused by the species (42.6%) followed by (31.7%) and hookworm. A total of 24.6% of malaria-positive cases were also coinfected with different viruses with higher frequencies of confection for HAV (8.2%) and DENV (6.2%), respectively. The patients revealed higher incidence of coinfections with (57%) as compared with (39.2%) and mixed infections (3.7%).
CONCLUSION
This study demonstrated that the study population exhibited a significant incidence of coinfections with intestinal helminth and viral malaria.
PubMed: 38576602
DOI: 10.1155/2024/8529788 -
PLoS Neglected Tropical Diseases Apr 2024The World Health Organization emphasizes the importance of integrated monitoring and evaluation in neglected tropical disease (NTD) control programs. Serological assays... (Review)
Review
BACKGROUND
The World Health Organization emphasizes the importance of integrated monitoring and evaluation in neglected tropical disease (NTD) control programs. Serological assays offer a potential solution for integrated diagnosis of NTDs, particularly for those requiring mass drug administration (MDA) as primary control and elimination strategy. This scoping review aims (i) to provide an overview of assays using serum or plasma to detect infections with soil-transmitted helminths (STHs) in both humans and animals, (ii) to examine the methodologies used in this research field and (iii) to discuss advancements in serological diagnosis of STHs to guide prevention and control programs in veterinary and human medicine.
METHODOLOGY
We conducted a systematic search in the Ovid MEDLINE, Embase and Cochrane Library databases, supplemented by a Google search using predefined keywords to identify commercially available serological assays. Additionally, we performed a patent search through Espacenet.
PRINCIPAL FINDINGS
We identified 85 relevant literature records spanning over 50 years, with a notable increased interest in serological assay development in recent years. Most of the research efforts concentrated on diagnosing Ascaris infections in both humans and pigs, primarily using ELISA and western blot technologies. Almost all records targeted antibodies as analytes, employing proteins and peptides as analyte detection agents. Approximately 60% of sample sets described pertained to human samples. No commercially available tests for Trichuris or hookworms were identified, while for Ascaris, there are at least seven different ELISAs on the market.
CONCLUSIONS
While a substantial number of assays are employed in epidemiological research, the current state of serological diagnosis for guiding STH prevention and control programs is limited. Only two assays designed for pigs are used to inform efficient deworming practices in pig populations. Regarding human diagnosis, none of the existing assays has undergone extensive large-scale validation or integration into routine diagnostics for MDA programs.
Topics: Humans; Animals; Swine; Ancylostomatoidea; Trichuris; Ascaris; Soil; Ascaris lumbricoides; Helminths; Feces; Helminthiasis; Prevalence
PubMed: 38574166
DOI: 10.1371/journal.pntd.0012049 -
PLoS Neglected Tropical Diseases Mar 2024Control efforts of soil-transmitted helminthiases rely primarily on large scale administration of anthelminthic drugs. The assessment of drug efficacies and... (Clinical Trial)
Clinical Trial
BACKGROUND
Control efforts of soil-transmitted helminthiases rely primarily on large scale administration of anthelminthic drugs. The assessment of drug efficacies and understanding of drug behavior is pivotal to the evaluation of treatment successes, both in preventive chemo-therapy programs as well as in research of novel treatment options. The current WHO guidelines recommend an interval of 14-21 days between the treatment and follow-up, yet no in-depth analysis of egg excretion patterns of Trichuris trichiura after treatment has been conducted to date.
METHODS
Within the framework of a multi-country trial to assess the efficacy and safety of albendazole-ivermectin combination therapy vs albendazole monotherapy against T. trichiura infections, we conducted a study collecting daily stool samples over the period of 28 days post-treatment in 87 participants in Pak Khan, Lao PDR. Egg counts were derived by duplicate Kato-Katz on-site for T. trichiura, hookworm and Ascaris lumbricoides and stool sample aliquots were subsequently analyzed by qPCR for the detection of T. trichiura infections. Sensitivity and specificity was calculated for each day separately using data derived by Kato-Katz to determine the optimal timepoint at which to assess drug efficacy.
RESULTS
Egg excretion patterns varied across treatment arms. For T. trichiura, only the albendazole-ivermectin treatment led to a considerable reduction in mean egg counts, whereas both treatments reduced hookworm egg counts and A. lumbricoides were cleared in all participants after day 7. For T. trichiura, we found sensitivity to be highest at days 18 and 22 when using egg counts as outcome and days 19 and 24 when using qPCR. Specificity was high (>0.9) from day 14 onwards. For hookworm, the highest sensitivity and specificity were found at days 17 and 25, respectively.
CONCLUSIONS
Based on our study, the ideal time period to assess drug efficacy for soil-transmitted helminth infections would be between day 18 and 24. The current WHO recommendation of 14 to 21 days is likely to yield acceptable outcome measures for soil-transmitted helminth infections.
TRIAL REGISTRATION
NCT03527732.
Topics: Animals; Humans; Albendazole; Ancylostomatoidea; Anthelmintics; Feces; Helminthiasis; Ivermectin; Soil; Trichuriasis; Trichuris
PubMed: 38517907
DOI: 10.1371/journal.pntd.0012073