1
|
Parajuli R, Dhakal P, Thapa S, Ghimire TR, Parajuli RP. Prevalence and contributing factors of intestinal parasitic infections among school children with malnutrition in Hetauda, Nepal: A cross-sectional study. Health Sci Rep 2024; 7:e2146. [PMID: 38812713 PMCID: PMC11130544 DOI: 10.1002/hsr2.2146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 04/04/2024] [Accepted: 05/07/2024] [Indexed: 05/31/2024] Open
Abstract
Background and Aims With existing undernutrition in the developing world, the prevalence of obesity is increasing rapidly. Some studies reported an association of intestinal parasitic infection (IPIs) with undernutrition while few recent studies reported an inverse association of IPIs with overweight and obesity. This study evaluated the comparative risk and associated factors of IPIs among under (body mass index [BMI] < 18.5), normal (BMI: 18.5-24.9) and overweight (BMI > 24.9) school-aged adolescents. Methods A total of 105 fecal samples were collected, with 35 samples from each group. The collected samples were tested for the presence of intestinal parasites via concentration method, and the parasites were identified morphologically. Results Overall prevalence of IPIs was 5.71% with 3 protozoa viz Giardia lamblia (2.86%), Entamoeba histolytica (1.90%) and Endolimax nana (0.95%). Univariate and multivariable regression analysis indicated none of the nutritional, socioeconomic status, demographic, lifestyle and behavioral characteristics were significantly associated with the prevalence of overall IPIs. Yet, significant numbers of male reported undernutrition and elevated risk of IPIs in this study population. Conclusion Despite low prevalence of IPIs in this study, risk of IPIs is attributable to individual differences in behavior like "not using soap for hand washing". Relatively elevated malnutrition with risky hygiene behaviors, male adolescents appeared as risky cluster of school age population.
Collapse
Affiliation(s)
| | - Pitambar Dhakal
- Central Department of ZoologyTribhuvan UniversityKirtipurNepal
| | - Sandeep Thapa
- Kathmandu Center for Genomics and Research Laboratory (KCGRL)GwarkoNepal
| | - Tirth Raj Ghimire
- Department of Zoology, Tri‐Chandra CampusTribhuvan UniversityKirtipurNepal
| | - Rajendra Prasad Parajuli
- Central Department of ZoologyTribhuvan UniversityKirtipurNepal
- Herbert Wertheim School of Public Health and Human Longevity ScienceUniversity of California San Diego (UCSD)CaliforniaUSA
| |
Collapse
|
2
|
Singh B, Dhakal P, Parajuli RP. Enteric parasites and associated factors in cancer patients in Nepal. J Parasit Dis 2024; 48:46-52. [PMID: 38440754 PMCID: PMC10908722 DOI: 10.1007/s12639-023-01638-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/15/2023] [Indexed: 03/06/2024] Open
Abstract
Infection with intestinal parasites is widespread worldwide, especially in developing countries. Intestinal parasites are a major cause of diarrhea in both immunocompetent and immunocompromised people, but cancer patients are more prone to infection. This study aimed to investigate the prevalence and risk factors of intestinal parasitic infections (IPIs) among cancer patients undergoing chemotherapy at Nepal Cancer Hospital and Research Center (NCHRC) in Nepal. One hundred individuals were selected with a convenience sampling strategy. The stool samples were examined by direct wet mount, sedimentation, flotation, and acid-fast methods to determine the prevalence and intensity of IPIs in this population. The overall prevalence of IPIs was 8% (4% protozoan and 4% helminths). Altogether, three species of intestinal parasites were detected. Cryptosporidium (4%) was predominant followed by Trichuris trichiura (2%) and Ancylostoma duodenale (2%). Multivariable regression analysis revealed that "not using soap for handwashing" was significantly associated with the prevalence of overall IPIs. None of the other evaluated risk factors indicated an association with IPIs infection. In this study, the IPIs were attributable to individual hygiene behaviors, but not to nutritional status or socio-demographic characteristics. Yet, significant numbers of males reported anemia and undernutrition in this study population.
Collapse
Affiliation(s)
- Barsha Singh
- Central Department of Zoology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Pitambar Dhakal
- Central Department of Zoology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | | |
Collapse
|
3
|
Nevin WD, Jones J, Tupper D, Dunbar JAT, Wilson D, Ross D, Woolley S, Dodd J, Biswas J, Lamb L, Beeching NJ, O’Shea MK, Fletcher TE. Gastrointestinal parasite infections in Nepalese Gurkha recruits arriving in the United Kingdom from 2012-2020. PLoS Negl Trop Dis 2024; 18:e0011931. [PMID: 38277403 PMCID: PMC10849272 DOI: 10.1371/journal.pntd.0011931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/07/2024] [Accepted: 01/21/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Gastrointestinal parasite (GIP) infections are a major cause of global morbidity, infecting hundreds of millions of people each year and potentially leading to lifelong infection and serious complications. Few data exist on screening for GIP infections in migrants entering the UK or on the current performance of different traditional diagnostic approaches. This study aimed to describe the prevalence of GIP infections in Nepalese Gurkha recruits screened on arrival in the UK. METHODOLOGY/PRINCIPAL FINDINGS We present a retrospective analysis of data from screening male adults (18-21 years) who arrived in the UK from Nepal between 2012 and 2020. Three separate faecal samples were obtained from participants at weekly intervals and processed for formalin-ethyl acetate (FEA) concentration/light microscopy and charcoal culture. Serum samples were analysed for IgG antibodies to Strongyloides stercoralis by ELISA. Results were available from 2,263 participants, of whom 463 (20.5%, 95% CI 18.8%-22.2%) had a positive diagnostic test for at least one GIP infection. A total of 525 potential infections were identified. Giardia duodenalis was most common (231/2263, 10.2%), followed by S. stercoralis (102/2263, 4.5%), and hookworm species (86/2263, 3.8%). Analysis (microscopy and culture) of the initial stool sample diagnosed only 244/427 (57.1%) faecally identified pathogens, including 41/86 (47.7%) hookworm infections. The proportion of participants infected with any GIP showed a downward trend over the study period. Log-binomial regression showed risk of infection decreasing by 6.1% year-on-year (95% CI 3.2% - 9.0%). This was driven predominantly by a fall in hookworm, S. stercoralis and Trichuris trichiura prevalence. CONCLUSIONS/SIGNIFICANCE The level of potentially pathogenic GIP infection in young Nepalese men migrating to the UK is high (20.5%) and requires a combined diagnostic approach including serology and analysis of multiple stool samples incorporating specialised parasitological methods. Advances in molecular approaches may optimise and simplify the intensive screening strategy required.
Collapse
Affiliation(s)
- William D. Nevin
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Infectious Diseases, Imperial College London, United Kingdom
| | - Jayne Jones
- Clinical Diagnostic Parasitology Laboratory, Liverpool School of Tropical Medicine, United Kingdom
| | - Donna Tupper
- Medical Centre, Infantry Training Centre, Catterick, United Kingdom
| | - James A. T. Dunbar
- Friarage Hospital, Northallerton, United Kingdom
- 212 Field Hospital, Royal Army Medical Corps, Defence Medical Services, United Kingdom
| | - Duncan Wilson
- Headquarters Defence Medical Services Group, Defence Medical Directorate, ICT Building, Edgbaston, Birmingham, United Kingdom
| | - David Ross
- Defence Public Health Unit, Defence Medical Services, United Kingdom
| | - Stephen Woolley
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - James Dodd
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Jason Biswas
- Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Lucy Lamb
- Department of Infectious Diseases, Imperial College London, United Kingdom
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, United Kingdom
- Department of Infectious Diseases, Royal Free Hospital, London, United Kingdom
| | - Nicholas J. Beeching
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Matthew K. O’Shea
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, United Kingdom
- Institute of Immunology and Immunotherapy, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Thomas E. Fletcher
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| |
Collapse
|
4
|
Rahimi BA, Rafiqi N, Tareen Z, Kakar KA, Wafa MH, Stanikzai MH, Beg MA, Dost AK, Taylor WR. Prevalence of soil-transmitted helminths and associated risk factors among primary school children in Kandahar, Afghanistan: A cross-sectional analytical study. PLoS Negl Trop Dis 2023; 17:e0011614. [PMID: 37695763 PMCID: PMC10513306 DOI: 10.1371/journal.pntd.0011614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/21/2023] [Accepted: 08/21/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Soil-transmitted helminth (STH) infections are global health problem, especially in low-income countries. Main objectives of this study were to estimate the prevalence and intensity of STH and its risk factors among school children in Kandahar city of Afghanistan. METHODOLOGY/PRINCIPAL FINDINGS This was a school-based cross-sectional analytical study, with data collected during eight-month-period (May-December, 2022) from 6- and 12-years old school children in Kandahar city, Afghanistan. All the stool samples were examined by saline wet mount method and Kato-Katz technique. Data were analyzed by using descriptive statistics, Chi square test, and multivariate logistic regression. A total of 1275 children from eight schools of Kandahar city were included in this study. Mean age of these children was 8.3 years with 53.3% boys. The overall prevalence of any intestinal parasitic infection was 68.4%. The overall prevalence of STH infection was 39.1%, with Ascaris lumbricoides (29.4%) as the most prevalent STH species. Mean intensity of overall STH infection was 97.8. Multivariate logistic regression revealed playing barefoot (AOR 1.6, 95% CI 1.1-2.2), not washing hands after defecating and before eating (AOR 1.3, 95% CI 1.0-1.7), having untrimmed nails (AOR 1.4, 95% CI 1.1-1.8), and belonging to poor families (AOR 1.3, 95% CI 1.0-1.7) as the risk factors associated with the predisposition of school children for getting STH in Kandahar city of Afghanistan. CONCLUSIONS/SIGNIFICANCE There is high prevalence of STH among school children of Kandahar city in Afghanistan. Most of the risk factors are related to poverty, decreased sanitation, and improper hygiene. Improvement of socioeconomic status, sanitation, and health education to promote public awareness about health and hygiene together with periodic mass deworming programs are better strategies for the control of STH infections in Afghanistan.
Collapse
Affiliation(s)
- Bilal Ahmad Rahimi
- Department of Pediatrics, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
- Department of Pediatrics, Faculty of Medicine, Malalay Institute of Higher Education, Kandahar, Afghanistan
| | - Najeebullah Rafiqi
- Department of Surgery, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
| | - Zarghoon Tareen
- Department of Pediatrics, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
| | - Khalil Ahmad Kakar
- Department of Public Health, Faculty of Medicine, Malalay Institute of Higher Education, Kandahar, Afghanistan
| | - Mohammad Hashim Wafa
- Department of Psychiatry, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
| | | | - Mohammad Asim Beg
- Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi, Pakistan
| | - Abdul Khaliq Dost
- Department of Surgery, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
| | - Walter R. Taylor
- Mahidol Oxford Tropical Medicine Clinical Research Unit (MORU), Mahidol University, Bangkok, Thailand
| |
Collapse
|
5
|
Micronutrients deficiencies and its correlation with the soil-transmitted helminthic infections among children and non-pregnant women in Nepal: findings from Nepal national micronutrient status survey. Sci Rep 2022; 12:22313. [PMID: 36566272 PMCID: PMC9789997 DOI: 10.1038/s41598-022-24634-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/17/2022] [Indexed: 12/25/2022] Open
Abstract
Despite having a high risk of soil-transmitted helminths (STHs) infection, no national level study has been conducted to assess incidence and correlates of STHs in Nepal. Thus, we hypothesized that micronutrients and social status are linked with incidence of STHs infection among 6-59 months children and 15-49 years non-pregnant women in Nepal and Kato-Katz technique was adopted to measure the type and intensity of STHs infections using fresh stool specimens and venous blood was used to examine micronutrients biomarkers. Anthropometric measurements such as height and weight, sociodemographic and health status were determined using structured questionnaire. Logistic regression was used to assess unadjusted and adjusted odds ratio (AOR) and the 95% CIs of ORs. The bivariate association of STHs was assessed with the covariates variables. Overall, 12% children and 19% non-pregnant women had STHs infection; A. lumbricoides was the predominant helminth in both study participants. In multivariate model; age, ethnicity, anaemia and zinc deficiency were associated with STHs infections in children. Similarly, higher odds of STHs occurrence was observed among non-pregnant women with vitamin A deficiency. Findings from this study suggest that high-risk population, with a focus on those of lower socioeconomic status should be on priority of deworming program, nutrition intervention, and mass administration of preventive chemotherapy and sanitation champions supplement to reduce the STHs infections in Nepal.
Collapse
|
6
|
Rahimi BA, Mahboobi BA, Wafa MH, Sahrai MS, Stanikzai MH, Taylor WR. Prevalence and associated risk factors of soil-transmitted helminth infections in Kandahar, Afghanistan. BMC Infect Dis 2022; 22:361. [PMID: 35410154 PMCID: PMC9003950 DOI: 10.1186/s12879-022-07336-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/31/2022] [Indexed: 12/30/2022] Open
Abstract
Background Soil-transmitted helminth (STH) infections are still a major health problem, especially in resource-limited countries. The community-based prevalence of STH is unknown in Afghanistan. Main objectives of this study were to estimate the prevalence and associated factors of STH among children in Daman district of Kandahar province in Afghanistan. Methods This was a community-based cross-sectional study, with data collected during five months (June–October, 2020) from children living in five villages of Daman district in Kandahar, Afghanistan. All the stool samples were examined by saline wet mount method. Data were analyzed by using descriptive statistics, Chi square test, and multivariate logistic regression. Results A total of 1426 children were studied, with majority (61.8%) of males and the mean age of 6.3 years. The overall prevalence of any intestinal parasitic infection was 39.8%. The overall prevalence of STH infection was 22.7%, with Ascaris lumbricoides (18.7%) as the most prevalent STH species, followed by hookworm (7.5%) and Trichuris trichiura (1.4%). Single, double, and triple STH infections were present in 14.9%, 7.2%, and 0.6% of the children, respectively. Multivariate logistic regression revealed that not washing hands after defecating/before eating (AOR 7.0, 95% CI 3.4–14.0), living in mud house (AOR 3.5, 95% CI 1.6–7.4), walking barefoot (AOR 2.2, 95% CI 1.6–3.1), living in overcrowded house (AOR 1.6, 95% CI 1.1–2.3), and practicing open defecation (AOR 1.4, 95% CI 1.1–2.0) as the risk factors associated with the predisposition of rural children for getting STH in Daman district of Afghanistan. Conclusions Prevalence of STH is high among children of Daman district in Afghanistan. Most of the risk factors are related to poverty, decreased sanitation, and improper hygiene. Improvement of socioeconomic status, sanitation, and health education to promote public awareness about health and hygiene together with periodic mass deworming programs are better strategies for the control of STH infections in Afghanistan. Also, government and international donor agencies in Afghanistan should help in improving socio-economic status of the rural areas through provision of basic facilities such as piped water, electricity, good housing, and proper toilets.
Collapse
Affiliation(s)
- Bilal Ahmad Rahimi
- Department of Pediatrics, Faculty of Medicine, Kandahar University, Beside Aino Mena Town, District 10, Durahi, Kandahar, Afghanistan. .,Head of Research Unit, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan.
| | - Bashir Ahmad Mahboobi
- Department of Pediatrics, Faculty of Medicine, Kandahar University, Beside Aino Mena Town, District 10, Durahi, Kandahar, Afghanistan
| | - Mohammad Hashim Wafa
- Department of Psychiatry, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
| | - Mohammad Sediq Sahrai
- Department of Internal Medicine, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
| | | | - Walter R Taylor
- Mahidol Oxford Tropical Medicine Clinical Research Unit (MORU), Mahidol University, Bangkok, Thailand
| |
Collapse
|
7
|
Bertoncello C, Amoruso I, Moscardino U, Fonzo M, Maharjan M, Buja A, Baldo V, Cocchio S, Baldovin T. Sex-Biased Prevalence of Intestinal Parasitic Infections and Gender Inequality in Rural Nepal. Int J Infect Dis 2021; 109:148-154. [PMID: 34182133 DOI: 10.1016/j.ijid.2021.06.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/17/2021] [Accepted: 06/17/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Intestinal parasitic infections (IPIs) are related to poverty and socioeconomic disparities. In rural Nepal, IPIs are highly endemic and gender inequality is still deeply rooted. This study provides a novel epidemiological assessment of IPIs in Nepal, juxtaposing spatial, age and sex stratification of prevalence. METHODS A PRISMA and PICO-based systematic review of peer-reviewed and grey literature provided IPI prevalence data for the Nepalese population. Demographic and environmental variables were considered to investigate differences related to dwelling area and sex. Variations among prevalence rates were calculated with 95% CI and significance level for odds ratio evaluated with chi-square test. RESULTS The IPI prevalence rate for the Nepalese general population was 37.6%. Moreover, IPI prevalence (52.3%) was significantly higher in rural areas than in urban areas (32.4%), and school-age girls (55.2%) were more infected than boys (48.6%). CONCLUSIONS The IPI infection rate appeared to be enhanced among young women living in rural Nepal, where they experienced low school attendance and heavy enrolment in agricultural work, as result of gender discrimination. Plausibly, these dynamics affect both girls' environmental exposure and fruition of periodic school-based preventive chemotherapy, thus increasing the chances of IPI infection.
Collapse
Affiliation(s)
- Chiara Bertoncello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Hygiene and Public Health, University of Padua, Padua, Italy
| | - Irene Amoruso
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Hygiene and Public Health, University of Padua, Padua, Italy.
| | - Ughetta Moscardino
- Department of Developmental Psychology and Socialisation, University of Padua, Padua, Italy
| | - Marco Fonzo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Hygiene and Public Health, University of Padua, Padua, Italy
| | - Mahendra Maharjan
- Central Department of Zoology, Tribhuvan University, Kirtipur, Nepal
| | - Alessandra Buja
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Hygiene and Public Health, University of Padua, Padua, Italy
| | - Vincenzo Baldo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Hygiene and Public Health, University of Padua, Padua, Italy
| | - Silvia Cocchio
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Hygiene and Public Health, University of Padua, Padua, Italy
| | - Tatjana Baldovin
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Hygiene and Public Health, University of Padua, Padua, Italy
| |
Collapse
|
8
|
Zibaei M, Nosrati MRC, Shadnoosh F, Houshmand E, Karami MF, Rafsanjani MK, Majidiani H, Ghaffarifar F, Cortes HCE, Dalvand S, Badri M. Insights into hookworm prevalence in Asia: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg 2021; 114:141-154. [PMID: 31917423 DOI: 10.1093/trstmh/trz115] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 09/09/2019] [Accepted: 09/04/2019] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Hookworm infections are neglected tropical diseases of humans and animals worldwide. A meta-analysis and systematic review was designed to evaluate the prevalence of hookworm infection in animal and human hosts in Asia until July 2018. METHODS The available online articles of five English databases (PubMed, Scopus, Science Direct, Web of Science and Google Scholar) were explored. RESULTS The most parasitized carnivores were jackal (48%, CI: 4 to 91%), followed by dog (41%, CI: 29 to 53%), cat (26%, CI: 14 to 38%) and the red fox (19%, CI: 13 to 24%). The weighted prevalence of Ancylostoma braziliensis, A. caninum, A. ceylanicum, A. tubaeforme and Uncinaria stenocephala isolated from different canids were found to be 27% (CI: 21 to 33%), 23% (CI: 7.0 to 53%), 24% (CI: 12 to 35%), 44% (CI: 37 to 51%) and 37% (CI: 18 to 55%), respectively. In total, 98 records were obtained for human hookworms from 3209 760 examined individuals and the calculated weighted prevalence in this population was 19% (CI: 17 to 20%). CONCLUSIONS These findings highlight a desirable ecological milieu for parasite survival and transmission in such territories, which implicates revisiting control programs and public health infrastructures in those areas.
Collapse
Affiliation(s)
- Mohammad Zibaei
- Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Farnosh Shadnoosh
- Department of Medical Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Houshmand
- Department of Parasitology, Faculty of veterinary medicine, Rasht Branch, Islamic Azad University, Guilan
| | - Maryam Fasihi Karami
- Department of Medical Parasitology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Hamidreza Majidiani
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fatemeh Ghaffarifar
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | - Sahar Dalvand
- Health Management and Economics Research Center, Iran University of Medical Sciences , Tehran, Iran
| | - Milad Badri
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| |
Collapse
|
9
|
Nasution RKA, Nasution BB, Lubis M, Lubis IND. Prevalence and Knowledge of Soil-Transmitted Helminth Infections in Mandailing Natal, North Sumatera, Indonesia. Open Access Maced J Med Sci 2019; 7:3443-3446. [PMID: 32002070 PMCID: PMC6980816 DOI: 10.3889/oamjms.2019.441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/15/2019] [Accepted: 09/16/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND: Soil-transmitted helminth (STH) infection remains of public health importance, particularly in developing countries. North Sumatra province of Indonesia has reported high prevalences of STH in many of its districts. AIM: In this study, we aimed to determine the prevalence of STH and evaluated STH knowledge and risk behaviours of school children in Mandailing Natal district. METHODS: We conducted a cross-sectional study in two primary schools in Mandailing Natal district, North Sumatera province, Indonesia. Data were collected directly from the subjects using a questionnaire after receiving consent from their parents. A stool sample was also collected to determine the STH status of each subject. Samples were then transported to the parasitology laboratory at Universitas Sumatera Utara in Medan to be analysed by a trained analyst. Kato-Katz method was used to prepare the slides (World Health Organization, 2002). The intensity of infection is classified into light, moderate and heavy infection. RESULTS: Prevalence of STH infections were 76.8% and 87.2% in Singkuand and Sikapas primary schools, respectively. The majority of infections were Ascaris lumbricoides and Trichuris trichiura at a light intensity. Only small numbers of children in the two schools used soap before eating, used soap after defecating, and wear sandal/shoes when walking outdoor. Less than 50% of children also knew the route of transmission of STH. Poorer knowledge and behaviours were shown in children from Sikapas than in Singkuang. CONCLUSION: High prevalence and poor hygiene behaviours found in this study reinforce the need to identify the correct intervention to address this STH problem in the region.
Collapse
Affiliation(s)
| | - Badai Buana Nasution
- Department of Paediatrics, Faculty of Medicine, Universitas Sumatera Utara Jl. Dr Mansyur No. 5, Medan, Indonesia
| | - Munar Lubis
- Department of Paediatrics, Faculty of Medicine, Universitas Sumatera Utara Jl. Dr Mansyur No. 5, Medan, Indonesia
| | - Inke Nadia D Lubis
- Department of Paediatrics, Faculty of Medicine, Universitas Sumatera Utara Jl. Dr Mansyur No. 5, Medan, Indonesia
| |
Collapse
|
10
|
Baldovin T, Amoruso I, Zangrando D, Cocchio S, Maharjan M, Lazzari R, Buja A, Baldo V, Bertoncello C. Soil-transmitted helminthiases in Nepal: Transmission boundaries and implications for local communities and international travelers. Acta Trop 2019; 196:155-164. [PMID: 30991017 DOI: 10.1016/j.actatropica.2019.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/02/2019] [Accepted: 04/12/2019] [Indexed: 12/28/2022]
Abstract
Soil transmitted helminthiasis (STHs) are endemic in Nepal but since the country territory is extremely heterogeneous, a multidisciplinary assessment is required to evaluate the risk of infection in different areas. Prevalence data were retrieved with systematic literature search and geographical coordinates were assigned to each survey site. Spatial stratification was then implemented considering land use and ecological parameters. STH transmission boundaries were tested after reference criteria and elevation was evaluated as additional predictor: the elevation threshold of 3057 m above sea level is demarking the STH transmission limit. Areas above this threshold are safe, but since lodging in at-risk sites is a compulsory stopover for international travelers, STH risk exposure should be considered for every travel to the country.
Collapse
|
11
|
Khanal V, Karkee R, Adhikari M, Gavidia T. Moderate-to-severe anaemia among children aged 6–59 months in Nepal: An analysis from Nepal Demographic and Health Survey, 2011. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2016. [DOI: 10.1016/j.cegh.2015.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
12
|
Abstract
BACKGROUND Neglected tropical diseases (NTDs) are generally assumed to be concentrated in poor populations, but evidence on this remains scattered. We describe within-country socioeconomic inequalities in nine NTDs listed in the London Declaration for intensified control and/or elimination: lymphatic filariasis (LF), onchocerciasis, schistosomiasis, soil-transmitted helminthiasis (STH), trachoma, Chagas' disease, human African trypanosomiasis (HAT), leprosy, and visceral leishmaniasis (VL). METHODOLOGY We conducted a systematic literature review, including publications between 2004-2013 found in Embase, Medline (OvidSP), Cochrane Central, Web of Science, Popline, Lilacs, and Scielo. We included publications in international peer-reviewed journals on studies concerning the top 20 countries in terms of the burden of the NTD under study. PRINCIPAL FINDINGS We identified 5,516 publications, of which 93 met the inclusion criteria. Of these, 59 papers reported substantial and statistically significant socioeconomic inequalities in NTD distribution, with higher odds of infection or disease among poor and less-educated people compared with better-off groups. The findings were mixed in 23 studies, and 11 studies showed no substantial or statistically significant inequality. Most information was available for STH, VL, schistosomiasis, and, to a lesser extent, for trachoma. For the other NTDs, evidence on their socioeconomic distribution was scarce. The magnitude of inequality varied, but often, the odds of infection or disease were twice as high among socioeconomically disadvantaged groups compared with better-off strata. Inequalities often took the form of a gradient, with higher odds of infection or disease each step down the socioeconomic hierarchy. Notwithstanding these inequalities, the prevalence of some NTDs was sometimes also high among better-off groups in some highly endemic areas. CONCLUSIONS While recent evidence on socioeconomic inequalities is scarce for most individual NTDs, for some, there is considerable evidence of substantially higher odds of infection or disease among socioeconomically disadvantaged groups. NTD control activities as proposed in the London Declaration, when set up in a way that they reach the most in need, will benefit the poorest populations in poor countries.
Collapse
|
13
|
Strunz EC, Addiss DG, Stocks ME, Ogden S, Utzinger J, Freeman MC. Water, sanitation, hygiene, and soil-transmitted helminth infection: a systematic review and meta-analysis. PLoS Med 2014; 11:e1001620. [PMID: 24667810 PMCID: PMC3965411 DOI: 10.1371/journal.pmed.1001620] [Citation(s) in RCA: 433] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 02/13/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Preventive chemotherapy represents a powerful but short-term control strategy for soil-transmitted helminthiasis. Since humans are often re-infected rapidly, long-term solutions require improvements in water, sanitation, and hygiene (WASH). The purpose of this study was to quantitatively summarize the relationship between WASH access or practices and soil-transmitted helminth (STH) infection. METHODS AND FINDINGS We conducted a systematic review and meta-analysis to examine the associations of improved WASH on infection with STH (Ascaris lumbricoides, Trichuris trichiura, hookworm [Ancylostoma duodenale and Necator americanus], and Strongyloides stercoralis). PubMed, Embase, Web of Science, and LILACS were searched from inception to October 28, 2013 with no language restrictions. Studies were eligible for inclusion if they provided an estimate for the effect of WASH access or practices on STH infection. We assessed the quality of published studies with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. A total of 94 studies met our eligibility criteria; five were randomized controlled trials, whilst most others were cross-sectional studies. We used random-effects meta-analyses and analyzed only adjusted estimates to help account for heterogeneity and potential confounding respectively. Use of treated water was associated with lower odds of STH infection (odds ratio [OR] 0.46, 95% CI 0.36-0.60). Piped water access was associated with lower odds of A. lumbricoides (OR 0.40, 95% CI 0.39-0.41) and T. trichiura infection (OR 0.57, 95% CI 0.45-0.72), but not any STH infection (OR 0.93, 95% CI 0.28-3.11). Access to sanitation was associated with decreased likelihood of infection with any STH (OR 0.66, 95% CI 0.57-0.76), T. trichiura (OR 0.61, 95% CI 0.50-0.74), and A. lumbricoides (OR 0.62, 95% CI 0.44-0.88), but not with hookworm infection (OR 0.80, 95% CI 0.61-1.06). Wearing shoes was associated with reduced odds of hookworm infection (OR 0.29, 95% CI 0.18-0.47) and infection with any STH (OR 0.30, 95% CI 0.11-0.83). Handwashing, both before eating (OR 0.38, 95% CI 0.26-0.55) and after defecating (OR 0.45, 95% CI 0.35-0.58), was associated with lower odds of A. lumbricoides infection. Soap use or availability was significantly associated with lower infection with any STH (OR 0.53, 95% CI 0.29-0.98), as was handwashing after defecation (OR 0.47, 95% CI 0.24-0.90). Observational evidence constituted the majority of included literature, which limits any attempt to make causal inferences. Due to underlying heterogeneity across observational studies, the meta-analysis results reflect an average of many potentially distinct effects, not an average of one specific exposure-outcome relationship. CONCLUSIONS WASH access and practices are generally associated with reduced odds of STH infection. Pooled estimates from all meta-analyses, except for two, indicated at least a 33% reduction in odds of infection associated with individual WASH practices or access. Although most WASH interventions for STH have focused on sanitation, access to water and hygiene also appear to significantly reduce odds of infection. Overall quality of evidence was low due to the preponderance of observational studies, though recent randomized controlled trials have further underscored the benefit of handwashing interventions. Limited use of the Joint Monitoring Program's standardized water and sanitation definitions in the literature restricted efforts to generalize across studies. While further research is warranted to determine the magnitude of benefit from WASH interventions for STH control, these results call for multi-sectoral, integrated intervention packages that are tailored to social-ecological contexts.
Collapse
Affiliation(s)
- Eric C. Strunz
- Children Without Worms, The Task Force for Global Health, Decatur, Georgia, United States of America
| | - David G. Addiss
- Children Without Worms, The Task Force for Global Health, Decatur, Georgia, United States of America
| | - Meredith E. Stocks
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Stephanie Ogden
- Children Without Worms, The Task Force for Global Health, Decatur, Georgia, United States of America
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- International Trachoma Initiative, The Task Force for Global Health, Decatur, Georgia, United States of America
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Matthew C. Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| |
Collapse
|
14
|
Parajuli RP, Fujiwara T, Umezaki M, Konishi S, Takane E, Maharjan M, Tachibana K, Jiang HW, Pahari K, Watanabe C. Prevalence and risk factors of soil-transmitted helminth infection in Nepal. Trans R Soc Trop Med Hyg 2014; 108:228-36. [PMID: 24488979 DOI: 10.1093/trstmh/tru013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The purpose of this study is to evaluate the prevalence and intensity and examine the risk factors of soil transmitted helminth (STH; i.e., roundworm [Ascaris lumbricoides], hookworms [Ancylostoma duodenale and Necator americanus], and whipworm [Trichuris trichiura]) infections in Nepal. METHODS Five hundred and ninety-four adults (256 men and 338 women) were selected via convenience sampling from five communities in Nepal. The Kato-Katz method was used to assess the prevalence and intensity of STH infection in this population. RESULTS Prevalence of STH infection ranged from 3.3% in Birendranagar in Chitwan, 3.5% in Kuleshor in Kathmandu, 11.7% in Kanyam in Ilam, 17.0% in Dhikurpokhari in Kaski and 51.4% in Khokana in Lalitpur District [corrected]. Multivariable regression analysis revealed that not using soap for hand-washing was significantly associated with the prevalence and infection intensity of roundworm, hookworms and whipworm. Similarly, not wearing sandals or shoes outside was significantly associated with the prevalence and infection intensity of roundworm and hookworms, but not with infection intensity of whipworm. Literacy, being underweight or overweight, anemia and occupation were not associated with prevalence and intensity of roundworm and hookworms infection, but there was an association between occupation and the prevalence of whipworm infection. CONCLUSION STH infection was associated with individual hygiene behavior, but not with nutritional status or socio-demographic characteristics. Health policy focusing on changing individual hygiene behaviors might be useful in addressing STH infection in Nepal.
Collapse
Affiliation(s)
- R P Parajuli
- Department of Human Ecology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
The influence of poverty and culture on the transmission of parasitic infections in rural nicaraguan villages. J Parasitol Res 2012; 2012:478292. [PMID: 22934154 PMCID: PMC3426246 DOI: 10.1155/2012/478292] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Revised: 04/25/2012] [Accepted: 04/30/2012] [Indexed: 11/17/2022] Open
Abstract
Intestinal parasitic infections cause one of the largest global burdens of disease. To identify possible areas for interventions, a structured questionnaire addressing knowledge, attitude, and practice regarding parasitic infections as well as the less studied role of culture and resource availability was presented to mothers of school-age children in rural communities around San Juan del Sur, Nicaragua. We determined that access to resources influenced knowledge, attitude, and behaviors that may be relevant to transmission of parasitic infections. For example, having access to a clinic and prior knowledge about parasites was positively correlated with the practice of having fencing for animals, having fewer barefoot children, and treating children for parasites. We also found that cultural beliefs may contribute to parasitic transmission. Manifestations of machismo culture and faith in traditional medicines conflicted with healthy practices. We identified significant cultural myths that prevented healthy behaviors, including the beliefs that cutting a child's nails can cause tetanus and that showering after a hot day caused sickness. The use of traditional medicine was positively correlated with the belief in these cultural myths. Our study demonstrates that the traditional knowledge, attitude, and practice model could benefit from including components that examine resource availability and culture.
Collapse
|
16
|
Abstract
SummaryIn the Terai region, despite its ecological richness, the people have long suffered from a deficiency of micronutrients such as vitamin A, iron and zinc. The aim of this study was to investigate dietary and nutritional intakes among people in the Terai region of Nepal. The results were compared by sex and ethnicity. Food consumption surveys (one-day weighed records) were conducted among 114 people (55Musharand 59Tharu). Nutritional intakes were calculated using Nepali food composition and other tables. The diet in the Terai region was characterized by a large amount of rice consumed with a tiny amount of curry ordalas a side dish. Intakes of vitamin A, iron, riboflavin and selenium were less than 50% of the recommended daily allowance irrespective of ethnicity or sex (with the exception of iron intake amongTharumales). Intakes of thiamine, riboflavin, niacin, phosphorus and zinc were higher among theTharuthan theMushar, while intakes of selenium and iodine were higher among theMusharthan theTharu. The nutritional significance of these differences was slight. Protein intake (per kg body weight) was lower in females than in males, while the energy-adjusted micronutrient intakes did not differ by sex. Intakes of vitamin A, iron, riboflavin and selenium were deficient among the participants. Intervention projects such as the introduction of kitchen gardens or fish farming may be effective, but will increase the degree of inequality between the two ethnic groups.
Collapse
|
17
|
Zonta ML, Oyhenart EE, Navone GT. Nutritional status, body composition, and intestinal parasitism among the Mbyá-Guaraní communities of Misiones, Argentina. Am J Hum Biol 2010; 22:193-200. [PMID: 19642206 DOI: 10.1002/ajhb.20977] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Indigenous communities in Argentina represent socially and economically neglected populations. They are living in extreme poverty and environmental degradation conditions. New information about health status and socio-environmental features is urgently needed to be applied in future sanitary policies. Present study describes the nutritional status, body composition, and intestinal parasitism among Mbyá-Guaraní children from three communities in the Misiones Province. Anthropometric parameters were analyzed for 178 individuals (aged 1-14). Data were transformed to z-scores using NHANES I and II. Stunting showed the greatest prevalence (44.9%). Children were found to have low arm circumference and low arm muscle area, although with tricipital skinfold value near to the reference. They also tend to have shorter than normal lower limbs. Fecal samples and anal brushes (for Enterobius vermicularis) were collected in 45 children (aged 1-13). Ritchie's sedimentation and Willis' flotation techniques were used to determine parasitoses. Ninety five percent of children were infected with at least one species and 81.4% were polyparasitized. The higher prevalences corresponded to Blastocystis hominis, hookworms (Ancylostoma duodenale/Necator americanus), and Entamoeba coli. Associations occurred between hookworms with B. hominis/E. coli and B. hominis with nonpathogenic amoebas. Thirty nine percent of the children with stunting presented B. hominis, Strongyloides, and hookworms. Our results indicate that this indigenous population is subjected to extreme poverty conditions and is one of the most marginalized in this country. Severe growth stunting and parasitic infection are still quite common among Mbyá children affecting about half of them along with significant changes in body composition and proportions.
Collapse
Affiliation(s)
- M L Zonta
- Centro de Estudios Parasitológicos y de Vectores, UNLP-CCT CONICET-La Plata, La Plata-Buenos Aires, Argentina.
| | | | | |
Collapse
|