Seroprevalence of five parasitic pathogens in pregnant women in ten Caribbean countries

Prevalence of Schistosoma infection and associated factors among pregnant women attending antenatal care at Shewa Robit Health Center, North-Central Ethiopia: a cross-sectional study

BACKGROUND

Schistosoma spp. and other intestinal parasites are common in Ethiopia. During pregnancy, SCH increases the risk of adverse birth outcomes. However, its epidemiology among pregnant women and awareness level about the disease are not well addressed in Ethiopia. This study was conducted to address this gap.

METHODS

A cross-sectional study was conducted from April to June 2023 among 422 pregnant women who attended Shewa Robit Health Center. Pregnant women who came to the health center for antenatal care services were enrolled in the study following systematic random sampling technique. Questionnaire data was collected on socio-demographic characteristics, KAP towards SCH, and associated factors. Stool samples were processed using the Kato-Katz technique, while urine samples were tested with urine test strips for hematuria, and filtration and centrifugation methods for detection of S. haematobium. Data were entered and analyzed using SPSS software version 25. Descriptive statistics and logistic regression were performed at a 95% confidence level.

RESULTS

Among 422 pregnant women, 38 (9.0%) were positive for hematuria, but none were infected by S. haematobium. Schistosoma mansoni was detected in 40 (9.5%; 95% confidence interval (CI): 6.6-12.6) participants. Habit of swimming or bathing (adjusted odds ratio (AOR) = 4.896; 95% CI: 2.193-10.933, p < 0.001) and habit of crossing freshwater on barefoot (AOR = 5.113; 95% CI: 1.171-22.324, p = 0.030) were significantly associated with S. mansoni infection. Of the participants, only 74 (17.5%) had previously heard of SCH. Out of 74 aware participants, 49 (66.2%) and 14 (18.9%) were unaware of the causative agent and possibility of a cure for SCH, respectively. Sixty-one (82.4%) were aware that SCH is preventable. Fifty-three (71.6%) and 4 (5.4%) participants believed that SCH is preventable and serious disease, respectively. Eight (10.8%) and 9 (12.2%) participants avoided contact with freshwater and used clean water for drinking and washing, respectively.

CONCLUSIONS

There is nearly moderate prevalence of S. mansoni infection in the study area. Pregnant women who often had freshwater contact were more likely to contract S. mansoni. Most pregnant women in the study area had low KAP levels towards SCH. Therefore, women of reproductive age groups should be the focus of SCH control programs.

Serological diagnosis of Toxocara canis in mothers and their neonate referred to selected teaching hospitals, Tehran, Iran, 2020

Toxocariasis is a common zoonotic parasitic disease, primarily caused by the larvae of Toxocara canis or T. cati. Humans become infected through accidental ingestion of infective eggs in soil contaminated with feces of infected animals, or by consuming undercooked meat from paratenic hosts harboring Toxocara larvae. This cross-sectional study aimed to evaluate the seroprevalence of Toxocara spp. in 250 mothers and their 250 neonates referred to selected teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences, Tehran, Iran in 2020. Data were recorded using a specialized questionnaire, and serum and peripheral blood smears (for eosinophil count) were collected. Serum samples were tested using the ELISA serological test for IgG antibodies against Toxocara spp. The collected data were analyzed using IBM SPSS Statistics software version 21.0. A chi-square test was performed, and a P value less than 0.05 was considered statistically significant. Among the 500 participants, 24 cases (4.8%) tested positive for anti-Toxocara canis IgG antibodies. Seropositive cases included 6 mothers only (25%), 6 neonates only (25%), and 12 cases both mother and their neonate (50%). Statistical analysis showed a significant relationship between the presence of anti-Toxocara antibodies and hospital type and nationality (P value < 0.05). However, no significant relationship was found between the presence of antibodies and other demographic variables such as age, sex, eosinophilia, and history of contact with animals in mothers and their neonates (P value > 0.05). This study indicates a substantial rate Toxocara infection in mothers and neonates, necessitating appropriate preventive measures by the relevant authorities.

Serological diagnosis of soil-transmitted helminth (Ascaris, Trichuris and hookworm) infections: A scoping 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.

Serosurvey of Toxoplasma gondii and Toxocara spp. co-infection in pregnant women in low-income areas of Brazil

Introduction

Despite human toxoplasmosis and toxocariasis having been listed among the top six most neglected parasitic zoonoses worldwide, presenting similar associated risk factors and transmission routes, few studies have been conducted in pregnant women and the consequences of concurrent infection remain to be fully established. Accordingly, the present study has serologically assessed the co-infection and associated risk factors for Toxoplasma gondii and Toxocara spp. in pregnant women, assisted by the public Unified National Health System (SUS) in southeastern Brazil.

Materials and Methods

Blood samples were collected and tested for IgG antibodies against Toxoplasma gondii by chemiluminescence immunoassay and against Toxocara spp. by enzyme-linked immunosorbent assay (ELISA). An epidemiological questionnaire was applied to gather socioeconomic information to assess the risk factors associated with seropositivity to toxocariasis/toxoplasmosis by univariate analysis followed by logistic regression.

Results

Overall, seropositivity was 69/280 (24.6, 95% CI: 19.96-30.01) for T. gondii and 56/280 (20.0, 95% CI: 15.73-25.08) for Toxocara spp. Co-infection was observed in 25/280 (8.9, 95% CI: 6.12-12.85) pregnant women, with increased odds (OR: 3.3, CI 95%: 1.77-6.14, p = 0.0002). Logistic regression revealed that a higher educational level (high school or college) significantly reduced the likelihood of co-infection seropositivity, owning cats increased the odds of toxocariasis, and older pregnant women presented significantly higher T. gondii seropositivity.

Conclusion

Co-infection herein highlights the importance of educational programs in the prevention of toxocariasis and toxoplasmosis in pregnant women and other high-risk populations.

Seroprevalence of human toxocariasis in Latin America and the Caribbean: a systematic review and meta-analysis

Introduction

The current study aimed to quantitatively synthesize available evidence regarding the seroprevalence of human toxocariasis in Latin America and the Caribbean.

Methods

A systematic research involving six electronic databases was conducted using a research strategy that combined MeSH terms with free terms. Article selection and information extraction were performed using a double and independent approach. The Newcastle-Ottawa tool was used to assess the risk of bias in the included articles. The meta-analysis used the random-effects approach, with subgroup analysis and sensitivity analysis for risk of bias also being performed.

Results

We included 101 articles with a total of 31,123 participants. The studies were conducted between 1990 and 2022, with Brazil accounting for the largest number of studies (n = 37). The overall seroprevalence of human toxocariasis was 31.0% (95% CI: 27.0-35.0%, I2 = 99%). The prevalence of the main characteristics observed in seropositive patients were as follows: ocular toxocariasis (30.0%), asymptomatic (26.0%), and presence of dogs at home (68.0%). In addition, the seroprevalence was lower in studies including only adults than in those including children or both. In contrast, no differences in seroprevalences were found between studies conducted in the community and hospital.

Conclusion

The overall seroprevalence of human toxocariasis in Latin America and the Caribbean was high. Notably, our findings showed that the seroprevalence was increased among populations who kept a dog at home but was decreased in populations comprising only adults. Our findings can be used to establish epidemiological surveillance strategies for the prevention and early identification of toxocariasis.

Burden of intestinal parasitic infections and associated factors among pregnant women in East Africa: a systematic review and meta-analysis

BACKGROUND

The ultimate goal of preventing intestinal parasites among pregnant women is to reduce maternal and newborn morbidity and mortality. Numerous primary studies were conducted in East Africa presented intestinal parasite infection and associated factors among pregnant women. However, the pooled finding is not known. Therefore, this review aimed to identify the pooled prevalence of intestinal parasite infection and its determinants among pregnant women in East Africa.

METHODS

Articles published from 2009 to 2021 were searched in PubMed, Web of Science, EMBASE, and HINARI databases. The search for unpublished studies such as thesis and dissertations was checked in Addis Ababa University and Africa Digital Library. PRISMA checklist was used to report the review. Articles published in the English Language were considered. The data were extracted by two authors using data extraction checklists on Microsoft excel. Heterogeneity among the included studies was checked using I² statistics on forest plots. Sensitivity and sub-group analyses were conducted to assess the presence of primary studies, and study characteristics responsible for the observed heterogeneity.

RESULTS

Of the 43 identified articles, about 23 articles were removed due to duplications. Then, by assessing the abstracts and full texts, four articles were removed because they failed to meet the eligibility criteria. Finally, 16 articles were included in the systematic and meta-analysis.The pooled prevalence of intestinal parasites among pregnant women in East Africa was 38.54 (28.77, 48.32). In this study, variables like residing in rural areas (OR: 3.75; CI: 1.15,12.16), availability of latrine(OR: 2.94; 95% CI: 2.22, 3.91), eating raw fruits/vegetables (OR: 2.44; 95% CI: 1.16, 5.11). and sources of water as unprotected sources (OR: 2.20; 95% CI: 1.11,4.35) show statistically significant association with the increased burden of intestinal parasites among pregnant women.

CONCLUSION

The burden of intestinal parasite infection among pregnant women in East Africa was high. Therefore, efforts should be made in deworming pregnant women at the community and institutional level by stakeholders to reduce the burden of intestinal parasite infections and related complications.

Long-Standing International Cooperation in Parasitology Research: A Summary of 35 Years of Activities in the Bolivian Chaco

The Bolivian Chaco is a semiarid region with a low population density, situated in the southeast part of the Plurinational State of Bolivia. Here, despite the improvements of the last 15 years, poverty remains high in rural areas, where social vulnerability is widespread. The Guaraní ethnic group often lives in isolated communities with a low standard of hygiene and sanitation. This epidemiological scenario favors the spread of transmissible diseases, including several parasitic infections belonging to the neglected tropical diseases (NTDs) group. In this area, a long-standing research activity, built upon the synergism between local and foreign institutions, has been established since the late 1980s and helps to fill in the knowledge gap about the epidemiology dynamics of soil-transmitted helminths, vector-borne parasites, and other parasitic diseases. A 35-year history of cooperation programs in parasitology research has contributed to informing local health authorities of the NTD burden in the Bolivian Chaco and, ultimately, supports local healthcare providers in the management of parasitic diseases.

Specific IgG and IgA Antibody Reactivities in Sera of Children by Enzyme-Linked Immunoassay and Comparison With Giardia duodenalis Diagnosis in Feces

Background

Giardia duodenalis is conventionally diagnosed in fecal samples using parasitological methods. However, sensitivity is poor when only a single sample is analyzed, due to intermittent excretion of cysts in feces. Alternatively, the serum antibodies to G. duodenalis can be used for parasite diagnosis and epidemiological studies to determine previous exposure. We compared the rate of G. duodenalis infection between serum anti-Giardia IgG and IgA antibodies and fecal examination in Brazilian children.

Methods

Fecal and serum samples were tested from 287 children at a clinical laboratory and from 187 children at daycare centers. Fecal samples were processed using conventional parasitological methods and coproantigen detection for Giardia diagnosis. Serum samples were tested using an in-house ELISA for detection of anti-Giardia IgG and IgA.

Results

G. duodenalis was found in 8.2% (N=39) of the 474 children analyzed. The sensitivity and specificity of ELISA were 80.0% and 90.0% for IgG and 80.0% and 83.3% for IgA, respectively. The total positivity rate of anti-Giardia IgG and IgA in the sera was 13.9% (N=66) and 23.6% (N=112). The agreement between the positivity of specific antibodies and the detection of G. duodenalis in feces was moderate for ELISA-IgG, kappa index (95% CI)=0.543 (0.422–0.664), and mild for ELISA-IgA, kappa index (95% CI)=0.283 (0.162–0.404). Among the children infected with other enteroparasites, 11.6% (N=10) and 24.4% (N=21) showed reactivity to anti-Giardia IgG and to IgA, respectively. This cross-reactivity was more frequent in samples from children infected with Endolimax nana and Entamoeba coli.

Conclusions

The higher frequency of specific antibody reactivity compared with G. duodenalis diagnosis in feces could reflect continuous exposure of children to G. duodenalis infection, resulting in long-lasting immunological memory and/or cross-reactivity with other intestinal amoebas.

Antiprotozoal Activity against Entamoeba histolytica of Flavonoids Isolated from Lippia graveolens Kunth

Amebiasis caused by Entamoeba histolytica is nowadays a serious public health problem worldwide, especially in developing countries. Annually, up to 100,000 deaths occur across the world. Due to the resistance that pathogenic protozoa exhibit against commercial antiprotozoal drugs, a growing emphasis has been placed on plants used in traditional medicine to discover new antiparasitics. Previously, we reported the in vitro antiamoebic activity of a methanolic extract of Lippia graveolens Kunth (Mexican oregano). In this study, we outline the isolation and structure elucidation of antiamoebic compounds occurring in this plant. The subsequent work-up of this methanol extract by bioguided isolation using several chromatographic techniques yielded the flavonoids pinocembrin (1), sakuranetin (2), cirsimaritin (3), and naringenin (4). Structural elucidation of the isolated compounds was achieved by spectroscopic/spectrometric analyses and comparing literature data. These compounds revealed significant antiprotozoal activity against E. histolytica trophozoites using in vitro tests, showing a 50% inhibitory concentration (IC₅₀) ranging from 28 to 154 µg/mL. Amebicide activity of sakuranetin and cirsimaritin is reported for the first time in this study. These research data may help to corroborate the use of this plant in traditional Mexican medicine for the treatment of dyspepsia.

Giardia and Cryptosporidium antibody prevalence and correlates of exposure among Alaska residents, 2007-2008

Giardia duodenalis and Cryptosporidium spp. are common intestinal protozoa that can cause diarrhoeal disease. Although cases of infection with Giardia and Cryptosporidium have been reported in Alaska, the seroprevalence and correlates of exposure to these parasites have not been characterised. We conducted a seroprevalence survey among 887 residents of Alaska, including sport hunters, wildlife biologists, subsistence bird hunters and their families and non-exposed persons. We tested serum using a multiplex bead assay to evaluate antibodies to the Giardia duodenalis variant-specific surface protein conserved structural regions and to the Cryptosporidium parvum 17- and 27-kDa antigens. Approximately one third of participants in each group had evidence of exposure to Cryptosporidium. Prevalence of Giardia antibody was highest among subsistence hunters and their families (30%), among whom positivity was associated with lack of community access to in-home running water (adjusted prevalence ratio [aPR] 1.15, 95% confidence interval (CI) 1.02-1.28) or collecting rain, ice, or snow to use as drinking water (aPR 1.09, 95% CI 1.01-1.18). Improving in-home water access for entire communities could decrease the risk of exposure to Giardia.