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Štrkolcová G, Fiľakovská Bobáková D, Kaduková M, Schreiberová A, Klein D, Halán M, Urbančíková I. Intestinal parasitic infections in children from marginalised Roma communities: prevalence and risk factors. BMC Infect Dis 2024; 24:596. [PMID: 38890608 PMCID: PMC11184866 DOI: 10.1186/s12879-024-09500-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Intestinal parasitic infections remain a significant global health issue, particularly affecting poor and marginalised populations. These infections significantly contribute to children's diseases, malnutrition, poor school performance, cognitive disorders, and future economic losses. This study aimed to explore and compare the occurrence of intestinal parasites in early childhood among the group of infants from the Slovak majority population and from marginalised Roma communities (MRCs). Furthermore, it aimed to explore the health complaints of children with and without intestinal parasitic infection in the past month and assess the effect of various risk factors on the occurrence of intestinal parasitic infection in infants from MRCs. METHODS We obtained cross-sectional data from mothers and stool samples of their children aged 13-21 months using the first wave of the longitudinal RomaREACH study. A total of 181 stools from infants were analysed: 105 infants from the Slovak majority population and 76 from MRCs. RESULTS Infants from MRCs are significantly more often infected by Ascaris lumbricoides, Trichuris trichiura and Giardia duodenalis than their better-off peers from the majority population. Infection rates are 30% in infants from MRCs vs. 0% in the majority population (p < 0.001). Single and mixed infections were observed in children from MRCs. Infants with intestinal parasitic infections suffer significantly more often from various health complaints, particularly cough, stomach ache, irritability, and diarrhoea. Within MRCs, the risk of parasitic infections in infants is significantly increased by risk factors such as the absence of flushing toilets in households (OR = 4.17, p < 0.05) and contact with un-dewormed animals (OR = 3.61, p < 0.05). Together with the absence of running water in the household, these three factors combined increase the risk more than ten times (p < 0.01). CONCLUSION Maintaining hygienic standards in conditions of socioeconomic deprivation in MRCs without running water and sewage in the presence of un-dewormed animals is problematic. These living conditions contribute to the higher prevalence of parasitic infections in children from MRCs, causing various health complaints and thus threatening their health and healthy development.
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Affiliation(s)
- Gabriela Štrkolcová
- Department of Epizootiology and Parasitology and Protection of One Health, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovakia
| | - Daniela Fiľakovská Bobáková
- Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia.
- Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czechia, Czechia.
| | - Michaela Kaduková
- Department of Epizootiology and Parasitology and Protection of One Health, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovakia
| | - Andrea Schreiberová
- Department of Epizootiology and Parasitology and Protection of One Health, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovakia
| | - Daniel Klein
- Institute of Mathematics, Faculty of Natural Sciences, PJ Safarik University, Kosice, Slovakia
| | - Miloš Halán
- Department of Epizootiology and Parasitology and Protection of One Health, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovakia
| | - Ingrid Urbančíková
- Department of Epidemiology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
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Tadesse G, Wuletaw Y, Mekete K, Sime H, Yard E, Appleby L, Grimes J, Dejene N, Gardiner I, Kazienga A, Abbeddou S, French M, Levecke B, Drake L. Investigating the effect of a school-based WASH intervention on soil-transmitted helminth and schistosome infections and nutritional status of school children in Ethiopia: a quasi-experimental study. Parasit Vectors 2024; 17:130. [PMID: 38486228 PMCID: PMC10938701 DOI: 10.1186/s13071-024-06155-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 01/22/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The impact of access to improved water, sanitation and hygiene (WASH) and health education on large-scale deworming programs aimed at controlling soil-transmitted helminth (STH) and schistosome (SCH) infections has not been well studied. We assessed the additional impact of improved WASH infrastructure and health education at schools on STH and SCH infections in Ethiopia. METHODS The study used a quasi-experimental design under which 30 schools were assigned to either an intervention (15 schools) or control (15 schools) arm. Both arms received a standard deworming treatment and lunch. In the intervention arm, improved WASH and health education were provided. At three consecutive time points (baseline in 2013, 2014 and 2015), the prevalence and intensity of STH and SCH infections and the nutritional status [hemoglobin concentrations and physical growth (height and weight)] were determined. To verify whether interventions were successfully implemented, the WASH status at school and the student knowledge, attitudes and practices related to WASH (WASH-KAP) were recorded. Differences in metrics between arms at baseline (2013) and follow-up (2015) were assessed both within and between the arms. RESULTS A significant increase in scores for both the school WASH and student KAP was found in the intervention arm, indicating successful implementation of the intervention. The prevalence of any STH infection was significantly reduced in the intervention arm but not in the control arm (F = 4.486, p = 0.034). There was a significantly greater reduction in the intensity of infection of hookworm and Ascaris lumbricoides compared to baseline in both arms. The intervention did not affect school children's height-for-age z-score (intervention arm * time coef = 0.12, p = 0.400) and body mass index-for-age z-scores (intervention * time coef = - 0.06, p = 0.526). Hemoglobin concentrations increased significantly more in the control than the intervention arm (coef = - 0.16, p = 0.006). CONCLUSIONS Although the intervention did increase school WASH and student WASH-KAP, our study found poor evidence of the additional benefit of improved WASH and health education to deworming and school food programs on parasite re-infection and the health outcomes of children.
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Affiliation(s)
- Gemechu Tadesse
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Yonas Wuletaw
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Heven Sime
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Elodie Yard
- Partnership for Child Development, London, UK
| | | | - Jack Grimes
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London, UK
| | | | | | - Adama Kazienga
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | - Bruno Levecke
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Okoyo C, Minnery M, Orowe I, Owaga C, Campbell SJ, Wambugu C, Olick N, Hagemann J, Omondi WP, McCracken K, Montresor A, Medley GF, Fronterre C, Diggle P, Mwandawiro C. Model-based geostatistical design and analysis of prevalence for soil-transmitted helminths in Kenya: Results from ten-years of the Kenya national school-based deworming programme. Heliyon 2023; 9:e20695. [PMID: 37829802 PMCID: PMC10565763 DOI: 10.1016/j.heliyon.2023.e20695] [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: 06/02/2023] [Revised: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 10/14/2023] Open
Abstract
Background Kenya is endemic for soil-transmitted helminths (STH) with over 6 million children in 27 counties currently at-risk. A national school-based deworming programme (NSBDP) was launched in 2012 with a goal to eliminate parasitic worms as a public health problem. This study used model-based geostatistical (MBG) approach to design and analyse the impact of the NSBDP and inform treatment strategy changes. Methods A cross-sectional study was used to survey 200 schools across 27 counties in Kenya. The study design, school selection and analysis followed the MBG approach which incorporated historical data on treatment, morbidity and environmental covariates to efficiently predict the helminths prevalence in Kenya. Results Overall, the NSBDP geographic area prevalence for any STH was estimated to sit between 2 % and <10 % with a high predictive probability of >0.999. Species-specific thresholds were between 2 % and <10 % for Ascaris lumbricoides, 0 % to <2 % for hookworm, and 0 % to <2 % for Trichuris trichiura, all with high predictive probability of >0.999. Conclusions Based on the World Health Organization guidelines, STH treatment requirements can now be confidently refined. Ten counties may consider suspending treatment and implement appropriate surveillance system, while another 10 will require treatment once every two years, and the remaining seven will require treatment once every year.
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Affiliation(s)
- Collins Okoyo
- School of Mathematics, University of Nairobi, Nairobi, Kenya
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya
- Department of Epidemiology, Statistics and Informatics (DESI), Kenya Medical Research Institute, Nairobi, Kenya
| | - Mark Minnery
- Deworm the World, Evidence Action, Washington DC, United States
| | - Idah Orowe
- School of Mathematics, University of Nairobi, Nairobi, Kenya
| | | | | | - Christin Wambugu
- Division of Adolescent and School Health (DASH), Ministry of Health, Nairobi, Kenya
| | - Nereah Olick
- School Health, Nutrition and Meals Unit (SHNMU), Ministry of Education, Nairobi, Kenya
| | - Jane Hagemann
- Deworm the World, Evidence Action, Washington DC, United States
| | - Wyckliff P. Omondi
- Division of Vector Borne and Neglected Tropical Diseases (DVBNTD), Ministry of Health, Nairobi, Kenya
| | - Kate McCracken
- Deworm the World, Evidence Action, Washington DC, United States
| | - Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Graham F. Medley
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Claudio Fronterre
- Centre for Health Informatics, Computing and Statistics (CHICAS), Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Peter Diggle
- Centre for Health Informatics, Computing and Statistics (CHICAS), Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
| | - Charles Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya
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Neto AFR, Di Christine Oliveira YL, de Oliveira LM, La Corte R, Jain S, de Lyra Junior DP, Fujiwara RT, Dolabella SS. Why Are We Still a Worm World in the 2020s? An Overview of Risk Factors and Endemicity for Soil-Transmitted Helminthiasis. Acta Parasitol 2023; 68:481-495. [PMID: 37531011 DOI: 10.1007/s11686-023-00701-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 07/18/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Soil-transmitted helminthiasis (STH) is one of the most common chronic infections in developing countries associated with poor socioeconomic and sanitary conditions. The main objective of this overview was to evaluate the influence of environmental factors, risk factors related to the host, and control strategies on the prevalence of STH in different regions of the world. METHODS LILACS, PubMed, Web of Knowledge, Embase, the Cochrane Library, and Clinical Trials (gray literature) databases were used to obtain the systematic reviews published until December 2020. The methodological quality of systematic reviews was assessed using the standard criteria recommended by AMSTAR. RESULTS The initial results of the bibliographic search identified 1448 articles, of which 66 studies were read in full and 16 met the inclusion criteria. All the reviews included in this overview associated variations in the global prevalence of STH with at least one of the factors related to the environment, host, and/or control strategies. Climate, temperature, soil moisture, precipitation, mass drug administration, lack of access to water, sanitation and hygiene (WASH), and non-use of footwear were considered the main factors associated with the prevalence of STH. Socioeconomic factors, low educational level, and wearing shoes were universal factors related to prevalence, regardless of the location studied. CONCLUSION The combination of environmental factors, with factors associated with hosts that predispose infection and reinfection of helminths, as well as the adoption of control strategies based on the treatment of target populations instead of the entire population, influenced the prevalence of STH in all the continents evaluated.
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Affiliation(s)
- Adelson Ferreira Ramos Neto
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | | | - Luciana Maria de Oliveira
- Department of Morphology, Center of Biology and Health Sciences, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - Roseli La Corte
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - Sona Jain
- Postgraduate Program in Industrial Biotechnology, Tiradentes University, Aracaju, SE, 49010-390, Brazil
| | | | - Ricardo Toshio Fujiwara
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Silvio Santana Dolabella
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil.
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil.
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Brandão J, Valério E, Weiskerger C, Veríssimo C, Sarioglou K, Novak Babič M, Solo-Gabriele HM, Sabino R, Rebelo MT. Strategies for Monitoring Microbial Life in Beach Sand for Protection of Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095710. [PMID: 37174228 PMCID: PMC10178049 DOI: 10.3390/ijerph20095710] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/28/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023]
Abstract
The 2021 revised guidelines of the World Health Organization recommend monitoring the quality of sand in addition to water at recreational beaches. This review provides background information about the types of beaches, the characteristics of sand, and the microbiological parameters that should be measured. Analytical approaches are described for quantifying fungi and fecal indicator bacteria from beach sand. The review addresses strategies to assess beach sand quality, monitoring approaches, sand remediation, and the proposed way forward for beach sand monitoring programs. In the proposed way forward, recommendations are provided for acceptable levels of fungi given their distribution in the environment. Additional recommendations include evaluating FIB distributions at beaches globally to assess acceptable ranges of FIB levels, similar to those proposed for fungi.
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Affiliation(s)
- João Brandão
- Department of Environmental Health, National Institute of Health Dr. Ricardo, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
- Centre for Environmental and Marine Studies (CESAM), Department of Animal Biology, University of Lisboa, Campo Grande 016, 1749-016 Lisboa, Portugal
| | - Elisabete Valério
- Department of Environmental Health, National Institute of Health Dr. Ricardo, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
- Centre for Environmental and Marine Studies (CESAM), Department of Animal Biology, University of Lisboa, Campo Grande 016, 1749-016 Lisboa, Portugal
| | - Chelsea Weiskerger
- Department of Civil and Environmental Engineering, Michigan State University, 1449 Engineering Research Ct. Room A127, East Lansing, MI 48824, USA
| | - Cristina Veríssimo
- Department of Transmittable Diseases, National Institute of Health Dr. Ricardo, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Konstantina Sarioglou
- Department of Environmental Health, National Institute of Health Dr. Ricardo, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Monika Novak Babič
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, 1000 Ljubljana, Slovenia
| | - Helena M Solo-Gabriele
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, 1251 Memorial Drive, Coral Gables, FL 33146, USA
| | - Raquel Sabino
- Department of Transmittable Diseases, National Institute of Health Dr. Ricardo, Avenida Padre Cruz, 1649-016 Lisboa, Portugal
| | - Maria Teresa Rebelo
- Centre for Environmental and Marine Studies (CESAM), Department of Animal Biology, University of Lisboa, Campo Grande 016, 1749-016 Lisboa, Portugal
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Schluth CG, Standley CJ, Bansal S, Carlson CJ. Spatial parasitology and the unmapped human helminthiases. Parasitology 2023; 150:1-9. [PMID: 36632014 PMCID: PMC10090474 DOI: 10.1017/s0031182023000045] [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: 08/28/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/13/2023]
Abstract
Helminthiases are a class of neglected tropical diseases that affect at least 1 billion people worldwide, with a disproportionate impact on resource-poor areas with limited disease surveillance. Geospatial methods can offer valuable insights into the burden of these infections, particularly given that many are subject to strong ecological influences on the environmental, vector-borne or zoonotic stages of their life cycle. In this study, we screened 6829 abstracts and analysed 485 studies that use maps to document, infer or predict transmission patterns for over 200 species of parasitic worms. We found that quantitative mapping methods are increasingly used in medical parasitology, drawing on One Health surveillance data from the community scale to model geographic distributions and burdens up to the regional or global scale. However, we found that the vast majority of the human helminthiases may be entirely unmapped, with research effort focused disproportionately on a half-dozen infections that are targeted by mass drug administration programmes. Entire regions were also surprisingly under-represented in the literature, particularly southern Asia and the Neotropics. We conclude by proposing a shortlist of possible priorities for future research, including several neglected helminthiases with a burden that may be underestimated.
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Affiliation(s)
| | - Claire J. Standley
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, USA
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, USA
| | - Shweta Bansal
- Department of Biology, Georgetown University, Washington, DC, USA
| | - Colin J. Carlson
- Department of Biology, Georgetown University, Washington, DC, USA
- Department of Microbiology and Immunology, Georgetown University Medical Center, Washington, DC, USA
- Center for Global Health Science and Security, Georgetown University Medical Center, Washington, DC, USA
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Essential Oils as Novel Anthelmintic Drug Candidates. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27238327. [PMID: 36500419 PMCID: PMC9735941 DOI: 10.3390/molecules27238327] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 12/02/2022]
Abstract
Helminths, with an estimated 1.5 billion annual global infections, are one of the major health challenges worldwide. The current strategy of the World Health Organization to prevent helminth infection includes increasing hygienic awareness, providing better sanitation and preventative anthelmintic drug therapy in vulnerable populations. Nowadays, anthelmintic drugs are used heavily in livestock, both in case of infection and as a preventative measure. However, this has led to the development of resistance against several of the most common drugs, such as levamisole, ivermectin and thiabendazole. As many as 70% of the livestock in developed countries now has helminths that are drug resistant, and multiple resistance is common. Because of this, novel anthelmintics are urgently needed to help combat large-scale production losses. Prior to this review, no comprehensive review of the anthelmintic effects of essential oils and their components existed. Multiple review articles have been published on the uses of a single plant and its extracts that only briefly touch upon their anthelmintic activity. This review aims to provide a detailed overview of essential oils and their components as anthelmintic treatment against a wider variety of helminths.
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Wei J, Hegde VL, Yanamandra AV, O'Hara MP, Keegan B, Jones KM, Strych U, Bottazzi ME, Zhan B, Sastry KJ, Hotez PJ. Mucosal Vaccination With Recombinant Tm-WAP49 Protein Induces Protective Humoral and Cellular Immunity Against Experimental Trichuriasis in AKR Mice. Front Immunol 2022; 13:800295. [PMID: 35197976 PMCID: PMC8859434 DOI: 10.3389/fimmu.2022.800295] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022] Open
Abstract
Trichuriasis is one of the most common neglected tropical diseases of the world's poorest people. A recombinant vaccine composed of Tm-WAP49, an immunodominant antigen secreted by adult Trichuris stichocytes into the mucosa of the cecum to which the parasite attaches, is under development. The prototype is being evaluated in a mouse model of Trichuris muris infection, with the ultimate goal of producing a mucosal vaccine through intranasal delivery. Intranasal immunization of mice with Tm-WAP49 formulated with the adjuvant OCH, a truncated analog of alpha-GalCer with adjuvanticity to stimulate natural killer T cells (NKT) and mucosal immunity, induced significantly high levels of IgG and its subclasses (IgG1 and IgG2a) in immunized mice. This also resulted in a significant reduction of worm burden after challenge with T. muris-infective eggs. The addition of QS-21 adjuvant to this vaccine formulation further reduced worm counts. The improved protection from the dual-adjuvanted vaccine correlated with higher serum antibody responses (IgG, IgG1, IgG2a, IgA) as well as with the induction of antigen-specific IgA in the nasal mucosa. It was also associated with the robust cellular responses including functional subsets of CD4 T cells producing IL-4, and cytotoxic CD8 T cells expressing granzyme B. The worm reduction achieved by mucosal immunization was higher than that induced by subcutaneous immunization. Intranasal immunization also induced a significantly higher nasal mucosa-secreted antigen-specific IgA response, as well as higher functional cellular responses including CD4+IL4+ (Th1) and CD8+GnzB+ (Th2) T cells, and antigen-specific INFγ-producing T cells in both spleen and MLNs and antibody-producing B cells (CD19+B220+/B220+GL7+). Mucosal immunization further induced long-term T lymphocyte memory with increased central (CD62L+CD44+) and effector (CD62L-CD44+) memory subsets of both CD4 and CD8 T cells at 60 days after the last immunization. In summary, intranasal immunization with recombinant Tm-WAP49 protein induced strong protection versus murine trichuriasis. It represents a promising vaccination approach against intestinal nematodes.
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Affiliation(s)
- Junfei Wei
- Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Venkatesh L Hegde
- Department of Thoracic/Head and Neck Medical Oncology, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Ananta V Yanamandra
- Department of Thoracic/Head and Neck Medical Oncology, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Madison P O'Hara
- Department of Thoracic/Head and Neck Medical Oncology, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, United States.,University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, United States
| | - Brian Keegan
- Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Kathryn M Jones
- Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Ulrich Strych
- Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Maria Elena Bottazzi
- Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States.,Department of Biology, Baylor University, Waco, TX, United States
| | - Bin Zhan
- Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
| | - K Jagannadha Sastry
- Department of Thoracic/Head and Neck Medical Oncology, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Peter J Hotez
- Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States.,Department of Biology, Baylor University, Waco, TX, United States
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Alatas FS, Pratiwi AA, Kurniawan A, Pudjiadi AH. Emerging Multiple Parasite Reinfection as Neglected Tropical Disease: A Case Series. JOURNAL OF CHILD SCIENCE 2022. [DOI: 10.1055/s-0042-1743196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractSoil-transmitted helminth infection is endemic in Indonesia, with cases of reinfection despite individualized therapy and a mass treatment program. Three cases of multiple helminth infections were described that might be associated with chronic bloody diarrhea and stunted growth. These case series alert pediatricians that untreated helminthic infections are part of the differential diagnosis in children with gastrointestinal bleeding. Environmental surveillance should be performed in high-risk areas to prevent reinfection and growth alteration. In endemic areas, bloody diarrhea warns for an early routine fecal analysis. Correct diagnosis, prompt treatment, and source control are crucial to prevent long-term complications.
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Affiliation(s)
- Fatima Safira Alatas
- Department of Child Health, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Aldisa Ayu Pratiwi
- Department of Child Health, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Agnes Kurniawan
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Antonius Hocky Pudjiadi
- Department of Child Health, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Scientific Affair of Indonesian Pediatric Society Head Office, Jakarta, Indonesia
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Status of Intestinal Helminth Infection in Schools Implementing the Home-Grown School Feeding Program and the Impact of the Program on Pupils in Anambra State, Nigeria. Acta Parasitol 2021; 66:1528-1537. [PMID: 34128144 DOI: 10.1007/s11686-021-00429-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Intestinal helminthiasis among pupils is a major impediment to their well-being and development. This 2-year study determined how home-grown school feeding programme (HGSFP) impacted on pupils' school attendance and created opportunity for more children to assess interventions geared towards the prevention and possible elimination of intestinal helminthiasis. METHODS Faecal samples were collected from 1677 consented pupils and examined for helminths using Kato-Katz technique. Pupils were treated with 40 mg Levamisole (anti-helminthic) and re-examined. Structured questionnaires and focus group discussions were used to determine anthropometric indices and risk factors. RESULTS A 6% prevalence rate which was not significant with respect to sex or age was observed. Helminth parasites observed were Ascaris lumbricoides (4.4%), Trichuris trichiura (0.8%), Hookworm spp. (0.2%), and Taenia spp. (0.5%). Two pupils (1.98%) recorded high intensity of infection (epg) while 98.02% had light infection. Ascaris lumbricoides voided following treatment were 290. The Body Mass Index (BMI) indicated that infected pupils had lower values (14.6317) compared to uninfected pupils (19.2003). The HGSFP significantly improved school attendance by 30%. Lack of knowledge about transmission (P = 0.0004), hand hygiene (P = 0.01) and usage of toilet (P = 0.01) were risk factors observed. CONCLUSION/SIGNIFICANCE Intestinal helminthiasis remains a public health problem among pupils because environmental and behavioural risk factors persist. HGSFP improved school attendance and created opportunity for more inclusive participation of school-aged children for deworming. This has great potential in fast-tracking the elimination of intestinal helminthiasis. The present study consequently advocates the need to sustain HGSFP in schools.
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Gazzinelli-Guimarães AC, Gazzinelli-Guimarães P, Weatherhead JE. A historical and systematic overview of Ascaris vaccine development. Parasitology 2021; 148:1795-1805. [PMID: 35586777 PMCID: PMC9109942 DOI: 10.1017/s0031182021001347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 11/06/2022]
Abstract
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 Ascaris 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 Ascaris 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 Ascaris vaccine that is critically needed to prevent significant morbidity in Ascaris-endemic regions around the world.
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Affiliation(s)
| | | | - Jill E. Weatherhead
- Department of Medicine, Infectious Diseases, Baylor College of Medicine, Houston, TX, USA
- Department of Pediatrics, Pediatric Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
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Piecyk A, Hahn MA, Roth O, Dheilly NM, Heins DC, Bell MA, Kalbe M. Cross-continental experimental infections reveal distinct defence mechanisms in populations of the three-spined stickleback Gasterosteus aculeatus. Proc Biol Sci 2021; 288:20211758. [PMID: 34547906 PMCID: PMC8456148 DOI: 10.1098/rspb.2021.1758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/02/2021] [Indexed: 11/12/2022] Open
Abstract
Epidemiological traits of host-parasite associations depend on the effects of the host, the parasite and their interaction. Parasites evolve mechanisms to infect and exploit their hosts, whereas hosts evolve mechanisms to prevent infection and limit detrimental effects. The reasons why and how these traits differ across populations still remain unclear. Using experimental cross-infection of three-spined stickleback Gasterosteus aculeatus and their species-specific cestode parasites Schistocephalus solidus from Alaskan and European populations, we disentangled host, parasite and interaction effects on epidemiological traits at different geographical scales. We hypothesized that host and parasite main effects would dominate both within and across continents, although interaction effects would show geographical variation of natural selection within and across continents. We found that mechanisms preventing infection (qualitative resistance) occurred only in a combination of hosts and parasites from different continents, while mechanisms limiting parasite burden (quantitative resistance) and reducing detrimental effects of infection (tolerance) were host-population specific. We conclude that evolution favours distinct defence mechanisms on different geographical scales and that it is important to distinguish concepts of qualitative resistance, quantitative resistance and tolerance in studies of macroparasite infections.
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Affiliation(s)
- Agnes Piecyk
- Evolutionary Ecology, Max Planck Institute for Evolutionary Biology, Plön, Germany
- Evolutionary Ecology of Marine Fishes, GEOMAR Helmholtz Centre for Ocean Research Kiel, Kiel, Germany
| | - Megan A. Hahn
- School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, NY, USA
| | - Olivia Roth
- Evolutionary Ecology of Marine Fishes, GEOMAR Helmholtz Centre for Ocean Research Kiel, Kiel, Germany
- Marine Evolutionary Biology, Kiel University, Kiel, Germany
| | - Nolwenn M. Dheilly
- School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, NY, USA
| | - David C. Heins
- Department of Ecology and Evolutionary Biology, Tulane University, New Orleans, LA, USA
| | - Michael A. Bell
- University of California Museum of Paleontology, University of California, Berkeley, CA, USA
| | - Martin Kalbe
- Evolutionary Ecology, Max Planck Institute for Evolutionary Biology, Plön, Germany
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Rahman MM, Rahaman MS, Islam MR, Hossain ME, Mannan Mithi F, Ahmed M, Saldías M, Akkol EK, Sobarzo-Sánchez E. Multifunctional Therapeutic Potential of Phytocomplexes and Natural Extracts for Antimicrobial Properties. Antibiotics (Basel) 2021; 10:1076. [PMID: 34572660 PMCID: PMC8468069 DOI: 10.3390/antibiotics10091076] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/30/2021] [Accepted: 09/03/2021] [Indexed: 12/21/2022] Open
Abstract
Natural products have been known for their antimicrobial factors since time immemorial. Infectious diseases are a worldwide burden that have been deteriorating because of the improvement of species impervious to various anti-infection agents. Hence, the distinguishing proof of antimicrobial specialists with high-power dynamic against MDR microorganisms is central to conquer this issue. Successful treatment of infection involves the improvement of new drugs or some common source of novel medications. Numerous naturally occurring antimicrobial agents can be of plant origin, animal origin, microbial origin, etc. Many plant and animal products have antimicrobial activities due to various active principles, secondary metabolites, or phytochemicals like alkaloids, tannins, terpenoids, essential oils, flavonoids, lectins, phagocytic cells, and many other organic constituents. Phytocomplexes' antimicrobial movement frequently results from a few particles acting in cooperative energy, and the clinical impacts might be because of the direct effects against microorganisms. The restorative plants that may furnish novel medication lead the antimicrobial movement. The purpose of this study is to investigate the antimicrobial properties of the phytocomplexes and natural extracts of the plants that are ordinarily being utilized as conventional medications and then recommended the chance of utilizing them in drugs for the treatment of multiple drug-resistant disease.
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Affiliation(s)
- Md. Mominur Rahman
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.S.R.); (M.R.I.); (M.E.H.); (F.M.M.); (M.A.)
| | - Md. Saidur Rahaman
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.S.R.); (M.R.I.); (M.E.H.); (F.M.M.); (M.A.)
| | - Md. Rezaul Islam
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.S.R.); (M.R.I.); (M.E.H.); (F.M.M.); (M.A.)
| | - Md. Emon Hossain
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.S.R.); (M.R.I.); (M.E.H.); (F.M.M.); (M.A.)
| | - Faria Mannan Mithi
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.S.R.); (M.R.I.); (M.E.H.); (F.M.M.); (M.A.)
| | - Muniruddin Ahmed
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh; (M.M.R.); (M.S.R.); (M.R.I.); (M.E.H.); (F.M.M.); (M.A.)
| | - Marianela Saldías
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile;
| | - Esra Küpeli Akkol
- Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, 06330 Ankara, Turkey;
| | - Eduardo Sobarzo-Sánchez
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile;
- Department of Organic Chemistry, Faculty of Pharmacy, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
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15
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Perera DJ, Ndao M. Promising Technologies in the Field of Helminth Vaccines. Front Immunol 2021; 12:711650. [PMID: 34489961 PMCID: PMC8418310 DOI: 10.3389/fimmu.2021.711650] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/26/2021] [Indexed: 12/18/2022] Open
Abstract
Helminths contribute a larger global burden of disease than both malaria and tuberculosis. These eukaryotes have caused human infections since before our earliest recorded history (i.e.: earlier than 1200 B.C. for Schistosoma spp.). Despite the prevalence and importance of these infections, helminths are considered a neglected tropical disease for which there are no vaccines approved for human use. Similar to other parasites, helminths are complex organisms which employ a plethora of features such as: complex life cycles, chronic infections, and antigenic mimicry to name a few, making them difficult to target by conventional vaccine strategies. With novel vaccine strategies such as viral vectors and genetic elements, numerous constructs are being defined for a wide range of helminth parasites; however, it has yet to be discussed which of these approaches may be the most effective. With human trials being conducted, and a pipeline of potential anti-helminthic antigens, greater understanding of helminth vaccine-induced immunity is necessary for the development of potent vaccine platforms and their optimal design. This review outlines the conventional and the most promising approaches in clinical and preclinical helminth vaccinology.
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Affiliation(s)
- Dilhan J. Perera
- Division of Experimental Medicine, McGill University, Montreal, QC, Canada
- Program of Infectious Diseases and Immunity in Global Health, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Momar Ndao
- Division of Experimental Medicine, McGill University, Montreal, QC, Canada
- Program of Infectious Diseases and Immunity in Global Health, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, QC, Canada
- National Reference Centre for Parasitology, Research Institute of McGill University Health Centre, Montreal, QC, Canada
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Wiley MB, Bobardt SD, Nordgren TM, Nair MG, DiPatrizio NV. Cannabinoid Receptor Subtype-1 Regulates Allergic Airway Eosinophilia During Lung Helminth Infection. Cannabis Cannabinoid Res 2021; 6:242-252. [PMID: 33998896 PMCID: PMC8217601 DOI: 10.1089/can.2020.0167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Introduction: Over 1 billion humans carry infectious helminth parasites that can lead to chronic comorbidities such as anemia and growth retardation in children. Helminths induce a T-helper type 2 (Th2) immune response in the host and can cause severe tissue damage and fibrosis if chronic. We recently reported that mice infected with the soil-transmitted helminth, Nippostrongylus brasiliensis, displayed elevated levels of endocannabinoids (eCBs) in the lung and intestine. eCBs are lipid-signaling molecules that control inflammation; however, their function in infection is not well defined. Materials and Methods: A combination of pharmacological approaches and genetic mouse models was used to investigate roles for the eCB system in inflammatory responses and lung injury in mice during parasitic infection with N. brasiliensis. Results: Hemorrhaging of lung tissue in mice infected with N. brasiliensis was exacerbated by inhibiting peripheral cannabinoid receptor subtype-1 (CB1Rs) with the peripherally restricted CB1R antagonist, AM6545. In addition, these mice exhibited an increase in nonfunctional alveolar space and prolonged airway eosinophilia compared to vehicle-treated infected mice. In contrast to mice treated with AM6545, infected cannabinoid receptor subtype-2-null mice (Cnr2-/-) did not display any changes in these parameters compared to wild-type mice. Conclusions: Roles for the eCB system in Th2 immune responses are not well understood; however, increases in its activity in response to infection suggest an immunomodulatory role. Moreover, these findings suggest a role for eCB signaling at CB1Rs but not cannabinoid receptor subtypes-2 in the resolution of Th2 inflammatory responses, which become host destructive over time.
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Affiliation(s)
- Mark B. Wiley
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, USA
| | - Sarah D. Bobardt
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, USA
| | - Tara M. Nordgren
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, USA
| | - Meera G. Nair
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, USA
| | - Nicholas V. DiPatrizio
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, California, USA
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Douglas B, Oyesola O, Cooper MM, Posey A, Tait Wojno E, Giacomin PR, Herbert DR. Immune System Investigation Using Parasitic Helminths. Annu Rev Immunol 2021; 39:639-665. [PMID: 33646858 DOI: 10.1146/annurev-immunol-093019-122827] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Coevolutionary adaptation between humans and helminths has developed a finely tuned balance between host immunity and chronic parasitism due to immunoregulation. Given that these reciprocal forces drive selection, experimental models of helminth infection are ideally suited for discovering how host protective immune responses adapt to the unique tissue niches inhabited by these large metazoan parasites. This review highlights the key discoveries in the immunology of helminth infection made over the last decade, from innate lymphoid cells to the emerging importance of neuroimmune connections. A particular emphasis is placed on the emerging areas within helminth immunology where the most growth is possible, including the advent of genetic manipulation of parasites to study immunology and the use of engineered T cells for therapeutic options. Lastly,we cover the status of human challenge trials with helminths as treatment for autoimmune disease, which taken together, stand to keep the study of parasitic worms at the forefront of immunology for years to come.
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Affiliation(s)
- Bonnie Douglas
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA; ,
| | - Oyebola Oyesola
- Department of Immunology, University of Washington, Seattle, Washington 98109, USA; ,
| | - Martha M Cooper
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland 4878, Australia; ,
| | - Avery Posey
- Parker Institute for Cancer Immunotherapy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA; .,Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.,Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania 19104, USA
| | - Elia Tait Wojno
- Department of Immunology, University of Washington, Seattle, Washington 98109, USA; ,
| | - Paul R Giacomin
- Centre for Molecular Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland 4878, Australia; ,
| | - De'Broski R Herbert
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA; ,
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Lynn MK, Morrissey JA, Conserve DF. Soil-Transmitted Helminths in the USA: a Review of Five Common Parasites and Future Directions for Avenues of Enhanced Epidemiologic Inquiry. CURRENT TROPICAL MEDICINE REPORTS 2021; 8:32-42. [PMID: 33552843 PMCID: PMC7847297 DOI: 10.1007/s40475-020-00221-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE OF REVIEW The aim of this review is to present a comprehensive look at five intestinal soil-transmitted helminths (STHs) of global health importance that may continue to plague low-income and rural areas of the USA and argue the need for enhanced surveillance of these infections, which primarily affect the nation's most vulnerable groups. RECENT FINDINGS Human STH infections in middle- and high-income countries are at particular risk for being undiagnosed; as common symptoms are non-specific, differentials require a high index of clinical suspicion, and cases are concentrated in areas of poverty where access to care is limited. Although autochthonous STHs are thought to be rare in the USA, infections were once common in the American South and Appalachia and robust epidemiologic surveillance is limited post 1980s. However, recent community studies and case reports from small-scale farms and areas of high rural or inner-city poverty reveal the potential for persisting helminth infections in distinct populations of the country. SUMMARY STHs are among the most common neglected tropical diseases globally causing significant morbidity in underserved communities and contributing to the continuation of cycles of poverty within vulnerable populations. Due to possible severe disease sequalae and their ability to perpetuate poverty and poverty-associated health outcomes within already vulnerable groups, it is vital that surveillance for these infections is enhanced to bolster health equity in the USA.
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Affiliation(s)
- Mary K. Lynn
- Laboratory of Vector-Borne and Zoonotic Diseases, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Josephine A. Morrissey
- Laboratory of Vector-Borne and Zoonotic Diseases, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Donaldson F. Conserve
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
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Sangalang SO, Medina SAJ, Ottong ZJ, Lemence ALG, Totanes D, Valencia JC, Singson PAA, Olaguera M, Prado NO, Ocaña RMZ, Canja RJF, Benolirao AJT, Mariano SMF, Gavieres JG, Aquino CP, Latag EC, Anglo MVJC, Borgemeister C, Kistemann T. Protocol for a Trial Assessing the Impacts of School-Based WaSH Interventions on Children's Health Literacy, Handwashing, and Nutrition Status in Low- and Middle-Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010226. [PMID: 33561075 PMCID: PMC7795080 DOI: 10.3390/ijerph18010226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/14/2020] [Accepted: 12/23/2020] [Indexed: 12/26/2022]
Abstract
Diarrhea, soil-transmitted helminth infection and malnutrition are leading causes of child mortality in low- and middle-income countries (LMICs). To reduce the prevalence of these diseases, effective interventions for adequate water, sanitation, and hygiene (WaSH) should be implemented. This paper describes the design of a cluster-randomized controlled trial that will compare the efficacy of four school-based WaSH interventions for improving children’s health literacy, handwashing, and nutrition. Interventions consisted of (1) WaSH policy reinforcement; (2) low-, medium-, or high-volume health education; (3) hygiene supplies; and (4) WaSH facilities (e.g., toilets, urinals, handwashing basins) improvements. We randomly allocated school clusters from the intervention arm to one of four groups to compare with schools from the control arm. Primary outcomes were: children’s health literacy, physical growth, nutrition status, and handwashing prevalence. Secondary outcomes were: children’s self-reported health status and history of extreme hunger, satisfaction with WaSH facilities, and school restrooms’ WaSH adequacy. We will measure differences in pre- and post-intervention outcomes and compare these differences between control and intervention arms. This research protocol can be a blueprint for future school-based WaSH intervention studies to be conducted in LMICs. Study protocols were approved by the ethics committees of the University of Bonn, Germany, and the University of the Philippines Manila. This trial was retroactively registered, ID number: DRKS00021623.
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Affiliation(s)
- Stephanie O. Sangalang
- Center for Development Research, University of Bonn, 53113 Bonn, Germany; (C.B.);
(T.K.)
- Correspondence: ; Tel.: +49-228-73-4924
| | - Shelley Anne J. Medina
- College of Social Work and Community Development, University of the Philippines Diliman, Quezon City 1101, Philippines;
| | - Zheina J. Ottong
- Marine Science Institute, University of the Philippines Diliman, Quezon City 1101, Philippines; (Z.J.O.); (S.M.F.M.)
- School of Earth Sciences and Environmental Engineering, Gwangju Institute of Science and Technology, Gwangju 61005, Korea
| | - Allen Lemuel G. Lemence
- National Graduate School of Engineering, College of Engineering, University of the Philippines Diliman, Quezon City 1101, Philippines;
| | - Donrey Totanes
- College of Mass Communication, University of the Philippines Diliman, Quezon City 1101, Philippines; (D.T.); (M.O.)
| | - John Cedrick Valencia
- National College of Public Administration and Governance, University of the Philippines Diliman, Quezon City 1101, Philippines; (J.C.V.); (R.J.F.C.)
| | | | - Mikaela Olaguera
- College of Mass Communication, University of the Philippines Diliman, Quezon City 1101, Philippines; (D.T.); (M.O.)
| | | | - Roezel Mari Z. Ocaña
- School of Medicine, Far Eastern University, Nicanor Reyes Medical Foundation, Quezon City 1118, Philippines;
| | - Rovin James F. Canja
- National College of Public Administration and Governance, University of the Philippines Diliman, Quezon City 1101, Philippines; (J.C.V.); (R.J.F.C.)
| | | | - Shyrill Mae F. Mariano
- Marine Science Institute, University of the Philippines Diliman, Quezon City 1101, Philippines; (Z.J.O.); (S.M.F.M.)
| | - Jergil Gyle Gavieres
- Department of Sociology, College of Social Sciences and Philosophy, University of the Philippines Dili-man, Quezon City 1101, Philippines; (J.G.G.); (C.P.A.)
| | - Clarisse P. Aquino
- Department of Sociology, College of Social Sciences and Philosophy, University of the Philippines Dili-man, Quezon City 1101, Philippines; (J.G.G.); (C.P.A.)
| | - Edison C. Latag
- College of Engineering, Technological University of the Philippines, Manila 1008, Philippines;
| | - Maria Vianca Jasmin C. Anglo
- Department of Psychology, College of Social Sciences and Philosophy, University of the Philippines Diliman, Quezon City 1101, Philippines;
| | - Christian Borgemeister
- Center for Development Research, University of Bonn, 53113 Bonn, Germany; (C.B.);
(T.K.)
| | - Thomas Kistemann
- Center for Development Research, University of Bonn, 53113 Bonn, Germany; (C.B.);
(T.K.)
- Institute of Hygiene and Public Health, University of Bonn, 53127 Bonn, Germany
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Eze P, Agu UJ, Aniebo CL, Agu SA, Lawani LO. Perception and attitudinal factors contributing to periodic deworming of preschool children in an urban slum, Nigeria. BMC Public Health 2020; 20:1839. [PMID: 33261596 PMCID: PMC7708184 DOI: 10.1186/s12889-020-09958-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/22/2020] [Indexed: 12/21/2022] Open
Abstract
Background Over 20 million preschool-age children (PSAC) in Nigeria require periodic chemotherapy (PC) for soil-transmitted helminth (STH) infections. Persistently low coverage for this age group threatens the World Health Organization (WHO) 2030 target for eliminating STH infections. Current strategies for targeting PSAC have been largely ineffective. Hence, PSAC are mostly dewormed by their parents/caregivers. However, little is known of the perception and attitude of parents/caregivers of PSAC to deworming in this setting. Methods A mixed methods design, combining a community-based interviewer-administered questionnaire-survey (n = 433) and focus group discussions (FGD) (n = 43) was used to assess the perceptions and attitudes of mothers to periodic deworming of preschool children aged 2–5 years in Abakpa-Nike, Enugu, Nigeria. Results Coverage of periodic deworming in PSAC is 42% (95% CI: 37.3–46.8%). There is significant difference in the specific knowledge of transmission of STH (AOR = 0.62, 95% CI: 0.48–0.81, p = 0.000), complication of STH infections (AOR = 0.77, 95% CI: 0.61–0.98, p = 0.034), accurate knowledge of deworming frequency (AOR = 0.41, 95% CI: 0.18–0.90, p = 0.026), and knowledge of PC drug, mebendazole (AOR = 0.28, 95% CI: 0.09–0.90, p = 0.031), and pyrantel (AOR = 8.03, 95% CI: 2.22–29.03, p = 0.001) between mothers who periodically deworm their PSAC and those who do not. There is no significant difference in specific knowledge of the symptoms of STH infections (AOR = 0.76, 95% CI: 0.57–1.02, p = 0.069) and PC drug, Albendazole (AOR = 1.00, 95% CI: 0.46–2.11, p = 0.972). FGD revealed misconceptions that are rooted in stark ignorance of the disease. Overall attitude to deworming is positive and favourable. Conclusions Poor coverage of periodic deworming for STH infections in PSAC in this setting are primarily driven by poor specific knowledge of the risks and burden of the infection. Focused health education on the burden and transmission of STH infections could complement existing strategies to improve periodic deworming of PSAC in this setting. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09958-x.
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Affiliation(s)
- Paul Eze
- Department of Health Policy and Administration, Penn State University, University Park, PA, 16802, USA.
| | - Ujunwa Justina Agu
- Department of Paediatrics, Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria
| | - Chioma Lynda Aniebo
- Department of Paediatrics, Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria
| | - Sergius Alex Agu
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Lucky Osaheni Lawani
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, M5T 3M6, Canada
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Almeida MM, Monteiro KJL, Bacelar PAA, Santos JPD, Freitas SPCD, Evangelista BBC, Leal DN, Silva DDAE, Cardoso AB, Nascimento EFD, Moraes Neto AHAD, Carvalho-Costa FA. Interactions between malnutrition, soil-transmitted helminthiasis and poverty among children living in periurban communities in Maranhao State, Northeastern Brazil. Rev Inst Med Trop Sao Paulo 2020; 62:e73. [PMID: 33027397 PMCID: PMC7534403 DOI: 10.1590/s1678-9946202062073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/01/2020] [Indexed: 11/22/2022] Open
Abstract
Poverty, malnutrition and neglected tropical diseases such as soil-transmitted helminthiases (STHs) interact in a multi-causal feedback network. This study aimed to assess the relationships between STHs, income and nutritional status of children in impoverished communities in the city of Caxias, Maranhao State, Northeastern Brazil. A cross-sectional survey (n=259 children) was carried out with the collection of fecal samples and assessment of sociodemographic, anthropometric, dietary and sanitation data. Hookworm infection and ascariasis presented prevalence rates of 14.3% and 9.3%, respectively. The logistic regression analysis showed that hookworm infection was more frequent in males (odds ratio [OR]=3.43; 95% confidence interval [CI]=1.45-8.08), children aged 11-15 years old (OR=3.72; 95% CI=1.19-11.62), children living in poor families (OR=2.44; 95% CI=1.04-5.68) and those living in rented houses (OR=5.74; 95%CI=1.91-17.25). Concerning ascariasis, living in the Caldeiroes community (OR=0.01; 95%CI=0-0.17) and belonging to the 11-15 years age group (OR=0.21; 95%CI=0.04-1.02) were protection factors. Poor children have a significantly lower frequency of consumption of meat, milk, vegetables, tubers and fruits than not poor children. The frequent consumption of meat, milk and tubers was associated with significant higher values in the parameter height-for-age, whereas the consumption of meat and milk positively influenced the weight-for-age. The frequencies of stunting, underweight and wasting were 8.1%, 4.9% and 2.9%, respectively. The multivariate model demonstrated that stunting was significantly associated with economic poverty (OR=2.82; 95%CI=1.03-7.70) and low weight was associated with male sex (OR=6.43; 95% CI=1.35-30.68). In conclusion, the study describes the interactions between the dimensions of development represented by income, STHs and nutritional status revealing the importance of raising income levels to improve the living conditions of families in impoverished communities in Northeastern Brazil.
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Affiliation(s)
- Mayron Morais Almeida
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, Rio de Janeiro, Brazil.,Escritório Técnico Regional Fiocruz Piauí, Teresina, Piauí, Brazil
| | | | - Polyanna Araújo Alves Bacelar
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, Rio de Janeiro, Brazil.,Escritório Técnico Regional Fiocruz Piauí, Teresina, Piauí, Brazil
| | - Jéssica Pereira Dos Santos
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, Rio de Janeiro, Brazil.,Escritório Técnico Regional Fiocruz Piauí, Teresina, Piauí, Brazil
| | | | | | | | | | | | - Elaine Ferreira do Nascimento
- Escritório Técnico Regional Fiocruz Piauí, Teresina, Piauí, Brazil.,Universidade Federal do Piauí, Coordenação do Programa de Pós‑Graduação em Políticas Públicas, Teresina, Piauí, Brazil
| | | | - Filipe Anibal Carvalho-Costa
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, Rio de Janeiro, Brazil.,Escritório Técnico Regional Fiocruz Piauí, Teresina, Piauí, Brazil
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22
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Cellular and molecular changes and immune response in the intestinal mucosa during Trichinella spiralis early infection in rats. Parasit Vectors 2020; 13:505. [PMID: 33023672 PMCID: PMC7539519 DOI: 10.1186/s13071-020-04377-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/23/2020] [Indexed: 01/01/2023] Open
Abstract
Background: The main targets of the host’s immune system in Trichinella spiralis infection are the adult worms (AW), at the gut level, and the migrant or newborn larvae (NBL), at systemic and pulmonary levels. Most of the studies carried out in the gut mucosa have been performed on the Payer’s patches and/or the mesenteric lymph nodes but not on the lamina propria, therefore, knowledge on the gut immune response against T. spiralis remains incomplete. Methods This study aimed at characterizing the early mucosal immune response against T. spiralis, particularly, the events taking place between 1 and 13 dpi. For this purpose, Wistar rats were orally infected with muscle larvae of T. spiralis and the humoral and cellular parameters of the gut immunity were analysed, including the evaluation of the ADCC mechanism exerted by lamina propria cells. Results A marked inflammation and structural alteration of the mucosa was found. The changes involved an increase in goblet cells, eosinophils and mast cells, and B and T lymphocytes, initially displaying a Th1 profile, characterised by the secretion of IFN-γ and IL-12, followed by a polarization towards a Th2 profile, with a marked increase in IgE, IgG1, IL-4, IL-5 and IL-13 levels, which occurred once the infection was established. In addition, the helminthotoxic activity of lamina propria cells demonstrated the role of the intestine as a place of migrant larvae destruction, indicating that not all the NBLs released in the gut will be able to reach the muscles. Conclusions The characterization of the immune response triggered in the gut mucosa during T. spiralis infection showed that not only an effector mechanism is directed toward the AW but also towards the NBL as a cytotoxic activity was observed against NBL exerted by lamina propria cells. ![]()
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23
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Miller MM, Reinhardt RL. The Heterogeneity, Origins, and Impact of Migratory iILC2 Cells in Anti-helminth Immunity. Front Immunol 2020; 11:1594. [PMID: 32793230 PMCID: PMC7390839 DOI: 10.3389/fimmu.2020.01594] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/16/2020] [Indexed: 12/12/2022] Open
Abstract
Soil-transmitted helminths represent a major global health burden with infections and infection-related comorbidities causing significant reductions in the quality of life for individuals living in endemic areas. Repeated infections and chronic colonization by these large extracellular worms in mammals led to the evolution of type-2 immunity characterized by the production of the type-2 cytokines interleukin (IL)-4, IL-5, and IL-13. Although a number of adaptive and innate immune cells produce type-2 cytokines, a key cellular source in the context of helminth infection is group 2 innate lymphoid cells (ILC2s). ILC2s promote mucosal barrier homeostasis, integrity, and repair by rapidly responding to epithelial cues in mucosal tissues. Though tissue-resident ILC2s (nILC2s) have been studied in detail over the last decade, considerably less is known with regard to a subset of inflammatory ILC2s (iILC2s) that migrate to the lungs of mice early after Nippostrongylus brasiliensis infection and are potent early producers of type-2 cytokines. This review will discuss the relationship and differences between nILC2s and iILC2s that establish their unique roles in anti-helminth immunity. We have placed particular emphasis on studies investigating iILC2 origin, function, and their potential long-term contribution to tissue-resident ILC2 reservoirs in settings of helminth infection.
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Affiliation(s)
- Mindy M Miller
- Department of Biomedical Research, National Jewish Health, Denver, CO, United States
| | - R Lee Reinhardt
- Department of Biomedical Research, National Jewish Health, Denver, CO, United States.,Department of Immunology and Microbiology, University of Colorado-Anschutz Medical, Aurora, CO, United States
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24
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Janda A, Eder K, Fressle R, Geweniger A, Diffloth N, Heeg M, Binder N, Sitaru AG, Rohr J, Henneke P, Hufnagel M, Elling R. Comprehensive infectious disease screening in a cohort of unaccompanied refugee minors in Germany from 2016 to 2017: A cross-sectional study. PLoS Med 2020; 17:e1003076. [PMID: 32231358 PMCID: PMC7108686 DOI: 10.1371/journal.pmed.1003076] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 02/25/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Information regarding the prevalence of infectious diseases (IDs) in child and adolescent refugees in Europe is scarce. Here, we evaluate a standardized ID screening protocol in a cohort of unaccompanied refugee minors (URMs) in a municipal region of southwest Germany. METHODS AND FINDINGS From January 2016 to December 2017, we employed a structured questionnaire to screen a cohort of 890 URMs. Collecting sociodemographic information and medical history, we also performed a standardized diagnostics panel, including complete blood count, urine status, microbial stool testing, tuberculosis (TB) screening, and serologies for hepatitis B virus (HBV) and human immunodeficiency virus (HIV). The mean age was 16.2 years; 94.0% were male, and 93.6% originated from an African country. The most common health complaints were dental problems (66.0%). The single most frequent ID was scabies (14.2%). Of the 776 URMs originating from high-prevalence countries, 7.7% and 0.4% tested positive for HBV and HIV, respectively. Nineteen pathogens were detected in a total of 119 stool samples (16.0% positivity), with intestinal schistosomiasis being the most frequent pathogen (6.7%). Blood eosinophilia proved to be a nonspecific criterion for the detection of parasitic infections. Active pulmonary TB was identified in 1.7% of URMs screened. Of note, clinical warning symptoms (fever, cough >2 weeks, and weight loss) were insensitive parameters for the identification of patients with active TB. Study limitations include the possibility of an incomplete eosinophilia workup (as no parasite serologies or malaria diagnostics were performed), as well as the inherent selection bias in our cohort because refugee populations differ across Europe. CONCLUSIONS Our study found that standardized ID screening in a URM cohort was practicable and helped collection of relevant patient data in a thorough and time-effective manner. However, screening practices need to be ameliorated, especially in relation to testing for parasitic infections. Most importantly, we found that only a minority of infections were able to be detected clinically. This underscores the importance of active surveillance of IDs among refugees.
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Affiliation(s)
- Ales Janda
- Department of Pediatrics and Adolescent Medicine, Medical Center—University of Freiburg, Freiburg, Germany
| | - Kristin Eder
- Department of Pediatrics and Adolescent Medicine, Medical Center—University of Freiburg, Freiburg, Germany
| | - Roland Fressle
- Practice for Childhood and Adolescent Medicine, Freiburg, Germany
| | - Anne Geweniger
- Department of Pediatrics and Adolescent Medicine, Medical Center—University of Freiburg, Freiburg, Germany
| | - Natalie Diffloth
- Department of Pediatrics and Adolescent Medicine, Medical Center—University of Freiburg, Freiburg, Germany
| | - Maximilian Heeg
- Department of Pediatrics and Adolescent Medicine, Medical Center—University of Freiburg, Freiburg, Germany
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nadine Binder
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
- Institute of Digitalization in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Germany
| | | | - Jan Rohr
- Department of Pediatrics and Adolescent Medicine, Medical Center—University of Freiburg, Freiburg, Germany
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp Henneke
- Department of Pediatrics and Adolescent Medicine, Medical Center—University of Freiburg, Freiburg, Germany
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Markus Hufnagel
- Department of Pediatrics and Adolescent Medicine, Medical Center—University of Freiburg, Freiburg, Germany
| | - Roland Elling
- Department of Pediatrics and Adolescent Medicine, Medical Center—University of Freiburg, Freiburg, Germany
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Berta Ottenstein Programme, University Medical Center, Medical Faculty, University of Freiburg, Freiburg, Germany
- * E-mail:
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25
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Mahmoud ME, Aldaraan KZ, Hassab MH, Aljabr SF. Schistosoma ova found in gastrostomy site granulation tissue. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2019.101377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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26
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Hasegawa M, Pilotte N, Kikuchi M, Means AR, Papaiakovou M, Gonzalez AM, Maasch JRMA, Ikuno H, Sunahara T, Ásbjörnsdóttir KH, Walson JL, Williams SA, Hamano S. What does soil-transmitted helminth elimination look like? Results from a targeted molecular detection survey in Japan. Parasit Vectors 2020; 13:6. [PMID: 31915050 PMCID: PMC6950881 DOI: 10.1186/s13071-019-3875-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 12/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Japan is one of the few countries believed to have eliminated soil-transmitted helminths (STHs). In 1949, the national prevalence of Ascaris lumbricoides was 62.9%, which decreased to 0.6% in 1973 due to improvements in infrastructure, socioeconomic status, and the implementation of national STH control measures. The Parasitosis Prevention Law ended in 1994 and population-level screening ceased in Japan; therefore, current transmission status of STH in Japan is not well characterized. Sporadic cases of STH infections continue to be reported, raising the possibility of a larger-scale recrudescence of STH infections. Given that traditional microscopic detection methods are not sensitive to low-intensity STH infections, we conducted targeted prevalence surveys using sensitive PCR-based assays to evaluate the current STH-transmission status and to describe epidemiological characteristics of areas of Japan believed to have achieved historical elimination of STHs. METHODS Stool samples were collected from 682 preschool- and school-aged children from six localities of Japan with previously high prevalence of STH. Caregivers of participants completed a questionnaire to ascertain access to water, sanitation and hygiene (WASH), and potential exposures to environmental contamination. For fecal testing, multi-parallel real-time PCR assays were used to detect infections of Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale and Trichuris trichiura. RESULTS Among the 682 children, no positive samples were identified, and participants reported high standards of WASH. CONCLUSIONS To our knowledge, this is the first STH-surveillance study in Japan to use sensitive molecular techniques for STH detection. The results suggest that recrudescence of STH infections has not occurred, and that declines in prevalence have been sustained in the sampled areas. These findings suggest that reductions in prevalence below the elimination thresholds, suggestive of transmission interruption, are possible. Additionally, this study provides circumstantial evidence that multi-parallel real-time PCR methods are applicable for evaluating elimination status in areas where STH prevalence is extremely low.
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Affiliation(s)
- Mitsuko Hasegawa
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Doctoral Leadership Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Nils Pilotte
- Department of Biological Sciences, Smith College, Northampton, Massachusetts USA
- Molecular and Cellular Biology Program, University of Massachusetts, Amherst, Massachusetts USA
| | - Mihoko Kikuchi
- Doctoral Leadership Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Arianna R. Means
- Department of Global Health, University of Washington, Seattle, Washington USA
- Department of Life Sciences, Natural History Museum, London, UK
| | - Marina Papaiakovou
- Department of Biological Sciences, Smith College, Northampton, Massachusetts USA
- Department of Life Sciences, Natural History Museum, London, UK
| | - Andrew M. Gonzalez
- Department of Biological Sciences, Smith College, Northampton, Massachusetts USA
| | | | - Hiroshi Ikuno
- Department of Bacteriology, BML, Inc, Saitama, Japan
| | - Toshihiko Sunahara
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Vector Ecology and Environment, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | | | - Judd L. Walson
- Department of Global Health, University of Washington, Seattle, Washington USA
- Department of Life Sciences, Natural History Museum, London, UK
- Departments of Medicine (Infectious Disease), Pediatrics and Epidemiology, University of Washington, Seattle, Washington USA
| | - Steven A. Williams
- Department of Biological Sciences, Smith College, Northampton, Massachusetts USA
- Molecular and Cellular Biology Program, University of Massachusetts, Amherst, Massachusetts USA
| | - Shinjiro Hamano
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Doctoral Leadership Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - the DeWorm3 Project Team
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Doctoral Leadership Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Biological Sciences, Smith College, Northampton, Massachusetts USA
- Molecular and Cellular Biology Program, University of Massachusetts, Amherst, Massachusetts USA
- Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Global Health, University of Washington, Seattle, Washington USA
- Department of Life Sciences, Natural History Museum, London, UK
- Department of Bacteriology, BML, Inc, Saitama, Japan
- Department of Vector Ecology and Environment, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington USA
- Departments of Medicine (Infectious Disease), Pediatrics and Epidemiology, University of Washington, Seattle, Washington USA
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Grant JR, Pilotte N, Williams SA. A Case for Using Genomics and a Bioinformatics Pipeline to Develop Sensitive and Species-Specific PCR-Based Diagnostics for Soil-Transmitted Helminths. Front Genet 2019; 10:883. [PMID: 31608116 PMCID: PMC6768101 DOI: 10.3389/fgene.2019.00883] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 08/21/2019] [Indexed: 12/22/2022] Open
Abstract
The balance of expense and ease of use vs. specificity and sensitivity in diagnostic assays for helminth disease is an important consideration, with expense and ease often winning out in endemic areas where funds and sophisticated equipment may be scarce. In this review, we argue that molecular diagnostics, specifically new assays that have been developed with the aid of next-generation sequence data and robust bioinformatic tools, more than make up for their expense with the benefit of a clear and precise assessment of the situation on the ground. Elimination efforts associated with the London Declaration and the World Health Organization (WHO) 2020 Roadmap have resulted in areas of low disease incidence and reduced infection burdens. An accurate assessment of infection levels is critical for determining where and when the programs can be successfully ended. Thus, more sensitive assays are needed in locations where elimination efforts are approaching a successful conclusion. Although microscopy or more general PCR targets have a role to play, they can mislead and cause study results to be confounded. Hyper-specific qPCR assays enable a more definitive assessment of the situation in the field, as well as of shifting dynamics and emerging diseases.
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Affiliation(s)
- Jessica R. Grant
- Department of Biological Sciences, Smith College, Northampton, MA, United States
| | - Nils Pilotte
- Department of Biological Sciences, Smith College, Northampton, MA, United States
- Molecular and Cellular Biology Program, University of Massachusetts, Amherst, MA, United States
| | - Steven A. Williams
- Department of Biological Sciences, Smith College, Northampton, MA, United States
- Molecular and Cellular Biology Program, University of Massachusetts, Amherst, MA, United States
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28
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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.
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29
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Stracke K, Clarke N, Awburn CV, Vaz Nery S, Khieu V, Traub RJ, Jex AR. Development and validation of a multiplexed-tandem qPCR tool for diagnostics of human soil-transmitted helminth infections. PLoS Negl Trop Dis 2019; 13:e0007363. [PMID: 31206520 PMCID: PMC6597125 DOI: 10.1371/journal.pntd.0007363] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 06/27/2019] [Accepted: 04/05/2019] [Indexed: 11/30/2022] Open
Abstract
Soil-transmitted helminths (STH) are a major cause of morbidity in tropical developing countries with a global infection prevalence of more than one billion people and disease burden of around 3.4 million disability adjusted life years. Infection prevalence directly correlates to inadequate sanitation, impoverished conditions and limited access to public health systems. Underestimation of infection prevalence using traditional microscopy-based diagnostic techniques is common, specifically in populations with access to benzimidazole mass treatment programs and a predominance of low intensity infections. In this study, we developed a multiplexed-tandem qPCR (MT-PCR) tool to identify and quantify STH eggs in stool samples. We have assessed this assay by measuring infection prevalence and intensity in field samples of two cohorts of participants from Timor-Leste and Cambodia, which were collected as part of earlier epidemiological studies. MT-PCR diagnostic parameters were compared to a previously published multiplexed qPCR for STH detection. The MT-PCR assay agreed strongly with qPCR data and showed a diagnostic specificity of 99.60-100.00% (sensitivity of 83.33-100.00%) compared to qPCR and kappa agreement exceeding 0.85 in all tests. In addition, the MT-PCR has the added advantage of distinguishing Ancylostoma spp. species, namely Ancylostoma duodenale and Ancylostoma ceylanicum. This semi-automated platform uses a standardized, manufactured reagent kit, shows excellent run-to-run consistency/repeatability and supports high-throughput detection and quantitation at a moderate cost.
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Affiliation(s)
- Katharina Stracke
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Naomi Clarke
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Camille V. Awburn
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Susana Vaz Nery
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Virak Khieu
- National Center for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Rebecca J. Traub
- Faculty for Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Aaron R. Jex
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Faculty for Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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30
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Webb LM, Tait Wojno ED. Notch Signaling Orchestrates Helminth-Induced Type 2 Inflammation. Trends Immunol 2019; 40:538-552. [PMID: 31103422 PMCID: PMC6545262 DOI: 10.1016/j.it.2019.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 12/18/2022]
Abstract
Infection with helminth parasites poses a significant challenge to the mammalian immune system. The type 2 immune response to helminth infection is critical in limiting worm-induced tissue damage and expelling parasites. Conversely, aberrant type 2 inflammation can cause debilitating allergic disease. Recent studies have revealed that key type 2 inflammation-associated immune and epithelial cell types respond to Notch signaling, broadly regulating gene expression programs in cell development and function. Here, we discuss new advances demonstrating that Notch is active in the development, recruitment, localization, and cytokine production of immune and epithelial effector cells during type 2 inflammation. Understanding how Notch signaling controls type 2 inflammatory processes could inform the development of Notch pathway modulators to treat helminth infections and allergies.
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Affiliation(s)
- Lauren M Webb
- Baker Institute for Animal Health and Department of Microbiology and Immunology, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
| | - Elia D Tait Wojno
- Baker Institute for Animal Health and Department of Microbiology and Immunology, Cornell University College of Veterinary Medicine, Ithaca, New York, USA.
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31
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Karpstein T, Pasche V, Häberli C, Scandale I, Neodo A, Keiser J. Evaluation of emodepside in laboratory models of human intestinal nematode and schistosome infections. Parasit Vectors 2019; 12:226. [PMID: 31088525 PMCID: PMC6515646 DOI: 10.1186/s13071-019-3476-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/30/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Helminthiases are very prevalent worldwide, yet their treatment and control rely on a handful of drugs. Emodepside, a marketed broad-spectrum veterinary anthelminthic with a unique mechanism of action, undergoing development for onchocerciasis is an interesting anthelmintic drug candidate. We tested the in vitro and in vivo activity of emodepside on nematode species that serve as models for human soil-transmitted helminth infection as well as on schistosomes. METHODS In vitro viability assays were performed over a time course of 72 hours for Trichuris muris, Necator americanus, Ancylostoma ceylanicum, Heligmosomoides polygyrus, Strongyloides ratti, Schistosoma mansoni and Schistosoma haematobium. The drug effect was determined by the survival rate for the larvae and by phenotypical scores for the adult worms. Additionally, mice infected with T. muris and hamsters harboring hookworm infection (N. americanus or A. ceylanicum) were administered orally with emodepside at doses ranging from 1.25 to 75 mg/kg. Expelled worms in the feces were counted until 3 days post-drug intake and worms residing in the intestines were collected and counted after dissection. RESULTS After 24 hours, emodepside was very active in vitro against both larval and adult stages of the nematodes T. muris, A. ceylanicum, N. americanus, H. polygyrus and S. ratti (IC50 < 4 µM). The good in vitro activity was confirmed in vivo. Hamsters infected with the hookworms were cured when administered orally with 2.5 mg/kg of the drug. Emodepside was also highly active in vivo against T. muris (ED50 = 1.2 mg/kg). Emodepside was moderately active on schistosomula in vitro (IC50 < 8 µM) 24 h post-drug incubation and its activity on adult S. mansoni and S. haematobium was low (IC50: 30-50 µM). CONCLUSIONS Emodepside is highly active against a broad range of nematode species both in vitro and in vivo. The development of emodepside for treating soil-transmitted helminth infections should be pursued.
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Affiliation(s)
- Tanja Karpstein
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Valérian Pasche
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Cécile Häberli
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Ivan Scandale
- Drugs for Neglected Disease initiative, Chemin Louis-Dunant 15, 1202 Geneva, Switzerland
| | - Anna Neodo
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Githang'a D, Wangia RN, Mureithi MW, Wandiga SO, Mutegi C, Ogutu B, Agweyu A, Wang JS, Anzala O. The effects of aflatoxin exposure on Hepatitis B-vaccine induced immunity in Kenyan children. Curr Probl Pediatr Adolesc Health Care 2019; 49:117-130. [PMID: 31103452 PMCID: PMC7116700 DOI: 10.1016/j.cppeds.2019.04.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Globally, approximately three million children die each year from vaccine preventable infectious diseases mainly in developing countries. Despite the success of the expanded immunization program, not all infants and children around the world develop the same protective immune response to the same vaccine. A vaccine must induce a response over the basal immune response that may be driven by population-specific, environmental or socio-economic factors. Mycotoxins like aflatoxins are immune suppressants that are confirmed to interfere with both cell-mediated and acquired immunity. The mechanism of aflatoxin toxicity is through the binding of the bio-activated AFB1-8, 9-epoxide to cellular macromolecules. METHODS We studied Hepatitis B surface antibodies [anti-HBs] levels to explore the immune modulation effects of dietary exposure to aflatoxins in children aged between one and fourteen years in Kenya. Hepatitis B vaccine was introduced for routine administration for Kenyan infants in November 2001. To assess the effects of aflatoxin on immunogenicity of childhood vaccines Aflatoxin B1-lysine in blood serum samples were determined using High Performance Liquid Chromatography with Fluorescence detection while anti-HBs were measured using Bio-ELISA anti-HBs kit. RESULTS The mean ± SD of AFB1-lysine adducts in our study population was 45.38 ± 87.03 pg/mg of albumin while the geometric mean was 20.40 pg/mg. The distribution of AFB1-lysine adducts was skewed to the right. Only 98/205 (47.8%) of the study population tested positive for Hepatitis B surface antibodies. From regression analysis, we noted that for every unit rise in serum aflatoxin level, anti-HBs dropped by 0.91 mIU/ml (-0.9110038; 95% C.I -1.604948, -0.21706). CONCLUSION Despite high coverage of routine immunization, less than half of the study population had developed immunity to HepB. Exposure to aflatoxin was high and weakly associated with low anti-HBs antibodies. These findings highlight a potentially significant role for environmental factors that may contribute to vaccine effectiveness warranting further research.
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Affiliation(s)
- D Githang'a
- KAVI - Institute of Clinical Research, University of Nairobi, Kenya; Department of Medical Microbiology, School of Medicine, College of Health Sciences, University of Nairobi, Kenya.
| | - R N Wangia
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA 30602, United States
| | - M W Mureithi
- KAVI - Institute of Clinical Research, University of Nairobi, Kenya; Department of Medical Microbiology, School of Medicine, College of Health Sciences, University of Nairobi, Kenya
| | - S O Wandiga
- Department of Chemistry, College of Biological and Physical Sciences, University of Nairobi, Kenya
| | - C Mutegi
- International Institute of Tropical Agriculture [IITA], P.O BOX 30772-00100, Nigeria
| | - B Ogutu
- Centre for Clinical Research-Kenya Medical Research Institute, Kenya
| | - A Agweyu
- KEMRI-Wellcome Trust Research Programme, P.O. Box 43640 - 00100, Nairobi, Kenya
| | - J-S Wang
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA 30602, United States
| | - O Anzala
- KAVI - Institute of Clinical Research, University of Nairobi, Kenya; Department of Medical Microbiology, School of Medicine, College of Health Sciences, University of Nairobi, Kenya
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Developing a real-time PCR assay based on multiplex high-resolution melt-curve analysis: a pilot study in detection and discrimination of soil-transmitted helminth and schistosome species. Parasitology 2018; 145:1733-1738. [PMID: 30152296 DOI: 10.1017/s0031182018001361] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
With the push towards control and elimination of soil-transmitted helminthiasis and schistosomiasis in low- and middle-income countries, there is a need to develop alternative diagnostic assays that complement the current in-country resources, preferably at a lower cost. Here, we describe a novel high-resolution melt (HRM) curve assay with six PCR primer pairs, designed to sub-regions of the nuclear ribosomal locus. Used within a single reaction and dye detection channel, they are able to discriminate Ancylostoma duodenale, Necator americanus, Strongyloides stercoralis, Ascaris lumbricoides, Trichuris trichiuria and Schistosoma spp. by HRM curve analysis. Here we describe the primers and the results of a pilot assessment whereby the HRM assay was tested against a selection of archived fecal samples from Ghanaian children as characterized by Kato-Katz and real-time PCR analysis with species-specific TaqMan hydrolysis probes. The resulting sensitivity and specificity of the HRM was 80 and 98.6% respectively. We judge the assay to be appropriate in modestly equipped and resourced laboratories. This method provides a potentially cheaper alternative to the TaqMan method for laboratories in lower resource settings. However, the assay requires a more extensive assessment as the samples used were not representative of all target organisms.
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Abstract
Cystic echinococcosis (CE) caused by Echinococcus granulosus sensu lato (s.l.) is a significant zoonosis, especially in developing countries of the Middle East, with many studies focusing on CE genotypes in Iran. We performed a systematic review to determine the exact status of E. granulosus genotypes in the country. We explored English (Pubmed, Scopus, ISI Web of Science and Science Direct) and Persian (Magiran, Iran Medex and Scientific Information Database) databases along with Google Scholar. Our review included 73 studies published prior to the end of 2015. In total, 2952 animal (intermediate and definitive) hosts were examined, and the prevalent genotypes comprised G1 (92.75%) and G6 (4.53%) in sheep, cattle, camels, goats and buffaloes; G3 (2.43%) in five herbivore hosts and dogs; G7 (0.2%) in sheep and goats; and G2 (0.06%) in dogs. G1 was mostly dominant in West Azerbaijan, whereas G3 and G6 were identified most frequently in the provinces of Isfahan and Fars, respectively. Regarding human CE infection, 340 cases were reported from Iran, with the identified genotypes G1 (n = 320), G6 (n = 13) and G3 (n = 7). Most CE-infected humans originated from Isfahan province (168 cases), whereas the lowest number of infected persons was noted in Kerman province (two cases). The information obtained from this systematic review is central to better understanding the biological and epidemiological characteristics of E. granulosus s.l. genotypes in Iran, leading to more comprehensive control strategies.
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Parija SC. Intestinal helminths - An old foe revisited. Trop Parasitol 2017; 7:61. [PMID: 29114480 PMCID: PMC5652055 DOI: 10.4103/tp.tp_53_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Subhash Chandra Parija
- Director, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. E-mail:
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