Occurrence of the most common helminth infections among children in the Eastern Slovak Republic

Human infections by Hymenolepis diminuta in Europe: a case report and literature review

We performed a review of published and gray literature of human Hymenolepis diminuta cases across Europe up to July 2022. Of all detectable publications and records, we further analyzed only those that contained demographic, clinical or epidemiological data regarding the infected subjects. Additionally, one case of hymenolepiasis in a 16-mo-old boy living in the urban part of Belgrade was included in the analysis. Published studies were based in 13/50 European countries and identified 104 laboratory-confirmed cases in total. Almost one-half (49%) of all cases originated from Mediterranean countries. Among symptomatic children, the infection most often manifested with diarrhea, abdominal pain, allergic reaction and behavioral changes. The diagnosis was made by the detection and identification of H. diminuta eggs or parts of strobila in stool samples, although cases of misdiagnosis were also reported. The parasite clearance was established with praziquantel or niclosamide, while the administration of albendazole or mebendazole led to unfavorable results. Future multicentric prospective studies focused on infection screening and the gathering of detailed sociodemographic and clinical data could provide an updated insight into the true distribution and characteristics of H. diminuta infection across Europe.

The survey of soil-transmitted helminth species abundance in Slovakia with an emphasis on parameters important for their distribution

Soil-transmitted helminths (STH) can be easily dispensable in socially disadvantaged groups. The Roma people represent the group most at risk in Slovakia. This study aimed to investigate the occurrence of STH infections in minorities living with animals under low hygienic conditions and on contaminated soil. Subsequently, we identified the risk assessment factors of the STH transmissions based on parasitological results. In our study, STHs were predominantly found among the Roma communities living in unsanitary conditions. The prevalence of Ascaris lumbricoides among the majority was 0.79%, and Trichuris trichiura was 0.05 %. On the contrary, a community-based cross-sectional survey across eastern Slovakia also found a prevalence of 22.28 and 3.47% for A. lumbricoides and T. trichiura among the Roma population. Inhabitants that belong to the Roma minority had a 37.12 infection OR times higher than non-Roma inhabitants. The Roma people living in the countryside have a 2.23-fold higher chance of getting infected with STH than Roma living in the city. Therefore, soil and domestic animals were also examined for the presence of the STH eggs to show the environmental burden. In general, the presence of STH eggs was confirmed in 26.26% of the soil examined samples. The detailed description is as follows: eggs of Toxocara spp., Trichuris spp., eggs from the family Ancylostomatidae, and Toxascaris leonina. Ascaris eggs were detected only in the soil from localities with low hygienic standards. The probability of contracting the STH eggs in segregated settlements was 15.94 times higher compared to urban or rural areas. In addition to humans, dogs can also be a source of STH eggs in the soil. The STH eggs were confirmed in 43.55% of dog droppings. The most interesting finding was that the eggs of the genus Ascaris were up to 7.93% of dog droppings from localities with a low hygienic standard were positive. This study revealed that climatic factors and the WASH conditions influenced the distribution of STHs to variable degrees. In addition, ethnicity and sanitation were crucial factors in the distribution of STH infection in eastern Slovakia.

Parasitic zoonoses in the Roma population

Roma people are the largest minority group in Europe. The vast majority live in substandard conditions in segregated settlements, overcrowded with people and animals that predispose them to various, especially zoonotic diseases. Parasitic zoonotic diseases remain a challenge in this vulnerable population group, especially among Roma children. PubMed was searched using the keywords Roma with combination of names of different parasites to get all available studies on prevalence of parasitic zoonoses among European Roma, published between years 2000 and 2020. After application of exclusion criteria, data were extracted from the studies that made the final sample. Parasitic zoonoses are common among Roma. Cryptosporidium, Toxoplasma gondii, soil-transmitted helminths and Giardia spp. are more common in Roma children compared to non-Roma children, and Toxoplasma gondii and soil-transmitted helminths are also more common in Roma adults compared to non-Roma adults. Data on prevalence of trichinellosis, echinococcosis, and taeniasis among Roma show that they do not affect Roma more often compared to the general population. Roma people, particularly children, are more susceptible to parasitic zoonoses. Substandard sanitary conditions and close contact with infected animals are important risk factors in this population and should be aimed with preventive measures.

Genotyping of Ascaris spp. infecting humans and pigs in Italy, Slovakia and Colombia

BACKGROUND

The systematics and taxonomy of Ascaris lumbricoides and Ascaris suum, two of the world's most widespread nematodes, still represent a highly debated scientific issue. Two different transmission scenarios have been described according to endemicity: separated host-specific transmission cycles in endemic regions, and a single pool of infection shared by humans and pigs in non-endemic regions. The swine roundworm A. suum is now recognized as an important cause of human ascariasis also in endemic areas such as China, where cross-infections and hybridization have also been reported, as well as in non-endemic regions like Italy. This study aimed to investigate the molecular epidemiology of human and pig ascariasis in three countries representing different epidemiological scenarios: Italy as a non-endemic country, Colombia as an endemic country, and Slovakia as a non-endemic country, but with a poor socio-economic context linked to some focal populations of Roma settlements.

MATERIALS AND METHODS

A total of 237 nematodes were analysed: 46 from Colombia (13 from humans, 33 from pigs), 114 from Slovakia (20 from humans, 94 from pigs) and 77 from Italy (17 from humans and 60 from pigs). Genotyping by PCR-RFLP of nuclear (ITS) and sequencing of mitochondrial (cox1) target regions were performed. ITS genotypes were used to estimate the Hardy-Weinberg (HW) equilibrium according to hosts and country of origin. The partial cox1 sequences were used to analyse genetic polymorphisms according to hosts and country of origin, as well as to infer the network of haplotypes, their evolutionary relationships and geographical distribution.

RESULTS

110 quality cox1 sequences were obtained. Haplotype network revealed three main groups corresponding to clade A, B and C. Clade C included most of the human cases from Italy, while those from Slovakia and Colombia were grouped in clade B. Ascaris from Italian and Colombian pigs showed HW equilibrium at the ITS marker, while disequilibrium was found in A. lumbricoides from Slovak pigs, which suggest a high unexpected amount of roundworms of human origin circulating also in pigs.

CONCLUSIONS

This study updates and extends the current understanding of Ascaris species and genotypes circulating in different epidemiological scenarios, with particular attention to the inclusion of human-derived Ascaris in the phylogenetic cluster C. Despite the evidence of HW equilibrium in the ITS in pig-derived Italian samples, the amount of genetic variation seems to support the existence of two closely related species.

Intestinal parasites in segregated minority communities of Slovakia: results from a cross-sectional survey in children

In Slovakia, the Roma population forms the second-largest ethnic minority. A large part of the Roma is semi-nomadic or lives in segregated settlements with poor living standards and limited access to health facilities. More than 40 years ago, a cross-sectional survey revealed a high prevalence of parasitic infections. There is a paucity of recent data, and hence, we designed a study to investigate the current status of intestinal parasitic infections in this population. Overall, 259 children aged 7 months to 18 years from 32 different segregated settlements provided faecal samples for microscopic examination using a sodium acetate-acetic acid-formalin concentration and the Paraprep L technique. Almost 40% of the samples yielded a positive result, with Ascaris lumbricoides (27.4%) and Giardia intestinalis (9.3%) being the most frequent helminth and intestinal protozoa species, respectively. Many children younger than 2 years were found to be infected, which suggests that community transmission is important. In view of our findings, there is a pressing need for targeted action to improve the health status of this neglected population.

Roma Health: An Overview of Communicable Diseases in Eastern and Central Europe

The Roma are Europe’s largest minority. They are also one of its most disadvantaged, with low levels of education and health and high levels of poverty. Research on Roma health often reveals higher burdens of disease in the communities studied. This paper aims to review the literature on communicable diseases among Roma across Eastern and Central Europe. A PubMed search was carried out for communicable diseases among Roma in these parts of Europe, specifically in Romania, Bulgaria, Hungary, Serbia, Slovakia, the Czech Republic and North Macedonia. The papers were then screened for relevance and utility. Nineteen papers were selected for review; most of them from Slovakia. Roma continue to have a higher prevalence of communicable diseases and are at higher risk of infection than the majority populations of the countries they live in. Roma children in particular have a particularly high prevalence of parasitic disease. However, these differences in disease prevalence are not present across all diseases and all populations. For example, when Roma are compared to non-Roma living in close proximity to them, these differences are often no longer significant.

The dwarf tapeworm Hymenolepis nana in pet rodents in Slovakia-epidemiological survey and genetic analysis

Rodents are popular companion animals and are often kept as pets for children. However, they can be reservoirs of a variety of zoonotic pathogens. As little attention is being paid to the possibility of acquiring parasitic infections from pet rodents, the occurrence of Hymenolepis nana in rodents from pet shops and breeding clubs of Slovakia was surveyed, with parallel genetic analyses to type isolates from rodent species. In 2016-2018, pooled faecal samples from 119 boxes with 228 mice, 191 rats, 124 hamsters and 25 Mongolian gerbils were collected from 12 pet shops and 3 breeding clubs in five cities of eastern Slovakia. H. nana eggs were detected in 25 (21.0%) boxes. Animals from pet shops were infected more frequently (24.6% positive boxes) than those from breeding clubs (17.2%), without statistical significance. The highest prevalence was recorded in rats from pet shops, where 41.7% of boxes contained parasite eggs. Hamsters and mice in pet shops were also frequently infected; in 23.8% and 25% of boxes, respectively, H. nana eggs were observed. Prevalence in rats and hamsters from breeding clubs was lower, but in mice surpassed 40%. Nine samples with positive PCR products in any of the four DNA regions, mitochondrial cox1 and nuclear pmy, ITS1 and ITS2 targets, gave profiles characteristic of H. nana. The results imply the risk of zoonotic transmission of hymenolepiasis in Slovakia. Particular attention should be given to hygiene level maintained while keeping rodents. Furthermore, rodents intended for sale should be tested for parasites and then dewormed.

Secular Trends of Ascariasis Infestation and Nutritional Status in Chinese Children From 2000 to 2014: Evidence From 4 Successive National Surveys

Background

This study aimed to assess secular trends and epidemiological status of ascariasis infestations and to explore its effects on the nutritional transition among Chinese children from 2000 to 2014.

Methods

Data were collected from 69 435 Chinese children aged 7-year-olds and 9-year-olds in 4 successive cross-sectional surveys of Chinese National Survey on Students’ Constitution and Health. Ascariasis infestation was defined by using the Kato-Katz method. Nutritional status was classified into stunting, thinness, overweight, and obesity by WHO definition.

Results

From 2000 to 2014, the ascariasis infestation rates decreased from 9.1% to 1.7%, the stunting and thinness prevalence decreased from 4.3% and 13.8% to 0.7% and 7.1%, while the overweight and obesity prevalence increased from 3.6% and 2.1% to 9.8% and 9.1%, respectively. Compared to children in the ascariasis noninfestation group, those infected with ascariasis had a worse nutritional status. Yet, the disparity in nutritional status between 2 groups disappeared over time. Provinces with a higher gross domestic product per capita simultaneously had lower ascariasis infestation rates, lower stunting and thinness prevalence, and higher overweight and obesity prevalence.

Conclusions

The retardation effects caused by ascariasis infestation on nutritional status in Chinese children seemed to be offset by the rapid economic development and nutritional transition over time; nevertheless, multiple prevention and control measures are still needed and should be continuously strengthened.

Contamination of Sandpits with Soil-Transmitted Helminths Eggs in an Urban Environment

The aim of this study was to monitor the occurrence of the propagative stages of intestinal endoparasites in dog excrements collected within the close proximity of sandpits in an urban environment (Košice, Slovakia) and to determine the level of sandpits contamination with soil-transmitted helminths (STHs). A total of 201 dog faecal samples were examined for the presence of helminth eggs with 10.95 % of the samples being positive. In faeces the most prevalent eggs were those of Toxocara canis (7.46 %). The contamination of sand with STH eggs in 84 sandpits was also investigated. Toxocara spp. eggs were found in 21.43 % of the sandpits. The eggs from the family Ancylostomatidae and Toxascaris leonina were also present. Taenia type eggs and Trichuris sp. eggs occurred less frequently. In some samples, not only monoinfection but also co-infection with eggs of 2‒3 helminth species were detected. In conclusion, the environmental contamination of sandpits with STHs eggs might pose a significant threat to the public health.

First report on Giardia duodenalis assemblage F in Slovakian children living in poor environmental conditions

BACKGROUND

Giardiasis is one of the most common gastrointestinal infections of humans and animals attributable to complex of eight morphologically identical genetic assemblages, further divided into sub-assemblages. Disease is common for a wide range of hosts and genetic characterization is needed for better understanding of multifaceted epidemiology for this protozoan parasite. The aim of this study was to identify genetic heterogeneity in assemblages and sub-assemblages of Giardiaduodenalis circulating among the children population living in deprived socioeconomic conditions.

METHODS

A total of 333 stool samples from children in eastern Slovakia were collected during the period of 2015-2016 and analysed by molecular methods. Molecular characterization of G. duodenalis was performed by sequence analysis of triose phosphate isomerase gene (tpi) and glutamate dehydrogenase gene (gdh).

RESULTS

G. duodenalis DNA was detected in 21 samples (6.3%), out of which 14 isolates (66.7%) belonged to assemblage B, 4 isolates (19.0%) to sub-assemblage AII and 3 isolates (14.3%) corresponded to assemblage F. As regards the determination of sub-assemblages of assemblage B, 4 isolates were characterized as sub-assemblage BIII and 6 isolates as sub-assemblage BIV.

CONCLUSION

This study is the first finding of cat specific assemblage F in man not only in Slovakia, but also in Europe. The absence of molecular data about G. duodenalis in companion animals in Slovakia establishes a strong need for further investigation for potential sources of giardiasis and understanding the epidemiology will help to improve the preventive strategies in eradication of infection in this population.