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Nath TC, Tusher PC, Siddiki T, Nyema J, Bhattacharjee T, Dey N, Mukutmoni M, Islam KM, Bhuiyan JU. Rare case of human Ancylostoma ceylanicum infection in Bangladesh. IJID REGIONS 2024; 11:100376. [PMID: 38827635 PMCID: PMC11141138 DOI: 10.1016/j.ijregi.2024.100376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/03/2024] [Accepted: 05/03/2024] [Indexed: 06/04/2024]
Abstract
The zoonotic hookworm species Ancylostoma ceylanicum has drawn more attention recently because of its potential impact on public health. Although A. duodenale and Necator americanus are more common, A. ceylanicum is still known to play a major role in human infections, particularly in regions where close human-animal interactions are prevalent. While there has been a notable increase in documenting the presence of A. ceylanicum in the Asia-Pacific area, bottlenecks remains in understanding its epidemiology in Bangladesh. This report highlights the first documented case of Ancylostoma ceylanicum infection isolated and identified in a 15-year-old girl experiencing frequent diarrhea and weakness, residing in an urban tea garden area in Sylhet, Bangladesh. Microscopic examination of stool samples revealed the presence of hookworm eggs and subsequent culture led to the observation of larvae. Molecular investigation by amplifying Internal Transcribed Spacer (ITS1+) regions of the ribosomal deoxyribonucleic acid (rDNA) confirmed the infection as A. ceylanicum. The identification of Ancylostoma ceylanicum in a human host in Bangladesh carries significant implications for global health. The careful measurement of eggs and larvae, coupled with molecular analysis, serves as an appropriate diagnostic strategy for confirming the infections. This finding emphasizes the emergence of A. ceylanicum as a zoonotic infection in endemic regions and calls for increased awareness among healthcare professionals and the general public.
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Affiliation(s)
- Tilak Chandra Nath
- Department of Parasitology, Sylhet Agricultural University, Sylhet, Bangladesh
- Parasite Resource Bank, Sylhet, Bangladesh
| | | | | | - Jannatul Nyema
- Department of Parasitology, Sylhet Agricultural University, Sylhet, Bangladesh
| | | | - Nilotpal Dey
- Department of Parasitology, Sylhet Agricultural University, Sylhet, Bangladesh
| | | | | | - Jamal Uddin Bhuiyan
- Department of Parasitology, Sylhet Agricultural University, Sylhet, Bangladesh
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Advantages and Limitations of Microscopy and Molecular Detections for Diagnosis of Soil-transmitted Helminths: An Overview. Helminthologia 2022; 59:321-340. [PMID: 36875683 PMCID: PMC9979072 DOI: 10.2478/helm-2022-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 10/31/2022] [Indexed: 02/05/2023] Open
Abstract
World Health Organization (WHO) reported that over 1.5 billion people are infected by soil-transmitted helminths (STH) worldwide in sub-Saharan Africa, the United States of America, China, and East Asia. Heavy infections and polyparasitism are associated with higher morbidity rates, and the patients are exposed to increased vulnerability to other diseases. Therefore, accurate diagnosis followed by mass treatment for morbidity control is necessary.STH diagnosis commonly involves the microscopic observation of the presence of the STH eggs and larvae in the faecal samples. Furthermore, molecular approaches are increasingly utilised in monitoring and surveillance as they show higher sensitivity. Their capability to differentiate hookworm species is an advantage over the Kato-Katz technique. This review discusses the advantages and limitations of microscopy and various molecular tools used for STH detection.
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Buonfrate D, Tamarozzi F, Paradies P, Watts MR, Bradbury RS, Bisoffi Z. The diagnosis of human and companion animal Strongyloides stercoralis infection: Challenges and solutions. A scoping review. ADVANCES IN PARASITOLOGY 2022; 118:1-84. [PMID: 36088083 DOI: 10.1016/bs.apar.2022.07.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Strongyloidiasis is the infection caused by soil-transmitted nematodes of Strongyloides species, infecting humans and some animals. Strongyloides stercoralis is the species with most clinical and epidemiological relevance in humans and dogs, due to its high prevalence and its capacity of inducing a life-threatening hyperinfection. Diagnosis of strongyloidiasis is challenging, due to the absence of a single reference standard test with high sensitivity and specificity, which also hampers the estimation of the accuracy of other diagnostic tests. In this chapter, we review the deployment and performance of the parasitological, immunological, molecular tests for the diagnosis of strongyloidiasis in humans and in dogs. Further, we comment the available evidence from genotyping studies that have addressed the zoonotic potential of S. stercoralis. Finally, we discuss the use of different diagnostic methods in relation to the purpose (i.e., screening, individual diagnosis, inclusion in a clinical trial) and the setting (endemic/non-endemic areas) and report the accuracy figures reported by systematic reviews on either parasitological, serological or molecular techniques published in literature.
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Affiliation(s)
- Dora Buonfrate
- Department of Infectious Tropical diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy.
| | - Francesca Tamarozzi
- Department of Infectious Tropical diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Paola Paradies
- Department of Emergency and Organs Transplantation, Veterinary Section, Campus of Veterinary Medicine, University of Bari, Bari, Italy
| | - Matthew R Watts
- Centre for Infectious Diseases and Microbiology, Institute of Clinical Pathology and Medical Research - New South Wales Health Pathology and Sydney Institute for Infectious Diseases, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Richard S Bradbury
- School of Health and Life Sciences, Federation University Australia, Berwick, VC, Australia
| | - Zeno Bisoffi
- Department of Infectious Tropical diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy; Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Hailu T, Amor A, Nibret E, Munshea A, Anegagrie M, Flores-Chavez MD, Tang THT, Saugar JM, Benito A. Evaluation of five diagnostic methods for Strongyloides stercoralis infection in Amhara National Regional State, northwest Ethiopia. BMC Infect Dis 2022; 22:297. [PMID: 35346087 PMCID: PMC8962492 DOI: 10.1186/s12879-022-07299-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Strongyloides stercoralis is an intestinal parasite that can cause chronic infection, hyperinfection and/or a dissemination syndrome in humans. The use of techniques targeting ova fails to detect S. stercoralis, as only larvae of the parasite are excreted in faeces. Due to the absence of “Gold” standard diagnostic method for S. stercoralis, there is a paucity of reported data worldwide.
Objective
This study aimed to evaluate the performance of diagnostic methods of S. stercoralis infection by taking the composite reference as a “Gold” standard.
Methods
A cross-sectional study was conducted among 844 schoolchildren in Amhara Region, Ethiopia, from April to December 2019. Stool samples were collected and processed with formol-ether concentration technique (FECT), spontaneous tube sedimentation technique (STST), Baermann concentration technique (BCT), agar plate culture (APC) and real-time polymerase chain reaction (RT-PCR). Sensitivity, specificity, positive predictive value, and negative predictive value of each diagnostic method were computed against the composite reference. The agreements of diagnostic methods were evaluated by Kappa value at 95% CI.
Results
The composite detection rate of S. stercoralis by the five diagnostic methods was 39.0% (329/844). The detection rate of the parasite from stool samples by FECT, STST, BCT, APC and RT-PCR was 2.0% (17/844), 4.0% (34/844), 10.2% (86/844), 10.9% (92/844) and 28.8% (243/844), respectively. The highest detection rate (37.8%; 319/844) of S. stercoralis was recorded by a combination of BCT, APC, and RT-PCR followed by a combination of STST, BCT, APC and RT-PCR (37.3%; 315/844). The sensitivity of FECT, STST, BCT, APC and RT-PCR against the composite reference was 5.2%, 10.3%, 26.4%, 28.0% and 73.9%, respectively. The diagnostic agreements of RT-PCR, APC, BCT, STST and FECT with the composite reference in detection of S. stercoralis were substantial (0.775), fair (0.321), fair (0.305), slight (0.123), and slight (0.062), respectively.
Conclusion
RT-PCR detected the highest number of S. stercoralis infections. A combination of RT-PCR with APC and/or BCT better detected S. stercoralis from stool samples compared to other combinations or single diagnostic methods. Therefore, RT-PCR and combination of RT-PCR with APC and/or BCT diagnostic methods should be advocated for detection of S. stercoralis infection.
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Sanyang AM, Joof E, Sey AP, Sambou S, Mohamed Z, Sanneh B. Prevalence and risk factors of strongyloidiasis among schoolchildren in Sabach Sanjal and Upper Badibou districts in the North Bank East Region of The Gambia. Parasite Epidemiol Control 2022; 15:e00228. [PMID: 35005262 PMCID: PMC8716566 DOI: 10.1016/j.parepi.2021.e00228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 10/01/2021] [Accepted: 10/05/2021] [Indexed: 11/29/2022] Open
Abstract
Background Strongyloidiasis is a parasitic disease that mainly affects humans and is caused by a roundworm called Strongyloides stercoralis. It is endemic in humid tropical regions that include Africa, Latin America and Southern Asia. Among the public health important soil-transmitted helminths (STHs) classified as neglected tropical diseases, S. stercoralis is the most neglected. A study of schistosomiasis and STHs mapping was conducted and S. stercoralis larvae were detected using the utilized diagnostic method; thus, this current study described the prevalence and risk factors of S. stercoralis infection in districts of Sabach Sanjal and Upper Badibou in The Gambia. Methods The cross-sectional study enrolled 851 schoolchildren, ages 7 to 14 years old. The participants were enrolled from 17 schools in Sabach Sanjal and Upper Badibou Districts. The WHO random sampling technique n/50 (25 boys and 25 girls) was used. Stool samples were collected from each participant and Kato-Katz smear method was used to screen for S. stercoralis infection. Results Out of the total 851 pupils, 76 pupils (8.9%) were positive for S. stercoralis infection. The mean age of infected persons was 10.1 years (±2.2). The prevalence of infection was higher among females (9.2%) than males (8.7%). Rates of infection for age categories 7–10 years and 11–14 years were 12.4% and 4.2%, respectively. Rates of infection by districts were 12.3% for Sabach Sanjal and 7.1% for Upper Badibou. Schoolchildren from Sabach Sanjal were 1.6 times more likely to have strongyloidiasis compared to those from Upper Badibou (aOR = 1.64, p-value = 0.058). Schoolchildren aged 7–10 years were 3.2 times more likely to have strongyloidiasis infection compared to the 11–14-year-olds (aOR = 3.20, p-value <0.001). Schoolchildren who ‘sometimes’ have water or tissue after defaecation have more infection rate compared to those who ‘always’ have water or tissue after defaecation. However, this difference was not statistically significant (aOR = 1.36, p-value = 0.308). Conclusion The study revealed the prevalence of strongyloidiasis in Sabach Sanjal and Upper Badibou districts of The Gambia. Kato-Katz technique might be inadequate for detecting S. stercoralis; thus, more studies are needed to determine the true prevalence of the disease in these two districts through the combined use of highly sensitive techniques such as Baermann, Koga Agar Culture and polymerase chain reaction.
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Affiliation(s)
- Abdoulie M Sanyang
- National Public Health Laboratories, Ministry of Health, Bertil Herding High way, Kotu, the Gambia
| | - Ebrima Joof
- National Public Health Laboratories, Ministry of Health, Bertil Herding High way, Kotu, the Gambia.,School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Alhagie Papa Sey
- National Public Health Laboratories, Ministry of Health, Bertil Herding High way, Kotu, the Gambia
| | - Sana Sambou
- Epidemiology and Disease Control Unit, Ministry of Health, Bertil Herding Highway, Kotu, the Gambia
| | - Zeehaida Mohamed
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Bakary Sanneh
- National Public Health Laboratories, Ministry of Health, Bertil Herding High way, Kotu, the Gambia
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Ortiz-Martínez S, Ramos-Rincón JM, Vásquez-Chasnamote ME, Gamboa-Paredes ON, Arista-Flores KM, Espinoza-Venegas LA, de-Miguel-Balsa E, Pinedo-Cancino VV, Górgolas-Hernández-Mora M, Casapía-Morales M. Prevalence of strongyloidiasis in Peru: systematic review and meta-analysis. BMC Infect Dis 2021; 21:755. [PMID: 34348671 PMCID: PMC8336367 DOI: 10.1186/s12879-021-06441-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 07/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background Strongyloidiasis is a disease of great public health significance, caused by the parasitic nematodes Strongyloides stercoralis, Strongyloides fuelleborni, and Strongyloides fuelleborni subsp. kellyi. This systematic review and meta-analysis aimed to assess the prevalence of Strongyloides stercoralis infection in Peru. Methods The review was based on a literature search in PubMed, SciELO and Google Scholar using the key words or root words “strongyl*” AND “Peru” on 15 July 2020. Eligible studies were published from 1 January 1981 to 15 July 2020 and written in English, Spanish, Italian, or French. Results We included 21 papers in the analysis. Studies were heterogeneous in terms of study population and diagnostic methods (e.g. Baermann technique, agar, Dancescu or charcoal cultures, serology, string capsule). Prevalence of S. stercoralis ranged from 0.3 to 45%. The pooled proportion of Strongyloides in the general population was 7.34% (95% CI 4.97 to 10.13%). Half the studies were designed to detect parasites in general. In studies designed to detect S. stercoralis, the most widely used diagnostic method was the Baermann technique. Conclusion Prevalence of S. stercoralis in Peru was high but varied by geographic area, techniques for stool examination, and participant characteristics.
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Affiliation(s)
- Sonia Ortiz-Martínez
- Medical Practice El Ballestero, Health Service of Castilla La Mancha, Albacete, Spain
| | - José-Manuel Ramos-Rincón
- Clinical Medicine Department, University Miguel Hernández of Elche, Ctra N-332, 03550 Sant Joan d'Alacant, Alicante, Spain. .,Internal Medicine Service, General University Hospital of Alicante-ISABIAL, Alicante, Spain.
| | | | | | | | | | - Eva de-Miguel-Balsa
- Clinical Medicine Department, University Miguel Hernández of Elche, Ctra N-332, 03550 Sant Joan d'Alacant, Alicante, Spain.,Intensive Care Unit, General University Hospital of Elche, Alicante, Spain
| | - Viviana-Vanessa Pinedo-Cancino
- Molecular Biology and Immunology Laboratory of the Specialized Unit of LIPNAA-CIRNA, National University of the Peruvian Amazon, Iquitos, Peru
| | - Miguel Górgolas-Hernández-Mora
- Infectious Disease Division, University Hospital Foundation Jiménez Díaz, Madrid, Spain.,Medicine Department, Autonomous University of Madrid, Madrid, Spain
| | - Martín Casapía-Morales
- Infectious Diseases and Tropical Medicine Service, Loreto Regional Hospital, Iquitos, Peru.,Medical Department, Amazon Rainforest Civil Association, Iquitos, Peru.,School of Medicine, National University of the Peruvian Amazon, Iquitos, Peru
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Evaluating the performance of diagnostic methods for soil transmitted helminths in the Amhara National Regional State, Northwest Ethiopia. BMC Infect Dis 2020; 20:803. [PMID: 33121458 PMCID: PMC7597015 DOI: 10.1186/s12879-020-05533-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Soil-transmitted helminths are more prevalent in tropics and sub-tropics including Ethiopia. Despite their high prevalence, direct saline microscopy with its low sensitivity has been used as a diagnostic method in almost all health facilities in Ethiopia. Alternative diagnostic methods which have higher sensitivity are not yet implemented. Therefore, this study aimed to compare and evaluate the performance of diagnostic methods for soil transmitted helminths. METHODS A cross-sectional study among 520 school children was conducted from October to December, 2019 in Amhara National Regional State. The study participants were selected using systematic random sampling technique. Stool samples were processed via formol ether concentration, Kato-Katz, spontaneous tube sedimentation and agar plate culture techniques. Data was entered into Epi-data version 3.1 and analysis was done using SPSS version 20.0. The sensitivity, specificity, and negative predictive value were calculated against the combined result. Strength of agreement of the diagnostic methods was determined by Kappa value. RESULTS The Overall prevalence of soil transmitted helminths was 40.8% using combination of methods. The prevalence 24.4, 22.5, and 32.4%, respectively was recorded by using formol ether concentration, Kato-Katz and spontaneous tube sedimentation. The highest prevalence of hookworm (29.2%) was detected by the agar plate culture. The sensitivity and negative predictive value of formol ether concentration were 57.9 and 78.4%, for Kato-Katz thick smear 55.2 and 76.4%, for spontaneous tube sedimentation were 79.2 and 87.5% to soil transmitted helminths detection, respectively. The sensitivity and negative predictive value of agar plate culture to hookworm detection were 86.4 and 93.5%, respectively. CONCLUSION Spontaneous tube sedimentation shows higher sensitivity in the detection of soil transmitted helminth infections. Agar plate culture method also indicated better performance for hookworm detection than other methods. Therefore, the employment of spontaneous tube sedimentation technique for routine laboratory and agar plate culture for research purposes will significantly aid in accurate diagnosis of parasitic infections.
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Hailu T, Nibret E, Amor A, Munshea A, Anegagrie M. Efficacy of Single Dose Ivermectin Against Strongyloides stercoralis Infection Among Primary School Children in Amhara National Regional State. Infect Dis (Lond) 2020; 13:1178633720932544. [PMID: 32595279 PMCID: PMC7297470 DOI: 10.1177/1178633720932544] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 05/15/2020] [Indexed: 01/05/2023] Open
Abstract
Background Ivermectin has been proven to be highly effective against Strongyloides stercoralis in some countries. However, its single dose (200 μg/kg) efficacy has not been proven up until now in Ethiopia. Objective This study aimed to evaluate the efficacy of single dose ivermectin against S. stercoralis infection among school children. Methods Stool sample was collected from April 2019 to December 2019 among 844 school children and screened by formol ether concentration, spontaneous tube sedimentation, Baermann concentration, and agar plate techniques. Single oral dose (200 μg/kg) ivermectin was given to 101 S. stercoralis-infected student and posttreatment diagnosis was done for 92 students after 2 weeks. Results Of the total 92 S. stercoralis-infected students who took ivermectin treatment, 87 were negative with cure rate of 94.6%. No side effect of ivermectin was observed. Conclusion Single dose ivermectin is an effective dose in uncomplicated chronic strongyloidiasis.
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Affiliation(s)
- Tadesse Hailu
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Endalkachew Nibret
- Department of Biology, Science College, Bahir Dar University, Bahir Dar, Ethiopia
| | - Arancha Amor
- Mundo Sano Foundation, Institute of Health Carlos III, Madrid, Spain
| | - Abaineh Munshea
- Department of Biology, Science College, Bahir Dar University, Bahir Dar, Ethiopia
| | - Melaku Anegagrie
- Mundo Sano Foundation, Institute of Health Carlos III, Madrid, Spain
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Soares FA, Benitez ADN, dos Santos BM, Loiola SHN, Rosa SL, Nagata WB, Inácio SV, Suzuki CTN, Bresciani KDS, Falcão AX, Gomes JF. A historical review of the techniques of recovery of parasites for their detection in human stools. Rev Soc Bras Med Trop 2020; 53:e20190535. [PMID: 32491097 PMCID: PMC7269538 DOI: 10.1590/0037-8682-0535-2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/30/2020] [Indexed: 11/22/2022] Open
Abstract
Since the early 20th century, the detection of intestinal parasites has improved with the development of several techniques for parasitic structures recovery and identification, which differ in sensitivity, specificity, practicality, cost, and infrastructure demand. This study aims to review, in chronological order, the stool examination techniques and discuss their advantages, limitations, and perspectives, and to provide professionals and specialists in this field with data that lays a foundation for critical analysis on the use of such procedures. The concentration procedures that constitute the main techniques applied in routine research and in parasitological kits are a) spontaneous sedimentation; b) centrifugation-sedimentation with formalin-ethyl acetate; and c) flotation with zinc sulfate solution. While selecting a technique, one should consider the purpose of its application and the technical-operational, biological, and physicochemical factors inherent in the procedures used in stool processing, which may restrict its use. These intrinsic limitations may have undergone procedural changes driven by scientific and technological development and by development of alternative methods, which now contribute to the improvement of diagnostic accuracy.
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Affiliation(s)
- Felipe Augusto Soares
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
| | | | | | | | - Stefany Laryssa Rosa
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
| | - Walter Bertequini Nagata
- Universidade Estadual Paulista, Faculdade de Medicina Veterinária, Departamento de Apoio, Produção e Saúde Animal, Araçatuba, SP, Brasil
| | - Sandra Valéria Inácio
- Universidade Estadual Paulista, Faculdade de Medicina Veterinária, Departamento de Apoio, Produção e Saúde Animal, Araçatuba, SP, Brasil
| | | | - Katia Denise Saraiva Bresciani
- Universidade Estadual Paulista, Faculdade de Medicina Veterinária, Departamento de Apoio, Produção e Saúde Animal, Araçatuba, SP, Brasil
| | | | - Jancarlo Ferreira Gomes
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
- Universidade Estadual de Campinas, Instituto de Computação, Campinas, SP, Brasil
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Wasihun AG, Teferi M, Negash L, Marugán J, Yemane D, McGuigan KG, Conroy RM, Abebe HT, Dejene TA. Intestinal parasitosis, anaemia and risk factors among pre-school children in Tigray region, northern Ethiopia. BMC Infect Dis 2020; 20:379. [PMID: 32460777 PMCID: PMC7251880 DOI: 10.1186/s12879-020-05101-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 05/17/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Intestinal parasitic infections (IPIs) and anaemia are major health problems. This study assessed the prevalence of intestinal parasitic infections, anaemia and associated factors among pre-school children in rural areas of the Tigray region, northern Ethiopia. METHODS A community based cross-sectional study was conducted among 610 pre-school children in rural communities of Northern Ethiopia from June 2017 to August 2017. Stool specimens were examined for the presence of trophozoites, cysts, oocysts, and ova using direct, formal-ethyl acetate concentration, Kato-Katz, and Ziehl-Neelsen techniques. Haemoglobin was measured using a HemoCue spectrometer. RESULTS Among the 610 participating pre-school children in the study, the prevalence of IPIs and anaemia were 58% (95% conference interval (CI): 54.1-61.9%) and 21.6% (95% CI: 18.5-25.1%), respectively. Single, double, and triple parasitic infections were seen in 249 (41, 95% CI: 37-45%), 83 (14, 95% CI: 11-17%), and 22 (3.6, 95% CI: 2.4-5.4%) children, respectively. Of the seven intestinal parasitic organisms recorded from the participants, Entamoeba histolytica/dispar was the most prevalent 220 (36.1%) followed by Giardia lamblia 128 (20.1%), and Hymenolepis nana 102 (16.7%). Mixed infections were common among G. lamblia, E. histolytica/dispar and Cryptosporidium spp. oocyst. Intestinal parasitic infection prevalence increased from 47% in children aged 6-11 months to 66% in those aged 48-59 months; the prevalence ratio (PR) associated with a one-year increase in age was 1.08 (95% CI: 1.02-1.14, p = 0.009). Age-adjusted prevalence was higher in children who had been dewormed (PR = 1.2; 95% CI: 1.00-1.4, p = 0.045), and lower in households having two or more children aged under five (PR = 0.76, 95% CI: 0.61-0.95, p = 0.015). Anaemia rose from 28% in children aged 6-11 months to 43% in those aged 12-23 months, then fell continuously with age, reaching 7% in those aged 48-59 months. Age adjusted, anaemia was more prevalent in households using proper disposal of solid waste (PR = 1.5, 95% CI: 0.1-2.10, p = 0.009) while eating raw meat (PR = 0.49, 95% CI: 0.45-0.54, p = 0.000), any maternal education (PR = 0.64 95% CI: 0.52-0.79, p = 0.000), and household water treatment (PR = 0.75, 95% CI: 0.56-1.0, p = 0.044) were associated with lower prevalence of anaemia. CONCLUSIONS More than half of the children were infected with intestinal parasites, while anaemia prevalence was concentrated in the 12-23 month age group. This study has identified a number of potentially modifiable risk factors to address the significant prevalence of IPIs and anaemia in these children. Improvements in sanitation, clean water, hand hygiene, maternal education could address both short and long-term consequences of these conditions in this vulnerable population.
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Affiliation(s)
- Araya Gebreyesus Wasihun
- Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Tigray, Ethiopia.
| | - Mekonen Teferi
- Department of Biology, College of Natural and Computational Sciences, Mekelle University, Tigray, Ethiopia
| | - Letemichal Negash
- Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle University, Tigray, Ethiopia
| | - Javier Marugán
- Department of Chemical and Environmental Technology, Universidad Rey Juan Carlos, C/ Tulipán s/n, 28933 Móstoles, Madrid, Spain
| | - Dejen Yemane
- Department of Environmental Health, College of Health Sciences, School of Public Health, Mekelle University, Tigray, Ethiopia
| | - Kevin G McGuigan
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland (RCSI), Dublin 2, Ireland
| | - Ronan M Conroy
- Data Science Centre, Royal College of Surgeons in Ireland (RCSI), Dublin 2, Ireland
| | - Haftu Temesgen Abebe
- Department of Bio Statistics, College of Health Sciences, School of Public Health, Mekelle University, Tigray, Ethiopia
| | - Tsehaye Asmelash Dejene
- Department of Medical Microbiology, College of Health Sciences, Aksum University, Tigray, Ethiopia
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Seroprevalence of the Strongyloides stercoralis Infection in Humans from Yungas Rainforest and Gran Chaco Region from Argentina and Bolivia. Pathogens 2020; 9:pathogens9050394. [PMID: 32443925 PMCID: PMC7281728 DOI: 10.3390/pathogens9050394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 12/15/2022] Open
Abstract
The threadworm, Strongyloides stercoralis, is endemic in tropical and subtropical areas. Data on the prevalence and distribution of infection with this parasite species is scarce in many critical regions. We conducted a seroprevalence study of S. stercoralis infection in 13 locations in the Gran Chaco and Yungas regions of Argentina and Bolivia during the period 2010-2016. A total of 2803 human serum samples were analyzed by ELISA-NIE which has a sensitivity of 75% and specificity of 95%. Results showed that 551 (19.6%) of those samples were positive. The adjusted prevalence was 20.9%, (95% confidence interval (CI) 19.4%-22.4%). The distribution of cases was similar between females and males with an increase of prevalence with age. The prevalence in the different locations ranged from 7.75% in Pampa del Indio to 44.55% in Santa Victoria Este in the triple border between Argentina, Bolivia, and Paraguay in the Chaco region. Our results show that S. stercoralis is highly prevalent in the Chaco and Yungas regions, which should prompt prospective surveys to confirm our findings and the design and deployment of control measures.
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scFv against HSP60 of Strongyloides sp. and Its Application in the Evaluation of Parasite Frequency in the Elderly. DISEASE MARKERS 2020; 2020:4086929. [PMID: 32399087 PMCID: PMC7201452 DOI: 10.1155/2020/4086929] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/20/2019] [Accepted: 12/24/2019] [Indexed: 02/07/2023]
Abstract
The present study is aimed at evaluating serological method using scFv anti-Strongyloides sp. and reporting the frequencies of the results with conventional parasitological technique (faeces) in elderly individuals. Among 112 elderly individuals (≥60 years of age), 14.28% were positive for at least one enteroparasite, with one individual positive for S. stercoralis. Sera were evaluated for the presence of anti-Strongyloides sp. antibodies using total or detergent fraction extracts of Strongyloides venezuelensis, which presented positivity rates of 19.64% and 10.71%, respectively. An anti-HSP60 single-chain variable fragment from Strongyloides sp. was used to detect parasite antigens, with 5.36% (6 individuals) of ELISA-positive individuals returning a positive result. While the serological test indicates previous or recent infection and may be limited by antigen purification, the anti-HSP60 method reflects the presence of Strongyloides sp. immune complexes and exhibits greater sensitivity and specificity. Our results demonstrate the variable occurrence of enteroparasites in elderly individuals residing in long-term nursing homes and validate a novel epidemiological tool to describe infection cases by Strongyloides sp.
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Errea RA, Vasquez-Rios G, Calderon ML, Siu D, Duque KR, Juarez LH, Gallegos R, Uriol C, Rondon CR, Baca KP, Fabian RJ, Canales M, Terashima A, Marcos LA, Samalvides F. Soil-Transmitted Helminthiasis in Children from a Rural Community Taking Part in a Periodic Deworming Program in the Peruvian Amazon. Am J Trop Med Hyg 2019; 101:636-640. [PMID: 31309921 PMCID: PMC6726937 DOI: 10.4269/ajtmh.18-1011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 03/04/2019] [Indexed: 12/19/2022] Open
Abstract
Children in the Peruvian Amazon Basin are at risk of soil-transmitted helminths (STH) infections. This study aimed to determine the prevalence of STH infection in children from a rural Amazonian community of Peru and to elucidate epidemiological risk factors associated with its perpetuation while on a school-based deworming program with mebendazole. Stool samples of children aged 2-14 years and their mothers were analyzed through direct smear analysis, Kato-Katz, spontaneous sedimentation in tube, Baermann's method, and agar plate culture. A questionnaire was administered to collect epidemiological information of interest. Among 124 children, 25.8% had one or more STH. Individual prevalence rates were as follows: Ascaris lumbricoides, 16.1%; Strongyloides stercoralis, 10.5%; hookworm, 1.6%; and Trichuris trichiura, (1.6%). The prevalence of common STH (A. lumbricoides, T. trichiura, and hookworm) was higher among children aged 2-5 years than older children (31.6% versus 12.8%; P = 0.01). In terms of sanitation deficits, walking barefoot was significantly associated with STH infection (OR = 3.28; CI 95% = 1.11-12.07). Furthermore, STH-infected children more frequently had a mother who was concomitantly infected by STH than the non-STH-infected counterpart (36.4% versus 14.1%, P = 0.02). In conclusion, STH infection is highly prevalent in children from this Amazonian community despite routine deworming. Institutional health policies may include hygiene and sanitation improvements and screening/deworming of mothers to limit the dissemination of STH. Further studies are needed to address the social and epidemiological mechanics perpetuating these infections.
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Affiliation(s)
- Renato A. Errea
- Instituto de Medicina Tropical “Alexander von Humboldt,” Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
| | - George Vasquez-Rios
- Instituto de Medicina Tropical “Alexander von Humboldt,” Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Maria L. Calderon
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Diego Siu
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kevin R. Duque
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luciana H. Juarez
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
- Scientific Society of Medical Students, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rodrigo Gallegos
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Celene Uriol
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
- Scientific Society of Medical Students, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Claudia R. Rondon
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Katia P. Baca
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rosario J. Fabian
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Marco Canales
- Instituto de Medicina Tropical “Alexander von Humboldt,” Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Angelica Terashima
- Instituto de Medicina Tropical “Alexander von Humboldt,” Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luis A. Marcos
- Instituto de Medicina Tropical “Alexander von Humboldt,” Universidad Peruana Cayetano Heredia, Lima, Peru
- Infectious Diseases Division, SUNY/Stony Brook University, Stony Brook, New York
| | - Frine Samalvides
- Instituto de Medicina Tropical “Alexander von Humboldt,” Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Infectious, Tropical and Dermatological Diseases, Hospital Cayetano Heredia, Lima, Peru
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Yang A, Bakhtari N, Langdon-Embry L, Redwood E, Grandjean Lapierre S, Rakotomanga P, Rafalimanantsoa A, De Dios Santos J, Vigan-Womas I, Knoblauch AM, Marcos LA. Kankanet: An artificial neural network-based object detection smartphone application and mobile microscope as a point-of-care diagnostic aid for soil-transmitted helminthiases. PLoS Negl Trop Dis 2019; 13:e0007577. [PMID: 31381573 PMCID: PMC6695198 DOI: 10.1371/journal.pntd.0007577] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 08/15/2019] [Accepted: 06/25/2019] [Indexed: 12/20/2022] Open
Abstract
Background Endemic areas for soil-transmitted helminthiases often lack the tools and trained personnel necessary for point-of-care diagnosis. This study pilots the use of smartphone microscopy and an artificial neural network-based (ANN) object detection application named Kankanet to address those two needs. Methodology/Principal findings A smartphone was equipped with a USB Video Class (UVC) microscope attachment and Kankanet, which was trained to recognize eggs of Ascaris lumbricoides, Trichuris trichiura, and hookworm using a dataset of 2,078 images. It was evaluated for interpretive accuracy based on 185 new images. Fecal samples were processed using Kato-Katz (KK), spontaneous sedimentation technique in tube (SSTT), and Merthiolate-Iodine-Formaldehyde (MIF) techniques. UVC imaging and ANN interpretation of these slides was compared to parasitologist interpretation of standard microscopy.Relative to a gold standard defined as any positive result from parasitologist reading of KK, SSTT, and MIF preparations through standard microscopy, parasitologists reading UVC imaging of SSTT achieved a comparable sensitivity (82.9%) and specificity (97.1%) in A. lumbricoides to standard KK interpretation (97.0% sensitivity, 96.0% specificity). The UVC could not accurately image T. trichiura or hookworm. Though Kankanet interpretation was not quite as sensitive as parasitologist interpretation, it still achieved high sensitivity for A. lumbricoides and hookworm (69.6% and 71.4%, respectively). Kankanet showed high sensitivity for T. trichiura in microscope images (100.0%), but low in UVC images (50.0%). Conclusions/Significance The UVC achieved comparable sensitivity to standard microscopy with only A. lumbricoides. With further improvement of image resolution and magnification, UVC shows promise as a point-of-care imaging tool. In addition to smartphone microscopy, ANN-based object detection can be developed as a diagnostic aid. Though trained with a limited dataset, Kankanet accurately interprets both standard microscope and low-quality UVC images. Kankanet may achieve sensitivity comparable to parasitologists with continued expansion of the image database and improvement of machine learning technology. For rainforest-enshrouded rural villages of Madagascar, soil-transmitted helminthiases are more the rule than the exception. However, the microscopy equipment and lab technicians needed for diagnosis are a distance of several days’ hike away. We piloted a solution for these communities by leveraging resources the villages already had: a traveling team of local health care workers, and their personal Android smartphones. We demonstrated that an inexpensive, commercially available microscope attachment for smartphones could rival the sensitivity and specificity of a regular microscope using standard field fecal sample processing techniques. We also developed an artificial neural network-based object detection Android application, called Kankanet, based on open-source programming libraries. Kankanet was used to detect eggs of the three most common soil-transmitted helminths: Ascaris lumbricoides, Trichuris trichiura, and hookworm. We found Kankanet to be moderately sensitive and highly specific for both standard microscope images and low-quality smartphone microscope images. This proof-of-concept study demonstrates the diagnostic capabilities of artificial neural network-based object detection systems. Since the programming frameworks used were all open-source and user-friendly even for computer science laymen, artificial neural network-based object detection shows strong potential for development of low-cost, high-impact diagnostic aids essential to health care and field research in resource-limited communities.
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Affiliation(s)
- Ariel Yang
- School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
- Global Health Institute, Stony Brook University, Stony Brook, New York, United States of America
- * E-mail:
| | - Nahid Bakhtari
- School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
- Global Health Institute, Stony Brook University, Stony Brook, New York, United States of America
| | - Liana Langdon-Embry
- School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
- Global Health Institute, Stony Brook University, Stony Brook, New York, United States of America
| | - Emile Redwood
- School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
- Global Health Institute, Stony Brook University, Stony Brook, New York, United States of America
| | - Simon Grandjean Lapierre
- Global Health Institute, Stony Brook University, Stony Brook, New York, United States of America
- Immunopathology axis, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
- Mycobacteria Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | | | | | | | - Inès Vigan-Womas
- Immunology of Infectious Diseases Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Astrid M. Knoblauch
- Global Health Institute, Stony Brook University, Stony Brook, New York, United States of America
- Mycobacteria Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Luis A. Marcos
- Global Health Institute, Stony Brook University, Stony Brook, New York, United States of America
- Department of Medicine, Stony Brook University, New York, United States of America
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Gétaz L, Castro R, Zamora P, Kramer M, Gareca N, Torrico-Espinoza MDC, Macias J, Lisarazu-Velásquez S, Rodriguez G, Valencia-Rivero C, Perneger T, Chappuis F. Epidemiology of Strongyloides stercoralis infection in Bolivian patients at high risk of complications. PLoS Negl Trop Dis 2019; 13:e0007028. [PMID: 30653489 PMCID: PMC6353209 DOI: 10.1371/journal.pntd.0007028] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 01/30/2019] [Accepted: 11/26/2018] [Indexed: 12/21/2022] Open
Abstract
Background Strongyloidiasis can be fatal in immunocompromised patients, but few epidemiological studies investigated the burden of this neglected tropical disease among these populations, particularly in low- and middle-income countries such as Bolivia. This study aimed to fill in this gap by estimating prevalence rate and risk factors associated with strongyloidiasis among patients at high risk of complications Methods A cross-sectional study was carried out in Santa Cruz (elevation 400 meters, tropical climate) and Cochabamba (elevation 2,500 meters, temperate climate), among patients with cancer, HIV infection and rheumatic or hematologic disease, using four coproparasitological techniques and one serological (ELISA) test. Results In total, 1,151 patients participated in this study, including individuals who were HIV-positive (30%) or with rheumatic (29%), oncologic (32%) or hematologic (9%) diseases. The serological and coproparasitological prevalence was 23.0% (95% confidence interval [CI], 20.7–25.5; n = 265/1151) and 7.6% (95% CI, 6.2–9.3; n = 88/1151), respectively, with an estimated actual prevalence of 20.2% (95% CI, 17.9–22.5). Positive serology and positive coproparasitology were associated with younger age and lower education levels. There was no significant difference in prevalence between Cochabamba and Santa Cruz as defined by coproparasitology (6.4% vs. 8.9%; p = 0.11) or serology (24.0% vs. 22.0%; p = 0.4). Among 64 patients in Cochabamba who had never travelled to the tropical lowlands, 5 (7.8%) had a positive coproparasitology. Conclusions Strongyloidiasis is widely prevalent in Bolivia among vulnerable patients at increased risk of life-threatening complications. Transmission of the parasite occurs both in tropical lowlands and temperate elevation (≥ 2,500 m). Control strategies to prevent transmission and complications of this serious parasitic disease should be urgently reinforced. Strongyloidiasis is an understudied chronic intestinal infection and one of the most overlooked of the neglected tropical diseases, particularly in countries such as Bolivia. The strongyloidiasis usually remains paucisymptomatic for decades in immunocompetent persons, but may lead to severe conditions with high mortality rates in immunocompromised individuals. We carried out a study to explore the epidemiology of strongyloidiasis among Bolivian patients with cancer, HIV infection, and rheumatic or hematologic diseases. Our study highlighted that strongyloidiasis was widely prevalent in tropical and inter-Andean temperate areas of Bolivia among patients at high risk of life-threatening complications. One in five participants was infected. We showed that strongyloidiasis was highly prevalent in both tropical and temperate regions. Improved access to adequate diagnosis, treatment, and preventive measures are therefore urgently required in Bolivia, and most likely elsewhere in the region. Treatment of uncomplicated strongyloidiasis is simple, highly effective, and potentially life-saving.
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Affiliation(s)
- Laurent Gétaz
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Division of Prison Health, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- * E-mail:
| | - Rosario Castro
- Division of Infectious Diseases, Hospital Clínico VIEDMA, Cochabamba, Bolivia
| | - Pablo Zamora
- Division of Parasitology, Centro Nacional de Enfermedades Tropicales (CENETROP), Santa Cruz, Bolivia
| | - Marcelo Kramer
- Center for Rheumatic Diseases M. Kramer, Santa Cruz, Bolivia
| | - Nestor Gareca
- Division of Rheumatology, Hospital Clínico VIEDMA, Cochabamba, Bolivia
| | | | - José Macias
- Division of Hematology & Oncology, Clinica Los Olivos, Cochabamba, Bolivia
| | - Susana Lisarazu-Velásquez
- Centro Departamental de Vigilancia y Referencia de Enfermedades de Transmisión Sexual ITS/VIH/SIDA (CDVIR), Santa Cruz, Bolivia
| | - Gloria Rodriguez
- Instituto Oncológico del Oriente Boliviano (IOOB), Santa Cruz, Bolivia
| | | | - Thomas Perneger
- Division of Clinical Epidemiology, Geneva University Hospitals, and Faculty of Medicine, University of Geneva, Switzerland
| | - François Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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Cunningham LJ, Odoom J, Pratt D, Boatemaa L, Asante-Ntim N, Attiku K, Banahene B, Osei-Atweneboana M, Verweij JJ, Molyneux D, Stothard RJ, Adams ER. Expanding molecular diagnostics of helminthiasis: Piloting use of the GPLN platform for surveillance of soil transmitted helminthiasis and schistosomiasis in Ghana. PLoS Negl Trop Dis 2018; 12:e0006129. [PMID: 29370166 PMCID: PMC5784883 DOI: 10.1371/journal.pntd.0006129] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/22/2017] [Indexed: 01/13/2023] Open
Abstract
The efforts to control and eradicate polio as a global health burden have been successful to the point where currently only three countries now report endemic polio, and the number of cases of polio continues to decrease. The success of the polio programme has been dependant on a well-developed network of laboratories termed the global polio laboratory network (GPLN). Here we explore collaborative opportunities with the GPLN to target two of the 18 diseases listed as a neglected tropical diseases (NTD) namely soil transmitted helminthiasis (STH) and Schistosomiasis (SCH). These were chosen based on prevalence and the use of faecal materials to identify both polio, STH and SCH. Our study screened 448 faecal samples from the Ghana GPLN using three triplex TaqMan assays to identify Ascaris lumbricoides, Necator americanus, Ancylostoma spp, Trichuris trchiura, Strongyloides stercoralis and Schistosoma spp. Our results found a combined helminth prevalence of 22%. The most common helminth infection was A. lumbricoides with a prevalence of 15% followed by N. americanus (5%), Ancylostoma spp. (2.5%), Schistosoma spp. (1.6%) and S. stercoralis (1%). These results show that it is possible to identify alternative pathogens to polio in the samples collected by the GPLN platform and to introduce new diagnostic assays to their laboratories. The diagnostic methods employed were also able to identify S. stercoralis positive samples, which are difficult to identify using parasitological methods such as Kato-Katz. This study raises the possibility of collaboration with the GPLN for the surveillance of a wider range of diseases which would both benefit the efforts to control the NTDs and also increase the scope of the GPLN as a diagnostic platform. The successful campaign being waged against polio has eliminated the disease from most countries where it was once endemic. With this success, it is anticipated that the disease will be eradicated in the coming years with only 37 cases being reported in 2016. Although the efforts to control polio are successful there are a number of low-profile, but no less serious disease, that are still highly prevalent throughout the world. These diseases have been termed the neglected tropical diseases (NTD) and this study aims to test the suitability of the Global Polio Laboratory Network (GPLN) as a platform to screen for two of the NTDs, soil transmitted helminthiasis (STH) and schistosomiasis (SCH). To test the suitability of the samples collected by the GPLN and the suitability of the laboratories themselves 448 samples from the Ghanaian GPLN laboratory were screened with multiplex TaqMan assays for the following six helminth types: Ascaris lumbricoides, Necator americanus, Ancylostoma spp, Trichuris trchiura, Strongyloides stercoralis and Schistosoma spp. Using this method this study was able to identify a prevalence of 22% for the combined helminth infection. The most common infection was A. lumbricoides with a prevalence of 15% followed by N. americanus (5%), Ancylostoma spp. (2.5%), Schistosoma spp. (1.6%) and S. stercoralis (1%). The success of this study indicates that this may be a cost-effective method to passively screen a country for STH and SCH and its success in identifying S. stercoralis infections makes it especially useful as this parasite is hard to identify using traditional surveillance techniques.
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Affiliation(s)
- Lucas J. Cunningham
- Parasitology Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- * E-mail:
| | - John Odoom
- Virology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | - Deborah Pratt
- Virology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | - Linda Boatemaa
- Virology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | - Nana Asante-Ntim
- Virology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | - Keren Attiku
- Virology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | - Bismarck Banahene
- Virology Department, Noguchi Memorial Institute for Medical Research, Accra, Ghana
| | - Mike Osei-Atweneboana
- Department of Environmental Biology and Health, Council for Scientific and Industrial Research, Accra, Ghana
| | - Jaco J. Verweij
- Laboratory for Medical Microbiology and Immunology, St Elisabeth Hospital, Tilburg, the Netherlands
| | - David Molyneux
- Parasitology Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Russell J. Stothard
- Parasitology Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Emily R. Adams
- Parasitology Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Abstract
PURPOSE OF REVIEW Cestodes infections in humans are among the most prevalent parasitosis worldwide. Although tapeworm infection is often asymptomatic, they can be associated with a range of symptoms. The landscape of cestode infections is changing with rapid diagnosis techniques and advanced molecular diagnosis aiding in identification of species specific epidemiology. RECENT FINDINGS Traditional descriptions of species by location have been challenged with molecular diagnostic techniques, which show variation in distribution of species, thought to be because of globalization and importation of disease. MAIN THEMES IN LITERATURE Epidemiology, molecular diagnostic techniques. SUMMARY Infection by tapeworms is often asymptomatic or accompanied by mild symptoms though can occasionally cause severe disease and contribute to anemia and malnutrition. Tapeworm infection is most prevalent in resource-poor countries but the distribution is worldwide. Epidemiology of infection is changing because of molecular diagnostics, which allow more accurate tracking of species.
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Affiliation(s)
- Camille Webb
- Division of Infectious Disease Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
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Cooper MT, Searing RA, Thompson DM, Bard D, Carabin H, Gonzales C, Zavala C, Woodson K, Naifeh M. Missing the Mark? A Two Time Point Cohort Study Estimating Intestinal Parasite Prevalence in Informal Settlements in Lima, Peru. Glob Pediatr Health 2017; 4:2333794X17739190. [PMID: 29152541 PMCID: PMC5680937 DOI: 10.1177/2333794x17739190] [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: 08/30/2017] [Accepted: 10/03/2017] [Indexed: 11/15/2022] Open
Abstract
Objectives: The World Health Organization's (WHO) recommendations list Peru as potentially needing prevention of soil-transmitted helminthiasis (STH). Prevalence of STH varies regionally and remains understudied in the newest informal settlements of the capital city, Lima. The purpose of this study was to evaluate the need for Mass Drug Administration (MDA) of antiparasitic drugs in the newest informal settlements of Lima. The aim of this study was to estimate the season-specific prevalence of STH to determine if these prevalence estimates met the WHO threshold for MDA in 3 informal settlements. Methods: A 2 time point cohort study was conducted among a sample of 140 children aged 1 to 10 years living in 3 purposively sampled informal settlements of Lima, Peru. Children were asked to provide 2 stool samples that were analyzed with the spontaneous sedimentation in tube technique. The season-specific prevalence proportions of MDA-targeted STH were estimated using a hidden (latent) Markov modeling approach to adjust for repeated measurements over the 2 seasons and the imperfect validity of the screening tests. Results: The prevalence of MDA targeted STH was low at 2.2% (95% confidence interval = 0.3% to 6%) and 3.8% (95% confidence interval = 0.7% to 9.3%) among children sampled in the summer and winter months, respectively, when using the most conservative estimate of test sensitivity. These estimates were below the WHO threshold for MDA (20%). Conclusions: Empiric treatment for STH by organizations active in the newest informal settlements is not supported by the data and could contribute to unnecessary medication exposures and poor allocation of resources.
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Affiliation(s)
| | - Rapha A Searing
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - David M Thompson
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - David Bard
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Hélène Carabin
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | | | - Kyle Woodson
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Monique Naifeh
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Oliveira-Arbex AP, David ÉB, Guimarães S. Blastocystis genetic diversity among children of low-income daycare center in Southeastern Brazil. INFECTION GENETICS AND EVOLUTION 2017; 57:59-63. [PMID: 29126996 DOI: 10.1016/j.meegid.2017.11.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 10/03/2017] [Accepted: 11/07/2017] [Indexed: 10/18/2022]
Abstract
Blastocystis, an unicellular anaerobic eukaryote, is known to be a very common intestinal parasite found in humans and animals fecal samples worldwide. Currently, there is an increasing interest to yield insights into its prevalence and diversity in human populations living in poor and deprived areas. In this study, we describe the prevalence and genetic variability of Blastocystis isolates obtained from daycare center attendees aged 0 to 6years and staff, as well as some children family members and their dogs in a low-income community in São Paulo State, Brazil. A total of 181 stool samples (123 from daycare children, 14 from workers, 44 from household members and 20 from dogs) were submitted to DNA extraction, tested by polymerase chain reaction (PCR) targeting the SSUrDNA gene and the amplicons retrieved were sequenced. The prevalence of Blastocystis was 40.7% (50/123) in children, 28.6% (4/14) in workers and 50% (22/44) in household members. No dog was found positive. Of the 76 PCR products generated, 57 were successfully sequenced. Four subtypes were identified and the most common were ST1 (54.4%) and ST3 (33.3%), followed by ST2 (7.0%) and ST7 (5.3%). The intra-subtype analysis revealed a total of 10 different alleles previously reported. No statistically significant correlation was observed between subtypes and sociodemographic variables analyzed. Here, the following findings must be highlighted: (1) predominance of subtypes 1 and 3, a pattern that has been observed in many populations worldwide; (2) absence of ST4, a common subtype in Europe but rarely detected in South America's human populations and, (3) human infection with ST7, a subtype primarily found in birds but occasionally seen in human infections, raising the possibility of zoonotic transmission.
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Affiliation(s)
- Ana Paula Oliveira-Arbex
- Parasitology Department, Institute of Bioscience, São Paulo State University (UNESP), Campus de Botucatu, Botucatu, São Paulo, Brazil
| | - Érica Boarato David
- Parasitology Department, Institute of Bioscience, São Paulo State University (UNESP), Campus de Botucatu, Botucatu, São Paulo, Brazil; Sagrado Coração University (USC), Department of Health Sciences, Bauru, São Paulo, Brazil
| | - Semíramis Guimarães
- Parasitology Department, Institute of Bioscience, São Paulo State University (UNESP), Campus de Botucatu, Botucatu, São Paulo, Brazil.
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Barreto RE, Narváez J, Sepúlveda NA, Velásquez FC, Díaz SC, López MC, Reyes P, Moncada LI. Combination of five diagnostic tests to estimate the prevalence of hookworm infection among school-aged children from a rural area of colombia. Acta Trop 2017; 173:160-170. [PMID: 28619671 DOI: 10.1016/j.actatropica.2017.05.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 05/06/2017] [Accepted: 05/26/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Public health programs for the control of soil-transmitted helminthiases require valid diagnostic tests for surveillance and parasitic control evaluation. However, there is currently no agreement about what test should be used as a gold standard for the diagnosis of hookworm infection. Still, in presence of concurrent data for multiple tests it is possible to use statistical models to estimate measures of test performance and prevalence. The aim of this study was to estimate the diagnostic accuracy of five parallel tests (direct microscopic examination, Kato-Katz, Harada-Mori, modified Ritchie-Frick, and culture in agar plate) to detect hookworm infections in a sample of school-aged children from a rural area in Colombia. METHODS AND RESULTS We used both, a frequentist approach, and Bayesian latent class models to estimate the sensitivity and specificity of five tests for hookworm detection, and to estimate the prevalence of hookworm infection in absence of a Gold Standard. The Kato-Katz and agar plate methods had an overall agreement of 95% and kappa coefficient of 0.76. Different models estimated a sensitivity between 76% and 92% for the agar plate technique, and 52% to 87% for the Kato-Katz technique. The other tests had lower sensitivity. All tests had specificity between 95% and 98%. The prevalence estimated by the Kato-Katz and Agar plate methods for different subpopulations varied between 10% and 14%, and was consistent with the prevalence estimated from the combination of all tests. The Harada-Mori, Ritchie-Frick and direct examination techniques resulted in lower and disparate prevalence estimates. Bayesian approaches assuming imperfect specificity resulted in lower prevalence estimates than the frequentist approach.
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Aragon S, Valero J, Jaramillo LE. Intestinal mass in a one year old child: An unusual presentation of Strongyloides stercolaris infection. Case report. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2017. [DOI: 10.1016/j.epsc.2017.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Cabada MM, Morales ML, Lopez M, Reynolds ST, Vilchez EC, Lescano AG, Gotuzzo E, Garcia HH, White AC. Hymenolepis nana Impact Among Children in the Highlands of Cusco, Peru: An Emerging Neglected Parasite Infection. Am J Trop Med Hyg 2016; 95:1031-1036. [PMID: 27672206 DOI: 10.4269/ajtmh.16-0237] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/05/2016] [Indexed: 11/07/2022] Open
Abstract
Hymenolepis nana is the most common cestode infection in the world. However, limited information is available regarding its impact on affected populations. We studied the epidemiology and symptoms associated with hymenolepiasis among children 3-16 years old in 16 rural communities of the highlands of the Cusco region in Peru. Information on demographics, socioeconomic status, symptoms as reported by parents, and parasitological testing was obtained from the database of an ongoing Fasciola hepatica epidemiologic study. A total of 1,230 children were included in the study. Forty-five percent were infected with at least one pathogenic intestinal parasite. Giardia spp. (22.9%) was the most common, followed by Hymenolepis (17.4%), Fasciola (14.1%), Ascaris lumbricoides (6.1%), and Strongyloides stercoralis (2%). The prevalence of Hymenolepis infection varied by community, by other parasitic infections, and by socioeconomic status. However, only years of education of the mother, use of well water, and age less than 10 years were associated with Hymenolepis infection in the multivariate analysis. Hymenolepis nana infection was associated with diarrhea, jaundice, headaches, fever, and fatigue. Children with > 500 eggs/g of stool were more likely to have symptoms of weight loss, jaundice, diarrhea, and fever. Hymenolepis nana infection and age were the only factors retained in the multivariate analysis modeling diarrhea. Hymenolepiasis is a common gastrointestinal helminth in the Cusco region and is associated with significant morbidity in children in rural communities. The impact caused by the emergence of Hymenolepis as a prevalent intestinal parasite deserves closer scrutiny.
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Affiliation(s)
- Miguel M Cabada
- Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas. .,Universidad Peruana Cayetano Heredia-University of Texas Medical Branch Collaborative Research Center-Cusco, Cusco, Peru
| | - Maria Luisa Morales
- Universidad Peruana Cayetano Heredia-University of Texas Medical Branch Collaborative Research Center-Cusco, Cusco, Peru
| | - Martha Lopez
- Universidad Peruana Cayetano Heredia-University of Texas Medical Branch Collaborative Research Center-Cusco, Cusco, Peru
| | - Spencer T Reynolds
- Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Elizabeth C Vilchez
- Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Andres G Lescano
- School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eduardo Gotuzzo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hector Hugo Garcia
- Departamento de Microbiologia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - A Clinton White
- Infectious Diseases Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
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Sungkar S, Pohan APN, Ramadani A, Albar N, Azizah F, Nugraha ARA, Wiria AE. Heavy burden of intestinal parasite infections in Kalena Rongo village, a rural area in South West Sumba, eastern part of Indonesia: a cross sectional study. BMC Public Health 2015; 15:1296. [PMID: 26702820 PMCID: PMC4690433 DOI: 10.1186/s12889-015-2619-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 12/16/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Intestinal parasitic infections (IPIs) are one of the major public health problems, especially in the rural area of developing countries with low socio-economic status and poor sanitation. The study was aimed to determine the prevalence of IPIs among the inhabitants of a rural area in South West Sumba, eastern part of Indonesia. METHODS A cross-sectional study was done in Kalena Rongo village, South West Sumba in April 2014. Stool samples were collected and examined for IPIs using direct smear method. RESULTS Faecal samples were collected from 424 of 473 inhabitants of the village, age 2 months to 80 years. About 95.5 % (405/424) of the participants had any IPIs. The most prevalent parasites found were Ascaris lumbricoides 65.8 % (279/424), Trichuris trichiura 60.4 % (256/424), hookworms 53.5 % (227/424), Blastocystis hominis 34.4 % (146/424), Entamoeba histolytica 17.9 % (76/424), and Giardia lamblia 4.5 % (19/424). The villagers used no latrine and defecated in their backyard. Clean water sources were scarce and far from the village. CONCLUSIONS In Kalena Rongo village, the rural area in eastern part of Indonesia, the finding of IPIs was conspicuous and therefore expressed the poor hygiene and absence of proper sanitation in the area. Integrated efforts, such as improving infrastructure to provide clean water source and educating the inhabitants for appropriate hygienic lifestyle are needed.
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Affiliation(s)
- Saleha Sungkar
- Department of Parasitology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Anggi P N Pohan
- Department of Parasitology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Antari Ramadani
- Department of Parasitology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Nafisah Albar
- Department of Parasitology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Fitri Azizah
- Department of Parasitology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Antonius R A Nugraha
- Department of Parasitology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Aprilianto E Wiria
- Department of Parasitology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia. .,Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.
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Abstract
Soil-transmitted helminths (STHs) infect over one billion people worldwide. Ascariasis may mimic a number of conditions, and individual clinical diagnosis often requires a thorough work-up. Kato-Katz thick smears are the standard detection method for Ascaris and, despite low sensitivity, are often used for mapping and monitoring and evaluation of national control programmes. Although increased sampling (number of stools) and diagnostic (number of examinations per stool) efforts can improve sensitivity, Kato-Katz is less sensitive than other microscopy methods such as FLOTAC®. Antibody-based diagnostics may be a sensitive diagnostic tool; however, their usefulness is limited to assessing transmission in areas aiming for elimination. Molecular diagnostics are highly sensitive and specific, but high costs limit their use to individual diagnosis, drug - efficacy studies and identification of Ascaris suum. Increased investments in research on Ascaris and other STHs are urgently required for the development of diagnostic assays to support efforts to reduce human suffering caused by these infections.
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Cimino RO, Jeun R, Juarez M, Cajal PS, Vargas P, Echazú A, Bryan PE, Nasser J, Krolewiecki A, Mejia R. Identification of human intestinal parasites affecting an asymptomatic peri-urban Argentinian population using multi-parallel quantitative real-time polymerase chain reaction. Parasit Vectors 2015; 8:380. [PMID: 26183074 PMCID: PMC4504406 DOI: 10.1186/s13071-015-0994-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 07/07/2015] [Indexed: 11/29/2022] Open
Abstract
Background In resource-limited countries, stool microscopy is the diagnostic test of choice for intestinal parasites (soil-transmitted helminths and/or intestinal protozoa). However, sensitivity and specificity is low. Improved diagnosis of intestinal parasites is especially important for accurate measurements of prevalence and intensity of infections in endemic areas. Methods The study was carried out in Orán, Argentina. A total of 99 stool samples from a local surveillance campaign were analyzed by concentration microscopy and McMaster egg counting technique compared to the analysis by multi-parallel quantitative real-time polymerase chain reaction (qPCR). This study compared the performance of qPCR assay and stool microscopy for 8 common intestinal parasites that infect humans including the helminths Ascaris lumbricoides, Ancylostoma duodenale, Necator americanus, Strongyloides stercoralis, Trichuris trichiura, and the protozoa Giardia lamblia, Cryptosporidium parvum/hominis, and Entamoeba histolytica, and investigated the prevalence of polyparasitism in an endemic area. Results qPCR showed higher detection rates for all parasites as compared to stool microscopy except T. trichiura. Species-specific primers and probes were able to distinguish between A. duodenale (19.1 %) and N. americanus (36.4 %) infections. There were 48.6 % of subjects co-infected with both hookworms, and a significant increase in hookworm DNA for A. duodenale versus N. americanus (119.6 fg/μL: 0.63 fg/μL, P < 0.001) respectively. qPCR outperformed microscopy by the largest margin in G. lamblia infections (63.6 % versus 8.1 %, P < 0.05). Polyparasitism was detected more often by qPCR compared to microscopy (64.7 % versus 24.2 %, P < 0.05). Conclusions Multi-parallel qPCR is a quantitative molecular diagnostic method for common intestinal parasites in an endemic area that has improved diagnostic accuracy compared to stool microscopy. This first time use of multi-parallel qPCR in Argentina has demonstrated the high prevalence of intestinal parasites in a peri-urban area. These results will contribute to more accurate epidemiological survey, refined treatment strategies on a public scale, and better health outcomes in endemic settings.
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Affiliation(s)
- Rubén O Cimino
- Instituto de Investigaciones en Enfermedades Tropicales - Universidad Nacional de Salta/CONICET, Oran, Argentina. .,Cátedra de Química Biológica, Facultad de Ciencias Naturales, Universidad Nacional de Salta, Oran, Argentina.
| | - Rebecca Jeun
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA.
| | - Marisa Juarez
- Instituto de Investigaciones en Enfermedades Tropicales - Universidad Nacional de Salta/CONICET, Oran, Argentina. .,Fundación Mundo Sano, Buenos Aires, Argentina.
| | - Pamela S Cajal
- Instituto de Investigaciones en Enfermedades Tropicales - Universidad Nacional de Salta/CONICET, Oran, Argentina.
| | - Paola Vargas
- Instituto de Investigaciones en Enfermedades Tropicales - Universidad Nacional de Salta/CONICET, Oran, Argentina.
| | - Adriana Echazú
- Instituto de Investigaciones en Enfermedades Tropicales - Universidad Nacional de Salta/CONICET, Oran, Argentina.
| | - Patricia E Bryan
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA.
| | - Julio Nasser
- Instituto de Investigaciones en Enfermedades Tropicales - Universidad Nacional de Salta/CONICET, Oran, Argentina. .,Cátedra de Química Biológica, Facultad de Ciencias Naturales, Universidad Nacional de Salta, Oran, Argentina.
| | - Alejandro Krolewiecki
- Instituto de Investigaciones en Enfermedades Tropicales - Universidad Nacional de Salta/CONICET, Oran, Argentina.
| | - Rojelio Mejia
- Cátedra de Química Biológica, Facultad de Ciencias Naturales, Universidad Nacional de Salta, Oran, Argentina. .,National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA.
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Alfredo Fernández-Niño J, David Ramírez J, Consuelo López M, Inés Moncada L, Reyes P, Darío Heredia R. Agreement of the Kato-Katz test established by the WHO with samples fixed with sodium acetate analyzed at 6 months to diagnose intestinal geohelminthes. Acta Trop 2015; 146:42-4. [PMID: 25771113 DOI: 10.1016/j.actatropica.2015.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 03/03/2015] [Accepted: 03/04/2015] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the performance of the Kato-Katz test (WHO version) with stool samples from a rural area, fixed with sodium acetate (SAF). The Kato-Katz test was used to compare unfixed samples (conventional test) with the same samples containing SAF fixative at time 0 and at 6 months. The study included stools from 154 subjects. A marginally statistically significant decrease in prevalence was estimated only for hookworm, when comparing unfixed samples versus the SAF fixed samples read at 6 months (p=0.06). A significant reduction in parasite load was found for hookworm (p<0.01) and Trichuris trichiura (p<0.01) between the unfixed and the fixed sample read at 6 months, but not for Ascaris lumbricoides (p=0.10). This research suggests that the SAF fixative solution is a good option for transporting samples for diagnosis, especially in rural areas in developing countries.
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Affiliation(s)
- Julián Alfredo Fernández-Niño
- Centro de Información para Decisiones en Salud Pública (CENIDSP), Instituto Nacional de Salud Pública, Cuernavaca (Morelos), Mexico; Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.
| | - Juan David Ramírez
- Grupo de Investigaciones Microbiológicas - UR (GIMUR), Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Myriam Consuelo López
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Ligia Inés Moncada
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Patricia Reyes
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Rubén Darío Heredia
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
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Buonfrate D, Formenti F, Perandin F, Bisoffi Z. Novel approaches to the diagnosis of Strongyloides stercoralis infection. Clin Microbiol Infect 2015; 21:543-52. [PMID: 25887711 DOI: 10.1016/j.cmi.2015.04.001] [Citation(s) in RCA: 147] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/31/2015] [Accepted: 04/01/2015] [Indexed: 12/23/2022]
Abstract
Strongyloides stercoralis differs from the other soil-transmitted helminths because it puts infected subjects at risk of a fatal syndrome (in cases of immunosuppression for medical conditions, immunosuppressant therapies, or both). Chronic strongyloidiasis is often a non-severe condition, or is sometimes even asymptomatic, but diagnosis and effective therapy are essential in order to eradicate the infection and the life-long risk involved. Therefore, diagnostic methods need to be highly sensitive. Stool microscopy and the Kato-Katz technique are commonly used in prevalence studies, but they are inadequate for S. stercoralis detection. This is probably the main reason why the global prevalence has long been underestimated. Concentration methods, the Baermann technique and Koga agar plate culture have better, but still unsatisfactory, sensitivity. Serological tests have demonstrated higher sensitivity; although some authors have concerns about their specificity, it is possible to define cut-off values over which infection is almost certain. In particular, the luciferase immunoprecipitation system technique combined with a recombinant antigen (NIE) demonstrated a specificity of almost 100%. ELISA coproantigen detection has also shown promising results, but still needs full evaluation. Molecular diagnostic methods are currently available in a few referral centres as in-house techniques. In this review, on the basis of the performance of the different diagnostic methods, we outline diagnostic strategies that could be proposed for different purposes, such as: prevalence studies in endemic areas; individual diagnosis and screening; and monitoring of cure in clinical care and clinical trials.
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Affiliation(s)
- D Buonfrate
- Centre for Tropical Diseases, Sacro Cuore Hospital, Negrar, Verona, Italy
| | - F Formenti
- Centre for Tropical Diseases, Sacro Cuore Hospital, Negrar, Verona, Italy
| | - F Perandin
- Centre for Tropical Diseases, Sacro Cuore Hospital, Negrar, Verona, Italy
| | - Z Bisoffi
- Centre for Tropical Diseases, Sacro Cuore Hospital, Negrar, Verona, Italy.
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Toledo R, Muñoz-Antoli C, Esteban JG. Strongyloidiasis with emphasis on human infections and its different clinical forms. ADVANCES IN PARASITOLOGY 2015; 88:165-241. [PMID: 25911368 DOI: 10.1016/bs.apar.2015.02.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Strongyloidiasis (caused by Strongyloides stercoralis, and to a lesser extent by Strongyloides fuelleborni) is one of the most neglected tropical diseases with endemic areas and affecting more than 100 million people worldwide. Chronic infections in endemic areas can be maintained for decades through the autoinfective cycle with the L3 filariform larvae. In these endemic areas, misdiagnosis, inadequate treatment and the facilitation of the hyperinfection syndrome by immunosuppression are frequent and contribute to a high mortality rate. Despite the serious health impact of strongyloidiasis, it is a neglected disease and very little is known about this parasite and the disease when compared to other helminth infections. Control of the disease is difficult because of the many gaps in our knowledge of strongyloidiasis. We examine the recent literature on different aspects of strongyloidiasis with emphasis in those aspects that need further research.
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Affiliation(s)
- Rafael Toledo
- Departamento de Parasitología, Universidad de Valencia, Valencia, Spain
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BUONFRATE D, MENA MA, ANGHEBEN A, REQUENA-MENDEZ A, MUÑOZ J, GOBBI F, ALBONICO M, GOTUZZO E, BISOFFI Z. Prevalence of strongyloidiasis in Latin America: a systematic review of the literature. Epidemiol Infect 2015; 143:452-60. [PMID: 24990510 PMCID: PMC9507070 DOI: 10.1017/s0950268814001563] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Strongyloides stercoralis is rarely recognized as a major public health issue, probably because its burden is largely underestimated. We reviewed the literature (both PubMed and 'grey' literature) about the prevalence of strongyloidiasis in Latin America, an area of presumable high endemicity. There were finally 88 papers involved in the analysis, covering the period between 1981 and 2011. Studies were heterogeneous in several aspects, such as the populations screened and the diagnostic methods used. Most of the studies relied on direct coproparasitological examination, which has low sensitivity for the detection of S. stercoralis larvae. The following countries presented areas of high prevalence (>20%): Argentina, Ecuador, Venezuela, Peru and Brazil. Globally, for most of the included countries it was not possible to define reliable data because of paucity and/or inadequacy of studies. S. stercoralis requires specific diagnostic methods for its detection; therefore, surveys should be specifically designed in order to avoid underestimation of the infection.
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Affiliation(s)
- D. BUONFRATE
- Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
| | - M. A. MENA
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - A. ANGHEBEN
- Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
- Author for correspondence: Dr A. Angheben, Centre for Tropical Diseases, Hospital Sacro Cuore – Don Calabria, Via Don Sempreboni 5, 37024 Negrar, Italy. ()
| | - A. REQUENA-MENDEZ
- Barcelona Centre for International Health Research (CRESIB, Hospital Clínic – Universitat de Barcelona), Barcelona, Spain
| | - J. MUÑOZ
- Barcelona Centre for International Health Research (CRESIB, Hospital Clínic – Universitat de Barcelona), Barcelona, Spain
| | - F. GOBBI
- Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
| | - M. ALBONICO
- Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
| | - E. GOTUZZO
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Z. BISOFFI
- Centre for Tropical Diseases (CTD), Sacro Cuore Hospital, Negrar, Verona, Italy
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Barros N, Montes M. Infection and Hyperinfection with Strongyloides stercoralis: Clinical Presentation, Etiology of Disease, and Treatment Options. CURRENT TROPICAL MEDICINE REPORTS 2014. [DOI: 10.1007/s40475-014-0030-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Pak BJ, Vasquez-Camargo F, Kalinichenko E, Chiodini PL, Nutman TB, Tanowitz HB, McAuliffe I, Wilkins P, Smith PT, Ward BJ, Libman MD, Ndao M. Development of a rapid serological assay for the diagnosis of strongyloidiasis using a novel diffraction-based biosensor technology. PLoS Negl Trop Dis 2014; 8:e3002. [PMID: 25102174 PMCID: PMC4125104 DOI: 10.1371/journal.pntd.0003002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 05/31/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Strongyloidiasis is a persistent human parasitic infection caused by the intestinal nematode, Strongyloides stercoralis. The parasite has a world-wide distribution, particularly in tropical and subtropical regions with poor sanitary conditions. Since individuals with strongyloidiasis are typically asymptomatic, the infection can persist for decades without detection. Problems arise when individuals with unrecognized S. stercoralis infection are immunosuppressed, which can lead to hyper-infection syndrome and disseminated disease with an associated high mortality if untreated. Therefore a rapid, sensitive and easy to use method of diagnosing Strongyloides infection may improve the clinical management of this disease. METHODOLOGY/PRINCIPAL FINDINGS An immunological assay for diagnosing strongyloidiasis was developed on a novel diffraction-based optical bionsensor technology. The test employs a 31-kDa recombinant antigen called NIE derived from Strongyloides stercoralis L3-stage larvae. Assay performance was tested using retrospectively collected sera from patients with parasitologically confirmed strongyloidiasis and control sera from healthy individuals or those with other parasitoses including schistosomiasis, trichinosis, echinococcosis or amebiasis who were seronegative using the NIE ELISA assay. If we consider the control group as the true negative group, the assay readily differentiated S. stercoralis-infected patients from controls detecting 96.3% of the positive cases, and with no cross reactivity observed in the control group These results were in excellent agreement (κ = 0.98) with results obtained by an NIE-based enzyme-linked immunosorbent assay (ELISA). A further 44 sera from patients with suspected S. stercoralis infection were analyzed and showed 91% agreement with the NIE ELISA. CONCLUSIONS/SIGNIFICANCE In summary, this test provides high sensitivity detection of serum IgG against the NIE Strongyloides antigen. The assay is easy to perform and provides results in less than 30 minutes, making this platform amenable to rapid near-patient screening with minimal technical expertise.
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Affiliation(s)
| | - Fabio Vasquez-Camargo
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Peter L. Chiodini
- Department of Clinical Parasitology, Hospital for Tropical Diseases, University College London Hospitals, London, United Kingdom
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas B. Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Herbert B. Tanowitz
- Department of Pathology Medicine, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Isabel McAuliffe
- US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Patricia Wilkins
- US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Brian J. Ward
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- J.D. MacLean Centre for Tropical Diseases, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Michael D. Libman
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- J.D. MacLean Centre for Tropical Diseases, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Momar Ndao
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- J.D. MacLean Centre for Tropical Diseases, Department of Medicine, McGill University, Montreal, Quebec, Canada
- * E-mail:
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Nikolay B, Brooker SJ, Pullan RL. Sensitivity of diagnostic tests for human soil-transmitted helminth infections: a meta-analysis in the absence of a true gold standard. Int J Parasitol 2014; 44:765-74. [PMID: 24992655 PMCID: PMC4186778 DOI: 10.1016/j.ijpara.2014.05.009] [Citation(s) in RCA: 173] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 05/19/2014] [Accepted: 05/20/2014] [Indexed: 01/19/2023]
Abstract
A Bayesian latent class meta-analysis of diagnostic tests for soil-transmitted helminths was performed. Overall sensitivity of evaluated diagnostic tests was low. Test performance was strongly influenced by intensity of infection. FLOTAC method sensitivity was highest overall and in both intensity groups. The performance of the Kato-Katz method in high intensity settings was acceptable.
Reliable, sensitive and practical diagnostic tests are an essential tool in disease control programmes for mapping, impact evaluation and surveillance. To provide a robust global assessment of the relative performance of available diagnostic tools for the detection of soil-transmitted helminths, we conducted a meta-analysis comparing the sensitivities and the quantitative performance of the most commonly used copro-microscopic diagnostic methods for soil-transmitted helminths, namely Kato-Katz, direct microscopy, formol-ether concentration, McMaster, FLOTAC and Mini-FLOTAC. In the absence of a perfect reference standard, we employed a Bayesian latent class analysis to estimate the true, unobserved sensitivity of compared diagnostic tests for each of the soil-transmitted helminth species Ascaris lumbricoides, Trichuris trichiura and the hookworms. To investigate the influence of varying transmission settings we subsequently stratified the analysis by intensity of infection. Overall, sensitivity estimates varied between the different methods, ranging from 42.8% for direct microscopy to 92.7% for FLOTAC. The widely used double slide Kato-Katz method had a sensitivity of 74–95% for the three soil-transmitted helminth species at high infection intensity, however sensitivity dropped to 53–80% in low intensity settings, being lowest for hookworm and A. lumbricoides. The highest sensitivity, overall and in both intensity groups, was observed for the FLOTAC method, whereas the sensitivity of the Mini-FLOTAC method was comparable with the Kato-Katz method. FLOTAC average egg count estimates were significantly lower compared with Kato-Katz, while the compared McMaster counts varied. In conclusion, we demonstrate that the Kato-Katz and Mini-FLOTAC methods had comparable sensitivities. We further show that test sensitivity of the Kato-Katz method is reduced in low transmission settings.
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Affiliation(s)
- Birgit Nikolay
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HT London, United Kingdom.
| | - Simon J Brooker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HT London, United Kingdom
| | - Rachel L Pullan
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HT London, United Kingdom
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Cabada MM, Lopez M, Arque E, Clinton White A. Prevalence of soil-transmitted helminths after mass albendazole administration in an indigenous community of the Manu jungle in Peru. Pathog Glob Health 2014; 108:200-5. [PMID: 24934795 PMCID: PMC4069337 DOI: 10.1179/2047773214y.0000000142] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Few data are available on the epidemiology of soil-transmitted helminths (STHs) in indigenous populations of the Peruvian Amazon. While albendazole is being increasingly used in deworming campaigns, few data exist on the impact of mass drug administration in isolated populations. We studied the prevalence of STHs, anemia, and malnutrition in a Matsigenka ethnic group from the Peruvian Amazon. Participants had received two doses of albendazole on consecutive days, 3 months before and again 2 weeks before data collection. Overall, 290 subjects were included. Most were female (53.7%) and 63.9% were ≤19 years old. Half of the participants had helminth infections. Trichiuris (30.2%), hookworm (19.1%), Ascaris (17.7%), and Strongyloides (5.6%) were the most common helminths. Other helminth ova included Capillaria hepatica and Fasciola-like eggs. Subjects of 5-19 years (51.8 %) and 20-35 years (68.6 %) old had helminths more often than those under 5 years (38%) and older than 35 years (41.5%) (P = 0.02). Anemia was detected in 41% of children and this was more common in children under 5 years that in those of 5-19 years [odd ratio (OR) = 5.68; 95% CI: 2.71-11.88]. Overall, 72.1% of children were malnourished. Stunting was common in children (70.7%), but wasting was not (2.9%). Despite repeated albendazole administration, this population continued to have a high prevalence of STHs, anemia, and malnutrition. In addition, we detected unusual organisms and organisms that do not respond to albendazole. Further studies are needed to assess the rationale and efficacy of mass chemotherapy for STHs in the Amazon.
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Marcos LA, Machicado JD. Soil-transmitted helminth infections in South America. THE LANCET. INFECTIOUS DISEASES 2014; 14:183. [PMID: 24571969 DOI: 10.1016/s1473-3099(13)70695-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Luis A Marcos
- Infection Prevention Department, Forrest General Hospital, Hattiesburg, MS, USA.
| | - Jorge D Machicado
- Department of Internal Medicine, University of Texas Health Science Center, Houston, TX, USA
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El Safadi D, Gaayeb L, Meloni D, Cian A, Poirier P, Wawrzyniak I, Delbac F, Dabboussi F, Delhaes L, Seck M, Hamze M, Riveau G, Viscogliosi E. Children of Senegal River Basin show the highest prevalence of Blastocystis sp. ever observed worldwide. BMC Infect Dis 2014; 14:164. [PMID: 24666632 PMCID: PMC3987649 DOI: 10.1186/1471-2334-14-164] [Citation(s) in RCA: 173] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 03/19/2014] [Indexed: 02/09/2024] Open
Abstract
Background Blastocystis sp. is currently the most common intestinal protist found in human feces and considered an emerging parasite with a worldwide distribution. Because of its potential impact in public health, we reinforced the picture of Blastocystis sp. prevalence and molecular subtype distribution in Africa by performing the first survey of this parasite in Senegal. Methods Stool samples from 93 symptomatic presenting with various gastrointestinal disorders or asymptomatic children living in three villages of the Senegal River Basin were tested for the presence of Blastocystis sp. by non-quantitative and quantitative PCR using primer pairs targeting the SSU rDNA gene. Positive samples were subtyped to investigate the frequency of Blastocystis sp. subtypes in our cohort and the distribution of subtypes in the symptomatic and asymptomatic groups of children. Results By the use of molecular tools, all 93 samples were found to be positive for Blastocystis sp. indicating a striking parasite prevalence of 100%. Mixed infections by two or three subtypes were identified in eight individuals. Among a total of 103 subtyped isolates, subtype 3 was most abundant (49.5%) followed by subtype 1 (28.2%), subtype 2 (20.4%) and subtype 4 (1.9%). Subtype 3 was dominant in the symptomatic group while subtypes 1 and 2 were detected with equal frequency in both symptomatic and asymptomatic groups. The distribution of subtypes was compared with those available in other African countries and worldwide. Comparison confirmed that subtype 4 is much less frequently detected or absent in Africa while it is commonly found in Europe. Potential sources of Blastocystis sp. infection including human-to-human, zoonotic, and waterborne transmissions were also discussed. Conclusions The prevalence of Blastocystis sp. in our Senegalese population was the highest prevalence ever recovered worldwide for this parasite by reaching 100%. All cases were caused by subtypes 1, 2, 3 and 4 with a predominance of subtype 3. More than half of the children infected by Blastocystis sp. presented various gastrointestinal disorders. Such high prevalence of blastocystosis in developing countries makes its control a real challenge for public health authorities.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Eric Viscogliosi
- Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille (CIIL), Inserm U1019, CNRS UMR 8204, Université Lille Nord de France, 1 rue du Professeur Calmette, BP 245, 59019 Lille cedex, France.
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Verhagen LM, Incani RN, Franco CR, Ugarte A, Cadenas Y, Sierra Ruiz CI, Hermans PWM, Hoek D, Campos Ponce M, de Waard JH, Pinelli E. High malnutrition rate in Venezuelan Yanomami compared to Warao Amerindians and Creoles: significant associations with intestinal parasites and anemia. PLoS One 2013; 8:e77581. [PMID: 24143243 PMCID: PMC3797096 DOI: 10.1371/journal.pone.0077581] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 09/03/2013] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Children in rural areas experience the interrelated problems of poor growth, anemia and parasitic infections. We investigated the prevalence of and associations between intestinal helminth and protozoan infections, malnutrition and anemia in school-age Venezuelan children. METHODS This cross-sectional study was conducted in 390 children aged 4-16 years from three rural areas of Venezuela: the Amazon Region, Orinoco Delta and Carabobo State. Stool samples were collected for direct parasitic examinations. Anthropometric indicators of chronic (height-for-age Z score) and acute (weight-for-height and Body Mass Index (BMI)-for-age Z score in respectively children under 5 years of age and children aged 5 years and above) malnutrition were calculated. Multivariate linear and logistic regression models were built to determine factors associated with nutritional status and polyparasitism. RESULTS Hookworm and Strongyloides stercoralis prevalences were highest in children from the Amazon rainforest (respectively 72% and 18%) while children from the Orinoco Delta and Carabobo State showed higher rates of Ascaris lumbricoides (respectively 28% and 37%) and Trichuris trichiura (40% in both regions). The prevalence of Giardia lamblia infection was not significantly different between regions (average: 18%). Anemia prevalence was highest in the Amazon Region (24%). Hemoglobin levels were significantly decreased in children with a hookworm infection. Malnutrition was present in respectively 84%, 30% and 13% of children from the Amazon Region, Orinoco Delta and Carabobo State. In multivariate analysis including all regions, G. lamblia and helminth infections were significantly and negatively associated with respectively height-for-age and weight-for-height/BMI-for-age Z scores. Furthermore, hemoglobin levels were positively associated with the height-for-age Z score (0.11, 95% CI 0.02 - 0.20). CONCLUSIONS In rural populations in Venezuela helminthiasis and giardiasis were associated with acute and chronic nutritional status respectively. These data highlight the need for an integrated approach to control transmission of parasites and improve the health status of rural Venezuelan children.
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Affiliation(s)
- Lilly M. Verhagen
- Laboratorio de Tuberculosis, Instituto de Biomedicina, Universidad Central de Venezuela, Caracas, Venezuela
- Laboratory of Pediatric Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Renzo N. Incani
- Departamento de Parasitología, Facultad de Ciencias de la Salud, Universidad de Carabobo, Valencia, Venezuela
| | - Carolina R. Franco
- Departamento de Pediatría, Hospital de Niños ‘J.M. de los Ríos’, Caracas, Venezuela
| | - Alejandra Ugarte
- Escuela de Bioanálisis, Universidad Central de Venezuela, Caracas, Venezuela
| | - Yeneska Cadenas
- Escuela de Bioanálisis, Universidad Central de Venezuela, Caracas, Venezuela
| | - Carmen I. Sierra Ruiz
- Laboratorio de Tuberculosis, Instituto de Biomedicina, Universidad Central de Venezuela, Caracas, Venezuela
| | - Peter W. M. Hermans
- Laboratory of Pediatric Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Denise Hoek
- Center for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Maiza Campos Ponce
- Department of Health Sciences, VU University, Amsterdam, The Netherlands
| | - Jacobus H. de Waard
- Laboratorio de Tuberculosis, Instituto de Biomedicina, Universidad Central de Venezuela, Caracas, Venezuela
| | - Elena Pinelli
- Center for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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Bisoffi Z, Buonfrate D, Montresor A, Requena-Méndez A, Muñoz J, Krolewiecki AJ, Gotuzzo E, Mena MA, Chiodini PL, Anselmi M, Moreira J, Albonico M. Strongyloides stercoralis: a plea for action. PLoS Negl Trop Dis 2013; 7:e2214. [PMID: 23675546 PMCID: PMC3649953 DOI: 10.1371/journal.pntd.0002214] [Citation(s) in RCA: 189] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Zeno Bisoffi
- Centre for Tropical Diseases, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy.
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Wang JX, Pan CS, Cui LW. Application of a real-time PCR method for detecting and monitoring hookworm Necator americanus infections in Southern China. Asian Pac J Trop Biomed 2012; 2:925-9. [PMID: 23593570 PMCID: PMC3621466 DOI: 10.1016/s2221-1691(13)60001-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Accepted: 11/17/2012] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To develop a quantitative PCR method for detecting hookworm infection and quantification. METHODS A real-time PCR method was designed based on the intergenic region II of ribosomal DNA of the hookworm Necator americanus. The detection limit of this method was compared with the microscopy-based Kato-Katz method. The real-time PCR method was used to conduct an epidemiological survey of hookworm infection in southern Fujian Province of China. RESULTS The real-time PCR method was specific for detecting Necator americanus infection, and was more sensitive than conventional PCR or microscopy-based method. A preliminary survey for hookworm infection in villages of Fujian Province confirmed the high prevalence of hookworm infections in the resident populations. In addition, the infection rate in women was significantly higher than that of in men. CONCLUSIONS A real-time PCR method is designed, which has increased detection sensitivity for more accurate epidemiological studies of hookworm infections, especially when intensity of the infection needs to be considered.
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Affiliation(s)
- Jia-Xu Wang
- Department of Microbiology, Xiamen Centre for Disease Control and Prevention, Xiamen 361021, Fujian, China
- School of Life Science, Xiamen University, Xiamen 361005, Fujian, China
| | - Cang-Sang Pan
- School of Life Science, Xiamen University, Xiamen 361005, Fujian, China
| | - Li-Wang Cui
- Department of Entomology, the Pennsylvania State University, 501 ASI Building, University Park, PA 16802, USA
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