Viability of six species of larval and non-larval helminth eggs for different conditions of temperature, pH and dryness

Thermosensory behaviors of the free-living life stages of Strongyloides species support parasitism in tropical environments

Soil-transmitted parasitic nematodes infect over 1 billion people worldwide and are a common source of neglected disease. Strongyloides stercoralis is a potentially fatal skin-penetrating human parasite that is endemic to tropical and subtropical regions around the world. The complex life cycle of Strongyloides species is unique among human-parasitic nematodes in that it includes a single free-living generation featuring soil-dwelling, bacterivorous adults whose progeny all develop into infective larvae. The sensory behaviors that enable free-living Strongyloides adults to navigate and survive soil environments are unknown. S. stercoralis infective larvae display parasite-specific sensory-driven behaviors, including robust attraction to mammalian body heat. In contrast, the free-living model nematode Caenorhabditis elegans displays thermosensory behaviors that guide adult worms to stay within a physiologically permissive range of environmental temperatures. Do S. stercoralis and C. elegans free-living adults, which experience similar environmental stressors, display common thermal preferences? Here, we characterize the thermosensory behaviors of the free-living adults of S. stercoralis as well as those of the closely related rat parasite, Strongyloides ratti. We find that Strongyloides free-living adults are exclusively attracted to near-tropical temperatures, despite their inability to infect mammalian hosts. We further show that lifespan is shorter at higher temperatures for free-living Strongyloides adults, similar to the effect of temperature on C. elegans lifespan. However, we also find that the reproductive potential of the free-living life stage is enhanced at warmer temperatures, particularly for S. stercoralis. Together, our results reveal a novel role for thermotaxis to maximize the infectious capacity of obligate parasites and provide insight into the biological adaptations that may contribute to their endemicity in tropical climates.

Synergistic effects of using sodium hypochlorite (bleach) and desiccation in surface inactivation for Toxocara spp

Toxocara cati and T. canis are parasitic nematodes found in the intestines of cats and dogs respectively, with a cosmopolitan distribution, and the potential for anthropozoonotic transmission, resulting in human toxocariasis. Spread of Toxocara spp. is primarily through the ingestion of embryonated eggs contaminating surfaces or uncooked food, or through the ingestion of a paratenic host containing a third-stage larva. The Toxocara spp. eggshell is composed of a lipid layer providing a permeability barrier, a chitinous layer providing structural strength, and thin vitelline and uterine layers, which combined create a biologically resistant structure, making the Toxocara spp. egg very hardy, and capable of surviving for years in the natural environment. The use of sodium hypochlorite, household bleach, as a disinfectant for Toxocara spp. eggs has been reported, with results varying from ineffective to limited effectiveness depending on parameters including contact time, concentration, and temperature. Desiccation or humidity levels have also been reported to have an impact on larval development and/or survival of Toxocara spp. eggs. However, to date, after a thorough search of the literature, no relevant publications have been found that evaluated the use of sodium hypochlorite and desiccation in combination. These experiments aim to assess the effects of using a combination of desiccation and 10% bleach solution (0.6% sodium hypochlorite) on fertilized or embryonated eggs of T. cati, T. canis, and T. vitulorum. Results of these experiments highlight the synergistic effects of desiccation and bleach, and demonstrate a relatively simple method for surface inactivation, resulting in a decrease in viability or destruction of T. cati, T. canis and T. vitulorum eggs. Implications for these findings may apply to larger scale elimination of ascarid eggs from both research, veterinary, and farming facilities to mitigate transmission.

Wildlife parasitology: sample collection and processing, diagnostic constraints, and methodological challenges in terrestrial carnivores

Wild terrestrial carnivores play a crucial role as reservoir, maintenance, and spillover hosts for a wide parasite variety. They may harbor, shed, and transmit zoonotic parasites and parasites of veterinary importance for domestic hosts. Although wild carnivores are globally distributed and comprise many different species, some living in close proximity to human settlements, only a few studies have investigated parasites of wild terrestrial carnivores using non-specific techniques. Access to samples of wild carnivores may be challenging as some species are protected, and others are secretive, possibly explaining the data paucity. Considering the importance of wild carnivores' health and ecological role, combined with the lack of specific diagnostic methodologies, this review aims to offer an overview of the diagnostic methods for parasite investigation in wild terrestrial carnivores, providing the precise techniques for collection and analysis of fecal, blood, and tissue samples, the environmental impact on said samples, and the limitations researchers currently face in analyzing samples of wild terrestrial carnivores. In addition, this paper offers some crucial information on how different environmental factors affect parasite detection postmortem and how insects can be used to estimate the time of death with a specific highlight on insect larvae. The paper contains a literature review of available procedures and emphasizes the need for diagnostic method standardization in wild terrestrial carnivores.

Study of helminth eggs ( Ascaris suum) inactivation by anaerobic digestion and electrochemical treatment

Background

The use of insufficiently treated wastewater or Faecal sludge in agriculture raises concerns because of the pathogen content. Helminth eggs (HE) are one of the most crucial pathogens for ensuring public health and safety. Widely used disinfection treatment methods do not guarantee the complete inactivation of helminth eggs. The current study evaluated the effectiveness of anaerobic digestion and electrochemical process on helminth ( Ascaris suum) egg inactivation.

Methods

Lab-scale biochemical methane potential (BMP) assay was conducted by spiking A. suum eggs in a serum bottle. Total solid (TS), volatile solid (VS), pH, biogas production and its composition, and volatile fatty acids (VFA) were analyzed along with A. suum inactivation every third day for the initial 15 days and fifth day for 45 days. In the second set of experiments, a hypochlorite (4700 ppm) solution was generated by electrolysis of aqueous NaCl solution in a membrane-less electrochemical cell. The hypochlorite was diluted (940, 470, 235, and 156ppm) in wastewater, spiked with A. suum eggs and then examined for inactivation at regular intervals.

Results

The results of the anaerobic digestion treatment documented 98% inactivation of A. suum eggs (0.15 eggs/mL) in 35 days and remained at 0.14 eggs/mL until day 45. Correlation analysis revealed a positive relationship between non-viable eggs and pH and a negative relationship with all the other parameters. Electrochemical treatment achieved 10% inactivation at 940 ppm concentration in 24h.

Conclusions

This study revealed that the inactivation of A. suum eggs by anaerobic digestion or electrochemical treatment is a combined effect of more than one parameter.

Epidemiology of protozoan and helminthic parasites in wild passerine birds of Britain and Ireland

Avian endoparasites play important roles in conservation, biodiversity and host evolution. Currently, little is known about the epidemiology of intestinal helminths and protozoans infecting wild birds of Britain and Ireland. This study aimed to determine the rates of parasite prevalence, abundance and infection intensity in wild passerines. Fecal samples (n = 755) from 18 bird families were collected from 13 sites across England, Wales and Ireland from March 2020 to June 2021. A conventional sodium nitrate flotation method allowed morphological identification and abundance estimation of eggs/oocysts. Associations with host family and age were examined alongside spatiotemporal and ecological factors using Bayesian phylogenetically controlled models. Parasites were detected in 20.0% of samples, with corvids and finches having the highest prevalences and intensities, respectively. Syngamus (33%) and Isospora (32%) were the most prevalent genera observed. Parasite prevalence and abundance differed amongst avian families and seasons, while infection intensity varied between families and regions. Prevalence was affected by diet diversity, while abundance differed by host age and habitat diversity. Infection intensity was higher in birds using a wider range of habitats, and doubled in areas with feeders present. The elucidation of these patterns will increase the understanding of parasite fauna in British and Irish birds.

Potentials and challenges in the isolation and detection of ascarid eggs in complex environmental matrices

Ascarid infections constitute a major concern for both human and animal health risk assessment. Although being effectively transmitted by soil, water and contaminated food, reliable detection of ascarid eggs in environmental media often remains challenging. However, contamination of the environment with ascarid ova has gained more attention as a decisive part of proper risk assessment in recent years. Due to various factors, such as sample matrices, dissociation detergents and flotation solutions, defined and standardised protocols for the isolation of eggs from complex environmental matrices are difficult to establish and therefore limited. Thus, this study reviews common techniques used for the recovery of ascarid eggs from environmental media with special emphasis on sampling strategies, purification procedures and microscopic as well as molecular detection of egg contamination. Despite various advancements, mainly in the field of molecular methods leading to more reliable and sensitive detection, it can be concluded that there is still a need for unified guidelines for sampling and recovery of ascarid eggs derived from complex environmental matrices.

Using quantitative PCR to identify opportunities to strengthen soil-transmitted helminth control in Solomon Islands: A cross-sectional epidemiological survey

Background

The Kato-Katz microscopy technique is the global standard for assessment of soil-transmitted helminth (STH) burden. However, major limitations include its poor sensitivity, requirement for rapid sample processing, and inability to differentiate hookworm species nor detect Strongyloides spp. infections. We assessed the prevalence and intensity of STH species in Solomon Islands by conducting a province-wide survey using quantitative PCR (qPCR) for diagnosis, which can provide much better characterisation of STH burden than microscopy.

Methodology/Principal findings

We conducted a cross-sectional survey in 18 villages in Western Province to detect infections with six STH species and quantify intensity with three. We used linear mixed model regression to identify potential water, sanitation, and hygiene (WASH) and environmental risk factors for infection. We collected stool specimens from 830 village residents. Overall STH prevalence was 63.3% (range 27.5 to 91.5% across villages), led by Necator americanus (54.5% [range 17.5–89.4%]), followed by Ancylostoma ceylanicum (15.5% [range 2.8–45.8%]), Trichuris trichiura (9.1% [range 0–79.2%]), and Strongyloides spp. (3.2% [range 0–29.2%]). Most infections were of light intensity for N. americanus (85.7%) and T. trichiura (90.7%). Owning a household latrine was associated with a lower risk of N. americanus infection (AOR 0.41, 95% CI 0.24–0.68) while greater precipitation was linked to more common T. trichiura infection (AOR 1.14, 95% CI 1.04–1.25).

Conclusion/Significance

In this first large-scale population survey of STH in the Pacific using qPCR, we found evidence that ivermectin should be incorporated into STH control programmes because of the presence of T. trichiura and Strongyloides spp., both of which are poorly responsive to albendazole. Furthermore, One Health strategies are needed for improved A. ceylanicum and Strongyloides spp. control, WASH access and use should be improved to complement deworming programmes, and control efforts should ideally be expanded to entire communities.

Trial registration

ClinicalTrials.gov Australian and New Zealand Clinical Trials Registry ACTRN12618001086257.

Routine assessments of the burden of intestinal worm infections rely on microscopy-based diagnostic methods, such as the Kato-Katz technique. However major limitations include its poor sensitivity, requirement for rapid sample processing, and inability to differentiate individual hookworm species and detect Strongyloides spp. infections. It is important to assess the burden of each of these infections to design control approaches beyond the current core strategy of albendazole preventive chemotherapy. Use of qPCR for diagnosis could address these gaps because it can distinguish all relevant intestinal worm species. We completed a province-wide intestinal worm infections prevalence survey using qPCR in Western Province, Solomon Islands. Overall prevalence was extremely high (62.5%). We identified a high burden of Necator americanus (54.5%) and detected Ancylostoma ceylanicum (15.5%), Trichuris trichiura (9.1%), and Strongyloides spp. (3.2%) infections. Increased age and precipitation were associated with higher prevalence of infection, while owning a household latrine was associated with lower odds of N. americanus infection. Our findings support the need to incorporate ivermectin into deworming programmes for Strongyloides spp. and T. trichiura control as these species are poorly responsive to albendazole, implement One Health strategies to address the zoonotic A. ceylanicum and Strongyloides spp., and expand control efforts to reach entire communities. WASH access should also be improved to complement deworming programmes.

Vertebrates as uninfected disseminators of helminth eggs and larvae

The passive dispersal of non-mobile organisms by vertebrates (zoochory) is a common mechanism used to explain their often widespread distribution. Transport occurs either internally via the vertebrate digestive tract (endozoochory), or externally be adhering to skin, feathers or fur (ectozoochory), and its success is due to both physiological and ecological factors associated with the disseminating 'hosting' animal. Helminth eggs and larvae are generally non-mobile stages that are largely dependent on the movement of another animal, typically a host, for geographical dissemination. Studies on the zoochory of helminths by vertebrates are extensive and particularly long-standing, stretching back to the 19th century, although this literature is often overlooked when considering the biogeography of parasites. This review assesses the potential of helminths to be dispersed passively by zoochory examining evidence from both laboratory and field studies. The physiological dynamics of the vertebrate intestines and skin surface as hostile environments, as well as the characteristics of eggs and larvae which may facilitate successful transport are evaluated. The various mechanisms of helminth endo- and ectozoochory are presented and the likelihood of long-distance dispersal determined. It is concluded that zoochory is a potentially important means of disseminating parasites.

A critical review on sludge management from onsite sanitation systems: A knowledge to be revised in the current situation

Access to safe excreta disposal is a basic human right and an essential element of human development. Developing countries (like India) have constructed millions of toilets with on-site sanitation technologies (OSTs). However, these OSTs lack the required management system for collection, transportation and disposal of Faecal Sludge (FS, sludge getting accumulated in OST), leading to considerable water and soil pollution. The major challenge in FS Management is the collation of scattered data and concentrated experiences (i.e., existing knowledge remains with the practitioners in the field without a written record). Therefore, a critical review of existing knowledge on OST, FS collection, transportation, and its utilisation is essential. This study highlighted shortcomings associated with existing OST, FS collection, transportation, and treatment systems. Furthermore, this study provided a framework for appropriate selection of OST based on available sanitation chains, and a critical analysis of FS characteristics (i.e., total solids, pH, electrical conductivity, biological oxygen demand, chemical oxygen demand, and pathogens of FS ranged from 830 to 72000 mg/L, 6.8 to 7.8, 1.9 to 3.5 mS/cm, 500-5000 mg/L, 100 to 49,000 mg/L, and 10⁶ to 10⁷ E-coli and 10³ to 10⁴ parasitic worms per litre of FS, respectively) to design treatment systems for FS utilisation as a resource in agricultural, aqua-culture, and construction application.

Association between water and sanitation service levels and soil-transmitted helminth infection risk factors: a cross-sectional study in rural Rwanda

BACKGROUND

Soil-transmitted helminth (STH) infections are one of the most prevalent neglected tropical diseases in the world. Drug treatment is the preferred method for infection control yet reinfection occurs rapidly, so water and sanitation represent important complementary barriers to transmission.

METHODS

A cross-sectional study was conducted to observe STH risk factors in rural Rwandan households in relation to the Sustainable Development Goal for water and sanitation service levels. Survey and observation data were collected from 270 households and 67 water sources in rural Rwanda and were processed in relation to broader risk factors identified from the literature for the role of water and sanitation in STH infection pathways.

RESULTS

A significant association between higher water and sanitation service levels and lower STH infection risk profiles was found for both water and sanitation. However, variability existed within service level classifications.

CONCLUSIONS

Greater granularity within service level assessments is required to more precisely assess the efficacy of water and sanitation interventions in reducing STH infection risks.

Statistical Regression Model of Water, Sanitation, and Hygiene; Treatment Coverage; and Environmental Influences on School-Level Soil-Transmitted Helminths and Schistosome Prevalence in Kenya: Secondary Analysis of the National Deworming Program Data

According to the Kenya National School-Based Deworming program launched in 2012 and implemented for the first 5 years (2012-2017), the prevalence of soil-transmitted helminths (STH) and schistosomiasis substantially reduced over the mentioned period among the surveyed schools. However, this reduction is heterogeneous. In this study, we aimed to determine the factors associated with the 5-year school-level infection prevalence and relative reduction (RR) in prevalence in Kenya following the implementation of the program. Multiple variables related to treatment, water, sanitation, and hygiene (WASH) and environmental factors were assembled and included in mixed-effects linear regression models to identify key determinants of the school location STH and schistosomiasis prevalence and RR. Reduced prevalence of Ascaris lumbricoides was associated with low (< 1%) baseline prevalence, seven rounds of treatment, high (50-75%) self-reported coverage of household handwashing facility equipped with water and soap, high (20-25°C) land surface temperature, and community population density of 5-10 people per 100 m2. Reduced hookworm prevalence was associated with low (< 1%) baseline prevalence and the presence of a school feeding program. Reduced Trichuris trichiura prevalence was associated with low (< 1%) baseline prevalence. Reduced Schistosoma mansoni prevalence was associated with low (< 1%) baseline prevalence, three treatment rounds, and high (> 75%) reported coverage of a household improved water source. Reduced Schistosoma haematobium was associated with high aridity index. Analysis indicated that a combination of factors, including the number of treatment rounds, multiple related program interventions, community- and school-level WASH, and several environmental factors had a major influence on the school-level infection transmission and reduction.

Effectiveness of helminth egg reduction by solar drying and liming of sewage sludge

The present study is aimed at assessing the effectiveness of solar drying process in terms of helminth egg reduction in sewage sludge (SS) generated from an activated sludge wastewater treatment plant (WWTP) in Marrakesh city (Morocco). It is also engaged to highlight a synergic effect of liming (1% CaO) and solar drying on helminth egg reduction. The solar drying process was conducted for 45 days, in summer under a semi-arid climate in a pilot scale polycarbonate-based tunnel (2 m³). Before undergoing solar drying process, data showed an important load of helminth eggs including Ascaris sp., Schistosoma spp., Capillaria spp., Trichuris spp., Ankylostome spp., Toxocara spp., and Taenia spp. in limed sludge (LS) and non-limed sludge (NLS) (15.2 and 17.9 eggs/g, respectively). Ascaris eggs were the most abundant (11.2 and 13.5 eggs/g in LS and NLS, respectively). By the end of the solar drying process, a considerable removal of the total helminth eggs was recorded in LS and NLS (92.8% and 91.6%, respectively). A complete removal of Schistosoma spp., Capillaria spp., Trichuris spp., Toxocara spp. and Taenia spp. was noted in LS and NLS. In the case of Ankylostome spp., data showed a total removal in LS and 81% in NLS; however, the final load is in agreement with the standards (0.4 egg/g). As for Ascaris spp., neither liming nor solar drying process allowed a complete removal (91% and 90% in NLS and LS, respectively) and the final load (1.1 egg/g) does not fulfill the WHO requirements for an agricultural use. Principal component analysis (PCA) demonstrated a negative correlation between dry matter (DM) content (hence temperature) and helminth egg concentration. No significant synergic effect of liming and solar drying process was showed by statistical analysis. This is substantiating that temperature is the key parameter involved in helminth egg removal while undergoing solar drying of SS.

The survival and dispersal of Taenia eggs in the environment: what are the implications for transmission? A systematic review

Taenia spp. are responsible for a substantial health and economic burden in affected populations. Knowledge of the fate of the eggs of Taenia spp. in the environment and of other factors facilitating the transmission of eggs to intermediate hosts is important for the control/elimination of infections caused by Taenia spp. The aim of this systematic review was to summarize current knowledge of the factors influencing the survival and dispersal of Taenia spp. eggs in the environment. Publications retrieved from international databases were systematically reviewed. Of the 1465 papers initially identified, data were ultimately extracted from 93 papers. The results of this systematic review indicate that survival is favoured at moderate temperatures (0-20 °C). Humidity seems to affect the survival of Taenia spp. eggs more than temperature. Under field circumstances, Taenia spp. eggs have been found to survive for up to 1 year. Taenia spp. eggs are commonly found on vegetables (0.9-30%) and in soil and water samples (0-43%), with their presence posing a risk to the consumer. Invertebrates may act as transport hosts, transferring the infection to an intermediate host, but the importance of this route of transmission is still open to question. Wastewater treatment systems are not capable of entirely eliminating Taenia spp. eggs. Access to surface water and the use of sewage sludge as fertilizer on pastures are important risk factors for bovine cysticercosis. Although information on the survival and spread of Taenia spp. eggs is available, in general the data retrieved and reviewed in this article were old, focused on very specific geographical regions and may not be relevant for other areas or not specific for different Taenia spp. Furthermore, it is unknown whether egg survival differs according to Taenia sp. Future studies are necessary to identify sustainable methods to identify and inactivate parasite eggs in the environment and reduce their spread.

Does the Introduction of Alien Species Represent a Sanitary Threat for Native Species? The Case of the Eastern Cottontail Sylvilagus floridanus in Italy

Introduction of alien species is a well-known threat to biodiversity. Where newly introduced, alien species may pose a risk for the local ecological community by competing for resources or by introducing pathogens. Sylvilagus floridanus is an American lagomorph introduced into Europe in the second half of 20th century, for hunting. This study evaluated the structure and epidemiological characteristics of the gastrointestinal parasite community in an introduced population of S. floridanus in the Province of Alessandria (Piedmont Region-Italy). Three alien parasites were reported out of 271 animals: Obeliscoides cuniculi in the stomach, Trichostrongylus calcaratus in the small intestine, and Passarulus nonnanulatus in the large intestine. All these nematodes are commonly reported in S. floridanus in its natural range, but they represent alien species in Europe. The report of these alien parasites is an example of the unexpected consequences caused by the introduction of non-native vertebrates. The documented introduction of new pathogens may alter the parasite community of the native lagomorphs, with possible long-term effects on local ecological dynamics.

Prevalence and intensity of neglected tropical diseases (schistosomiasis and soil-transmitted helminths) amongst rural female pupils in Ugu district, KwaZulu-Natal, South Africa

Background

Inadequate water supply and sanitation adversely affects the health and socio-economic development of communities and places them at risk of contracting schistosomiasis and soil-transmitted helminths (STHs). The aim of this study was to quantify the prevalence and intensity of schistosomiasis (bilharzia) and STHs amongst female school-going pupils in Ugu district.

Methods

A descriptive cross-sectional study was conducted in Ugu district amongst primary school pupils from 18 randomly selected schools in 2010. A structured questionnaire was used to collect information on the history and knowledge of bilharzia of 1057 pupils. One stool and 3 consecutive days of urine samples were collected per participant and screened for helminth ova. Findings were compared with those reported by the parasite control programme, which collected data in the same area in 1998.

Results

The prevalence of Ascaris lumbricoides and Trichuris trichiura was 25% and 26%, respectively, and their corresponding mean intensities of infection were 21 and 26 eggs per gram. The prevalence of Schistosoma haematobium was 32%, and its mean intensity of infection was 52 eggs per 10 mL urine. Of the pupils, 60% knew about schistosomiasis, 9% reported red urine in the past week and 22% had had dysuria before. Although the prevalence of ascariasis and trichuriasis had decreased since 1998 (62% and 59%, respectively), the prevalence of schistosomiasis had increased to 32% (p < 0.05).

Conclusion

Female pupils in rural schools remain at risk. A mass treatment campaign, increased public awareness and improved sanitation are required to reduce these infections and sustain a reduction of STHs and schistosomiasis.

Keywords

prevalence; intensity; schistosomiasis; soil-transmitted helminths; Ascaris lumbricoides; Trichuris trichiura; Schistosoma haematobium; parasite control programme; water contact.

Quick incubation process to determine inactivation of Ascaris and Toxocara eggs

Helminth eggs are among the most important biological contaminants in environmental engineering. They pose a significant health risk associated with poor sanitation, the use of contaminated water for irrigation, and the disposal of excreta or sludge to land. Helminths are parasitic worms transmitted to humans via their eggs, which is the infective stage of their life cycle. They are therefore relevant to public health and environmental fields due to their low infectious dose, their persistence in the environment (up to several years), and their high resistance to conventional disinfection processes. The evaluation of the efficiency of any process of inactivation, through the determination of the viability of these parasites, is fundamental, but the traditional incubation technique requires 20 days to determine both the viability and the infectivity of nematode eggs. However, the present study found that, using an inactivation process at a temperature of 60 °C for 1 hour and incubation at 28 °C and 34 °C, the absence of division of the nucleus of eggs of species from two genera, Ascaris lumbricoides and Toxocara canis, showed them to be inactivated following only 48 hours of incubation. Similar inactivation results were observed using an automatic system as long as the eggs were inactivated. The minimum time required to evaluate the inactivation of nematode eggs through the incubation technique was 48 hours.

Current time-temperature relationships for thermal inactivation of Ascaris eggs at mesophilic temperatures are too conservative and may hamper development of simple, but effective sanitation

Ascaris eggs are commonly used as indicators for pathogen inactivation during the treatment of fecal sludge and wastewater due to their highly resistant lipid membrane and ability to survive in the environment for long periods of time. Current guidelines suggest that thermal treatment alone cannot inactivate Ascaris eggs at temperatures below 45 °C, although some evidence in the literature suggests this to be incorrect. Here, we performed a controlled experiment to test the effect of mesophilic temperatures on Ascaris inactivation. We exposed Ascaris suum eggs to a temperature gradient between 34°C and 45 °C under anaerobic and aerobic conditions to observe the required exposure times for a 3-log reduction. Indeed, we found that temperatures lower than 45 °C did inactivate these eggs, and the required exposure times were up to two orders of magnitude shorter than suggested by current guidelines. Results from the anaerobic exposures were used to develop a time-temperature relationship that is appropriate for Ascaris inactivation at mesophilic temperatures. Data from the literature demonstrated that our relationship is conservative, with faster inactivation occurring under environmental conditions when Ascaris eggs were suspended in fecal sludge or manure. A specific aerobic relationship was not developed, but we demonstrated that aerobic conditions cause faster inactivation than anaerobic conditions. Therefore, the anaerobic relationship provides a conservative guideline for both conditions. We demonstrate that relatively low temperatures can considerably impact Ascaris viability and suggest that mesophilic temperatures can be used in waste treatment processes to inactivate pathogens. The development of safe, low-input, mesophilic treatment processes is particularly valuable for ensuring universal access to safe sanitation and excreta management.

Intestinal parasites in six Islamic medieval period latrines from 10th-11th century Córdoba (Spain) and 12th-13th century Mértola (Portugal)

OBJECTIVE

To investigate the types of intestinal parasites that infected people living in Islamic period southern Iberia (al-Andalus), and compare with other regions of Europe.

MATERIALS

Four cesspits from 10^th-11^th century CE Córdoba (Spain), and two from 12^th-13^th century Mértola (Portugal).

METHODS

Sediment from each cesspit was analyzed using digital light microscopy and enzyme-linked immunosorbent assay (ELISA).

RESULTS

Analysis revealed eggs of roundworm (Ascaris lumbricoides) in every cesspit analyzed, but no evidence of other species of helminth or protozoal parasites.

CONCLUSION

Differences were noted between parasite species found in Mediterranean Europe and northern Europe, where a range of zoonotic parasites were endemic alongside sanitation-related parasites. We suggest that the scarcity of zoonotic parasites in southern Europe in the medieval period may reflect contrasts in climate between northern and southern Europe.

SIGNIFICANCE

The repeated identification of roundworm eggs suggests that al-Andalus was less hygienic than historically depicted. We did not note a difference between parasites found in Muslim and Christian regions of Iberia, and the predominance of parasites spread by fecal contamination of food is consistent with past research.

LIMITATIONS

The eggs of some species of parasite are fragile, so may theoretically have been present in the population but did not survive for us to identify them.

SUGGESTIONS FOR FURTHER RESEARCH

To further investigate the role of climate upon the parasites that affected past human populations.

A Review on the Current Knowledge and Prospects for the Development of Improved Detection Methods for Soil-Transmitted Helminth Ova for the Safe Reuse of Wastewater and Mitigation of Public Health Risks

Climate change, increase in population and scarcity of freshwater have led to a global demand for wastewater reuse in irrigation. However, wastewater has to be treated in order to minimize the presence of pathogens, in particular, the ova of soil-transmitted helminthes (STHs). Limiting the transmission via removal of STH ova, accurate assessment of risks and minimizing the exposure to the public have been recommended by health regulators. The World Health Organization (WHO) guideline specifies a limit of ≤1 ova/L for safe wastewater reuse. Additionally, the Australian Guidelines for Water recycling (AGWR) recommend a hydraulic retention time of over 25 days in a lagoon or stabilization pond to ensure a 4 log reduction value of helminth ova and to mitigate soil-transmitted helminths associated risks to humans. However, the lack of fast and sensitive methods for assessing the concentration of STH ova in wastewater poses a considerable challenge for an accurate risk assessment. Consequently, it has been difficult to control soil-transmitted helminthiasis despite effective mass drug administration. This limitation can be overcome with the advent of novel techniques for the detection of helminth ova. Therefore, this review presents an assessment of the current methods to detect the viable ova of soil-transmitted helminths in wastewater. Furthermore, the review focuses on the perspectives for the emerging state-of-the-art research and developments that have the potential to replace currently available conventional and polymerase chain reaction based methods and achieve the guidelines of the WHO in order to allow the safe reuse of wastewater for non-potable applications, thereby minimizing public health risks.

Sludge nematodes, cestodes, and trematodes eggs variation from lagooning, activated sludge and infiltration-percolation wastewater treatment system under semi-arid climate

The prevalence and the identification of the helminth eggs load of raw sewage sludge was assessed of three different wastewater treatment systems. The results showed a variety of parasite species with following average concentrations; five taxa belonging to three classes nematodes, cestodes and trematodes were inventoried. The class of nematodes is the most diverse with 5 taxa. It is represented by the eggs of Ascaris sp., Capillaria sp., Trichuris sp., Toxocara sp., and Ankylostome sp., then comes the cestodes class, this is represented by the eggs of Tænia sp. The trematode class is represented by Schistosoma sp. The lagooning station of Chichaoua shows the highest load 7 species with Ascaris 21 eggs/g; Capillaria sp., 11 eggs/g; Trichuris sp., 6 eggs/g; Toxocara sp., 2 eggs/g and Ankylostome sp., 1 egg/g; Taenia sp., 2eggs/g; and Schistosoma sp., 1 egg/g. Infiltration-percolation sludge show the presence of 4 species of helminths eggs in sludge from anaerobic settling with different rates: 15 eggs/g for Ascaris sp., 15 eggs/g for Trichuris sp., 13 eggs/g for Capillaria sp., and 8 eggs/g for Taenia sp. However, in sand filter pool, the sludge helminth eggs load was decreased by 47% of Ascaris sp., 85% of Capillaria sp., and 75% of Taenia sp., Nevertheless, an increase of Trichuris eggs load was noted in the second sludge by 17%. Five helminth eggs was detected in primary sludge coming from decantation pools in activated sludge plant in Marrakech, that is Ascaris sp., with a load of 16 eggs/g; Capillaria sp., with 3 eggs/g, Trichuris eggs with 2 eggs/g; Taenia sp., with 4 eggs/g; and Schistosoma sp., with 2 eggs/g. The abatement load of Ascaris sp. with 81% and Schistosoma and Taenia sp., with 100% was noted in biological sludge. Nevertheless, an increase load of Capillaria and Trichuris eggs 81% and 75% respectively was observed in this sludge coming from biological pools. The distribution of parasitic helminth eggs is linked to the differences in demographic and socio-economic status, seasonal variation, physico-chemical characteristic of helminth eggs, and the purification wastewater system performance.

The inactivation of Ascaris suum eggs by short exposure to high temperatures

Ascaris sp. is the most prominent and resilient helminth of human health importance found in faecal sludge, making Ascaris sp. an ideal index organism for inactivation testing. Heat treatment destroys helminths,allowingfor safe handling and possible reuse of sludge. Technology developmentfocuses on rapid heating to minimize equipment size and cost. This study evaluates Ascaris suum eggs' viability with short heating time. Ascaris eggs were placed in a water bath at temperatures from 60 to 80 °C for various exposure times (5 seconds to 4 minutes) and were immediately processed and analysed via light microscopy. For all samples within these temperature and time ranges, less than 10% viable eggs were recovered. For 70, 75 and 80 °C, complete inactivation was observed for exposure time of 5 seconds and above.

Design, synthesis and biological evaluation of imidazo[1,2-a]pyridine analogues or derivatives as anti-helmintic drug

The Albendazole was used as the lead compound, which was modified by structural transformation and with alkyl groups. A total of 18 compounds (4a-4r) were designed and synthesized. The in vitro experiment results showed that compounds 4e, 4f, 4k, 4l, 4q and 4r had good inhibitory effect on egg and imago of roundworm. IC₅₀ of compound 4l to anti-egg of roundworm was 0.65 ± 0.01 μmol/L and to anti-imago of roundworm was 1.04 ± 0.01 μmol/L. At the same time, it showed that compound 4l had the best effect in vivo, and the rate of anti-helmintic could reach more than 99%. The results of acute toxicity tests indicated that these compounds were with LD₅₀ > 2100 mg/kg by oral administration, so they were low toxicity compounds. In a word, compound 4l was most likely to be a new anti-helmintic drug through screening in vitro and in vivo.

Taenia solium cysticercosis in West Africa: status update

Cysticercosis is caused by the larvae of the cestode Taenia solium. Few data are available on the prevalence of this disease in pigs and humans in West African countries. The aim of this study was to provide an overview of existing data concerning the spread of this parasitosis in the countries of the Economic Community of West African States (ECOWAS) on the basis of the literature published over the last five decades. Systematic searches for publications were carried out on PubMed and Google Scholar, as well as in certain regional and local journals. From a total of 501 articles initially retrieved concerning T. solium cysticercosis in West African countries, only 120 articles were relevant for this review and therefore finally retained. For pigs, only eight out of sixteen countries of the region have reported porcine cysticercosis. Post-mortem examination of carcasses at slaughterhouses, meat inspection at butcheries or tongue inspection in herds have been the main source of data, but may not entirely reflect actual parasite distribution. For humans, only five out of sixteen countries reported epidemiological data on neurocysticercosis. Most data referred to neurocysticercosis prevalence among epileptic patients or isolated clinical cases. Furthermore, existing data are often old. Overall, T. solium cysticercosis remains largely neglected in West Africa, and its prevalence appears not to be affected by any religion in particular. There is an urgent need to promote and implement health partnerships and programs on this disease in order to collect more data and identify sensitive populations in the countries of the ECOWAS area.

Removal of helminth eggs by centralized and decentralized wastewater treatment plants in South Africa and Lesotho: health implications for direct and indirect exposure to the effluents

Wastewater may contain contaminants harmful to human health; hence, there is the need for treatment before discharge. Centralized wastewater treatment systems are the favored treatment options globally, but these are not necessarily superior in reduction of pathogens as compared to decentralized wastewater treatment systems (collectively called DEWATS). This study was therefore undertaken to assess the soil-transmitted helminth (STH) and Taenia sp. egg reduction efficiency of selected anaerobic baffled reactors and planted gravel filters compared to centralized wastewater treatment plants in South Africa and Lesotho. The risk of ascariasis with exposure to effluents from the centralized wastewater treatment plants was also assessed using the quantitative microbial risk assessment (QMRA) approach. Eggs of Ascaris spp., hookworm, Trichuris spp., Taenia spp., and Toxocara spp. were commonly detected in the untreated wastewater. The DEWATS plants removed between 95 and 100% of the STH and Taenia sp. eggs, with centralized plants removing between 67 and 100%. Helminth egg concentrations in the final effluents from the centralized wastewater treatment plants were consistently higher than those in the WHO recommended guideline (≤ 1 helminth egg/L) for agricultural use resulting in higher risk of ascariasis. Therefore, in conclusion, DEWATS plants may be more efficient in reducing the concentration of helminth eggs in wastewater, resulting in lower risks of STH infections upon exposure.

Effect of dewatering and composting on helminth eggs removal from lagooning sludge under semi-arid climate

In this work, we assessed the drying and composting effectiveness of helminth eggs removal from sewage sludge of a lagoon wastewater treatment plant located in Chichaoua city. The composting was run after mixing sludge with green waste in different proportions: M1 (½ sludge + ½ green waste), M2 ([Formula: see text] sludge + [Formula: see text] green waste), and M3 ([Formula: see text] sludge + [Formula: see text] green waste) for 105 days. The analysis of the dewatered sewage sludge showed a load of 8-24 helminth eggs/g of fresh matter identified as Ascaris spp. eggs (5-19 eggs/g) followed by Toxocara spp. (0.2 to 2.4 eggs/g); Hookworm spp. and Capillaria spp. (0.4-1 egg/g); Trichuris spp., Taenia spp., and Shistosoma spp. (< 1 egg/g) in the untreated sludge. After 105 days of treatment by composting, we noted a total reduction of helminth eggs in the order of 97.5, 97.83, and 98.37% for mixtures M1, M2, and M3, respectively. The Ascaris spp. eggs were reduced by 98% for M1 and M3 treatments and by 97% for M₂ Treatment. Toxocara spp., Hookworm spp., Trichuris spp., Capillaria spp., and Shistosoma spp. eggs were totally eliminated (100% decrease) and the Taenia spp. was absent from the first stage of composting. These results confirm the effectiveness of both dehydrating and composting processes on the removal of helminth eggs.

Infectious helminth ova in wastewater and sludge: A review on public health issues and current quantification practices

Raw and partially treated wastewater has been widely used to maintain the global water demand. Presence of viable helminth ova and larvae in the wastewater raised significant public health concern especially when used for agriculture and aquaculture. Depending on the prevalence of helminth infections in communities, up to 1.0 × 10³ ova/larvae can be presented per litre of wastewater and 4 gm (dry weight) of sludge. Multi-barrier approaches including pathogen reduction, risk assessment, and exposure reduction have been suggested by health regulators to minimise the potential health risk. However, with a lack of a sensitive and specific method for the quantitative detection of viable helminth ova from wastewater, an accurate health risk assessment is difficult to achieve. As a result, helminth infections are difficult to control from the communities despite two decades of global effort (mass drug administration). Molecular methods can be more sensitive and specific than currently adapted culture-based and vital stain methods. The molecular methods, however, required more and thorough investigation for its ability with accurate quantification of viable helminth ova/larvae from wastewater and sludge samples. Understanding different cell stages and corresponding gene copy numbers is pivotal for accurate quantification of helminth ova/larvae in wastewater samples. Identifying specific genetic markers including protein, lipid, and metabolites using multiomics approach could be utilized for cheap, rapid, sensitive, specific and point of care detection tools for helminth ova and larva in the wastewater.

The time-temperature relationship for the inactivation of Ascaris eggs

A time-temperature plot presenting the inactivation of Ascaris eggs is expanded with additional literature data. The information is of value to designers and operators of sanitation equipment who have Ascaris inactivation as an objective.

Gastrointestinal parasites of canids, a latent risk to human health in Tunisia

BACKGROUND

Although data on the parasite environmental contamination are crucial to implement strategies for control and treatment, information about zoonotic helminths is very limited in Tunisia. Contamination of areas with canid faeces harboring infective parasite elements represents a relevant health-risk impact for humans. The aim of this study was to assess the environmental contamination with eggs and oocysts of gastrointestinal parasites of dogs and wild canids in Tunisia with special attention to those that can be transmitted to humans.

RESULTS

One thousand two hundred and seventy faecal samples from stray dogs and 104 from wild canids (red foxes and golden jackals) were collected from different geographical regions throughout Tunisia. The helminth eggs and protozoan oocysts were concentrated by sucrose flotation and identified by microscopic examination. The most frequently observed parasites in dog samples were Toxocara spp. (27.2%), E. granulosus (25.8%), and Coccidia (13.1%). For wild canid faeces, the most commonly encountered parasites were Toxocara spp. (16.3%) followed by Capillaria spp. (9.6%). The parasite contamination of dog faeces varied significantly from one region to another in function of the climate.

CONCLUSION

To our knowledge, the study highlights for the first time in Tunisia a serious environmental contamination by numerous parasitic stages infective to humans. Efforts should be made to increase the awareness of the contamination risk of such parasites in the environment and implement a targeted educational program.

Detection and quantification of soil-transmitted helminths in environmental samples: A review of current state-of-the-art and future perspectives

It is estimated that over a billion people are infected with soil-transmitted helminths (STHs) globally with majority occurring in tropical and subtropical regions of the world. The roundworm (Ascaris lumbricoides), whipworm (Trichuris trichiura), and hookworms (Ancylostoma duodenale and Necator americanus) are the main species infecting people. These infections are mostly gained through exposure to faecally contaminated water, soil or contaminated food and with an increase in the risk of infections due to wastewater and sludge reuse in agriculture. Different methods have been developed for the detection and quantification of STHs eggs in environmental samples. However, there is a lack of a universally accepted technique which creates a challenge for comparative assessments of helminths egg concentrations both in different samples matrices as well as between locations. This review presents a comparison of reported methodologies for the detection of STHs eggs, an assessment of the relative performance of available detection methods and a discussion of new emerging techniques that could be applied for detection and quantification. It is based on a literature search using PubMed and Science Direct considering all geographical locations. Original research articles were selected based on their methodology and results sections. Methods reported in these articles were grouped into conventional, molecular and emerging techniques, the main steps in each method were then compared and discussed. The inclusion of a dissociation step aimed at detaching helminth eggs from particulate matter was found to improve the recovery of eggs. Additionally the selection and application of flotation solutions that take into account the relative densities of the eggs of different species of STHs also results in higher egg recovery. Generally the use of conventional methods was shown to be laborious and time consuming and prone to human error. The alternate use of nucleic acid-based techniques has improved the sensitivity of detection and made species specific identification possible. However, these nucleic acid based methods are expensive and less suitable in regions with limited resources and skill. The loop mediated isothermal amplification method shows promise for application in these settings due to its simplicity and use of basic equipment. In addition, the development of imaging soft-ware for the detection and quantification of STHs shows promise to further reduce human error associated with the analysis of environmental samples. It may be concluded that there is a need to comparatively assess the performance of different methods to determine their applicability in different settings as well as for use with different sample matrices (wastewater, sludge, compost, soil, vegetables etc.).

Assessing the impact of intervention strategies against Taenia solium cysticercosis using the EPICYST transmission model

BACKGROUND

The pork tapeworm, Taenia solium, and associated human infections, taeniasis, cysticercosis and neurocysticercosis, are serious public health problems, especially in developing countries. The World Health Organization (WHO) has set goals for having a validated strategy for control and elimination of T. solium taeniasis/cysticercosis by 2015 and interventions scaled-up in selected countries by 2020. Timely achievement of these internationally-endorsed targets requires that the relative benefits and effectiveness of potential interventions be explored rigorously within a quantitative framework.

METHODS

A deterministic, compartmental transmission model (EPICYST) was developed to capture the dynamics of the taeniasis/cysticercosis disease system in the human and pig hosts. Cysticercosis prevalence in humans, an outcome of high epidemiological and clinical importance, was explicitly modelled. A next generation matrix approach was used to derive an expression for the basic reproduction number, R 0. A full sensitivity analysis was performed using a methodology based on Latin-hypercube sampling partial rank correlation coefficient index.

RESULTS

EPICYST outputs indicate that chemotherapeutic intervention targeted at humans or pigs would be highly effective at reducing taeniasis and cysticercosis prevalence when applied singly, with annual chemotherapy of humans and pigs resulting, respectively, in 94 and 74% of human cysticercosis cases averted. Improved sanitation, meat inspection and animal husbandry are less effective but are still able to reduce prevalence singly or in combination. The value of R 0 for taeniasis was estimated at 1.4 (95% Credible Interval: 0.5-3.6).

CONCLUSIONS

Human- and pig-targeted drug-focussed interventions appear to be the most efficacious approach from the options currently available. The model presented is a forward step towards developing an informed control and elimination strategy for cysticercosis. Together with its validation against field data, EPICYST will be a valuable tool to help reach the WHO goals and to conduct economic evaluations of interventions in varying epidemiological settings.

Fecal indicator and Ascaris removal from double pit latrine content

Since May 2006, the BRAC Water, Sanitation and Hygiene (WASH) Programme in Bangladesh has enabled more than 30 million people to achieve hygienic sanitation, contributing to an increase in sanitation coverage from 33 to 83% in programme areas and rapid progress towards universal access. In rural areas, most families have single pit latrines that need to be emptied when full. Since 2007, BRAC has promoted the use of hygienic double-pit latrines. Use of double-pit latrines, where appropriate, is also recommended in the Bangladeshi Draft National Water Supply and Sanitation Strategy. More than 800,000 double-pit latrines are in use in BRAC WASH areas, delaying the need for emptying and allowing time for the fecal matter to decompose while the resting pit is sealed. This paper focuses on a study undertaken by BRAC WASH to treat and safely use fecal material from double pit latrines as an organic fertilizer for rice and other crops. The study investigated the removal of pathogens from pit waste through simple solar drying and conducted analysis on nutrient properties of fecal sludge. The study showed a significant positive impact on developing organic fertilizer from fecal sludge.

Quantification of viable helminth eggs in samples of sewage sludge

For the application of sewage sludge as fertilizer, it is of fundamental importance the absence of pathogenic organisms, such as viable helminth eggs. Thus, the quantification of these organisms has to be carried out by means of the application of reliable and accurate methodologies. Nevertheless, until the present date, there is no consensus with regard to the adoption of a universal methodology for the detection and quantification of viable helminth eggs. It is therefore necessary to instigate a debate on the different protocols currently in use, as well as to assemble relevant information in order to assist in the development of a more comprehensive and accurate method to quantify viable helminth eggs in samples of sewage sludge and its derivatives.

Identification and quantification of pathogenic helminth eggs using a digital image system

A system was developed to identify and quantify up to seven species of helminth eggs (Ascaris lumbricoides -fertile and unfertile eggs-, Trichuris trichiura, Toxocara canis, Taenia saginata, Hymenolepis nana, Hymenolepis diminuta, and Schistosoma mansoni) in wastewater using different image processing tools and pattern recognition algorithms. The system was developed in three stages. Version one was used to explore the viability of the concept of identifying helminth eggs through an image processing system, while versions 2 and 3 were used to improve its efficiency. The system development was based on the analysis of different properties of helminth eggs in order to discriminate them from other objects in samples processed using the conventional United States Environmental Protection Agency (US EPA) technique to quantify helminth eggs. The system was tested, in its three stages, considering two parameters: specificity (capacity to discriminate between species of helminth eggs and other objects) and sensitivity (capacity to correctly classify and identify the different species of helminth eggs). The final version showed a specificity of 99% while the sensitivity varied between 80 and 90%, depending on the total suspended solids content of the wastewater samples. To achieve such values in samples with total suspended solids (TSS) above 150 mg/L, it is recommended to dilute the concentrated sediment just before taking the images under the microscope. The system allows the helminth eggs most commonly found in wastewater to be reliably and uniformly detected and quantified. In addition, it provides the total number of eggs as well as the individual number by species, and for Ascaris lumbricoides it differentiates whether or not the egg is fertile. The system only requires basically trained technicians to prepare the samples, as for visual identification there is no need for highly trained personnel. The time required to analyze each image is less than a minute. This system could be used in central analytical laboratories providing a remote analysis service.

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The system identifies and quantifies seven species of helminth eggs.

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The system shows a specificity of 99% and a sensitivity between 80 and 90%.

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The time required to analyze each image is less than a minute.

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The system reduces the need for highly trained personnel for the identification of helminth eggs.

Are we ready for Taenia solium cysticercosis elimination in sub-Saharan Africa?

The World Health Organization announced in November 2014 at the fourth international meeting on ‘the control of neglected zoonotic diseases – from advocacy to action’, that intervention tools for eliminating Taenia solium taeniosis/cysticercosis (TSTC) are in place. The aim of this work was to elucidate theoretical outcomes of various control options suggested for TSTC elimination in sub-Saharan Africa (SSA) over a 4-year period. Our current knowledge regarding T. solium epidemiology and control primarily builds on studies from Latin America. A simple transmission model – built on data from Latin America – has been used to predict the effect of various interventions such as mass treatment of humans, vaccination and treatment of pigs, and health education of communities, potentially leading to change in bad practices and reducing transmission risks. Based on simulations of the transmission model, even a 4-year integrated One Health approach fails to eliminate TSTC from a small community and in all simulations, the prevalence of human taeniosis and porcine cysticercosis start to rise as soon as the programmes end. Our current knowledge regarding transmission and burden of TSTC in SSA is scarce and while claiming to be tool ready, the selection of diagnostic and surveillance tools, as well as the algorithms and stepwise approaches for control and elimination of TSTC remain major challenges.

Prevalence of and Factors Associated with Human Cysticercosis in 60 Villages in Three Provinces of Burkina Faso

Background

Taenia solium, a zoonotic infection transmitted between humans and pigs, is considered an emerging infection in Sub-Saharan Africa, yet individual and community-level factors associated with the human infection with the larval stages (cysticercosis) are not well understood. This study aims to estimate the magnitude of association of individual-level and village-level factors with current human cysticercosis in 60 villages located in three Provinces of Burkina Faso.

Methodology/Principal Findings

Baseline cross-sectional data collected between February 2011 and January 2012 from a large community randomized-control trial were used. A total of 3609 individuals provided serum samples to assess current infection with cysticercosis. The association between individual and village-level factors and the prevalence of current infection with cysticercosis was estimated using Bayesian hierarchical logistic models. Diffuse priors were used for all regression coefficients. The prevalence of current cysticercosis varied across provinces and villages ranging from 0% to 11.5%. The results obtained suggest that increased age, being male and consuming pork as well as a larger proportion of roaming pigs and percentage of sand in the soil measured at the village level were associated with higher prevalences of infection. Furthermore, consuming pork at another village market had the highest increased prevalence odds of current infection. Having access to a latrine, living in a household with higher wealth quintiles and a higher soil pH measured at the village level decreased the prevalence odds of cysticercosis.

Conclusions/Significance

This is the first large-scale study to examine the association between variables measured at the individual-, household-, and village-level and the prevalence odds of cysticercosis in humans. Factors linked to people, pigs, and the environment were of importance, which further supports the need for a One Health approach to control cysticercosis infection.

Taenia solium is an infection that is transmitted between pigs and humans. Humans may get infected with the larvae of Taenia solium, which results in cysticercosis, an infection common in pig farming communities where there is poor sanitation and free roaming pigs. Most published studies on this infection have included less participants covering a restricted geographic area, thereby resulting in a limited understanding of the important risk factors for infection. Our study aimed to examine important individual-, household- and village-level characteristics associated with current infection using baseline data from 3609 participants living in 60 villages across three provinces in Burkina Faso. Blood samples from village participants were taken to assess whether they were infected with cysticercosis. We found that eating pork, especially in other village’s markets, being older and male, living in a poorer household, not having access to a latrine, and living in a village where a larger percentage of pigs are left roaming were associated with infection. Soil pH and composition may also play a role in infection. Our results suggest that interventions that include human and veterinary health as well as environmental components should be considered to effectively control cysticercosis in such settings.

Assessing the fate of Ascaris suum ova during mesophilic anaerobic digestion

There is limited knowledge about the survival of geohelminths, which are soil-transmitted human pathogens, in mesophilic anaerobic digestion processes. This study examined the fate of embryonated and unembryonated Ascaris suum ova in six laboratory-scale mesophilic (35 °C) anaerobic digesters processing swine manure to identify their survival strategies and investigate potential mechanisms to enhance their destruction. There was no significant difference in inactivation of Ascaris suum ova in digesters operated at different solids residence times (SRT) or feeding frequencies. Ova exposed to an anaerobic environment became dormant, or remained unembryonated throughout their residence in the reactors. Approximately 65% of ova were able to retain their viability for up to 16 days, after which the rate of inactivation increased until nearly all ova were nonviable by day 24. In contrast, ova exposed to aerobic conditions did not become dormant and progressed through several developmental stages until day 16, after which nearly all ova were observed to be nonviable. In addition, only 35% of fully developed ova exposed to the anaerobic environment retained their viability by day 16 compared to 65% for dormant ova. Results suggest that some ova are physically destroyed during digestion and ova can be inactivated faster if their development cycle is aerobically triggered before entering the anaerobic digestion process. Results also suggest that transfer of resource recovery technologies such as mesophilic anaerobic digestion to developing world settings must account for local climatic and health conditions so mutually beneficial outcomes can be attained.

Taenia solium taeniasis and cysticercosis control and elimination through community-based interventions

Taenia solium was declared potentially eradicable by the International Task Force for Disease Eradication in 1992. Yet, very few well-designed community-based randomized controlled trials have been conducted to measure the effectiveness of alternative control strategies. Most strategies have been tested in pre-post intervention designs in very few communities, often without a control group. The only two community-based randomized controlled trials suggest that an educational program alone or a combination of human and porcine mass treatment reduce porcine cysticercosis in the short term. A transmission dynamics model suggests that improved sanitation and pig management are more effective and sustainable than pig vaccination, human or porcine mass treatment. Current evidence does not support the eradication of Taenia solium in the foreseeable future. Investigators should follow international recommendations on the conduct of community-based randomized control trials to provide more valid estimates of the effect and cost-effectiveness of alternative control strategies for cysticercosis.