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Nishioka M, Hamabe K, Kunimune Y, Kodama M, Nakahara Y, Okayama N, Tominaga M, Furutani H, Ito F, Fujii T, Suehiro Y, Takami T, Yamasaki T. A case of asymptomatic infection of Ascaris suum identified by PCR-restriction fragment length polymorphism and DNA sequence analysis. Diagn Microbiol Infect Dis 2024; 110:116444. [PMID: 39024933 DOI: 10.1016/j.diagmicrobio.2024.116444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 07/12/2024] [Indexed: 07/20/2024]
Abstract
Human ascariasis is a soil-transmitted helminthiasis and remains a neglected tropical disease. Ascaris suum has the potential to cause cross-infections between humans and pigs. In this study, we present a rare case of a patient with asymptomatic infection by Ascaris suum. A 66-year-old male underwent colonoscopy, and a white linear worm body was found in the hepatic curvature. The worm was collected by aspiration and submitted to the laboratory for parasite identification. The patient had no symptoms related to parasitic infection. The worm was highly suspected to be of the genus Ascaris. Because of the difficulty of morphological classification, genetic analysis was performed. From PCR-restriction fragment length polymorphism results and sequence analysis of the internal transcribed spacer-1 region, it was determined to be A. suum. The experience with rapid differentiation of A. suum by performing genetic analysis will be useful for future examinations of parasitic infections.
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Affiliation(s)
- Mitsuaki Nishioka
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan.
| | - Koichi Hamabe
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan
| | - Yuki Kunimune
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan
| | - Masaki Kodama
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan
| | - Yukiko Nakahara
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan
| | - Naoko Okayama
- Division of Medical Genetics, Yamaguchi University Hospital, Ube 755-8505, Japan
| | - Mika Tominaga
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan
| | - Hiromi Furutani
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan
| | - Fusako Ito
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan
| | - Tomohiro Fujii
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan
| | - Yutaka Suehiro
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; Division of Medical Genetics, Yamaguchi University Hospital, Ube 755-8505, Japan; Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan
| | - Taro Takami
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan
| | - Takahiro Yamasaki
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan
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Wang J, Barr MM, Wehman AM. Extracellular vesicles. Genetics 2024; 227:iyae088. [PMID: 38884207 PMCID: PMC11304975 DOI: 10.1093/genetics/iyae088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 05/21/2024] [Indexed: 06/18/2024] Open
Abstract
Extracellular vesicles (EVs) encompass a diverse array of membrane-bound organelles released outside cells in response to developmental and physiological cell needs. EVs play important roles in remodeling the shape and content of differentiating cells and can rescue damaged cells from toxic or dysfunctional content. EVs can send signals and transfer metabolites between tissues and organisms to regulate development, respond to stress or tissue damage, or alter mating behaviors. While many EV functions have been uncovered by characterizing ex vivo EVs isolated from body fluids and cultured cells, research using the nematode Caenorhabditis elegans has provided insights into the in vivo functions, biogenesis, and uptake pathways. The C. elegans EV field has also developed methods to analyze endogenous EVs within the organismal context of development and adult physiology in free-living, behaving animals. In this review, we summarize major themes that have emerged for C. elegans EVs and their relevance to human health and disease. We also highlight the diversity of biogenesis mechanisms, locations, and functions of worm EVs and discuss open questions and unexplored topics tenable in C. elegans, given the nematode model is ideal for light and electron microscopy, genetic screens, genome engineering, and high-throughput omics.
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Affiliation(s)
- Juan Wang
- Department of Genetics, Human Genetics Institute of New Jersey, Rutgers University, Piscataway, NJ 08854, USA
| | - Maureen M Barr
- Department of Genetics, Human Genetics Institute of New Jersey, Rutgers University, Piscataway, NJ 08854, USA
| | - Ann M Wehman
- Department of Biological Sciences, University of Denver, Denver, CO 80210, USA
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Yang R, Xu M, Zhang L, Liao Y, Liu Y, Deng X, Wang L. Human Strongyloides stercoralis infection. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2024:S1684-1182(24)00120-8. [PMID: 39142910 DOI: 10.1016/j.jmii.2024.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 06/14/2024] [Accepted: 07/15/2024] [Indexed: 08/16/2024]
Abstract
Strongyloides stercoralis is an important soil-transmitted helminth occurring world-wide and affecting 30-100 million people. Because many cases are asymptomatic and sensitive diagnostic methods are lacking, S. stercoralis infection is frequently underdiagnosed. The increasing incidence of autoimmune and wasting diseases and increased use of immunosuppressive agents, as well as the increased use of immunosuppressants and cytotoxic drugs, have increased S. stercoralis infection and their mortality. This review provides information about S. stercoralis epidemiology, life cycle, aetiology, pathology, comorbidities, immunology, vaccines, diagnosis, treatment, prevention, control and makes some recommendations for future prevention and control of this important parasite.
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Affiliation(s)
- Ruibing Yang
- Guangzhou Kingmed Center for Clinical Laboratory, Guangzhou, Guangdong 510320, China
| | - Meiyining Xu
- Department of Parasitology of Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
| | - Lichao Zhang
- Guangdong Clinical Laboratory Center Guangdong Provincial People's Hospital, Guangzhou 510080, China
| | - Yao Liao
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510180, China
| | - Yuheng Liu
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510180, China
| | - Xiaoyan Deng
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510180, China.
| | - Lifu Wang
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, Guangdong 510180, China.
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Schemczssen-Graeff Z, Silva CR, de Freitas PNN, Constantin PP, Pileggi SAV, Olchanheski LR, Pileggi M. Probiotics as a strategy for addressing helminth infections in low-income countries: Working smarter rather than richer. Biochem Pharmacol 2024; 226:116363. [PMID: 38871336 DOI: 10.1016/j.bcp.2024.116363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 06/15/2024]
Abstract
Helminth infections, which affect approximately 1.5 billion individuals worldwide (mainly children), are common in low- and middle-income tropical countries and can lead to various diseases. One crucial factor affecting the occurrence of these diseases is the reduced diversity of the gut microbiome due to antibiotic use. This reduced diversity compromises immune health in hosts and alters host gene expression through epigenetic mechanisms. Helminth infections may produce complex biochemical signatures that could serve as therapeutic targets. Such therapies include next-generation probiotics, live biotherapeutic products, and biochemical drug approaches. Probiotics can bind ferric hydroxide, reducing the iron that is available to opportunistic microorganisms. They also produce short-chain fatty acids associated with immune response modulation, oral tolerance facilitation, and inflammation reduction. In this review, we examine the potential link between these effects and epigenetic changes in immune response-related genes by analyzing methyltransferase-related genes within probiotic strains discussed in the literature. The identified genes were only correlated with methylation in bacterial genes. Various metabolic interactions among hosts, helminth parasites, and intestinal microbiomes can impact the immune system, potentially aiding or hindering worm expulsion through chemical signaling. Implementing a comprehensive strategy using probiotics may reduce the impact of drug-resistant helminth strains.
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Affiliation(s)
- Zelinda Schemczssen-Graeff
- Comparative Immunology Laboratory, Department of Microbiology, Parasitology, and Pathology, Federal University of Paraná, Curitiba, Brazil
| | - Caroline Rosa Silva
- Department of Biotechnology, Genetics and Cell Biology, State University of Maringá, Maringá, Brazil
| | | | - Paola Pereira Constantin
- Department of Biotechnology, Genetics and Cell Biology, State University of Maringá, Maringá, Brazil
| | - Sônia Alvim Veiga Pileggi
- Environmental Microbiology Laboratory, Life Sciences and Health Institute, Structural and Molecular Biology, and Genetics Department, Ponta Grossa State University, Ponta Grossa, Brazil
| | - Luiz Ricardo Olchanheski
- Environmental Microbiology Laboratory, Life Sciences and Health Institute, Structural and Molecular Biology, and Genetics Department, Ponta Grossa State University, Ponta Grossa, Brazil
| | - Marcos Pileggi
- Environmental Microbiology Laboratory, Life Sciences and Health Institute, Structural and Molecular Biology, and Genetics Department, Ponta Grossa State University, Ponta Grossa, Brazil.
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Pinheiro AAS, Torrecilhas AC, Souza BSDF, Cruz FF, Guedes HLDM, Ramos TD, Lopes‐Pacheco M, Caruso‐Neves C, Rocco PRM. Potential of extracellular vesicles in the pathogenesis, diagnosis and therapy for parasitic diseases. J Extracell Vesicles 2024; 13:e12496. [PMID: 39113589 PMCID: PMC11306921 DOI: 10.1002/jev2.12496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 07/11/2024] [Indexed: 08/11/2024] Open
Abstract
Parasitic diseases have a significant impact on human and animal health, representing a major hazard to the public and causing economic and health damage worldwide. Extracellular vesicles (EVs) have long been recognized as diagnostic and therapeutic tools but are now also known to be implicated in the natural history of parasitic diseases and host immune response modulation. Studies have shown that EVs play a role in parasitic disease development by interacting with parasites and communicating with other types of cells. This review highlights the most recent research on EVs and their role in several aspects of parasite-host interactions in five key parasitic diseases: Chagas disease, malaria, toxoplasmosis, leishmaniasis and helminthiases. We also discuss the potential use of EVs as diagnostic tools or treatment options for these infectious diseases.
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Affiliation(s)
- Ana Acacia Sá Pinheiro
- Instituto de Biofísica Carlos Chagas FilhoUniversidade Federal do Rio de Janeiro (UFRJ)Rio de JaneiroBrazil
- Rio de Janeiro Innovation Network in Nanosystems for Health‐NanoSAÚDE/Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ)Rio de JaneiroBrazil
| | - Ana Claudia Torrecilhas
- Departamento de Ciências FarmacêuticasDiadema Campus, Instituto de Ciências Ambientais, Químicas e FarmacêuticasUniversidade Federal de São Paulo (UNIFESP)DiademaSão PauloBrazil
| | - Bruno Solano de Freitas Souza
- Center for Biotechnology and Cell TherapySão Rafael HospitalSalvadorBrazil
- D'Or Institute for Research and Education (IDOR)SalvadorBrazil
| | - Fernanda Ferreira Cruz
- Instituto de Biofísica Carlos Chagas FilhoUniversidade Federal do Rio de Janeiro (UFRJ)Rio de JaneiroBrazil
- Rio de Janeiro Innovation Network in Nanosystems for Health‐NanoSAÚDE/Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ)Rio de JaneiroBrazil
| | - Herbert Leonel de Matos Guedes
- Instituto de Microbiologia Paulo de Goés (IMPG)Universidade Federal do Rio de Janeiro (UFRJ)Rio de JaneiroBrazil
- Fundação Oswaldo Cruz (FIOCRUZ)Instituto Oswaldo Cruz (IOC)Rio de JaneiroBrazil
| | - Tadeu Diniz Ramos
- Instituto de Microbiologia Paulo de Goés (IMPG)Universidade Federal do Rio de Janeiro (UFRJ)Rio de JaneiroBrazil
- Fundação Oswaldo Cruz (FIOCRUZ)Instituto Oswaldo Cruz (IOC)Rio de JaneiroBrazil
| | - Miqueias Lopes‐Pacheco
- Instituto de Biofísica Carlos Chagas FilhoUniversidade Federal do Rio de Janeiro (UFRJ)Rio de JaneiroBrazil
- Deparment of PediatricsCenter for Cystic Fibrosis and Airway Disease ResearchEmory University School of MedicineAtlantaGeorgiaUSA
| | - Celso Caruso‐Neves
- Instituto de Biofísica Carlos Chagas FilhoUniversidade Federal do Rio de Janeiro (UFRJ)Rio de JaneiroBrazil
- Rio de Janeiro Innovation Network in Nanosystems for Health‐NanoSAÚDE/Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ)Rio de JaneiroBrazil
- National Institute of Science and Technology for Regenerative MedicineINCT‐REGENERARio de JaneiroBrazil
| | - Patricia R. M. Rocco
- Instituto de Biofísica Carlos Chagas FilhoUniversidade Federal do Rio de Janeiro (UFRJ)Rio de JaneiroBrazil
- Rio de Janeiro Innovation Network in Nanosystems for Health‐NanoSAÚDE/Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ)Rio de JaneiroBrazil
- National Institute of Science and Technology for Regenerative MedicineINCT‐REGENERARio de JaneiroBrazil
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Clare G, Kempen JH, Pavésio C. Infectious eye disease in the 21st century-an overview. Eye (Lond) 2024; 38:2014-2027. [PMID: 38355671 PMCID: PMC11269619 DOI: 10.1038/s41433-024-02966-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 01/10/2024] [Accepted: 01/26/2024] [Indexed: 02/16/2024] Open
Abstract
Infectious diseases affecting the eye often cause unilateral or asymmetric visual loss in children and people of working age. This group of conditions includes viral, bacterial, fungal and parasitic diseases, both common and rare presentations which, in aggregate, may account for a significant portion of the global visual burden. Diagnosis is frequently challenging even in specialist centres, and many disease presentations are highly regional. In an age of globalisation, an understanding of the various modes of transmission and the geographic distribution of infections can be instructive to clinicians. The impact of eye infections on global disability is currently not sufficiently captured in global prevalence studies on visual impairment and blindness, which focus on bilateral disease in the over-50s. Moreover, in many cases it is hard to differentiate between infectious and immune-mediated diseases. Since infectious eye diseases can be preventable and frequently affect younger people, we argue that in future prevalence studies they should be considered as a separate category, including estimates of disability-adjusted life years (DALY) as a measure of overall disease burden. Numbers of ocular infections are uniquely affected by outbreaks as well as endemic transmission, and their control frequently relies on collaborative partnerships that go well beyond the remit of ophthalmology, encompassing domains as various as vaccination, antibiotic development, individual healthcare, vector control, mass drug administration, food supplementation, environmental and food hygiene, epidemiological mapping, and many more. Moreover, the anticipated impacts of global warming, conflict, food poverty, urbanisation and environmental degradation are likely to magnify their importance. While remote telemedicine can be a useful aide in the diagnosis of these conditions in resource-poor areas, enhanced global reporting networks and artificial intelligence systems may ultimately be required for disease surveillance and monitoring.
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Affiliation(s)
| | - John H Kempen
- Department of Ophthalmology and Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary; and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
- Sight for Souls, Bellevue, WA, USA
- MCM Eye Unit; MyungSung Christian Medical Center (MCM) Comprehensive Specialized Hospital and MyungSung Medical College, Addis Ababa, Ethiopia
- Department of Ophthalmology, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia
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Roquini D, Lemes BL, Kreutz ALB, Spoladore SC, Amaro MC, Lopes FB, Fernandes JP, de Moraes J. Antihistamines H 1 as Potential Anthelmintic Agents against the Zoonotic Parasite Angiostrongylus cantonensis. ACS OMEGA 2024; 9:31159-31165. [PMID: 39035884 PMCID: PMC11256074 DOI: 10.1021/acsomega.4c04773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/23/2024]
Abstract
Infections caused by parasitic helminths pose significant health concerns for both humans and animals. The limited efficacy of existing drugs underscores the urgent need for novel anthelmintic agents. Given the reported potential of antihistamines against various parasites, including worms, this study conducted a screening of clinically available antihistamines against Angiostrongylus cantonensis-a nematode with widespread implications for vertebrate hosts, including humans. Twenty-one anti-H1 antihistamines were screened against first-stage larvae (L1) of A. cantonensis obtained from the feces of infected rats. Standard anthelmintic drugs ivermectin and albendazole were employed for comparative analysis. The findings revealed four active compounds (promethazine, cinnarizine, desloratadine, and rupatadine), with promethazine demonstrating the highest potency (EC50 = 31.6 μM). Additionally, morphological analysis showed that antihistamines induced significant changes in larvae. To understand the mechanism of action, antimuscarinic activities were reported based on average pK i values for human muscarinic receptor (mAChR) subtypes of the evaluated compounds. Furthermore, an analysis of the physicochemical and pharmacodynamic properties of antihistamines revealed that their anthelmintic activity does not correlate with their activity at H1 receptors. This study marks the first documentation of antihistamines' activity against A. cantonensis, offering a valuable contribution to the quest for novel agents effective against zoonotic helminths.
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Affiliation(s)
- Daniel
B. Roquini
- Núcleo
de Pesquisa em Doenças Negligenciadas, Universidade Guarulhos, 07023-070 Guarulhos, SP, Brazil
| | - Bruna L. Lemes
- Núcleo
de Pesquisa em Doenças Negligenciadas, Universidade Guarulhos, 07023-070 Guarulhos, SP, Brazil
| | - Amanda L. B. Kreutz
- Núcleo
de Pesquisa em Doenças Negligenciadas, Universidade Guarulhos, 07023-070 Guarulhos, SP, Brazil
| | - Sophia C. Spoladore
- Núcleo
de Pesquisa em Doenças Negligenciadas, Universidade Guarulhos, 07023-070 Guarulhos, SP, Brazil
| | - Monique C. Amaro
- Núcleo
de Pesquisa em Doenças Negligenciadas, Universidade Guarulhos, 07023-070 Guarulhos, SP, Brazil
| | - Flavia B. Lopes
- Departamento
de Medicina, Universidade Federal de São
Paulo, 04023-062 São Paulo, SP, Brazil
- Departamento
de Ciências Farmacêuticas, Universidade Federal de São Paulo, 09913-030 Diadema, SP, Brazil
| | - João Paulo
S. Fernandes
- Departamento
de Ciências Farmacêuticas, Universidade Federal de São Paulo, 09913-030 Diadema, SP, Brazil
| | - Josué de Moraes
- Núcleo
de Pesquisa em Doenças Negligenciadas, Universidade Guarulhos, 07023-070 Guarulhos, SP, Brazil
- Núcleo
de Pesquisa em Doenças Negligenciadas, Instituto Científico e Tecnológico, Universidade Brasil, 08230-030 São
Paulo, SP, Brazil
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Castañeda S, Adeniyi-Ipadeola G, Wu Y, Suarez-Reyes C, Jain A, Ramírez JD, Weatherhead JE. Characterizing Excretory-Secretory Products Proteome Across Larval Development Stages in Ascaris suum. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.07.03.601870. [PMID: 39005370 PMCID: PMC11245028 DOI: 10.1101/2024.07.03.601870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Introduction Ascaris lumbricoides and Ascaris suum are parasitic nematodes that primarily infest the small intestines of humans and pigs, respectively. Ascariasis poses a significant threat to human health and swine health. Understanding Ascaris larval development is crucial for developing novel therapeutic interventions that will prevent ascariasis in both humans and pigs. This study aimed to characterize the excretory-secretory (ES) proteome of different Ascaris suum larval stages (L3-egg, L3-lung, L3-trachea) to identify potential targets for intervention to prevent Ascaris -induced global morbidity. Methods Stage-specific larvae were isolated, cultured in vitro and ES-product was collected. Third-stage Ascaris larvae (L3) were isolated from embryonated eggs (L3-egg), isolated from the lungs of Balb/c mice infected with Ascaris suum eggs at day 8 post infection (L3-lungs) and isolated from the trachea of Balb/c mice infected with Ascaris suum eggs at day 12 post infection (L3-trachea). ES products were obtained by culturing larvae. Proteomic analysis was conducted using liquid chromatography-tandem mass spectrometry (LC-MS/MS) and bioinformatic tools including MaxQuant, Perseus, and Andromeda, following a detailed protocol available on GitHub. The analysis encompassed peptide identification, scoring, and quantification against an organism-specific database, with subsequent quality control, correlation assessment, and differential abundance determination using the Amica algorithm. Results A total of 58 unique proteins were identified in the ES products. Fourteen proteins were common across all stages, while others were stage-specific. Principal component analysis revealed distinct protein profiles for each stage, suggesting qualitatively different proteomes. Gene ontology analysis indicated stage-specific GO enrichment of specific protein classes, such as nuclear proteins in L3-egg ES products and metabolic enzymes in L3-lung and L3-trachea ES products. Discussion This study revealed stage-specific differences in the composition of Ascaris ES products. Further investigation into the functional roles of these proteins and their interactions with host cells is crucial for developing novel therapeutic and diagnostic strategies against ascariasis.
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Djibougou DA, Mensah GI, Kaboré A, Toé I, Sawadogo LT, Lompo PF, Kone AMM, Hien H, Meda CZ, Combary A, Bonfoh B, Addo KK, Belem AMG, Dabiré RK, Hoffmann J, Perreau M, Diagbouga PS. Immunological and Haematological Relevance of Helminths and Mycobacterium tuberculosis Complex Coinfection among Newly Diagnosed Pulmonary Tuberculosis Patients from Bobo-Dioulasso, Burkina Faso. Biomedicines 2024; 12:1472. [PMID: 39062045 PMCID: PMC11274831 DOI: 10.3390/biomedicines12071472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/08/2024] [Accepted: 06/14/2024] [Indexed: 07/28/2024] Open
Abstract
The effect of helminthiasis on host immunity is a neglected area of research, particularly in tuberculosis (TB) infection. This study aimed to evaluate the effect of helminthiasis on immunological and haematological parameters in newly diagnosed TB patients in Bobo-Dioulasso. After all biological analyses, we formed three subpopulations: group 1 (n = 82), as control, were participants without helminthic or Mycobacterium tuberculosis complex infection (Mtb-/Helm-), group 2 (n = 73) were TB patients without helminthic infection (Mtb+/Helm-), and group 3 (n = 22) were TB patients with helminthic infection (Mtb+/Helm+). The proportion of helminth coinfection was 23.16% (22/95) in TB patients, and Schistosoma mansoni infection was found in 77.3% (17/22) cases of helminthiasis observed in this study. A low CD4 T cell count and a low CD4:CD8 ratio were significantly associated with concomitant infection with helminths and the Mtb complex (Mtb+/Helm+) compared to the other groups (p < 0.05). However, there was no statistically significant difference in the CD8 median among the three participating groups (p > 0.05). Lymphopenia, monocytosis, thrombocytosis, and hypochromic microcytic anaemia were the haematological defects observed in the Mtb+/Helm+ and Mtb+/Helm- patients. Exploring these types of immune-haematological biomarkers would be a valuable aid in diagnosing and a better follow-up and monitoring of the tuberculosis-helminthiasis coinfection.
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Affiliation(s)
- Diakourga Arthur Djibougou
- Doctoral School of Natural Sciences and Agronomy, Université Nazi BONI, Bobo-Dioulasso 1091, Burkina Faso; (I.T.); (L.T.S.); (C.Z.M.); (A.M.-G.B.)
- Infectious Diseases Program, Centre MURAZ, Institut National de Santé Publique, Bobo-Dioulasso 1091, Burkina Faso; (A.M.M.K.); (H.H.); (R.K.D.)
- Institut de Recherche en Sciences de la Santé, CNRST, Bobo-Dioulasso 545, Burkina Faso
| | - Gloria Ivy Mensah
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra 00233, Ghana; (G.I.M.); (K.K.A.)
| | - Achille Kaboré
- Infectious Disease and Health Systems (IDHS), FHI 360, Washington, DC 20037, USA;
| | - Inoussa Toé
- Doctoral School of Natural Sciences and Agronomy, Université Nazi BONI, Bobo-Dioulasso 1091, Burkina Faso; (I.T.); (L.T.S.); (C.Z.M.); (A.M.-G.B.)
- Institut de Recherche en Sciences de la Santé, CNRST, Bobo-Dioulasso 545, Burkina Faso
| | - Leon Tinnoga Sawadogo
- Doctoral School of Natural Sciences and Agronomy, Université Nazi BONI, Bobo-Dioulasso 1091, Burkina Faso; (I.T.); (L.T.S.); (C.Z.M.); (A.M.-G.B.)
- National Tuberculosis Programme, Ministry of Health and Public Hygiene, Ouagadougou 01 P.O. Box 690, Burkina Faso;
| | - Palpouguini Felix Lompo
- Etudes Formation et Recherches Développement en Santé (EFORDS), Ouagadougou 10 P.O. Box 13064, Burkina Faso;
| | - Amariane M. M. Kone
- Infectious Diseases Program, Centre MURAZ, Institut National de Santé Publique, Bobo-Dioulasso 1091, Burkina Faso; (A.M.M.K.); (H.H.); (R.K.D.)
| | - Hervé Hien
- Infectious Diseases Program, Centre MURAZ, Institut National de Santé Publique, Bobo-Dioulasso 1091, Burkina Faso; (A.M.M.K.); (H.H.); (R.K.D.)
- Institut de Recherche en Sciences de la Santé, CNRST, Bobo-Dioulasso 545, Burkina Faso
| | - Clement Ziemlé Meda
- Doctoral School of Natural Sciences and Agronomy, Université Nazi BONI, Bobo-Dioulasso 1091, Burkina Faso; (I.T.); (L.T.S.); (C.Z.M.); (A.M.-G.B.)
- Infectious Diseases Program, Centre MURAZ, Institut National de Santé Publique, Bobo-Dioulasso 1091, Burkina Faso; (A.M.M.K.); (H.H.); (R.K.D.)
| | - Adjima Combary
- National Tuberculosis Programme, Ministry of Health and Public Hygiene, Ouagadougou 01 P.O. Box 690, Burkina Faso;
| | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifique de Côte d’Ivoire, Adiopodoumé 01 P.O. Box 1303, Côte d’Ivoire;
| | - Kennedy Kwasi Addo
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra 00233, Ghana; (G.I.M.); (K.K.A.)
| | - Adrien Marie-Gaston Belem
- Doctoral School of Natural Sciences and Agronomy, Université Nazi BONI, Bobo-Dioulasso 1091, Burkina Faso; (I.T.); (L.T.S.); (C.Z.M.); (A.M.-G.B.)
| | - Roch Konbobr Dabiré
- Infectious Diseases Program, Centre MURAZ, Institut National de Santé Publique, Bobo-Dioulasso 1091, Burkina Faso; (A.M.M.K.); (H.H.); (R.K.D.)
- Institut de Recherche en Sciences de la Santé, CNRST, Bobo-Dioulasso 545, Burkina Faso
| | - Jonathan Hoffmann
- Département Médical et Scientifique, Fondation Mérieux, 17 rue Bourgelat, 69002 Lyon, France;
| | - Matthieu Perreau
- Faculty of Biology and Medicine, Université de Lausanne, 1010 Lausanne, Switzerland;
| | - Potiandi Serge Diagbouga
- Institut de Recherche en Sciences de la Santé, CNRST, Bobo-Dioulasso 545, Burkina Faso
- Etudes Formation et Recherches Développement en Santé (EFORDS), Ouagadougou 10 P.O. Box 13064, Burkina Faso;
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10
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Keiser J, Bouchery T. A step forward in the journey towards hookworm vaccines. THE LANCET. INFECTIOUS DISEASES 2024; 24:673-674. [PMID: 38513685 DOI: 10.1016/s1473-3099(24)00145-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Jennifer Keiser
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Basel, Switzerland.
| | - Tiffany Bouchery
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Basel, Switzerland
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11
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le Grange DL, Pillay SF, Budding L, van Rooyen C, Goedhals J. A Retrospective Review of Neglected Tropical Diseases Diagnosed on Histopathological Specimens in the Free State Province, South Africa, 2015-2020. J Trop Med 2024; 2024:5076288. [PMID: 38957266 PMCID: PMC11219199 DOI: 10.1155/2024/5076288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 07/04/2024] Open
Abstract
Background Neglected tropical diseases (NTDs) are a heterogeneous group of medical conditions that commonly occur in underprivileged populations. NTDs are primarily diagnosed in tropical areas. Although South Africa is not situated in a tropical region, the high poverty rate makes the country susceptible to some NTDs. Limited data are available on the burden of NTDs in the Free State province of South Africa. This study aimed to determine the number of NTDs diagnosed on histopathological specimens in the public sector of the Free State province over a six-year period and to evaluate the patient demographics. Methods A retrospective, descriptive study was performed. All NTDs diagnosed in histopathological specimens from public sector hospitals in the province submitted to the Department of Anatomical Pathology, National Health Laboratory Service, and University of the Free State between 1 January 2015 and 31 December 2020 were included in the study. The demographic information, biopsy site, and referring hospital were noted for each case identified. Results A total of 72 NTDs were diagnosed. The five most common diagnoses were echinococcosis (n = 33; 45.8%), bilharzia (n = 13; 18.1%), leprosy (n = 9; 12.5%), mycetoma (n = 8; 11.1%), and intestinal worms (n = 5; 6.9%). Ten (30.3%) patients diagnosed with echinococcosis came from the Free State's neighbouring country, Lesotho. Conclusion Echinococcosis was the most prevalent NTD diagnosed in central South Africa. We recommend that the South African Department of Health add echinococcosis to the principal NTDs of significance in South Africa, alongside soil-transmitted helminths, schistosomiasis, leprosy, and rabies.
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Affiliation(s)
- Danita Linda le Grange
- Department of Anatomical Pathology, School of Pathology, Faculty of Health Sciences, University of the Free State and National Health Laboratory Services, Bloemfontein, South Africa
| | - She'neze Fatima Pillay
- Department of Chemical Pathology, School of Pathology, Faculty of Health Sciences, University of the Free State and National Health Laboratory Services, Bloemfontein, South Africa
| | - Liska Budding
- Department of Anatomical Pathology, School of Pathology, Faculty of Health Sciences, University of the Free State and National Health Laboratory Services, Bloemfontein, South Africa
| | - Cornel van Rooyen
- Department of Biostatistics, School of Biomedical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Jacqueline Goedhals
- Department of Anatomical Pathology, School of Pathology, Faculty of Health Sciences, University of the Free State and National Health Laboratory Services, Bloemfontein, South Africa
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12
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Pillay-Fuentes Lorente V, Nwogu-Attah JN, Steffens B, Bräm D, Sprecher V, Hofmann D, Buettcher M, Pillai G, Mouksassi S, Coulibaly J, Pfister M, Keiser J. Understanding Drug Exposure and Trichuris trichiura Cure Rates: A Pharmacometric Approach for Albendazole-Ivermectin Co-medication in Tanzania and Côte d'Ivoire. Drugs R D 2024; 24:331-340. [PMID: 39034337 PMCID: PMC11315861 DOI: 10.1007/s40268-024-00476-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Trichuriasis caused by the human whipworm Trichuris trichiura poses a significant public health concern. Albendazole-ivermectin co-medication is currently the most effective treatment. Studies conducted in Tanzania and Côte d'Ivoire unveiled differences in efficacy for albendazole-ivermectin combination therapy in both countries. A pharmacometrics approach was used to assess co-medication and study population effects on the pharmacokinetics of the two main metabolites of albendazole. An exploratory exposure-efficacy analysis was also carried out to investigate relationships between exposure measures and the egg reduction rate. METHODS Pharmacokinetic data from studies in Tanzania and Côte d'Ivoire in adolescents (aged 12-19 years) were included in the pharmacometric analysis. Participants received a single dose of either albendazole 400 mg alone or in combination with ivermectin 200 µg/kg. A pharmacometric analysis was performed to investigate the potential effects of the study population and co-administered ivermectin on the apparent clearance of the metabolites of albendazole. Non-linear mixed-effects modeling was conducted with MonolixSuite 2023R1. The pharmacokinetic exposure measures derived from simulations with individual model parameters were used in the exploratory-exposure response analysis. RESULTS Pharmacokinetic profiles were best described by a two-compartment model for albendazole sulfoxide and a one-compartment model for albendazole sulfone, with a transit compartment and linear elimination. While no co-medication effect was found, apparent clearance of albendazole sulfoxide (albendazole sulfone) in the Tanzanian study population was 75% (46%) higher than that in the Côte d'Ivoire study population. Exposure-efficacy response analyses indicated that peak concentration and the time-above-exposure threshold were associated with the egg reduction rate. CONCLUSIONS Study population but not co-administered ivermectin showed an effect on apparent clearance of albendazole sulfoxide and albendazole sulfone. Polymorphisms in drug-metabolizing enzymes and host-parasite interaction may explain this result. Difference in drug exposure did not explain the disparate efficacy responses in Tanzania and Côte d'Ivoire. Peak concentration and time-above-threshold were exposure measures associated with the egg reduction rate. Further studies evaluating genetic and resistance patterns in various regions in Africa are warranted.
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Affiliation(s)
- Veshni Pillay-Fuentes Lorente
- Division of Clinical Pharmacology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- APT-Africa Fellowship Program, c/o Pharmacometrics Africa NPC, Groote Schuur Hospital, Cape Town, South Africa
| | - Jacinta N Nwogu-Attah
- APT-Africa Fellowship Program, c/o Pharmacometrics Africa NPC, Groote Schuur Hospital, Cape Town, South Africa.
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Lead City University, Off Oba Otudeko Avenue, Toll-Gate Area, Ibadan, 200255, Oyo, Nigeria.
| | - Britta Steffens
- Pediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Dominic Bräm
- Pediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Viviane Sprecher
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Allschwil Switzerland, University of Basel, Basel, Switzerland
- Paediatric Infectious Diseases, Children's Hospital of Central Switzerland (KidZ), Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Daniela Hofmann
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Allschwil Switzerland, University of Basel, Basel, Switzerland
| | - Michael Buettcher
- Pediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital (UKBB), Basel, Switzerland
- Paediatric Infectious Diseases, Children's Hospital of Central Switzerland (KidZ), Lucerne Cantonal Hospital, Lucerne, Switzerland
- Faculty of Health Sciences and Medicine, University Lucerne, Lucerne, Switzerland
| | - Goonaseelan Pillai
- APT-Africa Fellowship Program, c/o Pharmacometrics Africa NPC, Groote Schuur Hospital, Cape Town, South Africa
- Division of Clinical Pharmacology, University of Cape Town, Cape Town, South Africa
- CP+ Associates GmbH, Basel, Switzerland
| | | | - Jean Coulibaly
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Ivory Coast
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Ivory Coast
| | - Marc Pfister
- Pediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital (UKBB), Basel, Switzerland
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Allschwil Switzerland, University of Basel, Basel, Switzerland
- Paediatric Infectious Diseases, Children's Hospital of Central Switzerland (KidZ), Lucerne Cantonal Hospital, Lucerne, Switzerland
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13
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Rokaitė R, Dženkaitis M, Nedzinskaitė M, Kučinskienė R. Biliary Ascariasis in a Pediatric Patient in Lithuania: Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:916. [PMID: 38929533 PMCID: PMC11205314 DOI: 10.3390/medicina60060916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 05/26/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
Hepatobiliary ascariasis is caused by the entry of the nematode A. lumbricoides from the duodenum into the biliary duct. We report a case of an Ascaris-induced extrahepatic biliary tract obstruction in a pediatric patient admitted to the hospital due to a wide spectrum of symptoms of biliary disease, which included abdominal pain in the upper abdominal quadrants, vomiting, and jaundice. Imaging tests-including ultrasound, magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography (ERCP)-were performed to confirm the diagnosis of biliary ascariasis. The tests did, in fact, demonstrate signs of this disease. Nevertheless, during the ERCP, only the remains of Ascaris parasites in the form of tissue fragments were extracted. We also aim to discuss the prevalence of ascariasis in children, the causes of migration of Ascaris parasites into the bile ducts, together with its clinical manifestations, as well as the diagnostic and treatment methods of this disease.
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Affiliation(s)
- Rūta Rokaitė
- Department of Pediatrics, Medical Academy, Lithuanian University of Health Sciences, LT 44307 Kaunas, Lithuania;
| | - Mindaugas Dženkaitis
- School of Medicine, College of Health and Agricultural Sciences, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
| | - Melita Nedzinskaitė
- Department of Pediatrics, Medical Academy, Lithuanian University of Health Sciences, LT 44307 Kaunas, Lithuania;
| | - Rūta Kučinskienė
- Department of Pediatrics, Medical Academy, Lithuanian University of Health Sciences, LT 44307 Kaunas, Lithuania;
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Alonaizan R. Molecular regulation of NLRP3 inflammasome activation during parasitic infection. Biosci Rep 2024; 44:BSR20231918. [PMID: 38623843 PMCID: PMC11096646 DOI: 10.1042/bsr20231918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 03/26/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024] Open
Abstract
Parasitic diseases are a serious global health concern, causing many common and severe infections, including Chagas disease, leishmaniasis, and schistosomiasis. The NLRP3 inflammasome belongs to the NLR (nucleotide-binding domain leucine-rich-repeat-containing proteins) family, which are cytosolic proteins playing key roles in the detection of pathogens. NLRP3 inflammasomes are activated in immune responses to Plasmodium, Leishmania, Toxoplasma gondii, Entamoeba histolytica, Trypanosoma cruzi, and other parasites. The role of NLRP3 is not fully understood, but it is a crucial component of the innate immune response to parasitic infections and its functions as a sensor triggering the inflammatory response to the invasive parasites. However, while this response can limit the parasites' growth, it can also result in potentially catastrophic host pathology. This makes it essential to understand how NLRP3 interacts with parasites to initiate the inflammatory response. Plasmodium hemozoin, Leishmania glycoconjugate lipophosphoglycan (LPG) and E. histolytica Gal/GalNAc lectin can stimulate NLRP3 activation, while the dense granule protein 9 (GRA9) of T. gondii has been shown to suppress it. Several other parasitic products also have diverse effects on NLRP3 activation. Understanding the mechanism of NLRP3 interaction with these products will help to develop advanced therapeutic approaches to treat parasitic diseases. This review summarizes current knowledge of the NLRP3 inflammasome's action on the immune response to parasitic infections and aims to determine the mechanisms through which parasitic molecules either activate or inhibit its action.
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Affiliation(s)
- Rasha Alonaizan
- Faculty of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
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15
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Kihoro RW, Mulewa D, Okoyo C, Ayaa D, Korir A, Njomo DW, Mwandawiro C, Masaku J. Epidemiology of soil-transmitted helminthiasis among school-aged children in pastoralist communities of Kenya: A cross-sectional study. PLoS One 2024; 19:e0304266. [PMID: 38781162 PMCID: PMC11115206 DOI: 10.1371/journal.pone.0304266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Soil-transmitted helminthiasis (STH) are a major public health problem in Sub-Saharan Africa. In Kenya, the National School Based Deworming Program (NSBDP) was launched in 2012 with a goal of reducing STH prevalence in school-aged children (SAC) to <1%, however monitoring and evaluation results have consistently showed > 20% prevalence in Narok County. We conducted a study to investigate factors associated with STH infections among SAC in Narok County. METHODOLOGY A cross-sectional study was conducted among 514 SAC from five schools in Trans Mara West sub-county, Narok County. The sub-county was selected because it had participating schools within the NSBDP with a high prevalence of STH infection. Participants were selected using systematic random sampling. Stool samples collected from participants were examined for STH eggs using Kato-Katz technique. An open data kit questionnaire was used to collect socio-demographics, household, and STH knowledge information from 139 of the 514 SAC. Descriptive statistics was used to summarize the data, prevalence and mean intensity of infections were calculated, and logistic regression used to determine factors associated with STH infections. RESULTS The overall prevalence of any STH infection was 24.6% (95%CI: 21.1-28.6). Trichuris trichiura 14.4% (95%CI: 11.7-17.8), Ascaris lumbricoides 12.5% (95%CI: 9.9-15.7) and hookworm 0%. From multivariable analysis the only factors significantly associated with increased risk of STH infection were, children attending Karda and Nkarano schools with aOR = 5.29 (95%CI: 1.45-19.24); p = 0.011 and aOR = 4.53 (95%CI: 1.29-15.97); p = 0.019 respectively. For A. lumbricoides, children attending Nkarano School were associated with a significant risk of infection with aOR = 7.81 (95%CI: 1.81-33.63); p = 0.006. CONCLUSIONS Despite the ongoing work of NSBDP, the STH prevalence is still ≥ 20% in Trans Mara West sub-county Narok County, among SAC. This underscores the need for continued annual MDA. Additionally, if possible, drug combinations may effectively manage T. trichiura, the region's most common helminth. The study found a correlation between children attending specific schools and STH infection risk, suggesting the importance of health education and improved water, sanitation, and hygiene practices holistically both in schools and associated catchment areas that can act as STH reservoirs to alleviate the burden of STH.
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Affiliation(s)
- Richelle W. Kihoro
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Damaris Mulewa
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
- Department of Developmental Studies, Daystar University, Nairobi, Kenya
| | - Collins Okoyo
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Dominic Ayaa
- Department of Developmental Studies, Daystar University, Nairobi, Kenya
| | - Agnes Korir
- Department of Developmental Studies, Daystar University, Nairobi, Kenya
| | - Doris W. Njomo
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Charles Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Janet Masaku
- Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
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Sargsian S, Mondragón-Palomino O, Lejeune A, Ercelen D, Jin WB, Varghese A, Lim YAL, Guo CJ, Loke P, Cadwell K. Functional characterization of helminth-associated Clostridiales reveals covariates of Treg differentiation. MICROBIOME 2024; 12:86. [PMID: 38730492 PMCID: PMC11084060 DOI: 10.1186/s40168-024-01793-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 03/10/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Parasitic helminths influence the composition of the gut microbiome. However, the microbiomes of individuals living in helminth-endemic regions are understudied. The Orang Asli, an indigenous population in Malaysia with high burdens of the helminth Trichuris trichiura, display microbiotas enriched in Clostridiales, an order of spore-forming obligate anaerobes with immunogenic properties. We previously isolated novel Clostridiales that were enriched in these individuals and found that a subset promoted the Trichuris life cycle. In this study, we aimed to further characterize the functional properties of these bacteria. RESULTS Clostridiales isolates were profiled for their ability to perform 57 enzymatic reactions and produce short-chain fatty acids (SCFAs) and hydrogen sulfide, revealing that these bacteria were capable of a range of activities associated with metabolism and host response. Consistent with this finding, monocolonization of mice with individual isolates identified bacteria that were potent inducers of regulatory T-cell (Treg) differentiation in the colon. Comparisons between variables revealed by these studies identified enzymatic properties correlated with Treg induction and Trichuris egg hatching. CONCLUSION We identified Clostridiales species that are sufficient to induce high levels of Tregs. We also identified a set of metabolic activities linked with Treg differentiation and Trichuris egg hatching mediated by these newly isolated bacteria. Altogether, this study provides functional insights into the microbiotas of individuals residing in a helminth-endemic region. Video Abstract.
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Affiliation(s)
- Shushan Sargsian
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Octavio Mondragón-Palomino
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Alannah Lejeune
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Defne Ercelen
- Department of Medicine, Division of Gastroenterology and Hepatology, New York University Langone Health, New York, NY, 10016, USA
| | - Wen-Bing Jin
- Weill Cornell Medicine, Jill Roberts Institute for Research in Inflammatory Bowel Disease, Cornell University, New York, NY, 10021, USA
| | - Alan Varghese
- Department of Cell Biology, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Yvonne A L Lim
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Chun-Jun Guo
- Weill Cornell Medicine, Jill Roberts Institute for Research in Inflammatory Bowel Disease, Cornell University, New York, NY, 10021, USA
| | - P'ng Loke
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA.
| | - Ken Cadwell
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA.
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA.
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA.
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17
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Chakrabarti S, Ajjampur SSR, Waddington HS, Kishore A, Nguyen PH, Scott S. Deworming and micronutrient status by community open defecation prevalence: An observational study using nationally representative data from India, 2016-2018. PLoS Med 2024; 21:e1004402. [PMID: 38728369 PMCID: PMC11125536 DOI: 10.1371/journal.pmed.1004402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 05/24/2024] [Accepted: 04/12/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Micronutrient deficiencies are widespread in India. Soil-transmitted helminth (STH) infections are acquired by interaction with soil and water contaminated by human feces and lead to blood loss and poor micronutrient absorption. The current recommendation for control of STH-related morbidity is targeted deworming, yet little is known about the effectiveness of deworming on micronutrient status in varying sanitation contexts. Ranging between 1% and 40% prevalence across Indian states, open defecation (OD) remains high despite India's investments at elimination by promoting community-wide sanitation. This variation provides an opportunity to study the relationship between deworming, micronutrient status, and OD at-scale. METHODS AND FINDINGS Cross-sectional datasets that were representative for India were obtained the Comprehensive National Nutrition Survey in 2016 to 2018 (n = 105,060 individuals aged 1 to 19 years). Consumption of deworming medication was described by age and community OD level. Logistic regression models were used to examine the relationship between deworming, cluster OD, and their interactions, with anemia and micronutrient deficiencies (iron, zinc, vitamin A, folate, and vitamin B12), controlling for age, sex, wealth, diet, and seasonality. These regression models further allowed us to identify a minimum OD rate after which deworming becomes ineffective. In sensitivity analyses, the association between deworming and deficiencies were tested in subsamples of communities classified into 3 OD levels based on statistical tertiles: OD free (0% of households in the community practicing OD), moderate OD (>0% and <30%), or high OD (at least 30%). Average deworming coverage and OD prevalence in the sample were 43.4% [IQR 26.0, 59.0] and 19.1% [IQR 0, 28.5], respectively. Controlling for other determinants of nutritional status, adolescents living in communities with higher OD levels had lower coverage of deworming and higher prevalence of anemia, zinc, vitamin A, and B12 deficiencies. Compared to those who were not dewormed, dewormed children and adolescents had lower odds of anemia (adjusted odds ratio 0.72, (95% CI [0.67, 0.78], p < 0.001) and deficiencies of iron 0.78, (95% CI [0.74, 0.82], p < 0.001) and folate 0.69, (95% CI [0.64,0.74], p<0.001)) in OD free communities. These protective effects remained significant for anemia but diminished for other micronutrient deficiencies in communities with moderate or high OD. Analysis of community OD indicated a threshold range of 30% to 60%, above which targeted deworming was no longer significantly associated with lower anemia, iron, and folate deficiency. The primary limitations of the study included potential for omitted variables bias and inability to capture longitudinal effects. CONCLUSIONS Moderate to high rates of OD significantly modify the association between deworming and micronutrient status in India. Public health policy could involve sequencing interventions, with focus on improving deworming coverage in communities that have achieved minimum thresholds of OD and re- triggering sanitation interventions in high OD communities prior to deworming days, ensuring high coverage for both. The efficacy of micronutrient supplementation as a complementary strategy to improve nutritional outcomes alongside deworming and OD elimination in this age group needs further study.
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Affiliation(s)
- Suman Chakrabarti
- International Food Policy Research Institute, Washington DC, and India
| | | | - Hugh Sharma Waddington
- London School of Hygiene & Tropical Medicine and London International Development Centre, London, United Kingdom
| | - Avinash Kishore
- International Food Policy Research Institute, Washington DC, and India
| | - Phuong H. Nguyen
- International Food Policy Research Institute, Washington DC, and India
| | - Samuel Scott
- International Food Policy Research Institute, Washington DC, and India
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18
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Behniafar H, Sepidarkish M, Tadi MJ, Valizadeh S, Gholamrezaei M, Hamidi F, Pazoki H, Alizadeh F, Kianifard N, Nooshabadi MS, Bagheri K, Hemmati F, Hemmati T, Tori NA, Siddiq A, Rostami A. The global prevalence of Trichuris trichiura infection in humans (2010-2023): A systematic review and meta-analysis. J Infect Public Health 2024; 17:800-809. [PMID: 38537575 DOI: 10.1016/j.jiph.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/01/2024] [Accepted: 03/03/2024] [Indexed: 04/15/2024] Open
Abstract
This systematic review and meta-analysis study aimed to evaluate global Trichuris infection prevalence, assessing progress towards the WHO's 2030 target. We searched international databases from 2010-2023, categorizing data by regions and socio-economic variables using a random-effects model. Analyzing 757 articles covering 7154,842 individuals from 78 countries, the study found a pooled global prevalence of (6.64-7.57%), with the highest rates in the Caribbean (21.72%; 8.90-38.18%) and South-East Asia (20.95; 15.71-26.71%) regions. Southern Africa (9.58; 2.11-21.46%), Latin America (9.58; 2.11-21.46%), and Middle Africa Middle Africa (8.94; 6.31-11.98%) also exhibited high prevalence. Eastern Europe had the lowest prevalence at 0.16% (0.09-0.24). Approximately 513 (480-547) million people worldwide were estimated to harbor Trichuris. Moreover ∼1.5% of people tested worldwide (2010-2023) had a moderate to heavy intensity of infection. The study emphasizes the persistent global health threat of Trichuris infection, urging tailored strategies for effective control and prevention on a global scale.
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Affiliation(s)
- Hamed Behniafar
- Department of Medical Parasitology, Sarab Faculty of Medical Sciences, Sarab, Iran
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Mehrdad Jafari Tadi
- Department of Cell and Molecular Medicine, Rush University Medical Center, Chicago, IL 60607, USA
| | - Soghra Valizadeh
- Department of Food Hygiene and Aquatic, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - Mostafa Gholamrezaei
- Department of Parasitology and Mycology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Faezeh Hamidi
- Department of Laboratory Sciences and Microbiology, Faculty of Medical Sciences, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
| | - Hossein Pazoki
- Department of Medical Microbiology, Faculty of Medicine, Infectious Diseases Research Center, Gonabad University of Medical Science, Gonabad, Iran
| | - Faezeh Alizadeh
- Department of Pharmaceutical Sciences, University of Illinois, Chicago, USA
| | - Nazanin Kianifard
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Kimia Bagheri
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Faezeh Hemmati
- Student Research Committee, Sarab Faculty of Medical Sciences, Sarab, Iran
| | - Taha Hemmati
- Student Research Committee, Sarab Faculty of Medical Sciences, Sarab, Iran
| | - Neda Ahmazadeh Tori
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | | | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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19
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Mules TC, Tang JS, Vacca F, Yumnam B, Schmidt A, Lavender B, Maclean K, Noble SL, Waugh C, van Ginkel R, Camberis M, Le Gros G, Inns S. Modulation of intestinal epithelial permeability by chronic small intestinal helminth infections. Immunol Cell Biol 2024; 102:396-406. [PMID: 38648862 DOI: 10.1111/imcb.12749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 03/18/2024] [Accepted: 03/28/2024] [Indexed: 04/25/2024]
Abstract
Increased permeability of the intestinal epithelial layer is linked to the pathogenesis and perpetuation of a wide range of intestinal and extra-intestinal diseases. Infecting humans with controlled doses of helminths, such as human hookworm (termed hookworm therapy), is proposed as a treatment for many of the same diseases. Helminths induce immunoregulatory changes in their host which could decrease epithelial permeability, which is highlighted as a potential mechanism through which helminths treat disease. Despite this, the influence of a chronic helminth infection on epithelial permeability remains unclear. This study uses the chronically infecting intestinal helminth Heligmosomoides polygyrus to reveal alterations in the expression of intestinal tight junction proteins and epithelial permeability during the infection course. In the acute infection phase (1 week postinfection), an increase in intestinal epithelial permeability is observed. Consistent with this finding, jejunal claudin-2 is upregulated and tricellulin is downregulated. By contrast, in the chronic infection phase (6 weeks postinfection), colonic claudin-1 is upregulated and epithelial permeability decreases. Importantly, this study also investigates changes in epithelial permeability in a small human cohort experimentally challenged with the human hookworm, Necator americanus. It demonstrates a trend toward small intestinal permeability increasing in the acute infection phase (8 weeks postinfection), and colonic and whole gut permeability decreasing in the chronic infection phase (24 weeks postinfection), suggesting a conserved epithelial response between humans and mice. In summary, our findings demonstrate dynamic changes in epithelial permeability during a chronic helminth infection and provide another plausible mechanism by which chronic helminth infections could be utilized to treat disease.
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Affiliation(s)
- Thomas C Mules
- Malaghan Institute of Medical Research, Wellington, New Zealand
- University of Otago, Wellington, New Zealand
| | - Jeffry S Tang
- Malaghan Institute of Medical Research, Wellington, New Zealand
- High-Value Nutrition National Science Challenge, Auckland, New Zealand
| | - Francesco Vacca
- Malaghan Institute of Medical Research, Wellington, New Zealand
| | - Bibek Yumnam
- Malaghan Institute of Medical Research, Wellington, New Zealand
| | - Alfonso Schmidt
- Malaghan Institute of Medical Research, Wellington, New Zealand
| | | | - Kate Maclean
- Malaghan Institute of Medical Research, Wellington, New Zealand
| | | | | | | | - Mali Camberis
- Malaghan Institute of Medical Research, Wellington, New Zealand
| | - Graham Le Gros
- Malaghan Institute of Medical Research, Wellington, New Zealand
| | - Stephen Inns
- Malaghan Institute of Medical Research, Wellington, New Zealand
- University of Otago, Wellington, New Zealand
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20
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Xiu L, Kassegne K, Yin J. Editorial: One Health in clinical microbiology. Front Cell Infect Microbiol 2024; 14:1404276. [PMID: 38686095 PMCID: PMC11056643 DOI: 10.3389/fcimb.2024.1404276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 04/05/2024] [Indexed: 05/02/2024] Open
Affiliation(s)
- Leshan Xiu
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China
| | - Kokouvi Kassegne
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China
| | - Jianhai Yin
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China
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21
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Maldonado-Barrueco A, San José-Villar SM, García-Rodríguez J, Alguacil-Guillén M, López-Janeiro Á, Trigo-Esteban E, Díaz-Menéndez M, Ruiz-Carrascoso G. Answer to April 2024 Photo Quiz. J Clin Microbiol 2024; 62:e0125923. [PMID: 38597632 PMCID: PMC11005401 DOI: 10.1128/jcm.01259-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Read the full article for the answer.
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Affiliation(s)
| | | | | | | | - Álvaro López-Janeiro
- Department of Pathological Anatomy, Hospital Universitario La Paz, Madrid, Spain
| | - Elena Trigo-Esteban
- Imported Pathology and International Health Unit, Hospital Universitario La Paz, Madrid, Spain
| | - Marta Díaz-Menéndez
- Imported Pathology and International Health Unit, Hospital Universitario La Paz, Madrid, Spain
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid, Spain
| | - Guillermo Ruiz-Carrascoso
- Department of Clinical Microbiology, Hospital Universitario La Paz, Madrid, Spain
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid, Spain
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22
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G/Kidan M, Fayisa ST, Hailu SS, Abebe AT. Ascariasis: A common disease with uncommon presentation in a resource limited setting. A case report. Radiol Case Rep 2024; 19:1560-1564. [PMID: 38317701 PMCID: PMC10839760 DOI: 10.1016/j.radcr.2023.12.063] [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: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 02/07/2024] Open
Abstract
Ascaris-induced intestinal obstruction is a rare complication primarily seen in children in areas with a high prevalence of worm infestations. It can occur through 2 mechanisms: immune-mediated reactions releasing neurotoxins that cause contractions and inflammation in the small intestine (aperistalsis), or mechanical obstruction by adult worms, commonly at the ileocecal valve. Partial obstructions are managed conservatively, while complete obstructions often require surgical intervention. In a recent case, a 19-year-old male presented with persistent abdominal pain, vomiting, and inability to pass stools, and gas. Imaging revealed partial obstruction, and conservative management with fluids, a nasogastric tube, and antibiotics led to the spontaneous passage of worms, relieving symptoms. The patient was discharged with anthelmintics and advised on follow-up and sanitary measures. This case is notable for the uncommon occurrence of Ascaris-induced intestinal obstruction in adults and the successful conservative management resulting in early worm expulsion.
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Affiliation(s)
- Messay G/Kidan
- Department of Radiology, Menelik II Comprehensive Specialized Hospital, Addis Ababa, Ethiopia
| | - Shimalis T. Fayisa
- Department of Radiology, School of Medicine, Collage of Health Science, Mizan Tepi University, Mizan, Ethiopia
| | - Samuel S. Hailu
- Department of Radiology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abel T. Abebe
- University of Texas Medical Branch, Galveston, TX, USA
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23
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Doolin ML, Dearing MD. Differential Effects of Two Common Antiparasitics on Microbiota Resilience. J Infect Dis 2024; 229:908-917. [PMID: 38036425 DOI: 10.1093/infdis/jiad547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/20/2023] [Accepted: 11/28/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Parasitic infections challenge vertebrate health worldwide, and off-target effects of antiparasitic treatments may be an additional obstacle to recovery. However, there have been few investigations of the effects of antiparasitics on the gut microbiome in the absence of parasites. METHODS We investigated whether two common antiparasitics-albendazole (ALB) and metronidazole (MTZ)-significantly alter the gut microbiome of parasite-free mice. We treated mice with ALB or MTZ daily for 7 days and sampled the fecal microbiota immediately before and after treatment and again after a two-week recovery period. RESULTS ALB did not immediately change the gut microbiota, while MTZ decreased microbial richness by 8.5% and significantly changed community structure during treatment. The structural changes caused by MTZ included depletion of the beneficial family Lachnospiraceae, and predictive metagenomic analysis revealed that these losses likely depressed microbiome metabolic function. Separately, we compared the fecal microbiotas of treatment groups after recovery, and there were minor differences in community structure between the ALB, MTZ, and sham-treated control groups. CONCLUSIONS These results suggest that a healthy microbiome is resilient after MTZ-induced depletions of beneficial gut microbes, and ALB may cause slight, latent shifts in the microbiota but does not deplete healthy gut microbiota diversity.
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Affiliation(s)
- Margaret L Doolin
- School of Biological Sciences, University of Utah, Salt Lake City, Utah, USA
| | - M Denise Dearing
- School of Biological Sciences, University of Utah, Salt Lake City, Utah, USA
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24
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Perera DJ, Koger-Pease C, Paulini K, Daoudi M, Ndao M. Beyond schistosomiasis: unraveling co-infections and altered immunity. Clin Microbiol Rev 2024; 37:e0009823. [PMID: 38319102 PMCID: PMC10938899 DOI: 10.1128/cmr.00098-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
Schistosomiasis is a neglected tropical disease caused by the helminth Schistosoma spp. and has the second highest global impact of all parasites. Schistosoma are transmitted through contact with contaminated fresh water predominantly in Africa, Asia, the Middle East, and South America. Due to the widespread prevalence of Schistosoma, co-infection with other infectious agents is common but often poorly described. Herein, we review recent literature describing the impact of Schistosoma co-infection between species and Schistosoma co-infection with blood-borne protozoa, soil-transmitted helminths, various intestinal protozoa, Mycobacterium, Salmonella, various urinary tract infection-causing agents, and viral pathogens. In each case, disease severity and, of particular interest, the immune landscape, are altered as a consequence of co-infection. Understanding the impact of schistosomiasis co-infections will be important when considering treatment strategies and vaccine development moving forward.
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Affiliation(s)
- Dilhan J. Perera
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Cal Koger-Pease
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Kayla Paulini
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Mohamed Daoudi
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Momar Ndao
- Division of Experimental Medicine, McGill University, Montreal, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
- National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, Canada
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25
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Espiau M, Ajanovic S, Zarzuela F, Maturana CR, Soler-Palacín P, Soriano-Arandes A, Sulleiro E. Management of paediatric soil-transmitted helminthiasis in a non-endemic area: experience in a reference international health unit. Parasitol Res 2024; 123:152. [PMID: 38441714 DOI: 10.1007/s00436-024-08171-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/26/2024] [Indexed: 03/07/2024]
Abstract
Soil-transmitted helminth (STH) infections inflict disability worldwide, especially in the poorest communities. Current therapeutic options against STHs show limited efficacy, particularly against Trichuris trichiura. The empirical management of patients coming from high-prevalence areas has been suggested for non-endemic areas. This study aimed to describe the management of STH infections in a non-endemic setting using an individualised approach. We performed a retrospective, descriptive study of all patients up to 16 years of age with STH infections attended at an international health unit in a non-endemic area (2014-2018), including all T. trichiura, Necator americanus, Ancylostoma duodenale, and Ascaris lumbricoides infections diagnosed using a formol-ether concentration technique and direct visualisation. Patients were treated according to current international guidelines. Sixty-one stool samples from 48 patients testing positive for STHs were collected, with 96% (46/48) reporting a previous long-term stay in endemic areas. Cure rates with 3-day benzimidazole regimens were 72% for T. trichiura, 40% for hookworms, and 83% for A. lumbricoides. The results were not influenced by any reinfection risk due to the study being performed in a non-endemic area. Patients coming from STH-endemic areas should be evaluated with appropriate diagnostic tools and followed up until cure control results. Cure rates in our cohort were moderate to low, similar to those published in studies in endemic areas. The efficacy of current treatment options is insufficient to recommend a specific empirical approach in high-income countries' healthcare systems.
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Affiliation(s)
- Maria Espiau
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sara Ajanovic
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francesc Zarzuela
- Microbiology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carles Rubio Maturana
- Microbiology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pere Soler-Palacín
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antoni Soriano-Arandes
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Microbiology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
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26
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Welsche S, Schneeberger PHH, Hattendorf J, Sayasone S, Hürlimann E, Keiser J. Egg excretion patterns of soil-transmitted helminth infections in humans following albendazole-ivermectin and albendazole treatment. PLoS Negl Trop Dis 2024; 18:e0012073. [PMID: 38517907 PMCID: PMC10990175 DOI: 10.1371/journal.pntd.0012073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 04/03/2024] [Accepted: 03/15/2024] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND Control efforts of soil-transmitted helminthiases rely primarily on large scale administration of anthelminthic drugs. The assessment of drug efficacies and understanding of drug behavior is pivotal to the evaluation of treatment successes, both in preventive chemo-therapy programs as well as in research of novel treatment options. The current WHO guidelines recommend an interval of 14-21 days between the treatment and follow-up, yet no in-depth analysis of egg excretion patterns of Trichuris trichiura after treatment has been conducted to date. METHODS Within the framework of a multi-country trial to assess the efficacy and safety of albendazole-ivermectin combination therapy vs albendazole monotherapy against T. trichiura infections, we conducted a study collecting daily stool samples over the period of 28 days post-treatment in 87 participants in Pak Khan, Lao PDR. Egg counts were derived by duplicate Kato-Katz on-site for T. trichiura, hookworm and Ascaris lumbricoides and stool sample aliquots were subsequently analyzed by qPCR for the detection of T. trichiura infections. Sensitivity and specificity was calculated for each day separately using data derived by Kato-Katz to determine the optimal timepoint at which to assess drug efficacy. RESULTS Egg excretion patterns varied across treatment arms. For T. trichiura, only the albendazole-ivermectin treatment led to a considerable reduction in mean egg counts, whereas both treatments reduced hookworm egg counts and A. lumbricoides were cleared in all participants after day 7. For T. trichiura, we found sensitivity to be highest at days 18 and 22 when using egg counts as outcome and days 19 and 24 when using qPCR. Specificity was high (>0.9) from day 14 onwards. For hookworm, the highest sensitivity and specificity were found at days 17 and 25, respectively. CONCLUSIONS Based on our study, the ideal time period to assess drug efficacy for soil-transmitted helminth infections would be between day 18 and 24. The current WHO recommendation of 14 to 21 days is likely to yield acceptable outcome measures for soil-transmitted helminth infections. TRIAL REGISTRATION NCT03527732.
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Affiliation(s)
- Sophie Welsche
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Pierre H. H. Schneeberger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jan Hattendorf
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Eveline Hürlimann
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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27
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Mejías-Alpízar MJ, Porras-Silesky C, Rodríguez EJ, Quesada J, Alfaro-Segura MP, Robleto-Quesada J, Gutiérrez R, Rojas A. Mitochondrial and ribosomal markers in the identification of nematodes of clinical and veterinary importance. Parasit Vectors 2024; 17:77. [PMID: 38378676 PMCID: PMC10880205 DOI: 10.1186/s13071-023-06113-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/26/2023] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Nematodes of the Ascarididae, Ancylostomatidae and Onchocercidae families are parasites of human and veterinary importance causing infections with high prevalence worldwide. Molecular tools have significantly improved the diagnosis of these helminthiases, but the selection of genetic markers for PCR or metabarcoding purposes is often challenging because of the resolution these may show. METHODS Nuclear 18S rRNA, internal transcribed spacers 1 (ITS-1) and 2 (ITS-2), mitochondrial gene cytochrome oxidase 1 (cox1) and mitochondrial rRNA genes 12S and 16S loci were studied for 30 species of the mentioned families. Accordingly, their phylogenetic interspecies resolution, pairwise nucleotide p-distances and sequence availability in GenBank were analyzed. RESULTS The 18S rRNA showed the least interspecies resolution since separate species of the Ascaris, Mansonella, Toxocara or Ancylostoma genus were intermixed in phylogenetic trees as opposed to the ITS-1, ITS-2, cox1, 12S and 16S loci. Moreover, pairwise nucleotide p-distances were significantly different in the 18S compared to the other loci, with an average of 99.1 ± 0.1%, 99.8 ± 0.1% and 98.8 ± 0.9% for the Ascarididae, Ancylostomatidae and Onchocercidae families, respectively. However, ITS-1 and ITS-2 average pairwise nucleotide p-distances in the three families ranged from 72.7% to 87.3%, and the cox1, 12S and 16S ranged from 86.4% to 90.4%. Additionally, 2491 cox1 sequences were retrieved from the 30 analyzed species in GenBank, whereas 212, 1082, 994, 428 and 143 sequences could be obtained from the 18S, ITS-1, ITS-2, 12S and 16S markers, respectively. CONCLUSIONS The use of the cox1 gene is recommended because of the high interspecies resolution and the large number of sequences available in databases. Importantly, confirmation of the identity of an unknown specimen should always be complemented with the careful morphological examination of worms and the analysis of other markers used for specific parasitic groups.
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Affiliation(s)
- María José Mejías-Alpízar
- Laboratorio de Helmintología, Departamento de Parasitología, Facultad de Microbiología, University of Costa Rica, San José, Costa Rica
| | - Catalina Porras-Silesky
- Laboratorio de Helmintología, Departamento de Parasitología, Facultad de Microbiología, University of Costa Rica, San José, Costa Rica
| | - Esteban José Rodríguez
- Centro de Investigación en Enfermedades Tropicales, University of Costa Rica, San José, Costa Rica
| | - Joban Quesada
- Laboratorio de Helmintología, Departamento de Parasitología, Facultad de Microbiología, University of Costa Rica, San José, Costa Rica
| | - María Paula Alfaro-Segura
- Laboratorio de Helmintología, Departamento de Parasitología, Facultad de Microbiología, University of Costa Rica, San José, Costa Rica
| | - Joby Robleto-Quesada
- Centro de Investigación en Enfermedades Tropicales, University of Costa Rica, San José, Costa Rica
| | - Ricardo Gutiérrez
- National Reference Center for Bacteriology, Costa Rican Institute for Research and Teaching in Nutrition and Health (INCIENSA), Tres Rios, Costa Rica
- Ross University School of Veterinary Medicine, West Farm, Basseterre, Saint Kitts and Nevis
| | - Alicia Rojas
- Laboratorio de Helmintología, Departamento de Parasitología, Facultad de Microbiología, University of Costa Rica, San José, Costa Rica.
- Centro de Investigación en Enfermedades Tropicales, University of Costa Rica, San José, Costa Rica.
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28
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Hon KL, Leung AKC. An update on the current and emerging pharmacotherapy for the treatment of human ascariasis. Expert Opin Pharmacother 2024. [PMID: 38372051 DOI: 10.1080/14656566.2024.2319686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 02/13/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Globally, Ascaris lumbricoides is the commonest helminthic infection that affects people in underdeveloped countries and returning immigrants in industrialized nations. This article aims to provide latest updates on the epidemiology, clinical manifestations, and pharmacotherapy of ascariasis. AREAS COVERED A PubMed search was conducted using Clinical Queries and the key terms 'human ascariasis' OR 'Ascaris lumbricoides.' Ascaris lumbricoides is highly endemic in tropical and subtropic regions and among returning immigrants in industrialized nations. Predisposing factors include poor sanitation and poverty. The prevalence is greatest in young children. Most infected patients are asymptomatic. Patients with A. lumbricoides infection should be treated with anti-helminthic drugs to prevent complications from migration of the worm. Mebendazole and albendazole are indicated for children and nonpregnant women. Pregnant individuals should be treated with pyrantel pamoate. EXPERT OPINION Cure rates with anthelmintic treatment are high. No emerging pharmacotherapy can replace these existing drugs of good efficacy, safety profile and low cost for public health. It is opinioned that advances in the management of ascariasis include diagnostic accuracy at affordable costs, Emodepside is highly effective in single doses against ascarids in mammals and in human trials. The drug could be registered for human use in multiple neglected tropical diseases.
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Affiliation(s)
- Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, and Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China
| | - Alexander K C Leung
- Department of Pediatrics, The University of Calgary and the Alberta Children's Hospital, Calgary, Alberta, Canada
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29
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Mationg MLS, Williams GM, Tallo VL, Olveda RM, McManus DP, Stewart DE, Gray DJ. A review of health education activities targeting schoolchildren for the control of soil-transmitted helminthiasis in Southeast Asia, with emphasis upon the Magic Glasses approach. ADVANCES IN PARASITOLOGY 2024; 123:1-22. [PMID: 38448146 DOI: 10.1016/bs.apar.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Soil-transmitted helminths continue to be a serious problem causing disease and morbidity globally. Children, mostly school-aged, are more at risk of these infections. The main strategy for control remains to be the mass drug administration (MDA) of antihelminthic drugs. With the limitation of MDA to prevent re-infection, the need for additional approaches such as hygiene education and improvements in water, sanitation and hygiene (WASH) infrastructure are required. Although the importance of health education as a crucial component of an integrated approaches to STH control is highlighted, this component has often been disregarded because the other more complex solutions have been the focus of most studies and programmes. We performed literature searches from four bibliographic databases - Scopus, PubMed, Web of Science and Cochrane Library - to determine availability of studies on the impact of health education interventions targeting STH infections on schoolchildren in Southeast Asia. Our review found only three studies that evaluated health education interventions targeting children. The current lack of evidence in this area suggests the need for more studies assessing the impact of health education intervention for STH control. A successful health education programme for STH called "The Magic Glasses" has been developed targeting schoolchildren in China and the Philippines. This public health intervention displayed significant impact in terms of improving knowledge, attitude and practices, reducing prevalence of STH infections in schoolchildren and encouraging compliance to MDA. This article details the successes and benefits of the Magic Glasses programme as a promising control tool for STH in the Southeast Asian region.
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Affiliation(s)
- Mary Lorraine S Mationg
- National Center for Epidemiology and Population Health, Australian National University, Canberra; QIMR Berghofer Medical Research Institute, Brisbane
| | | | | | | | | | - Donald E Stewart
- School of Medicine and Dentistry, Griffith Health, Griffith University
| | - Darren J Gray
- QIMR Berghofer Medical Research Institute, Brisbane.
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Coffeng LE, Stolk WA, de Vlas SJ. Predicting the risk and speed of drug resistance emerging in soil-transmitted helminths during preventive chemotherapy. Nat Commun 2024; 15:1099. [PMID: 38321011 PMCID: PMC10847116 DOI: 10.1038/s41467-024-45027-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/12/2024] [Indexed: 02/08/2024] Open
Abstract
Control of soil-transmitted helminths relies heavily on regular large-scale deworming of high-risk groups (e.g., children) with benzimidazole derivatives. Although drug resistance has not yet been documented in human soil-transmitted helminths, regular deworming of cattle and sheep has led to widespread benzimidazole resistance in veterinary helminths. Here we predict the population dynamics of human soil-transmitted helminth infections and drug resistance during 20 years of regular preventive chemotherapy, using an individual-based model. With the current preventive chemotherapy strategy of mainly targeting children in schools, drug resistance may evolve in soil-transmitted helminths within a decade. More intense preventive chemotherapy strategies increase the prospects of soil-transmitted helminths elimination, but also increase the speed at which drug efficacy declines, especially when implementing community-based preventive chemotherapy (population-wide deworming). If during the last decade, preventive chemotherapy against soil-transmitted helminths has led to resistance, we may not have detected it as drug efficacy has not been structurally monitored, or incorrectly so. These findings highlight the need to develop and implement strategies to monitor and mitigate the evolution of benzimidazole resistance.
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Affiliation(s)
- Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Wilma A Stolk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Rayment Gomez S, Maddren R, Liyew EF, Chernet M, Anjulo U, Tamiru A, Tollera G, Tasew G, Mengistu B, Collyer B, Forbes K, Anderson R. Spatial heterogeneity in mass drug administration from a longitudinal epidemiological study assessing transmission interruption of soil transmitted helminths in the Wolaita zone of southern Ethiopia (Geshiyaro Project). PLoS Negl Trop Dis 2024; 18:e0011947. [PMID: 38330143 PMCID: PMC10880954 DOI: 10.1371/journal.pntd.0011947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 02/21/2024] [Accepted: 01/28/2024] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVES Deworming programmes of soil-transmitted helminths are generally monitored and evaluated by aggregating drug coverage and infection levels at a district level. However, heterogeneity in drug coverage at finer spatial scales means indicators may remain above thresholds for elimination as a public health problem or of transmission in some areas. This paper aims to highlight the misleading information that aggregating data at larger spatial scales can have for programme decision making. METHODS Drug coverage data from the Geshiyaro project were compared at two spatial scales with reference to the World Health Organisation's targets. District (woreda) and village (kebele) level were compared. The association between infection levels and drug coverage was analysed by fitting a weighted least-squares function to the mean intensity of infection (eggs per gram of faeces) against drug coverage. RESULTS The data show clearly that when the evaluation of coverage is aggregated to the district level, information on heterogeneity at a finer spatial scale is lost. Infection intensity decreases significantly (p = 0.0023) with increasing drug coverage. CONCLUSION Aggregating data at large spatial scales can result in prematurely ceasing deworming, prompting rapid infection bounce-back. There is a strong need to define context-specific spatial scales for monitoring and evaluating intervention programmes.
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Affiliation(s)
- Santiago Rayment Gomez
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
| | - Rosie Maddren
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
| | - Ewnetu Firdawek Liyew
- Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Melkie Chernet
- Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ufaysa Anjulo
- Disease Prevention and Health Promotion Core Process, Ministry of Health, Wolaita, Ethiopia
| | - Adugna Tamiru
- Disease Prevention and Health Promotion Core Process, Ministry of Health, Wolaita, Ethiopia
| | - Getachew Tollera
- Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Birhan Mengistu
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
| | - Benjamin Collyer
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
| | - Kathryn Forbes
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
| | - Roy Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
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Cai W, Zhu Y, Wang F, Feng Q, Zhang Z, Xue N, Xu X, Hou Z, Liu D, Xu J, Tao J. Prevalence of Gastrointestinal Parasites in Zoo Animals and Phylogenetic Characterization of Toxascaris leonina (Linstow, 1902) and Baylisascaris transfuga (Rudolphi, 1819) in Jiangsu Province, Eastern China. Animals (Basel) 2024; 14:375. [PMID: 38338018 PMCID: PMC10854492 DOI: 10.3390/ani14030375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
The burden of gastrointestinal parasites in zoo animals has serious implications for their welfare and the health of veterinarians and visitors. Zhuyuwan Zoo is located in the eastern suburb of Yangzhou city in eastern China, in which over 40 species of zoo animals are kept. In order to understand the infection status of GI parasites in Zhuyuwan Zoo, a total of 104 fresh fecal samples collected randomly from birds (n = 19), primates (n = 19), and non-primate mammals (n = 66) were analyzed using the saturated saline flotation technique and nylon sifter elutriation and sieving method for eggs/oocysts, respectively. Two Ascaris species were molecularly characterized. The results showed that the overall prevalence of parasitic infection was 42.3% (44/104). The parasitic infection rate in birds, primates, and non-primate mammals were 26.3% (5/19), 31.6% (6/19), and 50.0% (33/66), respectively. A total of 11 species of parasites were identified, namely, Trichostrongylidae, Capillaria sp., Trichuris spp., Strongyloides spp., Amidostomum sp., Toxascaris leonina, Baylisascaris transfuga, Parascaris equorum, Paramphistomum spp., Fasciola spp., and Eimeria spp. Paramphistomum spp. eggs were first detected from the captive Père David's deer, and Fasciola spp. eggs were first reported from sika deer in zoo in China. A sequence analysis of ITS-2 and cox1 showed that the eggs isolated from the African lion (Panthera leo Linnaeus, 1758) were T. leonina, and the eggs from the brown bear (Ursus arctos Linnaeus, 1758) were B. transfuga. The public health threat posed by these potential zoonotic parasitic agents requires attention. These results lay a theoretical foundation for prevention and control of wild animal parasitic diseases at zoos in China.
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Affiliation(s)
- Weimin Cai
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (W.C.); (Y.Z.); (F.W.); (Q.F.); (Z.Z.); (N.X.); (Z.H.); (D.L.); (J.X.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225009, China
- Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou 225009, China
| | - Yu Zhu
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (W.C.); (Y.Z.); (F.W.); (Q.F.); (Z.Z.); (N.X.); (Z.H.); (D.L.); (J.X.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225009, China
- Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou 225009, China
| | - Feiyan Wang
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (W.C.); (Y.Z.); (F.W.); (Q.F.); (Z.Z.); (N.X.); (Z.H.); (D.L.); (J.X.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225009, China
- Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou 225009, China
| | - Qianqian Feng
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (W.C.); (Y.Z.); (F.W.); (Q.F.); (Z.Z.); (N.X.); (Z.H.); (D.L.); (J.X.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225009, China
- Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou 225009, China
| | - Zhizhi Zhang
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (W.C.); (Y.Z.); (F.W.); (Q.F.); (Z.Z.); (N.X.); (Z.H.); (D.L.); (J.X.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225009, China
- Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou 225009, China
| | - Nianyu Xue
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (W.C.); (Y.Z.); (F.W.); (Q.F.); (Z.Z.); (N.X.); (Z.H.); (D.L.); (J.X.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225009, China
- Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou 225009, China
| | - Xun Xu
- Yangzhou Zhuyuwan Zoo, Yangzhou 225009, China;
| | - Zhaofeng Hou
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (W.C.); (Y.Z.); (F.W.); (Q.F.); (Z.Z.); (N.X.); (Z.H.); (D.L.); (J.X.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225009, China
- Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou 225009, China
| | - Dandan Liu
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (W.C.); (Y.Z.); (F.W.); (Q.F.); (Z.Z.); (N.X.); (Z.H.); (D.L.); (J.X.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225009, China
- Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou 225009, China
| | - Jinjun Xu
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (W.C.); (Y.Z.); (F.W.); (Q.F.); (Z.Z.); (N.X.); (Z.H.); (D.L.); (J.X.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225009, China
- Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou 225009, China
| | - Jianping Tao
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (W.C.); (Y.Z.); (F.W.); (Q.F.); (Z.Z.); (N.X.); (Z.H.); (D.L.); (J.X.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou 225009, China
- Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou 225009, China
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Means AR, List K, Roll A, Gwayi-Chore MC, Dolley S, Schünemann HJ, Norman TC, Walson JL. Participatory development of a target policy profile to support soil-transmitted helminth elimination. FRONTIERS IN HEALTH SERVICES 2024; 3:1310694. [PMID: 38313331 PMCID: PMC10836137 DOI: 10.3389/frhs.2023.1310694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/21/2023] [Indexed: 02/06/2024]
Abstract
Introduction Soil-transmitted helminths (STH) are parasitic worms that infect nearly a quarter of the world's population, particularly those living in communities without access to adequate water, sanitation, and housing. Emerging evidence suggests that it may be possible to interrupt transmission of STH by deworming individuals of all ages via community-wide MDA (cMDA), as opposed to only treating children and other focal populations. Transitioning from a policy of STH control to STH elimination in targeted areas would require a fundamental shift in STH policy and programming. This policy change would require updated guidance to support countries as they adapt their current approaches for STH surveillance, supply chain management, community mobilization, and core programmatic activities in pursuit of STH elimination. There is an opportunity to engage with key stakeholders, such as program implementers and implementation partners, to understand what evidence they need to confidently adopt a new policy guideline and to deliver guideline adherent management at scale. Methods We aimed to engage with STH stakeholders to develop a Target Policy Profile (TPoP), a single document that describes optimal characteristics and evidence requirements that STH stakeholders prioritized in future potential STH transmission interruption efforts. Steps in TPoP development included a scoping review and key informant interviews (KIIs), which were used to design a two-stage Delphi technique to identify and verify TPoP components. Results The scoping review resulted in 25 articles, and 8 experts participated in KII's. Twenty respondents completed the first Delphi survey and 10 respondents completed the second. This systematic effort resulted in a net of 3 key information domains (background/context, clinical considerations, and implementation considerations) encompassing 24 evidence categories (examples include evidence regarding safety and adverse events, implementation feasibility, or evidence dissemination). For each evidence category, STH stakeholders reviewed, endorsed, or revised a range of options for how the evidence could be presented. Discussion This information can be used by guideline committees or global policy makers prior to convening guideline advisory groups. The TPoP tool may also speed the process of stakeholder consensus building around guidelines, accelerating progress towards implementing evidence-based policy at scale.
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Affiliation(s)
- Arianna Rubin Means
- Department of Global Health, University of Washington, Seattle, WA, United States
- The DeWorm3 Project, University of Washington, Seattle, WA, United States
| | - Kellie List
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Amy Roll
- Department of Global Health, University of Washington, Seattle, WA, United States
- The DeWorm3 Project, University of Washington, Seattle, WA, United States
| | - Marie-Claire Gwayi-Chore
- Department of Global Health, University of Washington, Seattle, WA, United States
- The DeWorm3 Project, University of Washington, Seattle, WA, United States
| | - Shawn Dolley
- Open Global Health, Arlington, VA, United States
| | - Holger J. Schünemann
- Departmentof Health Research Methods, Evidence, and Impact, and of Medicine, McMaster University, Hamilton, ON, Canada
- McMaster GRADE Centre & Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Thea C. Norman
- Bill & Melinda Gates Foundation, Seattle, WA, United States
| | - Judd L. Walson
- Department of Global Health, University of Washington, Seattle, WA, United States
- The DeWorm3 Project, University of Washington, Seattle, WA, United States
- Departments of Medicine, Pediatrics, and Epidemiology, University of Washington, Seattle, WA, United States
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Bathobakae L, Wilkinson T, Yasin S, Bashir R, Mateen N, Yuridullah R, Cavanagh Y, Baddoura W, Suh J. An Unpleasant Souvenir: Whipworm as an Incidental Finding During a Screening Colonoscopy. J Investig Med High Impact Case Rep 2024; 12:23247096231224328. [PMID: 38193443 PMCID: PMC10777755 DOI: 10.1177/23247096231224328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/15/2023] [Indexed: 01/10/2024] Open
Abstract
Trichuriasis is a neglected tropical disease caused by Trichuris trichiura that spreads through the ingestion of embryonated eggs in contaminated soil, water, or food. In nonendemic areas, T trichiura infestation is very rare and sporadic and is often diagnosed in immigrants from endemic countries such as the Philippines. Whipworms feed on human blood and also erode the colonic mucosa, thereby evoking an inflammatory response. In milder forms, trichuriasis can be asymptomatic and often an incidental diagnosis on screening colonoscopy. Heavily infested patients usually present with abdominal pain, nausea, vomiting, tenesmus, chronic diarrhea, iron deficiency anemia, or stunted growth. T trichiura worms can be removed with biopsy forceps during a colonoscopy; however, most patients require a course of albendazole, mebendazole, or ivermectin. We describe a unique case of T trichiura as an incidental finding during a screening colonoscopy. The whipworms were retrieved using biopsy forceps and the patient was treated with albendazole. At the time of the colonoscopy, the patient did not exhibit any specific symptoms related to the worm infestation.
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Affiliation(s)
| | | | - Saif Yasin
- St. George’s University, Grenada, West Indies
| | | | - Nargis Mateen
- St. Joseph’s University Medical Center, Paterson, NJ, USA
| | | | - Yana Cavanagh
- St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Walid Baddoura
- St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Jin Suh
- St. Joseph’s University Medical Center, Paterson, NJ, USA
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Nevin WD, Jones J, Tupper D, Dunbar JAT, Wilson D, Ross D, Woolley S, Dodd J, Biswas J, Lamb L, Beeching NJ, O’Shea MK, Fletcher TE. Gastrointestinal parasite infections in Nepalese Gurkha recruits arriving in the United Kingdom from 2012-2020. PLoS Negl Trop Dis 2024; 18:e0011931. [PMID: 38277403 PMCID: PMC10849272 DOI: 10.1371/journal.pntd.0011931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/07/2024] [Accepted: 01/21/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Gastrointestinal parasite (GIP) infections are a major cause of global morbidity, infecting hundreds of millions of people each year and potentially leading to lifelong infection and serious complications. Few data exist on screening for GIP infections in migrants entering the UK or on the current performance of different traditional diagnostic approaches. This study aimed to describe the prevalence of GIP infections in Nepalese Gurkha recruits screened on arrival in the UK. METHODOLOGY/PRINCIPAL FINDINGS We present a retrospective analysis of data from screening male adults (18-21 years) who arrived in the UK from Nepal between 2012 and 2020. Three separate faecal samples were obtained from participants at weekly intervals and processed for formalin-ethyl acetate (FEA) concentration/light microscopy and charcoal culture. Serum samples were analysed for IgG antibodies to Strongyloides stercoralis by ELISA. Results were available from 2,263 participants, of whom 463 (20.5%, 95% CI 18.8%-22.2%) had a positive diagnostic test for at least one GIP infection. A total of 525 potential infections were identified. Giardia duodenalis was most common (231/2263, 10.2%), followed by S. stercoralis (102/2263, 4.5%), and hookworm species (86/2263, 3.8%). Analysis (microscopy and culture) of the initial stool sample diagnosed only 244/427 (57.1%) faecally identified pathogens, including 41/86 (47.7%) hookworm infections. The proportion of participants infected with any GIP showed a downward trend over the study period. Log-binomial regression showed risk of infection decreasing by 6.1% year-on-year (95% CI 3.2% - 9.0%). This was driven predominantly by a fall in hookworm, S. stercoralis and Trichuris trichiura prevalence. CONCLUSIONS/SIGNIFICANCE The level of potentially pathogenic GIP infection in young Nepalese men migrating to the UK is high (20.5%) and requires a combined diagnostic approach including serology and analysis of multiple stool samples incorporating specialised parasitological methods. Advances in molecular approaches may optimise and simplify the intensive screening strategy required.
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Affiliation(s)
- William D. Nevin
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Infectious Diseases, Imperial College London, United Kingdom
| | - Jayne Jones
- Clinical Diagnostic Parasitology Laboratory, Liverpool School of Tropical Medicine, United Kingdom
| | - Donna Tupper
- Medical Centre, Infantry Training Centre, Catterick, United Kingdom
| | - James A. T. Dunbar
- Friarage Hospital, Northallerton, United Kingdom
- 212 Field Hospital, Royal Army Medical Corps, Defence Medical Services, United Kingdom
| | - Duncan Wilson
- Headquarters Defence Medical Services Group, Defence Medical Directorate, ICT Building, Edgbaston, Birmingham, United Kingdom
| | - David Ross
- Defence Public Health Unit, Defence Medical Services, United Kingdom
| | - Stephen Woolley
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - James Dodd
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Jason Biswas
- Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Lucy Lamb
- Department of Infectious Diseases, Imperial College London, United Kingdom
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, United Kingdom
- Department of Infectious Diseases, Royal Free Hospital, London, United Kingdom
| | - Nicholas J. Beeching
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Matthew K. O’Shea
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, United Kingdom
- Institute of Immunology and Immunotherapy, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Thomas E. Fletcher
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
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Iqbal S, Abid J, Akram S, Shah HBU, Farooq U, Ahmad AMR. Zinc status or supplementation and its relation to soil-transmitted helminthiasis in children: A systematic review. Parasite Immunol 2024; 46:e13015. [PMID: 37846743 DOI: 10.1111/pim.13015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/19/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023]
Abstract
Soil-transmitted helminths (STHs) parasitic infection is known as one of the most common infections around the world affecting more than a quarter of the world's population. The relationship between STH infections and micronutrient deficiencies are closely related and often coexist among the affected population. The study, therefore, aimed to summarise the available literature focusing on the effect of zinc status/deficiency or supplementation on STH infection or reinfection in children. For this purpose, we adopted a systematic approach and searched the existing literature on PubMed, Scopus, and Cochrane Library databases. A search term was entered to retrieve the available data. A total of 12 articles were included in this review after applying the inclusion/exclusion criteria. Most of the included studies reported a lower zinc status in children affected with any parasitic infection. Regarding the effect of zinc status and supplementation on parasitic infection in children, we found only a few studies (n = 4) with inconsistent result findings. This review reported that children infected with STH have lower zinc levels; however, a limited number of studies showed the effect of zinc supplements on the risk of STH warrants the need for further studies in this regard.
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Affiliation(s)
- Sehar Iqbal
- College of Pharmacy, Al-Ain University, Abu Dhabi, United Arab Emirates
| | - Juweria Abid
- Department of Nutrition & Dietetics, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Sajeela Akram
- Department of Human Nutrition & Dietetics, University of Chakwal, Chakwal, Pakistan
| | | | - Umar Farooq
- Department of Nutrition & Dietetics, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Abdul Momin Rizwan Ahmad
- Department of Nutrition & Dietetics, National University of Medical Sciences, Rawalpindi, Pakistan
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Kazura E, Johnson J, Morozoff C, Aruldas K, Avokpaho E, Togbevi CI, Chabi F, Gwayi-Chore MC, Nindi P, Titus A, Houngbegnon P, Kaliappan SP, Jacob Y, Simwanza J, Kalua K, Walson JL, Ibikounlé M, Ajjampur SSR, Means AR. Identifying opportunities to optimize mass drug administration for soil-transmitted helminths: A visualization and descriptive analysis using process mapping. PLoS Negl Trop Dis 2024; 18:e0011772. [PMID: 38175837 DOI: 10.1371/journal.pntd.0011772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 01/17/2024] [Accepted: 11/06/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND The control of soil-transmitted helminths (STH) is achieved through mass drug administration (MDA) with deworming medications targeting children and other high-risk groups. Recent evidence suggests that it may be possible to interrupt STH transmission by deworming individuals of all ages via community-wide MDA (cMDA). However, a change in delivery platforms will require altering implementation processes. METHODS We used process mapping, an operational research methodology, to describe the activities required for effective implementation of school-based and cMDA in 18 heterogenous areas and over three years in Benin, India, and Malawi. Planned activities were identified during workshops prior to initiation of a large cMDA trial (the DeWorm3 trial). The process maps were updated annually post-implementation, including adding or removing activities (e.g., adaptations) and determining whether activities occurred according to plan. Descriptive analyses were performed to quantify differences and similarities at baseline and over three implementation years. Comparative analyses were also conducted between study sites and areas implementing school-based vs. cMDA. Digitized process maps were developed to provide a visualization of MDA processes and inspected to identify implementation bottlenecks and inefficient activity flows. RESULTS Across three years and all clusters, implementation of cMDA required an average of 13 additional distinct activities and was adapted more often (5.2 adaptations per year) than school-based MDA. An average of 41% of activities across both MDA platforms did not occur according to planned timelines; however, deviations were often purposeful to improve implementation efficiency or effectiveness. Visualized process maps demonstrated that receipt of drugs at the local level may be an implementation bottleneck. Many activities rely on the effective setting of MDA dates and estimating quantity of drugs, suggesting that the timing of these activities is important to meet planned programmatic outcomes. CONCLUSION Implementation processes were heterogenous across settings, suggesting that MDA is highly context and resource dependent and that there are many viable ways to implement MDA. Process mapping could be deployed to support a transition from a school-based control program to community-wide STH transmission interruption program and potentially to enable integration with other community-based campaigns. TRIAL REGISTRATION NCT03014167.
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Affiliation(s)
- Eileen Kazura
- The Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Jabaselvi Johnson
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Chloe Morozoff
- The Department of Global Health, University of Washington, Seattle, Washington, United States of America
- The DeWorm3 Project, Seattle, Washington, United States of America
| | - Kumudha Aruldas
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | | | - Félicien Chabi
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Bénin
| | - Marie-Claire Gwayi-Chore
- The Department of Global Health, University of Washington, Seattle, Washington, United States of America
- The DeWorm3 Project, Seattle, Washington, United States of America
| | | | - Angelin Titus
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | | | - Yesudoss Jacob
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - James Simwanza
- Blantyre Institute for Community Outreach, Blantyre, Malawi
| | - Khumbo Kalua
- Blantyre Institute for Community Outreach, Blantyre, Malawi
| | - Judd L Walson
- The DeWorm3 Project, Seattle, Washington, United States of America
- The Departments of Global Health, Medicine, Pediatrics and Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Moudachirou Ibikounlé
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Bénin
- Centre de Recherche pour la lutte contre les Maladies Infectieuses Tropicales (CReMIT/TIDRC), Université d'Abomey-Calavi, Benin
| | - Sitara S R Ajjampur
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Arianna Rubin Means
- The Department of Global Health, University of Washington, Seattle, Washington, United States of America
- The DeWorm3 Project, Seattle, Washington, United States of America
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Portela CS, Mendes de Araújo CP, Moura Sousa P, Gomes Simão CL, Silva de Oliveira JC, Crainey JL. Filarial disease in the Brazilian Amazon and emerging opportunities for treatment and control. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2023; 5:100168. [PMID: 38283060 PMCID: PMC10821485 DOI: 10.1016/j.crpvbd.2023.100168] [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: 08/04/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 01/30/2024]
Abstract
Following the successful eradication of Wuchereria bancrofti, there are now just three species of conventional microfilaremic human filarial parasites endemic to the Brazilian Amazon region: Mansonella ozzardi, Mansonella perstans and Onchocerca volvulus. The zoonotic filarial parasite Dirofilaria immitis is also found in the Amazon region as are several sylvatic filarial parasites, some of which have been recorded causing zoonoses and some of which have never been recorded outside the region. Onchocerca volvulus is only found in the Amazonia onchocerciasis focus in the Brazilian state of Roraima where it affects the people of the Yanomami tribe living around the densely forested Venezuela border region. Mansonella ozzardi is by far the most common filarial parasite in Brazil and has a broad but patchy distribution throughout the western Amazon region. Recorded in the Brazilian states of Acre, Roraima, Matto Grosso, and within almost every municipality of Amazonas state, it is believed that pollution of the urban stream and river systems prevents the development of the simuliid vectors of M. ozzardi and explains the parasite's reduced distribution within urban areas and an absence of recent reports from the state capital Manaus. Decades of WHO-led periodic ivermectin treatment of Yanomami tribe's people have resulted in the partial suppression of O. volvulus transmission in this focus and has also probably affected the transmission of M. ozzardi in the region. Mansonella perstans, O. volvulus and very probably M. ozzardi infections can all be treated and most likely cured with a 4-6-week treatment course of doxycycline. The Brazilian Ministry of Health does not, however, presently recommend any treatment for mansonellosis infections and thus parasitic infections outside the Amazonia focus are typically left untreated. While the long treatment courses required for doxycycline-based mansonellosis therapies preclude their use in control programmes, new fast-acting filarial drug treatments are likely to soon become available for the treatment of both onchocerciasis and mansonellosis in the Amazon region. Filarial disease management in the Brazilian Amazon is thus likely to become dramatically more viable at a time when the public health importance of these diseases is increasingly being recognized.
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Affiliation(s)
- Cleudecir Siqueira Portela
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil
- Programa de Doutorado em Biologia da Interação Patógeno Hospedeiro, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
| | - Cláudia Patrícia Mendes de Araújo
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil
- Programa de Doutorado em Biologia da Interação Patógeno Hospedeiro, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
| | - Patrícia Moura Sousa
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil
- Programa de Doutorado em Biologia da Interação Patógeno Hospedeiro, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
| | - Carla Letícia Gomes Simão
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil
- Programa de Mestrado em Condições de Vida e Situações de Saúde na Amazônia, Instituto Leônidas e Maria Deane, Manaus, Amazonas, Brazil
| | - João Carlos Silva de Oliveira
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil
- Programa de Doutorado em Saúde Pública na Amazônia, Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Manaus, Amazonas, Brazil
| | - James Lee Crainey
- Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz Amazônia, Laboratório de Ecologia de Doenças Transmissíveis na Amazônia, Manaus, Amazonas, Brazil
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López-Gijón R, Camarós E, Rubio-Salvador Á, Duras S, Botella-López MC, Alemán-Aguilera I, Rodríguez-Aguilera Á, Bustamante-Álvarez M, Sánchez-Barba LP, Dufour B, Le Bailly M. Implications of the prevalence of Ascaris sp. in the funerary context of a Late Antique population (5th-7th c.) in Granada (Spain). INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 43:45-50. [PMID: 37738817 DOI: 10.1016/j.ijpp.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/27/2023] [Accepted: 09/10/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE To evaluate the prevalence of gastro-intestinal parasites in human remains from Late Antiquity (5th - 7th c.) Granada (Spain). MATERIALS The study included pelvic and cranial control samples from 17 skeletons from the archaeological sites of Los Mondragones (n = 13) and Rafael Guillén (n = 4). METHODS In the paleoparasitological study, soil samples from pelvic area and cranium were analyzed using the rehydration, homogenization, and micro-sieving method and visualization under brightfield microscopy. RESULTS Ascaris sp. eggs were detected in pelvic samples from seven individuals. CONCLUSIONS These findings may indicate that this parasite was endemic. Its detection frequency is one of the highest reported at group level in an osteological series from Late Antiquity. SIGNIFICANCE The prevalence of Ascaris sp. associated with skeletal remains has implications for assessing the lifestyle and health of populations in southern Spain during the Late Antique period. LIMITATIONS The number of individuals is small and taphonomic processes could have limited paleoparasitological findings SUGGESTIONS FOR FURTHER RESEARCH: Future interdisciplinary studies of this type are warranted in larger osteological series to improve knowledge of parasitosis in the past.
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Affiliation(s)
- Ramón López-Gijón
- Laboratorio de Antropología, Facultad de Medicina, Universidad de Granada, Av. de la Investigación 11, 18071 Granada, Spain.
| | - Edgard Camarós
- Departamento de Historia (Sección de Prehistoria), Universidad de Santiago de Compostela, Praza da Universidade, 15703 Santiago de Compostela, Spain
| | - Ángel Rubio-Salvador
- Laboratorio de Antropología, Facultad de Medicina, Universidad de Granada, Av. de la Investigación 11, 18071 Granada, Spain
| | - Salvatore Duras
- Laboratorio de Antropología, Facultad de Medicina, Universidad de Granada, Av. de la Investigación 11, 18071 Granada, Spain
| | - Miguel C Botella-López
- Laboratorio de Antropología, Facultad de Medicina, Universidad de Granada, Av. de la Investigación 11, 18071 Granada, Spain
| | - Inmaculada Alemán-Aguilera
- Laboratorio de Antropología, Facultad de Medicina, Universidad de Granada, Av. de la Investigación 11, 18071 Granada, Spain
| | | | - Macarena Bustamante-Álvarez
- Departamento de Prehistoria y Arqueología, Facultad de Filosofía y Letras, Campus de Cartuja s/n, 18016 Granada, Spain
| | - Lydia P Sánchez-Barba
- Laboratorio de Antropología, Facultad de Medicina, Universidad de Granada, Av. de la Investigación 11, 18071 Granada, Spain
| | - Benjamin Dufour
- CNRS UMR 6249 Chrono-environment, University of Franche-Comte, 16 route de Gray, 25030 Besançon Cedex, France
| | - Matthieu Le Bailly
- CNRS UMR 6249 Chrono-environment, University of Franche-Comte, 16 route de Gray, 25030 Besançon Cedex, France
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Sprecher VP, Coulibaly JT, Hürlimann E, Hattendorf J, Keiser J. Efficacy and Safety of Moxidectin-Albendazole and Ivermectin-Albendazole Combination Therapy Compared to Albendazole Monotherapy in Adolescents and Adults Infected with Trichuris trichiura: A Randomized, Controlled Superiority Trial. Clin Infect Dis 2023; 77:1294-1302. [PMID: 37357904 DOI: 10.1093/cid/ciad387] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/18/2023] [Accepted: 06/21/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND The currently recommended benzimidazole monotherapy is insufficiently effective to control infection with the soil-transmitted helminth Trichuris trichiura. Ivermectin-albendazole combination has shown promising, but setting-dependent efficacy, with therapeutic underperformance in Côte d'Ivoire. We evaluated whether moxidectin-albendazole could serve as an alternative to albendazole monotherapy in Côte d'Ivoire. METHODS In this community-based, randomized, placebo-controlled, parallel-group superiority trial, individuals aged 12-60 years were screened for T. trichiura eggs in their stool using quadruplicate Kato-Katz thick smears. Diagnostically and clinically eligible participants were randomly assigned (1:1:1) to receive single oral doses of moxidectin (8 mg) and albendazole (400 mg), ivermectin (200 µg/kg) and albendazole (400 mg), or albendazole (400 mg) and placebo. The primary outcome was proportion cured, ie, cure rate (CR), assessed at 2-3 weeks post-treatment. Safety endpoints were assessed pre-treatment and at 3 and 24 hours post-treatment. RESULTS For the 210 participants with primary outcome data, we observed CRs of 15.3% in the moxidectin-albendazole arm and 22.5% in the ivermectin-albendazole arm, which did not differ significantly from the CR of 13.4% in the albendazole arm (differences: 1.8%-points [95% confidence interval: -10.1 to 13.6] and 9.1%-points [-3.9 to 21.8], respectively). Most common adverse events were abdominal pain (range across arms: 11.9%-20.9%), headache (4.7%-14.3%), and itching (5.8%-13.1%), which were predominantly mild and transient. CONCLUSIONS All therapies showed similar low efficacy in treating trichuriasis in Côte d'Ivoire. Alternative treatment options need to be evaluated, and further analyses should be conducted to understand the lack of enhanced activity of the combination therapies in Côte d'Ivoire. CLINICAL TRIALS REGISTRATION NCT04726969.
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Affiliation(s)
- Viviane P Sprecher
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jean T Coulibaly
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Eveline Hürlimann
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Jan Hattendorf
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Mewara A, Kanaujia R, Malla N. Extra-intestinal complications of Ascaris lumbricoides infections in India: A systematic review and meta-analysis. Trans R Soc Trop Med Hyg 2023; 117:765-772. [PMID: 37264906 DOI: 10.1093/trstmh/trad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 06/03/2023] Open
Abstract
The aberrant migration of Ascaris lumbricoides may cause extra-intestinal ascariasis (EIA) involving hepato-biliary-pancreatic (HBP) or other extra-gastro-intestinal (EGI) organs. We performed a systematic review and meta-analysis to study the risk factors and clinical presentations of EIA, and differences in HBP and EGI ascariasis. Medline, Web of Science and Embase were searched for cases of EIA in the English language from India. From 1204 articles, 86 studies (105 cases) were included. The majority of the cases involved the HBP system (78%). Among HBP ascariasis, the most commonly involved site was the bile duct (53.6%). Females had 11.3 times higher odds (95% CI 2.852 to 44.856; p=0.001) of HBP ascariasis, while the pediatric population had lower odds (OR=0.323). Previous gallbladder disease was significantly associated with HBP ascariasis in adults (p=0.046), while a significantly higher number of cases of EGI ascariasis were observed among pediatric patients (p=0.003). Ocular symptoms occurred exclusively in the pediatric population (p=0.017). Overall, death was reported in 3.8% of patients (n=4). This review emphasizes the importance of the complications of EIA. It encourages future research into issues such as the reasons of higher gall bladder ascariasis in females and the implications of Ascaris-related complications following biliary tract interventions. It also suggests considering Ascaris as a differential diagnosis for airway obstuction in intubated critically ill patients.
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Affiliation(s)
- Abhishek Mewara
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Rimjhim Kanaujia
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Nancy Malla
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
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Mules TC, Inns S, Le Gros G. Helminths' therapeutic potential to treat intestinal barrier dysfunction. Allergy 2023; 78:2892-2905. [PMID: 37449458 DOI: 10.1111/all.15812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/20/2023] [Accepted: 07/02/2023] [Indexed: 07/18/2023]
Abstract
The intestinal barrier is a dynamic multi-layered structure which can adapt to environmental changes within the intestinal lumen. It has the complex task of allowing nutrient absorption while limiting entry of harmful microbes and microbial antigens present in the intestinal lumen. Excessive entry of microbial antigens via microbial translocation due to 'intestinal barrier dysfunction' is hypothesised to contribute to the increasing incidence of allergic, autoimmune and metabolic diseases, a concept referred to as the 'epithelial barrier theory'. Helminths reside in the intestinal tract are in intimate contact with the mucosal surfaces and induce a range of local immunological changes which affect the layers of the intestinal barrier. Helminths are proposed to prevent, or even treat, many of the diseases implicated in the epithelial barrier theory. This review will focus on the effect of helminths on intestinal barrier function and explore whether this could explain the proposed health benefits delivered by helminths.
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Affiliation(s)
- Thomas C Mules
- Malaghan Institute of Medical Research, Wellington, New Zealand
- University of Otago, Wellington, New Zealand
| | | | - Graham Le Gros
- Malaghan Institute of Medical Research, Wellington, New Zealand
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Khuroo MS. My 40-Year Encounter with ERCP: A Saga of Service, Syndromes, and Solutions. J Clin Exp Hepatol 2023; 13:1074-1090. [PMID: 37975034 PMCID: PMC10643499 DOI: 10.1016/j.jceh.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/18/2023] [Indexed: 09/03/2023] Open
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) has been a significant development in gastrointestinal endoscopy. I did my first ERCP at SKIMS on December 5, 1982, and over the last 40 years, I have performed 10,100 ERCP procedures, including 600 Sphincter of Oddi manometries (SOM), and 3200 therapeutic ERCPs. We were confronted with many clinical challenges that needed answers by applying ERCP as a primary diagnostic tool. These studies gave birth to and/or recognition of several clinical syndromes. The hepatobiliary and pancreatic ascariasis (HBPA) as a clinical disease was recognized in 1985. The nematode, Ascaris lumbricoides, was the most common cause of hepatobiliary and pancreatic diseases in Kashmir, and its impact on healthcare, clinical profile, management policies, and control measures was identified. Kashmir was recognized as an endemic zone for recurrent pyogenic cholangitis (RPC), which constituted 12.5% of all biliary diseases. RPC in this population was found essentially to be an aftermath of HBPA. A subset of patients with hepatic hydatidosis with rupture into the biliary tract was recognized at ERCP and primarily treated by endotherapy. Cholangiographic abnormalities in children with portal cavernoma evolved into the recognition of portal biliopathy. Extensive studies of the sphincter of Oddi manometry in patients with unexplained biliary and/or pancreatic pain following cholecystectomy identified the entity of the sphincter of Oddi dyskinesia (SOD). In a cross-over trial, Nifedipine, compared with a placebo, showed a significant clinical response in 20 of 28 such patients. ERCP studies done in patients with tropical calcific pancreatitis showed an anomalous union of bile and pancreatic ducts. Forty of the 220 patients with liver transplantation had biliary complications namely biliary leaks, bile duct strictures, SOD, and recurrence of underlying primary biliary cholangitis. Biliary complications caused considerable morbidity and mortality in patients with liver transplantation.
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Affiliation(s)
- Mohammad S. Khuroo
- Digestive Diseases Centre, Dr. Khuroo's Medical Clinic, Srinagar, India
- Dept. Gastroenterology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
- Dept. Gastroenterology, Hepatology, and Liver Transplantation, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
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Gerber DJF, Dhakal S, Islam MN, Al Kawsar A, Khair MA, Rahman MM, Karim MJ, Rahman MS, Aktaruzzaman MM, Tupps C, Stephens M, Emerson PM, Utzinger J, Vounatsou P. Distribution and treatment needs of soil-transmitted helminthiasis in Bangladesh: A Bayesian geostatistical analysis of 2017-2020 national survey data. PLoS Negl Trop Dis 2023; 17:e0011656. [PMID: 37930980 PMCID: PMC10662736 DOI: 10.1371/journal.pntd.0011656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 11/21/2023] [Accepted: 09/11/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND In Bangladesh, preventive chemotherapy targeting soil-transmitted helminth (STH) infections in school-age children has been implemented since 2008. To evaluate the success of this strategy, surveys were conducted between 2017 and 2020 in 10 out of 64 districts. We estimate the geographic distribution of STH infections by species at high spatial resolution, identify risk factors, and estimate treatment needs at different population subgroups. METHODOLOGY Bayesian geostatistical models were fitted to prevalence data of each STH species. Climatic, environmental, and socioeconomic predictors were extracted from satellite images, open-access, model-based databases, and demographic household surveys, and used to predict the prevalence of infection over a gridded surface at 1 x 1 km spatial resolution across the country, via Bayesian kriging. These estimates were combined with gridded population data to estimate the number of required treatments for different risk groups. PRINCIPAL FINDINGS The population-adjusted prevalence of Ascaris lumbricoides, Trichuris trichiura, and hookworm across all ages is estimated at 9.9% (95% Bayesian credible interval: 8.0-13.0%), 4.3% (3.0-7.3%), and 0.6% (0.4-0.9%), respectively. There were 24 out of 64 districts with an estimated population-adjusted STH infection prevalence above 20%. The proportion of households with improved sanitation showed a statistically important, protective association for both, A. lumbricoides and T. trichiura prevalence. Precipitation in the driest month of the year was negatively associated with A. lumbricoides prevalence. High organic carbon concentration in the soil's fine earth fraction was related to a high hookworm prevalence. Furthermore, we estimated that 30.5 (27.2; 36.0) million dosages of anthelmintic treatments for school-age children were required per year in Bangladesh. CONCLUSIONS/SIGNIFICANCE For each of the STH species, the prevalence was reduced by at least 80% since treatment was scaled up more than a decade ago. The current number of deworming dosages could be reduced by up to 61% if the treatment strategy was adapted to the local prevalence.
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Affiliation(s)
- Daniel J. F. Gerber
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Sanjaya Dhakal
- Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Md. Nazmul Islam
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - Abdullah Al Kawsar
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - Md. Abul Khair
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - Md. Mujibur Rahman
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - Md. Jahirul Karim
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - Md. Shafiqur Rahman
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - M. M. Aktaruzzaman
- Communicable Disease Control Unit, Directorate General of Health Services, Ministry of Health & Family Welfare, Dhaka, Bangladesh
| | - Cara Tupps
- Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Mariana Stephens
- Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Paul M. Emerson
- Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Penelope Vounatsou
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Nguyen PV, Quach DT, Bui MH, Dang TP, Talley NJ. A Clinicopathologic Continuum of Eosinophilic Gastrointestinal Diseases in an Adult With Tuberculosis and Latent Hepatitis B Virus Infection. ACG Case Rep J 2023; 10:e01176. [PMID: 37829167 PMCID: PMC10567028 DOI: 10.14309/crj.0000000000001176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023] Open
Abstract
Eosinophilic gastroenteritis (EGE) is considered distinct from eosinophilic colitis (EC). A 59-year-old man presented with a colonic tumor, who had resolution of pain and diarrhea after surgery, then 7 months later developed proton-pump inhibitor-responsive dysphagia with esophagitis, and 9 months later presented again with pain and diarrhea where EGE with concurrent eosinophilic esophagitis was diagnosed. Review of the resected tumor specimen identified EC with an adenoma. Workup revealed tuberculosis and latent hepatitis B virus requiring treatment before commencing immunosuppressive therapy plus a 6-food elimination diet that led to complete resolution within 3 weeks. EC may precede EGE and eosinophilic esophagitis.
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Affiliation(s)
- Phong V. Nguyen
- Department of Gastroenterology, Nhan Dan Gia Dinh Hospital, Ho Chi Minh, Vietnam
| | - Duc T. Quach
- Department of Gastroenterology, Nhan Dan Gia Dinh Hospital, Ho Chi Minh, Vietnam
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Minh H.Q. Bui
- Laboratory Department, Vinmec Central Park International Hospital, Ho Chi Minh, Vietnam
- Department of Pathology, Nhan Dan Gia Dinh Hospital, Ho Chi Minh, Vietnam
| | - Thinh P. Dang
- Department of Endoscopy, Nhan Dan Gia Dinh Hospital, Ho Chi Minh, Vietnam
| | - Nicholas J. Talley
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- School of Medicine and Public Health and NHMRC Centre of Research Excellence Digestive Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
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Franz A, Fuss A, Mazigo HD, Ruganuza D, Müller A. Prevalence of Schistosoma mansoni, soil-transmitted helminths and intestinal protozoa in orphans and street children in Mwanza city, Northern Tanzania. Infection 2023; 51:1399-1406. [PMID: 36805439 PMCID: PMC10545637 DOI: 10.1007/s15010-023-01999-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/06/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Parasitic infections are highly prevalent in low-income environments worldwide. While orphans and street children represent a particularly vulnerable population group, they are often exempt from preventive interventions such as Mass Drug Administration. In part, this could be due to a lack of data showing the burden of disease in this group. This study aims to address this gap. METHODS For this cross-sectional study, 144 orphans and 112 street children were screened for Schistosoma mansoni (S. mansoni), Schistosoma haematobium (S. haematobium), soil-transmitted helminths and intestinal protozoa using POC-CCA testing, urine filtration, and Kato-Katz technique. Nutritional status, water- and washing patterns were determined using a standardised questionnaire. Ultrasonography was performed to screen for organ abnormalities. RESULTS The prevalence of S. mansoni determined by POC-CCA-test was 65.9% for orphans and 94.5% for street children. 19.2% of the orphans tested positive for S. mansoni in Kato Katz. Of the street children, 77.1% showed positive test results in Kato-Katz. Only 1.3% of the orphans stated in the questionnaire that they use the lake to wash, whereas 91.1% of the street children named the lake as at least one of their options for washing. Microscopy showed positive results for Giardia intestinalis (G. intestinalis) in 8.2% and for Entamoeba histolytica/dispar (E. histolytica/dispar) in 23% of orphans and 8.1% for G. intestinalis, and 23.8% for E. histolytica/dispar in street children. In the ultrasonography, we did not observe patterns that indicate severe periportal fibrosis. CONCLUSION The results indicate a significantly higher rate of infections with S. mansoni in street children compared with orphans. This might be explained by the lack of access to adequate sanitation for street children as well as regular contact with the water of Lake Victoria. However, we did not find similar results concerning infection rates with protozoa. The study results show overall inadequate living conditions in this study population, which could be addressed by public health interventions.
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Affiliation(s)
- Anemone Franz
- Julius-Maximilians-Universität Würzburg, Medicine, Würzburg, Germany.
| | - Antje Fuss
- Medical Mission Institute, Biology, Würzburg, Germany
| | - Humphrey D Mazigo
- Medical Parasitology and Entomology, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania
| | - Deodatus Ruganuza
- Medical Parasitology and Entomology, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania
| | - Andreas Müller
- Tropical Medicine, Klinikum Würzburg Mitte, Würzburg, Germany
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Sheikh MM, Tak H, Fazili MF, Wani IN. A coprological survey on helminths of Jackal Canis aureus Linnaeus 1758 in Kashmir Himalaya. J Parasit Dis 2023; 47:491-500. [PMID: 37520190 PMCID: PMC10382462 DOI: 10.1007/s12639-023-01588-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/14/2023] [Indexed: 08/01/2023] Open
Abstract
A coprological examination was carried out between February 2017 and January 2019 to determine the prevalence of gastrointestinal helminths in jackals of Kashmir Himalaya, India. Fecal floatation and sedimentation technique revealed helminths in 215 scats out of 879 examined scats, with overall helminth prevalence of 24.45%. In the study, five different species of helminths were detected in scats of jackal: Toxocara canis (22.86%), Ancylostoma caninum (20.47%), Dipylidium caninum (17.17%), Trichuris vulpis (19.34%), and taeniid eggs (13.65%). One helminth species was found in (0.11%) of the jackal scats, two were in (1.25%), three were in (4.77%), four were in (16.38%), and five were in (1.92%). Toxocara canis, a nematode with great zoonotic significance, was most common helminth found in scats of jackal during the study. We observed significant seasonal fluctuation (p < 0.05) in the prevalence of gastrointestinal helminths, with summer having high frequency followed by autumn, spring, and winter having lowest prevalence. The study area's jackal population's preponderance of zoonotic helminth species suggests a high risk of zoonotic infection by canine intestinal helminths. This study will aid veterinarians in better plan preventative strategies with regard to wild animal intestinal parasites.
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Affiliation(s)
- Mohmad Muzafar Sheikh
- Parasitology Research Laboratory, Department of Zoology, University of Kashmir, Srinagar, Jammu and Kashmir 190006 India
| | - Hidayatullah Tak
- Parasitology Research Laboratory, Department of Zoology, University of Kashmir, Srinagar, Jammu and Kashmir 190006 India
| | - Mustahson F. Fazili
- Biodviersity Conservation Laboratory, Department of Zoology, University of Kashmir, Srinagar, Jammu and Kashmir 190006 India
| | - Ishfaq Nazir Wani
- Biodviersity Conservation Laboratory, Department of Zoology, University of Kashmir, Srinagar, Jammu and Kashmir 190006 India
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Gonçalves AAS, Lopes CA, Levenhagen MA, Gonzaga HT, Oliveira LCM, Costa-Cruz JM. Multiple Stool Sampling and Specific Parasitological Technique are Crucial to Diagnose Strongyloidiasis in Alcoholic Patients. Acta Parasitol 2023; 68:718-722. [PMID: 37531007 DOI: 10.1007/s11686-023-00700-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 07/18/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Chronic alcoholism is a well-known risk factor for strongyloidiasis, in these patients the disease is potentially more severe, probably due to the breakdown of local protective barriers and immunosuppression caused by alcohol, which can lead to autoinfection and dissemination. The aim of this study was to evaluate multiple stool sampling and a specific parasitological assay agar plate culture (APC) for the diagnosis of Strongyloides stercoralis in alcoholics. METHODS APC was compared to sedimentation technique (HPJ; Hoffman, Pons and Janer), as parasitological methods to detect S. stercoralis infection in alcoholic individuals. Three stool samples from 60 alcoholic and 60 non-alcoholic individuals were analyzed. RESULTS S. stercoralis larvae were observed in 11 (18.3%) alcoholic individuals and 1 (1.7%) nonalcoholic individual (P = 0.0042). In view of the combined results, sensitivity for the APC method was 63.6% (CI 31.6-87.6%) with the first sample reaching 100% (CI 67.8-100%) after analyzing three fecal samples. The HPJ sensitivity was 36.4% (CI 12.4-68.4) in the first sample, reaching 72.7% (CI 39.3-92.7) after three samples analyzed. CONCLUSION The present results suggest that in alcoholic patients, it is important to repeat stool sampling with specific techniques, especially using the APC method, to avoid misdiagnosis in cases that could evolve to disseminated strongyloidiasis.
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Affiliation(s)
- Alana A S Gonçalves
- PostGraduate Program in Health Sciences, Medicine School, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Camila A Lopes
- Laboratory of Parasitosis Diagnosis, Biomedical Sciences Institute, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Marcelo A Levenhagen
- Laboratory of Parasitosis Diagnosis, Biomedical Sciences Institute, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Henrique T Gonzaga
- Laboratory of Parasitosis Diagnosis, Biomedical Sciences Institute, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
| | - Luiz Carlos M Oliveira
- PostGraduate Program in Health Sciences, Medicine School, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Julia Maria Costa-Cruz
- Laboratory of Parasitosis Diagnosis, Biomedical Sciences Institute, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
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Rahimi BA, Rafiqi N, Tareen Z, Kakar KA, Wafa MH, Stanikzai MH, Beg MA, Dost AK, Taylor WR. Prevalence of soil-transmitted helminths and associated risk factors among primary school children in Kandahar, Afghanistan: A cross-sectional analytical study. PLoS Negl Trop Dis 2023; 17:e0011614. [PMID: 37695763 PMCID: PMC10513306 DOI: 10.1371/journal.pntd.0011614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/21/2023] [Accepted: 08/21/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Soil-transmitted helminth (STH) infections are global health problem, especially in low-income countries. Main objectives of this study were to estimate the prevalence and intensity of STH and its risk factors among school children in Kandahar city of Afghanistan. METHODOLOGY/PRINCIPAL FINDINGS This was a school-based cross-sectional analytical study, with data collected during eight-month-period (May-December, 2022) from 6- and 12-years old school children in Kandahar city, Afghanistan. All the stool samples were examined by saline wet mount method and Kato-Katz technique. Data were analyzed by using descriptive statistics, Chi square test, and multivariate logistic regression. A total of 1275 children from eight schools of Kandahar city were included in this study. Mean age of these children was 8.3 years with 53.3% boys. The overall prevalence of any intestinal parasitic infection was 68.4%. The overall prevalence of STH infection was 39.1%, with Ascaris lumbricoides (29.4%) as the most prevalent STH species. Mean intensity of overall STH infection was 97.8. Multivariate logistic regression revealed playing barefoot (AOR 1.6, 95% CI 1.1-2.2), not washing hands after defecating and before eating (AOR 1.3, 95% CI 1.0-1.7), having untrimmed nails (AOR 1.4, 95% CI 1.1-1.8), and belonging to poor families (AOR 1.3, 95% CI 1.0-1.7) as the risk factors associated with the predisposition of school children for getting STH in Kandahar city of Afghanistan. CONCLUSIONS/SIGNIFICANCE There is high prevalence of STH among school children of Kandahar city in Afghanistan. Most of the risk factors are related to poverty, decreased sanitation, and improper hygiene. Improvement of socioeconomic status, sanitation, and health education to promote public awareness about health and hygiene together with periodic mass deworming programs are better strategies for the control of STH infections in Afghanistan.
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Affiliation(s)
- Bilal Ahmad Rahimi
- Department of Pediatrics, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
- Department of Pediatrics, Faculty of Medicine, Malalay Institute of Higher Education, Kandahar, Afghanistan
| | - Najeebullah Rafiqi
- Department of Surgery, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
| | - Zarghoon Tareen
- Department of Pediatrics, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
| | - Khalil Ahmad Kakar
- Department of Public Health, Faculty of Medicine, Malalay Institute of Higher Education, Kandahar, Afghanistan
| | - Mohammad Hashim Wafa
- Department of Psychiatry, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
| | | | - Mohammad Asim Beg
- Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi, Pakistan
| | - Abdul Khaliq Dost
- Department of Surgery, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan
| | - Walter R. Taylor
- Mahidol Oxford Tropical Medicine Clinical Research Unit (MORU), Mahidol University, Bangkok, Thailand
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50
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Zacharia F, Silvestri V, Mushi V, Ogweno G, Makene T, Mhamilawa LE. Burden and factors associated with ongoing transmission of soil-transmitted helminths infections among the adult population: A community-based cross-sectional survey in Muleba district, Tanzania. PLoS One 2023; 18:e0288936. [PMID: 37494358 PMCID: PMC10370771 DOI: 10.1371/journal.pone.0288936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/06/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND In Tanzania, school-based Mass Drug Administration (MDA) campaigns have been the main strategy for the prevention and control of Soil Transmitted Helminths (STH) infection. Adults are not part of the program and could remain as the reservoir of infection, favoring continuity in transmission. Water, Sanitation, and Hygiene (WaSH) issues and slow progress in community awareness promotion campaigns contribute to the persistence of STH as public health issue among target populations notwithstanding the achievements of the control interventions. OBJECTIVE This study aimed to determine the current prevalence and the risk factors associated with ongoing transmission of STH infection among adults in Muleba District, Tanzania. METHODOLOGY A household-based quantitative cross-sectional study was carried out among 552 adults in Muleba district. Through a quantitative interviewer-administered questionnaire, information was registered related to socio-demographic characteristics, level of knowledge on the disease, and WaSH factors. The prevalence of STH and estimation of its intensity were assessed by analyzing stool samples through formol-ether concentration and the Kato-Katz technique. Descriptive statistics was used to summarise data; logistic regression to determine the association between STH infection and socio-demographic and WaSH factors. A p-value < 0.05 was considered statistically significant. RESULTS A total of 552 adults were included in the study; 50.7% (280/552) were female. The median age was of 30 years, ranging from 18 to 73 years. A prevalence of 9.1% (50/552) for STH infection was reported; the prevalence of Hookworm Spp., Ascaris lumbricoides, and Trichuris trichiura was 7.43%, 0.91%, and 0.72%, respectively. The factors significantly associated with STH infection were farming (aOR = 3.34, 95% CI: 1.45-7.70), the habit of not wearing shoes in general (aOR = 5.11, 95% CI: 1.55-16.87), and during garden activities (aOR = 4.89, 95% CI: 1.47-16.28). CONCLUSIONS AND RECOMMENDATIONS We observed an aggregated prevalence of STH infections (Ancylostoma duodenale, Trichuris trichiura, and Ascaris lumbricoides) of 9.1% among the adult population, indicating a decreasing prevalence but ongoing transmission. Integrated management is needed to address practices contributing to ongoing transmission.
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Affiliation(s)
- Franco Zacharia
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Valeria Silvestri
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Vivian Mushi
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Zoology and Wildlife Conservation, College of Natural and Applied Sciences, University of Dar es Salaam, Dar es Salaam, Tanzania
| | - George Ogweno
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Twilumba Makene
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Lwidiko E Mhamilawa
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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