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Badri M, Olfatifar M, Wandra T, Budke CM, Mahmoudi R, Abdoli A, Hajialilo E, Pestehchian N, Ghaffarifar F, Foroutan M, Hashemipour S, Sotoodeh S, Samimi R, Eslahi AV. The prevalence of human trichuriasis in Asia: a systematic review and meta-analysis. Parasitol Res 2022; 121:1-10. [PMID: 34993634 DOI: 10.1007/s00436-021-07365-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/27/2021] [Indexed: 11/30/2022]
Abstract
Trichuriasis is one of the most common soil-transmitted helminth (STH) infections, affecting populations globally. The condition is particularly prevalent in tropical and subtropical areas with low levels of sanitation and poor living conditions. The objective of this systematic review and meta-analysis was to evaluate the prevalence of Trichuris trichiura infection in Asia at the country and region level. Multiple databases/academic search engines (Web of Science, PubMed, ProQuest, Scopus, and Google Scholar) were searched for literature on T. trichiura prevalence in Asia published through January 2021. Pooled prevalence was determined using the meta-package in R (version 3.6.1). Out of 13,836 articles, 226 studies (5,439,500 individuals) from 26 countries met the inclusion criteria. Of the 226 studies, 151 were community-based studies that included individuals across the age spectrum, while 75 studies focused on school children (typically in the 5-16 years age range). The overall T. trichiura pooled prevalence was 15.3% (95% CI: 12.4-19.1%), with a pooled prevalence of 13.3% (95% CI: 10.0-17.1%) for the community studies and 20.9% (95% CI: 14.7-27.9%) for the studies only including school children. For studies including all age groups, individuals in the 1-15 years age group had the highest pooled prevalence at 23.4% (95% CI: 1.7-49.4%). There was a significant difference found in overall pooled prevalence by sex (p < 0.001) and community type (rural versus urban) (p < 0.001). Although prevalence appears to be decreasing, study findings suggest that T. trichiura infection continues to be a public health problem in Asia. Therefore, control programs focused on at-risk individuals in endemic areas are needed.
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Affiliation(s)
- Milad Badri
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Meysam Olfatifar
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Toni Wandra
- Directorate of Postgraduate, Sari Mutiara Indonesia University, Medan, Indonesia
| | - Christine M Budke
- Department of Veterinary Integrative Biosciences, College of Veterinary Medicine & Biomedical Sciences, Texas A & M University, College Station, TX, USA
| | - Razzagh Mahmoudi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Elham Hajialilo
- Department of Parasitology and Mycology, Qazvin University of Medical Sciences, Qazvin, Iran.,Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Nader Pestehchian
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Ghaffarifar
- Department of Parasitology and Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Masoud Foroutan
- Research Center for Environmental Contaminants (RCEC), Abadan University of Medical Sciences, Abadan, Iran
| | - Sima Hashemipour
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Simin Sotoodeh
- Clinical Research Development Unit, Kosar Hospital, Qazvin University Of Medical Sciences, Qazvin, Iran
| | - Rasoul Samimi
- Children Growth Research Center Research Institute for Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Aida Vafae Eslahi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
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Analysis of the population-level impact of co-administering ivermectin with albendazole or mebendazole for the control and elimination of Trichuris trichiura. Parasite Epidemiol Control 2016; 1:177-187. [PMID: 27430028 PMCID: PMC4946157 DOI: 10.1016/j.parepi.2016.02.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 02/22/2016] [Accepted: 02/23/2016] [Indexed: 11/25/2022] Open
Abstract
Introduction Soil-transmitted helminth (STH) infections are predominately controlled by providing children with preventive chemotherapy with either albendazole or mebendazole. However, neither has a high efficacy against Trichuris trichiura. This low efficacy limits the overall effectiveness of the current STH control programmes against T. trichiura. It has been demonstrated that co-administering ivermectin with albendazole or mebendazole significantly increases the efficacy of current treatments, which may increase the overall effectiveness of control programmes. Methods Using a STH transmission mathematical model, we evaluated the potential impact of co-administering ivermectin with albendazole or mebendazole to treat T. trichiura within a preventive chemotherapy programme targeting children (2–15 year olds). We evaluated the impact in terms of reduction in prevalent infections, mean worm burden, and prevalence of heavy infections. Results Although the current treatment strategy reduced T. trichiura worm burden and prevalence of heavy infections, due to their poor efficacy the long term impact of preventive chemotherapy for children was smaller compared to the other STH. Co-administering ivermectin increased the projected impact of the preventive chemotherapy programme in terms of all three of the explored metrics, practically in high transmission settings. Furthermore, ivermectin co-administration greatly increased the feasibility of and timeframe for breaking transmission. Conclusions Co-administering ivermectin notably increased the projected impact of preventive chemotherapy in high transmission settings and increased the feasibility for breaking transmission. This has important implications for control programmes, some of which may be shifting focus from morbidity control to interruption of transmission, and some of which may be logistically unable to provide preventive chemotherapy twice a year as recommended. However, the benefit of co-administering ivermectin is limited by the fact that 2–5 year olds are often ineligible to receive treatment. The impact of chemotherapy against Trichuris is smaller compared to what can be seen for the other soil-transmitted helminths. Co-administering ivermectin increases the projected impact of preventive chemotherapy. It also has the potential to interrupt transmission in some settings.
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Key Words
- ALB, albendazole
- Control
- ERRs, egg reduction rates
- Elimination
- IVM, ivermectin
- Ivermectin co-administration
- MBZ, mebendazole
- Mass drug administration
- Pre-SAC, preschool-aged
- R0, basic reproductive number
- SAC, school-aged children
- STH, soil-transmitted helminth
- Soil-transmitted helminth
- Trichuris trichiura
- WASH, water, sanitation and hygiene
- WHO, World Health Organisation
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