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Ruberanziza E, Owada K, Clark NJ, Umulisa I, Ortu G, Lancaster W, Munyaneza T, Mbituyumuremyi A, Bayisenge U, Fenwick A, Soares Magalhães RJ. Mapping Soil-Transmitted Helminth Parasite Infection in Rwanda: Estimating Endemicity and Identifying At-Risk Populations. Trop Med Infect Dis 2019; 4:tropicalmed4020093. [PMID: 31207897 PMCID: PMC6630518 DOI: 10.3390/tropicalmed4020093] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/11/2019] [Accepted: 06/12/2019] [Indexed: 01/17/2023] Open
Abstract
Soil-transmitted helminth (STH) infections are globally distributed intestinal parasite infections caused by Ascaris lumbricoides, Trichuris trichiura, and hookworms (Ancylostoma duodenale and Necator americanus). STH infection constitutes a major public health threat, with heavy burdens observed in many of the world’s tropical and subtropical regions. Mass drug administration and sanitation improvements can drastically reduce STH prevalence and associated morbidity. However, identifying targeted areas in need of treatment is hampered by a lack of knowledge on geographical and population-level risk factors. In this study, we applied Bayesian geostatistical modelling to data from a national school-based STH infection survey in Rwanda to (1) identify ecological and population-level risk factors and (2) provide comprehensive precision maps of infection burdens. Our results indicated that STH infections were heterogeneously distributed across the country and showed signatures of spatial clustering, though the magnitude of clustering varied among parasites. The highest rates of endemic clustering were attributed to A. lumbricoides infection. Concordant infection patterns among the three parasite groups highlighted populations currently most at-risk of morbidity. Population-dense areas in the Western and North-Western regions of Rwanda represent areas that have continued to exhibit high STH burden across two surveys and are likely in need of targeted interventions. Our maps support the need for an updated evaluation of STH endemicity in western Rwanda to evaluate progress in MDA efforts and identify communities that need further local interventions to further reduce morbidity caused by STH infections.
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Affiliation(s)
- Eugene Ruberanziza
- Neglected Tropical Diseases and Other Parasitic Diseases Unit, Malaria and Other Parasitic Diseases Division, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda.
| | - Kei Owada
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, the University of Queensland, Gatton 4343, Queensland, Australia.
- Children Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane 4101, Queensland, Australia.
| | - Nicholas J Clark
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, the University of Queensland, Gatton 4343, Queensland, Australia.
- Children Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane 4101, Queensland, Australia.
| | - Irenee Umulisa
- Neglected Tropical Diseases and Other Parasitic Diseases Unit, Malaria and Other Parasitic Diseases Division, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda.
| | - Giuseppina Ortu
- Schistosomiasis Control Initiative (SCI), Department of Infectious Diseases Epidemiology, Imperial College, London SW7 2AZ, UK.
| | | | - Tharcisse Munyaneza
- Microbiology Unit, National Reference Laboratory (NRL) Division, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda.
| | - Aimable Mbituyumuremyi
- Malaria and Other Parasitic Diseases Division, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda.
| | - Ursin Bayisenge
- Neglected Tropical Diseases and Other Parasitic Diseases Unit, Malaria and Other Parasitic Diseases Division, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda.
| | - Alan Fenwick
- Schistosomiasis Control Initiative (SCI), Department of Infectious Diseases Epidemiology, Imperial College, London SW7 2AZ, UK.
| | - Ricardo J Soares Magalhães
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, the University of Queensland, Gatton 4343, Queensland, Australia.
- Children Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane 4101, Queensland, Australia.
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Wright S, Earland D, Sakhuja S, Junkins A, Franklin S, Padilla L, Aung M, Jolly PE. Anemia in pregnancy in Western Jamaica. Int J Womens Health 2017; 9:431-439. [PMID: 28652822 PMCID: PMC5476652 DOI: 10.2147/ijwh.s129567] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Anemia is one of the most prevalent problems in pregnancy. In 2011, 29.9% of all pregnant women in Jamaica were diagnosed with anemia. OBJECTIVE The objective of this study was to determine the prevalence and predictors of anemia in pregnancy in Western Jamaica. METHODS A cross-sectional study was conducted among 293 mothers attending post-natal clinics in Western Jamaica. A questionnaire was administered to the mothers, and an abstraction form was used to collect clinical data from the mothers' records. RESULTS The prevalence of anemia among the women was 37.6%. Younger mothers (aged 18-24 years) were more likely to be anemic compared to those ≥35 years (odds ratio [OR]: 3.44, 95% CI: 1.07-11.06). Mothers who reported not always washing their hands after using the toilet were almost 10 times more likely to be anemic (OR: 9.7, 95% CI: 1.72-54.78) compared to those who reported always washing their hands. Mothers who attended a public facility for antenatal care were 2.3 times more likely to be anemic (OR: 2.31, 95% CI: 1.03-5.18) compared to those who obtained care at a private facility, and mothers who reported being told that they were anemic by a health care provider (HCP) were almost six times more likely to be anemic compared with those who were not told (OR: 5.58, 95% CI: 1.73-17.93). CONCLUSION The results of the study indicate that early identification and treatment of anemia, especially among younger pregnant women, should be a priority. HCP should ensure that women understand the need to be cured of their anemia and to adhere to preventive hygienic practices.
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Affiliation(s)
- Saidah Wright
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dominique Earland
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Swati Sakhuja
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Anna Junkins
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sarah Franklin
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Luz Padilla
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Maung Aung
- Western Region Health Authority, Cornwall Regional Hospital, Ministry of Health, Montego Bay, Jamaica
| | - Pauline E Jolly
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
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Abstract
Ascaris lumbricoides or roundworms' propensity to produce large number of eggs that are resistant to extremes of environmental conditions have made them one of the highly prevalent and geographically well distributed nematodes among poor socio-economic regions throughout the world. We present an unusual case of fatal gastro-intestinal ascariasis where general neglect, and firm and prolonged reliance on traditional healing methods led to aggregation of roundworms to such an extent that otherwise seems improbable in modern times and, hence, is worth reporting.
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Affiliation(s)
- Tanuj Kanchan
- Department of Forensic Medicine, Kasturba Medical College, Mangalore (A constituent College of Manipal University), India
| | - Harihar Wasti
- Department of Forensic Medicine, Institute of Medicine, Maharajgunj, Nepal
| | - Jenash Acharya
- Department of Forensic Medicine, Kathmandu Medical College, Teaching Hospital, Kathmandu, Nepal
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