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Parajuli R, Dhakal P, Thapa S, Ghimire TR, Parajuli RP. Prevalence and contributing factors of intestinal parasitic infections among school children with malnutrition in Hetauda, Nepal: A cross-sectional study. Health Sci Rep 2024; 7:e2146. [PMID: 38812713 PMCID: PMC11130544 DOI: 10.1002/hsr2.2146] [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: 10/09/2023] [Revised: 04/04/2024] [Accepted: 05/07/2024] [Indexed: 05/31/2024] Open
Abstract
Background and Aims With existing undernutrition in the developing world, the prevalence of obesity is increasing rapidly. Some studies reported an association of intestinal parasitic infection (IPIs) with undernutrition while few recent studies reported an inverse association of IPIs with overweight and obesity. This study evaluated the comparative risk and associated factors of IPIs among under (body mass index [BMI] < 18.5), normal (BMI: 18.5-24.9) and overweight (BMI > 24.9) school-aged adolescents. Methods A total of 105 fecal samples were collected, with 35 samples from each group. The collected samples were tested for the presence of intestinal parasites via concentration method, and the parasites were identified morphologically. Results Overall prevalence of IPIs was 5.71% with 3 protozoa viz Giardia lamblia (2.86%), Entamoeba histolytica (1.90%) and Endolimax nana (0.95%). Univariate and multivariable regression analysis indicated none of the nutritional, socioeconomic status, demographic, lifestyle and behavioral characteristics were significantly associated with the prevalence of overall IPIs. Yet, significant numbers of male reported undernutrition and elevated risk of IPIs in this study population. Conclusion Despite low prevalence of IPIs in this study, risk of IPIs is attributable to individual differences in behavior like "not using soap for hand washing". Relatively elevated malnutrition with risky hygiene behaviors, male adolescents appeared as risky cluster of school age population.
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Affiliation(s)
| | - Pitambar Dhakal
- Central Department of ZoologyTribhuvan UniversityKirtipurNepal
| | - Sandeep Thapa
- Kathmandu Center for Genomics and Research Laboratory (KCGRL)GwarkoNepal
| | - Tirth Raj Ghimire
- Department of Zoology, Tri‐Chandra CampusTribhuvan UniversityKirtipurNepal
| | - Rajendra Prasad Parajuli
- Central Department of ZoologyTribhuvan UniversityKirtipurNepal
- Herbert Wertheim School of Public Health and Human Longevity ScienceUniversity of California San Diego (UCSD)CaliforniaUSA
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Neto AFR, Di Christine Oliveira YL, de Oliveira LM, La Corte R, Jain S, de Lyra Junior DP, Fujiwara RT, Dolabella SS. Why Are We Still a Worm World in the 2020s? An Overview of Risk Factors and Endemicity for Soil-Transmitted Helminthiasis. Acta Parasitol 2023; 68:481-495. [PMID: 37531011 DOI: 10.1007/s11686-023-00701-1] [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: 02/13/2022] [Accepted: 07/18/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Soil-transmitted helminthiasis (STH) is one of the most common chronic infections in developing countries associated with poor socioeconomic and sanitary conditions. The main objective of this overview was to evaluate the influence of environmental factors, risk factors related to the host, and control strategies on the prevalence of STH in different regions of the world. METHODS LILACS, PubMed, Web of Knowledge, Embase, the Cochrane Library, and Clinical Trials (gray literature) databases were used to obtain the systematic reviews published until December 2020. The methodological quality of systematic reviews was assessed using the standard criteria recommended by AMSTAR. RESULTS The initial results of the bibliographic search identified 1448 articles, of which 66 studies were read in full and 16 met the inclusion criteria. All the reviews included in this overview associated variations in the global prevalence of STH with at least one of the factors related to the environment, host, and/or control strategies. Climate, temperature, soil moisture, precipitation, mass drug administration, lack of access to water, sanitation and hygiene (WASH), and non-use of footwear were considered the main factors associated with the prevalence of STH. Socioeconomic factors, low educational level, and wearing shoes were universal factors related to prevalence, regardless of the location studied. CONCLUSION The combination of environmental factors, with factors associated with hosts that predispose infection and reinfection of helminths, as well as the adoption of control strategies based on the treatment of target populations instead of the entire population, influenced the prevalence of STH in all the continents evaluated.
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Affiliation(s)
- Adelson Ferreira Ramos Neto
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | | | - Luciana Maria de Oliveira
- Department of Morphology, Center of Biology and Health Sciences, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - Roseli La Corte
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
| | - Sona Jain
- Postgraduate Program in Industrial Biotechnology, Tiradentes University, Aracaju, SE, 49010-390, Brazil
| | | | - Ricardo Toshio Fujiwara
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Silvio Santana Dolabella
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil.
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão, SE, 49100-000, Brazil.
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Zorbozan O, Turgay N. Monitoring the Trends in Intestinal Parasite Frequencies; 2018 and 2022 Data. TURKIYE PARAZITOLOJII DERGISI 2023; 47:59-63. [PMID: 36872488 DOI: 10.4274/tpd.galenos.2023.66376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Objective Monitoring intestinal parasite frequencies is effective on diagnosis, treatment, and prevention strategies to be developed against these parasites. In this study, it was aimed to reveal the parasite species and frequency data of stool samples in parasitology direct diagnosis laboratory. Methods Stool parasitological examination results were obtained retrospectively from our laboratory internal quality control data tables. Data belonging to the year 2018 and 2022 were compared retrospectively. Results Annual parasites detected in stool samples were 388 of 4.518, and 710 of 3.537, in 2018 and 2022, respectively. Frequency of parasite detection in stool samples was found to be significantly higher in 2022 (p<0.0001). Number of stools with more than one parasite was 12 and 30 in 2018 and 2022, respectively. Incidence of infection with more than one parasite was significantly higher in 2022 (p=0.0003). Five most common parasite species were Blastocystis spp., Enterobius vermicularis, Cryptosporidium spp., Giardia intestinalis and Entamoeba histolytica in 2018, respectively; and Cryptosporidium spp., Blastocystis spp., Cyclospora spp., Entamoeba dispar and Giardia intestinalis, in 2022, respectively. Cryptosporidium spp., Cyclospora spp. and Entamoeba dispar increased significantly, while Blastocystis spp. and Enterobius vermicularis decreased significantly, in 2022. Conclusion According to the data obtained, causative agents for intestinal parasitic infections were protozoans, especially Cryptosporidium spp. It has been concluded that tightening the measures for protection of water with one health approach and improving the education and habits of society on personal hygiene and food safety can be effective in reducing the frequency of intestinal parasite infections in our region.
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Affiliation(s)
- Orçun Zorbozan
- Ege Üniversitesi Tıp Fakültesi, Tıbbi Parazitoloji Anabilim Dalı, İzmir, Türkiye
| | - Nevin Turgay
- Ege Üniversitesi Tıp Fakültesi, Tıbbi Parazitoloji Anabilim Dalı, İzmir, Türkiye
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Micronutrients deficiencies and its correlation with the soil-transmitted helminthic infections among children and non-pregnant women in Nepal: findings from Nepal national micronutrient status survey. Sci Rep 2022; 12:22313. [PMID: 36566272 PMCID: PMC9789997 DOI: 10.1038/s41598-022-24634-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/17/2022] [Indexed: 12/25/2022] Open
Abstract
Despite having a high risk of soil-transmitted helminths (STHs) infection, no national level study has been conducted to assess incidence and correlates of STHs in Nepal. Thus, we hypothesized that micronutrients and social status are linked with incidence of STHs infection among 6-59 months children and 15-49 years non-pregnant women in Nepal and Kato-Katz technique was adopted to measure the type and intensity of STHs infections using fresh stool specimens and venous blood was used to examine micronutrients biomarkers. Anthropometric measurements such as height and weight, sociodemographic and health status were determined using structured questionnaire. Logistic regression was used to assess unadjusted and adjusted odds ratio (AOR) and the 95% CIs of ORs. The bivariate association of STHs was assessed with the covariates variables. Overall, 12% children and 19% non-pregnant women had STHs infection; A. lumbricoides was the predominant helminth in both study participants. In multivariate model; age, ethnicity, anaemia and zinc deficiency were associated with STHs infections in children. Similarly, higher odds of STHs occurrence was observed among non-pregnant women with vitamin A deficiency. Findings from this study suggest that high-risk population, with a focus on those of lower socioeconomic status should be on priority of deworming program, nutrition intervention, and mass administration of preventive chemotherapy and sanitation champions supplement to reduce the STHs infections in Nepal.
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Mahittikorn A, Masangkay FR, De Jesus Milanez G, Kuraeiad S, Kotepui M. Prevalence and effect of Plasmodium spp. and hookworm co-infection on malaria parasite density and haemoglobin level: a meta-analysis. Sci Rep 2022; 12:6864. [PMID: 35477943 PMCID: PMC9046215 DOI: 10.1038/s41598-022-10569-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/11/2022] [Indexed: 12/14/2022] Open
Abstract
The dual effects of co-infection of Plasmodium spp. and hookworm on malaria remain under debate. This study investigated prevalence, prevalence odds ratio (POR) of co-infection and impact of co-infection on malaria parasite density and haemoglobin levels in comparison to Plasmodium mono-infection. The protocol for this systematic review and meta-analysis is registered at PROPERO under ID: CRD42020202156. Relevant literatures were obtained from PubMed, ISI Web of Science, and Scopus on 25 December 2020. Mean difference (MD) and confidence interval (CI) of malaria parasite density and haemoglobin were compared using a random effect model. Heterogeneity was assessed using Cochrane Q and I2 statistics. Publication bias was determined by visualising funnel plot asymmetry. Of 1756 articles examined, 22,191 malaria cases across 37 studies included 6096 cases of co-infection of Plasmodium spp. and hookworm. The pooled prevalence was 20% (95% CI 15–26%, I2 99.6%, 37 studies) and was varied in terms of geographical region. Co-infection occurred by chance (OR 0.97, p 0.97, 95% CI 0.73–1.27, I2 95%, 30 studies). The mean malaria parasite density for co-infection (478 cases) was similar to Plasmodium mono-infection (920 cases) (p 0.24, MD 0.86, 95% CI − 0.58–2.29, I2 100%, 7 studies). The mean haemoglobin level for co-infection (90 cases) was similar to Plasmodium mono-infection (415 cases) (p 0.15, MD − 0.63, 95% CI − 1.49–0.23, I2 98%, 4 studies). Co-infection was common and occurred by chance but varied by geographic region. Further studies are required to investigate the mechanism of hookworm infection on malaria severity. Additionally, detection of hookworm infections among patients with malaria in endemic areas of both diseases is recommended to prevent severe malaria.
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Affiliation(s)
- Aongart Mahittikorn
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Giovanni De Jesus Milanez
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines
| | - Saruda Kuraeiad
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
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Chelkeba L, Mekonnen Z, Emana D, Jimma W, Melaku T. Prevalence of soil-transmitted helminths infections among preschool and school-age children in Ethiopia: a systematic review and meta-analysis. Glob Health Res Policy 2022; 7:9. [PMID: 35307028 PMCID: PMC8935818 DOI: 10.1186/s41256-022-00239-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 01/24/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There is a lack of comprehensive national data on prevalence, geographical distribution of different species, and temporal trends in soil-helminthiasis (STHs). Therefore, this study aimed to provide a summary and location of the available data on STHs infection among preschool and school-age children in Ethiopia. METHODS The search was carried out in Medline via PubMed, Scopus, Science Direct, Web of Science, and Google Scholar on data published between 1997 to February 2020 for studies describing the rate of STHs infection among preschool and school-age in Ethiopian. We followed the Patient, Intervention, Comparison, and Outcome (PICO) approach to identify the studies. Meta-regression was performed to understand the trends and to summarize the prevalence using the "metaprop" command using STATA software version 14.0 RESULTS: A total of 29,311 of the 61,690 children examined during the period under review were infected with one or more species of intestinal parasites yielding an overall prevalence of 48% (95% CI: 43-53%). The overall pooled estimate of STHs was 33% (95% CI: 28-38%). The prevalence was 44% (95% CI: 31-58%) in SNNPR, 34% (95% CI: 28-41%) in Amhara region, 31% (95% CI: 19-43%) in Oromia region and 10% (95% CI: 7-12%) in Tigray region. Soil-transmitted helminths infection rate has been decreasing from 44% (95% CI: 30-57%) pre-Mass Drug Administration (MDA) era (1997-2012) to 30% (95% CI: 25-34%) post-MDA (2013-2020), although statistically not significant (p = 0.45). A lumbricoides was the predominant species with a prevalence of 17%. CONCLUSION Southern Nations Nationalities and Peoples Region, Amhara, and Oromia regions carry the highest-burden and are categorized to Moderate Risk Zones (MRZ) and therefore, requiring MDA once annually with Albendazole or Mebendazole. The prevalence of STHs decreased after MDA compared to before MDA, but the decline was not statistically significant. A. lumbricoides was the predominant species of STHs among preschool and school-age children in Ethiopia. The high prevalence of STHs observed in this review, underscores the need for better control and prevention strategies in Ethiopia.
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Affiliation(s)
- Legese Chelkeba
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College Health Sciences, Black Lion Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zeleke Mekonnen
- Department of Parasitology, School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Daniel Emana
- Department of Parasitology, School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Worku Jimma
- Department of Information Science, College of Natural Sciences, Jimma University, Jimma, Ethiopia
| | - Tsegaye Melaku
- Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.
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Trend of Soil-Transmitted Helminths in Ethiopian Children: A Systematic Review and Meta-Analysis (2000-2018). J Parasitol Res 2021; 2021:5638836. [PMID: 34721896 PMCID: PMC8556119 DOI: 10.1155/2021/5638836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/23/2021] [Indexed: 11/23/2022] Open
Abstract
Background Ethiopia is one of the tropical countries with a heavy burden of soil-transmitted helminths. As a result, the nation has been implementing mass drug administration, water, sanitation, and hygiene and health extension programs to control those parasites. Hence, updated data about the prevalence and trend of parasites over time has a pivotal role to assess the success of existing control programs. Methods Studies conducted between 2000 and 2018 were searched from PubMed, Google Scholar, and local journals for systematic reviews and meta-analysis following the PRISMA guideline and checklists. Eligible studies were selected based on preset inclusion and exclusion criteria. The quality of the included studies was assessed using the Newcastle-Ottawa Scale in meta-analysis. Heterogeneity between studies was assessed using the Cochran Q test and I2 test statistics based on the random effect model. Comprehensive meta-analysis (CMA 2.0) was used to calculate the pooled prevalence, and metaregression was run to assess the trend of parasite prevalence over time. Results Thirty-eight studies recruiting 16,266 participants were included in the review. The pooled prevalence of intestinal parasites was 52.0% (95% CI: 44.4-59.5). Amhara region was with the highest prevalence (60.3%; 95% CI: 50.1-69.6). Among soil-transmitted helminths, Ascaris lumbricoides (11.2%; 95% CI: 8.4-14.8) was with the highest pooled prevalence followed by hookworms (10.4%; 95% CI: 7.9-13.7) and Trichuris trichiura (3.6%; 95% CI: 2.4-5.4). Metaregression analysis revealed that all soil-transmitted helminths did not show a significantly decreasing trend over time (p > 0.05). Conclusion Despite various control efforts having been made, soil-transmitted helminths are of high distribution, and their prevalence is not significantly decreasing in Ethiopia. Hence, other control approaches like community-led sanitation should be integrated with mass drug administration to achieve the national goal of soil-transmitted helminth elimination by 2025.
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Prevalence and Related Risk Factors of Intestinal Parasitosis among Private School-Going Pupils of Dharan Submetropolitan City, Nepal. J Parasitol Res 2021; 2021:6632469. [PMID: 34306741 PMCID: PMC8285192 DOI: 10.1155/2021/6632469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 05/25/2021] [Accepted: 06/16/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Intestinal parasitic infections are most common and prevalent among children and accounts for great morbidity and mortality. Objective This research is aimed at studying the prevalence and related risk factors of parasitic infections among private school-going pupils of Dharan Submetropolitan City. Methods and Materials This was a cross-sectional laboratory-based study conducted from 13 November 2018 to 26 February 2019 among 400 private school pupils. The stool samples were collected and microscopically examined for parasites using the formalin ethyl acetate sedimentation technique. Data Analysis. Statistical analysis was performed by using SPSS version 16.0. Pearson's Chi-square test was used to establish association between dependent and independent variables. The association was also determined using crude and adjusted odds ratio, and the test considered a P value < 0.05 as statistically significant with 95% confidence interval. Result In this study, 46 (11.5%) children were positive for intestinal parasites. In this study, 3 protozoans (Entamoeba histolytica = 3 (0.75%)) and 43 helminths (Ascaris lumbricoides = 22 (5.5%); Enterobiusvermicularis = 6 (1.5%); Ancylostoma duodenale = 2 (0.5%); and Trichuris trichiura = 13 (3.25%)) were isolated and identified. Statistically, significant difference in the parasitic prevalence with respect to age and gender was not seen (P > 0.05). However, the prevalence of parasitic infection was strongly associated with the ethnicity of the pupils (P = 0.001). The strong associated risk factors of intestinal parasitic infections were nail-biting habit, source of drinking water, biannual deworming, thumb-sucking, hand sanitation before having food and after toilet, knowledge of parents on parasitosis, health and sanitation, keeping cat/dog as pet, and wearing protective shoes during play (P = 0.001). Bowel syndromes like abdominal cramp and constipation also had a strong statistical association (P = 0.001) with the prevalence of parasitic infection. According to binary and multivariate logistic regression analyses, the parents without awareness, pupils with a nail-biting habit, pupils not wearing shoes during play, lack of deworming, drinking direct tap water, and pupils with poor hand sanitation were more likely to be infested with intestinal parasitic infections. Conclusion This study concludes that intestinal parasites are still prevalent among private school-going pupils of Dharan Submetropolitan City. The poor sanitation and sanitary habits like biting nails, consumption of untreated drinking water, and failure to practice proper hand washing were studied as contributors to the acquisition of intestinal parasitic infections. Therefore, integration of control measures such as provision of clean and safe drinking water, improved sanitation and hygiene, with biannual administration of drugs are necessary for effective eradication of parasitic infections.
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Gupta R, Rayamajhee B, Sherchan SP, Rai G, Mukhiya RK, Khanal B, Rai SK. Prevalence of intestinal parasitosis and associated risk factors among school children of Saptari district, Nepal: a cross-sectional study. Trop Med Health 2020; 48:73. [PMID: 32848503 PMCID: PMC7444033 DOI: 10.1186/s41182-020-00261-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/13/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Intestinal parasitosis, caused by both helminths and protozoans, are among the most prevalent infections, especially in developing countries. Enteric parasites continue to be a major cause of parasitic diseases which is the most common among street and school going children with poor sanitation. This cross-sectional study was carried out to determine the prevalence and potential risk factors of intestinal parasitosis among school going children of two schools of Saptari district of southern Nepal. Stool samples were collected in a clean, dry, screw-capped, and wide-mouthed plastic container, fixed with 10% formal-saline solution, and transported to the laboratory for further microscopic analysis by following concentration technique. RESULTS Out of the 285 stool samples analysed, 94 (33%) were positive for the parasitosis. Presence of intestinal parasites was marginally more in rural school (44.6%) than in urban (30%) (P < 0.05). Giardia lamblia was highly prevalent (15.4%) followed by Entamoeba histolytica-like (7.7%), E. coli (7%), Ascaris lumbricoides (1.8%), and Hymenolepis nana (1.08%), respectively. Children of the age group 11-15 years were highly affected (44.2%) compared to younger age groups. The findings of intestinal parasitosis in the study population were statistically significant with family income, hand-washing habit, type of drinking water, and availability of a toilet facility at home (P < 0.05). Over 85% of infection was associated with parasitosis that indicated mainly waterborne infection rather than soil-borne helminths. CONCLUSIONS Poor hygiene measures and farming occupation are identified as major risk factors of parasitic infections, so sanitation especially focusing on safe drinking water along with multi intervention strategies must be emphasized in the Saptari district of Nepal to reduce the burden of parasitic diseases in school children.
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Affiliation(s)
- Ranjit Gupta
- ShiGan International College of Science and Technology, Kathmandu, Nepal
| | - Binod Rayamajhee
- Department of Infectious Disease and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
- School of Optometry and Vision Science, Faculty of Science, UNSW, Sydney, NSW 2052 Australia
| | - Samendra P. Sherchan
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA USA
| | - Ganesh Rai
- ShiGan International College of Science and Technology, Kathmandu, Nepal
- National Institute of Tropical Medicine and Public Health Research, Kathmandu, Nepal
| | | | - Binod Khanal
- ShiGan International College of Science and Technology, Kathmandu, Nepal
| | - Shiba Kumar Rai
- ShiGan International College of Science and Technology, Kathmandu, Nepal
- National Institute of Tropical Medicine and Public Health Research, Kathmandu, Nepal
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Dukpa T, Dorji N, Thinley S, Wangchuk, Tshering K, Gyem K, Wangmo D, Sherpa PL, Dorji T, Montresor A. Soil-Transmitted Helminth infections reduction in Bhutan: A report of 29 years of deworming. PLoS One 2020; 15:e0227273. [PMID: 31899772 PMCID: PMC6941809 DOI: 10.1371/journal.pone.0227273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 12/16/2019] [Indexed: 11/19/2022] Open
Abstract
Soil Transmitted Helminth (STH) infections affect over 1.5 billion people worldwide. Although prevalent in all age groups, school aged children are a high-risk groups for STH infections. In Bhutan, epidemiological data on STH were collected from western Bhutan in 2003, which found a prevalence of 16.5%. However, little evidence is available on the prevalence of infection at national level. Therefore, this study was conducted with the aim to assess the prevalence and intensity of STH infections, and identify significant correlates of STH among students. A school-based survey was conducted in three regions of Bhutan. Two-stage cluster sampling was adopted to select a sample of 1500 students from 24 schools, in equal proportion from three regions of the country. A total of 1456 (97%) students were interviewed and their stool sample examined for the presence of parasites. Mini-FLOTAC technique was used to detect the parasite eggs/ova. The prevalence of any STH infection was 1.4%, with 0.8% Ascaris lumbricoides, 0.5% Trichuris trichiura and 0.2% hookworms. The eastern region had the highest prevalence at 2.3%. Except for one student who had moderate intensity of A. lumbricoides, the rest had light infection. Any STH presence was significantly associated with father's occupation, father's education level, type of house and the flooring of the house in which students reported to live. No significant associations were observed between water, sanitation and hygiene (WASH) variables measured and presence of any STH infection. The prevalence of STH was found to be very low with primarily light intensity in this study. Nonetheless, it was also found that the sanitation situation is not ideal in the country, with several students reporting constant or partial open defecation leading to environmental contamination. Based on this prevalence and in line with the WHO guideline, it is recommended that deworming be reduced to once a year in combination with concerted health education on proper hygiene and sanitation practice.
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Affiliation(s)
- Tshering Dukpa
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Nidup Dorji
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Sangay Thinley
- Comprehensive School Health Programme, Department of Public Health, Ministry of Health, Thimphu, Bhutan
| | - Wangchuk
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Karma Tshering
- Department of Microbioloy, Jigme Dorji Wangchuk National Referral Hospital, Thimphu, Bhutan
| | - Kinley Gyem
- Royal Center for Disease Control, Thimphu Bhutan
| | - Diki Wangmo
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Passang Lhamo Sherpa
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Tshering Dorji
- Laboratory Unit, Trashigang District Hospital, Trashigang, Bhutan
| | - Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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Shrestha J, Bhattachan B, Rai G, Park EY, Rai SK. Intestinal parasitic infections among public and private schoolchildren of Kathmandu, Nepal: prevalence and associated risk factors. BMC Res Notes 2019; 12:192. [PMID: 30925938 PMCID: PMC6441203 DOI: 10.1186/s13104-019-4225-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 03/25/2019] [Indexed: 11/30/2022] Open
Abstract
Objective Intestinal parasitic infections (IPIs) are a major cause of morbidity among children in developing countries. Investigation about the etiological agents and socio-ecological pattern of the infection would help to design better preventive strategy. The previous studies reported high prevalence of IPIs among schoolchildren of Nepal. Though these data may be essential for the policymakers and researchers, in Kathmandu, the capital of Nepal it remains unexplored whether the types of school and socioeconomic status affect the IPIs or not. The present study is an extension of previous works to investigate causative agents and associated risk factors. We examined 508 stool samples of schoolchildren from two schools by formal-ether concentration technique and analyzed the data based on school types. Results The overall IPIs rate was 19.9% (n = 101) with the dominance of protozoans (78.4%) over helminths (21.6%). Giardia duodenalis (32.7%) and Ascaris lumbricoides (21.8%) were the most commonly detected protozoan and helminth species respectively. Prevalence of IPIs was higher among children from public school (26.1%) than private school (12.1%). Higher infection rates were found among farmer’s children (29.0%) and Dalit children (36.2%). These findings reveal the different prevalence of IPIs among public and private schoolchildren and suggest the need of effective preventive measures.
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Affiliation(s)
- Jitendra Shrestha
- Shi-Gan International College of Science and Technology, Affiliated to Tribhuvan University, Kathmandu, Nepal. .,College of Pharmacy, Mokpo National University, Mokpo, South Korea.
| | - Balkrishna Bhattachan
- Shi-Gan International College of Science and Technology, Affiliated to Tribhuvan University, Kathmandu, Nepal
| | - Ganesh Rai
- Shi-Gan International College of Science and Technology, Affiliated to Tribhuvan University, Kathmandu, Nepal
| | - Eun Young Park
- College of Pharmacy, Mokpo National University, Mokpo, South Korea
| | - Shiba Kumar Rai
- Shi-Gan International College of Science and Technology, Affiliated to Tribhuvan University, Kathmandu, Nepal
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Adhikari R, Thapa S. Changing Trend of Infectious Diseases in Nepal. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1052:19-38. [PMID: 29785478 PMCID: PMC7122567 DOI: 10.1007/978-981-10-7572-8_3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Many infectious/communicable diseases (IDs) are endemic in Nepal. Until a decade and half ago, IDs were the major cause of both morbidity and mortality accounting 70% for both. However, as a result of various preventive measures implemented by both the state and non-state actors, the overall IDs have shown a changing (declining) trend. The most impressive decline has been seen in the intestinal helminth infection. Though the overall burden of IDs is decreasing, several newer infectious diseases (emerging infections) namely, dengue fever, scrub typhus, influenza (H5N1 and H1N1), and others are posing a great public health problem. On the other hand, though sporadic, outbreaks of endemic diseases together with HIV-TB coinfection and infection with drug resistance microbes during recent years have constituted a serious public health as well as medical problem. On the contrary, with the decline of IDs, noninfectious diseases (noncommunicable disease, NCD) namely, diabetes, cancer (and cancer therapy), and others are on the rise particularly in urban areas. Hence, currently Nepal is trapped in "double burden" of diseases. Risk of opportunistic infection has increased in immunocompromised person with NCD. To address the present situation, the multi-sectoral plan and strategies developed must be implemented effectively.
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Affiliation(s)
- Rameshwar Adhikari
- Research Center for Applied Science and Technology (RECAST), Tribhuvan University, Kathmandu, Nepal
| | - Santosh Thapa
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, Texas USA
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Yanola J, Nachaiwieng W, Duangmano S, Prasannarong M, Somboon P, Pornprasert S. Current prevalence of intestinal parasitic infections and their impact on hematological and nutritional status among Karen hill tribe children in Omkoi District, Chiang Mai Province, Thailand. Acta Trop 2018; 180:1-6. [PMID: 29306723 DOI: 10.1016/j.actatropica.2018.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 01/04/2018] [Accepted: 01/04/2018] [Indexed: 11/18/2022]
Abstract
Intestinal parasitic infection represents a substantial problem for children living in rural or limited resources areas and significantly relates to anemia and nutritional status. This study aimed to determine the current prevalence of intestinal parasitic infections among school-age children of Karen hill tribe population in Omkoi District, Chiang Mai Province, Thailand and assess the impact of intestinal parasitic infection on hematological and nutritional status in those children. A total of 375 Karen hill tribe children, 6-14 years of age, in Omkoi District were randomly selected to participate in this study. Stool samples were collected and examined for intestinal parasitic infection through formalin-ether concentration method. Blood samples were collected for hematological and iron analysis. The overall prevalence of intestinal parasitic infection was 47.7% (179/375), with single infections (29.3%) and polyparatism (18.4%). The most common pathogenic parasite was Trichuris trichiura (16.0%), followed by Ascaris lumbricoides (13%) and Giardia lamblia (3.5%). In addition, non-pathogenic amoeba, Entamoeba coli was observed with a high prevalence rate (31.2%). Anemia and eosinophilia prevalence were 6.40% (24/375) and 74.7% (280/375), respectively. Eosinophilia was significantly more prevalent in children with intestinal parasitic infection compared to uninfected children. Among 249 children, 13.7% were iron deficiency, 9.6% were thalassemia and hemoglobinophathy and 8% were G-6-PD deficiency. A high prevalence infection rate was significantly associated with eosinophilia, but independently related to anemia and iron deficiency. Intestinal parasitic infections are endemic in school-age children of Karen hill tribe population in Omkoi District. These data highlight the need for an integrated approach to control transmission of intestinal parasites and improve the health and sanitation status of Karen hill tribe children in Thailand.
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Affiliation(s)
- Jintana Yanola
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Woottichai Nachaiwieng
- Department of Public Health, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
| | - Suwit Duangmano
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Mujalin Prasannarong
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Pradya Somboon
- Department of Parasitology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sakorn Pornprasert
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
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Hagge DA, Parajuli P, Kunwar CB, Rana DRSJB, Thapa R, Neupane KD, Nicholls P, Adams LB, Geluk A, Shah M, Napit IB. Opening a Can of Worms: Leprosy Reactions and Complicit Soil-Transmitted Helminths. EBioMedicine 2017; 23:119-124. [PMID: 28882756 PMCID: PMC5605364 DOI: 10.1016/j.ebiom.2017.08.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/30/2017] [Accepted: 08/30/2017] [Indexed: 12/11/2022] Open
Abstract
Background > 94% of new annual leprosy cases are diagnosed in populations co-endemic for soil-transmitted helminths (STH). STH can profoundly dysregulate host immune responses towards Th2 bias, which can be restored over time after deworming. We hypothesize that STH co-infection is associated with leprosy reaction (denoted as simply “reaction” herein) occurrence within a co-endemic population. Methods A cohort study was performed on a cohort of Nepalese leprosy patients across treatment and diagnostic classifications who were screened by routine fecal smear microscopy and multiplex quantitative PCR (qPCR) for Ascaris lumbricoides (Al), Strongyloides stercoralis (Ss), Ancyclostoma duodenale (Ad) and Necator americanus (Na). Results Among 145 patients, 55% were positive for ≥ 1 STH (STH +): 34% Al +, 18% Ss +, 17% Ad + and 5% Na +. Significant inverse STH and reaction relationships were evidenced by the bulk of cases: 63% reaction-negative were STH + of total cases (p = 0.030) while 65% reaction-positive were STH − in new cases (96; p = 0.023). Strikingly, the majority of STH + were reaction-negative, even when considering each species: 59% Al +, 60% Ss +, 62% Ad + and 67% Na + of new leprosy cases. Conclusions Absence of STH co-infection is associated with leprosy reaction at diagnosis within a co-endemic population. This is likely due to immune reconstitution effects after deworming or interruption of chronic STH-mediated immune dysregulation. Fecal screening by qPCR revealed that 55% of 145 leprosy patients hosted 1 or more soil-transmitted helminth (STH) co-infections STH coinfection was significantly and inversely associated with leprosy reaction Chronic STH-induced immune bias followed by disruption of co-infection, potentially by deworming, may initiate immune reconstitution that can lead to reaction development
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Affiliation(s)
- Deanna A Hagge
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal.
| | - Pawan Parajuli
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Chhatra B Kunwar
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Divya R S J B Rana
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Ruby Thapa
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Kapil D Neupane
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Peter Nicholls
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Linda B Adams
- Department of Health and Human Services, Health Resources and Services Administration, Health Systems Bureau, National Hansen's Disease Programs (DHHS/HRSA/HSB/NHDP), Baton Rouge, Louisiana, USA
| | - Annemieke Geluk
- Department of Infectious Diseases, Leiden University Medical Center, The Netherlands
| | - Mahesh Shah
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Indra B Napit
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
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Oudni-M'rad M, Chaâbane-Banaoues R, M'rad S, Trifa F, Mezhoud H, Babba H. Gastrointestinal parasites of canids, a latent risk to human health in Tunisia. Parasit Vectors 2017; 10:280. [PMID: 28583158 PMCID: PMC5460421 DOI: 10.1186/s13071-017-2208-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/18/2017] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Although data on the parasite environmental contamination are crucial to implement strategies for control and treatment, information about zoonotic helminths is very limited in Tunisia. Contamination of areas with canid faeces harboring infective parasite elements represents a relevant health-risk impact for humans. The aim of this study was to assess the environmental contamination with eggs and oocysts of gastrointestinal parasites of dogs and wild canids in Tunisia with special attention to those that can be transmitted to humans. RESULTS One thousand two hundred and seventy faecal samples from stray dogs and 104 from wild canids (red foxes and golden jackals) were collected from different geographical regions throughout Tunisia. The helminth eggs and protozoan oocysts were concentrated by sucrose flotation and identified by microscopic examination. The most frequently observed parasites in dog samples were Toxocara spp. (27.2%), E. granulosus (25.8%), and Coccidia (13.1%). For wild canid faeces, the most commonly encountered parasites were Toxocara spp. (16.3%) followed by Capillaria spp. (9.6%). The parasite contamination of dog faeces varied significantly from one region to another in function of the climate. CONCLUSION To our knowledge, the study highlights for the first time in Tunisia a serious environmental contamination by numerous parasitic stages infective to humans. Efforts should be made to increase the awareness of the contamination risk of such parasites in the environment and implement a targeted educational program.
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Affiliation(s)
- Myriam Oudni-M'rad
- Laboratory of Medical and Molecular Parasitology-Mycology (LP3M), LR 12ES08. Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia.
| | - Raja Chaâbane-Banaoues
- Laboratory of Medical and Molecular Parasitology-Mycology (LP3M), LR 12ES08. Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia
| | - Selim M'rad
- Laboratory of Medical and Molecular Parasitology-Mycology (LP3M), LR 12ES08. Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia
| | - Fatma Trifa
- Laboratory of Biomass Valorisation and Production of Eukaryotic Proteins, Center of Biotechnology, University of Sfax, 3018, Sfax, Tunisia
| | - Habib Mezhoud
- Laboratory of Medical and Molecular Parasitology-Mycology (LP3M), LR 12ES08. Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia
| | - Hamouda Babba
- Laboratory of Medical and Molecular Parasitology-Mycology (LP3M), LR 12ES08. Faculty of Pharmacy, University of Monastir, 5000, Monastir, Tunisia.,Laboratory of Parasitology-Mycology, EPS F. Bourguiba, 5000, Monastir, Tunisia
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A School Health Project Can Uplift the Health Status of School Children in Nepal. PLoS One 2016; 11:e0166001. [PMID: 27812190 PMCID: PMC5094771 DOI: 10.1371/journal.pone.0166001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 10/23/2016] [Indexed: 11/19/2022] Open
Abstract
Background School health is effective in helping students achieve health literacy, enhance their health-related behaviors, and thereby improve their health status. However, in resource-limited countries, evidence is limited to show the impact of school health. We determined the association of the school health and nutrition (SHN) project activities on students’ a) health knowledge, b) hygiene practices, and c) health outcomes, one year after the project completion. Methods This is a cross-sectional study conducted among the schools with the SHN project and without the project in four districts of Nepal. We recruited 604 students from six schools in the project group and 648 students from other six schools in the comparison group. We used a self-administered questionnaire to collect the data, and analyzed them using regression models and a structural equation model (SEM). Results Students from the SHN project group reported the decreased odds of worm infestation (AOR = 0.50, 95% CI: 0.34 to 0.75) and diarrhea/ dysentery infection (AOR = 0.67, 95% CI: 0.47 to 0.97) compared to those in the comparison group. Furthermore, the SEM analysis also showed that the students in the project group were more likely to have better health outcomes (β = 0.03, p< 0.05). Conclusion Students in the SHN project group were more likely to have better health outcomes compared to those in the comparison group, even after one year of the project completion. As it can bring about sustainable changes for students, it should be scaled up in other parts of the country.
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