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Puchner KP, Bottazzi ME, Periago V, Grobusch M, Maizels R, McCarthy J, Lee B, Gaspari E, Diemert D, Hotez P. Vaccine value profile for Hookworm. Vaccine 2024; 42:S25-S41. [PMID: 37863671 DOI: 10.1016/j.vaccine.2023.05.013] [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: 07/04/2022] [Revised: 04/24/2023] [Accepted: 05/03/2023] [Indexed: 10/22/2023]
Abstract
Hookworm, a parasitic infection, retains a considerable burden of disease, affecting the most underprivileged segments of the general population in endemic countries and remains one of the leading causes of mild to severe anemia in Low and Middle Income Countries (LMICs), particularly in pregnancy and children under 5. Despite repeated large scale Preventive Chemotherapy (PC) interventions since more than 3 decades, there is broad consensus among scholars that elimination targets set in the newly launched NTD roadmap will require additional tools and interventions. Development of a vaccine could constitute a promising expansion of the existing arsenal against hookworm. Therefore, we have evaluated the biological and implementation feasibility of the vaccine development as well as the added value of such a novel tool. Based on pipeline landscaping and the current knowledge on key biological aspects of the pathogen and its interactions with the host, we found biological feasibility of development of a hookworm vaccine to be moderate. Also, our analysis on manufacturing and regulatory issues as well as potential uptake yielded moderate implementation feasibility. Modelling studies suggest a that introduction of a vaccine in parallel with ongoing integrated interventions (PC, WASH, shoe campaigns), could substantially reduce burden of disease in a cost - saving mode. Finally a set of actions are recommended that might impact positively the likelihood of timely development and introduction of a hookworm vaccine.
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Affiliation(s)
| | - Maria Elena Bottazzi
- National School of Tropical Medicine, Baylor College of Medicine, Baylor, TX, USA
| | | | - Martin Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Location AMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Rick Maizels
- Wellcome Centre for Integrative Parasitology, Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - James McCarthy
- The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Bruce Lee
- Public Health Informatics, Computational, and Operations Research, Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Erika Gaspari
- European & Developing Countries Clinical Trials Partnership (EDCTP), The Hague, The Netherlands
| | - David Diemert
- Department of Microbiology, Immunology & Tropical Medicine, George Washington University Medical Center, Washington, DC, USA
| | - Peter Hotez
- National School of Tropical Medicine, Baylor College of Medicine, Baylor, TX, USA
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Legge H, Pullan RL, Sartorius B. Improved household flooring is associated with lower odds of enteric and parasitic infections in low- and middle-income countries: A systematic review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002631. [PMID: 38039279 PMCID: PMC10691699 DOI: 10.1371/journal.pgph.0002631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/27/2023] [Indexed: 12/03/2023]
Abstract
Enteric and parasitic infections such as soil-transmitted helminths cause considerable mortality and morbidity in low- and middle-income settings. Earthen household floors are common in many of these settings and could serve as a reservoir for enteric and parasitic pathogens, which can easily be transmitted to new hosts through direct or indirect contact. We conducted a systematic review and meta-analysis to establish whether and to what extent improved household floors decrease the odds of enteric and parasitic infections among occupants compared with occupants living in households with unimproved floors. Following the PRISMA guidelines, we comprehensively searched four electronic databases for studies in low- and middle-income settings measuring household flooring as an exposure and self-reported diarrhoea or any type of enteric or intestinal-parasitic infection as an outcome. Metadata from eligible studies were extracted and transposed on to a study database before being imported into the R software platform for analysis. Study quality was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale. In total 110 studies were eligible for inclusion in the systematic review, of which 65 were eligible for inclusion in the meta-analysis after applying study quality cut-offs. Random-effects meta-analysis suggested that households with improved floors had 0.75 times (95CI: 0.67-0.83) the odds of infection with any type of enteric or parasitic infection compared with household with unimproved floors. Improved floors gave a pooled protective OR of 0.68 (95CI: 0.58-0.8) for helminthic infections and 0.82 OR (95CI: 0.75-0.9) for bacterial or protozoan infections. Overall study quality was poor and there is an urgent need for high-quality experimental studies investigating this relationship. Nevertheless, this study indicates that household flooring may meaningfully contribute towards a substantial portion of the burden of disease for enteric and parasitic infections in low- and middle-income settings.
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Affiliation(s)
- Hugo Legge
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Rachel L. Pullan
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Benn Sartorius
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Department of Health Metric Sciences, University of Washington, Seattle, Washington, United States of America
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Salou Bachirou Z, Mignanwande ZF, Bokossa H, Degnonvi H, Djossou P, Hondjrebo F, Amoukpo H, Anagonou EG, Agbo I, Toffa D, Ba R, Gine A, Diez G, Johnson RC. WASH and NTDs: Outcomes and lessons learned from the implementation of a formative research study in NTD skin co-endemic communities in Benin. Front Med (Lausanne) 2023; 10:1022314. [PMID: 36926314 PMCID: PMC10011489 DOI: 10.3389/fmed.2023.1022314] [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: 08/31/2022] [Accepted: 02/07/2023] [Indexed: 03/08/2023] Open
Abstract
Neglected Tropical Diseases (NTDs) are a diverse group of bacterial, viral, parasitic and fungal diseases affecting people, most of whom live below the poverty threshold. Several control strategies are defined against these diseases, including chemotherapy and Water, Hygiene and Sanitation (WASH). This study assesses the effect of promoting hygiene and sanitation on soil-transmitted helminthiasis s and NTDs of the skin. It took place in the communes of Ze, Lalo, and Zangnanado, three municipalities located in the south of Benin. This is a formative research that took place in three phases. The first phase entailed a baseline informations and situational analysis of the state of hygiene and health, using soil-transmitted helminthiasis and wound hygiene practices as cases studies. In the second phase, interventions to promote improved hygiene and sanitation were implemented. The third phase was devoted to post-intervention evaluation. The situation analysis showed that the prevalence of soil-transmitted helminthiasis was 6.43 and 7.10% in the municipalities of Ze and Lalo, respectively. In the communes of Zangnanado, the most common wound management practices identified were: putting sand or ashes in the wounds to keep flies away, the use of medicinal plants and the application of powder from antibiotic capsules for wound dressing. The post-intervention evaluation showed a decrease in the prevalence of soil-transmitted helminthiasis from 6.43 to 1.19% in the municipality of Lalo and from 7.10 to 1.75% in the municipality of Ze. In the commune of Zangnanado, a significant shift in wound management practices was noted, which led to the healing of several chronic wounds. This research supports the evidence that WASH-based interventions are very important to tackle neglected tropical diseases NTDs in addition to specific diseases based interventions.
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Affiliation(s)
- Zoulkifl Salou Bachirou
- Interfaculty Center for Training and Research in Environment for Sustainable Development (CIFRED), University of Abomey-Calavi, Abomey Calavi, Benin
| | - Zinsou Franck Mignanwande
- Interfaculty Center for Training and Research in Environment for Sustainable Development (CIFRED), University of Abomey-Calavi, Abomey Calavi, Benin
| | - Hervé Bokossa
- Interfaculty Center for Training and Research in Environment for Sustainable Development (CIFRED), University of Abomey-Calavi, Abomey Calavi, Benin
| | - Horace Degnonvi
- Interfaculty Center for Training and Research in Environment for Sustainable Development (CIFRED), University of Abomey-Calavi, Abomey Calavi, Benin
| | - Parfait Djossou
- Interfaculty Center for Training and Research in Environment for Sustainable Development (CIFRED), University of Abomey-Calavi, Abomey Calavi, Benin
| | - Flora Hondjrebo
- Interfaculty Center for Training and Research in Environment for Sustainable Development (CIFRED), University of Abomey-Calavi, Abomey Calavi, Benin
| | - Hermione Amoukpo
- Interfaculty Center for Training and Research in Environment for Sustainable Development (CIFRED), University of Abomey-Calavi, Abomey Calavi, Benin
| | - Esai Gimatal Anagonou
- Interfaculty Center for Training and Research in Environment for Sustainable Development (CIFRED), University of Abomey-Calavi, Abomey Calavi, Benin
| | - Inès Agbo
- Interfaculty Center for Training and Research in Environment for Sustainable Development (CIFRED), University of Abomey-Calavi, Abomey Calavi, Benin
| | - Damien Toffa
- Interfaculty Center for Training and Research in Environment for Sustainable Development (CIFRED), University of Abomey-Calavi, Abomey Calavi, Benin
| | - Rafiatou Ba
- Interfaculty Center for Training and Research in Environment for Sustainable Development (CIFRED), University of Abomey-Calavi, Abomey Calavi, Benin
| | | | | | - Roch Christian Johnson
- Interfaculty Center for Training and Research in Environment for Sustainable Development (CIFRED), University of Abomey-Calavi, Abomey Calavi, Benin
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Sedekia Y, Kapiga S, Mcharo O, Makata K, Torondel B, Dreibelbis R, Okello E. Does a school-based intervention to engage parents change opportunity for handwashing with soap at home? Practical experience from the Mikono Safi trial in Northwestern Tanzania. PLoS Negl Trop Dis 2022; 16:e0010438. [PMID: 35666720 PMCID: PMC9170081 DOI: 10.1371/journal.pntd.0010438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 04/20/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND School-based de-worming is advocated as a strategy for reducing the burden of soil-transmitted helminth (STH) infections among children. However, re-infection tends to occur rapidly, suggesting that comprehensive water, sanitation, and hygiene (WASH) improvements may be needed to prevent this. We qualitatively assessed the influence of parental engagement activities on parents' motivation to improve WASH infrastructure and hygiene practices at home in the context of a school-based de-worming programme. METHODOLOGY We conducted a longitudinal qualitative study nested within the Mikono Safi trial, designed to assess the effect of a WASH intervention on STH infection prevalence in children. Meetings were organized for parents/guardians at schools where they were given information about STH infection, the role of WASH in STH infection prevention, and actionable steps they could take at home. During the meetings, parents/guardians received information about their own child's STH infection status. Twenty purposively selected households were visited and interviewed 3 times over a period of about 8-months. We employed thematic analysis; findings are reported following the Capability-Opportunity-Motivation and Behaviour (COM-B) framework. PRINCIPAL FINDINGS The engagement strategy improved parents'/guardians' knowledge and skills about handwashing with soap and its benefits. Parents/guardians reported that the sessions had motivated them to improve WASH infrastructure at home. Of 20 households included in this study, 17 renovated or built new latrines and 18 installed handwashing facilities. However, only 8 households established and maintained handwashing stations with both soap and water at 8 months. CONCLUSIONS The engagement of parents/guardians in a school-based WASH education intervention as part of the Mikono Safi trial resulted in increased knowledge and motivation about handwashing and sanitation. This led to improvements in sanitation facilities and handwashing opportunities at home. However, long-term success in provision of water and soap was limited, indicating that sustained engagement may be required to encourage households to ensure these materials are consistently available at home.
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Affiliation(s)
| | - Saidi Kapiga
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine [LSHTM], London, United Kingdom
| | - Onike Mcharo
- Mwanza Intervention Trials Unit, Mwanza, Tanzania
| | | | - Belen Torondel
- Department of Disease Control, London School of Hygiene and Tropical Medicine [LSHTM], London, United Kingdom
| | - Robert Dreibelbis
- Department of Disease Control, London School of Hygiene and Tropical Medicine [LSHTM], London, United Kingdom
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Perez F, Vallet T, Bravo Z, Callahan K, Ruiz F. Acceptability of Mebendazole Chewable Tablet in Children Aged 2 to 4 Years in Peru. Pharmaceutics 2021; 14:pharmaceutics14010027. [PMID: 35056923 PMCID: PMC8780656 DOI: 10.3390/pharmaceutics14010027] [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: 11/15/2021] [Revised: 12/13/2021] [Accepted: 12/21/2021] [Indexed: 01/13/2023] Open
Abstract
Soil-transmitted helminthiasis (STH) is among the most common of parasitic infections, affecting vulnerable populations in tropical/subtropical areas globally. In endemic countries, children, a high-risk population, require treatment and preventive interventions. Mebendazole, a WHO-recommended medicine, originally formulated as a tablet that was often crushed for administration to young children unable to swallow it, was reformulated as a chewable tablet. Acceptability is a key aspect for treatment effectiveness in pediatrics. Herein, we used a validated data-driven approach to investigate the acceptability of the 500-mg mebendazole chewable tablet in children aged 2 to 4 years in Peru. Observer-reported outcomes were collected for 182 medicine intakes. Acceptability was scored using the acceptability reference framework: a three-dimensional map juxtaposing “positively accepted” and “negatively accepted” profiles. Results found that the 500-mg mebendazole chewable tablet was classified as “positively accepted” in children aged 2 to 4 years. Acceptability increased with age and some acceptability issue remain for the younger children. Nevertheless, this formulation was considerably better accepted than the conventional tablets regardless of treatment in young children. This chewable formulation appears to be an appropriate alternative to the hard tablet of mebendazole for treatment of STH and preventive interventions in children aged 2 to 4 years.
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Affiliation(s)
- Fernando Perez
- INMED Partnerships for Children/INMED Andes, 21630 Ridgetop Circle, Sterling, VA 20166, USA; (F.P.); (Z.B.); (K.C.)
| | - Thibault Vallet
- ClinSearch, 110 Avenue Pierre Brossolette, 92240 Malakoff, France;
| | - Zarela Bravo
- INMED Partnerships for Children/INMED Andes, 21630 Ridgetop Circle, Sterling, VA 20166, USA; (F.P.); (Z.B.); (K.C.)
| | - Kristin Callahan
- INMED Partnerships for Children/INMED Andes, 21630 Ridgetop Circle, Sterling, VA 20166, USA; (F.P.); (Z.B.); (K.C.)
| | - Fabrice Ruiz
- ClinSearch, 110 Avenue Pierre Brossolette, 92240 Malakoff, France;
- Correspondence: ; Tel.: +33-1-4735-1717
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Kaliappan S, Ramanujam K, Manuel M, Farzana J, Janagaraj V, Laxmanan S, Muliyil J, Sarkar R, Kang G, Walson J, Ajjampur S. Soil-transmitted helminth infections after mass drug administration for lymphatic filariasis in rural southern India. Trop Med Int Health 2021; 27:81-91. [PMID: 34704320 DOI: 10.1111/tmi.13697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Targeted deworming is the current strategy for control of morbidity associated with soil-transmitted helminths (STH) among at-risk populations: preschool-aged children, school-aged children and women of childbearing age. We report the prevalence and intensity of STH in a district after lymphatic filariasis (LF) mass drug administration (MDA) in southern India where albendazole was co-administered from 2001. METHODS Children aged 2 to 15 years and adults (defined as ≥15 years) in a rural administrative block of Tamil Nadu were recruited using a probability proportional to size method. Stool samples were screened and eggs per gram (EPG) determined by Kato-Katz method. Multilevel logistic regression (MLR) and multilevel negative binomial regression (MNBR) analyses were used to identify factors associated with infection and intensity, respectively. RESULTS Of 862 participants who provided samples, 60 (7.0%; 95% confidence interval (CI): 5.3-8.7) were positive for STH with a predominance of hookworm infections (n = 57, 6.6%; 95% CI: 5.0-8.3). Increasing age (odds ratio (OR): 1.09; 95% CI: 1.04-1.15) and regular usage of the toilet (OR: 0.32; 95% CI: 0.12-0.88) were independently associated with hookworm infection and age was significantly associated with increasing intensity of hookworm infection (infection intensity ratio (IIR): 1.28; 95% CI: 1.19-1.37). A brief review of STH prevalence in endemic settings before and after the stoppage of LF MDA indicated that, in most settings, a substantial reduction in STH prevalence is seen. CONCLUSION Community-wide MDA in all age groups in these post-LF MDA districts with low prevalence and light intensity infections could result in transmission interruption of STH.
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Affiliation(s)
- Saravanakumar Kaliappan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Karthikeyan Ramanujam
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Malathi Manuel
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Jasmine Farzana
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Venkateshprabhu Janagaraj
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Selvi Laxmanan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Jayaprakash Muliyil
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Rajiv Sarkar
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Gagandeep Kang
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Judd Walson
- Departments of Global Health, Medicine (Infectious Disease), Paediatrics & Epidemiology, University of Washington, Seattle, Washington, USA
| | - Sitara Ajjampur
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
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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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Keller L, Palmeirim MS, Ame SM, Ali SM, Puchkov M, Huwyler J, Hattendorf J, Keiser J. Efficacy and Safety of Ascending Dosages of Moxidectin and Moxidectin-albendazole Against Trichuris trichiura in Adolescents: A Randomized Controlled Trial. Clin Infect Dis 2021; 70:1193-1201. [PMID: 31044235 DOI: 10.1093/cid/ciz326] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 04/22/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Preventive chemotherapy is the main strategy to control soil-transmitted helminth (STH) infections. Albendazole and mebendazole are ubiquitously used, but they are not sufficiently effective against Trichuris trichiura. Moxidectin might be a useful addition to the small drug armamentarium. However, the optimal dosage of moxidectin alone and in combination with albendazole against T. trichiura and other STHs has not yet been determined. METHODS A Phase II, randomized, placebo-controlled, dose-finding trial was conducted in 2 secondary schools on Pemba Island, Tanzania. Using a computer-generated list, T. trichiura-infected adolescents were randomly assigned to 7 treatment arms: 8, 16, or 24 mg of moxidectin monotherapy; 8, 16, or 24 mg of moxidectin plus 400 mg of albendazole combination therapy; or placebo. The primary outcome was cure rate (CR) against T. trichiura, analyzed 13 to 20 days after treatment by quadruple Kato-Katz thick smears. RESULTS A total of 290 adolescents were enrolled (41 or 42 per arm). CRs against T. trichiura were 43, 46, and 44% for 8, 16, and 24 mg of moxidectin alone, respectively; 60, 62, and 66% for the same moxidectin dosages plus 400 mg of albendazole, respectively; and 12% for placebo. The moxidectin-albendazole arms also revealed higher CRs and egg reduction rates against hookworm than the monotherapy arms. Moxidectin and its combination with albendazole were well tolerated. CONCLUSIONS Moxidectin-albendazole is superior to moxidectin. There is no benefit of using doses above 8 mg, which is the recommended dose for onchocerciasis. The moxidectin-albendazole combination of 8 mg plus 400 mg should be investigated further to develop recommendations for appropriate control of STH infections. CLINICAL TRIALS REGISTRATION NCT03501251.
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Affiliation(s)
- Ladina Keller
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Marta S Palmeirim
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Shaali M Ame
- Public Health Laboratory Ivo de Carneri, Chake Chake, Republic of Tanzania
| | - Said M Ali
- Public Health Laboratory Ivo de Carneri, Chake Chake, Republic of Tanzania
| | - Maxim Puchkov
- Department of Pharmaceutical Sciences, Division of Pharmaceutical Technology, , Basel, Switzerland
| | - Jörg Huwyler
- Department of Pharmaceutical Sciences, Division of Pharmaceutical Technology, , Basel, Switzerland
| | - Jan Hattendorf
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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Aschale Y, Worku L, Addisu A, Alemu M, Alemu A. Comparison of direct wet mount, Kato-Katz and formol ether sedimentation technique for the diagnosis of hookworm infection in Debre Elias Woreda, Northwest Ethiopia. Trop Doct 2020; 51:170-174. [PMID: 33308052 DOI: 10.1177/0049475520975936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hookworm infection is a neglected parasitic disease. Direct wet mount is the usual method for the diagnosis of hookworm in Ethiopia, but its sensitivity is unsatisfactory. A cross-sectional study was therefore conducted from January to February 2018 among 192 study participants in Debre Elias district. Stool samples were processed by three methods: the prevalence of hookworm was 77.6%, 68.2% and 49.0% by Kato-Katz, formol ether sedimentation technique and direct wet mount, respectively. Direct wet mount had relatively low sensitivity (61.4%) compared to formol ether sedimentation technique (85.6%) and Kato-Katz (97.4%). The latter two compared well with the gold standard method with kappa values of κ = 0.94, κ = 0.71 and κ = 0.39, respectively, and are therefore recommended over against the direct wet mount technique in detecting hookworm.
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Affiliation(s)
- Yibeltal Aschale
- Lecturer, Department of Medical Laboratory Science, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Ligabaw Worku
- Lecturer, Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayenew Addisu
- Lecturer, Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Mekuannint Alemu
- Public health Officer, Department of public health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Abebe Alemu
- Medical Parasitologist, Injibara General Hospital, Injibara, Amhara region, Ethiopia
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Kim SH, Stothard JR, Rinamalo M, Rainima-Qaniuci M, Talemaitoga N, Kama M, Rafai E, Jang S, Kim JY, Oh YM, Kim EM, Hong ST, Lowry JH, Verweij JJ, Kelly-Hope LA, Choi MH. A first nation-wide assessment of soil-transmitted helminthiasis in Fijian primary schools, and factors associated with the infection, using a lymphatic filariasis transmission assessment survey as surveillance platform. PLoS Negl Trop Dis 2020; 14:e0008511. [PMID: 32976499 PMCID: PMC7518615 DOI: 10.1371/journal.pntd.0008511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 06/23/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Soil-transmitted helminthiasis (STH) is endemic in Fiji but its prevalence is not known and likely to have changed after a decade of mass drug administration (MDA) for lymphatic filariasis (LF). By linking with LF transmission assessment surveys (LF-TAS), we undertook the first nation-wide assessment of STH in Fijian primary schools, as well as an analysis of factors associated with STH infections. METHODOLOGY/PRINCIPAL FINDINGS A cross-sectional assessment for STH was conducted in all four Divisions of Fiji from 2014 to 2015. In the Western, Central, and Northern Divisions, schools were sub-sampled after LF-TAS, while, in the Eastern Division, schools were selected via simple random sampling. For the diagnosis of STH, stool samples were examined by coproscopy with a single Kato-Katz thick smear (KK) and the formol-ether-acetate concentration technique, except for the samples from the Eastern Division where only KK was used. Mean prevalence of any STH among class 1-2 students at the national level was 10.5% (95% CI: 6.9-15.5). Across the three Divisions via LF-TAS, the prevalence levels for ascariasis were 8.7% (95% CI: 4.3-16.6), hookworm 3.9% (95% CI: 2.3-6.6) and trichuriasis 0%. In the Eastern Division, ascariasis prevalence was 13.3% (95% CI: 6.4-25.6), and hookworm 0.7% (95% CI: 0.2-2.5), with one case of trichuriasis. Among class 3-8 students, ascariasis prevalence was lower. Lower risk of any STH was associated with wearing shoes (adjusted OR 0.54, 95% CI: 0.32-0.90) and having piped water from the Fiji Water Authority at home (adjusted OR 0.48, 95% CI: 0.25-0.92). CONCLUSIONS After a decade of community-based LF-MDA, STH in school-age children in Fiji is now close to 10%, but localities of endemicity remain. Preventive chemotherapy should be maintained in areas with elevated STH prevalence alongside targeted delivery of integrated WASH interventions. LF-TAS has provided an opportunity to develop future public health surveillance platforms.
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Affiliation(s)
- Sung Hye Kim
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - J. Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | | | | | - Mike Kama
- Ministry of Health, Dinem House, Suva, Republic of Fiji
| | - Eric Rafai
- Ministry of Health, Dinem House, Suva, Republic of Fiji
| | - Seoyun Jang
- Department of Tropical Medicine and Parasitology and Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Young Kim
- Department of Tropical Medicine and Parasitology and Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo Min Oh
- Department of Tropical Medicine and Parasitology and Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea
| | - Eun-Min Kim
- Department of Environmental Medical Biology and Arthropods of Medical Importance Resource Research Bank, Institute of Tropical Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sung-Tae Hong
- Department of Tropical Medicine and Parasitology and Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea
| | - John H. Lowry
- School of Geography, Earth Science, and Environment, The University of South Pacific, Suva, Republic of Fiji
| | - Jaco J. Verweij
- Laboratory of Medical Microbiology and Immunology, Elisabeth Hospital, Tilburg, The Netherlands
| | - Louise A. Kelly-Hope
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Min-Ho Choi
- Department of Tropical Medicine and Parasitology and Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea
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Pasaribu AP, Alam A, Sembiring K, Pasaribu S, Setiabudi D. Prevalence and risk factors of soil-transmitted helminthiasis among school children living in an agricultural area of North Sumatera, Indonesia. BMC Public Health 2019; 19:1066. [PMID: 31391023 PMCID: PMC6686497 DOI: 10.1186/s12889-019-7397-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 07/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Soil-transmitted helminth infection (STH) is one of the neglected tropical disease that affects approximately 2 billion people globally. School children represent the age group that is most commonly infected with STHs, resulting in poor school performance, impaired cognitive function, and many other detrimental effects. The transmission of STH is determined by many factors, such as hygiene and sanitation. Understanding the factors that influence disease transmission in a particular area is key to effective STH control. The objective of this study was to determine the prevalence of STH in North Sumatera and to identify the associated risk factors among school children. METHODS A cross-sectional study was carried out among primary school children in Suka village, Tigapanah subdistrict. Stool samples were processed using a single Kato-Katz method. The potential risk factors analyzed were parent education and occupation, hand washing habits, latrine usage, footwear usage and contact with soil. The Chi-square test was performed to identify an association between risk factors and parasitological results. Logistic regression analysis was used to measure the strength of association. RESULTS We enrolled 468 school children between 6 and 12 years of age. Among those children, 268 children (57.24%) were positive for one or more STH infections. Approximately 62.39% of children played with soil/dirt every day, and only 50% regularly washed their hands after activities. Most of the children wore shoes/slippers when going outside (87.82%) and used a latrine for defecation (85.04%). Playing with soil/dirt have been shown to increase the risk of STH infections 7.53 times, while hand washing habits and latrine usage decreased the risk of STH infections 0.16 times each. CONCLUSION The prevalence of STH infection in school children in Suka village, Tigapanah subdistrict is still high. Playing with soil/dirt increased the risk of infection, while hand washing habits and latrine usage decreased the risk of infection. The combined strategies of improving the personal hygiene of children and biannual deworming can reduce the risk of STH infection in school children in Suka village, Tigapanah subdistrict.
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Affiliation(s)
- Ayodhia Pitaloka Pasaribu
- Department of Child Health, Medical Faculty, Universitas Sumatera Utara, North Sumatera, Medan, Indonesia
| | - Anggraini Alam
- Department of Child Health, Medical Faculty, Universitas Padjajaran, Bandung, West Java Indonesia
| | - Krisnarta Sembiring
- Department of Child Health, Medical Faculty, Universitas Sumatera Utara, North Sumatera, Medan, Indonesia
| | - Syahril Pasaribu
- Department of Child Health, Medical Faculty, Universitas Sumatera Utara, North Sumatera, Medan, Indonesia
| | - Djatnika Setiabudi
- Department of Child Health, Medical Faculty, Universitas Padjajaran, Bandung, West Java Indonesia
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Muñoz-Antoli C, Gozalbo M, Pavón A, Pérez P, Toledo R, Esteban JG. Enteroparasites in Preschool Children on the Pacific Region of Nicaragua. Am J Trop Med Hyg 2017; 98:570-575. [PMID: 29260648 DOI: 10.4269/ajtmh.17-0551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The aim of this study was to determine for the first time the prevalence of enteroparasites in preschool children originating from the seven departments of the Pacific region in Nicaragua. One stool sample of each of 1,217 children, from 6 months to 5 years of age, was collected and personal data were recorded on delivery of the container. Samples fixed in 10% formalin were processed by a formol-acetate concentration and a modified Ziehl-Neelsen technique. The overall prevalence of enteroparasite infections was 68.2% with a total of at least 20 species. Blastocystis hominis (45.5%), Giardia intestinalis (31.7%), Trichuris trichiura (8.2%), and Ascaris lumbricoides (5.2%) were the most prevalent protozoa and helminth species in the total study as well as in all departments. Protozoan prevalence presented a statistically significant difference by gender (male: 69.6%; female: 46.7%; P < 0.001), and males presented a higher T. trichiura infection rate than females (male: 9.9%; female 6.4%; P < 0.035). Protozoan prevalence increased with age with a statistically significant difference (P < 0.001). Helminths were always more prevalent in urban areas (P < 0.0002). Protozoan infections result statistically higher than helminth infections so that water-based transmission could be suspected. Based on the differences with respect to species and parasite prevalence between the seven departments in the Pacific region of Nicaragua, the exploration of local factors associated with the transmission of enteroparasites should also be considered to reduce infection.
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Affiliation(s)
- Carla Muñoz-Antoli
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
| | - Mónica Gozalbo
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
| | - Aleyda Pavón
- Departamento Bionálisis Clínico, Instituto Politécnico de la Salud (IPS-Polisal), Universidad Nacional Autónoma de Nicaragua, Managua, Nicaragua
| | - Paloma Pérez
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
| | - Rafael Toledo
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
| | - Jose-Guillermo Esteban
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
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Bangert M, Molyneux DH, Lindsay SW, Fitzpatrick C, Engels D. The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals. Infect Dis Poverty 2017; 6:73. [PMID: 28372566 PMCID: PMC5379574 DOI: 10.1186/s40249-017-0288-0] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 03/16/2017] [Indexed: 01/14/2023] Open
Abstract
The Sustainable Development Goals (SDGs) call for an integrated response, the kind that has defined Neglected Tropical Diseases (NTDs) efforts in the past decade.NTD interventions have the greatest relevance for SDG3, the health goal, where the focus on equity, and its commitment to reaching people in need of health services, wherever they may live and whatever their circumstances, is fundamentally aligned with the target of Universal Health Coverage. NTD interventions, however, also affect and are affected by many of the other development areas covered under the 2030 Agenda. Strategies such as mass drug administration or the programmatic integration of NTD and WASH activities (SDG6) are driven by effective global partnerships (SDG17). Intervention against the NTDs can also have an impact on poverty (SDG1) and hunger (SDG2), can improve education (SDG4), work and economic growth (SDG8), thereby reducing inequalities (SDG10). The community-led distribution of donated medicines to more than 1 billion people reinforces women's empowerment (SDG5), logistics infrastructure (SDG9) and non-discrimination against disability (SDG16). Interventions to curb mosquito-borne NTDs contribute to the goals of urban sustainability (SDG11) and resilience to climate change (SDG13), while the safe use of insecticides supports the goal of sustainable ecosystems (SDG15). Although indirectly, interventions to control water- and animal-related NTDs can facilitate the goals of small-scale fishing (SDG14) and sustainable hydroelectricity and biofuels (SDG7).NTDs proliferate in less developed areas in countries across the income spectrum, areas where large numbers of people have little or no access to adequate health care, clean water, sanitation, housing, education, transport and information. This scoping review assesses how in this context, ending the epidemic of the NTDs can impact and improve our prospects of attaining the SDGs.
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Affiliation(s)
- Mathieu Bangert
- Department of Control of Neglected Tropical Diseases, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
| | - David H. Molyneux
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Christopher Fitzpatrick
- Department of Control of Neglected Tropical Diseases, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
| | - Dirk Engels
- Department of Control of Neglected Tropical Diseases, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
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Muñoz-Antoli C, Pavón A, Pérez P, Toledo R, Esteban JG. Soil-transmitted Helminth Infections in Schoolchildren of Laguna de Perlas (Nicaragua). J Trop Pediatr 2017; 63:124-134. [PMID: 27616686 DOI: 10.1093/tropej/fmw061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Soil-transmitted helminth (STH) prevalence, intensity, polyparasitism and co-infections in 425 children from 3 schools of Laguna de Perlas (Nicaragua) were investigated. Single stool samples were analysed by the formalin-ether method and the Kato-Katz. A total of 402 (94.6%) children were infected. Trichuris trichiura 308 (72.4%), Ascaris lumbricoides 115 (27.1%) and Hookworms 54 (12.7%) were the most prevalent STHs. Polyparasitism (322; 75.8%) with two species was most prevalent (109; 25.6%). T. trichiura with A. lumbricoides (19.3%) and T. trichiura with Hookworm (6.8%) were the most common combinations. Positive associations were observed between T. trichiura and A. lumbricoides and T. trichiura and Hookworm (p = 0.0001). Highest Hookworm intensities appeared when three STH co-infections occurred. Moderate- heavy STH intensities appear in up to 42.1% in trichuriasis, 57.5% in ascariasis and 11.1% in Hookworm infections. Integrated control interventions covering children need to be implemented mainly in a rural environment.
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Affiliation(s)
- C Muñoz-Antoli
- Facultad de Farmacia, Departamento de Parasitología, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, Burjassot-Valencia 46100, Spain
| | - A Pavón
- Departamento Bionálisis Clínico, Instituto Politécnico de la Salud (IPS-Polisal), Universidad Nacional Autónoma de Nicaragua, Managua, Nicaragua
| | - P Pérez
- Facultad de Farmacia, Departamento de Parasitología, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, Burjassot-Valencia 46100, Spain
| | - R Toledo
- Facultad de Farmacia, Departamento de Parasitología, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, Burjassot-Valencia 46100, Spain
| | - J G Esteban
- Facultad de Farmacia, Departamento de Parasitología, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, Burjassot-Valencia 46100, Spain
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15
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Romero-Sandoval N, Ortiz-Rico C, Sánchez-Pérez HJ, Valdivieso D, Sandoval C, Pástor J, Martín M. Soil transmitted helminthiasis in indigenous groups. A community cross sectional study in the Amazonian southern border region of Ecuador. BMJ Open 2017; 7:e013626. [PMID: 28292765 PMCID: PMC5353281 DOI: 10.1136/bmjopen-2016-013626] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 01/30/2017] [Accepted: 02/03/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Rural communities in the Amazonian southern border of Ecuador have benefited from governmental social programmes over the past 9 years, which have addressed, among other things, diseases associated with poverty, such as soil transmitted helminth infections. The aim of this study was to explore the prevalence of geohelminth infection and several factors associated with it in these communities. METHODS This was a cross sectional study in two indigenous communities of the Amazonian southern border of Ecuador. The data were analysed at both the household and individual levels. RESULTS At the individual level, the prevalence of geohelminth infection reached 46.9% (95% CI 39.5% to 54.2%), with no differences in terms of gender, age, temporary migration movements or previous chemoprophylaxis. In 72.9% of households, one or more members were infected. Receiving subsidies and overcrowding were associated with the presence of helminths. CONCLUSIONS The prevalence of geohelminth infection was high. Our study suggests that it is necessary to conduct studies focusing on communities, and not simply on captive groups, such as schoolchildren, with the object of proposing more suitable and effective strategies to control this problem.
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Affiliation(s)
- Natalia Romero-Sandoval
- Facultad de Ciencias Médicas, de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
- Grups de Recerca d'Amèrica i Àfrica Llatines-GRAAL, Barcelona, España
| | - Claudia Ortiz-Rico
- Grups de Recerca d'Amèrica i Àfrica Llatines-GRAAL, Barcelona, España
- Unidad de Bioestadística y Epidemiología, Universidad Autónoma de Barcelona, Barcelona, España
| | - Héctor Javier Sánchez-Pérez
- Grups de Recerca d'Amèrica i Àfrica Llatines-GRAAL, Barcelona, España
- El Colegio de la Frontera Sur-ECOSUR, San Cristóbal de Las Casas, Chiapas, México
| | - Daniel Valdivieso
- Facultad de Ciencias Médicas, de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Carlos Sandoval
- Fundación Ecuatoriana para la Investigación en Salud-FEPIS, Quinindé, Ecuador
| | | | - Miguel Martín
- Grups de Recerca d'Amèrica i Àfrica Llatines-GRAAL, Barcelona, España
- Unidad de Bioestadística y Epidemiología, Universidad Autónoma de Barcelona, Barcelona, España
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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: 14] [Impact Index Per Article: 1.8] [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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Immune Profile of Honduran Schoolchildren with Intestinal Parasites: The Skewed Response against Geohelminths. J Parasitol Res 2016; 2016:1769585. [PMID: 27882241 PMCID: PMC5108857 DOI: 10.1155/2016/1769585] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/10/2016] [Indexed: 01/18/2023] Open
Abstract
Soil-transmitted helminth infections typically induce a type-2 immune response (Th2), but no immunoepidemiological studies have been undertaken in Honduras, an endemic country where the main control strategy is children's annual deworming. We aimed to characterize the immune profile of Honduran schoolchildren harbouring these parasitoses. Demographic and epidemiological data were obtained through a survey; nutritional status was assessed through anthropometry; intestinal parasites were diagnosed by formol-ether and Kato-Katz; and blood samples were collected to determine immunological markers including Th1/Th2 cytokines, IgE, and eosinophil levels. A total of 225 children participated in the study, all of whom had received deworming during the national campaign five months prior to the study. Trichuriasis and ascariasis prevalence were 22.2% and 20.4%, respectively. Stunting was associated with both age and trichuriasis, whereas ascariasis was associated with sex and household conditions. Helminth infections were strongly associated with eosinophilia and hyper-IgE as well as with a Th2-polarized response (increased levels of IL-13, IL-10, and IL4/IFN-γ ratios and decreased levels of IFN-γ). Pathogenic protozoa infections were associated with a Th1 response characterized by elevated levels of IFN-γ and decreased IL10/IFN-γ ratios. Even at low prevalence levels, STH infections affect children's nutrition and play a polarizing role in their immune system.
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Soil-Transmitted Helminth Reinfection and Associated Risk Factors among School-Age Children in Chencha District, Southern Ethiopia: A Cross-Sectional Study. J Parasitol Res 2016; 2016:4737891. [PMID: 26941997 PMCID: PMC4749809 DOI: 10.1155/2016/4737891] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 12/23/2015] [Accepted: 12/27/2015] [Indexed: 12/15/2022] Open
Abstract
Mass drug administration (MDA) to the most risky population including school-age children (SAC) is the central strategy to control soil-transmitted helminth (STH) infection. The present study was aimed at estimating the prevalence of STHs reinfection three months posttreatment and associated risk factors among SAC in Chencha district. A cross-sectional study design was employed from April 20 to May 5, 2015, to enroll 408 SAC. Structured questionnaire and Kato-Katz thick smear technique were used to interview parents or guardians and quantify the number of eggs per gram of stool. Pearson chi-square and logistic regression were used to assess the association between predictor variable and STH reinfection. The prevalence of STHs within three months of mass chemotherapy among SAC was 36.8% which is 93.4% of the prevalence (39.4%) before treatment. The estimated prevalence of reinfection (95%CI) for Ascaris lumbricoides, Trichuris trichiura, and hookworms was 23.8% (21.1–28.2), 16.2% (12.7–20.1), and 1.0% (0.3–2.5), respectively. Children of merchant fathers were more likely to be reinfected by STHs in Chencha district. In conclusion, there is rapid reinfection after mass chemotherapy among SAC in Chencha district. Further studies should be carried out to generate cost efficient methods that can supplement mass drug administration to accelerate the control of STHs.
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Hepatobiliary and pancreatic ascariasis-sonographic pictorial essay on four pediatric cases with acute biliary colic. Emerg Radiol 2015; 23:197-200. [PMID: 26690772 DOI: 10.1007/s10140-015-1369-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 12/01/2015] [Indexed: 10/22/2022]
Abstract
Hepatobiliary and pancreatic ascariasis occur due to migration of the round worm ascaris lumbricoides through the bile duct orifice finally reaching the common bile duct, main pancreatic duct, intrahepatic ducts or gallbladder. These resulted in acute epigastric and right hypochondriac region colicky pain. Ultrasound is the investigation of choice in hepatobiliary ascariasis. We present here sonographic images on four pediatric patients with acute biliary colic.
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Freeman MC, Chard AN, Nikolay B, Garn JV, Okoyo C, Kihara J, Njenga SM, Pullan RL, Brooker SJ, Mwandawiro CS. Associations between school- and household-level water, sanitation and hygiene conditions and soil-transmitted helminth infection among Kenyan school children. Parasit Vectors 2015; 8:412. [PMID: 26248869 PMCID: PMC4528701 DOI: 10.1186/s13071-015-1024-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 07/29/2015] [Indexed: 01/20/2023] Open
Abstract
Background Soil-transmitted helminths, a class of parasitic intestinal worms, are pervasive in many low-income settings. Infection among children can lead to poor nutritional outcomes, anaemia, and reduced cognition. Mass treatment, typically administered through schools, with yearly or biannual drugs is inexpensive and can reduce worm burden, but reinfection can occur rapidly. Access to and use of sanitation facilities and proper hygiene can reduce infection, but rigorous data are scarce. Among school-age children, infection can occur at home or at school, but little is known about the relative importance of WASH in transmission in these two settings. Methods We explored the relationships between school and household water, sanitation, and hygiene conditions and behaviours during the baseline of a large-scale mass drug administration programme in Kenya. We assessed several WASH measures to quantify the exposure of school children, and developed theory and empirically-based parsimonious models. Results Results suggest mixed impacts of household and school WASH on prevalence and intensity of infection. WASH risk factors differed across individual worm species, which is expected given the different mechanisms of infection. Conclusions No trend of the relative importance of school versus household-level WASH emerged, though some factors, like water supply were more strongly related to lower infection, which suggests it is important in supporting other school practices, such as hand-washing and keeping school toilets clean. Electronic supplementary material The online version of this article (doi:10.1186/s13071-015-1024-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M C Freeman
- Department of Environmental Health, Emory University, Atlanta, Georgia, USA.
| | - A N Chard
- Department of Environmental Health, Emory University, Atlanta, Georgia, USA.
| | - B Nikolay
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - J V Garn
- Department of Environmental Health, Emory University, Atlanta, Georgia, USA.
| | - C Okoyo
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya.
| | - J Kihara
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya.
| | - S M Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya.
| | - R L Pullan
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - S J Brooker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - C S Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya.
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Sanchez AL, Mahoney DL, Gabrie JA. Interleukin-10 and soil-transmitted helminth infections in Honduran children. BMC Res Notes 2015; 8:55. [PMID: 25888883 PMCID: PMC4347577 DOI: 10.1186/s13104-015-1019-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 02/13/2015] [Indexed: 12/31/2022] Open
Abstract
Background Soil-transmitted helminths (STH) establish chronic infections in the human intestine. The host reacts to these infections with a dominant T-helper type 2 cell (Th2) response that while attempting to control the worm population, can also provide an anti-inflammatory environment favourable for parasite survival. Regulatory cytokine interleukin 10 (IL-10) has been proposed as a key molecule involved in the attenuation of chronic inflammation and the ensuing tolerance for these helminth parasites. The objective of this study was to determine whether STH-infected children from an endemic community had increased circulating IL-10 levels when compared to non-infected children. Results A total of 39 children (25 boys and 14 girls, 7–15 years of age) were enrolled in study. Utilizing the Kato-Katz method to detect intestinal helminthiases, 10 children were non-infected and 29 were harbouring STH infections by Ascaris lumbricoides, Trichuris trichiura and/or hookworms. Of the 29 infected children, 11 had single-species infections and 18 were polyparasitized with two or three STH species. Serum samples from all 39 children were tested for IL-10 serum concentrations, out of which 12 had undetectable levels while 27 had levels ranging from 0.4-105 pg/mL. Excluding extreme outlying values, 25 samples had IL-10 concentration values ranging from 0.4 -7.2 pg/mL. Differences in IL-10 levels among non-parasitized, monoparasitized, and polyparasitized groups were not statistically significant. However, children infected with any of the three STH species investigated had higher IL-10 levels than non-parasitized children (geometric means: 0.89 pg/mL vs. 0.74 pg/mL, p = 0.428). Similarly, polyparasitized children had higher IL-10 levels than both monoparasitized and non-parasitized children (1.04 pg/mL, 0.69 pg/mL, and 0.74 pg/mL, respectively, p = 0.481). A significant moderate negative correlation between IL-10 levels and children’s age was found, but no correlations were observed between IL-10 levels and intensity of infection by any of the parasite species investigated. Conclusions We found no strong evidence for an association between STH infection and serum IL-10 concentration levels. However, the trends identified here warrant further investigation. Additional research is needed to expand the current understanding of the immune response elicited by STH infections in children living in endemic communities.
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Affiliation(s)
- Ana Lourdes Sanchez
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Avenue, St. Catharines, ON, Canada, L2S 3A1.
| | - Dylan Lewis Mahoney
- Department of Biological Sciences, Faculty of Mathematics and Sciences, Brock University, 500 Glenridge Avenue, St. Catharines, ON, Canada, L2S 3A1.
| | - José Antonio Gabrie
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Avenue, St. Catharines, ON, Canada, L2S 3A1.
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Urdaneta-Morales S. Chagas' disease: an emergent urban zoonosis. The caracas valley (Venezuela) as an epidemiological model. Front Public Health 2014; 2:265. [PMID: 25520950 PMCID: PMC4252636 DOI: 10.3389/fpubh.2014.00265] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 11/14/2014] [Indexed: 01/10/2023] Open
Abstract
The unprecedented emergence of important public health and veterinary zoonoses is usually a result of exponential population growth and globalization of human activities. I characterized Chagas’ disease as an emergent zoonosis in the Caracas Valley (Venezuela) due to the following findings: the presence of reservoirs (Didelphis marsupialis, Rattus rattus) and vectors (Panstrongylus geniculatus, Panstrongylus rufotuberculatus) infected with Trypanosoma cruzi in urbanized or marginalized areas; the elevated contact between P. geniculatus and human beings detected by parasitological and molecular examinations of triatomine feces demonstrated the possibility of transmission risks; a study of outbreaks of urban Chagas’ disease reported the first proven case of oral transmission of T. cruzi to human beings; the risk of transmission of glandular metacyclic stages from marsupials by experimental ocular and oral instillation; mice genitalia infected with T. cruzi contaminated blood resulted in the formation of amastigotes very close to the lumen suggesting that there may be a possibility of infection via their release into the urine and thence to the exterior; the ubiquitous histotropism and histopathology of T. cruzi was demonstrated using a mouse model; the presence of experimental T. cruzi pseudocysts in adipose, bone-cartilage, and eye tissue indicated a potential risk for transplants. Socio-sanitary programs that include improvements in housing, vector control, and access to medical treatment, as well as strategies aimed at combating social inequalities, poverty, and underdevelopment should be undertaken in those areas where zoonoses are most prevalent. Disciplines, such as Ecology, Epidemiology, Medical Entomology, Human and Veterinary Medicine, Environmental Studies, Public Health, Social and Political Studies, Immunology, Microbiology, and Pharmacology could all provide important contributions that aim to reduce the occurrence of factors governing the spread of emergent diseases.
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Affiliation(s)
- Servio Urdaneta-Morales
- Laboratory for the Biology of Vectors and Parasites, Tropical Zoology and Ecology Institute, Central University of Venezuela , Caracas , Venezuela
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