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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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Agrawal R, Pattnaik S, Kshatri JS, Kanungo S, Mandal N, Palo SK, Pati S. Prevalence and correlates of soil-transmitted helminths in schoolchildren aged 5 to 18 years in low- and middle-income countries: a systematic review and meta-analysis. Front Public Health 2024; 12:1283054. [PMID: 38577281 PMCID: PMC10991833 DOI: 10.3389/fpubh.2024.1283054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/01/2024] [Indexed: 04/06/2024] Open
Abstract
Background According to the Global Burden of Disease (GBD) 2019 report, up to 1.5 million disability-adjusted life years (DALYs) are lost due to soil-transmitted helminths (STHs), and 5.9 million people are at risk of acquiring STHs. Regions with the highest prevalence of STH infections include Sub-Saharan Africa, China, South America, and Asia. While there are numerous fragmented studies on STH, comprehensive information on the prevalence and geographic distribution of different species, as well as their regional variations in the context of STHs is limited. The present systematic review and meta-analysis study attempts to provide a summary of the prevalence, geographical variation, and determinants of STHs among schoolchildren aged 5 to 18 years. Methods An extensive literature search was carried out using PubMed, Embase, Cinhal, and Psychinfo for studies published between 1999 and 2022 that reported the rate of STH infection in school-going children aged 5-18 years. A random effects model was employed in this meta-analysis due to expected heterogeneity. Subgroup analysis was carried out based on sex and STH species because of expected geographical variation. Results A total of 19,725 of the 49,630 children examined were infected with STH, yielding an overall pooled prevalence of 37.16% (95% CI: 29.74-44.89). The prevalence was highest in the Western Pacific region at 50.41% (95% CI: 33.74-67.04) followed by Europe at 39.74% (95% CI: 20.40-61.0) and Africa at 37.10% (95% CI: 26.84-47.95). Ascaris lumbricoides was found to be the most prevalent helminth with a prevalence of 24.07% (95% CI: 17.07-31.83). Conclusion The Western Pacific region is classified as a High-risk Zone (HRZ), while Southeast Asia, Africa, Europe, and the Eastern Mediterranean are classified as moderate-risk zones (MRZs). We found a 12% reduction in the pooled prevalence of STH infection from 1999 to 2012. Ascaris lumbricoides was the predominant species among schoolchildren. Mass Drug Administration (MDA) of Albendazole tablets and improved water, sanitation, and hygiene (WASH) practices are effective in controlling and preventing STH. Ensuring their implementation and access is crucial to addressing the problem. Systematic review registration https://www.crd.york.ac.uk/prospero/#loginpage, CRD42022333341.
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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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Hakizimana E, Kim JY, Oh S, Yoon M, Yong TS. Intestinal parasitic infections among children aged 12-59 months in Nyamasheke District, Rwanda. PARASITES, HOSTS AND DISEASES 2023; 61:304-309. [PMID: 37648236 PMCID: PMC10471473 DOI: 10.3347/phd.23045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/03/2023] [Indexed: 09/01/2023]
Abstract
Intestinal parasitic infections are a public health burden and a major cause of illness in developing countries. The diseases lead to various health threats, including growth retardation and mental health-related disorders, especially in children. We assessed the risk factors for intestinal parasitic infections among children aged 12-59 months residing in Nyamasheke District, Rwanda. A cross-sectional descriptive study was conducted using secondary data from 1,048 children aged 12-59 months whose stool samples were examined for the presence of intestinal parasites and whose results were registered in the laboratory information system in 2020. The prevalence of intestinal parasites in children aged 12-59 months was 53.2%. The dominant parasites were Ascaris lumbricoides (13.1%), followed by Giardia lamblia (10.9%), Entamoeba histolytica (7.9%), Trichuris trichiura (6.5%), hookworms (1.7%), and Taenia species (1.4%). A significant association was observed between intestinal parasites and the literacy of mothers or children's caregivers (odds ratio (OR)=5.09, P<0.001). Children from farming households were 2.8-fold more likely to contract intestinal parasitic infections than those from nonfarming households (OR=2.8, P<0.001). A significant association was also observed between intestinal parasites and food safety (OR=4.9, P<0.001). Intestinal parasitic infections were significantly associated with hand hygiene practices after using the toilet and washing fresh fruits before eating (P<0.001). The information gathered will help public health providers and partners develop control plans in highly endemic areas in Rwanda.
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Affiliation(s)
- Evariste Hakizimana
- Department of Tropical Medicine, Institute of Tropical Medicine, Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul 03722,
Korea
- Graduate School of Public Health, Yonsei University, Seoul 03722,
Korea
- Kamonyi Health Center, Nyamasheke District, Western Province,
Rwanda
| | - Ju Yeong Kim
- Department of Tropical Medicine, Institute of Tropical Medicine, Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul 03722,
Korea
| | - Singeun Oh
- Department of Tropical Medicine, Institute of Tropical Medicine, Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul 03722,
Korea
| | - Moonsoo Yoon
- Department of Tropical Medicine, Institute of Tropical Medicine, Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul 03722,
Korea
| | - Tai-Soon Yong
- Department of Tropical Medicine, Institute of Tropical Medicine, Arthropods of Medical Importance Resource Bank, Yonsei University College of Medicine, Seoul 03722,
Korea
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Prevalence and Associated Risk Factors of Intestinal Parasites and Enteric Bacterial Infections among Selected Region Food Handlers of Ethiopia during 2014-2022: A Systematic Review and Meta-Analysis. ScientificWorldJournal 2022; 2022:7786036. [PMID: 36277127 PMCID: PMC9581692 DOI: 10.1155/2022/7786036] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022] Open
Abstract
Food-borne disease due to intestinal parasites (IPs) and enteric bacterial infections (EBIs) remain a major public health problem. Food handlers, individuals involved in preparing and serving food, working with poor personal hygiene could pose a potential threat of spreading IPs and EBIs to the public. The aim of this study was to examine the overall prevalence and risk factors of IPs and EBIs among food handlers in four selected regions of Ethiopia. Scientific articles written in English were recovered from PubMed, ScienceDirect, Web of Science, Google Scholar, Cochrane Library, and other sources from Google Engine and University Library Databases. “Prevalence,” “Intestinal Parasites,” “Enteric Bacterial Infections,” “Associated Factors,” “Food Handlers,” and “Ethiopia” were the search terms used for this study. For critical appraisal, PRISMA 2009 was applied. Stata software version 16 was used to perform the meta-analysis. Heterogeneity and publication bias were evaluated using Cochran's Q, inverse variance (I2), and funnel plot asymmetry tests. A random-effects model was used to calculate the pooled burden of IPs and EBIs and its associated factors among food handlers, along with the parallel odds ratio (OR) and 95% confidence interval (CI). For this meta-analysis, a total of 5844 food handlers were included in the 20 eligible studies. The overall pooled prevalence of IPs and EBIs among food handlers in four selected regions of Ethiopia was 29.16% (95% CI: 22.61, 35.71), with covering (25.77%) and (3.39%) by IPs and EBIs, respectively. Ascaris lumbricoides, Entamoeba histolytica/dispar, Giardia lamblia, and hookworm were the most prevalent IPs among food handlers with a pooled prevalence of 7.58%, 6.78%, 3.67%, and 2.70%, respectively. Salmonella and Shigella spp. were the most prevalent EBIs among food handlers with a pooled prevalence of 2.78% and 0.61%, respectively. A high prevalence of IPs and EBIs among food handlers was observed in Oromia (38.56%; 95% CI: 29.98, 47.14), while a low prevalence was observed in the Tigray region (19.45%; 95% CI: 6.08, 32.82). Food handlers who had not taken food hygiene training (OR: 0.68, 95% CI: −0.34, 1.69), untrimmed finger nail (OR: 2.23, 95% CI: 1.47, 2.99), lack of periodic medical checkup (OR: 1.52, 95% CI: 0.41, 2.64), lack of handwashing habits (OR: 1.97, 95% CI: 0.53, 3.41), and eating raw vegetables and meat (OR: 2.63, 95% CI: 0.92, 4.34) were factors significantly associated with the prevalence of IPs and EBIs. The prevalence of IPs and EBIs was high in the selected Ethiopian region (Amhara, Oromia, SNNPR, and Tigray) food handlers along an increasing prevalence trend from 2014 to 2022. Therefore, this study recommends the provision of proper health education and training regarding personal hygiene, hand washing, food handling, medical checks, as well as raw vegetable and meat safety.
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Development of allele-specific PCR methodology (AS-PCR) to screening A. lumbricoides and A. suum. Parasitol Res 2022; 121:2389-2397. [PMID: 35710846 DOI: 10.1007/s00436-022-07572-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/03/2022] [Indexed: 10/18/2022]
Abstract
Ascaris lumbricoides and Ascaris suum are described as helminths that infect humans and pigs, respectively. It is estimated that infection by A. lumbricoides affects about 447 million individuals living in tropical regions of developing countries. However, there is an increasing number of cases of human ascariasis in countries with no recent history of autochthonous infection by A. lumbricoides. In these places, pigs have been incriminated as the main source of human infection. Conventional parasitological diagnosis does not allow species-specific identification, and the real epidemiological scenario of human and swine ascariasis is still uncertain. Therefore, this work presents the application of a species-specific molecular diagnosis, based on the allele-specific PCR methodology (AS-PCR), using the Internal Transcript Space 1 (ITS-1) of the ribosomal DNA, as a target for differentiating between the two species, using DNA obtained from eggs. To validate the methodology, stool samples positive for Ascaris spp, were obtained from 68 humans from seven Brazilian states and from six pigs from the state of Minas Gerais. All samples obtained from humans were genotyped as A. lumbricoides and all samples obtained from swine were genotyped as A. suum. These results are in agreement with the literature, which demonstrates that in most endemic regions, transmission cycles are separate. Therefore, the execution of this work allowed the availability of a useful methodology for the differential diagnosis of the species, which may contribute to the characterization of the real epidemiological profile of human and swine ascariasis, and to the implementation of future control strategies.
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Tadesse Boltena M, El-Khatib Z, Kebede AS, Asamoah BO, Yaw ASC, Kamara K, Constant Assogba P, Tadesse Boltena A, Adane HT, Hailemeskel E, Biru M. Malaria and Helminthic Co-Infection during Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5444. [PMID: 35564842 PMCID: PMC9101176 DOI: 10.3390/ijerph19095444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 12/22/2022]
Abstract
Malaria and helminthic co-infection during pregnancy causes fetomaternal haemorrhage and foetal growth retardation. This study determined the pooled burden of pregnancy malaria and helminthic co-infection in sub-Saharan Africa. CINAHL, EMBASE, Google Scholar, Scopus, PubMed, and Web of Science databases were used to retrieve data from the literature, without restricting language and publication year. The Joanna Briggs Institute's critical appraisal tool for prevalence studies was used for quality assessment. STATA Version 14.0 was used to conduct the meta-analysis. The I2 statistics and Egger's test were used to test heterogeneity and publication bias. The random-effects model was used to estimate the pooled prevalence at a 95% confidence interval (CI). The review protocol has been registered in PROSPERO, with the number CRD42019144812. In total, 24 studies (n = 14,087 participants) were identified in this study. The pooled analysis revealed that 20% of pregnant women were co-infected by malaria and helminths in sub-Saharan Africa. The pooled prevalence of malaria and helminths were 33% and 35%, respectively. The most prevalent helminths were Hookworm (48%), Ascaris lumbricoides (37%), and Trichuris trichiura (15%). Significantly higher malaria and helminthic co-infection during pregnancy were observed. Health systems in sub-Saharan Africa must implement home-grown innovative solutions to underpin context-specific policies for the early initiation of effective intermittent preventive therapy.
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Affiliation(s)
- Minyahil Tadesse Boltena
- Armauer Hansen Research Institute, Ministry of Health, Addis Ababa 1005, Ethiopia; (H.T.A.); (E.H.); (M.B.)
| | - Ziad El-Khatib
- Department of Global Public Health, Karolinska Institutet, 17176 Stockholm, Sweden
- World Health Programme, Université du Québec en Abitibi-Témiscamingue (UQAT), Rouyn-Noranda, QC J9X 5E4, Canada
| | | | - Benedict Oppong Asamoah
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, 22184 Lund, Sweden; (B.O.A.); (A.T.B.)
| | - Appiah Seth Christopher Yaw
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi 101, Ghana;
| | - Kassim Kamara
- Directorate of Health Security and Emergencies, Ministry of Health and Sanitation, Freetown 00232, Sierra Leone;
| | - Phénix Constant Assogba
- Research Unit in Applied Microbiology and Pharmacology of Natural Substances, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Abomey-Calavi 526, Benin;
| | - Andualem Tadesse Boltena
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, 22184 Lund, Sweden; (B.O.A.); (A.T.B.)
| | - Hawult Taye Adane
- Armauer Hansen Research Institute, Ministry of Health, Addis Ababa 1005, Ethiopia; (H.T.A.); (E.H.); (M.B.)
| | - Elifaged Hailemeskel
- Armauer Hansen Research Institute, Ministry of Health, Addis Ababa 1005, Ethiopia; (H.T.A.); (E.H.); (M.B.)
- Department of Medical Microbiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Mulatu Biru
- Armauer Hansen Research Institute, Ministry of Health, Addis Ababa 1005, Ethiopia; (H.T.A.); (E.H.); (M.B.)
- Child and Family Health, Department of Health Sciences, Lund University, 22184 Lund, Sweden
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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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Brandt O, Wegenstein B, Müller I, Smith D, Nqweniso S, Adams L, Müller S, du Randt R, Pühse U, Gerber M, Navarini AA, Utzinger J, Daniel Labhardt N, Schindler C, Walter C. Association between allergic sensitization and intestinal parasite infection in schoolchildren in Gqeberha, South Africa. Clin Exp Allergy 2022; 52:670-683. [PMID: 35073608 PMCID: PMC9310757 DOI: 10.1111/cea.14100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/03/2022] [Accepted: 01/17/2022] [Indexed: 11/30/2022]
Abstract
Background Inconsistent data exist regarding the influence of parasitic infection on the prevalence of allergic sensitization and disorders. Objective To investigate the impact of geohelminth and protozoan infections on sensitization patterns and allergic symptoms of children living in low‐income communities in Gqeberha, South Africa. Methods In a cross‐sectional study, 587 schoolchildren aged 8–12 years were recruited in June 2016 and screened for reactivity to common allergens by skin prick tests (SPTs) and for parasitic infections by stool examination. Additionally, questionnaires were completed to record allergic symptoms the children may have experienced. Results Positive SPTs were found in 237/587 children (40.4%), and about one‐third of whom were polysensitized. Sensitizations were most frequently detected against the house dust mites (HDM) Dermatophagoides spp. (31.9%) and Blomia tropicalis (21.0%). Infections with geohelminths (Ascaris lumbricoides, Trichuris trichiura) were found in 26.8% and protozoan infections (Giardia intestinalis, Cryptosporidia spp.) in 13.9% of study participants. Mixed logistic regression analyses revealed negative associations between parasite infection and sensitization to Blomia tropicalis (OR: 0.54, 95% CI 0.33–0.89) and to Dermatophagoides spp. (OR 0.65, 95% CI 0.43–0.96), and between protozoan infection and allergic sensitization to any aeroallergen, although these associations were not significant when adjusted for false discovery. Geohelminth infection and intensity of geohelminth infection were both associated with reduced risk of polysensitization (OR 0.41, 95% CI 0.21–0.86), and this association remained significant with adjustment for false discovery. Reported respiratory symptoms were associated with HDM sensitization (ORs from 1.54 to 2.48), but not with parasite infection. Conclusions and clinical relevance Our data suggest that geohelminth infection and high geohelminth infection intensity are associated with a reduced risk of polysensitization.
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Affiliation(s)
- Oliver Brandt
- Department of Dermatology, Allergy Unit, University Hospital, University of Basel, Basel, Switzerland.,Department of Dermatology, University Hospital, University of Basel, Basel, Switzerland.,Pediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Benjamin Wegenstein
- Department of Dermatology, Allergy Unit, University Hospital, University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Ivan Müller
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Danielle Smith
- Department of Human Movement Science, Nelson Mandela University, Ggeberha, South Africa
| | - Siphesihle Nqweniso
- Department of Human Movement Science, Nelson Mandela University, Ggeberha, South Africa
| | - Larissa Adams
- Department of Human Movement Science, Nelson Mandela University, Ggeberha, South Africa
| | - Simon Müller
- Department of Dermatology, University Hospital, University of Basel, Basel, Switzerland
| | - Rosa du Randt
- Department of Human Movement Science, Nelson Mandela University, Ggeberha, South Africa
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Alexander A Navarini
- Department of Dermatology, University Hospital, University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | | | - Cheryl Walter
- Department of Human Movement Science, Nelson Mandela University, Ggeberha, South Africa
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Dahal A, Barnabas F, Damen J, Udo W, Mantu E, Joseph S, Ekpo M, Ashien U. Soil-transmitted helminths contamination of carrots and cucumbers, and molecular identification of Ascaris lumbricoides in Jos Plateau State, Nigeria. NIGERIAN JOURNAL OF MEDICINE 2022. [DOI: 10.4103/njm.njm_75_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
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Aemiro A, Menkir S, Tegen D, Tola G. Prevalence of Soil-Transmitted Helminthes and Associated Risk Factors Among People of Ethiopia: A Systematic Review and Meta-Analysis. INFECTIOUS DISEASES: RESEARCH AND TREATMENT 2022; 15:11786337211055437. [PMID: 35356097 PMCID: PMC8958720 DOI: 10.1177/11786337211055437] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/02/2021] [Indexed: 11/15/2022]
Abstract
Background: A Soil-transmitted helminthic infection (STHIs) remains a notable health problem in resource-limited countries. Objective: This systematic review and meta-analysis aimed to determine the overall prevalence of STH infections in Ethiopia. Methods: Articles written in English were searched from online public databases. Searching terms taken separately and jointly were “prevalence,” “soil-transmitted helminths” “nematode,” “Geo-helminths,” “roundworm,” “Necator,” “Ancylostoma,” “Ascaris,” “Trichuris,” “hookworm,” “whipworm,” “ S. strecoralies,” “associated factors,” and “Ethiopia.” We used STATA version 14 for meta-analysis and Cochran’s Q test statistics and the I2 test for heterogeneity. Result: From 297 reviewed articles 41 fulfilled the inclusion criteria. The pooled prevalence of STH infections in Ethiopia was 36.78% Ascaris lumbricoides had the highest pooled prevalence 17.63%, followed by hook worm12.35%. Trichuris trichiura 7.24% when the prevalence of S. strecoralies was 2.16% (95% CI: 0.97-3.35). Age, sex, residence, family education level, lack of shoe wearing habits and open defecation were identified as risk factors for STH infection. Eating unwashed and uncooked fruit and vegetables increased the risk of STH infection by 1.88 times while untrimmed finger nail and lack of hand washing habits increase the risk of STH infection by 1.28 and 3.16 times respectively with 95% CI. Limitation: Lack of published studies from Afar, Gambela, Somali, and Benshangul gumuz regions may affect the true picture. The other limitation is that the search strategy will be restricted articles published only in the English language but there might be articles that published using another language. Conclusion: Ascaris lumbricoides, hookworms and Trichuris trichiura, are the most prevalent soil-transmitted helminthes infections in Ethiopia. Age, sex, residence, family education level, lack of shoe wearing habits Open defecation untrimmed finger nail and lack of hand washing habits significantly associated with STH infection. When eating unwashed, uncooked fruit and vegetables were not significantly associated with STH infection. Strategic use of anti-helminthic, health education, and adequate sanitation, taking into account this epidemiologic information is helpful in the control of STH infections in Ethiopia.
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Affiliation(s)
- Aleka Aemiro
- Department of Biology, Mekdela Amba University College of Natural and Computational Science, Mekdela, Ethiopia
| | - Sisay Menkir
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Dires Tegen
- South Gondar Zone, Dera Woreda Education Office, Ethiopia
| | - Gedam Tola
- Department of Biology, Debark University College of Natural and Computational Science, Debark, Ethiopia
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Prevalence of soil-transmitted helminth infections, schistosomiasis, and lymphatic filariasis before and after preventive chemotherapy initiation in the Philippines: A systematic review and meta-analysis. PLoS Negl Trop Dis 2021; 15:e0010026. [PMID: 34928944 PMCID: PMC8722724 DOI: 10.1371/journal.pntd.0010026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 01/03/2022] [Accepted: 11/24/2021] [Indexed: 11/19/2022] Open
Abstract
Objective To estimate the impact of preventive chemotherapy on the prevalence and intensity of soil-transmitted helminth (STH) infections, schistosomiasis, and lymphatic filariasis in the Philippines, using systematic review and meta-analysis. Methods We included reports reporting prevalence of STH infections, schistosomiasis, or lymphatic filariasis in the Philippines published until 31 March 2021. Peer-reviewed studies were identified in electronic databases. Grey literature reports by the University of the Philippines and the Department of Health were also included. Pooled infection prevalence, before and after the initiation of preventive chemotherapy, stratified by age group, was calculated using the inverse variance heterogeneity model. Findings A total of 109 reports were included in the review and meta-analysis. Overall prevalence of moderate-heavy intensity Ascaris lumbricoides (6.6%) and Trichuris trichiura (2.7%) infection after initiation of preventive chemotherapy were significantly lower than the prevalence prior to initiation (23.6% for A. lumbricoides and 12.2% for T. trichiura). Prevalence reductions were also found in school and preschool-age children for A. lumbricoides and T. trichiura. Studies conducted after preventive chemotherapy initiation had significantly lower overall prevalence of moderate-heavy intensity schistosomiasis (3.1% vs 0.2%) and of schistosomiasis in school-age children (30.5% vs 1%). Pooled prevalence of lymphatic filariasis prior to preventive chemotherapy initiation was 3.2% across 12 provinces, while currently only two provinces still have prevalence of more than 1%. There were no published studies reporting prevalence of lymphatic filariasis after initiation of preventive chemotherapy. Heterogeneity was high with I2 mostly above 90%. Conclusion The burden of STH infections and schistosomiasis in children were significantly lower in studies conducted following the initiation of preventive chemotherapy. Eliminating morbidity and interrupting transmission, however, may require expanded control initiatives including community-wide treatment, and improved water, sanitation, and hygiene. Lymphatic filariasis burden has decreased since the implementation of preventive chemotherapy, with all but two provinces having reached the elimination of lymphatic filariasis as a public health problem. Mass treatment with anti-parasitic medications is a key control and elimination strategy for several helminth infections, namely intestinal worm infections, schistosomiasis, and lymphatic filariasis, which are common in the Philippines and other endemic countries. To gain insight into the impact of such a strategy that has been in place for more than 14 years, we used systematic review and meta-analysis to compare the prevalence of each of these helminth infections in the Philippines before and after the initiation of mass treatment. The review included 109 reports, composed of peer-reviewed studies and grey literature. The pooled overall prevalence of heavy intensity and the prevalence in children of intestinal worm infection and schistosomiasis were significantly lower in studies conducted after initiation of mass treatment. The studies included are highly heterogenous reflecting variability in sampling procedures, diagnostic tests, study sites, and years of data collection. Eliminating morbidity and interrupting transmission may require expanded control initiatives including community-wide treatment, and improved water, sanitation, and hygiene. The same significantly lower prevalence after initiation of mass treatment was observed for lymphatic filariasis where only two out of the initial 12 endemic provinces still require mass treatment due to prevalence above 1%.
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Status of Intestinal Helminth Infection in Schools Implementing the Home-Grown School Feeding Program and the Impact of the Program on Pupils in Anambra State, Nigeria. Acta Parasitol 2021; 66:1528-1537. [PMID: 34128144 DOI: 10.1007/s11686-021-00429-w] [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] [Received: 05/20/2020] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Intestinal helminthiasis among pupils is a major impediment to their well-being and development. This 2-year study determined how home-grown school feeding programme (HGSFP) impacted on pupils' school attendance and created opportunity for more children to assess interventions geared towards the prevention and possible elimination of intestinal helminthiasis. METHODS Faecal samples were collected from 1677 consented pupils and examined for helminths using Kato-Katz technique. Pupils were treated with 40 mg Levamisole (anti-helminthic) and re-examined. Structured questionnaires and focus group discussions were used to determine anthropometric indices and risk factors. RESULTS A 6% prevalence rate which was not significant with respect to sex or age was observed. Helminth parasites observed were Ascaris lumbricoides (4.4%), Trichuris trichiura (0.8%), Hookworm spp. (0.2%), and Taenia spp. (0.5%). Two pupils (1.98%) recorded high intensity of infection (epg) while 98.02% had light infection. Ascaris lumbricoides voided following treatment were 290. The Body Mass Index (BMI) indicated that infected pupils had lower values (14.6317) compared to uninfected pupils (19.2003). The HGSFP significantly improved school attendance by 30%. Lack of knowledge about transmission (P = 0.0004), hand hygiene (P = 0.01) and usage of toilet (P = 0.01) were risk factors observed. CONCLUSION/SIGNIFICANCE Intestinal helminthiasis remains a public health problem among pupils because environmental and behavioural risk factors persist. HGSFP improved school attendance and created opportunity for more inclusive participation of school-aged children for deworming. This has great potential in fast-tracking the elimination of intestinal helminthiasis. The present study consequently advocates the need to sustain HGSFP in schools.
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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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Kantzanou M, Karalexi MA, Vrioni G, Tsakris A. Prevalence of Intestinal Parasitic Infections among Children in Europe over the Last Five Years. Trop Med Infect Dis 2021; 6:160. [PMID: 34564544 PMCID: PMC8482161 DOI: 10.3390/tropicalmed6030160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/25/2021] [Accepted: 09/01/2021] [Indexed: 11/17/2022] Open
Abstract
While the prevalence of intestinal parasitic infections (IPI) has been most commonly studied in African and Asian populations, less is known about the prevalence rates of IPI in European children, as well as the potential risk factors that favor the spread of parasites. We aimed to review published evidence on the prevalence rates of IPI in children residing in Europe, and to quantitatively synthesize the results of published studies. We searched Medline from 1 January 2015 to 1 April 2021 to address the most recently published prevalence patterns of IPI in European children. Random-effects meta-analyses were performed by type of IPI infection, age group and sex, depending on data availability. Of the 967 potentially relevant articles, eight eligible cross-sectional studies were included in this analysis, yielding a sample of 3376 children (0-19 years). The overall prevalence rate was 5.9% for any IPI in children residing in European countries. Blastocystis hominis was the most commonly detected parasite yielding a prevalence rate of 10.7%. Other parasites included Entamoeba coli, Endolimax nana, and Blastocystis hominis. Studies focusing on specific types of parasites showed prevalence rates ranging from 1.3% for Cryptosporidium to 68.3% for Dientamoeba fragilis. Despite the scarce literature, the present review showed relatively low prevalence rates of IPI in Europe. Future studies accounting for proper diagnostic methods used for the detection of parasites and including information on potential sociodemographic factors, such as travelling history and history of immigration, are needed to guide clinicians about which children to test, as well as when and how to test children for IPI.
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Affiliation(s)
- Maria Kantzanou
- Department of Hygiene, Epidemiology & Medical Statistics Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece;
| | - Maria A. Karalexi
- Department of Hygiene, Epidemiology & Medical Statistics Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece;
| | - Georgia Vrioni
- Laboratory of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece; (G.V.); (A.T.)
| | - Athanasios Tsakris
- Laboratory of Microbiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 11527 Athens, Greece; (G.V.); (A.T.)
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Urban JF, Nielsen MK, Gazzola D, Xie Y, Beshah E, Hu Y, Li H, Rus F, Flanagan K, Draper A, Vakalapudi S, Li RW, Ostroff GR, Aroian RV. An inactivated bacterium (paraprobiotic) expressing Bacillus thuringiensis Cry5B as a therapeutic for Ascaris and Parascaris spp. infections in large animals. One Health 2021; 12:100241. [PMID: 33889707 PMCID: PMC8048022 DOI: 10.1016/j.onehlt.2021.100241] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 02/07/2023] Open
Abstract
Ascaris and Parascaris are important parasites in the family Ascarididae, large, ubiquitous intestinal-dwelling nematodes infecting all classes of vertebrates. Parasitic nematode drug resistance in veterinary medicine and drug recalcitrance in human medicine are increasing worldwide, with few if any new therapeutic classes on the horizon. Some of these parasites are zoonotic, e.g., Ascaris is passed from humans to pigs and vice versa. The development of new therapies against this family of parasites would have major implications for both human and livestock health. Here we tested the therapeutic ability of a paraprobiotic or dead probiotic that expresses the Bacillus thuringiensis Cry5B protein with known anthelmintic properties, against zoonotic Ascaris suum and Parascaris spp. This paraprobiotic, known as IBaCC, intoxicated A. suum larvae in vitro and was highly effective in vivo against intestinal A. suum infections in a new mouse model for this parasite. Fermentation was scaled up to 350 l to treat pigs and horses. Single dose Cry5B IBaCC nearly completely cleared A. suum infections in pigs. Furthermore, single dose Cry5B IBaCC drove fecal egg counts in Parascaris-infected foals to zero, showing at least parity with, and potential superiority to, current efficacy of anthelmintics used against this parasite. Cry5B IBaCC therefore represents a new, paraprobiotic One Health approach towards targeting Ascarididae that is safe, effective, massively scalable, stable, and useful in human and veterinary medicine in both the developed and developing regions of the world. IBaCC is Bacillus thuringiensis Cry5B protein crystals trapped inside dead bacteria. IBaCC intoxicates Ascaris suum intestinal parasitic nematodes in vitro. IBaCC is highly effective against A. suum parasites in vivo in mice and pigs. IBaCC is highly effective against related Parascaris parasites in foals. IBaCC represents a new paradigm for treating ascarid parasites of humans and animals.
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Affiliation(s)
- Joseph F Urban
- U. S. Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Animal and Parasitic Diseases Laboratory, Beltsville, MD, United States of America.,U. S. Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Diet, Genomics and Immunology Laboratory, Beltsville, MD, United States of America
| | - Martin K Nielsen
- M.H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, United States of America
| | - David Gazzola
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Yue Xie
- U. S. Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Animal and Parasitic Diseases Laboratory, Beltsville, MD, United States of America.,U. S. Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Diet, Genomics and Immunology Laboratory, Beltsville, MD, United States of America.,Department of Parasitology, College of Veterinary Medicine, Sichuan Agricultural University, Sichuan, China
| | - Ethiopia Beshah
- U. S. Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Animal and Parasitic Diseases Laboratory, Beltsville, MD, United States of America.,U. S. Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Diet, Genomics and Immunology Laboratory, Beltsville, MD, United States of America
| | - Yan Hu
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Hanchen Li
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Florentina Rus
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Kelly Flanagan
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Austin Draper
- Synthetic Biomanufacturing Facility, Utah State University, Logan, UT, United States of America
| | - Sridhar Vakalapudi
- Synthetic Biomanufacturing Facility, Utah State University, Logan, UT, United States of America
| | - Robert W Li
- U. S. Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Animal and Parasitic Diseases Laboratory, Beltsville, MD, United States of America
| | - Gary R Ostroff
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Raffi V Aroian
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, United States of America
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Karshima SN, Karshima MN. Epidemiology of Cryptosporidium Infections among People Living with HIV/AIDS in Nigeria: Results of Systematic Review and Meta-analysis. Acta Parasitol 2021; 66:60-74. [PMID: 32683583 DOI: 10.1007/s11686-020-00253-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/06/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Cryptosporidium is implicated in diarrhea epidemics in many parts of the world and is said to be the most common protozoan cause of diarrhea among people living with HIV/AIDS (PLWHA) globally. To provide data on the burden of Cryptosporidium infections among Nigerians living with HIV/AIDS, we reported the prevalence, geographic distribution and Cryptosporidium species diversity among this population in Nigeria. METHODS We used the PRISMA guidelines to perform a systematic review and meta-analysis of articles published between January 1, 1995 and April 21, 2020. Pooled estimate (PE), heterogeneity, quality of each study and publication bias were determined using the random-effects model, Cochran's Q test, the 9 point Joanna Briggs Institute Critical Appraisal Instrument and the Egger's regression asymmetry test, respectively. RESULTS Forty-six articles reported 2612 positive cases of Cryptosporidium infections from 12,756 PLWHA examined in 20 Nigerian States and the Federal Capital Territory. Overall pooled estimate was 14.5% (95% CI 10.4-19.9) with a range of 0.3% (95% CI 0.0-1.8) to 43.7% (95% CI 35.6-52.3) across sub-groups, with the PEs in relation to CD4+ T cell count, species and age showing significant variations at p < 0.05. Cryptosporidium hominis was the most prevalent (3.5%, 95% CI 2.3-5.2) of the six Cryptosporidium species reported in Nigeria. CONCLUSION Cryptosporidium infections are moderately prevalent among PLWHA in Nigeria with the highest regional prevalence in the north-east. In addition to personal hygienic practices, the inclusion of Cryptosporidium screening as part of HIV/AIDS clinics in Nigeria will reduce the burden of the parasite among PLWHA in Nigeria.
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Horikoshi Y, Ibrahim UM, Morris SK. School-based approach for parasitic disease control in Japan and Africa. Pediatr Int 2021; 63:264-269. [PMID: 33174267 DOI: 10.1111/ped.14535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/13/2020] [Accepted: 11/06/2020] [Indexed: 12/17/2022]
Abstract
Japan has achieved significant improvements in the control and prevention of parasitic infections through a school-based approach since the 1930s. The use of chemical fertilizers in agriculture, safe water and food, and improved sanitation and hygiene also contributed to the near eradication of endemic parasites. However, parasite infections continued to affect children mostly in resource-limited countries. The African continent has one of the highest burdens of such infections. The application of school-based approaches has several advantages where the structure of health-care systems is not optimal. In Africa, soil-transmitted helminths and schistosomiasis are frequently targets for school-based public health intervention. Mass drug administration by teachers at school can reach targeted children effectively and safely. The limitations of this approach include missing unattended children and absentee of teachers. Initially, mass drug administration at school for parasitic infections was thought to improve health and even socioeconomic status of children in the community. However, more recently the socioeconomic impact has been questioned although the reduction of parasitic diseases is still apparent. Moreover, other basic public health measurements such as increased toilet use, assuring safe water access and avoiding the use of human excrement as an agricultural fertilizer, are equally important for control and prevention of parasitic diseases. Further global efforts should be continued to achieve equal health for every child in a sustainable way.
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Affiliation(s)
- Yuho Horikoshi
- Bauchi branch, Nigeria country office, World Health Organization, Bauchi city, Nigeria.,Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | | | - Shaun K Morris
- Division of Infectious Diseases and the Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Comorbidity of Geo-Helminthes among Malaria Outpatients of the Health Facilities in Ethiopia: Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030862. [PMID: 33498343 PMCID: PMC7908091 DOI: 10.3390/ijerph18030862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 01/15/2023]
Abstract
Background: Coinfection of malaria and intestinal helminths affects one third of the global population, largely among communities with severe poverty. The spread of these parasitic infections overlays in several epidemiological locations and the host shows different outcomes. This systematic review and meta-analysis determine the pooled prevalence of malaria and intestinal helminthiases coinfections among malaria suspected patients in Ethiopia. Methods: Primary studies published in English language were retrieved using appropriate search terms on Google Scholar, PubMed/MEDLINE, CINHAL, Scopus, and Embase. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. A pooled statistical meta-analysis was conducted using STATA Version 14.0 software. The heterogeneity and publication bias were assessed using the I2 statistics and Egger’s test, respectively. Duval and Tweedie’s nonparametric trim and fill analysis using the random-effect analysis. The Random effects model was used to estimate the summary prevalence of comorbidity of malaria and soil transmitted helminthiases and the corresponding 95% confidence intervals (CI). The review protocol has registered in PROSPERO number CRD42019144803. Results: We identified ten studies (n = 6633 participants) in this study. The overall pooled result showed 13% of the ambulatory patients infected by malaria and intestinal helminths concurrently in Ethiopia. The pooled prevalence of Plasmodium falciparum and Plasmodium vivax, and mixed infections were 12, 30, and 6%, respectively. The most common intestinal helminth parasites detected were Hookworm, Ascaris lumbricoides, and Tirchuris trichiura. Conclusions: The comorbidity of malaria and intestinal helminths causes lower hemoglobin level leading to maternal anemia, preterm delivery, and still birth in pregnant women and lactating mother. School-aged children and neonates coinfected by plasmodium species and soil transmitted helminths develop cognitive impairment, protein energy malnutrition, low birth weight, small for gestational age, and gross motor delay. The Ministry of Health of Ethiopia and its international partners working on malaria elimination programs should give more emphasis to the effect of the interface of malaria and soil transmitted helminths, which calls for an integrated disease control and prevention.
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Intestinal parasites among food handlers in Iran: A systematic review and meta-analysis. Food Microbiol 2020; 95:103703. [PMID: 33397621 DOI: 10.1016/j.fm.2020.103703] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/26/2020] [Accepted: 11/27/2020] [Indexed: 01/28/2023]
Abstract
Regarding preparing and serving foods, food handlers have an influential role in the spreading of foodborne infections. Due to the great potential to cause foodborne infections, intestinal parasites (IPs) are considered a significant public health problem in today's societies. In Iran, despite several regional reports, national data on IPs prevalence in food handlers are lacking. The aim of the present study, therefore, is to estimate the pooled prevalence of IPs infections and associated pooled odds ratio of educational level among food handlers in Iran. PubMed, Web of Science, Scopus, Embase, and Google Scholar databases (international) and SID and Magiran databases (national) were systematically searched for studies that reporting the prevalence of IPs in food handlers in Iran, published between 2000 and 2020. Pooled prevalence was estimated using a random-effects model with a 95% confidence interval (CI) and depicted as a forest plot, while heterogeneity was evaluated using Cochran's Q-test. The overall pooled prevalence estimate for IPs was 19.3% (95% CI = 14.9-23.7%). Prevalence of the protozoan parasites (20%, 95% CI = 13.7-26.3%) was significantly higher than that of the helminthic parasites (1.6%, 95% CI = 1.1-2.0%). Giardia lamblia (5.2%), Entamoeba coli (5.0%), and Blastocystis spp. (4.4%), as protozoan parasites, and Ascaris lumbricoides (1.4%), Enterobius vermicularis (0.9%), and Hymenolepis nana (0.5%), as helminthic parasites, were the most commonly reported species. Food handlers with low educational levels were 20% more exposed to IPs infection, compared to those with high educational levels (OR = 1.21, 95% CI = 0.88 to 1.65). The prevalence of IPs infections among food handlers in Iran is significant. Besides taking into account this epidemiologic information, a holistic approach, including periodic stool screening, health education, and treatment of infected food handlers, will help in the control of these infections in Iran.
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Eze P, Agu UJ, Aniebo CL, Agu SA, Lawani LO. Perception and attitudinal factors contributing to periodic deworming of preschool children in an urban slum, Nigeria. BMC Public Health 2020; 20:1839. [PMID: 33261596 PMCID: PMC7708184 DOI: 10.1186/s12889-020-09958-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/22/2020] [Indexed: 12/21/2022] Open
Abstract
Background Over 20 million preschool-age children (PSAC) in Nigeria require periodic chemotherapy (PC) for soil-transmitted helminth (STH) infections. Persistently low coverage for this age group threatens the World Health Organization (WHO) 2030 target for eliminating STH infections. Current strategies for targeting PSAC have been largely ineffective. Hence, PSAC are mostly dewormed by their parents/caregivers. However, little is known of the perception and attitude of parents/caregivers of PSAC to deworming in this setting. Methods A mixed methods design, combining a community-based interviewer-administered questionnaire-survey (n = 433) and focus group discussions (FGD) (n = 43) was used to assess the perceptions and attitudes of mothers to periodic deworming of preschool children aged 2–5 years in Abakpa-Nike, Enugu, Nigeria. Results Coverage of periodic deworming in PSAC is 42% (95% CI: 37.3–46.8%). There is significant difference in the specific knowledge of transmission of STH (AOR = 0.62, 95% CI: 0.48–0.81, p = 0.000), complication of STH infections (AOR = 0.77, 95% CI: 0.61–0.98, p = 0.034), accurate knowledge of deworming frequency (AOR = 0.41, 95% CI: 0.18–0.90, p = 0.026), and knowledge of PC drug, mebendazole (AOR = 0.28, 95% CI: 0.09–0.90, p = 0.031), and pyrantel (AOR = 8.03, 95% CI: 2.22–29.03, p = 0.001) between mothers who periodically deworm their PSAC and those who do not. There is no significant difference in specific knowledge of the symptoms of STH infections (AOR = 0.76, 95% CI: 0.57–1.02, p = 0.069) and PC drug, Albendazole (AOR = 1.00, 95% CI: 0.46–2.11, p = 0.972). FGD revealed misconceptions that are rooted in stark ignorance of the disease. Overall attitude to deworming is positive and favourable. Conclusions Poor coverage of periodic deworming for STH infections in PSAC in this setting are primarily driven by poor specific knowledge of the risks and burden of the infection. Focused health education on the burden and transmission of STH infections could complement existing strategies to improve periodic deworming of PSAC in this setting. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09958-x.
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Affiliation(s)
- Paul Eze
- Department of Health Policy and Administration, Penn State University, University Park, PA, 16802, USA.
| | - Ujunwa Justina Agu
- Department of Paediatrics, Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria
| | - Chioma Lynda Aniebo
- Department of Paediatrics, Enugu State University Teaching Hospital, Parklane, Enugu, Nigeria
| | - Sergius Alex Agu
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Lucky Osaheni Lawani
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, M5T 3M6, Canada
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Hailegebriel T, Nibret E, Munshea A. Prevalence of Soil-Transmitted Helminth Infection Among School-Aged Children of Ethiopia: A Systematic Review and Meta-Analysis. Infect Dis (Lond) 2020; 13:1178633720962812. [PMID: 33088182 PMCID: PMC7543112 DOI: 10.1177/1178633720962812] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 09/10/2020] [Indexed: 12/03/2022] Open
Abstract
Background: Soil-transmitted helminths (STH) are still major health problems in resource-poor countries. Despite several epidemiological studies were available in Ethiopia, summarized data on the prevalence of STH among school-aged children (SAC) is lacking in the country. Objective: This study was aimed to summarize the existing published studies of STH among SAC children in Ethiopia. Methods: The search was carried out in open access databases such as Science Direct, Scopus, and PubMed Central which reported STH in Ethiopia. Open access articles published between 2000 and 2019 were included in this meta-analysis. The pooled prevalence was determined using a random-effect model while heterogeneities between studies were evaluated by I2 test. Results: A total of 46 338 children (Male = 23 374 and Female = 22 964) were included in the 70 eligible studies for this meta-analysis. The pooled prevalence of STH among SAC was 33.4%; 95% CI, 29.3% to 37.7% in Ethiopia. Ascaris lumbricoides (19.9%; 95% CI, 17.2%-22.6%) was the most prevalent STH followed by Trichuris trichiura (12.4%; 95% CI, 10.6%-14.1%), and hookworm (7.9%; 95% CI, 6.9%-8.9%) infection in the country. High prevalence of STH was observed in Oromia (42.5%; 95% CI, 31.6%-53.4%) followed by SNNPR (38.3%; 95% CI, 27.7%-48.8%) and Amhara (32.9%; 95% CI, 27.0%-38.8%) regional states. High heterogeneity on the prevalence of STH was observed across studies within and among regions (I2 > 96% and P < .001). Conclusion: This review showed that more than one-third of the Ethiopian SAC were infected with STH. The high prevalence of STH observed in this review highlight the needs of improved control and prevention strategies in Ethiopia.
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Affiliation(s)
- Tamirat Hailegebriel
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Endalkachew Nibret
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abaineh Munshea
- Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia
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23
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Epidemiology of intestinal parasitic infections in preschool and school-aged Ethiopian children: a systematic review and meta-analysis. BMC Public Health 2020; 20:117. [PMID: 31992252 PMCID: PMC6988312 DOI: 10.1186/s12889-020-8222-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 01/15/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Numerous studies have been carried out on assessing the prevalence of intestinal parasites infections (IPIs) amongpreschool and school-age children in Ethiopia, but there is lack of study systematically gathered and analyzedinformation for policymakers. Therefore, the aim of this systematic review and meta-analysis was to provide a summary on prevalence, geographical distribution and trends of IPIs among preschool and school-age childrenin Ethiopia. METHODS The search were carried out in Medline via PubMed, Scopus, Science Direct, Web of Science, and Google Scholar from 1996to July2019 for studies describing prevalence of IPIs among preschooland school-age children. We conducted meta-regression to understand the trends and the source of heterogeneity and pooled the prevalence using 'metaprop' command using STATA software version 14. RESULTS Eighty-three(83) studies examining 56,786 fecal specimens were included. The prevalence of IPIs was 48%(95%CI: 42 to 53%) and showedsignificantly decreasing trends 17% (95% CI: 2.5 to 32%) for each consecutive 6 years) and was similar in males and females. The pooled prevalence in years 1997-2002, 2003-2008, 2009-2014 and > 2014 was 71% (95% CI: 57 to 86%), 42% (95% CI: 27 to 56%), 48% (95% CI: 40 to 56%) and 42% (95% CI: 34 to 49%), respectively. Poly-parasitism was observed in 16% (95% CI: 13 to 19%,) of the cases. CONCLUSION Intestinal parasite infections are highly prevalent among preschool and school-age children and well distributed across the regional states of Ethiopia. Southern and Amhara regional states carry the highest burden. We observed significant decreasing trends in prevalence of IPIs among preschool and school-ageEthiopian children over the last two decades. Therefore, this study is important to locate the geographical distribution and identified high risk areas that should be prioritized further interventions, which complement global efforts towards elimination of IPIs infections by 2020.
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Dhaka R, Verma R, Kumar R, Chayal V, Bhalla K, Singh R, Agrawal G, Kumar G. Pattern and determinants of soil-transmitted helminthiasis in a rural area of Haryana: A school-based study. J Family Med Prim Care 2019; 8:1971-1975. [PMID: 31334164 PMCID: PMC6618185 DOI: 10.4103/jfmpc.jfmpc_278_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: In the world, helminthiasis is the major public health problem in school-age children. More than 60 million school-age children live in intensively transmitted areas and they need immediate treatment and preventive interventions. Methodology: The study was conducted in the rural government schools of Block Beri, District Jhajjar (Haryana), India, and the study was descriptive and cross-sectional in design. The study recruited 300 school-going children in the age group of 6–10 years. Results: In this study, the mean age of subjects was 7.68 ± 1.467 years and prevalence of soil-transmitted helminths was 28.7%. The association between practice of hand washing and practice of washing fruits and vegetables with helminthic children were found statistically significant. Conclusion and Recommendation: Impart health education among community through primary care physician about wash hands before eating food and after defecation, washed thoroughly raw and uncooked food before eating.
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Affiliation(s)
- Rohit Dhaka
- Department of Community Medicine, Pt BD Sharma PGIMS, Rohtak, Haryana, India
| | - Ramesh Verma
- Department of Community Medicine, Pt BD Sharma PGIMS, Rohtak, Haryana, India
| | - Raj Kumar
- Department of Community Medicine, Pt BD Sharma PGIMS, Rohtak, Haryana, India
| | - Vinod Chayal
- Department of Community Medicine, Pt BD Sharma PGIMS, Rohtak, Haryana, India
| | - Kapil Bhalla
- Department of Pediatric, Pt BD Sharma PGIMS, Rohtak, Haryana, India
| | - Ranvir Singh
- Medical Officer, Director General Health Services, Haryana, Jhajjar, India
| | - Ginni Agrawal
- Department of Community Medicine, Pt BD Sharma PGIMS, Rohtak, Haryana, India
| | - Gopal Kumar
- Department of Community Medicine, Pt BD Sharma PGIMS, Rohtak, Haryana, India
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