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Alharazi T. Prevalence and risk factors of intestinal parasitic infections among pregnant women in Taiz Governorate, Yemen: A hospital-based study. Helminthologia 2023; 60:201-207. [PMID: 38152474 PMCID: PMC10750245 DOI: 10.2478/helm-2023-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/22/2023] [Indexed: 12/29/2023] Open
Abstract
Background Intestinal parasitic infections in pregnant women have been associated with severe adverse outcomes such as anemia, low birth weight, and mother and fetus morbidity and mortality. This study aimed to determine the prevalence of intestinal parasitic infection and its associated risk factors among pregnant women in Taiz, Yemen. Methods A cross-sectional study was conducted between July 2022 and January 2023. Sociodemographic and other explanatory variables were obtained via face-to-face interviews using a structured questionnaire. The wet-mount and formol-ether concentration techniques were applied to identify the IPIs. Data were analyzed using SPSS, version 20, and p-values < 0.05 were considered statistically significant. An analysis of descriptive statistics and multivariate logistic regression was conducted. A p-value < 0.05 was deemed statistically significant. The study included a total of 393 pregnant women. Results Of the 393 pregnant women screened for intestinal parasites, 144 (36.6 %) had at least one parasite. The most common intestinal parasite was Giardia lamblia (12.2 %), followed by Ascaris lumbricoides (10.9 %), Entamoeba histolytica/dispar (7.4 %), Enterobius vermicularis (14.3 %), and Hymenolepis nana (1.8 %). Being a farmer (AOR = 2.7, 95% CI: 1.69-4.26, p = 0:003) and drinking from unsafe water wells, streams, rain, and dams (AOR = 2:6, 95% CI: 1.68-4.25, p ≤ 0:001) were significantly associated with IPIs. Conclusion Pregnant women in the study area still face a severe health burden due to intestinal parasitic infection. Therefore, it is recommended that health education should be improved, and safe tap water should be provided to pregnant women to reduce the incidence of IPIs.
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Affiliation(s)
- T. Alharazi
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail, Kingdom of Saudi Arabia
- Department of Medical Microbiology and Immunology, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
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Blumenröder S, Wilson D, Ndaboine E, Mirambo MM, Mushi MF, Bader O, Zimmermann O, Mshana SE, Groß U. Neonatal infection in Sub-Saharan Africa: a cross-sectional pilot study on bacterial pathogens and maternal risk factors. Front Microbiol 2023; 14:1171651. [PMID: 37180246 PMCID: PMC10167281 DOI: 10.3389/fmicb.2023.1171651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction Although child morbidity and mortality could be reduced in Sub-Saharan Africa during the last years both remain high. Since neonatal infections play a major role, we conducted a cross-sectional pilot study in the lake region of Western Tanzania in order to analyze not only the prevalence of neonatal infection with its bacterial etiology including antimicrobial resistance pattern but also to detect potential maternal risk factors. Methods We screened 156 women for potential risk factors and examined their neonates for clinical signs of an infection including microbiological verification. All women were interviewed for medical history and their socio-economic background. High-vaginal swabs (HVS) of pregnant women and blood cultures of sick infants were investigated for bacterial pathogens using culture followed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) or polymerase-chain-reaction (PCR)-based assays. Antimicrobial resistances were determined using a disk diffusion test and verified by VITEK 2. Maternal malaria, blood glucose, and hemoglobin levels were determined by rapid tests and helminth infections by stool microscopy. Results and discussion Our results showed a prevalence of 22% for neonatal infections. In total, 57% of them had culture-positive bloodstream infections with Gram-negative bacteria being the most prevalent. All these expressed resistance against ampicillin. The prevalence of maternal infection with helminths or Plasmodium was low, indicating that anti-worming strategies and intermittent preventive treatment of malaria for pregnant women (IPTp) are effective. The study identified maternal urinary tract infection (UTI) and an elevated blood glucose level as potential maternal risk factors for early neonatal infection, an elevated blood glucose level, and maternal anemia for a late-onset infection. Conclusion Our study, therefore, indicates that monitoring maternal UTI in the last trimester as well as levels of maternal hemoglobin and blood glucose might be important to predict and eventually manage neonatal infections. As Gram-negative bacteria with resistance to ampicillin were most prevalent in culture-proven neonatal sepsis, WHO recommendations for calculated antibiosis in the sick young infant should be discussed.
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Affiliation(s)
- Simone Blumenröder
- Institute of Medical Microbiology and Virology, University Medical Centre Göttingen, Göttingen, Germany
| | - Damas Wilson
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Edgard Ndaboine
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Martha F. Mushi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Oliver Bader
- Institute of Medical Microbiology and Virology, University Medical Centre Göttingen, Göttingen, Germany
| | - Ortrud Zimmermann
- Institute of Medical Microbiology and Virology, University Medical Centre Göttingen, Göttingen, Germany
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Uwe Groß
- Institute of Medical Microbiology and Virology, University Medical Centre Göttingen, Göttingen, Germany
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Mosisa G, Diriba DC, Tsegaye R, Kejela G, Bayisa D, Oluma A, Wakuma B, Abadiga M, Turi E, Abera T, Bayisa L, Tufa G. Burden of intestinal parasitic infections and associated factors among pregnant women in East Africa: a systematic review and meta-analysis. Matern Health Neonatol Perinatol 2023; 9:5. [PMID: 37020236 PMCID: PMC10077618 DOI: 10.1186/s40748-023-00150-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/17/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND The ultimate goal of preventing intestinal parasites among pregnant women is to reduce maternal and newborn morbidity and mortality. Numerous primary studies were conducted in East Africa presented intestinal parasite infection and associated factors among pregnant women. However, the pooled finding is not known. Therefore, this review aimed to identify the pooled prevalence of intestinal parasite infection and its determinants among pregnant women in East Africa. METHODS Articles published from 2009 to 2021 were searched in PubMed, Web of Science, EMBASE, and HINARI databases. The search for unpublished studies such as thesis and dissertations was checked in Addis Ababa University and Africa Digital Library. PRISMA checklist was used to report the review. Articles published in the English Language were considered. The data were extracted by two authors using data extraction checklists on Microsoft excel. Heterogeneity among the included studies was checked using I2 statistics on forest plots. Sensitivity and sub-group analyses were conducted to assess the presence of primary studies, and study characteristics responsible for the observed heterogeneity. RESULTS Of the 43 identified articles, about 23 articles were removed due to duplications. Then, by assessing the abstracts and full texts, four articles were removed because they failed to meet the eligibility criteria. Finally, 16 articles were included in the systematic and meta-analysis.The pooled prevalence of intestinal parasites among pregnant women in East Africa was 38.54 (28.77, 48.32). In this study, variables like residing in rural areas (OR: 3.75; CI: 1.15,12.16), availability of latrine(OR: 2.94; 95% CI: 2.22, 3.91), eating raw fruits/vegetables (OR: 2.44; 95% CI: 1.16, 5.11). and sources of water as unprotected sources (OR: 2.20; 95% CI: 1.11,4.35) show statistically significant association with the increased burden of intestinal parasites among pregnant women. CONCLUSION The burden of intestinal parasite infection among pregnant women in East Africa was high. Therefore, efforts should be made in deworming pregnant women at the community and institutional level by stakeholders to reduce the burden of intestinal parasite infections and related complications.
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Affiliation(s)
- Getu Mosisa
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Dereje Chala Diriba
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Reta Tsegaye
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Gemechu Kejela
- Department of Public Health, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Diriba Bayisa
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Adugna Oluma
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Bizuneh Wakuma
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Muktar Abadiga
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ebisa Turi
- Department of Public Health, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Tesfaye Abera
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Lami Bayisa
- School of Nursing and Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Girma Tufa
- Department of Midwifery, Institutes of Health Sciences, Bule Hora University, Bule Hora, Ethiopia
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Micronutrients deficiencies and its correlation with the soil-transmitted helminthic infections among children and non-pregnant women in Nepal: findings from Nepal national micronutrient status survey. Sci Rep 2022; 12:22313. [PMID: 36566272 PMCID: PMC9789997 DOI: 10.1038/s41598-022-24634-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/17/2022] [Indexed: 12/25/2022] Open
Abstract
Despite having a high risk of soil-transmitted helminths (STHs) infection, no national level study has been conducted to assess incidence and correlates of STHs in Nepal. Thus, we hypothesized that micronutrients and social status are linked with incidence of STHs infection among 6-59 months children and 15-49 years non-pregnant women in Nepal and Kato-Katz technique was adopted to measure the type and intensity of STHs infections using fresh stool specimens and venous blood was used to examine micronutrients biomarkers. Anthropometric measurements such as height and weight, sociodemographic and health status were determined using structured questionnaire. Logistic regression was used to assess unadjusted and adjusted odds ratio (AOR) and the 95% CIs of ORs. The bivariate association of STHs was assessed with the covariates variables. Overall, 12% children and 19% non-pregnant women had STHs infection; A. lumbricoides was the predominant helminth in both study participants. In multivariate model; age, ethnicity, anaemia and zinc deficiency were associated with STHs infections in children. Similarly, higher odds of STHs occurrence was observed among non-pregnant women with vitamin A deficiency. Findings from this study suggest that high-risk population, with a focus on those of lower socioeconomic status should be on priority of deworming program, nutrition intervention, and mass administration of preventive chemotherapy and sanitation champions supplement to reduce the STHs infections in Nepal.
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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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Prevalence of Intestinal Parasitic Infections and Their Associated Risk Factors among Pregnant Women Attending Antenatal Care Center at Woreilu Health Center, Woreilu, Northeast Ethiopia. J Parasitol Res 2022; 2022:5242252. [PMID: 35450129 PMCID: PMC9017482 DOI: 10.1155/2022/5242252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 03/29/2022] [Indexed: 11/18/2022] Open
Abstract
Background Intestinal parasitic infections (IPIs) affect millions of pregnant women worldwide and if left untreated can cause adverse effects for mothers, fetuses, and newborns. This study was aimed at determining the prevalence and associated risk factors of intestinal parasitic infections among pregnant women in Woreilu, Northeast Ethiopia. Methods A cross-sectional study was conducted in Woreilu Health Center from October 2018 to February 2019. A convenient sampling technique was used to select the study subjects. The data related to the sociodemographic information and associated risk factors were collected by the interview technique, and fresh stool samples were collected from each pregnant woman. The microscopic examination of the stool samples was done by using direct wet mount preparations in normal saline and formol ether concentration techniques. Descriptive statistics and binary logistic regression were used. A p value < 0.05 was taken as statistically significant. Results A total of 331 pregnant women were included. The mean ± standard deviation of age of the participants was 26.3 ± 5.96 years ranging between 16 and 43 years. The overall prevalence of IPIs was 144 (43.5%) with the predominance of E. histolytica/dispar (44.4%) followed by A. lumbricoides (15.7%). Being a student (AOR = 3.35, 95% CI: 1.01-11.09, p = 0.047), second trimester (AOR = 3.94, 95% CI: 1.46-10.64, p = 0.007), third trimester (AOR = 3.32, 95% CI: 1.15-9.6, p = 0.027), and using spring water for drinking (AOR = 2.91, 95% CI: 1.62-5.22, p ≤ 0.001) were significantly associated with IPIs. Conclusion The prevalence of IPIs was high in this study. Being a student, second and third trimester, and using spring water for drinking were associated factors with IPIs. Therefore, improving the sanitation of the students and providing clean drinking water for the women should be strengthened. Screening women and providing health education during their antenatal care (ANC) visits are also recommended.
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Idowu OA, Babalola AS, Olapegba T. Prevalence of soil-transmitted helminth infection among children under 2 years from urban and rural settings in Ogun state, Nigeria: implication for control strategy. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2022. [DOI: 10.1186/s43054-021-00096-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Pre-school-aged children are always excluded in mass intervention policies for control of soil-transmitted helminths in Nigera. The need for evidence on infectivity of children in this age group cannot be overemphasized. This study seeks to determine the prevalence of STH among 103 children who are less than 2 years of age in an urban and rural area of Ogun State, Nigeria. This study through questionnaire administration also obtained relevant demographic information and hygiene behavior from parents of children recruited to this study.
Results
The overall prevalence of 69.9% was recorded, with Ascaris lumbricoides occurring as the most prevalent helminth (68.0%). This was followed by Hook worm (49.5%) and Trichris trichuria (18.5%). A significant increase in prevalence of hookworm was observed with increase in age (p < 0.05). Generally, A. Lumbricoides was found to be more prevalent as a single infection in the study population. Most of the T. Trichuria and hookworm infections were either in co-infections infections with A. Lumbricoides. The prevalence of A. Lumbricoides and Hookworm were significantly high in rural community when compared with urban (p < 0.05). Poor hygiene practices were common among the study participants.
Conclusions
The prevalence of STH infection is incredibly high in this age group that was for a long time considered as less important when it comes to burden due to STH. Therefore, there is a need to include them into future plans for control interventions.
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Prevalence of Intestinal Parasitic Infections and Associated Risk Factors among Pregnant Women Attending Prenatal Care in the Northwestern Ethiopia. BIOMED RESEARCH INTERNATIONAL 2022; 2021:3387742. [PMID: 34977238 PMCID: PMC8718307 DOI: 10.1155/2021/3387742] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/09/2021] [Indexed: 11/18/2022]
Abstract
Intestinal parasitic infections (IPIs) are the common health problems in developing countries with low socioeconomic and poor living conditions. IPIs affect millions of pregnant women worldwide and may lead to adverse maternal and fetal effects. The present study was aimed at determining the prevalence and associated risk factors of IPIs among pregnant women in Ethiopia. A hospital-based cross-sectional study involving 384 pregnant women was conducted from November 2018 to March 2019. Relevant information on potential risk factors associated with IPIs was gathered using a semistructured questionnaire. Stool samples were collected and examined using wet mount and formol-ether concentration techniques. Logistic regression was used to evaluate the possible association between dependent and independent variables. The overall prevalence of IPIs was 36.7%. Seven species of parasites were identified. The most prevalent intestinal protozoan parasite identified was Entamoeba histolytica/dispar (9.6%) followed by Giardia intestinalis (8.9%). The predominant helminth parasite identified was Ascaris lumbricoides (8.6%), followed by hookworm (5.2%), Taenia spp. (3.6%), Strongyloides stercoralis (1.3%), and Schistosoma mansoni (1.04%). Six pregnant women (1.56%) had infection by two parasite species. The odds of IPIs were higher among illiterates (AOR = 4.63), lowest monthly income earners (AOR = 3.49), primigravida (pregnant for the first time) (AOR = 2.04), those who used unboiled well/stream/river water for drinking (AOR = 14.55), ate soil (AOR = 2.32), and consumed raw vegetables (AOR = 1.91). The prevalence of IPIs in the study subjects was substantially high. Thus, screening of the women for IPIs and providing health education during their antenatal care (ANC) visit are recommended to prevent possible adverse maternal and fetal effects resulting from these infections.
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Wachamo D, Bonja F, Tadege B, Hussen S. Magnitude of parasitic infections and associated factors among pregnant women at health facilities in Hawassa, Southern Ethiopia. F1000Res 2021; 10:122. [PMID: 34136132 PMCID: PMC8182691 DOI: 10.12688/f1000research.27584.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Intestinal parasitic infections (IPIs) are common problems during pregnancy, with adverse outcomes including low birth weight and prenatal mortality. The burden of parasitic infections and its impacts are high among pregnant women in developing countries like Ethiopia. Therefore, this study aimed to assess the burden and associated factors of parasitic infections. Methods: A facility-based cross-sectional study was conducted among 365 randomly selected women attending antenatal clinic at five selected health facilities. Data was collected by a pre-tested questionnaire and stool specimens were collected in clean plastic containers. A combination of direct microscopy and the formol-ether concentration technique was used as soon as the specimen collected. Data entry and analysed for descriptive and logistic regression models by SPSS v.23. The result declared as statistically significant at p < 0.05. Results: The overall prevalence of IPI was 161 (45.9%). The most frequently identified parasites were Ascaris lumbricoides (27.9%), Schistosoma species (13.7%), Trichuris trichiura (5.1%), Hookworm (4.8%), and Taenia species. (1.4%). The IPIs were associated with women having no formal education [AOR=2.19, 95% CI: 1.05-4.57] or elementary school education [AOR=1.90, 95% CI: 1.11-3.27], as compared with high school educated and above. Monthly income of less than 1920 Ethiopian birr [AOR=2.06, 95% CI: 1.28-3.31], sharing a latrine with neighbours [AOR=1.83, 95% CI: 1.14-2.93], using lake water for washing clothes [AOR=2.24, 95% CI: 1.34-3.74], habit of eating raw vegetables [AOR=2.26, 95% CI: 1.30-3.92] were associated with IPI as compared to their counterparts. Conclusions: Nearly half of the pregnant women were infected with IPs. The health facilities and clinicians need to focus on prevention of IPIs by early diagnosis, treating lake water before use, promote proper latrine utilization and provision of pertinent health education as part of ante-natal care service. It is important to minimize the impact of IPIs on pregnant women and their child.
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Affiliation(s)
- Demelash Wachamo
- Department of Public Health, Hawassa College of Health Sciences, Hawassa, Sidama National Regional State, 84, Ethiopia
| | - Fisseha Bonja
- Medical Laboratory, College of Medicine and Health Sciences, Hawassa University, Hawassa, Sidama National Regional State, 1015, Ethiopia
| | - Bamlaku Tadege
- Medical Laboratory, College of Medicine and Health Sciences, Hawassa University, Hawassa, Sidama National Regional State, 1015, Ethiopia
| | - Siraj Hussen
- Medical Laboratory, College of Medicine and Health Sciences, Hawassa University, Hawassa, Sidama National Regional State, 1015, Ethiopia
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Ness TE, Agrawal V, Bedard K, Ouellette L, Erickson TA, Hotez P, Weatherhead JE. Maternal Hookworm Infection and Its Effects on Maternal Health: A Systematic Review and Meta-Analysis. Am J Trop Med Hyg 2020; 103:1958-1968. [PMID: 32840198 DOI: 10.4269/ajtmh.20-0503] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Hookworm is an intestinal parasite that infects nearly 230 million people, with another 5.1 billion at risk, especially in poverty-stricken tropical and subtropical regions. Pregnancy is an especially vulnerable time for hookworm infection because of its effect on both maternal and subsequently fetal health. A systematic review and meta-analysis was conducted. The meta-analysis was performed on the association between maternal hookworm and maternal anemia, as well as maternal hookworm coinfection with malaria. The prevalence of hookworm ranged from 1% to 78% in pregnant women, whereas malaria prevalence ranged from 11% to 81%. Pregnant women with hookworm infection were more likely to have anemia (combined odds ratio [cOR] 2.55 [2.20, 2.96], P < 0.001). In addition, pregnant woman with hookworm were more likely to have malaria coinfection (cOR 1.60 [1.38, 1.86], P < 0.001). Other effects on maternal and child health were investigated and summarized without systematic review or meta-analysis because of the limited study numbers. Despite current deworming recommendations in pregnant women, heavy hookworm burden, coinfection with malaria, and subsequent anemia persist. Although this is likely due, in part, to a lack of implementation of preventive chemotherapy, additional interventions such as health education, proper waste management, or linking malaria and soil-transmitted helminth treatment and prevention programs may also be needed. Further investigations on maternal-child outcomes as a result of hookworm infection during pregnancy will highlight public health interventional targets to reduce morbidity in pregnant women and children globally.
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Affiliation(s)
- Tara E Ness
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Vedika Agrawal
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Kathryn Bedard
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | | | - Timothy A Erickson
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Peter Hotez
- Department of Biology, Baylor University, Waco, Texas.,Hagler Institute for Advanced Study at Texas A&M University, College Station, Texas.,National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas.,Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jill E Weatherhead
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas.,Department of Medicine, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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Mohan S, Halle-Ekane G, Konje JC. Intestinal parasitic infections in pregnancy - A review. Eur J Obstet Gynecol Reprod Biol 2020; 254:59-63. [PMID: 32942076 DOI: 10.1016/j.ejogrb.2020.09.007] [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: 06/08/2020] [Revised: 08/31/2020] [Accepted: 09/04/2020] [Indexed: 11/17/2022]
Abstract
Intestinal parasitic infections are widespread worldwide and with increased global travel and transport of food, these are not entirely limited to traditionally endemic areas. The prevalence of parasitic infections in endemic areas among pregnant women ranges from 24 to 70 % with approximately 10 % of women having multiple parasites. Pregnancy with its increased nutritional demands and altered immunological defenses is an especially vulnerable time for acquiring parasitic infections, which may be associated with adverse outcomes such as anaemia, which in some cases may even contribute to mortality. The presence of a helminthic infections during pregnancy may also cause immunological effects that can contribute to maternal morbidity and mortality as well as affecting the maternal immune response and immune system function in the baby after birth. Mass administration of anthelminthic drug therapy has been applied in endemic areas but there is inconclusive evidence of its benefit in improving pregnancy outcomes, however, no safety concerns have been highlighted with the use of the recommended drugs for parasitic infections.
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Affiliation(s)
- Suruchi Mohan
- Department of Obstetrics, Sidra Medicine, PO Box 26999, Doha, Qatar.
| | - Gregory Halle-Ekane
- Department of Obstetrics/Gynaecology, Faculty of Health Sciences, University of Buea, Cameroon.
| | - Justin C Konje
- Department of Obstetrics, Sidra Medicine, PO Box 26999, Doha, Qatar.
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Prevalence and risk factors of intestinal parasitic infestations among preschool children in Sekota town, Waghimra zone, Ethiopia. BMC Pediatr 2019; 19:437. [PMID: 31722686 PMCID: PMC6854779 DOI: 10.1186/s12887-019-1774-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 10/07/2019] [Indexed: 11/23/2022] Open
Abstract
Background Intestinal parasitic infestations triggered considerable gastrointestinal morbidity, malnutrition, and mortality worldwide. In particular, young children in developing countries affected most. Helminthiasis infestation accounts for 10–20% of prevalence on preschool children worldwide. Unfortunately, small children below 5 years are uniquely susceptible to intestinal parasitic infestations in poor communities. This is because of children’s behavior like playing with soil and putting hand -to- mouth habit. Thus, the aim of this study was to assess the prevalence and risk factors of intestinal parasitic infestations among preschool children in Sekota town, Ethiopia. Methods A community-based cross-sectional study was carried out on 378 preschool children in Sekota town from February 15 – March 10/2019. Stool specimens were collected and examined for intestinal parasites using wet mount and formal ether concentration technique. The risk factors of intestinal parasites were assessed using a pretested structured questionnaire. The data were entered and analyzed using Epi-data version 4.2.0.0 and SPSS-version 23 statistical software respectively. Both bivariable and multivariable analysis was carried out, and potential co-linearity was tested for closely similar variables. Variables with P value less than 0.05 in multivariable analysis was considered as statistically significant and reported with 95% CI and odds ratio. Results The prevalence of intestinal parasitic infestations in Sekota town on wet mount and formal ether concentration techniques was 83(21.9%), (95% CI, 17.7–26.3%) and 113(29.9%), (95% CI, 25.1–34.8%) respectively. In multivariable analysis, not taking medication as periodical deworming (AOR, 95% CI), (2.5, 1.5–4.3), presence of animals in the living room (AOR, 95% CI) (3.1, 1.8–5.3), and being a government employee as an occupation (AOR, 95% CI), (3.4, 1.1–10.0) were increasing the odds of intestinal parasitic infestations. Conclusions The prevalence of intestinal parasitic infestations in Sekota town is high, which is a public health problem. The risk factors that contributed to intestinal parasitic infestations in this study were preventable and modifiable. Therefore, the concerned bodies need to emphasis on periodical deworming and keeping animals in separate room.
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Yesuf DA, Abdissa LT, Gerbi EA, Tola EK. Prevalence of intestinal parasitic infection and associated factors among pregnant women attending antenatal care at public health facilities in Lalo Kile district, Oromia, Western Ethiopia. BMC Res Notes 2019; 12:735. [PMID: 31703749 PMCID: PMC6839149 DOI: 10.1186/s13104-019-4781-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 11/01/2019] [Indexed: 08/30/2023] Open
Abstract
OBJECTIVE This study aimed to assess the prevalence of intestinal parasitic infection and associated factors among pregnant women attending antenatal care at public health facilities in Lalo Kile district, Oromia, Western Ethiopia. RESULTS Out of the 315 respondents, the mean age was 24.7 ± 2.54 years ranging between 15 and 44 years. The majority of the respondents were Oromo in ethnicity (90.2%) and protestant in religion (83.2%) and almost all (99%) of the study participants were married. Two hundred twenty-six (72%) of pregnant women were attended at least primary school and two hundred forty-six (78.1%) of the respondents were from farmer households. About half of the households (51.7%) had a monthly income of greater than 35 USD. The overall prevalence of intestinal parasitic infection was 138 (43.8%) with the predominance of hookworm (33.7%) followed by Ascaris lumbricoides (7.3%). Being a farmer [AOR, 95% CI 7.3 (1.46, 37.00), P = 0.03], walking barefooted [AOR, 95% CI 6.13 (1.98, 19.00), P = 0.002] and absence of proper handwashing after latrine [AOR, 95% CI 5.36 (1.78, 16.00), P = 0.003] were significantly associated with occurrence of the intestinal parasitic infection.
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Affiliation(s)
| | - Lensa Tesfaye Abdissa
- Department of Medical Laboratory Science, Institute of Health Science, Wollega University, Nekemte, Ethiopia
| | - Emiru Adeba Gerbi
- Department of Public Health, Institute of Health Science, Wollega University, Nekemte, Ethiopia
| | - Edosa Kifle Tola
- Department of Medical Laboratory Science, Institute of Health Science, Wollega University, Nekemte, Ethiopia.
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Avokpaho E, d'Almeida TC, Sadissou I, Tokplonou L, Adamou R, Sonon P, Milet J, Cottrell G, Mondière A, Massougbodji A, Moutairou K, Donadi EA, Teixeira Mendes Junior C, Favier B, Carosella E, Moreau P, Rouas-Freiss N, Garcia A, Courtin D. HLA-G expression during hookworm infection in pregnant women. Acta Trop 2019; 196:52-59. [PMID: 31078470 DOI: 10.1016/j.actatropica.2019.04.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 01/25/2023]
Abstract
INTRODUCTION HLA-G plays a key role on immune tolerance. Pathogens can induce soluble HLA-G (sHLA-G) production to down-regulate the host immune response, creating a tolerogenic environment favorable for their dissemination. To our knowledge, no study has yet been conducted to assess the relationship between sHLA-G and geohelminth infections. METHODS The study was conducted in Allada, Southeastern Benin, from 2011-2014. The study population encompassed 400 pregnant women, included before the end of the 28th week of gestation and followed-up until delivery. At two antenatal care visits and at delivery, stool and blood samples were collected. Helminths were diagnosed by means of the Kato-Katz concentration technique. We used quantile regression to analyze the association between helminth infections and sHLA-G levels during pregnancy. RESULTS sHLA-G levels gradually increased during pregnancy and reached maximal levels at delivery. Prevalence of helminth infections was low, with a majority of hookworm infections. We found significantly more hookworm-infected women above the 80th quantile (Q80) of the distribution of the mean sHLA-G level (p < 0.03, multivariate quantile regression). Considering only women above the Q80 percentile, the mean sHLA-G level was significantly higher in hookworm-infected compared to uninfected women (p = 0.04). CONCLUSION High levels of sHLA-G were associated with hookworm infection in pregnant women. This result is consistent with the potential involvement of sHLA-G in immune tolerance induced by helminths during pregnancy.
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Affiliation(s)
- Euripide Avokpaho
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Tania C d'Almeida
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Ibrahim Sadissou
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France; Université d'Abomey-Calavi, Cotonou, Benin; Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Léonidas Tokplonou
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France; Université d'Abomey-Calavi, Cotonou, Benin
| | - Rafiou Adamou
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France; Université d'Abomey-Calavi, Cotonou, Benin
| | - Paulin Sonon
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France; Université d'Abomey-Calavi, Cotonou, Benin; Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Jacqueline Milet
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Gilles Cottrell
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Amandine Mondière
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | | | | | - Eduardo A Donadi
- Division of Clinical Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Celso Teixeira Mendes Junior
- Department of Chemistry, Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo, Brazil
| | - Benoit Favier
- CEA, Institut des Maladies Emergentes et des Thérapies Innovantes (IMETI), Service de Recherche en Hémato-Immunologie (SRHI), Hôpital Saint-Louis, IUH, Paris, France; Université Paris Diderot, Sorbonne Paris Cite, IUH, Hôpital Saint-Louis, UMRE5, IUH, Paris, France
| | - Edgardo Carosella
- CEA, Institut des Maladies Emergentes et des Thérapies Innovantes (IMETI), Service de Recherche en Hémato-Immunologie (SRHI), Hôpital Saint-Louis, IUH, Paris, France; Université Paris Diderot, Sorbonne Paris Cite, IUH, Hôpital Saint-Louis, UMRE5, IUH, Paris, France
| | - Philippe Moreau
- CEA, Institut des Maladies Emergentes et des Thérapies Innovantes (IMETI), Service de Recherche en Hémato-Immunologie (SRHI), Hôpital Saint-Louis, IUH, Paris, France; Université Paris Diderot, Sorbonne Paris Cite, IUH, Hôpital Saint-Louis, UMRE5, IUH, Paris, France
| | - Nathalie Rouas-Freiss
- CEA, Institut des Maladies Emergentes et des Thérapies Innovantes (IMETI), Service de Recherche en Hémato-Immunologie (SRHI), Hôpital Saint-Louis, IUH, Paris, France; Université Paris Diderot, Sorbonne Paris Cite, IUH, Hôpital Saint-Louis, UMRE5, IUH, Paris, France
| | - André Garcia
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - David Courtin
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France.
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Espinosa Aranzales AF, Radon K, Froeschl G, Pinzón Rondón ÁM, Delius M. Prevalence and risk factors for intestinal parasitic infections in pregnant women residing in three districts of Bogotá, Colombia. BMC Public Health 2018; 18:1071. [PMID: 30157817 PMCID: PMC6114175 DOI: 10.1186/s12889-018-5978-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 08/17/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Intestinal parasitic infections (IPI) lead to significant morbidity and mortality in pediatric and adult populations worldwide. Intestinal parasitism during pregnancy is of interest as it may affect the health of pregnant women and their offspring. This study determined the prevalence of IPI in pregnant women living in substandard conditions in three urban districts of Bogotá, Colombia. Associations between prevalence and sociodemographic factors, housing, and living conditions were also evaluated. METHODS In a cross-sectional and community-based study, pregnant women were recruited from three districts of Bogotá. A total of 550 participants answered a questionnaire; 331 of these also provided stool samples, with 233 providing one and 98 providing two stool samples. Questionnaire responses were associated with the presence of intestinal parasites, which was determined using a standard combined microscopy technique including direct wet mount and formol-ether concentration. Results were verified by supplementary examination of 48 stool samples by quantitative polymerase chain reaction (qPCR). RESULTS Among pregnant women who lived in selected poor residential areas in Bogotá, the overall prevalence of intestinal parasitism was 41% with 9% polyparasitism. Pathogenic parasites were present in 1.2% of the 331 participants including Giardia lamblia and Ascaris lumbricoides. Higher prevalence was found for parasites with debated pathogenicity, including Blastocystis hominis (25%), Endolimax nana (15%), Entamoeba coli (8%), and Iodamoeba butschlii (2%). Entamoeba histolytica/dispar complex was also detected (1.5%). When comparing a subset of stool samples using the combined microscopy technique and qPCR, the latter detected a higher 58.3% overall IPI prevalence. Higher prevalence of infections by any intestinal parasite was found in participants who had never been dewormed (p = 0.01). Higher but not statistically significant associations were found between any parasite and women living with a partner, and intestinal polyparasitism and being from a minority group and not having a water sink. CONCLUSIONS This first study of the prevalence of intestinal parasitism in Bogotá focused on pregnant women living in poverty, found a high prevalence of intestinal parasites of debated pathogenicity, and confirmed a low prevalence of pathogenic intestinal parasites. These results highlight the need for educational interventions to disrupt transmission routes for prevalent parasites.
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Affiliation(s)
- Angela Fernanda Espinosa Aranzales
- Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Center for International Health, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Katja Radon
- Center for International Health, Medical Center of the University of Munich (LMU), Munich, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Guenter Froeschl
- Center for International Health, Medical Center of the University of Munich (LMU), Munich, Germany
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | | | - Maria Delius
- Center for International Health, Medical Center of the University of Munich (LMU), Munich, Germany
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
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Feleke BE, Jember TH. Prevalence of helminthic infections and determinant factors among pregnant women in Mecha district, Northwest Ethiopia: a cross sectional study. BMC Infect Dis 2018; 18:373. [PMID: 30081837 PMCID: PMC6080381 DOI: 10.1186/s12879-018-3291-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 08/01/2018] [Indexed: 11/10/2022] Open
Abstract
Background Intestinal parasites are the most common infections in developing countries. Prevalence and impacts of these parasites are high in pregnant women. The aims of this study were to determine prevalence of helminthic infection and evaluate the determinant factors during pregnancy. Methods A cross-sectional study was conducted in Mecha district from November 2015 to January 2016. The data were collected by interview technique and collecting the stool sample from each pregnant woman. Descriptive statistics and binary logistic regression were used. Results A total of 783 pregnant women were included. The prevalence of intestinal parasite among pregnant women was 70.6% [95% CI 67 -74%]. Ascaris lumbricoides (32.7%) was the predominant intestinal parasite species. Intestinal parasitic infection were 2.94 folds higher in the absence of latrine (AOR: 2.94 [95% CI: 1.5–5.8]). Absence of regular hand washing habit increase the odds of infection by 3.33 folds higher (AOR: 3.33 [95% CI: 1.54–7.14]). Not wearing shoe increased the odds of helminthic infection by 6.87 folds higher (AOR: 6.87 [95% CI: 3.67–12.9]). Illiteracy increases the odds of intestinal parasitic infection by 2.32 folds higher (AOR: 2.32 [95% CI: 1.04–5.26]). Ingestion of raw vegetables increases the odds of intestinal parasitic infection by 2.65 folds higher (AOR: 2.65 [95% CI: 3.23–9.9]). The odds of intestinal parasitic infection were higher in rural areas (AOR: 2 [95% CI: 5–10]). Intestinal parasitic infection was higher in women aged less than 21 years (AOR: 6.48 [95% CI: 2.91–14.4]). Conclusion The prevalence of helminthic infection is high in this study. Latrine utilization, hand washing habit, eating raw vegetables and bare foot were the major determinant factors for the high prevalence. Therefore, health education and improvements in sanitary infrastructure could achieve long-term and sustainable reductions in helminth prevalence.
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Affiliation(s)
- Berhanu Elfu Feleke
- Department of Epidemiology and Biostatistics, University of Bahir Dar, Bahir Dar, Ethiopia.
| | - Tadesse Hailu Jember
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Lo AC, Faye B, Gyan BA, Amoah LE. Plasmodium and intestinal parasite perturbations of the infected host's inflammatory responses: a systematic review. Parasit Vectors 2018; 11:387. [PMID: 29970128 PMCID: PMC6031113 DOI: 10.1186/s13071-018-2948-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 06/12/2018] [Indexed: 01/03/2023] Open
Abstract
Co-infection of malaria and intestinal parasites is widespread in sub-Saharan Africa and causes severe disease especially among the poorest populations. It has been shown that an intestinal parasite (helminth), mixed intestinal helminth or Plasmodium parasite infection in a human induces a wide range of cytokine responses, including anti-inflammatory, pro-inflammatory as well as regulatory cytokines. Although immunological interactions have been suggested to occur during a concurrent infection of helminths and Plasmodium parasites, different conclusions have been drawn on the influence this co-infection has on cytokine production. This review briefly discusses patterns of selected cytokine (IL-6, IL-8, IL-10, TNF-α and INF-γ) responses associated with infections caused by Plasmodium, intestinal parasites as well as a Plasmodium-helminth co-infection.
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Affiliation(s)
- Aminata Colle Lo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.,University Cheikh Anta DIOP, Dakar, Senegal
| | | | - Ben Adu Gyan
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Linda Eva Amoah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
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Zheng X, Lin M, Xie DD, Li J, Chen JT, Eyi UM, Monte-Nguba SM, Ehapo JCS, Yang H, Yang HT, Yang LY. Prevalence of HIV and malaria: a cross-sectional study on Bioko Island, Equatorial Guinea. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2017; 16:65-70. [PMID: 28367743 DOI: 10.2989/16085906.2016.1257495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Malaria and HIV are two of the most severe public health problems in Africa. However, epidemiological data on Bioko Island is scarce. To investigate the prevalence of malaria and HIV infections and assess association of malaria and HIV infections and possible confounding factors, we performed a cross-sectional survey of people of malaria-endemic Bioko Island, Equatorial Guinea. A cross-sectional study of 1 526 subjects was carried out to determine the prevalence of malaria and HIV infection in Malabo region hospital on Bioko Island. Questionnaires were administered and venous blood samples were drawn for malaria parasites and HIV detection. The prevalence of participants infected with malaria and HIV in this area were 13.8% and 6.6% respectively. The average prevalence of co-infection for malaria and HIV was 0.92%. HIV-infection was significantly associated with the age and gender. Malaria infections were significantly associated with the age. This study showed that the prevalence of HIV and malaria on Bioko Island was higher than expected, although the co-infection prevalence of malaria and HIV was low. The results also indicated that malaria and HIV infections lead to more public health risk to youngsters and women.
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Affiliation(s)
- Xiangbin Zheng
- a Central Laboratory , Chaozhou Central Hospital Affiliated to Southern Medical University , Chaozhou , Guangdong , People's Republic of China
| | - Min Lin
- a Central Laboratory , Chaozhou Central Hospital Affiliated to Southern Medical University , Chaozhou , Guangdong , People's Republic of China
| | - Dong-De Xie
- b Laboratory Medical Center , The People's Hospital of Jiangmen , Jiangmen , Guangdong , People's Republic of China.,c The Chinese medical aid team to the Republic of Equatorial Guinea , Guangzhou , Guangdong Province , People's Republic of China
| | - Jian Li
- d Department of Parasitology , College of Basic Medicine, Hubei University of Medicine , Shiyan , Hubei , People's Republic of China
| | - Jiang-Tao Chen
- c The Chinese medical aid team to the Republic of Equatorial Guinea , Guangzhou , Guangdong Province , People's Republic of China.,e Laboratory Medical Center , Huizhou Municipal Central People's Hospital , Guangdong, Huizhou , Guangdong , People's Republic of China
| | - Urbano Monsuy Eyi
- f Central Blood Transfusion Service , Malabo Regional Hospital , Malabo , Republic of Equatorial Guinea
| | - Santiago-M Monte-Nguba
- g Medical Laboratory , Malabo Regional Hospital , Malabo , Republic of Equatorial Guinea
| | - Juan Carlos Sala Ehapo
- g Medical Laboratory , Malabo Regional Hospital , Malabo , Republic of Equatorial Guinea
| | - Hui Yang
- a Central Laboratory , Chaozhou Central Hospital Affiliated to Southern Medical University , Chaozhou , Guangdong , People's Republic of China
| | - Hui-Tian Yang
- a Central Laboratory , Chaozhou Central Hospital Affiliated to Southern Medical University , Chaozhou , Guangdong , People's Republic of China
| | - Li-Ye Yang
- a Central Laboratory , Chaozhou Central Hospital Affiliated to Southern Medical University , Chaozhou , Guangdong , People's Republic of China
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Tay SCK, Nani EA, Walana W. Parasitic infections and maternal anaemia among expectant mothers in the Dangme East District of Ghana. BMC Res Notes 2017; 10:3. [PMID: 28057071 PMCID: PMC5217638 DOI: 10.1186/s13104-016-2327-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 12/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parasitic infections are of public health concern globally, particular among at risk groups such as pregnant women in developing countries. The presence of these parasites during pregnancy potentiate adverse effects to both the mother and the unborn baby. This study sought to establish the prevalence of some parasitic agents among antenatal attendees in the Dangme East District of Ghana. A cross-sectional prospective study was conduct between April and July, 2012. Venous blood specimens were collected from each participant for haemoglobin estimation and malaria microscopy. In addition participants' early morning mid-stream urine and stool specimens were analyzed microscopically for parasitic agents. RESULTS A total of 375 pregnant women were involved in the study, of which anaemia was present in 66.4% (249/375). However, parasitic infections associated anaemia prevalence was 49.6% (186/375). In all, 186 cases of parasitic infections were observed; 171 (44.0%) were single isolated infections while 15 (4.0%) were co-infections. Plasmodium species were significantly associated with anaemia (13.3%, χ2 = 23.290, p < 0.001). Also, the presence of Schistosoma haematobium (3.7%, χ2 = 7.267, p = 0.008), Schistosoma mansoni (5.3%, χ2 = 5.414, p = 0.023) and hookworm (3.7%, χ2 = 11.267, p = 0.008) were significantly associated with anaemia in pregnancy. Except where co-infections exist (3.7%, χ2 = 11.267, p = 0.001), the rest of the single infections were insignificantly associated with anaemia. Collectively, intestinal helminthes were predominantly significant with anaemia in pregnancy (p = 0.001, χ2 = 107.800). CONCLUSION The study revealed relatively high prevalence of parasitic infections among the study population, suggesting that about three-quarters of the anaemic mothers are either single or co-infected with parasitic agents.
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Affiliation(s)
- Samuel Crowther Kofi Tay
- Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Agbeko Nani
- Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Williams Walana
- Department of Clinical Microbiology, School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana.
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Macheka LR, Olowoyo JO, Matsela L, Khine AA. Prevalence of geophagia and its contributing factors among pregnant women at Dr. George Mukhari Academic Hospital, Pretoria. Afr Health Sci 2016; 16:972-978. [PMID: 28479889 DOI: 10.4314/ahs.v16i4.13] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Geophagia is very common among pregnant women, particularly in Africa. There are many reasons given for geophagia such as cultural, medicinal and religious, making it an acceptable norm regardless of health risks involved. OBJECTIVES The study explored prevalence and factors influencing geophagia among women visiting an antenatal clinic in Pretoria. METHODS A quantitative survey was done on a convenience sample of 597 pregnant women and structured interviews conducted. Statistical analysis was done using simple percentage and interview data analyzed using Epi Info statistical software. RESULTS Geophagia was reported by 54.0% of the women (n=323) and of these, 75.2% (n=243) ate at least 3 teaspoons per day. Reasons for the practice ranged from simple unexplained craving to belief that soil acts as an iron supplement. The study revealed that education levels did not act as a contributing factor as both literate and illiterate women were consumers. Partners of consumers played a key role in influencing the practice as most consumers were not married. CONCLUSION Geophagia is practiced by a considerable proportion of pregnant women in this area. Greater vigilance may be needed as part of the antenatal classes to avoid potentially harmful effects of the habit.
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Affiliation(s)
- L R Macheka
- Sefako Makgatho Health Sciences University, Biology
| | - J O Olowoyo
- Sefako Makgatho Health Sciences University, Biology
| | - L Matsela
- Sefako Makgato Health Sciences University, Obstetrics and Gynaecology
| | - A A Khine
- Sefako Makgato Health Sciences University, Chemical Pathology
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Derso A, Nibret E, Munshea A. Prevalence of intestinal parasitic infections and associated risk factors among pregnant women attending antenatal care center at Felege Hiwot Referral Hospital, northwest Ethiopia. BMC Infect Dis 2016; 16:530. [PMID: 27716099 PMCID: PMC5045606 DOI: 10.1186/s12879-016-1859-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 09/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parasitic infections affect tens of millions of pregnant women worldwide, and directly or indirectly lead to a spectrum of adverse maternal and fetal/placental effects. The objective of this study was to assess the prevalence of intestinal parasite infections and associated risk factors among pregnant women attending antenatal care center in Felege Hiwot Referral Hospital, Bahir Dar city, northwest Ethiopia. METHODS A cross-sectional hospital based study was conducted from November 2013 to January 2014 among 384 pregnant women. Stool samples were examined for the presence of trophozoites, cysts, oocysts, and ova using direct, formal-ether sedimentation, and modified Ziehl-Neelsen techniques. RESULTS An overall prevalence of 31.5 % intestinal parasite infections was recorded. Eight different species of intestinal parasites were found: two protozoan and six helminth species. The highest prevalence was due to Giardia lamblia (13.3 %) followed by Entamoeba histolytica/dispar (7.8 %), hookworm (5.5 %), Ascaris lumbricoides (2.9 %), Schistosoma mansoni (2.9 %), Strongyloides stercoralis (1.6 %), Taenia spp. (0.8 %), and Hymenolepis nana (0.3 %). CONCLUSIONS A relatively high prevalence of intestinal parasite infections was observed among pregnant women. Routine stool examination and provision of health education are required for early medical intervention that would affect the pregnant mothers and their foetuses.
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Affiliation(s)
- Adane Derso
- Department of Biology, College of Science, Bahir Dar University, P.O.Box 79, Bahir Dar, Ethiopia
| | - Endalkachew Nibret
- Department of Biology, College of Science, Bahir Dar University, P.O.Box 79, Bahir Dar, Ethiopia.
| | - Abaineh Munshea
- Department of Biology, College of Science, Bahir Dar University, P.O.Box 79, Bahir Dar, Ethiopia
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Campbell SJ, Nery SV, Doi SA, Gray DJ, Soares Magalhães RJ, McCarthy JS, Traub RJ, Andrews RM, Clements ACA. Complexities and Perplexities: A Critical Appraisal of the Evidence for Soil-Transmitted Helminth Infection-Related Morbidity. PLoS Negl Trop Dis 2016; 10:e0004566. [PMID: 27196100 PMCID: PMC4873196 DOI: 10.1371/journal.pntd.0004566] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Soil-transmitted helminths (STH) have acute and chronic manifestations, and can result in lifetime morbidity. Disease burden is difficult to quantify, yet quantitative evidence is required to justify large-scale deworming programmes. A recent Cochrane systematic review, which influences Global Burden of Disease (GBD) estimates for STH, has again called into question the evidence for deworming benefit on morbidity due to STH. In this narrative review, we investigate in detail what the shortfalls in evidence are. METHODOLOGY/PRINCIPAL FINDINGS We systematically reviewed recent literature that used direct measures to investigate morbidity from STH and we critically appraised systematic reviews, particularly the most recent Cochrane systematic review investigating deworming impact on morbidity. We included six systematic reviews and meta-analyses, 36 literature reviews, 44 experimental or observational studies, and five case series. We highlight where evidence is insufficient and where research needs to be directed to strengthen morbidity evidence, ideally to prove benefits of deworming. CONCLUSIONS/SIGNIFICANCE Overall, the Cochrane systematic review and recent studies indicate major shortfalls in evidence for direct morbidity. However, it is questionable whether the systematic review methodology should be applied to STH due to heterogeneity of the prevalence of different species in each setting. Urgent investment in studies powered to detect direct morbidity effects due to STH is required.
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Affiliation(s)
- Suzy J. Campbell
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
| | - Susana V. Nery
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
| | - Suhail A. Doi
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
| | - Darren J. Gray
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Ricardo J. Soares Magalhães
- Children's Health and Environment Program, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Queensland, Australia
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - James S. McCarthy
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Rebecca J. Traub
- Faculty of Veterinary and Agricultural Science, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ross M. Andrews
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Archie C. A. Clements
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
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Epidemiology of Plasmodium and Helminth Coinfection and Possible Reasons for Heterogeneity. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3083568. [PMID: 27092310 PMCID: PMC4820611 DOI: 10.1155/2016/3083568] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 03/05/2016] [Accepted: 03/08/2016] [Indexed: 12/27/2022]
Abstract
Understanding the impact of helminth infections on clinical malaria is useful for designing effective malaria control strategies. Plenty of epidemiological studies have been conducted to unravel the nature of interactions between Plasmodium and helminth infection. Careful broad summarization of the existing literature suggests that Schistosoma mansoni and hookworm infections may increase the risk of clinical malaria and associated morbidities, but Trichuris trichiura infection is not associated with the occurrence of clinical malaria and related outcomes. However, findings about effect of Ascaris lumbricoides and Schistosoma haematobium infection on clinical malaria are contradictory. Furthermore, the nature of relationship of helminth infection with severe malaria has also not been determined with certainty. This review summarizes the findings of epidemiological studies of Plasmodium and helminth coinfection, placing greater emphasis on the impact of the coinfection on malaria. Possible reasons for the heterogeneity of the findings on malaria and helminth coinfections are also discussed.
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Naing C, Whittaker MA, Nyunt-Wai V, Reid SA, Wong SF, Mak JW, Tanner M. Malaria and soil-transmitted intestinal helminth co-infection and its effect on anemia: a meta-analysis. Trans R Soc Trop Med Hyg 2015; 107:672-83. [PMID: 24123127 DOI: 10.1093/trstmh/trt086] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
This study aimed to synthesize available evidence on the extent of malaria and soil-transmitted intestinal helminth (STH) co-infections in people living in endemic countries and to explore the effect of interactions between malaria and STHs on anemia. We searched relevant studies in electronic databases up to March 2013. Studies comparing malaria and STH co-infected patients with those not co-infected were included and the effect estimates were pooled using a random-effects model. We identified 30 studies for meta-analyses of which 17 were cross-sectional design. The majority of included studies (80%) were carried out in African countries. Among pregnant women, those infected with hookworm were found to have higher association with malaria infection compared with those without (summary OR: 1.36; 95% CI: 1.17-1.59; I(2): 0%). Among non-pregnant adults, the summary OR of the association between anemia and the combined malaria and STH was 2.91 (1.38-6.14). The summary OR of the association between anemia and malaria alone was 1.53 (0.97-2.42), while the association between anemia and STH alone was 0.28 (0.04-1.95). There is no good evidence to support a different effect of malaria and STH on anemia. A subgroup analysis showed a higher risk of malaria infection in the primigravidae (summary OR: 1.61; 95% CI: 1.3-1.99; I(2): 0%). In conclusion, the malaria-STH co-infection was variable with complex outcomes on anemia.
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Affiliation(s)
- Cho Naing
- School of Population Health, University of Queensland, Queensland 4006, Australia
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Mpairwe H, Tweyongyere R, Elliott A. Pregnancy and helminth infections. Parasite Immunol 2014; 36:328-37. [PMID: 24471654 PMCID: PMC4260141 DOI: 10.1111/pim.12101] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 01/22/2014] [Indexed: 01/13/2023]
Abstract
It has been proposed that helminth infection may be particularly detrimental during pregnancy, through adverse effects on maternal anaemia and on birth outcomes, and that anthelminthic treatment during pregnancy will therefore be particularly beneficial. However, the few treatment trials that have been conducted have given, but little support to this notion and further trials in settings of nutritional stress are needed. It has also been proposed that prenatal exposure to helminth infection has an important effect on the development of the foetal immune response. There is evidence that this may impact, long-term, upon responses to helminth and nonhelminth antigens, and to allergens. Exposure to helminths in utero may also have nonspecific effects that may modify the offspring's susceptibility to diseases mediated by inflammation, including metabolic disorders. The mechanisms of such effects are not known, but they deserve to be explored as current epidemiological findings suggest the possibility of primary prevention for inflammatory conditions such as allergy, through intervention during pregnancy.
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Affiliation(s)
- H Mpairwe
- MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda
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Straubinger K, Prazeres da Costa C. Maternal helminth infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 828:27-48. [PMID: 25253026 DOI: 10.1007/978-1-4939-1489-0_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- Kathrin Straubinger
- Department of Parasitology, Institute of Medical Microbiology, Immunology and Hygiene, Technische Universität München, Trogerstrasse 30, 81675, Munich, Germany,
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Casmo V, Augusto G, Nala R, Sabonete A, Carvalho-Costa FA. The effect of hookworm infection and urinary schistosomiasis on blood hemoglobin concentration of schoolchildren living in northern Mozambique. Rev Inst Med Trop Sao Paulo 2014; 56:219-24. [PMID: 24879000 PMCID: PMC4085861 DOI: 10.1590/s0036-46652014000300007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 10/17/2013] [Indexed: 11/21/2022] Open
Abstract
This study aims to assess the association between schistosomiasis and hookworm infection with hemoglobin levels of schoolchildren in northern Mozambique. Through a cross-sectional survey, 1,015 children from five to 12 years old in the provinces of Nampula, Cabo Delgado and Niassa were studied. Hookworm infection and urinary schistosomiasis were diagnosed, through Ritchie and filtration methods, with a prevalence of 31.3% and 59.1%, respectively. Hemoglobin levels were obtained with a portable photometer (Hemocue®). The average hemoglobin concentration was 10.8 ± 1.42 g/dL, and 62.1% of the children presented levels below 11.5 g/dL, of which 11.8% of the total number of children had hemoglobin levels below 9 g/dL. A multiple linear regression analysis demonstrated negative interactions between hemoglobin levels and ancylostomiasis, this being restricted to the province of Cabo Delgado (β = -0.55; p < 0.001) where an independent interaction between hemoglobin levels and urinary schistosomiasis was also observed (β = -0.35; p = 0.016). The logistical regression model indicated that hookworm infection represents a predictor of mild (OR = 1.87; 95% CI = 1.17-3.00) and moderate/severe anemia (OR = 2.71; 95% CI = 1.50 - 4.89). We concluded that, in the province of Cabo Delgado, hookworm and Schistosoma haematobium infections negatively influence hemoglobin levels in schoolchildren. Periodical deworming should be considered in the region. Health education and improvements in sanitary infrastructure could achieve long-term and sustainable reductions in soil-transmitted helminthiases and schistosomiasis prevalence rates.
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Affiliation(s)
- Verónica Casmo
- Laboratório de Parasitologia Intestinal e Vesical do Instituto Nacional de Saúde de Moçambique, Cidade de Maputo, Moçambique
| | - Gerito Augusto
- Laboratório de Parasitologia Intestinal e Vesical do Instituto Nacional de Saúde de Moçambique, Cidade de Maputo, Moçambique
| | - Rassul Nala
- Laboratório de Parasitologia Intestinal e Vesical do Instituto Nacional de Saúde de Moçambique, Cidade de Maputo, Moçambique
| | - Acácio Sabonete
- Laboratório de Parasitologia Intestinal e Vesical do Instituto Nacional de Saúde de Moçambique, Cidade de Maputo, Moçambique
| | - Filipe Anibal Carvalho-Costa
- Laboratório de Epidemiologia e Sistemática Molecular/Laboratório de Virologia Comparada e Ambiental, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Intestinal helminth infections in pregnant women attending antenatal clinic at kitale district hospital, kenya. J Parasitol Res 2014; 2014:823923. [PMID: 24971167 PMCID: PMC4058276 DOI: 10.1155/2014/823923] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 05/04/2014] [Accepted: 05/05/2014] [Indexed: 11/30/2022] Open
Abstract
Intestinal helminth infections during pregnancy are associated with adverse outcomes including low birth weight and prenatal mortality. The infections are a major public health problem in developing countries. A hospital based survey was undertaken for six months to determine the infection prevalence, intensity, and risk factors. The study involved expectant women attending antenatal clinic. Stool samples were screened microscopically for helminth ova using Kato Katz technique. Information on risk factors was collected using semistructured questionnaire and analyzed using SPSS. Epidemiological data was analysed using descriptive statistics and multivariate analysis. The overall prevalence of infection was 21 (13.8%). Ascariasis was the most prevalent 10 (6.5%), hookworm infection was 6 (3.9%), and trichuriasis was 2 (1.3%). Pregnant women aged below 29 years (OR = 3.63, CI = 0.87–11.75) and those with primary level of education (OR = 3.21, CI = 0.88–11.75) were at a higher risk of infection compared to those aged ≥ 29 years with secondary level of education. Hand washing was significantly associated with reduced likelihood of infection (OR = 0.18, 95% CI = 0.06–0.57). It was concluded that intestinal helminth infections were prevalent among pregnant women. We recommended that all expectant women visiting antenatal clinics be screened for intestinal helminth infections and positive cases be advised to seek treatment.
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The association of parasitic infections in pregnancy and maternal and fetal anemia: a cohort study in coastal Kenya. PLoS Negl Trop Dis 2014; 8:e2724. [PMID: 24587473 PMCID: PMC3937317 DOI: 10.1371/journal.pntd.0002724] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 01/17/2014] [Indexed: 11/19/2022] Open
Abstract
Background Relative contribution of these infections on anemia in pregnancy is not certain. While measures to protect pregnant women against malaria have been scaling up, interventions against helminthes have received much less attention. In this study, we determine the relative impact of helminthes and malaria on maternal anemia. Methods A prospective observational study was conducted in coastal Kenya among a cohort of pregnant women who were recruited at their first antenatal care (ANC) visit and tested for malaria, hookworm, and other parasitic infections and anemia at enrollment. All women enrolled in the study received presumptive treatment with sulfadoxine-pyrimethamine, iron and multi-vitamins and women diagnosed with helminthic infections were treated with albendazole. Women delivering a live, term birth, were also tested for maternal anemia, fetal anemia and presence of infection at delivery. Principal Findings Of the 706 women studied, at the first ANC visit, 27% had moderate/severe anemia and 71% of women were anemic overall. The infections with highest prevalence were hookworm (24%), urogenital schistosomiasis (17%), trichuria (10%), and malaria (9%). In adjusted and unadjusted analyses, moderate/severe anemia at first ANC visit was associated with the higher intensities of hookworm and P. falciparum microscopy-malaria infections. At delivery, 34% of women had moderate/severe anemia and 18% of infants' cord hemoglobin was consistent with fetal anemia. While none of the maternal infections were significantly associated with fetal anemia, moderate/severe maternal anemia was associated with fetal anemia. Conclusions More than one quarter of women receiving standard ANC with IPTp for malaria had moderate/severe anemia in pregnancy and high rates of parasitic infection. Thus, addressing the role of co-infections, such as hookworm, as well as under-nutrition, and their contribution to anemia is needed. International guidelines recommend routine prevention and treatments which are safe and effective during pregnancy to reduce hookworm, malaria and other infections among pregnant women living in geographic areas where these infections are prevalent. Despite their effectiveness, programs to address common infections such as hookworm, schistosomiasis and malaria during pregnancy have not been widely adopted. Hookworm, malaria and other infections have been associated with anemia in children, but the studies on the impact of these infections on anemia in pregnancy have not been as clear. This study was undertaken to evaluate the prevalence of parasitic infections among women attending antenatal care which provided the nationally recommended malaria preventive treatment program in coastal Kenya. At the first ANC visit, more than 70% of women were anemic, nearly one-fourth had hookworm and about 10% had malaria. Women with high levels of hookworm or malaria infections were at risk of anemia.
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Ivan E, Crowther NJ, Mutimura E, Osuwat LO, Janssen S, Grobusch MP. Helminthic infections rates and malaria in HIV-infected pregnant women on anti-retroviral therapy in Rwanda. PLoS Negl Trop Dis 2013; 7:e2380. [PMID: 23967365 PMCID: PMC3744439 DOI: 10.1371/journal.pntd.0002380] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Accepted: 07/10/2013] [Indexed: 02/02/2023] Open
Abstract
Background Within sub-Saharan Africa, helminth and malaria infections cause considerable morbidity in HIV-positive pregnant women and their offspring. Helminth infections are also associated with a higher risk of mother-to-child HIV transmission. The aim of this study was to determine the prevalence of, and the protective and risk factors for helminth and malaria infections in pregnant HIV-positive Rwandan women receiving anti-retroviral therapy (ART). Methodology and principle findings Pregnant females (n = 980) were recruited from health centres in rural and peri-urban locations in the central and eastern provinces of Rwanda. Helminth infection was diagnosed using the Kato Katz method whilst the presence of Plasmodium falciparum was identified from blood smears. The prevalence of helminth infections was 34.3%; of malaria 13.3%, and of co-infections 6.6%. Helminth infections were more common in rural (43.1%) than peri-urban (18.0%; p<0.0005) sites. A CD4 count ≤350 cells/mm3 was associated with a higher risk of helminth infections (odds ratio, 3.39; 95% CIs, 2.16–5.33; p<0.0005) and malaria (3.37 [2.11–5.38]; p<0.0005) whilst helminth infection was a risk factor for malaria infection and vice versa. Education and employment reduced the risk of all types of infection whilst hand washing protected against helminth infection (0.29 [0.19–0.46]; p<0.0005);). The TDF-3TC-NVP (3.47 [2.21–5.45]; p<0.0005), D4T-3TC-NVP (2.47 [1.27–4.80]; p<0.05) and AZT-NVP (2.60 [1.33–5.08]; p<0.05) regimens each yielded higher helminth infection rates than the AZT-3TC-NVP regimen. Anti-retroviral therapy had no effect on the risk of malaria. Conclusion/significance HIV-positive pregnant women would benefit from the scaling up of de-worming programs alongside health education and hygiene interventions. The differential effect of certain ART combinations (as observed here most strongly with AZT-3TC-NVP) possibly protecting against helminth infection warrants further investigation. There is an overlap in the worldwide distribution of intestinal worms (helminths), malaria and HIV. Co-infections with helminth and malaria parasites cause a significant problem in the host, particularly in the presence of HIV infection. The aim of this study was to assess the prevalence of intestinal worm and malaria infection and co-infections and the associated risk factors among HIV-positive pregnant women that attended rural and peri-urban health centers in Rwanda. Our findings indicate that intestinal worms were more common among HIV-infected pregnant women in the rural than peri-urban settings. HIV-positive pregnant women who had lower CD4 cell counts were more at risk of being infected by intestinal worms and malaria. Malaria also increased the risk of being infected by intestinal worms and vice versa. Socio-economic factors such as lack of education and unemployment were among the risk factors for intestinal worm infections and malaria. Hand washing was found to reduce the risk for worm infections; whilst one particular ART combination (AZT-3TC-NVP) led to a reduced rate of helminth infections when compared to others.
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Affiliation(s)
- Emil Ivan
- Kigali Health Institute Department of Biomedical Laboratory Sciences, Kigali, Rwanda
- Rwanda Biomedical Centre National Reference Laboratory, Department of Laboratory Network, Kigali, Rwanda
- Department of Chemical Pathology, University of the Witwatersrand Medical School, National Health Laboratory Services, Parktown, Johannesburg, South Africa
| | - Nigel J. Crowther
- Department of Chemical Pathology, University of the Witwatersrand Medical School, National Health Laboratory Services, Parktown, Johannesburg, South Africa
| | - Eugene Mutimura
- Women Equity in Access to Care and Treatment (WE-ACTx), Kigali, Rwanda and Regional Alliance for Sustainable Development (RASD Rwanda), Kigali, Rwanda
| | - Lawrence Obado Osuwat
- Department of Medical Laboratory Science, School of Health Sciences, Mount Kenya University, Kigali, Rwanda
| | - Saskia Janssen
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Center of Tropical Medicine and Travel Medicine, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Martin P. Grobusch
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Center of Tropical Medicine and Travel Medicine, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- * E-mail:
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Desai M, Phillips-Howard PA, Odhiambo FO, Katana A, Ouma P, Hamel MJ, Omoto J, Macharia S, van Eijk A, Ogwang S, Slutsker L, Laserson KF. An analysis of pregnancy-related mortality in the KEMRI/CDC health and demographic surveillance system in western Kenya. PLoS One 2013; 8:e68733. [PMID: 23874741 PMCID: PMC3712942 DOI: 10.1371/journal.pone.0068733] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 05/31/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Pregnancy-related (PR) deaths are often a result of direct obstetric complications occurring at childbirth. METHODS AND FINDINGS To estimate the burden of and characterize risk factors for PR mortality, we evaluated deaths that occurred between 2003 and 2008 among women of childbearing age (15 to 49 years) using Health and Demographic Surveillance System data in rural western Kenya. WHO ICD definition of PR mortality was used: "the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death". In addition, symptoms and events at the time of death were examined using the WHO verbal autopsy methodology. Deaths were categorized as either (i) directly PR: main cause of death was ascribed as obstetric, or (ii) indirectly PR: main cause of death was non-obstetric. Of 3,223 deaths in women 15 to 49 years, 249 (7.7%) were PR. One-third (34%) of these were due to direct obstetric causes, predominantly postpartum hemorrhage, abortion complications and puerperal sepsis. Two-thirds were indirect; three-quarters were attributable to human immunodeficiency virus (HIV/AIDS), malaria and tuberculosis. Significantly more women who died in lower socio-economic groups sought care from traditional birth attendants (p = 0.034), while less impoverished women were more likely to seek hospital care (p = 0.001). The PR mortality ratio over the six years was 740 (95% CI 651-838) per 100,000 live births, with no evidence of reduction over time (χ(2) linear trend = 1.07; p = 0.3). CONCLUSIONS These data supplement current scanty information on the relationship between infectious diseases and poor maternal outcomes in Africa. They indicate low uptake of maternal health interventions in women dying during pregnancy and postpartum, suggesting improved access to and increased uptake of skilled obstetric care, as well as preventive measures against HIV/AIDS, malaria and tuberculosis among all women of childbearing age may help to reduce pregnancy-related mortality.
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Affiliation(s)
- Meghna Desai
- Malaria Branch, KEMRI/CDC Research and Public Health Collaboration, Kisumu, Kenya.
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Webuye Health and Demographic Surveillance Systems Baseline Survey of Soil-Transmitted Helminths and Intestinal Protozoa among Children up to Five Years. J Trop Med 2013; 2013:734562. [PMID: 23533444 PMCID: PMC3600298 DOI: 10.1155/2013/734562] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 01/23/2013] [Indexed: 11/18/2022] Open
Abstract
Background. The intestinal parasitic infections (IPIs) are globally endemic, and they constitute the greatest cause of illness and disease worldwide. Transmission of IPIs occurs as a result of inadequate sanitation, inaccessibility to potable water, and poor living conditions. Objectives. To determine a baseline prevalence of IPIs among children of five years and below at Webuye Health and Demographic Surveillance (HDSS) area in western Kenya. Methods. Cross-sectional survey was used to collect data. Direct saline and formal-ether-sedimentation techniques were used to process the specimens. Descriptive and inferential statistics such as Chi-square statistics were used to analyze the data. Results. A prevalence of 52.3% (417/797) was obtained with the male child slightly more infected than the female (53.5% versus 51%), but this was not significant (χ (2) = 0.482, P > 0.05). Giardia lamblia and Entamoeba histolytica were the most common pathogenic IPIs with a prevalence of 26.1% (208/797) and 11.2% (89/797), respectively. Soil-transmitted helminths (STHs) were less common with a prevalence of 4.8% (38/797), 3.8% (30/797), and 0.13% (1/797) for Ascaris lumbricoides, hookworms, and Trichuris trichiura, respectively. Conclusions. Giardia lamblia and E. histolytica were the most prevalent pathogenic intestinal protozoa, while STHs were less common. Community-based health promotion techniques are recommended for controlling these parasites.
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Dauby N, Goetghebuer T, Kollmann TR, Levy J, Marchant A. Uninfected but not unaffected: chronic maternal infections during pregnancy, fetal immunity, and susceptibility to postnatal infections. THE LANCET. INFECTIOUS DISEASES 2012; 12:330-40. [PMID: 22364680 DOI: 10.1016/s1473-3099(11)70341-3] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Chronic infections during pregnancy are highly prevalent in some parts of the world. Infections with helminths, Trypanosoma cruzi, Plasmodium spp, and HIV might affect the development of fetal immunity and susceptibility to postnatal infections independently of in-utero transmission of the pathogens. Fetal adaptive immune responses are common in neonates who have been exposed to maternal infection during pregnancy but not infected themselves. Such responses could affect the development of immunity to the homologous pathogens and their control during the first few years of life. Fetal innate and regulatory responses might also affect immunity to unrelated pathogens and responses to vaccines. Strategies to improve child health should integrate the possible clinical implications of in-utero exposure to chronic maternal infections.
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Affiliation(s)
- Nicolas Dauby
- Institute for Medical Immunology, Université Libre de Bruxelles, Charleroi, Belgium
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Roberts T, Gravett CA, Velu PP, Theodoratou E, Wagner TA, Zhang JSF, Campbell H, Rubens CE, Gravett MG, Rudan I. Epidemiology and aetiology of maternal parasitic infections in low- and middle-income countries. J Glob Health 2011. [PMID: 23198118 PMCID: PMC3484768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There have been very few systematic reviews looking at maternal infections in the developing world, even though cutting maternal mortality by three quarters is United Nation's Millennium Development Goal number five. This systematic review has two aims. The first is to present the prevalence of parasitic infections in the developing world over the last 30 years and the second is to evaluate the quality and distribution of research in this field. METHODS A systematic review of Medline, EMBASE and Global Health databases was undertaken using pre-determined search criteria. Three levels of quality criteria for exclusion of inadequate studies identified 115 out of initial 8580 titles. The data were extracted for 5 domains: worldwide pathogen prevalence, year of study, study setting, sample size and diagnostic test for each pathogen. RESULTS The initial search retrieved 8580 results. From these titles, 43 studies on malaria, 12 studies on helminths, 49 studies on Toxoplasma gondii, 7 studies on Chagas disease, 5 studies on Trichomonas, 1 leishmaniasis study and 1 study on trichinellosis were extracted for analysis. High prevalence of malaria was found in Gabon (up to 57%) India (55%), Cameroon (50%), Yemen (55%), Nigeria (up to 64%) and Ghana (54%). High prevalence of hookworm infections was found in Nepal at 78.8% and high values of Ascaris lumbricoides were found in Nepal, (56.2%), Kenya (52.3%) and Gabon (45.5%). High levels of Schistosoma mansoni were found in Zimbabwe (50%) and Tanzania (63.5%). The prevalence of active Toxoplasma gondii infection was found to be highest in India (27.7%). CONCLUSION This study highlights the large burden of maternal parasitic infections globally. It may serve as a useful starting point for health policy development and research prioritization in this area.
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Affiliation(s)
- Tom Roberts
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK,Joint first and joint senior authorship
| | - Courtney A. Gravett
- Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), Seattle Children’s Hospital, Seattle, Washington, USA,Joint first and joint senior authorship
| | - Prasad Palani Velu
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK
| | - Evropi Theodoratou
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK
| | - Thor A. Wagner
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Jian Shayne F. Zhang
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK
| | - Harry Campbell
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK,Joint first and joint senior authorship
| | - Craig E. Rubens
- Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), Seattle Children’s Hospital, Seattle, Washington, USA,Department of Pediatrics, University of Washington, Seattle, Washington, USA,Joint first and joint senior authorship
| | - Michael G. Gravett
- Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), Seattle Children’s Hospital, Seattle, Washington, USA,Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA,Joint first and joint senior authorship
| | - Igor Rudan
- Centre for Population Health Sciences and Global Health Academy, The University of Edinburgh, Scotland, UK,Joint first and joint senior authorship
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Sanyaolu AO, Oyibo WA, Fagbenro-Beyioku AF, Gbadegeshin AH, Iriemenam NC. Comparative study of entero-parasitic infections among HIV sero-positive and sero-negative patients in Lagos, Nigeria. Acta Trop 2011; 120:268-72. [PMID: 21896269 DOI: 10.1016/j.actatropica.2011.08.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 07/08/2011] [Accepted: 08/19/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND Intestinal parasites are endemic in many parts of the world where HIV infection is also widespread. Previous studies had shown that the spectrum of opportunistic and common endemic parasitic infections with HIV vary in different regions and usually reflect the infections prevalent in these regions. This present study was aimed at comparing the prevalence and types of intestinal parasitic infections in HIV sero-positive and sero-negative patients in Lagos. MATERIALS AND METHODS Venous blood and stool samples of 1080 patients, recruited from three health care institutions were screened for HIV infection and intestinal parasites using HIV-1, HIV-2 rapid tests, direct wet mount with saline/iodine and formol-ether technique, respectively. RESULTS Results showed that 6% (65/1080) of patients were sero-positive for HIV infection. In addition, 23.3% (252/1080) patients were infected with intestinal parasites and 33.8% (22/65) of patients with HIV had intestinal parasites co-infections. The prevalence of Entamoeba histolytica/Entamoeba dispar, Entamoeba coli, Iodamoeba butschilii, Giardia intestinalis, and Hookworm were statistically significantly higher among HIV sero-positive patients as compared to the HIV sero-negative patients. In addition, HIV sero-positive patients had higher odds of mixed intestinal parasites than the HIV sero-negative patients (9.1% versus 3.9%; adjusted OR 2.05, 95% CI, 1.14-3.72, P=0.021). CONCLUSION In this study population, HIV sero-positive patients were more likely to have intestinal parasitic infections. The study underscores the public health significance of intestinal parasitic infections in HIV infected individuals.
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Affiliation(s)
- Adekunle O Sanyaolu
- Central Public Health Laboratory of the Federal Ministry of Health, Yaba, Lagos, Nigeria
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Nacher M. Interactions between worms and malaria: good worms or bad worms? Malar J 2011; 10:259. [PMID: 21910854 PMCID: PMC3192711 DOI: 10.1186/1475-2875-10-259] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Accepted: 09/12/2011] [Indexed: 01/10/2023] Open
Abstract
In the past decade there have been an increasing number of studies on co-infections between worms and malaria. However, this increased interest has yielded results that have been at times conflicting and made it difficult to clearly grasp the outcome of this interaction. Despite the heterogeneity of study designs, reviewing the growing body of research may be synthesized into some broad trends: Ascaris emerges mostly as protective from malaria and its severe manifestations, whereas hookworm seems to increase malaria incidence. As efforts are made to de-worm populations in malaria endemic areas, there is still no clear picture of the impact these programmes have in terms of quantitative and qualitative changes in malaria.
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Affiliation(s)
- Mathieu Nacher
- Centre d'investigation Clinique épidémiologie Clinique Antilles-Guyane, Centre Hospitalier de Cayenne, French Guiana.
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Thigpen MC, Filler SJ, Kazembe PN, Parise ME, Macheso A, Campbell CH, Newman RD, Steketee RW, Hamel M. Associations between peripheral Plasmodium falciparum malaria parasitemia, human immunodeficiency virus, and concurrent helminthic infection among pregnant women in Malawi. Am J Trop Med Hyg 2011; 84:379-85. [PMID: 21363973 DOI: 10.4269/ajtmh.2011.10-0186] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Approximately 2 billion persons worldwide are infected with schistosomiasis and soil-transmitted helminths (STH), many in areas where endemic malaria transmission coexists. Few data exist on associations between these infections. Nested within a larger clinical trial, primigravid and secundigravid women provided blood samples for human immunodeficiency virus (HIV) testing and peripheral malaria films and stool and urine for evaluation of STH and Schistosoma spp. during their initial antenatal clinic visit. The most common parasitic infections were malaria (37.6%), S. haematobium (32.3%), and hookworm (14.4%); 14.2% of women were HIV-infected. S. haematobium infection was associated with lower malarial parasite densities (344 versus 557 parasites/μL blood; P < 0.05). In multivariate analysis, HIV and hookworm infection were independently associated with malaria infection (adjusted odds ratio = 1.9 and 95% confidence interval = 1.2-3.0 for HIV; adjusted odds ratio = 1.9 and 95% confidence interval = 1.03-3.5 for hookworm). Concurrent helminthic infection had both positive and negative effects on malaria parasitemia among pregnant women in Malawi.
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Affiliation(s)
- Michael C Thigpen
- Malaria Branch, Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Boel M, Carrara VI, Rijken M, Proux S, Nacher M, Pimanpanarak M, Paw MK, Moo O, Gay H, Bailey W, Singhasivanon P, White NJ, Nosten F, McGready R. Complex Interactions between soil-transmitted helminths and malaria in pregnant women on the Thai-Burmese border. PLoS Negl Trop Dis 2010; 4:e887. [PMID: 21103367 PMCID: PMC2982827 DOI: 10.1371/journal.pntd.0000887] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2010] [Accepted: 10/19/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Deworming is recommended by the WHO in girls and pregnant and lactating women to reduce anaemia in areas where hookworm and anaemia are common. There is conflicting evidence on the harm and the benefits of intestinal geohelminth infections on the incidence and severity of malaria, and consequently on the risks and benefits of deworming in malaria affected populations. We examined the association between geohelminths and malaria in pregnancy on the Thai-Burmese border. METHODOLOGY Routine antenatal care (ANC) included active detection of malaria (weekly blood smear) and anaemia (second weekly haematocrit) and systematic reporting of birth outcomes. In 1996 stool samples were collected in cross sectional surveys from women attending the ANCs. This was repeated in 2007 when malaria incidence had reduced considerably. The relationship between geohelminth infection and the progress and outcome of pregnancy was assessed. PRINCIPAL FINDINGS Stool sample examination (339 in 1996, 490 in 2007) detected a high prevalence of geohelminths 70% (578/829), including hookworm (42.8% (355)), A. lumbricoides (34.4% (285)) and T.trichuria (31.4% (250)) alone or in combination. A lower proportion of women (829) had mild (21.8% (181)) or severe (0.2% (2)) anaemia, or malaria 22.4% (186) (P.vivax monoinfection 53.3% (101/186)). A. lumbricoides infection was associated with a significantly decreased risk of malaria (any species) (AOR: 0.43, 95% CI: 0.23-0.84) and P.vivax malaria (AOR: 0.29, 95% CI: 0.11-0.79) whereas hookworm infection was associated with an increased risk of malaria (any species) (AOR: 1.66, 95% CI: 1.06-2.60) and anaemia (AOR: 2.41, 95% CI: 1.18-4.93). Hookworm was also associated with low birth weight (AOR: 1.81, 95% CI: 1.02-3.23). CONCLUSION/SIGNIFICANCE A. lumbricoides and hookworm appear to have contrary associations with malaria in pregnancy.
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Walson JL, Stewart BT, Sangaré L, Mbogo LW, Otieno PA, Piper BKS, Richardson BA, John-Stewart G. Prevalence and correlates of helminth co-infection in Kenyan HIV-1 infected adults. PLoS Negl Trop Dis 2010; 4:e644. [PMID: 20361031 PMCID: PMC2846937 DOI: 10.1371/journal.pntd.0000644] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Accepted: 02/10/2010] [Indexed: 02/02/2023] Open
Abstract
Background Deworming HIV-1 infected individuals may delay HIV-1 disease progression. It is important to determine the prevalence and correlates of HIV-1/helminth co-infection in helminth-endemic areas. Methods HIV-1 infected individuals (CD4>250 cells/ul) were screened for helminth infection at ten sites in Kenya. Prevalence and correlates of helminth infection were determined. A subset of individuals with soil-transmitted helminth infection was re-evaluated 12 weeks following albendazole therapy. Results Of 1,541 HIV-1 seropositive individuals screened, 298 (19.3%) had detectable helminth infections. Among individuals with helminth infection, hookworm species were the most prevalent (56.3%), followed by Ascaris lumbricoides (17.1%), Trichuris trichiura (8.7%), Schistosoma mansoni (7.1%), and Stongyloides stercoralis (1.3%). Infection with multiple species occurred in 9.4% of infections. After CD4 count was controlled for, rural residence (RR 1.40, 95% CI: 1.08–1.81), having no education (RR 1.57, 95% CI: 1.07–2.30), and higher CD4 count (RR 1.36, 95% CI: 1.07–1.73) remained independently associated with risk of helminth infection. Twelve weeks following treatment with albendazole, 32% of helminth-infected individuals had detectable helminths on examination. Residence, education, and CD4 count were not associated with persistent helminth infection. Conclusions Among HIV-1 seropositive adults with CD4 counts above 250 cells/mm3 in Kenya, traditional risk factors for helminth infection, including rural residence and lack of education, were associated with co-infection, while lower CD4 counts were not. Trial Registration ClinicalTrials.gov NCT00130910 Over one-third of people worldwide are currently infected with parasitic worms. The majority of these infections occur in sub-Saharan Africa, where over half of the population may be infected with at least one type of parasitic worm. HIV infection is also common in many of these countries, and there is significant geographic overlap in the presence of HIV and worm infection. Several studies have suggested that treatment of worm infections in people with HIV may delay the progression of HIV disease. Treatment has been shown to both decrease levels of the HIV virus in the blood of people with HIV and to increase the number of immune cells (CD4 cells) targeted by HIV. It is important to determine which populations of HIV-infected individuals are at greatest risk of worm infection in order to develop potential interventions for the treatment and prevention of worm infection in HIV-infected individuals. We report findings from a large study examining the prevalence and associated co-factors for worm infection among individuals at ten sites in Kenya.
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Affiliation(s)
- Judd L Walson
- Department of Global Health, University of Washington, Seattle, WA, USA.
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