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Martviset P, Phadungsil W, Na-Bangchang K, Sungkhabut W, Panupornpong T, Prathaphan P, Torungkitmangmi N, Chaimon S, Wangboon C, Jamklang M, Chumkiew S, Watthanasiri P, Geadkaew-Krenc A, Grams R, Mungthin M, Chantree P. Current prevalence and geographic distribution of helminth infections in the parasitic endemic areas of rural Northeastern Thailand. BMC Public Health 2023; 23:448. [PMID: 36882723 PMCID: PMC9993603 DOI: 10.1186/s12889-023-15378-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/06/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Helminth infection is a global health issue that not only causes acute helminthiasis but long-term infection may lead to complicated symptoms as well as severe complications. The World Health Organization cooperated with the Ministry of Public Health in many countries, particularly where high prevalence, spending a lot of resources for limiting the infection. In Thailand, the incidence of parasitic helminth infections was continuously declined in the last few decades according to several campaigns for parasitic elimination. However, the rural community in the northeast of Thailand where the highest prevalence of the country still needs to be monitored. This present study aims to report the current prevalence of parasitic helminth infections in Nakhon Ratchasima and Chaiyaphum provinces where sharing a huge area of the northeastern region of Thailand but only a few studies have been published. METHODS The stool specimens were collected from 11,196 volunteers and processed by modified Kato-Katz thick smear, PBS-ethyl acetate concentration techniques, and PCR. The epidemiological data were collected, analyzed, and used for generating of parasitic hotspots. RESULTS The results indicated that O. viverrini remains the major parasite in this area with a total prevalence of 5.05% followed by Taenia spp., Hookworms, T. trichiura, and Echinostoma spp., respectively. Mueang district of Chaiyaphum province has the highest prevalence especially O. viverrini with a prevalence of 7.15% that higher than the latest national surveillance. Interestingly, the prevalence of O. viverrini was hugely reported (more than 10%) in five subdistricts. The geographic localization of O. viverrini infections revealed that a lot of water reservoirs such as the lakes or branches of the river in the two-most prevalent subdistricts. Our finding indicated that gender and age were insignificantly different. CONCLUSION This finding suggested that the parasitic helminth infection in the rural areas of northeast of Thailand remains high and the housing location is a major contributing factor for the parasitic infection.
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Affiliation(s)
- Pongsakorn Martviset
- Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.,Thammasat University Research Unit in Nutraceuticals and Food Safety, Thammasat University, Pathumthani, Thailand
| | - Wansika Phadungsil
- Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
| | - Kesara Na-Bangchang
- Graduate Program in Bioclinical Sciences, Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand
| | - Wiwat Sungkhabut
- Office of Disease Prevention and Control Region-9, Ministry of Public Health of Thailand, Nakhon Ratchasima, Thailand
| | | | - Parisa Prathaphan
- Thammasat University Research Unit in Nutraceuticals and Food Safety, Thammasat University, Pathumthani, Thailand
| | - Nattaya Torungkitmangmi
- Graduate Program in Biochemistry and Molecular Biology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Salisa Chaimon
- Thammasat University Research Unit in Nutraceuticals and Food Safety, Thammasat University, Pathumthani, Thailand
| | - Chompunoot Wangboon
- Institute of Science, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Mantana Jamklang
- Institute of Science, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Sirilak Chumkiew
- Institute of Science, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Pichanee Watthanasiri
- Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
| | - Amornrat Geadkaew-Krenc
- Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
| | - Rudi Grams
- Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
| | - Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Pathanin Chantree
- Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathumthani, Thailand. .,Thammasat University Research Unit in Nutraceuticals and Food Safety, Thammasat University, Pathumthani, Thailand.
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Landeryou T, Maddren R, Rayment Gomez S, Kalahasti S, Liyew EF, Chernet M, Mohammed H, Wuletaw Y, Truscott J, Phillips AE, Ower A, Forbes K, Anjulo U, Mengistu B, Tasew G, Salasibew M, Anderson R. Longitudinal monitoring of prevalence and intensity of soil-transmitted helminth infections as part of community-wide mass drug administration within the Geshiyaro project in the Bolosso Sore district, Wolaita, Ethiopia. PLoS Negl Trop Dis 2022; 16:e0010408. [PMID: 36121895 PMCID: PMC9521932 DOI: 10.1371/journal.pntd.0010408] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/29/2022] [Accepted: 08/19/2022] [Indexed: 11/18/2022] Open
Abstract
Mass drug administration (MDA), targeted at school-aged children (SAC) is recommended by the World Health Organization for the control of morbidity induced by soil-transmitted helminth (STH) infection in endemic countries. However, MDA does not prevent reinfection between treatment rounds, and research suggests that only treating SAC will not be sufficient to interrupt transmission of STH. In countries with endemic infection, such as Ethiopia, the coverage, community-groups targeted, and rates of reinfection will determine how effective MDA is in suppressing transmission in the long-term. In this paper, individually-linked longitudinal data from three epidemiological STH surveys conducted between November 2018 and November 2020 in the Wolaita region of Ethiopia are analysed to determine how STH prevalence and intensity changes according to individual level treatment data collected over two rounds of MDA. This study demonstrates that while community-wide MDA successfully reduces overall infection intensity across the villages treated, the observed levels of non-compliance to treatment by individuals acts to maintain levels of parasite abundance whereby transmission interruption is not possible at to, despite reasonable levels of MDA coverage in the communities studied (ranging from 65% to 84% of the village populations). This quantifies with substantial data the often-postulated difference between coverage (accepting treatment) and compliance (swallowing of treatment), the latter impacting the former to a previously unquantified level. The paper highlights the need to focus treatment to partially treated, or never treated groups of individuals within existing community wide MDA control activities to interrupt the transmission of STH, and to reduce the basic reproductive number, R0, of the parasites to less than unity in value.
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Affiliation(s)
- Toby Landeryou
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
- * E-mail:
| | - Rosie Maddren
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
| | - Santiago Rayment Gomez
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
| | - Suprabhath Kalahasti
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
| | - Ewnetu Firdawek Liyew
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Melkie Chernet
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Hussein Mohammed
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Yonas Wuletaw
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - James Truscott
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
| | - Anna E. Phillips
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
| | - Alison Ower
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
| | - Kathryn Forbes
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
| | - Ufaysa Anjulo
- Disease Prevention and Health Promotion Core Process, Ministry of Health, Wolaita, Ethiopia
| | - Birhan Mengistu
- Children’s Investment fund Foundation, London, United Kingdom
| | - Geremew Tasew
- Disease Prevention and Health Promotion Core Process, Ministry of Health, Wolaita, Ethiopia
| | | | - Roy Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, United Kingdom
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Risk of acquiring Ascaris lumbricoides infection in an endemically infected rural community in Venezuela. Epidemiol Infect 2022; 150:e151. [PMID: 35983726 PMCID: PMC9428904 DOI: 10.1017/s0950268822001273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Soil-transmitted helminths, such as Ascaris lumbricoides, are the most prevalent parasites globally. Optimal anthelmintic treatment for A. lumbricoides in endemically infected communities is challenged by several host-related and environmental factors influencing infection acquisition. We assessed the risk of A. lumbricoides (re)infection after treatment in a Venezuelan rural community. Individual merthiolate-iodine-formaldehyde-fixed faecal samples were collected from 224 persons before a single-dose pyrantel treatment and at 1, 3, 6, 9 and 15 months after treatment. Effects of age, sex and socioeconomic status (SES) on A. lumbricoides prevalence, eggs/gram faeces (EPG) and infection (re)acquisition were assessed using both generalised linear mixed-effects models and survival analysis. Pre-treatment A. lumbricoides prevalence was 39.7%. Higher prevalence was associated with younger age and lower SES. Higher EPG values were observed among young children. Median time to A. lumbricoides infection was six months after treatment: at 1, 3, 6, 9 and 15 months post-treatment, cumulative incidence was 6.7%, 18.9%, 34.6%, 42.2%, and 52.6%, respectively. Younger age, lower SES, and pre-treatment A. lumbricoides infection status showed significantly elevated hazard ratios. Mass drug administration protocols would benefit from considering these factors in selective treatment strategies and possibly more than just annual or biannual treatments in the target population.
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Chis Ster I, Niaz HF, Chico ME, Oviedo Y, Vaca M, Cooper PJ. The epidemiology of soil-transmitted helminth infections in children up to 8 years of age: Findings from an Ecuadorian birth cohort. PLoS Negl Trop Dis 2021; 15:e0009972. [PMID: 34797823 PMCID: PMC8641893 DOI: 10.1371/journal.pntd.0009972] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 12/03/2021] [Accepted: 11/03/2021] [Indexed: 12/11/2022] Open
Abstract
Background There are few prospective longitudinal studies of soil-transmitted helminth (STH) infections during early childhood. We studied the epidemiology of and risk factors for soil-transmitted helminth infections from birth to 8 years of age in tropical Ecuador. Methods 2,404 newborns were followed to 8 years of age with periodic stool sample collections. Stool samples were collected also from household members at the time of the child’s birth and examined by microscopy. Data on social, environmental, and demographic characteristics were collected by maternal questionnaire. Associations between potential risk factors and STH infections were estimated using generalized estimated equations applied to longitudinal binary outcomes for presence or absence of infections at collection times. Results Of 2,404 children, 1,120 (46.6%) were infected with at least one STH infection during the first 8 years of life. The risk of A. lumbricoides (16.2%) was greatest at 3 years, while risks of any STH (25.1%) and T. trichiura (16.5%) peaked at 5 years. Factors significantly associated with any STH infection in multivariable analyses included age, day-care (OR 1.34, 95% CI 1.03–1.73), maternal Afro-Ecuadorian ethnicity (non-Afro vs. Afro, OR 0.55, 95% CI 0.43–0.70) and lower educational level (secondary vs. illiterate, OR 0.31, 95% CI 0.22–0.45)), household overcrowding (OR 1.53, 95% CI 1.21–1.94)), having a latrine rather than a water closet (WC vs. latrine, OR 0.77, 95% CI 0.62–0.95)), and STH infections among household members (OR 2.03, 95% CI 1.59–2.58)). T. trichiura was more associated with poverty (high vs. low socioeconomic status, OR, 0.63, 95% CI 0.40–0.99)] and presence of infected siblings in the household (OR 3.42, 95% CI 2.24–5.22). Conclusion STH infections, principally with A. lumbricoides and T. trichiura, peaked between 3 and 5 years in this cohort of children in tropical Ecuador. STH infections among household members were an important determinant of infection risk and could be targeted for control and elimination strategies. Soil-transmitted helminths (STH) cause significant morbidity among children in low and middle-income countries (LMICs). We followed a birth cohort to 8 years of age in a rural area of coastal Ecuador and showed almost half acquired STH infections during childhood. The dominant STH parasites in this setting in children were Ascaris lumbricoides and Trichuris trichiura and infections peaked in frequency between 3 and 5 years of age. Risk of infection during childhood was associated with markers of marginalisation (Afro-Ecuadorian ethnicity and low educational level), household poverty (overcrowding and poor sanitation), and STH infections among other household members. There was evidence of a reduction in STH infection risk across all ages in study households over the calendar time course of this longitudinal study in parallel with improvements in living conditions, a period of economic growth, and increased government support for those living in extreme poverty. Our data indicate that targeting anthelmintic treatment at members of STH-infected households is likely to reduce the risk of infection in young children.
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Affiliation(s)
- Irina Chis Ster
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Hamzah F. Niaz
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Martha E. Chico
- Fundacion Ecuatoriana Para La Investigacion en Salud, Quito, Ecuador
| | - Yisela Oviedo
- Fundacion Ecuatoriana Para La Investigacion en Salud, Quito, Ecuador
| | - Maritza Vaca
- Fundacion Ecuatoriana Para La Investigacion en Salud, Quito, Ecuador
| | - Philip J. Cooper
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
- Fundacion Ecuatoriana Para La Investigacion en Salud, Quito, Ecuador
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
- * E-mail:
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Kurscheid J, Laksono B, Park MJ, Clements ACA, Sadler R, McCarthy JS, Nery SV, Soares-Magalhaes R, Halton K, Hadisaputro S, Richardson A, Indjein L, Wangdi K, Stewart DE, Gray DJ. Epidemiology of soil-transmitted helminth infections in Semarang, Central Java, Indonesia. PLoS Negl Trop Dis 2020; 14:e0008907. [PMID: 33370267 PMCID: PMC7793285 DOI: 10.1371/journal.pntd.0008907] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 01/08/2021] [Accepted: 10/21/2020] [Indexed: 11/18/2022] Open
Abstract
Soil-transmitted helminth (STH) infections are endemic in Indonesia. However, prevalence data for many parts of the country are incomplete. The aim of this study was to determine human STH prevalence and knowledge and practices relating to STH risk behaviour, to provide a current view of the status of STH infection in rural communities in Central Java. A cross-sectional survey of 16 villages was conducted in Semarang, Central Java in 2015. Demographic and household data together with information about knowledge and practices relating to STH and hygiene were elicited through face-to-face interviews. Stool samples were collected and examined using the flotation method. Children (aged 2–12 years) also had their haemoglobin (Hb) levels, height and weight data collected, and BMI estimated. Data were analysed using univariate logistic regression analysis. A total of 6,466 individuals with a mean age of 33.5 years (range: 2–93) from 2,195 households were interviewed. The overall prevalence of STH was 33.8% with Ascaris lumbricoides (roundworm) the predominant nematode identified (prevalence = 26.0%). Hookworm and Trichuris trichiura (whipworm) were found in 7.9% and 1.8% of participants, respectively. Females were at increased odds of infection with A. lumbricoides (adjusted OR 1.14, 95% CI [1.02–1.29], p = 0.02). Adults in age groups 51–60 and over 60 years had the highest odds of being infected with hookworm (adjusted OR 3.01, 95% CI [1.84–4.91], p<0.001 and adjusted OR 3.79, 95% CI [2.30–6.26], p<0.001, respectively) compared to 6–12 year olds. Farmers also had higher odds of being infected with hookworm (adjusted OR 2.36, 95% CI [1.17–4.76], p = 0.02) compared to other occupation categories. Poverty (OR 2.14, 95% CI [1.77–2.58], p<0.001), overcrowding (OR 1.35, 95% CI [1.27–1.44], p<0.001), goat ownership (OR 1.61, 95% CI [1.10–2.41], p = 0.02) and the presence of dry floor space in the home (OR 0.73, 95% CI [0.58–0.91], p = 0.01) were all household factors significantly associated with an increased odds of infection. Infection with STH was not significantly associated with the gastrointestinal illness (p>0.05), BMI or Hb levels; however, one third of all 2–12 year olds surveyed were found to be anaemic (i.e. Hb concentrations below 110g/l or 115g/l for children under 5 and 5 years or older, respectively), with a greater proportion of school-age children at risk. Knowledge and behaviour related to hygiene and gastrointestinal diseases varied widely and were generally not associated with STH infection. The study revealed that STH infection remains endemic in Central Java despite ongoing deworming programs. Current control efforts would benefit from being re-evaluated to determine a more effective way forward. Among the major NTDs, STH are one of the most common disabling chronic infections. Currently available drug treatments, whilst considered safe and generally well tolerated, do not confer protection against new infections. In Indonesia, prevalences of STH of up to 90% have been reported but these estimates are based on data from the 1980s and 90s. More up-to-date STH prevalence estimates are urgently needed to help guide future control efforts. A cross-sectional survey was conducted in rural villages in Semarang, Central Java to determine human STH prevalence and associated risk factors. One-third of all cohort participants were positive for STH with prevalences of 26%, 7.9% and 1.8% identified for Ascaris lumbricoides, hookworm and Trichuris trichiura at 7.9% and 1.8%, respectively. Risk of A. lumbricoides infection was higher for females, whilst farmers and adults over 50 had an increased risk of hookworm infection. Poverty, overcrowding in the home and goat ownership were also associated with an increased risk at the household level. Soil-transmitted helminthiases remains a significant health problem in Central Java, Indonesia, exacerbated by limited knowledge about STH, poor sanitation and hygiene and poverty prevalent in the region. Control efforts would benefit from an integrated approach emphasising WASH, health education and chemotherapy. Further studies investigating environmental contamination with STH in and around homes in endemic areas could provide further insight into links between household factors and STH identified in our study.
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Affiliation(s)
- Johanna Kurscheid
- Department of Global Health, Research School of Population Health, Australian National University, Acton, Australia
- * E-mail:
| | - Budi Laksono
- Yayasan Wahana Bakti Sejatera Foundation (YWBS), Semarang, Indonesia
| | - M. J. Park
- Department of Nursing, College of Nursing, Konyang University, Daejeon, South Korea
| | | | - Ross Sadler
- School of Public Health, Griffith Health, Griffith University, South Brisbane, Australia
| | | | - Susana V. Nery
- Public Health Interventions Group, Kirby Institute, University of New South Wales, Kensington, Australia
| | | | - Kate Halton
- Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | | | - Alice Richardson
- Statistical Consulting Unit, Australian National University, Acton, Australia
| | - Léa Indjein
- School of Veterinary Science, University of Queensland, Gatton, Australia
| | - Kinley Wangdi
- Department of Global Health, Research School of Population Health, Australian National University, Acton, Australia
| | - Donald E. Stewart
- Department of Global Health, Research School of Population Health, Australian National University, Acton, Australia
- School of Medicine, Griffith Health, Griffith University, South Brisbane, Australia
| | - Darren J. Gray
- Department of Global Health, Research School of Population Health, Australian National University, Acton, Australia
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Ali SA, Niaz S, Aguilar-Marcelino L, Ali W, Ali M, Khan A, Amir S, Nasreen, Alanazi AD, Cossio-Bayugar R, Amaro-Estrada I. Prevalence of Ascaris lumbricoides in contaminated faecal samples of children residing in urban areas of Lahore, Pakistan. Sci Rep 2020; 10:21815. [PMID: 33311542 PMCID: PMC7733436 DOI: 10.1038/s41598-020-78743-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/27/2020] [Indexed: 12/31/2022] Open
Abstract
Ascariasis is a common public health problem of preschool and primary school children in developing countries like Pakistan. The aim of the present study was to determine the prevalence and pattern of Ascaris lumbericoides (A. lumbricoides) infection among children residing in urban areas of Lahore, to provide information on ascariasis to promote awareness and prevention programs between the participants specially on the months or season of higher prevalence. To investigate the prevalence of Ascaris Lumbricoides in the contaminated faecal samples of children residing in urban areas of Lahore, a study was conducted from November 2010 to October 2012 and we collected 3600 stratified faecal samples from six urban study areas. Overall 32/3600 (0.88%) prevalence of fecal samples was found positive for eggs of Ascaris lumbricoides. Area wise highest presence positivity 1.67% was observed in Allama Iqbal Town followed by 1.17% in Samanabad, 1.00% in Wapda Town, 1.00% in Gulberg, 0.50% in Cantt, and the lowest 0.00% in Valencia Town respectively (p < 0.001) The highest month wise positivity prevalence 3/300 (3.33%) (p < 0.001) was observed in the month of September that gradually declined up to 0/300 (0.00%) in the month of March. The results reveal that urban areas of Lahore are susceptible to Ascaris Lubricoides infection and the highest prevalence were observed autumn on the month of September.
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Affiliation(s)
- Shahida Azhar Ali
- Department of Zoology, University of the Punjab, Quaid-i-Azam Campus, Lahore, Pakistan
| | - Sadaf Niaz
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Liliana Aguilar-Marcelino
- Centro Nacional de Investigación Disciplinaria en Salud Animal e Inocuidad, INIFAP, Km 11 Carretera Federal Cuernavaca-Cuautla, No. 8534, Col. Progreso, CP 62550, Jiutepec, Morelos, Mexico
| | - Wajid Ali
- Center for Integrated Mountain Research, University of the Punjab, Lahore, Pakistan
| | - Majid Ali
- Center for Integrated Mountain Research, University of the Punjab, Lahore, Pakistan
| | - Adil Khan
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan, Pakistan.
| | - Sohail Amir
- Hayat Abad Medical Complex, Peshawar, Pakistan
| | - Nasreen
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Abdullah D Alanazi
- Department of Biological Sciences, Faculty of Science and Humanities, Shaqra University, P.O. Box 1040, Ad-Dawadimi, 11911, Saudi Arabia
| | - Raquel Cossio-Bayugar
- Centro Nacional de Investigación Disciplinaria en Salud Animal e Inocuidad, INIFAP, Km 11 Carretera Federal Cuernavaca-Cuautla, No. 8534, Col. Progreso, CP 62550, Jiutepec, Morelos, Mexico
| | - Itzel Amaro-Estrada
- Centro Nacional de Investigación Disciplinaria en Salud Animal e Inocuidad, INIFAP, Km 11 Carretera Federal Cuernavaca-Cuautla, No. 8534, Col. Progreso, CP 62550, Jiutepec, Morelos, Mexico
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Incani RN, Grillet ME, Mughini-Gras L. Hotspots and correlates of soil-transmitted helminth infections in a Venezuelan rural community: Which are the "wormy" houses? J Infect 2020; 82:143-149. [PMID: 33271168 DOI: 10.1016/j.jinf.2020.10.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 09/29/2020] [Accepted: 10/06/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine spatial clustering and risk factors for occurrence and intensity of infection for soil-transmitted helminthiasis (STH), namely Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis and hookworms in a Venezuelan rural community. METHODS MIF-fixed faecal samples were individually collected for STH testing. The Getis-Ord statistic was used to determine significant STH clustering within 25/50/100 m radiuses around houses. Individual- and house-level factors associated with STH occurrence and intensity of infection were determined using generalized estimating equations. RESULTS Significant clusters of "wormy" houses for one or multiple parasites were found at distances of 25-50 m around 13 houses. Risk factors differed between occurrence and intensity of infection. Overcrowding in the house increased occurrence of S. stercoralis, T. trichiura and hookworm infections, while poor housing conditions increased A. lumbricoides infection risk. Overcrowding, poor faecal disposal system, economic dependency and lack of basic services differentially influenced the STHs. The "wormy" houses were mainly those built with waste materials, under economic dependency and lacking indoor water supply. CONCLUSIONS STH distribution in a community is clustered, with significant hotspots of STH occurrence and intensity of infection and different associated risk factors. Targeting the "wormy" houses is expected to affect STH morbidity more efficiently.
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Affiliation(s)
- Renzo Nino Incani
- Department de Parasitology, Faculty of Health Sciences, Universidad de Carabobo, Valencia, Venezuela.
| | - María Eugenia Grillet
- Laboratorio de Biología de Vectores y Parásitos, Instituto de Zoología y Ecología Tropical, Facultad de Ciencias, Universidad Central de Venezuela, Caracas, Venezuela.
| | - Lapo Mughini-Gras
- Center for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Faculty of Veterinary Medicine, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands.
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Eighteenth Century Urban Growth and Parasite Spread at the Fortress of Louisbourg, Nova Scotia, Canada. BIOARCHAEOLOGY AND SOCIAL THEORY 2020. [DOI: 10.1007/978-3-030-53417-2_12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Cheema HA, Waheed N, Saeed A. Rare presentation of haemobilia and Loeffler's pneumonia in a child by ascaris lumbricoides. BMJ Case Rep 2019; 12:12/8/e230198. [PMID: 31466983 DOI: 10.1136/bcr-2019-230198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Ascariasis is a soil-sourced, second most common parasitic infection worldwide. Because of its wandering nature, it migrates from the intestine to other organs of the body like the lungs and biliary system. This results in complications such as biliary colic, acute cholecystitis, pyogenic cholangitis, liver abscesses, pancreatitis and loeffler's pneumonia. We report a unique case of an 8-year-old boy who presented with upper gastrointestinal bleed and chest infection. He was diagnosed as haemobilia and loeffler's pneumonia caused by ascaris lumbricoides.
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Affiliation(s)
- Huma Arshad Cheema
- Department of Pediatric Medicine, Division of Pediatric Gastroenterology, Hepatology & Nutrition, The Children's Hospital & The Institute of Child Health, Lahore, Pakistan
| | - Nadia Waheed
- Department of Pediatric Medicine, Division of Pediatric Gastroenterology, Hepatology & Nutrition, The Children's Hospital & The Institute of Child Health, Lahore, Pakistan
| | - Anjum Saeed
- Department of Pediatric Medicine, Division of Pediatric Gastroenterology, Hepatology & Nutrition, The Children's Hospital & The Institute of Child Health, Lahore, Pakistan
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Dunn JC, Bettis AA, Wyine NY, Lwin AMM, Tun A, Maung NS, Anderson RM. Soil-transmitted helminth reinfection four and six months after mass drug administration: results from the delta region of Myanmar. PLoS Negl Trop Dis 2019; 13:e0006591. [PMID: 30768602 PMCID: PMC6395004 DOI: 10.1371/journal.pntd.0006591] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 02/28/2019] [Accepted: 01/24/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Mass drug administration (MDA), targeted at school-aged children (SAC) is the method recommended by the World Health Organization for the control of morbidity induced by soil-transmitted helminth (STH) infection in endemic countries. However, MDA does not prevent reinfection between treatment rounds and research suggests that only treating SAC will not be sufficient to bring prevalence to low levels and possibly interrupt transmission of STH. In countries with endemic infection, such as Myanmar, the coverage, who is targeted, and rates of reinfection will determine how effective MDA is in suppressing transmission in the long-term. METHODS/PRINCIPAL FINDINGS In this paper, data from an epidemiological study on STH, comprising three surveys conducted between June 2015 and June 2016 in the delta region of Myanmar, are analysed to determine how STH prevalence and intensity in the study community changes over the course of a year, including reinfection after two MDA rounds in which the whole study sample (all age groups, n = 523) were treated with albendazole. Prevalence in the first survey (August 2015) was 27.92% for any STH, 5.54% for Ascaris lumbricoides, 17.02% for Trichuris trichiura and 9.75% for hookworm. Over the year (survey one to survey three), prevalence of any STH decreased by 8.99% (P < 0.001) and mean EPG significantly decreased for T. trichiura (P < 0.01) and hookworm (P < 0.001). Risk ratios (RRs) for a four-month reinfection period (August to December) were statistically significant and were below one, indicating that STH prevalence had not bounced back to the prevalence levels recorded immediately prior to the last round of treatment (any STH RR = 0.67, 95% CI 0.56-0.81; A. lumbricoides RR = 0.31, 95% CI 0.16-0.59; T. trichiura RR = 0.70, 95% CI 0.55-0.88; hookworm RR = 0.69, 95% CI 0.50-0.95). The only statistically significant RR for the six-month reinfection period (December to June) was for A. lumbricoides infection in SAC (RR = 2.67, 95% CI 1.37-5.21). All six-month RRs were significantly higher than four-month RRs (P < 0.05). Evidence of predisposition to infection (low and high), as measured by the Kendall Tau-b statistic, was found for all species overall and within most age groups stratifications, except for hookworm infection in preschool-aged children. CONCLUSIONS/SIGNIFICANCE This study demonstrates that, for certain demographic groups, a six-month gap between MDA in these communities is enough time for STH infection to return to STH prevalence levels recorded immediately before the previous MDA round, and that on average the same individuals are being consistently infected between MDA rounds.
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Affiliation(s)
- Julia C. Dunn
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - Alison A. Bettis
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - Nay Yee Wyine
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | | | - Aung Tun
- Ministry of Health and Sports, Nyapyitaw, Myanmar
| | | | - Roy M. Anderson
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
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11
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de Glanville WA, Thomas LF, Cook EAJ, Bronsvoort BMDC, Wardrop N, Wamae CN, Kariuki S, Fèvre EM. General contextual effects on neglected tropical disease risk in rural Kenya. PLoS Negl Trop Dis 2018; 12:e0007016. [PMID: 30576335 PMCID: PMC6342328 DOI: 10.1371/journal.pntd.0007016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 01/22/2019] [Accepted: 11/22/2018] [Indexed: 01/20/2023] Open
Abstract
The neglected tropical diseases (NTDs) are characterized by their tendency to cluster within groups of people, typically the poorest and most marginalized. Despite this, measures of clustering, such as within-group correlation or between-group heterogeneity, are rarely reported from community-based studies of NTD risk. We describe a general contextual analysis that uses multi-level models to partition and quantify variation in individual NTD risk at multiple grouping levels in rural Kenya. The importance of general contextual effects (GCE) in structuring variation in individual infection with Schistosoma mansoni, the soil-transmitted helminths, Taenia species, and Entamoeba histolytica/dispar was examined at the household-, sublocation- and constituency-levels using variance partition/intra-class correlation co-efficients and median odds ratios. These were compared with GCE for HIV, Plasmodium falciparum and Mycobacterium tuberculosis. The role of place of residence in shaping infection risk was further assessed using the spatial scan statistic. Individuals from the same household showed correlation in infection for all pathogens, and this was consistently highest for the gastrointestinal helminths. The lowest levels of household clustering were observed for E. histolytica/dispar, P. falciparum and M. tuberculosis. Substantial heterogeneity in individual infection risk was observed between sublocations for S. mansoni and Taenia solium cysticercosis and between constituencies for infection with S. mansoni, Trichuris trichiura and Ascaris lumbricoides. Large overlapping spatial clusters were detected for S. mansoni, T. trichiura, A. lumbricoides, and Taenia spp., which overlapped a large cluster of elevated HIV risk. Important place-based heterogeneities in infection risk exist in this community, and these GCEs are greater for the NTDs and HIV than for TB and malaria. Our findings suggest that broad-scale contextual drivers shape infectious disease risk in this population, but these effects operate at different grouping-levels for different pathogens. A general contextual analysis can provide a foundation for understanding the complex ecology of NTDs and contribute to the targeting of interventions.
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Affiliation(s)
- William A. de Glanville
- Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Lian F. Thomas
- Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Elizabeth A. J. Cook
- Centre for Immunity, Infection and Evolution, Institute for Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- International Livestock Research Institute, Nairobi, Kenya
| | - Barend M. de C. Bronsvoort
- The Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian, United Kingdom
| | - Nicola Wardrop
- Department of Geography and Environment, University of Southampton, Highfield Campus, Southampton, United Kingdom
| | - Claire N. Wamae
- School of Pharmacy and Health Sciences, United States International University, Nairobi, Kenya
| | - Samuel Kariuki
- Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Eric M. Fèvre
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Neston, United Kingdom
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Camacho M, Araújo A, Morrow J, Buikstra J, Reinhard K. Recovering parasites from mummies and coprolites: an epidemiological approach. Parasit Vectors 2018; 11:248. [PMID: 29661215 PMCID: PMC5902992 DOI: 10.1186/s13071-018-2729-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 02/19/2018] [Indexed: 11/10/2022] Open
Abstract
In the field of archaeological parasitology, researchers have long documented the distribution of parasites in archaeological time and space through the analysis of coprolites and human remains. This area of research defined the origin and migration of parasites through presence/absence studies. By the end of the 20th century, the field of pathoecology had emerged as researchers developed an interest in the ancient ecology of parasite transmission. Supporting studies were conducted to establish the relationships between parasites and humans, including cultural, subsistence, and ecological reconstructions. Parasite prevalence data were collected to infer the impact of parasitism on human health. In the last few decades, a paleoepidemiological approach has emerged with a focus on applying statistical techniques for quantification. The application of egg per gram (EPG) quantification methods provide data about parasites' prevalence in ancient populations and also identify the pathological potential that parasitism presented in different time periods and geographic places. Herein, we compare the methods used in several laboratories for reporting parasite prevalence and EPG quantification. We present newer quantification methods to explore patterns of parasite overdispersion among ancient people. These new methods will be able to produce more realistic measures of parasite infections among people of the past. These measures allow researchers to compare epidemiological patterns in both ancient and modern populations.
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Affiliation(s)
- Morgana Camacho
- Escola Nacional de Saúde Pública Sergio Arouca/Fundação Oswaldo Cruz (ENSP/FIOCRUZ), Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Adauto Araújo
- Escola Nacional de Saúde Pública Sergio Arouca/Fundação Oswaldo Cruz (ENSP/FIOCRUZ), Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil
| | - Johnica Morrow
- Department of Physical & Life Sciences, Chadron State College, 1000 Main Street, Chadron, NE, 69337, USA
| | - Jane Buikstra
- School of Evolution and Social Change, Arizona State University, Tempe, AZ, USA
| | - Karl Reinhard
- Pathoecology Laboratory, School of Natural Resources, University of Nebraska - Lincoln, Lincoln, NE, 68583-0987, USA.
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Wright JE, Werkman M, Dunn JC, Anderson RM. Current epidemiological evidence for predisposition to high or low intensity human helminth infection: a systematic review. Parasit Vectors 2018; 11:65. [PMID: 29382360 PMCID: PMC5791198 DOI: 10.1186/s13071-018-2656-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/17/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The human helminth infections include ascariasis, trichuriasis, hookworm infections, schistosomiasis, lymphatic filariasis (LF) and onchocerciasis. It is estimated that almost 2 billion people worldwide are infected with helminths. Whilst the WHO treatment guidelines for helminth infections are mostly aimed at controlling morbidity, there has been a recent shift with some countries moving towards goals of disease elimination through mass drug administration, especially for LF and onchocerciasis. However, as prevalence is driven lower, treating entire populations may no longer be the most efficient or cost-effective strategy. Instead, it may be beneficial to identify individuals or demographic groups who are persistently infected, often termed as being "predisposed" to infection, and target treatment at them. METHODS The authors searched Embase, MEDLINE, Global Health, and Web of Science for all English language, human-based papers investigating predisposition to helminth infections published up to October 31st, 2017. The varying definitions used to describe predisposition, and the statistical tests used to determine its presence, are summarised. Evidence for predisposition is presented, stratified by helminth species, and risk factors for predisposition to infection are identified and discussed. RESULTS In total, 43 papers were identified, summarising results from 34 different studies in 23 countries. Consistent evidence of predisposition to infection with certain species of human helminth was identified. Children were regularly found to experience greater predisposition to Ascaris lumbricoides, Schistosoma mansoni and S. haematobium than adults. Females were found to be more predisposed to A. lumbricoides infection than were males. Household clustering of infection was identified for A. lumbricoides, T. trichiura and S. japonicum. Ascaris lumbricoides and T. trichiura also showed evidence of familial predisposition. Whilst strong evidence for predisposition to hookworm infection was identified, findings with regards to which groups were affected were considerably more varied than for other helminth species. CONCLUSION This review has found consistent evidence of predisposition to heavy (and light) infection for certain human helminth species. However, further research is needed to identify reasons for the reported differences between demographic groups. Molecular epidemiological methods associated with whole genome sequencing to determine 'who infects whom' may shed more light on the factors generating predisposition.
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Affiliation(s)
- James E. Wright
- 0000 0001 2113 8111grid.7445.2Department of Infectious Disease Epidemiology, Imperial College London, St. Mary’s Campus, London, W2 1PG UK
- 0000 0001 2113 8111grid.7445.2London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, Imperial College London, St Mary’s Campus, London, W2 1PG UK
- 0000 0001 2172 097Xgrid.35937.3bThe DeWorm3 Project, The Natural History Museum of London, London, SW7 5BD UK
| | - Marleen Werkman
- 0000 0001 2113 8111grid.7445.2Department of Infectious Disease Epidemiology, Imperial College London, St. Mary’s Campus, London, W2 1PG UK
- 0000 0001 2113 8111grid.7445.2London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, Imperial College London, St Mary’s Campus, London, W2 1PG UK
- 0000 0001 2172 097Xgrid.35937.3bThe DeWorm3 Project, The Natural History Museum of London, London, SW7 5BD UK
| | - Julia C. Dunn
- 0000 0001 2113 8111grid.7445.2Department of Infectious Disease Epidemiology, Imperial College London, St. Mary’s Campus, London, W2 1PG UK
- 0000 0001 2113 8111grid.7445.2London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, Imperial College London, St Mary’s Campus, London, W2 1PG UK
| | - Roy M. Anderson
- 0000 0001 2113 8111grid.7445.2Department of Infectious Disease Epidemiology, Imperial College London, St. Mary’s Campus, London, W2 1PG UK
- 0000 0001 2113 8111grid.7445.2London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, Imperial College London, St Mary’s Campus, London, W2 1PG UK
- 0000 0001 2172 097Xgrid.35937.3bThe DeWorm3 Project, The Natural History Museum of London, London, SW7 5BD UK
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14
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Reda AA. Probiotics for the Control of Helminth Zoonosis. J Vet Med 2018; 2018:4178986. [PMID: 29666821 PMCID: PMC5831688 DOI: 10.1155/2018/4178986] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 12/27/2017] [Indexed: 12/12/2022] Open
Abstract
This paper is a comprehensive, concise, and an up to date review about probiotics effect and mechanisms against helminth infections of zoonotic importance. Zoonoses are diseases that can be transmitted from animals to humans in a reversible way. Despite zoonotic helminth diseases being still a challenge to the public health and the agriculture industries globally, they were still neglected in both human and veterinary medicine. Moreover, the increasing emergence of anthelmintic drug resistance constitutes failures of most disease control strategies, alarming for a quest to new alternative control approaches. Consequently, the use of beneficial microorganisms, probiotics, is becoming interesting for its prophylactic or therapeutic application against several diseases including helminths. Recent studies on probiotics against parasites and the interactions between bacteria, parasites, and the immune system in the gut draw much attention. However, the effects of these beneficial microorganisms in helminth infections remain largely unexplored. Therefore, the aim of the present review is to raise attention and to summarize recent findings on probiotics research against helminth parasites of zoonotic significance. State-of-the-art research on beneficial effects of bacteria on helminth infections and their proposed mechanisms of action is thoroughly discussed.
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Affiliation(s)
- Abadi Amare Reda
- School of Veterinary Medicine, Wollo University, P.O. Box 1145, Dessie, Ethiopia
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15
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Eyebe S, Sabbagh A, Pion SD, Nana-Djeunga HC, Kamgno J, Boussinesq M, Chesnais CB. Familial Aggregation and Heritability of Loa loa Microfilaremia. Clin Infect Dis 2017; 66:751-757. [DOI: 10.1093/cid/cix877] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 10/07/2017] [Indexed: 11/13/2022] Open
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16
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Oswald WE, Stewart AEP, Kramer MR, Endeshaw T, Zerihun M, Melak B, Sata E, Gessese D, Teferi T, Tadesse Z, Guadie B, King JD, Emerson PM, Callahan EK, Freeman MC, Flanders WD, Clasen TF, Moe CL. Association of community sanitation usage with soil-transmitted helminth infections among school-aged children in Amhara Region, Ethiopia. Parasit Vectors 2017; 10:91. [PMID: 28212668 PMCID: PMC5316142 DOI: 10.1186/s13071-017-2020-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 02/07/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Globally, in 2010, approximately 1.5 billion people were infected with at least one species of soil-transmitted helminth (STH), Ascaris lumbricoides, Trichuris trichiura, hookworm (Ancylostoma duodenale and Necator americanus). Infection occurs through ingestion or contact (hookworm) with eggs or larvae in the environment from fecal contamination. To control these infections, the World Health Organization recommends periodic mass treatment of at-risk populations with deworming drugs. Prevention of these infections typically relies on improved excreta containment and disposal. Most evidence of the relationship between sanitation and STH has focused on household-level access or usage, rather than community-level sanitation usage. We examined the association between the proportion of households in a community with latrines in use and prevalence of STH infections among school-aged children. METHODS Data on STH prevalence and household latrine usage were obtained during four population-based, cross-sectional surveys conducted between 2011 and 2014 in Amhara, Ethiopia. Multilevel regression was used to estimate the association between the proportion of households in the community with latrines in use and presence of STH infection, indicated by > 0 eggs in stool samples from children 6-15 years old. RESULTS Prevalence of STH infection was estimated as 22% (95% CI: 20-24%), 14% (95% CI: 13-16%), and 4% (95% CI: 4-5%) for hookworm, A. lumbricoides, and T. trichiura, respectively. Adjusting for individual, household, and community characteristics, hookworm prevalence was not associated with community sanitation usage. Trichuris trichuria prevalence was higher in communities with sanitation usage ≥ 60% versus sanitation usage < 20%. Association of community sanitation usage with A. lumbricoides prevalence depended on household sanitation. Community sanitation usage was not associated with A. lumbricoides prevalence among households with latrines in use. Among households without latrines in use, A. lumbricoides prevalence was higher comparing communities with sanitation usage ≥ 60% versus < 20%. Households with a latrine in use had lower prevalence of A. lumbricoides compared to households without latrines in use only in communities where sanitation usage was ≥ 80%. CONCLUSIONS We found no evidence of a protective association between community sanitation usage and STH infection. The relationship between STH infection and community sanitation usage may be complex and requires further study.
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Affiliation(s)
- William E. Oswald
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
- Department of Epidemiology, Emory University, Atlanta, GA USA
| | | | | | | | | | | | | | | | | | | | | | - Jonathan D. King
- The Carter Center, Atlanta, GA USA
- World Health Organization, Geneva, Switzerland
| | - Paul M. Emerson
- The Carter Center, Atlanta, GA USA
- International Trachoma Initiative, Atlanta, GA USA
| | | | | | | | - Thomas F. Clasen
- Department of Environmental Health, Emory University, Atlanta, GA USA
| | - Christine L. Moe
- Hubert Department of Global Health and Center for Global Safe Water, Sanitation, and Hygiene, Emory University, Atlanta, GA USA
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18
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Elhadidy T, Eldesoqy ME, Morsy NE, Abdelwahab HW, Tohlob M. Ascaris lumbricoides through pleural biopsy needle. A rare case of intrapleural ascariasis. Arch Bronconeumol 2016; 53:171-172. [PMID: 27823891 DOI: 10.1016/j.arbres.2016.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/02/2016] [Accepted: 08/10/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Tamer Elhadidy
- Chest Medicine Department, Mansoura University, Mansoura, Egipto
| | | | | | | | - Mohammad Tohlob
- Chest Medicine Department, Mansoura University, Mansoura, Egipto
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Ortu G, Assoum M, Wittmann U, Knowles S, Clements M, Ndayishimiye O, Basáñez MG, Lau C, Clements A, Fenwick A, Magalhaes RJS. The impact of an 8-year mass drug administration programme on prevalence, intensity and co-infections of soil-transmitted helminthiases in Burundi. Parasit Vectors 2016; 9:513. [PMID: 27660114 PMCID: PMC5034474 DOI: 10.1186/s13071-016-1794-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 09/07/2016] [Indexed: 11/18/2022] Open
Abstract
Background Soil-transmitted helminth (STH) infections are amongst the most prevalent infections in the world. Mass drug administration (MDA) programmes have become the most commonly used national interventions for endemic countries to achieve elimination. This paper aims to describe the effect of an 8-year MDA programme on the prevalence, intensity of infection and co-infection of STH in Burundi from 2007 to 2014 and critically appraise the trajectory towards STH elimination in the country. Results Annual STH parasitological surveys (specifically, a “pilot study” from 2007 to 2011, an “extension study” from 2008 to 2011, and a “national reassessment” in 2014; n = 27,658 children), showed a significant drop in prevalence of infection with any STH (“pooled STH”) between baseline and 2011 in both studies, falling from 32 to 16 % in the pilot study, and from 35 to 16 % in the extension study. Most STH infections were of low intensity according to WHO classification. The national reassessment in 2014 showed that prevalence of pooled STH remained significantly below the prevalence in 2007 in both studies but there was no further decrease in STH prevalence from 2011 levels during this time. Spatial dependence analysis showed that prevalence of Trichuris trichiura and Ascaris lumbricoides had a tendency to cluster over the years, whilst only trends in spatial dependence were evident for hookworm infections. Spatial dependence fluctuated over the course of the programme for Ascaris lumbricoides and Trichuris trichiura. However, spatial trends in spatial dependence were evident in 2010 for Ascaris lumbricoides. Analysis of spatial clustering of intensity of infection and heavy infections revealed that the intensity changed over time for all parasites. Heavy intensity was only evident in Ascaris lumbricoides for 2008 and did not appear in proceeding years and other parasites. Conclusions These results demonstrate that sustained annual MDA significantly reduced the prevalence of STH infection in school-age children but was unable to achieve elimination. Additionally, significant decline in prevalence was accompanied by a drop in spatial clustering of infection indicators across all sites from 2008. The lack of consistency in the results of the spatial dependence analysis highlights that MDA programmes can interrupt the normal transmission dynamics of STH parasites. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1794-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Giuseppina Ortu
- Schistosomiasis Control Initiative, Imperial College London, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St. Mary's Campus), Norfolk Place, London, W2 1PG, UK.
| | - Mohamad Assoum
- School of Medicine, The University of Queensland, Brisbane, Australia.,Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Udo Wittmann
- Schistosomiasis Control Initiative, Imperial College London, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St. Mary's Campus), Norfolk Place, London, W2 1PG, UK
| | - Sarah Knowles
- Schistosomiasis Control Initiative, Imperial College London, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St. Mary's Campus), Norfolk Place, London, W2 1PG, UK
| | - Michelle Clements
- Schistosomiasis Control Initiative, Imperial College London, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St. Mary's Campus), Norfolk Place, London, W2 1PG, UK
| | - Onésime Ndayishimiye
- Programme National Intégré de lutte contre les Maladies Tropicales Négligées et la Cécité (PNIMTNC) - Ministère de la Santé Publique et de la lutte contre le SIDA, Bujumbura, Burundi
| | - Maria-Gloria Basáñez
- Schistosomiasis Control Initiative, Imperial College London, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St. Mary's Campus), Norfolk Place, London, W2 1PG, UK.,London Centre for Neglected Tropical Disease Research, Imperial College London, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St. Mary's Campus), Norfolk Place, London, W2 1PG, UK
| | - Colleen Lau
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Brisbane, Australia.,Research School of Population Health, Australian National University, Canberra, Australia
| | - Archie Clements
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Alan Fenwick
- Schistosomiasis Control Initiative, Imperial College London, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine (St. Mary's Campus), Norfolk Place, London, W2 1PG, UK
| | - Ricardo J Soares Magalhaes
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Brisbane, Australia.,School of Veterinary Science, The University of Queensland (Gatton Campus), Via Warrego Highway, Gatton, QLD, 4343, Australia
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Ascaris and hookworm transmission in preschool children in rural Panama: role of subsistence agricultural activities. Parasitology 2016; 143:1043-54. [DOI: 10.1017/s0031182016000366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
SUMMARYThis longitudinal study explored whether aspects of subsistence agriculture were associated with presence and intensity of Ascaris and hookworm in preschool children in rural Panama. Questionnaires were used to collect data on household socio-demographics, child exposure to agriculture and household agricultural practices. Stool samples were collected from children (6 months–5 years) at 3 time points, with albendazole administered after each to clear infections, resulting in 1 baseline and 2 reinfection measures. A novel Agricultural Activity Index (AAI) was developed using principal components analysis to measure the intensity of household agricultural practices. Zero-inflated negative binomial regression models revealed baseline hookworm egg counts were higher if children went to the agricultural plot and if the plot was smaller. Baseline and reinfection Ascaris egg counts were higher if children went to the plot and households had higher AAI, and higher at baseline if the plot was smaller. Caregiver time in the plot was negatively associated with baseline Ascaris egg counts, but positively associated with baseline hookworm and Ascaris reinfection egg counts. Children who spent more time playing around the home were less likely to be infected with Ascaris at baseline. We conclude that preschool child exposure to subsistence agriculture increased Ascaris and hookworm intensity.
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Medley GF, Turner HC, Baggaley RF, Holland C, Hollingsworth TD. The Role of More Sensitive Helminth Diagnostics in Mass Drug Administration Campaigns: Elimination and Health Impacts. ADVANCES IN PARASITOLOGY 2016; 94:343-392. [PMID: 27756457 DOI: 10.1016/bs.apar.2016.08.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Diagnostics play a crucial role in determining treatment protocols and evaluating success of mass drug administration (MDA) programmes used to control soil-transmitted helminths (STHs). The current diagnostic, Kato-Katz, relies on inexpensive, reusable materials and can be used in the field, but only trained microscopists can read slides. This diagnostic always underestimates the true prevalence of infection, and the accuracy worsens as the true prevalence falls. We investigate how more sensitive diagnostics would impact on the management and life cycle of MDA programmes, including number of mass treatment rounds, health impact, number of unnecessary treatments and probability of elimination. We use an individual-based model of STH transmission within the current World Health Organization (WHO) treatment guidelines which records individual disability-adjusted life years (DALY) lost. We focus on Ascaris lumbricoides due to the availability of high-quality data on existing diagnostics. We show that the effect of improving the sensitivity of diagnostics is principally determined by the precontrol prevalence in the community. Communities at low true prevalence (<30%) and high true prevalence (>70%) do not benefit greatly from improved diagnostics. Communities with intermediate prevalence benefit greatly from increased chemotherapy application, both in terms of reduced DALY loss and increased probability of elimination. Our results suggest that programmes should be extended beyond school-age children, especially in high prevalence communities. Finally, we argue against using apparent or measured prevalence as an uncorrected proxy for true prevalence.
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Affiliation(s)
- G F Medley
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - H C Turner
- Imperial College London, London, United Kingdom
| | - R F Baggaley
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - C Holland
- Trinity College Dublin, Dublin, Ireland
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Benjamin-Chung J, Nazneen A, Halder AK, Haque R, Siddique A, Uddin MS, Koporc K, Arnold BF, Hubbard AE, Unicomb L, Luby SP, Addiss DG, Colford JM. The Interaction of Deworming, Improved Sanitation, and Household Flooring with Soil-Transmitted Helminth Infection in Rural Bangladesh. PLoS Negl Trop Dis 2015; 9:e0004256. [PMID: 26624994 PMCID: PMC4666415 DOI: 10.1371/journal.pntd.0004256] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 11/02/2015] [Indexed: 11/18/2022] Open
Abstract
Background The combination of deworming and improved sanitation or hygiene may result in greater reductions in soil-transmitted helminth (STH) infection than any single intervention on its own. We measured STH prevalence in rural Bangladesh and assessed potential interactions among deworming, hygienic latrines, and household finished floors. Methodology We conducted a cross-sectional survey (n = 1,630) in 100 villages in rural Bangladesh to measure three exposures: self-reported deworming consumption in the past 6 months, access to a hygienic latrine, and household flooring material. We collected stool samples from children 1–4 years, 5–12 years, and women 15–49 years. We performed mini-FLOTAC on preserved stool samples to detect Ascaris lumbricoides, Enterobius vermicularis, hookworm, and Trichuris trichiura ova. Approximately one-third (32%) of all individuals and 40% of school-aged children had an STH infection. Less than 2% of the sample had moderate/heavy intensity infections. Deworming was associated with lower Ascaris prevalence (adjusted prevalence ratio (PR) = 0.53; 95% CI 0.40, 0.71), but there was no significant association with hookworm (PR = 0.93, 95% CI 0.60, 1.44) or Trichuris (PR = 0.90, 95% CI 0.74, 1.08). PRs for hygienic latrine access were 0.91 (95% CI 0.67,1.24), 0.73 (95% CI 0.43,1.24), and 1.03 (95% CI 0.84,1.27) for Ascaris, hookworm, and Trichuris, respectively. Finished floors were associated with lower Ascaris prevalence (PR = 0.56, 95% CI 0.32, 0.97) but not associated with hookworm (PR = 0.48 95% CI 0.16,1.45) or Trichuris (PR = 0.98, 95% CI 0.72,1.33). Across helminths and combinations of exposures, adjusted prevalence ratios for joint exposures were consistently more protective than those for individual exposures. Conclusions We found moderate STH prevalence in rural Bangladesh among children and women of childbearing age. This study is one of the first to examine independent and combined associations with deworming, sanitation, and hygiene. Our results suggest that coupling deworming with sanitation and flooring interventions may yield more sustained reductions in STH prevalence. Soil-transmitted helminth infections remain prevalent in many low-resource areas of the world. The World Health Organization recommends that schoolchildren in countries where these infections remain common receive deworming medication two times a year. However, previous research has shown that people who live in countries where these infections are common are frequently reinfected within 6 months of taking deworming medication. Programs that improve sanitation and hygiene might help complement deworming programs to reduce reinfection and prevent transmission. We conducted a survey of women and children in rural Bangladesh to understand potential sanitation and hygiene interventions that could complement deworming. We found that people who took deworming medication and had access to a hygienic latrine had a lower worm infection prevalence than people who only took deworming medication. We also found that people who took deworming medication and had a house with a finished floor had a lower prevalence than people who only took deworming medication. Our results suggest that coupling deworming with sanitation and flooring interventions may be a more successful strategy for reducing STH transmission in the long run.
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Affiliation(s)
- Jade Benjamin-Chung
- School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- * E-mail:
| | - Arifa Nazneen
- Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Amal K. Halder
- Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Rashidul Haque
- Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Abdullah Siddique
- Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Muhammed Salah Uddin
- Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Kim Koporc
- Children Without Worms, Task Force for Global Health, Atlanta, Georgia, United States of America
| | - Benjamin F. Arnold
- School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Alan E. Hubbard
- School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Leanne Unicomb
- Centre for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Stephen P. Luby
- Department of Medicine, Stanford University, Stanford, California, United States of America
| | - David G. Addiss
- Children Without Worms, Task Force for Global Health, Atlanta, Georgia, United States of America
| | - John M. Colford
- School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
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Smith JL, Sivasubramaniam S, Rabiu MM, Kyari F, Solomon AW, Gilbert C. Multilevel Analysis of Trachomatous Trichiasis and Corneal Opacity in Nigeria: The Role of Environmental and Climatic Risk Factors on the Distribution of Disease. PLoS Negl Trop Dis 2015. [PMID: 26222549 PMCID: PMC4519340 DOI: 10.1371/journal.pntd.0003826] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The distribution of trachoma in Nigeria is spatially heterogeneous, with large-scale trends observed across the country and more local variation within areas. Relative contributions of individual and cluster-level risk factors to the geographic distribution of disease remain largely unknown. The primary aim of this analysis is to assess the relationship between climatic factors and trachomatous trichiasis (TT) and/or corneal opacity (CO) due to trachoma in Nigeria, while accounting for the effects of individual risk factors and spatial correlation. In addition, we explore the relative importance of variation in the risk of trichiasis and/or corneal opacity (TT/CO) at different levels. Data from the 2007 National Blindness and Visual Impairment Survey were used for this analysis, which included a nationally representative sample of adults aged 40 years and above. Complete data were available from 304 clusters selected using a multi-stage stratified cluster-random sampling strategy. All participants (13,543 individuals) were interviewed and examined by an ophthalmologist for the presence or absence of TT and CO. In addition to field-collected data, remotely sensed climatic data were extracted for each cluster and used to fit Bayesian hierarchical logistic models to disease outcome. The risk of TT/CO was associated with factors at both the individual and cluster levels, with approximately 14% of the total variation attributed to the cluster level. Beyond established individual risk factors (age, gender and occupation), there was strong evidence that environmental/climatic factors at the cluster-level (lower precipitation, higher land surface temperature, higher mean annual temperature and rural classification) were also associated with a greater risk of TT/CO. This study establishes the importance of large-scale risk factors in the geographical distribution of TT/CO in Nigeria, supporting anecdotal evidence that environmental conditions are associated with increased risk in this context and highlighting their potential use in improving estimates of disease burden at large scales. Trichiasis (TT) and corneal opacity (CO) are chronic stages of trachoma, which remains an important cause of blindness. This study used multilevel spatial models to investigate risk factors for TT/CO in Nigeria, including data for more than 13,500 adults aged 40 years and above collected in the 2007 National Blindness and Visual Impairment survey. Individual-level risk factors were consistent with those identified in other studies, including a higher risk in females, older individuals and those with lower socioeconomic status. After controlling for these factors, there was evidence that a number of environmental and climatic factors are associated with the distribution of TT/CO in Nigeria. These findings establish for the Nigerian context the importance of risk factors at different scales for the later stages of trachoma, supporting anecdotal evidence that hotter, drier environmental conditions are associated with increased risk.
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Affiliation(s)
- Jennifer L. Smith
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Global Health Group, University of California San Francisco, San Francisco, California, United States of America
- * E-mail:
| | - Selvaraj Sivasubramaniam
- Medical Statistics Team, Division of Applied Health Sciences, University of Aberdeen, United Kingdom
| | | | - Fatima Kyari
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- College of Health Sciences of University of Abuja, Abuja, Nigeria
| | - Anthony W. Solomon
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Clare Gilbert
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Walana W, Aidoo ENK, Tay SCK. Prevalence of hookworm infection: a retrospective study in Kumasi. Asian Pac J Trop Biomed 2014; 4:S158-61. [PMID: 25183072 PMCID: PMC4025262 DOI: 10.12980/apjtb.4.2014apjtb-2013-0014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 02/19/2014] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To establish the prevalence of hookworm infection among patients who reported at the parasitology laboratory of the Komfo Anokye Teaching Hospital for intestinal parasitic investigation. METHOD This retrospective study covered available data from January 2001 to December 2011. Records of patients referred to the parasitology laboratory of the hospital were manually reviewed for hookworm infection. Data on age, sex and status of hookworm infection (either present or absent) were retrieved and analyzed by using Microsoft Excel 2007 statistical package. RESULTS A total of 47 147 patients was reported at the laboratory for intestinal parasitic investigation. Among these patients, 158 patient were positive, representing an overall prevalence of 0.3% (158/47 147). Among the positive cases, the study revealed that the proportion of individuals in age groups <1, 1 to 9, 10 to 19, 20 to 29 and 30 to 39 years were 1.3% (2), 10.8% (17), 16.5% (26), 27.2% (43) and 23.4% (37) respectively. Furthermore, people in age group 40 to 49, 50 to 59 and ≥60 years were infected in the proportion of 8.7% (14), 5.7% (9) and 7.0% (11) respectively. Among the infected patients, the number of females was 62.7% (99) while that of males was 37.3% (59). The yearly prevalence rate dropped consistently from 0.84% in 2001 to 0.11% in 2005. However it increased marginally in 2006 (0.27%) and dropped to 0.00% in 2011. CONCLUSION Hookworm infestation was found to be generally high between April and August. However the overall prevalence was relatively low among the study population.
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Affiliation(s)
- Williams Walana
- Department of Clinical Laboratory Sciences, School of Medicine and Health Sciences (SMHS), University for Development Studies, Tamale, Ghana
| | - Eric Nana Kofi Aidoo
- Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Crowther Kofi Tay
- Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Betson M, Nejsum P, Bendall RP, Deb RM, Stothard JR. Molecular epidemiology of ascariasis: a global perspective on the transmission dynamics of Ascaris in people and pigs. J Infect Dis 2014; 210:932-41. [PMID: 24688073 PMCID: PMC4136802 DOI: 10.1093/infdis/jiu193] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background. The roundworm Ascaris lumbricoides infects 0.8 billion people worldwide, and Ascaris suum infects innumerable pigs across the globe. The extent of natural cross-transmission of Ascaris between pig and human hosts in different geographical settings is unknown, warranting investigation. Methods. Adult Ascaris organisms were obtained from humans and pigs in Europe, Africa, Asia, and Latin America. Barcodes were assigned to 536 parasites on the basis of sequence analysis of the mitochondrial cytochrome c oxidase I gene. Genotyping of 410 worms was also conducted using a panel of microsatellite markers. Phylogenetic, population genetic, and Bayesian assignment methods were used for analysis. Results. There was marked genetic segregation between worms originating from human hosts and those originating from pig hosts. However, human Ascaris infections in Europe were of pig origin, and there was evidence of cross-transmission between humans and pigs in Africa. Significant genetic differentiation exists between parasite populations from different countries, villages, and hosts. Conclusions. In conducting an analysis of variation within Ascaris populations from pig and human hosts across the globe, we demonstrate that cross-transmission takes place in developing and developed countries, contingent upon epidemiological potential and local phylogeography. Our results provide novel insights into the transmission dynamics and speciation of Ascaris worms from humans and pigs that are of importance for control programs.
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Affiliation(s)
- Martha Betson
- Department of Production and Population Health, Royal Veterinary College, Hatfield, Hertfordshire, United Kingdom Department of Parasitology, Pembroke Place, Liverpool School of Tropical Medicine, United Kingdom
| | - Peter Nejsum
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | | | - Rinki M Deb
- Department of Parasitology, Pembroke Place, Liverpool School of Tropical Medicine, United Kingdom
| | - J Russell Stothard
- Department of Parasitology, Pembroke Place, Liverpool School of Tropical Medicine, United Kingdom
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Schüle SA, Clowes P, Kroidl I, Kowuor DO, Nsojo A, Mangu C, Riess H, Geldmacher C, Laubender RP, Mhina S, Maboko L, Löscher T, Hoelscher M, Saathoff E. Ascaris lumbricoides infection and its relation to environmental factors in the Mbeya region of Tanzania, a cross-sectional, population-based study. PLoS One 2014; 9:e92032. [PMID: 24643023 PMCID: PMC3958400 DOI: 10.1371/journal.pone.0092032] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 02/17/2014] [Indexed: 11/29/2022] Open
Abstract
Background With one quarter of the world population infected, the intestinal nematode Ascaris lumbricoides is one of the most common infectious agents, especially in the tropics and sub-tropics. Infection is caused by oral intake of eggs and can cause respiratory and gastrointestinal problems. To identify high risk areas for intervention, it is necessary to understand the effects of climatic, environmental and socio-demographic conditions on A. lumbricoides infection. Methodology Cross-sectional survey data of 6,366 study participants in the Mbeya region of South-Western Tanzania were used to analyze associations between remotely sensed environmental data and A. lumbricoides infection. Non-linear associations were accounted for by using fractional polynomial regression, and socio-demographic and sanitary data were included as potential confounders. Principal Findings The overall prevalence of A. lumbricoides infection was 6.8%. Our final multivariable model revealed a significant non-linear association between rainfall and A. lumbricoides infection with peak prevalences at 1740 mm of mean annual rainfall. Mean annual land surface temperature during the day was linearly modeled and negatively associated with A. lumbricoides infection (odds ratio (OR) = 0.87, 95% confidence interval (CI) = 0.78–0.97). Furthermore, age, which also showed a significant non-linear association (infection maximum at 7.7 years), socio-economic status (OR = 0.82, CI = 0.68–0.97), and latrine coverage around the house (OR = 0.80, CI = 0.67–0.96) remained in the final model. Conclusions A. lumbricoides infection was associated with environmental, socio-demographic and sanitary factors both in uni- and multivariable analysis. Non-linear analysis with fractional polynomials can improve model fit, resulting in a better understanding of the relationship between environmental conditions and helminth infection, and more precise predictions of high prevalence areas. However, socio-demographic determinants and sanitary conditions should also be considered, especially when planning public health interventions on a smaller scale, such as the community level.
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Affiliation(s)
- Steffen Andreas Schüle
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- Institute for Medical Bioinformatics, Biometry, and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
- Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
- * E-mail:
| | - Petra Clowes
- NIMR-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- NIMR-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
| | | | - Anthony Nsojo
- NIMR-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
| | - Chacha Mangu
- NIMR-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
| | - Helene Riess
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- Institute for Medical Bioinformatics, Biometry, and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Rüdiger Paul Laubender
- Institute for Medical Bioinformatics, Biometry, and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - Seif Mhina
- Mbeya Regional Medical Office, Mbeya, Tanzania
| | - Leonard Maboko
- NIMR-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
| | - Thomas Löscher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- NIMR-Mbeya Medical Research Center (MMRC), Mbeya, Tanzania
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- German Center for Infection Research (DZIF), partner site Munich, Munich, Germany
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Santaweesuk S, Chapman RS, Siriwong W. Effects of an injury and illness prevention program on occupational safety behaviors among rice farmers in Nakhon Nayok Province, Thailand. Risk Manag Healthc Policy 2014; 7:51-60. [PMID: 24634590 PMCID: PMC3953033 DOI: 10.2147/rmhp.s55810] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The objective of this study was to determine the effects of an Injury and Illness Prevention (IIP) program intervention on occupational safety behavior among rice farmers in Nakhon Nayok Province, Thailand. This was a quasi-experimental study in an intervention group and a control group. It was carried out in two rice farming communities, in which most people are rice farmers with similar socio-demographic characteristics. Multistage sampling was employed, selecting one person per rice farming household. The intervention group was 62 randomly selected rice farmers living in a rural area; another 55 rice farmers served as the control group. A structured face-to-face interview questionnaire was administered to participants to evaluate their safety behaviors in four areas: equipment use, pesticide use, ergonomics, and working conditions. The 2-week intervention program consisted of four elements: 1) health education, 2) safety inspection, 3) safety communication, and 4) health surveillance. Data were collected at baseline and 4 months after the intervention (follow-up). We used a general linear model repeated-measures analysis of variance to assess the mean difference between baseline and follow-up occupational safety behavior points between the intervention and control groups. Pesticide safety behaviors significantly increased in the intervention group compared with the control group. Ergonomics and working conditions points also increased in the intervention group, but not significantly so. The equipment use score decreased in the intervention group. It is necessary to identify and develop further measures to improve occupational safety behaviors. Some methods, such as effective risk communication, could be added to increase risk perception.
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Affiliation(s)
- Sapsatree Santaweesuk
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
- Srinakarinwirot University Ongkharak Campus, Nakhon Nayok, Thailand
| | - Robert S Chapman
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Wattasit Siriwong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
- Thai Fogarty ITREOH Center, Chulalongkorn University, Bangkok, Thailand
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Strunz EC, Addiss DG, Stocks ME, Ogden S, Utzinger J, Freeman MC. Water, sanitation, hygiene, and soil-transmitted helminth infection: a systematic review and meta-analysis. PLoS Med 2014; 11:e1001620. [PMID: 24667810 PMCID: PMC3965411 DOI: 10.1371/journal.pmed.1001620] [Citation(s) in RCA: 427] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 02/13/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Preventive chemotherapy represents a powerful but short-term control strategy for soil-transmitted helminthiasis. Since humans are often re-infected rapidly, long-term solutions require improvements in water, sanitation, and hygiene (WASH). The purpose of this study was to quantitatively summarize the relationship between WASH access or practices and soil-transmitted helminth (STH) infection. METHODS AND FINDINGS We conducted a systematic review and meta-analysis to examine the associations of improved WASH on infection with STH (Ascaris lumbricoides, Trichuris trichiura, hookworm [Ancylostoma duodenale and Necator americanus], and Strongyloides stercoralis). PubMed, Embase, Web of Science, and LILACS were searched from inception to October 28, 2013 with no language restrictions. Studies were eligible for inclusion if they provided an estimate for the effect of WASH access or practices on STH infection. We assessed the quality of published studies with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. A total of 94 studies met our eligibility criteria; five were randomized controlled trials, whilst most others were cross-sectional studies. We used random-effects meta-analyses and analyzed only adjusted estimates to help account for heterogeneity and potential confounding respectively. Use of treated water was associated with lower odds of STH infection (odds ratio [OR] 0.46, 95% CI 0.36-0.60). Piped water access was associated with lower odds of A. lumbricoides (OR 0.40, 95% CI 0.39-0.41) and T. trichiura infection (OR 0.57, 95% CI 0.45-0.72), but not any STH infection (OR 0.93, 95% CI 0.28-3.11). Access to sanitation was associated with decreased likelihood of infection with any STH (OR 0.66, 95% CI 0.57-0.76), T. trichiura (OR 0.61, 95% CI 0.50-0.74), and A. lumbricoides (OR 0.62, 95% CI 0.44-0.88), but not with hookworm infection (OR 0.80, 95% CI 0.61-1.06). Wearing shoes was associated with reduced odds of hookworm infection (OR 0.29, 95% CI 0.18-0.47) and infection with any STH (OR 0.30, 95% CI 0.11-0.83). Handwashing, both before eating (OR 0.38, 95% CI 0.26-0.55) and after defecating (OR 0.45, 95% CI 0.35-0.58), was associated with lower odds of A. lumbricoides infection. Soap use or availability was significantly associated with lower infection with any STH (OR 0.53, 95% CI 0.29-0.98), as was handwashing after defecation (OR 0.47, 95% CI 0.24-0.90). Observational evidence constituted the majority of included literature, which limits any attempt to make causal inferences. Due to underlying heterogeneity across observational studies, the meta-analysis results reflect an average of many potentially distinct effects, not an average of one specific exposure-outcome relationship. CONCLUSIONS WASH access and practices are generally associated with reduced odds of STH infection. Pooled estimates from all meta-analyses, except for two, indicated at least a 33% reduction in odds of infection associated with individual WASH practices or access. Although most WASH interventions for STH have focused on sanitation, access to water and hygiene also appear to significantly reduce odds of infection. Overall quality of evidence was low due to the preponderance of observational studies, though recent randomized controlled trials have further underscored the benefit of handwashing interventions. Limited use of the Joint Monitoring Program's standardized water and sanitation definitions in the literature restricted efforts to generalize across studies. While further research is warranted to determine the magnitude of benefit from WASH interventions for STH control, these results call for multi-sectoral, integrated intervention packages that are tailored to social-ecological contexts.
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Affiliation(s)
- Eric C. Strunz
- Children Without Worms, The Task Force for Global Health, Decatur, Georgia, United States of America
| | - David G. Addiss
- Children Without Worms, The Task Force for Global Health, Decatur, Georgia, United States of America
| | - Meredith E. Stocks
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Stephanie Ogden
- Children Without Worms, The Task Force for Global Health, Decatur, Georgia, United States of America
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- International Trachoma Initiative, The Task Force for Global Health, Decatur, Georgia, United States of America
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Matthew C. Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
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Halpenny CM, Paller C, Koski KG, Valdés VE, Scott ME. Regional, household and individual factors that influence soil transmitted helminth reinfection dynamics in preschool children from rural indigenous Panamá. PLoS Negl Trop Dis 2013; 7:e2070. [PMID: 23437411 PMCID: PMC3578751 DOI: 10.1371/journal.pntd.0002070] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 01/08/2013] [Indexed: 11/22/2022] Open
Abstract
Background Few studies have investigated the relative influence of individual susceptibility versus household exposure factors versus regional clustering of infection on soil transmitted helminth (STH) transmission. The present study examined reinfection dynamics and spatial clustering of Ascaris lumbricoides, Trichuris trichiura and hookworm in an extremely impoverished indigenous setting in rural Panamá over a 16 month period that included two treatment and reinfection cycles in preschool children. Methodology/Principle Findings Spatial cluster analyses were used to identify high prevalence clusters for each nematode. Multivariate models were then used (1) to identify factors that differentiated households within and outside the cluster, and (2) to examine the relative contribution of regional (presence in a high prevalence cluster), household (household density, asset-based household wealth, household crowding, maternal education) and individual (age, sex, pre-treatment eggs per gram (epg) feces, height-for-age, latrine use) factors on preschool child reinfection epgs for each STH. High prevalence spatial clusters were detected for Trichuris and hookworm but not for Ascaris. These clusters were characterized by low household density and low household wealth indices (HWI). Reinfection epg of both hookworm and Ascaris was positively associated with pre-treatment epg and was higher in stunted children. Additional individual (latrine use) as well as household variables (HWI, maternal education) entered the reinfection models for Ascaris but not for hookworm. Conclusions/Significance Even within the context of extreme poverty in this remote rural setting, the distinct transmission patterns for hookworm, Trichuris and Ascaris highlight the need for multi-pronged intervention strategies. In addition to poverty reduction, improved sanitation and attention to chronic malnutrition will be key to reducing Ascaris and hookworm transmission. Control of soil transmitted helminth (STH) infections is of central importance to improving preschool child health because these infections can have long lasting consequences on growth and development. Our study in indigenous Ngäbe preschool children in western Panama was conducted over a period of 16 months. We monitored reinfection dynamics of three STH infections (Ascaris, Trichuris and hookworm) over two reinfection cycles to gain an understanding of regional, household and individual factors that influenced transmission of these infections among preschool children. Despite the rural setting, where virtually all households live under conditions of extreme poverty, we identified spatial clusters of high prevalence of Trichuris and hookworm in the most remote and poorest area, whereas Ascaris was present throughout the study area. Preschool children who were chronically malnourished (low height-for-age) had a higher reinfection burden of Ascaris and hookworm. Household poverty (low relative household wealth and maternal education) and infrequent latrine use were also influential in Ascaris reinfection. This cross-disciplinary analysis of preschool child STH transmission in a poor rural setting provides pertinent information for STH control programs that aim to break the cycle of poverty and infection.
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Affiliation(s)
- Carli M. Halpenny
- Institute of Parasitology and McGill School of Environment Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada
| | - Claire Paller
- Institute of Parasitology and McGill School of Environment Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada
| | - Kristine G. Koski
- School of Dietetics and Human Nutrition Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada
| | - Victoria E. Valdés
- Escuela de Nutrición y Dietética, Facultad de Medicina, Universidad de Panamá, Ciudad de Panamá, Panamá
| | - Marilyn E. Scott
- Institute of Parasitology and McGill School of Environment Macdonald Campus of McGill University, Ste-Anne de Bellevue, Quebec, Canada
- * E-mail:
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30
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Briones-Chávez C, Torres-Zevallos H, Canales M, Stamato CM, O'Riordan TG, Terashima A. Differences in prevalence of geohelminth infections between indigenous and settler populations in a remote Amazonian region of Peru. Trop Med Int Health 2013; 18:615-8. [DOI: 10.1111/tmi.12077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Carlo Briones-Chávez
- Facultad de Medicina Alberto Hurtado; Universidad Peruana Cayetano Heredia; Lima; Peru
| | | | - Marco Canales
- Instituto de Medicina Tropical Alexander von Humboldt; Universidad Peruana Cayetano Heredia; Lima; Peru
| | | | - Thomas G. O'Riordan
- Division of Pulmonary and Critical Care Medicine; University of Washington; Seattle; WA; USA
| | - Angélica Terashima
- Instituto de Medicina Tropical Alexander von Humboldt; Universidad Peruana Cayetano Heredia; Lima; Peru
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31
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Ascariasis in people and pigs: New inferences from DNA analysis of worm populations. INFECTION GENETICS AND EVOLUTION 2012; 12:227-35. [DOI: 10.1016/j.meegid.2012.01.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Revised: 01/12/2012] [Accepted: 01/14/2012] [Indexed: 11/18/2022]
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