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Geer K, Mekonnen Z, Taye B. Decreased Weight-for-Age Associated with Mass Deworming among Young Ethiopian Schoolchildren in Jimma Town, Southwest Ethiopia: A School-Based Cross-Sectional Study. Am J Trop Med Hyg 2024; 110:103-110. [PMID: 38081046 DOI: 10.4269/ajtmh.23-0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/24/2023] [Indexed: 01/05/2024] Open
Abstract
School-based mass deworming programs are implemented to reduce soil-transmitted helminth (STH) infection prevalence and intensity among school-aged children. However, previous studies debate the impact of deworming beyond the removal of worms. Hence, this study aimed to examine the effect of mass deworming on nutritional indicators in young Ethiopian schoolchildren. A school-based cross-sectional study was conducted among 1,036 participants from April to May 2020 in Jimma Town, Ethiopia. An interviewer-based questionnaire was administered to the children to gather data on sociodemographic, lifestyle variables, and deworming status. Anthropometric measurements were taken for the height and weight of the children. Stool samples were collected and analyzed for STH infection using direct wet mount microscopy and the Kato-Katz technique. In multivariate logistic regression analysis, deworming within the past 6 months or 1 year was not significantly associated with underweight, stunting, and thinning. However, deworming within the past year was significantly associated with decreased weight-for-age z-score (adjusted mean difference = -0.245; 95% CI: -0.413 to -0.076; P = 0.004). Deworming in the past 6 months demonstrated a nonsignificant trend toward increased stunting (adjusted odds ratio = 1.258; 95% CI: 0.923-1.714; P = 0.145). This study provides evidence that deworming in the past 6 months or 1 year was not significantly associated with underweight, stunting, and thinning. However, deworming within the past year was associated with a significantly decreased weight-for-age z-score in young Ethiopian schoolchildren of Jimma Town after adjustment for confounding variables.
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Affiliation(s)
- Kylie Geer
- Department of Biology, Colgate University, Hamilton, New York
| | - Zeleke Mekonnen
- Institute of Health, School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Bineyam Taye
- Department of Biology, Colgate University, Hamilton, New York
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Santos MCS, Oliveira GLD, Mingoti SA, Heller L. Sewerage as a protective factor for prevalence of hookworm infection in schoolchildren in Brazil: A multilevel ecological analysis of national prevalence surveys (1950-2018). THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 895:164621. [PMID: 37271392 DOI: 10.1016/j.scitotenv.2023.164621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/05/2023] [Accepted: 05/31/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION The prevalence of hookworm infection in Brazil has decreased considerably in recent decades. However, there is no definitive consensus as to which changes have contributed to this reduction. A hypothesis is that improvements in environmental factors have contributed to lowering the parasite load and the level of host-parasite contact. METHODS This is an ecological study using unbalanced panel data from two Brazilian surveys (1947-1953 and 2010-2015), with municipalities as the analysis unit. The sample comprised 1428 municipalities, in which a total of 745,983 schoolchildren aged 7 to 14 were examined. Zero-inflated Poisson regression models, with fixed and random effects were estimated to evaluate the association of potential explanatory variables with the prevalence of hookworm infection at a significance level of 5 %. RESULTS We identified a significant decrease in the prevalence between the first and last analyzed periods (RR 0.096; CI 0.086-0.107); The following variables were found to have a protective effect: access to sanitary sewage systems (RR 0.984, CI 0.982-0.986), urbanization (RR 0.995, CI 0.993-0.997), and gross domestic product (RR 0.929, CI 0.912-0.945). CONCLUSION The findings of this study show a decrease in the prevalence of hookworm infections over six decades in schoolchildren in the Brazilian municipalities. Environmental, demographic, and economic factors were associated with this trend. A historical analysis indicates that interventions aimed at improving sanitation contributed to reducing the disease prevalence.
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Affiliation(s)
- Mariana Cristina Silva Santos
- Rene Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Ave, Barro Preto, Belo Horizonte, Minas Gerais 30190-009, Brazil.
| | - Guilherme Lopes de Oliveira
- Federal Center for Technological Education of Minas Gerais, 5253 Amazonas Ave, Nova Suiça, Belo Horizonte, Minas Gerais 30421169, Brazil.
| | - Sueli Aparecida Mingoti
- Federal University of Minas Gerais, 6627 Pres Antônio Carlos Ave, Pampulha, Belo Horizonte, Brazil
| | - Léo Heller
- Rachou Institute (IRR), Oswaldo Cruz Foundation (FIOCRUZ), 1715 Augusto de Lima Ave, Barro Preto, Belo Horizonte, Minas Gerais 30190-009, Brazil.
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Macpherson ML, Zendejas-Heredia PA, Sylvester W, Gasser RB, Traub RJ, Colella V, Macpherson CN. Zoonotic helminths of dogs and risk factors associated with polyparasitism in Grenada, West Indies. Parasitology 2023; 150:754-759. [PMID: 37184089 PMCID: PMC10410397 DOI: 10.1017/s0031182023000495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/16/2023]
Abstract
Canine soil-transmitted helminths (STHs) cause important zoonoses in the tropics, with varying degrees of intensity of infection in humans and dogs. This study aimed to investigate the prevalence and associated risk factors for STHs in community dogs residing in Grenada, West Indies. In May 2021, 232 canine fecal samples were examined for zoonotic helminths by microscopy (following flotation), and genomic DNA from a subset of 211 of these samples were subjected to multiplex qPCR for the detection and specific identification of hookworms, Toxocara spp. and Strongyloides. Microscopic examination revealed that 46.5% (108/232, 95% CI 40–52.9), 9% (21/232, 95% CI 5.35–12.7) and 5.2% (12/232, 95% CI 2.3–8) of the samples contained eggs of Ancylostoma spp., Toxocara spp. and Trichuris vulpis, respectively. Multiplex qPCR revealed that, 42.2% (89/211, 95% CI 35.5–48.8) were positive for at least 1 zoonotic parasite. Of these, 40.8% (86/211, 95% CI 34.1–47.3) of samples tested positive for Ancylostoma spp., 36% (76/211, 95% CI 29.5–42.9) were positive for A. caninum, 13.3% (28/211, 95% CI 9–18.6) for A. ceylanicum, 5.7% for T. canis (12/211, 95% CI 2.97–8.81) and 1% (2/211, 95% CI 0–2.26) for Strongyloides spp. (identified as S. stercoralis and S. papillosus by conventional PCR-based Sanger sequencing). Using a multiple logistic regression model, a low body score and free-roaming behaviour were significant predictors of test-positivity for these parasitic nematodes in dogs (P < 0.05). Further studies of zoonotic STHs in humans should help elucidate the public health relevance of these parasites in Grenada.
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Affiliation(s)
- Maxine L.A. Macpherson
- Windward Islands Research and Education Foundation, St. George's, Grenada, West Indies
- School of Veterinary Medicine, St. George's University, St. George's, Grenada, West Indies
| | | | - Wayne Sylvester
- Windward Islands Research and Education Foundation, St. George's, Grenada, West Indies
- School of Veterinary Medicine, St. George's University, St. George's, Grenada, West Indies
| | - Robin B. Gasser
- Faculty of Science, Melbourne Veterinary School, University of Melbourne, Parkville, VIC, Australia
| | - Rebecca J. Traub
- Faculty of Science, Melbourne Veterinary School, University of Melbourne, Parkville, VIC, Australia
| | - Vito Colella
- Faculty of Science, Melbourne Veterinary School, University of Melbourne, Parkville, VIC, Australia
| | - Calum N.L. Macpherson
- Windward Islands Research and Education Foundation, St. George's, Grenada, West Indies
- School of Veterinary Medicine, St. George's University, St. George's, Grenada, West Indies
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Kouamé PK, Galli A, Peter M, Loss G, Wassa D, Bonfoh B, Utzinger J, Winkler MS. Access to Water and Sanitation Infrastructures for Primary Schoolchildren in the South-Central Part of Côte d'Ivoire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8863. [PMID: 34444615 PMCID: PMC8392625 DOI: 10.3390/ijerph18168863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022]
Abstract
In rural settings of Côte d'Ivoire, access to water, sanitation, and hygiene (WASH) at schools is often lacking. The purpose of this study was to assess the availability, quality, and use of WASH infrastructure in schools in the south-central part of Côte d'Ivoire, and to determine the hygiene practices of schoolchildren. A cross-sectional study was conducted in 20 primary schools with (n = 10) or without (n = 10) direct access to drinking water. The survey was comprised of a questionnaire directed at schoolchildren aged 8-17 years, an assessment of the WASH infrastructure, and the testing of drinking water samples for Escherichia coli and total coliforms. Overall, 771 schoolchildren were enrolled in the study. One out of four children (24.9%) reported that they used available toilets. Among those children not using toilets, more than half (57.5%) reported that they practised open defecation. Drinking water infrastructure was limited in most schools because of poor storage tanks, the low flow of water, or broken wells. All drinking water samples (n = 18) tested positive for total coliforms and 15 (83.3%) tested positive for E. coli. The lack of WASH infrastructures in primary schools in the south-central part of Côte d'Ivoire, in combination with poor hygiene practices, might govern disease transmission and absenteeism at school, especially among females.
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Affiliation(s)
- Parfait K. Kouamé
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303 Abidjan 01, Côte d’Ivoire; (P.K.K.); (B.B.)
| | - Anaïs Galli
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (G.L.); (J.U.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Maryna Peter
- Institute for Ecopreneurship, University of Applied Sciences and Arts Northwestern Switzerland, CH-4132 Muttenz, Switzerland;
| | - Georg Loss
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (G.L.); (J.U.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | | | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, 01 BP 1303 Abidjan 01, Côte d’Ivoire; (P.K.K.); (B.B.)
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (G.L.); (J.U.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
| | - Mirko S. Winkler
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; (G.L.); (J.U.); (M.S.W.)
- University of Basel, P.O. Box, CH-4003 Basel, Switzerland
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Avokpaho EFGA, Houngbégnon P, Accrombessi M, Atindégla E, Yard E, Rubin Means A, Kennedy DS, Littlewood DTJ, Garcia A, Massougbodji A, Galagan SR, Walson JL, Cottrell G, Ibikounlé M, Ásbjörnsdóttir KH, Luty AJF. Factors associated with soil-transmitted helminths infection in Benin: Findings from the DeWorm3 study. PLoS Negl Trop Dis 2021; 15:e0009646. [PMID: 34403424 PMCID: PMC8396766 DOI: 10.1371/journal.pntd.0009646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 08/27/2021] [Accepted: 07/13/2021] [Indexed: 11/19/2022] Open
Abstract
Background Despite several years of school-based MDA implementation, STH infections remain an important public health problem in Benin, with a country-wide prevalence of 20% in 2015. The DeWorm3 study is designed to assess the feasibility of using community-based MDA with albendazole to interrupt the transmission of STH, through a series of cluster-randomized trials in Benin, India and Malawi. We used the pre-treatment baseline survey data to describe and analyze the factors associated with STH infection in Comé, the study site of the DeWorm3 project in Benin. These data will improve understanding of the challenges that need to be addressed in order to eliminate STH as a public health problem in Benin. Methods Between March and April 2018, the prevalence of STH (hookworm spp., Ascaris and Trichuris trichiura) was assessed by Kato-Katz in stool samples collected from 6,153 residents in the community of Comé, Benin using a stratified random sampling procedure. A standardized survey questionnaire was used to collect information from individual households concerning factors potentially associated with the presence and intensity of STH infections in pre-school (PSAC, aged 1–4), school-aged children (SAC, aged 5–14) and adults (aged 15 and above). Multilevel mixed-effects models were used to assess associations between these factors and STH infection. Results The overall prevalence of STH infection was 5.3%; 3.2% hookworm spp., 2.1% Ascaris lumbricoides and 0.1% Trichuris. Hookworm spp. were more prevalent in adults than in SAC (4.4% versus 2.0%, respectively; p = 0.0001) and PSAC (4.4% versus 1.0%, respectively; p<0.0001), whilst Ascaris lumbricoides was more prevalent in SAC than in adults (3.0% versus 1.7%, respectively; p = 0.004). Being PSAC (adjusted Odds Ratio (aOR) = 0.2, p< 0.001; adjusted Infection Intensity Ratio (aIIR) = 0.1, p<0.001) or SAC (aOR = 0.5, p = 0.008; aIIR = 0.3, p = 0.01), being a female (aOR = 0.6, p = 0.004; aIIR = 0.3, p = 0.001), and having received deworming treatment the previous year (aOR = 0.4, p< 0.002; aIIR = 0.2, p<0.001) were associated with a lower prevalence and intensity of hookworm infection. Lower income (lowest quintile: aOR = 5.0, p<0.001, 2nd quintile aOR = 3.6, p = 0.001 and 3rd quintile aOR = 2.5, p = 0.02), being a farmer (aOR = 1.8, p = 0.02), medium population density (aOR = 2.6, p = 0.01), and open defecation (aOR = 0.5, p = 0.04) were associated with a higher prevalence of hookworm infection. Lower education—no education, primary or secondary school- (aIIR = 40.1, p = 0.01; aIIR = 30.9, p = 0.02; aIIR = 19.3, p = 0.04, respectively), farming (aIIR = 3.9, p = 0.002), natural flooring (aIIR = 0.2, p = 0.06), peri-urban settings (aIIR = 6.2, 95%CI 1.82–20.90, p = 0.003), and unimproved water source more than 30 minutes from the household (aIIR = 13.5, p = 0.02) were associated with a higher intensity of hookworm infection. Improved and unshared toilet was associated with lower intensity of hookworm infections (aIIR = 0.2, p = 0.01). SAC had a higher odds of Ascaris lumbricoides infection than adults (aOR = 2.0, p = 0.01) and females had a lower odds of infection (aOR = 0.5, p = 0.02). Conclusion Hookworm spp. are the most prevalent STH in Comé, with a persistent reservoir in adults that is not addressed by current control measures based on school MDA. Expanding MDA to target adults and PSAC is necessary to substantially impact population prevalence, particularly for hookworm. Trial registration ClinicalTrials.gov NCT03014167. Despite several years of deworming campaigns targeting school-aged children, soil-transmitted helminths (STH) remains a public health problem in most developing countries, including Benin. The burden is mostly on children and pregnant women, but also on the whole society. Soil-transmitted helminths are responsible for malnutrition, anemia, low birth weight, cognitive impairment, decrease of school performance, and subsequently economic loss. The current strategy of the Benin National Neglected Tropical Diseases (NTD) Program is to achieve STH control through mass drug administration campaigns targeting school-aged children (SAC). The baseline data of Deworm3 study, implemented in Comé, southern Benin, as part of a multicountry (Benin, Malawi and India) STH elimination trial, shows that previous school deworming campaigns decreased STH prevalence; however there is a persistent reservoir of STH infection in adults and pre-school aged children that should be targeted for a better impact. In order to eliminate STH as a public health problem, Benin National NTD Program would need to increase its target population, from the SAC to the whole community. The future results of Deworm3 trial would demonstrate whether the STH elimination goal STH using community wide mass drug administration would be achievable.
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Affiliation(s)
- Euripide F. G. A. Avokpaho
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Benin
- Université de Paris, ED 393 Pierre Louis de Santé Publique, Paris, France
- * E-mail:
| | | | - Manfred Accrombessi
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Benin
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Eloïc Atindégla
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Benin
| | - Elodie Yard
- DeWorm3, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Arianna Rubin Means
- DeWorm3, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - David S. Kennedy
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- DeWorm3, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | | | | | | | - Sean R. Galagan
- DeWorm3, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Judd L. Walson
- DeWorm3, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | | | - Moudachirou Ibikounlé
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Benin
- Centre de Recherche pour la lutte contre les Maladies Infectieuses Tropicales (CReMIT/TIDRC), Université d’Abomey-Calavi, Abomey-Calavi, Bénin
| | - Kristjana Hrönn Ásbjörnsdóttir
- DeWorm3, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Centre for Public Health Sciences, University of Iceland, Reykjavík, Iceland
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Hookworm infection still prevalent in the less developed urban area in jakarta, Indonesia. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Haldeman MS, Nolan MS, Ng'habi KRN. Human hookworm infection: Is effective control possible? A review of hookworm control efforts and future directions. Acta Trop 2020; 201:105214. [PMID: 31600519 DOI: 10.1016/j.actatropica.2019.105214] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 10/01/2019] [Accepted: 10/05/2019] [Indexed: 12/24/2022]
Abstract
Human hookworm, a soil-transmitted helminth (STH) infection caused by either Necator americanus or Anclystoma duodenale, is a major cause of morbidity globally and predominantly affects the world's poorest populations. Transmitted primarily by larval invasion of exposed skin, the adults inhabit the host small intestine, where they consume host blood. The resultant chronic iron deficiency anemia can lead to stunted growth and cognitive deficits in children, reduced work capacity in adults, and a variety of pregnancy complications. Historically, successful STH elimination has only been achieved in regions with concomitant significant economic growth. Since 2001, control of the STHs has been attempted via single-dose mass deworming of at-risk school-aged and preschool-aged children within STH-endemic countries, with the goal of morbidity reduction. Research questioning this strategy has grown in recent years, and current studies are evaluating the effectiveness of novel deworming strategies, including multidrug regimens and expansion of deworming to entire communities. While footwear campaigns may be associated with reduced odds of hookworm infection, the evidence supporting the impact of water, sanitation, and hygiene (WASH) interventions upon hookworm is mixed. Progress towards a human hookworm vaccine continues, with promising results from recent Phase 1 trials and several others ongoing. Integrated STH control programs, which combine mass deworming with WASH interventions, are relatively unstudied but may be a promising advancement. Whether interruption of STH transmission can be achieved apart from significant economic growth remains unanswered, but likely the implementation of intensive, integrated control programs will be necessary to achieve that goal.
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Affiliation(s)
- Matthew S Haldeman
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA; Department of Family and Preventive Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina, USA.
| | - Melissa S Nolan
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Kija R N Ng'habi
- Mbeya College of Health and Allied Sciences, University of Dar Es Salaam, Mbeya, Tanzania
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Bin Abdulrahman AK, Bin Abdulrahman KA, Almadi MK, Alharbi AM, Mahmoud MA, Almasri MS, Alanazi TR, Alarifi RA, Kilani AA, Albluwi OS, Al Fraih MA, Al Otabi YT, Alanazi HO, Almufarih WA, Alokayli AM, Alwhibi OA. Do various personal hygiene habits protect us against influenza-like illness? BMC Public Health 2019; 19:1324. [PMID: 31640641 PMCID: PMC6805437 DOI: 10.1186/s12889-019-7726-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 10/09/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Several studies have reported an association between improvements in hand hygiene and the reductions in rates of intestinal parasitic diseases. However, only a some have addressed its link to the frequency of influenza-like illness. The current study aimed to find the correlation between personal hygiene habits and the frequency of influenza-like illness. METHODS A cross-sectional study targeting 3000 participants conducted in Riyadh city, Saudi Arabia. A systematic random sampling methodology was applied for participant from different part of Riyadh city using a computer generating system. The researcher first started by calling each participant. A full explanation was given to each participant in details (from the purpose of the research, consent to answer the questionnaire, to the explanation of the outcome definition). Each point of the questionnaire was explained to them to make sure they had excellent comprehension, and therefore, respond accurately. Descriptive statistics and Odds Ratio and its 95% confidence intervals were used to determine the association between frequency of influenza-like illness and the studied variables. RESULTS Two thousand eighty-two (69.4%) completed the questionnaire. The participants who spent 5-10 s in handwashing with soap and rubbing were at increased risk of more frequent influenza-like illness (odds ratio = 1.37, 1.08-1.75). Handwashing with soap and rubbing after handshaking is an independent protective habit against frequent influenza-like illness (adjusted OR = 0.59, 0.37-0.94). CONCLUSION The decrease of the frequency of influenza-like illness could be done through the following: getting the influenza vaccine annually, washing hands with soap and hand rubbing not less than 15 s after getting out of the bathroom, before and after handshaking and before eating. Soap companies should invent soaps that take less rubbing time to kill bacteria, and subsequently may maximize compliance in the community.
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Affiliation(s)
- Amro K. Bin Abdulrahman
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Khalid A. Bin Abdulrahman
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Mansour K. Almadi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdulrahman M. Alharbi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Mahmoud A. Mahmoud
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Mohammed S. Almasri
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Tariq R. Alanazi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Rakan A. Alarifi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdullah A. Kilani
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Omar S. Albluwi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Muaath A. Al Fraih
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Yaser T. Al Otabi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Hani O. Alanazi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Waleed A. Almufarih
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdullah M. Alokayli
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Omar A. Alwhibi
- Department of Public Health, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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Mupfasoni D, Bangert M, Mikhailov A, Marocco C, Montresor A. Sustained preventive chemotherapy for soil-transmitted helminthiases leads to reduction in prevalence and anthelminthic tablets required. Infect Dis Poverty 2019; 8:82. [PMID: 31575378 PMCID: PMC6774215 DOI: 10.1186/s40249-019-0589-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/14/2019] [Indexed: 11/27/2022] Open
Abstract
Background The goal of soil-transmitted helminthiases (STH) control programmes is to eliminate STH-associated morbidity in the target population by reducing the prevalence of moderate- and heavy-intensity infections and the overall STH infection prevalence mainly through preventive chemotherapy (PC) with either albendazole or mebendazole. Endemic countries should measure the success of their control programmes through regular epidemiological assessments. We evaluated changes in STH prevalence in countries that conducted effective PC coverage for STH to guide changes in the frequency of PC rounds and the number of tablets needed. Methods We selected countries from World Health Organization (WHO)‘s Preventive Chemotherapy and Transmission control (PCT) databank that conducted ≥5 years of PC with effective coverage for school-age children (SAC) and extracted STH baseline and impact assessment data using the WHO Epidemiological Data Reporting Form, Ministry of Health reports and/or peer-reviewed publications. We used pooled and weighted means to plot the prevalence of infection with any STH and with each STH species at baseline and after ≥5 years of PC with effective coverage. Finally, using the WHO STH decision tree, we estimated the reduction in the number of tablets needed. Results Fifteen countries in four WHO regions conducted annual or semi-annual rounds of PC for STH for 5 years or more and collected data before and after interventions. At baseline, the pooled prevalence was 48.9% (33.1–64.7%) for any STH, 23.2% (13.7–32.7%) for Ascaris lumbricoides, 21.01% (9.7–32.3%) for Trichuris trichiura and 18.2% (10.9–25.5%) for hookworm infections, while after ≥5 years of PC for STH, the prevalence was 14.3% (7.3–21.3%) for any STH, 6.9% (1.3–12.5%) for A. lumbricoides, 5.3% (1.06–9.6%) for T. trichiura and 8.1% (4.0–12.2%) for hookworm infections. Conclusions Countries endemic for STH have made tremendous progress in reducing STH-associated morbidity, but very few countries have data to demonstrate that progress. In this study, the data show that nine countries should adapt their PC strategies and the frequency of PC rounds to yield a 36% reduction in drug needs. The study also highlights the importance of impact assessment surveys to adapt control strategies according to STH prevalence. Electronic supplementary material The online version of this article (10.1186/s40249-019-0589-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Denise Mupfasoni
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
| | - Mathieu Bangert
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Alexei Mikhailov
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Chiara Marocco
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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Noon JB, Schwarz EM, Ostroff GR, Aroian RV. A highly expressed intestinal cysteine protease of Ancylostoma ceylanicum protects vaccinated hamsters from hookworm infection. PLoS Negl Trop Dis 2019; 13:e0007345. [PMID: 31009474 PMCID: PMC6497320 DOI: 10.1371/journal.pntd.0007345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/02/2019] [Accepted: 03/28/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Human hookworms (Necator americanus, Ancylostoma duodenale, and Ancylostoma ceylanicum) are intestinal blood-feeding parasites that infect ~500 million people worldwide and are among the leading causes of iron-deficiency anemia in the developing world. Drugs are useful against hookworm infections, but hookworms rapidly reinfect people, and the parasites can develop drug resistance. Therefore, having a hookworm vaccine would be of tremendous benefit. METHODOLOGY/PRINCIPAL FINDINGS We investigated the vaccine efficacy in outbred Syrian hamsters of three A. ceylanicum hookworm antigen candidates from two classes of proteins previously identified as promising vaccine candidates. These include two intestinally-enriched, putatively secreted cathepsin B cysteine proteases (AceyCP1, AceyCPL) and one small Kunitz-type protease inhibitor (AceySKPI3). Recombinant proteins were produced in Pichia pastoris, and adsorbed to Alhydrogel. Recombinant AceyCPL (rAceyCPL)/Alhydrogel and rAceySKPI3/Alhydrogel induced high serum immunoglobulin G (IgG) titers in 8/8 vaccinates, but were not protective. rAceyCP1/Alhydrogel induced intermediate serum IgG titers in ~60% of vaccinates in two different trials. rAceyCP1 serum IgG responders had highly significantly decreased hookworm burdens, fecal egg counts and clinical pathology compared to Alhydrogel controls and nonresponders. Protection was highly correlated with rAceyCP1 serum IgG titer. Antisera from rAceyCP1 serum IgG responders, but not nonresponders or rAceyCPL/Alhydrogel vaccinates, significantly reduced adult A. ceylanicum motility in vitro. Furthermore, rAceyCP1 serum IgG responders had canonical Th2-specific recall responses (IL4, IL5, IL13) in splenocytes stimulated ex vivo. CONCLUSIONS/SIGNIFICANCE These findings indicate that rAceyCP1 is a promising vaccine candidate and validates a genomic/transcriptomic approach to human hookworm vaccine discovery.
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Affiliation(s)
- Jason B. Noon
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Erich M. Schwarz
- Department of Molecular Biology and Genetics, Cornell University, Ithaca, New York, United States of America
| | - Gary R. Ostroff
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Raffi V. Aroian
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
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Doulberis M, Papaefthymiou A, Kountouras J, Polyzos SA, Srivastava DS, Perrig M, Katsinelos P, Özgüler O, Kotronis G, Gialamprinou D, Papamichos S, Ingold J, Xanthis A, Exadaktylos AK. Hookworms in Emergency Department: The "Vampire" Within. J Acute Med 2018; 8:135-148. [PMID: 32995216 PMCID: PMC7517929 DOI: 10.6705/j.jacme.201812_8(4).0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 09/27/2018] [Indexed: 06/11/2023]
Abstract
Hookworms infection is a soil-transmitted helminthic disease particularly endemic in developing counties of tropical regions. It is attributed mainly to two human pathogens nematodes namely Necator americanus and Ancylostoma duodenale. Although the disease has been characterized as "neglected" is very diffi cult to be eliminated and the economic consequences are great. Worms are fed with blood of hosts in small intestine and cause typically iron deficiency anemia with relevant symptoms as well as eosinophilia. Patients admitted in emergency department claim often diffuse general symptoms, whereas cases with obscure gastrointestinal bleeding can be seen. Within this brief review, after introducing some basic elements of hookworms' epidemiology, taxonomy and socioeconomic problem is emphasized, pathogenesis, and life cycle of parasite are concisely explained. Furthermore, clinical manifestations often or rarely seen in emergency department are described. Therapeutic options are also enclosed. Awareness of the problem and critical thinking of patients coming from endemic regions could result to identifying more hookworm cases and their therapy will efficiently alleviate not only the patients per se but health system and societies as well.
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Affiliation(s)
- Michael Doulberis
- University Hospital Inselspital Bern Department of General Internal Medicine Bern Switzerland
- Aristotle University of Thessaloniki Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital Thessaloniki, Macedonia Greece
| | | | - Jannis Kountouras
- Aristotle University of Thessaloniki Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital Thessaloniki, Macedonia Greece
| | - Stergios A Polyzos
- Thessaloniki First Department of Pharmacology, Medical School, Aristotle University of Thessaloniki Macedonia Greece
| | | | - Martin Perrig
- University Hospital Inselspital Bern Department of General Internal Medicine Bern Switzerland
| | - Panagiotis Katsinelos
- Aristotle University of Thessaloniki Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital Thessaloniki, Macedonia Greece
| | - Onur Özgüler
- General Hospital Bürgerspital Department of Emergency Medicine Solothurn Switzerland
| | - Georgios Kotronis
- General Hospital Agios Pavlos of Thessaloniki Department of Internal Medicine Thessaloniki, Macedonia Greece
| | - Dimitra Gialamprinou
- Aristotle University of Thessaloniki Department of Pediatrics, Papageorgiou University Hospital Thessaloniki, Macedonia Greece
| | - Spyros Papamichos
- University Hospital Inselspital Bern Department of Hematology Bern Switzerland
| | - Jonas Ingold
- Tiefenau Hospital of Bern Department of General Internal Medicine Bern Switzerland
| | - Andreas Xanthis
- Aristotle University of Thessaloniki Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital Thessaloniki, Macedonia Greece
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Impact of community-based integrated mass drug administration on schistosomiasis and soil-transmitted helminth prevalence in Togo. PLoS Negl Trop Dis 2018; 12:e0006551. [PMID: 30125274 PMCID: PMC6124778 DOI: 10.1371/journal.pntd.0006551] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 09/05/2018] [Accepted: 05/22/2018] [Indexed: 11/19/2022] Open
Abstract
Background Togo has conducted annual, integrated, community-based mass drug administration (MDA) for soil-transmitted helminths (STH) and schistosomiasis since 2010. Treatment frequency and target populations are determined by disease prevalence, as measured by baseline surveys in 2007 and 2009, and WHO guidelines. Reported programmatic treatment coverage has averaged over 94%. Togo conducted a cross-sectional survey in 2015 to assess the impact of four to five years of MDA on these diseases. Methodology/Principal findings In every sub-district in the country outside the capital, the same schools were visited as at baseline and a sample of fifteen children age 6 to 9 years old was drawn. Each child submitted urine and a stool sample. Urine samples were tested by dipstick for the presence of blood as a proxy measure of Schistosoma haematobium infection. Stool samples were analyzed by the Kato-Katz method for STH and Schistosoma mansoni. At baseline, 17,100 children were enrolled at 1,129 schools in 562 sub-districts; in 2015, 16,890 children were enrolled at the same schools. The overall prevalence of both STH and schistosomiasis declined significantly, from 31.5% to 11.6% for STH and from 23.5% to 5.0% for schistosomiasis (p<0.001 in both instances). Egg counts from both years were available only for hookworm and S. mansoni; intensity of infection decreased significantly for both infections from 2009 to 2015 (p<0.001 for both infections). In areas with high baseline prevalence, rebound of hookworm infection was noted in children who had not received albendazole in the past 6 months. Conclusions/Significance After four to five years of MDA in Togo, the prevalence and intensity of STH and schistosomiasis infection were significantly reduced compared to baseline. Data on STH indicate that stopping MDA in areas with high baseline prevalence may result in significant rebound of infection. Togo’s findings may help refine treatment recommendations for these diseases. Mass drug administration (MDA) is a key component of programs aimed at controlling soil-transmitted helminths (STH) and schistosomiasis, diseases that disproportionately impact individuals in developing countries and adversely affect physical and cognitive development. The World Health Organization recommends evaluating the impact of mass drug administration on the prevalence of these infections after five years of MDA. We present here a study of the impact of four to five years of MDA on the prevalence and intensity of STH and schistosomiasis infections in school children in Togo. The prevalence and intensity of these infections in 2015 were significantly reduced compared to a baseline survey conducted in 2009. Local baseline prevalence in 2009 was the strongest predictor of infection in 2015. These infections are more prevalent in boys than in girls, and in older versus younger children. We found that in areas with high baseline prevalence of hookworm the risk of rebound of infection is high among children who do not receive bi-annual treatment. This information is important for programs weighing the decision to stop MDA in areas where prevalence has been reduced through treatment. This and other findings from this study may help refine treatment recommendations for these diseases.
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