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Naqvi FA, Das JK, Salam RA, Raza SF, Lassi ZS, Bhutta ZA. Interventions for Neglected Tropical Diseases Among Children and Adolescents: A Meta-analysis. Pediatrics 2022; 149:186947. [PMID: 35503336 DOI: 10.1542/peds.2021-053852e] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) are a group of communicable diseases affecting the poorest populations around the world. OBJECTIVE To assess the effectiveness of interventions, including mass drug administration (MDA), water, sanitation, and hygiene (WASH), vector control, health education, and micronutrients supplementation, for NTDs among children and adolescents. METHODS We conducted a literature search on the Cochrane Controlled Trials Register, Medline, and other databases until December 2020. We included randomized controlled trials and quasi-experimental studies conducted among children and adolescents. Two authors independently screened studies for relevance. Two authors independently extracted data, assessed the risk of bias, performed metaanalysis, and rated the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation. RESULTS We included 155 studies (231 articles) involving 262 299 participants. For soil-transmitted helminthiasis, MDA may reduce the prevalence of Ascaris, Trichuris, and hookworm by 58%, 36%, and 57%, respectively. We are uncertain of the effect of health education, WASH, and iron supplementation on soil-transmitted helminthiasis prevalence. For Schistosomiasis, health education probably reduces the intensity and prevalence of S. mansoni, whereas micronutrient supplementation may reduce anemia prevalence and the infection intensity of S. hematobium compared with no supplementation. We are uncertain of the effect of MDA and vector control on Schistosomiasis outcomes. For trachoma, health education probably reduces the prevalence of active Trachoma, whereas we are uncertain of the effect of MDA, WASH, and vector control on Trachoma outcomes. There is limited data on the effectiveness of interventions for NTDs targeting children and adolescents. CONCLUSION Future studies are needed to evaluate the relative effectiveness and cost-effectiveness of various interventions specifically targeting children and adolescents.
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Affiliation(s)
- Fatima Abbas Naqvi
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Rehana A Salam
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Syeda Fatima Raza
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Zohra S Lassi
- Robinson Research Institute, the University of Adelaide, Adelaide, Australia.,Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Zulfiqar A Bhutta
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan.,Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
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Kaliappan S, Ramanujam K, Manuel M, Farzana J, Janagaraj V, Laxmanan S, Muliyil J, Sarkar R, Kang G, Walson J, Ajjampur S. Soil-transmitted helminth infections after mass drug administration for lymphatic filariasis in rural southern India. Trop Med Int Health 2021; 27:81-91. [PMID: 34704320 DOI: 10.1111/tmi.13697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Targeted deworming is the current strategy for control of morbidity associated with soil-transmitted helminths (STH) among at-risk populations: preschool-aged children, school-aged children and women of childbearing age. We report the prevalence and intensity of STH in a district after lymphatic filariasis (LF) mass drug administration (MDA) in southern India where albendazole was co-administered from 2001. METHODS Children aged 2 to 15 years and adults (defined as ≥15 years) in a rural administrative block of Tamil Nadu were recruited using a probability proportional to size method. Stool samples were screened and eggs per gram (EPG) determined by Kato-Katz method. Multilevel logistic regression (MLR) and multilevel negative binomial regression (MNBR) analyses were used to identify factors associated with infection and intensity, respectively. RESULTS Of 862 participants who provided samples, 60 (7.0%; 95% confidence interval (CI): 5.3-8.7) were positive for STH with a predominance of hookworm infections (n = 57, 6.6%; 95% CI: 5.0-8.3). Increasing age (odds ratio (OR): 1.09; 95% CI: 1.04-1.15) and regular usage of the toilet (OR: 0.32; 95% CI: 0.12-0.88) were independently associated with hookworm infection and age was significantly associated with increasing intensity of hookworm infection (infection intensity ratio (IIR): 1.28; 95% CI: 1.19-1.37). A brief review of STH prevalence in endemic settings before and after the stoppage of LF MDA indicated that, in most settings, a substantial reduction in STH prevalence is seen. CONCLUSION Community-wide MDA in all age groups in these post-LF MDA districts with low prevalence and light intensity infections could result in transmission interruption of STH.
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Affiliation(s)
- Saravanakumar Kaliappan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Karthikeyan Ramanujam
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Malathi Manuel
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Jasmine Farzana
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Venkateshprabhu Janagaraj
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Selvi Laxmanan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Jayaprakash Muliyil
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Rajiv Sarkar
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Gagandeep Kang
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Judd Walson
- Departments of Global Health, Medicine (Infectious Disease), Paediatrics & Epidemiology, University of Washington, Seattle, Washington, USA
| | - Sitara Ajjampur
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
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Wong LW, Ong KS, Khoo JR, Goh CBS, Hor JW, Lee SM. Human intestinal parasitic infection: a narrative review on global prevalence and epidemiological insights on preventive, therapeutic and diagnostic strategies for future perspectives. Expert Rev Gastroenterol Hepatol 2020; 14:1093-1105. [PMID: 32755242 DOI: 10.1080/17474124.2020.1806711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Intestinal parasitic infection (IPI) is a global health concern among socioeconomically deprived communities in many developing countries. Many preventative strategies have been deployed to control IPI, however, there is a lack in standards on the techniques used to diagnose and monitor the prevalence of IPI. AREAS COVERED The present article will review the diseases associated with IPI and discuss the current IPI control strategies such as the water, sanitation, and hygiene (WASH) interventions, community-led total sanitation (CLTS) approach, and regular anthelminthic treatments. For the first time, this review will also evaluate all currently practised diagnostic techniques for the detection of intestinal parasites and provide insights on future IPI control strategies. EXPERT OPINION Advanced and improved diagnostic methods such as qPCR coupled with a high-resolution melting curve, aptamers, biosensors, and detection of extracellular vesicles can be used for detection of IPI. Vaccination against intestinal parasites can be made available to increase antibodies to interfere with the blood-feeding process by the parasites, which subsequently reduces the reproductive rates of the parasites. These methods collectively can serve as future management strategies for intestinal parasitic infections.
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Affiliation(s)
- Li Wen Wong
- School of Science, Monash University Malaysia , Bandar Sunway, Malaysia
| | - Kuan Shion Ong
- School of Science, Monash University Malaysia , Bandar Sunway, Malaysia.,Tropical Medicine and Biology Multidisciplinary Platform, Monash University Malaysia , Bandar Sunway, Malaysia
| | - Jun Rong Khoo
- School of Science, Monash University Malaysia , Bandar Sunway, Malaysia
| | - Calvin Bok Sun Goh
- School of Science, Monash University Malaysia , Bandar Sunway, Malaysia.,Tropical Medicine and Biology Multidisciplinary Platform, Monash University Malaysia , Bandar Sunway, Malaysia
| | - Jia Wei Hor
- Department of Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur, Malaysia
| | - Sui Mae Lee
- School of Science, Monash University Malaysia , Bandar Sunway, Malaysia.,Tropical Medicine and Biology Multidisciplinary Platform, Monash University Malaysia , Bandar Sunway, Malaysia
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Mirza Z, Soto ER, Hu Y, Nguyen TT, Koch D, Aroian RV, Ostroff GR. Anthelmintic Activity of Yeast Particle-Encapsulated Terpenes. Molecules 2020; 25:E2958. [PMID: 32605043 PMCID: PMC7411854 DOI: 10.3390/molecules25132958] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 12/31/2022] Open
Abstract
Soil-transmitted nematodes (STN) infect 1-2 billion of the poorest people worldwide. Only benzimidazoles are currently used in mass drug administration, with many instances of reduced activity. Terpenes are a class of compounds with anthelmintic activity. Thymol, a natural monoterpene phenol, was used to help eradicate hookworms in the U.S. South circa 1910. However, the use of terpenes as anthelmintics was discontinued because of adverse side effects associated with high doses and premature stomach absorption. Furthermore, the dose-response activity of specific terpenes against STNs has been understudied. Here we used hollow, porous yeast particles (YPs) to efficiently encapsulate (>95%) high levels of terpenes (52% w/w) and evaluated their anthelmintic activity on hookworms (Ancylostoma ceylanicum), a rodent parasite (Nippostrongylus brasiliensis), and whipworm (Trichuris muris). We identified YP-terpenes that were effective against all three parasites. Further, YP-terpenes overcame albendazole-resistant Caenorhabditis elegans. These results demonstrate that terpenes are broad-acting anthelmintics. Terpenes are predicted to be extremely difficult for parasites to resist, and YP encapsulation provides water-suspendable terpene materials without surfactants and sustained terpene release that could lead to the development of formulations for oral delivery that overcome fast absorption in the stomach, thus reducing dosage and toxic side effects.
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Affiliation(s)
- Zeynep Mirza
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
| | - Ernesto R. Soto
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
| | - Yan Hu
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
- Department of Biology, Worcester State University, Worcester, MA 01602, USA
| | - Thanh-Thanh Nguyen
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
| | - David Koch
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
| | - Raffi V. Aroian
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
| | - Gary R. Ostroff
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (Z.M.); (E.R.S.); (Y.H.); (T.-T.N.); (D.K.); (R.V.A.)
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Kulinkina AV, Sarkar R, Mohan VR, Walz Y, Kaliappan SP, Ajjampur SSR, Ward H, Naumova EN, Kang G. Prediction of hookworm prevalence in southern India using environmental parameters derived from Landsat 8 remotely sensed data. Int J Parasitol 2019; 50:47-54. [PMID: 31756313 DOI: 10.1016/j.ijpara.2019.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/30/2019] [Accepted: 10/03/2019] [Indexed: 11/20/2022]
Abstract
Soil-transmitted helminth infections propagate poverty and slow economic growth in low-income countries. As with many other neglected tropical diseases, environmental conditions are important determinants of soil-transmitted helminth transmission. Hence, remotely sensed data are commonly utilised in spatial risk models intended to inform control strategies. In the present study, we build upon the existing modelling approaches by utilising fine spatial resolution Landsat 8 remotely sensed data in combination with topographic variables to predict hookworm prevalence in a hilly tribal area in southern India. Hookworm prevalence data collected from two field surveys were used in a random forest model to investigate the predictive capacity of 15 environmental variables derived from two remotely sensed images acquired during dry and rainy seasons. A variable buffer radius (100-1000 m) was applied to the point-prevalence locations in order to integrate environmental conditions around the village centroids into the modelling approach and understand where transmission is more likely. Elevation and slope were the most important variables in the models, with lower elevation and higher slope correlating with higher transmission risk. A modified normalised difference water index was among other recurring important variables, likely responsible for some seasonal differences in model performance. The 300 m buffer distance produced the best model performance in this setting, with another spike at 700 m, and a marked drop-off in R2 values at 1000 m. In addition to assessing a large number of environmental correlates with hookworm transmission, the study contributes to the development of standardised methods of spatial linkage of continuous environmental data with point-based disease prevalence measures for the purpose of spatially explicit risk profiling.
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Affiliation(s)
- Alexandra V Kulinkina
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA; Partners In Health, Neno, Malawi.
| | - Rajiv Sarkar
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Venkata R Mohan
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Yvonne Walz
- Institute for Environment and Human Security, United Nations University, Bonn, Germany
| | | | - Sitara S R Ajjampur
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Honorine Ward
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India; Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA
| | - Elena N Naumova
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
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Abraham D, Kaliappan SP, Walson JL, Rao Ajjampur SS. Intervention strategies to reduce the burden of soil-transmitted helminths in India. Indian J Med Res 2018; 147:533-544. [PMID: 30168484 PMCID: PMC6118140 DOI: 10.4103/ijmr.ijmr_881_18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Soil-transmitted helminth (STH) infections continue to be a major global cause of morbidity, with a large proportion of the burden of STH infections occurring in India. In addition to direct health impacts of these infections, including anaemia and nutritional deficiencies in children, these infections also significantly impact economic development, as a result of delays in early childhood cognitive development and future income earning potential. The current World Health Organization strategy for STH is focused on morbidity control through the application of mass drug administration to all pre-school-aged and school-aged children. In India, the control of STH-related morbidity requires mobilization of significant human and financial resources, placing additional burdens on limited public resources. Infected adults and untreated children in the community act as a reservoir of infection by which treated children get rapidly reinfected. As a result, deworming programmes will need to be sustained indefinitely in the absence of other strategies to reduce reinfection, including water, hygiene and sanitation interventions (WASH). However, WASH interventions require sustained effort by the government or other agencies to build infrastructure and to promote healthy behavioural modifications, and their effectiveness is often limited by deeply entrenched cultural norms and behaviours. Novel strategies must be explored to provide a lasting solution to the problem of STH infections in India other than the indefinite provision of deworming for morbidity control.
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Affiliation(s)
- Dilip Abraham
- Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | | | - Judd L Walson
- Department of Global Health, Medicine (Infectious Disease), Paediatrics & Epidemiology, University of Washington, Seattle, USA; DeWorm3, Division of Life Sciences, Natural History Museum, London, UK
| | - Sitara Swarna Rao Ajjampur
- Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
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Halder JB, Benton J, Julé AM, Guérin PJ, Olliaro PL, Basáñez MG, Walker M. Systematic review of studies generating individual participant data on the efficacy of drugs for treating soil-transmitted helminthiases and the case for data-sharing. PLoS Negl Trop Dis 2017; 11:e0006053. [PMID: 29088274 PMCID: PMC5681297 DOI: 10.1371/journal.pntd.0006053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 11/10/2017] [Accepted: 10/19/2017] [Indexed: 11/23/2022] Open
Abstract
Background Preventive chemotherapy and transmission control (PCT) by mass drug administration is the cornerstone of the World Health Organization (WHO)’s policy to control soil-transmitted helminthiases (STHs) caused by Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm) and hookworm species (Necator americanus and Ancylostama duodenale) which affect over 1 billion people globally. Despite consensus that drug efficacies should be monitored for signs of decline that could jeopardise the effectiveness of PCT, systematic monitoring and evaluation is seldom implemented. Drug trials mostly report aggregate efficacies in groups of participants, but heterogeneities in design complicate classical meta-analyses of these data. Individual participant data (IPD) permit more detailed analysis of drug efficacies, offering increased sensitivity to identify atypical responses potentially caused by emerging drug resistance. Methodology We performed a systematic literature review to identify studies concluding after 2000 that collected IPD suitable for estimating drug efficacy against STH. We included studies that administered a variety of anthelmintics with follow ups less than 60 days after treatment. We estimated the number of IPD and extracted cohort- and study-level meta-data. Principal findings We estimate that there exist individual data on approximately 35,000 participants from 129 studies conducted in 39 countries, including 34 out of 103 countries where PCT is recommended. We find significant heterogeneity in diagnostic methods, times of outcome assessment, and the reported measure of efficacy. We also quantify cohorts comprising pre-school age children, pregnant women, and co-infected participants, including with HIV. Conclusions We argue that establishing a global IPD repository would improve the capacity to monitor and evaluate the efficacy of anthelmintic drugs, respond to changes and safeguard the ongoing effectiveness of PCT. Establishing a fair, transparent data governance policy will be key for the engagement of the global STH community. Soil-transmitted helminthiases (STHs) caused by roundworm, whipworm or hookworm affect over one billion of the world’s poorest people mostly living in low and middle income countries, exerting a major health and economic toll. These infections are controlled by regular mass drug distribution to affected populations. But with very few alternative medicines, the effectiveness of treatment programmes is vulnerable to the potential emergence of drug resistance. Despite a recent scale-up of mass drug distribution, systematic monitoring and evaluation of the efficacy of treatment is too rarely undertaken and our knowledge of how the drugs are performing is largely based on information from clinical trials. However, the design and reporting of information from these trials is very variable which makes it difficult to form a comprehensive picture of the status and trends in drug efficacy. Here, we present a systematic review of published studies completed since 2000, characterise variation in their design, implementation and reporting and estimate the abundance of individual participant data. We argue that the co-ordinated sharing of these individual data would greatly increase the capacity of the global health community to monitor effectively drug efficacy, to respond accordingly to changes, and thereby to safeguard the effectiveness of STH control.
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Affiliation(s)
- Julia B. Halder
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research, Imperial College London, Norfolk Place, London, United Kingdom
| | | | - Amélie M. Julé
- Infectious Diseases Data Observatory (IDDO), University of Oxford, Oxford, United Kingdom
- Centre for Global Health and Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Phillipe J. Guérin
- Infectious Diseases Data Observatory (IDDO), University of Oxford, Oxford, United Kingdom
- Centre for Global Health and Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Piero L. Olliaro
- Centre for Global Health and Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- World Health Organization Special Programme on Research and Training in Tropical Diseases (TDR), Geneva, Switzerland
| | - María-Gloria Basáñez
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research, Imperial College London, Norfolk Place, London, United Kingdom
| | - Martin Walker
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research, Imperial College London, Norfolk Place, London, United Kingdom
- Department of Pathobiology and Population Sciences and London Centre for Neglected Tropical Disease Research, Royal Veterinary College, Hatfield, United Kingdom
- * E-mail:
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8
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Salam N, Azam S. Prevalence and distribution of soil-transmitted helminth infections in India. BMC Public Health 2017; 17:201. [PMID: 28209148 PMCID: PMC5311856 DOI: 10.1186/s12889-017-4113-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 02/06/2017] [Indexed: 11/29/2022] Open
Abstract
Background Understanding the prevalence of soil-transmitted helminth infections is necessary to plan control strategies and focus on highly endemic regions for preventive chemotherapy and improved sanitation facilities. India is known to be endemic for soil-transmitted helminth infections. Methods To understand the prevalence, spatial distribution and identify high-risk zones, a systematic search of published literature was carried out based on PRISMA guidelines from the year 2000 to 2015. Results A careful screening of the identified literature yielded 39 studies that reported the prevalence of soil-transmitted helminth infections from 19 different states of India. Ascaris lumbricoides was the most prevalent parasite. Higher than 50% prevalence was reported from six states. Nearly 90% studies reported the prevalence of more than one parasite species in the same sample population. Conclusion This is the first study to comprehensively review the literature associated with soil-transmitted helminth infections from India giving a clear idea of its prevalence, distribution and high endemic areas.
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Affiliation(s)
- Nasir Salam
- Department of Pharmacology, College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia.
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Clarke NE, Clements ACA, Doi SA, Wang D, Campbell SJ, Gray D, Nery SV. Differential effect of mass deworming and targeted deworming for soil-transmitted helminth control in children: a systematic review and meta-analysis. Lancet 2017; 389:287-297. [PMID: 27979381 DOI: 10.1016/s0140-6736(16)32123-7] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 09/27/2016] [Accepted: 09/28/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Soil-transmitted helminth infections are a major global health issue, causing substantial morbidity in the world's poorest populations. Regular delivery of anthelmintic drugs is the mainstay for global soil-transmitted helminth control. Deworming campaigns are often targeted to school-aged children, who are at high risk of soil-transmitted-helminth-associated morbidity. However, findings from modelling studies suggest that deworming campaigns should be expanded community-wide for effective control of soil-transmitted helminth transmission. We aimed to do a systematic review and meta-analysis to compare the effect of mass (community-wide) and targeted (children only) anthelmintic delivery strategies on soil-transmitted helminth prevalence in school-aged children. METHODS In this systematic review and meta-analysis, we searched MEDLINE, Embase, and Web of Science for articles published on or before Nov 5, 2015, reporting soil-transmitted helminth prevalence before and after distribution of albendazole or mebendazole, either targeted to children or delivered to the whole community. We excluded studies in which drug delivery was restricted to infected individuals or to a subset of the community or school, or if follow-up time was less than 3 months or greater than 18 months after drug delivery. We extracted data on study year, country, drug administration strategy, drug dose, number of deworming rounds, treatment coverage, diagnostic method, follow-up interval, and soil-transmitted helminth prevalence before and after treatment. We used inverse variance weighted generalised linear models, with prevalence reduction as the outcome variable, to examine the effect of mass versus targeted drug administration, as well as baseline prevalence, number of drug doses, and follow-up time. This study is registered with PROSPERO, number CRD42016026929. FINDINGS Of 10 538 studies identified, 56 studies were eligible for the systematic review and 38 of these were included in meta-analysis. Results of the regression models showed that mass deworming led to a significantly greater reduction in prevalence in children than targeted deworming, for both hookworm (odds ratio 4·6, 95% CI 1·8-11·6; p=0·0020) and Ascaris lumbricoides (16·4, 2·1-125·8; p=0·0092), with no effect seen for Trichuris trichiura. There was significant heterogeneity across studies; for targeted studies I2 was 97% for A lumbricoides and hookworm, and 96% for T trichiura, and for mass studies, I2 was 89% for A lumbricoides, 49% for hookworm, and 66% for T trichiura. INTERPRETATION The results of this meta-analysis suggest that expanding deworming programmes community-wide is likely to reduce the prevalence of soil-transmitted helminths in the high-risk group of school-aged children, which could lead to improved morbidity outcomes. These findings are in support of recent calls for re-evaluation of global soil-transmitted helminth control guidelines. FUNDING None.
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Affiliation(s)
- Naomi E Clarke
- Research School of Population Health, Australian National University, Canberra, ACT, Australia.
| | - Archie C A Clements
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Suhail A Doi
- Research School of Population Health, Australian National University, Canberra, ACT, Australia; College of Medicine, Qatar University, Doha, Qatar; School of Agricultural, Computational and Environmental Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Dongxu Wang
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Suzy J Campbell
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Darren Gray
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Susana V Nery
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
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