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Caravedo MA, Morales ML, Tanabe M, Lopez M, White AC, Cabada MM. Demographic Characteristics and Low Iron Status Markers Are Associated with Hemoglobin Levels and Anemia among Children Living at High Elevation in Cusco, Peru. Am J Trop Med Hyg 2024; 110:1014-1020. [PMID: 38531100 PMCID: PMC11066345 DOI: 10.4269/ajtmh.23-0666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/06/2023] [Indexed: 03/28/2024] Open
Abstract
Anemia is a complex condition associated with diet, chronic infections, and blood loss. Children living at high altitudes have higher absolute hemoglobin levels due to hypoxemia. However, they are exposed to repeated infections and dietary limitations. We conducted a cross-sectional study to identify factors affecting the hemoglobin concentration in children living in high-altitude rural communities in the Anta province of Peru. All children 3-16 years of age attending public schools were invited to participate. We enrolled children 3-16 years old in schools and visited their homes to collect demographic, socioeconomic, medical history, and anthropometric data. Children provided blood and stool samples for complete blood counts, iron status markers, and helminth infection testing. Among the 2,000 children enrolled, the mean age was 9.9 (±3.4) years, 1,004 (50.2%) were female, and the median residence altitude was 3,398 (interquartile range 3,35-3,497) meters. The mean hemoglobin level was 15 (±1.15) mg/dL; 320 (16%) had anemia as defined by WHO. Children with anemia were more likely to have lower serum iron levels (odds ratio [OR] 2.8 [95% CI 2.2-3.6], P <0.001) and serum transferrin saturation (OR 2.8 [95% CI 2-3.9], P <0.001). Younger age (OR 0.85 [95% CI 0.82-0.89], P <0.001), stunting (OR 0.68 [95% CI 0.59-0.79], P <0.001), education of the mother (OR 0.94 [95% CI 0.91-0.98], P <0.005), and low eosinophils (OR 0.49 [95% CI 0.26-0.9], P = 0.022) were associated with anemia. Helminth infections were not associated with anemia. Anemia among children at high altitude is multifactorial, but iron deficiency is a contributing factor. Further studies are needed to evaluate iron status and anemia in children living at high altitudes.
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Affiliation(s)
- Maria A. Caravedo
- Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas
| | - Maria Luisa Morales
- Sede Cusco – Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Melinda Tanabe
- Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas
| | - Martha Lopez
- Sede Cusco – Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - A. Clinton White
- Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas
| | - Miguel M. Cabada
- Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas
- Sede Cusco – Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Cusco, Peru
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Ibrahim N, Abdel Khalek EM, Makhlouf NA, Abdel-Gawad M, Mekky M, Ramadan HKA, Abu-Elfatth A, El-Latif NA, Hassan MK, Eldeeb R, Abdelmalek M, Abd-Elsalam S, Attia H, Mohammed AQ, Aboalam H, Farouk M, Alboraie M. Clinical characteristics of human fascioliasis in Egypt. Sci Rep 2023; 13:16254. [PMID: 37758788 PMCID: PMC10533839 DOI: 10.1038/s41598-023-42957-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 09/16/2023] [Indexed: 09/29/2023] Open
Abstract
There is a lack of epidemiological data on fascioliasis in Egypt regarding disease characteristics and treatment outcomes across different governorates. We aimed to identify the demographic, epidemiologic, clinical, laboratory, and radiological characteristics and treatment outcomes of patients diagnosed with fascioliasis in Egypt. Data on human fascioliasis were collected retrospectively from patients' medical records in the period between January 2018 and January 2020. The study included 261 patients. More than 40% of enrolled patients were in the age group of 21-40 years old. Geographically, 247 (94.6%) were from Assiut Governorate with 69.3% were from rural areas. The most frequent symptoms were right upper quadrant pain (96.9%), and fever (80.1%). Eosinophilia was found in 250 cases (95.8%). Hepatic focal lesions were detected in 131 (50.2%); out of them 64/131 (48.9%) had a single lesion. All patients received a single dose of 10 mg/kg of triclabendazole, 79.7% responded well to a single dose, while in 20.3% a second ± a third dose of treatment was requested. After therapy, there was a reduction in leucocytes, Fasciola antibodies titer, eosinophilic count, bilirubin, and liver enzymes with an increase in hemoglobin level. According to our findings, a high index of suspicion should be raised in cases with fever, right upper abdominal pain, and peripheral eosinophilia, and further imaging workup is mandated to detect hepatic focal lesions. Prompt treatment by triclabendazole can serve as a standard-of-care regimen even for suspected cases.
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Affiliation(s)
- Nagat Ibrahim
- Department of Gastroenterology, Hepatology, and Infectious Diseases, Assiut Liver Center, Ministry of Health, Assiut, Egypt
| | | | - Nahed A Makhlouf
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Muhammad Abdel-Gawad
- Hepatology, Gastroenterology, and Infectious Diseases Department, Al-Azhar University, Assiut, 71631, Egypt.
| | - Mohamed Mekky
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Haidi Karam-Allah Ramadan
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ahmed Abu-Elfatth
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Naglaa Abd El-Latif
- Parasitology Department, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Marwa Khalaf Hassan
- Tropical Medicine and Gastroenterology, Assiut Liver Center, Ministry of Health, Assiut, Egypt
| | - Rabab Eldeeb
- Tropical Medicine, Alexandria University, Alexandria, Egypt
| | - Mohamed Abdelmalek
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | - Hanaa Attia
- General Manager of Endemic Diseases Control, Ministry of Health, Behera, Egypt
| | - Ahmed Qasem Mohammed
- Hepatology, Gastroenterology, and Infectious Diseases Department, Al-Azhar University, Assiut, 71631, Egypt
| | - Hani Aboalam
- Tropical Medicine and Gastroenterology, Assiut Liver Center, Ministry of Health, Assiut, Egypt
| | - Mahmoud Farouk
- Department of Tropical Medicine and Gastroenterology, Luxor University, Luxor, Egypt
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
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Alvi MA, Khalid A, Ali RMA, Saqib M, Qamar W, Li L, Ahmad B, Fu BQ, Yan HB, Jia WZ. Genetic variation and population structure of Fasciola hepatica: an in silico analysis. Parasitol Res 2023; 122:2155-2173. [PMID: 37458821 DOI: 10.1007/s00436-023-07917-0] [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: 04/11/2023] [Accepted: 06/29/2023] [Indexed: 08/17/2023]
Abstract
Fasciola hepatica is a trematode leading to heavy economic setbacks to the livestock sector globally. The population's genetic information and intimate kinship level are frequently assessed using analysis of mitochondrial DNA. In this analysis, we retrieved cox1 (n = 247) and nad1 (n = 357) sequences of F. hepatica from the NCBI GenBank database and aligned the sequences with the respective reference sequences using MEGA software. The median joining network was drawn using PopArt software while neutrality and diversity indices were estimated with the help of DnaSp software. Neighbor-joining phylogenetic tree was constructed using the MEGA software package. A total of 46 and 98 distinctive haplotypes were observed for cox1 and nad1 genes, respectively. Diversity indices indicated high haplotype and nucleotide diversities in both genes. Positive Tajima's D and Fu's Fs values were found for the entire population of both the genes under study. The cox1 and nad1 gene segments in this study showed high Tajima's D values, suggesting a low likelihood of future population growth. The Tajima's D value of the nad1 gene sequence is lower (2.14910) than that of the cox1 gene sequence (3.40314), which suggests that the former is growing at a slower rate. However, the region-wise analysis revealed that both the cox1 and nad1 genes showed deviation from neutrality suggesting a recent population expansion as a result of an excess of low-frequency polymorphism. Furthermore, the overall host-wise analysis showed positive and significant Tajima's D values for the cox1 and nad1 gene sequences. To the best of our knowledge, this is the first attempt to provide insights into genetic variations and population structure of F. hepatica at a global scale using cox1 and nad1 genes. Our findings suggest the existence of specific variants of F. hepatica in different parts of the world and provide information on the molecular ecology of F. hepatica. The results of this study also mark a critical development in upcoming epidemiological investigations on F. hepatica and will also contribute to understanding the global molecular epidemiology and population structure of F. hepatica.
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Affiliation(s)
- Mughees Aizaz Alvi
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, National Para-Reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730046, China
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Adeel Khalid
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Rana Muhammad Athar Ali
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Muhammad Saqib
- Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan
| | - Warda Qamar
- Department of Parasitology, University of Agriculture, Faisalabad, Pakistan
| | - Li Li
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, National Para-Reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730046, China
| | - Bilal Ahmad
- Faculty of Veterinary and Animal Sciences, PMAS Arid Agriculture University, Rawalpindi, Pakistan
| | - Bao-Quan Fu
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, National Para-Reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730046, China
| | - Hong-Bin Yan
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, National Para-Reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730046, China.
| | - Wan-Zhong Jia
- State Key Laboratory for Animal Disease Control and Prevention, College of Veterinary Medicine, Lanzhou University, National Para-Reference Laboratory for Animal Echinococcosis, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730046, China.
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases, Yangzhou, 225009, Jiangsu, China.
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Serrat J, Becerro-Recio D, Torres-Valle M, Simón F, Valero MA, Bargues MD, Mas-Coma S, Siles-Lucas M, González-Miguel J. Fasciola hepatica juveniles interact with the host fibrinolytic system as a potential early-stage invasion mechanism. PLoS Negl Trop Dis 2023; 17:e0010936. [PMID: 37083884 PMCID: PMC10155961 DOI: 10.1371/journal.pntd.0010936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 05/03/2023] [Accepted: 03/20/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The trematode Fasciola hepatica is the most widespread causative agent of fasciolosis, a parasitic disease that mainly affects humans and ruminants worldwide. During F. hepatica infection, newly excysted juveniles (FhNEJ) emerge in the duodenum of the mammalian host and migrate towards their definitive location, the intra-hepatic biliary ducts. Understanding how F. hepatica traverses the intestinal wall and migrates towards the liver is pivotal for the development of more successful strategies against fasciolosis. The central enzyme of the mammalian fibrinolytic system is plasmin, a serine protease whose functions are exploited by a number of parasite species owing to its broad spectrum of substrates, including components of tissue extracellular matrices. The aim of the present work is to understand whether FhNEJ co-opt the functions of their host fibrinolytic system as a mechanism to facilitate trans-intestinal migration. METHODOLOGY/PRINCIPAL FINDINGS A tegument-enriched antigenic extract of FhNEJ (FhNEJ-Teg) was obtained in vitro, and its capability to bind the zymogen plasminogen (PLG) and enhance its conversion to the active protease, plasmin, were analyzed by a combination of enzyme-linked immunosorbent, chromogenic and immunofluorescence assays. Additionally, PLG-binding proteins in FhNEJ-Teg were identified by bidimensional electrophoresis coupled to mass spectrometry analysis, and the interactions were validated using FhNEJ recombinant proteins. CONCLUSIONS/SIGNIFICANCE Our results show that FhNEJ-Teg contains proteins that bind PLG and stimulate its activation to plasmin, which could facilitate the traversal of the intestinal wall by FhNEJ and contribute to the successful establishment of the parasite within its mammalian host. Altogether, our findings contribute to a better understanding of host-parasite relationships during early fasciolosis and may be exploited from a pharmacological and/or immunological perspective for the development of treatment and control strategies against this global disease.
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Affiliation(s)
- Judit Serrat
- Laboratory of Helminth Parasites of Zoonotic Importance (ATENEA), Institute of Natural Resources and Agrobiology of Salamanca (IRNASA-CSIC), Salamanca, Spain
| | - David Becerro-Recio
- Laboratory of Helminth Parasites of Zoonotic Importance (ATENEA), Institute of Natural Resources and Agrobiology of Salamanca (IRNASA-CSIC), Salamanca, Spain
| | - María Torres-Valle
- Laboratory of Helminth Parasites of Zoonotic Importance (ATENEA), Institute of Natural Resources and Agrobiology of Salamanca (IRNASA-CSIC), Salamanca, Spain
| | - Fernando Simón
- Laboratory of Parasitology, Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - María Adela Valero
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos IIII, Madrid, Spain
| | - María Dolores Bargues
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos IIII, Madrid, Spain
| | - Santiago Mas-Coma
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos IIII, Madrid, Spain
| | - Mar Siles-Lucas
- Laboratory of Helminth Parasites of Zoonotic Importance (ATENEA), Institute of Natural Resources and Agrobiology of Salamanca (IRNASA-CSIC), Salamanca, Spain
| | - Javier González-Miguel
- Laboratory of Helminth Parasites of Zoonotic Importance (ATENEA), Institute of Natural Resources and Agrobiology of Salamanca (IRNASA-CSIC), Salamanca, Spain
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Antitupa I, Vargas-Mayuri NJ, Mayo JV, Estares-Porras LA, Quispe Paredes WM, Sánchez EL, Solis-Sánchez G. Serological surveillance of parasitic zoonoses in 13 highlands regions of Peru: Period 2016-2019. Rev Peru Med Exp Salud Publica 2023; 40:189-199. [PMID: 38232265 PMCID: PMC10953634 DOI: 10.17843/rpmesp.2023.402.12472] [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: 12/19/2022] [Accepted: 06/21/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVES. Motivation for the study. To understand the characteristics and distribution of the main parasitic zoonoses in Peru and to generate data for decision making in surveillance, prevention and control. Main findings. These parasitic zoonoses are distributed in areas of extreme poverty in the central and southern highlands of Peru. Fascioliasis seropositivity was found to be higher than for echinococcosis and cysticercosis. In addition, sociodemographic characteristics and lifestyle habits influence the transmission of these zoonoses. Implications. An active search for these zoonoses should be carried out in other risk areas with similar epidemiological characteristics to determine the prevalence of each of these zoonoses and implement multisectoral prevention and control programs. . To determine seropositivity to anti-IgG antibodies against Echinococcus granulosus, Fasciola hepatica and Taenia solium cysticercus infection and to describe the characteristics of the infected patients in 13 regions of the Peruvian highlands between 2016 and 2019. MATERIALS AND METHODS. Cross-sectional, observational study, in which we analyzed 7811 epidemiological records of laboratory-based surveillance of parasitic zoonoses from 2016 to 2019. Diagnosis was established by detecting IgG type anti-E. granulosus, F. hepatica and T. solium cysticercus antibodies using native antigens by enzyme-linked immunosorbent assay (ELISA) and Immunoblot. We evaluated the difference in the frequency of the cases according to identified characteristics using Pearson's chi-square test and Fisher's exact test. RESULTS. Seropositivity was 7.9% for fascioliasis, 4.9% for cystic echinococcosis, and 2.3% for T. solium cysticercus. These rates were higher in Cerro de Pasco for cystic echinococcosis (24.5%), in Ayacucho for T. solium cysticercus (4.5%) and in Puno for fascioliasis (40.6%). Regarding the sociodemographic characteristics, we found a statistically significant difference in the frequency of cases for all zoonoses according to age group, occupation, and region of residence. We also found a difference with the consumption of vegetables in emollients, and between clinical-epidemiological characteristics and having a family history of parasitic zoonoses. CONCLUSIONS. From the 7811 samples, we found that these parasitic zoonoses are distributed in 13 regions of the Peruvian highlands, and represent a major health problem, with frequencies that change according to different characteristics.
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Affiliation(s)
- Isidro Antitupa
- National Referral Laboratory for Metaxenics and Parasitic Zoonoses, Instituto Nacional de Salud, Lima, Perú.National Referral Laboratory for Metaxenics and Parasitic ZoonosesInstituto Nacional de SaludLimaPerU
| | - Nury Jakeline Vargas-Mayuri
- National Referral Laboratory for Metaxenics and Parasitic Zoonoses, Instituto Nacional de Salud, Lima, Perú.National Referral Laboratory for Metaxenics and Parasitic ZoonosesInstituto Nacional de SaludLimaPerU
| | - Jhon Vicent Mayo
- National Referral Laboratory for Metaxenics and Parasitic Zoonoses, Instituto Nacional de Salud, Lima, Perú.National Referral Laboratory for Metaxenics and Parasitic ZoonosesInstituto Nacional de SaludLimaPerU
| | - Luis Arturo Estares-Porras
- Directorate of Prevention and Control of Metaxenic Diseases and Zoonoses of the General Directorate of Strategic Interventions in Public Health, Ministerio de Salud, Lima, Peru.Directorate of Prevention and Control of Metaxenic Diseases and Zoonoses of the General Directorate of Strategic Interventions in Public HealthMinisterio de SaludLimaPeru
| | - William Marcelino Quispe Paredes
- National Referral Laboratory for Metaxenics and Parasitic Zoonoses, Instituto Nacional de Salud, Lima, Perú.National Referral Laboratory for Metaxenics and Parasitic ZoonosesInstituto Nacional de SaludLimaPerU
| | - Elizabeth Luz Sánchez
- National Referral Laboratory for Metaxenics and Parasitic Zoonoses, Instituto Nacional de Salud, Lima, Perú.National Referral Laboratory for Metaxenics and Parasitic ZoonosesInstituto Nacional de SaludLimaPerU
| | - Gilmer Solis-Sánchez
- Universidad Científica del Sur, Lima, Peru.Universidad Científica del SurUniversidad Científica del SurLimaPeru
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Tidman R, Kanankege KST, Bangert M, Abela-Ridder B. Global prevalence of 4 neglected foodborne trematodes targeted for control by WHO: A scoping review to highlight the gaps. PLoS Negl Trop Dis 2023; 17:e0011073. [PMID: 36862635 PMCID: PMC9980766 DOI: 10.1371/journal.pntd.0011073] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Foodborne trematodiases (FBTs) are a group of trematodes targeted for control as part of the World Health Organization (WHO) road map for neglected tropical diseases from 2021 to 2030. Disease mapping; surveillance; and capacity, awareness, and advocacy building are critical to reach the 2030 targets. This review aims to synthesise available data on FBT prevalence, risk factors, prevention, testing, and treatment. METHODS We searched the scientific literature and extracted prevalence data as well as qualitative data on the geographical and sociocultural risk factors associated with infection, preventive/protective factors, and methods and challenges of diagnostics and treatment. We also extracted WHO Global Health Observatory data representing the countries that reported FBTs during 2010 to 2019. RESULTS One hundred and fifteen studies reporting data on any of the 4 FBTs of focus (Fasciola spp., Paragonimus spp., Clonorchis sp., and Opisthorchis spp.) were included in the final selection. Opisthorchiasis was the most commonly reported and researched FBT, with recorded study prevalence ranging from 0.66% to 88.7% in Asia, and this was the highest FBT prevalence overall. The highest recorded study prevalence for clonorchiasis was 59.6%, reported in Asia. Fascioliasis was reported in all regions, with the highest prevalence of 24.77% reported in the Americas. The least data was available on paragonimiasis, with the highest reported study prevalence of 14.9% in Africa. WHO Global Health Observatory data indicated 93/224 (42%) countries reported at least 1 FBT and 26 countries are likely co-endemic to 2 or more FBTs. However, only 3 countries had conducted prevalence estimates for multiple FBTs in the published literature between 2010 to 2020. Despite differing epidemiology, there were overlapping risk factors for all FBTs in all geographical areas, including proximity to rural and agricultural environments; consumption of raw contaminated food; and limited water, hygiene, and sanitation. Mass drug administration and increased awareness and health education were commonly reported preventive factors for all FBTs. FBTs were primarily diagnosed using faecal parasitological testing. Triclabendazole was the most reported treatment for fascioliasis, while praziquantel was the primary treatment for paragonimiasis, clonorchiasis, and opisthorchiasis. Low sensitivity of diagnostic tests as well as reinfection due to continued high-risk food consumption habits were common factors. CONCLUSION This review presents an up-to-date synthesis on the quantitative and qualitative evidence available for the 4 FBTs. The data show a large gap between what is being estimated and what is being reported. Although progress has been made with control programmes in several endemic areas, sustained effort is needed to improve surveillance data on FBTs and identify endemic and high-risk areas for environmental exposures, through a One Health approach, to achieve the 2030 goals of FBT prevention.
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Affiliation(s)
- Rachel Tidman
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
- World Organisation for Animal Health, Paris, France
- * E-mail: (RT); (KK)
| | - Kaushi S. T. Kanankege
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
- College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, United States of America
- * E-mail: (RT); (KK)
| | - Mathieu Bangert
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Bernadette Abela-Ridder
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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Rosas-Hostos Infantes LR, Paredes Yataco GA, Ortiz-Martínez Y, Mayer T, Terashima A, Franco-Paredes C, Gonzalez-Diaz E, Rodriguez-Morales AJ, Bonilla-Aldana DK, Vargas Barahona L, Grimshaw AA, Chastain DB, Sillau S, Marcos LA, Henao-Martínez AF. The global prevalence of human fascioliasis: a systematic review and meta-analysis. Ther Adv Infect Dis 2023; 10:20499361231185413. [PMID: 37434654 PMCID: PMC10331341 DOI: 10.1177/20499361231185413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/14/2023] [Indexed: 07/13/2023] Open
Abstract
Background Fascioliasis is a parasitic zoonosis that can infect humans and be a source of significant morbidity. The World Health Organization lists human fascioliasis as a neglected tropical disease, but the worldwide prevalence of fascioliasis data is unknown. Objective We aimed to estimate the global prevalence of human fascioliasis. Data sources and methods We performed a systematic review and prevalence meta-analysis. We used the following inclusion criteria: articles published in the English, Portuguese, or Spanish languages from December 1985 to October 2022 and studies assessing the prevalence of Fasciola in the general population with an appropriate diagnostic methodology, including longitudinal studies, prospective and retrospective cohorts, case series, and randomized clinical trials (RCTs). We excluded animal studies. Two reviewers independently reviewed the selected studies for methodological quality, performing critical standard measures from JBI SUMARI. A random-effects model was conducted of the summary extracted data on the prevalence proportions. We reported the estimates according to the GATHER statement. Results In all, 5617 studies were screened for eligibility. Fifty-five studies from 15 countries were selected, including 154,697 patients and 3987 cases. The meta-analysis revealed a pooled prevalence of 4.5% [95% confidence interval (CI): 3.1-6.1; I2 = 99.4%; T2 = 0.07]. The prevalence in South America, Africa, and Asia was 9.0%, 4.8%, and 2.0%, respectively. The highest prevalence was found in Bolivia (21%), Peru (11%), and Egypt (6%). Subgroup analysis showed higher prevalence estimates in children, in studies from South America, and when Fas2-enzyme-linked immunosorbent assay (ELISA) was used as a diagnostic method. A larger study sample size (p = 0.027) and an increase in female percentage (p = 0.043) correlated with a decrease in prevalence. Multiple meta-regression showed a higher prevalence for hyperendemic than hypoendemic (p = 0.002) or mesoendemic (p = 0.013) regions. Conclusion The estimated prevalence and projected disease burden of human fascioliasis are high. Study findings support that fascioliasis continues to be a globally neglected tropical disease. Strengthening epidemiological surveillance and implementing measures to control and treat fascioliasis is imperative in the most affected areas.
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Affiliation(s)
| | | | - Yeimer Ortiz-Martínez
- Department of Internal Medicine, Universidad Industrial de Santander and Hospital Universitario de Santander, Bucaramanga, Colombia
| | - Treana Mayer
- Department of Microbiology, Immunology & Pathology, Colorado State University, Fort Collins, CO, USA
| | - Angelica Terashima
- Laboratorio de Parasitología, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Perú
- Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas, Hospital Nacional Cayetano Heredia, Lima, Perú
| | - Carlos Franco-Paredes
- Hospital Infantil de México Federico Gómez, México City, México
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá
| | - Esteban Gonzalez-Diaz
- Epidemiological Surveillance and Preventive Medicine Unit, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico
| | - Alfonso J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autónoma de las Américas-Institucion Universitaria Vision de las Americas, Pereira, Risaralda, Colombia
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
- Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru
| | | | - Lilian Vargas Barahona
- Division of Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Daniel B. Chastain
- Department of Clinical & Administrative Pharmacy, University of Georgia College of Pharmacy, Albany, GA, USA
| | - Stefan Sillau
- Department of Neurology and Biostatistics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Luis A. Marcos
- Division of Infectious Diseases, Departments of Medicine, Microbiology and Immunology, Stony Brook University, Stony Brook, NY, USA
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Geospatial analysis of the associations between environmental contamination with livestock feces and children with chronic fascioliasis in the Anta province of Cusco, Peru. PLoS Negl Trop Dis 2022; 16:e0010499. [PMID: 35709246 PMCID: PMC9242436 DOI: 10.1371/journal.pntd.0010499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 06/29/2022] [Accepted: 05/14/2022] [Indexed: 12/02/2022] Open
Abstract
Fasciola hepatica is a neglected parasitic infection with significant human health and livestock industry impact. The Andean Altiplano harbors an estimated 50% of the Fasciola’s world infection burden. There is scarce data regarding the spatial associations between different Fasciola hosts. In this project, we aimed to determine the geospatial relationships between Fasciola eggs passed in feces of different livestock species and the risk of infection among each household as a unit. We used data from a cross-sectional study evaluating children and livestock feces for Fasciola infection around households in three districts of Anta province, in the Cusco region of Peru. Each sample was geographically tagged and evaluated for fascioliasis using microscopy methods. A total of 2070 households were included, the median age was 9.1 years (6.7–11.8), 49.5% were female, and 7.2% of the households had at least one infected child. A total of 2420 livestock feces samples were evaluated. The infection rate in livestock samples was 30.9%. The highest infection rate was found in sheep with 40.8%, followed by cattle (33.8%), and swine (26.4%). The median distance between a household with an infected child to a positive animal sample was 44.6 meters (IQR 14.7–112.8) and the distance between a household with no infected children to a positive animal sample was 62.2 meters (IQR 18.3–158.6) (p = 0.025). The multivariable logistic regression adjusted by presence of poor sanitation, unsafe water consumption, altitude, and presence of multiple infected children per household demonstrated an association between household infection and any cattle feces at a 50 meters radius (Uninfected: OR 1.42 (95%CI 1.07–1.89), p = 0.017. Infected: OR 1.89 (95%CI 1.31–2.73), p = 0.001), positive cattle feces at a 100 meters radius (OR 1.35 (95% CI 1.08–1.69), p = 0.008), and negative cattle feces at a 200 meters radius (OR 1.08 (95% CI 1.01–1.15), p = 0.022). We identified potential hot and cold spots for fascioliasis in the Anta province. An association between environmental contamination with feces from different livestock species and infected children in rural households was found in our study. Local health authorities may apply this strategy to estimate the risk of infection in human populations and apply targeted interventions. Fasciola hepatica is the parasite that causes fascioliasis in the Andes region. The factors associated with transmission of the disease among humans have not been well described in the area studied. In this study, we evaluate the spatial relationships between infected households and the environmental burden of Fasciola eggs passed by different livestock in the Cusco region of Peru. We geographically marked and tested for fascioliasis feces provided by children and livestock. Infected and uninfected cattle as well as sheep feces were more likely to be in proximity to human households with infected children than to households without infected children. We were able to identify and map the areas of higher and lower infections rates. This information and strategy may be used in the control of the disease.
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Fernandez-Baca MV, Hoban C, Ore RA, Ortiz P, Choi YJ, Murga-Moreno C, Mitreva M, Cabada MM. The Differences in the Susceptibility Patterns to Triclabendazole Sulfoxide in Field Isolates of Fasciola hepatica Are Associated with Geographic, Seasonal, and Morphometric Variations. Pathogens 2022; 11:pathogens11060625. [PMID: 35745479 PMCID: PMC9227168 DOI: 10.3390/pathogens11060625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/14/2022] [Accepted: 05/19/2022] [Indexed: 02/01/2023] Open
Abstract
Triclabendazole (TCBZ) resistance is an emerging problem in fascioliasis that is not well understood. Studies including small numbers of parasites fail to capture the complexity of susceptibility variations between and within Fasciolahepatica populations. As the first step to studying the complex resistant phenotype−genotype associations, we characterized a large sample of adult F. hepatica with diverging TCBZ susceptibility. We collected parasites from naturally infected livestock slaughtered in the Cusco and Cajamarca regions of Peru. These parasites were exposed to TCBZ sulfoxide (TCBZ.SO) in vitro to determine their susceptibility. We used a motility score to determine the parasite’s viability. We titrated drug concentrations and times to detect 20% non-viable (susceptible conditions) or 80% non-viable (resistant conditions) parasites. We exposed 3348 fully motile parasites to susceptible (n = 1565) or resistant (n = 1783) conditions. Three hundred and forty-one (21.8%) were classified as susceptible and 462 (25.9%) were classified as resistant. More resistant parasites were found in Cusco than in Cajamarca (p < 0.001). Resistant parasites varied by slaughterhouse (p < 0.001), month of the year (p = 0.008), fluke length (p = 0.016), and year of collection (p < 0.001). The in vitro susceptibility to TCBZ.SO in wildtype F. hepatica was associated with geography, season, and morphometry.
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Affiliation(s)
- Martha V. Fernandez-Baca
- Sede Cusco, Instituto de Medicina Tropical “Alexander von Humboldt”, Universidad Peruana Cayetano Heredia, Calle Jose Carlos Mariategui J-6, Wanchaq, Cusco 08002, Peru; (M.V.F.-B.); (R.A.O.)
| | - Cristian Hoban
- Laboratorio de Inmunología, Facultad de Ciencias Veterinarias, Universidad Nacional de Cajamarca, Avenida Atahualpa 1050, Cajamarca 06001, Peru; (C.H.); (P.O.); (C.M.-M.)
| | - Rodrigo A. Ore
- Sede Cusco, Instituto de Medicina Tropical “Alexander von Humboldt”, Universidad Peruana Cayetano Heredia, Calle Jose Carlos Mariategui J-6, Wanchaq, Cusco 08002, Peru; (M.V.F.-B.); (R.A.O.)
| | - Pedro Ortiz
- Laboratorio de Inmunología, Facultad de Ciencias Veterinarias, Universidad Nacional de Cajamarca, Avenida Atahualpa 1050, Cajamarca 06001, Peru; (C.H.); (P.O.); (C.M.-M.)
| | - Young-Jun Choi
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, 4523 Clayton Avenue, MSC 8051-0043-15, St. Louis, MO 63110, USA;
| | - César Murga-Moreno
- Laboratorio de Inmunología, Facultad de Ciencias Veterinarias, Universidad Nacional de Cajamarca, Avenida Atahualpa 1050, Cajamarca 06001, Peru; (C.H.); (P.O.); (C.M.-M.)
| | - Makedonka Mitreva
- Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, 4523 Clayton Avenue, MSC 8051-0043-15, St. Louis, MO 63110, USA;
- McDonnell Genome Institute, Washington University, 4444 Forest Park Avenue, St. Louis, MO 63108, USA
- Correspondence: (M.M.); (M.M.C.)
| | - Miguel M. Cabada
- Sede Cusco, Instituto de Medicina Tropical “Alexander von Humboldt”, Universidad Peruana Cayetano Heredia, Calle Jose Carlos Mariategui J-6, Wanchaq, Cusco 08002, Peru; (M.V.F.-B.); (R.A.O.)
- Department of Medicine, Division of Infectious Diseases, School of Medicine, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA
- Correspondence: (M.M.); (M.M.C.)
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10
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Plasma cytokines during acute human fascioliasis. Parasitol Res 2021; 120:2965-2968. [PMID: 34245363 DOI: 10.1007/s00436-021-07230-8] [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: 03/23/2021] [Accepted: 06/18/2021] [Indexed: 10/20/2022]
Abstract
Fascioliasis is a foodborne trematode endemic worldwide. Children under 15 years have the highest prevalence of infection. We hypothesized that acute fascioliasis would be associated with more pronounced cytokine changes than in chronic disease or no helminth infections. To test this hypothesis, 33 children who lived in the Peruvian highlands were classified into 3 groups: acute fascioliasis, chronic fascioliasis, and no helminth infection. Type Th1, Th2, and Th17 cytokines were measured in plasma by cytometric bead array. Children with acute infection had higher levels of IL-5 and IL-17 compared with controls (p < 0.001 and p < 0.007, respectively). The increased IL-5 plasma concentration in children with acute infection was associated with the eosinophilia found in that group.
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Morales ML, Tanabe MB, White AC, Lopez M, Bascope R, Cabada MM. Triclabendazole Treatment Failure for Fasciola hepatica Infection among Preschool and School-Age Children, Cusco, Peru 1. Emerg Infect Dis 2021; 27:1850-1857. [PMID: 34152949 PMCID: PMC8237897 DOI: 10.3201/eid2707.203900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We conducted a retrospective cohort study of children who had chronic fascioliasis in the highlands of Peru to determine triclabendazole treatment efficacy. Children passing Fasciola eggs in stool were offered directly observed triclabendazole treatment (>1 doses of 10 mg/kg). Parasitologic cure was evaluated by using microscopy of stool 1–4 months after each treatment. A total of 146 children who had chronic fascioliasis participated in the study; 53% were female, and the mean ± SD age was 10.4 ± 3.1 years. After the first treatment, 55% of the children achieved parasitologic cure. Cure rates decreased after the second (38%), third (30%), and fourth (23%) treatments; 17 children (11.6%) did not achieve cure after 4 treatments. Higher baseline egg counts and lower socioeconomic status were associated with triclabendazole treatment failure. Decreased triclabendazole efficacy in disease-endemic communities threatens control efforts. Further research on triclabendazole resistance and new drugs to overcome it are urgently needed.
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Webb CM, Morales ML, Lopez M, Baca-Turpo B, Arque E, White AC, Cabada MM. Stunting in pre-school and school-age children in the Peruvian highlands and its association with Fasciola infection and demographic factors. PLoS Negl Trop Dis 2021; 15:e0009519. [PMID: 34153050 PMCID: PMC8248620 DOI: 10.1371/journal.pntd.0009519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/01/2021] [Accepted: 05/30/2021] [Indexed: 11/18/2022] Open
Abstract
Fascioliasis is a zoonotic trematode infection that is endemic in the highlands of Peru. Chronic fascioliasis can be asymptomatic and remain undiagnosed for years. Chronic malnutrition in children, as manifested by stunting, leads to delayed cognitive development and lost productivity. We hypothesized that fascioliasis is among the factors associated with stunting in children from endemic areas. We conducted a cross-sectional study among children attending pre-school and school in 26 communities in the Anta province in the Cusco region of Peru. We conducted interviews to collect information on demographic, socioeconomic, and medical history. Blood was collected and tested for complete cell count and FAS2 ELISA for Fasciola antibodies. Three stool samples per participant were tested for parasites by Kato-Katz and Lumbreras rapid sedimentation methods. Chronic fascioliasis was determined by the presence of ova in stool. Children's height, weight, and age were recorded and used to calculate height for age Z scores (HAZ). Three thousand children participated in the study. Nine percent (264) of children had at least one positive test for Fasciola infection, 6% (164) had chronic fascioliasis, and 3% (102) had only positive antibody tests. The median HAZ was -1.41 (IQR: -2.03 to -0.81) and was similar in males and females. Twenty six percent (776) of children had stunting with HAZ < -2. Children with chronic fascioliasis had a lower median HAZ than children without Fasciola (-1.54 vs. -1.4, p = 0.014). History of treatment for malnutrition, history of treatment for anemia, having other helminths in stool, lower socioeconomic score, living at a higher elevation, and fewer years of schooling of both parents were associated with a lower HAZ score. In a multiple regression analysis, older age and a lower socioeconomic score were associated with a lower HAZ score. While fascioliasis and other helminths were associated with lower HAZ, they were not independent of the socioeconomic score.
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Affiliation(s)
- Camille M. Webb
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Maria Luisa Morales
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Martha Lopez
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Benicia Baca-Turpo
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Eulogia Arque
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - A. Clinton White
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Miguel M. Cabada
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, United States of America
- Alexander von Humboldt Tropical Medicine Institute, Department of Medicine, Universidad Peruana Cayetano Heredia, Cusco, Peru
- UPCH–UTMB Collaborative Research Center—Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
- * E-mail:
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Caravedo MA, Ramirez W, Morales ML, Lopez M, Janes CE, Bunag BA, Mixon KL, White AC, Tanabe MB, Cabada MM. Fasciola hepatica Infection Risk for Adult Household Members with Children with Fascioliasis in Cusco, Peru. Am J Trop Med Hyg 2021; 104:2069-2073. [PMID: 33939646 DOI: 10.4269/ajtmh.21-0131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/15/2021] [Indexed: 11/07/2022] Open
Abstract
Fasciola hepatica is highly prevalent in the highlands of Peru. School-age children have the greatest risk of infection. Mass treatment of at-risk populations has been proposed to control the infection and prevent complications. However, the decreasing effectiveness of triclabendazole raises concerns regarding this strategy. Previous studies reported aggregation of Fasciola infection among family members. This study aimed to determine the risk of fascioliasis among household members living with Fasciola-infected children identified through school-based testing. We conducted a cross-sectional study including adult members of households where children with and without fascioliasis were identified. Demographic, epidemiological, and socioeconomic information was collected. One blood sample was drawn to test for Fasciola antibodies, and three stool samples were collected for microscopy for Fasciola ova. We tested 326 adults from 213 households. Of these adult subjects, chronic fascioliasis (24 of 326, 7.4%) was the most common helminth infection. Thirty-nine subjects (12.7%) tested positive for Fasciola antibodies. Combining microscopy and serum antibody tests, 13.2% (43 of 326) had evidence of Fasciola infection. One third (104 of 326, 31.9%) of the participants lived with at least one child infected with Fasciola hepatica. Adults with fascioliasis were four times more likely to live with an infected child. Poverty and diet were associated with increased risk of Fasciola infection. Adults with fascioliasis were significantly more likely to live with Fasciola-infected children.
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Affiliation(s)
- Maria A Caravedo
- 1Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Walter Ramirez
- 2Department of Pediatrics, Hospital Nacional Adolfo Guevara Velasco ESSALUD, Cusco, Peru
| | - Maria L Morales
- 3Cusco Branch, Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Martha Lopez
- 3Cusco Branch, Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Claire E Janes
- 4School of Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Brittany A Bunag
- 4School of Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Katie L Mixon
- 4School of Medicine, University of Texas Medical Branch, Galveston, Texas
| | - A Clinton White
- 1Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.,3Cusco Branch, Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Melinda B Tanabe
- 1Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Miguel M Cabada
- 1Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.,3Cusco Branch, Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru
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Alba A, Vazquez AA, Hurtrez-Boussès S. Towards the comprehension of fasciolosis (re-)emergence: an integrative overview. Parasitology 2021; 148:385-407. [PMID: 33261674 PMCID: PMC11010171 DOI: 10.1017/s0031182020002255] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/24/2020] [Accepted: 11/24/2020] [Indexed: 02/06/2023]
Abstract
The increasing distribution and prevalence of fasciolosis in both human and livestock are concerning. Here, we examine the various types of factors influencing fasciolosis transmission and burden and the interrelations that may exist between them. We present the arsenal of molecules, 'adjusting' capabilities and parasitic strategies of Fasciola to infect. Such features define the high adaptability of Fasciola species for parasitism that facilitate their transmission. We discuss current environmental perturbations (increase of livestock and land use, climate change, introduction of alien species and biodiversity loss) in relation to fasciolosis dynamics. As Fasciola infection is directly and ultimately linked to livestock management, living conditions and cultural habits, which are also changing under the pressure of globalization and climate change, the social component of transmission is also discussed. Lastly, we examine the implication of increasing scientific and political awareness in highlighting the current circulation of fasciolosis and boosting epidemiological surveys and novel diagnostic techniques. From a joint perspective, it becomes clear that factors weight differently at each place and moment, depending on the biological, environmental, social and political interrelating contexts. Therefore, the analyses of a disease as complex as fasciolosis should be as integrative as possible to dissect the realities featuring each epidemiological scenario. Such a comprehensive appraisal is presented in this review and constitutes its main asset to serve as a fresh integrative understanding of fasciolosis.
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Affiliation(s)
- Annia Alba
- Centro de Investigaciones, Diagnóstico y Referencia, Instituto de Medicina Tropical ‘Pedro Kourí’, Havana, Cuba
| | - Antonio A. Vazquez
- Centro de Investigaciones, Diagnóstico y Referencia, Instituto de Medicina Tropical ‘Pedro Kourí’, Havana, Cuba
- MIVEGEC, IRD, CNRS, Université de Montpellier, Montpellier, France
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15
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Caravedo MA, Cabada MM. Human Fascioliasis: Current Epidemiological Status and Strategies for Diagnosis, Treatment, and Control. Res Rep Trop Med 2020; 11:149-158. [PMID: 33273878 PMCID: PMC7705270 DOI: 10.2147/rrtm.s237461] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose of the Review This review aims to critically assess current knowledge about the epidemiology, diagnosis, and management of Fasciola infection in humans. Recent Findings Fascioliasis is an emerging neglected zoonotic infection affecting the health and wellbeing of human populations. The burden of infection is unclear, and studies have shown the geographic expansion of fascioliasis in human and livestock likely related to climate change. The infection can be asymptomatic or present in acute or chronic forms. Regardless of the presentation, fascioliasis can be associated with long-term complications such as anemia and malnutrition. Early in the infection, antibody testing is the only tool available for diagnosis confirmation. In the chronic forms serology and stool microscopy are helpful. Other tests such as antigen detection and PCR-based methods including isothermal tests have shown promising results. Triclabendazole is the only drug available to treat Fasciola infection. However, reports of resistant infections in livestock and human threaten the clinical care and control of the infection in endemic areas. Summary Fascioliasis is an emerging infection around the world with an uncertain burden. Lack of standardization of diagnostic testing and treatment alternatives hinder treatment and control of the infection.
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Affiliation(s)
- Maria Alejandra Caravedo
- Division of Infectious Diseases Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Miguel Mauricio Cabada
- Division of Infectious Diseases Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.,Cusco Branch - Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco, Peru
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Arias-Pacheco C, Lucas JR, Rodríguez A, Córdoba D, Lux-Hoppe EG. Economic impact of the liver condemnation of cattle infected with Fasciola hepatica in the Peruvian Andes. Trop Anim Health Prod 2020; 52:1927-1932. [PMID: 31965412 DOI: 10.1007/s11250-020-02211-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 01/11/2020] [Indexed: 12/24/2022]
Abstract
Fasciolosis is a zoonotic food- and waterborne infection related to great economic losses on ruminant production. In order to determine the prevalence of bovine liver condemnations due to fasciolosis in an abattoir at the Central Andes of Peru, we evaluated the records of an authorized slaughterhouse in Huancayo, at 3300 m above sea level, over 16 months. Subsequently, the average weights of condemned viscera and carcasses were also estimated to determine the direct and indirect economic losses. Fasciolosis was the main cause of liver condemnation, with a prevalence of 55.72% (3926/7046; CI 95%: 56.88-54.56%). The livers infected were more than double the amount of livers supplied to markets in this period. Although the average price of liver in the Peruvian Andes is very cheap, approximately 16.45 tons of livers were destroyed, estimating a direct economic loss of US$ 35,080 (CI 95%: US$ 29,178-40,938). The indirect loss due to decreased body weight gain (calculated using 10% of the average weight of a healthy animal carcass) was estimated at US$ 354,570 (CI 95%: US$ 387,908-US$ 321,227). Fasciolosis is an important zoonotic disease that threatens food security in the Andean region, with major repercussions on the income of the livestock industry and the availability of cheap protein sources.
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Affiliation(s)
- Carmen Arias-Pacheco
- Universidade Estadual Paulista (UNESP), Faculdade de Ciências Agrárias e Veterinárias, São Paulo State, Jaboticabal, Brazil
| | - J Raúl Lucas
- Universidad Nacional Mayor de San Marcos (UNMSM), Facultad de Medicina Veterinaria, Av. Circunvalación 2800, Lima, Peru.
| | | | | | - Estevam G Lux-Hoppe
- Universidade Estadual Paulista (UNESP), Faculdade de Ciências Agrárias e Veterinárias, São Paulo State, Jaboticabal, Brazil
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17
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Pineau P, Ruiz E, Deharo E, Bertani S. On hepatocellular carcinoma in South America and early-age onset of the disease. Clin Res Hepatol Gastroenterol 2019; 43:522-526. [PMID: 30482474 DOI: 10.1016/j.clinre.2018.10.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 10/26/2018] [Indexed: 02/08/2023]
Abstract
Hepatocellular carcinoma (HCC) is one of the most predominant tumor types worldwide, being particularly prevalent in sub-Saharan Africa and East Asia. However, HCC is inexplicably underreported in South America, despite unsettling clinical epidemiological trends of the disease on this continent. Here, we review the current knowledge on HCC presentation in Peru. We emphasize the well-documented occurrence of an early-age nosological form of the disease in Andean descent populations. We further discuss the reasons for such HCC clinical presentation, as well as the implications for liver cancer screening, management, and prevention.
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Affiliation(s)
- Pascal Pineau
- Institut Pasteur, Unité organisation nucléaire et oncogenèse, Inserm, U 993, 75015 Paris, France.
| | - Eloy Ruiz
- Instituto nacional de enfermedades neoplasicas, Departamento de cirugía en abdomen, 34 Lima, Peru
| | - Eric Deharo
- Université de Toulouse, IRD, UPS, UMR 152 Pharmadev, 31000 Toulouse, France
| | - Stéphane Bertani
- Université de Toulouse, IRD, UPS, UMR 152 Pharmadev, 31000 Toulouse, France.
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