Repurposing drugs for the treatment and control of helminth infections

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Drug repurposing continues to be the central drug discovery strategy for helminths.

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Most repurposed drugs come from veterinary medicine and known drug classes.

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Only a handful of drugs have advanced clinically.

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More collaborations and funding are needed to advance discoveries to the market.

Helminth infections are responsible for a considerable public health burden, yet the current drug armamentarium is small. Given the high cost of drug discovery and development, the high failure rates and the long duration to develop novel treatments, drug repurposing circumvents these obstacles by finding new uses for compounds other than those they were initially intended to treat. In the present review, we summarize in vivo and clinical trial findings testing clinical candidates and marketed drugs against schistosomes, food-borne trematodes, soil-transmitted helminths, Strongyloides stercoralis, the major human filariases lymphatic filariasis and onchocerciasis, taeniasis, neurocysticercosis and echinococcosis. While expanding the applications of broad-spectrum or veterinary anthelmintics continues to fuel alternative treatment options, antimalarials, antibiotics, antiprotozoals and anticancer agents appear to be producing fruitful results as well. The trematodes and nematodes continue to be most investigated, while cestodal drug discovery will need to be accelerated. The most clinically advanced drug candidates include the artemisinins and mefloquine against schistosomiasis, tribendimidine against liver flukes, oxantel pamoate against trichuriasis, and doxycycline against filariasis. Preclinical studies indicate a handful of promising future candidates, and are beginning to elucidate the broad-spectrum activity of some currently used anthelmintics. Challenges and opportunities are further discussed.

Parasites in Food: From a Neglected Position to an Emerging Issue

Foodborne parasites have long been a neglected group of pathogens, as they often have insidious, chronic effects, rather than being acute diseases, and they are often associated with impoverished or marginalized populations. In addition, due to the long incubation period for most foodborne parasites, source attribution is often difficult, if not impossible. However, global trends have enabled foodborne parasites to emerge in different populations in new locations, transmitted through different food types, and sometimes with unexpected symptoms. This emergence of foodborne parasites has brought them into focus. In this chapter, six foodborne parasites are used as examples on emergence: Echinococcus multilocularis is spreading to new locations; Cryptosporidium spp. are beginning to be associated not only with water, but also with salads; Trypanosoma cruzi is being manifest with acute disease due to foodborne transmission, particularly transmitted with juices; Trichinella spp. have become less of a burden regarding transmission via pork in many countries, but now game animals are becoming a concern; anisakiasis is becoming a global problem as the world develops a taste for sushi, and similarly for opisthorchiasis, which is increasingly being associated with cholangiocarcinoma. However, the emergence of these foodborne parasites provides an incentive for increased efforts being made toward control. In this chapter, having described how the parasites are emerging from their neglected position, the focus turns toward control. In addition to considering control measures that may be applied to the specific parasites, an overview is provided of some of the organized collaborations, projects, and consortia, as well as some of their outputs, that have in focus the control of these emerging and important pathogens.

Enhanced steroid dosing reduces seizures during antiparasitic treatment for cysticercosis and early after

OBJECTIVE

Neurocysticercosis (NCC) is a major cause of seizures and epilepsy in endemic countries. Antiparasitic treatment of brain cysts leads to seizures due to the host's inflammatory reaction, requiring concomitant steroids. We hypothesized that increased steroid dosing will reduce treatment-associated seizures.

METHODS

Open-label randomized trial comparing 6 mg/day dexamethasone for 10 days (conventional) with 8 mg/day for 28 days followed by a 2-week taper (enhanced) in patients with NCC receiving albendazole. Follow-up included active seizure surveillance and brain imaging. Study outcomes were seizure days and patients with seizures, both measured in days 11-42. Additional analyses compared days 1-10, 11-21, 22-32, 33-42, 43-60, and 61-180.

RESULTS

Thirty-two individuals were randomized into each study arm; two did not complete follow-up. From days 11 to 42, 59 partial and 6 generalized seizure days occurred in 20 individuals, nonsignificantly fewer in the enhanced arm (12 vs. 49, p = 0.114). The numbers of patients with seizures in this period showed similar nonsignificant differences. In the enhanced steroid arm there were significantly fewer days and individuals with seizures during antiparasitic treatment (days 1-10: 4 vs. 17, p = 0.004, and 1 vs. 10, p = 0.003, number needed to treat [NNT] 4.6, relative risk [RR] 0.1013, 95% confidence interval [CI] 0.01-0.74) and early after dexamethasone cessation (days 11-21: 6 vs. 27, p = 0.014, and 4 vs. 12, p = 0.021, NNT 4.0, RR 0.33, 95% CI 0.12-0.92) but not after day 21. There were no significant differences in antiparasitic efficacy or relevant adverse events.

SIGNIFICANCE

Increased dexamethasone dosing results in fewer seizures for the first 21 days during and early after antiparasitic treatment for viable parenchymal NCC but not during the first 11-42 days, which was the primary predetermined time of analysis.

Molecular identification of Spirometra spp. (Cestoda: Diphyllobothriidae) in some wild animals from Brazil

Species of the genus Spirometra are diphyllobothriid tapeworms with complex life cycles and are involved in human sparganosis, a neglected disease that affects individuals worldwide. Although some species were reported in wild felids and human cases of sparganosis were described in Brazil, the biology and taxonomy of these parasites are poorly understood. In the present study, samples of diphyllobothriids (eggs and/or proglottids) obtained from the stools of wild carnivores (Leopardus pardalis and Lycalopex vetulus) and plerocercoid larvae found in a snake (Crotalus durissus) from Brazil were analysed by amplifying a fragment of the gene cytochrome c oxidase subunit 1 (cox 1). The DNA sequences obtained here for the first time from the Spirometra spp. from Brazil were used to evaluate the phylogenetic relationships with other species. Molecular data identified two species in the Brazilian samples (evolutionary divergence of 17.8-19.2%). The species were identified as Spirometra sp. 1, found in Le. pardalis, and Spirometra sp. 2 found in Ly. vetulus and C. durissus, and they differed from Asian isolates of Spirometra erinaceieuropaei (17.5-20.2% and 12.2-15.6%, respectively), a species previously considered to be distributed worldwide. Moreover, Spirometra sp. 1 is genetically distinct from Sparganum proliferum from Venezuela (19.6-20.4%), while Spirometra sp. 2 is more closely related with the Venezuelan species (6.1-7.0%). Sequences of Spirometra sp. 2 revealed that it is conspecific with the Argentinean isolate of Spirometra found in Lycalopex gymnocercus (1.9-2.2%). Taxonomic and phylogenetic aspects related to New World species of Spirometra are briefly discussed.

The forgotten exotic tapeworms: a review of uncommon zoonotic Cyclophyllidea

As training in helminthology has declined in the medical microbiology curriculum, many rare species of zoonotic cestodes have fallen into obscurity. Even among specialist practitioners, knowledge of human intestinal cestode infections is often limited to three genera, Taenia, Hymenolepis and Dibothriocephalus. However, five genera of uncommonly encountered zoonotic Cyclophyllidea (Bertiella, Dipylidium, Raillietina, Inermicapsifer and Mesocestoides) may also cause patent intestinal infections in humans worldwide. Due to the limited availability of summarized and taxonomically accurate data, such cases may present a diagnostic dilemma to clinicians and laboratories alike. In this review, historical literature on these cestodes is synthesized and knowledge gaps are highlighted. Clinically relevant taxonomy, nomenclature, life cycles, morphology of human-infecting species are discussed and clarified, along with the clinical presentation, diagnostic features and molecular advances, where available. Due to the limited awareness of these agents and identifying features, it is difficult to assess the true incidence of these 'forgotten' cestodiases as clinical misidentifications are likely to occur. Also, the taxonomic status of many of the human-infecting species of these tapeworms is unclear, hampering accurate species identification. Further studies combining molecular data and morphological observations are necessary to resolve these long-standing taxonomic issues and to elucidate other unknown aspects of transmission and ecology.

Efficacy against nematode and cestode infections and safety of a novel topical fipronil, (S)-methoprene, eprinomectin and praziquantel combination product in domestic cats under field conditions in Europe

A novel topical combination product (BROADLINE(®), Merial) composed of fipronil, (S)-methoprene, eprinomectin and praziquantel was evaluated for safety and efficacy against nematode and cestode infections in domestic cats. The study comprised a multi-centre, positive control, blinded, field study, using a randomized block design based on order of presentation for allocation. In total 196 client-owned cats, confirmed as positive for naturally acquired infections of nematodes and/or cestodes by pre-treatment faecal examination, were studied in seven countries in Europe. Pre-treatment faecal examination revealed the presence of Toxocara, hookworm, Capillaria and/or spirurid nematode infections in 129, 73, 33 or 1 cat(s), respectively; infections with taeniid and Dipylidium cestodes were demonstrated in 39 and 17 cats, respectively. Cats were allocated randomly to one of two treatments in a ratio of 2, topical fipronil (8.3%, w/v), (S)-methoprene (10%, w/v), eprinomectin (0.4%, w/v) and praziquantel (8.3%, w/v) (BROADLINE(®), Merial; 130 cats); and 1, topical PROFENDER(®) Spot-On (Bayer; 66 cats) and treated once on Day 0. For evaluation of efficacy, two faecal samples were collected, one prior to treatment (Day -4 ± 4 days) and one at the end of the study (Day 14 ± 5 days). These were examined for fecal forms of nematode and cestode parasites. For evaluation of safety, cats were examined by a veterinarian before treatment and at the end of the study, and cat owners recorded the health status of their cats daily until the end of the study. For cats treated with Broadline(®), the efficacy was >99.9%, 100%, and 99.6% for Toxocara, hookworms, and Capillaria, respectively; and the efficacy was >99.9%, >99.9%, and 98.5%, respectively, for the cats treated with Profender(®) (p<0.001 for all nematodes and both treatments). Efficacy was 100% for both cestodes for both treatments (p<0.001). No treatment related adverse experiences were observed throughout the study. For both treatments, every cat that completed the study was given a safety score of 'excellent' for both local and systemic evaluations. The topical combination product of fipronil, (S)-methoprene, eprinomectin and praziquantel was shown to have an excellent safety profile and demonstrated high levels of efficacy when administered once as topical solution to cats infected with nematodes and cestodes under field conditions.

Novel PCRs for differential diagnosis of cestodes

Cestodes or tapeworms belong to a diverse group of helminths. The adult Taenia saginata and Taenia solium tapeworm can infest the human gut and the larval stage of Echinococcus spp. and T. solium can infect tissues of the human body, causing serious disease. Molecular diagnostics can be performed on proglottids, eggs and on cyst fluids taken by biopsy. Detection of cestodes when a helminthic infection is suspected is of vital importance and species determination is required for appropriate patient care. For routine diagnostics a single test that is able to detect and type a range of cestodes is preferable. We sought to improve our diagnostic procedure that used to rely on PCR and subsequent sequencing of the Cox1 and Nad1 genes. We have compared these PCRs with novel PCRs on the 12S rRNA and Nad5 gene and established the sensitivity and specificity. A single PCR on the 12S gene proved to be very suitable for detection and specification of Taenia sp. and Echinococcus sp. Both targets harbour enough polymorphic sites to determine the various Echinococcus species. The 12S PCR was most sensitive of all tested.

Composition, structure and pattern of helminth assemblages associated with central European herons (Ardeidae)

Helminths parasitizing the ardeid birds are poorly understood, and the majority of studies are limited to checklists and records of novel host-parasite interactions. Here we analyzed the prevalence, intensity and diversity of the helminth component communities associated with an extensive cohort of the five most common Czech herons (Ardea cinerea, Ardea alba, Nycticorax nycticorax, Botaurus stellaris and Ixobrychus minutus) collected in the years 1962-2013. Comparison with Ukrainian datasets supports the existence of local helminth component communities, subject to strong geographic variation. The diversity of the component communities ranged between 37.3±9.6 (A. cinerea) and 2.5±1.1 (I. minutus) species. Similarly, the frequency of particular helminths differed by over one order of magnitude, whereas the helminth load differed by over two orders of magnitude. Typically, the dominant species (Echinochasmus beleocephalus, Uroproctepisthmium bursicola, Posthodiplostomum cuticola, Apharyngostrigea cornu, Desmidocercella numidica and Neogryporhynchus cheilancristrotus) were considered local, with intermediate host species available onsite, as represented by freshwater mollusks. Of the digeneans, 52% of the species likely infected their definitive hosts outside the study area, frequently utilizing invertebrates of salt or brackish waters. For A. cinerea, the largest number of species was in adult males; however the helminth load of the adults was lower than in their juvenile counterparts. This study provides the first systematically collected evidence for the intra-annual changes of the helminth assemblages in herons.

Comparing cestode infections and their consequences for host fitness in two sexual branchiopods: alien Artemia franciscana and native A. salina from syntopic-populations

The American brine shrimp Artemia franciscana is invasive in the Mediterranean region where it has displaced native species (the sexual A. salina, and the clonal A. parthenogenetica) from many salt pond complexes. Artemia populations are parasitized by numerous avian cestodes whose effects have been studied in native species. We present a study from the Ebro Delta salterns (NE Spain), in a salt pond where both A. franciscana and native A. salina populations coexist, providing a unique opportunity to compare the parasite loads of the two sexual species in syntopy. The native species had consistently higher infection parameters, largely because the dominant cestode in A. salina adults and juveniles (Flamingolepis liguloides) was much rarer in A. franciscana. The most abundant cestodes in the alien species were Eurycestus avoceti (in adults) and Flamingolepis flamingo (in juveniles). The abundance of E. avoceti and F. liguloides was higher in the A. franciscana population syntopic with A. salina than in a population sampled at the same time in another pond where the native brine shrimp was absent, possibly because the native shrimp provides a better reservoir for parasite circulation. Infection by cestodes caused red colouration in adult and juvenile A. salina, and also led to castration in a high proportion of adult females. Both these effects were significantly stronger in the native host than in A. franciscana with the same parasite loads. However, for the first time, significant castration effects (for E. avoceti and F. liguloides) and colour change (for six cestode species) were observed in infected A. franciscana. Avian cestodes are likely to help A. franciscana outcompete native species. At the same time, they are likely to reduce the production of A. franciscana cysts in areas where they are harvested commercially.

Efficacy of condensed tannins against larval Hymenolepis diminuta (Cestoda) in vitro and in the intermediate host Tenebrio molitor (Coleoptera) in vivo

Natural anti-parasitic compounds in plants such as condensed tannins (CT) have anthelmintic properties against a range of gastrointestinal nematodes, but for other helminths such effects are unexplored. The aim of this study was to assess the effects of CT from three different plant extracts in a model system employing the rat tapeworm, Hymenolepis diminuta, in its intermediate host, Tenebrio molitor. An in vitro study examined infectivity of H. diminuta cysticercoids (excystation success) isolated from infected beetles exposed to different concentrations of CT extracts from pine bark (PB) (Pinus sps), hazelnut pericarp (HN) (Corylus avellana) or white clover flowers (WC) (Trifolium repens), in comparison with the anthelmintic drug praziquantel (positive control). In the in vitro study, praziquantel and CT from all three plant extracts had dose-dependent inhibitory effects on cysticercoid excystation. The HN extract was most effective at inhibiting excystation, followed by PB and WC. An in vivo study was carried out on infected beetles (measured as cysticercoid establishment) fed different doses of PB, HN and praziquantel. There was a highly significant inhibitory effect of HN on cysticercoid development (p=0.0002). Overall, CT showed a promising anti-cestodal effect against the metacestode stage of H. diminuta.

Differential diagnosis and molecular characterization of Hymenolepis nana and Hymenolepis diminuta (Cestoda: Cyclophyllidea: Hymenolepididae) based on nuclear rDNA ITS2 gene marker

Given the widespread distribution and medical implication of members of the genus Hymenolepis, specific identification of the aetiological agent becomes imperative. For precise diagnosis of the species, molecular techniques such as PCR and RFLP of the nuclear ribosomal internal transcribed spacer 2 (rDNA-ITS2) gene marker were carried out. The results showed distinct restriction patterns for both Hymenolepis nana and Hymenolepis diminuta when digested with either of the enzymes RsaI, HaeIII or HhaI. The annotated rDNA-ITS2 sequences from the two species revealed differences in the length; the folded secondary structure also depicted clear demarcation between the two species with variations in length of the helices, pyrimidine-pyrimidine mismatches and sites where motifs occur. In phylogenetic analysis of the evolutionary relationship between the two species as well as with other members of the family Hymenolepididae, the species causing human hymenolepiasis were found to be distantly related as they diverged independently from the ancestral lineage.

Helminths of veterinary and zoonotic importance in Nigerian ruminants: a 46-year meta-analysis (1970-2016) of their prevalence and distribution

BACKGROUND

The livestock industry plays a vital role in the economy of Nigeria. It serves as a major source of income and livelihood for majority of Nigerians who are rural settlers and contributes about 5.2% to the National Gross Domestic Product (GDP). Helminths however, cause economic losses due to reductions in milk production, weight gain, fertility and carcass quality. Zoonotic helminths of livestock origin cause health problems in humans.

METHODS

Using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, the prevalence and distribution of helminths of veterinary and zoonotic importance in Nigerian ruminants were determined in a meta-analysis of data published between 1970 and 2016. Data were stratified based on regions, hosts, study periods, sample sizes and study types while helminths were phylogenetically grouped into cestodes, nematodes and trematodes.

RESULTS

Data from 44 studies reported across 19 Nigerian states revealed an overall pooled prevalence estimate (PPE) of 7.48% (95% CI: 7.38-7.57) for helminths of veterinary and zoonotic importance from a total of 320 208 ruminants. We observed a significant variation (P < 0.001) between the PPEs range of 1.90% (95% CI: 1.78-2.02) and 60.98% (95% CI: 58.37-63.55) reported across different strata. High heterogeneity (99.78, 95% CI: 7.38-7.57) was observed. Strongyloides papillosus was the most prevalent (Prev: 32.02%, 95% CI: 31.01-33.11), while, Fasciola gigantica had the widest geographical distribution.

CONCLUSIONS

Helminths of veterinary and zoonotic importance are prevalent in ruminants and well distributed across Nigeria. Our findings show that helminths of ruminants may also be possible causes of morbidity in humans and economic losses in the livestock industry in Nigeria. High heterogeneity was observed within studies and the different strata. Good agricultural practices on farms, standard veterinary meat inspection and adequate hygiene and sanitation in abattoirs, farms and livestock markets need to be implemented in Nigeria in order to reduce the economic, public health and veterinary threats due to these helminths.

Molecular identification of cestodes and nematodes by cox1 gene real-time PCR and sequencing

Unlike bacteria and fungi, identification of helminths by gene sequencing is not well-standardized. No "pan-cestode" or "pan-nematode" PCR primers are available. In this study, we designed 2 pairs of PCR primers for amplifying the cox1 genes of cestodes and nematodes respectively and validated their usefulness for real-time PCR and sequencing identification using clinical samples with cestodes and nematodes collected from a variety of animals and human in 7 countries in Asia, Europe and Africa. The detection limits of the cox1 real-time PCR assays for cestodes and nematodes were 10 copies/reaction of extracted DNA, corresponding to C_T values of 33 and 31 respectively. Real-time PCR using the 2 pairs of primers and probes showed positive results for all 20 clinical samples of cestodes and nematodes. Using phenotypic identification results as the reference standard, DNA sequencing successfully identified all the 5 cestodes and 7 nematodes with cox1 gene sequences available in GenBank, with all these names appearing as the best match of the cox1 gene sequences of the corresponding clinical samples. The percentage nucleotide identities between the cox1 gene sequences of the samples and those of the corresponding best match sequences in GenBank were 98-100%. For the remaining 5 cestodes and 3 nematodes, the corresponding cox1 gene sequences were not available in GenBank. cox1 gene sequencing is discriminative enough for accurately identifying most of the cestodes and nematodes in the present study. Further expansion of the cox1 gene sequence database will enable accurate identification of more cestodes and nematodes.

You are how you eat: differences in trophic position of two parasite species infecting a single host according to stable isotopes

Parasitism is commonly recognised as a consumer strategy, although, the interaction of parasites in communities and ecosystems are generally poorly understood. As parasites are integral parts of food webs, analysis of the trophic interactions between parasites and hosts was assessed through comparison of stable isotope ratios of carbon (13C/12C) and nitrogen (15N/14N). Largemouth yellowfish (Labeobarbus kimberleyensis) infected with the Asian tapeworm (Schyzocotyle acheilognathi) were collected from the Vaal Dam. Signatures of δ13C and δ15N were assessed in host muscle and liver tissue, and cestodes using an elemental analyser coupled with an isotope ratio-mass spectrometer (EA-IRMS). Hosts were enriched by 4.1‰ in the heavy nitrogen isotope with respect to the S. acheilognathi and therefore occupy a higher trophic position than the parasite. Comparison of δ13C indicates that dietary sources of carbon in cestodes are derived from the host liver. Comparison of stable isotope signatures between Paradiplozoon ichthyoxanthon (another common parasite of the Largemouth yellowfish in the Vaal River) and S. acheilognathi showed that the monogenean was enriched by 5.3‰ in 15N which accounts for a difference of almost two trophic positions. Isotope differences in the host-parasite system considered indicate that differences can be related to the mode of nutrient acquisition employed by host and parasites. Cestodes, being depleted in both 13C and 15N relative to the host and monogenean (P. ichthyoxanthon), indicate that S. acheilognathi assimilates nutrients derived from the host metabolism which are released from the liver.

Microbiome "Inception": an Intestinal Cestode Shapes a Hierarchy of Microbial Communities Nested within the Host

The concept of a holobiont, a host organism and its associated microbial communities, encapsulates the vital role the microbiome plays in the normal functioning of its host. Parasitic infections can disrupt this relationship, leading to dysbiosis. However, it is increasingly recognized that multicellular parasites are themselves holobionts. Intestinal parasites share space with the host gut microbiome, creating a system of nested microbiomes within the primary host. However, how the parasite, as a holobiont, interacts with the host holobiont remains unclear, as do the consequences of these interactions for host health. Here, we used 16S amplicon and shotgun metagenomics sequencing to characterize the microbiome of the intestinal cestode Eubothrium and its effect on the gut microbiome of its primary host, Atlantic salmon. Our results indicate that cestode infection is associated with salmon gut dysbiosis by acting as a selective force benefiting putative pathogens and potentially introducing novel bacterial species to the host. Our results suggest that parasitic cestodes may themselves be holobionts nested within the microbial community of their holobiont host, emphasizing the importance of also considering microbes associated with parasites when studying intestinal parasitic infections. IMPORTANCE The importance of the parasite microbiome is gaining recognition. Of particular concern is understanding how these parasite microbiomes influence host-parasite interactions and parasite interactions with the vertebrate host microbiome as part of a system of nested holobionts. However, there are still relatively few studies focusing on the microbiome of parasitic helminths in general and almost none on cestodes in particular, despite the significant burden of disease caused by these parasites globally. Our study provides insights into a system of significance to the aquaculture industry, cestode infections of Atlantic salmon and, more broadly, expands our general understanding of parasite-microbiome-host interactions and introduces a new element, the microbiome of the parasite itself, which may play a critical role in modulating the host microbiome, and, therefore, the host response, to parasite infection.

Host specificity and seasonality of helminth component communities in central European grebes (Podicipediformes) and loons (Gaviiformes)

Structure and pattern of helminth component communities parasitizing grebes and loons are poorly understood. Here we analyze the prevalence, intensity and diversity of helminths in 505 Czech grebes (Podiceps cristatus, Podiceps nigricollis, Tachybaptus ruficollis) and loons (Gavia arctica, Gavia stellata) collected between 1962 and 2014. The species richness of helminth component communities ranged from 31±8 (P. cristatus) to 50±4 (G. stellata) species, with helminth load similar in all five host species, but with strong differences in prevalence and intensity of infection at a helminth species-specific level. The dominance was low, ranging from 0.11 (P. cristatus and G. stellata) to 0.21 (P. nigricollis). Dominant species (>25% prevalence) in P. cristatus were Confluaria sp., Tylodelphys clavata, Echinochasmus coaxatus, Petasiger neocomense and Ligula colymbi; in P. nigricollis and T. ruficollis: Confluaria sp. and Tatria sp.; in G. arctica and G. stellata: Tetrabothrius microcephalus, Stephanoprora denticulata, Cryptocotyle concava, Diplostomum gavium and Ichthyocotylurus erraticus; in G. stellata only: Echinochasmus (Monilifer) spinulosus. Four (12%) of the grebe digenean species were not locally acquired (with non-sympatric intermediate hosts) despite the fact that they represented 25% of digenean individuals found. In loons, five (28%) of digenean species and striking 38% of individuals found used the non-sympatric intermediate host species. Component communities of grebes were similar to each other (Sørensen similarity index 0.47-0.65) but differed strongly from those hosted by loons (0.00-0.20). We present the first systematically collected evidence of intra-annual changes of helminth component communities in grebes, and provide 20 new host records.

Investigations on the occurrence of tapeworm infections in German horse populations with comparison of different antibody detection methods based on saliva and serum samples

Background

Effective and sustainable worm control in horses would benefit from detailed information about the current regional occurrence of tapeworms. Different diagnostic methods are currently available to detect Anoplocephala spp. infections in horses. However, the format as well as the sensitivity and specificity of the methods vary considerably.

Methods

A coprological, serological and questionnaire study was conducted to investigate the prevalence and risk factors of tapeworm infections on 48 horse farms in the region of Berlin and Brandenburg, Germany. In total, faecal samples of 484 horses were analysed using the double centrifugation/combined sedimentation-flotation and mini-FLOTAC. Serum (n = 481) and saliva (n = 365) samples were analysed by ELISAs to determine antibody levels against Anoplocephala spp. 12/13 kDa excretory/secretory (E/S) antigens.

Results

Cestode eggs were detected in 0.6% of faecal samples (farm prevalence 6.3%) without differences between the two methods. In contrast, antibodies against Anoplocephala spp. were detected in 16.2% (farm prevalence 52.1%) and in 29.5% (farm prevalence 75.7%) of the serum and saliva samples, respectively. Both ELISA based methods for detection of tapeworms reported a greater number of infected animals requiring treatment than were positively identified by coproscopy. Logistic regression analysis identified permanent pasture access, large pastures and regular pasture changes and high strongyle egg counts as risk factors for positive serum antibody responses to Anoplocephala spp. while last treatment with praziquantel was protective. Other protective factors were the presence of foals and high numbers of horses on the farm. Daily removal of faeces from the pasture and horse age did not have a significant effect.

Conclusions

The findings of the present serological investigation indicate that tapeworm prevalence in Berlin/Brandenburg horse farms is much higher than would be anticipated by using conventional/coproscopic analyses. Moreover, the majority of tapeworm-positive horses had not received a cestocidal drug at their last treatment. Considering the already known low sensitivity of the coproscopic detection, the equine veterinary diagnostics can be enhanced by the use of antibody detection methods such as the saliva-based ELISA.

Electronic supplementary material

The online version of this article (doi:10.1186/s13071-020-04318-5) contains supplementary material, which is available to authorized users.

Characterisation of gastrointestinal helminths and their impact in commercial small-scale chicken flocks in the Mekong Delta of Vietnam

Commercial small-scale chicken farms managed as all-in-all-out but operating with low standards of hygiene/biosecurity are increasingly common in Vietnam. These conditions facilitate the transmission of gastrointestinal helminths. However, there are no published data on helminths in these systems. We aimed (1) to determine the prevalence/burden of gastrointestinal helminths in small-scale commercial flocks in the Mekong Delta region and (2) to investigate the association between worm burdens and birds' weight and disease status. Randomly selected chickens (n = 120) from 'normal' flocks were investigated at the end of their production cycle (~ 18 weeks), as well as 90 chickens from 'diseased' flocks with signs of respiratory and/or severe disease. The gastrointestinal tract of chickens was dissected and all visible helminths were identified and counted. A total of 54.2% and 54.4% normal and diseased chickens contained helminths. Among colonised birds, the diseased ones harboured a higher mass of helminth worms than normal (healthy) birds (3.8 ± SD 8.6 g vs. 1.9 ± SD 6.3 g, respectively). Eight species were identified, including nematodes (Ascaridia galli, Cheilospirura hamulosa and Heterakis gallinarum), cestodes (Hymenolepis, Raillietina cesticillus, Raillietina echinobothrida, Raillietina tetragona,) and one trematode (Echinostomatidae). Heterakis gallinarum was the most prevalent helminth (43.3% and 42.2% in normal and sick chickens, respectively), followed by A. galli (26.7% and 41.1%). Colonised chickens weighed 101.5 g less than non-colonised birds. Colonisation was higher during the rainy months (May-November) for both H. gallinarum and A. galli. Anthelminthic usage was not associated with reduced helminth burdens. We recommend upgrading cleaning and disinfection and limiting access to ranging areas to control helminths in small-scale chicken flocks.

Helminth infections in the US military: from strongyloidiasis to schistosomiasis

BACKGROUND

Helminth infections caused by parasitic worms, including nematodes (roundworms), cestodes (tapeworms) and trematodes (flukes), can cause chronic symptoms and serious clinical outcomes if left untreated. The US military frequently conducts activities in helminth-endemic regions, particularly Africa, the Middle East and Southeast Asia. However, the military does not currently screen for these infections, and to date, no comprehensive surveillance studies have been completed to assess the frequency of helminth diagnoses in the military personnel and their families.

METHODS

To determine the burden of helminth infections in the US Military Health System (MHS), we conducted a retrospective analysis of International Classification of Diseases (ICD)-9/10 diagnosis codes from all medical encounters in the MHS Data Repository (MDR) from fiscal years (FY) 2012 to 2018. Chart reviews were conducted to assign ICD diagnoses as incorrect, suspected, probable or confirmed based on the laboratory results and symptoms.

RESULTS

Abstraction of MHS data revealed over 50 000 helminth diagnoses between FY 2012 and FY 2018. Of these, 38 445 of diagnoses were amongst unique subjects. After chart review, we found there were 34 425 validated helminth infections diagnosed amongst the unique subjects of US military personnel, retirees and dependents. Nearly 4000 of these cases represented infections other than enterobiasis. There were 351 validated strongyloidiasis diagnoses, 317 schistosomiasis diagnoses and 191 diagnoses of cysticercosis during the study period. Incidence of intestinal nematode infection diagnoses showed an upward trend, whilst the incidence of cestode infection diagnoses decreased.

CONCLUSIONS

The results of this study demonstrate that helminth infections capable of causing severe morbidity are often diagnosed in the US military. As helminth infections are often asymptomatic or go undiagnosed, the true burden of helminth infections in US military personnel and dependents may be higher than observed here. Prospective studies of US military personnel deployed to helminth-endemic areas may be indicated to determine if post-deployment screening and/or empirical treatment are warranted.

Gastrointestinal helminth parasites of local chickens from selected communities in Nsukka region of south eastern Nigeria

The prevalence of gastrointestinal helminths of local chickens in Nsukka region of Southeastern Nigeria was studied using 125 free range local birds purchased from four communities in Nsukka zone namely, Obollo-afor, Orba, Nsukka urban and Owerre Eze-orba. The birds were sacrificed humanely and their oesophagus, crop, proventriculus, gizzard, small intestine and caecum examined for the presence of gastrointestinal helminths. Worms when present were isolated and identified using standard parasitological procedures. The study identified four species of cestodes namely Raillietina echinobothridia, R. tetragona, R. cesticillus and Choanotaenia infundibulum and two species of nematodes namely, Ascaridia galli and Heterakis gallinarum. Results obtained showed 96.8 % prevalence of gastrointestinal helminth parasites in the birds with cestodes being the more prevalent class (70.4 %). Raillietina spp was the most prevalent cestode encountered and A. galli the most prevalent nematode. Prevalence rates of infections recorded 14.4 % for nematode species, 26.4 % for cestodes and 56 % for mixed infections of nematodes and cestodes. It was concluded that local chickens are common in the area and could serve as a potential source of helminth infections to intensively managed birds in the study area.

Composition, structure and pattern of helminth assemblages associated with central European storks (Ciconiidae)

The composition, structure and pattern of helminth assemblages associated with the storks (Ciconiidae), ibises and spoonbills (Threskiornithidae) are poorly understood. Here we analyze the prevalence, intensity and diversity of the helminth component communities associated with the white stork Ciconia ciconia and black stork Ciconia nigra, and notice the findings of helminths on Eurasian spoonbill Platalea leucorodia and glossy ibis Plegadis falcinellus obtained in the Czech Republic in years 1962-2013. Comparison with datasets from multiple European countries supports the existence of well-defined local helminth component communities, which are subject to strong geographic variation. The estimated diversity of the helminth component communities reached 11.0±1.6 (C. ciconia) and 12.5±5.4 (C. nigra) species, with the Berger-Parker dominance index reaching only 0.24 and 0.21, respectively. Typically, the dominant species (Chaunocephalus ferox, Tylodelphys excavata and Dictymetra discoidea in C. ciconia, and Cathaemasia hians and Dicheilonema ciconiae in C. nigra) were considered as local, with intermediate host species available onsite. Altogether 10 of the 11 species with known life cycle were capable to complete their life cycle locally, which is in strong contrast with the situation in Czech egrets and herons. In C. ciconia and C. nigra, the highest helminth load was in juveniles, whereas Echinostoma sudanense, absent in the juveniles, was associated with intermediate hosts absent in the study area. Relative prevalence and frequency of helminths associated with male and female C. ciconia was similar to each other. The first systematically collected evidence of the intra-annual changes of the helminth assemblages in storks is provided.

Predator-prey interactions between native brine shrimp Artemia parthenogenetica and the alien boatman Trichocorixa verticalis: influence of salinity, predator sex, and size, abundance and parasitic status of prey

Trichocorixa verticalis (T. verticalis), native to North America and the Caribbean islands, is an invasive waterboatman species (Corixidae) in the southwest of the Iberian Peninsula. Previous studies in the native range have suggested that predation by T. verticalis can regulate the abundance of Anostracan and Cladoceran zooplankton in saline ecosystems, causing increases in phytoplankton through a trophic cascade. In this experimental study, we tested the predator–prey relationship between the native brine shrimp Artemia parthenogenetica, and T. verticalis from the Odiel salt ponds in SW Spain. In three experiments, we investigated (1) the effects of Artemia life stage (metanauplii, juveniles, and adults), (2) abundance (three, six, and 12 adult Artemia) and (3) parasitic status (Artemia infected with avian cestodes or uninfected) on predation rates by T. verticalis. We also considered how predation rates in all three experiments were influenced by the sex of T. verticalis and by different salinities (25 and 55 g l⁻¹). Experiment 1 showed that predation rates were highest for metanauplii, possibly because their photophilic behavior makes them more prone to predation. In Experiment 2, we found that predation rate was higher for female T. verticalis and the higher salinity, although the strength of the sex effect varied between treatments. Experiment 3 showed that T. verticalis selectively predated adult Artemia infected with cestodes (red in color), as previously reported for predation by avian final hosts. Collectively, these results indicate that T. verticalis are important predators in their introduced range, and are likely to reduce the abundance of Artemia in more salt ponds as they expand their range, thus increasing phytoplankton abundance through trophic cascades.

Seasonal patterns in risk factors for Taenia solium transmission: a GPS tracking study of pigs and open human defecation in northern Peru

BACKGROUND

Taenia solium (cysticercosis) is a parasitic cestode that is endemic in rural populations where open defecation is common and free-roaming pigs have access to human feces. The purpose of this study was to examine the roaming patterns of free-range pigs, and identify areas where T. solium transmission could occur via contact with human feces. We did this by using GPS trackers to log the movement of 108 pigs in three villages of northern Peru. Pigs were tracked for approximately six days each and tracking was repeated in the rainy and dry seasons. Maps of pig ranges were analyzed for size, distance from home, land type and contact with human defecation sites, which were assessed in a community-wide defecation survey.

RESULTS

Consistent with prior GPS studies and spatial analyses, we found that the majority of pigs remained close to home during the tracking period and had contact with human feces in their home areas: pigs spent a median of 79% (IQR: 61-90%) of their active roaming time within 50 m of their homes and a median of 60% of their contact with open defecation within 100 m of home. Extended away-from-home roaming was predominately observed during the rainy season; overall, home range areas were 61% larger during the rainy season compared to the dry season (95% CI: 41-73%). Both home range size and contact with open defecation sites showed substantial variation between villages, and contact with open defecation sites was more frequent among pigs with larger home ranges and pigs living in higher density areas of their village.

CONCLUSIONS

Our study builds upon prior work showing that pigs predominately roam and have contact with human feces within 50-100 m of the home, and that T. solium transmission is most likely to occur in these concentrated areas of contact. This finding, therefore, supports control strategies that target treatment resources to these areas of increased transmission. Our finding of a seasonal trend in roaming ranges may be useful for control programs relying on pig interventions, and in the field of transmission modeling, which require precise estimates of pig behavior and risk.

Prevalence and burden of gastrointestinal helminthes among grey-breasted helmet guinea fowls (Numida meleagris galeata) encountered in Gombe state, Nigeria

This cross sectional survey was conducted from July to December 2015 in order to investigate the burden of gastrointestinal helminthes among guinea fowls in Gombe, Northeastern Nigeria. A total of six hundred fowls (viscera) were purchased from six randomly selected slaughter slabs. Out of the 600 birds examined, 479 (79.83%; 95% CI: 76.4, 82.9) were found harbouring one or more gastrointestinal helminthes. Of this, 238 birds (39.7%; 35.8, 43.6) were infected by nematode species and 392 birds (65.3%; 61.4, 69.0) by cestode species. A total of nine nematodes and seven cestodes species were recovered from these birds. There was no any trematode observed among the studied birds. The prevalences of the nematodes identified in descending order were: Ascaridia galli 56.7% (52.7, 60.6); Ascaridia numidae 38.0% (34.2, 42.0); Heterakis gallinarum 17.2% (14.4, 20.4); Heterakis meleagridis 8.3% (6.4, 10.8); Strongyloides avium 3.5% (2.3, 5.3); Subulura brumpti 3.2% (2.0, 5.0); Gongylonema ingluvicola 2.2% (1.3, 3.7) and both Dispharynx spiralis and Tetrameres numidae had 0.7% (0.3, 1.7). While for cestodes: Raillietina tetragona 72.8% (69.1, 76.2); Raillietina echinobothrida 67.3% (63.5, 71.0); Raillietina cesticillus 50% (46.0, 54.0); Raillietina magninumida 25.7% (22.3, 29.3); Hymenolopsis cantaniana 17.3% (14.5, 20.6); Davainea nana 4.2% (2.8, 6.1) and the lowest was observed in Choanotaenia infundibulum with 2% (1.2, 3.5). Infection rates did not differ significantly based on sex (P > 0.05). However, the occurrence of mixed infection as compared with single infection was statistically significant in both cestodes and nematodes (P < 0.001). The results obtained indicated high prevalence of gastrointestinal helminthes among guinea fowls. These birds may serve as important source of helminthes to other commercial birds in the study area.

New arrangement of three genera of fish tapeworms (Cestoda: Proteocephalidae) in catfishes (Siluriformes) from the Neotropical Region: taxonomic implications of molecular phylogenetic analyses

Tapeworms (Cestoda: Proteocephalidae) are the dominant component of communities of intestinal parasites in pimelodid and other catfishes (Siluriformes) from South America. Even though these parasites have been studied intensively over more than one century, molecular taxonomy and phylogenetics have questioned their morphology-based classification, thus raising doubts about the systematic value of traits commonly used to circumscribe individual taxa. In the present study, members of three morphologically well-characterized genera of proteocephalids from pimelodid (Hemisorubim platyrhynchos and Sorubim lima) and auchenipterid (Ageneiosus inermis) catfishes from the Paraná or Amazon River basins were subjected to DNA sequencing of the large subunit nuclear ribosomal RNA (lsrDNA) and complete mitochondrial cytochrome c oxidase subunit I (COI). Phylogenetic analyses revealed the sister relationship between Manaosia bracodemoca and Mariauxiella piscatorum, and among Mariauxiella pimelodi and Ageneiella brevifilis. As a result, Mar. piscatorum and A. brevifilis are transferred to Manaosia and Mariauxiella, respectively, as Manaosia piscatorum n. comb. and Mariauxiella brevifilis n. comb., and the genus Ageneiella is suppressed. Diagnoses of Manaosia and Mariauxiella are amended. In addition, the present study revealed misidentification of tapeworms whose sequences are deposited in the GenBank database.