Epithelial cytokines in soil-transmitted helminth infections.

Diagnosis, epidemiology and control of soil-transmitted helminth infection in Zanzibar, Tanzania

Spatiotemporal impact of an eight-year mass drug administration programme on soil transmitted helminth infections and anaemia in Burundi.

Researchers have raised the possibility that soil-transmitted helminth (STH) infections might modify the host's immune response against other systemic infections. STH infections can alter the immune response towards type 2 immunity that could then affect the likelihood and severity of other illnesses. However, the importance of co-infections is not completely understood, and the impact and direction of their effects vary considerably by infection. This review synthesizes evidence regarding the relevance of STH co-infections, the potential mechanisms that explain their effects, and how they might affect control and elimination efforts. According to the literature reviewed, there are both positive and negative effects associated with STH infections on other diseases such as malaria, human immunodeficiency virus (HIV), tuberculosis, gestational anemia, pediatric anemia, neglected tropical diseases (NTDs) like lymphatic filariasis, onchocerciasis, schistosomiasis, and trachoma, as well as Coronavirus Disease 2019 (COVID-19) and human papillomavirus (HPV). Studies typically describe how STHs can affect the immune system and promote increased susceptibility, survival, and persistence of the infection in the host by causing a TH2-dominated immune response. The co-infection of STH with other diseases has important implications for the development of treatment and control strategies. Eliminating parasites from a human host can be more challenging because the TH2-dominated immune response induced by STH infection can suppress the TH1 immune response required to control other infections, resulting in an increased pathogen load and more severe disease. Preventive chemotherapy and treatment are currently the most common approaches used for the control of STH infections, but these approaches alone may not be adequate to achieve elimination goals. Based on the conclusions drawn from this review, integrated approaches that combine drug administration with water, sanitation and hygiene (WASH) interventions, hygiene education, community engagement, and vaccines are most likely to succeed in interrupting the transmission of STH co-infections. Gaining a better understanding of the behavior and relevance of STH co-infections in the context of elimination efforts is an important intermediate step toward reducing the associated burden of disease.

BackgroundDespite efforts to control neglected tropical diseases (NTDs), schistosomiasis and soil-transmitted helminthiases remain widely prevalent in sub-Saharan Africa. Recent data suggest that these infections are prevalent among preschool aged children (PSAC) in poor communities. Evidence of schistosomiasis and soil-transmitted helminths (STH) infection patterns and prevalence among PSAC is essential for effective treatment and control programmes. The aim of the study was to determine the prevalence, intensity and risk factors of schistosomiasis and STH infection among PSAC in the Ingwavuma area of uMkhanyakude District, South Africa.MethodsA cross-sectional study was conducted among 1143 PSAC aged 1–5 years in 34 preschools and early childhood development (ECD) centres. Data on risk factors was collected using a semi-structured questionnaire. A Kruskal–Wallis test was used to compare the differences in infection intensity with age. Pearson Chi-square test and multivariate logistic regression were performed to assess the association between PSAC infection status, sociodemographic, household, water and sanitation variables and hygiene practices of PSAC and their caregivers.ResultsWe observed a low prevalence of Schistosoma haematobium (1.0%) and S. mansoni (0.9%). The prevalence of Ascaris lumbricoides (18.3%) was high compared to Trichuris trichiura (1.2%), hookworms (1.6%) and Taenia (6.4%). The odds of schistosome infection were lowest among PSAC under younger (15–24 years) caregivers (0.1, 95% CI: 0.02–0.54) and those who used tap water (0.3, 95% CI: 0.09–0.78) for domestic purposes. Schistosome infection was however higher among PSAC who bathed in river water (17.4, 95% CI: 5.96–51.04). STH infection on the other hand was lowest among PSAC who did not play in soil (0.1, 95% CI: 0.51–0.28), were from households that used tap water for domestic purposes (0.5, 95% CI: 0.27–0.80) and PSAC under the care of younger (25–35 years) caregivers (0.3, 95% CI: 0.10–0.75). The risk of STH infection was highest among PSAC who did not wash their hands with soap (3.5, 95% CI: 1.04–11.67) and PSAC whose nails were not trimmed (3.6, 95% CI: 1.75–7.26).ConclusionsThe findings show low prevalence and infection intensity of schistosomiasis and STH infection except A. lumbricoides among PSAC. Factors predicting schistosomiasis and STH infection among PSAC were related to caregivers’ age, educational status, water and hygiene practices. STH infection was exclusively associated with PSAC playing and handwashing habits. These findings highlight the need to include PSAC caregivers in schistosomiasis and STH prevention and control programmes.

Soil-transmitted helminth (STH) infections, caused by parasitic nematodes, are significant public health concern in many parts of the world, including Nigeria. This review aims to comprehensively analyze the available studies and research trends on STH infections among children aged 0 – 17 years in northern Nigeria. The review focuses studies on the prevalence and risk factors related to STH infections from year 2000 – 2022 in this specific region and emphasizes the urgent need for effective control measure to mitigate the burden of these infections. The population involved 25 studies (92.6%) on School-aged Children (SAC) and 2 studies (7.4%) on Pre-school age Children (PSAC). A total of 8 514 children examined, 4 384 (51.5%) males and 4 130 (48.5%) females. Children from rural areas were 5 165 (60.7%) and 3 349 (39.3%) children from urban areas. Sample size ranges from 100 – 620, 22 (74.1%) studies employed Formol-ether concentration as stool examination technique, 4 (14.8%) and 3 (11.1%) used Kato-Katz and Direct smear methods respectively. The overall pool prevalence estimates (PPE) for STH infections were 3 160 (37.1%, 95% CI: 36.5–37.7). PPE for males 1 880 (59.5%, 95% CI: 58.6–60.1) was higher than for females 1 280 (40.5%, 95% CI: 54.2–55.3). Children from rural areas had the highest PPE 1 955 (37.9%) OR 1.26 (95% CI: 0.32–3.73) p=0.02, while children from urban areas had 3 160 (35.9%) OR 1.15 (95% CI: 0.62–5.02) p=0.01. There was no significant association between STH infections and community settings among SAC and PSAC. The most common PPEs by species identified was Ascaris lumbricoides 1 022 (32.3%, 95% CI: 31.7–32.9), hookworm 931 (29.5%, 95% CI: 28.9 – 30.1) and the least; Trichuris trichjura 356 (11.3%, 95% CI: 10.7 – 11.9). Children between 10 – 15 years had highest prevalence (48.6%), and 0 – 9 years had the least prevalence (23.5%) by age groups. Four common risk factors identified, walking barefooted 6 (22.2%) OR 1.16 (95% CI: 1.53 - 6.42) p-0.44, drinking untreated water 12 (44.4%) OR 1.66 (95% CI: 1.30 - 19.49) p=0.53, open field or bush defecation 8 (29.6) OR 3.41 (95% CI: 1.94 - 9.32) p=0.72 and eating unwashed fruits or vegetable 1 (3.7) OR 2.01 (95% CI: 1.32 - 4.51) p=0.54. The research underscores the need for enhanced surveillance, improved sanitation, and comprehensive sustainable interventions to reduce the prevalence and morbidity associated with STH infections in northern Nigeria.

Background & objectives Soil-transmitted helminth (STH) infections are a significant public health concern, affecting over 1.5 billion people worldwide. STH infection among children leads to stunted growth, impaired cognitive development, and reduced productivity. In India, while multi-prong efforts are being made to control STH infections including mass drug administration (MDA) programme, the problem is still prevalent. This study aimed to investigate the prevalence, type of STH and determinants associated with STH infection among children (1-15 yr) in a tribal dominated district of Odisha, India. Methods A cross-sectional survey was carried out among 2320 children aged 1-15 yr in the Nabarangapur district of Odisha, sampling 30 clusters from five blocks using the Probability Proportional to Size (PPS) method. Participants were randomly selected from each cluster for screening, which included anthropometric measurements to assess nutritional status and cognitive evaluation using the Vineland Maturity Test scale (VSMS). Morning stool samples from 1927 children were collected, processed and examined microscopically to detect STH infections and Kato Katz thick smear technique was used for STH-positive cases to count the eggs. Results Of the 1927 children, 255 (13.2%) were found infected with one or more STH species. Among the STH positives, hook worm was the most common with a prevalence of 71.3 per cent, followed by Ascaris lumbricoides (round worm) at 28.2 per cent. The mean age (±standard deviation) of STH positive children was 6.5 (± 3.29) yr. Practicing open defecation, was significantly associated with higher STH infection rate. Based on the egg count of STH-positive cases, majority (90.5%) had mild infection, 4.7 per cent moderate and 4.3 per cent severe infection. Interpretation & conclusions The present study indicated that school-going children in the study setting, especially from tribal areas, carried considerable risk of STH infection. Identifying the prevalent risk factors, developing multi-prong integrated strategies could be effective in preventing and controlling STH infection in these areas. The interventions need to focus on improving awareness on STH, ensuring hygiene and sanitation practices and compliance to biannual administration of albendazole under health programmes.

Soil-transmitted helminth (STH) infections are a significant public health problem, especially in tropical and subtropical countries with limited sanitation. Transmission occurs through soil contaminated with the feces of infected individuals, which contain helminth eggs such as Ascaris lumbricoides (roundworm) and Trichuris trichiura (whipworm), as well as hookworm larvae. This study aims to analyze the relationship between STH infection and hematological status (reticulocyte count and hemoglobin level) and Clean and Healthy Living Behavior (PHBS) in vulnerable elementary school students. Using a cross-sectional design, the study involved 44 students at SDN Sobontoro 2. The results showed that 23% of students (10 children) tested positive for STH infection. Statistical analysis using the Spearman test found no significant correlation between STH infection and reticulocyte count (p=0.072) or hemoglobin level (p=0.124). However, a very significant relationship was found between STH infection and PHBS (p=0.000). These findings underline that poor PHBS practices are a major risk factor that directly contributes to high rates of STH infections. ABSTRAKInfeksi cacing usus yang ditularkan melalui tanah, atau Soil Transmitted Helminth (STH), merupakan masalah kesehatan masyarakat yang signifikan, terutama di negara-negara tropis dan subtropis dengan sanitasi terbatas. Penularannya terjadi melalui tanah yang terkontaminasi tinja penderita, yang mengandung telur cacing seperti Ascaris lumbricoides (cacing gelang) dan Trichuris trichiura (cacing cambuk), serta larva cacing tambang (hookworm). Penelitian ini bertujuan untuk menganalisis hubungan antara infeksi STH dengan status hematologis (angka retikulosit dan kadar hemoglobin) serta Perilaku Hidup Bersih dan Sehat (PHBS) pada siswa sekolah dasar yang rentan. Menggunakan desain cross-sectional, penelitian melibatkan 44 siswa di SDN Sobontoro 2. Hasil menunjukkan 23% siswa (10 anak) positif terinfeksi STH. Analisis statistik menggunakan uji Spearman tidak menemukan korelasi signifikan antara infeksi STH dengan angka retikulosit (p=0,072) maupun kadar hemoglobin (p=0,124). Namun, ditemukan hubungan yang sangat signifikan antara infeksi STH dan PHBS (p=0,000). Temuan ini menggarisbawahi bahwa praktik PHBS yang buruk adalah faktor risiko utama yang berkontribusi langsung terhadap tingginya angka infeksi STH.

Soil-transmitted helminth (STH) infections are common in regions with high rates of anemia, particularly in low-income countries where poor nutrition is prevalent. Children attending school in these areas are most vulnerable to anemia. Both anemia and STH infections can negatively affect children's physical development, school attendance, and learning abilities. This study aims to examine the relationship between STH infections and anemia in children. A systematic review and meta-analysis following PRISMA guidelines were conducted. Articles were selected based on eligibility criteria defined using the PICO model: Population = Primary School Children, Intervention = STH infections, Comparison = No STH infections, Outcome = Anemia. The article search covered publications from 2002 to 2024 across databases such as PubMed, Science Direct, Google Scholar, Springer Link, Hindawi, and PLOS One. Keywords used included "STH," "Anaemia," "STH AND Children," and "STH AND Anaemia." Inclusion criteria consisted of full-text, cross-sectional studies published in English that discussed the impact of STH on anemia in school-aged children. The final results were expressed as adjusted odds ratios (aOR) from multivariate analysis. Data were analyzed using RevMan 5.4, and meta-analysis was performed on 12 articles from Africa and Asia. The results indicated that children infected with STH had significantly lower hemoglobin levels, leading to anemia (aOR = 2.23, 95% CI = 1.07 to 4.65, p = 0.03). This study demonstrates that STH infections contribute to anemia in school-aged children.

Soil-transmitted helminth (STH) infections are one of the most common infectious diseases in the developing world, with prevalence rates as high as 65%. STH infections generally affect the digestive system, which can reduce appetite and nutrient absorption. This study aimed to determine the association between STH infection and macronutrient intake in stunted toddlers aged 12-36 months in Panti Sub-district, Jember Regency. This study used observational analysis method with cross-sectional approach. The total number of subjects was 83 stunted toddlers. Data on STH infection were collected through fecal examination and 2x24 hour food recall questionnaire to assess their macronutrient intake. The results of the study showed that the prevalence of STH was 4.8% with species identified in the examinations such as Ascaris lumbricoides (2.4%) and hookworm (2.4%). The majority of macronutrient intake was considered sufficient for protein (77.1%), deficit for carbohydrate (94%) and fat (77.1%). Bivariate analysis using the contingency coefficient correlation test showed that there was no significant correlation between STH infection and macronutrient intake. Based on the results of this study, macronutrient intake may be influenced by other factors such as the role of parents in preparing nutritious food, economic status, and mild degree of infection. However, the underlying mechanism remains unclear and should be further investigated.

Limited research has documented an association between soil-transmitted helminth (STH) infections and child development. This has recently been identified as an important knowledge gap. A longitudinal cohort study was conducted in Iquitos, Peru, between September 2011 and July 2016. A cohort of 880 children, recruited at 1 year of age, was followed up to 5 years. STH infection was measured annually and child development was measured with the Wechsler Preschool and Primary Scale of Intelligence III (WPPSI-III) at 5 years. Linear-regression models were used to investigate the effect of the number of detected STH infections between 1 and 5 years of age on WPPSI-III scores at 5 years of age. Bayesian latent class analysis was used to adjust for exposure misclassification. A total of 781 (88.8%) children were included in the analysis. In multivariable analysis, adjusted for STH misclassification, increasing numbers of Ascaris, Trichuris, hookworm and any STH infections were associated with lower WPPSI-III scores. Among the largest observed effects were those for the effect of Ascaris infection on verbal IQ scores [difference in IQ (95% CrI) for two, three, and four or five detected infections compared with zero or one infection: -8.27 (-13.85, -3.10), -6.69 (-12.05, -2.05) and -5.06 (-10.75, 0.05), respectively]. Misclassification of STH infection generally led to a bias towards the null. These results document an association between STH infection and child development. The results highlight the importance of adjusting for STH misclassification; however, future research is needed to accurately determine the sensitivity of STH diagnostic techniques. STH control in preschool children may contribute to lowering the disease burden associated with poor child development.

Soil-transmitted helminth (STH) infections affect persons living in areas with poor water, sanitation, and hygiene (WASH). Preschool-aged children (PSAC) and school-aged children (SAC) are disproportionately affected by STH infections. We aimed to identify WASH factors associated with STH infection among PSAC and SAC in Kibera, Kenya. In 2012, households containing a PSAC or SAC were randomly selected from those enrolled in the International Emerging Infections Program, a population-based surveillance system. We administered a household questionnaire, conducted environmental assessments for WASH, and tested three stools from each child for STH eggs using the Kato-Katz method. WASH factors were evaluated for associations with STH infection using univariable and multivariable Poisson regression. Any-STH prevalence was 40.8% among 201 PSAC and 40.0% among 475 SAC enrolled. Using the Joint Monitoring Programme water and sanitation classifications, 1.5% of households reported piped water on premises versus 98.5% another improved water source; 1.3% reported improved sanitation facilities, while 81.7% used shared sanitation facilities, 13.9% had unimproved facilities, and 3.1% reported no facilities (open defecation). On univariable analysis, STH infection was significantly associated with a household toilet located off-premises (prevalence ratio (PR) = 1.33; p = 0.047), while always treating water (PR = 0.81; p = 0.04), covering drinking water containers (PR = 0.75; p = 0.02), using clean towels during hand drying (PR = 0.58; p<0.01), having finished household floor material (PR = 0.76; p<0.01), having electricity (PR = 0.70; p<0.01), and increasing household elevation in 10-meter increments (PR = 0.89; p<0.01) were protective against STH infection. On multivariable analysis, usually versus always treating water was associated with increased STH prevalence (adjusted prevalence ratio (aPR) = 1.52; p<0.01), while having finished household floor material (aPR = 0.76; p = 0.03), reported child deworming in the last year (aPR = 0.76; p<0.01), and 10-meter household elevation increases (aPR = 0.89; p<0.01) were protective against infection. The intersection between WASH and STH infection is complex; site-specific WASH interventions should be considered to sustain the gains made by deworming activities.

Infection by soil transmitted helminthes has been increasingly recognized as an important public health problem in poor and developing countries. To initiate prevention and control measures for these neglected diseases, adequate information is required among high risk group. The objective of this study was to determine the prevalence and associated risk factors for soil transmitted helminth infections among urban dwellers in Amanuel, east Gojjam, Ethiopia. A cross-sectional study, involving 403 individuals, was carried out in Amanuel between November 2010 and January 2011. A structured questionnaire and observation for demographic and associated risk factors for soil transmitted helminthes (STHs) infections were used for data collection. Stool samples were collected in plastic containers from each participant and transported to Amanuel Health center for parasitological examination. Both direct wet smear and former-ether sedimentation concentration techniques were used to determine the presence of helminthes eggs. The overall prevalence of STH infections was 46.2% (186/403). Hookworm infection was the predominant soil transmitted helminth infections, which was detected in 77(19.1%) followed by A. lumbricoides which was infected 52(13%) of the study subjects. T. trichuria was the least prevalent geo-helminth infection, detected in only 23 (5.7%) of the study subjects. Majorities, 152(37.7%), had single infection. Double infection occurred in 25(6.2%) of the study subjects and only 9(2.2%) had multiple infection. The prevalence of soil transmitted helminthes was generally high in school age children and low in infants. The common predictors of STH infections in the study, among others, were poor personal hygienic conditions, less frequent wearing shoes habit, soil contacting occupation risk, and lack of hand washing habit after using toilet. On the basis of this result, it can be concluded that STH infection is an important problem among the community of Amanuel town. Therefore, it is recommended that education on personal and environmental hygiene should be taken into account to reduce the prevalence of STH infections. Moreover, school age children and other risk groups should receive regular treatment to control the transmissions of STH infections.

Risk mapping and socio-ecological drivers of soil-transmitted helminth infections in the Philippines: a spatial modelling study

Water, sanitation and hygiene related risk factors for soil-transmitted helminth and Giardia duodenalis infections in rural communities in Timor-Leste

Malnutrition and soil-transmitted helminthic (STH) infection is still a major concern among Orang Asli pre-school children in Malaysia. The objective of this study was to determine the prevalence of malnutrition and STH infection. Besides, this study was also to identify the association between malnutrition and STH. A total of 256 Orang Asli (131 males and 125 females) from Temiar sub-tribes pre-school children aged one to six years from 19 villages in three Orang Asli settlements of Pos Hendrop, Pos Balar and Pos Tohoi located in Gua Musang, Kelantan had participated in this cross-sectional study between September to December 2014. A face-to-face interview was carried out using pre-tested questionnaires on socio-demographic. Children were measured on their body weight and height. The collected stool samples were examined using direct wet smear method for the presence of STH parasite. The results showed the prevalence of underweight and stunting among the children were 45.3% and 76.2% respectively. A total of 161 (62.9%) subjects were positively infected by at least one species of STH. The overall parasite infections were Ascaris lumbricoides (41.0%), Trichuris trichiura (28.5%) and hookworm (2.0%). From the total infected children, 8.6% of them were infected by two species of STH. This research revealed that gender and age group showed statistically significance with stunted with (p=0.003, p=0.049) respectively. Gender and age groups also reported significant association to STH infection among the subjects with (p=0.013, p=0.001) respectively. However, our results indicated that there was no significant association between STH infection with underweight and stunted. Our study reported that the prevalence of malnutrition and STH are still a major concern for the public health and a threat among Orang Asli pre-school children in Kelantan. Immediate action and innovative intervention should be taken by the Government to overcome the problems as these children are the future generations of the country.