Prevalence and clinical aspects of human Trichostrongylus colubriformis infection in Lao PDR

Abstract

There have been few studies on human trichostrongyliasis in Southeast Asia, information on its clinical manifestations is also sparse. Trichostrongyliasis occurs predominantly in areas where poor hygiene is common especially where human/animal feces are used as a fertilizer, thereby contaminating vegetables and stream water. The intimate coexistence of domestic animals and humans explains the prevalence of Trichostrongylus infection in such areas. The goal of the current study was to determine the prevalence of trichostrongyliasis among villagers in Thakamrien village, Sonkon district, Savannakhet province, Laos, and to investigate potential relationships between clinical features, laboratory data, and severity of infection. Of 272 villagers examined, 160 (58.8%) were determined positive for helminthic infections by fecal examination, and 59 (36.9%) of these were infected with Trichostrongylus. Only 58 cases were in the inclusion criteria of the study and then underwent further assessment, including a questionnaire on personal behaviors, physical examination, and laboratory tests. Villagers in the trichostrongyliasis group were more likely than the control group to have consumed fresh vegetables, not washed their hands before meals or after using the toilet, and to have had close contact with herbivorous animals (goats and cows). Similarly, villagers in the trichostrongyliasis group were more likely than the control group to have a history of loose feces, rash, or abdominal pain; however, no obvious clinical symptoms were observed during physical examination of the trichostrongyliasis patients. The degree of infection was determined by both fecal egg counts and quantification of adult worms after deworming. Laboratory data were evaluated for any relationship with severity of infection. No significant differences were found in laboratory values between the trichostrongyliasis and control groups, with most values being within normal limits; however, both groups had high eosinophil counts. This study demonstrated that the useful clinical characteristics of trichostrongyliasis patients include history of loose feces, rashes, and abdominal pain, as well as in personal behaviors, such as the regular consumption of fresh vegetables, lack of hand washing, and close contact with cattle.