Burden Of Helminth Infections Research Articles

Impact of Anthelmintic Treatment on the Burden of Helminth Infections in Primary Schoolchildren in Biyela Health Zone in Kinshasa, Democratic Republic of the Congo

Background: The study evaluated the impact of anthilminthic treatment, given as non-investigational drugs, on helminth infections, anaemia, and hemoglobin (Hb) level in the context of a malaria clinical trial in which Sulfadoxine Pyrimethamine (SP) and SP+Piperaquine (PQ) were also evaluated as an intermittent preventive treatment strategy in schoolchildren in the Democratic Republic of Congo (DRC). Methods: In a nested cohort study, 616 malaria asymptomatic children attending primary schools of Biyela health area were enrolled and follow-up from November 2012 to November 2013. The control group for the nested study was the negative on helminth infections. They received one dose of PZQ and ALB at baseline and then 2 doses of ALB at 4 months intervals. During the 12-months of follow-up, stool and urine samples were collected for helminth infections and finger prick blood for Hb level. Paired test analyses were used to compare the status before and after treatment, and confounding variables for Hb level were tested by multiple linear regression analysis. Results: At baseline, the prevalence of helminth infections and anaemia were 39.2% (95% CI: 34.7-43.7), and 41.8% (95% CI: 37.3-46.3), respectively. Mean Hb level was 11.6g/dl (SD±1.3). After 12-months post-anthelminthic treatment, the prevalence of helminth infections reduced to 7.2% (p<0.001). There was no change in Hb level and anaemia in the control which received only the anthelminthic drug (p=1.00 and p=0.26, respectively) at 12-months postintervention, compared to those who received active antimalarial SP (p=0.02 and p=0.09, respectively) and PQ (p=0.01 and p<0.001, respectively). Similarly, no difference in Hb level was observed among the infected and uninfected schoolchildren with helminths at 12-months after anthelminthic treatment. Conclusion: These findings suggest that anthelminthic treatment reduces significantly the prevalence of helminth infections. There was no impact on anaemia and Hb level due to the use of anthelmintic drugs.

Low incidence of helminth infections (schistosomiasis, strongyloidiasis, filariasis, toxocariasis) among Dutch long-term travelers: A prospective study, 2008-2011.

BackgroundDespite the considerable burden of helminth infections in developing countries and increasing international travel, little is known about the risks of infection for travelers.ObjectiveWe studied the attack and incidence rate of serology confirmed strongyloidiasis, filariasis, and toxocariasis among long-term travelers and associated factors. A second objective was to evaluate eosinophilia as a positive/negative predictive value (PPV/NPV) for a recent helminth infection.MethodsFrom 2008 to 2011, clients of the Public Health Service travel clinic planning travel to (sub)tropical countries for 12–52 weeks were invited to participate in a prospective study. Participants kept a weekly diary, recording itinerary, symptoms, and physician visits during travel and completed a post-travel questionnaire. Pre- and post-travel blood samples were serologically tested for the presence of IgG antibodies against Schistosoma species, Strongyloides stercoralis, filarial species, and Toxacara species and were used for a blood cell count. Factors associated with recent infection were analyzed using Poisson regression. Differences among groups of travelers were studied using chi square tests.ResultsFor the 604 participants, median age was 25 years (interquartile range [IQR]: 23–29), 36% were male, median travel duration was 20 weeks (IQR: 15–25), and travel purpose was predominantly tourism (62%). Destinations were Asia (45%), Africa (18%), and the Americas (37%).Evidence of previous infection was found in 13/604 participants: antibodies against Schistosoma spp. in 5 (0.8%), against S.stercoralis in 3 (0.5%), against filarial species in 4 (0.7%), and against Toxocara spp. in 1 (0.2%). Ten recent infections were found in 9 participants (3, 1, 6, 0 cases, in the above order), making the attack rates 0.61, 0.17, 1.1 and 0, and the incidence rates per 1000 person-months 1.5, 0.34, 2.6 and 0. The overall PPV and NPV of eosinophila for recent infection were 0 and 98%, respectively.ConclusionsThe risk of the helminth infections under study in this cohort of long-term travelers was low. Routine screening for eosinophilia appeared not to be of diagnostic value.