Hookworm Larvae Research Articles

Controlled infection with cryopreserved human hookworm induces CTLA-4 expression on Tregs and upregulates tryptophan metabolism

ABSTRACT Infecting humans with controlled doses of helminths, such as human hookworm (termed hookworm therapy), is proposed to prevent or treat various intestinal and extraintestinal diseases. However, full-scale clinical trials examining hookworm therapy are limited by the inability to scale-up the production of hookworm larvae to infect sufficient numbers of patients. With the aim of overcoming this challenge, this study infected four healthy individuals with hookworm larvae that had been reanimated from cryopreserved eggs to examine their viability and immunogenicity. We demonstrate that reanimated cryopreserved hookworm larvae establish a viable hookworm infection and elicit a similar immune response to larvae cultured from fresh stool. Furthermore, a refined understanding of the therapeutic mechanisms of hookworm is imperative to determine which diseases to target with hookworm therapy. To investigate potential therapeutic mechanisms, this study assessed changes in the immune cells, microbiome, and plasma metabolome in the four healthy individuals infected with cryopreserved hookworm larvae and another nine individuals infected with larvae cultured from freshly obtained stool. We identified potential immunoregulatory mechanisms by which hookworm may provide a beneficial effect on its host, including increased expression of CTLA-4 on regulatory T cells (Tregs) and upregulation of tryptophan metabolism. Furthermore, we found that a participant’s baseline microbiome predicted the severity of symptoms and intestinal inflammation experienced during a controlled hookworm infection. In summary, our findings demonstrate the feasibility of full-scale clinical trials examining hookworm therapy by minimizing the reliance on human donors and optimizing the culturing process, thereby enabling viable hookworm larvae to be mass-produced and enabling on-demand inoculation of patients. Furthermore, this study provides insights into the complex interactions between helminths and their host, which could inform the development of novel therapeutic strategies.

Parasite Contamination of Water Source at Pangkalan Masyhur Sub-district, Medan Johor District

According to World Health Organisation (WHO) estimates, at least 1,8 billion people consume contaminated water worldwide, hence most of the diarrheal disease in the world is attributable to unsafe water, and the lack of sanitation and hygiene. Water utilization by humans and animals can generate biological pollutants which may contaminate the water. These contaminants come from waste products that may contain bacteria, protozoa, and other parasites. This was a descriptive study with cross sectional design and simple random sampling to determine the contamination of water source by pathogens, particularly parasites at Region V Pangkalan Masyhur sub-district, Medan Johor district, Medan, North Sumatera in 2012. Samples were obtained from each house, depending on the main water source used, either from tap water, open wells, or the nearby river streams. Modified Caldwell’s sedimentation technique was applied to examine the samples under light microscope. Out of the 103 water samples collected, most were from tap water (78 samples), followed by open wells (19 samples), and only six were from the nearby river streams. We found Paramecium caudatum from nine samples (8,7%) collected from the open wells and the nearby river streams, followed by hookworm larva in one tap water sample (1%). No protozoa such as Entamoeba spp., Cryptosporidium spp., and Giardia spp. found in any of the samples. Based on this data, the abundant presence of P.caudatum represented the condition of high organic debris in the open wells and the nearby river streams. Additionally, the presence of hookworm larva in the tap water indicated the distribution system was contaminated with the surrounding soil. Hence it is imperative to provide counseling about optimal environmental sanitation and clean water management, including proper maintenance for water source and its distribution system. Tap water distribution, including its network of pipe deliverance system, must be checked and maintained regularly.

Strategic approaches to mitigating Hookworm infection: An optimal control and cost-effectiveness analysis

Human hookworm infection remains a serious threat to public health, particularly in highly endemic regions. The high mortality rate associated with this infection emphasizes the urgent need for effective control measures and intervention strategies to curb its spread. A nonlinear deterministic hookworm model with saturated incidence is investigated in this paper. The model exhibits a unique disease-free and endemic equilibria, and the reproduction number is computed and explained. Sensitivity analysis shows that increasing the transmission rate, β, the hatching rate, α, the number of eggs excreted within the environment, Ne, and the rate of excretion of the eggs, γ, significantly increases the reproduction number. Based on this analysis, we extend the model to consider optimal control in the presence of three time-dependent controls namely: sanitation, preventative chemotherapy, and shoe-wearing. We define an objective function to be minimized and the conditions necessary for the optimal control are established and proved using Pontryagin’s maximum principle. We present a one-way analysis of variance to evaluate the impact of constant implementation of the control measures on the number of infected individuals. Numerical simulations also show that hookworm infection can be contained in the presence of all control measures. However, a cost-effectiveness analysis shows that combining shoe-wearing control with preventative chemotherapy is the most cost-effective measure for controlling hookworm infection. The results presented hold substantial implications for public health policy, especially in low-income regions.

Influence of fecal fermentation on the anthelmintic activity of proanthocyanidins and ellagitannins against human intestinal nematodes and Caenorhabditis elegans.

Some tannin-rich plants such as Combretum mucronatum and Phyllanthus urinaria are widely used in Africa for the control of parasitic nematodes in both humans and livestock. Tannins have been recognized as an alternative source of anthelmintic therapies, and hence, recent studies have focused on both the hydrolyzable and condensed tannins. These groups of compounds, however, have poor oral bioavailability and are metabolized by gut microbiota into lower molecular weight compounds. The role of these metabolites in the anthelmintic activities of tannins has not been explored yet. This study investigated the effects of fecal metabolism on the anthelmintic potential of procyanidin C1 (PC1) and geraniin and the tannin-enriched extracts of C. mucronatum (CML) and P. urinaria (PUH), which contain these compounds, respectively. Metabolites were formed by anaerobic fermentation of the test compounds and extracts in a fresh human fecal suspension for 0 h, 4h, and 24h. Lyophilized samples were tested in vitro against hookworm larvae and whipworm (Trichuris trichiura) larvae obtained from naturally infected human populations in Pru West District, Bono East Region, Ghana, and against the wildtype strain of Caenorhabditis elegans (L4). Both extracts and compounds in the undegraded state exhibited concentration-dependent inhibition of the three nematodes. Their activity, however, significantly decreased upon fecal metabolism. Without fermentation, the proanthocyanidin-rich CML extract was lethal against hookworm L3 (LC50 = 343.5μg/mL, 95% confidence interval (CI) = 267.5-445.4), T. trichiura L1 (LC50 = 230.1μg/mL, CI = 198.9-271.2), and C. elegans (LC50 = 1468.1μg/mL, CI = 990.3-1946.5). PUH, from which the ellagitannin geraniin was isolated, exhibited anthelmintic effects in the unfermented form with LC50 of 300.8μg/mL (CI = 245.1-374.8) against hookworm L3 and LC50 of 331.6μg/mL (CI = 290.3-382.5) against T. trichiura L1, but it showed no significant activity against C. elegans L4 larvae at the tested concentrations. Similarly, both compounds, procyanidin C1 and geraniin, lost their activity when metabolized in fecal matter. The activity of geraniin at a concentration of 170μg/mL against C. elegans significantly declined from 30.4% ± 1.8% to 14.5% ± 1.5% when metabolized for 4h, whereas that of PC1 decreased from 32.4% ± 2.3% to 8.9% ± 0.9% with similar treatment. There was no significant difference between the anthelmintic actions of metabolites from the structurally different tannin groups. The outcome of this study revealed that the intact bulky structure of tannins (hydrolyzable or condensed) may be required for their anthelmintic action. The fermented products from the gut may not directly contribute toward the inhibition of the larvae of soil-transmitted helminths.

Controlled human hookworm infection remodels plasmacytoid dendritic cells and regulatory T cells towards profiles seen in natural infections in endemic areas

Hookworm infection remains a significant public health concern, particularly in low- and middle-income countries, where mass drug administration has not stopped reinfection. Developing a vaccine is crucial to complement current control measures, which necessitates a thorough understanding of host immune responses. By leveraging controlled human infection models and high-dimensional immunophenotyping, here we investigated the immune remodeling following infection with 50 Necator americanus L3 hookworm larvae in four naïve volunteers over two years of follow-up and compared the profiles with naturally infected populations in endemic areas. Increased plasmacytoid dendritic cell frequency and diminished responsiveness to Toll-like receptor 7/8 ligand were observed in both controlled and natural infection settings. Despite the increased CD45RA+ regulatory T cell (Tregs) frequencies in both settings, markers of Tregs function, including inducible T-cell costimulatory (ICOS), tumor necrosis factor receptor 2 (TNFR2), and latency-associated peptide (LAP), as well as in vitro Tregs suppressive capacity were higher in natural infections. Taken together, this study provides unique insights into the immunological trajectories following a first-in-life hookworm infection compared to natural infections.

Geohelminthiases: Soil contamination and associated physicochemical parameters favouring ova dispersion in public schools in Ondo State, Nigeria.

Geohelminth infections are common diseases in sub-Saharan Africa and are a major contributor to setbacks in the socioeconomic and health status of people. This study assessed parasite ova/larvae dispersion in public schools and the associated physicochemical parameters in Akungba Akoko, Ondo Statestate, Nigeria. A total number of five hundred and sixteen (516) soil samples were collected from all the public primary schools (6) in the study area and examination was done in triplicate in all the primary schools in the community using standard procedures, a total of six thousand and twenty-eight (6,028) parasites were recovered after laboratory analyses; hookworm larvae n=2210 (36.66%), followed by Trichuris trichiura n=1572 (26.08%), hookworm ova, n= 1001 (16.61%), Strongyloides stercoralis ova, n= 636 (10.55%) and Ascaris lumbricoides ova, n= 600 (9.95%). The physico-chemical parameters of soil samples at different cardinal points within and around the study area revealed the highest pH (7.82 and the highest electrical conductivity (612.54mS/cm, soil temperature ranged from 22.61 and 26.08 and the highest total dissolved solid was 337.72ppm. Correlation analyses carried out on the recovered parasites with physicochemical parameters revealed that hookworm larvae showed a positive correlation with temperature, with a weak negative correlation with electrical conductivity and total dissolved solids, and Trichuris trichiura had a significant negative correlation with pH and total dissolved solids. The other parasites also showed varying correlations with the physicochemical parameters. Based on these findings, environmental modifications are recommended as an effective preventive measure. Harnessing the results of the physicochemical parameters in relation to the parasites, mass chemotherapy of schoolchildren, health education campaigns, improved sanitary conditions, provision of toilet facilities, and personal hygiene are equally recommended.

Prevalence of Cockroach Density, Gastrointestinal Disorders, and Identification of Parasites in Cockroaches in Helvetia Deli Serdang Village

Background. Cockroaches are known to be vectors of various pathogens that can infect humans, one of which is intestinal parasites. Parasitic infectious diseases can cause symptoms of gastrointestinal disorders in sufferers, which can interfere with the sufferer's quality of life. This research aims to determine cockroach density, and gastrointestinal disorders in the community, and identify parasites in cockroaches. Method. The research method used in this research is observational analytics. The population and sample for this study were the houses of the Helvetia Deli Serdang Village community which met the slum criteria of 100 houses. The caught cockroaches are then examined in the laboratory. Results. The results obtained were that 96 houses (96%) were not infested with cockroaches, 4 houses (4%) had no cockroaches, and no houses were infested with cockroaches. The number of respondents who had experienced gastrointestinal disorders was 41 respondents (41%) and 59 respondents (59%) had never experienced them. Based on laboratory examination, 22 rhabditiform hookworm larvae (21.78%), 5 hookworm eggs (4.95%), and 1 Oxyruris vermicularis egg (0.99%) were found. Toxocara sp. as many as 1 piece (0.99%), and cysts Entamoeba histolytica as much as 1 piece (0.99%). Conclusion. Based on these results, there was no high density of cockroaches found at the research location, the majority of respondents had never experienced gastrointestinal disorders in the past year, and parasites were found in cockroaches.

Molecular identification and genetic diversity of zoonotic hookworm infections in domestic dogs from northeastern, Thailand.

Hookworm infections remain a significant public health concern in tropical and subtropical regions, including Thailand. This study investigated the species and genetic diversity of hookworm infections in domestic dogs from northeastern Thailand. The molecular analysis focused on amplifying and sequencing specific regions of ribosomal RNA genes (ITS1-5.8S-ITS2 region) and the mitochondrial cytochrome c oxidase subunit 1 (cox1) gene in hookworm larvae recovered from 21 domestic dog stool samples. Among 21 larvae (one larva per infected dog) analyzed, 14 had sequences identical to Ancylostoma caninum, and 7 showed sequences almost identical to Ancylostoma ceylanicum. Phylogenetic analysis of cox1 sequences placed A. caninum and A. ceylanicum in separate clades. The median-joining network of A. caninum cox1 sequences from Thailand showed high haplotype diversity and belonged to the same cluster as sequences from Australia while forming separate clusters from those of A. caninum samples from the USA. The available published A. ceylanicum cox1 sequences (n = 33), in combination with seven sequences in the present study, represented 15 haplotypes distributed among three clusters. Interestingly, A. ceylanicum sequences from dogs and humans shared the same haplotypes. These findings are crucial for recognizing the potential for zoonotic transmission, highlighting the necessity for targeted control measures, and increasing awareness among pet owners and healthcare professionals to mitigate the risk of hookworm transmission to humans.

The impact of community based interventions for the prevention and control of soil-transmitted helminths: A systematic review and meta-analysis.

Soil-transmitted helminths (STHs) are among the most common human infections worldwide and a major cause of morbidity. They are caused by different species of parasitic worms and transmitted by eggs released in faeces or when hookworm larvae penetrate the skin. The main control strategy in endemic regions is periodic treatment with deworming medication. In the last 10 years, there has been a scale-up of prevention and control activities with a focus on community-based interventions (CBIs). This review aims to systematically analyse the impact of CBIs on the prevalence and infection intensity of STHs. A systematic review was published on this topic in 2014, but there have subsequently been several new studies published which are included in this review. Electronic database search of MEDLINE (Ovid), Global Health Online (Ovid), Cochrane Library, Embase (Ovid) and Web of Science was conducted. Titles, abstracts, and full texts were screened by two independent reviewers according to predefined eligibility criteria. Data were extracted and a meta-analysis of included studies was conducted. A total of 11,954 de-duplicated titles were screened, and 33 studies were included in the review. 14 focussed on community-wide treatment, 11 studies investigated school-based interventions, and 3 studies investigating both. Results suggest that CBIs are effective in reducing the prevalence of Hookworm, Trichuris trichiura and Ascaris lumbricoides. School-based treatment and community-wide treatment, as well as annual and semi-annual deworming, all reduce STH prevalence significantly. Mass drug administration was effective in reducing the infection intensity of Hookworm (Mean difference: -211.36 [95% CI: -519.12, 96.39]), Trichuris trichiura (-736.69 [-1349.97, -123.42]) and Ascaris lumbricoides (-2723.34 [-5014.85, -431.84]). The results suggest that CBIs are effective in reducing the prevalence and intensity of STH infections. While most studies delivered preventive chemotherapy (PC), few studies explored the impact of interventions such as water, sanitation, and hygiene (WASH) or health education, which may be essential in preventing reinfection after PC.

Soil-Transmitted Parasites and Non-Pathogenic Nematodes in Different Regions of Porto Alegre City, Brazil: A Comparison between Winter and Summer

We assessed the prevalence of soil-associated parasites and non-pathogenic nematodes in eight public areas of Porto Alegre (Rio Grande do Sul state, southern Brazil), the most populous city in Rio Grande do Sul. Soil samplings were carried out during the winter of 2022 and summer of 2023: A total of 80 samples were collected in winter and 80 in summer (ten samples from each sampling site per season), totaling 160 soil samples. The frequency of microscopic non-pathogenic nematode larvae was significantly higher (p = 0.048) in winter (93.75%) than in summer (82.50%). Considering the pooled data from winter and summer (n = 160) for human pathogenic parasites, the following frequencies were observed (using microscopy analysis): hookworm (filariform) larvae (1.25%), hookworm (rhabditiform) larvae (11.25%), Strongyloides spp. (filariform) larvae (0.63%), Strongyloides spp. (rhabditiform) larvae (2.5%), hookworm eggs (10.63%), Ascaris spp. eggs (10.00%), and Trichuris spp. eggs (1.25%). Hookworm (rhabditiform) larvae were the most frequent parasitic structures (15.00%) in winter, and A. lumbricoides eggs were the most frequent parasitic structures (8.75%) in summer. No statistically significant difference was observed in the frequency of pathogenic parasites between the seasons (p > 0.05). Toxoplasma gondii DNA was assessed, but all soil samples tested negative in molecular analysis. Our results indicate that soil from many regions of Porto Alegre shows a high prevalence of soil-transmitted helminths, indicating the need for improvements in social conditions and environmental sanitation in the city. Our study also suggests that climate change may affect soil biodiversity, potentially harming non-pathogenic nematodes and favoring human pathogenic parasites.

Protective efficacy of short-term infection with Necator americanus hookworm larvae in healthy volunteers in the Netherlands: a single-centre, placebo-controlled, randomised, controlled, phase 1 trial

Vaccine development against hookworm is hampered by the absence of the development of protective immunity in populations repeatedly exposed to hookworm, limiting identification of mechanisms of protective immunity and new vaccine targets. Immunisation with attenuated larvae has proven effective in dogs and partial immunity has been achieved using an irradiated larvae model in healthy volunteers. We aimed to investigate the protective efficacy of immunisation with short-term larval infection against hookworm challenge. We did a single-centre, placebo-controlled, randomised, controlled, phase 1 trial at Leiden University Medical Center (Leiden, Netherlands). Healthy volunteers (aged 18-45 years) were recruited using advertisements on social media and in publicly accessible areas. Volunteers were randomly assigned (2:1) to receive three short-term infections with 50 infectious Necator americanus third-stage filariform larvae (50L3) or placebo. Infection was abrogated with a 3-day course of albendazole 400 mg, 2 weeks after each exposure. Subsequently all volunteers were challenged with two doses of 50L3 at a 2-week interval. The primary endpoint was egg load (geometric mean per g faeces) measured weekly between weeks 12 and 16 after first challenge, assessed in the per-protocol population, which included all randomly assigned volunteers with available data on egg counts at week 12-16 after challenge. This study is registered with ClinicalTrials.gov, NCT03702530. Between Nov 8 and Dec 14, 2018, 26 volunteers were screened, of whom 23 enrolled in the trial. The first immunisation was conducted on Dec 18, 2018. 23 volunteers were randomly assigned (15 to the intervention group and eight to the placebo group). Egg load after challenge was lower in the intervention group than the placebo group (geometric mean 571 eggs per g [range 372-992] vs 873 eggs per g [268-1484]); however, this difference was not statistically significant (p=0·10). Five volunteers in the intervention group developed a severe skin rash, which was associated with 40% reduction in egg counts after challenge (geometric mean 742 eggs per g [range 268-1484] vs 441 eggs per g [range 380-520] after challenge; p=0·0025) and associated with higher peak IgG1 titres. To our knowledge, this is the first study to describe a protective effect of short-term exposure to hookworm larvae and show an association with skin response, eosinophilic response, and IgG1. These findings could inform future hookworm vaccine development. Dioraphte Foundation.

Dermoscopic characteristics of cutaneous larva migrans in dark skin: a study from Banjul, The Gambia.

Cutaneous larva migrans (CLM) results from hookworm larvae infestation, mainly Ancylostoma braziliense or Ancylostoma caninum. It is common in Sub-Saharan Africa, often acquired through soil contact, especially in sandy beaches, manifesting as serpiginous, erythematous and intensely pruritic tracts within the epidermis, and presenting with diverse clinical appearances. Diagnosis is mostly clinical; however, dermoscopy can enhance diagnostic accuracy and distinction from mimics. The current body of literature is deficient in its representation of dermoscopic data for CLM in Black patients. This study explores dermoscopy in nine dark-skinned patients with 16 CLM lesions. Distinctive serpiginous structureless areas displaying a range of colours, peripheral scales surrounding brown areas and brown dots were predominant features, whereas vascular characteristics were less evident. This article highlights the presence of distinct reaction patterns, including brown dots, scales, and accentuated, often disrupted brown reticular lines in addition to the characteristic winding tracts in darker skin.

Monitoring of soil transmitted helminth (STH) Helminthiasis on school-age children in final garbage dump, Bantar Gebang, East Bekasi

The prevalence of helminthiasis in West Java is 13.9%, but there is no data on STH helminthiasis on school-age children in the final garbage dump (FGD), Bantar Gebang, East Bekasi, Indonesia. Therefore, it is necessary to monitor STH helminthiasis on school-age children living around FGD. This study aims to determine the description of helminthiasis on school-age children who live in the FGD Bantar Gebang, Indonesia. This type of research is descriptive quantitative with a cross-sectional design. The sample in this study consisted of 79 stool children aged 5-9 years, 5 g of fly vectors from wet, dry, and soil were taken from 36 locations around the FGD. STH examination on stool, flies, and soil samples was carried out using the native, Harada Mori, flotation, and sedimentation methods. All data were analyzed using a descriptive approach to determine the percentage of the incidence of STH. The results of this study, among others, from 79 children there were six (7.60%) children infected with STH with the genus or species Ascaris lumbricoides, hookworm, and Trichuris trichiura. As for the 18 points of soil extraction, there were 12 (66.7%) positive points containing hookworm larvae, while the flies found were more dominant in Musca domestica than Chrysomya sp. with worm parasites attached to the fly's body are Ascaris lumbricoides, Diphyllobothrium latum. Enterobius vermicularis, hookworm, Hymenolepis sp., Schistosoma sp., Trichuris trichiura. The conclusion of this study is percentage incidence of STH helminthiasis on school-age children living in FGD Bantar Gebang is 7.60% which is in the low category.

Interpretation of Detection and identification standard of hookworm-Hook-worm larvae coproculture techniques (WS/T 791-2021)

Detection and identification standard of hookworm-Hookworm larvae coproculture techniques (WS/T 791-2021) is the first recommended technical standard for hookworm detection and species identification using the hookworm larvae coproculture technique in China. This standard was issued on November 23, 2021, and had been in effect since May 1, 2022. This article provides a detailed interpretation pertaining to the background, drafting process, main contents, and dos and don'ts for better understanding and application of this standard among professionals working in disease control and prevention institutions and medical institutions.

Wash Deployment and Geo-helminth Ova Dispersion in Primary Schools in Akure North and Owo Local Government Areas, Ondo State, Nigeria

Soil-Transmitted Helminths (geo-helminths) are intestinal parasites causing human infections that are soil-borne. The study assessed the level of soil contamination with geo-helminths ova and also evaluated the level of compliance to WASH policies in some selected public and private schools in Akure North and Owo Local Government Areas of Ondo state, respectively. The study was conducted in the major districts of the two towns.
 Methods
 Soil samples were collected from three (3) different locations within each school premise: Toilet areas, classroom and playground. Assessment sheets were used to evaluate data on indicators of compliance to WASH interventions. Modified Baemann’s culture technique was used in the extraction of geo-helminths larvae and sedimentation techniques were used in the concentration and isolation of geo-helminths eggs. The significant difference in soil contamination between public and private schools was obtained using statistical analysis.
 Result
 Of the 162 soil samples examined from each local government area, Akure North had the highest number of contaminated samples, n=116 (71.61%), while Owo local government had the least, n =88 (54.32%). Four (4) different geo-helminth species were identified; Hookworm, Ascaris lumbricoides, Strongyloides stercoralis, and Trichuris trichiura. The most occurring parasites seen in Akure North were hookworm larvae (67.83%), Strongyloides stercoralis (67.83%), hookworm ova (11.25%) and ova of Ascaris lumbricoides (7.56%). Likewise, Hookworm larvae had the highest level of occurrence (51.67%), while Trichuris trichiura was the least occurring (0.77%) in Owo local government area. Public schools had the higher parasite count 668/780 (85.64%), while private schools had the lesser parasite count, 112 /780 (14.36%).
 Conclusion
 The study revealed poor deployment of WASH in the schools, and children were predisposed to geo-helminths infections due to the high level of contamination, particularly in the public schools.

Optimizing the xWORM assay for monitoring hookworm larvae motility

Parasitic worms (helminths) infect almost all taxa across the animal kingdom, and pose significant challenges to public health and economies, particularly in developing countries. To address this problem, researchers have developed various tools to measure the motility and viability of helminths. However, the conditions used in anthelmintic screening assays are often not optimized, and can vary considerably between research teams. These unoptimized conditions may impact novel drug screens, as little is known about the effects of different conditions on the health of the target parasites. To improve future research, this study determined the effects of key assay parameters including, media type, media concentration, in-well parasite density, and assay duration on the infective third-stage larva (L3) of two types of hookworms, namely Nippostrongylus brasiliensis in rodents, and Necator americanus in humans. Conditions were screened over several days using the xCELLigence worm real-time motility assay (xWORM); a real-time impedance-based helminth motility assay using the xCELLigence system with 96-well microplates. While results varied depending on the species and media used, the study found that 500–1,000 L3/200-µL and a media concentration of 3.13–25% generally produced good to excellent assay conditions. The findings of this study can guide the future selection of xWORM assay parameters for novel drug trials involving these parasite species and serve as a suggested model for optimizing trial conditions for alternative parasite targets and assays.

Controlled Hookworm Infection for Medication-free Maintenance in Patients with Ulcerative Colitis: A Pilot, Double-blind, Randomized Control Trial.

Human hookworm has been proposed as a treatment for ulcerative colitis (UC). This pilot study assessed the feasibility of a full-scale randomized control trial examining hookworm to maintain clinical remission in patients with UC. Twenty patients with UC in disease remission (Simple Clinical Colitis Activity Index [SCCAI] ≤4 and fecal calprotectin (fCal) <100 ug/g) and only on 5-aminosalicylate received 30 hookworm larvae or placebo. Participants stopped 5-aminosalicylate after 12 weeks. Participants were monitored for up to 52 weeks and exited the study if they had a UC flare (SCCAI ≥5 and fCal ≥200 µg/g). The primary outcome was difference in rates of clinical remission at week 52. Differences were assessed for quality of life (QoL) and feasibility aspects including recruitment, safety, effectiveness of blinding, and viability of the hookworm infection. At 52 weeks, 4 of 10 (40%) participants in the hookworm group and 5 of 10 (50%) participants in the placebo group had maintained clinical remission (odds ratio, 0.67; 95% CI, 0.11-3.92). Median time to flare in the hookworm group was 231 days (interquartile range [IQR], 98-365) and 259 days for placebo (IQR, 132-365). Blinding was quite successful in the placebo group (Bang's blinding index 0.22; 95% CI, -0.21 to 1) but less successful in the hookworm group (0.70; 95% CI, 0.37-1.0). Almost all participants in the hookworm group had detectable eggs in their faeces (90%; 95% CI, 0.60-0.98), and all participants in this group developed eosinophilia (peak eosinophilia 4.35 × 10^9/L; IQR, 2.80-6.68). Adverse events experienced were generally mild, and there was no significant difference in QoL. A full-scale randomized control trial examining hookworm therapy as a maintenance treatment in patients with UC appears feasible.

Identifikasi Jenis Parasit Nematoda Usus Pada Lalapan Sayur Kubis (Brassica oleracea) Mentah

Brassica oleracea includes vegetables that are consumed as raw vegetables. The habit of eating raw vegetables in the form of fresh vegetables needs to be observed, especially if the method of washing them is not good so that there are still nematode eggs in the cabbage. This study aims to determine the type of intestinal nematode parasites found in raw cabbage sold at the MMTC market and at food stalls in Lau Dendang, Percut Sei Tuan District. This research method uses the Univariate Analysis method where the data that has been obtained is easy to simplify. Then the data can be made in tabular form according to laboratory standards. The results showed that there was contamination by intestinal nematode parasites based on the type of sampling location, namely at the MMTC market and at the food stalls in Lau Dendang. In the MMTC market, there were 5 positive samples (33%) containing hookworm larvae (Ancylostoma and Necator) on cabbage and 10 negative samples (66%) on cabbage. Meanwhile, at the food stall in Lau Dendang, there were 2 positive samples (13%) and 13 negative samples (86%) containing hookworm larvae (Ancylostoma and Necator) in cabbage which is a raw vegetable.

Parasitological and Bacteriological Evaluation of Common Raw Fruits Collected from Two Major Markets in Iwo, Osun State, South-West Nigeria.

Fruits are a vital part of human nutrition because they contain the growth factors required to maintain normal health. Fruits are also known to harbour a wide range of parasites and bacteria. Consumption of unwashed raw fruits can lead to foodborne pathogens. This study was carried out to examine the presence of parasites and bacteria on fruits sold at two major markets in Iwo, Osun state, South-West Nigeria. Twelve different fresh fruits and seven different fresh fruits were purchased from different vendors from "Odo-ori" and "Adeeke" markets, respectively. The samples were transported to the microbiology laboratory of Bowen University, Iwo, Osun state for bacteriological and parasitological analysis. The parasites were concentrated by sedimentation and were examined using a light microscope, while for the microbial analysis, culturing and biochemical tests were also carried out on all the samples. The parasites discovered include Fasciola hepatica eggs, Ascaris lumbricoides and Strongyloides stercoralis larvae, hookworm larvae, and Taenia and Trichuris trichiura eggs. Ascaris lumbricoides was most frequently detected (40.0%). Bacteria isolated from the sampled fruits include Klebsiella oxytoca, Klebsiella pneumoniae, Enterobacter aerogenes, Escherichia coli, Kluyvera ascorbata, Proteus mirabilis, Staphylococcus intermedius, Staphylococcus sp., Micrococcus sedentarius, Corynebacterium diphtheriae, and Streptococcus zooepidemicus. The presence of parasites and bacteria on the fruits observed indicates that public health diseases may arise from their consumption. Awareness and education among farmers, vendors, and consumers about the importance of personal and food hygiene through proper washing or disinfection of fruits could reduce the risk of parasites and bacterial fruit contamination.

Assessment of an Immuno-Diagnostic Method for Hookworm-Related Cutaneous Larva Migrans Using Crude Extracts of Ancylostoma caninum

People can become infected with cutaneous larva migrans (CLM) through skin penetration by the infective zoonotic larvae of hookworms. Few studies have investigated CLM's immunodiagnosis, and the existing studies were limited to crude somatic or excretory/secretory antigens (Ags) from adult worms. Here, we aimed to develop an indirect enzyme-linked immunosorbent assay (ELISA) to differentiate and diagnose hwCLM by detecting immunoglobulin (Ig)E, IgG, and IgG subclasses 1-4 (IgG1-4) against the somatic Ag of adult Ancylostoma caninum checkerboard titrations of adult A. caninum worm extract. Pooled serum controls were immunocharacterized using an indirect ELISA. The IgG1-4 and IgE results were unsatisfactory; however, the use of total IgG achieved results comparable to those of immunoblotting. Thus, we continued to analyze the IgG-ELISA using serum samples from patients with hwCLM and heterologous infections as well as from healthy controls. The sensitivity and excellent specificity of the total IgG-ELISA were 93.75% and 98.37%, respectively, and its positive and negative predictive values were 75% and 99.67%, respectively. Antibodies from five cases of angiostrongyliasis, gnathostomiasis, and dirofilariasis cross-reacted with the somatic Ag of adult A. caninum. This new assay can adequately serodiagnose hwCLM when combined with clinical features and/or histological examination.