Intestinal Helminth Infections Research Articles

INTESTINAL HELMINTHIASIS AMONG SLAUGHTERED CATTLE IN BENIN CITY, EDO STATE, NIGERIA

The gastrointestinal tract of cattle harbours a number of parasites particularly helminthes that are responsible for clinical and sub clinical parasitism. This study was conducted to determine the prevalence of intestinal helminth infections among slaughtered cattle in Benin City, Edo State, Nigeria. A total of 215 cattle consisting of 134 males and 81 females. Faecal samples were collected from the rectum of each slaughtered cattle into a clean universal container for parasitological investigation using standard procedures. An overall prevalence of 36.3% of intestinal helminthiasis was observed among slaughtered cattle in this study. Gender and breed significantly affected the prevalence of intestinal helminthiasis among slaughtered cattle (P=0.0093; P<0.0001 respectively). The intestinal helminthes recovered were Fasciola hepatica, Strongyloides papillosus, Taenia saginata, Paramphistomum cervi, Dicrocoelium hospes and Monieza benedeni. Fasciola hepatica was the most prevalent (56.41%) while Monieza benedeni showed the least (2.56%) helminth observed. Measures to control parasitic infections among cattle with a view of improving the quality of growth and productivity are advocated

Co-infection of intestinal helminths in humans and animals in the Philippines.

BackgroundA large number of studies have assessed risk factors for infection with soil-transmitted helminths (STH), but few have investigated the interactions between the different parasites or compared these between host species across hosts. Here, we assessed the associations between Ascaris, Trichuris, hookworm, strongyle and Toxocara infections in the Philippines in human and animal hosts.MethodsFaecal samples were collected from humans and animals (dogs, cats and pigs) in 252 households from four villages in southern Philippines and intestinal helminth infections were assessed by microscopy. Associations between worm species were assessed using multiple logistic regression.Results Ascaris infections showed a similar prevalence in humans (13.9%) and pigs (13.7%). Hookworm was the most prevalent infection in dogs (48%); the most prevalent infection in pigs was strongyles (42%). The prevalences of hookworm and Toxocara in cats were similar (41%). Statistically significant associations were observed between Ascaris and Trichuris and between Ascaris and hookworm infections in humans, and also between Ascaris and Trichuris infections in pigs. Dual and triple infections were observed, which were more common in dogs, cats and pigs than in humans.ConclusionsAssociations are likely to exist between STH species in humans and animals, possibly due to shared exposures and transmission routes. Individual factors and behaviours will play a key role in the occurrence of co-infections, which will have effects on disease severity. Moreover, the implications of co-infection for the emergence of zoonoses need to be explored further.

RURAL LEFT-BEHIND CHILDREN ARE SERIOUSLY AFFLICTED WITH INTESTINAL HELMINTH INFECTIONS IN SOUTHERN SICHUAH, CHINA.

Rural children are seriously afflicted with intestinal helminth infections in China. Of note, the term rural children includes rural left-behind children (LBC) and rural non-left-behind children (NLBC); the difference in the prevalence of intestinal helminths between the 2 groups remains unclear. In this study, Gulin and Xuyong counties in southern Sichuan were chosen for investigation in 2019. The Kato Katz thick smear method was used to detect the presence of intestinal helminth eggs in rural children. For children aged 3-6 yr, the adhesive tape perianal swab method was used to detect Enterobius vermicularis and tapeworm eggs. Statistical differences in infection rates between the 2 groups were determined by the chi-square test. In total, 1,608 rural children, 911 LBC and 697 NLBC, participated in the investigation. Six species of intestinal helminths were detected. A total of 358 (39.3%) and 130 (18.7%) intestinal helminth positives were found among LBC and NLBC, respectively; the former had a higher (P < 0.05) infection level. Moreover, an analysis of double worm infection rates among intestinal helminth positive LBC and NLBC showed a difference between the 2 groups that was also statistically significant. These surveys indicated that the risk of intestinal helminth infection was substantially higher and the severity of infection much worse in rural LBC in southern Sichuan. More attention should be paid to the parasitic infection of LBC.

Ineffectiveness of TF-Test® and Coproplus® Methods in Strongyloides stercoralis Infection Diagnosis.

S. stercoralis diagnosis is currently performed by parasitological methods, mainly by Baermann-Moraes (BM), although Agar Plate Culture (APC) presents a higher sensitivity. New techniques, such as TF-Test® and Coproplus® have been suggested as more practical alternatives. The aim of this study was to evaluate the sensitivity of TF-Test® and Coproplus®, compared with APC, BM and Spontaneous Sedimentation (SS) methods. One-hundred and forty male alcoholic patients, who provided three stools samples collected on alternate days, were included in this study. The most frequently found parasite was S. stercoralis, 20% (28/140), and the most sensitive method was APC, 96.4% (27/28), followed by BM, 89.3% (25/28) and SS, 57.1% (16/28). TF-Test® and Coproplus® presented a sensitivity of 46.4 (13/28) and 39.3% (11/28), respectively. In samples with a parasitic load of 1-10 larvae/g of feces, which occurred in 39.3% (11/28) of the infected patients, both the TF-Test® and Coproplus® methods demonstrated sensitivities of 18.2% (2/11), while APC and BM methods reached a sensitivity of 100% (11/11) (p < 0.05). For other intestinal helminth infections, TF-Test® and Coproplus® sensitivities were 22.2 (4/18) and 11.1% (2/18), respectively, this being lower than the SS, 66.7% (12/18) (p < 0.05). On the other hand, for protozoa infection diagnosis, TF-Test® and Coproplus® presented the highest sensitivities, 62.2 (46/74) and 43.2% (32/74), respectively. TF-Test® and Coproplus® methods presented the lowest sensitivities for S. stercoralis and other helminth infection diagnosis; therefore, they can be indicated for use in parasitological diagnosis, only when associated with other more effective methods of helminth identification.

The Role of the Intestinal Epithelium in the "Weep and Sweep" Response during Gastro-Intestinal Helminth Infections.

Simple SummaryThe immune system actively combats intruders such as bacteria, viruses, fungi, and protozoan and metazoan parasites using leukocytes. During an infection white blood cells are activated to internalize bacteria or viruses and release a number of molecules to kill pathogens. Unfortunately, those mechanisms are ineffective against larger intruders like helminths, which are too large to be killed by a single immune cell. To eliminate gastro-intestinal helminths an integrated response involving the nervous, endocrine, and immune systems are used to expel the parasites. This is achieved through increased gut hydration and muscle contractions which detach worms from the gut and lead to release outside the body in a “weep and sweep” response. Epithelial cells of the intestine are significant players in this process, being responsible for detecting the presence of helminths in the gut and participating in the regulation of parasite expulsion. This paper describes the role of the gut epithelium in detecting and eliminating helminths from the intestine.Helminths are metazoan parasites infecting around 1.5 billion people all over the world. During coevolution with hosts, worms have developed numerous ways to trick and evade the host immune response, and because of their size, they cannot be internalized and killed by immune cells in the same way as bacteria or viruses. During infection, a substantial Th2 component to the immune response is evoked which helps restrain Th1-mediated tissue damage. Although an enhanced Th2 response is often not enough to kill the parasite and terminate an infection in itself, when tightly coordinated with the nervous, endocrine, and motor systems it can dislodge parasites from tissues and expel them from the gut. A significant role in this “weep and seep” response is attributed to intestinal epithelial cells (IEC). This review highlights the role of various IEC lineages (enterocytes, tuft cells, Paneth cells, microfold cells, goblet cells, and intestine stem cells) during the course of helminth infections and summarizes their roles in regulating gut architecture and permeability, and muscle contractions and interactions with the immune and nervous system.

Knowledge and awareness of intestinal parasitic infections among students at King Abdulaziz University in Jeddah, Saudi Arabia

Objective: Intestinal parasite illnesses are one of the most significant public health concerns in both developing and many developed countries, increasing morbidity and mortality. Various researchers have suggested that illness awareness and knowledge are beneficial in avoiding and limiting the spread of numerous diseases. The current study aims to examine information on knowledge and awareness on intestinal parasite illnesses among university students attending King Abdulaziz University (KAU) in Jeddah, Saudi Arabia. Methods: Students were given a self-administered questionnaire to complete in order to collect information on their demographics as well as their KAP toward intestinal helminth infections. Simple random sampling was used to conduct this cross-sectional investigation. 213 volunteers from various KAU faculties were included in the study, and the participants were informed and consented to the study’s purposes. A questionnaire was made available online for students to complete. The gathered data underwent additional statistical analysis. Results: The study included 213 students from various disciplines. Male participation was 22.53% and female participation 77.46%. Bachelor degree students made up 89.2%, diploma students 7.04%, master degree students 3.29%, and one PhD student 0.47%. Knowledge assessment on intestinal parasite illnesses revealed that overall, 53.52% of respondents were aware of these infections while 46.48% were not, which was a statistically significant difference. Conclusion: Students, particularly those majoring in fields other than health sciences, have a poor grasp of and awareness of intestinal parasite diseases; hence, there is a need for more initiatives to implement change. Key words: Knowledge, Awareness, Intestinal Parasitic Infection, Students, Jedda

Prevalence and associated risk factors of common intestinal parasitic infections of helminthes among the asymptomatic primary school children at Woldia Town, North Wollo Zone, Amhara Region, in Ethiopia

Background: Intestinal worm infestation is a global health problem and serious concern for the third world countries. The most common intestinal parasites of helminthes that inhabit in human gut include Nematodes (roundworms) and Platyhelminthes (Cestodes and trematodes) which are wide spread throughout the world. Prevention and control of all parasitic infections including helminthes require research work based on the identification of parasites and associated predisposing factors. Objective: The aim of this study was to determine the prevalence and associated risk factors of intestinal parasitic infections of helminthes among the asymptomatic primary school children at Woldia town, North Wollo Zone North Eastern Ethiopia. Methods: The study design was school based cross sectional study from November 2019 to February 2020. The technique of sampling was simple random sampling method and the sample size was computed based on the formula proposed by single population proportion to include 442 study participants. The method of data collection was laboratory microscopic stool examination using direct wet mount and formol-ether concentration technique and the structured questionnaires about the associated risk factors and sociodemographic factors. Analysis of the data was made manually using the thematic framework method including the descriptive statistics Result: The overall prevalence of intestinal parasitic infections of helminths among the asymptomatic primary school children at woldia town was 96(22.7%). The predominant intestinal parasites of helminthes was Ascaries lumbercoides 40 (9.5%) followed by Trichuris trichiura 18 (4.3%), Hymenolopis nana 13 (3.1%) and Hook worms 10 (2.4%). From the overall prevalence of intestinal parasitic infections of helminthes, 96(22.7%), the results obtained by direct wet mount method was 36(37.5%) while the Formol-ether concentration technique method revealed 60(62.5%). Moreover, the result also showed parasitic infections of helminthes were associated with associated predisposing factors. Concluding remarks and recommendations: In this study the overall prevalence of helminthic infections was relatively lower. However the control and intervention of intestinal helminthic infections requires a constant provision of periodic deworming treatment and regular health educations regarding personal hygiene and environmental sanitations.

Intestinal helminth infection transforms the CD4+ T cell composition of the skin

Intestinal helminth parasites can alter immune responses to vaccines, other infections, allergens and autoantigens, implying effects on host immune responses in distal barrier tissues. We herein show that the skin of C57BL/6 mice infected with the strictly intestinal nematode Heligmosomoides polygyrus contain higher numbers of CD4+ T cells compared to the skin of uninfected controls. Accumulated CD4+ T cells were H. polygyrus-specific TH2 cells that skewed the skin CD4+ T cell composition towards a higher TH2/TH1 ratio which persisted after worm expulsion. Accumulation of TH2 cells in the skin was associated with increased expression of the skin-homing chemokine receptors CCR4 and CCR10 on CD4+ T cells in the blood and mesenteric lymph nodes draining the infected intestine and was abolished by FTY720 treatment during infection, indicating gut-to-skin trafficking of cells. Remarkably, skin TH2 accumulation was associated with impaired capacity to initiate IFN-γ recall responses and develop skin-resident memory cells to mycobacterial antigens, both during infection and months after deworming therapy. In conclusion, we show that infection by a strictly intestinal helminth has long-term effects on immune cell composition and local immune responses to unrelated antigens in the skin, revealing a novel process for T cell colonisation and worm-mediated immunosuppression in this organ.

Intestinal Helminth Infections among Children with Disabilities in Bantul Regency, Special Region of Yogyakarta

&lt;p&gt;Due to physical, intellectual, mental, and/or sensory limitations, person with disabilities tend to experience obstacles and limitations in their ability to care for themselves, knowledge of health, and access to health services. As a result, people with disabilities are more at risk of experiencing health problems, one of which is intestinal helminth infection. The aim of this study was to assess the prevalence of intestinal helminth infections and associated risk factors among children with disabilities at school age in Bantul Regency, Special Region of Yogyakarta. A school-based cross-sectional study design was conducted from October until December 2019. A total of 130 stool samples were collected and examined by the flotation, Kato-Katz, Harada-Mori, and Baermann methods to detect the presence of helminth eggs and/or larvae. An interview with parents/guardians of the subject based on a questionnaire was conducted to obtain information regarding the associated risk factor. The overall prevalence of intestinal helminth infections among subjects was 1.5% (CI=95%). Of these, 0,07% (1/130) was positive for hookworm infection, and the remaining 0,07% (1/130) was positive for &lt;em&gt;Trichuris trichiura&lt;/em&gt;. Analysis for all risk factors showed no statistically significant association between all risk factors and the intestinal helminths infections in the study subjects (p&amp;gt;0.05).&lt;/p&gt;

Soil-transmitted helminths, intestinal protozoa and Clonorchis sinensis infections in southeast China

BackgroundExtensive parasitic diseases epidemiology in Zhejiang province has not been carried out since the second national survey in 2004. Therefore, dynamics in prevalence and infection pattern of the major intestinal parasites should be explored.MethodsThe distribution of three parasites including soil-transmitted helminths (STH), intestinal protozoa and C. sinensis in Zhejiang from 2014 to 2015 were explored. Kato-Katz technique was used for STH and C. sinensis detection, whereas transparent adhesive paper anal swab was used for pinworm detection, and iodine smear was used for protozoa detection. A questionnaire survey on alimentary habits and sanitary behaviors was conducted in half of the studied counties.ResultsThis study recruited 23,552 participants: 19,935 from rural and 3617 from urban area. Overall prevalence of intestinal helminth infections was 1.80%. In this study, seven helminth species were identified including A. duodenale, N. americanus, Trichuris trichiura, Ascaris lumbricoides, C. sinensis, Fasciolopsis buski and pinworm. The average prevalence of STH infection was 1.71%: 1.94% in rural and 0.44% in urban area. Hookworm was the most prevalent infection at 1.58%: 1.79% in rural and 0.44% in urban area. Prevalence varied considerably in the studied counties. Prevalence was highest in Yongkang county at 10.25%. Only 2.79% of children from rural area were infected with pinworm. A proportion of 0.40% of rural participants were infected with protozoa, whereas Endolimax nana was the most prevalent at 0.23%. C. sinensis showed infection only in one man. Awareness on C. sinensis was 24.47% in rural and 45.96% in urban area, respectively.ConclusionsPrevalence of STH and protozoa infections declined considerably whereas C. sinensis infections remained few in Zhejiang province compared with the prevalence reported in previous large scale surveys (19.56% for national STH infection in 2004, 18.66% and 4.57% for provincial STH and protozoa infection, respectively in 1999). The findings of this study showed that hookworm, mainly N. americanus remained a parasitic threat to population health, mainly in the central and western Zhejiang. Therefore, more health education regarding fertilization and farming habits is necessary in rural areas. The awareness concerning hookworm infection should be reinforced.

Small Intestinal Levels of the Branched Short-Chain Fatty Acid Isovalerate Are Elevated during Infection with Heligmosomoides polygyrus and Can Promote Helminth Fecundity.

Heligmosomoides polygyrus is a helminth which naturally infects mice and is widely used as a laboratory model of chronic small intestinal helminth infection. While it is known that infection with H. polygyrus alters the composition of the host's bacterial microbiota, the functional implications of this alteration are unclear. We investigated the impact of H. polygyrus infection on short-chain fatty acid (SCFA) levels in the mouse intestine and sera. We found that helminth infection resulted in significantly upregulated levels of the branched SCFA isovaleric acid, exclusively in the proximal small intestine, which is the site of H. polygyrus colonization. We next set out to test the hypothesis that elevating local levels of isovaleric acid was a strategy used by H. polygyrus to promote its own fitness within the mammalian host. To test this, we supplemented the drinking water of mice with isovalerate during H. polygyrus infection and examined whether this affected helminth fecundity or chronicity. We did not find that isovaleric acid supplementation affected helminth chronicity; however, we found that it did promote helminth fecundity, as measured by helminth egg output in the feces of mice. Through antibiotic treatment of helminth-infected mice, we found that the bacterial microbiota was required in order to support elevated levels of isovaleric acid in the proximal small intestine during helminth infection. Overall, our data reveal that during H. polygyrus infection there is a microbiota-dependent localized increase in the production of isovaleric acid in the proximal small intestine and that this supports helminth fecundity in the murine host.

Malaria and Intestinal Helminth Co-infection among Pregnant Women Attending Federal Teaching Hospital Gombe, Gombe State, Nigeria

Malaria and intestinal helminth infections are of public health concern globally, particularly among the risk groups like pregnant women in developing countries. In this study the prevalence of malaria and intestinal helminth coinfection and their relationship with anaemia were assessed. Two hundred (200) pregnant women aged between 16-55 years reporting to Federal Teaching Hospital Gombe (FTHG), Gombe State for antenatal clinics were enrolled at booking. Venous blood and stool samples were collected from each participant who consented to participate in this study, for haemoglobin estimation, determination of malaria parasitaemia and intestinal helminth parasite. Microscopy and Formal-ether concentration technique (FECT) were used to estimate the prevalence of malaria and determine the presence of intestinal helminth parasite, respectively. Chi-square (χ2) test was used to analyse the relationship between prevalence of intestinal helminth infection with Malaria and Anaemia among the participant. Results obtained revealed that 107 (53.5%) who consented to participate in the study are positive for malaria, with 11 (5.5%) infected with both malaria and intestinal helminths. Findings also revealed that more women 116 (58%) had mild anaemia among the study population. Three intestinal helminths Ascaris lumbricoides, Trichiuris trichiura and Hookworms were also recovered. A significant (P≤ 0.05) correlation between the prevalence of malaria, intestinal helminth and anaemia. Findings of this study provides an insight and further improves our understanding of the some clinical factors responsible for anaemia in pregnancy.

Gut Helminth Infection-Induced Immunotolerance and Consequences for Human Papillomavirus Persistence.

Cervical cancer, a malignancy caused by persistent human papillomavirus (HPV) infection, develops in more than 500,000 women annually. More than 90% of deaths from cervical cancer occur in low- and middle-income countries. A common epidemiological feature of countries with high cervical cancer incidence is a high burden of intestinal helminth infection. The ability of intestinal helminths to trigger immunoregulation, resulting in a "tolerogenic" systemic immune environment, provides fertile soil for the persistence of oncogenic viruses such as HPV. Animal models have shown that intestinal helminth infection permits the persistence of some viruses, however, HPV-specific and human studies are lacking. Large, well-organized trials evaluating the consequences of intestinal helminth infection on the human immune system and HPV persistence may lead to improved strategies for HPV prevention in helminth-endemic regions of the world. Additionally, such studies would offer insight into the specific ways that intestinal helminth infection contributes to immunomodulation, which could identify new therapeutic targets for a range of diseases, from inflammatory disorders to cancer. In this review, we discuss the evidence for helminth-induced systemic and local immune dysregulation, discuss possible mechanisms by which chronic intestinal helminth infection may facilitate HPV persistence, and suggest novel helminth-related interventions that could offer a high leverage (if somewhat unconventional) approach to HPV and cervical cancer control in resource-constrained regions.

The prevalence of parasitic gastrointestinal infection and hygiene knowledge in elementary school children in Boyolali district

Introduction: Currently, the integrated data regarding the prevalence of gastrointestinal parasitic infections in Central Java is still lacking particularly, the Simo district which considered to have the second lowest percentage of clean and healthy living habits (60.25%) in Boyolali Regency. Therefore, an estimation of the prevalence of intestinal protozoan and helminth infections are crucial in order to formulate a proper community intervention especially in elementary school children in Boyolali.Methods: A cross-sectional study was conducted using total sampling method and involving first to sixth-grade elementary schoolchildren. Stool specimens were examined using direct, modified Ziehl–Neelsen and Kato staining methods. All of the data were compiled and analyzed using chi square test.Results: Among 127 participants, 17 students (13.58%) were infected with intestinal protozoans and 13 students (10.24%) were infected with helminth. The age ranged from 6 to 14 years old. The most frequent protozoan parasite detected was B. hominis (11.80%) while the most frequent helminth detected was A. lumbricoides (5.51%).Conclusion : In conclusion, there was a considerable helminth and protozoa infection among students in Simo region. Further and wider studies are needed to confirm these findings.

Gastro Intestinal Helminths among Hausa-Fulani in Wamakko and Tambuwal Local Government Area of Sokoto, Nigeria

Background: Gastro Intestinal Helminths infection is one of the major health burdens in developing countries particularly in Sub -Saharan Africa. It has been estimated to affect about 2.5 billion people globally and 250 million people are thought to be ill as a result of such infections, the majority being children.&#x0D; Aims: The study aimed to determine the prevalence and associated risk factors of gastro intestinal helminths infections among people of Wamakko and Tambuwal local government area in Sokoto state.&#x0D; Study Design: This was a cross-sectional, descriptive study.&#x0D; Place and Duration of Study: The study was conducted among Hausa- Fulani in wamakko and Tambuwal area in Sokoto, from June 2019 to October 2019.&#x0D; Methodology: Parasitological examination was carried out on stool samples from 243 participants using microscopy following formal ether concentration methods.&#x0D; Results: Finding revealed that 29 (12%) were positive for gastro intestinal helminths infections. Males recorded more prevalence (11.9%) than the females (11.8%).&#x0D; Conclusion: Gastro intestinal helminths parasites continue to remain a serious public health problem in North-western Nigeria. Low level of education, occupational status, and poor water supply seems to be among significant risk factors for these infections. Creating awareness, increase level of sanitation, good water supply and de-worming programme among school children will reduce prevalence and intensity of gastro intestinal helminths parasitic infections in the study area.

Prevalence And Sociodemographic Characteristics Of Helminthic Infections Among Primary School Pupils In Gombe, North-eastern Nigeria

Background: The public health burden and prevalence of intestinal helminths in Nigeria are increasing, with 45% of school age children being infected annually. Interrogating the burden and associated demographics will aid preventive measures, early diagnosis and prompt treatment. Objective: The objective of the study was to determine the prevalence of intestinal helminthic infections in school children, types and associated sociodemographic characteristics. Methodology: This was a cross sectional study that used multistage sampling technique to obtain a sample of 350 pupils aged 5 to 14 years from 24 primary schools in Gombe LGA of Gombe state from July 2018 to January 2019. Stool samples were examined with Direct and Formol- ether concentration methods. Results: The prevalence of helminthic infection was 23.7%. The proportion of various types of helminths were 26.5%, 24.1%, 21.7%, and 0.6% for A. lumbricoides, Hookworm, H. nana and Trichuris trichuira respectively while multiple infection accounted for 18.1%. Majority (43; 51.8%) of the infections were light infections. Infection in Public schools accounted for 96.4%. There was a significant association between helminthic infection and public school (p&lt;0.001), low Socio-economic class (P= 0.004) and use of insanitary toilets (P = 0.003). Conclusion: Intestinal helminthic infection is a public health problem in primary school children in Gombe, especially in public schools that are attended by students from low social class and whose toilet facilities are in poor states. Regular health education with provision of water closet toilets and de-worming of public primary school children at intervals are recommended to decrease worm burden.

Association between intestinal helminthic infections and anaemia status in preschool children in the district Skardu of Pakistan.

To evaluate the frequency of parasitic infections and to assess the relation between intestinal helminth infection and the anaemia status of pre-school children. The community-based cross-sectional study was conducted in Skardu, Pakistan, from August 2016 to January 2017, and comprised pre-school children of either gender. Demographical data was collected using a structured questionnaire. Stool samples were collected and examined for the presence and differentiation of ova / larvae of different intestinal helminths under microscope at the pathology department of a local healthcare facility. Blood haemoglobin was measured from blood samples and anaemia was defined as blood Hb <11g/dL. Data was analysed using SPSS 22. Of the 300 paediatric subjects, 169 (56.3%) were males and 131 (43.7%) females. The overall mean age of the sample was 36±16 months. Of the total, 161(53.67%) were found infected. Among the infected, 93(31%) were males and 68(22.67%) were females (p=0.10). Among those who were infection-free, 46(15.3%) children were anaemic. Prevalence of helminthic infections in pre-school children in Skardu was found to be high. The public health problem needs to be addressed for the healthy development of children.

PGD2 and CRTH2 counteract Type 2 cytokine-elicited intestinal epithelial responses during helminth infection.

Type 2 inflammation is associated with epithelial cell responses, including goblet cell hyperplasia, that promote worm expulsion during intestinal helminth infection. How these epithelial responses are regulated remains incompletely understood. Here, we show that mice deficient in the prostaglandin D2 (PGD2) receptor CRTH2 and mice with CRTH2 deficiency only in nonhematopoietic cells exhibited enhanced worm clearance and intestinal goblet cell hyperplasia following infection with the helminth Nippostrongylus brasiliensis. Small intestinal stem, goblet, and tuft cells expressed CRTH2. CRTH2-deficient small intestinal organoids showed enhanced budding and terminal differentiation to the goblet cell lineage. During helminth infection or in organoids, PGD2 and CRTH2 down-regulated intestinal epithelial Il13ra1 expression and reversed Type 2 cytokine-mediated suppression of epithelial cell proliferation and promotion of goblet cell accumulation. These data show that the PGD2-CRTH2 pathway negatively regulates the Type 2 cytokine-driven epithelial program, revealing a mechanism that can temper the highly inflammatory effects of the anti-helminth response.

Helminth-mediated disease tolerance in TB: A role for microbiota?

Intestinal helminth infections are most prevalent in peri-equatorial regions of the world and have an overlapping geographical distribution with Mycobacterium tuberculosis (Mtb) infection—the causative agent of tuberculosis (TB). Importantly, approximately 40% of TB patients are asymptomatically infected with helminth parasites. While experimental and epidemiological evidence suggest that helminth infections alter the course of TB, other studies do not support this link [1]. Although the direct immunomodulatory effects of helminth infections on adaptive host immunity have been studied extensively, these can only partially explain the complex nature of helminth–TB interactions. Indeed, the potent immunomodulatory abilities of helminths may even reduce TB-associated tissue pathology [1] and contribute to disease tolerance [2]. However, helminth infections also induce changes to the gut microbiota that can have a systemic impact on heterologous infectious diseases [3]. Given previous studies demonstrating that the gut microbiota can shape disease tolerance to pulmonary infections [4], here, we discuss the current understanding of how the gut microbiota impacts TB and posit that helminth-mediated changes to this vast microbial community may contribute to the clinical course of TB in co-endemic regions (Fig 1). Open in a separate window Fig 1 Helminth infections, eliciting robust type 2 immune responses, might contribute to Mtb disease tolerance by inhibiting type 1 and type 3 immune responses, thus reducing inflammation and pathology while maintaining bacterial burden. An alternative, but not mutually exclusive, possibility is that helminth-mediated changes to the gut microbiota shape TB outcomes. The robust regulatory capacity of the gut microbiota (via immune suppression, metabolite processing, and niche competition) is an appealing mechanism to explain the contradicting data regarding the exact role of helminth infections in TB disease progression and disease tolerance in asymptomatic infected patients. This figure was created with BioRender.com. Mtb, Mycobacterium tuberculosis; TB, tuberculosis.

Helminthic Infestation in Children Aged 6 to 59 Months with Diarrhea in Calabar

Background: Helminthic infections and diarrheal diseases have remained public health problem worldwide, especially in developing countries. Children below five years of age are at a higher risk. This study therefore aims to determine the prevalence, and intensity of intestinal helminths in children with and without the diarrheal disease. Materials and Methods: This was a cross-sectional analytical study of 130 children aged 6 to 59 months, carried out in the Children Emergency Room and the Diarrhea Treatment and Training Unit of the University of Calabar Teaching Hospital (U. C. T. H), Calabar, Nigeria. Those admitted with and without diarrhoea were consecutively recruited. Data were obtained by administration of questionnaires to parents/caregivers whose children met the inclusion criteria. Clinical examinations including anthropometric parameters (weight and length/height) were carried out on all the children recruited for the study while mid-upper arm circumference was done for children aged 12–59 months. Stool samples were collected from each child into a wide mouth universal, clean, dry, leak-proof, container, with the help of their parents/guardians. Microscopy was carried out on the stool samples collected within 1 h in the microbiology laboratory for the presence of ova, larva, or worm segment using direct microscopy with saline and iodine wet preparation and formol ether concentration. Ova were identified and quantified. The type of worm and intensity were recorded. Results: Out of the 130 children, 65 (50%) had diarrhea while the other 65 (50%) were without diarrhoea. The mean age of subjects with diarrhea was 16.86 ± 11.7 months and 17.60 ± 9.9 months for those without diarrhoea. There was no significant difference in sex distribution between the age groups (P = 0.86). The overall prevalence of intestinal helminthic infection in the study population was 1.5%. The prevalence of intestinal helminths in those with diarrhea and those without diarrhea was 3.1% and 0.0%, respectively, (P = 0.496). Only Ancylostoma duodenale (hookworm) was isolated in those with diarrhea and it was of light intensity. There was no significant difference in the method of disposal and source of water, comparing subjects having diarrhea and those not having diarrhea (P &gt; 0.05). The proportions of subjects that usually played in the sand, go on footwear outside home, and go on footwear at home, were not significantly different comparing those having diarrhea and those not having diarrhea (P &gt; 0.05). Conclusions: The prevalence rate of intestinal helminths in children with and without diarrhoea was low. There was general environmental cleanliness and personal hygiene in the study population which were likely responsible for the low helminthic infection thus emphasizing the need for maintenance of good hygiene, access to good water supply and periodic intake of anti-helminthic drugs in view of the public health importance of helminthic infection and diarrhoea.