Lumbricoides Infection Research Articles

Ascariasis, Amebiasis and Giardiasis in Mexican children: distribution and geographical, environmental and socioeconomic risk factors

The aim of this study is to provide an overview of the geographical distribution of Ascariasis, Amebiasis and Giardiasis, and to identify specific geographical, socioeconomic and environmental factors that are associated with the incidence of these infections in Mexican children. We made use of publicly available data that was reported by federal organizations in Mexico for the year 2010. The contribution of geographical, socioeconomic and environmental factors to the incidence of infections was assessed by a multivariable regression model using a backwards selection procedure. A. lumbricoides incidence was associated with mean minimum temperature of the state, the state-wide rate of households without access to piped water and toilet, explaining 77% of the incidence of A. lumbricoides infections. Mean minimum precipitation in the state, the rate of households without access to a toilet, piped water and sewage system best explained (73%) the incidence of E. histolytica infections. G. lamblia infections were only explained by the latitude of the state (11%). In addition to the well-known socioeconomic factors contributing to the incidence of A. lumbricoides and E. histolytica we found that temperature and precipitation were associated with higher risk of infection.

Effects of nutritional supplements on the re-infection rate of soil-transmitted helminths in school-age children: A systematic review and meta-analysis.

The effect of nutritional supplements on the re-infection rate of species-specific soil-transmitted helminth infections in school-aged children remains complex and available evidence on the subject matter has not been synthesized. The review included randomised controlled trials (RCTs) and cluster RCTs investigating food supplements on school-aged children between the age of 4-17 years. A search for RCTs was conducted on eight databases from inception to 12th June 2019. Cochrane Risk of Bias tool was used to assess the risk of bias in all included studies. Meta-analysis and narrative synthesis were conducted to describe and analyze the results of the review. Outcomes were summarized using the mean difference or standardized mean difference where appropriate. The search produced 1,816 records. Six studies met the inclusion criteria (five individually RCTs and one cluster RCT). Four studies reported data on all three STH species, while one study only reported data on Ascaris lumbricoides infections and the last study reported data on only hookworm infections. Overall, the risk of bias in four individual studies was low across most domains. Nutritional supplementation failed to statistically reduce the re-infection rates of the three STH species. The effect of nutritional supplements on measures of physical wellbeing in school-aged children could not be determined. The findings from this systematic review suggest that nutritional supplements for treatment of STH in children should not be encouraged unless better evidence emerges. Conclusion of earlier reviews on general populations may not necessarily apply to children since children possibly have a higher re-infection rate.

Market integration and soil-transmitted helminth infection among the Shuar of Amazonian Ecuador.

BackgroundSoil-transmitted helminth (STH) infections have many negative health outcomes (e.g., diarrhea, nutritional deficiencies) that can also exacerbate poverty. These infections are generally highest among low-income populations, many of which are also undergoing market integration (MI; increased participation in a market-based economy). Yet the direct impact of MI-related social and environmental changes on STH infection patterns is poorly understood, making it unclear which lifestyle factors should be targeted to better control disease spread. This cross-sectional study examines if household infrastructure associated with greater MI is associated with lower STH burdens among Indigenous Ecuadorian Shuar.MethodsKato-Katz fecal smears were used to determine STH infection status and intensity (n = 620 participants; 308 females, 312 males, aged 6 months—86 years); Ascaris lumbricoides (ascarid) and Trichuris trichiura (whipworm) were the primary infection types detected. Structured interviews assessing lifestyle patterns (e.g., measures of household infrastructure) measured participant MI. Multilevel regression analyses and zero-inflated negative binomial regression models tested associations between MI measures and STH infection status or intensity, controlling for individual and community characteristics.ResultsParticipants residing in more market-integrated households exhibited lower infection rates and intensities than those in less market integrated households. Parasite infection status and T. trichiura infection intensity were lower among participants living in houses with wood floors than those with dirt floors, while individuals using well or piped water from a spring exhibited lower A. lumbricoides infection intensities compared to those using river or stream water. Unexpectedly, latrine type was not significantly related to STH infection status or intensity. These results suggest that sources of exposure differ between the two helminth species.ConclusionsThis study documents associations between household measures and STH infection among an Indigenous population undergoing rapid MI. These findings can help healthcare programs better target interventions and reduce STH exposure among at-risk populations.

Exposure to Toxocara spp. and Ascaris lumbricoides infections and risk of allergic rhinitis in children

BackgroundSubstantial experimental studies suggest a role for helminthes infections in the pathogenesis of allergies, but epidemiologic data have been inconsistent. Unlike to asthma, the association between helminthes infection and allergic rhinitis (AR) has been poorly studied. Therefore, we sought to evaluate the association between exposure to Ascaris and Toxocara infections and AR.MethodsWe did an age- and gender-matched case–control study of 81 children with physician-confirmed AR and 101 control subjects in a referral hospital for pediatric diseases in northern Iran. Exposure to Ascaris and Toxocara infections was evaluated by anti-A. lumbricoides- and anti-Toxocara- IgG antibodies using a commercial enzyme-linked immunosorbent assay. Associations were determined using multivariate logistic regression.ResultsAscaris seropositivity was higher in children with rhinitis than in controls (12.34 vs. 3.96%). Ascaris seropositivity was positively associated with AR in univariate analysis (OR, 3.42; 95% CI 1.03–11.3; P value = 0.035), but this association was not significant after adjustment for potential confounders (OR, 1.85; 95% CI 0.42–8.18). Also Toxocara seropositivity was higher in children with AR than in healthy subjects (3.7% vs. 0.99), indicating non-significant association with AR in both univariate (OR, 3.84; 95% CI 0.39–37.7) and multivariate analyses (OR, 0.8; 95% CI 0.04–15.44).ConclusionOur results revealed that AR is not associated with seropositivity to Ascaris and Toxocara infections in general; however, a higher seropositivity rate was found for both parasites in children with AR. More studies with longitudinal design and larger sample size are needed to elucidate this association.

PENGARUH SUHU DAN WAKTU PEMANASAN TERHADAP KETAHANAN TELUR Ascaris lumbricoides

The prevalence of intestinal nematode infection in Soil Transmitted Helminth (STH) is still high in Indonesia because the tropical climate and high rainfall greatly affect soil moisture as an important medium in its life cycle. One of the STH species is Ascaris lumbricoides which is transmitted through food contamination, especially raw vegetables. Eggs from Ascaris worms have resistance to strong acids, strong bases, oxidants, reductants, and surface-active agents. Ascaris lumbricoides eggs are resistant in 10% formalin dissolved in aquadest, NaCl 0.85%, and sodium phosphate. Ascaris lumbricoides eggs also have durability in 10% formalin solution which is heated at 60°C, 70°C and 80°C. This study aims to determine the resistance of Ascaris lumbricoides eggs to temperature and heating time. This research is expected to provide benefits in proving the temperature and heating time can affect the resistance of Ascaris lumbricoides eggs, so that it can provide certainty and a sense of security for the public that the heating process in food, especially vegetables can cause Ascaris lumbricoides eggs to be inactive.This research is a true experimental study with the design of The Randomized Posttest Control Group Design. The treatments used are heating temperatures 80°C, 90°C and 100°C for 10 minutes, 20 minutes, and 30 minutes. Based on the research, it was found that Ascaris lumbricoides eggs could not withstand heating 80°C, 90°C and 100°C for 10 minutes, 20 minutes, and 30 minutes. Suggestions in this study are to avoid Ascaris lumbricoides infection by increasing personal hygiene and always consuming foods, especially vegetables that have been heated for at least 80 ° C for 10 minutes.

Whipworm and roundworm infections.

Trichuriasis and ascariasis are neglected tropical diseases caused by the gastrointestinal dwelling nematodes Trichuris trichiura (a whipworm) and Ascaris lumbricoides (a roundworm), respectively. Both parasites are staggeringly prevalent, particularly in tropical and subtropical areas, and are associated with substantial morbidity. Infection is initiated by ingestion of infective eggs, which hatch in the intestine. Thereafter, T. trichiura larvae moult within intestinal epithelial cells, with adult worms embedded in a partially intracellular niche in the large intestine, whereas A. lumbricoides larvae penetrate the gut mucosa and migrate through the liver and lungs before returning to the lumen of the small intestine, where adult worms dwell. Both species elicit type 2 anti-parasite immunity. Diagnosis is typically based on clinical presentation (gastrointestinal symptoms and inflammation) and the detection of eggs or parasite DNA in the faeces. Prevention and treatment strategies rely on periodic mass drug administration (generally with albendazole or mebendazole) to at-risk populations and improvements in water, sanitation and hygiene. The effectiveness of drug treatment is very high for A. lumbricoides infections, whereas cure rates for T. trichiura infections are low. Novel anthelminthic drugs are needed, together with vaccine development and tools for diagnosis and assessment of parasite control in the field.

Performance of two serodiagnostic tests for loiasis in a Non-Endemic area

Loiasis, caused by the filarial nematode Loa loa, is endemic in Central and West Africa where about 10 million people are infected. There is a scarcity of convenient, commercial diagnostics for L. loa. Microscopy requires trained personnel and has low sensitivity, while the serodiagnosis is currently not standardized. Individual case management is also important in non-endemic countries to treat migrants, expatriates and tourists. We retrospectively compared the performance of a Loa Antibody Rapid Test (RDT) and a commercial ELISA pan-filarial test on 170 patients, 65 with loiasis [8 with eyeworm, 29 with positive microfilaremia, 28 with neither microfilaremia nor history of eyeworm but eosinophilia and history of Calabar swelling (probable loiasis)], 95 with other common parasitic infections and no previous exposure to L. loa (37 with M. perstans, 1 with Brugia sp., 18 with strongyloidiasis, 20 with schistosomiasis, 5 with hookworm, 4 with Ascaris lumbricoides infection, 10 with hyper-reactive malarial splenomegaly), and 10 uninfected controls. The sensitivity of the RDT and of the ELISA were 93.8% (61/65) and 90.8% (59/65), respectively. For the RDT, most of the cross-reactions were observed in patients with M. perstans: 7/37 (18.9%), followed by 1/10 (10%) with hyper-reactive malarial splenomegaly and 1/20 (5%) with schistosomiasis. None of the 27 subjects infected with intestinal nematodes was found positive at this test. The ELISA is meant to be a pan-filarial assay, and reacted extensively with cases of M. perstans (95%), as expected, and also in 11/18 (61.1%) patients with strongyloidiasis and in 3/5 (60%) with hookworm infection. The RDT and the ELISA are both highly sensitive for the diagnosis of loiasis. The main difference lies in the extent of cross-reactivity with other parasites. Considering that the RDT is specifically meant for Loa loa infection, and its high sensitivity, this test could be a useful tool for the diagnosis of occult loiasis.

Anthelmintic drugs for treating ascariasis.

BackgroundAscaris lumbricoides is a common infection, and mainly affects children living in low‐income areas. Water and sanitation improvement, health education, and drug treatment may help break the cycle of transmission, and effective drugs will reduce morbidity.ObjectivesTo compare the efficacy and safety of anthelmintic drugs (albendazole, mebendazole, ivermectin) for treating people with Ascaris infection.Search methodsWe searched the Cochrane Infectious Disease Group Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, three other databases, and reference lists of included studies, without language restrictions, up to 4 July 2019.Selection criteriaRandomized controlled trials (RCT) that compared albendazole, mebendazole, and ivermectin in children and adults with confirmed Ascaris infection.Data collection and analysisTwo review authors independently assessed studies for inclusion, assessed risk of bias, and extracted data from the included trials. A third review author checked the quality of data extraction. We used the Cochrane 'Risk of bias' assessment tool to determine the risk of bias in included trials. We used risk ratios (RRs) with 95% confidence intervals (CIs) to compare dichotomous outcomes in treatment and control groups. We used the fixed‐effect model for studies with low heterogeneity and the random‐effects model for studies with moderate to high heterogeneity. We assessed the certainty of the evidence using the GRADE approach. We used the control rate average to provide illustrative cure rates in the comparison groups.Main resultsWe included 30 parallel‐group RCTs, which enrolled 6442 participants from 17 countries across Africa, Asia, Central America and the Caribbean, and South America. Participants were from 28 days to 82 years of age, recruited from school, communities, and health facilities. Twenty studies were funded or co‐funded by manufacturers, while 10 studies were independent of manufacturer funding. Twenty‐two trials had a high risk of bias for one or two domains (blinding, incomplete outcome data, selective reporting).Single dose of albendazole (four trials), mebendazole (three trials) or ivermectin (one trial) was compared to placebo. Parasitological cure at 14 to 60 days was high in all the studies (illustrative cure of 93.0% in the anthelmintic group and 16.1% in the placebo group; RR 6.29, 95% CI 3.91 to 10.12; 8 trials, 1578 participants; moderate‐certainty evidence). Single dose of albendazole is as effective as multiple doses of albendazole (illustrative cure of 93.2% with single dose, 94.3% with multiple doses; RR 0.98, 95% CI 0.92 to 1.05; 3 trials, 307 participants; high‐certainty evidence); or as single dose of mebendazole (illustrative cure of 98.0% with albendazole, 96.9% with mebendazole; RR 1.01, 95% CI 1.00 to 1.02; 6 trials, 2131 participants; high‐certainty evidence). Studies did not detect a difference between a single dose of albendazole and a single dose of ivermectin (cure rates of 87.8% with albendazole, 90.2% with ivermectin; RR 0.99, 95% CI 0.91 to 1.08; 3 trials, 519 participants; moderate‐certainty evidence).Across all the studies, failure after single dose of albendazole ranged from 0.0% to 30.3%, mebendazole from 0.0% to 22.2%, and ivermectin from 0.0% to 21.6%.The egg reduction rate (ERR) measured up to 60 days after the treatment was high in all treated groups, regardless of the anthelmintic used (range 96% to 100%). It was not possible to evaluate parasitological cure by classes of infection intensity.No included trials reported complication or serious adverse events. Other adverse events were apparently similar among the compared anthelmintic groups (moderate‐ to low‐certainty evidence). The most commonly reported other adverse events were nausea, vomiting, abdominal pain, diarrhoea, headache, and fever.Authors' conclusionsSingle‐dose of albendazole, mebendazole, and ivermectin all appeared effective against Ascaris lumbricoides infection, yielding high parasitological cure and large reductions in eggs excreted, with no differences detected between them. The drugs appear to be safe to treat children and adults with confirmed Ascaris infection. There is little to choose between drugs and regimens in terms of cure or adverse events.

Study on the prevalence of intestinal parasitic infections and the assessment of the efficacy of albendazole in soil-transmitted helminths in school-going children in East Sikkim.

Background:The problem of intestinal parasitic infections (IPIs) in children is one of the most worrisome problems worldwide. The latest estimates indicate that more than 880 million children are in the need of treatment for these parasites.Objective:The aim of this study was to measure the prevalence of IPIs in school-going children in East Sikkim, India, and to assess the efficacy of single-dose albendazole (ALB) in children infected with soil-transmitted helminths (STHs).Subjects and Methods:A total of 300 stool samples were collected from the schoolchildren of government schools of East Sikkim. Samples were processed for the identification of IPIs by direct microscopy and formalin-ether concentration method. Fecal egg counting was carried out for STH by Stoll's egg counting technique, pre- and posttreatment with single-dose ALB. The second stool samples were collected 10–14 days posttreatment of ALB. Cure rate (CR) and the fecal egg reduction rate (ERR), the two most widely used indicators for assessing the efficacy of an anthelmintic, were used in this study. The data were analyzed and the results were interpreted statistically.Results:The overall prevalence of the IPIs was 33.9%. Helminthic infection was 4.6% and protozoan infection was 29.3%. Among helminthes Ascaris lumbricoides and among protozoans Entamoeba spp. were the dominant intestinal parasites. For drug efficacy, A. lumbricoides had CR 55.5% and ERR 81.4%. Moreover, for Trichuris trichiura, CR and ERR was 100%. The study has shown less efficacy against A. lumbricoides infections compared to T. trichiura.Conclusion:The study provides useful insight into the current prevalence of IPIs in school-going children in government schools in East Sikkim region. Keeping in view of less efficacy of ALB, it is necessary to keep the monitoring of development of drug resistance simultaneously.

EOSINOPHILIA AS A PREDICTOR MORBIDITY OF SOIL- TRANSMITTED HELMINTHIASES AMONG WIDODAREN PLANTATION WORKERS IN JEMBER

Background: Helminthiasis is a neglected tropical disease and still remain a health problem in tropical and sub-tropical countries, including Indonesia. According to WHO, approximately 1,5 billion people or 24% of the world’s population, are infected with Soil-Transmitted Helminth (STH). Morbidity is directly related to the intensity of STH infestation. Some of the studies shown a significant correlation between eosinophilia and helminthiasis. Eosinophilia on the blood smear examination may be used as a marker of STH infestation. Purpose: to determine the correlation between Soil-Transmitted Helminthiases and eosinophilia as a predictor of morbidity of STH infestation among Widodaren Plantation Workers in Jember. Methods: This observational analytical study use the Kato-Katz method to determine infestation of STH and its intensity measured by egg count per gram stool (EPG). Blood smear examination stained with Giemsa conduct to determine eosinophil count. Results: Prevalence of STH infestation was 22,7% (15/66). Ascaris lumbricoides infection was 13,6% (9/66) and Hookworm infection was 4,5% (3/66). There is mixed infection between A. lumbricoides and Hookworm, the prevalence was 4,5%% (3/66). All of the infection intensity was light. The prevalence of eosinophilia was 27,2% (18/66). There was a significant correlation between STH infection and eosinophilia (P=0,000) but, there was a very weak correlation between the intensity of STH infection and eosinophilia (r=0,281; p=0,258). Conclusion: The prevalence of STH infection among Widodaren Plantation Workers is 22,7% and predominated by A. lumbriocides. There is a positive correlation between intensity of STH infection and eosinophilia as predictor morbidity of STH infection with very weak power.

Single-dose Albendazole 400 mg Effectiveness in <i>Ascaris lumbricoides</i> and <i>Trichuris trichiura </i>Infections

Soil-Transmitted Helminthiasis is caused by nematode worm infections, namely Ascaris lumbricoides (round worm), Trichuris trichiura (whipworm) and Necator americanus or Ancylostoma duodenale (hookworm). At present, the prevalence of Soil-Transmitted Helminthiasis in Indonesia is still high. To reduce the prevalence of Soil-Transmitted Helminthiasis in Indonesia, the Ministry of Health of the Republic of Indonesia holds a mass worm treatment program for pre-school age children and school-aged children. The drug given is albendazole 400 mg single dose. This study aimed to determine the effectiveness of a single dose of albendazole 400 mg against infections of Ascaris lumbricoides and Trichuris trichiura. This study used a Pre-Experiment research design (One Group Pretest-Posttest). The research subjects were 66 people. Subjects positive for Ascaris lumbricoides were 37 people (mild infection 67.57%, moderate infection 27.03% and severe infection 5.41%). After giving a single dose of albendazole 400 mg to 37 people who were positive for Ascaris lumbricoides, 37 people had not found eggs of Ascaris lumbricoides on faecal examination after treatment. Positive subjects Trichuris trichiura were 54 people (mild infections 51.85%, moderate infections 44.44% and severe infections 3.73%). After giving a single dose of albendazole 400 mg to 54 positive people Trichuris trichiura, in severe infections, the percentage of eggs dropped was 100%. In moderate infections, the percentage of the number of eggs dropped is 95.83%. In mild infections, the percentage of total recovery was 7.14%, and the percentage of eggs dropped was 39.29%. The results of the Wilcoxon test on Ascaris lumbricoides obtained a significance value of <0.05, which means that there are significant differences in the examination before treatment and after treatment. The results of the Wilcoxon test on Trichuris trichiura obtained a significance value of 0.05, which means there were no significant differences in the results of the examination before treatment and after treatment. Albendazole 400 mg single dose is effective against Ascaris lumbricoides infection and is not effective against Trichuris trichiura infection.

Analysis of factors related to human soil-transmitted nematode infections in Chongqing City

To investigate the related factors of soil-transmitted nematode infections in Chongqing City, so as to provide the basis for scientific prevention and treatment of the infections. From 2011 to 2015, the stool samples of residents of the surveillance sites in Chongqing City were collected every year, and the soil-transmitted nematode eggs were examined by the modified Kato-Katz thick smear method (three smears for a single stool sample). The respondents were surveyed by questionnaires, and the factors affecting soil-transmitted nematode infections were identified. The prevalence of human soil-transmitted nematode infections were 6.44%, 7.30%, 6.85%, 6.93% and 5.56% in Chongqing City from 2011 to 2015, respectively. The more unclean drinking water and the lower frequency of washing hands after using the toilet were the risk factors for Ascaris lumbricoides infection. The more harmless toilets, the higher level of fertilizer application, the lower frequency of drinking raw water, and the lower frequency of food without washing were the protective factors for A. lumbricoides infection. The local soil-transmitted nematode infections are at a low epidemic level in Chongqing City, and it is necessary to ad-here to the classified guidance, comprehensive prevention and further monitoring on the basis of health education, water and toilet improvement, and environmental sanitation improvement in order to consolidate the prevention and control achievements.

Exposure to Ascaris lumbricoides infection and risk of childhood asthma in north of Iran.

Asthma and Ascaris lumbricoides infection are common health issues affecting 250 and 700 million people worldwide, respectively. The relationship between ascariasis and asthma is a matter of substantial interest and research. We performed a case-control study to evaluate whether the exposure to Ascaris infection is associated with asthma in children. We also assessed potential risk factors for Ascaris infection and asthma in study area. We enrolled 145 asthmatic children and 115 healthy controls. The Global Initiative for Asthma guideline was used to evaluate asthma symptoms and severity in study participants. Ascaris infection was assessed by the presence of anti-Ascaris IgG ≥ 11IU/mL measured by enzyme-linked immunosorbent assay. We have found a significant relationship between exposure to Ascaris and asthma (odds ratio, 2.92; 95% CI 1.04-8.18; P value = 0.034), and this relationship remained significant after adjustment for covariates (adjusted OR, 3.36; 95% CI 1.04-13%; P value = 0.047). Ascaris infection was more frequent in children with mild sustainable asthma (13.2%; 15/113) than in children with moderate sustainable asthma (6.2%, 2/32), although there was a non-significant difference between these groups (OR, 2.3; 95% CI 0.5-10.1; P value = 0.35). Based on results of a multi-regression analysis, contact with soil (OR, 6.7; 95% CI 1.9-23.5), and drinking unsafe water (OR, 4.2; 95% CI 1.2-14.2) were significant risk factors for Ascaris infection in the study area. Results of this study suggest that A. lumbricoides infection might affect susceptibility to asthma in children. These results could be useful in prevention, early diagnosis and management of childhood asthma.

Mapping Soil-Transmitted Helminth Parasite Infection in Rwanda: Estimating Endemicity and Identifying At-Risk Populations.

Soil-transmitted helminth (STH) infections are globally distributed intestinal parasite infections caused by Ascaris lumbricoides, Trichuris trichiura, and hookworms (Ancylostoma duodenale and Necator americanus). STH infection constitutes a major public health threat, with heavy burdens observed in many of the world’s tropical and subtropical regions. Mass drug administration and sanitation improvements can drastically reduce STH prevalence and associated morbidity. However, identifying targeted areas in need of treatment is hampered by a lack of knowledge on geographical and population-level risk factors. In this study, we applied Bayesian geostatistical modelling to data from a national school-based STH infection survey in Rwanda to (1) identify ecological and population-level risk factors and (2) provide comprehensive precision maps of infection burdens. Our results indicated that STH infections were heterogeneously distributed across the country and showed signatures of spatial clustering, though the magnitude of clustering varied among parasites. The highest rates of endemic clustering were attributed to A. lumbricoides infection. Concordant infection patterns among the three parasite groups highlighted populations currently most at-risk of morbidity. Population-dense areas in the Western and North-Western regions of Rwanda represent areas that have continued to exhibit high STH burden across two surveys and are likely in need of targeted interventions. Our maps support the need for an updated evaluation of STH endemicity in western Rwanda to evaluate progress in MDA efforts and identify communities that need further local interventions to further reduce morbidity caused by STH infections.

Long Term School Based Deworming against Soil-Transmitted Helminths Also Benefits the Untreated Adult Population: Results from a Community-Wide Cross Sectional Survey.

Background Soil-transmitted helminths (STH) are a public health problem in Kenya. The primary control strategy for these infections is preventive chemotherapy (PC) delivered through school based deworming (SBD) programs. The World Health Organization (WHO) recommends the inclusion of other at-risk groups in the PC. The untreated groups in endemic areas have been shown to act as reservoirs for STH transmission. Few field based studies have focused on the possible benefits of SBD to the untreated groups in the community. This study sought to determine the levels of STH among all age groups in a community where SBD has been going on for more than 10 years. Methods This was a cross sectional study where 3,292 individuals, ranging from 2 to 98 years, were enrolled. Stool samples were analyzed using duplicate Kato Katz thick smear technique for presence of STH eggs. Statistical analysis was conducted using STATA software 14.0 (Stata corporation). Results Out of the total 3,292 stool samples analyzed, only 13 were positive for any STH. Of these, 12 were infected with Trichuris trichiura and one case was of hookworm. There was no Ascaris lumbricoides infection detected. Of the 13 STH infections, seven of the infections were of school going age (6-18 years), 5 were of preschool age (<6 years), and one was of adult age group (18>). More male (61.5%) than female were infected with STH. Conclusion This study shows very low prevalence of STH among all age groups in Mwea, suggesting that long term SBD may also be benefitting the untreated groups in the community and thus the potential to achieve STH elimination in such endemic areas.

Effect of integrated control intervention on soil-transmitted helminth infections in Jiangxi province in southeast China

Soil transmitted helminths (STHs) burden was enormous in China several decades ago, however, rigorous control efforts have been successful with appreciable reduction in diseases burden. Here, we assessed provincial-level data derived from cross sectional surveys, executed in 1989, 2002 and 2014, on the prevalence of STHs among populations in Jiangxi province, China. This study, also, reported STHs integrated control intervention aimed at reducing STHs transmission and worm burden among population at county-level. The intervention strategies included mass drug administration (MDA), health education, improved water supply for drinking, improved sanitary facilities and environmental modification in Guixi municipality.The overall infection rate of STHs in Jiangxi province decreased from 77.7% (1989) to 6.3% (2014), while Ascaris lumbricoides, hookworm and Trichuris trichiura decreased from 71.1%, 17.6% and 17.0% (1989) to 0.9%, 4.7% and 1.0% (2014), respectively. STHs infection rates in female population were higher than male in the three surveys. Reduction in STHs prevalence was observed in all age groups, but the decline was less in higher age group. STHs prevalence in Guixi intervention region indicated remarkable reduction from 31.8% (2006) to 6.1% (2009) (χ2＝255.22, P＜0.01). A. lumbricoides, hookworm and T. trichiura infection rates decreased from 10.4%, 17.0% and 7.1% (2006) to 0.1%, 4.1% and 2.2%, respectively (2009) (X2A.l = 110.23, P<0.01; X2hk = 103.57, P < 0.01; X2T.t = 32.0, P < 0.01). A. lumbricoides infection rate declined the most of all STHs.Following control efforts with integrated control intervention strategies, STHs prevalence in Jiangxi province experienced remarkable trend in decline between 1989 and 2014. Consolidating control efforts with sustained integrated control strategies is, therefore, important to achieving STHs elimination in China.

Soil-transmitted helminth reinfection four and six months after mass drug administration: results from the delta region of Myanmar.

BackgroundMass drug administration (MDA), targeted at school-aged children (SAC) is the method recommended by the World Health Organization for the control of morbidity induced by soil-transmitted helminth (STH) infection in endemic countries. However, MDA does not prevent reinfection between treatment rounds and research suggests that only treating SAC will not be sufficient to bring prevalence to low levels and possibly interrupt transmission of STH. In countries with endemic infection, such as Myanmar, the coverage, who is targeted, and rates of reinfection will determine how effective MDA is in suppressing transmission in the long-term.Methods/principal findingsIn this paper, data from an epidemiological study on STH, comprising three surveys conducted between June 2015 and June 2016 in the delta region of Myanmar, are analysed to determine how STH prevalence and intensity in the study community changes over the course of a year, including reinfection after two MDA rounds in which the whole study sample (all age groups, n = 523) were treated with albendazole. Prevalence in the first survey (August 2015) was 27.92% for any STH, 5.54% for Ascaris lumbricoides, 17.02% for Trichuris trichiura and 9.75% for hookworm. Over the year (survey one to survey three), prevalence of any STH decreased by 8.99% (P < 0.001) and mean EPG significantly decreased for T. trichiura (P < 0.01) and hookworm (P < 0.001). Risk ratios (RRs) for a four-month reinfection period (August to December) were statistically significant and were below one, indicating that STH prevalence had not bounced back to the prevalence levels recorded immediately prior to the last round of treatment (any STH RR = 0.67, 95% CI 0.56–0.81; A. lumbricoides RR = 0.31, 95% CI 0.16–0.59; T. trichiura RR = 0.70, 95% CI 0.55–0.88; hookworm RR = 0.69, 95% CI 0.50–0.95). The only statistically significant RR for the six-month reinfection period (December to June) was for A. lumbricoides infection in SAC (RR = 2.67, 95% CI 1.37–5.21). All six-month RRs were significantly higher than four-month RRs (P < 0.05). Evidence of predisposition to infection (low and high), as measured by the Kendall Tau-b statistic, was found for all species overall and within most age groups stratifications, except for hookworm infection in preschool-aged children.Conclusions/significanceThis study demonstrates that, for certain demographic groups, a six-month gap between MDA in these communities is enough time for STH infection to return to STH prevalence levels recorded immediately before the previous MDA round, and that on average the same individuals are being consistently infected between MDA rounds.

Ascaris lumbricoides infection: Still a threat for iron deficiency anaemia in 2-year-old Bangladeshi slum-dwelling children.

IntroductionAlthough parasitic infections lead to extracorporeal iron loss resulting in iron deficiency anaemia (IDA), data associating IDA with parasitic infections in the first two years of life are limited. We sought to evaluate the prevalence and severity of anaemia and IDA during this period and to investigate the association between intestinal parasitic infections and IDA.MethodologyData was collected under MAL-ED study protocol in Bauniabadh slum of Dhaka, Bangladesh. The presence of parasites in stool was detected using wet preparation microscopy at 7, 15, and 24 months. Anaemia was defined as serum haemoglobin < 11 g/dL and IDA was defined by serum haemoglobin < 11 g/dL, serum ferritin < 12 g/L and soluble transferrin receptor > 8.3 mg/L. Logistic regression was done to quantify the relation between stool parasite and IDA separately on samples collected at 7, 15 and 24 months.Results265 children were enrolled after birth and samples were collected at 7, 15 and 24 months. Anaemia was detected at 7, 15 and 24 months in 117 (48.8%), 106 (44.2%) and 67 (27.9%) cases whereas IDA was found in 15 (6.3%), 47 (19.6%) and 39 (16.3%) cases, respectively. Iron deficiency anaemia at 24 months was significantly associated with Ascaris lumbricoides infection (OR 3.76; 95 % CI, 1.08-13.11).ConclusionsThe prevalence of anaemia and IDA in slum dwelling children of Dhaka is high and Ascaris lumbricoides infection was found to have a strong association with IDA at 24 months of age.

Ascaris lumbricoides coinfection reduces tissue damage by decreasing IL-6 levels without altering clinical evolution of pulmonary tuberculosis or Th1/Th2/Th17 cytokine profile.

Immunological control of Mycobacterium tuberculosis infection is dependent on the cellular immune response, mediated predominantly by Th1 type CD4+ T cells. Polarization of the immune response to Th2 can inhibit the host immune protection against pathogens. Patients with tuberculosis coinfected with helminths demonstrate more severe pulmonary symptoms, a deficiency in the immune response against tuberculosis, and an impaired response to anti-tuberculosis therapy. We evaluated the cellular immune response and the impact of the presence of Ascaris lumbricoides on the immune and clinical response in pulmonary tuberculosis patients. Ninety-one individuals were included in the study: 38 tuberculosis patients, 11 tuberculosis patients coinfected with Ascaris lumbricoides and other helminths, 10 Ascaris lumbricoides patients, and 34 non-infected control individuals. Clinical evolution of pulmonary tuberculosis was studied on 0, 30, 60, and 90 days post-diagnosis of Mycobacterium tuberculosis and Ascaris lumbricoides. Furthermore, immune cells and plasma cytokine profiles were examined in mono/coinfection by Mycobacterium tuberculosis and Ascaris lumbricoides using flow cytometry. There were no statistical differences in any of the evaluated parameters and the results indicated that Ascaris lumbricoides infection does not lead to significant clinical repercussions in the presentation and evolution of pulmonary tuberculosis. The association with Ascaris lumbricoides did not influence the Th1, Th2, and Th17 type responses, or the proportions of T lymphocyte subpopulations. However, higher serum levels of IL-6 in tuberculosis patients may explain the pulmonary parenchymal damage.

Correction to: The Dynamics of Ascaris lumbricoides Infections.

In the original article, the second author's name was incorrect in the metadata. The given name is T. Déirdre, and the family name is Hollingsworth.