Soil-transmitted Helminth Infections Research Articles

A scoping review of transmission models for soil-transmitted helminth infections to underpin the development of a transmission model for Strongyloides stercoralis.

A scoping review of transmission models for soil-transmitted helminth infections to underpin the development of a transmission model for Strongyloides stercoralis.

Study on Single and Combination of Galangal, Turmeric, and Ginger Ethanol Extracts as Anthelmintic

Soil-Transmitted Helminth infection (STH) such as ascariasis, has become one of the most persistent parasitic diseases in most developing countries, including Indonesia. Galangal, turmeric, and ginger plants are known to provide various of pharmacologically active substances which commonly used as antibacterial, aphrodisiac, and antiparasitic. This research was aimed to study the anthelmintic activity of ethanol extract of ginger, turmeric, galangal in single extract as well as their combination against Ascaris suum Goeze as a model. The anthelmintic activity was analyzed by determining the profile of time of paralysis (TOP), time of death (TOD), and the IC50­ of the inhibition activity from single extracts and extract combinations as well as the combination index (CI). The results showed that galangal, turmeric, and ginger ethanol extract have anthelmintic activity with IC50 7.66, 22, and 13,14 mg/mL, respectively. Meanwhile, the IC50 values for the extract combination of galangal with turmeric (KL), galangal with ginger (JL), and turmeric with ginger (JK) were 10.22; 3.92; and 34.93 mg/mL, respectively. The synergistic combination properties were shown by combination of galangal with turmeric extracts and galangal with ginger extracts with the combination index (CI) 0,67 and 0,38, respectively.

Strong association between high burden of soil-transmitted helminthiasis and household transmission among Malaysian Negritos, urging anthelmintic treatment beyond children

The Orang Asli (OA), Malaysia’s indigenous minority, continue to experience ongoing soil-transmitted helminth (STH) infections despite efforts including the Resettlement Programme (RPS). This study explores STH epidemiology and associated risks of moderate-to-heavy infections among 259 indigenous Negritos across four states in Peninsular Malaysia. Stool samples, anthropometrics, haemoglobin levels (finger-prick) and sociodemographic and environmental-sanitation factors via pretested questionnaires were collected. Parasitological examinations (direct faecal smear, formol-ether concentration, and Kato-Katz techniques) were thoroughly performed. The study revealed a 63.3% overall STH prevalence, with Trichuris trichiura (57.9%) being the most common, followed by Ascaris lumbricoides (35.5%) and hookworm (8.9%). Moderate-to-heavy infections were observed in 39.3% for T. trichiura and 48.9% for A. lumbricoides, with mixed infections of these two species being the most prevalent (50.6%). The risk for moderate-to-heavy infection increased significantly if other household members were infected (P < 0.001). Adults and adolescents also showed high infection rates, with no significant differences with children’s groups. These findings emphasize the need for anthelmintic treatment across all age groups and strategize local policies targeting older groups of the OA community to control ongoing transmission and reduce the STH burden and protect the future well-being of OA children, who deserve a healthier future.

Deep-amplicon sequencing of the complete beta-tubulin gene in Trichuris trichiura before and after albendazole treatment

Concerns about the emergence of benzimidazole resistance in soil-transmitted helminths (STH) infections, particularly against Trichuris trichiura, have arisen. Previous studies of veterinary nematodes have linked benzimidazole resistance to single-nucleotide polymorphisms (SNPs) at three specific codons in the beta-tubulin gene, but similar associations in STH have not been consistently observed. In this work, we screened the complete beta-tubulin gene previously linked to benzimidazole resistance in T. trichiura by deep-amplicon sequencing to identify genetic variants and associate levels of diversity with drug response to albendazole. We used 99 DNA samples extracted from T. trichiura pooled eggs, previously semi-purified from human stool samples collected in Manhiça district, Mozambique. We obtained a set of 39 amplicons of the complete gene by subjecting the pooled eggs to long-read PCR and subsequently sequencing them. Of those amplicons, 22 and 17 were obtained from stool samples collected before, and 21 days after albendazole treatment, respectively. We observed genetic variation across the whole gene sequence, in both exons and introns; however, none were associated with the previously proposed resistance-associated SNPs, and none were predicted to significantly affect protein function. No significant differences in genetic diversity were observed between pre- and post-treatment samples. Using publicly available genome-wide data, we also analysed a second beta-tubulin isotype in the T. trichiura genome. We focused on detecting the canonical SNPs and assessing for signatures of genetic selection around this second isotype gene. This analysis did not reveal evidence supporting this second isotype's role in anthelmintic resistance. Despite the limitations of our study, such as a small sample size, particularly paired pre- and post-treatment samples (n=6), or a restricted geographical area, we found no evidence linking either of the two beta-tubulin genes to benzimidazole resistance in T. trichiura, suggesting that genetic markers of drug resistance likely exist outside the beta-tubulin genes.

Can Benzimidazole Resistance Undermine the Philippines’ Success in Controlling and Eliminating Soil-Transmitted Helminth Infections? A Mini-Review

Abstract Soil-transmitted helminth (STH) infections remain a significant global health burden, affecting over 1.5 billion people worldwide. In the Philippines, STH infections continue to be prevalent, despite ongoing control efforts. The Integrated Helminth Control Program (IHCP), whose cornerstone is mass drug administration (MDA) with benzimidazole drugs, has shown some success in reducing STH prevalence in the country. However, the persistence of infection prevalence being above the national and global targets and the potential for benzimidazole resistance have raised concerns about the long-term sustainability of current control strategies. This review examines the development of benzimidazole resistance in STH, focusing on the role of single nucleotide polymorphisms (SNPs) in the β-tubulin isotype that alter the protein’s amino acid constitution, thereby negatively affecting benzimidazole drug binding efficiency. This review discusses the epidemiology of STH infections in the Philippines, the implementation of IHCP and the potential challenges posed by benzimidazole resistance. This review highlights the need for further research to assess the occurrence of benzimidazole resistance in Philippine STH populations and to explore alternative control strategies. Understanding the mechanisms of benzimidazole resistance and developing effective countermeasures is crucial for achieving sustainable STH control and elimination in the Philippines.

Gut-microbiome profiles among Soil-transmitted helminths (STHs) infected Ethiopian children enrolled in the school-based mass deworming program.

Soil-transmitted helminths (STHs) and mutualistic gut microbes coexist in the gastrointestinal tract. However, limited data exist regarding how STH infections are associated with gut microbiome profiles. We conducted a cross-sectional analysis of baseline data collected in a longitudinal study to identify and explain differences in microbial communities between STH-infected and non-infected Ethiopian school children. We collected 138 stool samples and analyzed them for STH infection using standard direct wet mount and Kato Katz methods. The gut microbiome profiles were characterized using targeted amplicon sequencing of the 16S rRNA gene from the total DNA extracted from the stools. Children infected with Trichuris trichiura showed significantly lower microbial diversity than those who were non-infected (p<0.05). We also observed significant difference in microbiome composition based on Trichuris trichiura infection status (PERMANOVA p< 0.01). A comparison of microbial taxa at the genus level among participants infected with different helminth species showed a significant increase in Agathobacter relative abundance among children infected with Trichuris trichiura compared to non-infected subjects (adjusted p = 0.001). Our results indicate that changes in the gut microbiome composition may vary depending on the species of helminth present. Further studies should investigate how Trichuris trichiura selectively alters microbiome composition compared to other STH species.

Contribution of socio-demographic factors in prevalence of soil-transmitted helminth infections among newly arrived laborers in Jeddah, Saudi Arabia.

Soil-transmitted diseases are caused by intestinal worms transmitted via various routes into the human body resulting in various clinical manifestations. This study aimed to investigate the socio-demographic factors contributing mainly to the prevalence of soil-transmitted helminths (STHs) among newly arrived laborers in Jeddah, Saudi Arabia. A total of 188 stool specimens were collected and examined macroscopically and microscopically using different techniques. In addition, real-time PCR was used as a molecular tool to detect several STHs. The descriptive analysis was used to evaluate demographic data and categorical variables in association with STHs infection. Of all participants, the mean age was 26.08±2.67 years, including 103 females and 85 males. A total of 86 (45.70%) were illiterate, followed by 60 (31.90%) of participants belonging to elementary level. STHs and other intestinal parasites were detected among 35 newly arrived laborers (18.61%). Nineteen cases (10.11%) were infected with STHs, including 15 cases with one STHs (four A. lumbricoides, four N. americanus, four T. trichiura, two S. stercoralis, one A. duodenale) and four cases with two STHs (two T. trichiura and N. americanus; one S. stercoralis and A. duodenale; one T. trichiura and S. stercoralis). High rates of STHs infection were detected among drivers (11.70%) followed by housemaids (11.20%), but with no significant association to occupation. Higher rates of STHs infection were detected among those used to walk on soil barefoot in their home countries before arriving in Jeddah. This study found that none of the newly arrived expatriate laborers in Jeddah was aware of STHs. About 10% of them had infection with one or two STHs, mainly among newly arrived laborers from Asian countries. There is a need for awareness programs and regular screening for STHs and other intestinal parasites among newly arrived expatriate laborers.

Low prevalence of soil transmitted helminth infection in Ugandan children hospitalized with severe malaria.

Co-infection by intestinal helminths and Plasmodium spp. may be common in endemic communities. Several studies have identified a relationship between helminth infection, Plasmodium spp. infection and malaria severity. However, the relationship is not well defined, and results are inconclusive. We analyzed 202 stool samples from a cohort of children with severe malaria enrolled in two hospitals in Uganda from 2014-2017 and asymptomatic community children from the same household or neighborhood and enrolled at the same time, all 6 months to 48 months of age. We investigated if intestinal helminth infection modified risk of severe malaria. We extracted nucleic acids from stool and tested them for six helminth species ( Anyclostoma duodenale, Ascaris lumbricoides, Necator americanus, Strongyloides stercolaris, Trichuris trichiura, Shistosoma mansoni ) using highly sensitive quantitative PCR. We found a low prevalence of infection by ≥1 intestinal helminth species in children with severe malaria (5.1%, n=9/177) and community control children (4.0%, n=1/25). Infection by ≥1 of the helminths assessed was not associated with severe malaria (aRR = 1.0, 95% Confidence Interval = 0.82, 1.3, p = 0.78). In 2003 Uganda instituted a national deworming program, with anti-helminth medication provided twice annually to children 6 months to 5 years of age. In these areas of Uganda, the national deworming campaign has been highly successful, as stool-based helminth infection was rare even when using highly sensitive methods of detection and was not a major contributor to risk of severe malaria.

The Recombinase Polymerase Amplification Test for Strongyloides stercoralis Is More Sensitive than Microscopy and Real-Time PCR in High-Risk Communities of Cusco, Peru.

Strongyloidiasis is a neglected, soil-transmitted helminth infection prevalent worldwide. The true burden of strongyloidiasis is unclear due to the lack of sensitive, field-friendly diagnostic tests. PCR tests to detect Strongyloides DNA in stool are sensitive and specific, but the need for expensive equipment limits their use in endemic regions. Isothermal PCR amplification tests are easier to deploy while maintaining sensitivity and specificity. We developed and evaluated a recombinase polymerase amplification lateral flow assay (RPA-LFA) to detect Strongyloides stercoralis in human stool samples. Three hundred stool samples were collected in three communities in the jungle of Cusco, Peru. Samples were tested for S. stercoralis larvae using microscopy (Baermann's, agar plate culture (APC), and rapid sedimentation), real-time PCR, and RPA-LF for Strongyloides DNA. The RPA-LFA showed an analytical limit of detection of 20 pg/µL. The prevalence of S. stercoralis was 27%, 38%, 46.3%, and 46% using microscopy, PCR, microscopy/PCR, and RPA-LFA, respectively. RPA-LFA had a sensitivity and specificity of 59.3% and 58.9%, 66.2% and 71.4%, and 77.2% and 73.1% when microscopy, microscopy/PCR, and real-time PCR were used as the gold standards, respectively. The Strongyloides RPA-LFA is a novel, fast, highly sensitive, and specific molecular method with the potential for deployment in endemic regions.

Systematic review and meta-analysis protocol: Diagnostic accuracy assessment for soil-transmitted helminth using microscopy and molecular-based methods

Soil-transmitted helminth (STH) is a part of NTDs that remains to be eliminated because of its significant global impact. Diagnostics are essential in aiding the elimination of STH infection. Therefore, it is imperative to evaluate the progress of diagnostic techniques, especially molecular-based techniques. Nevertheless, there is currently no comprehensive systematic review and meta-analysis (SRMA) evaluating the performance of molecular-based techniques for diagnosing STH. This protocol, registered on PROSPERO (CRD42024563432), intends to assess the diagnostic accuracy of molecular-based techniques compared to microscopic-based techniques for four common STH infections (A. lumbricoides, T. trichiura, hookworms, and S. stercoralis) across global studies. Two authors will independently conduct the screening, study selection, data extraction, and quality assessment of this SRMA. The obtained studies will be assessed using QUADAS-2 and will be analyzed for publication bias and diagnostic accuracy, including sensitivity, specificity, NPV, PPV, and DOR, and SROC. This developed protocol is expected to be versatile enough to be implemented in the range of studies assessing the diagnostic accuracy of the advance compared to the convention methods with adjustments. The findings of this SRMA are expected to provide a valuable contribution towards achieving the goal of eradicating STH infection by 2030.

Unveiling soil-transmitted helminth infections and associated risk factors in rural primary schoolchildren in Malaysia.

Soil-transmitted helminths (STHs) are known as one of the neglected parasitic diseases, leading to significant health issues and associated complications. This study aims to assess the current prevalence of STH infections and the associated risk factors among rural primary schoolchildren in Malaysia. A cross-sectional study was conducted among 638 schoolchildren (7-11 years old) from 10 rural primary schools in five regions of Malaysia. The overall prevalence of STH infections among schoolchildren was 54.5%, with T. trichiura being the predominant STH species (50.9%), followed by A. lumbricoides (19.6%) and hookworms (7.4%). The highest prevalence of STH infections was recorded in the schools in Perak (96.6%), followed by Pahang (85.4%), Johor (42.1%) and Sabah (6.2%). At the same time, none of the schoolchildren in Sarawak were infected with STHs. The findings also highlighted that the older age group (10-11 years old) exhibited a higher prevalence of STH infection and T. trichiura compared to those aged 7-9 years old (P = 0.01) among the schools with a high prevalence of STH infections (>= 70%). Several variables, such as being female (1.9 [1.2, 3.0]) (Adjusted odd ratio [95% confidence interval]), low household income (30.9 [7.0, 136.5]), using untreated water supply (1.9 [1.1, 3.2]), indiscriminate defaecation (1.9 [1.1, 3.1]), indiscriminate garbage disposal (2.8 [1.3, 6.0]), eating with hands (5.9 [3.4, 10.4]) and experiencing pallor signs (2.3 [1.1, 5.0]), emerged as significant predictors of STH infections in this study population. The present study underscores that in specific rural community areas of Malaysia, STH infections continue to pose health concerns among primary schoolchildren. Hence, to ensure the sustained effectiveness of the measures taken to control STH infections, a collaborative and ongoing effort between various stakeholders is imperative to provide targeted support to rural communities, especially those in areas lacking essential amenities and healthcare services.

Persistent transmission of soil-transmitted helminths despite 16 years of uninterrupted Mebendazole- and ivermectin-based preventive chemotherapy in the Lomie Health District (East Region, Cameroon): The emergency of complementary control strategies.

The control of the Soil-Transmitted Helminths (STH) infections primarily relies on the school-based Preventive Chemotherapy (PCT) with mebendazole. Given the efficacy of ivermectin on STH, the control of the latter is expected to be potentialized in areas where ivermectin is also distributed for onchocerciasis and/or lymphatic filariasis control/elimination. This study aimed to assess the prevalence and intensity of STH in the Lomie Health District where annual school-based deworming campaigns and community-directed treatments with Ivermectin have been underway for almost two decades. A quantitative cross-sectional study was conducted in 10 schools of the Lomie Health District, East Region, Cameroon. Stool samples were collected from school-aged children and analysed using the Kato-Katz technique. Semi-structured questionnaires were administered to enrolees to assess compliance with water, sanitation, and hygiene (WASH). Of the 491 children (median age: 9 years; IQR: 7-10) enrolled, 83.9% (95% CI: 80.3-87.1) were infected with at least one STH species. Trichuris trichiura was the predominant species (78.5%), and no hookworm was found. The prevalence trend slightly decreased between 1987 and 2010 (~8%) and remained unchanged since 2010 (p-value = 0.05). Overall, 46.8% and 41.8% of children were heavy-to-moderately infected with Ascaris lumbricoides and T. trichiura. Poor hand hygiene (OR: 2.24, 95% IC: 1.4-3.4, p-value = 0.0002) and the use of river as a source of drinking water (OR: 14.8, 95% IC: 6.9-33.3, p-value = 0.0001) were the main risk factors associated with the STH infection in Lomie Health District. The persistent high prevalence and intensity of STH infection despite 16 years of mebendazole-based PCT and expected collateral impact of ivermectin mass distribution, points to plausible implementation gaps, poor compliance to WASH or sub-optimal efficacy of the anthelminthics used. This study highlights the need to further assess the cause of the persistent high prevalence and implement context-adapted control measures in order to curb STH transmission.

Efficacy of albendazole against soil-transmitted helminth infections in Ethiopia: a systematic review and meta-analysis

Soil-transmitted helminths (STH) are neglected parasites more prevalent in the tropics. Periodic mass distribution of albendazole, is one key strategy to control STHI in endemic areas. However, benzimidazoles have low efficacy against STHI, and there is a lack of information on the magnitude of the problem in Ethiopia. Articles were searched from PubMed using MeSH words, Google Scholar, Web of science, EMBASE and Scopus database to retrieve the data published and available until December 30, 2022. Totally, 107 published articles were retrieved. Only studies conducted in English that reported the efficacy of albendazole against STHI in any year and studies with more than fifty positive cases were included in the present study. The efficacy of albendazole was estimated by its cure rate and egg reduction rate. Excel software was used to extract the name of the authors, the total sample size, number of cured participants, treatment assessment time, STH parasite involved, the study area, and the year of publication. The pooled efficacy of albendazole against STHs was analyzed using comprehensive meta-analysis version 2.2 software. A total of 14 studies (13 for hookworm, 12 for Ascaris lumbricoides, and 12 for Trichuris trichiura) fulfilled the inclusion criteria for the present systematic review and meta-analysis. The total positives for hookworm, A. lumbricoides, and T. trichiura were 1253 (24.9%), 1570 (29.5%), and 1647 (30.6%), respectively. The overall pooled efficacy of albendazole was 92.2% (95% CI 86.2–98.9%) against hookworm, 97.7% (95% CI 96.3–98.6%) against A. lumbricoides, and 38.6% (95% CI 31.0–46.9%) against T. trichiura. In subgroup analysis, the efficacy of albendazole against hookworm was 93.4% (95% CI 85.1–97.2%) in Oromia, 96.7% (95% CI 93.8–98.2%) in Sidama, and 77.2% (95% CI 64.4–86.4%) in Amhara region. Its heterogeneity was high (I2 = 89.418). The efficacy of albendazole against A. lumbricoides was 98.3% (95% CI 97.0–99.0%) in Oromia and 96.63% (95% CI 93.2–98.3%) in Sidama region. Its heterogeneity was moderate (I2 = 41.5%). Albendazole efficacy against T. trichiura was 39.0% (95% CI 30.4–48.5%) in Oromia and 37.8% (95% CI 21.8–56.9%) in Sidama region with high heterogeneity (I2 = 90.6%). In the present review, albendazole is effective against hookworm and A. lumbricoides but less effective against T. trichiura. Albendazole should therefore be used as a treatment option in hookworm and A. lumbricoides endemic areas. However, alternative drugs should be sought for T. trichiura.

Communities’ knowledge, perceptions and preventive practices on soil-transmitted helminthes in Jimma, Oromia, Ethiopia: Formative mixed study

Background Soil-transmitted helminthes (STH) infections are one of the most common neglected tropical diseases. It has become one of a significant public health problem programmatically aimed for prevention and control in Ethiopia. Limited evidence is available on communities’ knowledge, perceptions, and practices regarding STH particularly in rural settings of Jimma, Ethiopia. Methods A community-based cross-sectional study triangulated with the qualitative method was conducted. The survey included 732 sampled rural households. Linear regression was used to assess association between predictors of knowledge and preventive practices of STH; likewise logistic regression was used to identify the predictors of hand washing practice at critical times. Kruskal-Wallis and Mann-Whitney tests were done to test differences in median risk perception score by socio-demographic factors. Qualitative data were collected through 7 key informant interviews, 6 focus group discussions and 7 expert group discussions then transcribed verbatim. Then, the data were coded, categorized and thematized using the Atlas ti.7.1.4 software package. Results Almost all of the respondents (99.6%) had heard of STH. The prevalence of comprehensive knowledge, risk perception and preventive practices towards STH were 46.7%:(95%CI:43.2, 50.4), 55.2%: (95%CI:51.2,59) and 44.4%:(95%CI:40.8, 48.2) respectively. Likewise, the magnitude of knowledge and practice of hand washing at critical times were 42.5%: (95%CI: 38.7,45.9) and 43.9%: (95%CI: 40, 47.5) respectively. Risk perception and comprehensive knowledge towards STH varied significantly across districts and by respondents’ educational status. Ownership of improved latrine was associated to comprehensive knowledge of STH. The STH preventive practice that varied across districts was predicted by the overall and knowledge specific to washing hands at critical times. The practice of washing hands at critical times was significantly associated to knowledge of hand washing, owning improved latrine, and age from 15 to 34 year compared to &gt;45 year. Moreover, qualitative findings were supportive of the findings. Conclusion Despite reported exposures to STH communication opportunities, the study found modest levels of knowledge, perceptions, and preventive practices related to STH among rural communities where the burden of STH was the programmatic concern. These levels of knowledge, perceptions, and practices varied across the districts. Educational and latrine status predicted overall knowledge, whereas knowledge specific to hand washing and overall knowledge were predictors of STH preventive practice. Furthermore, washing hands during critical times was moderately improved among the young-aged, ownership of improved latrine and knowledgeable on hand washing. This study underscores the need for locally tailored and contextualized community behavioral change interventions needs to be strengthened toward improved STH preventive practices.

Socio-economic risk factors for intestinal helminthiases in selected endemic communities in Mindanao, the Philippines: a cross-sectional study

Abstract Background Parasitic neglected tropical diseases (NTDs) or ‘infectious diseases of poverty’ continue to affect the poorest communities in the world, including in the Philippines. Socio-economic conditions contribute to persisting endemicity of these infectious diseases. As such, examining these underlying factors may help identify gaps in implementation of control programs. This study aimed to determine the prevalence of schistosomiasis and soil-transmitted helminthiasis (STH) and investigate the role of socio-economic and risk factors in the persistence of these diseases in endemic communities in the Philippines. Methods This cross-sectional study involving a total of 1,152 individuals from 386 randomly-selected households was conducted in eight municipalities in Mindanao, the Philippines. Participants were asked to submit fecal samples which were processed using the Kato-Katz technique to check for intestinal helminthiases. Moreover, each household head participated in a questionnaire survey investigating household conditions and knowledge, attitude, and practices related to intestinal helminthiases. Associations between questionnaire responses and intestinal helminth infection were assessed. Results Results demonstrated an overall schistosomiasis prevalence of 5.7% and soil-transmitted helminthiasis prevalence of 18.8% in the study population. Further, the household questionnaire revealed high awareness of intestinal helminthiases, but lower understanding of routes of transmission. Potentially risky behaviors such as walking outside barefoot and bathing in rivers were common. There was a strong association between municipality and prevalence of helminth infection. Educational attainment and higher “practice” scores (relating to practices which are effective in controlling intestinal helminths) were inversely associated with soil-transmitted helminth infection. Conclusion Results of the study showed remaining high endemicity of intestinal helminthiases in the area despite ongoing control programs. Poor socio-economic conditions and low awareness about how intestinal helminthiases are transmitted may be among the factors hindering success of intestinal helminth control programs in the provinces of Agusan del Sur and Surigao del Norte. Addressing these sustainability gaps could contribute to the success of alleviating the burden of intestinal helminthiases in endemic areas.

Baseline gut microbiota diversity and composition and albendazole efficacy in hookworm-infected individuals

Soil-transmitted helminth (STH) infections account for a significant global health burden, necessitating mass drug administration with benzimidazole-class anthelmintics, such as albendazole (ALB), for morbidity control. However, ALB efficacy shows substantial variability, presenting challenges for achieving consistent treatment outcomes. We have explored the potential impact of the baseline gut microbiota on ALB efficacy in hookworm-infected individuals through microbiota profiling and machine learning (ML) techniques. Our investigation included 89 stool samples collected from hookworm-infected individuals that were analyzed by microscopy and quantitative PCR (qPCR). Of these, 44 were negative by microscopy for STH infection using the Kato-Katz method and qPCR 21 days after treatment, which entails a cure rate of 49.4%. Microbiota characterization was based on amplicon sequencing of the V3–V4 16S ribosomal RNA gene region. Alpha and beta diversity analyses revealed no significant differences between participants who were cured and those who were not cured, suggesting that baseline microbiota diversity does not influence ALB treatment outcomes. Furthermore, differential abundance analysis at the phylum, family and genus levels yielded no statistically significant associations between bacterial communities and ALB efficacy. Utilizing supervised ML models failed to predict treatment response accurately. Our investigation did not provide conclusive insights into the relationship between gut microbiota and ALB efficacy. However, the results highlight the need for future research to incorporate longitudinal studies that monitor changes in the gut microbiota related to the infection and the cure with ALB, as well as functional metagenomics to better understand the interaction of the microbiome with the drug, and its role, if there is any, in modulating anthelmintic treatment outcomes in STH infections. Interdisciplinary approaches integrating microbiology, pharmacology, genetics and data science will be pivotal in advancing our understanding of STH infections and optimizing treatment strategies globally.Graphical

The Assessment of Teaching Programme Regarding Prevention and Management of Helminthic Infections among School Children in Selected Schools of Alappuzha District

Background: Intestinal worm infestation is a global health problem. Soil-transmitted helminth (STH) infections form the most important group of intestinal worms affecting two billion people worldwide, causing considerable morbidity and suffering, though entirely preventable. Worm infestation is the common but neglected problem especially among school children especially between the age group of 5to 14 years. The poor standard of living includes improper disposal of faecal and other wastes, overcrowding, unhygienic health practices and poor environmental sanitation are the reasons for the worm infestation among the children. Objectives: To evaluate the impact of teaching programme regarding prevention and management of worm infestation among school children in selected schools of Alappuzha District. Materials and Methods: The research method adopted for this study was a quantitative research approach with an experimental research design. The sample consists of 75 school children of age 10 to 12 years. Systematic random sample and convenient sampling technique were adapted to choose the students. The knowledge about worm infestation was assessed through pre-test and after providing the health education the Post-test was done using the same questionnaire for the same participants convenient sampling technique. Results: The study revealed that majority of the children, 35 (46%) had average knowledge, 10 (14%) had good knowledge and 30(40%) had below average knowledge scores in pre-test, whereas in the post test 42samples (56%) had good knowledge, 30(40%) had average knowledge scores and only 3(4%) had below average knowledge. The t-value was computed to find the significant difference in the mean pre-test and Post-test knowledge scores was found to be significant (t= 10.44, P&lt;0.05). Conclusion: The findings showed that school children had significantly gained the knowledge in the post test which implies that the structured teaching programme was effective in improving the knowledge of the subjects.

Associations between Knowledge, Attitude and Behavior with Helminthiasis in Children

Soil-transmitted helminths (STH) infection is currently one of the highest prevalence neglected tropical diseases in children. Factors contributing to such case are children’s hygiene, as well as the existence of helminths in the surrounding soil. A child’s education has large influence on their behavior and attitude towards hygiene. However, previous studies showed varying results on wether hygiene affects the rate of STH infection. Therefore, this research is done to determine whether there is significant association between hygiene and STH infection in children. This observational analysis with a cross-sectional design was conducted on elementary school children by interviewing the children and obtaining fecal samples. Analysis of 197 fecal samples shows that 14.7% of the children were infected with STH and results of the interview show more children had poor knowledge about STH infection (69%). Good hygiene attitude and behavior were found in the majority of the subjects (58.9% and 81.7% respectively). The chi-square analysis performed shows no significant relation between knowledge (p=0.626), attitude (p=0.975), and behavior (p=0.376) and the incidence of STH infection. In this study, although children demonstrated poor knowledge of STH infection but had good hygiene attitudes and behaviors, there was no significant link between these factors and STH infection. This emphasizes the need for ongoing hygiene education in elementary school children.

Correlating Cases of Soil-Transmitted Helminths and Remote Sensing Covariates: A Case Study Utilizing 2015, 2017, and 2019 Metadata of Camarines Sur, Philippines.

Soil-transmitted helminth (STH) is a group of helminths that are considered to be neglected tropical diseases (NTDs) and, globally, affect more than 1.5 to 2.6 million people yearly. Depending on the species, they can be acquired by ingesting embryonated eggs from contaminated matter or by skin penetration. Most species of STH are found in the tropics, such as the Philippines. Despite the Mass Drug Administration (MDA), the cases of STH infection continue to rise in the country. Surveys from the Research Institute of Tropical Medicine (RITM) indicate that a high prevalence of STH (Ascaris lumbricoides, Trichuris trichiura, and Necator americanus) was primarily observed in the provinces of the country, such as in Camarines Sur. To correlate remote sensing covariates such as Normalized Difference Vegetation Index (NDVI) and Normalized Difference Built-up Index (NDBI) - to STH-infected cases of the 37 municipalities of Camarines Sur. The available public health record of STH cases from 2015 to 2019 were calculated using the Quantum Geographic Information System (QGIS)and correlated using Pearson Correlation Coefficient. The results showed that infection was higher in children than adults, and A. lumbricoides caused 60% of infection. No correlation of indices with infection cases during 2015 and 2017 was observed; however, 2019 showed a moderate strength (p = 0.037) in correlation. This indicates that infection relied not mainly on vegetation and urbanization but on additional environmental factors and non-environmental variables.

The concentration McMaster method for diagnosis of patent Ascaris and Trichuris infections in humans

In tropical and subtropical regions, soil-transmitted helminth (STH) infections such as Ascaris lumbricoides, Trichuris trichiura, and hookworms have a significant impact on public health. Globally, A. lumbricoides infects approximately 0.8 billion people, while T. trichiura infects around 500 million. This study involved a comparison of three diagnostic methods, Kato-Katz and two flotation methods (concentration McMaster, and simple McMaster), for the detection of Ascaris and Trichuris in human faeces. We conducted a comparison of the number of eggs in faeces (or faecal egg counts (FECs)) obtained with these methods using freshly collected samples that were positive for T. trichiura and spiked with a known quantity of Ascaris sp. eggs. Additionally, for the concentration McMaster method we assessed FECs after storing the samples at 5 °C for up to 21 days. The concentration McMaster method demonstrated superiority over the simple McMaster method in terms of higher detection levels for both helminths, while the Kato-Katz method yielded FEC values very close to the ’true’ spiking values. Importantly, the concentration McMaster method was considerably easier to read compared with the Kato-Katz method, and it allowed for sample storage at 5 °C for up to 14 days without affecting FEC results. Consequently, we conclude that the concentration McMaster method is an effective and user-friendly alternative for diagnosis of Ascaris and Trichuris infections in humans. Furthermore, it offers the advantage of sample storage before analysis, enhancing flexibility in the workflow.