Soil-transmitted Helminth Infection In Children Research Articles

Surveillance of Soil-Transmitted Helminth Infection in Preschool Child Population: Do Changes in Behavior and Immunological Responses Affect Prevalence?

Soil-transmitted helminths (STHs) persist as a significant global public health issue among neglected tropical diseases (NTDs), particularly in children. STH infection can induce immune responses that affect the course of the disease; if treatment fails, chronic infection can lead to stunting, especially among children aged 24-59 months, which is a vulnerable period for growth and development. We conducted a correlational, cross-sectional data collection study to evaluate the characteristics and association of 25(OH)D, interleukin-5 (IL-5), and interleukin-13 (IL-13) with the prevalence of STH infection in children aged 24-59 months in Bandung District, Indonesia, in October 2019-January 2023. We recruited 694 subjects (401 stunted and 293 normal-height children). The prevalence of STH infection among the stunted and normal-height groups was 5.7% (95% CI: 3.85-8.46%) and 3.4% (95% CI; 1.86-6.17%) (p = 0.156), respectively. The probability of the prevalence of STH infection in children with levels of 25(OH)D, IL-5, and IL-13 below the cut-off point was 6,93 to 16.71 times higher. We found a relationship between IL-5, IL-13, and environmental factors and the prevalence of STH infection in stunted children.

Soil-transmitted helminthes infection and related factors among primary school students at Ea Po commune, Cu Jut district, Dak Nong province

Background: Soil-transmitted helminth infection is a common and a significant health problem in poor and developing countries. Children are the most commonly infected with soil-transmitted helminths. Objectives: To determine the proportion of soil-transmitted helminth and related factors to soil-transmitted helminth infection in primary school students in Ea Po commune, Cu Jut district, Dak Nong province, in 2021. Material and methods: A cross-sectional study was caried out on 440 primary school students attending two primary schools. Participants were interviewed and collected the fecal to detect soil-transmitted helminths by the Kato technique. Results: The prevalence of soil-transmitted helminth infection among primary school students was 17.5%. Ethnicity, hand washing before eating, barefoot walking, and toilet were related factors to soil-transmitted helminth infection. Conclusion: These results reinforce the need to take more effective actions to address soil-transmitted helminth infection in children. Key words: prevalence, related factors, soil-transmitted helminths.

Stunting as a Risk Factor of Soil-Transmitted Helminthiasis in Children: A Literature Review.

As a high-burden neglected tropical disease, soil-transmitted helminth (STH) infections remain a major problem in the world, especially among children under five years of age. Since young children are at high risk of being infected, STH infection can have a long-term negative impact on their life, including impaired growth and development. Stunting, a form of malnutrition in young children, has been long assumed as one of the risk factors in acquiring the STH infections. However, the studies on STH infection in children under five with stunting have been lacking, resulting in poor identification of the risk. Accordingly, we collected and reviewed existing related research articles to provide an overview of STH infection in a susceptible population of stunted children under five years of age in terms of prevalence and risk factors. There were 17 studies included in this review related to infection with Ascaris lumbricoides, Trichuris trichiura, hookworm, and Strongyloides stercoralis from various countries. The prevalence of STH infection in stunted children ranged from 12.5% to 56.5%. Increased inflammatory markers and intestinal microbiota dysbiosis might have increased the intensity of STH infection in stunted children that caused impairment in the immune system. While the age from 2 to 5 years along with poor hygiene and sanitation has shown to be the most common risk factors of STH infections in stunted children; currently there are no studies that show direct results of stunting as a risk factor for STH infection. While stunting itself may affect the pathogenesis of STH infection, further research on stunting as a risk factor for STH infection is encouraged.

The epidemiology of soil-transmitted helminth infections in children up to 8 years of age: Findings from an Ecuadorian birth cohort.

There are few prospective longitudinal studies of soil-transmitted helminth (STH) infections during early childhood. We studied the epidemiology of and risk factors for soil-transmitted helminth infections from birth to 8 years of age in tropical Ecuador. 2,404 newborns were followed to 8 years of age with periodic stool sample collections. Stool samples were collected also from household members at the time of the child's birth and examined by microscopy. Data on social, environmental, and demographic characteristics were collected by maternal questionnaire. Associations between potential risk factors and STH infections were estimated using generalized estimated equations applied to longitudinal binary outcomes for presence or absence of infections at collection times. Of 2,404 children, 1,120 (46.6%) were infected with at least one STH infection during the first 8 years of life. The risk of A. lumbricoides (16.2%) was greatest at 3 years, while risks of any STH (25.1%) and T. trichiura (16.5%) peaked at 5 years. Factors significantly associated with any STH infection in multivariable analyses included age, day-care (OR 1.34, 95% CI 1.03-1.73), maternal Afro-Ecuadorian ethnicity (non-Afro vs. Afro, OR 0.55, 95% CI 0.43-0.70) and lower educational level (secondary vs. illiterate, OR 0.31, 95% CI 0.22-0.45)), household overcrowding (OR 1.53, 95% CI 1.21-1.94)), having a latrine rather than a water closet (WC vs. latrine, OR 0.77, 95% CI 0.62-0.95)), and STH infections among household members (OR 2.03, 95% CI 1.59-2.58)). T. trichiura was more associated with poverty (high vs. low socioeconomic status, OR, 0.63, 95% CI 0.40-0.99)] and presence of infected siblings in the household (OR 3.42, 95% CI 2.24-5.22). STH infections, principally with A. lumbricoides and T. trichiura, peaked between 3 and 5 years in this cohort of children in tropical Ecuador. STH infections among household members were an important determinant of infection risk and could be targeted for control and elimination strategies.

Prevalence and intensity of soil-transmitted helminth infections of children in sub-Saharan Africa, 2000–18: a geospatial analysis

SummaryBackgroundDriven by global targets to eliminate soil-transmitted helminths as a public health problem, governments have rapidly rolled out control programmes using school and community-based platforms. To justify and target ongoing investment, quantification of impact and identification of remaining high-risk areas are needed. We aimed to assess regional progress towards these targets.MethodsWe did a continental-scale ecological analysis using a Bayesian space–time hierarchical model to estimate the effects of known environmental, socioeconomic, and control-related factors on the prevalence of soil-transmitted helminths, and we mapped the probability that implementation units had achieved moderate-to-heavy intensity infection prevalence of less than 2% among children aged 5–14 years between Jan 1, 2000, and Dec 31, 2018.FindingsWe incorporated data from 26 304 georeferenced surveys, spanning 3096 (60%) of the 5183 programmatic implementation units. Our findings suggest a reduction in the prevalence of soil-transmitted helminths in children aged 5–14 years in sub-Saharan Africa, from 44% in 2000 to 13% in 2018, driven by sustained delivery of preventive chemotherapy, improved sanitation, and economic development. Nevertheless, 1301 (25%) of 5183 implementation units still had an estimated prevalence of moderate-to-heavy intensity infection exceeding the 2% target threshold in 2018, largely concentrated in nine countries (in 1026 [79%] of 1301 implementation units): Nigeria, Democratic Republic of the Congo, Ethiopia, Cameroon, Angola, Mozambique, Madagascar, Equatorial Guinea, and Gabon.InterpretationOur estimates highlight the areas to target and strengthen interventions, and the areas where data gaps remain. If elimination of soil-transmitted helminths as a public health problem is to be achieved in sub-Saharan Africa by 2030, continued investment in treatment and prevention activities are essential to ensure that no areas are left behind.FundingBill & Melinda Gates Foundation.

Mapping Soil-Transmitted Helminth Infections of Children in Sub-Saharan Africa, 2000-2018

Background: Soil-transmitted helminths (STH) are among the most widespread neglected tropical diseases (NTDs) and infect over 1 billion people worldwide, with sub-Saharan Africa (SSA) accounting for >80% of disease burden. Driven by elimination targets, governments across SSA have rapidly rolled out control programmes using school and community based platforms. To justify and target ongoing investment in control, there is an urgent need to quantify their likely impact across SSA, and identify areas that remain at highest risk and unlikely to attain elimination thresholds. We examined the changes in STH prevalence amongst school-aged children in SSA from 2000 to 2018 at the programmatic implementation unit (IU) level to assess regional progress towards elimination. Methods: We used quantitative survey data for Africa that consisted of 23,356 georeferenced survey data points from 2000-2018, and spanning 3,011 of the 5,183 programmatic IUs within the spatial extents of STH in SSA. The data were used within a joint multivariable Bayesian space-time hierarchical framework with covariates to estimate STH prevalence and intensity at IU level from 2000 to 2018. Findings: Our findings suggest a steady decline in the prevalence of STH in SSA school-aged children, from 35% (or 74.6 million cases) in 2000 to 11% (or 33.9 million cases) in 2018, with the largest regional period decline for hookworm (23% to 5%), followed by Ascaris lumbricoides (14% to 7%) and Trichuris trichiura (5% to 2%), with convergence of hookworm and A. lumbricoides levels in 2013. By 2018, approximately 37% (1,938 of 5,183) of IU’s in SSA still had an estimated prevalence of moderate-to-heavy intensity infection exceeding the 1% target threshold, largely concentrated in five countries: Democratic Republic of Congo, Ethiopia, Nigeria, Mozambique and Cameroon. The strongest factors driving reductions in prevalence were sustained effective preventative chemotherapy treatments, followed by improved sanitation, and lastly economic development. Interpretation: Our estimates provide an important tool for identifying where to target and further strengthen interventions, and where data gaps remain. If elimination of STH as a public health problem is to be achieved in SSA by 2030, renewed and increased investment in STH treatment and prevention activities are urgently required to accelerate reductions and ensure that no areas are left behind. Funding Statement: This work was primarily supported by the grant OPP1182963 from the Bill & Melinda Gates Foundation. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Not required.

Domains of transmission and association of community, school, and household sanitation with soil-transmitted helminth infections among children in coastal Kenya.

IntroductionFew studies have simultaneously examined the role of sanitation conditions at the home, school, and community on soil-transmitted helminth (STH) infection. We examined the contribution of each domain that children inhabit (home, village, and school) to STH infection and estimated the association of STH infection with sanitation in each domain.MethodsUsing data from 4,104 children from Kwale County, Kenya, who reported attending school, we used logistic regression models with cross-classified random effects to calculate measures of general contextual effects and estimate associations of village sanitation coverage (percentage of households with reported access to sanitation), school sanitation coverage (number of usable toilets per enrolled pupil), and sanitation access at home with STH infection.FindingsWe found reported use of a sanitation facility by households was associated with reduced prevalence of hookworm infection but not with reduced prevalence of T. trichiura infection. School sanitation coverage > 3 toilets per 100 pupils was associated with lower prevalence of hookworm infection. School sanitation was not associated with T. trichiura infection. Village sanitation coverage > 81% was associated with reduced prevalence of T. trichiura infection, but no protective association was detected for hookworm infection. General contextual effects represented by residual heterogeneity between village and school domains had comparable impact upon likelihood of hookworm and T. trichiura infection as sanitation coverage in either of these domains.ConclusionFindings support the importance of providing good sanitation facilities to support mass drug administration in reducing the burden of STH infection in children.

Soil-Transmitted Helminthiasis in Children from a Rural Community Taking Part in a Periodic Deworming Program in the Peruvian Amazon.

.Children in the Peruvian Amazon Basin are at risk of soil-transmitted helminths (STH) infections. This study aimed to determine the prevalence of STH infection in children from a rural Amazonian community of Peru and to elucidate epidemiological risk factors associated with its perpetuation while on a school-based deworming program with mebendazole. Stool samples of children aged 2–14 years and their mothers were analyzed through direct smear analysis, Kato–Katz, spontaneous sedimentation in tube, Baermann’s method, and agar plate culture. A questionnaire was administered to collect epidemiological information of interest. Among 124 children, 25.8% had one or more STH. Individual prevalence rates were as follows: Ascaris lumbricoides, 16.1%; Strongyloides stercoralis, 10.5%; hookworm, 1.6%; and Trichuris trichiura, (1.6%). The prevalence of common STH (A. lumbricoides, T. trichiura, and hookworm) was higher among children aged 2–5 years than older children (31.6% versus 12.8%; P = 0.01). In terms of sanitation deficits, walking barefoot was significantly associated with STH infection (OR = 3.28; CI 95% = 1.11–12.07). Furthermore, STH-infected children more frequently had a mother who was concomitantly infected by STH than the non-STH–infected counterpart (36.4% versus 14.1%, P = 0.02). In conclusion, STH infection is highly prevalent in children from this Amazonian community despite routine deworming. Institutional health policies may include hygiene and sanitation improvements and screening/deworming of mothers to limit the dissemination of STH. Further studies are needed to address the social and epidemiological mechanics perpetuating these infections.

Prevalensi dan Tingkat Infeksi Soil Transmitted Helminths Dihubungkan dengan Golongan Usia dan Jenis Kelamin pada 5 Sekolah Dasar

<p>Soil transmitted helminths (STH) infection is an infectious disease with a high prevalence,<br />especially in developing countries. More than 1.5 billion people or 24% of the world's population are infected with STH. Indonesia is one of 11 countries in Southeast Asia which are declared as endemic for STH infection. Data on the prevalence of STH infection in children in Indonesia is still quite high, namely 60-90%. Meanwhile, infections that occur continuously will reduce the quality of human resources, especially children. This study was conducted with the aim to determine the prevalence and level of STH infection in children of primary school age, and to find out whether there is a relationship between the prevalence and rate of STH infection with age and sex. This research was conducted in 5 State Elementary Schools (SD) located in Jakarta, Bekasi and Serang (Banten) in 2016. This study used analytical cross sectional method. Samples in the form of feces of students int he 5 state elementary schools. Stool samples collected were 61 from SDN Tanah Tinggi 01 Pagi<br />Central Jakarta, 57 from SDN Pondok Bambu 04 Duren Sawit East Jakarta, 57 from SDN 02 Bantar Gebang Bekasi, 52 from SDN Cikedokan 01 Kecamatan Cikarang Barat Bekasi and 55 from SDN Cakung Serang. The samples collected had fulfilled the inclusion criteria, aged 6-12 years, had agreed and signed the informed consent sheet. Exclusion criteria included taking worm medicine 6 months earlier and not collecting feces on a predetermined day. Examination of the sample was carried out by the Kato-Katz method. The results of this study indicate that, there is only one school that is positive for helminthiasis, while 4 other schools are negative. At SDN in Serang (Banten) 9 children were found infected with STH or prevalence was 16.4% with mild intensity. The types of STH found were Ascaris lumbricoides (68.75%), Trichuris trichiura (31.25%), and no eggs from Necator americanus. The highest frequency occurs in children aged 6-8 years. There is no significant relationship between the prevalence and rate of STH infection with age and sex.</p>

Soil-transmitted helminth infections, associated factors and nutritional status in an estate community in Sri Lanka

Objectives: To determine the prevalence, intensity, and risk factors associated with soil transmitted helminth (STH) infections and to explore the association between STH infections and nutritional status of an estate community. Methods: A cross-sectional study was conducted in Hanthana Tea Estate (HTE) in Kandy, Sri Lanka, from September 2013 to November 2014. Demographic data were obtained using an interviewer-administrated structured questionnaire. Haemoglobin and serum albumin concentrations were measured in children. Faecal samples were analyzed by direct smears in saline and iodine and Kato-Katz technique using single-stool samples. Anthropometric measurements were obtained to calculate weight-for-age (WAZ), height-for-age (HAZ), and body-mass-index-for-age (BAZ) to evaluate underweight, stunting and wasting, respectively. Results: A total of 233 children (50% female, aged between 1 and 12 years, mean age 6.2±3.4) and 98 parents (93% female, aged between 20 and 52 years, mean age 33±6.2 years) participated in this study. The prevalence of STH infections in children and adults were 27.4% and 14.3% respectively. Ascaris lumbricoides was found in children and adult populations predominantly (26.6% and 14.3% respectively) followed by Trichuris trichiura (0.8% and 1%). Of the infected group, 57.8% of children and 92.8% of adults had a light infection. Moderate infection was found in 40.6% of the children, and 7.2% of the adults. Only one child had a heavy egg count (≥ 50000). The prevalence of STH infections was significantly higher among children than adults (p = 0.014). Not hand washing before a meal (p = 0.002) and after defecation (p Conclusions: Prevalence of STH infections was notably high in both children (27.4%) and their parents (14.3%), indicating a high level of morbidity among the study population. Therefore, a coordinated control and prevention programme considering the diverse socio-demographic characteristics of estate communities is needed to eliminate STH infections in the study population.

Investigating the differential impact of school and community-based integrated control programmes for soil-transmitted helminths in Timor-Leste: the (S)WASH-D for Worms pilot study protocol.

BackgroundWater, sanitation and hygiene (WASH) interventions represent an important component of soil-transmitted helminth (STH) infection control, alongside the administration of anthelmintic drugs, which are generally targeted to school-aged children. Recent modelling studies have suggested that STH control programmes should be broadened to include all age groups across the community. We describe the protocol for a pilot study investigating the impact of school-versus-community-based delivery of integrated WASH and deworming programmes on STH infections in school-aged children in Timor-Leste.MethodsThe (S)WASH-D for Worms pilot is a two-arm, non-randomised cluster intervention study. The aims are to determine feasibility and acceptability of the intervention and study procedures and to establish proof of principle for the hypothesis that STH control programmes directed to the entire community will lead to greater reductions in STH infections in children than programmes directed only to school-aged children. Of the six participating communities, three receive a school-based integrated WASH and deworming programme and three additionally receive a community-based integrated WASH and deworming programme. The primary outcomes are the proportions of eligible children who enrol in the study and participate in the data collection, and outcomes relating to WASH and deworming programme completion, coverage, and use. Secondary outcomes are the cumulative incidence and mean intensity of STH infection in school-aged children at 6-month follow-up, mean haemoglobin concentration and several anthropometric indices. Results will inform the design of a cluster-randomised controlled trial (RCT).DiscussionThis pilot study is being conducted in preparation for a cluster-RCT investigating the differential impact of school- and community-based integrated STH control programmes on STH infections in school-aged children. It aims to establish feasibility and proof of principle, while results of the subsequent RCT could have significant implications for global STH control policy.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12615001012561 Electronic supplementary materialThe online version of this article (doi:10.1186/s40814-016-0109-4) contains supplementary material, which is available to authorized users.

Modeling the economic and epidemiologic impact of hookworm vaccine and mass drug administration (MDA) in Brazil, a high transmission setting

BackgroundAlthough mass drug administration (MDA) has helped reduce morbidity attributed to soil-transmitted helminth infections in children, its limitations for hookworm infection have motivated the development of a human hookworm vaccine to both improve morbidity control and ultimately help block hookworm transmission leading to elimination. However, the potential economic and epidemiologic impact of a preventive vaccine has not been fully evaluated. MethodsWe developed a dynamic compartment model coupled to a clinical and economics outcomes model representing both the human and hookworm populations in a high transmission region of Brazil. Experiments simulated different implementation scenarios of MDA and vaccination under varying circumstances. ResultsConsidering only intervention costs, both annual MDA and vaccination were highly cost-effective (ICERs ≤$790/DALY averted) compared to no intervention, with vaccination resulting in lower incremental cost-effectiveness ratios (ICERs ≤$444/DALY averted). From the societal perspective, vaccination was economically dominant (i.e., less costly and more effective) versus annual MDA in all tested scenarios, except when vaccination was less efficacious (20% efficacy, 5 year duration) and MDA coverage was 75%. Increasing the vaccine's duration of protection and efficacy, and including a booster injection in adulthood all increased the benefits of vaccination (i.e., resulted in lower hookworm prevalence, averted more disability-adjusted life years, and saved more costs). Assuming its target product profile, a pediatric hookworm vaccine drastically decreased hookworm prevalence in children to 14.6% after 20 years, compared to 57.2% with no intervention and 54.1% with MDA. The addition of a booster in adulthood further reduced the overall prevalence from 68.0% to 36.0% and nearly eliminated hookworm infection in children. ConclusionUsing a human hookworm vaccine would be cost-effective and in many cases economically dominant, providing both health benefits and cost-savings. It could become a key technology in effecting control and elimination efforts for hookworm globally.

Current Status of Soil-Transmitted Helminths among School Children in Kakamega County, Western Kenya.

Background. School age children are at high risk of soil-transmitted helminth (STH) worldwide. In Kenya, STH infections in children remain high despite the periodic administration of anthelmintic drugs. Our study assessed the prevalence and intensity of STH in primary school-aged children in Kakamega County, western Kenya. Methodology. We carried out a cross-sectional study on a population of 731 children attending 7 primary schools in March 2014. Children aged 4–16 years were examined for STH by the quantitative Kato-Katz technique. Infection intensities were expressed as eggs per gram (epg) of faeces. Findings. Among 731 school children examined for STH, 44.05% were infected. Highest prevalence of STH was in Shitaho primary school where 107 participants were examined and 62.6% were infected with mean intensity of 11667 epg. Iyenga had the least prevalence where 101 participants were examined and 26.7% were infected with mean intensity of 11772 epg. A. lumbricoides was the most prevalent STH species with 43.5% infected, while hookworm infections were low with 1.8% infected. Conclusion. Prevalence of STHs infections in Kakamega County remains high. We recommend guidelines and other control strategies to be scaled up to break transmission cycles.

Correlation between eosinophil count and soil-transmitted helminth infection in children

ObjectiveTo assess the prevalence of soil-transmitted helminth (STH) infection and its correlation with eosinophil counts among elementary school children within the Medan Belawan District, North Sumatera Province, Indonesia. MethodsNinety-nine subjects participated in this study (ascariasis, n = 40; trichuriasis, n = 9; mixed infection, n = 50). Stool samples were examined by using the Kato-Katz method, and blood samples were examined by using peripheral blood smears. ResultsThe prevalence of STH infection in children from two elementary schools was 65.4%; the baseline prevalences of ascariasis, trichuriasis, and mixed infection were 37.1%, 21.9%, and 40.8%, respectively. The respective mean eosinophil counts among children with ascariasis, trichuriasis, and mixed infection were 7.18%, 8.11%, and 8.64% (P = 0.32), and the respective prevalences of eosinophilia were 47.5%, 77.8%, and 70% (P = 0.05). The eosinophil counts correlated significantly with the number of eggs per gram of feces; ascariasis correlated strongly (P < 0.001; r = 0.62), and trichuriasis showed correlated weakly (P = 0.04; r = 0.21) with this parameter. The mean eosinophil count correlated significantly with STH infection intensity (P < 0.001). ConclusionsEosinophil counts correlated strongly with ascariasis while weakly with trichuriasis. We determined that eosinophil count may be used as a marker of STH infection.

Patterns of soil-transmitted helminth infection and impact of four-monthly albendazole treatments in preschool children from semi-urban communities in Nigeria: a double-blind placebo-controlled randomised trial

BackgroundChildren aged between one and five years are particularly vulnerable to disease caused by soil-transmitted helminths (STH). Periodic deworming has been shown to improve growth, micronutrient status (iron and vitamin A), and motor and language development in preschool children and justifies the inclusion of this age group in deworming programmes. Our objectives were to describe the prevalence and intensity of STH infection and to investigate the effectiveness of repeated four-monthly albendazole treatments on STH infection in children aged one to four years.MethodsThe study was carried out in four semi-urban villages situated near Ile-Ife, Osun State, Nigeria. The study was a double-blind placebo-controlled randomised trial. Children aged one to four years were randomly assigned to receive either albendazole or placebo every four months for 12 months with a follow-up at 14 months.ResultsThe results presented here revealed that 50% of the preschool children in these semi-urban communities were infected by one or more helminths, the most prevalent STH being Ascaris lumbricoides (47.6%). Our study demonstrated that repeated four-monthly anthelminthic treatments with albendazole were successful in reducing prevalence and intensity of A. lumbricoides infections. At the end of the follow-up period, 12% and 43% of the children were infected with A. lumbricoides and mean epg was 117 (S.E. 50) and 1740 (S.E. 291) in the treatment and placebo groups respectively compared to 45% and 45% of the children being infected with Ascaris and mean epg being 1095 (S.E. 237) and 1126 (S.E. 182) in the treatment and placebo group respectively at baseline.ConclusionResults from this study show that the moderate prevalence and low intensity of STH infection in these preschool children necessitates systematic treatment of the children in child health programmes.Trial RegistrationCurrent controlled trials ISRCTN44215995.