Soil-transmitted Helminths Research Articles

The impact of neglected tropical diseases on women and girl refugees: A call for increased awareness and strategic intervention

As the number of forcibly displaced women and girls increases, it becomes ever important to recognize the negative health impacts of being displaced. Women and girl refugees are disproportionately affected by sexual and gender-based violence and mental health concerns. In addition to these health concerns in women, crowding and lack of clean water in refugee camps leads to the spread of infectious diseases in general. Neglected tropical diseases (NTDs) are infectious diseases of poverty found in tropical areas, and longstanding infections lead to significant morbidity. Particularly for women, these diseases can impact fertility, chronic disease in pregnancy, and social stigma. Despite being a high-risk group, there are minimal data on the impact of NTDs on the health of Women and girl refugees. Diseases such as schistosomiasis, soil-transmitted helminth infections, strongyloidiasis, and leishmaniasis have all been shown to affect Women and girl refugees, but the majority of these data describe NTDs in this population only after resettlement. Access to medical care with providers that are knowledgeable about NTDs while in situations of displacement as well as after third-country resettlement is crucial to their timely diagnosis and treatment to prevent longstanding sequalae. More studies in this at-risk population are needed to understand the extent of this issue and begin to work towards lasting, equitable healthcare.

Soil-transmitted helminths infection in pregnant women with anemia: a systematic review

Background: Soil-transmitted helminths are widespread and grow well in countries with tropical and subtropical climates. It is one of the predispositions to anemia for pregnant women during pregnancy. This condition has long-term adverse effects on mothers and their children, causing the need for serious discussion and treatment. Methods: This systematic review uses pre-existing research by collecting data from valid sources such as Pubmed, Google Scholar, and NCBI, using the inclusion and exclusion criteria that have been determined. Results: Based on the vast amount of research that has previously been conducted, it was found that there is a close relationship involving the soil-transmitted helminth infection and various types of worms infecting pregnant women, which causes anemia. Pregnant women need nutrients and increased blood volume during pregnancy. However, the infection interferes with the absorption of micronutrients in the gastrointestinal tract, resulting in impaired nutrient transport between the woman and her unborn child. Conclusion: Soil-transmitted helminth infection is a predisposing factor for anemia in pregnant women and has long-term adverse effects for both mother and child.

UJI LISIS TELUR Ascaris lumbricoides SETELAH PEMBERIAN EKSTRAK ETANOL 70% JAHE MERAH (Zingiber officinale var rubrum)

Worm infection is an environmental-based disease, can be transmitted through the soil or known as soil-transmitted helminth (STH). Infections caused by this parasite can be eradicated by administering synthetic drugs and herbal medicines. One of the plants that can be used as herbal medicine is red ginger (Zingiber officinale var rubrum). Red ginger (Zingiber officinale var rubrum) has one of the benefits, namely to treat intestinal worms. This study aimed to determine the lysis of Ascaris lumbricoides eggs after administration of 70% Ethanol Extract of Red Ginger (Zingiber officinale var rubrum). The method used in this research is a laboratory experiment. The results showed that at a concentration of 5% within 45 minutes there was no color change and there was no damage to the eggs of Ascarias lumbricoides, while at concentrations of 10% and 15% within 45 minutes it could cause changes in the color of the eggs and could lyse the eggs of Ascarias lumbricoides. Red ginger contains tannins, flavonoids, saponins and triterpenoids that are able to lyse eggs of Ascaris lumbricoides.

Assessment of cetyl-trimethyl-ammonium bromide (CTAB) based method for the extraction of soil-transmitted helminth DNAs from stools for molecular dagnostic of soil-transmitted helminthiasis

Although several protocols were developed to extract DNA for soil-transmitted helminthiasis diagnostic, amplifying these extracts remains challenging due to DNA polymerase inhibitors. This study aimed to assess a DNA extraction method for efficient detection of soil-transmitted helminth species by determining stool mass and the type of DNA polymerase that can be used for this extraction method. For this study, 141 stool samples harbouring soil-transmitted eggs and 50 samples without egg were obtained from school-aged children of Makenene in the Centre region of Cameroon. DNA was extracted from 10, 20, 40 and 80 mg of stool using commercial kit and/or cetyltrimethylammonium bromide (CTAB)-based method. The amount of stool for molecular diagnostic of soil-transmitted helminthiasis was determined by amplifying Ascaris lumbricoides DNA. The performances of three DNA polymerases and CTAB-based method were assessed by amplifying DNA of different soil-transmitted helminth species. For this study, 94 stools with A. lumbricoides eggs, 39 with Trichuris trichuria and 15 with hookworm were analyzed. DNA of A. lumbricoides, T. trichuria, Necator americanus and Ancylostoma duodenale were detected in 97.9% of extracts from stools harbouring soil-transmitted helminth eggs. Soil-transmitted helminth DNAs were significantly (X2 = 17.66; df = 3; p 〈00001) more amplified in extracts from 10 and 20 mg than those from 40 and 80 mg. The amplification rate with “Q5 high fidelity DNA polymerase” was significantly (X2 = 30.54; df = 2; p < 0.00001) higher than that of other DNA polymerases. Multiplex-PCR confirmed co-infections of A. lumbricoides with either T. trichuria or N. americanus. The extraction cost for the CTAB-based method was $1.45. This method appearedis reliable and 3 times cost effective than commercial kit. Its combination with the “Q5 high fidelity DNA polymerase” may improve soil-transmitted helminthiasis diagnostic.

The development of an artificial intelligence-based digital pathology for neglected tropical diseases: A platform specific analysis of the World Health Organization diagnostic target product profile for soil-transmitted helminthiasis

The World Health Organization (WHO) recently published target product profiles (TPPs) for neglected tropical diseases (NTDs) to inform and accelerate the development of diagnostics tools necessary to achieve targets in the decade ahead. These TPPs describe the minimal and ideal requirements for various diagnostic needs related to NTD specific use-cases. An early step towards the manufacture and implementation of new diagnostics is to critically review the TPPs and translate these into an initial design and ultimately into user requirement specifications (URS). Artificial intelligence-based digital pathology (AI-DP) may overcome critical shortcomings of current standards for most NTDs reliant on microscopy, such as poor reproducibility and error-prone manual read-out. Furthermore, a digitalised workflow can create opportunities to reduce operational costs via increased throughput and automated data capture, analysis, and reporting. Despite these promising benefits, a critical review of the NTD TPPs with consideration to an AI-DP diagnostic solution is lacking. We present a systematic analysis of one of the WHO TPPs with the aim to inform the development of a URS for an AI-DP solution for NTDs. As a case study we focused on monitoring and evaluation (M&amp;amp;E) of programs designed to control soil-transmitted helminths (STHs). To this end, we start by outlining a brief overview of diagnostic needs for STHs, after which we systematically analyse the recently published WHO TPPs, highlighting the technical considerations for an AI-DP diagnostic solution to meet the minimal requirements for this TPP. Finally, we further reflect on the feasibility of an AI-DP informing STH programs towards the WHO 2030 targets in due time.

The accuracy of nucleic acid amplification tests (NAATs) in detecting human intestinal nematode infections: A protocol for a systematic review and meta-analysis.

Human intestinal nematode infections are a global public health issue as they can result in considerable morbidity in infected individuals, mainly in developing countries. These infections continue to go undiagnosed, as they tend to be mainly endemic in resource-poor communities where there is a shortage of experienced laboratory staff and relevant diagnostic technologies. This is further exacerbated by the nature of intermittent shedding of eggs and larvae by these parasites. Diagnostic methods range from simple morphological identification to more specialised high-throughput sequencing technologies. Microscopy-based methods, although simple, are labour-intensive and considerably less sensitive than molecular methods which are rapid and have high levels of accuracy. Molecular methods use nucleic acid amplification (NAA) to amplify the deoxyribonucleic acid (DNA) or ribonucleic acid (RNA) fragments of the parasite to detect and determine its presence using different technologies (NAAT). They have increased the sensitivity of detection and quantitation of intestinal nematode infections, especially in low infection intensity settings. The absence of a gold standard test limits current diagnosis and, in turn, restricts intervention measures and effective control efforts. The objective of this review is to determine the accuracy of NAATs in detecting human intestinal nematode infections using Kato-Katz as the reference test for the most common soil-transmitted helminth (STH) infections and the scotch tape test for enterobiasis and Baermann method for strongyloidiasis. Relevant studies will be identified by searches in electronic databases. Two reviewers will independently screen the literature against eligibility criteria. The methodological quality of studies will then be appraised by two reviewers using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Discrepancies will be addressed by a third reviewer. The true positives, false positives, true negatives and false negatives of all the studies will be extracted into contingency tables. In paired forest plots, study-specific sensitivity and specificity with a 95 per cent confidence interval will be displayed. The systematic review of this protocol will report the diagnostic accuracy of currently available NAATs for the detection of human intestinal nematode infections. This will help healthcare providers and administrators determine the diagnostic method to be used in different clinical and preventive settings. Trial registration: PROSPERO registration number for this protocol is CRD42022315730.

PREVALENCE, INTENSITY AND RISK FACTORS OF SOIL TRANSMITTED HELMINTH INFECTIONS AMONG SCHOOL CHILDREN IN SUB URBAN AREAS OF OGUN STATE, NIGERIA.

The public health concern for intestinal helminths emphasizes the need for frequent assessment to reduce the burden of diseases particularly soil transmitted helminthiases in school age children. Which threaten their physical and cognitive development, educational attainment and work productivity in later life. The prevalence, intensity and associated risk factors of soil transmitted helminths (STHs) among primary school children in Sub urban area of Ogun State were investigated. Faecal samples from school children aged 5 19 years, enrolled in the study were screened for parasites’ ova/egg and larvae using formol ethyl acetate concentration technique. Out of 517 school children examined, 30.2% harboured Ascaris lumbricoides while 6.2% and 1.2% were infected with hookworm and Strongyloides stercoralis respectively. The prevalence and intensity of infection was higher in males (56.6%) than in the females (50.6%) with no significant difference (p&gt;0.05). Prevalence of infections was significantly highest (59.7%) in children aged 5 8years and lowest (40.0%) in age groups 17 19years. Single infection with Ascaris lumbricoides was significantly higher (p&lt;0.05) in age group 5 8years (36.8%) compare to the older age groups (9 12, 13 16, 17 19years) with 32.2%, 16.8% and 0.0% respectively. Co infection of Ascaris lumbricoides and hookworm was the commonest (11.6%) multiple infections observed. A significant association between prevalence of Ascaris lumbricoides and available water source, parental occupation and sites of defecation was found. The high prevalence of soil transmitted helminths among school age children in this study show the importance of government and non governmental organization intervention and the need for regular educational programme on soil transmitted helminth infections subsequent reduction of transmission risk.

A review on innovative optical devices for the diagnosis of human soil-transmitted helminthiasis and schistosomiasis: from research and development to commercialization.

Diagnosis of soil-transmitted helminth (STH) and schistosome infections relies largely on conventional microscopy which has limited sensitivity, requires highly trained personnel and is error-prone. Rapid advances in miniaturization of optical systems, sensors and processors have enhanced research and development of digital and automated microscopes suitable for the detection of these diseases in resource-limited settings. While some studies have reported proof-of-principle results, others have evaluated the performance of working prototypes in field settings. The extensive commercialization of these innovative devices has, however, not yet been achieved. This review provides an overview of recent publications (2010–2022) on innovative field applicable optical devices which can be used for the diagnosis of STH and schistosome infections. Using an adapted technology readiness level (TRL) scale taking into account the WHO target product profile (TPP) for these diseases, the developmental stages of the devices were ranked to determine the readiness for practical applications in field settings. From the reviewed 18 articles, 19 innovative optical devices were identified and ranked. Almost all of the devices (85%) were ranked with a TRL score below 8 indicating that, most of the devices are not ready for commercialization and field use. The potential limitations of these innovative devices were discussed. We believe that the outcome of this review can guide the end-to-end development of automated digital microscopes aligned with the WHO TPP for the diagnosis of STH and schistosome infections in resource-limited settings.

Prevalence, correlates of undernutrition and intestinal parasitic infection among children below 5 years living in the forest community of Ndelele, East Region of Cameroon: A cross-sectional assessment.

In low- and middle-income countries, undernutrition often co-exists with intestinal parasites, especially Soil Transmitted Helminth (STH) infections in children. The collective impact of both conditions result in undernutrition and can exacerbate the general poor health status of children. A cross-sectional survey of 422 mother-child (12-59 months old) pairs from 14 villages in the District of Ndelele, East Region of Cameroon, was carried out to assess the magnitude and correlates of undernutrition and intestinal parasites. Socio-demographic data were collected from mothers and anthropometric data were collected from children. Parasitological assessment was performed using a combination of direct microscopy flotation, sedimentation and centrifugation techniques. Correlates of undernutrition and intestinal parasites were identified using multinomial logistic regression at individual and household levels. 83.77% of the children assessed for undernutrition were undernourished and 66.82% were positive for one or more intestinal parasites. It was not uncommon for the study participants to be concurrently infected with two or more intestinal parasites. The most common intestinal parasitic infections detected in the study were A. lumbricoides, E. histolytica/dispar and Hookworm infection. Multinomial logistic regression using Nutritional status as outcome showed that, children who were not exclusively breastfed were 106% (RR = 2.06; C.I = 1.12-3.80) more likely to be underweight compared to those who were exclusively breastfed. The household size of 4 to 6 persons also significantly impacted wasting (p-value = 0.007) at 7% (RR = 1.07, C.I = 0.49-2.32). Analysis by a logistic regression model with STH infection as outcome revealed that, Fingernail cleanness (p-value = 0.044; AOR = 1.75; CI = 1.09-2.78) and household size (p-value = 0.038; AOR = 0.55; CI = 0.32-0.92) were positively associated with intestinal parasite infection at the 5% significant level. This study reveals that intestinal helminthic parasitic infections (STH) and undernutrition are serious health problems in children below five in the study area. To address this dire situation, concerted efforts are needed to improve sanitation, hygiene education access, community deworming programs, and improve diets.

Deworming program for women of reproductive age implemented through national iron folate supplementation program reduces prevalence of anemia: evidence from a community trial in rural Bangladesh

Background: Anemia causes debilitating outcomes for women and children, and can be of multifactorial etiology, soil transmitted helminth (STH) infection being one of them. The Bangladeshi government does not have any regular deworming program for women of reproductive age (WRAs), who constitute an important portion of the population. Hence, we conducted this study to generate evidence on the effect of regular deworming on STH infection status and anemia status of WRAs in rural Bangladesh. Methods: This was a quasi-experimental study conducted in rural Bangladesh using existing healthcare delivery platform (Community Clinics) for mass deworming of WRAs. Catchment areas of two community clinics constituted the intervention arm, where the WRAs received two cycles of deworming four months apart on top of government recommended iron-folate supplementation (IFA), and catchment areas of two different community clinics were considered as the control arm where the study population received IFA but no deworming medication. Baseline and endline surveys were conducted on randomly selected participants to measure prevalence of anemia and STH infection using HemoCue 201+ and Kato-Katz respectively. Results: The study area contained 4791 women aged 15-49 years. Among them, 2441 lived in the intervention area and 2350 lived in the control area. Compliance to deworming medication and IFA was 82% (2001 out of 2441) and 79% (1938 out of 2441) for the two cycles, respectively. In the baseline survey there was no significant difference in prevalence of anemia between the intervention and control arms (63.7% vs 65.7%; p=0.522). However, the endline survey yielded significant difference in anemia prevalence between the arms (47.5% vs 65.7%, p&lt;0.001) rendering a 14% reduction in anemia due the intervention (p=0.004). Similarly, our intervention was shown to reduce STH infection by 16% (p&lt;0.001) Conclusions: Our study clearly showed that regular deworming of WRA benefits their anemia and STH infection status.

Gut microbiome of helminth-infected indigenous Malaysians is context dependent

BackgroundWhile microbiomes in industrialized societies are well characterized, indigenous populations with traditional lifestyles have microbiomes that are more akin to those of ancient humans. However, metagenomic data in these populations remains scarce, and the association with soil-transmitted helminth infection status is unclear. Here, we sequenced 650 metagenomes of indigenous Malaysians from five villages with different prevalence of helminth infections.ResultsIndividuals from villages with higher prevalences of helminth infections have more unmapped reads and greater microbial diversity. Microbial community diversity and composition were most strongly associated with different villages and the effects of helminth infection status on the microbiome varies by village. Longitudinal changes in the microbiome in response to albendazole anthelmintic treatment were observed in both helminth infected and uninfected individuals. Inference of bacterial population replication rates from origin of replication analysis identified specific replicating taxa associated with helminth infection.ConclusionsOur results indicate that helminth effects on the microbiota were highly dependent on context, and effects of albendazole on the microbiota can be confounding for the interpretation of deworming studies. Furthermore, a substantial quantity of the microbiome remains unannotated, and this large dataset from an indigenous population associated with helminth infections is a valuable resource for future studies.AEGeXaED_X6wKACk1ZMX_FVideo

PEMERIKSAAN TELUR SOIL TRANSMITTED HELMINTH (STH) PADA KUBIS (BRASSICA OLERACEA) DAN KEMANGI (OCIMUM BASILICUM) DI PASAR TRADISIONAL BEKASI

Worm infections caused by Soil Transmitted Helminth (STH) in Indonesia cause diarrhea, malnutrition, and malaise. One of the epidemiology of STH occurs through soil or fertilizer contaminated with STH in vegetables. Therefore, it is necessary to examine and identify STH in vegetables, especially cabbage and basil. The purpose of this study was to determine STH eggs in vegetables from cabbage (Brassica oleracea) and basil (Ocimum basilicum) taken at Pasar Baru, Bekasi. This type of research is descriptive and quantitative with a cross-sectional design. The samples in this study were 12 cabbage and 9 basil leaves taken from Pasar Baru, Bekasi. The sampling technique used was purposive sampling. Data analysis was done by quantitative descriptive. The results of this study showed that 3 (25%) samples of cabbage and 3 (22.22%) of basil were found to be positive for the presence of STH eggs. The species of STH eggs that were identified were fertile and non-fertile Ascaris lumbricoides. This study concluded that there was contamination of fertile and non-fertile A. lumbrocoides eggs in cabbage and basil vegetables sold in Pasar Baru, Bekasi.Keywords: STH eggs, basil, cabbage, Ascaris lumbricoides, sedimentation method

Policy stakeholder perspectives on barriers and facilitators to launching a community-wide mass drug administration program for soil-transmitted helminths

BackgroundRecent evidence suggests that soil-transmitted helminth (STH) transmission interruption may be feasible through community-wide mass drug administration (cMDA) that deworms community members of all ages. A change from school-based deworming to cMDA will require reconfiguring of STH programs in endemic countries. We conducted formative qualitative research in Benin, India, and Malawi to identify barriers and facilitators to successfully launching a cMDA program from the policy-stakeholder perspective.MethodsWe conducted 40 key informant interviews with policy stakeholders identified as critical change agents at national, state/district, and sub-district levels. Participants included World Health Organization country office staff, implementing partners, and national and sub-national government officials. We used the Consolidated Framework for Implementation Research to guide data collection, coding, and analysis. Heat maps were used to organize coded data and differentiate perceived facilitators and barriers to launching cMDA by stakeholder.ResultsKey facilitators to launching a cMDA program included availability of high-quality, tailored sensitization materials, and human and material resources that could be leveraged from previous MDA campaigns. Key barriers included the potential to overburden existing health workers, uncertainty of external funding to sustain a cMDA program, and concerns about weak intragovernmental coordination to implement cMDA. Cross-cutting themes included the need for rigorous trial evidence on STH transmission interruption to gain confidence in cMDA, and implementation evidence to effectively operationalize cMDA. Importantly, if policy stakeholders anticipate a cMDA program cannot be sustained due to cost and human resource barriers in the long term they may be less likely to support the launch of a program in the short term.ConclusionsOverall, policy stakeholders were optimistic about implementing cMDA primarily because they believe that the tools necessary to successfully implement cMDA are already available. Policy stakeholders in this study were cautiously optimistic about launching cMDA to achieve STH transmission interruption and believe that it is feasible to implement. However, launching cMDA as an alternative policy to school-based deworming will require addressing key resource and evidence barriers.Trial registration This study was registered in the U.S. National Library of Medicine Clinical Trials registry (NCT03014167).

Bacterial and parasitic contamination of raw vegetable: potential risk for food-borne diseases

Food-borne diseases can be transmitted through raw vegetables contaminated with bacteria and intestinal parasites. The study aimed to determine bacteria and intestinal parasites that contaminate raw vegetables in traditional markets. In this study, we collected raw vegetables from eight traditional markets. We chose randomly at each market five samples of vegetables that usually consumed in raw, like lettuce, tomato, cabbage, basil, long bean, and cucumber. The bacteria were identified by culture and microbiological test and the intestinal parasites were identified using sedimentation and floatation methods. This study showed that all of raw vegetables were contaminated with &lt;em&gt;Escherichia coli&lt;/em&gt; (E. coli) (91%), &lt;em&gt;Staphylococcus aureus&lt;/em&gt; (84%), and &lt;em&gt;Vibrio cholera&lt;/em&gt; (79%). Besides bacteria, 36% of samples were contaminated by soil-transmitted helminths (STH), and intestinal protozoa contaminated 27% of samples. Lettuce was the most contaminated vegetable with bacteria and intestinal parasites. The results of this study proved that there was bacterial contamination as well as intestinal parasites in raw vegetables sold in traditional markets which could be a source of spread of food-borne diseases. Therefore, handling raw vegetables properly is needed as an effort to prevent it.

Hubungan Mencuci Tangan dan Perawatan Kuku dengan Kejadian Helmintiasis pada Siswa/i Sekolah Dasar

Introductions: Helminthiasis is a worm infection that often attacks children to adults. A quarter of the world’s population suffers from Soil-Transmitted Helminthes (STH). Various problems arising from worm infection include changes in appetite, nausea, vomiting, and weight loss. In children, it can inhibit growth and development. The purpose was to identify handwashing behaviour, nail hygiene and incidence of Helminthiasis in Elementary School students. Methods: This is quantitative research with a cross-sectional study to link hand washing and nail hygiene with worms in students with 106 respondents. Examination of faecal preparations was carried out at the Thamrin Laboratory. Result: The results obtained were 14 people (13,2%) with hand washing behaviour in the poor category, 14 people (13,2%) with nail hygiene in the poor category, and 14 people (13,2%) have worm infection. Based on bivariate analysis, p-value=0.000 (5%), Conclusion: There is a relationship between hand washing behaviour and nail hygiene with the incidence of worms in students of Elementary School.

A New Comestible Formulation of Parasiticide Fungi to Reduce the Risk of Soil-Transmitted Helminth Infections in a Canine Shelter.

Dogs cared for in a shelter are dewormed every three-four months, but they all become infected one-two months later by the soil-transmitted helminths (STHs) Toxocara canis, Toxascaris leonina, Trichuris vulpis, and Ancylostoma caninum. For the purpose of reducing their risk of infection by decreasing the survival of helminths' infective stages in soil, chlamydospores of two parasiticide fungi, Mucor circinelloides (ovicide) and Duddingtonia flagrans (larvicide) were formulated as handmade edible gelatins and given three days per week for 17 months to 18 dogs (DRF, dogs receiving fungi); a second group was maintained without fungi (CD, control dogs). All individuals were dewormed at months 0, 3, 7, 10 and 13, and it was observed that the levels of helminths egg-output were reduced by 96-98% fourteen days after each treatment. Fecal egg counts of STHs were similar in both groups until the 6th-8th months, and then remained significantly lower in DRF than in CD (42-100% ascarids; 30-100% trichurids and ancylostomatids). According to the results, and considering that gelatin treats have always been fully accepted, it is concluded that this new formulation offers an efficient solution to decrease the risk of infection among dogs maintained in shelters, and is therefore recommended.

The survey of soil-transmitted helminth species abundance in Slovakia with an emphasis on parameters important for their distribution.

Soil-transmitted helminths (STH) can be easily dispensable in socially disadvantaged groups. The Roma people represent the group most at risk in Slovakia. This study aimed to investigate the occurrence of STH infections in minorities living with animals under low hygienic conditions and on contaminated soil. Subsequently, we identified the risk assessment factors of the STH transmissions based on parasitological results. In our study, STHs were predominantly found among the Roma communities living in unsanitary conditions. The prevalence of Ascaris lumbricoides among the majority was 0.79%, and Trichuris trichiura was 0.05 %. On the contrary, a community-based cross-sectional survey across eastern Slovakia also found a prevalence of 22.28 and 3.47% for A. lumbricoides and T. trichiura among the Roma population. Inhabitants that belong to the Roma minority had a 37.12 infection OR times higher than non-Roma inhabitants. The Roma people living in the countryside have a 2.23-fold higher chance of getting infected with STH than Roma living in the city. Therefore, soil and domestic animals were also examined for the presence of the STH eggs to show the environmental burden. In general, the presence of STH eggs was confirmed in 26.26% of the soil examined samples. The detailed description is as follows: eggs of Toxocara spp., Trichuris spp., eggs from the family Ancylostomatidae, and Toxascaris leonina. Ascaris eggs were detected only in the soil from localities with low hygienic standards. The probability of contracting the STH eggs in segregated settlements was 15.94 times higher compared to urban or rural areas. In addition to humans, dogs can also be a source of STH eggs in the soil. The STH eggs were confirmed in 43.55% of dog droppings. The most interesting finding was that the eggs of the genus Ascaris were up to 7.93% of dog droppings from localities with a low hygienic standard were positive. This study revealed that climatic factors and the WASH conditions influenced the distribution of STHs to variable degrees. In addition, ethnicity and sanitation were crucial factors in the distribution of STH infection in eastern Slovakia.

Community-wide mass drug administration for soil-transmitted helminths – risk of drug resistance and mitigation strategies

Mass drug administration programs for the control of soil-transmitted helminths (STH) in humans most commonly utilize a single class of drugs; the benzimidazoles. Most such programs focus on the treatment of pre-school and school aged children attending schools, although there is increasing interest in the potential utility of community-wide MDA to reduce infection intensity within communities and possibly to interrupt STH transmission. In animals, mass treatment with benzimidazoles leads to the rapid selection of parasites containing resistance-encoding single nucleotide polymorphisms (SNP) and the potential emergence of resistance in parasite species that infect humans is of major potential public health concern. As programs scale up delivery of anthelmintics and consider expanding treated populations, monitoring of drug efficacy and the potential emergence of anthelmintic resistance with sensitive diagnostic tools is critical to ensure the continued success of STH control programs. In particular, as programs consider the adoption of community-wide deworming, there is concern that such a strategy may increase the risk of drug resistance by limiting the number of untreated individuals which serve as a refugia of unexposed worm populations. We review the literature for evidence of drug resistance in human STH infections and explore risks and mitigation strategies for emergence of drug resistance in the context of community-wide deworming.

Diseases among Orang Asli community in Malaysia: a systematic review

Orang Asli, the indigenous people of Peninsular Malaysia, is a minority population and placed behind in terms of socioeconomy, education and health. The Malaysian government has supported Orang Asli since the second Malaysia Plan in the 1970s, resulting in changes in their living standard, access to health, education and occupation. Hence, this review aims to assess the recent prevalence of diseases among Orang Asli in Peninsular Malaysia. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) review protocol guided this systematic review. The research question was formulated based on Population, Interest, Comparison and Outcome (PICO). The selected databases include Web of Science, Scopus, Ovid and EBSCOhost. The process of identification, screening and inclusion identified 33 articles. The mixed methods appraisal tool (MMAT) was then used to rank the quality of the articles. Selangor is the most frequent state involved in this review (12 studies), followed by Perak (10 studies), Pahang (10 studies) and Kedah (one study). We categorised into four categories of diseases, namely neglected tropical disease (n = 20), non-communicable disease (n = 6), nutritional status (n = 5), and hepatic disease (n = 2). The prevalence of diseases among Orang Asli is higher than in the general population, especially for soil-transmitted helminth (STH) and malnutrition. There is increasing research on non-communicable diseases due to an increasing trend in the socioeconomic status and lifestyle of the Orang Asli. Government agencies and private organisations must work together to empower Orang Asli with a healthy lifestyle, improve their socioeconomic status, and enhance food security, all of which will improve Orang Asli's health and reduce the prevalence of diseases.

Co-occurrence of Intestinal Parasites among School Children of Akonolinga, Centre Region of Cameroon: Emergency Need to Reduce the Health Divide

Background: Intestinal parasitosis pose a serious problem to public health and development, especially for the underprivileged population of low and middle-income countries. School children, who are the most affected, can harbour several parasites at the same time. There is a need to adopt efficient strategies for the elimination of intestinal parasitic infections as a public health problem by 2030.&#x0D; Methods: This cross-sectional study was conducted to highlight the level of co-occurrence of intestinal parasites among pupils of the Akonolinga locality of the Centre region of Cameroon. Pupils were randomly recruited from 5 public schools; stool samples were collected from those whose parents agreed to participate in the study. Helminth eggs and protozoan cysts were assessed by direct smear and the formol-ether concentration technique.&#x0D; Results: Out of the 416 pupils recruited, 252 were infected by at least one of the ten intestinal parasites identified. The most frequent soil-transmitted helminths were Ascaris lumbricoides and Trichuris trichiura with prevalences of 21.4 % and 18.5 %, respectively. Entamoeba coli was the main protozoan followed by E. histolytica/dispar with prevalences of 29.3% and 23.8%, respectively, and Embadomonas intestinalis was found in only one pupil (0.2%). The co-occurrence of intestinal parasites reached 50% and children with up to four different parasites were detected. The pair of intestinal protozoan parasites, E. histolytica/dispar and E. coli were the most observed with a frequency of 9.5%. Living in a rural setting and young age were important determinants for most of the parasite infections and co-occurrence of parasites.&#x0D; Conclusion: The co-occurrence of intestinal parasites among school children of Akonolinga is high, and this situation is more alarming in rural areas and in younger children. The living conditions and the co-occurrence of parasites must be integrated into public policies for fighting against intestinal parasite infections.