Soil-transmitted Helminthiasis Infection Research Articles

Helminthiasis and malaria co-infection among women of reproductive age in a rural setting of Kilifi County, coastal Kenya: A mixed method study.

Soil transmitted helminthiasis (STH), Schistosoma haematobium and malaria co-infection lead to increased susceptibility to other infections and poor pregnancy outcomes among women of reproductive age (WRA). This study sought to establish risk factors, burden of co-infection with STH, S. haematobium and Plasmodium sp. among WRA in Kilifi County, Kenya.A mixed method cross-sectional study was conducted on 474 WRA in 2021. Simple random sampling was used to select WRA from four villages in two purposively sampled sub-counties. Study participants were interviewed, and stool samples collected and analysed using Kato-Katz technique for STH. Urine samples were collected for examination of S. haematobium while malaria microscopic test was done using finger prick blood samples. Further, 15 focus group discussions (FGDs) were conducted with purposively selected WRA and qualitative data analyzed thematically using Nvivo software. Quantitative and qualitative methods were triangulated to comprehensively strengthen the study findings. Prevalence of S. haematobium was 22.3% (95%CI: 13.5-36.9), any STH 5.2% (95%CI: 1.9-14.3) and malaria 8.3% (95%: 3.8-18.2). Co-infections between any STH and S. haematobium was 0.8% (95%CI: 0.2-3.2) and between S. haematobium and malaria 0.8% (95%CI: 0.2-3.1). Multivariable analysis showed increased odds of any STH infections among participants in Rabai Sub-County, (aOR = 9.74; p = 0.026), businesswomen (aOR = 5.25; p<0.001), housewives (aOR = 2.78; p = 0.003), and casual laborers (aOR = 27.03; p<0.001). Qualitative analysis showed that the three parasitic diseases were common and responsible for possible causes of low birth weight, susceptibility to other infections and complications such as infertility and cancer later in life.The study demonstrated that STH, S. haematobium and malaria are still a public health problem to WRA. Some of the associated risks of infection were geographical location, socio-economic and WASH factors. Hence the need to implement integrated control efforts of the three parasitic infection.

Epidemiology of soil-transmitted helminthiasis among school-aged children in pastoralist communities of Kenya: A cross-sectional study.

Soil-transmitted helminthiasis (STH) are a major public health problem in Sub-Saharan Africa. In Kenya, the National School Based Deworming Program (NSBDP) was launched in 2012 with a goal of reducing STH prevalence in school-aged children (SAC) to <1%, however monitoring and evaluation results have consistently showed > 20% prevalence in Narok County. We conducted a study to investigate factors associated with STH infections among SAC in Narok County. A cross-sectional study was conducted among 514 SAC from five schools in Trans Mara West sub-county, Narok County. The sub-county was selected because it had participating schools within the NSBDP with a high prevalence of STH infection. Participants were selected using systematic random sampling. Stool samples collected from participants were examined for STH eggs using Kato-Katz technique. An open data kit questionnaire was used to collect socio-demographics, household, and STH knowledge information from 139 of the 514 SAC. Descriptive statistics was used to summarize the data, prevalence and mean intensity of infections were calculated, and logistic regression used to determine factors associated with STH infections. The overall prevalence of any STH infection was 24.6% (95%CI: 21.1-28.6). Trichuris trichiura 14.4% (95%CI: 11.7-17.8), Ascaris lumbricoides 12.5% (95%CI: 9.9-15.7) and hookworm 0%. From multivariable analysis the only factors significantly associated with increased risk of STH infection were, children attending Karda and Nkarano schools with aOR = 5.29 (95%CI: 1.45-19.24); p = 0.011 and aOR = 4.53 (95%CI: 1.29-15.97); p = 0.019 respectively. For A. lumbricoides, children attending Nkarano School were associated with a significant risk of infection with aOR = 7.81 (95%CI: 1.81-33.63); p = 0.006. Despite the ongoing work of NSBDP, the STH prevalence is still ≥ 20% in Trans Mara West sub-county Narok County, among SAC. This underscores the need for continued annual MDA. Additionally, if possible, drug combinations may effectively manage T. trichiura, the region's most common helminth. The study found a correlation between children attending specific schools and STH infection risk, suggesting the importance of health education and improved water, sanitation, and hygiene practices holistically both in schools and associated catchment areas that can act as STH reservoirs to alleviate the burden of STH.

Prevalence and intensity of urinary schistosomiasis and soil-transmitted helminths among women of reproductive age in Mwaluphamba, Kwale

Objective: To assess the epidemiology of urinary schistosomiasis and soil-transmitted helminthiasis among women of reproductive age in Mwaluphamba, Kwale County, Kenya. Methods: A community-based cross-sectional study design was employed to randomly sample 422 women of reproductive age (15-&lt;50 years) from four villages in Mwaluphamba location. Stool specimens were collected and examined using the Kato-Katz method, while filtration technique was used to analyze urine specimens. Participants’ sociodemographic details were obtained using a standardized questionnaire. Results: Urinary schistosomiasis prevalence was at 4.7% (20/422, 95% CI 2.8%-6.9%) while the prevalence of soil-transmitted helminthiasis infection was 4.5% (19/422, 95% CI 2.6%-6.7%). The infection intensities of urinary schistosomiasis among the study participants ranged from 1 to 120 eggs/10 mL of urine with median egg count of 18.45 eggs/10 mL. The patients were diagnosed with light infection, of 56.16 egg/gram and 48.48 egg/gram for Trichuris trichiura and hookworms, respectively. Women without latrines had 15.7 times higher risk of having urinary schistosomiasis compared to those with a latrine. Similarly, use of surface water (aOR=1.0, 95% CI 0.2-1.4, P=0.010) and crossing the river to go to a place (aOR=1.1, 95% CI 0.3-1.6, P=0.009) were statistically significant risk factors for getting urinary schistosomiasis. In bivariable regression analysis, defecating around the water source (OR=4.3, 95% CI 1.5-12.9) had a statistically significant association with the prevalence of soil-transmitted helminthiasis (P=0.008). Conclusions: This study has given an insight on the prevalence and intensity of urinary schistosomiasis and soil-transmitted helminthiasis in Mwaluphamba location that form a basis for strengthening the control and elimination programmes for these neglected tropical diseases.

Soil-transmitted helminthiasis (STH) endemicity and performance of preventive chemotherapy intervention programme in Nigeria (in year 2021)

Preventive chemotherapy (PC) is an important tool to address transmission and reduce morbidities associated with soil-transmitted helminths (STHs). The aim of the study is to assess the PC implementation programme coverage and relate the same to the endemicity of STH in Nigeria. The secondary data collected by the World Health Organization (WHO) through the expanded special project for elimination of neglected tropical diseases (ESPEN) and made available at the ESPEN portal was used for the study. The PC implementation coverage and frequency of treatment were evaluated and related to STH endemicity levels in Nigeria. STH was actively transmitted in all six geopolitical zones of Nigeria. The southern part of Nigeria was more endemic compared with northern Nigeria. There was no PC intervention in preschoolers and effective PC coverage (19.3%) fell below the WHO ≥ 75% PC coverage index benchmark in school children. The percentages of children that harbour low, moderate, and high STH infections were 41.5, 41.6, and 13.4%, respectively. Multiple treatments did not necessarily reduce the endemicity of STH on certain occasions. STH continues to be a public health threat in Nigeria. The current treatment strategies should be reviewed to accommodate preschoolers in PC implementation programmes. Treatment should be integrated with the WASH programme in order to achieve a lasting impact.

Precision and geographical prevalence mapping of schistosomiasis and soil-transmitted helminthiasis among school-aged children in selected districts of north-western Tanzania

BackgroundThe identification and mapping of at-risk populations at a lower administrative level than the district are prerequisites for the planning, resource allocation and design of impactful control intervention measures. Thus, the objective of the current study was to conduct sub-district precision mapping of soil-transmitted helminthiasis (STH) and schistosomiasis in 29 districts of north-western Tanzania using the current recommended World Health Organization criteria.MethodsA cross-sectional survey was conducted in 145 schools between March and May 2021. A urine filtration technique was used for the quantification of Schistosoma haematobium eggs, whereas quantification of Schistosoma mansoni and STH eggs was done using the Kato–Katz technique. Microhaematuria was examined using a urine dipstick.ResultsThe overall prevalences of any STH and schistosome infections were 9.3% [95% confidence interval (95%CI) 8.6–9.9] and 14.6% (95%CI 13.9–15.4), respectively. The overall prevalence of S. mansoni was 8.7% (95%CI 8.1–9.3), and 36.4%, 41.6%, and 21.9% of the children had low, moderate, and heavy infections, respectively. The overall prevalence of S. haematobium was 6.1% (95%CI 5.5–6.5), and 71.7% and 28.3% of the infected children had light and heavy intensity infections, respectively. The prevalence of microhaematuria was 7.3% (95%CI 6.7–7.8), with males having the highest prevalence (8.4%, P < 0.001). The prevalences of Trichuris trichiura, Ascaris lumbricoides and hookworm were, respectively, 1.3% (95%CI 0.1–1.5), 2.9% (95%CI 2.5–3.3) and 6.2% (95%CI 5.7–6.7). Most of the children infected with STH had light to moderate intensities of infection. The overall prevalence of co-infection with STH and schistosomiasis was 19.1%. The prevalence of schistosomiasis (P < 00.1) and STH (P < 0.001) varied significantly between schools and sub-districts. Schistosoma mansoni and S. haematobium were observed in 60 and 71 schools, respectively, whereas any STH was observed in 49 schools. In schools where schistosomiasis was observed, prevalence was < 10% in 90.8% of them, and ranged from ≥ 10% to < 50% in the other 9.2%. In schools where any STH was observed, the prevalence was < 10% in 87.7% of them.ConclusionsThe data reported here show that schistosomiasis and STH are widely distributed around Lake Victoria. In most of the schools where schistosomiasis and STH occurred the transmission thresholds were low. These data are important and need to be taken into consideration when decisions are made on the implementation of the next round of mass chemotherapies for schistosomiasis and STH in Tanzania.Graphical

Integrated survey of helminthic neglected tropical diseases and comparison of two mosquito sampling methods for lymphatic filariasis molecular xenomonitoring in the River Galana area, Kilifi County, coastal Kenya.

A lymphatic filariasis (LF) endemic focus along the River Galana/ Sabaki in Kilifi County, coastal Kenya, provided a platform to conduct an integrated survey for three helminthic neglected tropical diseases (NTDs), namely soil-transmitted helminthiasis (STH), schistosomiasis (SCH) and LF. Additionally, the study compared the performance of two mosquito trapping methods for LF molecular xenomonitoring (MX). Cross-sectional surveys measuring STH, SCH and LF prevalence were conducted in four villages. Mosquitoes were trapped using the CDC light trap (CDC-LT) and the Ifakara A tent trap (Ifakara-TT) methods and stored in pools which were tested for Wuchereria bancrofti DNA using the real-time polymerase chain reaction assay. A total of 907 people (436 adults; 471 children) participated in the parasitological testing. Among the STH infections, Trichuris trichiura and hookworms were most prevalent among the children and adult populations, respectively. The schistosome worm eggs detected belonged to the species Schistosoma haematobium and the prevalence of the infection was generally higher among the children compared with the adult population. The prevalence of LF infection among the adult population ranged from 1.8% to 7.6% across all 4 villages (P < 0.05). A total of 3,652 mosquitoes, including Anopheles, Culex, Mansonia, and Aedes species were collected. One mosquito pool consisting of Anopheles mosquitoes tested positive for filarial DNA out of 1,055 pools that were tested. The CDC-LT caught significantly more mosquitoes compared with the Ifakara-TT (P < 0.001). This study demonstrated that integrated epidemiological surveys using standard parasitological and entomological methods can provide useful information on co-endemic parasitic diseases which could help direct interventions and surveillance activities.

Community-wide prevalence and intensity of soil-transmitted helminthiasis and Schistosoma mansoni in two districts of Sierra Leone.

In Sierra Leone, nationally powered school-based surveys have documented significant progress in the control of soil-transmitted helminthiasis (STH) and schistosomiasis. In order to assess the district-level prevalence and intensity of infection among key at-risk groups outside of school age children (SAC), we conducted a multi-stage, cluster-sample household survey in Bo and Kenema districts in May 2018. From both districts, we examined 1,282 pre-school age children (PSAC), 730 school age children (SAC), and 517 adults over 14 years (including 387 women of reproductive age, or WRA) for STH and Schistosoma mansoni infection using Kato Katz technique. In Bo, STH prevalence was 8.0% (95% Upper Confidence Limit 10.2%) in PSAC, 6.4% (95% Upper Confidence Limit 9.0%) in SAC, 14.1% (95% Upper Confidence Limit 17.4%) in all adults and 11.9% (95% Upper Confidence Limit 17.4%) in WRA. In Kenema, STH prevalence was 18.1% (95% Upper Confidence Limit 20.5%) in PSAC, 17.3% (95% Upper Confidence Limit 20.7%) in SAC, and 16.9% (95% Upper Confidence Limit 20.5%) in all adults and 16.9% (95% Upper Confidence Limit 22.6%) in WRA. Hookworm species were the most prevalent of STH in both districts overall. The overall prevalence of S. mansoni was <10% in Bo and <20% in Kenema, and was similar across age groups. No moderate or heavy intensity STH infections or heavy intensity S. mansoni infections, as per World Health Organization (WHO) classification, were detected in either district. Sanitation variables, such as toilet access and quality, were independently associated with STH and S. mansoni infection. In Kenema, STH prevalence in SAC was within the WHO-defined range for annual treatment, whereas a previous nationally-powered survey estimated it to lie within the range of treatment once per two years. By utilizing community-based sampling, we were able to assess prevalence among WRA and make recommendations based on current guidance from WHO. To continue toward elimination of STH and S. mansoni as a public health problem, resources should be mobilized to increase access to and uptake of improved sanitation at community and household levels.

The first report on the prevalence of soil-transmitted helminth infections and associated risk factors among traditional pig farmers in Bali Province, Indonesia.

Background and Aim:Pigs are the main livestock commodity in Bali Province, Indonesia, where traditional farming practices are widely used. Traditional pig farmers are often closely associated with poverty and a perceived lack of knowledge regarding health and hygiene. Data on soil-transmitted helminthiasis (STH) and risk factors associated with STH worm infection among traditional pig farmers in Bali were previously unavailable. This study aimed to analyze the prevalence and risk factors for STH infections among traditional pig farmers in Bali Province, Indonesia.Materials and Methods:This study involved the fecal examination of 238 traditional pig farmers from all areas of Bali Province in Indonesia. In addition, several pig feces samples were combined into one pooled sample belonging to each farm. All fresh fecal samples were stored in a 5% formaldehyde solution before being analyzed using concentration flotation techniques. Subsequently, risk factors were determined through an interview and a questionnaire. The odds ratio (OR) and Chi-square tests were used to determine the risk factors associated with STH infections.Results:The result showed that there was a high prevalence of STH infections among traditional pig farmers and pig farms in Bali, with rates of 21.8% and 76.5%, respectively. This could be due to risk factors, such as personal hygiene (OR: 5.756; confidence interval [CI]: 2.96-11.193; p=0.00), sanitation (OR: 1.914; CI: 1.024-3.576; p=0.042), education level (OR: 7.579; CI: 2.621-21.915; p=0.00), household income (OR: 2.447; CI: 1.122-5.338; p=0.025), and occupation (OR: 2.95; CI: 1.356-6.415; p=0.006).Conclusion:The infections seen in farmers were distributed among hookworm, Ascaris spp., and Trichuris spp., at 15.1%, 9.2%, and 4.2%, respectively. The risk factors associated with infections of STH and Ascaris spp. were personal hygiene, home sanitation, education level, household income, and having a primary occupation as a traditional pig farmer. In contrast, personal hygiene, education level, and primary occupation were the only risk factors for hookworm infection, while personal hygiene and home sanitation were the risk factors associated with Trichuris spp. infection. The limitation of this study was that the number of samples was relatively small due to the difficulty of obtaining stool samples from traditional pig farmers, with many individuals refusing to provide their stool for inspection. We suggest that future research focus on identifying the species of worms that infect traditional pig farmers and to better identify the zoonotic link of STH transmission from pigs to humans.

High infection rates for onchocerciasis and soil-transmitted helminthiasis in children under five not receiving preventive chemotherapy: a bottleneck to elimination

BackgroundThe current mainstay for control/elimination of onchocerciasis and soil-transmitted helminthiasis (STH) relies on ivermectin- and mebendazole/albendazole-based preventive chemotherapies. However, children under five years of age have been excluded in both research activities and control programs, because they were believed to have insignificant infection rates. There is therefore a need for up-to-date knowledge on the prevalence and intensity of STH and onchocerciasis infections in this age group. This study aimed at assessing the rates and intensities of onchocerciasis and STH infections in children under five years of age who are excluded from ivermectin- or mebendazole/albendazole-based preventive chemotherapies.MethodsA series of cross-sectional surveys was conducted in four Health Districts in the Centre and Littoral Regions of Cameroon between 2018 and 2019. All subjects aged 2 to 4 years, were screened for prevalence (or infection rate) and intensity [number of eggs per gram of stool (epg) or number of microfilariae per skin snip (mf/ss)] of STH and onchocerciasis infections respectively using the Kato-Katz and skin snip methodologies. Chi-square and the non-parametric tests (Mann Whitney and Kruskal Wallis) were used to compare infection rates and intensities of infections between Health Districts and genders, respectively.ResultsA total of 421 children were enrolled in this study. The overall prevalence of onchocerciasis was 6.6% [95% confidence interval (CI): 4.3‒9.9], ranging from 3.6% (in the Ntui Health District) to 12.2% (in the Bafia Health District). The intensity of infection ranged from 0.5 to 46 microfilariae per skin snip [median: 5; interquartile range (IQR): 2.25‒8.5]. The overall prevalence of STH was 9.6% (95% CI: 6.5‒13.9), with a high infection rate (29.6%) in the Akonolinga Health District. Two STH species (Ascaris lumbricoides and Trichuris trichiura) were found among infected individuals. The median intensities of STH infections were 1,992 epg (IQR: 210‒28,704) and 96 epg (IQR: 48‒168) for A. lumbricoides and T. trichiura, respectively.ConclusionsThis study reveals that children < 5 years of age are highly infected with STH and onchocerciasis, and could contribute to the spread of these diseases, perpetuating a vicious circle of transmission and hampering elimination efforts. These findings reveal the urgent need to provide (or scale) treatments (likely pediatric formulations) to these preschool-aged children, especially in areas of high transmission, to accelerate efforts to reach WHO 2030 target.Graphical

Hemoglobin Level and Risk of Anemia in Soil-Transmitted Helminths Infections among Children: A Systematic Review and Meta-analysis

Introduction. Soil Transmitted Helminthiasis (STH) is a Neglected Tropical Disease with almost 25% world population infected. Children were vulnerable to infection with morbidities affecting growth. STH infection alters children nutritional status which potentially causing anemia. Meta-analysis relating STH infections to hemoglobin (Hb) level and risk of anemia in children is limited.&#x0D; Aim. To compare hemoglobin levels and risk of anemia in children infected and uninfected with STH.&#x0D; Methods. Meta-analysis conducted from journals obtained from Pubmed, ScienceDirect, WileyLibrary, Cochrane, EBSCO, Proquest, DOAJ, and GoogleScholar from 2011-2021. Full text cross sectional studies on children with relevant topic is included, while unclear, inaccessible, or post interventional studies were excluded. Articles were analyzed in Review Manager 5.4 in mean difference (MD) and odds ratio (OR) with Confidence Interval (CI) of 95%.&#x0D; Result. Out of 25,683 articles in literature search, 29 were eligible for systematic review and meta-analysis. STH infection significantly decreases hemoglobin level (MD -0.2g/dL; p=0.02) and increases risk of anemia (OR 1.83; p&lt;0.00001). Species analysis presented parallel result on Trichuris trichiura (MD -0.31g/dL; p=0.001 and OR 1.66; p=0.009), Hookworm (MD -0.56g/dL; p=0.02 and OR 3.3; p&lt;0.00001), and multiple infection (MD -0.25g/dL; p=0.03 and OR 4.49; p=0.005). Ascaris lumbricoides didn’t show significance on hemoglobin level but comparable for risk of anemia (MD -0.16g/dL; p=0.17 and OR 1.57; p=0.001).&#x0D; Discussion. All STH infections exhibits lower hemoglobin level and higher risk of anemia caused by lower nutrition absorption and occult bleeding in gastrointestinal tract. Hookworm and multiple infections has the highest risk of anemia. Proportion of anemia may vary in studies and influenced by sociodemographic characteristics, but higher proportions occur in STH infected.&#x0D; Conclusion. Children infected with STH has lower hemoglobin level and in risk of anemia compared to uninfected children, hence further study is still needed to be conducted.&#x0D; Keywords: Anemia, Children, Hemoglobin, Infection, Soil Transmitted Helminths

Prevalence, intensity and endemicity of intestinal schistosomiasis and soil-transmitted helminthiasis and its associated factors among school-aged children in Southern Ethiopia

Preventive chemotherapy (PC), the main strategy recommended by the World Health Organization to eliminate soil-transmitted helminthiasis (STH) and schistosomiasis (SCH), should be strengthened through identification of the remaining SCH transmission foci and evaluating its impact to get a lesson. This study was aimed to assess the prevalence of STH/SCH infections, the intensity of infections, and factors associated with STH infection among school-aged children (SAC) in Uba Debretsehay and Dara Mallo districts (previously not known to be endemic for SCH) in southern Ethiopia, October to December 2019. Structured interview questionnaire was used to collect household data, anthropometric measurements were taken and stool samples collected from 2079 children were diagnosed using the Kato-Katz technique. Generalize mixed-effects logistic regression models were used to assess the association of STH infections with potential predictors. A P-value less than 0.05 was considered statistically significant. The prevalence of Schistosoma mansoni in the Dara Mallo district was 34.3% (95%CI 30.9–37.9%). Light, moderate, and heavy S. mansoni infections were 15.2%, 10.9%, and 8.2% respectively. The overall prevalence of any STH infection was 33.2% with a 95% confidence interval (CI) of 31.1–35.3%. The intensity of infections was light (20.9%, 11.3% & 5.3%), moderate (1.1%, 0.1% & 0.4%) and heavy (0.3%, 0% & 0%) for hookworm, whipworm and roundworms respectively. The overall moderate-to-heavy intensity of infection among the total diagnosed children was 2% (41/2079). STH infection was higher among male SAC with Adjusted Odds Ratio (AOR) of 1.7 (95%CI 1.4–2.1); occupation of the household head other than farmer or housewife (AOR = 0.5; 95%CI 0.3–0.8), middle [AOR = 1.1; 95%CI 1.0–1.3] or high [AOR = 0.7; 95%CI 0.5–0.9] socioeconomic status. Dara Mallo district was moderate endemic for S. mansoni; and it needs sub-district level mapping and initiating a deworming campaign. Both districts remained moderate endemic for STH. Evidence-based strategies supplementing existing interventions with the main focus of the identified factors is important to realize the set targets.

Soil-transmitted helminthiasis and undernutrition among schoolchildren in Mettu town, Southwest Ethiopia

Soil-transmitted helminthiasis (STHs) and undernutrition are common health problems in developing countries. Several reports showed that STH and undernutrition are often associated. The main aim of this study was to determine the association of STH and undernutrition among schoolchildren in Mettu town, Southwest Ethiopia. A cross-sectional study design was employed. To collect socio-demographic data, semi-structured questionnaire and physical observation were used. Kato-Katz technique and Anthropometric measurements were also considered to see STH infection and determine the nutritional statuses of the study participants respectively. Then, the data generated from the study was managed using Chi-square test and logistic regression analysis to determine the association of demographic variables with infections of helminthes and assess the risk factors for nutritional status of the study participants respectively. As a result, among the 392 study schoolchildren, 331 (84.4%) children were positive for different species of STH and undernutrition accounted 32.6%. Ascaris lumbricoides (39.0%), Trichuris trichiura (32.9%) and hookworm (28.1%) are the predominant STH identified from the study participants. Age, maternal educational and occupation status, and fingernail status of children were found significantly associated (p < 0.05) with the risk of getting STH. Bivariate logistic regression analysis showed that, age (AOR 2.18, 95% CI 1.53, 6.59), maternal illiteracy (AOR 0.13, 95% CI 0.91, 0.34) and maternal occupation (AOR 1.67, 95% CI 1.08, 5.91) were major co-founding factors for the prevalence of STH among study participants. In addition, children with T. trichiura infection were more likely (P < 0.01) to suffer from undernutrition (AOR 0.52, 95% CI 0.31, 0.83). Thus, the findings revealed the high prevalence of STH and it has significant association with undernutrition among school age children in the study area. Anti-helminthic mass drug administration and maternal health education should be anticipated to curve the tragedy.

Prevalence, Risk Factors, and Coinfection of Urogenital Schistosomiasis and Soil-Transmitted Helminthiasis among Primary School Children in Biase, Southern Nigeria.

Schistosomiasis and soil-transmitted helminthiasis (STH) are neglected tropical diseases (NTDs) that cause chronic infections and ill health. The study was carried out to determine the current infection status and risk factors associated with Schistosoma haematobium and soil-transmitted helminth (STH) coinfection among school children in Biase Local Government Area (LGA), Cross River State, Nigeria. A cross-sectional study was carried out. Urine and fecal samples were randomly collected from 630 school children in six villages of Biase LGA. Urine sedimentation and Kato-Katz techniques were used to diagnose urogenital schistosomiasis and STHs, respectively. A structured questionnaire was used to collect demographic information and risk factors. The prevalence of S. haematobium in Biase LGA was 6.03%, with males (27 pupils, 9.00%) significantly more (χ2 = 8.903, p value = 0.003, C.I. = −82.650–120.650) infected than the females (11 pupils, 3.33%), while the prevalence of STH infection was 11.27% with no significant difference (χ2 = 0.002, p value = 0.962, C.I. = −16.441–54.559) in prevalence between males (34 pupils, 11.33%) and females (37 pupils, 11.21%). Prevalence of S. haematobium and STHs ranged from 1.82 to 19.13% and from 4.55 to 19.05% within the communities, respectively, with Abini (22 pupils, 19.13%) and Adim (20 pupils, 19.05%) communities having the highest prevalence for S. haematobium and STHs, respectively. The most infected age group was 11–13 years (21 pupils, 9.68%) for S. haematobium and 14–16 years (5 pupils, 21.74%) for STHs. Ascaris lumbricoides, hookworms, and Trichuris trichiura had prevalence of 5.56%, 3.02%, and 2.70%, respectively. An overall prevalence of 7.14% and 8.41% was observed for haematuria and proteinuria, respectively. Prevalence of coinfection among the parasites was 4.76%. Male pupils (OR = 2.868, C.I.: 1.397–5.889), pupils of the age group of 11–13 years (OR = 2.496, C.I.: 1.287–4.838), school children that swim (OR = 1.527, C.I.: 0.784–2.974), those that cross streams to farm (OR = 25.286, C.I.: 4.091–156.283), those that visit stream or river severally (OR = 3.077, C.I.: 1.204–7.863), and those whose home is 1 km (OR = 3.116, C.I.: 1.292–7.518) from the stream are at higher odds of infection with S. haematobium. For STHs, male pupils (OR = 1.012, C.I.: 0.617–1.659), pupils of the age group of 11–13 years (OR = 2.609, C.I.: 1.582–4.302), pupils that walk barefoot (OR = 18.746, C.I.: 6.786–51.783), those that do not wash fruits and vegetables before eating (OR = 2.334, C.I.: 1.400–3.892), those that do not wash hands after using the toilet (OR = 1.200, C.I.: 0.730–1.973), those that eat soils (OR = 2.741, C.I.: 1.533–4.902), those that drink water from streams or rivers (OR = 189.509, C.I.: 24.807–1447.740), and those that use pit latrine (OR = 2.920, C.I.: 1.746–4.885) and/or open defecation (OR = 2.552, C.I.: 1.454–4.479) are at high odds of being infected with STHs. Urogenital schistosomiasis and soil-transmitted helminthiasis are still endemic diseases in Biase LGA. Although the degree of infection is quite low or moderate, there is a need to intensify and sustain control measures such as provision of sustainable clean water supply, health education intervention, and chemotherapy.

Hotspots and correlates of soil-transmitted helminth infections in a Venezuelan rural community: Which are the “wormy” houses?

ObjectivesTo determine spatial clustering and risk factors for occurrence and intensity of infection for soil-transmitted helminthiasis (STH), namely Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis and hookworms in a Venezuelan rural community. MethodsMIF-fixed faecal samples were individually collected for STH testing. The Getis–Ord statistic was used to determine significant STH clustering within 25/50/100 m radiuses around houses. Individual- and house-level factors associated with STH occurrence and intensity of infection were determined using generalized estimating equations. ResultsSignificant clusters of “wormy” houses for one or multiple parasites were found at distances of 25–50 m around 13 houses. Risk factors differed between occurrence and intensity of infection. Overcrowding in the house increased occurrence of S. stercoralis, T. trichiura and hookworm infections, while poor housing conditions increased A. lumbricoides infection risk. Overcrowding, poor faecal disposal system, economic dependency and lack of basic services differentially influenced the STHs. The “wormy” houses were mainly those built with waste materials, under economic dependency and lacking indoor water supply. ConclusionsSTH distribution in a community is clustered, with significant hotspots of STH occurrence and intensity of infection and different associated risk factors. Targeting the “wormy” houses is expected to affect STH morbidity more efficiently.

Prevalence, intensity and associated risk factors of soil-transmitted helminth and schistosome infections in Kenya: Impact assessment after five rounds of mass drug administration in Kenya.

BackgroundIn Kenya, over five million school age children (SAC) are estimated to be at risk of parasitic worms causing soil-transmitted helminthiasis (STH) and schistosomiasis. As such, the Government of Kenya launched a National School Based Deworming (NSBD) program in 2012 targeting the at-risk SAC living in endemic regions, with the aim of reducing infections prevalence to a level where they no longer constitute a public health problem. The impact of the program has been consistently monitored from 2012 to 2017 through a robust and extensive monitoring and evaluation (M&E) program. The aim of the current study was to evaluate the parasitological outcomes and additionally investigate water, sanitation and hygiene (WASH) related factors associated with infection prevalence after five rounds of mass drug administration (MDA), to inform the program’s next steps.Materials and methodsWe utilized a cross-sectional design in a representative, stratified, two-stage sample of school children across six regions in Kenya. A sample size of 100 schools with approximately 108 children per school was purposively selected based on the Year 5 STH infection endemicity prior to the survey. Stool samples were examined for the presence of STH and Schistosoma mansoni eggs using double-slide Kato-Katz technique, urine samples were processed using urine filtration technique for the presence of S. haematobium eggs. Survey questionnaires were administered to all the participating children to collect information on their demographic and individual, household and school level WASH characteristics.Principal findingsOverall, STH prevalence was 12.9% (95%CI: 10.4–16.1) with species prevalence of 9.7% (95%CI: 7.5–12.6) for Ascaris lumbricoides, 3.6% (95%CI: 2.2–5.8) for Trichuris trichiura and 1.0% (95%CI: 0.6–1.5) for hookworm. S. mansoni prevalence was 2.2% (95%CI: 1.2–4.3) and S. haematobium prevalence was 0.3% (95%CI: 0.1–1.0). All the infections showed significant prevalence reductions when compared with the baseline prevalence, except S. mansoni. From multivariable analysis, increased odds of any STH infections were associated with not wearing shoes, adjusted odds ratio (aOR) = 1.36 (95%CI: 1.09–1.69); p = 0.007; high number of household members, aOR = 1.21 (95%CI: 1.04–1.41); p = 0.015; and school absenteeism of more than two days, aOR = 1.33 (95%CI: 1.01–1.80); p = 0.045. Further, children below five years had up to four times higher odds of getting STH infections, aOR = 4.68 (95%CI: 1.49–14.73); p = 0.008. However, no significant factors were identified for schistosomiasis, probably due to low prevalence levels affecting performance of statistical analysis.ConclusionsAfter five rounds of MDA, the program shows low prevalence of STH and schistosomiasis, however, not to a level where the infections are not a public health problem. With considerable inter-county infection prevalence heterogeneity, the program should adopt future MDA frequencies based on the county’s infection prevalence status. Further, the program should encourage interventions aimed at improving coverage among preschool age children and improving WASH practices as long-term infection control strategies.

Prevalence, Infection Intensity and Risk Factors of Schistosomiasis and Soil Transmitted Helminthiasis among School Aged Children in Tiko Health District, Southwest Cameroon: A Community-Based Cross-Sectional Study

Aims: This study aimed at determining the prevalence, infection intensities and risk factors associated with Schistosomiasis (SCH) and Soil transmitted helminthiasis (STH) among school aged children (SAC) in Tiko Health District (THD).&#x0D; Study Design: A community-based cross-sectional study was conducted in three health areas (Likomba, Holforth and Tiko town) in Tiko Health District.&#x0D; Place and Duration of Study: The study was carried out in THD from July to October, 2018.&#x0D; Methodology: The study included 464 children of both sexes aged between 4 – 15 years. Stool and urine samples were collected from 464 children and processed using the Kato Katz and Urine filtration techniques respectively. Information on socio-demographic characteristics and risk factors were collected using structured questionnaires. Data was analyzed using SPSS version 25 with statistical significance set at p&lt; 0.05.&#x0D; Results: Of the 464 SAC examined, the overall prevalence of Schistosomiasis, STH and Schistosomiasis/STH co-infection rate in THD was 16.16%, 14.44% and 0.43% respectively. Females (18.98%; 14.81%) were more infected with Schistosomiasis when compared to STH than males (13.71%; 14.11%). The order of STH prevalence observed was Ascariasis (9.27%) &gt; Hookworm disease (3.88%) &gt; Trichuriasis (1.29%). The mean infection intensity for Urinary Schistosomiasis and STH was 4.36 eggs per 10ml and 11.74 eggs per gram (EPG) respectively. SAC residing in Likomba HA were significantly at higher risk of Schistosomiasis (aOR: 4.40, P=0.008) and STH (aOR: 2.14, P = 0.031). Use of tap water was associated with STH.&#x0D; Conclusion: Tiko Health District can be considered as a moderate-risk zone for Schistosomiasis and a low risk zone for STH infection according to WHO classification.

Soil-transmitted helminthiasis in four districts in Bangladesh: household cluster surveys of prevalence and intervention status

BackgroundIn 2016, after 8 years of twice-annual nationwide preventive chemotherapy (PC) administration to school-age children (SAC), the Bangladesh Ministry of Health & Family Welfare (MOHFW) sought improved impact and intervention monitoring data to assess progress toward the newly adopted goal of eliminating soil-transmitted helminthiasis (STH) as a public health problem.MethodsWe surveyed four Bangladeshi districts between August and October 2017. We conducted a multi-stage, cluster-sample, household survey which produced equal-probability samples for preschool-age children (PSAC; 1–4 years), SAC (5–14 years), and adults (≥ 15 years). Standardized questionnaires were administered, using Android-based smart phones running an Open Data Kit application. Stool samples were collected and testing for STH prevalence and infection intensity used the Kato-Katz technique.ResultsIn all, 4318 stool samples were collected from 7164 participants. Estimates of STH prevalence by risk group in three of the four surveyed districts ranged from 3.4 to 5.0%, all with upper, 1-sided 95% confidence limits < 10%. However, STH prevalence estimates in Sirajganj District ranged from 23.4 to 29.1%. Infections in that district were spatially focal; four of the 30 survey clusters had > 50% prevalence in at least one risk group. Among all tested specimens, Ascaris lumbricoides was the most common STH parasite [8.2% (n = 352)], followed by Trichuris trichiura [0.9% (n = 37)], and hookworm [0.6% (n = 27)]. In each district, PC coverage among SAC was above the 75% program target but did not exceed 45% among PSAC in any district. Improved sanitation at home, school, or work was over 90% in all districts.ConclusionsIn the three low-prevalence districts, the MOHFW is considering decreasing the frequency of mass drug administration, per World Health Organization (WHO) guidelines. Also, the MOHFW will focus programmatic resources and supervisory efforts on Sirajganj District. Despite considering WHO guidance, the MOHFW will not expand PC administration to women of reproductive age partly due to the low prevalence of hookworm and T. trichiura, the STH parasites that contribute most to morbidity in that risk group. Data collected from surveys such as ours would help effectively guide future STH control efforts in Bangladesh and elsewhere.

Soil-Transmitted Helminthiasis — China, 2018

What is already known about this topic? Soil-transmitted helminthiasis (STH) is distributed widely in China and a large number of the population is afflicted. However, trends of STH infections are decreasing. What is added by this report? The most recent data indicates that the overall prevalence of STH was 1.29% in 2018 in China, which was based on the national sentinel surveillance and demonstrates a continuous decline pattern. What are the implications for public health practice? Considering the current prevalence in China and various endemic statuses in different regions, precision control measures should be implemented for the control and elimination of STH in China.

Prevalence and the factors influencing soil transmitted helminths among school age children of 5 to 14 years in a rural area of Coimbatore district

Background: Highest intensity of soil transmitted helminthiasis (STH) is seen among school age children. The objective of this study is to find out the prevalence and factors associated with STH infection among school age children of 5-14 years in a rural area of Coimbatore district.Methods: After getting ethical clearance, five of the fourteen villages of Vedapatti were selected by cluster sampling method. Totally 819 participated in the survey conducted between November 2015-July 2016 in the field practice area. Consent from parents and assent from child were obtained. Structured questionnaire was used to collect information. Totally 610 gave one adequate stool sample. Early morning samples were collected and transported to the laboratory within four hours. Formal ether concentration method was performed and examination was done. Data analysis was done with SPSS-19 software. Prevalence is expressed in percentage with 95% confidence interval (CI). Univariate and Multivariate analysis were performed. Strength of association was expressed in terms of odds ratio and adjusted odds ratio with 95% confidence interval. P value &lt;0.05 was considered as statistically significant.Results: The prevalence of STH was 7.70% (95% CI: 5.58- 9.82). Ascaris lumbricoides was highly prevalent 6.9% (4.89% to 8.91%) followed by hook worm 0.2(0.15% to 0.55%) and Trichuris trichura 0.7%(0.04% to 1.36%). Uni variate and Multivariate logistic regression analysis showed that pucca houses offered protection against STH.Conclusions: STH is still a public health problem in Coimbatore. When regular deworming is accompanied by appropriate sanitation and hygiene activities designed to prevent re infection of STH, a long-term impact can be achieved.

Child development center-based sentinel surveillance of soil-transmitted helminthiases in preschool-age children in selected local government units in the Philippines

Soil-transmitted helminthiasis (STH) remains a public health concern in developing countries, such as the Philippines. Preschool-age children (PSAC) are among the high-risk groups for STH. Data on the status of STH in PSAC are needed to help guide policy formulation and program implementation; however, in the usual setting, such data may remain limited. This study aimed to describe the parasitologic status of PSAC in selected local government units (LGUs) in the Philippines through sentinel surveillance methodology in a child-development center (CDC)-based setting.This cross-sectional study, which included 1732 PSAC in selected barangays (a village or the smallest administrative unit in the country) in the provinces of Cavite, Guimaras, Iloilo, Negros Occidental, and Davao del Norte and cities of Iloilo and Lapu-Lapu in the Philippines, utilized Kato-Katz technique to determine parasitologic status. A single Kato-Katz smear was prepared from the adult-thumb sized stool sample submitted by each participant. Ten percent of Kato-Katz slides examined by field microscopists were re-examined by a reference microscopist as part of quality control.Results showed a prevalence of any STH infection and a moderate-heavy ((M−H)) intensity prevalence of 24.9% and 10.3%, respectively. Five cases of schistosomiasis were found in Lapu-Lapu City and Davao del Norte. While the Philippines’ Department of Health (DOH) - Integrated Helminth Control Program (IHCP) target for prevalence of any STH of less than 50% was attained, none of the barangays or villages met the World Health Organization (WHO) target for (M−H) intensity STH prevalence of less than 1%, despite the program being implemented for almost a decade.Sentinel surveillance in PSAC, possibly adopting a CDC-based approach, may be implemented biannually in the Philippines and other countries where a similar early child care development system exist to generate data needed to guide policy formulation and program implementation. Preventive chemotherapy through facility-based mass drug administration (MDA), such as CDC-based MDA, may be explored to improve the mode of MDA delivery and coverage in PSAC.