Soil-transmitted Helminthiasis Infection Research Articles

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.

Prevalence, intensity and factors associated with soil-transmitted helminths infections among preschool-age children in Hoima district, rural western Uganda

BackgroundOver 80% of morbidity due to soil-transmitted helminthiasis (STH) occurs in low-income countries. Children under 5 account for 20–30% of the burden in endemic areas. This study assessed the prevalence, intensity and factors associated with STH infections among preschool-age children (PSAC) in Hoima district, Uganda. The PSAC are particularly vulnerable because the chronicity of this condition usually affects their physical and mental growth and development.MethodsA cross-sectional study was carried out among 562 PSAC (1–5 years old) in 6 counties of Hoima district using Expanded Program on Immunization (EPI) method. Stool samples from children were examined using the formol ether concentration technique for STH egg detection. Egg counts were represented as egg per gram (EPG). A structured questionnaire was used to collect information on factors associated with STH infection. Generalized linear models were used to analyze relationships between STH infection and associated factors.ResultsOverall STH prevalence was 26.5%. Hookworm infection was the most prevalent (18.5%), followed by A.lumbricoides (9.8%) and T.trichiura (0.5%). Prevalence of STH infection was significantly higher in children aged 5 years (Pearson chi-square test, p = 0.009) than in children aged 1 year. The general geometric mean (GM) counts for Hookworm infection was (696.1 EPG; range (530.3–913.8)) with girls having a higher GM (789.8 EPG; range (120–13,200)) than boys. Eating uncooked or unwashed vegetables (adj. Prevalence Ratio (PR) = 1.9, 95% CI: 1.3–2.7) and fruits (adj.PR = 1.8, 95% CI: 1.1–2.8), indiscriminate disposal of young children’s faeces (adj.PR = 1.5, 95% CI: 1.1–2.0); not washing hands after defecation (adj.PR = 2.6, 95% CI: 1.9–3.6); and not deworming children regularly (adj.PR = 1.4, 95% CI: 1.1–1.8) were significantly associated with STH infection.ConclusionThe prevalence of Soil transmitted helminths infection among preschool-age children in Hoima district significantly increased with age. Poor hygiene, inadequate sanitation and irregular deworming were associated with STH infections among PSAC in the study area. Intense health education on the importance of hygienic practices, improved sanitation and regular deworming of PSAC should be integrated into prevention and control programs.

Elimination of soil-transmitted helminthiasis infection in Bangladesh: Knowledge, attitudes, and practices regarding mass drug administration

# Background To determine whether aggregated searches for pregnancy prevention or pregnancy termination predicts US State teenage birth rates. # Methods US birth rate data for the 50 states, and search engine query data (Google Trends) for "condom" and "abortion" were used in an ecological analysis. Multivariable ordinary least squares regression was used to predict state-level birth rates from state-level searches for condom and abortion. # Results The final model accounted for 35% of the variance (R^2^=0.347). Abortion and condom had similar, absolute, standardized parameters (β≈0.5). High state-levels of searches for abortion were associated with higher teenage birth rates, whereas high state-levels of searches for condom were associated with lower teenage birth rates. # Conclusions Google Trends data for abortion and condom can be used to model US state-levels teenage birth rates. This raises the possibility of well targeted, accessible and relevant information for populations wanting to avoid unwanted pregnancies.

Elimination of soil-transmitted helminthiasis infection in Bangladesh: Knowledge, attitudes, and practices regarding mass drug administration

# Background Despite several cycles of Mass Drug Administration (MDA), however, the prevalence of Soil-transmitted helminthiasis (STH) remains high in Bangladesh. A clear understanding of local knowledge, attitudes, and practices (KAP) related to the acceptance and utilization of MDA is critical for effective implementation of this intervention. # Methods This research, a cross-sectional descriptive study that utilized quantitative methods, was conducted between February and June 2017. A total of 380 questionnaire surveys were distributed to school-aged children (SAC), the parents of SAC, and school teachers. # Results Out of 160 SACs, 81.9% knew of STH and 75.6% knew of MDA. SAC showed a high awareness of STH and recognized the importance of preventive measures and MDA. In terms of the parents of SAC and school teachers, close to half of the respondents were knowledgeable about STH and MDA. While nearly all of the participants held positive attitudes toward MDA, the respondents pointed out that school-based MDA presents severe limitations, as non-school-going children are neglected by this effort. A total of 68.3% of all school teachers and 56.8% of all parents of SAC found MDA efforts to be effective. # Conclusion STH infections still remain a significant public health burden in Bangladesh. Reforming the MDA policy is necessary to achieve the target of STH elimination.

Elimination of soil-transmitted helminthiasis infection in Bangladesh: Knowledge, attitudes, and practices regarding mass drug administration

Elimination of soil-transmitted helminthiasis infection in Bangladesh: Knowledge, attitudes, and practices regarding mass drug administration

Effect of Multiple Rounds of Mass Drug Administration under Lymphatic Filariasis Elimination Program on Prevalence of Soil-Transmitted Helminthiasis in One of the Co-endemic Districts of India

Both soil-transmitted helminthiasis and lymphatic filariasis are co-endemic in some districts of India. The study was aimed at comparing the prevalence of soil-transmitted helminthiasis (STH) infection before and after mass drug administration (MDA) given for lymphatic filariasis at Alappuzha. We examined stool samples of 219 children aged between 9 and 10 years from nine schools at Alappuzha, Kerala, in June 2015. The current STH situation was compared with that in the year 1999 (before the institution of MDA) in the same age group in the same district. WHO-recommended Kato-Katz technique was used for STH prevalence estimation. Information regarding socio-demographic variables, sanitation, personal hygiene practices was also recorded. Chi-square test was used to study association of risk factors with STH infection. A total of 79 (36.07%) children were found to be positive for STH infection. Out of all samples positive for Ascaris lumbricoides, 4 (5%) were found co-infected with Trichuris trichiura and none with hookworm. Factors like absence of household latrine, lack of hand washing before meals and practice of consuming unwashed fruits were found to be significantly associated with occurrence of STH infection. Over the years, consecutive rounds of MDA for LF have led to a decline in intestinal worm burden but with little effect on the overall prevalence of STH. Thus, STH control activities working synergistically with the Filarial Elimination Strategy can yield better results in the co-endemic areas with optimum resource utilization.

The COUNTDOWN Study Protocol for Expansion of Mass Drug Administration Strategies against Schistosomiasis and Soil-Transmitted Helminthiasis in Ghana.

(1) Background: Current international policy for schistosomiasis and soil-transmitted helminthiasis (STH) control emphasises mass administration of deworming drugs in school-based programmes. However, this approach is insufficient to control the transmission of these diseases, and their burden in non-school cohorts is recognised, albeit under-researched. This research will investigate the feasibility and acceptability of expanding access to praziquantel (PZQ) against schistosomiasis, and albendazole (ALB) against STH, to communities in selected transmission settings in Ghana. (2) Methods: A three-site longitudinal study will be implemented to investigate the effectiveness of expanding treatment strategies for PZQ and ALB to community members. In the context of community mass drug administration (to preschool children, school non-attending children, and adults, including pregnant women), the intervention will be assessed in a random sample of community members, at baseline with follow-up at 6, 12, and 18 months. In each community, 658 participants will be enrolled, and 314 followed up at each time point. The primary outcome measure is the prevalence of infection of Schistosoma haematobium and/or S. mansoni at study endpoint, as assessed by longitudinal surveys. Secondary outcomes are to quantify the infection of schistosomiasis and STH infections in non-treated cohorts, reductions in prevalence of STH, and intensity of schistosomiasis and STH, and treatment coverage. Nested within this study will be qualitative, cost-benefit, and cost-effectiveness evaluations that will explore accessibility, feasibility, and economic impact of expanded treatment from different complementary perspectives. (3) Discussion: Using a multidisciplinary approach, this study will generate evidence for improved availability, acceptability, affordability, and accessibility to deworming drugs against schistosomiasis and STH to individuals and communities in Ghana. This is likely to have considerable research, programmatic, and political value to contribute evidence for national programme policy development within Ghana, and, more broadly, World Health Organization policy development.

Risk Factors for Soil-Transmitted Helminthiasis in Preschool Children Living in Farmland, North Sumatera, Indonesia.

Background Disease burden from soil-transmitted helminthiasis (STH) is mainly attributed to its chronic and insidious impact on health and quality of life. Strategy recommended by World Health Organization (WHO) to control it was previously focused on school-aged children, but now preschool-aged children are involved. This study was intended to determine STH infection risk factors in preschool children. Methods A cross-sectional study was conducted in Suka Village, North Sumatera, Indonesia, from October to December 2016. Subjects were children aged 1 to 5 years without history of taking antihelminthic. Subjects were obtained by consecutive sampling. Demographic data and risk factors for helminthiasis were collected using questionnaire-based interview. Subjects were divided into two groups, positive and negative STH infection, based on Kato Katz method. Analysis was done using chi-square and logistic regression test. p value < 0.05 was considered significant. Results We enrolled 90 subjects in this study, with the mean age being 31.7 months. STH infection prevalence was 34.4%. Statistical analysis revealed that mother/caregiver hand washing habit (p = 0.007), mother/caregiver nail trimming habit (p = 0.018), and children nail trimming habit (p = 0.022) were significant risk factors for STH infection. Conclusion Mother/caregiver hand washing habit is the most influential risk factor for STH infection in preschool children.

Assessment of the burden of soil-transmitted helminthiasis after five years of mass drug administration for Onchocerciasis and Lymphatic filariasis in Kebbi State, Nigeria

There is a hypothesis that Mass drug administration (MDA) of ivermectin and albendazole for the treatment of onchocerciasis and lymphatic filariasis could have an impact on the burden of soil-transmitted helminthiasis (STH) in MDA communities. We, therefore, assessed the burden of STH (Ascaris lumbricoides, Trichuris trichiura, and hookworm) infections in nine communities from 3 LGAs (two MDA local government areas (LGAs) and one control LGA) in Kebbi State, Nigeria after 5-years (2010–2015) of MDA for onchocerciasis and/or lymphatic filariasis. We also administered questionnaire to obtain demographic information and history of MDA in the past five years. The three LGAs are Bagudo (Ivermectin MDA); Zuru (Ivermectin/Albendazole MDA) and Dandi (No MDA). The study was a cross sectional survey. The total number of people that complied with provision of stool samples and questionnaire were 1357 persons; stool samples collected were examined for STH infections in the three LGAs. Zuru LGA had the highest prevalence of STH (41.89, 95% CI: 37.08–46.81) followed by Dandi LGA (24.66, 95% CI: 20.69–28.97) and Bagudo LGA (3.36, 95% CI: 1.97–5.32). Prevalence of STH infection was not significantly different among age group and sex. Geometric mean intensity per gram of infection for both A. lumbricoides and Hookworm were highest in Zuru LGA with (1.16 GMI, 95% CI: 0.97–1.36) and (1.49 GMI, 95% CI: 1.29–1.70) respectively. Treatment coverage was less than 65% from 2010 to 2013 in the intervention LGAs. The study shows that STH is still a public health problem in Zuru LGA (IVM+ALB) and requires MDA of albendazole for STH control to continue, while Dandi LGA (No MDA history) requires MDA with albendazole to scale up treatment for STH control.

Water Resource, Hygienic Practice, and Soil Transmitted Helminthiasis in Some Rural Communities of Osun State, Nigeria

Provision of water, sanitation and hygiene (WASH) resources has been advocated as necessary add-on strategy for sustainable control of soil-transmitted helminthiasis (STH) alongside annual mass drug administration (MDA) of albendazole to endemic communities. This study investigated the burden of STH and status of WASH resources in eight rural communities in Aiyedaade LGA, Osun State, Nigeria. Four of the communities were supported with improved water and hygiene resources (Category A), and another four supported only with improved water resources (Category B). Two hundred and sixteen (216) fresh stool samples were collected from consenting community members and screened for Ascaris lumbricoides, Hookworm and Trichuris trichiura infections using ether concentration method. The status and condition of WASH resources were determined using questionnaire and physical observation. An overall prevalence of 35.2% was observed for any STH infection. Species’ prevalence of Ascaris lumbricoides, Hookworm and Trichuris trichiura prevalence was 33.8%, 22.7%, and 0.5% respectively. Intensity of STH infection was significantly higher in Category A communities than in Category B communities. The prevalence of STH in Category A communities was higher (42.0%) than that in Category B communities (30.1%). There were significant differences (p = 0.000) in STH infections between the two categories. The status of improved water supply was not significantly different (p = 0.3153) in the two categories. Knowledge, attitude, and practices about STH, its transmission and control were low in both categories of communities. These results imply that current implementation of WASH which tends to focus on resource distribution, equity, and coverage, is unlikely to impact on STH transmission and control. Therefore, it is necessary for WASH providers to consider STH transmission control in their planning and implementation of WASH intervention for STH endemic communities.

A preliminary survey of school-based water, sanitation, hygiene (WASH) resources and soil-transmitted helminthiasis in eight public schools in Odeda LGA, Ogun State, Nigeria

AbstractThis cross-sectional study was undertaken to assess the status of school-based water, sanitation and hygiene (WASH) resources and soil-transmitted helminthiasis (STH) in Odeda, Ogun State, Nigeria. The status and condition of WASH resources were determined in eight selected schools (three with WASH support and five without). Stool samples were also collected from 428 pupils from both school categories and screened for STH infections. Findings showed that water and sanitation conditions of WASH resource programming schools were better than those in schools without WASH support. However, pupils’ knowledge about STH infections and basic hygiene were not significantly different between both categories of school (P &amp;gt; 0·05). The prevalence of Hookworm, Ascariasis and Trichuriasis cases recorded were 26·2, 18·2 and 1·6% respectively, with an overall prevalence of 33·4%. By school categories, Ascariasis (14·9vs20·6), Hookworm (17·7vs32·0), Trichuriasis (1·7vs1·6) and, any STH prevalence (27·4vs37·5) were recorded for schools with WASH resource programming and those without respectively. A greater portion of the infected children 95 (66·4%) were from schools without WASH support. Our findings imply that WASH resource may have very positive impact on the control of STH among school children. However, there is need for improvement on coverage, adequacy and maintenance of WASH facilities in school.

Initiating NTD programs targeting schistosomiasis and soil-transmitted helminthiasis in two provinces of the Democratic Republic of the Congo: Establishment of baseline prevalence for mass drug administration

BackgroundSchistosomiasis (SCH) and soil-transmitted helminthiasis (STH) are widely distributed in the Democratic Republic of the Congo (DRC) and constitute a serious public health problem. As recommended by the World Health Organization (WHO), before launching mass chemotherapy to control these diseases, parasitological surveys were conducted in sentinel sites in six health zones (HZs) in Bandundu and Maniema provinces. Baseline prevalence and intensity of infection for SCH and STH were determined to establish the appropriate treatment plan using Praziquantel (PZQ) and Albendazole (ALB). MethodsParasitological surveys were conducted from April to May 2015 in twenty-six selected sampling units (schools) for baseline mapping in six HZs: Fifty school children (25 females and 25 males) aged 9–15 years were randomly selected per sampling unit. A total of 1300 samples (urine and stool) were examined using haematuria dipsticks, parasite-egg filtration and the point-of-care Circulating Cathodic Antigen (POC-CCA) assay for urine samples and the Kato-Katz technique for stool specimens. ResultsThree species of schistosomes (S. mansoni, S. haematobium and S. intercalatum) and three groups of STH (hookworm, Ascaris and Trichuris) were detected at variable prevalence and intensity among the schools, the HZs and the provinces. In Bandundu, no SCH was detected by either Kato-Katz or the POC-CCA technique, despite a high prevalence of STH with 68% and 80% at Kiri and Pendjua HZs, respectively. In Maniema, intestinal schistosomiasis was detected by both Kato-Katz and POC-CCA with an average prevalence by Kato-Katz of 32.8% and by POC-CCA of 42.1%.Comparative studies confirmed the greater sensitivity (and operational feasibility) of the POC-CCA test on urine compared to Kato-Katz examination of stool for diagnosing intestinal schistosomiasis even in areas of comparatively light infections. STH was widely distributed and present in all HZs with a mean prevalence (95% CI) of 59.62% (46.00–65.00%). The prevalence of hookworm, roundworm and whipworm were 51.62% (32.40%–71.50%), 15.77% (0.50%–39.60%) and 13.46 (0.50%–33.20%), respectively. ConclusionThis study provided the evidence base for implementing programs targeting SCH and STH in these Health Zones. Observations also reinforce the operational value and feasibility of the POC-CCA test to detect S. mansoni and, for the first time, S. intercalatum infections in a routine NTD program setting.

Total serum IgE levels in soil-transmitted helminth infected children with atopy symptoms

Background High total serum immunoglobulin E (IgE) levelsand eosinophilia are markers for atopy, but other factors mayalso play a key role in affecting atopy, such as intestinal parasiticinfection. Helminthiasis has been associated with a reduced riskof atopy and asthma symptoms in areas with high prevalence ofparasitic infections.Objective To assess for associations between total serum IgElevel and soil-transmitted helminthiasis (STH) infection, as wellas between STH infection and allergy symptoms.Methods We conducted a cross-sectional stu dy on 84consecutively-enrolled children , aged 7- 13 years, in theSecanggang Subdistrict, Langkat District, North SumateraProvince. Subjects were enrolled into one of two groups, with orwithout STH infection. Total serum IgE measurements and stoolSTH examinations were performed in all subjects. Data on atopyor allergy symptoms were obtained by parental interview.Results The 42 subjects with STH infection had significantlyhigher mean total serum lg E levels than the 42 subjects withoutinfec tion, 1,13 1.26 IU/mL and 744.76 IU/mL, respectiv ely(P = 0.029). We also fo und significant positive association sbetween STH infection and asthma symptoms (P= 0.049), as wellas eczema symptoms (P=0.044).Conclusion Mean total serum IgE level is higher in STHinfectedsubjects than in those without infection. In addition,STH infection is positively associated with asthma and eczemasymptoms.

Efficacy of mebendazole and levamisole, alone or in combination, for soil-transmitted helminthiasis

BackgroundThe World Health Organization (WHO) recommends four, single-dose drugs (albendazole, levamisole, mebendazole, and pyrantel pamoate) for management of soil­transmitted helminthiasis (STH). Previous studies have shown varied and inconsistent outcomes of these STH treatments.ObjectiveTo compare the efficacy of mebendazole and levami­sole, alone or in combination, for the treatment of STH.MethodsAn open randomized controlled trial was conducted in Secanggang, North Sumatera from August to October 2009. School-aged children with STH infection were randomized into three groups. Group I received a single dose of mebendazole (500 mg); group II received a single dose of levamisole (2.5 mg/kg); and group III received a single dose of mebendazole-levamisole combined. Stool samples were collected at baseline, and the 1st, 2nd, 3rd, and 4th weeks after treatment and examined by the Kato-Katz technique. Statistical analyses were Kruskal-Wallis test for cure rate and Analysis of Variance (ANOVA) test for egg reduction rate. ResultsSTH was diagnosed in 197 children with the following parasite species: Ascariasis (96 children, 48.7%), Trichuriasis (58 children, 29.4%), and mixed infection (43 children, 21.8%). We found no hookworm infection in any of our subjects. Groups I and III had significantly higher efficacy (P=0.0001) against STH (egg reduction rate 99.3% and 99.9%; cure rate 92.2% and 98.4%, respectively) at 4th week of treatment.ConclusionA single dose of mebendazole alone and combined with levamisole have better efficacy compared to a single dose of levamisole for the treatment of STH. The highest efficacy of these treatments is noted at the 4th week after drug administration

Pilot Assessment of Soil-Transmitted Helminthiasis in the Context of Transmission Assessment Surveys for Lymphatic Filariasis in Benin and Tonga

BackgroundMass drug administration (MDA) for lymphatic filariasis (LF) programs has delivered more than 2 billion treatments of albendazole, in combination with either ivermectin or diethylcarbamazine, to communities co-endemic for soil-transmitted helminthiasis (STH), reducing the prevalence of both diseases. A transmission assessment survey (TAS) is recommended to determine if MDA for LF can be stopped within an evaluation unit (EU) after at least five rounds of annual treatment. The TAS also provides an opportunity to simultaneously assess the impact of these MDAs on STH and to determine the frequency of school-based MDA for STH after community-wide MDA is no longer needed for LF.Methodology/Principal FindingsPilot studies conducted in Benin and Tonga assessed the feasibility of a coordinated approach. Of the schools (clusters) selected for a TAS in each EU, a subset of 5 schools per STH ecological zone was randomly selected, according to World Health Organization (WHO) guidelines, for the coordinated survey. In Benin, 519 children were sampled in 5 schools and 22 (4.2%) had STH infection (A. lumbricoides, T. trichiura, or hookworm) detected using the Kato-Katz method. All infections were classified as light intensity under WHO criteria. In Tonga, 10 schools were chosen for the coordinated TAS and STH survey covering two ecological zones; 32 of 232 (13.8%) children were infected in Tongatapu and 82 of 320 (25.6%) in Vava'u and Ha'apai. All infections were light-intensity with the exception of one with moderate-intensity T. trichiura.ConclusionsSynchronous assessment of STH with TAS is feasible and provides a well-timed evaluation of infection prevalence to guide ongoing treatment decisions at a time when MDA for LF may be stopped. The coordinated field experiences in both countries also suggest potential time and cost savings. Refinement of a coordinated TAS and STH sampling methodology should be pursued, along with further validation of alternative quantitative diagnostic tests for STH that can be used with preserved stool specimens.

Mapping of schistosomiasis and soil-transmitted helminthiasis in the regions of Littoral, North-West, South and South-West Cameroon and recommendations for treatment

BackgroundThe previous nationwide mapping of schistosomiasis and soil-transmitted helminthiasis (STH) in Cameroon was conducted 25 years ago. Based on its results, mass drug administration (MDA) of praziquantel was limited to the three northern regions and few health districts in the southern part of Cameroon. In 2010, we started the process of updating the disease distribution in order to improve the control strategies. Three of the ten regions of Cameroon were mapped in 2010 and the data were published. In 2011, surveys were conducted in four additional regions, i.e. Littoral, North-West, South and South-West.MethodsParasitological surveys were conducted in March 2011 in selected schools in all 65 health districts of the four targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration.ResultsThe results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma haematobium was the most prevalent schistosome species, with an overall prevalence of 3.2%, followed by S. mansoni (3%) and S. guineensis (1.2%). The overall prevalence of schistosomiasis across the four regions was 7.4% (95% CI: 6.7-8.3%). The prevalence for Ascaris lumbricoides was 19.5% (95% CI: 18.3-20.7%), Trichuris trichiura 18.9% (95% CI: 17.7-20.1%) and hookworms 7.6% (95% CI: 6.8-8.4%), with an overall STH prevalence of 32.5% (95% CI: 31.1-34.0%) across the four regions. STH was more prevalent in the South region (52.8%; 95% CI: 48.0-57.3%), followed by the South-West (46.2%; 95% CI: 43.2-49.3%), the North-West (35.9%; 95% CI: 33.1-38.7%) and the Littoral (13.0%; 95% CI: 11.3-14.9%) regions.ConclusionsIn comparison to previous data in 1985–87, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is recommended, as well as an extension of praziquantel in identified moderate and high risk communities for schistosomiasis.

Mebendazole vs. mebendazole-pyrantel pamoate for soil-transmitted helminthiasis infection in children

AbstractBackground Soil-transmitted helminthiasis (STH) is the mostcommon infection in developing countries. Although it causeshigh morbidity, it is still difficult to find the efficacy dose ofantihelmintics for its treatment.Objective To determine the efficacy ofmebendazole and mebendazole-pyrantel pamoate in treating STH infection in children.Methods We conducted a randomized open-label controlled trialfrom July to September 2009 in Secanggang, Langkat District,North Sumatera Province, Indonesia, on primary school-agedchildren. Before the intervention, data on age, sex, nutritionalstatus, and STH infection status were collected. The childrenwere randomized into two groups. Children in group I received asingle dose of 500 mgmebendazole while they in group II receiveda single dose of 500 mg of mebendazole combined with 10 mg/kgBW of pyrantel pamoate. We examined subjects' stool specimenson days 7, 14, 21, and 28 after treatment to determine cure ratesand egg reductions. Statistical analyses were performed by Chisquare and student's Ttest with 95% confidence intervals and Pvalues of&lt; 0.05 considered to be significant.Results We found that the cure rates were 95.4%, 78.5%, and893%for Ascaris lumbricoides, Trichuris trichiura, and mixed (A lumbricoidesand T trichiura) infections, respectively, in the mebendazole group.The cure rates were 98.5%, 89.2%, and 90.2% for A lumbricoides,T trichiura, and mixed infections, respectively, in the mebendazolepyrantelpamoate group. Although the cure rate results were notsignificantly different between the 2 treatment groups, the total eggsper gram (EPG) was significantly lower for both A lumbricoides andT trichiura infections (P=0.001 and P=0.002, respectively) in thecombination therapy group than in the mebendazole alone group.Conclusion Mebendazole in combination with pyrantel pamoatehas higher efficacy than mebendazole alone in terms of faster eggreduction rates. However, the cure rates of these two antihelminticsregimens are similar.

Mebendazole vs. mebendazole-pyrantel pamoate for soil-transmitted helminthiasis infection in children

Mebendazole vs. mebendazole-pyrantel pamoate for soil-transmitted helminthiasis infection in children

Prevalence Soil Transmitted Helminthiasis and malaria co-infection among pregnant women and risk factors in Gilgel Gibe dam Area, Southwest Ethiopia

BackgroundMalaria and Soil Transmitted Helminthiasis (STH) are co-endemic and major public health problems in Ethiopia. The aim of the study was to assess the prevalence of malaria and STHs co-infection and to determine the association risk factors.MethodsA cross-sectional community based study was conducted on 388 pregnant women living in three districts around Gilgel Gibe Dam area, southwestern Ethiopia. Socio-demographic and socio-economic data, single stool sample and blood sample were collected from each participant.ResultsThe prevalence of STH and malaria was 159 (41%) and 45 (11.6%), respectively and the prevalence of STHs/malaria co-infection was 30 (7.7%). Hookworm was the most prevalent 114 (29.4%) soil transmitted helminthiasis infection followed by Ascaris lumbricoides (A. lumbricoides) 58 (15%) and Trichuris trichiura (T. trichiura) 13 (3.4%). Habit of eating soil (Adjusted Odds Ratio (AOR) = 4.64, 95% CI: 1.50-14.36, P=0.008), presence of stagnant water near study participants’ house (AOR=2.99, 95% CI: 1.28-6.99, P=0.012) and habit of using human feces as a fertilizer (AOR= 5.34, 95% CI: 1.99-14.28, P<0.001) were found to be significantly associated with malaria and STH co-infection among the pregnant women. Hookworm parasitic load was positively correlated with malaria parasitic load (r = 0.299, P<0.001) while A. lumbricoides parasitic load was negatively correlated with malaria parasitic load (r = −0.095, P<0.001).ConclusionIntestinal parasite and/or malaria co-infection is a health problem among pregnant women living around Gilgel Gibe dam area. Therefore, intervention including improving sanitation, removing stagnant water, and health education to the pregnant women should be given.

Monitoring the impact of a mebendazole mass drug administration initiative for soil-transmitted helminthiasis (STH) control in the Western Visayas Region of the Philippines from 2007 through 2011

School-aged children in tropical developing countries carry the highest burden of soil-transmitted helminth (STH) infections in the world. The Western Visayas region of the Philippines continues to struggle with this as a major public health issue in both private and public schools. The War on Worms-Western Visayas approach was launched in 2007 with school-based mass drug administration (MDA) as one of the strategies to control morbidity from STH in support of the Department of Health – Integrated Helminth Control Program. This study aimed to determine trends in prevalence and intensity of STH infections as well as to assess related morbidity and program sustainability through 2011. A cross-sectional parasitologic survey was conducted on three independent samples of Grade 3 students in 2007, 2009, and 2011. Supporting aggregate data were obtained for MDA coverage, National Achievement Test mean percentage scores, and nutritional status. Tests for trend were utilized to detect changes in prevalence over time, with a particular emphasis on trends seen between 2009 and 2011. The initial impact of the program was robust as cumulative prevalence, infection intensities, and parasite densities were all reduced four years following the launch. However, subsequent and significant increases in each were found from 2009 until 2011. These results implicate issues with program sustainability, despite consistent MDA, and existing frameworks for environmental sanitation, hygiene, and education.