Trichuris Trichiura Infections Research Articles

A randomized assessors-blind clinical trial to evaluate the safety and the efficacy of albendazole alone and in combination with mebendazole or pyrantel for the treatment of Trichuris trichiura infection in school-aged children in Lambaréné and surroundings.

Helminthiasis remains a public health issue in endemic areas. Various drugs have been proposed to improve efficacy against helminths. The study aimed to assess the safety and efficacy of three different anthelmintic combinations to treat Trichuris trichiura infections. We conducted a randomized assessors-blind clinical trial involving children aged 2-17 years with T. trichiura. Participants were randomly assigned to one of three treatment arms. On the first and third days, all participants got albendazole 400 mg, and on the second day, albendazole (arm A), mebendazole 500 mg (arm B), or pyrantel 125 mg/kg (arm C). We assessed treatment efficacy using the cure rate (CR) and egg reduction rate (ERR) at 3 and 6 weeks post-treatment. At 3 weeks post-treatment, ERR and CR were highest in study arm A [ERR = 94%, 95% confidence interval (CI): 92-95; CR = 71%; 95% CI: 58-81] compared to the B and C arms. Decrease in ERR was significant only for arm B versus arm A (P-value <0.001); decrease in ERR was significant for arms B and C (P-value <0.001). No statistical difference was observed in CR when comparing arms A and B (P-value =1.00) and C (P-value =0.27). At 6 weeks, a decrease in ERR was observed in three arms, significant only for arm C, 81% (95% CI: 78-83). A significant increase in egg counts was observed between 3 and 6 weeks post-treatment. All treatments were safe with mild adverse events. Albendazole 400 mg/day (arm A) showed the highest efficacy against trichuriasis. Nonetheless, this treatment regimen was able to cure half of the treated individuals highlighting concerns about controlling the transmission of T. trichiura.CLINICAL TRIALRegistered at ClinicalTrials.gov (NCT04326868).

Trichuris trichiura infection is associated with changes in gut microbiome composition and function among women of reproductive age from Pemba, Tanzania

Large intestine-dwelling helminths affect microbiome composition. In sub-Saharan Africa, where helminth infections are endemic, the use of chemotherapeutic drugs is the primary strategy for controlling soil-transmitted helminthiases (STHs). However, the emergence of anthelmintic resistance necessitates the urgent exploration of alternative and complementary treatments to achieve the World Health Organization’s goal of eliminating STHs. One promising avenue involves the manipulation of gut microbiota in at-risk populations. This study aimed to enhance the understanding of the interplay between Trichuris trichiura and the gut microbiome. In this study, we used the Mini-FLOTAC technique for parasitological analyses and a shotgun metagenomic sequencing approach to investigate the effect of T. trichiura on the gut microbiome by comparing infected and non-infected women of reproductive age (WRA) from Pemba. Structural and functional analyses of the gut microbiome revealed that T. trichiura infection shaped the host gut microbiome in WRA. Some taxa vary according to infection status. Prevotella genus was more abundant in healthy participants, whereas species such as Weissella cibaria, Leuconostoc citreum (new emergent probiotics), and Leuconostoc lactis (starter) decreased in infected individuals, suggesting the use of potential probiotic treatments to mitigate dysbiosis induced by STHs. Furthermore, the overall number of common fungi, irrespective of species, was significantly higher in the mycobiome of Trichuris infected participants. Functional analysis revealed significant differences in metabolic pathways (p &amp;lt; 0.05), with cholesterol metabolism and pathogenic infections being more abundant in the infected samples than in the non-infected samples. In conclusion, this study sheds light on the intricate interactions between helminth infections and the gut microbiome in the WRA, particularly in STH-endemic regions. The identified associations between specific gut microbial changes and T. trichiura infection may pave the way for innovative complementary treatments to effectively combat STHs.

S2900 Trichuris Trichiura Infection Detected During Screening Colonoscopy

S2900 Trichuris Trichiura Infection Detected During Screening Colonoscopy

Fine mapping of ascaris lumbricoides, trichuris trichiura and hookworm infections in sub-districts of makenene in Centre Region of Cameroon

Fine mapping of ascaris lumbricoides, trichuris trichiura and hookworm infections in sub-districts of makenene in Centre Region of Cameroon

Predisposition to soil-transmitted helminth reinfection after four rounds of mass drug administration: results from a longitudinal cohort in the Geshiyaro project, a transmission elimination feasibility study in the Wolaita zone of southern Ethiopia.

Current WHO strategies for reaching soil-transmitted helminths (STH) elimination as a public health problem excludes treating certain adult populations in endemic areas, creating infection reservoirs that drive 'bounce back' of STH infection to pretreatment levels post-mass drug administration (MDA). Predisposition is a widespread, but poorly understood phenomena among helminth infections where individuals are predisposed to reinfection after repeated treatments. This analysis uses Geshiyaro project data, an STH control programme exploring transmission interruption by community-wide MDA and enhanced water, sanitation and hygiene during 2019-2023. Parasitological survey data from longitudinal cohorts are analysed using Kendall's Tau-b rank correlation to assess the evidence for predisposition to light or heavy infection between four consecutive rounds of MDA. Correlation analyses revealed the strongest evidence for predisposition to heavy or light Ascaris lumbricoides infection was between survey 1 and 2 (Tau-b 0.29; p<0.001). Overall patterns were not observed for Trichuris trichiura or hookworm infections, however, some significant and notable correlations were recorded for some stratifications and time points. Evidence for predisposition in endemic settings in southern Ethiopia with low STH prevalence suggests that more targeted approaches to MDA in those predisposed to infection may be a sensible control strategy if cheap, point of care diagnostics are available.

Physical Fitness, Growth and Appetite of Kenyan School Boys with Hookworm, Trichuris trichiura and Ascaris lumbricoides Infections are Improved Four Months after a Single Dose of Albendazole

We studied physical fitness with the Harvard Step Test, growth, and appetite in primary school boys infected with hookworm (96% baseline prevalence), Trichuris trichiura (98% prevalence) and Ascaris lumbricoides (41% prevalence) who received a single 600-mg dose of albendazole or an identical placebo. Boys were examined, allocated at random within pairs by descending hookworm egg count to placebo (n = 26) or albendazole (n = 27) groups, treated, and re-examined 4 mo later. Four months after treatment, the albendazole group showed highly significant improvements in fitness score, resting heart rate, and heart rates at 1, 2, 3 and 4 min after the Harvard Step Test, whereas the placebo group had not changed significantly. The albendazole group also exhibited significantly more rapid growth judged by weight gain (1.0 kg greater than the placebo group, P < 0.0002), height increment (0.6 cm more, P < 0.003), arm circumference (0.3 cm more, P < 0.0002), and triceps and subscapular skinfolds (1.0 mm more, P < 0.0002), and showed improved appetite with objective and subjective measures. We conclude that single-dose treatment with albendazole can allow improved physical fitness, growth, and appetite in school-age children in areas where these helminths and poor growth are highly prevalent.

Anthelmintic treatment follow up in a rural community in Camamu, Bahia, Brazil.

Enteroparasites are an important public health problem and the treatment seeks to cure and reduce transmission. The aim of this study was to evaluate the therapeutic efficacy of anthelmintic treatment in individuals living in a rural community area in Camamu, Bahia, Brazil. The parasitological diagnosis was performed by spontaneous sedimentation, Baermann-Moraes and Agar Plate Culture methods. A total of 212 individuals were evaluated. The most frequent helminth was Trichuris trichiura, 24.5% (52/212), followed by Ascaris lumbricoides, 21.2% (45/212), hookworms, 16.5% (35/212), and S. stercoralis, 4.7% (10/212). In the anthelmintic treatment follow up, T. trichiura infection presented the lowest parasitological cure rate, only 60.6% (20/33). Hookworm, Ascaris lumbricoides and Strongyloides stercoralis infections demonstrated cure rates of 70.5 (12/17), 78.1 (25/32) and 100% (5/5), respectively. Individuals who remained infected underwent a new drug therapy. The second parasitological cure rate for T. trichiura was 38.5% (5/13), and 66.7% (2/3) and 75% (3/4) for hookworms and Ascaris lumbricoides, respectively. Trichuris trichiura infection presented the lowest parasitological cure rate at this second evaluation. This reinforces the need to perform a follow-up of all treated individuals. The possibility of drug resistance denotes the necessity for studies to clarify the mechanisms and to evaluate new therapeutic approaches.

Spatio-temporal distribution characteristics of soil-transmitted nematodiasis in Sichuan Province from 2016 to 2021

To investigate the trends in the prevalence of soil-transmitted nematode infections and the spatio-temporal distribution characteristics of soil-transmitted nematodiasis in Sichuan Province from 2016 to 2021, so as to provide the evidence for formulating the soil-transmitted nematodiasis elimination strategy in Sichuan Province. The soil-transmitted nematodiasis surveillance data in Sichuan Province from 2016 to 2021 were collected, and the epidemic trend of soil-transmitted nematode infections was identified. The distribution maps of soil-transmitted nematode infections in Sichuan Province were plotted to identify their spatial distribution characteristics. In addition, the spatial clusters of soil-transmitted nematode infections were detected using globa and local spatial autocorrelation analyses. The prevalence of soil-transmitted nematode infections appeared a decline with time in Sichuan Province from 2016 to 2021 (χ2= 400.24, P < 0.01). Global spatial autocorrelation analysis identified positive spatial autocorrelations in the prevalence of soil-transmitted nematode infections (Moran's I = 0.322, Z = 16.293, P < 0.01), hookworm infections (Moran's I = 0.425, Z = 21.290, P < 0.01), Ascaris lumbricoides infections (Moran's I = 0.102, Z = 5.782, P < 0.01) and Trichuris trichiura infections (Moran's I = 0.084, Z = 6.873, P < 0.01). Local spatial autocorrelation analysis showed that the high-high clusters of soil-transmitted nematode infections were mainly located in 37 counties (cities, districts) of Sichuan Province, and the high-high clusters of hookworm, A. lumbricoides and T. trichiura infections were mainly identified in 39 counties (cities, districts) in mountainous areas around Sichuan Basin and hilly areas, 9 counties (cities, districts) in mountainous areas in southwestern Sichuan Province, and 8 counties (cities, districts) in mountainous areas in southwestern Sichuan Province, respectively. The prevalence of soil-transmitted nematode infections appeared a tendency towards a decline in Sichuan Province from 2016 to 2021, which showed spatial clusters. The management of soil-transmitted nematodiasis requires to be reinforced in high-risk areas of Sichuan Province with adaptations to local epidemiological features.

Efficacy and safety of moxidectin and albendazole compared with ivermectin and albendazole coadministration in adolescents infected with Trichuris trichiura in Tanzania: an open-label, non-inferiority, randomised, controlled, phase 2/3 trial

Control efforts against soil-transmitted helminths focus on preventive chemotherapy with albendazole and mebendazole, however these drugs yield unsatisfactory results against Trichuris trichiura infections. We aimed to assess the efficacy and safety of moxidectin and albendazole compared with ivermectin and albendazole against T trichiura in adolescents living on Pemba Island, Tanzania. This open-label, non-inferiority, randomised, controlled, phase 2/3 trial was done in four secondary schools (Kilindi, Kwale, Ndagoni [Chake Chake District], and Kiuyu [Wete District]) on Pemba Island, Tanzania. Adolescents aged 12-19 years who tested positive for T trichiura in at least two of four Kato-Katz slides with a mean infection intensity of 48 eggs per gram (EPG) of stool or higher were considered for inclusion. Participants were randomly assigned (21:21:2:2:8) to five treatment groups (8 mg moxidectin and 400 mg albendazole [group 1], 200 μg/kg ivermectin and 400 mg albendazole [group 2], 400 mg albendazole [group 3], 200 μg/kg ivermectin [group 4], or 8 mg moxidectin [group 5]) using a computer-generated randomisation code, stratified by baseline T trichiura infection intensity. Study site investigators and participants were not masked to study treatment; however, allocation was concealed to participants. The primary outcome was egg reduction rate (ERR) of T trichiura 14-21 days after treatment in the available case population. Moxidectin and albendazole was considered non-inferior to ivermectin and albendazole (control group) when the lower limit of the two-sided 95% CI of the difference was higher than the non-inferiority margin of -2 percentage points. This study is registered with ClinicalTrials.gov, NCT04700423. Between March 1 and April 30, 2021, 771 participants were assessed for eligibility. 221 (29%) of 771 participants were ineligible and a further 14 (2%) were excluded. 207 (39%) of 536 participants were randomly assigned to moxidectin and albendazole, 211 (39%) to ivermectin and albendazole, 19 (4%) to albendazole, 19 (4%) to ivermectin, and 80 (15%) to moxidectin. Primary outcome data were available for all 536 participants. The geometric mean ERR of T trichiura after 14-21 days was 96·8% (95% CI 95·8 to 97·6) with moxidectin and albendazole and 99·0% (98·7 to 99·3) with ivermectin and albendazole (difference of -2·2 percentage points [-4·2 to -1·4]). No serious adverse events were reported during the study. The most reported adverse events were headache (160 [34%] of 465), abdominal pain (78 [17%]), itching (44 [9%]), and dizziness (26 [6%]). Our findings show inferiority of moxidectin and albendazole to ivermectin and albendazole against T trichiura. However, given the high efficacy, moxidectin coadministration might complement treatment progammes, particularly in areas in which ivermectin is not available FUNDING: Bill and Melinda Gates Foundation, reference number OPP1153928.

Fine mapping of Ascaris lumbricoides, Trichuris trichiura and hookworm infections in sub-districts of Makenene in Centre Region of Cameroun

Preventive chemotherapy (PC) that remains the main control strategy recommended by the World Health Organization to achieve the elimination of soil-transmitted helminth (STH) infections as a public health problem must be strengthened by identifying the remaining transmission hot-spots for the deployment of appropriate control measures. This study was designed to assess the prevalence and infections intensities of soil-transmitted helminths and perform micro scale mapping in order to identify transmission hot-spots for targeted control operations. Stool samples were collected from 1775 children in ten primary schools of eight sub-districts of Makenene in Cameroon. Kato Katz technique was used to process and examine stool samples to detect the eggs of soil-transmitted nematodes. The prevalence of soil-transmitted helminth species as well as the infection intensities was compared. Data visualizations in forms of maps were made using Quantum geographic information system (QGIS) software. The overall prevalence of soil-transmitted helminth infections was 4.8% with a 95% confidence interval (CI) of 3.8–5.9%: 3.0% (95% CI 2.2–3.9) for Ascaris lumbricoides, 1.4% (95% CI 0.9–2.0) for Trichuris trichiura and 0.8% (95% CI 0.5–1.4) for hookworms. The prevalence of soil-transmitted helminth species differ significantly between schools and sub-districts. The intensity of infections was light (2.4%, 1.1% and 0.8%), moderate (0.4%, 0.1% and 0.1%) and heavy (0.2%, 0.2% and 0%) for A. lumbricoides, T. trichiura and hookworm respectively. The mean intensity of infections was 7255 EPG for A. lumbricoides, 2900 EPG for T. trichiura and 298 EPG for hookworm. Between schools, significant difference was recorded in the means of infection intensities of T. Trichiura and hookworms but not for A. lumbricoides. This difference was also significant for T. Trichiura when comparison were between sex. No significant difference were recorded when the comparison were between age. Fine mapping revealed that children harbouring heavy infections were clustered in the same sub-districts; highlighting the presence of high endemicity sub-districts and hot-spots for the transmission of different soil-transmitted helminth species. This study showed a diversity in the prevalence and transmission of different soil-transmitted helminth species. It also hightlighted the need for micro scale mapping to enable the localisation of high endemicity sub-districts and transmission hot-spot sites where targeted control operations must be deployed to achieve STH elimination.

Association of Soil-Transmitted Helminths Infection with Total Serum Immunoglobulin E Levels and Total Eosinophils in Elementary School Students in Medan

BACKGROUND: Soil-transmitted helminths infection is widespread in tropical and subtropical areas. More than 267 million preschool-aged children and more than 568 million school-age children live in areas where this parasite is transmitted intensively and requires treatment and prevention. People at risk are preschool children, school-aged children, reproductive age women, and adults in certain high-risk occupations, such as tea pickers or miners. Worm infections often infect elementary schoolchildren because at this time, children have many activities and are often in direct contact with a dirty environment so that it can cause children not to pay attention to personal hygiene. AIM: This study aimed to determine the association of STH infection with total serum IgE levels and eosinophil counts in elementary school students in Medan. METHODS: This cross-sectional study was conducted on 65 elementary school students at Medan orphanage who met inclusion and exclusion criteria. Examination of STH infection was carried out using Kato-Katz method, and blood tests were performed to assess total serum IgE and blood eosinophils counts. Univariate and bivariate analysis was performed to determine the association of STH infection with total serum IgE levels and eosinophil counts in these students using Pearson correlation test and Chi-square. RESULTS: Of the 65 elementary school students in the orphanage who were willing to have their routine blood and feces checked, 36 boys (55.3%) and 29 girls (44.6%), 39 children were infected with STH (60%). The most common infections were Ascaris lumbricoides (26.1%), Trichuris trichiura (18.4%), and mixed infections (15.3%) with an average of mild infection intensity. The results of the analysis showed that there was no significant association between STH infection and eosinophils counts (p = 0.582, 95% confidence interval, OR 1.3). In addition, there was also no significant association of STH infection with total serum IgE levels (p = 0.883, 95% confidence interval, OR 63.6). CONCLUSION: In this study, there was no association between STH infection with eosinophils counts and total serum immunoglobulin E levels in elementary school students in Medan.

Role of Seasonal Variation on The Prevalence and Risk Factors of Trichuriasis Among the Aboriginal Community in Malaysia.

SummaryTrichuris trichiura is a soil-transmitted helminth prevalent in developing countries with poor, inadequate sanitation and unsafe water sources. In Malaysia, the prevalence of trichuriasis is relatively high among the aboriginal community due to poverty and poor sanitation. However, there are few studies to determine the seasonal variation on the prevalence and risk factors to acquire Trichuris trichiura infection in Malaysia. The present study found higher Trichuris trichiura infection during the dry season (63.6%; 138/217) in comparison to the wet season (55.5%; 142/256). Low household income, low education level and practice of open defecation were significant risk factors to acquire Trichuris trichiura infection during the wet season. Usage of untreated water supplies for daily activities was a risk factor to acquire trichuriasis during the dry season. This study highlighted that poverty and poor sanitation practices as well as drinking untreated water put the aborigines at high risk to acquire trichuriasis. Therefore, health education, improved sanitation and provision of treated water supply are recommended for the prevention and control of Trichuris trichiura infections in the aboriginal community.

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 of soil-transmitted helminth infections, schistosomiasis, and lymphatic filariasis before and after preventive chemotherapy initiation in the Philippines: A systematic review and meta-analysis

ObjectiveTo estimate the impact of preventive chemotherapy on the prevalence and intensity of soil-transmitted helminth (STH) infections, schistosomiasis, and lymphatic filariasis in the Philippines, using systematic review and meta-analysis.MethodsWe included reports reporting prevalence of STH infections, schistosomiasis, or lymphatic filariasis in the Philippines published until 31 March 2021. Peer-reviewed studies were identified in electronic databases. Grey literature reports by the University of the Philippines and the Department of Health were also included. Pooled infection prevalence, before and after the initiation of preventive chemotherapy, stratified by age group, was calculated using the inverse variance heterogeneity model.FindingsA total of 109 reports were included in the review and meta-analysis. Overall prevalence of moderate-heavy intensity Ascaris lumbricoides (6.6%) and Trichuris trichiura (2.7%) infection after initiation of preventive chemotherapy were significantly lower than the prevalence prior to initiation (23.6% for A. lumbricoides and 12.2% for T. trichiura). Prevalence reductions were also found in school and preschool-age children for A. lumbricoides and T. trichiura. Studies conducted after preventive chemotherapy initiation had significantly lower overall prevalence of moderate-heavy intensity schistosomiasis (3.1% vs 0.2%) and of schistosomiasis in school-age children (30.5% vs 1%). Pooled prevalence of lymphatic filariasis prior to preventive chemotherapy initiation was 3.2% across 12 provinces, while currently only two provinces still have prevalence of more than 1%. There were no published studies reporting prevalence of lymphatic filariasis after initiation of preventive chemotherapy. Heterogeneity was high with I2 mostly above 90%.ConclusionThe burden of STH infections and schistosomiasis in children were significantly lower in studies conducted following the initiation of preventive chemotherapy. Eliminating morbidity and interrupting transmission, however, may require expanded control initiatives including community-wide treatment, and improved water, sanitation, and hygiene. Lymphatic filariasis burden has decreased since the implementation of preventive chemotherapy, with all but two provinces having reached the elimination of lymphatic filariasis as a public health problem.

Infection of Plasmodium falciparum and helminths among school children in communities in Southern and Northern Ghana

BackgroundInfections of Plasmodium species, Schistosoma species and soil-transmitted helminths (STH) inflict a significant burden on children mostly in deprived communities in Ghana. Despite the deployment of malaria vector control and the annual Mass Drug Administration by National Control Programmes, these infections still pose major public health concerns in Ghana. Some remote communities which are hard-to-reach are not covered by MDA campaigns which is a major challenge to meeting elimination targets. Adequate data is necessary for formulating policies and strengthening interventions to mitigate transmission. This study assessed the infection burden of Plasmodium, Schistosoma species and STH infections among school children in communities in Southern and Northern Ghana.MethodSchool children living in communities in Southern (Ada Foah, Pediatorkope, Tuanikope) and Northern (Kpalsogu) Ghana were enrolled in a cross-sectional study. A total of 493 (241 males and 252 females) school children aged (2–15 years) were enrolled in the study. Stool samples were collected to screen for Schistosoma mansoni and STH infections using the formol-ether concentration technique and urine samples were also collected to screen for S. haematobium using the routine urine examination method. Plasmodium parasitaemia was determined from thick and thin finger-prick blood samples.ResultsOverall, the prevalence of P. falciparum, S. mansoni, S. haematobium, Trichuris trichiura and hookworm infections were 17.2% (95%CI 12.8–19.7), 22.6% (95%CI 25.2–32.7), 1.6% (95%CI 0.89–5.2), 1.2% (95%CI 0.78–4.8) and 1.2% (95%CI 0.78–4.8) respectively. Plasmodium falciparum infection was generally widespread in all the study sites with Ada Foah recording the highest prevalence (35.3%) and Kpalsogu recording the lowest (5.8%). Schistosoma mansoni was present in only two Southern communities with Tuanikope recording the highest prevalence of 70.3% as against 51.5% recorded in Pediatorkope. A total of 4.5% (95% CI 2.82–10.8) of the children were co-infected with P. falciparum, Schistosoma species and STHs. This occurred only in the Southern communities; of which combination of P. falciparum and S. mansoni were predominant (1.4%).ConclusionA relatively low burden of parasites co-infection among children only in the Southern communities was detected. However, there were a high prevalence of single infections of P. falciparum and S. mansoni in those communities. Control measures for the helminths needs to be restarted in the island communities with a high burden of S. mansoni infections and that of Plasmodium needs to be scaled up in Ada Foah where P. falciparum infections were high.

Surveillance of human soil-transmitted nematodiasis in Jurong City from 2016 to 2020

To investigate the prevalence of soil-transmitted nematode human infections in Jurong City from 2016 to 2020, so as to provide the scientific evidence for formulating the control strategy. During the period from 2016 to 2020, the permanent residents at ages of over 3 years living in Jurong City were selected as the study subjects. Stool samples were collected for the detection of soil-transmitted nematode eggs using the modified Kato-Katz thick smear method (two detections for one stool sample), and the species of hookworm was identified in stool-positive stool samples using the culture method. The prevalence and intensity of soil-transmitted nematode infections were calculated, and the change of the infection prevalence among years was examined using the Cochran-Armitage test for trend. A total of 10 011 people-time populations were detected for soil-transmitted nematode infections in Jurong City from 2016 to 2020, and 56 egg-positives were identified, with mean prevalence of 0.56%. The prevalence of soil-transmitted nematode human infections appeared a tendency towards a decline year by year in Jurong City (χ2trend = 5.15, P < 0.01). The mean prevalence of hookworm, Ascaris lumbricoides and Trichuris trichiura infections was 0.44%, 0.11% and 0.20% in Jurong City from 2016 to 2020, respectively, and individuals with hookworm infections accounted for 78.57% of all cases with soil-transmitted nematode infections. Single parasite (98.21%) and mild infection were pre-dominant in individuals with soil-transmitted nematode infections, and no multiple infections were seen after 2016. The prevalence of human soil-transmitted nematodiasis is low in Jurong City. Based on reinforcement of soil-transmitted nematodiasis surveillance, an increase in the health education investment is required to consolidate the control achievements.

PENGGUNAAN HANDUK, KEBIASAAN MENGGIGIT KUKU JARI TANGAN TERHADAP KEJADIAN INFEKSI SOIL TRANSMITTED HELMINTH (STH) PADA ANAK PANTI ASUHAN DI JAYAPURA

Problem: Helminthiasis is generally caused by the group of Soil Transmitted Helminth (STH) worms, namely Ascaris lumbricoides, Trichuris trichiura and hookworm. Worms have an impact on health problems such as diarrhea, malnutrition and anemia. Risk factors for helminthic infection including poor personal hygiene care, nail biting habits, the habit of not wearing footwear, contact with soil media, will increase the transmission of eggs that inhabit the intestines. The Aim Of The Research: To determine the prevalence of helminthiasis and risk factors for STH intestinal worms in children living in an orphanage in Jayapura. Research Method: Fecal samples were collected from orphanage children (n= 63) using saturated salt solution to detect the presence of STH worm eggs between months August-October 2020. The Results: The prevalence of STH worm infection in orphanages in Jayapura was 12.69% in the highest age group, 6-11 years old with Ascaris lumbricoides, Trichuris trichiura and hookworm infections. The dominant risk factors represented among the most infected children include sharing of towels, the habit of biting fingernails and the habit of not wearing footwear while playing were very significant factors for the incidence of STH worm infection (p&lt;0.05). Conclusion: The prevalence of STH worm infection in orphanage children in Jayapura was 12.69% in the highest age group 6-11 years with the most dominant risk factors are the habit of not wearint footwear while playing, the habit of biting fingernails and sharing towel together.

Hand hygiene intervention to optimise soil-transmitted helminth infection control among primary school children: the Mikono Safi cluster randomised controlled trial in northwestern Tanzania

BackgroundSoil-transmitted helminth (STH) infections are highly prevalent in resource-limited countries. We assessed the effect of a combination intervention aiming to enhance handwashing with soap on STH reinfection following mass drug administration among primary school children in Kagera region, Northwestern Tanzania.MethodsWe conducted a cluster randomised trial in sixteen primary schools with known high STH prevalence. Schools were randomly assigned in a 1:1 ratio to either receive the intervention or continue with routine health education. The intervention included teacher-led classroom teaching, parental engagement sessions, environmental modifications and improved handwashing stations. The evaluation involved two cross-sectional surveys in a representative sample of students, with the end-line survey conducted 12 months after the baseline survey. The primary outcome was the combined prevalence of Ascaris lumbricoides and Trichuris trichiura infections at the end-line survey. Secondary outcomes included reported handwashing behaviour, the prevalence and intensity of individual STHs, and hand contamination with STH ova and coliform bacteria. End-line STH prevalence and intensity were adjusted for baseline differences of potential confounders.ResultsAt the end-line survey, 3081 school children (1566 from intervention schools and 1515 from control schools) provided interview data and stool specimens. More school children in the intervention group reported the use of water and soap during handwashing compared to school children in the control group (58% vs. 35%; aOR=1.76, 95%CI 1.28–2.43, p=0.001). The combined prevalence of A. lumbricoides and T. trichiura infections was 39% in both trial arms (aOR = 1.19; 95%CI 0.74–1.91). The prevalence of A. lumbricoides was 15% in the intervention and 17% in the control arm (aOR =1.24, 95%CI 0.59–2.59) and that of T. trichiura was 31% in both arms (aOR=1.17, 95%CI 0.73–1.88). No significant differences were found for STH infection intensity in both the main study and the hand contamination sub-study.ConclusionsThe intervention was effective in increasing reported handwashing behaviour at school, but failed to show a similar effect in the home. The intervention had no effect on STH infection, possibly due to infection in the home environment, other transmission routes such as contaminated water or food or limited changes in school children’s handwashing behaviour.Trial registrationThe trial was registered on June 21, 2017, by the International Standard Randomised Controlled Trial Number (ISRCTN45013173).

Efficacy and Safety of Albendazole and High-Dose Ivermectin Coadministration in School-Aged Children Infected With Trichuris trichiura in Honduras: A Randomized Controlled Trial.

The efficacy of currently available anthelminthics against Trichuris trichiura infections is significatively lower than for other soil-transmitted helminths. The combination of ivermectin (IVM) and albendazole (ALB) has shown significant improvements in efficacy. Safety and efficacy randomized controlled clinical trial comparing 3 experimental regimens against ALB monotherapy for the treatment of T. trichiura infections in northern Honduras. Infected children were randomized to 4 treatment arms: arm 1, single-dose ALB (400 mg); arm 2, single-dose ALB (400 mg) plus IVM (600 μg/kg); arm 3, ALB (400 mg) for 3 consecutive days; or arm 4, ALB (400 mg) plus IVM (600 μg/kg) for 3 consecutive days. Efficacy was measured based on the egg reduction and cure rates, both assessed 14-21 days after treatment, using the Kato-Katz method. Safety was evaluated by analyzing the frequency and severity of adverse events. Of 176 children randomized to 1 of the 4 treatment arms, 117 completed treatment and follow-up. The egg reduction rates for arms 1, 2, 3, and 4 were 47.7%, 96.7%, 72.1%, and 100%, respectively; with P values <.001 for comparisons between IVM groups and ALB-only arms. The cure rates were 4.2%, 88.6%, 33.3%, and 100%, respectively. A total of 48 adverse events (85.4% mild) were reported in 36 children. The combined use of ALB and high-dose IVM is a highly effective and well tolerated treatment for the treatment of T. trichiura infections, offering significantly improved treatment for the control of this infection. NCT04041453.

Impact of early life geohelminths on wheeze, asthma and atopy in Ecuadorian children at 8 years.

BackgroundEarly‐life exposures to geohelminths may protect against development of wheeze/asthma and atopy.ObjectiveTo study the effect of maternal geohelminths and infections in children during the first 5 years on atopy, wheeze/asthma and airways reactivity/inflammation at 8 years.MethodsBirth cohort of 2404 neonates followed to 8 years in rural Ecuador. Data on wheeze/asthma were collected by questionnaire and atopy by skin prick test (SPT) reactivity to 9 allergens. We measured airways reactivity to bronchodilator, fractional exhaled nitric oxide (FeNO) and nasal eosinophilia. Stool samples were examined for geohelminths by microscopy.Results1933 (80.4%) children were evaluated at 8 years. Geohelminths were detected in 45.8% of mothers and 45.5% of children to 5 years. Frequencies of outcomes at 8 years were as follows: wheeze (6.6%), asthma between 5 and 8 years (7.9%), SPT (14.7%), airways reactivity (10%) and elevated FeNO (10.3%) and nasal eosinophilia (9.2%). Any maternal geohelminth was associated with reduced SPT prevalence (OR 0.72). Childhood Trichuris trichiura infections during the first 5 years were associated with reduced wheeze (OR 0.57) but greater parasite burdens with Ascaris lumbricoides at 5 years were associated with increased wheeze (OR 2.83) and asthma (OR 2.60). Associations between maternal geohelminths and wheeze/asthma were modified by atopy. Parasite‐specific effects on wheeze/asthma and airways reactivity and inflammation were observed in non‐atopic children.ConclusionsOur data provide novel evidence for persistent effects of in utero geohelminth exposures on childhood atopy but highlight the complex nature of the relationship between geohelminths and the airways. Registered as an observational study (ISRCTN41239086).