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1.
Artigo em Inglês | MEDLINE | ID: mdl-21706929

RESUMO

Only few studies in rural China have explored the epidemiology of intestinal helminth infections and identified risk factors for transmission. The study was carried out in Simao and Mengla counties, where single fecal samples were collected from 317 school-aged children and from 94 inhabitants of a single village. Fecal specimens were examined with the Kato-Katz thick smear method and examined for helminth eggs. Data regarding socio-demographic and behavioral risk factors were collected using questionnaires. In Simao County the overall soil-transmitted helminthes (STH) prevalence was 40.2% (2.7, 5.4 and 35.7% for ascariasis, trichuriasis and hookworm infection, respectively). The STH infection rates were significantly higher in Mengla County, with an overall prevalence of 68.3% (19.0, 34.6 and 47.3% for ascariasis, trichuriasis and hookworm infection, respectively). Females were less likely to be infected with Trichuris trichiura (OR 0.29; 95% CI 0.15-0.56) and with hookworms (OR 0.55; 95% CI 0.33-0.93) than males. Hookworm infections were more prevalent among those 12 years of age or older (OR 2.9; 95% CI 1.2-7.1). Children of mothers with educational attainment of secondary school or higher had a protective effect against T. trichiura (OR 0.18; 95% CI 0.06-0.54) and hookworm (OR 0.21; 95% CI 0.09-0.51) infections. In the village survey, hookworm was the most prevalent species (62.8%) with infection seen in those 50 years of age and older. Based on recommended intervention strategies by the World Health Organization, Simao County should opt for school-based deworming once each year, while Mengla County should implement a similar strategy biannually, but should include the elderly population.


Assuntos
Infecções por Nematoides/epidemiologia , Infecções por Nematoides/transmissão , Microbiologia do Solo , Solo/parasitologia , Adolescente , Ancylostomatoidea/isolamento & purificação , Animais , Ascaris/isolamento & purificação , Criança , China/epidemiologia , Fezes/parasitologia , Feminino , Helmintíase/diagnóstico , Helmintíase/epidemiologia , Helmintíase/transmissão , Humanos , Modelos Logísticos , Masculino , Infecções por Nematoides/diagnóstico , Prevalência , Fatores de Risco , População Rural , Instituições Acadêmicas , Distribuição por Sexo , Inquéritos e Questionários , Trichuris/isolamento & purificação
2.
Parasitol Int ; 56(4): 281-6, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17627869

RESUMO

The purpose of this study was to improve our understanding of the molecular epidemiology of human Blastocystis, focusing on 239 randomly selected individuals in a single village in Yunnan province, China. Emphasis was placed on the relative frequency of different Blastocystis subtypes and underlying risk factors. We used a cross-sectional study design, by employing a pre-tested questionnaire to obtain demographic data and behavioural risk factors, and collected faecal samples for culture and subsequent identification of Blastocystis. DNA was extracted from Blastocystis isolates and the subtypes were identified using 7 subtype-specific sequenced-tagged site (STS) primers. Overall, 78 faecal samples were Blastocystis culture-positive (32.6%, 95% confidence interval: 26.7-38.6%). The majority (n=73, 93.6%) were single infections with one of the known subtypes, whereas 2 isolates consisted of 2 concurrent subtypes. The remaining 3 isolates could not be identified with the currently known STS primers. Risk factors for a Blastocystis infection were drinking unboiled water, consumption of raw water plants and pig ownership. The consumption of raw water plants was positively associated with subtype 1 infections, and drinking unboiled water with subtype 3 infections. In conclusion, human Blastocystis was common in this village in southwest China, and different subtypes were associated with distinct transmission routes or sources of infection, and hence Blastocystis subtypes might be linked to specific environmental compartments.


Assuntos
Infecções por Blastocystis/epidemiologia , Blastocystis/genética , Epidemiologia Molecular , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Blastocystis/classificação , Infecções por Blastocystis/parasitologia , Criança , Pré-Escolar , China , Estudos Transversais , DNA de Protozoário/análise , Fezes/parasitologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco
3.
Acta Trop ; 141(Pt B): 271-80, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25308524

RESUMO

The current global strategy for the control of soil-transmitted helminthiasis emphasises periodic administration of anthelminthic drugs to at-risk populations. However, this approach fails to address the root social and ecological causes of soil-transmitted helminthiasis. For sustainable control, it has been suggested that improvements in water, sanitation and hygiene behaviour are required. We designed a 5-year multi-intervention trial in Menghai county, Yunnan province, People's Republic of China. Three different interventions were implemented, each covering a village inhabited by 200-350 people. The interventions consisted of (i) initial health education at study inception and systematic treatment of all individuals aged ≥2 years once every year with a single dose of albendazole; (ii) initial health education and bi-annual albendazole administration; and (iii) bi-annual treatment coupled with latrine construction at family level and regular health education. Interventions were rigorously implemented for 3 years, whilst the follow-up, which included annual albendazole distribution, lasted for 2 more years. Before the third round of treatment, the prevalence of Ascaris lumbricoides was reduced by only 2.8% in the annual treatment arm, whilst bi-annual deworming combined with latrine construction and health education resulted in a prevalence reduction of 53.3% (p<0.001). All three control approaches significantly reduced the prevalence of Trichuris trichiura and hookworm, with the highest reductions achieved when chemotherapy was combined with sanitation and health education. The prevalence of T. trichiura remained at 30% and above regardless of the intervention. Only bi-annual treatment combined with latrine construction and health education significantly impacted on the prevalence of Taenia spp., but none of the interventions significantly reduced the prevalence of Strongyloides stercoralis. Our findings support the notion that in high-endemicity areas, sustainable control of soil-transmitted helminth infections necessitates measures to reduce faecal environmental contamination to complement mass drug administration. However, elimination of soil-transmitted helminthiasis will not be achieved in the short run even with a package of interventions, and probably requires improvements in living conditions, changes in hygiene behaviour and more efficacious anthelminthic drugs and treatment regimens.


Assuntos
Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Educação em Saúde/métodos , Helmintíase/prevenção & controle , Saneamento/métodos , Solo/parasitologia , Banheiros , Ancylostomatoidea , Animais , Ascaríase/epidemiologia , Ascaríase/prevenção & controle , Ascaris lumbricoides , China/epidemiologia , Fezes/parasitologia , Helmintíase/epidemiologia , Infecções por Uncinaria/epidemiologia , Infecções por Uncinaria/prevenção & controle , Humanos , Higiene , Prevalência , Estudos Prospectivos , Strongyloides stercoralis , Estrongiloidíase/epidemiologia , Estrongiloidíase/prevenção & controle , Taenia , Teníase/epidemiologia , Teníase/prevenção & controle , Tricuríase/epidemiologia , Tricuríase/prevenção & controle , Trichuris
4.
Acta Trop ; 141(Pt B): 184-9, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25174679

RESUMO

The presence of large Trichuris spp. eggs in human faecal samples is occasionally reported. Such eggs have been described as variant Trichuris trichiura or Trichuris vulpis eggs. Within the frame of a randomised controlled trial, faecal samples collected from 115 Bulang individuals from Yunnan, People's Republic of China were subjected to the Kato-Katz technique (fresh stool samples) and the FLOTAC and ether-concentration techniques (sodium acetate-acetic acid-formalin (SAF)-fixed stool samples). Large Trichuris spp. eggs were noted in faecal samples with a prevalence of 6.1% before and 21.7% after anthelminthic drug administration. The observed prevalence of standard-sized T. trichiura eggs was reduced from 93.0% to 87.0% after treatment. Considerably more cases of large Trichuris spp. eggs and slightly more cases with normal-sized T. trichiura eggs were identified by FLOTAC compared to the ether-concentration technique. No large Trichuris spp. eggs were observed on the Kato-Katz thick smears.


Assuntos
Anti-Helmínticos/uso terapêutico , Fezes/parasitologia , Contagem de Ovos de Parasitas , Tricuríase/tratamento farmacológico , Trichuris/isolamento & purificação , Adolescente , Adulto , Albendazol/uso terapêutico , Animais , Criança , Pré-Escolar , China , Feminino , Humanos , Masculino , Fenilenodiaminas/uso terapêutico , Prevalência , Sensibilidade e Especificidade , Tricuríase/epidemiologia , Tricuríase/parasitologia , Adulto Jovem
5.
Artigo em Zh | MEDLINE | ID: mdl-25782270

RESUMO

OBJECTIVE: To understand the status of Toxoplasma gondii infection in the population of Pu'er City, so as to provide the evidence for formulating the strategy of toxoplasmosis control. METHODS: The population from Jingdong, Jinggu, and Menglian counties in Pu' er City was surveyed; IgG of T. gondii in serum was detected by ELISA. RESULTS: Totally 906 resident serum samples were detected and the IgG positive rate was 24.2%. The positive rates were higher in the aged groups of 30-39 years and 60-69 years, and the difference among different aged groups was significant (Χ2 = 17.77, P < 0.01). There were no significant differences between different sexualities, and among different educational levels and living habits (P > 0.05). The positive rates were 26.6% (194/730), 15.5% (22/142), and 8.8% (3/34) in farmers, students and other occupations, respectively, and there was a significant difference among them (Χ2 = 12.51, P < 0.01). The positive rates were 23.3% (198/849)and 36.8% (21/57) in the farmers who had the habit of rearing pigs in pens and the farmers who had the habit of free ranging pigs, respectively, and there was a significant difference between them (Χ2 = 5.33, P < 0.05). CONCLUSION: The IgG positive rate of T. gondii is very high in Pu'er City, and therefore, the health education for toxoplasmosis control should be strengthened.


Assuntos
Toxoplasma/imunologia , Toxoplasmose Animal/sangue , Toxoplasmose/sangue , Adolescente , Adulto , Idoso , Animais , Anticorpos Antiprotozoários/sangue , Gatos , Bovinos , Criança , Pré-Escolar , China/epidemiologia , Cidades , Cães , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Suínos , Toxoplasma/fisiologia , Toxoplasmose/epidemiologia , Toxoplasmose/parasitologia , Toxoplasmose Animal/epidemiologia , Toxoplasmose Animal/parasitologia , Adulto Jovem
6.
Artigo em Zh | MEDLINE | ID: mdl-24800574

RESUMO

OBJECTIVE: To understand the prevalence of human intestinal parasite infections in Lahu Ethnic residents so as to provide the evidence for effective control. METHODS: The prevalence of soil-transmitted nematode infections in local people was determined by Kato-Katz technique and individual sanitary behaviors and habits were requested by a standardized questionnaire in 3 villages of Xiaojie Township, Jinghong City, Yunnan Province. The relationship between intestinal parasite infections and behavioral characteristics was analyzed. RESULTS: Of 289 subjects, 255 individuals were infected with soil-transmitted nematodes; the prevalence was 88.24%. Among the infected individuals, 210 were found infected with hookworm and the infection rate was 72.66%; 154 subjects were infected with Ascaris lumbricoides and the infection rate was 53.29%; 13 were infected with Trichuris trichura, and the infection rate was 4.50%; 16 were infected with other parasites and the infection rate was 5.54%. The percentages of people with light infection of hookworm, A. lumbricoides and T. trichura were 90.48%, 97.40% and 100%, respectively. CONCLUSIONS: There is high prevalence of soil-transmitted nematode infections in Lahu Ethnic residents in Jinghong City, but the infection intensity was generally low. The control and monitoring of soil-transmitted parasite infections should be strengthened in this area.


Assuntos
Infecções por Nematoides/epidemiologia , Solo/parasitologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China/epidemiologia , China/etnologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Infecções por Nematoides/prevenção & controle , Prevalência
7.
PLoS Negl Trop Dis ; 8(7): e2983, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25010608

RESUMO

BACKGROUND: There is considerable debate on the health impacts of soil-transmitted helminth infections. We assessed effects of deworming on physical fitness and strength of children in an area in Yunnan, People's Republic of China, where soil-transmitted helminthiasis is highly endemic. METHODOLOGY: The double-blind, randomized, placebo-controlled trial was conducted between October 2011 and May 2012. Children, aged 9-12 years, were treated with either triple-dose albendazole or placebo, and monitored for 6 months post-treatment. The Kato-Katz and Baermann techniques were used for the diagnosis of soil-transmitted helminth infections. Physical fitness was assessed with a 20-m shuttle run test, where the maximum aerobic capacity within 1 min of exhaustive exercise (VO2 max estimate) and the number of 20-m laps completed were recorded. Physical strength was determined with grip strength and standing broad jump tests. Body height and weight, the sum of skinfolds, and hemoglobin levels were recorded as secondary outcomes. PRINCIPAL FINDINGS: Children receiving triple-dose albendazole scored slightly higher in the primary and secondary outcomes than placebo recipients, but the difference lacked statistical significance. Trichuris trichiura-infected children had 1.6 ml kg(-1) min(-1) (P = 0.02) less increase in their VO2 max estimate and completed 4.6 (P = 0.04) fewer 20-m laps than at baseline compared to non-infected peers. Similar trends were detected in the VO2 max estimate and grip strength of children infected with hookworm and Ascaris lumbricoides, respectively. In addition, the increase in the VO2 max estimate from baseline was consistently higher in children with low-intensity T. trichiura and hookworm infections than in their peers with high-intensity infections of all soil-transmitted helminths (range: 1.9-2.1 ml kg(-1) min(-1); all P<0.05). CONCLUSIONS/SIGNIFICANCE: We found no strong evidence for significant improvements in physical fitness and anthropometric indicators due to deworming over a 6-month follow-up period. However, the negative effect of T. trichiura infections on physical fitness warrants further investigation.


Assuntos
Anti-Helmínticos/uso terapêutico , Helmintíase , Aptidão Física/fisiologia , Estudantes/estatística & dados numéricos , Albendazol/administração & dosagem , Albendazol/uso terapêutico , Anti-Helmínticos/administração & dosagem , Criança , China/epidemiologia , Feminino , Helmintíase/tratamento farmacológico , Helmintíase/epidemiologia , Humanos , Masculino
8.
Parasit Vectors ; 7: 344, 2014 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-25060336

RESUMO

BACKGROUND: The transmission of soil-transmitted helminths (STHs) is associated with poverty, poor hygiene behaviour, lack of clean water and inadequate waste disposal and sanitation. Periodic administration of benzimidazole drugs is the mainstay for global STH control but it does not prevent re-infection, and is unlikely to interrupt transmission as a stand-alone intervention. FINDINGS: We reported recently on the development and successful testing in Hunan province, PR China, of a health education package to prevent STH infections in Han Chinese primary school students. We have recently commenced a new trial of the package in the ethnically diverse Xishuangbanna autonomous prefecture in Yunnan province and the approach is also being tested in West Africa, with further expansion into the Philippines in 2015. CONCLUSIONS: The work in China illustrates well the direct impact that health education can have in improving knowledge and awareness, and in changing hygiene behaviour. Further, it can provide insight into the public health outcomes of a multi-component integrated control program, where health education prevents re-infection and periodic drug treatment reduces prevalence and morbidity.


Assuntos
Educação em Saúde , Helmintíase/prevenção & controle , Helmintos/fisiologia , Enteropatias Parasitárias/prevenção & controle , Solo/parasitologia , Adolescente , Animais , Criança , Pré-Escolar , China/epidemiologia , Helmintíase/epidemiologia , Helmintíase/parasitologia , Humanos , Higiene , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Prevalência , Saúde Pública , Saneamento , Instituições Acadêmicas , Estudantes
9.
Am J Trop Med Hyg ; 89(1): 23-31, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23690551

RESUMO

Post-treatment soil-transmitted helminth re-infection patterns were studied as part of a randomized controlled trial among school-aged children from an ethnic minority group in Yunnan province, People's Republic of China. Children with a soil-transmitted helminth infection (N = 194) were randomly assigned to triple-dose albendazole or placebo and their infection status monitored over a 6-month period using the Kato-Katz and Baermann techniques. Baseline prevalence of Trichuris trichiura, Ascaris lumbricoides, hookworm, and Strongyloides stercoralis were 94.5%, 93.3%, 61.3%, and 3.1%, respectively, with more than half of the participants harboring triple-species infections. For the intervention group (N = 99), the 1-month post-treatment cure rates were 96.7%, 91.5%, and 19.6% for hookworm, A. lumbricoides, and T. trichiura, respectively. Egg reduction rates were above 88% for all three species. Rapid re-infection with A. lumbricoides was observed: the prevalence 4 and 6 months post-treatment was 75.8% and 83.8%, respectively. Re-infection with hookworm and T. trichiura was considerably slower.


Assuntos
Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Helmintíase/tratamento farmacológico , Albendazol/administração & dosagem , Ancylostomatoidea , Animais , Anti-Helmínticos/administração & dosagem , Ascaríase/tratamento farmacológico , Ascaríase/epidemiologia , Ascaris lumbricoides , Criança , China/epidemiologia , Método Duplo-Cego , Fezes/parasitologia , Feminino , Helmintíase/epidemiologia , Infecções por Uncinaria/tratamento farmacológico , Infecções por Uncinaria/epidemiologia , Humanos , Masculino , Contagem de Ovos de Parasitas , Prevalência , Solo/parasitologia , Strongyloides stercoralis , Estrongiloidíase/tratamento farmacológico , Estrongiloidíase/epidemiologia , Resultado do Tratamento , Tricuríase/tratamento farmacológico , Tricuríase/epidemiologia , Trichuris
10.
Parasit Vectors ; 5: 50, 2012 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-22424138

RESUMO

BACKGROUND: Chronic soil-transmitted helminth (STH) infections have been associated with reduced physical fitness, but available evidence is limited. The aim of this cross-sectional survey was to assess the feasibility of measuring children's physical fitness and to relate it to STH infections. Our study was carried out among school-aged children of the Bulang ethnic group in rural southwest People's Republic of China (P.R. China). Standardized, quality-controlled methods were employed to determine STH infections (Kato-Katz technique), haemoglobin levels, anthropometry (body weight and height) and physical fitness (20-m shuttle run test). RESULTS: A compliance of 87% suggested good acceptance of the methods used. Among 69 children with complete data records, infection prevalence of Trichuris trichiura, Ascaris lumbricoides and hookworm were 81%, 44% and 6%, respectively. The maximum volume of oxygen that can be utilized within 1 min during exhaustive exercise (VO2 max estimate) of T. trichiura-infected children was 1.94 ml kg⁻¹ min⁻¹ lower than that of their non-infected counterparts (P = 0.005). Until exhaustion, T. trichiura-infected children had completed 6.14 20-m laps less (P = 0.004). Additionally, the mean VO2 max estimate of stunted children was lowered by 1.63 ml kg⁻¹ min⁻¹ (P = 0.002) and they completed 5.32 20-m laps less (P = 0.001) compared to children of normal stature. No significant association between stunting and infection with any STH species could be established. CONCLUSIONS: Implementation of physical fitness tests in rural, resource-constraint settings is feasible. The physical fitness of children who are stunted or infected with STHs, particularly T. trichiura, is significantly impaired. We have launched a larger study and will determine the dynamics of school-aged children's physical fitness over a 7-month period after administration of anthelminthic drugs.


Assuntos
Helmintíase/epidemiologia , Aptidão Física , Adolescente , Idoso , Animais , Antropometria , Criança , China , Estudos Transversais , Feminino , Hemoglobinas/análise , Humanos , Masculino , Prevalência , População Rural , Instituições Acadêmicas , Estudantes
11.
PLoS Negl Trop Dis ; 5(6): e1203, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21738805

RESUMO

BACKGROUND: Current efforts to control human soil-transmitted helminths (STHs) involve the periodic mass administration of benzimidazole drugs to school aged children and other at- risk groups. Given that high levels of resistance to these drugs have developed in roundworms of livestock, there is a need to monitor drug efficacy in human STHs. The current study aimed to evaluate an in vitro egg hatch assay for measuring the sensitivity of human hookworms to benzimidazole drugs in an isolated field setting in southern Yunnan province, People's Republic of China. METHODOLOGY/PRINCIPAL FINDINGS: Egg hatch assays were performed with hookworm (Necator americanus) eggs extracted from 37 stool samples received from local school-aged children. The mean IC(50) was 0.10 ug/ml thiabendazole (95% CIs: 0.09-0.12 ug/ml). Observation of the eggs immediately prior to assay set-up revealed that a small percentage had embryonated in some samples. Scoring of % embryonation of eggs prior to the assay allowed for corrections to be made to IC(50), IC(95) and IC(99) values. Examination of the data with and without this correction revealed that the embryonation of a small number of eggs did not affect IC(50) values, but did increase IC(95) and IC(99) values for some samples. CONCLUSIONS/SIGNIFICANCE: This study has highlighted the impact of egg embryonation on the use of benzimidazole drug sensitivity assays for human hookworms in field settings. Given the greater flexibility required in human stool collection procedures compared to livestock studies, we suggest that embryonation of some eggs may be an unavoidable issue in some human studies. Hence, it needs to be measured and accounted for when analysing dose response data, particularly for generation of IC(95) and IC(99) values. The protocols used in this study and our suggested measures for accounting for egg embryonation should have widespread application in monitoring benzimidazole sensitivity at field sites worldwide.


Assuntos
Anti-Helmínticos/farmacologia , Necator americanus/efeitos dos fármacos , Necator americanus/crescimento & desenvolvimento , Tiabendazol/farmacologia , Adolescente , Animais , Criança , China , Fezes/parasitologia , Humanos , Concentração Inibidora 50 , Testes de Sensibilidade Parasitária/métodos
12.
PLoS One ; 6(9): e25003, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21980373

RESUMO

BACKGROUND: The control of soil-transmitted helminth (STH) infections currently relies on the large-scale administration of single-dose oral albendazole or mebendazole. However, these treatment regimens have limited efficacy against hookworm and Trichuris trichiura in terms of cure rates (CR), whereas fecal egg reduction rates (ERR) are generally high for all common STH species. We compared the efficacy of single-dose versus triple-dose treatment against hookworm and other STHs in a community-based randomized controlled trial in the People's Republic of China. METHODOLOGY/PRINCIPAL FINDINGS: The hookworm CR and fecal ERR were assessed in 314 individuals aged ≥5 years who submitted two stool samples before and 3-4 weeks after administration of single-dose oral albendazole (400 mg) or mebendazole (500 mg) or triple-dose albendazole (3×400 mg over 3 consecutive days) or mebendazole (3×500 mg over 3 consecutive days). Efficacy against T. trichiura, Ascaris lumbricoides, and Taenia spp. was also assessed. ALBENDAZOLE CURED SIGNIFICANTLY MORE HOOKWORM INFECTIONS THAN MEBENDAZOLE IN BOTH TREATMENT REGIMENS (SINGLE DOSE: respective CRs 69% (95% confidence interval [CI]: 55-81%) and 29% (95% CI: 20-45%); triple dose: respective CRs 92% (95% CI: 81-98%) and 54% (95% CI: 46-71%)). ERRs followed the same pattern (single dose: 97% versus 84%; triple dose: 99.7% versus 96%). Triple-dose regimens outperformed single doses against T. trichiura; three doses of mebendazole - the most efficacious treatment tested - cured 71% (95% CI: 57-82%). Both single and triple doses of either drug were highly efficacious against A. lumbricoides (CR: 93-97%; ERR: all >99.9%). Triple dose regimens cured all Taenia spp. infections, whereas single dose applications cured only half of them. CONCLUSIONS/SIGNIFICANCE: Single-dose oral albendazole is more efficacious against hookworm than mebendazole. To achieve high CRs against both hookworm and T. trichiura, triple-dose regimens are warranted. TRIAL REGISTRATION: www.controlled-trials.com ISRCTN47375023.


Assuntos
Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Helmintíase/tratamento farmacológico , Helmintos/efeitos dos fármacos , Helmintos/patogenicidade , Mebendazol/uso terapêutico , Taenia/efeitos dos fármacos , Taenia/patogenicidade , Adolescente , Adulto , Animais , Criança , Pré-Escolar , China , Esquema de Medicação , Feminino , Humanos , Masculino , Solo/parasitologia , Adulto Jovem
13.
Artigo em Zh | MEDLINE | ID: mdl-22263493

RESUMO

We established and perfected the system of control work, achieved the expected targets, and explored the advisable pattern for prevention and control on soil-transmitted nematode diseases. To perform the prevention and control on soil-transmitted nematodiasis, there should be the guidance of government, the multi-sectoral cooperation, community participation, paying attention to the organization and management, and highlighting the key points including education and deworming.


Assuntos
Doenças Parasitárias/prevenção & controle , China , Educação em Saúde , Humanos , Doenças Parasitárias/tratamento farmacológico , Saneamento
14.
Artigo em Zh | MEDLINE | ID: mdl-22164489

RESUMO

In the national monitoring point, Menghai County, Yunnan Province, the total prevalence rate of soil-transmitted nematode infections was 88.12%, of which the rates of Ascaris lumbricoides, Trichuris trichiura, hookworm and cestode infections were 69.70%, 59.79%, 36.79%, and 1.30% respectively from 2006 to 2009. The infection intensities were slight. The Ascaris lumbricoides infection rate in soil of vegetable garden was 44.5%. In conclusion, the infection rate of soil-transmitted nematodes is high in the monitoring point.


Assuntos
Nematoides/fisiologia , Infecções por Nematoides/epidemiologia , Vigilância de Evento Sentinela , Solo/parasitologia , Adolescente , Animais , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Masculino , Nematoides/isolamento & purificação , Infecções por Nematoides/parasitologia
15.
Adv Parasitol ; 73: 21-50, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20627138

RESUMO

This review focuses on the issue of multiparasitism, with a special emphasis on its characteristics, its extent in eastern Asia and its significance for infectious disease control. Multiparasitism is pervasive among socially and economically disadvantaged or marginalised communities, particularly in tropical and subtropical areas. Intestinal parasites are the most numerous group, but an array of parasites is located elsewhere than in the human gastrointestinal tract. Although multiparasitism has been recognised for decades, in-depth studies are rare, and its public health and economic implications have yet to be fully elucidated. The assessment of multiparasitism is hampered by a lack of sensitive broad-spectrum diagnostic tools and the need to collect multiple biological samples for detailed appraisal. Non-specific symptoms and mainly subtle effects complicate the appreciation of its influence on cognitive and physical development, health, economic productivity and general well-being. Multiparasitism has been reported from virtually every eastern Asian country, and studies regarding the extent of multiparasitism and its effects on child health have been implemented in the region. However, new research is needed, as no comprehensive evaluations of multiparasitism in eastern Asia could be identified. Two case studies pertaining to multiparasitism at the local and regional scale are presented. Multiparasitism was rampant in an ethnic minority village in southern People's Republic of China where the challenges associated with its thorough evaluation are illustrated. The results from a cross-sectional survey covering 35 villages highlight the significance of its evaluation for the design of locally adapted and sustainable parasite control and poverty alleviation programmes. We conclude by listing a set of research needs for future investigations.


Assuntos
Doenças Parasitárias/epidemiologia , Doenças Parasitárias/parasitologia , Controle de Doenças Transmissíveis/métodos , Comorbidade , Estudos Transversais , Etnicidade , Ásia Oriental/epidemiologia , Humanos , Doenças Parasitárias/diagnóstico , Doenças Parasitárias/prevenção & controle , Prevalência , População Rural
16.
Parasit Vectors ; 3: 61, 2010 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-20650011

RESUMO

BACKGROUND: Expert opinion-derived disability weights are widely employed for estimating the global burden of diseases and injuries. For chronic diseases such as soil-transmitted helminthiasis and schistosomiasis, it has been suggested that a patient-based quality of life (QoL) approach should be considered for a more accurate appraisal of disability weights. METHODS AND RESULTS: We carried out a cross-sectional survey and assessed the prevalence and intensity of soil-transmitted helminth infections as well as self-rated QoL indicators among 252 students attending grades 5-8 in two schools (Bulangshan and Pu'er) in Yunnan province, People's Republic of China. Each student provided a single stool sample, which was subjected to duplicate Kato-Katz thick smear readings and a single FLOTAC examination for parasitological diagnosis. Prevalence rates for hookworm, Trichuris trichiura and Ascaris lumbricoides were high in Bulangshan (75.9%, 70.0% and 68.2%), while the respective prevalence rates in Pu'er were 66.9%, 56.5% and 9.2%. Students were interviewed with two standardised questionnaires, the EuroQoL-5 Dimensions (EQ-5D) and ShortForm-12 (SF-12) Health Survey. Impairment in any of the five dimensions of the EQ-5D was reported by 87% of the students. However, no clear differences could be observed between individuals with and those without helminth infections, and there were discrepancies between the two schools. A multivariate logistic regression model revealed no differences between students with varying infection status in the domains of the SF-12 (odds ratio close to 1.0). Somewhat more pronounced, yet not statistically significant differences were observed when end-of-school-term marks were compared with students' helminth infection status: infected individuals had lower marks in Chinese, English and mathematics, but not in sports, compared to their helminth-free counterparts. CONCLUSIONS: Our results point to unresolved issues and challenges regarding the cultural appropriateness of the widely used standard QoL questionnaires. Hence, new research is needed to further develop these instruments and to validate them in connection with chronic parasitic diseases.

17.
PLoS Negl Trop Dis ; 3(9): e520, 2009 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-19771154

RESUMO

BACKGROUND: Several angiostrongyliasis outbreaks have been reported in recent years but the disease continues to be neglected in public health circles. We describe an outbreak in Dali, southwest China in order to highlight some key problems for the control of this helminth infection. METHODOLOGY/PRINCIPAL FINDINGS: All available medical records of suspected angiostrongyliasis patients visiting hospitals in Dali in the period 1 October 2007-31 March 2008 were reviewed, and tentative diagnoses of varying strengths were reached according to given sets of criteria. Snails collected from local markets, restaurants and natural habitats were also screened for the presence of Angiostrongylus cantonensis. A total of 33 patients met criteria for infection, and 11 among them were classified as clinically confirmed. An additional eight patients were identified through a surveillance system put in operation in response to the outbreak. The epidemic lasted for 8 months with its peak in February 2008. Of the 33 patients, 97.0% complained of severe headache. 84.8% patients had high eosinophil cell counts either in the peripheral blood or in cerebrospinal fluid (CSF). Three-quarters of the patients were treated with a combination of albendazole and corticosteroids, resulting in significantly improved overall conditions. Twenty-two patients reported the consumption of raw or undercooked snails prior to the onset of the symptoms, and approximately 1.0% of the Pomacea canaliculata snails on sale were found to be infected with A. cantonensis. The snails were also found in certain habitats around Dali but no parasites were detected in these populations. CONCLUSIONS/SIGNIFICANCE: The import and sale of infected P. canaliculata is the likely trigger for this angiostrongyliasis outbreak. Awareness of angiostrongyliasis must be raised, and standardized diagnosis and treatment are needed in order to provide clinicians with a guide to address this disease. Health education campaigns could limit the risk, and a hospital-based surveillance system should be established in order to detect future outbreaks.

18.
PLoS Negl Trop Dis ; 2(10): e322, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18923706

RESUMO

BACKGROUND: Tribendimidine is an anthelminthic drug with a broad spectrum of activity. In 2004 the drug was approved by Chinese authorities for human use. The efficacy of tribendimidine against soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) has been established, and new laboratory investigations point to activity against cestodes and Strongyloides ratti. METHODOLOGY/PRINCIPAL FINDINGS: In an open-label randomized trial, the safety and efficacy of a single oral dose of albendazole or tribendimidine (both drugs administered at 200 mg for 5- to 14-year-old children, and 400 mg for individuals > or = 15 years) against soil-transmitted helminths, Strongyloides stercoralis, and Taenia spp. were assessed in a village in Yunnan province, People's Republic of China. The analysis was on a per-protocol basis and the trial is registered with controlled-trials.com (number ISRCTN01779485). Both albendazole and tribendimidine were highly efficacious against A. lumbricoides and, moderately, against hookworm. The efficacy against T. trichiura was low. Among 57 individuals who received tribendimidine, the prevalence of S. stercoralis was reduced from 19.3% to 8.8% (observed cure rate 54.5%, p = 0.107), and that of Taenia spp. from 26.3% to 8.8% (observed cure rate 66.7%, p = 0.014). Similar prevalence reductions were noted among the 66 albendazole recipients. Taking into account "new" infections discovered at treatment evaluation, which were most likely missed pre-treatment due to the lack of sensitivity of available diagnostic approaches, the difference between the drug-specific net Taenia spp. cure rates was highly significant in favor of tribendimidine (p = 0.001). No significant adverse events of either drug were observed. CONCLUSIONS/SIGNIFICANCE: Our results suggest that single-dose oral tribendimidine can be employed in settings with extensive intestinal polyparasitism, and its efficacy against A. lumbricoides and hookworm was confirmed. The promising results obtained with tribendimidine against S. stercoralis and Taenia spp. warrant further investigations. In a next step, multiple-dose schedules should be evaluated.


Assuntos
Albendazol/administração & dosagem , Anti-Helmínticos/administração & dosagem , Fenilenodiaminas/administração & dosagem , Estrongiloidíase/tratamento farmacológico , Teníase/tratamento farmacológico , Administração Oral , Adolescente , Animais , Criança , Pré-Escolar , China , Humanos , Masculino , Solo/parasitologia , Strongyloides stercoralis/efeitos dos fármacos , Estrongiloidíase/parasitologia , Taenia/efeitos dos fármacos , Teníase/parasitologia , Resultado do Tratamento
19.
Am J Trop Med Hyg ; 78(5): 760-9, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18458311

RESUMO

Intestinal multiparasitism, the accuracy of different diagnostic techniques, and the influence of sampling effort were studied among 215 individuals in a Bulang village, Yunnan province, People's Republic of China. Behavioral, demographic, and socioeconomic data were obtained by questionnaire. Multiple stool specimens were examined by the Kato-Katz, Koga agar plate, Baermann, and ether-concentration methods. Eight helminth and 7 protozoa species were diagnosed. The prevalence of each of the 3 main soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) exceeded 85%. Blastocystis hominis was the most prevalent intestinal protozoan (20.0%). Over 80% of the individuals harbored 3 or more intestinal parasites concurrently. The infection intensities were predominantly light for hookworm and T. trichiura but moderate for A. lumbricoides. Examination of 3 instead of 1 stool specimen increased the sensitivity of helminth diagnosis, most notably for hookworm. Intestinal multiparasitism is rampant in this rural part of Yunnan province and calls for control measures.


Assuntos
Doenças Parasitárias/epidemiologia , População Rural/estatística & dados numéricos , Distribuição por Idade , China/epidemiologia , Fezes/parasitologia , Inquéritos Epidemiológicos , Humanos , Doenças Parasitárias/diagnóstico , Cooperação do Paciente , Prevalência , Inquéritos e Questionários
20.
PLoS Negl Trop Dis ; 1(1): e75, 2007 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-17989788

RESUMO

BACKGROUND: Strongyloides stercoralis is a neglected soil-transmitted helminth species, and there is a lack of parasitologic and epidemiologic data pertaining to this parasite in China and elsewhere. We studied the local occurrence of S. stercoralis in a village in Yunnan province, China, and comparatively assessed the performance of different diagnostic methods. METHODOLOGY/PRINCIPAL FINDINGS: Multiple stool samples from a random population sample were subjected to the Kato-Katz method, an ether-concentration technique, the Koga agar plate method, and the Baermann technique. Among 180 participants who submitted at least 2 stool samples, we found a S. stercoralis prevalence of 11.7%. Males had a significantly higher prevalence than females (18.3% versus 6.1%, p = 0.011), and infections were absent in individuals <15 years of age. Infections were only detected by the Baermann (highest sensitivity) and the Koga agar plate method, but neither with the Kato-Katz nor an ether-concentration technique. The examination of 3 stool samples rather than a single one resulted in the detection of 62% and 100% more infections when employing the Koga agar plate and the Baermann technique, respectively. The use of a mathematical model revealed a 'true' S. stercoralis prevalence in the current setting of up to 16.3%. CONCLUSIONS/SIGNIFICANCE: We conclude that S. stercoralis is endemic in the southern part of Yunnan province and that differential diagnosis and integrated control of intestinal helminth infections needs more pointed emphasis in rural China.


Assuntos
Strongyloides stercoralis/patogenicidade , Estrongiloidíase/epidemiologia , Adolescente , Adulto , Ágar , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , China/epidemiologia , Diagnóstico Diferencial , Etnicidade , Características da Família , Fezes/parasitologia , Feminino , Geografia , Humanos , Intestinos/parasitologia , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural/estatística & dados numéricos , Saneamento/normas , Strongyloides stercoralis/crescimento & desenvolvimento , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/diagnóstico , Inquéritos e Questionários
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