Cluster of Parasite Infections by the Spatial Scan Analysis in Korea.

This study was performed to find out the clusters with high parasite infection risk to discuss the geographical pattern. Clusters were detected using SatScan software, which is a statistical spatial scan program using Kulldorff's scan statistic. Information on the parasitic infection cases in Korea 2011-2019 were collected from the Korea Centers for Disease Control and Prevention. Clusters of Ascaris lumbricoides infection were detected in Jeollabuk-do, and T. trichiura in Ulsan, Busan, and Gyeongsangnam-do. C. sinensis clusters were detected in Ulsan, Daegu, Busan, Gyeongsangnam-do, and Gyeongsangbuk-do. Clusters of intestinal trematodes were detected in Ulsan, Busan, and Gyeongsangnam-do. P. westermani cluster was found in Jeollabuk-do. E. vermicularis clusters were distributed in Gangwon-do, Jeju-do, Daegu, Daejeon, and Gwangju. This clustering information can be referred for surveillance and control on the parasitic infection outbreak in the infection-prone areas.

Worm Infections in Children.

• On the basis of research evidence, worm infections are important global child health conditions causing chronic disability that lasts from childhood into adulthood (Table 1). (2)(3) Evidence Quality: B • On the basis of research evidence, the major worm infections found in developing countries include ascariasis, trichuriasis, hookworm infection, and schistosomiasis; toxocariasis, enterobiasis, and cysticercosis are also found in poor regions of North America and Europe. (4)(9)(13) Evidence Quality: B • On the basis of expert consensus, children and adolescents are often vulnerable to acquiring large numbers of worms, ie, high-intensity infections (Fig 1)(21)(22)(23) Evidence Quality: D • On the basis of expert consensus and research evidence, moderate and heavy worm burdens cause increased morbidity because of growth and intellectual stunting in children and adolescents. Many of these effects may result from helminth-induced malnutrition. (21)(22)(23) Evidence Quality: C • On the basis of expert consensus and research evidence, worm infections are also commonly associated with eosinophilia. (48) (49) Evidence Quality: B • On the basis of research evidence as well as consensus, helminthes can cause inflammation in the lung (asthma), gastrointestinal tract (enteritis and colitis), liver (hepatitis and fibrosis), and urogenital tract. (7)(21)(22)(23)(27)(28)(40)(41)(43) Evidence Quality: B • On the basis of research evidence, microscopy techniques for diagnosis of worm infections in children often exhibit suboptimal sensitivities and specificities, necessitating new or improved diagnostic modalities such as polymerase chain reaction. (54)(55) Evidence Quality: A • On the basis of research evidence and expert consensus, mass drug administration ("preventive chemotherapy") has becomea standard practice for ministries of health in low- and middle-income countries to control intestinal helminth infections and schistosomiasis. (67)(68) Evidence Quality: B.

Prevalence of enterobiasis among primary school children in Ragama, Sri Lanka.

OBJECTIVES: To determine the prevalence of enterobiasis among school children in Ragama Medical Officer of Health (MOH) region and the association between clinical features, potential risk factors and infection status. DESIGN: Cross sectional study. SETTING: School based. Participants 260 school children aged 5-7 years, attending five state schools in the Ragama MOH region. MAIN OUTCOME MEASURES: Prevalence of Enterobius vermicularis infection as diagnosed using adhesive cellophane tapes on the perianal skin on 2 consecutive days. RESULTS: The overall prevalence of enterobiasis was 38%. The risk factors significant on a univariate analysis were male gender, maternal under-education, non-permanency of paternal employment, more household members, more siblings in a family, more persons sleeping with an index child and lack of recent deworming. On a multivariate model more household members, more children in a household, more persons sleeping with the index child, non-permanency of paternal employment and lack of recent deworming were significantly associated with infection. None of the clinical manifestations evaluated (peri-anal itching, insomnia, abdominal pain, and enuresis) showed a significant association with enterobiasis. CONCLUSIONS: Enterobiasis is highly prevalent among primary school children in Ragama.

Parents' knowledge about enterobiasis might be one of the most important risk factors for enterobiasis in children.

To know the prevalence of Enterobius vermicularis infection and what are the most important risk factors, we evaluated the incidence and risk factors of enterobiasis among children attended in kindergartens in Busan metropolitan city, Republic of Korea. A total of 1,674 children from 21 kindergartens in 11 of 16 autonomous districts of Busan were evaluated for E. vermicularis infection by the cellotape anal swab technique. The overall egg-positive rate for E. vermicularis was 10.7% (179/1,674), and the prevalence of enterobiasis in each kindergarten ranged between 0% and 32.4%. There was an increasing tendency of the egg positive rate according to the population density; the higher the population density communities had, the higher egg-positive rate for E. vermicularis was detected (P = 0.001). Among personal hygiene factors involving children, thumb-sucking (P = 0.036) and fingernail-trimming (P = 0.024) were highly associated with enterobiasis. In addition, taking anthelmintic medications against E. vermicularis infection was strongly associated with enterobiasis (P = 0.014). Moreover, parents' knowledge of enterobiasis was correlated significantly with the incidence of enterobiasis of their children (P = 0.006). In conclusion, we need to consider not only personal hygiene but also parents' knowledge about enterobiasis as a factor in order to develop new strategies for elimination or to complete reduction of enterobiasis in Korea.

Low socioeconomic level and enterobius vermicularis: A interventional study to children and their mothers in home.

To determine the effects of care and monitoring provided at home to children in whom Enterobius vermicularis is detected and their mothers on the presence of observing the parasite and the knowledge and practices of the children and their mothers on the issue. This study used a pre-test-post-test quasi-experimental design. In the study, 20 students and their mothers were determined as the experimental group, while 18 students and their mothers were determined as the control group. Home visits were made to the families of the children in the experimental group for 6 months. At these home visits, health education on the parasite was provided to the mothers and the children. There were highly significant differences between the experiment and control groups in terms of E. vermicularis presence, knowledge and hygiene practice scores (p < .001).

[Investigation of Enterobius vermicularis infection in children in Jiangxi Province in 2014].

OBJECTIVE: To know the status of Enterobius vermicularis infection in children in Jiangxi Province in 2014, so as to provide the evidence for the formulation of prevention and control measures. METHODS: A survey was performed according to the scheme of the 3rd Principal Human Parasites of Jiangxi Province in 2014. Based on the ecological regions, a stratified cluster sampling method was applied by the economic and geographic situation. There were 84 survey sites from 28 counties, and the basic data were also collected in the different investigation sites, and the round-end tube adhesive cellophane anal swab was used to examine E. vermicularis eggs for the children aged 3-6 years. RESULTS: A total of 1 486 children aged 3-6 years were detected, the E. vermicularis infection rate was 13.73% (204/1 486), and the infection rates were 13.89% (114/821) and 13.53% (90/665) in the male and female, respectively. The infection rate in the different age groups showed a gradual rise then fall trend, the lowest infection rate was 10.05% (38/378) in the 3-year age group, and the highest infection rate was 18.24% (81/444) in the 5-year age group. The infection rates in the high, medium and low-income survey sites were 13.79% (87/631), 17.23% (51/296), and 11.81% (66/559), respectively. The E. vermicularis infection rates in the 4 ecological regions were from 12.34% to 17.74%, but there was no significant difference among the different ecological regions (P > 0.05). CONCLUSIONS: The status of E. vermicularis infection in children in Jiangxi Province is relatively serious, and therefore, the parasitic disease control sectors should continue to strengthen the monitoring and control work of E. vermicularis infection in children.

Regular Deworming: A Missed Opportunity to Prevent Peritoneal Dialysis-Related Infections in Children.

Chronic peritoneal dialysis (PD) is a common dialysis treatment modality used to treat children with end-stage renal disease. Dialysis-related infections are the leading cause of technique failure. Enterobius vermicularis infestation indirectly increases the infection rate by causing pruritus around the anus, especially at night. We observed a significant decrease in the total infection rate (2.3 vs 5.4 per patient-year) following regular deworming over a 1-year study period. Regular deworming may be considered to prevent secondary bacterial infections in children on chronic PD.

[Effect of control program of human intestinal parasitic diseases in Nanping City].

OBJECTIVE: To understand the epidemic status of human intestinal parasitic diseases and evaluate the effect of the control program in Nanping City, so as to provide an evidence for improving the disease control. METHODS: The villages were selected by the stratified cluster sampling method and the residents in these villages were surveyed for human intestinal parasitic diseases, and kindergartens were also selected and the children in these kindergartens were surveyed for Enterobius vermicularis infection. RESULTS: In 2007, before the control program, 9 851 residents of Nanping City were surveyed, with the parasitic infection rate of 9.10% (896 infection cases), and the infection rate of E. vermicularis of children was 18.56% (328/1 767). From 2011 to 2014, when the control program was performed, 4 679 residents were surveyed, with the infection rate of 4.06% (190 infection cases), and the infection rate of E. vermicularis of children was 3.87% (33/853). After the control program was launched, the infection rates of human intestinal parasites were decreased. The overall parasitic infection rate and hookworm infection rate showed increasing trends by age (χ2 = 49.03 and 53.58 respectively, both P < 0.01). CONCLUSIONS: The infection situation of human intestinal parasites is decreased after the implementation of the control program but the infection rate is still at a high level, and the control work should be strengthened.

[Investigation of Intestinal Parasites and Level of Hygiene Knowledge of School Students]. / Ögrencilerde Bagirsak Parazitlerinin ve Hijyen Bilgi Düzeylerinin Arastirilmasi.

OBJECTIVE: In this study, the prevalence of intestinal parasites and its relationship with some hygiene habits and socio-demographic characteristics of students in Yigilca were investigated. METHODS: This study was conducted in three parts. Firstly, the prevalence of parasitic diseases was measured, and questionnaires about the level of knowledge of hygiene were administered. Secondly, control and intervention groups were determined. Lastly, some education and training courses were organized and provided to the intervention group, including parents and children, about the prevention of parasitic diseases and habits of cleaning. RESULTS: In this study, 540 cellophane tapes and 523 stool samples were studied. Among the samples analyzed, 87 (16.1%) with Enterobius vermicularis, 79 (15.1%) with Giardia intestinalis, 73 (13.9%) with various non-pathogenic parasites, 1 (0.19%) with Ascaris lumbricoides, and 1 (0.19%) with Hymenolepis nana were found. G. intestinalis was highly positive among the children who do not wash their hands after defecation. Also, some intestinal parasites were found to be related to the socio-demographic characteristics of families; parental education, family income, and father's profession were found to be associated with the presence of intestinal parasites. After training, the intervention group showed a significant decrease in the number of giardiasis and enterobiasis cases. CONCLUSION: Education on hygiene will prevent parasitic diseases from an early age.

Pinworm control and risk factors of pinworm infection among primary-school children in Taiwan.

Longitudinal pinworm (Enterobius vermicularis) infection rates were estimated at a mass screening for first-grade children during 1991-1996; children were provided medication at the screening. This campaign was able to decrease the infection rates for the 1991 cohort from 16.3% to 0.6%. A case-control study was further conducted for the investigation of risk factors among fourth-graders. Cases comprised 429 children with at least one infection between September 1996 to June 1999, and controls were 280 randomly selected uninfected classmates. Parents were asked to complete a questionnaire survey to report students' personnel hygiene habits. The case-control study revealed that significant factors associated with the infection included playing on the floor (odds ratio [OR], 2.5), nail biting (OR, 2.1), failure to wash hands before meals (OR, 1.7) and living in nonapartment dwellings (OR, 1.6). Girls were at a higher, but not significant, risk (OR, 1.4), than boys. In conclusion, inadequate personal hygiene increases the risk for pinworm infection. The mass screening-medication campaign can be adapted to countries with a similar parasitic problem.

Fenbendazole treatment without environmental decontamination eradicates Syphacia muris from all rats in a large, complex research institution.

Syphacia muris parasitism was eliminated from rats and voles by feeding fenbendazole-medicated chow (150 ppm) for five 7-day periods; treatment periods were separated by 7-day periods of feeding non-medicated chow, yielding atotal treatment course of 9 weeks. No other manipulations to facilitate eradication, including the use of filter tops, autoclaved cages, environmental decontamination, colony depopulation, breeding cessation, and research restriction, were done. The examination of 3143 cellophane-tape impressions of the anus and 160 cecal examinations from euthanized rats and voles during the treatment period and for 7 months afterwards confirmed the efficacy of treatment. Treatment was rapidly effective in voles. In rats, pinworm eggs persisted at high levels for 2 weeks after the start of treatment, but no eggs were found after 22 days.

Toxicity evaluation of prophylactic treatments for mites and pinworms in mice.

The detection of external and internal parasites in laboratory mice is a particularly problematic aspect of animal health evaluation. Because these organisms must be detected by direct examination of the feces or hair coat, low-level infestation or sporadic shedding can make them difficult to detect, thereby undermining confidence that negative reports are truly negative. Prophylactic treatment of suspect colonies with anthelminthics and/or insecticides may therefore be indicated under some circumstances. However, when considering the use of prophylactic treatments, the potential for toxicity is an important factor, especially in genetically modified strains of mice. To evaluate the potential toxicity of prophylactic anti- parasitic treatments on strains of mice that are commonly used as experimental models and in genetic engineering in our facility, we surveyed a number of strains and ages of mice for toxic reactions during treatment regimens that combine anthelminthic and anti-acaricidal agents. Three experimental protocols (ivermectin, piperazine, and dichlorvos in combination; ivermectin alone; and fenbendazole/permethrin or fenbendazole/dichlorvos) were evaluated. Our data suggest a potential for toxicity associated with these treatments and indicate to us that prophylactic treatment regimens should be initiated with caution.

An action plan to prevent and combat threadworm infection.

Threadworm infection is common in preschool and school-age children and is easily spread to the entire family. The infection can be treated using medication, which should be taken by all members of the family, but good hygiene measures are equally important to ensure reinfection does not occur.

[An improved complex of measures to prevent enterobiasis]. / Sovershenstvovanie kompleksa meropriiatii po profilaktike énterobioza.

Enterobiasis is the most common helminth in the USSR. Despite of its clinical manifestations in children, some parents do not see a doctor. 105 parents were interrogated by questionnaires. 71% of them called the reason why they had taken no medical advice and the rest evaded the question. The parents' questionnaire is an important measure for preventing and controlling enterobiasis with regard to better health education methods used in the work with parents and tutors from pediatric institutions.

[Significance of personal hygiene habits in the prevention of enterobiasis]. / Znachenie navykov lichnoi gigieny v profilaktike énterobioza.

The pupils from Rostov-on-Don were interviewed by a questionnaire on medical helminthology. They were found to poor knowledge in this sphere. They do not observe elementary personal hygienic rules. The ways of improving the hygienic education of pupils.

[The hygienic bases for the prevention of enterobiasis]. / Gigienicheskie osnovy profilaktiki énterobioza.

Evidence is provided for the value and priority of sanitary and hygienic measures and hygienic education of the population in the prevention of enterobiasis. It is emphasized that preventive work can be successful only when the parents, tutors of preschool institutions and teachers of schools are obligatorily attracted to it.

[The sanitary-epidemiological assessment of the enterobiasis situation and its prevention in children's institutions in new buildings]. / Sanitarno-épidemiologicheskaia otsenka situatsii i profilaktiki énterobioza v detskikh uchrezhdeniiakh na novostroikakh.

A complex plan of enterobiasis control measures for a sharp and stable decrease of the prevalence level at nursery schools in new buildings is presented. This complex plan allows one to reduce the extent of investigations 3-4-fold. A trial of the complex plan proposed on territories with foci of different types should be expedient with its subsequent introduction into the practice.

[The primary and secondary prevention of enterobiasis today]. / Pervichnaia i vtorichnaia profilaktika énterobioza na sovremennom étape.

The paper provides evidence for dividing the prevention of enterobiasis, which is the major human helminthiasis in Russia, into social and medical ones. It proposes to implement 4 directions of medical prophylaxis: behavioral, sanitary and hygienic, functional and biological, and therapeutic and health-improving actions. The paper also characterizes measures underlying each of them.

[New approaches to the eradication of enterobiasis in children]. / Novye podkhody k ozdorovleniiu detei ot énterobioza.

The paper outlines the results of studies dealt with the detection of risk factors and groups for enterobiasis, the efficiency of the treatment of children suffering from the disease with medamine, biologicals, and Normase. It is shown that risk factors may include an abnormal course of antenatality, minor developmental malformations (diastema, dystrophy, abnormalities of the eye, hand, foot, etc.), as well as early artificial feeding of babies (before they reach 3 months of life). Enterobiasis is found to have a negative influence on the physical, nervous, and mental development and suppression of non-specific immunity in children, which is suggested by the reduction in salivary lysozyme activity, which is lower than the normal level and on blood alpha-interferon production. There is strong evidence for the considerable immunosuppressive effects of enterobiasis on the formation of a postvaccinal immunity against measles. When given in a single course dose, medamine shows a 100% efficiency in the treatment of enterobiasis. Moreover, bificol, bifidumbacterin, and Normase may be useful to enhance the treatment efficiency and children's recovery from enterobiasis.