Anthelmintic resistance in soil-transmitted helminths: One-Health considerations.

The One-Health approach recognizes the intricate connection between human, animal, and environmental health, and that cooperative effort from various professionals provides comprehensive awareness and potential solutions for issues relating to the health of people, animals, and the environment. This approach has increasingly gained appeal as the standard strategy for tackling emerging infectious diseases, most of which are zoonoses. Treatment with anthelmintics (AHs) without a doubt minimizes the severe consequences of soil-transmitted helminths (STHs); however, evidence of anthelmintic resistance (AR) development to different helminths of practically every animal species and the distinct groups of AHs is overwhelming globally. In this regard, the correlation between the application of anthelmintic drugs in both human and animal populations and the consequent development of anthelmintic resistance in STHs within the context of a One-Health framework is explored. This review provides an overview of the major human and animal STHs, treatment of the STHs, AR development and drug-related factors contributing towards AR, One-Health and STHs, and an outline of some One-Health strategies that may be used in combating AR.

Identifying opportunities to optimize mass drug administration for soil-transmitted helminths: A visualization and descriptive analysis using process mapping.

BACKGROUND: The control of soil-transmitted helminths (STH) is achieved through mass drug administration (MDA) with deworming medications targeting children and other high-risk groups. Recent evidence suggests that it may be possible to interrupt STH transmission by deworming individuals of all ages via community-wide MDA (cMDA). However, a change in delivery platforms will require altering implementation processes. METHODS: We used process mapping, an operational research methodology, to describe the activities required for effective implementation of school-based and cMDA in 18 heterogenous areas and over three years in Benin, India, and Malawi. Planned activities were identified during workshops prior to initiation of a large cMDA trial (the DeWorm3 trial). The process maps were updated annually post-implementation, including adding or removing activities (e.g., adaptations) and determining whether activities occurred according to plan. Descriptive analyses were performed to quantify differences and similarities at baseline and over three implementation years. Comparative analyses were also conducted between study sites and areas implementing school-based vs. cMDA. Digitized process maps were developed to provide a visualization of MDA processes and inspected to identify implementation bottlenecks and inefficient activity flows. RESULTS: Across three years and all clusters, implementation of cMDA required an average of 13 additional distinct activities and was adapted more often (5.2 adaptations per year) than school-based MDA. An average of 41% of activities across both MDA platforms did not occur according to planned timelines; however, deviations were often purposeful to improve implementation efficiency or effectiveness. Visualized process maps demonstrated that receipt of drugs at the local level may be an implementation bottleneck. Many activities rely on the effective setting of MDA dates and estimating quantity of drugs, suggesting that the timing of these activities is important to meet planned programmatic outcomes. CONCLUSION: Implementation processes were heterogenous across settings, suggesting that MDA is highly context and resource dependent and that there are many viable ways to implement MDA. Process mapping could be deployed to support a transition from a school-based control program to community-wide STH transmission interruption program and potentially to enable integration with other community-based campaigns. TRIAL REGISTRATION: NCT03014167.

Species-specific predation determines the feeding impacts of six soil protist species on bacterial and eukaryotic prey.

Predatory protists play a central role in nutrient cycling and are involved in other ecosystem functions by predating the microbiome. While most soil predatory protist species arguably are bacterivorous, some protist species can prey on eukaryotes. However, studies about soil protist feeding mainly focused on bacteria as prey and rarely tested both bacteria and eukaryotes as potential prey. In this study, we aimed to decipher soil predator-prey interactions of three amoebozoan and three heterolobosean soil protists and potential bacterial (Escherichia coli; 0.5-1.5 µm), fungal (Saccharomyces cerevisiae; 5-7 µm) and protist (Plasmodiophora brassicae; 3-5 µm) prey, either as individual prey or in all their combinations. We related protist performance (relative abundance) and prey consumption (qPCR) to the protist phylogenetic group and volume. We showed that for the six soil protist predators, the most suitable prey was E. coli, but some species also grew on P. brassicae or S. cerevisiae. While protist relative abundances and growth rates depended on prey type in a protist species-specific manner, phylogenetic groups and volume affected prey consumption. Yet we conclude that protist feeding patterns are mainly species-specific and that some known bacterivores might be more generalist than expected, even preying on eukaryotic plant pathogens such as P. brassicae.

Impact of conflict on the elimination targets of lymphatic filariasis, schistosomiasis and soil-transmitted helminths in Cabo Delgado province, Mozambique.

BACKGROUND: Mozambique has one of the highest burdens of neglected tropical diseases in Africa. Lymphatic filariasis, schistosomiasis and soil-transmitted helminths are being targeted for elimination as part of integrated mass drug administration campaigns. The progress made towards interruption of transmission has been affected by recent conflict in Cabo Delgado province. The aim of this paper was to determine the potential impact of this crisis on the neglected tropical diseases programme and the challenges in reaching the elimination goals of 2030. METHODOLOGY: A desk-based secondary data analysis was conducted on publicly available sources of neglected tropical diseases, conflict incidents, internally displaced persons and geographical access between 2020 and 2022. Data were summarised and mapped using GIS software. A combined risk stratified assessment at district level was developed with five classifications i) Very high-risk; ii) High-risk; iii) Medium to high-risk; iv) Medium risk; and v) Not at risk due to conflict absence but co-endemic. RESULTS: Lymphatic filariasis, schistosomiasis and soil-transmitted helminths were co-endemic in 115 out of 156 (74%) districts. Between 2020 and 2022 a total of 1,653 conflict-related incidents were reported, most of them in Cabo Delgado province (n = 1,397, 85%). A five-fold increase of internally displaced persons was recorded from April 2020 (n = 172,186) to November 2022 (n = 935,130). Geographical accessibility also deteriorated across the province with an increase from five (29%) in 2021 to seven (41%) districts in 2022 classified as hard-to-reach. The combined risk stratification identified that most districts in Cabo Delgado province had medium to high-risk (n = 7; 41%); very high-risk (n = 5, 29%); medium risk (n = 3, 18%); high-risk (n = 2, 12%). CONCLUSION: Most of the districts of Cabo Delgado were considered to be at risk of not meeting the neglected tropical diseases road map 2030 targets due to the humanitarian crisis ongoing. There is the need for practical strategies and funding to overcome these hostile challenges.

Larva migrans in Votuporanga, São Paulo, Brazil: Where does the danger hide? / Larva migrans em Votuporanga, SP, Brazil: Onde se esconde o perigo?

Abstract Soil samples collected near municipal schools (public/EMEI and private/EPEI schools), clubs (CLB), public squares (PS) and residential condominiums (CND) and samples of animal faeces from the Zoonosis Control Centre (CCZ) of the municipality of Votuporanga/SP were analysed using the Baermann method for the detection of zoonotic helminth larvae. The prevalence rates of the nematode genera identified were determined, and the results were compared using Fisher's exact and chi-square frequency tests. Information about cases of larvae migrans in the population were collected from the Family Health Units and the private health plans. All sites were positive for Ancylostoma spp. and, with the exception of EPEIs and dog faeces, for Strongyloides spp. The prevalence of Ancylostoma spp. was 87.5% for CND samples, 74.29% for EMIEs, 63.64% for CLB, 61.76% for PS and 64.29% for dog's and 42.86% for cats at CCZ. The prevalence of Strongyloides spp. ranged from 14.29% (cats/CCZ) to 41.18% (PS). Cases of cutaneous larva migrans were reported during interviews. Thus, from the public health perspective, the risk of individuals that frequent recreational areas in the municipality, especially children, to be infected by helminth larvae is noteworthy, indicating the need to develop policies aimed at controlling this important zoonosis.

Resumo Amostras de solo colhidas em escolas municipais (ensino público/EMEI e privado/EPEI), clubes (CLB), praças públicas (PP), condomínios residenciais (CND) e de fezes de animais do Centro de Controle de Zoonoses (CCZ) do município de Votuporanga/SP, foram submetidas ao método Baermann para detecção de larvas de helmintos zoonóticos. Foram determinadas as taxas de prevalência dos nematódeos identificados, e os resultados confrontados pelos testes Exato de Fisher e Qui-quadrado. Atendimentos de casos de larvas migrans na população foram levantados em entrevistas realizadas em Unidades de Saúde da Família e em planos de saúde privados. Todos os locais apresentaram positividade para Ancylostoma spp. e, com exceção de EPEIs e de fezes caninas, para Strongyloides spp. Prevalência de Ancylostoma spp. foi verificada em amostras de CNDs (87,50%), EMEIs (74,29%), CLBs (63,64%), PPs (61,76%) e em fezes de cães e gatos do CCZ (64,29% e 42,86%, respectivamente). As prevalências de Strongyloides spp. variaram de 14,29% (gatos/CCZ) a 41,18% (PP). Atendimentos de casos de larva migrans cutânea foram relatados nas entrevistas. Portanto, ressalta-se o risco de frequentadores de áreas de lazer do município, especialmente crianças, de adquirirem infecção por larvas de helmintos, indicando a necessidade da elaboração de propostas de políticas voltadas ao controle dessa importante zoonose.

A Newly Introduced and Invasive Land Slug in Brazil: Meghimatium pictum(Gastropoda, Philomycidae) from China

The land slug Meghimatium pictum (Stoliczka, 1873), native to China, is recorded for the first time in Brazil. This is also the first record of a species of the eastern Asiatic genus Meghimatium on the American continents. The species was identified using morphological criteria and analysis of the cytochrome oxidase subunit I, COI. Our records indicate this species is widely distributed in southern and southeastern Brazil, in the States of São Paulo, Paraná, Santa Catarina and Rio Grande do Sul, in disturbed and natural areas. We morphologically characterize M. pictum (external characteristics, reproductive system, jaw and radula) and provide some biological information based on field observations. We also discuss when M. pictum was probably introduced, from whence it came, possible pathways of introduction, and its characteristics as an invasive species and potential agricultural pest.

Guideline: preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups

This guideline provides global, evidence-informed recommendations on preventive chemotherapy (deworming), as a public health intervention in areas endemic for soil-transmitted helminths, to decrease the worm burden of soil-transmitted helminth infections in children, adolescent girls, women of reproductive age and pregnant women, including those coinfected with HIV. The recommendations contained in this guideline are intended for a wide audience, including policy-makers and their expert advisers as well as technical and programme staff at government institutions and organizations involved in the design, implementation and expansion of programmes to control soil-transmitted helminth infections and nutrition-sensitive actions for a safe and hygienic environment to improve public health. This guideline aims to help WHO Member States and their partners to achieve the United Nations Sustainable Development Goals and the global targets presented in the World Health Assembly resolution WHA66.12 on Neglected tropical diseases, the Comprehensive implementation plan on maternal, infant and young child nutrition, the Global strategy for women's, children's, and adolescents' health (2016­2030), Water, sanitation and hygiene for accelerating and sustaining progress on neglected tropical diseases: a global strategy 2015­2020, Accelerating work to overcome the global impact of neglected tropical diseases: a roadmap for implementation, Accelerating progress on HIV, tuberculosis, malaria, hepatitis and neglected tropical diseases: a new agenda for 2016­2030 and Eliminating soil-transmitted helminthiases as a public health problem in children: progress report 2001­2010 and strategic plan 2011­2020.

Guideline: preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups

This guideline provides global, evidence-informed recommendations on preventive chemotherapy (deworming), as a public health intervention in areas endemic for soil-transmitted helminths, to decrease the worm burden of soil-transmitted helminth infections in children, adolescent girls, women of reproductive age and pregnant women, including those coinfected with HIV. The recommendations contained in this guideline are intended for a wide audience, including policy-makers and their expert advisers as well as technical and programme staff at government institutions and organizations involved in the design, implementation and expansion of programmes to control soil-transmitted helminth infections and nutrition-sensitive actions for a safe and hygienic environment to improve public health. This guideline aims to help WHO Member States and their partners to achieve the United Nations Sustainable Development Goals and the global targets presented in the World Health Assembly resolution WHA66.12 on Neglected tropical diseases, the Comprehensive implementation plan on maternal, infant and young child nutrition, the Global strategy for women's, children's, and adolescents' health (2016­2030), Water, sanitation and hygiene for accelerating and sustaining progress on neglected tropical diseases: a global strategy 2015­2020, Accelerating work to overcome the global impact of neglected tropical diseases: a roadmap for implementation, Accelerating progress on HIV, tuberculosis, malaria, hepatitis and neglected tropical diseases: a new agenda for 2016­2030 and Eliminating soil-transmitted helminthiases as a public health problem in children: progress report 2001­2010 and strategic plan 2011­2020.