Association of Intestinal Helminthiasis with Disseminated Leishmaniasis, Brazil.

Disseminated leishmaniasis is an emerging clinical form of Leishmania braziliensis infection. Evidence shows that co-infection by L. braziliensis and intestinal helminths does not affect clinical manifestations or response to therapy in cutaneous leishmaniasis patients. We evaluated whether co-infection was associated with those aspects in disseminated leishmaniasis patients in Brazil.

Bacilli load in PTB- intestinal helminths co-infected and PTB non -infected patients at selected public health facilities in Jimma zone, Oromia, Ethiopia: comparative cross-sectional study.

BACKGROUND: Tuberculosis (TB) and intestinal helminths are diseases that pose a dual burden on public health in low-income countries. Previous studies have shown that helminths can affect the shedding of bacteria or the bacterial load in the sputum of active TB patients. However, there is limited information on bacterial load in TB patients with helminth infections. OBJECTIVE: This study aimed to compare bacterial load in helminths-infected and non-infected pulmonary tuberculosis patients at selected public health facilities in Jimma zone, Oromia, Ethiopia. METHODS: The study was conducted in Jimma Zone, Oromia, Ethiopia. A facility-based comparative cross-sectional study was employed from August 01, 2020, to January 2021. A total of 124 (55 intestinal helminths-infected and 69 non-infected) newly diagnosed smear-positive pulmonary tuberculosis (PTB) patients were included in the study. A convenience sampling technique was employed to recruit study participants, and a semi-structured questionnaire was used to collect data regarding socio-demographic characteristics and possible risk factors for intestinal helminths co-infection. Stool examination was performed using both wet mount and Kato Katz technique. Additionally, weight and height measurements, sputum, and blood samples were taken to determine body mass index, bacilli load, and diabetic mellitus, respectively. Data were entered into Epi-Data software version 3.1 and analyzed using Statistical Packages for Social Sciences (SPSS) Version 25. A statistically significant difference was defined as a P-value of less than 0.05. RESULTS: Intestinal helminths reduced bacilli load 3 times more than intestinal helminths non-infected PTB (AOR = 3.44; 95% CI; 1.52, 7.79; P = 0.003) However, diabetes mellitus, HIV, drinking alcohol and cigarette smoking were not associated with bacilli load. The rate of co-infection TB with intestinal helminths was 44%. The three most prevalent parasites detected were Trichuris trichiura 29 (66%), hookworm 19 (43%), and Ascaris lumbricoides 11(25%)). Among co-infected patients about 36 (81.8%) had a single parasite infection, and 19 (43.2%) had multiple infections. A body mass index < 18.5 (AOR = 3.26; 95% CI; 1.25, 8.56;P = 0.016) and untrimmed fingernail status (AOR = 3.63; 95%CI;1.32,9.93;P = 0.012) were significantly associated with PTB- intestinal helminth -co-infection. CONCLUSION: Helminth infection was associated with a lower bacilli load compared to helmenths non-infected PTB. The rate of co-infection TB with intestinal helminths was 44%. Trichuris trichiura was the most prevalent helminth. Untrimmed fingernail and a body mass index were associated with PTB-intestinal helminth co-infection.

Humans seropositive for Trypanosoma cruzi co-infected with intestinal helminths have higher infectiousness, parasitaemia and Th2-type response in the Argentine Chaco.

BACKGROUND: The Gran Chaco ecoregion is a well-known hotspot of several neglected tropical diseases (NTDs) including Chagas disease, soil-transmitted helminthiasis and multiparasitic infections. Interspecific interactions between parasite species can modify host susceptibility, pathogenesis and transmissibility through immunomodulation. Our objective was to test the association between human co-infection with intestinal parasites and host parasitaemia, infectiousness to the vector and immunological profiles in Trypanosoma cruzi-seropositive individuals residing in an endemic region of the Argentine Chaco. METHODS: We conducted a cross-sectional serological survey for T. cruzi infection along with an intestinal parasite survey in two adjacent rural villages. Each participant was tested for T. cruzi and Strongyloides stercoralis infection by serodiagnosis, and by coprological tests for intestinal parasite detection. Trypanosoma cruzi bloodstream parasite load was determined by quantitative PCR (qPCR), host infectiousness by artificial xenodiagnosis and serum human cytokine levels by flow cytometry. RESULTS: The seroprevalence for T. cruzi was 16.1% and for S. stercoralis 11.5% (n = 87). We found 25.3% of patients with Enterobius vermicularis. The most frequent protozoan parasites were Blastocystis spp. (39.1%), Giardia lamblia (6.9%) and Cryptosporidium spp. (3.4%). Multiparasitism occurred in 36.8% of the examined patients. Co-infection ranged from 6.9% to 8.1% for T. cruzi-seropositive humans simultaneously infected with at least one protozoan or helminth species, respectively. The relative odds of being positive by qPCR or xenodiagnosis (i.e. infectious) of 28 T. cruzi-seropositive patients was eight times higher in people co-infected with at least one helminth species than in patients with no such co-infection. Trypanosoma cruzi parasite load and host infectiousness were positively associated with helminth co-infection in a multiple regression analysis. Interferon-gamma (IFN-γ) response, measured in relation to interleukin (IL)-4 among humans infected with T. cruzi only, was 1.5-fold higher than for T. cruzi-seropositive patients co-infected with helminths. The median concentration of IL-4 was significantly higher in T. cruzi-seropositive patients with a positive qPCR test than in qPCR-negative patients. CONCLUSIONS: Our results show a high level of multiparasitism and suggest that co-infection with intestinal helminths increased T. cruzi parasitaemia and upregulated the Th2-type response in the study patients.

Associations of Plasmodium and Intestinal Helminth Infections with Maternal Anemia and Adverse Pregnancy Outcomes in Northwest Ethiopia.

Malaria and intestinal helminth infections are significant public health challenges in Ethiopia. However, little is known about the relationship of Plasmodium and intestinal helminth infections in pregnancy with maternal anemia and adverse pregnancy outcomes. A health-facility-based cross-sectional study was conducted among 526 parturients in northwest Ethiopia to investigate the associations of these parasitic infections with anemia and adverse pregnancy outcomes. Maternal and newborn profiles were collected using questionnaires and checklists. Maternal hematocrit was determined using the micro-hematocrit method. Malaria was diagnosed by microscopy, rapid diagnostic tests, and quantitative polymerase chain reaction, whereas intestinal parasites were detected microscopically using stool wet mount and Kato-Katz preparations. Among the women, 38.6% were anemic, and 36.5% had adverse pregnancy outcomes. Single infections of hookworm (adjusted odds ratio [aOR] = 3.11, 95% CI: 1.64-5.87) in pregnancy were associated with anemia at parturiency, whereas malaria single infections were associated with anemia (aOR = 4.28, 95% CI: 2.17-8.23) and adverse pregnancy outcomes (aOR = 2.94, 95% CI: 1.47-5.91). Moreover, intestinal helminth coinfections in pregnancy were associated with anemia (aOR = 13.3, 95% CI: 4.8-36.8), whereas malaria-helminth coinfections were associated with anemia (aOR = 7.47, 95% CI: 3.71-15.04) and adverse pregnancies (aOR = 4.75, 95% CI: 2.36-9.57). Overall, the study showed that Plasmodium and intestinal helminth infections in pregnancy are associated with anemia and adverse pregnancy outcomes. Thus, strengthening malaria and intestinal parasite infection prevention and control practices in pregnancy is warranted to alleviate the burden of anemia and adverse pregnancy outcomes.

CO-INFECTION WITH MALARIA AND INTESTINAL PARASITES AND ITS ASSOCIATION WITH ANEMIA IN CHILDREN (ZERO TO TEN YEARS OLD) IN TIKO SUBDIVISION, CAMEROON.

Concomitant infections with malaria and intestinal parasitic infections may be associated with anemia in children (0-10 yr). This study determined the prevalence of co-infection with malaria and intestinal parasitic infections and determined its association with anemia in children (0-10 yr) in Tiko, Cameroon. A hospital-based cross-sectional study was carried out whereby venous blood and stool samples were collected from 377 febrile children. Blood was used to perform a full blood count. Thick and thin blood films were prepared and stained with Giemsa for malaria parasite diagnosis. The formol ether concentration technique was used to analyze the stools. Pearson's chi-square test, Student's t-test, and other statistical analyses were performed. Of the 377 participants, 139 (36.9%) were positive for malaria, 21 (5.6%) had intestinal helminths, 8 (2%) had co-infection, and 79 (21.0%) were anemic. Malaria and anemia were prevalent among the children and were significantly associated (P = 0.025). There was no statistically significant difference (P > 0.05) among age groups. Girls were more often infected with malaria (69, 37.3%), and boys were more often infected with intestinal parasites (13, 7.0%), but there was no statistical association for both malaria and intestinal parasitic infections (IPIs) for both sexes (P > 0.05). Hookworms, Ascaris lumbricoides, and Trichuris trichiura were the intestinal parasites found in this study. There was a significant association between anemia and parasitic co-infection in children (P = 0.003). Malaria and IPIs are prevalent in the Tiko municipality. They play a great role in anemia especially when there is a co-infection. Public education and awareness campaigns are necessary in this municipality.

Intestinal Helminthiasis: Risk factors and relationship with Nutritional status and Anaemia among Institutionalised Children in three States of South-East Nigeria.

BACKGROUND: Intestinal helminthiasis occurs in sub-optimal living conditions with poor hygiene practices and is more prevalent in rural, suburban and institutionalized centres. Heavy helminthic burden negatively affects the nutritional status and the severity of anaemia among children living in orphanages. AIM: To determine the risk factors and relationship of intestinal helminthiasis with nutritional status and anaemia among institutionalized children in three states of South-East Nigeria. METHODS: A cross-sectional study was conducted over seven months involving 198 children recruited from orphanages in Anambra, Ebonyi and Enugu states. Their stool samples were analyzed using the Kato-Katz and Ether concentration techniques, and packed cell volume and anthropometric indices were documented. Data were analyzed. RESULTS: Of the 198 children, 109 (55.1%) were females with a median age of 2.5 years and interquartile range (3 months - 17 years). The prevalence of intestinal helminthiasis was 2.5%. Among the children that had intestinal helminthiasis, 4 (80%) had mono-parasitism with Ascaris lumbricoides, while 1 (20%) had mixed infestation of Ascaris lumbricoides and Trichuris trichiura. There was a significant association (p=0.01) between being infested with intestinal helminthiasis and caregiver handwashing practices. The anthropometric indices demonstrated that 5.6%, 6.6% and 13.1% of the children were underweight, wasted and stunted respectively. No helminth-infested child had malnutrition and only 1 (20%) infested child had moderate anaemia. CONCLUSION: Caregivers' good handwashing practice was associated with reduced prevalence of intestinal infestations and should be encouraged. There was no relationship found between the presence of helminthic infestations and nutritional status or anaemia among the institutionalised children.

CONTEXTE: Les helmintiases intestinales surviennent dans des conditions de vie sous-optimales avec des pratiques d'hygiène médiocres et sont plus fréquentes dans les centres ruraux, périurbains et institutionnalisés. Une charge helminthique importante affecte négativement l'état nutritionnel et la gravité de l'anémie chez les enfants vivant dans des orphelinats. OBJECTIF: Déterminer les facteurs de risque et la relation entre les helmintiases intestinales, l'état nutritionnel et l'anémie chez les enfants institutionnalisés dans trois États du sud-est du Nigéria. MÉTHODES: Une étude transversale a été menée sur sept mois, impliquant 198 enfants recrutés dans des orphelinats des États d'Anambra, d'Ebonyi et d'Enugu. Leurs échantillons de selles ont été analysés à l'aide des techniques de Kato-Katz et de concentration à l'éther, et le volume globulaire et les indices anthropométriques ont été documentés. Les données ont été analysées. RÉSULTATS: Sur les 198 enfants, 109 (55,1 %) étaient des filles avec un âge médian de 2,5 ans et une plage interquartile (3 mois - 17 ans). La prévalence des helmintiases intestinales était de 2,5 %. Parmi les enfants atteints d'helmintiases intestinales, 4 (80 %) présentaient une mono-parasitose à Ascaris lumbricoides, tandis que 1 (20 %) présentait une infestation mixte à Ascaris lumbricoides et Trichuris trichiura. Il y avait une association significative (p=0,01) entre l'infestation par les helmintiases intestinales et les pratiques de lavage des mains par les aidants. Les indices anthropométriques ont montré que 5,6 %, 6,6 % et 13,1 % des enfants étaient respectivement sous-pondérés, émaciés et retardés en taille. Aucun enfant infesté par les helminthes n'était malnutri et seul 1 (20 %) enfant infesté avait une anémie modérée. CONCLUSION: La bonne pratique du lavage des mains par les aidants était associée à une prévalence réduite des infestations intestinales et devrait être encouragée. Aucune relation n'a été trouvée entre la présence d'infestations helminthiques et l'état nutritionnel ou l'anémie chez les enfants institutionnalisés. Mots-clés: Anémie, Enfants, Helminthes, Institutionnalisés, État nutritionnel.

Intestinal helminthic infections: a narrative review to guide the hepatogastroenterologist.

Intestinal helminthic infections are not uncommon in Western Europe, mainly due to modern travel, emigration and globalization. Moreover, some helminthic infections are endemic in Western Europe and are part of the everyday clinical practice. The hepatogastroenterologist should therefore recognize and manage these patients or at least refer them to appropriate reference centers. Signs and symptoms are often unspecific or even absent. Discerning the disease at an early stage avoids expensive diagnostic testing, life-threatening complications and in some cases even further spread of the disease. This review article aims to guide the hepatogastroenterologist when suspecting a helminthic infection by addressing the most prevalent symptoms, summarizing the most probable associated helminthic entities, highlighting practical steps in diagnosis and available treatments.

Evidence and potential drivers of neglected parasitic helminth and protist infections among a small preliminary sample of children from rural Mississippi.

INTRODUCTION: Intestinal infections with helminths (parasitic worms) and protists (single-celled eukaryotes) may be neglected health issues in low-resource communities across the United States. Because they predominantly infect school-aged children and can lead to nutritional deficiencies and developmental delays, these infections can affect lifelong health. More research is needed to understand the prevalence and risk factors of these parasitic infections in the United States. METHODS: A total of 24 children (ages 0.5-14 years) from a low-resource, rural Mississippi Delta community provided stool samples for 18s rRNA amplification and sequencing to determine infection presence. Parent/guardian interviews provided age, sex, and household size to test for associations with infection. RESULTS: Infections were found in 38% (n = 9) of the samples. 25% (n = 6) of participants were infected with helminths (platyhelminths [n = 5]; nematodes [n = 2]), while 21% (n = 5) were infected with protists (Blastocystis [n = 4]; Cryptosporidium [n = 1]). There were no associations between infection status and age, sex, or household size. Problematically, analytical methods did not allow for more specific classifications for helminth species. CONCLUSIONS: These preliminary findings suggest parasitic infections may be overlooked health issues in the rural Mississippi Delta and emphasize the need for more research on potential health outcomes within the United States.

Malarial and intestinal parasitic co-infections in indigenous populations of the Brazilian Amazon rainforest.

The Brazilian Amazon rainforest region has a significant prevalence of malarial and intestinal parasitic infections in indigenous populations, accounting for a disproportionate burden. Thus, a cross-sectional study was conducted to assess the prevalence and association between malarial and intestinal protozoan and helminth infections in four remote indigenous villages in the Brazilian Amazon Forest. A total of 430 individuals participated in the study, and Plasmodium infections were diagnosed by examination of thick blood smears and PCR. Stool samples 295 individuals (69%) were examined by direct smear and the Kato-Katz technique. The overall prevalence of malaria, intestinal protozoan infection, and intestinal helminth infection was 14.2%, 100%, and 39.3%, respectively. Polyparasitism was predominant (83.7%), and most infected individuals had at least two or more different species of intestinal protozoan and/or helminth parasites. The prevalence of co-infection was 49.5%, and in individuals with intestinal protozoa and helminth infections (34%), Entamoeba. coli, Entamoeba histolytica, and Ascaris lumbricoides were the most common parasites. In individuals with malaria and protozoa infections (10.2%), P. vivax, E. coli, and E. histolytica predominated, and in individuals with malaria, protozoa, and helminth infections (5.4%). P. vivax, E. coli, E. histolytica, and A. lumbricoides predominated. Intestinal polyparasitism was common in the study population, and the presence of helminths was associated with an increased number of intestinal parasitic species. However, Plasmodium infections were neither a risk nor a protective factor for helminth infections; the same was true for helminth infections in relation to Plasmodium. The high prevalence of intestinal polyparasitism with Plasmodium co-infections highlights the need for combining strategies that may help control both malaria and intestinal parasite and generate a health approach aligned with indigenous perspectives.

Magnitude of anemia and associated factors among adult patients at Baso Liben District: a cross-sectional study.

BACKGROUND: Despite the fact that anemia is a common health problem with many consequences, its magnitude among adults and the different contributing factors have not been documented in the study setting. Hence, this study aimed to determine the magnitude of anemia and associated factors among adult patients of Baso Liben District. METHODS: A facility-based cross-sectional study was conducted from 1 December 2019, to February 30, 2020. A total of 347 adult patients attending Yejubie Hospital were enrolled in the study. Socio-demographic data were collected through face-to-face interview. Patients' hemoglobin level was determined by a Mindray BC-5800 CBC hematology analyzer. The presence of intestinal parasites and malaria infection were assessed. RESULTS: The overall magnitude of anemia was 25.94% with moderate severity according to the WHO anemia classification. The prevalence of mild, moderate, and severe anemia was 13.54%, 8.36%, and 4.03%, respectively. Anemia was associated with age range ≥55 years (AOR = 31.66), large family size (AOR = 6.62), being married (AOR = 0.24), intestinal parasite infections (AOR = 4.05), malaria infection (AOR = 4.61), and pregnancy (AOR = 4.09). CONCLUSION: The prevalence of anemia was moderate. Intestinal parasitic infection, age, malaria, family size, and pregnancy were associated factors with anemia.

Intestinal parasitic infections and risk factors for infection in Kenyan children with and without HIV infection.

It has been reported that HIV infection is not a risk factor for Entamoeba species infection but is for Giardia intestinalis assemblage B in children living in Western Kenya. This study aimed to investigate the prevalence of and the risk factors for Entamoeba spp. and G. intestinalis infection in children living in Nairobi, Kenya. This cross-sectional study included 87 children with HIV [HIV(+)] and 85 without HIV [HIV(-)]. Stool and blood samples were collected for the detection of the parasites by PCR and immunological analyses using flow cytometry. Sociobehavioral and hygienic data were collected using questionnaires and analyzed statistically. The prevalence of Entamoeba spp. infection was significantly lower in the HIV(+) than in the HIV(-) children (63.2% vs. 78.8%, P = 0.024), whereas the prevalence of G. intestinalis infection was not (27.6% vs. 32.9%, P = 0.445). "Not boiling drinking water" (adjusted odds ratio [aOR]: 3.8, P = 0.044) and "helping in nursery care" (aOR: 2.8, P = 0.009) were related to G. intestinalis assemblage B infection, and "CD4/CD8 ratio ≥1" was related to Entamoeba spp. infection (aOR: 3.3, P = 0.005). In stratified regression analyses, HIV infection was negatively associated with G. intestinalis assemblage B infection in females (aOR: 0.3, P = 0.022), but positively associated in males (aOR 3.8, P = 0.04). These results suggest that G. intestinalis assemblage B infection is related to hygienic conditions, while Entamoeba spp. infection is an indicator of better immunological status, and that the role of HIV infection in Giardia infection may differ between Kenyan boys and girls.

Evidence of reduced academic performance among schoolchildren with helminth infection.

BACKGROUND: Soil-transmitted helminths (STHs) pose a formidable health risk to school-age children in resource-limited settings. Unfortunately, mass deworming campaigns have been derailed since the onset of the coronavirus disease 2019 pandemic. The present study assessed the cross-sectional associations between STHs, nutritional status and academic performance of schoolchildren in the Banda District of Ghana. METHODS: Schoolchildren (5-16 y of age; n=275) were recruited through both school and household visits by community health workers using a multistage cluster sampling technique. In addition to school microscopy, anthropometric records were also taken. RESULTS: The prevalence of geohelminthiasis was 40.4% (95% confidence interval 34.6 to 46.2). STHs targeted for elimination by the World Health Organization and national programmes were detected among schoolchildren. Children with intestinal parasite infection (53.7 [standard deviation {SD} 11.5]) had lower mean academic scores compared with uninfected children (59.6 [SD 16.9]) (p=0.034). In multiple regression analysis, intestinal parasite infection status and z-scores for weight-for-age showed a collective significant effect on the academic score (F1117=8.169, p<0.001, R2=0.125). CONCLUSIONS: Schoolchildren with STHs had poorer academic performance compared with uninfected children, despite their nutritional status. In addition to school feeding programmes, school-based mass drug administration campaigns may be critical for improving learning outcomes in young schoolchildren.

Inusual hallazgo en paciente cirrótico con anemia crónica e hipereosinofilia usando cápsula endoscópica: a propósito de un caso (video) / Unusual finding in cirrhotic patient with chronic anemia and hypereosinophilia using an endoscopic capsule: a case report (video)

We report a clinical case from a patient with alcoholic cirrhosis who had chronic anemia and carried out several endoscopic studies without evidence of active bleeding, a complementary study with endoscopic capsule was requested to search for a source of bleeding. In the analysis of laboratory data, the presence of hypereosinophilia stands out in parallel. The images obtained in the video capsule study show geoparasites helminth-type. After parasite treatment, anemia improves and the absolute eosinophil count is normalized.

Reportamos el caso de un paciente cirrótico por alcohol con anemia crónica quien se realizó varios estudios endoscópicos sin evidencia de sangrado activo, por tal motivo se solicitó estudio complementario con cápsula endoscópica para búsqueda de fuente de sangrado. En el análisis de los datos de laboratorio paralelamente destaca la presencia de hipereosinofilia. Las imágenes obtenidas en el estudio de la video cápsula muestran varios geoparásitos de tipo helmintos. Posterior al tratamiento antiparasitario mejora la anemia y se normaliza el recuento absoluto de eosinófilos.

Perfil epidemiológico y parasitosis intestinales en tres comunidades atendidas por organización no gubernamental, Tegucigalpa, Honduras / Epidemiologic profile and intestinal parasitism in three communities served by non-governmental organization, Tegucigalpa, Honduras

Antecedentes: Alternativas y Oportunidades (AyO), Organización No Gubernamental (ONG) sin fines de lucro ha ofrecido programas educativos durante 32 años en mercados capitalinos y comunidades de escasos recursos de Tegucigalpa y Comayagüela. Objetivos: Determinar las características epidemiológicas y la frecuencia de parásitos intestinales de la población en tres sitios beneficiarios de AyO. Participantes y Métodos: Estudio descriptivo transversal de mayo a octubre 2019. Previo consentimiento/ asentimiento informados, se obtuvo datos sociodemográficos y epidemiológicos por encuesta en voluntarios de 0-49 años que proveyeron una muestra fresca de heces, examinada en el laboratorio por métodos directo, Kato-Katz, Baermann, coloración ácido resistente modificada y prueba inmunoantigénica ELISA. Resultados: Se encontró que en total 147 participantes era pobre, tenía trabajo informal mal remunerado, casas de adobe, madera, bloque o ladrillo; 92.5% (136) tenía letrina o inodoro, 97.2% (142) quemaba la basura o era recogida por camiones y 72.6% (106) compraba agua. La frecuencia de parásitos intestinales fue 3.4% (5) infección por helmintos, 62.5% (92) infecciones por protozoos comensales y dos especies patógenas: Giardia duodenalis 15.0% (22) y Cyclospora cayetanensis 2.0% (3). Blastocystis spp. 52.3% (77) y protozoos comensales Endolimax nana 36.7% (54), Entamoeba coli 32.6% (48) y Entamoeba hartmanni 23.2% (34), fueron los más frecuentes; 6.1% (9), tenía quistes de Entamoeba histolytica/E. dispar. La prueba inmunoenzimática de ELISA detectó 16.1% (19/118) infecciones por Giardia y ninguna infección por Cryptosporidium. Discusión: Promoción en higiene (WASH) y uso de filtros para agua de consumo es información importante que AyO debe promover al educar comunidades en salud...(AU)

Stunting among children aged 24-59 months and associations with sanitation, enteric infections, and environmental enteric dysfunction in rural northwest Ethiopia.

Stunting is a public health issue of global concern. Despite, poor sanitation, diarrhea, parasitic infections, and environmental enteric dysfunction (EED) are associated with stunting, their link is poorly understood and has not been investigated in Ethiopia. This study was conducted to assess the associations of stunting with sanitation, enteric infections, and EED among children aged 24-59 months in rural northwest Ethiopia. A community-based cross-sectional study was conducted among 224 randomly selected children aged 24-59 months in rural areas of the east Dembiya district. We collected information on household food insecurity and dietary diversity using pre-tested questionnaires adopted from the food and nutrition technical assistance (FANTA) project. We used height-for-age-z score (HAZ) to define stunting. We also used the data collected to measure the environmental exposures of children to intestinal parasitic infections and fecal biomarkers of EED. A multivariable binary logistic regression model was used to assess the association of stunting with sanitation, enteric infections, and EED. Of the 224 children, 33% (95% CI 27, 39%) were stunted. Stunting in children was significantly associated with poor dietary intake (AOR 3.0, 95% CI 1.2, 7.3), open defecation practice (AOR 3.0, 95% CI 1.2, 7.9), presence of animal excreta in the living environment (AOR 3.4, 95% CI 1.2, 9.9), E. coli contamination of drinking water (AOR 4.2, 95% CI 1.1, 15.3), diarrheal disease incidence (AOR 3.4, 95% CI 1.5, 7.7), intestinal parasites in children (AOR 3.3, 95% CI 1.3, 8.8), and higher EED disease activity scores (AOR 2.9, 95% CI 1.2, 6.7). One-third of the children in the study area were stunted and this high prevalence of stunting was associated with poor dietary intake, poor hygiene and sanitation conditions, enteric infections, and EED. Thus, stunting can be prevented by improving sanitation and hygienic conditions to prevent repeated enteric infections in children and by promoting dietary diversity of children.

Prevalence and Associated Risk Factors of Human Intestinal Helminths Parasitic Infections in Ethiopia: A Systematic Review and Meta-Analysis.

Background: Intestinal helminth infections are still public health problems in tropical and subtropical countries including Ethiopia. This review and meta-analysis aimed to produce the pooled prevalence and associated risk factors of human intestinal helminth parasitic infections (HIHPIs) in Ethiopia. Methods: Articles written in English were searched from online databases. Sixty-seven studies were included. Meta-analysis was computed using STATA version 14. Result: The pooled prevalence of HIHPIs was (33.35%, 95% CI: 28.85%, 37.86%). Ascaris lumbricoides (10.84%, 95% CI: 9.34, 12.34), hookworm spp. (8.89%, 95% CI: 7.75, 10.04), Schistosoma mansoni (4.22%, 95% CI: 3.64, 4.81), Trichuris trichiura (2.51%, 95% CI: 2.17, 2.86), Hymenolepis nana (2.29%, 95% CI: 1.96, 2.63), Taenia species (1.01%, 95% CI: 0.80, 1.22), Strongyloides stercoralis (1.17%, 95% CI: 0.92, 1.41), and Enterobius vermicularis(0.71%, 95% CI: 0.52, 0.90) were recorded. Handwashing before food (OR: 5.22,95% CI: 3.49, 6.94), handwashing after toilet (OR: 3.03, 95%; CI: 1.01, 5.05), age (OR: 1.66, 95% CL. 1.09, 2.23), open defecation (OR: 2.42, 95% CI: 1.60, 3.24), eating raw and unwashed vegetables/fruits (OR: 1.98, 95%; CI: 1.30, 2.66), maternal education (OR: 1.81, 95% CI: 0.91, 2.72), family income (OR: 2.00, 95% CI: 0.87, 3.31), source of drinking water (OR: 3.12, 95% CI: 1.96, 4.27), swimming/contact with river water (OR: 1.90, 95% CI: 1.11, 2.69), barefoot (OR: 3.28, 95% CI: 1.67, 4.88), playing with soil (OR: 2.64, 95% CI: 1.40, 3.88), and family size (OR: 3.75, 95% CI: 2.03, 5.46) were factors associated with HIHPIs in Ethiopia. High heterogeneity of the prevalence of HIHPIs was observed among the studies within and among regions (I2 > 99.6% and P ≤ 0.001). Conclusion: HIHPIs in Ethiopia were significantly high. Therefore, special attention should be given by all stakeholders to minimize HIHPIs in Ethiopia.

Clinical Presentation and Intensity of Infection with Intestinal Helminths among School Children in Ile-Ife, Osun State, Nigeria.

BACKGROUND: Intestinal helminthiases are public health problems of children in developing countries of the world and account for significant morbidity as it results in stunted growth, intestinal obstruction, anaemia, cognitive impairment, acute pancreatitis, acute cholecystitis and rectal prolapse. This study assessed intestinal helminths, infection intensity and symptoms in primary school children in Ile-Ife. METHODS: It was a cross sectional study. Three hundred and eighty-four pupils randomly selected from six public primary schools in Ife Central Local Government were enrolled for the study. Ethical approval was obtained. Stool samples were collected and processed using the Formol-ether concentration method. Questionnaires were administered to obtain relevant information. Data entry and processing were done using Microsoft excel and IBM SPSS Statistics for windows, version 17. Statistical analysis included frequency, proportion and percentages. RESULTS: Helminthic parasites were recovered from the stool of the schoolchildren and the overall prevalence of helminthic infection was 24%. Ascaris lumbricoides was the most prevalent (22.1%) with moderate and light intensities of infection, Hookworm (3.4%) with light intensity infection and Hymenolepis nana 0.3%. Symptoms were present in 48.2% of the participants and 31.5% presented with abdominal pain, nausea 22.1%, diarrhoea 21.1%, anorexia 7%. Weight loss, nausea and vomiting were found to be significantly associated with infection with intestinal helminths. CONCLUSION: Light to moderate intestinal helminthic infections are still prevalent among school children with weight loss, nausea and vomiting being the most significant symptoms. Continuous studies among school children are needed including those in private schools to better understand the epidemiology of these infections.

BACKGROUND: Les helminthiases intestinales sont des problèmes de santé publique, des enfants dans les pays en voie de développement du monde et représentent une morbidité importante, car elles entraînent un retard de croissance, l'obstruction intestinale, l'anémie, les troubles cognitifs, la pancréatite aiguë, la cholécystite aiguë et prolapsus rectal. Cette étude a évalué les helminthes intestinaux, l'intensité de l'infection et les symptômes chez les enfants des écoles primaires d'Ile-Ife. MÉTHODES: Il s'agissait d'une étude transversale. Trois cent quatre-vingt-quatre élèves choisis au hasard dans six écoles primaires publiques de Ife Central Local Government ont été recrutés pour l'étude. L'approbation éthique a été obtenue. Les échantillons de selles ont été collectés et traités en utilisant la méthode de concentration Formol-Ether. Des questionnaires ont été administrés pour obtenir des informations pertinentes. La saisie et le traitement des données ont été effectués à l'aide de Microsoft Excel et IBM SPSS. Statistique pour wndows, version 17. L'analyse statistique comprenait fréquence, proportion et pourcentages. RÉSULTATS: Les parasites helminthiques ont été récupérés dans les selles des écoliers et la prévalence globale de l'infection helminthique était de 24%. Ascaris lumbricoides était le plus répandu (22,1%) avec une intensités d'infection modérée et légère, l'ankylostome (3,4%) avec une intensités d'infection légère et Hymenolepis nana 0,3 %. Les symptômes étaient présents chez 48,2% des participants et 31,5% présentaient des douleurs abdominales, nausées 22,1%, diarrhées 21,1%, anorexie 7%. La perte de poids, les nausées et les vomissements ont été associés de manière significative à l'infection par des helminthes intestinaux. CONCLUSION: Les infections légères à modérées par les helminthes intestinaux sont encore répandues chez les écoliers, la perte de poids, les nausées et les vomissements étant les symptômes les plus significatifs. Des études continues parmi les enfants scolarisés, y compris dans les écoles privées, sont nécessaires pour mieux comprendre l'épidémiologie de ces infections. Mots-clés: Helminthes, Intensité, Enfants scolarisés, Symptômes.

The effect of compliance to Hand hygiene during COVID-19 on intestinal parasitic infection and intensity of soil transmitted helminthes, among patients attending general hospital, southern Ethiopia: Observational study.

BACKGROUND: Intestinal parasitic infection (IPIs) is one of the major health problems in Sub -Saharan Africa where water, sanitation and hygiene practices are inadequate. Taking into account the national level implementation of intensive hand hygiene against COVID-19 pandemic and general protective effect this study assessed its effect on intestinal parasite. OBJECTIVE: This study aim to investigate the effect of compliance to hand hygiene practice on the prevalence of intestinal parasitic infection (IPIs) and intensity of Soil transmitted helminthes (STH) among patients attending tertiary care hospital in southern Ethiopia. METHODS: Observational study was conducted from June to September 2021. Data on socio demographic, hand hygiene practice and intestinal parasite (prevalence and intensity of helminthic infection) was collected from randomly selected and consented patients. Compliance to hand hygiene practice was assessed using pre-tested questionnaire. Fresh stool sample from each participant was examined by direct wet mount, concentration and Ziehl-Neelson (ZN) staining technique to detect intestinal parasite. Intensity of STH measurements was done through direct egg-count per gram using Kato Katz methods. Data analysis was done using SPSS version 25. Odds ratio with 95% confidence interval was used to measure association and p-value <0.05 was considered as statistically significant. RESULTS: The study population (N = 264) consisted of 139(52.65%) male and 125 (47.34%) female with the mean ages of 36 ±16.12(±SD). The proportion of good compliance to hand hygiene during COVID-19 to was 43.93% (95%CI: 37% to 47) and prevalence of intestinal parasite was 26.14% (95%CI:21.2% to 31.75) comprising 23.48% intestinal protozoa and 6.43% of soil transmitted helminthic infection. Gardia lamblia, Entamoeba histolytica/dispar, Ascaris lumbricoides were the common parasite in the study area with prevalence of 15.53%, 6.44%, and 1.52% respectively. Prevalence of intestinal parasite among participants with good compliance to hand hygiene group and poor compliance to hand hygiene were (14.65% vs. 35.13%)(AOR: 0.48,95%CI:0.13 to 0.68) (p = 0.002) implying that good compliance to hand hygiene can reduce the risk of IPIs by 52%. Moreover significantly lower odds of intestinal protozoa among good compliance to hand hygiene group than the control (OR:0.38; (95%CI: 0.20 to 0.71);P = 0.001. However, no significant difference in the odds of intensity of STH infection in good compliance hand hygiene and poor compliance group. The result of this study also confirmed the association between intestinal parasitic infections and younger /adolescent age, education status, habit of eating raw vegetable and figure nail status. CONCLUSION: Good hand hygiene compliance during COVID-19 significantly associated with reduction of intestinal parasitic infection. This finding highlights the secondary protective effect of improved hand hygiene against IPIs and suggest it can used in augmenting the existing parasitic control strategies in the study setting.

The implementation of the Kinyoun staining technique in a resource-limited setting is feasible and reveals a high prevalence of intestinal cryptosporidiosis in patients with HIV.

OBJECTIVES: In resource-limited settings, intestinal Cryptosporidial or coccidian infections are common causes of chronic diarrhea but usually remain undiagnosed by routine stool investigation. Here, the addition of the Kinyoun staining technique after stool concentration was evaluated as an easy and inexpensive method for diagnosis of intestinal parasitic infection in patients with HIV. METHODS: This cross-sectional study investigated patients with HIV with diarrhea and randomly selected patients with HIV without diarrhea as controls. Stool samples were examined by wet mount microscopy and Kinyoun staining after stool concentration. Clinical, sociodemographic, and behavioral data were collected. Statistical analysis was performed using chi-squared test and multivariate regression analysis. RESULTS: In total, 163 participants were included (62.0% female, mean age 38.2 [SD ± 10.7] years). Diarrhea was present in 52.1% (85/163). The prevalence of intestinal parasites was 18.4% (30/163). Cryptosporidial infections were more frequent among patients with diarrhea (12.9% [11/85] vs 1.3% [1/78], P = 0.005) and in patients with CD4+ cell count <200 cells/µl (25.9% [7/27] vs 3.7% [5/136], P = 0.001). Risk factors for intestinal parasitic infections were diarrhea and the habit of regularly eating uncooked food. Kinyoun staining was necessary for the detection of cryptosporidiosis. CONCLUSION: In our cohort, the prevalence of intestinal parasitic infection was high, especially after additional use of Kinyoun staining for detection of Cryptosporidia or intestinal coccidia. Considering its clinical relevance, particularly in individuals at risk, the implementation of this technique should be considered in resource-limited settings.