Intestinal parasitoses and schistosome infections among students with special reference to praziquantel efficacy in patients with schistosomosis in Hajjah governorate, Yemen

The majority of the population in Yemen lives in rural areas and suffers from parasitic infections. Therefore, the present study aimed to determine the prevalence of intestinal parasitoses and schistosome infections among the students enrolled in the primary schools in Hajjah governorate ­ north of Yemen, along with an assessment of praziquantel (PZQ) in the treatment of microscopy-confirmed cases of Schistosoma mansoni and Schistosoma haematobium. For this purpose, 780 samples (320 stool and 460 urine) were examined microscopically. The present study revealed an overall infection rate of 75.3% (241/320) with intestinal parasites and Schistosoma mansoni. The detected parasite species included Entamoeba histolytica (27.8%), Hymenolepis nana (12.2%), Giardia lamblia (9.7%), Entamoeba coli (9.4%), S. mansoni (9.1%), Ascaris lumbricoides (6.9%), Trichuris trichiura (3.1%), Enterobius vermicularis (2.8%) and Ancylostoma duodenale (2.2%). Schistosoma haematobium was prevalent among 1.7% (8/460) of the investigated students. On the other hand, PZQ yielded a cure rate of 75.7% of Schistosoma-infected students when administered at 40 mg/kg body weight. However, a 100% cure rate was achieved when administered at 60 mg/kg body weight. Therefore, the findings of the present study highlight the importance of monitoring PZQ efficacy through large-scale studies in different settings endemic for schistosomosis in the country.

Risk Factors for End-Stage Renal Failure Among Patients on Hemodialysis in Aljomhory Hospital, Sa'adah Governorate, Yemen: Hospital-Based Case-Control Study.

BACKGROUND: More than 16% of the world's population is affected by chronic kidney disease, and these people are at the highest risk of developing end-stage renal failure (ESRF). OBJECTIVE: The aim of this study was to determine the risk factors of ESRF in Sa'adah Governorate in Yemen. METHODS: A hospital-based case-control study (86 cases and 263 controls) was conducted in the Aljomhory Hemodialysis Center in Sa'adah city, Yemen. Patients with ESRF who attended the hemodialysis center in Aljomhory Hospital in Sa'adah City from January 1 to February 15, 2016, were included. Control participants were healthy persons without end-stage renal disease (ESRD) who attended Aljomhory Hospital as outpatients' relatives during the study period. RESULTS: A total of 86 cases and 263 controls were included in this study. The mean age was 43.3 (SD 17.7) years for cases and 32.3 (SD 13.0) years for controls. In univariate analysis of factors associated with ESRD, patients aged≥40 years were 3.7 times more likely to have ESRD than younger patients. The odds of ESRD was higher among men than women. Illiteracy was significantly associated with higher odds of ESRD. Hypertension (odds ratio [OR]=8.34), diabetes (OR=3.07), cardiovascular diseases (OR=12.71), presence of urinary stones (OR=21.87), recurrent urinary tract infection (OR=9.64), cigarette smoking (OR=2.44), and shammah use (OR=6.65) were significantly associated with higher odds of ESRD. Hypertension (OR=6.68), urinary stones (OR=16.08), and recurrent urinary tract infection (OR=8.75) remained significantly associated with ERD in multivariate analysis. CONCLUSIONS: Hypertension, presence of urinary stones, and recurrent urinary tract infections were significantly associated with ESRF development. Improving the management of hypertension and designing suitable interventions to control problems of the urinary tract would help reduce ESRD prevalence.

Malaria status in Al-Hodeidah Governorate, Yemen: malariometric parasitic survey & chloroquine resistance P. falciparum local strain.

Malaria continues to be a major public health problem in Al-Hodeidah G. A cross-sectional malariometic parasitic survey including 4000 Yemenis of various age /sex groups were enrolled in this study from 43 villages/or Harah in five selected districts representing Al-Hodeidah G. Duplicate thin and thick blood smears were stained with Giemsa's stain and examined. Out of 4000 examined slides, 646 (16.2%) were found to be malaria positive, 508 (78.6%) of them were detected through ACD, while 138 (21.4%) cases were detected by PCD. The overall parasite rate was 16.2%, a situation of prevalently mesoendemic condition. P. falciparum was the predominant species recorded (96.7%), followed by P. vivax (1.7%), the least prevalent was P. malariae (0.3%). Yemen has been considered free of ovale malaria. The recorded an indigenous case of P. ovale for the first time in Yemen should be taken into consideration for the existence of this particular Plasmodium species when surveying for malaria in the future. The present study was the first document in Yemen to compare simultaneously the in vivo and in vitro response to chloroquine among 209 of P. falciparum field isolate patients that were satisfied all criteria of WHO for the implementation of the in vivo and in vitro tests and were obtained by PCD and ACD methods. Chloroquine resistance of local strain of P. falciparum was recorded in all studied districts (Zabid, Bajil, Azohrah, Azaidiah and Al-Hodeidah city). RIII (high level of resistance) was recorded for the first time in Yemen and should be taken into consideration in the treatment of infected malaria patients. This calls for urgent revision of the current malaria treatment policy in Yemen where chloroquine is the first-line treatment of uncomplicated P. falciparum malaria.