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1.
Washington, D.C.; OPS; 2021-10-01.
No convencional en Español | PAHO-IRIS | ID: phr-54947

RESUMEN

La hoja de ruta para las enfermedades tropicales desatendidas, publicada por la OMS en el 2012, estableció dos metas para el control de las geohelmintiasis para el 2020, a saber: suministrar tratamiento regular a 75% de los niños en edad preescolar y escolar que lo requirieran y lograr la cobertura de 75% con la quimioterapia preventiva en los niños en edad preescolar y escolar en 100% de los países. En el 2017, los datos recopilados de los 103 países donde las geohelmintiasis son endémicas mostraban que era factible alcanzar esas dos metas. En octubre del 2018, un grupo de representantes de esos países, junto con asociados de otras instituciones que apoyan las actividades de control, se reunió en Basilea para proponer nuevas metas que orientaran la quimioterapia preventiva y otras actividades de control una vez alcanzadas las metas para el 2020. Los indicadores establecidos por el grupo de trabajo y que se presentan en esta publicación pueden considerarse recomendaciones de los expertos dirigidas al Departamento de la OMS de Control de Enfermedades Tropicales Desatendidas, para distribuir a su vez a las oficinas regionales y en los países de la OMS, los funcionarios del ministerio de salud y los responsables de los programas en los países con endemicidad, a fin de sustentar la lista definitiva de los indicadores en materia de geohelmintiasis que deberán alcanzarse para el 2030.


Asunto(s)
Helmintiasis , Enfermedades Desatendidas , Salud del Niño , Lactante , Quimioterapia , Enfermedades Endémicas , Control de Enfermedades Transmisibles , Enfermedades Transmisibles , Desarrollo Sostenible , Cambio Climático , Medio Ambiente y Salud Pública
2.
Washington, D.C.; OPS; 2021-10-01. (OPS/CDE/VT/21-0012).
No convencional en Español | PAHO-IRIS | ID: phr-54946

RESUMEN

El Grupo Asesor de la OMS sobre la desparasitación en adolescentes y mujeres en edad reproductiva convocó una reunión de expertos internacionales en el Centro de la Fundación Rockefeller de Bellagio (Italia) en junio del 2017. Los objetivos generales de la reunión fueron examinar la evidencia actual sobre la presencia y las repercusiones en la salud de las geohelmintiasis en las adolescentes y mujeres en edad reproductiva y determinar las brechas en la investigación; plantear las estrategias operativas para controlar las geohelmintiasis en cada uno de los diferentes subgrupos de adolescentes y mujeres en edad reproductiva (adolescentes, mujeres embarazadas, mujeres en lactancia y mujeres no embarazadas ni en lactancia); y definir un plan de acción para promover un mayor control de las geohelmintiasis en las adolescentes y mujeres en edad reproductiva. En este informe se describen esos objetivos, que se desagregaron en 12 subobjetivos y se abordaron en las cinco sesiones siguientes: introducción y orientación; evidencia; enseñanzas extraídas en el terreno; cómo avanzar; y recomendaciones y próximos pasos. Además, se incluye la Declaración de Bellagio, que se aprobó por unanimidad con motivo de la reunión.


Asunto(s)
Helmintiasis , Parásitos , Nutrición, Alimentación y Dieta , Salud Reproductiva , Mujeres Embarazadas , Alimentos para Embarazadas y Nodrizas , Salud del Lactante , Atención Perinatal , Salud de la Mujer
3.
Washington D.C; Organización Panamericana de la Salud; 1 ed; Oct. 2021. 55 p. ilus.
Monografía en Español | LIPECS, MINSAPERÚ | ID: biblio-1348006

RESUMEN

En el presente informe se describen esos objetivos, que se desagregaron en 12 subobjetivos y se abordaron en las cinco sesiones siguientes: introducción y orientación; evidencia; enseñanzas extraídas en el terreno; cómo avanzar; y recomendaciones y próximos pasos. Además, se incluye la Declaración de Bellagio, que se aprobó por unanimidad con motivo de la reunión


Asunto(s)
Mujeres Embarazadas , Alimentos para Embarazadas y Nodrizas , Informe de Investigación , Salud Reproductiva , Nutrición, Alimentación y Dieta , Helmintiasis
4.
Infect Dis Poverty ; 10(1): 116, 2021 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-34507609

RESUMEN

BACKGROUND: Soil-transmitted helminths (STH) infections still present a global health problem. Mass drug administration (MDA) is a widely applied strategy to reduce morbidity and mortality caused by STH. Yet, this approach has some shortcomings. In this study, we analyzed the impact of a multi-intervention integrated deworming approach including MDA, health education (HE), and environmental sanitation improvements (ESI) for sustained STH control in Jiangsu Province of China that was applied from 1989 to 2019. METHODS: Data, including infection rate of STH, medications used, coverage of the medication, non-hazardous lavatory rate, and household piped-water access rate in rural areas, and actions related to HE and ESI were collected (from archives) and analyzed in this retrospective descriptive study. Pearson's correlation analysis was applied to test correlations. RESULTS: There was a dramatic decline in the infection rate of STH from 1989 (59.32%) to 2019 (0.12%). From 1995 to 1999, MDA and HE were recommended in rural areas. A negative correlation was observed between infection rate and medication from 1994 to 1998 (r = - 0.882, P = 0.048). From 2000 to 2005, targeted MDA was given to high-risk populations with HE continuously promoting good sanitation behaviors. From 2006 to 2014, targeted MDA + HE and ESI were used to consolidate the control effect. ESI was strengthened from 2006, and a negative correlation was observed between the coverage rate of the non-hazardous lavatory and the infection rate from 2006 to 2019 (r = - 0.95, P < 0.001). The targeted MDA was interrupted in 2015, while continuous efforts like HE and ESI contributed in sustaining STH control. CONCLUSIONS: Multi-intervention integrated deworming strategy contributes to the reduction of STH infections. This approach is a valuable example of how different interventions can be integrated to promote durable STH control.


Asunto(s)
Antihelmínticos/uso terapéutico , Helmintiasis/tratamiento farmacológico , Helmintiasis/epidemiología , Helmintos/aislamiento & purificación , Saneamiento/métodos , Suelo/parasitología , Animales , China/epidemiología , Estudios Transversales , Helmintiasis/prevención & control , Helmintiasis/transmisión , Helmintos/clasificación , Humanos , Prevalencia , Estudios Retrospectivos
5.
Clin Immunol ; 231: 108844, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34478881

RESUMEN

The development of T follicular helper cells (Tfh) is a multifactorial process that occurs in multiple stages. After their activation the Tfh cells interact with the B cells to complete their differentiation. During this process, the Tfh cells begin to express canonical molecules such as the transcription factor B-cell lymphoma 6 protein, the CXC chemokine receptors type 5, and the inducible T-cell costimulator, as well as secreting other molecules such as IL-21. This whole process is regulated positively and negatively by several factors so that the best response is offered in the face of diseases of various origins, among them helminthiasis. In this context, the role of circulating Tfh, IL-4 and IgG subtypes is essential for an effective response against these pathogens. In this review, the migration process and the differentiation of Tfh, the regulation, their cell subtypes and the role of Tfh in the context of helminth infections will be addressed.


Asunto(s)
Helmintiasis/inmunología , Células T Auxiliares Foliculares/inmunología , Animales , Diferenciación Celular/inmunología , Humanos , Activación de Linfocitos/inmunología
6.
BMJ Glob Health ; 6(8)2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34385158

RESUMEN

Neglected tropical diseases (NTDs) remain a significant cause of morbidity and mortality in many low-income and middle-income countries. Several NTDs, namely lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases (STH) and trachoma, are predominantly controlled by preventive chemotherapy (or mass drug administration), following recommendations set by the WHO. Over one billion people are now treated for NTDs with this strategy per year. However, further investment and increased domestic healthcare spending are urgently needed to continue these programmes. Consequently, it is vital that the cost-effectiveness of preventive chemotherapy is understood. We analyse the current estimates on the cost per disability-adjusted life year (DALY) of the preventive chemotherapy strategies predominantly used for these diseases and identify key evidence gaps that require further research. Overall, the reported estimates show that preventive chemotherapy is generally cost-effective, supporting WHO recommendations. More specifically, the cost per DALY averted estimates relating to community-wide preventive chemotherapy for lymphatic filariasis and onchocerciasis were particularly favourable when compared with other public health interventions. Cost per DALY averted estimates of school-based preventive chemotherapy for schistosomiasis and STH were also generally favourable but more variable. Notably, the broader socioeconomic benefits are likely not being fully captured by the DALYs averted metric. No estimates of cost per DALY averted relating to community-wide mass antibiotic treatment for trachoma were found, highlighting the need for further research. These findings are important for informing global health policy and support the need for continuing NTD control and elimination efforts.


Asunto(s)
Helmintiasis , Medicina Tropical , Análisis Costo-Beneficio , Helmintiasis/tratamiento farmacológico , Helmintiasis/epidemiología , Helmintiasis/prevención & control , Humanos , Enfermedades Desatendidas/tratamiento farmacológico , Enfermedades Desatendidas/epidemiología , Enfermedades Desatendidas/prevención & control , Años de Vida Ajustados por Calidad de Vida
7.
Acta Trop ; 223: 106082, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34364893

RESUMEN

Helminthiases are common neglected tropical diseases in Thailand, thus regular surveillance is necessary for their control. During fiscal year 2019, the Thailand Ministry of Public Health carried out a cross-sectional nationwide survey in people of all age groups from the 12 Regional Health Offices in 76 provinces of Thailand. Multi-stage cluster random sampling design was employed to assess the prevalence of helminth infections and certain behavioural risk factors. A total of 16,187 stool samples and demographic data were obtained from the participants. Stool examination was done and parasite eggs/lavae were identified microscopically by experienced technicians. Positive stool samples for Opisthorchis viverrini, hookworms, or Ascaris lumbricoides were further quantified and expressed in eggs per gram feces (EPG). The results revealed an overall prevalence of helminthic infections of 9.79% with over 14 species identified. The highest prevalence was hookworms (4.47%) followed by O. viverrini (2.2%) with mean infection intensities of 222.7 EPG and 120.9, respectively. The majority of the infections were low intensity (97.4% for hookworms and 99.1% for O. viverrini). Similarly for A. lumbricoides, 93.9% of the positive cases were low infections. Two major helminthiases caused by hookworms and O. viverrini were highlighted in this report. While the liver fluke was highly endemic in Northeast Thailand, the hookworms were prevalent in the southmost region of the country. Association with demographic characteristics and risk behaviors of the two parasites were analyzed and presented in this study. Overall, this countrywide survey provides basic information of the current status of helminth infections in Thailand. Moreover, the data clearly indicates a dramatic reduction of O. viverrini prevalence likely due to extensive control activities under the national campaign against the liver fluke over the past five years.


Asunto(s)
Helmintiasis , Animales , Estudios Transversales , Heces , Helmintiasis/epidemiología , Humanos , Opistorquiasis , Opisthorchis , Prevalencia , Tailandia/epidemiología
8.
PLoS Negl Trop Dis ; 15(8): e0009625, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34339450

RESUMEN

The World Health Organization has recommended the application of mass drug administration (MDA) in treating high prevalence neglected tropical diseases such as soil-transmitted helminths (STHs), schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma. MDA-which is safe, effective and inexpensive-has been widely applied to eliminate or interrupt the transmission of STHs in particular and has been offered to people in endemic regions without requiring individual diagnosis. We propose two mathematical models to investigate the impact of MDA on the mean number of worms in both treated and untreated human subpopulations. By varying the efficay of drugs, initial conditions of the models, coverage and frequency of MDA (both annual and biannual), we examine the dynamic behaviour of both models and the possibility of interruption of transmission. Both models predict that the interruption of transmission is possible if the drug efficacy is sufficiently high, but STH infection remains endemic if the drug efficacy is sufficiently low. In between these two critical values, the two models produce different predictions. By applying an additional round of biannual and annual MDA, we find that interruption of transmission is likely to happen in both cases with lower drug efficacy. In order to interrupt the transmission of STH or eliminate the infection efficiently and effectively, it is crucial to identify the appropriate efficacy of drug, coverage, frequency, timing and number of rounds of MDA.


Asunto(s)
Antihelmínticos/administración & dosificación , Helmintiasis/prevención & control , Helmintiasis/transmisión , Administración Masiva de Medicamentos , Transmisión de Enfermedad Infecciosa/prevención & control , Humanos , Kenia , Modelos Teóricos , Suelo/parasitología
9.
Front Cell Infect Microbiol ; 11: 680665, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34350132

RESUMEN

Matrix metalloproteinases (MMPs) are crucial for tissue remodeling and repair and are expressed in diverse infections, whereas tissue inhibitors of metalloproteinases (TIMPs) are endogenous inhibitors of MMPs. However, the interaction of MMPs and TIMPs in tuberculous lymphadenitis (TBL), an extra-pulmonary form of tuberculosis (EPTB) and helminth (Hel+) coinfection is not known. Therefore, this present study investigates the levels of circulating MMPs (1, 2, 3, 7, 8, 9, 12, 13) and TIMPs (1, 2, 3, 4) in TBL individuals with helminth (Strongyloides stercoralis [Ss], hereafter Hel+) coinfection and without helminth coinfection (hereafter, Hel-). In addition, we have also carried out the regression analysis and calculated the MMP/TIMP ratios between the two study groups. We describe that the circulating levels of MMPs (except MMP-8 and MMP-12) were elevated in TBL-Hel+ coinfected individuals compared to TBL-Hel- individuals. Similarly, the systemic levels of TIMPs (1, 2, 3, 4) were increased in TBL-Hel+ compared to TBL-Hel- groups indicating that it is a feature of helminth coinfection per se. Finally, our multivariate analysis data also revealed that the changes in MMPs and TIMPs were independent of age, sex, and culture status between TBL-Hel+ and TBL-Hel- individuals. We show that the MMP-2 ratio with all TIMPs were significantly associated with TBL-helminth coinfection. Thus, our results describe how helminth infection has a profound effect on the pathogenesis of TBL and that both MMPs and TIMPs could dampen the immunity against the TBL-Hel+ coinfected individuals.


Asunto(s)
Coinfección , Helmintiasis , Metaloproteinasas de la Matriz/sangre , Inhibidores Tisulares de Metaloproteinasas/sangre , Tuberculosis Ganglionar , Animales , Helmintiasis/complicaciones , Helmintos , Humanos , Tuberculosis Ganglionar/complicaciones
10.
BMJ Open ; 11(7): e049734, 2021 07 05.
Artículo en Inglés | MEDLINE | ID: mdl-34226233

RESUMEN

OBJECTIVE: To present a costing study integrated within the DeWorm3 multi-country field trial of community-wide mass drug administration (cMDA) for elimination of soil-transmitted helminths. DESIGN: Tailored data collection instruments covering resource use, expenditure and operational details were developed for each site. These were populated alongside field activities by on-site staff. Data quality control and validation processes were established. Programmed routines were used to clean, standardise and analyse data to derive costs of cMDA and supportive activities. SETTING: Field site and collaborating research institutions. PRIMARY AND SECONDARY OUTCOME MEASURES: A strategy for costing interventions in parallel with field activities was discussed. Interim estimates of cMDA costs obtained with the strategy were presented for one of the trial sites. RESULTS: The study demonstrated that it was both feasible and advantageous to collect data alongside field activities. Practical decisions on implementing the strategy and the trade-offs involved varied by site; trialists and local partners were key to tailoring data collection to the technical and operational realities in the field. The strategy capitalised on the established processes for routine financial reporting at sites, benefitted from high recall and gathered operational insight that facilitated interpretation of the estimates derived. The methodology produced granular costs that aligned with the literature and allowed exploration of relevant scenarios. In the first year of the trial, net of drugs, the incremental financial cost of extending deworming of school-aged children to the whole community in India site averaged US$1.14 (USD, 2018) per person per round. A hypothesised at-scale routine implementation scenario yielded a much lower estimate of US$0.11 per person treated per round. CONCLUSIONS: We showed that costing interventions alongside field activities offers unique opportunities for collecting rich data to inform policy toward optimising health interventions and for facilitating transfer of economic evidence from the field to the programme. TRIAL REGISTRATION NUMBER: NCT03014167; Pre-results.


Asunto(s)
Helmintiasis , Helmintos , Animales , Niño , Helmintiasis/tratamiento farmacológico , Helmintiasis/prevención & control , Humanos , India , Administración Masiva de Medicamentos , Suelo
11.
Biomed Res Int ; 2021: 6682418, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34327236

RESUMEN

Background: Soil-transmitted helminths (STHs) and Schistosoma mansoni are the main causes of morbidity among schoolchildren in the tropics. A school-based deworming program was launched to control and eliminate the infection in endemic countries including Ethiopia. Although periodic deworming is conducted in endemic areas, the prevalence of the infection is high in the country. In addition, periodic evaluation of the efficacy of the anthelminthic drug is limited. Objective: This study is aimed at checking the efficacy of mebendazole and praziquantel with the respective STHs and Schistosoma mansoni parasites. Methods: A longitudinal study was conducted from February to March 2018 among 422 schoolchildren. Stool samples were collected at baseline and at 2 and 4 weeks posttreatment and were processed using the Kato-Katz technique. Schoolchildren positive for STHs were treated with mebendazole and those positive for Schistosoma mansoni with praziquantel. After two weeks, a second round of stool was collected and examined, and then, single-dose redosing was given to each positive child. Lastly, the third stool sample was collected two weeks after the initiation of the redosing and checked for STHs and S. mansoni parasites. A close follow-up of students who were treated was done. All the data were entered and analyzed using SPSS version 20 for analysis. Descriptive statistics was used to compute the cure rate and egg reduction rate of mebendazole and praziquantel. Results: Among 422 participants, the prevalence of STHs, hookworm, Ascaris lumbricoides, and S. mansoni was 44.7%, 35.1%, 21.1%, and 13.9%, respectively. The cure rate of mebendazole against A. lumbricoides increased from 60% in the single dose to 100% in redosing after two weeks. The cure rate of mebendazole against hookworm also increased from 32.4% in the single dose to 91.0% in the redosing. The cure rate of praziquantel against S. mansoni-infected children was 91.5% in the first round and 100% in the redosing phase. There was a 98.6-100% egg reduction rate in the redosing regimen of both drugs. Conclusion: The cure and egg reduction rates of single-dose mebendazole in the treatment of hookworm and A. lumbricoides are lower at week two than at redosing, while cure and egg reduction rates of single-dose praziquantel are satisfactory to treat S. mansoni. Therefore, single-dose praziquantel to S. mansoni and redosing of single-dose mebendazole to A. lumbricoides and hookworm infections can be used for treatment purposes.


Asunto(s)
Helmintos/fisiología , Mebendazol/uso terapéutico , Praziquantel/uso terapéutico , Schistosoma mansoni/fisiología , Esquistosomiasis mansoni/tratamiento farmacológico , Instituciones Académicas , Suelo/parasitología , Estudiantes , Adolescente , Animales , Niño , Etiopía , Femenino , Geografía , Helmintiasis/tratamiento farmacológico , Helmintiasis/parasitología , Helmintos/efectos de los fármacos , Humanos , Masculino , Mebendazol/farmacología , Óvulo/citología , Praziquantel/farmacología , Schistosoma mansoni/efectos de los fármacos , Esquistosomiasis mansoni/parasitología , Resultado del Tratamiento
12.
Mol Immunol ; 137: 124-133, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34246032

RESUMEN

As long-lived parasites, helminths depend upon immunomodulation of their hosts for survival. The release of excretory-secretory (ES) products, including proteins, lipids and RNAs is how successful host manipulation is achieved. It has recently been discovered that the ES products of helminths contain extracellular vesicles (EVs), with every species investigated found to secrete these lipid-bound structures. EVs are perfect for packaging and delivering immune modulators to target cell types. This review outlines the research carried out on helminth EVs and their constituents thus far, as well as their interaction with components of the mammalian immune system. We discuss how targeting EVs will aid treatment of helminth infection and consider how EVs and their immunomodulatory cargo could be used as therapeutics as we progress through this exciting era.


Asunto(s)
Vesículas Extracelulares/inmunología , Helmintiasis/inmunología , Helmintos/inmunología , Interacciones Huésped-Parásitos/inmunología , Sistema Inmunológico/inmunología , Animales , Helmintiasis/parasitología , Humanos , Inmunomodulación/inmunología , Lípidos/inmunología
13.
Am J Trop Med Hyg ; 105(3): 573-583, 2021 07 19.
Artículo en Inglés | MEDLINE | ID: mdl-34280146

RESUMEN

Cervical cancer, a malignancy caused by persistent human papillomavirus (HPV) infection, develops in more than 500,000 women annually. More than 90% of deaths from cervical cancer occur in low- and middle-income countries. A common epidemiological feature of countries with high cervical cancer incidence is a high burden of intestinal helminth infection. The ability of intestinal helminths to trigger immunoregulation, resulting in a "tolerogenic" systemic immune environment, provides fertile soil for the persistence of oncogenic viruses such as HPV. Animal models have shown that intestinal helminth infection permits the persistence of some viruses, however, HPV-specific and human studies are lacking. Large, well-organized trials evaluating the consequences of intestinal helminth infection on the human immune system and HPV persistence may lead to improved strategies for HPV prevention in helminth-endemic regions of the world. Additionally, such studies would offer insight into the specific ways that intestinal helminth infection contributes to immunomodulation, which could identify new therapeutic targets for a range of diseases, from inflammatory disorders to cancer. In this review, we discuss the evidence for helminth-induced systemic and local immune dysregulation, discuss possible mechanisms by which chronic intestinal helminth infection may facilitate HPV persistence, and suggest novel helminth-related interventions that could offer a high leverage (if somewhat unconventional) approach to HPV and cervical cancer control in resource-constrained regions.


Asunto(s)
Helmintiasis/inmunología , Tolerancia Inmunológica/inmunología , Parasitosis Intestinales/inmunología , Infecciones por Papillomavirus/inmunología , Neoplasias del Cuello Uterino/inmunología , Países en Desarrollo , Femenino , Helmintiasis/epidemiología , Humanos , Parasitosis Intestinales/epidemiología , Papillomaviridae , Infecciones por Papillomavirus/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/virología
15.
Immunology ; 164(3): 569-586, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34197631

RESUMEN

Multiple sclerosis (MS) is currently thought to arise by interactions between genetic susceptibility and environmental factors. Infections in general trigger autoimmune responses causing clinical manifestations of disease. However, as a result of regulatory T (Treg)- and regulatory B (Breg)-cell induction, helminth infections tend to dampen disease activity. IL-35, the newest member of the IL-12 family, is an inhibitory cytokine composed of an EBI3ß chain subunit, and an IL-12p35 subunit. The aim of this study was to investigate the role of IL-35 during parasite infections occurring in individuals with MS. Numbers of IL-35-producing Breg cells are higher in CSF from helminth-infected than from uninfected MS subjects, a finding associated with decreased MRI disease activity. Interestingly, stimulation of CD19+ B cells with IL-35 promotes conversion of these cells to Breg cells producing both IL-35 and IL-10. Coculture of B cells from helminth-infected MS patients inhibits proliferation of Th1 and Th17 myelin peptide-specific T cells, as well as production of IFN-γ and IL-17. Following activation, CD4+ CD25+ Treg cells significantly upregulate expression of EBI3 and IL-12p35 mRNA. Furthermore, CD4+ CD25- T cells activated in the presence of IL-35 induce a population of cells with regulatory function, known as iTR35. Finally, B cells from normal individuals cultured in vitro in the presence of the helminth antigen SEA increase expression of the transcription BATF, IRF4 and IRF8, acquiring a pattern similar to that of IL-35 Breg cells. These data highlight the important immunoregulatory effects of IL-35 on both Breg and Treg cells, observed in helminth-infected MS subjects.


Asunto(s)
Linfocitos B Reguladores/inmunología , Helmintiasis/inmunología , Interleucinas/metabolismo , Esclerosis Múltiple/complicaciones , Linfocitos T Reguladores/inmunología , Adulto , Animales , Linfocitos B Reguladores/metabolismo , Femenino , Helmintiasis/parasitología , Helmintos/inmunología , Helmintos/aislamiento & purificación , Interacciones Huésped-Parásitos , Humanos , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/inmunología , Linfocitos T Reguladores/metabolismo , Células TH1/inmunología , Células Th17/inmunología
16.
Syst Rev ; 10(1): 203, 2021 07 10.
Artículo en Inglés | MEDLINE | ID: mdl-34246316

RESUMEN

BACKGROUND: Infectious diseases such as tuberculosis (TB), malaria and soil-transmitted helminthiasis continue to impose a significant global health burden and socio-economic impact. Globally, minority indigenous people are disproportionately affected by poverty and are shown to experience a disparate burden of disease and poorer health outcomes than the comparative majority population. Despite these inequalities, countries rarely systematically compile epidemiological data disaggregated by ethnicity to enable the extent of the differential to be quantified. METHODS: The systematic review will be reported in accordance with The Preferred Reporting Items for Systematic Review and Meta- Analyses (PRISMA) guidelines. Systematic searches will be conducted in EMBASE, Medline, Scopus and Web of Science for studies reporting data which enable the prevalence of TB, malaria, and/or soil-transmitted helminth (STH) infections amongst minority indigenous populations within the Southeast Asia Region (SEAR) and Western Pacific Region (WPR) to be calculated. Where studies provide data on disease prevalence for both minority indigenous and other populations within the same study, a comparative analysis will be undertaken. In addition to a narrative synthesis, where sufficient data are available, a random-effects meta-analysis will be conducted to obtain a pooled estimate value for each disease/infection by country and mortality stratum. Heterogeneity between studies will be examined using the Cochran's Q test and quantitatively measured by the index of heterogeneity squared (I2) statistics. The methodological quality of the included studies will be assessed using a modified Newcastle-Ottawa Scale. DISCUSSION: This systematic review aims to analyse the available data on the prevalence of TB, malaria and STH infections within minority indigenous populations of the SEAR and WPR. REGISTRATION: Open Science Framework registration: osf.io/m6sqc.


Asunto(s)
Helmintiasis , Helmintos , Malaria , Tuberculosis , Animales , Helmintiasis/epidemiología , Humanos , Pueblos Indígenas , Malaria/epidemiología , Metaanálisis como Asunto , Grupos de Población , Prevalencia , Suelo , Revisiones Sistemáticas como Asunto
17.
PLoS Negl Trop Dis ; 15(7): e0009462, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34292937

RESUMEN

BACKGROUND: A national mapping survey of schistosomiasis (SCH) and soil-transmitted helminthiases (STH) was conducted in The Gambia in May, 2015. The survey aimed at establishing endemicity of schistosomiasis and soil-transmitted helminthiases to inform decisions on program planning and implementation of mass drug administration (MDA). METHODOLOGY/PRINCIPAL FINDINGS: A cross-section of 10,434 eligible school aged children (SAC), aged 7 to 14 years old were enrolled in the survey. The participants were randomly sampled from 209 schools countrywide using N/50, where N = total eligible children per school. Stool, and urine samples were provided by each child and examined for schistosomiasis and soil-transmitted helminthic infections using double Kato-Katz, urine filtration, dipstick techniques and CCA rapid test kits. Data were managed using online LINKS system enabling real-time data availability and access. Epi Info version 3.5.3 and health mapper version 4.3.2 were used to generate outputs of endemicity and distribution. Descriptions of mapped districts for MDA eligibility and frequency were done with reference to WHO PC strategy recommendations. Mapping results indicated that nationally, the prevalence of schistosomiasis (SCH) and soil-transmitted helminthiases (STH) was 4.3% and 2.5% respectively. In terms of distribution STH are more common in Western Region One (WR1) at 4.1% prevalence, then Lower River Region (LRR) 3.6%, and Western Region Two (WR2) 3.0%. In contrast, SCH indicated much higher prevalence in Central River Region (CRR) at a rate of 14.2%. This is within medium prevalence range, and is followed by Upper River Region (URR) at 9.4%, which is within low prevalence range. At the district level, schistosomiasis prevalence seems to be highest in Niani district (22%) in CRR. Banjul island, the capital city, seems to have the highest prevalence of STH (up to 55%), followed by Kombo South with 22% prevalence. Schistosoma haematobium characterised by haematuria, was the most dominant infection of schistosomiasis discovered followed by Schistosoma mansoni which reported in 0.1% of infections. Out of 42 districts mapped 14, or 38%, of them are co-endemic for soil-transmitted helminthiases (ascariasis, trichuriasis, and hook-worm infections) and schistosomiasis (S. haematobium and S. mansoni). CONCLUSIONS: We identified that 24/42(57%) districts mapped in The Gambia are endemic for schistosomiasis expressing the need for preventive chemotherapy. Twenty (47%) of the districts mapped are endemic for STH. However, only two STH endemic districts namely Banjul (55%) and Kombo South (22%) were within rates eligible for mass drug administration.


Asunto(s)
Antihelmínticos/administración & dosificación , Helmintiasis/tratamiento farmacológico , Suelo/parasitología , Adolescente , Animales , Niño , Estudios Transversales , Heces/parasitología , Femenino , Gambia/epidemiología , Helmintiasis/epidemiología , Helmintiasis/parasitología , Helmintiasis/transmisión , Helmintos/clasificación , Helmintos/efectos de los fármacos , Helmintos/fisiología , Humanos , Masculino , Administración Masiva de Medicamentos
18.
PLoS Negl Trop Dis ; 15(7): e0009597, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34310596

RESUMEN

Soil-transmitted helminths, such as roundworms (Ascaris lumbricoides), whipworms (Trichuris trichiura) and hookworms (Necator americanus and Ancylostoma spp.), are gastrointestinal parasites that occur predominantly in low- to middle-income countries worldwide and disproportionally impact children. Depending on the STH species, health status of the host and infection intensity, direct impacts of these parasites include malnutrition, anaemia, diarrhoea and physical and cognitive stunting. The indirect consequences of these infections are less well understood. Specifically, gastrointestinal infections may exert acute or chronic impacts on the natural gut microfauna, leading to increased risk of post-infectious gastrointestinal disorders, and reduced gut and overall health through immunomodulating mechanisms. To date a small number of preliminary studies have assessed the impact of helminths on the gut microbiome, but these studies are conflicting. Here, we assessed STH burden in 273 pre-school and school-aged children in Tha Song Yang district, Tak province, Thailand receiving annual oral mebendazole treatment. Ascaris lumbricoides (107/273) and Trichuris trichiura (100/273) were the most prevalent species and often occurred as co-infections (66/273). Ancylostoma ceylanicum was detected in a small number of children as well (n = 3). All of these infections were of low intensity (<4,999 or 999 eggs per gram for Ascaris and Trichuris respectively). Using this information, we characterised the baseline gut microbiome profile and investigated acute STH-induced alterations, comparing infected with uninfected children at the time of sampling. We found no difference between these groups in bacterial alpha-diversity, but did observe differences in beta-diversity and specific differentially abundant OTUs, including increased Akkermansia muciniphila and Bacteroides coprophilus, and reduced Bifidobacterium adolescentis, each of which have been previously implicated in STH-associated changes in the gut microfauna.


Asunto(s)
Antihelmínticos/uso terapéutico , Microbioma Gastrointestinal/efectos de los fármacos , Helmintiasis/tratamiento farmacológico , Mebendazol/uso terapéutico , Suelo/parasitología , Antihelmínticos/administración & dosificación , Niño , Preescolar , Heces/parasitología , Femenino , Helmintiasis/epidemiología , Humanos , Masculino , Administración Masiva de Medicamentos , Mebendazol/administración & dosificación , Tailandia/epidemiología
19.
PLoS Negl Trop Dis ; 15(7): e0009453, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34314436

RESUMEN

We describe an unusual case of type 2 leprosy reaction (T2R) with septic shock-like features induced by helminth infection in a 31-year-old Moluccan male patient with a history of completed treatment of WHO multidrug therapy (MDT)-multibacillary (MB) regimen 2 years before admission. During the course of illness, the patient had numerous complications, including septic shock, anemia, and disseminated intravascular coagulation (DIC). Nevertheless, antibiotic therapies failed to give significant results, and the source of infection could not be identified. Helminth infection was subsequently revealed by endoscopic examination followed by parasitological culture. Resolution of symptoms and normal level of organ function-specific markers were resolved within 3 days following anthelmintic treatment. This report demonstrated the challenge in the diagnosis and treatment of severe T2R. Given that helminth infections may trigger severe T2R that mimics septic shock, health professionals need to be aware of this clinical presentation, especially in endemic regions of both diseases.


Asunto(s)
Helmintiasis/parasitología , Leprostáticos/efectos adversos , Lepra/tratamiento farmacológico , Sepsis/parasitología , Adulto , Animales , Helmintiasis/etiología , Helmintos/clasificación , Helmintos/genética , Helmintos/aislamiento & purificación , Humanos , Leprostáticos/uso terapéutico , Lepra/complicaciones , Masculino , Infecciones Oportunistas/etiología , Infecciones Oportunistas/parasitología , Sepsis/etiología
20.
PLoS Negl Trop Dis ; 15(7): e0008815, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34319986

RESUMEN

Improved sanitation has been hypothesized to reduce soil-transmitted helminth (STH) infections by reducing the prevalence and concentration of STH eggs/larvae in soil. We evaluated the effect of a randomized sanitation program (providing households with an improved dual-pit latrine, tools for child/animal feces management, and behavioral messaging) on reducing the prevalence and concentration of STH eggs in soil from household courtyards. We collected soil samples from 1405 households enrolled in the sanitation intervention (n = 419) and control (n = 914) groups of a cluster-randomized controlled trial (WASH Benefits) in rural Bangladesh approximately 2 years after the initiation of the interventions. We analyzed samples for Ascaris lumbricoides, Trichuris trichiura, and hookworm eggs by microscopy. We estimated prevalence ratios (PR) and egg count ratio (ECR) to compare the prevalence of STH eggs and arithmetic and geometric mean egg counts for STH eggs per gram of soil in the sanitation and control arms. Among intervention households, latrines achieved high and sustained user uptake by adults while child open defecation remained common and most households did not dispose of child feces hygienically. In courtyard soil from control households, the prevalence of any STH eggs was 75.7% and the prevalence of any larvated STH eggs was 67.3%. A. lumbricoides was detected in 63.0% of control samples and T. trichiura in 55.7% of control samples; hookworm was not detected in any sample. In the control arm, the arithmetic mean egg count for any STH was 3.96 eggs/dry gram, while the geometric mean was 1.58 eggs/dry gram. There was no difference between the intervention and control groups in the prevalence of any STH eggs (PR = 0.98 (95% CI: 0.91, 1.05)) or mean egg counts (ECR = 0.08 (95% CI: -0.10, 0.26) for geometric mean and 0.07 (95% CI: -0.22, 0.37) for arithmetic mean). Adjusted models gave similar results. A compound-level sanitation intervention that provided improved latrines and tools for disposal of child and animal feces did not have an impact on STH eggs in soil. In order to effectively reduce the prevalence and concentration of STH eggs in the environment, sustained, widespread use of sanitation strategies to isolate and hygienically dispose of child and animal feces may need to complement traditional strategies for containment of adult human feces. Trial Registration: NCT01590095.


Asunto(s)
Helmintiasis/transmisión , Helmintos/aislamiento & purificación , Suelo/parasitología , Adolescente , Animales , Bangladesh/epidemiología , Niño , Preescolar , Composición Familiar , Heces/parasitología , Femenino , Helmintiasis/epidemiología , Helmintiasis/parasitología , Helmintiasis/prevención & control , Helmintos/clasificación , Helmintos/genética , Helmintos/fisiología , Humanos , Higiene , Masculino , Recuento de Huevos de Parásitos , Población Rural/estadística & datos numéricos , Saneamiento
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