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1.
PLoS Negl Trop Dis ; 14(2): e0008000, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32040473

RESUMO

BACKGROUND: Soil-transmitted helminths (STHs) comprise a group of helminth parasites that are included in the list of Neglected Tropical Diseases and require a passage through the soil to become infective. Several studies have detected that infection with STHs are associated with certain socioeconomic, environmental and soil characteristics. In Argentina, the presence of these parasites has been detected through a few point studies conducted in localities from 11 of the 23 provinces that comprise the country. METHODS/PRINCIPAL FINDINGS: The most important characteristics previously associated with the presence of STHs were identified and ranked through the use of an expert survey and the Analytical Hierarchy Process (AHP) in order to construct a risk map of STHs specific for Argentina. Prevalence data from previous studies was used to validate the generated risk map. The map shows that half of Argentina, from the Central provinces to the North, contains localities with the characteristics necessary for the development of these parasites. CONCLUSIONS/SIGNIFICANCE: The predicted map should serve as a useful tool for guiding the identification of survey areas for the generation of baseline data, detecting hotspots of infection, planning and prioritizing areas for control interventions, and eventually performing post-implementation surveillance activities.


Assuntos
Helmintíase/epidemiologia , Helmintíase/transmissão , Solo/parasitologia , Argentina/epidemiologia , Humanos , Prevalência , Fatores de Risco
2.
PLoS One ; 15(2): e0229235, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32069318

RESUMO

Life Cycle Assessment typically focuses on the footprint of products and services, expressed on three Areas of Protection (AoP): Human Health, Ecosystems and Resources. While the handprint is often expressed qualitatively, quantified handprints have recently been compared directly to the footprint concerning one AoP: Human Health. We propose to take this one step further by simultaneously comparing the quantified handprint and footprint on all AoPs through normalization and weighting of the results towards a single score. We discuss two example cases of a pharmaceutical treatment: mebendazole to treat soil-transmitted helminthiases and paliperidone palmitate to treat schizophrenia. Each time, treatment is compared to 'no treatment'. The footprint of health care is compared to the handprint of improved patient health. The handprint and footprint were normalized separately. To include sensitivity in the normalization step we applied four sets of external normalization factors for both handprint (Global Burden of Disease) and footprint (ReCiPe and PROSUITE). At the weighting step we applied 26 sets of panel weighting factors from three sources. We propose the Relative Sustainability Benefit Rate (RSBR) as a new metric to quantify the relative difference in combined handprint and footprint single score between two alternatives. When only considering the footprint, the first case study is associated with an increased single score burden of treatment compared to 'no treatment', while in the second case study treatment reduces the single score burden by 41.1% compared to 'no treatment'. Also including the handprint provided new insights for the first case study, now showing a decrease of 56.4% in single score burden for treatment compared to 'no treatment'. For the second case study the reduction of single score burden was confirmed as the handprint burden was also decreased because of treatment by 9.9%, reinforcing the findings.


Assuntos
Assistência à Saúde/normas , Setor de Assistência à Saúde/normas , Necessidades e Demandas de Serviços de Saúde/normas , Helmintíase/tratamento farmacológico , Modelos Estatísticos , Preparações Farmacêuticas/administração & dosagem , Esquizofrenia/tratamento farmacológico , Nível de Saúde , Helmintíase/epidemiologia , Humanos , Esquizofrenia/epidemiologia
3.
BMC Infect Dis ; 20(1): 12, 2020 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-31906872

RESUMO

BACKGROUND: Determination of the prevalence and distribution pattern of intestinal parasites is a fundamental step to set up an effective control program to improve the health status. This study aimed to determine the prevalence of intestinal parasitic infections and associated risk factors among inhabitants of Rudbar-e Jonub county, southeast of Kerman province, southeastern Iran. METHODS: In this cross-sectional study, 861 stool specimens were collected from inhabitants of Rudbar-e Jonub county through a multistage cluster sampling method in 2018. The collected specimens were examined by parasitological methods including, direct wet-mounting (for the fresh specimens with a watery consistency), formalin-ethyl acetate sedimentation and agar plate culture. RESULTS: The prevalence of intestinal parasites was 34.2% (95% CI 30.1 to 38.2). The prevalence of protozoan parasites 32.3% (95% CI 28.4 to 36.5) was significantly higher than helminthic parasites 3.2% (95% CI 2.1 to 4.7). Blastocystis sp. (13.3%), Entamoeba coli (11.4%) and Giardia lamblia (10.6%) as protozoan parasite and Hymenolepis nana (2.4%) as helminthic parasite were the most common detected intestinal parasites in the study. Entamoeba histolytica/dispar (1.5%), Iodamoeba bütschlii (1.0%), Chilomastix mesnili (0.5%), Entamoeba hartmanni (0.4%), Enterobius vermicularis (0.3%) and Ascaris lambercoides (0.3%) were other detected parasites. Multiple logistic regression revealed a significant association of intestinal parasitic infections with source of drinking water and residency status (rural/urban). Multiple infections with 2 or 3 parasitic agents constituted 22.7% of 295 infected cases. CONCLUSIONS: This study revealed a high prevalence of intestinal protozoan infections among inhabitants of Rudbar-e Jonub county. Intestinal parasites especially protozoans remain a challenging public health problem wherever sanitation and health measures are limited in Iran.


Assuntos
Enteropatias Parasitárias/epidemiologia , Adolescente , Adulto , Animais , Criança , Estudos Transversais , Fezes/parasitologia , Feminino , Helmintíase/epidemiologia , Helmintíase/parasitologia , Humanos , Enteropatias Parasitárias/parasitologia , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Parasitos/classificação , Prevalência , Infecções por Protozoários/epidemiologia , Infecções por Protozoários/parasitologia , Fatores de Risco , Adulto Jovem
4.
PLoS One ; 15(1): e0227273, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31899772

RESUMO

Soil Transmitted Helminth (STH) infections affect over 1.5 billion people worldwide. Although prevalent in all age groups, school aged children are a high-risk groups for STH infections. In Bhutan, epidemiological data on STH were collected from western Bhutan in 2003, which found a prevalence of 16.5%. However, little evidence is available on the prevalence of infection at national level. Therefore, this study was conducted with the aim to assess the prevalence and intensity of STH infections, and identify significant correlates of STH among students. A school-based survey was conducted in three regions of Bhutan. Two-stage cluster sampling was adopted to select a sample of 1500 students from 24 schools, in equal proportion from three regions of the country. A total of 1456 (97%) students were interviewed and their stool sample examined for the presence of parasites. Mini-FLOTAC technique was used to detect the parasite eggs/ova. The prevalence of any STH infection was 1.4%, with 0.8% Ascaris lumbricoides, 0.5% Trichuris trichiura and 0.2% hookworms. The eastern region had the highest prevalence at 2.3%. Except for one student who had moderate intensity of A. lumbricoides, the rest had light infection. Any STH presence was significantly associated with father's occupation, father's education level, type of house and the flooring of the house in which students reported to live. No significant associations were observed between water, sanitation and hygiene (WASH) variables measured and presence of any STH infection. The prevalence of STH was found to be very low with primarily light intensity in this study. Nonetheless, it was also found that the sanitation situation is not ideal in the country, with several students reporting constant or partial open defecation leading to environmental contamination. Based on this prevalence and in line with the WHO guideline, it is recommended that deworming be reduced to once a year in combination with concerted health education on proper hygiene and sanitation practice.


Assuntos
Anti-Helmínticos/administração & dosagem , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Helmintíase/epidemiologia , Solo/parasitologia , Adolescente , Albendazol/administração & dosagem , Animais , Butão/epidemiologia , Criança , Estudos Transversais , Defecação , Água Potável/parasitologia , Fezes/parasitologia , Feminino , Helmintíase/parasitologia , Helmintíase/prevenção & controle , Helmintíase/transmissão , Humanos , Higiene , Masculino , Prevalência , Saneamento/métodos , Saneamento/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adulto Jovem
5.
Acta Trop ; 201: 105214, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31600519

RESUMO

Human hookworm, a soil-transmitted helminth (STH) infection caused by either Necator americanus or Anclystoma duodenale, is a major cause of morbidity globally and predominantly affects the world's poorest populations. Transmitted primarily by larval invasion of exposed skin, the adults inhabit the host small intestine, where they consume host blood. The resultant chronic iron deficiency anemia can lead to stunted growth and cognitive deficits in children, reduced work capacity in adults, and a variety of pregnancy complications. Historically, successful STH elimination has only been achieved in regions with concomitant significant economic growth. Since 2001, control of the STHs has been attempted via single-dose mass deworming of at-risk school-aged and preschool-aged children within STH-endemic countries, with the goal of morbidity reduction. Research questioning this strategy has grown in recent years, and current studies are evaluating the effectiveness of novel deworming strategies, including multidrug regimens and expansion of deworming to entire communities. While footwear campaigns may be associated with reduced odds of hookworm infection, the evidence supporting the impact of water, sanitation, and hygiene (WASH) interventions upon hookworm is mixed. Progress towards a human hookworm vaccine continues, with promising results from recent Phase 1 trials and several others ongoing. Integrated STH control programs, which combine mass deworming with WASH interventions, are relatively unstudied but may be a promising advancement. Whether interruption of STH transmission can be achieved apart from significant economic growth remains unanswered, but likely the implementation of intensive, integrated control programs will be necessary to achieve that goal.


Assuntos
Erradicação de Doenças/métodos , Erradicação de Doenças/tendências , Helmintíase/prevenção & controle , Infecções por Uncinaria/prevenção & controle , Saneamento/métodos , Animais , Previsões , Helmintíase/epidemiologia , Infecções por Uncinaria/epidemiologia , Humanos
6.
PLoS One ; 14(12): e0224422, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31856176

RESUMO

BACKGROUND: Preventive chemotherapy was administered to 3.2 million Sierra Leoneans in 13 health districts for lymphatic filariasis, onchocerciasis, and soil transmitted helminthes from October 2008 to February 2009. This paper aims to report the findings of a coverage survey conducted in 2009, compare the coverage survey findings with two reported rates for lymphatic filariasis coverage obtained using pre-mass drug administration (MDA) registration and national census projections, and use the comparison to understand the best source of population estimates in calculating coverage for NTD programming in Sierra Leone. METHODOLOGY/PRINCIPAL FINDINGS: Community drug distributors (CDDs) conducted a pre- MDA registration of the population. Two coverage rates for MDA for lymphatic filariasis were subsequently calculated using the reported number treated divided by the total population from: 1) the pre-MDA register and 2) national census projections. A survey was conducted to validate reported coverage data. 11,602 persons participated (response rate of 76.8%). Overall, reported coverage data aggregated to the national level were not significantly different from surveyed coverage (z-test >0.05). However, estimates based on pre-MDA registration have higher agreement with surveyed coverage (mean Kendall's W = 0.68) than coverage calculated with census data (mean Kendall's = 0.59), especially in districts with known large-scale migration, except in a highly urban district where it was more challenging to conduct a pre-MDA registration appropriately. There was no significant difference between coverage among males versus females when the analyses were performed excluding those women who were pregnant at the time of MDA. The surveyed coverage estimate was near or below the minimum 65% epidemiological coverage target for lymphatic filariasis MDA in all districts. CONCLUSION/SIGNIFICANCE: These results from Sierra Leone illustrate the importance of choosing the right denominator for calculating treatment coverage for NTD programs. While routinely reported coverage results using national census data are often good enough for programmatic decision making, census projections can quickly become outdated where there is substantial migration, e.g. due to the impact of civil war, with changing economic opportunities, in urban settings, and where there are large migratory populations. In districts where this is known to be the case, well implemented pre-MDA registration can provide better population estimates. Pre-MDA registration should, however, be implemented correctly to reduce the risk of missing pockets of the population, especially in urban settings.


Assuntos
Filariose Linfática/prevenção & controle , Helmintíase/prevenção & controle , Oncocercose/prevenção & controle , Adulto , Albendazol/uso terapêutico , Censos , Quimioprevenção/métodos , Filariose Linfática/epidemiologia , Feminino , Filaricidas/uso terapêutico , Helmintíase/epidemiologia , Humanos , Ivermectina/uso terapêutico , Masculino , Administração Massiva de Medicamentos/métodos , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/prevenção & controle , Oncocercose/epidemiologia , Serra Leoa/epidemiologia , Inquéritos e Questionários
7.
PLoS Negl Trop Dis ; 13(11): e0007488, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31765383

RESUMO

INTRODUCTION: Few studies have simultaneously examined the role of sanitation conditions at the home, school, and community on soil-transmitted helminth (STH) infection. We examined the contribution of each domain that children inhabit (home, village, and school) to STH infection and estimated the association of STH infection with sanitation in each domain. METHODS: Using data from 4,104 children from Kwale County, Kenya, who reported attending school, we used logistic regression models with cross-classified random effects to calculate measures of general contextual effects and estimate associations of village sanitation coverage (percentage of households with reported access to sanitation), school sanitation coverage (number of usable toilets per enrolled pupil), and sanitation access at home with STH infection. FINDINGS: We found reported use of a sanitation facility by households was associated with reduced prevalence of hookworm infection but not with reduced prevalence of T. trichiura infection. School sanitation coverage > 3 toilets per 100 pupils was associated with lower prevalence of hookworm infection. School sanitation was not associated with T. trichiura infection. Village sanitation coverage > 81% was associated with reduced prevalence of T. trichiura infection, but no protective association was detected for hookworm infection. General contextual effects represented by residual heterogeneity between village and school domains had comparable impact upon likelihood of hookworm and T. trichiura infection as sanitation coverage in either of these domains. CONCLUSION: Findings support the importance of providing good sanitation facilities to support mass drug administration in reducing the burden of STH infection in children.


Assuntos
Características da Família , Helmintíase/epidemiologia , Helmintíase/prevenção & controle , Características de Residência/estatística & dados numéricos , Saneamento/estatística & dados numéricos , Instituições Acadêmicas/estatística & dados numéricos , Solo/parasitologia , Adolescente , Ancylostomatoidea , Animais , Criança , Pré-Escolar , Estudos Transversais , Feminino , Helmintíase/transmissão , Infecções por Uncinaria/epidemiologia , Infecções por Uncinaria/prevenção & controle , Infecções por Uncinaria/transmissão , Humanos , Higiene , Quênia/epidemiologia , Modelos Logísticos , Masculino , Prevalência , Fatores de Risco , População Urbana/estatística & dados numéricos
8.
BMC Res Notes ; 12(1): 644, 2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31585533

RESUMO

OBJECTIVES: Soil-transmitted helminthes are among the most common infections worldwide and affect the poorest and most deprived communities. A health facility based cross-sectional study was conducted among pregnant women attending at Maytsebri primary hospital. Data was entered and analysed using SPSS version 20 software. Multivariate analyses were used to identify determinant factors associated with soil transmitted helminthiasis. A total of 448 pregnant women were examined microscopically with a Katokatz technique for parasitological study to each women. RESULTS: Out of the total 448 pregnant women examined in the primary hospital, 229 (51.5%) women were infected by at least one of the soil transmitted helminthiasis. Hookworm was the most prevalent 179 (78.16%) soil transmitted helminthes infection. Women who had a habit of eating soil were 2.6 times more likely to be infected by soil transmitted helminthes compared to who do not eat soil. Participants who wear shoe always were 95% less likely to be infected by soil transmitted helminthes. Efforts should be done to advance the awareness of women how to prevent soil transmitted helminthes.


Assuntos
Ancylostomatoidea/isolamento & purificação , Ascaris/isolamento & purificação , Helmintíase/epidemiologia , Solo/parasitologia , Trichuris/isolamento & purificação , Adolescente , Adulto , Animais , Estudos Transversais , Escolaridade , Etiópia/epidemiologia , Comportamento Alimentar , Feminino , Helmintíase/diagnóstico , Helmintíase/prevenção & controle , Helmintíase/transmissão , Hospitais , Humanos , Pessoa de Meia-Idade , Gravidez , Cuidado Pré-Natal , Prevalência , Fatores de Risco
9.
BMC Infect Dis ; 19(1): 838, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31604429

RESUMO

BACKGROUND: Helminthic and protozoan infections are common, particularly in low- or middle-income countries. Although an association between parasite carriage and markers of poor growth have been shown in some studies, systematic reviews have suggested only a modest impact of clearing carriage. The prevalence of these pathogens and the effect that they have on growth in preschool children has never been investigated in Malawi. METHODS: One hundred ninety-three children aged 0-72 months were randomly recruited from rural villages in the Mangochi district of Malawi. Formol-ether concentration was performed on stool and the samples examined with a light microscope. Anthropometric data was taken for each child and the haemoglobin measured with a point of care test. RESULTS: The mean age of the children was 2 years 4 months. Overall prevalence of intestinal parasite infection was 37.3%. Protozoa were found in 28.5% of children, while helminths were found in 8.8%. The most commonly found organisms were Giardia lambia (12.4%), Entamoeba coli (10.4%) and Hookworm species (3.6%). Stunting was seen in 47.8% of children, 12.9% were underweight and 5.0% were wasted. No significant association was found between markers of poor growth and infection with any intestinal parasite. CONCLUSIONS: We found that prevalence of helminth infection was low in preschool children living in the Mangochi district compared to international standards. However a significant proportion of the preschool population are infected with protozoa, particularly Giardia lambia. In this cohort, despite a significant prevalence of stunting, helminth infection was not significantly associated with any markers of poor growth. The significance of protozoal carriage and contribution to growth restriction in this context creates further avenues for future research.


Assuntos
Helmintíase/diagnóstico , Enteropatias Parasitárias/diagnóstico , Ancylostomatoidea/isolamento & purificação , Animais , Criança , Pré-Escolar , Entamoeba/isolamento & purificação , Fezes/parasitologia , Feminino , Giardia lamblia/isolamento & purificação , Helmintíase/epidemiologia , Humanos , Lactente , Recém-Nascido , Enteropatias Parasitárias/epidemiologia , Malaui/epidemiologia , Masculino , Estado Nutricional , Prevalência
10.
Dokl Biol Sci ; 487(1): 108-111, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31571077

RESUMO

Progressive expansion of the most hazardous human parasitoses caused by trematodes, cestodes and nematodes has been found on the south of the Russian Far East. Decelerating expansion of the trematode Clonorchis sinensis, an agent of clonorchiasis towards the southern Primorye Territory from the Amur River basin, that began 10-15 years ago, was revealed. A prognosis was made on the activation of the natural foci of clonorchiasis and paragonimiasis. Circulation possibilities are discussed of the highly pathogenic trematode Pagonimus heterotremusar in the South Asian regional ecosystems. Our experiments showed that the freshwater gastropods of the Parajuga genus from the Amur River basin and those of Stenothyra genus from Primorsky Territory were resistant to this trematode infection. Nevertheless, this does not exclude the possibility of this parasite penetration into the Far East region via infection of the local gastropods of other genera.


Assuntos
Reservatórios de Doenças/parasitologia , Helmintíase/parasitologia , Animais , Canidae/parasitologia , Cestoides/patogenicidade , Clima , Demografia/estatística & dados numéricos , Felidae/parasitologia , Peixes/parasitologia , Helmintíase/epidemiologia , Helmintíase/transmissão , Humanos , Moluscos/parasitologia , Nematoides/patogenicidade , Sibéria , Trematódeos/patogenicidade
11.
Infect Dis Poverty ; 8(1): 82, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31575378

RESUMO

BACKGROUND: The goal of soil-transmitted helminthiases (STH) control programmes is to eliminate STH-associated morbidity in the target population by reducing the prevalence of moderate- and heavy-intensity infections and the overall STH infection prevalence mainly through preventive chemotherapy (PC) with either albendazole or mebendazole. Endemic countries should measure the success of their control programmes through regular epidemiological assessments. We evaluated changes in STH prevalence in countries that conducted effective PC coverage for STH to guide changes in the frequency of PC rounds and the number of tablets needed. METHODS: We selected countries from World Health Organization (WHO)'s Preventive Chemotherapy and Transmission control (PCT) databank that conducted ≥5 years of PC with effective coverage for school-age children (SAC) and extracted STH baseline and impact assessment data using the WHO Epidemiological Data Reporting Form, Ministry of Health reports and/or peer-reviewed publications. We used pooled and weighted means to plot the prevalence of infection with any STH and with each STH species at baseline and after ≥5 years of PC with effective coverage. Finally, using the WHO STH decision tree, we estimated the reduction in the number of tablets needed. RESULTS: Fifteen countries in four WHO regions conducted annual or semi-annual rounds of PC for STH for 5 years or more and collected data before and after interventions. At baseline, the pooled prevalence was 48.9% (33.1-64.7%) for any STH, 23.2% (13.7-32.7%) for Ascaris lumbricoides, 21.01% (9.7-32.3%) for Trichuris trichiura and 18.2% (10.9-25.5%) for hookworm infections, while after ≥5 years of PC for STH, the prevalence was 14.3% (7.3-21.3%) for any STH, 6.9% (1.3-12.5%) for A. lumbricoides, 5.3% (1.06-9.6%) for T. trichiura and 8.1% (4.0-12.2%) for hookworm infections. CONCLUSIONS: Countries endemic for STH have made tremendous progress in reducing STH-associated morbidity, but very few countries have data to demonstrate that progress. In this study, the data show that nine countries should adapt their PC strategies and the frequency of PC rounds to yield a 36% reduction in drug needs. The study also highlights the importance of impact assessment surveys to adapt control strategies according to STH prevalence.


Assuntos
Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Quimioprevenção/estatística & dados numéricos , Helmintíase/prevenção & controle , Mebendazol/uso terapêutico , Albendazol/provisão & distribução , Animais , Anti-Helmínticos/provisão & distribução , Ascaríase/epidemiologia , Ascaríase/parasitologia , Ascaríase/prevenção & controle , Ascaris lumbricoides/fisiologia , Helmintíase/epidemiologia , Helmintíase/parasitologia , Infecções por Uncinaria/epidemiologia , Infecções por Uncinaria/parasitologia , Infecções por Uncinaria/prevenção & controle , Humanos , Mebendazol/provisão & distribução , Prevalência , Solo/parasitologia , Tricuríase/epidemiologia , Tricuríase/parasitologia , Tricuríase/prevenção & controle , Trichuris/fisiologia
12.
PLoS Negl Trop Dis ; 13(10): e0007776, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31618208

RESUMO

We investigated the impact of helminths and malaria infection on Kaposi's sarcoma associated herpesvirus (KSHV) seropositivity, using samples and data collected from a cluster-randomised trial of intensive versus standard anthelminthic treatment. The trial was carried out in 2012 to 2016 among fishing communities on Lake Victoria islands in Uganda. Plasma samples from 2881 participants from two household surveys, the baseline (1310 participants) and the final (1571 participants) surveys were tested for KSHV IgG antibody responses to K8.1 and ORF73 recombinant proteins using ELISA. The baseline survey was carried out before the trial intervention while the final survey was carried out after three years of the trial intervention. Additionally, a subset sample of 372 participants from the final survey was tested for IgE, IgG and IgG4 antibody concentrations to S. mansoni adults worm antigen (SWA) and S. mansoni egg antigen (SEA) using ELISA. Infection by helminths (S. mansoni, N. americanus, T. trichiura and S. stercoralis) was diagnosed using real-time PCR, urine circulating cathodic antigen (CCA) and stool microscopy (Kato-Katz method) while malaria infection was diagnosed using microscopy. We analysed the relationship between helminth and malaria infections and KSHV seropositivity using regression modelling, allowing for survey design. At baseline, 56% of the participants were male while 48% of the participants were male in the final survey. The most prevalent helminth infection was S. mansoni (at baseline 52% and 34% in the final survey by microscopy, 86% by CCA and 50% by PCR in the final survey). KSHV seropositivity was 66% (baseline) and 56% (final survey) among those 1-12 years and >80% in those 13+ years in both surveys; malaria parasitaemia prevalence was 7% (baseline) and 4% (final survey). At baseline, individuals infected with S. mansoni (detected by microscopy) were more likely to be KSHV seropositive (aOR = 1.86 (1.16, 2.99) p = 0.012) and had higher anti-K8.1 antibody levels (acoefficient = 0.03 (0.01, 0.06) p = 0.02). In the final survey, S. mansoni (by microscopy, adjusted Odds Ratio (aOR = 1.43 (1.04-1.95), p = 0.028) and malaria parasitaemia (aOR = 3.49 (1.08-11.28), p = 0.038) were positively associated with KSHV seropositivity. Additionally, KSHV seropositive participants had higher S. mansoni-specific IgE and IgG antibody concentrations in plasma. Furthermore, HIV infected individuals on cART were less likely to be KSHV seropositive compared to HIV negative individuals (aOR = 0.46 (0.30, 0.71) p = 0.002). Schistosoma species skew the immune response towards Th2 and regulatory responses, which could impact on KSHV reactivation if co-infected with both organisms.


Assuntos
Antígenos de Helmintos/imunologia , Herpesvirus Humano 8/imunologia , Doenças Parasitárias/epidemiologia , Doenças Parasitárias/imunologia , Adolescente , Adulto , Idoso , Albendazol/uso terapêutico , Animais , Anticorpos Anti-Helmínticos/sangue , Criança , Pré-Escolar , Estudos Transversais , Infecções por HIV/imunologia , Helmintíase/tratamento farmacológico , Helmintíase/epidemiologia , Helmintíase/imunologia , Helmintíase/parasitologia , Humanos , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Lactente , Ilhas , Lagos , Malária/imunologia , Pessoa de Meia-Idade , Razão de Chances , Doenças Parasitárias/tratamento farmacológico , Doenças Parasitárias/fisiopatologia , Praziquantel/uso terapêutico , Prevalência , Schistosoma mansoni/imunologia , Esquistossomose mansoni/epidemiologia , Uganda/epidemiologia , Adulto Jovem
13.
Parasit Vectors ; 12(1): 503, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31665080

RESUMO

BACKGROUND: National deworming programmes rely almost exclusively on mass drug administration (MDA) to children to control morbidity caused by these parasitic infections. The provision of other interventions, consisting of preventive chemotherapy at high population level coverage together with water, sanitation and hygiene (WaSH) and changes in risk behaviour, should enable sustainable control of soil-transmitted helminths (STH) and schistosomiasis and ultimately interrupt transmission. METHODS/DESIGN: Two interventions will be implemented by the project: (i) community-wide biannual albendazole and annual praziquantel treatment with a target of 80-90% treatment coverage ("expanded MDA"); and (ii) provision of WaSH with behaviour change communication (BCC), within the Wolaita zone, Ethiopia. The project has three study arms: (i) expanded community-wide MDA, WaSH and BCC; (ii) expanded community-wide MDA only; and (iii) annual school-based MDA (the current National STH/schistosomiasis Control Programme). The impact of these interventions will be evaluated through prevalence mapping at baseline and endline (after four rounds of MDA), combined with annual longitudinal parasitological surveillance in defined cohorts of people to monitor trends in prevalence and reinfection throughout the project. Treatment coverage and individual compliance to treatment will be monitored by employing fingerprint biometric technology and barcoded identification cards at treatment. WaSH utilisation will be evaluated through school and household level observations and annual WaSH assessment survey. Complementary qualitative surveys will explore practices, cultural and social drivers of risk behaviours, uptake of WaSH and treatment, and assessing the impact of the BCC. DISCUSSION: The study has the potential to define an 'End Game' for STH and schistosomiasis programmes through provision of multiple interventions. Interrupting transmission of these infections would eliminate the need for long-term repeated MDA, lead to sustained health improvements in children and adults, thereby allowing health systems to focus on other disease control priorities.


Assuntos
Albendazol/administração & dosagem , Anti-Helmínticos/administração & dosagem , Helmintíase/prevenção & controle , Praziquantel/administração & dosagem , Esquistossomose/prevenção & controle , Adolescente , Criança , Pré-Escolar , Análise Custo-Benefício , Estudos Transversais , Demografia , Etiópia/epidemiologia , Comportamentos Relacionados com a Saúde , Helmintíase/epidemiologia , Helmintíase/transmissão , Humanos , Higiene/normas , Lactente , Estudos Longitudinais , Administração Massiva de Medicamentos/economia , Modelos Biológicos , Doenças Negligenciadas/prevenção & controle , Prevalência , Saneamento/normas , Esquistossomose/epidemiologia , Esquistossomose/transmissão , Instituições Acadêmicas , Solo/parasitologia , Inquéritos e Questionários , Abastecimento de Água/normas
14.
Korean J Parasitol ; 57(4): 329-339, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31533400

RESUMO

Indonesia and South Korea have become inseparable in various respects since the 2 countries established diplomatic relation in 1973. Indonesia is a tropical region that stretches across the equator, comprised of 5 main islands (Java, Kalimantan, Sumatra, Sulawesi, and Papua) and 4 archipelagoes (Riau, Bangka Belitung, Nusa Tenggara, and Maluku). As most population of Eastern Indonesia (Sulawesi, Papua and Nusa Tenggara & Maluku) live in poor areas, it is expected that there will be many parasites. Nevertheless, little is known about the status of parasites in Indonesia. This study examines the prevalences of malaria and lymphatic filaria, which are prevalent in Indonesia, as well as those of soil-transmitted-helminths (STH). As a result, the Plasmodium falciparum and P. vivax case loads are almost equal. The current prevalence of P. vivax is uniformly low (<5%) in all age groups and annual parasite incidence (API) showed decreasing tendency as 0.84 per 1,000 population in 2016. However, more than 65 million people still live in malaria epidemic regions. Lymphatic filariasis remains an important public health problem and 236 cities were classified as endemic areas in 514 cities/districts in 2017. It is difficult to ascertain the current prevalence rate of STH in Indonesia, although West Sumba and Southwest Sumba in East Nusa Tenggara reported prevalence rate of more than 20%. The study also considers the (sero) prevalences of other parasites identified in Indonesia. This report should be useful not only to parasitologists but also to travelers and people with business in Indonesia.


Assuntos
Doenças Parasitárias/epidemiologia , Filariose Linfática/epidemiologia , Helmintíase/epidemiologia , Helmintíase/transmissão , Indonésia/epidemiologia , Malária/epidemiologia , Doenças Parasitárias/transmissão , Prevalência , Esquistossomose Japônica/epidemiologia , Solo/parasitologia , Teníase/epidemiologia
15.
BMC Infect Dis ; 19(1): 822, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533666

RESUMO

BACKGROUND: Current guidelines and targets for soil-transmitted helminth (STH) control focus on school-based deworming for school-age children, given the high risk of associated morbidity in this age group. However, expanding deworming to all age groups may achieve improved STH control among both the community in general and school-age children, by reducing their risk of reinfection. This trial aims to compare school-based targeted deworming with community-wide mass deworming in terms of impact on STH infections among school-age children. METHODS: The CoDe-STH (Community Deworming against STH) trial is a cluster-randomised controlled trial (RCT) in 64 primary schools in Dak Lak province, Vietnam. The control arm will receive one round of school-based targeted deworming with albendazole, while in the intervention arm, community-wide mass deworming with albendazole will be implemented alongside school-based deworming. Prevalence of STH infections will be measured in school-age children at baseline and 12 months following deworming. The primary outcome is hookworm prevalence in school-age children at 12 months, by quantitative PCR. Analysis will be intention-to-treat, with outcomes compared between study arms using generalised linear and non-linear mixed models. Additionally, cost-effectiveness of mass and targeted deworming will be calculated and compared, and focus group discussions and interviews will be used to assess acceptability and feasibility of deworming approaches. Individual based stochastic models will be used to predict the impact of mass and targeted deworming strategies beyond the RCT timeframe to assess the likelihood of parasite population 'bounce-back' if deworming is ceased due to low STH prevalence. DISCUSSION: The first large-scale trial comparing mass and targeted deworming for STH control in South East Asia will provide key information for policy makers regarding the optimal design of STH control programs. TRIAL REGISTRATION: ACTRN12619000309189 .


Assuntos
Antiprotozoários/uso terapêutico , Helmintíase/tratamento farmacológico , Helmintos/isolamento & purificação , Solo/parasitologia , Albendazol/uso terapêutico , Ancylostomatoidea/isolamento & purificação , Animais , Criança , Análise Custo-Benefício , Feminino , Helmintíase/economia , Helmintíase/epidemiologia , Humanos , Masculino , Prevalência , Vietnã/epidemiologia
16.
Pan Afr Med J ; 33: 94, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489072

RESUMO

Introduction: Soil-transmitted helminth infections (STHs) and schistosomiasis have serious consequences for the health, education and nutrition of children in developing countries. As Loum is known as a highly endemic commune for these infections, several deworming campaigns have been carried out in the past. The purpose of this study was to determine any changes that have occurred since then in the characteristics of these infections among schoolchildren in this site. Methods: A cross-sectional study was conducted in October 2016 on 289 schoolchildren. Stool and urine samples were collected and examined to determine the prevalence and intensity of helminth infections. Results: The highest prevalence was noted for Schistosoma haematobium (34.2%), followed by Ascaris lumbricoides (8.6%), S. mansoni (4.9%) and Trichuris trichiura (4.9%) in decreasing order. A prevalence of less than 2% was noted for each of the other two helminths. The highest mean intensity was found for S. haematobium (39.6 eggs/10 ml of urine), followed by A. lumbricoides (24.2 eggs per gram of faeces: epg), Strongyloides stercoralis (16.6 epg) and Schistosoma mansoni (12.3 epg). The prevalence of T. trichiura was significantly higher in boys and that of S. haematobium in children aged 10 years or older, while the differences between other values of prevalence or between egg burdens were not significant. Conclusion: Compared with values reported in 2003, the prevalence and intensity of schistosomiases and STH infections in Loum has sharply decreased in 2016. Confirmation of this decrease in the years to come allowed to space deworming campaigns among schoolchildren.


Assuntos
Anti-Helmínticos/administração & dosagem , Helmintíase/epidemiologia , Esquistossomose/epidemiologia , Solo/parasitologia , Adolescente , Camarões/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Fezes/parasitologia , Feminino , Helmintíase/tratamento farmacológico , Helmintíase/parasitologia , Humanos , Masculino , Prevalência , Esquistossomose/tratamento farmacológico , Esquistossomose/parasitologia , Fatores Sexuais
17.
Parasit Vectors ; 12(1): 429, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488219

RESUMO

BACKGROUND: The World Health Assembly endorsed the WHO Neglected Tropical Disease (NTD) Roadmap in 2013, in which NTDs were suggested as tracers of equity in the assessment of progress towards the Sustainable Development Goals. Nationwide surveys were undertaken in all 18 states of Sudan to identify the geographical distribution and to estimate the prevalence and intensity of schistosomiasis and other intestinal helminthiases from December 2016 to March 2017. METHODS: We used two-stage random sampling. Each district was subdivided into one to three different ecological zones (EZs) based on proximity to water bodies. Probability-proportional-to-size sampling was used to select schools from each EZ. We estimated schistosomiasis and intestinal helminthiasis prevalence by the centrifugation method and Kato-Katz smears. Multi-level mixed-effect models were used to investigate the relationship between the prevalence of infections and risk factors, including improved water or latrine status at the household or school level. We estimated the cost-effectiveness of a one-time mass drug administration (MDA) intervention with 75% coverage at the district and EZ levels. RESULTS: A total of 105,167 students from 1772 schools were surveyed. The overall egg-positive rates were: Schistosoma haematobium, 5.2%; S. mansoni, 0.06%; and intestinal helminths, 5.47%. Severe endemic areas were concentrated in East and South Darfur States. Children living in a house or attending schools with an improved latrine were less likely to be infected with schistosomiasis than those without a latrine (adjusted odds ratio, aOR: 0.45, 95% confidence interval, CI: 0.41-0.51 and aOR: 0.75, 95% CI: 0.70-0.81 at the household or the school levels, respectively). Open defecation was strongly associated with schistosomiasis (aOR: 1.50, 95% CI: 1.35-1.66). In community-wide mass treatment at the district level with an 8% threshold for schistosomiasis, 2.2 million people would not benefit from MDA interventions with 75% coverage despite high endemicity, whilst 1.7 million people would receive the MDA intervention unnecessarily. EZ-level MDA was estimated to be more cost-effective than district-level administration under all circumstances. CONCLUSIONS: Our findings provide updated prevalence figures to guide preventive chemotherapy programmes for schistosomiasis and intestinal helminthiasis in Sudan. Schistosomiasis was found to be common among the inhabitants of fragile and conflict-affected areas. In addition, we found that MDA interventions would be more cost-effective at the sub-district level than at the district level, and there was a strong association between schistosomiasis prevalence and latrine status, at both the household and school levels. This study will help the Sudanese government and its neighbouring countries develop adequate control and elimination strategies.


Assuntos
Helmintíase/epidemiologia , Enteropatias Parasitárias/epidemiologia , Esquistossomose/epidemiologia , Adolescente , Adulto , Animais , Criança , Pré-Escolar , Fezes/parasitologia , Feminino , Humanos , Lactente , Masculino , Administração Massiva de Medicamentos/economia , Administração Massiva de Medicamentos/estatística & dados numéricos , Pessoa de Meia-Idade , Prevalência , Schistosoma haematobium , Solo/parasitologia , Sudão/epidemiologia , Inquéritos e Questionários , Adulto Jovem
18.
BMC Public Health ; 19(1): 1204, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477069

RESUMO

BACKGROUND: Intestinal worm infection adversely impacted child health and was one of the China's largest health burdens. However, yet little was known about associations between intestinal worm infection and malnutrition in school-aged children in rural China. This study aimed to fill into the gap. METHODS: Data were from a survey of children aged 9-11 years old in Guizhou Province, China conducted in June 2013. Considering anemia and low intelligent quotient (IQ) as mediating factors, binomial logistic regression was used to estimate the associations of intestinal worm infection with thinness, underweight, and stunting. Moreover, the associations between socio-demographic factors and malnutrition were also explored. RESULTS: Among 2179 children, part of children was infected by intestinal worm (41.85%). Stunting (28%), low memory IQ (87.52%), and low process IQ (62.59%) were highly prevalent in the sample. Socio-demographic factors were associated with thinness, underweight, stunting, low memory IQ, low process IQ, anaemia, and intestinal worm infection. Intestinal worm infection was associated with low IQ, anemia, and stunting. In addition, anemia and low IQ could not confound the other expected associations. CONCLUSION: This study demonstrated the association between intestinal worm infections and stunting appeared to be largely mediated via low IQ. The study highlighted the importance of deworming and improving nutrition in the surveyed areas.


Assuntos
Transtornos da Nutrição Infantil/epidemiologia , Helmintíase/epidemiologia , Enteropatias Parasitárias/epidemiologia , População Rural/estatística & dados numéricos , Criança , China/epidemiologia , Feminino , Humanos , Masculino , Fatores de Risco , Inquéritos e Questionários
19.
BMC Public Health ; 19(1): 1066, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391023

RESUMO

BACKGROUND: Soil-transmitted helminth infection (STH) is one of the neglected tropical disease that affects approximately 2 billion people globally. School children represent the age group that is most commonly infected with STHs, resulting in poor school performance, impaired cognitive function, and many other detrimental effects. The transmission of STH is determined by many factors, such as hygiene and sanitation. Understanding the factors that influence disease transmission in a particular area is key to effective STH control. The objective of this study was to determine the prevalence of STH in North Sumatera and to identify the associated risk factors among school children. METHODS: A cross-sectional study was carried out among primary school children in Suka village, Tigapanah subdistrict. Stool samples were processed using a single Kato-Katz method. The potential risk factors analyzed were parent education and occupation, hand washing habits, latrine usage, footwear usage and contact with soil. The Chi-square test was performed to identify an association between risk factors and parasitological results. Logistic regression analysis was used to measure the strength of association. RESULTS: We enrolled 468 school children between 6 and 12 years of age. Among those children, 268 children (57.24%) were positive for one or more STH infections. Approximately 62.39% of children played with soil/dirt every day, and only 50% regularly washed their hands after activities. Most of the children wore shoes/slippers when going outside (87.82%) and used a latrine for defecation (85.04%). Playing with soil/dirt have been shown to increase the risk of STH infections 7.53 times, while hand washing habits and latrine usage decreased the risk of STH infections 0.16 times each. CONCLUSION: The prevalence of STH infection in school children in Suka village, Tigapanah subdistrict is still high. Playing with soil/dirt increased the risk of infection, while hand washing habits and latrine usage decreased the risk of infection. The combined strategies of improving the personal hygiene of children and biannual deworming can reduce the risk of STH infection in school children in Suka village, Tigapanah subdistrict.


Assuntos
Agricultura , Helmintíase/epidemiologia , Helmintíase/transmissão , Características de Residência/estatística & dados numéricos , Solo/parasitologia , Criança , Estudos Transversais , Fezes/parasitologia , Feminino , Humanos , Higiene/normas , Indonésia/epidemiologia , Masculino , Prevalência , Fatores de Risco , Toaletes/estatística & dados numéricos
20.
PLoS Negl Trop Dis ; 13(8): e0007446, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31369558

RESUMO

BACKGROUND: Because the success of deworming programs targeting soil-transmitted helminths (STHs) is evaluated through the periodically assessment of prevalence and infection intensities, the use of the correct diagnostic method is of utmost importance. The STH community has recently published for each phase of a deworming program the minimal criteria that a potential diagnostic method needs to meet, the so-called target product profiles (TPPs). METHODOLOGY: We compared the diagnostic performance of a single Kato-Katz (reference method) with that of other microscopy-based methods (duplicate Kato-Katz, Mini-FLOTAC and FECPAKG2) and one DNA-based method (qPCR) for the detection and quantification of STH infections in three drug efficacy trials in Ethiopia, Lao PDR, and Tanzania. Furthermore, we evaluated a selection of minimal diagnostic criteria of the TPPs. PRINCIPAL FINDINGS: All diagnostic methods showed a clinical sensitivity of ≥90% for all STH infections of moderate-to-heavy intensities. For infections of very low intensity, only qPCR resulted in a sensitivity that was superior to a single Kato-Katz for all STHs. Compared to the reference method, both Mini-FLOTAC and FECPAKG2 resulted in significantly lower fecal egg counts for some STHs, leading to a substantial underestimation of the infection intensity. For qPCR, there was a positive significant correlation between the egg counts of a single Kato-Katz and the DNA concentration. CONCLUSIONS/SIGNIFICANCE: Our results indicate that the diagnostic performance of a single Kato-Katz is underestimated by the community and that diagnostic specific thresholds to classify intensity of infection are warranted for Mini-FLOTAC, FECPAKG2 and qPCR. When we strictly apply the TPPs, Kato-Katz is the only microscopy-based method that meets the minimal diagnostic criteria for application in the planning, monitoring and evaluation phase of an STH program. qPCR is the only method that could be considered in the phase that aims to seek confirmation for cessation of program. TRIAL REGISTRATION: ClinicalTrials.gov NCT03465488.


Assuntos
Testes Diagnósticos de Rotina/métodos , Helmintíase/parasitologia , Helmintíase/transmissão , Helmintos/isolamento & purificação , Técnicas de Diagnóstico Molecular/métodos , Reação em Cadeia da Polimerase em Tempo Real/métodos , Solo/parasitologia , Adolescente , Animais , Brasil , Criança , Testes Diagnósticos de Rotina/instrumentação , Etiópia/epidemiologia , Fezes/parasitologia , Feminino , Helmintíase/diagnóstico , Helmintíase/epidemiologia , Helmintos/genética , Humanos , Laos/epidemiologia , Masculino , Microscopia , Técnicas de Diagnóstico Molecular/instrumentação , Contagem de Ovos de Parasitas/métodos , Prevalência , Sensibilidade e Especificidade , Tanzânia/epidemiologia , Organização Mundial da Saúde
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