RESUMO
In countries where soil-transmitted helminth (STH) infections are endemic, deworming programs are recommended to reduce morbidity; however, increasing levels of resistance to benzimidazoles are of concern. In an observational study in Peru, we studied the clinical efficacy of 400 mg of albendazole 20 days after treatment among children aged 2-11 years. Of 426 participants who provided samples, 52.3% were infected with a STH, 144 (33.8%) were positive for Ascaris (41.8% light, 50.8% moderate, and 7.4% heavy infections), 147 (34.5%) were positive for Trichuris (75.2% light, 22.5% moderate, and 2.3% heavy infections), and 1.1% were positive for hookworm species (100% light infections). Additional stool samples were examined at 20, 90, and 130 days after the initial treatment. At 20 days post-administration of albendazole, the cure rate (CR) of Ascaris infection was 80.1% (95% CI: 73.5-86.7), and the egg reduction rate (ERR) was 70.8% (95% CI: 57.8-88.7); the CR for Trichuris infection was 27.1% (95% CI: 20.0-34.3), and the ERR was 29.8% (95% CI: -1.40 to 57.5). Among participants with persistent or recurrent infections with Trichuris, the combined therapy of albendazole (400 mg) and ivermectin at 600 µg/dose increased overall CR for Trichuris infection to 75.2% (95% CI: 67.3-83.2%) with an ERR of 84.2% (95% CI: 61.3-93.8%). Albendazole administration alone for the control of STH was associated with high rates of treatment failure, especially for Trichuris. Combined single doses of albendazole and ivermectin was observed to have improved efficacy.
Assuntos
Albendazol , Anti-Helmínticos , Helmintíase , Ivermectina , Solo , Humanos , Albendazol/uso terapêutico , Albendazol/administração & dosagem , Peru/epidemiologia , Pré-Escolar , Criança , Ivermectina/uso terapêutico , Ivermectina/administração & dosagem , Masculino , Feminino , Solo/parasitologia , Helmintíase/tratamento farmacológico , Helmintíase/epidemiologia , Anti-Helmínticos/uso terapêutico , Anti-Helmínticos/administração & dosagem , Fezes/parasitologia , Quimioterapia Combinada , Animais , Resultado do Tratamento , Tricuríase/tratamento farmacológico , Tricuríase/epidemiologia , Ascaríase/tratamento farmacológico , Ascaríase/epidemiologia , Trichuris/efeitos dos fármacosRESUMO
BACKGROUND: Soil-transmitted helminth (STH) infections have many negative health outcomes (e.g., diarrhea, nutritional deficiencies) that can also exacerbate poverty. These infections are generally highest among low-income populations, many of which are also undergoing market integration (MI; increased participation in a market-based economy). Yet the direct impact of MI-related social and environmental changes on STH infection patterns is poorly understood, making it unclear which lifestyle factors should be targeted to better control disease spread. This cross-sectional study examines if household infrastructure associated with greater MI is associated with lower STH burdens among Indigenous Ecuadorian Shuar. METHODS: Kato-Katz fecal smears were used to determine STH infection status and intensity (n = 620 participants; 308 females, 312 males, aged 6 months-86 years); Ascaris lumbricoides (ascarid) and Trichuris trichiura (whipworm) were the primary infection types detected. Structured interviews assessing lifestyle patterns (e.g., measures of household infrastructure) measured participant MI. Multilevel regression analyses and zero-inflated negative binomial regression models tested associations between MI measures and STH infection status or intensity, controlling for individual and community characteristics. RESULTS: Participants residing in more market-integrated households exhibited lower infection rates and intensities than those in less market integrated households. Parasite infection status and T. trichiura infection intensity were lower among participants living in houses with wood floors than those with dirt floors, while individuals using well or piped water from a spring exhibited lower A. lumbricoides infection intensities compared to those using river or stream water. Unexpectedly, latrine type was not significantly related to STH infection status or intensity. These results suggest that sources of exposure differ between the two helminth species. CONCLUSIONS: This study documents associations between household measures and STH infection among an Indigenous population undergoing rapid MI. These findings can help healthcare programs better target interventions and reduce STH exposure among at-risk populations.
Assuntos
Fezes/parasitologia , Helmintíase , Pobreza/estatística & dados numéricos , Solo/parasitologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Ascaríase/epidemiologia , Ascaríase/transmissão , Ascaris lumbricoides/isolamento & purificação , Criança , Pré-Escolar , Estudos Transversais , Equador/epidemiologia , Características da Família , Feminino , Helmintíase/epidemiologia , Helmintíase/transmissão , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Grupos Populacionais/estatística & dados numéricos , Prevalência , Fatores de Risco , Saneamento/estatística & dados numéricos , Inquéritos e Questionários , Banheiros/estatística & dados numéricos , Tricuríase/epidemiologia , Tricuríase/transmissão , Trichuris/isolamento & purificação , Adulto JovemRESUMO
Trichuris spp. infections can cause typhlitis or typhlocolitis in many species, but there are no published studies about its pathology in cats. Trichuris sp. infection in cats appears to be rare in most parts of the world but is frequent in some tropical and subtropical regions. The purpose of this study was to describe intestinal lesions associated with natural Trichuris sp. infections in cats of St. Kitts, West Indies. Comprehensive autopsies, histopathological assessment of small and large intestine, and total worm counts were performed in a cross-sectional study of 30 consecutive feline mortalities. Trichuris were found in 17 of 30 (57%; 95% confidence interval, 39%-74%) of the study cats with a median worm count of 11 (range, 1-170), indicating most cats had a low-intensity infection. Trichuris infection was associated with typhlitis but not consistency of feces or body condition score. In most cats examined, the typhlitis was categorized as mild (10/15, 67%) and, less frequently, moderate (2/15, 13%) or marked (3/15, 20%). The inflammatory infiltrate varied from predominantly eosinophilic (5/15, 33%) to neutrophilic (4/15, 27%), a mixture of eosinophilic and neutrophilic (2/15, 13%), a mixture of neutrophilic and lymphoplasmacytic (1/15, 7%), or a mixture of eosinophilic, neutrophilic, and lymphoplasmacytic (3/15, 20%). In some cats, surface erosions and catarrhal exudate were adjacent to adult worms. These findings are similar to those reported with low-intensity Trichuris infections in other species.
Assuntos
Doenças do Gato/parasitologia , Gastroenteropatias/veterinária , Tricuríase/veterinária , Trichuris/isolamento & purificação , Tiflite/veterinária , Animais , Doenças do Gato/epidemiologia , Doenças do Gato/patologia , Gatos , Estudos Transversais , Feminino , Gastroenteropatias/epidemiologia , Gastroenteropatias/parasitologia , Gastroenteropatias/patologia , Prevalência , Tricuríase/epidemiologia , Tricuríase/parasitologia , Tricuríase/patologia , Tiflite/epidemiologia , Tiflite/parasitologia , Tiflite/patologia , Índias Ocidentais/epidemiologiaRESUMO
OBJECTIVES: Little research exists documenting levels of intestinal inflammation among indigenous populations where exposure to macroparasites, like soil-transmitted helminths (STHs), is common. Reduced STH exposure is hypothesized to contribute to increased prevalence of elevated intestinal inflammation in wealthy nations, likely due to coevolutionary histories between STHs and human immune systems that favored anti-inflammatory pathways. Here, we document levels of intestinal inflammation and test associations with STH infection among the Shuar of Ecuador, an indigenous population undergoing socioeconomic/lifestyle changes that influence their hygienic environment. We predict that fecal calprotectin (FC; a measure of intestinal inflammation) will be lower in STH infected individuals and that FC will be negatively associated with infection intensity. METHODS: Stool samples to analyze FC levels and STH infection were collected from 69 Shuar participants (ages 5-75 years). Children (<15 years) and adults (15+ years) were analyzed separately to understand the role of exposure in immune system development and the intestinal inflammatory response. RESULTS: Two species of STH were present: Ascaris lumbricoides and Trichuris trichiura. The relationships between infection and intestinal inflammation were age- and species-specific. While no significant relationships were found among adults, children who were singly infected with T. trichiura had lower FC levels than uninfected children. Infection intensity was not significantly associated with FC in children or adults. CONCLUSIONS: These preliminary results provide limited support for our hypotheses, documenting tentative age- and species-specific associations between FC and infection status. Findings may point to the importance of species-specific STH exposure during immune system development.
Assuntos
Helmintíase/complicações , Helmintíase/epidemiologia , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/epidemiologia , Adolescente , Adulto , Idoso , Ascaríase/complicações , Ascaríase/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Equador , Fezes/química , Fezes/parasitologia , Feminino , Humanos , Complexo Antígeno L1 Leucocitário/análise , Masculino , Pessoa de Meia-Idade , Tricuríase/complicações , Tricuríase/epidemiologia , Adulto JovemRESUMO
The prevalence and intensity of soil-transmitted helminth (STH) infections in schoolchildren from Corn Islands (Nicaragua) were examined to detect mono- or poly-STH infected children, measuring different intensity levels, and to elucidate measurably increased odds of being anemic. A total of 341 stool samples provided by 2- to 15-year-old children were examined using a concentration technique and a Kato-Katz slide. Intensity of infection was expressed as eggs per gram (epg) of feces to classify light, moderate, or heavy intensity infection. A finger-prick blood sample was obtained from each student in the field. Soil-transmitted helminth prevalence was 54.3%, with Trichuris trichiura as the most prevalent species (48.9%). The combination T. trichiura/Ascaris lumbricoides (12.6%) was the most common. When T. trichiura or A. lumbricoides appeared as a single infection, light or moderate intensity infections were seen, whereas when multiple species were identified, heavy infections were present. Anemia was detected in those with any kind of STH infection (42.7%), with statistically significant differences (P = 0.004) when compared with uninfected individuals (28.2%). Polyparasite infection with one parasite species at moderate intensity and the other parasite species at light intensity or absent was found to be a significant factor for the odds of being anemic (odds ratio = 2.07). The present study reveals a high level of STH transmission requiring a deworming control program in Corn Islands and pointing to the need of improving the education and sanitary conditions of the population to avoid environmental contamination and reinfection.
Assuntos
Anemia/epidemiologia , Ascaríase/epidemiologia , Ascaris lumbricoides/isolamento & purificação , Tricuríase/epidemiologia , Trichuris/isolamento & purificação , Adolescente , Anemia/complicações , Anemia/parasitologia , Animais , Ascaríase/complicações , Ascaríase/parasitologia , Ascaríase/transmissão , Ascaris lumbricoides/classificação , Criança , Pré-Escolar , Coinfecção , Fezes/parasitologia , Feminino , Humanos , Ilhas/epidemiologia , Masculino , Nicarágua/epidemiologia , Contagem de Ovos de Parasitas , Prevalência , Instituições Acadêmicas , Solo/parasitologia , Tricuríase/complicações , Tricuríase/parasitologia , Tricuríase/transmissão , Trichuris/classificaçãoRESUMO
The aim of this study was to determine for the first time the prevalence of enteroparasites in preschool children originating from the seven departments of the Pacific region in Nicaragua. One stool sample of each of 1,217 children, from 6 months to 5 years of age, was collected and personal data were recorded on delivery of the container. Samples fixed in 10% formalin were processed by a formol-acetate concentration and a modified Ziehl-Neelsen technique. The overall prevalence of enteroparasite infections was 68.2% with a total of at least 20 species. Blastocystis hominis (45.5%), Giardia intestinalis (31.7%), Trichuris trichiura (8.2%), and Ascaris lumbricoides (5.2%) were the most prevalent protozoa and helminth species in the total study as well as in all departments. Protozoan prevalence presented a statistically significant difference by gender (male: 69.6%; female: 46.7%; P < 0.001), and males presented a higher T. trichiura infection rate than females (male: 9.9%; female 6.4%; P < 0.035). Protozoan prevalence increased with age with a statistically significant difference (P < 0.001). Helminths were always more prevalent in urban areas (P < 0.0002). Protozoan infections result statistically higher than helminth infections so that water-based transmission could be suspected. Based on the differences with respect to species and parasite prevalence between the seven departments in the Pacific region of Nicaragua, the exploration of local factors associated with the transmission of enteroparasites should also be considered to reduce infection.
Assuntos
Helmintíase/complicações , Tricuríase/complicações , Animais , Ascaris lumbricoides/parasitologia , Ascaris lumbricoides/patogenicidade , Pré-Escolar , Fezes/parasitologia , Feminino , Helmintíase/epidemiologia , Helmintos/parasitologia , Helmintos/patogenicidade , Humanos , Lactente , Masculino , Nicarágua/epidemiologia , Prevalência , População Rural , Tricuríase/epidemiologia , Trichuris/parasitologia , Trichuris/patogenicidadeRESUMO
INTRODUCTION: Currently, Paraguay has no data on the prevalence of soil-transmitted geohelminth infection in schoolchildren aged 6 to 12 years. AIM: To determine the prevalence and intensity of infection by Ascaris lumbricoides, Trichuris trichiura and hookworms and the socio-cultural-environmental characteristics of the affected population. METHODS: Descriptive, cross-sectional study, in three semi-tropical climatic zones: continental, semi steppe and humid. A total of 1,404 schoolchildren from 20 schools in eight departments were selected from the country's three climate zones. Copro-parasitological exams were analyzed in situ with the Kato-Katz method. RESULTS: The national prevalence for geohelminthiasis was 3.73% (95% CI = 2.8-4.8). The risk factors found were consumption of well water OR: 2.88 (95% CI = 1.64-2.07), ground floor in housing OR: 2.56 (95% CI = 1.45-4.50) and lack of flushing water baths in households OR: 2.29 (95% CI = 1.23-4.28). CONCLUSION: Although the national prevalence of geohelminthiasis was low, it is recommended to promote good hygienic practices, use of footwear, and safe water consumption, as well as designing interventions with all relevant sectors to improve access to safe water and improved basic sanitation facilities.
Assuntos
Ascaríase/epidemiologia , Ascaris lumbricoides/isolamento & purificação , Fezes/parasitologia , Tricuríase/epidemiologia , Trichuris/isolamento & purificação , Animais , Ascaríase/diagnóstico , Criança , Estudos Transversais , Características Culturais , Feminino , Humanos , Masculino , Paraguai/epidemiologia , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Tricuríase/diagnósticoRESUMO
Resumen Introducción: Actualmente Paraguay no cuenta con estudios de prevalencia de infección por geohelmintos transmitidos por contacto con el suelo en escolares de 6 a 12 años. Objetivo: Determinar la prevalencia e intensidad de infección por Ascaris lumbricoides, Trichuris trichiura y las uncinarias y las características socio culturalesambientales de la población afectada. Materiales y Métodos: Estudio descriptivo, de corte transversal, en tres zonas climáticas: semi tropical continental, semi tropical semi estépico y semi tropical húmedo. Se seleccionaron 1.404 escolares de 20 escuelas de ocho departamentos, de las tres zonas climáticas del país. Se analizaron exámenes coproparasitológicos in situ con el método Kato-Katz. Resultados: La prevalencia nacional de geohelmintiasis fue de 3,7% (IC95% = 2,8-4,8). Los factores de riesgo fueron el consumo de agua de pozo OR: 2,88 (IC95% = 1,64-2,07), piso de tierra en la vivienda OR: 2,56 (IC95% = 1,45-4,50) y falta de baño con arrastre de agua en los hogares OR: 2,29 (IC95% = 1,23-4,28). Conclusión: A pesar de que la prevalencia nacional de geohelmintiasis fue baja, se recomienda promocionar buenas prácticas higiénicas, el uso de calzado, y consumo de agua segura, así como diseñar intervenciones con los sectores pertinentes para mejorar el acceso al agua segura y a instalaciones mejoradas de saneamiento básico.
Introduction: Currently, Paraguay has no data on the prevalence of soil-transmitted geohelminth infection in schoolchildren aged 6 to 12 years. Aim: To determine the prevalence and intensity of infection by Ascaris lumbricoides, Trichuris trichiura and hookworms and the socio-cultural-environmental characteristics of the affected population. Methods: Descriptive, cross-sectional study, in three semi-tropical climatic zones: continental, semi steppe and humid. A total of 1,404 schoolchildren from 20 schools in eight departments were selected from the country's three climate zones. Copro-parasitological exams were analyzed in situ with the Kato-Katz method. Results: The national prevalence for geohelminthiasis was 3.73% (95% CI = 2.8-4.8). The risk factors found were consumption of well water OR: 2.88 (95% CI = 1.64-2.07), ground floor in housing OR: 2.56 (95% CI = 1.45-4.50) and lack of flushing water baths in households OR: 2.29 (95% CI = 1.23-4.28). Conclusion: Although the national prevalence of geohelminthiasis was low, it is recommended to promote good hygienic practices, use of footwear, and safe water consumption, as well as designing interventions with all relevant sectors to improve access to safe water and improved basic sanitation facilities.
Assuntos
Humanos , Animais , Masculino , Feminino , Criança , Ascaríase/epidemiologia , Tricuríase/epidemiologia , Ascaris lumbricoides/isolamento & purificação , Fezes/parasitologia , Paraguai/epidemiologia , Ascaríase/diagnóstico , Fatores Socioeconômicos , Tricuríase/diagnóstico , Trichuris/isolamento & purificação , Prevalência , Estudos Transversais , Fatores de Risco , Características CulturaisRESUMO
Soil-transmitted helminth (STH) infections are widely distributed in tropical and subtropical areas, including Brazil. We performed a nationwide population-based study including all deaths in Brazil from 2000 to 2011, in which STHs (ascariasis, trichuriasis and/or hookworm infection) were mentioned on death certificates, either as underlying or as associated causes of death. Epidemiological characteristics, time trends and spatial analysis of STH-related mortality were analysed. STHs was identified on 853/12 491 280 death certificates: 827 (97·0%) deaths related to ascariasis, 25 (2·9%) to hookworm infections, and 1 (0·1%) to trichuriasis. The average annual age-adjusted mortality rate was 0·34/1 000 000 inhabitants (95% confidence interval: 0·27-0·44). Females, children <10 years of age, indigenous ethnic groups and residents in the Northeast region had highest STH-related mortality rates. Nationwide mortality decreased significantly over time (annual percent change: -5·7%; 95% CI: -6·9 to -4·4), with regional differences. We identified spatial high-risk clusters for STH-related mortality mainly in the North, Northeast and South regions. Diseases of the digestive system and infectious/parasitic diseases were the most commonly associated causes of death mentioned in the STH-related deaths. Despite decreasing mortality in Brazil, a considerable number of deaths is caused by STHs, with ascariasis responsible for the vast majority. There were marked regional differences, affecting mainly children and vulnerable populations.
Assuntos
Helmintíase/mortalidade , Solo/parasitologia , Adolescente , Adulto , Idoso , Ascaríase/epidemiologia , Ascaríase/mortalidade , Ascaríase/parasitologia , Ascaríase/transmissão , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Geografia , Helmintíase/epidemiologia , Helmintíase/parasitologia , Helmintíase/transmissão , Infecções por Uncinaria/epidemiologia , Infecções por Uncinaria/mortalidade , Infecções por Uncinaria/parasitologia , Infecções por Uncinaria/transmissão , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Doenças Negligenciadas , Análise Espacial , Tricuríase/epidemiologia , Tricuríase/mortalidade , Tricuríase/parasitologia , Tricuríase/transmissão , Adulto JovemRESUMO
Soil-transmitted helminth (STH) prevalence, intensity, polyparasitism and co-infections in 425 children from 3 schools of Laguna de Perlas (Nicaragua) were investigated. Single stool samples were analysed by the formalin-ether method and the Kato-Katz. A total of 402 (94.6%) children were infected. Trichuris trichiura 308 (72.4%), Ascaris lumbricoides 115 (27.1%) and Hookworms 54 (12.7%) were the most prevalent STHs. Polyparasitism (322; 75.8%) with two species was most prevalent (109; 25.6%). T. trichiura with A. lumbricoides (19.3%) and T. trichiura with Hookworm (6.8%) were the most common combinations. Positive associations were observed between T. trichiura and A. lumbricoides and T. trichiura and Hookworm (p = 0.0001). Highest Hookworm intensities appeared when three STH co-infections occurred. Moderate- heavy STH intensities appear in up to 42.1% in trichuriasis, 57.5% in ascariasis and 11.1% in Hookworm infections. Integrated control interventions covering children need to be implemented mainly in a rural environment.