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Effects of nutritional supplements on the re-infection rate of soil-transmitted helminths in school-age children: A systematic review and meta-analysis.

ABSTRACT: BACKGROUND:The effect of nutritional supplements on the re-infection rate of species-specific soil-transmitted helminth infections in school-aged children remains complex and available evidence on the subject matter has not been synthesized. METHODS:The review included randomised controlled trials (RCTs) and cluster RCTs investigating food supplements on school-aged children between the age of 4-17 years. A search for RCTs was conducted on eight databases from inception to 12th June 2019. Cochrane Risk of Bias tool was used to assess the risk of bias in all included studies. Meta-analysis and narrative synthesis were conducted to describe and analyze the results of the review. Outcomes were summarized using the mean difference or standardized mean difference where appropriate. RESULTS:The search produced 1,816 records. Six studies met the inclusion criteria (five individually RCTs and one cluster RCT). Four studies reported data on all three STH species, while one study only reported data on Ascaris lumbricoides infections and the last study reported data on only hookworm infections. Overall, the risk of bias in four individual studies was low across most domains. Nutritional supplementation failed to statistically reduce the re-infection rates of the three STH species. The effect of nutritional supplements on measures of physical wellbeing in school-aged children could not be determined. CONCLUSIONS:The findings from this systematic review suggest that nutritional supplements for treatment of STH in children should not be encouraged unless better evidence emerges. Conclusion of earlier reviews on general populations may not necessarily apply to children since children possibly have a higher re-infection rate.

SUBMITTER: Isah AUJ

PROVIDER: S-EPMC7425883 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Effects of nutritional supplements on the re-infection rate of soil-transmitted helminths in school-age children: A systematic review and meta-analysis.

Isah Aisha Ummi Jibrin AUJ Ekwunife Obinna Ikechukwu OI Ejie Izuchukwu Loveth IL Mandrik Olena O

PloS one 20200813 8

<h4>Background</h4>The effect of nutritional supplements on the re-infection rate of species-specific soil-transmitted helminth infections in school-aged children remains complex and available evidence on the subject matter has not been synthesized.<h4>Methods</h4>The review included randomised controlled trials (RCTs) and cluster RCTs investigating food supplements on school-aged children between the age of 4-17 years. A search for RCTs was conducted on eight databases from inception to 12th Ju ...[more]

PMID: 32790693

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Project description:BackgroundThis study aims to establish the prevalence of soil-transmitted helminth (STH) intestinal infections, nutritional status, and anemia in school children aged 7 to 10 years old in the biogeographic provinces of Colombia in 2012-2013. STH prevalence in the country has not been described within the last 30 years and it is needed in order to establish policies its control in the country.MethodologyNational Survey of STH in school-aged children with a multistage stratified probability sampling was conducted. The overall prevalence and intensity of STH infection, as well as for each parasite, (A. lumbricoides, T. trichiura and hookworms) were calculated for the country and for each of the nine biogeographic provinces.Principal findingsStool samples were collected from 6045 children in eight out of nine biogeographic provinces. The combined prevalence of STH in the country was 29.6%. T. trichiura was the most prevalent helminth (18.4%), followed by A. lumbricoides (11.3%), and hookworms (6.4%). For A. lumbricoides and hookworms, the highest prevalence values were found in the Amazonía province (58.0% and 35.7%, respectively). Regarding STH intensity, most cases showed moderate intensity (41.3%) for A. lumbricoides, and light intensity, for T. trichiura and hookworms. The national prevalence of anemia in school-aged children was 14.2%, lowest in the Nor-Andina province (3.5%), and highest in the Territorios Insulares oceánicos del Caribe province (45.1%).SignificanceColombia has a moderate risk of STH infection in school-aged populations, with considerable variation in the prevalence values among the biogeographic provinces. Like any public health issue, this problem should be handled with a comprehensive approach that involves deworming programs and strategies for STH control according to the specific epidemiological and socioeconomic conditions and sanitation service coverage in each biogeographic province. The program should be further supported by intersectoral action to improve living conditions, particularly the excreta disposal, promoted at municipality levels.

Project description:BackgroundThe control or elimination of neglected tropical diseases has recently become the focus of increased interest and funding from international agencies through the donation of drugs. Resources are becoming available for the treatment of soil-transmitted helminth (STH) infection through school-based deworming strategies. However, little research has been conducted to assess the impact of STH treatment that could be used to guide the design of efficient elimination programs.MethodologyWe construct and analyse an age-structured model of STH population dynamics under regular treatment. We investigate the potential for elimination with finite rounds of treatment, and how this depends on the value of the basic reproductive number R0 and treatment frequency.Principal findingsAnalysis of the model indicates that its behaviour is determined by key parameter groupings describing the basic reproduction number and the fraction of it attributable to the treated group, the timescale of material in the environment and the frequency and efficacy of treatment. Mechanisms of sexual reproduction and persistence of infectious material in the environment are found to be much more important in the context of elimination than in the undisturbed baseline scenario. For a given rate of drug use, sexual reproduction dictates that less frequent, higher coverage treatment is more effective. For a given treatment coverage level, the lifespan of infectious material in the environment places a limit on the effectiveness of increased treatment frequency.ConclusionsOur work suggests that for models to capture the dynamics of parasite burdens in populations under regular treatment as elimination is approached, they need to include the effects of sexual reproduction among parasites and the dynamics infectious material in the reservoir. The interaction of these two mechanisms has a strong effect on optimum treatment strategies, both in terms of how frequently to treat and for how long.

Project description:Soil transmitted helminths are wide spread in developing countries and in Ethiopia the prevalence of STHs varies in different parts of the country. The aim of this study was to determine the prevalence and intensity of soil transmitted helminths among school children of Mendera Elementary School Jimma town, Southwestern Ethiopia.A cross-sectional study was conducted between March 29 and April 9, 2010 to determine the prevalence and intensity of soil transmitted helminths among elementary school children. The study participants were randomly selected from class enrollment list after proportional allocation of the total sample size to each grade. Data about the background characteristics were collected using structured questionnaire. The stool samples were examined by McMaster method for the egg count which was used to determine intensity of infection. Data were analyzed using SPSS for windows version 16 and p-value less than 5% was considered as statistically significant.Of the total 715 stool specimens examined, 346 were positive for at least one intestinal parasite making the prevalence 48.4%. The most prevalent parasites were Ascaris lumbricoides 169 (23.6%) and Trichuris trichiura 165 (23.1%). The prevalence of soil transmitted helminth in this study was 45.6% (326/715). There was statistically significant difference in the prevalence of Trichuriasis between those who use latrine always and who use sometimes (p = 0.010). Females are two times more likely to be positive for Ascaris than males (p = 0.039). Majority of the students had light infection of soil transmitted helminths and none of them had heavy intensity of infection of Trichuriasis and hookworms.Nearly half of the school children were infected with at least one STHs and majority of the students had light infection of soil transmitted helminths. Students who did not wash their hands after defecation were three times more likely to be positive for Ascaris infection than those who washed their hands after defecation. Therefore, measures like health information dissemination on the advantage of washing hands after defecation and on proper use of latrine should be taken into account to alleviate the problem.

Project description:BackgroundSoil-transmitted helminth (STH) infections are endemic in Honduras and efforts are underway to decrease their transmission. However, current evidence is lacking in regards to their prevalence, intensity and their impact on children's health.ObjectivesTo evaluate the prevalence and intensity of STH infections and their association with nutritional status in a sample of Honduran children.MethodologyA cross-sectional study was done among school-age children residing in rural communities in Honduras, in 2011. Demographic data was obtained, hemoglobin and protein concentrations were determined in blood samples and STH infections investigated in single-stool samples by Kato-Katz. Anthropometric measurements were taken to calculate height-for-age (HAZ), BMI-for-age (BAZ) and weight-for-age (WAZ) to determine stunting, thinness and underweight, respectively.ResultsAmong 320 children studied (48% girls, aged 7-14 years, mean 9.76 ± 1.4) an overall STH prevalence of 72.5% was found. Children >10 years of age were generally more infected than 7-10 year-olds (p = 0.015). Prevalence was 30%, 67% and 16% for Ascaris, Trichuris and hookworms, respectively. Moderate-to-heavy infections as well as polyparasitism were common among the infected children (36% and 44%, respectively). Polyparasitism was four times more likely to occur in children attending schools with absent or annual deworming schedules than in pupils attending schools deworming twice a year (p<0.001). Stunting was observed in 5.6% of children and it was associated with increasing age. Also, 2.2% of studied children were thin, 1.3% underweight and 2.2% had anemia. Moderate-to-heavy infections and polyparasitism were significantly associated with decreased values in WAZ and marginally associated with decreased values in HAZ.ConclusionsSTH infections remain a public health concern in Honduras and despite current efforts were highly prevalent in the studied community. The role of multiparasite STH infections in undermining children's nutritional status warrants more research.

Project description:BackgroundThere is a lack of comprehensive national data on prevalence, geographical distribution of different species, and temporal trends in soil-helminthiasis (STHs). Therefore, this study aimed to provide a summary and location of the available data on STHs infection among preschool and school-age children in Ethiopia.MethodsThe search was carried out in Medline via PubMed, Scopus, Science Direct, Web of Science, and Google Scholar on data published between 1997 to February 2020 for studies describing the rate of STHs infection among preschool and school-age in Ethiopian. We followed the Patient, Intervention, Comparison, and Outcome (PICO) approach to identify the studies. Meta-regression was performed to understand the trends and to summarize the prevalence using the "metaprop" command using STATA software version 14.0 RESULTS: A total of 29,311 of the 61,690 children examined during the period under review were infected with one or more species of intestinal parasites yielding an overall prevalence of 48% (95% CI: 43-53%). The overall pooled estimate of STHs was 33% (95% CI: 28-38%). The prevalence was 44% (95% CI: 31-58%) in SNNPR, 34% (95% CI: 28-41%) in Amhara region, 31% (95% CI: 19-43%) in Oromia region and 10% (95% CI: 7-12%) in Tigray region. Soil-transmitted helminths infection rate has been decreasing from 44% (95% CI: 30-57%) pre-Mass Drug Administration (MDA) era (1997-2012) to 30% (95% CI: 25-34%) post-MDA (2013-2020), although statistically not significant (p = 0.45). A lumbricoides was the predominant species with a prevalence of 17%.ConclusionSouthern Nations Nationalities and Peoples Region, Amhara, and Oromia regions carry the highest-burden and are categorized to Moderate Risk Zones (MRZ) and therefore, requiring MDA once annually with Albendazole or Mebendazole. The prevalence of STHs decreased after MDA compared to before MDA, but the decline was not statistically significant. A. lumbricoides was the predominant species of STHs among preschool and school-age children in Ethiopia. The high prevalence of STHs observed in this review, underscores the need for better control and prevention strategies in Ethiopia.

Project description:BackgroundFrom 2011 to 2015, seven trachoma impact surveys in 150 districts across Amhara, Ethiopia, included in their design a nested study to estimate the zonal prevalence of intestinal parasite infections including soil-transmitted helminths (STH) and Schistosoma mansoni.MethodsA multi-stage cluster random sampling approach was used to achieve a population-based sample of children between the ages of 6 and 15 years. Stool samples of approximately 1 g were collected from assenting children, preserved in 10 ml of a sodium acetate-acetic acid-formalin solution, and transported to the Amhara Public Health Research Institute for processing with the ether concentration method and microscopic identification of parasites. Bivariate logistic and negative binomial regression were used to explore associations with parasite prevalence and intensity, respectively.ResultsA total of 16,955 children were selected within 768 villages covering 150 districts representing all ten zones of the Amhara region. The final sample included 15,455 children of whom 52% were female and 75% reported regularly attending school. The regional prevalence among children of 6 to 15 years of age was 36.4% (95% confidence interval, CI: 34.9-38.0%) for any STH and 6.9% (95% CI: 5.9-8.1%) for S. mansoni. The zonal prevalence of any STH ranged from 12.1 to 58.3%, while S. mansoni ranged from 0.5 to 40.1%. Categories of risk defined by World Health Organization guidelines would indicate that 107 districts (71.3%) warranted preventive chemotherapy (PC) for STH and 57 districts (38.0%) warranted PC for schistosomiasis based solely on S. mansoni. No statistical differences in the prevalence of these parasites were observed among boys and girls, but age and school attendance were both associated with hookworm infection (prevalence odds ratio, POR: 1.02, P = 0.03 per 1 year, and POR: 0.81, P = 0.001, respectively) and age was associated with infection by any STH (POR: 1.02, P = 0.03). Age was also associated with reduced intensity of Ascaris lumbricoides infection (unadjusted rate ratio: 0.96, P = 0.02) and increased intensity of hookworm infection (unadjusted rate ratio: 1.07, P < 0.001).ConclusionsThese surveys determined that between 2011 and 2015, STH and Schistosoma mansoni were present throughout the region, and accordingly, these results were used to guide PC distribution to school-age children in Amhara.

Project description:BackgroundMalaria burden remains high in the sub-Saharan region where helminths are prevalent and where children are often infected with both types of parasites. Although the effect of helminths on malaria infection is evident, the impact of these co-infections is not clearly elucidated yet and the scarce findings are conflicting. In this study, we investigated the effect of schistosomiasis, considering soil-transmitted helminths (STH), on prevalence and incidence of Plasmodium falciparum infection.MethodologyThis longitudinal survey was conducted in school-age children living in two rural communities in the vicinity of Lambaréné, Gabon. Thick blood smear light microscopy, urine filtration and the Kato-Katz technique were performed to detect malaria parasites, S. haematobium eggs and, STH eggs, respectively. P. falciparum carriage was assessed at inclusion, and incidence of malaria and time to the first malaria event were recorded in correlation with Schistosoma carriage status. Stratified multivariate analysis using generalized linear model was used to assess the risk of plasmodium infection considering interaction with STH, and survival analysis to assess time to malaria.Main findingsThe overall prevalence on subject enrolment was 30%, 23% and 9% for S. haematobium, P. falciparum infections and co-infection with both parasites, respectively. Our results showed that schistosomiasis in children tends to increase the risk of plasmodium infection but a combined effect with Trichuris trichiura or hookworm infection clearly increase the risk (aOR = 3.9 [95%CI: 1.7-9.2]). The incidence of malaria over time was 0.51[95%CI: 0.45-0.57] per person-year and was higher in the Schistosoma-infected group compared to the non-infected group (0.61 vs 0.43, p = 0.02), with a significant delay of time-to first-malaria event only in children aged from 6 to 10-years-old infected with Schistosoma haematobium.ConclusionsOur results suggest that STH enhance the risk for P. falciparum infection in schistosomiasis-positive children, and when infected, that schistosomiasis enhances susceptibility to developing malaria in young children but not in older children.

Dataset Information

Effects of nutritional supplements on the re-infection rate of soil-transmitted helminths in school-age children: A systematic review and meta-analysis.

Publications

Effects of nutritional supplements on the re-infection rate of soil-transmitted helminths in school-age children: A systematic review and meta-analysis.

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