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Prevalence, intensity and associated risk factors of soil transmitted helminth infections: A comparison between Negritos (indigenous) in inland jungle and those in resettlement at town peripheries.

ABSTRACT: BACKGROUND:Formerly known as the Malaysian hunter gatherers, the Negrito Orang Asli (OA) were heavily dependent on the forest for sustenance and early studies indicated high prevalence of intestinal parasitism. Initiation of a redevelopment program in the 1970s aimed to demarginalize the OA was expected to reduce soil transmitted helminth (STH) infections. Gradually, the OA were relocated to new resettlement areas at the peripheries. The aim of this study was to compare STH infections between Negritos who are still living in the inland jungle with those living in resettlements. METHODOLOGY/PRINCIPAL FINDINGS:A total of 416 Negrito participants were grouped into two categories of communities based on location; Inland Jungle Villages (IJV); and Resettlement Plan Scheme (RPS). Iodine wet mount, formalin-ether sedimentation, modified Trichrome and modified Ziehl-Neelsen staining and Kato-Katz methods were performed on stool samples. A questionnaire was used to collect information regarding demographic, socioeconomic, environmental and hygiene behaviors. Prevalence of STH was significantly higher in IJV (91.3%) versus RPS (83.1%) (P = 0.02). However, the percentage of individuals with severe intensity of Trichuris trichiura infections was significantly higher in the RPS (17.2%) compared to IJV (6.5%) (P = 0.01). Severe Ascaris lumbricoides infection was observed at 20.0% amongst RPS Negritos and 15.0% amongst IJV (P = 0.41). Whilst for hookworm infection, both prevalence and individuals with moderate to severe infections were higher in the IJV (26.2%, 41.0%) versus RPS (18.7%, 24.0%) (P values = 0.08, 0.09), accordingly. The prevalence other intestinal parasitic infections (e.g. Entamoeba sp., Blastocystis and flukes) was also higher in IJV versus RPS. Apart from poor hygienic behaviors as significant risk factors in both communities, low socio-economic status was highly associated with STH infections in RPS (P<0.001) but not significantly associated in IJV. CONCLUSIONS:The findings showed that ex situ development plan by RPS has not profoundly contributed to the STH reduction among the OA. Conversely, burden rate of T. trichiura infections increased due to their extreme poverty and poor hygienic behaviors. Here, we are suggesting biannual mass albendazole intervention (triple dose regimens in RPS, but a single dose in IJV) and community empowerment to both communities. For a long-term and better uptake, these strategies must be done together with the community input and participation, respecting their traditional customs and accompanied by recruitment of more OA people in the health-care taskforce.

SUBMITTER: Muslim A

PROVIDER: S-EPMC6497322 | biostudies-other | 2019 Apr

REPOSITORIES: biostudies-other

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Prevalence, intensity and associated risk factors of soil transmitted helminth infections: A comparison between Negritos (indigenous) in inland jungle and those in resettlement at town peripheries.

Muslim Azdayanti A Mohd Sofian Sakinah S Shaari Syahrul Azlin SA Hoh Boon-Peng BP Lim Yvonne Ai-Lian YA

PLoS neglected tropical diseases 20190422 4

<h4>Background</h4>Formerly known as the Malaysian hunter gatherers, the Negrito Orang Asli (OA) were heavily dependent on the forest for sustenance and early studies indicated high prevalence of intestinal parasitism. Initiation of a redevelopment program in the 1970s aimed to demarginalize the OA was expected to reduce soil transmitted helminth (STH) infections. Gradually, the OA were relocated to new resettlement areas at the peripheries. The aim of this study was to compare STH infections be ...[more]

PMID: 31009476

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Project description:BackgroundSoil-transmitted helminth (STH) infections are caused by roundworms (Ascaris lumbricoides), whipworms (Trichuris trichiura), and hookworms (Necator americanus and Ancylostoma duodenale). In Uganda, baseline surveys conducted during the late 1990s and early 2000s suggested STH infections were common, with prevalence >50% among surveyed schoolchildren. In 2003, a national program was launched with mass preventative chemotherapy (PC) and health education for children 1-14 years old. Little evidence is available to show the impact of national deworming.MethodsWe conducted population-based, cross-sectional household surveys in five districts (Buikwe, Kassanda, Kiryandongo, Kisoro, and Rubanda) in March and May 2022. Our primary objective was to estimate STH prevalence by species due to infections of any intensity and infections of moderate-to-heavy intensity among preschool-aged children (PSAC, 1-4 years old), school-aged children (SAC, 5-14 years old), and women of reproductive age (WRA, 15-49 years old). Laboratory technicians used duplicate Kato-Katz microscopy to determine fecal egg count.ResultsOverall, 3,352 PSAC; 3,884 SAC; and 1,226 WRA provided stool samples. The prevalence of any infection remained high in Kisoro at or above ~50% within all risk groups. In other districts, the prevalence of any infection ranged from approximately 5 to 16% among PSAC, 6 to 23% among SAC, and 12 to 19% among WRA. Moderate-to-heavy intensity infection prevalence was highest in Kisoro (~15-26%), followed by Rubanda (<5%), and was ≤1% in other districts. A. lumbricoides and T. trichiura infections were largely confined to Kisoro and Rubanda, whereas hookworm was most common in other districts.ConclusionsThe STH prevalence has decreased markedly in three districts in Uganda. Based on our findings, the national deworming program should consider decreasing PC distribution frequency in these districts per the World Health Organization guidelines. Efforts are needed to understand why the Kisoro and Rubanda districts did not demonstrate similar gains.

Project description:Control of soil-transmitted helminth (STH) infections relies on the periodic and long-term administration of anthelmintic drugs to high-risk groups, particularly school-age children living in endemic areas. There is limited data on the effectiveness of long-term periodic anthelmintic treatment on the prevalence of STHs, particularly from operational programmes. The current study investigated the impact of 15 to 17 years of treatment with the broad-spectrum anthelmintic ivermectin, used for the control of onchocerciasis, on STH prevalence and intensity in school-age and pre-school children.A cross-sectional study was conducted in communities that had received annual or twice-annual ivermectin treatments and geographically adjacent communities that had not received treatment in two districts of Esmeraldas Province in Ecuador. Stool samples were collected from school-age children and examined for STH infection using the Kato-Katz and formol-ether concentration methods. Samples were collected also from pre-school children and examined by the formol-ether concentration method. Data on risk factors for STH infection were collected by parental questionnaire. We sampled a total of 3,705 school-age children (6-16 years) from 31 treated and 27 non-treated communities, and 1,701 pre-school children aged 0-5 years from 18 treated and 18 non-treated communities. Among school-age children, ivermectin treatment had significant effects on the prevalence (adjusted OR = 0.06, 95% CI 0.03-0.14) and intensity of Trichuris trichiura infection (adjusted RR = 0.28, 95% CI 0.11-0.70), but appeared to have no impact on Ascaris lumbricoides or hookworm infection. Reduced prevalence and intensities of T. trichiura infection were observed among children not eligible to receive ivermectina, providing some evidence of reduced transmission of T. trichiura infection in communities receiving mass ivermectin treatments.Annual and twice-annual treatments with ivermectin over a period of up to 17 years may have had a significant impact on T. trichiura infection. The present data indicate that the long-term control of onchocerciasis with ivermectin may provide additional health benefits by reducing infections with trichuriasis. The addition of a second anthelmintic drug such as albendazole may be useful for a long-term effect on A. lumbricoides infection.

Project description:BackgroundDriven by global targets to eliminate soil-transmitted helminths as a public health problem, governments have rapidly rolled out control programmes using school and community-based platforms. To justify and target ongoing investment, quantification of impact and identification of remaining high-risk areas are needed. We aimed to assess regional progress towards these targets.MethodsWe did a continental-scale ecological analysis using a Bayesian space-time hierarchical model to estimate the effects of known environmental, socioeconomic, and control-related factors on the prevalence of soil-transmitted helminths, and we mapped the probability that implementation units had achieved moderate-to-heavy intensity infection prevalence of less than 2% among children aged 5-14 years between Jan 1, 2000, and Dec 31, 2018.FindingsWe incorporated data from 26 304 georeferenced surveys, spanning 3096 (60%) of the 5183 programmatic implementation units. Our findings suggest a reduction in the prevalence of soil-transmitted helminths in children aged 5-14 years in sub-Saharan Africa, from 44% in 2000 to 13% in 2018, driven by sustained delivery of preventive chemotherapy, improved sanitation, and economic development. Nevertheless, 1301 (25%) of 5183 implementation units still had an estimated prevalence of moderate-to-heavy intensity infection exceeding the 2% target threshold in 2018, largely concentrated in nine countries (in 1026 [79%] of 1301 implementation units): Nigeria, Democratic Republic of the Congo, Ethiopia, Cameroon, Angola, Mozambique, Madagascar, Equatorial Guinea, and Gabon.InterpretationOur estimates highlight the areas to target and strengthen interventions, and the areas where data gaps remain. If elimination of soil-transmitted helminths as a public health problem is to be achieved in sub-Saharan Africa by 2030, continued investment in treatment and prevention activities are essential to ensure that no areas are left behind.FundingBill & Melinda Gates Foundation.

Project description:BackgroundSoil transmitted Helminths (STH) infections remain a public health concern worldwide, particularly in tropical and subtropical areas where these diseases are highly endemic. Knowing the prevalence and risk factors of the disease is crucial for efficient STH control strategies in endemic areas. The scarcity of epidemiological data on STH for Equatorial Guinea has motivated the decision to perform the present study.MethodsA cluster-based cross-sectional study was carried out in Bata district from November 2020 to January 2021. Stool samples were collected for the diagnostic of STH infections using Kato-Katz technique. Descriptive statistics was performed for determination of STH prevalence and intensity, while logistic regression models were used to assess the risk factors associated with STH infections.ResultsA total of 340 participants were included in the study with a mean age of 24 years (SD = 23.7) and 1.2 female-to-male sex-ratio. The overall prevalence of any STH was 60% (95%CI: 55-65). The most prevalent species were Ascaris lumbricoides (43%, 95%CI: 37-48) and Trichuris trichiura (40%, 95%CI: 35-46). Intensity of infection were mainly light to moderate. A trend of association was observed between age and any STH infection (overall p-value = 0.07), with a significant difference observed between children aged 5-14 years as compared to those aged 1-4 (aOR 2.12; 95%CI: 1.02-4.43, p-value = 0.04), while locality was significantly associated with STH infection (overall p-value<0.001) with a higher odds observed for peri-urban area as compared to urban area (aOR 4.57; 95%CI: 2.27-9.60, p-value<0.001).ConclusionBata district is a high STH transmission area, where school-aged children and peri-urban areas are associated with a higher risk of any STH infection. This situation calls for a full implementation of the WHO recommendations for STH control; mass drug administration of anthelminthic twice a year to the whole population with great attention to school age children, and prioritizing peri-urban areas where safe water, improve sanitation, and hygiene education should be implemented to achieve a better control.

Project description:BackgroundSoil-transmitted helminths (STH), i.e., Ascaris lumbricoides, Trichuris trichiura and hookworms are among the most prevalent Neglected Tropical Diseases (NTDs) in Ethiopia. Although pre-school aged children pay a high morbidity toll associated with STH infections, evidence on prevalence, intensity and intervention status is lacking in Ethiopia. This study, therefore, aimed to address these gaps to inform decision made on STH.MethodsWe did a community-based cross-sectional study in five districts of Gamo Gofa zone, Southern Ethiopia; in January 2019. Data were collected using pre-tested questionnaire, and the Kato-Katz technique was used to diagnose parasites eggs in stool. Then, collected data were edited and entered into EpiData 4.4.2, and exported to SPSS software (IBM, version 25) for analysis.ResultsA total of 2462 PSAC participated in this study. Overall, the prevalence of STH was 23.5% (578/2462) (95% confidence interval (CI) = 21.8%-25.2%). As caris lumbricoides was the most prevalent (18.6%), followed by Trichuris trichiura (9.2%), and hookworms (3.1%). Of the total, 7.4% PSAC were infected with two STH species. Most of the positive cases with STH showed low infection intensities, while 15.1% ascariasis cases showed moderate infection intensities. The study found that 68.7% of PSAC were treated with albendazole. Also, household's level data showed that 39.4% used water from hand-dug well; 52.5% need to travel ≥30 minutes to collect water; 77.5% did not treat water, and 48.9% had no hand washing facility. In addition, almost 93% care givers achieved less than the mean knowledge and practice score (≤5) on STH prevention.ConclusionsThis study showed that significant proportions of pre-school aged children are suffering from STH infections despite preventive chemotherapy exist at the study area. Also, gaps in the interventions against STH were highlighted. Thus, a call for action is demanding to eliminate STH among PSAC in Ethiopia by 2030.

Project description:BackgroundHonduras is endemic for soil-transmitted helminth (STH) infections, but critical information gaps still remain on the prevalence and intensity of these infections as well as on their spatial distribution at subnational levels.ObjectivesFirstly, to review the research activity on STH infections in Honduras and secondly, to carry out a national prevalence analysis and map the geographical distribution of these infections in children.MethodsA systematic search was conducted of the published and grey literature to identify scientific work on the impact and prevalence of STH infections done between May 1930 and June 30, 2012. International databases and Honduran journals were searched. Grey literature was gleaned from local libraries and key informants. Select studies conducted between 2001 and 2012 were used to produce prevalence maps and to investigate association between STH prevalence and socio-economic and environmental factors.ResultsOf 257 identified studies, 211 (21.4% peer-reviewed) were retained for analysis and categorized as clinical research (10.9%), treatment efficacy studies (8.1%) or epidemiological studies (81%). Prevalence analysis and geographical mapping included 36 epidemiological studies from Honduras's 18 departments and 23% of its municipalities. Overall STH prevalence was >50% in 40.6% of municipalities. Prevalences above 20% for each trichuriasis, ascariasis, and hookworm infection were found in 68%, 47.8%, and 7.2% of studied municipalities, respectively. Municipalities with lower human development index, less access to of potable water, and with higher annual precipitation showed higher STH prevalences.ConclusionsThis is the first study to provide a comprehensive historic review of STH research activity and prevalence in Honduras, revealing important knowledge gaps related to infection risk factors, disease burden, and anti-parasitic drug efficacy, among others. Our decade-long prevalence analysis reveals geographical differences in STH prevalence and these findings suggest that differential intervention strategies might be necessary in Honduras for the control of these infections.

Project description:This study compared the current nutritional status, hemoglobin levels and their associations with soil-transmitted helminth (STH) infections between two categories of Negritos (indigenous): (i) Inland Jungle Villages (IJV) (ii) and Resettlement Plan Scheme (RPS) near town peripheries, decades after redevelopment and demarginalization. A total of 416 Negritos (IJV: 149; RPS: 267) was included for nutritional profiling based on anthropometric analysis. However, only 196 (IJV: 64; RPS: 132) individuals consented to blood taking for the hemoglobin (Hb) measurements. Subsequently, the association of undernutrition and anemia with STH infections were determined based on univariate and multivariate logistic regression analyses. The overall prevalence of stunting, wasting, and underweight amongst children and adolescents (n = 343) were 45.8%, 42.3% and 59.1%, respectively. In adults (n = 73), the prevalence of underweight was low (6.8%) but overweight and obese was prominent (26.0%). For anemia (n = 196), an overall prevalence rate of 68.4% were observed with 80% and 70.4% of children aged 2-6 y/o and aged 7-12 y/o, respectively being anemic. Comparatively, the prevalence of underweight (WAZ) was significantly higher in the RPS versus the IJV (P = 0.03) In the IJV, children aged ≤ 6 y/o and having STH poly-parasitism were associated with underweight (P = 0.01) and moderate-severe T. trichiura infection was associated with anemia. Whilst in the RPS, underweight was highly associated with only T. trichiura infection (P = 0.04). Wasting was significantly associated with young children aged ≤10 in both IJV (P = 0.004) and RPS (P = 0.02). Despite efforts in improving provision of facilities and amenities among the indigenous, this study highlighted a high magnitude of nutritional issues among the Negritos especially those in the RPS and their likely association with STH infections and decades of demarginalization. Joint nutritional intervention strategies with mass anti-helminthic treatment are imperative and urgently needed to reduce the undernutrition problems especially among indigenous children.

Project description:BackgroundSoil-transmitted helminths (STH) are one of the most common infections affecting underprivileged populations in low- and middle-income countries. Ascaris lumbricoides, Trichuris trichiura, and hookworm are the three main species that infect people. School children are the most vulnerable groups for STH infections due to their practice of walking and playing barefoot, poor personal hygiene, and environmental sanitation. However, evidence is limited in the study area. So, this study aimed to assess the current prevalence, infection intensity, and associated risk factors of STHs among school children in Tachgayint woreda, Northcentral Ethiopia.MethodsA cross-sectional study was conducted among school children of Tachgayint woreda from February to May 2021. The study participants were chosen via systematic random sampling. Stool samples were collected from 325 children and examined using the Kato-Katz technique. The data was analyzed using SPSS version 23. Binary and multivariable logistic regression analyses were used to identify the potential associated factors for STHs. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to measure the magnitude of the association. A P-value <0.05 was considered statistically significant.ResultsThe overall prevalence of STHs in this study was 36.0% (95% CI: 30.5-41.2%). Ascaris lumbricoides are the most prevalent species 89 (27.4%) followed by hookworm 14 (4.3%) and Trichuris trichiura 10 (3.1%). All of the infected school children had light-intensity of infections with the mean of eggs per gram (EPG) being 464.53. Lack of shoe wearing habit (AOR = 4.08, 95% CI: 1.29-12.88) and having untrimmed fingernail (AOR = 1.85, 95% CI: 1.06-3.22) were identified as risk factors for STH infections.ConclusionsMore than one-third of the school children were infected with at least one STH species and this indicates that STHs are still a health problem among school children in the study area. Therefore, periodic deworming, implementation of different prevention strategies, and health education programs should be regularly applied in the area.

Project description:Background Ethiopia has set national targets for eliminating soil-transmitted helminths (STH) as public health problems by 2020 and for breaking their transmission by 2025 using periodic mass treatment of children in endemic areas. However, the status of STH infection among the adults living in the same communities remains unknown. The aim of this study, therefore, was to determine the prevalence and intensity of STH infections and associated factors among the household heads in the peri-urban areas of Jimma town, Oromia, Ethiopia. Methods A community-based cross-sectional study was conducted in five peri-urban kebeles (smallest administrative unit in Ethiopia) of Jimma town from May to July 2021. A semi-structured questionnaire was used to collect data on socio-demographic and predisposing factors. The Kato-Katz concentration technique was utilized to detect and quantify the STH in stool samples. Both bivariate and multivariate analyses were done. P-value <0.05 was considered statistically significant. Results A total of 376 household heads (19.9% women and 80.1% men) from peri-urban areas were included in the study. The overall STH prevalence was 18.1% (95% CI: 14.6–22.1) with A. lumbricoides being the predominant species (11.4%) followed by T. trichiura (7.2%) and hookworm (2.1%). Most of the STH positive household heads had single infections (85.3%) and light-intensity infections (88.5%). Wealth status (AOR = 2.7; 95% CI: 1.31–5.50, P = 0.007), hand washing habits before meals (AOR = 7.07; 95% CI: 1.79–27.88, p = 0.005), fingernails status (AOR = 2.99; 95% CI: 1.59–5.65, p = 0.001), and toilet facility type (AOR = 2.06; 95% CI: 1.13–3.76, p = 0.017) were found to have statistically significant associations with the STH infection. Conclusion The findings of this study showed a nearly moderate level of STH prevalence among household heads in the peri-urban community. This could serve as an important reservoir for reinfection of the treated children and other at-risk groups in the community.

Dataset Information

Prevalence, intensity and associated risk factors of soil transmitted helminth infections: A comparison between Negritos (indigenous) in inland jungle and those in resettlement at town peripheries.

Publications

Prevalence, intensity and associated risk factors of soil transmitted helminth infections: A comparison between Negritos (indigenous) in inland jungle and those in resettlement at town peripheries.

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