MyMedR

Human intestinal parasitic infection: a narrative review on global prevalence and epidemiological insights on preventive, therapeutic and diagnostic strategies for future perspectives

Wong LW, Ong KS, Khoo JR, Goh CBS, Hor JW, Lee SM

Expert Rev Gastroenterol Hepatol, 2020 Nov;14(11):1093-1105.

PMID: 32755242 DOI: 10.1080/17474124.2020.1806711

INTRODUCTION: Intestinal parasitic infection (IPI) is a global health concern among socioeconomically deprived communities in many developing countries. Many preventative strategies have been deployed to control IPI, however, there is a lack in standards on the techniques used to diagnose and monitor the prevalence of IPI.

AREAS COVERED: The present article will review the diseases associated with IPI and discuss the current IPI control strategies such as the water, sanitation, and hygiene (WASH) interventions, community-led total sanitation (CLTS) approach, and regular anthelminthic treatments. For the first time, this review will also evaluate all currently practised diagnostic techniques for the detection of intestinal parasites and provide insights on future IPI control strategies.

EXPERT OPINION: Advanced and improved diagnostic methods such as qPCR coupled with a high-resolution melting curve, aptamers, biosensors, and detection of extracellular vesicles can be used for detection of IPI. Vaccination against intestinal parasites can be made available to increase antibodies to interfere with the blood-feeding process by the parasites, which subsequently reduces the reproductive rates of the parasites. These methods collectively can serve as future management strategies for intestinal parasitic infections.

Matched MeSH terms: Anthelmintics/therapeutic use*

Post-era mass drug administration: an update on intestinal parasitic infections in urban poor communities in Peninsular Malaysia

Sahimin N, Abd Khalil NS, Lewis JW, Mohd Zain SN

Trop Biomed, 2020 Jun 01;37(2):363-371.

PMID: 33612805

The health impact of a Malaysian national helminth control program which provided school-based anthelmintic chemotherapy from 1974 to 1983 was re-visited after three decades post MDA and associated risk factors amongst urban poor communities identified. Stool samples collected were screened using the formalin ethyl-acetate concentration technique recovered at least one species of helminth and/or protozoan. Despite a steady decline observed between 1974-1983 however, post MDA infections continue to persist in pockets of communities moderately (18.9%; n=39/206) with higher infection recorded amongst PPR flat residents (22.5%, n=16/71). Among risk factors identified, waste management method was the primary factor for Ascaris lumbricoides infections (n=33; 16.0%), whereas age, education, employment and source of drinking water were significant risk factors for cryptosporidiosis. Despite the government's efforts to improve health through the provision of basic amenities to the general public, higher prevalence values amongst PPR flat dwellers suggests the need to implement targeted chemotherapeutic treatment of, once a year deworming as recommended by World Health Organization when the baseline prevalence of soil-transmitted helminth infections in the community is over 20%, in addition to preventive measures though improvements in health awareness programs and improved waste management methods.

Matched MeSH terms: Anthelmintics/therapeutic use

100 Questions in Livestock Helminthology Research

Morgan ER, Aziz NA, Blanchard A, Charlier J, Charvet C, Claerebout E, et al.

Trends Parasitol, 2019 01;35(1):52-71.

PMID: 30477758 DOI: 10.1016/j.pt.2018.10.006

An elicitation exercise was conducted to collect and identify pressing questions concerning the study of helminths in livestock, to help guide research priorities. Questions were invited from the research community in an inclusive way. Of 385 questions submitted, 100 were chosen by online vote, with priority given to open questions in important areas that are specific enough to permit investigation within a focused project or programme of research. The final list of questions was divided into ten themes. We present the questions and set them briefly in the context of the current state of knowledge. Although subjective, the results provide a snapshot of current concerns and perceived priorities in the field of livestock helminthology, and we hope that they will stimulate ongoing or new research efforts.

Matched MeSH terms: Anthelmintics/therapeutic use

Assessment of gastrointestinal nematode infection, anthelmintic usage and husbandry practices on two small-scale goat farms in Malaysia

Wong F, Sargison N

Trop Anim Health Prod, 2018 Mar;50(3):581-587.

PMID: 29143232 DOI: 10.1007/s11250-017-1472-8

Haemonchosis is a common problem on goat farms in tropical countries such as Malaysia. Prevention of production losses generally depends on the use of anthelmintic drugs, but is threatened by the emergence of anthelmintic resistance. This study investigates anthelmintic efficacy on small-scale Malaysian goat farms and describes putative risk factors. Adult goats had moderate to high pre-treatment faecal trichostrongyle egg counts, despite being housed on slatted floors and fed on cut-and-carry forage, raising questions about the source of nematode infection. Our results show multiple resistance to benzimidazole and macrocyclic lactone anthelmintic drugs and allow us to discuss the genetic origins of resistance with reference to farm husbandry and management. We conclude that improvement in Malaysian goat production efficiency will require the development of sustainable helminth control strategies, underpinned by a better understanding of the origins and population genetics of anthelmintic resistance.

Matched MeSH terms: Anthelmintics/therapeutic use*

Fulltext Toward the formation of a Companion Animal Parasite Council for the Tropics (CAPCT)

Traub RJ, Irwin P, Dantas-Torres F, Tort GP, Labarthe NV, Inpankaew T, et al.

Parasit Vectors, 2015 May 13;8:271.

PMID: 25963851 DOI: 10.1186/s13071-015-0884-4

This letter advises the imminent formation of the Companion Animal Parasites Council for the Tropics (CAPCT). The CAPCT consists of region-specific (e.g., Asia-Pacific, Latin America and Caribbean, Africa) experts comprising academics, veterinarians, parasitologists, physicians and allied industry partners that will work together to inform, guide and develop best-practice recommendations for the optimal diagnosis, treatment and control of companion animal parasites in the tropics, with the aim of protecting the health of pets and that of the public.

Matched MeSH terms: Anthelmintics/therapeutic use*

Fulltext Developing and evaluating health education learning package (HELP) to control soil-transmitted helminth infections among Orang Asli children in Malaysia

Al-Delaimy AK, Al-Mekhlafi HM, Lim YA, Nasr NA, Sady H, Atroosh WM, et al.

Parasit Vectors, 2014;7:416.

PMID: 25179100 DOI: 10.1186/1756-3305-7-416

This study was carried out to develop a health education learning package (HELP) about soil-transmitted helminth (STH) infections, and to evaluate what impact such a package could have in terms of reducing the incidence and intensity of STH infections among Orang Asli schoolchildren in Pahang, Malaysia.

Matched MeSH terms: Anthelmintics/therapeutic use

Fulltext Does vitamin A supplementation protect schoolchildren from acquiring soil-transmitted helminthiasis? A randomized controlled trial

Al-Mekhlafi HM, Anuar TS, Al-Zabedi EM, Al-Maktari MT, Mahdy MA, Ahmed A, et al.

Parasit Vectors, 2014;7:367.

PMID: 25127885 DOI: 10.1186/1756-3305-7-367

Despite the intensive global efforts to control intestinal parasitic infections, the prevalence of soil-transmitted helminth (STH) infections is still very high in many developing countries particularly among children in rural areas.

Matched MeSH terms: Anthelmintics/therapeutic use

Fulltext Evaluation of enhanced virgin coconut oil and senduduk (Melastoma malabathricum) as anthelmintics against caprine strongyle nematodes

Basripuzi HB, Sani RA, Ariff OM, Chandrawathani P

Trop Biomed, 2013 Sep;30(3):516-25.

PMID: 24189681 MyJurnal

A study was conducted to evaluate the anthelmintic properties of enhanced virgin coconut oil (EVCO) and senduduk (Melastoma malabathricum) plant against strongyle nematodes in goats. Two preparations of 10% EVCO dissolved in 90% virgin coconut oil and 10% EVCO dissolved in 90% palm oil, were given orally to two groups of mixed breeds goats. The efficacy test indicated that EVCO was insufficiently active as an anthelmintic. Four concentrations of senduduk solution (1.25, 2.5, 5.0 and 10 mg ml(-1)) were compared with a control and albendazole in an in vitro test for larvicidal effect. There was no significant larval mortality using senduduk solution. An in vivo test of senduduk was conducted by comparing three groups of goats, namely control, levamisole and treatment groups that were given a daily oral dose of senduduk crude extract with 1g kg(-1) from Day 0 to Day 12 and 2 g kg(-1) from Day 13 to Day 30. This efficacy test with senduduk also gave negative results. The findings obtained indicated that EVCO and senduduk were ineffective as anthelmintics against caprinestrongyle nematodes at the concentrations used.

Matched MeSH terms: Anthelmintics/therapeutic use*

Follicular cutaneous larva migrans: a report of three cases and review of the literature

Veraldi S, Persico MC, Francia C, Nazzaro G, Gianotti R

Int J Dermatol, 2013 Mar;52(3):327-30.

PMID: 23414157 DOI: 10.1111/j.1365-4632.2012.05723.x

Hookworm-related cutaneous larva migrans (CLM) is characterized clinically by erythematous and slightly raised tracks, located especially on the feet. These tracks may be single or multiple, linear or serpiginous, more or less ramified and intertwined. The length is variable (up to many cm); the width ranges from 1 mm to 4 mm. Tracks are often accompanied by severe pruritus.

Matched MeSH terms: Anthelmintics/therapeutic use

Growth reduction among primary schoolchildren with light trichuriasis in Malaysia treated with albendazole

Tee MH, Lee YY, Majid NA, Noori NM, Raj SM

Southeast Asian J. Trop. Med. Public Health, 2013 Jan;44(1):19-24.

PMID: 23682433

We studied asymptomatic primary schoolchildren in northeastern Malaysia with light to moderate trichuriasis to determine the effect of albendazole treatment on growth rates and TNF-alpha levels. Thirty-seven schoolchildren aged 6-7 years with stool samples positive for Trichuris trichiura and negative for other geohelminths and protozoa were randomized to receive albendazole 400 mg or a placebo daily for 2 days. Anthropometric parameters at baseline, 3, 6 and 12 months were compared between the 2 groups. The placebo group had a significantly greater increase in height (p = 0.04) than the albendazole treatment group. There were no significant differences in urinary TNF-alpha levels (p = 0.8) between the 2 groups and no significant changes between baseline and 1 month post-treatment levels. Further studies are needed to determine the etiology of this apparent association between the albendazole treatment group and the delay in growth rate at 6 months post-treatment.

Matched MeSH terms: Anthelmintics/therapeutic use*

Fulltext Prevalence and associated factors of Schistosomiasis among children in Yemen: implications for an effective control programme

Sady H, Al-Mekhlafi HM, Mahdy MA, Lim YA, Mahmud R, Surin J

PLoS Negl Trop Dis, 2013;7(8):e2377.

PMID: 23991235 DOI: 10.1371/journal.pntd.0002377

BACKGROUND: Schistosomiasis, one of the most prevalent neglected tropical diseases, is a life-threatening public health problem in Yemen especially in rural communities. This cross-sectional study aims to determine the prevalence and associated risk factors of schistosomiasis among children in rural Yemen.

METHODS/FINDINGS: Urine and faecal samples were collected from 400 children. Urine samples were examined using filtration technique for the presence of Schistosoma haematobium eggs while faecal samples were examined using formalin-ether concentration and Kato Katz techniques for the presence of S. mansoni. Demographic, socioeconomic and environmental information were collected via a validated questionnaire. Overall, 31.8% of the participants were found to be positive for schistosomiasis; 23.8% were infected with S. haematobium and 9.3% were infected with S. mansoni. Moreover, 39.5% of the participants were anaemic whereas 9.5% had hepatosplenomegaly. The prevalence of schistosomiasis was significantly higher among children aged >10 years compared to those aged ≤ 10 years (P<0.05). Multivariate analysis confirmed that presence of other infected family member (P<0.001), low household monthly income (P = 0.003), using unsafe sources for drinking water (P = 0.003), living nearby stream/spring (P = 0.006) and living nearby pool/pond (P = 0.002) were the key factors significantly associated with schistosomiasis among these children.

CONCLUSIONS/SIGNIFICANCE: This study reveals that schistosomiasis is still highly prevalent in Yemen. These findings support an urgent need to start an integrated, targeted and effective schistosomiasis control programme with a mission to move towards the elimination phase. Besides periodic drug distribution, health education and community mobilisation, provision of clean and safe drinking water, introduction of proper sanitation are imperative among these communities in order to curtail the transmission and morbidity caused by schistosomiasis. Screening and treating other infected family members should also be adopted by the public health authorities in combating this infection in these communities.

Matched MeSH terms: Anthelmintics/therapeutic use

Fulltext Severe chronic iron deficiency anaemia secondary to Trichuris dysentery syndrome - a case report

Azira N MS, Zeehaida M

Trop Biomed, 2012 Dec;29(4):626-31.

PMID: 23202608

Trichuris dysentery syndrome is caused by Trichuris trichiura which contributes to one of the most common helminthic infections in the world. It is associated with heavy colonic infection that manifests as mucoid diarrhoea, rectal bleeding, rectal prolapse, iron deficiency anaemia, and finger clubbing. Here, we report a case of trichuris dysentery syndrome complicated with severe chronic iron deficiency anaemia in a 4-year-old girl who required blood transfusion. The nematode was visualized on stool microscopic and colonoscopic examination. A longer duration of anti-helminthic treatment is required to achieve effective and better outcome.

Matched MeSH terms: Anthelmintics/therapeutic use

Fulltext Symptomatic chronic strongyloidiasis in children following treatment for solid organ malignancies: case reports and literature review

Norsarwany M, Abdelrahman Z, Rahmah N, Ariffin N, Norsyahida A, Madihah B, et al.

Trop Biomed, 2012 Sep;29(3):479-88.

PMID: 23018511

Strongyloidiasis is an infection caused by the intestinal nematode Strongyloides stercoralis. Infected healthy individuals are usually asymptomatic, however it is potentially fatal in immunocompromised hosts due to its capacity to cause an overwhelming hyperinfection. Strongyloidiasis could be missed during routine screening because of low and intermittent larval output in stool and variable manifestations of the symptoms. We present two cases of strongyloidiasis occurring in children with solid organ malignancies suspected to have the infection based on their clinical conditions and treatment history for cancer. Both patients were diagnosed by molecular and serological tests and were successfully treated. Thus, strongyloidiasis in patients undergoing intensive treatment for malignancies should be suspected, properly investigated and treated accordingly.

Matched MeSH terms: Anthelmintics/therapeutic use

Cutaneous larva migrans in Hospital Kuala Lumpur, Malaysia: rate of correct diagnosis made by the referring primary care doctors

Yap FB

Trans R Soc Trop Med Hyg, 2011 Jul;105(7):405-8.

PMID: 21600621 DOI: 10.1016/j.trstmh.2011.04.002

A retrospective study was undertaken to determine the clinical features of cutaneous larva migrans (CLM) seen in the Department of Dermatology, Hospital Kuala Lumpur (Kuala Lumpur, Malaysia) and to assess the rate of correct diagnosis made by the referring primary care doctors. Clinical records of all 31 patients with CLM seen between January 2006 and June 2010 were retrieved. The majority of patients were male. The mean age was 32.2 years. Pruritus was reported in 83.9% of cases and serpiginous tracts in 100%. The mean lesion count was 4.4 and the mean duration of disease before presentation was 3.1 weeks. The majority of skin lesions were on the buttock and lower extremities. Only 45.2% of patients had the correct diagnosis made by the referring primary care doctors. Older age of patients and lower number of lesions were associated with a higher rate of correct diagnosis. The low rate of correct diagnosis made by the referring primary care doctors to the dermatologists in this study warrants the need for education of not only primary care doctors but also future primary care providers, consisting of medical students, house officers and junior medical officers.

Study site: Department of Dermatology, Hospital Kuala Lumpur

Matched MeSH terms: Anthelmintics/therapeutic use

Fulltext Intraocular nematode with diffuse unilateral subacute neuroretinitis: case report

Yusoff M, Alwi AA, Said MM, Zakariah S, Ghani ZA, Zunaina E

BMC Ophthalmol, 2011;11:15.

PMID: 21679403 DOI: 10.1186/1471-2415-11-15

Live intraocular nematode is a rare occurrence. Nematode can migrate actively within the eye, creating visual symptoms and damaging ocular tissue.

Matched MeSH terms: Anthelmintics/therapeutic use

Fulltext An increasingly notorious mimicker of testicular tumours; crossing borders

Periyasamy P, Subramaniam SR, Rajalingham S

BMJ Case Rep, 2011;2011.

PMID: 22675021 DOI: 10.1136/bcr.09.2011.4816

Data from the WHO state that up to 85% of cases of human schistosomiasis are from Africa. The common sites of this parasitic infection are the intestine and bladder. Testicular schistosomiasis is extremely rare but the number of reported cases worldwide has doubled over the past decade. The authors report a case of testicular schistosomiasis of a Myanmar immigrant in Malaysia who presented with a 6-month history of progressively enlarging left testicular swelling. His biochemical markers and cultures were not suggestive of an ongoing infection. Hence, a testicular malignancy was strongly suspected, for which, he underwent a left orchidectomy. Our clinical suspicion was proven wrong when the histopathology of the removed left testis revealed schistosomal eggs with granulamatous tissue formation. Subsequently, the patient was treated with praziquantel.

Matched MeSH terms: Anthelmintics/therapeutic use

Hypereosinophilia responding to empirical antihelminthic treatment

Loh KY, Lee XE

Southeast Asian J. Trop. Med. Public Health, 2010 Nov;41(6):1322-3.

PMID: 21329305

We report a 20-year-old college student presents with bilateral ankle edema associated with hypereosinophilia following a history of traveling in a rural area. Physical examinations and investigations failed to diagnose any underlying cause. She was treated with antihelminth medication and the edema subsided within a week and the eosinophil counts normalized within two weeks.

Matched MeSH terms: Anthelmintics/therapeutic use*

Fulltext Creeping eruption

Yap FB

Int J Infect Dis, 2010 Jun;14(6):e545.

PMID: 19889564 DOI: 10.1016/j.ijid.2009.07.006

Matched MeSH terms: Anthelmintics/therapeutic use*

Fulltext A survey of parasitic infection on small ruminant farms in Kinta and Hilir Perak districts, Perak, Malaysia

Chandrawathani P, Nurulaini R, Adnan M, Premalaatha B, Khadijah S, Jamnah O, et al.

Trop Biomed, 2009 Apr;26(1):11-5.

PMID: 19696722 MyJurnal

This paper reports the occurrence of helminth and protozoan infections on small ruminants from eight farms situated in Kinta and Perak Tengah district, Perak. The results of this survey indicate that helminthiasis and coccidiosis is rampant in sheep and goat farms. Several anthelmintics have been used for the control of helminths. The smallholders depended on health and extention services from the State Veterinary Department. This survey is part of an ongoing programme by the Department of Veterinary Services to upgrade services and report the current status of parasitic diseases in the state.

Matched MeSH terms: Anthelmintics/therapeutic use

Fulltext A second case of diphyllobothriasis in Malaysia

Rohela M, Jamaiah I, Goh KL, Nissapatorn V

Southeast Asian J. Trop. Med. Public Health, 2006 Sep;37(5):896-8.

PMID: 17333730

Diphyllobothriasis was first reported in Malaysia in 2002. We are reporting a second case of diphyllobothriasis in Malaysia. The patient was a 37-year-old Chinese male seen at the outpatient clinic with a complaint of passing strands of white color flat worm in his stool. He had no other abdominal complaints. Laboratory and physical examinations were normal. Diphyllobothrium latum was confirmed by examination of the gravid proglottids passed out and the typical operculated eggs expelled from the ruptured proglottids. The patient had a history of eating raw fish. He was treated with a single dose of praziquantel.
Study site: Outpatient clinic, University Malaya Specialist Center (UMSC), Kuala Lumpur, Malaysia

Matched MeSH terms: Anthelmintics/therapeutic use

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