Soil-transmitted helminthiasis (STH), among the most common neglected tropical diseases, is a major public health problem in Malaysia with a possible impact on the nutritional status and school participation of rural children. This study was carried out among Aboriginal schoolchildren, living in an endemic area for STH in Malaysia, to determine the possible relationship between intestinal helminthiasis and school absenteeism. We also evaluated whether successful treatment of the infection will affect school attendance among the subjects. Stool analysis revealed that more than 90% of the subjects were infected with at least 1 helminth species, with Ascaris lumbricoides and Trichuris trichiura infections being most prevalent. Infection of moderate-to-heavy worm burdens, low level of fathers' education and anaemia were identified as the significant predictors of high absenteeism among the subjects (P<0·05). Following treatment of the infected children, it was found that school absenteeism was reduced significantly (P<0·01). In conclusion, STH continues to have significant impacts on public health, particularly in rural communities with a negatively significant effect on the school participation of Aboriginal children. A school-based de-worming programme should be introduced and incorporated in the current educational assistance targeted towards the Aboriginal communities, under the auspices of the government.
Soil-transmitted helminth (STH) infections in Malaysia are still highly prevalent, especially in rural and remote communities. Complete estimations of the total disease burden in the country has not been performed, since available data are not easily accessible in the public domain. The current study utilised geographical information system (GIS) to collate and map the distribution of STH infections from available empirical survey data in Peninsular Malaysia, highlighting areas where information is lacking. The assembled database, comprising surveys conducted between 1970 and 2012 in 99 different locations, represents one of the most comprehensive compilations of STH infections in the country. It was found that the geographical distribution of STH varies considerably with no clear pattern across the surveyed locations. Our attempt to generate predictive risk maps of STH infections on the basis of ecological limits such as climate and other environmental factors shows that the prevalence of Ascaris lumbricoides is low along the western coast and the southern part of the country, whilst the prevalence is high in the central plains and in the North. In the present study, we demonstrate that GIS can play an important role in providing data for the implementation of sustainable and effective STH control programmes to policy-makers and authorities in charge.
Introduction: World Health Organization in 2019 reported that about 1.5 billion people are infected with soil-trans-mitted helminths (STH) worldwide. Infected children with STH might manifest signs of anaemia and impaired nutri-tionally or physically. This study aimed to look at the prevalence of STH in the area of North Sabah among rural pri-mary schools and examine the associated factors. Methods: A cross-sectional study was conducted in four selected primary school in the district of Kudat of Sabah from 2014 to 2015. Tools used for the study were questionnaire and stool sampling. Questionnaire focused data on sociodemographic, hygiene and use of anti-helminths drugs. Stool samples collected were sent for microscopic examination for presence of STH ova. Written consents were obtained from parents/guardians. Chi-square was used to examine the association of having STH and factors on utilities fa-cilities, hygiene and anti-helminths drug. SPSS version 23 was used for statistical analysis. Results: There was 433 school children aged 7 to 12 years old with 224 males and 209 females respondents. Three-quarters main source of water supply in the homes from treated water. Those with proper built toilet were 96%. Practices of washing hands after toilet and before eating were 96% as well. Almost 95% wear slippers when outside homes. Only 61% took their anti-helminths drug in the past 1 year while in the last 6 months the uptake was 38.7%. The prevalence of positive ova of STH in the stool sample was 57 out of 433 or 13.2%. STH infection was not statistically significant associated with the above factors. Conclusion: The prevalence of STH infection among primary school children in the district of Kudat although has lowered over the years is still considered higher than most states in Malaysia. Continuous public health intervention is necessary to further bring down the prevalence of STH infections.
Helminth infections (HIs) are an important public health problem in tropical countries, and the associated problems have been neglected in rural areas of Thailand. Therefore, this study reports the prevalence and intensity of HIs among inhabitants of the Khon Sawan district, Chaiyaphum province, and Kaeng Samnam Nang district, Nakhon Ratchasima province, which are located near the Chi River and Lahanna water reservoir, northeastern Thailand. A cross-sectional descriptive study was conducted between July 31, 2018, and June 30, 2019, among rural villagers from 40 rural villages in 4 subdistricts. The participants were selected from the village enrolment list after proportional allocation of the total sample size. Faecal samples from 691 inhabitants were prepared using solvent-free faecal parasite concentrator, and helminths were then detected using a light microscope. Statistical analysis included the Chi-square test with Yates correction, and multivariable logistic regression was performed. A P-value of <0.05 was considered statistically significant. The prevalence of HIs was 2.03%. The most prevalent helminths were Opisthorchis viverrini (1.31%), followed by Strongyloides stercoralis (0.44%), Ascaris lumbricoides (0.29%), hookworm (0.15%), Teania spp. (0.15%) and one minute intestinal fluke (0.15%). Coinfections were identified in 2 cases for S. stercoralis and hookworm and 1 case for O. viverrini and S. stercoralis infection. All infected participants had a light intensity of HI. There was no significant difference between general characteristics for all HIs. The prevalence of HIs was not significantly associated with general characteristics. This study indicates that the infections result mainly from foodborne helminths and skin-penetrating nematodes. Therefore, interventions should concentrate on the personal hygiene of the population and improving sanitation to reduce HIs in this area.
Introduction Helminthiasis is a common parasitic condition particularly among children in
rural areas in developing countries where poor hygiene standard is practiced.
The study aimed to determine the prevalence of helminthiasis among Indian
preschoolers in urban areas in Penang and its associated factors.
Methods A total of 194 urban Indian preschoolers aged 4 to 6 years old were selected
randomly from 11 kindergartens in the state of Penang for this cross sectional
study. Data collection was carried out in 2 phases. First, microscopic stool
examinations were done to examine the presence of helminths. Second, self
administered questionnaires which inquired about human, environment and
socioeconomic factors were completed by the parents/guardians.
Results The overall prevalence of helminthiasis was 7.2% and the most frequently
encountered infective agent was Ascaris lumbricoides (57.1%) and followed
by the tapeworms (42.86%). The logistic regression indicated that habitual
thumb sucking (AOR= 5.6. 95%CI: 1.73-18.39) and families owning
domestic pets (AOR= 3.2; 95%CI: 1.03-10.14) were the significant
contributing factors to helminthiasis among the Indian pre-schoolers in urban
Penang. Although the prevalence of helminth infection among the urban
Indian preschoolers is lower than rural area, it is still a public health concern.
Children habitual thumb sucking and rearing domestic pets at home were the
significant contributing factors in helminthiasis.
Conclusion Prevention strategy should focus on health education and promotion among
adults and children, awareness on domestic animal hygiene and maintaining
good environmental sanitation. Multi agency collaboration is clearly
essential, especially between state health, education and veterinary
departments in curbing this disease.
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.
Helminth parasite infections are significantly impacting global health, with more than two billion infections worldwide with a high morbidity rate. The complex life cycle of the nematodes has made host immune response studies against these parasites extremely difficult. In this study, we utilized two phage antibody libraries; the immune and naïve library were used to identify single chain fragment variable (scFv) clones against a specific filarial antigen (BmR1). The V-gene analysis of isolated scFv clones will help shed light on preferential VDJ gene segment usage against the filarial BmR1 antigen in healthy and infected states. The immune library showed the usage of both lambda and kappa light chains. However, the naïve library showed preferential use of the lambda family with different amino acid distributions. The binding characteristics of the scFv clones identified from this work were analyzed by immunoassay and immunoaffinity pull down of BmR1. The work highlights the antibody gene usage pattern of a naïve and immune antibody library against the same antigen as well as the robust nature of the enriched antibodies for downstream applications.
Soil-transmitted helminth (STH) infections have been documented among these minority groups since 1938. However the prevalence of STH is still high among these communities. Most studies tend to consider the Orang Asli (indigenous) as a homogenous group. In contrary, different subtribes have their own cultural practices. To understand this variation better, we studied the prevalence and associated factors of STH and other gut parasitic infections among two common subtribes (i.e. Temuan and Temiar). Results showed that the prevalence of the overall STH infections was higher in the Temuan subtribe (53.2% of 171) compared to the Temiar subtribe (52.7% of 98). Trichuris trichiura (46.2%) was the most prevalent parasite in the Temuan subtribe, followed by Ascaris spp. (25.7%) and hookworm (4.1%). In contrast, Ascaris spp. (39.8%) was more prevalent among the Temiar subtribe, preceded by T. trichiura (35.7%) and finally hookworm (8.3%). There were also co-infections of helminthiasis and intestinal protozoa among both Temuan and Temiar subtribes with rates being three times higher among the Temiar compared to Temuan. The most common co-infection was with Entamoeba histolytica/dispar/moshkovskii (n = 24; 24.5%, 16.0-33.0), followed by Giardia spp. (n = 3; 3.1%, -0.3-6.5). In Temuan, STH infection individuals were also infected with Entamoeba histolytica/dispar/moshkovskii (n = 11; 6.4%, 5.0-13.8), Cryptosporidium spp. (n = 3, 1.8%, -0.2-3.8) and Giardia spp. (n = 2, 1.2%, -0.4-2.8). In comparison, there was no Cryptosporidium spp. detected among the Temiar. However, it was interesting to note that there was an occurrence of co-infection of intestinal helminthiasis and sarcocystosis (intestinal) in a Temiar individual. The last report of sarcocystosis (muscular) among the Orang Asli was in 1978. The present study highlighted the importance of understanding the variation of infections amongst the different Orang Asli subtribes. It is vital to note these differences and use this knowledge to customise effective control measures for the various subtribes.
Soil-transmitted helminth (STH) infections of humans fall within the World Health Organization's (WHO) grouping termed the neglected tropical diseases (NTDs). It is estimated that they affect approximately 1.4 billion people worldwide. A significant proportion of these infections are in the population of Southeast Asia. This review analyses published data on STH prevalence and intensity in Southeast Asia over the time period of 1900 to the present to describe age related patterns in these epidemiological measures. This is with a focus on the four major parasite species affecting humans; namely Ascaris lumbricoides, Trichuris trichiura and the hookworms; Necator americanus and Ancylostoma duodenale. Data were also collected on the diagnostic methods used in the published surveys and how the studies were designed to facilitate comparative analyses of recorded patterns and changes therein over time. PubMed, Google Scholar, EMBASE, ISI Web of Science, Cochrane Database of Systematic Reviews and the Global Atlas of Helminth Infections search engines were used to identify studies on STH in Southeast Asia with the search based on the major key words, and variants on, "soil-transmitted helminth" "Ascaris" "Trichuris" "hookworm" and the country name. A total of 280 studies satisfied the inclusion criteria from 11 Southeast Asian countries; Brunei, Cambodia, Indonesia, Lao People's Democratic Republic (Lao PDR), Malaysia, Myanmar, Philippines, Singapore, Thailand, Timor-Leste and Vietnam. It was concluded that the epidemiological patterns of STH infection by age and species mix in Southeast Asia are similar to those reported in other parts of the world. In the published studies there were a large number of different diagnostic methods used with differing sensitivities and specificities, which makes comparison of the results both within and between countries difficult. There is a clear requirement to standardise the methods of both STH diagnosis in faecal material and how the intensity of infection is recorded and reported in future STH research and in monitoring and evaluation (M&E) of the impact of continuing and expanding mass drug administration (MDA) programmes.
Saline extracts of ether-treated Dirofilaria immitis, Ascaris suum, and Ancylostoma spp. were used in indirect hemagglutination tests of serum from 164 patients with a diagnosis of eosinophilic lung and 114 persons with other diseases or no disease (blood donors). In the first group, positive reactions with one, two or all three antigens were obtained in 89 percent of cases and the titers, at medium or high levels in 77 percent, decreased after treatment with diethylcarbamazine. In the other group, antibodies were demonstrable in the serum of only 22 percent of cases and titers usually were low. These observations indicate the presence of several antigen-antibody systems, some of which appear to be specific. With extracts of Dirofilaria the indirect hemagglutination and the complement-fixation tests were similar in sensitivity and specificity, but the results from neither test appeared to indicate infection with a specific worm.
The prevalence of intestinal parasitic infections among schoolchildren in Colalao del Valle, a high-altitude community in Tucumán province, Argentina, was investigated. The data revealed a high prevalence of parasitism (79.7%) with no significant differences in distribution by sex or age. Protozoa infections were the most common with Blastocystis hominis being the most prevalent (62.5%), followed by Giardia lamblia (29.7%), Endolimax nana (15.6%), Entamoeba coli (12.5%) and Iodamoeba bütschlii (3.1%). Interestingly, there was an absence of soil-transmitted helminths among the studied population which could be related to climate (variable temperatures, moderate rainfall) and soil type (clay).
Studies on parasite populations in Antarctic soils are scarce and thus little is known about the threat of these parasites towards either the natural fauna or human visitors. However, human presence in Antarctica, mainly through research and tourism, keeps increasing over time, potentially exposing visitors to zoonotic infections from Antarctic wildlife and environment. Most available literature to date has focused on faecal samples from Antarctic vertebrates. Therefore, this study addressed the possible presence of parasites in Antarctic soil that may be infectious to humans. Soil samples were obtained from five locations on Signy Island (South Orkney Islands, maritime Antarctic), namely North Point and Gourlay Peninsula (penguin rookeries), Pumphouse (relic coal-powered pump house), Jane Col (barren high altitude fellfield) and Berntsen Point (low altitude vegetated fellfield close to current research station). Approximately 10% of the soil samples (14/135) from 3 out of the 5 study sites had parasites which included Diphyllobotridae spp. eggs, Cryptosporidium sp., an apicomplexan protozoa (gregarine), Toxoplasma gondii, helminths (a cestode, Tetrabothrius sp., and a nematode larva) and mites. The presence of parasites in the 3 sites are most likely due to the presence of animal and human activities as two of these sites are penguin rookeries (North Point and Gourlay Peninsula) while the third site (Pumphouse Lake) has human activity. While some of the parasite species found in the soil samples appear to be distinctive, there were also parasites such as Cryptosporidium and Toxoplasma gondii that have a global distribution and are potentially pathogenic.
The Orang Aslis are indigenous minority peoples of Peninsular Malaysia, numbering 147,412 in 2003.Currently, the Orang Asli are divided into four language groupings namely the Northern Aslian, the Central Aslian, and the Southern Aslian groups, all of whom speak Austroasiatic languages; a fourth group in the South of Peninsular Malaysia speak a Malay dialect belonging to the Austronesian group of languages.This research was carried out on only one of the Northern Aslian group, the Jehai, who are also named Negritos based on their physical features. The Jehai live in the Belum and the Temenggor Forest that straddles Upper Perak and West Kelantan and until recently, were nomadic and lived by hunting-gathering.The World Health Organization (WHO) estimates that approximately two billion people worldwide are infected with the soil-transmitted nematode helminths,Ascaris lumbricoides, Trichuris trichiura and the hookworms Necator americanus and Ancylostoma duodenale, with 400 million of these infected being children of school age.Global numbers of A. lumbricoides infection have been estimated at about 1.5 billion cases. (Crompton, 2001). T. trichiura infection affects approximately 1,049 million people worldwide and an estimated 1.2 billion people are infected by hookworms. In Malaysia, the most common soil-transmitted helminth infections are A. lumbricoides, T. trichiura and hookworms.
However, as there have been no extensive surveys on these infections, it is difficult to estimate with certainty the current overall incidence of infection with soil-transmitted helminths (STHs) among the Malaysian population.
The total serum IgE levels in infants and children was quantitated by the radioimmunoassay technique. The serum levels increased from about 300 IUlml in the 2-3 month old infants to about 8000 1U/m1 in the 10-year-old children who were probably infected with intestinal helminths. The total serum IgE levels in infants with cow's milk protein-sensitive entero-pathy were similar in level to those in normal infants. Infants and children with acute gastroenteritis, giardia infection and malnutrition had elevated levels of serum IgE levels. The high serum I gE levels noted in Malaysian children are probably indicative of the pattern in the tropics. (Copied from article).
Introduction Strongyloides stercoralis is an intestinal helminth that infects humans
through contact with soil containing the larvae.
Methods A systematic search was performed for relevant titles, abstract and keywords
in database from Cochrane Library, PLOS One, PubMed and several other
sources in October 2017 based on PICO strategy. Out of 511 papers that were
evaluated for possible inclusion, final assessment for eligibility has yielded a
total of 17 papers to be included which were found suitable for analysis
covering period from 2012 till 2016.
Results A major challenge of giving an overview of prevalence data for S. stercoralis
lies in the low sensitivity of diagnostic method used which resulted in very
low prevalence in certain countries. Cambodia and Laos presented with high
prevalence ranging from 17.4% to 45.9% by using high sensitivity of
diagnostic methods. The current prevalence situation of S. stercoralis in
Southeast Asia still have wide gaps remains due to several reasons.
Conclusions The information we have today only scratches the surface which cannot truly
reflect the true burden of S. stercoralis in Southeast Asia The main risk factor
is personal hygiene practices especially amongst males.
The present study was designed to study the enteric parasites infection in domestic rabbits in Upper Egypt and its impact on their health. A total of 298 faecal samples were collected from different farms in Upper Egypt. Each faecal sample was screened for parasitic isolation during May 2011- October 2012. Furthermore, The Eimeria species from samples containing isolated and sporulated oocysts were morphologically identified under microscope. Additionally, the Sheather's sugar flotation and Modified Zeihl Neelsen techniques were used to detect the Cryptosporidium species oocyst. According to results of the present study, the overall enteric parasite infections in rabbits was 68.12%, with 5.7% samples were found to be positive for helminths (P. ambiguus) and 49% were found to harbour various species of protozoa (Eimeria spp. and Cryptosporidium oocysts). Influences of age, sex and breed on the prevalence were recorded. Also, there was strong significant seasonal trends in the prevalence of the recovered parasites. Eight species of Eimeria were detected. Concurrent infection with two to eight Eimeria species occurred most frequently. Cryptosporidium oocyst was detected in 45 rabbits (15.1%). To the best of author's knowledge, this the first report of E. piriformis and Cryptosporidium species in rabbits in Egypt. Histopathological changes were indicative of inflammatory reactions brought about by parasitic infection with Eimeria species and its consequent irritating effects on intestine. The current study showed the characteristics of the prevalence of rabbit enteric parasite infection in Egypt and provided relevant 'baseline' data for assessing the effectiveness of future control strategies against these parasites in Egypt.
In the first part of this study, we investigated the prevalence and associated key factors of soil-transmitted helminth (STH) infections among Orang Asli children in rural Malaysia; an alarming high prevalence and five key factors significantly associated with infections were reported. Part 2 of this study aims to evaluate the knowledge, attitude and practices (KAP) on STH infections among Orang Asli in Peninsular Malaysia.
Intestinal parasites are the causative agents of a number of important human infections in developing countries. The objective of this study was to determine the prevalence of selected helminths and protozoan infections among patients admitted with gastrointestinal disorders at Hospital Universiti Sains Malaysia, Kelantan, Malaysia using multiplex real-time PCR. In addition microscopic examination was also performed following direct smear, zinc sulphate concentration and Kato-Katz thick smear techniques; and the presence of protozoan parasites was confirmed using trichrome and acid-fast stains. Of the 225 faecal samples analysed, 26.2% were positive for intestinal parasites by the multiplex real-time PCR, while 5.3% were positive by microscopy. As compared to microscopy, the multiplex real-time PCR detected 5.8 and 4.5 times more positives for the selected helminth and protozoan infections respectively. Among the selected helminths detected in this study, hookworm was the most prevalent by real-time PCR, while Ascaris lumbricoides was detected the most by microscopy. Meanwhile, among the selected protozoa detected in this study, Entamoeba histolytica was the most prevalent by real-time PCR, however microscopy detected equal number of cases with E. histolytica and Giardia lamblia. This study showed that real-time PCR can be used to obtain a more accurate prevalence data on intestinal helminths and protozoa.
The Corona pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) calls on the Saudi government to take action to control the infection. The government closed borders, prohibited travel, limited outdoor movements, and told primary and secondary care facilities to reduce all regular non-urgent health services. It is not known whether these measures have impacted the prevalence of parasitic intestinal infections. This study has therefore been carried out to investigate this issue. Dataset of 217 stool samples submitted to the King Faisal Medical Complex (KFMC) Microbiology Laboratory in Taif, Saudi Arabia for parasitological examination during the pandemic (January-June 2020) and 649 samples submitted during the corresponding months of the previous year (January-June 2019) were extracted and analyzed. Overall, 24.1% (209/866) of samples were parasitespositives; 26.6% (173/649) before and 16.5% (36/217) during the pandemic, with 79% reduction. There was a significant difference in gender-parasitism between the two periods where the majority of parasitism were for males (p<0.001). Infections were frequent in patients aged 5- 14 years both before (84/649; 12.9%) and during (12/217; 5.5%) the pandemic, with significant difference observed between the two cohorts (p<0.002). Moreover, the majority of infected patients were non-Saudi (67.9%; 142/209), with a significant difference in nationality reported, (p=0.024). Protozoa were identified in 21.8% (189) of all samples investigated, of which, Blastocystis hominis, Entamoeba coli, Giardia lamblia, Entamoeba histolytica/dispar and Cryptosporidium species were identified in 6.1% (53), 5.4% (47), 5.0% (44), 2.8% (25), and 2.3% (20), respectively. Helminths were diagnosed in 2.3% (20/866) of samples. Eggs of hookworm, Ascaris, Taenia spp, and Hymenolepis nana were detected in 0.9% (8), 0.5% (5), 0.3% (3) and 0.4% (4), respectively. In parallel with our research hypothesis, a substantial decrease in the burden of intestinal parasitic infections was recorded with the lock-down measures taken during the Corona pandemic.