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Fulltext Ascariasis, trichuriasis, and growth of schoolchildren in Northeastern Peninsular Malaysia

Raj SM, Naing NN

Southeast Asian J Trop Med Public Health, 1998 Dec;29(4):729-34.
PMID: 10772554

A study to determine the effect of antihelminthic treatment on growth and nutritional status was undertaken on 103 children in the second grade of primary school, 71 of whom were found to be infected with Ascaris lumbricoides or Trichuris trichiura. The median Ascaris and Trichuris intensities in the infected group were 19,600 (range; 0-488,000) and 2,800 (range; 0-84,600) eggs per gram of feces respectively. Forty-three children harbored both types of worm. Fourteen weeks after two 400 mg doses of albendazole were administered to infected children, the increases in weight, height, weight for age, height for age and weight for height were significantly higher among infected children than controls who were uninfected at baseline. The observed gains were independent of sex and socioeconomic status. Decrease in log transformed Trichuris intensity correlated with increases in weight (r=0.24; p=0.02) and weight for age (r=0.20; p=0.06) but decrease in Ascaris intensity did not correlate with increases in any of the anthropometric parameters. The results suggest that antihelminthic treatment has beneficial short-term effects on growth and nutritional status of a modest magnitude among early primary schoolchildren in the area.

Matched MeSH terms: Trichuriasis/drug therapy*; Trichuriasis/epidemiology
Fulltext Intestinal helminthiasis in relation to height and weight of early primary school children in northeastern peninsular Malaysia

Mahendra Raj S, Sein KT, Khairul Anuar A, Mustaffa BE

Southeast Asian J Trop Med Public Health, 1997 Jun;28(2):314-20.
PMID: 9444012

Stool examination, height and weight measurements were undertaken on 249 early primary school children at two schools in North-eastern Peninsular Malaysia. Helminth infected children were treated and follow-up anthropometric measurements and stool examination undertaken on all (n = 100) children at one of the schools 16 months later; to observe the relationship between acquisition of infection and growth. Baseline Ascaris prevalence rates at the two schools were 16.0% (23/144) and 47.6% (50/105) respectively whilst Trichuris rates were 33.3% (48/144) and 52.4% (55/105). Hookworm infection was uncommon. There was no difference in weight or height for age between infected and uninfected children at any time. Acquisition of worm infection over the initial 16 month follow-up period was not associated with significant decreases in growth rates. However the small subsets of children with heavy Ascaris infection were consistently lighter and shorter at all evaluation times. They also gained significantly less weight and tended to have reduced linear growth rates between measurements. Further interventional studies are required to determine if this association is one of cause and effect or largely incidental.

Matched MeSH terms: Trichuriasis/epidemiology*; Trichuriasis/physiopathology
Effect of intestinal helminthiasis on school attendance by early primary schoolchildren

Raj SM, Sein KT, Anuar AK, Mustaffa BE

Trans R Soc Trop Med Hyg, 1997 3 1;91(2):131-2.
PMID: 9196748

Stool examination of 249 early primary schoolchildren at 2 schools in north-eastern peninsular Malaysia revealed that 73 were infected with Ascaris lumbricoides, 103 with Trichuris trichiura, and 18 with hookworms. Infected children were treated with a single dose of 400 mg of albendazole. The school attendance records during a 60 d period before treatment and 2 consecutive 60 d periods after treatment were examined. The absenteeism rate did not improve more among infected children after treatment than it did among the uninfected control children. The correlation between worm intensity and the number of lost school-days was poor. There was no evidence that intestinal helminthiasis caused school absenteeism among this group of children.

Matched MeSH terms: Trichuriasis/drug therapy; Trichuriasis/parasitology
Effect of intestinal helminthiasis on intestinal permeability of early primary schoolchildren

Raj SM, Sein KT, Anuar AK, Mustaffa BE

Trans R Soc Trop Med Hyg, 1996 11 1;90(6):666-9.
PMID: 9015510

Intestinal permeability of 246 early primary schoolchildren at 2 schools (106 of whom were infected with intestinal helminths) was assessed by using the lactulose/mannitol differential absorption test. The ratio of the urinary recoveries of lactulose and mannitol was determined after oral administration of a standard solution of the 2 sugars. Assessment of intestinal permeability was repeated on 100 infected children after treatment and on a cohort of 68 uninfected children. Infected and uninfected groups were compared with respect to baseline lactulose/mannitol ratio (L/M1) and change in lactulose/mannitol ratio between assessments (delta L/M). The correlations between baseline intensity of infection and L/M1, and between fall in intensity and delta L/M, were evaluated. Based on a crude index of socioeconomic status, each child was assigned to one of 3 socioeconomic groups; all but 3 children belonged to either groups 2 or 3. Trichuris trichiura and Ascaris lumbricoides were the 2 predominant infections; the hookworm infection rate was relatively low. The results suggested that helminthiasis exerted only a marginal effect on intestinal permeability, the impact of which in children from lower socioeconomic backgrounds was negligible in comparison with the cumulative effects of other factors.

Matched MeSH terms: Trichuriasis/drug therapy; Trichuriasis/metabolism
Fulltext Efficacy of single dose albendazole on the prevalence and intensity of infection of soil-transmitted helminths in Orang Asli children in Malaysia

Norhayati M, Oothuman P, Azizi O, Fatmah MS

Southeast Asian J Trop Med Public Health, 1997 Sep;28(3):563-9.
PMID: 9561609

The efficacy of a single-dose 400 mg albendazole to treat Ascaris, Trichuris and hookworm infection was studied in Orang Asli community. Kato-Katz examination was performed on fecal samples which were collected before treatment, 1 and 4 months after treatment. A total of 123 children were involved in all three surveys. The cure rate of Ascaris infection was 97.4% and the egg reduction after treatment was 99.9%. The cure rate for hookworm infection was 93.1% with 96.6% egg reduction. Although the cure rate was low in Trichuris infection (5.5%), egg reduction was more evident (49.1%). The reinfection rate at 4 months after treatment was 54.5%, 3.6% and 10.3% for Ascaris, Trichuris and hookworm infection, respectively. Within 4 months after treatment almost one-fifth children with Ascaris and hookworm infection reached pre-treatment intensity infection. In Trichuris infection, however more than half of the children reached their pre-treatment intensity infection at 4 months after treatment. Findings suggest that 4-monthly targeted periodic treatment with 400 mg single-dose albendazole in highly endemic areas can have a significant impact on intensity infection of Ascaris and hookworm, but not on Trichuris infection.

Matched MeSH terms: Trichuriasis/drug therapy*; Trichuriasis/transmission
The effect of repeated chemotherapy on age-related predisposition to Ascaris lumbricoides and Trichuris trichiura

Chan L, Kan SP, Bundy DA

Parasitology, 1992 Apr;104 ( Pt 2):371-7.
PMID: 1594301

This study examines the persistence of predisposition to Ascaris lumbricoides and Trichuris trichiura during repeated chemotherapy in an urban community in Kuala Lumpur, Malaysia. Significant predisposition was observed over 2 periods of reinfection with and without age-standardization of data. Analysis of different age groups indicated that predisposition was most strongly detectable in the younger age classes. The intensities of infection with both parasites were strongly correlated at each cycle of intervention, suggesting that individuals were similarly predisposed to both species.

Matched MeSH terms: Trichuriasis/drug therapy*; Trichuriasis/epidemiology
Fulltext Helminthic infections of urban and rural schoolchildren in Penang Island, Malaysia: implications for control

Rahman WA

Southeast Asian J Trop Med Public Health, 1998 Sep;29(3):596-8.
PMID: 10437964

The intestinal parasites of schoolchildren from an urban and a rural area on Penang island, Malaysia were compared. Examination of stool samples for helminth eggs showed that helminths found were Trichuris, Ascaris and hookworms. The results indicate that there is no significant difference (p<0.05) between rural and urban schoolchildren as regards to the prevalence of the three species of helminths. An extensive control program targetted at schoolchildren to monitor the helminth problem on the island is suggested.

Matched MeSH terms: Trichuriasis/epidemiology*; Trichuriasis/prevention & control
Fecal occult blood testing on Trichuris-infected primary school children in northeastern peninsular Malaysia

Raj SM

Am J Trop Med Hyg, 1999 Jan;60(1):165-6.
PMID: 9988342

Stool specimens of 104 primary schoolchildren (mean+/-SD age = 8.2+/-0.3 years) were examined for helminth eggs and for occult blood to investigate the possibility that trichuriasis causes occult intestinal bleeding in the absence of the overt Trichuris dysentery syndrome. A commercially available guaiac test was used to detect fecal occult blood. Sixty-one children had Trichuris infection, 11 of whom had heavy infections (> 10,000 eggs per gram of feces [epg]), and 53 had Ascaris infections. No hookworm infection was detected. Baseline screening yielded only one weakly positive occult blood test result in a child with a light (800 epg) Trichuris infection. Serial stool occult blood testing on the 11 subjects with heavy trichuriasis and 8 uninfected controls yielded a single weakly positive result in the control group. The results provide no evidence that trichuriasis predisposes to significant occult gastrointestinal bleeding in children in the absence of the dysenteric syndrome.

Matched MeSH terms: Trichuriasis/complications*; Trichuriasis/epidemiology
Fulltext Ascaris and Trichuris do not contribute to growth retardation in primary school children

Lai KP, Kaur H, Mathias RG, Ow-Yang CK

Southeast Asian J Trop Med Public Health, 1995 Jun;26(2):322-8.
PMID: 8629068

To access the effectiveness of the treatment of soil-transmitted helminthiasis (STH) on the growth of primary school children, 353 children were block stratified to receive either mebendazole plus pyrantel oxantel pamoate every three months or a placebo. The children were followed for two years with 89% completing the trial. Follow-up stools indicated that the treatment was efficacious for ascariasis and trichuriasis. There was virtually no hookworm infection. The children were malnourished as measured by the number below -2 SD of height and weight standards. There was no difference in height or weight between the treatment and control groups by sex initially or at the end of two years of follow-up. The treatment of Ascaris and Trichuris had no effect on growth parameters. The effect of STH on growth may be mediated through hookworm infections.

Matched MeSH terms: Trichuriasis/complications*; Trichuriasis/drug therapy
Fulltext Fecal parasite risk in the endangered proboscis monkey is higher in an anthropogenically managed forest environment compared to a riparian rain forest in Sabah, Borneo

Klaus A, Strube C, Röper KM, Radespiel U, Schaarschmidt F, Nathan S, et al.

PLoS One, 2018;13(4):e0195584.
PMID: 29630671 DOI: 10.1371/journal.pone.0195584

Understanding determinants shaping infection risk of endangered wildlife is a major topic in conservation medicine. The proboscis monkey, Nasalis larvatus, an endemic primate flagship species for conservation in Borneo, is endangered through habitat loss, but can still be found in riparian lowland and mangrove forests, and in some protected areas. To assess socioecological and anthropogenic influence on intestinal helminth infections in N. larvatus, 724 fecal samples of harem and bachelor groups, varying in size and the number of juveniles, were collected between June and October 2012 from two study sites in Malaysian Borneo: 634 samples were obtained from groups inhabiting the Lower Kinabatangan Wildlife Sanctuary (LKWS), 90 samples were collected from groups of the Labuk Bay Proboscis Monkey Sanctuary (LBPMS), where monkeys are fed on stationary feeding platforms. Parasite risk was quantified by intestinal helminth prevalence, host parasite species richness (PSR), and eggs per gram feces (epg). Generalized linear mixed effect models were applied to explore whether study site, group type, group size, the number of juveniles per group, and sampling month predict parasite risk. At the LBPMS, prevalence and epg of Trichuris spp., strongylids, and Strongyloides spp. but not Ascaris spp., as well as host PSR were significantly elevated. Only for Strongyloides spp., prevalence showed significant changes between months; at both sites, the beginning rainy season with increased precipitation was linked to higher prevalence, suggesting the external life cycle of Strongyloides spp. to benefit from humidity. Higher prevalence, epgs, and PSR within the LBPMS suggest that anthropogenic factors shape host infection risk more than socioecological factors, most likely via higher re-infection rates and chronic stress. Noninvasive measurement of fecal parasite stages is an important tool for assessing transmission dynamics and infection risks for endangered tropical wildlife. Findings will contribute to healthcare management in nature and in anthropogenically managed environments.

Matched MeSH terms: Trichuriasis/parasitology; Trichuriasis/transmission; Trichuriasis/veterinary
Trichuriasis in Malaya

Pallister RA

Malayan Medical Journal, 1933;8:303-5.

Matched MeSH terms: Trichuriasis
Whipworms of south-east Asian rodents are distinct from Trichuris muris

Ribas A, Wells K, Morand S, Chaisiri K, Agatsuma T, Lakim MB, et al.

Parasitol Int, 2020 Aug;77:102128.
PMID: 32330535 DOI: 10.1016/j.parint.2020.102128

The whipworm Trichuris muris is known to be associated with various rodent species in the northern hemisphere, but the species identity of whipworm infecting rodents in the Oriental region remains largely unknown. We collected Trichuris of Muridae rodents in mainland and insular Southeast Asia between 2008 and 2015 and used molecular and morphological approaches to identify the systematic position of new specimens. We discovered two new species that were clearly distinct from T. muris, both in terms of molecular phylogenetic clustering and morphological features, with one species found in Thailand and another one in Borneo. We named the new species from Thailand as Trichuris cossoni and the species from Borneo as Trichuris arrizabalagai. Molecular phylogeny using internal transcribed spacer region (ITS1-5.8S-ITS2) showed a divergence between T. arrizabalagai n. sp., T. cossoni n. sp. and T. muris. Our findings of phylogeographically distinct Trichuris species despite some globally distributed host species requires further research into the distribution of different species, previously assumed to belong to T. muris, which has particular relevance for using these species as laboratory model organisms.

Matched MeSH terms: Trichuriasis
Fulltext Efficacy of Albendazole-Pyrantel Pamoate Compared to Albendazole Alone for Trichuris trichiura Infection in Children: A Double Blind Randomised Controlled Trial

Sapulete EJJ, de Dwi Lingga Utama IMG, Sanjaya Putra IGN, Kanya Wati D, Arimbawa IM, Gustawan IW

Malays J Med Sci, 2020 May;27(3):67-74.
PMID: 32684807 DOI: 10.21315/mjms2020.27.3.7

Background: Soil transmitted helminths (STH) are intestinal nematodes and constitute one of the most neglected tropical diseases to exist. Objective: This study determined the efficacy of albendazole-pyrantel pamoate compared to albendazole in 8-12 years old children with Trichuris trichiura infection.
Methods: A randomised controlled trial was conducted between October 2017 and February 2018 on participants whose stool examinations confirmed the presence of Trichuris trichiura infection. The subjects were randomised into two groups. The statistical analysis used Chi-square test.
Results: There were 392 of 600 children at five public elementary schools in Bangli and Bali and were infected with Trichuris trichiura. The cure rate of Trichuris trichiura infection seven days following treatment was lower with the combination of albendazole and pyrantel pamoate compared to that of albendazole. The egg reduction rate of Trichuris trichiura infection was lower with the combination of albendazole and pyrantel pamoate compared to albendazole.
Conclusion: The study indicated that a combination of albendazole and pyrantel pamoate does not improve cure rate or egg reduction rate in 8-12 years old children with Trichuris trichiura infection.

Matched MeSH terms: Trichuriasis
Fulltext The effect of repeated chemotherapy on the prevalence and intensity of Ascaris lumbricoides and Trichuris trichiura infection

Chan L, Kan SP, Bundy DA

Southeast Asian J Trop Med Public Health, 1992 Jun;23(2):228-34.
PMID: 1439974

The prevalence and intensity of intestinal nematode infections were assessed during 3 anthelminthic interventions in an urban community in Malaysia. The prevalence levels of Ascaris lumbricoides at Interventions 1, 2 and 3 were 30.6%, 18.9% and 15.5%, respectively and the mean intensities were 1.9, 0.75 and 0.81 worms per person. For Trichuris trichiura, the prevalence levels at Interventions 1, 2 and 3 were 46.9%, 21.6% and 15.7%, respectively. The mean intensities for T. trichiura at Interventions 1, 2 and 3 were 3.30, 0.92 and 0.07 worms per person. No gender-related prevalence and intensity were observed for the two geohelminths in this community. Prevalences and intensity had convex age profiles. Although repeated chemotherapeutic intervention reduced both prevalence and intensity levels, intensity was a more sensitive indicator than prevalence. The results indicate that age-targetting treatment at school children of 7-12 years of age would be an appropriate strategy for this community.

Matched MeSH terms: Trichuriasis/drug therapy*; Trichuriasis/epidemiology; Trichuriasis/parasitology
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: Trichuriasis/drug therapy*; Trichuriasis/epidemiology; Trichuriasis/pathology
Pattern and predictors of soil-transmitted helminth reinfection among aboriginal schoolchildren in rural Peninsular Malaysia

Hesham Al-Mekhlafi M, Surin J, Atiya AS, Ariffin WA, Mohammed Mahdy AK, Che Abdullah H

Acta Trop, 2008 Aug;107(2):200-4.
PMID: 18582430 DOI: 10.1016/j.actatropica.2008.05.022

Data on soil-transmitted helminth (STH) infections and reinfection among Orang Asli (aborigine) schoolchildren and their nutritional and socioeconomic status were analyzed to investigate the pattern and the possible predictors of STH reinfection. In this longitudinal study, 120 (60 males and 60 females) Orang Asli primary schoolchildren aged 7-12 years and living in remote areas in Pos Betau, Kuala Lipis, Pahang were screened for the presence of STH using modified cellophane thick smear and Harada Mori techniques. The overall prevalence of ascariasis, trichuriasis and hookworm infections were 65.8, 97.5 and 10.8%, respectively. After complete deworming with a 3-day course of 400mg/daily of albendazole tablets, children were re-examined at 3 and 6 months from baseline. The reinfection rate, by one or more of STH species, at 3 months after deworming was high (49.5%) while 79.6% of the children were reinfected at 6 months after deworming. Logistic regression analyses showed that females, stunted children and those living in houses without toilets had significantly higher reinfection rates than others at 3 months (P<0.05). At 6 months, maternal employment status emerged as another predictor where children of working mothers had significantly higher reinfection rates (P=0.026). In conclusion, reinfection rate of STH is high and thus necessitates frequent and periodic deworming among children. Public health personnel need to re-look at the current control measures and identify innovative and integrated ways in order to reduce STH significantly in the rural communities.

Matched MeSH terms: Trichuriasis/epidemiology; Trichuriasis/parasitology; Trichuriasis/transmission
Do ascariasis, trichuriasis and hookworm infections predispose to non-specific abdominal symptoms among adults in endemic areas?

Raj SM, Anteson R, Sivakumaran S, Abdullah MR, Low HC

Trop Doct, 1993 Oct;23(4):166-7.
PMID: 8273160
Matched MeSH terms: Trichuriasis/complications
Intestinal parasitism in a Kampong on Pulau Pangkor, West Malaysia

Nawalinski T, Roundy LM

Southeast Asian J Trop Med Public Health, 1978 Sep;9(3):440-1.
PMID: 749228
Matched MeSH terms: Trichuriasis/epidemiology
The efficacy of treatment with albendazole

Hanjeet K, Mathias RG

Acta Trop, 1991 Dec;50(2):111-4.
PMID: 1685866

Albendazole, a benzimidazole derivative, was administered as a single dose of either 400 mg or 600 mg to two groups to ascertain the efficacy, tolerance and safety of the regimens. At a dose of 400 mg, a cure rate 35/36 (97%) against Ascaris was found. At 600 mg, the cure rate was 21/30 (70%), significantly lower than the 400 mg rate. Against Trichuris, albendazole at 400 mg had a cure rate of 21/48 (44%), at 600 mg there was a cure rate of 29/43 (67%). Mild side effects were noted in 7 individuals. Whether the moderate increase in efficacy against Trichuris and the loss of efficacy against Ascaris improves the cost:benefit ratio must be left to the prescriber of the drug.

Matched MeSH terms: Trichuriasis/drug therapy*
Age-related prevalence, intensity and frequency distribution of gastrointestinal helminth infection in urban slum children from Kuala Lumpur, Malaysia

Bundy DA, Kan SP, Rose R

Trans R Soc Trop Med Hyg, 1988;82(2):289-94.
PMID: 3188158

The gastrointestinal helminth infection status of 1574 children living in a slum area of Kuala Lumpur, Malaysia was assessed by quantitative coprology. Almost two-thirds were infected with Trichuris trichiura, 49.6% with Ascaris lumbricoides, and 5.3% with hookworm. Infection prevalence rose rapidly to a stable asymptote at 7 years of age, and the age-intensity profile was convex with maximal values in the 5-10 year age classes. This pattern was the same for males and females, but differed markedly between different ethnic groups. The frequency distributions of A. lumbricoides and T. trichiura were highly overdispersed (k values were 0.21 and 0.27, respectively), and age-dependent over the 0-8 year age classes. This suggests that the force of infection with these nematodes is lower in infants than in older children.

Matched MeSH terms: Trichuriasis/epidemiology

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