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Fulltext Soil-transmitted helminth infections and associated risk factors in three Orang Asli tribes in Peninsular Malaysia

Anuar TS, Salleh FM, Moktar N

Sci Rep, 2014;4:4101.
PMID: 24525479 DOI: 10.1038/srep04101

Currently, information on prevalence of soil-transmitted helminth (STH) infections among different tribes of Orang Asli (aboriginal) is scarce in Malaysia. The present study is a cross-sectional study aimed at determining the factors associated with the prevalence of STH infections among the Proto-Malay, Negrito and Senoi tribes. Faecal samples were collected from 500 participants and socioeconomic data was collected via pre-tested questionnaire. All samples were processed using formalin-ether sedimentation and Wheatley's trichrome staining. Trichuris trichiura (57%) was the most common STH seen among the participants, followed by Ascaris lumbricoides (23.8%) and hookworm (7.4%). Trichuriasis and ascariasis showed an age-dependency relationship; significantly higher rates were observed among Senois who aged <15 years. Likewise, Negritos also showed an age-dependency association with ascariasis affecting mainly the under 15 years old individuals. Multivariate logistic regression model indicated the following predictors of trichuriasis among these communities; being aged <15 years, consuming raw vegetables, belonging to a large household members (≥8) and earning low household income (

Matched MeSH terms: Ascaris lumbricoides/isolation & purification
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: Ascaris lumbricoides/isolation & purification
Patterns and Risk Factors of Soil-Transmitted Helminthiasis Among Orang Asli Subgroups in Peninsular Malaysia

Ngui R, Aziz S, Chua KH, Aidil RM, Lee SC, Tan TK, et al.

Am J Trop Med Hyg, 2015 Aug;93(2):361-70.
PMID: 26055746 DOI: 10.4269/ajtmh.13-0677

A cross-sectional study was conducted to provide comprehensive data on the patterns and associated risk factors of soil-transmitted helminth (STH) infections among five Orang Asli subgroups in Peninsular Malaysia. The overall prevalence of STH infections was 59.9% (95% confidence interval [CI] = 56.1-63.7%). Trichuris trichiura (54.3%; 95% CI = 50.4-58.2%) was the predominant species followed by Ascaris lumbricoides (26.7%; 95% CI = 23.3-30.1%) and hookworm (9.1%; 95% CI = 6.9-11.3%). This study showed diversity for STH infections by subgroup with poverty and personal sanitary behavior as important risk factors for infection. Risk profile analyses indicating that Orang Kuala subgroup who has a generally well-developed infrastructure and better quality of life had a low rate of infection. There is a need for poverty reduction and promotion of deworming programs along with mass scale campaigns to create awareness about health and hygiene to reduce STH infections.

Matched MeSH terms: Ascaris lumbricoides/isolation & purification
Clinical trial of phenyelene di-iso-thiocyanate (1.4), Jonit, in the treatment of hookworm disease in Malaysia

O'Holohan DR, Hugoe-Matthews J, Kanagasabai K

Southeast Asian J. Trop. Med. Public Health, 1971 Mar;2(1):51-5.
PMID: 5112340
Matched MeSH terms: Ascaris/isolation & purification
Fulltext A polyphenol-enriched diet and Ascaris suum infection modulate mucosal immune responses and gut microbiota composition in pigs

Williams AR, Krych L, Fauzan Ahmad H, Nejsum P, Skovgaard K, Nielsen DS, et al.

PLoS One, 2017;12(10):e0186546.
PMID: 29028844 DOI: 10.1371/journal.pone.0186546

Polyphenols are a class of bioactive plant secondary metabolites that are thought to have beneficial effects on gut health, such as modulation of mucosal immune and inflammatory responses and regulation of parasite burdens. Here, we examined the interactions between a polyphenol-rich diet supplement and infection with the enteric nematode Ascaris suum in pigs. Pigs were fed either a basal diet or the same diet supplemented with grape pomace (GP), an industrial by-product rich in polyphenols such as oligomeric proanthocyanidins. Half of the animals in each group were then inoculated with A. suum for 14 days to assess parasite establishment, acquisition of local and systemic immune responses and effects on the gut microbiome. Despite in vitro anthelmintic activity of GP-extracts, numbers of parasite larvae in the intestine were not altered by GP-supplementation. However, the bioactive diet significantly increased numbers of eosinophils induced by A. suum infection in the duodenum, jejunum and ileum, and modulated gene expression in the jejunal mucosa of infected pigs. Both GP-supplementation and A. suum infection induced significant and apparently similar changes in the composition of the prokaryotic gut microbiota, and both also decreased concentrations of isobutyric and isovaleric acid (branched-chain short chain fatty acids) in the colon. Our results demonstrate that while a polyphenol-enriched diet in pigs may not directly influence A. suum establishment, it significantly modulates the subsequent host response to helminth infection. Our results suggest an influence of diet on immune function which may potentially be exploited to enhance immunity to helminths.

Matched MeSH terms: Ascaris suum/physiology*
Fulltext Prevalence and risk factors of geohelminthiasis among the rural village children in Kota Marudu, Sabah, Malaysia

Lim-Leroy A, Chua TH

PLoS One, 2020;15(9):e0239680.
PMID: 32986746 DOI: 10.1371/journal.pone.0239680

Geohelminthiasis is a worldwide problem, especially in low-income countries. Children from rural areas and those living in poverty, lacking basic health amenities and having poor environmental sanitation are likely to be affected. Adverse effects such as anemia, protein malnutrition, colitis are common which can affect both the children's physical and mental growing development. A cross-sectional study on geohelminthiasis was conducted among children from 238 households in 13 villages in Kota Marudu of northern Sabah, East Malaysia. The study involved interviewing villagers using questionnaires to collect demographic and socio-economic data, getting faecal samples from the children, collecting soil samples and identifying parasite eggs with microscopy and molecular methods. A total of 407 children (6 months-17 years old) enrolled in the study. Geohelminthiasis was detected in the faecal samples of children from 54% (7/13) of the villages with mean prevalence of infection per village of 9.0% (0%-34.9%). On a household basis, 18% (43/238) of the households sampled had infected children, with mean prevalence rate per household of 11% (0%-43%). The prevalence was for Ascaris lumbricoides: 9.6% (39/407), Trichuris trichiura: 2.7% (11/407) and hookworms (Necator americanus and Ancylostoma sp.): 2.7% (11/407). The overall mean infection rate of the children examined was 14.3%. Significantly higher prevalence was recorded for the children of mothers who did not have any formal education (p = 0.003); household income of less than USD119 (RM500) (p<0.001); children from homes without proper sanitation facilities (p<0.001); children who usually go about barefoot (p<0.001) and not washing feet before entering the house (p = 0.017). Soil samples were found to have geohelminth eggs or larvae which could be due to unhygienic sanitation practices. This study shows the geohelminthiasis is prevalent in the villages, and the risk factors are lack of maternal education, low income, poor sanitation facilities and irregular deworming practice. Expanding deworming coverage in the study region may help reduce the worm infections in these communities, so that the mental and physical development of the children would not be affected by geohelminthiasis. The data on the prevalence of geohelminthiasis in this study would contribute to better public health monitoring and operation to reduce the infection in rural areas.

Matched MeSH terms: Ascaris lumbricoides/isolation & purification*
Fulltext 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 A, Mohd Sofian S, Shaari SA, Hoh BP, Lim YA

PLoS Negl Trop Dis, 2019 Apr;13(4):e0007331.
PMID: 31009476 DOI: 10.1371/journal.pntd.0007331

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.

Matched MeSH terms: Ascaris lumbricoides/isolation & purification
Spectrum of cholangitis in a rural setting in North-eastern Peninsular Malaysia

Khan TF, Raj SM, Visvanathan R

Trop Doct, 1993 Jul;23(3):117-8.
PMID: 8356738
Matched MeSH terms: Ascaris lumbricoides
Fulltext Intestinal geohelminthiasis and growth in pre-adolescent primary school children in Northeastern Peninsular Malaysia

Mahendra Raj S

Southeast Asian J. Trop. Med. Public Health, 1998 Mar;29(1):112-7.
PMID: 9740282

A cohort of one hundred 8-9 year old school children in Northeastern Peninsular Malaysia underwent stool examination, weight and height measurements. Seventy-three children were infected with Ascaris lumbricoides and/or Trichuris trichiura. All infected children were treated with albendazole at baseline, 6 months and 9 months. Measurements were repeated on all but 2 children at 1 year. Repeat stool examination (n = 94) at 1 year revealed a marked reduction in the level of Ascaris infection and a modest reduction in Trichuris infection. There was no difference in net growth between treated children and uninfected controls. Post-hoc analysis by gender however revealed that infected girls (n = 33) experienced significantly higher increments in weight, height and weight for age. Furthermore, children found to be infected at baseline level but worm free at follow-up, were observed to have experienced greater increments in height and height for age. The evidence suggests that periodic antihelminthic treatment may have a positive effect on the growth of subsets of pre-adolescent children but it is emphasised that further work is required to validate these findings.

Matched MeSH terms: Ascaris lumbricoides
Fulltext Correlation between Soil Transmitted Helminth Infection and Eosinophil Levels among Primary School Children in Medan

Darlan DM, Tala ZZ, Amanta C, Warli SM, Arrasyid NK

Open Access Maced J Med Sci, 2017 Apr 15;5(2):142-146.
PMID: 28507618 DOI: 10.3889/oamjms.2017.014

BACKGROUND: Soil Transmitted Helminth infection is one of most prevalent health problems worldwide, especially in environments with poor sanitation. Based on World Health Organisation (WHO) data, more than 2 billion people, or 24% of the world's population, are infected with intestinal parasite. The highest prevalence is located in areas of poor sanitation and unsafe water supplies. In Indonesia, the prevalence of parasite infections is 15% of the entire population.
AIM: The purpose of this study was to determine the relationship between Soil Transmitted Helminth infection on levels of eosinophils among primary school children. In addition, this study also aimed to determine the prevalence of different types of worm infections and the levels of eosinophils in children infected with worms.
MATERIAL AND METHODS: This study was analytic observational using a cross-sectional method. The sampling technique was consecutive and in total 132 samples was obtained. The study involved primary school children in Amplas Medan and Hamparan Perak, Deli Serdang through May to October 2016. Univariate analysis was performed to determine STH infection prevalence and bivariate analysis was used to find the correlation between STH infection and eosinophil levels through a Chi square (χ2) test.
RESULTS: The results showed that the prevalence of Soil Transmitted Helminth was 7.6%. The most common types of STH infection were 3.8% with Trichuris trichiura and 3% with Ascaris lumbricoides. A significant correlation was found between Parasite infection and eosinophil levels (Contingency Coefficient (C) = 0.2, χ2 = 5.3, p = 0.021) and the risk of STH infection that caused eosinophilia or increased eosinophil levels in the children with a Prevalence Ratio (PR) of 1.56 (Confidence Interval (CI) 95%: 1.10-2.22).
CONCLUSION: It is recommended that schools at similar risk improve and maintain hygiene and healthy behaviour in the school environment and that parents and teachers pay greater attention to the cleanliness of their children.

Matched MeSH terms: Ascaris lumbricoides
Prevalence and intensity of helminths among inhabitants of the Chi River and Lahanna water reservoir areas of Northeastern Thailand

Rattanapitoon SK, Pechdee P, Boonsuya A, Meererksom T, Wakkhuwatapong P, Leng M, et al.

Trop Biomed, 2020 Sep 01;37(3):730-743.
PMID: 33612786 DOI: 10.47665/tb.37.3.730

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.

Matched MeSH terms: Ascaris lumbricoides
Fulltext The health of Malaysia’s “Orang Asli” peoples: a review of the scientific evidence on nutritional outcome, parasite infestations, and discussion on implications for clinical practice

Phua, K.L.

Malaysian Journal of Public Health Medicine, 2015;15(1):0-0.
MyJurnal

The Orang Asli of Malaysia continue to experience poor health. There appears to be stagnation of certain aspect of their health status. Underweight (low weight-for-age) and stunting (low height-for-age) are significant amongst Orang Asli children. Worm infestation such as Ascaris, Trichuris and hookworm continue to afflict Orang Asli communities in Malaysia. Orang Asli communities can also be afflicted by other kinds of parasites, e.g. malaria parasites, microsporida parasites and Cryptosporidium parasites. Thus, primary care doctors who treat Orang Asli patients should be on the lookout for malnutrition and its effects (including anaemia, iodine deficiency, Vitamin A deficiency) as well as worm and parasite infestations. Such patients may need to undergo de-worming at regular intervals because of the tendency to get re-infected. Primary care doctors also need to be aware of possible interactions between infestations and nutritional deficiencies.

Matched MeSH terms: Ascaris
Biliary ascariasis: a wandering worm

Lim, C.B., Munirah, A., Alias, M., Nandy, A.K., Thamby Dorai, C.R.

Malaysian Journal of Paediatrics and Child Health, 2000;12(1):68-71.
MyJurnal

Ascaris lumbricoides infection usually results in mild gastrointestinal symptoms. However, heavy worm load infections can cause major complications. In one-third of the latter cases, the worms enter the bile duct causing cholangitis, biliary colic and acute pancreatitis. We describe an eleven-year-old Indian boy who presented with high grade fever, vomiting of worms, jaundice and right hypochondria! pain. Examination revealed an ill, malnourished and jaundiced child. His abdomen was tender with positive Murphy's sign and hepatomegaly. Urgent ultrasound showed hepatomegaly with dilated intrahepatic and common bile ducts (CBD). There were tubular echogenic filling defects with central sonolucency along the long axis of the CBD. He was fasted, started on intravenous fluids and broad spectrum antibiotics. As there was no improvement after 24 hours, endoscopic retrograde cholangio-pancreaticography (ERCP) was performed: it showed worms in the CBD. A stent was inserted to decompress the bile ducts and to ensure biliary drainage. The patient improved, the fever settled, jaundice resolved, serum amylase and transaminase levels normalised. It was planned to remove the stent at a later date.

Matched MeSH terms: Ascaris lumbricoides
The problem of soil transmitted helminths in squatter areas around Kualalumpur

Yan CW, Ishak F, Hee GL, Devaraj JM, Ismail K, Jalleh RP, et al.

Med J Malaysia, 1978 Sep;33(1):34-43.
PMID: 571513
Matched MeSH terms: Ascaris
Fulltext Helminthiasis among Indian preschoolers from urban areas in Penang

Vikneswaran Sabramani, Halim Ismail, Asrul Abdul Wahab

Int J Public Health Res, 2015;5(2):584-591.
MyJurnal

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.

Matched MeSH terms: Ascaris lumbricoides
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: Ascaris lumbricoides
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: Ascaris lumbricoides

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