Sample records for sth

  1. Height, zinc and soil-transmitted helminth infections in schoolchildren: a study in Cuba and Cambodia.

    PubMed

    de Gier, Brechje; Mpabanzi, Liliane; Vereecken, Kim; van der Werff, Suzanne D; D'Haese, Patrick C; Fiorentino, Marion; Khov, Kuong; Perignon, Marlene; Chamnan, Chhoun; Berger, Jacques; Parker, Megan E; Díaz, Raquel Junco; Núñez, Fidel Angel; Rivero, Lázara Rojas; Gorbea, Mariano Bonet; Doak, Colleen M; Ponce, Maiza Campos; Wieringa, Frank T; Polman, Katja

    2015-04-20

    Soil-transmitted helminth (STH) infections and zinc deficiency are often found in low- and middle-income countries and are both known to affect child growth. However, studies combining data on zinc and STH are lacking. In two studies in schoolchildren in Cuba and Cambodia, we collected data on height, STH infection and zinc concentration in either plasma (Cambodia) or hair (Cuba). We analyzed whether STH and/or zinc were associated with height for age z-scores and whether STH and zinc were associated. In Cuba, STH prevalence was 8.4%; these were mainly Ascaris lumbricoides and Trichuris trichiura infections. In Cambodia, STH prevalence was 16.8%, mostly caused by hookworm. In Cuban children, STH infection had a strong association with height for age (aB-0.438, p = 0.001), while hair zinc was significantly associated with height for age only in STH uninfected children. In Cambodian children, plasma zinc was associated with height for age (aB-0.033, p = 0.029), but STH infection was not. Only in Cambodia, STH infection showed an association with zinc concentration (aB-0.233, p = 0.051). Factors influencing child growth differ between populations and may depend on prevalences of STH species and zinc deficiency. Further research is needed to elucidate these relationships and their underlying mechanisms.

  2. Methods for quantification of soil-transmitted helminths in environmental media: current techniques and recent advances

    PubMed Central

    Collender, Philip A.; Kirby, Amy E.; Addiss, David G.; Freeman, Matthew C.; Remais, Justin V.

    2015-01-01

    Limiting the environmental transmission of soil-transmitted helminths (STH), which infect 1.5 billion people worldwide, will require sensitive, reliable, and cost effective methods to detect and quantify STH in the environment. We review the state of the art of STH quantification in soil, biosolids, water, produce, and vegetation with respect to four major methodological issues: environmental sampling; recovery of STH from environmental matrices; quantification of recovered STH; and viability assessment of STH ova. We conclude that methods for sampling and recovering STH require substantial advances to provide reliable measurements for STH control. Recent innovations in the use of automated image identification and developments in molecular genetic assays offer considerable promise for improving quantification and viability assessment. PMID:26440788

  3. Height, Zinc and Soil-Transmitted Helminth Infections in Schoolchildren: A Study in Cuba and Cambodia

    PubMed Central

    de Gier, Brechje; Mpabanzi, Liliane; Vereecken, Kim; van der Werff, Suzanne D.; D’Haese, Patrick C.; Fiorentino, Marion; Khov, Kuong; Perignon, Marlene; Chamnan, Chhoun; Berger, Jacques; Parker, Megan E.; Junco Díaz, Raquel; Angel Núñez, Fidel; Rojas Rivero, Lázara; Bonet Gorbea, Mariano; Doak, Colleen M.; Campos Ponce, Maiza; Wieringa, Frank T.; Polman, Katja

    2015-01-01

    Soil-transmitted helminth (STH) infections and zinc deficiency are often found in low- and middle-income countries and are both known to affect child growth. However, studies combining data on zinc and STH are lacking. In two studies in schoolchildren in Cuba and Cambodia, we collected data on height, STH infection and zinc concentration in either plasma (Cambodia) or hair (Cuba). We analyzed whether STH and/or zinc were associated with height for age z-scores and whether STH and zinc were associated. In Cuba, STH prevalence was 8.4%; these were mainly Ascaris lumbricoides and Trichuris trichiura infections. In Cambodia, STH prevalence was 16.8%, mostly caused by hookworm. In Cuban children, STH infection had a strong association with height for age (aB-0.438, p = 0.001), while hair zinc was significantly associated with height for age only in STH uninfected children. In Cambodian children, plasma zinc was associated with height for age (aB-0.033, p = 0.029), but STH infection was not. Only in Cambodia, STH infection showed an association with zinc concentration (aB-0.233, p = 0.051). Factors influencing child growth differ between populations and may depend on prevalences of STH species and zinc deficiency. Further research is needed to elucidate these relationships and their underlying mechanisms. PMID:25903454

  4. Opening a Can of Worms: Leprosy Reactions and Complicit Soil-Transmitted Helminths.

    PubMed

    Hagge, Deanna A; Parajuli, Pawan; Kunwar, Chhatra B; Rana, Divya R S J B; Thapa, Ruby; Neupane, Kapil D; Nicholls, Peter; Adams, Linda B; Geluk, Annemieke; Shah, Mahesh; Napit, Indra B

    2017-09-01

    >94% of new annual leprosy cases are diagnosed in populations co-endemic for soil-transmitted helminths (STH). STH can profoundly dysregulate host immune responses towards Th2 bias, which can be restored over time after deworming. We hypothesize that STH co-infection is associated with leprosy reaction (denoted as simply "reaction" herein) occurrence within a co-endemic population. A cohort study was performed on a cohort of Nepalese leprosy patients across treatment and diagnostic classifications who were screened by routine fecal smear microscopy and multiplex quantitative PCR (qPCR) for Ascaris lumbricoides (Al), Strongyloides stercoralis (Ss), Ancyclostoma duodenale (Ad) and Necator americanus (Na). Among 145 patients, 55% were positive for ≥1 STH (STH+): 34% Al+, 18% Ss+, 17% Ad+and 5% Na+. Significant inverse STH and reaction relationships were evidenced by the bulk of cases: 63% reaction-negative were STH+ of total cases (p=0.030) while 65% reaction-positive were STH- in new cases (96; p=0.023). Strikingly, the majority of STH+ were reaction-negative, even when considering each species: 59% Al+, 60% Ss+, 62% Ad+and 67% Na+of new leprosy cases. Absence of STH co-infection is associated with leprosy reaction at diagnosis within a co-endemic population. This is likely due to immune reconstitution effects after deworming or interruption of chronic STH-mediated immune dysregulation. Copyright © 2017. Published by Elsevier B.V.

  5. Involvement of STH7 in light-adapted development in Arabidopsis thaliana promoted by both strigolactone and karrikin.

    PubMed

    Thussagunpanit, Jutiporn; Nagai, Yuko; Nagae, Miyu; Mashiguchi, Kiyoshi; Mitsuda, Nobutaka; Ohme-Takagi, Masaru; Nakano, Takeshi; Nakamura, Hidemitsu; Asami, Tadao

    2017-02-01

    Strigolactones (SLs) and karrikins (KARs) regulate photomorphogenesis. GR24, a synthetic SL and KAR 1 , a KAR, inhibit the hypocotyl elongation of Arabidopsis thaliana in a weak light. GR24 and KAR 1 up-regulate the expression of STH7, encoding a transcription factor belonging to the double B-box zinc finger subfamily. In this study, we used STH7-overexpressing (STH7ox) lines and functionally defective STH7 (STH7-SRDX) mutants to investigate roles of SLs and KARs in photomorphogenesis of Arabidopsis. Hypocotyl elongation of STH7-SRDX mutants was less sensitive to both GR24 and KAR 1 treatment than that of wild-type Arabidopsis under weak light conditions. Furthermore, the chlorophyll and anthocyanin content was increased in STH7ox lines when de-etiolated with light and GR24-treated plants had enhanced anthocyanin production. GR24 and KAR 1 treatment significantly increased the expression level of photosynthesis-related genes LHCB1 and rbcS. The results strongly suggest that SL and KAR induce photomorphogenesis of Arabidopsis in an STH7-dependent manner.

  6. A cross-sectional survey of soil-transmitted helminthiases in two Myanmar villages receiving mass drug administration: epidemiology of infection with a focus on adults.

    PubMed

    Dunn, Julia C; Bettis, Alison A; Wyine, Nay Yee; Lwin, Aye Moe Moe; Lwin, Soe Thiha; Su, Khine Khine; Sein, Myint Myint; Tun, Aung; Maung, Nay Soe; Anderson, Roy M

    2017-08-04

    Soil-transmitted helminths (STH) are still highly prevalent in southeast Asia. The country of Myanmar has had ongoing mass drug administration (MDA) programmes since 2003 in an attempt to control STH and reduce STH-related morbidities. Whilst the MDA programmes have reported high nationwide coverage, there have been no epidemiological surveys that included measurements from adults. This paper details three cross-sectional surveys that took place over the course of a year in two villages endemic for STH and receiving MDA in lower Myanmar. At baseline, 27.81% of participants were infected with at least one type of STH. The most prevalent STH was Trichuris trichiura (18.12%) followed by hookworm (8.71%) and Ascaris lumbricoides (5.34%). Most infections were of low intensity, measured by eggs per gram of faeces (EPG). Gender stratification revealed that A. lumbricoides prevalence was significantly higher in females, whereas hookworm prevalence was significantly higher in males. The distribution of EPG in the study sample was highly overdispersed, suggesting that most people release few eggs whereas a few people release many eggs. Adults harbour a major proportion of the overall STH burden; 65.15% of STH infections were harboured by adults. STH infection remains at medium prevalence in the study villages despite past and recent MDA. Recorded prevalence of STH in school-aged children has not substantially decreased since the last monitoring and evaluation activities in Myanmar in 2013. Analyses suggest that adults are a major contributor to the total STH prevalence and EPG burden, probably perpetuating transmission.

  7. Soil-Transmitted Helminthiasis and Vitamin A Deficiency: Two Problems, One Policy.

    PubMed

    Strunz, Eric C; Suchdev, Parminder S; Addiss, David G

    2016-01-01

    Vitamin A deficiency (VAD) and soil-transmitted helminthiasis (STH) represent two widely prevalent and often overlapping global health problems. Approximately 75% of countries with moderate or severe VAD are coendemic for STH. We reviewed the literature on the complex relationship between STH and VAD. Treatment for STH significantly increases provitamin A (e.g., β-carotene) levels but is associated with minimal increases in preformed vitamin A (retinol). Interpretation of the data is complicated by variations in STH infection intensity and limitations of vitamin A biomarkers. Despite these challenges, increased coordination of STH and VAD interventions represents an important public health opportunity. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Risk factors for soil-transmitted helminth infections during the first 3 years of life in the tropics; findings from a birth cohort.

    PubMed

    Menzies, Stefanie K; Rodriguez, Alejandro; Chico, Martha; Sandoval, Carlos; Broncano, Nely; Guadalupe, Irene; Cooper, Philip J

    2014-02-01

    Soil-transmitted helminths (STH) infect more than 2 billion humans worldwide, causing significant morbidity in children. There are few data on the epidemiology and risk factors for infection in pre-school children. To investigate risk factors for infection in early childhood, we analysed data prospectively collected in the ECUAVIDA birth cohort in Ecuador. Children were recruited at birth and followed up to 3 years of age with periodic collection of stool samples that were examined microscopically for STH parasites. Data on social, demographic, and environmental risk factors were collected from the mother at time of enrollment. Associations between exposures and detection of STH infections were analysed by multivariable logistic regression. Data were analysed from 1,697 children for whom a stool sample was obtained at 3 years. 42.3% had at least one STH infection in the first 3 years of life and the most common infections were caused by A. lumbricoides (33.2% of children) and T. trichiura (21.2%). Hookworm infection was detected in 0.9% of children. Risk of STH infection was associated with factors indicative of poverty in our study population such as Afro-Ecuadorian ethnicity and low maternal educational level. Maternal STH infections during pregnancy were strong risk factors for any childhood STH infection, infections with either A. lumbricoides or T. trichiura, and early age of first STH infection. Children of mothers with moderate to high infections intensities with A. lumbricoides were most at risk. Our data show high rates of infection with STH parasites during the first 3 years of life in an Ecuadorian birth cohort, an observation that was strongly associated with maternal STH infections during pregnancy. The targeted treatment of women of childbearing age, in particular before pregnancy, with anthelmintic drugs could offer a novel approach to the prevention of STH infections in pre-school children.

  9. Risk Factors for Soil-Transmitted Helminth Infections during the First 3 Years of Life in the Tropics; Findings from a Birth Cohort

    PubMed Central

    Menzies, Stefanie K.; Rodriguez, Alejandro; Chico, Martha; Sandoval, Carlos; Broncano, Nely; Guadalupe, Irene; Cooper, Philip J.

    2014-01-01

    Background Soil-transmitted helminths (STH) infect more than 2 billion humans worldwide, causing significant morbidity in children. There are few data on the epidemiology and risk factors for infection in pre-school children. To investigate risk factors for infection in early childhood, we analysed data prospectively collected in the ECUAVIDA birth cohort in Ecuador. Methods and Findings Children were recruited at birth and followed up to 3 years of age with periodic collection of stool samples that were examined microscopically for STH parasites. Data on social, demographic, and environmental risk factors were collected from the mother at time of enrolment. Associations between exposures and detection of STH infections were analysed by multivariable logistic regression. Data were analysed from 1,697 children for whom a stool sample was obtained at 3 years. 42.3% had at least one STH infection in the first 3 years of life and the most common infections were caused by A. lumbricoides (33.2% of children) and T. trichiura (21.2%). Hookworm infection was detected in 0.9% of children. Risk of STH infection was associated with factors indicative of poverty in our study population such as Afro-Ecuadorian ethnicity and low maternal educational level. Maternal STH infections during pregnancy were strong risk factors for any childhood STH infection, infections with either A. lumbricoides or T. trichiura, and early age of first STH infection. Children of mothers with moderate to high infections intensities with A. lumbricoides were most at risk. Conclusions Our data show high rates of infection with STH parasites during the first 3 years of life in an Ecuadorian birth cohort, an observation that was strongly associated with maternal STH infections during pregnancy. The targeted treatment of women of childbearing age, in particular before pregnancy, with anthelmintic drugs could offer a novel approach to the prevention of STH infections in pre-school children. PMID:24587469

  10. Moderate and high endemicity of schistosomiasis is a predictor of the endemicity of soil-transmitted helminthiasis - Systematic review

    PubMed Central

    Yajima, A.; Gabrielli, A. F.; Montresor, A.; Engels, D.

    2017-01-01

    The authors conducted a systematic literature review with the following aims: (i) to investigate how frequently soil-transmitted helminthiasis (STH) infections are endemic where schistosomiasis is present; and (ii) to assess the correlation between the risk level of schistosomiasis and that of STH. Among 155 sites on which data were collected and analyzed, schistosomiasis was present in 130 sites, all of which were also co-endemic for STH, whereas 25 sites were endemic only for STH. Out of 83 sites where at least one biannual round of preventive chemotherapy (PC) for schistosomiasis is recommended, 94% were also eligible for at least a yearly round of PC against STH. And among 21 sites where PC for schistosomiasis is recommended once a year, 81% were also eligible for at least a yearly round of PC for STH. This fact provides managers of control programmes with the operationally important indication that use of available information on endemicity of schistosomiasis is a valid tool to predict the presence of STH in the same geographical area as well as to estimate the need of PC for STH. The implementation of this tool is expected to save financial and human resources and help accelerate the scale-up of PC throughout the world. PMID:21215979

  11. The accuracy of formol-ether concentration in diagnosing soiltransmitted helminths in elementary school 27 Peusangan in Bireuen

    NASA Astrophysics Data System (ADS)

    Fitriani, C. L.; Panggabean, M.; Pasaribu, A. P.

    2018-03-01

    Soil-transmitted helminths (STH) or a group of parasitic nematode worms causing human infection through contact with moist soil may contribute to anemia, nutritional disorders, physical and intellectual growth retardation. School-age children are at high risk of STH infection due to frequent contact with soil. Reliable, sensitive, and practical diagnostic are the test series for detecting STH. This study aimed to assess the sensitivity and specificity of the formol-ether concentration (FEC) in the diagnosis of STH when compared to the Kato-Katz technique. The study was designed at state elementary school 27 Peusangan, Bireuen. The FEC study on a total of 80 (100%) elementary students showed that 12 (15%) sample had the STH infection, while Kato-Katz technique (Gold standard) showed that 31 (38.75%) sample had the STH infection. The FEC technique has the sensitivity of (38.71%), specificity of (100%) and accuracy of (76.25%). The Kato-Katz technique is better than the FEC technique for assessing STH in Bireuen due to mild infection.

  12. Enabling low-noise null-point scanning thermal microscopy by the optimization of scanning thermal microscope probe through a rigorous theory of quantitative measurement.

    PubMed

    Hwang, Gwangseok; Chung, Jaehun; Kwon, Ohmyoung

    2014-11-01

    The application of conventional scanning thermal microscopy (SThM) is severely limited by three major problems: (i) distortion of the measured signal due to heat transfer through the air, (ii) the unknown and variable value of the tip-sample thermal contact resistance, and (iii) perturbation of the sample temperature due to the heat flux through the tip-sample thermal contact. Recently, we proposed null-point scanning thermal microscopy (NP SThM) as a way of overcoming these problems in principle by tracking the thermal equilibrium between the end of the SThM tip and the sample surface. However, in order to obtain high spatial resolution, which is the primary motivation for SThM, NP SThM requires an extremely sensitive SThM probe that can trace the vanishingly small heat flux through the tip-sample nano-thermal contact. Herein, we derive a relation between the spatial resolution and the design parameters of a SThM probe, optimize the thermal and electrical design, and develop a batch-fabrication process. We also quantitatively demonstrate significantly improved sensitivity, lower measurement noise, and higher spatial resolution of the fabricated SThM probes. By utilizing the exceptional performance of these fabricated probes, we show that NP SThM can be used to obtain a quantitative temperature profile with nanoscale resolution independent of the changing tip-sample thermal contact resistance and without perturbation of the sample temperature or distortion due to the heat transfer through the air.

  13. Effect of Poor Access to Water and Sanitation As Risk Factors for Soil-Transmitted Helminth Infection: Selectiveness by the Infective Route.

    PubMed

    Echazú, Adriana; Bonanno, Daniela; Juarez, Marisa; Cajal, Silvana P; Heredia, Viviana; Caropresi, Silvia; Cimino, Ruben O; Caro, Nicolas; Vargas, Paola A; Paredes, Gladys; Krolewiecki, Alejandro J

    2015-09-01

    Soil-transmitted helminth (STH) infections are a public health problem in resource-limited settings worldwide. Chronic STH infection impairs optimum learning and productivity, contributing to the perpetuation of the poverty-disease cycle. Regular massive drug administration (MDA) is the cardinal recommendation for its control; along with water, sanitation and hygiene (WASH) interventions. The impact of joint WASH interventions on STH infections has been reported; studies on the independent effect of WASH components are needed to contribute with the improvement of current recommendations for the control of STH. The aim of this study is to assess the association of lacking access to water and sanitation with STH infections, taking into account the differences in route of infection among species and the availability of adequate water and sanitation at home. Cross-sectional study, conducted in Salta province, Argentina. During a deworming program that enrolled 6957 individuals; 771 were randomly selected for stool/serum sampling for parasitological and serological diagnosis of STH. Bivariate stratified analysis was performed to explore significant correlations between risk factors and STH infections grouped by mechanism of entry as skin-penetrators (hookworms and Strongyloides stercoralis) vs. orally-ingested (Ascaris lumbricoides and Trichuris trichiura). After controlling for potential confounders, unimproved sanitation was significantly associated with increased odds of infection of skin-penetrators (adjusted odds ratio [aOR] = 3.9; 95% CI: 2.6-5.9). Unimproved drinking water was significantly associated with increased odds of infection of orally-ingested (aOR = 2.2; 95% CI: 1.3-3.7). Lack of safe water and proper sanitation pose a risk of STH infections that is distinct according to the route of entry to the human host used by each of the STH species. Interventions aimed to improve water and sanitation access should be highlighted in the recommendations for the control of STH.

  14. Effect of Poor Access to Water and Sanitation As Risk Factors for Soil-Transmitted Helminth Infection: Selectiveness by the Infective Route

    PubMed Central

    Echazú, Adriana; Bonanno, Daniela; Juarez, Marisa; Cajal, Silvana P.; Heredia, Viviana; Caropresi, Silvia; Cimino, Ruben O.; Caro, Nicolas; Vargas, Paola A.; Paredes, Gladys; Krolewiecki, Alejandro J.

    2015-01-01

    Background Soil-transmitted helminth (STH) infections are a public health problem in resource-limited settings worldwide. Chronic STH infection impairs optimum learning and productivity, contributing to the perpetuation of the poverty-disease cycle. Regular massive drug administration (MDA) is the cardinal recommendation for its control; along with water, sanitation and hygiene (WASH) interventions. The impact of joint WASH interventions on STH infections has been reported; studies on the independent effect of WASH components are needed to contribute with the improvement of current recommendations for the control of STH. The aim of this study is to assess the association of lacking access to water and sanitation with STH infections, taking into account the differences in route of infection among species and the availability of adequate water and sanitation at home. Methods and Findings Cross-sectional study, conducted in Salta province, Argentina. During a deworming program that enrolled 6957 individuals; 771 were randomly selected for stool/serum sampling for parasitological and serological diagnosis of STH. Bivariate stratified analysis was performed to explore significant correlations between risk factors and STH infections grouped by mechanism of entry as skin-penetrators (hookworms and Strongyloides stercoralis) vs. orally-ingested (Ascaris lumbricoides and Trichuris trichiura). After controlling for potential confounders, unimproved sanitation was significantly associated with increased odds of infection of skin-penetrators (adjusted odds ratio [aOR] = 3.9; 95% CI: 2.6–5.9). Unimproved drinking water was significantly associated with increased odds of infection of orally-ingested (aOR = 2.2; 95% CI: 1.3–3.7). Conclusions Lack of safe water and proper sanitation pose a risk of STH infections that is distinct according to the route of entry to the human host used by each of the STH species. Interventions aimed to improve water and sanitation access should be highlighted in the recommendations for the control of STH. PMID:26421865

  15. Moderate and high endemicity of schistosomiasis is a predictor of the endemicity of soil-transmitted helminthiasis: a systematic review.

    PubMed

    Yajima, A; Gabrielli, A F; Montresor, A; Engels, D

    2011-02-01

    The authors conducted a systematic literature review with the following aims: to investigate how frequently soil-transmitted helminthiasis (STH) infections are endemic where schistosomiasis is present; and to assess the correlation between the risk level of schistosomiasis and that of STH. Among 155 sites on which data were collected and analyzed, schistosomiasis was present in 130, all of which were also co-endemic for STH, whereas 25 sites were endemic only for STH. Ninety percent (117 out of 130) of the areas eligible for preventive chemotherapy (PC) against schistosomiasis are also eligible for PC against STH. This fact provides managers of control programmes with the operationally important indication that use of available information on endemicity of schistosomiasis is a valid tool to predict the presence of STH in the same geographical area and to estimate the need of PC for STH. The implementation of this tool is expected to save financial and human resources and help accelerate the scale-up of PC throughout the world. Copyright © 2010 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  16. Gut Instincts: Knowledge, Attitudes, and Practices regarding Soil-Transmitted Helminths in Rural China

    PubMed Central

    Lu, Louise; Liu, Chengfang; Zhang, Linxiu; Medina, Alexis; Smith, Scott; Rozelle, Scott

    2015-01-01

    Background Soil-transmitted helminth (STH) infections affect more than two out of every five schoolchildren in the poorest regions of rural China, an alarmingly high prevalence rate given the low cost and wide availability of safe and effective deworming treatment. Understanding of local knowledge, attitudes, and practices regarding STH infection in rural China has until now, been sparse, although such information is critical for prevention and control initiatives. Methodology/Principal Findings This study aims to elucidate the structural and sociocultural factors that underlie high STH infection rates as well as explain why deworming treatment is rarely sought for children. In-depth, qualitative interviews were conducted in six rural villages in Guizhou Province; participants included schoolchildren, children’s parents and grandparents, and village doctors. Data analysis exposed three predominant reasons for high STH prevalence: (1) lack of awareness and skepticism about the high prevalence of STH infection, (2) local myths about STH infection and deworming treatment, and (3) poor quality of village health care. Conclusions/Significance The findings from this study reveal reasons for why deworming treatment is not sought, and inform specific recommendations for a deworming intervention that can more effectively address underlying barriers to deworming in areas of persistently high STH infection rates. The main barrier to seeking STH treatment is not availability or cost of the drugs, but rather the lack of impetus to seek the drugs. A comprehensive nationwide deworming program in China should involve annual provision of free deworming treatment in village clinics or schools, distribution of culturally appropriate educational materials to inform children and families about STH infection, and improvement of the quality of health care delivered by village clinicians. PMID:25807188

  17. Infection with Soil-Transmitted Helminths Is Associated with Increased Insulin Sensitivity.

    PubMed

    Wiria, Aprilianto E; Hamid, Firdaus; Wammes, Linda J; Prasetyani, Margaretta A; Dekkers, Olaf M; May, Linda; Kaisar, Maria M M; Verweij, Jaco J; Guigas, Bruno; Partono, Felix; Sartono, Erliyani; Supali, Taniawati; Yazdanbakhsh, Maria; Smit, Johannes W A

    2015-01-01

    Given that helminth infections have been shown to improve insulin sensitivity in animal studies, which may be explained by beneficial effects on energy balance or by a shift in the immune system to an anti-inflammatory profile, we investigated whether soil-transmitted helminth (STH)-infected subjects are more insulin sensitive than STH-uninfected subjects. We performed a cross-sectional study on Flores island, Indonesia, an area with high prevalence of STH infections. From 646 adults, stool samples were screened for Trichuris trichiura by microscopy and for Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale, and Strongyloides stercoralis by qPCR. No other helminth was found. We collected data on body mass index (BMI, kg/m2), waist-to-hip ratio (WHR), fasting blood glucose (FBG, mmol/L), insulin (pmol/L), high sensitive C-reactive protein (ng/ml) and Immunoglobulin E (IU/ml). The homeostatic model assessment for insulin resistance (HOMAIR) was calculated and regression models were used to assess the association between STH infection status and insulin resistance. 424 (66%) participants had at least one STH infection. STH infected participants had lower BMI (23.2 vs 22.5 kg/m2, p value = 0.03) and lower HOMAIR (0.97 vs 0.81, p value = 0.05). In an age-, sex- and BMI-adjusted model a significant association was seen between the number of infections and HOMAIR: for every additional infection with STH species, the HOMAIR decreased by 0.10 (p for linear trend 0.01). This effect was mainly accounted for by a decrease in insulin of 4.9 pmol/L for every infection (p for trend = 0.07). STH infections are associated with a modest improvement of insulin sensitivity, which is not accounted for by STH effects on BMI alone.

  18. Soil-Transmitted Helminth Eggs Are Present in Soil at Multiple Locations within Households in Rural Kenya.

    PubMed

    Steinbaum, Lauren; Njenga, Sammy M; Kihara, Jimmy; Boehm, Alexandria B; Davis, Jennifer; Null, Clair; Pickering, Amy J

    2016-01-01

    Almost one-quarter of the world's population is infected with soil-transmitted helminths (STH). We conducted a study to determine the prevalence and location of STH-Ascaris, Trichuris, and hookworm spp.-egg contamination in soil within rural household plots in Kenya. Field staff collected soil samples from July to September 2014 from the house entrance and the latrine entrance of households in Kakamega County; additional spatial sampling was conducted at a subset of households (N = 22 samples from 3 households). We analyzed soil samples using a modified version of the US Environmental Protection Agency (EPA) method for enumerating Ascaris in biosolids. We found 26.8% of households had one or more species of STH eggs present in the soil in at least one household location (n = 18 out of 67 households), and Ascaris was the most commonly detected STH (19.4%, n = 13 out of 67 households). Prevalence of STH eggs in soil was equally likely at the house entrance (19.4%, N = 67) as at the latrine entrance (11.3%, N = 62) (p = 0.41). We also detected STH eggs at bathing and food preparation areas in the three houses revisited for additional spatial sampling, indicating STH exposure can occur at multiple sites within a household plot, not just near the latrine. The highest concentration of eggs in one house occurred in the child's play area. Our findings suggest interventions to limit child exposure to household soil could complement other STH control strategies.

  19. Immediate effects on adult drinkers of exposure to alcohol harm reduction advertisements with and without drinking guideline messages: experimental study.

    PubMed

    Wakefield, Melanie A; Brennan, Emily; Dunstone, Kimberley; Durkin, Sarah J; Dixon, Helen G; Pettigrew, Simone; Slater, Michael D

    2018-06-01

    To compare the immediate effects on drinkers of television advertisements focusing upon short- versus long-term harms with and without low-risk drinking guidelines. Between-participants on-line experiment, with random assignment to view: (a) alcohol product advertisements (ALC control); (b) advertisements unrelated to alcohol (NON-ALC control); (c) advertisements featuring short-term harms (STH) of alcohol; (d) advertisements featuring STH plus a STH guideline (STH+G); (e) advertisements featuring long-term harms (LTH); or (f) advertisements featuring LTH plus a LTH guideline (LTH+G). Australia, 2016. A total of 3718 drinkers aged 18-64 years (48.5% male). Post-exposure likelihood that participants provided a correct estimate of drinking levels associated with short- and long-term harms; post-exposure intentions to avoid alcohol or reduce consumption. After exposure to STH+G or LTH+G advertisements, participants were more likely to estimate correctly rather than overestimate drinking levels associated with harm, compared with those exposed to STH (P < 0.001) and LTH advertisements without guidelines, respectively (P = 0.019) and ALC control (STH+G, P < 0.001; LTH+G, P < 0.001) and NON-ALC control conditions (STH+G, P < 0.001; LTH+G, P = 0.011). Drinkers exposed to STH conditions were more likely to intend to reduce next-week alcohol consumption than those exposed to ALC control (both P < 0.001) and NON-ALC control conditions (STH, P = 0.001; STH+G, P < 0.001); a similar pattern was observed for intentions to avoid alcohol. Drinkers exposed to LTH conditions were also more likely than drinkers exposed to ALC or NON-ALC controls to intend to avoid and reduce alcohol in the next week. Additionally, drinkers exposed to LTH+G were more likely to intend to reduce drinking than those exposed to LTH advertisements without guidelines (P = 0.022). Response patterns for low- and high-risk drinkers by condition were similar. Alcohol harm television advertisements increase intentions to reduce alcohol consumption among both low- and high-risk drinkers. The addition of low-risk drinking guidelines can enhance these effects for advertisements featuring long-term harms and improve estimates of both short- and long-term harmful drinking levels. © 2018 Society for the Study of Addiction.

  20. The Impact of Lymphatic Filariasis Mass Drug Administration Scaling Down on Soil-Transmitted Helminth Control in School-Age Children. Present Situation and Expected Impact from 2016 to 2020.

    PubMed

    Mupfasoni, Denise; Montresor, Antonio; Mikhailov, Alexei; King, Jonathan

    2016-12-01

    Lymphatic filariasis (LF) and soil-transmitted-helminths (STH) are co-endemic in 58 countries which are mostly in Africa and Asia. Worldwide, 486 million school-age children are considered at risk of both diseases. In 2000, the World Health Organization (WHO) established the global programme to eliminate LF by 2020. Since then, the LF elimination programme has distributed ivermectin or diethylcarbamazine citrate (DEC) in combination with albendazole, thereby also treating STH. Consequently, many school-age children have been treated for STH through the LF programme. As treatment targets towards the 2020 LF elimination goal are achieved, many countries are implementing the transmission assessment survey (TAS) and, if the LF prevalence is estimated to be less than 1%, scaling down mass drug administration (MDA). We analysed the 2014 data on preventive chemotherapy (PC) reported from LF STH co-endemic countries and projected the year and location of TAS expected to be conducted between 2016 and 2020 to assess the impact of this scaling down on STH PC. Eighty percent of all co-endemic countries that have already stopped LF MDA nationally were able to establish STH PC through schools. It is estimated that 14% of the total number of children presently covered by the LF programme is at risk of not continuing to receive PC for STH. In order to achieve and maintain the WHO 2020 goal for STH control, there is an urgent need to establish and reinforce school-based deworming programmes in countries scaling-down national LF elimination programmes.

  1. Strawberry-Tree Honey Induces Growth Inhibition of Human Colon Cancer Cells and Increases ROS Generation: A Comparison with Manuka Honey

    PubMed Central

    Afrin, Sadia; Forbes-Hernandez, Tamara Y.; Gasparrini, Massimiliano; Bompadre, Stefano; Quiles, José L.; Sanna, Gavino; Spano, Nadia; Giampieri, Francesca; Battino, Maurizio

    2017-01-01

    Honey is a natural product known to modulate several biological activities including cancer. The aim of the present study was to examine the phytochemical content and the antioxidant activity of Strawberry tree (Arbutus unedo) honey (STH) and its cytotoxic properties against human colon adenocarcinoma (HCT-116) and metastatic (LoVo) cell lines in comparison with Manuka (Leptospermum scoparium) honey (MH). Several unifloral STH and MH were analyzed for their phenolic, flavonoid, amino acid and protein contents, as well as their radical scavenging activities. STH from the Berchidda area showed the highest amount of phenolic, flavonoid, amino acid and protein content, and antioxidant capacity compared to MH. Both STH and MH induced cytotoxicity and cell death in a dose- and time-dependent manner in HCT-116 and LoVo cells, with less toxicity on non-cancer cells. Compared to MH, STH showed more effect at lower concentrations on HCT-116 and LoVo cells. In addition, both honeys increased intracellular reactive oxygen species (ROS) generation. In HCT-116 cells, STH and MH induced similar ROS production but in LoVo cells STH induced a higher percentage of ROS compared to MH. Our results indicate that STH and MH can induce cell growth inhibition and ROS generation in colon adenocarcinoma and metastatic cells, which could be due to the presence of phytochemicals with antioxidant properties. These preliminary results are interesting and suggest a potential chemopreventive action which could be useful for further studies in order to develop chemopreventive agents for colon cancer. PMID:28287469

  2. Soil-Transmitted Helminths in Pre-School-Aged and School-Aged Children in an Urban Slum: A Cross-Sectional Study of Prevalence, Distribution, and Associated Exposures

    PubMed Central

    Davis, Stephanie M.; Worrell, Caitlin M.; Wiegand, Ryan E.; Odero, Kennedy O.; Suchdev, Parminder S.; Ruth, Laird J.; Lopez, Gerard; Cosmas, Leonard; Neatherlin, John; Njenga, Sammy M.; Montgomery, Joel M.; Fox, LeAnne M.

    2014-01-01

    Soil-transmitted helminths (STHs) are controlled by regular mass drug administration. Current practice targets school-age children (SAC) preferentially over pre-school age children (PSAC) and treats large areas as having uniform prevalence. We assessed infection prevalence in SAC and PSAC and spatial infection heterogeneity, using a cross-sectional study in two slum villages in Kibera, Nairobi. Nairobi has low reported STH prevalence. The SAC and PSAC were randomly selected from the International Emerging Infections Program's surveillance platform. Data included residence location and three stools tested by Kato-Katz for STHs. Prevalences among 692 analyzable children were any STH: PSAC 40.5%, SAC 40.7%; Ascaris: PSAC 24.1%, SAC 22.7%; Trichuris: PSAC 24.0%, SAC 28.8%; hookworm < 0.1%. The STH infection prevalence ranged from 22% to 71% between sub-village sectors. The PSAC have similar STH prevalences to SAC and should receive deworming. Small areas can contain heterogeneous prevalences; determinants of STH infection should be characterized and slums should be assessed separately in STH mapping. PMID:25157123

  3. Pilot assessment of soil-transmitted helminthiasis in the context of transmission assessment surveys for lymphatic filariasis in Benin and Tonga.

    PubMed

    Chu, Brian K; Gass, Katherine; Batcho, Wilfrid; 'Ake, Malakai; Dorkenoo, Améyo M; Adjinacou, Elvire; Mafi, 'Eva; Addiss, David G

    2014-02-01

    Mass drug administration (MDA) for lymphatic filariasis (LF) programs has delivered more than 2 billion treatments of albendazole, in combination with either ivermectin or diethylcarbamazine, to communities co-endemic for soil-transmitted helminthiasis (STH), reducing the prevalence of both diseases. A transmission assessment survey (TAS) is recommended to determine if MDA for LF can be stopped within an evaluation unit (EU) after at least five rounds of annual treatment. The TAS also provides an opportunity to simultaneously assess the impact of these MDAs on STH and to determine the frequency of school-based MDA for STH after community-wide MDA is no longer needed for LF. Pilot studies conducted in Benin and Tonga assessed the feasibility of a coordinated approach. Of the schools (clusters) selected for a TAS in each EU, a subset of 5 schools per STH ecological zone was randomly selected, according to World Health Organization (WHO) guidelines, for the coordinated survey. In Benin, 519 children were sampled in 5 schools and 22 (4.2%) had STH infection (A. lumbricoides, T. trichiura, or hookworm) detected using the Kato-Katz method. All infections were classified as light intensity under WHO criteria. In Tonga, 10 schools were chosen for the coordinated TAS and STH survey covering two ecological zones; 32 of 232 (13.8%) children were infected in Tongatapu and 82 of 320 (25.6%) in Vava'u and Ha'apai. All infections were light-intensity with the exception of one with moderate-intensity T. trichiura. Synchronous assessment of STH with TAS is feasible and provides a well-timed evaluation of infection prevalence to guide ongoing treatment decisions at a time when MDA for LF may be stopped. The coordinated field experiences in both countries also suggest potential time and cost savings. Refinement of a coordinated TAS and STH sampling methodology should be pursued, along with further validation of alternative quantitative diagnostic tests for STH that can be used with preserved stool specimens.

  4. Distribution of schistosomiasis and soil transmitted helminthiasis in Zimbabwe: towards a national plan of action for control and elimination.

    PubMed

    Midzi, Nicholas; Mduluza, Takafira; Chimbari, Moses J; Tshuma, Clement; Charimari, Lincoln; Mhlanga, Gibson; Manangazira, Portia; Munyati, Shungu M; Phiri, Isaac; Mutambu, Susan L; Midzi, Stanley S; Ncube, Anastancia; Muranzi, Lawrence P; Rusakaniko, Simbarashe; Mutapi, Francisca

    2014-08-01

    Schistosomiasis and STH are among the list of neglected tropical diseases considered for control by the WHO. Although both diseases are endemic in Zimbabwe, no nationwide control interventions have been implemented. For this reason in 2009 the Zimbabwe Ministry of Health and Child Care included the two diseases in the 2009-2013 National Health Strategy highlighting the importance of understanding the distribution and burden of the diseases as a prerequisite for elimination interventions. It is against this background that a national survey was conducted. A countrywide cross-sectional survey was carried out in 280 primary schools in 68 districts between September 2010 and August 2011. Schistosoma haematobium was diagnosed using the urine filtration technique. Schistosoma mansoni and STH (hookworms, Trichuris trichiura, Ascaris lumbricoides) were diagnosed using both the Kato Katz and formol ether concentration techniques. Schistosomiasis was more prevalent country-wide (22.7%) than STH (5.5%). The prevalence of S. haematobium was 18.0% while that of S. mansoni was 7.2%. Hookworms were the most common STH with a prevalence of 3.2% followed by A. lumbricoides and T. trichiura with prevalence of 2.5% and 0.1%, respectively. The prevalence of heavy infection intensity as defined by WHO for any schistosome species was 5.8% (range 0%-18.3% in districts). Only light to moderate infection intensities were observed for STH species. The distribution of schistosomiasis and STH varied significantly between provinces, districts and schools (p<0.001). Overall, the prevalence of co-infection with schistosomiasis and STH was 1.5%. The actual co-endemicity of schistosomiasis and STH was observed in 43 (63.2%) of the 68 districts screened. This study provided comprehensive baseline data on the distribution of schistosomiasis and STH that formed the basis for initiating a national control and elimination programme for these two neglected tropical diseases in Zimbabwe.

  5. Distribution of Schistosomiasis and Soil Transmitted Helminthiasis in Zimbabwe: Towards a National Plan of Action for Control and Elimination

    PubMed Central

    Midzi, Nicholas; Mduluza, Takafira; Chimbari, Moses J.; Tshuma, Clement; Charimari, Lincoln; Mhlanga, Gibson; Manangazira, Portia; Munyati, Shungu M.; Phiri, Isaac; Mutambu, Susan L.; Midzi, Stanley S.; Ncube, Anastancia; Muranzi, Lawrence P.; Rusakaniko, Simbarashe; Mutapi, Francisca

    2014-01-01

    Background Schistosomiasis and STH are among the list of neglected tropical diseases considered for control by the WHO. Although both diseases are endemic in Zimbabwe, no nationwide control interventions have been implemented. For this reason in 2009 the Zimbabwe Ministry of Health and Child Care included the two diseases in the 2009–2013 National Health Strategy highlighting the importance of understanding the distribution and burden of the diseases as a prerequisite for elimination interventions. It is against this background that a national survey was conducted. Methodology A countrywide cross-sectional survey was carried out in 280 primary schools in 68 districts between September 2010 and August 2011. Schistosoma haematobium was diagnosed using the urine filtration technique. Schistosoma mansoni and STH (hookworms, Trichuris trichiura, Ascaris lumbricoides) were diagnosed using both the Kato Katz and formol ether concentration techniques. Main findings Schistosomiasis was more prevalent country-wide (22.7%) than STH (5.5%). The prevalence of S. haematobium was 18.0% while that of S. mansoni was 7.2%. Hookworms were the most common STH with a prevalence of 3.2% followed by A. lumbricoides and T. trichiura with prevalence of 2.5% and 0.1%, respectively. The prevalence of heavy infection intensity as defined by WHO for any schistosome species was 5.8% (range 0%–18.3% in districts). Only light to moderate infection intensities were observed for STH species. The distribution of schistosomiasis and STH varied significantly between provinces, districts and schools (p<0.001). Overall, the prevalence of co-infection with schistosomiasis and STH was 1.5%. The actual co-endemicity of schistosomiasis and STH was observed in 43 (63.2%) of the 68 districts screened. Conclusion and recommendations This study provided comprehensive baseline data on the distribution of schistosomiasis and STH that formed the basis for initiating a national control and elimination programme for these two neglected tropical diseases in Zimbabwe. PMID:25121489

  6. Partnering for impact: Integrated transmission assessment surveys for lymphatic filariasis, soil transmitted helminths and malaria in Haiti.

    PubMed

    Knipes, Alaine Kathryn; Lemoine, Jean Frantz; Monestime, Franck; Fayette, Carl R; Direny, Abdel N; Desir, Luccene; Beau de Rochars, Valery E; Streit, Thomas G; Renneker, Kristen; Chu, Brian K; Chang, Michelle A; Mace, Kimberly E; Won, Kimberly Y; Lammie, Patrick J

    2017-02-01

    Since 2001, Haiti's National Program for the Elimination of Lymphatic Filariasis (NPELF) has worked to reduce the transmission of lymphatic filariasis (LF) through annual mass drug administration (MDA) with diethylcarbamazine and albendazole. The NPELF reached full national coverage with MDA for LF in 2012, and by 2014, a total of 14 evaluation units (48 communes) had met WHO eligibility criteria to conduct LF transmission assessment surveys (TAS) to determine whether prevalence had been reduced to below a threshold, such that transmission is assumed to be no longer sustainable. Haiti is also endemic for malaria and many communities suffer a high burden of soil transmitted helminths (STH). Heeding the call from WHO for integration of neglected tropical diseases (NTD) activities, Haiti's NPELF worked with the national malaria control program (NMCP) and with partners to develop an integrated TAS (LF-STH-malaria) to include assessments for malaria and STH. The aim of this study was to evaluate the feasibility of using TAS surveys for LF as a platform to collect information about STH and malaria. Between November 2014 and June 2015, TAS were conducted in 14 evaluation units (EUs) including 1 TAS (LF-only), 1 TAS-STH-malaria, and 12 TAS-malaria, with a total of 16,655 children tested for LF, 14,795 tested for malaria, and 298 tested for STH. In all, 12 of the 14 EUs passed the LF TAS, allowing the program to stop MDA for LF in 44 communes. The EU where children were also tested for STH will require annual school-based treatment with albendazole to maintain reduced STH levels. Finally, only 12 of 14,795 children tested positive for malaria by RDT in 38 communes. Haiti's 2014-2015 Integrated TAS surveys provide evidence of the feasibility of using the LF TAS as a platform for integration of assessments for STH and or malaria.

  7. Mapping the Risk of Soil-Transmitted Helminthic Infections in the Philippines

    PubMed Central

    Leonardo, Lydia; Gray, Darren J.; Carabin, Hélène; Halton, Kate; McManus, Donald P.; Williams, Gail M.; Rivera, Pilarita; Saniel, Ofelia; Hernandez, Leda; Yakob, Laith; McGarvey, Stephen T.; Clements, Archie C. A.

    2015-01-01

    Background In order to increase the efficient allocation of soil-transmitted helminth (STH) disease control resources in the Philippines, we aimed to describe for the first time the spatial variation in the prevalence of A. lumbricoides, T. trichiura and hookworm across the country, quantify the association between the physical environment and spatial variation of STH infection and develop predictive risk maps for each infection. Methodology/Principal Findings Data on STH infection from 35,573 individuals across the country were geolocated at the barangay level and included in the analysis. The analysis was stratified geographically in two major regions: 1) Luzon and the Visayas and 2) Mindanao. Bayesian geostatistical models of STH prevalence were developed, including age and sex of individuals and environmental variables (rainfall, land surface temperature and distance to inland water bodies) as predictors, and diagnostic uncertainty was incorporated. The role of environmental variables was different between regions of the Philippines. This analysis revealed that while A. lumbricoides and T. trichiura infections were widespread and highly endemic, hookworm infections were more circumscribed to smaller foci in the Visayas and Mindanao. Conclusions/Significance This analysis revealed significant spatial variation in STH infection prevalence within provinces of the Philippines. This suggests that a spatially targeted approach to STH interventions, including mass drug administration, is warranted. When financially possible, additional STH surveys should be prioritized to high-risk areas identified by our study in Luzon. PMID:26368819

  8. Soil-transmitted helminth infections associated with wastewater and sludge reuse: A review of current evidence.

    PubMed

    Amoah, Isaac Dennis; Adegoke, Anthony Ayodeji; Stenström, Thor Axel

    2018-05-19

    To review current evidence on infections related to the concentration of soil-transmitted helminth (STH) eggs in wastewater, sludge and vegetables irrigated with wastewater or grown on sludge-amended soils. Search of Web of Science, Science Direct, PubMed and Google Scholar databases for publications reporting on STH egg concentration in wastewater, sludge and vegetables and for epidemiological studies on wastewater/sludge reuse and STH infections. STH egg concentrations were variable but high in wastewater and sludge especially in developing countries. They ranged from 6 to 16,000 eggs/L in wastewater and from 0 to 23,000 eggs/g in sludge and far exceed limits set in the WHO guideline for wastewater/sludge reuse. Numbers of STH eggs on vegetables ranged from 0 to 100 eggs/g. The concentration of STH eggs in wastewater, sludge and vegetables therefore relates to risks of infection through different exposure routes. Epidemiological evidence reveals an increased prevalence of STH infections associated with direct exposure to wastewater or sludge (farmers) and consumption of vegetables grown on soil treated with it. This calls for increased efforts to reduce the adverse health impact of wastewater and sludge reuse in line with the WHO multi-barrier approach. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. Soil-transmitted helminths in southern highland Rwanda: associated factors and effectiveness of school-based preventive chemotherapy.

    PubMed

    Staudacher, Olga; Heimer, Jakob; Steiner, Florian; Kayonga, Yvette; Havugimana, Jean M; Ignatius, Ralf; Musemakweri, Andre; Ngabo, Fidele; Harms, Gundel; Gahutu, Jean-Bosco; Mockenhaupt, Frank P

    2014-07-01

    Preventive chemotherapy of schoolchildren against soil-transmitted helminths (STHs) is widely implemented in Rwanda. However, data on its actual efficacy are lacking. We assessed prevalence, associated factors and manifestation of STH infection among schoolchildren in southern highland Rwanda as well as cure and reinfection rates. Six hundred and twenty-two children (rural, 301; urban, 321) were included preceding the administration of a single dose of 500 mg mebendazole. Before treatment, and after 2 and 15 weeks, STH infection was determined by Kato-Katz smears and by PCR assays for Ascaris lumbricoides. Clinical and anthropometric data, socio-economic status and factors potentially associated with STH infection were assessed. Soil-transmitted helminth (STH) infection was present in 38% of rural and in 13% of urban schoolchildren. Ascaris lumbricoides accounted for 96% of infections. Of these, one-third was detected by PCR exclusively. Factors associated with STH infection differed greatly between rural and urban children. Likewise, STH infection was associated with stunting and anaemia only among urban children. The cure rate after 2 weeks was 92%. Among eight non-cleared A. lumbricoides infections, seven were submicroscopic. Reinfection within 3 months occurred in 7%, but the rate was higher among rural children, and with initially present infection, particularly at comparatively high intensity. The rural-urban difference in factors associated with STH infection and in reinfection rates highlights the need for targeted interventions to reduce transmission. PCR assays may help in detecting low-level infections persisting after treatment. In southern Rwanda, mebendazole is highly effective against the STH infections predominated by A. lumbricoides. © 2014 John Wiley & Sons Ltd.

  10. Soil-transmitted helminths in pre-school-aged and school-aged children in an urban slum: a cross-sectional study of prevalence, distribution, and associated exposures.

    PubMed

    Davis, Stephanie M; Worrell, Caitlin M; Wiegand, Ryan E; Odero, Kennedy O; Suchdev, Parminder S; Ruth, Laird J; Lopez, Gerard; Cosmas, Leonard; Neatherlin, John; Njenga, Sammy M; Montgomery, Joel M; Fox, LeAnne M

    2014-11-01

    Soil-transmitted helminths (STHs) are controlled by regular mass drug administration. Current practice targets school-age children (SAC) preferentially over pre-school age children (PSAC) and treats large areas as having uniform prevalence. We assessed infection prevalence in SAC and PSAC and spatial infection heterogeneity, using a cross-sectional study in two slum villages in Kibera, Nairobi. Nairobi has low reported STH prevalence. The SAC and PSAC were randomly selected from the International Emerging Infections Program's surveillance platform. Data included residence location and three stools tested by Kato-Katz for STHs. Prevalences among 692 analyzable children were any STH: PSAC 40.5%, SAC 40.7%; Ascaris: PSAC 24.1%, SAC 22.7%; Trichuris: PSAC 24.0%, SAC 28.8%; hookworm < 0.1%. The STH infection prevalence ranged from 22% to 71% between sub-village sectors. The PSAC have similar STH prevalences to SAC and should receive deworming. Small areas can contain heterogeneous prevalences; determinants of STH infection should be characterized and slums should be assessed separately in STH mapping. © The American Society of Tropical Medicine and Hygiene.

  11. Prospects for elimination of soil-transmitted helminths.

    PubMed

    Ásbjörnsdóttir, Kristjana H; Means, Arianna R; Werkman, Marleen; Walson, Judd L

    2017-10-01

    Soil-transmitted helminths (STH) are endemic in 120 countries and are associated with substantial morbidity and loss of economic productivity. Although current WHO guidelines focus on morbidity control through mass drug administration (MDA), there is global interest in whether a strategy targeting disease elimination might be feasible in some settings. This review summarizes the prospects for switching from control to an elimination strategy. STH control efforts have reduced the intensity of infections in targeted populations with associated reductions in morbidity. However, adults are not frequently targeted and remain important reservoirs for reinfection of treated children. Recent modeling suggests that transmission interruption may be possible through expanded community-wide delivery of MDA, the feasibility of which has been demonstrated by other programs. However, these models suggest that high levels of coverage and compliance must be achieved. Potential challenges include the risk of prematurely dismantling STH programs and the potential increased risk of antihelminthic resistance. Elimination of STH may offer an opportunity to eliminate substantial STH-related morbidity while reducing resource needs of neglected tropical disease programs. Evidence from large community trials is needed to determine the feasibility of interrupting the transmission of STH in some geographic settings.

  12. A Cross-Sectional Study of Water, Sanitation, and Hygiene-Related Risk Factors for Soil-Transmitted Helminth Infection in Urban School- and Preschool-Aged Children in Kibera, Nairobi

    PubMed Central

    Worrell, Caitlin M.; Wiegand, Ryan E.; Davis, Stephanie M.; Odero, Kennedy O.; Blackstock, Anna; Cuéllar, Victoria M.; Njenga, Sammy M.; Montgomery, Joel M.; Roy, Sharon L.; Fox, LeAnne M.

    2016-01-01

    Soil-transmitted helminth (STH) infections affect persons living in areas with poor water, sanitation, and hygiene (WASH). Preschool-aged children (PSAC) and school-aged children (SAC) are disproportionately affected by STH infections. We aimed to identify WASH factors associated with STH infection among PSAC and SAC in Kibera, Kenya. In 2012, households containing a PSAC or SAC were randomly selected from those enrolled in the International Emerging Infections Program, a population-based surveillance system. We administered a household questionnaire, conducted environmental assessments for WASH, and tested three stools from each child for STH eggs using the Kato-Katz method. WASH factors were evaluated for associations with STH infection using univariable and multivariable Poisson regression. Any-STH prevalence was 40.8% among 201 PSAC and 40.0% among 475 SAC enrolled. Using the Joint Monitoring Programme water and sanitation classifications, 1.5% of households reported piped water on premises versus 98.5% another improved water source; 1.3% reported improved sanitation facilities, while 81.7% used shared sanitation facilities, 13.9% had unimproved facilities, and 3.1% reported no facilities (open defecation). On univariable analysis, STH infection was significantly associated with a household toilet located off-premises (prevalence ratio (PR) = 1.33; p = 0.047), while always treating water (PR = 0.81; p = 0.04), covering drinking water containers (PR = 0.75; p = 0.02), using clean towels during hand drying (PR = 0.58; p<0.01), having finished household floor material (PR = 0.76; p<0.01), having electricity (PR = 0.70; p<0.01), and increasing household elevation in 10-meter increments (PR = 0.89; p<0.01) were protective against STH infection. On multivariable analysis, usually versus always treating water was associated with increased STH prevalence (adjusted prevalence ratio (aPR) = 1.52; p<0.01), while having finished household floor material (aPR = 0.76; p = 0.03), reported child deworming in the last year (aPR = 0.76; p<0.01), and 10-meter household elevation increases (aPR = 0.89; p<0.01) were protective against infection. The intersection between WASH and STH infection is complex; site-specific WASH interventions should be considered to sustain the gains made by deworming activities. PMID:26950552

  13. Effects of Chronic Ascariasis and Trichuriasis on Cytokine Production and Gene Expression in Human Blood: A Cross-Sectional Study

    PubMed Central

    Benitez, Susana; Broncano, Nely; Chico, Martha E.; Vaca, Maritza; Alexander, Neal; Lewis, David J.; Dougan, Gordon; Cooper, Philip J.

    2011-01-01

    Background Chronic soil-transmitted helminth (STH) infections are associated with effects on systemic immune responses that could be caused by alterations in immune homeostasis. To investigate this, we measured the impact in children of STH infections on cytokine responses and gene expression in unstimulated blood. Methodology/Principal Findings Sixty children were classified as having chronic, light, or no STH infections. Peripheral blood mononuclear cells were cultured in medium for 5 days to measure cytokine accumulation. RNA was isolated from peripheral blood and gene expression analysed using microarrays. Different infection groups were compared for the purpose of analysis: STH infection (combined chronic and light vs. uninfected groups) and chronic STH infection (chronic vs. combined light and uninfected groups). The chronic STH infection effect was associated with elevated production of GM-CSF (P = 0.007), IL-2 (P = 0.03), IL-5 (P = 0.01), and IL-10 (P = 0.01). Data reduction suggested that chronic infections were primarily associated with an immune phenotype characterized by elevated IL-5 and IL-10, typical of a modified Th2-like response. Chronic STH infections were associated with the up-regulation of genes associated with immune homeostasis (IDO, P = 0.03; CCL23, P = 0.008, HRK, P = 0.005), down-regulation of microRNA hsa-let-7d (P = 0.01) and differential regulation of several genes associated with granulocyte-mediated inflammation (IL-8, down-regulated, P = 0.0002; RNASE2, up-regulated, P = 0.009; RNASE3, up-regulated, p = 0.03). Conclusions/Significance Chronic STH infections were associated with a cytokine response indicative of a modified Th2 response. There was evidence that STH infections were associated with a pattern of gene expression suggestive of the induction of homeostatic mechanisms, the differential expression of several inflammatory genes and the down-regulation of microRNA has-let-7d. Effects on immune homeostasis and the development of a modified Th2 immune response during chronic STH infections could explain the systemic immunologic effects that have been associated with these infections such as impaired immune responses to vaccines and the suppression of inflammatory diseases. PMID:21666788

  14. A Cross-Sectional Study of Water, Sanitation, and Hygiene-Related Risk Factors for Soil-Transmitted Helminth Infection in Urban School- and Preschool-Aged Children in Kibera, Nairobi.

    PubMed

    Worrell, Caitlin M; Wiegand, Ryan E; Davis, Stephanie M; Odero, Kennedy O; Blackstock, Anna; Cuéllar, Victoria M; Njenga, Sammy M; Montgomery, Joel M; Roy, Sharon L; Fox, LeAnne M

    2016-01-01

    Soil-transmitted helminth (STH) infections affect persons living in areas with poor water, sanitation, and hygiene (WASH). Preschool-aged children (PSAC) and school-aged children (SAC) are disproportionately affected by STH infections. We aimed to identify WASH factors associated with STH infection among PSAC and SAC in Kibera, Kenya. In 2012, households containing a PSAC or SAC were randomly selected from those enrolled in the International Emerging Infections Program, a population-based surveillance system. We administered a household questionnaire, conducted environmental assessments for WASH, and tested three stools from each child for STH eggs using the Kato-Katz method. WASH factors were evaluated for associations with STH infection using univariable and multivariable Poisson regression. Any-STH prevalence was 40.8% among 201 PSAC and 40.0% among 475 SAC enrolled. Using the Joint Monitoring Programme water and sanitation classifications, 1.5% of households reported piped water on premises versus 98.5% another improved water source; 1.3% reported improved sanitation facilities, while 81.7% used shared sanitation facilities, 13.9% had unimproved facilities, and 3.1% reported no facilities (open defecation). On univariable analysis, STH infection was significantly associated with a household toilet located off-premises (prevalence ratio (PR) = 1.33; p = 0.047), while always treating water (PR = 0.81; p = 0.04), covering drinking water containers (PR = 0.75; p = 0.02), using clean towels during hand drying (PR = 0.58; p<0.01), having finished household floor material (PR = 0.76; p<0.01), having electricity (PR = 0.70; p<0.01), and increasing household elevation in 10-meter increments (PR = 0.89; p<0.01) were protective against STH infection. On multivariable analysis, usually versus always treating water was associated with increased STH prevalence (adjusted prevalence ratio (aPR) = 1.52; p<0.01), while having finished household floor material (aPR = 0.76; p = 0.03), reported child deworming in the last year (aPR = 0.76; p<0.01), and 10-meter household elevation increases (aPR = 0.89; p<0.01) were protective against infection. The intersection between WASH and STH infection is complex; site-specific WASH interventions should be considered to sustain the gains made by deworming activities.

  15. The past matters: estimating intrinsic hookworm transmission intensity in areas with past mass drug administration to control lymphatic filariasis.

    PubMed

    Werkman, Marleen; Truscott, James E; Toor, Jaspreet; Wright, James E; Anderson, Roy M

    2017-05-23

    Current WHO guidelines for soil-transmitted helminth (STH) control focus on mass drug administration (MDA) targeting preschool-aged (pre-SAC) and school-aged children (SAC), with the goal of eliminating STH as a public health problem amongst children. Recently, attention and funding has turned towards the question whether MDA alone can result in the interruption of transmission for STH. The lymphatic filariasis (LF) elimination programme, have been successful in reaching whole communities. There is the possibility of building upon the infrastructure created for these LF-programmes to enhance the control of STH. Using hookworm as an example, we explore what further MDA coverage might be required to induce interruption of transmission for hookworm in the wake of a successful LF programme. Analyses based on the model of STH transmission and MDA impact predict the effects of previous LF control by MDA over five years, on a defined baseline prevalence of STH in an area with a defined transmission intensity (the basic reproductive number R 0 ). If the LF MDA programme achieved a high coverage (70, 70 and 60% for pre-SAC, SAC and adults, respectively) we expect that in communities with a hookworm prevalence of 15%, after 5 years of LF control, the intrinsic R 0 value in that setting is 2.47. By contrast, if lower LF coverages were achieved (40, 40 and 30% for pre-SAC, SAC and adults, respectively), with the same prevalence of 15% at baseline (after 5 years of LF MDA), the intrinsic hookworm R 0 value is predicted to be 1.67. The intrinsic R 0 value has a large effect on the expected successes of follow-up STH programmes post LF MDA. Consequently, the outcomes of identical programmes may differ between these communities. To design the optimal MDA intervention to eliminate STH infections, it is vital to have information on historical MDA programmes and baseline prevalence to estimate the intrinsic transmission intensity for the defined setting (R 0 ). The baseline prevalence alone is not sufficient to inform policy for the control of STH, post cessation of LF MDA, since this will be highly dependent on the intensity and effectiveness of past programmes and the intrinsic transmission intensity of the dominant STH species in any given setting.

  16. Soil-Transmitted Helminths and Associated Factors among Pre-School Children in Butajira Town, South-Central Ethiopia: A Community-Based Cross-Sectional Study

    PubMed Central

    Shumbej, Teha; Belay, Tariku; Mekonnen, Zeleke; Tefera, Tamirat; Zemene, Endalew

    2015-01-01

    Background Soil-transmitted helminths (STH) remain a major public health problem, particularly in tropical and sub-tropical regions of the world. Though infections are prevalent among all age groups, the world health organization (WHO) considers Pre-school age children (PSAC), school-aged children, and pregnant women as segments of population at high risk of STH morbidities. Objective This study aimed at determining the prevalence and infection intensity of STH and associated factors among PSAC in Butajira Town, south-central Ethiopia. Methods A community-based cross-sectional study was conducted from May to June, 2014 in Butajira Town. The PSAC were selected by systematic sampling technique and invited to participate in the present study. McMaster technique was employed for parasitological analysis of stool samples. Pearson’s Chi-square and Fisher’s exact tests were performed where appropriate to identify any association between STH infection and independent factors. Multivariate logistic regression model was fitted to identify independent predictors of STH among the PSAC. P-value less than 0.05 was considered statistically significant. Results A total of 377 (with 96% compliance rate) PSAC were able to provide complete data (socio-demographic information and stool sample). The study showed that 23.3% (88/377) PSAC were infected with one or more species of STH. Ascaris lumbricoides was the most prevalent STH (14.9%) followed by Trichuris trichiura (6.4%). The overall infection intensity, expressed as geometric mean for A. lumbricoides, T. trichiura, and hookworms were 229, 178, and 154 eggs per gram of stool, respectively. The multivariate logistic regression model estimated that being in the age group of 36–47 months (AOR: 2.5, 95% CI: 1.2–5.3, P = 0.016), untrimmed finger nail (AOR: 3.2, 95% CI: 1.8–5.5, P < 0.001), and not washing hands before a meal (AOR: 3.0, 95% CI: 1.7–5.4, P < 0.001) were independent predictors of STH infections among the children. Conclusion The present study showed that STH was a public health problem among PSAC in the study area necessitating annual deworming to control morbidities associated with STH. Besides, the existing health education program should also be strengthened to prevent re-infection. PMID:26305361

  17. Soil-Transmitted Helminths and Associated Factors among Pre-School Children in Butajira Town, South-Central Ethiopia: A Community-Based Cross-Sectional Study.

    PubMed

    Shumbej, Teha; Belay, Tariku; Mekonnen, Zeleke; Tefera, Tamirat; Zemene, Endalew

    2015-01-01

    Soil-transmitted helminths (STH) remain a major public health problem, particularly in tropical and sub-tropical regions of the world. Though infections are prevalent among all age groups, the world health organization (WHO) considers Pre-school age children (PSAC), school-aged children, and pregnant women as segments of population at high risk of STH morbidities. This study aimed at determining the prevalence and infection intensity of STH and associated factors among PSAC in Butajira Town, south-central Ethiopia. A community-based cross-sectional study was conducted from May to June, 2014 in Butajira Town. The PSAC were selected by systematic sampling technique and invited to participate in the present study. McMaster technique was employed for parasitological analysis of stool samples. Pearson's Chi-square and Fisher's exact tests were performed where appropriate to identify any association between STH infection and independent factors. Multivariate logistic regression model was fitted to identify independent predictors of STH among the PSAC. P-value less than 0.05 was considered statistically significant. A total of 377 (with 96% compliance rate) PSAC were able to provide complete data (socio-demographic information and stool sample). The study showed that 23.3% (88/377) PSAC were infected with one or more species of STH. Ascaris lumbricoides was the most prevalent STH (14.9%) followed by Trichuris trichiura (6.4%). The overall infection intensity, expressed as geometric mean for A. lumbricoides, T. trichiura, and hookworms were 229, 178, and 154 eggs per gram of stool, respectively. The multivariate logistic regression model estimated that being in the age group of 36-47 months (AOR: 2.5, 95% CI: 1.2-5.3, P = 0.016), untrimmed finger nail (AOR: 3.2, 95% CI: 1.8-5.5, P < 0.001), and not washing hands before a meal (AOR: 3.0, 95% CI: 1.7-5.4, P < 0.001) were independent predictors of STH infections among the children. The present study showed that STH was a public health problem among PSAC in the study area necessitating annual deworming to control morbidities associated with STH. Besides, the existing health education program should also be strengthened to prevent re-infection.

  18. Detecting and enumerating soil-transmitted helminth eggs in soil: New method development and results from field testing in Kenya and Bangladesh.

    PubMed

    Steinbaum, Lauren; Kwong, Laura H; Ercumen, Ayse; Negash, Makeda S; Lovely, Amira J; Njenga, Sammy M; Boehm, Alexandria B; Pickering, Amy J; Nelson, Kara L

    2017-04-01

    Globally, about 1.5 billion people are infected with at least one species of soil-transmitted helminth (STH). Soil is a critical environmental reservoir of STH, yet there is no standard method for detecting STH eggs in soil. We developed a field method for enumerating STH eggs in soil and tested the method in Bangladesh and Kenya. The US Environmental Protection Agency (EPA) method for enumerating Ascaris eggs in biosolids was modified through a series of recovery efficiency experiments; we seeded soil samples with a known number of Ascaris suum eggs and assessed the effect of protocol modifications on egg recovery. We found the use of 1% 7X as a surfactant compared to 0.1% Tween 80 significantly improved recovery efficiency (two-sided t-test, t = 5.03, p = 0.007) while other protocol modifications-including different agitation and flotation methods-did not have a significant impact. Soil texture affected the egg recovery efficiency; sandy samples resulted in higher recovery compared to loamy samples processed using the same method (two-sided t-test, t = 2.56, p = 0.083). We documented a recovery efficiency of 73% for the final improved method using loamy soil in the lab. To field test the improved method, we processed soil samples from 100 households in Bangladesh and 100 households in Kenya from June to November 2015. The prevalence of any STH (Ascaris, Trichuris or hookworm) egg in soil was 78% in Bangladesh and 37% in Kenya. The median concentration of STH eggs in soil in positive samples was 0.59 eggs/g dry soil in Bangladesh and 0.15 eggs/g dry soil in Kenya. The prevalence of STH eggs in soil was significantly higher in Bangladesh than Kenya (chi-square, χ2 = 34.39, p < 0.001) as was the concentration (Mann-Whitney, z = 7.10, p < 0.001). This new method allows for detecting STH eggs in soil in low-resource settings and could be used for standardizing soil STH detection globally.

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

    PubMed

    Al-Delaimy, Ahmed K; Al-Mekhlafi, Hesham M; Lim, Yvonne A L; Nasr, Nabil A; Sady, Hany; Atroosh, Wahib M; Mahmud, Rohela

    2014-09-02

    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. To identify the key risk factors of STH in Orang Asli communities, we applied an extensive mixed methods approach which involved an intensive literature review, as well as community-based discussions with children, their parents, teachers and health personnel, whilst also placing the children under direct observation. To evaluate the package, 317 children from two schools in Lipis, Pahang were screened for STH infections, treated by a 3-day course of albendazole and then followed up over the next 6 months. The knowledge of teachers, parents and children towards STH infections were assessed at baseline and after 3 months. The developed package consists of a half day workshop for teachers, a teacher's guide book to STH infections, posters, a comic book, a music video, a puppet show, drawing activities and an aid kit. The package was well-received with effective contributions being made by teachers, children and their parents. The incidence rates of hookworm infection at different assessment points were significantly lower among children in the intervention school compared to those in the control school. Similarly, the intensity of trichuriasis, ascariasis and hookworm infections were found to be significantly lower among children in the HELP group compared to those in the control group (P < 0.05). Moreover, the package significantly improved the knowledge, attitude and practices (KAP) of Orang Asli people and the knowledge of teachers towards STH infections. A school-based health education learning package (HELP) was developed which displayed a significant impact in terms of reducing the intensity of all three main STH infections, as well as in reducing the prevalence of hookworm infections. Moreover, the knowledge levels of both teachers and the Orang Asli population regarding STH was significantly improved, a fact which greatly helped in attracting community participation and thus raising the general level of awareness regarding these forms of infections.

  20. Malnutrition and soil-transmitted helminthic infection among Orang Asli pre-school children in Gua Musang, Kelantan, Malaysia

    NASA Astrophysics Data System (ADS)

    Geik, Oui Pek; Sidek, Razalee

    2015-09-01

    Malnutrition and soil-transmitted helminthic (STH) infection is still a major concern among Orang Asli pre-school children in Malaysia. The objective of this study was to determine the prevalence of malnutrition and STH infection. Besides, this study was also to identify the association between malnutrition and STH. A total of 256 Orang Asli (131 males and 125 females) from Temiar sub-tribes pre-school children aged one to six years from 19 villages in three Orang Asli settlements of Pos Hendrop, Pos Balar and Pos Tohoi located in Gua Musang, Kelantan had participated in this cross-sectional study between September to December 2014. A face-to-face interview was carried out using pre-tested questionnaires on socio-demographic. Children were measured on their body weight and height. The collected stool samples were examined using direct wet smear method for the presence of STH parasite. The results showed the prevalence of underweight and stunting among the children were 45.3% and 76.2% respectively. A total of 161 (62.9%) subjects were positively infected by at least one species of STH. The overall parasite infections were Ascaris lumbricoides (41.0%), Trichuris trichiura (28.5%) and hookworm (2.0%). From the total infected children, 8.6% of them were infected by two species of STH. This research revealed that gender and age group showed statistically significance with stunted with (p=0.003, p=0.049) respectively. Gender and age groups also reported significant association to STH infection among the subjects with (p=0.013, p=0.001) respectively. However, our results indicated that there was no significant association between STH infection with underweight and stunted. Our study reported that the prevalence of malnutrition and STH are still a major concern for the public health and a threat among Orang Asli pre-school children in Kelantan. Immediate action and innovative intervention should be taken by the Government to overcome the problems as these children are the future generations of the country.

  1. Detecting and enumerating soil-transmitted helminth eggs in soil: New method development and results from field testing in Kenya and Bangladesh

    PubMed Central

    Kwong, Laura H.; Ercumen, Ayse; Negash, Makeda S.; Lovely, Amira J.; Njenga, Sammy M.; Boehm, Alexandria B.; Pickering, Amy J.; Nelson, Kara L.

    2017-01-01

    Globally, about 1.5 billion people are infected with at least one species of soil-transmitted helminth (STH). Soil is a critical environmental reservoir of STH, yet there is no standard method for detecting STH eggs in soil. We developed a field method for enumerating STH eggs in soil and tested the method in Bangladesh and Kenya. The US Environmental Protection Agency (EPA) method for enumerating Ascaris eggs in biosolids was modified through a series of recovery efficiency experiments; we seeded soil samples with a known number of Ascaris suum eggs and assessed the effect of protocol modifications on egg recovery. We found the use of 1% 7X as a surfactant compared to 0.1% Tween 80 significantly improved recovery efficiency (two-sided t-test, t = 5.03, p = 0.007) while other protocol modifications—including different agitation and flotation methods—did not have a significant impact. Soil texture affected the egg recovery efficiency; sandy samples resulted in higher recovery compared to loamy samples processed using the same method (two-sided t-test, t = 2.56, p = 0.083). We documented a recovery efficiency of 73% for the final improved method using loamy soil in the lab. To field test the improved method, we processed soil samples from 100 households in Bangladesh and 100 households in Kenya from June to November 2015. The prevalence of any STH (Ascaris, Trichuris or hookworm) egg in soil was 78% in Bangladesh and 37% in Kenya. The median concentration of STH eggs in soil in positive samples was 0.59 eggs/g dry soil in Bangladesh and 0.15 eggs/g dry soil in Kenya. The prevalence of STH eggs in soil was significantly higher in Bangladesh than Kenya (chi-square, χ2 = 34.39, p < 0.001) as was the concentration (Mann-Whitney, z = 7.10, p < 0.001). This new method allows for detecting STH eggs in soil in low-resource settings and could be used for standardizing soil STH detection globally. PMID:28379956

  2. Pilot Assessment of Soil-Transmitted Helminthiasis in the Context of Transmission Assessment Surveys for Lymphatic Filariasis in Benin and Tonga

    PubMed Central

    Chu, Brian K.; Gass, Katherine; Batcho, Wilfrid; 'Ake, Malakai; Dorkenoo, Améyo M.; Adjinacou, Elvire; Mafi, 'Eva; Addiss, David G.

    2014-01-01

    Background Mass drug administration (MDA) for lymphatic filariasis (LF) programs has delivered more than 2 billion treatments of albendazole, in combination with either ivermectin or diethylcarbamazine, to communities co-endemic for soil-transmitted helminthiasis (STH), reducing the prevalence of both diseases. A transmission assessment survey (TAS) is recommended to determine if MDA for LF can be stopped within an evaluation unit (EU) after at least five rounds of annual treatment. The TAS also provides an opportunity to simultaneously assess the impact of these MDAs on STH and to determine the frequency of school-based MDA for STH after community-wide MDA is no longer needed for LF. Methodology/Principal Findings Pilot studies conducted in Benin and Tonga assessed the feasibility of a coordinated approach. Of the schools (clusters) selected for a TAS in each EU, a subset of 5 schools per STH ecological zone was randomly selected, according to World Health Organization (WHO) guidelines, for the coordinated survey. In Benin, 519 children were sampled in 5 schools and 22 (4.2%) had STH infection (A. lumbricoides, T. trichiura, or hookworm) detected using the Kato-Katz method. All infections were classified as light intensity under WHO criteria. In Tonga, 10 schools were chosen for the coordinated TAS and STH survey covering two ecological zones; 32 of 232 (13.8%) children were infected in Tongatapu and 82 of 320 (25.6%) in Vava'u and Ha'apai. All infections were light-intensity with the exception of one with moderate-intensity T. trichiura. Conclusions Synchronous assessment of STH with TAS is feasible and provides a well-timed evaluation of infection prevalence to guide ongoing treatment decisions at a time when MDA for LF may be stopped. The coordinated field experiences in both countries also suggest potential time and cost savings. Refinement of a coordinated TAS and STH sampling methodology should be pursued, along with further validation of alternative quantitative diagnostic tests for STH that can be used with preserved stool specimens. PMID:24551267

  3. The global limits and population at risk of soil-transmitted helminth infections in 2010

    PubMed Central

    2012-01-01

    Background Understanding the global limits of transmission of soil-transmitted helminth (STH) species is essential for quantifying the population at-risk and the burden of disease. This paper aims to define these limits on the basis of environmental and socioeconomic factors, and additionally seeks to investigate the effects of urbanisation and economic development on STH transmission, and estimate numbers at-risk of infection with Ascaris lumbricoides, Trichuris trichiura and hookworm in 2010. Methods A total of 4,840 geo-referenced estimates of infection prevalence were abstracted from the Global Atlas of Helminth Infection and related to a range of environmental factors to delineate the biological limits of transmission. The relationship between STH transmission and urbanisation and economic development was investigated using high resolution population surfaces and country-level socioeconomic indicators, respectively. Based on the identified limits, the global population at risk of STH transmission in 2010 was estimated. Results High and low land surface temperature and extremely arid environments were found to limit STH transmission, with differential limits identified for each species. There was evidence that the prevalence of A. lumbricoides and of T. trichiura infection was statistically greater in peri-urban areas compared to urban and rural areas, whilst the prevalence of hookworm was highest in rural areas. At national levels, no clear socioeconomic correlates of transmission were identified, with the exception that little or no infection was observed for countries with a per capita gross domestic product greater than US$ 20,000. Globally in 2010, an estimated 5.3 billion people, including 1.0 billion school-aged children, lived in areas stable for transmission of at least one STH species, with 69% of these individuals living in Asia. A further 143 million (31.1 million school-aged children) lived in areas of unstable transmission for at least one STH species. Conclusions These limits provide the most contemporary, plausible representation of the extent of STH risk globally, and provide an essential basis for estimating the global disease burden due to STH infection. PMID:22537799

  4. Risk Factors for Soil-Transmitted Helminthiasis in Preschool Children Living in Farmland, North Sumatera, Indonesia.

    PubMed

    Novianty, Sri; Dimyati, Yazid; Pasaribu, Syahril; Pasaribu, Ayodhia Pitaloka

    2018-01-01

    Disease burden from soil-transmitted helminthiasis (STH) is mainly attributed to its chronic and insidious impact on health and quality of life. Strategy recommended by World Health Organization (WHO) to control it was previously focused on school-aged children, but now preschool-aged children are involved. This study was intended to determine STH infection risk factors in preschool children. A cross-sectional study was conducted in Suka Village, North Sumatera, Indonesia, from October to December 2016. Subjects were children aged 1 to 5 years without history of taking antihelminthic. Subjects were obtained by consecutive sampling. Demographic data and risk factors for helminthiasis were collected using questionnaire-based interview. Subjects were divided into two groups, positive and negative STH infection, based on Kato Katz method. Analysis was done using chi-square and logistic regression test. p value < 0.05 was considered significant. We enrolled 90 subjects in this study, with the mean age being 31.7 months. STH infection prevalence was 34.4%. Statistical analysis revealed that mother/caregiver hand washing habit ( p = 0.007), mother/caregiver nail trimming habit ( p = 0.018), and children nail trimming habit ( p = 0.022) were significant risk factors for STH infection. Mother/caregiver hand washing habit is the most influential risk factor for STH infection in preschool children.

  5. Soil-Transmitted Helminth Eggs Are Present in Soil at Multiple Locations within Households in Rural Kenya

    PubMed Central

    Steinbaum, Lauren; Njenga, Sammy M.; Kihara, Jimmy; Boehm, Alexandria B.; Davis, Jennifer; Null, Clair; Pickering, Amy J.

    2016-01-01

    Almost one-quarter of the world’s population is infected with soil-transmitted helminths (STH). We conducted a study to determine the prevalence and location of STH—Ascaris, Trichuris, and hookworm spp.—egg contamination in soil within rural household plots in Kenya. Field staff collected soil samples from July to September 2014 from the house entrance and the latrine entrance of households in Kakamega County; additional spatial sampling was conducted at a subset of households (N = 22 samples from 3 households). We analyzed soil samples using a modified version of the US Environmental Protection Agency (EPA) method for enumerating Ascaris in biosolids. We found 26.8% of households had one or more species of STH eggs present in the soil in at least one household location (n = 18 out of 67 households), and Ascaris was the most commonly detected STH (19.4%, n = 13 out of 67 households). Prevalence of STH eggs in soil was equally likely at the house entrance (19.4%, N = 67) as at the latrine entrance (11.3%, N = 62) (p = 0.41). We also detected STH eggs at bathing and food preparation areas in the three houses revisited for additional spatial sampling, indicating STH exposure can occur at multiple sites within a household plot, not just near the latrine. The highest concentration of eggs in one house occurred in the child’s play area. Our findings suggest interventions to limit child exposure to household soil could complement other STH control strategies. PMID:27341102

  6. Helminth prevalence among adults in rural Kenya: a stool survey for soil-transmitted helminths and schistosomiasis in Nyanza province.

    PubMed

    Andereck, Jonathan W; Kipp, Aaron M; Ondiek, Michael; Vermund, Sten H

    2014-12-01

    Soil-transmitted helminth (STH) prevalence in children is high in rural southwestern Kenya, but adult prevalence data are scarce. A 2010 study of a village in Nyanza province found a pediatric STH prevalence of 44% using a direct stool-smear method. Adult STH prevalence and associated predictors was measured in the same village. Adults (≥18 years) presenting at the out-patient department of the small hospital or community outreach events completed a short questionnaire and provided stool samples. Light microscopy for ova and larvae was conducted using a stool concentration technique to improve sensitivity. Multivariable regression models were used to identify predictors of STH prevalence. Among 344 adults, STH prevalence was 15.7% (54/344). Hookworm was most common (13.1%; 45/344), followed by Ascaris lumbricoides (6.1%; 21/344) and Trichuris trichiura (0.6%; 2/344). Twelve participants (3.5%; 12/344) had multiple STHs and three (0.9%; 3/344) had Schistosoma mansoni. Female sex, older age and lower education level were significant STH predictors. Adult STH prevalence was lower than previous studies of children from the same village. Adults with the identified risk factors had a prevalence of ≥20%, which may warrant periodic, targeted deworming of adults with these risk factors given the low cost and low toxicity of anthelmintic drugs. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Prevalence and intensity of soil-transmitted helminthiasis, prevalence of malaria and nutritional status of school going children in honduras.

    PubMed

    Mejia Torres, Rosa Elena; Franco Garcia, Dora Nelly; Fontecha Sandoval, Gustavo Adolfo; Hernandez Santana, Adriana; Singh, Prabhjot; Mancero Bucheli, Sandra Tamara; Saboya, Martha; Paz, Mirian Yolanda

    2014-10-01

    Many small studies have been done in Honduras estimating soil-transmitted helminthiasis (STH) prevalence but a country-wide study was last done in 2005. The country has the highest burden of malaria among all Central American countries. The present study was done to estimate country-wide STH prevalence and intensity, malaria prevalence and nutritional status in school going children. A cross-sectional study was conducted following PAHO/WHO guidelines to select a sample of school going children of 3rd to 5th grades, representative of ecological regions in the country. A survey questionnaire was filled; anthropometric measurements, stool sample for STH and blood sample for malaria were taken. Kato-Katz method was used for STH prevalence and intensity and rapid diagnostic tests, microscopy, and polymerase chain reaction (PCR) were used for malaria parasite detection. A total of 2554 students were studied of which 43.5% had one or more STH. Trichuriasis was the most prevalent (34%) followed by ascariasis (22.3%) and hookworm (0.9%). Ecological regions II (59.7%) and VI (55.6%) in the north had the highest STH prevalence rates while IV had the lowest (10.6%). Prevalence of one or more high intensity STH was low (1.6%). Plasmodium vivax was detected by PCR in only 5 students (0.2%), all of which belonged to the same municipality; no P. falciparum infection was detected. The majority of children (83%) had normal body mass index for their respective age but a significant proportion were overweight (10.42%) and obese (4.35%). Biannual deworming campaigns would be necessary in ecological regions II and VI, where STH prevalence is >50%. High prevalence of obesity in school going children is a worrying trend and portends of future increase in obesity related diseases. Malaria prevalence, both symptomatic and asymptomatic, was low and provides evidence for Honduras to embark on elimination of the disease.

  8. A Scoping Review and Prevalence Analysis of Soil-Transmitted Helminth Infections in Honduras

    PubMed Central

    Sanchez, Ana Lourdes; Gabrie, José Antonio; Rueda, María Mercedes; Mejia, Rosa Elena; Bottazzi, Maria Elena; Canales, Maritza

    2014-01-01

    Background Honduras is endemic for soil-transmitted helminth (STH) infections, but critical information gaps still remain on the prevalence and intensity of these infections as well as on their spatial distribution at subnational levels. Objectives Firstly, to review the research activity on STH infections in Honduras and secondly, to carry out a national prevalence analysis and map the geographical distribution of these infections in children. Methods A systematic search was conducted of the published and grey literature to identify scientific work on the impact and prevalence of STH infections done between May 1930 and June 30, 2012. International databases and Honduran journals were searched. Grey literature was gleaned from local libraries and key informants. Select studies conducted between 2001 and 2012 were used to produce prevalence maps and to investigate association between STH prevalence and socio-economic and environmental factors. Results Of 257 identified studies, 211 (21.4% peer-reviewed) were retained for analysis and categorized as clinical research (10.9%), treatment efficacy studies (8.1%) or epidemiological studies (81%). Prevalence analysis and geographical mapping included 36 epidemiological studies from Honduras's 18 departments and 23% of its municipalities. Overall STH prevalence was >50% in 40.6% of municipalities. Prevalences above 20% for each trichuriasis, ascariasis, and hookworm infection were found in 68%, 47.8%, and 7.2% of studied municipalities, respectively. Municipalities with lower human development index, less access to of potable water, and with higher annual precipitation showed higher STH prevalences. Conclusions This is the first study to provide a comprehensive historic review of STH research activity and prevalence in Honduras, revealing important knowledge gaps related to infection risk factors, disease burden, and anti-parasitic drug efficacy, among others. Our decade-long prevalence analysis reveals geographical differences in STH prevalence and these findings suggest that differential intervention strategies might be necessary in Honduras for the control of these infections. PMID:24466359

  9. A scoping review and prevalence analysis of soil-transmitted helminth infections in Honduras.

    PubMed

    Sanchez, Ana Lourdes; Gabrie, José Antonio; Rueda, María Mercedes; Mejia, Rosa Elena; Bottazzi, Maria Elena; Canales, Maritza

    2014-01-01

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

  10. Prevalence and Intensity of Soil-Transmitted Helminthiasis, Prevalence of Malaria and Nutritional Status of School Going Children in Honduras

    PubMed Central

    Mejia Torres, Rosa Elena; Franco Garcia, Dora Nelly; Fontecha Sandoval, Gustavo Adolfo; Hernandez Santana, Adriana; Singh, Prabhjot; Mancero Bucheli, Sandra Tamara; Saboya, Martha; Paz, Mirian Yolanda

    2014-01-01

    Background Many small studies have been done in Honduras estimating soil-transmitted helminthiasis (STH) prevalence but a country-wide study was last done in 2005. The country has the highest burden of malaria among all Central American countries. The present study was done to estimate country-wide STH prevalence and intensity, malaria prevalence and nutritional status in school going children. Methods and Findings A cross-sectional study was conducted following PAHO/WHO guidelines to select a sample of school going children of 3rd to 5th grades, representative of ecological regions in the country. A survey questionnaire was filled; anthropometric measurements, stool sample for STH and blood sample for malaria were taken. Kato-Katz method was used for STH prevalence and intensity and rapid diagnostic tests, microscopy, and polymerase chain reaction (PCR) were used for malaria parasite detection. A total of 2554 students were studied of which 43.5% had one or more STH. Trichuriasis was the most prevalent (34%) followed by ascariasis (22.3%) and hookworm (0.9%). Ecological regions II (59.7%) and VI (55.6%) in the north had the highest STH prevalence rates while IV had the lowest (10.6%). Prevalence of one or more high intensity STH was low (1.6%). Plasmodium vivax was detected by PCR in only 5 students (0.2%), all of which belonged to the same municipality; no P. falciparum infection was detected. The majority of children (83%) had normal body mass index for their respective age but a significant proportion were overweight (10.42%) and obese (4.35%). Conclusions Biannual deworming campaigns would be necessary in ecological regions II and VI, where STH prevalence is >50%. High prevalence of obesity in school going children is a worrying trend and portends of future increase in obesity related diseases. Malaria prevalence, both symptomatic and asymptomatic, was low and provides evidence for Honduras to embark on elimination of the disease. PMID:25330010

  11. Risk factors associated with malnutrition in one-year-old children living in the Peruvian Amazon.

    PubMed

    Joseph, Serene A; Casapía, Martín; Blouin, Brittany; Maheu-Giroux, Mathieu; Rahme, Elham; Gyorkos, Theresa W

    2014-12-01

    Children under two years of age are in the most critical window for growth and development. As mobility increases, this time period also coincides with first exposure to soil-transmitted helminth (STH) infections in tropical and sub-tropical environments. The association between malnutrition and STH infection, however, has been understudied in this vulnerable age group. A nested cross-sectional survey was conducted in 12 and 13-month old children participating in a deworming trial in Iquitos, an STH-endemic area of the Peruvian Amazon. An extensive socio-demo-epi questionnaire was administered to the child's parent. Length and weight were measured, and the Bayley Scales of Infant and Toddler Development were administered to measure cognition, language, and fine motor development. Stool specimens were collected to determine the presence of STH. The association between malnutrition (i.e. stunting and underweight) and STH infection, and other child, maternal, and household characteristics, was analyzed using multivariable Poisson regression. A total of 1760 children were recruited between September 2011 and June 2012. Baseline data showed a prevalence of stunting and underweight of 24.2% and 8.6%, respectively. In a subgroup of 880 randomly-allocated children whose specimens were analyzed by the Kato-Katz method, the prevalence of any STH infection was 14.5%. Risk factors for stunting in these 880 children included infection with at least one STH species (aRR = 1.37; 95% CI 1.01, 1.86) and a lower development score (aRR = 0.97; 95% CI: 0.95, 0.99). A lower development score was also a significant risk factor for underweight (aRR = 0.92; 95% CI: 0.89, 0.95). The high prevalence of malnutrition, particularly stunting, and its association with STH infection and lower developmental attainment in early preschool-age children is of concern. Emphasis should be placed on determining the most cost-effective, integrated interventions to reduce disease and malnutrition burdens in this vulnerable age group.

  12. Soil-transmitted helminth prevalence and infection intensity among geographically and economically distinct Shuar communities in the Ecuadorian Amazon.

    PubMed

    Cepon-Robins, Tara J; Liebert, Melissa A; Gildner, Theresa E; Urlacher, Samuel S; Colehour, Alese M; Snodgrass, J Josh; Madimenos, Felicia C; Sugiyama, Lawrence S

    2014-10-01

    Soil-transmitted helminth (STH) infections can result in a variety of negative health outcomes (e.g., diarrhea, nutritional deficiencies). Market integration (MI; participation in market-based economies) has been suggested to alter levels of STH exposure due to associated changes in diet, sanitation, and behavior, but the effects are complicated and not well understood. Some effects of economic development result in decreased exposure to certain pathogens, and other factors can lead to higher pathogen exposure. With geographic location used as a proxy, the present study investigates the effects of economic development on parasite load among an indigenous population at multiple points along the spectrum of MI. This research has many implications for public health, including an increased understanding of how social and economic changes alter disease risk around the world and how changing parasite load affects other health outcomes (i.e., allergy, autoimmunity). Specifically, this study examines the prevalence of intestinal helminths among the Shuar, an indigenous group in the Morona-Santiago region of Ecuador, from 2 geographically/economically separated areas, with the following objectives: (1) report STH infection prevalence and intensity among Shuar; (2) explore STH infection prevalence and intensity as it relates to age distribution in the Shuar population; (3) compare STH infection patterns in geographically and economically separated Shuar communities at different levels of MI. Kato-Katz thick smears were made from fresh stool samples and examined to determine STH presence/intensity. Results indicate that 65% of the 211 participants were infected with at least 1 STH. Twenty-five percent of the sample had coinfections with at least 2 species of helminth. Infection was more common among juveniles (<15 yr) than adults. Infection prevalence and intensity was highest among more isolated communities with less market access. This study documents preliminary associations between STH infection and exposure to MI, with implications for public health research and interventions.

  13. Towards an effective control programme of soil-transmitted helminth infections among Orang Asli in rural Malaysia. Part 2: Knowledge, attitude, and practices

    PubMed Central

    2013-01-01

    Background 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. Methods A cross-sectional study was carried out among 215 households from 13 villages in Lipis district, Pahang, Malaysia. Demographic and socioeconomic information of the participants and their KAP on STH were collected by using a pre-tested questionnaire. Results Overall, 61.4% of the participants had prior knowledge about intestinal helminths with a lack of knowledge on the transmission (28.8%), signs and symptoms (29.3%) as well as the prevention (16.3%). Half of the respondents considered STH as harmful, while their practices to prevent infections were still inadequate. Significant associations between the KAP and age, gender, educational and employment status, family size, and household monthly income were reported. Moreover, significantly lower prevalence of STH infections was reported among children of respondents who wear shoes/slippers when outside the house (72.8%; 95% CI= 62.6, 80.5 vs 87.0%; 95% CI= 81.4, 91.1), wash their hands before eating (32.4%; 95% CI= 24.3, 42.2 vs 51.4%; 95% CI= 44.7, 60.1), and wash their hands after defecation (47.8%; 95% CI= 35.7, 57.1 vs 69.2%; 95% CI= 63.7, 78.7) as compared to their counterparts. Multiple logistic regression analysis indicated that the educational level of the respondents was the most important factor significantly associated with the KAP on STH among this population. Conclusion This study reveals inadequate knowledge, attitude and practices on STH infections among Orang Asli in rural Malaysia. Hence, there is a great need for a proper health education programme and community mobilisation to enhance prevention and instil better knowledge on STH transmission and prevention. This is crucial for an effective and sustainable STH control programme to save the lives and future of the most vulnerable children in rural Malaysia. PMID:23356968

  14. Towards an effective control programme of soil-transmitted helminth infections among Orang Asli in rural Malaysia. Part 2: Knowledge, attitude, and practices.

    PubMed

    Nasr, Nabil A; Al-Mekhlafi, Hesham M; Ahmed, Abdulhamid; Roslan, Muhammad Aidil; Bulgiba, Awang

    2013-01-28

    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. A cross-sectional study was carried out among 215 households from 13 villages in Lipis district, Pahang, Malaysia. Demographic and socioeconomic information of the participants and their KAP on STH were collected by using a pre-tested questionnaire. Overall, 61.4% of the participants had prior knowledge about intestinal helminths with a lack of knowledge on the transmission (28.8%), signs and symptoms (29.3%) as well as the prevention (16.3%). Half of the respondents considered STH as harmful, while their practices to prevent infections were still inadequate. Significant associations between the KAP and age, gender, educational and employment status, family size, and household monthly income were reported. Moreover, significantly lower prevalence of STH infections was reported among children of respondents who wear shoes/slippers when outside the house (72.8%; 95% CI= 62.6, 80.5 vs 87.0%; 95% CI= 81.4, 91.1), wash their hands before eating (32.4%; 95% CI= 24.3, 42.2 vs 51.4%; 95% CI= 44.7, 60.1), and wash their hands after defecation (47.8%; 95% CI= 35.7, 57.1 vs 69.2%; 95% CI= 63.7, 78.7) as compared to their counterparts. Multiple logistic regression analysis indicated that the educational level of the respondents was the most important factor significantly associated with the KAP on STH among this population. This study reveals inadequate knowledge, attitude and practices on STH infections among Orang Asli in rural Malaysia. Hence, there is a great need for a proper health education programme and community mobilisation to enhance prevention and instil better knowledge on STH transmission and prevention. This is crucial for an effective and sustainable STH control programme to save the lives and future of the most vulnerable children in rural Malaysia.

  15. Stunting and soil-transmitted-helminth infections among school-age pupils in rural areas of southern China

    PubMed Central

    2010-01-01

    Background Stunting and soil-transmitted helminth (STH) infections including ascariasis, trichuriasis and hookworm remain major public health problems in school-age pupils in developing countries. The objectives of this study were to determine the prevalence of stunting for children and its association with three major soil-transmitted helminths (STH) in rural areas of southern China. The study also aims to determine risk factors for stunting and to provide guidance on the prevention and control of stunting and STH infections for future studies in this field. Results A cross-sectional survey was carried out in the poor rural areas in Guangxi Autonomous Regional and Hainan Province where STH prevalence was higher between September and November 2009. Pupils were from 15 primary schools. All the school-age pupils aged between 9 and 12 years old (mean age 11.2 ± 3.2 years), from grades three to six took part in this study. Study contents include questionnaire surveys, physical examination and laboratory methods (stool checking for eggs of three major STH infections and haemoglobin determination was performed for the anaemia test). Finally 1031 school-age pupils took part in survey. The results showed that the overall prevalence of stunting (HAZ < 2SD) was 25.6%, based on the WHO Child Growth Standards (2007). Risk factors for stunting based on logistic regression analyses were: (1) STH moderate-to-heavy intensity infections (OR = 1.93;95%CI:1.19,3.11); (2) anaemia (OR = 3.26;95%CI: 2.02,5.27); (3) education level of mother (OR = 2.13; 95%CI: 1.39,3.25). The overall prevalence of major STH infections was 36.7%, STH moderate-to-heavy intensity infections was 16.7%. The overall prevalence of ascariasis, trichuriasis, hookworm and co-infection were 18.5%, 11.2%, 14.7% and 9.1% respectively. The prevalence of anaemic children (HB < 12 g/dl) was 13.1%. Conclusion The present study showed that stunting was highly prevalent among the study population and STH infection is one of the important risk factors for stunting, with moderate-to-heavy intensity infections being the main predictor of stunting. Hence, additional interventions measures such as to promote de-worming treatment, to enhance health education and to improve hygiene and sanitation in order to reduce stunting in this population, are needed throughout the primary school age group. PMID:20942948

  16. Global feasibility assessment of interrupting the transmission of soil-transmitted helminths: a statistical modelling study.

    PubMed

    Brooker, Simon J; Nikolay, Birgit; Balabanova, Dina; Pullan, Rachel L

    2015-08-01

    Emphasis is being given to the control of neglected tropical diseases, including the possibility of interrupting the transmission of soil-transmitted helminths (STH). We evaluated the feasibility by country of achieving interruption of the transmission of STH. Based on a conceptual framework for the identification of the characteristics of a successful STH control programme, we assembled spatial data for a range of epidemiological, institutional, economic, and political factors. Using four different statistical methods, we developed a composite score of the feasibility of interrupting STH transmission and undertook a sensitivity analysis of the data and methods. The most important determining factors in the analysis were underlying intensity of STH transmission, current implementation of control programmes for neglected tropical diseases, and whether countries receive large-scale external funding and have strong health systems. The composite scores suggested that interrupting STH transmission is most feasible in countries in the Americas and parts of Asia (eg, Argentina [range of composite feasibility scores, depending on scoring method, 9·4-10·0], Brazil [8·7- 9·7], Chile [8·84-10·0], and Thailand [9·1-10·0]; there was perfect agreement between the four methods), and least feasible in countries in sub-Saharan Africa (eg, Congo [0·4-2·7] and Guinea [2·0-5·6]; there was full agreement between methods), but there were important exceptions to these trends (eg, Ghana [7·4-10·0]; there was agreement between three methods). Agreement was highest between the scores derived with the expert opinion and principal component analysis weighting schemes (Pearson correlation coefficient, r=0·98). The largest disagreement was between benefit-of-the-doubt-derived and principal-component-analysis-derived weighting schemes (r=0·74). The interruption of STH transmission is feasible, especially in countries with low intensity of transmission, supportive household environments, strong health systems, and the availability of suitable delivery platforms and in-country funds, but to achieve local elimination of STH an intersectoral approach to STH control will be needed. Bill & Melinda Gates Foundation and Wellcome Trust. Copyright © 2015 Brooker et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by Elsevier Ltd.. All rights reserved.

  17. Development of an educational cartoon to prevent worm infections in Chinese schoolchildren

    PubMed Central

    2013-01-01

    Background With more than two billion people infected worldwide, soil-transmitted helminths (STH) are the most widespread infections. To date, STH control efforts rely predominantly on recurrent mass drug administration (MDA), which does not prevent reinfection. Additional public health measures including novel health educational tools are required for more sustained integrated control of STH. We describe the development of an educational cartoon video (The Magic Glasses) targeting STH infections in Chinese schoolchildren and its pilot testing in China. We applied an extensive community-based mixed methods approach involving input from the target group of 9–10 year old schoolchildren and key informants, such as teachers, doctors and parents, in order to identify potential STH infection risks in the study area and to formulate key messages for the cartoon. The development of the educational cartoon included three major steps: formative research, production, and pilot testing and revision. Results We found that most adults and approximately 50% of the schoolchildren were aware of roundworm (Ascaris) infection, but knowledge of transmission, prevention and treatment of STH was poor. Observations in the study area showed that unhygienic food practices, such as eating raw and unwashed fruit or playing in vegetable gardens previously fertilised with human faeces, posed major STH infection risks. Conclusions It was crucial to assess the intellectual, emotional, social and cultural background of the target population prior to video production in order to integrate the key messages of the cartoon into everyday situations. Overall, our strategy for the development of the cartoon and its incorporation into a health education package proved successful, and we provide a summary of recommendations for the development of future educational videos based on our experiences in China. PMID:24289667

  18. Soil-Transmitted Helminths and Schistosoma mansoni Infections in Ethiopian Orthodox Church Students around Lake Tana, Northwest Ethiopia.

    PubMed

    Afework Bitew, Aschalew; Abera, Bayeh; Seyoum, Walle; Endale, Befekadu; Kiber, Tibebu; Goshu, Girma; Admass, Addiss

    2016-01-01

    Soil-transmitted helminths (STH) and Schistosoma mansoni infections are the major neglected tropical diseases that result in serious consequences on health, education and nutrition in children in developing countries. The Ethiopian Orthodox church students, who are called Yekolotemari in Amharic, live in areas with poor sanitation and hygiene. Moreover, they are not included in the national STH control programs. Thus, STH and S. mansoni infections prevalence is unknown. A cross-sectional study was conducted on 384 students in June 2014 to determine STH and S. mansoni infections prevalence. Moreover, the knowledge of students about STH and S. mansoni was assessed. Data on knowledge and clinical symptoms were collected using structured questionnaires via face to face interview. Stool specimens were examined by formol-ether concentration method. The overall prevalence of intestinal helminths infections was 85.9% (95% confidence interval (CI): 82.1-89%). STHs infections prevalence was 65.6% (95% CI: 60.7-70.2%). The prevalence of hookworm, Ascaris lumbricoides and Trichuris trichiura were 31.8% (95% CI: 27.3-36.6%), 29.4% (25-31%) and 3.1% (1.8-5.4%), respectively. On the other hand, S. mansoni prevalence was 14.3% (95% CI: 11.1-18.1%). Majority of students infected with S. mansoni had bloody stool with crud odds-ratio of 2.9 (95% CI: 1.5-5.5). Knowledge assessment showed that 50 (13%) and 18 (4.9%) of the respondents knew about transmission of STH and S. mansoni, respectively. The prevalence of STH and S. mansoni infections were high thus de-worming program should include the students of Ethiopian Orthodox churches. Furthermore, provision and use of sanitary facilities, health education for students to create awareness of parasitic infections and improved personal hygiene should be in place.

  19. Soil-transmitted helminthiasis in Latin America and the Caribbean: modelling the determinants, prevalence, population at risk and costs of control at sub-national level.

    PubMed

    Colston, Josh; Saboyá, Martha

    2013-05-01

    We present an example of a tool for quantifying the burden, the population in need of intervention and resources need to contribute for the control of soil-transmitted helminth (STH) infection at multiple administrative levels for the region of Latin America and the Caribbean (LAC). The tool relies on published STH prevalence data along with data on the distribution of several STH transmission determinants for 12,273 sub-national administrative units in 22 LAC countries taken from national censuses. Data on these determinants was aggregated into a single risk index based on a conceptual framework and the statistical significance of the association between this index and the STH prevalence indicators was tested using simple linear regression. The coefficient and constant from the output of this regression was then put into a regression formula that was applied to the risk index values for all of the administrative units in order to model the estimated prevalence of each STH species. We then combine these estimates with population data, treatment thresholds and unit cost data to calculate total control costs. The model predicts an annual cost for the procurement of preventive chemotherapy of around US$ 1.7 million and a total cost of US$ 47 million for implementing a comprehensive STH control programme targeting an estimated 78.7 million school-aged children according to the WHO guidelines throughout the entirety of the countries included in the study. Considerable savings to this cost could potentially be made by embedding STH control interventions within existing health programmes and systems. A study of this scope is prone to many limitations which restrict the interpretation of the results and the uses to which its findings may be put. We discuss several of these limitations.

  20. Albendazole and ivermectin for the control of soil-transmitted helminths in an area with high prevalence of Strongyloides stercoralis and hookworm in northwestern Argentina: A community-based pragmatic study.

    PubMed

    Echazú, Adriana; Juarez, Marisa; Vargas, Paola A; Cajal, Silvana P; Cimino, Ruben O; Heredia, Viviana; Caropresi, Silvia; Paredes, Gladys; Arias, Luis M; Abril, Marcelo; Gold, Silvia; Lammie, Patrick; Krolewiecki, Alejandro J

    2017-10-01

    Recommendations for soil-transmitted helminth (STH) control give a key role to deworming of school and pre-school age children with albendazole or mebendazole; which might be insufficient to achieve adequate control, particularly against Strongyloides stercoralis. The impact of preventive chemotherapy (PC) against STH morbidity is still incompletely understood. The aim of this study was to assess the effectiveness of a community-based program with albendazole and ivermectin in a high transmission setting for S. stercoralis and hookworm. Community-based pragmatic trial conducted in Tartagal, Argentina; from 2012 to 2015. Six communities (5070 people) were enrolled for community-based PC with albendazole and ivermectin. Two communities (2721 people) were re-treated for second and third rounds. STH prevalence, anemia and malnutrition were explored through consecutive surveys. Anthropometric assessment of children, stool analysis, complete blood count and NIE-ELISA serology for S. stercoralis were performed. STH infection was associated with anemia and stunting in the baseline survey that included all communities and showed a STH prevalence of 47.6% (almost exclusively hookworm and S. stercoralis). Among communities with multiple interventions, STH prevalence decreased from 62% to 23% (p<0.001) after the first PC; anemia also diminished from 52% to 12% (p<0.001). After two interventions S. stercoralis seroprevalence declined, from 51% to 14% (p<0.001) and stunting prevalence decreased, from 19% to 12% (p = 0.009). Hookworm' infections are associated with anemia in the general population and nutritional impairment in children. S. stercoralis is also associated with anemia. Community-based deworming with albendazole and ivermectin is effective for the reduction of STH prevalence and morbidity in communities with high prevalence of hookworm and S. stercoralis.

  1. Complexities and Perplexities: A Critical Appraisal of the Evidence for Soil-Transmitted Helminth Infection-Related Morbidity

    PubMed Central

    Nery, Susana V.; Doi, Suhail A.; Gray, Darren J.; Soares Magalhães, Ricardo J.; McCarthy, James S.; Traub, Rebecca J.; Andrews, Ross M.; Clements, Archie C. A.

    2016-01-01

    Background: Soil-transmitted helminths (STH) have acute and chronic manifestations, and can result in lifetime morbidity. Disease burden is difficult to quantify, yet quantitative evidence is required to justify large-scale deworming programmes. A recent Cochrane systematic review, which influences Global Burden of Disease (GBD) estimates for STH, has again called into question the evidence for deworming benefit on morbidity due to STH. In this narrative review, we investigate in detail what the shortfalls in evidence are. Methodology/Principal Findings: We systematically reviewed recent literature that used direct measures to investigate morbidity from STH and we critically appraised systematic reviews, particularly the most recent Cochrane systematic review investigating deworming impact on morbidity. We included six systematic reviews and meta-analyses, 36 literature reviews, 44 experimental or observational studies, and five case series. We highlight where evidence is insufficient and where research needs to be directed to strengthen morbidity evidence, ideally to prove benefits of deworming. Conclusions/Significance: Overall, the Cochrane systematic review and recent studies indicate major shortfalls in evidence for direct morbidity. However, it is questionable whether the systematic review methodology should be applied to STH due to heterogeneity of the prevalence of different species in each setting. Urgent investment in studies powered to detect direct morbidity effects due to STH is required. PMID:27196100

  2. Nano-Localized Thermal Analysis and Mapping of Surface and Sub-Surface Thermal Properties Using Scanning Thermal Microscopy (SThM).

    PubMed

    Pereira, Maria J; Amaral, Joao S; Silva, Nuno J O; Amaral, Vitor S

    2016-12-01

    Determining and acting on thermo-physical properties at the nanoscale is essential for understanding/managing heat distribution in micro/nanostructured materials and miniaturized devices. Adequate thermal nano-characterization techniques are required to address thermal issues compromising device performance. Scanning thermal microscopy (SThM) is a probing and acting technique based on atomic force microscopy using a nano-probe designed to act as a thermometer and resistive heater, achieving high spatial resolution. Enabling direct observation and mapping of thermal properties such as thermal conductivity, SThM is becoming a powerful tool with a critical role in several fields, from material science to device thermal management. We present an overview of the different thermal probes, followed by the contribution of SThM in three currently significant research topics. First, in thermal conductivity contrast studies of graphene monolayers deposited on different substrates, SThM proves itself a reliable technique to clarify the intriguing thermal properties of graphene, which is considered an important contributor to improve the performance of downscaled devices and materials. Second, SThM's ability to perform sub-surface imaging is highlighted by thermal conductivity contrast analysis of polymeric composites. Finally, an approach to induce and study local structural transitions in ferromagnetic shape memory alloy Ni-Mn-Ga thin films using localized nano-thermal analysis is presented.

  3. Treatment for Schistosoma japonicum, Reduction of Intestinal Parasite Load, and Cognitive Test Score Improvements in School-Aged Children

    PubMed Central

    Ezeamama, Amara E.; McGarvey, Stephen T.; Hogan, Joseph; Lapane, Kate L.; Bellinger, David C.; Acosta, Luz P.; Leenstra, Tjalling; Olveda, Remigio M.; Kurtis, Jonathan D.; Friedman, Jennifer F.

    2012-01-01

    Background To determine whether treatment of intestinal parasitic infections improves cognitive function in school-aged children, we examined changes in cognitive testscores over 18 months in relation to: (i) treatment-related Schistosoma japonicum intensity decline, (ii) spontaneous reduction of single soil-transmitted helminth (STH) species, and (iii) ≥2 STH infections among 253 S. japonicum-infected children. Methodology Helminth infections were assessed at baseline and quarterly by the Kato-Katz method. S. japonicum infection was treated at baseline using praziquantel. An intensity-based indicator of lower vs. no change/higher infection was defined separately for each helminth species and joint intensity declines of ≥2 STH species. In addition, S. japonicum infection-free duration was defined in four categories based on time of schistosome re-infection: >18 (i.e. cured), >12 to ≤18, 6 to ≤12 and ≤6 (persistently infected) months. There was no baseline treatment for STHs but their intensity varied possibly due to spontaneous infection clearance/acquisition. Four cognitive tests were administered at baseline, 6, 12, and 18 months following S. japonicum treatment: learning and memory domains of Wide Range Assessment of Memory and Learning (WRAML), verbal fluency (VF), and Philippine nonverbal intelligence test (PNIT). Linear regression models were used to relate changes in respective infections to test performance with adjustment for sociodemographic confounders and coincident helminth infections. Principal Findings Children cured (β = 5.8; P = 0.02) and those schistosome-free for >12 months (β = 1.5; P = 0.03) scored higher in WRAML memory and VF tests compared to persistently infected children independent of STH infections. A decline vs. no change/increase of any individual STH species (β:11.5–14.5; all P<0.01) and the joint decline of ≥2 STH (β = 13.1; P = 0.01) species were associated with higher scores in WRAML learning test independent of schistosome infection. Hookworm and Trichuris trichiura declines were independently associated with improvements in WRAML memory scores as was the joint decline in ≥2 STH species. Baseline coinfection by ≥2 STH species was associated with low PNIT scores (β = −1.9; P = 0.04). Conclusion/Significance Children cured/S. japonicum-free for >12 months post-treatment and those who experienced declines of ≥2 STH species scored higher in three of four cognitive tests. Our result suggests that sustained deworming and simultaneous control for schistosome and STH infections could improve children's ability to take advantage of educational opportunities in helminth-endemic regions. PMID:22563514

  4. Status of soil-transmitted helminth infections in schoolchildren in Laguna Province, the Philippines: Determined by parasitological and molecular diagnostic techniques.

    PubMed

    Mationg, Mary Lorraine S; Gordon, Catherine A; Tallo, Veronica L; Olveda, Remigio M; Alday, Portia P; Reñosa, Mark Donald C; Bieri, Franziska A; Williams, Gail M; Clements, Archie C A; Steinmann, Peter; Halton, Kate; Li, Yuesheng; McManus, Donald P; Gray, Darren J

    2017-11-01

    Soil-transmitted helminths (STH) are the most common parasitic infections in impoverished communities, particularly among children. Current STH control is through school-based mass drug administration (MDA), which in the Philippines is done twice annually. As expected, MDA has decreased the intensity and prevalence of STH over time. As a result, the common Kato Katz (KK) thick smear method of detecting STH is less effective because it lacks sensitivity in low intensity infections, making it difficult to measure the impact of deworming programs. A cross-sectional study was carried out over a four-week period from October 27, 2014 until November 20, 2014 in Laguna province, the Philippines. Stool samples were collected from 263 schoolchildren, to determine the prevalence of STH and compare diagnostic accuracy of multiplex quantitative polymerase chain reaction (qPCR) with the KK. A large discrepancy in the prevalence between the two techniques was noted for the detection of at least one type of STH infection (33.8% by KK vs. 78.3% by qPCR), Ascaris lumbricoides (20.5% by KK vs. 60.8% by qPCR) and Trichuris trichiura (23.6% by KK vs. 38.8% by qPCR). Considering the combined results of both methods, the prevalence of at least one type of helminth infection, A. lumbricoides, and T. trichiura were 83.3%, 67.7%, and 53.6%, respectively. Sensitivity of the qPCR for detecting at least one type of STH infection, A. lumbricoides, and T. trichiura were 94.1%, 89.9%, and 72.3% respectively; whereas KK sensitivity was 40.6%, 30.3%, and 44.0%, respectively. The qPCR method also detected infections with Ancylostoma spp. (4.6%), Necator americanus (2.3%), and Strongyloides stercoralis (0.8%) that were missed by KK. qPCR may provide new and important diagnostic information to improve assessment of the effectiveness and impact of integrated control strategies particularly in areas where large-scale STH control has led to low prevalence and/or intensity of infection.

  5. Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: A systematic review and meta-analysis.

    PubMed

    Pabalan, Noel; Singian, Eloisa; Tabangay, Lani; Jarjanazi, Hamdi; Boivin, Michael J; Ezeamama, Amara E

    2018-01-01

    Evidence of an adverse influence of soil transmitted helminth (STH) infections on cognitive function and educational loss is equivocal. Prior meta-analyses have focused on randomized controlled trials only and have not sufficiently explored the potential for disparate influence of STH infection by cognitive domain. We re-examine the hypothesis that STH infection is associated with cognitive deficit and educational loss using data from all primary epidemiologic studies published between 1992 and 2016. Medline, Biosis and Web of Science were searched for original studies published in the English language. Cognitive function was defined in four domains (learning, memory, reaction time and innate intelligence) and educational loss in two domains (attendance and scholastic achievement). Pooled effect across studies were calculated as standardized mean differences (SMD) to compare cognitive and educational measures for STH infected/non-dewormed children versus STH uninfected /dewormed children using Review Manager 5.3. Sub-group analyses were implemented by study design, risk of bias (ROB) and co-prevalence of Schistosoma species infection. Influential studies were excluded in sensitivity analysis to examine stability of pooled estimates. We included 36 studies of 12,920 children. STH infected/non-dewormed children had small to moderate deficits in three domains-learning, memory and intelligence (SMD: -0.44 to -0.27, P<0.01-0.03) compared to STH-uninfected/dewormed children. There were no differences by infection/treatment status for reaction time, school attendance and scholastic achievement (SMD: -0.26 to -0.16, P = 0.06-0.19). Heterogeneity of the pooled effects in all six domains was high (P<0.01; I2 = 66-99%). Application of outlier treatment reduced heterogeneity in learning domain (P = 0.12; I2 = 33%) and strengthened STH-related associations in all domains but intelligence (SMD: -0.20, P = 0.09). Results varied by study design and ROB. Among experimental intervention studies, there was no association between STH treatment and educational loss/performance in tests of memory, reaction time and innate intelligence (SMD: -0.27 to 0.17, P = 0.18-0.69). Infection-related deficits in learning persisted within design/ROB levels (SMD: -0.37 to -52, P<0.01) except for pre-vs post intervention design (n = 3 studies, SMD = -0.43, P = 0.47). Deficits in memory, reaction time and innate intelligence persisted within observational studies (SMD: -0.23 to -0.38, all P<0.01) and high ROB strata (SMD:-0.37 to -0.83, P = 0.07 to <0.01). Further, in Schistosoma infection co-prevalent settings, associations were generally stronger and statistically robust for STH-related deficits in learning, memory and reaction time tests(SMD:-0.36 to -0.55, P = 0.003-0.02). STH-related deficits in school attendance and scholastic achievement was noted in low (SMD:-0.57, P = 0.05) and high ROB strata respectively. We provide evidence of superior performance in five of six educational and cognitive domains assessed for STH uninfected/dewormed versus STH infected/not-dewormed school-aged children from helminth endemic regions. Cautious interpretation is warranted due to high ROB in some of the primary literature and high between study variability in most domains. Notwithstanding, this synthesis provides empirical support for a cognitive and educational benefit of deworming. The benefit of deworming will be enhanced by strategically employing, integrated interventions. Thus, multi-pronged inter-sectoral strategies that holistically address the environmental and structural roots of child cognitive impairment and educational loss in the developing world may be needed to fully realize the benefit of mass deworming programs.

  6. Soil-transmitted helminth infection, loss of education and cognitive impairment in school-aged children: A systematic review and meta-analysis

    PubMed Central

    Pabalan, Noel; Singian, Eloisa; Tabangay, Lani; Jarjanazi, Hamdi; Boivin, Michael J.

    2018-01-01

    Background Evidence of an adverse influence of soil transmitted helminth (STH) infections on cognitive function and educational loss is equivocal. Prior meta-analyses have focused on randomized controlled trials only and have not sufficiently explored the potential for disparate influence of STH infection by cognitive domain. We re-examine the hypothesis that STH infection is associated with cognitive deficit and educational loss using data from all primary epidemiologic studies published between 1992 and 2016. Methods Medline, Biosis and Web of Science were searched for original studies published in the English language. Cognitive function was defined in four domains (learning, memory, reaction time and innate intelligence) and educational loss in two domains (attendance and scholastic achievement). Pooled effect across studies were calculated as standardized mean differences (SMD) to compare cognitive and educational measures for STH infected/non-dewormed children versus STH uninfected /dewormed children using Review Manager 5.3. Sub-group analyses were implemented by study design, risk of bias (ROB) and co-prevalence of Schistosoma species infection. Influential studies were excluded in sensitivity analysis to examine stability of pooled estimates. Findings We included 36 studies of 12,920 children. STH infected/non-dewormed children had small to moderate deficits in three domains—learning, memory and intelligence (SMD: -0.44 to -0.27, P<0.01–0.03) compared to STH-uninfected/dewormed children. There were no differences by infection/treatment status for reaction time, school attendance and scholastic achievement (SMD: -0.26 to -0.16, P = 0.06–0.19). Heterogeneity of the pooled effects in all six domains was high (P<0.01; I2 = 66–99%). Application of outlier treatment reduced heterogeneity in learning domain (P = 0.12; I2 = 33%) and strengthened STH-related associations in all domains but intelligence (SMD: -0.20, P = 0.09). Results varied by study design and ROB. Among experimental intervention studies, there was no association between STH treatment and educational loss/performance in tests of memory, reaction time and innate intelligence (SMD: -0.27 to 0.17, P = 0.18–0.69). Infection-related deficits in learning persisted within design/ROB levels (SMD: -0.37 to -52, P<0.01) except for pre-vs post intervention design (n = 3 studies, SMD = -0.43, P = 0.47). Deficits in memory, reaction time and innate intelligence persisted within observational studies (SMD: -0.23 to -0.38, all P<0.01) and high ROB strata (SMD:-0.37 to -0.83, P = 0.07 to <0.01). Further, in Schistosoma infection co-prevalent settings, associations were generally stronger and statistically robust for STH-related deficits in learning, memory and reaction time tests(SMD:-0.36 to -0.55, P = 0.003–0.02). STH-related deficits in school attendance and scholastic achievement was noted in low (SMD:-0.57, P = 0.05) and high ROB strata respectively. Interpretation We provide evidence of superior performance in five of six educational and cognitive domains assessed for STH uninfected/dewormed versus STH infected/not-dewormed school-aged children from helminth endemic regions. Cautious interpretation is warranted due to high ROB in some of the primary literature and high between study variability in most domains. Notwithstanding, this synthesis provides empirical support for a cognitive and educational benefit of deworming. The benefit of deworming will be enhanced by strategically employing, integrated interventions. Thus, multi-pronged inter-sectoral strategies that holistically address the environmental and structural roots of child cognitive impairment and educational loss in the developing world may be needed to fully realize the benefit of mass deworming programs. PMID:29329288

  7. Soil-transmitted helminth infection and nutritional status among urban slum children in Kenya.

    PubMed

    Suchdev, Parminder S; Davis, Stephanie M; Bartoces, Monina; Ruth, Laird J; Worrell, Caitlin M; Kanyi, Henry; Odero, Kennedy; Wiegand, Ryan E; Njenga, Sammy M; Montgomery, Joel M; Fox, LeAnne M

    2014-02-01

    To evaluate the nutritional impact of soil-transmitted helminth (STH) infection, we conducted a cross-sectional survey of 205 pre-school (PSC) and 487 school-aged children (SAC) randomly selected from the surveillance registry of the Centers for Disease Control and Prevention of the Kibera slum in Kenya. Hemoglobin, iron deficiency (ID), vitamin A deficiency (VAD), inflammation, malaria, anthropometry, and STH ova were measured. Poisson regression models evaluated associations between STH and malnutrition outcomes and controlled for confounders. Approximately 40% of PSC and SAC had STH infection, primarily Ascaris and Trichuris; 2.9% of PSC and 1.1% of SAC had high-intensity infection. Malnutrition prevalence among PSC and SAC was anemia (38.3% and 14.0%, respectively), ID (23.0% and 5.0%, respectively), VAD (16.9% and 4.5%, respectively), and stunting (29.7% and 16.9%, respectively). In multivariate analysis, STH in PSC was associated with VAD (prevalence ratio [PR] = 2.2, 95% confidence interval = 1.1-4.6) and ID (PR = 3.3, 95% confidence interval = 1.6-6.6) but not anemia or stunting. No associations were significant in SAC. Integrated deworming and micronutrient supplementation strategies should be evaluated in this population.

  8. The burden of moderate-to-heavy soil-transmitted helminth infections among rural malaysian aborigines: an urgent need for an integrated control programme.

    PubMed

    Ahmed, Abdulhamid; Al-Mekhlafi, Hesham M; Choy, Seow Huey; Ithoi, Init; Al-Adhroey, Abdulelah H; Abdulsalam, Awatif M; Surin, Johari

    2011-12-30

    Soil-transmitted helminth (STH) infections, among the most common neglected tropical diseases, continue to be a major threat to the health and socioeconomic wellbeing of infected people especially children in developing countries. A cross-sectional study among 254 aboriginal schoolchildren was conducted in order to determine the current prevalence and intensity of infections and to investigate the potential risk factors associated with moderate-to-heavy burden of STH infections among these children. Overall, 93.7% of children were found to be infected with one or more STH species. The prevalence of trichuriasis, ascariasis and hookworm infections were 84.6%, 47.6% and 3.9%, respectively. Almost half of the participants had heavy trichuriasis, one-quarter had heavy ascariasis whereas all hookworm infections were light infections. Overall, moderate-to-heavy STH infections accounted for 56.7% of the total infections. Univariate analysis revealed that those using untreated water supply (P = 0.013), living in houses without toilets (P = 0.027) and having domestic animals in the houses (P = 0.044) had significantly higher prevalence of moderate-to-heavy infections than others. Logistic regression analysis confirmed using untreated water for drinking (P = 0.001) and the absence of a toilet in the house (P = 0.003) as significant risk factors of moderate-to-heavy STH infections among these children. The high proportion of moderate-to-heavy STH infections further confirms the need for serious attention towards these devastating diseases that has put lives and the future of aboriginal children in jeopardy. Introduction of more poverty alleviation schemes, proper sanitation, provision of clean and safe drinking water, health education, as well as the introduction of periodic school-based deworming programmes are imperative among these communities in order to curtail the transmission and morbidity caused by STH.

  9. Soil-Transmitted Helminths and Schistosoma mansoni Infections in Ethiopian Orthodox Church Students around Lake Tana, Northwest Ethiopia

    PubMed Central

    Afework Bitew, Aschalew; Abera, Bayeh; Seyoum, Walle; Endale, Befekadu; Kiber, Tibebu; Goshu, Girma; Admass, Addiss

    2016-01-01

    Background Soil-transmitted helminths (STH) and Schistosoma mansoni infections are the major neglected tropical diseases that result in serious consequences on health, education and nutrition in children in developing countries. The Ethiopian Orthodox church students, who are called Yekolotemari in Amharic, live in areas with poor sanitation and hygiene. Moreover, they are not included in the national STH control programs. Thus, STH and S. mansoni infections prevalence is unknown. Methods A cross-sectional study was conducted on 384 students in June 2014 to determine STH and S. mansoni infections prevalence. Moreover, the knowledge of students about STH and S. mansoni was assessed. Data on knowledge and clinical symptoms were collected using structured questionnaires via face to face interview. Stool specimens were examined by formol-ether concentration method. Results The overall prevalence of intestinal helminths infections was 85.9% (95% confidence interval (CI): 82.1–89%). STHs infections prevalence was 65.6% (95% CI: 60.7–70.2%). The prevalence of hookworm, Ascaris lumbricoides and Trichuris trichiura were 31.8% (95% CI: 27.3–36.6%), 29.4% (25–31%) and 3.1% (1.8–5.4%), respectively. On the other hand, S. mansoni prevalence was 14.3% (95% CI: 11.1–18.1%). Majority of students infected with S. mansoni had bloody stool with crud odds-ratio of 2.9 (95% CI: 1.5–5.5). Knowledge assessment showed that 50 (13%) and 18 (4.9%) of the respondents knew about transmission of STH and S. mansoni, respectively. Conclusions The prevalence of STH and S. mansoni infections were high thus de-worming program should include the students of Ethiopian Orthodox churches. Furthermore, provision and use of sanitary facilities, health education for students to create awareness of parasitic infections and improved personal hygiene should be in place. PMID:27203749

  10. The burden of moderate-to-heavy soil-transmitted helminth infections among rural malaysian aborigines: an urgent need for an integrated control programme

    PubMed Central

    2011-01-01

    Background Soil-transmitted helminth (STH) infections, among the most common neglected tropical diseases, continue to be a major threat to the health and socioeconomic wellbeing of infected people especially children in developing countries. Methods A cross-sectional study among 254 aboriginal schoolchildren was conducted in order to determine the current prevalence and intensity of infections and to investigate the potential risk factors associated with moderate-to-heavy burden of STH infections among these children. Results Overall, 93.7% of children were found to be infected with one or more STH species. The prevalence of trichuriasis, ascariasis and hookworm infections were 84.6%, 47.6% and 3.9%, respectively. Almost half of the participants had heavy trichuriasis, one-quarter had heavy ascariasis whereas all hookworm infections were light infections. Overall, moderate-to-heavy STH infections accounted for 56.7% of the total infections. Univariate analysis revealed that those using untreated water supply (P = 0.013), living in houses without toilets (P = 0.027) and having domestic animals in the houses (P = 0.044) had significantly higher prevalence of moderate-to-heavy infections than others. Logistic regression analysis confirmed using untreated water for drinking (P = 0.001) and the absence of a toilet in the house (P = 0.003) as significant risk factors of moderate-to-heavy STH infections among these children. Conclusion The high proportion of moderate-to-heavy STH infections further confirms the need for serious attention towards these devastating diseases that has put lives and the future of aboriginal children in jeopardy. Introduction of more poverty alleviation schemes, proper sanitation, provision of clean and safe drinking water, health education, as well as the introduction of periodic school-based deworming programmes are imperative among these communities in order to curtail the transmission and morbidity caused by STH. PMID:22208559

  11. Home Healthcare Program for Soil-Transmitted Helminthiasis in Schoolchildren along the Mekong River Basin.

    PubMed

    Kaewpitoon, Soraya J; Loyd, Ryan A; Kaewpitoon, Natthawut

    2015-05-01

    Soil-transmitted helminths (STH) are among the most important groups of infectious agents responsible for physical and intellectual growth retardation in children worldwide. Current status is need requiredfor the development of control programs. To determine the STH infections among the schoolchildren in the Mekong River basin near rural Ubon Ratchathani, Thailand and Champassak, Laos PDR, including their caregiver knowledge and attitude concerning prevention of STH infections. A cross sectional survey was designed as a home healthcare programfrom October 2009 to April 2012. 1,957 fecal samples were collected from children aged 5-12 years in five districts of Ubon Ratchathani province (1,012 fecal samples; Khong Chiam, Si Mueang Mai, Phibun Mangsahan, Sirindhorn, and Pho Sai), Thailand, and one district of Champassak Province (945 fecal samples; Pakse), Lao PDR. Fecal samples were prepared by the modified formalin ethylacetate concentration technique, and determined by light microscope. The knowledge and attitude of children's caregivers concerning prevention of soil-transmitted helminth infections were completed interviewed by semi-structured questionnaires. The overall intestinal helminth prevalence rate was 11.88%. Classified by species the STHs were as follows: Ascaris lumbricoides (30.9%), Trichuris trichiura (21.7%), and hookworm (20.5%). The highest prevalence was recorded in children aged 9 years and above. The highest prevalence of STH infection was found in the Pakse district of Laos PDR (16.08%). The intensities of infection with A. lumbricoides, T trichiura, and Hookworm were 1.82 ± 0.36, 1.32 ± 0.30, and 1.29 ± 0.32, respectively. 1,077 of caregivers were completed interviewed and found that the caregivers had fair levels of knowledge and attitude regarding soil-transmitted helminthiasis. These results suggest that priority should be given to STH eradication, the development of control programs in the Mekong River Basin, and the provision of education about STH to caregivers to reduce the risk of STH infection in their schoolchildren.

  12. Differential human gut microbiome assemblages during soil-transmitted helminth infections in Indonesia and Liberia.

    PubMed

    Rosa, Bruce A; Supali, Taniawati; Gankpala, Lincoln; Djuardi, Yenny; Sartono, Erliyani; Zhou, Yanjiao; Fischer, Kerstin; Martin, John; Tyagi, Rahul; Bolay, Fatorma K; Fischer, Peter U; Yazdanbakhsh, Maria; Mitreva, Makedonka

    2018-02-28

    The human intestine and its microbiota is the most common infection site for soil-transmitted helminths (STHs), which affect the well-being of ~ 1.5 billion people worldwide. The complex cross-kingdom interactions are not well understood. A cross-sectional analysis identified conserved microbial signatures positively or negatively associated with STH infections across Liberia and Indonesia, and longitudinal samples analysis from a double-blind randomized trial showed that the gut microbiota responds to deworming but does not transition closer to the uninfected state. The microbiomes of individuals able to self-clear the infection had more alike microbiome assemblages compared to individuals who remained infected. One bacterial taxon (Lachnospiracae) was negatively associated with infection in both countries, and 12 bacterial taxa were significantly associated with STH infection in both countries, including Olsenella (associated with reduced gut inflammation), which also significantly reduced in abundance following clearance of infection. Microbial community gene abundances were also affected by deworming. Functional categories identified as associated with STH infection included arachidonic acid metabolism; arachidonic acid is the precursor for pro-inflammatory leukotrienes that threaten helminth survival, and our findings suggest that some modulation of arachidonic acid activity in the STH-infected gut may occur through the increase of arachidonic acid metabolizing bacteria. For the first time, we identify specific members of the gut microbiome that discriminate between moderately/heavily STH-infected and non-infected states across very diverse geographical regions using two different statistical methods. We also identify microbiome-encoded biological functions associated with the STH infections, which are associated potentially with STH survival strategies, and changes in the host environment. These results provide a novel insight of the cross-kingdom interactions in the human gut ecosystem by unlocking the microbiome assemblages at taxonomic, genetic, and functional levels so that advances towards key mechanistic studies can be made.

  13. Albendazole and ivermectin for the control of soil-transmitted helminths in an area with high prevalence of Strongyloides stercoralis and hookworm in northwestern Argentina: A community-based pragmatic study

    PubMed Central

    Juarez, Marisa; Vargas, Paola A.; Cajal, Silvana P.; Cimino, Ruben O.; Heredia, Viviana; Caropresi, Silvia; Paredes, Gladys; Arias, Luis M.; Abril, Marcelo; Gold, Silvia; Lammie, Patrick; Krolewiecki, Alejandro J.

    2017-01-01

    Background Recommendations for soil-transmitted helminth (STH) control give a key role to deworming of school and pre-school age children with albendazole or mebendazole; which might be insufficient to achieve adequate control, particularly against Strongyloides stercoralis. The impact of preventive chemotherapy (PC) against STH morbidity is still incompletely understood. The aim of this study was to assess the effectiveness of a community-based program with albendazole and ivermectin in a high transmission setting for S. stercoralis and hookworm. Methodology Community-based pragmatic trial conducted in Tartagal, Argentina; from 2012 to 2015. Six communities (5070 people) were enrolled for community-based PC with albendazole and ivermectin. Two communities (2721 people) were re-treated for second and third rounds. STH prevalence, anemia and malnutrition were explored through consecutive surveys. Anthropometric assessment of children, stool analysis, complete blood count and NIE-ELISA serology for S. stercoralis were performed. Principal findings STH infection was associated with anemia and stunting in the baseline survey that included all communities and showed a STH prevalence of 47.6% (almost exclusively hookworm and S. stercoralis). Among communities with multiple interventions, STH prevalence decreased from 62% to 23% (p<0.001) after the first PC; anemia also diminished from 52% to 12% (p<0.001). After two interventions S. stercoralis seroprevalence declined, from 51% to 14% (p<0.001) and stunting prevalence decreased, from 19% to 12% (p = 0.009). Conclusions Hookworm’ infections are associated with anemia in the general population and nutritional impairment in children. S. stercoralis is also associated with anemia. Community-based deworming with albendazole and ivermectin is effective for the reduction of STH prevalence and morbidity in communities with high prevalence of hookworm and S. stercoralis. PMID:28991899

  14. Prevalence & risk factors for soil transmitted helminth infection among school children in south India

    PubMed Central

    Kattula, Deepthi; Sarkar, Rajiv; Ajjampur, Sitara Swarna Rao; Minz, Shantidani; Levecke, Bruno; Muliyil, Jayaprakash; Kang, Gagandeep

    2014-01-01

    Background & objectives: Soil-transmitted helminths (STH) are a major public health problem in tropical and sub-tropical countries, affecting the physical growth and cognitive development in school-age children. This study was aimed to assess the prevalence and risk factors of STH infection among school children aged 6-14 yr in Vellore and Thiruvanamalai districts in south India. Methods: Children aged 6-14 yr, going to government and government aided schools (n=33, randomly selected) in Vellore and Thiruvanamalai districts were screened to estimate the prevalence of STH, and a case control study was done on a subset to assess the risk factors for the infection. Results: The prevalence of STH was 7.8 per cent, varying widely in schools from 0 to 20.4 per cent, in 3706 screened children. Hookworm (8.4%) rates were high in rural areas, while Ascaris (3.3%) and Trichuris (2.2%) were more prevalent among urban children. Consumption of deworming tablets (OR=0.25, P < 0.01) offered protection, while residing in a field hut (OR=6.73, P=0.02) and unhygienic practices like open air defaecation (OR=5.37, P < 0.01), keeping untrimmed nails (OR=2.53, P=0.01) or eating food fallen on the ground (OR=2.52, P=0.01) were important risk factors for STH infection. Interpretation & conclusions: Our study indicated that school children with specific risk factors in the studied area were vulnerable subpopulation with elevated risk of STH infection. Identifying risk factors and dynamics of transmission in vulnerable groups can help to plan for effective prevention strategies. PMID:24604041

  15. Prevalence of soil-transmitted helminths in remote villages in East Kwaio, Solomon Islands.

    PubMed

    Harrington, Humpress; Bradbury, Richard; Taeka, James; Asugeni, James; Asugeni, Vunivesi; Igeni, Tony; Gwala, John; Newton, Lawrence; Fa, Chillion Evan; Kilivisi, Fawcett Laurence; Esau, Dorothy; Flores, Angelica; Ribeyro, Elmer; Liku, Daisy; Muse, Alwin; Asugeni, Lyndel; Talana, Jeptha; Shield, Jennifer; MacLaren, David J; Massey, Peter D; Muller, Reinhold; Speare, Rick

    2015-01-01

    Although soil-transmitted helminths (STH) are endemic in Solomon Islands, there are few recent reports on their prevalence. This study aimed to determine the prevalence of STH in residents of remote communities in Solomon Islands. A cross-sectional convenience-sampled survey of residents of four adjacent villages in Malaita, Solomon Islands was performed in Atoifi and Na'au in April 2011 and in Abitona and Sifilo in April 2012. All residents older than one year were invited to participate, which involved providing a single sample of faeces examined using a modified Kato-Katz technique and completing a questionnaire that asked demographic and STH-related behaviour questions. The overall participation rate was 52.8%, with 402 participants comprising 49.8% males. Hookworm was the predominant STH with only a single case of trichuriasis found in Atoifi. The total prevalence of hookworm was 22.6% (95% confidence interval: 18.6-27.1); the prevalence of hookworm in Abitona, Na'au and Sifilo was 20.0%, 29.9% and 27.4%, respectively, whereas in Atoifi it was 2.3% (P < 0.001). Intensity was low in all villages. Although health behaviours differed significantly between Atoifi and the other three villages, the type of toilet used was the only significant association with hookworm. Residents of Atoifi have a relative freedom from STH compared to the other three villages. Rather than a region-wide morbidity control approach, a "one village at a time" approach aiming to eliminate STH and dealing with each village as a separate autonomous unit empowered to manage its own challenges may be a preferred option.

  16. An unceasing problem: soil-transmitted helminthiases in rural Malaysian communities.

    PubMed

    Al-Mekhlafi, M S Hesham; Atiya, A S; Lim, Y A L; Mahdy, A K Mohammed; Ariffin, W A Wan; Abdullah, H Che; Surin, Johari

    2007-11-01

    Despite great development in socioeconomic status throughout 50 years of independence, Malaysia is still plagued with soil-transmitted helminthiases (STH). STH continue to have a significant impact on public health particularly in rural communities. In order to determine the prevalence of STH among rural Orang Asli children and to investigate the possible risk factors affecting the pattern of this prevalence, fecal samples were collected from 292 Orang Asli primary schoolchildren (145 males and 147 females) age 7-12 years, from Pos Betau, Kuala Lipis, Pahang. The samples were examined by Kato-Katz and Harada Mori techniques. Socioeconomic data were collected using pre-tested questionnaires. The overall prevalence of ascariasis, trichuriasis, and hookworm infections were 67.8, 95.5 and 13.4%, respectively. Twenty-nine point eight percent of the children had heavy trichuriasis, while 22.3% had heavy ascariasis. Sixty-seven point seven percent of the children had mixed infections. Age > 10 years (p = 0.016), no toilet in the house (p = 0.012), working mother (p = 0.040), low household income (p = 0.033), and large family size (p = 0.028) were identified as risk factors for ascariasis. Logistic regression confirmed low income, no toilet in the house and working mother as significant risk factors for ascariasis. The prevalence of STH is still very high in rural Malaysian communities. STH may also contribute to other health problems such as micronutrient deficiencies, protein-energy malnutrition and poor educational achievement. Public health personnel need to reassess current control measures and identify innovative and integrated ways in order to reduce STH significantly in rural communities.

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

    PubMed

    Al-Mekhlafi, Hesham M; Anuar, Tengku Shahrul; Al-Zabedi, Ebtesam M; Al-Maktari, Mohamed T; Mahdy, Mohammed A K; Ahmed, Abdulhamid; Sallam, Atiya A; Abdullah, Wan Ariffin; Moktar, Norhayati; Surin, Johari

    2014-08-15

    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. A randomized, double-blind, placebo-controlled trial was conducted on 250 Aboriginal schoolchildren in Malaysia to investigate the effects of a single high-dose of vitamin A supplementation (200,000 IU) on STH reinfection. The effect of the supplement was assessed at 3 and 6 months after receiving interventions; after a complete 3-day deworming course of 400 mg/daily of albendazole tablets. Almost all children (98.6%) were infected with at least one STH species. The overall prevalence of ascariasis, trichuriasis and hookworm infection was 67.8%, 95.5% and 13.4%, respectively. Reinfection rates of Ascaris, Trichuris and hookworm were high; at 6 months, assessment reached 80% of the prevalence reported before treatment. There were no significant differences in the reinfection rates and intensities of STH between vitamin A supplemented-children and those who received placebo at 3 and 6 months (p > 0.05). Vitamin A supplementation showed no protective effect against STH reinfection and this could be due to the high endemicity of STH in this community. Long-term interventions to reduce poverty will help significantly in reducing this continuing problem and there is no doubt that reducing intestinal parasitic infection would have a positive impact on the health, nutrition and education of these children. This trial was registered at clinicaltrials.gov as NCT00936091.

  18. Pattern and predictors of soil-transmitted helminth reinfection among aboriginal schoolchildren in rural Peninsular Malaysia.

    PubMed

    Hesham Al-Mekhlafi, M; Surin, Johari; Atiya, A S; Ariffin, W A; Mohammed Mahdy, A K; Che Abdullah, H

    2008-08-01

    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.

  19. Assessment of schistosomiasis and soil-transmitted helminths prevalence in school-aged children and opportunities for integration of control in local health services in Kwilu Province, the Democratic Republic of the Congo.

    PubMed

    Inocencio da Luz, R; Linsuke, S; Lutumba, P; Hasker, E; Boelaert, M

    2017-11-01

    To determine the prevalence of schistosomiasis (SCH) and soil-transmitted helminths (STH) in the Democratic Republic of Congo, and to assess the capacity of the local health centres for diagnosis and treatment. Cross-sectional school-based survey in two health districts in the Province of Kwilu. We collected a stool and a urine sample for parasitological examination. Urine filtration and duplicate Kato-Katz thick smears were used for the diagnosis of SCH. Health centres were evaluated using a structured questionnaire. In total, 526 children participated in the study and the overall prevalence of Schistosoma mansoni infection was 8.9% (95% CI: 3.5-13.2) in both districts. The prevalence was higher in Mosango (11.7%; 95% CI: 8.9-14.8) than Yasa Bonga district (6.2%; 95% CI: 1.1-11.4). Urine filtration showed that Schistosoma haematobium infection was not present. The combined STH infection prevalence was 58.1% in both districts; hookworm infection was the most common STH found in 52.9% (95% CI: 29.3-62.4) of subjects, followed by Ascaris lumbricoides 9.3% (95% CI: 5.8-15.5) and Trichuris trichiura 2.1% (95% CI: 0.9-4.9). Mixed STH infections were observed as well as SCH-STH coinfection. Further mapping of both SCH and STH burden is needed, and coverage of preventive chemotherapy in school-aged children should be increased. © 2017 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  20. Association of community sanitation usage with soil-transmitted helminth infections among school-aged children in Amhara Region, Ethiopia.

    PubMed

    Oswald, William E; Stewart, Aisha E P; Kramer, Michael R; Endeshaw, Tekola; Zerihun, Mulat; Melak, Berhanu; Sata, Eshetu; Gessese, Demelash; Teferi, Tesfaye; Tadesse, Zerihun; Guadie, Birhan; King, Jonathan D; Emerson, Paul M; Callahan, Elizabeth K; Freeman, Matthew C; Flanders, W Dana; Clasen, Thomas F; Moe, Christine L

    2017-02-17

    Globally, in 2010, approximately 1.5 billion people were infected with at least one species of soil-transmitted helminth (STH), Ascaris lumbricoides, Trichuris trichiura, hookworm (Ancylostoma duodenale and Necator americanus). Infection occurs through ingestion or contact (hookworm) with eggs or larvae in the environment from fecal contamination. To control these infections, the World Health Organization recommends periodic mass treatment of at-risk populations with deworming drugs. Prevention of these infections typically relies on improved excreta containment and disposal. Most evidence of the relationship between sanitation and STH has focused on household-level access or usage, rather than community-level sanitation usage. We examined the association between the proportion of households in a community with latrines in use and prevalence of STH infections among school-aged children. Data on STH prevalence and household latrine usage were obtained during four population-based, cross-sectional surveys conducted between 2011 and 2014 in Amhara, Ethiopia. Multilevel regression was used to estimate the association between the proportion of households in the community with latrines in use and presence of STH infection, indicated by > 0 eggs in stool samples from children 6-15 years old. Prevalence of STH infection was estimated as 22% (95% CI: 20-24%), 14% (95% CI: 13-16%), and 4% (95% CI: 4-5%) for hookworm, A. lumbricoides, and T. trichiura, respectively. Adjusting for individual, household, and community characteristics, hookworm prevalence was not associated with community sanitation usage. Trichuris trichuria prevalence was higher in communities with sanitation usage ≥ 60% versus sanitation usage < 20%. Association of community sanitation usage with A. lumbricoides prevalence depended on household sanitation. Community sanitation usage was not associated with A. lumbricoides prevalence among households with latrines in use. Among households without latrines in use, A. lumbricoides prevalence was higher comparing communities with sanitation usage ≥ 60% versus < 20%. Households with a latrine in use had lower prevalence of A. lumbricoides compared to households without latrines in use only in communities where sanitation usage was ≥ 80%. We found no evidence of a protective association between community sanitation usage and STH infection. The relationship between STH infection and community sanitation usage may be complex and requires further study.

  1. Integrated Rapid Mapping of Neglected Tropical Diseases in Three States of South Sudan: Survey Findings and Treatment Needs

    PubMed Central

    Finn, Timothy P.; Stewart, Barclay T.; Reid, Heidi L.; Petty, Nora; Sabasio, Anthony; Oguttu, David; Lado, Mounir; Brooker, Simon J.; Kolaczinski, Jan H.

    2012-01-01

    Background Integrated rapid mapping to target interventions for schistosomiasis, soil-transmitted helminthiasis (STH) and lymphatic filariasis (LF) is ongoing in South Sudan. From May to September 2010, three states – Unity, Eastern Equatoria and Central Equatoria – were surveyed with the aim of identifying which administrative areas are eligible for mass drug administration (MDA) of preventive chemotherapy (PCT). Methods and Principal Findings Payams (third administrative tier) were surveyed for Schistosoma mansoni, S. haematobium and STH infections while counties (second administrative tier) were surveyed for LF. Overall, 12,742 children from 193 sites were tested for schistosome and STH infection and, at a subset of 50 sites, 3,980 adults were tested for LF. Either S. mansoni or S. haematobium or both species were endemic throughout Unity State and occurred in foci in Central and Eastern Equatoria. STH infection was endemic throughout Central Equatoria and the western counties of Eastern Equatoria, while LF was endemic over most of Central- and Eastern Equatoria, but only in selected foci in Unity. All areas identified as STH endemic were co-endemic for schistosomiasis and/or LF. Conclusions The distribution and prevalence of major NTDs, particularly schistosomiasis, varies considerably throughout South Sudan. Rapid mapping is therefore important in identifying (co)-endemic areas. The present survey established that across the three surveyed states between 1.2 and 1.4 million individuals are estimated to be eligible for regular MDA with PCT to treat STH and schistosomiasis, respectively, while approximately 1.3 million individuals residing in Central- and Eastern Equatoria are estimated to require MDA for LF. PMID:23285184

  2. Missing the Mark? A Two Time Point Cohort Study Estimating Intestinal Parasite Prevalence in Informal Settlements in Lima, Peru.

    PubMed

    Cooper, Michael Townsend; Searing, Rapha A; Thompson, David M; Bard, David; Carabin, Hélène; Gonzales, Carlos; Zavala, Carmen; Woodson, Kyle; Naifeh, Monique

    2017-01-01

    Objectives: The World Health Organization's (WHO) recommendations list Peru as potentially needing prevention of soil-transmitted helminthiasis (STH). Prevalence of STH varies regionally and remains understudied in the newest informal settlements of the capital city, Lima. The purpose of this study was to evaluate the need for Mass Drug Administration (MDA) of antiparasitic drugs in the newest informal settlements of Lima. The aim of this study was to estimate the season-specific prevalence of STH to determine if these prevalence estimates met the WHO threshold for MDA in 3 informal settlements. Methods : A 2 time point cohort study was conducted among a sample of 140 children aged 1 to 10 years living in 3 purposively sampled informal settlements of Lima, Peru. Children were asked to provide 2 stool samples that were analyzed with the spontaneous sedimentation in tube technique. The season-specific prevalence proportions of MDA-targeted STH were estimated using a hidden (latent) Markov modeling approach to adjust for repeated measurements over the 2 seasons and the imperfect validity of the screening tests. Results : The prevalence of MDA targeted STH was low at 2.2% (95% confidence interval = 0.3% to 6%) and 3.8% (95% confidence interval = 0.7% to 9.3%) among children sampled in the summer and winter months, respectively, when using the most conservative estimate of test sensitivity. These estimates were below the WHO threshold for MDA (20%). Conclusions : Empiric treatment for STH by organizations active in the newest informal settlements is not supported by the data and could contribute to unnecessary medication exposures and poor allocation of resources.

  3. Missing the Mark? A Two Time Point Cohort Study Estimating Intestinal Parasite Prevalence in Informal Settlements in Lima, Peru

    PubMed Central

    Cooper, Michael Townsend; Searing, Rapha A.; Thompson, David M.; Bard, David; Carabin, Hélène; Gonzales, Carlos; Zavala, Carmen; Woodson, Kyle; Naifeh, Monique

    2017-01-01

    Objectives: The World Health Organization’s (WHO) recommendations list Peru as potentially needing prevention of soil-transmitted helminthiasis (STH). Prevalence of STH varies regionally and remains understudied in the newest informal settlements of the capital city, Lima. The purpose of this study was to evaluate the need for Mass Drug Administration (MDA) of antiparasitic drugs in the newest informal settlements of Lima. The aim of this study was to estimate the season-specific prevalence of STH to determine if these prevalence estimates met the WHO threshold for MDA in 3 informal settlements. Methods: A 2 time point cohort study was conducted among a sample of 140 children aged 1 to 10 years living in 3 purposively sampled informal settlements of Lima, Peru. Children were asked to provide 2 stool samples that were analyzed with the spontaneous sedimentation in tube technique. The season-specific prevalence proportions of MDA-targeted STH were estimated using a hidden (latent) Markov modeling approach to adjust for repeated measurements over the 2 seasons and the imperfect validity of the screening tests. Results: The prevalence of MDA targeted STH was low at 2.2% (95% confidence interval = 0.3% to 6%) and 3.8% (95% confidence interval = 0.7% to 9.3%) among children sampled in the summer and winter months, respectively, when using the most conservative estimate of test sensitivity. These estimates were below the WHO threshold for MDA (20%). Conclusions: Empiric treatment for STH by organizations active in the newest informal settlements is not supported by the data and could contribute to unnecessary medication exposures and poor allocation of resources. PMID:29152541

  4. Prevalence of soil-transmitted helminths in remote villages in East Kwaio, Solomon Islands

    PubMed Central

    Harrington, Humpress; Bradbury, Richard; Taeka, James; Asugeni, James; Asugeni, Vunivesi; Igeni, Tony; Gwala, John; Newton, Lawrence; Fa, Chillion Evan; Kilivisi, Fawcett Laurence; Esau, Dorothy; Flores, Angelica; Ribeyro, Elmer; Liku, Daisy; Muse, Alwin; Asugeni, Lyndel; Talana, Jeptha; Shield, Jennifer; MacLaren, David J; Massey, Peter D; Muller, Reinhold

    2015-01-01

    Objective Although soil-transmitted helminths (STH) are endemic in Solomon Islands, there are few recent reports on their prevalence. This study aimed to determine the prevalence of STH in residents of remote communities in Solomon Islands. Methods A cross-sectional convenience-sampled survey of residents of four adjacent villages in Malaita, Solomon Islands was performed in Atoifi and Na’au in April 2011 and in Abitona and Sifilo in April 2012. All residents older than one year were invited to participate, which involved providing a single sample of faeces examined using a modified Kato-Katz technique and completing a questionnaire that asked demographic and STH-related behaviour questions. Results The overall participation rate was 52.8%, with 402 participants comprising 49.8% males. Hookworm was the predominant STH with only a single case of trichuriasis found in Atoifi. The total prevalence of hookworm was 22.6% (95% confidence interval: 18.6–27.1); the prevalence of hookworm in Abitona, Na’au and Sifilo was 20.0%, 29.9% and 27.4%, respectively, whereas in Atoifi it was 2.3% (P < 0.001). Intensity was low in all villages. Although health behaviours differed significantly between Atoifi and the other three villages, the type of toilet used was the only significant association with hookworm. Discussion Residents of Atoifi have a relative freedom from STH compared to the other three villages. Rather than a region-wide morbidity control approach, a “one village at a time” approach aiming to eliminate STH and dealing with each village as a separate autonomous unit empowered to manage its own challenges may be a preferred option. PMID:26668767

  5. Knowledge, attitudes and practices among parents and teachers about soil-transmitted helminthiasis control programs for school children in Guimaras, Philippines.

    PubMed

    Parikh, Divya Sinha; Totañes, Francis I G; Tuliao, Alex H; Ciro, Raezelle N T; Macatangay, Bernard J C; Belizario, Vicente Y

    2013-09-01

    We determined the attitudes toward and practices regarding soil-transmitted helminthes (STH) control among parents and school teachers to identify reasons behind attitudes and practices that do not promote STH control. Written knowledge, attitudes and practices surveys were distributed to parents (N = 531) and teachers (N = 105) of students at 11 elementary schools in Guimaras Province, the Philippines. The survey addressed attitudes about mass drug administration (MDA), knowledge about STH control, hygienic practices, and acceptability of distributing deworming tablets among teachers. More than 90% of parents and teachers held favorable attitudes towards MDA. Sixty-nine percent of parents and 75.5% of teachers believed stool exams were necessary before MDA. Thirty-seven percent of parents stated they would not allow teachers to administer deworming tablets and 91.5% of parents feared teachers would not detect side effects of the medication. Forty-eight percent of teachers felt they could safely give deworming tablets and 81.4% of teachers were afraid of managing the side effects of deworming tablets. Forty-seven point eight percent of parents and 42.2% of teachers stated defecation in the open occured in their community. Although attitudes toward STH control were largely favorable, misconceptions about the MDA strategy, lack of support for teachers giving deworming tablets, and the practice of open defecation still exist as barriers to STH control efforts. The next step to achieve effective STH control will be to clarify misconceptions in education campaigns, to train teachers about medication administration, campaign to improve sanitation and hygiene and begin targeted mass treatment in Guimaras, the Philippines.

  6. Patterns and Risk Factors of Soil-Transmitted Helminthiasis among Orang Asli Subgroups in Peninsular Malaysia

    PubMed Central

    Ngui, Romano; Aziz, Shafie; Chua, Kek Heng; Aidil, Roslan Muhammad; Lee, Soo Ching; Tan, Tiong Kai; Sani, Mistam Mohd; Arine, Ahmad Fadzlun; Rohela, Mahmud; Lim, Yvonne A. L.

    2015-01-01

    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. PMID:26055746

  7. Patterns and Risk Factors of Soil-Transmitted Helminthiasis Among Orang Asli Subgroups in Peninsular Malaysia.

    PubMed

    Ngui, Romano; Aziz, Shafie; Chua, Kek Heng; Aidil, Roslan Muhammad; Lee, Soo Ching; Tan, Tiong Kai; Sani, Mistam Mohd; Arine, Ahmad Fadzlun; Rohela, Mahmud; Lim, Yvonne A L

    2015-08-01

    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. © The American Society of Tropical Medicine and Hygiene.

  8. Soil-transmitted helminth infections and nutritional status in Ecuador: findings from a national survey and implications for control strategies.

    PubMed

    Moncayo, Ana L; Lovato, Raquel; Cooper, Philip J

    2018-04-28

    The estimation of prevalence and intensity of soil-transmitted helminth (STH) infections at a country-level is an essential prerequisite for the implementation of a rational control programme. The aim of this present study was to estimate the prevalence and distribution of STH infections and malnutrition in school-age children in rural areas of Ecuador. Cross-sectional study from October 2011 to May 2012. Eighteen rural schools were randomly selected from the three ecological regions of Ecuador (coastal, highlands and Amazon basin). 920 children aged 6-16 years. Prevalence and intensity of STH infections associated with malnutrition (thinness/wasting or stunting). The results showed that 257 (27.9%) children were infected with at least one STH parasite. The prevalence of Trichuris trichiura , Ascaris lumbricoides and hookworm was 19.3%, 18.5% and 5.0%, respectively. Malnutrition was present in 14.2% of children and most common was stunting (12.3%). Compared with other regions, schoolchildren in the Amazon region had the highest STH prevalence (58.9%) of which a greater proportion of infections were moderate/heavy intensity (45.6%) and had the highest prevalence of malnutrition (20.4%). A positive association was observed between moderate to heavy infections with A. lumbricoides and malnutrition (adjusted OR 1.85, 95% CI 1.04 to 3.31, p=0.037). Our estimate of the prevalence of STH infections of 27.9% at a national level in Ecuador is lower than suggested by previous studies. Our data indicate that schoolchildren living in the Amazon region have a greater risk of STH infection and stunting compared with children from other regions. The implementation of school-based preventive chemotherapy and nutritional supplement programmes within the Amazon region should be prioritised. Long-term control strategies require improvements in water, sanitation and hygiene. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Parasitological and nutritional status of school-age and preschool-age children in four villages in Southern Leyte, Philippines: Lessons for monitoring the outcome of Community-Led Total Sanitation.

    PubMed

    Belizario, Vicente Y; Liwanag, Harvy Joy C; Naig, June Rose A; Chua, Paul Lester C; Madamba, Manuel I; Dahildahil, Roy O

    2015-01-01

    While preventive chemotherapy remains to be a major strategy for the prevention and control of soil-transmitted helminthiases (STH), improvements in water, sanitation, and hygiene (WASH) comprise the long-term strategy to achieve sustained control of STH. This study examined the parasitological and nutritional status of school-age and preschool-age children in four villages in Southern Leyte, Philippines where two of the villages attained Open-Defecation-Free (ODF) status after introduction of Community-Led Total Sanitation (CLTS). A total of 341 children (89.0% of the total eligible population) submitted stool samples which were examined using the Kato-Katz technique. Results showed that 27.9% of the total stool samples examined had at least one type of STH (cumulative prevalence), while 7.9% had moderate-heavy intensity infections. Between the two villages where CLTS was introduced, Buenavista had a significantly higher cumulative prevalence of STH at 67.4% (p<0.001) and prevalence of moderate-heavy intensity STH at 23.5% (p=0.000), while Caubang had a significantly lower cumulative prevalence at 4.9% and prevalence of moderate-heavy intensity at 1.8%. On the other hand, the non-CLTS villages of Bitoon and Saub had similar rates for cumulative prevalence (16.7% and 16.8%, respectively; p=0.984) and prevalence of moderate-heavy intensity STH (2.0% and 3.1%, respectively; p=1.000). The findings may be explained by factors that include possible reversion to open defecation, non-utilization of sanitary facilities, and mass drug administration (MDA) coverage, although further studies that can accurately assess the impact of CLTS are recommended. While this study was descriptive, the data indicate no clear pattern among the parasitological and nutritional parameters, as well as the presence of CLTS in the village, suggesting the need to monitor the ODF status of villages on a regular basis even after the end of CLTS activities to ensure the sustainability of the CLTS approach. In order to achieve effective control of STH, deeper collaboration between the WASH and STH sectors are recommended where partners can work together in the area of monitoring and evaluation that may include improved parasitological and nutritional status in high-risk groups, as well as sustainable behavior change as outcome indicators. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. A dark mode in scanning thermal microscopy

    NASA Astrophysics Data System (ADS)

    Ramiandrisoa, Liana; Allard, Alexandre; Joumani, Youssef; Hay, Bruno; Gomés, Séverine

    2017-12-01

    The need for high lateral spatial resolution in thermal science using Scanning Thermal Microscopy (SThM) has pushed researchers to look for more and more tiny probes. SThM probes have consequently become more and more sensitive to the size effects that occur within the probe, the sample, and their interaction. Reducing the tip furthermore induces very small heat flux exchanged between the probe and the sample. The measurement of this flux, which is exploited to characterize the sample thermal properties, requires then an accurate thermal management of the probe-sample system and to reduce any phenomenon parasitic to this system. Classical experimental methodologies must then be constantly questioned to hope for relevant and interpretable results. In this paper, we demonstrate and estimate the influence of the laser of the optical force detection system used in the common SThM setup that is based on atomic-force microscopy equipment on SThM measurements. We highlight the bias induced by the overheating due to the laser illumination on the measurements performed by thermoresistive probes (palladium probe from Kelvin Nanotechnology). To face this issue, we propose a new experimental procedure based on a metrological approach of the measurement: a SThM "dark mode." The comparison with the classical procedure using the laser shows that errors between 14% and 37% can be reached on the experimental data exploited to determine the heat flux transferred from the hot probe to the sample.

  11. Cognitive Performance and Iron Status are Negatively Associated with Hookworm Infection in Cambodian Schoolchildren.

    PubMed

    Kuong, Khov; Fiorentino, Marion; Perignon, Marlene; Chamnan, Chhoun; Berger, Jacques; Sinuon, Muth; Molyden, Vann; Burja, Kurt; Parker, Megan; Ly, Sou Chheng; Friis, Henrik; Roos, Nanna; Wieringa, Frank T

    2016-10-05

    Soil-transmitted helminth (STH) infection has been associated with lower cognitive performance of schoolchildren. To identify pathways through which STH infection might affect school performance, baseline data from a large rice-fortification trial in Cambodian schoolchildren were used to investigate associations between STH infection, micronutrient status, anemia, and cognitive performance. Complete data on anthropometry, cognitive performance, and micronutrient status were available for 1,760 schoolchildren, 6-16 years of age. STH infection was identified using Kato-Katz, whereas cognitive performance was assessed using Raven's Colored Progressive Matrices (RCPM), block design, and picture completion. STH infection was found in 18% of the children; almost exclusively hookwork infection. After adjusting for age and gender, raw cognitive test scores were significantly lower in hookworm-infected children (-0.65; -0.78; -2.03 points for picture completion, RCPM, and block design, respectively; P < 0.05 for all). Hookworm infection was associated with iron status (total body iron), but not with vitamin A and zinc status, nor with inflammation or anthropometry. Body iron was negatively associated with increased intensity of hookworm infection (R = 0.22, P < 0.001). Hookworm infection in Cambodian schoolchildren was associated with lower cognitive performance, an effect most likely mediated through lower body iron. Interventions that are more effective against hookworm infection are needed to contribute to better health and improvement of cognitive performance. © The American Society of Tropical Medicine and Hygiene.

  12. Water, Sanitation, Hygiene, and Soil-Transmitted Helminth Infection: A Systematic Review and Meta-Analysis

    PubMed Central

    Strunz, Eric C.; Addiss, David G.; Stocks, Meredith E.; Ogden, Stephanie; Utzinger, Jürg; Freeman, Matthew C.

    2014-01-01

    Background Preventive chemotherapy represents a powerful but short-term control strategy for soil-transmitted helminthiasis. Since humans are often re-infected rapidly, long-term solutions require improvements in water, sanitation, and hygiene (WASH). The purpose of this study was to quantitatively summarize the relationship between WASH access or practices and soil-transmitted helminth (STH) infection. Methods and Findings We conducted a systematic review and meta-analysis to examine the associations of improved WASH on infection with STH (Ascaris lumbricoides, Trichuris trichiura, hookworm [Ancylostoma duodenale and Necator americanus], and Strongyloides stercoralis). PubMed, Embase, Web of Science, and LILACS were searched from inception to October 28, 2013 with no language restrictions. Studies were eligible for inclusion if they provided an estimate for the effect of WASH access or practices on STH infection. We assessed the quality of published studies with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. A total of 94 studies met our eligibility criteria; five were randomized controlled trials, whilst most others were cross-sectional studies. We used random-effects meta-analyses and analyzed only adjusted estimates to help account for heterogeneity and potential confounding respectively. Use of treated water was associated with lower odds of STH infection (odds ratio [OR] 0.46, 95% CI 0.36–0.60). Piped water access was associated with lower odds of A. lumbricoides (OR 0.40, 95% CI 0.39–0.41) and T. trichiura infection (OR 0.57, 95% CI 0.45–0.72), but not any STH infection (OR 0.93, 95% CI 0.28–3.11). Access to sanitation was associated with decreased likelihood of infection with any STH (OR 0.66, 95% CI 0.57–0.76), T. trichiura (OR 0.61, 95% CI 0.50–0.74), and A. lumbricoides (OR 0.62, 95% CI 0.44–0.88), but not with hookworm infection (OR 0.80, 95% CI 0.61–1.06). Wearing shoes was associated with reduced odds of hookworm infection (OR 0.29, 95% CI 0.18–0.47) and infection with any STH (OR 0.30, 95% CI 0.11–0.83). Handwashing, both before eating (OR 0.38, 95% CI 0.26–0.55) and after defecating (OR 0.45, 95% CI 0.35–0.58), was associated with lower odds of A. lumbricoides infection. Soap use or availability was significantly associated with lower infection with any STH (OR 0.53, 95% CI 0.29–0.98), as was handwashing after defecation (OR 0.47, 95% CI 0.24–0.90). Observational evidence constituted the majority of included literature, which limits any attempt to make causal inferences. Due to underlying heterogeneity across observational studies, the meta-analysis results reflect an average of many potentially distinct effects, not an average of one specific exposure-outcome relationship. Conclusions WASH access and practices are generally associated with reduced odds of STH infection. Pooled estimates from all meta-analyses, except for two, indicated at least a 33% reduction in odds of infection associated with individual WASH practices or access. Although most WASH interventions for STH have focused on sanitation, access to water and hygiene also appear to significantly reduce odds of infection. Overall quality of evidence was low due to the preponderance of observational studies, though recent randomized controlled trials have further underscored the benefit of handwashing interventions. Limited use of the Joint Monitoring Program's standardized water and sanitation definitions in the literature restricted efforts to generalize across studies. While further research is warranted to determine the magnitude of benefit from WASH interventions for STH control, these results call for multi-sectoral, integrated intervention packages that are tailored to social-ecological contexts. Please see later in the article for the Editors' Summary PMID:24667810

  13. Soil-transmitted helminthiasis: the relationship between prevalence and classes of intensity of infection.

    PubMed

    Montresor, Antonio; À Porta, Natacha; Albonico, Marco; Gabrielli, Albis Francesco; Jankovic, Dina; Fitzpatrick, Christopher; Vercruysse, Jozef; Levecke, Bruno

    2015-04-01

    Recently, WHO has developed a predictive model to evaluate the impact of preventive chemotherapy programs to control the morbidity of soil-transmitted helminths (STHs). To make predictions, this model needs baseline information about the proportion of infections classified as low, moderate and high intensity, for each of the three STH species. However, epidemiological data available are often limited to prevalence estimates. We reanalyzed available data from 19 surveys in 10 countries and parameterized the relationship between prevalence of STH infections and the proportion of moderate and heavy intensity infections. The equations derived allow feeding the WHO model with estimates of the proportion of the different classes of infection intensity when only prevalence data is available. The prediction capacities of the STH model using the equations developed in the present study, should be tested by comparing it with the changes on STH epidemiological data observed in control programs operating for several years. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. A successful experience of soil-transmitted helminth control in the Republic of Korea

    PubMed Central

    Hong, Sung-Tae; Choi, Min-Ho; Huh, Sun; Rim, Han-Jong; Lee, Soon-Hyung

    2006-01-01

    Soil-transmitted helminths (STH), namely Ascaris, Trichuris and hookworms (Ancylostoma and Necator), present a global health problem to about a half of the earth's population. In the Republic of Korea, STH were highly prevalent and were considered a high priority target for national control. To promote the control, a non-governmental organization named Korea Association for Parasite Eradication (currently Korea Association of Health Promotion) was founded in 1964, and mass fecal examination followed by selective mass chemotherapy with anthelmintics was performed twice a year from 1969 to 1995 targeting whole nationwide schoolchildren. Meanwhile, decreasing patterns of national STH infections have been monitored by 7 times' quinquennial national surveys targeting general population. In 1971, the overall intestinal helminth egg positive rate was 84.3% (Ascaris 58.2%, Trichuris 65.4%, and hookworms 10.7%), which became 63.2% in 1976, 41.1% in 1981, 12.9% in 1986, 3.8% in 1992, 2.4% in 1997, and 4.3% (Ascaris 0.03%, Trichuris 0.02%, and hookworms 0%) in 2004. During the control period, national economy rapidly developed, and living standards including environment, sanitation, and agricultural technology greatly improved, which undoubtedly boosted the STH control effects. Our experience indicates that social driving force to establish an eligible national control system to conduct repeated mass chemotherapy, together with improvement of environment and sanitation, is important for initiating and achieving STH control in a developing community. PMID:16969055

  15. Epidemiology of soil-transmitted helminthiases-related mortality in Brazil.

    PubMed

    Martins-Melo, Francisco R; Ramos, Alberto N; Alencar, Carlos H; Lima, Mauricélia S; Heukelbach, Jorg

    2017-04-01

    Soil-transmitted helminth (STH) infections are widely distributed in tropical and subtropical areas, including Brazil. We performed a nationwide population-based study including all deaths in Brazil from 2000 to 2011, in which STHs (ascariasis, trichuriasis and/or hookworm infection) were mentioned on death certificates, either as underlying or as associated causes of death. Epidemiological characteristics, time trends and spatial analysis of STH-related mortality were analysed. STHs was identified on 853/12 491 280 death certificates: 827 (97·0%) deaths related to ascariasis, 25 (2·9%) to hookworm infections, and 1 (0·1%) to trichuriasis. The average annual age-adjusted mortality rate was 0·34/1 000 000 inhabitants (95% confidence interval: 0·27-0·44). Females, children <10 years of age, indigenous ethnic groups and residents in the Northeast region had highest STH-related mortality rates. Nationwide mortality decreased significantly over time (annual percent change: -5·7%; 95% CI: -6·9 to -4·4), with regional differences. We identified spatial high-risk clusters for STH-related mortality mainly in the North, Northeast and South regions. Diseases of the digestive system and infectious/parasitic diseases were the most commonly associated causes of death mentioned in the STH-related deaths. Despite decreasing mortality in Brazil, a considerable number of deaths is caused by STHs, with ascariasis responsible for the vast majority. There were marked regional differences, affecting mainly children and vulnerable populations.

  16. Evaluating the efficacy of a centrifugation-flotation method for extracting Ascaris ova from soil.

    PubMed

    Cranston, Imogen; Teoh, Penelope J; Baker, Sarah M; Sengupta, Mita E; Ensink, Jeroen H J

    2016-07-01

    Soil transmitted helminths (STH) continue to be associated with high burdens of disease, with an estimated 1.45 billion people infected with STH globally. The promotion and construction of latrines is considered the first barrier to prevent transmission of STH. The absence of a reliable method to extract STH ova from soil makes it challenging to examine whether the use of latrines may or may not have an effect on environmental contamination with ova. The present study evaluated the recovery rate of a method developed to extract STH ova from soil. The adapted centrifugation and flotation technique was applied to 15 soil types, which were seeded with Ascaris suum ova. Soil type, soil moisture content, soil texture and organic matter content were assessed for each soil sample. The average ova recovery rate was 28.2%, with the recovery rate of the method decreasing with increasing soil moisture content, particle size and organic matter content. The association between recovery rate and organic matter content was statistically significant. The present study identified a low recovery rate for an adapted centrifugation-flotation method, although this was similar to the recovery rate demonstrated by other methods developed for soil. Soil organic matter content was significantly associated with ova recovery rates. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. High prevalence of soil-transmitted helminths in Southern Belize-highlighting opportunity for control interventions

    PubMed Central

    Kaminsky, Rina Girard; Ault, Steven K.; Castillo, Phillip; Serrano, Kenton; Troya, Guillermo

    2014-01-01

    Objective To assess prevalence and intensity of soil-transmitted helminths (STH) in school age children of two southern districts as baseline information prior to implement a deworming program against intestinal parasites as part of an integrated country development plan. Methods Children randomly selected from urban and rural schools in Southern Belize provided one stool sample each, analysed by the Kato-Katz method to assess prevalence and intensity of STH infections. Epi Info software was used for data analysis; Chi-square test and Fischer exact test were applied to compare group proportions; P<0.05 was considered of statistical significance; descriptive statistics were expressed as percentages. Results A total of 500 children from 10 schools participated in the study from May to December 2005. Prevalence of STH ranged between 40% and 82% among schools, with a median of 59.2%; the majority of light intensity, and with 2.2% high intensity infection. Trichuris and Ascaris infections presented similar frequency in children aged from 6 to 9 years old; hookworm infections tended to be more frequent in the older group 10 to 12 years old. Statistical significances (P≤0.01) were found in children in rural schools infected with any species of STH, in moderate Trichuris infections, in hookworm infections in rural areas with strong Mayan presence and in Ascaris infections in children of Mayan origin. Conclusions High prevalence of STH in Southern Belize provided sound ground for implementing an integrated deworming control program. PMID:25182717

  18. Diagnostic Accuracy and Cost-Effectiveness of Alternative Methods for Detection of Soil-Transmitted Helminths in a Post-Treatment Setting in Western Kenya

    PubMed Central

    Kepha, Stella; Kihara, Jimmy H.; Njenga, Sammy M.; Pullan, Rachel L.; Brooker, Simon J.

    2014-01-01

    Objectives This study evaluates the diagnostic accuracy and cost-effectiveness of the Kato-Katz and Mini-FLOTAC methods for detection of soil-transmitted helminths (STH) in a post-treatment setting in western Kenya. A cost analysis also explores the cost implications of collecting samples during school surveys when compared to household surveys. Methods Stool samples were collected from children (n = 652) attending 18 schools in Bungoma County and diagnosed by the Kato-Katz and Mini-FLOTAC coprological methods. Sensitivity and additional diagnostic performance measures were analyzed using Bayesian latent class modeling. Financial and economic costs were calculated for all survey and diagnostic activities, and cost per child tested, cost per case detected and cost per STH infection correctly classified were estimated. A sensitivity analysis was conducted to assess the impact of various survey parameters on cost estimates. Results Both diagnostic methods exhibited comparable sensitivity for detection of any STH species over single and consecutive day sampling: 52.0% for single day Kato-Katz; 49.1% for single-day Mini-FLOTAC; 76.9% for consecutive day Kato-Katz; and 74.1% for consecutive day Mini-FLOTAC. Diagnostic performance did not differ significantly between methods for the different STH species. Use of Kato-Katz with school-based sampling was the lowest cost scenario for cost per child tested ($10.14) and cost per case correctly classified ($12.84). Cost per case detected was lowest for Kato-Katz used in community-based sampling ($128.24). Sensitivity analysis revealed the cost of case detection for any STH decreased non-linearly as prevalence rates increased and was influenced by the number of samples collected. Conclusions The Kato-Katz method was comparable in diagnostic sensitivity to the Mini-FLOTAC method, but afforded greater cost-effectiveness. Future work is required to evaluate the cost-effectiveness of STH surveillance in different settings. PMID:24810593

  19. The epidemiology of soil-transmitted helminths in Bihar State, India.

    PubMed

    Greenland, Katie; Dixon, Ruth; Khan, Shabbir Ali; Gunawardena, Kithsiri; Kihara, Jimmy H; Smith, Jennifer L; Drake, Lesley; Makkar, Prerna; Raman, Sri; Singh, Sarman; Kumar, Sanjay

    2015-05-01

    Soil-transmitted helminths (STHs) infect over a billion individuals worldwide. In India, 241 million children are estimated to need deworming to avert the negative consequences STH infections can have on child health and development. In February-April 2011, 17 million children in Bihar State were dewormed during a government-led school-based deworming campaign. Prior to programme implementation, a study was conducted to assess STH prevalence in the school-age population to direct the programme. The study also investigated risk factors for STH infections, including caste, literacy, and defecation and hygiene practices, in order to inform the development of complementary interventions. A cross-sectional survey was conducted among children in 20 schools in Bihar. In addition to providing stool samples for identification of STH infections, children completed a short questionnaire detailing their usual defecation and hand-hygiene practices. Risk factors for STH infections were explored. In January-February 2011, 1279 school children aged four to seventeen provided stool samples and 1157 children also completed the questionnaire. Overall, 68% of children (10-86% across schools) were infected with one or more soil-transmitted helminth species. The prevalence of ascariasis, hookworm and trichuriasis was 52%, 42% and 5% respectively. The majority of children (95%) practiced open defecation and reported most frequently cleansing hands with soil (61%). Increasing age, lack of maternal literacy and certain castes were independently associated with hookworm infection. Absence of a hand-washing station at the schools was also independently associated with A. lumbricoides infection. STH prevalence in Bihar is high, and justifies mass deworming in school-aged children. Open defecation is common-place and hands are often cleansed using soil. The findings reported here can be used to help direct messaging appropriate to mothers with low levels of literacy and emphasise the importance of water and sanitation in the control of helminths and other diseases.

  20. Soil-transmitted helminth infections and nutritional status in school-age children from rural communities in Honduras.

    PubMed

    Sanchez, Ana Lourdes; Gabrie, Jose Antonio; Usuanlele, Mary-Theresa; Rueda, Maria Mercedes; Canales, Maritza; Gyorkos, Theresa W

    2013-01-01

    Soil-transmitted helminth (STH) infections are endemic in Honduras and efforts are underway to decrease their transmission. However, current evidence is lacking in regards to their prevalence, intensity and their impact on children's health. To evaluate the prevalence and intensity of STH infections and their association with nutritional status in a sample of Honduran children. A cross-sectional study was done among school-age children residing in rural communities in Honduras, in 2011. Demographic data was obtained, hemoglobin and protein concentrations were determined in blood samples and STH infections investigated in single-stool samples by Kato-Katz. Anthropometric measurements were taken to calculate height-for-age (HAZ), BMI-for-age (BAZ) and weight-for-age (WAZ) to determine stunting, thinness and underweight, respectively. Among 320 children studied (48% girls, aged 7-14 years, mean 9.76 ± 1.4) an overall STH prevalence of 72.5% was found. Children >10 years of age were generally more infected than 7-10 year-olds (p = 0.015). Prevalence was 30%, 67% and 16% for Ascaris, Trichuris and hookworms, respectively. Moderate-to-heavy infections as well as polyparasitism were common among the infected children (36% and 44%, respectively). Polyparasitism was four times more likely to occur in children attending schools with absent or annual deworming schedules than in pupils attending schools deworming twice a year (p<0.001). Stunting was observed in 5.6% of children and it was associated with increasing age. Also, 2.2% of studied children were thin, 1.3% underweight and 2.2% had anemia. Moderate-to-heavy infections and polyparasitism were significantly associated with decreased values in WAZ and marginally associated with decreased values in HAZ. STH infections remain a public health concern in Honduras and despite current efforts were highly prevalent in the studied community. The role of multiparasite STH infections in undermining children's nutritional status warrants more research.

  1. The Epidemiology of Soil-Transmitted Helminths in Bihar State, India

    PubMed Central

    Greenland, Katie; Dixon, Ruth; Khan, Shabbir Ali; Gunawardena, Kithsiri; Kihara, Jimmy H.; Smith, Jennifer L.; Drake, Lesley; Makkar, Prerna; Singh, Sarman; Kumar, Sanjay

    2015-01-01

    Background Soil-transmitted helminths (STHs) infect over a billion individuals worldwide. In India, 241 million children are estimated to need deworming to avert the negative consequences STH infections can have on child health and development. In February-April 2011, 17 million children in Bihar State were dewormed during a government-led school-based deworming campaign. Prior to programme implementation, a study was conducted to assess STH prevalence in the school-age population to direct the programme. The study also investigated risk factors for STH infections, including caste, literacy, and defecation and hygiene practices, in order to inform the development of complementary interventions. Methods A cross-sectional survey was conducted among children in 20 schools in Bihar. In addition to providing stool samples for identification of STH infections, children completed a short questionnaire detailing their usual defecation and hand-hygiene practices. Risk factors for STH infections were explored. Results In January-February 2011, 1279 school children aged four to seventeen provided stool samples and 1157 children also completed the questionnaire. Overall, 68% of children (10-86% across schools) were infected with one or more soil-transmitted helminth species. The prevalence of ascariasis, hookworm and trichuriasis was 52%, 42% and 5% respectively. The majority of children (95%) practiced open defecation and reported most frequently cleansing hands with soil (61%). Increasing age, lack of maternal literacy and certain castes were independently associated with hookworm infection. Absence of a hand-washing station at the schools was also independently associated with A. lumbricoides infection. Conclusions STH prevalence in Bihar is high, and justifies mass deworming in school-aged children. Open defecation is common-place and hands are often cleansed using soil. The findings reported here can be used to help direct messaging appropriate to mothers with low levels of literacy and emphasise the importance of water and sanitation in the control of helminths and other diseases. PMID:25993697

  2. Molecular Characterization of Enterotoxigenic Escherichia coli Isolates Recovered from Children with Diarrhea during a 4-Year Period (2007 to 2010) in Bolivia

    PubMed Central

    Gonzales, Lucia; Sanchez, Samanta; Zambrana, Silvia; Wiklund, Gudrun; Svennerholm, Ann-Mari

    2013-01-01

    Enterotoxigenic Escherichia coli (ETEC) is an important cause of childhood diarrhea. This study aimed to characterize ETEC strains isolated from Bolivian children aged <5 years according to enterotoxin profile, colonization factors (CFs), suggested virulence genes, and severity of disease. A total of 299 ETEC isolates recovered from children with diarrhea and 55 ETEC isolates from children without diarrhea (controls) were isolated over a period of 4 years. Strains expressing heat-labile toxin (LT) or heat-stable toxin (ST) alone were about equally common and twice as common as ETEC producing both toxins (20%). ETEC strains expressing human ST (STh) were more common in children aged <2 years, while ETEC strains expressing LT plus STh (LT/STh) were more frequent in 2- to 5-year-old children. Severity of disease was not related to the toxin profile of the strains. CF-positive isolates were more frequently identified in diarrheal samples than in control samples (P = 0.02). The most common CFs were CFA/I and CS14. CFA/I ETEC strains were more frequent in children aged <2 years than CS1+CS3 isolates and CS14 isolates, which were more prevalent in 2- to 5-year-old children. The presence of suggested ETEC virulence genes (clyA, eatA, tia, tibC, leoA, and east-1) was not associated with disease. However, east-1 was associated with LT/STh strains (P < 0.001), eatA with STh strains (P < 0.001), and tia with LT/STh strains (P < 0.001). A minor seasonal peak of ETEC infections was identified in May during the cold-dry season and coincided with the peak of rotavirus infections; this pattern is unusual for ETEC and may be important for vaccination strategies in Bolivia. PMID:23390275

  3. Soil-Transmitted Helminth Infections and Nutritional Status in School-age Children from Rural Communities in Honduras

    PubMed Central

    Sanchez, Ana Lourdes; Gabrie, Jose Antonio; Usuanlele, Mary-Theresa; Rueda, Maria Mercedes; Canales, Maritza; Gyorkos, Theresa W.

    2013-01-01

    Background Soil-transmitted helminth (STH) infections are endemic in Honduras and efforts are underway to decrease their transmission. However, current evidence is lacking in regards to their prevalence, intensity and their impact on children's health. Objectives To evaluate the prevalence and intensity of STH infections and their association with nutritional status in a sample of Honduran children. Methodology A cross-sectional study was done among school-age children residing in rural communities in Honduras, in 2011. Demographic data was obtained, hemoglobin and protein concentrations were determined in blood samples and STH infections investigated in single-stool samples by Kato-Katz. Anthropometric measurements were taken to calculate height-for-age (HAZ), BMI-for-age (BAZ) and weight-for-age (WAZ) to determine stunting, thinness and underweight, respectively. Results Among 320 children studied (48% girls, aged 7–14 years, mean 9.76±1.4) an overall STH prevalence of 72.5% was found. Children >10 years of age were generally more infected than 7–10 year-olds (p = 0.015). Prevalence was 30%, 67% and 16% for Ascaris, Trichuris and hookworms, respectively. Moderate-to-heavy infections as well as polyparasitism were common among the infected children (36% and 44%, respectively). Polyparasitism was four times more likely to occur in children attending schools with absent or annual deworming schedules than in pupils attending schools deworming twice a year (p<0.001). Stunting was observed in 5.6% of children and it was associated with increasing age. Also, 2.2% of studied children were thin, 1.3% underweight and 2.2% had anemia. Moderate-to-heavy infections and polyparasitism were significantly associated with decreased values in WAZ and marginally associated with decreased values in HAZ. Conclusions STH infections remain a public health concern in Honduras and despite current efforts were highly prevalent in the studied community. The role of multiparasite STH infections in undermining children's nutritional status warrants more research. PMID:23951385

  4. Diagnostic accuracy and cost-effectiveness of alternative methods for detection of soil-transmitted helminths in a post-treatment setting in western Kenya.

    PubMed

    Assefa, Liya M; Crellen, Thomas; Kepha, Stella; Kihara, Jimmy H; Njenga, Sammy M; Pullan, Rachel L; Brooker, Simon J

    2014-05-01

    This study evaluates the diagnostic accuracy and cost-effectiveness of the Kato-Katz and Mini-FLOTAC methods for detection of soil-transmitted helminths (STH) in a post-treatment setting in western Kenya. A cost analysis also explores the cost implications of collecting samples during school surveys when compared to household surveys. Stool samples were collected from children (n = 652) attending 18 schools in Bungoma County and diagnosed by the Kato-Katz and Mini-FLOTAC coprological methods. Sensitivity and additional diagnostic performance measures were analyzed using Bayesian latent class modeling. Financial and economic costs were calculated for all survey and diagnostic activities, and cost per child tested, cost per case detected and cost per STH infection correctly classified were estimated. A sensitivity analysis was conducted to assess the impact of various survey parameters on cost estimates. Both diagnostic methods exhibited comparable sensitivity for detection of any STH species over single and consecutive day sampling: 52.0% for single day Kato-Katz; 49.1% for single-day Mini-FLOTAC; 76.9% for consecutive day Kato-Katz; and 74.1% for consecutive day Mini-FLOTAC. Diagnostic performance did not differ significantly between methods for the different STH species. Use of Kato-Katz with school-based sampling was the lowest cost scenario for cost per child tested ($10.14) and cost per case correctly classified ($12.84). Cost per case detected was lowest for Kato-Katz used in community-based sampling ($128.24). Sensitivity analysis revealed the cost of case detection for any STH decreased non-linearly as prevalence rates increased and was influenced by the number of samples collected. The Kato-Katz method was comparable in diagnostic sensitivity to the Mini-FLOTAC method, but afforded greater cost-effectiveness. Future work is required to evaluate the cost-effectiveness of STH surveillance in different settings.

  5. Soil-Transmitted Helminths in Southwestern China: A Cross-Sectional Study of Links to Cognitive Ability, Nutrition, and School Performance among Children

    PubMed Central

    Liu, Chengfang; Luo, Renfu; Yi, Hongmei; Zhang, Linxiu; Li, Shaoping; Bai, Yunli; Medina, Alexis; Rozelle, Scott; Smith, Scott; Wang, Guofei; Wang, Jujun

    2015-01-01

    Background Empirical evidence suggests that the prevalence of soil-transmitted helminth (STH) infections in remote and poor rural areas is still high among children, the most vulnerable to infection. There is concern that STH infections may detrimentally affect children’s healthy development, including their cognitive ability, nutritional status, and school performance. Medical studies have not yet identified the exact nature of the impact STH infections have on children. The objective of this study is to examine the relationship between STH infections and developmental outcomes among a primary school-aged population in rural China. Methodology/Principal Findings We conducted a large-scale survey in Guizhou province in southwest China in May 2013. A total of 2,179 children aged 9-11 years living in seven nationally-designated poverty counties in rural China served as our study sample. Overall, 42 percent of the sample’s elementary school-aged children were infected with one or more of the three types of STH—Ascaris lumbricoides (ascaris), Trichuris trichuria (whipworm) and the hookworms Ancylostoma duodenale or Necator americanus. After controlling for socioeconomic status, we observed that infection with one or more STHs is associated with worse cognitive ability, worse nutritional status, and worse school performance than no infection. This study also presents evidence that children with Trichuris infection, either infection with Trichuris only or co-infected with Trichuris and Ascaris, experience worse cognitive, nutritional and schooling outcomes than their uninfected peers or children infected with only Ascaris. Conclusions/Significance We find that STH infection still poses a significant health challenge among children living in poor, rural, ethnic areas of southwest China. Given the important linkages we find between STH infection and a number of important child health and educational outcomes, we believe that our results will contribute positively to the debate surrounding the recent Cochrane report. PMID:26110518

  6. Comparison of del Nido and St Thomas Cardioplegia Solutions in Pediatric Patients: A Prospective Randomized Clinical Trial.

    PubMed

    Talwar, Sachin; Bhoje, Amolkumar; Sreenivas, Vishnubhatla; Makhija, Neeti; Aarav, Sudheer; Choudhary, Shiv Kumar; Airan, Balram

    2017-01-01

    We conducted a prospective randomized trial to compare del Nido (DN) cardioplegia with conventional cold blood cardioplegia (St Thomas [STH]) in pediatric patients. We randomized 100 pediatric patients aged ≤12 years undergoing elective repair of ventricular septal defects and tetralogy of Fallot to the DN and the STH groups. In the DN group, a 20 mL/kg single dose was administered. In the STH group, a 30 mL/kg dose was administered, followed by repeated doses at 25- to 30-minute intervals. The primary outcome was cardiac index that was measured 4 times intra- and postoperatively. Troponin-I, interleukin-6, and tissue necrosis factor-alpha were measured. Myocardial biopsy was obtained to assess electron-microscopic ultrastructural changes. Cardiac indices were significantly higher in the DN group than in the STH group 2 hours after termination of cardiopulmonary bypass (P = 0.0006), after 6 hours (P = 0.0006), and after 24 hours (P ≤ 0.0001). On repeated measure regression analysis, the cardiac index was on an average 0.50 L/min/m 2 higher in the DN group than in the STH group at any time point (P = 0.002). Duration of mechanical ventilation (P = 0.01), intensive care unit stay (P = 0.01), and hospital stay (P = 0.0007) was significantly lower in the DN group. Patients in the DN group exhibited lower troponin-I release 24 hours following cardiopulmonary bypass (P = 0.021). Electron microscopic studies showed more myofibrillar disarray in the STH group (P = 0.02). Use of long-acting DN cardioplegia solution was associated with better preservation of cardiac index, lesser troponin-I release, and decreased morbidity. Ultrastructural changes showed better preservation of myofibrillar architecture. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. [Intelligence level and characteristics of cognitive structure in school-age children infected with soil-transmitted helminthes].

    PubMed

    Shang, Yu; Tang, Lin-Hua

    2010-12-30

    To investigate the intelligence level and characteristics of cognitive structure of school-age children infected with soil-transmitted helminthes (STH) (hookworm, Ascaris lumbricoides and Trichuris trichiura). 1 031 children of 9 to 12 years old from Baishui village of Guangxi, Longzhou and Xinzhu villages of Hainan were selected for the survey. Stool samples from children were collected and examined by modified Kato-Katz method. 77 children infected with only one species (hookworm, A. lumbricoides, or T. trichiura) were used as case group and 39 healthy children as control. The cognitive ability for children were assessed by WISC-LV. A total of 378 cases with STH infection was found from 1 031 children, and the overall prevalence of STH infection was 36.7%. The prevalence of moderate and heavy STH infections was 16.8% (173/1 031). The verbal comprehension (VCI), working memory (WMI), processing speed (PSI) and full scale IQ (FSIQ) indices of case group were lower than those of control group (P < 0.05). The VCI (97.2), WMI (84.6), PSI (91.1) and FSIQ (95.4) indices in moderate/heavy infection group were lower than those in light infection group (99.2, 103.3, 88.3 and 99.1, respectively) and control group (102.0, 104.2, 91.9 and 100.1, respectively) (P < 0.05). The WMI index in hookworm infection group (83.7) was lower than that in A. lumbricoides (87.6) or T. trichiura (88.3) infection groups (P < 0.05). The PSI index of T. trichiura infection group (92.8) was lower than that of A. lumbricoides (97.3) or hookworm (94.4) infection groups (P < 0.05). The total intelligence level of STH infection children is in a normal range, or on borderline. The low VCI, WMI, PSI indices have been found in moderate/heavy STH infection children.

  8. An environmental assessment and risk map of Ascaris lumbricoides and Necator americanus distributions in Manufahi District, Timor-Leste

    PubMed Central

    Wardell, Rebecca; Clements, Archie C. A.; Lal, Aparna; Summers, David; Llewellyn, Stacey; Campbell, Suzy J.; McCarthy, James; Gray, Darren J.; V. Nery, Susana

    2017-01-01

    Background In Timor-Leste there have been intermittent and ineffective soil-transmitted helminth (STH) deworming programs since 2004. In a resource-constrained setting, having information on the geographic distribution of STH can aid in prioritising high risk communities for intervention. This study aimed to quantify the environmental risk factors for STH infection and to produce a risk map of STH in Manufahi district, Timor-Leste. Methodology/Principal findings Georeferenced cross-sectional data and stool samples were obtained from 2,194 participants in 606 households in 24 villages in the Manufahi District as part of cross sectional surveys done in the context of the “WASH for Worms” randomised controlled trial. Infection status was determined for Ascaris lumbricoides and Necator americanus using real-time quantitative polymerase chain reaction. Baseline infection data were linked to environmental data obtained for each household. Univariable and multivariable multilevel mixed-effects logistic regression analysis with random effects at the village and household level were conducted, with all models adjusted for age and sex. For A. lumbricoides, being a school-aged child increased the odds of infection, whilst higher temperatures in the coolest quarter of the year, alkaline soils, clay loam/loam soils and woody savannas around households were associated with decreased infection odds. For N. americanus, greater precipitation in the driest month, higher average enhanced vegetation index, age and sandy loam soils increased infection odds, whereas being female and living at higher elevations decreased the odds of infection. Predictive risk maps generated for Manufahi based upon these final models highlight the high predicted risk of N. americanus infection across the district and the more focal nature of A. lumbricoides infection. The predicted risk of any STH infection is high across the entire district. Conclusions/Significance The widespread predicted risk of any STH infection in 6 to 18 year olds provides strong evidence to support strategies for control across the entire geographical area. As few studies include soil texture and pH in their analysis, this study adds to a growing body of evidence suggesting these factors influence STH infection distribution. This study also further supports that A. lumbricoides prefers acidic soils, highlighting a potential relatively unexplored avenue for control. Trial registration ClinicalTrials.gov ACTRN12614000680662. PMID:28489889

  9. Measuring the Effect of Soil-Transmitted Helminth Infections on Cognitive Function in Children: Systematic Review and Critical Appraisal of Evidence.

    PubMed

    Owada, Kei; Nielsen, Mark; Lau, Colleen L; Clements, Archie C A; Yakob, Laith; Soares Magalhães, Ricardo J

    2017-01-01

    Recently the role of soil-transmitted helminth (STH) infections in children's cognitive developmental impairment has been under scrutiny. We conducted a systematic review of the evidence for associations between STH infections and cognitive function of children using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. We aimed to identify the domains of cognitive function in three age strata (<24months, 24-59months and ≥60months) and critically appraise the general design protocol of the studies, with a focus on the cognitive function measurement tools used. A total of 42 papers fulfilled the inclusion criteria, including 10 studies from a recent Cochrane review. Our findings demonstrate variation in tested domains, lack of consistency in the use of measurement tools and analysis of results. Cognitive function measures in children aged under 59months have been mainly limited to domains of gross motor, fine motor and language skills, whereas in children aged 60months and above most studies tested domains such as memory and processing speed. Even within the same age group the results on the association between STH infections and measures of cognitive development were often conflicting. The current study highlights the need for methodological consensus in the use of measurement tools and data analysis protocols if the effect of STH infections on cognitive function domains in children is to be correctly established. This will be an imperative next step to generate conclusive evidence of the role of STH infections in cognitive development in children. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Trichuris and hookworm infections associated with anaemia during pregnancy.

    PubMed

    Gyorkos, Theresa W; Gilbert, Nicolas L; Larocque, Renée; Casapía, Martín

    2011-04-01

    To assess the following associations between the second and third trimesters of pregnancy: (i) the intensity of soil-transmitted helminth (STH) infection and haemoglobin/anaemia, (ii) the effect of mebendazole treatment on the occurrence of STH infection, and (iii) the effect of mebendazole treatment on haemoglobin/anaemia. Data originated from a trial of 1042 pregnant women recruited in their second trimester and followed to delivery. Baseline assessments included socio-demographic/health information from questionnaires, haemoglobin/anaemia from HemoCue ascertainment of fingerprick blood, and the presence and intensity of STH (Ascaris lumbricoides, hookworms and Trichuris trichiura) infections from Kato-Katz examination. All women were given iron supplements; half were randomly allocated to receive single dose 500 mg mebendazole, and half, placebo. Haemoglobin/anaemia and STH infection status were determined again in the third trimester of pregnancy. Complete information was available from 935 (89.7%) women. Mebendazole significantly reduced the prevalence and intensity of all three STH infections. Higher intensities of hookworm and Trichuris infections in the second trimester were associated with a higher risk of anaemia in the third trimester. Overall, women with moderate/heavy Trichuris infection were found to be at a higher risk of anaemia; the highest risk was observed among those with moderate/heavy hookworm co-infection (adjusted OR = 2.77; 95% CI: 1.26, 6.11). Mebendazole treatment did not reduce the risk of anaemia. Higher intensities of both Trichuris and hookworm infections are associated with anaemia in pregnancy. The importance of Trichuris infections during pregnancy requires renewed attention. © 2011 Blackwell Publishing Ltd.

  11. PREVALENCE OF LYMPHATIC FILARIASIS, MALARIA AND SOIL TRANSMITTED HELMINTHIASIS IN A COMMUNITY OF BARDIYA DISTRICT, WESTERN NEPAL.

    PubMed

    Ranjitkar, Samir; Alifrangis, Michael; Adhikari, Madhav; Olsen, Annette; Simonsen, Paul E; Meyrowitsch, Dan Wolf

    2014-11-01

    Lymphatic filariasis (LF), malaria and soil transmitted helminthiasis (STH) cause major health problems in Nepal, but in spite of this very few stud- ies have been carried out on these parasitic infections in Nepal. A cross sectional survey of all three categories of parasitic infections was carried out in Deuda- kala Village of Bardiya District, western Nepal. A total of 510 individuals aged 5 years and above were examined from finger prick blood for circulating filarial antigen (CFA), malaria antigen using a rapid diagnostic test (RDT), and malaria DNA using a PCR-based assay. In addition, 317 individuals were examined for soil-transmitted helminth (STH) eggs by the Kato-Katz technique. Prevalence of LF, malaria (antigen) and STH infection was 25.1%, 0.6% and 18.3%, respectively. PCR analysis did not detect any additional malaria cases. The prevalence of LF and STH infections differ significantly among different age groups and ethnic communities. The high prevalence of LF in the community studied indicates an immediate need for implementing a mass drug administration program for its control in this particular geographical area of Nepal.

  12. Methods for Quantification of Soil-Transmitted Helminths in Environmental Media: Current Techniques and Recent Advances.

    PubMed

    Collender, Philip A; Kirby, Amy E; Addiss, David G; Freeman, Matthew C; Remais, Justin V

    2015-12-01

    Limiting the environmental transmission of soil-transmitted helminths (STHs), which infect 1.5 billion people worldwide, will require sensitive, reliable, and cost-effective methods to detect and quantify STHs in the environment. We review the state-of-the-art of STH quantification in soil, biosolids, water, produce, and vegetation with regard to four major methodological issues: environmental sampling; recovery of STHs from environmental matrices; quantification of recovered STHs; and viability assessment of STH ova. We conclude that methods for sampling and recovering STHs require substantial advances to provide reliable measurements for STH control. Recent innovations in the use of automated image identification and developments in molecular genetic assays offer considerable promise for improving quantification and viability assessment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Unprogrammed Deworming in the Kibera Slum, Nairobi: Implications for Control of Soil-Transmitted Helminthiases

    PubMed Central

    Harris, Julie R.; Worrell, Caitlin M.; Davis, Stephanie M.; Odero, Kennedy; Mogeni, Ondari D.; Deming, Michael S.; Mohammed, Aden; Montgomery, Joel M.; Njenga, Sammy M.; Fox, LeAnne M.; Addiss, David G.

    2015-01-01

    Background Programs for control of soil-transmitted helminth (STH) infections are increasingly evaluating national mass drug administration (MDA) interventions. However, “unprogrammed deworming” (receipt of deworming drugs outside of nationally-run STH control programs) occurs frequently. Failure to account for these activities may compromise evaluations of MDA effectiveness. Methods We used a cross-sectional study design to evaluate STH infection and unprogrammed deworming among infants (aged 6–11 months), preschool-aged children (PSAC, aged 1–4 years), and school-aged children (SAC, aged 5–14 years) in Kibera, Kenya, an informal settlement not currently receiving nationally-run MDA for STH. STH infection was assessed by triplicate Kato-Katz. We asked heads of households with randomly-selected children about past-year receipt and source(s) of deworming drugs. Local non-governmental organizations (NGOs) and school staff participating in school-based deworming were interviewed to collect information on drug coverage. Results Of 679 children (18 infants, 184 PSAC, and 477 SAC) evaluated, 377 (55%) reported receiving at least one unprogrammed deworming treatment during the past year. PSAC primarily received treatments from chemists (48.3%) or healthcare centers (37.7%); SAC most commonly received treatments at school (55.0%). Four NGOs reported past-year deworming activities at 47 of >150 schools attended by children in our study area. Past-year deworming was negatively associated with any-STH infection (34.8% vs 45.4%, p = 0.005). SAC whose most recent deworming medication was sourced from a chemist were more often infected with Trichuris (38.0%) than those who received their most recent treatment from a health center (17.3%) or school (23.1%) (p = 0.05). Conclusion Unprogrammed deworming was received by more than half of children in our study area, from multiple sources. Both individual-level treatment and unprogrammed preventive chemotherapy may serve an important public health function, particularly in the absence of programmed deworming; however, they may also lead to an overestimation of programmed MDA effectiveness. A standardized, validated tool is needed to assess unprogrammed deworming. PMID:25763577

  14. Long-term outcome of stapled transanal rectal resection (STARR) versus stapled hemorrhoidopexys (STH) for grade III-IV hemorrhoids: preliminary results.

    PubMed

    Zanella, Simone; Spirch, Saverio; Scarpa, Marco; Ricci, Francesco; Lumachi, Franco

    2014-01-01

    Circular stapled transanal hemorrhoidopexy (STH) was first introduced by A. Longo for the correction of internal mucosal prolapse and obstructed defecation and in 1998, was proposed as alternative to conventional excisional hemorrhoidectomy. More recently, stapled transanal rectal resection (STARR) has gradually gained popularity, as the Longo procedure, in the treatment of hemorrhoids. The aim of our study was to evaluate the usefulness of STARR as alternative to STH in patients with grade III (n=218, 68.1%) and IV (n=102, 31.9%) hemorrhoids. A group of 320 consecutive patients (median age=51 years; range=16-85) underwent STH (n=281) or STARR (n=39) procedure. The rate of postoperative bleeding (53.8% vs. 74.4%, p<0.01) was significantly reduced in patients who underwent STARR procedure, which required a longer (45 ± 22 vs. 26 ± 11 min, p<0.01) operative time. There were no differences between groups with regard to use of painkillers, postoperative pain intensity, short- (three months) and long-term (one and three years) residual pain, soiling, incontinence and urgency. Patients treated with the STARR procedure had lower recurrence rate of hemorrhoids and a lower incidence of prolapse, both at one year (none vs. 1.4%, p=0.593 and 2.6% vs. 5.3%, p=0.396, respectively) and at two years (none vs. 6.8%, p=0.078 and none vs. 13.2%, p=0.012, respectively). The one-year (9.0 ± 1.8 vs. 9.4 ± 0.7, p=0.171) and two-year (9.6 ± 0.8 vs. 9.1 ± 1.7, p=0.072) general satisfaction was similar but higher in STARR patients than in the STH group. In conclusion, according to our preliminary results, the STARR procedure leads to a lower incidence of complications and recurrences and should be considered for patients with grade III or IV hemorrhoids previously selected for stapled hemorrhoidectomy, as a promising alternative to STH. Copyright © 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  15. Epidemiological surveys of, and research on, soil-transmitted helminths in Southeast Asia: a systematic review.

    PubMed

    Dunn, Julia C; Turner, Hugo C; Tun, Aung; Anderson, Roy M

    2016-01-27

    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.

  16. Mapping of schistosomiasis and soil-transmitted helminthiasis in the regions of centre, East and West Cameroon.

    PubMed

    Tchuem Tchuenté, Louis-Albert; Kamwa Ngassam, Romuald Isaka; Sumo, Laurentine; Ngassam, Pierre; Dongmo Noumedem, Calvine; Nzu, Deguy D'or Luogbou; Dankoni, Esther; Kenfack, Christian Mérimé; Gipwe, Nestor Feussom; Akame, Julie; Tarini, Ann; Zhang, Yaobi; Angwafo, Fru Fobuzski

    2012-01-01

    Schistosomiasis and soil-transmitted helminthiasis (STH) are widely distributed in Cameroon. Although mass drug administration (MDA) of mebendazole is implemented nationwide, treatment with praziquantel was so far limited to the three northern regions and few health districts in the southern part of Cameroon, based on previous mapping conducted 25 years ago. To update the disease distribution map and determine where treatment with praziquantel should be extended, mapping surveys were conducted in three of the seven southern regions of Cameroon, i.e. Centre, East and West. Parasitological surveys were conducted in April-May 2010 in selected schools in all 63 health districts of the three targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration. The results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma mansoni was the most prevalent schistosome species, with an overall prevalence of 5.53%, followed by S. haematobium (1.72%) and S. guineensis (0.14%). The overall prevalence of schistosomiasis across the three regions was 7.31% (95% CI: 6.86-7.77%). The prevalence for Ascaris lumbricoides was 11.48 (95% CI: 10.93-12.04%), Trichuris trichiura 18.22% (95% CI: 17.56-18.90%) and hookworms 1.55% (95% CI: 1.35-1.78%), with an overall STH prevalence of 24.10% (95% CI: 23.36-24.85%) across the three regions. STH was more prevalent in the East region (46.57%; 95% CI: 44.41-48.75%) in comparison to the Centre (25.12; 95% CI: 24.10-26.17%) and West (10.49%; 95% CI: 9.57-11.51%) regions. In comparison to previous data, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is recommended, as well as an extension of praziquantel in identified moderate and high risk communities for schistosomiasis.

  17. Mapping of Schistosomiasis and Soil-Transmitted Helminthiasis in the Regions of Centre, East and West Cameroon

    PubMed Central

    Tchuem Tchuenté, Louis-Albert; Kamwa Ngassam, Romuald Isaka; Sumo, Laurentine; Ngassam, Pierre; Dongmo Noumedem, Calvine; Nzu, Deguy D'or Luogbou; Dankoni, Esther; Kenfack, Christian Mérimé; Gipwe, Nestor Feussom; Akame, Julie; Tarini, Ann; Zhang, Yaobi; Angwafo, Fru Fobuzski

    2012-01-01

    Background Schistosomiasis and soil-transmitted helminthiasis (STH) are widely distributed in Cameroon. Although mass drug administration (MDA) of mebendazole is implemented nationwide, treatment with praziquantel was so far limited to the three northern regions and few health districts in the southern part of Cameroon, based on previous mapping conducted 25 years ago. To update the disease distribution map and determine where treatment with praziquantel should be extended, mapping surveys were conducted in three of the seven southern regions of Cameroon, i.e. Centre, East and West. Methodology Parasitological surveys were conducted in April–May 2010 in selected schools in all 63 health districts of the three targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration. Principal Findings The results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma mansoni was the most prevalent schistosome species, with an overall prevalence of 5.53%, followed by S. haematobium (1.72%) and S. guineensis (0.14%). The overall prevalence of schistosomiasis across the three regions was 7.31% (95% CI: 6.86–7.77%). The prevalence for Ascaris lumbricoides was 11.48 (95% CI: 10.93–12.04%), Trichuris trichiura 18.22% (95% CI: 17.56–18.90%) and hookworms 1.55% (95% CI: 1.35–1.78%), with an overall STH prevalence of 24.10% (95% CI: 23.36–24.85%) across the three regions. STH was more prevalent in the East region (46.57%; 95% CI: 44.41–48.75%) in comparison to the Centre (25.12; 95% CI: 24.10–26.17%) and West (10.49%; 95% CI: 9.57–11.51%) regions. Conclusions/Significance In comparison to previous data, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is recommended, as well as an extension of praziquantel in identified moderate and high risk communities for schistosomiasis. PMID:22413029

  18. Monitoring the impact of a national school based deworming programme on soil-transmitted helminths in Kenya: the first three years, 2012 - 2014.

    PubMed

    Okoyo, Collins; Nikolay, Birgit; Kihara, Jimmy; Simiyu, Elses; Garn, Joshua V; Freeman, Mathew C; Mwanje, Mariam T; Mukoko, Dunstan A; Brooker, Simon J; Pullan, Rachel L; Njenga, Sammy M; Mwandawiro, Charles S

    2016-07-25

    In 2012, the Kenyan Ministries of Health and of Education began a programme to deworm all school-age children living in areas at high risk of soil-transmitted helminths (STH) and schistosome infections. The impact of this school-based mass drug administration (MDA) programme in Kenya is monitored by the Kenya Medical Research Institute (KEMRI) as part of a five-year (2012-2017) study. This article focuses on the impact of MDA on STH infections and presents the overall achieved reductions from baseline to mid-term, as well as yearly patterns of reductions and subsequent re-infections per school community. The study involved a series of pre- and post-intervention, repeat cross-sectional surveys in a representative, stratified, two-stage sample of schools across Kenya. The programme contained two tiers of monitoring; a national baseline and mid-term survey including 200 schools, and surveys conducted among 60 schools pre- and post-intervention. Stool samples were collected from randomly selected school children and tested for helminth infections using Kato-Katz technique. The prevalence and mean intensity of each helminth species were calculated at the school and county levels and 95 % confidence intervals (CIs) were obtained by binomial and negative binomial regression, respectively, taking into account clustering by schools. The overall prevalence of STH infection at baseline was 32.3 % (hookworms: 15.4 %; Ascaris lumbricoides: 18.1 %; and Trichuris trichiura: 6.7 %). After two rounds of MDA, the overall prevalence of STH had reduced to 16.4 % (hookworms: 2.3 %; A. lumbricoides: 11.9 %; and T. trichiura: 4.5 %). The relative reductions of moderate to heavy intensity of infections were 33.7 % (STH combined), 77.3 % (hookworms) and 33.9 % (A. lumbricoides). For T. trichiura, however, moderate to heavy intensity of infections increased non-significantly by 18.0 % from baseline to mid-term survey. The school-based deworming programme has substantially reduced STH infections, but because of ongoing transmission additional strategies may be required to achieve a sustained interruption of transmission.

  19. Evaluating the sustainability, scalability, and replicability of an STH transmission interruption intervention: The DeWorm3 implementation science protocol.

    PubMed

    Means, Arianna Rubin; Ajjampur, Sitara S R; Bailey, Robin; Galactionova, Katya; Gwayi-Chore, Marie-Claire; Halliday, Katherine; Ibikounle, Moudachirou; Juvekar, Sanjay; Kalua, Khumbo; Kang, Gagandeep; Lele, Pallavi; Luty, Adrian J F; Pullan, Rachel; Sarkar, Rajiv; Schär, Fabian; Tediosi, Fabrizio; Weiner, Bryan J; Yard, Elodie; Walson, Judd

    2018-01-01

    Hybrid trials that include both clinical and implementation science outcomes are increasingly relevant for public health researchers that aim to rapidly translate study findings into evidence-based practice. The DeWorm3 Project is a series of hybrid trials testing the feasibility of interrupting the transmission of soil transmitted helminths (STH), while conducting implementation science research that contextualizes clinical research findings and provides guidance on opportunities to optimize delivery of STH interventions. The purpose of DeWorm3 implementation science studies is to ensure rapid and efficient translation of evidence into practice. DeWorm3 will use stakeholder mapping to identify individuals who influence or are influenced by school-based or community-wide mass drug administration (MDA) for STH and to evaluate network dynamics that may affect study outcomes and future policy development. Individual interviews and focus groups will generate the qualitative data needed to identify factors that shape, contextualize, and explain DeWorm3 trial outputs and outcomes. Structural readiness surveys will be used to evaluate the factors that drive health system readiness to implement novel interventions, such as community-wide MDA for STH, in order to target change management activities and identify opportunities for sustaining or scaling the intervention. Process mapping will be used to understand what aspects of the intervention are adaptable across heterogeneous implementation settings and to identify contextually-relevant modifiable bottlenecks that may be addressed to improve the intervention delivery process and to achieve intervention outputs. Lastly, intervention costs and incremental cost-effectiveness will be evaluated to compare the efficiency of community-wide MDA to standard-of-care targeted MDA both over the duration of the trial and over a longer elimination time horizon.

  20. Dimension- and shape-dependent thermal transport in nano-patterned thin films investigated by scanning thermal microscopy

    NASA Astrophysics Data System (ADS)

    Ge, Yunfei; Zhang, Yuan; Weaver, Jonathan M. R.; Dobson, Phillip S.

    2017-12-01

    Scanning thermal microscopy (SThM) is a technique which is often used for the measurement of the thermal conductivity of materials at the nanometre scale. The impact of nano-scale feature size and shape on apparent thermal conductivity, as measured using SThM, has been investigated. To achieve this, our recently developed topography-free samples with 200 and 400 nm wide gold wires (50 nm thick) of length of 400-2500 nm were fabricated and their thermal resistance measured and analysed. This data was used in the development and validation of a rigorous but simple heat transfer model that describes a nanoscopic contact to an object with finite shape and size. This model, in combination with a recently proposed thermal resistance network, was then used to calculate the SThM probe signal obtained by measuring these features. These calculated values closely matched the experimental results obtained from the topography-free sample. By using the model to analyse the dimensional dependence of thermal resistance, we demonstrate that feature size and shape has a significant impact on measured thermal properties that can result in a misinterpretation of material thermal conductivity. In the case of a gold nanowire embedded within a silicon nitride matrix it is found that the apparent thermal conductivity of the wire appears to be depressed by a factor of twenty from the true value. These results clearly demonstrate the importance of knowing both probe-sample thermal interactions and feature dimensions as well as shape when using SThM to quantify material thermal properties. Finally, the new model is used to identify the heat flux sensitivity, as well as the effective contact size of the conventional SThM system used in this study.

  1. Impact of Six Rounds of Mass Drug Administration on Brugian Filariasis and Soil-Transmitted Helminth Infections in Eastern Indonesia

    PubMed Central

    Supali, Taniawati; Djuardi, Yenny; Bradley, Mark; Noordin, Rahmah; Rückert, Paul; Fischer, Peter U.

    2013-01-01

    Background The lymphatic filarial parasite Brugia timori occurs only in eastern Indonesia where it causes high morbidity. The absence of an animal reservoir, the inefficient transmission by Anopheles mosquitoes and the high sensitivity to DEC/albendazole treatment make this species a prime candidate for elimination by mass drug administration (MDA). Methodology/Principal Findings We evaluated the effect of MDA using DEC and albendazole on B. timori and soil transmitted helminths (STH) in a cross-sectional study of a sentinel village on Alor Island annually over a period of 10 years. Pre-MDA the microfilaria (MF) prevalence was 26% and 80% of the residents had filaria-specific IgG4 antibodies. In 2010, 34 months after the 6th round of MDA, MF and antibody rates were only 0.17% and 6.4%, respectively. The MDA campaign had also a beneficial effect on STH. Baseline prevalence rates for Ascaris, hookworm and Trichuris were 34%, 28%, and 11%, respectively; these rates were reduced to 27%, 4%, and 2% one year after the 5th round of MDA. Unfortunately, STH rates rebounded 34 months after cessation of MDA and approached pre-MDA rates. However, the intensity of STH infection in 2009 was still reduced, and no heavy infections were detected. Conclusions/Significance MDA with DEC/albendazole has had a major impact on B. timori MF and IgG4 antibody rates, providing a proof of principle that elimination is feasible. We also documented the value of annual DEC/albendazole as a mass de-worming intervention and the importance of continuing some form of STH control after cessation of MDA for filariasis. PMID:24349595

  2. Impact of six rounds of mass drug administration on Brugian filariasis and soil-transmitted helminth infections in eastern Indonesia.

    PubMed

    Supali, Taniawati; Djuardi, Yenny; Bradley, Mark; Noordin, Rahmah; Rückert, Paul; Fischer, Peter U

    2013-01-01

    The lymphatic filarial parasite Brugia timori occurs only in eastern Indonesia where it causes high morbidity. The absence of an animal reservoir, the inefficient transmission by Anopheles mosquitoes and the high sensitivity to DEC/albendazole treatment make this species a prime candidate for elimination by mass drug administration (MDA). We evaluated the effect of MDA using DEC and albendazole on B. timori and soil transmitted helminths (STH) in a cross-sectional study of a sentinel village on Alor Island annually over a period of 10 years. Pre-MDA the microfilaria (MF) prevalence was 26% and 80% of the residents had filaria-specific IgG4 antibodies. In 2010, 34 months after the 6(th) round of MDA, MF and antibody rates were only 0.17% and 6.4%, respectively. The MDA campaign had also a beneficial effect on STH. Baseline prevalence rates for Ascaris, hookworm and Trichuris were 34%, 28%, and 11%, respectively; these rates were reduced to 27%, 4%, and 2% one year after the 5(th) round of MDA. Unfortunately, STH rates rebounded 34 months after cessation of MDA and approached pre-MDA rates. However, the intensity of STH infection in 2009 was still reduced, and no heavy infections were detected. MDA with DEC/albendazole has had a major impact on B. timori MF and IgG4 antibody rates, providing a proof of principle that elimination is feasible. We also documented the value of annual DEC/albendazole as a mass de-worming intervention and the importance of continuing some form of STH control after cessation of MDA for filariasis.

  3. [Effect of gravitation loading and retabolil on development of atrophy in muscles and bones of rats due to suspension].

    PubMed

    KaplanskiI, A S; Il'ina-Kakueva, E I; Durnova, G N; Alekseev, E A; Loginov, V I

    1999-01-01

    In a 3-wk experiment with tail-suspended rats histological and histomorphometric methods were used to determine the effects of graded gravitational loading (GGL) and anabolic steroid retabolil (nortestosterone decanoate) on the course of atrophy in soleus m. (SM), gastrocnemius m. (GM), tibia and humerus, and functioning of somatotrophic hormones (STH) of the pituitary and thyrocytes of the thyroid. Suspension was found to produce atrophy in SM and, to a less degree, in GM, partial transformation of SM slow fibers into the fast ones, suppression of the tibial longitudinal growth, demineralization of the tibial and humeral spongious metaphyses; besides, functional activities of STH-cells and thyrocytes were inhibited. Graded gravitational loading of rats by intermittence of suspension for 2 hrs slowed down atrophy in both muscles and osteopenia in tibia, stimulated the synthetic and secretory functions of STH-cells without any marked effect on thyrocytes or humeral osteopenia. GGL failed to influence the slow-to-fast transformation of SM fibers. Two injections of retabolil at the total dose of 3 mg/kg of the body mass somewhat interfered with the SM atrophy and humoral osteopenia, and were favorable to the synthetic but not secretory activity of STH-cells. Neither SM and tibial atrophies nor thyroid activity of the gland were improved. The prophylactic action of GGL upon the SM and humeral atrophies was significantly higher when combined with retabolil, whereas GM and tibia were not noticeably cured by retabolil. Inhibition of the SM atrophy and humeral osteopenia in rats treated with GGL and retabolil concurred with elevated activities of STH-cells and thyrocytes indirectly suggesting their more intensive production of the growth hormone and thyroid hormones, respectively.

  4. Solar hydrogen production by tandem cell system composed of metal oxide semiconductor film photoelectrode and dye-sensitized solar cell

    NASA Astrophysics Data System (ADS)

    Arakawa, H.; Shiraishi, C.; Tatemoto, M.; Kishida, H.; Usui, D.; Suma, A.; Takamisawa, A.; Yamaguchi, T.

    2007-09-01

    Photocatalytic and photoelectrochemical approaches to solar hydrogen production in our group were introduced. In photocatalytic water splitting system using NiO x/ TiO II powder photocatalyst with concentrated Na IICO 3 aqueous solution, solar energy conversion efficiency to H II and O II production (STH efficiency) was 0.016%. In addition, STH efficiency of visible light responding photocatalyst, NiOx/ promoted In 0.9Ni 0.1TaO 4, was estimated at 0.03%. In photoelectrochemical system using an oxide semiconductor film phptoelectrode, STH efficiencies of meosporous TiO II (Anatase) , mesoporous visible light responding S-doped TiO II (Anatase) and WO 3 film were 0.32-0.44% at applied potential of 0.35 V vs NHE, 0.14% at 0.55 V and 0.44% at 0.9 V, respectively. Finally, solar hydrogen production by tandem cell system composed of an oxide semiconductor photoelectrode, a Pt wire counter electrode and a dye-sensitized solar cell (DSC) was investigated. As photoelectrodes, meosporous TiO II (Anatase), mesoporous S-doped TiO II (Anatase), WO 3, BiVO 4 and Fe IIO 3 film were tested. STH efficiency of tandem cell system composed of a WO 3 film photoelectrode, and a two-series-connected DSC (Voc = 1.4 V) was 2.5-2.8%. In conclusion, it is speculated that more than 5% STH efficiency will be obtained by tandem cell system composed of an oxide semiconductor photoelectrode and a two-series-connected DSC in near future. This suggests a cost-effective and practical application of this system for solar hydrogen production.

  5. Diagnostic Tests to Support Late-Stage Control Programs for Schistosomiasis and Soil-Transmitted Helminthiases.

    PubMed

    Hawkins, Kenneth R; Cantera, Jason L; Storey, Helen L; Leader, Brandon T; de Los Santos, Tala

    2016-12-01

    Global efforts to address schistosomiasis and soil-transmitted helminthiases (STH) include deworming programs for school-aged children that are made possible by large-scale drug donations. Decisions on these mass drug administration (MDA) programs currently rely on microscopic examination of clinical specimens to determine the presence of parasite eggs. However, microscopy-based methods are not sensitive to the low-intensity infections that characterize populations that have undergone MDA. Thus, there has been increasing recognition within the schistosomiasis and STH communities of the need for improved diagnostic tools to support late-stage control program decisions, such as when to stop or reduce MDA. Failure to adequately address the need for new diagnostics could jeopardize achievement of the 2020 London Declaration goals. In this report, we assess diagnostic needs and landscape potential solutions and determine appropriate strategies to improve diagnostic testing to support control and elimination programs. Based upon literature reviews and previous input from experts in the schistosomiasis and STH communities, we prioritized two diagnostic use cases for further exploration: to inform MDA-stopping decisions and post-MDA surveillance. To this end, PATH has refined target product profiles (TPPs) for schistosomiasis and STH diagnostics that are applicable to these use cases. We evaluated the limitations of current diagnostic methods with regards to these use cases and identified candidate biomarkers and diagnostics with potential application as new tools. Based on this analysis, there is a need to develop antigen-detecting rapid diagnostic tests (RDTs) with simplified, field-deployable sample preparation for schistosomiasis. Additionally, there is a need for diagnostic tests that are more sensitive than the current methods for STH, which may include either a field-deployable molecular test or a simple, low-cost, rapid antigen-detecting test.

  6. Morphology and histochemistry of the "C" cells of guinea pig thyroid gland after treatment with STH preparation: Part II--young animals.

    PubMed

    Sawicki, B

    1977-01-01

    Investigations were carried out on 32 male guinea pigs 2 to 3 months of age. The STH (produced by BIOMED, Warszawa, Poland) was administered intramuscularly every other day, in 7 injections of 20 Evans's units (E. U.) or 100 E. U./kg body weight each. Thyroid gland sections were stained with heamatoxylin and eosin and with the Azan method. The C cells were detected with the modified silver method of Grimelius and with the HCl-toluidine blue and HCl-lead haemotoxylin techniques. Moreover, reactions were performed for succinate and alpha-glycerophosphate dehydrogenases and also for non-specific esterases and non-specific acetylcholinesterase. STH evoked proliferation of the C cells, changed their morphology and activity pattern of the enzymes present therein, probably testifying to an enhanced secretory activity of these cells.

  7. Soil-Transmitted Helminth Infections and Correlated Risk Factors in Preschool and School-Aged Children in Rural Southwest China

    PubMed Central

    Wang, Xiaobing; Zhang, Linxiu; Luo, Renfu; Wang, Guofei; Chen, Yingdan; Medina, Alexis; Eggleston, Karen; Rozelle, Scott; Smith, D. Scott

    2012-01-01

    We conducted a survey of 1707 children in 141 impoverished rural areas of Guizhou and Sichuan Provinces in Southwest China. Kato-Katz smear testing of stool samples elucidated the prevalence of ascariasis, trichuriasis and hookworm infections in pre-school and school aged children. Demographic, hygiene, household and anthropometric data were collected to better understand risks for infection in this population. 21.2 percent of pre-school children and 22.9 percent of school aged children were infected with at least one of the three types of STH. In Guizhou, 33.9 percent of pre-school children were infected, as were 40.1 percent of school aged children. In Sichuan, these numbers were 9.7 percent and 6.6 percent, respectively. Number of siblings, maternal education, consumption of uncooked meat, consumption of unboiled water, and livestock ownership all correlated significantly with STH infection. Through decomposition analysis, we determined that these correlates made up 26.7 percent of the difference in STH infection between the two provinces. Multivariate analysis showed that STH infection is associated with significantly lower weight-for-age and height-for-age z-scores; moreover, older children infected with STHs lag further behind on the international growth scales than younger children. PMID:23029330

  8. Determining soil-transmitted helminth infection status and physical fitness of school-aged children.

    PubMed

    Yap, Peiling; Fürst, Thomas; Müller, Ivan; Kriemler, Susi; Utzinger, Jürg; Steinmann, Peter

    2012-08-22

    Soil-transmitted helminth (STH) infections are common. Indeed, more than 1 billion people are affected, mainly in the developing world where poverty prevails and hygiene behavior, water supply, and sanitation are often deficient. Ascaris lumbricoides, Trichuris trichiura, and the two hookworm species, Ancylostoma duodenale and Necator americanus, are the most prevalent STHs. The estimated global burden due to hookworm disease, ascariasis, and trichuriasis is 22.1, 10.5, and 6.4 million disability-adjusted life years (DALYs), respectively. Furthermore, an estimated 30-100 million people are infected with Strongyloides stercoralis, the most neglected STH species of global significance which arguably also causes a considerable public health impact. Multiple-species infections (i.e., different STHs harbored in a single individual) are common, and infections have been linked to lowered productivity and thus economic outlook of developing countries. For the diagnosis of common STHs, the World Health Organization (WHO) recommends the Kato-Katz technique, which is a relatively straightforward method for determining the prevalence and intensity of such infections. It facilitates the detection of parasite eggs that infected subjects pass in their feces. With regard to the diagnosis of S. stercoralis, there is currently no simple and accurate tool available. The Baermann technique is the most widely employed method for its diagnosis. The principle behind the Baermann technique is that active S. stercoralis larvae migrate out of an illuminated fresh fecal sample as the larvae are phototactic. It requires less sophisticated laboratory materials and is less time consuming than culture and immunological methods. Morbidities associated with STH infections range from acute but common symptoms, such as abdominal pain, diarrhea, and pruritus, to chronic symptoms, such as anemia, under- and malnutrition, and cognitive impairment. Since the symptoms are generally unspecific and subtle, they often go unnoticed, are considered a normal condition by affected individuals, or are treated as symptoms of other diseases that might be more common in a given setting. Hence, it is conceivable that the true burden of STH infections is underestimated by assessment tools relying on self-declared signs and symptoms as is usually the case in population-based surveys. In the late 1980s and early 1990s, Stephenson and colleagues highlighted the possibility of STH infections lowering the physical fitness of boys aged 6-12 years. This line of scientific inquiry gained new momentum recently. The 20-meter (m) shuttle run test was developed and validated by Léger et al. and is used worldwide to measure the aerobic fitness of children. The test is easy to standardize and can be performed wherever a 20-m long and flat running course and an audio source are available, making its use attractive in resource-constrained settings. To facilitate and standardize attempts at assessing whether STH infections have an effect on the physical fitness of school-aged children, we present methodologies that diagnose STH infections or measure physical fitness that are simple to execute and yet, provide accurate and reproducible outcomes. This will help to generate new evidence regarding the health impact of STH infections.

  9. Sequence analysis of tau 3'untranslated region and saitohin gene in sporadic progressive supranuclear palsy

    PubMed Central

    Ezquerra, M; Campdelacreu, J; Munoz, E; Oliva, R; Tolosa, E

    2004-01-01

    Objectives: To search for genetic changes in the 3'untranslated region (3'UTR) of tau and adjacent sequence LOC147077, and in the coding region of STH in PSP patients. Methods: The study included 57 PSP patients and 83 healthy controls. The genetic analysis of each region was performed through sequencing. The Q7R polymorphism was studied through restriction enzyme and electrophoresis analysis. Results: No mutations were found in the regions analysed. The QQ genotype of the STH polymorphism was over-represented in participants with PSP (91.5%) compared with control subjects (47%) (p⩽0.00001). This genotype co-segregated with the H1/H1 haplotype in our PSP cases. Conclusions: Our results do not support a major role for the tau 3'UTR in PSP genetics. The QQ genotype of STH confers susceptibility for PSP and is in linkage disequilibrium with the H1/H1 haplotype. PMID:14707330

  10. Rationale for the Coadministration of Albendazole and Ivermectin to Humans for Malaria Parasite Transmission Control

    PubMed Central

    Kobylinski, Kevin C.; Alout, Haoues; Foy, Brian D.; Clements, Archie; Adisakwattana, Poom; Swierczewski, Brett E.; Richardson, Jason H.

    2014-01-01

    Recently there have been calls for the eradication of malaria and the elimination of soil-transmitted helminths (STHs). Malaria and STHs overlap in distribution, and STH infections are associated with increased risk for malaria. Indeed, there is evidence that suggests that STH infection may facilitate malaria transmission. Malaria and STH coinfection may exacerbate anemia, especially in pregnant women, leading to worsened child development and more adverse pregnancy outcomes than these diseases would cause on their own. Ivermectin mass drug administration (MDA) to humans for malaria parasite transmission suppression is being investigated as a potential malaria elimination tool. Adding albendazole to ivermectin MDAs would maximize effects against STHs. A proactive, integrated control platform that targets malaria and STHs would be extremely cost-effective and simultaneously reduce human suffering caused by multiple diseases. This paper outlines the benefits of adding albendazole to ivermectin MDAs for malaria parasite transmission suppression. PMID:25070998

  11. School hygiene and deworming are key protective factors for reduced transmission of soil-transmitted helminths among schoolchildren in Honduras.

    PubMed

    Gabrie, José Antonio; Rueda, María Mercedes; Canales, Maritza; Gyorkos, Theresa W; Sanchez, Ana Lourdes

    2014-08-04

    Among many neglected tropical diseases endemic in Honduras, soil-transmitted helminth (STH) infections are of particular importance. However, knowledge gaps remain in terms of risk factors involved in infection transmission. The aim of this study was to investigate risk factors associated with STH infections in schoolchildren living in rural Honduras. A cross-sectional study was conducted among Honduran rural schoolchildren in 2011. Demographic, socio-economic, and epidemiological data were obtained through a standardized questionnaire and STH infections were determined by the Kato-Katz method. Logistic regression models accounting for school clustering were used to assess putative risk factors for infection. A total of 320 children completed the study. Prevalences for any STH and for Ascaris lumbricoides, Trichuris trichiura and hookworms were: 72.5%, 30.3%, 66.9% and 15.9%, respectively. A number of risk factors were identified at the individual, household, and school level. Boys were at increased odds of infection with hookworms (OR 2.33, 95% CI = 1.23-4.42). Higher socio-economic status in the family had a protective effect against infections by A. lumbricoides (OR 0.80, 95% CI = 0.65-0.99) and T. trichiura (OR 0.77, 95% CI = 0.63-0.94).Low school hygiene conditions significantly increased the odds for ascariasis (OR 14.85, 95% CI = 7.29-30.24), trichuriasis (OR 7.32, 95% CI = 3.71-14.45), mixed infections (OR 9.02, 95% CI = 4.66-17.46), and ascariasis intensity of infection (OR 3.32, 95% CI = 1.05 -10.52).Children attending schools not providing deworming treatment or that had provided it only once a year were at increased odds of ascariasis (OR 10.40, 95% CI = 4.39-24.65), hookworm (OR 2.92, 95% CI = 1.09-7.85) and mixed infections (OR 10.57, 95% CI = 4.53-24.66). Poverty-reduction strategies will ultimately lead to sustainable control of STH infections in Honduras, but as shorter-term measures, uninterrupted bi-annual deworming treatment paired with improvements in school sanitary conditions may result in significant reductions of STH prevalence among Honduran schoolchildren.

  12. Mapping of schistosomiasis and soil-transmitted helminthiasis in the regions of Littoral, North-West, South and South-West Cameroon and recommendations for treatment.

    PubMed

    Tchuem Tchuenté, Louis-Albert; Dongmo Noumedem, Calvine; Ngassam, Pierre; Kenfack, Christian Mérimé; Gipwe, Nestor Feussom; Dankoni, Esther; Tarini, Ann; Zhang, Yaobi

    2013-12-23

    The previous nationwide mapping of schistosomiasis and soil-transmitted helminthiasis (STH) in Cameroon was conducted 25 years ago. Based on its results, mass drug administration (MDA) of praziquantel was limited to the three northern regions and few health districts in the southern part of Cameroon. In 2010, we started the process of updating the disease distribution in order to improve the control strategies. Three of the ten regions of Cameroon were mapped in 2010 and the data were published. In 2011, surveys were conducted in four additional regions, i.e. Littoral, North-West, South and South-West. Parasitological surveys were conducted in March 2011 in selected schools in all 65 health districts of the four targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration. The results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma haematobium was the most prevalent schistosome species, with an overall prevalence of 3.2%, followed by S. mansoni (3%) and S. guineensis (1.2%). The overall prevalence of schistosomiasis across the four regions was 7.4% (95% CI: 6.7-8.3%). The prevalence for Ascaris lumbricoides was 19.5% (95% CI: 18.3-20.7%), Trichuris trichiura 18.9% (95% CI: 17.7-20.1%) and hookworms 7.6% (95% CI: 6.8-8.4%), with an overall STH prevalence of 32.5% (95% CI: 31.1-34.0%) across the four regions. STH was more prevalent in the South region (52.8%; 95% CI: 48.0-57.3%), followed by the South-West (46.2%; 95% CI: 43.2-49.3%), the North-West (35.9%; 95% CI: 33.1-38.7%) and the Littoral (13.0%; 95% CI: 11.3-14.9%) regions. In comparison to previous data in 1985-87, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is recommended, as well as an extension of praziquantel in identified moderate and high risk communities for schistosomiasis.

  13. Mapping of schistosomiasis and soil-transmitted helminthiasis in the regions of Littoral, North-West, South and South-West Cameroon and recommendations for treatment

    PubMed Central

    2013-01-01

    Background The previous nationwide mapping of schistosomiasis and soil-transmitted helminthiasis (STH) in Cameroon was conducted 25 years ago. Based on its results, mass drug administration (MDA) of praziquantel was limited to the three northern regions and few health districts in the southern part of Cameroon. In 2010, we started the process of updating the disease distribution in order to improve the control strategies. Three of the ten regions of Cameroon were mapped in 2010 and the data were published. In 2011, surveys were conducted in four additional regions, i.e. Littoral, North-West, South and South-West. Methods Parasitological surveys were conducted in March 2011 in selected schools in all 65 health districts of the four targeted regions, using appropriate research methodologies, i.e. Kato-Katz and urine filtration. Results The results showed significant variation of schistosomiasis and STH prevalence between schools, villages, districts and regions. Schistosoma haematobium was the most prevalent schistosome species, with an overall prevalence of 3.2%, followed by S. mansoni (3%) and S. guineensis (1.2%). The overall prevalence of schistosomiasis across the four regions was 7.4% (95% CI: 6.7-8.3%). The prevalence for Ascaris lumbricoides was 19.5% (95% CI: 18.3-20.7%), Trichuris trichiura 18.9% (95% CI: 17.7-20.1%) and hookworms 7.6% (95% CI: 6.8-8.4%), with an overall STH prevalence of 32.5% (95% CI: 31.1-34.0%) across the four regions. STH was more prevalent in the South region (52.8%; 95% CI: 48.0-57.3%), followed by the South-West (46.2%; 95% CI: 43.2-49.3%), the North-West (35.9%; 95% CI: 33.1-38.7%) and the Littoral (13.0%; 95% CI: 11.3-14.9%) regions. Conclusions In comparison to previous data in 1985–87, the results showed an increase of schistosomiasis transmission in several health districts, whereas there was a significant decline of STH infections. Based on the prevalence data, the continuation of annual or bi-annual MDA for STH is recommended, as well as an extension of praziquantel in identified moderate and high risk communities for schistosomiasis. PMID:24365046

  14. [Soil transmitted helminthiasis in Argentina. A systematic review].

    PubMed

    Socías, M Eugenia; Fernández, Anabel; Gil, José F; Krolewiecki, Alejandro J

    2014-01-01

    A systematic review of surveys performed between 1980 and 2011 (published in MEDLINE/Pubmed and/or LILACS indexed journals, available in the baseline data from a Mass Deworming National Program (MDNP, 2005) was used to identify the prevalence, distribution and detection of risk areas for soil transmitted helminth infections (STH) in Argentina. We found 310 publications in the database using the pre-defined key-words (medical subject headings) for research purposes. Only 24 articles with 26 surveillance sites in 8 provinces and a total of 5495 surveyed individuals fulfilled the inclusion criteria. Frequency rates for STH had a wide range: Ascaris lumbricoides: 0-67%, hookworms: 0-90%, Trichuris trichiura: 0-24.6 and Strongyloides stercoralis: 0-83%. The estimated combined incidence varied from 0.8% to 88.6%. Baseline surveys from the MDNP reporting on 1943 children from 12 provinces confirmed the heterogeneity, with combined STH frequency rates ranging from 0 to 42.7%. Surveys included in this review showed that the distribution of STH in Argentina is not homogeneous, with areas of high incidence (> 20%) in the northeastern and northwestern provinces where mass deworming activities would be highly beneficial. In several surveys, the high overall incidence was mostly due to hookworms and S. stercoralis, a situation to be considered when selecting diagnostic and therapeutic control strategies. The scarcity or absence of data from various provinces and the availability of less than 8000 surveyed individuals should be considered.

  15. Determining Soil-transmitted Helminth Infection Status and Physical Fitness of School-aged Children

    PubMed Central

    Yap, Peiling; Fürst, Thomas; Müller, Ivan; Kriemler, Susi; Utzinger, Jürg; Steinmann, Peter

    2012-01-01

    Soil-transmitted helminth (STH) infections are common. Indeed, more than 1 billion people are affected, mainly in the developing world where poverty prevails and hygiene behavior, water supply, and sanitation are often deficient1,2. Ascaris lumbricoides, Trichuris trichiura, and the two hookworm species, Ancylostoma duodenale and Necator americanus, are the most prevalent STHs3. The estimated global burden due to hookworm disease, ascariasis, and trichuriasis is 22.1, 10.5, and 6.4 million disability-adjusted life years (DALYs), respectively4. Furthermore, an estimated 30-100 million people are infected with Strongyloides stercoralis, the most neglected STH species of global significance which arguably also causes a considerable public health impact5,6. Multiple-species infections (i.e., different STHs harbored in a single individual) are common, and infections have been linked to lowered productivity and thus economic outlook of developing countries1,3. For the diagnosis of common STHs, the World Health Organization (WHO) recommends the Kato-Katz technique7,8, which is a relatively straightforward method for determining the prevalence and intensity of such infections. It facilitates the detection of parasite eggs that infected subjects pass in their feces. With regard to the diagnosis of S.stercoralis, there is currently no simple and accurate tool available. The Baermann technique is the most widely employed method for its diagnosis. The principle behind the Baermann technique is that active S.stercoralis larvae migrate out of an illuminated fresh fecal sample as the larvae are phototactic9. It requires less sophisticated laboratory materials and is less time consuming than culture and immunological methods5. Morbidities associated with STH infections range from acute but common symptoms, such as abdominal pain, diarrhea, and pruritus, to chronic symptoms, such as anemia, under- and malnutrition, and cognitive impairment10. Since the symptoms are generally unspecific and subtle, they often go unnoticed, are considered a normal condition by affected individuals, or are treated as symptoms of other diseases that might be more common in a given setting. Hence, it is conceivable that the true burden of STH infections is underestimated by assessment tools relying on self-declared signs and symptoms as is usually the case in population-based surveys. In the late 1980s and early 1990s, Stephenson and colleagues highlighted the possibility of STH infections lowering the physical fitness of boys aged 6-12 years11,12. This line of scientific inquiry gained new momentum recently13,14,15. The 20-meter (m) shuttle run test was developed and validated by Léger et al.16 and is used worldwide to measure the aerobic fitness of children17. The test is easy to standardize and can be performed wherever a 20-m long and flat running course and an audio source are available, making its use attractive in resource-constrained settings13. To facilitate and standardize attempts at assessing whether STH infections have an effect on the physical fitness of school-aged children, we present methodologies that diagnose STH infections or measure physical fitness that are simple to execute and yet, provide accurate and reproducible outcomes. This will help to generate new evidence regarding the health impact of STH infections. PMID:22951972

  16. Assessing the feasibility of interrupting the transmission of soil-transmitted helminths through mass drug administration: The DeWorm3 cluster randomized trial protocol.

    PubMed

    Ásbjörnsdóttir, Kristjana Hrönn; Ajjampur, Sitara S Rao; Anderson, Roy M; Bailey, Robin; Gardiner, Iain; Halliday, Katherine E; Ibikounle, Moudachirou; Kalua, Khumbo; Kang, Gagandeep; Littlewood, D Timothy J; Luty, Adrian J F; Means, Arianna Rubin; Oswald, William; Pullan, Rachel L; Sarkar, Rajiv; Schär, Fabian; Szpiro, Adam; Truscott, James E; Werkman, Marleen; Yard, Elodie; Walson, Judd L

    2018-01-01

    Current control strategies for soil-transmitted helminths (STH) emphasize morbidity control through mass drug administration (MDA) targeting preschool- and school-age children, women of childbearing age and adults in certain high-risk occupations such as agricultural laborers or miners. This strategy is effective at reducing morbidity in those treated but, without massive economic development, it is unlikely it will interrupt transmission. MDA will therefore need to continue indefinitely to maintain benefit. Mathematical models suggest that transmission interruption may be achievable through MDA alone, provided that all age groups are targeted with high coverage. The DeWorm3 Project will test the feasibility of interrupting STH transmission using biannual MDA targeting all age groups. Study sites (population ≥80,000) have been identified in Benin, Malawi and India. Each site will be divided into 40 clusters, to be randomized 1:1 to three years of twice-annual community-wide MDA or standard-of-care MDA, typically annual school-based deworming. Community-wide MDA will be delivered door-to-door, while standard-of-care MDA will be delivered according to national guidelines. The primary outcome is transmission interruption of the STH species present at each site, defined as weighted cluster-level prevalence ≤2% by quantitative polymerase chain reaction (qPCR), 24 months after the final round of MDA. Secondary outcomes include the endline prevalence of STH, overall and by species, and the endline prevalence of STH among children under five as an indicator of incident infections. Secondary analyses will identify cluster-level factors associated with transmission interruption. Prevalence will be assessed using qPCR of stool samples collected from a random sample of cluster residents at baseline, six months after the final round of MDA and 24 months post-MDA. A smaller number of individuals in each cluster will be followed with annual sampling to monitor trends in prevalence and reinfection throughout the trial. ClinicalTrials.gov NCT03014167.

  17. Water Splitting with Series-Connected Polymer Solar Cells.

    PubMed

    Esiner, Serkan; van Eersel, Harm; van Pruissen, Gijs W P; Turbiez, Mathieu; Wienk, Martijn M; Janssen, René A J

    2016-10-12

    We investigate light-driven electrochemical water splitting with series-connected polymer solar cells using a combined experimental and modeling approach. The expected maximum solar-to-hydrogen conversion efficiency (η STH ) for light-driven water splitting is modeled for two, three, and four series-connected polymer solar cells. In the modeling, we assume an electrochemical water splitting potential of 1.50 V and a polymer solar cell for which the external quantum efficiency and fill factor are both 0.65. The minimum photon energy loss (E loss ), defined as the energy difference between the optical band gap (E g ) and the open-circuit voltage (V oc ), is set to 0.8 eV, which we consider a realistic value for polymer solar cells. Within these approximations, two series-connected single junction cells with E g = 1.73 eV or three series-connected cells with E g = 1.44 eV are both expected to give an η STH of 6.9%. For four series-connected cells, the maximum η STH is slightly less at 6.2% at an optimal E g = 1.33 eV. Water splitting was performed with series-connected polymer solar cells using polymers with different band gaps. PTPTIBDT-OD (E g = 1.89 eV), PTB7-Th (E g = 1.56 eV), and PDPP5T-2 (E g = 1.44 eV) were blended with [70]PCBM as absorber layer for two, three, and four series-connected configurations, respectively, and provide η STH values of 4.1, 6.1, and 4.9% when using a retroreflective foil on top of the cell to enhance light absorption. The reasons for deviations with experiments are analyzed and found to be due to differences in E g and E loss . Light-driven electrochemical water splitting was also modeled for multijunction polymer solar cells with vertically stacked photoactive layers. Under identical assumptions, an η STH of 10.0% is predicted for multijunction cells.

  18. Towards an effective control programme of soil-transmitted helminth infections among Orang Asli in rural Malaysia. Part 1: Prevalence and associated key factors

    PubMed Central

    2013-01-01

    Background Despite the continuous efforts to improve the quality of life of Orang Asli (Aborigines) communities, these communities are still plagued with a wide range of health problems including parasitic infections. The first part of this study aimed at determining the prevalence of soil-transmitted helminth (STH) infections and identifying their associated factors among rural Orang Asli children. Methods A cross-sectional study was carried out among 484 Orang Asli children aged ≤ 15 years (235 females and 249 males) belonging to 215 households from 13 villages in Lipis district, Pahang, Malaysia. Faecal samples were collected and examined by using formalin-ether sedimentation, Kato Katz and Harada Mori techniques. Demographic, socioeconomic, environmental and behavioural information were collected by using a pre-tested questionnaire. Results Overall, 78.1% of the children were found to be infected with one or more STH species. The prevalence of trichuriasis, ascariasis and hookworm infections were 71.7%, 37.4% and 17.6%, respectively. Almost all, three quarters and one fifth of trichuriasis, ascariasis and hookworm infections, respectively, were of moderate-to-heavy intensities. Multiple logistic regression analysis showed that age of ≥ 6 years (school-age), using unsafe water supply as a source for drinking water, absence of a toilet in the house, large family size (≥ 7 members), not washing hands before eating, and not washing hands after defecation were the key factors significantly associated with STH among these children. Conclusion This study reveals an alarmingly high prevalence of STH among Orang Asli children and clearly brings out an urgent need to implement school-based de-worming programmes and other control measures like providing a proper sanitation, as well as a treated drinking water supply and proper health education regarding good personal hygiene practices. Such an integrated control program will help significantly in reducing the prevalence and intensity of STH in Orang Asli communities. PMID:23356952

  19. Analysis of the Fluoroquinolone Antibiotic Resistance Mechanism of Salmonella enterica Isolates.

    PubMed

    Kim, Soo-Young; Lee, Si-Kyung; Park, Myeong-Soo; Na, Hun-Taek

    2016-09-28

    Quinolone-resistant Salmonella strains were isolated from patient samples, and several quinolone-sensitive strains were used to analyze mutations in the quinolone resistance-determining region (QRDR) of gyrA, gyrB, parC, and parE and to screen for plasmid-mediated quinolone resistance. Among the 21 strains that showed resistance to nalidixic acid and ciprofloxacin (MIC 0.125-2.0 μg/ml), 17 strains had a mutation in QRDR codon 87 of gyrA, and 3 strains had a single mutation (Ser83 → Phe). Another cause of resistance, efflux pump regulation, was studied by examining the expression of acrB, ramA, marA, and soxS. Five strains, including Sal-KH1 and Sal-KH2, showed no increase in relative expression in an analysis using the qRT-PCR method (p < 0.05). In order to determine the genes involved in the resistance, the Sal-9 isolate that showed decreased susceptibility and did not contain a mutation in the gyrA QRDR was used to make the STM (MIC 8 μg/ml) and STH (MIC 16 μg/ml) ciprofloxacin-resistant mutants. The gyrA QRDR Asp87 → Gly mutation was identified in both the STM and STH mutants by mutation analysis. qRT-PCR analysis of the efflux transporter acrB of the AcrAB-TolC efflux system showed increased expression levels in both the STM (1.79-fold) and STH (2.0-fold) mutants. In addition, the expression of the transcriptional regulator marA was increased in both the STM (6.35-fold) and STH (21.73-fold) mutants. Moreover, the expression of soxS was increased in the STM (3.41-fold) and STH (10.05-fold) mutants (p < 0.05). Therefore, these results indicate that AcrAB-TolC efflux pump activity and the target site mutation in gyrA are involved in quinolone resistance.

  20. Turning poop into profit: Cost-effectiveness and soil transmitted helminth infection risk associated with human excreta reuse in Vietnam

    PubMed Central

    Tran-Thi, Ngan; Lowe, Rachel J.; Vu-Van, Tu; MacDonald, Lauren E.; Pham-Duc, Phuc

    2017-01-01

    Human excreta is a low cost source of nutrients vital to plant growth, but also a source of pathogens transmissible to people and animals. We investigated the cost-savings and infection risk of soil transmitted helminths (STHs) in four scenarios where farmers used either inorganic fertilizer or fresh/composted human excreta supplemented by inorganic fertilizer to meet the nutrient requirements of rice paddies in the Red River Delta, Vietnam. Our study included two main components: 1) a risk estimate of STH infection for farmers who handle fresh excreta, determined by systematic review and meta-analysis; and 2) a cost estimate of fertilizing rice paddies, determined by nutrient assessment of excreta, a retailer survey of inorganic fertilizer costs, and a literature review to identify region-specific inputs. Our findings suggest that farmers who reuse fresh excreta are 1.24 (95% CI: 1.13–1.37, p-value<0.001) times more likely to be infected with any STH than those who do not handle excreta or who compost appropriately, and that risk varies by STH type (Ascaris lumbricoides RR = 1.17, 95% CI = 0.87–1.58, p-value = 0.29; Hookworm RR = 1.02, 95% CI = 0.50–2.06, p-value = 0.96; Trichuris trichiura RR = 1.38, 95% CI = 0.79–2.42, p-value = 0.26). Average cost-savings were highest for farmers using fresh excreta (847,000 VND) followed by those who composted for 6 months as recommended by the WHO (312,000 VND) and those who composted for a shorter time (5 months) with lime supplementation (37,000 VND/yr); however, this study did not assess healthcare costs of treating acute or chronic STH infections in the target group. Our study provides evidence that farmers in the Red River Delta are able to use a renewable and locally available resource to their economic advantage, while minimizing the risk of STH infection. PMID:29176840

  1. Turning poop into profit: Cost-effectiveness and soil transmitted helminth infection risk associated with human excreta reuse in Vietnam.

    PubMed

    Tran-Thi, Ngan; Lowe, Rachel J; Schurer, Janna M; Vu-Van, Tu; MacDonald, Lauren E; Pham-Duc, Phuc

    2017-11-01

    Human excreta is a low cost source of nutrients vital to plant growth, but also a source of pathogens transmissible to people and animals. We investigated the cost-savings and infection risk of soil transmitted helminths (STHs) in four scenarios where farmers used either inorganic fertilizer or fresh/composted human excreta supplemented by inorganic fertilizer to meet the nutrient requirements of rice paddies in the Red River Delta, Vietnam. Our study included two main components: 1) a risk estimate of STH infection for farmers who handle fresh excreta, determined by systematic review and meta-analysis; and 2) a cost estimate of fertilizing rice paddies, determined by nutrient assessment of excreta, a retailer survey of inorganic fertilizer costs, and a literature review to identify region-specific inputs. Our findings suggest that farmers who reuse fresh excreta are 1.24 (95% CI: 1.13-1.37, p-value<0.001) times more likely to be infected with any STH than those who do not handle excreta or who compost appropriately, and that risk varies by STH type (Ascaris lumbricoides RR = 1.17, 95% CI = 0.87-1.58, p-value = 0.29; Hookworm RR = 1.02, 95% CI = 0.50-2.06, p-value = 0.96; Trichuris trichiura RR = 1.38, 95% CI = 0.79-2.42, p-value = 0.26). Average cost-savings were highest for farmers using fresh excreta (847,000 VND) followed by those who composted for 6 months as recommended by the WHO (312,000 VND) and those who composted for a shorter time (5 months) with lime supplementation (37,000 VND/yr); however, this study did not assess healthcare costs of treating acute or chronic STH infections in the target group. Our study provides evidence that farmers in the Red River Delta are able to use a renewable and locally available resource to their economic advantage, while minimizing the risk of STH infection.

  2. Solar water splitting by photovoltaic-electrolysis with a solar-to-hydrogen efficiency over 30%

    PubMed Central

    Jia, Jieyang; Seitz, Linsey C.; Benck, Jesse D.; Huo, Yijie; Chen, Yusi; Ng, Jia Wei Desmond; Bilir, Taner; Harris, James S.; Jaramillo, Thomas F.

    2016-01-01

    Hydrogen production via electrochemical water splitting is a promising approach for storing solar energy. For this technology to be economically competitive, it is critical to develop water splitting systems with high solar-to-hydrogen (STH) efficiencies. Here we report a photovoltaic-electrolysis system with the highest STH efficiency for any water splitting technology to date, to the best of our knowledge. Our system consists of two polymer electrolyte membrane electrolysers in series with one InGaP/GaAs/GaInNAsSb triple-junction solar cell, which produces a large-enough voltage to drive both electrolysers with no additional energy input. The solar concentration is adjusted such that the maximum power point of the photovoltaic is well matched to the operating capacity of the electrolysers to optimize the system efficiency. The system achieves a 48-h average STH efficiency of 30%. These results demonstrate the potential of photovoltaic-electrolysis systems for cost-effective solar energy storage. PMID:27796309

  3. Solar water splitting by photovoltaic-electrolysis with a solar-to-hydrogen efficiency over 30.

    PubMed

    Jia, Jieyang; Seitz, Linsey C; Benck, Jesse D; Huo, Yijie; Chen, Yusi; Ng, Jia Wei Desmond; Bilir, Taner; Harris, James S; Jaramillo, Thomas F

    2016-10-31

    Hydrogen production via electrochemical water splitting is a promising approach for storing solar energy. For this technology to be economically competitive, it is critical to develop water splitting systems with high solar-to-hydrogen (STH) efficiencies. Here we report a photovoltaic-electrolysis system with the highest STH efficiency for any water splitting technology to date, to the best of our knowledge. Our system consists of two polymer electrolyte membrane electrolysers in series with one InGaP/GaAs/GaInNAsSb triple-junction solar cell, which produces a large-enough voltage to drive both electrolysers with no additional energy input. The solar concentration is adjusted such that the maximum power point of the photovoltaic is well matched to the operating capacity of the electrolysers to optimize the system efficiency. The system achieves a 48-h average STH efficiency of 30%. These results demonstrate the potential of photovoltaic-electrolysis systems for cost-effective solar energy storage.

  4. Monitoring the impact of a mebendazole mass drug administration initiative for soil-transmitted helminthiasis (STH) control in the Western Visayas Region of the Philippines from 2007 through 2011.

    PubMed

    Sanza, Megan; Totanes, Francis Isidore; Chua, Paul Lester; Belizario, Vicente Y

    2013-08-01

    School-aged children in tropical developing countries carry the highest burden of soil-transmitted helminth (STH) infections in the world. The Western Visayas region of the Philippines continues to struggle with this as a major public health issue in both private and public schools. The War on Worms-Western Visayas approach was launched in 2007 with school-based mass drug administration (MDA) as one of the strategies to control morbidity from STH in support of the Department of Health - Integrated Helminth Control Program. This study aimed to determine trends in prevalence and intensity of STH infections as well as to assess related morbidity and program sustainability through 2011. A cross-sectional parasitologic survey was conducted on three independent samples of Grade 3 students in 2007, 2009, and 2011. Supporting aggregate data were obtained for MDA coverage, National Achievement Test mean percentage scores, and nutritional status. Tests for trend were utilized to detect changes in prevalence over time, with a particular emphasis on trends seen between 2009 and 2011. The initial impact of the program was robust as cumulative prevalence, infection intensities, and parasite densities were all reduced four years following the launch. However, subsequent and significant increases in each were found from 2009 until 2011. These results implicate issues with program sustainability, despite consistent MDA, and existing frameworks for environmental sanitation, hygiene, and education. Copyright © 2013 Elsevier B.V. All rights reserved.

  5. High-resolution Optical Spectroscopic Observations of Four Symbiotic Stars: AS 255, MWC 960, RW Hya, and StH α 32

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pereira, C. B.; Drake, N. A.; Roig, F.

    We report on the analysis of high-resolution optical spectra of four symbiotic stars: AS 255, MWC 960, RW Hya, and StH α 32. We employ the local-thermodynamic-equilibrium model atmospheres of Kurucz and the spectral analysis code moog to analyze the spectra. The abundance of barium and carbon was derived using the spectral synthesis technique. The chemical composition of the atmospheres of AS 255 and MWC 960 show that they are metal-poor K giants with metallicities of −1.2 and −1.7 respectively. StH α 32 is a CH star and also a low-metallicity object (−1.4). AS 255 and MWC 960 are yellowmore » symbiotic stars and, like other previously studied yellow symbiotics, are s -process enriched. StH α 32, like other CH stars, is also an s -process and carbon-enriched object. RW Hya has a metallicity of −0.64, a value in accordance with previous determinations, and is not s -process enriched. Based on its position in the 2MASS diagram, we suggest that RW Hya is at an intermediate position between yellow symbiotics and classical S-type symbiotics. We also discuss whether the dilution effect was the mechanism responsible for the absence of the s -process elements overabundance in RW Hya. The luminosity obtained for StH α 32 is below the luminosity of the asymptotic giant branch (AGB) stars that started helium burning (via thermal pulses) and became self-enriched in neutron-capture elements. Therefore, its abundance peculiarities are due to mass transfer from the previous thermally pulsing AGB star (now the white dwarf) that was overabundant in s -process elements. For the stars AS 255 and MWC 960, the determination of their luminosities was not possible due to uncertainties in their distance and interstellar absorption. AS 255 and MWC 960 have a low galactic latitude and could be bulge stars or members of the inner halo population. The heavy-element abundance distribution of AS 255 and MWC 960 is similar to that of the other yellow symbiotics previously analyzed. Their abundance patterns follow that of the thick disk population for RW Hya and of the halo population for AS 255, MWC 960, and StH α 32. We also determined the rotational velocities of these four symbiotic stars and compare our results with those of single field stars.« less

  6. Initiating NTD programs targeting schistosomiasis and soil-transmitted helminthiasis in two provinces of the Democratic Republic of the Congo: Establishment of baseline prevalence for mass drug administration.

    PubMed

    Kabore, Achille; Ibikounle, Moudachirou; Tougoue, Jean Jacques; Mupoyi, Sylvain; Ndombe, Martin; Shannon, Scott; Ottesen, Eric A; Mukunda, Faustin; Awaca, Naomi

    2017-02-01

    Schistosomiasis (SCH) and soil-transmitted helminthiasis (STH) are widely distributed in the Democratic Republic of the Congo (DRC) and constitute a serious public health problem. As recommended by the World Health Organization (WHO), before launching mass chemotherapy to control these diseases, parasitological surveys were conducted in sentinel sites in six health zones (HZs) in Bandundu and Maniema provinces. Baseline prevalence and intensity of infection for SCH and STH were determined to establish the appropriate treatment plan using Praziquantel (PZQ) and Albendazole (ALB). Parasitological surveys were conducted from April to May 2015 in twenty-six selected sampling units (schools) for baseline mapping in six HZs: Fifty school children (25 females and 25 males) aged 9-15 years were randomly selected per sampling unit. A total of 1300 samples (urine and stool) were examined using haematuria dipsticks, parasite-egg filtration and the point-of-care Circulating Cathodic Antigen (POC-CCA) assay for urine samples and the Kato-Katz technique for stool specimens. Three species of schistosomes (S. mansoni, S. haematobium and S. intercalatum) and three groups of STH (hookworm, Ascaris and Trichuris) were detected at variable prevalence and intensity among the schools, the HZs and the provinces. In Bandundu, no SCH was detected by either Kato-Katz or the POC-CCA technique, despite a high prevalence of STH with 68% and 80% at Kiri and Pendjua HZs, respectively. In Maniema, intestinal schistosomiasis was detected by both Kato-Katz and POC-CCA with an average prevalence by Kato-Katz of 32.8% and by POC-CCA of 42.1%. Comparative studies confirmed the greater sensitivity (and operational feasibility) of the POC-CCA test on urine compared to Kato-Katz examination of stool for diagnosing intestinal schistosomiasis even in areas of comparatively light infections. STH was widely distributed and present in all HZs with a mean prevalence (95% CI) of 59.62% (46.00-65.00%). The prevalence of hookworm, roundworm and whipworm were 51.62% (32.40%-71.50%), 15.77% (0.50%-39.60%) and 13.46 (0.50%-33.20%), respectively. This study provided the evidence base for implementing programs targeting SCH and STH in these Health Zones. Observations also reinforce the operational value and feasibility of the POC-CCA test to detect S. mansoni and, for the first time, S. intercalatum infections in a routine NTD program setting. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Synoptic Patterns Related to Tropical Cyclone Recurvature

    DTIC Science & Technology

    1988-03-01

    STY :Yfarge. Dominant and secondary contour patterns (Fig. 3.2) are identified and the angular difference (Table 5) between the pattern and the best...DATA l\\LVL/4/ DATA VRU/’ 1’/,VRV/𔃼’/ c DATA C/.0436610743/ ,DD/ 114.5915590262/ 1\\AYIELIST/~GRID/ 0:\\ VST ,:\\EST,l\\STH,l\\l\\TH c EQUIV ALE:\\CE...READ (5,:\\GRID) \\VRITE (6,:\\GRID) l\\1 = i\\\\ VST + l\\EST + 1 :\\J = 1\\STH + 1\\NTH + 1 IuCOYIP=20 IVCOl’viP= 20 0:RECU=O 1’\\RECV=O C** READ IN NO

  8. The Antiaircraft Journal. Volume 94, Number 6, November-December 1951

    DTIC Science & Technology

    1951-12-01

    authorized by the Visiting Forces Act. Getting their heads together, the Yanks and Tommies have discovered each other to be pretty regular fellows...Francis A., to 3Sth AAA Brig, Ft Meade, Md. McDaniel, Otto L., to Hq Fourth Army, Ft Sam Houston, Tex. Pape, Robin B., to SOth AAA Gp, Ft Totten , NY...to 71 Sth AAA Gun Bn, Ft Totten , NJ. Kee, Pat M., to 209th AAA Gp, Indiantown Gap, Pa. Kennaman, Jack R., to SOlst AAA Gun Bn, North Richland, Wash

  9. A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste: the WASH for WORMS research protocol.

    PubMed

    Nery, Susana Vaz; McCarthy, James S; Traub, Rebecca; Andrews, Ross M; Black, Jim; Gray, Darren; Weking, Edmund; Atkinson, Jo-An; Campbell, Suzy; Francis, Naomi; Vallely, Andrew; Williams, Gail; Clements, Archie

    2015-12-30

    There is limited evidence demonstrating the benefits of community-based water, sanitation and hygiene (WASH) programmes on infections with soil-transmitted helminths (STH) and intestinal protozoa. Our study aims to contribute to that evidence base by investigating the effectiveness of combining two complementary approaches for control of STH: periodic mass administration of albendazole, and delivery of a community-based WASH programme. WASH for WORMS is a cluster-randomised controlled trial to test the hypothesis that a community-based WASH intervention integrated with periodic mass distribution of albendazole will be more effective in reducing infections with STH and protozoa than mass deworming alone. All 18 participating rural communities in Timor-Leste receive mass chemotherapy every 6 months. Half the communities also receive the community-based WASH programme. Primary outcomes are the cumulative incidence of infection with STH. Secondary outcomes include the prevalence of protozoa; intensity of infection with STH; as well as morbidity indicators (anaemia, stunting and wasting). Each of the trial outcomes will be compared between control and intervention communities. End points will be measured 2 years after the first albendazole distribution; and midpoints are measured at 6 months intervals (12 months for haemoglobin and anthropometric indexes). Mixed-methods research will also be conducted in order to identify barriers and enablers associated with the acceptability and uptake of the WASH programme. Ethics approval was obtained from the human ethics committees at the University of Queensland, Australian National University, Timorese Ministry of Health, and University of Melbourne. The results of the trial will be published in peer-reviewed journals presented at national and international conferences, and disseminated to relevant stakeholders in health and WASH programmes. This study is funded by a Partnership for Better Health--Project grant from the National Health and Research Council (NHMRC), Australia. ACTRN12614000680662; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Water, Sanitation and Hygiene (WASH) and environmental risk factors for soil-transmitted helminth intensity of infection in Timor-Leste, using real time PCR.

    PubMed

    Campbell, Suzy J; Nery, Susana V; Wardell, Rebecca; D'Este, Catherine A; Gray, Darren J; McCarthy, James S; Traub, Rebecca J; Andrews, Ross M; Llewellyn, Stacey; Vallely, Andrew J; Williams, Gail M; Clements, Archie C A

    2017-03-01

    No investigations have been undertaken of risk factors for intensity of soil-transmitted helminth (STH) infection in Timor-Leste. This study provides the first analysis of risk factors for intensity of STH infection, as determined by quantitative PCR (qPCR), examining a broad range of water, sanitation and hygiene (WASH) and environmental factors, among communities in Manufahi District, Timor-Leste. A baseline cross-sectional survey of 18 communities was undertaken as part of a cluster randomised controlled trial, with additional identically-collected data from six other communities. qPCR was used to assess STH infection from stool samples, and questionnaires administered to collect WASH, demographic, and socioeconomic data. Environmental information was obtained from open-access sources and linked to infection outcomes. Mixed-effects multinomial logistic regression was undertaken to assess risk factors for intensity of Necator americanus and Ascaris infection. 2152 participants provided stool and questionnaire information for this analysis. In adjusted models incorporating WASH, demographic and environmental variables, environmental variables were generally associated with infection intensity for both N. americanus and Ascaris spp. Precipitation (in centimetres) was associated with increased risk of moderate-intensity (adjusted relative risk [ARR] 6.1; 95% confidence interval [CI] 1.9-19.3) and heavy-intensity (ARR 6.6; 95% CI 3.1-14.1) N. americanus infection, as was sandy-loam soil around households (moderate-intensity ARR 2.1; 95% CI 1.0-4.3; heavy-intensity ARR 2.7; 95% CI 1.6-4.5; compared to no infection). For Ascaris, alkaline soil around the household was associated with reduced risk of moderate-intensity infection (ARR 0.21; 95% CI 0.09-0.51), and heavy-intensity infection (ARR 0.04; 95% CI 0.01-0.25). Few WASH risk factors were significant. In this high-prevalence setting, strong risk associations with environmental factors indicate that anthelmintic treatment alone will be insufficient to interrupt STH transmission, as conditions are favourable for ongoing environmental transmission. Integrated STH control strategies should be explored as a priority.

  11. Water, Sanitation and Hygiene (WASH) and environmental risk factors for soil-transmitted helminth intensity of infection in Timor-Leste, using real time PCR

    PubMed Central

    Nery, Susana V.; Wardell, Rebecca; D’Este, Catherine A.; Gray, Darren J.; McCarthy, James S.; Traub, Rebecca J.; Andrews, Ross M.; Llewellyn, Stacey; Vallely, Andrew J.; Williams, Gail M.; Clements, Archie C. A.

    2017-01-01

    Background No investigations have been undertaken of risk factors for intensity of soil-transmitted helminth (STH) infection in Timor-Leste. This study provides the first analysis of risk factors for intensity of STH infection, as determined by quantitative PCR (qPCR), examining a broad range of water, sanitation and hygiene (WASH) and environmental factors, among communities in Manufahi District, Timor-Leste. Methods A baseline cross-sectional survey of 18 communities was undertaken as part of a cluster randomised controlled trial, with additional identically-collected data from six other communities. qPCR was used to assess STH infection from stool samples, and questionnaires administered to collect WASH, demographic, and socioeconomic data. Environmental information was obtained from open-access sources and linked to infection outcomes. Mixed-effects multinomial logistic regression was undertaken to assess risk factors for intensity of Necator americanus and Ascaris infection. Results 2152 participants provided stool and questionnaire information for this analysis. In adjusted models incorporating WASH, demographic and environmental variables, environmental variables were generally associated with infection intensity for both N. americanus and Ascaris spp. Precipitation (in centimetres) was associated with increased risk of moderate-intensity (adjusted relative risk [ARR] 6.1; 95% confidence interval [CI] 1.9–19.3) and heavy-intensity (ARR 6.6; 95% CI 3.1–14.1) N. americanus infection, as was sandy-loam soil around households (moderate-intensity ARR 2.1; 95% CI 1.0–4.3; heavy-intensity ARR 2.7; 95% CI 1.6–4.5; compared to no infection). For Ascaris, alkaline soil around the household was associated with reduced risk of moderate-intensity infection (ARR 0.21; 95% CI 0.09–0.51), and heavy-intensity infection (ARR 0.04; 95% CI 0.01–0.25). Few WASH risk factors were significant. Conclusion In this high-prevalence setting, strong risk associations with environmental factors indicate that anthelmintic treatment alone will be insufficient to interrupt STH transmission, as conditions are favourable for ongoing environmental transmission. Integrated STH control strategies should be explored as a priority. PMID:28346536

  12. Neglected tropical diseases among two indigenous subtribes in peninsular Malaysia: highlighting differences and co-infection of helminthiasis and sarcocystosis.

    PubMed

    Lee, Soo Ching; Ngui, Romano; Tan, Tiong Kai; Muhammad Aidil, Roslan; Lim, Yvonne Ai Lian

    2014-01-01

    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.

  13. Self-Trapped Excitons in Ionic-Covalent Silver Halide Crystals and Nanostructures: High-Frequency EPR, ESE, ENDOR and ODMR Studies

    PubMed Central

    Baranov, P. G.; Poluektov, O. G.; Schmidt, J.

    2010-01-01

    Silver halides have unique features in solid state physics because their properties are considered to be of borderline nature between ionic and covalent bonding. In AgCl, the self-trapped hole (STH) is centered and partly trapped in the cationic sublattice, forming an Ag2+ ion inside of a (AgCl6)4− complex as a result of the Jahn–Teller distortion. The STH in AgCl can capture an electron from the conduction band forming the self-trapped exciton (STE). Recent results of a study of STE by means of high-frequency electron paramagnetic resonance, electron spin echo, electron–nuclear double resonance (ENDOR) and optically detected magnetic resonance (ODMR) are reviewed. The properties of the STE in AgCl crystals, such as exchange coupling, the ordering of the triplet and singlet sublevels, the dynamical properties of the singlet and triplet states, and the hyperfine interaction with the Ag and Cl (Br) nuclei are discussed. Direct information about the spatial distribution of the wave function of STE unpaired electrons was obtained by ENDOR. From a comparison with the results of an ENDOR study of the shallow electron center and STH, it is concluded that the electron is mainly contained in a hydrogen-like 1s orbital with a Bohr radius of 15.1 ± 0.6 Å, but near its center the electron density reflects the charge distribution of the hole. The hole of the STE is virtually identical to an isolated STH center. For AgCl nanocrystals embedded into the KCl crystalline matrix, the anisotropy of the g-factor of STE and STH was found to be substantially reduced compared with that of bulk AgCl crystals, which can be explained by a considerable suppression of the Jahn–Teller effect in nanoparticles. A study of ODMR in AgBr nanocrystals in KBr revealed spatial confinement effects and allowed estimating the nanocrystal size from the shape of the ODMR spectra. PMID:21151483

  14. Neglected Tropical Diseases among Two Indigenous Subtribes in Peninsular Malaysia: Highlighting Differences and Co-Infection of Helminthiasis and Sarcocystosis

    PubMed Central

    Lee, Soo Ching; Ngui, Romano; Tan, Tiong Kai; Muhammad Aidil, Roslan; Lim, Yvonne Ai Lian

    2014-01-01

    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. PMID:25248116

  15. Infection and Co-infection with Helminths and Plasmodium among School Children in Côte d’Ivoire: Results from a National Cross-Sectional Survey

    PubMed Central

    Yapi, Richard B.; Hürlimann, Eveline; Houngbedji, Clarisse A.; Ndri, Prisca B.; Silué, Kigbafori D.; Soro, Gotianwa; Kouamé, Ferdinand N.; Vounatsou, Penelope; Fürst, Thomas; N’Goran, Eliézer K.; Utzinger, Jürg; Raso, Giovanna

    2014-01-01

    Background Helminth infection and malaria remain major causes of ill-health in the tropics and subtropics. There are several shared risk factors (e.g., poverty), and hence, helminth infection and malaria overlap geographically and temporally. However, the extent and consequences of helminth-Plasmodium co-infection at different spatial scales are poorly understood. Methodology This study was conducted in 92 schools across Côte d’Ivoire during the dry season, from November 2011 to February 2012. School children provided blood samples for detection of Plasmodium infection, stool samples for diagnosis of soil-transmitted helminth (STH) and Schistosoma mansoni infections, and urine samples for appraisal of Schistosoma haematobium infection. A questionnaire was administered to obtain demographic, socioeconomic, and behavioral data. Multinomial regression models were utilized to determine risk factors for STH-Plasmodium and Schistosoma-Plasmodium co-infection. Principal Findings Complete parasitological and questionnaire data were available for 5,104 children aged 5-16 years. 26.2% of the children were infected with any helminth species, whilst the prevalence of Plasmodium infection was 63.3%. STH-Plasmodium co-infection was detected in 13.5% and Schistosoma-Plasmodium in 5.6% of the children. Multinomial regression analysis revealed that boys, children aged 10 years and above, and activities involving close contact to water were significantly and positively associated with STH-Plasmodium co-infection. Boys, wells as source of drinking water, and water contact were significantly and positively associated with Schistosoma-Plasmodium co-infection. Access to latrines, deworming, higher socioeconomic status, and living in urban settings were negatively associated with STH-Plasmodium co-infection; whilst use of deworming drugs and access to modern latrines were negatively associated with Schistosoma-Plasmodium co-infection. Conclusions/Significance More than 60% of the school children surveyed were infected with Plasmodium across Côte d’Ivoire, and about one out of six had a helminth-Plasmodium co-infection. Our findings provide a rationale to combine control interventions that simultaneously aim at helminthiases and malaria. PMID:24901333

  16. A cluster-randomised controlled trial integrating a community-based water, sanitation and hygiene programme, with mass distribution of albendazole to reduce intestinal parasites in Timor-Leste: the WASH for WORMS research protocol

    PubMed Central

    Nery, Susana Vaz; McCarthy, James S; Traub, Rebecca; Andrews, Ross M; Black, Jim; Gray, Darren; Weking, Edmund; Atkinson, Jo-An; Campbell, Suzy; Francis, Naomi; Vallely, Andrew; Williams, Gail; Clements, Archie

    2015-01-01

    Introduction There is limited evidence demonstrating the benefits of community-based water, sanitation and hygiene (WASH) programmes on infections with soil-transmitted helminths (STH) and intestinal protozoa. Our study aims to contribute to that evidence base by investigating the effectiveness of combining two complementary approaches for control of STH: periodic mass administration of albendazole, and delivery of a community-based WASH programme. Methods and analysis WASH for WORMS is a cluster-randomised controlled trial to test the hypothesis that a community-based WASH intervention integrated with periodic mass distribution of albendazole will be more effective in reducing infections with STH and protozoa than mass deworming alone. All 18 participating rural communities in Timor-Leste receive mass chemotherapy every 6 months. Half the communities also receive the community-based WASH programme. Primary outcomes are the cumulative incidence of infection with STH. Secondary outcomes include the prevalence of protozoa; intensity of infection with STH; as well as morbidity indicators (anaemia, stunting and wasting). Each of the trial outcomes will be compared between control and intervention communities. End points will be measured 2 years after the first albendazole distribution; and midpoints are measured at 6 months intervals (12 months for haemoglobin and anthropometric indexes). Mixed-methods research will also be conducted in order to identify barriers and enablers associated with the acceptability and uptake of the WASH programme. Ethics and dissemination Ethics approval was obtained from the human ethics committees at the University of Queensland, Australian National University, Timorese Ministry of Health, and University of Melbourne. The results of the trial will be published in peer-reviewed journals presented at national and international conferences, and disseminated to relevant stakeholders in health and WASH programmes. This study is funded by a Partnership for Better Health—Project grant from the National Health and Research Council (NHMRC), Australia. Trial registration number ACTRN12614000680662; Pre-results PMID:26719316

  17. The Effect of Three-Monthly Albendazole Treatment on Malarial Parasitemia and Allergy: A Household-Based Cluster-Randomized, Double-Blind, Placebo-Controlled Trial

    PubMed Central

    Kaisar, Maria M. M.; May, Linda; Prasetyani, Margaretta A.; Wahyuni, Sitti; Djuardi, Yenny; Ariawan, Iwan; Wibowo, Heri; Lell, Bertrand; Sauerwein, Robert; Brice, Gary T.; Sutanto, Inge; van Lieshout, Lisette; de Craen, Anton J. M.; van Ree, Ronald; Verweij, Jaco J.; Tsonaka, Roula; Houwing-Duistermaat, Jeanine J.; Luty, Adrian J. F.; Sartono, Erliyani; Supali, Taniawati; Yazdanbakhsh, Maria

    2013-01-01

    Background Helminth infections are proposed to have immunomodulatory activities affecting health outcomes either detrimentally or beneficially. We evaluated the effects of albendazole treatment, every three months for 21 months, on STH, malarial parasitemia and allergy. Methods and Findings A household-based cluster-randomized, double-blind, placebo-controlled trial was conducted in an area in Indonesia endemic for STH. Using computer-aided block randomization, 481 households (2022 subjects) and 473 households (1982 subjects) were assigned to receive placebo and albendazole, respectively, every three months. The treatment code was concealed from trial investigators and participants. Malarial parasitemia and malaria-like symptoms were assessed in participants older than four years of age while skin prick test (SPT) to allergens as well as reported symptoms of allergy in children aged 5–15 years. The general impact of treatment on STH prevalence and body mass index (BMI) was evaluated. Primary outcomes were prevalence of malarial parasitemia and SPT to any allergen. Analysis was by intention to treat. At 9 and 21 months post-treatment 80.8% and 80.1% of the study subjects were retained, respectively. The intensive treatment regiment resulted in a reduction in the prevalence of STH by 48% in albendazole and 9% in placebo group. Albendazole treatment led to a transient increase in malarial parasitemia at 6 months post treatment (OR 4.16(1.35–12.80)) and no statistically significant increase in SPT reactivity (OR 1.18(0.74–1.86) at 9 months or 1.37 (0.93–2.01) 21 months). No effect of anthelminthic treatment was found on BMI, reported malaria-like- and allergy symptoms. No adverse effects were reported. Conclusions The study indicates that intensive community treatment of 3 monthly albendazole administration for 21 months over two years leads to a reduction in STH. This degree of reduction appears safe without any increased risk of malaria or allergies. Trial Registration Controlled-Trials.com ISRCTN83830814 PMID:23526959

  18. Assessing the feasibility of interrupting the transmission of soil-transmitted helminths through mass drug administration: The DeWorm3 cluster randomized trial protocol

    PubMed Central

    Ajjampur, Sitara S. Rao; Anderson, Roy M.; Bailey, Robin; Gardiner, Iain; Halliday, Katherine E.; Ibikounle, Moudachirou; Kalua, Khumbo; Kang, Gagandeep; Littlewood, D. Timothy J.; Luty, Adrian J. F.; Means, Arianna Rubin; Oswald, William; Pullan, Rachel L.; Sarkar, Rajiv; Schär, Fabian; Szpiro, Adam; Truscott, James E.; Werkman, Marleen; Yard, Elodie; Walson, Judd L.

    2018-01-01

    Current control strategies for soil-transmitted helminths (STH) emphasize morbidity control through mass drug administration (MDA) targeting preschool- and school-age children, women of childbearing age and adults in certain high-risk occupations such as agricultural laborers or miners. This strategy is effective at reducing morbidity in those treated but, without massive economic development, it is unlikely it will interrupt transmission. MDA will therefore need to continue indefinitely to maintain benefit. Mathematical models suggest that transmission interruption may be achievable through MDA alone, provided that all age groups are targeted with high coverage. The DeWorm3 Project will test the feasibility of interrupting STH transmission using biannual MDA targeting all age groups. Study sites (population ≥80,000) have been identified in Benin, Malawi and India. Each site will be divided into 40 clusters, to be randomized 1:1 to three years of twice-annual community-wide MDA or standard-of-care MDA, typically annual school-based deworming. Community-wide MDA will be delivered door-to-door, while standard-of-care MDA will be delivered according to national guidelines. The primary outcome is transmission interruption of the STH species present at each site, defined as weighted cluster-level prevalence ≤2% by quantitative polymerase chain reaction (qPCR), 24 months after the final round of MDA. Secondary outcomes include the endline prevalence of STH, overall and by species, and the endline prevalence of STH among children under five as an indicator of incident infections. Secondary analyses will identify cluster-level factors associated with transmission interruption. Prevalence will be assessed using qPCR of stool samples collected from a random sample of cluster residents at baseline, six months after the final round of MDA and 24 months post-MDA. A smaller number of individuals in each cluster will be followed with annual sampling to monitor trends in prevalence and reinfection throughout the trial. Trial registration ClinicalTrials.gov NCT03014167 PMID:29346377

  19. The Interaction of Deworming, Improved Sanitation, and Household Flooring with Soil-Transmitted Helminth Infection in Rural Bangladesh.

    PubMed

    Benjamin-Chung, Jade; Nazneen, Arifa; Halder, Amal K; Haque, Rashidul; Siddique, Abdullah; Uddin, Muhammed Salah; Koporc, Kim; Arnold, Benjamin F; Hubbard, Alan E; Unicomb, Leanne; Luby, Stephen P; Addiss, David G; Colford, John M

    2015-12-01

    The combination of deworming and improved sanitation or hygiene may result in greater reductions in soil-transmitted helminth (STH) infection than any single intervention on its own. We measured STH prevalence in rural Bangladesh and assessed potential interactions among deworming, hygienic latrines, and household finished floors. We conducted a cross-sectional survey (n = 1,630) in 100 villages in rural Bangladesh to measure three exposures: self-reported deworming consumption in the past 6 months, access to a hygienic latrine, and household flooring material. We collected stool samples from children 1-4 years, 5-12 years, and women 15-49 years. We performed mini-FLOTAC on preserved stool samples to detect Ascaris lumbricoides, Enterobius vermicularis, hookworm, and Trichuris trichiura ova. Approximately one-third (32%) of all individuals and 40% of school-aged children had an STH infection. Less than 2% of the sample had moderate/heavy intensity infections. Deworming was associated with lower Ascaris prevalence (adjusted prevalence ratio (PR) = 0.53; 95% CI 0.40, 0.71), but there was no significant association with hookworm (PR = 0.93, 95% CI 0.60, 1.44) or Trichuris (PR = 0.90, 95% CI 0.74, 1.08). PRs for hygienic latrine access were 0.91 (95% CI 0.67,1.24), 0.73 (95% CI 0.43,1.24), and 1.03 (95% CI 0.84,1.27) for Ascaris, hookworm, and Trichuris, respectively. Finished floors were associated with lower Ascaris prevalence (PR = 0.56, 95% CI 0.32, 0.97) but not associated with hookworm (PR = 0.48 95% CI 0.16,1.45) or Trichuris (PR = 0.98, 95% CI 0.72,1.33). Across helminths and combinations of exposures, adjusted prevalence ratios for joint exposures were consistently more protective than those for individual exposures. We found moderate STH prevalence in rural Bangladesh among children and women of childbearing age. This study is one of the first to examine independent and combined associations with deworming, sanitation, and hygiene. Our results suggest that coupling deworming with sanitation and flooring interventions may yield more sustained reductions in STH prevalence.

  20. Bayesian Geostatistical Model-Based Estimates of Soil-Transmitted Helminth Infection in Nigeria, Including Annual Deworming Requirements

    PubMed Central

    Oluwole, Akinola S.; Ekpo, Uwem F.; Karagiannis-Voules, Dimitrios-Alexios; Abe, Eniola M.; Olamiju, Francisca O.; Isiyaku, Sunday; Okoronkwo, Chukwu; Saka, Yisa; Nebe, Obiageli J.; Braide, Eka I.; Mafiana, Chiedu F.; Utzinger, Jürg; Vounatsou, Penelope

    2015-01-01

    Background The acceleration of the control of soil-transmitted helminth (STH) infections in Nigeria, emphasizing preventive chemotherapy, has become imperative in light of the global fight against neglected tropical diseases. Predictive risk maps are an important tool to guide and support control activities. Methodology STH infection prevalence data were obtained from surveys carried out in 2011 using standard protocols. Data were geo-referenced and collated in a nationwide, geographic information system database. Bayesian geostatistical models with remotely sensed environmental covariates and variable selection procedures were utilized to predict the spatial distribution of STH infections in Nigeria. Principal Findings We found that hookworm, Ascaris lumbricoides, and Trichuris trichiura infections are endemic in 482 (86.8%), 305 (55.0%), and 55 (9.9%) locations, respectively. Hookworm and A. lumbricoides infection co-exist in 16 states, while the three species are co-endemic in 12 states. Overall, STHs are endemic in 20 of the 36 states of Nigeria, including the Federal Capital Territory of Abuja. The observed prevalence at endemic locations ranged from 1.7% to 51.7% for hookworm, from 1.6% to 77.8% for A. lumbricoides, and from 1.0% to 25.5% for T. trichiura. Model-based predictions ranged from 0.7% to 51.0% for hookworm, from 0.1% to 82.6% for A. lumbricoides, and from 0.0% to 18.5% for T. trichiura. Our models suggest that day land surface temperature and dense vegetation are important predictors of the spatial distribution of STH infection in Nigeria. In 2011, a total of 5.7 million (13.8%) school-aged children were predicted to be infected with STHs in Nigeria. Mass treatment at the local government area level for annual or bi-annual treatment of the school-aged population in Nigeria in 2011, based on World Health Organization prevalence thresholds, were estimated at 10.2 million tablets. Conclusions/Significance The predictive risk maps and estimated deworming needs presented here will be helpful for escalating the control and spatial targeting of interventions against STH infections in Nigeria. PMID:25909633

  1. Bayesian geostatistical model-based estimates of soil-transmitted helminth infection in Nigeria, including annual deworming requirements.

    PubMed

    Oluwole, Akinola S; Ekpo, Uwem F; Karagiannis-Voules, Dimitrios-Alexios; Abe, Eniola M; Olamiju, Francisca O; Isiyaku, Sunday; Okoronkwo, Chukwu; Saka, Yisa; Nebe, Obiageli J; Braide, Eka I; Mafiana, Chiedu F; Utzinger, Jürg; Vounatsou, Penelope

    2015-04-01

    The acceleration of the control of soil-transmitted helminth (STH) infections in Nigeria, emphasizing preventive chemotherapy, has become imperative in light of the global fight against neglected tropical diseases. Predictive risk maps are an important tool to guide and support control activities. STH infection prevalence data were obtained from surveys carried out in 2011 using standard protocols. Data were geo-referenced and collated in a nationwide, geographic information system database. Bayesian geostatistical models with remotely sensed environmental covariates and variable selection procedures were utilized to predict the spatial distribution of STH infections in Nigeria. We found that hookworm, Ascaris lumbricoides, and Trichuris trichiura infections are endemic in 482 (86.8%), 305 (55.0%), and 55 (9.9%) locations, respectively. Hookworm and A. lumbricoides infection co-exist in 16 states, while the three species are co-endemic in 12 states. Overall, STHs are endemic in 20 of the 36 states of Nigeria, including the Federal Capital Territory of Abuja. The observed prevalence at endemic locations ranged from 1.7% to 51.7% for hookworm, from 1.6% to 77.8% for A. lumbricoides, and from 1.0% to 25.5% for T. trichiura. Model-based predictions ranged from 0.7% to 51.0% for hookworm, from 0.1% to 82.6% for A. lumbricoides, and from 0.0% to 18.5% for T. trichiura. Our models suggest that day land surface temperature and dense vegetation are important predictors of the spatial distribution of STH infection in Nigeria. In 2011, a total of 5.7 million (13.8%) school-aged children were predicted to be infected with STHs in Nigeria. Mass treatment at the local government area level for annual or bi-annual treatment of the school-aged population in Nigeria in 2011, based on World Health Organization prevalence thresholds, were estimated at 10.2 million tablets. The predictive risk maps and estimated deworming needs presented here will be helpful for escalating the control and spatial targeting of interventions against STH infections in Nigeria.

  2. Effects of a post-deworming health hygiene education intervention on absenteeism in school-age children of the Peruvian Amazon.

    PubMed

    Thériault, François L; Maheu-Giroux, Mathieu; Blouin, Brittany; Casapía, Martin; Gyorkos, Theresa W

    2014-08-01

    Soil-transmitted helminth (STH) infections are a leading cause of disability and disease burden in school-age children of worm-endemic regions. Their effect on school absenteeism, however, remains unclear. The World Health Organization currently recommends delivering mass deworming and health hygiene education through school-based programs, in an effort to control STH-related morbidity. In this cluster-RCT, the impact of a health hygiene education intervention on absenteeism was measured. From April to June 2010, all Grade 5 students at 18 schools in a worm-endemic region of the Peruvian Amazon were dewormed. Immediately following deworming, nine schools were randomly assigned to the intervention arm of the trial using a matched-pair design. The Grade 5 students attending intervention schools (N = 517) received four months of health hygiene education aimed at increasing knowledge of STH prevention. Grade 5 students from the other nine schools (N = 571) served as controls. Absenteeism was measured daily through teachers' attendance logs. After four months of follow-up, overall absenteeism rates at intervention and control schools were not statistically significantly different. However, post-trial non-randomized analyses have shown that students with moderate-to-heavy Ascaris infections and light hookworm infections four months after deworming had, respectively, missed 2.4% (95% CI: 0.1%, 4.7%) and 4.6% (95% CI: 1.9%, 7.4%) more schooldays during the follow-up period than their uninfected counterparts. These results provide empirical evidence of a direct effect of STH infections on absenteeism in school-age children.

  3. Effects of a Post-Deworming Health Hygiene Education Intervention on Absenteeism in School-Age Children of the Peruvian Amazon

    PubMed Central

    Thériault, François L.; Maheu-Giroux, Mathieu; Blouin, Brittany; Casapía, Martin; Gyorkos, Theresa W.

    2014-01-01

    Soil-transmitted helminth (STH) infections are a leading cause of disability and disease burden in school-age children of worm-endemic regions. Their effect on school absenteeism, however, remains unclear. The World Health Organization currently recommends delivering mass deworming and health hygiene education through school-based programs, in an effort to control STH-related morbidity. In this cluster-RCT, the impact of a health hygiene education intervention on absenteeism was measured. From April to June 2010, all Grade 5 students at 18 schools in a worm-endemic region of the Peruvian Amazon were dewormed. Immediately following deworming, nine schools were randomly assigned to the intervention arm of the trial using a matched-pair design. The Grade 5 students attending intervention schools (N = 517) received four months of health hygiene education aimed at increasing knowledge of STH prevention. Grade 5 students from the other nine schools (N = 571) served as controls. Absenteeism was measured daily through teachers' attendance logs. After four months of follow-up, overall absenteeism rates at intervention and control schools were not statistically significantly different. However, post-trial non-randomized analyses have shown that students with moderate-to-heavy Ascaris infections and light hookworm infections four months after deworming had, respectively, missed 2.4% (95% CI: 0.1%, 4.7%) and 4.6% (95% CI: 1.9%, 7.4%) more schooldays during the follow-up period than their uninfected counterparts. These results provide empirical evidence of a direct effect of STH infections on absenteeism in school-age children. PMID:25122469

  4. Prevalence of soil transmitted nematodes on Nukufetau, a remote Pacific island in Tuvalu

    PubMed Central

    Speare, Rick; Latasi, Falatea Fab; Nelesone, Tekaai; Harmen, Sonia; Melrose, Wayne; Durrheim, David; Heukelbach, Jorg

    2006-01-01

    Background The population of Nukufetau, a remote coral atoll island in Tuvalu in the Western Pacific, received annual mass drug administration (MDA) of diethylcarbamazine and albendazole under the Pacific Elimination of Lymphatic Filariasis program in 2001, 2002 and 2003, with the last MDA occurring six months before a cross-sectional survey of the whole population for soil transmitted helminths (STH). Methods A cross-sectional survey in May 2004 recruited 206 residents (35.2% of the population) who provided a single faecal sample that was preserved, concentrated and examined microscopically. Results Overall prevalence of STH was 69.9%; only hookworm and Trichuris trichiura were diagnosed. Trichuris was present in 68.4% with intensity of infection being light in 56.3%, medium in 11.7% and heavy in 0.5%. Hookworm occurred in 11.7% with intensity of infection 11.2% being light and medium in 0.5%. Twenty individuals (9.7%) had dual infections. The prevalence of Trichuris was constant across all ages while the prevalence of hookworm was significantly lower in residents below 30 years of age. In the age group 5–12 years comparison of results with a 2001 survey [1] suggested that the prevalence of STH has declined minimally, due to sustained high prevalence of Trichuris, while hookworm has declined dramatically from 34.4% to 1.6%. Conclusion The results of this survey suggest that although the MDA appears to have reduced hookworm prevalence in residents below 30 years of age, there has been minimal effect on Trichuris prevalence. An integrated program to control STH is required. PMID:16836746

  5. School-based control of soil-transmitted helminthiasis in western Visayas, Philippines.

    PubMed

    Belizario, V Y; Totañes, F I G; de Leon, W U; Matias, K M H

    2014-05-01

    We evaluated the effect of a local government unit-led, school-based, teacher-assisted mass drug administration (MDA) treatment of soil-transmitted helminthiasis (STH) on the morbidity of school children in selected provinces of western Visayas, the Philippines. Parasitological assessment was done on stool samples using the Kato-Katz technique. Nutritional status and school performance were also evaluated using secondary data from the Department of Education. The overall prevalence of STH decreased from 71.1% to 44.3% (p < 0.0001) and the prevalence of heavy infection with STH decreased from 40.5% to 14.5% (p < 0.0001), after two years of biannual MDA. The prevalence of underweight children decreased from 26.2% to 17.8% (p < 0.0001) and the prevalence of stunted children decreased from 20.9% to 16.6% (p < 0.0001) after two years of biannual MDA. School performance improved on standardized testing from a mean percentage of 53.8% to 64.6%. Advocacy, social mobilization, strong local government support and intersectoral collaboration with other agencies probably contributed to the success of the program.

  6. Sentinel surveillance of soil-transmitted helminthiasis in preschool-aged and school-aged children in selected local government units in the Philippines: follow-up assessment.

    PubMed

    Belizario, Vicente Y; Totañes, Francis Isidore G; de Leon, Winifreda U; Ciro, Raezelle Nadine T; Lumampao, Yvonne F

    2015-03-01

    This study was a follow-up to the baseline nationwide survey of soil-transmitted helminth (STH) infections in preschool-aged children in the Philippines and in school-aged children in selected sentinel sites to assess the Integrated Helminth Control Program of the Department of Health. The objective of the study was to describe the current prevalence and intensity of STH infections in preschool-aged and school-aged children in 6 sentinel provinces and to compare these data with baseline findings. A cross-sectional study design was used to determine the prevalence and intensity of STH infections. Parasitological assessment involved the examination of stool samples by the Kato-Katz method. Although parasitological parameters in the 2 age groups at follow-up showed significant reductions from the baseline, these parameters remained high despite 3 years of mass drug administration (MDA). Efforts toward achieving high MDA coverage rates, provision of clean water, environmental sanitation, and promotion of hygiene practices must be prioritized. © 2013 APJPH.

  7. Detection with synthetic oligonucleotide probes of nucleotide sequence variations in the genes encoding enterotoxins of Escherichia coli.

    PubMed Central

    Nishibuchi, M; Murakami, A; Arita, M; Jikuya, H; Takano, J; Honda, T; Miwatani, T

    1989-01-01

    We examined variations in the genes encoding heat-stable enterotoxin (ST) and heat-labile enterotoxin (LT) in 88 strains of Escherichia coli isolated from individuals with traveler's diarrhea to find suitable sequences for use as oligonucleotide probes. Four oligonucleotide probes of the gene encoding ST of human origin (STIb or STh), one oligonucleotide probe of the gene encoding ST of porcine origin (STIa or STp), and three oligonucleotide probes of the gene encoding LT of human origin (LTIh) were used in DNA colony hybridization tests. In 15 of 22 strains possessing the STh gene and 28 of 42 strains producing LT, the sequences of all regions tested were identical to the published sequences. One region in the STh gene examined with a 18-mer probe was relatively well conserved and was shown to be closely associated with the enterotoxicity of the E. coli strains in suckling mice. This oligonucleotide, however, hybridized with strains of Vibrio cholerae O1, V. parahaemolyticus, and Yersinia enterocolitica that gave negative results in the suckling mouse assay. PMID:2685027

  8. Factors Associated with the Performance and Cost-Effectiveness of Using Lymphatic Filariasis Transmission Assessment Surveys for Monitoring Soil-Transmitted Helminths: A Case Study in Kenya

    PubMed Central

    Smith, Jennifer L.; Sturrock, Hugh J. W.; Assefa, Liya; Nikolay, Birgit; Njenga, Sammy M.; Kihara, Jimmy; Mwandawiro, Charles S.; Brooker, Simon J.

    2015-01-01

    Transmission assessment surveys (TAS) for lymphatic filariasis have been proposed as a platform to assess the impact of mass drug administration (MDA) on soil-transmitted helminths (STHs). This study used computer simulation and field data from pre- and post-MDA settings across Kenya to evaluate the performance and cost-effectiveness of the TAS design for STH assessment compared with alternative survey designs. Variations in the TAS design and different sample sizes and diagnostic methods were also evaluated. The district-level TAS design correctly classified more districts compared with standard STH designs in pre-MDA settings. Aggregating districts into larger evaluation units in a TAS design decreased performance, whereas age group sampled and sample size had minimal impact. The low diagnostic sensitivity of Kato-Katz and mini-FLOTAC methods was found to increase misclassification. We recommend using a district-level TAS among children 8–10 years of age to assess STH but suggest that key consideration is given to evaluation unit size. PMID:25487730

  9. The nutritional impacts of soil-transmitted helminths infections among Orang Asli schoolchildren in rural Malaysia

    PubMed Central

    2012-01-01

    Background Soil-transmitted helminths (STH) infections, anaemia and malnutrition are major public health problems in school-age children in developing countries. This study was conducted on 289 Orang Asli (aboriginal) schoolchildren in order to assess the current prevalence and predictors of anaemia and malnutrition, as well as the nutritional impacts of STH infections among these children. Methods A cross-sectional study was combined with a longitudinal follow-up three months after treatment with anthelminthic drugs. Blood samples were collected from the children to measure haemoglobin (Hb) level. Anthropometric and socioeconomic data were also collected and the children were screened for STH. Results The baseline findings revealed that the prevalence of anaemia, significant stunting, underweight and wasting among the children were 41.0%, 28.0%, 29.2% and 12.5%, respectively. Overall, the prevalence of trichuriasis, ascariasis and hookworm infections were 84.6%, 47.6% and 3.9%, respectively. Haemoglobin level was significantly lower among the moderate-to-heavy infected children compared to the negative-to-light infected children. Age <10years and moderate-to-heavy ascariasis were the predictors of anaemia. Stunting was associated with gender, age, moderate-to-heavy ascariasis and trichuriasis. Three months post-treatment assessment showed that the moderate-to-heavy infected children gained significant increment in their mean Hb level compared to the negative-to-light infected children (0.44 g/dL compared to 0.08 g/dL). However, no difference was found in the mean increments in growth indices between the groups. Conclusion STH infections, anaemia and malnutrition are still prevalent and a matter of public health concern in Orang Asli communities in Malaysia. Sustainable deworming programme at school and community levels among these populations will help to improve their health and nutritional status. PMID:22704549

  10. Does anodal transcranial direct current stimulation modulate sensory perception and pain? A meta-analysis study.

    PubMed

    Vaseghi, B; Zoghi, M; Jaberzadeh, S

    2014-09-01

    The primary aim of this systematic review was to evaluate the effects of anodal transcranial direct current stimulation (a-tDCS) on sensory (STh) and pain thresholds (PTh) in healthy individuals and pain levels (PL) in patients with chronic pain. Electronic databases were searched for a-tDCS studies. Methodological quality was examined using the PEDro and Downs and Black (D&B) assessment tools. a-tDCS of the primary motor cortex (M1) increases both STh (P<0.005, with the effect size of 22.19%) and PTh (P<0.001, effect size of 19.28%). In addition, STh was increased by a-tDCS of the primary sensory cortex (S1) (P<0.05 with an effect size of 4.34). Likewise, PL decreased significantly in the patient group following application of a-tDCS to both the M1 and dorsolateral prefrontal cortex (DLPFC). The average decrease in visual analogue score was 14.9% and 19.3% after applying a-tDCS on the M1 and DLPFC. Moreover, meta-analysis showed that in all subgroups (except a-tDCS of S1) active a-tDCS and sham stimulation produced significant differences. This review provides evidence for the effectiveness of a-tDCS in increasing STh/PTh in healthy group and decreasing PL in patients. However, due to small sample sizes in the included studies, our results should be interpreted cautiously. Given the level of blinding did not considered in inclusion criteria, the result of current study should be interpreted with caution. Site of stimulation should have a differential effect over pain relief. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Contamination of commonly consumed raw vegetables with soil transmitted helminth eggs in Mazandaran province, northern Iran.

    PubMed

    Rostami, Ali; Ebrahimi, Maryam; Mehravar, Saeed; Fallah Omrani, Vahid; Fallahi, Shirzad; Behniafar, Hamed

    2016-05-16

    Soil-transmitted helminth (STH) infections are responsible for significant burden of morbidity and mortality worldwide. Consumption of raw vegetables without proper washing is one of the major routes of such infections. We evaluate the prevalence of STH contamination in commonly used vegetables in Mazandaran province, northern Iran. A total of 772 fresh raw vegetables were obtained from retail markets. Each sample was divided into two groups. One group was used as the unwashed sample and the second group was washed with standard washing procedures. Then, samples were examined for helminth eggs by using standard methods. Data analysis was performed using SPSS20. The overall prevalence of STHs was 14.89% (115/772). The rate of STH contamination was significantly higher in warm seasons (20.5%, 79/386) than in cold seasons (9.32%, 36/386) among the unwashed vegetables (OR=2.50; CI 95%=1.64-3.8; P<0.001). No parasites were observed in standard washed samples (OR=271.40; CI 95%=16.84-4373.64; P<0.001). Prevalence of STH contamination was significantly higher in leafy vegetables than root vegetables (OR=1.67; CI 95%=1.09-2.55; P<0.05). The prevalence of STHs species in all the vegetables were as follows: Ascaris lumbricoides (3.36%), Trichuris trichiura (2.2%), hookworms (2.9%), Toxocara spp. (1.68%), Trichostrongylus spp. (1.55), Taenia sp. (0.9%) and Hymenolepis nana (2.2%). The results of the present study emphasized that vegetables are potential risk factor for transmission of helminth infection to human in northern Iran. It is necessary that health authorities trained the consumers to proper and standard washing of vegetables before consumption. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Fear of Birth Defects Is a Major Barrier to Soil-Transmitted Helminth Treatment (STH) for Pregnant Women in the Philippines

    PubMed Central

    Totañes, Francis Isidore G.; Macatangay, Bernard J. C.; Belizario, Vicente Y.

    2014-01-01

    The World Health Organization recommends anthelminthic treatment for pregnant women after the first trimester in soil-transmitted helminth (STH) endemic regions to prevent adverse maternal-fetal consequences. Although studies have shown the high prevalence of infection in the Philippines, no research has evaluated deworming practices. We hypothesized that pregnant women are not receiving deworming treatment and we aimed to identify barriers to World Health Organization guideline implementation. We conducted key informant interviews with local Department of Health (DOH) administrators, focus group discussions with nurses, midwives, and health care workers, and knowledge, attitudes, and practices surveys with women of reproductive age to elicit perspectives about deworming during pregnancy. Key informant interviews revealed that healthcare workers were not deworming pregnant women due to inadequate drug supply, infrastructure and personnel as well as fear of teratogenicity. Focus group discussions showed that healthcare workers similarly had not implemented guidelines due to infrastructure challenges and concerns for fetal malformations. The majority of local women believed that STH treatment causes side effects (74.8%) as well as maternal harm (67.3%) and fetal harm (77.9%). Women who were willing to take anthelminthics while pregnant had significantly greater knowledge as demonstrated by higher Treatment Scores (mean rank 146.92 versus 103.1, z = −4.40, p<0.001) and higher Birth Defect Scores (mean rank 128.09 versus 108.65, z = −2.43, p = 0.015). This study concludes that World Health Organization guidelines are not being implemented in the Philippines. Infrastructure, specific protocols, and education for providers and patients regarding anthelminthic treatment are necessary for the successful prevention of STH morbidity and mortality among pregnant women. PMID:24586245

  13. Acute psychological stress increases plasma levels of cortisol, prolactin and TSH.

    PubMed

    Schedlowski, M; Wiechert, D; Wagner, T O; Tewes, U

    1992-01-01

    The effects of acute stress during a parachute jump on hormonal responses were studied in 12 experienced and 11 inexperienced military parachutists. Each subject performed two jumps. Prior to and immediately after each jump blood samples were drawn and analysed for plasma levels of cortisol, prolactin, thyrotropin (TSH), somatotropin (STH), and luteinizing hormone (LH). While there was a significant increase in cortisol, prolactin and TSH levels after both jumps, no alterations could be observed in STH and LH levels. Stress-induced hormonal responses were not affected by jump experience. There was also no association between the endocrine variables and anxiety scores.

  14. A search for J-band variability from late-L and T brown dwarfs

    NASA Astrophysics Data System (ADS)

    Clarke, F. J.; Hodgkin, S. T.; Oppenheimer, B. R.; Robertson, J.; Haubois, X.

    2008-06-01

    We present J-band photometric observations of eight late-L and T type brown dwarfs designed to search for variability. We detect small amplitude periodic variability from three of the objects on time-scales of several hours, probably indicating the rotation period of the objects. The other targets do not show any variability down to the level of 0.5-5 per cent This work is based on observations obtained at the European Southern Observatory, La Silla, Chile (ESO Programme 72.C-0006). E-mail: fclarke@astro.ox.ac.uk (FJC); sth@ast.cam.ac.uk (STH); bro@amnh.org (BRO); xavier.haubois@obspm.fr (XH)

  15. [The para-clinic investigation of temporo-mandibular joint changes in patients with acromegaly].

    PubMed

    Morăraşu, C; Burlui, V; Olaru, C; Boza, C; Bortă, C; Morăraşu, G; Brînză, M

    2001-01-01

    The Acromegaly is an endocrinological disease determined by the hypersecretion of STH in a certain period of the body evolution and it causes the hypertrophy of bones in general and of mandible and cranio-facial bones, determining a disorder due to this development of bones, associated with troubles in the activity of muscles and of the phospho-calcium metabolism. This study was made on a group of 33 acromegaly patients. Their temporo-mandibular joint was investigated by ortopantomography, tomography, computer tomography and scintigraphy. All of these exams shows the changes in temporo-mandibular joint due to the cells hyperactivity determined by the hypersecretion of STH.

  16. Hormonal status and fluid electrolyte metabolism in motion sickness

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Grigoriev, A.I.; Nichiporuk, I.A.; Yasnetsov, V.V.

    1988-04-01

    In the first experimental series, 10 healthy male test subjects with a high susceptibility to motion sickness showed a significant increase of ACTH, cortisol, STH, prolactin, ADH, aldosterone concentrations, and plasma renin activity after vestibular tests. The 10 subjects with a moderate susceptibility exhibited a still higher increase of the hormones, except plasma renin. The 8 test subjects with a low susceptibility displayed a considerable increase in ACTH, cortisol, and STH after vestibular stimulation. In the second experimental series, the increase of STH, cortisol, ADH, aldosterone and renin occurred immediately after rotation in the moderate susceptibility subjects and an hourmore » after exposure in the high susceptibility subjects. This may be indicative of specific immediate adaptation mechanisms or excitation transfer in the CNS in high susceptibility persons. In the third experimental animal series, the permeability of the blood-brain barrier for /sup 125/I and IgG increased after rotation. Greater concentrations of potassium, chloride, and urea in CSF are suggestive of an inhibition process activation in the CNS and, probably, of an active urea transport by the vascular plexus epithelium which maintains constant osmotic pressure of cerebral extracellular fluid and prevents hyper-hydration of CNS neurons.« less

  17. Actin-related proteins regulate the RSC chromatin remodeler by weakening intramolecular interactions of the Sth1 ATPase.

    PubMed

    Turegun, Bengi; Baker, Richard W; Leschziner, Andres E; Dominguez, Roberto

    2018-01-01

    The catalytic subunits of SWI/SNF-family and INO80-family chromatin remodelers bind actin and actin-related proteins (Arps) through an N-terminal helicase/SANT-associated (HSA) domain. Between the HSA and ATPase domains lies a conserved post-HSA (pHSA) domain. The HSA domain of Sth1, the catalytic subunit of the yeast SWI/SNF-family remodeler RSC, recruits the Rtt102-Arp7/9 heterotrimer. Rtt102-Arp7/9 regulates RSC function, but the mechanism is unclear. We show that the pHSA domain interacts directly with another conserved region of the catalytic subunit, protrusion-1. Rtt102-Arp7/9 binding to the HSA domain weakens this interaction and promotes the formation of stable, monodisperse complexes with DNA and nucleosomes. A crystal structure of Rtt102-Arp7/9 shows that ATP binds to Arp7 but not Arp9. However, Arp7 does not hydrolyze ATP. Together, the results suggest that Rtt102 and ATP stabilize a conformation of Arp7/9 that potentiates binding to the HSA domain, which releases intramolecular interactions within Sth1 and controls DNA and nucleosome binding.

  18. Impact of Health Education on Soil-Transmitted Helminth Infections in Schoolchildren of the Peruvian Amazon: A Cluster-Randomized Controlled Trial

    PubMed Central

    Gyorkos, Theresa W.; Maheu-Giroux, Mathieu; Blouin, Brittany; Casapia, Martin

    2013-01-01

    Background To control soil-transmitted helminth (STH) infections, the World Health Organization recommends school-based deworming programs with a health hygiene education component. The effect of such health hygiene interventions, however, has not been adequately studied. The objective of the present study was to determine the effectiveness of a health hygiene education intervention on the occurrence of STH re-infection four months post-de-worming. Methodology/Principal Findings An open-label pair-matched cluster-randomized trial was conducted in Grade 5 schoolchildren of 18 primary schools (9 intervention and 9 control) in the Peruvian Amazon. Baseline assessment included interview with a pre-tested questionnaire and collection of single stool specimens that were examined using the single Kato-Katz thick smear. All schoolchildren were then treated with single-dose albendazole (400 mg). Schoolchildren in intervention schools then received 1) an initial one hour in-class activity on health hygiene and sanitation and 30-minute refresher activities every two weeks over four months; and 2) a half-day workshop for teachers and principals, while children in control schools did not. Four months later, STH infection was re-assessed in all schools by laboratory technologists blinded to intervention status. From April 21–October 20, 2010, a total of 1,089 schoolchildren (518 and 571 from intervention and control schools, respectively) participated in this study. Intervention children scored significantly higher on all aspects of a test of STH-related knowledge compared with control children (aOR = 18·4; 95% CI: 12·7 to 26·6). The intensity of Ascaris lumbricoides infection at follow-up was statistically significantly lower (by 58%) in children in intervention schools compared with children in control schools (aIRR = 0·42; 95% CI = 0·21 to 0·85). No significant changes in hookworm or Trichuris trichiura intensity were observed. Conclusions/Significance A school-based health hygiene education intervention was effective in increasing STH knowledge and in reducing Ascaris lumbricoides infection. The benefits of school-based periodic deworming programs are likely to be enhanced when a sustained health hygiene education intervention is integrated into school curricula. PMID:24069469

  19. Schistosoma haematobium and soil-transmitted Helminths in Tana Delta District of Kenya: infection and morbidity patterns in primary schoolchildren from two isolated villages.

    PubMed

    Njaanake, Kariuki H; Vennervald, Birgitte J; Simonsen, Paul E; Madsen, Henry; Mukoko, Dunstan A; Kimani, Gachuhi; Jaoko, Walter G; Estambale, Benson B

    2016-02-03

    Schistosomes and soil-transmitted helminths (STH) (hookworm, Trichuris trichiura and Ascaris lumbricoides) are widely distributed in developing countries where they infect over 230 million and 1.5 billion people, respectively. The parasites are frequently co-endemic and many individuals are co-infected with two or more of the species, but information on how the parasites interact in co-infected individuals is scarce. The present study assessed Schistosoma haematobium and STH infection and morbidity patterns among school children in a hyper-endemic focus in the Tana River delta of coastal Kenya. Two hundred and sixty-two children aged 5-12 years from two primary schools were enrolled in the study. For each child, urine was examined for S. haematobium eggs and haematuria, stool was examined for STH eggs, peripheral blood was examined for eosinophilia and haemoglobin level, the urinary tract was ultrasound-examined for S. haematobium-related pathology, and the height and weight was measured and used to calculate the body mass index (BMI). Prevalences of S. haematobium, hookworm, T. trichiura and A. lumbricoides infection were 94, 81, 88 and 46 %, respectively. There was no significant association between S. haematobium and STH infection but intensity of hookworm infection significantly increased with that of T. trichiura. Lower BMI scores were associated with high intensity of S. haematobium (difference =-0.48, p > 0.05) and A. lumbricoides (difference =-0.67, p < 0.05). Haematuria (both macro and micro) was common and associated with S. haematobium infection, while anaemia was associated with high intensity of S. haematobium (OR = 2.08, p < 0.05) and high hookworm infections OR = 4.75; p < 0.001). The majority of children had eosinophilia, which was significantly associated with high intensity of hookworm infection (OR = 5.34, p < 0.05). Overall 38 % of the children had ultrasound-detectable urinary tract morbidity, which was associated with high intensity of S. haematobium infection (OR = 3.13, p < 0.05). Prevalences of S. haematobium and STH infections among the primary school children were high and the parasites were responsible for significant morbidity. A clear synergistic interaction was observed between hookworm and T. trichiura infections. Increased coverage in administration of praziquantel and albendazole in the area is recommended to control morbidity due to these infections.

  20. First-principles study of hole polaron formation and migration in SrI2

    NASA Astrophysics Data System (ADS)

    Zhou, Fei; Sadigh, Babak; Aberg, Daniel

    2015-03-01

    We investigate the formation of self-trapped holes (STH) in the high performance scintillator material SrI2 using a recently developed first principles method, polaron self-interaction correction (pSIC). pSIC removes the significant spurious self-interaction of localized polaron states. It is capable of accurately reproduce the configurational energy landscape of polaronic states from optimized hybrid functionals at the computational cost of the local density approximation. We searched for and identified all symmetrically distinct STH states localized on neighboring I-I dimers, i.e. Vk centers, and found non-trivial relation between the STH formation energies and dimer separation. All possible polaron hopping paths of the type IAIB -->IBIC are investigated systematically with pSIC and the elastic band method, and paths with low migration barrier energy of about 0.2 eV were identified, suggesting high mobility in SrI2. We expect that the present approach can be applied to study polaron formation and migration in other materials. Support from the National Nuclear Security Administration Office of Nonproliferation Research and Development (NA-22) is acknowledged. This work performed under the auspices of the U.S. Department of Energy by Lawrence Livermore N We acknowledge funding from the NA-22 agency.

  1. Soil-transmitted helminthiasis: a critical but neglected factor influencing school participation of Aboriginal children in rural Malaysia.

    PubMed

    Ahmed, Abdulhamid; Al-Mekhlafi, Hesham M; Azam, Mohammad Nurul; Ithoi, Init; Al-Adhroey, Abdulelah H; Abdulsalam, Awatif M; Surin, Johari

    2012-05-01

    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.

  2. Soil-transmitted helminths and haemoglobin status among Afghan children in World Food Programme assisted schools.

    PubMed

    Gabrielli, A F; Ramsan, M; Naumann, C; Tsogzolmaa, D; Bojang, B; Khoshal, M H; Connolly, M; Stothard, J R; Montresor, A; Savioli, L

    2005-12-01

    In recent years there have been major socio-economic changes within Afghanistan such that the present public health burden of soil-transmitted helminths (STH), especially that within school-aged children, remains to be determined. A baseline parasitological survey was therefore carried out in four defined areas of Afghanistan to better assess the distribution, prevalence and intensity of STH infections prior to a nationwide de-worming campaign beginning within World Food Programme assisted schools. A cross-sectional examination of 1001 children aged between 8 and 15 years old revealed that approximately half (47.2%) were infected with at least one STH. Infections with Ascaris lumbricoides were most widespread (40.9%) and elevated prevalences were detected in urban environments; for example, schoolchildren in Kabul were more likely to be infected (OR=2.2, 95% CI 1.6-3.0) than elsewhere and these infections were often of higher intensity (OR=7.6, 95% CI 4.9-11.8). Trichuris trichiura (9.9%) and hookworms (0.7%), previously unknown from Afghanistan, were encountered. The blood haemoglobin concentration of surveyed children was also assessed: 4% resulted to be anaemic (Hb<11 g dl(-1)), and 0.4% to be severely anaemic (Hb<7 g dl(-1)).

  3. Soil-Transmitted Helminth Infections and Associated Risk Factors in Three Orang Asli Tribes in Peninsular Malaysia

    PubMed Central

    Anuar, Tengku Shahrul; Salleh, Fatmah Md; Moktar, Norhayati

    2014-01-01

    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 (

  4. Elucidation of the Molecular Basis for Arabinoxylan-Debranching Activity of a Thermostable Family GH62 α-l-Arabinofuranosidase from Streptomyces thermoviolaceus

    PubMed Central

    Wang, Weijun; Mai-Gisondi, Galina; Stogios, Peter J.; Kaur, Amrit; Xu, Xiaohui; Cui, Hong; Turunen, Ossi; Savchenko, Alexei

    2014-01-01

    Xylan-debranching enzymes facilitate the complete hydrolysis of xylan and can be used to alter xylan chemistry. Here, the family GH62 α-l-arabinofuranosidase from Streptomyces thermoviolaceus (SthAbf62A) was shown to have a half-life of 60 min at 60°C and the ability to cleave α-1,3 l-arabinofuranose (l-Araf) from singly substituted xylopyranosyl (Xylp) backbone residues in wheat arabinoxylan; low levels of activity on arabinan as well as 4-nitrophenyl α-l-arabinofuranoside were also detected. After selective removal of α-1,3 l-Araf substituents from disubstituted Xylp residues present in wheat arabinoxylan, SthAbf62A could also cleave the remaining α-1,2 l-Araf substituents, confirming the ability of SthAbf62A to remove α-l-Araf residues that are (1→2) and (1→3) linked to monosubstituted β-d-Xylp sugars. Three-dimensional structures of SthAbf62A and its complex with xylotetraose and l-arabinose confirmed a five-bladed β-propeller fold and revealed a molecular Velcro in blade V between the β1 and β21 strands, a disulfide bond between Cys27 and Cys297, and a calcium ion coordinated in the central channel of the fold. The enzyme-arabinose complex structure further revealed a narrow and seemingly rigid l-arabinose binding pocket situated at the center of one side of the β propeller, which stabilized the arabinofuranosyl substituent through several hydrogen-bonding and hydrophobic interactions. The predicted catalytic amino acids were oriented toward this binding pocket, and the catalytic essentiality of Asp53 and Glu213 was confirmed by site-specific mutagenesis. Complex structures with xylotetraose revealed a shallow cleft for xylan backbone binding that is open at both ends and comprises multiple binding subsites above and flanking the l-arabinose binding pocket. PMID:24951792

  5. A Double-Blind Randomized Controlled Trial of Maternal Postpartum Deworming to Improve Infant Weight Gain in the Peruvian Amazon.

    PubMed

    Mofid, Layla S; Casapía, Martín; Aguilar, Eder; Silva, Hermánn; Montresor, Antonio; Rahme, Elham; Fraser, William D; Marquis, Grace S; Vercruysse, Jozef; Allen, Lindsay H; Blouin, Brittany; Razuri, Hugo; Pezo, Lidsky; Gyorkos, Theresa W

    2017-01-01

    Nutritional interventions targeting the critical growth and development period before two years of age can have the greatest impact on health trajectories over the life course. Compelling evidence has demonstrated that interventions investing in maternal health in the first 1000 days of life are beneficial for both mothers and their children. One such potential intervention is deworming integrated into maternal postpartum care in areas where soil-transmitted helminth (STH) infections are endemic. From February to August 2014, 1010 mother-infant pairs were recruited into a trial aimed at assessing the effectiveness of maternal postpartum deworming on infant and maternal health outcomes. Following delivery, mothers were randomly assigned to receive either single-dose 400 mg albendazole or placebo. Participants were followed-up at 1 and 6 months postpartum. There was no statistically significant difference in mean weight gain between infants in the experimental and control groups (mean difference: -0.02; 95% CI: -0.1, 0.08) at 6 months of age. Further, deworming had no effect on measured infant morbidity indicators. However, ad hoc analyses restricted to mothers who tested positive for STHs at baseline suggest that infants of mothers in the experimental group had greater mean length gain in cm (mean difference: 0.8; 95% CI: 0.1, 1.4) and length-for-age z-score (mean difference: 0.5; 95% CI: 0.2, 0.8) at 6 months of age. In a study population composed of both STH-infected and uninfected mothers, maternal postpartum deworming was insufficient to impact infant growth and morbidity indicators up to 6 months postpartum. Among STH-infected mothers, however, important improvements in infant length gain and length-for-age were observed. The benefits of maternal postpartum deworming should be further investigated in study populations having higher overall prevalences and intensities of STH infections and, in particular, where whipworm and hookworm infections are of public health concern. ClinicalTrials.gov (NCT01748929).

  6. Soil-transmitted helminth infections and physical fitness in school-aged Bulang children in southwest China: results from a cross-sectional survey

    PubMed Central

    2012-01-01

    Background Chronic soil-transmitted helminth (STH) infections have been associated with reduced physical fitness, but available evidence is limited. The aim of this cross-sectional survey was to assess the feasibility of measuring children's physical fitness and to relate it to STH infections. Our study was carried out among school-aged children of the Bulang ethnic group in rural southwest People's Republic of China (P.R. China). Standardized, quality-controlled methods were employed to determine STH infections (Kato-Katz technique), haemoglobin levels, anthropometry (body weight and height) and physical fitness (20-m shuttle run test). Results A compliance of 87% suggested good acceptance of the methods used. Among 69 children with complete data records, infection prevalence of Trichuris trichiura, Ascaris lumbricoides and hookworm were 81%, 44% and 6%, respectively. The maximum volume of oxygen that can be utilized within 1 min during exhaustive exercise (VO2 max estimate) of T. trichiura-infected children was 1.94 ml kg-1 min-1 lower than that of their non-infected counterparts (P = 0.005). Until exhaustion, T. trichiura-infected children had completed 6.14 20-m laps less (P = 0.004). Additionally, the mean VO2 max estimate of stunted children was lowered by 1.63 ml kg-1 min-1 (P = 0.002) and they completed 5.32 20-m laps less (P = 0.001) compared to children of normal stature. No significant association between stunting and infection with any STH species could be established. Conclusions Implementation of physical fitness tests in rural, resource-constraint settings is feasible. The physical fitness of children who are stunted or infected with STHs, particularly T. trichiura, is significantly impaired. We have launched a larger study and will determine the dynamics of school-aged children's physical fitness over a 7-month period after administration of anthelminthic drugs. PMID:22424138

  7. Identifying geoscience knowledge likely to affect foreign policy

    NASA Astrophysics Data System (ADS)

    Kelmelis, J. A.

    2006-12-01

    The earth sciences play an important role in foreign policy and have done so throughout history. Whether it is access to resources, knowledge of weather or other earth system conditions, planning for or responding to disasters, protecting the environment, facilitating transportation and communication, or any of a number of other important topics, the geosciences continue to inform our decision making. The importance of science, technology, and health (STH) is being increasingly recognized in the foreign policy community. The National Research Council (NRC) recommended that the Department of State (State) expand its scientific base to address the importance of STH issues. In part, this consists of increasing the number of scientists within State. Another important aspect is not only identifying the STH issues that are of current concern, but also the issues that will be of importance in the future. A number of studies funded by the U.S. Government have identified some important STH areas of concern at a high level. These provide a basis for more in-depth investigations. However, there are additional phenomena, beyond those identified in the studies, which have foreign policy implications. The scientific findings may be well known to scientists but their foreign policy importance is not always obvious. The scientific and foreign policy communities could improve their dialog to better develop strategies for foreign policy and future scientific research. One way to help facilitate that is to ease identification of scientific issues with potential significance to foreign policy and to clarify uncertainties around those issues. A qualitative method relating the likelihood that the scientific finding has foreign policy importance to the potential level of foreign policy importance has been used to clarify the significance of a variety of scientific findings including Arctic warming, methane hydrates, atmospheric dust, disease, and natural hazards. From a foreign policy perspective, the significance of some scientific findings can cascade through emerging international issues and manifest themselves in ways that have both strategic and tactical concern.

  8. Thermal conductivity profile determination in proton-irradiated ZrC by spatial and frequency scanning thermal wave methods

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jensen, C.; Department of Mechanical and Aerospace Engineering, Utah State University, Logan, Utah 84322; Chirtoc, M.

    2013-10-07

    Using complementary thermal wave methods, the irradiation damaged region of zirconium carbide (ZrC) is characterized by quantifiably profiling the thermophysical property degradation. The ZrC sample was irradiated by a 2.6 MeV proton beam at 600 °C to a dose of 1.75 displacements per atom. Spatial scanning techniques including scanning thermal microscopy (SThM), lock-in infrared thermography (lock-in IRT), and photothermal radiometry (PTR) were used to directly map the in-depth profile of thermal conductivity on a cross section of the ZrC sample. The advantages and limitations of each system are discussed and compared, finding consistent results from all techniques. SThM provides themore » best resolution finding a very uniform thermal conductivity envelope in the damaged region measuring ∼52 ± 2 μm deep. Frequency-based scanning PTR provides quantification of the thermal parameters of the sample using the SThM measured profile to provide validation of a heating model. Measured irradiated and virgin thermal conductivities are found to be 11.9 ± 0.5 W m{sup −1} K{sup −1} and 26.7 ±1 W m{sup −1} K{sup −1}, respectively. A thermal resistance evidenced in the frequency spectra of the PTR results was calculated to be (1.58 ± 0.1) × 10{sup −6} m{sup 2} K W{sup −1}. The measured thermal conductivity values compare well with the thermal conductivity extracted from the SThM calibrated signal and the spatially scanned PTR. Combined spatial and frequency scanning techniques are shown to provide a valuable, complementary combination for thermal property characterization of proton-irradiated ZrC. Such methodology could be useful for other studies of ion-irradiated materials.« less

  9. Assessing the interruption of the transmission of human helminths with mass drug administration alone: optimizing the design of cluster randomized trials.

    PubMed

    Anderson, Roy; Farrell, Sam; Turner, Hugo; Walson, Judd; Donnelly, Christl A; Truscott, James

    2017-02-17

    A method is outlined for the use of an individual-based stochastic model of parasite transmission dynamics to assess different designs for a cluster randomized trial in which mass drug administration (MDA) is employed in attempts to eliminate the transmission of soil-transmitted helminths (STH) in defined geographic locations. The hypothesis to be tested is: Can MDA alone interrupt the transmission of STH species in defined settings? Clustering is at a village level and the choice of clusters of villages is stratified by transmission intensity (low, medium and high) and parasite species mix (either Ascaris, Trichuris or hookworm dominant). The methodological approach first uses an age-structured deterministic model to predict the MDA coverage required for treating pre-school aged children (Pre-SAC), school aged children (SAC) and adults (Adults) to eliminate transmission (crossing the breakpoint in transmission created by sexual mating in dioecious helminths) with 3 rounds of annual MDA. Stochastic individual-based models are then used to calculate the positive and negative predictive values (PPV and NPV, respectively, for observing elimination or the bounce back of infection) for a defined prevalence of infection 2 years post the cessation of MDA. For the arm only involving the treatment of Pre-SAC and SAC, the failure rate is predicted to be very high (particularly for hookworm-infected villages) unless transmission intensity is very low (R 0 , or the effective reproductive number R, just above unity in value). The calculations are designed to consider various trial arms and stratifications; namely, community-based treatment and Pre-SAC and SAC only treatment (the two arms of the trial), different STH transmission settings of low, medium and high, and different STH species mixes. Results are considered in the light of the complications introduced by the choice of statistic to define success or failure, varying adherence to treatment, migration and parameter uncertainty.

  10. Biological Systems for Hydrogen Photoproduction (Presentation)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ghirardi, M. L.

    2012-05-01

    This presentation summarizes NREL biological systems for hydrogen photoproduction work for the DOE Hydrogen and Fuel Cells Program Annual Merit Review and Peer Evaluation Meeting, May 14-18, 2012. General goal is develop photobiological systems for large-scale, low cost and efficient H{sub 2} production from water (barriers AH, AI and AJ). Specific tasks are: (1) Address the O{sub 2} sensitivity of hydrogenases that prevent continuity of H{sub 2} photoproduction under aerobic, high solar-to-hydrogen (STH) light conversion efficiency conditions; and (2) Utilize a limited STH H{sub 2}-producing method (sulfur deprivation) as a platform to address or test other factors limiting commercial algalmore » H{sub 2} photoproduction, including low rates due to biochemical and engineering mechanisms.« less

  11. Profiling the Local Seebeck Coefficient of InAs-GaAs Quantum Dots Using Scanning Thermoelectric Microscopy

    NASA Astrophysics Data System (ADS)

    Lin, Yen-Hsiang; Walrath, Jenna; Huang, Simon; Goldman, Rachel

    2014-03-01

    Thermoelectric (TE) devices offer a method of recovering waste heat through solid state conversion of heat to electricity. However, the typical efficiencies of TE devices are 5-10% which constitutes a barrier to wide spread use. There have recently been a number of reports of an increase in the bulk thermopower due to nanostructuring. In addition to our recent report of enhanced thermopower for GaAs embedded with indium nanocrystals, a theoretical study by Mahan and Sofo suggested that the best thermoelectric materials have a delta function density of states. Quantum dots fit ideally into such a picture. To date, the influence of nanostructuring on the electronic LDOS and thermopower has been studied using spatially averaged measurements; a nanoscale investigation of the effects of nanostructures on thermopower has yet to be presented. To investigate the link between dimensionality and TE properties, we are examining structures ranging from QDs to bulk-like layers, comparing SThEM measurements of the local Seebeck coefficient, S, with STS measurements of the local density of states (LDOS). STM, STS, and SThEM performed on InAs quantum dots (QDs) grown on GaAs. SThEM reveals enhanced S-values near the QD edge; STS reveals band-bending at the QD/GaAs interface, suggesting that the S enhancement is due to interfacial charge accumulation.

  12. Removal of helminth eggs by centralized and decentralized wastewater treatment plants in South Africa and Lesotho: health implications for direct and indirect exposure to the effluents.

    PubMed

    Amoah, Isaac Dennis; Reddy, Poovendhree; Seidu, Razak; Stenström, Thor Axel

    2018-05-01

    Wastewater may contain contaminants harmful to human health; hence, there is the need for treatment before discharge. Centralized wastewater treatment systems are the favored treatment options globally, but these are not necessarily superior in reduction of pathogens as compared to decentralized wastewater treatment systems (collectively called DEWATS). This study was therefore undertaken to assess the soil-transmitted helminth (STH) and Taenia sp. egg reduction efficiency of selected anaerobic baffled reactors and planted gravel filters compared to centralized wastewater treatment plants in South Africa and Lesotho. The risk of ascariasis with exposure to effluents from the centralized wastewater treatment plants was also assessed using the quantitative microbial risk assessment (QMRA) approach. Eggs of Ascaris spp., hookworm, Trichuris spp., Taenia spp., and Toxocara spp. were commonly detected in the untreated wastewater. The DEWATS plants removed between 95 and 100% of the STH and Taenia sp. eggs, with centralized plants removing between 67 and 100%. Helminth egg concentrations in the final effluents from the centralized wastewater treatment plants were consistently higher than those in the WHO recommended guideline (≤ 1 helminth egg/L) for agricultural use resulting in higher risk of ascariasis. Therefore, in conclusion, DEWATS plants may be more efficient in reducing the concentration of helminth eggs in wastewater, resulting in lower risks of STH infections upon exposure.

  13. The combined effect of the Lymphatic Filariasis Elimination Programme and the Schistosomiasis and Soil-transmitted Helminthiasis Control Programme on soil-transmitted helminthiasis in schoolchildren in Tanzania.

    PubMed

    Massa, Khalid; Magnussen, Pascal; Sheshe, Amir; Ntakamulenga, Robert; Ndawi, Benedict; Olsen, Annette

    2009-01-01

    The combined effect of the Lymphatic Filariasis Elimination Programme (LFEP) and the National Schistosomiasis and Soil-transmitted Helminthiasis Control Programme (NSSCP) on soil-transmitted helminthiasis (STH) was evaluated. In September 2004, before mass drug administration (MDA) with ivermectin and albendazole by the LFEP in October, the prevalence and intensity of STH were recorded in 228 pupils in one primary school. After 8 months, all available pupils were re-examined, and the prevalence of Ascaris lumbricoides, Trichuris trichiura and hookworm had decreased from 0.9 to 0.7% (P=0.84), from 4.8 to 0.7% (P=0.004) and from 45.6 to 11.9% (P<0.001), respectively. Overall, 81.2% of the schoolchildren stated that they were treated by the LFEP in October 2004. After the 8 months follow-up, pupils were treated with praziquantel and albendazole by the present project (substitute for the NSSCP). After another 4 months (at 12 months follow-up), the prevalence of hookworm infection was reduced to 4.8% (P=0.003), while the prevalence of T. trichiura was reduced to 0.3% (P=0.54) and the prevalence of A. lumbricoides remained unchanged. Mass co-administration of ivermectin and albendazole by the LFEP had a significant effect on STH, which was further amplified by treatment with praziquantel and albendazole 4 months later.

  14. Regional variation in Ascaris lumbricoides and Trichuris trichiura infections by age cohort and sex: effects of market integration among the indigenous Shuar of Amazonian Ecuador.

    PubMed

    Gildner, Theresa E; Cepon-Robins, Tara J; Liebert, Melissa A; Urlacher, Samuel S; Madimenos, Felicia C; Snodgrass, J Josh; Sugiyama, Lawrence S

    2016-11-24

    Soil-transmitted helminth (STH) infection peaks during childhood and varies by sex. The impact of market integration (MI) (increasing production for and consumption from a market-based economy) on these infection patterns, however, is unclear. In this study, STH infection is examined by sex and age among indigenous Shuar inhabiting two regions of Amazonian Ecuador: (1) the modestly market-integrated Upano Valley (UV) and (2) the more traditional Cross-Cutucú (CC) region. Kato-Katz fecal smears were examined for parasite presence and infection intensity. Factorial ANOVAs and post hoc simple effects analyses were performed by sex to compare infection intensity between regions and age categories (infant/child, juvenile/adolescent, adult). Significant age and regional differences in Ascaris lumbricoides and Trichuris trichiura infection were detected. Overall, infants/children and juveniles/adolescents displayed higher parasite loads than adults. CC females exhibited higher A. lumbricoides loads than UV females, while the opposite pattern was observed for T. trichiura infection in males. Regional infection patterns varied by sex and parasite species, perhaps due to MI-linked environmental and lifestyle changes. These results have public health implications for the identification of individuals at risk for infection and contribute to ongoing efforts to track changes and alleviate STH infection in indigenous populations undergoing MI.

  15. Two omega method for active thermocouple microscopy.

    PubMed

    Thiery, Laurent; Gavignet, Eric; Cretin, Bernard

    2009-03-01

    We present a contribution to a new mode of scanning thermal microscopy (SThM) based on the use of thermoelectric junction operating in ac active mode. This is the first alternative to 3omega operating mode of a resistive SThM probe for measuring thermophysical parameters of materials at micro- and nanoscale. Whereas a current at omega frequency generates by Joule effect a 2omega thermal oscillation along the wires, the junction thermoelectric voltage can be measured by means of a differential bridge scheme associated to a lock-in amplifier. A thermal model is presented that confirms measurements performed in different situations with different wire probes. Values of thermal contact conductance of different materials have been extracted and a comparison has been performed between this technique and the resistive 3omega mode.

  16. A Double-Blind Randomized Controlled Trial of Maternal Postpartum Deworming to Improve Infant Weight Gain in the Peruvian Amazon

    PubMed Central

    Casapía, Martín; Aguilar, Eder; Silva, Hermánn; Montresor, Antonio; Rahme, Elham; Fraser, William D.; Marquis, Grace S.; Vercruysse, Jozef; Allen, Lindsay H.; Blouin, Brittany; Razuri, Hugo; Pezo, Lidsky

    2017-01-01

    Background Nutritional interventions targeting the critical growth and development period before two years of age can have the greatest impact on health trajectories over the life course. Compelling evidence has demonstrated that interventions investing in maternal health in the first 1000 days of life are beneficial for both mothers and their children. One such potential intervention is deworming integrated into maternal postpartum care in areas where soil-transmitted helminth (STH) infections are endemic. Methodology/Principal Findings From February to August 2014, 1010 mother-infant pairs were recruited into a trial aimed at assessing the effectiveness of maternal postpartum deworming on infant and maternal health outcomes. Following delivery, mothers were randomly assigned to receive either single-dose 400 mg albendazole or placebo. Participants were followed-up at 1 and 6 months postpartum. There was no statistically significant difference in mean weight gain between infants in the experimental and control groups (mean difference: -0.02; 95% CI: -0.1, 0.08) at 6 months of age. Further, deworming had no effect on measured infant morbidity indicators. However, ad hoc analyses restricted to mothers who tested positive for STHs at baseline suggest that infants of mothers in the experimental group had greater mean length gain in cm (mean difference: 0.8; 95% CI: 0.1, 1.4) and length-for-age z-score (mean difference: 0.5; 95% CI: 0.2, 0.8) at 6 months of age. Conclusions/Significance In a study population composed of both STH-infected and uninfected mothers, maternal postpartum deworming was insufficient to impact infant growth and morbidity indicators up to 6 months postpartum. Among STH-infected mothers, however, important improvements in infant length gain and length-for-age were observed. The benefits of maternal postpartum deworming should be further investigated in study populations having higher overall prevalences and intensities of STH infections and, in particular, where whipworm and hookworm infections are of public health concern. Trial registration ClinicalTrials.gov (NCT01748929). PMID:28056024

  17. Use of Remote Sensing/Geographical Information Systems (RS/GIS) to Identify the Distributional Limits of Soil-Transmitted Helminths (STHs) and Their Association to Prevalence of Intestinal Infection in School-Age Children in Four Rural Communities in Boaco, Nicaragua

    NASA Technical Reports Server (NTRS)

    Moreno, Max J.; Al-Hamdan, Mohammad Z.; Parajon, David G.; Rickman, Douglas L.; Luvall, Jeffrey; Parajon, Laura C.; Martinez, Roberto A.; Estes, Sue

    2011-01-01

    STHs can infect all members of a population but school-age children living in poverty are at greater risk. Infection can be controlled with drug treatment, health education and sanitation. Helminth control programs often lack resources and reliable information to identify areas of highest risk to guide interventions and to monitor progress. Objectives: To use RS/GIS to identify the environmental variables that correlate with the ecology of STHs and with the prevalence of STH infections. Methods: Geo-referenced in situ prevalence data will be overlaid over an ecological map derived from the RS environmental data using ESRI s ArcGIS 9.3. Prevalence data and RS environmental data matching at the same geographical location will be analyzed for correlation and those RS environmental variables that better correlate with prevalence data will be included in a multivariate regression model. Temperature, vegetation, and distance to bodies of water will be inferred using data from the Moderate-Resolution Imaging Spectroradiometer (MODIS) onboard the Terra and Aqua satellites, and Thematic Mapper (TM) and Enhance Thematic Mapper Plus (ETM+) satellite sensors onboard Landsat 5 and Landsat 7 respectively. Elevation will be estimated with data from The Shuttle Radar Topography Mission (SRTM). Prevalence and intensity of infections will be determined by parasitological survey (Kato Katz) of children enrolled in rural schools in Boaco, Nicaragua, in the communities of El Roblar, Cumaica Norte, Malacatoya 1, and Malacatoya 2). Expected Results: Associations between RS environmental data and prevalence in situ data will be determined and their applications to public health will be discussed. Discussion/Conclusions: The use of RS/GIS data to predict the prevalence of STH infections could be useful for helminth control programs, providing improved geographical guidance of interventions while increasing cost-effectiveness. Learning Objectives: (1) To identify the RS environmental variables that can help predict the prevalence of STH infections. (2) To understand potential applications of RS/GIS to national helminth control programs. (3) To asses the applicability of RS/GIS to control STH infections.

  18. Modeling, simulation, and fabrication of a fully integrated, acid-stable, scalable solar-driven water-splitting system.

    PubMed

    Walczak, Karl; Chen, Yikai; Karp, Christoph; Beeman, Jeffrey W; Shaner, Matthew; Spurgeon, Joshua; Sharp, Ian D; Amashukeli, Xenia; West, William; Jin, Jian; Lewis, Nathan S; Xiang, Chengxiang

    2015-02-01

    A fully integrated solar-driven water-splitting system comprised of WO3 /FTO/p(+) n Si as the photoanode, Pt/TiO2 /Ti/n(+) p Si as the photocathode, and Nafion as the membrane separator, was simulated, assembled, operated in 1.0 M HClO4 , and evaluated for performance and safety characteristics under dual side illumination. A multi-physics model that accounted for the performance of the photoabsorbers and electrocatalysts, ion transport in the solution electrolyte, and gaseous product crossover was first used to define the optimal geometric design space for the system. The photoelectrodes and the membrane separators were then interconnected in a louvered design system configuration, for which the light-absorbing area and the solution-transport pathways were simultaneously optimized. The performance of the photocathode and the photoanode were separately evaluated in a traditional three-electrode photoelectrochemical cell configuration. The photocathode and photoanode were then assembled back-to-back in a tandem configuration to provide sufficient photovoltage to sustain solar-driven unassisted water-splitting. The current-voltage characteristics of the photoelectrodes showed that the low photocurrent density of the photoanode limited the overall solar-to-hydrogen (STH) conversion efficiency due to the large band gap of WO3 . A hydrogen-production rate of 0.17 mL hr(-1) and a STH conversion efficiency of 0.24 % was observed in a full cell configuration for >20 h with minimal product crossover in the fully operational, intrinsically safe, solar-driven water-splitting system. The solar-to-hydrogen conversion efficiency, ηSTH , calculated using the multiphysics numerical simulation was in excellent agreement with the experimental behavior of the system. The value of ηSTH was entirely limited by the performance of the photoelectrochemical assemblies employed in this study. The louvered design provides a robust platform for implementation of various types of photoelectrochemical assemblies, and can provide an approach to significantly higher solar conversion efficiencies as new and improved materials become available. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Geographical distribution of intestinal schistosomiasis and soil-transmitted helminthiasis and preventive chemotherapy strategies in Sierra Leone.

    PubMed

    Koroma, Joseph B; Peterson, Jen; Gbakima, Aiah A; Nylander, Francis E; Sahr, Foday; Soares Magalhães, Ricardo J; Zhang, Yaobi; Hodges, Mary H

    2010-11-23

    A national baseline mapping of schistosomiasis and soil-transmitted helminthiasis (STH) was performed in Sierra Leone. The aim was to provide necessary tools for the Ministry of Health and Sanitation to plan the intervention strategies in the national integrated control program on neglected tropical diseases according to the World Health Organization (WHO) guidelines for preventative chemotherapy (PCT) and for future monitoring and evaluation. 53 primary schools were randomly selected through a two-staged random sampling throughout the country. Approximately one hundred children aged 5-16 years of age were systematically selected from each school and their stool samples examined in a field laboratory. A total of 5,651 samples were examined. Data were analyzed with multivariable logistic regression models using model-based geostatistics. Spatial analysis predicted that S. mansoni infection was positively associated with population density and elevation and that there was a large cluster of high risk of S. mansoni infection (prevalence >70%) in the north and most of the eastern areas of the country, in line with the observed prevalence in Kono (63.8-78.3%), Koinadugu (21.6-82.1%), Kailahun (43.5-52.6%), Kenema (6.1-68.9%) and Tonkolili (0-57.3%). Hookworm infection was negatively associated with population density and land surface temperature, and was high across Sierra Leone with a large cluster of high infection risk (prevalence >70%) in the north-eastern part of the country. Remarkably low prevalence of Ascaris lumbricoides (7.2%) and Trichuris trichiura (3.3%) was recorded when compared with results published in the 1990s. Results justify PCT for schistosomiasis for school age children and at-risk adults every year in high-risk communities in five districts and every two years in moderate-risk communities in one more district. The high prevalence of STH, particularly hookworm, coupled with widespread anemia according to a national report in Sierra Leone, suggests all but one district justifying biannual PCT for STH for pre-school children, school age children, and at-risk adults. PCT for STH in the remaining district, Kono is justified annually.

  20. Controlling Neglected Tropical Diseases (NTDs) in Haiti: Implementation Strategies and Evidence of Their Success.

    PubMed

    Lemoine, Jean Frantz; Desormeaux, Anne Marie; Monestime, Franck; Fayette, Carl Renad; Desir, Luccene; Direny, Abdel Nasser; Carciunoiu, Sarah; Miller, Lior; Knipes, Alaine; Lammie, Patrick; Smith, Penelope; Stockton, Melissa; Trofimovich, Lily; Bhandari, Kalpana; Reithinger, Richard; Crowley, Kathryn; Ottesen, Eric; Baker, Margaret

    2016-10-01

    Lymphatic filariasis (LF) and soil-transmitted helminths (STH) have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA) program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti's neglected tropical disease (NTD) program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a "directly observed treatment" strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained- 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH-and the significant reduction in burden of infection- 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti's very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of "best practices" for NTD control but also are poised to help solve two of the most important future NTD challenges-how to maintain control of STH infections after the community-based LF "treatment platform" ceases and how to ensure appropriate morbidity management for patients currently suffering from lymphatic filarial disease.

  1. Transcriptome analysis of adipose tissues from two fat-tailed sheep breeds reveals key genes involved in fat deposition.

    PubMed

    Li, Baojun; Qiao, Liying; An, Lixia; Wang, Weiwei; Liu, Jianhua; Ren, Youshe; Pan, Yangyang; Jing, Jiongjie; Liu, Wenzhong

    2018-05-08

    The level of fat deposition in carcass is a crucial factor influencing meat quality. Guangling Large-Tailed (GLT) and Small-Tailed Han (STH) sheep are important local Chinese fat-tailed breeds that show distinct patterns of fat depots. To gain a better understanding of fat deposition, transcriptome profiles were determined by RNA-sequencing of perirenal, subcutaneous, and tail fat tissues from both the sheep breeds. The common highly expressed genes (co-genes) in all the six tissues, and the genes that were differentially expressed (DE genes) between these two breeds in the corresponding tissues were analyzed. Approximately 47 million clean reads were obtained for each sample, and a total of 17,267 genes were annotated. Of the 47 highly expressed co-genes, FABP4, ADIPOQ, FABP5, and CD36 were the four most highly transcribed genes among all the known genes related to adipose deposition. FHC, FHC-pseudogene, and ZC3H10 were also highly expressed genes and could, thus, have roles in fat deposition. A total of 2091, 4233, and 4131 DE genes were identified in the perirenal, subcutaneous, and tail fat tissues between the GLT and STH breeds, respectively. Gene Ontology (GO) analysis showed that some DE genes were associated with adipose metabolism. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis revealed that PPAR signaling pathway and ECM-receptor interaction were specifically enriched. Four genes, namely LOC101102230, PLTP, C1QTNF7, and OLR1 were up-regulated and two genes, SCD and UCP-1, were down-regulated in all the tested tissues of STH. Among the genes involved in ECM-receptor interaction, the genes encoding collagens, laminins, and integrins were quite different depending on the depots or the breeds. In STH, genes such as LAMB3, RELN, TNXB, and ITGA8, were identified to be up regulated and LAMB4 was observed to be down regulated. This study unravels the complex transcriptome profiles in sheep fat tissues, highlighting the candidate genes involved in fat deposition. Further studies are needed to investigate the roles of the candidate genes in fat deposition and in determining the meat quality of sheep.

  2. Schistosomiasis and Soil Transmitted Helminths Distribution in Benin: A Baseline Prevalence Survey in 30 Districts.

    PubMed

    Boko, Pelagie M; Ibikounle, Moudachirou; Onzo-Aboki, Ablawa; Tougoue, Jean-Jacques; Sissinto, Yollande; Batcho, Wilfrid; Kinde-Gazard, Dorothe; Kabore, Achille

    2016-01-01

    In 2013, Benin developed strategies to control neglected tropical diseases and one of the first step was the disease mapping of the entire country in order to identify endemic districts of schistosomiasis and soil transmitted helminths (STH). This study was carried out in 30 of the 77 districts of Benin. Of these 30 districts 22 were previously treated for Lymphatic Filariasis (LF) using the Ivermectin and Albendazole combination. In each district, five schools were selected and 50 children aged 8 to 14 years were sampled in each school, making a total of 250 children sampled in the district. The schools were selected mainly according to their proximity to lakes or any bodies of water that were likely to have been used by the children. Samples of faeces and urine were collected from each pupil. Urinary schistosomiasis was identified using the urine filtration technique while STH and intestinal schistosomiasis were identified through the Kato Katz method. Overall a total of 7500 pupils were surveyed across 150 schools with a gender ratio of 1:1. Hookworm was identified in all 30 districts with a prevalence ranging from 1.2% (95%CI: 0.0-2.5) to 60% (95%CI: 53.9-66.1). Ascaris lumbricoides was detected in 19 districts with a prevalence rate between 1% (95%CI: 0.0-2.2) and 39% (95%CI: 32.9-45.0). In addition to these common STH, Trichuris trichiura, Enterobius vermicularis and Strongyloides stercoralis were found at low prevalence. Only 16 districts were endemic to Schistosoma mansoni, while 29 districts were endemic to S. haematobium. The S. haematobium prevalence ranged from 0.8% (95% CI: 0.0-1.9) to 56% (95% CI: 50.2-62.5) while the prevalence of S. mansoni varied from 0.4% (95%CI: 0.0-1.2) to 46% (95% CI: 39.8-52.2). The 22 districts, where LF was successfully eliminated, still require mass drug administration (MDA) of albendazole indicating that school-based MDA would be needed even after LF elimination in districts co-endemic to LF and STH in Benin.

  3. Geographical Distribution of Intestinal Schistosomiasis and Soil-Transmitted Helminthiasis and Preventive Chemotherapy Strategies in Sierra Leone

    PubMed Central

    Koroma, Joseph B.; Peterson, Jen; Gbakima, Aiah A.; Nylander, Francis E.; Sahr, Foday; Soares Magalhães, Ricardo J.; Zhang, Yaobi; Hodges, Mary H.

    2010-01-01

    Background A national baseline mapping of schistosomiasis and soil-transmitted helminthiasis (STH) was performed in Sierra Leone. The aim was to provide necessary tools for the Ministry of Health and Sanitation to plan the intervention strategies in the national integrated control program on neglected tropical diseases according to the World Health Organization (WHO) guidelines for preventative chemotherapy (PCT) and for future monitoring and evaluation. Methodology/Principal Findings 53 primary schools were randomly selected through a two-staged random sampling throughout the country. Approximately one hundred children aged 5–16 years of age were systematically selected from each school and their stool samples examined in a field laboratory. A total of 5,651 samples were examined. Data were analyzed with multivariable logistic regression models using model-based geostatistics. Spatial analysis predicted that S. mansoni infection was positively associated with population density and elevation and that there was a large cluster of high risk of S. mansoni infection (prevalence >70%) in the north and most of the eastern areas of the country, in line with the observed prevalence in Kono (63.8–78.3%), Koinadugu (21.6–82.1%), Kailahun (43.5–52.6%), Kenema (6.1–68.9%) and Tonkolili (0–57.3%). Hookworm infection was negatively associated with population density and land surface temperature, and was high across Sierra Leone with a large cluster of high infection risk (prevalence >70%) in the north-eastern part of the country. Remarkably low prevalence of Ascaris lumbricoides (7.2%) and Trichuris trichiura (3.3%) was recorded when compared with results published in the 1990s. Conclusions/Significance Results justify PCT for schistosomiasis for school age children and at-risk adults every year in high-risk communities in five districts and every two years in moderate-risk communities in one more district. The high prevalence of STH, particularly hookworm, coupled with widespread anemia according to a national report in Sierra Leone, suggests all but one district justifying biannual PCT for STH for pre-school children, school age children, and at-risk adults. PCT for STH in the remaining district, Kono is justified annually. PMID:21124881

  4. Distribution of Classical and Nonclassical Virulence Genes in Enterotoxigenic Escherichia coli Isolates from Chilean Children and tRNA Gene Screening for Putative Insertion Sites for Genomic Islands▿†

    PubMed Central

    Del Canto, Felipe; Valenzuela, Patricio; Cantero, Lidia; Bronstein, Jonathan; Blanco, Jesús E.; Blanco, Jorge; Prado, Valeria; Levine, Myron; Nataro, James; Sommerfelt, Halvor; Vidal, Roberto

    2011-01-01

    Enterotoxigenic Escherichia coli (ETEC) is an important cause of diarrhea. Three adhesins (Tia, TibA, EtpA), an iron acquisition system (Irp1, Irp2, and FyuA), a GTPase (LeoA), and an autotransporter (EatA) are ETEC virulence-related proteins that, in contrast to the classical virulence factors (enterotoxins and fimbrial colonization factors) have not heretofore been targets in characterizing isolates from epidemiological studies. Here, we determined the occurrence of these nonclassical virulence genes in 103 ETEC isolates from Chilean children with diarrhea and described their association with O serogroups and classical virulence determinants. Because tia, leoA, irp2, and fyuA are harbored by pathogenicity islands inserted into the selC and asnT tRNA genes (tDNAs), we analyzed the regions flanking these loci. Ten additional tDNAs were also screened to identify hot spots for genetic insertions. Associations between the most frequent serogroups and classical colonization factor (CF)-toxin profiles included O6/LT-STh/CS1-CS3-CS21 (i.e., O6 serogroup, heat-labile [LT] and human heat-stable [STh] enterotoxins, and CFs CS1, -3 and -21), O6/LT-STh/CS2-CS3-CS21, and O104-O127/STh/CFAI-CS21. The eatA and etpA genes were detected in more than 70% of the collection, including diverse serogroups and virulence profiles. Sixteen percent of the ETEC strains were negative for classical and nonclassical adhesins, suggesting the presence of unknown determinants of adhesion. The leuX, thrW, and asnT tDNAs were disrupted in more than 65% of strains, suggesting they are hot spots for the insertion of mobile elements. Sequences similar to integrase genes were identified next to the thrW, asnT, pheV, and selC tDNAs. We propose that the eatA and etpA genes should be included in characterizations of ETEC isolates in future epidemiological studies to determine their prevalence in other geographical regions. Sequencing of tDNA-associated genetic insertions might identify new ETEC virulence determinants. PMID:21775541

  5. Comparison of individual and pooled stool samples for the assessment of intensity of Schistosoma mansoni and soil-transmitted helminth infections using the Kato-Katz technique.

    PubMed

    Kure, Ashenafi; Mekonnen, Zeleke; Dana, Daniel; Bajiro, Mitiku; Ayana, Mio; Vercruysse, Jozef; Levecke, Bruno

    2015-09-24

    Our group has recently provided a proof-of-principle for the examination of pooled stool samples using McMaster technique as a strategy for the rapid assessment of intensity of soil-transmitted helminth infections (STH, Ascaris lumbricoides, Trichuris trichiura and hookworm). In the present study we evaluated this pooling strategy for the assessment of intensity of both STH and Schistosoma mansoni infections using the Kato-Katz technique. A cross-sectional survey was conducted in 360 children aged 5-18 years from six schools in Jimma Zone (southwest Ethiopia). We performed faecal egg counts (FECs) in both individual and pooled samples (pools sizes of 5, 10 and 20) to estimate the number of eggs per gram of stool (EPG) using the Kato-Katz technique. We also assessed the time to screen both individual and pooled samples. Except for hookworms, there was a significant correlation (correlation coefficient = 0.53-0.95) between the mean of individual FECs and the FECs of pooled samples for A. lumbricoides, T. trichiura and S. mansoni, regardless of the pool size. Mean FEC were 2,596 EPG, 125 EPG, 47 EPG, and 41 EPG for A. lumbricoides, T. trichiura, S. mansoni and hookworm, respectively. There was no significant difference in FECs between the examination of individual and pooled stool samples, except for hookworms. For this STH, pools of 10 resulted in a significant underestimation of infection intensity. The total time to obtain individual FECs was 65 h 5 min. For pooled FECs, this was 19 h 12 min for pools of 5, 14 h 39 min for pools of 10 and 12 h 42 min for pools of 20. The results indicate that pooling of stool sample holds also promise as a rapid assessment of infections intensity for STH and S. mansoni using the Kato-Katz technique. In this setting, the time in the laboratory was reduced by 70 % when pools of 5 instead of individual stool samples were screened.

  6. Schistosomiasis and Soil Transmitted Helminths Distribution in Benin: A Baseline Prevalence Survey in 30 Districts

    PubMed Central

    Boko, Pelagie M.; Ibikounle, Moudachirou; Onzo-Aboki, Ablawa; Tougoue, Jean-Jacques; Sissinto, Yollande; Batcho, Wilfrid; Kinde-Gazard, Dorothe; Kabore, Achille

    2016-01-01

    In 2013, Benin developed strategies to control neglected tropical diseases and one of the first step was the disease mapping of the entire country in order to identify endemic districts of schistosomiasis and soil transmitted helminths (STH). This study was carried out in 30 of the 77 districts of Benin. Of these 30 districts 22 were previously treated for Lymphatic Filariasis (LF) using the Ivermectin and Albendazole combination. In each district, five schools were selected and 50 children aged 8 to 14 years were sampled in each school, making a total of 250 children sampled in the district. The schools were selected mainly according to their proximity to lakes or any bodies of water that were likely to have been used by the children. Samples of faeces and urine were collected from each pupil. Urinary schistosomiasis was identified using the urine filtration technique while STH and intestinal schistosomiasis were identified through the Kato Katz method. Overall a total of 7500 pupils were surveyed across 150 schools with a gender ratio of 1:1. Hookworm was identified in all 30 districts with a prevalence ranging from 1.2% (95%CI: 0.0–2.5) to 60% (95%CI: 53.9–66.1). Ascaris lumbricoides was detected in 19 districts with a prevalence rate between 1% (95%CI: 0.0–2.2) and 39% (95%CI: 32.9–45.0). In addition to these common STH, Trichuris trichiura, Enterobius vermicularis and Strongyloides stercoralis were found at low prevalence. Only 16 districts were endemic to Schistosoma mansoni, while 29 districts were endemic to S. haematobium. The S. haematobium prevalence ranged from 0.8% (95% CI: 0.0–1.9) to 56% (95% CI: 50.2–62.5) while the prevalence of S. mansoni varied from 0.4% (95%CI: 0.0–1.2) to 46% (95% CI: 39.8–52.2). The 22 districts, where LF was successfully eliminated, still require mass drug administration (MDA) of albendazole indicating that school-based MDA would be needed even after LF elimination in districts co-endemic to LF and STH in Benin. PMID:27643795

  7. Control of soil-transmitted helminthiasis in Myanmar: results of 7 years of deworming.

    PubMed

    Tun, Aung; Myat, Su Mon; Gabrielli, Albis Francesco; Montresor, Antonio

    2013-08-01

    After a baseline survey in 2003 which showed an overall parasitological prevalence of soil-transmitted helminths of 69.7% in school children (prevalence of ascariasis 48.5%, prevalence of trichuriasis 57.5% and prevalence of hookworm infection 6.5), a national deworming programme was established. After 7 years of implementation, it had resulted in a significant reduction of STH prevalence (prevalence of any STH 21%, prevalence of ascariasis 5.8%, prevalence of trichuriasis 18.6% and prevalence of hookworm infection 0.3%) as well as a reduction of the infections of moderate-heavy intensity from 18.5% at baseline to less than 7%. The results are encouraging and a reduction of the frequency of deworming can be envisaged in two of four ecological areas of Myanmar. © 2013 John Wiley & Sons Ltd.

  8. Can coverage of schistosomiasis and soil transmitted helminthiasis control programmes targeting school-aged children be improved? New approaches.

    PubMed

    Massa, K; Olsen, A; Sheshe, A; Ntakamulenga, R; Ndawi, B; Magnussen, P

    2009-11-01

    Control programmes generally use a school-based strategy of mass drug administration to reduce morbidity of schistosomiasis and soil-transmitted helminthiasis (STH) in school-aged populations. The success of school-based programmes depends on treatment coverage. The community-directed treatment (ComDT) approach has been implemented in the control of onchocerciasis and lymphatic filariasis in Africa and improves treatment coverage. This study compared the treatment coverage between the ComDT approach and the school-based treatment approach, where non-enrolled school-aged children were invited for treatment, in the control of schistosomiasis and STH among enrolled and non-enrolled school-aged children. Coverage during the first treatment round among enrolled children was similar for the two approaches (ComDT: 80.3% versus school: 82.1%, P=0.072). However, for the non-enrolled children the ComDT approach achieved a significantly higher coverage than the school-based approach (80.0 versus 59.2%, P<0.001). Similar treatment coverage levels were attained at the second treatment round. Again, equal levels of treatment coverage were found between the two approaches for the enrolled school-aged children, while the ComDT approach achieved a significantly higher coverage in the non-enrolled children. The results of this study showed that the ComDT approach can obtain significantly higher treatment coverage among the non-enrolled school-aged children compared to the school-based treatment approach for the control of schistosomiasis and STH.

  9. A call to strengthen the global strategy for schistosomiasis and soil-transmitted helminthiasis: the time is now

    PubMed Central

    Lo, Nathan C.; Addiss, David G.; Hotez, Peter J.; King, Charles H.; Stothard, J. Russell; Evans, Darin S.; Colley, Daniel G.; Lin, William; Coulibaly, Jean T.; Bustinduy, Amaya L.; Raso, Giovanna; Bendavid, Eran; Bogoch, Isaac I.; Fenwick, Alan; Savioli, Lorenzo; Molyneux, David; Utzinger, Jürg; Andrews, Jason R.

    2016-01-01

    Summary In 2001, the World Health Assembly (WHA) passed the landmark WHA 54.19 resolution for global scale up of mass administration of anthelminthic drugs for morbidity control of schistosomiasis and soil-transmitted helminthiasis (STH), which affect over 1.5 billion of the world's poorest people. Since then, over a decade of research and experience has yielded critical new knowledge on the control and elimination of these helminthiases. However, the global strategy has remained largely unchanged since the original 2001 WHA resolution and associated World Health Organization (WHO) guidelines on preventive chemotherapy. Here, we highlight recent advances that, taken together, support a call to revise the global strategy and guidelines for preventive chemotherapy and complementary interventions against schistosomiasis and STH. This includes the development of guidance that is specific to goals of “morbidity control” and “elimination of transmission.” We quantify the result of forgoing this opportunity by computing the yearly disease burden, mortality, and lost economic productivity associated with maintaining status quo. Without change, we estimate that the population of sub-Saharan Africa will likely lose 2.3 million disability-adjusted life years and US$3.5 billion of economic productivity every year, which is comparable to recent acute epidemics, including the 2014 Ebola and 2015 Zika epidemics. We propose that the time is now to strengthen the global strategy to address the substantial disease burden of schistosomiasis and STH. PMID:27914852

  10. Radiolabeled Escherichia coli heat-stable enterotoxin analogs for in vivo imaging of colorectal cancer

    NASA Astrophysics Data System (ADS)

    Giblin, M. F.; Sieckman, G. L.; Owen, N. K.; Hoffman, T. J.; Forte, L. R.; Volkert, W. A.

    2005-12-01

    The human Escherichia coli heat-stable enterotoxin (STh, amino acid sequence N1SSNYCCELCCNPACTGCY19) binds specifically to the guanylate cyclase C (GC-C) receptor, which is present in high density on the apical surface of normal intestinal epithelial cells as well as on the surface of human colon cancer cells. In the current study, two STh analogs were synthesized and evaluated in vitro and in vivo. Both analogs shared identical 6-19 core sequences, and had N-terminal pendant DOTA moieties. The analogs differed in the identity of a 6 amino acid peptide sequence intervening between DOTA and the 6-19 core. In one analog, the peptide was an RGD-containing sequence found in human fibronectin (GRGDSP), while in the other this peptide sequence was randomly scrambled (GRDSGP). The results indicated that the presence of the human fibronectin sequence in the hybrid peptide did not affect tumor localization in vivo.

  11. Investigating the Effectiveness of Current and Modified World Health Organization Guidelines for the Control of Soil-Transmitted Helminth Infections.

    PubMed

    Farrell, Sam H; Coffeng, Luc E; Truscott, James E; Werkman, Marleen; Toor, Jaspreet; de Vlas, Sake J; Anderson, Roy M

    2018-06-01

    Considerable efforts have been made to better understand the effectiveness of large-scale preventive chemotherapy therapy for the control of morbidity caused by infection with soil-transmitted helminths (STHs): Ascaris lumbricoides, Trichuris trichiura, and the 2 hookworm species, Necator americanus and Ancylostoma duodenale. Current World Health Organization (WHO) guidelines for STH control include mass drug administration (MDA) programs based on prevalence measurements, aiming at reducing morbidity in pre-school-aged children (pre-SAC) and school-aged children (SAC) by lowering the prevalence of moderate- to heavy-intensity infections to <1%. We project the likely impact of following the current WHO guidelines and assess whether the WHO morbidity goals will be achieved across a range of transmission settings. We also investigate modifications that could be made to the current WHO treatment guidelines, and project their potential impacts in achieving morbidity and transmission control. While the standard guidelines are sufficient at low transmission levels, community-wide treatment (ie, involving pre-SAC, SAC, and adults) is essential if WHO morbidity goals are to be met in moderate- to high-transmission settings. Moreover, removing the recommendation of decreasing the treatment frequency at midline (5-6 years after the start of MDA) further improves the likelihood of achieving morbidity control in SAC. We meld analyses based on 2 mathematical models of parasite transmission and control by MDA for the dominant STH species, to generate a unified treatment approach applicable across all settings, regardless of which STH infection is most common. We recommend clearly defined changes to the current WHO guidelines.

  12. Prevalence and clustering of soil-transmitted helminth infections in a tribal area in southern India.

    PubMed

    Kaliappan, Saravanakumar Puthupalayam; George, Santosh; Francis, Mark Rohit; Kattula, Deepthi; Sarkar, Rajiv; Minz, Shantidani; Mohan, Venkata Raghava; George, Kuryan; Roy, Sheela; Ajjampur, Sitara Swarna Rao; Muliyil, Jayaprakash; Kang, Gagandeep

    2013-12-01

    To estimate the prevalence, spatial patterns and clustering in the distribution of soil-transmitted helminth (STH) infections, and factors associated with hookworm infections in a tribal population in Tamil Nadu, India. Cross-sectional study with one-stage cluster sampling of 22 clusters. Demographic and risk factor data and stool samples for microscopic ova/cysts examination were collected from 1237 participants. Geographical information systems mapping assessed spatial patterns of infection. The overall prevalence of STH was 39% (95% CI 36%–42%), with hookworm 38% (95% CI 35–41%) and Ascaris lumbricoides 1.5% (95% CI 0.8–2.2%). No Trichuris trichiura infection was detected. People involved in farming had higher odds of hookworm infection (1.68, 95% CI 1.31–2.17, P < 0.001). In the multiple logistic regression, adults (2.31, 95% CI 1.80–2.96, P < 0.001), people with pet cats (1.55, 95% CI 1.10–2.18, P = 0.011) and people who did not wash their hands with soap after defecation (1.84, 95% CI 1.27–2.67, P = 0.001) had higher odds of hookworm infection, but gender and poor usage of foot wear did not significantly increase risk. Cluster analysis, based on design effect calculation, did not show any clustering of cases among the study population; however, spatial scan statistic detected a significant cluster for hookworm infections in one village. Multiple approaches including health education, improving the existing sanitary practices and regular preventive chemotherapy are needed to control the burden of STH in similar endemic areas.

  13. Histopathology of valves in infective endocarditis, diagnostic criteria and treatment considerations.

    PubMed

    Brandão, Tatiana J D; Januario-da-Silva, Carolina A; Correia, Marcelo G; Zappa, Monica; Abrantes, Jaime A; Dantas, Angela M R; Golebiovski, Wilma; Barbosa, Giovanna Ianini F; Weksler, Clara; Lamas, Cristiane C

    2017-04-01

    Infective endocarditis (IE) is a severe disease. Pathogen isolation is fundamental so as to treat effectively and reduce morbidity and mortality. Blood and valve culture and histopathology (HP) are routinely employed for this purpose. Valve HP is the gold standard for diagnosis. To determine the sensitivity and specificity of clinical criteria for IE (the modified Duke and the St Thomas' minor modifications, STH) of blood and valve culture compared to valve HP, and to evaluate antibiotic treatment duration. Prospective case series of patients, from 2006 to 2014 with surgically treated IE. Statistical analysis was done by the R software. There were 136 clinically definite episodes of IE in 133 patients. Mean age ± SD was 43 ± 15.6 years and IE was left sided in 81.6 %. HP was definite in 96 valves examined, which were used as gold standard. Sensitivity of blood culture was 61 % (CI 0.51, 0.71) and of valve culture 15 % (CI 0.07, 0.26). The modified Duke criteria were 65 % (CI 0.55, 0.75) sensitive and 33 % specific, while the STH's sensitivity was 72 % (CI 0.61, 0.80) with similar specificity. In multivariate analysis and logistic regression, the only variable with statistical significance was duration of antibiotic therapy postoperatively. Valve HP had high sensitivity and valve culture low sensitivity in the diagnosis of IE. The STH's criteria were more sensitive than the modified Duke criteria. Valve HP should guide duration of postoperative antibiotic treatment.

  14. Successful Control of Soil-Transmitted Helminthiasis in School Age Children in Burkina Faso and an Example of Community-Based Assessment via Lymphatic Filariasis Transmission Assessment Survey.

    PubMed

    Drabo, François; Ouedraogo, Hamado; Bougma, Roland; Bougouma, Clarisse; Bamba, Issouf; Zongo, Dramane; Bagayan, Mohamed; Barrett, Laura; Yago-Wienne, Fanny; Palmer, Stephanie; Chu, Brian; Toubali, Emily; Zhang, Yaobi

    2016-05-01

    Burkina Faso is endemic with soil-transmitted helminth infections. Over a decade of preventive chemotherapy has been implemented through annual lymphatic filariasis (LF) mass drug administration (MDA) for population aged five years and over, biennial treatment of school age children with albendazole together with schistosomiasis MDA and biannual treatment of pre-school age children through Child Health Days. Assessments were conducted to evaluate the current situation and to determine the treatment strategy for the future. A cross-sectional assessment was conducted in 22 sentinel sites across the country in 2013. In total, 3,514 school age children (1,748 boys and 1,766 girls) were examined by the Kato-Katz method. Overall, soil-transmitted helminth prevalence was 1.3% (95% CI: 1.0-1.8%) in children examined. Hookworm was the main species detected, with prevalence of 1.2% (95% CI: 0.9-1.6%) and mean egg counts of 2.1 epg (95% CI: 0-4.2 epg). Among regions, the Centre Ouest region had the highest hookworm prevalence of 3.4% (95% CI: 1.9-6.1%) and mean egg counts of 14.9 epg (95% CI: 3.3-26.6 epg). A separate assessment was conducted in the Centre Nord region in 2014 using community-based cluster survey design during an LF transmission assessment survey (TAS). In this assessment, 351 children aged 6-7 years and 345 children aged 10-14 years were examined, with two cases (0.6% (95% CI: 0.2-2.1%)) and seven cases (2.0% (95% CI: 1.0-4.1%)) of hookworm infection was identified respectively. The results using both age groups categorized the region to be 2% to <10% in STH prevalence according to the pre-defined cut-off values. Through large-scale preventive chemotherapy, Burkina Faso has effectively controlled STH in school age children in the country. Research should be conducted on future strategies to consolidate the gain and to interrupt STH transmission in Burkina Faso. It is also demonstrated that LF TAS provides one feasible and efficient platform to assess the STH situation for post LF MDA decision making.

  15. Geographical distribution of soil transmitted helminths and the effects of community type in South Asia and South East Asia - A systematic review.

    PubMed

    Silver, Zachary A; Kaliappan, Saravanakumar P; Samuel, Prasanna; Venugopal, Srinivasan; Kang, Gagandeep; Sarkar, Rajiv; Ajjampur, Sitara S R

    2018-01-01

    Soil-transmitted helminth (STH) infections are among the most prevalent neglected tropical diseases (NTD) worldwide. Since the publication of the WHO road map to combat NTD in 2012, there has been a renewed commitment to control STH. In this study, we analysed the geographical distribution and effect of community type on prevalence of hookworm, Trichuris and Ascaris in south Asia and south east Asia. We conducted a systematic review of open-access literature published in PubMed Central and the Global Atlas of Helminth Infection. A total of 4182 articles were available and after applying selection criteria, 174 studies from the region were retained for analysis. Ascaris was the commonest STH identified with an overall prevalence of 18% (95% CI, 14-23%) followed by Trichuris (14%, 9-19%) and hookworm (12%, 9-15%). Hookworm prevalence was highest in Laos, Vietnam and Cambodia. We found a geographical overlap in countries with high prevalence rates for Trichuris and Ascaris (Malaysia, Philippines, Myanmar, Vietnam and Bangladesh). When the effect of community type was examined, prevalence rates of hookworm was comparable in rural (19%, 14-24%) and tribal communities (14%, 10-19%). Tribal communities, however, showed higher prevalence of Trichuris (38%, 18-63%) and Ascaris (32%, 23-43%) than rural communities (13%, 9-20% and 14%, 9-20% respectively). Considerable between and within country heterogeneity in the distribution of STH (I2 >90%) was also noted. When available data from school aged children (SAC) were analysed, prevalence of Ascaris (25% 16-31%) and Trichuris (22%, 14-34%) were higher than among the general population while that of hookworm (10%, 7-16%) was comparable. Our analysis showed significant variation in prevalence rates between and within countries in the region. Highlighting the importance of community type in prevalence and species mix, we showed that tribal and rural communities had higher hookworm infections than urban communities and for ascariasis and trichuriasis, tribal populations had higher levels of infection than rural populations. We also found a higher prevalence of ascariasis and trichuriasis in SAC compared to the general population but comparable levels of hookworm infections. These key findings need to be taken into account in planning future MDA and other interventions.

  16. The Fit for School Health Outcome Study - a longitudinal survey to assess health impacts of an integrated school health programme in the Philippines.

    PubMed

    Monse, Bella; Benzian, Habib; Naliponguit, Ella; Belizario, Vincente; Schratz, Alexander; van Palenstein Helderman, Wim

    2013-03-21

    Child health in many low- and middle-income countries lags behind international goals and affects children's education, well-being, and general development. Large-scale school health programmes can be effective in reducing preventable diseases through cost-effective interventions. This paper outlines the baseline and 1-year results of a longitudinal health study assessing the impact of the Fit for School Programme in the Philippines. A longitudinal 4-year cohort study was conducted in the province of Camiguin, Mindanao (experimental group); an external concurrent control group was studied in Gingoog, Mindanao. The study has three experimental groups: group 1-daily handwashing with soap, daily brushing with fluoride toothpaste, biannual deworming with 400 mg albendazole (Essential Health Care Program [EHCP]); group 2-EHCP plus twice-a-year access to school-based Oral Urgent Treatment; group 3-EHCP plus weekly toothbrushing with high-fluoride concentration gel. A non-concurrent internal control group was also included. Baseline data on anthropometric indicators to calculate body mass index (BMI), soil-transmitted helminths (STH) infection in stool samples, and dental caries were collected in August 2009 and August 2010. Data were analysed to assess validity of the control group design, baseline, and 1-year results. In the cohort study, 412 children were examined at baseline and 341 1 year after intervention. The baseline results were in line with national averages for STH infection, BMI, and dental caries in group 1 and the control groups. Children lost to follow-up had similar baseline characteristics in the experimental and control groups. After 1 year, group 1 showed a significantly higher increase in mean BMI and lower prevalence of moderate to heavy STH infection than the external concurrent control group. The increases in caries and dental infections were reduced but not statistically significant. The results for groups 2 and 3 will be reported separately. Despite the short 1-year observation period, the study found a reduction in the prevalence of moderate to heavy STH infections, a rise in mean BMI, and a (statistically non-significant) reduction in dental caries and infections. The study design proved functional in actual field conditions. Critical aspects affecting the validity of cohort studies are analysed and discussed. DRKS00003431 WHO Universal Trial Number U1111-1126-0718.

  17. Impact of Long-Term Treatment with Ivermectin on the Prevalence and Intensity of Soil-Transmitted Helminth Infections

    PubMed Central

    Moncayo, Ana Lucia; Vaca, Maritza; Amorim, Leila; Rodriguez, Alejandro; Erazo, Silvia; Oviedo, Gisela; Quinzo, Isabel; Padilla, Margarita; Chico, Martha; Lovato, Raquel; Gomez, Eduardo; Barreto, Mauricio L.; Cooper, Philip J.

    2008-01-01

    Background Control of soil-transmitted helminth (STH) infections relies on the periodic and long-term administration of anthelmintic drugs to high-risk groups, particularly school-age children living in endemic areas. There is limited data on the effectiveness of long-term periodic anthelmintic treatment on the prevalence of STHs, particularly from operational programmes. The current study investigated the impact of 15 to 17 years of treatment with the broad-spectrum anthelmintic ivermectin, used for the control of onchocerciasis, on STH prevalence and intensity in school-age and pre-school children. Methods and Findings A cross-sectional study was conducted in communities that had received annual or twice-annual ivermectin treatments and geographically adjacent communities that had not received treatment in two districts of Esmeraldas Province in Ecuador. Stool samples were collected from school-age children and examined for STH infection using the Kato-Katz and formol-ether concentration methods. Samples were collected also from pre-school children and examined by the formol-ether concentration method. Data on risk factors for STH infection were collected by parental questionnaire. We sampled a total of 3,705 school-age children (6–16 years) from 31 treated and 27 non-treated communities, and 1,701 pre-school children aged 0–5 years from 18 treated and 18 non-treated communities. Among school-age children, ivermectin treatment had significant effects on the prevalence (adjusted OR =  0.06, 95% CI 0.03–0.14) and intensity of Trichuris trichiura infection (adjusted RR = 0.28, 95% CI 0.11–0.70), but appeared to have no impact on Ascaris lumbricoides or hookworm infection. Reduced prevalence and intensities of T. trichiura infection were observed among children not eligible to receive ivermectina, providing some evidence of reduced transmission of T. trichiura infection in communities receiving mass ivermectin treatments. Conclusion Annual and twice-annual treatments with ivermectin over a period of up to 17 years may have had a significant impact on T. trichiura infection. The present data indicate that the long-term control of onchocerciasis with ivermectin may provide additional health benefits by reducing infections with trichuriasis. The addition of a second anthelmintic drug such as albendazole may be useful for a long-term effect on A. lumbricoides infection. PMID:18820741

  18. Malaria, schistosomiasis and soil transmitted helminth burden and their correlation with anemia in children attending primary schools in Kinshasa, Democratic Republic of Congo.

    PubMed

    Matangila, Junior R; Doua, Joachim Yorokpa; Linsuke, Sylvie; Madinga, Joule; Inocêncio da Luz, Raquel; Van Geertruyden, Jean-Pierre; Lutumba, Pascal

    2014-01-01

    Anaemia reduces cognitive potential in school children, retards their growth and predisposes them to other diseases. As there is a paucity of data on the current burden of P. falciparum, S. mansoni and soil transmitted helminths (STH) infections and their correlation with schoolchildren's anemia in the Democratic Republic of Congo (DRC), we collect these data. This study reports baseline data collected from a randomized controlled trial investigating the impact of IPT with SP and SP-PQ on anemia and malaria morbidity in Congolese schoolchildren (Trial registration: NCT01722539; PACTR201211000449323). S. mansoni and STH infections were assessed using kato-katz technique. Malaria infection and hemoglobin concentration were assessed using Blood smear and Hemocontrol device, respectively. A total of 616 primary schoolchildren from 4 to 13 years old were enrolled in the study. The prevalence of Plasmodium spp. infection was 18.5% (95%CI:15.6-21.9). Amongst those infected, 24 (21%), 40 (35.1%), 40 (35.1%), 10 (8.8%), had light, moderate, heavy, very high malaria parasite density, respectively. Above 9 years of age (p = 0.02), male and history of fever (p = 0.04) were both associated with malaria infection. The overall prevalence of S. mansoni infection was 6.4% (95%CI:4.4-9.1). Girls were associated with S. mansoni infection (p = 0.04). T. trichiura was the most prevalent STH infection (26.3%), followed by A. lumbricoides (20.1%). Co-infection with malaria-S. mansoni and malaria-STH was, respectively, 1.5% (CI95%:0.7-3.3) and 6.4% (CI95% 4.4-9.1). The prevalence of anemia was found to be 41.6% (95%CI:37.7-45.6) and anemia was strongly related with Plasmodium ssp infection (aOR:4.1; CI95%:2.6-6.5;p<0.001) and S. mansoni infection (aOR:3.3;CI95%:1.4-7.8;p<0.01). Malaria and S. mansoni infection were strongly associated with high prevalence of anemia in schoolchildren. Therefore, specific school-based interventions, such as intermittent preventive treatment or prophylaxis, LLITN distribution, anthelminthic mass treatment and micronutrient supplementation are needed to improve school children's health.

  19. Detailed Aggregate Resources Study, Dry Lake Valley, Nevada.

    DTIC Science & Technology

    1981-05-29

    LOCAL SAND SOURCES IGENERALLY CYLINDERS. DRYING SHRINKAGE I COLLECTED WITHIN A FEW MILES OF CORRESPONDING LEDGE-ROCK SOURCES) SUPPLIED FINE MENS...COMPRESSIVE AND TENSILE STh LEDGE-ROCK SOURCES SUPPLIED COARSE AGGREGATES; LOCAL SAND SOURCES IGENERALLY CYLINDERS. DRYING SHRINKAGE COLLECTED WITHIN A FEW

  20. Heritability and factors associated with number of harness race starts in the Spanish Trotter horse population.

    PubMed

    Solé, M; Valera, M; Gómez, M D; Sölkner, J; Molina, A; Mészáros, G

    2017-05-01

    Longevity/durability is a relevant trait in racehorses. Genetic analysis and knowledge of factors that influence number of harness race starts would be advantageous for both horse welfare and the equine industry. To perform a genetic analysis on harness racing using number of races as a measure of longevity/durability and to identify factors associated with career length in Spanish Trotter Horses (STH). Longitudinal study. Performance data (n = 331,970) on the STH population for harness racing at national level between 1990 and 2014 were used. A grouped data model was fitted to assess factors influencing the risk of ending harness racing career and to estimate the heritability and breeding values for total number of harness races starts as an indicator of horses' longevity and durability. The model included sex, age at first race and first start earnings as time-independent effects, and the calendar year, driver, trainer, racetrack category and season of competition as time-dependent effects. Across the whole dataset, the average number of harness races horses achieved in Spain was 54.7 races, and this was associated with the horses' sex, age at first race and first start earnings, calendar year, driver, racetrack category, and season. The heritability estimated (0.17 ± 0.01) for number of harness race starts indicates that a beneficial response to direct genetic selection can be expected. Data on horses' health status were not available. Horses' total number of harness race starts is a promising tool for genetic analysis and the evaluation of racing longevity and durability. The estimated heritability provides evidence to support the application of genetic selection of total career number of races to improve longevity/durability of STH. © 2016 EVJ Ltd.

  1. Update on the Mapping of Prevalence and Intensity of Infection for Soil-Transmitted Helminth Infections in Latin America and the Caribbean: A Call for Action

    PubMed Central

    Saboyá, Martha Idalí; Catalá, Laura; Nicholls, Rubén Santiago; Ault, Steven Kenyon

    2013-01-01

    It is estimated that in Latin America and the Caribbean (LAC) at least 13.9 million preschool age and 35.4 million school age children are at risk of infections by soil-transmitted helminths (STH): Ascaris lumbricoides, Trichuris trichiura and hookworms (Necator americanus and Ancylostoma duodenale). Although infections caused by this group of parasites are associated with chronic deleterious effects on nutrition and growth, iron and vitamin A status and cognitive development in children, few countries in the LAC Region have implemented nationwide surveys on prevalence and intensity of infection. The aim of this study was to identify gaps on the mapping of prevalence and intensity of STH infections based on data published between 2000 and 2010 in LAC, and to call for including mapping as part of action plans against these infections. A total of 335 published data points for STH prevalence were found for 18 countries (11.9% data points for preschool age children, 56.7% for school age children and 31.3% for children from 1 to 14 years of age). We found that 62.7% of data points showed prevalence levels above 20%. Data on the intensity of infection were found for seven countries. The analysis also highlights that there is still an important lack of data on prevalence and intensity of infection to determine the burden of disease based on epidemiological surveys, particularly among preschool age children. This situation is a challenge for LAC given that adequate planning of interventions such as deworming requires information on prevalence to determine the frequency of needed anthelmintic drug administration and to conduct monitoring and evaluation of progress in drug coverage. PMID:24069476

  2. Prevalence and risk factors for giardiasis and soil-transmitted helminthiasis in three municipalities of Southeastern Minas Gerais State, Brazil: risk factors for giardiasis and soil-transmitted helminthiasis.

    PubMed

    Pinheiro, Izabella de Oliveira; de Castro, Milton Ferreira; Mitterofhe, Adalberto; Pires, Flávia Alves Condé; Abramo, Clarice; Ribeiro, Luiz Cláudio; Tibiriçá, Sandra Helena Cerrato; Coimbra, Elaine Soares

    2011-05-01

    Giardiasis and soil-transmitted helminthiasis (STH) are parasitic diseases that are among the major health concerns observed in economically disadvantaged populations of developing countries, and have clear social and environmental bases. In Brazil, there is a lack of epidemiologic data concerning these infections in the study area, whose inhabitants have plenty of access to health care services, including good dwelling and adequate sanitary conditions. In this survey we investigated the risk factors for giardiasis and STH in three municipalities with good sanitation, situated in Minas Gerais state, Brazil. A cross-sectional survey was conducted in the municipalities of Piau, Coronel Pacheco and Goianá, in both urban and rural areas. The fieldwork consisted of a questionnaire and the examination of 2,367 stool samples using the Hoffmann, Pons and Janer method. Of all individuals from the population sample, 6.1% were found infected with the parasitic diseases included in this work. Hookworm infection was the most prevalent disease, followed by giardiasis, trichuriasis and ascariasis. Infection was more prevalent in males (8.1%, p < 0.001; odds ratio [OR] = 1.975) and in individuals living in rural areas (8.6%, p = 0.003; OR = 1.693). Multivariate analysis showed that variables such as inadequate sewage discharge (p < 0.001), drinking of unsafe water (p < 0.001), lack of sanitary infrastructure (p = 0.015), and host sex (p < 0.001) were the risk factors more strongly associated with infection status (95% confidence interval [CI]). In this study we demonstrate that giardiasis and STH still persist, infecting people who have good housing conditions and free access to public health care and education.

  3. Prevalence soil transmitted helminthiasis and malaria co-infection among pregnant women and risk factors in Gilgel Gibe Dam area, southwest Ethiopia.

    PubMed

    Getachew, Million; Tafess, Ketema; Zeynudin, Ahmed; Yewhalaw, Delenesaw

    2013-07-09

    Malaria and Soil Transmitted Helminthiasis (STH) are co-endemic and major public health problems in Ethiopia. The aim of the study was to assess the prevalence of malaria and STHs co-infection and to determine the association risk factors. A cross-sectional community based study was conducted on 388 pregnant women living in three districts around Gilgel Gibe Dam area, southwestern Ethiopia. Socio-demographic and socio-economic data, single stool sample and blood sample were collected from each participant. The prevalence of STH and malaria was 159 (41%) and 45 (11.6%), respectively and the prevalence of STHs/malaria co-infection was 30 (7.7%). Hookworm was the most prevalent 114 (29.4%) soil transmitted helminthiasis infection followed by Ascaris lumbricoides (A. lumbricoides) 58 (15%) and Trichuris trichiura (T. trichiura) 13 (3.4%). Habit of eating soil (Adjusted Odds Ratio (AOR) = 4.64, 95% CI: 1.50-14.36, P=0.008), presence of stagnant water near study participants' house (AOR=2.99, 95% CI: 1.28-6.99, P=0.012) and habit of using human feces as a fertilizer (AOR= 5.34, 95% CI: 1.99-14.28, P<0.001) were found to be significantly associated with malaria and STH co-infection among the pregnant women. Hookworm parasitic load was positively correlated with malaria parasitic load (r = 0.299, P<0.001) while A. lumbricoides parasitic load was negatively correlated with malaria parasitic load (r = -0.095, P<0.001). Intestinal parasite and/or malaria co-infection is a health problem among pregnant women living around Gilgel Gibe dam area. Therefore, intervention including improving sanitation, removing stagnant water, and health education to the pregnant women should be given.

  4. Investigating the Effectiveness of Current and Modified World Health Organization Guidelines for the Control of Soil-Transmitted Helminth Infections

    PubMed Central

    Farrell, Sam H; Coffeng, Luc E; Truscott, James E; Werkman, Marleen; Toor, Jaspreet; de Vlas, Sake J; Anderson, Roy M

    2018-01-01

    Abstract Background Considerable efforts have been made to better understand the effectiveness of large-scale preventive chemotherapy therapy for the control of morbidity caused by infection with soil-transmitted helminths (STHs): Ascaris lumbricoides, Trichuris trichiura, and the 2 hookworm species, Necator americanus and Ancylostoma duodenale. Current World Health Organization (WHO) guidelines for STH control include mass drug administration (MDA) programs based on prevalence measurements, aiming at reducing morbidity in pre–school-aged children (pre-SAC) and school-aged children (SAC) by lowering the prevalence of moderate- to heavy-intensity infections to <1%. Methods We project the likely impact of following the current WHO guidelines and assess whether the WHO morbidity goals will be achieved across a range of transmission settings. We also investigate modifications that could be made to the current WHO treatment guidelines, and project their potential impacts in achieving morbidity and transmission control. Results While the standard guidelines are sufficient at low transmission levels, community-wide treatment (ie, involving pre-SAC, SAC, and adults) is essential if WHO morbidity goals are to be met in moderate- to high-transmission settings. Moreover, removing the recommendation of decreasing the treatment frequency at midline (5–6 years after the start of MDA) further improves the likelihood of achieving morbidity control in SAC. Conclusions We meld analyses based on 2 mathematical models of parasite transmission and control by MDA for the dominant STH species, to generate a unified treatment approach applicable across all settings, regardless of which STH infection is most common. We recommend clearly defined changes to the current WHO guidelines. PMID:29860285

  5. Haplotypes and gene expression implicate the MAPT region for Parkinson disease

    PubMed Central

    Tobin, J.E.; Latourelle, J.C.; Lew, M.F.; Klein, C.; Suchowersky, O.; Shill, H.A.; Golbe, L.I.; Mark, M.H.; Growdon, J.H.; Wooten, G.F.; Racette, B.A.; Perlmutter, J.S.; Watts, R.; Guttman, M.; Baker, K.B.; Goldwurm, S.; Pezzoli, G.; Singer, C.; Saint-Hilaire, M.H.; Hendricks, A.E.; Williamson, S.; Nagle, M.W.; Wilk, J.B.; Massood, T.; Laramie, J.M.; DeStefano, A.L.; Litvan, I.; Nicholson, G.; Corbett, A.; Isaacson, S.; Burn, D.J.; Chinnery, P.F.; Pramstaller, P.P.; Sherman, S.; Al-hinti, J.; Drasby, E.; Nance, M.; Moller, A.T.; Ostergaard, K.; Roxburgh, R.; Snow, B.; Slevin, J.T.; Cambi, F.; Gusella, J.F.; Myers, R.H.

    2009-01-01

    Background Microtubule-associated protein tau (MAPT) has been associated with several neurodegenerative disorders including forms of parkinsonism and Parkinson disease (PD). We evaluated the association of the MAPT region with PD in a large cohort of familial PD cases recruited by the GenePD Study. In addition, postmortem brain samples from patients with PD and neurologically normal controls were used to evaluate whether the expression of the 3-repeat and 4-repeat isoforms of MAPT, and neighboring genes Saitohin (STH) and KIAA1267, are altered in PD cerebellum. Methods Twenty-one single-nucleotide polymorphisms (SNPs) in the region of MAPT on chromosome 17q21 were genotyped in the GenePD Study. Single SNPs and haplotypes, including the H1 haplotype, were evaluated for association to PD. Relative quantification of gene expression was performed using real-time RT-PCR. Results After adjusting for multiple comparisons, SNP rs1800547 was significantly associated with PD affection. While the H1 haplotype was associated with a significantly increased risk for PD, a novel H1 subhaplotype was identified that predicted a greater increased risk for PD. The expression of 4-repeat MAPT, STH, and KIAA1267 was significantly increased in PD brains relative to controls. No difference in expression was observed for 3-repeat MAPT. Conclusions This study supports a role for MAPT in the pathogenesis of familial and idiopathic Parkinson disease (PD). Interestingly, the results of the gene expression studies suggest that other genes in the vicinity of MAPT, specifically STH and KIAA1267, may also have a role in PD and suggest complex effects for the genes in this region on PD risk. PMID:18509094

  6. Prevalence Soil Transmitted Helminthiasis and malaria co-infection among pregnant women and risk factors in Gilgel Gibe dam Area, Southwest Ethiopia

    PubMed Central

    2013-01-01

    Background Malaria and Soil Transmitted Helminthiasis (STH) are co-endemic and major public health problems in Ethiopia. The aim of the study was to assess the prevalence of malaria and STHs co-infection and to determine the association risk factors. Methods A cross-sectional community based study was conducted on 388 pregnant women living in three districts around Gilgel Gibe Dam area, southwestern Ethiopia. Socio-demographic and socio-economic data, single stool sample and blood sample were collected from each participant. Results The prevalence of STH and malaria was 159 (41%) and 45 (11.6%), respectively and the prevalence of STHs/malaria co-infection was 30 (7.7%). Hookworm was the most prevalent 114 (29.4%) soil transmitted helminthiasis infection followed by Ascaris lumbricoides (A. lumbricoides) 58 (15%) and Trichuris trichiura (T. trichiura) 13 (3.4%). Habit of eating soil (Adjusted Odds Ratio (AOR) = 4.64, 95% CI: 1.50-14.36, P=0.008), presence of stagnant water near study participants’ house (AOR=2.99, 95% CI: 1.28-6.99, P=0.012) and habit of using human feces as a fertilizer (AOR= 5.34, 95% CI: 1.99-14.28, P<0.001) were found to be significantly associated with malaria and STH co-infection among the pregnant women. Hookworm parasitic load was positively correlated with malaria parasitic load (r = 0.299, P<0.001) while A. lumbricoides parasitic load was negatively correlated with malaria parasitic load (r = −0.095, P<0.001). Conclusion Intestinal parasite and/or malaria co-infection is a health problem among pregnant women living around Gilgel Gibe dam area. Therefore, intervention including improving sanitation, removing stagnant water, and health education to the pregnant women should be given. PMID:23837685

  7. Update on the mapping of prevalence and intensity of infection for soil-transmitted helminth infections in Latin America and the Caribbean: a call for action.

    PubMed

    Saboyá, Martha Idalí; Catalá, Laura; Nicholls, Rubén Santiago; Ault, Steven Kenyon

    2013-01-01

    It is estimated that in Latin America and the Caribbean (LAC) at least 13.9 million preschool age and 35.4 million school age children are at risk of infections by soil-transmitted helminths (STH): Ascaris lumbricoides, Trichuris trichiura and hookworms (Necator americanus and Ancylostoma duodenale). Although infections caused by this group of parasites are associated with chronic deleterious effects on nutrition and growth, iron and vitamin A status and cognitive development in children, few countries in the LAC Region have implemented nationwide surveys on prevalence and intensity of infection. The aim of this study was to identify gaps on the mapping of prevalence and intensity of STH infections based on data published between 2000 and 2010 in LAC, and to call for including mapping as part of action plans against these infections. A total of 335 published data points for STH prevalence were found for 18 countries (11.9% data points for preschool age children, 56.7% for school age children and 31.3% for children from 1 to 14 years of age). We found that 62.7% of data points showed prevalence levels above 20%. Data on the intensity of infection were found for seven countries. The analysis also highlights that there is still an important lack of data on prevalence and intensity of infection to determine the burden of disease based on epidemiological surveys, particularly among preschool age children. This situation is a challenge for LAC given that adequate planning of interventions such as deworming requires information on prevalence to determine the frequency of needed anthelmintic drug administration and to conduct monitoring and evaluation of progress in drug coverage.

  8. Soil transmitted helminthiases: implications of climate change and human behaviour.

    USDA-ARS?s Scientific Manuscript database

    Soil transmitted helminthiases (STH) collectively cause the highest global burden of parasitic disease after malaria and are most prevalent in the poorest communities, especially in sub-Saharan Africa. Climate change is predicted to alter the physical environment through cumulative impacts of warmin...

  9. Development of the hybrid sulfur cycle for use with concentrated solar heat. I. Conceptual design

    DOE PAGES

    Gorensek, Maximilian B.; Corgnale, Claudio; Summers, William A.

    2017-07-27

    We propose a detailed conceptual design of a solar hybrid sulfur (HyS) cycle. Numerous design tradeoffs, including process operating conditions and strategies, methods of integration with solar energy sources, and solar design options were considered. A baseline design was selected, and process flowsheets were developed. Pinch analyses were performed to establish the limiting energy efficiency. Detailed material and energy balances were completed, and a full stream table prepared. Design assumptions include use of: location in the southwest US desert, falling particle concentrated solar receiver, indirect heat transfer via pressurized helium, continuous operation with thermal energy storage, liquid-fed electrolyzer with PBImore » membrane, and bayonet-type acid decomposer. Thermochemical cycle efficiency for the HyS process was estimated to be 35.0%, LHV basis. The solar-to-hydrogen (STH) energy conversion ratio was 16.9%. This thus exceeds the Year 2015 DOE STCH target of STH >10%, and shows promise for meeting the Year 2020 target of 20%.« less

  10. Development of the hybrid sulfur cycle for use with concentrated solar heat. I. Conceptual design

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gorensek, Maximilian B.; Corgnale, Claudio; Summers, William A.

    We propose a detailed conceptual design of a solar hybrid sulfur (HyS) cycle. Numerous design tradeoffs, including process operating conditions and strategies, methods of integration with solar energy sources, and solar design options were considered. A baseline design was selected, and process flowsheets were developed. Pinch analyses were performed to establish the limiting energy efficiency. Detailed material and energy balances were completed, and a full stream table prepared. Design assumptions include use of: location in the southwest US desert, falling particle concentrated solar receiver, indirect heat transfer via pressurized helium, continuous operation with thermal energy storage, liquid-fed electrolyzer with PBImore » membrane, and bayonet-type acid decomposer. Thermochemical cycle efficiency for the HyS process was estimated to be 35.0%, LHV basis. The solar-to-hydrogen (STH) energy conversion ratio was 16.9%. This thus exceeds the Year 2015 DOE STCH target of STH >10%, and shows promise for meeting the Year 2020 target of 20%.« less

  11. Soil-Transmitted Helminthiasis and Schistosomiasis in Children of Poor Families in Leyte, Philippines: Lessons for Disease Prevention and Control.

    PubMed

    Liwanag, Harvy Joy; Uy, Jhanna; Bataller, Ramil; Gatchalian, Janis Ruth; De La Calzada, Betty; Uy, Justine Alessandra; Dayrit, Manuel

    2017-10-01

    Neglected tropical diseases (NTDs) continue to be a public health problem in the Philippines. We assessed the association of soil-transmitted helminthiasis (STH) and schistosomiasis with selected health-related and socioeconomic variables in four villages in Leyte, Philippines. Stool specimens from 418 adults and 533 of their children from 209 families were examined through the Kato-Katz technique. STH and schistosomiasis were present in 64.6% and 12.5%, respectively, of study participants. Analysis through the generalized linear mixed model revealed a number of associations between infection in parents and their children. Findings indicate that years of disease prevention and control efforts in these areas have been unable to bring down prevalence in children and their parents. Eliminating NTDs as public health problems will require a systems thinking approach beyond implementation of vertical control programs alone. © The Author [2017]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  12. How Does Anodal Transcranial Direct Current Stimulation of the Pain Neuromatrix Affect Brain Excitability and Pain Perception? A Randomised, Double-Blind, Sham-Control Study

    PubMed Central

    Vaseghi, Bita; Zoghi, Maryam; Jaberzadeh, Shapour

    2015-01-01

    Background Integration of information between multiple cortical regions of the pain neuromatrix is thought to underpin pain modulation. Although altered processing in the primary motor (M1) and sensory (S1) cortices is implicated in separate studies, the simultaneous changes in and the relationship between these regions are unknown yet. The primary aim was to assess the effects of anodal transcranial direct current stimulation (a-tDCS) over superficial regions of the pain neuromatrix on M1 and S1 excitability. The secondary aim was to investigate how M1 and S1 excitability changes affect sensory (STh) and pain thresholds (PTh). Methods Twelve healthy participants received 20 min a-tDCS under five different conditions including a-tDCS of M1, a-tDCS of S1, a-tDCS of DLPFC, sham a-tDCS, and no-tDCS. Excitability of dominant M1 and S1 were measured before, immediately, and 30 minutes after intervention respectively. Moreover, STh and PTh to peripheral electrical and mechanical stimulation were evaluated. All outcome measures were assessed at three time-points of measurement by a blind rater. Results A-tDCS of M1 and dorsolateral prefrontal cortex (DLPFC) significantly increased brain excitability in M1 (p < 0.05) for at least 30 min. Following application of a-tDCS over the S1, the amplitude of the N20-P25 component of SEPs increased immediately after the stimulation (p < 0.05), whilst M1 stimulation decreased it. Compared to baseline values, significant STh and PTh increase was observed after a-tDCS of all three stimulated areas. Except in M1 stimulation, there was significant PTh difference between a-tDCS and sham tDCS. Conclusion a-tDCS of M1 is the best spots to enhance brain excitability than a-tDCS of S1 and DLPFC. Surprisingly, a-tDCS of M1 and S1 has diverse effects on S1 and M1 excitability. A-tDCS of M1, S1, and DLPFC increased STh and PTh levels. Given the placebo effects of a-tDCS of M1 in pain perception, our results should be interpreted with caution, particularly with respect to the behavioural aspects of pain modulation. Trial Registration Australian New Zealand Clinical Trials, ACTRN12614000817640, http://www.anzctr.org.au/. PMID:25738603

  13. The Fit for School health outcome study - a longitudinal survey to assess health impacts of an integrated school health programme in the Philippines

    PubMed Central

    2013-01-01

    Background Child health in many low- and middle-income countries lags behind international goals and affects children’s education, well-being, and general development. Large-scale school health programmes can be effective in reducing preventable diseases through cost-effective interventions. This paper outlines the baseline and 1-year results of a longitudinal health study assessing the impact of the Fit for School Programme in the Philippines. Methods A longitudinal 4-year cohort study was conducted in the province of Camiguin, Mindanao (experimental group); an external concurrent control group was studied in Gingoog, Mindanao. The study has three experimental groups: group 1—daily handwashing with soap, daily brushing with fluoride toothpaste, biannual deworming with 400 mg albendazole (Essential Health Care Program [EHCP]); group 2—EHCP plus twice-a-year access to school-based Oral Urgent Treatment; group 3—EHCP plus weekly toothbrushing with high-fluoride concentration gel. A non-concurrent internal control group was also included. Baseline data on anthropometric indicators to calculate body mass index (BMI), soil-transmitted helminths (STH) infection in stool samples, and dental caries were collected in August 2009 and August 2010. Data were analysed to assess validity of the control group design, baseline, and 1-year results. Results In the cohort study, 412 children were examined at baseline and 341 1 year after intervention. The baseline results were in line with national averages for STH infection, BMI, and dental caries in group 1 and the control groups. Children lost to follow-up had similar baseline characteristics in the experimental and control groups. After 1 year, group 1 showed a significantly higher increase in mean BMI and lower prevalence of moderate to heavy STH infection than the external concurrent control group. The increases in caries and dental infections were reduced but not statistically significant. The results for groups 2 and 3 will be reported separately. Conclusions Despite the short 1-year observation period, the study found a reduction in the prevalence of moderate to heavy STH infections, a rise in mean BMI, and a (statistically non-significant) reduction in dental caries and infections. The study design proved functional in actual field conditions. Critical aspects affecting the validity of cohort studies are analysed and discussed. Trial registration DRKS00003431 WHO Universal Trial Number U1111-1126-0718 PMID:23517517

  14. Surgically Implanted JSATS Micro-Acoustic Transmitters Effects on Juvenile Chinook Salmon and Steelhead Tag Expulsion and Survival, 2010

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Woodley, Christa M.; Carpenter, Scott M.; Carter, Kathleen M.

    2011-09-16

    The purpose of this study was to evaluate survival model assumptions associated with a concurrent study - Acoustic Telemetry Evaluation of Dam Passage Survival and Associated Metrics at John Day, The Dalles, and Bonneville Dams, 2010 by Thomas Carlson and others in 2010 - in which the Juvenile Salmonid Acoustic Telemetry System (JSATS) was used to estimate the survival of yearling and subyearling Chinook salmon (Oncorhynchus tshawytscha) and steelhead (O. mykiss) migrating through the Federal Columbia River Power System (FCRPS). The micro-acoustic transmitter used in these studies is the smallest acoustic transmitter model to date (12 mm long x 5more » mm wide x 4 mm high, and weighing 0.43 g in air). This study and the 2010 study by Carlson and others were conducted by researchers from the Pacific Northwest National Laboratory and the University of Washington for the U.S. Army Corps of Engineers, Portland District, to meet requirements set forth by the 2008 FCRPS Biological Opinion. In 2010, we compared survival, tag burden, and tag expulsion in five spring groups of yearling Chinook salmon (YCH) and steelhead (STH) and five summer groups of subyearling Chinook salmon (SYC) to evaluate survival model assumptions described in the concurrent study. Each tagging group consisted of approximately 120 fish/species, which were collected and implanted on a weekly basis, yielding approximately 600 fish total/species. YCH and STH were collected and implanted from late April to late May (5 weeks) and SYC were collected and implanted from mid-June to mid-July (5 weeks) at the John Day Dam Smolt Monitoring Facility. The fish were collected once a week, separated by species, and assigned to one of three treatment groups: (1) Control (no surgical treatment), (2) Sham (surgical implantation of only a passive integrated transponder [PIT] tag), and (3) Tagged (surgical implantation of JSATS micro-acoustic transmitter [AT] and PIT tags). The test fish were held for 30 days in indoor circular tanks at the Bonneville Dam Juvenile Monitoring Facility. Overall mortality ranged weekly from 45 to 72% for YCH, 55 to 83% for STH, and 56 to 84% for SYC. The high background mortality in all groups and species made it difficult to discern tag effects. However, for YCH, STH, and SYC, the Tagged treatment groups had the highest overall mean mortality - 62%, 79%, and 76%, respectively. Fungal infections were found on 35% of all fish. Mean tag burden for the Tagged treatment group was relatively low for YCH (1.7%) and moderate for SYC (4.2%), while STH had a very low mean tag burden (0.7%). Tag burden was significantly higher in the Tagged treatment group for all species when compared to the Sham treatment group because of the presence of two tags. Surgeon performance did not contribute to the difference in mortality between the Sham and Tagged treatment groups. Tag expulsion from fish that survived to the end of the 30-day experiment was low but occurred in all species, with only two PIT tags and one AT lost, one tag per species. The high background mortality in this experiment was not limited to a treatment, temperature, or month. The decreased number of surviving fish influenced our experimental results and thus analyses. For future research, we recommend that a more natural exposure to monitor tag effects and other factors, such as swimming ability and predator avoidance, be considered to determine the effects of AT- and PIT- implantation on fishes.« less

  15. Preliminary Investigation of the Role of Cellular Immunity in Estrous Cycle Modulation of Post-Resection Breast Cancer Spread

    DTIC Science & Technology

    2004-08-01

    established MTCIL tumor rolls retain this unique biologic feature. -ll suspeniionsw from sth moat vsital porn MTP ntutur arnd injected we inoutlated...rather than linear or continuous process. This biologic growth pattern is not unique nor unprecedented. Growth studies in children using serial height

  16. Paediatric oral peanut challenges: a comparison of practice in London and western Switzerland.

    PubMed

    Ludman, S; Wassenberg, J; Du Toit, G; Fox, A T; Lack, G; Eigenmann, P A

    2013-04-01

    There are guidelines on how to develop a food challenge protocol, but at present there is no gold standard guidance on method, and separate units produce differing protocols. We performed a retrospective analysis of 200 patients' data from the paediatric allergy units in Lausanne and Geneva, Western Switzerland, and St Thomas' Hospital (STH), UK. St Thomas' Hospital has a younger cohort with a lower overall mean spIgE (2.36 kU/l vs. 8.00 kU/l, P = 0.004). The target peanut protein volumes differed: Switzerland 4.4 g vs. STH 8.4 g. Despite this, the dose actually achieved in positive challenges was not significantly different (2.33 g vs. 1.49 g, P = 0.16). 26% of challenges reacted at 4 g or more of peanut protein. The differences in results highlight how the variation in reasoning behind food challenge alters the outcome. Standardization of food challenges would allow easy comparison between hospitals and geographical areas for research purposes. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  17. Controlling lymphatic filariasis and soil-transmitted helminthiasis together in South Asia: opportunities and challenges

    PubMed Central

    Padmasiri, EA; Montresor, A; Biswas, G; de Silva, NR

    2017-01-01

    Summary Lymphatic filariasis (LF) and the major soil-transmitted helminth (STH) infections are co-endemic in many countries, particularly in Asia. Control strategies for both groups of infections have increasingly focused on the use of mass chemotherapy. With the use of albendazole, there is now a tool that is common to both. However, there are also important differences in their modes of transmission and epidemiology, and as a result, in the overall control strategies. The Global Programme for the Elimination of Lymphatic Filariasis aims to eliminate LF through time-limited, Mass Drug Administration programmes. STH control activities are more diffuse, aiming to piggy-back de-worming onto existing services such as school health activities; controlling morbidity, rather than eliminating infection, is the stated goal. In order to maximize health benefits to communities that are endemic for one or both of these infections, it is vitally important that policy makers and programme managers have a clear understanding of both commonalities and differences, and implement control programmes that allocate available resources in an optimal manner. PMID:16546228

  18. Prevalence, risk factors and clinical features associated with intestinal parasitic infections in children from San Juan y Martínez, Pinar del Río, Cuba.

    PubMed

    Escobedo, A A; Cañete, R; Núñez, F A

    2008-09-01

    A cross-sectional study was carried out in 200 children aged 5-15 years, to examine the presence of intestinal parasitic infections (IPIs) and to assess the risk factors and clinical features associated with them in children in San Juan y Martinez (SIM), Cuba. Three fresh faecal samples were collected from each child and were examined by direct wet mount, brine flotation, formalin-ether and Kato-Katz techniques. Data relating to demography, source of drinking water, personal hygiene habits and clinical features were also collected Living in the rural area was significantly associated with the highest infection rates (p < 0.01). According to clinical features and laboratory examinations, children with abdominal pain were about four times more likely to have IPIs (OR 4.05, CI, 1.11, 13.18) especially soil-transmitted helminths (STH). We suggest that IPIs, especially STH, in SJM should be strongly suspected in children with abdominal pain from rural areas. Targeted and frequent interventions to control these infections are needed in this municipality.

  19. Mathematical inference on helminth egg counts in stool and its applications in mass drug administration programmes to control soil-transmitted helminthiasis in public health.

    PubMed

    Levecke, Bruno; Anderson, Roy M; Berkvens, Dirk; Charlier, Johannes; Devleesschauwer, Brecht; Speybroeck, Niko; Vercruysse, Jozef; Van Aelst, Stefan

    2015-03-01

    In the present study, we present a hierarchical model based on faecal egg counts (FECs; expressed in eggs per 1g of stool) in which we first describe the variation in FECs between individuals in a particular population, followed by describing the variance due to counting eggs under a microscope separately for each stool sample. From this general framework, we discuss how to calculate a sample size for assessing a population mean FEC and the impact of an intervention, measured as reduction in FECs, for any scenario of soil-transmitted helminth (STH) epidemiology (the intensity and aggregation of FECs within a population) and diagnostic strategy (amount of stool examined (∼sensitivity of the diagnostic technique) and examination of individual/pooled stool samples) and on how to estimate prevalence of STH in the absence of a gold standard. To give these applications the most wide relevance as possible, we illustrate each of them with hypothetical examples. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Pharmaceutical cocrystals: a comparison of sulfamerazine with sulfamethazine

    NASA Astrophysics Data System (ADS)

    Lu, Jie; Li, Yi-Ping; Wang, Jing; Li, Zhen; Rohani, Sohrab; Ching, Chi-Bun

    2011-11-01

    Although there has been much debate about its definition among scientists, a cocrystal may be defined as a crystalline material that consists of two or more electrically neutral molecular species held together by non-covalent forces, and meanwhile all components are solids at room temperature. Obviously it is great to introduce predictable structural motifs to an active pharmaceutical ingredient (API) by design. One widely used approach to cocrystal design is based on the consideration of Δp Ka, which can represent the propensity of molecular species to form a cocrystal or a salt. In this work, p-aminobenzoic acid (PABA) was mixed with sulfamerazine (SMZ) or sulfamethazine (STH) by use of neat cogrinding and solvent-drop cogrinding. It was found that PABA and SMZ with a Δp Ka of 2.13 would form a binary eutectic, while PABA and STH with a larger Δp Ka of 2.59 can form a cocrystal in the ratio of 1:1. The phenomenon indicates that not only the Δp Ka but also the stereo-hindrance effect (geometric fit) should be considered during the design of pharmaceutical cocrystals.

  1. Health education and the control of intestinal worm infections in China: a new vision.

    PubMed

    McManus, Donald P; Bieri, Franziska A; Li, Yue-Sheng; Williams, Gail M; Yuan, Li-Ping; Henglin, Yang; Du, Zun-Wei; Clements, Archie Ca; Steinmann, Peter; Raso, Giovanna; Yap, Peiling; Magalhães, Ricardo J Soares; Stewart, Donald; Ross, Allen G; Halton, Kate; Zhou, Xiao-Nong; Olveda, Remigio M; Tallo, Veronica; Gray, Darren J

    2014-07-24

    The transmission of soil-transmitted helminths (STHs) is associated with poverty, poor hygiene behaviour, lack of clean water and inadequate waste disposal and sanitation. Periodic administration of benzimidazole drugs is the mainstay for global STH control but it does not prevent re-infection, and is unlikely to interrupt transmission as a stand-alone intervention. We reported recently on the development and successful testing in Hunan province, PR China, of a health education package to prevent STH infections in Han Chinese primary school students. We have recently commenced a new trial of the package in the ethnically diverse Xishuangbanna autonomous prefecture in Yunnan province and the approach is also being tested in West Africa, with further expansion into the Philippines in 2015. The work in China illustrates well the direct impact that health education can have in improving knowledge and awareness, and in changing hygiene behaviour. Further, it can provide insight into the public health outcomes of a multi-component integrated control program, where health education prevents re-infection and periodic drug treatment reduces prevalence and morbidity.

  2. Controlling lymphatic filariasis and soil-transmitted helminthiasis together in South Asia: opportunities and challenges.

    PubMed

    Padmasiri, E A; Montresor, A; Biswas, G; de Silva, N R

    2006-09-01

    Lymphatic filariasis (LF) and the major soil-transmitted helminth (STH) infections are co-endemic in many countries, particularly in Asia. Control strategies for both groups of infections have increasingly focused on the use of mass chemotherapy. With the use of albendazole, there is now a tool that is common to both. However, there are also important differences in their modes of transmission and epidemiology, and, as a result, in the overall control strategies. The Global Programme for the Elimination of Lymphatic Filariasis aims to eliminate LF through time-limited mass drug administration programmes. Control activities for STH are more diffuse, aiming to piggy-back de-worming onto existing services, such as school health activities; controlling morbidity, rather than eliminating infection, is the stated goal. In order to maximize health benefits to communities that are endemic for one or both of these infections, it is vitally important that policy makers and programme managers have a clear understanding of both commonalities and differences, and implement control strategies that allocate available resources in an optimal manner.

  3. EPR reversible signature of self-trapped holes in fictive temperature-treated silica glass

    NASA Astrophysics Data System (ADS)

    Lancry, Matthieu; Ollier, Nadège; Babu, B. H.; Herrero, Christian; Poumellec, Bertrand

    2018-03-01

    Post-mortem electron paramagnetic resonance spectroscopy experiments have been carried out between room temperature and 20 K to examine the radiation-induced defects in fictive temperature (Tf) treated Heraeus F300 silica (0.1 ppm OH, 1500 ppm Cl2). In particular, we focus our attention on Self-Trapped Hole (STH) centers detected in 1000 °C, 1100 °C, and 1200 °C Tf treated samples irradiated at room temperature by gamma rays at 6 kGy. By repeating annealing cycles between 77 and 300 K on the same samples, we observed that the EPR signal attributed to STH decreases as the temperature increases but in a reversible manner. We evidenced a deviation from the Curie law for T > 70 K and suggested an interpretation based on the decrease in the "strain-assisted TH" population by reversible excitation of the trapped hole to a delocalized state with an activation energy of 7.8 meV. This also means that the precursors of hole trapping sites (a local strain atomic configuration) remain stable until 300 K at least.

  4. Chronic cat allergen exposure induces a TH2 cell-dependent IgG4 response related to low sensitization.

    PubMed

    Renand, Amedee; Archila, Luis D; McGinty, John; Wambre, Erik; Robinson, David; Hales, Belinda J; Thomas, Wayne R; Kwok, William W

    2015-12-01

    In human subjects, allergen tolerance has been observed after high-dose allergen exposure or after completed allergen immunotherapy, which is related to the accumulation of anti-inflammatory IgG4. However, the specific T-cell response that leads to IgG4 induction during chronic allergen exposure remains poorly understood. We sought to evaluate the relationship between cat allergen-specific T-cell frequency, cat allergen-specific IgE and IgG4 titers, and clinical status in adults with cat allergy with and without cat ownership and the cellular mechanism by which IgG4 is produced. Fel d 1-, Fel d 4-, Fel d 7-, and Fel d 8-specific T-cell responses were characterized by CD154 expression after antigen stimulation. In allergic subjects without cat ownership, the frequency of cat allergen (Fel d 1 and Fel d 4)-specific TH2 (sTH2) cells correlates with higher IgE levels and is linked to asthma. Paradoxically, we observed that subjects with cat allergy and chronic cat exposure maintain a high frequency of sTH2 cells, which correlates with higher IgG4 levels and low sensitization. B cells from allergic, but not nonallergic subjects, are able to produce IgG4 after cognate interactions with sTH2 clones and Fel d 1 peptide or the Fel d 1 recombinant protein. These experiments suggest that (1) allergen-experienced B cells with the capacity to produce IgG4 are present in allergic subjects and (2) cat allergen exposure induces an IgG4 response in a TH2 cell-dependent manner. Thus IgG4 accumulation could be mediated by chronic activation of the TH2 response, which in turn drives desensitization. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  5. Spatial Modelling of Soil-Transmitted Helminth Infections in Kenya: A Disease Control Planning Tool

    PubMed Central

    Pullan, Rachel L.; Gething, Peter W.; Smith, Jennifer L.; Mwandawiro, Charles S.; Sturrock, Hugh J. W.; Gitonga, Caroline W.; Hay, Simon I.; Brooker, Simon

    2011-01-01

    Background Implementation of control of parasitic diseases requires accurate, contemporary maps that provide intervention recommendations at policy-relevant spatial scales. To guide control of soil transmitted helminths (STHs), maps are required of the combined prevalence of infection, indicating where this prevalence exceeds an intervention threshold of 20%. Here we present a new approach for mapping the observed prevalence of STHs, using the example of Kenya in 2009. Methods and Findings Observed prevalence data for hookworm, Ascaris lumbricoides and Trichuris trichiura were assembled for 106,370 individuals from 945 cross-sectional surveys undertaken between 1974 and 2009. Ecological and climatic covariates were extracted from high-resolution satellite data and matched to survey locations. Bayesian space-time geostatistical models were developed for each species, and were used to interpolate the probability that infection prevalence exceeded the 20% threshold across the country for both 1989 and 2009. Maps for each species were integrated to estimate combined STH prevalence using the law of total probability and incorporating a correction factor to adjust for associations between species. Population census data were combined with risk models and projected to estimate the population at risk and requiring treatment in 2009. In most areas for 2009, there was high certainty that endemicity was below the 20% threshold, with areas of endemicity ≥20% located around the shores of Lake Victoria and on the coast. Comparison of the predicted distributions for 1989 and 2009 show how observed STH prevalence has gradually decreased over time. The model estimated that a total of 2.8 million school-age children live in districts which warrant mass treatment. Conclusions Bayesian space-time geostatistical models can be used to reliably estimate the combined observed prevalence of STH and suggest that a quarter of Kenya's school-aged children live in areas of high prevalence and warrant mass treatment. As control is successful in reducing infection levels, updated models can be used to refine decision making in helminth control. PMID:21347451

  6. Pressure ulcer and wounds reporting in NHS hospitals in England part 1: Audit of monitoring systems.

    PubMed

    Smith, Isabelle L; Nixon, Jane; Brown, Sarah; Wilson, Lyn; Coleman, Susanne

    2016-02-01

    Internationally, health-care systems have attempted to assess the scale of and demonstrate improvement in patient harms. Pressure ulcer (PU) monitoring systems have been introduced across NHS in-patient facilities in England, including the Safety Thermometer (STh) (prevalence), Incident Reporting Systems (IRS) and the Strategic Executive Information System (STEIS) for serious incidents. This is the first of two related papers considering PU monitoring systems across NHS in-patient facilities in England and focusses on a Wound Audit (PUWA) to assess the accuracy of these systems. Part 2 of this work and recommendations are reported pp *-*. The PUWA was undertaken in line with 'gold-standard' PU prevalence methods in a stratified random sample of NHS Trusts; 24/34 (72.7%) invited NHS Trusts participated, from which 121 randomly selected wards and 2239 patients agreed to participate. The PUWA identified 160 (7.1%) patients with an existing PU, compared to 105 (4.7%) on STh. STh had a weighted sensitivity of 48.2% (95%CI 35.4%-56.7%) and weighted specificity of 99.0% (95%CI 98.99%-99.01%). The PUWA identified 189 (8.4%) patients with an existing/healed PU compared to 135 (6.0%) on IRS. IRS had an unweighted sensitivity of 53.4% (95%CI 46.3%-60.4%) and unweighted specificity of 98.3% (95%CI 97.7%-98.8%). 83 patients had one or more potentially serious PU on PUWA and 8 (9.6%) of these patients were reported on STEIS. The results identified high levels of under-reporting for all systems and highlighted data capture challenges, including the use of clinical staff to inform national monitoring systems and the completeness of clinical records for PUs. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Patent Human Infections with the Whipworm, Trichuris trichiura, Are Not Associated with Alterations in the Faecal Microbiota

    PubMed Central

    Reyes, Jorge; Chico, Martha; Salter, Susannah J.; Vaca, Maritza; Parkhill, Julian

    2013-01-01

    Background The soil-transmitted helminth (STH), Trichuris trichiura colonises the human large intestine where it may modify inflammatory responses, an effect possibly mediated through alterations in the intestinal microbiota. We hypothesised that patent T. trichiura infections would be associated with altered faecal microbiota and that anthelmintic treatment would induce a microbiota resembling more closely that observed in uninfected individuals. Materials and Methods School children in Ecuador were screened for STH infections and allocated to 3 groups: uninfected, T. trichiura only, and mixed infections with T. trichiura and Ascaris lumbricoides. A sample of uninfected children and those with T. trichiura infections only were given anthelmintic treatment. Bacterial community profiles in faecal samples were studied by 454 pyrosequencing of 16 S rRNA genes. Results Microbiota analyses of faeces were done for 97 children: 30 were uninfected, 17 were infected with T. trichiura, and 50 with T. trichiura and A. lumbricoides. Post-treatment samples were analyzed for 14 children initially infected with T. trichiura alone and for 21 uninfected children. Treatment resulted in 100% cure of STH infections. Comparisons of the microbiota at different taxonomic levels showed no statistically significant differences in composition between uninfected children and those with T. trichiura infections. We observed a decreased proportional abundance of a few bacterial genera from the Clostridia class of Firmicutes and a reduced bacterial diversity among children with mixed infections compared to the other two groups, indicating a possible specific effect of A. lumbricoides infection. Anthelmintic treatment of children with T. trichiura did not alter faecal microbiota composition. Discussion Our data indicate that patent human infections with T. trichiura may have no effect on faecal microbiota but that A. lumbricoides colonisation might be associated with a disturbed microbiota. Our results also catalogue the microbiota of rural Ecuadorians and indicate differences with individuals from more urban industrialised societies. PMID:24124574

  8. Patent human infections with the whipworm, Trichuris trichiura, are not associated with alterations in the faecal microbiota.

    PubMed

    Cooper, Philip; Walker, Alan W; Reyes, Jorge; Chico, Martha; Salter, Susannah J; Vaca, Maritza; Parkhill, Julian

    2013-01-01

    The soil-transmitted helminth (STH), Trichuris trichiura colonises the human large intestine where it may modify inflammatory responses, an effect possibly mediated through alterations in the intestinal microbiota. We hypothesised that patent T. trichiura infections would be associated with altered faecal microbiota and that anthelmintic treatment would induce a microbiota resembling more closely that observed in uninfected individuals. School children in Ecuador were screened for STH infections and allocated to 3 groups: uninfected, T. trichiura only, and mixed infections with T. trichiura and Ascaris lumbricoides. A sample of uninfected children and those with T. trichiura infections only were given anthelmintic treatment. Bacterial community profiles in faecal samples were studied by 454 pyrosequencing of 16 S rRNA genes. Microbiota analyses of faeces were done for 97 children: 30 were uninfected, 17 were infected with T. trichiura, and 50 with T. trichiura and A. lumbricoides. Post-treatment samples were analyzed for 14 children initially infected with T. trichiura alone and for 21 uninfected children. Treatment resulted in 100% cure of STH infections. Comparisons of the microbiota at different taxonomic levels showed no statistically significant differences in composition between uninfected children and those with T. trichiura infections. We observed a decreased proportional abundance of a few bacterial genera from the Clostridia class of Firmicutes and a reduced bacterial diversity among children with mixed infections compared to the other two groups, indicating a possible specific effect of A. lumbricoides infection. Anthelmintic treatment of children with T. trichiura did not alter faecal microbiota composition. Our data indicate that patent human infections with T. trichiura may have no effect on faecal microbiota but that A. lumbricoides colonisation might be associated with a disturbed microbiota. Our results also catalogue the microbiota of rural Ecuadorians and indicate differences with individuals from more urban industrialised societies.

  9. Current status of soil transmitted helminths and Schistosoma mansoni infection among children in two primary schools in North Gondar, Northwest Ethiopia: a cross sectional study.

    PubMed

    Mathewos, Biniam; Alemu, Abebe; Woldeyohannes, Desalegn; Alemu, Agersew; Addis, Zelalem; Tiruneh, Moges; Aimero, Mulugeta; Kassu, Afework

    2014-02-10

    School age children are one of the groups at high risk for intestinal parasitic infections especially in developing countries like Ethiopia as the supply of good quality drinking water and latrine coverage are poor. Though there are previous data on the prevalence of soil transmitted helminths (STHs) and Schistosoma mansoni infection among these high risk groups current status in the study area is unknown. Therefore, the aim of this study was to determine the current prevalence and associated risk factors of STHs and S. mansoni infections among school children. A cross-sectional study was carried out in Gorgora and Chuahit towns, North Gondar Zone, North West Ethiopia from January 20 to February 25, 2012 involving 261 school children. A pre-tested and structured questionnaire was used to collect socio-demographic data and possible risk factors. Stool samples were collected and examined for intestinal parasites using Kato Katz method. Chi-square test was used to see if there is association between sociodemographic factors and other risk factors for STH and S. mansoni infection and odds ratio with 95% CI was computed as measures of association. P < 0.05 was taken as statistically significant. Out of the 261 study participants, 174 (66.7%) were infected with one or more species of intestinal parasites. Ascaris lumbricoides was the predominant isolates (39.8%) followed by Trichuris trichiura (6.1%) and Hookworms (4.9%). Schistosoma mansoni was detected in 33.7% of the children. Among infected individuals, 9.5% were coinfected by S. mansoni and A. lumbricoides and 1.5% with S. mansoni and T. trichiura. Swimming habit (OR: 2.536, 95% CI: 1.122, 5.737, P = 0.022) was significantly associated with S. mansoni infection. The prevalence of STH and S. mansoni was high among school children. This should call for implementation of an integrated strategy to reduce morbidity and control of transmission of STH and S. mansoni.

  10. Association of enteric parasitic infections with intestinal inflammation and permeability in asymptomatic infants of São Tomé Island.

    PubMed

    Garzón, Marisol; Pereira-da-Silva, Luis; Seixas, Jorge; Papoila, Ana Luísa; Alves, Marta; Ferreira, Filipa; Reis, Ana

    2017-05-01

    The cumulative effect of repeated asymptomatic enteric infections on intestinal barrier is not fully understood in infants. We aimed to evaluate the association between previous enteric parasitic infections and intestinal inflammation and permeability at 24-months of age, in asymptomatic infants of São Tomé Island. A subset of infants from a birth cohort, with intestinal parasite evaluations in at least four points of assessment, was eligible. Intestinal inflammatory response and permeability were assessed using fecal S100A12 and alpha-1-antitrypsin (A1AT), respectively. The cutoff <-1SD for weight-for-length and length-for-age was used to define wasting and stunting. Multivariable linear regression analysis explored if cumulative enteric parasitic infections explained variability of fecal biomarkers, after adjusting for potential confounders. Eighty infants were included. Giardia duodenalis and soil-transmitted helminths (STH) were the most frequent parasites. The median (interquartile range) levels were 2.87 μg/g (2.41-3.92) for S100A12 and 165.1 μg/g (66.0-275.6) for A1AT. Weak evidence of association was found between S100A12 levels and G. duodenalis (p = 0.080) and STH infections (p = 0.089), and between A1AT levels and parasitic infection of any etiology (p = 0.089), at 24-months of age. Significant associations between A1AT levels and wasting (p = 0.006) and stunting (p = 0.044) were found. Previous parasitic infections were not associated with fecal biomarkers at 24 months of age. To summarize, previous asymptomatic parasitic infections showed no association with intestinal barrier dysfunction. Notwithstanding, a tendency toward increased levels of the inflammatory biomarker was observed for current G. duodenalis and STH infections, and increased levels of the permeability biomarker were significantly associated with stunting and wasting.

  11. A Novel Multi-Scale Domain Overlapping CFD/STH Coupling Methodology for Multi-Dimensional Flows Relevant to Nuclear Applications

    NASA Astrophysics Data System (ADS)

    Grunloh, Timothy P.

    The objective of this dissertation is to develop a 3-D domain-overlapping coupling method that leverages the superior flow field resolution of the Computational Fluid Dynamics (CFD) code STAR-CCM+ and the fast execution of the System Thermal Hydraulic (STH) code TRACE to efficiently and accurately model thermal hydraulic transport properties in nuclear power plants under complex conditions of regulatory and economic importance. The primary contribution is the novel Stabilized Inertial Domain Overlapping (SIDO) coupling method, which allows for on-the-fly correction of TRACE solutions for local pressures and velocity profiles inside multi-dimensional regions based on the results of the CFD simulation. The method is found to outperform the more frequently-used domain decomposition coupling methods. An STH code such as TRACE is designed to simulate large, diverse component networks, requiring simplifications to the fluid flow equations for reasonable execution times. Empirical correlations are therefore required for many sub-grid processes. The coarse grids used by TRACE diminish sensitivity to small scale geometric details such as Reactor Pressure Vessel (RPV) internals. A CFD code such as STAR-CCM+ uses much finer computational meshes that are sensitive to the geometric details of reactor internals. In turbulent flows, it is infeasible to fully resolve the flow solution, but the correlations used to model turbulence are at a low level. The CFD code can therefore resolve smaller scale flow processes. The development of a 3-D coupling method was carried out with the intention of improving predictive capabilities of transport properties in the downcomer and lower plenum regions of an RPV in reactor safety calculations. These regions are responsible for the multi-dimensional mixing effects that determine the distribution at the core inlet of quantities with reactivity implications, such as fluid temperature and dissolved neutron absorber concentration.

  12. Assessment of the anthelmintic efficacy of albendazole in school children in seven countries where soil-transmitted helminths are endemic.

    PubMed

    Vercruysse, Jozef; Behnke, Jerzy M; Albonico, Marco; Ame, Shaali Makame; Angebault, Cécile; Bethony, Jeffrey M; Engels, Dirk; Guillard, Bertrand; Nguyen, Thi Viet Hoa; Kang, Gagandeep; Kattula, Deepthi; Kotze, Andrew C; McCarthy, James S; Mekonnen, Zeleke; Montresor, Antonio; Periago, Maria Victoria; Sumo, Laurentine; Tchuenté, Louis-Albert Tchuem; Dang, Thi Cam Thach; Zeynudin, Ahmed; Levecke, Bruno

    2011-03-29

    The three major soil-transmitted helminths (STH) Ascaris lumbricoides, Trichuris trichiura and Necator americanus/Ancylostoma duodenale are among the most widespread parasites worldwide. Despite the global expansion of preventive anthelmintic treatment, standard operating procedures to monitor anthelmintic drug efficacy are lacking. The objective of this study, therefore, was to define the efficacy of a single 400 milligram dose of albendazole (ALB) against these three STH using a standardized protocol. Seven trials were undertaken among school children in Brazil, Cameroon, Cambodia, Ethiopia, India, Tanzania and Vietnam. Efficacy was assessed by the Cure Rate (CR) and the Fecal Egg Count Reduction (FECR) using the McMaster egg counting technique to determine fecal egg counts (FEC). Overall, the highest CRs were observed for A. lumbricoides (98.2%) followed by hookworms (87.8%) and T. trichiura (46.6%). There was considerable variation in the CR for the three parasites across trials (country), by age or the pre-intervention FEC (pre-treatment). The latter is probably the most important as it had a considerable effect on the CR of all three STH. Therapeutic efficacies, as reflected by the FECRs, were very high for A. lumbricoides (99.5%) and hookworms (94.8%) but significantly lower for T. trichiura (50.8%), and were affected to different extents among the 3 species by the pre-intervention FEC counts and trial (country), but not by sex or age. Our findings suggest that a FECR (based on arithmetic means) of >95% for A. lumbricoides and >90% for hookworms should be the expected minimum in all future surveys, and that therapeutic efficacy below this level following a single dose of ALB should be viewed with concern in light of potential drug resistance. A standard threshold for efficacy against T. trichiura has yet to be established, as a single-dose of ALB is unlikely to be satisfactory for this parasite. ClinicalTrials.gov NCT01087099.

  13. Is anthelmintic resistance a concern for the control of human soil-transmitted helminths?

    PubMed Central

    Vercruysse, Jozef; Albonico, Marco; Behnke, Jerzy M.; Kotze, Andrew C.; Prichard, Roger K.; McCarthy, James S.; Montresor, Antonio; Levecke, Bruno

    2011-01-01

    The major human soil-transmitted helminths (STH), Ascaris lumbricoides, hookworms (Necator americanus and Ancylostoma duodenale) and Trichuris trichiura have a marked impact on human health in many parts of the world. Current efforts to control these parasites rely predominantly on periodic mass administration of anthelmintic drugs to school age children and other at-risk groups. After many years of use of these same drugs for controlling roundworms in livestock, high levels of resistance have developed, threatening the sustainability of these livestock industries in some locations. Hence, the question arises as to whether this is likely to also occur in the human STH, thereby threatening our ability to control these parasites. This is particularly important because of the recent increase in mass control programmes, relying almost exclusively on benzimidazole anthelmintics. It will be important to ensure that resistance is detected as it emerges in order to allow the implementation of mitigation strategies, such as use of drug combinations, to ensure that the effectiveness of the few existing anthelmintic drugs is preserved. In this review we address these issues by firstly examining the efficacy of anthelmintics against the human STH, and assessing whether there are any indications to date that resistance has emerged. We then consider the factors that influence the effect of current drug-use patterns in selecting for resistant parasite populations. We describe the tools currently available for resistance monitoring (field-based coprological methods), and those under development (in vitro bioassays and molecular tests), and highlight confounding factors that need to be taken into account when interpreting such resistance-monitoring data. We then highlight means to ensure that the currently available tools are used correctly, particularly with regard to study design, and we set appropriate drug-efficacy thresholds. Finally, we make recommendations for monitoring drug efficacy in the field, as components of control programmes, in order to maximise the ability to detect drug resistance, and if it arises to change control strategy and prevent the spread of resistance. PMID:24533260

  14. High School Students' Understanding of the Human Body System

    ERIC Educational Resources Information Center

    Assaraf, Orit Ben-Zvi; Dodick, Jeff; Tripto, Jaklin

    2013-01-01

    In this study, 120 tenth-grade students from 8 schools were examined to determine the extent of their ability to perceive the human body as a system after completing the first stage in their biology curriculum--"The human body, emphasizing homeostasis". The students' systems thinking was analyzed according to the STH thinking model, which roughly…

  15. Micromachined Chip Scale Thermal Sensor for Thermal Imaging.

    PubMed

    Shekhawat, Gajendra S; Ramachandran, Srinivasan; Jiryaei Sharahi, Hossein; Sarkar, Souravi; Hujsak, Karl; Li, Yuan; Hagglund, Karl; Kim, Seonghwan; Aden, Gary; Chand, Ami; Dravid, Vinayak P

    2018-02-27

    The lateral resolution of scanning thermal microscopy (SThM) has hitherto never approached that of mainstream atomic force microscopy, mainly due to poor performance of the thermal sensor. Herein, we report a nanomechanical system-based thermal sensor (thermocouple) that enables high lateral resolution that is often required in nanoscale thermal characterization in a wide range of applications. This thermocouple-based probe technology delivers excellent lateral resolution (∼20 nm), extended high-temperature measurements >700 °C without cantilever bending, and thermal sensitivity (∼0.04 °C). The origin of significantly improved figures-of-merit lies in the probe design that consists of a hollow silicon tip integrated with a vertically oriented thermocouple sensor at the apex (low thermal mass) which interacts with the sample through a metallic nanowire (50 nm diameter), thereby achieving high lateral resolution. The efficacy of this approach to SThM is demonstrated by imaging embedded metallic nanostructures in silica core-shell, metal nanostructures coated with polymer films, and metal-polymer interconnect structures. The nanoscale pitch and extremely small thermal mass of the probe promise significant improvements over existing methods and wide range of applications in several fields including semiconductor industry, biomedical imaging, and data storage.

  16. Outbreaks of cholera-like diarrhoea caused by enterotoxigenic Escherichia coli in the Brazilian Amazon Rainforest.

    PubMed

    Vicente, Ana C P; Teixeira, Luiz F M; Iniguez-Rojas, L; Luna, M G; Silva, L; Andrade, J R C; Guth, B E C

    2005-09-01

    The relationship between enteropathogens and severe diarrhoea in the Brazilian Amazon is poorly understood. In 1998, outbreaks of acute diarrhoea clinically diagnosed as cholera occurred in two small villages localized far from the main cholera route in the Brazilian rainforest. PCR was performed on some enteropathogens and heat-labile (LT) and/or heat-stable (STh) toxin genes, the virulence determinants of enterotoxigenic Escherichia coli (ETEC), were detected. Further characterization of ETEC isolates revealed the presence of two clones, one from each outbreak. One presenting serotype O167:H5 harboured LT-I and STh toxin genes and expressed the CS5CS6 colonization factor. The other, a non-typeable serotype, was positive for the LT-I gene and expressed the CS7 colonization factor. The current study demonstrates the importance of molecular diagnosis in regions such as the Amazon basin, where the enormous distances and local support conditions make standard laboratory diagnosis difficult. Here we also show that the mis-identified cholera cases were in fact associated with ETEC strains. This is the first report of ETEC, molecularly characterized as the aetiological agent of severe diarrhoea in children and adults in the Brazilian Amazon Rainforest.

  17. Albendazole versus metronidazole in the treatment of adult giardiasis: a randomized, double-blind, clinical trial.

    PubMed

    Cañete, Roberto; Rodríguez, Pablo; Mesa, Lumey; Brito, Katia; Prior, Ada; Guilhem, Dirce; Novaes, M R C G

    2012-01-01

    Albendazole (ABZ) is a benzimidazole carbamate compound currently in use for human medical practice against enterobiasis and soil-transmitted helminthiasis (STH); However, its spectrum of activity is broad and goes beyond these infections. This study compares the efficacy and safety of ABZ versus metronidazole (MTZ) in human giardiasis. A randomized, double-blind, clinical trial was carried out at the Centre of Hygiene, Epidemiology and Microbiology in Matanzas City, Cuba. Adult patients with confirmed symptomatic G. duodenalis mono-infection were randomly assigned to receive either ABZ [400 mg daily (n = 75)] or MTZ [250 mg t.i.d. (n = 75)], both for 5 days. Follow-up fecal samples were obtained at 3, 5, 7 days after treatment end. The efficacy was similar for both treatment groups: ABZ (82.6%) and MTZ (85.3%); p > 0.05. Side-effects including bitter taste, headache, vomiting and dizziness were significantly higher in the MTZ group. Abdominal pain was significantly higher in ABZ group. ABZ was found as effective as MTZ in the treatment of G. duodenalis infections in adult patients from Cuba and could be a useful drug in areas where co-infection with STH infections is common.

  18. Proceedings on Combating the Unrestricted Warfare Threat: Integrating Strategy, Analysis, and Technology, 20-21 March 2007

    DTIC Science & Technology

    2007-03-01

    Prosthetics to enable return to units without loss of capability Quantum...and will give us a big advantage in terms of unrestricted warfare. Figure 17 high-Productivity Computing System PRoSThETICS We have an exciting...program in prosthetics (Figure 18). It started with a monkey at Duke University. We put microelectronic implants into her brain, taught her

  19. Long-term myocardial preservation: beneficial and additive effects of polarized arrest (Na+-channel blockade), Na+/H+-exchange inhibition, and Na+/K+/2Cl- -cotransport inhibition combined with calcium desensitization.

    PubMed

    Snabaitis, A K; Chambers, D

    1999-11-27

    Polarized arrest, induced by tetrodotoxin (TTX) at an optimal concentration of 22 micromol/L, has been shown to reduce ionic imbalance and improve myocardial preservation compared with hyperkalemic (depolarized) arrest. Additional pharmacologic manipulation of ionic changes (involving inhibition of Na+ influx by the Na+/H+ exchanger [HOE694] and Na+/K+/2Cl- cotransporter [furosemide], and calcium desensitization [BDM]) may further improve long-term preservation. In this study, we (i) established optimal concentrations of each drug, (ii) determined additive effects of optimal concentrations of each drug and (iii) compared our optimal preservation solution to an established depolarizing cardioplegia (St Thomas' Hospital solution No 2: STH2) used during long-term hypothermic storage for clinical transplantation. The isolated working rat heart, perfused with Krebs Henseleit (KH) buffer was used; cardiac function was measured after 20 min aerobic working mode perfusion. The hearts (n=6/group) were arrested with a 2 ml infusion (for 30 sec) of the polarizing (control) solution (22 micromol/L TTX in KH) or control+drug and subjected to 5 hr or 8 hr of storage at 7.5 degrees C in the arresting solution. Postischemic function during reperfusion was measured (expressed as percentage of preischemic function). Dose-response studies established optimal concentrations of HOE694 (10 micromol/L), furosemide (1.0 micromol/L) and BDM (30 mmol/L) in the polarizing (control) solution. Sequential addition to the control solution (Group I) of optimal concentrations of HOE694 (Group II), furosemide (Group III), and BDM (Group IV) were compared with STH2 (Group V); postischemic recovery of aortic flow was 29+/-7%, 49+/-6%*, 56+/-2%*, 76+/-3%*, and 25+/-6%, respectively (*P<0.05 vs. I and V). Creatine kinase leakage was lowest, and myocardial ATP content was highest in Group IV. A polarizing preservation solution (KH+TTX) containing HOE694, furosemide, and BDM significantly enhanced long-term preservation compared with an optimized depolarizing solution (STH2) used clinically for long-term donor heart preservation.

  20. Controlling Neglected Tropical Diseases (NTDs) in Haiti: Implementation Strategies and Evidence of Their Success

    PubMed Central

    Lemoine, Jean Frantz; Desormeaux, Anne Marie; Monestime, Franck; Fayette, Carl Renad; Desir, Luccene; Direny, Abdel Nasser; Carciunoiu, Sarah; Miller, Lior; Knipes, Alaine; Lammie, Patrick; Smith, Penelope; Stockton, Melissa; Trofimovich, Lily; Bhandari, Kalpana; Reithinger, Richard; Crowley, Kathryn; Ottesen, Eric; Baker, Margaret

    2016-01-01

    Lymphatic filariasis (LF) and soil-transmitted helminths (STH) have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA) program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti’s neglected tropical disease (NTD) program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a “directly observed treatment” strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained– 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH—and the significant reduction in burden of infection– 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti’s very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of “best practices” for NTD control but also are poised to help solve two of the most important future NTD challenges—how to maintain control of STH infections after the community-based LF “treatment platform” ceases and how to ensure appropriate morbidity management for patients currently suffering from lymphatic filarial disease. PMID:27706162

  1. Global epidemiology, ecology and control of soil-transmitted helminth infections

    PubMed Central

    Brooker, Simon; Clements, Archie CA; Bundy, Don AP

    2007-01-01

    Soil-transmitted helminth (STH) infections are among the most prevalent of chronic human infections worldwide. Based on the demonstrable impact on child development, there is a global commitment to finance and implement control strategies with a focus on school-based chemotherapy programmes. The major obstacle to the implementation of cost-effective control is the lack of accurate descriptions of the geographical distribution of infection. In recent years considerable progress has been made in the use of geographical information systems (GIS) and remote sensing (RS) to better understand helminth ecology and epidemiology, and to develop low cost ways to identify target populations for treatment. This chapter explores how this information has been used practically to guide large-scale control programmes. The use of satellite-derived environmental data has yielded new insights into the ecology of infection at a geographical scale that has proven impossible to address using more traditional approaches, and has in turn allowed spatial distributions of infection prevalence to be predicted robustly by statistical approaches. GIS/RS have increasingly been used in the context of large-scale helminth control programmes, including not only STH infections but also those focusing on schistosomiasis, filariasis and onchocerciasis. The experience indicates that GIS/RS provides a cost-effective approach to designing and monitoring programs at realistic scale. Importantly, the use of this approach has begun to transition from being a specialist approach of international vertical programs to become a routine tool in developing public sector control programs. GIS/RS is used here to describe the global distribution of STH infections and to estimate the number of infections in school age children in sub-Saharan Africa (89.9 million) and the annual cost of providing a single anthelmintic treatment using a school-based approach (US$5.0-7.6 million). These are the first estimates at a continental scale to explicitly include the fine spatial distribution of infection prevalence and population, and suggest that traditional methods have overestimated the situation. The results suggest that continent-wide control of parasites is, from a financial perspective, an attainable goal. PMID:16647972

  2. Current status of soil transmitted helminths and Schistosoma mansoni infection among children in two primary schools in North Gondar, Northwest Ethiopia: a cross sectional study

    PubMed Central

    2014-01-01

    Background School age children are one of the groups at high risk for intestinal parasitic infections especially in developing countries like Ethiopia as the supply of good quality drinking water and latrine coverage are poor. Though there are previous data on the prevalence of soil transmitted helminths (STHs) and Schistosoma mansoni infection among these high risk groups current status in the study area is unknown. Therefore, the aim of this study was to determine the current prevalence and associated risk factors of STHs and S. mansoni infections among school children. Methods A cross-sectional study was carried out in Gorgora and Chuahit towns, North Gondar Zone, North West Ethiopia from January 20 to February 25, 2012 involving 261 school children. A pre-tested and structured questionnaire was used to collect socio-demographic data and possible risk factors. Stool samples were collected and examined for intestinal parasites using Kato Katz method. Chi-square test was used to see if there is association between sociodemographic factors and other risk factors for STH and S. mansoni infection and odds ratio with 95% CI was computed as measures of association. P < 0.05 was taken as statistically significant. Results Out of the 261 study participants, 174 (66.7%) were infected with one or more species of intestinal parasites. Ascaris lumbricoides was the predominant isolates (39.8%) followed by Trichuris trichiura (6.1%) and Hookworms (4.9%). Schistosoma mansoni was detected in 33.7% of the children. Among infected individuals, 9.5% were coinfected by S. mansoni and A. lumbricoides and 1.5% with S. mansoni and T. trichiura. Swimming habit (OR: 2.536, 95% CI: 1.122, 5.737, P = 0.022) was significantly associated with S. mansoni infection. Conclusion The prevalence of STH and S. mansoni was high among school children. This should call for implementation of an integrated strategy to reduce morbidity and control of transmission of STH and S. mansoni. PMID:24512613

  3. A Comparison of the Sensitivity and Fecal Egg Counts of the McMaster Egg Counting and Kato-Katz Thick Smear Methods for Soil-Transmitted Helminths

    PubMed Central

    Levecke, Bruno; Behnke, Jerzy M.; Ajjampur, Sitara S. R.; Albonico, Marco; Ame, Shaali M.; Charlier, Johannes; Geiger, Stefan M.; Hoa, Nguyen T. V.; Kamwa Ngassam, Romuald I.; Kotze, Andrew C.; McCarthy, James S.; Montresor, Antonio; Periago, Maria V.; Roy, Sheela; Tchuem Tchuenté, Louis-Albert; Thach, D. T. C.; Vercruysse, Jozef

    2011-01-01

    Background The Kato-Katz thick smear (Kato-Katz) is the diagnostic method recommended for monitoring large-scale treatment programs implemented for the control of soil-transmitted helminths (STH) in public health, yet it is difficult to standardize. A promising alternative is the McMaster egg counting method (McMaster), commonly used in veterinary parasitology, but rarely so for the detection of STH in human stool. Methodology/Principal Findings The Kato-Katz and McMaster methods were compared for the detection of STH in 1,543 subjects resident in five countries across Africa, Asia and South America. The consistency of the performance of both methods in different trials, the validity of the fixed multiplication factor employed in the Kato-Katz method and the accuracy of these methods for estimating ‘true’ drug efficacies were assessed. The Kato-Katz method detected significantly more Ascaris lumbricoides infections (88.1% vs. 75.6%, p<0.001), whereas the difference in sensitivity between the two methods was non-significant for hookworm (78.3% vs. 72.4%) and Trichuris trichiura (82.6% vs. 80.3%). The sensitivity of the methods varied significantly across trials and magnitude of fecal egg counts (FEC). Quantitative comparison revealed a significant correlation (Rs >0.32) in FEC between both methods, and indicated no significant difference in FEC, except for A. lumbricoides, where the Kato-Katz resulted in significantly higher FEC (14,197 eggs per gram of stool (EPG) vs. 5,982 EPG). For the Kato-Katz, the fixed multiplication factor resulted in significantly higher FEC than the multiplication factor adjusted for mass of feces examined for A. lumbricoides (16,538 EPG vs. 15,396 EPG) and T. trichiura (1,490 EPG vs. 1,363 EPG), but not for hookworm. The McMaster provided more accurate efficacy results (absolute difference to ‘true’ drug efficacy: 1.7% vs. 4.5%). Conclusions/Significance The McMaster is an alternative method for monitoring large-scale treatment programs. It is a robust (accurate multiplication factor) and accurate (reliable efficacy results) method, which can be easily standardized. PMID:21695104

  4. Relationship between Carotid Intima Media Thickness and Helminth Infections on Flores Island, Indonesia

    PubMed Central

    Wiria, Aprilianto Eddy; Wammes, Linda J.; Hamid, Firdaus; Dekkers, Olaf M.; Prasetyani, Margaretta A.; May, Linda; Kaisar, Maria M. M.; Verweij, Jaco J.; Tamsma, Jouke T.; Partono, Felix; Sartono, Erliyani

    2013-01-01

    Objective To examine the association between helminth infections and atherosclerosis. Background Chronic helminth infection, which can lead to poor nutritional status and anti-inflammatory response, might protect against the development of atherosclerosis. Methods A cross-sectional study was performed in Flores, Indonesia, an area highly endemic for soil-transmitted helminths (STH). Stool samples from 675 participants aged 18–80 years were collected and screened for Trichuris trichiura by microscopy and for Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale, and Strongyloides stercoralis by qPCR. We collected data on body mass index (BMI), waist to hip ratio (WHR), blood pressure, fasting blood glucose (FBG), lipid, high sensitive C-reactive protein (hs-CRP), total immunoglobulin-E (TIgE) and Escherichia coli lipopolysaccharide stimulated cytokines (tumor necrosis factor and interleukin-10). In a subset of 301 elderly adults (≥40 years of age) carotid intima media thickness (cIMT) was measured. Results Participants with any STH infection had lower BMI (kg/m2) (mean difference −0.66, 95%CI [−1.26, −0.06]), WHR (−0.01, [−0.02, −0.00]), total cholesterol (mmol/L) (−0.22, [−0.43, −0.01]) and LDL-cholesterol (mmol/L) (−0.20, [−0.39, −0.00]) than uninfected participants. After additional adjustment for BMI the association between helminth infection and total cholesterol (mean difference −0.17, 95%CI [−0.37, 0.03]) as well as LDL-cholesterol (−0.15, [−0.33, 0.04]) was less pronounced. BMI, WHR, and total cholesterol were negatively associated with number species of helminth co-infections. Participants with high TIgE, an indicator of exposure to helminths, had lower FBG, TC, and HDL. The association between TIgE and TC and HDL remained significant after adjustment with BMI. No clear association was found between STH infection or TIgE and mean cIMT. Conclusions This cross-sectional study presents evidence that helminth infections were negatively associated with risk factors for cardiovascular disease, an association at least partially mediated by an effect on BMI. The significance of this finding needs to be determined. PMID:23365679

  5. Strongyloides stercoralis and hookworm co-infection: spatial distribution and determinants in Preah Vihear Province, Cambodia.

    PubMed

    Forrer, Armelle; Khieu, Virak; Schär, Fabian; Vounatsou, Penelope; Chammartin, Frédérique; Marti, Hanspeter; Muth, Sinuon; Odermatt, Peter

    2018-01-12

    Strongyloides stercoralis and hookworm are two soil-transmitted helminths (STH) that are highly prevalent in Cambodia. Strongyloides stercoralis causes long-lasting infections and significant morbidity but is largely neglected, while hookworm causes the highest public health burden among STH. The two parasites have the same infection route, i.e. skin penetration. The extent of co-distribution, which could result in potential high co-morbidities, is unknown in highly endemic settings like Cambodia. The aim of this study was to predict the spatial distribution of S. stercoralis-hookworm co-infection risk and to investigate determinants of co-infection in Preah Vihear Province, North Cambodia. A cross-sectional survey was conducted in 2010 in 60 villages of Preah Vihear Province. Diagnosis was performed on two stool samples, using combined Baermann technique and Koga agar culture plate for S. stercoralis and Kato-Katz technique for hookworm. Bayesian multinomial geostatistical models were used to assess demographic, socioeconomic, and behavioural determinants of S. stercoralis-hookworm co-infection and to predict co-infection risk at non-surveyed locations. Of the 2576 participants included in the study, 48.6% and 49.0% were infected with S. stercoralis and hookworm, respectively; 43.8% of the cases were co-infections. Females, preschool aged children, adults aged 19-49 years, and participants who reported regularly defecating in toilets, systematically boiling drinking water and having been treated with anthelmintic drugs had lower odds of co-infection. While S. stercoralis infection risk did not appear to be spatially structured, hookworm mono-infection and co-infection exhibited spatial correlation at about 20 km. Co-infection risk was positively associated with longer walking distances to a health centre and exhibited a small clustering tendency. The association was only partly explained by climatic variables, suggesting a role for underlying factors, such as living conditions and remoteness. Both parasites were ubiquitous in the province, with co-infections accounting for almost half of all cases. The high prevalence of S. stercoralis calls for control measures. Despite several years of school-based de-worming programmes, hookworm infection levels remain high. Mebendazole efficacy, as well as coverage of and compliance to STH control programmes should be investigated.

  6. Monitoring and evaluating the impact of national school-based deworming in Kenya: study design and baseline results.

    PubMed

    Mwandawiro, Charles S; Nikolay, Birgit; Kihara, Jimmy H; Ozier, Owen; Mukoko, Dunstan A; Mwanje, Mariam T; Hakobyan, Anna; Pullan, Rachel L; Brooker, Simon J; Njenga, Sammy M

    2013-07-05

    An increasing number of countries in Africa and elsewhere are developing national plans for the control of neglected tropical diseases. A key component of such plans is school-based deworming (SBD) for the control of soil-transmitted helminths (STHs) and schistosomiasis. Monitoring and evaluation (M&E) of national programmes is essential to ensure they are achieving their stated aims and to evaluate when to reduce the frequency of treatment or when to halt it altogether. The article describes the M&E design of the Kenya national SBD programme and presents results from the baseline survey conducted in early 2012. The M&E design involves a stratified series of pre- and post-intervention, repeat cross-sectional surveys in a representative sample of 200 schools (over 20,000 children) across Kenya. Schools were sampled based on previous knowledge of STH endemicity and were proportional to population size. Stool (and where relevant urine) samples were obtained for microscopic examination and in a subset of schools; finger-prick blood samples were collected to estimate haemoglobin concentration. Descriptive and spatial analyses were conducted. The evaluation measured both prevalence and intensity of infection. Overall, 32.4% of children were infected with at least one STH species, with Ascaris lumbricoides as the most common species detected. The overall prevalence of Schistosoma mansoni was 2.1%, while in the Coast Province the prevalence of S. haematobium was 14.8%. There was marked geographical variation in the prevalence of species infection at school, district and province levels. The prevalence of hookworm infection was highest in Western Province (25.1%), while A. lumbricoides and T. trichiura prevalence was highest in the Rift Valley (27.1% and 11.9%). The lowest prevalence was observed in the Rift Valley for hookworm (3.5%), in the Coast for A. lumbricoides (1.0%), and in Nyanza for T. trichiura (3.6%). The prevalence of S. mansoni was most common in Western Province (4.1%). The current findings are consistent with the known spatial ecology of STH and schistosome infections and provide an important empirical basis on which to evaluate the impact of regular mass treatment through the school system in Kenya.

  7. Relationship between carotid intima media thickness and helminth infections on Flores Island, Indonesia.

    PubMed

    Wiria, Aprilianto Eddy; Wammes, Linda J; Hamid, Firdaus; Dekkers, Olaf M; Prasetyani, Margaretta A; May, Linda; Kaisar, Maria M M; Verweij, Jaco J; Tamsma, Jouke T; Partono, Felix; Sartono, Erliyani; Supali, Taniawati; Yazdanbakhsh, Maria; Smit, Johannes W A

    2013-01-01

    To examine the association between helminth infections and atherosclerosis. Chronic helminth infection, which can lead to poor nutritional status and anti-inflammatory response, might protect against the development of atherosclerosis. A cross-sectional study was performed in Flores, Indonesia, an area highly endemic for soil-transmitted helminths (STH). Stool samples from 675 participants aged 18-80 years were collected and screened for Trichuris trichiura by microscopy and for Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale, and Strongyloides stercoralis by qPCR. We collected data on body mass index (BMI), waist to hip ratio (WHR), blood pressure, fasting blood glucose (FBG), lipid, high sensitive C-reactive protein (hs-CRP), total immunoglobulin-E (TIgE) and Escherichia coli lipopolysaccharide stimulated cytokines (tumor necrosis factor and interleukin-10). In a subset of 301 elderly adults (≥40 years of age) carotid intima media thickness (cIMT) was measured. Participants with any STH infection had lower BMI (kg/m2) (mean difference -0.66, 95%CI [-1.26, -0.06]), WHR (-0.01, [-0.02, -0.00]), total cholesterol (mmol/L) (-0.22, [-0.43, -0.01]) and LDL-cholesterol (mmol/L) (-0.20, [-0.39, -0.00]) than uninfected participants. After additional adjustment for BMI the association between helminth infection and total cholesterol (mean difference -0.17, 95%CI [-0.37, 0.03]) as well as LDL-cholesterol (-0.15, [-0.33, 0.04]) was less pronounced. BMI, WHR, and total cholesterol were negatively associated with number species of helminth co-infections. Participants with high TIgE, an indicator of exposure to helminths, had lower FBG, TC, and HDL. The association between TIgE and TC and HDL remained significant after adjustment with BMI. No clear association was found between STH infection or TIgE and mean cIMT. This cross-sectional study presents evidence that helminth infections were negatively associated with risk factors for cardiovascular disease, an association at least partially mediated by an effect on BMI. The significance of this finding needs to be determined.

  8. Nanostructures: Physics and Technology International Symposium (9th), St. Petersburg, Russia, June 18-22, 2001 Proceedings

    DTIC Science & Technology

    2001-06-22

    detection: SThM operates because of heat extending into the microfabricated thermocouple. Therefore, the nature of the thermal contact between tip and...local heating phenomena . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202 ix NC.05 Yu. V. Dubrovskii, A. Patane, P. N... heating . During the growth process the rotation of the samples is used, temperature field inhomogenity across the surface is about ∼ 5%. In order to

  9. Notes on Finite Cooperative Games,

    DTIC Science & Technology

    1981-02-01

    solution concepts: .-%. P Th. 1: (VIN) M (r) + o (Peleg) 11 r STh. II: (VI) K(r) + 0 (Maschler & Peleg) Donald Brown and Peter Loeb, "The Values of...C. If ZeJ and ySZ ipso facto ZeC C. Since K K 0jC- for any j, CcC, OJC. Then C is a filter and C 3. By Zorn’s Lemma there exists UI such that UI is

  10. Metabolic Effects of FecB Gene on Follicular Fluid and Ovarian Vein Serum in Sheep (Ovis aries)

    PubMed Central

    Guo, Xiaofei; Wang, Xiangyu; Di, Ran; Liu, Qiuyue; Hu, Wenping; He, Xiaoyun; Yu, Jiarui; Zhang, Xiaosheng; Zhang, Jinlong; Broniowska, Katarzyna; Chen, Wei; Wu, Changxin; Chu, Mingxing

    2018-01-01

    The FecB gene has been discovered as an important gene in sheep for its high relationship with the ovulation rate, but its regulatory mechanism remains unknown. In the present study, liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS) techniques were adopted to detect the metabolic effects of FecB gene in follicular fluid (FF) and ovarian vein serum (OVS) in Small Tail Han (STH) sheep. ANOVA and random forest statistical methods were employed for the identification of important metabolic pathways and biomarkers. Changes in amino acid metabolism, redox environment, and energy metabolism were observed in FF from the three FecB genotype STH ewes. Principal component analysis (PCA) and hierarchical clustering analysis (HCA) showed that metabolic effects of FecB gene are more pronounced in FF than in OVS. Therefore, the difference of the metabolic profile in FF is also affected by the FecB genotypes. In Spearman correlation analysis, key metabolites (e.g., glucose 6-phosphate, glucose 1-phosphate, aspartate, asparagine, glutathione oxidized (GSSG), cysteine-glutathione disulfide, γ-glutamylglutamine, and 2-hydrosybutyrate) in ovine FF samples showed a significant correlation with the ovulation rate. Our findings will help to explain the metabolic mechanism of high prolificacy ewes and benefit fertility identification. PMID:29439449

  11. Origin and Evolution of Allopolyploid Wheatgrass Elymus fibrosus (Schrenk) Tzvelev (Poaceae: Triticeae) Reveals the Effect of Its Origination on Genetic Diversity

    PubMed Central

    Gu, Hai-Lan; Wu, Pan-Pan; Yi, Xu; Wang, Wei-Jie; Shi, Han-Feng; Wu, De-Xiang; Sun, Genlou

    2016-01-01

    Origin and evolution of tetraploid Elymus fibrosus (Schrenk) Tzvelev were characterized using low-copy nuclear gene Rpb2 (the second largest subunit of RNA polymerase II), and chloroplast region trnL–trnF (spacer between the tRNA Leu (UAA) gene and the tRNA-Phe (GAA) gene). Ten accessions of E. fibrosus along with 19 Elymus species with StH genomic constitution and diploid species in the tribe Triticeae were analyzed. Chloroplast trnL–trnF sequence data suggested that Pseudoroegneria (St genome) was the maternal donor of E. fibrosus. Rpb2 data confirmed the presence of StH genomes in E. fibrosus, and suggested that St and H genomes in E. fibrosus each is more likely originated from single gene pool. Single origin of E. fibrosus might be one of the reasons causing genetic diversity in E. fibrosus lower than those in E. caninus and E. trachycaulus, which have similar ecological preferences and breeding systems with E. fibrosus, and each was originated from multiple sources. Convergent evolution of St and H copy Rpb2 sequences in some accessions of E. fibrosus might have occurred during the evolutionary history of this allotetraploid. PMID:27936163

  12. Toxocara (Nematoda: Ascaridida) and Other Soil-Transmitted Helminth Eggs Contaminating Soils in Selected Urban and Rural Areas in the Philippines

    PubMed Central

    Paller, Vachel Gay V.; de Chavez, Emmanuel Ryan C.

    2014-01-01

    The extent of contamination of soils with soil transmitted helminthes (STH) eggs, particularly Toxocara, was determined in selected urban and rural towns of Laguna, Philippines. Soil samples were collected from public schools, house yards, and empty lots. Results revealed that, of the 1480 soil samples collected, 460 (31%) were positive for STH eggs. Toxocara sp. was the most prevalent (77%), followed by Ascaris sp. (11%), hookworms/strongyles/free-living nematodes (7%), and Trichuris sp. (5%). Some soil physicochemical parameters were also determined and associated with Toxocara eggs prevalence and density in soil. Results revealed that Toxocara sp. eggs were most prevalent in less acidic, relatively high temperature and high moisture soil conditions. They were also prevalent in sandy, silty, and loamy soil textures but less prevalent in clayey. No significant differences were found between depth 1 (0–5 cm) and depth 2 (6–10 cm). This study revealed that Toxocara sp. eggs are ubiquitous and the extent of contamination in soils from the selected towns of Laguna is relatively high. Hence, the data generated in this study can be used in promoting public awareness, particularly for pet owners and local health officials, for effective prevention and control of this parasitosis. PMID:25383372

  13. Generation of biallelic knock-out sheep via gene-editing and somatic cell nuclear transfer

    PubMed Central

    Li, Honghui; Wang, Gui; Hao, Zhiqiang; Zhang, Guozhong; Qing, Yubo; Liu, Shuanghui; Qing, Lili; Pan, Weirong; Chen, Lei; Liu, Guichun; Zhao, Ruoping; Jia, Baoyu; Zeng, Luyao; Guo, Jianxiong; Zhao, Lixiao; Zhao, Heng; Lv, Chaoxiang; Xu, Kaixiang; Cheng, Wenmin; Li, Hushan; Zhao, Hong-Ye; Wang, Wen; Wei, Hong-Jiang

    2016-01-01

    Transgenic sheep can be used to achieve genetic improvements in breeds and as an important large-animal model for biomedical research. In this study, we generated a TALEN plasmid specific for ovine MSTN and transfected it into fetal fibroblast cells of STH sheep. MSTN biallelic-KO somatic cells were selected as nuclear donor cells for SCNT. In total, cloned embryos were transferred into 37 recipient gilts, 28 (75.7%) becoming pregnant and 15 delivering, resulting in 23 lambs, 12 of which were alive. Mutations in the lambs were verified via sequencing and T7EI assay, and the gene mutation site was consistent with that in the donor cells. Off-target analysis was performed, and no off-target mutations were detected. MSTN KO affected the mRNA expression of MSTN relative genes. The growth curve for the resulting sheep suggested that MSTN KO caused a remarkable increase in body weight compared with those of wild-type sheep. Histological analyses revealed that MSTN KO resulted in muscle fiber hypertrophy. These findings demonstrate the successful generation of MSTN biallelic-KO STH sheep via gene editing in somatic cells using TALEN technology and SCNT. These MSTN mutant sheep developed and grew normally, and exhibited increased body weight and muscle growth. PMID:27654750

  14. [The effect of ivermectin on geohelminth frequency (i.e. as used in the onchocerciasis control program in Colombia)].

    PubMed

    Knudson, Angélica; Ariza, Yoseth; López, Myriam C; Fajardo, Oscar S; Reyes, Patricia; Moncada, Ligia I; Duque, Sofía; Álvarez, Carlos A; Nicholls, Rubén S

    2012-08-01

    Evaluating the effect of ivermectin on soil-transmitted helminthes (STH) infection frequency in a Colombian population included in the Onchocerciasis Elimination Program for the Americas (OEPA). This was an impact evaluation study which adopted a longitudinal approach using the population of Naicioná (1996) as baseline for comparison to people from the same population as controls (2008). The cross-sectional approach involved comparing the reference population of Naicioná (2008) to the population of Dos Quebradas (2008) used as controls. Fecal samples were processed by a modified Ritchie-Frick method. Ascaris lumbricoides was the most frequently found parasite in Naicioná (60/121; 49.6 %: 37.8-63.895%CI) and in Dos Quebradas (36/76; 47.4 %: 33.2-65.6 95 % CI). Ivermectin's main effect on the population aged over 5 years was a decreased risk of Trichiuris trichiura infection in both longitudinal assessment (86 % reduction: 74-93 95 % CI) and cross-sectional assessment (63 %:24-82 95 % CI). A 93 % reduction (45-99 95 % CI) in Strongyloides stercoralis frequency was found in longitudinal assessment, compared to 85 % in cross-sectional assessment (-031-99 95 % CI). Ivermectin use in the OEPA is not sufficient for STH morbidity control. Integrated programs including education and basic sanitation are required.

  15. Spatial co-distribution of neglected tropical diseases in the East African Great Lakes region: revisiting the justification for integrated control

    PubMed Central

    Clements, Archie C. A.; Deville, Marie-Alice; Ndayishimiye, Onésime; Brooker, Simon; Fenwick, Alan

    2010-01-01

    Summary OBJECTIVE To determine spatial patterns of co-endemicity of schistosomiasis mansoni and the soil-transmitted helminths (STHs) Ascaris lumbricoides, Trichuris trichiura and hookworm in the Great Lakes region of East Africa, to help plan integrated neglected tropical disease programmes in this region. METHOD Parasitological surveys were conducted in Uganda, Tanzania, Kenya and Burundi in 28 213 children in 404 schools. Bayesian geostatistical models were used to interpolate prevalence of these infections across the study area. Interpolated prevalence maps were overlaid to determine areas of co-endemicity. RESULTS In the Great Lakes region, prevalence was 18.1% for Schistosoma mansoni, 50.0% for hookworm, 6.8% for A. lumbricoides and 6.8% for T. trichiura. Hookworm infection was ubiquitous, whereas S. mansoni, A. lumbricoides and T. trichiura were highly focal. Most areas were endemic (prevalence ≥10%) or hyperendemic (prevalence ≥50%) for one or more STHs, whereas endemic areas for schistosomiasis mansoni were restricted to foci adjacent large perennial water bodies. CONCLUSION Because of the ubiquity of hookworm, treatment programmes are required for STH throughout the region but efficient schistosomiasis control should only be targeted at limited high-risk areas. Therefore, integration of schistosomiasis with STH control is only indicated in limited foci in East Africa. PMID:20409287

  16. Soil-Transmitted Helminths: Mathematical Models of Transmission, the Impact of Mass Drug Administration and Transmission Elimination Criteria.

    PubMed

    Truscott, J E; Turner, H C; Farrell, S H; Anderson, R M

    2016-01-01

    Infections caused by soil-transmitted helminthias (STHs) affect over a billion people worldwide, causing anaemia and having a large social and economic impact through poor educational outcomes. They are identified in the World Health Organization (WHO) 2020 goals for neglected tropical diseases as a target for renewed effort to ameliorate their global public health burden through mass drug administration (MDA) and water and hygiene improvement. In this chapter, we review the underlying biology and epidemiology of the three causative intestinal nematode species that are mostly considered under the STH umbrella term. We review efforts to model the transmission cycle of these helminths in populations and the effects of preventative chemotherapy on their control and elimination. Recent modelling shows that the different epidemiological characteristics of the parasitic nematode species that make up the STH group can lead to quite distinct responses to any given form of MDA. When connected with models of treatment cost-effectiveness, these models are potentially a powerful tool for informing public policy. A number of shortcomings are identified; lack of critical types of data and poor understanding of diagnostic sensitivities hamper efforts to test and hence improve models. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. An All-Solution-Based Hybrid CMOS-Like Quantum Dot/Carbon Nanotube Inverter.

    PubMed

    Shulga, Artem G; Derenskyi, Vladimir; Salazar-Rios, Jorge Mario; Dirin, Dmitry N; Fritsch, Martin; Kovalenko, Maksym V; Scherf, Ullrich; Loi, Maria A

    2017-09-01

    The development of low-cost, flexible electronic devices is subordinated to the advancement in solution-based and low-temperature-processable semiconducting materials, such as colloidal quantum dots (QDs) and single-walled carbon nanotubes (SWCNTs). Here, excellent compatibility of QDs and SWCNTs as a complementary pair of semiconducting materials for fabrication of high-performance complementary metal-oxide-semiconductor (CMOS)-like inverters is demonstrated. The n-type field effect transistors (FETs) based on I - capped PbS QDs (V th = 0.2 V, on/off = 10 5 , S S-th = 114 mV dec -1 , µ e = 0.22 cm 2 V -1 s -1 ) and the p-type FETs with tailored parameters based on low-density random network of SWCNTs (V th = -0.2 V, on/off > 10 5 , S S-th = 63 mV dec -1 , µ h = 0.04 cm 2 V -1 s -1 ) are integrated on the same substrate in order to obtain high-performance hybrid inverters. The inverters operate in the sub-1 V range (0.9 V) and have high gain (76 V/V), large maximum-equal-criteria noise margins (80%), and peak power consumption of 3 nW, in combination with low hysteresis (10 mV). © 2017 The Authors. Published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. Photoelectrochemical Hydrogen Production

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hu, Jian

    The objectives of this project, covering two phases and an additional extension phase, were the development of thin film-based hybrid photovoltaic (PV)/photoelectrochemical (PEC) devices for solar-powered water splitting. The hybrid device, comprising a low-cost photoactive material integrated with amorphous silicon (a-Si:H or a-Si in short)-based solar cells as a driver, should be able to produce hydrogen with a 5% solar-to-hydrogen conversion efficiency (STH) and be durable for at least 500 hours. Three thin film material classes were studied and developed under this program: silicon-based compounds, copper chalcopyrite-based compounds, and metal oxides. With the silicon-based compounds, more specifically the amorphous siliconmore » carbide (a-SiC), we achieved a STH efficiency of 3.7% when the photoelectrode was coupled to an a-Si tandem solar cell, and a STH efficiency of 6.1% when using a crystalline Si PV driver. The hybrid PV/a-SiC device tested under a current bias of -3~4 mA/cm{sup 2}, exhibited a durability of up to ~800 hours in 0.25 M H{sub 2}SO{sub 4} electrolyte. Other than the PV driver, the most critical element affecting the photocurrent (and hence the STH efficiency) of the hybrid PV/a-SiC device was the surface energetics at the a-SiC/electrolyte interface. Without surface modification, the photocurrent of the hybrid PEC device was ~1 mA/cm{sup 2} or lower due to a surface barrier that limits the extraction of photogenerated carriers. We conducted an extensive search for suitable surface modification techniques/materials, of which the deposition of low work function metal nanoparticles was the most successful. Metal nanoparticles of ruthenium (Ru), tungsten (W) or titanium (Ti) led to an anodic shift in the onset potential. We have also been able to develop hybrid devices of various configurations in a monolithic fashion and optimized the current matching via altering the energy bandgap and thickness of each constituent cell. As a result, the short-circuit photocurrent density of the hybrid device (measured in a 2-electrode configuration) increased significantly without assistance of any external bias, i.e. from ≤1 mA/cm{sup 2} to ~5 mA/cm{sup 2}. With the copper chalcopyrite compounds, we have achieved a STH efficiency of 3.7% in a coplanar configuration with 3 a-Si solar cells and one CuGaSe{sub 2} photocathode. This material class exhibited good durability at a photocurrent density level of -4 mA/cm{sup 2} (“5% STH” equivalent) at a fixed potential (-0.45 VRHE). A poor band-edge alignment with the hydrogen evolution reaction (HER) potential was identified as the main limitation for high STH efficiency. Three new pathways have been identified to solve this issue. First, PV driver with bandgap lower than that of amorphous silicon were investigated. Crystalline silicon was identified as possible bottom cell. Mechanical stacks made with one Si solar cell and one CuGaSe{sub 2} photocathode were built. A 400 mV anodic shift was observed with the Si cell, leading to photocurrent density of -5 mA/cm{sup 2} at 0VRHE (compared to 0 mA/cm{sup 2} at the same potential without PV driver). We also investigated the use of p-n junctions to shift CuGaSe{sub 2} flatband potential anodically. Reactively sputtered zinc oxy-sulfide thin films was evaluated as n-type buffer and deposited on CuGaSe{sub 2}. Ruthenium nanoparticles were then added as HER catalyst. A 250 mV anodic shift was observed with the p-n junction, leading to photocurrent density at 0VRHE of -1.5 mA/cm{sup 2}. Combining this device with a Si solar cell in a mechanical stack configuration shifted the onset potential further (+400 mV anodically), leading to photocurrent density of -7 mA/cm{sup 2} at 0VRHE. Finally, we developed wide bandgap copper chalcopyrite thin film materials. We demonstrated that Se can be substituted with S using a simple annealing step. Photocurrent densities in the 5-6 mA/cm{sub 2} range were obtained with red 2.0eV CuInGaS{sub 2} photocathodes. With the metal oxide compounds, we have demonstrated that a WO{sub 3}-based hybrid photoelectrode was feasible. Specifically, we showed that WO{sub 3} paired with an a-Si tandem solar cell can generate short circuit photocurrent density of 2.5 mA/cm{sup 2}, equivalent to STH efficiency of 3.1%. Long-term durability tests demonstrated WO{sub 3} ability to split water over extended periods, for up to 600 hours at current density levels of 2.0-2.5 mA/cm{sup 2}. Efforts have been done to decrease WO{sub 3} bandgap using foreign elements incorporation. We did not manage to reduce the bandgap of WO{sub 3} with this method. However, more promising results have been achieved with bilayered systems, where only the top part of WO{sub 3} films was modified. Also, we have demonstrated that alloying WO{sub 3} with CuO can form 2.2eV bandgap CuWO{sub 4}. Incorporating conductive carbon nanotubes in CuWO{sub 4} reduced its intrinsic bulk resistance. Saturation photocurrent densities in the 0.4-0.5 mA/cm{sub 2} range were achieved. Recently, in collaboration with University of Texas at Arlington, we have identified new quaternary metal oxides with CuWO{sub 4} as primary material host. Our experimental work on ceramics confirmed the theoretical calculations that crowned bismuth as a possible candidate to improve CuWO{sub 4} water splitting efficiency.« less

  19. The Enlisted Survival Tracking File (STF): A Revision.

    DTIC Science & Technology

    1982-09-01

    GAY , J I aORACK UNCLASSIFIED NPRDC-TN-N2-27 NLSEEEI*EIIIIIl IIIIIIIIIIIIII IIIIIIIIIIIIII IIIIIIIIIIIIII IIIIIIIIIIIIII IIIIIIIIIIIIII lllllllllllhl...Son Diego, CaI~lomis 92152 82 09 28 011 NPRDC Technical Note 82-27 September 1982 THE ENIZTED SURVIVAL TRACKING PILE (STh): A REVISIO Kenneth W. Gay ...W. Gay , Naval Military Personnel Command 3ules 1. Borack Navy Personnel Research and Development Center , PEIrFORMING, OrGANI9AWION NAME AND A5ES I

  20. Probing the band structure and local electronic properties of low-dimensional semiconductor structures

    NASA Astrophysics Data System (ADS)

    Walrath, Jenna Cherie

    Low-dimensional semiconductor structures are important for a wide variety of applications, and recent advances in nanoscale fabrication are paving the way for increasingly precise nano-engineering of a wide range of materials. It is therefore essential that the physics of materials at the nanoscale are thoroughly understood to unleash the full potential of nanotechnology, requiring the development of increasingly sophisticated instrumentation and modeling. Of particular interest is the relationship between the local density of states (LDOS) of low-dimensional structures and the band structure and local electronic properties. This dissertation presents the investigation of the band structure, LDOS, and local electronic properties of nanostructures ranging from zero-dimensional (0D) quantum dots (QDs) to two-dimensional (2D) thin films, synthesizing computational and experimental approaches including Poisson-Schrodinger band structure calculations, scanning tunneling microscopy (STM), scanning tunneling spectroscopy (STS), and scanning thermoelectric microscopy (SThEM). A method is presented for quantifying the local Seebeck coefficient (S) with SThEM, using a quasi-3D conversion matrix approach to directly convert temperature gradient-induced voltages S. For a GaAs p-n junction, the resulting S-profile is consistent with that computed using the free carrier concentration profile. This combined computational-experimental approach is expected to enable nanoscale measurements of S across a wide variety of heterostructure interfaces. The local carrier concentration, n, is profiled across epitaxial InAs/GaAs QDs, where SThEM is used to profile the temperature gradient-induced voltage, which is converted to a profile of the local S and finally to an n profile. The S profile is converted to a conduction band-edge profile and compared with Poisson-Schrodinger band-edge simulations. The combined computational-experimental approach suggests a reduced n in the QD center in comparison to that of the 2D alloy layer. The surface composition and band structure of ordered horizontal Sb2Te3 nanowires induced by femtosecond laser irradiation of a thin film are investigated, revealing a band gap modulation between buried Sb2Te3 nanowires and the surrounding insulating material. Finally, STM and STS are used to investigate the band structure of BiSbTe alloys at room temperature, revealing both the Fermi level and Dirac point located inside the bulk bandgap, indicating bulk-like insulating behavior with accessible surface states.

  1. Efficacy and safety of co-administered ivermectin plus albendazole for treating soil-transmitted helminths: A systematic review, meta-analysis and individual patient data analysis.

    PubMed

    Palmeirim, Marta S; Hürlimann, Eveline; Knopp, Stefanie; Speich, Benjamin; Belizario, Vicente; Joseph, Serene A; Vaillant, Michel; Olliaro, Piero; Keiser, Jennifer

    2018-04-01

    The soil-transmitted helminths (STH), Ascaris lumbricoides, Trichuris trichiura and hookworms, infect 1.5 billion people worldwide and cause an estimated burden of 3.3 million disability-adjusted life years (DALYs). Current control strategies focus on morbidity reduction through preventive chemotherapy (PC) but the most commonly used recommended drugs (albendazole and mebendazole) are particularly inefficacious against T. trichiura. This, together with the threat of emerging drug resistance, calls for new control strategies, including co-administration with other anthelminthics. Ivermectin plus albendazole is widely used against lymphatic filariasis, but its efficacy and safety against STH infections has not yet been fully understood. We conducted a systematic literature review and meta-analysis on the efficacy and safety of ivermectin-albendazole co-administration in five different databases (i.e. PubMed, ISI Web of Science, ScienceDirect, CENTRAL and clinicaltrials.gov) from 1960 to January 2018. Four studies reporting efficacy of ivermectin-albendazole against STH infections and five studies on its safety met the selection criteria and were included for quantitative analysis. Ivermectin-albendazole was significantly associated with lower risk (risk ratio (RR) = 0.44, 95% confidence interval (CI) = 0.31-0.62) for T. trichiura infection after treatment compared to albendazole alone. The co-administration revealed no or only a marginal benefit on cure and egg reduction rates over albendazole alone for A. lumbricoides and hookworm infections. Adverse events (AEs) occurring after ivermectin-albendazole co-administration were mostly mild and transient. Overall, the number of individuals reporting any AE was not different (RR = 1.09, 95% CI = 0.87-1.36) in co-treated and albendazole-treated patients. However, although not statistically significant, sub-group analysis showed a tendency for slightly more AEs in patients with filariasis treated with ivermectin-albendazole compared to those treated with albendazole alone (RR = 1.29, 95% CI = 0.81-2.05). Our findings suggest a good tolerability and higher efficacy of ivermectin-albendazole against T. trichiura compared to the current standard single-dose albendazole treatment, which supports the use of this co-administration in PC programs. Large-scale definitive randomized controlled trials are required to confirm our results.

  2. Efficacy and safety of co-administered ivermectin plus albendazole for treating soil-transmitted helminths: A systematic review, meta-analysis and individual patient data analysis

    PubMed Central

    Palmeirim, Marta S.; Hürlimann, Eveline; Knopp, Stefanie; Belizario, Vicente; Joseph, Serene A.; Olliaro, Piero

    2018-01-01

    Background The soil-transmitted helminths (STH), Ascaris lumbricoides, Trichuris trichiura and hookworms, infect 1.5 billion people worldwide and cause an estimated burden of 3.3 million disability-adjusted life years (DALYs). Current control strategies focus on morbidity reduction through preventive chemotherapy (PC) but the most commonly used recommended drugs (albendazole and mebendazole) are particularly inefficacious against T. trichiura. This, together with the threat of emerging drug resistance, calls for new control strategies, including co-administration with other anthelminthics. Ivermectin plus albendazole is widely used against lymphatic filariasis, but its efficacy and safety against STH infections has not yet been fully understood. Methods and findings We conducted a systematic literature review and meta-analysis on the efficacy and safety of ivermectin-albendazole co-administration in five different databases (i.e. PubMed, ISI Web of Science, ScienceDirect, CENTRAL and clinicaltrials.gov) from 1960 to January 2018. Four studies reporting efficacy of ivermectin-albendazole against STH infections and five studies on its safety met the selection criteria and were included for quantitative analysis. Ivermectin-albendazole was significantly associated with lower risk (risk ratio (RR) = 0.44, 95% confidence interval (CI) = 0.31–0.62) for T. trichiura infection after treatment compared to albendazole alone. The co-administration revealed no or only a marginal benefit on cure and egg reduction rates over albendazole alone for A. lumbricoides and hookworm infections. Adverse events (AEs) occurring after ivermectin-albendazole co-administration were mostly mild and transient. Overall, the number of individuals reporting any AE was not different (RR = 1.09, 95% CI = 0.87–1.36) in co-treated and albendazole-treated patients. However, although not statistically significant, sub-group analysis showed a tendency for slightly more AEs in patients with filariasis treated with ivermectin-albendazole compared to those treated with albendazole alone (RR = 1.29, 95% CI = 0.81–2.05). Conclusions Our findings suggest a good tolerability and higher efficacy of ivermectin-albendazole against T. trichiura compared to the current standard single-dose albendazole treatment, which supports the use of this co-administration in PC programs. Large-scale definitive randomized controlled trials are required to confirm our results. PMID:29702653

  3. Solar Water Splitting at λ=600 nm: A Step Closer to Sustainable Hydrogen Production.

    PubMed

    Zhang, Jinshui; Wang, Xinchen

    2015-06-15

    Overall water splitting with a semiconductor photocatalyst under visible-light irradiation is considered as a "dream reaction" in chemistry. The development of a 600 nm photocatalyst for solar water splitting highlighted here is not only an important milestone towards sustainable hydrogen production, but also a new starting point for artificial photosynthesis. STH=solar-to-hydrogen energy conversion efficiency. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. An Overview of Conceptual Frameworks

    DTIC Science & Technology

    2008-05-01

    197 and references therein). The list given here varies somewhat to that in Frawley [13] Ch 5. No theoretical commitment is made here to the...equal Balance the electrical loads on each generator oald_v_2 to be equal in value, amount, etc. to sth else that has the opposite effect AM is a...actually or potentially circular (as when, for example, to demand is defined as ‘to request firmly’, and to request as ‘to demand gently

  5. The steps to health employee weight management randomized control trial: rationale, design and baseline characteristics.

    PubMed

    Østbye, Truls; Stroo, Marissa; Brouwer, Rebecca J N; Peterson, Bercedis L; Eisenstein, Eric L; Fuemmeler, Bernard F; Joyner, Julie; Gulley, Libby; Dement, John M

    2013-07-01

    The workplace can be an important setting for addressing obesity. An increasing number of employers offer weight management programs. Present the design, rationale and baseline characteristics of the Steps to Health study (STH), a randomized trial to evaluate the effectiveness of two preexisting employee weight management programs offered at Duke University and Medical Center. 550 obese (BMI ≥30) employee volunteers were randomized 1:1 to two programs. Baseline data, collected between January 2011 and July 2012, included height/weight, accelerometry, workplace injuries, health care utilization, and questionnaires querying socio-cognitive factors, perceptions of health climate, physical activity, and dietary intake. In secondary analyses participants in the two programs will also be compared to a non-randomized observational control group of obese employees. At baseline, the mean age was 45 years, 83% were female, 41% white, and 53% black. Mean BMI was 37.2. Participants consumed a mean of 2.37 servings of fruits and vegetables per day (in the past week), participated in 11.5 min of moderate-to-vigorous physical activity, and spent 620 min being sedentary. STH addresses the need for evaluation of worksite interventions to promote healthy weight. In addition to having direct positive effects on workers' health, worksite programs have the potential to increase productivity and reduce health care costs. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Diagnosis of soil-transmitted helminthiasis in an Amazonic community of Peru using multiple diagnostic techniques.

    PubMed

    Machicado, Jorge D; Marcos, Luis A; Tello, Raul; Canales, Marco; Terashima, Angelica; Gotuzzo, Eduardo

    2012-06-01

    An observational descriptive study was conducted in a Shipibo-Conibo/Ese'Eja community of the rainforest in Peru to compare the Kato-Katz method and the spontaneous sedimentation in tube technique (SSTT) for the diagnosis of intestinal parasites as well as to report the prevalence of soil-transmitted helminth (STH) infections in this area. A total of 73 stool samples were collected and analysed by several parasitological techniques, including Kato-Katz, SSTT, modified Baermann technique (MBT), agar plate culture, Harada-Mori culture and the direct smear examination. Kato-Katz and SSTT had the same rate of detection for Ascaris lumbricoides (5%), Trichuris trichiura (5%), hookworm (14%) and Hymenolepis nana (26%). The detection rate for Strongyloides stercoralis larvae was 16% by SSTT and 0% by Kato-Katz, but 18% by agar plate culture and 16% by MBT. The SSTT also had the advantage of detecting multiple intestinal protozoa such as Blastocystis hominis (40%), Giardia intestinalis (29%) and Entamoeba histolytica/E. dispar (16%). The most common intestinal parasites found in this community were B. hominis, G. intestinalis, H. nana, S. stercoralis and hookworm. In conclusion, the SSTT is not inferior to Kato-Katz for the diagnosis of common STH infections but is largely superior for detecting intestinal protozoa and S. stercoralis larvae. Copyright © 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  7. The acceptability and safety of praziquantel alone and in combination with mebendazole in the treatment of Schistosoma mansoni and soil-transmitted helminthiasis in children aged 1-4 years in Uganda.

    PubMed

    Namwanje, Harriet; Kabatereine, Narcis B; Olsen, Annette

    2011-10-01

    There is limited information on the acceptability and safety of praziquantel for treatment of schistosomiasis in children below the age of four years. In addition, although mebendazole has been extensively used together with praziquantel against infections with schistosomiasis and soil-transmitted helminthiasis (STH) in school-aged children, no specific acceptability or safety studies have been published on this drug combination in younger children. A randomized clinical trial was conducted to determine the safety of praziquantel alone and in combination with mebendazole in the treatment of Schistosoma mansoni and STH in children aged 1 to 4 years. A total of 596 children from Bwondha fishing community in Mayuge district and Wang-Kado fishing community in Nebbi district were investigated using duplicate Kato-Katz thick smears of two stool samples and 130 (21·8%) were found infected with S. mansoni. Of these, 19·2% (25) had heavy intensity of infections. Of the infected children, 82 were included and randomised into praziquantel (40 mg/kg) + mebendazole (500 mg) or praziquantel (40 mg/kg) alone. Many symptoms were reported before treatment while very few were reported after treatment and all on treatment day. No serious adverse events were reported or observed after treatment. Praziquantel with or without mebendazole was well tolerated in small children in the study area.

  8. Structural Characterization and Evolutionary Relationship of High-Molecular-Weight Glutenin Subunit Genes in Roegneria nakaii and Roegneria alashanica.

    PubMed

    Zhang, Lujun; Li, Zhixin; Fan, Renchun; Wei, Bo; Zhang, Xiangqi

    2016-07-19

    The Roegneria of Triticeae is a large genus including about 130 allopolyploid species. Little is known about its high-molecular-weight glutenin subunits (HMW-GSs). Here, we reported six novel HMW-GS genes from R. nakaii and R. alashanica. Sequencing indicated that Rny1, Rny3, and Ray1 possessed intact open reading frames (ORFs), whereas Rny2, Rny4, and Ray2 harbored in-frame stop codons. All of the six genes possessed a similar primary structure to known HMW-GS, while showing some unique characteristics. Their coding regions were significantly shorter than Glu-1 genes in wheat. The amino acid sequences revealed that all of the six genes were intermediate towards the y-type. The phylogenetic analysis showed that the HMW-GSs from species with St, StY, or StH genome(s) clustered in an independent clade, varying from the typical x- and y-type clusters. Thus, the Glu-1 locus in R. nakaii and R. alashanica is a very primitive glutenin locus across evolution. The six genes were phylogenetically split into two groups clustered to different clades, respectively, each of the two clades included the HMW-GSs from species with St (diploid and tetraploid species), StY, and StH genomes. Hence, it is concluded that the six Roegneria HMW-GS genes are from two St genomes undergoing slight differentiation.

  9. The Impact of Two Semiannual Treatments with Albendazole Alone on Lymphatic Filariasis and Soil-Transmitted Helminth Infections: A Community-Based Study in the Republic of Congo

    PubMed Central

    Pion, Sébastien D. S.; Chesnais, Cédric B.; Bopda, Jean; Louya, Frédéric; Fischer, Peter U.; Majewski, Andrew C.; Weil, Gary J.; Boussinesq, Michel; Missamou, François

    2015-01-01

    Implementation of mass drug administration (MDA) with ivermectin plus albendazole (ALB) for lymphatic filariasis (LF) has been delayed in central Africa because of the risk of serious adverse events in subjects with high Loa loa microfilaremia. We conducted a community trial to assess the impact of semiannual MDA with ALB (400 mg) alone on LF and soil-transmitted helminth (STH) infections in the Republic of Congo. Evaluation at 12 months showed that ALB MDA had not significantly reduced Wuchereria bancrofti antigenemia or microfilaria (mf) rates in the community (from 17.3% to 16.6% and from 5.3% to 4.2%, respectively). However, the geometric mean mf count in mf-positive subjects was reduced from 202.2 to 80.9 mf/mL (60% reduction, P = 0.01). The effect of ALB was impressive in 38 subjects who were mf-positive at baseline and retested at 12 months: 37% had total mf clearance, and individual mf densities were reduced by 73.0%. MDA also dramatically reduced the hookworm infection rate in the community from 6.5% to 0.6% (91% reduction), with less impressive effects on Ascaris and Trichuris. These preliminary results suggest that semiannual community MDA with ALB is a promising strategy for controlling LF and STH in areas with coendemic loiasis. PMID:25758650

  10. U.S. State Department urged to beef up science component

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    The U.S. State Department often comes under pressure to respond to a variety of international emergencies one after another, from the U.S. embassy bombings in Kenya and Tanzania to Hurricane Mitch in Central America to the crisis in Kosovo.Many of the department's priorities include significant science, technology, and health (STH) components: nuclear nonproliferation, global climate change, protecting scientific databases, and international food and water supply safety, including arsenic in drinking water wells in Bangladesh, among other varied issues.

  11. Real-Space Formation and Dissipation Dynamics of Hexagonal Reconstruction on Au(100) in Aqueous Media as Explored by Potentiodynamic Scanning Tunneling Microscopy

    DTIC Science & Technology

    1993-04-01

    the clusters appear to form monoatomic layers on the (i x 1) substrate. This assertion, derived from the apparent z-corrugation in the STH images, is...top-layer lattice and thereby displacing one of the nearest-neighbor atoms. A related , although more concerted, atomic motion can also provide a viable...microscopic rate-limiting step(s) for this process are not necessarily related straightforwardly to the free- energy difference for the overall macroscopic

  12. High Efficiency Solar Thermochemical Reactor for Hydrogen Production.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    McDaniel, Anthony H.

    2017-09-30

    This research and development project is focused on the advancement of a technology that produces hydrogen at a cost that is competitive with fossil-based fuels for transportation. A twostep, solar-driven WS thermochemical cycle is theoretically capable of achieving an STH conversion ratio that exceeds the DOE target of 26% at a scale large enough to support an industrialized economy [1]. The challenge is to transition this technology from the laboratory to the marketplace and produce hydrogen at a cost that meets or exceeds DOE targets.

  13. Global trends in neglected tropical disease control and elimination: impact on child health.

    PubMed

    Barry, Meagan A; Simon, Gregory G; Mistry, Neeraj; Hotez, Peter J

    2013-08-01

    The neglected tropical diseases (NTDs) are a group of 17 lesser known chronic infections which predominantly affect poor and disenfranchised communities. There are a number of NTDs that cause significant global morbidity in children, including the three major soil transmitted helminth (STH) infections (ascariasis, trichuriasis and hookworm infection), schistosomiasis and trachoma. These NTDs, together with lymphatic filariasis and onchocerciasis, are currently being targeted for global control and elimination through mass drug administration (MDA) campaigns. They represent the most common NTDs and share significant geographical overlap. Additionally, many individuals are polyparasitised with more than a single NTD. Integrated NTD control and elimination MDA programmes offer safe and efficacious treatments for all seven NTDs. However, the current global level of MDA coverage for the leading childhood NTDs, that is, STH infections, schistosomiasis and trachoma, remains well under 50%. Limiting factors for global coverage include insufficient global financial support, drug donation capacity of pharmaceutical companies and targeting school age children to the exclusion of other age groups in need of treatment, such as preschool age children. There is also a need for development of novel prevention and treatment modalities, such as next-generation small molecule drugs and vaccines. Efforts are underway to harness the momentum of a 2012 London Declaration on NTDs and a 2013 World Health Assembly (WHA) resolution as a means to control or in some cases eliminate by 2020 these NTDs that affect children worldwide.

  14. Prevalence of Schistosomes and Soil-Transmitted Helminths and Morbidity Associated with Schistosomiasis among Adult Population in Lake Victoria Basin, Tanzania.

    PubMed

    Siza, Julius E; Kaatano, Godfrey M; Chai, Jong-Yil; Eom, Keeseon S; Rim, Han-Jong; Yong, Tai-Soon; Min, Duk-Young; Chang, Su Young; Ko, Yunsuk; Changalucha, John M

    2015-10-01

    The objective of this study was to carry out a community survey on schistosomiais and soil-transmitted helminth (STH) infections in order to suggest feasible and effective intervention strategies in Lake Victoria basin, Tanzania. A total of 37 communities selected from 23 districts of the 4 regions in the Lake Victoria basin of Tanzania were involved in the study. From each of the selected locality, 50 adult community members, 25 males and 25 females, were recruited for the study. Each study participant was requested to submit stool and urine specimens. From each stool specimen, duplicate Kato-Katz thick smears were prepared and microscopically examined for Schistosoma mansoni and STH eggs. Urine specimens were processed by the filtration technique and microscopically examined for Schistosoma haematobium eggs. Ultrasound examination for morbidity due to schistosomiasis was performed. Mass treatment was done using praziquantel and albendazole for schistosome and STHs infections, respectively. Out of 1,606 adults who provided stool specimens, 199 (12.4%) were positive for S. mansoni, 349 (21.7%) for hookworms, 133 (8.3%) for Ascaris lumbricoides, and 33 (2.0%) for Trichuris trichiura. Out of 1,400 participants who provided urine specimens, 25 (1.8%) were positive for S. haematobium eggs. Because of the co-endemicity of these afflictions and their impact on vulnerable population groups, the helminthiasis could be simultaneously treated with 2 drugs, praziquantel for schistosomiasis and albendazole for STHs.

  15. Triple Co-Administration of Ivermectin, Albendazole and Praziquantel in Zanzibar: A Safety Study

    PubMed Central

    Mohammed, Khalfan A.; Haji, Hamad J.; Gabrielli, Albis-Francesco; Mubila, Likezo; Biswas, Gautam; Chitsulo, Lester; Bradley, Mark H.; Engels, Dirk; Savioli, Lorenzo; Molyneux, David H.

    2008-01-01

    Background Public health interventions based on distribution of anthelminthic drugs against lymphatic filariasis (LF), onchocerciasis, soil-transmitted helminthiasis (STH) and schistosomiasis have been implemented separately to date. A better use of available resources might be facilitated by a more coordinated approach to control such infections, including the possibility of co-administering the three recommended anthelminthic drugs through a single, large-scale intervention. Methodology/Principal Findings Ivermectin, albendazole and praziquantel were co-administered to 5,055 children and adults living in areas endemic for LF, STH and schistosomiasis in Zanzibar, United Republic of Tanzania, during a pilot intervention aimed at elucidating and quantifying possible side-effects. Subsequently, these drugs were co-administered to about 700,000 individuals during a countrywide intervention targeting a large part of the total population of Zanzibar. Passive and active surveillance measures carried out during both interventions showed that side-effects attributable to the three drugs given at the same time were mild and self-limiting events. Conclusions/Significance Our data suggest that co-administration of ivermectin, albendazole and praziquantel is safe in areas where lymphatic filariasis, soil-transmitted helminthiasis and schistosomiasis are co-endemic and where several rounds of treatment with one or two drugs have been implemented in the past. Passive surveillance measures, however, should be continued and detection, management and reporting of possible side-effects should be considered a key component of any health intervention administering drugs. PMID:18235853

  16. Efficient Solar Energy Conversion Systems for Hydrogen Production from Water using Semiconductor Photoelectrodes and Photocatalysts

    NASA Astrophysics Data System (ADS)

    Sayama, K.; Arai, T.

    2008-02-01

    Efficient solar energy conversion system for hydrogen production from water, solar-hydrogen system, is one of most important technologies for genuinely sustainable development of the society in the world wide scale. However, there are many problems to breakthrough such as low solar-to-H2 efficiency (STH), high cost, low stability, etc in order to realize the system practically and economically. The solar-hydrogen systems using semiconductors are mainly classified as follows; solar cell-electrolysis system, semiconductor photoelectrode system, and photocatalyst system. There are various merits and demerits in each system. The solar cell-electrolysis system is very efficient but is very high cost. The photocatalyst system is very simple and relatively low cost, but the efficiency is still very low. On the other hand, various semiconductor systems with high efficiency have been investigated. A high STH more than 10% was reported using non-oxide semiconductor photoelectrodes such as InGaP, while the preparation methods were costly. In a European project, some simple oxide semiconductor photoelectrodes such as Fe2O3 and WO3 are mainly studied. Here, we investigated various photoelectrodes using mixed metal oxide especially on BiVO4 semiconductor, and a high throughput screening system of new visible light responsible semiconductors for photoelectrode and photocatalyst. Moreover, photocatalysis-electrolysis hybrid system for economical H2 production is studied to overcome the demerit of photocatalyst system on the gas separation and low efficiency.

  17. The impact of two semiannual treatments with albendazole alone on lymphatic filariasis and soil-transmitted helminth infections: a community-based study in the Republic of Congo.

    PubMed

    Pion, Sébastien D S; Chesnais, Cédric B; Bopda, Jean; Louya, Frédéric; Fischer, Peter U; Majewski, Andrew C; Weil, Gary J; Boussinesq, Michel; Missamou, François

    2015-05-01

    Implementation of mass drug administration (MDA) with ivermectin plus albendazole (ALB) for lymphatic filariasis (LF) has been delayed in central Africa because of the risk of serious adverse events in subjects with high Loa loa microfilaremia. We conducted a community trial to assess the impact of semiannual MDA with ALB (400 mg) alone on LF and soil-transmitted helminth (STH) infections in the Republic of Congo. Evaluation at 12 months showed that ALB MDA had not significantly reduced Wuchereria bancrofti antigenemia or microfilaria (mf) rates in the community (from 17.3% to 16.6% and from 5.3% to 4.2%, respectively). However, the geometric mean mf count in mf-positive subjects was reduced from 202.2 to 80.9 mf/mL (60% reduction, P = 0.01). The effect of ALB was impressive in 38 subjects who were mf-positive at baseline and retested at 12 months: 37% had total mf clearance, and individual mf densities were reduced by 73.0%. MDA also dramatically reduced the hookworm infection rate in the community from 6.5% to 0.6% (91% reduction), with less impressive effects on Ascaris and Trichuris. These preliminary results suggest that semiannual community MDA with ALB is a promising strategy for controlling LF and STH in areas with coendemic loiasis. © The American Society of Tropical Medicine and Hygiene.

  18. Solar Water Splitting Utilizing a SiC Photocathode, a BiVO4 Photoanode, and a Perovskite Solar Cell.

    PubMed

    Iwase, Akihide; Kudo, Akihiko; Numata, Youhei; Ikegami, Masashi; Miyasaka, Tsutomu; Ichikawa, Naoto; Kato, Masashi; Hashimoto, Hideki; Inoue, Haruo; Ishitani, Osamu; Tamiaki, Hitoshi

    2017-11-23

    We have successfully demonstrated solar water splitting using a newly fabricated photoelectrochemical system with a Pt-loaded SiC photocathode, a CoO x -loaded BiVO 4 photoanode, and a perovskite solar cell. Detection of the evolved H 2 and O 2 with a 100 % Faradaic efficiency indicates that the observed photocurrent was used for water splitting. The solar-to-hydrogen (STH) efficiency was 0.55 % under no additional bias conditions. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Schistosomiasis and soil-transmitted helminthiasis in Rwanda: an update on their epidemiology and control.

    PubMed

    Rujeni, Nadine; Morona, Domenica; Ruberanziza, Eugene; Mazigo, Humphrey D

    2017-03-01

    Even though Rwanda lies within a region that has a high prevalence of schistosomiasis and soil-transmitted helminth (STH) infections, epidemiological information regarding these infections in the country remains scarce. The present review attempts to compile the available data on schistosomiasis and STHs, from 1940 to 2014, to provide an insight on the epidemiological profile of these infections. This information will, in turn, support the design and implementation of sustainable control measures. The available records indicate that only Schistosoma mansoni and all the major species of STHs are endemic in Rwanda. In 2008, the national prevalence of S. mansoni was reported to be 2.7%, ranging from 0 to 69.5%, and that of STH infections was 65.8% (diagnosed using the Kato-Katz technique). The prevalence of these infections varies from one district to another, with schoolchildren remaining a highly affected group. The main control approach is mass drug administration using albendazole and praziquantel, mostly targeting school-aged children in school environments. In 2008, adult individuals living in areas with a prevalence of S. mansoni ≥30% were also included in the mass drug administration programme. However, despite Rwanda achieving an almost 100% coverage of this programme in 2008-2010, the transmission of S. mansoni and STHs continues to take place, as illustrated by the most recent surveys. If Rwanda is to achieve sustainable control and elimination of schistosomiasis and STHs, there is a need to revise the country's control strategy and adopt an integrated control approach that involves a combination of measures.

  20. First molecular identification and report of genetic diversity of Strongyloides stercoralis, a current major soil-transmitted helminth in humans from Lao People's Democratic Republic.

    PubMed

    Laymanivong, Sakhone; Hangvanthong, Bouasy; Insisiengmay, Bounnaloth; Vanisaveth, Viengxay; Laxachack, Pinnakhone; Jongthawin, Jurairat; Sanpool, Oranuch; Thanchomnang, Tongjit; Sadaow, Lakkhana; Phosuk, Issarapong; Rodpai, Rutchanee; Maleewong, Wanchai; Intapan, Pewpan M

    2016-08-01

    Strongyloidiasis is a major soil-transmitted helminth (STH) disease that affects people worldwide. We present updated data on prevalence in the Lao People's Democratic Republic (Lao PDR) in 2015, arising from a community cross-sectional helminthiasis survey. Fecal samples were collected from 327 individuals across three provinces in Lao PDR (Luang Prabang in the north, Khammouane in the center, and Champasack in the south). Agar plate culture and Kato-Katz methods were used to examine duplicate stool samples from each participant to detect Strongyloides stercoralis and co-infecting helminths. Overall prevalences of S. strercoralis human hookworm, Taenia spp., Trichuris trichiura, Ascaris lumbricoides, and Enterobius vermicularis were 41.0, 28.1, 4.9, 4.0, 1.5, and 0.9 %, respectively. The prevalence of miscellaneous trematodiases (including opisthorchiasis) was 37.9 % and of Schistosoma mekongi infection was 0.3 %. Strongyloidiasis is a current major STH disease in Lao PDR. We also report the molecular-phylogenetic identification of S. stercoralis adult males collected from 40 representative human strongyliodiasis fecal samples. DNA was extracted, amplified, and sequenced from a portion of the mitochondrial cox1 gene and the nuclear 18S ribosomal DNA. Phylogenetic analyses indicated that all specimens sequenced belonged to S. stercoralis (Bavay, 1876) Stiles and Hassall, 1902. The cox1 sequences exhibited great diversity (24 haplotypes) in Lao PDR. This is the first molecular identification and report of genetic diversity of S. stercoralis in humans from Lao PDR. An effective parasite control program is needed to reduce the serious health impacts.

  1. Integrated Schistosomiasis and Soil-Transmitted Helminthiasis Control over Five Years on Kome Island, Tanzania

    PubMed Central

    Kaatano, Godfrey M.; Siza, Julius E.; Mwanga, Joseph R.; Min, Duk-Yong; Yong, Tai-Soon; Chai, Jong-Yil; Ko, Yunsuk; Chang, Su Young; Kullaya, Cyril M.; Rim, Han-Jong; Changalucha, John M.; Eom, Keeseon S.

    2015-01-01

    Integrated control strategies are important for sustainable control of schistosomiasis and soil-transmitted helminthiasis, despite their challenges for their effective implementation. With the support of Good Neighbors International in collaboration with National Institute of Medical Research, Mwanza, Tanzania, integrated control applying mass drug administration (MDA), health education using PHAST, and improved safe water supply has been implemented on Kome Island over 5 years for controlling schistosomiasis and soil-transmitted helminths (STHs). Baseline surveys for schistosomiasis and STHs was conducted before implementation of any integrated control strategies, followed by 4 cross-sectional follow-up surveys on randomly selected samples of schoolchildren and adults in 10 primary schools and 8 villages, respectively, on Kome islands. Those follow-up surveys were conducted for impact evaluation after introduction of control strategies interventions in the study area. Five rounds of MDA have been implemented from 2009 along with PHAST and improved water supply with pumped wells as other control strategies for complementing MDA. A remarkable steady decline of schistosomiasis and STHs was observed from 2009 to 2012 with significant trends in their prevalence decline, and thereafter infection rate has remained at a low sustainable control. By the third follow-up survey in 2012, Schistosoma mansoni infection prevalence was reduced by 90.5% and hookworm by 93.3% among schoolchildren while in adults the corresponding reduction was 83.2% and 56.9%, respectively. Integrated control strategies have successfully reduced S. mansoni and STH infection status to a lower level. This study further suggests that monitoring and evaluation is a crucial component of any large-scale STH and schistosomiasis intervention. PMID:26537032

  2. Integrated Schistosomiasis and Soil-Transmitted Helminthiasis Control over Five Years on Kome Island, Tanzania.

    PubMed

    Kaatano, Godfrey M; Siza, Julius E; Mwanga, Joseph R; Min, Duk-Yong; Yong, Tai-Soon; Chai, Jong-Yil; Ko, Yunsuk; Chang, Su Young; Kullaya, Cyril M; Rim, Han-Jong; Changalucha, John M; Eom, Keeseon S

    2015-10-01

    Integrated control strategies are important for sustainable control of schistosomiasis and soil-transmitted helminthiasis, despite their challenges for their effective implementation. With the support of Good Neighbors International in collaboration with National Institute of Medical Research, Mwanza, Tanzania, integrated control applying mass drug administration (MDA), health education using PHAST, and improved safe water supply has been implemented on Kome Island over 5 years for controlling schistosomiasis and soil-transmitted helminths (STHs). Baseline surveys for schistosomiasis and STHs was conducted before implementation of any integrated control strategies, followed by 4 cross-sectional follow-up surveys on randomly selected samples of schoolchildren and adults in 10 primary schools and 8 villages, respectively, on Kome islands. Those follow-up surveys were conducted for impact evaluation after introduction of control strategies interventions in the study area. Five rounds of MDA have been implemented from 2009 along with PHAST and improved water supply with pumped wells as other control strategies for complementing MDA. A remarkable steady decline of schistosomiasis and STHs was observed from 2009 to 2012 with significant trends in their prevalence decline, and thereafter infection rate has remained at a low sustainable control. By the third follow-up survey in 2012, Schistosoma mansoni infection prevalence was reduced by 90.5% and hookworm by 93.3% among schoolchildren while in adults the corresponding reduction was 83.2% and 56.9%, respectively. Integrated control strategies have successfully reduced S. mansoni and STH infection status to a lower level. This study further suggests that monitoring and evaluation is a crucial component of any large-scale STH and schistosomiasis intervention.

  3. Prevalence of Schistosomes and Soil-Transmitted Helminths among Schoolchildren in Lake Victoria Basin, Tanzania

    PubMed Central

    Siza, Julius E.; Kaatano, Godfrey M.; Chai, Jong-Yil; Eom, Keeseon S.; Rim, Han-Jong; Yong, Tai-Soon; Min, Duk-Young; Chang, Su Young; Ko, Yunsuk; Changalucha, John M.

    2015-01-01

    The objectives of this study was to conduct a survey on schistosomiasis and soil-transmitted helminth (STH) infections in order to come up with feasible control strategies in Lake Victoria basin, Tanzania. Depending on the size of the school, 150-200 schoolchildren were recruited for the study. Duplicate Kato-Katz stool smears were prepared from each child and microscopically examined for Schistosoma mansoni and STHs. Urine specimens were examined for Schistosoma haematobium eggs using the filtration technique. After the survey, mass drug administration was done using praziquantel and albendazole for schistosomiasis and STHs infections, respectively. A total of 5,952 schoolchildren from 36 schools were recruited for the study and had their stool and urine specimens examined. Out of 5,952 schoolchildren, 898 (15.1%) were positive for S. mansoni, 754 (12.6%) for hookworms, 188 (3.2%) for Ascaris lumblicoides, and 5 (0.008%) for Trichuris trichiura. Out of 5,826 schoolchildren who provided urine samples, 519 (8.9%) were positive for S. haematobium eggs. The results revealed that intestinal schistosomiasis, urogenital schistosomiasis, and STH infections are highly prevalent throughought the lake basin. The high prevalence of intestinal and urogenital schistosomisiasis in the study area was a function of the distance from Lake Victoria, the former being more prevalent at localities close to the lake, whilst the latter is more so away from it. Control of schistosomiasis and STHs in the study area requires an integrated strategy that involves provision of health education to communities, regular treatments, and provision of adequate safe water supply and sanitation facilities. PMID:26537030

  4. Prevalence of Schistosomes and Soil-Transmitted Helminths among Schoolchildren in Lake Victoria Basin, Tanzania.

    PubMed

    Siza, Julius E; Kaatano, Godfrey M; Chai, Jong-Yil; Eom, Keeseon S; Rim, Han-Jong; Yong, Tai-Soon; Min, Duk-Young; Chang, Su Young; Ko, Yunsuk; Changalucha, John M

    2015-10-01

    The objectives of this study was to conduct a survey on schistosomiasis and soil-transmitted helminth (STH) infections in order to come up with feasible control strategies in Lake Victoria basin, Tanzania. Depending on the size of the school, 150-200 schoolchildren were recruited for the study. Duplicate Kato-Katz stool smears were prepared from each child and microscopically examined for Schistosoma mansoni and STHs. Urine specimens were examined for Schistosoma haematobium eggs using the filtration technique. After the survey, mass drug administration was done using praziquantel and albendazole for schistosomiasis and STHs infections, respectively. A total of 5,952 schoolchildren from 36 schools were recruited for the study and had their stool and urine specimens examined. Out of 5,952 schoolchildren, 898 (15.1%) were positive for S. mansoni, 754 (12.6%) for hookworms, 188 (3.2%) for Ascaris lumblicoides, and 5 (0.008%) for Trichuris trichiura. Out of 5,826 schoolchildren who provided urine samples, 519 (8.9%) were positive for S. haematobium eggs. The results revealed that intestinal schistosomiasis, urogenital schistosomiasis, and STH infections are highly prevalent throughought the lake basin. The high prevalence of intestinal and urogenital schistosomisiasis in the study area was a function of the distance from Lake Victoria, the former being more prevalent at localities close to the lake, whilst the latter is more so away from it. Control of schistosomiasis and STHs in the study area requires an integrated strategy that involves provision of health education to communities, regular treatments, and provision of adequate safe water supply and sanitation facilities.

  5. Particulate Photocatalyst Sheets Based on Carbon Conductor Layer for Efficient Z-Scheme Pure-Water Splitting at Ambient Pressure.

    PubMed

    Wang, Qian; Hisatomi, Takashi; Suzuki, Yohichi; Pan, Zhenhua; Seo, Jeongsuk; Katayama, Masao; Minegishi, Tsutomu; Nishiyama, Hiroshi; Takata, Tsuyoshi; Seki, Kazuhiko; Kudo, Akihiko; Yamada, Taro; Domen, Kazunari

    2017-02-01

    Development of sunlight-driven water splitting systems with high efficiency, scalability, and cost-competitiveness is a central issue for mass production of solar hydrogen as a renewable and storable energy carrier. Photocatalyst sheets comprising a particulate hydrogen evolution photocatalyst (HEP) and an oxygen evolution photocatalyst (OEP) embedded in a conductive thin film can realize efficient and scalable solar hydrogen production using Z-scheme water splitting. However, the use of expensive precious metal thin films that also promote reverse reactions is a major obstacle to developing a cost-effective process at ambient pressure. In this study, we present a standalone particulate photocatalyst sheet based on an earth-abundant, relatively inert, and conductive carbon film for efficient Z-scheme water splitting at ambient pressure. A SrTiO 3 :La,Rh/C/BiVO 4 :Mo sheet is shown to achieve unassisted pure-water (pH 6.8) splitting with a solar-to-hydrogen energy conversion efficiency (STH) of 1.2% at 331 K and 10 kPa, while retaining 80% of this efficiency at 91 kPa. The STH value of 1.0% is the highest among Z-scheme pure water splitting operating at ambient pressure. The working mechanism of the photocatalyst sheet is discussed on the basis of band diagram simulation. In addition, the photocatalyst sheet split pure water more efficiently than conventional powder suspension systems and photoelectrochemical parallel cells because H + and OH - concentration overpotentials and an IR drop between the HEP and OEP were effectively suppressed. The proposed carbon-based photocatalyst sheet, which can be used at ambient pressure, is an important alternative to (photo)electrochemical systems for practical solar hydrogen production.

  6. Integrated Surveys of Neglected Tropical Diseases in Southern Sudan: How Much Do They Cost and Can They Be Refined?

    PubMed Central

    Kolaczinski, Jan H.; Hanson, Kara; Robinson, Emily; Picon, Diana; Sabasio, Anthony; Mpakateni, Martin; Lado, Mounir; Moore, Stephen; Petty, Nora; Brooker, Simon

    2010-01-01

    Background Increasing emphasis on integrated control of neglected tropical diseases (NTDs) requires identification of co-endemic areas. Integrated surveys for lymphatic filariasis (LF), schistosomiasis and soil-transmitted helminth (STH) infection have been recommended for this purpose. Integrated survey designs inevitably involve balancing the costs of surveys against accuracy of classifying areas for treatment, so-called implementation units (IUs). This requires an understanding of the main cost drivers and of how operating procedures may affect both cost and accuracy of surveys. Here we report a detailed cost analysis of the first round of integrated NTD surveys in Southern Sudan. Methods and Findings Financial and economic costs were estimated from financial expenditure records and interviews with survey staff using an ingredients approach. The main outcome was cost per IU surveyed. Uncertain variables were subjected to univariate sensitivity analysis and the effects of modifying standard operating procedures were explored. The average economic cost per IU surveyed was USD 40,206 or USD 9,573, depending on the size of the IU. The major cost drivers were two key categories of recurrent costs: i) survey consumables, and ii) personnel. Conclusion The cost of integrated surveys in Southern Sudan could be reduced by surveying larger administrative areas for LF. If this approach was taken, the estimated economic cost of completing LF, schistosomiasis and STH mapping in Southern Sudan would amount to USD 1.6 million. The methodological detail and costing template provided here could be used to generate cost estimates in other settings and readily compare these to the present study, and may help budget for integrated and single NTDs surveys elsewhere. PMID:20644619

  7. Effect of Deworming on Indices of Health, Cognition, and Education among Schoolchildren in Rural China: A Cluster-Randomized Controlled Trial

    PubMed Central

    Liu, Chengfang; Lu, Louise; Zhang, Linxiu; Luo, Renfu; Sylvia, Sean; Medina, Alexis; Rozelle, Scott; Smith, Darvin Scott; Chen, Yingdan; Zhu, Tingjun

    2017-01-01

    Soil-transmitted helminths (STHs) infect over one billion people worldwide. There is concern that chronic infection with STHs among school-aged children may detrimentally affect their development, including their health, cognition, and education. However, two recent Cochrane reviews examining the impact of deworming drugs for STH on nutrition, hemoglobin, and school performance found that randomized controlled trials (RCTs) in the literature provide an insufficient evidence base to draw reliable conclusions. This study uses a cluster-RCT to add to existing evidence by assessing the impact of a deworming intervention on nutrition, cognition, and school performance among schoolchildren in rural China. The intervention, implemented by local health practitioners in a setting with a baseline infection prevalence of 41.9% (95% confidence interval [CI] = 39.8%, 43.9%) and infection intensity of 599.5 eggs per gram of feces among positive-tested schoolchildren (95% CI = 473.2, 725.8), consisted of distributing a 400-mg dose of albendazole accompanied with educational training about STH infection, treatment, and prevention. The intervention was conducted twice over the course of the study—at baseline in May 2013 and later in November 2013. We found that the deworming intervention reduced both infection prevalence and infection intensity, but these declines in infection were not accompanied by an impact on outcomes of nutrition, cognition, or school performance. Our interpretation is that the impact of deworming was attenuated by the light infection intensity in our sample population. Evidence from future RCTs is needed to assess the effect of deworming on key outcomes in areas with moderate and severe worm infections. PMID:28093533

  8. Assessing "First Mile" Supply Chain Factors Affecting Timeliness of School-Based Deworming Interventions: Supply and Logistics Performance Indicators.

    PubMed

    Koporc, Kimberly M; Strunz, Eric; Holloway, Cassandra; Addiss, David G; Lin, William

    2015-12-01

    Between 2007 and 2012, Children Without Worms (CWW) oversaw the Johnson & Johnson (J&J) donation of Vermox (mebendazole) for treatment of school-age children to control soil-transmitted helminthiasis (STH). To identify factors associated with on-time, delayed, or missed mass drug administration (MDA) interventions, and explore possible indicators for supply chain performance for drug donation programs, we reviewed program data for the 14 STH-endemic countries CWW supported during 2007-2012. Data from drug applications, shipping records, and annual treatment reports were tracked using Microsoft Excel. Qualitative data from interviews with key personnel were used to provide additional context on the causes of delayed or missed MDAs. Four possible contributory factors to delayed or missed MDAs were considered: production, shipping, customs clearance, and miscellaneous in-country issues. Coverage rates were calculated by dividing the number of treatments administered by the number of children targeted during the MDA. Of the approved requests for 78 MDAs, 54 MDAs (69%) were successfully implemented during or before the scheduled month. Ten MDAs (13%) were classified as delayed; seven of these were delayed by one month or less. An additional 14 MDAs (18%) were classified as missed. For the 64 on-time or delayed MDAs, the mean coverage was approximately 88%. To continue to assess the supply chain processes and identify areas for improvement, we identified four indicators or metrics for supply chain performance that can be applied across all neglected tropical disease (NTD) drug donation programs: (1) donor having available inventory to satisfy the country request for donation; (2) donor shipping the approved number of doses; (3) shipment arriving at the Central Medical Stores one month in advance of the scheduled MDA date; and (4) country programs implementing the MDA as scheduled.

  9. Adult population as potential reservoir of NTD infections in rural villages of Kwale district, Coastal Kenya: implications for preventive chemotherapy interventions policy.

    PubMed

    Njenga, Sammy M; Mwandawiro, Charles S; Muniu, Erastus; Mwanje, Mariam T; Haji, Fatma M; Bockarie, Moses J

    2011-09-14

    Neglected tropical diseases (NTDs) are major public health problems in developing countries where they contribute to suffering of populations living in poor settings. As part of a research project started in September 2009 in Kwale district, Coast Region, Kenya, a baseline cross-sectional survey was conducted in 5 rural villages to provide information on the status of NTDs, including urinary schistosomiasis, soil-transmitted helminthiasis (STH), and lymphatic filariasis. This paper presents the results of a parasitological investigation among adults in the study villages. A total of 599 adults in the 5 study villages were tested for NTD infections in urine, stool and blood. The presence of Schistosoma haematobium infection was determined by the urine filtration method. The presence of STH in stool was determined by Kato-Katz method while filarial antigenaemia was determined using immunochromatographic (ICT) test. The study revealed high prevalence of hookworm (41.7%) and schistosomiasis (18.2%) infections among adults in the study villages. Of the 599 individuals examined, 50.1% had one or more helminthic infections. There was low level of polyparasitism with helminthic NTDs in the study population with 9.5% and 1.7% of the participants having two and three infections, respectively. In the current study, hookworm and schistosomiasis infections were identified as important infections among adults living in areas of high endemicity for these infections. Thus, if this section of the population is left untreated it may remain an important potential reservoir and a source of re-infection for school-age children treated in school deworming programmes. Therefore, there is a need to design novel strategies for preventive chemotherapy interventions that could allow inclusion of adults in an effort to reduce force of infection in high endemic communities.

  10. Expanding molecular diagnostics of helminthiasis: Piloting use of the GPLN platform for surveillance of soil transmitted helminthiasis and schistosomiasis in Ghana.

    PubMed

    Cunningham, Lucas J; Odoom, John; Pratt, Deborah; Boatemaa, Linda; Asante-Ntim, Nana; Attiku, Keren; Banahene, Bismarck; Osei-Atweneboana, Mike; Verweij, Jaco J; Molyneux, David; Stothard, Russell J; Adams, Emily R

    2018-01-01

    The efforts to control and eradicate polio as a global health burden have been successful to the point where currently only three countries now report endemic polio, and the number of cases of polio continues to decrease. The success of the polio programme has been dependant on a well-developed network of laboratories termed the global polio laboratory network (GPLN). Here we explore collaborative opportunities with the GPLN to target two of the 18 diseases listed as a neglected tropical diseases (NTD) namely soil transmitted helminthiasis (STH) and Schistosomiasis (SCH). These were chosen based on prevalence and the use of faecal materials to identify both polio, STH and SCH. Our study screened 448 faecal samples from the Ghana GPLN using three triplex TaqMan assays to identify Ascaris lumbricoides, Necator americanus, Ancylostoma spp, Trichuris trchiura, Strongyloides stercoralis and Schistosoma spp. Our results found a combined helminth prevalence of 22%. The most common helminth infection was A. lumbricoides with a prevalence of 15% followed by N. americanus (5%), Ancylostoma spp. (2.5%), Schistosoma spp. (1.6%) and S. stercoralis (1%). These results show that it is possible to identify alternative pathogens to polio in the samples collected by the GPLN platform and to introduce new diagnostic assays to their laboratories. The diagnostic methods employed were also able to identify S. stercoralis positive samples, which are difficult to identify using parasitological methods such as Kato-Katz. This study raises the possibility of collaboration with the GPLN for the surveillance of a wider range of diseases which would both benefit the efforts to control the NTDs and also increase the scope of the GPLN as a diagnostic platform.

  11. Soil-transmitted helminthiasis in rural south-west China: prevalence, intensity and risk factor analysis.

    PubMed

    Mofid, Layla S; Bickle, Quentin; Jiang, Jin-Yong; Du, Zun-Wei; Patrick, Edward

    2011-05-01

    Only few studies in rural China have explored the epidemiology of intestinal helminth infections and identified risk factors for transmission. The study was carried out in Simao and Mengla counties, where single fecal samples were collected from 317 school-aged children and from 94 inhabitants of a single village. Fecal specimens were examined with the Kato-Katz thick smear method and examined for helminth eggs. Data regarding socio-demographic and behavioral risk factors were collected using questionnaires. In Simao County the overall soil-transmitted helminthes (STH) prevalence was 40.2% (2.7, 5.4 and 35.7% for ascariasis, trichuriasis and hookworm infection, respectively). The STH infection rates were significantly higher in Mengla County, with an overall prevalence of 68.3% (19.0, 34.6 and 47.3% for ascariasis, trichuriasis and hookworm infection, respectively). Females were less likely to be infected with Trichuris trichiura (OR 0.29; 95% CI 0.15-0.56) and with hookworms (OR 0.55; 95% CI 0.33-0.93) than males. Hookworm infections were more prevalent among those 12 years of age or older (OR 2.9; 95% CI 1.2-7.1). Children of mothers with educational attainment of secondary school or higher had a protective effect against T. trichiura (OR 0.18; 95% CI 0.06-0.54) and hookworm (OR 0.21; 95% CI 0.09-0.51) infections. In the village survey, hookworm was the most prevalent species (62.8%) with infection seen in those 50 years of age and older. Based on recommended intervention strategies by the World Health Organization, Simao County should opt for school-based deworming once each year, while Mengla County should implement a similar strategy biannually, but should include the elderly population.

  12. A randomized cross-over comparison of two low-dose oral contraceptives upon hormonal and metabolic serum parameters: II. Effects upon thyroid function, gastrin, STH, and glucose tolerance.

    PubMed

    Kuhl, H; Gahn, G; Romberg, G; Althoff, P H; Taubert, H D

    1985-07-01

    The effect of a low-dose triphasic oral contraceptive (OC) containing ethinyl estradiol and levonorgestrel (EE/NG) upon thyroid function and some other biochemical serum parameters was compared to that of a preparation containing EE and desogestrel (EE/DG). Blood samples were taken on Day 6, 11, 21, and 28 of a control cycle and of the third cycle of treatment with either the EE/NG or EE/DG preparation (11 volunteers each). After a washout period of 3 months, the contraceptives were changed in a cross-over fashion. Blood samples were again taken on Day 6, 11, 21, and 28 of the third washout cycle and the third treatment cycle. There was a significant increase (13%) in basal glucose level during treatment with both OC, but no change in glucose tolerance. Both the EE/NG and FE/DG preparation elevated serum T4 (40%), FT4 (15-22%), T3 (17-28%), and TBG (20%) significant, whereby the effect was more pronounced during the second treatment period after washing-out. The effective thyroxine ratio (ETR) was slightly (4%) but significantly increased. Contrary to this, the levels of FT3, reverse T3 (rT3), TSH, and gastrin were not altered. STH showed great individual fluctuations, but was significantly elevated by 50% during treatment with both OC. There was no effect of endogenous estradiol upon thyroid or other parameter, even though it was raised considerably in some women under OC. Although the increase in T4 and T3 is probably due to a rise in estrogen-induced TBG production, the data seem to indicate that there is a slight but effective stimulation of thyroid function during treatment with low-dose OC.

  13. The Partitioning of Impurity Elements in Iron-Carbon Alloys

    DTIC Science & Technology

    1975-09-01

    Chemical composition Carbides Steels lo. ABSTRACT YCanliniM an ravaria «Id* 11 nacaiaary and ld* niif |r by block numbmt) (SEE REVERSE SIDE) DD 1...ee9 lns/.^‘:;𔃼Sl’’l96t ^^2^ ” hontin^s of Mekel-Chromium. 9 LOw’^’l’lt^ jr STh"s Trans. ASM. v. 60. 1967. p, 699-706. ’ Trans. TMS-AIMl^V 242 I968^p... 9 ) Thus if M’ > M (as in Figure 1), k < 1 and the ferrite is richer in X than the carbide. If M* < M, then k > 1 and the carbide is

  14. Camp Humphreys/Pyongtaek AB, South Korea. Revised Uniform Summary of Surface Weather Observations (RUSSWO). Parts A-F.

    DTIC Science & Technology

    1982-09-10

    public rolesw m Distribution Unlimited DISTRIBUTION STATEMENT ACCESSION FOR NTIS GRAM NNOU DTIC JUSrIFICATION ELECTE f SDEC 22=90 DISTRIBUTION/ D...20, it dilfl.e.t I-o ROport) IS SUPPLEN ENTARY NOTES Supersedes USAFETAC/ DS-80/081 AD A088 955. 𔄃*0g was ,Continu -n -- 6;! M It ll ec ’rd;idntiy by...n , -.wii iF m m dUlnUUMK., sD166 11 VlP TWF ’V ! x LIUg F IS.AlI. AWImIALI. M (RuiL OS lushl 56 ctc. *4rtion Me I~ (Used for ൰-15 31 ft. Sth’iM~3t~t

  15. Geotechnical applications of CCPs in Wisconsin

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Edil, T.C.; Benson, C.H.

    2006-07-01

    The article reports research case histories on applications of coal combustion products (CCPs) in Wisconsin developed by the University of Wisconsin Consortium for Fly Ash Use in Geotechnical Applications (FAUGA). Fly ash was used to stabilize poor soils during construction of Wisconsin State Highway (STH) 60, and bottom ash was used as a granular working platform. Long term performance is proving good. Nearly all Class C fly ash in Wisconsin is now used in construction. Leaching characteristics of pavements incorporating fly ash are being monitored by pan lysimeters underneath. A computer model, WiscLEACH has been developed to predict the maximummore » concentration of chemicals in ground water adjacent to roadways using CCPs. 1 photo.« less

  16. Interrupting transmission of soil-transmitted helminths: a study protocol for cluster randomised trials evaluating alternative treatment strategies and delivery systems in Kenya

    PubMed Central

    Brooker, Simon J; Mwandawiro, Charles S; Halliday, Katherine E; Njenga, Sammy M; Mcharo, Carlos; Gichuki, Paul M; Wasunna, Beatrice; Kihara, Jimmy H; Njomo, Doris; Alusala, Dorcas; Chiguzo, Athuman; Turner, Hugo C; Teti, Caroline; Gwayi-Chore, Claire; Nikolay, Birgit; Truscott, James E; Hollingsworth, T Déirdre; Balabanova, Dina; Griffiths, Ulla K; Freeman, Matthew C; Allen, Elizabeth; Pullan, Rachel L; Anderson, Roy M

    2015-01-01

    Introduction In recent years, an unprecedented emphasis has been given to the control of neglected tropical diseases, including soil-transmitted helminths (STHs). The mainstay of STH control is school-based deworming (SBD), but mathematical modelling has shown that in all but very low transmission settings, SBD is unlikely to interrupt transmission, and that new treatment strategies are required. This study seeks to answer the question: is it possible to interrupt the transmission of STH, and, if so, what is the most cost-effective treatment strategy and delivery system to achieve this goal? Methods and analysis Two cluster randomised trials are being implemented in contrasting settings in Kenya. The interventions are annual mass anthelmintic treatment delivered to preschool- and school-aged children, as part of a national SBD programme, or to entire communities, delivered by community health workers. Allocation to study group is by cluster, using predefined units used in public health provision—termed community units (CUs). CUs are randomised to one of three groups: receiving either (1) annual SBD; (2) annual community-based deworming (CBD); or (3) biannual CBD. The primary outcome measure is the prevalence of hookworm infection, assessed by four cross-sectional surveys. Secondary outcomes are prevalence of Ascaris lumbricoides and Trichuris trichiura, intensity of species infections and treatment coverage. Costs and cost-effectiveness will be evaluated. Among a random subsample of participants, worm burden and proportion of unfertilised eggs will be assessed longitudinally. A nested process evaluation, using semistructured interviews, focus group discussions and a stakeholder analysis, will investigate the community acceptability, feasibility and scale-up of each delivery system. Ethics and dissemination Study protocols have been reviewed and approved by the ethics committees of the Kenya Medical Research Institute and National Ethics Review Committee, and London School of Hygiene and Tropical Medicine. The study has a dedicated web site. Trial registration number NCT02397772. PMID:26482774

  17. Adult population as potential reservoir of NTD infections in rural villages of Kwale district, Coastal Kenya: implications for preventive chemotherapy interventions policy

    PubMed Central

    2011-01-01

    Background Neglected tropical diseases (NTDs) are major public health problems in developing countries where they contribute to suffering of populations living in poor settings. As part of a research project started in September 2009 in Kwale district, Coast Region, Kenya, a baseline cross-sectional survey was conducted in 5 rural villages to provide information on the status of NTDs, including urinary schistosomiasis, soil-transmitted helminthiasis (STH), and lymphatic filariasis. This paper presents the results of a parasitological investigation among adults in the study villages. Methods A total of 599 adults in the 5 study villages were tested for NTD infections in urine, stool and blood. The presence of Schistosoma haematobium infection was determined by the urine filtration method. The presence of STH in stool was determined by Kato-Katz method while filarial antigenaemia was determined using immunochromatographic (ICT) test. Results The study revealed high prevalence of hookworm (41.7%) and schistosomiasis (18.2%) infections among adults in the study villages. Of the 599 individuals examined, 50.1% had one or more helminthic infections. There was low level of polyparasitism with helminthic NTDs in the study population with 9.5% and 1.7% of the participants having two and three infections, respectively. Conclusions In the current study, hookworm and schistosomiasis infections were identified as important infections among adults living in areas of high endemicity for these infections. Thus, if this section of the population is left untreated it may remain an important potential reservoir and a source of re-infection for school-age children treated in school deworming programmes. Therefore, there is a need to design novel strategies for preventive chemotherapy interventions that could allow inclusion of adults in an effort to reduce force of infection in high endemic communities. PMID:21917166

  18. Nutritional and Hormonal Status of Premature Infants Born with Intrauterine Growth Restriction at the Term Corrected Age.

    PubMed

    Belyaeva, I A; Namazova-Baranova, L S; Bombardirova, E P; Okuneva, M V

    Inadequate nutrition supply during the period of intrauterine growth and the first year of life leads to persistent metabolic changes and provokes development of various diseases. Тo compare physical development, body composition, and hormonal status (insulin, insulin-like growth factor-1 (IGF-1), somatotropic hormone (STH), C-Peptide, cortisol) indices in premature infants born with intrauterine growth restriction (IUGR) at the term corrected age with the same indices in mature infants with IUGR and premature infants with weight appropriate for their gestational age (GA). А crossover study of anthropometric measures, body composition and growth hormones changes assessment was carried out. It included 140 premature infants with weight appropriate for their GA, 58 premature infants with IUGR and 64 mature infants with IUGR. Anthropometric measures were assessed with Fenton and Anthro growth charts (WHO, 2009); body composition was studied with the air plethysmography method (РЕA POD, LMi, USA). Level of hormones in blood serum was assessed with biochemical methods. It is found that anthropometric measures in premature infants with weight appropriate for their GA and premature infants with IUGR at the term corrected age did not have any significant differences while premature infants with IUGR tended to have lower weight. Studying body composition we found that both groups of premature infants had slightly higher level of fat mass in comparison with mature infants. High concentration of insulin, cortisol, IGF-1, and C-peptide was found in premature and mature infants with IUGR. Instead, lower levels of STH was found in infants with IUGR. Formula fed premature infants (comparing to breastfed ones) had higher levels of fat mass, insulin, IGF-1, and C-peptide. Mature infants with IUGR did not tend to have the correlation between levels of fat mass, insulin, IGF-1, C-peptide, and type of feeding. Not only insufficient intrauterine growth but also nutrition pattern plays important role in development of body composition disbalance and hormonal shifts in premature infants.

  19. Improved NADPH supply for xylitol production by engineered Escherichia coli with glycolytic mutations.

    PubMed

    Chin, Jonathan W; Cirino, Patrick C

    2011-01-01

    Escherichia coli engineered to uptake xylose while metabolizing glucose was previously shown to produce high levels of xylitol from a mixture of glucose and xylose when expressing NADPH-dependent xylose reductase from Candida boidinii (CbXR) (Cirino et al., Biotechnol Bioeng. 2006;95:1167-1176). We then described the effects of deletions of key metabolic pathways (e.g., Embden-Meyerhof-Parnas and pentose phosphate pathway) and reactions (e.g., transhydrogenase and NADH dehydrogenase) on resting-cell xylitol yield (Y RPG: moles of xylitol produced per mole of glucose consumed) (Chin et al., Biotechnol Bioeng. 2009;102:209-220). These prior results demonstrated the importance of direct NADPH supply by NADP+-utilizing enzymes in central metabolism for driving heterologous NADPH-dependent reactions. This study describes strain modifications that improve coupling between glucose catabolism (oxidation) and xylose reduction using two fundamentally different strategies. We first examined the effects of deleting the phosphofructokinase (pfk) gene(s) on growth-uncoupled xylitol production and found that deleting both pfkA and sthA (encoding the E. coli-soluble transhydrogenase) improved the xylitol Y RPG from 3.4 ± 0.6 to 5.4 ± 0.4. The second strategy focused on coupling aerobic growth on glucose to xylitol production by deleting pgi (encoding phosphoglucose isomerase) and sthA. Impaired growth due to imbalanced NADPH metabolism (Sauer et al., J Biol Chem. 2004;279:6613-6619) was alleviated upon expressing CbXR, resulting in xylitol production similar to that of the growth-uncoupled precursor strains but with much less acetate secretion and more efficient utilization of glucose. Intracellular nicotinamide cofactor levels were also quantified, and the magnitude of the change in the NADPH/NADP+ ratio measured from cells consuming glucose in the absence vs. presence of xylose showed a strong correlation to the resulting Y RPG. Copyright © 2011 American Institute of Chemical Engineers (AIChE).

  20. Saitohin Q7R polymorphism is associated with late-onset Alzheimer's disease susceptibility among caucasian populations: a meta-analysis.

    PubMed

    Huang, Rong; Tian, Sai; Cai, Rongrong; Sun, Jie; Xia, Wenqing; Dong, Xue; Shen, Yanjue; Wang, Shaohua

    2017-08-01

    Saitohin (STH) Q7R polymorphism has been reported to influence the individual's susceptibility to Alzheimer's disease (AD); however, conclusions remain controversial. Therefore, we performed this meta-analysis to explore the association between STH Q7R polymorphism and AD risk. Systematic literature searches were performed in the PubMed, Embase, Cochrane Library and Web of Science for studies published before 31 August 2016. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the strength of the association using a fixed- or random-effects model. Subgroup analyses, Galbraith plot and sensitivity analyses were also performed. All statistical analyses were performed with STATA Version 12.0. A total of 19 case-control studies from 17 publications with 4387 cases and 3972 controls were included in our meta-analysis. The results showed that the Q7R polymorphism was significantly associated with an increased risk of AD in a recessive model (RR versus QQ+QR, OR = 1.27, 95% CI = 1.01-1.60, P = 0.040). After excluding the four studies not carried out in caucasians, the overall association was unchanged in all comparison models. Further subgroup analyses stratified by the time of AD onset, and the quality of included studies provided statistical evidence of significant increased risk of AD in RR versus QQ+QR model only in late-onset subjects (OR = 1.56, 95% CI = 1.07-2.26, P = 0.021) and in studies with high quality (OR = 1.37, 95% CI = 1.01-1.86, P = 0.043). This meta-analysis suggests that the RR genotype in saitohin Q7R polymorphism may be a human-specific risk factor for AD, especially among late-onset AD subjects and caucasian populations. © 2017 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  1. Systematic review of studies generating individual participant data on the efficacy of drugs for treating soil-transmitted helminthiases and the case for data-sharing.

    PubMed

    Halder, Julia B; Benton, Joanne; Julé, Amélie M; Guérin, Phillipe J; Olliaro, Piero L; Basáñez, María-Gloria; Walker, Martin

    2017-10-01

    Preventive chemotherapy and transmission control (PCT) by mass drug administration is the cornerstone of the World Health Organization (WHO)'s policy to control soil-transmitted helminthiases (STHs) caused by Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm) and hookworm species (Necator americanus and Ancylostama duodenale) which affect over 1 billion people globally. Despite consensus that drug efficacies should be monitored for signs of decline that could jeopardise the effectiveness of PCT, systematic monitoring and evaluation is seldom implemented. Drug trials mostly report aggregate efficacies in groups of participants, but heterogeneities in design complicate classical meta-analyses of these data. Individual participant data (IPD) permit more detailed analysis of drug efficacies, offering increased sensitivity to identify atypical responses potentially caused by emerging drug resistance. We performed a systematic literature review to identify studies concluding after 2000 that collected IPD suitable for estimating drug efficacy against STH. We included studies that administered a variety of anthelmintics with follow ups less than 60 days after treatment. We estimated the number of IPD and extracted cohort- and study-level meta-data. We estimate that there exist individual data on approximately 35,000 participants from 129 studies conducted in 39 countries, including 34 out of 103 countries where PCT is recommended. We find significant heterogeneity in diagnostic methods, times of outcome assessment, and the reported measure of efficacy. We also quantify cohorts comprising pre-school age children, pregnant women, and co-infected participants, including with HIV. We argue that establishing a global IPD repository would improve the capacity to monitor and evaluate the efficacy of anthelmintic drugs, respond to changes and safeguard the ongoing effectiveness of PCT. Establishing a fair, transparent data governance policy will be key for the engagement of the global STH community.

  2. Systematic review of studies generating individual participant data on the efficacy of drugs for treating soil-transmitted helminthiases and the case for data-sharing

    PubMed Central

    Halder, Julia B.; Benton, Joanne; Julé, Amélie M.; Guérin, Phillipe J.; Olliaro, Piero L.; Basáñez, María-Gloria; Walker, Martin

    2017-01-01

    Background Preventive chemotherapy and transmission control (PCT) by mass drug administration is the cornerstone of the World Health Organization (WHO)’s policy to control soil-transmitted helminthiases (STHs) caused by Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm) and hookworm species (Necator americanus and Ancylostama duodenale) which affect over 1 billion people globally. Despite consensus that drug efficacies should be monitored for signs of decline that could jeopardise the effectiveness of PCT, systematic monitoring and evaluation is seldom implemented. Drug trials mostly report aggregate efficacies in groups of participants, but heterogeneities in design complicate classical meta-analyses of these data. Individual participant data (IPD) permit more detailed analysis of drug efficacies, offering increased sensitivity to identify atypical responses potentially caused by emerging drug resistance. Methodology We performed a systematic literature review to identify studies concluding after 2000 that collected IPD suitable for estimating drug efficacy against STH. We included studies that administered a variety of anthelmintics with follow ups less than 60 days after treatment. We estimated the number of IPD and extracted cohort- and study-level meta-data. Principal findings We estimate that there exist individual data on approximately 35,000 participants from 129 studies conducted in 39 countries, including 34 out of 103 countries where PCT is recommended. We find significant heterogeneity in diagnostic methods, times of outcome assessment, and the reported measure of efficacy. We also quantify cohorts comprising pre-school age children, pregnant women, and co-infected participants, including with HIV. Conclusions We argue that establishing a global IPD repository would improve the capacity to monitor and evaluate the efficacy of anthelmintic drugs, respond to changes and safeguard the ongoing effectiveness of PCT. Establishing a fair, transparent data governance policy will be key for the engagement of the global STH community. PMID:29088274

  3. Assessment of serum pharmacokinetics and urinary excretion of albendazole and its metabolites in human volunteers.

    PubMed

    Ceballos, Laura; Krolewiecki, Alejandro; Juárez, Marisa; Moreno, Laura; Schaer, Fabian; Alvarez, Luis I; Cimino, Rubén; Walson, Judd; Lanusse, Carlos E

    2018-01-01

    Soil Transmitted Helminth (STH) infections negatively impact physical and mental development in human populations. Current WHO guidelines recommend morbidity control of these infections through mass drug administration (MDA) using albendazole (ABZ) or mebendazole. Despite major reductions in STH associated morbidity globally, not all programs have demonstrated the expected impact on prevalence of parasite infections. These therapeutic failures may be related to poor programmatic coverage, suboptimal adherence or the exposure of parasites to sub-therapeutic drug concentrations. As part of the DeWorm3 project, we sought to characterize the serum disposition kinetics and pattern of urinary excretion of ABZ and its main metabolites ABZ sulphoxide (ABZSO) and ABZ sulphone (ABZSO2) in humans, and the assessment of the duration and optimal time point where ABZ and/or its metabolites can be measured in urine as an indirect assessment of an individual's adherence to treatment. Consecutive venous blood and urine samples were collected from eight (8) human volunteers up to 72 h post-ABZ oral administration. ABZ/metabolites were quantified by HPLC. The ABZSO metabolite was the main analyte recovered both in serum and urine. ABZSO Cmax in serum was 1.20 ± 0.44 μg/mL, reached at 4.75 h post-treatment. In urine, ABZSO Cmax was 3.24 ± 1.51 μg/mL reached at 6.50 h post-ABZ administration. Pharmacokinetic data obtained for ABZ metabolites in serum and urine, including the recovery of the ABZ sulphoxide derivative up to 72 h in both matrixes and the recovery of the amino-ABZ sulphone metabolite in urine samples, are suggesting the possibility of developing a urine based method to assess compliance to ABZ treatment. Such an assay may be useful to optimize ABZ use in human patients. ClinicalTrials.gov NCT03192449.

  4. Comparison of Individual and Pooled Stool Samples for the Assessment of Soil-Transmitted Helminth Infection Intensity and Drug Efficacy

    PubMed Central

    Mekonnen, Zeleke; Meka, Selima; Ayana, Mio; Bogers, Johannes; Vercruysse, Jozef; Levecke, Bruno

    2013-01-01

    Background In veterinary parasitology samples are often pooled for a rapid assessment of infection intensity and drug efficacy. Currently, studies evaluating this strategy in large-scale drug administration programs to control human soil-transmitted helminths (STHs; Ascaris lumbricoides, Trichuris trichiura, and hookworm), are absent. Therefore, we developed and evaluated a pooling strategy to assess intensity of STH infections and drug efficacy. Methods/Principal Findings Stool samples from 840 children attending 14 primary schools in Jimma, Ethiopia were pooled (pool sizes of 10, 20, and 60) to evaluate the infection intensity of STHs. In addition, the efficacy of a single dose of mebendazole (500 mg) in terms of fecal egg count reduction (FECR; synonym of egg reduction rate) was evaluated in 600 children from two of these schools. Individual and pooled samples were examined with the McMaster egg counting method. For each of the three STHs, we found a significant positive correlation between mean fecal egg counts (FECs) of individual stool samples and FEC of pooled stool samples, ranging from 0.62 to 0.98. Only for A. lumbricoides was any significant difference in mean FEC of the individual and pooled samples found. For this STH species, pools of 60 samples resulted in significantly higher FECs. FECR for the different number of samples pooled was comparable in all pool sizes, except for hookworm. For this parasite, pools of 10 and 60 samples provided significantly higher FECR results. Conclusion/Significance This study highlights that pooling stool samples holds promise as a strategy for rapidly assessing infection intensity and efficacy of administered drugs in programs to control human STHs. However, further research is required to determine when and how pooling of stool samples can be cost-effectively applied along a control program, and to verify whether this approach is also applicable to other NTDs. PMID:23696905

  5. Assessing “First Mile” Supply Chain Factors Affecting Timeliness of School-Based Deworming Interventions: Supply and Logistics Performance Indicators

    PubMed Central

    Koporc, Kimberly M.; Strunz, Eric; Holloway, Cassandra; Addiss, David G.; Lin, William

    2015-01-01

    Background Between 2007 and 2012, Children Without Worms (CWW) oversaw the Johnson & Johnson (J&J) donation of Vermox (mebendazole) for treatment of school-age children to control soil-transmitted helminthiasis (STH). To identify factors associated with on-time, delayed, or missed mass drug administration (MDA) interventions, and explore possible indicators for supply chain performance for drug donation programs, we reviewed program data for the 14 STH-endemic countries CWW supported during 2007–2012. Methodology Data from drug applications, shipping records, and annual treatment reports were tracked using Microsoft Excel. Qualitative data from interviews with key personnel were used to provide additional context on the causes of delayed or missed MDAs. Four possible contributory factors to delayed or missed MDAs were considered: production, shipping, customs clearance, and miscellaneous in-country issues. Coverage rates were calculated by dividing the number of treatments administered by the number of children targeted during the MDA. Principal Findings Of the approved requests for 78 MDAs, 54 MDAs (69%) were successfully implemented during or before the scheduled month. Ten MDAs (13%) were classified as delayed; seven of these were delayed by one month or less. An additional 14 MDAs (18%) were classified as missed. For the 64 on-time or delayed MDAs, the mean coverage was approximately 88%. Conclusions and Significance To continue to assess the supply chain processes and identify areas for improvement, we identified four indicators or metrics for supply chain performance that can be applied across all neglected tropical disease (NTD) drug donation programs: (1) donor having available inventory to satisfy the country request for donation; (2) donor shipping the approved number of doses; (3) shipment arriving at the Central Medical Stores one month in advance of the scheduled MDA date; and (4) country programs implementing the MDA as scheduled. PMID:26657842

  6. Socioeconomic Inequalities in Neglected Tropical Diseases: A Systematic Review

    PubMed Central

    Houweling, Tanja A. J.; Karim-Kos, Henrike E.; Kulik, Margarete C.; Stolk, Wilma A.; Haagsma, Juanita A.; Lenk, Edeltraud J.; Richardus, Jan Hendrik; de Vlas, Sake J.

    2016-01-01

    Background Neglected tropical diseases (NTDs) are generally assumed to be concentrated in poor populations, but evidence on this remains scattered. We describe within-country socioeconomic inequalities in nine NTDs listed in the London Declaration for intensified control and/or elimination: lymphatic filariasis (LF), onchocerciasis, schistosomiasis, soil-transmitted helminthiasis (STH), trachoma, Chagas’ disease, human African trypanosomiasis (HAT), leprosy, and visceral leishmaniasis (VL). Methodology We conducted a systematic literature review, including publications between 2004–2013 found in Embase, Medline (OvidSP), Cochrane Central, Web of Science, Popline, Lilacs, and Scielo. We included publications in international peer-reviewed journals on studies concerning the top 20 countries in terms of the burden of the NTD under study. Principal findings We identified 5,516 publications, of which 93 met the inclusion criteria. Of these, 59 papers reported substantial and statistically significant socioeconomic inequalities in NTD distribution, with higher odds of infection or disease among poor and less-educated people compared with better-off groups. The findings were mixed in 23 studies, and 11 studies showed no substantial or statistically significant inequality. Most information was available for STH, VL, schistosomiasis, and, to a lesser extent, for trachoma. For the other NTDs, evidence on their socioeconomic distribution was scarce. The magnitude of inequality varied, but often, the odds of infection or disease were twice as high among socioeconomically disadvantaged groups compared with better-off strata. Inequalities often took the form of a gradient, with higher odds of infection or disease each step down the socioeconomic hierarchy. Notwithstanding these inequalities, the prevalence of some NTDs was sometimes also high among better-off groups in some highly endemic areas. Conclusions While recent evidence on socioeconomic inequalities is scarce for most individual NTDs, for some, there is considerable evidence of substantially higher odds of infection or disease among socioeconomically disadvantaged groups. NTD control activities as proposed in the London Declaration, when set up in a way that they reach the most in need, will benefit the poorest populations in poor countries. PMID:27171166

  7. Analysis of Strain Dependent Damping in Materials via Modeling of Material Point Hysteresis

    DTIC Science & Technology

    1991-07-01

    Read input quantities fromi input files. C RBAD(9:5STIi’LE RM(q.A)-)’)SY READ (9, -’(X)’-) RP.AD(9,’jA) ’)SN RFPD(9, ’(A)’ ) SALP 5 FOR.%MT(A) REA" (9...IBSN,IESK) CALL ShLRLN( SALP , IBSAL?, IESALP?) CALL SThLEN( BA, ThSA, IESA) CALL STRLEN(SYT,ZBSFT,J:ESFT) CA*LL STRLEN (Sa~l, IBSARI, IMSAM~) CALL STRI2N...CHAP.ACTER-󈨊 TITLE,SYS,SG,SN, SALP ,SGO,SGP,SA,SI’T CU1RXCT2R- ( ) SARI, SAýR2 ,SAR3, SAR4, SARS, SARI, SAR7,SARP PARAMETER (SARl-’g0-’) PARAMETPR (SAR2""Ys

  8. [The effect of a single inhalation of mineral water on the blood hormonal status in healthy volunteers].

    PubMed

    Khinchagov, B P; Polushina, N D; Frolkov, V K

    1998-01-01

    Concentrations of ACTH, TTH, STH, LH, PSH, hydrocortisone, insulin, glucagone, triiodthyronine, thyroxine, aldosterone, glucose and unesterified fatty acids (NEFA) were measured in the blood of 23 healthy male volunteers aged 18 to 35 years 15, 30 and 60 min after a single nose inhalation and oral intake of mineral water Essentuki No. 17. Inhalation of Essentuki No. 17 stimulated secretion of the hormones and some parameters of metabolic reactions: the levels of glucose, NEFA, hydrocortisone, aldosterone, TTH, PSH and LH rose while those of insulin and growth hormone decreased. Oral intake of this water brought about the same changes in the hormone status except blood insulin the levels of which went up.

  9. DC thermal microscopy: study of the thermal exchange between a probe and a sample

    NASA Astrophysics Data System (ADS)

    Gomès, Séverine; Trannoy, Nathalie; Grossel, Philippe

    1999-09-01

    The Scanning Thermal Microscopic (SThM) probe, a thin Pt resistance wire, is used in the constant force mode of an Atomic Force Microscope (AFM). Thermal signal-distance curves for differing degrees of relative humidity and different surrounding gases demonstrate how heat is transferred from the heated probe to the sample. It is known that water affects atomic force microscopy and thermal measurements; we report here on the variation of the water interaction on the thermal coupling versus the probe temperature. Measurements were taken for several solid materials and show that the predominant heat transfer mechanisms taking part in thermal coupling are dependent on the thermal conductivity of the sample. The results have important implications for any quantitative interpretation of thermal images made in air.

  10. Prevalence of and risk factors for malaria, filariasis, and intestinal parasites as single infections or co-infections in different settlements of Gabon, Central Africa.

    PubMed

    M'bondoukwé, Noé Patrick; Kendjo, Eric; Mawili-Mboumba, Denise Patricia; Koumba Lengongo, Jeanne Vanessa; Offouga Mbouoronde, Christelle; Nkoghe, Dieudonné; Touré, Fousseyni; Bouyou-Akotet, Marielle Karine

    2018-01-30

    Malaria, filariasis, and intestinal parasitic infections (IPIs) are common and frequently overlap in developing countries. The prevalence and predictors of these infections were investigated in three different settlements (rural, semi-urban, and urban) of Gabon. During cross-sectional surveys performed from September 2013 to June 2014, 451 individuals were interviewed. In addition, blood and stool samples were analysed for the presence of Plasmodium, filarial roundworm, intestinal protozoan, and helminth infections. Intestinal parasitic infections (61.1%), including intestinal protozoa (56.7%) and soil-transmitted helminths (STHs) (22.2%), predominated, whereas Plasmodium falciparum (18.8%), Loa loa (4.7%), and Mansonella perstans (1.1%) were less prevalent. Filariasis and STHs were mainly found in rural settlements, whereas a higher plasmodial infection prevalence rate was observed in the periurban area. The most common IPI was blastocystosis (48.6%), followed by ascaridiasis (13.7%), trichuriasis (11.8%), amoebiasis (9.3%), giardiasis (4.8%), and strongyloidiasis (3.7%). Hookworm was detected in one adult from rural Dienga. Adults had a higher prevalence of Blastocystis hominis and STHs, whereas Giardia duodenalis was more frequently observed among children aged below 5 years (P < 0.01). The polyparasitism rate was 41.5%, with 7.0% Plasmodium-IPIs and 1.8% Plasmodium-STH co-infections. The multivariate analysis showed that living in a suburban area, belonging to the age group of 5-15 years, having none or a secondary education, or having an open body water close to home were significant risk factors for malaria (P ≤ 0.01). For STH infections, identified risk factors were drinking untreated water and living in a rural area (P ≤ 0.04). No significant predictors were identified for IPIs and malaria-IPI co-infection. This study reports a high prevalence of IPIs and intestinal protozoa, but a low rate of malaria-IPI co-infections in the study sites. Improvements in the living conditions of the population such as adequate water supply and proper health education and sanitation should be integrated into control strategies for malaria, STHs, and IPIs.

  11. Interrupting transmission of soil-transmitted helminths: a study protocol for cluster randomised trials evaluating alternative treatment strategies and delivery systems in Kenya.

    PubMed

    Brooker, Simon J; Mwandawiro, Charles S; Halliday, Katherine E; Njenga, Sammy M; Mcharo, Carlos; Gichuki, Paul M; Wasunna, Beatrice; Kihara, Jimmy H; Njomo, Doris; Alusala, Dorcas; Chiguzo, Athuman; Turner, Hugo C; Teti, Caroline; Gwayi-Chore, Claire; Nikolay, Birgit; Truscott, James E; Hollingsworth, T Déirdre; Balabanova, Dina; Griffiths, Ulla K; Freeman, Matthew C; Allen, Elizabeth; Pullan, Rachel L; Anderson, Roy M

    2015-10-19

    In recent years, an unprecedented emphasis has been given to the control of neglected tropical diseases, including soil-transmitted helminths (STHs). The mainstay of STH control is school-based deworming (SBD), but mathematical modelling has shown that in all but very low transmission settings, SBD is unlikely to interrupt transmission, and that new treatment strategies are required. This study seeks to answer the question: is it possible to interrupt the transmission of STH, and, if so, what is the most cost-effective treatment strategy and delivery system to achieve this goal? Two cluster randomised trials are being implemented in contrasting settings in Kenya. The interventions are annual mass anthelmintic treatment delivered to preschool- and school-aged children, as part of a national SBD programme, or to entire communities, delivered by community health workers. Allocation to study group is by cluster, using predefined units used in public health provision-termed community units (CUs). CUs are randomised to one of three groups: receiving either (1) annual SBD; (2) annual community-based deworming (CBD); or (3) biannual CBD. The primary outcome measure is the prevalence of hookworm infection, assessed by four cross-sectional surveys. Secondary outcomes are prevalence of Ascaris lumbricoides and Trichuris trichiura, intensity of species infections and treatment coverage. Costs and cost-effectiveness will be evaluated. Among a random subsample of participants, worm burden and proportion of unfertilised eggs will be assessed longitudinally. A nested process evaluation, using semistructured interviews, focus group discussions and a stakeholder analysis, will investigate the community acceptability, feasibility and scale-up of each delivery system. Study protocols have been reviewed and approved by the ethics committees of the Kenya Medical Research Institute and National Ethics Review Committee, and London School of Hygiene and Tropical Medicine. The study has a dedicated web site. NCT02397772. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Lessons from implementing mass drug administration for soil transmitted helminths among pre-school aged children during school based deworming program at the Kenyan coast.

    PubMed

    Musuva, Rosemary M; Matey, Elizabeth; Masaku, Janet; Odhiambo, Gladys; Mwende, Faith; Thuita, Isaac; Kihara, Jimmy; Njomo, Doris

    2017-06-14

    The 2012 London declaration which committed to "sustaining, expanding and extending drug access programmes to ensure the necessary supply of drugs and other interventions to help control soil-transmitted helminths (STH) by 2020" has seen many countries in Africa roll out mass drug administration (MDA) especially among school age children. In Kenya, however, during the National school-based deworming exercise, pre-school aged children (PSAC) have to access treatment at primary schools as the pre-school teachers are not trained to carry out deworming. With studies being conducted on the effectiveness of MDAs, the experiences of key education stakeholders which could improve the programme by giving best practices, and challenges experienced have not been documented. This was a cross-sectional qualitative study using Focus group discussions (FGDs) and Key informant interviews (KIIs). It was conducted in 4 sub-counties with high STH prevalence at the Kenyan coast (Matuga, Malindi, Lunga Lunga and Msambweni) to understand best practices for implementing MDA among PSAC.FGDs categorized by gender were conducted among local community members, whereas KIIs involved pre-school teachers, primary school teachers, community health extension workers (CHEWs) and opinion leaders. Participants were purposefully selected with the saturation model determining the number of interviews and focus groups. Voice data collected was transcribed verbatim then coded and analyzed using ATLAS.Ti version 6. Majority of the primary school teachers and CHEWs reported that they were satisfied with the method of mobilization used and the training tools. This was however not echoed by the pre-school teachers, parents and chiefs who complained of being left out of the process. Best practices mentioned included timely drug delivery, support from pre-school teachers, and management of side effects. Overcrowding during the drug administration day, complexity of the forms (for instance the 'S form') and long distance between schools were mentioned as challenges. There is need to utilize better sensitization methods to include the local administration as well as the parents for better uptake of the drugs. Extending deworming training to pre-school teachers will enhance the national deworming programme.

  13. Sustained effectiveness of weekly iron-folic acid supplementation and regular deworming over 6 years in women in rural Vietnam

    PubMed Central

    Casey, Gerard J.; Tinh, Ta T.; Tien, Nong T.; Hanieh, Sarah; Cavalli-Sforza, Luca T.; Montresor, Antonio

    2017-01-01

    Background Weekly iron-folic acid (IFA) supplementation and regular deworming is effective for the prevention of iron deficiency and anaemia in women of child-bearing age. Between 2006 and 2013, a program of weekly IFA and biannual deworming was implemented in Yen Bai province, Vietnam. In this study we aimed to determine the effectiveness of the program in reducing anaemia and the prevalence of hookworm infection after 72 months (six years). Methods This prospective cohort study followed up a cohort of 389 women of child-bearing age from baseline until six years after the introduction of the weekly IFA (one tablet containing 200 mg ferrous sulphate, 0.4mg folic acid) and deworming (one 400mg tablet of albendazole given twice yearly) program (May 2006 to 2012). In each of the six surveys (baseline and five follow-up surveys) we measured haemoglobin and ferritin, and the burden of soil transmitted helminth (STH) infections, and in the 72 month survey we also administered a questionnaire to assess adherence and possible impediments to participating in the program. Results Two hundred and fifty six (65.8%) of the original 389 women enrolled in the cohort attended the final 72 month survey. Haemoglobin levels were 122 g/L [95% C.I. 120, 124] at baseline and increased to 135g/L [95% C.I. 133, 138] after 72 months. The prevalence of anaemia was 37.8% [95% C.I. 31.0, 44.7] at baseline and reduced to 14.3% [95% C.I. 9.5, 19.1]. Hookworm infection prevalence, 75.9% [95% C.I. 68.1, 83.8] at baseline, reduced to 10.2% [95% C.I. 5.4, 15.0] with no moderate or heavy intensity infections. Seventy-two percent of participants reported still taking at least 75% of the weekly supplements, and 85.0% had taken the most recent deworming treatment. Discussion Anaemia rates fell significantly during the six-year program, and STH infections were eliminated as a public health risk. Adherence was well maintained but long-term sustainability is challenging in the absence of ongoing external support. PMID:28406909

  14. [Endocrinology 1999-2000].

    PubMed

    Schreiber, V

    2001-02-15

    Long-lasting problem on the differentiation of adenohypophyseal cell, which prepares them for their specific tasks (somatotropic, lactotropic ect.), becomes elucidated after recognition of the differentiational effect of transcription factor Pit-1. Expression of that factor in somatotrops results in STH secretion, contrary to lactotrops producing prolactin. Subclinical hypothyreosis (increased TSH with normal T3 and T4) endangers vessel not because of hypercholesterolemia, but because of changes in the dynamics of the blood flow. The idea of cardiotropic effect of thyroidal hormones is supported by the finding that administration of trijodthyronine to children after the surgical correction of heart malformations (cardiopulmonary bypass) improves myocardial function--it elevates cardiac output and decreases requirements on the intensive care. Receptors for hormones in tissues are flexible, they can be "heterooligomers" for dopamine and somatostatin. Mutations of mineralocorticoid receptor may cause hypertension in pregnancy and progesterone receptors have several isoforms. Receptors can be also activated by short exposition to a hormone. Glucocorticoids have probably also membrane receptors. Diabetes mellitus "type I" needn't to be immunogenic and DM type II not only results from down-regulation of receptors and subsequent insulin resistance, but it can be also caused by defects in insulin secretion. Insulin has receptors in the brain and participates in the appetite regulation. The attempt to use "desensibilisation" by peroraly administered insulin in patients with immunogenic DM had no effect. Stress affects memory mechanisms, heavy emotional stress during gravidity can bring congenital malformations. The decrease of mental functions in aged women depends on the level of free estradiol (the fraction, which is not bound to plasma proteins). Activation of dopaminergic neurons can be achieved by neurotropic growth factors. Nesiritide is a recombinant brain natriuretic hormone successfully tested in heart failure. The role of leptin in the appetite regulation in man is still not clear, other signalling molecules may have also an effect, e.g., ghrelin, which primarily stimulates STH secretion and brings about weight gain. Sildenafil influences nitrergic neurons elsewhere than in penis, for example it has positive effects in patients with oesophageal achalasia.

  15. Theory of Gyrotron Traveling Wave Amplifiers at Harmonics of the Gyration Frequency

    NASA Astrophysics Data System (ADS)

    Li, Qiangfa

    In developing gyrotrons at millimeter and submillimeter wavelengths, a means of operation at lower applied magnetic fields is desirable because of the size and weight of convetional magnets, and the expense and complexity of cryogenic magnets. This requirement can be met by operating the devices at higher harmonics of the electron gyration frequency. In the present work, a unified theory is developed for the gyrotron traveling wave amplifers (gyro-TWA) at harmonics of the gyration frequency, both in the nonlinear regime and in the linear regime. This theory can be applied to a wide class of waveguide cross sections, arbitrary harmonic number, any waveguide mode, and generalized electron beam model. The fields in the beam-field interaction region in the waveguide are expressed in the form of an infinite series of multipoles expanded around the guiding center of the electrons. A set of equations governing the nonlinear behavior of the gyro-TWA is derived. A general dispersion equation is derived both from that set of nonlinear equations by an iteration method and from plasma kinetic theory. The latter is employed to analyze gyro-TWA devices in a systematic and generalized manner. The Laplace transformation is introduced to allow inclusion of the initial values at the input end of the waveguide. From the linear theory it is found that for a gyrotron working at s-th gyration harmonic the electrons can interact only with the 2s-th order multipole field component. It is also found that a higher order waveguide mode is not always better than a lower order mode for the gyro-TWA working at higher harmonics. A novel out-ridged waveguide is proposed and analyzed for the use in gyrotrons. The prominent features of this new waveguide include simplicity of manufacture, freedom from local modes, good separation of lower order modes, high power handling ability, and high gain per unit length at higher gyration harmonics. A comparison of the gyro-TWAs with several different waveguide structures, such as the out-ridged, magnetron-type, rectangular and circular waveguides, is made through numerical examples of the gain-frequency curves computed from the linear kinetic theory.

  16. Efficacy of Single-Dose and Triple-Dose Albendazole and Mebendazole against Soil-Transmitted Helminths and Taenia spp.: A Randomized Controlled Trial

    PubMed Central

    Steinmann, Peter; Utzinger, Jürg; Du, Zun-Wei; Jiang, Jin-Yong; Chen, Jia-Xu; Hattendorf, Jan; Zhou, Hui; Zhou, Xiao-Nong

    2011-01-01

    Background The control of soil-transmitted helminth (STH) infections currently relies on the large-scale administration of single-dose oral albendazole or mebendazole. However, these treatment regimens have limited efficacy against hookworm and Trichuris trichiura in terms of cure rates (CR), whereas fecal egg reduction rates (ERR) are generally high for all common STH species. We compared the efficacy of single-dose versus triple-dose treatment against hookworm and other STHs in a community-based randomized controlled trial in the People's Republic of China. Methodology/Principal findings The hookworm CR and fecal ERR were assessed in 314 individuals aged ≥5 years who submitted two stool samples before and 3–4 weeks after administration of single-dose oral albendazole (400 mg) or mebendazole (500 mg) or triple-dose albendazole (3×400 mg over 3 consecutive days) or mebendazole (3×500 mg over 3 consecutive days). Efficacy against T. trichiura, Ascaris lumbricoides, and Taenia spp. was also assessed. Albendazole cured significantly more hookworm infections than mebendazole in both treatment regimens (single dose: respective CRs 69% (95% confidence interval [CI]: 55–81%) and 29% (95% CI: 20–45%); triple dose: respective CRs 92% (95% CI: 81–98%) and 54% (95% CI: 46–71%)). ERRs followed the same pattern (single dose: 97% versus 84%; triple dose: 99.7% versus 96%). Triple-dose regimens outperformed single doses against T. trichiura; three doses of mebendazole – the most efficacious treatment tested – cured 71% (95% CI: 57–82%). Both single and triple doses of either drug were highly efficacious against A. lumbricoides (CR: 93–97%; ERR: all >99.9%). Triple dose regimens cured all Taenia spp. infections, whereas single dose applications cured only half of them. Conclusions/Significance Single-dose oral albendazole is more efficacious against hookworm than mebendazole. To achieve high CRs against both hookworm and T. trichiura, triple-dose regimens are warranted. Trial Registration www.controlled-trials.com ISRCTN47375023 PMID:21980373

  17. Application of a Multiplex Quantitative PCR to Assess Prevalence and Intensity Of Intestinal Parasite Infections in a Controlled Clinical Trial

    PubMed Central

    Llewellyn, Stacey; Inpankaew, Tawin; Nery, Susana Vaz; Gray, Darren J.; Verweij, Jaco J.; Clements, Archie C. A.; Gomes, Santina J.; Traub, Rebecca; McCarthy, James S.

    2016-01-01

    Background Accurate quantitative assessment of infection with soil transmitted helminths and protozoa is key to the interpretation of epidemiologic studies of these parasites, as well as for monitoring large scale treatment efficacy and effectiveness studies. As morbidity and transmission of helminth infections are directly related to both the prevalence and intensity of infection, there is particular need for improved techniques for assessment of infection intensity for both purposes. The current study aimed to evaluate two multiplex PCR assays to determine prevalence and intensity of intestinal parasite infections, and compare them to standard microscopy. Methodology/Principal Findings Faecal samples were collected from a total of 680 people, originating from rural communities in Timor-Leste (467 samples) and Cambodia (213 samples). DNA was extracted from stool samples and subject to two multiplex real-time PCR reactions the first targeting: Necator americanus, Ancylostoma spp., Ascaris spp., and Trichuris trichiura; and the second Entamoeba histolytica, Cryptosporidium spp., Giardia. duodenalis, and Strongyloides stercoralis. Samples were also subject to sodium nitrate flotation for identification and quantification of STH eggs, and zinc sulphate centrifugal flotation for detection of protozoan parasites. Higher parasite prevalence was detected by multiplex PCR (hookworms 2.9 times higher, Ascaris 1.2, Giardia 1.6, along with superior polyparasitism detection with this effect magnified as the number of parasites present increased (one: 40.2% vs. 38.1%, two: 30.9% vs. 12.9%, three: 7.6% vs. 0.4%, four: 0.4% vs. 0%). Although, all STH positive samples were low intensity infections by microscopy as defined by WHO guidelines the DNA-load detected by multiplex PCR suggested higher intensity infections. Conclusions/Significance Multiplex PCR, in addition to superior sensitivity, enabled more accurate determination of infection intensity for Ascaris, hookworms and Giardia compared to microscopy, especially in samples exhibiting polyparasitism. The superior performance of multiplex PCR to detect polyparasitism and more accurately determine infection intensity suggests that it is a more appropriate technique for use in epidemiologic studies and for monitoring large-scale intervention trials. PMID:26820626

  18. Integrated control programmes for schistosomiasis and other helminth infections in P.R. China.

    PubMed

    Xu, Jing; Xu, Jun-Fang; Li, Shi-Zhu; Zhang, Li-Juan; Wang, Qiang; Zhu, Hui-Hui; Zhou, Xiao-Nong

    2015-01-01

    The prevalence of human schistosomiasis and soil-transmitted helminthiasis (STH) has decreased significantly in the People's Republic of China (P.R. China), particularly after 2005 when the national control programmes were reinforced by forming of integrated control strategies. Furthermore, social-economic development also contributed to the decrease of schistosome and soil-transmitted helminth infections. The prevalence of the zoonotic helminthiasis, including clonorchiasis and echinococcosis, on the other hand, is either underestimated or has in fact increased due to changes in social and environmental factors. In comparison with the control strategies in force and their effects on those four kinds of helminthiasis, the challenges and control priorities for the potential transfer from control to elimination of each disease is reviewed, to provide evidence for policy-makers to act upon. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Tailoring Water, Sanitation, and Hygiene (WASH) Targets for Soil-Transmitted Helminthiasis and Schistosomiasis Control.

    PubMed

    Campbell, Suzy J; Biritwum, Nana-Kwadwo; Woods, Geordie; Velleman, Yael; Fleming, Fiona; Stothard, J Russell

    2018-01-01

    The World Health Organization's (WHO) 2015-2020 Global Strategy on water, sanitation, and hygiene (WASH) and neglected tropical diseases (NTDs) encourages integration, whilst maintaining existing structured NTD investments, and acceleration towards Sustainable Development Goal (SDG) targets. Accordingly, SDG-associated and WASH-NTD indicators have been developed, commencing important intersectoral dialogue, alongside opportunities for future disease-specific refinements. The rationale for soil-transmitted helminthiasis (STH)- and schistosomiasis-specific WASH considerations, and a traffic-light figure, are presented here to indicate where current international definitions may, or may not, suffice. Certain unique aspects in control dynamics and parasitic lifecycles, however, necessitate additional implementation research with more appropriate measurement indicators developed to record programmatic interventions and to define strategic priorities more effectively. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. Soil-transmitted helminthiases: implications of climate change and human behavior.

    PubMed

    Weaver, Haylee J; Hawdon, John M; Hoberg, Eric P

    2010-12-01

    Soil-transmitted helminthiases (STHs) collectively cause the highest global burden of parasitic disease after malaria and are most prevalent in the poorest communities, especially in sub-Saharan Africa. Climate change is predicted to alter the physical environment through cumulative impacts of warming and extreme fluctuations in temperature and precipitation, with cascading effects on human health and wellbeing, food security and socioeconomic infrastructure. Understanding how the spectrum of climate change effects will influence STHs is therefore of critical importance to the control of the global burden of human parasitic disease. Realistic progress in the global control of STH in a changing climate requires a multidisciplinary approach that includes the sciences (e.g. thermal thresholds for parasite development and resilience) and social sciences (e.g. behavior and implementation of education and sanitation programs). Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. Cysteine proteinases from papaya (Carica papaya) in the treatment of experimental Trichuris suis infection in pigs: two randomized controlled trials.

    PubMed

    Levecke, Bruno; Buttle, David J; Behnke, Jerzy M; Duce, Ian R; Vercruysse, Jozef

    2014-05-30

    Cysteine proteinases (CPs) from papaya (Carica papaya) possess anthelmintic properties against human soil-transmitted helminths (STH, Ascaris lumbricoides, Trichuris trichiura and hookworm), but there is a lack of supportive and up-to-date efficacy data. We therefore conducted two randomized controlled trials in pigs to assess the efficacy of papaya CPs against experimental infections with T. suis. First, we assessed efficacy by means of egg (ERR) and adult worm reduction rate (WRR) of a single-oral dose of 450 μmol active CPs (CP450) against low (inoculum of 300 eggs) and high (inoculum of 3,000 eggs) intensity T. suis infections and compared the efficacy with those obtained after a single-oral dose of 400 mg albendazole (ALB). In the second trial, we determined and compared the efficacy of a series of CP doses (45 [CP45], 115 [CP115], 225 [CP225], and 450 [CP450] μmol) against high intensity infections. CP450 was highly efficacious against both levels of infection intensity, resulting in ERR and WRR of more than 97%. For both levels of infection intensity, CP450 was significantly more efficacious compared to ALB by means of WRR (low infection intensity: 99.0% vs. 39.0%; high infection intensity; 97.4% vs. 23.2%). When the efficacy was assessed by ERR, a significant difference was only observed for high intensity infections, CP450 being more efficacious than ALB (98.9% vs. 59.0%). For low infection intensities, there was no significant difference in ERR between CP450 (98.3%) and ALB (64.4%). The efficacy of CPs increased as a function of increasing dose. When determined by ERR, the efficacy ranged from 2.1% for CP45 to 99.2% for CP450. For WRR the results varied from -14.0% to 99.0%, respectively. Pairwise comparison revealed a significant difference in ERR and WRR only between CP45 and CP450, the latter being more efficacious. A single dose of 450 μmol CPs provided greater efficacy against T. suis infections in pigs than a single-oral dose of 400 mg ALB. Although these results highlight the possibility of papaya CPs for controlling human STH, further development is needed in order to obtain and validate an oral formulation for human application.

  2. Intestinal polyparasitism with special emphasis to soil-transmitted helminths among residents around Gilgel Gibe Dam, Southwest Ethiopia: a community based survey.

    PubMed

    Mekonnen, Zeleke; Suleman, Sultan; Biruksew, Abdissa; Tefera, Tamirat; Chelkeba, Legese

    2016-11-23

    One third of the world population is estimated to be infected with intestinal parasites. The most affected people are children and the poor people living in tropics and subtropics. Polyparasitism (the concurrent infection with multiple intestinal parasite species) is found to be the norm among the same population although accurate estimate of its magnitude is unknown. It was found that polyparasitism might have a greater impact on morbidity than single species infection which might also increase susceptibility to other infections. Therefore, this study aimed at determining the prevalence and distribution of intestinal polyparasitism with special emphasis on Soil-Transmitted Helminths (STH) among residents around Gilgel Gibe dam located in Jimma zone of Oromia regional state, Ethiopia. A total of 1,021 participants were recruited in this study and provided stool samples for parasitological examination. Direct wet mount and Kato-Katz techniques were employed for stool examination. Pearson chi-square test was employed to assess the association of infection status and polyparasitism with gender and age group of the study participants. Five hundred thirty two individuals were infected with at least one parasite, providing the overall prevalence of 52.1%. Among positive individuals, 405 (76.1%), 114 (21.4%), and 13 (2.5%) individuals were infected with only one, two and three species of parasites, respectively. The overall prevalence of intestinal polyparasitism observed among the study participants was 12.4% (127/1,021). The predominant STH was hookworm, with a prevalence of 44.1%. Hookworm and Ascaris lumbricoides were the most frequently recorded combination in cases of polyparasitic infection. The study revealed that there was no significant difference in the distribution of polyparasitism with regard to age group and sex of the study participants (p > 0.05). The study indicated the presence of high prevalence of parasites as well as distribution of polyparasitism in the area. Moreover, the detection of Schistosoma mansoni in the community living within close proximity of the newly constructed dam would be taken as an indication of future risk factor. Further investigation on the predictors of polyparasitism and the assessment of effects of polyparasitism on the population are needed. Finally, there is a need to undertake integrated control strategies which involve improved sanitation, health education and chemotherapy that targets the whole community instead of only certain segments of populations.

  3. Baseline prevalence and intensity of schistosomiasis at sentinel sites in Madagascar: Informing a national control strategy.

    PubMed

    Rasoamanamihaja, Clara Fabienne; Rahetilahy, Alain Marcel; Ranjatoarivony, Bruno; Dhanani, Neerav; Andriamaro, Luciano; Andrianarisoa, Samuel Hermas; Jourdan, Peter Mark

    2016-01-27

    Schistosomiasis affects more than 800 million people, mostly in sub-Saharan Africa. A baseline sentinel site study was conducted in the Western half of Madagascar to determine the prevalence and intensity of schistosomiasis and soil-transmitted helminth (STH) infections prior to mass drug administration, and to explore the associations between infection and school attendance, and access to water, sanitation and hygiene (WASH) facilities. A three-stage, cluster-randomised cross-sectional study was conducted in 29 sentinel sites in October 2015. Twenty school attending and 4 non-attending children in each of the age groups from 7 to 10 years old were randomly selected at each site for detection of Schistosoma haematobium eggs in a single urine slide by filtration, and of S. mansoni, Ascaris lumbricoides, Trichuris trichiura and hookworm eggs in duplicate Kato-Katz slides from a single stool sample. School attendance was registered individually, and school-level access to WASH facilities was scored through pre-defined observed and reported factors. Logistic regression analysis was performed, adjusting for gender, age and study site. School-level WASH status was analysed using Spearman's rank correlation coefficient. A total of 1,958 children were included. The prevalence of S. haematobium infection and heavy-intensity infection was 30.5% and 15.1%, respectively. The prevalence of S. mansoni infection and heavy-intensity infection was 5.0% and 0.9%, respectively. The prevalence of any STH infection was 4.7%. There was no significant difference in prevalence of infection or heavy-intensity infection of either schistosome species between attending and non-attending children, apart from heavy-intensity S. mansoni infection that was significantly more common in children who did not attend school regularly (aOR = 7.5 (95% CI = 1.1-49.5); p = 0.037). Only a minority of schools had adequate access to WASH facilities, and in this study, we found no significant association between school-level WASH status and schistosomiasis. This study found an alarmingly high prevalence and intensity of schistosomiasis, and the results warrant urgent scale-up of the national NTD control programme that will need to include both non-attending and attending school-age children in order to reach WHO roadmap targets for the control of schistosomiasis by 2020.

  4. Identifying optimal threshold statistics for elimination of hookworm using a stochastic simulation model.

    PubMed

    Truscott, James E; Werkman, Marleen; Wright, James E; Farrell, Sam H; Sarkar, Rajiv; Ásbjörnsdóttir, Kristjana; Anderson, Roy M

    2017-06-30

    There is an increased focus on whether mass drug administration (MDA) programmes alone can interrupt the transmission of soil-transmitted helminths (STH). Mathematical models can be used to model these interventions and are increasingly being implemented to inform investigators about expected trial outcome and the choice of optimum study design. One key factor is the choice of threshold for detecting elimination. However, there are currently no thresholds defined for STH regarding breaking transmission. We develop a simulation of an elimination study, based on the DeWorm3 project, using an individual-based stochastic disease transmission model in conjunction with models of MDA, sampling, diagnostics and the construction of study clusters. The simulation is then used to analyse the relationship between the study end-point elimination threshold and whether elimination is achieved in the long term within the model. We analyse the quality of a range of statistics in terms of the positive predictive values (PPV) and how they depend on a range of covariates, including threshold values, baseline prevalence, measurement time point and how clusters are constructed. End-point infection prevalence performs well in discriminating between villages that achieve interruption of transmission and those that do not, although the quality of the threshold is sensitive to baseline prevalence and threshold value. Optimal post-treatment prevalence threshold value for determining elimination is in the range 2% or less when the baseline prevalence range is broad. For multiple clusters of communities, both the probability of elimination and the ability of thresholds to detect it are strongly dependent on the size of the cluster and the size distribution of the constituent communities. Number of communities in a cluster is a key indicator of probability of elimination and PPV. Extending the time, post-study endpoint, at which the threshold statistic is measured improves PPV value in discriminating between eliminating clusters and those that bounce back. The probability of elimination and PPV are very sensitive to baseline prevalence for individual communities. However, most studies and programmes are constructed on the basis of clusters. Since elimination occurs within smaller population sub-units, the construction of clusters introduces new sensitivities for elimination threshold values to cluster size and the underlying population structure. Study simulation offers an opportunity to investigate key sources of sensitivity for elimination studies and programme designs in advance and to tailor interventions to prevailing local or national conditions.

  5. Decoupling Hydrogen and Oxygen Production in Acidic Water Electrolysis Using a Polytriphenylamine-Based Battery Electrode.

    PubMed

    Ma, Yuanyuan; Dong, Xiaoli; Wang, Yonggang; Xia, Yongyao

    2018-03-05

    Hydrogen production through water splitting is considered a promising approach for solar energy harvesting. However, the variable and intermittent nature of solar energy and the co-production of H 2 and O 2 significantly reduce the flexibility of this approach, increasing the costs of its use in practical applications. Herein, using the reversible n-type doping/de-doping reaction of the solid-state polytriphenylamine-based battery electrode, we decouple the H 2 and O 2 production in acid water electrolysis. In this architecture, the H 2 and O 2 production occur at different times, which eliminates the issue of gas mixing and adapts to the variable and intermittent nature of solar energy, facilitating the conversion of solar energy to hydrogen (STH). Furthermore, for the first time, we demonstrate a membrane-free solar water splitting through commercial photovoltaics and the decoupled acid water electrolysis, which potentially paves the way for a new approach for solar water splitting. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. The yeast prefoldin-like URI-orthologue Bud27 associates with the RSC nucleosome remodeler and modulates transcription

    PubMed Central

    Mirón-García, María Carmen; Garrido-Godino, Ana Isabel; Martínez-Fernández, Verónica; Fernández-Pevida, Antonio; Cuevas-Bermúdez, Abel; Martín-Expósito, Manuel; Chávez, Sebastián; de la Cruz, Jesús; Navarro, Francisco

    2014-01-01

    Bud27, the yeast orthologue of human URI/RMP, is a member of the prefoldin-like family of ATP-independent molecular chaperones. It has recently been shown to mediate the assembly of the three RNA polymerases in an Rpb5-dependent manner. In this work, we present evidence of Bud27 modulating RNA pol II transcription elongation. We show that Bud27 associates with RNA pol II phosphorylated forms (CTD-Ser5P and CTD-Ser2P), and that its absence affects RNA pol II occupancy of transcribed genes. We also reveal that Bud27 associates in vivo with the Sth1 component of the chromatin remodeling complex RSC and mediates its association with RNA pol II. Our data suggest that Bud27, in addition of contributing to Rpb5 folding within the RNA polymerases, also participates in the correct assembly of other chromatin-associated protein complexes, such as RSC, thereby modulating their activity. PMID:25081216

  7. Efficient Suppression of Electron–Hole Recombination in Oxygen-Deficient Hydrogen-Treated TiO2 Nanowires for Photoelectrochemical Water Splitting

    PubMed Central

    2013-01-01

    There is an increasing level of interest in the use of black TiO2 prepared by thermal hydrogen treatments (H:TiO2) due to the potential to enhance both the photocatalytic and the light-harvesting properties of TiO2. Here, we examine oxygen-deficient H:TiO2 nanotube arrays that have previously achieved very high solar-to-hydrogen (STH) efficiencies due to incident photon-to-current efficiency (IPCE) values of >90% for photoelectrochemical water splitting at only 0.4 V vs RHE under UV illumination. Our transient absorption (TA) mechanistic study provides strong evidence that the improved electrical properties of oxygen-deficient TiO2 enables remarkably efficient spatial separation of electron–hole pairs on the submicrosecond time scale at moderate applied bias, and this coupled to effective suppression of microsecond to seconds charge carrier recombination is the primary factor behind the dramatically improved photoelectrochemical activity. PMID:24376902

  8. Cohort Profile: The Ecuador Life (ECUAVIDA) study in Esmeraldas Province, Ecuador

    PubMed Central

    Cooper, Philip J; Chico, Martha E; Platts-Mills, Thomas AE; Rodrigues, Laura C; Strachan, David P; Barreto, Mauricio L

    2015-01-01

    The ECUAVIDA birth cohort is studying the impact of exposures to soil-transmitted helminth (STH) parasites and early-life microbial exposures on the development of atopy, allergic diseases and immune responses in childhood. A total of 2404 newborns were recruited between 2006 and 2009 in a public hospital serving the rural district of Quininde, Esmeraldas Province, in a tropical region of coastal Ecuador. Detailed measurements were done around the time of the birth, at 7 and 13 months and at 2 and 3 years, and data collection is ongoing at 5 and 8 years. Data being collected include questionnaires for: sociodemographic, lifestyle, psychosocial (at 4–6 years only) and dietary (at 6–7 years only) factors; childhood morbidity and clinical outcomes; stool samples for parasites; blood samples for DNA, measurements of vaccine responses and other measures of immune function/inflammation; and anthropometrics. Allergen skin prick test reactivity is done from 2 years and measures of airway function and inflammation at 8 years. PMID:24990475

  9. Prevalence of intestinal parasitic infection and associated risk factors among village health volunteers in rural communities of southern Thailand.

    PubMed

    Punsawad, Chuchard; Phasuk, Nonthapan; Bunratsami, Suchirat; Thongtup, Kanjana; Siripakonuaong, Niramon; Nongnaul, Somchok

    2017-06-09

    Intestinal parasitic infections remain prevalent and constitute a public health problem in certain rural areas of Thailand. Village health volunteers (VHVs), who are members of a Thai healthcare alliance, function as key providers of health prevention measures, disease control, and health education and share national health promotion campaigns with community members. This study is aimed at evaluating the prevalence, intensity, and risk factors for intestinal parasitic infection in VHVs in order to design community awareness and health education campaigns for the target population. This cross-sectional study was conducted between January to April 2016 among village health volunteers (VHVs) from four sub-districts of Nopphitam District, Nakhon Si Thammarat Province, southern Thailand. Subjects for the study were selected using a simple random sampling method. Socio-demographic variables and risk factors were collected by a structured questionnaire. Stool specimens were collected and processed using direct wet mount and formol-ether concentration techniques to determine the presence of parasites and modified Kato-Katz thick smear to determine the intensity of infection. A total of 324 VHVs were enrolled. The overall prevalence of intestinal helminths was 9.3% (95% confidence interval [CI]: 6.3-13.0). The prevalence of hookworm, Strongyloides stercoralis, and Trichuris trichiura were 8.0% (95% CI: 5.3-11.5), 0.9% (95% CI: 0.2-2.7), and 0.3% (95% CI: 0-1.7), respectively. Mean intensity of hookworm infection was 1732 eggs per gram of stool. The prevalence was lower for protozoan infection than for helminth infection. Blastocystis hominis accounted for the highest percentage of intestinal protozoan infections 4.0% (95% CI: 2.2-6.8), followed by Giardia intestinalis 0.6% (95% CI: 0-2.2). No statistically significant difference was observed in the prevalence of intestinal parasitic infection among sub-districts (p > 0.05). Having dogs at home was associated with soil-transmitted helminth (STH) infection in study participants (Crude prevalence ratio [CPR]: 2.3; 95% CI: 1.0-5.2). This study is the first to describe the prevalence of intestinal parasitic infection VHVs from southern Thailand. Hookworm infection is more prevalent than other types of STH infection. The development of community awareness campaigns and appropriate control measures should be considered to reduce the prevalence of hookworm infection, especially among VHVs who are the key persons providing health education to the community.

  10. Efficacy of integrated school based de-worming and prompt malaria treatment on helminths -Plasmodium falciparum co-infections: A 33 months follow up study.

    PubMed

    Midzi, Nicholas; Mtapuri-Zinyowera, Sekesai; Sangweme, Davison; Paul, Noah H; Makware, Godfrey; Mapingure, Munyaradzi P; Brouwer, Kimberly C; Mudzori, James; Hlerema, Gibson; Chadukura, Vivian; Mutapi, Francisca; Kumar, Nirbhay; Mduluza, Takafira

    2011-06-22

    The geographical congruency in distribution of helminths and Plasmodium falciparum makes polyparasitism a common phenomenon in Sub Saharan Africa. The devastating effects of helminths-Plasmodium co-infections on primary school health have raised global interest for integrated control. However little is known on the feasibility, timing and efficacy of integrated helminths-Plasmodium control strategies. A study was conducted in Zimbabwe to evaluate the efficacy of repeated combined school based antihelminthic and prompt malaria treatment. A cohort of primary schoolchildren (5-17 years) received combined Praziquantel, albendazole treatment at baseline, and again during 6, 12 and 33 months follow up surveys and sustained prompt malaria treatment. Sustained prompt malaria treatment was carried out throughout the study period. Children's infection status with helminths, Plasmodium and helminths-Plasmodium co-infections was determined by parasitological examinations at baseline and at each treatment point. The prevalence of S. haematobium, S. mansoni, STH, malaria, helminths-Plasmodium co-infections and helminths infection intensities before and after treatment were analysed. Longitudinal data showed that two rounds of combined Praziquantel and albendazole treatment for schistosomiasis and STHs at 6 monthly intervals and sustained prompt malaria treatment significantly reduced the overall prevalence of S. haematobium, S. mansoni, hookworms and P. falciparum infection in primary schoolchildren by 73.5%, 70.8%, 67.3% and 58.8% respectively (p < 0.001, p < 0.001, p < 0.001, p < 0.001 respectively). More importantly, the prevalence of STH + schistosomes, P. f + schistosomes, and P. f + STHs + schistosomes co-infections were reduced by 68.0%, 84.2%, and 90.7%, respectively. The absence of anti-helminthic treatment between the 12 mth and 33 mth follow-up surveys resulted in the sharp increase in STHs + schistosomes co-infection from 3.3% at 12 months follow up survey to 10.7%, slightly more than the baseline level (10.3%) while other co-infection combinations remained significantly low. The overall prevalence of heavy S. haematobium, S. mansoni and hookworms infection intensities were significantly reduced from: 17.9-22.4% to 2.6-5.1%, 1.6-3.3% to 0.0% and 0.0-0.7% to 0.0% respectively. Biannual Integrated school based antihelminthic and sustained prompt malaria treatment has a potential to reduce the burden of helminths-plasmodium co-infections in primary school children. In areas of stable malaria transmission, active case finding is recommended to track and treat asymptomatic malaria cases as these may sustain transmission in the community.

  11. Efficacy of integrated school based de-worming and prompt malaria treatment on helminths -Plasmodium falciparum co-infections: A 33 months follow up study

    PubMed Central

    2011-01-01

    Background The geographical congruency in distribution of helminths and Plasmodium falciparum makes polyparasitism a common phenomenon in Sub Saharan Africa. The devastating effects of helminths-Plasmodium co-infections on primary school health have raised global interest for integrated control. However little is known on the feasibility, timing and efficacy of integrated helminths-Plasmodium control strategies. A study was conducted in Zimbabwe to evaluate the efficacy of repeated combined school based antihelminthic and prompt malaria treatment. Methods A cohort of primary schoolchildren (5-17 years) received combined Praziquantel, albendazole treatment at baseline, and again during 6, 12 and 33 months follow up surveys and sustained prompt malaria treatment. Sustained prompt malaria treatment was carried out throughout the study period. Children's infection status with helminths, Plasmodium and helminths-Plasmodium co-infections was determined by parasitological examinations at baseline and at each treatment point. The prevalence of S. haematobium, S. mansoni, STH, malaria, helminths-Plasmodium co-infections and helminths infection intensities before and after treatment were analysed. Results Longitudinal data showed that two rounds of combined Praziquantel and albendazole treatment for schistosomiasis and STHs at 6 monthly intervals and sustained prompt malaria treatment significantly reduced the overall prevalence of S. haematobium, S. mansoni, hookworms and P. falciparum infection in primary schoolchildren by 73.5%, 70.8%, 67.3% and 58.8% respectively (p < 0.001, p < 0.001, p < 0.001, p < 0.001 respectively). More importantly, the prevalence of STH + schistosomes, P. f + schistosomes, and P. f + STHs + schistosomes co-infections were reduced by 68.0%, 84.2%, and 90.7%, respectively. The absence of anti-helminthic treatment between the 12 mth and 33 mth follow-up surveys resulted in the sharp increase in STHs + schistosomes co-infection from 3.3% at 12 months follow up survey to 10.7%, slightly more than the baseline level (10.3%) while other co-infection combinations remained significantly low. The overall prevalence of heavy S. haematobium, S. mansoni and hookworms infection intensities were significantly reduced from: 17.9-22.4% to 2.6-5.1%, 1.6-3.3% to 0.0% and 0.0-0.7% to 0.0% respectively. Conclusion Biannual Integrated school based antihelminthic and sustained prompt malaria treatment has a potential to reduce the burden of helminths-plasmodium co-infections in primary school children. In areas of stable malaria transmission, active case finding is recommended to track and treat asymptomatic malaria cases as these may sustain transmission in the community. PMID:21696629

  12. Controlling Taenia solium and soil transmitted helminths in a northern Lao PDR village: Impact of a triple dose albendazole regime.

    PubMed

    Ash, Amanda; Okello, Anna; Khamlome, Boualam; Inthavong, Phouth; Allen, John; Thompson, R C Andrew

    2017-10-01

    Taenia solium taeniasis-cysticercosis and soil-transmitted helminths (STHs) are parasitic Neglected Tropical Diseases endemic throughout Southeast Asia. Within Lao PDR, a remote northern hill tribe village had previously been identified as a hyper endemic focus for T. solium. To reduce this observed prevalence, a One Health intervention covering both pigs and humans was implemented, which included two Mass drug administrations (MDA1 and MDA2) for village residents using a triple dose albendazole 400mg treatment regime. In addition to the effect on T. solium levels, the dual impact of this anthelmintic regime on STHs within the community was also monitored. Faecal samples were collected pre and post MDA1 and MDA2 and analysed for the presence of Taenia species and the STHs Ascaris lumbricoides, Trichuris trichiura and hookworm species. The McMaster technique was used to measure the changes in both prevalence and intensity of infection. Molecular characterisation of Taenia and hookworm species was conducted to detect zoonotic species. The level of taeniasis within the sampled population decreased by 79.4% after MDA1, remained steady during the five month inter-treatment interval and decreased again by 100% after MDA2. The prevalence of STHs decreased by 65.5% and 62.8% after MDA1 and MDA2 respectively; however an increase to 62.1% of pre MDA1 levels was detected during the inter-treatment interval. Individually, hookworm prevalence decreased by 83.4% (MDA1) and 84.5% (MDA2), A. lumbricoides by 95.6% and 93.5% and T. trichiura by 69.2% and 61%. The intensity of infection within the sampled population also decreased, with egg reduction rates of 94.4% and 97.8% for hookworm, 99.4% and 99.3% for A. lumbricoides and 77.2% and 88.5% for T. trichiura. Molecular characterisation identified a T. solium tapeworm carrier from 21.6% (13/60) of households in the village. T. saginata was identified in 5% (3/60) of households. The zoonotic hookworm A. ceylanicum was detected in the resident dog population. These results suggest that the triple dose albendazole 400mg treatment regime achieved a significant reduction in the level of taeniasis whilst simultaneously reducing the STH burden within the village. The increased STH prevalence detected between MDAs reflects the need for behavioural changes and a sustained chemotherapy programme, which may also need to include the resident dog population. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  13. The yeast prefoldin-like URI-orthologue Bud27 associates with the RSC nucleosome remodeler and modulates transcription.

    PubMed

    Mirón-García, María Carmen; Garrido-Godino, Ana Isabel; Martínez-Fernández, Verónica; Fernández-Pevida, Antonio; Cuevas-Bermúdez, Abel; Martín-Expósito, Manuel; Chávez, Sebastián; de la Cruz, Jesús; Navarro, Francisco

    2014-09-01

    Bud27, the yeast orthologue of human URI/RMP, is a member of the prefoldin-like family of ATP-independent molecular chaperones. It has recently been shown to mediate the assembly of the three RNA polymerases in an Rpb5-dependent manner. In this work, we present evidence of Bud27 modulating RNA pol II transcription elongation. We show that Bud27 associates with RNA pol II phosphorylated forms (CTD-Ser5P and CTD-Ser2P), and that its absence affects RNA pol II occupancy of transcribed genes. We also reveal that Bud27 associates in vivo with the Sth1 component of the chromatin remodeling complex RSC and mediates its association with RNA pol II. Our data suggest that Bud27, in addition of contributing to Rpb5 folding within the RNA polymerases, also participates in the correct assembly of other chromatin-associated protein complexes, such as RSC, thereby modulating their activity. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

  14. Evaluation of Stress Corrosion Resistance Properties of 15CrMoR(H) in H2S Environment

    NASA Astrophysics Data System (ADS)

    Zhang, Yiliang; Wang, Jing; Wu, Mingyao; Li, Shurui; Liu, Wenbin

    To evaluate the hydrogen resistant properties of the 15CrMoR(H) with new smelting process, according to NACE and National Standards, three tests including NACE standard tensile test, NACE standard bent-beam test and hydrogen induced cracking test are executed in saturated hydrogen sulfide(H2S) environment. Stress-life mathematical model of this material is given by analyzing and fitting the results of tensile test. Test results show that the threshold sth of tensile test is 0.7R eL(252MPa); the threshold nominal stress SC of bent-beam is higher than 4.5 R eL (1620MPa); for HIC test, the crack length rate CLR is 4.40%, the crack thickness rate CTR is 0.87% and the crack sensitive rate CSR is 0.04%. Compare with EFC standard, the safety margin of HIC test is 3.4, 3.4 and 37.5 times respectively. All the experimental results show that the new 15CrMoR(H) material has excellent H2S environmental cracking resistance properties.

  15. Implications of the UK NHS consent policy for nuclear medicine practice.

    PubMed

    Greaves, Claire D; Tindale, Wendy B

    2005-02-01

    To comply with government policy on consent, the Sheffield Teaching Hospitals (STH) National Health Service (NHS) Trust introduced a new consent policy in February 2002. Verbal or written consent (depending on the level of risk) must be obtained prior to each study. The patient must be fully informed and given time to reach a decision. Consideration needs to be given to the following: to whom, when and how to provide such information and obtain consent. Each study type and patient circumstance needs to be classified according to risk. Consideration of the risks resulted in a local policy in which written consent is required for the following: therapeutic procedures, studies on pregnant women, studies in which pregnancy needs to be avoided, research procedures, cardiac stress for myocardial perfusion scintigraphy and intrathecal administration. Patient information leaflets have been updated with new information about the study and any risks. Information is now available for both patients and hospital staff. Compliance with the consent policy in a service department provides logistic challenges, but it is possible to fully inform patients in advance about their treatment, allowing them to give informed consent.

  16. Association between footwear use and neglected tropical diseases: a systematic review and meta-analysis.

    PubMed

    Tomczyk, Sara; Deribe, Kebede; Brooker, Simon J; Clark, Hannah; Rafique, Khizar; Knopp, Stefanie; Utzinger, Jürg; Davey, Gail

    2014-01-01

    The control of neglected tropical diseases (NTDs) has primarily focused on preventive chemotherapy and case management. Less attention has been placed on the role of ensuring access to adequate water, sanitation, and hygiene and personal preventive measures in reducing exposure to infection. Our aim was to assess whether footwear use was associated with a lower risk of selected NTDs. We conducted a systematic review and meta-analysis to assess the association between footwear use and infection or disease for those NTDs for which the route of transmission or occurrence may be through the feet. We included Buruli ulcer, cutaneous larva migrans (CLM), leptospirosis, mycetoma, myiasis, podoconiosis, snakebite, tungiasis, and soil-transmitted helminth (STH) infections, particularly hookworm infection and strongyloidiasis. We searched Medline, Embase, Cochrane, Web of Science, CINAHL Plus, and Popline databases, contacted experts, and hand-searched reference lists for eligible studies. The search was conducted in English without language, publication status, or date restrictions up to January 2014. Studies were eligible for inclusion if they reported a measure of the association between footwear use and the risk of each NTD. Publication bias was assessed using funnel plots. Descriptive study characteristics and methodological quality of the included studies were summarized. For each study outcome, both outcome and exposure data were abstracted and crude and adjusted effect estimates presented. Individual and summary odds ratio (OR) estimates and corresponding 95% confidence intervals (CIs) were calculated as a measure of intervention effect, using random effects meta-analyses. Among the 427 studies screened, 53 met our inclusion criteria. Footwear use was significantly associated with a lower odds of infection of Buruli ulcer (OR=0.15; 95% CI: 0.08-0.29), CLM (OR=0.24; 95% CI: 0.06-0.96), tungiasis (OR=0.42; 95% CI: 0.26-0.70), hookworm infection (OR=0.48; 95% CI: 0.37-0.61), any STH infection (OR=0.57; 95% CI: 0.39-0.84), strongyloidiasis (OR=0.56; 95% CI: 0.38-0.83), and leptospirosis (OR=0.59; 95% CI: 0.37-0.94). No significant association between footwear use and podoconiosis (OR=0.63; 95% CI: 0.38-1.05) was found and no data were available for mycetoma, myiasis, and snakebite. The main limitations were evidence of heterogeneity and poor study quality inherent to the observational studies included. Our results show that footwear use was associated with a lower odds of several different NTDs. Access to footwear should be prioritized alongside existing NTD interventions to ensure a lasting reduction of multiple NTDs and to accelerate their control and elimination. PROSPERO International prospective register of systematic reviews CRD42012003338.

  17. A Rationale for Schistosomiasis Control in Elementary Schools of the Rainforest Zone of Pernambuco, Brazil

    PubMed Central

    Favre, Tereza C.; Pereira, Ana P. B.; Galvão, Aline F.; Zani, Luciana C.; Barbosa, Constança S.; Pieri, Otávio S.

    2009-01-01

    Background Since its beginning in 1999, the Schistosomiasis Control Program within the Unified Health System (PCE-SUS) has registered a cumulative coverage of just 20% of the population from the Rainforest Zone of Pernambuco (ZMP), northeast Brazil. This jeopardizes the accomplishment of the minimum goal of the Fifty-Fourth World Health Assembly, resolution WHA54.19, of providing treatment for schistosomiasis and soil-transmitted helminthiases (STH) to 75% of school-aged children at risk, which requires attending at least 166,000 residents in the 7–14 age range by year 2010 in that important endemic area. In the present study, secondary demographic and parasitological data from a representative municipality of the ZMP are analyzed to provide evidence that the current, community-based approach to control schistosomiasis and STH is unlikely to attain the WHA-54.19 minimum goal and to suggest that school-based control actions are also needed. Methodology/Principal Findings Data available on the PCE-SUS activities related to diagnosis and treatment of the population from the study municipality were obtained from the State Secretary of Health of Pernambuco (SES/PE) for 2002–2006, complemented by the Municipal Secretary of Health (SMS) for 2003–2004. Data from a school-based stool survey carried out by the Schistosomiasis Reference Service of the Oswaldo Cruz Foundation (SRE/Fiocruz) in 2004 were used to provide information on infection status variation among school-aged children (7–14 years). According to the SES, from 2004 to 2006, only 2,977 (19.5%) of the estimated 15,288 residents of all ages were examined, of which 396 (13.3%) were positive for Schistosoma mansoni. Among these, only 180 (45.5%) were treated. According to the SMS, of the 1,766 examined in the 2003–2004 population stool survey 570 (32.3%) were children aged 7–14 years. One year later, the SRE/Fiocruz school survey revealed that the infection status among those children remained unchanged at 14%–15% prevalence. By 2006, the school-aged population was estimated at 2,981, of which 2,007 (67.3%) were enrolled as pupils. Conclusions It is suggested that in the most troubled municipalities individual diagnosis and treatment should be concentrated in school-aged children rather than the whole population. School-based actions involving teachers and children's families may help the health teams to scale up control actions in order to attain the WHA-54.19 minimum goal. This strategy should involve health and education organs and include both enrolled and non-enrolled children. PMID:19290040

  18. Transplantable, STH-producing and diabetogenic pituitary adenoma of the BD IX-strain of rats.

    PubMed

    Stekar, J

    1976-03-19

    A chromophobic pituitary adenoma induced on BD IX-rats has been grafted on animals of the same strain. The transplanted tumour takes in 90-100%; it grows at a slow rate (in 7 months after grafting a weight of 7-20 g is attained). Tumour-bearing animals display gigantism and hypertrophy of adrenals; moreover, in 33% of cases, diabetes is observed. With non-diabetic animals, splenomegaly and marked leukocytosis are observed; immature white and red cells are present in the peripheral blood. Spontaneous regression of the tumour never occurs. After surgical removal, tumour regrowth and the formation of metastases are observed. Diabetes is characterised by pronounced hyperglycaemia, glucosuria, polyphagia and polydipsia. Histochemically, insulin cannot be detected in pancreas. Splenomegaly is never observed in diabetic animals. Transplanted adenoma frequently tends to stop growing. No recurrence is observable after extirpation. Spontaneous regression of the tumour sometimes occurs. Gigantism, hypertrophy of adrenals and diabetes are considered as consequences of growth hormone- and ACTH-secretion of the transplanted adenoma. At present the tumour is running in the 8th passage. It did not change its characteristics over a period of 5 years.

  19. Mediator binds to boundaries of chromosomal interaction domains and to proteins involved in DNA looping, RNA metabolism, chromatin remodeling, and actin assembly

    PubMed Central

    Chereji, Răzvan V.; Bharatula, Vasudha; Elfving, Nils; Blomberg, Jeanette; Larsson, Miriam; Morozov, Alexandre V.; Broach, James R.

    2017-01-01

    Abstract Mediator is a multi-unit molecular complex that plays a key role in transferring signals from transcriptional regulators to RNA polymerase II in eukaryotes. We have combined biochemical purification of the Saccharomyces cerevisiae Mediator from chromatin with chromatin immunoprecipitation in order to reveal Mediator occupancy on DNA genome-wide, and to identify proteins interacting specifically with Mediator on the chromatin template. Tandem mass spectrometry of proteins in immunoprecipitates of mediator complexes revealed specific interactions between Mediator and the RSC, Arp2/Arp3, CPF, CF 1A and Lsm complexes in chromatin. These factors are primarily involved in chromatin remodeling, actin assembly, mRNA 3′-end processing, gene looping and mRNA decay, but they have also been shown to enter the nucleus and participate in Pol II transcription. Moreover, we have found that Mediator, in addition to binding Pol II promoters, occupies chromosomal interacting domain (CID) boundaries and that Mediator in chromatin associates with proteins that have been shown to interact with CID boundaries, such as Sth1, Ssu72 and histone H4. This suggests that Mediator plays a significant role in higher-order genome organization. PMID:28575439

  20. Association between Footwear Use and Neglected Tropical Diseases: A Systematic Review and Meta-Analysis

    PubMed Central

    Brooker, Simon J.; Clark, Hannah; Rafique, Khizar; Knopp, Stefanie; Utzinger, Jürg; Davey, Gail

    2014-01-01

    Background The control of neglected tropical diseases (NTDs) has primarily focused on preventive chemotherapy and case management. Less attention has been placed on the role of ensuring access to adequate water, sanitation, and hygiene and personal preventive measures in reducing exposure to infection. Our aim was to assess whether footwear use was associated with a lower risk of selected NTDs. Methodology We conducted a systematic review and meta-analysis to assess the association between footwear use and infection or disease for those NTDs for which the route of transmission or occurrence may be through the feet. We included Buruli ulcer, cutaneous larva migrans (CLM), leptospirosis, mycetoma, myiasis, podoconiosis, snakebite, tungiasis, and soil-transmitted helminth (STH) infections, particularly hookworm infection and strongyloidiasis. We searched Medline, Embase, Cochrane, Web of Science, CINAHL Plus, and Popline databases, contacted experts, and hand-searched reference lists for eligible studies. The search was conducted in English without language, publication status, or date restrictions up to January 2014. Studies were eligible for inclusion if they reported a measure of the association between footwear use and the risk of each NTD. Publication bias was assessed using funnel plots. Descriptive study characteristics and methodological quality of the included studies were summarized. For each study outcome, both outcome and exposure data were abstracted and crude and adjusted effect estimates presented. Individual and summary odds ratio (OR) estimates and corresponding 95% confidence intervals (CIs) were calculated as a measure of intervention effect, using random effects meta-analyses. Principal Findings Among the 427 studies screened, 53 met our inclusion criteria. Footwear use was significantly associated with a lower odds of infection of Buruli ulcer (OR = 0.15; 95% CI: 0.08–0.29), CLM (OR = 0.24; 95% CI: 0.06–0.96), tungiasis (OR = 0.42; 95% CI: 0.26–0.70), hookworm infection (OR = 0.48; 95% CI: 0.37–0.61), any STH infection (OR = 0.57; 95% CI: 0.39–0.84), strongyloidiasis (OR = 0.56; 95% CI: 0.38–0.83), and leptospirosis (OR = 0.59; 95% CI: 0.37–0.94). No significant association between footwear use and podoconiosis (OR = 0.63; 95% CI: 0.38–1.05) was found and no data were available for mycetoma, myiasis, and snakebite. The main limitations were evidence of heterogeneity and poor study quality inherent to the observational studies included. Conclusions/Significance Our results show that footwear use was associated with a lower odds of several different NTDs. Access to footwear should be prioritized alongside existing NTD interventions to ensure a lasting reduction of multiple NTDs and to accelerate their control and elimination. Protocol Registration PROSPERO International prospective register of systematic reviews CRD42012003338 PMID:25393620

  1. A cross-sectional study on schistosomiasis and soil-transmitted helminths in Mbita district, western Kenya using different copromicroscopic techniques.

    PubMed

    Ng'etich, Annette I; Rawago, Fredrick O; Jura, Walter G Z O; Mwinzi, Pauline N; Won, Kimberly Y; Odiere, Maurice R

    2016-02-16

    Identification of populations to be targeted for individual treatment and broad-spectrum therapy in schistosomiasis-endemic areas, assessment of therapy efficacy, morbidity, and evaluation of control strategies need to be based on reliable diagnostic tools. Kato-Katz is routinely used and remains the standard diagnostic technique for schistosomiasis, despite its many challenges. This study was conducted in Nyamanga village, Mbita, western Kenya, and evaluated the diagnostic performance of Kato-Katz, Mini-Parasep and modified Mini-FLOTAC techniques in detection of Schistosoma mansoni and soil-transmitted helminths (Ascaris lumbricoides, Trichuris trichiura and hookworm) ova. Stool samples from 132 individuals were screened for eggs of S. mansoni by the 3 techniques. Mini-Parasep faecal parasite concentrator (Apacor Ltd, England), a single-use diagnostic device with a built-in filter for faecal concentration of helminth eggs by sedimentation was employed on stool samples fixed in 10% formalin. A modified Mini-FLOTAC (University of Naples, Italy) was based on floatation of helminths eggs with two different solutions (FS2 and FS7) using a closed system (Fill-FLOTAC) with 5% formalin. Kato-Katz was performed following WHO recommendation. Prevalence of S. mansoni and STH, sensitivity and degree of agreement among the 3 techniques were determined. Prevalence of S. mansoni was 47.0%, 34.1% and 20.5% by Mini-Parasep, Kato-Katz and modified Mini-FLOTAC FS7 techniques, respectively. Prevalence of any STH infection was 6.1%, 3.0%, 6.1% and 6.8% by Mini-Parasep, Kato-Katz, modified Mini-FLOTAC FS2 and modified Mini-FLOTAC FS7 techniques, respectively. Considering the pooled results of the three methods (Mini-Parasep, Kato-Katz and modified Mini-FLOTAC FS7) as diagnostic 'gold' standard, the sensitivity of Mini-Parasep, Kato-Katz and modified Mini-FLOTAC FS7 for S. mansoni was 77.5%, 56.1%, and 33.8%, respectively. Mini-Parasep and modified Mini-FLOTAC FS7 techniques had moderate (κ = 0.46) and fairly good (κ = 0.25) agreements with Kato-Katz for S. mansoni, respectively. Mini-Parasep detected a higher proportion of light intensity S. mansoni infections compared to Kato-Katz, which detected high proportions of heavy infections. Mini-Parasep detected a similar mean number of S. mansoni eggs per gram (EPG) of stool compared to the standard Kato-Katz (62.9 vs 97.3; t (131) = -0.49, P = 0.6265) and significantly higher EPG compared to the modified Mini-FLOTAC FS7 (62.9 vs 34.6; t (131) = 5.39, P < 0.0001). The high sensitivity of Mini-Parasep suggests its promising potential as an alternative tool in enhancing diagnosis and in monitoring schistosomiasis transmission and determining endpoint of intervention programs, especially in low endemicity areas. Mini-Parasep is also easy to operate, safe and also permits work with fresh stool.

  2. Origin and Reticulate Evolutionary Process of Wheatgrass Elymus trachycaulus (Triticeae: Poaceae)

    PubMed Central

    Zuo, Hongwei; Wu, Panpan; Wu, Dexiang; Sun, Genlou

    2015-01-01

    To study origin and evolutionary dynamics of tetraploid Elymus trachycaulus that has been cytologically defined as containing StH genomes, thirteen accessions of E. trachycaulus were analyzed using two low-copy nuclear gene Pepc (phosphoenolpyruvate carboxylase) and Rpb2 (the second largest subunit of RNA polymerase II), and one chloroplast region trnL–trnF (spacer between the tRNA Leu (UAA) gene and the tRNA-Phe (GAA) gene). Our chloroplast data indicated that Pseudoroegneria (St genome) was the maternal donor of E. trachycaulus. Rpb2 data indicated that the St genome in E. trachycaulus was originated from either P. strigosa, P. stipifolia, P. spicata or P. geniculate. The Hordeum (H genome)-like sequences of E. trachycaulus are polyphyletic in the Pepc tree, suggesting that the H genome in E. trachycaulus was contributed by multiple sources, whether due to multiple origins or introgression resulting from subsequent hybridization. Failure to recovering St copy of Pepc sequence in most accessions of E. trachycaulus might be caused by genome convergent evolution in allopolyploids. Multiple copies of H-like Pepc sequence from each accession with relative large deletions and insertions might be caused by either instability of Pepc sequence in H- genome or incomplete concerted evolution. Our results highlighted complex evolutionary history of E. trachycaulus. PMID:25946188

  3. Mediator binds to boundaries of chromosomal interaction domains and to proteins involved in DNA looping, RNA metabolism, chromatin remodeling, and actin assembly.

    PubMed

    Chereji, Razvan V; Bharatula, Vasudha; Elfving, Nils; Blomberg, Jeanette; Larsson, Miriam; Morozov, Alexandre V; Broach, James R; Björklund, Stefan

    2017-09-06

    Mediator is a multi-unit molecular complex that plays a key role in transferring signals from transcriptional regulators to RNA polymerase II in eukaryotes. We have combined biochemical purification of the Saccharomyces cerevisiae Mediator from chromatin with chromatin immunoprecipitation in order to reveal Mediator occupancy on DNA genome-wide, and to identify proteins interacting specifically with Mediator on the chromatin template. Tandem mass spectrometry of proteins in immunoprecipitates of mediator complexes revealed specific interactions between Mediator and the RSC, Arp2/Arp3, CPF, CF 1A and Lsm complexes in chromatin. These factors are primarily involved in chromatin remodeling, actin assembly, mRNA 3'-end processing, gene looping and mRNA decay, but they have also been shown to enter the nucleus and participate in Pol II transcription. Moreover, we have found that Mediator, in addition to binding Pol II promoters, occupies chromosomal interacting domain (CID) boundaries and that Mediator in chromatin associates with proteins that have been shown to interact with CID boundaries, such as Sth1, Ssu72 and histone H4. This suggests that Mediator plays a significant role in higher-order genome organization. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

  4. Effects of school-based deworming on hemoglobin level, growth development and school performance of primary school children in North Sumatera

    NASA Astrophysics Data System (ADS)

    Pasaribu, A. P.; Angellee, J.; Pasaribu, S.

    2018-03-01

    Worm infestation is mainly caused by soil-transmitted helminths (STH) infecting one-third of the world’s population, where the most affected are primary school children. This chronic, long-lasting infection can affect the growth aspects in children. A school-based deworming is one of the treatments recommended by WHO to counterattack worm infection in primary school children. To evaluate the effect of school-based deworming on the hemoglobin level, growth and school performance of primary school children, an open randomized clinical trial was conducted on 165 targeted populations in SukaKaro village, North Sumatra; 156 of which were then chosen based on inclusion and exclusion criteria. The samples’ feces- sampling, hemoglobin level, and growth chart data were recorded on the first day of study before any treatment was given. They were then divided into two groups; the first group of 80 samples did not receive any treatment, while the second group of 76 samples received 400mg of albendazole as part of a school-based deworming program. The samples were being followed up after sixth months of study. In conclusion, albendazole is able to improve the hemoglobin level, growth development, and school performance of the samples, although there were no significant differences between the two groups.

  5. Quantitative PCR and Digital PCR for Detection of Ascaris lumbricoides Eggs in Reclaimed Water

    PubMed Central

    Santísima-Trinidad, Ana Belén; Bornay-Llinares, Fernando Jorge; Martín González, Marcos; Pascual Valero, José Antonio; Ros Muñoz, Margarita

    2017-01-01

    The reuse of reclaimed water from wastewater depuration is a widespread and necessary practice in many areas around the world and must be accompanied by adequate and continuous quality control. Ascaris lumbricoides is one of the soil-transmitted helminths (STH) with risk for humans due to its high infectivity and an important determinant of transmission is the inadequacy of water supplies and sanitation. The World Health Organization (WHO) recommends a limit equal to or lower than one parasitic helminth egg per liter, to reuse reclaimed water for unrestricted irrigation. We present two new protocols of DNA extraction from large volumes of reclaimed water. Quantitative PCR (qPCR) and digital PCR (dPCR) were able to detect low amounts of A. lumbricoides eggs. By using the first extraction protocol, which processes 500 mL of reclaimed water, qPCR can detect DNA concentrations as low as one A. lumbricoides egg equivalent, while dPCR can detect DNA concentrations as low as five A. lumbricoides egg equivalents. By using the second protocol, which processes 10 L of reclaimed water, qPCR was able to detect DNA concentrations equivalent to 20 A. lumbricoides eggs. This fact indicated the importance of developing new methodologies to detect helminth eggs with higher sensitivity and precision avoiding possible human infection risks. PMID:28377928

  6. Comparative study of quality and efficacy of originator's and generic ABZ for the mass treatment of soil-transmitted nematode infections in Nepal

    PubMed Central

    Albonico, Marco; Mathema P., Pragya; Montresor, Antonio; Khakurel, Balkrishna; Reggi, Valerio; Pandey, Sharada; Savioli, Lorenzo

    2017-01-01

    Quality and efficacy of two locally-manufactured generic albendazole (ABZ) products (Curex and Royal Drug) used for de-worming children in Nepal since 1999 were tested against the originator product (GSK). The study conducted disintegration and dissolution testing and a randomised controlled clinical trial comparing cure rates (CR) and egg reduction rates (ERR) for Ascaris lumbricoides, Trichuris trichiura and hookworm infections. Stool samples from 1277 children were examined before and 21 days after treatment. For A. lumbricoides GSK's (97.0%) and Royal Drug's (95.0 %) product provided significantly higher CR than Curex's (82.6%); however, all products provided ERR higher than 90%. For T. trichiura Curex's product showed significantly lower ERR (63.2%). For hookworm, GSK's product performed significantly better (CR 74.3%, ERR 87.1%) than Royal Drug's (CR 53.3%, ERR 80.8%) and Curex's (CR 50.7%, ERR 73.1%). Only GSK's product passed both disintegration and dissolution. Both generic products failed dissolution. Curex's product showed poor disintegration. Despite its lower efficacy the cheaper Curex's product achieved good results in controlling morbidity due to soil-transmitted helminth (STH) infections. This study shows that cost-effectiveness of drugs used in mass de-worming campaigns should not be inferred on the basis of one single quality testing parameter. PMID:17129592

  7. Social stigma towards neglected tropical diseases: a systematic review.

    PubMed

    Hofstraat, Karlijn; van Brakel, Wim H

    2016-03-01

    People affected by neglected tropical diseases (NTDs) are frequently the target of social stigmatization. To date not much attention has been given to stigma in relation to NTDs. The objective of this review is to identify the extent of social stigma and the similarities and differences in the causes, manifestations, impact of stigma and interventions used between the NTDs. A systematic review was conducted in Pubmed, ScienceDirect, PsycINFO and Web of Knowledge. The search encompassed 17 NTDs, including podoconiosis, but not leprosy as this NTD has recently been reviewed. However, leprosy was included in the discussion. The 52 selected articles provided evidence on stigma related to lymphatic filariasis (LF), podoconiosis, Buruli ulcer, onchocerciasis, schistosomiasis, leishmaniasis, Chagas disease, trachoma, soil-transmitted helminthiasis (STH) and human African trypanosomiasis. The similarities predominated in stigma related to the various NTDs; only minimal differences in stigma reasons and measures were found. These similarities suggest that joint approaches to reduce stigmatization may be feasible. Lessons from leprosy and other stigmatized health conditions can be used to plan such joint approaches. Further research will be necessary to study the efficacy of joint interventions and to investigate stigma related to NTDs for which no evidence is available yet. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Metabolic evolution of two reducing equivalent-conserving pathways for high-yield succinate production in Escherichia coli.

    PubMed

    Zhu, Xinna; Tan, Zaigao; Xu, Hongtao; Chen, Jing; Tang, Jinlei; Zhang, Xueli

    2014-07-01

    Reducing equivalents are an important cofactor for efficient synthesis of target products. During metabolic evolution to improve succinate production in Escherichia coli strains, two reducing equivalent-conserving pathways were activated to increase succinate yield. The sensitivity of pyruvate dehydrogenase to NADH inhibition was eliminated by three nucleotide mutations in the lpdA gene. Pyruvate dehydrogenase activity increased under anaerobic conditions, which provided additional NADH. The pentose phosphate pathway and transhydrogenase were activated by increased activities of transketolase and soluble transhydrogenase SthA. These data suggest that more carbon flux went through the pentose phosphate pathway, thus leading to production of more reducing equivalent in the form of NADPH, which was then converted to NADH through soluble transhydrogenase for succinate production. Reverse metabolic engineering was further performed in a parent strain, which was not metabolically evolved, to verify the effects of activating these two reducing equivalent-conserving pathways for improving succinate yield. Activating pyruvate dehydrogenase increased succinate yield from 1.12 to 1.31mol/mol, whereas activating the pentose phosphate pathway and transhydrogenase increased succinate yield from 1.12 to 1.33mol/mol. Activating these two pathways in combination led to a succinate yield of 1.5mol/mol (88% of theoretical maximum), suggesting that they exhibited a synergistic effect for improving succinate yield. Copyright © 2014 International Metabolic Engineering Society. Published by Elsevier Inc. All rights reserved.

  9. Prevalence of Soil-Transmitted Helminthiases and Schistosomiasis in Preschool Age Children in Mwea Division, Kirinyaga South District, Kirinyaga County, and Their Potential Effect on Physical Growth

    PubMed Central

    Mkoji, Gerald M.

    2017-01-01

    Intestinal parasitic infections can significantly contribute to the burden of disease, may cause nutritional and energetic stress, and negatively impact the quality of life in low income countries of the world. This cross-sectional study done in Mwea irrigation scheme, in Kirinyaga, central Kenya, assessed the public health significance of soil-transmitted helminthiases (STH), schistosomiasis, and other intestinal parasitic infections, among 361 preschool age children (PSAC) through fecal examination, by measuring anthropometric indices, and through their parents/guardians, by obtaining sociodemographic information. Both intestinal helminth and protozoan infections were detected, and, among the soil-transmitted helminth parasites, there were Ascaris lumbricoides (prevalence, 3%), Ancylostoma duodenale (<1%), and Trichuris trichiura (<1%). Other intestinal helminths were Hymenolepis nana (prevalence, 3.6%) and Enterobius vermicularis (<1%). Schistosoma mansoni occurred at a prevalence of 5.5%. Interestingly, the protozoan, Giardia lamblia (prevalence, 14.7%), was the most common among the PSAC. Other protozoans were Entamoeba coli (3.9%) and Entamoeba histolytica (<1). Anthropometric indices showed evidence of malnutrition. Intestinal parasites were associated with hand washing behavior, family size, water purification, and home location. These findings suggest that G. lamblia infection and malnutrition may be significant causes of ill health among the PSAC in Mwea, and, therefore, an intervention plan is needed. PMID:29138640

  10. Functional Analysis of the Chaperone-Usher Fimbrial Gene Clusters of Salmonella enterica serovar Typhi.

    PubMed

    Dufresne, Karine; Saulnier-Bellemare, Julie; Daigle, France

    2018-01-01

    The human-specific pathogen Salmonella enterica serovar Typhi causes typhoid, a major public health issue in developing countries. Several aspects of its pathogenesis are still poorly understood. S . Typhi possesses 14 fimbrial gene clusters including 12 chaperone-usher fimbriae ( stg, sth, bcf , fim, saf , sef , sta, stb, stc, std, ste , and tcf ). These fimbriae are weakly expressed in laboratory conditions and only a few are actually characterized. In this study, expression of all S . Typhi chaperone-usher fimbriae and their potential roles in pathogenesis such as interaction with host cells, motility, or biofilm formation were assessed. All S . Typhi fimbriae were better expressed in minimal broth. Each system was overexpressed and only the fimbrial gene clusters without pseudogenes demonstrated a putative major subunits of about 17 kDa on SDS-PAGE. Six of these (Fim, Saf, Sta, Stb, Std, and Tcf) also show extracellular structure by electron microscopy. The impact of fimbrial deletion in a wild-type strain or addition of each individual fimbrial system to an S . Typhi afimbrial strain were tested for interactions with host cells, biofilm formation and motility. Several fimbriae modified bacterial interactions with human cells (THP-1 and INT-407) and biofilm formation. However, only Fim fimbriae had a deleterious effect on motility when overexpressed. Overall, chaperone-usher fimbriae seem to be an important part of the balance between the different steps (motility, adhesion, host invasion and persistence) of S . Typhi pathogenesis.

  11. Soil transmitted helminths and schistosoma mansoni infections among school children in Zarima town, northwest Ethiopia.

    PubMed

    Alemu, Abebe; Atnafu, Asmamaw; Addis, Zelalem; Shiferaw, Yitayal; Teklu, Takele; Mathewos, Biniam; Birhan, Wubet; Gebretsadik, Simon; Gelaw, Baye

    2011-07-09

    In Ethiopia, because of low quality drinking water supply and latrine coverage, helminths infections are the second most predominant causes of outpatient morbidity. Indeed, there is a scarcity of information on the prevalence of soil transmitted helminths and Schistosomiasis in Ethiopia, special in study area. Therefore, the aim of this study was to determine the prevalence and associated risk factors of soil transmitted helminths and intestinal Schistosomiasis. Cross-sectional study was conducted among 319 school children of Zarima town from April 1 to May 25, 2009. A pre-tested structured questionnaire was used to collect socio-demographic data and possible risk factors exposure. Early morning stool samples were collected and a Kato Katz semi concentration technique was used to examine and count parasitic load by compound light microscope. Data entry and analysis was done using SPSS-15 version and p-value < 0.05 considered statistically significant. Out of 319 study subjects, 263 (82.4%) of the study participants infected with one or more parasites. From soil transmitted helminths, Ascaris lumbricoides was the predominant isolate (22%) followed by Hookworms (19%) and Trichuris trichiura (2.5%). Schistosoma mansoni was also isolated in 37.9% of the study participants. Hookworm and S. mansoni infections showed statistically significant associations with shoe wearing and swimming habit of school children, respectively. Prevalence of soil transmitted helminths (STH) and S.mansoni was high and the diseases were still major health problem in the study area which alerts public health intervention as soon as possible.

  12. Systematic engineering of pentose phosphate pathway improves Escherichia coli succinate production.

    PubMed

    Tan, Zaigao; Chen, Jing; Zhang, Xueli

    2016-01-01

    Succinate biosynthesis of Escherichia coli is reducing equivalent-dependent and the EMP pathway serves as the primary reducing equivalent source under anaerobic condition. Compared with EMP, pentose phosphate pathway (PPP) is reducing equivalent-conserving but suffers from low efficacy. In this study, the ribosome binding site library and modified multivariate modular metabolic engineering (MMME) approaches are employed to overcome the low efficacy of PPP and thus increase succinate production. Altering expression levels of different PPP enzymes have distinct effects on succinate production. Specifically, increased expression of five enzymes, i.e., Zwf, Pgl, Gnd, Tkt, and Tal, contributes to increased succinate production, while the increased expression of two enzymes, i.e., Rpe and Rpi, significantly decreases succinate production. Modular engineering strategy is employed to decompose PPP into three modules according to position and function. Engineering of Zwf/Pgl/Gnd and Tkt/Tal modules effectively increases succinate yield and production, while engineering of Rpe/Rpi module decreases. Imbalance of enzymatic reactions in PPP is alleviated using MMME approach. Finally, combinational utilization of engineered PPP and SthA transhydrogenase enables succinate yield up to 1.61 mol/mol glucose, which is 94% of theoretical maximum yield (1.71 mol/mol) and also the highest succinate yield in minimal medium to our knowledge. In summary, we systematically engineered the PPP for improving the supply of reducing equivalents and thus succinate production. Besides succinate, these PPP engineering strategies and conclusions can also be applicable to the production of other reducing equivalent-dependent biorenewables.

  13. Approved oncology drugs lack in vivo activity against Trichuris muris despite in vitro activity.

    PubMed

    Cowan, Noemi; Raimondo, Alessia; Keiser, Jennifer

    2016-11-01

    Infections with soil-transmitted helminths (STHs) are considered among the most persistent global health problems. The few available drugs have limitations including low efficacy against Trichuris trichiura infections. As a starting point toward drug repositioning, we studied a set of FDA-approved oncology drugs for activity against Trichuris muris since targets relevant to cancer therapy might have a function in helminth biology. Drugs were tested in vitro on the larval and adult stage of T. muris. Compounds active in vitro were tested in the T. muris mouse model at single oral dosages of 200-400 mg/kg. Of the 114 drugs tested in vitro, 12 showed activity against T. muris larvae (>80 % drug effect at 50 μM). Ten of these drugs were also active on the adult worm stage (>80 % drug effect at 50 μM), of which six revealed IC 50 values between 1.8 and 5.0 μM. Except for tamoxifen citrate, all in vitro active drugs were protein kinase inhibitors. None of the drugs tested in vivo showed efficacy, revealing worm burden reductions of 0-24 % and worm expulsion rates of 0-7.9 %. The promising in vitro activities of protein kinases could not be confirmed in vivo. Drug discovery against STH should be strengthened including the definition of compound progression criteria. Follow-up structure-activity relationship studies with modified compounds might be considered.

  14. Self-trapped holes in β-Ga2O3 crystals

    NASA Astrophysics Data System (ADS)

    Kananen, B. E.; Giles, N. C.; Halliburton, L. E.; Foundos, G. K.; Chang, K. B.; Stevens, K. T.

    2017-12-01

    We have experimentally observed self-trapped holes (STHs) in a β-Ga2O3 crystal using electron paramagnetic resonance (EPR). These STHs are an intrinsic defect in this wide-band-gap semiconductor and may serve as a significant deterrent to producing usable p-type material. In our study, an as-grown undoped n-type β-Ga2O3 crystal was initially irradiated near room temperature with high-energy neutrons. This produced gallium vacancies (acceptors) and lowered the Fermi level. The STHs (i.e., small polarons) were then formed during a subsequent irradiation at 77 K with x rays. Warming the crystal above 90 K destroyed the STHs. This low thermal stability is a strong indicator that the STH is the correct assignment for these new defects. The S = 1/2 EPR spectrum from the STHs is easily observed near 30 K. A holelike angular dependence of the g matrix (the principal values are 2.0026, 2.0072, and 2.0461) suggests that the defect's unpaired spin is localized on one oxygen ion in a nonbonding p orbital aligned near the a direction in the crystal. The EPR spectrum also has resolved hyperfine structure due to equal and nearly isotropic interactions with 69,71Ga nuclei at two neighboring Ga sites. With the magnetic field along the a direction, the hyperfine parameters are 0.92 mT for the 69Ga nuclei and 1.16 mT for the 71Ga nuclei.

  15. An Improved Multiplex Real-Time SYBR Green PCR Assay for Analysis of 24 Target Genes from 16 Bacterial Species in Fecal DNA Samples from Patients with Foodborne Illnesses.

    PubMed

    Kawase, Jun; Etoh, Yoshiki; Ikeda, Tetsuya; Yamaguchi, Keiji; Watahiki, Masanori; Shima, Tomoko; Kameyama, Mitsuhiro; Horikawa, Kazumi; Fukushima, Hiroshi; Goto, Ryoichi; Shirabe, Komei

    2016-05-20

    Here, we developed a new version of our original screening system (Rapid Foodborne Bacterial Screening 24; RFBS24), which can simultaneously detect 24 genes of foodborne pathogens in fecal DNA samples. This new version (RFBS24 ver. 5) detected all known stx2 subtypes, enterotoxigenic Escherichia coli (STh genotype), and Vibrio parahaemolyticus (trh2), which were not detected by the original RFBS24 assay. The detection limits of RFBS24 ver. 5 were approximately 5.6 × 10(-2)-5.6 × 10(-5) (ng DNA)/reaction, significantly lower (10- to 100-fold) than those of the original RFBS24 for the 22 target genes analyzed here. We also tested the new assay on fecal DNA samples from patients infected with Salmonella, Campylobacter, or enterohemorrhagic E. coli. The number of bacterial target genes detected by RFBS24 ver. 5 was greater than that detected by RFBS24. RFBS24 ver. 5 combined with an Ultra Clean Fecal DNA Isolation Kit showed adequate performance (sensitivity and specificity 89% and 100%, respectively, for Salmonella spp. and 100% and 83%, respectively, for Campylobacter jejuni) in terms of rapid detection of a causative pathogen during foodborne-illness outbreaks. Thus, RFBS24 ver. 5 is more useful than the previous assay system for detection of foodborne pathogens and offers quick simultaneous analysis of many targets and thus facilitates rapid dissemination of information to public health officials.

  16. Soil-transmitted helminth infections and risk factors in preschool children in southern rural Lao People's Democratic Republic.

    PubMed

    Kounnavong, Sengchanh; Vonglokham, Manithong; Houamboun, Keonakhone; Odermatt, Peter; Boupha, Boungnong

    2011-03-01

    The current widespread school-based control of soil-transmitted helminth (STH) infections is also advocated for preschool children. The objective of this study was to assess infection with STHs as well as their determinants in preschool children (<60 months) in southern rural Lao People's Democratic Republic (Lao PDR). A cluster survey was carried out from October to December 2006 in three districts of Savannakhet Province. The prevalence of Ascaris lumbricoides, hookworm and Trichuris trichiura was 27.4% (95% CI 27.0-27.6%), 10.9% (95% CI 10.7-11.0%) and 10.9% (95% CI 10.7-11.1%), respectively. Of the children studied, 28.4% had a monoparasitic infection and 9.3% had a polyparasitic infection. Older children had a higher risk for hookworm infection [odds ratio (OR) = 1.75, 95% CI 1.03-3.01; P = 0.041] and multiple infections (OR = 1.81, 95% CI 1.01-3.20; P = 0.044). Low socioeconomic status was associated with A. lumbricoides (OR = 0.61, 95% CI 0.38-0.98; P = 0.043) and monoparasitic infections (OR = 0.62, 95% CI 0.38-0.99; P = 0.049). In Lao PDR, deworming of preschool children is warranted. Preventive measures should address important risk factors. Health education regarding personal hygiene, appropriate water management and the construction and proper use of latrines are additional essential elements. Copyright © 2010 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  17. Combining Footwear with Public Health Iconography to Prevent Soil-Transmitted Helminth Infections.

    PubMed

    Paige, Sarah B; Friant, Sagan; Clech, Lucie; Malavé, Carly; Kemigabo, Catherine; Obeti, Richard; Goldberg, Tony L

    2017-01-11

    Shoes are effective for blocking soil-transmitted helminths (STHs) that penetrate the skin. Unfortunately, shoe-wearing is uncommon in many areas where STHs are prevalent, in part because local populations are unaware of the health benefits of wearing shoes. This is especially true in low-literacy populations, where information dissemination through written messages is not possible. We launched a public health intervention that combines a public health image with sandals. The image is a "lenticular image" that combines two alternating pictures to depict the efficacy of shoes for preventing STH infection. This image is adhered to the shoe, such that the message is linked directly to the primary means of prevention. To create a culturally appropriate image, we conducted five focus group discussions, each with a different gender and age combination. Results of focus group discussions reinforced the importance of refining public health messages well in advance of distribution so that cultural acceptability is strong. After the image was finalized, we deployed shoes with the image in communities in western Uganda where hookworm is prevalent. We found that the frequency of shoe-wearing was 25% higher in communities receiving the shoes than in control communities. Microscopic analyses of fecal samples for parasites showed a sustained reduction in infection intensity for parasites transmitted directly through the feet when people received shoes with a public health image. Our results show that combining culturally appropriate images with public health interventions can be effective in low-literacy populations. © The American Society of Tropical Medicine and Hygiene.

  18. Total number of planetary nebulae in different galaxies and the PN distance scale.

    NASA Astrophysics Data System (ADS)

    Peimbert, M.

    1990-12-01

    RESUMEN A partir de una muestra de quince galaxias se encuentra que la tasa de natalidad de nebulosas planetarias por unidad de luminosidad, , disminuye al aumentar la luminosidad y al aumentar (B - V)0. Se discuten posibles explicaciones para estos resultados. Se estima el valor de para la Galaxia y a partir de el se encuentra que el numero total de nebulosas planetarias en nuestra galaxia con R < 0.64 pc- es de 7200 j 1800. El valor galactico de implica que la mayorfa de las estrellas de masa intermedia pasa por la etapa de nebulosa planetaria. El valor galactico de , la tasa de mortalidad estelar por unidad de luminosidad y la tasa de natalidad de enanas blancas favorecen escalas de distancias largas para nebulosas planetarias, como la de Cudworth (1974) y la de Mallik y Peimbert (1988). ABSTRACT From a sample of fifteen galaxies it is found that the birth rate of PN per unit luminosity, , decreases with increasing luminosity and with increasing (B - V)0 possible reasons for these relationships are discussed. The value for the Galaxy is estimated and, from it, a total number of PN of 7200 # 1800 wid R < 0.64 pc is obtained. The galactic value implies that most of the intermediate mass stars go through the PN stage. The galactic value, the stellar death rate per unit luminosity and the white dwarf birth rate are in favor of long distance scales to PN like those of Cudworth (1974) and Mallik and (1988). Key wonis: NEBULAE.PLANETARY - STARS-EVOLUTION - STARS-SThLIAR STA. S

  19. Nanostructured hematite for photoelectrochemical water splitting

    NASA Astrophysics Data System (ADS)

    Ling, Yichuan

    Solar water splitting is an environmentally friendly reaction of producing hydrogen gas. Since Honda and Fujishima first demonstrated solar water splitting in 1972 by using semiconductor titanium dioxide (TiO2) as photoanode in a photoelectrochemical (PEC) cell, extensive efforts have been invested into improving the solar-to-hydrogen (STH) conversion efficiency and lower the production cost of photoelectrochemical devices. In the last few years, hematite (alpha-Fe2O3) nanostructures have been extensively studied as photoanodes for PEC water splitting. Although nanostructured hematite can improve its photoelectrochemical water splitting performance to some extent, by increasing active sites for water oxidation and shortening photogenerated hole path length to semiconductor/electrolyte interface, the photoactivity of pristine hematite nanostructures is still limited by a number of factors, such as poor electrical conductivities and slow oxygen evolution reaction kinetics. Previous studies have shown that tin (Sn) as an n-type dopant can substantially enhance the photoactivity of hematite photoanodes by modifying their optical and electrical properties. In this thesis, I will first demonstrate an unintentional Sn-doping method via high temperature annealing of hematite nanowires grown on fluorine-doped tin oxide (FTO) substrate to enhance the donor density. In addition to introducing extrinsic dopants into semiconductors, the carrier densities of hematite can also be enhanced by creating intrinsic defects. Oxygen vacancies function as shallow donors for a number of hematite. In this regard, I have investigated the influence of oxygen content on thermal decomposition of FeOOH to induce oxygen vacancies in hematite. In the end, I have studied low temperature activation of hematite nanostructures.

  20. Governance, organization, accountability and sustainability of a region-wide school-based deworming program in Loreto, Peru

    PubMed Central

    Rodriguez Ferrucci, H; Razuri, H; Casapia, M; Rahme, E; Silva, H; Ault, S; Blouin, B; Mofid, LS; Montresor, A; Gyorkos, TW

    2017-01-01

    Chau Cuica was the name given by the regional government of Loreto in Peru for its school-based deworming program which was initiated in 2012 with a donation of mebendazole from an international non-governmental organization. Embedded in the program from the start was a sentinel surveillance component which consisted of 16 sentinel schools representing Loreto’s seven provinces. Coverage rates varied between 35% and 61% over the first two years of the program (and seven deworming cycles). Initial prevalences of soil-transmitted helminth infections were high, with 82.4% of schoolchildren having at least one infection and prevalences of both A. lumbricoides and T. trichiura infections both exceeding 60%. After two years, these prevalences had dropped to 56% for any STH infection, 38% for A. lumbricoides and 34% for T. trichiura. Importantly, the proportions of children with moderate and heavy infections also dropped. Both the regional Ministry of Health and the Ministry of Education were jointly charged to implement this deworming program. The program’s costs were estimated to be approximately 22 cents (USD) per child per deworming cycle. The responsibility for the surveillance component was initially undertaken by research partners from a local NGO and a Canadian university, which transferred gradually over the course of the deworming program to being entirely the responsibility of the Ministry of Health. This regional deworming program may serve as a model for other jurisdictions who are planning a school-based deworming program with an integrated surveillance component to monitor impact. PMID:27048990

  1. Role of malnutrition and parasite infections in the spatial variation in children's anaemia risk in northern Angola.

    PubMed

    Soares Magalhães, Ricardo J; Langa, Antonio; Pedro, João Mário; Sousa-Figueiredo, José Carlos; Clements, Archie C A; Vaz Nery, Susana

    2013-05-01

    Anaemia is known to have an impact on child development and mortality and is a severe public health problem in most countries in sub-Saharan Africa. We investigated the consistency between ecological and individual-level approaches to anaemia mapping by building spatial anaemia models for children aged ≤15 years using different modelling approaches. We aimed to (i) quantify the role of malnutrition, malaria, Schistosoma haematobium and soil-transmitted helminths (STHs) in anaemia endemicity; and (ii) develop a high resolution predictive risk map of anaemia for the municipality of Dande in northern Angola. We used parasitological survey data for children aged ≤15 years to build Bayesian geostatistical models of malaria (PfPR≤15), S. haematobium, Ascaris lumbricoides and Trichuris trichiura and predict small-scale spatial variations in these infections. Malnutrition, PfPR≤15, and S. haematobium infections were significantly associated with anaemia risk. An estimated 12.5%, 15.6% and 9.8% of anaemia cases could be averted by treating malnutrition, malaria and S. haematobium, respectively. Spatial clusters of high risk of anaemia (>86%) were identified. Using an individual-level approach to anaemia mapping at a small spatial scale, we found that anaemia in children aged ≤15 years is highly heterogeneous and that malnutrition and parasitic infections are important contributors to the spatial variation in anaemia risk. The results presented in this study can help inform the integration of the current provincial malaria control programme with ancillary micronutrient supplementation and control of neglected tropical diseases such as urogenital schistosomiasis and STH infections.

  2. Moderate salt treatment alleviates ultraviolet-B radiation caused impairment in poplar plants

    NASA Astrophysics Data System (ADS)

    Ma, Xuan; Ou, Yong-Bin; Gao, Yong-Feng; Lutts, Stanley; Li, Tao-Tao; Wang, Yang; Chen, Yong-Fu; Sun, Yu-Fang; Yao, Yin-An

    2016-09-01

    The effects of moderate salinity on the responses of woody plants to UV-B radiation were investigated using two Populus species (Populus alba and Populus russkii). Under UV-B radiation, moderate salinity reduced the oxidation pressure in both species, as indicated by lower levels of cellular H2O2 and membrane peroxidation, and weakened the inhibition of photochemical efficiency expressed by O-J-I-P changes. UV-B-induced DNA lesions in chloroplast and nucleus were alleviated by salinity, which could be explained by the higher expression levels of DNA repair system genes under UV-B&salt condition, such as the PHR, DDB2, and MutSα genes. The salt-induced increase in organic osmolytes proline and glycine betaine, afforded more efficient protection against UV-B radiation. Therefore moderate salinity induced cross-tolerance to UV-B stress in poplar plants. It is thus suggested that woody plants growing in moderate salted condition would be less affected by enhanced UV-B radiation than plants growing in the absence of salt. Our results also showed that UV-B signal genes in poplar plants PaCOP1, PaSTO and PaSTH2 were quickly responding to UV-B radiation, but not to salt. The transcripts of PaHY5 and its downstream pathway genes (PaCHS1, PaCHS4, PaFLS1 and PaFLS2) were differently up-regulated by these treatments, but the flavonoid compounds were not involved in the cross-tolerance since their concentration increased to the same extent in both UV-B and combined stresses.

  3. Multiplex real time PCR panels to identify fourteen colonization factors of enterotoxigenic Escherichia coli (ETEC).

    PubMed

    Liu, Jie; Silapong, Sasikorn; Jeanwattanalert, Pimmada; Lertsehtakarn, Paphavee; Bodhidatta, Ladaporn; Swierczewski, Brett; Mason, Carl; McVeigh, Annette L; Savarino, Stephen J; Nshama, Rosemary; Mduma, Esto; Maro, Athanasia; Zhang, Jixian; Gratz, Jean; Houpt, Eric R

    2017-01-01

    Enterotoxigenic Escherichia coli (ETEC) is a leading cause of childhood diarrhea in low income countries and in travelers to those areas. Inactivated enterotoxins and colonization factors (CFs) are leading vaccine candidates, therefore it is important to determine the prevailing CF types in different geographic locations and populations. Here we developed real time PCR (qPCR) assays for 14 colonization factors, including the common vaccine targets. These assays, along with three enterotoxin targets (STh, STp, and LT) were formulated into three 5-plex qPCR panels, and validated on 120 ETEC isolates and 74 E. coli colony pools. The overall sensitivity and specificity was 99% (199/202) and 99% (2497/2514), respectively, compared to the CF results obtained with conventional PCR. Amplicon sequencing of discrepant samples revealed that the qPCR was 100% accurate. qPCR panels were also performed on nucleic acid extracted from stool and compared to the results of the ETEC isolates or E. coli colony pools cultured from them. 95% (105/110) of the CF detections in the cultures were confirmed in the stool. Additionally, direct testing of stool yielded 30 more CF detections. Among 74 randomly selected E. coli colony pools with paired stool, at least one CF was detected in 63% (32/51) of the colony pools while at least one CF was detected in 78% (47/60) of the stool samples (P = NS). We conclude that these ETEC CF assays can be used on both cultures and stool samples to facilitate better understanding of CF distribution for ETEC epidemiology and vaccine development.

  4. Contribution of Wastewater Irrigation to Soil Transmitted Helminths Infection among Vegetable Farmers in Kumasi, Ghana.

    PubMed

    Amoah, Isaac Dennis; Abubakari, Amina; Stenström, Thor Axel; Abaidoo, Robert Clement; Seidu, Razak

    2016-12-01

    Wastewater irrigation is associated with several benefits but can also lead to significant health risks. The health risk for contracting infections from Soil Transmitted Helminths (STHs) among farmers has mainly been assessed indirectly through measured quantities in the wastewater or on the crops alone and only on a limited scale through epidemiological assessments. In this study we broadened the concept of infection risks in the exposure assessments by measurements of the concentration of STHs both in wastewater used for irrigation and the soil, as well as the actual load of STHs ova in the stool of farmers and their family members (165 and 127 in the wet and dry seasons respectively) and a control group of non-farmers (100 and 52 in the wet and dry seasons, respectively). Odds ratios were calculated for exposure and non-exposure to wastewater irrigation. The results obtained indicate positive correlation between STH concentrations in irrigation water/soil and STHs ova as measured in the stool of the exposed farmer population. The correlations are based on reinfection during a 3 months period after prior confirmed deworming. Farmers and family members exposed to irrigation water were three times more likely as compared to the control group of non-farmers to be infected with Ascaris (OR = 3.9, 95% CI, 1.15-13.86) and hookworm (OR = 3.07, 95% CI, 0.87-10.82). This study therefore contributes to the evidence-based conclusion that wastewater irrigation contributes to a higher incidence of STHs infection for farmers exposed annually, with higher odds of infection in the wet season.

  5. Therapeutic efficacy of different brands of albendazole against soil transmitted helminths among students of Mendera Elementary School, Jimma, Southwest Ethiopia

    PubMed Central

    Tefera, Ephrem; Belay, Tariku; Mekonnen, Seleshi Kebede; Zeynudin, Ahmed; Belachew, Tefera

    2015-01-01

    Introduction Different brands Albendazole are commercially available and the efficacious brand/s is/are required for effective control of STHs infection. Thus, this study is aimed at determining the therapeutic efficacy of different brands of albendazole against soil transmitted helminths among school children of Jimma town. Methods A cross sectional survey for prevalence of geohelminths and a randomized trial for efficacy study of different brands of albendazole was conducted among students Mendera Elementary School from March 29 to April 29, 2010. Positive subjects were randomized into three treatment arms using lottery method. The collected stool samples were examined by the McMaster method. CRs were calculated using SPSS windows version 16 and ERRs were calculated using appropriate formula. Results Of the 715 school children who had their stools examined, 326 were positive for STHs with a prevalence rate of 45.6%. The cure rates (CR) for A. lumbricoides, T. trichiura and Hookworm were 99.4, 59.9 and 93.7%, respectively. Similarly, the egg reduction rates (ERR) were 97, 99.9 and 99.9% respectively. A statistical significant mean STH egg count difference were observed between pre and post-intervention study (p <0.001). But no statistical significant curing effect difference were observed among the three brands used against the three STHs (p >0.05). Conclusion All the three brands of Albendazole tested regardless of the brand type were therapeutically efficacious for Ascariasis, Trichuriasis and Hookworm infections irrespective of the infection status whether it was single or multiple. PMID:26958115

  6. Therapeutic efficacy of different brands of albendazole against soil transmitted helminths among students of Mendera Elementary School, Jimma, Southwest Ethiopia.

    PubMed

    Tefera, Ephrem; Belay, Tariku; Mekonnen, Seleshi Kebede; Zeynudin, Ahmed; Belachew, Tefera

    2015-01-01

    Different brands Albendazole are commercially available and the efficacious brand/s is/are required for effective control of STHs infection. Thus, this study is aimed at determining the therapeutic efficacy of different brands of albendazole against soil transmitted helminths among school children of Jimma town. A cross sectional survey for prevalence of geohelminths and a randomized trial for efficacy study of different brands of albendazole was conducted among students Mendera Elementary School from March 29 to April 29, 2010. Positive subjects were randomized into three treatment arms using lottery method. The collected stool samples were examined by the McMaster method. CRs were calculated using SPSS windows version 16 and ERRs were calculated using appropriate formula. Of the 715 school children who had their stools examined, 326 were positive for STHs with a prevalence rate of 45.6%. The cure rates (CR) for A. lumbricoides, T. trichiura and Hookworm were 99.4, 59.9 and 93.7%, respectively. Similarly, the egg reduction rates (ERR) were 97, 99.9 and 99.9% respectively. A statistical significant mean STH egg count difference were observed between pre and post-intervention study (p <0.001). But no statistical significant curing effect difference were observed among the three brands used against the three STHs (p >0.05). All the three brands of Albendazole tested regardless of the brand type were therapeutically efficacious for Ascariasis, Trichuriasis and Hookworm infections irrespective of the infection status whether it was single or multiple.

  7. Soil transmitted helminths and schistosoma mansoni infections among school children in zarima town, northwest Ethiopia

    PubMed Central

    2011-01-01

    Background In Ethiopia, because of low quality drinking water supply and latrine coverage, helminths infections are the second most predominant causes of outpatient morbidity. Indeed, there is a scarcity of information on the prevalence of soil transmitted helminths and Schistosomiasis in Ethiopia, special in study area. Therefore, the aim of this study was to determine the prevalence and associated risk factors of soil transmitted helminths and intestinal Schistosomiasis. Methods Cross-sectional study was conducted among 319 school children of Zarima town from April 1 to May 25, 2009. A pre-tested structured questionnaire was used to collect socio-demographic data and possible risk factors exposure. Early morning stool samples were collected and a Kato Katz semi concentration technique was used to examine and count parasitic load by compound light microscope. Data entry and analysis was done using SPSS-15 version and p-value < 0.05 considered statistically significant. Results Out of 319 study subjects, 263 (82.4%) of the study participants infected with one or more parasites. From soil transmitted helminths, Ascaris lumbricoides was the predominant isolate (22%) followed by Hookworms (19%) and Trichuris trichiura (2.5%). Schistosoma mansoni was also isolated in 37.9% of the study participants. Hookworm and S. mansoni infections showed statistically significant associations with shoe wearing and swimming habit of school children, respectively. Conclusion Prevalence of soil transmitted helminths (STH) and S.mansoni was high and the diseases were still major health problem in the study area which alerts public health intervention as soon as possible. PMID:21740589

  8. Bridging the age gap in breast cancer: evaluation of decision support interventions for older women with operable breast cancer: protocol for a cluster randomised controlled trial.

    PubMed

    Collins, Karen; Reed, Malcolm; Lifford, Kate; Burton, Maria; Edwards, Adrian; Ring, Alistair; Brain, Katherine; Harder, Helena; Robinson, Thompson; Cheung, Kwok Leung; Morgan, Jenna; Audisio, Riccardo; Ward, Susan; Richards, Paul; Martin, Charlene; Chater, Tim; Pemberton, Kirsty; Nettleship, Anthony; Murray, Christopher; Walters, Stephen; Bortolami, Oscar; Armitage, Fiona; Leonard, Robert; Gath, Jacqui; Revell, Deirdre; Green, Tracy; Wyld, Lynda

    2017-07-31

    While breast cancer outcomes are improving steadily in younger women due to advances in screening and improved therapies, there has been little change in outcomes among the older age group. It is inevitable that comorbidities/frailty rates are higher, which may increase the risks of some breast cancer treatments such as surgery and chemotherapy, many older women are healthy and may benefit from their use. Adjusting treatment regimens appropriately for age/comorbidity/frailty is variable and largely non-evidence based, specifically with regard to rates of surgery for operable oestrogen receptor-positive disease and rates of chemotherapy for high-risk disease. This multicentre, parallel group, pragmatic cluster randomised controlled trial (RCT) (2015-18) reported here is nested within a larger ongoing 'Age Gap Cohort Study' (2012-18RP-PG-1209-10071), aims to evaluate the effectiveness of a complex intervention of decision support interventions to assist in the treatment decision making for early breast cancer in older women. The interventions include two patient decision aids (primary endocrine therapy vs surgery/antioestrogen therapy and chemotherapy vs no chemotherapy) and a clinical treatment outcomes algorithm for clinicians. National and local ethics committee approval was obtained for all UK participating sites. Results from the trial will be submitted for publication in international peer-reviewed scientific journals. 115550. European Union Drug Regulating Authorities Clinical Trials (EudraCT) number 2015-004220-61;Pre-results. Sponsor's Protocol Code Number Sheffield Teaching Hospitals STH17086. ISRCTN 32447*. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. BiVO4/WO3/SnO2 Double-Heterojunction Photoanode with Enhanced Charge Separation and Visible-Transparency for Bias-Free Solar Water-Splitting with a Perovskite Solar Cell.

    PubMed

    Baek, Ji Hyun; Kim, Byeong Jo; Han, Gill Sang; Hwang, Sung Won; Kim, Dong Rip; Cho, In Sun; Jung, Hyun Suk

    2017-01-18

    Coupling dissimilar oxides in heterostructures allows the engineering of interfacial, optical, charge separation/transport and transfer properties of photoanodes for photoelectrochemical (PEC) water splitting. Here, we demonstrate a double-heterojunction concept based on a BiVO 4 /WO 3 /SnO 2 triple-layer planar heterojunction (TPH) photoanode, which shows simultaneous improvements in the charge transport (∼93% at 1.23 V vs RHE) and transmittance at longer wavelengths (>500 nm). The TPH photoanode was prepared by a facile solution method: a porous SnO 2 film was first deposited on a fluorine-doped tin oxide (FTO)/glass substrate followed by WO 3 deposition, leading to the formation of a double layer of dense WO 3 and a WO 3 /SnO 2 mixture at the bottom. Subsequently, a BiVO 4 nanoparticle film was deposited by spin coating. Importantly, the WO 3 /(WO 3 +SnO 2 ) composite bottom layer forms a disordered heterojunction, enabling intimate contact, lower interfacial resistance, and efficient charge transport/transfer. In addition, the top BiVO 4 /WO 3 heterojunction layer improves light absorption and charge separation. The resultant TPH photoanode shows greatly improved internal quantum efficiency (∼80%) and PEC water oxidation performance (∼3.1 mA/cm 2 at 1.23 V vs RHE) compared to the previously reported BiVO 4 /WO 3 photoanodes. The PEC performance was further improved by a reactive-ion etching treatment and CoO x electrocatalyst deposition. Finally, we demonstrated a bias-free and stable solar water-splitting by constructing a tandem PEC device with a perovskite solar cell (STH ∼3.5%).

  10. Impact of Four Years of Annual Mass Drug Administration on Prevalence and Intensity of Schistosomiasis among Primary and High School Children in Western Kenya: A Repeated Cross-Sectional Study

    PubMed Central

    Abudho, Bernard O.; Ndombi, Eric M.; Guya, Bernard; Carter, Jennifer M.; Riner, Diana K.; Kittur, Nupur; Karanja, Diana M. S.; Secor, W. Evan; Colley, Daniel G.

    2018-01-01

    Abstract. Schistosomiasis remains a major public health problem in Kenya. The World Health Organization recommends preventive chemotherapy with praziquantel (PZQ) to control morbidity due to schistosomiasis. Morbidity is considered linked to intensity of infection, which along with prevalence is used to determine the frequency of mass drug administration (MDA) to school-age children. We determined the impact of annual school-based MDA on children across all primary and high school years using a repeated cross-sectional study design in five schools near Lake Victoria in western Kenya, an area endemic for Schistosoma mansoni. At baseline and for the following four consecutive years, between 897 and 1,440 school children in Grades 1–12 were enrolled and evaluated by Kato-Katz for S. mansoni and soil-transmitted helminths (STH), followed by annual MDA with PZQ and albendazole. Four annual rounds of MDA with PZQ were associated with reduced S. mansoni prevalence in all school children (44.7–14.0%; P < 0.001) and mean intensity of infection by 91% (90.4 to 8.1 eggs per gram [epg] of stool; P < 0.001). Prevalence of high-intensity infection (≥ 400 epg) decreased from 6.8% at baseline to 0.3% by the end of the study. Soil-transmitted helminth infections, already low at baseline, also decreased significantly over the years. In this high prevalence area, annual school-based MDA with high coverage across all Grades (1–12) resulted in rapid and progressive declines in overall prevalence and intensity of infection. This decrease was dramatic in regard to heavy infections in older school-attending children. PMID:29532768

  11. Impact of Four Years of Annual Mass Drug Administration on Prevalence and Intensity of Schistosomiasis among Primary and High School Children in Western Kenya: A Repeated Cross-Sectional Study.

    PubMed

    Abudho, Bernard O; Ndombi, Eric M; Guya, Bernard; Carter, Jennifer M; Riner, Diana K; Kittur, Nupur; Karanja, Diana M S; Secor, W Evan; Colley, Daniel G

    2018-05-01

    Schistosomiasis remains a major public health problem in Kenya. The World Health Organization recommends preventive chemotherapy with praziquantel (PZQ) to control morbidity due to schistosomiasis. Morbidity is considered linked to intensity of infection, which along with prevalence is used to determine the frequency of mass drug administration (MDA) to school-age children. We determined the impact of annual school-based MDA on children across all primary and high school years using a repeated cross-sectional study design in five schools near Lake Victoria in western Kenya, an area endemic for Schistosoma mansoni . At baseline and for the following four consecutive years, between 897 and 1,440 school children in Grades 1-12 were enrolled and evaluated by Kato-Katz for S. mansoni and soil-transmitted helminths (STH), followed by annual MDA with PZQ and albendazole. Four annual rounds of MDA with PZQ were associated with reduced S. mansoni prevalence in all school children (44.7-14.0%; P < 0.001) and mean intensity of infection by 91% (90.4 to 8.1 eggs per gram [epg] of stool; P < 0.001). Prevalence of high-intensity infection (≥ 400 epg) decreased from 6.8% at baseline to 0.3% by the end of the study. Soil-transmitted helminth infections, already low at baseline, also decreased significantly over the years. In this high prevalence area, annual school-based MDA with high coverage across all Grades (1-12) resulted in rapid and progressive declines in overall prevalence and intensity of infection. This decrease was dramatic in regard to heavy infections in older school-attending children.

  12. sushruta-samhitA: A critical review Part - 2: Few new additions

    PubMed Central

    Sharma, Hari S.; Sharma, Hiroe I.; Sharma, Hemadri A.

    2012-01-01

    In this part importace and specialize of sushruta are specified. In Part – 1 all the translation works in all the available languages is narrated. After studying all those books and keeping in to mind about a comprehensive work of sushruta it is necessary to elaborate in this present text. This part is divided into 5 sections. (A) All available commentaries taken in to consideration for this part is written, (B) Specialities of sushruta are most important as he has narrated all eight sections of Ayurveda elabroted widely where as caraka has only narrated mainly selected part of kAya-cikitsA and left other sections for other authors e.g., “atra dhAnavantareyaNAM adhikArah” etc., Specifying a list of all sections and chapters with the numbers of prose + poetery, (C) None of the translator or commentator touched the importance of sushruta in the literature of samskRta, where as sushruta was a great poet. Giving similar resemblance of common use by mass, he tried to explain the tough subject in simpler mode of knowledge for proper understanding to all public. He has specifically selected the prosody for the specified subject. Examples are given in this section. (D) sushruta has written prosody in14 metres and long sentences too in samskRta that shows his ability and wast knowledge in the literature. All references of each and every metre is noted from all sections of sushruta with complete reference numbers. And no where this subject is published till now- (E) A challenging word regarding the work of sushruta “shArIre sushruto naSTah” is turned back while quoting various references of shArIra-sthAnam and placing its world wide importance by various writers. PMID:23723665

  13. Effectiveness of Albendazole for Hookworm Varies Widely by Community and Correlates with Nutritional Factors: A Cross-Sectional Study of School-Age Children in Ghana.

    PubMed

    Humphries, Debbie; Nguyen, Sara; Kumar, Sunny; Quagraine, Josephine E; Otchere, Joseph; Harrison, Lisa M; Wilson, Michael; Cappello, Michael

    2017-02-08

    Mass drug administration (MDA) targeting school-age children is recommended by the World Health Organization for the global control of soil-transmitted helminth (STH) infections. Although considered safe and cost-effective to deliver, benzimidazole anthelminthics are variably effective against the three most common STHs, and widespread use has raised concern about the potential for emerging resistance. To identify factors mediating response to albendazole, we conducted a cross-sectional study of hookworm infection in the Kintampo North Municipality of Ghana in 2011. Among 140 school-age children residing in five contiguous communities, the hookworm prevalence was 59% (82/140). The overall cure rate following administration of single-dose albendazole (400 mg) was 35% (27/76), with a community-wide fecal egg reduction rate (ERR) of 61% (95% confidence interval: 51.8-71.1). Significant disparities were observed in albendazole effectiveness by community, with a cure rate as low as 0% ( N = 24) in Jato Akuraa and ERRs ranging from 53% to 95% across the five study sites. Individual host factors associated with response to deworming treatment included time since last meal, pretreatment blood hemoglobin level, and mid-upper arm circumference. These data demonstrate significant community-level variation in the effectiveness of albendazole, even among populations living in close proximity. Identification of host factors that influence response to albendazole, most notably the timing of drug administration and nutritional factors, creates an opportunity to enhance the effectiveness of deworming through targeted interventions. These findings also demonstrate the importance of measuring anthelminthic response as part of the monitoring and evaluation of community-based deworming programs. © The American Society of Tropical Medicine and Hygiene.

  14. Effectiveness of Albendazole for Hookworm Varies Widely by Community and Correlates with Nutritional Factors: A Cross-Sectional Study of School-Age Children in Ghana

    PubMed Central

    Humphries, Debbie; Nguyen, Sara; Kumar, Sunny; Quagraine, Josephine E.; Otchere, Joseph; Harrison, Lisa M.; Wilson, Michael; Cappello, Michael

    2017-01-01

    Mass drug administration (MDA) targeting school-age children is recommended by the World Health Organization for the global control of soil-transmitted helminth (STH) infections. Although considered safe and cost-effective to deliver, benzimidazole anthelminthics are variably effective against the three most common STHs, and widespread use has raised concern about the potential for emerging resistance. To identify factors mediating response to albendazole, we conducted a cross-sectional study of hookworm infection in the Kintampo North Municipality of Ghana in 2011. Among 140 school-age children residing in five contiguous communities, the hookworm prevalence was 59% (82/140). The overall cure rate following administration of single-dose albendazole (400 mg) was 35% (27/76), with a community-wide fecal egg reduction rate (ERR) of 61% (95% confidence interval: 51.8–71.1). Significant disparities were observed in albendazole effectiveness by community, with a cure rate as low as 0% (N = 24) in Jato Akuraa and ERRs ranging from 53% to 95% across the five study sites. Individual host factors associated with response to deworming treatment included time since last meal, pretreatment blood hemoglobin level, and mid-upper arm circumference. These data demonstrate significant community-level variation in the effectiveness of albendazole, even among populations living in close proximity. Identification of host factors that influence response to albendazole, most notably the timing of drug administration and nutritional factors, creates an opportunity to enhance the effectiveness of deworming through targeted interventions. These findings also demonstrate the importance of measuring anthelminthic response as part of the monitoring and evaluation of community-based deworming programs. PMID:27895280

  15. Contribution of Wastewater Irrigation to Soil Transmitted Helminths Infection among Vegetable Farmers in Kumasi, Ghana

    PubMed Central

    Abubakari, Amina; Stenström, Thor Axel; Abaidoo, Robert Clement; Seidu, Razak

    2016-01-01

    Wastewater irrigation is associated with several benefits but can also lead to significant health risks. The health risk for contracting infections from Soil Transmitted Helminths (STHs) among farmers has mainly been assessed indirectly through measured quantities in the wastewater or on the crops alone and only on a limited scale through epidemiological assessments. In this study we broadened the concept of infection risks in the exposure assessments by measurements of the concentration of STHs both in wastewater used for irrigation and the soil, as well as the actual load of STHs ova in the stool of farmers and their family members (165 and 127 in the wet and dry seasons respectively) and a control group of non-farmers (100 and 52 in the wet and dry seasons, respectively). Odds ratios were calculated for exposure and non-exposure to wastewater irrigation. The results obtained indicate positive correlation between STH concentrations in irrigation water/soil and STHs ova as measured in the stool of the exposed farmer population. The correlations are based on reinfection during a 3 months period after prior confirmed deworming. Farmers and family members exposed to irrigation water were three times more likely as compared to the control group of non-farmers to be infected with Ascaris (OR = 3.9, 95% CI, 1.15–13.86) and hookworm (OR = 3.07, 95% CI, 0.87–10.82). This study therefore contributes to the evidence-based conclusion that wastewater irrigation contributes to a higher incidence of STHs infection for farmers exposed annually, with higher odds of infection in the wet season. PMID:27923048

  16. Prevalence and Risk Factors of Intestinal Parasitism in Rural and Remote West Malaysia

    PubMed Central

    Ngui, Romano; Ishak, Saidon; Chuen, Chow Sek; Mahmud, Rohela; Lim, Yvonne A. L.

    2011-01-01

    Background Intestinal parasitic infections (IPIs) have a worldwide distribution and have been identified as one of the most significant causes of illnesses and diseases among the disadvantaged population. In Malaysia, IPIs still persist in some rural areas, and this study was conducted to determine the current epidemiological status and to identify risk factors associated with IPIs among communities residing in rural and remote areas of West Malaysia. Methods/Findings A total of 716 participants from 8 villages were involved, comprising those from 1 to 83 years old, 550 (76.8%) participants aged ≤12 years and 166 (23.2%) aged ≥13 years, and 304 (42.5%) male and 412 (57.5%) female. The overall prevalence of IPIs was high (73.2%). Soil-transmitted helminth (STH) infections (73.2%) were significantly more common compared to protozoa infections (21.4%) (p<0.001). The prevalence of IPIs showed an age dependency relationship, with significantly higher rates observed among those aged ≤12 years. Multivariate analysis demonstrated that participants aged ≤12 years (OR = 2.23; 95% CI = 1.45–3.45), low household income (OR = 4.93; 95% CI = 3.15–7.73), using untreated water supply (OR = 2.08; 95% CI = 1.36–3.21), and indiscriminate defecation (OR = 5.01; 95% CI = 3.30–7.62) were identified as significant predictors of IPIs among these communities. Conclusion Essentially, these findings highlighted that IPIs are highly prevalent among the poor rural communities in West Malaysia. Poverty and low socioeconomic with poor environmental sanitation were indicated as important predictors of IPIs. Effective poverty reduction programmes, promotion of deworming, and mass campaigns to heighten awareness on health and hygiene are urgently needed to reduce IPIs. PMID:21390157

  17. Bridging the age gap in breast cancer: evaluation of decision support interventions for older women with operable breast cancer: protocol for a cluster randomised controlled trial

    PubMed Central

    Collins, Karen; Reed, Malcolm; Lifford, Kate; Burton, Maria; Edwards, Adrian; Ring, Alistair; Brain, Katherine; Harder, Helena; Robinson, Thompson; Cheung, Kwok Leung; Morgan, Jenna; Audisio, Riccardo; Ward, Susan; Richards, Paul; Martin, Charlene; Chater, Tim; Pemberton, Kirsty; Nettleship, Anthony; Murray, Christopher; Walters, Stephen; Bortolami, Oscar; Armitage, Fiona; Leonard, Robert; Gath, Jacqui; Revell, Deirdre; Green, Tracy; Wyld, Lynda

    2017-01-01

    Introduction While breast cancer outcomes are improving steadily in younger women due to advances in screening and improved therapies, there has been little change in outcomes among the older age group. It is inevitable that comorbidities/frailty rates are higher, which may increase the risks of some breast cancer treatments such as surgery and chemotherapy, many older women are healthy and may benefit from their use. Adjusting treatment regimens appropriately for age/comorbidity/frailty is variable and largely non-evidence based, specifically with regard to rates of surgery for operable oestrogen receptor-positive disease and rates of chemotherapy for high-risk disease. Methods and analysis This multicentre, parallel group, pragmatic cluster randomised controlled trial (RCT) (2015-18) reported here is nested within a larger ongoing ‘Age Gap Cohort Study’ (2012-18RP-PG-1209-10071), aims to evaluate the effectiveness of a complex intervention of decision support interventions to assist in the treatment decision making for early breast cancer in older women. The interventions include two patient decision aids (primary endocrine therapy vs surgery/antioestrogen therapy and chemotherapy vs no chemotherapy) and a clinical treatment outcomes algorithm for clinicians. Ethics and dissemination National and local ethics committee approval was obtained for all UK participating sites. Results from the trial will be submitted for publication in international peer-reviewed scientific journals. IRAS reference 115550. Trial registration number European Union Drug Regulating Authorities Clinical Trials (EudraCT) number 2015-004220-61;Pre-results. Sponsor's Protocol Code Number Sheffield Teaching Hospitals STH17086. ISRCTN 32447*. PMID:28760787

  18. Strongyloides stercoralis is associated with significant morbidity in rural Cambodia, including stunting in children

    PubMed Central

    Forrer, Armelle; Khieu, Virak; Schär, Fabian; Hattendorf, Jan; Marti, Hanspeter; Neumayr, Andreas; Char, Meng Chuor; Hatz, Christoph; Muth, Sinuon

    2017-01-01

    Background Strongyloides stercoralis is a soil-transmitted nematode that can replicate within its host, leading to long-lasting and potentially fatal infections. It is ubiquitous and highly prevalent in Cambodia. The extent of morbidity associated with S. stercoralis infection is difficult to assess due to the broad spectrum of symptoms and, thus, remains uncertain. Methodology/Principal findings Clinical signs were compared among S. stercoralis infected vs. non-infected participants in a cross-sectional survey conducted in 2012 in eight villages of Northern Cambodia, and before and after treatment with a single oral dose of ivermectin (200μg/kg BW) among participants harboring S. stercoralis. Growth retardation among schoolchildren and adolescents was assessed using height-for-age and thinness using body mass index-for-age. S. stercoralis prevalence was 31.1% among 2,744 participants. Urticaria (55% vs. 47%, OR: 1.4, 95% CI: 1.1–1.6) and itching (52% vs. 48%, OR: 1.2, 95% CI: 1.0–1.4) were more frequently reported by infected participants. Gastrointestinal, dermatological, and respiratory symptoms were less prevalent in 103 mono-infected participants after treatment. Urticaria (66% vs. 11%, OR: 0.03, 95% CI: 0.01–0.1) and abdominal pain (81 vs. 27%, OR: 0.07, 95% CI: 0.02–0.2) mostly resolved by treatment. S. stercoralis infection was associated with stunting, with 2.5-fold higher odds in case of heavy infection. Conclusions/Significance The morbidity associated with S. stercoralis confirmed the importance of gastrointestinal and dermatological symptoms unrelated to parasite load, and long-term chronic effects when associated with malnutrition. The combination of high prevalence and morbidity calls for the integration of S. stercoralis into ongoing STH control measures in Cambodia. PMID:29059195

  19. Paradoxical helminthiasis and giardiasis in Cape Town, South Africa: epidemiology and control.

    PubMed

    Adams, Vera J; Markus, Miles B; Adams, Joanita F A; Jordaan, Esme; Curtis, Bronwyn; Dhansay, Muhammad A; Obihara, Charlie C; Fincham, John E

    2005-09-01

    South Africa has endorsed a World Health Assembly (WHA) resolution calling for control of soil-transmitted helminths (STHs). In Cape Town, services and housing that exist in old-established suburbs should minimise the prevalence of intestinal parasitic infections, even when residents are poor. Where families live in shacks in densely-populated areas without effective sanitation, more than 90% of children can be infected by STHs. The humoral immune response to worms theoretically favours infection by Mycobacterium tuberculosis and HIV. Obtain estimates of gender-, age-, school-related and overall prevalence of helminthiasis and giardiasis in a low-income but well-serviced community. Assess possible sources of infection. Alert health services to the need for control measures and the threat from protozoal pathogens. Warn that the immune response to intestinal parasites may favour tuberculosis (TB) and HIV/AIDS. A cross-sectional study of the prevalence of helminthiasis and giardiasis was carried out in a large, non-selective sample of children attending nine schools. Gender, school and age effects were related to non-medical preventive services, sewage disposal practices and possible sources of infection. The overall STH infestation rate was 55.8%. Prevalence was inluenced by school and age but not by gender. Eggs and cysts were seen at the following prevalence: Ascaris 24.8%; Trichuris 50.6%; Hymenolepis nana 2.2%; Enterobius 0.6%; Giardia 17.3%; hookworm 0.08%; and Trichostrongylus 0.1%. Approximately 60% of sewage sludge is used in a form that will contain viable eggs and cysts. Prevalence trends in this old community in Cape Town could indicate infection by swallowing eggs or cysts on food or in water, more than by exposure to polluted soil. Sewage sludge and effluent might be sources of infection. In adjacent, under serviced, newer communities, promiscuous defecation occurs. Probable vectors are discussed. The immune response to intestinal parasites might be a risk factor for HIV/AIDS and TB.

  20. The WFCAM Transit Survey: a search for rocky planets around cool stars

    NASA Astrophysics Data System (ADS)

    Birkby, Jayne

    2010-09-01

    The theory of core accretion makes two intriguing, observable predictions: i) that the formation of rocky/icy planets is common around M-dwarfs, and ii) that hot-Jupiters are extremely difficult to produce around low-mass stars. Furthermore, due to their small physical size and lower bolometric luminosity, M-dwarfs are up to 300? more sensitive to planetary transits in their habitable zones than solar-type stars. We present here the WFCAM Transit Survey (WTS); an ambitious, near- infrared photometric monitoring campaign of ˜6000 M-dwarfs across four 1.5 sq deg fields situated >5 degrees above and below the galactic plane. We utilise a unique opportunity provided by the highly efficient queue-scheduled operational mode of the UKIRT to observe our fields, with at least one visible at any time, when atmospheric conditions and RA coverage are unsuitable for other ongoing UKIRT programs. By probing the peak of the M-dwarf spectral energy distribution (13<17), we obtain a statistically significant sample of low-mass stars, which allows us to place meaningful constraints on the occurrence and formation of planets around M-dwarfs. The WTS has achieved one thousand epochs after 2 years in one of our target fields and will continue until April 2012. Our light curves have a per datapoint photometric precision of ˜3-4 mmag for the brightest objects, with RMS scatter < 1% for J<16, sufficient to detect Earth-like transits around M-dwarfs. I report here on the goals of our survey, our most recent results and the properties of our M-dwarf target sample. I also discuss our processing methods and how we combat the challenges encountered when observing occultations of faint red stars and the spectroscopic follow-up required to confirm them. (http://www.ast.cam.ac.uk/˜sth/wts/index.html)

  1. Polyparasite Helminth Infections and Their Association to Anaemia and Undernutrition in Northern Rwanda

    PubMed Central

    Mupfasoni, Denise; Karibushi, Blaise; Koukounari, Artemis; Ruberanziza, Eugene; Kaberuka, Teddy; Kramer, Michael H.; Mukabayire, Odette; Kabera, Michee; Nizeyimana, Vianney; Deville, Marie-Alice; Ruxin, Josh; Webster, Joanne P.; Fenwick, Alan

    2009-01-01

    Background Intestinal schistosomiasis and soil-transmitted helminth (STH) infections constitute major public health problems in many parts of sub-Saharan Africa. In this study we examined the functional significance of such polyparasite infections in anemia and undernutrition in Rwandan individuals. Methods Three polyparasite infection profiles were defined, in addition to a reference profile that consisted of either no infections or low-intensity infection with only one of the focal parasite species. Logistic regression models were applied to data of 1,605 individuals from 6 schools in 2 districts of the Northern Province before chemotherapeutic treatment in order to correctly identify individuals who were at higher odds of being anaemic and/or undernourished. Findings Stunted relative to nonstunted, and males compared to females, were found to be at higher odds of being anaemic independently of polyparasite infection profile. The odds of being wasted were 2-fold greater for children with concurrent infection of at least 2 parasites at M+ intensity compared to those children with the reference profile. Males compared to females and anaemic compared to nonanaemic children were significantly more likely to be stunted. None of the three polyparasite infection profiles were found to have significant effects on stunting. Conclusion The present data suggest that the levels of polyparasitism, and infection intensities in the Rwandan individuals examined here may be lower as compared to other recent similar epidemiological studies in different regions across sub-Saharan Africa. Neither the odds of anaemia nor the odds of stunting were found to be significantly different in the three-polyparasite infection profiles. However, the odds of wasting were higher in those children with at least two parasites at M+ intensity compared to those children with the reference profile. Nevertheless, despite the low morbidity levels indicated in the population under study here, we recommend sustainable efforts for the deworming of affected populations to be continued in order to support the economic development of the country. PMID:19753110

  2. Temperature measurement based on photoluminescence of Er3+ doped Sr0.3Cd0.7F2 microcrystal coupled to scanning thermal microscopy

    NASA Astrophysics Data System (ADS)

    Trannoy, N.; Sayoud, A.; Diaf, M.; Duvaut, Th.; Jouart, J. P.; Grossel, Ph.

    2015-04-01

    Rare earth doped sub-micrometric luminescent materials are promising candidates for temperature sensing and play an efficient role in many technological fields. In this paper, a new optical sensor is developed for measuring local temperatures. This sensor is based on a thermal-resistive probe and on photoluminescence of a luminescent fluoride microcrystal. The final purpose is to develop a device calibrated in temperature and capable of acquiring images of local temperature at sub-micrometric scale. Indeed, the sensor temperature can be obtained in two distinct ways: one from the thermal probe parameters and the other from the green photoluminescence generated in the anti-Stokes mode by the active Er ions directly excited by a red laser. The thermal probe is based on Wollaston wire whose thermal-resistive element is in platinum/rhodium. Its temperature is estimated from the probe electrical characteristics and a modeling. A microcrystal of Sr0.3Cd0.7F2: Er3+(4%)-Yb3+(6%) of about 25 μm in diameter is glued at the probe extremity. This luminescent material has the particularity to give a green emission spectrum with intensities sensitive to small temperature variations. Using the fluorescence intensity ratio (FIR) technique, the crystal temperature is estimated from the intensity measurements at green wavelengths 522, 540 and 549 nm by taking advantage of particular optical properties due to the crystalline nature of Sr0.3Cd0.7F2: Er3+-Yb3+. The microcrystal temperature is then assessed as a function of electric current in the thermal probe by applying the Boltzmann's equations. The coupling of the scanning thermal microscope (SThM) with the photoluminescence probe reveals that the particle fluorescence signal is affected by the temperature rise of an electrical microsystem submitted to a Joule heating. The first results are presented and discussed.

  3. Novel Insights in the Fecal Egg Count Reduction Test for Monitoring Drug Efficacy against Soil-Transmitted Helminths in Large-Scale Treatment Programs

    PubMed Central

    Levecke, Bruno; Speybroeck, Niko; Dobson, Robert J.; Vercruysse, Jozef; Charlier, Johannes

    2011-01-01

    Background The fecal egg count reduction test (FECRT) is recommended to monitor drug efficacy against soil-transmitted helminths (STHs) in public health. However, the impact of factors inherent to study design (sample size and detection limit of the fecal egg count (FEC) method) and host-parasite interactions (mean baseline FEC and aggregation of FEC across host population) on the reliability of FECRT is poorly understood. Methodology/Principal Findings A simulation study was performed in which FECRT was assessed under varying conditions of the aforementioned factors. Classification trees were built to explore critical values for these factors required to obtain conclusive FECRT results. The outcome of this analysis was subsequently validated on five efficacy trials across Africa, Asia, and Latin America. Unsatisfactory (<85.0%) sensitivity and specificity results to detect reduced efficacy were found if sample sizes were small (<10) or if sample sizes were moderate (10–49) combined with highly aggregated FEC (k<0.25). FECRT remained inconclusive under any evaluated condition for drug efficacies ranging from 87.5% to 92.5% for a reduced-efficacy-threshold of 90% and from 92.5% to 97.5% for a threshold of 95%. The most discriminatory study design required 200 subjects independent of STH status (including subjects who are not excreting eggs). For this sample size, the detection limit of the FEC method and the level of aggregation of the FEC did not affect the interpretation of the FECRT. Only for a threshold of 90%, mean baseline FEC <150 eggs per gram of stool led to a reduced discriminatory power. Conclusions/Significance This study confirms that the interpretation of FECRT is affected by a complex interplay of factors inherent to both study design and host-parasite interactions. The results also highlight that revision of the current World Health Organization guidelines to monitor drug efficacy is indicated. We, therefore, propose novel guidelines to support future monitoring programs. PMID:22180801

  4. Impact of single annual treatment and four-monthly treatment for hookworm and Ascaris lumbricoides, and factors associated with residual infection among Kenyan school children.

    PubMed

    Kepha, Stella; Mwandawiro, Charles S; Anderson, Roy M; Pullan, Rachel L; Nuwaha, Fred; Cano, Jorge; Njenga, Sammy M; Odiere, Maurice R; Allen, Elizabeth; Brooker, Simon J; Nikolay, Birgit

    2017-02-09

    School-based deworming is widely implemented in various countries to reduce the burden of soil-transmitted helminths (STHs), however, the frequency of drug administration varies in different settings. In this study, we compared the impact of a single annual treatment and 4-monthly treatment over a follow-up among Kenyan school children, and investigated the factors associated with residual infection. We performed a secondary analysis of data from a randomized trial investigating whether deworming for STHs alters risk of acquiring malaria. Children received either a single treatment or 4-monthly albendazole treatments were followed longitudinally from February 2014 to October 2014. The relative impact of treatment and factors associated with residual infections were investigated using mixed-effects regression models. Predisposition to infection was assessed based on Spearman's rank and Kendall's Tau correlation coefficients. In the 4-monthly treatment group, the proportion of children infected with hookworm decreased from 59.9 to 5.7%, while Ascaris lumbricoides infections dropped from 55.7 to 6.2%. In the single treatment group, hookworm infections decreased over the same time period from 58.7 to 18.3% (12.6% absolute difference in reduction, 95% CI: 8.9-16.3%), and A. lumbricoides from 56.7 to 23.3% (17.1% absolute difference in reduction, 95% CI: 13.1-21.1%). There was strong evidence for predisposition to both STH types. Residual hookworm infection among children on 4-monthly treatment were associated with male sex and baseline nutritional status, whereas A. lumbricoides infection was associated with individual and school-level infection at baseline, latrine cleanliness at schools. This study found that 4-monthly treatment w more effective than single annual treatment. Repeated treatments led to dramatic reductions in the intensities of STHs, but did not completely clear infections among school children in Kenya, a presumed reflection of reinfection in a setting where there is ongoing transmission.

  5. A controlled, before-and-after trial of an urban sanitation intervention to reduce enteric infections in children: research protocol for the Maputo Sanitation (MapSan) study, Mozambique

    PubMed Central

    Brown, Joe; Cumming, Oliver; Bartram, Jamie; Cairncross, Sandy; Ensink, Jeroen; Holcomb, David; Knee, Jackie; Kolsky, Peter; Liang, Kaida; Liang, Song; Nala, Rassul; Norman, Guy; Rheingans, Richard; Stewart, Jill; Zavale, Olimpio; Zuin, Valentina; Schmidt, Wolf-Peter

    2015-01-01

    Introduction Access to safe sanitation in low-income, informal settlements of Sub-Saharan Africa has not significantly improved since 1990. The combination of a high faecal-related disease burden and inadequate infrastructure suggests that investment in expanding sanitation access in densely populated urban slums can yield important public health gains. No rigorous, controlled intervention studies have evaluated the health effects of decentralised (non-sewerage) sanitation in an informal urban setting, despite the role that such technologies will likely play in scaling up access. Methods and analysis We have designed a controlled, before-and-after (CBA) trial to estimate the health impacts of an urban sanitation intervention in informal neighbourhoods of Maputo, Mozambique, including an assessment of whether exposures and health outcomes vary by localised population density. The intervention consists of private pour-flush latrines (to septic tank) shared by multiple households in compounds or household clusters. We will measure objective health outcomes in approximately 760 children (380 children with household access to interventions, 380 matched controls using existing shared private latrines in poor sanitary conditions), at 2 time points: immediately before the intervention and at follow-up after 12 months. The primary outcome is combined prevalence of selected enteric infections among children under 5 years of age. Secondary outcome measures include soil-transmitted helminth (STH) reinfection in children following baseline deworming and prevalence of reported diarrhoeal disease. We will use exposure assessment, faecal source tracking, and microbial transmission modelling to examine whether and how routes of exposure for diarrhoeagenic pathogens and STHs change following introduction of effective sanitation. Ethics Study protocols have been reviewed and approved by human subjects review boards at the London School of Hygiene and Tropical Medicine, the Georgia Institute of Technology, the University of North Carolina at Chapel Hill, and the Ministry of Health, Republic of Mozambique. Trial registration number NCT02362932. PMID:26088809

  6. Low Efficacy of Single-Dose Albendazole and Mebendazole against Hookworm and Effect on Concomitant Helminth Infection in Lao PDR

    PubMed Central

    Soukhathammavong, Phonepasong Ayé; Sayasone, Somphou; Phongluxa, Khampheng; Xayaseng, Vilavanh; Utzinger, Jürg; Vounatsou, Penelope; Hatz, Christoph; Akkhavong, Kongsap; Keiser, Jennifer; Odermatt, Peter

    2012-01-01

    Background Albendazole and mebendazole are increasingly deployed for preventive chemotherapy targeting soil-transmitted helminth (STH) infections. We assessed the efficacy of single oral doses of albendazole (400 mg) and mebendazole (500 mg) for the treatment of hookworm infection in school-aged children in Lao PDR. Since Opisthorchis viverrini is co-endemic in our study setting, the effect of the two drugs could also be determined against this liver fluke. Methodology We conducted a randomized, open-label, two-arm trial. In total, 200 children infected with hookworm (determined by quadruplicate Kato-Katz thick smears derived from two stool samples) were randomly assigned to albendazole (n = 100) and mebendazole (n = 100). Cure rate (CR; percentage of children who became egg-negative after treatment), and egg reduction rate (ERR; reduction in the geometric mean fecal egg count at treatment follow-up compared to baseline) at 21–23 days posttreatment were used as primary outcome measures. Adverse events were monitored 3 hours post treatment. Principal Findings Single-dose albendazole and mebendazole resulted in CRs of 36.0% and 17.6% (odds ratio: 0.4; 95% confidence interval: 0.2–0.8; P = 0.01), and ERRs of 86.7% and 76.3%, respectively. In children co-infected with O. viverrini, albendazole and mebendazole showed low CRs (33.3% and 24.2%, respectively) and moderate ERRs (82.1% and 78.2%, respectively). Conclusions/Significance Both albendazole and mebendazole showed disappointing CRs against hookworm, but albendazole cured infection and reduced intensity of infection with a higher efficacy than mebendazole. Single-dose administrations showed an effect against O. viverrini, and hence it will be interesting to monitor potential ancillary benefits of a preventive chemotherapy strategy that targets STHs in areas where opisthorchiasis is co-endemic. Clinical Trial Registration Current Controlled Trials ISRCTN29126001 PMID:22235353

  7. Water, sanitation and hygiene related risk factors for soil-transmitted helminth and Giardia duodenalis infections in rural communities in Timor-Leste.

    PubMed

    Campbell, Suzy J; Nery, Susana V; D'Este, Catherine A; Gray, Darren J; McCarthy, James S; Traub, Rebecca J; Andrews, Ross M; Llewellyn, Stacey; Vallely, Andrew J; Williams, Gail M; Amaral, Salvador; Clements, Archie C A

    2016-11-01

    There is little evidence on prevalence or risk factors for soil transmitted helminth infections in Timor-Leste. This study describes the epidemiology, water, sanitation and hygiene, and socioeconomic risk factors of STH and intestinal protozoa amongst communities in Manufahi District, Timor-Leste. As part of a cluster randomised controlled trial, a baseline cross-sectional survey was conducted across 18 villages, with data from six additional villages. Stool samples were assessed for soil transmitted helminth and protozoal infections using quantitative PCR (qPCR) and questionnaires administered to collect water, sanitation and hygiene and socioeconomic data. Risk factors for infection were assessed using multivariable mixed-effects logistic regression, stratified by age group (preschool, school-aged and adult). Overall, soil transmitted helminth prevalence was 69% (95% Confidence Interval 67-71%), with Necator americanus being most common (60%; 95% Confidence Interval 58-62%) followed by Ascaris spp. (24%; 95% Confidence Interval 23-26%). Ascaris-N. americanus co-infection was common (17%; 95% Confidence Interval 15%-18%). Giardia duodenalis was the main protozoan identified (13%; 95% Confidence Interval 11-14%). Baseline water, sanitation and hygiene infrastructure and behaviours were poor. Although risk factors varied by age of participants and parasite species, risk factors for N. americanus infection included, generally, age in years, male sex, and socioeconomic quintile. Risk factors for Ascaris included age in years for children, and piped water to the yard for adults. In this first known assessment of community-based prevalence and associated risk factors in Timor-Leste, soil transmitted helminth infections were highly prevalent, indicating a need for soil transmitted helminth control. Few associations with water, sanitation and hygiene were evident, despite water, sanitation and hygiene being generally poor. In our water, sanitation and hygiene we will investigate implications of improving WASH on soil transmitted helminth infection in impoverished communities. Copyright © 2016 Australian Society for Parasitology. Published by Elsevier Ltd. All rights reserved.

  8. Evaluation of Biochemical, Hematological and Parasitological Parameters of Protein-Deficient Hamsters Infected with Ancylostoma ceylanicum

    PubMed Central

    Pacanaro, Carina P.; Dias, Sílvia R.; Serafim, Luciana R.; Costa, Mariana P.; Aguilar, Edenil; Paes, Paulo R.; Alvarez-Leite, Jacqueline I.; Rabelo, Élida M.

    2014-01-01

    Background Hookworms infect millions of people worldwide and can cause severe clinical symptoms in their hosts. Prospective cohort studies in Brazil show high rates of hookworm reinfection in malnourished children compared to well-nourished children, despite previous treatment. Additionally, soil-transmitted helminth (STH) infections can worsen the nutritional status of affected populations. Therefore, this study aims to clarify the effects of host malnutrition during Ancylostoma ceylanicum infection and how this infection affects host physiological parameters using a hamster model. Methodology/Principal Findings Hamsters were divided into four experimental groups: normal diet or low-protein diet (also referred to as “malnourished”) and A. ceylanicum infection or no infection. More severe pathogenesis was observed in the infected malnourished group, as demonstrated by significant decreases in the hemoglobin concentration, erythrocyte number and packed-cell volume compared to the non-infected malnourished group. Greater numbers of adult parasites and eggs were observed in the malnourished group compared to the control group; however, the oviposition rate was lower in the malnourished group. In general, greater values of total lipids were observed in malnourished animals compared to control animals, including lipids excreted in the stool. Conclusions In this work, we have demonstrated that animals fed an isocaloric low-protein diet presented more severe pathogenesis when infected with A. ceylanicum. The increased lipid concentration in the liver and blood is related to the conversion of the excess carbohydrate into fatty acids that increase the concentration of triglycerides in general. Triglycerides were excreted in the feces, indicating that infection associated with malnutrition caused a greater loss of these molecules for this group of animals and confirming the hypothesis that both nutrition and infection are responsible for the malabsorption syndrome. Taken together, the results found in this work confirm the hypothesis that the nutritional condition of the host greatly influences the course of the infection. PMID:25254370

  9. Fecal occult blood and fecal calprotectin as point-of-care markers of intestinal morbidity in Ugandan children with Schistosoma mansoni infection.

    PubMed

    Bustinduy, Amaya L; Sousa-Figueiredo, José C; Adriko, Moses; Betson, Martha; Fenwick, Alan; Kabatereine, Narcis; Stothard, J Russell

    2013-11-01

    Calprotectin is a calcium-binding cytoplasmic protein found in neutrophils and increasingly used as a marker of bowel inflammation. Fecal occult blood (FOB) is also a dependable indicator of bowel morbidity. The objective of our study was to determine the applicability of these tests as surrogate markers of Schistosoma mansoni intestinal morbidity before and after treatment with praziquantel (PZQ). 216 children (ages 3-9 years old) from Buliisa District in Lake Albert, Uganda were examined and treated with PZQ at baseline in October 2012 with 211 of them re-examined 24 days later for S. mansoni and other soil transmitted helminths (STH). POC calprotectin and FOB assays were performed at both time points on a subset of children. Associations between the test results and infection were analysed by logistic regression. Fecal calprotectin concentrations of 150-300 µg/g were associated with S. mansoni egg patent infection both at baseline and follow up (OR: 12.5 P = 0.05; OR: 6.8 P = 0.02). FOB had a very strong association with baseline anemia (OR: 9.2 P = 0.03) and medium and high egg intensity schistosomiasis at follow up (OR: 6.6 P = 0.03; OR: 51.3 P = 0.003). Both tests were strongly associated with heavy intensity S. mansoni infections. There was a significant decrease in FOB and calprotectin test positivity after PZQ treatment in those children who had egg patent schistosomiasis at baseline. Both FOB and calprotectin rapid assays were found to correlate positively and strongly with egg patent S. mansoni infection with a positive ameloriation response after PZQ treatment indicative of short term reversion of morbidity. Both tests were appropriate for use in the field with excellent operational performance and reliability. Due to its lower-cost which makes its scale-up of use affordable, FOB could be immediately adopted as a monitoring tool for PC campaigns for efficacy evaluation before and after treatment.

  10. Occurrence of Diarrheagenic Virulence Genes and Genetic Diversity in Escherichia coli Isolates from Fecal Material of Various Avian Hosts in British Columbia, Canada

    PubMed Central

    Mazumder, Asit

    2014-01-01

    Contamination of surface water by fecal microorganisms originating from human and nonhuman sources is a public health concern. In the present study, Escherichia coli isolates (n = 412) from the feces of various avian host sources were screened for various virulence genes: stx1 and stx2 (Shiga toxin-producing E. coli [STEC]), eae (enteropathogenic E. coli [EPEC]), est-h, est-p, and elt (encoding heat-stable toxin [ST] variants STh and STp and heat-labile toxin [LT], respectively) (enterotoxigenic E. coli [ETEC]), and ipaH (enteroinvasive E. coli [EIEC]). None of the isolates were found to be positive for stx1, while 23% (n = 93) were positive for only stx2, representing STEC, and 15% (n = 63) were positive for only eae, representing EPEC. In addition, five strains obtained from pheasant were positive for both stx2 and eae and were confirmed as non-O157 by using an E. coli O157 rfb (rfbO157) TaqMan assay. Isolates positive for the virulence genes associated with ETEC and EIEC were not detected in any of the hosts. The repetitive element palindromic PCR (rep-PCR) fingerprint analysis identified 143 unique fingerprints, with an overall Shannon diversity index of 2.36. Multivariate analysis of variance (MANOVA) showed that the majority of the STEC and EPEC isolates were genotypically distinct from nonpathogenic E. coli and clustered independently. MANOVA analysis also revealed spatial variation among the E. coli isolates, since the majority of the isolates clustered according to the sampling locations. Although the presence of virulence genes alone cannot be used to determine the pathogenicity of strains, results from this study show that potentially pathogenic STEC and EPEC strains can be found in some of the avian hosts studied and may contaminate surface water and potentially impact human health. PMID:24441159

  11. Pathogenic Potential, Genetic Diversity, and Population Structure of Escherichia coli Strains Isolated from a Forest-Dominated Watershed (Comox Lake) in British Columbia, Canada

    PubMed Central

    Mazumder, Asit

    2014-01-01

    Escherichia coli isolates (n = 658) obtained from drinking water intakes of Comox Lake (2011 to 2013) were screened for the following virulence genes (VGs): stx1 and stx2 (Shiga toxin-producing E. coli [STEC]), eae and the adherence factor (EAF) gene (enteropathogenic E. coli [EPEC]), heat-stable (ST) enterotoxin (variants STh and STp) and heat-labile enterotoxin (LT) genes (enterotoxigenic E. coli [ETEC]), and ipaH (enteroinvasive E. coli [EIEC]). The only genes detected were eae and stx2, which were carried by 37.69% (n = 248) of the isolates. Only eae was harbored by 26.74% (n = 176) of the isolates, representing potential atypical EPEC strains, while only stx2 was detected in 10.33% (n = 68) of the isolates, indicating potential STEC strains. Moreover, four isolates were positive for both the stx2 and eae genes, representing potential EHEC strains. The prevalence of VGs (eae or stx2) was significantly (P < 0.0001) higher in the fall season, and multiple genes (eae plus stx2) were detected only in fall. Repetitive element palindromic PCR (rep-PCR) fingerprint analysis of 658 E. coli isolates identified 335 unique fingerprints, with an overall Shannon diversity (H′) index of 3.653. Diversity varied among seasons over the years, with relatively higher diversity during fall. Multivariate analysis of variance (MANOVA) revealed that the majority of the fingerprints showed a tendency to cluster according to year, season, and month. Taken together, the results indicated that the diversity and population structure of E. coli fluctuate on a temporal scale, reflecting the presence of diverse host sources and their behavior over time in the watershed. Furthermore, the occurrence of potentially pathogenic E. coli strains in the drinking water intakes highlights the risk to human health associated with direct and indirect consumption of untreated surface water. PMID:25548059

  12. The Socioeconomic Benefit to Individuals of Achieving the 2020 Targets for Five Preventive Chemotherapy Neglected Tropical Diseases.

    PubMed

    Redekop, William K; Lenk, Edeltraud J; Luyendijk, Marianne; Fitzpatrick, Christopher; Niessen, Louis; Stolk, Wilma A; Tediosi, Fabrizio; Rijnsburger, Adriana J; Bakker, Roel; Hontelez, Jan A C; Richardus, Jan H; Jacobson, Julie; de Vlas, Sake J; Severens, Johan L

    2017-01-01

    Lymphatic filariasis (LF), onchocerciasis, schistosomiasis, soil-transmitted helminths (STH) and trachoma represent the five most prevalent neglected tropical diseases (NTDs). They can be controlled or eliminated by means of safe and cost-effective interventions delivered through programs of Mass Drug Administration (MDA)-also named Preventive Chemotherapy (PCT). The WHO defined targets for NTD control/elimination by 2020, reinforced by the 2012 London Declaration, which, if achieved, would result in dramatic health gains. We estimated the potential economic benefit of achieving these targets, focusing specifically on productivity and out-of-pocket payments. Productivity loss was calculated by combining disease frequency with productivity loss from the disease, from the perspective of affected individuals. Productivity gain was calculated by deducting the total loss expected in the target achievement scenario from the loss in a counterfactual scenario where it was assumed the pre-intervention situation in 1990 regarding NTDs would continue unabated until 2030. Economic benefits from out-of-pocket payments (OPPs) were calculated similarly. Benefits are reported in 2005 US$ (purchasing power parity-adjusted and discounted at 3% per annum from 2010). Sensitivity analyses were used to assess the influence of changes in input parameters. The economic benefit from productivity gain was estimated to be I$251 billion in 2011-2020 and I$313 billion in 2021-2030, considerably greater than the total OPPs averted of I$0.72 billion and I$0.96 billion in the same periods. The net benefit is expected to be US$ 27.4 and US$ 42.8 for every dollar invested during the same periods. Impact varies between NTDs and regions, since it is determined by disease prevalence and extent of disease-related productivity loss. Achieving the PCT-NTD targets for 2020 will yield significant economic benefits to affected individuals. Despite large uncertainty, these benefits far exceed the investment required by governments and their development partners within all reasonable scenarios. Given the concentration of the NTDs among the poorest households, these investments represent good value for money in efforts to share the world's prosperity and reduce inequity.

  13. Assessment of Efficacy and Quality of Two Albendazole Brands Commonly Used against Soil-Transmitted Helminth Infections in School Children in Jimma Town, Ethiopia

    PubMed Central

    Suleman, Sultan; Mohammed, Tesfaye; Deti, Habetewold; D'Hondt, Matthias; Wynendaele, Evelien; Mekonnen, Zeleke; Vercruysse, Jozef; Duchateau, Luc; De Spiegeleer, Bart; Levecke, Bruno

    2015-01-01

    Background There is a worldwide upscale in mass drug administration (MDA) programs to control the morbidity caused by soil-transmitted helminths (STHs): Ascaris lumbricoides, Trichuris trichiura and hookworm. Although anthelminthic drugs which are used for MDA are supplied by two pharmaceutical companies through donation, there is a wide range of brands available on local markets for which the efficacy against STHs and quality remain poorly explored. In the present study, we evaluated the drug efficacy and quality of two albendazole brands (Bendex and Ovis) available on the local market in Ethiopia. Methodology/Principal Findings A randomized clinical trial was conducted according to the World Health Organization (WHO) guidelines to assess drug efficacy, by means of egg reduction rate (ERR), of Bendex and Ovis against STH infections in school children in Jimma, Ethiopia. In addition, the chemical and physicochemical quality of the drugs was assessed according to the United States and European Pharmacopoeia, encompassing mass uniformity of the tablets, amount of active compound and dissolution profile. Both drugs were highly efficacious against A. lumbricoides (>97%), but showed poor efficacy against T. trichiura (~20%). For hookworms, Ovis was significantly (p < 0.05) more efficacious compared to Bendex (98.1% vs. 88.7%). Assessment of the physicochemical quality of the drugs revealed a significant difference in dissolution profile, with Bendex having a slower dissolution than Ovis. Conclusion/Significance The study revealed that differences in efficacy between the two brands of albendazole (ABZ) tablets against hookworm are linked to the differences in the in-vitro drug release profile. Differences in uptake and metabolism of this benzimidazole drug among different helminth species may explain that this efficacy difference was only observed in hookworms and not in the two other species. The results of the present study underscore the importance of assessing the chemical and physicochemical quality of drugs before conducting efficacy assessment in any clinical trials to ensure appropriate therapeutic efficacy and to exclude poor drug quality as a factor of reduced drug efficacy other than anthelminthic resistance. Overall, this paper demonstrates that “all medicines are not created equal”. PMID:26406600

  14. Entrainment effects in periodic forcing of the flow over a backward-facing step

    NASA Astrophysics Data System (ADS)

    Berk, T.; Medjnoun, T.; Ganapathisubramani, B.

    2017-07-01

    The effect of the Strouhal number on periodic forcing of the flow over a backward-facing step (height, H ) is investigated experimentally. Forcing is applied by a synthetic jet at the edge of the step at Strouhal numbers ranging from 0.21

  15. Assessment of Efficacy and Quality of Two Albendazole Brands Commonly Used against Soil-Transmitted Helminth Infections in School Children in Jimma Town, Ethiopia.

    PubMed

    Belew, Sileshi; Getachew, Mestawet; Suleman, Sultan; Mohammed, Tesfaye; Deti, Habetewold; D'Hondt, Matthias; Wynendaele, Evelien; Mekonnen, Zeleke; Vercruysse, Jozef; Duchateau, Luc; De Spiegeleer, Bart; Levecke, Bruno

    2015-09-01

    There is a worldwide upscale in mass drug administration (MDA) programs to control the morbidity caused by soil-transmitted helminths (STHs): Ascaris lumbricoides, Trichuris trichiura and hookworm. Although anthelminthic drugs which are used for MDA are supplied by two pharmaceutical companies through donation, there is a wide range of brands available on local markets for which the efficacy against STHs and quality remain poorly explored. In the present study, we evaluated the drug efficacy and quality of two albendazole brands (Bendex and Ovis) available on the local market in Ethiopia. A randomized clinical trial was conducted according to the World Health Organization (WHO) guidelines to assess drug efficacy, by means of egg reduction rate (ERR), of Bendex and Ovis against STH infections in school children in Jimma, Ethiopia. In addition, the chemical and physicochemical quality of the drugs was assessed according to the United States and European Pharmacopoeia, encompassing mass uniformity of the tablets, amount of active compound and dissolution profile. Both drugs were highly efficacious against A. lumbricoides (>97%), but showed poor efficacy against T. trichiura (~20%). For hookworms, Ovis was significantly (p < 0.05) more efficacious compared to Bendex (98.1% vs. 88.7%). Assessment of the physicochemical quality of the drugs revealed a significant difference in dissolution profile, with Bendex having a slower dissolution than Ovis. The study revealed that differences in efficacy between the two brands of albendazole (ABZ) tablets against hookworm are linked to the differences in the in-vitro drug release profile. Differences in uptake and metabolism of this benzimidazole drug among different helminth species may explain that this efficacy difference was only observed in hookworms and not in the two other species. The results of the present study underscore the importance of assessing the chemical and physicochemical quality of drugs before conducting efficacy assessment in any clinical trials to ensure appropriate therapeutic efficacy and to exclude poor drug quality as a factor of reduced drug efficacy other than anthelminthic resistance. Overall, this paper demonstrates that "all medicines are not created equal".

  16. Schistosoma mansoni and soil-transmitted helminths among preschool-aged children in Chuahit, Dembia district, Northwest Ethiopia: prevalence, intensity of infection and associated risk factors.

    PubMed

    Alemu, Agersew; Tegegne, Yalewayker; Damte, Demekech; Melku, Mulugeta

    2016-05-23

    Intestinal schistosomiasis and soil-transmitted helminthiasis are the major public health problems globally. Compared with any other age group, pre-school aged children and school-aged children are the most exposed. There are few studies showing the burden of intestinal schistosomiasis, and soil-transmitted helminthiasis among pre-school aged children in Ethiopia. Hence, this study aimed to assess the prevalence of schistosoma mansoni and soil-transmitted helminths and associated risk factors among preschool aged children of Chuahit and surrounding Kebeles, Northwest Ethiopia. A community based cross sectional study was conducted from February 2 to March 27 2015. Four hundred one preschool-aged children were included in the study by using two stage cluster sampling technique. Pretested structured questionnaire was employed to collected data via face-to-face interview technique. A single stool specimen was collected, and a portion of the sample was processed by Kato Katz method. Of the total children, 141 (35.2 %) harbored one or more intestinal helminthes. Schistosoma mansoni was found in 45 (11.2 %) of preschool age children. Ascaris lumbricoides was the predominant isolate, 77 (19.2 %) followed by S. mansoni, 45 (11.2 %). The least parasites isolated were Tania species, 2 (0.5 %). After adjusting for other variables, being mothers who did not have the habit of washing hands after toilet (AOR = 7.3, 95%CI: 2.97-17.95), being occupationally housewife mothers (AOR = 8.9, 95%CI: 2.27-25.4), using protected spring water as a main family source of water (AOR = 3.9, 95%CI: 1.2-12.3) and child habit of not wearing shoe (AOR = 1.91, 95%CI: 1.01-3.64) were significantly associated with high prevalence of soil-transmitted helminthiasis among preschool-age children in Chuahit. The current study showed that relatively higher level of STH and S. mansoni among preschool-aged children in Chuahit. This finding calls for a need of public health education, promotion of women education and provision of safe water to reduce the burden of soil-transmitted intestinal helminthiasis and schistosomiaisis.

  17. Computer-determined dosage of insulin in the management of neonatal hyperglycaemia (HINT2): protocol of a randomised controlled trial.

    PubMed

    Alsweiler, Jane; Williamson, Kathryn; Bloomfield, Frank; Chase, Geoffrey; Harding, Jane

    2017-03-06

    Neonatal hyperglycaemia is frequently treated with insulin, which may increase the risk of hypoglycaemia. Computer-determined dosage of insulin (CDD) with the STAR-GRYPHON program uses a computer model to predict an effective dose of insulin to treat hyperglycaemia while minimising the risk of hypoglycaemia. However, CDD models can require more frequent blood glucose testing than common clinical protocols. The aim of this trial is to determine if CDD using STAR-GRYPHON reduces hypoglycaemia in hyperglycaemic preterm babies treated with insulin independent of the frequency of blood glucose testing. Design: Multicentre, non-blinded, randomised controlled trial. Neonatal intensive care units in New Zealand and Australia. 138 preterm babies ≤30 weeks' gestation or ≤1500 g at birth who develop hyperglycaemia (two consecutive blood glucose concentrations ≥10 mmol/L, at least 4 hours apart) will be randomised to one of three groups: (1) CDD using the STAR-GRYPHON model-based decision support system: insulin dose and frequency of blood glucose testing advised by STAR-GRYPHON, with a maximum testing interval of 4 hours; (2) bedside titration: insulin dose determined by medical staff, maximum blood glucose testing interval of 4 hours; (3) standard care: insulin dose and frequency of blood glucose testing determined by medical staff. The target range for blood glucose concentrations is 5-8 mmol/L in all groups. A subset of babies will have masked continuous glucose monitoring. is the number of babies with one or more episodes of hypoglycaemia (blood glucose concentration <2.6 mmol/L), during treatment with insulin. This protocol has been approved by New Zealand's Health and Disability Ethics Committee: 14/STH/26. A data safety monitoring committee has been appointed to oversee the trial. Findings will be disseminated to participants and carers, peer-reviewed journals, guideline developers and the public. 12614000492651. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Studies on occurrence, characterisation and decontamination of emerging pathogenic Escherichia coli (STEC, ETEC and EIEC) in table eggs.

    PubMed

    Vinayananda, C O; Fairoze, Nadeem; Madhavaprasad, C B; Byregowda, S M; Nagaraj, C S; Bagalkot, Prashanth; Karabasanavar, Nagappa

    2017-12-01

    1. Escherichia coli is one of the most common facultative anaerobic species present in the gastrointestinal tract of animals and human beings. Usually they occur as commensals, but some serotypes can cause significant illnesses in humans as well as mammals and birds. 2. The occurrence of E. coli in different categories of table eggs collected from markets was evaluated. Isolates were analysed for the presence of virulence genes, antibiotic susceptibility pattern and efficacy of peracetic acid and chlorine for the purpose of decontaminating table eggs. 3. Significant differences were observed in the occurrence of E. coli between different groups viz. processed (cleaned, washed, sanitised and packed eggs), unprocessed (un-cleaned, un-sanitised and loose eggs) and free range (eggs obtained from backyard poultry) table eggs. Overall, E. coli occurred in table eggs at 28.6% with 22.9, 29.2 and 50.0% occurrence in processed, unprocessed and free-range table eggs, respectively. 4. A total of 24 isolates of E. coli were obtained and screened for virulence genes viz. STH, SLT1/2 and INVE genes. Of the 24 isolates recovered, 10 typeable isolates belonged to O141, O119, O9, O120 and O101 serotypes, while the remaining 14 were untypeable. Antibiograms of the isolates showed multiple antimicrobial resistance (MAR) index in the range of 0.13-0.40. 5. Peracetic acid (PAA) and chlorine (CL) were studied for their sanitisation efficacy; concentrations of 100 mg/kg of PAA and 200 mg/kg of CL completely inactivated E. coli over the egg surface and also resulted in 2.58 and 2.38 log reduction in total viable counts (TVC), respectively. 6. The presence of virulence-associated shiga-like toxin (SLT1/2) and invasion E (INVE) genes and antimicrobial resistance among the emerging serotypes of pathogenic E. coli isolated from table eggs has public health implications. It underscores the need to implement better management practices across the production systems and marketing channels to produce E. coli-free wholesome eggs for consumers.

  19. The Socioeconomic Benefit to Individuals of Achieving the 2020 Targets for Five Preventive Chemotherapy Neglected Tropical Diseases

    PubMed Central

    Luyendijk, Marianne; Fitzpatrick, Christopher; Niessen, Louis; Stolk, Wilma A.; Tediosi, Fabrizio; Rijnsburger, Adriana J.; Bakker, Roel; Hontelez, Jan A. C.; Richardus, Jan H.; Jacobson, Julie; de Vlas, Sake J.; Severens, Johan L.

    2017-01-01

    Background Lymphatic filariasis (LF), onchocerciasis, schistosomiasis, soil-transmitted helminths (STH) and trachoma represent the five most prevalent neglected tropical diseases (NTDs). They can be controlled or eliminated by means of safe and cost-effective interventions delivered through programs of Mass Drug Administration (MDA)—also named Preventive Chemotherapy (PCT). The WHO defined targets for NTD control/elimination by 2020, reinforced by the 2012 London Declaration, which, if achieved, would result in dramatic health gains. We estimated the potential economic benefit of achieving these targets, focusing specifically on productivity and out-of-pocket payments. Methods Productivity loss was calculated by combining disease frequency with productivity loss from the disease, from the perspective of affected individuals. Productivity gain was calculated by deducting the total loss expected in the target achievement scenario from the loss in a counterfactual scenario where it was assumed the pre-intervention situation in 1990 regarding NTDs would continue unabated until 2030. Economic benefits from out-of-pocket payments (OPPs) were calculated similarly. Benefits are reported in 2005 US$ (purchasing power parity-adjusted and discounted at 3% per annum from 2010). Sensitivity analyses were used to assess the influence of changes in input parameters. Results The economic benefit from productivity gain was estimated to be I$251 billion in 2011–2020 and I$313 billion in 2021–2030, considerably greater than the total OPPs averted of I$0.72 billion and I$0.96 billion in the same periods. The net benefit is expected to be US$ 27.4 and US$ 42.8 for every dollar invested during the same periods. Impact varies between NTDs and regions, since it is determined by disease prevalence and extent of disease-related productivity loss. Conclusion Achieving the PCT-NTD targets for 2020 will yield significant economic benefits to affected individuals. Despite large uncertainty, these benefits far exceed the investment required by governments and their development partners within all reasonable scenarios. Given the concentration of the NTDs among the poorest households, these investments represent good value for money in efforts to share the world’s prosperity and reduce inequity. PMID:28103243

  20. Biofilm Formation on Stainless Steel by Streptococcus thermophilus UC8547 in Milk Environments Is Mediated by the Proteinase PrtS.

    PubMed

    Bassi, D; Cappa, F; Gazzola, S; Orrù, L; Cocconcelli, P S

    2017-04-15

    In Streptococcus thermophilus , gene transfer events and loss of ancestral traits over the years contribute to its high level of adaptation to milk environments. Biofilm formation capacity, a phenotype that is lost in the majority of strains, plays a role in persistence in dairy environments, such as milk pasteurization and cheese manufacturing plants. To investigate this property, we have studied S. thermophilus UC8547, a fast-acidifying dairy starter culture selected for its high capacity to form biofilm on stainless steel under environmental conditions resembling the dairy environment. Using a dynamic flow cell apparatus, it was shown that S. thermophilus UC8547 biofilm formation on stainless steel depends on the presence of milk proteins. From this strain, which harbors the prtS gene for the cell wall protease and shows an aggregative phenotype, spontaneous mutants with impaired biofilm capacity can be isolated at high frequency. These mutants lack the PrtS expendable island, as confirmed by comparison of the genome sequence of UC8547Δ3 with that of the parent strain. The prtS island excision occurs between two 26-bp direct repeats located in the two copies of the IS Sth1 flanking this genomic island. The central role of PrtS was confirmed by analyzing the derivative strain UC8547Δ16, whose prtS gene was interrupted by an insertional mutation, thereby making it incapable of biofilm formation. PrtS, acting as a binding substance between the milk proteins adhered to stainless steel and S. thermophilus cell envelopes, mediates biofilm formation in dairy environments. This feature provides S. thermophilus with an ecological benefit for its survival and persistence in this environment. IMPORTANCE The increased persistence of S. thermophilus biofilm has consequences in the dairy environment: if, on the one hand, the release of this microorganism from biofilm can promote the fermentation of artisanal cheeses, under industrial conditions it may lead to undesirable contamination of dairy products. The study of the molecular mechanism driving S. thermophilus biofilm formation provides increased knowledge on how an ancestral trait affects relevant phenotypes, such as persistence in the environment and efficiency of growth in milk. This study provides insight into the genetic factors affecting biofilm formation at dairy plants. Copyright © 2017 American Society for Microbiology.

  1. The Right Tool for the Job: Detection of Soil-Transmitted Helminths in Areas Co-endemic for Other Helminths

    PubMed Central

    Periago, Maria V.; Diniz, Renata C.; Pinto, Simone A.; Yakovleva, Anna; Correa-Oliveira, Rodrigo; Diemert, David J.; Bethony, Jeffrey M.

    2015-01-01

    Background Due to the recent increased use of the McMaster (MM) fecal egg counting method for assessing benzimidazole drug efficacy for treating soil-transmitted helminth (STH) infections, the aim of the current study was to determine the operational value of including the MM method alongside the Kato-Katz (KK) fecal thick smear to increase the diagnostic sensitivity when STHs are co-endemic with trematode helminths (e.g., Schistosoma mansoni). Methods A cross-sectional study was conducted in school-aged children aged 4-18 years in the northeastern region of the State of Minas Gerais (Brazil), where Necator americanus, Ascaris lumbricoides, Trichuris trichiura, and S. mansoni are co-endemic. One fecal sample from each participant was collected and transported to the field laboratory for analysis. Coprological diagnosis was performed on each fecal sample by three different methods: Formalin-Ether Sedimentation (FES), KK and the MM technique. The diagnostic sensitivity and negative predictive value (NPV) of each technique was calculated using the combination of all three techniques as the composite standard. In order to determine the agreement between the three techniques Fleiss´ kappa was used. Both the Cure Rate (CR) and the Fecal Egg Count Reduction (FECR) were calculated using the two quantification techniques (i.e., the MM and KK). Results Fecal samples from 1260 children were analyzed. The KK had higher diagnostic sensitivity than the MM for the detection of both A. lumbricoides (KK 97.3%, MM 69.5%) and hookworm (KK 95.1%, MM 80.8%). The CR of a single dose of mebendazole varied significantly between the KK and MM for both A. lumbricoides (p = 0.016) and hookworm (p = 0.000), with lower rates obtained with the KK. On the other hand, the FECR was very similar between both techniques for both A. lumbricoides and hookworm. Conclusion The MM did not add any diagnostic value over the KK in areas where both STHs and trematodes were co-endemic. The lower sensitivity of the MM would have an important impact on the administration of selective school-based treatment in this area since if only the MM were used, 36 (13.9%) children diagnosed with A. lumbricoides would have gone untreated. PMID:26241329

  2. Intestinal parasitic infections among prison inmates and tobacco farm workers in Shewa Robit, north-central Ethiopia.

    PubMed

    Mamo, Hassen

    2014-01-01

    Intestinal parasitic infections (IPIs) particularly soil-transmitted helminthiasis (STH) and schistosomiasis are among neglected tropical diseases (NTDs) globally. Apart from being associated with anemia, malabsorption and retarded cognitive development these diseases are complicating the clinical picture of more serious infections like HIV, TB and malaria. Renewed and up-to-date information on the epidemiology of IPIs in more vulnerable groups such as irrigated-farm workers and prisoners would significantly contribute towards improving the health condition of such at-risk groups. A cross-sectional survey was conducted to determine the prevalence of IPIs among prison inmates and tobacco farm workers in Shewa-Robit, north-central Ethiopia in November 2008. A total of 236 fecal samples were examined microscopically to detect helminths and/or protozoa using direct-smear and formol-ether concentration methods. Overall, 8 intestinal parasite species have been recovered singly or in combinations from 146 (61.8 %) samples. The prevalence in prison population (88/121 = 72.7%) was significantly higher than that in tobacco farm (58/115 = 50.4%). There were no significant differences in the prevalence of IPI by most socio-demographics. Except for hookworm there was no significant difference in parasite prevalence between different age-groups though the frequency of individual parasites slightly varied between the age-groups. Multivariate logistic regression analysis showed that inmates were more likely to acquire IPIs than tobacco-farm workers (Odds Ratio (OR) = 2.62, 95% confidence interval (CI) = 1.52-4.5). In addition, participants who did not report past treatment for IPIs were more likely to acquire IPIs than participants who self-reported treatment for IPIs in the past twelve months (OR = 3.25, 95% CI = 1.75-6.06). All other socio-demographics were not significantly associated with IPIs in univariate analysis. Entamoeba histolytica/dispar/moshkovskii was the most frequently encountered species in both study sites accounting for 48.8 and 51.7 percent of the positives in prison and tobacco farm population respectively. Other intestinal parasites detected, with slight variation in prevalence in the two study areas, were hookworm, Ascaris lumbricoides, Trichuris trichiura, Schistosoma mansoni, Strongyloides stercolaris, Hymenolepis nana and Taenia sp. 35.5 and 33.0 percent of the total positive cases were mixed infections in Shewa Robit prison and tobacco farm, respectively. The results show that IPIs are common health problems in the studied populations.

  3. Efficacy and tolerance of lysine clonixinate versus paracetamol/codeine following inguinal hernioplasty.

    PubMed

    de los Santos, A R; Di Girolamo, G; Martí, M L

    1998-01-01

    In this study lysine clonixinate, a nonsteroidal antiinflammatory agent with selective inhibition of cyclooxygenase-2 and 5-lipooxygenase in in vitro and in vivo pharmacodynamic studies, was evaluated in a prospective, randomized, double-blind, double-dummy clinical study versus paracetamol/codeine, in 151 patients with pain following inguinal hernioplasty. Patients were treated with one 125 mg tablet of lysine clonixinate or paracetamol/codeine (500 mg + 30 mg) administered at fixed doses every 4 h during 2 days. Controls were carried out 1, 2 and 4 h after the first intake of day 1 and day 2. Each control included assessment of pain at rest, when coughing, sitting and upon moderate pressure. Both treatment groups (lysine clonixinate, 77 patients and paracetamol/codeine, 74 patients) were comparable in terms of demographic and baseline pain intensities. Spontaneous pain was reduced significantly in both treatment groups from the 1st-h control. The following values were recorded in the lysine clonixinate group during day 1: baseline: 6.86 +/- 1.24; 1st h: 4.49 +/- 1.77; 2nd h: 2.96 +/- 1.74; 4th h: 2.23 +/- 1.51. The following values for the same group during day 2 were: predose: 1.70 +/- 1.64; 1st h: 1.16 +/- 1.17; 2nd h: 0.78 +/- 1.06; 4th h: 0.63 +/- 1.05. The paracetamol/codeine group revealed the following values: day 1: baseline: 6.72 +/- 1.22; 1st h: 4.57 +/- 1.72; 2nd h: 2.97 +/- 1.68; 4th h: 2.47 +/- 1.68 and day 2: predose: 2.02 +/- 1.57; 1st h: 1.32 +/- 1.23; 2nd h: 0.82 +/- 0.99; 4th h: 0.66 +/- 0.89. Reduction of pain induced by coughing, sitting and pressure showed similar behavior patterns. No significant differences between both treatment groups were encountered in terms of analgesic efficacy. Incidence of adverse effects was significantly higher in the paracetamol/codeine group (X2: p < 0.05): 11 out of 74 patients; three patients had to discontinue treatment. In the lysine clonixinate group four out of 77 patients showed side effects but these did not require treatment discontinuation.

  4. Identification of Rapeseed MicroRNAs Involved in Early Stage Seed Germination under Salt and Drought Stresses

    PubMed Central

    Jian, Hongju; Wang, Jia; Wang, Tengyue; Wei, Lijuan; Li, Jiana; Liu, Liezhao

    2016-01-01

    Drought and salinity are severe and wide-ranging abiotic stresses that substantially affect crop germination, development and productivity, and seed germination is the first critical step in plant growth and development. To comprehensively investigate small-RNA targets and improve our understanding of miRNA-mediated post-transcriptional regulation networks during Brassica napus seed imbibition under drought and salt stresses, we constructed three small-RNA libraries from B. napus variety ZS11 embryos exposed to salt (200 mM NaCl, denoted “S”), drought (200 g L−1 PEG-6000, denoted “D”), and distilled water (denoted “CK”) during imbibition and sequenced them using an Illumina Genome Analyzer. A total of 11,528,557, 12,080,081, and 12,315,608 raw reads were obtained from the CK, D, and S libraries, respectively. Further analysis identified 85 known miRNAs belonging to 31 miRNA families and 882 novel miRNAs among the three libraries. Comparison of the D and CK libraries revealed significant down-regulation of six miRNA families, miR156, miR169, miR860, miR399, miR171, and miR395, whereas only miR172 was significantly up-regulated. In contrast, comparison of the S library with the CK library showed significant down-regulation of only two miRNA families: miRNA393 and miRNA399. Putative targets for 336, 376, and 340 novel miRNAs were successfully predicted in the CK, D, and S libraries, respectively, and 271 miRNA families and 20 target gene families [including disease resistance protein (DIRP), drought-responsive family protein (DRRP), early responsive to dehydration stress protein (ERD), stress-responsive alpha-beta barrel domain protein (SRAP), and salt tolerance homolog2 (STH2)] were confirmed as being core miRNAs and genes involved in the seed imbibition response to salt and drought stresses. The sequencing results were partially validated by quantitative RT-PCR for both conserved and novel miRNAs as well as the predicted target genes. Our data suggest that diverse and complex miRNAs are involved in seed imbibition, indicating that miRNAs are involved in plant hormone regulation, and may play important roles during seed germination under salt- or drought-stress conditions. PMID:27242859

  5. Prevalence of anemia and associated factors among school children in Gondar town public primary schools, northwest Ethiopia: A school-based cross-sectional study.

    PubMed

    Getaneh, Zegeye; Enawgaw, Bamlaku; Engidaye, Getabalew; Seyoum, Masresha; Berhane, Muruts; Abebe, Zegeye; Asrie, Fikir; Melku, Mulugeta

    2017-01-01

    Anemia is a global public health problem affecting 305 million school children (SC) worldwide. It has deleterious effects in SC, including lower school achievement due to impaired cognitive development and physical growth, fatigue and poor attention span, and increased morbidity because of reduced resistance to infection. Hence, the aim of this study was to assess the prevalence and associated factors of anemia among SC attending public primary schools in Gondar town, northwest Ethiopia. A school-based cross sectional study was conducted on a total of 523 SC aged from 6-14 years old. Multi-stage sampling followed by systematic random sampling techniques were employed to select study participants. Data on socio-demographic and socio-economic characteristics, and dietary status of children were collected using pre-tested structured questionnaire through face-to-face interview of children's caregivers. Anthropometric measurements were taken. Hemoglobin (Hb) concentration was determined by using HemoCue 301+analyser. Stool and blood samples were collected in the school premises, and examined for intestinal and hemoparasites, respectively. Data were entered into Epi Info version 3.5.3 and transferred to SPSS version 20 for analysis. Bivariate and multivariate binary logistic regression models were fitted to identify associated factors of anemia. P-value < 0.05 was considered as statistically significant. Of the total SC participated in the study, 269 (51.4%) were males. The median (inter quartile range (IQR)) age was 12 (10-13) years, and 332 (63.5%) of them were in the age group 11-14 years. About 81 (15.5%; 95%CI: 12.4%, 18.7%) of them were anemic: 56 (69.1%) and 25 (38.9%) of them were mildly and moderately anemic, respectively. Low maternal education (AOR = 2.30; 95%CI: 1.11, 4.78), stunting (AOR = 2.22; 95%CI: 1.30, 3.80), severe food insecurity (AOR = 5.11; 95%CI: 1.53, 17.13), and soil-transmitted helminthic (STH) infection (AOR = 7.13; 95%CI: 3.16, 16.86) were found significantly associated with anemia. Anemia among SC was found to be a mild public health problem. It was strongly associated with low maternal education, food insecurity, stunting and intestinal helminthic infection. Focused policies and strategies towards the above factors should be designed to reduce anemia among SC.

  6. Sherman Creek Hatchery; Washington Department of Fish and Wildlife Fish Program, 2001 Annual Report.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Combs, Mitch

    2002-01-01

    Sherman Creek Hatchery's primary objective is the restoration and enhancement of the recreational and subsistence fishery in Lake Roosevelt and Banks Lake. The Sherman Creek Hatchery (SCH) was designed to rear 1.7 million kokanee fry for acclimation and imprinting during the spring and early summer. Additionally, it was designed to trap all available returning adult kokanee during the fall for broodstock operations and evaluations. Since the start of this program, the operations on Lake Roosevelt have been modified to better achieve program goals. The Washington Department of Fish and Wildlife, Spokane Tribe of Indians and the Colville Confederated Tribe formmore » the interagency Lake Roosevelt Hatcheries Coordination Team (LRHCT) which sets goals and objectives for both Sherman Creek and the Spokane Tribal Hatchery and serves to coordinate enhancement efforts on Lake Roosevelt and Banks Lake. The primary changes have been to replace the kokanee fingerling program with a yearling (post smolt) program of up to 1,000,000 fish. To construct and operate twenty net pens to handle the increased production. The second significant change was to rear up to 300,000 rainbow trout fingerling at SCH from July through October, for stocking into the volunteer net pens. This enables the Spokane Tribal Hatchery (STH) to rear additional kokanee to further the enhancement efforts on Lake Roosevelt. Current objectives include increased use of native/indigenous stocks where available for propagation into Upper Columbia River Basin Waters. Monitoring and evaluation is preformed by the Lake Roosevelt Fisheries Monitoring Program. From 1988 to 1998, the principle sport fishery on Lake Roosevelt has shifted from walleye to include rainbow trout and kokanee salmon (Underwood et al. 1997, Tilson and Scholz 1997). The angler use, harvest rates for rainbow and kokanee and the economic value of the fishery has increased substantially during this 10-year period. The most recent information from the monitoring program also suggests that the hatchery and net pen rearing programs have been beneficial to enhancing the Lake Roosevelt fishery while not negatively impacting wild and native stocks within the lake. The 2001 fishing season has been especially successful with great fishing for both rainbow and kokanee throughout Lake Roosevelt. The results of the Two Rivers Fishing Derby identified 100 percent of the rainbow and 47 percent of the kokanee caught were of hatchery origin.« less

  7. Synchronicity of the East Asian Summer Monsoon variability and Northern Hemisphere climate change since the last deglaciation

    NASA Astrophysics Data System (ADS)

    Shinozaki, T.; Uchida, M.; Minoura, K.; Kondo, M.; Rella, S. F.; Shibata, Y.

    2011-06-01

    Understanding of the mechanism of the East Asian Summer Monsoon (EASM) is required for the prediction of climate change in East Asia in a scenario of modern global warming. In this study, we present high-resolution climate records from peat sediments in Northeast Japan to reconstruct the EASM variability based on peat bulk cellulose δ13C since the last deglaciation. We used a 8.8 m long peat sediment core collected from the Tashiro Bog, Northeast Japan. Based on 42 14C measurements, the core bottom reaches ~15.5 ka. δ13C, accumulation rate and accumulation flux time-series correlate well to Greenland ice core δ18O variability, suggesting that the climate record in Northeast Japan is linked to global climate changes. The δ13C record at Tashiro Bog and other paleo-EASM records at Northeast and Southern China consistently demonstrate that hydrological environments were spatially different in mid-high and mid-low latitude regions over the last 15.5 kyr. During global cooling (warming) periods, mid-high and mid-low latitude regions were characterized by wet (dry) and dry (wet) environments, respectively. We suggest that these climatic patterns are related to the migration of the EASM-related rain belt during global climate changes, as a consequence of variations in intensity and location of both the Intertropical Convergence Zone (ITCZ) and the Western Pacific Subtropical High (STH). The location of the rain belt largely influences the East Asian hydrological environment. Our δ13C time-series are characterized by a 1230 yr throughout the Holocene and a 680 yr periodicity during the early Holocene. The 1230 yr periodicity is in agreement with North Atlantic ice-rafted debris (IRD) events, suggesting a teleconnection between the Northeast Japan and the North Atlantic during the Holocene. In addition, it is the first evidence that the Bond events were recorded in terrestrial sediment in Japan. On the other hand, the 680 yr periodicity between 10.0 and 8.0 kyr is consistent with a prominent 649 yr solar activity cycle, suggesting that solar activity affected EASM precipitation during the Hypsithermal, when orbital-scale solar insolation was at a maximum in the Northern Hemisphere.

  8. Estimating the sensitivity and specificity of Kato-Katz stool examination technique for detection of hookworms, Ascaris lumbricoides and Trichuris trichiura infections in humans in the absence of a 'gold standard'.

    PubMed

    Tarafder, M R; Carabin, H; Joseph, L; Balolong, E; Olveda, R; McGarvey, S T

    2010-03-15

    The accuracy of the Kato-Katz technique in identifying individuals with soil-transmitted helminth (STH) infections is limited by day-to-day variation in helminth egg excretion, confusion with other parasites and the laboratory technicians' experience. We aimed to estimate the sensitivity and specificity of the Kato-Katz technique to detect infection with Ascaris lumbricoides, hookworm and Trichuris trichiura using a Bayesian approach in the absence of a 'gold standard'. Data were obtained from a longitudinal study conducted between January 2004 and December 2005 in Samar Province, the Philippines. Each participant provided between one and three stool samples over consecutive days. Stool samples were examined using the Kato-Katz technique and reported as positive or negative for STHs. In the presence of measurement error, the true status of each individual is considered as latent data. Using a Bayesian method, we calculated marginal posterior densities of sensitivity and specificity parameters from the product of the likelihood function of observed and latent data. A uniform prior distribution was used (beta distribution: alpha=1, beta=1). A total of 5624 individuals provided at least one stool sample. One, two and three stool samples were provided by 1582, 1893 and 2149 individuals, respectively. All STHs showed variation in test results from day to day. Sensitivity estimates of the Kato-Katz technique for one stool sample were 96.9% (95% Bayesian Credible Interval [BCI]: 96.1%, 97.6%), 65.2% (60.0%, 69.8%) and 91.4% (90.5%, 92.3%), for A. lumbricoides, hookworm and T. trichiura, respectively. Specificity estimates for one stool sample were 96.1% (95.5%, 96.7%), 93.8% (92.4%, 95.4%) and 94.4% (93.2%, 95.5%), for A. lumbricoides, hookworm and T. trichiura, respectively. Our results show that the Kato-Katz technique can perform with reasonable accuracy with one day's stool collection for A. lumbricoides and T. trichiura. Low sensitivity of the Kato-Katz for detection of hookworm infection may be related to rapid degeneration of delicate hookworm eggs with time. (c) 2009 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.

  9. Intestinal parasites, growth and physical fitness of schoolchildren in poor neighbourhoods of Port Elizabeth, South Africa: a cross-sectional survey.

    PubMed

    Müller, Ivan; Yap, Peiling; Steinmann, Peter; Damons, Bruce P; Schindler, Christian; Seelig, Harald; Htun, Nan S N; Probst-Hensch, Nicole; Gerber, Markus; du Randt, Rosa; Pühse, Uwe; Walter, Cheryl; Utzinger, Jürg

    2016-09-05

    As traditional lifestyle and diets change with social and economic development, disadvantaged communities in low- and middle-income countries increasingly face a double burden of communicable and non-communicable diseases. We studied the relationship between physical fitness and infections with soil-transmitted helminths (STHs), intestinal protozoa and Helicobacter pylori among schoolchildren in Port Elizabeth, South Africa. We conducted a cross-sectional survey among 1009 children, aged 9 to 12 years, from eight primary schools in socioeconomically disadvantaged neighbourhoods of Port Elizabeth. Physical fitness was determined using field-deployable tests of the Eurofit fitness test battery. Stool samples were analysed with the Kato-Katz thick smear technique to diagnose STHs and with rapid diagnostic tests (RDTs) to detect intestinal protozoa and H. pylori infections. Haemoglobin (Hb) levels were assessed and anthropometric indicators determined. Complete data were available for 934 children (92 %). In two schools, high STH prevalences were found (Ascaris lumbricoides 60 and 72 %; Trichuris trichiura 65 % each). For boys and girls co-infected with A. lumbricoides and T. trichiura (n = 155) the maximal oxygen uptake (VO2 max) was estimated to be 50.1 and 47.2 ml kg(-1) min(-1), compared to 51.5 and 47.4 ml kg(-1) min(-1) for their non-infected peers (n = 278), respectively. On average, children without helminth infections had greater body mass (P = 0.011), height (P = 0.009) and a higher body mass index (P = 0.024) and were less often stunted (P = 0.006), but not significantly less wasted compared to their peers with a single or dual species infection. Among 9-year-old boys, a negative correlation between helminth infections and VO2 max, grip strength and standing broad jump distance was observed (P = 0.038). The overall mean Hb level was 122.2 g l(-1). In the two schools with the highest prevalence of STHs the Hb means were 119.7 and 120.5 g l(-1), respectively. Intestinal parasite infections appear to have a small but significant negative effect on the physical fitness of infected children, as expressed by their maximal oxygen uptake. We observed a clear impact on anthropometric indicators.

  10. Sherman Creek Hatchery; Washington Department of Fish and Wildlife Fish Program, 2003 Annual Report.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lovrak, Jon; Combs, Mitch

    2004-01-01

    Sherman Creek Hatchery's primary objective is the restoration and enhancement of the recreational and subsistence fishery in Lake Roosevelt and Banks Lake. The Sherman Creek Hatchery (SCH) was designed to rear 1.7 million kokanee fry for acclimation and imprinting during the spring and early summer. Additionally, it was designed to trap all available returning adult kokanee during the fall for broodstock operation and evaluation. Since the start of this program, the operations on Lake Roosevelt have been modified to better achieve program goals. The Washington Department of Fish and Wildlife, Spokane Tribe of Indians and the Colville Confederated Tribes formmore » the interagency Lake Roosevelt Hatcheries Coordination Team (LRHCT) which sets goals and objectives for both Sherman Creek and the Spokane Tribal Hatchery. The LRHCT also serves to coordinate enhancement efforts on Lake Roosevelt and Banks Lake. Since 1994 the kokanee fingerling program has changed to yearling releases. By utilizing both the hatcheries and additional net pens, up to 1,000,000 kokanee yearlings can be reared and released. The construction and operation of twenty net pens in 2001 enabled the increased production. Another significant change has been to rear up to 300,000 rainbow trout fingerling at SCH from July through October, for stocking into the volunteer net pens. This enables the Spokane Tribal Hatchery (STH) to rear additional kokanee to further the enhancement efforts on Lake Roosevelt. Current objectives include increased use of native tributary stocks where available for propagation into Upper Columbia River Basin waters. The Lake Roosevelt Fisheries Evaluation Program (LRFEP) is responsible for monitoring and evaluation on the Lake Roosevelt Projects. From 1988 to 1998, the principal sport fishery on Lake Roosevelt has shifted from walleye to include rainbow trout and kokanee salmon (Underwood et al. 1997, Tilson and Scholz 1997). The angler use, harvest rates for rainbow and kokanee and the economic value of the fishery has increased substantially during this 10-year period. The investigations on the lake also suggest that the hatchery and net pen programs have enhanced the Lake Roosevelt fishery while not negatively impacting wild and native stocks within the lake. The 2003 Fourth Annual Two Rivers Trout Derby was again a great success. The harvest and data collection were the highest level to date with 1,668 rainbow trout and 416 kokanee salmon caught. The fishermen continue to praise the volunteer net pen program and the hatchery efforts as 90% of the rainbows and 93% of the kokanee caught were of hatchery origin (Lee, 2003).« less

  11. Intestinal Parasitic Infections among Prison Inmates and Tobacco Farm Workers in Shewa Robit, North-Central Ethiopia

    PubMed Central

    Mamo, Hassen

    2014-01-01

    Background Intestinal parasitic infections (IPIs) particularly soil-transmitted helminthiasis (STH) and schistosomiasis are among neglected tropical diseases (NTDs) globally. Apart from being associated with anemia, malabsorption and retarded cognitive development these diseases are complicating the clinical picture of more serious infections like HIV, TB and malaria. Renewed and up-to-date information on the epidemiology of IPIs in more vulnerable groups such as irrigated-farm workers and prisoners would significantly contribute towards improving the health condition of such at-risk groups. Methods A cross-sectional survey was conducted to determine the prevalence of IPIs among prison inmates and tobacco farm workers in Shewa-Robit, north-central Ethiopia in November 2008. A total of 236 fecal samples were examined microscopically to detect helminths and/or protozoa using direct-smear and formol-ether concentration methods. Results Overall, 8 intestinal parasite species have been recovered singly or in combinations from 146 (61.8 %) samples. The prevalence in prison population (88/121 = 72.7%) was significantly higher than that in tobacco farm (58/115 = 50.4%). There were no significant differences in the prevalence of IPI by most socio-demographics. Except for hookworm there was no significant difference in parasite prevalence between different age-groups though the frequency of individual parasites slightly varied between the age-groups. Multivariate logistic regression analysis showed that inmates were more likely to acquire IPIs than tobacco-farm workers (Odds Ratio (OR)  = 2.62, 95% confidence interval (CI)  = 1.52–4.5). In addition, participants who did not report past treatment for IPIs were more likely to acquire IPIs than participants who self-reported treatment for IPIs in the past twelve months (OR = 3.25, 95% CI = 1.75–6.06). All other socio-demographics were not significantly associated with IPIs in univariate analysis. Entamoeba histolytica/dispar/moshkovskii was the most frequently encountered species in both study sites accounting for 48.8 and 51.7 percent of the positives in prison and tobacco farm population respectively. Other intestinal parasites detected, with slight variation in prevalence in the two study areas, were hookworm, Ascaris lumbricoides, Trichuris trichiura, Schistosoma mansoni, Strongyloides stercolaris, Hymenolepis nana and Taenia sp. 35.5 and 33.0 percent of the total positive cases were mixed infections in Shewa Robit prison and tobacco farm, respectively. Conclusion The results show that IPIs are common health problems in the studied populations. PMID:24926687

  12. Improved mapping strategy to better inform policy on the control of schistosomiasis and soil-transmitted helminthiasis in Sierra Leone.

    PubMed

    Hodges, Mary; Dada, Nsa; Wamsley, Anna; Paye, Jusufu; Nyorkor, Emanuel; Sonnie, Mustapha; Barnish, Guy; Bockarie, Moses; Zhang, Yaobi

    2011-06-06

    Schistosomiasis and soil-transmitted helminthiasis (STH) are endemic in Sierra Leone confirmed by national mapping in 2008. To better inform planning of preventive chemotherapy strategy, another survey was conducted before mass drug administration (MDA) in seven districts according to the mapping results or local knowledge. Fifty-nine chiefdoms and one school in every chiefdom were selected. Thirty school children aged 9-14 years from each school (total: 1760) were examined by parasitological methods for infection with Schistosoma mansoni and STHs. The overall prevalence of S. mansoni was 40.2% (95% confidence interval (CI): 37.9-42.5%), particularly in Kailahun (63.3%), Kenema (46.7%), Koinadugu (41.9%) and Kono (71.7%). The results demonstrated the focal distribution of S. mansoni in Bo, Tonkolili and Bombali districts with prevalence ranging from 0.0-63.3%, 3.3-90.0% and 0.0-67.9% respectively. The arithmetic mean intensity of S. mansoni infection was 95.4 epg (95% CI: 61.4-129.5 epg), Heavy mean intensity of infection was found in Kailahun (120.2 epg), Kenema (104.5 epg), Koinadugu (112.3 epg) and Kono (250.3 epg). Heavy or moderate infection with S. mansoni occurred in 20.7% of children examined. Hookworm prevalence was moderate: 31.2% (95% CI: 29.1-33.4%), but high in Bo (50.0%) and Tonkolili (56.7%). Hookworm intensity of infection was light with a mean epg of 53.0 (95% CI: 38.4-67.7 epg). Prevalence and intensity of Ascaris lumbricoides (1.5%, 17.8 epg) and Trichuris trichiura (2.5%, 20.3 epg) was low. The prediction by previous spatial analysis that S. mansoni was highly endemic across north-eastern Sierra Leone was confirmed with a significant proportion of children heavily or moderately infected. The distribution of S. mansoni in Bo, Tonkolili and Bombali districts ranged widely, highlighting the importance of considering the nature of focal transmission in national mapping exercises. These results were used to refine the MDA for schistosomiasis control to chiefdom implementation units rather than the entire district in these 3 districts. The survey demonstrated that sufficient number of survey sites for schistosomiasis mapping in each district should be used to provide a better national planning of MDA activities, and that it is affordable with the contributions from all parties involved and national resources mobilized.

  13. Critical Research for Cost-Effective Photoelectrochemical Production of Hydrogen

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Xu, Liwei; Deng, Xunming; Abken, Anka

    2014-10-29

    The objective of this project is to develop critical technologies required for cost-effective production of hydrogen from sunlight and water using a-Si triple junction solar cell based photo-electrodes. In this project, Midwest Optoelectronics, LLC (MWOE) and its collaborating organizations utilize triple junction a-Si thin film solar cells as the core element to fabricate photoelectrochemical (PEC) cells. Triple junction a-Si/a-SiGe/a-SiGe solar cell is an ideal material for making cost-effective PEC system which uses sun light to split water and generate hydrogen. It has the following key features: 1) It has an open circuit voltage (Voc ) of ~ 2.3V and hasmore » an operating voltage around 1.6V. This is ideal for water splitting. There is no need to add a bias voltage or to inter-connect more than one solar cell. 2) It is made by depositing a-Si/a-SiGe/aSi-Ge thin films on a conducting stainless steel substrate which can serve as an electrode. When we immerse the triple junction solar cells in an electrolyte and illuminate it under sunlight, the voltage is large enough to split the water, generating oxygen at the Si solar cell side (for SS/n-i-p/sunlight structure) and hydrogen at the back, which is stainless steel side. There is no need to use a counter electrode or to make any wire connection. 3) It is being produced in large rolls of 3ft wide and up to 5000 ft long stainless steel web in a 25MW roll-to-roll production machine. Therefore it can be produced at a very low cost. After several years of research with many different kinds of material, we have developed promising transparent, conducting and corrosion resistant (TCCR) coating material; we carried out extensive research on oxygen and hydrogen generation catalysts, developed methods to make PEC electrode from production-grade a-Si solar cells; we have designed and tested various PEC module cases and carried out extensive outdoor testing; we were able to obtain a solar to hydrogen conversion efficiency (STH) about 5.7% and a running time about 480 hrs, which are very promising results; we have also completed a techno-economic analysis of our PEC system, which indicates that a projected hydrogen generation cost of $2/gge is achievable with a 50 Ton-per-day (TPD) scale under certain conditions.« less

  14. Prevalence of anemia and associated factors among school children in Gondar town public primary schools, northwest Ethiopia: A school-based cross-sectional study

    PubMed Central

    Getaneh, Zegeye; Enawgaw, Bamlaku; Engidaye, Getabalew; Seyoum, Masresha; Berhane, Muruts; Abebe, Zegeye; Asrie, Fikir; Melku, Mulugeta

    2017-01-01

    Background Anemia is a global public health problem affecting 305 million school children (SC) worldwide. It has deleterious effects in SC, including lower school achievement due to impaired cognitive development and physical growth, fatigue and poor attention span, and increased morbidity because of reduced resistance to infection. Hence, the aim of this study was to assess the prevalence and associated factors of anemia among SC attending public primary schools in Gondar town, northwest Ethiopia. Methods A school-based cross sectional study was conducted on a total of 523 SC aged from 6–14 years old. Multi-stage sampling followed by systematic random sampling techniques were employed to select study participants. Data on socio-demographic and socio-economic characteristics, and dietary status of children were collected using pre-tested structured questionnaire through face-to-face interview of children’s caregivers. Anthropometric measurements were taken. Hemoglobin (Hb) concentration was determined by using HemoCue 301+analyser. Stool and blood samples were collected in the school premises, and examined for intestinal and hemoparasites, respectively. Data were entered into Epi Info version 3.5.3 and transferred to SPSS version 20 for analysis. Bivariate and multivariate binary logistic regression models were fitted to identify associated factors of anemia. P-value < 0.05 was considered as statistically significant. Result Of the total SC participated in the study, 269 (51.4%) were males. The median (inter quartile range (IQR)) age was 12 (10–13) years, and 332 (63.5%) of them were in the age group 11–14 years. About 81 (15.5%; 95%CI: 12.4%, 18.7%) of them were anemic: 56 (69.1%) and 25 (38.9%) of them were mildly and moderately anemic, respectively. Low maternal education (AOR = 2.30; 95%CI: 1.11, 4.78), stunting (AOR = 2.22; 95%CI: 1.30, 3.80), severe food insecurity (AOR = 5.11; 95%CI: 1.53, 17.13), and soil-transmitted helminthic (STH) infection (AOR = 7.13; 95%CI: 3.16, 16.86) were found significantly associated with anemia. Conclusion Anemia among SC was found to be a mild public health problem. It was strongly associated with low maternal education, food insecurity, stunting and intestinal helminthic infection. Focused policies and strategies towards the above factors should be designed to reduce anemia among SC. PMID:29284032

  15. Mechanical Reinforcement, Shapestabilization and Thermal Improvement of Phase-Change Energy Storage Materials Using Graphene Oxide Aerogel

    NASA Astrophysics Data System (ADS)

    Schuman, Yue Xu

    Paraffin is known as a good energy storage phase change material (PCM) because of its high energy storage capacity and low cost. However, the leakage of liquid paraffin beyond its melting point and its low thermal conductivity hinder applications of paraffin in energy storage systems. Recently, nanomaterials have been used to create PCM composites in order to enhance their thermal properties while shape stabilizing the PCMs. However, fundamental studies on the material structures and mechanical behavior of the thermally enhanced PCM composites are limited especially at the nanoscale. In this study, we developed a PCM composite using graphene oxide aerogel (GOxA) as the reinforcing 3D network. The GOxA functions thermally as a heat transfer path and mechanically as a nanofiller to reinforce the PCM matrix. We characterized the morphology, the crystal and molecular structures as well as the multiscale mechanical and thermal behavior of the GOxA-PCM composite to evaluate the role of GOxA in the PCM composite. The molecular and diffraction characterizations imply that the GOxA network may affect the paraffin's crystallization, potentially forming an interfacial phase at the surfaces of GOxA. Furthermore, the mechanical properties were studied using nanoindentation at the nano/microscale and a digital durometer at the macroscale from 25degree C to 80 degree C. The mechanical characterizations show that the GOxA-PCM composite is 3 7x harder than pure paraffin and maintains significant strength even above paraffin's melting point due to the support from the GoxA. Moreover, the composite is much less strain-rate sensitive than paraffin. The reinforcement via GOxA is much beyond the prediction by the rule of mixture, implying a strong GOxA-paraffin interfacial bonding. Finally, a thermal scanning microscopy (SThM) along with AFM was used to study the thermal properties at microscale. AFM and thermal images indicate that GOxA-PCM has a better thermal conductivity. The latent heats and thermal conductivities were analyzed using DSC and TPS at the macroscale. Results imply that there might be an interphase between the paraffin and the GOxA resulting in a greater latent heat storage ability and better thermal conductivity of the GOxA-PCM. We believe this is the first fundamental study on the mechanical and thermal behaviors of paraffin and GOxA-PCM composite at the multiscale. The enhancement in hardness, latent heat, and thermal conductivity are expected to aid the analysis and design of thermal energy storage composites with higher performance in the future.

  16. Improved mapping strategy to better inform policy on the control of schistosomiasis and soil-transmitted helminthiasis in Sierra Leone

    PubMed Central

    2011-01-01

    Background Schistosomiasis and soil-transmitted helminthiasis (STH) are endemic in Sierra Leone confirmed by national mapping in 2008. To better inform planning of preventive chemotherapy strategy, another survey was conducted before mass drug administration (MDA) in seven districts according to the mapping results or local knowledge. Fifty-nine chiefdoms and one school in every chiefdom were selected. Thirty school children aged 9-14 years from each school (total: 1760) were examined by parasitological methods for infection with Schistosoma mansoni and STHs. Results The overall prevalence of S. mansoni was 40.2% (95% confidence interval (CI): 37.9-42.5%), particularly in Kailahun (63.3%), Kenema (46.7%), Koinadugu (41.9%) and Kono (71.7%). The results demonstrated the focal distribution of S. mansoni in Bo, Tonkolili and Bombali districts with prevalence ranging from 0.0-63.3%, 3.3-90.0% and 0.0-67.9% respectively. The arithmetic mean intensity of S. mansoni infection was 95.4 epg (95% CI: 61.4-129.5 epg), Heavy mean intensity of infection was found in Kailahun (120.2 epg), Kenema (104.5 epg), Koinadugu (112.3 epg) and Kono (250.3 epg). Heavy or moderate infection with S. mansoni occurred in 20.7% of children examined. Hookworm prevalence was moderate: 31.2% (95% CI: 29.1-33.4%), but high in Bo (50.0%) and Tonkolili (56.7%). Hookworm intensity of infection was light with a mean epg of 53.0 (95% CI: 38.4-67.7 epg). Prevalence and intensity of Ascaris lumbricoides (1.5%, 17.8 epg) and Trichuris trichiura (2.5%, 20.3 epg) was low. Conclusions The prediction by previous spatial analysis that S. mansoni was highly endemic across north-eastern Sierra Leone was confirmed with a significant proportion of children heavily or moderately infected. The distribution of S. mansoni in Bo, Tonkolili and Bombali districts ranged widely, highlighting the importance of considering the nature of focal transmission in national mapping exercises. These results were used to refine the MDA for schistosomiasis control to chiefdom implementation units rather than the entire district in these 3 districts. The survey demonstrated that sufficient number of survey sites for schistosomiasis mapping in each district should be used to provide a better national planning of MDA activities, and that it is affordable with the contributions from all parties involved and national resources mobilized. PMID:21645386

  17. Schistosoma haematobium hotspots in south Nyanza, western Kenya: prevalence, distribution and co-endemicity with Schistosoma mansoni and soil-transmitted helminths

    PubMed Central

    2014-01-01

    Background Schistosomiasis studies in western Kenya have mainly focused on the intestinal form, with evidence of urinary schistosomiasis remaining anecdotal. Detailed disease mapping has been carried out predominantly along the shores of Lake Victoria, but there is a paucity of information on intestinal and urinary schistosomiasis in inland sites. Methods This cross-sectional survey of 3,487 children aged 7–18 years from 95 schools in south Nyanza, western Kenya determined the prevalence, infection intensity, and geographical distribution of Schistosoma haematobium, evaluating its co-endemicity with Schistosoma mansoni and soil-transmitted helminths (STHs). Helminth eggs were analyzed from single urine (for S. haematobium) and stool (for S. mansoni and STHs) samples by centrifugation and Kato-Katz, respectively. Hematuria was used as a proxy indicator for S. haematobium. Schools and water bodies (ponds, water-points, streams, dams and rivers) were mapped using Geographical Information System and prevalence maps obtained using ArcView GIS Software. Results S. haematobium infections with an overall prevalence of 9.3% (95% CI = 8.4-10.2%) were mostly prevalent in Rachuonyo, 22.4% (95% CI = 19.2-25.9% and 19.7 eggs/10 ml) and Migori, 10.7% (95% CI = 9.2-12.3% and 29.5 eggs/10 ml) districts, particularly around Kayuka pond and Ongoche river respectively. Overall infections correlated with hematuria (r = 0.9, P < 0.0001) and were more likely in boys (P < 0.0001, OR = 0.624). S. mansoni infections with an overall prevalence of 13% (95% CI =11.9-14.1%) were majorly confined along the shores of Lake Victoria. STH infections were homogenously distributed with A. lumbricoides occurring in 5.4% (95% CI = 4.7-6.3%) and T. trichiura in 2.8% (95% CI = 2.3-3.4%) of the children. Although S. mansoni infections were more co-endemic with S. haematobium, only A. lumbricoides infections were positively associated with S. haematobium (P = 0.0295, OR = 0.4585). Overall prevalence of S. haematobium monoinfection was 7.2% (95% CI = 6.4-8%), S. mansoni monoinfection was 12.3% (95% CI = 10.4-12.5%), and S. haematobium-S. mansoni coinfection was 1.2% (95% CI = 0.9-1.6%). There was no significant difference in infection intensity between mono and coinfections. Conclusion Prevalence distribution maps obtained are important for planning and implementing disease control programs in these areas. PMID:24667030

  18. Intestinal helminthic infection and anemia among pregnant women attending ante-natal care (ANC) in East Wollega, Oromia, Ethiopia.

    PubMed

    Mengist, Hylemariam Mihiretie; Zewdie, Olifan; Belew, Adugna

    2017-09-05

    Ethiopia is a developing country where intestinal helminthic infections are major public health problems. The burden of intestinal parasites, particularly the soil-transmitted helminths (STHs), is often very high in school children and pregnant women. Anemia, associated with STH, is a major factor in women's health, especially during pregnancy; it is an important contributor to maternal mortality. The aim of this study was to determine the prevalence of intestinal helminthic infection and anemia among pregnant women attending ANC in East Wollega Zone, Ethiopia. A cross-sectional study was conducted in five health centers of East Wollega Zone of Oromia Region, Ethiopia between November 2015 and January 2016. The health centers were selected randomly and study participants were enrolled consecutively with proportions from all the health centers. Stool and blood specimens were processed using standard operating procedures in accordance with structured questionnaires. Logistic regression models were applied to assess the association between predictors and outcome variables. P values less than 0.05 were taken as significant levels. Results were presented in tables and figures. A total of 372 pregnant women were enrolled in this study with a median age of 25 years (range 17-40 years). The total prevalence of intestinal helminths was 24.7% (92/372) with the predominance of Hookworm (15.1%) followed by Ascaris lumbricoides (6.5%). Illiteracy [AOR, 95% CI 2.21 (1.3, 4.8), P = 0.042], absence of latrine [AOR, 95% CI 4.62 (1.7, 8.3), P = 0.013] and regular consumption of raw and/or unwashed fruit [AOR, 95% CI 3.30 (1.2, 6.3), P = 0.011] were significant predictors of intestinal helminthic infection. The overall prevalence of anemia was 17.5% (65/372) where mild anemia accounts for 80% of the total anemia. Anemia was significantly associated with the first trimester of gestation [AOR, 95% CI 2.82 (1.3, 6.2), P = 0.009], previous malaria infection [AOR, 95% CI 2.32 (1.3, 5.3), P = 0.003], failing to take iron supplements regularly [AOR, 95% CI 1.82 (1.1, 4.8), P = 0.022] and infection with intestinal helminths specifically with Hookworm (P = 0.001) and Ascaris lumbricoides (P = 0.022). The prevalence of intestinal helminths and anemia was significantly high in this study. Different socio-demographic, lifestyle and obstetric factors were identified as significant contributors of intestinal helminthic infection and anemia among pregnant women. Therefore, public health measures and intensive antenatal care services are vital to promoting safe pregnancy.

  19. Is there a difference in prevalence of helminths between households using ecological sanitation and those using traditional pit latrines? A latrine based cross sectional comparative study in Malawi.

    PubMed

    Kumwenda, Save; Msefula, Chisomo; Kadewa, Wilfred; Diness, Yohane; Kato, Charles; Morse, Tracy; Ngwira, Bagrey

    2017-06-09

    Studies have shown that households using sludge from human excreta for agriculture are at an increased risk of soil transmitted helminths. However, while use of ecological sanitation (EcoSan) latrines is increasing in most African countries including Malawi, few studies have been done to check whether use of such sludge could potentially increase the prevalence of helminthic infections among household members as a results of exposure to faecal sludge/compared to use of traditional latrines. A cross sectional study was done targeting households using EcoSan and traditional pit latrines. Samples were collected from both types of latrines in Chikwawa (rural) and Blantyre (urban) districts. These two districts have a high number of EcoSan latrines in southern region of Malawi. 156 latrines were sampled (n = 95 traditional; n = 61 EcoSan), and processed following standard guidelines using modified triple floatation method. Identification of helminth ova (Ascaris lumbricoides, hookworms, Trichuris trichiura, Taenia spp. and Diphyllobothrium latum) was done using standard microscopy methods. The difference between the prevalence and mean concentration of helminths between the two types of latrines was tested using Chi Square and t test respectively. Of the total latrines tested, 85.9% (n = 134) had at least one species of helminth while 84.6% (n = 132) had at least a STH, with 82.0% (n = 50) in EcoSan and 86.3% (n = 82) in traditional pit latrines. There was no significant difference between the prevalence of helminths in EcoSan and traditional pit latrines [χ 2  = 0.43 (1), P = 0.5]. The prevalence of Ascaris lumbricoides was significantly higher in EcoSan than in traditional pit latrines [χ 2  = 5.44 (1) p = 0.02] while prevalence of hookworms was significantly higher in traditional pit latrines than in EcoSan latrines [χ 2  = 13.98 (1) p < 0.001]. The highest concentration of helminths per gram of faecal sludge was in traditional pit latrines [31.2 (95% CI 19.1-43.2)] than in EcoSan latrines [26.4 (95% CI 16.5-36.3)]. There was no significant difference between overall prevalence of helminths between households using EcoSan and those using traditional pit latrines. However, Ascaris lumbricoides was significantly higher in households using EcoSan latrines. EcoSan users need awareness on safe ways of handling faecal sludge in order to reduce chances of reinfection from Ascaris lumbricoides. Further research should be undertaken on household members to identify those infected and potential routes of infection to enable preventive targeting.

  20. Mortality and Disability-Adjusted Life-Years (Dalys) for Common Neglected Tropical Diseases in Ethiopia, 1990-2015: Evidence from the Global Burden of Disease Study 2015

    PubMed Central

    Deribew, A; Kebede, B; Tessema, GA; Adama, YA; Misganaw, A; Gebre, T; Hailu, A; Biadgilign, S; Amberbir, A; Desalegn, B; Abajobir, AA; Shafi, O; Abera, SF; Negussu, N; Mengistu, B; Amare, AT; Mulugeta, A; Kebede, Z; Mengistu, B; Tadesse, Z; Sileshi, M; Tamiru, M; Chromwel, EA; Glenn, SD; Stanaway, JD; Deribe, K

    2017-01-01

    Introduction Neglected tropical diseases (NTDs) are important public health problems in Ethiopia. In 2013, the Federal Ministry of Health (FMOH) has launched a national NTD master plan to eliminate major NTDs of public health importance by 2020. Benchmarking the current status of NTDs in the country is important to monitor and evaluate the progress in the implementation of interventions and their impacts. Therefore, this study aims to assess the trends of mortality and Disability-adjusted Life-Years (DALY) for the priority NTDs over the last 25 years. Methods We used the Global Burden of Disease (GBD) 2015 estimates for this study. The GBD 2015 data source for cause of death and DALY estimation included verbal autopsy (VA), Demographic and Health Surveys (DHS), and other disease specific surveys, Ministry of Health reports submitted to United Nations (UN) agencies and published scientific articles. Cause of Death Ensemble modeling (CODEm) and/or natural history models were used to estimate NTDs mortality rates. DALY were estimated as the sum of Years of Life Lost (YLL) due to premature mortality and Years Lived with Disability (YLD). Results All NTDs caused an estimated of 6,293 deaths (95% uncertainty interval (UI): 3699-10,080) in 1990 and 3,593 deaths (95% UI: 2051 – 6178) in 2015, a 43% reduction over the 25 years. Age-standardized mortality rates due to schistosomiasis, STH and leshmaniasis have declined by 91.3%, 73.5% and 21.6% respectively between 1990 to 2015. The number of DALYs due to all NTDs has declined from 814.4 thousand (95% UI: 548 thousand–1.2million) in 1990 to 579.5 thousand (95%UI: 309.4 thousand–1.3 million) in 2015. Age-standardized DALY rates due to all NTDs declined by 30.7%, from 17.6 per 1000(95%UI: 12.5-26.5) in 1990 to 12.2 per 1000(95%UI: 6.5 – 27.4) in 2015. Age-standardized DALY rate for trachoma declined from 92.7 per 100,000(95% UI: 63.2 – 128.4) in 1990 to 41.2 per 100,000(95%UI: 27.4–59.2) in 2015, a 55.6% reduction between 1990 and 2015. Age-standardized DALY rates for onchocerciasis, schistosomiasis and lymphiaticfilariasis decreased by 66.2%, 29.4% and 12.5% respectively between 1990 and 2015. DALY rate for ascariasis fell by 56.8% over the past 25 years. Conclusions Ethiopia has made a remarkable progress in reducing the DALY rates for most of the NTDs over the last 25 years. The rapid scale of interventions and broader system strengthening may have a lasting impact on achieving the 2020 goal of elimination of most of NTDs. Ethiopia should strengthen the coverage of integrated interventions of NTD through proper coordination with other health programs and sectors and community participation to eliminate NTDs by 2020. PMID:28878427

  1. About the singular behavior of the ionic condensation of sodium chondroitin sulfate: Conductivity study in water and water dioxane mixture

    NASA Astrophysics Data System (ADS)

    M'halla, Jalel; Besbes, Rafik; Bouazzi, Ramzi; Boughammoura, Sondes

    2006-01-01

    In this work, we generalized the (Bjerrum-Debye-Fuoss-MSA) double layer model to an ellipsoidal polyion (chondroitin sulfate) of (∣ Zs∣ e) structural charge, Ls structural length, R minor axe and ( R2 + L2/4) 1/2 major axe. With L ⩽ Ls. Na + counter ions are distributed on the contact (or condensed) layer and on the Debye layer (ionic atmosphere). Both layers are ellipsoidal equipotentials of, respectively, R and d minor axes and are concentric to the polyion. With d = ( R + 1/2 Γ), Γ is the Debye-MSA screen parameter. The equilibrium distribution of Na + ions is derived from a "two states" statistical approach, leading to a general implicit expression for the rate of condensation (1 - α). The generality of this formula results from the fact that it takes into account the finite size of the polyion ( L ≠ ∞ and R ≠ 0) and allows to calculate α for different conformations of the polyion: (ellipsoidal L ≠ 0, cylindrical: L = Ls, spherical: L → 0, and Manning's model: RL-1 → 0). The main conclusion of this model is that, α obeys to the Ostwald's principle of dilution ( α → 1 when CNa+ → 0). This result is contrary to Manning's theory, for which α is a constant αM independent on the concentration Ci: αM = bS/(∣ Zi∣ Lb), with bS = Ls/∣ Zs∣ and Lb = e2/( ɛkT) is the Bjerrum length. However, our analysis shows that the rate of variation: (∂ α/∂ Ci) in a given range of concentration, depends on the structural parameter bS. Indeed, the critical Manning condition ( α-1αM = 1, ⇒(∂ α/∂ Ci) ≈ 0), is compatible with the general following "rod-like model" approximation: (1-α)≈|Zi|(πbS)[4πZi2Lb][αCiR2];withbS″=αM-1 only for some peculiar values of bS and Lb (i.e., dielectric constant: ɛ). In water at 25 °C ( ɛ = 78.3), this singular behavior occurs for a range of a relative low or moderate concentration for some polyelectrolytes of bS structural parameter of about 5.8 Å. This is the case of sodium chondroitin sulfate in water ( bS = 5.72 Å). The addition of dioxane increases Lb, consequently, α is shifted from its Manning's value. In order to verify this dioxane effect, we have compared experimental equivalent conductibilities Λexp of sodium chondroitin sulfate in water ( no shift) and water-dioxane (60 wt%) mixture ( positive shift), to their theoretical values ΛM, ΛcthandΛsth corresponding, respectively, to the Manning, cylindrical and spherical models. This comparison allows also, to explain the conformation "chosen" by the polyion, in order to minimizing the friction effects (due to: viscosity; ionic and dielectric relaxations) and therefore, to optimize its mobility by the shift of its rate of ionic condensation α.

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