Natural contamination of human hands with enteric parasites in Indian Subcontinent

AIM: To investigate the prevalence of enteric parasite contamination on hands and the potential role naturally contaminated hands may have in their transmission. METHODS: Prior to initiating the survey, the protocol was reviewed and approved by respective Institutional Review Boards of each survey site(Dhaka, Bangladesh and Kolkata, India). Both stool and corresponding hand wash samples collected, were analyzed for the presence of enteric parasitic ova/(oo)cysts employing conventional microscopy coupled with permanent staining techniques. Additionally molecular approachessuch as polymerase chain reaction(PCR) of enteric parasites recovered from both stool and corresponding hand wash samples, were also used to further confirm their identity. RESULTS: A total of 972 stool samples were collected from both sites surveyed(300 volunteers from Kolkata, India and 672 from Dhaka, Bangladesh). Parasitic analysis revealed, 113(38%) from Kolkata, India and 267(40%) of stool samples from Dhaka, Bangladesh were positive for parasitic ova/(oo)cysts. When the corresponding hand wash samples were analyzed, 43(14%) stool-positive volunteers in Kolkata, India and 47(7%) in Dhaka, Bangladesh were positive for enteric parasitic ova/(oo)cysts. Ascaris lumbricoides(A. lumbricoides) ova and Giardia lamblia(G. lamblia) cysts predominated in hands wash samples from both sites surveyed(from India, A. lumbricoides ova, 53%; G. lamblia cysts 31% and from Bangladesh, A. lumbricoides ova, 47%; G. lamblia cysts 19%). Genotypic analysis of enteric parasitic ova/(oo)cysts obtained from both stool and corresponding hand wash samples taken from the same person were found to be identical. CONCLUSION: These results suggest a possible role of hands contaminated with enteric parasites' ova/(oo)cysts in the transmission of these parasites highlighting another role of hand hygiene/proper hand washing in reducing the disease burden in low socioeconomic communities.

High prevalence of soil-transmitted helminth infections among primary school children,Uttar Pradesh,India,2015

Background:Soil-transmitted helminth(STH)infections often affect the poorest and most deprived communities.In order to generate reliable data for planning a school based deworming program,we conducted a survey among primary school children studying in government schools in the Indian state of Uttar Pradesh.The objectives of our survey were to estimate the prevalence and intensity of STH infections.Methods:We conducted a cross-sectional survey among children studying in 130 primary schools from 9 agroclimatic zones,during May-August 2015.Information about socio-demographic details,defecation and handhygiene practices,and stool samples were collected from the school children.Stool samples were examined using the Kato-Katz method.Results:Stool samples from 6421 school children were examined.The overall weighted prevalence of any STH in the State was 75.6%(95%CI:71.2-79.5).The prevalence was more than 50%in six of the nine agro-climatic zones.A.lumbricoides was the most prevalent STH(prevalence:69.6%),followed by hookworm(prevalence:22.6%)and T.trichura(4.6%).The majority of the STH infections were of low intensity.The practice of open defecation and not washing hands with soap after defecation and residence in kutcha house were significant risk factors of STH infection.Conclusions:STH prevalence among primary school children in Uttar Pradesh was high.Given the WHO guidelines on deworming frequency according to STH prevalence,Govt of Uttar Pradesh needs to implement a school-based deworming program with bi-annual frequency.The findings of our survey would also help monitor the performance of school based deworming programme.