Intestinal Helminthic Infection Increases Serum Levels of IL-2 and Decreases Serum TGF-Beta Levels in Nigerian Asthmatic Patients

Background: Asthma is less common in countries outside the organization for economic cooperation and development (OECD). One suggested mechanism for this disparity is the early life exposure to helminthic infection in non-OECD countries due to predominant Th1 immune response, which down-regulates Th2 responses required for exacerbation of asthma. This report is the first in the literature to describe the effects of helminthic infection on immune responses in asthmatic children compared to non-asthmatic controls. Methods: We administered the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire to 1690 high school students in three rural communities in southwestern Nigeria. Based on questionnaire responses and medical examination, identified asthma cases were matched with controls. Stool samples were collected from all subjects and screened for intestinal helminthic infection. The serum of 12 asthmatics and 12 non-asthmatics (6 with intestinal helminthic infection and 6 without intestinal helminthic infection in each group) were assayed for interleukin (IL)-2, IL-4, IL-5, IL-6, IL-10, IL-12, IL-13, IL-17A, interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), granulocyte macrophage colo- ny-stimulating factor (GM-CSF), and transforming growth factor-beta (TGF-β). Results: The mean (±SD) serum levels of IL-2 significantly increased in asthma cases with intestinal helminthic infection compared with asthma cases without infection (41.5 ± 9.7 vs. 29.7 ± 10.3;p = 0.035), controls with intestinal helminthic infection compared with cases without infection (52 ± 4.7 vs. 29.7 ± 10.3;p < 0.001), and controls with intestinal helminthic infection compared to controls without infection (52 ± 4.7 vs. 34.2 ± 10.4;p = 0.003). Mean levels of TGF-β significantly increased in controls without infection compared with asthma cases with infection (1833 ± 93.1 vs. 633.3 ± 294.4;p < 0.001), controls without intestinal helminthic infection compared with asthma cases without infection (1833 ± 93.1 vs. 916.7 ± 204.1;p < 0.001), controls with intestinal helminthic infection compared to controls without infection (2366.7 ± 760.7 vs. 1833 ± 93.1;p < 0.001), and controls with intestinal helminthic infection compared with asthma cases without infection (2366.7 ± 760.7 vs.916.71 ± 204.1;p = 0.007). Conclusion: Intestinal helminthic infection independently increases IL-2 levels, while asthma decreases the level of TGF-β, which is further depressed by intestinal helminthic infection.

Intestinal protozoa and intestinal helminthic infections among schoolchildren in Central Sudan

Objective:To determine the prevalence of intestinal parasitic infections and soil-transmitted helminths(STHs) among primary schoolchildren in El dhayga,Central Sudan.Methods:In this cross-sectional study,three fresh faecal samples were collected from each child,which were examined by direct wet mount,brine flotation,formalin-ether and Kato-Katz techniques.The intensity of each STH infection was expressed as the mean of eggs per gram counts of the three samples.Results:In total,142(90.4%) of 157 children harboured at least one type of intestinal parasite.Ascaris lumbricoides,Hymenolepis nana,Entamoeba histolytica and Giardia lamblia were the most common parasites found,with prevalence rates of 32.5%,30.6%,33.1%and 19.7%,respectively.Out of these 157 children,29(18.5%) harboured more than two intestinal parasitic infections.No cases of Schistosoma mansoni or Enterobius vermicularis were identified. Conclusions:The study demonstrates significant burden of intestinal protozoa and STH infections in this part of Sudan and highlights the need for preventive and intervention measures.

Prevalence of gastrointestinal helminthic infections and associated risk factors among schoolchildren in Tilili town,northwest Ethiopia

Objective:To determine the prevalence of gastrointestinal helminthes and associated risk factors among schoolchildren in Tilili town,northwest Ethiopia.Methods:A cross-sectional study involving 383 schoolchildren was conducted between November 2011 to February 2012.Each student was selected using systematic random sampling method.Questionnaire and observation were used to identify socio-demographic and associated risk factors.Fresh stool samples were observed using formal-ether concentration technique.Data were analyzed using SPSS 16.0statistical software.Results:Four species of intestinal helminthes were identified with an overall prevalence of 44.2%(170 of 385 schoolchildren).The predominant parasites were Ascaris lumbricoides(A.lumbricoides)153(39.7%)and Trichuris trichiura(T.trichiura)30(7.8%).One hundred thirty five(35.1%)had single infections and 35(9.2%)were infected with more than one helminthic parasites in which 32(8.4%)were double infections and 3(0.8%)were triple infections.Significant associations were observed between intestinal helminth infection and those of age,grade level,and school variables.Prevalence of hookworm infection was significant in children who did not wear shoes regularly(P<0.05).Conclusions:intervention programs and education on personal and environmental hygiene should be implemented for the prevention and control of helminthic infections in the study area.

Acute cholecystitis and helminthic infestation

Acute cholecystitis is an important acute medical problem, so acute disorder of the gall bladder requires good clinical management. There are several etiologies of acute cholecystitis. Although it is not common, helminthic infection is one of the causes of acute cholecystitis. This condition is little mentioned in literature but it is an important issue in several tropical countries. Here, the authors performed a literature review to summarize published data available on an international database (PubMed). All available publications with complete information are summarized and extracted. In this article, the authors briefly summarized clinical features and management of acute cholecystitis and helminthic infestation. The relationship of nematode, trematode and cestode infestations with acute cholecystitis is also summarised.

Prevalence and intensity of urinary schistosomiasis and soil-transmitted helminths among women of reproductive age in Mwaluphamba,Kwale

Objective:To assess the epidemiology of urinary schistosomiasis and soil-transmitted helminthiasis among women of reproductive age in Mwaluphamba,Kwale County,Kenya.Methods:A community-based cross-sectional study design was employed to randomly sample 422 women of reproductive age(15-<50 years)from four villages in Mwaluphamba location.Stool specimens were collected and examined using the Kato-Katz method,while filtration technique was used to analyze urine specimens.Participants’sociodemographic details were obtained using a standardized questionnaire.Results:Urinary schistosomiasis prevalence was at 4.7%(20/422,95%CI 2.8%-6.9%)while the prevalence of soil-transmitted helminthiasis infection was 4.5%(19/422,95%CI 2.6%-6.7%).The infection intensities of urinary schistosomiasis among the study participants ranged from 1 to 120 eggs/10 mL of urine with median egg count of 18.45 eggs/10 mL.The patients were diagnosed with light infection,of 56.16 egg/gram and 48.48 egg/gram for Trichuris trichiura and hookworms,respectively.Women without latrines had 15.7 times higher risk of having urinary schistosomiasis compared to those with a latrine.Similarly,use of surface water(aOR=1.0,95%CI 0.2-1.4,P=0.010)and crossing the river to go to a place(aOR=1.1,95%CI 0.3-1.6,P=0.009)were statistically significant risk factors for getting urinary schistosomiasis.In bivariable regression analysis,defecating around the water source(OR=4.3,95%CI 1.5-12.9)had a statistically significant association with the prevalence of soil-transmitted helminthiasis(P=0.008).Conclusions:This study has given an insight on the prevalence and intensity of urinary schistosomiasis and soil-transmitted helminthiasis in Mwaluphamba location that form a basis for strengthening the control and elimination programmes for these neglected tropical diseases.

Assessment of albendazole efficacy against Ascaris lumbricoides at three sites of Andhra Pradesh,Odisha,and Kerala in India

Objective:To assess efficacy of albendazole against Ascaris(A.)lumbricoides among school-children at three sites of Rajahmundry,Sundergarh and Wayanad.Methods:Sites were selected based on soil-transmitted helminths prevalence,different sociocultural-geographical characteristics and operational feasibility.9-12 Years old children from 14 schools were included.The study was conducted in two rounds:baseline&follow up survey.All eligible children found positive for A.lumbricoides at baseline were administered supervised single tablet albendazole 400 mg under the National Deworming Day Initiative.During post-treatment follow-up survey,eligible children who provided second stool sample were included in the final analysis.Stool samples were examined using WHO recommended Kato-Katz technique.Efficacy was estimated based on cure rate(CR)and Fecal Egg Count Reduction Rate(FECRR)among children found positive in baseline and follow-up surveys.Results:328 Out of 625(52.5%)were found positive for A.lumbricoides in the baseline survey and 85 out of 178 samples(47.8%)during post-treatment follow-up survey.Overall,the estimated CR was 52.2%.FECRR(95%CI)for albendazole was 72.6%(79.2%-66.0%).The FECRR was highest in East Godaveri[89.7%(96.8%-82.6%)],followed by Sundergarh[86.4%(95.3%-77.5%)]and Wayanad[69%(81.7%-56.4%)].Conclusions:Our study confirmed overall reduction in FEC although with varying albendazole efficacy for A.lumbricoides infection at three different locations in India.However,these finding may be assessed in context of ongoing MDA under Filaria control program and further studies by in vivo as well as in vitro methods are required to reach to a conclusion on possible resistance if any.

Ancylostoma ceylanicum and other zoonotic canine hookworms:neglected public and animal health risks in the Asia-Pacific region

Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 milion cases globally and approximately four million disability-adjusted life years lost annually.More than one-fth of these cases are attrib-uted to Ancylostoma ceylanicum,an emerging zoonotic health issue in the Asia-Pacific region.This review presents key research gaps regarding the epidemiology,diagnosis,control,prevention and elimination of A.ceylanicum and other canine zoonotic hookworms as neglected health threats.A.ceylanicum is the second most prevalent human hook-worm in the region;it is the most common hookworm among dogs and cats-reservoirs of zoonotic infections.Previous population genetic and phylogenetic analyses revealed that A.ceylanicum has three possible transmis-sion dynamics:zoonotic,animal-only,and human-only pathways.The actual burden of zoonotic ancylostomiasis in most endemic countries remains unknown due to the use of parasitological techniques(e.g.,Kato-Katz thick smear and floatation techniques)that have reduced diagnostic performance and do not allow accurate species identifica-tion in helminth surveys.The emergence of benzimidazole resistance in soil-transmitted helminths(STHs),includ-ing hookworms,is a concern due to the protracted implementation of mass drug administration(MDA).Resistance is conferred by single nucleotide polymorphisms(SNPs)that occur in theβ-tubulin isotype 1 gene.These mutations have been reported in drug-resistant A.caninum but have not been found in A.ceylanicum in the field.A.ceylanicum remains understudied in the Asia-Pacific region.The zoonotic nature of the parasite warrants investigation of its occur-rence in human and animal reservoir hosts to understand the dynamics of zoonotic transmission in different endemic foci.The detection of benzimidazole resistance-associated SNPs in zoonotic hookworms from Asia-Pacific countries has yet to be thoroughly explored.Considering the high level of hookworm endemicity in the region,the circulation of resistant isolates between humans and animals potentially presents a significant One Health threat that can under-mine current MDA and proposed animal deworming-based control efforts.

Performance of a Horizontal Flow Constructed Reed Bed Filter for Municipal Wastewater Treatment: The Case Study of the Prototype Installed at Gaston Berger University, Saint-Louis, Senegal

In Saint-Louis, Senegal, a constructed wetland with horizontal flow reed beds (FHa and FHb) has demonstrated significant efficacy in treating municipal wastewater. Analyzing various treatment stages, the system showed only a slight temperature variation, from an influent average of 26.3°C to an effluent of 24.7°C. Electrical conductivity decreased from 1331 mS/cm to 974.5 mS/cm post-primary treatment, with suspended solids (SS) dramatically reduced from 718.9 mg/L to 5.7 mg/L in the final effluent. Biochemical oxygen demand (BOD5) and chemical oxygen demand (COD) saw a notable decrease, from initial levels of 655.6 mg/L and 1240 mg/L to 2.3 mg/L and 71.3 mg/L, respectively. Nitrogenous compounds (N-TN) and phosphates () also decreased significantly, indicating the system’s nutrient removal capacity. Microbiological analysis revealed a reduction in fecal coliforms from 7.5 Ulog/100ml to 1.8 Ulog/100ml and a complete elimination of helminth eggs. The presence of Phragmites and Typha was instrumental in enhancing these reductions. The system’s compliance with the Senegalese standards for disposal into natural environments, WHO recommendations for unrestricted water reuse in irrigation, and the European legislation for water reuse was established. The effluent quality met the stringent criteria for various classes of agricultural reuse, illustrating the system’s potential for sustainable water management. This wetland model presents a robust solution for water-stressed regions, ensuring environmental protection while supporting agricultural needs. The study calls for ongoing research to further refine the system for optimal, reliable wastewater treatment and water resource sustainability.

Evaluation of Immunological Markers in Children Infected with Intestinal Parasites in Three Communities, Nigeria

Helminthiases are neglected parasites that induce changes in the host’s immune response. The study assayed some immunological markers in helminth infections in children and adolescents. Stool and blood samples were collected from 276 subjects resident in three rural communities of Rivers and Imo States. Of these, 98 (35.5%) were infected with one or more of 3 parasitic species, of which Ascaris lumbricoides 39 (39.8%), Ancylostoma duodenale 30 (30.6%) and Trichuris trichiura 29 (29.6%) were recovered. Intestinal helminth parasites were identified using formol-ether concentration. Of the infected subjects, 66 had single species infections and 32 had multiple infections with two or three helminth species and children of the 6 - 10 years age group had the highest incidence. Sera of 60 infected subjects and 30 controls were evaluated to define immunological serum levels of IgE, IL-5, IFN-γ and C3 using the ELISA technique, while white blood cell differential counts and neutrophil-lymphocyte ratio (NLR) were evaluated using haematology auto-analyser. Elevation of IL-5, IgE, WBC and eosinophil levels were demonstrated in the infected groups (p < 0.01), higher in the multiple infected groups, compared to the control. Their concentrations across the different age groups were also significantly different (p = 0.0001), the highest in 6 - 5 years and the lowest in 0 - 5 years. Differences in IFN-γ and C3 levels among non-parasitized, single-parasitized and poly-parasitized groups were not statistically significant. Neutrophil, lymphocyte and NLR levels between control and helminth infected subjects were not significantly different. The result suggested that IgE, IL-5, total WBC and eosinophil increased in helminth infections, more in poly-parasitized and 6 - 10 years children.

Prevalence, Pattern and Risk Factors of Soil Transmitted Helminth Infections amongst Children in a Tertiary Institution in South East, Nigeria

Introduction: Soil-transmitted helminthic infection (STHI) is a common public health challenge of children in the most deprived communities in low income countries. In the long-term, STHI can cause developmental and growth disorders leading to future learning defect. Objective: Our aim was to determine the prevalence and pattern of soil-transmitted helminthic infection among children attending a tertiary hospital in Imo State, Nigeria. Patients and Method: The study involved a cross-sectional survey of 268 children, aged 7 months to 18 years seen in a tertiary health facility in Nigeria;from August to December 2022. Data were collected using a structured questionnaire and stool samples were analyzed for intestinal helminths using the Kato-Katz method. Results: The prevalence of soil-transmitted helminthic infection (STHI) was 38.4%. Of all STHIs, Ascaris lumbricoides was the commonest geohelminth observed, 81 (62.1%). Multiple infections were noted in 25 (62.4%) of the specimen. The prevalence of soil-transmitted helminthic infection amongst subjects’ 5 - 9 years was high and least in children older than 15 years. This difference was not statistically significant (p = 0.3407). Statistically significant relationship was detected between STHI and low socioeconomic class. Conclusion: The high prevalence rate of soil-transmitted helminthic infection amongst the subjects is disturbing. This high rate justifies strengthening a structured and routine deworming amongst children in order to improve outcome.

Trends on gastrointestinal bleeding and mortality:Where are we standing?

Bleeding from the gastrointestinal tract and its management are associated with significant morbidity and mortality.The predisposing factors that led to the occurrence of these hemorrhagic instances are largely linked to the life style of the affected persons.Designing a new strategy aimed at educating the publics and improving their awareness of the problem could effectively help in eradicating this problem with no associated risks and in bringing the mortality rates down to almost zero.

Hygiene hypothesis in inflammatory bowel disease: A criticalreview of the literature

The hygiene hypothesis is thought to be a significant contributor to the growing incidence of inflammatory bowel disease (IBD) around the world, although the evidence for specific factors that underlie the hygiene hypothesis in IBD is unclear. We aimed to systematically review the literature to determine which hygiene-related factors are associated with the development of IBD. Publications identified from a broad based MEDLINE and Current Contents search between 1966 and 2007 on key terms relevant to the 'hygiene hypothesis' and IBD including H pylori exposure, helminths, cold chain hypothesis, measles infection and vaccination, antibiotic use, breastfeeding, family size, sibship, urban upbringing, day care attendance and domestic hygiene were reviewed. The literature suggests that the hygiene hypothesis and its association with decreased microbial exposure in childhood probably plays an important role in the development of IBD, although the strength of the supporting data for each of the factors varies considerably. The most promising factors that may potentially be associated with development of IBD include H pylori exposure, helminths, breastfeeding and sibship. However, the vast majority of studies in this area are plagued by serious methodological shortcomings, particularly the reliance on retrospective recall of information making it difficult to truly ascertain the importance of a 'hygiene hypothesis' in IBD. The 'hygiene hypothesis' in IBD is an important area of research that may give clues to the aetiology of this disease. Directions for future research are recommended.

Schistosoma mansoni proteins attenuate gastrointestinal motility disturbances during experimental colitis in mice

AIM:To investigate the therapeutic effect of Schistosoma mansoni(S.mansoni) soluble worm proteins on gastrointestinal motility disturbances during experimental colitis in mice. METHODS:Colitis was induced by intrarectal injection of trinitrobenzene sulphate(TNBS) and 6 h later,mice were treated ip with S.mansoni proteins.Experiments were performed 5 d after TNBS injection.Inflammationwas quantified using validated inflammation parameters. Gastric emptying and geometric center were measured to assess in vivo gastrointestinal motility.Peristaltic activity of distal colonic segments was studied in vitro using a modified Trendelenburg set-up.Cytokine profiles of T-lymphocytes isolated from the colon were determined by real time reverse transcriptase-polymerase chain reaction. RESULTS:Intracolonic injection of TNBS caused severe colitis.Treatment with S.mansoni proteins significantly ameliorated colonic inflammation after 5 d.TNBS did not affect gastric emptying but significantly decreased the geometric center and impaired colonic peristaltic activity 5 d after the induction of colitis.Treatment with S.mansoni proteins ameliorated these in vivo and in vitro motility disturbances.In addition,TNBS injection caused a downregulation of effector T cell cytokines after 5 d,whereas a S.mansoni protein effect was no longer observed at this time point. CONCLUSION:Treatment with S.mansoni proteins attenuated intestinal inflammation and ameliorated motility disturbances during murine experimental colitis.

Helminth infections and intestinal inflammation

Evidence from epidemiological studies indicates an inverse correlation between the incidence of certain immune-mediated diseases, including inflammatory bowel diseases (IBD), and exposure to helminths. Helminth parasites are the classic inducers of Th2 responses. The Th2-polarized T cell response driven by helminth infection has been linked to the attenuation of some damaging Th1 driven inflammatory responses, preventing some Th1-mediated autoimmune diseases in the host, including experimentally induced colitis. Helminth parasites (the porcine whipworm, Trichuris suis ) have been tested for treating IBD patients, resulting in clinical amelioration of the disease. As a result, there is a great deal of interest in the research community in exploring the therapeutic use of helminth parasites for the control of immune-mediated diseases, including IBD. However, recent studies have provided evidence indicating the exacerbating effects of helminths on bacterial as well as non-infectious colitis in animal models. Therefore, a better understanding of mechanisms by which helminths modulate host immune responses in the gut may reveal novel, more effective and safer approaches to helminth-based therapy of IBD.

Soil-transmitted helminth egg contamination from soil of indigenous communities in selected barangays in Tigaon, Camarines Sur, Philippines

Objective:To provide baseline data on the prevalence and intensity of soil-transmitted helminthiasis egg contamination in the soil among indigenous communities.Methods:A total of 317 soil samples from three barangays of indigenous communities communities in Tigaon,Camarines Sur,Philippines were examined for soil-transmitted helminthiasis egg contamination using optimized sugar flotation method.Results:Of the soil samples examined,141(44.48%)were contaminated by Ascaris spp.,Toxocara spp.,and Trichuris spp.with cumulative prevalence varying across the study sites(P<0.01).Ascaris spp.was predominant in all study sites,followed by Toxocara spp.and Trichuris spp.with a prevalence of 41.96%,7.57%,and 5.36%,respectively.Interestingly,Toxocara pp.has the highest intensity of contamination,followed by Ascaris spp.and Trichuris spp.in term of geometric mean soil-transmitted helminthiasis eggs recovered per one gram soil sample(34.25,21.45,and 11.85 respectively).Each study site harbors significant amount of soiltransmitted helminthiasis eggs and zoonotic Toxocara eggs,which present high risk of soil-transmitted helminthiasis infection,particularly among children observed to play and cohabitate with animals known to be hosts of these parasites.Conclusions:The alarming rate of soil-transmitted helminthiasis and Toxocara egg contamination reported in this study suggests that additional measures should be undertaken to control soil-transmitted helminthiasis and zoonotic intestinal infections in the country.

Enteric parasites prevalence at Saint Camille Medical Centre in Ouagadougou,Burkina Faso

Objective:To assess the prevalence of parasitic infections among patients attending Saint Camille Medical Centre and to estimate co-parasitic infections rates.Methods:From January to December 2009,stool samples were collected from 11 728 persons,aged from five months to 72 years and suffering from gastroenteritis.After macroscopic description,the stools were examined by light microscopy to search for the presence of parasites.Results:From the 11 728 analyzed stools,6 154(52.47%) were infected with at least one parasite.Protozoan frequently encountered were:Giardia intestinalis(43.47%),Entamoeba histolytica/Entamoeba dispar(30.74%) and Trichomonas irUestinalis(21.72%),while Hymenolepis nana(2.25%) was the most common helminth.Co-infections occurred in 22.34%cases.Within the multi-infected samples,dual and triple infections accounted for 71.18%and 20.00%,respectively.Giardia irUestinalis for protozoan and Hymenolepis nana for helminths were the most implicated co-infections.Conclusions: This study confirms that intestinal parasites are still a public health problem in Burkina Faso.To reduce the incidence of parasitic infections,it is necessary to promote the education of people so that they practice the rules of individual and collective hygiene.

Phytochemical and antioxidant activities of Rumex crispus L. in treatment of gastrointestinal helminths in Eastern Cape Province, South Africa

Objective: To evaluate the antioxidant activities and phytochemical content of the leaf and root extracts of Rumex crispus using the solvents extraction; methanol extract,ethanol extract, acetone extract(ACE), and water extract.Methods: Total flavonoids content, total phenolic content, and total proanthocyanidin were evaluated using spectrophotometric equivalents of the standards, quercetin, gallic acid and catechin respectively. The antioxidant activities of the plant extracts were determined using ABTS, DPPH, ferric reducing antioxidant power, total antioxidant capacity and nitric oxide scavenging assays.Results: The flavonoids and phenols contents of the extracts were in the range of(19.39 ± 4.08) to(526.23 ± 17.52) mg QE/g and(16.95 ± 12.03) to(240.68 ± 3.50) mg GAE/g, respectively. ACE of the leaf has the highest value of total flavonoids content(526.23 ± 17.52) mg QE/g while ACE of the root has the highest value of total phenolic content(240.68 ± 3.50) mg GAE/g. The highest content of total proanthocyanidin(645.38 ± 1.33) mg CE/g was in ACE of the root. Significant amounts of saponin and alkaloid were also present in the root and leaf extracts. All solvent fractions showed significant antioxidant activities(P < 0.05) with ACE of the root having the highest scavenging value as shown in DPPH, ABTS, total antioxidant capacity, nitric oxide and ferric reducing antioxidant power(IC50= 0.014 mg/m L, <0.005 mg/m L, 0.048 mg/m L,0.067 mg/m L, and 0.075 mg/m L, respectively).Conclusions: In this study, the mean phytochemical content of the root of Rumex crispus is higher than that of the leaf and this may have contributed to its high antioxidant activities. This may also justify the frequent use of the root more than the leaves in traditional medicine for the cure of helminthic infections.

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

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 December2005.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 Axaris 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.

Strongyloidiasis:A case with acute pancreatitis and a literature review

Strongyloides stercoralis,a soil transmitted helminth infection,affects millions with varying prevalence worldwide.A large number of affected hosts are asymptomatic.Symptoms pertaining to pulmonary and gastrointestinal involvement may be present.Manifestations of involvement beyond lung and intestine can be seen with dissemination of infection and lethal hyperinfection.Immunosuppression secondary to use of steroids or other immunosuppressants and coexistence of human T-lymphotropic virus type-1 are the known risk factors for dissemination and hyperinfection.Diagnostic modalities comprise stool examination,serology and molecular testing.Stool tests are inexpensive but are limited by low sensitivity,whereas serologic and molecular tests are more precise but at the expense of higher cost.Treatment with Ivermectin or Albendazole as an alternative is safe and efficacious.We present a rare case of acute pancreatitis secondary to Strongyloides.High index of suspicion in patients specifically from endemic countries of origin and lack of other common etiologies of acute pancreatitis may help in early diagnosis and prompt treatment of this potentially fatal infection.

Malaria helminth co-infections and their contribution for aneamia in febrile patients attending Azzezo health center,Gondar,Northwest Ethiopia:a cross sectional study

Objective:To assess the prevalence of malaria helminth co-infections and their contribution for aneamia in febrile patients attending Azzezo health center,Gondar,Northwest Ethiopia. Methods:A cross section study was conducted among febrile patients attending Azezo health center from February-March 30,2011.Convenient sampling technique was used to select 384 individuals.Both capillary blood and stool were collected.Giemsa stained thick and thin blood film were prepared for identification of Plasmodium species and stool sample was examined by direct wet mount and formalin-ether concentration technique for detection of intestinal helminthes parasites.Haemoglobin concentration was determined using a portable haemoglobin spectrophotometer,Hemocue Hb 201 analyzer.Results:Out of 384 febrile patients examined for malaria parasites,44(11.5%) individuals were positive for malaria parasites,of which Plasmodium vivax accounted for 75.0%(33),Plasmodium falciparum for 20.5%(9| infectious,whereas two person (4.5%) had mixed species infection.Prevalence of malaria was higher in males(28) when compared with prevalence in females(16).More than half(207,53.9%) of study participants had one or more infection.Prevalence was slightly higher in females(109,52.7%) than in males(98,47.3%).About helminths,Ascaris lumbricoides was the predominant isolate(62.1%) followed by hookworms(18.4%). Only 22 participants were co-infected with malaria parasite and helminths and co-infection with Ascaris lumbricoides was predominant(45.0%).The prevalence of anemia was 10.9%and co-infection with Plasmodium and helminth parasites was significantly associated with(P【0.000 1) higher aneamia prevalence compared to individuals without any infection.Conclusions: Prevalence of malaria and soil transmitted helminths is high and the disease is still major health problem in the study area.Hence,simultaneous combat against the two parasitic infections is very crucial to improve health of the affected communities in economically developing countries.