Prevalence of Soil-Transmitted Helminths and Intestinal Protozoa among School Children in Lome, Togo

Background: Significant morbidity in children is associated with infectious diseases especially soil-transmitted helminth (STH) infections which are prevalent in sub-Saharan African countries. The objective of this study is to estimate the prevalence of STH and intestinal protozoa among schoolchildren in Lomé, Togo. Patients and Methods: In November 2013, in each of the five districts of the Lomé-commune region, thirty pupils per level of the third, fourth, fifth and sixth grades of five primary schools were included. Each child submitted a single stool sample that was analyzed by the Kato-Katz method for STH. In addition, stool samples of school children selected in third and sixth grades were examined by direct visualization using saline and Lugol’s stain for intestinal protozoa. Results: A total of 2944 children were enrolled at 25 schools. The overall prevalence of STH at schools was 5.0% (range 1.5% to 8.6%), was higher in boys than girls, and increased with age and grade. Hookworm was the most prevalent species (3.4% of children surveyed). Intestinal protozoa were found in 52.2% (765/1465) of children tested and commensal amoebae represented 22.7% of these protozoa identified. Entamoeba histolytica/dispar/moshkovskii and Giardia intestinalis were identified in 2.3% and 11.5% of children, respectively. Co-infestation was noted in 1.35% of children with intestinal helminths and 12.2% of children with protozoa. Conclusion: Although a high prevalence of intestinal protozoa was found in our study, the majority were non-pathogenic protozoa and the low prevalence of STH among school-age children in Lomé-commune region confirms that mass drug administration (MDA) is not needed. Children should receive additional education on best hygiene practices.

Co-parasitism of intestinal protozoa and Schistosoma japonicum in a rural community in the Philippines

Background:Co-parasitism is a frequent occurrence in impoverished communities in the tropics resulting in a considerable disease burden.While there are extensive reports of intestinal helminthiases,including schistosomiasis japonica,the occurrence and extent of diseases caused by intestinal protozoa(IP)have yet to be investigated in depth in the Philippines.We present a detailed analysis of polyparasitism in a rural community of Northern Samar,focusing on co-infections of IP with Schistosoma japonicum.Methods:A descriptive cross sectional study was carried out in 2015 across 18 barangays(villages)endemic for S.japonicum in Northern Samar,the Philippines to assess the burden of human schistosomiasis and IP infections.Faecal samples collected from 412 participants from the 18 barangays were included in the final molecular analysis.A multiplex quantitative PCR assay was developed and used for the detection of Blastocystis spp.,Entamoeba histolytica,Cryptosporidium spp.and Giardia duodenalis in stool samples.The findings were combined with previous results of droplet digital PCR diagnosis of individuals from the same 18 barangays infected with S.japonicum determined using the same stool samples for analysis.Results:Mean age of the study participants was 40.3 years(95%CI:38.8-41.8)with 53%(n=218)being males.Prevalence of S.japonicum(74.5%)and Blastocystis spp.(58.7%)was significantly higher compared to other infections,with E.histolytica having the lowest prevalence(12.1%).A majority of individuals were infected with more than one parasite with two infections being most common(n=175,42.5%).The prevalence of individuals with two parasites was significantly higher than all others with 27.9%(n=115)subjects harbouring a single parasite species.Of individuals with two infections,S.japonicum and Blastocystis spp.were the most common combination(n=110,62.9%).Examining age within the population,58.5%(n=38)of school-aged children and 60.1%(n=14)of women of child bearing age harboured at least two parasite species.Conclusions:The study revealed that polyparasitism with IP infections and schistosomiasis japonica is highly prevalent in individuals in Northern Samar which likely contributes to the significant public health and socio-economic burden suffered by this population.More generally,the findings are of relevance when considering implementation of integrated control strategies for intestinal parasites.

Impact of co-infections with enteric pathogens on children suffering from acute diarrhea in southwest China

Background:Acute diarrhea is a global health problem,resulting in high morbidity and mortality in children.It has been suggested that enteric pathogen co-infections play an important role in gastroenteritis,but most research efforts have only focused on a small range of species belonging to a few pathogen groups.This study aimed to assess the impact of co-infections with a broad range of enteric pathogens on children aged below five years who suffer from acute diarrhea in southwest China.Method:A total of 1020 subjects(850 diarrhea cases and 170 healthy controls)were selected from four sentinel hospitals in Kunming,Yunnan province,southwest China,from June 2014 to July 2015.Stool specimens were collected to detect five virus(rotavirus group A,RVA;norovirus,NoV;Sapovirus,SaV;astrovirus,As;and adenovirus,Ad),seven bacterial(diarrheagenic Escherichia coli,DEC;non-typhoidal Salmonella,NTS;Shigella spp.;Vibrio cholera;Vibrio parahaemolyticus;Aeromonas spp.;and Plesiomonas spp.),and three protozoan(Cryptosporidium spp.,Giardia lamblia,and Blastocystis hominis,B.hominis)species using standard microbiologic and molecular methods.Data were analyzed using the partial least square regression technique and chi-square test.Results:At least one enteric pathogen was detected in 46.7%(n=397)of acute gastroenteritis cases and 13.5%(n=23)of healthy controls(χ^(2)=64.4,P<0.05).Single infection with RVA was associated with acute diarrhea(26.5%vs.5.8%,P<0.05).The prevalence of a single infection with B.hominis in diarrhea cases was higher than in healthy controls(3.1%vs.0.5%,OR=4.7,95%CI:1.01–112.0).Single infection with NoV GII was not associated with diarrhea(4.4%vs.3.5%,OR=1.2,95%CI:0.5–3.3).Single infections with bacterial species were not observed.The prevalence of co-infections with two enteric pathogens in diarrhea cases was higher than in asymptomatic children(20.1%vs.5.3%,P<0.05).RVA-NoV GII was the most common co-infection in symptomatic children(4.4%),with it aggravating the severity of diarrhea.Conclusions:Although it is clear that RVA has an overwhelming impact on diarrhea illnesses in children,co-infection with other enteric pathogens appears to also aggravate diarrhea severity.These findings should serve as evidence for public health services when planning and developing intervention programs.