Current Status of Soil-transmitted Nematode Infection in China

Objective To carry out national surveys for ascertaining the current status and trends of soil-transmitted nematode infections in China, providing scientific basis for further developing control strategies. Methods In 1988-1992 （hereinafter abbreriated as ＂survey in 1990＂）, a stratified cluster random sampling method was used in the survey. In 2001-2004 （hereinafter abbreriated as ＂survey in 2003＂）, in order to compare with the survey in 1990, two-characteristic stratified cluster random sampling method was used and 687 investigation spots were sampled from the 2848 spots selected in the survey in 1990. Kato-Katz thick smear method was used to examine the eggs of soil-transmitted nematodes in fecal samples. Results The prevalence rates were 53.6% and 19.6% for soil-transmitted nematodes, 14.6% and 6.120% for hookworms, 44.6% and 12.7% for Ascaris lumbricoides, 17.4% and 4.630% for Trichuris trichiura in survey 1990 and survey 2003, respectively. The prevalence rates of soil-transmitted nematodes were higher in 13 provinces than the average level in China in the survey in 1990, and higher in 8 provinces than the average level in the survey in 2003. The prevalence of hookworms, Ascaris lumbricoides, Trichuris trichiura and the overall prevalence of soil-transmitted nematodes were higher in females than in males. It is estimated from the results of survey in 2003 that the number of persons with soil-transmitted nematode infections in the country is about 129 million, less than that in the survey in 1990. Conclusion The prevalence of soil-transmitted nematodes has declined considerably but is still relatively high in some provinces and autonomous regions. Control activities and socioeconomic development may have contributed to the decreased prevalence.

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.

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.

Soil-transmitted helminths detected from environmental samples in a campus of southern Brazil

Soil harbours enormous biodiversity,essential for maintaining environmental and human health.However,soil can also be a reservoir of various parasitic pathogens,such as soil-transmitted helminths(STH).We evaluated the presence of STH(e.g.,hookworms,roundworms and whipworms)in soil samples collected at twenty points within the perimeter of Campus do Vale(a university campus belonging to the Federal University of Rio Grande do Sul-UFRGS),during 2022 winter season.Considering the One Health perspective,human,animal and environmentrelated data from each sampling point were collected.All soil samples showed nematode larvae,representing natural components of soil biodiversity.Considering STH eggs,35%(n=7)of soil samples showed hookworm eggs(e.g.,from Necator americanus or Ancylostoma duodenale),10%(n=2)showed roundworm(Ascaris lumbricoides)eggs,and 5%(n=1)showed whipworm(Trichuris trichiura-like)eggs.Of note,10%of the sampling points showed the presence of rhabditiform hookworm larvae,5%showed Strongyloides stercoralis rhabditiform larvae and 5%had the presence of filariform hookworm larvae,indicating a risk of human percutaneous infection.The significant people circulation in Campus do Vale,in association with other environment-related factors,help to explain the prevalence of STH observed in this study.

Prevalence of soil-transmitted helminths infections among preschool and school-age children in Ethiopia:a systematic review and meta-analysis

Background:There is a lack of comprehensive national data on prevalence,geographical distribution of different species,and temporal trends in soil-helminthiasis(STHs).Therefore,this study aimed to provide a summary and location of the available data on STHs infection among preschool and school-age children in Ethiopia.Methods:The search was carried out in Medline via PubMed,Scopus,Science Direct,Web of Science,and Google Scholar on data published between 1997 to February 2020 for studies describing the rate of STHs infection among preschool and school-age in Ethiopian.We followed the Patient,Intervention,Comparison,and Outcome(PICO)approach to identify the studies.Meta-regression was performed to understand the trends and to summarize the prevalence using the“metaprop”command using STATA software version 14.0 Results:A total of 29,311 of the 61,690 children examined during the period under review were infected with one or more species of intestinal parasites yielding an overall prevalence of 48%(95%CI:43-53%).The overall pooled estimate of STHs was 33%(95%CI:28-38%).The prevalence was 44%(95%CI:31-58%)in SNNPR,34%(95%CI:28-41%)in Amhara region,31%(95%CI:19-43%)in Oromia region and 10%(95%CI:7-12%)in Tigray region.Soil-transmitted helminths infection rate has been decreasing from 44%(95%CI:30-57%)pre-Mass Drug Administration(MDA)era(1997-2012)to 30%(95%CI:25-34%)post-MDA(2013-2020),although statistically not significant(p=0.45).A lumbricoides was the predominant species with a prevalence of 17%.Conclusion:Southern Nations Nationalities and Peoples Region,Amhara,and Oromia regions carry the highest-burden and are categorized to Moderate Risk Zones(MRZ)and therefore,requiring MDA once annually with Albendazole or Mebendazole.The prevalence of STHs decreased after MDA compared to before MDA,but the decline was not statistically significant.A.lumbricoides was the predominant species of STHs among preschool and school-age children in Ethiopia.The high prevalence of STHs observed in this review,underscores the need for better control and prevention strategies in Ethiopia.

Policy stakeholder perspectives on barriers and facilitators to launching a community-wide mass drug administration program for soil-transmitted helminths

Background:Recent evidence suggests that soil-transmitted helminth(STH)transmission interruption may be feasible through community-wide mass drug administration(cMDA)that deworms community members of all ages.A change from school-based deworming to cMDA will require reconfiguring of STH programs in endemic countries.We conducted formative qualitative research in Benin,India,and Malawi to identify barriers and facilitators to successfully launching a cMDA program from the policy-stakeholder perspective.Methods:We conducted 40 key informant interviews with policy stakeholders identified as critical change agents at national,state/district,and sub-district levels.Participants included World Health Organization country office staff,implementing partners,and national and sub-national government officials.We used the Consolidated Framework for Implementation Research to guide data collection,coding,and analysis.Heat maps were used to organize coded data and differentiate perceived facilitators and barriers to launching cMDA by stakeholder.Results:Key facilitators to launching a cMDA program included availability of high-quality,tailored sensitization materials,and human and material resources that could be leveraged from previous MDA campaigns.Key barriers included the potential to overburden existing health workers,uncertainty of external funding to sustain a cMDA program,and concerns about weak intragovernmental coordination to implement cMDA.Cross-cutting themes included the need for rigorous trial evidence on STH transmission interruption to gain confidence in cMDA,and implemen-tation evidence to effectively operationalize cMDA.Importantly,if policy stakeholders anticipate a cMDA program cannot be sustained due to cost and human resource barriers in the long term they may be less likely to support the launch of a program in the short term.Conclusions:Overall,policy stakeholders were optimistic about implementing cMDA primarily because they believe that the tools necessary to successfully implement cMDA are already available.Policy stakeholders in this study were cautiously optimistic about launching cMDA to achieve STH transmission interruption and believe that it is feasible to implement.However,launching cMDA as an alternative policy to school-based deworming will require addressing key resource and evidence barriers.

Effectiveness of ivermectin mass drug administration in the control of soil-transmitted helminth infections in endemic populations: a systematic review and meta-analysis

Background Current soil-transmitted helminth(STH)control guidelines endorse the use of albendazole or meben-dazole for school-based targeted preventive chemotherapy(PC),yet their reduced efficacy against Strongyloides sterc-oralis and Trichuris trichiura presents significant limitations.Emerging evidence indicates that community-wide PC[or mass drug administration(MDA)]using ivermectin,commonly used in other neglected tropical disease(NTD)control programs,may play an important role in controlling these parasites.We conducted a systematic review and meta-analysis to evaluate the effectiveness of ivermectin PC in reducing STH prevalence in endemic populations.Methods We searched Pubmed,EMBASE,and Web of Science on February 14,2023,for studies that investigated the effectiveness of ivermectin PC,either alone or in combination with other anthelmintic drugs,on STH infec-tions,and provided a measure of STH prevalence before and after PC.We calculated pooled prevalence reductions for each STH using random-effects meta-analyses.Our protocol is available on PROSPERO(registration number CRD42023401219).Results A total of 21 were eligible for the systematic review,of which 15 were eligible for meta-analysis.All studies delivered ivermectin through MDA.The pooled prevalence reduction of S.stercoralis following MDA with ivermec-tin alone was 84.49%(95%CI:54.96-94.66)across five studies and 81.37%(95% CI:61.62-90.96)across seven studies with or without albendazole.The prevalence reduction of T.trichiura was 49.93%(95%CI:18.23-69.34)across five studies with ivermectin alone,and 89.40%(95%CI:73.66-95.73)across three studies with the addition of albendazole.There was high heterogeneity for all syntheses(I^(2)>65%).Conclusions This study underscores the key role of ivermectin-based MDA in addressing limitations in current global STH guidelines in terms of limited efficacy against S.stercoralis and T.trichiura.Based on these findings,revising inter-national STH guidelines to include ivermectin is a promising option to progress the control and eventual elimination ofSTHsandotherNTDs.

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.

2009年安徽省土源性线虫监测数据分析

目的了解我省土源性线虫病的流行状况及影响因素。方法根据《全国土源性线虫病监测方案操作手册》的要求，对全省的3个监测点实施监测和调查。结果全省土源性线虫感染率为4．0％。钩虫是我省主要流行的土源性线虫，其感染人数占总感染人数的95．1％。男性感染率高于女性。除40-50岁年龄组外，其余各年龄组呈现感染率随年龄增加而升高的趋势。土源性线虫以轻度感染为主，农民和从事家务活动者是感染的高危人群。土壤蛔虫卵检出率为333％．其中受精活蛔虫卵占50％。结论我省土源性线虫感染率较往年有大幅度下降．

低温对中国河南株旋毛虫肌幼虫生存能力和感染力的影响

目的:了解低温(-18℃、-72℃)冻存对中国河南株旋毛虫肌幼虫(肌幼虫)生存能力和感染力的影响。方法:将含有肌幼虫的小鼠骨骼肌肌肉经-18℃、-72℃冻存处理不同时间后观察肌幼虫活力;55只小鼠分别经口感染300条经过-18℃、-72℃处理不同时间的肌幼虫,感染小鼠35 d后收集肌幼虫,测定生殖力指数(RCI)。结果:肌幼虫经-18℃冻存0、6、12、24、36、48 h的死亡率分别为0.00%、6.30%、18.23%、35.81%、74.60%及100.00%;经-72℃冻存0、15、30、45、60 min的死亡率分别为0.00%、21.21%、57.11%、86.24%及100.00%;肌幼虫死亡率随-18℃、-72℃冻存处理时间的延长而升高(P<0.01)。经过-18℃冻存处理6、12、24、36 h后感染小鼠的肌幼虫RCI分别为(126.38±6.90)、(68.58±4.83)、(12.58±1.77)、(5.77±0.77),与未冻存(0 h)组肌幼虫的RCI(163.70±10.70)差异均有统计学意义(P<0.01);通过-72℃冻存处理15、30、45 min后感染小鼠的RCI分别为(18.19±2.15)、(8.83±1.39)、(3.10±0.26),与未冻存(0 min)组肌幼虫的RCI(163.70±10.70)差异均有统计学意义(P<0.01);肌幼虫的RCI均随-18℃、-72℃冻存处理时间延长而下降(P<0.01)。结论:低温冻存可导致中国河南株肌幼虫存活能力和感染能力下降,-18℃冻存48 h或-72℃冻存60 min可完全灭活小鼠肌肉内的中国河南株肌幼虫。

热带地区土源性线虫病感染连续化疗后的疗效观察

本文选用噻嘧啶、阿苯达唑、甲苯达唑和左旋咪唑等驱虫药物，在热带地区的海南省琼海市朝烈村委会现场，采用改良加藤涂片法和试管滤纸培养法对居民普查粪检，两年连续6次化疗驱虫普治（第1年4次，第2年2次），对钩虫、蛔虫、鞭虫等土源性线虫病感染者观察疗效。结果钩虫和蛔虫感染者的疗效甚佳，钩虫的虫卵阴转率高达96．4％，残存的5例美洲钩虫感染者，克粪虫卵数大幅度减少，均在300个以内，蛔虫的虫卵阴转率高达99．3％，克粪虫卵数为24个；其疗效与选用驱虫药物和安排服药间隔时间有关。鞭虫感染者的疗效不甚理想，虫卵阴转率仅63．3％，可能与选用的几种驱虫药，只有甲苯达唑对鞭虫感染者有一定疗效，而本文的各个疗程的剂量都均偏低有关。

The control of soil-transmitted helminthiases in the Philippines: the story continues

Background:Soil-transmitted helminth(STH)infections have long been an important public health concern in the Philippines.In this review,we describe the current status of STH infections there and highlight the control efforts undertaken to reduce STH burden.Main text:A nationwide STH mass drug administration(MDA)programme was started in 2006 but the overall STH prevalence remains stubbornly high across the Philippines,rangi ng from 24.9%to 97.4%.

Capacity gaps in health facilities for case management of intestinal schistosomiasis and soil-transmitted helminthiasis in Burundi

Background:Schistosomiasis and soil-transmitted helminthiasis(STH)are endemic diseases in Burundi.STH control is integrated into health facilities(HF)across the country,but schistosomiasis control is not.The present study aimed to assess the capacity of HF for integrating intestinal schistosomiasis case management into their routine activities.In addition,the current capacity for HF-based STH case management was evaluated.Methods:A random cluster survey was carried out in July 2014,in 65 HF located in Schistosoma mansoni and STH endemic areas.Data were collected by semi-quantitative questionnaires.Staff with different functions at the HF were interviewed(managers,care providers,heads of laboratory and pharmacy and data clerks).Data pertaining to knowledge of intestinal schistosomiasis and STH symptoms,human and material resources and availability and costs of diagnostic tests and treatment were collected.Findings:Less than half of the 65 care providers mentioned one or more major symptoms of intestinal schistosomiasis(abdominal pain 43.1%,bloody diarrhoea 13.9%and bloody stool 7.7%).Few staff members(15.7%)received higher education,and less than 10%were trained in-job on intestinal schistosomiasis case management.Clinical guidelines and laboratory protocols for intestinal schistosomiasis diagnosis and treatment were available in one third of the HF.Diagnosis was performed by direct smear only.Praziquantel was not available in any of the HF.The results for STH were similar,except that major symptoms were more known and cited(abdominal pain 69.2%and diarrhoea 60%).Clinical guidelines were available in 61.5%of HF,and albendazole or mebendazole was available in all HF.Conclusions:The current capacity of HF for intestinal schistosomiasis and STH detection and management is inadequate.Treatment was not available for schistosomiasis.These issues need to be addressed to create an enabling environment for successful integration of intestinal schistosomiasis and STH case management into HF routine activities in Burundi for better control of these diseases.

Prevalence and risk factors of schistosomiasis and soil-transmitted helminthiases among preschool aged children (1-5 years) in rural KwaZulu-Natal, South Africa: a cross-sectional study

Background:Despite efforts to control neglected tropical diseases(NTDs),schistosomiasis and soil-transmitted helminthiases remain widely prevalent in sub-Saharan Africa.Recent data suggest that these infections are prevalent among preschool aged children(PSAC)in poor communities.Evidence of schistosomiasis and soil-transmitted helminths(STH)infection patterns and prevalence among PSAC is essential for effective treatment and control programmes.The aim of the study was to determine the prevalence,intensity and risk factors of schistosomiasis and STH infection among PSAC in the Ingwavuma area of uMkhanyakude District,South Africa.Methods:A cross-seaional study was conducted among 1143 PSAC aged 1-5 years in 34 preschools and early childhood development(ECD)centres.Data on risk factors was collected using a semi-struaured questionnaire.A Kruskal-Wallis test was used to compare the differences in infection intensity with age.Pearson Chi-square test and multivariate logistic regression were performed to assess the association between PSAC infection status,sociodemographic,household,water and sanitation variables and hygiene practices of PSAC and their caregivers.Results:We observed a low prevalence o f Schistosom a haem atobium(1.0%)and 5.m ansoni(0.9%).The prevalence of Ascaris lum bricoides(18.3%)was high compared to Trichuris trichiuro(1.2%),hookworms(1.6%)and Taenio(6.4%).The odds of schistosome infection were lowest among PSAC under younger(15-24 years)caregivers(0.1,95%CI:0.02-0.54)and those who used tap water(0.3,95%Cl:0.09-0.78)for domestic purposes.Schistosome infection was however higher among PSAC who bathed in river water(17.4,95%CI:5.96-51.04).STH infection on the other hand was lowest among PSAC who did not play in soil(0.1,95%CI:0.51-0.28),were from households that used tap water for domestic purposes(0.5,95%CI:0.27-0.80)and PSAC under the care of younger(25-35 years)caregivers(0.3,95%Cl:0.10-0.75).The risk of STH infeaion was highest among PSAC who did not wash their hands with soap(3.5,95%CI:1.04-11.67)and PSAC whose nails were not trimmed(3.6,95%CI:1.75-7.26).Conclusions:The findings show low prevalence and infection intensity of schistosomiasis and STH infection except A lum bricoides among PSAC.Factors predicting schistosomiasis and STH infection among PSAC were related to caregivers'age,educational status,water and hygiene practices.STH infection was exclusively associated with PSAC playing and handwashing habits.These findings highlight the need to include PSAC caregivers in schistosomiasis and STH prevention and control programmes.

Schistosomiasis and soil-transmitted helminthiasis in Rwanda:an update on their epidemiology and control

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.

Prevalence and distribution of soil-transmitted helminth infections in Nigerian children:a systematic review and meta-analysis

Background:Soil transmitted helminth(STH)infections still remain a notable health problem in resource-limited countries due to difficulties in the implementation of control measures.In Nigeria for instance,despite several community-based and provincial reports,national data on prevalence,burdens and risk zones(RZs)for STH infections are lacking.Methods:The present study employed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)to determine the prevalence,distribution and RZs for STH infections among Nigerian children through a meta-analysis of data published between 1980 and 2015.Pooled prevalence estimate(PPE)was determined by the random-effects model while heterogeneity was evaluated using the Cochran’s Q-test.Results:A total of 18901 of the 34518 Nigerian children aged 0-17 years examined across 19 Nigerian states during the period under review were infected with one or more species of STHs.The overall PPE for STH infections was 54.8%(95%CI:54.2-55.3).PPEs for sub-groups ranged between 13.2%(95%CI:11.5-15.1)and 80.9%(95%CI:80.0-81.7).Highest PPEs for STH infections were observed among children within community settings(59.0%,95%CI:57.7-60.4)and school-aged children(54.9%,95%CI:54.3-55.5).Ascaris lumbricoides was the most prevalent species(44.6%,95%CI:44.0-45.2).Over 36%(15/41)of the studies were published from south-western Nigeria.South-western region was the only high risk zone(HRZ)for STH infections while the rest of the regions were low risk zones(LRZs).Conclusions:STH infections involving Ascaris lumbricoides,Strongyloides stercoralis,Trichuris trichiura and hookworms are highly prevalent across Nigeria.Strategic use of anthelmintics,health education and adequate sanitation,taking into account this epidemiologic information will help in the control of these infections in Nigeria.

Burden and factors associated with schistosomiasis and soil-transmitted helminth infections among school-age children in Huambo,Uige and Zaire provinces,Angola

Background:Schistosomiasis and soil-transmitted helminths(STHs)contribute high disease burdens amongst the neglected tropical diseases(NTDs)and are public health problems in Angola.This study reports the prevalence,intensity and risk factors for schistosomiasis and STH infection in Huambo,Uige and Zaire provinces,Angola,to inform a school-based preventive chemotherapy program.Methods:A two-stage cluster design was used to select schools and schoolchildren to participate in parasitological and water,sanitation and hygiene(WASH)surveys across Huambo,Uige,and Zaire provinces.Point-of-care circulating cathodic antigen and urinalysis rapid diagnostic tests(RDTs)were used to determine the prevalence of Schistosoma mansoni and S.haematobium,respectively.Kato-Katz was used to identify and quantify STH species and quantify and compare with RDTs for S.mansoni.Urine filtration was used to quantify and compare with RDTs for S.haematobium.Descriptive statistics were used for prevalence and infection intensity of schistosomiasis and STH infection.Performance of RDTs was assessed through specificity and Cohen’s Kappa agreement with microscopy.A multivariate regression analysis was used to determine demographic and WASH factors associated with schistosomiasis and STH infection.Results:A total 575 schools and 17,093 schoolchildren participated in the schistosomiasis survey,of which 121 schools and 3649 schoolchildren participated in the STH survey.Overall prevalence of S.mansoni was 21.2%(municipality range 0.9–74.8%)and S.haematobium 13.6%(range 0–31.2%),with an overall prevalence of schistosomiasis of 31.4%(range 5.9–77.3%).Overall prevalence of Ascaris lumbricoides was 25.1%(range 0–89.7%),hookworm 5.2%(range 0–42.6%),and Trichuris trichiura 3.6%(range 0–24.2%),with an overall prevalence of STH infection of 29.5%(range 0.8–89.7%).Ecological zone and ethnicity were factors associated with schistosomiasis and STH infection,with older age and female sex additional risk factors for S.haematobium.Conclusions:Most municipalities met World Health Organization defined prevalence thresholds for a schistosomiasis preventive chemotherapy program.A STH preventive chemotherapy program is indicated for nearly all municipalities in Uige and select municipalities in Huambo and Zaire.The association between ecological zone and ethnicity with schistosomiasis and STH infection necessitates further evaluation of home and school environmental,sociodemographic and behavioural factors to inform targeted control strategies to complement preventive chemotherapy programs.

白枕鹤旋形华首线虫病的诊断

2004年7月,无锡市锡惠公园动物园一只圈养白枕鹤患病,根据临床症状,剖检变化,并结合实验室诊断,确诊该白枕鹤患有旋形华首线虫病。

Multi-intervention integrated deworming strategy for sustained control of soil-transmitted helminths infections: a case study in Jiangsu Province, China

Background:Soil-transmitted helminths(STH)infections still present a global health problem.Mass drug adminis‑tration(MDA)is a widely applied strategy to reduce morbidity and mortality caused by STH.Yet,this approach has some shortcomings.In this study,we analyzed the impact of a multi-intervention integrated deworming approach including MDA,health education(HE),and environmental sanitation improvements(ESI)for sustained STH control in Jiangsu Province of China that was applied from 1989 to 2019.Methods:Data,including infection rate of STH,medications used,coverage of the medication,non-hazardous lavatory rate,and household piped-water access rate in rural areas,and actions related to HE and ESI were collected(from archives)and analyzed in this retrospective descriptive study.Pearson’s correlation analysis was applied to test correlations.Results:There was a dramatic decline in the infection rate of STH from 1989(59.32%)to 2019(0.12%).From 1995 to 1999,MDA and HE were recommended in rural areas.A negative correlation was observed between infection rate and medication from 1994 to 1998(r=-0.882,P=0.048).From 2000 to 2005,targeted MDA was given to high-risk populations with HE continuously promoting good sanitation behaviors.From 2006 to 2014,targeted MDA+HE and ESI were used to consolidate the control efect.ESI was strengthened from 2006,and a negative correlation was observed between the coverage rate of the non-hazardous lavatory and the infection rate from 2006 to 2019(r=-0.95,P<0.001).The targeted MDA was interrupted in 2015,while continuous eforts like HE and ESI contributed in sustaining STH control.Conclusions:Multi-intervention integrated deworming strategy contributes to the reduction of STH infections.This approach is a valuable example of how diferent interventions can be integrated to promote durable STH control.

High infection rates for onchocerciasis and soil-transmitted helminthiasis in children under fve not receiving preventive chemotherapy:a bottleneck to elimination

Background:The current mainstay for control/elimination of onchocerciasis and soil-transmitted helminthiasis(STH)relies on ivermectin-and mebendazole/albendazole-based preventive chemotherapies.However,children under fve years of age have been excluded in both research activities and control programs,because they were believed to have insignifcant infection rates.There is therefore a need for up-to-date knowledge on the prevalence and inten‑sity of STH and onchocerciasis infections in this age group.This study aimed at assessing the rates and intensities of onchocerciasis and STH infections in children under fve years of age who are excluded from ivermectin-or mebenda‑zole/albendazole-based preventive chemotherapies.Methods:A series of cross-sectional surveys was conducted in four Health Districts in the Centre and Littoral Regions of Cameroon between 2018 and 2019.All subjects aged 2 to 4 years,were screened for prevalence(or infection rate)and intensity[number of eggs per gram of stool(epg)or number of microflariae per skin snip(mf/ss)]of STH and onchocerciasis infections respectively using the Kato-Katz and skin snip methodologies.Chi-square and the nonparametric tests(Mann Whitney and Kruskal Wallis)were used to compare infection rates and intensities of infections between Health Districts and genders,respectively.Results:A total of 421 children were enrolled in this study.The overall prevalence of onchocerciasis was 6.6%[95% confdence interval(CI):4.3‒9.9],ranging from 3.6%(in the Ntui Health District)to 12.2%(in the Bafa Health District).The intensity of infection ranged from 0.5 to 46 microflariae per skin snip[median:5;interquartile range(IQR):2.25‒8.5].The overall prevalence of STH was 9.6%(95%CI:6.5‒13.9),with a high infection rate(29.6%)in the Akonolinga Health District.Two STH species(Ascaris lumbricoides and Trichuris trichiura)were found among infected individuals.The median intensities of STH infections were 1,992 epg(IQR:210‒28,704)and 96 epg(IQR:48‒168)for A.lumbricoides and T.trichiura,respectively.Conclusions:This study reveals that children<5 years of age are highly infected with STH and onchocerciasis,and could contribute to the spread of these diseases,perpetuating a vicious circle of transmission and hampering elimi‑nation eforts.These fndings reveal the urgent need to provide(or scale)treatments(likely pediatric formulations)to these preschool-aged children,especially in areas of high transmission,to accelerate eforts to reach WHO 2030 target.