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Genetic influences on plasma cytokine variation in a parasitized population.

The soil-transmitted helminths are the most common helminthic infections, affecting about one-fourth of the world's population. There is a significant genetic component to susceptibility to infection with these organisms. Substantial changes in plasma cytokine levels are associated with helminthic infections, and there may be significant genetic components to this cytokine variation. Six plasma cytokine levels were assessed for 367 members of a single pedigree from the Jirel population of eastern Nepal. This population experiences moderate rates of infection with geohelminths. Sex, age, helminthic infection, infection with Giardia, and presence of a household latrine were considered as covariates in all analyses of the cytokine data. The analyses of the single Jirel pedigree revealed significant heritabilities for IFN-gamma (h2 = 0.654+/-0.096), TNF-alpha (h2 = 0.458+/-0.101), IL-2 (h2 = 0.583+/-0.101), IL-4 (h2 = 0.700+/-0.095), IL-5 (h2 = 0.676+/-0.087), and IL-10 (h2 = 0.597+/-0.093). The ratios of IL-4 to IFN-gamma and of IL-10 to IFN-gamma were used as indicators of the degree of type 2 bias in immunological response; analyses of these variables indicated that approximately 40-60% of the variation (h2 = 0.400-0.577) in these derived measures of relative type 2/type 1 response is due to genetic factors.

Agriculture↗

Hygiene and restraint of pigs is associated with absence of Taenia solium cysticercosis in a rural community of Mexico.

OBJECTIVE: To determine the prevalence and risk factors associated to pig cysticercosis in a rural community of Veracruz, Mexico. MATERIAL AND METHODS: Swine cysticercosis was diagnosed by tongue palpation and circulating antibodies in pigs kept in 178 household backyards. Risk factors were assessed by interviewing owners to collect information on pig breeding conditions and demographic characteristics. RESULTS: None of the 53 pigs studied showed cysts in the tongue, nor antibodies against Taenia solium in Western blot assays. Latrines were available in 91% of the houses and pigs were kept in restrained areas. CONCLUSIONS: The present study shows that pig breeding under restraint with basic hygiene and sanitary conditions, may be effective and practical interventions to restrain Taenia solium in rural communities.

Animals↗

Control of schistosomiasis in the Gezira.

For the control of schistosomiasis in irrigated agricultural schemes, the inhabitants must have:- 1) Enough potable water. 2) Latrines. 3) Proper health education to motivate the community to participate in the control. 4) Proper diagnostic facilities. 5) Proper available chemotherapy. 6) Focal mullusciciding. 7) If possible trial of biological and environmental methods of control. Following the above methods, we could reduce the prevalence of schistosomiasis from over 50% to about 13%. The important achievement, is the improvement of the health of the community; therefore more production and reduced morbidity and mortality.

Animals↗

Prevalence and intensity of infections of Ascaris lumbricoides and Trichuris trichiura and associated socio-demographic variables in four rural Honduran communities.

Between January and March 1998, a cross-sectional survey was carried out in four rural communities in Honduras, Central America. We examined the prevalence and intensity of Ascaris lumbricoides and Trichuris trichiura infections among 240 fecal specimens, and the association between selected socio-demographic variables and infection for 62 households. The overall prevalence of A. lumbricoides and T. trichiura was 45% (95% CI 39.0-51.9) and 38% (95% CI 31.8-44.4) respectively. The most intense infections for Ascaris and Trichuris were found in children aged 2-12 years old. By univariate analysis variables associated with infections of A. lumbricoides were: number of children 2-5 years old (p=0.001), level of formal education of respondents (p=0.01), reported site of defecation of children in households (p=0.02), households with children who had a recent history of diarrhea (p=0.002), and the location of households (p=0.03). Variables associated with both A. lumbricoides and T. trichiura infection included: number of children 6-14 years old (p=0.01, p=0.04, respectively), ownership of a latrine (p=0.04, p=0.03, respectively) and coinfection with either helminth (p=0.001, p=0.001, respectively). By multivariate analysis the number of children 2-5 years living in the household, (p=0.01, odds ratio (OR)=22.2), children with a recent history of diarrhea (p=0.0, OR=39.8), and infection of household members with T. trichiura (p=0.02, OR=16.0) were associated with A. lumbricoides infection. The number of children 6-14 years old in the household was associated with both A. lumbricoides and T. trichiura infection (p=0.04, p=0.01, OR=19.2, OR=5.2, respectively).

Adolescent↗

The state of the art of paleoparasitological research in the Old World.

Paleoparasitology in the Old World has mainly concerned the study of latrine sediments and coprolites collected from mummified bodies or archaeological strata, mostly preserved by natural conditions. Human parasites recovered include cestodes, trematodes, and nematodes. The well preserved conditions of helminth eggs allowed paleoepidemiological approaches taking into account the number of eggs found by archaeological stratum. Tentatively, sanitation conditions were assessed for each archaeological period.

Animals↗

Domestic water use in a rural village in minas gerais, brazil, with an enphasis on spatial patterns, sharing of water, and factors in water use

This paper examines the relationship between domestic water use and socioeconomic, environmental, and spatial parameters at the household level in a small rural village in northern Minas Gerais State. Five methods are used - direct observation, household interviews, self-reporting by households, regression analysis, and statistical mapping. Results show that water use is characterized by 1) generally low but widely fluctuating values per person per day, 2) sharing of water sources between households, 3) the use of multiple sources by individual households, 4) avoidance of heavily contaminated stream sites, and 5) predominance of socioeconomic factors in water use. Households owning their own water supply used, on average, 25.3 liters per person/day and those without a supply 9. 0 l, with higher use of the local streams among the latter. Water use varied spatially. The socioeconomic factors house quality, latrine ownership, type of watersource, and a utility index were significantly correlated with water use. Implications of this simple household water sources and the more deficient sanitary facilities for potential water-borne disease transmission are briefly discussed and suggestions made for further improvements. This study confirms the appropriateness of the application of direct observation, interview, and microgeographical methods for quantitative water use studies.

Journal Article↗

[Intestinal parasitosis in Mbyá-Guaraní populations from Misiones Province, Argentina: epidemiological and nutritional aspects].

Intestinal parasite infestation in indigenous Mbyá-Guaraní communities in Misiones, Argentina, was described and associated with nutritional status and environmental and cultural factors. The results were compared with those from Takuapí, a neighboring indigenous population, and the nearest urban population, Aristóbulo del Valle. The Ritchie, Willis, and Kato Katz techniques were used to analyze the stool samples. Anthropometric parameters were analyzed and earth samples processed. From a total sample of 296 individuals analyzed in the four populations, 100 (87.7%), 63 (88.7%), 49 (96.1%), and 50 (82%) were infested in Kaaguy Poty, Yvy Pytá, Takuapí, and Aristóbulo del Valle, respectively. 84% of infested individuals had multiple parasites. The 43% of the individuals presented malnutrition, and 87% of these were infested. There was an association between use of latrines and Giardia lamblia (p < 0.01); open-air defecation, lack of footwear, and hookworms (p < 0.01); and housing type and total helminthes (p < 0.01). Earth samples were contaminated with parasites. The results suggest the relationship between environmental contamination and high prevalence of intestinal parasites in these human populations.

Adolescent↗

Challenges in implementing a point-of-use water quality intervention in rural Kenya.

To prevent diarrheal diseases in western Kenya, CARE Kenya initiated the Water, Sanitation, and Education for Health (WASEH) Project in 1998. The project targets 72 farming and fishing communities with a total population of 43 000. Although the WASEH Project facilitated construction of shallow wells and pit latrines, the water quality still needed improvement. Consequently, in 2001, CARE implemented the Safe Water System (which consists of point-of-use water treatment with sodium hypochlorite, safe storage, and behavior change techniques) within the already established WASEH infrastructure, using existing community organizations in combination with a social marketing approach that introduced affordable products. The project has resulted in adoption rates of 33.5% for chemical water treatment and 18.5% for clay pots modified for safe water storage.

Behavior Therapy↗

The SAFE strategy for trachoma control: Using operational research for policy, planning and implementation.

Trachoma is a neglected disease and also the world's leading infectious cause of blindness. It causes misery, dependency and is a barrier to development. Trachoma is controlled by a WHO-endorsed integrated strategy of surgery for trichiasis, antibiotic therapy, facial cleanliness and environmental improvement, which is known by the acronym SAFE. The strategy is based on evidence from field trials and is continually being refined by operational research that informs national policy and planning; the strategy has affected both programme delivery and implementation. As a result of the findings of operational research, surgery is now frequently conducted by paramedics in communities rather than by ophthalmologists in hospitals; yearly mass distribution of a single oral dose of azithromycin has replaced the use of topical tetracycline; and the promotion of better hygiene, face-washing and the use of latrines are used to reduce transmission. Those who implement programmes have been equal partners in conducting operational research thus reducing the "know-do" gap and minimizing the lag that often exists between the completion of trials and putting their results into practice. Operational research has become a part of practice. Although there are still many questions without answers, national programme coordinators have a reasonable expectation that trachoma control programmes based on SAFE will work.

Anti-Bacterial Agents↗

Child health in arid areas of Ethiopia: longitudinal study of the morbidity in infectious diseases.

We describe the incidence of some childhood infections in drought prone areas of southern Ethiopia. Our results are based on 24 months' biweekly observations of 828 children aged 0-5 years in the pastoralist community of Dubluk and the agricultural community of Elka. An average of 23% of the children in Dubluk and 13% in Elka were sick during any 2-week period. Diarrhoeal diseases represented the main cause of morbidity, but the yearly number of diarrhoeal episodes were lower than previously reported from Ethiopia. Respiratory tract infections and to a lesser extent diarrhoeal diseases, showed highest incidence rates during the main dry season. The highest incidence of lower respiratory tract infections coincided with an outbreak of measles. In Dubluk, children who lived near to the wells had higher incidence rates than those who lived further away, probably reflecting the importance of crowding on transmission rates. In Elka, literacy of mothers was associated with reduced incidence of both diarrhoeal and respiratory tract infections, whereas the use of open pit latrines was associated with increased diarrhoeal incidence. The decline in disease incidence in this region during the last months of our study may reflect an improvement of nutritional status.

Child, Preschool↗

[Palaeoparasitological study of atypical elements of the low and High Nile Valley].

Paleoparasitology in the Old World has mainly concerned the study of latrine sediments and coprolites collected from mummified bodies or archaeological strata, mostly preserved by natural conditions. For the first time, different unusual archaeological samples were studied to look for the eggs of helminths parasites (embalming reject jar, canopic package, shroud). Now, samples of organic matter have been successfully processed in order to extract helminths eggs, following the protocol of BOUCHET 2001 (4). Helminth eggs are frequently preserved in the late Quaternary archaeological contexts because of their hard-wearing chitin shell. Six types of eggs were revealed (Schistosoma mansoni, Schistosoma haematobium, Taenia, Enterobius vermicularis, Ascaris lumbricoides and Trichuris trichiura). This study allows to enlarge the Palaeoparasitological research with material never exploited. Moreover, if we take into account identified parasite and geography, it's possible to enlarge the debate to parasite spatio-temporal migration. Considering the particular context of samples preservation, it's interesting to observe an exceptional conservation of parasitological sign related to excellent taphonomic condition (aridity anaeroby, rapid interruption of thanatomorphosis, natural "mummification").

Animals↗

Epidemiologic differences between cyclosporiasis and cryptosporidiosis in Peruvian children.

We compared the epidemiologic characteristics of cyclosporiasis and cryptosporidiosis in data from a cohort study of diarrhea in a periurban community near Lima, Peru. Children had an average of 0.20 episodes of cyclosporiasis/year and 0.22 episodes of cryptosporidiosis/year of follow-up. The incidence of cryptosporidiosis peaked at 0.42 for 1-year-old children and declined to 0.06 episodes/child-year for 5- to 9-year-old children. In contrast, the incidence of cyclosporiasis was fairly constant among 1- to 9-year-old children (0.21 to 0.28 episodes/child-year). Likelihood of diarrhea decreased significantly with each episode of cyclosporiasis; for cryptosporidiosis, this trend was not statistically significant. Both infections were more frequent during the warm season (December to May) than the cooler season (June to November). Cryptosporidiosis was more frequent in children from houses without a latrine or toilet. Cyclosporiasis was associated with ownership of domestic animals, especially birds, guinea pigs, and rabbits.

Animals↗

[Epidemiological Studies On Protozoan Infection In Gyeong-Gi Do And Jeonra Bug Do]

The present study was designed to elucidate the recent prevalence of the intestinal protozoa and to demonstrate the relationship on prevalence of the surveyed population with their academic career and living conditions. During the period from May to July 1981, total 2,735 fecal specimens were collected from the inhabitants of 11 areas in Gyeong-gi Do (province) near by Seoul City, and 6 areas in Jeonra Bug Do, southwestern part of Korea. The samples were fixed with SAF solution and were examined by formalin-ether sedimentation technique. The results are summarized as follows: Overall positive rate of intestinal protozoa was 11.1 %: Gyeong-gi Do, 10.7 %; Jeonra Bug Do, 11.7 %. Five species of intestinal protozoa were detected: Entamoeba histolytica 0.69 %, Entamoeba coli 5.52 percent, Endolimax nana 2.71 %, Giardia lamblia 2.23 %, Iodamoeba butschlii 0.l8 %. Highest positive rates among the examined areas were recognized: Incheon City of Gyeong-gi Do, 26.7 %; Im-sil Gun(county) of Jeonra Bug Do, 19.9 %. By species, E. nana showed the highest prevalence rate (13.74 %) in Incheon City, and E. histolytica (2.37 %) and E. coli (9.95 %) in Im-sil Gun. Prevalence of E. histolytica in rural areas was higher than in urban areas. No significant difference in the prevalence rate by sex and age was recognized, although the group under 10 years and over 60 years were lower than in other age groups. The highest positive rate of E. histolytica was observed in pauper group and significant linearity of prevalence rate of E. histolytica by monthly income was observed. The inhabitants who used conventional latrine showed higher prevalence, 11.5 %, than the group of inhabitants who used modified privy. Although no significant difference of positive rate was recognized by academic career, but the lowest prevalence rate was observed in college graduates. Over half of the surveyed population, 64.8 % has no experience on anthelmintic practice. Number of anthelmintic application resulted no difference in prevalence. In conclusion, prevalences of intestinal protozoa in Gyeong-gi Do and Jeonra Bug Do decreased remarkably in comparison with those of one decade before. However, economic level, academic career and anthelmintic administration seemed no essential reasons for such declination.

Journal Article↗

Epidemiological survey of Giardia spp. and Blastocystis hominis in an Argentinian rural community.

The aim of this study was to relate personal data, socio-cultural and environmental characteristics, and the presence of symptoms/signs with the frequencies of Giardia spp. and Blastocystis hominis among a rural population in Buenos Aires Province, Argentina. Of the surveyed population (350), 3.7% were infected with only Giardia spp. or 22.9% with B. hominis, and 2.3% were infected with both protozoa. The frequency of infection according to sex; 6.1% of males were infected and 1.6% of females by Giardia spp., 26.7% and 19.5% by B. hominis, and 2.4% and 2.2% by both parasites, respectively. Giardia spp. was detected in only three adults (over 14 years), but B. hominis was more frequent in adults than in children. The prevalences of these protozoa in this community are lower than those reported by other Argentinean studies, which is probably associated with the low density of the studied population (5.95 inhab/km2). Statistical analysis revealed that a male sex, flooding of the home, the use of a latrine, and an abdominal pain were correlated with the presence of these parasites, which indicate the importance of these factors in rural communities.

Adolescent↗

Evaluation of the effect of different methods of control of soil-transmitted helminths in Khuzestan, southwest Iran.

Three methods of control of soil-transmitted helminths, namely, sanitation, mass-treatment, and sanitation plus mass-treatment, were tried in 15 villages in Khuzestan, southwest Iran. Stool samples from the inhabitants of each village were examined both quantitatively and qualitatively just before starting each control method and again about 4 years later, except for the inhabitants of one village whose stools were re-examined 7 months after moving to a new settlement. Sanitation measures consisted of one latrine for each family and the provision of a sanitary water supply in each village. The drugs piperazine and bephenium hydroxynapthoate were administered alternately every 3 months. The reduction in rates of infection with Ascaris, hookworm, and Trichostrongylus spp., respectively, for the above mentioned methods were as follows: sanitation alone, 28%, 4% and 30%; mass-treatment alone, 84%, 73%, and 31%; sanitation plus mass-treatment, 79%, 69%, and 30% and in the newly constructed village, 76%, 21%, and 38%. In a control group corresponding reductions were 19%, 11%, and 31%. The percentage of egg reduction in persons still infected with these three parasites was, respectively, as follows: mass-treatment plus sanitation, 88%, 88%, and 53%; mass-treatment alone, 90%, 87%, and 37%; sanitation alone, 60%, 26%, and 0.6%; in the newly constructed village, 87%, 78%, and 39%; and in the control group, 29% increased 12%, and 24.5%. The significance of these findings is discussed.

Animals↗

Schistosomiasis control in Puerto Rico: twenty-five years of operational experience.

A program to control schistosomiasis in Puerto Rico was initiated in 1953, using limited chemotherapy and snail control by environmental, biological and chemical means. At the same time, extensive programs of water supply, health education, and free latrine distribution were underway throughout the island. The impact of the program was evaluated initially by examinations of fecal samples from first-grade children until 1966, and subsequently by island-wide surveys using adult worm antigen for skin test on fifth-graders in 1963, 1969, and 1976. There was a decrease in the proportion of children reacting positively to the skin test from 24% in 1963 to 5% in 1976. The decrease in the proportion of positive skin test reactions was one and a half times as great in the area under snail control as in the rest of the endemic area, and most of the decrease outside the snail control program was due to improved water supply. Calibration tests indicated a decrease in prevalence among the entire population, if determined by multiple fecal exams, from 15% in 1963 to less than 4% in 1976. Thus the estimated number of persons passing eggs in Puerto Rico was about 100,000 in 1976, in a population of 3 million. The cost of snail control was minimized by emphasizing environmental and biological methods, showing that the disease can be controlled on a large scale with simple techniques. Eradication of the parasite from Puerto Rico is quite likely in the next few years with the advent of the new drug, oxamniquine, and would be a cheaper strategy than continued snail control.

Antibodies↗

The epidemiology of trachoma in southern Malawi.

A population-based prevalence survey of ocular disease was conducted in the Lower Shire River Valley of Malawi in 1983. A total of 5,436 children less than 6 years of age and 1,664 persons greater than or equal to 6 years were examined. The prevalence of inflammatory trachoma peaked in the 1-2-year-old age group at 48.7% and declined rapidly with age to less than 5% by age 15. The prevalence of cicatricial trachoma was low in young children and climbed gradually with age to greater than 40% among those greater than or equal to 50 years. Risk factors for inflammatory disease in young children included low socioeconomic status of the family, long walking distance to the household's primary source of water, absence of a latrine in the family compound, and presence of trachoma among siblings. Indices of crowding practices were not associated with inflammatory disease. An apparent inverse association of facewashing and inflammatory trachoma in children did not hold up when adjusted for other risk factors.

Adolescent↗

Echinostomiasis: a common but forgotten food-borne disease.

Human echinostomiasis, endemic to southeast Asia and the Far East, is a food-borne, intestinal, zoonotic parasitosis attributed to at least 16 species of digenean trematodes transmitted by snails. Two separate life cycles of echinostomes, human and sylvatic, efficiently operate in endemic areas. Clinical symptoms of echinostomiasis include abdominal pain, violent watery diarrhea, and anorexia. The disease occurs focally and transmission is linked to fresh or brackish water habitats. Infections are associated with common sociocultural practices of eating raw or insufficiently cooked mollusks, fish, crustaceans, and amphibians, promiscuous defecation, and the use of night soil (human excrement collected from latrines) for fertilization of fish ponds. The prevalence of infection ranges from 44% in the Philippines to 5% in mainland China, and from 50% in northern Thailand to 9% in Korea. Although the patterns of other food-borne trematodiases have changed in Asia following changes in habits, cultural practices, health education, industrialization, and environmental alteration, human echinostomiasis remains a health problem. The disease is most prevalent in remote rural places among low-wage earners and in women of child bearing age. Echinostomiasis is aggravated by socioeconomic factors such as poverty, malnutrition, an explosively growing free-food market, a lack of supervised food inspection, poor or insufficient sanitation, other helminthiases, and declining economic conditions. Furthermore, World Health Organization control programs implemented for other food-borne helminthiases and sustained in endemic areas are not fully successful for echinostomiasis because these parasites display extremely broad specificity for the second intermediate host and are capable of completing the life cycle without involvement of the human host.

Amphibians↗