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Epidemiological study of intestinal helminthiasis in a Marrakech raw sewage spreading zone.

It has been suspected for some time that raw sewage is a potential source of protozoan and helminthic infections (10). Shuval et al. (16, 17) and W.H.O. (21) have shown that irrigating crops with untreated wastewater causes significant intestinal infections in both consumers and farm workers. This study compared the stools of "sewage farming" children exposed to raw sewage (El Azzouzia area) and those of a control group. Stool specimens from 253 exposed children and 275 controls were analyzed. 73% of the exposed were infected with one or more helminths verses 30% of the control group. The main parasites were Ascaris and Trichuris. The El Azzouzia children were more heavily infected and their polyparasitism index (PPI: 13%) was considerably higher than that of the controls (PPI: 2%). Thus "sewage farming" children are exposed to detectable risk from the parasitic nematodes in raw sewage.

Adolescent↗

Mebendazole in the treatment of helminthiasis.

Mebendazole, a new broad-spectrum anthelmintic, was used to treat patients with nematode infections--ascariasis, trichuriasis and hookworm. The dosage for adults was 100 mg twice daily for 3 days and for children, 50 mg twice daily for 3 days. Pretreatment and post-treatment egg counts on stool specimens showed that after mebendazole there was a reduction of over 99% in egg count per gram of stool in all three types of infection. The overall cure rates for the infections were as follows: Ascaris lumbricoides, 86.8% (59/68); Trichuris trichiura, 86.0% (37/43); and hookworm, 85.7% (24/28). The drug was equally effective in light and heavy infections. No important side effect was noted with this drug. It is suggested that mebendazole is the drug of choice for trichuriasis and mixed nematode infection.

Adult↗

Heligmosomoides polygyrus: a model for chronic gastrointestinal helminthiasis.

Establishment of chronic infections and strain-dependent variation in resistance to challenge infections are well-known features of the relationship between mice and the intestinal nematode parasite Heligmosomoides polygyrus. Here, Fernando Monroy and Javier Enriquez examine host responses, immunogenic and nonimmunogenic antigens of the parasite, and parasite immune evasion strategies in this useful laboratory mouse model of nematode parasitism of mammals.

Journal Article↗

Alternate grazing of horses and sheep as control for gastro-intestinal helminthiasis in horses.

Gastro-intestinal helminth infections of a group of three yearling mare Shetland ponies, which were set-stocked on a small pasture from February until September, were compared with those of a similar group of ponies, which grazed a similar pasture from February to July and subsequently was removed to a pasture which had been grazed by sheep from April to July. In addition both groups were treated with cambendazole when the latter group was removed to the sheep pasture. Pasture larval counts and worm counts demonstrated that the group grazed after the sheep acquired considerably smaller burdens of nematodes of the subfamilies Cyathostominae and Strongylinae, but considerably higher burdens of Trichostrongylus axei than the group which remained on the same pasture. The T. axei infections in the former group caused an increase in the serum pepsinogen levels within two weeks after removal to the sheep pasture followed by a gradual decrease. At necropsy T. axei populations consisted almost exclusively of inhibited early third stage larvae.

Animal Husbandry↗

Progress in the prevention and control of schistosomiasis and soil-transmitted helminthiasis.

In the last two decades important progress has been made in the understanding the epidemiology and the disease burden of schistosomiasis and soil-transmitted nematodes infection. In addition, practical tools for disease control have been developed and a strategy for the prevention and control of morbidy of schistosomaisis and soil-transmitted nematodes infection has been endorsed by the World Health Organization. This paper presents the recent progress in the prevention and control of these infections: the estimates of chronic and subtle morbidity in high risk groups and the evidence that these chronic and severe sequelae of infections can be reversed by appropriate treatment; the use of anthelminthic drugs during pregnancy and lactation; the relevance to control morbidity due to these infections also in pre-school children; the efficacy of anthelminthic drugs and the possible threat of drug resistance; price, quality and accessibility of treatment by delivering drugs through the school system and ways of reaching also non-enrolled school-age children. Finally, the strategy, targets and recommendations of the World Health Organization for the control of schistosomiasis and soil-transmitted nematodes infection are described.

Animals↗

Amphibian deformities and Ribeiroia infection: an emerging helminthiasis.

Since their widespread appearance in the mid-1990s, malformed amphibians have evoked fear, as well as fascination within the scientific and public communities. Recent evidence from field and laboratory studies has implicated infection by a digenetic trematode--Ribeiroia ondatrae--as an important cause of such deformities. Ribeiroia spp. have a complex life cycle involving planorbid snails, amphibians and water birds. Under natural conditions, malformations might promote parasite transmission by increasing the susceptibility of infected amphibians to predation by definitive hosts. However, with respect to the recent outbreak of deformities, we suggest that exogenous agents (e.g. pesticides, nutrient run-off, introduced fishes) might be interacting with Ribeiroia, resulting in elevated infection levels, and we highlight the need for studies incorporating multiple stressor dynamics to further explore this problem.

Amphibians↗

Density dependence in establishment, growth and worm fecundity in intestinal helminthiasis: the population biology of Trichuris muris (Nematoda) infection in CBA/Ca mice.

The results are presented of an experimental study of the population biology of chronic Trichuris muris (Nematoda) infection in cortisone-treated CBA/Ca mice. Attention is focused upon both the validity of the common use of faecal egg counts to demonstrate density dependence in helminth fecundity, and the identification of other possible density-dependent mechanisms that may regulate worm numbers in chronic trichuriasis. The results show that faecal egg counts, although demonstrating high daily variation, are not an artefact of host faecal output but a significant density-dependent function of worm burden. This finding contrasts with the observations on Heligmosomoides polygyrus infection in outbred MFI mice, but accords with similar studies in a wide variety of host - helminth systems. Worm establishment in the murine host is found to be a density related function of infection dose. This is attributed to the probable existence of a physical gut-carrying capacity in the murine host for T. muris. Worm distribution in the gut is also shown to the density dependent, with worms being displaced from the caecum to the colon at increasing intensities of infection. The sex ratio of the adult parasites, however, is found to be both unitary and independent of worm burden. Evidence for a significant density-dependent decline in female T. muris growth or size is presented. The results also show a significant positive association between female T. muris weight and per capita fecundity. These findings indicate that the stunted growth of individual worms at high parasite densities may be a potential mechanism underlying density dependence in helminth fecundity.

Animals↗

Relationships between vitamin A, iron status and helminthiasis in Bangladeshi school children.

OBJECTIVE: To explore the relationships between biochemical indicators of vitamin A and iron status and the intestinal helminths Ascaris lumbricoides and hookworm in primary school children. SETTING: Two rural governmental schools in northwestern Bangladesh. DESIGN: Cross-sectional study. SUBJECTS: The sample consisted of 164 children in grades 3-5. METHODS: Serum retinol and beta-carotene (by high-performance liquid chromatography, HPLC), haemoglobin (HemoCue), ferritin (enzyme-linked immunoadsorbent assay, ELIZA) and height and weight were measured. Dietary intake of vitamin A was assessed using a food frequency questionnaire and faecal analyses were done using Stoll's egg-count technique. RESULTS: The mean serum retinol was 26.8 microg dl(-1) and 20% had a level of < 20 microg dl(-1), the cut-off value for low vitamin A status. There was a strong positive association between serum beta-carotene and serum retinol (r = 0.44, P < 0.001), suggesting those with higher retinol levels had a higher carotene intake. Thirty-one per cent were anaemic (Hb < 11.5 g dl(-1)), 30% had iron deficiency (serum ferritin < 12.0 microg l(-1)) and 14% were suffering from iron deficiency anaemia. Children with a serum retinol level of 20 microg dl(-1) had significantly lower ferritin (14.0 compared to 26.0 microg l(-1), P = 0.005) and Hb levels (11.7 compared to 12.4 g dl(-1), P = 0.005) than those with higher levels. The proportion of iron deficiency anaemia was significantly greater among children with hookworm. Our data suggest that hookworm exerts its impact on iron status independently of the vitamin A status of the host. CONCLUSIONS: Programmes to improve iron status should consider including both vitamin A prevention programmes and deworming.

Anemia, Iron-Deficiency↗

[Toxocariasis--a neglected ubiquitous helminthiasis in children and adolescents].

More than 40 years ago, Toxocara ssp. was identified as the cause of larva migrans visceralis and ocular larva migrans, which mainly affect infants and children. Although widespread in most parts of the world, the parasitic disease is rarely diagnosed in Germany. Focusing on clinical and pathophysiological similarities with allergic asthma of childhood, the main epidemiological, clinical, therapeutical, and pathophysiological aspects of toxocariasis will be reviewed in the following survey.

Adolescent↗