[Laboratory diagnosis of protozoan and parasitic infections. 2. Helminthiasis. j. Strongyloides stercoralis infection].
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Relation of hepatolithiasis to helminthic infestation.
BACKGROUND AND AIM: The relation of helminthic infestation to hepatolithiasis is a subject of dispute. This case-control study was undertaken to evaluate the prevalence of helminthiasis in hepatolithiasis patients and to compare the clinicopathological features of hepatolithiasis between patients with and without helminthiasis. METHODS: The prevalence of ascariasis or clonorchiasis was evaluated using ELISA in 131 patients with hepatolithiasis who were treated at Show-Chwan Memorial Hospital and 121 subjects who constituted a control group. The patients' detailed histories and medical charts were reviewed. RESULTS: The prevalence of positive immunodiagnosis of ascariasis and clonorchiasis was higher in patients with hepatolithiasis than in control subjects (33.6%, 44/131 vs 17.4%, 21/121, odds ratio [OR] = 2.41, 95% confidence interval [CI] = 1.28-4.56, P = 0.005; and 6.9%, 9/131 v 0.8%, 1/121, OR = 8.85, 95% CI = 1.12-188.69, P = 0.02). Patients with helminthiasis rarely had concurrent gallbladder stones (26%, 12/47 vs 55%, 46/84, OR = 0.28, 95% CI = 0.12-0.66, P = 0.002). Prior to the diagnosis of hepatolithiasis in adulthood, most of the patients with helminthiasis tended to have a history of recurrent abdominal pain in their childhood and an asymptomatic 'lucid interval' during their teenage years (70.2%, 33/47 vs 39.3%, 33/84, OR = 3.64, 95% CI = 1.59-8.42, P = 0.0005). However, the prevalence of intrahepatic duct stricture (38.3%, 18/47 vs 40.5%, 34/84, OR = 0.91, 95% CI = 0.41-2.02, P > 0.05), secondary biliary cirrhosis (6.4%, 3/47 vs 3.6%, 3/84, OR = 1.84, 95% CI = 0.28-12.03, P > 0.05), cholangiocarcinoma (2.1%, 1/47 vs 0%, 0/84, OR = approximately , P > 0.05), and stone recurrence (54.8%, 24/42 vs 50.0%, 38/76, OR = 1.33, 95% CI = 0.58-3.06, P > 0.05) did not significantly increase. CONCLUSIONS: Helminthiasis is a possible risk factor for hepatolithiasis, although it is unlikely to increase the incidence of complications, including bile duct stricture, secondary biliary cirrhosis, and cholangiocarcinoma. Patients with helminthiasis tend to have a history of an asymptomatic 'lucid interval' between the periods of recurrent abdominal pain in their childhood and the diagnosis of hepatolithiasis in their adulthood.
Adult↗
Risk factors of helminthiases among schoolchildren in southern Thailand.
School-age children are particularly at risk of soil-transmitted helminthiasis (STH), which affects their growth and development. Hence, school-based helminthiasis control has been discussed and conducted as one of cost-effective ways in developing countries. A parasite control program is to be planned and conducted in an evidence based way as one of practical medical fields. However, a prevalence is likely to be influenced by various factors such as local environment and residents' behavior and so on. As few reports mentioning the relation of the prevalence and children's behavior and practice have been published, we conducted a survey to investigate such relation by asking children directly. Two hundred and eighty pupils in grade 3 to grade 5 were enrolled, who were in the two schools in Nakhon Si Thammarat Province, southern Thailand. A cross-sectional study was conducted in February and in November 2001, on the relationship between helminthiasis and children's knowledge and practice by using Kato-Katz method and a questionnaire, respectively. Hookworm (Hw) was the most predominant helminth followed by Trichuris. Boys had more intensive Hw infection than girls (p = 0.022), and wore shoes less frequently than girls (p < 0.001). The pupils who nearly acquired Hw infection after the first stool examination had lower levels of the knowledge of STH comparing to those who did not (p = 0.011). This study suggests that a prior survey can identify unique local factors as a part of diagnostic process, the results of which are useful for teachers to understand some points of health education at schools and can be applied as indicators for monitoring and evaluation.
Child↗
[Dirofilariasis in the Autonomous Republic of Crimea].
The paper presents data on the prevalence of dirofilariasis in the Autonomous Republic of Crimea during 5 years from 1999 to 2003. The nematode Dirofilaria repens is a causative agent of the disease. Sporadic cases of helminthiasis are annually registered in some urban and rural areas on the plain of the peninsula. The disease is absent on the foothills and Black sea coast of the southern and eastern parts of Crimea. The localization of the parasite is typical of this helminthiasis. Dirofilariasis in Crimea may be regarded as a transmissible helminthiasis with natural focal trends.
Animals↗
[Intestinal schistosomiasis, a facultative precancerous condition? Review of the literature with reference to Schistosoma japonicum associated rectum carcinoma].
After a latency period of 20 years, in a 39-year-old Austrian citizen of Chinese origin, a surgically removed rectal carcinoma, as well as the neighboring chronic inflammatory rectal mucosa with various degrees of dysplasia and one positive neighboring lymph node, showed helminthiasis in the histopathological examination, convincing us of a link between carcinoma and chronic helminthiasis. Whereas the etiological context between chronic infection by Schistosoma haematobium and endemic frequent urinary bladder carcinoma is considered a matter of fact, whether of not the incidence of intestinal carcinoma is increased in connection with chronic intestinal schistosomiasis is controversial. The etiological and pathogenetic link between helminthiasis and carcinoma should be considered in the same way as for other related inflammatory large-bowel diseases. In the sequence chronic inflammation-severe dysplasia, the formation of carcinoma could possibly occur. Besides a survey of trematodes parasitology and pathology, the link between rectal carcinoma and Schistosomiasis japonicum is pointed out by means of appropriate literature investigations.
Adult↗
The problem and control of gastrointestinal helminthiases in Zimbabwe.
An overview of the problem of gastrointestinal (GI) helminthiases in Zimbabwe is given in terms of prevalence, distribution, clinical significance of individual parasites and their transmission patterns. Although data on these aspects are incomplete, the available information and the results of studies conducted elsewhere should assist in the planning and implementation of effective helminthiasis intervention strategies. Community-based integrated helminthiasis control measures that include mass chemotherapy, improved sanitation and health education are considered to be the most practical interventions and are being evaluated in Zimbabwe. This community-based approach is cost-effective, as most of the control measures are carried out on a self-help basis. Besides, local voluntary health committees provide consistent community-level surveillance to promote and motivate the population to join in the intervention measures that include improved sanitation and health education, aspects which have broader implications for improved health.
Adolescent↗
Preclinical and clinical studies with latex from Ficus glabrata HBK, a traditional intestinal anthelminthic in the Amazonian area.
Ficus glabrata latex has been a well-known anthelminthic remedy in the neotropical regions since ancient times. The latex has been commercially exploited for decades because of its content of the proteolytic enzyme-complex ficin. A safe dosage regimen with direct use of the latex has been elucidated to control intestinal helminthiasis in the Indian and non-Indian rural population. Helminthiasis was common in three Amazonian villages, field bases for the clinical study, with an overall prevalence of 92%. Specific prevalences were: Ascaris 68%, Strongyloides 42%, Trichuris 41%, Ancylostoma/Necator 26% and Taenia 1%. Variation in the biological activity of the latex was estimated by using a milk coagulating test. Pharmacological studies with live Ascaris demonstrated a lethal effect at concentrations down to 0.05% latex in physiological saline solution. A clinical trial on 181 persons has resulted in a recommended dosage of 1.0 cm3 of prepared latex/kg per day for 3 days to be repeated every 3 months.
Adolescent↗
Could control of soil-transmitted helminthic infection influence the HIV/AIDS pandemic.
In May 2001, the World Health Assembly (WHA) estimated that two billion people were infected by soil-transmitted helminths (S-THs) and schistosomiasis, worldwide. The WHA urged member states to recognise that there can be synergy between public health control programmes for S-THs, schistosomiasis and other diseases. This is particularly relevant to the new dimension created by the HIV/AIDS epidemics in the same impoverished communities and countries where helminthiasis is hyperendemic. Immunological adaptation between humans and parasitic helminths has developed during evolution. Review of 109 research papers, 76% (83/109) of which, were published between 1995 and February 2002, revealed increasing evidence that this relationship may have created an opportunity for more rapid infection by the human immunodeficiency virus (HIV), as well as quicker progression to AIDS. Moreover, the efficacy of some vaccines against HIV is likely to be impaired by chronic helminthiasis. For this, there is strong, indirect evidence. There is an urgent need for parasitologists, epidemiologists, immunologists and virologists to undertake comprehensive, transdisciplinary research. On the other hand, there is no current evidence that immunosuppression by HIV facilitates helminthic infection. The situation in regard to strongyloidiasis, however, is not yet clear.
Animals↗
Attitudes towards helminthic infection in the Jirel population of eastern Nepal.
Intestinal worm infections, including roundworm, hookworm, and whipworm, are major international health concerns, affecting approximately one fourth of the world's population. Many intervention schemes have been attempted to control these infections in heavily exposed populations, but success has been limited because individuals are readily reinfected upon renewed exposure. Few data are available concerning people's health beliefs about soil-transmitted helminthic infections in such populations. The purpose of this study was to assess health beliefs about common helminthiasis in a population experiencing moderate to high rates of infection. The focal population for the study was the Jirel population, a tribal group distributed across nine villages in the Jiri Region of Dolakha District, eastern Nepal. The results indicate that beliefs about the types, causes, and treatments of helminthic infections have been developed and reinforced by experience and empirical evidence. People's frequent inability to confirm the efficacy of drug therapy by observing worms in stools has led to dissatisfaction with biomedical approaches. Carefully planned education programs are required to alter prevailing attitudes and improve control of soil-transmitted helminthiasis in the region.
Adolescent↗
Do helminths play a role in carcinogenesis?
Chronic helminthiasis is recognized as a significant factor in cancer development in humans. However, the mechanisms by which helminths initiate and promote malignant transformation of host cells are still not understood fully. Human helminthiasis can cause genetic instability and affect inter- and intracellular communication, ultimately leading to tumour development through inflammation, modulation of the host immune system, and secretion of soluble factors that interact with host cells.
Animals↗
Intestinal Helminths in relationship to Chronic Diarrhoea in Human Immunodeficiency Virus-Seropositive Adults in Enugu.
Human immunodeficiency virus (HIV) infection and intestinal helminthiasis are common conditions in Nigeria. Chronic diarrhoea is a common manifestation of acquired immune deficiency syndrome ( AIDS). Helminths such as Strongyloides stercoralis and Trichuris trichiura may cause chronic diarrhoea especially in immunocompromised individuals. In order to determine whether any relationship exists between HIV infection and intestinal helminthiasis, stool samples from all HIV seropositive adults (with or without diarrhoea) admitted to the medical wards of the University of Nigeria Teaching Hospital, Enugu from August 1996 to October 1998 were examined microscopically for helminths. Out of 383 HIV-seropositive patients studied, 181 (47.26%) presented with chronic diarrhoea whereas 202 (52.74%) had no diarrhoea. The overall prevalence rate of gut helminths was 17.74%. The prevalence rate in the patients with chronic diarrhoea was 19.34% and that of those without chronic diarrhoea was 16.34%. The difference was not statistically significant. The helminths identified were Ascaris lumbricoides, Hookworm, Strongyloides stercoralis and Trichuris trichiura but there was no statistically significant difference in the two groups of patients. The study showed that there may be no clearcut relationship between gut helminths and HIV infection.
Adolescent↗
[Parasitic diseases in the Russian Federation under the conditions of population migration].
Migration of the population has been established to substantially increase the risk of importation of parasitic diseases into Russia. Mass importation of malaria into Russia has started since 1993 when local cases of malaria (secondary to imported ones), whose source was newcomers from Tadjikistan and Azerbaijan, were notified. The migration of the population has increased the incidence of helminthiasis and protozoan diseases earlier sporadically recorded in Russia. In 1996 to 2002, a total of 7386 patients with parasitic diseases considered by official statistics as other helminthiasis and other protozoan diseases were notified. In some areas, the morbidity rates due to hymenolepidiasis and trichocephaliasis have been formed from imported cases, the number of imported cases of opisthorchiasis increased, the area of spreading echinococciasis in Russia expanded at the expense of imported cases of echinococciasis from Kazakhstan, Uzbekistan, and the Ukraine.
Emigration and Immigration↗
[Study of Brazilian agricultural workers. A medico-socio-psychological study].
UNLABELLED: The general state of health of native Brazilian agricultural workers - a total of 750 people from 3 different plantations in the States of Paraná and Saso Paulo - was examined. The main interest of this study war centred on infectious and parasitic diseases, nutritional conditions as well as social, intellectual factors. OBSERVATIONS: Apart from the high number of cases of helminthiasis, amounting to 80%, the general state of health of the examined subjects was found to be good - indeed better than that of a hypothetical, comparable group of Europeans. Except for the Chagas' disease, by which 5% of the test subjects were afflicted, infectious diseases posed no serious problems. There was no case of malnutrition. The relatively lower intellectual level can not be attributed to any heriditary factor, and could definitely be improved by proper schooling. Corrective measures: Chagas: Since brick houses have replaced the wooden ones for several years, new infections are unlikely. Helminthiasis: In addition to the anthelminthic treatment, sanitary prophylactic measures should be taken. Social-intellectual factors: The following points should be emphasized: elementary schooling on the plantations; teaching at intermediary level; sewing and cooking courses; general hygience.
Adolescent↗
[Correlation between serum IgE level and human basophil degranulation by anti-IgE antibodies].
The human basophil degranulation test (HBDT) by anti-IgE antibodies was applied in 3 groups of subjects: 20 controls, 26 patients with helminthiasis and 28 allergic patients. Mean degranulation was higher in patients with helminthiasis than in the two other groups. A correlation was found between IgE serum level and HBDT results by anti-IgE (r = 0.373; p less than 0.02) with Spearman's rank correlation test. Therefore, degranulation with anti-IgE antibodies would appear to depend on the quantity of cell-bound IgE rather than on intrinsic basophil sensitivity.
Antibodies, Anti-Idiotypic↗
[Radioimmunologic dosage of total IgE serum in various helminthiases and protozoan infections (author's transl)].
The both purposes of our investigation were to determine initially the level of total serum IgE in various parasitic infections and the variations of this level after the initiation of specific treatment. In the study, III sera from black race patients with a clinical and biological diagnosis of helmintic or protozoal infections and without allergic diseases were tested by the commercially available "Radioimmunosorbent test" (Pharmacia Laboratories). In helmintic infections: the IgE concentration was higher than normal level: --in 100% of patients infested with ankylostoma, trichocephalus (mean concentration m: 2,961 UI/ml) or schistosoma (m: 1,578 UI/ml); --in 70% of patients infested with ascaris (m: 1,110 UI/ml). In protozoal infections: the abnormal IGE level was found only in 44% and 14% of cases respectively of malaria (m = 704 UI/ml) and of leishmaniasis (441 UI/ml). The time course of total serum IgE determined after the treatment initiation showed that: a) in patients with intracellular helminthiasis and protozoal infections serum IgE concentrations were gradually increased in a statistically highly significant way; b) in cases with intestinal helminthiasis, high levels disappeared ane returned rapidly to normal values.
Adolescent↗
Anthelminthic treatment raises plasma iron levels but does not decrease the acute-phase response in Jakarta school children.
The study was conducted to investigate the impact of intestinal helminthiasis and treatment on iron status and acute phase response (APR) among urban Indonesian primary school children, aged 8-11 years old. The prevalence of helminthiasis among these children was; Ascaris lumbricoides, 81.6%; Trichuris trichiura, 88.3%; and mixed infection of A. lumbricoides and T. trichiura, 70.0%. Of 120 children enrolled in the investigation, 59 received a single 400 mg dose of albendazole, and 61 received a placebo. Ten days following treatment, the prevalence of ascariasis and trichuriasis in the treatment group diminished to 0% and 27%, respectively, and in the placebo group to 63.9% and 68.9%. Plasma iron, hemoglobin, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC), interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor (TNF) concentrations were determined prior to the intervention and 10 days after. Plasma iron concentrations and WBC count rose in the treatment group (p=< or =0.05) when compared to baseline status. Increases in hemoglobin concentrations observed in the treatment group 10 days post-treatment were not statistically significant. CRP, IL-1, IL-6 and TNF were found to be within normal limits for both groups both before and after treatment. ESR increased significantly in both treatment and placebo groups when compared the rates measured before treatment. These findings show that treatment with albendazole is associated not only with a decreased worm burden in school children, but also a rise in plasma iron.
Acute-Phase Reaction↗
[Chronic recurrent subileus due to Strongyloides stercoralis infection under immunosuppressive therapy].
HISTORY AND CLINICAL FINDINGS: A 33-year-old woman from Laos was admitted due to recurrent vomiting and weight loss. Since one year, she was receiving immunosuppressive therapy (azathioprine 50 mg/d and methylprednisolone 18 mg/d) for a mixed connective tissue disease. Because of a drug induced Stevens-Johnson-Syndrome one month earlier high doses of methylprednisolone (100 mg/d intravenously) had been administered. The patient's general condition was reduced. Examination elicited a mild pain in the middle abdomen on palpation but no resistance or tumour. The differential diagnosis included obstructive and (or) inflammatory disease of the gastrointestinal tract. INVESTIGATIONS: Elevated IgE-levels (1111 IU/ml; normal up to 100 IU/ml) and eosinophilia (8%) lead to the suspicion of a helminthiasis. Oesophagogastroduodenoscopy showed a significant duodenal stenosis. Duodenal biopsy revealed a severe infestation with Strongyloides stercoralis. Stool examinations were negative though. TREATMENT AND COURSE: With administration of thiabendazole (2 g/d) a rapid recovery was noted. A second oesophagogastroduodenoscopy one week after the onset of therapy revealed no further stenosis. Since there was no activity of the mixed connective tissue disease the methylprednisolone dosage was reduced and the administration of azathioprine was ceased. 3 weeks after beginning of treatment the patient was discharged in improved condition. CONCLUSION: In immunocompromised patients suffering from gastrointestinal complaints who have been in endemic areas an infection with Strongyloides stercoralis should be excluded. Without treatment, this helminthiasis may be fatal.
Adult↗
Delay in timing of the oxfendazole pulse release bolus in calves in The Netherlands.
The efficacy of the oxfendazole pulse release bolus (OPRB) was tested in a grazing experiment at the University of Utrecht. Three groups of four OPRB-treated calves and one group of four untreated control calves were grazed on separate pastures between 18 May and 21 October 1987. Based on faecal egg counts for strongyle-type eggs and Nematodirus eggs, embryonation of Nematodirus eggs and faecal larval counts for lungworm, the first pulse of oxfendazole was released after 28 to 63 days, which was later than the period of approximately three weeks indicated by the manufacturer and others. As far as could be detected, the second to fifth pulses were not as delayed, but generally the three-week period was also exceeded. This delayed release of the pulse resulted in a build-up of pasture infectivity for gastrointestinal nematode larvae and lungworm larvae. Nevertheless, this did not result in clinical gastrointestinal helminthiasis and husk in the treated groups of calves, whereas severe husk and mild gastrointestinal helminthiasis were seen in the control group.
Animals↗