Assessment of the nail contamination with soil-transmitted helminths in schoolchildren in Jimma Town, Ethiopia

Abstract

Background Large-scale deworming programs have been successful in reducing the burden of disease due to soil-transmitted helminth (STH; Ascaris lumbricloides, Trichuris trichiura and hookworm) infections, but re-infection in absence of other measures is unavoidable. We assessed the role of nail contamination as a source of infection with the goal to evaluate the potential of nail clipping as a simple measure to further reduce STH-attributable morbidity. Methods A cross-sectional study was conducted in Jimma Town (Ethiopia). Both stool samples and clipped nails were collected from 600 schoolchildren and microscopically screened for the presence of STHs. We also interviewed the children to gain insights into their hygiene practices. Subsequently, we explored any associations between infection, nail contamination and personal hygiene. Results Any STH infections were observed in 24.3% of the children (A. lumbricoides: 18.5%; T. trichiura: 9.8%; hookworm: 0.5%). The intensity of the infections was mainly low, only in a few cases a moderate-to-heavy intensity infection was observed (A. lumbricoides: 4.3%; T. trichiura: 0.2%). Other helminth species observed were Schistosoma mansoni (5.0%), Hymenolepis nana (2.7%), Taenia spp. and Enterobius vermicularis (<1.0%). The analysis of the nail material revealed the presence of A. lumbricoides (1.7%), Taenia spp. (1.0%), T. trichiura (0.5%), E. vermicularis (0.5%) and H. nana (0.2%). The odds of infection with any STH increased as the frequency of trimming decreased. The odds of nail contamination with any STH and A. lumbricoides were higher for younger children. Conclusions The presence of helminth eggs under the nails of children highlights a poor personal hygiene. The association between any STH infection and frequency of nail trimming needs to be explored in an intervention study. The recent prevalence of any STH infections indicated that scaling down of the frequency of deworming is justified but that STH is still a public health problem.

Prevalence of Enterobius vermicularis among children in Iran: A comprehensive systematic review and meta-analysis

“…Another study conducted in Argentina reported a prevalence rate of 28.4% among the 303 participants ( Rivero et al, 2018 ). In Ethiopia, a study by Tadege and colleagues found a % infection rate of 1% among the collected 600 samples ( Tadege et al, 2022 ). In Egypt, a study by Elmonir et al reported an infection rate of 8.6% among a total of 996 collected samples ( Elmonir et al, 2021 ).…”

“…This can result in fatigue, lack of concentration, reduced efficiency, and increased susceptibility to other diseases in children. Treating this infectious agent and the diseases it causes can impose significant costs on the healthcare sector ( Rivero et al, 2018 ; Tadege et al, 2022 ; Elmonir et al, 2021 ; Fan et al, 2021 ).…”

Schistosoma mansoni Infections and Morbidities Among School Children in Hotspot Areas of Jimma Town, Southwest Ethiopia: A Cross-Sectional Study

“…Previous studies conducted in Jimma Town also reported prevalence of S. mansoni ranging from 5.0-28.7%. 20,21,28 Nationally, more than a third of children are estimated to be infected with S. mansoni , with high variability in different areas. 29 Even compared to the local situation, this study was conducted in primary schoolchildren with presumably higher risk of S. mansoni infection and re-infection rates due to the availability of freshwater bodies around the schools.…”

A comprehensive evaluation of an artificial intelligence based digital pathology to monitor large-scale deworming programs against soil-transmitted helminths: a study protocol

“…The study will be conducted in both Ethiopia and Uganda. The selection of these countries and the corresponding partners (Ethiopia: Jimma University; Uganda: Vector Control and Neglected Tropical Diseases Division, Ministry of Health of Uganda) were based on ongoing collaborations [20, 29–36], the presence of an STH control program (Ethiopia: since 2015; Uganda: since 2003), and the availability of recent data on both the prevalence and intensity of STH infections [31, 32, 37]. Finally, both countries operate differently, allowing AI-DP evaluation in a fully equipped laboratory (Jimma University, Ethiopia) and a field setting (VCD, Uganda) that best mimic monitoring and evaluation (M&E) activities as part of the national STH deworming program.…”

“…Uganda: since 2003), and the availability of recent data on both the prevalence and intensity of STH infecUons [31,32,37]. Finally, both countries operate differently, allowing AI-DP evaluaUon in a fully equipped laboratory (Jimma University, Ethiopia) and a field sekng (VCD, Uganda) that best mimic monitoring and evaluaUon (M&E) acUviUes as part of the naUonal STH deworming program.…”