Effect of Mass Stool Examination and Mass Treatment For Decreasing Intestinal Helminth and Protozoan Infection Rates in Bolivian Children: A Cross-Sectional Study

Abstract

Bolivia is one of the countries with a high intestinal helminth and protozoan infection rate. Despite the high prevalence of the parasitic infection, nationwide preventive measures for Bolivian children have not yet been implemented. We evaluated the effect of mass stool examination and treatment as a strategy for decreasing the infection rate. This study was conducted between 2013 and 2015 in children aged 2–18 years. A total of 2,033 stool samples (575 in 2013, 815 in 2014 and 642 in 2015) were collected and examined using the formalin-ether medical sedimentation method. As an anthelminthic medicine, nitazoxanide was given to all infected children within 2 months post-examination, each year. The effect of mass stool examination and treatment was evaluated based on the changes in the overall or individual parasitic infection rates during the study period. The overall parasitic infection rate decreased significantly from 65.2% in 2013 to 43.0% in 2015; a 22.2 percentage point decrease (P<0.001). Protozoan infection accounted for a large portion of the parasitic infections, in the following rates: 62.4% in 2013, 49.3% in 2014, and 41.0% in 2015. The rate of the most common helminth infection, Hymenolepis nana, decreased significantly from 9.0% in 2013 to 6.4% in 2014 to 3.4% in 2015 (P<0.001). Prevalence of the most common pathogenic protozoan infection, Entamoeba histolytica, decreased significantly from 19.0% in 2013 to 3.0% in 2015 (P<0.001). Conversely, the rate of Giardia intestinalis increased significantly from 16.5% in 2013 to 21.2% in 2015 (P<0.01). Mass stool examination and treatment for intestinal helminth and protozoan infections was effective for decreasing the overall parasitic infection rate in the study population, excluding Giardia intestinalis. Further studies on the long-term effect of mass stool examination and treatment for decreasing all intestinal parasitic infection rates in Bolivian children are needed.

Intestinal polyparasitism and levels of mucosal anthelmintic SIgA in children from endemic areas in Northeastern Brazil

“…mansoni in our survey was similar to that found for the entire state of Sergipe, which seems to be indicative of a failure to control this parasite 75 . The lower frequency of STH probably reflects the result of prolonged treatment on a large scale in school‐aged children 76–79 …”

The neglected cestode infection: Epidemiology of Hymenolepis nana infection among children in rural Yemen

“…Moreover, mass drug administration (MDA), the key strategy for controlling schistosomiasis and STH infections in Yemen, has been largely interrupted due to the war (Al-Mekhlafi et al, 2018). A much lower prevalence of H. nana infection is commonly reported worldwide (Oliveira et al, 2015;Asai et al, 2016;Spinicci et al, 2018;Periago et al, 2018;von Huth et al, 2019). However, a similar prevalence (17.4 %) has been reported among children aged 3 -16 years in the highlands of Peru (Cabada et al, 2016).…”

“…A much lower prevalence of H. nana infection is commonly reported worldwide ( Oliveira et al, 2015 ; Asai et al, 2016 ; Spinicci et al, 2018 ; Periago et al, 2018 ; von Huth et al, 2019 ). However, a similar prevalence (17.4 %) has been reported among children aged 3 – 16 years in the highlands of Peru ( Cabada et al, 2016 ).…”

“…In such circumstances, preschool children will continue serving as a source of infection within endemic communities, and other age groups will be reinfected within a short period of time. Therefore, it is vital to include preschool-aged children in MDA with praziquantel to improve the control of schistosomiasis and other intestinal parasitic infections (including H. nana ) ( Soares Magalhães et al, 2013 ; Asai et al, 2016 ). However, the absence of paediatric formulations of praziquantel hampers the routine treatment of preschool-aged children.…”

Ascariasis: A common disease with uncommon presentation in a resource limited setting. A case report

“…Ascariasis, which is caused by the nematode Ascaris lumbricoides, is the most prevalent and largest helminth infection in humans worldwide [1] . In regions endemic to Ascariasis, clinical manifestations predominantly arise in individuals with high worm burdens and those who experience frequent infections, despite the fact that the majority of infections are asymptomatic.…”