Helminth Elimination in the Pursuit of Sustainable Development Goals: A "Worm Index" for Human Development

Hotez, Peter J.; Herricks, Jennifer R.

doi:10.1371/journal.pntd.0003618

Cited by 37 publications

(45 citation statements)

References 18 publications

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“…However, data on its epidemiology suggest that is highly underreported [9, 10]. This fact is mainly linked to diagnostic challenges: traditional identification of eggs in stool has nil sensitivity for S. stercoralis , and a high number of infections thus go undetected [11, 12]. Its diagnosis relies on identification of larvae in stool, with the two most appropriate methods being the Baermann, Harada Mori and Koga agar plate culture techniques, even though their sensitivity is not optimal [13].…”

Section: Introductionmentioning

confidence: 99%

High prevalence of Strongyloides stercoralis in school-aged children in a rural highland of north-western Ethiopia: the role of intensive diagnostic work-up

et al. 2016

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BackgroundSoil-transmitted helminthiases (hookworms, Ascaris lumbricoides and Trichuris trichiura) are extremely prevalent in school-aged children living in poor sanitary conditions. Recent epidemiological data suggest that Strongyloides stercoralis is highly unreported. However, accurate data are essential for conducting interventions aimed at introducing control and elimination programmes.MethodsWe conducted a cross-sectional survey of 396 randomly selected school-aged children in Amhara region in rural area in north-western Ethiopia, to assess the prevalence of S. stercoralis and other intestinal helminths. We examined stools using three techniques: conventional stool concentration; and two S. stercoralis-specific methods, i.e. the Baermann technique and polymerase chain reaction. The diagnostic accuracy of these three methods was then compared.ResultsThere was an overall prevalence of helminths of 77.5%, with distribution differing according to school setting. Soil-transmitted helminths were recorded in 69.2%. Prevalence of S. stercoralis and hookworm infection was 20.7 and 54.5%, respectively, and co-infection was detected in 16.3% of cases. Schistosoma mansoni had a prevalence of 15.7%. Prevalence of S. stercoralis was shown 3.5% by the conventional method, 12.1% by the Baermann method, and 13.4% by PCR, which thus proved to be the most sensitive.ConclusionsOur results suggest that S. stercoralis could be overlooked and neglected in Ethiopia, if studies of soil-transmitted helminths rely on conventional diagnostic techniques alone. A combination of molecular and stool microscopy techniques yields a significantly higher prevalence. In view of the fact that current control policies for triggering drug administration are based on parasite prevalence levels, a comprehensive diagnostic approach should instead be applied to ensure comprehensive control of helminth infections.

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Section: Introductionmentioning

confidence: 99%

High prevalence of Strongyloides stercoralis in school-aged children in a rural highland of north-western Ethiopia: the role of intensive diagnostic work-up

et al. 2016

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“…Economic rank [5,6] People living with HIV/AIDS in 2013 [7] Tuberculosis prevalence in 2013 [9] Suspected malaria cases in 2013 [11] European tenets of blue marble health also provide a key roadmap towards completing the Millennium Development Goals and embarking on new Sustainable Development Goals [2,5,15].…”

Section: Countrymentioning

confidence: 99%

Blue marble health and “the big three diseases”: HIV/AIDS, tuberculosis, and malaria

Hotez

2015

Microbes and Infection

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“…Evidence already exists of the reduced efficacy of drugs used to combat lymphatic filariasis [9] and schistosomiasis [10], with frequent treatment involving anthelmintic drugs appearing to hasten the development of drug resistance in some animals [11]. While chemotherapy has reduced levels of infection in the short-term, ensuring that positive health benefits extend beyond the cessation of chemotherapy programs has been challenging without improvements in the other factors that predispose populations to helminthiases [12,13]. Helminth infections, and indeed many infectious diseases, are strongly influenced by environmental and socio-economic conditions, and by human behavior and the effectiveness of health service provision [13], or what Lambin et al [14] term the pathogenic landscape for disease.…”

Section: Introductionmentioning

confidence: 99%

“…While chemotherapy has reduced levels of infection in the short-term, ensuring that positive health benefits extend beyond the cessation of chemotherapy programs has been challenging without improvements in the other factors that predispose populations to helminthiases [12,13]. Helminth infections, and indeed many infectious diseases, are strongly influenced by environmental and socio-economic conditions, and by human behavior and the effectiveness of health service provision [13], or what Lambin et al [14] term the pathogenic landscape for disease. A major increase in schistosomiasis following the construction of dams and irrigation infrastructure has been well-documented [15], as has the eradication of schistosomiasis in Japan through modernization of agricultural practices [16] and reduced hookworm infections as a result of improvements in sanitation and housing [17].…”

Section: Introductionmentioning

confidence: 99%

Uncovering the Pathogenic Landscape of Helminth (Opisthorchis viverrini) Infections: A Cross-Sectional Study on Contributions of Physical and Social Environment and Healthcare Interventions

et al. 2016

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BackgroundHelminth infections have proven recalcitrant to control by chemotherapy in many parts of Southeast Asia and indeed farther afield. This study isolates and examines the influence of different aspects of the physical and social environment, and uneven intervention effort contributing to the pathogenic landscape of human Opisthorchis viverrini infections.MethodologyA cross-sectional survey, involving 632 participants, was conducted in four villages in northeast Thailand to examine the impact on prevalence and parasite burden of the reservoir dam environment, socio-economic, demographic, and behavioral factors, and health center intervention efforts. Formalin-ether concentration technique was used for diagnoses, and multivariate models were used for analyses.Principal FindingsThe importance attributed to O. viverrini infections varied among health centers in the four study villages. Villages where O. viverrini infections were not prioritized by the health centers as the healthcare focus were at a higher risk of infection (prevalence) with odds ratio (risk factor) of 5.73 (3.32–10.27) and p-value < 0.01. Priority of healthcare focus, however, did not appear to influence behavior, as the consumption of raw fish, the main source of O. viverrini infections in the study area, was 11.4% higher in villages that prioritized O. viverrini infections than those that did not (p-value = 0.01). Landscape variation, notably proximity to reservoir, affects vulnerability of local population to infection. Infection intensity was higher in population located closer to the reservoir with risk ratio of 2.09 (1.12–4.02) and p-value < 0.01. Patterns of infection intensities among humans were found to match fish infection intensity, where higher infection intensities were associated with fish obtained from the reservoir waterbody type (p-value = 0.023).Conclusions/SignificanceThis study demonstrated the importance of environmental influence and healthcare focus as risk factors of infections in addition to the socio-economic, demographic, and behavioral factors commonly explored in existing studies. The reservoir was identified as a crucial source to target for opisthorchiasis intervention efforts and the need to consider infection intensity in disease control efforts was highlighted. The holistic approach in this study, which underscores the close relationship between the environment, animals, and humans in development of human infections or diseases, is an important contribution to the framework of One Health approach, where consideration of helminth diseases has largely been overlooked.

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Helminth Elimination in the Pursuit of Sustainable Development Goals: A "Worm Index" for Human Development

Cited by 37 publications

References 18 publications

High prevalence of Strongyloides stercoralis in school-aged children in a rural highland of north-western Ethiopia: the role of intensive diagnostic work-up

High prevalence of Strongyloides stercoralis in school-aged children in a rural highland of north-western Ethiopia: the role of intensive diagnostic work-up

Blue marble health and “the big three diseases”: HIV/AIDS, tuberculosis, and malaria

Uncovering the Pathogenic Landscape of Helminth (Opisthorchis viverrini) Infections: A Cross-Sectional Study on Contributions of Physical and Social Environment and Healthcare Interventions

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