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ObjectiveTo understand the prevalence of hookworm infection and its relevant behavioral factors in rural areas of Tiantai County， Zhejiang Province， and to provide scientific evidence for prevention and control of hookworm disease. MethodsBy using a stratified cluster random sampling strategy， local residents aged ≥3 years was divided into 5 districts according to geographical location； furthermore， those in one administrative village （surveillance site） were investigated in each district. Species of hookworm were identified by filter paper culture in vitro， and enterobius vermicularis eggs were detected by cellophane anal swab in children aged 3‒9 year. Risk factors were determined by questionnaire. ResultsA total of 1 013 residents were investigated in 5 surveillance sites. Thirty nine cases with hookworm infection were detected， with the total infection rate of 3.85% . All species detected were determined to be Necator americanus. The infection rate significantly differed across the towns （χ2=48.32， P<0.05）， with the highest rate in Nanping Town （10.95%） . It significantly differed by age groups （χ2=65.65， P<0.05）， with the highest rate in those aged >70 years （9.75%）. Furthermore， it decreased with educational background. It was significantly associated with fertilize with fresh manure （χ2=6.87， P<0.05） and barefoot labor （χ2=157.69， P<0.05）. ConclusionThe overall infection rate of hookworm in Tiantai County remains low. Dominant species of hookworm is hookworm Necator americanus. It is necessary to strengthen the advocacy of hookworm prevention and control knowledge， improve hygiene in work and life style， and increase self-protection awareness.
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Objective To investigate the family aggregation of human hookworm infections in Sichuan Province and to identify its influencing factors, so as to provide insights into management of hookworm infections. Methods Three to four counties (districts) were sampled from basins, hilly regions and mountainous regions around the basins in Sichuan Province from 2017 to 2022 as fixed survey sites, and 17 to 30 counties (districts) were selected as mobile survey sites. At least 1 000 permanent residents at ages of 3 years and older were sampled from each survey site, and hookworm eggs were detected in human stool samples using the Kato-Katz technique. Subjects with 2 and more family members and at least 2 individuals diagnosed with hookworm infections in the county (district) where they lived were selected, and the familial aggregation of hookworm infections was analyzed using the test of goodness of fit for binomial distribution. In addition, the knowledge and practice of hookworm disease control were investigated among residents in Hejiang County and Wutongqiao District, Leshan City, Sichuan Province in 2021 and 2022, and the difference in the knowledge and practice of hookworm disease control was compared between members with and without familial aggregation of hookworm infections. Results A total of 66 812 residents from 25 196 households were sampled from main endemic areas of hookworm diseases in Sichuan Province from 2017 to 2022 for detection of hookworm infections, and 4 403 infections were identified (6.59% prevalence). The distribution of human hookworm infections in Sichuan Province did not fit the binomial distribution, and showed family aggregations (χ2 = 2 116.759, P < 0.001). Family aggregation of human hookworm infections was found in endemic areas with 1% and higher prevalence of human hookworm infections (χ2 = 136.006 to 428.738, all P values < 0.001), and family aggregation of human hookworm infections was identified in different years (χ2 = 87.615 to 471.838, all P values < 0.001) and in different terrains of endemic areas (χ2 = 8.423 to 1 144.176, all P values < 0.001). The members with hookworm infections had median eggs per gram of 180 (interquartile range, 780) in aggregated families and 72 (102) in non-aggregated families (Z = −2.686, P < 0.05). The proportion of members in families with aggregation of hookworm infections who knew the preventive measures of hookworm disease was significantly lower than in non-aggregated families (24.49% vs. 51.72%; χ2 = 10.262, P < 0.05), and the proportion of members in families with aggregation of hookworm infections who often worked barefoot on the ground was significantly higher than in non-aggregated families (30.61% vs. 13.25%; χ2 = 6.289, P < 0.05). Conclusions There is a familial aggregation of human hookworm infections in Sichuan Province, and awareness of preventive measures for hookworm disease and frequent working barefoot on the ground are associated with familial aggregation of hookworm infections.
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Background: Anemia still remains as one of the major public health problems in India despite implementing preventive measures. The objective was to find the prevalence and determinants of anemia among school going children in Tamil Nadu. Methods: We used the data from the fourth round of district level household survey (DLHS-4) for Tamil Nadu pertaining to the year 2012-13. Our analysis included 23997 children. Descriptive statistics, Random intercept and empty models of two-level logistic regression analysis were used. Results: The overall prevalence of anemia was found to be 41.4% (95% CI: 40.77%-42.02%). We observed a district level variation on anemia (District level variance=0.1, p<0.001) and the intra class correlation coefficient was 0.0295. The prevalence of anemia was more in coastal districts as compared to non-coastal districts (43.85% vs. 40.18%, p<0.001). Variables that are found to have significant association with anemia on multilevel analysis were younger age (Adjusted odds ratio (AOR)=1.343, 95% CI: 1.270-1.420), female children (AOR=1.462, 95% CI: 1.387-1.541), more than eight family members in the household (AOR=1.120, 95% CI: 1.008-1.245), rural residence (AOR=1.103, 95% CI: 1.038-1.172) and lower standard of living (AOR=1.203, 95% CI: 1.084-1.334). Conclusions: Half of school going children were anemic in the state. Geospatial distribution of anemia varied significantly. Governments and regional health centres should take adequate measures to avert the consequences of anemia in school going children considering these factors.
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La uncinariasis fue descrita por primera vez por Dubini en 1838. Es una helmintiasis intestinal causada por el Necator americanus y/o Ancylostoma duodenale. Frecuentemente son endémicas de áreas tropicales y subtropicales; afecta tanto a niños como a adultos. La transmisión asciende cuando existen entornos socioculturales y demográficos que favorecen la contaminación fecal, por lo que es considerado un problema de salud pública en el mundo. Se presenta el caso de un paciente masculino de 20 años que acudió a urgencias por astenia, adinamia, taquicardia y palidez mucocutánea generalizada; el hemograma reportó anemia severa y eosinofilia. Se requirió transfusión de 4 UI de glóbulos rojos y sulfato ferroso. El examen coprológico mostró infección por Necator americanus, que fue tratada con albendazol y, posteriormente, fue egresado de la institución sanitaria. La infección por uncinarias constituye una causa olvidada para el clínico de hemorragia de las vías digestivas y desarrollo de anemia. Por tanto, el presente estudio destaca que esta parasitosis es una causa importante en el diagnóstico diferencial. Además, se ofrece mayor importancia a las estrategias preventivas como la capacitación a profesionales de salud, el refuerzo de técnicas de aseo, la disminución de la contaminación y el aumento de la higiene personal(AU)
Hookworm infection was first described by Dubini in 1838. It is an intestinal helminth infection caused by Necator americanus and/or Ancylostoma duodenale. They are frequently endemic to tropical and subtropical areas and affect both children and adults. Transmission increases when there are socio-cultural and demographic environments that favor fecal contamination; therefore, it is a public health problem worldwide. We describe the case of a 20-year-old male patient who presented to the emergency department with asthenia, adynamia, tachycardia, and generalized mucocutaneous pallor. The blood test showed severe anemia and eosinophilia. Transfusion of 4 IU of red blood cells and ferrous sulphate was required. The coprological test showed infection by Necator americanus, which was treated with albendazole. Afterwards, the patient was discharged from the health institution. Hookworm infection is a neglected cause of gastrointestinal bleeding and anemia by the clinician. Therefore, the present study highlights this parasitosis as an important cause in the differential diagnosis. In addition, greater importance is given to preventive strategies such as training the health professionals, reinforcement of hygiene techniques, decrease of contamination and increase of proper personal hygiene(AU)
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Humanos , Masculino , Adulto JovenRESUMEN
Objective To investigate the prevalence and risk factors of hookworm infections among vegetable growers in Anhui Province, so as to provide the evidence for formulating the control strategy and interventions for hookworm human infections.. Methods A total of 1 179 vegetable growers were randomly sampled from 7 counties in Anhui province according to the natural ecological function areas in 2018 and 2019, and the basic features and risk factors of hookworm infections were collected from all subjects using a self-designed questionnaire, including living environment, vegetable planting and fertilization, type of household crops, animal feeding, hygiene and labor habits. In addition, stool samples were collected from all participants, and each stool sample was subjected to twice tests with the Kato-Katz technique. The risk factors of hookworm infections were identified among vegetable growers with the Bayesian log-binomial regression model. Results The prevalence of hookworm infection was 3.90% among the 1 179 vegetable growers. The prevalence of hookworm infection was 10.07% (15/149) among unemployed subjects, 5.32% (31/583) among farmers, and 0 among full-time vegetable growers (0/377) and subjects with other occupations (0/70), and there was a significant difference among subjects in terms of occupation (χ2=36.37, P < 0.01). Bayesian log-binomial regression analysis showed that fertilization with human feces [relative risk (RR)=18.25, 95% confidence interval (CI): (4.31, 77.17)], barefoot labor in vegetable fields [RR=2.86, 95% CI: (1.43, 5.70)], and living in plain ecological areas along the middle and lower reaches of the Yangtze River [RR=4.19, 95% CI: (1.19, 14.81)] were independent risk factors of hookworm infections among vegetable growers. Stratified analysis showed that fertilization with human feces, barefoot labor in vegetable fields, drinking well water or mountain spring, and living in plain ecological areas along the middle and lower reaches of the Yangtze River were independent risk factors of hookw, orm infection among farmers, and living in plain ecological areas along the middle and lower reaches of the Yangtze River and growing rice were independent risk factors of hookw, orm infection among unemployed individuals. Conclusions The prevalence of hookworm infection is high among vegetable growers in Anhui Province, and fertilization with human feces, barefoot labor in vegetable fields and living in plain ecological areas along the middle and lower reaches of the Yangtze River are risk factors of hookw, orm infections among vegetable growers.
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Detection and identification standard of hookworm—Hookworm larvae coproculture techniques (WS/T 791—2021) is the first recommended technical standard for hookworm detection and species identification using the hookworm larvae coproculture technique in China. This standard was issued on November 23, 2021, and had been in effect since May 1, 2022. This article provides a detailed interpretation pertaining to the background, drafting process, main contents, and dos and don’ts for better understanding and application of this standard among professionals working in disease control and prevention institutions and medical institutions.
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Objective To investigate the prevalence and influencing factors of soil-transmitted nematode infections in Ningbo City from 2016 to 2021, so as to provide insights into the development of targeted control measures against soil-transmitted nematodiasis. Methods Permanent residents at ages of 3 years and older were sampled in Ningbo City using a multi-stage sampling method each year during the period from 2016 to 2021. Soil-transmitted nematode eggs were detected in stool samples using a modified Kato-Katz thick smear method (two slides for each stool sample), and Enterobius vermicularis eggs were additionally identified among children at ages of 3 to 12 years using the adhesive cellophane-tape perianal swab method. The time- and regions-specific prevalence of soil-transmitted nematode infections was calculated, and the factors affecting hookworm infections were identified using a multivariate logistic regression model. Results A total of 11 573 person-times were detected for soil-transmitted nematode infections in Ningbo City from 2016 to 2021, and 296 egg-positives were detected, with a mean prevalence rate of 2.56% [95% confidential interval (CI): (2.28%, 2.87%)]. Hookworm was the predominant species of soil-transmitted nematode among egg-positives in Ningbo City (98.31%, 291/296), and there was a significant difference in the prevalence of hook-worm infections among years (χ2 = 190.27, P < 0.01). The highest prevalence of hook-worm infections was observed in Ninghai County (4.06%), and there was a region-specific prevalence rate of hookworm infection in Ningbo City (χ2 = 148.43, P < 0.01). Multivariate logistic regression analysis showed that elderly residents at ages of over 60 years [odds ratio (OR)= 1.94, 95% CI: (1.07, 3.54), P < 0.05], males [OR = 2.19, 95% CI: (1.72, 2.80), P < 0.01], farmers [OR = 6.94, 95% CI: (3.37, 14.29), P < 0.01] and residents with a low education level [illiteracy or semi-illiterate: OR = 3.82, 95% CI: (1.56, 9.35), P < 0.05; primary school: OR = 2.70, 95% CI: (1.11, 6.59), P < 0.05] were at a higher risk for hookworm infections. Conclusions The overall prevalence of soil-transmitted nematode infections was low among residents in Ningbo City from 2016 to 2021. The surveillance and health education for human hookworm disease remain to be reinforced among male farmers with a low education level at ages of over 60 years in Ninghai County.
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@#As one of the species of soil-transmitted helminths (STH), hookworm infection is widely prevalent in tropical and subtropical developing countries. Hookworm is harmful to human health mainly including anemia, digestive tract symptoms, female infection can also cause menopause, abortion, infection in infants and young children can lead growth retardation. With the development of economy and implementation of mass drug administration strategies, the infection of hookworm in human body has decreased continuously, but there are still a large number of mild infection cases which clinical symptoms are not obvious, easy to cause missed diagnosis and misdiagnosis. Several zoonotic hookworm species can cause large-scale infections in cats, dogs and other animals, so as to increase the risk of human hookworm infection. Therefore, it is important to find a highly sensitive and rapid detection techniques to identify hookworm species. In this paper, the existing detection techniques of hookworm were reviewed and their application were prospected to provide ideas for hookworm detection at present situation.
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As a type of highly plastic innate immune cells, macrophages may be differentiated into M1 and M2 macrophages upon different stimuli, and M2 macrophages are involved in immune regulation, tissue remodeling and regeneration, and wound healing. Previous epidemiological studies have shown a significant negative correlation between the prevalence of helminth infections and the incidence of inflammatory diseases, such as allergy and autoimmune diseases. As a common type of intestinal helminths, hookworm infection may trigger high levels of type II host immune responses, with alternative activation of macrophages, which are effective to inhibit the development and progression of inflammatory diseases. This review summarizes the advances in alternative activation of macrophages in hookworm therapy for inflammatory diseases.
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As a common soil-borne nematode, hookworm is mainly parasitized in the intestine, and the clinical manifestations of hookworm infections mainly include gastrointestinal symptoms and iron-deficiency anemia. In addition, hookworm may be also parasitized in other organs in addition to gastrointestinal system, resulting in development of disorders in other systems. Proteinuria caused by hookworm infections is rare and easy to be misdiagnosed in clinical practices. Hereby, the diagnosis and treatment of a case of proteinuria associated with hookworm infections was reported, in order to increase the understanding of hookworm infection-associated proteinuria among clinicians.
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@#Abstract: Objective To analyze the epidemic characteristics of soil-transmitted helminth (STH) by the spatial epidemiological method in Jiangxi Province. Methods Surveillance data of STH in Jiangxi Province from 2016 to 2019 were collected for descriptive epidemiological analysis. The space-time permutation distribution of STH infection areas was analyzed with spatial autocorrelation, hotspot analysis methods and retrospective space-time permutation scan statistics. Results The infection rates of STH were 1.32% (947/71 766), 1.14% (803/70 547), 0.87% (604/69 507) and 0.90% (628/69 620), respectively, and the differences were statistically significant in different years (P<0.01). The rates of hookworm infection were 0.65% (466/71 766), 0.64% (450/70 547), 0.48% (336/69 507) and 0.52% (362/69 620), respectively, and the differences were statistically significant (P<0.01). The infection rates of Ascaris lumbricoides were 0.55% (393/71 766), 0.41% (287/70 547), 0.32% (221/69 507) and 0.32% (225/69 620), respectively, and the differences were statistically significant in different years (P<0.01). The infection rates of Trichuris trichiura were 0.17% (125/71 766), 0.10% (74/70 547), 0.08% (57/69 507) and 0.07% (49/69 620), respectively, and the differences were statistically significant among different years (P<0.01). The results of global spatial autocorrelation analysis showed that there was a spatial autocorrelation index Moran's I value of hookworm infection rate in 2016, Trichuris trichiura infection rate in 2016, 2018 and 2019, with statistical significance (P<0.05). The results of hotspot analysis, SaTScan and FleXScan spatial and temporal scanning analysis showed that there were high-value aggregation regions for each species in each year. Conclusion The infection rates of STH, hookworm, Ascaris lumbricoides and Trichuris trichiura showed a decreasing trend and space-time clustering from 2016 to 2019. It should be taken into account in the formulation of control strategies.
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With the improvement of sanitation, the infection rate of hookworm is greatly reduced and the severe infected case is rarely reported. Combined morphological and molecular biological examinations, a severe hookworm infection patient was diagnosed in Department of Laboratorial Examination, Quanzhou First Affiliated Hospital of Fujian Medical University. The morphological methods such as direct fecal smear microscopy, saturated brine flotation and hookworm larvae culture methods were used to identify the eggs and larvae from stool samples of the patient. There were a large number of hookworm eggs in patient's stool samples, and the average count was 60 840 per gram by modified Kato method, which belonged to severe hookworm infection. Meanwhile, to distinguish the hookworm species, the semi-nested RT-PCR assay was employed to detect hookworm internal transcribed spacer series from eggs in patient's stool samples, and the result showed that the hookworm species was confirmed to be Necator americanus.
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Animales , Humanos , Ancylostomatoidea/genética , Heces , Infecciones por Uncinaria/diagnóstico , Necator americanus/genética , Reacción en Cadena de la PolimerasaRESUMEN
Aims:The study aimed at determining the prevalence and risk factors for intestinal helminth infection among school-age children in Calabar, Cross River State, Nigeria. Study Design:Cross-sectional observational study was conducted in two Local Government Areas (Calabar South and Calabar Municipality) in Calabar. Place and Duration of Study:The study was carried out in Calabar, from May to October, 2018. Methodology:Faecal samples were collected from pupils in sterile dry specimen bottles with the use of applicator sticks and analyzed using sedimentation and floatation techniques. Data obtained was analyzed using Statistical Package for Social Sciences (SPSS) version 21. Results:Overall prevalence of intestinal helminth was 18.5%. Parasites recovered were Ascaris lumbricoides(9.3%), Trichuris trichiura(4.0%), Hookworm(2.6%), Taenia solium(0.9), Enterobius vermicularis (0.9), Strongyloides stercoralis (0.4%) and Schistosoma mansoni (0.4%) (P = 0000). Males (22.1%) were more infected than females (14.0%) in the study area (P = 0.031).Prevalence of intestinal helminths was lowest in age group 11-15 years (14.4%) and highest in age group 6-10 years (23.5%)(P = 0.005). After multivariate analysis, source of water [OR=3.355, 95% CI 1.448 –7.770], type of sewage system [OR=7.547, 95% CI 5.011 –8.358], hand washing before meal [OR=4.069, 95% CI 1.719 –9.631] and hand washing after defecation[OR=2.281, 95% CI 1.059 –4.917] were statistically associated with thedetected intestinal helminthic infections in faecal samples (p = .05). Conclusion:The presence of these intestinal parasites in these schools is a public health problem and there is therefore a need to prevent these infections by improving individual personal hygiene through health education, general sanitation and provision of adequate social amenities.
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La uncinariasis, anquilostomiasis o también conocida como anemia tropical, es una parasitosis intestinal de gran importancia mundial. Las uncinarias son parásitos nematodos transmitidas por el contacto de la piel con suelos contaminados. Una de las consecuencias más importantes de la infección masiva por estos parásitos es el sangrado intestinal crónico que conduce a disminución de la hemoglobina, y en casos inusuales, esta anemia puede llegar a ser severa. Con el objetivo de poner en discusión la importancia y morbilidad de esta enfermedad, presentamos el caso de un varón de 23 años, procedente de una zona tropical del Perú, quien ingresa por emergencia con un valor de hemoglobina de 2,3 mg/dL, alteración del nivel de conciencia e historia de rectorragia. Durante el proceso diagnóstico se encuentra en la colonoscopia múltiples parásitos con áreas de sangrado y colitis erosiva, mientras que en el examen parasitológico se observan huevos de Ancylostoma/Necator spp 2+. La sintomatología mejora posterior al tratamiento con albendazol. La uncinariasis debe siempre sospecharse en el proceso diagnóstico de pacientes con anemia crónica tanto en Perú como en zonas tropicales del mundo.(AU)
Uncinariasis or ancylostomiasis, a.k.a. tropical anemia, is an intestinal parasitosis of great importance worldwide. Hookworms are parasitic nematodes transmitted by skin contact with contaminated soils. One of the most important consequences of massive infection by these parasites is chronic intestinal bleeding, which leads to reduced hemoglobin. In unusual cases the resulting anemia may be severe. With the purpose of discussing the importance and morbidity of this disease, a case is presented of a male 23-year-old patient from a tropical area in Peru who was admitted for an emergency hemoglobin value of 2.3 mg/dL, altered mental status and a history of rectal bleeding. During diagnostic examination, colonoscopy revealed multiple parasites with bleeding areas and erosive colitis, whereas parasitological analysis found eggs of Ancylostoma/Necator spp 2+. Symptoms improved after treatment with albendazole. Uncinariasis should always be suspected in the process of diagnosis of patients with chronic anemia both in Peru and in tropical areas worldwide(AU)
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Humanos , Masculino , Adulto Joven , Colonoscopía/métodos , Infecciones por Uncinaria/complicaciones , Infecciones por Uncinaria/diagnóstico , Perú , Anemia/complicacionesRESUMEN
Objective To understand the prevalence of soil-borne nematode infections among residents living in urban/town areas of China, so as to provide insights into the control and elimination of soil-borne nematodiasis. Methods A total of 5 epidemic areas were classified in China according to the prevalence of human Clonorchis sinensis infections captured from the 2014–2015 national survey on major human parasitic diseases in China, and the total sample size was estimated according to the binomial distribution and Poisson’s distribution. Then, the total sample size was allocated proportionally to each province (autonomous region, municipality) of China based on the percentage of residents living in urban and town areas, and the number of survey sites in each province (autonomous region, municipality) was proportionally assigned according to the percentages of residents living in urban and town areas. Then, stratified sampling was performed at county, township and community levels according to the number of sampling sites in each province (autonomous region, municipality), and the survey site (community) was defined as the smallest sampling unit. All permanent residents in the survey sites were selected as the study subjects, and their stool samples were collected for identification and counting of parasite egg using a Kato-Katz technique. The prevalence and intensity of each parasite species were calculated. Results From 2014 to 2015, among the 133 231 residents detected in 31 provinces (autonomous regions, municipalities) of China, the overall prevalence of soil-borne nematode infections was 1.23% (1 636/133 231), and the prevalence rates of hookworm, Ascaris lumbricoides and Trichuris trichiura infections were 0.77% (1 032/133 231), 0.32% (426/133 231) and 0.17% (224/133 231), respectively. The highest prevalence of soil-borne nematode infections was seen in Jiangxi (4.03%, 82/2 034) and Chongqing (4.03%, 524/13 012), followed by in Hainan (3.47%, 72/2 075). The prevalence of soilborne nematode infections was 1.07% (662/62 139) in men and 1.37% (974/71 092) in women, and the greatest prevalence was found in residents at ages of 65 to 70 years (2.56%, 219/8 569). With regard to occupations and education levels, herdsmen (2.47%, 2/81) and illiterate residents (3.33%, 226/6 795) were found to have the highest prevalence of soil-borne nematode infections, respectively. In addition, mild infections were predominantly identified in hookworm-, A. lumbricoides- and T. trichiura-infected individuals (all > 90%). Conclusions The overall prevalence of soil-borne nematodiasis remains low in urban and town areas of China; however, human infections are widespread. According to the epidemiological features, health education combined with deworming are recommended to reduce the prevalence of soil-borne nematode infections among residents living in urban and town areas of China.
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Objective To understand the current status and changing tendency of human hookworm infections in Anhui Province. Methods According to the unified national survey scheme, a total of 48 survey sites were sampled from 16 counties (cities) in 4 ecological regions of Anhui Province using a stratified cluster random sampling method from 2014 to 2015. The hookworm eggs were detected in the fecal samples from permanent residents at ages of over one year living in the survey sites using a modified Kato-Katz thick smear method, and the subjects’health knowledge and behaviors were investigated using questionnaire survey. Results A total of 12 300 persons were examined in the 48 survey sites from 4 ecological regions of Anhui Province between 2014 and 2015, and 259 subjects were identified with hookworm infections, with a mean prevalence of 2.11%. Among the four ecological regions, the North China Plain had the highest prevalence of human hookworm infections (3.02%) and in all survey sites, Linquan County had the highest prevalence (7.03%). Ancylostoma duodenale was the predominant hookworm species identified (62.16%), and 65.64% had mild infections. The prevalence of human hookworm infections was significantly greater in women than in men (χ2 = 4.16, P < 0.05), and showed a tendency towards a rise with ages (χ2trend = 113.36, P < 0.01). In addition, the prevalence of human hookworm infections varied in occupations (χ2 = 159.41, P < 0.01) and education levels (χ2 = 34.95, P < 0.01). Questionnaire survey showed low prevalence of human hookworm infections in subjects knowing the question“how hookworm infection occurs”and denying“using fresh stools for fertilization”(χ2 = 15.05, P < 0.01; χ2 = 4.19, P < 0.05). Conclusions The prevalence of human hookworm infections has greatly decreased in Anhui Province; however, the prevalence remains relatively high in some regions and populations. The North China Plain should be regarded as the key area for hookworm disease prevention and control, and housewives and populations with advanced ages and low educational levels are key targeted populations in Anhui Province.
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La uncinariasis es endémica en zonas tropicales. Es común en preescolares y escolares pero infrecuente en lactantes antes de los 6 meses debido al mecanismo de transmisión que implica contacto de la piel con el suelo contaminado. La infección se caracteriza por anemia ferropénica secundaria a sangrado digestivo crónico. Una forma inusual de presentación es el sangrado digestivo masivo que causa anemia severa. Presentación del caso: Niña shuar de 4 meses sin antecedentes patológicos, referida del Hospital General Puyo por un cuadro de melenas de 3 meses de evolución. Al mes de edad inició con deposiciones melénicas ocasionales y palidez que empeoraron dos semanas antes del ingreso. Se apreció palidez generalizada, hipoactividad y edema en miembros inferiores. Presentó hemoglobina 2,8 g/dL, hematocrito 9%, volumen corpuscular medio 73 fl, ancho de distribución de eritrocitos 18%, reticulocitos 1% y eosinófilos 4%. El coprológico y coproparasitario reportaron heces alquitranosas, sangre positiva y huevos de uncinarias más Kato-Katz compatible con intensidad de infección moderada. Se diagnosticó anemia severa por sangrado digestivo secundario a uncinarias. Se trató con Albendazol 400 mg vía oral en una toma más transfusión sanguínea. A los 5 días mejoró la hemoglobina y disminuyó el edema. Las melenas cesaron. Se dió el alta para control ambulatorio. Conclusión: La uncinariasis es una enfermedad endémica cuya presencia e impacto en lactantes se ha subestimado pues no es considerada como causa de sangrado digestivo. Debe pensarse en esta parasitosis en contextos de zonas endémicas en niños que cumplan un perfil clínico similar al descrito
Hookworms are endemic nematodes from tropical regions. Infection is more common in preschool and school children, but it is less frequent in infants under 6 months, because of the transmission mechanism that implies contact between contaminated soil and skin. The clinical disease is characterized by manifestations related to iron-deficiency anemia, secondary to a chronic digestive blood loss. An unusual way of presentation is the massive digestive bleeding that causes severe anemia. Case report: A four month shuar girl with no significant medical history, referred from General Puyo hospital, presented upper digestive bleeding of 3 months duration. At month of age, the girl presented self-limited melenas and skin pallor that worsen two weeks before the admission. The girl was hypo active, with a pale complexion, and had edema of feet. Her blood count showed hemoglobin 2.8 g/dl, hematocrit 9%, mean corpuscular volume 73 fl, red cell distribution width 18%, reticulocyte count 1%, eosinophils 4%. Coprological analysis reported tarry stools, positive fecal occult blood test, and hookworm eggs determined by Kato Katz as a moderate infection. It was diagnosed iron-deficiency anemia secondary to an upper digestive bleeding caused by hookworms. The infection was treated with a single oral dose of albendazole 400mg plus blood transfusion. After 5 days of treatment, hemoglobin increased and edema was reduced. Melenas disappeared completely. Finally the discharge was indicated for outdoor control. Conclusion: Hookworm infestation is an endemic disease whose presence and impact in infants has been underestimated because it is not necessary as a cause of digestive bleeding. This disease should be considered in contexts of endemic areas in children who meet a clinical profile similar to that described
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Humanos , Masculino , Femenino , Lactante , Infecciones por Uncinaria , Lactante , Anemia , Piel , Contaminantes del Suelo , Informes de Casos , EcuadorRESUMEN
Objective To understand the demographic characteristics and clinical features of hookworm infectors in high infection area in South Mountain area of Zhejiang Province,and to find the risk factors of infection,so as to provide the evidence for formulating prevention and control measures.Methods In 2018,according to the soil-borne nematode monitoring results of the previous year in Zhejiang Province,three villages with relatively more hookworm infections were selected from Qingtian County in South Mountain area of Zhejiang Province,and more than 10 cases of hookworm infection were selected from each survey site.A face to face questionnaire survey was conducted by all investigators using a questionnaire designed by the Center for Infectious Disease Control and Prevention,Zhejiang Provincial Center for Disease Control and Prevention,and information on the general condition,past diagnosis history,clinical symptoms and risk factors of infection of infected persons were collected.The stool samples were collected and tested for infection by modified Kato-Katz method to evaluate the drug deworming effect in the previous year.Results A total of 33 cases of hookworm infection were investigated,including 18 males and 15 females;the age ranged from 33-85 years old,mainly concentrated in 60-79 years old,a total of 23 cases (69.7％).Ten cases (30.3％) had been diagnosed with hookworm disease;19 cases (57.6％) had similar symptoms of hooky dermatitis;and 12 cases (36.4％) had gastrointestinal symptoms in the past three years.There were 31 cases (93.9％) worked in the field for more than one month each year,18 cases (54.5％) used fresh manure directly at home,6 cases (18.2％) were used to working barefoot in the field,and 30 cases (90.9％) used to wearing slippers in the field.A total of 32 eligible stool samples were examined,and 4 case (12.5％) were still positive for hookworm eggs.Conclusions Among the infectors,fertilizing with fresh stool,working barefoot or wearing slippers in the field may serve as the risk factors.There is a certain failure proportion to eliminate the infection status when adopting only one round anthelminthic treatment.For prevention and control hookworm infections,comprehensive intervention measures including infection source management,harmless treatment of stools,individual behavior intervention and environment improvement are suggested.
RESUMEN
Hookworm infection remains a global health concern, which threatens human health. Hookworm infection is widely prevalent across the world, notably in tropical and subtropical areas. Recently, with the in-depth study of the immunity of parasitic infections, the“bidirectional effect”of host immune responses induced by helminth infections (including hookworm infections) has become increasingly prominent. On one hand, an immune response is induced in the host to kill the infected worms; on the other hand, the host produces a series of immunological changes that are conducive to the maintenance of parasite survival. The immune state of the host is regulated by various complicated mechanisms, and this may lead to the reduction in the incidence of allergic and autoimmune diseases or alleviation of the disease symptoms, which provide new insights into the management of these allergic and autoimmune diseases. The present article reviewed the advances of host immune responses induced by hook-worm infection and its potential values in the treatment of allergic asthma, inflammatory bowel disease and rheumatoid arthritis.
RESUMEN
Objective To understand the epidemic trend of soil-transmitted nematodiasis in Zhenjiang City from 2006 to 2018, so as to provide evidence for formulating targeted control measures. Methods The permanent residents at ages of 3 years and greater and the immigrants who had lived in Zhenjiang City for more than one year were selected as the study subjects. Fecal samples were collected, and the soil-transmitted nematode eggs were detected in fecal samples with the modified Kato-Katz technique (three smears from one stool sample), while the children at ages of 12 years and lower were tested for Enterobius vermicularis eggs using the adhesive cellophane-tape perianal swab method. The prevalence and intensity of parasitic infections were estimated in Zhenjiang City each year from 2006 to 2018, and the data pertaining to the deworming for soil-transmitted nematode infections were collected during the study period. Results A total of 202 880 person-times were subjected to stool examinations in Zhenjiang City from 2006 to 2018, and 946 persons were detected with soil-transmitted nematode infections, with a mean prevalence of 0.47%. The overall prevalence of human soil-transmitted nematode infections appeared a decline tendency (P < 0.01), with a reduction from 1.10% in 2006 to 0.11% in 2018, and there was a region-specific overall prevalence (P < 0.01), with the highest prevalence seen in Runzhou District (1.65%) and the lowest detected in New District (0.04%). The mean prevalence of human Ascaris lumbricoides, hookworm and Trichuris trichiura infections was 0.33%, 0.09% and 0.04% in Zhenjiang City, respectively, and showed a decline tendency year by year from 2006 to 2018 (P < 0.01). Among all infections, mild infections were predominant. During the period from 2006 through 2018, a total of 45 427 children were examined in Zhenjiang City from 2006 to 2018, and 145 children were positive for E. vermicularis infections, with a mean prevalence of 0.32%. The prevalence of E. vermicularis infections decreased from 1.33% in 2006 to 0.22% in 2018 in children, and the overall prevalence appeared a decline tendency (P < 0.01). A single parasite infection was predominant in soil-transmitted nematode infections (97.46%), and mixed infection of two parasites were mainly detected before 2007. A total of 535 089 person-times received deworming in Zhenjiang City from 2006 to 2018, and the rate of adverse events was 0.002%. Conclusions Currently, the soil-transmitted nematode infection is at a low level in Zhenjiang City, and the overall prevalence of soil-transmitted nematode infections shows a decline tendency year by year. The surveillance and health education of soil-transmitted nematodiasis should be further intensified to consolidate the control achievements.