Pattern of intestinal parasitic infections in children with malnutrition in Somalia.

Objectives: Children living in conflict zones plagued with adverse climatic conditions often suffer from acute malnutrition. Being coinfected with intestinal parasites could worsen the prognosis if adequate interventions are not promptly instituted. We determined the pattern of intestinal parasitic infections (IPIs) in children with acute malnutrition in the Bay and Banadir regions of Somalia. Methods: A hospital-based cross-sectional study was conducted from August to October 2023 in 222 children with acute malnutrition aged 6-59 months, using a structured questionnaire and stool examination by a trained laboratorian. The prevalence of IPI was estimated and the pattern of IPI was explored. The relationship between the presence of IPI and demographic characteristics was examined with multiple logistic regression at a 95% level of confidence. Results: The mean age was 20.4 ± 12.3 months, 125 (56.3%) were females, and 41.9% were internally displaced. The prevalence of IPI was 82.9% (95% confidence interval: 77.4-87.3), Of the infected, 73.9% (136 of 184) had single parasitic infection and 23.4% (43 of 184) had double parasitic infections. Ascaris lumbricoides (46.6%), Giardia lamblia (22.1%), and Entamoeba histolytica (17.6%) were the most common parasites identified. The age of 13-36 months (adjusted odds ratio: 1.13, P = 0.02) and eating once a day (adjusted odds ratio: 1.13, P = 0.06) were associated with being infected with intestinal parasites. Conclusions: The prevalence of intestinal parasitic infection was high in children with malnutrition in the Bay and Banadir regions. Deworming should be extended to all children with malnutrition. Food, sanitation, and water provision initiatives should be improved at the community level.

Exploring frailty in apparently healthy senior dogs: a cross-sectional study.

BACKGROUND: As dogs age, they face various health challenges, and preventive care may be overlooked, impacting their quality of life. Frailty, a concept established in human medicine, has recently been applied to dogs using validated tools like the frailty index and frailty phenotype. This study aims to characterize frailty in senior pet dogs and investigate associated factors. To achieve this goal, 88 apparently healthy dogs, as reported by their owners, voluntarily participated in thorough consultations. These consultations included supplementary examinations such as urinary analyses, hematological assessments, and blood biochemistry. Additionally, owners completed questionnaires addressing their dog's overall health, cognitive and locomotor status, as well as their own attachment to the dog and personality traits. Subsequently, each dog was classified as robust or frail based on the presence of multiple criteria out of a set of five. All collected data underwent preliminary screening by a multiple factorial analysis, followed by binomial logistic regression to model frailty. RESULTS: The final population consisted of 74 dogs, with a frailty prevalence of 41.9% (95% CI: 30.5 - 53.9). In the statistical analysis, older age of the dog, lower owner attachment score, lack of regular deworming, and a disparity in extraversion between owner and dog were identified as contributing factors to frailty. CONCLUSIONS: This study emphasizes the importance of regular deworming and strong owner-pet attachment in reducing frailty in dogs. It underscores the significance of proactive pet care and highlights the complex relationship between owner-dog personalities and canine frailty. This research advocates for a holistic approach that considers both human and canine traits to promote better health outcomes.

Antibody response after feline panleukopenia virus vaccination in kittens with and without intestinal parasites.

OBJECTIVES: Vaccinations should only be given to healthy cats, and deworming before vaccination is generally recommended; however, so far, no study has investigated the influence of intestinal parasitic infection on the immune response in kittens. The aim of this prospective study was to compare the antibody response to feline panleukopenia virus (FPV) vaccination in kittens with and without intestinal parasites. METHODS: Overall, 74 healthy kittens were included. Of these, 17 had intestinal parasites (12/17 Toxocara cati, 6/17 Cystoisospora felis, 1/17 Capillaria species). Both kittens with and without (n = 57) parasites received two primary kitten vaccinations with modified live FPV vaccines in a 4-week interval starting at the age of 8-12 weeks. Anti-FPV antibodies were determined at the beginning of the study (week 0) and at week 8 (4 weeks after the second vaccination) by haemagglutination inhibition. A ⩾four-fold titre increase (week 8 vs week 0) was defined as a response to vaccination. Comparison of the immune response in the kittens with and without intestinal parasites was performed using Pearson's χ2 test. RESULTS: Pre-vaccination antibodies were present in 4/17 (23.5%) kittens with intestinal parasites and in 24/57 (42.1%) without parasites. A ⩾four-fold titre increase was seen in 13/17 (76.5%) kittens with parasites compared with 32/57 (56.1%) kittens without parasites. There was neither a significant difference in pre-vaccination antibodies (P = 0.17), nor in vaccination response (P = 0.13) between kittens with and without parasites. CONCLUSIONS AND RELEVANCE: The results indicate that asymptomatic intestinal infections with endoparasites do not interfere with the immune response to kitten vaccination series. Parasitic infection (at least with T cati, C felis and Capillaria species) is therefore not a reason to postpone important vaccinations.

Prevalence of Taenia solium cysticercosis in domestic pigs following albendazole deworming intervention in rural communities of Mbulu district, Tanzania.

Taeniosis and cysticercosis are infections caused by cestodes, Taenia solium is among them. T.solium neurocysticercosis accounts for 30% of acquired epilepsy in human in developing countries. This study was carried out to determine the prevalence of cysticercosis among domestic pigs in Mbulu district following deworming intervention. The study was conducted among three rural communities monitoring community intervention in Mbulu district between March 2020 and September 2021. Live pigs were diagnosed by lingual examination for the presence of T. solium cysticerci, and pig-rearing practices were recorded. Logistic regression was performed to determine the role of risk factors on pig infection outcome. We conveniently sampled 510 pigs; 267 (52.4%) were sampled in the year 2020 and 243 (47.6%) in 2021. All pigs were examined by lingual examination for the presence of pork tapeworm larvae, and 43 (8.4%) pigs were found to be infected. Twenty-one (48.8%) of the infected pigs were males and 22 (51.2%) were females, and the overall annual prevalence of tapeworm larvae was 9% and 7.8% for 2020 and 2021, respectively. The pigs were twice more likely to be found infected during the rainy season compared to the dry season in 2020 (OR = 2.27, 95%CI of 1.16-7.22). The reported pig-rearing practices were free-range, penned, and tethered, 141 (52.8%), 64 (24%), and 62 (23.2%), respectively. Of the 94 visited households in 2020, 78 (83%) reported drinking water without boiling, and 59 (62.8%) household leaders reported having heard about taeniosis/cysticercosis. The prevalence of cysticercosis among domestic pigs in this study was high, with seasonal variations. Despite the ongoing national school deworming and community deworming program, there was no significant change in the prevalence of cysticercosis over two consecutive years. The reported pig infections imply fecal-oral transmission with humans tapeworm eggs released from infected humans. Most households reported consuming unboiled drinking water that might be contaminated. Integrating pig vaccination and deworming, health education and school or community deworming along with improved pig management practice and general community water sanitation hygiene (WASH) are recommended to reduce the burden of pork tapeworm in the study communities.

Farm size and biosecurity measures associated with Strongylus vulgaris infection in horses.

BACKGROUND: Selective anthelmintic treatment, advocated due to evolving anthelmintic resistance, has been associated with an increase in Strongylus vulgaris prevalence. Reverting to routine interval anthelmintic treatments is not viable and therefore, identifying other management factors correlated with S. vulgaris infection is vital. OBJECTIVES: To investigate possible risk factors associated with the presence of S. vulgaris infection in resident horses on Swedish horse establishments. STUDY DESIGN: Internet-based questionnaire survey. METHODS: A questionnaire, created using the internet-based survey platform Netigate, was distributed to owners of equine establishments throughout Sweden via established equine platforms and social media channels. The survey was available for response from 21 May until 1 September 2022. Questions were closed ended with branching logic paths. RESULTS: Four factors were significantly associated with S. vulgaris infection, with an increased odds of infection seen in livery yards (odds ratio [OR] 1.67, 95% confidence interval [CI] 1.18-2.36, p = 0.004) and premises with more than 10 resident horses (OR 2.42, 95% CI 1.64-3.56, p < 0.001). A lower odds of infection were seen in establishments using quarantine routines (OR 0.69, 95% CI 0.50-0.96, p = 0.03) and anthelmintic treatment of new horses prior to arrival at the premise (OR 0.37, 95% CI 0.18-0.74, p = 0.005). MAIN LIMITATION: Due to the presence of S. vulgaris infection in the present study being based on S. vulgaris diagnostics performed at the farm level, any association between faecal diagnostic use and risk of infection could not be investigated. CONCLUSIONS: Although the use of diagnostics for S. vulgaris can keep infection rates low, large farms or livery yards with many different horse owners, and those with low use of biosecurity measures as regards to new horses arriving at the premise, are associated with a higher risk of infection.

Meta-analysis and public policy: Reconciling the evidence on deworming.

The WHO recommends mass drug administration (MDA) for intestinal worm infections in areas with over 20% infection prevalence. Recent Cochrane meta-analyses endorse treatment of infected individuals but recommend against MDA. We conducted a theory-agnostic random-effects meta-analysis of the effect of multiple-dose MDA and a cost-effectiveness analysis. We estimate significant effects of MDA on child weight (0.15 kg, 95% CI: 0.07, 0.24; P < 0.001), mid-upper arm circumference (0.20 cm, 95% CI: 0.03, 0.37; P = 0.02), and height (0.09 cm, 95% CI: 0.01, 0.16; P = 0.02) when prevalence is over 20% but not on Hb (0.06 g/dL, 95% CI: -0.01, 0.14; P = 0.1). These results suggest that MDA is a cost-effective intervention, particularly in the settings where it is recommended by the WHO.

Bridging the vitamin A and deworming coverage gap among underserved populations in India through government and civil society organization partnerships.

BACKGROUND: Vitamin A deficiency (VAD) is a major public health problem in India, where approximately 62% of children under five have low retinol levels (< 70 µmol/L). This study aims to (1) evaluate vitamin A supplementation (VAS) and deworming (VAS + D) coverage in Nagaland state through government and civil society organization (CSO) partnerships, (2) examine socio-demographic barriers and facilitators to VAS + D coverage, (3) examine associations between socio-demographic characteristics and source of VAS coverage (i.e., government vs. CSOs), and (4) estimate the impact of VAS on health outcomes due to increased coverage through government and CSO partnerships. METHODS: A cross-sectional statewide coverage survey was conducted in Nagaland, India with 1,272 caregivers of children 6-59 months. Household socio-demographic data and VAS + D exposure variables were collected via quantitative survey. Univariate analyses were used to assess the associations between the independent and outcome variables; odds ratios were computed to measure the strength of the association at a significance level of < 0.05. The Lives Saved Tool (LiST) was used to estimate the impact of increased VAS coverage on child undernutrition, morbidity and mortality. RESULTS: Most children (77.2%) received VAS in the past six months, with 28.1% receiving VAS in capsule form (provided primarily by CSOs) and 70.2% received VAS in syrup form (provided primarily by government). Total deworming coverage was 74.2%, with 43.5% receiving both VAS and deworming. Lower pre-school enrollment was a barrier to receiving VAS (47.4% not enrolled vs. 80.9% enrolled, p < 0.001). A barrier to receiving VAS + D was lack of knowledge of benefits (p < 0.001). Based on LiST modeling, increasing VAS coverage by 22% through CSOs resulted in an estimated 114 stunting cases averted, 25,017 diarrhea cases averted, and 9 lives saved in 2019 in Nagaland State. CONCLUSIONS: Government and CSO partnerships can reduce disparities in VAS coverage and decrease under-five child morbidity and mortality.

Investigating the effect of a school-based WASH intervention on soil-transmitted helminth and schistosome infections and nutritional status of school children in Ethiopia: a quasi-experimental study.

BACKGROUND: The impact of access to improved water, sanitation and hygiene (WASH) and health education on large-scale deworming programs aimed at controlling soil-transmitted helminth (STH) and schistosome (SCH) infections has not been well studied. We assessed the additional impact of improved WASH infrastructure and health education at schools on STH and SCH infections in Ethiopia. METHODS: The study used a quasi-experimental design under which 30 schools were assigned to either an intervention (15 schools) or control (15 schools) arm. Both arms received a standard deworming treatment and lunch. In the intervention arm, improved WASH and health education were provided. At three consecutive time points (baseline in 2013, 2014 and 2015), the prevalence and intensity of STH and SCH infections and the nutritional status [hemoglobin concentrations and physical growth (height and weight)] were determined. To verify whether interventions were successfully implemented, the WASH status at school and the student knowledge, attitudes and practices related to WASH (WASH-KAP) were recorded. Differences in metrics between arms at baseline (2013) and follow-up (2015) were assessed both within and between the arms. RESULTS: A significant increase in scores for both the school WASH and student KAP was found in the intervention arm, indicating successful implementation of the intervention. The prevalence of any STH infection was significantly reduced in the intervention arm but not in the control arm (F = 4.486, p = 0.034). There was a significantly greater reduction in the intensity of infection of hookworm and Ascaris lumbricoides compared to baseline in both arms. The intervention did not affect school children's height-for-age z-score (intervention arm * time coef = 0.12, p = 0.400) and body mass index-for-age z-scores (intervention * time coef = - 0.06, p = 0.526). Hemoglobin concentrations increased significantly more in the control than the intervention arm (coef = - 0.16, p = 0.006). CONCLUSIONS: Although the intervention did increase school WASH and student WASH-KAP, our study found poor evidence of the additional benefit of improved WASH and health education to deworming and school food programs on parasite re-infection and the health outcomes of children.

Feasibility of delivering vitamin A supplementation (VAS) and deworming through routine community health services in Siaya County, Kenya: A cross-sectional study.

Vitamin A deficiency and soil-transmitted helminth infection are serious public health problems in Kenya. The coverage of vitamin A supplementation and deworming medication (VASD) provided through mass campaigns is generally high, yet with a cost that is not sustainable, while coverage offered through routine health services is low. Alternative strategies are needed that achieve the recommended coverage of >80% of children twice annually and can be managed by health systems with limited resources. We undertook a study from September to December 2021 to compare the feasibility and coverage of VASD locally delivered by community health volunteers (CHV) ("intervention arm") to that achieved by the bi-annual Malezi Bora campaign event ("control arm"). This comparative cross-sectional study was conducted in sub-counties of Siaya County using both qualitative and quantitative methods. VASD were offered through the CHS in Alego Usonga and through Malezi Bora in Bondo Sub-County. Coverage was assessed by a post-event coverage survey among caregivers of children aged 6-59 months (n = 307 intervention; n = 318 control). Key informant interviews were conducted with n = 43 personnel across both modalities, and 10 focus group discussions were conducted with caregivers of children aged 6-59 months to explore knowledge, attitudes and perceptions of the two strategies. VAS coverage by CHV was 90.6% [95% CI: 87.3-93.9] compared to 70.4% [95% CI: 65.4-75.4] through the Malezi Bora, while deworming coverage was 73.9% [95% CI: 69.0-78.7] and 54.7% [95% CI: 49.2-60.2], respectively. With sufficient training and oversight, CHV can achieve superior coverage to campaigns.

Association between knowledge and actual practices of family member caregivers of lowincome families on the prevention and control of soil-transmitted helminthiasis in an urban barangay: An analytical cross-sectional study / Health Sciences Journal

Introduction@#Soil-transmitted helminthiasis (STH) remains to be highly prevalent in the Philippines, despite the implementation of school-based bi-annual mass drug administration and other preventive measures under the Garantisadong Pambata Program by the Department of Health (DOH).@*Methods@#This analytical cross-sectional study determined the association between the level of knowledge and the actual practices of family care givers in the prevention of STH among school-age children belonging to low-income families in an urban barangay.@*Results@#Among 193 respondents, 97.93% had good level of knowledge of STH prevention and control, 83.42% had good hand hygiene practices, but only 39.90% adhered to the recommended bi-annual anti-helminthic prophylaxis for their school-aged children. A positive association was noted between level of knowledge and actual hand hygiene practices, but this was not statistically significant (i.e., prevalence odds ratio = 5.3, p = 0.129). Among those who did not comply with the bi-annual anti-helminthic administration, there was a prevalence odds ratio (POR) of 0.66 that the family care giver was knowledgeable on STH prevention and control, and this negative association was not statistically significant (i.e., p = 0.529). @*Conclusion@#Level of knowledge on STH prevention was positively associated with hand hygiene practices but was negatively associated with compliance with the bi-annual deworming prophylaxis. But these associations were not statistically significant.

Survey on sanitary practices and knowledge about infectious diseases among equine owners in the State of Rio Grande do Norte, Brazil.

As the primary decision-maker about the health, nutrition, and well-being of their horses, owners' knowledge of correct management practices and clinical changes can potentially affect the immediate health of their horses, in addition to having an impact on the prevention of disease spread in the herd. The adoption of management practices to prevent the introduction and spread of pathogens depends on various factors, including demographics, awareness of the problem, perceived responsibility, previously held beliefs, and sociocultural norms. This study aimed to evaluate the health management practices and the level of knowledge about infectious diseases of equine owners in the state of Rio Grande do Norte, Brazil. A cross-sectional study was conducted by distributing a questionnaire to horse owners in Rio Grande do Norte, Brazil. The participants included horse owners irrespective of the duration of ownership, experience, or sports practiced. In addition to the hygiene and management of animals, the questionnaire addressed topics related to the facilities where the horses were kept. Three hundred and two horse owners distributed in 60 of the 167 municipalities in the state of Rio Grande do Norte participated in this study. Among the interviewed owners, 63.90% (193/302) answered that they do not quarantine animals introduced into the herd or those visiting the property. Regarding the deworming program, 95.03% (287/302) of the owners regularly dewormed their animals. However, more than half of the participants sought veterinary guidance (54.30%). Investing in educational programs and increasing the awareness of equine owners in the state of Rio Grande do Norte about the main infectious diseases in horses is essential toward improving sanitary management and the general health of animals. Informed owners play an essential role in creating safer environments for their horses, thereby contributing to the sustainability of the equine industry.

Como principal tomador de decisão sobre a saúde, nutrição e bem-estar de seus cavalos, o conhecimento dos proprietários sobre práticas corretas de manejo e mudanças clínicas pode potencialmente afetar a saúde imediata de seus cavalos, além de ter um impacto na prevenção de propagação das doenças no rebanho. A adoção de práticas de manejo para prevenir a introdução e disseminação de patógenos depende de uma variedade de fatores, incluindo dados demográficos, consciência do problema, responsabilidade percebida, crenças anteriores e normas socioculturais. Este trabalho teve como objetivo avaliar as práticas de manejo da saúde e o nível de conhecimento sobre doenças infecciosas de proprietários de equinos no estado do Rio Grande do Norte, Brasil Brasil. As amostras incluíram proprietários de cavalos, independentemente da duração da posse, experiência ou esporte praticado. O questionário abordou temas relacionados às instalações onde os cavalos eram mantidos, além do manejo higiênico-sanitário dos animais. Participaram do estudo 302 proprietários de cavalos distribuídos em 60 dos 167 municípios do estado do Rio Grande do Norte. Dentre os proprietários entrevistados, 63,90% (193/302) responderam que não colocam em quarentena os animais introduzidos no rebanho ou que estão visitando a propriedade. Em relação ao programa de desverminação, 95,03% (287/302) proprietários administravam vermifugação regularmente aos seus animais. No entanto, pouco mais da metade procura orientação veterinária (54,30%). Investir em programas de educação e conscientização dos proprietários de equinos do estado do Rio Grande do Norte sobre as principais doenças infecciosas em equinos é fundamental para melhorar o manejo sanitário e a saúde geral dos animais. Proprietários informados desempenham um papel essencial na criação de ambientes mais seguros para os cavalos, contribuindo para a sustentabilidade da indústria equina como um todo.

Combination with Annual Deworming Treatments Does Not Enhance the Effects of PCV2 Vaccination on the Development of TB in Wild Boar Populations.

Vaccination against PCV2 has been proven to be an effective measure to reduce the severity of TB in wild boar. The combination of this measure with strategies focused on treating other key concomitant pathogens, such as nematodes, could be a useful strategy. This study assesses whether a combination of deworming treatments and PCV2 vaccination may reduce the prevalence and severity of TB in wild boar. The study was conducted on five game estates in mid-western Spain where four groups of wild boar were produced: control, vaccinated, dewormed and vaccinated-dewormed. Wild boars from all groups were hunted between 2017 and 2020, and all of them received a TB diagnosis based on pathological and microbiological tests. Generalised linear models were used to explore the effect of deworming and PCV2 vaccination on TB prevalence and severity. PCV2-vaccinated animals showed lower probabilities of suffering severe TB lesions. However, no differences regarding TB severity were found between dewormed and non-dewormed wild boar. PCV2 vaccination reduces TB severity in wild boar. However, annual deworming does not produce a long-term parasitological reduction that can influence the development of TB in wild boar, nor does it improve the effect of PCV2 vaccination on TB.

Water, sanitation and hygiene (WASH) practices and deworming improve nutritional status and anemia of unmarried adolescent girls in rural Bangladesh.

BACKGROUND: In Bangladesh, undernutrition and anemia are more occurrent among adolescent girls. BRAC, the largest non-governmental organization (NGO), has been implementing a community-based nutrition education service package targeting adolescent girls for reducing their undernutrition and anemia. OBJECTIVE: We aimed to explore the underlying factors associated with nutritional status and anemia among adolescent girls under the BRAC nutrition program areas to improve their existing intervention package. METHODOLOGY: We conducted a cross-sectional and comparative study in 2016, in 24 upazilas of Bogra, Barguna, Comilla, Dinajpur, Feni, Jessore, and Meherpur districts where the BRAC nutrition program was implemented while the remaining 27 upazilas of those districts were selected as comparison area. We followed a multistage cluster random sampling for selecting 1620 unmarried adolescent girls aged 10-19 years for interviewing in the intervention and comparison areas. Data were collected on socio-demographic information, dietary intake, morbidity, water, sanitation, and hygiene (WASH) practice, anthropometry, and serum hemoglobin (Hb) level by using a pre-structured questionnaire. The nutritional status of the adolescent girls was expressed as height-for-age Z (HAZ) and body mass index-for-age Z (BMIZ) score, while anemia referred to the serum Hb at the level of below 12 g/dl for adolescent girls. All statistical analyses were done in STATA version 17 (Chicago Inc.). FINDINGS: The prevalence of stunting (22.9% vs. 22.5%), thinness (12% vs. 14%), and anemia (34.5% vs. 37.3%) exhibited similarities between the intervention and comparison regions. Stunting and thinness were predictors for each other for this population group. Our findings indicated that adolescent girls who were not washing hands with soap after defecation were likely to be stunted [AOR 1.51 (95% CI 1.12-2.04)], and who did not utilize sanitary latrines had an increased likelihood of being thin [AOR 2.38 (95% CI 1.11-5.08)]. Conversely, those who did not watch television [AOR 1.69 (95% CI 1.12-2.56)] and did not have deworming tablets [AOR 1.33 (95% CI 1.07-1.64)] in the 6 months leading up to the interview had a 69% and 33% higher probability of being anemic, respectively. CONCLUSION: For sustainable improvement in the undernutrition and anemia of adolescent girls, integration of WASH, consistent administration of deworming tablets and broadcasting awareness programs through television are urgent to scale up the nutrition intervention programs in similar settings like Bangladesh.

Community-wide versus school-based targeted deworming for soil-transmitted helminth control in school-aged children in Vietnam: the CoDe-STH cluster-randomised controlled trial.

Background: Soil-transmitted helminth (STH) infection control programs typically consist of school-based preventive chemotherapy (PC) targeted to school-aged children. STH reservoirs in untreated community members contribute to ongoing transmission in children. The CoDe-STH (Community Deworming against STH) trial, conducted in Dak Lak province, Vietnam, between October 2019 and November 2020, aimed to determine whether community-wide mass drug administration (MDA) is more effective than school-based targeted PC in reducing STH prevalence and intensity in children. Methods: In this two-arm cluster randomised controlled trial, 64 primary schools were randomly assigned 1:1 to receive either school-based targeted PC ("school arm") or community-wide MDA ("community arm"). A single dose of albendazole 400 mg was used for deworming. The primary outcome was hookworm prevalence in schoolchildren, measured using quantitative real-time PCR. We also measured infection intensity for Necator americanus only, using qPCR cycle threshold (Ct) values converted into eggs per gram of faeces (EPG). Analysis was by intention to treat. The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000309189). Findings: The analysis included 4955 children in the school arm and 5093 children in the community arm. N. americanus was the dominant STH species. The relative reduction in hookworm prevalence was not significantly different between the school arm (30.1%, 95% confidence interval [CI] 20.5-36.9) and the community arm (34.6%, 95% CI 19.9-49.4). Due to lower baseline prevalence than expected, the study was underpowered to detect a difference in prevalence reduction between the study arms. The community arm showed significantly greater relative reduction in N. americanus infection intensity (56.0%, 95% CI 39.9-72.1) compared to the school arm (3.4%, 95% CI -24.7 to 31.4). The community arm also showed greater relative reduction in prevalence of moderate-to-heavy intensity (≥2000 EPG) N. americanus infections (81.1%; 95% CI 69.7-92.6) compared to the school arm (39.0%, 95% CI 13.7-64.2). Interpretation: Although no impact was seen on overall prevalence, community-wide MDA was more effective in lowering N. americanus infection intensity in schoolchildren compared to school-based targeted PC, measured 12 months after one round of albendazole deworming with high coverage. Funding: National Health and Medical Research Council, Australia (APP1139561).

Relationships of deworming drug consumption and animal protein intake with stunting.

By the end of 2022, the nationwide incidence of stunting remained high, including in Lampung Province, where it was 15.8%, above the target of 14% to be achieved by 2024. Since 2019, stunting has become a national priority due to suspected factors such as low nutrition intake, especially from animal protein sources, high rates of worm infections, and low compliance of under-fives in consuming deworming drugs. Therefore, this research aimed to analyze the relationship between deworming consumption, adequacy of animal protein intake, and stunting incidence in children aged 12-59 months in Bandar Lampung in 2022. This research used an analytic survey with a cross-sectional approach to analyze the relationship between deworming consumption, adequacy of animal protein intake, and stunting in under-fives at two priority stunting handling neighbourhoods in Bandar Lampung, namely Way Gubak and Karang Maritim. The sample consisted of 262 under fives and their mothers who visited the integrated health post in the selected neighbourhoods from November to December 2022, and the data obtained were analyzed using logistic regression. The results revealed a relationship between the consumption of an deworming and varying animal protein consumption with stunting incidence. This indicated a need to promote the importance of consuming deworming and adequate consumption of animal protein with variation to prevent stunting in children in Bandar Lampung.

Model-based geostatistical design and analysis of prevalence for soil-transmitted helminths in Kenya: Results from ten-years of the Kenya national school-based deworming programme.

Background: Kenya is endemic for soil-transmitted helminths (STH) with over 6 million children in 27 counties currently at-risk. A national school-based deworming programme (NSBDP) was launched in 2012 with a goal to eliminate parasitic worms as a public health problem. This study used model-based geostatistical (MBG) approach to design and analyse the impact of the NSBDP and inform treatment strategy changes. Methods: A cross-sectional study was used to survey 200 schools across 27 counties in Kenya. The study design, school selection and analysis followed the MBG approach which incorporated historical data on treatment, morbidity and environmental covariates to efficiently predict the helminths prevalence in Kenya. Results: Overall, the NSBDP geographic area prevalence for any STH was estimated to sit between 2 % and <10 % with a high predictive probability of >0.999. Species-specific thresholds were between 2 % and <10 % for Ascaris lumbricoides, 0 % to <2 % for hookworm, and 0 % to <2 % for Trichuris trichiura, all with high predictive probability of >0.999. Conclusions: Based on the World Health Organization guidelines, STH treatment requirements can now be confidently refined. Ten counties may consider suspending treatment and implement appropriate surveillance system, while another 10 will require treatment once every two years, and the remaining seven will require treatment once every year.

Selective Anthelmintic Treatment in Horses in Sweden Based on Coprological Analyses: Ten-Year Results.

In Sweden, routine deworming has been used for several decades; however, to slow down the development of anthelmintic resistance, selective treatment is currently recommended. As part of a monitoring programme, equestrian premises submitted faecal samples to the National Veterinary Institute (SVA) twice per year between 2008 and 2017. Analyses for strongyles (small and large), tapeworms and ascarids, followed by premise-specific advice regarding deworming and parasite control strategies, were provided. In total, 43,330 faecal samples, collected from 26,625 horses on 935 premises in springtime (March to June), were analysed by quantitative or semi-quantitative flotation. Moreover, Strongylus vulgaris was detected by larval culture or PCR. Between 4 and 11% of individual horses tested positive for S. vulgaris and 3-10% were shedding tapeworm eggs. There were recurrent high and low egg shedders; 75% of horses with S. vulgaris appeared to have been recently introduced into the herd; the proportion of S. vulgaris-positive premises increased when individual samples rather than pooled samples were used. Based on the results of S. vulgaris diagnostics and strongyle egg-shedding level, 59% of the horses did not need to be dewormed.

Helminth infection in horses - a cross-sectional study from stables in Lower Silesia (Poland).

Parasitosis in horses may be uncontrolled and expose breeders and owners to serious financial losses or, possibly, to the loss of animals. Therefore, the prevention and monitoring of the development of parasitic diseases should play an important role in the breeding process. The aim of this study was to confirm the influence of factors such as age, breed, herd size, deworming program, and type of anthelmintics, on the prevalence and intensity of parasites (helminths) in domestic horses in Lower Silesia. The study was carried out between August and November of 2020. The samples of horse feces were collected from 50 different stables in the area of Lower Silesia, Poland. A total of 286 individuals from various breeds were examined. Detailed analysis revealed that the mean age of infected horses was significantly lower than in uninfected horses. The mean time since the last deworming procedure was almost twice as low in uninfected horses than in infected ones. Additionally, the deworming agent affects the prevalence of infection. The analysis was also performed for the same factors in reference to quantitative data. The mean EPG was four-fold higher in juvenile horses than in adults and three-fold higher when the horses were dewormed with the use of fenbendazole instead of ivermectin or ivermectin with praziquantel combined.

A positive consequence of the COVID-19 pandemic: how the counterfactual experience of school closures is accelerating a multisectoral response to the treatment of neglected tropical diseases.

Global access to deworming treatment is one of the public health success stories of low-income countries in the twenty-first century. Parasitic worm infections are among the most ubiquitous chronic infections of humans, and early success with mass treatment programmes for these infections was the key catalyst for the neglected tropical disease (NTD) agenda. Since the launch of the 'London Declaration' in 2012, school-based deworming programmes have become the world's largest public health interventions. WHO estimates that by 2020, some 3.3 billion school-based drug treatments had been delivered. The success of this approach was brought to a dramatic halt in April 2020 when schools were closed worldwide in response to the COVID-19 pandemic. These closures immediately excluded 1.5 billion children not only from access to education but also from all school-based health services, including deworming. WHO Pulse surveys in 2021 identified NTD treatment as among the most negatively affected health interventions worldwide, second only to mental health interventions. In reaction, governments created a global Coalition with the twin aims of reopening schools and of rebuilding more resilient school-based health systems. Today, some 86 countries, comprising more than half the world's population, are delivering on this response, and school-based coverage of some key school-based programmes exceeds those from January 2020. This paper explores how science, and a combination of new policy and epidemiological perspectives that began in the 1980s, led to the exceptional growth in school-based NTD programmes after 2012, and are again driving new momentum in response to the COVID-19 pandemic. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'.