The prevalence of soil transmitted helminth infections in minority indigenous populations of South-East Asia and the Western Pacific Region: A systematic review and meta-analysis.

INTRODUCTION: Soil transmitted helminth (STH) infections cause one of the most prevalent diseases in man. STHs disproportionately impact socio-economically disadvantaged communities including minority indigenous populations. This systematic review aimed to quantify the prevalence of STH infection within minority indigenous populations of the South-East Asia and Western Pacific Regions. METHODS: The systematic review was conducted in accordance with The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines following a published protocol. A random effects meta-analysis was used to estimate the pooled prevalence of STH infection, and meta-regression analysis was used to quantify associations with study characteristics. Where comparative data were available, sub-group analysis was conducted to evaluate the risk of STH infection in minority indigenous people relative to other population groups. The heterogeneity between studies was evaluated visually using Forest plots and was assessed quantitatively by the index of heterogeneity (I2) and Cochran Q-statistics. RESULTS: From 1,366 unique studies that were identified, 81 were included in the final analysis. The pooled prevalence of infection within minority indigenous populations was 61.4% (95% CI 50.8, 71.4) for overall STH infection; 32.3% (95% CI 25.7, 39.3) for Ascaris.lumbricoides; 43.6% (95% CI 32.6, 54.8) for Trichuris.trichiura; 19.9% (95% CI 15.7, 24.5) for hookworm and 6.3% (95% CI 3.2, 10.2) for Strongyloides.stercoralis. A significant increase in T. trichiura prevalence was observed over time. The stratified analysis showed that the prevalence of infection for STH overall and for each STH species were not significantly different in minority indigenous participants compared to other populations groups. CONCLUSION: The prevalence of STH infection is high within minority indigenous populations across countries at very different levels of socio-economic development. The increasing prevalence of T. trichiura calls for the implementation of more effective therapies and control strategies.

Risk factors associated with soil transmitted helminth (STH) infection in two indigenous communities in Malaysia.

Soil-transmitted helminth (STH) could possibly cause mild to severe health effects such as diarrhea, weakness, intestinal blood loss, and impaired cognitive development and growth. In Malaysia, previous studies depicted a high prevalence rate of STH was due to poor hygiene practice and low efficacies of anthelminthic drugs. This study was conducted to investigate hand hygiene practice and WASH criteria's (Water, sanitation and hygiene) related to STH infection among two indigenous tribes in Peninsular Malaysia. A cross-sectional study was carried out to study the relationship among STH infection compared to water quality, sanitation, and hygiene conditions. A total of 190 individuals from two indigenous villages participated in the study, with ages ranging from 5 to 60 years old. In addition, Pearson's Chisquare (X2) test was utilized to test the relationship among STH with demographic socioeconomic and behavioral factors. The confidence interval (CI) of 95% is used to estimate the precision of the odds ratio (OR). Multivariate logistic regression models were also used to identify the risk factors associated with STH infections. The overall findings indicated a prevalence rate of 72% for STH, and distributed mainly among children aged < 12 years. Furthermore, multivariate analyses using logistic regression revealed chronic health problems, incorrect hand washing, and walking bare footed were associated with STH infection. Overall results indicated high prevalence of STH among the indigenous villagers, which aligns with the published literature and proves to be a problem need to be addressed as neglected disease. Interestingly, there was a significant relationship between the presences of chronic diseases and STH infection, which prompted other questions the awareness needs to be educated and the simple and low-cost intervention on the proper way of hand washing may help to reduce STH infection in these indigenous communities.

Comparison of Helminth Infection among the Native Populations of the Arctic and Subarctic Areas in Western Siberia Throughout History: Parasitological Researches on Contemporary and the Archaeological Resources.

The aim of this parasitological study is examining contemporary (the late 20th century) specimens of the arctic or subarctic areas in Western Siberia and comparing them with the information acquired from archaeological samples from the same area. In the contemporary specimens, we observed the parasite eggs of 3 different species: Opisthochis felineus, Ascaris lumbricoides, and Enterobius vermicularis. Meanwhile, in archaeoparasitological results of Vesakoyakha, Kikki-Akki, and Nyamboyto I burial grounds, the eggs of Diphyllobothrium and Taenia spp. were found while no nematode (soil-transmitted) eggs were observed in the same samples. In this study, we concluded helminth infection pattern among the arctic and subarctic peoples of Western Siberia throughout history as follows: the raw fish-eating tradition did not undergo radical change in the area at least since the 18th century; and A. lumbricoides or E. vermicularis did not infect the inhabitants of this area before 20th century. With respect to the Western Siberia, we caught glimpse of the parasite infection pattern prevalent therein via investigations on contemporary and archaeoparasitological specimens.

Shadow Puppets and Neglected Diseases: Evaluating a Health Promotion Performance in Rural Indonesia.

'Rama and the Worm' is a shadow puppet production targeting neglected diseases in Central Java. It is an entertainment-based intervention study to promote health by reducing the impact of parasitic diseases such as soil-transmitted helminths (STH). The study uses traditional Javanese shadow puppetry (wayang kulit) as a vehicle in village communities to disseminate health messages and promote behaviour change to prevent diseases caused, primarily, by inadequate sanitation and poor hygiene. The health education messages contained in the play, although using traditional characters and themes, required the creation of a completely new narrative script, using characters and plot lines familiar to the wayang kulit repertoire, but placing them in new situations that relate specifically to health promotion objectives. The intervention was piloted in a village in Central Java, Indonesia using a pre/post design with both qualitative and quantitative analysis. A total of 96 male and female villagers, aged between 7 and 87 years, provided both baseline and follow up data. Participant knowledge and behaviours related to gastrointestinal and helminth-related disease were assessed before and after the intervention through a questionnaire administered by interview. Results revealed statistically significant improvements in both knowledge (48.6% pre-intervention score vs. 62.8% post-intervention score, p < 0.001) and behaviour (77.4% vs. 80.6%, p = 0.004) related to gastrointestinal and helminth disease. Findings of the study indicate the wayang kulit performance is an effective health education tool. The results provide proof of concept with scaling up the next step forward. The wayang kulit production provides a significant additional component for an integrated, comprehensive approach to reduction and elimination of STH infection.

Why were Sardinians the shortest Europeans? A journey through genes, infections, nutrition, and sex.

Since ancient times the Mediterranean island of Sardinia has been known for harboring a population with an average body height shorter than almost every other ethnic group in Europe. After over a century of investigations, the cause(s) at the origin of this uniqueness are not yet clear. The shorter stature of Sardinians appears to have been documented since prehistoric times, as revealed by the analysis of skeletal remains discovered in archaeological sites on the island. Recently, a number of genetic, hormonal, environmental, infective and nutritional factors have been put forward to explain this unique anthropometric feature, which persisted for a long time, even when environmental and living conditions improved around 1960. Although some of the putative factors are supported by sound empirical evidence, weaker support is available for others. The recent advent of whole genome analysis techniques shed new light on specific variants at the origin of this short stature. However, the marked geographical variability of stature across time and space within the island, and the well-known presence of pockets of short height in the population of the southern districts, are still puzzling findings that have attracted the interest of anthropologists and geneticists. The purpose of this review is to focus on the state-of-the-art research on stature, as well as the factors that made Sardinians the shortest among Europeans.

Neglected tropical diseases among two indigenous subtribes in peninsular Malaysia: highlighting differences and co-infection of helminthiasis and sarcocystosis.

Soil-transmitted helminth (STH) infections have been documented among these minority groups since 1938. However the prevalence of STH is still high among these communities. Most studies tend to consider the Orang Asli (indigenous) as a homogenous group. In contrary, different subtribes have their own cultural practices. To understand this variation better, we studied the prevalence and associated factors of STH and other gut parasitic infections among two common subtribes (i.e. Temuan and Temiar). Results showed that the prevalence of the overall STH infections was higher in the Temuan subtribe (53.2% of 171) compared to the Temiar subtribe (52.7% of 98). Trichuris trichiura (46.2%) was the most prevalent parasite in the Temuan subtribe, followed by Ascaris spp. (25.7%) and hookworm (4.1%). In contrast, Ascaris spp. (39.8%) was more prevalent among the Temiar subtribe, preceded by T. trichiura (35.7%) and finally hookworm (8.3%). There were also co-infections of helminthiasis and intestinal protozoa among both Temuan and Temiar subtribes with rates being three times higher among the Temiar compared to Temuan. The most common co-infection was with Entamoeba histolytica/dispar/moshkovskii (n = 24; 24.5%, 16.0-33.0), followed by Giardia spp. (n = 3; 3.1%, -0.3-6.5). In Temuan, STH infection individuals were also infected with Entamoeba histolytica/dispar/moshkovskii (n = 11; 6.4%, 5.0-13.8), Cryptosporidium spp. (n = 3, 1.8%, -0.2-3.8) and Giardia spp. (n = 2, 1.2%, -0.4-2.8). In comparison, there was no Cryptosporidium spp. detected among the Temiar. However, it was interesting to note that there was an occurrence of co-infection of intestinal helminthiasis and sarcocystosis (intestinal) in a Temiar individual. The last report of sarcocystosis (muscular) among the Orang Asli was in 1978. The present study highlighted the importance of understanding the variation of infections amongst the different Orang Asli subtribes. It is vital to note these differences and use this knowledge to customise effective control measures for the various subtribes.

Relevance of eosinophilia and hyper-IgE in immigrant children.

Immigrants from undeveloped countries are a growing problem in Europe. Spain has become a frequent destination for immigrants (20% of whom are children) because of its geographic location and its historic and cultural links with Africa and Latin America. Eosinophilia is frequent in adult immigrants, travelers and expatriates coming from tropical areas. However, there are few studies that focus on the incidence and causes of tropical eosinophilia and hyper-IgE in immigrant children.We evaluated, prospectively, the prevalence and causes of eosinophilia and hyper-immunoglobulin E (IgE) in 362 immigrant children coming from Sub-Saharan Africa, Northern Africa and Latin America to Salamanca, Spain, between January 2007 and December 2011.Absolute eosinophilia and hyper-IgE were present in 22.9% and 56.8% of the analyzed children, respectively. The most frequent causes of absolute eosinophilia were filariasis (52.6%), strongyloidiasis (46.8%) and schistosomiasis (28.9%). Filariasis (41.9%), strongyloidiasis (29.6%) and schistosomiasis (22.2%) were the most frequent causes of increased levels of IgE. The area under the ROC curve showed similar values between eosinophil count and IgE levels in the diagnosis of helminthiasis (69% [95% confidence interval (CI) 63%-74%] vs 67% [95% CI 60%-72%], P = 0.24). Eosinophilia and hyper-IgE have a high value as biomarkers of helminthiasis in children coming from tropical and subtropical areas.

Soil-transmitted helminth prevalence and infection intensity among geographically and economically distinct Shuar communities in the Ecuadorian Amazon.

Soil-transmitted helminth (STH) infections can result in a variety of negative health outcomes (e.g., diarrhea, nutritional deficiencies). Market integration (MI; participation in market-based economies) has been suggested to alter levels of STH exposure due to associated changes in diet, sanitation, and behavior, but the effects are complicated and not well understood. Some effects of economic development result in decreased exposure to certain pathogens, and other factors can lead to higher pathogen exposure. With geographic location used as a proxy, the present study investigates the effects of economic development on parasite load among an indigenous population at multiple points along the spectrum of MI. This research has many implications for public health, including an increased understanding of how social and economic changes alter disease risk around the world and how changing parasite load affects other health outcomes (i.e., allergy, autoimmunity). Specifically, this study examines the prevalence of intestinal helminths among the Shuar, an indigenous group in the Morona-Santiago region of Ecuador, from 2 geographically/economically separated areas, with the following objectives: (1) report STH infection prevalence and intensity among Shuar; (2) explore STH infection prevalence and intensity as it relates to age distribution in the Shuar population; (3) compare STH infection patterns in geographically and economically separated Shuar communities at different levels of MI. Kato-Katz thick smears were made from fresh stool samples and examined to determine STH presence/intensity. Results indicate that 65% of the 211 participants were infected with at least 1 STH. Twenty-five percent of the sample had coinfections with at least 2 species of helminth. Infection was more common among juveniles (<15 yr) than adults. Infection prevalence and intensity was highest among more isolated communities with less market access. This study documents preliminary associations between STH infection and exposure to MI, with implications for public health research and interventions.

Soil-transmitted helminthiases in secondary school students in selected sites in two provinces in the Philippines: policy implications.

The latest World Health Organization (WHO) strategic plan for eliminating soil-transmitted helminthiases (STHs) as a public health problem in children puts the emphasis on school-age children. On the other hand, the Philippine national helminth control program excludes secondary school students in mass deworming for STH. This study determined the prevalence and intensity of STH in a sample of 633 students (14-15 years old) in selected secondary schools in two Philippine provinces. Stool specimens were processed following the Kato-Katz technique and examined for the presence of helminth ova. Overall cumulative prevalence of STH was 31.3%, while prevalence of moderate-heavy-intensity infections was 7.7%, well beyond the WHO target of ≤1% for reducing morbidity in school-age children. Recommendations were made to update the Philippine helminth control program and to re-examine the WHO strategic plan so that helminth prevention and control strategies may also be emphasized for secondary school students especially in high-prevalence areas.

Helminths and human ancestral immune ecology: What is the evidence for high helminth loads among foragers?

OBJECTIVES: Recent theories of human immune ecology have invoked high helminth loads as an important selection factor among early humans. However, few studies have assessed this assumption among extant human foragers. METHODS: We review the current evidence for high helminth loads in documented forager populations and present new data from members of a Kawymeno Waorani forager group in Amazonian Ecuador (n = 16) compared with neighboring Kichwa subsistence farmers (n = 63). RESULTS: Stool samples indicated a near absence of helminths among the Kawymeno foraging group (6.25% with Ascaris lumbricoides and 0% with Ancylostoma duodenale or Trichuris trichiura). In contrast neighboring, isolated Kichwa subsistence farmers in a similar ecosystem had abundant helminth infestations (76.1% with Ascaris lumbricoides, 11.1% with Ancylostoma duodenale, and 1.5% with Trichuris trichiura). The presence of helminths among the Waorani and Kichwa was triangulated across multiple data sources, including presence in stool samples, medical exams, and 3 years of participant observation. CONCLUSIONS: These findings, coupled with the modern forager literature, raise questions as to whether helminths were prevalent enough in Paleolithic humans to be a unique evolutionary selective force in human physiology.

Intestinal parasitic infections among long-term-residents and settled immigrants in Qatar in the period 2005 to 2011.

The expanding economy of Qatar in the last two decades has attracted immigrants, often from countries with poor socio-economic levels. Many arrive with patent intestinal parasitic infections, and recent analyses have indicated consistently rising trends in the prevalence of some infections. Here, we examined 18,563 hospital records of subjects in Qatar seeking medical assistance for a variety of ailments, combining data from 2009 to 2011 with the earlier dataset from 2005 to 2008 to enable trends to be identified across a 7-year period. We found that 8.6% were infected with one or more species of parasites, however in contrast to the earlier period (2005-2008), in the latter 3 years there were falling trends of prevalence providing some optimism that parasitic infections among the resident immigrants have begun to decline. We identified also geographic regions from which resident workers still maintain a relatively high prevalence of helminth infections despite their long-term residence in Qatar.

Differences in prevalence of geohelminth infections between indigenous and settler populations in a remote Amazonian region of Peru.

OBJECTIVE: To compare prevalences of intestinal helminths and waterborne protozoa in indigenous and settler populations in a remote area of Peru. These populations live in adjacent but segregated small urban villages. METHODS: Stool samples were collected from representative members of these two populations and analysed for geohelminths and protozoa. RESULTS: The risk of soil-transmitted helminths is significantly higher in the settler than the indigenous population in the same isolated region of Peru (OR 5.18; 95% CI 3.44-7.81; P < 0.001). In contrast, the rates of protozoa presence were similar in both populations (OR 1.28; 95% CI 0.77-2.14; P = 0.336). CONCLUSIONS: Potential explanations for unexpected finding of a lower prevalence of helminths in indigenous relative to the settler population could include housing design in flood - prone areas and the use of local medicinal plants that possibly have antihelmintic properties.

Towards an effective control programme of soil-transmitted helminth infections among Orang Asli in rural Malaysia. Part 2: Knowledge, attitude, and practices.

BACKGROUND: In the first part of this study, we investigated the prevalence and associated key factors of soil-transmitted helminth (STH) infections among Orang Asli children in rural Malaysia; an alarming high prevalence and five key factors significantly associated with infections were reported. Part 2 of this study aims to evaluate the knowledge, attitude and practices (KAP) on STH infections among Orang Asli in Peninsular Malaysia. METHODS: A cross-sectional study was carried out among 215 households from 13 villages in Lipis district, Pahang, Malaysia. Demographic and socioeconomic information of the participants and their KAP on STH were collected by using a pre-tested questionnaire. RESULTS: Overall, 61.4% of the participants had prior knowledge about intestinal helminths with a lack of knowledge on the transmission (28.8%), signs and symptoms (29.3%) as well as the prevention (16.3%). Half of the respondents considered STH as harmful, while their practices to prevent infections were still inadequate. Significant associations between the KAP and age, gender, educational and employment status, family size, and household monthly income were reported. Moreover, significantly lower prevalence of STH infections was reported among children of respondents who wear shoes/slippers when outside the house (72.8%; 95% CI= 62.6, 80.5 vs 87.0%; 95% CI= 81.4, 91.1), wash their hands before eating (32.4%; 95% CI= 24.3, 42.2 vs 51.4%; 95% CI= 44.7, 60.1), and wash their hands after defecation (47.8%; 95% CI= 35.7, 57.1 vs 69.2%; 95% CI= 63.7, 78.7) as compared to their counterparts. Multiple logistic regression analysis indicated that the educational level of the respondents was the most important factor significantly associated with the KAP on STH among this population. CONCLUSION: This study reveals inadequate knowledge, attitude and practices on STH infections among Orang Asli in rural Malaysia. Hence, there is a great need for a proper health education programme and community mobilisation to enhance prevention and instil better knowledge on STH transmission and prevention. This is crucial for an effective and sustainable STH control programme to save the lives and future of the most vulnerable children in rural Malaysia.

Intestinal parasitism prevalence amongst children from six indigenous communities residing in Cali, Colombia.

OBJECTIVE: Establishing the prevalence of intestinal parasitism in children aged 5 to 14 years of age from six indigenous communities residing in the city of Cali. METHODOLOGY: A cross-sectional, descriptive epidemiological study was carried out in six indigenous communities residing in the city of Cali; it consisted of making a direct serial and concentration coproparasitological examination of a randomly selected sample of fifty-seven 5 to 14 year-old children. RESULTS: Of the 57 samples obtained, 84 % of the children were infected with parasites; protozoa (98 %) predominated over helminths (16.7 %) and mixed parasitemia was found in 14.6 % of the samples. Monoparasitism appeared in children over 10 years of age and biparasitism (10.4 %) and polyparasitism (52.1 %) in children under 10 years of age. Regarding occult blood determination, 6 % were observed to be positive in all the samples analysed; 4 % of these results were associated with E. histolyticaldispar. The simple parasitism index (SPI) reflected a high degree of infestation amongst the children included in the study. CONCLUSIONS: The prevalence of intestinal parasitism in indigenous infants was higher than that reported nationally in the overall adolescent and school-aged children population in the same age group. Mono- and polyparasitism prevailed in the positive samples. The infestation load was not randomly distributed amongst the communities.

Anemia in Cambodia: prevalence, etiology and research needs.

Anemia is a severe global public health problem with serious consequences for both the human and socio-economic health. This paper presents a situation analysis of the burden of anemia in Cambodia, including a discussion of the country-specific etiologies and future research needs. All available literature on the prevalence and etiology of anemia in Cambodia was collected using standard search protocols. Prevalence data was readily identified for pre-school aged children and women of reproductive age, but there is a dearth of information for school-aged children, men and the elderly. Despite progress in nation-wide programming over the past decade, anemia remains a significant public health problem in Cambodia, especially for women and children. Anemia is a multifaceted disease and both nutritional and non-nutritional etiologies were identified, with iron deficiency accounting for the majority of the burden of disease. The current study highlights the need for a national nutrition survey, including collection of data on the iron status and prevalence of anemia in all population groups. It is impossible to develop effective intervention programs without a clear picture of the burden and cause of disease in the country.

Republished research: Helminths: an unrecognised disease burden prevalent among migrants in the gastroenterology clinic.

OBJECTIVE: To estimate the prevalence of, and implement a diagnostic strategy for, imported helminth infection in the gastroenterology clinic. DESIGN: A retrospective study of eosinophil count and probable tropical exposure (phase I) followed by a prospective study of parasitological investigation (phase II). SETTING: Gastroenterology service of an inner London hospital. PATIENTS: Adult patients newly attending general gastroenterology and inflammatory bowel disease clinics. INTERVENTIONS: In phase I, evidence of undiagnosed helminth infection was sought by analysing patient records for associations between eosinophil count and ethnicity. In phase II, a UK guideline for investigation of eosinophilia in migrants was implemented and diagnostic yield determined. MAIN OUTCOME MEASURES: In phase I, prevalence of eosinophilia was determined; in phase II, helminth prevalence and degree of eosinophilia before and after treatment were reported. Information on symptomatic response to treatment was recorded. Ethnicity was used as a proxy measure for tropical exposure. RESULTS: 426 new patients attended in a 12 month period. Eosinophilia was present in 27 (6.3%). 10/27 (37.0%) patients with eosinophilia were of African or Asian ethnicity whereas only 20% (85/426) of patients overall were from these ethnic groups (χ(2)=5.27, p=0.02). Following implementation of the protocol, 25/36 migrants with eosinophilia attended for parasitological investigations. Helminth infection was diagnosed in 10/25 (40%). Strongyloidiasis (six patients) and schistosomiasis (three patients) were the most common diagnoses. Median eosinophil count was 1.06×10(9)/l in those with helminths and 0.58×10(9)/l in those without (p=0.004). Eosinophil counts normalised in, and symptomatic improvement was reported by, most patients after treatment. CONCLUSIONS: Eosinophilia is associated with African or Asian ethnicity in an inner city gastroenterology service. This association is probably explained by imported helminths, which are prevalent in this setting, may be a cause of gastrointestinal symptoms and is easily diagnosed and treated by standard protocols.

Intestinal parasitism prevalence amongst children from six indigenous communities residing in Cali, Colombia / Prevalencia de parasitismo intestinal en menores de seis comunidades indígenas residentes en Cali, Colombia

Objective Establishing the prevalence of intestinal parasitism in children aged 5 to 14 years of age from six indigenous communities residing in the city of Cali. Methodology A cross-sectional, descriptive epidemiological study was carried out in six indigenous communities residing in the city of Cali; it consisted of making a direct serial and concentration coproparasitological examination of a randomly selected sample of fifty-seven 5 to 14 year-old children. Results Of the 57 samples obtained, 84 % of the children were infected with parasites; protozoa (98 %) predominated over helminths (16.7 %) and mixed parasitemia was found in 14.6 % of the samples. Monoparasitism appeared in children over 10 years of age and biparasitism (10.4 %) and polyparasitism (52.1 %) in children under 10 years of age. Regarding occult blood determination, 6 % were observed to be positive in all the samples analysed; 4 % of these results were associated with E. histolyticaldispar. The simple parasitism index (SPI) reflected a high degree of infestation amongst the children included in the study. Conclusions The prevalence of intestinal parasitism in indigenous infants was higher than that reported nationally in the overall adolescent and school-aged children population in the same age group. Mono- and polyparasitism prevailed in the positive samples. The infestation load was not randomly distributed amongst the communities.

Objetivo Establecer la prevalencia de parasitismo intestinal en menores de 5 a 14 años de seis comunidades indígenas residentes en la ciudad de Cali. Metodología Se llevó a cabo un estudio epidemiológico transversal en seis comunidades indígenas residentes en la ciudad de Cali, que consistió en realizar un examen seriado coproparasitológico a una muestra de menores entre 5 y 14 años elegida al azar. Resultados De las 57 muestras, un total de 84 % estaban infectados con parásitos; en los cuales predominaron los protozoarios (98 %) sobre los helmintos (16,7 %) y la presencia de enfermedades parasitarias intestinales mixtas fue del 14,6 %. El monoparasitismo se observe en los mayores de 10 años; en niños por debajo de los 10 años se observó el biparasitismo (10,4 %) y poliparasitismo (52,1 %). Con relación a la determinación de sangre oculta, un 6 % de las muestras fueron positivas, 4 % de esos resultados estaban asociados con E. histolyticaldispar. El índice de parasitismo simple refleja un alto grado de infestación en los menores incluidos en este estudio. Conclusiones La prevalencia de parasitismo intestinal en menores de ascendencia indígena es mayor a la reportada en el orden nacional en menores escolares y adolescentes. Sobresalieron el mono y poliparasitismo en las muestras positivas. La carga de infestación no se distribuyó al azar entre las comunidades.

Evaluación de la posible asociación entre la presencia de parásitos intestinales y Helicobacter pylori en población infantil de la etnia Warao, Venezuela / Evaluation of the possible association between the presence of intestinal parasites and Helicobacter pylori in children of ethnic Warao

Las infecciones por microorganismos gastrointestinales constituyen hoy en día una de las principales causas de morbilidad y mortalidad en países en vías de desarrollo. Nos planteamos como objetivo evaluar la posible asociación entre la presencia de parásitos intestinales y la infección por Helicobacter pylori, y el comportamiento de anticuerpos séricos y secretores en una población infantil de la etnia Warao del Edo. Delta Amacuro, Venezuela. La presencia de parásitos se determinó por examen microscópico directo de las heces. Los niveles séricos de IgE total, IgG anti H. pylori e IgA anti Giardia duodenalis; y los secretores IgA total y específica a G. duodenalis y H. pylori en muestra de saliva, se determinaron utilizando el método de ELISA. El 65% de los niños estaban parasitados por protozoarios, observándose un 47% de poliparasitismo. Encontramos una mayor seroprevalencia de H. pylori en el grupo de niños no parasitados (46%) comparado con los parasitados (25%) (P<0,05). Sin embargo, los niños seropositivos a H. pylori y parasitados con G. duodenalis mostraron niveles séricos de IgE total mayores que los no parasitados (P<0,01); en contraparte, los niveles de IgA secretora total y especifica a H. pylori y G. duodenalis estaban disminuidos (P<0,05). Es posible que la respuesta inflamatoria generada por Giardia pueda aumentar los niveles de IgE total y disminuir la respuesta de IgA secretora favoreciendo la instauración de la infección por H. pylori.

The infections for gastrointestinal microorganisms represent nowadays one of the major reasons of morbidity and mortality in developing countries. We had evaluated both, the possible association between the presence of intestinal parasites and infection by Helicobacter pylori, and the production of serum and salivary antibodies in Amerindian Warao children from the Orinoco Delta, Venezuela. The prevalence of parasites was determined by faecal examination. The levels of serum antibodies (total IgE, specific anti- H. pylori IgG and anti G. duodenalis IgA) and salivary antibodies (total and specific IgA to G. duodenalis and H. pylori), was determined by ELISA. 65% of the child population was parasitized by protozoos, and a 47% of polyparasitism was observed. We found a major seroprevalence of H. pylori in the group of children not parasitized (46 %) compared with the parasitized ones (25 %) (P<0.05). Nevertheless, the seropositive children to H. pylori and parasitized with G. duodenalis showed levels of total IgE higher than the non parasitized ones (P<0.01); in contrast, levels of total and specific secretory IgA to H. pylori and G. duodenalis were decreased (P<0.05). It is possible that the inflammatory response generated by G. duodenalis infection may increase levels of total IgE and diminish secretory IgA response favoring the establishment of infection by H. pylori.

Soil-transmitted helminth and other intestinal parasitic infections among school children in indigenous people communities in Davao del Norte, Philippines.

A significant portion of the population in the Philippines consists of indigenous people (IP) groups, approximately 9% or 8.1 million. Data on the health status of these groups are very limited including the status of soil-transmitted helminth (STH) infections. Provision of such data will be of great importance in the formulation of policy on control and prevention of these diseases in this group. This study was conducted in selected villages/barangays in the municipalities of Carmen, Kapalong, San Isidro and Sto. Tomas in the Province of Davao del Norte in Southern Mindanao, Philippines. Parasitologic assessment was performed using Kato-Katz to qualify and quantify STH infections, while nutritional status assessment was based on hemoglobin determination and on nutritional status indicators, i.e., weight-for-age (WFA), height-for-age (HFA), and body mass index (BMI) for age derived from anthropometric measurements. A total of 572 school children participated in the survey, 264 (46.2%) of whom belonged to a specific IP group. Results showed that 34.1% of the school children had at least one STH infection while 5.9% had heavy intensity infections. Cumulative prevalence in IP school children was significantly higher than in non-IP children with rates at 39.0% and 29.9%, respectively (P = 0.021). Overall prevalence of school children with below normal WFA was 29.9%, while prevalence of those with below normal HFA and BMI for age was 42.8% and 14.9%, respectively. Of those examined, 8.3% had below normal hemoglobin levels. There was no significant difference observed between the nutritional status parameters of IP and non-IP school children. The parasitologic parameters reported in this study signify the need to pay more attention to IP children who are at higher risk of morbidity due to helminth infections. Access of IP communities to quality health services, which include mass drug administration (MDA) and health education on a regular basis, must be ensured. Further studies to determine factors that contribute to the higher prevalence of STH among IP groups are recommended.

Life history, immune function, and intestinal helminths: Trade-offs among immunoglobulin E, C-reactive protein, and growth in an Amazonian population.

OBJECTIVES: Infection with helminths is associated with shifts in host immunity, including increased production of immunoglobulin E (IgE) and reduced inflammation. Given limited energy budgets, these shifts may involve changes in energy allocation toward competing demands. Here we test for potential trade-offs between growth, IgE, and the inflammatory marker C-reactive protein (CRP). METHODS: Dried blood spots and anthropometrics were collected from 162 Shuar forager-horticulturalists from a village in southeastern Ecuador. Enzyme-linked immunosorbent assays (ELISAs) were used to measure IgE and CRP. Relationships among IgE, CRP, and anthropometrics were examined in three groups: children aged 2-7 years (n = 63), children aged 8-15 (n = 61), and adults over age 18 (n = 37). RESULTS: Geometric mean IgE was 1,196 IU ml⁻¹ while geometric mean CRP was 1.33 mg l⁻¹. In children, IgE and CRP were negatively correlated (r = -0.21, P = 0.02, df = 122). Controlling for fat stores and age, IgE was associated with lower stature in children (t = -2.04, P = 0.04, df = 109), and adults (t = -3.29, P < 0.01, df = 33). In children there was a significant interaction between age and CRP, such that in younger children CRP was associated with shorter stature, but in older children was associated with greater stature (t = 2.15, P = 0.04, df = 109). CONCLUSIONS: These results suggest that infection with helminths may have hidden costs associated with immunological changes, and that these costs may ultimately affect growth and other life history parameters.