clove and Ascariasis

A controlled randomized trial of anti-helminthic treatment was undertaken in 1996-1997 in a rural area of Madagascar where populations were simultaneously infected with Ascaris lumbricoides, Plasmodium falciparum, and Schistosoma mansoni. Levamisole was administered bimonthly to 107 subjects, whereas 105 were controls. Levamisole was highly effective in reducing Ascaris egg loads in the treated group (P < 10(-3) at all visits), whereas it had no effect on schistosomiasis. Subjects 5-14 years of age, treated with levamisole, had a significant increase of their P. falciparum densities compared with controls (P = 0.003). There was no effect of the treatment on children 6 months to 4 years of age, nor on adults > 15 years of age. This study confirms the results of a randomized trial, which showed a negative interaction in those > 5 years of age between Ascaris and malaria parasite density in another Malagasy population, submitted to a higher malaria transmission.

Topics: Adolescent; Age Factors; Animals; Anthelmintics; Ascariasis; Ascaris lumbricoides; Child; Child, Preschool; Female; Humans; Infant; Levamisole; Madagascar; Malaria, Falciparum; Male; Parasite Egg Count; Plasmodium falciparum; Schistosoma mansoni; Schistosomiasis; Seasons; Time Factors

Soil-transmitted helminth (STH) infections carry the highest number of disability adjusted life years among all neglected tropical diseases, disproportionately affecting low-income countries such as Madagascar.  This study describes the epidemiology of STH and S. stercoralis infections in twelve remote villages surrounding Ranomafana National Park (RNP), Ifanadiana, Madagascar. Questionnaires and stool samples were collected from 574 subjects from random households. The Kato-Katz method and spontaneous sedimentation technique were used to examine stool samples for evidence of infection. Infection prevalence rates were 71.4% for Ascaris lumbricoides (95% CI: 67.7-75.1), 74.7% for Trichuris trichiura (95% CI: 71.1-78.2), 33.1% for hookworm (95% CI: 29.2-36.9), and 3.3% for Strongyloides stercoralis (95% CI: 1.84-4.77). Participants who were older in age (OR = 0.96; 95% CI: 0.95-0.99) and who had a high school education (OR = 0.17; 95% CI: 0.04-0.77) were less likely to be infected with a STH. Females were less likely to be infected with A. lumbricoides (OR = 0.52; 95% CI: 0.33-0.82). Participants living in villages further from the main road were more likely to be infected with a STH (F = 4.00, p = 0.02). Overall, this study found that 92.5% (95% CI: 90.3-94.6) of the people living in rural regions near RNP have at least one STH infection. This calls into question the current preventative chemotherapy (PC) program in place and suggests that further medical, socioeconomic, and infrastructural deveopments are needed to reduce STH prevalence rates among this underserved population.

Topics: Age Factors; Ancylostomatoidea; Animals; Ascariasis; Ascaris lumbricoides; Education; Feces; Hookworm Infections; Humans; Madagascar; Parks, Recreational; Prevalence; Risk Factors; Rural Population; Strongyloides stercoralis; Strongyloidiasis; Surveys and Questionnaires; Trichuriasis; Trichuris

Topics: Aged; Anthelmintics; Ascariasis; Capsule Endoscopy; Endoscopy, Gastrointestinal; Female; Humans; Intestine, Small; Madagascar; Prognosis; Travel; Treatment Outcome

An epidemiological study of human intestinal helminthiasis was conducted during July and August 1995, in the middle west of Madagascar, with 4571 adults and children ranging from six months to 90 years, in 61 communities between Betafo and Miandrivazo. Faecal examination utilising the MIF concentration method revealed that ascariasis was the dominant nematodosis in the middle west with high prevalences in the high-altitude communities. Ascaris lumbricoides prevalences increase among children and women. Interesting more than 50% of the pattern, ascariasis is a public health problem and its association with infant malnutrition is statistically significant. Hookworm infection prevalence is higher in low-altitude communities, it increases among adults. The Trichuris trichiura prevalences were lower than the prevalences of ascariasis and hookworm infection in all of the communities. Important variations of the prevalences of intestinal helminthiasis are observed essentially in relation with climatic conditions.

Topics: Adolescent; Adult; Aged; Altitude; Ascariasis; Child; Child, Preschool; Female; Hookworm Infections; Humans; Infant; Intestinal Diseases, Parasitic; Madagascar; Male; Middle Aged; Nematode Infections; Nutrition Disorders

Ascaris lumbricoides worm counts were examined as the outcome products of exposure proxy variables. A survey of 663 children, 4-10 yr old, living in southeastern Madagascar revealed prevalences of 93% for A. lumbricoides, 55% for Trichuris trichiura, and 27% for hookworm. Worm expulsions were conducted on 428 of these children; the data revealed an overdispersed distribution of A. lumbricoides, with an arithmetic mean of 19.2 worms per child. A concurrent socioeconomic household survey was conducted by visitation and interview. Exposure to infection was assessed by environmental, demographic, behavioral, and socioeconomic indicators. Ascaris lumbricoides aggregations were associated with gender, housing style, ethnicity, and agricultural factors. The results suggest that exposure and infection are ubiquitous in this child population, and that A. lumbricoides intensity is influenced by gender-related behavioral and environmental factors that contribute to exposure.

Topics: Animals; Antinematodal Agents; Ascariasis; Ascaris lumbricoides; Child; Child, Preschool; Drug Therapy, Combination; Educational Status; Feces; Female; Health Behavior; Housing; Humans; Madagascar; Male; Mebendazole; Prevalence; Pyrantel Pamoate; Risk Factors; Rural Population; Sanitation; Sex Factors; Social Class

The relationships between Ascaris lumbricoides worm burden, growth status, general delayed cutaneous hypersensitivity (DCH) response, and plant anthelmintic use were investigated in a 12-mo prospective survey of 663 children, 4-10 yr old, living in the Ranomafana rainforest, Madagascar. Initial fecal examinations revealed prevalences of 93% for A. lumbricoides, 55% for Trichuris trichuria, and 27% for hookworm. After anthelmintic treatment and a 12-mo reinfection period, 428 of the children participated in worm expulsion studies using pyrantel pamoate, revealing an overdispersed A. lumbricoides worm population, mean = 19.2 (SD = 20.4). Malnutrition was common with 72% of the children growth stunted, 61% underweight, and 6% wasted. The children were also skin tested to recall antigens for DCH, with 94% reacting. The DCH immune response was significantly decreased in the malnourished children; however, DCH was not reduced in relation to increasing worm intensity. Growth status, growth velocity, and triceps skinfold did not vary significantly in relation to A. lumbricoides worm burden. Traditional plant anthelmintic treatment was effective in significantly reducing worm intensity. This study indicates that, in human communities where the children are predominately stunted, A. lumbricoides does not aggregate in the most malnourished or immunodepressed children.

Topics: Analysis of Variance; Animals; Anthelmintics; Anthropometry; Ascariasis; Ascaris lumbricoides; Child; Child Development; Child, Preschool; Cross-Sectional Studies; Feces; Female; Humans; Hypersensitivity, Delayed; Madagascar; Male; Nutrition Disorders; Parasite Egg Count; Phytotherapy; Prevalence; Prospective Studies; Regression Analysis; Skin Tests

An epidemiological study of intestinal nematodes was conducted with 1,292 children, ranging from birth through 11 yr old, living in the Ranomafana rainforest of southeast Madagascar. Fecal examinations revealed prevalences of 78% for Ascaris lumbricoides, 38% for Trichuris trichiura, 16% for hookworm, and 0.4% for Schistosoma mansoni. Infection intensity was measured indirectly by fecal egg counts and directly by A. lumbricoides expulsion following treatment with pyrantel pamoate. The mean A. lumbricoides worm burden for children, 5-11 yr old, was 19.2 (SD 20.4) worms per child, with a median of 13 worms (n = 428). The distributions were overdispersed for all 3 nematodes. The age profiles showed a rapid acquisition of A. lumbricoides during infancy, increasing to 100% prevalence by age 10. After mebendazole anthelmintic treatment and a 12-mo reinfection period, the nematodes had rebounded to pretreatment prevalence and intensity levels. There was evidence for age-dependent predisposition of the children to infection intensity for each of the 3 nematodes. Dual species intensity correlation was consistently strong for A. lumbricoides and T. trichiura. The significantly higher prevalence and intensity of ascariasis in girls were thought to be related to exposure.

Topics: Age Distribution; Ancylostomatoidea; Animals; Ascariasis; Ascaris lumbricoides; Child; Child, Preschool; Cohort Studies; Feces; Female; Hookworm Infections; Humans; Infant; Infant, Newborn; Intestinal Diseases, Parasitic; Longitudinal Studies; Madagascar; Male; Parasite Egg Count; Pilot Projects; Prevalence; Sex Distribution; Trichuriasis; Trichuris

This study of bilharzia and other intestinal parasites was carried out on 496 children in the Firaisana of Ankilivalo. As well as determine the prevalence of these parasites, data was collected on nutrition, agriculture and the use of water in order to gain an understanding of the transmission and effects of these parasites, and hence make recommendations for their control. In two schools within the area of a major irrigation scheme the prevalence of bilharzia was 69%, and 50% of children suffer from at least one other intestinal worm. In a school outside the main irrigation area, the prevalence was much lower (7%), but nutritional standards were also lower. Ultimately, control of bilharzia will depend on improvements to the irrigation and drainage infrastructure, and in standards of sanitation. However, chemotherapy is the only method of bringing the disease under control in the short term.

Topics: Adolescent; Ancylostomiasis; Ascariasis; Child; Child, Preschool; Female; Humans; Intestinal Diseases, Parasitic; Madagascar; Male; Schistosomiasis haematobia; Trichuriasis