clove and Hookworm-Infections

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

Endemic areas for soil-transmitted helminthiases often lack the tools and trained personnel necessary for point-of-care diagnosis. This study pilots the use of smartphone microscopy and an artificial neural network-based (ANN) object detection application named Kankanet to address those two needs.. A smartphone was equipped with a USB Video Class (UVC) microscope attachment and Kankanet, which was trained to recognize eggs of Ascaris lumbricoides, Trichuris trichiura, and hookworm using a dataset of 2,078 images. It was evaluated for interpretive accuracy based on 185 new images. Fecal samples were processed using Kato-Katz (KK), spontaneous sedimentation technique in tube (SSTT), and Merthiolate-Iodine-Formaldehyde (MIF) techniques. UVC imaging and ANN interpretation of these slides was compared to parasitologist interpretation of standard microscopy.Relative to a gold standard defined as any positive result from parasitologist reading of KK, SSTT, and MIF preparations through standard microscopy, parasitologists reading UVC imaging of SSTT achieved a comparable sensitivity (82.9%) and specificity (97.1%) in A. lumbricoides to standard KK interpretation (97.0% sensitivity, 96.0% specificity). The UVC could not accurately image T. trichiura or hookworm. Though Kankanet interpretation was not quite as sensitive as parasitologist interpretation, it still achieved high sensitivity for A. lumbricoides and hookworm (69.6% and 71.4%, respectively). Kankanet showed high sensitivity for T. trichiura in microscope images (100.0%), but low in UVC images (50.0%).. The UVC achieved comparable sensitivity to standard microscopy with only A. lumbricoides. With further improvement of image resolution and magnification, UVC shows promise as a point-of-care imaging tool. In addition to smartphone microscopy, ANN-based object detection can be developed as a diagnostic aid. Though trained with a limited dataset, Kankanet accurately interprets both standard microscope and low-quality UVC images. Kankanet may achieve sensitivity comparable to parasitologists with continued expansion of the image database and improvement of machine learning technology.

Topics: Ancylostomatoidea; Animals; Ascaris lumbricoides; Feces; Helminthiasis; Hookworm Infections; Humans; Image Processing, Computer-Assisted; Madagascar; Microscopy; Neural Networks, Computer; Parasite Egg Count; Point-of-Care Systems; Sensitivity and Specificity; Smartphone; Software; Soil; Trichuris

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

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

An evaluation of health problems is done in a village in Eastern Madagascar, where takes place a development programme. 217 inhabitants go through physical examination and lab tests are performed (Blood smear - Thick drop. Emmel test. Stools examination for parasites and enteroviruses). The epidemiologic investigation reveals the prevalences of Malaria (39,4 p. 100) intestinal schistosomiasis (59,9 p. 100) Ascaridiasis (61,3 p. 100) Hookworm (29,9 p. 100) Trichuriasis (19,8 p. 100) and sickle cells anemia (4,80 p. 100). The signs and symptoms are analysed, particularly spleen enlargement which is shown to be due to schistosomiasis. The local transmition pattern of schistosomiasis is investigated and, according to the malacological findings, is thought to be intermittent. The determination of the local hookworm is started. It should be Necator americanus. The sanitary programme to be set is considered regarding the local contexte.

Topics: Age Factors; Anemia, Sickle Cell; Animals; Ascaridiasis; Disease Vectors; Feces; Health Surveys; Hookworm Infections; Humans; Madagascar; Malaria; Mollusca; Sanitation; Schistosomiasis; Splenomegaly; Trichuriasis