Acceptability of Mebendazole Chewable Tablet in Children Aged 2 to 4 Years in Peru

Soil-transmitted helminthiasis (STH) is among the most common of parasitic infections, affecting vulnerable populations in tropical/subtropical areas globally. In endemic countries, children, a high-risk population, require treatment and preventive interventions. Mebendazole, a WHO-recommended medicine, originally formulated as a tablet that was often crushed for administration to young children unable to swallow it, was reformulated as a chewable tablet. Acceptability is a key aspect for treatment effectiveness in pediatrics. Herein, we used a validated data-driven approach to investigate the acceptability of the 500-mg mebendazole chewable tablet in children aged 2 to 4 years in Peru. Observer-reported outcomes were collected for 182 medicine intakes. Acceptability was scored using the acceptability reference framework: a three-dimensional map juxtaposing “positively accepted” and “negatively accepted” profiles. Results found that the 500-mg mebendazole chewable tablet was classified as “positively accepted” in children aged 2 to 4 years. Acceptability increased with age and some acceptability issue remain for the younger children. Nevertheless, this formulation was considerably better accepted than the conventional tablets regardless of treatment in young children. This chewable formulation appears to be an appropriate alternative to the hard tablet of mebendazole for treatment of STH and preventive interventions in children aged 2 to 4 years.

Evaluation of the Anthelminthic Therapy of Albendazole as a Mass Drug in Elementary School in Klungkung, Bali, Indonesia

Soil transmitted helminthiasis still remains problem among tropic and subtropics developing countries worldwide. Contribute to more than a billion morbidities of people from children to adults. Children are the most affected population by this infection. This study aims to evaluate mass drug anthelminthic therapy of albendazole in school and preschool children. A cross sectional study recruited preschool and school-age children as subject of this research. During the period of May-July 2020, fecal samples were collected one month after albendazole treatment and examined by Kato kats technique. Total 130 samples were examined, and it was found that only 1 (0.007%) was positive for Trichuris trichiura. Accordingly, we can conclude that Albendazole is effective for treating Soil transmitted helminthiasis in preschool and school-age children. Keyword: anthelminthic, albendazole, school, children

Akurasi Diagnostik Kecacingan Metode Direct Slidedan Kato Katzpada Penderita Helminthiasis Di Kota Mataram

Worms are diseases caused by the entry of parasites (in the form of worms) into the human body. The types of worms that are often found to cause infection are roundworms (Ascarislumbricoides), whipworms (Trichuris trichiura) and hookworms (Necatoramericanus) which are transmitted through the soil (Soil Transmitted Helminthiasis. Examination of helminth infections can be done qualitativelyand quantitative. The qualitative examination that is often used is the Direct slide method. while the quantitative examination that is often used is the Kato Katz method. This study aims to compare the accuracy of the worm infection examination between the Direct slide method and the Kato Katz method by examining stool samples. This research was conducted on 47 Ampenan Elementary School Students located on the coast in Mataram City, where the coastal area is one of the good breeding grounds for worms. This study used a comparative analytical research design with a cross sectional approach. To establish the diagnosis of helminthiasis and the type of worm that infects, an examination of worm eggs in stool samples is carried out using the Direct slide and Kato Katz methods. The results showed that the number of samples infected with STH was more commonly found by the Kato-Katz method. The results of measurements using the Direct slide method and the Kato Katz method showed that the highest prevalence of STH infection was Ascaris lumbricoides infection. Direct slide method produces a sensitivity level of 95.16% and a specificity of 100%.

Assessment of the required performance and the development of corresponding program decision rules for neglected tropical diseases diagnostic tests: Monitoring and evaluation of soil-transmitted helminthiasis control programs as a case study

Recently, the World Health Organization established the Diagnostic Technical Advisory Group to identify and prioritize diagnostic needs for neglected tropical diseases, and to ultimately describe the minimal and ideal characteristics for new diagnostic tests (the so-called target product profiles (TPPs)). We developed two generic frameworks: one to explore and determine the required sensitivity (probability to correctly detect diseased persons) and specificity (probability to correctly detect persons free of disease), and another one to determine the corresponding samples sizes and the decision rules based on a multi-category lot quality assurance sampling (MC-LQAS) approach that accounts for imperfect tests. We applied both frameworks for monitoring and evaluation of soil-transmitted helminthiasis control programs. Our study indicates that specificity rather than sensitivity will become more important when the program approaches the endgame of elimination and that the requirements for both parameters are inversely correlated, resulting in multiple combinations of sensitivity and specificity that allow for reliable decision making. The MC-LQAS framework highlighted that improving diagnostic performance results in a smaller sample size for the same level of program decision making. In other words, the additional costs per diagnostic tests with improved diagnostic performance may be compensated by lower operational costs in the field. Based on our results we proposed the required minimal and ideal diagnostic sensitivity and specificity for diagnostic tests applied in monitoring and evaluating of soil-transmitted helminthiasis control programs.

1395Estimates of people infected with soil-transmitted-helminthiasis and drug requirements for preventive chemotherapy in Ogun, Nigeria

Background Soil transmitted helminthiasis (STH) are among the most common human infections worldwide with over 1 billion people affected. This study produced predictive risk maps of STH and estimated the number of people infected, and the amount of drug required for preventive chemotherapy in Ogun state, Nigeria. Methods Georeferenced STH infection data obtained from community cross-sectional survey, at 33 locations between July 2016-November 2018, together with remotely sensed environmental and socio-economic data were analyzed using Bayesian geostatistical models. Result An overall prevalence of 17.2% (95 % CI: 14.9, 19.5) was recorded for STH infection. Ascaris lumbricoides infections was the most predominant, 13.6% (95% CI: 11.5, 15.7), while Hookworm and Trichuris trichiura had 4.6 % (95% CI: 3.3, 5.9) and 1.7% (95 % CI: 0.9, 2.4), respectively. The predictive maps reveal a spatial pattern of high risk in the central, western and on the border connecting Republic of Benin. The model identified soil pH, soil moisture and elevation as important predictors of the STH infection. Approximately 1.1 million persons (preschoolers, school-aged children (SAC) and adults) are infected and requires 7.8 million doses. Also, 375,374 SAC were estimated to be infected, requiring 2.7 million doses for annual PC. Conclusion Our predictive risk maps and estimated PC needs provide useful information for the elimination of STH, by identifying priority areas for delivery of interventions in Ogun State, Nigeria.

Soil-Transmitted Helminthiasis, Nutritional Status, and Hemoglobin Levels of School-Age Children in Makassar

Introduction: Soil-transmitted helminthiasis (STH) is common in areas with poor sanitation. In Indonesia, the prevalence of the disease is still high ranging from 16–72%, despite the elimination efforts that have been done. This study aimed to determine the prevalence of STH, nutritional status, and hemoglobin levels of elementary school-age children in of slum area in Makassar. Methods: This was an observational study with a cross-sectional approach. Subjects were 33 elementary school-age children in one of the slum areas in Makassar, South Sulawesi, Indonesia. Stool samples were collected and examined using the Kato-Katz method. Hemoglobin levels were examined with the Azidemet hemoglobin method using capillary blood samples. Assessment of nutritional status was carried out anthropometrically using weight for height, height for age, and body mass index (BMI) for age as indicators. Results: The prevalence of STH in this study was 27%, all of them had low nutritional status. As many as 15% and 45% of subjects were severely wasted and wasted, respectively, based on the weight for height indication, 61% were wasted based on the BMI for age indicator, and 12% were stunted based on the height for age indicator. Ten percent of the subjects had low hemoglobin levels, none of them had STH. Conclusion: The STH prevalence of school-age children in one of the slum areas in Makassar is still high. Subjects with STH also experienced low nutritional status.

Behavioral factors affecting soil-transmitted helminthiasis among pregnant women attending antenatal care follow-up in Dembia, Ethiopia

Background Globally, 2 billion people infected with soil-transmitted helminthiasis, nearly 250 million women live in helminthiasis endemic area. Sub-Saharan Africa is the most affected region by soil-transmitted helminths. The prevalence of soil-transmitted helminthiasis and its determinants among pregnant mothers was not well known in this study area. Therefore, the current study was aimed to determine the prevalence of soil-transmitted infestation and its determinants in the West Dembia district. Methods A facility-based cross-sectional study design was used from October to November 2020 in the West Dembia district. A systematic random sampling technique was used to take part 416 pregnant women. Data were collected using a pretested standardized questionnaire and stool sample was collected from each participant. Data were entered into Epi-info version 7 and exported to Stata version 14 for analysis. A crude Odds Ratio (COR) and an Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) were computed. The goodness of fit for the model was checked using Hosmer and Lemeshow test. Results Of all, 416 pregnant women were examined and 115 (27.6%) of women were positive at least to one of the common soil-transmitted helminthiases. Out of the total cases, Ascaris, Hookworm, and Schistosoma species account for 45(39%), 44(38%), and 24(21%), respectively. Rural dwellers AOR: 1.9, (95% CI: 1.04, 3.67), never using latrine AOR: 3.6, (95% CI: 1.35, 9.74), not using soap for handwashing AOR: 2.7: (95% CI: 1.31, 5.36), eating raw vegetables AOR: 2.4, (95% CI: 1.44, 3.94), the habit of eating soil AOR: 3.4, (95% CI: 1.22, 9.43) were statistically significantly associated with soil-transmitted helminthiasis infestation. Conclusion The prevalence of soil-transmitted helminthiasis infestation among pregnant women is high. Rural dwellers, not using a latrine, not using soap for handwashing, eating raw vegetables, and habit of eating soil were predictors to the infestation of soil-transmitted helminthiasis among pregnant women. Therefore, besides strengthening chemotherapy prevention, Antenatal care health promotion activities need to focus on behavioral change.

Environmental enteric dysfunction, soil transmitted helminthiasis and stunting among 36- to 59-month-old children in Quezon Province, Philippines

Introduction: Environmental enteric dysfunction (EED) is relevant in public health as it is a potential cause of child stunting. In the Philippines, stunting affects 33.4% of children in 2015. As of date, no local studies on EED exist. This study primarily aimed to determine the prevalence of EED, soil transmitted helminthiasis (STH) and stunting; and their relationships. Methods: A cross-sectional study was conducted among 120 children aged 36-59 months old in Quezon Province, Philippines. EED was assessed via glucose hydrogen breath test with a cut-off of >20 ppm over baseline by 90 minutes suggestive of small intestinal bacterial overgrowth (SIBO), a biomarker of EED. Kato Katz Technique was used to determine STH. Stunting was determined using the 2006 World Health Organization Child Growth Standards. Descriptive and correlation analyses of data were done at 10% level of significance. The study received approval from the National Ethics Committee of PCHRD-DOST, Philippines. Results: Data on expired hydrogen level of <20ppm were documented. The prevalence of STH among children were 38.1% for Ascaris lumbricodes, 15.3% for Trichuris trichiura, and 1.7% for hookworm infections. A high rate of stunting at 40.0% was observed. There was a significant positive association between stunting and the presence of Ascaris (p=0.01). Conclusion: There was no case of EED detected in the study. The severity of stunting was high at 40.0%. Among the STH, the prevalence of 38.1% children having Ascaris lumbricodes was alarming in terms of morbidity control. Nutrition interventions including WASH practices and the use of anthelminthic drugs need to be intensified to address stunting and STH.

Antihelmintic Treatment And Strategy To Eliminate Soil-Transmitted Helminth In Children

Introduction: Soil-transmitted helminthiasis (STH) is one of the neglected tropical diseases. These worm infections contributed to global child health. Children suffer from chronic disease and fail to reach their full physical and intellectual capacity. Antihelmintic treatment or deworming is recommended for controlling STH. World Health Organization is focusing predominantly on deworming school-age children. Even antihelmintic treatment has to be repeated regularly, children can reinfect if their environment contaminated. It needs a strategy to control STH and treating adults as well as a child.Methods: We searched the literature for relevant clinical research and articles using Google Scholar and PubMed which were published between 2014 and 2018 with keywords “soil-transmitted helminths”, “soil-transmitted helminthiasis”, combined with “eradication” and “elimination”. We excluded research and article which were not written in English. Our study included a total number of ten publications.Results: The studies mentioned that antihelmintic requires the control of STH transmission and need for the treatment in different age groups.Conclusion: According to our findings, the mass drug administration is recommended as a control strategy in both low and middle-income countries to reduce helminthiasis and schistosomiasis. High STH reinfection rate requires an integrated approach including the use of safe pure water, improvement for personal hygiene and sanitation, proper toilets, and reducing the practice of defecation in nature. The previous studies showed that studies focused on deworming using antihelmintic

Prevalence of intestinal schistosomiasis in pre-school aged children: a pilot survey in Marolambo District, Madagascar

School-aged children (SAC) have a considerable burden of intestinal schistosomiasis in Madagascar yet its burden in pre-school aged children (PSAC) is currently overlooked. To assess the at-risk status of PSAC, we undertook a pilot epidemiological survey in June 2019 examining children (n = 89), aged 2–4-years of balanced gender, in six remote villages in Marolambo District, Madagascar. Diagnosis included use of urine-circulating cathodic antigen (CCA) dipsticks and coproscopy of stool with duplicate Kato-Katz (K-K) thick smears. Prevalence of intestinal schistosomiasis by urine-CCA was 67.4% (95% confidence interval [CI]: 56.5–77.2%) and 35.0% (95% CI: 24.7–46.5%) by K-K. The relationship between faecal eggs per gram (epg) and urine-CCA G-scores (G1 to G10) was assessed by linear regression modelling, finding for every increment in G-score, epg increased by 20.4 (6.50–34.4, P = 0.006). Observed proportions of faecal epg intensities were light (78.6%), moderate (17.9%) and heavy (3.6%). Soil-transmitted helminthiasis was noted, prevalence of ascariasis was 18.8% and trichuriasis was 33.8% (hookworm was not reported). Co-infection of intestinal schistosomiasis and soil-transmitted helminthiasis occurred in 36.3% of PSAC. These results provide solid evidence highlighting the overlooked burden of intestinal schistosomiasis in PSAC, and they also offer technical guidance for better surveillance data for the Madagascan national control programme.