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Abstract
A nationwide survey of human parasites in China was conducted during 1988-1992, with a coverage of 30 provinces/autonomous regions/municipalities (P/A/M). A total of 2,848 pilot sites in 726 counties were selected by random sampling, and 1,477,742 individuals residing on were surveyed by fecal examination. The status of paragonimiasis, hydatid diseases, cysticercosis and trichinellosis were summarized through data review. The overall infection rate of intestinal parasites was 62.6% whereas at provincial level, the highest infection rate (94.7%) was recovered in Hainan, and the lowest (17.5%) in Heilong-jiang. A high proportion (43.3%) of polyparasitism among the infected population (882,080) was revealed. Altogether 56 species of parasites comprising protozoa (19), trematode (16), cestodes (8), nematodes (12) and thorny-headed worm (1) were discovered. During the survey a new species and several new records were documented. The number of the population infected with common intestinal parasites was estimated. The diversities of parasite distribution were noted in different nationalities as well as in varied occupations.
... The second national survey revealed that soil-transmitted helminth infections decline substantially by 407 million infections compared with that in the first national survey (CONSIHPD, 2005). The standardized rate of hookworm, A. lumbricoides and T. trichiura infections had decreased by 61%, 71%, and 74%, respectively (CONSIHPD, 2005;Xu et al., 1995;Yu et al., 1994). Although the infection rate tended to increase gradually from the north to the south of the country (CONSIHPD, 2005), the infection rates in some southern areas, i.e. ...
... Although the infection rate tended to increase gradually from the north to the south of the country (CONSIHPD, 2005), the infection rates in some southern areas, i.e. Jiangsu, Guangdong, Shanghai and Zhejiang provinces/municipalities were lower than those of many other central and southern provinces/autonomous regions/municipalities due to large-scale control activities, rapid local economical development, and improved living standards of the farmers (CONSIHPD, 2005;Yu et al., 1994). In some less-developed counties and townships in central and western P.R. China, the number of soil-transmitted helminth infections remained high and difficult to control due to complicated natural, social, and behavioural factors. ...
... In some less-developed counties and townships in central and western P.R. China, the number of soil-transmitted helminth infections remained high and difficult to control due to complicated natural, social, and behavioural factors. The inaccessibility of transportation as well as budgetary constraints were key impediments for parasitic disease control (CONSIHPD, 2005;Yu et al., 1994). ...
Changes in the natural environment and agricultural systems induced by economic and industrial development, including population dynamics (growth, urbanization, migration), are major causes resulting in the persistence, emergence and re-emergence of infectious diseases in developing countries. In the face of rapid demographic, economic and social transformations, China is undergoing unprecedented environmental and agricultural change. We review emerging and re-emerging diseases such as schistosomiasis, dengue, avian influenza, angiostrogyliasis and soil-transmitted helminths that have occurred in China due to environmental and agricultural change. This commentary highlights the research priorities and the response strategies, namely mitigation and adaptation, undertaken to eliminate the resurgence of those infectious diseases.
... Multiparasitism has also been reported from the Americas (Ferreira et al., 1994;Guignard et al., 2000;Jardim-Botelho et al., 2008) and eastern Asia (Auer, 1990;Sayasone et al., 2009b), including P.R. China (Booth et al., 1996;Yu et al., 1994). All studies consistently found that multiparasitism is the norm rather than the exception (Keusch and Migasena, 1982;King and Bertino, 2008;McKenzie, 2005;Singer and de Castro, 2007;. ...
... During the first nationwide survey pertaining to human intestinal parasites in P.R. China, carried out between 1988 and 1992, faecal samples of almost 1.5 million individuals were screened by the Kato-Katz technique, and Lugol-stained or saline direct smears were prepared. Among those infected with at least one parasite, 43.3% were found to harbour up to nine different species concurrently (Yu et al., 1994). The second national survey, carried out between 2001 and 2004, documented a significantly lower prevalence of common STHs, but unfortunately, no information is available on intestinal protozoa, and multiparasitism rates were not published in the peer-reviewed international literature (Ministry of Health, 2005). ...
... China found a prevalence of infection of 62.6% in 1988-1992, 43.3% of whom were infected by multiple species. A total of 56 intestinal parasite species were identified and the highest number of parasite species found in a single individual was nine (Yu et al., 1994). The second survey implemented between 2001 and 2004 found multiple infections among 24.1% of all infected individuals. ...
This review focuses on the issue of multiparasitism, with a special emphasis on its characteristics, its extent in eastern Asia and its significance for infectious disease control. Multiparasitism is pervasive among socially and economically disadvantaged or marginalised communities, particularly in tropical and subtropical areas. Intestinal parasites are the most numerous group, but an array of parasites is located elsewhere than in the human gastrointestinal tract. Although multiparasitism has been recognised for decades, in-depth studies are rare, and its public health and economic implications have yet to be fully elucidated. The assessment of multiparasitism is hampered by a lack of sensitive broad-spectrum diagnostic tools and the need to collect multiple biological samples for detailed appraisal. Non-specific symptoms and mainly subtle effects complicate the appreciation of its influence on cognitive and physical development, health, economic productivity and general well-being. Multiparasitism has been reported from virtually every eastern Asian country, and studies regarding the extent of multiparasitism and its effects on child health have been implemented in the region. However, new research is needed, as no comprehensive evaluations of multiparasitism in eastern Asia could be identified. Two case studies pertaining to multiparasitism at the local and regional scale are presented. Multiparasitism was rampant in an ethnic minority village in southern People's Republic of China where the challenges associated with its thorough evaluation are illustrated. The results from a cross-sectional survey covering 35 villages highlight the significance of its evaluation for the design of locally adapted and sustainable parasite control and poverty alleviation programmes. We conclude by listing a set of research needs for future investigations.
... Multiparasitism has also been reported from the Americas (Ferreira et al., 1994;Guignard et al., 2000;Jardim-Botelho et al., 2008) and eastern Asia (Auer, 1990;Sayasone et al., 2009b), including P.R. China (Booth et al., 1996;Yu et al., 1994). All studies consistently found that multiparasitism is the norm rather than the exception (Keusch and Migasena, 1982;King and Bertino, 2008;McKenzie, 2005;Singer and de Castro, 2007;. ...
... During the first nationwide survey pertaining to human intestinal parasites in P.R. China, carried out between 1988 and 1992, faecal samples of almost 1.5 million individuals were screened by the Kato-Katz technique, and Lugol-stained or saline direct smears were prepared. Among those infected with at least one parasite, 43.3% were found to harbour up to nine different species concurrently (Yu et al., 1994). The second national survey, carried out between 2001 and 2004, documented a significantly lower prevalence of common STHs, but unfortunately, no information is available on intestinal protozoa, and multiparasitism rates were not published in the peer-reviewed international literature (Ministry of Health, 2005). ...
... China found a prevalence of infection of 62.6% in 1988-1992, 43.3% of whom were infected by multiple species. A total of 56 intestinal parasite species were identified and the highest number of parasite species found in a single individual was nine (Yu et al., 1994). The second survey implemented between 2001 and 2004 found multiple infections among 24.1% of all infected individuals. ...
This review focuses on the issue of multiparasitism, with a special emphasis on its characteristics, its extent in eastern Asia and its significance for infectious disease control. Multiparasitism is pervasive among socially and economically disadvantaged or marginalised communities, particularly in tropical and subtropical areas. Intestinal parasites are the most numerous group, but an array of parasites is located elsewhere than in the human gastrointestinal tract. Although multiparasitism has been recognised for decades, in-depth studies are rare, and its public health and economic implications have yet to be fully elucidated. The assessment of multiparasitism is hampered by a lack of sensitive broad-spectrum diagnostic tools and the need to collect multiple biological samples for detailed appraisal. Non-specific symptoms and mainly subtle effects complicate the appreciation of its influence on cognitive and physical development, health, economic productivity and general well-being. Multiparasitism has been reported from virtually every eastern Asian country, and studies regarding the extent of multiparasitism and its effects on child health have been implemented in the region. However, new research is needed, as no comprehensive evaluations of multiparasitism in eastern Asia could be identified. Two case studies pertaining to multiparasitism at the local and regional scale are presented. Multiparasitism was rampant in an ethnic minority village in southern People's Republic of China where the challenges associated with its thorough evaluation are illustrated. The results from a cross-sectional survey covering 35 villages highlight the significance of its evaluation for the design of locally adapted and sustainable parasite control and poverty alleviation programmes. We conclude by listing a set of research needs for future investigations.
... In a nationwide effort to assess the prevalence of parasitic diseases, the Chinese Academy of Preventive Medicine and the Ministry of Health initiated the largest human parasite survey ever undertaken. From 1988 to 1992, 1,477,742 persons were examined in 2,848 study sites in 726 sampled counties (5)(6)(7)(8). China's 30 provinces were divided into sectors; the counties and townships in each sector were then grouped into high, intermediate, and low on the basis of socioeconomic parameters (including levels of sanitation, income, and literacy) (8). ...
... China's 30 provinces were divided into sectors; the counties and townships in each sector were then grouped into high, intermediate, and low on the basis of socioeconomic parameters (including levels of sanitation, income, and literacy) (8). All long-term residents in each randomly selected site (5,8,9) were asked to submit a fecal specimen for examination (8); compliance was at least 90%. Fecal specimens were collected at village offices or township health centers and examined by personnel trained specifically to participate in the nationwide survey. ...
... The identification and quantitation of helminth eggs was determined by the Kato-Katz thick-smear technique on all slides positive for hookworm and Trichuris, but in only one slide of every 10 Ascaris-positive slides (8). To examine eggs of Enterobius vermicularis, adhesive transparent tape was applied to the perianal area on children under 12 years of age (5,8). To ensure quality control for fecal examinations, random checks of selected slides were made throughout the study. ...
Despite great strides in their control throughout the People's Republic of China, helminth infections remain an important public health problem. The Institute of Parasitic Diseases of the Chinese Academy of Preventive Medicine, under the guidance of the Chinese Ministry of Health, completed a nationwide survey of more than 1 million people that showed the high prevalence and intensity of intestinal nematode infections; prevalence can sometimes exceed 50% in the Yangtze River valley provinces. Schistosoma japonicum is also a major cause of illness in this region. Attempts to control Chinese helminthic diseases with conventional anthelminthic drugs have been partially thwarted by high posttreatment rates of reinfection. Recently, several new human trematode pathogens have been identified. Novel approaches to chemoprophylaxis and vaccination may alleviate the public health problem caused by Chinese helminths. However, recombinant helminth vaccine development will depend on first cataloguing the extensive genetic diversity of Chinese helminths and candidate vaccine antigens. Evidence from biogeography, genetics, and systematics suggests that the genetic diversification of Chinese helminths and their vectors is an ongoing evolutionary process that began 12 million years ago near the convergence of major Asian river systems. Construction of the Three Gorges Super Dam on the Yangtze River may promote the emergence and reemergence of new helminths and their snail vectors
... The nationwide survey of intestinal parasites revealed previously that the South China Sea island of Hainan Province had the highest rates of intestinal parasitism in China. Based on 7,958 fecal examinations, it was discovered that 94.1% of the population harbored 1 or more intestinal parasites (Yu et al., 1994). This included 61.8% prevalence of ascariasis, 66.7% prevalence of trichuriasis, and 60.8% prevalence of hookworm . ...
... The study was carried out in a village located on the island Province of Hainan, located in the South China Sea. Earlier results of a nationwide survey completed in 1992 identified Hainan as having the highest intensity and prevalence rates of geohelminth infections in China (Yu et. al, 1994;Hotez et al., 1997.) Our study suggests that high rates of hookworm and A. lumbricoides transmission continue in this region, whereas the overall prevalence of trichuriasis has diminished. Based on a participation rate of 80% in the village, the prevalence of hookworm infection in Xiulongkan was 60%. Of those that did not participate in ...
Hookworm infection as well as other intestinal nematodiases are endemic to Sichuan Province in China. In order to research the prevalence and intensity of these infections we visited two villages in Hejiang County (southern Sichuan Province) and Santai County (northwestern Sichuan Province) between July and October of 1997. Fecal examinations were performed on adult villagers over the age of 15 years (currently children under this age are dewormed annually with anthelmintic drugs). Among 310 residents of Lugao Village (Hejiang County), 87, 63 and 60% were infected with hookworm, Ascaris or Trichuris, respectively. The prevalence of hookworm determined to rise linearly with age (r = 0.97). High intensity infections with hookworm still occur in this region as 22% of the residents have over 3000 eggs per gram (PEG) of feces as determined by quantitative egg counts. The majority of these individuals harbored mixed infection with Necator americanus and Ancylostoma duodenale, although the former predominated when adult hookworms were collected from 30 village residents treated with pyrantel pamoate. In contrast, among the 334 Xinjian villagers examined (Santai County) the majority harbored predominantly light hookworm infections--66.1% of the residents has less than 400 EPG by quantitative fecal examination and only 3.7% exhibited greater than 3000 EPG. Again, N. americanus was the predominant hookworm seen after worm expulsion. We have round that despite economic development which is occurring in some parts of China, significant hookworm infections and clinical hookworm anemia still exist in areas of Sichuan Province. In Hejiang County we found that the intensity of hookworm infection has actually risen within the last 10 years. Hookworm is a medical problem among the elderly in Sichuan.
... China is endemic for T. solium cysticercosis as consumption of pork is very popular and the frequency of ingestion of undercooked pork contaminated with T. solium cysticerci is high (Ito et al., 2003b). However, there is little detailed information available on the epidemiology of T. solium taeniasis and cysticercosis in the northeastern area including Inner Mongolia, China (Wei et al., 1988;Yu et al., 1994). Many cysticercosis patients, especially those with neurocysticercosis (NCC), have been reported in most of the provinces and autonomous regions of China (Ito et al., 2002aIto et al., , 2003bSingh et al., 2002;Yu et al., 1994).Xu et al. (1999)identified 16 508 Chinese cysticercosis cases from 1988 to 1992. ...
... However, there is little detailed information available on the epidemiology of T. solium taeniasis and cysticercosis in the northeastern area including Inner Mongolia, China (Wei et al., 1988;Yu et al., 1994). Many cysticercosis patients, especially those with neurocysticercosis (NCC), have been reported in most of the provinces and autonomous regions of China (Ito et al., 2002aIto et al., , 2003bSingh et al., 2002;Yu et al., 1994).Xu et al. (1999)identified 16 508 Chinese cysticercosis cases from 1988 to 1992. There were five concentrated epidemic areas: northeast, north including Inner Mongolia, northwest, east and south. ...
Severe anaemia is a common presentation in non-pregnant adults admitted to hospital in southern Africa. Standard syndromic treatment based on data from the pre-HIV era is for iron deficiency, worms and malaria. We prospectively investigated 105 adults admitted consecutively to medical wards with haemoglobin < 7 g/dl. Those with acute blood loss were excluded. Patients were investigated for possible parasitic, bacterial, mycobacterial and nutritional causes of anaemia, including bone marrow aspiration, to identify potentially treatable causes. Seventy-nine per cent of patients were HIV-positive. One-third of patients had tuberculosis, which was diagnosed only by bone marrow culture in 8% of HIV-positive patients. In 21% of individuals bacteria were cultured, with non-typhi salmonella predominating and Streptococcus pneumoniae rare. Iron deficiency, hookworm infection and malaria were not common in HIV-positive anaemic adults, although heavy hookworm infections were found in 6 (27%) of the 22 HIV-negative anaemic adults. In conclusion, conventional treatment for severe anaemia in adults is not appropriate in an area of high HIV prevalence. Occult mycobacterial disease and bacteraemia are common, but iron deficiency is not common in HIV-positive patients. In addition to iron supplements, management of severe anaemia should include investigation for tuberculosis, and consideration of antibiotics active against enterobacteria.
... China is endemic for T. solium cysticercosis as consumption of pork is very popular and the frequency of ingestion of undercooked pork contaminated with T. solium cysticerci is high (Ito et al., 2003b. However, there is little detailed information available on the epidemiology of T. solium taeniasis and cysticercosis in the northeastern area including Inner Mongolia, China (Wei et al., 1988;Yu et al., 1994). Many cysticercosis patients, especially those with neurocysticercosis (NCC), have been reported in most of the provinces and autonomous regions of China (Ito et al., 2002a(Ito et al., , 2003bSingh et al., 2002;Yu et al., 1994). ...
... However, there is little detailed information available on the epidemiology of T. solium taeniasis and cysticercosis in the northeastern area including Inner Mongolia, China (Wei et al., 1988;Yu et al., 1994). Many cysticercosis patients, especially those with neurocysticercosis (NCC), have been reported in most of the provinces and autonomous regions of China (Ito et al., 2002a(Ito et al., , 2003bSingh et al., 2002;Yu et al., 1994). Xu et al. (1999) identified 16 508 Chinese cysticercosis cases from 1988 to 1992. ...
Neurocysticercosis (NCC) is one of the major causes of neurological disease in China. ELISA and immunoblotting using glycoproteins purified by preparative isoelectric focusing were used to detect human cysticercosis in Tongliao area, Inner Mongolia, China in 1998. Approximately 89% (39 of 44 inpatients and outpatients with suspected NCC at Tongliao City Hospital) were residents of Inner Mongolia. About 53% were male and 77% were of working age (18-59 years), and 32% were farmers. Immunoblotting and ELISA showed a high correlation. Of the 44 patients, 31 positive by cerebral computed tomography (CT) scan were confirmed serologically to have cysticercosis. In the ELISA, patients with no lesions by CT scan had lower OD values, similar to those of normal serum. These findings confirm that both ELISA and immunoblotting assays are sufficiently sensitive to detect asymptomatic or symptomatic cysticercosis patients.
... Intestinavl parasitic infections pose a substantial threat to public health and are a huge burden to the economic development of a developing country. [1][2][3] Parasites infecting the gastrointestinal tract were established in 3.5 billion people and clinical symptoms were observed in 450 million people worldwide with an annual death rate of over 2 lakhs of people resulting from these illnesses. [4] Soil-transmitted helminth (STH) infections are identified among 1.5 billion infected people in the world, forming 24% of the world's population and affecting the developing countries having deprived access to sanitation, hygiene, and potable water in tropical and subtropical regions, predominantly reported from Asia, China, sub-Saharan Africa, and South America. ...
A BSTRACT
Introduction
Intestinal parasitic infections pose a substantial threat to public health and are a huge burden to the economic development of a developing country. We aimed to identify the spectrum of intestinal parasitic infections with an emphasis on demographic and clinical characteristics observed among immunocompromised and immunocompetent patients.
Materials and Methods
This observational study was performed in the Parasitology section of the Department of Microbiology from January 2022 to July 2022. A total of 2628 stool samples were obtained from patients presenting with chief complaints of abdominal pain, distension, vomiting, and foul-smelling feces. All the clinical and diagnostic data of the patients enrolled in the above-mentioned period were extracted from the ward files, hospital electronic records, and laboratory registers.
Result
A total of 2628 stool samples were sent to the Parasitology section of the Department of Microbiology. Out of the above-mentioned samples, 70 (70/2628, 2.66%) samples yielded gastrointestinal parasites on microscopic examination. The mean age of the patients included in our cohort study was 32.53 ± 16.21 years with a male predominance of 72.86% (51/70, 72.86%). The most common gastrointestinal parasite identified from stool samples was Giardia lamblia (61/70, 87.14%). All cases of opportunistic gastrointestinal infection caused by Cryptosporidium spp . (4/70, 5.71%) in our study cohort were found to infest the immunocompromised patients.
Conclusion
This study determines the spectrum of intestinal parasitic infections among the immunocompromised and immunocompetent individuals and guides physicians in starting appropriate anti-parasitic treatment along with the instillation of strict hand hygiene techniques.
... In the early 1960s, there were many parasitic infections that seriously impacted the health of people worldwide, especially in China (1,2). Parasitic infection was problematic and a huge burden on economic development (3,4). Despite the exceptional improvements that have been accomplished in fighting parasites over the last 60 years in China, parasitic infections still account for a large percentage of the burden (1). ...
Background
This study performed a follow-up investigation of parasitic infections and the evolution of the infection spectra in Shanghai and its surrounding areas in Eastern China. The current study was conducted in the Shanghai Ruijin Hospital, a tertiary hospital affiliated with Shanghai Jiao Tong University School of Medicine.
Methods
This retrospective investigation reviewed a total of 412 parasitic infections in patients admitted to the Department of Infectious Diseases, Ruijin Hospital from January 1, 2010 to July 31, 2022. Detailed information for these patients was retrieved from the Electronic Medical Record System. Analysis was performed using GraphPad Prism 5.0 and SPSS Statistics 26.
Results
Overall, 17 species of parasites were detected from the 412 admissions. Over the 13 years, the number of patients peaked in 2021 and food-born parasites (FBPs) were the primary species. During the most recent 5 years, Clonorchis sinensis, replacing Paragonimus westermani, has become the primary parasite detected among the patients, consistent with the observation that eating uncooked fish has turned into the most common route of transmission. Paragonimus westermani infections declined with age, but Cysticercus increased with age. The periods from the onset of symptoms to definite diagnosis for some patients infected with Sparganum mansoni, Paragonimus westermani, and Cysticercus were more than 6 months. Interestingly, eosinophilia was only detected in 51.83% of parasite-infected patients. In addition, superinfections of parasites were common in our study.
Conclusion
Our study demonstrates the transitional change in the prevalence of parasitic infection over the latest 13 years in a single center in Eastern China. The incidence of parasitic infections peaked in 2021, and the dominant parasitic species switched from a soil origin to foodborne. The direction for the diagnosis and prevention of parasitic infection among different age groups should alter according to age. It is difficult to diagnose parasitic infections and superinfections that occur in some patients. Thus, more sensitive and efficient detection methods should be developed. In addition, although eosinophilia and elevated IgE are still reliable indicators for initiating screening of parasitic infection, the development of novel parasitic diagnostic kits is still in urgent need for occult infection.
... The survey carried around 991 patients in South India with symptomatic localization-related seizures, 40% were found to have active NCC, calcified cysticercosis as evident on CT scan [25]. The prevalence of NCC in rural setting of China and Korea is around 3%-4% based on sero-surveillance data obtained with unfractionated antigen test [26,27]. In United States, most of the cases are among the immigrants traveled from Latin America or from rural areas of endemic countries, although about 1000 new cases diagnosed annually in USA [28]. ...
... In the early 1960s, there were many parasitic diseases that seriously affected the health of people worldwide, especially in China and poor countries. Parasitic infection was used to be a troublesome problem that hindered social and economic development [1,2]. Though exceptional achievements have been accomplished in ghting parasites in the past 60 years, parasitic infections in China still account for a large percentage of the global burden [3]. ...
Background
Parasitic infections represent a worldwide public health issue in many developing countries. Few epidemiological studies regarding parasitic infections and the evolution of infection spectrum in China have been reported up to date. It is necessary to investigate the epidemiological feature of parasitic infection during recent years.
Methods
Three hundred and thirty-six cases of parasitic infections were retrospectively enrolled and analyzed. Electronic medical records of the enrolled parasitic patients from January 1, 2010 to May 31, 2021 were retrieved from the Electronic Medical Record System of a tertiary hospital in China. Demographic characteristics and data of laboratory tests were exported in Excel and analysis were performed using Graphpad Prism 5.
Results
Overall, seventeen species of parasites were detected in 336 admissions with a total number of infected individuals reached the peak in 2018. Moreover, the regions of patients distributed mainly included: Shanghai (40.48%), Zhejiang (18.45%), Anhui (6.85%), Jiangsu (6.25%) and Jiangxi (4.76%). Two hundred and eighty-eight cases were diagnosed with single species of parasitic infection and 47 cases were found mixed species infection. Foodborne parasites (FBPs) were the primary species of parasites and the top 4 were clonorchis sinensis (24.70%), sparganum mansoni (16.07%), paragonimus westermani (20.83%) and cysticercus (17.86%). Obvious eosinophil elevation was found in 56.54% enrolled patients. Patients with periods of infection before the time of diagnosis lasted longer than 6 months includes four parasites: sparganum mansoni (28.30%, 15/53), paragonimus westermani (38.57%, 27/70), cysticercus (25.00%, 15/60).
Conclusions
Our study demonstrated the prevalence of parasitic infection over the latest 12 years in a single center of China. The trend of parasitic infection rate reached the peak in 2018 with the dominating parasitic species changed from soil origin to foodborne. Furthermore, with the emergence of various dietary habits and the development of living conditions, unclean diets especially eating raw meat had become the main route of transmission for parasites, which alarmed that food safety education for public should be strengthened and enlarged. Although eosinophil elevation and IgE is reliable indicators for initiating screening of parasitic infection but enough for diagnosis, novel diagnostic kits for parasites should be devepoled.
... Ancylostomiasis, schistosomiasis, malaria, filariasis and leishmaniasis were listed as five major parasitic diseases in the early Peoples' Republic of China. Ancylostomiasis is widely prevalent in China (17) and is a public health problem with a considerable negative influence on health, hindering socioeconomic development (18). The pathogenic mechanism of both hookworm species is similar (19)(20), with their eggs developing into infective larvae in vitro (21), which then puncture human skin (22) to migrate and reach the small intestine (23). ...
Background:
Ancylostomiasis is a prevalent and global parasitic disease, including China. A systematic review is significant to understand the epidemiological features of hookworm and provide guidance for prevention and treatment.
Methods:
We systematically searched academic databases and assessed 944 papers published from 1955-2015 to establish the comprehensive analysis of prevalence of hookworm disease in China. We searched Chinese databases, including CNKI, Wanfang and VIP, for literature with the subject word "Ancylostomiasis and hookworm". The data were analyzed with SPSS 19.0 software using Spearman correlation analysis. Results were statistically significant for a P-value of <0.01.
Results:
The search yielded 532,151 cases from epidemiological investigation and 7294 cases based on hospital diagnosis. Hookworm infection was highest (15.83%) in Fujian province, with high rates also found in East China, Southwest China, Central China and Southern China and lower rates in Northwest China, North China and Northeast China. In terms of occupation, farmers had the highest proportion of infections (72.54%). There was no correlation between epidemiological investigations and hospital-diagnosed cases. However, there was significant positive correlation between hospital-diagnosed cases and misdiagnosed cases. The proportion of hospital-misdiagnosed cases was 32.80%.
Conclusion:
Ancylostomiasis is a serious public health problem that negatively influences health and hinders socioeconomic development. Positive measures are required by both health services and individuals to prevent and control hookworm disease.
... Clonorchiasis and paragonomiasis represent two key food-borne trematode infections in China. With regard to the former, approximately 15 million people are infected nationwide [11,26], representing an 80% increase compared with the infections identified in the first national survey of parasitic diseases in 1994 [2]. Today, China accounts for 85% of global clonorchiasis. ...
... Of note, the two surveys used an insensitive diagnostic approach with only one stool sample subjected to a single Kato-Katz thick smear. The first survey covered 30 provinces/autonomous regions/municipalities (P/A/M) with around 1.5 million people screened, and found an overall prevalence of 0.37% [10]. Data from the second survey, which took place in 31 P/A/M and screened around 350,000 people, showed an overall prevalence of 0.58% [7]. ...
Background
Clonorchiasis, one of the most important food-borne trematodiases, affects more than 12 million people in the People’s Republic of China (P.R. China). Spatially explicit risk estimates of Clonorchis sinensis infection are needed in order to target control interventions.
Methodology
Georeferenced survey data pertaining to infection prevalence of C. sinensis in P.R. China from 2000 onwards were obtained via a systematic review in PubMed, ISI Web of Science, Chinese National Knowledge Internet, and Wanfang Data from January 1, 2000 until January 10, 2016, with no restriction of language or study design. Additional disease data were provided by the National Institute of Parasitic Diseases, Chinese Center for Diseases Control and Prevention in Shanghai. Environmental and socioeconomic proxies were extracted from remote-sensing and other data sources. Bayesian variable selection was carried out to identify the most important predictors of C. sinensis risk. Geostatistical models were applied to quantify the association between infection risk and the predictors of the disease, and to predict the risk of infection across P.R. China at high spatial resolution (over a grid with grid cell size of 5×5 km).
Principal findings
We obtained clonorchiasis survey data at 633 unique locations in P.R. China. We observed that the risk of C. sinensis infection increased over time, particularly from 2005 onwards. We estimate that around 14.8 million (95% Bayesian credible interval 13.8–15.8 million) people in P.R. China were infected with C. sinensis in 2010. Highly endemic areas (≥ 20%) were concentrated in southern and northeastern parts of the country. The provinces with the highest risk of infection and the largest number of infected people were Guangdong, Guangxi, and Heilongjiang.
Conclusions/Significance
Our results provide spatially relevant information for guiding clonorchiasis control interventions in P.R. China. The trend toward higher risk of C. sinensis infection in the recent past urges the Chinese government to pay more attention to the public health importance of clonorchiasis and to target interventions to high-risk areas.
... The Chinese government has historically carried out national surveys for other human parasitic diseases [38]. Between 1988 and 1992, and again between 2001 and 2004, national surveys tested for 56 different parasites, including protozoa and helminths [28,39], using a random sampling scheme and a set of diagnostics similar to the national schistosomiasis surveys [40]. However, sampling for these national surveys was not informed by routine surveillance data. ...
Though it has been a focus of the country's public health surveillance systems since the 1950s, schistosomiasis represents an ongoing public health challenge in China. Parallel, schistosomiasis-specific surveillance systems have been essential to China's decades-long campaign to reduce the prevalence of the disease, and have contributed to the successful elimination in five of China's twelve historically endemic provinces, and to the achievement of morbidity and transmission control in the other seven. More recently, an ambitious goal of achieving nation-wide transmission interruption by 2020 has been proposed. This paper details how schistosomiasis surveillance systems have been structured and restructured within China's evolving public health system, and how parallel surveillance activities have provided an information system that has been integral to the characterization of, response to, and control of the disease. With the ongoing threat of re-emergence of schistosomiasis in areas previously considered to have achieved transmission control, a critical examination of China's current surveillance capabilities is needed to direct future investments in health information systems and to enable improved coordination between systems in support of ongoing control. Lessons drawn from China's experience are applied to the current global movement to reduce the burden of helminthiases, where surveillance capacity based on improved diagnostics is urgently needed.
... infections reduced by 60.7%, 71.3% and 73.6%, respectively. The number of people infected with soil-transmitted nematodes decreased from 536 million in 1990 to 129 million in 2003, of which 39.3, 85.9 and 29.1 million represented infections with hookworms, A. lumbricoides and T. trichiura, respectively [17,18]. The infection rates of soil-transmitted nematodes in populations continue to decline, and the number of infected people decreased from 20.9 million in 2006 to 6.9 million in 2012. ...
To further enhance dialogue and promote cross-strait cooperation in the prevention and control of parasitic diseases, this paper reviewed the progress and current challenges in the cross-strait control and research of parasitic infections, based on three cross-strait meetings on parasitological research in the last decade. The major outcome of the 3rd Meeting of Cross-Strait Parasitological Research held in April 2013 was identifying the research priorities for parasitological research.
Electronic supplementary material
The online version of this article (doi:10.1186/2049-9957-3-40) contains supplementary material, which is available to authorized users.
... In P.R. China, the great progress made in WASH indicators over the past two decades-in 1990, 33% of the total population had no access to safe water and 69% used unimproved sanitation facilities-have certainly contributed to the impressive reductions in the prevalence of soil-transmitted helminths that have been documented through nation-wide surveys. Indeed, the first national survey undertaken between 1988 and 1992 found prevalences of 47%, 19% and 17% for A. lumbricoides, T. trichiura and hookworm (Yu et al., 1994), while the second national survey, completed in 2004, found respective prevalences of 13%, 5% and 6% (Ministry of Health, 2005). These declines are confirmed by a recent systematic review of soil-transmitted helminth surveys across P.R. ...
... Enhanced efforts should be required to integrate measures to control helminthiasis. Preventative chemotherapy can be integrated for control of several helminthiasis since praziquental, mebendazole, and albendazole are belonging to broad-spectrum anthelminthics, and there is extensive overlap and co-endemicity among these parasitic diseases Shang et al., 2010;Yu et al., 1994b). To reach the long term goals to reduce or interrupt transmission of helminthiasis, improvement of hygiene, housing, and sanitation conditions will help to consolidate and gain further achievements for parasitic disease control . ...
... Malek (1980) gives a detailed account of snail-transmitted parasites, including those listed in the previous paragraph, and the diseases they cause. In addition to these reviews and conference proceedings, individual papers in journals give information on endemic areas and the incidence of infection in fish (examples are Vicharsi et al. 1982;Ditrich et al. 1990;Park et al. 1993;Yu et al. 1994a;Yu et al. 1994b). ...
... Three large-scale surveys for clonorchiasis have been carried out in mainland of China. The prevalence of clonorchiasis was 0.37% according to the first national parasite survey involving in 30 Provinces/Municipalities/ Autonomous Regions (P/M/As) between 1988 and 1992 (hereinafter referring as 1992) [9]. Then, it increased to 0.58% in the second national parasite survey involving in 31 P/M/As between 2001 and 2004 (hereinafter referring as 2004a) [10,11]. ...
This paper reviews the epidemiological status and characteristics of clonorchiasis at global level and the etiological relationship between Clonorchis sinensis infection and cholangiocarcinoma (CCA). A conservative estimation was made that 15 million people were infected in the world in 2004, of which over 85% distributed in China. The epidemiology of clonorchiasis is characterized by rising trend in its prevalence, variability among sexes and age, as well as endemicity in different regions. More data indicate that C. sinensis infection is carcinogenic to human, and it is predicted that nearly 5 000 CCA cases attributed to C. sinensis infection may occur annually in the world decades later, with its overall odds ratio of 4.47. Clonorchiasis is becoming one major public health problem in east Asia, and it is worthwhile to carry out further epidemiological studies.
... This phenomenon is common in regions where different parasites co-exist at high frequencies (Petney and Andrews, 1998). For example, a considerable proportion of people have been found to be concurrently infected with multiple parasite species in rural parts of China (Yu et al., 1994;Steinmann et al., 2008) and across Africa (Raso et al., 2004;McKenzie, 2005). Hookworm and schistosomiasis are among the most frequent co-existing parasitic diseases, mainly in sub-Saharan Africa, as well as in parts of South America and southeast Asia. ...
Co-infection with hookworm and schistosomes is a common phenomenon in sub-Saharan Africa, as well as in parts of South America and southeast Asia. As a first step towards understanding the metabolic response of a hookworm-schistosome co-infection in humans, we investigated the metabolic consequences of co-infection in an animal model, using a nuclear magnetic resonance (NMR)-based metabolic profiling technique, combined with multivariate statistical analysis. Urine and serum samples were obtained from hamsters experimentally infected with 250 Necator americanus infective L(3) and 100 Schistosoma japonicum cercariae simultaneously. In the co-infection model, similar worm burdens were observed as reported for single infection models, whereas metabolic profiles of co-infection represented a combination of the altered metabolite profiles induced by single infections with these two parasites. Consistent differences in metabolic profiles between the co-infected and non-infected control hamsters were observed from 4 weeks p.i. onwards. The predominant metabolic alterations in co-infected hamsters consisted of depletion of amino acids, tricarboxylic acid cycle intermediates (e.g. citrate and succinate) and glucose. Moreover, alterations of a series of gut microbial-related metabolites, such as decreased levels of hippurate, 3-hydroxyphenylpropionic acid, 4-hydroxyphenylpropionic acid and trimethylamine-N-oxide, and increased concentrations of 4-cresol glucuronide and phenylacetylglycine were associated with co-infection. Our results provide a first step towards understanding the metabolic response of an animal host to multiple parasitic infections.
... The prevalence rates shown in Table 2.4 range from 0.1 % to 50.0% with wide variations. 18,22,23,[78][79][80][81][82][83][84][85][86] It can be noted that taeniasis is highly endemic in some areas in China and Nepal. ...
Taenia soliurn taeniasis and cysticercosis are recognized as a major public health problem in Latin America. T. soliurn transmission not only affects the health of the individual, but also social and economic development, perpetuating the cycle of poverty. To determine prevalence rates, population knowledge and risk factors associated with transmission, an epidemiological study was undertaken in the rural community of Jalaca. Two standardized questionnaires were used to collect epidemiological and T. soli urn general knowledge data. Kato-Katz technique and an immunoblot assay (EITB) were used to determine taeniasis and seroprevalence, respectively. In total, 139 individuals belonging to 56 households participated in the study. Household characteristics were consistent with conditions of poverty of rural Honduras: 21.4% had no toilet or latrines, 19.6% had earthen floor, and 51.8% lacked indoor tap water. Pigs were raised in 46.4% of households, of which 70% allowed their pigs roaming freely. A human seroprevalence rate of 18.7% and a taeniasis prevalence rate of 2.4% were found. Only four persons answered correctly 2: 6 out of ten T. soliurn knowledge questions, for an average passing score of 2.9%. In general, a serious gap exists in knowledge regarding how humans acquire the infections, especially neurocysticercosis was identified. After regression analysis, the ability to recognize adult tapeworms and awareness of the clinical importance of taeniasis, were found to be significant risk factors for T. soliurn seropositivity. These results demonstrate a high level of transmission and a low level of kn~,wledge about Taenia soliurn in Jalaca. Consequently, intervention measures integrated with health education are necessary to decrease the burden caused by this parasite.
... Hookworm disease remains the most devastating helminth infection in the world, despite considerable advances in chemotherapy and control. There are an estimated 1 billion people infected with 1 or more species of hookworm (Gilles, 1985), with an estimated 190 million cases in China alone (Yu et al., 1994;Xu et al., 1995). Adult hookworms inhabit the small intestine, where they attach to the mucosa and feed on blood and are the major cause of anemia in the tropics (Gilles, 1985;Hotez, 1989;Hotez et al., 1995). ...
There are 2 major species of hookworms that infect humans. Ancylostoma duodenale and Necator americanus. Although traditionally considered to be identical for treatment purposes, there are significant life history differences between the species that must be considered for the rational design of chemotherapeutic and immunoprophylactic control strategies. However, identification of the species infecting a particular population has been problematic, as the eggs of the 2 species cannot be reliably differentiated by classical parasitological methods. A PCR-based technique for the differentiation of hookworm species that infect humans is reported. A fragment of the 3' untranslated region of the cAMP-dependent protein kinase catalytic subunit gene was amplified from A. duodenale and N. americanus genomic DNA using primers derived from the corresponding A. caninum cDNA. Digestion of the amplified DNA with the restriction enzymes HpaII, MboI, TaqI, and ThaI generated specific restriction fragment patterns unique to each species. The technique can distinguish between pure and mixtures of hookworm DNA and can amplify DNA from a single egg. The primers also amplify the fragment from the DNA of several other species of hookworms that infect humans and other animals. The technique is fast, simple, and hookworm specific and represents a considerable savings in time over current methods used for distinguishing between human hookworm infections.
... Although the prevalence of the infection is high and widely spread in most developing countries, there is relatively less attention paid to the public health problems caused by the infection due to competing demands of the resources and low burden in developed countries. In China, a large scale survey on human parasites was conducted in 1992 (Yu et al, 1994). There have been many reports published after the survey (Xu et al, 1995;Lai and Hsi, 1996). ...
The prevalence of ascariasis is very high in parts of rural areas in southern China. The high prevalence of ascariasis is one of the most neglected public health problems. A longitudinal investigation on the prevalence of ascariasis in a rural community in China was reported previously. In this article, we re-analyze the reported age specific prevalence of ascariasis using a life table method. The results from our analysis may provide a better summary of the impact of the disease on the studied population.
... A nationwide survey of human parasites was conducted between 1998 and 1992 covering 30 provinces in China and involving 1.48 million people. The average prevalence rate for taeniosis was 0.112% but it ranged from 0.66 to 6.0% in different provinces (Yu et al., 1994). In an earlier survey, examination of the stool from 34 million individuals in Henan province, conducted between 1975 and 1987 yielded a taeniosis rate of 0.55%. ...
Several reports of patients with cysticercosis from many countries in Asia such as India, China, Indonesia, Thailand, Korea, Taiwan and Nepal are a clear indicator of the wide prevalence of Taenia solium cysticercosis and taeniosis in these and other Asian countries. However, epidemiological data from community based studies are sparse and available only for a few countries in Asia. Cysticercosis is the cause of epilepsy in up to 50% of Indian patients presenting with partial seizures. It is also a major cause of epilepsy in Bali (Indonesia), Vietnam and possibly China and Nepal. Seroprevalence studies indicate high rates of exposure to the parasite in several countries (Vietnam, China, Korea and Bali (Indonesia)) with rates ranging from 0.02 to 12.6%. Rates of taeniosis, as determined by stool examination for ova, have also been reported to range between 0.1 and 6% in the community in India, Vietnam, China, and Bali (Indonesia). An astonishingly high rate of taeniosis of 50% was reported from an area in Nepal populated by pig rearing farmers. In addition to poor sanitation, unhealthy pig rearing practices, low hygienic standards, unusual customs such as consumption of raw pork is an additional factor contributing to the spread of the disease in some communities of Asia. Undoubtedly, cysticercosis is a major public health problem in several Asian countries effecting several million people by not only causing neurological morbidity but also imposing economic hardship on impoverished populations. However, there are wide variations in the prevalence rates in different regions and different socio-economic groups in the same country. It is important to press for the recognition of cysticercosis as one of the major public health problems in Asia that needs to be tackled vigorously by the governments and public health authorities of the region.
... In A. lumbricoides infections in the present survey, the proportion of moderate and heavy infection cases was relatively high compared with that found in a previous large-scale survey conducted in China (Yu et al. 1994;Xu et al. 1995), where the A. lumbricoides infection rate was lower. The worm burden of the cases is positively related with the infection rate (MHW and KAH 1997). ...
In order to investigate the epidemiological situation of intestinal parasite infections in Laos, parasitological surveys were carried out on a national scale including 17 provinces and the Vientiane Municipality. A total of 29,846 stool specimens were collected from primary schoolchildren from May 2000 to June 2002 and examined once with the cellophane thick smear technique. The cumulative egg positive rate for intestinal helminths was 61.9%. By species, the rate for Ascaris lumbricoides was 34.9%, hookworm 19.1%, Trichuris trichiura 25.8%, Opisthorchis viverrini 10.9%, Taenia spp. 0.6% and Hymenolepis spp. 0.2%. The northern mountainous regions such as Phongsaly, Huaphan or Saysomboune Province showed a higher prevalence (over 70%) of soil- transmitted helminths. The regions along the Mekong River such as Khammuane, Saravane or Savannakhet Province showed a higher prevalence (over 20%) of fish-borne parasites. On the other hand, Schistosoma mansoni eggs were detected in 1.7% of schoolchildren only in Champassak Province, a previously endemic area. The highest prevalence was noted in Phongsaly Province (96.0%) and the lowest in Bolikhamxay Province (27.5%). An additional small-scale survey by cellophane anal swab detected Enterobius vermicularis eggs in 35.7% of 451 schoolchildren aged 6-8 years in Khammuane, Vientiane, Champassak Province and the Vientiane Municipality. Meanwhile, the mean blood haemoglobin level of hookworm-infected children was not lower than that of children not infected with hookworm, suggesting that nutritional factors are more important than parasite infection per se. Nevertheless, the above results indicate that a nationwide parasite control project is necessary to reduce possible morbidity due to parasitic diseases in the country.
... Human hookworm infection is endemic in the People's Republic of China [1, 2]. According to the Chinese nationwide parasite survey, in which examinations of fecal specimens were conducted for 1,477,742 persons in all provinces during 1988-1992, 194 million cases of hookworm infection were estimated to have occurred [1,3]. This nationwide survey found that the South ...
We examined risk factors associated with Necator americanus infection among persons aged ⩾50 years in Hainan Province, People's Republic of China. Age and sex made the most important
contributions to the variation in infection intensity (28%–30%), with age alone responsible for 27% of this variation. When
stratified by 20-year age intervals, the influence of shared residence was 23% for persons aged ⩾50 years and 27% for those
aged <20 years, who had the highest and lowest levels of infection intensity, respectively. This points to shared residence
as a means of capturing the complex relationship between aging and shared socioeconomic, environmental, and behavioral factors
that influence transmission of Necator infection. None of the other 26 personal or 32 household risk factors were found to be significant. The importance of aging
in Necator infection reveals an emerging public health problem among the elderly population of developing countries.
Background:
Clonorchis sinensis, one of the most important food-borne zoonotic trematodes, remains prevalent in China. Understanding its infection status in animals is crucial for controlling human clonorchiasis. Here we conducted a systematic review and meta-analysis to focus on the spatio-temporal disparities of C. sinensis infection in animals in China.
Methods:
Data on C. sinensis prevalence in snails, the second intermediate hosts, or animal reservoirs in China were extracted from electronic databases including PubMed, Embase, Web of Science, Chinese Wanfang database, CNKI, VIP, and China Biomedical Literature database. A random-effects meta-analysis model was utilized to estimate the pooled prevalence in each of the above animal hosts. Subgroup analysis and multivariable meta-regression were performed to explore potential sources of heterogeneity across studies and compare the temporal disparity of infection rates between high and low epidemic areas. Scatter plots were used to depict the biogeographical characteristics of regions reporting C. sinensis infection in animals.
Results:
The overall pooled prevalence of C. sinensis was 0.9% (95% CI: 0.6-1.2%) in snails, 14.2% (12.7-15.7%) in the second intermediate host, and 14.3% (11.4-17.6%) in animal reservoirs. Prevalence in low epidemic areas (with human prevalence < 1%) decreased from 0.6% (0.2-1.2%) before 1990 to 0.0% (0.0-3.6%) after 2010 in snails (P = 0.0499), from 20.3% (15.6-25.3%) to 8.8% (5.6-12.6%) in the second intermediate hosts (P = 0.0002), and from 18.3% (12.7-24.7%) to 4.7% (1.0-10.4%) in animal reservoirs. However, no similar decrease in prevalence was observed in high epidemic areas (with human prevalence ≥ 1.0%). C. sinensis infections were predominantly reported in areas with altitudes below 2346 m and annual cumulative precipitation above 345 mm and were mostly concentrated in eastern China.
Conclusions:
There are spatio-temporal disparities in the animal infections of C. sinensis in different areas of China. Animal infections are primarily concentrated in regions with low altitude and high precipitation. The results suggest that implementing One Health-based comprehensive measures targeting both humans and animals, especially in high epidemic areas, is essential for successful eradication of C. sinensis in China.
In China, the prevalence of Clonorchis sinensis (C. sinensis) infections is only evaluated at the provincial level by national sampling surveys, and data from villages and counties are still lacking. In this study, we conducted a cross-sectional survey in 10 villages located along the Lalin River in northeast China. Clonorchiasis was diagnosed using a modified Kato–Katz method that detects the C. sinensis egg in stools. A total of 3,068 persons were screened and 2,911 were recruited for the study. Overall, the prevalence of C. sinensis infection was 29.3%. Among 175 participants who were cured after antiparasitic treatment, 54 (30.86%) were re-infected in this survey. After calibration of potential confounders, male gender, occupation as a farmer, smoking, and occasionally or frequently eating raw fish were independent risk factors for C. sinensis infection. The results of laboratory examinations in the C. sinensis/hepatitis B or C virus co-infection group were similar to those in the hepatitis B or C virus mono-infection groups. In conclusion, C. sinensis is highly endemic in villages along the Lalin River, and the primary route of infection is the consumption of raw freshwater fish. Co-infection with C. sinensis did't aggravate the clinical manifestations of viral hepatitis in this cross-sectional study.
Cysticercosis is a common and prevalent parasitic zoonosis in China. In order to understand more about the disease epidemiology, this review emphasizes disease transmission and disease burden of human infection with T. solium in China, using a meta-analysis methodology with publications from the 1930s to the 2000s. The results showed that human cases of taeniasis and cysticercosis were found in all 31 provinces, municipalities and autonomous regions in mainland China, with five special epidemic zones. Higher prevalence presented in remote areas than urban areas, with the majority of cases found in minority clusters. The average incidence of taeniasis solium in China was 0.112%, ranging from 0.046-15%. The estimated number of taeniasis patients was 1.26 million. The estimated number of cysticercosis cases was about 3-6 million, and the incidence rate varied from 0.14-3.2% in the endemic areas. The majority of cases occurred in the 20-50 year age group, accounting for 73.06% of total cases. The ratio of male to female cases was 2.4:1. There are still many cases of auto-infection due to unhealthy habits. The serious cases are those with cerebral involvement, often suffering from epilepsy and meningoencephalitis. It was estimated that about 0.2 billion kg of pork discarded due to infection caused a loss of one billion RMB per year in China. A close relationship between incidence of cysticercosis and economic level and education level has been shown. It is imperative to formulate cost-effective strategies to control cysticercosis in China, based on the most recent data derived from the 2nd Nationwide Survey on Important Parasitic Diseases.
This review collects and summarizes the published literature on chemical and biological public health safety hazards associated with aquacultured products and the degree of risk they pose compared with equivalent products captured in the wild.
Food-borne trematodiases are a group of neglected tropical diseases caused by liver, lung, and intestinal parasitic fluke infections. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2010 study) and a WHO initiative, we assessed the global burden of human food-borne trematodiasis, as expressed in disability-adjusted life years (DALYs) for the year 2005.
We systematically searched electronic databases for reports about human food-borne trematodiasis without language restriction, between Jan 1, 1980, and Dec 31, 2008. We used a broad search strategy with a combination of search terms and parasite and disease names. The initial search results were then screened on the basis of title, abstract, and, finally, full text. Relevant quantitative and qualitative data on human prevalence, morbidity, and mortality of food-borne trematodiasis were extracted. On the basis of available information on pathological and clinical appearance, we developed simplified disease models and did meta-analyses on the proportions and odds ratios of specified sequelae and estimated the global burden of human food-borne trematodiasis.
We screened 33,921 articles and identified 181 eligible studies containing quantitative information for inclusion in the meta-analyses. About 56·2 million people were infected with food-borne trematodes in 2005: 7·9 million had severe sequelae and 7158 died, most from cholangiocarcinoma and cerebral infection. Taken together, we estimate that the global burden of food-borne trematodiasis was 665,352 DALYs (lower estimate 479,496 DALYs; upper estimate 859,051 DALYs). Furthermore, knowledge gaps in crucial epidemiological disease parameters and methodological features for estimating the global burden of parasitic diseases that are characterised by highly focal spatial occurrence and scarce and patchy information were highlighted.
Despite making conservative estimates, we found that food-borne trematodiases are an important cluster of neglected diseases.
Swiss National Science Foundation; Institute for Health Metrics and Evaluation.
The aim of the study is to demonstrate and understand the acquired immunity in golden hamsters (Mesocricetus auratus) elicited by primary Necator americanus infective third-stage larvae (L3) infection. Hamsters infected with 150 L3 for 1, 2, 3, 6 and 10 weeks, were challenged with the same number of L3 and sacrificed 25 days post challenge. The primarily infected hamsters exhibited 99-100% protection against subsequent L3 challenge compared to un-infected naive hamsters. The acquired immunity was developed as early as 1 week post L3 infection and lasted up to 10 weeks. Similar protective immunity was obtained in hamsters infected with N. americanus L3 and then treated orally with a single of 100mg/kg albendazole, followed by challenge with N. americanus L3 4 and 8 weeks post-treatment. The infected hamsters exhibited a rise in IgG antibodies against L3 and juvenile adult worm antigens. Histological examination showed that challenging L3 were trapped in the skin of primarily infected hamsters and surrounded or infiltrated by different inflammatory cells. The trapped L3 were damaged and dead followed by the formation of granulomas encasing dead worms. The results demonstrate that hamsters primarily infected with N. americanus L3 develop acquired immunity against re-infection.
The aim of the study is to understand the anti-Clonorchis sinensis properties of mebendazole and albendazole, and compare to praziquantel and tribendimidine. Two hundred and thirty rats were divided into five batches for experimental treatment. In four batches, each rat was infected orally with 50 or 100 C. sinensis metacercariae. Twenty-eight to 46 days post-infection, groups of rats were treated orally with single doses of mebendazole, albendazole, praziquantel, tribendimidine, or multiple daily doses of albendazole. While in the remaining batch, mebendazole or praziquantel was administered to groups of rats infected each with 50 metacercariae for 7 or 14 days. In each batch of test, untreated but infected rats served as control. All rats were euthanized 2-4 weeks post-drug administration for assessment of efficacy. In the first batch of test, rats treated with mebendazole or tribendimidine at single doses of 150, 75, and 37.5 mg/kg resulted in worm burden reductions of 99.0%, 94.0%, and 73.1%, or 98.0%, 80.6%, and 60.4%, respectively. When rats were treated with albendazole at the same dose levels, no or poor effect was seen. In the second batch of test, promising effect against adult C. sinensis in rats treated with mebendazole or tribendimidine at single doses of 100 and 50 mg/kg were also observed, but under the single dose of 25 mg/kg, only tribendimidine still remained the effect. In the third batch of test, the aforementioned three single dose levels of mebendazole, albendazole and praziquantel were applied. Again, mebendazole exhibited higher effect and albendazole exhibited no or poor effect. While praziquantel, administered at a higher dose of 300 mg/kg, also showed promising effect. In the fourth batch of test, oral administration of albendazole at a daily dose of 150 or 100 mg/kg for 2 or 3 days resulted in moderate or higher efficacy with worm burden reductions of 79.2% and 91.9%, respectively. In the fifth batch of test, single mebendazole doses of 150 or 75 mg/kg exhibited promising effect against 14-day-old C. sinensis in rats with worm burden reductions of 95.3% and 86.4%, respectively, but mebendazole was short of the effect against 7-day-old worms. Under the same dose level, praziquantel possessed an effect against both 7- and 14-day-old juvenile C. sinensis. The results confirm that in infected rats, mebendazole administered orally at a single dose of 150 mg/kg exhibits potential effect against juvenile (14-day-old) and adult C. sinensis. No or less effect is obtained from albendazole under the same dose levels, but extension of treatment course may enhance the effect of albendazole against this species of fluke. The single effective dose ranges of mebendazole and tribendimidine against C. sinensis in rats are similar with a broad window, while the window for praziquantel is narrow.
Tribendimidine is an anthelminthic drug with a broad spectrum of activity. In 2004 the drug was approved by Chinese authorities for human use. The efficacy of tribendimidine against soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) has been established, and new laboratory investigations point to activity against cestodes and Strongyloides ratti.
In an open-label randomized trial, the safety and efficacy of a single oral dose of albendazole or tribendimidine (both drugs administered at 200 mg for 5- to 14-year-old children, and 400 mg for individuals > or = 15 years) against soil-transmitted helminths, Strongyloides stercoralis, and Taenia spp. were assessed in a village in Yunnan province, People's Republic of China. The analysis was on a per-protocol basis and the trial is registered with controlled-trials.com (number ISRCTN01779485). Both albendazole and tribendimidine were highly efficacious against A. lumbricoides and, moderately, against hookworm. The efficacy against T. trichiura was low. Among 57 individuals who received tribendimidine, the prevalence of S. stercoralis was reduced from 19.3% to 8.8% (observed cure rate 54.5%, p = 0.107), and that of Taenia spp. from 26.3% to 8.8% (observed cure rate 66.7%, p = 0.014). Similar prevalence reductions were noted among the 66 albendazole recipients. Taking into account "new" infections discovered at treatment evaluation, which were most likely missed pre-treatment due to the lack of sensitivity of available diagnostic approaches, the difference between the drug-specific net Taenia spp. cure rates was highly significant in favor of tribendimidine (p = 0.001). No significant adverse events of either drug were observed.
Our results suggest that single-dose oral tribendimidine can be employed in settings with extensive intestinal polyparasitism, and its efficacy against A. lumbricoides and hookworm was confirmed. The promising results obtained with tribendimidine against S. stercoralis and Taenia spp. warrant further investigations. In a next step, multiple-dose schedules should be evaluated.
A total of 2848 study sites, with about 500 people in each, were randomly sampled for this investigation which covered a total population of 1 477 742. By stool examinations using the Kato-Katz thick-smear and larval-culture techniques, overall prevalences of 47.0%, 18.8%, and 17.2% were obtained for Ascaris lumbricoides, Trichuris trichiura, and hookworm infections, respectively. The number of infections due to Ascaris, Trichuris, and hookworm was estimated as 531 million, 212 million, and 194 million, respectively. Egg counts showed that 75-95% of the subjects had light infections. Higher prevalences of ascariasis and trichuriasis were found in the age group of 5-9, 10-14 and 15-19 years, and among adults for hookworm. Students, farmers (including vegetable growers) and fishermen were the occupational groups with high infection rates. The prevalence of helminthiases was found to be closely associated with climatic and geographical factors. In view of the morbidity and mortality due to these helminthiases, their control, particularly in schoolchildren, is very important.
The review concentrates on literature that has appeared since the 1960s. Since then, numerous species of Paragonimus have been described, mainly from Asia but also from Africa and the Americas. Some of these cause disease in humans. Recent information on life cycles and routes of transmission is summarized. All described species and their hosts are listed, with synonyms where known. For well-known species such as Paragonimus westermani, subspecific taxa and strains are reviewed and genetic studies discussed. Paragonimiasis in humans and experimental animals is discussed with emphasis on clinical manifestations and pathology, diagnosis, immune interactions with the host, treatment and public health issues.
There is growing international interest in the possible relationships between helminthic infection and allergic disease, although the nature of the relationships remains uncertain and controversial. The interrelationships of current and past infection with Ascaris lumbricoides and asthma and atopy were investigated in a cross-sectional sample of 2,164 children between the ages of 8 and 18 years from Anqing Province, China. The children were sampled from a larger family-based study of the genetics of asthma. The prevalence of either a history of or a positive stool examination for Ascaris was 24.5%. Asthma was defined for analytic purposes using previously validated, stringent criteria including airways responsiveness to methacholine. Independently of the other factors assessed, infection with A. lumbricoides was associated with increased risk of asthma (p < 0.001), an increased number of skin tests positive to aeroallergens (p < 0.001), and an increased dose-response slope to methacholine (p = 0.003). The association of sensitization to common aeroallergens with increased asthma risk was enhanced in those children infected with Ascaris, and such infection was associated with an increased risk of asthma independent of sensitization to aeroallergens in this selected population. These data suggest a complex relationship between ascariasis and susceptibility to childhood asthma among predisposed children that may involve an interaction with the immune response to inhaled aeroallergens.
Parasitic infections are widespread in rural areas of West China. The remote and humid environment, traditional ways of life, contaminated potable water and limited health services all contribute to the transmission and persistence of fecal parasites.
To describe the prevalence of intestinal parasitic infections in an area of West China, including its associations with demographic variables.
Single fecal specimens were collected using a previously validated kit. Parasites were detected microscopically by iodine-stained smear, modified Kato-Katz thick smear, simple saline smear, test tube filter paper culture and adhesive cellophane tape anal swab.
The prevalence of enteric parasites in the population was 51.7%. The proportion of individuals infected with one parasite was 36.5%, two parasites 12.7%, three parasites 3.0% and four parasites 0.08%. Parasites identified included Ascaris lumbricoides in 41.4% of all individuals tested, Ancylostoma duodenale in 17.7%, Trichurias trichuria in 8.25%, Enterobius vermicularis in 0.43%, Blastocystis hominis in 1.37%, Entamoeba coli in 0.47%, Entamoeba histolytica in 0.16%, Giardia lamblia in 0.04%, Strongyloides stercoralis in 0.04% and Clonorchis sinensis in 0.04%. The prevalence was significantly increased in women, people aged 15 to 19 years and over 80 years, the rural farm population, farmers, preschool and primary school groups, residents of a hilly rather than mountainous or plains terrain, and in intermediate income groups. The prevalence was significantly negatively associated with educational level, but not with age or income.
This study supports the use of simple fecal examinations to monitor the parasite burden in rural areas of developing countries. Enteric parasites remain common in this population in rural China.
We comparatively assessed the in vivo efficacy of artemether, artesunate, praziquantel and tribendimidine against different stages of Clonorchis sinensis. Rats were infected with 40-50 C. sinensis metacercariae, and drugs were administered singly by the oral route at different dosages. Rats were dissected 2-4 weeks post-treatment and C. sinensis trematodes were removed from the liver and bile ducts and counted. We used a negative binomial regression model to test the effect of drug and dosage in terms of worm burden reduction. Single 150 mg/kg oral doses of artesunate, artemether, tribendimidine and praziquantel, administered to rats infected with adult C. sinensis, resulted in mean worm burden reductions of 100, 100, 89.5 and 80.7%, respectively (all P<0.001). Halving the dose to 75 mg/kg still resulted in highly significant worm burden reductions for artesunate, artemether and tribendimidine (71.4-100%), but not for praziquantel (20.7%). In the juvenile infection model, a single 150 mg/kg oral dose of tribendimidine and praziquantel resulted in mean worm burden reductions of 99.1 and 90.0%, respectively, whereas considerably lower reductions were observed for artemether (59.2%) and artesunate (57.6%) when used at the same single dose. The in vivo results presented here with the artemisinins and tribendimidine provide further data for clinical investigations to assess the safety and efficacy of these drugs in clonorchiasis patients.
Intestinal multiparasitism, the accuracy of different diagnostic techniques, and the influence of sampling effort were studied among 215 individuals in a Bulang village, Yunnan province, People's Republic of China. Behavioral, demographic, and socioeconomic data were obtained by questionnaire. Multiple stool specimens were examined by the Kato-Katz, Koga agar plate, Baermann, and ether-concentration methods. Eight helminth and 7 protozoa species were diagnosed. The prevalence of each of the 3 main soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) exceeded 85%. Blastocystis hominis was the most prevalent intestinal protozoan (20.0%). Over 80% of the individuals harbored 3 or more intestinal parasites concurrently. The infection intensities were predominantly light for hookworm and T. trichiura but moderate for A. lumbricoides. Examination of 3 instead of 1 stool specimen increased the sensitivity of helminth diagnosis, most notably for hookworm. Intestinal multiparasitism is rampant in this rural part of Yunnan province and calls for control measures.
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