Search Results (121)

Background and Objectives: Accurate diagnosis of intestinal parasitic infections remains essential for patient management, surveillance, and control programs. The Mini Parasep^® and Mini Parasep^® Solvent-Free (SF) fecal parasite concentrators were developed to improve laboratory safety and simplify stool processing; however, their diagnostic performance has not been comprehensively synthesized. This systematic review and meta-analysis evaluated the diagnostic sensitivity of Mini Parasep^® for detecting intestinal parasites in human stool specimens. Materials and Methods: A systematic literature search was conducted in Ovid, Embase, Scopus, PubMed, Nursing & Allied Health Premium, and Google Scholar from database inception to the final search date. Studies evaluating Mini Parasep^® or Mini Parasep^® SF in human stool samples and reporting sufficient data to calculate diagnostic sensitivity were eligible. A composite reference standard, defined as positivity by any diagnostic method used within each study, was accepted as the reference standard. Pooled sensitivity estimates and 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analyses were performed according to parasite species, study design, geographic region, country, and participant characteristics. Results: Eleven studies met the inclusion criteria. Overall, Mini Parasep^® demonstrated good sensitivity for detecting any intestinal parasitic infection, with a pooled sensitivity of 82.4% (95% CI: 61.0–93.4%, I² = 95.3%, 6 studies). Among pathogenic protozoa, pooled sensitivities were 78.9% (95% CI: 39.3–95.6%, I² = 43.7%, 4 studies) for Entamoeba histolytica, 76.3% (95% CI: 34.8–95.1%, I² = 71.1%, 4 studies) for Giardia duodenalis, and 74.4% (95% CI: 60.4–84.7%, I² = 0%, 2 studies) for Blastocystis spp. Among soil-transmitted helminths, sensitivity was highest for Ascaris lumbricoides (92.8%; 95% CI: 88.4–95.7%, I² = 0%, 2 studies), followed by Strongyloides stercoralis (73.7%; 95% CI: 50.2–88.6%, I² = 0%; 3 studies), hookworm (53.6%; 95% CI: 33.3–72.8%, I² = 23.1%, 5 studies), and Trichuris trichiura (39.4%; 95% CI: 8.6–81.8%, I² = 74.8%; 3 studies). High sensitivities were observed for Taenia spp. (89.0%; 95% CI: 74.0–95.8%, I² = 0%; 3 studies) and Schistosoma mansoni (92.8%; 95% CI: 86.9–96.1%, I² = 0%, 2 studies), whereas sensitivity for Opisthorchis viverrini was moderate (56.8%; 95% CI: 35.1–76.1%, I² = 88.8%, 7 studies). High heterogeneity was observed for several parasite-specific analyses. Conclusions: Mini Parasep^® demonstrates good overall diagnostic sensitivity and performs particularly well for A. lumbricoides, S. mansoni, and Taenia spp. However, diagnostic performance varies substantially across parasite species, with lower sensitivity observed for hookworm, T. trichiura, and O. viverrini. Mini Parasep^® represents a practical alternative to conventional concentration techniques for routine stool examination, although complementary diagnostic approaches may be required when detecting low-intensity infections or parasites with lower recovery rates. Full article

Human intestinal nematode infections (HINIs) remain a public health concern despite reduced prevalence following mass drug administration (MDA) in low- and middle-income countries. Children continue to bear a substantial burden of infection, and caregiver knowledge and practices may influence their risk of acquiring infection. Sustaining control during the transition of prevention programmes to surveillance-based strategies requires an understanding of behavioural determinants of transmission. Therefore, we assessed caregiver knowledge, attitudes, and practices (KAP) and their associations with sociodemographic characteristics and child infection status. A community-based cross-sectional study was conducted among 945 caregivers of primary school children in Anuradhapura, a low-prevalence setting where school-based MDA ceased in 2019, to assess caregiver KAP and child HINI status. An interviewer-administered questionnaire assessed KAP, sociodemographic, water, sanitation, hygiene (WASH), and behavioural factors. Participants were predominantly mothers (89.5%). Good knowledge was observed in 61.7%, positive attitudes in 95.6% and good practices in 99.2%. Knowledge gaps persisted regarding transmission and complications. Higher caregiver knowledge (OR = 0.52; 95% CI: 0.36–0.72) and regular deworming (OR = 0.58, 95% CI: 0.40–0.83) were associated with lower odds of infection, whereas attitudes and practices were not independently associated. Caregiver knowledge remains a key determinant of infection risk. Gaps in knowledge, misconceptions, and practices may sustain transmission even in low-prevalence settings. Strengthening health education, school-based hygiene promotion, and community engagement remains essential to reinforce preventive behaviours and support long-term control as countries transition from routine MDA to elimination-oriented strategies. Full article

Reuse of human excreta and derivatives is becoming a common practice in areas with agricultural predominance. While in situ treated faeces through ecological sanitation (Ecosan), known as “faecal by-products” are being used to sustain soil nutrients and improve on-site sanitation, the concern remains about the health risks related to the survival of pathogens in these by-products in the community of farmers. This study assessed the survival of faecal pathogens and estimated microbial risks associated with the use of Ecosan faecal by-products in agriculture. The quantitative microbial risks assessment (QMRA) framework was used to estimate the risks posed by each faecal pathogen in solid and semi-solid faecal by-products under the probabilistic model of Monte Carlo simulation. Ascaris lumbricoides (6.5 eggs/gr), Taenia species (0.3 egg/gr), Schistosoma species (9.3 cercariae/gr), Entamoeba species (4.4 cysts/gr), and Escherichia coli (451 Cfu/gr) were detected in semi-solid faecal products. Exposure scenarios were observed throughout four critical points: vault faecal by-products removal/unloading, transport, collection, and application of faecal by-products in the gardens. Due to the presence of eggs and cysts, an estimated annual risk of infections was found in semi-solid faecal by-products with Schistosoma species (88%) and Ascaris lumbricoides (90%). Both concentrations were above World Health organisation (WHO) standards of associated infective risks of 0–10% of helminths in faecal sludge applied in the gardens. The users of faecal by-products, particularly farmers are exposed not only to high concentrations of helminth eggs but also to protozoa and bacteria with infective risks of Entamoeba species (99%) and E. coli species (62%). A stepwise implementation of faecal pathogens die-off during treatment of faecal by-products in compliance with the WHO’s 2018 guidelines can prevent the use of unsanitary faecal by-products. According to these findings, the proper control of intestinal protozoa and soil-transmitted helminths (STHs) should be enforced through personal protective measures in Burera district, Rwanda. Full article

Long-tailed macaques (Macaca fascicularis) commonly inhabit human-modified environments across Asia, where close human–macaque interactions have increased interest in understanding soil-transmitted helminth (STH) infections at human–wildlife interfaces. Because gastrointestinal helminth infections can affect animal health, understanding STH prevalence may support wildlife health surveillance. This systematic review and meta-analysis aimed to estimate the prevalence of major STHs in long-tailed macaques across diverse habitat settings in Asia. EMBASE, PubMed, and Scopus were systematically searched for studies published between 2000 and January 2026, with additional records identified through Google Scholar. Random-effects models with Freeman–Tukey double-arcsine transformation were used to calculate pooled prevalence estimates, and subgroup analyses were performed by habitat type, country, and diagnostic method. Thirty-five studies comprising 5505 macaques from seven countries, predominantly in Southeast Asia, were included. Studies involved urban/temple-associated free-ranging, wild/semi-wild, and captive populations. Among free-ranging macaques, pooled prevalence estimates were 19.3% for Strongyloides spp., 12.9% for hookworms, 9.1% for Trichuris spp., and 3.3% for Ascaris spp. In captive macaque populations, pooled prevalence estimates were 3.6% for Strongyloides spp., 2.2% for hookworm, 1.4% for Ascaris spp., and 8.2% for Trichuris spp. Subgroup analyses by habitat type suggested relatively higher prevalence estimates in urban/temple-associated settings than in wild/semi-wild habitats for several STH taxa. However, substantial between-study heterogeneity (I² > 90% in most analyses), publication bias, and possible small-study effects were identified in some analyses, particularly for hookworm prevalence estimates. These findings indicate that STH infections have been documented among long-tailed macaque populations across diverse habitat settings in Asia. Nevertheless, pooled prevalence estimates should be interpreted cautiously because of substantial heterogeneity, diagnostic variability, and possible publication bias. Future standardized surveillance and molecular investigations may support improved understanding of the prevalence and distribution of STH infections at human–wildlife interfaces. Full article

Colorectal cancer (CRC) is an increasing health concern in low- and middle-income countries (LMICs), especially in Africa, driven by dietary shifts, urbanisation, infections, and limited treatment access. The gut microbiome plays a central role in CRC, while soil-transmitted helminths (STHs) exert complex effects that can promote or mitigate risk depending on species, infection intensity, and host context. This systematic review synthesised 17 human studies (2000–2026) examining helminth impacts on gut microbial diversity, revealing a dualistic pattern. Several studies reported that chronic or moderate helminth infections, such as Ascaris lumbricoides and Trichuris trichiura, were associated with increased bacterial richness and the expansion of beneficial taxa, including Paraprevotellaceae, Parabacteroides, Agathobacter, Ruminococcaceae, and Lactobacillus. These taxa are associated with the production of short-chain fatty acids (SCFAs), protection of the epithelial barrier, and regulation of the immune system, suggesting a potential buffering effect against inflammation-driven carcinogenesis. On the contrary, other studies demonstrated helminth-associated dysbiosis characterised by reduced diversity and enrichment of pro-inflammatory and oncogenic taxa. T. trichiura and Strongyloides stercoralis infections were associated with the expansion of Treponema succinifaciens, Streptococcus gallolyticus, Enterobacteriaceae, and Ruminococcus torques, which are linked to reduced gut microbiome diversity, pro-inflammatory states, and oncogenic processes. Furthermore, A. lumbricoides infections altered the host microbiome at the phylum level, with increased Proteobacteria and reduced Firmicutes and Bacteroidetes, alongside metabolome shifts in amino acid and lipid pathways that have been associated with tumourigenic processes. Collectively, the evidence shows that helminthiasis may either enrich potentially protective microbes or be associated with pro-tumourigenic dysbiosis, with outcomes shaped by species, infection intensity, and host context. Notably, none of the included studies directly assessed CRC, underscoring the fact that current evidence is indirect and mechanistic. Overall, helminths are associated with gut microbiome shifts in both potentially protective and potentially harmful directions. This systematic synthesis of human evidence provides an integrated understanding of how helminth-associated microbiome shifts may influence colorectal carcinogenesis and highlights the need for longitudinal mechanistic studies to clarify causality and inform biomarker discovery and prevention in endemic regions. Full article

Prevalence of soil-transmitted helminth (STH) infections in Sri Lanka has declined from 73.3% in 1954 to <1% in 2017, leading to revised deworming policies and discontinuation of routine deworming in three districts, including Anuradhapura, in 2019. As countries approach elimination, this study assessed human intestinal nematode infection (HINI) prevalence in Anuradhapura, a low-endemic setting, using microscopic and molecular methods. From January to November 2023, 967 primary school children were recruited and screened for HINI using direct smears, Kato–Katz, formalin ether concentration, agar plate culture, scotch tape, and qPCR. Combined microscopy and molecular prevalence was 41.2% for STH and 54.1% for HINI. The most prevalent HINI was Enterobius vermicularis (191, 24.5%), followed by Strongyloides stercoralis (120, 19.2%), Ascaris lumbricoides (113, 18.1%), Trichuris trichiura (40, 6.4%), and hookworm (43, 6.9%). Against the composite reference standard, qPCR demonstrated superior diagnostic performance across all species, achieving sensitivities of 86.7% for Ascaris, 85.0% for Trichuris, and 97.7% for hookworm, consistently exceeding those of microscopy-based methods. Correspondingly, qPCR also identified the highest infection prevalences, detecting Ascaris, Trichuris, and hookworm infections in 15.7%, 5.4%, and 6.7% of participants, respectively. All infections were low-intensity as determined by Kato–Katz. Microscopy significantly underestimates STH prevalence. In post-deworming settings, integrated surveillance including molecular diagnostics is essential. The high prevalence of S. stercoralis and E. vermicularis highlights the need for expanded surveillance and targeted interventions to support sustainable control. Full article

Strongyloides stercoralis (S. stercoralis) is an important soil-transmitted helminth that infests over 600 million people worldwide. However, data on its seroprevalence in remote regions, such as Thailand’s island areas, remain limited. This study examined the seroprevalence and associated risk factors of anti-Strongyloides spp. IgG seropositivity among primary school children in Koh Yao, an island in southern Thailand. A total of 351 primary school children (156 males and 195 females) were included. The seroprevalence of anti-Strongyloides spp. IgG was determined using the Strongyloides-specific IgG antibodies ELISA, and risk factor data were collected through a questionnaire. Hematological parameters were also analyzed. Univariate and multivariate logistic regression analyses were used to assess associations between risk factors and anti-Strongyloides spp. IgG seropositivity. The seroprevalence of anti-Strongyloides spp. IgG was 3.7% (13/351 participants). Analysis of the risk factors revealed that participants who drank filtered water exhibited lower odds of anti-Strongyloides spp. IgG seropositivity compared to those who drank tap or rainwater (AOR = 0.21, 95% CI 0.05–0.95, p = 0.043). However, due to the small number of seropositive cases, this association is hypothesis-generating and likely serves as a proxy for better household hygiene rather than a direct protective factor. This study is the first report on anti-Strongyloides spp. IgG seropositivity among primary school children in Koh Yao, southern Thailand, demonstrating a low seropositivity rate in this population. These findings provide location-specific information on modifiable risk behaviors, aiding in developing more effective control and prevention strategies for anti-Strongyloides spp. IgG seropositivity in Thailand’s island area. Full article

Background: Strongyloides stercoralis is a soil-transmitted helminth capable of establishing chronic infection through an autoinfective cycle, with the potential to progress to life-threatening hyperinfection, particularly in immunocompromised individuals. Case Presentation: We report the case of a 70-year-old man from an endemic region in Colombia with metastatic urothelial carcinoma who developed hyperinfection syndrome following corticosteroid therapy for spinal cord compression. The patient presented with progressive respiratory failure and diffuse alveolar hemorrhage. Chest imaging showed bilateral ground glass opacities, and bronchoalveolar lavage revealed numerous larvae consistent with S. stercoralis, confirming the diagnosis. Despite supportive care and broad-spectrum antimicrobial therapy, the patient experienced rapid clinical deterioration and died. Conclusions: This case highlights the importance of considering strongyloidiasis in the differential diagnosis of diffuse alveolar hemorrhage in endemic settings, particularly in patients receiving corticosteroids. Early recognition and timely treatment are essential to reduce the high associated mortality. Preventive strategies, including targeted screening or empiric ivermectin administration prior to immunosuppression, should be considered in high-risk populations. Full article

Background: Soil-transmitted helminth (STH) infections are a recognized public health challenge, particularly in rural and island settings. Despite the implementation of national control programs, epidemiological data from geographically isolated communities remain limited. In this study, we aimed to determine the prevalence of STH infections and identify associated risk factors among adults in Koh Yao Islands, southern Thailand. Methods: A community-based cross-sectional survey was conducted in three subdistricts of Koh Yao, Phang Nga Province, from January to September 2024. Demographic data and information on potential risk factors were collected using structured questionnaires. Stool specimens were analyzed using the formalin–ethyl acetate concentration technique and the modified Kato–Katz method. Associations were assessed using univariate and multivariate logistic regression analyses. Results: A total of 241 adults participated in the study, with females accounting for 68.9% and males for 31.1%. The overall prevalence of STH infections was 2.49%, with hookworms and Trichuris trichiura identified as the predominant species. All infected individuals had an educational level lower than a bachelor’s degree. Univariate analysis showed that participants who did not use hygienic toilets at home had a significantly higher likelihood of developing STH than those who did (crude odds ratio = 46.80; 95% confidence interval [CI]: 2.55–859.00; p = 0.010). Multivariable logistic regression analysis confirmed that the absence of hygienic toilet use at home was independently associated with STH infection (adjusted odds ratio = 30.69; 95% CI: 1.17–804.65; p = 0.040). Conclusions: This study documents low overall prevalence of STH infections in the study area, with hookworms and T. trichiura as the predominant organisms. These findings support continued targeted public health measures, including periodic deworming and health education initiatives, to strengthen hygiene practices, particularly in high-risk populations. Future investigations should incorporate environmental assessments and longitudinal monitoring to evaluate the durability of current control strategies. Full article

Soil-transmitted helminthiases (STH) represent the most prevalent helminth infections worldwide and are closely associated with inadequate sanitation and poverty. During 2020 and 2021, a significant information gap emerged as a consequence of the SARS-CoV-2 pandemic. Therefore, the objective of this study was to provide an updated post-pandemic overview by estimating the prevalence of STH, identifying the etiological agents involved, and analyzing the risk factors associated with these infections. The study was conducted in Ilaló, Pichincha, Ecuador, where a total of 320 individuals were examined using three diagnostic methods: Kato-Katz, McMaster, and Mini-FLOTAC. Of these, 73 participants tested positive (22.81%, 95% CI: 22.3–23.4). The most frequently identified parasite was Ascaris lumbricoides (74.73%, 95% CI: 73.7–75.8). The main risk factors identified were pig farming (OR: 4.16; 95% CI: 2.34–7.42) and vegetable and fruit cultivation (OR: 11.66; 95% CI: 4.32–41.08). These findings provide relevant epidemiological data on STH in the region, demonstrating a reduction in infection prevalence likely associated with improved prevention and control measures implemented during the COVID-19 pandemic. Full article

Ascaris lumbricoides is one of the most epidemiologically significant soil-transmitted helminths, and the environmental persistence of its eggs is largely attributed to their robust structural architecture. The search for ovicidal alternatives capable of overcoming this barrier has increasingly focused on metallic nanoparticles obtained through biological synthesis. Scanning electron microscopy (SEM) was employed to evaluate the ultrastructural effects of silver nanoparticles (AgNPs) biosynthesised by the nematophagous fungus Duddingtonia flagrans on A. lumbricoides eggs. Ultraviolet-visible spectroscopy and transmission electron microscopy confirmed the synthesis of AgNPs, revealing predominantly spherical, well-dispersed particles with an average diameter of 9.22 ± 4.9 nm. Cytotoxicity assays indicated an IC₅₀ of 7.7 µg/mL. SEM analyses showed that eggs in the control group maintained intact morphology, with no apparent deformities. In contrast, exposure to AgNPs induced pronounced structural alterations, including marked wrinkling, surface erosion and shell collapse, suggesting disruption of multiple layers. Albendazole alone produced deep linear fissures consistent with internal metabolic failure, though with minimal external erosion. The combined treatment with AgNPs and albendazole resulted in severe degradation. These findings demonstrate that AgNPs exhibit significant ovicidal activity and may serve as effective adjuvants to enhance the action of conventional anthelmintics against highly resistant helminth eggs. Full article

Helminth infections caused by soil-transmitted species, like Ascaris lumbricoides, Trichuris trichiura, and hookworms, affect over one billion people worldwide, yet accurate diagnosis remains challenging due to low sensitivity of microscopy in detecting eggs in stool samples, especially in low-intensity infections. Molecular diagnostics, particularly PCR-based detection of helminth DNA in stool samples, have emerged as more sensitive and specific alternatives. Here we review advances in DNA extraction methods that overcome inhibitors in stool, multiplex PCR assays, and next-generation sequencing technologies enabling species differentiation and detection of drug resistance markers. These molecular tools enhance epidemiological surveillance and inform control strategies. Despite challenges such as sample complexity and cost, ongoing improvements in molecular diagnostics hold promise for more effective helminth detection and management in clinical and field settings. Full article

Background: Soil-transmitted helminth (STH) infections, including ascariasis, trichuriasis, and hookworm disease, are among the most common neglected tropical diseases (NTDs) globally. This study evaluates the disease burden of STH in China from 1990 to 2021 and projects trends to 2035. Methods: Data from the Global Burden of Disease 2021 database were utilized to analyze the prevalence and disability-adjusted life years (DALYs) of STH infections in China from 1990 to 2021. The estimated annual percentage change (EAPC) was calculated to assess trends over time, and a Bayesian age-period-cohort model was used to project the disease burden up to 2035. Results: From 1990 to 2021, the prevalence and DALYs of STH infections decreased significantly by 85.08% and 98.01% in China, respectively. The age-standardized prevalence rate (ASPR) of STH infections dropped from 34,073.24/10⁵ to 4981.01/10⁵ with an EAPC of −6.62% [95% confidence interval (CI): −7.40%, −5.83%], and the age-standardized DALY rate (ASDR) decreased from 1.77/10⁵ to 0.18/10⁵, with an EAPC of −14.05% (95% CI: −15.04%, −13.06%). Trichuriasis contributed to 78.85% of the total ASPR for STH, whereas hookworm disease accounted for 51.14% of STH’s ASDR. The highest disease burden due to STH peaked in the 5–9 years age group, with prevalence of 8030.05/10⁵ [95% uncertainty interval (UI): 5356.86/10⁵–11,662.62/10⁵] and DALYs rate of 2.99/10⁵ (95% UI: 1.56/10⁵−4.87/10⁵). The projected ASDR and ASPR of trichuriasis rose to 0.55/10⁵ and 5362.50/10⁵ by 2035. Conclusions: China has achieved remarkable reductions in the burden of STH infections over the past three decades. However, the predominance between the species has changed. The projected rebound in trichuriasis underscores the importance of sustained control efforts. To achieve the 2030 elimination target outlined in the WHO NTDs roadmap, it is crucial to integrate precision epidemiology with ongoing water, sanitation, and hygiene initiatives, targeted chemotherapy and health education. Full article

The treatment of parasitic infections has evolved in terms of effectiveness and the prevention of drug resistance. This is highlighted by the discovery of ivermectin (IVM), a macrocyclic lactone and broad-spectrum antiparasitic agent. IVM garnered scientific attention by presenting a therapeutic alternative in the field of veterinary medicine due to its control of multiple parasite species, including nematodes and soil-transmitted helminths. Shortly after its discovery, IVM was approved for human use by the World Health Organization (WHO) and United States Food and Drug Administration (FDA) for combating head lice, onchocerciasis, rosacea, scabies, and worm infestations within the gastrointestinal tract (GIT). In veterinary medicine, IVM is available in a range of formulations and can be administered via different routes (i.e., oral, topical, and parenteral), whereas for humans, IVM is only approved as a single oral dose and dermal cream. Establishing a comprehensive overview of IVM’s applications in both human and veterinary medicine is necessary, particularly in light of its repurposing potential as a treatment for various conditions and emerging diseases. Given its primary application in veterinary medicine, there is a need to enhance the development of dosage forms suitable for human use. Therefore, this review details the discovery, mechanisms, and applications of IVM, while also examining the challenges of resistance, side-effects, and controversy surrounding its use, to ultimately emphasize the importance of targeted, optimized IVM delivery via tailored dosage form development in animals and humans as part of the One Health approach to interlink innovations across veterinary and human medicine fields. Full article