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Epidemiology and clinical features of soil-transmitted helminths

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      Abstract

      Soil-transmitted helminths (STH) consist of Ascaris lumbricoides, Trichuris trichiura, and hookworm ( Necator americanus and Ancylostoma duodenale). It affects nearly 1.7 billion people globally in which Ascaris contributes nearly 1.2 billion cases. The main mode for transmission of Ascaris and Trichuris is through contaminated food and water, whereas hookworm transmitted by skin penetration. STH were mainly seen in areas with poverty, overcrowding, and poor sanitation. The prevalence is more in rural areas compared to urban areas. It affects mainly children and causes lack of school attendance, anemia, and cognitive deficits. This review emphasizes on the epidemiology and clinical features of all STH and emphasizes on the role on preventive measures in containing STH.

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      Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm.

      The three main soil-transmitted helminth infections, ascariasis, trichuriasis, and hookworm, are common clinical disorders in man. The gastrointestinal tract of a child living in poverty in a less developed country is likely to be parasitised with at least one, and in many cases all three soil-transmitted helminths, with resultant impairments in physical, intellectual, and cognitive development. The benzimidazole anthelmintics, mebendazole and albendazole, are commonly used to remove these infections. The use of these drugs is not limited to treatment of symptomatic soil-transmitted helminth infections, but also for large-scale prevention of morbidity in children living in endemic areas. As a result of data showing improvements in child health and education after deworming, and the burden of disease attributed to soil-transmitted helminths, the worldwide community is awakening to the importance of these infections. Concerns about the sustainability of periodic deworming with benzimidazole anthelmintics and the emergence of resistance have prompted efforts to develop and test new control tools.
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        Global numbers of infection and disease burden of soil transmitted helminth infections in 2010

        Background Quantifying the burden of parasitic diseases in relation to other diseases and injuries requires reliable estimates of prevalence for each disease and an analytic framework within which to estimate attributable morbidity and mortality. Here we use data included in the Global Atlas of Helminth Infection to derive new global estimates of numbers infected with intestinal nematodes (soil-transmitted helminths, STH: Ascaris lumbricoides, Trichuris trichiura and the hookworms) and use disability-adjusted life years (DALYs) to estimate disease burden. Methods Prevalence data for 6,091 locations in 118 countries were sourced and used to estimate age-stratified mean prevalence for sub-national administrative units via a combination of model-based geostatistics (for sub-Saharan Africa) and empirical approaches (for all other regions). Geographical variation in infection prevalence within these units was approximated using modelled logit-normal distributions, and numbers of individuals with infection intensities above given thresholds estimated for each species using negative binomial distributions and age-specific worm/egg burden thresholds. Finally, age-stratified prevalence estimates for each level of infection intensity were incorporated into the Global Burden of Disease Study 2010 analytic framework to estimate the global burden of morbidity and mortality associated with each STH infection. Results Globally, an estimated 438.9 million people (95% Credible Interval (CI), 406.3 - 480.2 million) were infected with hookworm in 2010, 819.0 million (95% CI, 771.7 – 891.6 million) with A. lumbricoides and 464.6 million (95% CI, 429.6 – 508.0 million) with T. trichiura. Of the 4.98 million years lived with disability (YLDs) attributable to STH, 65% were attributable to hookworm, 22% to A. lumbricoides and the remaining 13% to T. trichiura. The vast majority of STH infections (67%) and YLDs (68%) occurred in Asia. When considering YLDs relative to total populations at risk however, the burden distribution varied more considerably within major global regions than between them. Conclusion Improvements in the cartography of helminth infection, combined with mathematical modelling approaches, have resulted in the most comprehensive contemporary estimates for the public health burden of STH. These numbers form an important benchmark upon which to evaluate future scale-up of major control efforts.
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          Soil-transmitted helminth infections: updating the global picture.

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            Author and article information

            Affiliations
            Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
            Author notes
            Address for correspondence: Dr. Subhash Chandra Parija, Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. E-mail: subhashparija@ 123456yahoo.co.in
            Journal
            Trop Parasitol
            Trop Parasitol
            TP
            Tropical Parasitology
            Medknow Publications & Media Pvt Ltd (India )
            2229-5070
            2229-7758
            Jul-Dec 2017
            : 7
            : 2
            : 81-85
            5652059
            TP-7-81
            10.4103/tp.TP_27_17
            Copyright: © 2017 Tropical Parasitology

            This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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