Association between footwear use and neglected tropical diseases: a systematic review and meta-analysis

BACKGROUND The control of neglected tropical diseases (NTDs) has primarily focused on preventive chemotherapy and case management. Less attention has been placed on the role of ensuring access to adequate water, sanitation, and hygiene and personal preventive measures in reducing exposure to infection. Our aim was to assess whether footwear use was associated with a lower risk of selected NTDs. METHODOLOGY We conducted a systematic review and meta-analysis to assess the association between footwear use and infection or disease for those NTDs for which the route of transmission or occurrence may be through the feet. We included Buruli ulcer, cutaneous larva migrans (CLM), leptospirosis, mycetoma, myiasis, podoconiosis, snakebite, tungiasis, and soil-transmitted helminth (STH) infections, particularly hookworm infection and strongyloidiasis. We searched Medline, Embase, Cochrane, Web of Science, CINAHL Plus, and Popline databases, contacted experts, and hand-searched reference lists for eligible studies. The search was conducted in English without language, publication status, or date restrictions up to January 2014. Studies were eligible for inclusion if they reported a measure of the association between footwear use and the risk of each NTD. Publication bias was assessed using funnel plots. Descriptive study characteristics and methodological quality of the included studies were summarized. For each study outcome, both outcome and exposure data were abstracted and crude and adjusted effect estimates presented. Individual and summary odds ratio (OR) estimates and corresponding 95% confidence intervals (CIs) were calculated as a measure of intervention effect, using random effects meta-analyses. PRINCIPAL FINDINGS Among the 427 studies screened, 53 met our inclusion criteria. Footwear use was significantly associated with a lower odds of infection of Buruli ulcer (OR=0.15; 95% CI: 0.08-0.29), CLM (OR=0.24; 95% CI: 0.06-0.96), tungiasis (OR=0.42; 95% CI: 0.26-0.70), hookworm infection (OR=0.48; 95% CI: 0.37-0.61), any STH infection (OR=0.57; 95% CI: 0.39-0.84), strongyloidiasis (OR=0.56; 95% CI: 0.38-0.83), and leptospirosis (OR=0.59; 95% CI: 0.37-0.94). No significant association between footwear use and podoconiosis (OR=0.63; 95% CI: 0.38-1.05) was found and no data were available for mycetoma, myiasis, and snakebite. The main limitations were evidence of heterogeneity and poor study quality inherent to the observational studies included. CONCLUSIONS/SIGNIFICANCE Our results show that footwear use was associated with a lower odds of several different NTDs. Access to footwear should be prioritized alongside existing NTD interventions to ensure a lasting reduction of multiple NTDs and to accelerate their control and elimination. PROTOCOL REGISTRATION PROSPERO International prospective register of systematic reviews CRD42012003338

A survey of blood parasites among blood donors at Eku, Delta State, Nigeria

This study involved blood film examination of 500 healthy blood donors (308 males and 192 females) between the ages of 15-54 years who attended Baptist Medical Centre Eku, Delta State, between August, 2004 and March 2005, 219 (43.80%) were positive for blood parasites; 26 (5.20%) for Trypanasoma, 152 (30.40%) for Plasmodium and 41 (8.20%) for microfilariae. Male blood donors showed relatively higher prevalence (32.20%) than female donors (11.60%). Although parasite prevalence was highest in the age-group 30-34 years, there was no statistical difference among age groups. All blood group types and parasites, though blood group O had the dominant prevalence (44.92%). In addition, the rural-urban prevalence, skewed toward rural blood donors (29.00%), but this was not statistically significant. With respect to occupation, the farming blood donors had the highest prevalence (57.53%) while student donors had the least (14.72%). The study confirms that blood transfusion will always represent a risk, through small to the recipient. Careful and critical examinations of donors to improve good donor selection and transfusion practice are essential. Keywords: prevalence, parasites, blood donors, Nigeria Nigerian Journal of Parasitology Vol. 25, 2004: 87-9

Observations on the intestinal helminth parasites of cichlids in the upper reaches of River Orogodo, a freshwater body in Delta State, Southern Nigeria

The prevalence and intensity of intestinal helminth parasites of five predominant cichlids; Hemichromis fasciatus, Chromidotilapia guentheri, Tilapia mariae, Tilapia zilli and Tilapia aurea of the upper reaches of River Orogodo in Delta State, Southern Nigeria were examined. The water body was randomly sampled using a variety of fishing gear which included funnel entrance traps, cast nets of varying mesh sizes and baited hook long lines. Of a total of 183 fishes investigated, 111 (60.66%) were infected. The increasing order of relative prevalence was Chromidotilapia quentheri (21.62%), Tilapia mariae (63.64%), Tilapia aurea (70.97%), Tilapia zilli (71.79%) and Hemichromis faciatus (74.42%). The intestinal helminth parasites recovered were Acanthophalans (Acanthogyrus sp and Octospiniferoides sp), Nematodes (Camallanus sp and Cucullanus sp) and Cestodes (Wenyonia sp). Tilapia mariae had the highest parasite intensity (425) while Chromidotilapia quentheri had the least (65). Although, the sex predilection skewed towards females (64.77%) as against males (56.84%) significant difference was not observed (P>0.05). Viable preventive measures against fish parasitism in Nigerian freshwater bodies are highly recommended.Keywords: helminth, cichlids, freshwater, Nigeria Tropical Freshwater Biology 2003/2004 Vol. 12/13: 131-13

Anthropogenic Indices of Soil-Transmitted Helminthiasis among Children in Delta State, Southern Nigeria

"nBackground: The prevalence and intensity of soil-transmitted helminth infections and the anthropogenic risk factors of 978 ran­domly selected primary school children from Igbede community in Isoko South Local Government Area of Delta State Southern Nigeria were evaluated."nMethods: Subjects were screened for the presence of STH using direct smear method and kato-katz techniques. This study was conducted between April and December, 2007 and comprised of 516 (52.76%) males and 462 (47.24%) females be­tween the age of 5 and 13 years."nResults: Nine hundred and seven (92.74%) of the subjects were infected by soil-transmitted helminthes (STH). The overall prevalence by species was Ascaris lumbricoides (76.89%), Hookworm (54.60%) and Trichuris Trichiura (29.24%). Three hundred and eight two (39.40%) were infected with two or more STH. The prevalence and intensity of all species of STH significantly varied with age (P< 0.05), with highest prevalence in age group 5-7 years. The sex related prevalence showed that males were more infected for all species of STH than females, but this was only statistically significant for hookworm (P< 0.05). Multiple logistic regression analysis for the epidemiological variable showed that walking barefoot was the only risk factor for hookworm infection while licking of fingers as well as drinking from well and surface tank was risk factors for A. lumbricoides and T. trichiura infections."nConclusion: Considering the high prevalence of STH observed from this study, establishment of sustainable and regular deworming programme in the community coupled with health education messages on good hygienic practices are highly essential

On the occurrence of three non-native cichlid species including the first record of a feral population of Pelmatolapia (Tilapia) mariae (Boulenger, 1899) in Europe

Thermally influenced freshwater systems provide suitable conditions for non-native species of tropical and subtropical origin to survive and form proliferating populations beyond their native ranges. In Germany, non-native convict cichlids (Amatitlania nigrofasciata) and tilapia (Oreochromis sp.) have established populations in the Gillbach, a small stream that receives warm water discharge from a local power plant. Here, we report on the discovery of spotted tilapia (Pelmatolapia mariae) in the Gillbach, the first record of a reproducing population of this species in Europe. It has been hypothesized that Oreochromis sp. in the Gillbach are descendants of aquaculture escapees and our mtDNA analysis found both O. mossambicus and O. niloticus maternal lineages, which are commonly used for hybrids in aquaculture. Convict cichlids and spotted tilapia were most probably introduced into the Gillbach by aquarium hobbyists. Despite their high invasiveness worldwide, we argue that all three cichlid species are unlikely to spread and persist permanently beyond the thermally influenced range of the Gillbach river system. However, convict cichlids from the Gillbach are known to host both native and non-native fish parasites and thus, non-native cichlids may constitute threats to the native fish fauna. We therefore strongly recommend continuous monitoring of the Gillbach and similar systems