Epidemiology of single and multiple species of helminth infections among school children in Busia District, Kenya

Objective: To describe the patterns of single and multiple helminth infection in school children from Busia District, Kenya.Design: A cross-sectional school survey using a randomly selected sample, forming part of an evaluation study of an ongoing deworming project.Setting: Budalangi and Funyula divisions of Busia District, Western Province, Kenya.Subjects: One thousand seven hundred and thirty eight school children aged 8-20 years randomly selected from those enrolled in standards 3-8 in 25 randomly selected primary schools.Results: Overall, 91.7% of children were infected with either hookworm, Ascaris lumbricoides, Trichuris trichiura or Schistosoma mansoni. Infection prevalence of each species varied considerably among schools, being most marked for S. mansoni, where prevalence was highest in lakeshore schools. Children were typically infected with two or more species of helminth. Infection intensity of each geohelminth species was higher in school children infected with multiple species than in school children with single species infections, and intensity increased with the number of concurrent infections.Conclusion: Helminth infections are exceptionally common among school children in Busia district, thus confirming the good sense of the school-based approach adopted by the control programme. The study also shows that there is an association between concurrent infectionand the intensity of infection, which may have consequences for nutritional and educational status

Foward Chaining dalam meningkatkan KEmandirian Lepas Pakai Celana saat BAB pada Remaja dengan Severe IDD

Tujuan dari penelitian ini adalah untuk mengetahui efektivitas penerapan teknik forward chaining dalam meningkatkan kemandirian lepas pakai celana saat buang air besar (BAB) pada remaja laki-laki dengan Intellectual Developmental Disorder taraf berat (severe IDD). Metode penelitian yang digunakan adalah metode eksperimen single case dengan desain A-B. Alat ukur yang digunakan adalah behaviour ceklist berupa ketrampilan lepas pakai celana yang terdiri dari 17 langkah rantai perilaku. Pengukuran dilakukan saat pra intervensi dan selama intervensi. Partisipan dalam intervensi ini adalah seorang remaja laki-laki, berusia 17 tahun dengan severe IDD, IQ < 30, dengan problem motorik dan problem komunikasi. Pemberian intervensi teknik forward chaining ini dikombinasikan dengan pemberian reinforcement positif berupa pujian dan tepuk tangan saat partisipan bisa mengerjakan tugas. Intervensi teknik forward chaining diberikan dalam 12 sesi dengan durasi 60 menit untuk setiap sesi. Analisis data dilakukan dengan analisis grafik. Hasil menunjukkan jumlah ‘prompt’ semakin berkurang dan meningkatnya keberhasilan subjek dalam melaksanakan tahapan perilaku lepas pakai celana saat BAB. Dengan demikian disimpulkan bahwa penerapan teknik forward chaining bersama dengan penguatan positif secara langsung terbukti efektif meningkatkan kemandirian lepas pakai celana secara mandiri saat BAB pada remaja severe IDD

STATIONS D’EPURATION A LITS FILTRANTS PLANTES DE MACROPHYTES WASTE WATER TREATMENT PLANTS WITH MACROPHYTES

L’utilisation de marais pour l’amélioration de la qualité de l’eau est une technique très ancienne. Depuis que l’homme rejettedes effluents pollués dans le milieu naturel, les marais ont été impliqués – volontairement ou non – dans l’épuration de ceux-ci.De nombreuses recherches sont actuellement menées afin de mieux comprendre les phénomènes intervenant dans le sol pourl’épuration, l’influence des conditions climatiques, les tailles et formes des lits, la charge hydraulique et le type de plantesutilisées. Le présent travail se veut une contribution à la mise en valeur des techniques d’épuration des eaux usées domestiquespar lits plantés de macrophytes

Atomic and molecular interstellar absorption lines toward the high galactic latitude stars HD~141569 and HD~157841 at ultra-high resolution

We present ultra-high resolution (0.32 km/s) spectra obtained with the 3.9m Anglo-Australian Telescope (AAT) and Ultra-High-Resolution Facility (UHRF), of interstellar NaI D1, D2, Ca II K, K I and CH absorption toward two high galactic latitude stars HD141569 and HD157841. We have compared our data with 21-cm observations obtained from the Leiden/Dwingeloo HI survey. We derive the velocity structure, column densities of the clouds represented by the various components and identify the clouds with ISM structures seen in the region at other wavelengths. We further derive abundances, linear depletions and H2 fractional abundances for these clouds, wherever possible. Toward HD141569, we detect two components in our UHRF spectra : a weak, broad component at - 15 km/s, seen only in CaII K absorption and another component at 0 km/s, seen in NaI D1, D2, Ca II K, KI and CH absorption. In the case of the HD157841 sightline, a total of 6 components are seen on our UHRF spectra in NaI D1, D2 Ca II K, K I and CH absorption. 2 of these 6 components are seen only in a single species.Comment: 16 pages, Latex, 4 figures, ps files Astrophysical Journal (in press

Reductions in the Prevalence and Incidence of Geohelminth Infections following a City-wide Sanitation Program in a Brazilian Urban Centre

In the city of Salvador, a large urban centre in Northeast Brazil, a city-wide sanitation intervention started in 1997, aiming to improve the sewerage coverage of households from 26% to 80%. Our aim was to study the impact of the intervention on the prevalence and incidence of geohelminths in the school-aged population. The longitudinal study comprised two cohorts: from the beginning of 1997 to 1998, where data was collected before the intervention, and at the end of 2003 to 2004, after the intervention. Copro-parasitological examinations were carried out on every individual from both cohorts, at the start and nine months later. Demographic, socio-economic, and environmental data were collected using semi-structured questionnaires. The variables utilized to demonstrate the effects of intervention, when utilized together in a multivariate model, accounted for a 100% observed reduction in the prevalence ratio (PR) and incidence ratio (IR). As well as proving that the variables associated with the effect of the program intervention were mediators in this reduction, the reduction in the PR and IR between these periods demonstrated that modifications to the urban environment, particularly those associated with sanitary sewage systems, affected the health of the population, significantly reducing the prevalence of geohelminths

Role of the employment status and education of mothers in the prevalence of intestinal parasitic infections in Mexican rural schoolchildren

&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Intestinal parasitic infections are a public health problem in developing countries such as Mexico. As a result, two governmental programmes have been implemented: a) "National Deworming Campaign" and b) "Opportunities" aimed at maternal care. However, both programmes are developed separately and their impact is still unknown. We independently investigated whether a variety of socio-economic factors, including maternal education and employment levels, were associated with intestinal parasite infection in rural school children.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; This cross-sectional study was conducted in 12 rural communities in two Mexican states. The study sites and populations were selected on the basis of the following traits: a) presence of activities by the national administration of albendazole, b) high rates of intestinal parasitism, c) little access to medical examination, and d) a population having less than 2,500 inhabitants. A total of 507 schoolchildren (mean age 8.2 years) were recruited and 1,521 stool samples collected (3 per child). Socio-economic information was obtained by an oral questionnaire. Regression modelling was used to determine the association of socio-economic indicators and intestinal parasitism.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; More than half of the schoolchildren showed poliparasitism (52%) and protozoan infections (65%). The prevalence of helminth infections was higher in children from Oaxaca (53%) than in those from Sinaloa (33%) (p &#60; 0.0001). Giardia duodenalis and Hymenolepis nana showed a high prevalence in both states. Ascaris lumbricoides, Trichuris trichiura and Entamoeba hystolitica/dispar showed low prevalence. Children from lower-income families and with unemployed and less educated mothers showed higher risk of intestinal parasitism (odds ratio (OR) 6.0, 95% confidence interval (CI) 1.6–22.6; OR 4.5, 95% CI 2.5–8.2; OR 3.3, 95% CI 1.5–7.4 respectively). Defecation in open areas was also a high risk factor for infection (OR 2.4, 95% CI 2.0–3.0).&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusion:&lt;/b&gt; Intestinal parasitism remains an important public health problem in Sinaloa (north-western Mexico) and Oaxaca (south-eastern Mexico). Lower income, defecation in open areas, employment status and a lower education level of mothers were the significant factors related to these infections. We conclude that mothers should be involved in health initiatives to control intestinal parasitism in Mexico.&lt;/p&gt

Sex differences in clinical presentation and risk stratification in the emergency department: an observational multicenter cohort study

Objective: The aim of this study was to investigate whether sex differences exist in disease presentations, disease severity and (case-mix adjusted) outcomes in the Emergency Department (ED).Methods: Observational multicenter cohort study using the Netherlands Emergency Department Evaluation Database (NEED), including patients >= 18 years of three Dutch EDs. Multivariable logistic regression was used to study the associations between sex and outcome measures in-hospital mortality and Intensive Care Unit/Medium Care Unit (ICU/MCU) admission in ED patients and in subgroups triage categories and presenting complaints.Results: Of 148,825 patients, 72,554 (48.8%) were females. Patient characteristics at ED presentation and diagnoses (such as pneumonia, cerebral infarction, and fractures) were comparable between sexes at ED presentation. In-hospital mortality was 2.2% in males and 1.7% in females. ICU/MCU admission was 4.7% in males and 3.1% in females. Males had higher unadjusted (OR 1.34(1.25-1.45)) and adjusted (AOR 1.34(1.24-1.46)) risks for mortality, and unadjusted (OR 1.54(1.46-1.63)) and adjusted (AOR 1.46(1.37-1.56)) risks for ICU/MCU admission. Males had higher adjusted mortality and ICU/MCU admission for all triage categories, and with almost all presenting complaints except for headache.Conclusions: Although patient characteristics at ED presentation for both sexes are comparable, males are at higher unadjusted and adjusted risk for adverse outcomes. Males have higher risks in all triage categories and with almost all presenting complaints. Future studies should investigate reasons for higher risk in male ED patients

Economic evaluations of onchocerciasis interventions: a systematic review and research needs

Objective To provide a systematic review of economic evaluations that has been conducted for onchocerciasis interventions, to summarise current key knowledge and to identify research gaps. Method A systematic review of the literature was conducted on the 8th of August 2018 using the PubMed (MEDLINE) and ISI Web of Science electronic databases. No date or language stipulations were applied to the searches. Results We identified 14 primary studies reporting the results of economic evaluations of onchocerciasis interventions, seven of which were cost‐effectiveness analyses. The studies identified used a variety of different approaches to estimate the costs of the investigated interventions/programmes. Originally, the studies only quantified the benefits associated with preventing blindness. Gradually, methods improved and also captured onchocerciasis‐associated skin disease. Studies found that eliminating onchocerciasis would generate billions in economic benefits. The majority of the cost‐effectiveness analyses evaluated annual mass drug administration (MDA). The estimated cost per disability‐adjusted life year (DALY) averted of annual MDA varies between US$3 and US$30 (cost year variable). Conclusions The cost benefit and cost effectiveness of onchocerciasis interventions have consistently been found to be very favourable. This finding provides strong evidential support for the ongoing efforts to eliminate onchocerciasis from endemic areas. Although these results are very promising, there are several important research gaps that need to be addressed as we move towards the 2020 milestones and beyond

Patterns of soil-transmitted helminth infection and impact of four-monthly albendazole treatments in preschool children from semi-urban communities in Nigeria: a double-blind placebo-controlled randomised trial

Background Children aged between one and five years are particularly vulnerable to disease caused by soil-transmitted helminths (STH). Periodic deworming has been shown to improve growth, micronutrient status (iron and vitamin A), and motor and language development in preschool children and justifies the inclusion of this age group in deworming programmes. Our objectives were to describe the prevalence and intensity of STH infection and to investigate the effectiveness of repeated four-monthly albendazole treatments on STH infection in children aged one to four years. Methods The study was carried out in four semi-urban villages situated near Ile-Ife, Osun State, Nigeria. The study was a double-blind placebo-controlled randomised trial. Children aged one to four years were randomly assigned to receive either albendazole or placebo every four months for 12 months with a follow-up at 14 months. Results The results presented here revealed that 50% of the preschool children in these semi-urban communities were infected by one or more helminths, the most prevalent STH being Ascaris lumbricoides (47.6%). Our study demonstrated that repeated four-monthly anthelminthic treatments with albendazole were successful in reducing prevalence and intensity of A. lumbricoides infections. At the end of the follow-up period, 12% and 43% of the children were infected with A. lumbricoides and mean epg was 117 (S.E. 50) and 1740 (S.E. 291) in the treatment and placebo groups respectively compared to 45% and 45% of the children being infected with Ascaris and mean epg being 1095 (S.E. 237) and 1126 (S.E. 182) in the treatment and placebo group respectively at baseline. Conclusion Results from this study show that the moderate prevalence and low intensity of STH infection in these preschool children necessitates systematic treatment of the children in child health programmes

Hookworm-Related Anaemia among Pregnant Women: A Systematic Review

Anaemia affects large numbers of pregnant women in developing countries and increases their risk of dying during pregnancy and delivering low birth weight babies, who in turn are at increased risk of dying. Human hookworm infection has long been recognized among the major causes of anaemia in poor communities, but understanding of the benefits of the management of hookworm infection in pregnancy has lagged behind the other major causes of maternal anaemia. Low coverage of anthelmintic treatment in maternal health programmes in many countries has been the result. After systematically reviewing the available literature we observed that increasing hookworm infection intensity is associated with lower haemoglobin levels in pregnant women. We also estimate that between a quarter and a third of pregnant women in sub-Saharan Africa are infected with hookworm and at risk of preventable hookworm-related anaemia. However, all identified intervention studies showed a benefit of deworming for maternal or child health and we argue that increased efforts should be made to increase the coverage of anthelmintic treatment among pregnant women