Self-rated quality of life and school performance in relation to helminth infections: case study from Yunnan, People's Republic of China

Background: Expert opinion-derived disability weights are widely employed for estimating the global burden of diseases and injuries. For chronic diseases such as soil-transmitted helminthiasis and schistosomiasis, it has been suggested that a patient-based quality of life (QoL) approach should be considered for a more accurate appraisal of disability weights. METHODS AND RESULTS: We carried out a cross-sectional survey and assessed the prevalence and intensity of soil-transmitted helminth infections as well as self-rated QoL indicators among 252 students attending grades 5-8 in two schools (Bulangshan and Pu'er) in Yunnan province, People's Republic of China. Each student provided a single stool sample, which was subjected to duplicate Kato-Katz thick smear readings and a single FLOTAC examination for parasitological diagnosis. Prevalence rates for hookworm, Trichuris trichiura and Ascaris lumbricoides were high in Bulangshan (75.9%, 70.0% and 68.2%), while the respective prevalence rates in Pu'er were 66.9%, 56.5% and 9.2%. Students were interviewed with two standardised questionnaires, the EuroQoL-5 Dimensions (EQ-5D) and ShortForm-12 (SF-12) Health Survey. Impairment in any of the five dimensions of the EQ-5D was reported by 87% of the students. However, no clear differences could be observed between individuals with and those without helminth infections, and there were discrepancies between the two schools. A multivariate logistic regression model revealed no differences between students with varying infection status in the domains of the SF-12 (odds ratio close to 1.0). Somewhat more pronounced, yet not statistically significant differences were observed when end-of-school-term marks were compared with students' helminth infection status: infected individuals had lower marks in Chinese, English and mathematics, but not in sports, compared to their helminth-free counterparts. CONCLUSIONS: Our results point to unresolved issues and challenges regarding the cultural appropriateness of the widely used standard QoL questionnaires. Hence, new research is needed to further develop these instruments and to validate them in connection with chronic parasitic disease

Toward an Open-Access Global Database for Mapping, Control, and Surveillance of Neglected Tropical Diseases

Abstract Background: After many years of general neglect, interest has grown and efforts came under way for the mapping, control, surveillance, and eventual elimination of neglected tropical diseases (NTDs). Disease risk estimates are a key feature to target control interventions, and serve as a benchmark for monitoring and evaluation. What is currently missing is a georeferenced global database for NTDs providing open-access to the available survey data that is constantly updated and can be utilized by researchers and disease control managers to support other relevant stakeholders. We describe the steps taken toward the development of such a database that can be employed for spatial disease risk modeling and control of NTDs

Toward an Open-Access Global Database for Mapping, Control, and Surveillance of Neglected Tropical Diseases

There is growing interest in the scientific community, health ministries, and other organizations to control and eventually eliminate neglected tropical diseases (NTDs). Control efforts require reliable maps of NTD distribution estimated from appropriate models and survey data on the number of infected people among those examined at a given location. This kind of data is often available in the literature as part of epidemiological studies. However, an open-access database compiling location-specific survey data does not yet exist. We address this problem through a systematic literature review, along with contacting ministries of health, and research institutions to obtain disease data, including details on diagnostic techniques, demographic characteristics of the surveyed individuals, and geographical coordinates. All data were entered into a database which is freely accessible via the Internet (http://www.gntd.org). In contrast to similar efforts of the Global Atlas of Helminth Infections (GAHI) project, the survey data are not only displayed in form of maps but all information can be browsed, based on different search criteria, and downloaded as Excel files for further analyses. At the beginning of 2011, the database included over 12,000 survey locations for schistosomiasis across Africa, and it is continuously updated to cover other NTDs globally

Effect of Sanitation on Soil-Transmitted Helminth Infection: Systematic Review and Meta-Analysis

A systematic review and meta-analysis by Kathrin Ziegelbauer and colleagues finds that sanitation is associated with a reduced risk of transmission of helminthiases to humans

Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk - Results from the PROG-IMT collaboration.

AIMS: Carotid intima media thickness (CIMT) predicts cardiovascular (CVD) events, but the predictive value of CIMT change is debated. We assessed the relation between CIMT change and events in individuals at high cardiovascular risk. METHODS AND RESULTS: From 31 cohorts with two CIMT scans (total n = 89070) on average 3.6 years apart and clinical follow-up, subcohorts were drawn: (A) individuals with at least 3 cardiovascular risk factors without previous CVD events, (B) individuals with carotid plaques without previous CVD events, and (C) individuals with previous CVD events. Cox regression models were fit to estimate the hazard ratio (HR) of the combined endpoint (myocardial infarction, stroke or vascular death) per standard deviation (SD) of CIMT change, adjusted for CVD risk factors. These HRs were pooled across studies. In groups A, B and C we observed 3483, 2845 and 1165 endpoint events, respectively. Average common CIMT was 0.79mm (SD 0.16mm), and annual common CIMT change was 0.01mm (SD 0.07mm), both in group A. The pooled HR per SD of annual common CIMT change (0.02 to 0.43mm) was 0.99 (95% confidence interval: 0.95-1.02) in group A, 0.98 (0.93-1.04) in group B, and 0.95 (0.89-1.04) in group C. The HR per SD of common CIMT (average of the first and the second CIMT scan, 0.09 to 0.75mm) was 1.15 (1.07-1.23) in group A, 1.13 (1.05-1.22) in group B, and 1.12 (1.05-1.20) in group C. CONCLUSIONS: We confirm that common CIMT is associated with future CVD events in individuals at high risk. CIMT change does not relate to future event risk in high-risk individuals

Characteristics of studies examining the association of sanitation availability or sanitation use with soil-transmitted helminth infections, including quality assessment.

a<p>Data provided by author.</p><p>A.l., <i>Ascaris lumbricoides</i>; BM, Baermann (technique); Cal., calculated; DS, direct smear; FEC, formalin-ether concentration (technique); FES, formalin-ether sedimentation (technique); HH, household; H-M, Harada-Mori (technique); Hw, hookworm; KAP, Koga agar plate (technique); K-K, Kato-Katz (technique); Mod., modified; MVA, multivariate analysis; PAFS, polyvinyl alcohol fixative solution; PSc, pre-school children; n.s., not stated; RFEC, Ritchie's formalin-ether concentration (technique); Sc, schoolchildren; SS, stool sedimentation (technique); STH, soil-transmitted helminths; T-L, Teleman-Lima (technique); T.t., <i>Trichuris trichiura</i>; UVA, univariate analysis; ZSF, zinc sulfate flotation (technique).</p

Meta-analysis examining the association of sanitation facilities with <i>A. lumbricoides</i> infection.

<p>Data are presented separately for availability and use of sanitation. Rectangles indicate ORs, and sizes of the rectangles represent the weight given to each study in the meta-analysis; open diamonds and vertical dashed lines indicate combined ORs; and horizontal lines indicate 95% CIs. Data are presented separately for ^aonly pit latrine, ^bonly solar urine-diverting desiccating latrine, ^conly adults, ^donly children. N.A., not assessed.</p

Meta-analysis examining the association of sanitation facilities with hookworm infection.

<p>Data are presented separately for availability and use of sanitation. Rectangles indicate ORs, and sizes of the rectangles represent the weight given to each study in the meta-analysis; open diamonds and vertical dashed lines indicate combined ORs; and horizontal lines indicate 95% CIs. Data are presented separately for ^aonly pit latrine, ^bonly solar urine-diverting desiccating latrine, ^conly adults, ^donly children. N.A., not assessed.</p

Summary results of sub-group analysis examining the association of sanitation with soil-transmitted helminth infections.

<p>N.A., not assessed.</p