BACKGROUND

The deworming program, also known as preventive chemotherapy, is one of the most important strategies in combatting Soil-transmitted Helminthiasis. With more than two decades of implementation, only a few countries have reached the target deworming coverage of 75% by the World Health Organization (WHO). In the Philippines, the national deworming coverage from 2018 to 2022 is still below both the WHO and the Department of Health's target deworming coverage. As a result, there is an increasing prevalence of soil-transmitted helminthiasis among populations in endemic areas in the country including South Cotabato.

The purpose of this qualitative study was to describe the experiences of health workers in the implementation of the STH deworming program in South Cotabato, specifically their lived experiences in implementing the deworming program, the challenges and issues they encountered during the implementation, coping strategies, and their insights about the status of the deworming program in the province and how to improve it.

Seventeen health workers implementing the deworming program in the province of South Cotabato were interviewed through in-depth interviews and focus group discussions. Interviews were conducted online due to mobility restrictions during the pandemic. The transcripts were analyzed using Colaizzi’s descriptive phenomenological method and essential themes were formulated.

Our analysis revealed that health workers’ lived experiences revolve around ensuring the quality implementation of the program such as combatting misconceptions about deworming through house-tohouse visitation and education campaigns, reaching far-flung areas, and ensuring children are in good health condition before taking a deworming medicine. Common challenges experienced by the participants were the misconceptions and disinformation regarding deworming, the limited and difficult access to some areas, problems in logistics, and the limited support of some stakeholders. Moreover, participants cited the importance of good community engagement, active involvement and commitment of stakeholders, providing support to health workers, and robust monitoring and evaluation of the program in improving the implementation of deworming.

In the context of this study, there is still a need to intensify the training for implementers to cater more effectively to the concerns of the people and debunk misconceptions about the program. Utilization of various media for information dissemination, enhancing access to hard-to-reach areas, and strengthening community engagements, particularly with barangay and local government officials are essential to address the gaps in the implementation. There must also be improvements in monitoring and evaluation of the program, and additional support and incentives to healthcare workers to sustain implementations.

Juvenile Dermatomyositis (JDM) is a rare type of idiopathic inflammatory myopathy affecting children, characterized by symmetric proximal muscle weakness and pathognomonic cutaneous manifestation such as heliotrope rash and Gottron papules. In the Philippines, there are only 40 cases from 2011 to 2022. It is an autoimmune disease, although several studies have associated its onset to the presence of systemic infections. In cases complicated by systemic infection, early initiation of comprehensive treatment is essential in order to achieve remission.

This is a case of a 2-year old female presenting with a 2 month history of erythematous macules over the metacarpophalangeal (MCP), proximal interphalangeal (PIP), distal interphalangeal joints (DIP), and knees, nailfold changes, and facial erythema on sun exposure. This was associated with decreased activity, inability to walk continuously, and symmetric proximal muscle weakness. Skin punch biopsy was done which revealed interface vacuolar dermatitis, alcian blue stain positive. Laboratories revealed elevated ANA, aldolase, LDH, and SGPT which were all consistent with dermatomyositis. Patient was started on oral prednisone, hydroxychloroquine and topical corticosteroids. Notably, the patient was also diagnosed with pulmonary tuberculosis and ascariasis. Thus, she was also started on anti-Kochs regimen and mebendazole. After 2 months of steroid therapy and hydroxychloroquine, there was improvement in cutaneous lesions with significant increase in activity and mobility.

In a country where pulmonary tuberculosis and ascariasis is common, it is of utmost importance to probe for underlying infections which may occur with or may be contributory to the onset of juvenile dermatomyositis.

Neuroschistosomiasis is a serious complication of schistosomiasis, where Schistosoma parasites migrate to the central nervous system. It is often overlooked but can cause significant neurological symptoms. We present a 10-year-old male with headache and papilledema, emphasizing the importance of considering neuroschistosomiasis in patients with neurological symptoms and a history of schistosomiasis exposure. Early diagnosis and timely treatment with antischistosomal drugs and corticosteroids are crucial for positive outcomes. Raising awareness and implementing appropriate management approaches can improve the prognosis of neuroschistosomiasis.
Neuroschistosomiasis

OBJECTIVE: To investigate the sequences of internal transcribed spacer 2 (ITS2) and cyclooxygenase 1 (COX1) genes of Paragonimus metacercariae in freshwater crabs in Henan Province, identify the species of Paragonimus and evaluate its genetic relationships with Paragonimus isolates from other provinces in China. METHODS: Freshwater crabs were collected from 8 survey sites in Zhengzhou, Luoyang, Pingdingshan, Nanyang and Jiyuan cities of Henan Province from 2016 to 2021, and Paragonimus metacercariae were detected in freshwater crabs. Genomic DNA was extracted from Paragonimus metacercariae, and the ITS2 and COX1 genes were amplified using PCR assay, followed by sequencing of PCR amplification products. The gene sequences were spliced and aligned using the software DNASTAR, and aligned with the sequences of Paragonimus genes in the GenBank. Phylogenetic trees were created using the MEGA6 software with the Neighbor-Joining method based on ITS2 and COX1 gene sequences, with Fasciola hepatica as the outgroup. RESULTS: The detection rates of Paragonimus metacercariae were 6.83% (11/161), 50.82% (31/61), 18.52% (5/26), 8.76% (12/137), 14.29% (9/63), 17.76% (19/105), 18.50% (32/173) and 42.71% (41/96) in freshwater crabs from 8 survey sites in Zhengzhou, Luoyang, Pingdingshan, Nanyang and Jiyuan cities of Henan Province, with a mean detection rate of 19.46% (160/822), and a mean infection intensity of 0.57 metacercariae/g. The amplified ITS2 and COX1 gene fragments of Paragonimus were approximately 500 bp and 450 bp in lengths, respectively. The ITS2 gene sequences of Paragonimus metacercariae from 8 survey sites of Henan Province showed the highest homology (99.8% to 100.0%) with the gene sequence of P. skrjabini (GenBank accession number: MW960209.1), and phylogenetic analysis showed that the Paragonimus in this study was clustered into the same clade with P. skrjabini from Sichuan Province (GenBank accession number: AY618747.1), Guangxi Zhuang Autonomous Region (GenBank accession number: AY618729.1) and Hubei Province (GenBank accession number: AY618751.1), and P. miyazaki from Fujian Province (GenBank accession number: AY618741.1) and Japan (GenBank accession number: AB713405.1). The COX1 gene sequences of Paragonimus metacercariae from 8 survey sites of Henan Province showed the highest homology (90.0% to 100.0%) with the gene sequence of P. skrjabini (GenBank accession number: AY618798.1), and phylogenetic analysis showed that the Paragonimus in this study was clustered into the same clade with all P. skrjabini and clustered into the same sub-clade with P. skrjabini from Hubei Province (GenBank accession numbers: AY618782.1 and AY618764.1). CONCLUSIONS Paragonimus species from freshwater crabs in Henan Province were all characterized as P. skrjabini, and the ITS2 and COX1 gene sequences had the highest homology to those of P. skrjabini from Hubei Province. The results provide insights into study of Paragonimus in Henan Province and China.
Animals ; Paragonimus/genetics* ; Brachyura/genetics* ; Cyclooxygenase 1/genetics* ; Phylogeny ; China/epidemiology* ; Sequence Analysis, DNA ; Paragonimiasis

Helminth infections are widespread worldwide, and pose a serious threat to human health and animal husbandry development. Understanding of helminth-host interactions is critical to effective control and ultimate eradication of helminthiasis. Following host infections, helminth infections firstly initiate innate immune responses and then mediate adaptive immune responses. Type 1 immune responses are predominant at early stage of helminth infections, which mainly play anti-infective actions, and type 2 immune responses are predominant at late stage of infections, which are associated with helminth immune evasion and aggravation of tissue damages. This review summarizes the progress of researches on type 1/2 immune responses-associated signaling pathways mediated by helminth infections in hosts.
Animals ; Humans ; Helminthiasis ; Helminths ; Immunity, Innate ; Signal Transduction ; Host-Parasite Interactions

With the improvement of sanitation, the infection rate of hookworm is greatly reduced and the severe infected case is rarely reported. Combined morphological and molecular biological examinations, a severe hookworm infection patient was diagnosed in Department of Laboratorial Examination, Quanzhou First Affiliated Hospital of Fujian Medical University. The morphological methods such as direct fecal smear microscopy, saturated brine flotation and hookworm larvae culture methods were used to identify the eggs and larvae from stool samples of the patient. There were a large number of hookworm eggs in patient's stool samples, and the average count was 60 840 per gram by modified Kato method, which belonged to severe hookworm infection. Meanwhile, to distinguish the hookworm species, the semi-nested RT-PCR assay was employed to detect hookworm internal transcribed spacer series from eggs in patient's stool samples, and the result showed that the hookworm species was confirmed to be Necator americanus.
Ancylostomatoidea/genetics* ; Animals ; Feces ; Hookworm Infections/diagnosis* ; Humans ; Necator americanus/genetics* ; Polymerase Chain Reaction

Pulmonary paragonimiasis and tuberculosis are endemic in Asia, South America, and Africa. However, differential diagnosis among the diseases is difficult because they present with similar clinical symptoms and diagnostic features. Here, we report a case of pulmonary paragonimiasis that was identified using Ziehl-Neelsen stain after initially being assessed for pulmonary tuberculosis. Following anti-Paragonimus chemotherapy, the patient's symptoms, laboratory test results, and lung lesions improved. Thus, the identification of Paragonimus westermani using Ziehl-Neelsen stain can be considered in the diagnosis.
Africa ; Asia ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Lung ; Paragonimiasis ; Paragonimus westermani ; South America ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: Soil-transmitted helminthes (STH) infections are among the most common infections worldwide and affect the most deprived communities. Adequate water, sanitation, and hygiene (WASH) prevents environmental contamination, thereby preventing transmission of STH. Cognizant of this, WASH education was implemented in rural Dembiya to reduce intestinal parasitic infections. This study was, therefore, conducted to assess the impacts of the intervention on households' WASH conditions and prevalence of intestinal parasitic infections. METHOD: An uncontrolled before-and-after intervention study was used. Cross-sectional studies were done before and after the intervention. Two hundred twenty-five and 302 under five children were recruited randomly at the baseline and endline, respectively. Data were collected using a structured questionnaire and observational checklists. Direct stool examination and Kato-Katz methods were used to identify parasites in the stool. We used percent point change and prevalence ratio (PR) to see the effects of the intervention on WASH conditions and prevalence of intestinal parasitic infections respectively. Pearson chi-squared and Fisher's exact tests were used to test for statistically significant percentage point changes of WASH conditions. The effect of the intervention on intestinal parasitic infections was statistically tested on the basis of PR with 95% confidence interval (CI). RESULTS: The baseline prevalence of intestinal parasitic infections was 25.8%, and the endline prevalence was 23.8%. The prevalence of intestinal parasitic infections was not significantly decreased at the endline compared with the baseline [PR = 0.92, 95% CI = (0.62, 1.38)]. Ascaris Lumbricoides was the most prevalent parasitic infection both at the baseline and endline. The proportion of children who had good hygienic condition increased from 1.3% at the baseline to 34.4% at the end line (p <  0.05). The percentage of mothers/care givers who washed hands at different pick times was significantly increased from 24.4% at the baseline to 68.2% at the endline (p <  0.001). The proportion of households who practiced home-based water treatment was significantly increased from 7.6% at the baseline to 47% at the endline (p <  0.001). The proportion of households who used sanitary latrine was increased from 32% at the baseline to 49% at the endline (p <  0.05). CONCLUSION This before-and-after intervention study found that households' WASH performance was significantly improved at the endline compared with the baseline. The endline prevalence of intestinal parasitic infections was slightly lower than the baseline prevalence; however, the reduction was not statistically significant. The local health office needs to strengthen the WASH education program, mobilize the community to construct WASH facilities, and support the community to sustain households' WASH performance.
Adult ; Child, Preschool ; Cross-Sectional Studies ; Drinking Water ; parasitology ; standards ; Ethiopia ; epidemiology ; Family Characteristics ; Feces ; parasitology ; Female ; Health Behavior ; physiology ; Health Education ; Health Knowledge, Attitudes, Practice ; Helminthiasis ; epidemiology ; prevention & control ; Humans ; Hygiene ; education ; Infant ; Intestinal Diseases, Parasitic ; epidemiology ; prevention & control ; Male ; Prevalence ; Rural Population ; Sanitation ; Soil ; parasitology ; Surveys and Questionnaires

No abstract available.
Larva Migrans ; Sparganosis

Anisakiasis is a zoonotic disease induced by anisakid nematodes, and endoscopic inspection is used for a diagnosis or remedy for it. Anisakis simplex, Anisakis physeteris, and Pseudoterranova decipiens had been reported to be the major species causing human infections, particularly, in Japan. However, in Korea, recent studies strongly suggested that Anisakis pegreffii is the major species of human infections. To support this suggestion, we collected anisakid larvae (n=20) from 20 human patients who were undergone gastrointestinal endoscopy at a health check-up center in Korea, and molecular identification was performed on the larvae using PCR-RFLP analysis and gene sequencing of rDNA ITS regions and mtDNA cox2. In addition, anisakid larvae (n=53) collected from the sea eel (Astroconger myriaster) were also examined for comparison with those extracted from humans. The results showed that all human samples (100%) were identified as A. pegreffii, whereas 90.7% of the samples from the sea eel were A. pegreffii with the remaining 9.3% being Hysterothylacium aduncum. Our study confirmed that A. pegreffii is the predominant species causing human anisakiasis in Korea, and this seems to be due to the predominance of this larval type in the fish (sea eels) popularly consumed by the Korean people. The possibility of human infection with H. aduncum in Korea is also suggested.
Anisakiasis ; Anisakis ; Diagnosis ; DNA, Mitochondrial ; DNA, Ribosomal ; Eels ; Endoscopy, Gastrointestinal ; Humans ; Japan ; Korea ; Larva ; Zoonoses