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

Objective: To understand the prevalence of major human parasitic diseases and related factors in Henan province. Methods: This stratified sampling survey was carried out according to the requirement of national survey protocol of major human parasitic diseases, 2014-2015. The prevalence of soil-transmitted helminths infection, taeniasis and intestinal protozoiasis were surveyed in 104 sites selected from 35 counties (districts) and the prevalence of clonorchiasis was surveyed in 62 sites selected from 37 townships. In each survey spot, 250 persons were surveyed. A total of 26 866 persons and 15 893 persons were surveyed. Modified Kato-Katz thick smear was used to detect the eggs of intestinal helminthes. Tube fecal culture was used to identify the species of hookworm. The Enterobius eggs were detected in children aged 3 to 6 years by using adhesive tape. The cyst and trophozoite of intestinal protozoa were examined with physiological saline direct smear method and iodine stain method. Results: The overall infestation rate of intestinal parasites was2.02% in Henan, and the worm infection rate was higher than protozoa infection rate. Fourteen kinds of intestinal parasites were found, including nematode (5 species), trematode (2 species), and protozoan (7 species). The infection rate of Enterobius vermicularis was highest, and Qinba Mountain ecological area had the highest infestation rate of intestinal parasites in 4 ecological areas of Henan. There was no significant difference in intestinal parasite infection rate between males and females (χ(2)=3.630, P=0.057), and the differences in intestinal parasite infection rate among different age groups had significance (χ(2)=124.783, P=0.000 1). The infection rate reached the peak in age group ≤9 years and the major parasite was Enterobius vermicularis. Furthermore the overall human infection rate of parasite showed a downward trend with the increase of educational level of the people (χ(2)=70.969, P=0.000 1), the differences had significance (χ(2)=120.118, P=0.000 1). For different populations, the infection rate of intestinal parasites was highest among preschool children. The infection of intestinal helminth was mainly mild, only 2 severe cases were detected. The infection rate of Clonorchis sinensis in urban residents was only 0.006%. Logistic regression analysis showed that being preschool children (χ(2)=15.765, P=0.000 1) and drinking well water (χ(2)=45.589, P=0.000 1) were the risk factors for intestinal parasite infection, and annual income per capita of farmers was the protective factor against intestinal parasite infection. The infection rates of protozoa and intestinal parasites decreased sharply compared with the results of previous two surveys, and the rate of intestinal helminth infection also dropped sharply compared with the second survey. The numbers of protozoa, helminth and intestinal parasites detected in this survey were all less than the numbers found in the previous two surveys. Conclusions: Compared the results of three surveys in Henan, the infection rate of protozoa and intestinal parasites showed a downward trend. The prevention and treatment of Enterobius vermicularis infection in children should be the key point of parasitic disease control in the future.
Animals ; Child ; Child, Preschool ; Clonorchiasis/epidemiology* ; Farmers ; Feces/parasitology* ; Female ; Helminthiasis/epidemiology* ; Helminths ; Humans ; Intestinal Diseases, Parasitic/parasitology* ; Male ; Prevalence ; Protective Factors ; Risk Factors ; Rural Population ; Soil Microbiology ; Surveys and Questionnaires ; Taeniasis/epidemiology* ; Trematode Infections/parasitology* ; Urban Population ; Water Wells

The infection status of freshwater fish with digenetic trematode metacercariae was examined in water systems of Hantangang and Imjingang (River), the Republic of Korea. A total of 877 (594 from Hantangang and 283 from Imjingang) fishes were examined by the artificial digestion methods. Clonorchis sinensis metacercariae were detected in 7 (1.2%) fishes (in 3 spp.) from Hantangang in Cheorwon-gun, Gangwon-do, and 40 (14.1%) fishes (in 7 spp.) from Munsancheon in Paju-si, Gyeonggi-do. The average densities were 1.9 and 35.6 per fish infected, respectively. Metagonimus spp. metacercariae were detected in 312 (52.5%) and 113 (39.9%) fishes from Hantangang and Imjingang, and their average densities were 47.5 and 9.6 per fish infected, respectively. Centrocestus armatus metacercariae were found in 161 (27.1%) and 70 (24.7%) fishes from Hantangang and Imjingang, and their average number per fish infected was 694 and 82, respectively. Echinostoma spp. metacercariae were detected in 50 (8.4%) and 94 (33.2%) fishes from Hantangang and Imjingang, and their average densities were 9.6 and 23.1 per fish infected, respectively. The infection status of fishes with metacercariae of Stephanoprora spp., Diplostomum spp., Clinostomum complanatum, Metorchis orientalis, and Metorchis taiwanensis were analyzed by surveyed regions. Conclusively, it was confirmed that C. sinensis metacercariae were quite commonly detected in fishes from Munsancheon but rarely from other localities, whereas the metacercariae of other digenetic trematodes were relatively prevalent in fishes from water systems of Hantangang and Imjingang in Korea.
Animals ; Female ; Fish Diseases/epidemiology/*parasitology ; Fresh Water/parasitology ; Male ; Metacercariae/classification/genetics/growth & development/*isolation & purification ; Prevalence ; Republic of Korea/epidemiology ; Trematoda/classification/genetics/growth & development/*isolation & purification ; Trematode Infections/epidemiology/parasitology/*veterinary

The infection status of zoonotic trematode metacercariae was investigated in a total of 2,293 freshwater fish collected from 11 rivers or streams in 9 administrative regions of Gangwon-do, Korea for 5 years (2009-2013). All fish were collected by netting methods and examined using the artificial digestion methods. Clonorchis sinensis metacercariae were detected in 4 fish species, i.e., Pungtungia herzi, Squalidus japonicus coreanus, Acheilognathus rhombeus, and Ladislabia taczanowskii, from only Hantangang in Cheorwon-gun. Metagonimus spp. metacercariae were found in 1,154 (50.3%) fish and their average number per infected fish was 55.8. Among the positive fish species, especially Tribolodon hakonensis from Namdaecheon in Yangyang-gun and Plecoglossus altivelis from Osipcheon in Samcheok-si were most heavily infected. Centrocestus armatus metacercariae were detected in 611 (26.7%) fish and the average metacercarial burden per infected fish was 1,032. Two chub species, Zacco platypus and Zacco temminckii were highly and heavily infected with C. armatus metacercariae in almost all regions surveyed. Echinostoma spp. metacercariae were also found in 24 fish from a few localities, but their numbers per fish infected were very low. From the above results, it is confirmed that the metacercariae of intestinal flukes, especially Metagonimus spp. and C. armatus, were heavily infected, while C. sinensis metacercariae were rarely found in fish from Gangwon-do, Korea.
Animals ; Biodiversity ; Fish Diseases/*epidemiology/*parasitology ; Fishes ; Fresh Water ; Korea ; Parasite Load ; Prevalence ; Trematoda/*classification/*isolation & purification ; Trematode Infections/epidemiology/parasitology/*veterinary

OBJECTIVETo investigate the epidemiological situation of cercarial trematodes infection in freshwater snails from different water resources in Chiang Mai province, Thailand.

METHODSThe snail specimens were collected from 13 districts of Chiang Mai province during April 2008 to February 2012. The prevalence of cercarial infection in snails was investigated using the crushing method. The drawing was done with the help of a camera lucida for the morphological study.

RESULTSA total of 2 479 snail individuals were collected and classified into 7 families, 11 genera, and 14 species, Among them, 8 snails species were found to be infected with an overall prevalence of 17.27% (428/2 479), which infected with nine groups of cercariae; gymnocephalous cercaria, strigea cercaria, megalurous cercaria, monostome cercaria, parapleurolophocercous cercaria (Haplorchis cercaria), pleurolophocercous cercaria, furcocercous cercaria (Transversotrema cercaria), xiphidiocercaria, and virgulate cercaria. The parapleurolophocercous cercaria was found to be the dominant type among the cercarial infection in the snails (64.25%).

CONCLUSIONSThe various species of snails found in the research location act as the intermediate hosts for the high prevalence of parasitic infection of many species of mammals. This work will provide new information on both the distribution and first intermediate host of trematodes.

Animals ; Cercaria ; growth & development ; isolation & purification ; Fresh Water ; Prevalence ; Snails ; parasitology ; Thailand ; epidemiology ; Trematoda ; growth & development ; isolation & purification

OBJECTIVETo evaluate the effect of preventive medicine for residents living around mosquito breeding water during rest period of malaria by delimiting a certain range.

METHODThe study adopted the stratified cluster random sampling method to select subjects from 6 counties in the high epidemic area along and north of the Huai River since March 2007. Then the villages of 6 counties were stratified into five levels according to the case reported in year 2006, and one village was randomly selected from each level, thereby 30 villages were selected in total.300-500 subjects were interviewed in each village, and in total 12 860 subjects were recruited in the study. The five selected villages in each county were allocated to three intervention groups according to the block randomization method. The first intervention group included 9 villages, 4362 people; the second intervention group was consisted of 12 villages, 4471 people; the non-intervention group had 9 villages, 4027 people. The basic information of the subjects were collected by questionnaire to analyze the relation between malaria cases and the distribution of the mosquito breeding water, then accordingly delimited the range for preventive medicine. Group 1 received the delimiting preventive medicine treatment, group 2 received routine medicine treatment, while non-treatment group received no treatment. The morbidity, standardized morbidity, net change of morbidity (the D-value of the standardized morbidity before and after the intervention), age-specified incidence, and the protective rate (PR), effectiveness index (IE) and the capture rate of the delimited method group were then calculated.

RESULTSGroup 1 had 1219 (27.9%) people taking medicine and Group 2 had 219 (4.9%) people. In 2006, before the prevention conducting, the high incidence aging group in the first, second and nonintervention group was separately people aging 50 - 59, 60 - 69 and ≥ 70 years old; whose incidence was 36.22‰ (18/497), 40.11‰ (15/374) and 34.88‰ (9/258) respectively. After the intervention, the high incidence aging groups in the first and second intervention group changed to the population over 70 years old, with incidence at 9.17‰ (3/327) and 22.01‰ (7/318) respectively; while the high incidence aging groups in the nonintervention group changed to people aging between 30-39 years old, with the rate at 24.88‰ (10/402). In 2006, the morbidity of malaria in the first, second intervention group and nonintervention group was separately 18.78‰ (83/4420), 20.27‰ (93/4587) and 14.61‰ (53/3627); while the standardized incidence was separately 18.85‰, 20.72‰ and 14.89‰. In 2007, after the prevention conducting, the morbidity in the three groups was 2.75‰ (12/4362), 11.63‰ (52/4471) and 12.17‰ (49/4027), respectively; while the standardized incidences was 2.81‰, 12.75‰ and 12.35‰, respectively. The net value of changes of morbidity in the three groups was separately 16.04%, 7.97% and 2.54%. The difference in net values of changes of morbidity between intervention group 1 and 2 had statistical significance (χ(2) = 7.74, P < 0.05). Comparing with the nonintervention group, the PR and IE in intervention group 1 was separately 84.2% and 6.31; while the capture rate was 69.2% (9/13).

CONCLUSIONThe delimiting preventive medicine treatment during rest period of malaria was very effective for eliminating the potential infection source of malaria and reducing the morbidity of malaria.

Adolescent ; Adult ; Aged ; Animals ; Child ; Child, Preschool ; China ; epidemiology ; Culicidae ; physiology ; Humans ; Incidence ; Infant ; Infant, Newborn ; Malaria ; drug therapy ; epidemiology ; prevention & control ; Middle Aged ; Water ; parasitology ; Young Adult

The occurrence of 37-collar spined echinostome metacercariae in freshwater snails was investigated in 6 districts of Chiang Mai Province, Thailand, from October 2011 to April 2012. A total of 2,914 snails that belong to 12 species were examined, and 7 snail species (Clea helena, Eyriesia eyriesi, Bithynia funiculata, Bithynia siamensis siamensis, Filopaludina doliaris, Filopaludina sumatrensis polygramma, and Filopaludina martensi martensi) were found infected with echinostome metacercariae. The prevalence of metacercariae was the highest in Filopaludina spp. (38.5-58.7%) followed by B. funiculata (44.0%), E. eyriesi (12.5%), B. siamensis siamensis (8.2%), and C. helena (5.1%). Metacercariae were experimentally fed to hamsters and domestic chicks, and adult flukes were recovered from both hosts at days 15 and 20 post-infection. The adult flukes were identified based on morphological features, morphometrics, host-parasite relationships, and geographical distribution. They were compatible to Echinostoma revolutum or Echinostoma jurini, with only minor differences. As the adults were recovered from both hamsters and chicks, our specimens were more compatible to E. revolutum rather than E. jurini (reported only from mammals). This is the first report for metacercariae of E. revolutum in the snail host, C. helena, and also confirmed that Filopaludina spp., E. eryresi, and Bithynia spp. act as the second intermediate hosts of E. revolutum under natural conditions, which are indigenously distributed in Chiang Mai province.
Animals ; Chickens ; Cricetinae ; Echinostoma/anatomy & histology/isolation & purification/pathogenicity/*physiology ; Fresh Water ; Life Cycle Stages ; Metacercariae/anatomy & histology/isolation & purification/pathogenicity/*physiology ; Prevalence ; Snails/*parasitology ; Thailand/epidemiology

The first case of human cryptosporidiosis was reported in Korea in 1995; however, an outbreak of Cryptosporidium has not been reported in Korea until now. This paper describes the first outbreak of cryptosporidiosis in Korea. On May 24, 2012, a local public health center filed a report on 126 residents with gastrointestinal symptoms in an old apartment complex in Seoul. Epidemiological investigations were implemented on 125 of the 126 patients. The patients were reported continuously over a period of 22 days. Diarrhea was the most common clinical symptom, and lasted for 5 days on average. The tap water was the only common exposure of the patients. During the environmental investigation it was discovered that the water and septic tanks were situated closely and that the waste water pipes were corroded where they passed over the water pipes. Cryptosporidium parvum was detected in 3 of the 7 stool specimens by PCR-RFLP. A number of Cryptosporidium oocysts were also detected in the water specimens from the water tank. In conclusion, Cryptosporidium parvum was the key causal pathogen of this outbreak. It is presumed that the tap water was contaminated by a sewage leak from the aged pipelines.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cryptosporidiosis/*epidemiology/parasitology ; Cryptosporidium parvum/*isolation & purification ; Diarrhea/parasitology ; *Disease Outbreaks ; Drinking Water/*parasitology ; Female ; Food Contamination ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Public Health ; Republic of Korea/epidemiology ; Sewage/parasitology ; Young Adult

Among Paragonimus species, P. paishuihoensis is one of the most mysterious and poorly understood species. Metacercariae are characterized by having a unique dendritically branched excretory bladder. However, the morphology of the adult worm remains unknown. To date, metacercariae of this species have been reported only in China and Thailand. In this study, we first found P. paishuihoensis metacercariae in freshwater crabs, Potamon lipkei, in Hinheub District, Vientiane, Lao PDR, with a prevalence of 77.7% and the average intensity of 10.3 (range 1-28) metacercariae per crab. The molecular data based on ITS2 and CO1 markers indicated that P. paishuihoensis from Laos and Thailand were almost completely identical and were close to members of the Paragonimus bangkokensis/Paragonimus harinasutai complex. Attempts to infect experimental animals (cats, dogs, and rats) with P. paishuihoensis were unsuccessful, suggesting that these animals might be unsuitable definitive hosts for the species. Further studies are necessary to elucidate the taxonomic status and life cycle of P. paishuihoensis.
Animals ; Brachyura/*parasitology ; Cluster Analysis ; DNA, Ribosomal Spacer/chemistry/genetics ; Electron Transport Complex IV/genetics ; Fresh Water ; Laos ; Metacercariae/*isolation & purification ; Molecular Sequence Data ; Paragonimus/*isolation & purification ; Phylogeny ; Polymerase Chain Reaction ; Prevalence ; Sequence Analysis, DNA ; Sequence Homology

From May to June 2012, a waterborne outbreak of 124 cases of cryptosporidiosis occurred in the plumbing systems of an older high-rise apartment complex in Seoul, Republic of Korea. The residents of this apartment complex had symptoms of watery diarrhea and vomiting. Tap water samples in the apartment complex and its adjacent buildings were collected and tested for 57 parameters under the Korean Drinking Water Standards and for additional 11 microbiological parameters. The microbiological parameters included total colony counts, Clostridium perfringens, Enterococcus, fecal streptococcus, Salmonella, Shigella, Pseudomonas aeruginosa, Cryptosporidium oocysts, Giardia cysts, total culturable viruses, and Norovirus. While the tap water samples of the adjacent buildings complied with the Korean Drinking Water Standards for all parameters, fecal bacteria and Cryptosporidium oocysts were detected in the tap water samples of the outbreak apartment complex. It turned out that the agent of the disease was Cryptosporidium parvum. The drinking water was polluted with sewage from a septic tank in the apartment complex. To remove C. parvum oocysts, we conducted physical processes of cleaning the water storage tanks, flushing the indoor pipes, and replacing old pipes with new ones. Finally we restored the clean drinking water to the apartment complex after identification of no oocysts.
Cryptosporidiosis/*epidemiology/*parasitology ; Cryptosporidium parvum/genetics/growth & development/*isolation & purification ; Disease Outbreaks ; Drinking Water/*parasitology ; Housing ; Humans ; Oocysts/growth & development ; Republic of Korea/epidemiology ; Water Supply/analysis