Hymenolepis nana, the dwarf tapeworm, is a common intestinal infection of children worldwide. We evaluated infection and risk factor data that were previously collected from 14,761 children aged 2-15 years during a large-scale program in northern Peru. We found that 1,124 of 14,761 children (7.61%) had H. nana infection, a likely underestimate given that only a single stool sample was examined by microscopy for diagnosis. The strongest association with infection was lack of adequate water (adjusted prevalence ratio [aPR] 2.22, 95% confidence interval [CI] 1.82-2.48) and sanitation infrastructure in the house (aPR 1.94, 95% CI 1.64-2.29). One quarter of those tested did not have a bathroom or latrine at home, which doubled their likelihood of infection. Similarly, one quarter did not have piped public water to the house, which also increased the likelihood of infection. Continued efforts to improve access to basic water and sanitation services will likely reduce the burden of infection in children for this and other intestinal infections.

Bolivia is one of the countries with a high intestinal helminth and protozoan infection rate. Despite the high prevalence of the parasitic infection, nationwide preventive measures for Bolivian children have not yet been implemented. We evaluated the effect of mass stool examination and treatment as a strategy for decreasing the infection rate. This study was conducted between 2013 and 2015 in children aged 2-18 years. A total of 2,033 stool samples (575 in 2013, 815 in 2014 and 642 in 2015) were collected and examined using the formalin-ether medical sedimentation method. As an anthelminthic medicine, nitazoxanide was given to all infected children within 2 months post-examination, each year. The effect of mass stool examination and treatment was evaluated based on the changes in the overall or individual parasitic infection rates during the study period. The overall parasitic infection rate decreased significantly from 65.2% in 2013 to 43.0% in 2015; a 22.2 percentage point decrease (P<0.001). Protozoan infection accounted for a large portion of the parasitic infections, in the following rates: 62.4% in 2013, 49.3% in 2014, and 41.0% in 2015. The rate of the most common helminth infection, Hymenolepis nana, decreased significantly from 9.0% in 2013 to 6.4% in 2014 to 3.4% in 2015 (P<0.001). Prevalence of the most common pathogenic protozoan infection, Entamoeba histolytica, decreased significantly from 19.0% in 2013 to 3.0% in 2015 (P<0.001). Conversely, the rate of Giardia intestinalis increased significantly from 16.5% in 2013 to 21.2% in 2015 (P<0.01). Mass stool examination and treatment for intestinal helminth and protozoan infections was effective for decreasing the overall parasitic infection rate in the study population, excluding Giardia intestinalis. Further studies on the long-term effect of mass stool examination and treatment for decreasing all intestinal parasitic infection rates in Bolivian children are needed.

Worldwide, traditional usage of herbal medicines is a common practice to treat various parasitic infections. In India, bark decoction of Oroxylum indicum (L.) Kurz. (Bignoniaceae) is used as a traditional medicine to cure intestinal-helminthic infections. This study investigated the anthelmintic efficacy of methanolic bark extract of O. indicum on Hymenolepis diminuta (Cestoda), using both in vitro and in vivo methods. Utilizing a mini-questionnaire, first, we collected information about the pattern of anthelmintic use of this plant. Later, in vitro efficacy of extract was tested at 10, 20 and 30 mg/ml on both the artificially excysted juveniles and adult H. diminuta worms. Herein, scanning electron microscopy (SEM) was also utilized to determine the possible effects of extract on tegumental surfaces of juvenile and adult cestode. In vivo, extract was tested at 250, 500 and 1000 mg/kg in H. diminuta albino rat model, against juvenile and adult cestode. Praziquantel (PZQ) served as reference drug in anthelmintic assays. The acute toxicity of extract was determined as per the OECD guidelines. The field questionnaire data revealed that 78 % of people in the area use O. indicum stem bark against intestinal helminths, and of these, 75 % of people also believed it highly efficacious anthelmintic remedy. In vitro testing of extract revealed significant effects on juvenile worms, and 30 mg/ml of extract caused mortality of juveniles at the initial period (0.25 ± 0.00 h). Conversely, PZQ (1 mg/ml) showed paralysis and mortality of juvenile cestodes in 0.44 ± 0.04 and 1.11 ± 0.06 h, respectively. As determined by SEM, in vitro exposure to extract showed substantial effects on both juveniles and adult worms in the form of wrinkled scolex, distorted tegument and eroded microtriches. In vivo study revealed better efficacy of extract against juveniles than adult stages of parasite. Treatment of rats with 1000 mg/kg of extract caused 79.3 % reduction in EPG counts and 70.8 % of reduction in worm counts, which compared well to PZQ efficacy. In acute toxicity study, administration of a single oral dose of 2000 mg/kg of extract to mice did not cause any signs of toxicity or mortality within 2-week observation. Hence, the LD50 of extract was estimated to be greater than 2000 mg/kg. In conclusion, the bark extract of O. indicum possesses concentration-dependent effects against the larval and adult H. diminuta worms, and thus the extract holds promise in the control of intestinal helminthiases. This also supports the common belief of people about the reputation of this plant as anthelmintic in traditional medicine. There is a need to standardize the formulations of this plant for their possible use as standardized herbal anthelmintic agents in the future.

BACKGROUND: Hymenolepis nana is among the most common intestinal parasitic infections causing a public health threat in poor communities in Sub-Saharan Africa. The present study was conducted to determine the prevalence of H. nana infections and associated risk factors among preschool children of displacement communities in Khartoum state, Sudan.
METHODS: A cross-sectional survey was conducted in May 2013 in displacement camps, Khartoum state, Sudan. A simple random sample of preschool children from the displacement camps, aged between 1 and 5 years, were included. Information was collected by presenting a questionnaire and taking 500 fresh stool specimens which were examined microscopically for the presence of eggs, using direct saline and formal-ether concentration techniques.
RESULTS: The prevalence of H. nana was determined to be 32.6% (163/500), 95% CI (28.5%-36.9%). Infections of H. nana were more prevalent among males than females, and this association was statistically significant (P < 0.001, OR = 2.125, 95% CI = 1.452-3.108). H. nana infections were significantly prevalent among the older age group (2.6-5.0 years) (P < 0.001, OR = 2.909, 95% CI = 1.914-4.420). Approximately 76.7% of infected preschool children had diarrhea and it was significantly associated with H. nana infection (P < 0.001, OR = 9.45, 95% CI = 6.10-14.64). None of the preschool children had access to a clean water supply. No significant association was found between use of latrines and infections of H. nana (P = 0.56, OR = 0.880, 95% CI = 0.73-1.763).
CONCLUSIONS: There was a high prevalence rate of H. nana infection among preschool children of displacement camps in Khartoum state, Sudan. Being male, aged between 2.6 and 5.0 years, and having diarrhea were identified as important risk factors for H. nana infection. Measures including health education, environmental hygiene, water supply and treatment should be taken into account to reduce the high prevalence of H. nana.

Tribendimidine has been registered for the treatment of human soil transmitted helminthiases in China. In the model nematode Caenorhabditis elegans it is an agonist of L-subtype nicotinic acetylcholine receptors and therefore shares its mode of action with levamisole and pyrantel. Besides its broad spectrum of nematicidal efficacy, tribendimidine is efficacious against several trematodes and has been attributed to have anti-cestodal effects. However, there are few published data available for the latter. The efficacy of tribendimidine and its nematicidal metabolite deacylated amidantel against Hymenolepis microstoma were examined for their anti-cestodal potential. Doses of 50 and 100mg/kg body weight deacylated amidantel and 10, 25, 50, and 100mg/kg tribendimidine were administered orally on three consecutive days to mice experimentally infected with eight cysticercoids. Necropsy was performed and the worm burdens were determined one day after the last treatment. Furthermore, levamisole was used in combination with tribendimidine (100mg/kg levamisole plus 10 and 25mg/kg tribendimidine, respectively) and alone (50 and 100mg/kg) to investigate any possible interactions of the partner compounds against cestodes. Tribendimidine showed a very high efficacy at dosages of 50mg/kg or higher. Surprisingly, deacylated amidantel led to no reduction of the worm burden in any of the treatments. Combinations of levamisole with tribendimidine did not augment the effects of tribendimidine alone and as expected levamisole alone also showed no anti-cestodal activity. To our knowledge, this study shows for the first time activity of tribendimidine against a cestode in a controlled laboratory study. Due to the excellent cure rates observed here, multiple tribendimidine treatments might be considered as useful scheme for treatments of cestode, nematode and trematode infections although this would significantly increase both costs and management efforts. Moreover, the differences between tribendimidine and deacylated amidantel indicate at least a strong difference in sensitivity of H. microstoma or a strong difference in drug availability.

暂无摘要。

暂无摘要。

暂无摘要。

The effect of sodium benzoate (SB) on the pathogenesis of Hymenolepis nana (H. nana) and its neurological manifestations was studied in the present work. One hundred and thirty five mice were classified into three groups. GI: received SB alone. GII: received SB before & after infection with H. nana and GIII: infected with H. nana. All groups were subjected to parasitological, histopathological, immunohistochemical and biochemical assays. The results revealed a significant decrease in IL-4 serum level with a significant increase in gamma amino butyric acid (GABA) and decrease in zinc brain levels in GI, while GII showed non significant increase in IL-4 level that resulted in a highly significant increase in the mean number of cysticercoids and adult worms with delayed expulsion as compared to GIII. This was reflected on histopathological and immunohistochemical changes in the brain. Also, there was a highly significant increase in GABA and decrease in zinc brain levels in GII to the degree that induced behavioral changes. This emphasizes the possible synergistic effect of SB on the neurological manifestations of H. nana and could, in part, explain the increased incidence of behavioral changes in children exposed to high doses of SB and unfortunately have H. nana infection.

Use of Strobilanthes discolor T. Anders leaves in the treatment of intestinal worm infections is a common ethnobotanical practice in the Naga tribes of north-eastern part of India. In the present communication the anticestodal efficacy of Strobilanthes discolor leaf extract was investigated using Hymenolepis diminuta-rat experimental model. The effects of leaf extract were adjudged by monitoring the eggs per gram of faeces (EPG) counts and percentage worm recovery rates following treatment with methanol leaf extract of this plant to different groups of rats harbouring Hymenolepis diminuta infections. The leaf extract showed significant reductions in EPG counts as well as in recovery of surviving worms at autopsy. A notable result of the extract\'s efficacy was observed against the larval stages of parasite, where no single worm was recovered at its 800 mg/kg dose administered twice daily for 3 days. Effects of plant extract on adult stages were almost comparable with that of a standard drug, Praziquantel. The study suggests that the leaf extract of Strobilanthes discolor possesses significant anticestodal activity and supports its use in the folk medicine.