BACKGROUND: Helminth infections, including Opisthorchis viverrini, hookworm, and Trichuris trichiura, are prevalent in Khong district, Champasack province, southern Lao People\'s Democratic Republic (PDR). Schistosomiasis caused by Schistosoma mekongi is of public health concern on the islands of the Khong district. This study aimed to assess the impact of an Eco-Health/One-Health approach in combination with mass drug administration (MDA) to reduce these helminth infections.
METHODS: We conducted a community intervention using a stepped-wedge trial approach on two endemic islands (Donsom and Donkhone) of the Khong district, Champasack province, Lao PDR, between April 2012 and March 2013. In each study village, 30-40 households were randomly selected. All members of selected households, who were at home during the study period were invited to participate in the study. A baseline study was conducted to assess helminth infections, knowledge attitudes and practices toward Schistosoma mekongi infection, behavior of open defecation and availability of latrine at home. After the baseline (T0), the Eco-Health/One-Health approach was implemented on Donsom (intervention) and Donkhone island (control). An assessment was conducted in 2014 (T1), one year after the completion of intervention implementation, to assess the short-term impact of the Eco-Health/One-Health approach on helminth infections and compare intervention and control islands. Later in 2015, the Eco-Health/One-Health approach was implemented on control island (Donkhone). After the implementation of intervention, the parasitological assessments were conducted annually in humans in 2015 (T2), in 2016 (T3) and in 2017 (T4), and in dogs in 2017 (T4) to evaluate the long-term impact of the intervention on helminth infections. Frequency was used to describe the prevalence of helminth infections. Logistic regression was applied to associate the KAP (knowledge, attitudes, and practices and open defecation behavior) and the reduction of helminth infections between intervention and control islands. The reduction in prevalence pre- and post-intervention was associated using a McNemar test. A two-independent sample t-test was applied to compare the mean eggs per gram (EPG) of helminth infections between control and intervention islands. A paired t-test test was used to compare the mean EPG of stool samples before (baseline) and after (follow-up) interventions for the two islands separately. A P-value lower than 0.05 was considered statistically significant.
RESULTS: Eco-Health/One-Health approach appears to be associated with reduction in prevalence of S. mekongi by 9.0% [odds ratio (OR) = 0.49, P = 0.003] compared to the use of mass drug administration alone (control island). Additionally, this intervention package significantly reduced O. viverrini infection by 20.3% (OR = 1.92, P < 0.001) and hookworm by 17.9% (OR = 0.71, P = 0.045), respectively. Annual parasitological assessments between 2012 and 2017 showed that the Eco-Health/One-Health approach, coupled with MDA, steadily reduced the prevalence of S. mekongi on the intervention island from 29.1% to 1.8% and on the control island from 28.4% to 3.1%, respectively.
CONCLUSIONS: The study findings suggest that the Eco-Health/One-Health approach appears to be associated with a significant reduction in prevalence of S. mekongi and helminth co-infections, particularly hookworm and T. trichiura. Therefore, implementing the Eco-Health/One-Health approach in schistosomiasis-endemic areas could accelerate the achievement of national goals for transmission interruption by 2025 and elimination by 2030.

Modulating the gut microbiota is recognised as one strategy for preventing and fighting diseases. While the significant impact of diet on the gut microbiota\'s composition and function has been extensively researched, there is a notable lack of studies on the interactions between diet, microbiota, and helminth infections. Here, we used a combination of self-reported food intake and a 16S rDNA sequencing approach to analyse the composition of the gut microbiota in women of reproductive age from the two main islands of the Zanzibar archipelago, where helminth infections are endemic. We also applied a Spearman correlation analysis to food/nutrients and gut microbiota. Our results reveal that, despite close ethnic and cultural ties, the participants\' gut microbiota differs depending on their location. A nutrient intake analysis revealed deficiencies in minerals and vitamins, indicating an imbalanced diet. A correlation analysis identified bacterial taxa consistently correlated with specific food or nutrients in healthy women from both locations, and in two types of helminth infections. Escherichia/Shigella abundances, usually associated with Trichuris trichiura infection, consistently correlated with insufficient levels of vitamins B2 and B12. In conclusion, our findings suggest that the increased consumption of specific food like cassava and fish, as well as essential nutrients such as calcium, B vitamins, and vitamin A, may modulate the gut microbiota of populations residing in regions where helminth infections are endemic.

BACKGROUND: Soil-transmitted helminthiasis (STH) and schistosomiasis (SCH) are among the most prevalent neglected tropical diseases (NTDs), affecting 1.5 billion globally, with a significant burden in sub-Saharan Africa, particularly Nigeria. These diseases impair health and contribute to socio-economic challenges, especially in children, undermining educational and future economic prospects. The 2030 NTD Roadmap highlights Mass Drug Administration (MDA) as a critical strategy for controlling these NTDs, targeting vulnerable populations like school-age children. Despite some successes, challenges persist, indicating the need for deeper insights into program implementation. This study focuses on the perspectives of health workers implementing MDA in selected local government areas (LGAs) of Ogun State, Nigeria, aiming to identify challenges and enablers that align with the broader NTD 2030 goals.
RESULTS: The study used a qualitative research approach involving focus group discussions and in-depth interviews with health workers engaged in neglected tropical disease control programs in Ogun State, Nigeria, between July and September 2022. A semi-structured questionnaire guided the exploration of ideas, and the data were analyzed using the QRS Nvivo 12 software package. The study found that the school-based MDA control program\'s efficacy largely relies on strong collaborations and partnerships, particularly with educators, community heads, and other stakeholders. These alliances and strategic communication methods, like town announcements and media campaigns, have been pivotal in reaching communities. However, the program does grapple with hurdles such as parental misconceptions, limited funds, insufficient staffing, and misalignment with the Ministry of Education. It is recommended to boost funding, foster early stakeholder involvement, enhance mobilization techniques, and consider introducing a monitoring card system similar to immunization.
CONCLUSIONS: The MDA Integrated Control Programs for STH and SCH in Ogun State schools demonstrate a holistic approach, integrating knowledge, collaboration, communication, and feedback. Health workers have shown commitment and adeptness in their roles. However, achieving maximum efficacy requires addressing critical barriers, such as parental misconceptions and funding challenges. Adopting the recommended strategies, including proactive communication, increased remuneration, and introducing a tracking system, can significantly enhance the program\'s reach and impact. The involvement of all stakeholders, from health workers to community leaders and parents, is essential for the program\'s sustainability and success.

The gut microbiota has coevolved with the host for hundreds of millions of years, playing a beneficial role in host health. Human parasitic helminths are widespread and pose a pervasive global public health issue. Although Type 2 immunity provides partial resistance to helminth infections, the composition of the gut microbiota can change correspondingly. Therefore, it raises the question of what role the gut microbiota plays during helminth infection. Akkermansia muciniphila has emerged as a notable representative of beneficial microorganisms in the gut microbiota. Recent studies indicate that A. muciniphila is not merely associated with helminth infection but is also causally linked to infection. Here, we provide an overview of the crosstalk between A. muciniphila and enteric helminth infection. Our goal is to enhance our understanding of the interplay among A. muciniphila, helminths, and their hosts while also exploring the potential underlying mechanisms.

Soil-transmitted helminthiasis remains a notable health problem in developing countries. In 1990 in Shanghai, a city in eastern China, 47% of the population was affected. Due to a series of comprehensive approaches, the prevalence decreased to 0.5% in 2009. We collected 10-year surveillance data to assess the epidemic situation of soil-transmitted helminth (STH) infections in Shanghai. Stool samples and questionnaires from participants were collected. The Kato-Katz technique was used to detect infections with Ascaris lumbricoides, hookworm (Ancylostoma duodenale and Necator americanus), and Trichuris trichiura. From 2014 to 2023, a total of 77,685 participants were screened for parasitic infections, and the overall prevalence of STH infections decreased from 0.1% to 0% in Shanghai. Of 77,685 participants, 25 (0.03%) were positive for intestinal helminths, with the most common parasite being A. lumbricoides (72.0%). Generally, elderly participants from rural areas with lower education levels were more likely to be infected with STHs. A total of 2,914 questionnaires were collected, and most respondents (72.6%) had good knowledge about the transmission routes of STHs. However, 12.3% of participants did not know the damage to health caused by STHs, and 19.3% had no idea of how to prevent infection. These data demonstrate the current state of STH infections in Shanghai. The results suggest that various comprehensive measures should be encouraged, continuously implemented, and strengthened accordingly so that STH elimination can be integrated into the Healthy China initiative by 2030.

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.
［摘要］ 蠕虫感染遍布全球, 严重威胁人类健康以及畜牧业发展。阐明蠕虫与宿主间的相互作用是有效控制并最终根 除相关疾病的关键。蠕虫感染宿主后首先启动固有免疫应答, 进而介导适应性免疫应答, 在感染早期以1类免疫应答为 主, 主要发挥抗感染作用; 后期则以2类免疫应答为主, 与蠕虫免疫逃避、加重组织损伤相关。本文就蠕虫感染宿主后参 与调控1/2类免疫应答相关信号通路的研究进展进行综述。.

Different human and animal pathogens trigger distinct immune responses in their hosts. The infection of bacteria or viruses can trigger type I pro-inflammatory immune responses (e.g., IFN-γ, TNF-α, TH1 cells), whereas infection by helminths typically elicits a type II host resistance and tolerizing immune response (e.g., IL-4, IL-5, IL-13, TH2 cells). In some respects, the type I and II immune responses induced by these different classes of pathogens are antagonistic. Indeed, recent studies indicate that infection by helminths differentially shapes the response and outcome of subsequent infection by viruses and bacteria. In this review, we summarize the current knowledge on how helminth infections influence concurrent or subsequent microbial infections and also discuss the implications for helminth-mediated immunity on the outcome of SARS-CoV-2 disease.

Neglected tropical diseases, such as soil-transmitted helminths and Schistosomiasis, are prevalent in sub-Saharan Africa, particularly Ogun State, Nigeria. School-based mass drug administration program is the primary control intervention, but the coverage and uptake of this intervention have been inadequate. This study aimed to investigate community perceptions of school-based mass drug administration programs for these infections in Ogun State, Nigeria, and identify the barriers to their uptake and coverage.
The study used a qualitative research approach involving focus group discussions and in-depth interviews with community members and stakeholders engaged in neglected tropical disease control programs in Ogun State, Nigeria. A semi-structured questionnaire guided the exploration of ideas, and the data were analyzed using the QRS Nvivo 12 software package. The study found several barriers, such as the influence of parents, lack of sufficient knowledge, and side effects. The study recommended strategies such as improving community sensitization and engagement, drug distribution and performance, and enhancing partner collaboration and coordination to improve the school-based mass drug administration programs.
The study revealed correct perceptions of transmission but some misconceptions about disease causation, transmission, and drug safety. Participants expressed a desire for better sensitization campaigns and more assurances of their safety. The study recommends strengthening health education messages and increasing the visibility of on-site medical personnel. The findings have implications for improving the performance of these programs and reducing the burden of intestinal parasitic infections in the community. The study highlights the need for community engagement and education, health system support, and partner collaboration to successfully implement mass drug administration programs.

This study sought to investigate the parasitic diseases of neglected tropical diseases defined by the World Health Organization based on the Global Burden of Disease Study (GBD) database. Importantly, we analyzed the prevalence and burden of these diseases in China from 1990 to 2019 to provide valuable information to formulate more effective measures for their management and prevention.
Data on the prevalence and burden of neglected parasitic diseases in China from 1990 to 2019 were extracted from the global health data exchange (GHDx) database, including the absolute number of prevalence, age-standardized prevalence rate, disability-adjusted life year (DALY) and age-standardized DALY rate. Descriptive analysis was used to analyze the prevalence and burden changes, sex and age distribution of various parasitic diseases from 1990 to 2019. A time series model [Auto-Regressive Integrated Moving Average (ARIMA)] was used to predict the DALYs of neglected parasitic diseases in China from 2020 to 2030.
In 2019, the number of neglected parasitic diseases in China was 152518062, the age-standardized prevalence was 11614.1 (95% uncertainty interval (UI) 8758.5-15244.5), the DALYs were 955722, and the age-standardized DALY rate was 54.9 (95% UI 26.0-101.8). Among these, the age-standardized prevalence of soil-derived helminthiasis was the highest (9370.2/100,000), followed by food-borne trematodiases (1502.3/100,000) and schistosomiasis (707.1/100,000). The highest age-standardized DALY rate was for food-borne trematodiases (36.0/100,000), followed by cysticercosis (7.9/100,000) and soil-derived helminthiasis (5.6/100,000). Higher prevalence and disease burden were observed in men and the upper age group. From 1990 to 2019, the number of neglected parasitic diseases in China decreased by 30.4%, resulting in a decline in DALYs of 27.3%. The age-standardized DALY rates of most diseases were decreased, especially for soil-derived helminthiasis, schistosomiasis and food-borne trematodiases. The ARIMA prediction model showed that the disease burden of echinococcosis and cysticercosis exhibited an increasing trend, highlighting the need for further prevention and control.
Although the prevalence and disease burden of neglected parasitic diseases in China have decreased, many issues remain to be addressed. More efforts should be undertaken to improve the prevention and control strategies for different parasitic diseases. The government should prioritize multisectoral integrated control and surveillance measures to prioritize the prevention and control of diseases with a high burden of disease. In addition, the older adult population and men need to pay more attention.

BACKGROUND: Soil-transmitted helminths (STHs) were previously endemic in Shandong Province, China. This study aimed to analyze the STHs prevalence trend and the natural, social, and human cognitive and behavioural factors influencing the discrepancies between high and low infection levels from 2016 to 2020 in Shandong Province in eastern China.
METHODS: STHs surveillance data of Shandong Province from 2016 to 2020 were obtained from China Information Management System for Prevention and Control of Parasitic Diseases. STHs infections were detected by modified Kato-Katz method. Comprehensive information on the natural and social factors, STHs-related knowledge and behaviours were collected through questionnaire surveys. Retrospective spatial scan analysis was performed using SaTScan v10.1 to evaluate any identified spatial clusters of STHs infection for statistical significance and Bayes discriminant analysis was used to discriminate the high or low infection groups of the villages.
RESULTS: In total, 72,160 participants were involved in our survey from 2016 to 2020. The overall STHs prevalence rate was 1.13%, with the eastern region of Shandong Province having the highest rate (2.02%). The predominant species was T. trichiura, with the prevalence rate of 0.99% and the ≥ 70-year age group possessed the highest rate of 2.21%. The STHs prevalence rate showed an annual linear downward trend from 2016 to 2020 ([Formula: see text] = 127.600, P < 0.001). Respondents aged ≥ 60 years had the lowest awareness level of STHs-related prevention knowledge (all P < 0.05), and were the most likely to adopt the practice of fertilizing with fresh stool (χ2 = 28.354, P < 0.001). Furthermore, the southern region demonstrated the highest temperature and rainfall level and the lowest GNP and annual net income per capita (all P < 0.05).
CONCLUSIONS: There is a remarkable declining in STHs prevalence in Shandong Province from 2016 to 2020. However, the prevalence rates of STHs especially T. trichiura in the southern and eastern regions were still high, and the elderly were more susceptible to be infected with STHs owning to their low awareness level of STHS-related prevention knowledge and high adoption rate of dangerous production and living behaviours. Integrated approaches of health education, environment improvement and behaviour change should be strengthened to obtain a further reduction of STHs prevalence in China.