BACKGROUND: Achieving the elimination of soil-transmitted helminth (STH) infections requires a sufficient understanding of the current epidemiological status of STH endemicity. We aimed to examine the status of STH in Myanmar - a country with the eighth highest STH prevalence in the world, 10 years after instigation of the national deworming programme.
METHODS: In August 2016 we screened for STH infections using Kato Katz (KK) microscopy and real-time PCR (qPCR) in schoolchildren from the Bago Region township of Phyu, a STH sentinel site in Myanmar. Ten schools were randomly selected, and one stool sample each from a total of 264 students was examined. Prevalence and intensity of infection were calculated for each STH.
RESULTS: High prevalence of STH was identified in the study area with 78.8% of the schoolchildren infected with at least one STH by qPCR, and 33.3% by KK. The most prevalent STH was Trichuris trichiura, diagnosed by both KK (26.1%) and qPCR (67.1%), followed by Ascaris lumbricoides (15.5% KK; 54.9% qPCR). No hookworm infections were identified by KK; however, the qPCR analysis showed a high prevalence of Ancylostoma sp. infection (29.6%) with few Necator americanus (1.1%) infections.
CONCLUSIONS: Despite bi-annual deworming of schoolchildren in the fourth-grade and below, STH prevalence remains stubbornly high. These results informed the expansion of the Myanmar National STH control programme to include all school-aged children by the Ministry of Health and Sports in 2017, however further expansion to the whole community should be considered along with improving sanitation and hygiene measures. This would be augmented by rigorous monitoring and evaluation, including national prevalence surveys.

OBJECTIVE: To understand the prevalence of soil-borne nematode infections among residents living in urban/town areas of China, so as to provide insights into the control and elimination of soil-borne nematodiasis.
METHODS: A total of 5 epidemic areas were classified in China according to the prevalence of human Clonorchis sinensis infections captured from the 2014-2015 national survey on major human parasitic diseases in China, and the total sample size was estimated according to the binomial distribution and Poisson\'s distribution. Then, the total sample size was allocated proportionally to each province (autonomous region, municipality) of China based on the percentage of residents living in urban and town areas, and the number of survey sites in each province (autonomous region, municipality) was proportionally assigned according to the percentages of residents living in urban and town areas. Then, stratified sampling was performed at county, township and community levels according to the number of sampling sites in each province (autonomous region, municipality), and the survey site (community) was defined as the smallest sampling unit. All permanent residents in the survey sites were selected as the study subjects, and their stool samples were collected for identification and counting of parasite egg using a Kato-Katz technique. The prevalence and intensity of each parasite species were calculated.
RESULTS: From 2014 to 2015, among the 133 231 residents detected in 31 provinces (autonomous regions, municipalities) of China, the overall prevalence of soil-borne nematode infections was 1.23% (1 636/133 231), and the prevalence rates of hookworm, Ascaris lumbricoides and Trichuris trichiura infections were 0.77% (1 032/133 231), 0.32% (426/133 231) and 0.17% (224/133 231), respectively. The highest prevalence of soil-borne nematode infections was seen in Jiangxi (4.03%, 82/2 034) and Chongqing (4.03%, 524/13 012), followed by in Hainan (3.47%, 72/2 075). The prevalence of soilborne nematode infections was 1.07% (662/62 139) in men and 1.37% (974/71 092) in women, and the greatest prevalence was found in residents at ages of 65 to 70 years (2.56%, 219/8 569). With regard to occupations and education levels, herdsmen (2.47%, 2/81) and illiterate residents (3.33%, 226/6 795) were found to have the highest prevalence of soil-borne nematode infections, respectively. In addition, mild infections were predominantly identified in hookworm-, A. lumbricoides- and T. trichiura-infected individuals (all > 90%).
CONCLUSIONS: The overall prevalence of soil-borne nematodiasis remains low in urban and town areas of China; however, human infections are widespread. According to the epidemiological features, health education combined with deworming are recommended to reduce the prevalence of soil-borne nematode infections among residents living in urban and town areas of China.
［摘要］ 目的 了解我国城镇地区居民土源性线虫病流行状况, 为土源性线虫病防控与消除提供参考。方法 根据2014–2015年全国人体重点寄生虫病现状调查, 按人群华支睾吸虫感染率将全国划分为5类流行区, 采用二项分布和泊松分布计算总样本量, 将总样本量按城镇人口占比等比例分配到各省份, 各省份调查点数再按辖区城区和镇区人口占比等比例分配。各省份根据调查点数, 自县 (市、区) 、乡 (镇、街道) 和居委会分级抽样, 调查点 (居委会) 为最小抽样单位。以调查点内常住人口作为调查对象, 收集其粪便标本, 采用改良加藤厚涂片法 (1粪2检) 鉴别土源性线虫虫卵并计数, 计算各虫种感染率及感染度。结果 2014–2015年, 全国31个省 (直辖市、自治区) 共调查城镇居民133 231人, 土源性线虫感染率为1.23% (1 636/133 231), 其中钩虫、蛔虫和鞭虫感染率分别为0.77% (1 032/133 231) 、0.32% (426/133 231) 和 0.17% (224/133 231) 。全国城镇居民土源性线虫感染率以江西省 (82/2 034) 和重庆市 (524/13 012) 最高, 均为4.03%; 其次为海南省, 感染率为3.47% (72/2 075) 。男、女性居民土源性线虫感染率分别为1.07% (662/62 139) 和1.37% (974/71 092) 。土源性线虫感染率以65～70岁年龄组居民最高, 为2.56% (219/8 569) ; 各职业中, 以牧民感染率最高[2.47% (2/81) ]; 不同文化程度居民中, 以文盲感染率最高[3.33% (226/6 795) ]。钩虫、蛔虫和鞭虫轻度感染者所占比例均＞ 90%。结论 我国城镇居民土源性线虫病流行总体处于较低水平, 但分布较广泛。针对城镇地区土源性线虫病流行特点, 可采取健康教育和药物驱虫相结合的措施, 以降低居民感染率。.

Soil-transmitted helminths (STHs) are widely distributed and remain a public health problem in the People\'s Republic of China. Altogether, 301 counties across 30 regions were investigated during the national surveillance on STHs carried out in 2016 based on the modified Kato-Katz thick smear method to examine faecal samples. A total of 305 081 people were investigated with 7 366 (2.4%) found to be infected. The infection rates were the following: hookworm 1.4%, Ascaris lumbricoides 0.8% and Trichuris trichiura 0.5%. Having established that the STHs infection rate is relatively low, it is time to move towards elimination. The national surveillance system is essential for providing basic data and formulation of useful control strategies towards achieving this goal.

OBJECTIVE: To investigate the prevalence and risk factors of helminthic infections including Schistosoma japonicum, Ascaris lumbricoides and Trichuris trichiura and human immunodeficiency virus (HIV), and find out the association among them in a rural community of southwestern China.
METHODS: A community-based cross sectional study was conducted. One town was selected randomly; the infections of S.japonicum, A.lumbricoides and T.trichiura were detected with the modified Kato-Katz thick smear method and HIV infection with the diagnostic Test Kit among all residents. A questionnaire survey was conducted to investigate the related risk factors.
RESULTS: Among the participants, the infection rates of HIV, S.japonicum, A.lumbricoides and T.trichiura were 2.33%, 2.05%, 13.47% and 30.59% respectively; 7.08% (31/438) were infected with both A.lumbricoides and T.trichiura; 0.23% (1/438) were co-infected with HIV and A.lumbricoides, and the same with HIV and T.trichiura. The multivariate logistic regression analysis showed that sex (male, OR=3.26, 95% CI：0.97, 10.95) and drug abuse (OR=72.86, 95% CI：18.51, 286.76) were significantly associated with HIV infection. Home toilet was negatively related to A.lumbricoides infection (OR=0.52, 95% CI：0.27, 0.98) and T.trichiura infection (OR=0.48, 95% CI：0.28, 0.80). Compared with the people in Villages Four, the people living in Village One were at a higher risk for A.lumbricoides infection (OR=3.14, 95% CI：1.35, 7.27), and compared with the people living in Village Four, the people living in Village Two and Village Three were more likely to be infected with T.trichiura (OR=3.73, 95% CI：1.92, 7.26; OR=4.53, 95% CI：2.12, 9.68). The people aged between 11 and 20 years had a higher T.trichiura infection risk than the people aged more than 50 years (OR = 3.72, 95% CI：1.59, 8.67). There was a significant association between A.lumbricoides and T.trichiura infections (OR = 3.11, 95% CI：1.63, 5.93). There was no association between S.japonicum infection and related factors above mentioned.
CONCLUSIONS: The infection rates of HIV, S.japonicum, A.lumbricoides and especially T.trichiura were rather high in this area, and therefore, the prevention and treatment of these diseases should be strengthened. Further studies on the relationship between HIV and the infections of helminths, especially S.japonicum are needed.
［摘要］ 目的 了解我国西南彝族农村地区HIV、血吸虫、蛔虫及鞭虫感染状况, 调查是否存在混合感染。方法 在我 国西南部某山区随机选取一个彝族乡开展横断面调查, 检测村民HIV、血吸虫、蛔虫及鞭虫感染情况; 并对村民进行问卷 调查, 了解HIV及寄生虫感染的危险因素。结果 我国西南彝族农村地区居民HIV、血吸虫、蛔虫和鞭虫感染率分别为 2.33%、2.05%、13.47%和30.59%, 鞭虫与蛔虫共同感染检出率为7.08%, HIV与蛔虫和鞭虫共同感染检出率均为0.23%。 男性以及吸毒是HIV感染的危险因素［OR = 3.26, 95% CI： (0.97, 10.95); OR = 72.86, 95% CI： (18.51, 286.76)]; 厕所与蛔 虫和鞭虫感染间均存在负相关关系［OR = 0.51, 95% CI： (0.27, 0.98); OR = 0.48, 95% CI： (0.28, 0.80)］。与居住在村4的 居民相比, 村1村民感染蛔虫风险较高［OR = 3.14, 95% CI： (1.35, 7.27)]; 与居住在村4的居民相比, 居住在村2和村3的 村民鞭虫感染风险较高［OR = 3.73, 95% CI： (1.92, 7.26); OR = 4.53, 95% CI： (2.12, 9.68)]。此外, 11～20岁年龄组村民 鞭虫感染风险高于>50岁村民［OR = 3.72, 95% CI： (1.59, 8.67)]; 蛔虫与鞭虫感染间存在相关关系［OR = 3.11, 95% CI： (1.63, 5.93)], 未发现与血吸虫感染相关的因素。结论 我国西南彝族农村居民HIV及寄生虫感染率尤其是鞭虫感染 率较高; 应进一步探索HIV与寄生虫感染, 尤其是与血吸虫感染间的关系。.

Trichuriasis is soil-source parasitic disease, usually endemic in warm, humid, tropical and subtropical countries. We report a case of trichuriasis diagnosed by colonoscopy performed in a non-endemic area and review the literature on the colonoscopic diagnosis of Trichuris trichiura spanning 22 years (1989-2011) in mainland China. A total of 4382 trichuriasis cases were diagnosed by colonoscopy out of 41,337 patients who underwent colonoscopy. Most of the patients were cured by unloading the whipworms using colonoscopy pincers. We strongly suggest colonoscopy as a useful diagnostic and treatment tool, especially when the patient is lightly infected or is infected by only a few male worms with no eggs in the stool. The geographical distribution, parasite burden, and the parasitizing locations of T. trichiura in the intestine of the human body were analyzed, and the clinical signs and symptoms, as well as the utility of colonoscopy in the diagnosis and treatment of trichuriasis are discussed.