Ivermectin Treatment and Sanitation Effectively Reduce Strongyloides stercoralis Infection Risk in Rural Communities in Cambodia

Strongyloides stercoralis is the only soil-transmitted helminth with the ability to replicate within its host, leading to long-lasting and potentially fatal infections. It is ubiquitous and its worldwide prevalence has recently been estimated to be at least half that of hookworm. Information on the...

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Veröffentlicht in:PLoS neglected tropical diseases 2016-08, Vol.10 (8), p.e0004909
Hauptverfasser: Forrer, Armelle, Khieu, Virak, Schindler, Christian, Schär, Fabian, Marti, Hanspeter, Char, Meng Chuor, Muth, Sinuon, Odermatt, Peter
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container_issue 8
container_start_page e0004909
container_title PLoS neglected tropical diseases
container_volume 10
creator Forrer, Armelle
Khieu, Virak
Schindler, Christian
Schär, Fabian
Marti, Hanspeter
Char, Meng Chuor
Muth, Sinuon
Odermatt, Peter
description Strongyloides stercoralis is the only soil-transmitted helminth with the ability to replicate within its host, leading to long-lasting and potentially fatal infections. It is ubiquitous and its worldwide prevalence has recently been estimated to be at least half that of hookworm. Information on the epidemiology of S. stercoralis remains scarce and modalities for its large-scale control are yet to be determined. A community-based two-year cohort study was conducted among the general population in a rural province in North Cambodia. At each survey, participants infected with S. stercoralis were treated with a single oral dose of ivermectin (200μg/kg BW). Diagnosis was performed using a combination of the Baermann method and Koga agar plate culture on two stool samples. The cohort included participants from eight villages who were either positive or negative for S. stercoralis at baseline. Mixed logistic regression models were employed to assess risk factors for S. stercoralis infection at baseline and re-infection at follow-up. A total of 3,096 participants were examined at baseline, revealing a S. stercoralis prevalence of 33.1%. Of these participants, 1,269 were followed-up over two years. Re-infection and infection rates among positive and negative participants at baseline were 14.4% and 9.6% at the first and 11.0% and 11.5% at the second follow-up, respectively. At follow-up, all age groups were at similar risk of acquiring an infection, while infection risk significantly decreased with increasing village sanitation coverage. Chemotherapy-based control of S. stercoralis is feasible and highly beneficial, particularly in combination with improved sanitation. The impact of community-based ivermectin treatment on S. stercoralis was high, with over 85% of villagers remaining negative one year after treatment. The integration of S. stercoralis into existing STH control programs should be considered without further delay.
doi_str_mv 10.1371/journal.pntd.0004909
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It is ubiquitous and its worldwide prevalence has recently been estimated to be at least half that of hookworm. Information on the epidemiology of S. stercoralis remains scarce and modalities for its large-scale control are yet to be determined. A community-based two-year cohort study was conducted among the general population in a rural province in North Cambodia. At each survey, participants infected with S. stercoralis were treated with a single oral dose of ivermectin (200μg/kg BW). Diagnosis was performed using a combination of the Baermann method and Koga agar plate culture on two stool samples. The cohort included participants from eight villages who were either positive or negative for S. stercoralis at baseline. Mixed logistic regression models were employed to assess risk factors for S. stercoralis infection at baseline and re-infection at follow-up. A total of 3,096 participants were examined at baseline, revealing a S. stercoralis prevalence of 33.1%. Of these participants, 1,269 were followed-up over two years. Re-infection and infection rates among positive and negative participants at baseline were 14.4% and 9.6% at the first and 11.0% and 11.5% at the second follow-up, respectively. At follow-up, all age groups were at similar risk of acquiring an infection, while infection risk significantly decreased with increasing village sanitation coverage. Chemotherapy-based control of S. stercoralis is feasible and highly beneficial, particularly in combination with improved sanitation. The impact of community-based ivermectin treatment on S. stercoralis was high, with over 85% of villagers remaining negative one year after treatment. 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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Infection Risk in Rural Communities in Cambodia. PLoS Negl Trop Dis 10(8): e0004909. doi:10.1371/journal.pntd.0004909</rights><rights>2016 Forrer et al 2016 Forrer et al</rights><rights>2016 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Infection Risk in Rural Communities in Cambodia. 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Of these participants, 1,269 were followed-up over two years. Re-infection and infection rates among positive and negative participants at baseline were 14.4% and 9.6% at the first and 11.0% and 11.5% at the second follow-up, respectively. At follow-up, all age groups were at similar risk of acquiring an infection, while infection risk significantly decreased with increasing village sanitation coverage. Chemotherapy-based control of S. stercoralis is feasible and highly beneficial, particularly in combination with improved sanitation. The impact of community-based ivermectin treatment on S. stercoralis was high, with over 85% of villagers remaining negative one year after treatment. The integration of S. stercoralis into existing STH control programs should be considered without further delay.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27548286</pmid><doi>10.1371/journal.pntd.0004909</doi><oa>free_for_read</oa></addata></record>
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source MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; Public Library of Science (PLoS); PubMed Central
subjects Adolescent
Adult
Age
Animals
Antinematodal Agents - therapeutic use
Biology and Life Sciences
Cambodia - epidemiology
Chemotherapy
Child
Child, Preschool
Cohort Studies
Community Medicine - methods
Confidence intervals
Control
Dosage and administration
Drug dosages
Enterobiasis
Epidemiology
Family Characteristics
Feces - parasitology
Female
Health aspects
Humans
Infections
Ivermectin
Ivermectin - administration & dosage
Ivermectin - therapeutic use
Laboratories
Male
Medicine and Health Sciences
Middle Aged
Parasites
People and Places
Prevalence
Risk Factors
Rural areas
Rural Population
Sanitation
Strongyloides stercoralis - drug effects
Strongyloidiasis - drug therapy
Strongyloidiasis - epidemiology
Strongyloidiasis - parasitology
Strongyloidiasis - prevention & control
Threadworm
Towns
Tropical diseases
Young Adult
title Ivermectin Treatment and Sanitation Effectively Reduce Strongyloides stercoralis Infection Risk in Rural Communities in Cambodia
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