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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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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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.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0004909</identifier><identifier>PMID: 27548286</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>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</subject><ispartof>PLoS neglected tropical diseases, 2016-08, Vol.10 (8), p.e0004909</ispartof><rights>COPYRIGHT 2016 Public Library of Science</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. 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. PLoS Negl Trop Dis 10(8): e0004909. doi:10.1371/journal.pntd.0004909</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c624t-bce75aa39ec637e4b813563ac5f5a2fcafcda5e6bf24772797f048ac1dd4b3143</citedby><cites>FETCH-LOGICAL-c624t-bce75aa39ec637e4b813563ac5f5a2fcafcda5e6bf24772797f048ac1dd4b3143</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993485/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993485/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53770,53772,79347,79348</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27548286$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Mejia, Rojelio</contributor><creatorcontrib>Forrer, Armelle</creatorcontrib><creatorcontrib>Khieu, Virak</creatorcontrib><creatorcontrib>Schindler, Christian</creatorcontrib><creatorcontrib>Schär, Fabian</creatorcontrib><creatorcontrib>Marti, Hanspeter</creatorcontrib><creatorcontrib>Char, Meng Chuor</creatorcontrib><creatorcontrib>Muth, Sinuon</creatorcontrib><creatorcontrib>Odermatt, Peter</creatorcontrib><title>Ivermectin Treatment and Sanitation Effectively Reduce Strongyloides stercoralis Infection Risk in Rural Communities in Cambodia</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Animals</subject><subject>Antinematodal Agents - therapeutic use</subject><subject>Biology and Life Sciences</subject><subject>Cambodia - epidemiology</subject><subject>Chemotherapy</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>Community Medicine - methods</subject><subject>Confidence intervals</subject><subject>Control</subject><subject>Dosage and administration</subject><subject>Drug dosages</subject><subject>Enterobiasis</subject><subject>Epidemiology</subject><subject>Family Characteristics</subject><subject>Feces - parasitology</subject><subject>Female</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Infections</subject><subject>Ivermectin</subject><subject>Ivermectin - administration & dosage</subject><subject>Ivermectin - therapeutic use</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Parasites</subject><subject>People and Places</subject><subject>Prevalence</subject><subject>Risk Factors</subject><subject>Rural areas</subject><subject>Rural Population</subject><subject>Sanitation</subject><subject>Strongyloides stercoralis - drug effects</subject><subject>Strongyloidiasis - drug therapy</subject><subject>Strongyloidiasis - epidemiology</subject><subject>Strongyloidiasis - parasitology</subject><subject>Strongyloidiasis - prevention & control</subject><subject>Threadworm</subject><subject>Towns</subject><subject>Tropical diseases</subject><subject>Young Adult</subject><issn>1935-2735</issn><issn>1935-2727</issn><issn>1935-2735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNp1kl2LEzEUhgdR3HX1H4gOLHjXOskkk8mNsJRVCwtCd70OZ_LRps4ka5Ip9M6fbvqxSwtKAgknz_vm5OQUxXtUTVHN0Oe1H4ODfvrokppWVUV4xV8Ul4jXdIJZTV-e7C-KNzGuq4py2qLXxQVmlLS4bS6LP_ONDoOWybryIWhIg3apBKfKe3A2QbLelbfG7IiN7rflQqtR6vI-Be-W295bpWMZkw7SB-htLOduD2fZwsZfZfZdjPmknPlhGLOlzXwOzmDovLLwtnhloI_63XG9Kn5-vX2YfZ_c_fg2n93cTWSDSZp0UjMKUHMtm5pp0rWopk0NkhoK2EgwUgHVTWcwYQwzzkxFWpBIKdLViNRXxceD72PvozgWLwrU4gq3NM9MzA-E8rAWj8EOELbCgxX7gA9LASFZ2WvRKtTqjhnVcU0kazhviDItIYC7DtEqe3053jZ2g1YyFzXX4Mz0_MTZlVj6jSCc12SfzPXRIPjfo47pPykfqSXkrKwzPpvJwUYpbgjjBPEG40xN_0HlofRgpXfa2Bw_E3w6Eaw09GkVfT_ufjWeg-QAyuBjDNo8vxBVYtelT1mLXZeKY5dm2YfT6jyLntqy_gvNsueo</recordid><startdate>20160822</startdate><enddate>20160822</enddate><creator>Forrer, Armelle</creator><creator>Khieu, Virak</creator><creator>Schindler, Christian</creator><creator>Schär, Fabian</creator><creator>Marti, Hanspeter</creator><creator>Char, Meng Chuor</creator><creator>Muth, Sinuon</creator><creator>Odermatt, Peter</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7SS</scope><scope>7T2</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>F1W</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>H95</scope><scope>H97</scope><scope>K9.</scope><scope>L.G</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20160822</creationdate><title>Ivermectin Treatment and Sanitation Effectively Reduce Strongyloides stercoralis Infection Risk in Rural Communities in Cambodia</title><author>Forrer, Armelle ; Khieu, Virak ; Schindler, Christian ; Schär, Fabian ; Marti, Hanspeter ; Char, Meng Chuor ; Muth, Sinuon ; Odermatt, Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c624t-bce75aa39ec637e4b813563ac5f5a2fcafcda5e6bf24772797f048ac1dd4b3143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Animals</topic><topic>Antinematodal Agents - therapeutic use</topic><topic>Biology and Life Sciences</topic><topic>Cambodia - epidemiology</topic><topic>Chemotherapy</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>Community Medicine - methods</topic><topic>Confidence intervals</topic><topic>Control</topic><topic>Dosage and administration</topic><topic>Drug dosages</topic><topic>Enterobiasis</topic><topic>Epidemiology</topic><topic>Family Characteristics</topic><topic>Feces - parasitology</topic><topic>Female</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Infections</topic><topic>Ivermectin</topic><topic>Ivermectin - administration & dosage</topic><topic>Ivermectin - therapeutic use</topic><topic>Laboratories</topic><topic>Male</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Parasites</topic><topic>People and Places</topic><topic>Prevalence</topic><topic>Risk Factors</topic><topic>Rural areas</topic><topic>Rural Population</topic><topic>Sanitation</topic><topic>Strongyloides stercoralis - 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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. 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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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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