Effect of Mass Stool Examination and Mass Treatment For Decreasing Intestinal Helminth and Protozoan Infection Rates in Bolivian Children: A Cross-Sectional Study

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...

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Published in:	PLoS neglected tropical diseases Vol. 10; no. 12; p. e0005147
Main Authors:	Asai, Takao, Còrdova Vidal, Claudia, Strauss, Wilma, Ikoma, Toshikazu, Endoh, Kazuo, Yamamoto, Masaharu
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 06-12-2016 Public Library of Science (PLoS)
Subjects:	Adolescent Animals Anthelmintics Biology and Life Sciences Bolivia - epidemiology Child Child, Preschool Children Cross-Sectional Studies Diagnosis Drug therapy Entamoeba histolytica - isolation & purification Entamoebiasis - drug therapy Entamoebiasis - epidemiology Entamoebiasis - parasitology Entamoebiasis - prevention & control Feces - parasitology Female Giardia lamblia - isolation & purification Giardiasis - drug therapy Giardiasis - epidemiology Giardiasis - parasitology Giardiasis - prevention & control Health aspects Helminthiasis Helminthiasis - drug therapy Helminthiasis - epidemiology Helminthiasis - parasitology Helminthiasis - prevention & control Humans Hymenolepiasis - drug therapy Hymenolepiasis - epidemiology Hymenolepiasis - parasitology Hymenolepiasis - prevention & control Hymenolepis - isolation & purification Infections Intestinal Diseases, Parasitic - drug therapy Intestinal Diseases, Parasitic - epidemiology Intestinal Diseases, Parasitic - prevention & control Male Mass Screening Medical technology Medicine and Health Sciences Parasites Prevalence Protozoa Protozoan Infections - epidemiology Sedimentation & deposition Students Thiazoles - therapeutic use Tropical diseases Young Adult Bolivia
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 The authors have declared that no competing interests exist. Conceived and designed the experiments: TA MY.Performed the experiments: CCV WS.Analyzed the data: TI KE.Contributed reagents/materials/analysis tools: CCV.Wrote the paper: TA MY.
ISSN:	1935-2735 1935-2727 1935-2735
DOI:	10.1371/journal.pntd.0005147