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•We present novel clinical data and unique findings on the microbiome of villagers from a rural area of the Philippines.•This builds on cohorts of individuals with well-defined ...polyparasitism through DNA sequencing-based microbiome profiling.•The cohorts size and complexity of helminth infections presented new host microbiome associations.•The number or diversity of worm species present also increases the richness of the host microbiome.•Bacterial associations with helminth infection status and complexity provided highly statistically significant findings.
Polyparasitism, involving soil-transmitted helminths. and Schistosoma blood flukes, is common in low to middle income countries. These helminths impact on the gut environment and can cause changes to the gut microbiome composition. Here we examined the gut microbiome in individuals with polyparasitism from two human cohorts in the Philippines utilising DNA sequencing-based profiling. Multiple helminth species infections were high with 70.3% of study participants harbouring at least two parasite species, and 16% harbouring at least five species. Increased numbers of helminth co-infections, in particular with the gut-resident soil-transmitted helminths, were significantly associated with increased bacterial diversity; however no significant parasite-gut microbiome associations were evident for individuals infected only with Schistosoma japonicum. In general, a healthy gut is associated with high bacterial diversity, which in these human cohorts may be the result of helminth-mediated immune modulation, or due to changes in the gut environment caused by these parasitic helminths.
We explored differences in distress scores at intake as well as the change in anxiety and depression scores over the course of 12 therapy sessions for Native Hawaiian and Pacific Islander (NHPI) ...college students. Data were collected from the Center for Collegiate Mental Health (N = 256,242). Results support the notion that NHPI college students experience anxiety and depression in therapy differently from other ethnic groups with moderate‐to‐large magnitudes of effect.
In many countries, a clear dose–response relationship exists between ACEs score and mental illness, addiction, poor diet, medication non-adherence, utilisation of health services and chronic ...morbidity throughout one’s lifespan.1 2 During childhood, exposure to multiple ACEs is associated with delayed brain and cognitive development, impaired mental health, compromised academic performance and social-behavioural issues.1 In later life, experiencing four or more ACEs is associated with risk behaviours including smoking, alcohol and drug use, sexual risk-taking, interpersonal and self-directed violence, and homelessness.1 2 Consequently, individuals with higher ACEs scores are at an elevated risk of developing non-communicable diseases (NCDs), including cancers, circulatory diseases, chronic respiratory diseases and metabolic disorders in adulthood.2 The burden resulting from childhood abuse and/or neglect is significantly higher among specific sociodemographic groups. The ‘Aboriginal health gap’ refers to long-standing disparities between Australian Indigenous and non-Indigenous populations observed with various health indicators, including life expectancy, NCD prevalence, health service access, nutrition and overall well-being. ...there continues to be a substantial difference in socioeconomic conditions, and healthcare access that further exacerbates the gaps.10 11 The Australian Institute of Health and Welfare’s (2019) estimates reveal a consistent and substantial disparity in disease-specific age-standardised mortality rates for the leading causes of death between Indigenous and Non-Indigenous Australians (figure 2).12 Indigenous Australians experience a 1.5-fold higher age-standardised mortality rate (229 per 100 000 people) for heart diseases and cancers compared with non-indigenous Australians (151 per 100 000 people), while for diabetes, this rate is 5-fold higher (74 per 100 000 compared with 16 per 100 000).12 From 2006 to 2019, there was an annual average increase of 67 per 100 000 people in age-standardised mortality rates for Indigenous Australians, whereas non-Indigenous Australians experienced a decrease of 6 per 100 000 people during the same period.12 Figure 2. Beyond genetic predisposition, the connection of intergenerational trauma and exposure to ACEs in Indigenous Australians is influenced by systemic racism resulting in overlapping economic deprivation, compromised family dynamics, poor physical and mental health, and substance dependence.14 15 Available studies suggest no substantial difference in the prevalence of at least one childhood trauma between Indigenous people (64%) and the general population (62%).4 16–19 However, consensus among these studies indicates that Indigenous populations have a notably higher prevalence of multiple ACEs, including physical, sexual abuse and domestic violence, compared with the non-Indigenous population (table 1).4 16–19 Table 1 ACEs spectrum by Indigenous status Indigenous population (%) General population (%) ACEs≥4 64.0 28.0 Abuse Physical abuse 17.3 8.5 Sexual abuse 14.6 7.7 Physical and sexual abuse 23.1 13.4 Neglect (physical and emotional) 52.5 18.0 Household dysfunction Parental mental illness† – 33.0 Parental incarceration† – 10.0 Parental substance abuse 52.2 24.0 Domestic violence 41.2 18.0 Parental divorce† – 37.0 Housing instability 56.6 18.0 *Data sources:
Preventive chemotherapy is the current global control strategy for schistosomiasis. The WHO target coverage rate is at least 75% for school-aged children. In the Philippines, the reported national ...coverage rate (43.5%) is far below the WHO target. This study examined the factors associated with non-compliance to mass drug administration.
A cross-sectional survey was conducted in 2015 among 2189 adults in the province of Northern Samar, the Philippines using a structured face-to-face survey questionnaire.
The overall rate of non-compliance to mass drug administration (MDA) in the last treatment round was 27%. Females (aOR = 1.67, P = 0.033) were more likely to be non-compliant. Respondents who believed that schistosomiasis was acquired by open defecation and poor sanitation (aOR = 1.41, P = 0.015), and by drinking unclean water (aOR = 2.09, P = 0.001) were more likely to refuse treatment. Uncertainties on whether schistosomiasis can be treated (aOR = 2.39, P = 0.033), their fear of adverse reactions to praziquantel (aOR = 1.94, P = 0.021), misconceptions about alternative forms of treatment (aOR = 1.45, P = 0.037), and that praziquantel is used for purposes other than deworming (aOR = 2.15, P = 0.021) were all associated with a higher odd of non-compliance. In contrary, being a farmer (aOR = 0.62, P =0.038), participation in past MDA (aOR = 0.30, P < 0.001), informed about impending MDA (aOR = 0.08, P < 0.001), and having heard of schistosomiasis (aOR = 0.22, P = 0.045) were all significantly associated with reduced non-compliance.
To improve drug compliance for schistosomiasis there is an urgent need for intensive health education campaigns before conducting MDA that would not only provide disease specific information, but also deal with prevailing misconceptions about transmission, prevention, treatment, and drug side-effects.
Summary Background A cross-sectional survey was performed in 2012 among 18 rural barangays in Northern Samar, the Philippines in order to determine the prevalence of single and multiple species ...helminth infections and the underlying risk factors of acquiring one or more parasites. Methods A total of 6976 participants who completed a medical questionnaire and provided a stool sample for examination were included in the final analysis. Results The overall prevalence rates of Schistosoma japonicum , Ascaris lumbricoides , Trichuris trichiura , and hookworm were found to be moderate to high at 28.9%, 36.5%, 61.8%, and 28.4%, respectively. However, the prevalence of harbouring any of the helminths was found to be higher at 75.6%. Significant variation was evident among the predicted barangay-specific random effects for infection with S. japonicum (barangay variance of 0.66, 95% confidence interval 0.31–1.40) and for any helminth infection (barangay variance of 0.63, 95% confidence interval 0.30–1.29). The predictive models showed, with greater than 80% sensitivity and specificity, that low socio-economic status, low levels of education, poor sanitation, proximity to water sources, occupation (i.e., farming and fishing), and male sex were all reliable indicators of infection status. Conclusions This study will aid in the targeting of limited resources for national treatment and WASH (water, sanitation, and hygiene) efforts in low- and middle-income countries.
Immune responses that target sialidase occur following natural cholera and have been associated with protection against cholera. Sialidase is a neuraminidase that facilitates the binding of cholera ...toxin (CT) to intestinal epithelial cells. Despite this, little is known about age-related sialidase-specific immune responses and the impact of nutritional status and co-infection on sialidase-specific immunity.
We enrolled 50 culture-confirmed
O1 cholera cases presenting to the icddr,b Dhaka hospital with moderate to severe dehydration. We evaluated antibody responses out to 18 months (day 540) following cholera. We assessed immune responses targeting sialidase, lipopolysaccharide (LPS), cholera toxin B subunit (CtxB), and vibriocidal responses. We also explored the association of sialidase-specific immune responses to nutritional parameters and parasitic co-infection of cases.
This longitudinal cohort study showed age-dependent differences in anti-sialidase immune response after natural cholera infection. Adult patients developed plasma anti-sialidase IgA and IgG responses after acute infection (P<0.05), which gradually decreased from day 30 on. In children, no significant anti-sialidase IgA, IgM, and IgG response was seen with the exception of a late IgG response at study day 540 (p=0.05 compared to adults). There was a correlation between anti-sialidase IgA with vibriocidal titers, as well as anti-sialidase IgA and IgG with anti-LPS and anti-CtxB antibody responses in adult patients, whereas in children, a significant positive correlation was seen only between anti-sialidase IgA and CtxB IgA responses. Stunted children showed significantly lower anti-sialidase IgA, IgG, and IgM antibody responses and higher LPS IgG and IgM antibody responses than healthy children. The anti-sialidase IgA and IgG responses were significantly higher in cases with concomitant parasitic infection.
Our data suggest that cholera patients develop age-distinct systemic and mucosal immune responses against sialidase. The stunted children have a lower anti-sialidase antibody response which may be associated with gut enteropathy and the neuraminidase plays an important role in augmented immune response in cholera patients infected with parasites.
Schistosoma japonicum is stubbornly persistent in China and the Philippines. Fast and accurate diagnostic tools are required to monitor effective control measures against schistosomiasis japonica. ...Promising antigen candidates for the serological diagnosis of schistosomiasis japonica have generally been identified from the Chinese strain of S. japonicum. However, the Chinese (SjC) and Philippine (SjP) strains of S. japonicum express a number of clear phenotypic differences, including aspects of host immune responses. This feature thereby emphasized the requirement to determine whether antigens identified as having diagnostic value for SjC infection are also suitable for the diagnosis of SjP infection. In the current study, 10 antigens were selected for comparison of diagnostic performance of the SjP infection using ELISA. On testing of sera from 180 subjects in the Philippines, SjSAP4 exhibited the best diagnostic performance with 94.03% sensitivity and 98.33% specificity using an optimized serum dilution. In another large scale testing with 412 serum samples, a combination (SjSAP4+Sj23-LHD (large hydrophilic domain)) provided the best diagnostic outcome with 87.04% sensitivity and 96.67% specificity. This combination could be used in future for serological diagnosis of schistosomiasis in the Philippines, thereby representing an important component for monitoring integrated control measures.
•Sj23-LHD was the most promising antigen candidate for early diagnosis of schistosomiasis japonica in a murine model.•SjSAP4+Sj23-LHD had the highest diagnostic value when probed with sera from a human cohort with low infection intensity.•We have developed a novel diagnostic tool that can aid in the integrated control of schistosomiasis in the Philippines.
Schistosomiasis japonica remains a major public health concern in China and the Philippines. Development of accurate and affordable diagnostic tools is a necessity for the control and elimination of schistosomiasis. The differences in the mammalian host immunological responses to Chinese (SjC) and Philippine (SjP) strains of S. japonicum necessitated validation of proven SjC serological markers for application in the diagnosis of SjP infections. Ten antigens were selected for comparison, in ELISA, for their potential of the diagnosis of SjP infection. The results provide the basis for developing an affordable and easy-to-operate tool for the diagnosis of schistosomiasis in the Philippines.
Understanding the specific geospatial variations in childhood stunting is essential for aligning appropriate health services to where new and/or additional nutritional interventions are required to ...achieve the Sustainable Development Goals (SDGs) and national targets.
We described local variations in the prevalence of childhood stunting at the second administrative level and its determinants in Nigeria after accounting for the influence of geospatial dependencies.
This study used the 2018 national Nigeria Demographic and Health Survey datasets (NDHS; N = 12,627). We used a Bayesian geostatistical modelling approach to investigate the prevalence of stunting at the second administrative level and its proximal and contextual determinants among children under five years of age in Nigeria.
In 2018, the overall prevalence of childhood stunting in Nigeria was 41.5% (95% credible interval (CrI) from 26.4% to 55.7%). There were striking variations in the prevalence of stunting that ranged from 2.0% in Shomolu in Lagos State, Southern Nigeria to 66.4% in Biriniwa in Jigawa State, Northern Nigeria. Factors positively associated with stunting included being perceived as small at the time of birth and experience of three or more episodes of diarrhoea in the two weeks before the survey. Children whose mothers received a formal education and/or were overweight or obese were less likely to be stunted compared to their counterparts. Children who were from rich households, resided in households with improved cooking fuel, resided in urban centres, and lived in medium-rainfall geographic locations were also less likely to be stunted.
The study findings showed wide variations in childhood stunting in Nigeria, suggesting the need for a realignment of health services to the poorest regions of Northern Nigeria.
Developing programs that ensure a safe start to life for Indigenous children can lead to better health outcomes. To create effective strategies, governments must have accurate and up-to-date ...information. Accordingly, we reviewed the health disparities of Australian children in Indigenous and remote communities using publicly available reports. A thorough search was performed on Australian government and other organisational websites (including the Australian Bureau of Statistics ABS and the Australian Institute of Health and Welfare AIHW), electronic databases MEDLINE and grey literature sites for articles, documents and project reports related to Indigenous child health outcomes. The study showed Indigenous dwellings had higher rates of crowding when compared to non-Indigenous dwellings. Smoking during pregnancy, teenage motherhood, low birth weight and infant and child mortality were higher among Indigenous and remote communities. Childhood obesity (including central obesity) and inadequate fruit consumption rates were also higher in Indigenous children, but Indigenous children from remote and very remote areas had a lower rate of obesity. Indigenous children performed better in physical activity compared to non-Indigenous children. No difference was observed in vegetable consumption rates, substance-use disorders or mental health conditions between Indigenous and non-Indigenous children. Future interventions for Indigenous children should focus on modifiable risk factors, including unhealthy housing, perinatal adverse health outcomes, childhood obesity, poor dietary intake, physical inactivity and sedentary behaviours.
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