There is no doubt that on a global basis, Haemonchus contortus is by far the most important parasite of small ruminants (sheep and goats). This is particularly more so now, with the development of high levels of resistance to both the broad and narrow spectrum anthelmintic drugs in H. contortus throughout the world. Epidemiological studies describe the lower environmental limits for haemonchosis to occur in sheep, as being a mean monthly temperature of 18C and approximately 50mm rainfall. Thus it has been generally recognised that H. contortus is a problem parasite restricted to the warm, wet countries where sheep and goats are raised. However, recent evidence shows that this parasite is apparently common even in northern Europe. Thus the need for sustainable control strategies for H. contortus is becoming much more pressing. This report highlights two examples of sustainable and highly efficient control programmes for H. contortus, that can be implemented in regions at the extremes of its geographic range (Malaysia and Sweden), where the authors have had direct involvement.
The World Health Organization has recommended the application of mass drug administration (MDA) in treating high prevalence neglected tropical diseases such as soil-transmitted helminths (STHs), schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma. MDA-which is safe, effective and inexpensive-has been widely applied to eliminate or interrupt the transmission of STHs in particular and has been offered to people in endemic regions without requiring individual diagnosis. We propose two mathematical models to investigate the impact of MDA on the mean number of worms in both treated and untreated human subpopulations. By varying the efficay of drugs, initial conditions of the models, coverage and frequency of MDA (both annual and biannual), we examine the dynamic behaviour of both models and the possibility of interruption of transmission. Both models predict that the interruption of transmission is possible if the drug efficacy is sufficiently high, but STH infection remains endemic if the drug efficacy is sufficiently low. In between these two critical values, the two models produce different predictions. By applying an additional round of biannual and annual MDA, we find that interruption of transmission is likely to happen in both cases with lower drug efficacy. In order to interrupt the transmission of STH or eliminate the infection efficiently and effectively, it is crucial to identify the appropriate efficacy of drug, coverage, frequency, timing and number of rounds of MDA.
Despite the intensive global efforts to control intestinal parasitic infections, the prevalence of soil-transmitted helminth (STH) infections is still very high in many developing countries particularly among children in rural areas.
The purpose of this study is to see the anthelmintic activity potential of papaya seeds against Hymenolepis diminuta in rats. The objectives of this study were: (1) to determine the effectiveness of papaya seeds on helminths especially H. diminuta in rats and (2) to determine the effective dose level on helminths in rats. Thirty six male rats from strain Sprague-Dawley were chosen as samples in this experiment. Two types of dose level were used for papaya seeds treatments such as 0.6 g kg-1 and 1.2 g kg-1. The geometric mean (GEM) was used to calculate mean for eggs per gram (EPG) before and after the treatment to be included in the reduction percentage calculation. After 21 days post treatment, necropsies were done to get the worm count and the GEM was used to calculate the efficacy percentage for the treatment. Results from this study showed that the reduction percentages in EPG for papaya seeds treatment for both doses level were very high which is 96.8% for 0.6g kg-1 dose level and 96.2% for 1.2 g kg-1 dose level. Whereas the efficacy percentage based on the worm counts for both doses level were also very high that was 90.77% for 0.6 g kg-1 dose level and 93.85% for 1.2 g kg-1.
The health impact of a Malaysian national helminth control program which provided school-based anthelmintic chemotherapy from 1974 to 1983 was re-visited after three decades post MDA and associated risk factors amongst urban poor communities identified. Stool samples collected were screened using the formalin ethyl-acetate concentration technique recovered at least one species of helminth and/or protozoan. Despite a steady decline observed between 1974-1983 however, post MDA infections continue to persist in pockets of communities moderately (18.9%; n=39/206) with higher infection recorded amongst PPR flat residents (22.5%, n=16/71). Among risk factors identified, waste management method was the primary factor for Ascaris lumbricoides infections (n=33; 16.0%), whereas age, education, employment and source of drinking water were significant risk factors for cryptosporidiosis. Despite the government's efforts to improve health through the provision of basic amenities to the general public, higher prevalence values amongst PPR flat dwellers suggests the need to implement targeted chemotherapeutic treatment of, once a year deworming as recommended by World Health Organization when the baseline prevalence of soil-transmitted helminth infections in the community is over 20%, in addition to preventive measures though improvements in health awareness programs and improved waste management methods.
The therapeutic and prophylactic effects of closantel on natural infections with Haemonchus contortus were studied in goats in Peninsular Malaysia. Closantel was highly effective against H. contortus, either at a subcutaneous (s.c.) injection of 5.0 mg kg-1 body weight (100%), or in an oral drench mixture with mebendazole at a dose of 10.0 mg kg-1 (99.2%), as indicated by faecal egg counts. H. contortus larvae were absent from faecal cultures for 5, 6 and 7 weeks following treatment with s.c. injections of closantel at doses of 2.5 mg kg-1, 5.0 mg kg-1 and 10.0 mg kg-1 respectively, and for 6 weeks after treatment with closantel at 10.0 mg kg-1, given orally. Through its sustained activity, closantel not only prevented reinfection with H. contortus but also caused a dramatic reduction in pasture contamination. The potential utility of closantel in the strategic control of haemonchosis in goats, and as an alternative treatment for benzimidazoles and levamisole resistant H. contortus strains, is discussed.
Fasciolopsiasis is a disease caused by the largest intestinal fluke, Fasciolopsis buski. The disease is endemic in the Far East and Southeast Asia. Human acquires the infection after eating raw freshwater plants contaminated with the infective metacercariae. There has been no report of fasciolopsiasis either in man or in animal in Malaysia. We are reporting the first case of fasciolopsiasis in Malaysia in a 39-year-old female farmer, a native of Sabah (East Malaysia). This patient complained of cough and fever for a duration of two weeks, associated with loss of appetite and loss of weight. She had no history of traveling overseas. Physical examination showed pallor, multiple cervical and inguinal lymph nodes and hepatosplenomegaly. Laboratory investigations showed that she had iron deficiency anemia. There was leukocytosis and a raised ESR. Lymph node biopsy revealed a caseating granuloma. Stool examination was positive for the eggs of Fasciolopsis buski. The eggs measure 140 x 72.5 microm and are operculated. In this case, the patient did not present with symptoms suggestive of any intestinal parasitic infections. Detection of Fasciolopsis buski eggs in the stool was an incidental finding. She was diagnosed as a case of disseminated tuberculosis with fasciolopsiasis and was treated with antituberculosis drugs and praziquantel, respectively.
The lymphatic filarial parasite Brugia timori occurs only in eastern Indonesia where it causes high morbidity. The absence of an animal reservoir, the inefficient transmission by Anopheles mosquitoes and the high sensitivity to DEC/albendazole treatment make this species a prime candidate for elimination by mass drug administration (MDA).