Co-infection of intestinal helminths in humans and animals in the Philippines

Abstract

Background: A large number of studies have assessed risk factors for infection with soil-transmitted helminths (STH), but few have investigated the interactions between the different parasites or compared these between host species across hosts. Here, we assessed the associations between Ascaris, Trichuris, hookworm, strongyle and Toxocara infections in the Philippines in human and animal hosts.

Methods: Faecal samples were collected from humans and animals (dogs, cats and pigs) in 252 households from four villages in southern Philippines and intestinal helminth infections were assessed by microscopy. Associations between worm species were assessed using multiple logistic regression.

Results: Ascaris infections showed a similar prevalence in humans (13.9%) and pigs (13.7%). Hookworm was the most prevalent infection in dogs (48%); the most prevalent infection in pigs was strongyles (42%). The prevalences of hookworm and Toxocara in cats were similar (41%). Statistically significant associations were observed between Ascaris and Trichuris and between Ascaris and hookworm infections in humans, and also between Ascaris and Trichuris infections in pigs. Dual and triple infections were observed, which were more common in dogs, cats and pigs than in humans.

Conclusions: Associations are likely to exist between STH species in humans and animals, possibly due to shared exposures and transmission routes. Individual factors and behaviours will play a key role in the occurrence of co-infections, which will have effects on disease severity. Moreover, the implications of co-infection for the emergence of zoonoses need to be explored further.

Keywords: Helminths; Philippines; Toxocara; co-infection; epidemiology; strongyle.

Figure 1.

Prevalence of intestinal helminth infections in humans, dogs, cats and pigs. The total numbers of humans, dogs, cats and pigs sampled were 663, 91, 27 and 136, respectively.

Figure 2.

Observed and expected prevalence of single and co-infections. Bars on observed values are 95% CI. Values for no infections are summarised in Supplementary Table S2. A: Ascaris; H: hookworm; Tr: Trichuris; To: Toxocara and S: strongyles.