Strategies to Decrease the Prevalence of Soil-Transmitted Helminths in Central India

Abstract

Background Intestinal parasites are a major public health problem in tropical countries. Over 1.5 billion people are infected with soil-transmitted helminths (STH), of which 225 million are in India. Parasitic infections are associated with poor sanitation, lack of safe potable water, and improper hygiene. Materials and Methods The study was undertaken to ascertain the impact of control strategies, namely open-defecation free drive and mass drug administration of single dose albendazole. Stool samples received at AIIMS Bhopal Microbiology laboratory, across all age groups, were studied for protozoan trophozoites/cysts and helminthic ova. Results Out of 4,620 stool samples, 389 (8.41%) were positive either for protozoal or helminthic infections. Protozoan infections were more common than helminthic infections with Giardia duodenalis infection being the most common, 201 (51.67%), followed by Entamoeba histolytica , 174 (44.73%). The helminthic infections constituted 14 (3.5%) of the positive stool samples with Hookworm ova in 6 (1.5%) cases. Conclusion This study proves that strategies, namely "Swachh Bharat Abhiyan" and "National Deworming Day" started in 2014 and 2015 led to significant reduction of intestinal parasite infections in Central India, with a higher reduction of STH compared with protozoan parasite infection being ascribed to the activity spectrum of albendazole.

Keywords: National Deworming Day; Swachh Bharat Abhiyan; central India; neglected tropical disease; soil-transmitted helminths.

Fig. 1

Size, shape, and overall morphological features of helminths in stool specimen (400× magnification). The figure on the left demonstrates the nonbile stained egg of Hymenolepis nana in iodine mount. Egg is ovoid in shape, 35 to 45 μm in size with two membranes and hooklets. The figure on the right shows Rhabditiform larva (L1 larva) of Strongyloides stercoralis in saline wet mount. L1 Larva measures 100 to 380 μm in length with prominent genital primordium.

Fig. 2

The figure demonstrates the oocysts of Cystoisospora belli in stool sample stained with modified acid fast at 400× magnification. The oocysts are 25 to 30 μm in size with ellipsoidal shape.