What does soil-transmitted helminth elimination look like? Results from a targeted molecular detection survey in Japan.


Journal

Parasites & vectors
ISSN: 1756-3305
Titre abrégé: Parasit Vectors
Pays: England
ID NLM: 101462774

Informations de publication

Date de publication:
08 Jan 2020
Historique:
received: 08 09 2019
accepted: 30 12 2019
entrez: 10 1 2020
pubmed: 10 1 2020
medline: 30 5 2020
Statut: epublish

Résumé

Japan is one of the few countries believed to have eliminated soil-transmitted helminths (STHs). In 1949, the national prevalence of Ascaris lumbricoides was 62.9%, which decreased to 0.6% in 1973 due to improvements in infrastructure, socioeconomic status, and the implementation of national STH control measures. The Parasitosis Prevention Law ended in 1994 and population-level screening ceased in Japan; therefore, current transmission status of STH in Japan is not well characterized. Sporadic cases of STH infections continue to be reported, raising the possibility of a larger-scale recrudescence of STH infections. Given that traditional microscopic detection methods are not sensitive to low-intensity STH infections, we conducted targeted prevalence surveys using sensitive PCR-based assays to evaluate the current STH-transmission status and to describe epidemiological characteristics of areas of Japan believed to have achieved historical elimination of STHs. Stool samples were collected from 682 preschool- and school-aged children from six localities of Japan with previously high prevalence of STH. Caregivers of participants completed a questionnaire to ascertain access to water, sanitation and hygiene (WASH), and potential exposures to environmental contamination. For fecal testing, multi-parallel real-time PCR assays were used to detect infections of Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale and Trichuris trichiura. Among the 682 children, no positive samples were identified, and participants reported high standards of WASH. To our knowledge, this is the first STH-surveillance study in Japan to use sensitive molecular techniques for STH detection. The results suggest that recrudescence of STH infections has not occurred, and that declines in prevalence have been sustained in the sampled areas. These findings suggest that reductions in prevalence below the elimination thresholds, suggestive of transmission interruption, are possible. Additionally, this study provides circumstantial evidence that multi-parallel real-time PCR methods are applicable for evaluating elimination status in areas where STH prevalence is extremely low.

Sections du résumé

BACKGROUND BACKGROUND
Japan is one of the few countries believed to have eliminated soil-transmitted helminths (STHs). In 1949, the national prevalence of Ascaris lumbricoides was 62.9%, which decreased to 0.6% in 1973 due to improvements in infrastructure, socioeconomic status, and the implementation of national STH control measures. The Parasitosis Prevention Law ended in 1994 and population-level screening ceased in Japan; therefore, current transmission status of STH in Japan is not well characterized. Sporadic cases of STH infections continue to be reported, raising the possibility of a larger-scale recrudescence of STH infections. Given that traditional microscopic detection methods are not sensitive to low-intensity STH infections, we conducted targeted prevalence surveys using sensitive PCR-based assays to evaluate the current STH-transmission status and to describe epidemiological characteristics of areas of Japan believed to have achieved historical elimination of STHs.
METHODS METHODS
Stool samples were collected from 682 preschool- and school-aged children from six localities of Japan with previously high prevalence of STH. Caregivers of participants completed a questionnaire to ascertain access to water, sanitation and hygiene (WASH), and potential exposures to environmental contamination. For fecal testing, multi-parallel real-time PCR assays were used to detect infections of Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale and Trichuris trichiura.
RESULTS RESULTS
Among the 682 children, no positive samples were identified, and participants reported high standards of WASH.
CONCLUSIONS CONCLUSIONS
To our knowledge, this is the first STH-surveillance study in Japan to use sensitive molecular techniques for STH detection. The results suggest that recrudescence of STH infections has not occurred, and that declines in prevalence have been sustained in the sampled areas. These findings suggest that reductions in prevalence below the elimination thresholds, suggestive of transmission interruption, are possible. Additionally, this study provides circumstantial evidence that multi-parallel real-time PCR methods are applicable for evaluating elimination status in areas where STH prevalence is extremely low.

Identifiants

pubmed: 31915050
doi: 10.1186/s13071-019-3875-z
pii: 10.1186/s13071-019-3875-z
pmc: PMC6950881
doi:

Substances chimiques

Soil 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

6

Subventions

Organisme : Bill and Melinda Gates Foundation
ID : OPP1129535

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Auteurs

Mitsuko Hasegawa (M)

Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
Doctoral Leadership Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.

Nils Pilotte (N)

Department of Biological Sciences, Smith College, Northampton, Massachusetts, USA.
Molecular and Cellular Biology Program, University of Massachusetts, Amherst, Massachusetts, USA.

Mihoko Kikuchi (M)

Doctoral Leadership Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.

Arianna R Means (AR)

Department of Global Health, University of Washington, Seattle, Washington, USA.
Department of Life Sciences, Natural History Museum, London, UK.

Marina Papaiakovou (M)

Department of Biological Sciences, Smith College, Northampton, Massachusetts, USA.
Department of Life Sciences, Natural History Museum, London, UK.

Andrew M Gonzalez (AM)

Department of Biological Sciences, Smith College, Northampton, Massachusetts, USA.

Jacqueline R M A Maasch (JRMA)

Department of Biological Sciences, Smith College, Northampton, Massachusetts, USA.

Hiroshi Ikuno (H)

Department of Bacteriology, BML, Inc, Saitama, Japan.

Toshihiko Sunahara (T)

The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
Department of Vector Ecology and Environment, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.

Kristjana H Ásbjörnsdóttir (KH)

Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA.

Judd L Walson (JL)

Department of Global Health, University of Washington, Seattle, Washington, USA.
Department of Life Sciences, Natural History Museum, London, UK.
Departments of Medicine (Infectious Disease), Pediatrics and Epidemiology, University of Washington, Seattle, Washington, USA.

Steven A Williams (SA)

Department of Biological Sciences, Smith College, Northampton, Massachusetts, USA.
Molecular and Cellular Biology Program, University of Massachusetts, Amherst, Massachusetts, USA.

Shinjiro Hamano (S)

Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan. shinjiro@nagasaki-u.ac.jp.
Doctoral Leadership Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan. shinjiro@nagasaki-u.ac.jp.
The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan. shinjiro@nagasaki-u.ac.jp.

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