Ancylostomiasis

Neglected by government officials and medical professionals, parasitic infections can lead to lifelong health consequences, according to a biological anthropologist. Most Americans view parasitic infections as a problem of the past or one that only impacts low-income countries. However, new research from Washington University in St. Louis finds evidence that the problem is likely widespread in low-resource communities throughout southern United States where environmental conditions combined with infrastructural neglect and inadequate access to health care create the perfect breeding ground for these infections. In a small, preliminary study published on March 2 in American Journal of Human Biology, 38% of children sampled from a rural Mississippi Delta community were found to have either parasitic worms or protist infections -- a single-cell parasitic organisms that can negatively impact intestinal health. Parasitic infections are a neglected health issue in low-resource communities, according to Theresa Gildner, study co-author and assistant professor of biological anthropology in Arts & Sciences at WashU. School-age children are especially at risk for these infections due to increased exposure through play, poor hand hygiene and their still-developing immune systems. Left untreated, the infections can lead to nutritional deficiencies and lifelong health consequences. Gildner said many of the community members they worked with during this project expressed frustration with state and federal governments that do not listen to their concerns related to these issues. "This is a failure of all levels of government to provide basic services to vulnerable citizens. Health conditions -- including parasitic and intestinal infections -- linked with poor sanitation will likely worsen in coming years as climate change and associated extreme weather events further strain already weak infrastructure systems," said Gildner, an expert on parasitic disease and health disparities. According to Gildner, President Biden's infrastructure bill is a step in the right direction, but more work is needed in the near future to invest in crumbling infrastructure. "I do not know if President Biden's infrastructure bill will directly help the communities where we have worked -- we haven't heard anything from our community partners -- but I think there could be indirect benefits. For instance, drawing more attention to the immediate need for investment in failing infrastructure may lead to more localized projects that benefit these communities," she said. But any efforts to address these infrastructure needs should start with direct and respectful community engagement by locally elected officials. After all, she said, "Individuals living in these communities have the best sense of what the issues are through their lived experiences and may have ideas for what is most needed to improve conditions in their specific community." This is a failure of all levels of government to provide basic services to vulnerable citizens. Health conditions -- including parasitic and intestinal infections -- linked with poor sanitation will likely worsen in coming years as climate change and associated extreme weather events further strain already weak infrastructure systems. About the research Understanding U.S. infection patterns -- including the current extent of parasitic infections and key sources of exposure -- is critical to improving health outcomes, Gildner said. Previous studies in the U.S. have been case-based or focused exclusively on immigrant populations. Very few surveys have been conducted in regions with the most risk factors for exposure. In the summer of 2019, members of the Rural Embodiment and Community Health (REACH) research team -- led by Gildner and Tara J. Cepon-Robins, associate professor of anthropology at the University of Colorado Colorado Springs (UCCS), and including WashU biologist Elizabeth K. Mallott and former UCCS undergraduate student Isabella C. Recca -- traveled to the rural Mississippi Delta to conduct preliminary research in the community. They chose to direct their focus on a small, predominantly Black, rural community that is frequently affected by flooding and sewage backups due to community-reported infrastructural neglect. In total, 24 children -- including 12 boys and 12 girls ranging in age from infant to 14 years old -- from 12 households participated in the study. Altogether, 38% of the children were found to have one or both types of parasitic infections. Contrary to expectations, they found no significant differences in infection status based on age, sex or household size, although Gildner acknowledges that could be due to the relatively small sample size. She hopes ongoing research with a larger dataset will allow the team to better test these patterns in the near future. Last summer, the team collected additional samples from adults and in the same Mississippi community, as well as in East St. Louis in a community facing similar issues related to failing infrastructure, persistent flooding and sewage backups, Gildner said. The team also is analyzing soil samples collected from various shared community spaces during the 2022 trip to better examine these patterns. And plans are underway to collect additional data in other Mississippi Delta communities this summer. Education is key Lack of education is one of the reasons why parasitic infections often go undetected. "One interesting thing that we noticed during our 2019 visit to Mississippi is that some of the grandparents we spoke to were aware of the threat posed by parasite infections locally because they had heard of these issues as children," Gildner said. "One grandparent told us they remembered public health educational programs that discussed the risks posed by hookworm infection and encouraged community members to wear shoes outdoors to prevent infection. "However, that messaging stopped after their early childhood and they had always wondered why no one talked about these infections anymore. This kind of messaging could be relatively straightforward to implement, although basic information on key parasite infections would have to be provided since many people are no longer aware of these diseases." Even health care providers often assume that parasitic infection risk is greatest for Americans traveling abroad. Educating health care providers about the threat posed by parasitic infections in the U.S., how to recognize symptoms and test appropriately is key. "Without this basic medical knowledge, diagnoses may be missed and treatment delayed," Gildner said. "For instance, one participant this past summer had been diagnosed with Helicobacter pylori, a bacterium we have recently started studying that can cause stomach ulcers and certain gastric cancers in severe cases. However, she told us it took months and visits to multiple doctors before she was properly tested and diagnosed, in large part due to the assumption that symptomatic cases of this bacterial infection aren't a significant concern in the U.S." Although it is an option for regions suffering from heavy parasitic infection rates, preventative mass drug administration is not a practical first step to addressing the problem, Gildner explained. There's not enough public awareness of the conditions and the safe effective drugs used to treat common parasite infections are incredibly expensive in the U.S., she said. However, Gildner would like to see more government investment in research at other locations across the U.S. to help clarify the current extent of parasite infections and identify key sources of exposure that could be targeted to improve health outcomes.

For 28.7% of canine participants in Florida study, standard treatment for hookworm is ineffective AUSTIN, Texas, June 23, 2022 /PRNewswire/ -- ACVIM Forum booth 713—Antech Diagnostics, operating North America's largest network of diagnostic reference laboratories in veterinary medicine, will present three abstracts showing that its novel molecular diagnostic test for intestinal parasites in cats and dogs, KeyScreen™ GI Parasite PCR, accurately identifies treatment-resistance (A. caninum benzimidazole resistance) for hookworm infection in dogs and zoonotic Giardia in cats and dogs. Additionally, a study of pet dogs in Florida showed high frequency of treatment-resistant hookworm across a broad range of breeds. Antech's Director of Molecular Diagnostics, R&D, Dr. Christian M. Leutenegger, will present the data at the American College of Veterinary Internal Medicine (ACVIM) 2022 Forum, which begins today. KeyScreen relies on the most advanced diagnostic platform in human and animal medicine to detect 20 intestinal parasites in cats and dogs as well as emerging issues in veterinary medicine, A. caninum benzimidazole resistance and A/B assemblages of Giardia duodenalis: both present human health risks. As treatment resistance grows, and parasites continue to increase, mutate and migrate, veterinary medicine requires new diagnostic tools like KeyScreen that offer greater sensitivity, accuracy and are more complete than traditional screening tools. The new studies presented at ACVIM Forum demonstrate KeyScreen's value as a highly sensitive method for detecting more disease as well as emerging threats to both human and animal health. The study abstract, "High Frequency of the Benzimidazole Resistance Genetic Marker in the Pet Dog Population in Florida," showed that 25 of 87 fecal samples that were hookworm-positive as determined by routine ova and parasite (O&P) screening also carried the genetic marker for benzimidazole resistance, suggesting that current routine treatment would likely be ineffective. Anthelmintic resistance was once contained to Greyhounds. However, study data showed that a variety of dog breeds carry the resistance gene, including German Shepherds, Boxers, Golden doodles, Yorkshire terriers, Labrador retrievers, Basenjis, Siberian huskies, American Staffordshire terriers, Beagles, Australia cattle dogs, poodles, dachshunds and mixed breeds. The opportunity for routine identification of the genetic marker for treatment resistance will help veterinarians identify this resistance and guide treatment choices. Christian M. Leutenegger, Dr.Med.Vet., B.Sc., Ph.D., FVH, Director of Molecular Diagnostics, R&D at Antech, who is KeyScreen's inventor and lead investigator of the study commented: "When we introduced KeyScreen in January, I posited that 'we don't know what we don't know' about emerging parasitic threats due to the limitations of traditional screening technology. With more than a quarter of the stool samples containing hookworms with resistance to benzimidazoles, this view has borne true. Treatment-resistant hookworm has been an emerging threat for several years. Now that we have a window into where and in what populations it exists, we'll be able to make better, more effective treatment decisions that can protect pets, people and help contain benzimidazole resistance, which—if it continues unabated—can severely impact both human and animal health and well-being." In a second study abstract, "Comparison of qPCR and centrifugal flotation for the detection of Ancylostoma in experimentally infected Beagles," researchers compared KeyScreen with O&P for the detection of Ancylostoma caninum and Ancylostoma spp. While overall agreement was 97.5%, KeyScreen detected Ancylostoma caninum eggs in feces earlier, day 17 vs. day 28, and more consistently than O&P, confirming its high sensitivity. A final study abstract, "Differentiating Giardia duodenalis assemblages with a novel beta-giardin PCR assay," found that KeyScreen accurately identified the A/B assemblages of Giardia duodenalis, which have zoonotic potential. These data suggest that KeyScreen can provide a new method for determining zoonotic risk, allowing veterinary teams to guide pet owners appropriately to protect at-risk individuals who may come in contact with the affected pet. Molecular diagnostics read the genetic material of a parasite or virus, making KeyScreen the most advanced parasite screening test in veterinary medicine. KeyScreen is practical for use in routine wellness exams: it's affordable, detects 20 parasites from a single, storable 0.15 gram sample, and offers next-day results for most North American practices. Significantly, KeyScreen can be substituted for traditional "fecals," liberating veterinary staff for patient care, which is uniquely valuable during this time of veterinary staff shortages amidst dramatic increases in pet ownership. Additionally, by finding more disease the first time, while also checking for zoonotic assemblages and resistance markers, KeyScreen supports further cost and efficiency gains by eliminating the time and resource strain of repeat pet visits for persistent symptoms. Using KeyScreen, veterinarians can deliver the right treatment to pets the first time, helping them regain health faster. For more information about KeyScreen visit and the press release announcing the new test: "Antech introduces veterinary medicine's most advanced parasite screening test." At ACVIM Forum: "Differentiating Giardia duodenalis assemblages with a novel beta-giardin PCR assay," —Thursday, June 23, 2022; 1:25 pm CT "High Frequency of the Benzimidazole Resistance Genetic Marker in the Pet Dog Population in Florida"—June 24, 2022 at 8:30 am CT "Comparison of qPCR and centrifugal flotation for the detection of Ancylostoma in experimentally infected Beagles" —June 24, 2022 at 8:45 am CT About Antech At the heart of Antech is our love for pets and our desire to see them live longer, healthier lives. Through superior diagnostic testing delivered with a flexible, can-do spirit, we endeavor to treat every sample as if it belongs to our own pet. Our innovative diagnostics, accessible through North America's largest reference laboratory network, span world-class imaging equipment, and services, advanced molecular and predictive diagnostic testing, and core diagnostics with gold-standard accuracy. 24x7 access to the most accomplished team of board-certified pathologists, medical consultants across 14 specialty areas, and industry-leading education round out our support for today's high-performance practices. Antech is helping to drive the future of veterinary care as part of Mars Petcare, the world's largest family-owned company focusing on pet health. Visit us at antechdiagnostics.com. Follow us on Instagram, Twitter, LinkedIn, and Facebook. SOURCE Antech Diagnostics