A free weekly iron-folic acid supplementation and regular deworming program is associated with improved hemoglobin and iron status indicators in Vietnamese women

Background Anemia due to iron deficiency is recognized as one of the major nutritional deficiencies in women and children in developing countries. Daily iron supplementation for pregnant women is recommended in many countries although there are few reports of these programs working efficiently or effectively. Weekly iron-folic acid supplementation (WIFS) and regular deworming treatment is recommended for non-pregnant women living in areas with high rates of anemia. Following a baseline survey to assess the prevalence of anemia, iron deficiency and soil transmitted helminth infections, we implemented a program to make WIFS and regular deworming treatment freely and universally available for all women of reproductive age in two districts of a province in northern Vietnam over a 12 month period. The impact of the program at the population level was assessed in terms of: i) change in mean hemoglobin and iron status indicators, and ii) change in the prevalence of anemia, iron deficiency and hookworm infections. Method Distribution of WIFS and deworming were integrated with routine health services and made available to 52,000 women. Demographic data and blood and stool samples were collected in baseline, and three and 12-month post-implementation surveys using a population-based, stratified multi-stage cluster sampling design. Results The mean Hb increased by 9.6 g/L (95% CI, 5.7, 13.5, p < 0.001) during the study period. Anemia (Hb<120 g/L) was present in 131/349 (37.5%, 95% CI 31.3, 44.8) subjects at baseline, and in 70/363 (19.3%, 95% CI 14.0, 24.6) after twelve months. Iron deficiency reduced from 75/329 (22.8%, 95% CI 16.9, 28.6) to 33/353 (9.3%, 95% CI 5.7, 13.0) by the 12-mnth survey, and hookworm infection from 279/366 (76.2%,, 95% CI 68.6, 83.8) to 66/287 (23.0%, 95% CI 17.5, 28.5) over the same period. Conclusion A free, universal WIFS program with regular deworming was associated with reduced prevalence and severity of anemia, iron deficiency and ho

Lessons learned from implementation of a demonstration program to reduce the burden of anemia and hookworm in women in Yen Bai Province, Viet Nam

Background Iron deficiency, anemia and hookworm disease are important public health problems for women of reproductive age living in developing countries and affect the health of newborns and infants. Iron supplementation and deworming treatment are effective in addressing these problems in both pregnant and non-pregnant women. Daily iron supplementation and deworming after the first trimester is recommended for pregnant women although these programs usually do not operate efficiently or effectively. Weekly iron-folic acid supplementation and regular deworming for non-pregnant women may be a viable approach for improving iron status and preventing anemia during the reproductive years. Addressing these diseases at a population level before women become pregnant could significantly improve women's health before and during pregnancy, as well as their infants' growth and development. Methods and Results This paper describes the major processes undertaken in a demonstration intervention of preventive weekly iron-folic acid supplementation with regular deworming for all 52,000 women aged 15–45 years in two districts of Yen Bai province, in northern Viet Nam. The intervention strategy included extensive consultation with community leaders and village, commune, district and provincial health staff, and training for village health workers. Distribution of the drugs was integrated with the existing health service infrastructure and the village health workers were the direct point of contact with women. Iron-folic acid tablets and deworming treatment were provided free of charge from May 2006. An independent Vietnamese NGO was commissioned to evaluate compliance and identify potential problems. The program resulted in effective distribution of iron-folic acid tablets and deworming treatment to all villages in the target districts, with full or partial compliance of 85%. Conclusion Training for health staff, the strong commitment of all partners and the use of appropriate educational materials led to broad support for weekly iron-folic acid supplementation and high participation in the regular deworming days. In March 2008 the program was expanded to all districts in the province, a target population of approximately 250,000 WRA, and management was handed over to provincial authorities.

Estágio em clínica de animais de companhia: síndrome de disfunção cognitiva canina

Este estágio foi realizado em clínica de animais de companhia. Observou e acompanhou-se tanto consultas com carácter preventivo como de clínica médica e cirúrgica. As consultas de medicina preventiva consistiram essencialmente em vacinações e desparasitações, enquanto outras foram meramente informativas. As consultas de clínica médica incidiram em diversas áreas, incluíndo dermatologia, gastroenterologia e cardiologia. As cirurgias efetuadas foram sobretudo eletivas, mas também se assistiu a cirurgias corretivas. Um dos casos observados foi um cão com disfunção cognitiva. Este foi o caso escolhido para ser alvo do estudo mais aprofundado que é apresentado na segunda secção deste relatório. A disfunção cognitiva canina é o equivalente à doença humana de Alzheimer. Esta condição é relativamente desconhecida e os seus sinais clínicos são frequentemente considerados normais da idade. No entanto, quando detetada e tratada atempadamente é possível abrandar a sua evolução, devendo os proprietários de cães afetados ser sensibilizados a procurar assistência profissional; Internship in small animal practice: canine cognitive dysfunction syndrome Abstract: This internship was conducted in small animal clinic. The attended appointments consisted mostly of cases of preventive and internal medicine and also surgical assistance. The appointments of preventive medicine included vaccinations, deworming and some merely informative sessions. The cases of internal medicine concerned areas such as dermatology, gastroenterology and cardiology. The surgical interventions were mainly optional but also corrective procedures. One of the observed cases was a dog with cognitive dysfunction. This case was elected to be the target of further study which is presented in the second section of this report. The canine cognitive dysfunction is the equivalent to the human Alzheimer’s disease. This condition is still largely unknown and its clinical presentation is often considered normal of aging. However, if detected and treated early it is possible to slow down its progress, thus the owners of affected dogs should be encouraged to seek professional assistance.

Risk Factors for Soil-transmitted Helminth Infections in Schoolchildren from Rural Communities in Honduras

Background: Honduras is endemic for soil-transmitted helminth (STH) infections. However, knowledge gaps remain in terms of risk factors involved in STH transmission and infection intensity. Objectives: To determine the prevalence and intensity of STH infections in schoolchildren living in rural Honduras. Additionally, to investigate risk factors associated with STH infections. Methods: A cross-sectional study was done among Honduran rural schoolchildren, in 2011. Demographic and epidemiological data were obtained and STH infections were determined using Kato-Katz method. Results: A total of 320 children completed the study. Overall and specific prevalences for Ascaris lumbricoides, Trichuris trichiura and hookworms were 72.5%, 30%, 67% and 16%, respectively. Several risk factors associated with STH transmission and infection intensity were identified at the individual and familial level as well as at the schools. Conclusions: Improving hygienic conditions and providing semi-annual deworming treatment are feasible interventions that could enhance undergoing STH control activities.

Soil-Transmitted Helminth Infections and Nutritional Status in School-age Children from Rural Communities in Honduras

Background: Soil-transmitted helminth (STH) infections are endemic in Honduras and efforts are underway to decrease their transmission. However, current evidence is lacking in regards to their prevalence, intensity and their impact on children’s health. Objectives: To evaluate the prevalence and intensity of STH infections and their association with nutritional status in a sample of Honduran children. Methodology: A cross-sectional study was done among school-age children residing in rural communities in Honduras, in 2011. Demographic data was obtained, hemoglobin and protein concentrations were determined in blood samples and STH infections investigated in single-stool samples by Kato-Katz. Anthropometric measurements were taken to calculate heightfor- age (HAZ), BMI-for-age (BAZ) and weight-for-age (WAZ) to determine stunting, thinness and underweight, respectively. Results: Among 320 children studied (48% girls, aged 7–14 years, mean 9.7661.4) an overall STH prevalence of 72.5% was found. Children .10 years of age were generally more infected than 7–10 year-olds (p = 0.015). Prevalence was 30%, 67% and 16% for Ascaris, Trichuris and hookworms, respectively. Moderate-to-heavy infections as well as polyparasitism were common among the infected children (36% and 44%, respectively). Polyparasitism was four times more likely to occur in children attending schools with absent or annual deworming schedules than in pupils attending schools deworming twice a year (p,0.001). Stunting was observed in 5.6% of children and it was associated with increasing age. Also, 2.2% of studied children were thin, 1.3% underweight and 2.2% had anemia. Moderate-to-heavy infections and polyparasitism were significantly associated with decreased values in WAZ and marginally associated with decreased values in HAZ. Conclusions: STH infections remain a public health concern in Honduras and despite current efforts were highly prevalent in the studied community. The role of multiparasite STH infections in undermining children’s nutritional status warrants more research.

Untersuchungen zum Gesundheitsstatus und zu betrieblichen Maßnahmen der Gesundheitsvorsorge in der ökologischen Schweinehaltung

Im Rahmen dieser Arbeit wurde mittels einer umfassenden und von einer Projektgruppe begleiteten Literaturanalyse sowie anhand von Praxiserhebungen der Frage nachgegangen, wie es um die Tiergesundheit in der ökologischen Schweinehaltung bestellt ist. Ferner wurde untersucht, ob die ökologischen Rahmenrichtlinien (EWG-VO 2092/91) ein Hemmnis für die Sicherstellung eines hohen Gesundheitsstatus der Nutztiere darstellen. Die Literaturauswertung ergab, dass die Erkrankungsraten sowohl auf ökologisch wie auf konventionell geführten Betrieben ein hohes Niveau aufwiesen. Die Ursachen wurden vorrangig in einem unzureichenden betrieblichen Management gesehen, während den EG-Rahmenrichtlinien in der Regel keine maßgebliche Bedeutung für den Gesundheitsstatus beigemessen wurde. In Praxiserhebungen wurde die Status-quo-Situation zur Tiergesundheit auf sechs ökologisch wirt- schaftenden Schweinemastbetrieben erfasst. Ferner wurde untersucht, inwieweit eine Verbesserung des Gesundheitsstatus auf den Betrieben mit einem Mehraufwand an Arbeitszeit und Investitionen verbunden ist. Hierzu wurden die Bereiche Haltung, Fütterung und Hygienemanagement mittels einer Schwachstellenanalyse (Hazard Analysis Critical Control Points-Konzept) beurteilt. Der Zeit- bedarf für Maßnahmen zur Gesundheitsvorsorge wurde durch Arbeitszeitaufzeichnungen erfasst. Die Untersuchungen zeigten, dass auf den Betrieben zum Teil erhebliche Mängel im Hygiene- management bestanden. Anhand von Schlachtkörperbefunden wurde eine hohe Rate pathologischer Leberveränderungen, verursacht durch Larven des Schweinespulwurms Ascaris suum, diagnosti- ziert. Insgesamt wiesen die Schlachtkörper der Tiere von den sechs Betrieben mit durchschnittlich 48,8 % sowie die Schlachtkörper von ökologischen Vergleichsbetrieben mit 63,9 % signifikant höhere Befundraten auf als die Schlachtkörper konventioneller Vergleichsbetriebe (17,4 %). Der Arbeitszeitbedarf für die Mastschweinehaltung auf den sechs Betrieben variierte zwischen 2,0 und 3,7 Arbeitskraftstunden pro Mastplatz und Jahr und lag damit deutlich höher als vergleichbare Literaturdaten. Zwischen den Betrieben traten hohe Unterschiede hinsichtlich der zeitlichen Aufwendungen für Hygiene- und Tiergesundheitsmaßnahmen auf. Während der Interventionsphase wurden das Entwurmungs- und das Hygieneregime der sechs Betriebe optimiert. Die Buchten wurden ordnungsgemäß gereinigt und desinfiziert und der erforderliche Arbeitszeitaufwand quantifiziert. Dieser lag zusammen mit den zusätzlichen Kosten um ca. 46 % höher als der betrieblich übliche Arbeitszeitaufwand. Betriebe mit neu konzipierten Ställen und glatten Buchtenböden und -wänden konnten diese mit vergleichsweise geringem Arbeitsaufwand reinigen und desinfizieren. In einigen Altgebäuden hingegen war aufgrund rauer und schadhafter Oberflächen eine ordnungsgemäße Reinigung und Desinfektion nur bedingt durchzuführen. Die Rate der Leberveränderungen am Schlachthof konnte von durchschnittlich 48,9 % auf 32,7 % gesenkt werden. Während sich die Befundraten auf einigen Betrieben signifikant verbesserten, trat bei der Nutzung von unrenovierten Ställen in Altgebäuden keine Besserung ein. Es wird geschlussfolgert, dass die Rahmenbedingungen der EG-Verordnung einem hohen Tiergesundheitsstatus nicht entgegen stehen, in der Regel jedoch mit einem erhöhten Aufwand für Hygienemaßnahmen verbunden sind. Voraussetzung für eine geringe Parasitenbelastung sind ein konsequent umgesetztes Hygiene- und Entwurmungsregime sowie gut zu reinigende Buchten. Letzteres ist allerdings bei der Nutzung von Altgebäuden nicht immer gegeben.

Participatory research approaches in the development of improved management practices in indigenous chickens production systems with smallholder farmers in Kenya

This thesis is concerned with development of improved management practices in indigenous chicken production systems in a research process that includes participatory approaches with smallholder farmers and other stakeholders in Kenya. The research process involved a wide range of activities that included on-station experiments, field surveys, stakeholder consultations in workshops, seminars and visits, and on-farm farmer participatory research to evaluate the effect of some improved management interventions on production performance of indigenous chickens. The participatory research was greatly informed from collective experiences and lessons of the previous activities. The on-station studies focused on hatching, growth and nutritional characteristics of the indigenous chickens. Four research publications from these studies are included in this thesis. Quantitative statistical analyses were applied and they involved use of growth models estimated with non-linear regressions for the growth characteristics, chi-square determinations to investigate differences among different reciprocal crosses of indigenous chickens and general linear models and covariance determination for the nutrition study. The on-station studies brought greater understanding of performance and production characteristics of indigenous chickens and the influence of management practices on these characteristics. The field surveys and stakeholder consultations helped in understanding the overarching issues affecting the productivity of the indigenous chickens systems and their place in the livelihoods of smallholder farmers. These activities created strong networking opportunities with stakeholders from a wide spectrum. The on-farm farmer participatory research involved selection of 200 farmers in five regions followed by training and introduction of interventions on improved management practices which included housing, vaccination, deworming and feed supplementation. Implementation and monitoring was mainly done by individual farmers continuously for close to one and half years. Six quarterly visits to the farms were made by the research team to monitor and provide support for on-going project activities. The data collected has been analysed for 5 consecutive 3-monthly periods. Descriptive and inferential statistics were applied to analyse the data collected involving treatment applications, production characteristics and flock demography characteristics. Out of the 200 farmers initially selected, 173 had records on treatment applications and flock demography characteristics while 127 farmers had records on production characteristics. The demographic analysis with a dissimilarity index of flock size produced 7 distinct farm groups from among the 173 farms. Two of these farm groups were represented in similar numbers in each of the five regions. The research process also involved a number of dissemination and communication strategies that have brought the process and project outcomes into the domain of accessibility by wider readership locally and globally. These include workshops, seminars, field visits and consultations, local and international conferences, electronic conferencing, publications and personal communication via emailing and conventional posting. A number of research and development proposals were also developed based on the knowledge and experiences gained from the research process. The thesis captures the research process activities and outcomes in 8 chapters which include in ascending order – introduction, theoretical concepts underpinning FPR, research methodology and process, on-station research output, FPR descriptive statistical analysis, FPR inferential statistical analysis on production characteristics, FPR demographic analysis and conclusions. Various research approaches both quantitative and qualitative have been applied in the research process indicating the possibilities and importance of combining both systems for greater understanding of issues being studied. In our case, participatory studies of the improved management of indigenous chickens indicates their potential importance as livelihood assets for poor people.

Fatores socioeconômicos e percepção de risco de produtores de gado de corte no uso de produtos veterinários

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Anti-Toxocara spp. antibodies in an adult healthy population: serosurvey and risk factors in Southeast Brazil.

Objective: To evaluate the frequency of anti-Toxocara spp. antibodies in an adult healthy population. Methods: The study was performed by interviewing 253 blood donors, from 19 to 65 years of age, in a hematological centre in Presidente Prudente, São Paulo, southeast Brazil. A survey was applied to blood donors in order to evaluate the possible factors associated to the presence of antibodies, including individual (gender and age), socioeconomic (scholarship, familial income and sanitary facilities) and habit information (contact with soil, geophagy, onycophagy and intake of raw/undercooked meat) as well as the presence of dogs or cats in the household. ELISA test was run for detection of the anti-Toxocara spp. IgG antibodies. Bivariate analysis followed by logistic regression was performed to evaluate the potential risk factors associated to seropositivity. Results: The overall prevalence observed in this study was 8.7% (22/253). Contact with soil was the unique risk factor associated with the presence of antibodies (P=0.0178 ; OR=3.52; 95% CI=1.244-9.995) Conclusions. The results of this study reinforce the necessity in promoting preventive public health measures, even for healthy adult individual, particularly those related to the deworming of pets to avoid the soil contamination, and hygiene education of the population.

A survey on intestinal parasites of livestock guardian dogs and herding dogs in Switzerland

The present study describes the occurrence of intestinal parasite infections in livestock guardian dogs and herding dogs. A total of 71 guardian dogs (more than half of the total number of guardian dogs in Switzerland) and 21 herding dogs were coprologically examined, using a combined sedimentation-flotation method. In 21 (23 %) of the dogs intestinal parasites were detected, and 8 (8.7 %) of these dogs shed either sporocysts of Sarcocystis sp. (n = 6) or taeniid eggs (n = 2). The evaluation of questionnaires providing data on age, origin and deworming schemes of the dogs completed the study.

Increased parasite resistance and recurrent airway obstruction in horses of a high-prevalence family

BACKGROUND: Equine recurrent airway obstruction (RAO) shares many characteristics with human asthma. In humans, an inverse relationship between susceptibility to asthma and resistance to parasites is suspected. HYPOTHESIS/OBJECTIVES: Members of a high-incidence RAO half-sibling family (F) shed fewer strongylid eggs compared with RAO-unaffected pasture mates (PM) and that RAO-affected horses shed fewer eggs than RAO-unaffected half-siblings. ANIMALS: Seventy-three F and 73 unrelated, age matched PM. METHODS: Cases and controls kept under the same management and deworming regime were examined. Each individual was classified as RAO affected or RAO unaffected and fecal samples were collected before and 1-3 weeks and 3 months after deworming. Samples were analyzed by combined sedimentation-flotation and modified McMaster methods and classified into 3 categories of 0 eggs per gram of feces (EpG), 1-100 EpG, and > 100 EpG, respectively. RESULTS: PM compared with RAO-affected F had a 16.7 (95% confidence interval [CI]: 2.0-136.3) times higher risk for shedding > 100 EpG compared with 0 EpG and a 5.3 (95% CI: 1.0-27.4) times higher risk for shedding > 100 EpG compared with 0 EpG. There was no significant effect when RAO-unaffected F were compared with their PM. RAO-unaffected compared with RAO-affected offspring had a 5.8 (95% CI: 0.0-1.0) times higher risk for shedding 1-100 EpG. Age, sex, breed, and sharing pastures with other species had no significant confounding effects. CONCLUSION AND CLINICAL IMPORTANCE: RAO is associated with resistance against strongylid parasites in a high-prevalence family.

Coprological study on intestinal helminths in Swiss dogs: temporal aspects of anthelminthic treatment

Coproscopic examination of 505 dogs originating from the western or central part of Switzerland revealed the presence (prevalence data) of the following helminthes: Toxocara canis (7.1%), hookworms (6.9%), Trichuris vulpis (5.5%), Toxascaris leonina (1.3%), Taeniidae (1.3%), Capillaria spp. (0.8%), and Diphyllobothrium latum (0.4%). Potential risk factors for infection were identified by a questionnaire: dogs from rural areas significantly more often had hookworms and taeniid eggs in their feces when compared to urban family dogs. Access to small rodents, offal, and carrion was identified as risk factor for hookworm and Taeniidae, while feeding of fresh and uncooked meat did not result in higher prevalences for these helminths. A group of 111 dogs was treated every 3 months with a combined medication of pyrantel embonate, praziquantel, and febantel, and fecal samples were collected for coproscopy in monthly intervals. Despite treatment, the yearly incidence of T. canis was 32%, while hookworms, T. vulpis, Capillaria spp., and Taeniidae reached incidences ranging from 11 to 22%. Fifty-seven percent of the 111 dogs had helminth eggs in their feces at least once during the 1-year study period. This finding implicates that an infection risk with potential zoonotic pathogens cannot be ruled out for the dog owner despite regular deworming four times a year.

Survey of public knowledge about Echinococcus multilocularis in four European countries: Need for proactive information

Background Public information about prevention of zoonoses should be based on the perceived problem by the public and should be adapted to regional circumstances. Growing fox populations have led to increasing concern about human alveolar echinococcosis, which is caused by the fox tapeworm Echinococcus multilocularis. In order to plan information campaigns, public knowledge about this zoonotic tapeworm was assessed. Methods By means of representative telephone interviews (N = 2041), a survey of public knowledge about the risk and the prevention of alveolar echinococcosis was carried out in the Czech Republic, France, Germany and Switzerland in 2004. Results For all five questions, significant country-specific differences were found. Fewer people had heard of E. multilocularis in the Czech Republic (14%) and France (18%) compared to Germany (63%) and Switzerland (70%). The same effect has been observed when only high endemic regions were considered (Czech Republic: 20%, France: 17%, Germany: 77%, Switzerland: 61%). In France 17% of people who knew the parasite felt themselves reasonably informed. In the other countries, the majority felt themselves reasonably informed (54–60%). The percentage that perceived E. multilocularis as a high risk ranged from 12% (Switzerland) to 43% (France). In some countries promising measures as deworming dogs (Czech Republic, Switzerland) were not recognized as prevention options. Conclusion Our results and the actual epidemiological circumstances of AE call for proactive information programs. This communication should enable the public to achieve realistic risk perception, give clear information on how people can minimize their infection risk, and prevent exaggerated reactions and anxiety.

[Helminth control in the adult horse: the need for a re-orientation].

The epidemiological situation of strongyle infections in adult horses in Switzerland is characterized by a strong dominance of small strongyles (Cyathostominae) and an overall low level of egg shedding in the faeces. The prevailing attitude towards anthelmintic therapy considers neither husbandry conditions nor pasture hygiene measures. Instead, calendar-based routine medication, comprising usually 3 to 4 annual treatments, is the typical strategy. Such an approach, however, often results in an excessive administration of anthelmintics. With respect to the continuous spread of drug resistant cyathostomins a change of strategy seems inevitable. A consensus has been agreed on between equine parasitologists and clinicians of the Vetsuisse Faculty in Zurich and Berne to focus on the concept of a selective control approach, based on individual faecal egg counts as the central element. It is now recommended that clinically healthy horses (> 4 y) are treated only when their strongyle egg count is equal to or higher than 200 eggs per gram of faeces. A regular analysis of the strongyle population based on larval cultures, the control of drug efficacy, and quarantine measures for incoming horses are mandatory components of the concept. Recent experiences in several pilot farms have indicated that only 4 % of the McMaster analyses resulted in a deworming treatment. For horses that did not receive any nematicidal anthelmintic during the current season, a "safety" treatment is recommended at the end of the grazing period.

Genetic identification of an oxyurid from a captive, black-handed spider monkey—implications for treatment and control

Parasites are of major clinical significance in captive primates in zoos, particularly those with direct life cycles. Oxyurid nematodes can be a persistent problem, as infection intensity and environmental contamination with infective eggs are usually high. Observations at the Basel Zoo in Switzerland have revealed that particularly black-handed spider monkeys (Ateles geoffroyi) exhibit continuous oxyurid nematode infection(s), despite regular deworming with anthelmintics. In the present study, using a molecular approach, we were able to identify the nematode (Trypanoxyuris atelis) causing this ongoing problem, and we are now evaluating a practical treatment and control regimen to tackle this parasite problem.