Helminth Infections and their Impact on Global Public Health

Foreword
References
Preface
Contents
Editor and Contributors
Chapter 1: Epidemiology and Economics of Deworming
1.1 Introduction
1.1.1 The Evolution of Deworming Programmes
1.1.1.1 The Importance of Scale
1.1.1.2 Developing more Efficient Programmes
1.1.1.3 Towards a New Global Policy on Deworming
1.2 Global Evidence of Deworming
1.2.1 Coverage Achieved to Date
1.2.2 Looking Towards the Endpoint
1.2.3 Elimination as a Public Health Problem or Interruption of Transmission?
1.3 Assessing the Impact: The ``Worm Wars´´ and Beyond
1.3.1 Reviewing the Statistical Evidence from Meta-Analyses
1.3.2 Debates over Long-Run Results of Deworming
1.3.3 Reframing the Debates over Evidence as Policy Decisions
1.4 The Economics of Interventions
1.4.1 Costs Related to Deworming Programmes
1.4.1.1 Delivery Cost Benchmarks and Drivers
1.4.1.2 Cost of the Drugs
1.4.2 Cost-Effectiveness of Deworming
1.4.3 Economic Benefits of Deworming
1.5 Health System Issues
1.5.1 Reliance on External Support and Donations and MDA Instability
1.5.2 MDA Does Not Equate with UHC
1.5.3 Rethinking Infection Mapping Strategies
1.5.4 Towards Patient-Led, On-Demand Treatment
1.5.5 Improved Health Information Systems to Support UHC
1.5.6 Future Research Is Needed for UHC Integration
1.6 Conclusions
References
Chapter 2: History and Diversity: Establishing a Context for Helminth Biology
2.1 Introduction
2.2 Complexities Surrounding Helminth Systematics
2.2.1 Helminth Parasites and the World Stadium
2.2.2 Host Colonization Drives Helminth Evolution
2.2.3 Anthropogenic Translocation of Parasitic Helminths
2.3 Defining Diversity
2.3.1 Molecular Epidemiology, Diversity, and Helminth Systematics
2.3.2 Populations, Natural Hybrids, and Adequate Sampling
2.4 Genomics, Systematics, and Parasitic Worms
2.4.1 Phylogenomics and Evolutionary Inference
2.4.2 Comparative Genomics, Transcriptomics, and Evolutionary Inference
2.5 Conclusions: Human Helminths in a World under Change
References
Chapter 3: Paleoparasitology of Helminths
3.1 Introduction
3.2 Materials
3.3 Methods
3.3.1 Morphological Examination
3.3.2 Ancient DNA
3.4 Review of the Literature
3.4.1 Africa
3.4.1.1 Trematodes
3.4.1.2 Cestodes
3.4.1.3 Nematodes
3.4.2 Middle East
3.4.2.1 Trematodes
3.4.2.2 Cestodes
3.4.2.3 Nematodes
3.4.3 Europe
3.4.3.1 Trematodes
3.4.3.2 Cestodes
3.4.3.3 Nematodes
3.4.4 Asia
3.4.4.1 Trematodes
3.4.4.2 Cestodes
3.4.4.3 Nematodes
3.4.5 America
3.4.5.1 Trematodes
3.4.5.2 Cestodes
3.4.5.3 Nematodes
3.5 Conclusions
References
Chapter 4: Under the Influence: The Systemic Consequences of Helminth Infection
4.1 Introduction
4.2 Immunomodulation
4.3 Therapies with, and from, Helminths
4.4 Vaccine Unresponsiveness
4.5 Co-Infection: Ups and Downs
4.6 Microbiome Interactions
4.7 Metabolism: Inflammation and Helminth Infection
4.8 Transgenerational Effects
4.9 Pathology, Neurotropism and Cancer
4.10 Conclusions
4.11 Acknowledgements
References
Chapter 5: Schistosomiasis
5.1 Introduction
5.2 The Agent and Life Cycle
5.3 Epidemiology of Schistosomiasis
5.4 Immunopathogenesis of Schistosoma Infection
5.4.1 Acute Schistosomiasis
5.4.2 Chronic Schistosomiasis
5.4.2.1 Granuloma Formation
5.4.2.2 Immunomodulation of the Granulomatous Response
5.5 Pathogenesis and Clinical Features of Schistosomiasis
5.5.1 Stage of Invasion (Cercarial Dermatitis)
5.5.2 Stage of Maturation (Katayama Fever; Acute Schistosomiasis)
5.5.3 Stage of Established Infection
5.5.4 Stage of Late Infection and Sequelae
5.5.4.1 Systemic Non-specific Morbidity
5.5.4.2 Genitourinary Schistosomiasis
5.5.4.3 Intestinal Schistosomiasis
5.5.4.4 Hepatosplenic Schistosomiasis
5.5.4.5 Neuroschistosomiasis
5.5.4.6 Cardiopulmonary Schistosomiasis
5.5.4.7 Coinfection of Schistosoma and Endemic Pathogens
5.6 Diagnosis
5.6.1 Parasitological Techniques
5.6.2 Immunological Techniques
5.6.3 Molecular Techniques
5.6.4 Other Useful Non-specific Tests
5.7 Treatment of Schistosomiasis
5.7.1 Schistosomicidal Agents
5.7.1.1 Praziquantel
5.7.1.2 Other Drugs
5.7.1.3 Novel Therapeutic Approaches
5.7.1.4 Adjuvant Therapy
5.7.2 Symptomatic Treatment and Management of Complications
5.8 Prognosis
5.9 Prevention and Control
5.9.1 Preventive Chemotherapy
5.9.2 Vector Control
5.9.3 Vaccine Development
5.9.3.1 The Immediate Need of a Vaccine
5.9.3.2 The Prospects of the Candidate Vaccine Antigens
5.9.3.3 The Breakthrough Progress
References
Chapter 6: Fascioliasis
6.1 Introduction
6.2 The Agent
6.3 Epidemiology of Infection
6.3.1 Epidemiological Heterogeneity of Human Fascioliasis
6.3.2 Seasonality and Long-Term Impacts of Climate and Global Changes
6.3.3 Sources of Human Infection
6.4 The Host Response to the Parasite
6.4.1 Immunological Processes
6.4.2 Associations with Other Parasites
6.5 Pathology
6.5.1 Liver and Biliary Tract
6.5.2 Other Locations, Ectopic Fascioliasis and at Distance Effects
6.6 Clinical Manifestations
6.6.1 Invasive or Acute Phase
6.6.2 Biliary or Chronic Phase
6.6.3 Clinical Laboratory Analyses
6.7 Diagnosis
6.7.1 Direct Techniques
6.7.2 Indirect Techniques
6.8 Treatment
6.9 Prognosis, Complications, Sequelae and Death Causes
6.10 Prevention and Control
6.10.1 Prevention of Human Infection
6.10.2 Control Measures at Community Level
6.10.3 Progress in Vaccinology
6.11 Acknowledgements
References
Chapter 7: Clonorchiasis and Opisthorchiasis
7.1 Introduction
7.2 History
7.3 The Life Cycle
7.4 Taxonomy and Genetic Variability
7.5 Geographical Distribution
7.6 Intermediate Hosts
7.7 Final Hosts
7.8 Epidemiology
7.9 Animal Reservoir
7.10 Pathology and Pathogenesis
7.10.1 Clonorchis sinensis
7.10.2 Opisthorchis viverrini
7.10.3 Opisthorchis felineus
7.10.4 Associated Pathologies
7.10.5 Carcinogenesis Induced by Liver Flukes
7.10.6 Toxic Effects of Parasite Excretory/Secretory (ES) Products
7.10.7 Immunopathology due to Infection-Related Inflammation
7.11 Immune Response
7.11.1 O. viverrini
7.11.2 C. sinensis
7.11.3 O. felineus
7.12 Clinical Manifestations
7.12.1 Opisthorchis viverrini
7.12.2 Clonorchis sinensis
7.12.3 Opisthorchis felineus
7.13 Diagnosis
7.13.1 Parasitological Diagnosis
7.13.2 Detection of Parasite Antigens in Stools
7.13.3 Detection of Parasite DNA in Stools
7.13.4 Serological Diagnosis
7.14 Human Treatment
7.15 Prevention and Control
References
Chapter 8: Echinococcosis
8.1 Introduction
8.2 The Agent
8.2.1 Life Cycle
8.2.2 The Echinococcal Cyst and Its Natural History
8.2.3 Alveolar Echinococcosis Lesions and Their Natural History
8.3 Epidemiology of Infection
8.3.1 Geographical Distribution and Burden of Infection
8.3.2 Transmission and Risk Factors for Human Infection
8.3.3 Genetic Diversity
8.4 Host Response to the Parasite
8.4.1 Immune Response to E. granulosus sensu lato
8.4.2 Immune Response to E. multilocularis
8.5 Clinical Manifestations of CE
8.6 Clinical Manifestations of AE
8.7 Diagnosis
8.7.1 Imaging
8.7.2 Serology
8.8 Treatment
8.8.1 Treatment of CE
8.8.2 Surgery
8.8.3 Medical Treatment
8.8.4 Percutaneous Treatment
8.8.4.1 Needle-Based Techniques
8.8.4.2 Catheter-Based Techniques
8.8.4.3 General Indications for Percutaneous Techniques
8.8.5 Watch and Wait
8.8.6 Treatment of AE
8.8.7 Medical Treatment
8.8.8 Surgery and Interventional Nonsurgical Procedures
8.8.9 Watch and Wait
8.9 Prognosis and Follow-Up
8.10 Prevention and Control
References
Chapter 9: Taeniasis and Cysticercosis
9.1 Introduction
9.2 The Agent
9.3 Epidemiology of Infection
9.4 The Host Response to the Parasite and Pathogenesis
9.4.1 Innate Immunity
9.4.2 Adaptive Immunity
9.4.3 Humoral Responses
9.4.4 Cellular Responses
9.4.5 Other Immunomodulation and Evasion Mechanisms
9.5 Inmunopathological Processes
9.6 Clinical Manifestations
9.6.1 Taeniasis
9.6.2 Cysticercosis
9.7 Diagnosis
9.7.1 Diagnosis of Taeniasis
9.7.1.1 Parasitological Diagnosis
9.7.1.2 Immunodiagnosis
9.7.1.3 Molecular Diagnosis
9.7.2 Diagnosis of Cysticercosis
9.7.2.1 Parasitological Diagnosis
9.7.2.2 Neuroimaging
9.7.2.3 Immunodiagnosis
9.7.2.4 Molecular Diagnosis
9.8 Treatment
9.8.1 Taeniasis
9.8.2 Cysticercosis
9.8.2.1 Cysticidal Therapy
9.8.2.2 Symptomatic Therapy
9.8.2.3 Corticosteroids
9.8.2.4 Surgery
9.9 Prognosis
9.10 Prevention and Control
References
Chapter 10: Trichinellosis
10.1 Introduction
10.2 The Agent
10.2.1 Species and Genotypes
10.2.2 Parasite Cycle
10.3 Epidemiology of Infection
10.3.1 Past Situation
10.3.2 Present Situation
10.3.3 An Emerging or Re-emerging Disease?
10.4 The Host Response to Trichinella
10.4.1 Immune Response at Intestinal Level
10.4.2 Cells Involved in the Intestinal Response
10.4.2.1 Mucosal Mast Cells and Goblet Cells
10.4.2.2 Eosinophils at the Intestinal Level
10.4.2.3 Inflammatory Response at Intestinal Level
10.4.3 Immune Response at Muscle Level
10.4.3.1 The Role of Eosinophils
10.5 Immunopathology
10.5.1 Enteral Phase of Infection
10.5.2 Parenteral Phase of Infection
10.5.3 Heart and CNS Involvement
10.6 Clinical Manifestations
10.6.1 Acute Phase
10.6.2 Complications
10.6.2.1 Cardiovascular Complications
10.6.2.2 Neurological Complications
10.6.2.3 Other Complications
10.6.3 Clinical Forms
10.6.3.1 Severity and Infective Dose
10.6.3.2 Species and Genotypes
10.6.3.3 Pregnancy and Childhood
10.7 Diagnosis
10.7.1 Nonspecific Laboratory Signs
10.7.1.1 Eosinophilia
10.7.1.2 Muscle Enzymes
10.7.1.3 Immunoglobulin Level Increase
10.7.1.4 Matrix Metalloproteinases
10.7.2 Immunodiagnosis
10.7.2.1 Antigens to Be Used in the Serological Methods
10.7.2.2 Antibody Response
10.7.2.3 Serological Techniques
10.7.3 Muscle Biopsy
10.7.3.1 Trichinelloscopy
10.7.3.2 Artificial Digestion
10.7.3.3 Histology
10.7.3.4 Molecular Analysis
10.7.4 Differential Diagnosis
10.8 Treatment, Evolution, and Prognosis
10.8.1 Specific Treatment
10.8.1.1 Mebendazole
10.8.1.2 Albendazole
10.8.2 Nonspecific Treatment
10.8.3 Pregnancy and Childhood
10.8.4 Evolution and Prognosis
10.8.4.1 Lethality
10.8.4.2 Chronic Trichinellosis
10.9 Perspectives of Control
10.10 Conclusions
References
Chapter 11: Soil-Transmitted Helminthiasis
11.1 Introduction
11.2 The Agents
11.3 Epidemiology of Infection
11.4 The Host Response to the Parasite
11.5 Immunopathological Processes
11.6 Clinical Manifestations in Immunocompetent and Immunocompromised Patients
11.7 Diagnosis (Inclusive of Histopathology)
11.8 Treatment
11.8.1 Clinical Management
11.8.1.1 Ascariasis
11.8.1.2 Trichuriasis
11.8.1.3 Hookworm Infections
11.8.2 Preventive Chemotherapy
11.8.3 Drug Efficacy and Its Assessment
11.9 Prognosis
11.10 Prevention and Control
11.10.1 Preventive Chemotherapy
11.10.2 Global Goals and Targets
11.10.3 Integrated Approach
11.10.4 Complementary Public Health Interventions
11.10.5 Vaccinology
11.10.6 Conclusions
References
Chapter 12: Strongyloides stercoralis and Strongyloidosis
12.1 Introduction
12.2 The Agent
12.2.1 Life Cycle and Morphology
12.2.2 Phylogenetic Analysis
12.2.3 Mechanisms of Development
12.3 Epidemiology of Infection
12.4 The Host Response to the Parasite and Immunopathological Processes
12.5 Clinical Manifestations and Prognosis in Immunocompetent and Immunocompromised Patients
12.6 Diagnosis (Inclusive Histopathology)
12.6.1 Microscopic Examination and Histopathology
12.6.2 Serological Diagnosis
12.6.3 PCR-Based Examination
12.7 Treatment
12.7.1 First-Line Therapy
12.7.2 Alternative
12.8 Prevention and Control
12.9 Concluding Remarks
References
Chapter 13: Anisakiasis
13.1 Introduction
13.2 The Agent
13.3 Current Methods Used for the Identification of Anisakis spp.
13.3.1 Allozyme Markers
13.3.2 PCR-RFLP Analysis
13.3.3 DNA Sequencing of Nuclear and Mitochondrial Gene Loci
13.3.4 DNA Microsatellite Loci (SSRs)
13.3.5 Multiplex and Species-Specific PCR
13.3.6 Real-Time PCR
13.4 Life Cycle, Hosts, and Geographical Distribution of Anisakis spp.
13.4.1 Host Preference
13.4.2 Geographical Distribution of Nine Species of Anisakis
13.5 The Human Response to the Parasite
13.5.1 Immunopathological Processes
13.5.2 Histopathology of Anisakiasis
13.6 Clinical Manifestations of Anisakiasis
13.6.1 Gastric Anisakiasis (GA)
13.6.2 Intestinal Anisakiasis (IA)
13.6.3 Gastro-allergic Anisakiasis (GAA)
13.6.4 Anisakis Allergy
13.6.5 Anisakis and Cancer
13.7 Diagnosis of Human Anisakiasis
13.7.1 Histological Diagnosis
13.7.2 Molecular Diagnosis
13.7.3 Sero-diagnosis
13.8 ``Omic´´ Technologies Applied to Anisakid Nematodes
13.9 Treatment
13.10 Prevention and Control
References
Chapter 14: Lymphatic and Tissue Filariasis
14.1 The Agents
14.2 Lymphatic Filariasis
14.2.1 Life Cycle, Vectors, and Morphology
14.2.2 Epidemiology of Infection
14.2.3 The Host Response to the Parasite
14.2.4 Immunopathological Processes and Disease
14.2.5 Diagnosis
14.3 Tissue Filariasis
14.3.1 Life Cycle, Vectors, and Morphology
14.3.1.1 Loa loa
14.3.1.2 Onchocerca volvulus
14.3.1.3 Mansonella perstans, M. ozzardi, and M. streptocerca
14.3.2 Epidemiology of Infection
14.3.2.1 Loa loa
14.3.2.2 Onchocerca volvulus
14.3.2.3 Mansonella perstans, M. ozzardi, and M. streptocerca
14.3.3 The Host Response to the Parasite
14.3.3.1 Loa loa
14.3.3.2 Onchocerca volvulus
14.3.3.3 Mansonella perstans, M. ozzardi, and M. streptocerca
14.3.4 Immunopathological Processes and Disease
14.3.4.1 Loa loa
14.3.4.2 Onchocerca volvulus
14.3.4.3 Mansonella perstans, M. ozzardi, and M. streptocerca
14.3.5 Diagnosis (Inclusive of Histopathology)
14.3.5.1 Loa loa
14.3.5.2 Onchocerca volvulus
14.3.5.3 Mansonella perstans, M. ozzardi, and M. streptocerca
14.4 Alterations in Clinical Manifestations of Immunocompromised Filarial-Infected Individuals
14.5 Treatment and Prognosis
14.6 Prevention and Control
References
Chapter 15: Dirofilaria Infections in Humans and Other Zoonotic Filariases
15.1 The Main Agents of Zoonotic Filariases: An Introduction
15.2 Dirofilaria Infections in Humans: Epidemiology and Clinical Manifestations
15.3 Is the Spread of Dirofilaria Infection an Actual Trend?
15.4 Prospects for the Control of Dirofilaria Infections in Humans
15.5 Other Species of Filarial Nematodes Infecting Humans
References
Chapter 16: Toxocariasis
16.1 Introduction
16.2 Life Cycle and Transmission Routes
16.3 Clinical Syndromes
16.3.1 Visceral Larva Migrans
16.3.2 Ocular Larva Migrans
16.3.3 Neurotoxocariasis
16.3.4 Covert Toxocariasis
16.4 Epidemiology
16.5 Immune Response and Pathogenesis
16.6 Diagnosis
16.6.1 Clinical Signs and Symptoms
16.6.2 Medical Imaging Techniques
16.6.3 Haematological and Biochemical Assessment
16.6.4 Serodiagnosis
16.6.4.1 Antibody Detection
16.6.4.2 Antigen Detection
16.6.5 Molecular Diagnostic Methods
16.6.6 Diagnosis of T. cati Infection
16.7 Need for Standardisation of Diagnostic Tools
16.7.1 Standardisation of Serodiagnosis
16.7.1.1 Standardisation of Antigen for Serodiagnosis
16.7.1.2 Evaluation of Commercially Available Kits
16.7.1.3 Representation of Results
16.7.1.4 Cut-off Value Determination
16.7.2 Improvement of Alternative Methods for Definitive Diagnosis
16.7.3 Problems with Epidemiological Surveys of Human Toxocariasis
16.8 Treatment
16.9 Prevention and Control of Infection
16.10 Conclusions
References
Chapter 17: Can the Study of Parasitic Helminths Be Fruitful for Human Diseases?
17.1 Introduction
17.2 Worms and Asthma
17.3 Worms and Arthritis
17.4 Worms and Multiple Sclerosis
17.5 Worms and Type 1 Diabetes
17.6 Worms and Inflammatory Bowel Disease
17.7 Worms and Metabolic Syndrome
17.8 Conclusions
References