Soil transmitted helminthiases is a collective name for diseases caused by a group of intestinal parasites belonging to the phylum nematode.They are transmitted primarily through contaminated soil.Eggs present in human faeces contaminate the soil in areas where sanitation is poor.

Soil transmitted helminthiasisis classified as one of the neglected tropical diseases (NTDs), it affects approximately 2 billion people.Globally the school age children are the most commonly infected; resulting in poor school performance, morbidity and many more. STH infections are widely distributed in tropical and sub-tropical areas, with the greatest numbers occurring in sub-Saharan Africa, America, China and East Asia.

TYPES OF SOIL TRANSMITTED HELMINTHIASIS

Soil transmitted helminthiasis includes specie specific diseases such as:

Ascariasis: caused by round worm;Ascaris lumbricoides

Hookworm diseases: caused by Hookworm (Ancyclostoma deuodenale and Necatoramericanus)

Trichuriasis: caused by whipworm;Trichuris trichiura

Strongyloidiasis: caused by a thread worm; Strongyloides stercoralis

PEOPLE AT RISK OF GETTING INFECTED

Preschool aged children

School aged children

Women of childbearing age (including pregnant women in the second and third trimester and breastfeeding women.

EPIDEMIOLOGY

Soil-transmitted helminthiases are found mainly in areas with warm and moist climates where sanitation and hygiene are poor. More than 1.5 billion people (24% of the world’s population) are infected with soil-transmitted helminth infections worldwide. Infections are widely distributed in tropical and sub-tropical areas, with the greatest occurrence in sub-Saharan Africa, America, China and East Asia.

MODE OF TRANSMISSION

Thetransmission is determined by some factors such as; Hygiene, Sanitation and Poverty.

HOW IT IS TRANSMITTED:

Soil-transmitted helminth lives in the intestine of man and their eggs are passed through the faeces of infected persons. If an infected person defecates outside (near bushes, in a garden, or field) or the faeces of infected persons are used as fertilizer, the eggs are deposited on soil. Ascaris and hookworm eggs become infective as they mature in soil. People are infected with Ascaris and whipworm when eggs are ingested. This can happen when hands or fingers that have touched contaminated dirt are put in the mouth or by consuming vegetables and fruits that has not been carefully cooked, washed or peeled.

Hookworm eggs are not infective until they come in contact with soil. Where they hatch, releasing larvae (immature worms) that mature into a form that can penetrate the skin of humans. Hookworm infection is transmitted primarily through penetration when a person walks barefoot on contaminated soil.

WAYS IN WHICH THE EGGS ARE INGESTED BY HUMANS;

Through food (e.g. vegetables or fruits that are not carefully cooked, washed or peeled),

Through hands or utensils that are not properly washed.

For hookworms;

It is through penetration of the skin by the infective hook worms’ larvae (Necator americanus and Ancylostoma duodenale)in contaminated soil.

EFFECT OF SOIL TRANSMITTED HELMINTHIASIS ON HUMAN LIFE

Soil transmitted helminthiasis limit child growth and learning,

It can lead to anaemia due to blood loss and chronic protein deficiency(Hookworms infection)

It can also cause intestinal discomfort, obstruction and impaired nutritional status(Roundworms)

It can cause chronic abdominal pain, diarrhea, blood loss, dysentery and rectal prolapse (Whipworm infection).

SYMPTOMS OF SOIL TRANSMITTED HELMINTHIASIS

People with less severe soil-transmitted helminth infections usually have no symptoms. However, severe infections can cause a range of health problems, including:

Abdominal pain,

Diarrhea,

Blood and protein loss,

Physical and cognitive growth retardation,

Loss of appetite,

Malnutrition.

DISEASE MANAGEMENT:

DIAGNOSIS

Soil transmitted helminthiasis (STHs) can be readily diagnosed by the detection of helminthiasis eggs in stool samples using microscopic techniques. However, a very effective method for egg analysis is the kato-katz techniques. It is a highly accurate and rapid method.

TREATMENT

This can be achieved through regular mass drug administration (MDA) with a single dose of Albendazole or Mebendazole.

PREVENTION AND CONTROL

WHO recommended strategy for soil transmitted helminthiasis control is to conduct a regular periodic treatment of all at risk population in endemic areas. However, the following preventive measures can be adhered to:

Stakeholder and government agencies should encourage good environmental sanitation and proper fecal waste disposal by providing good functional toilet facility for the community member.

Availability of clean water for personal and domestic use.

Proper washing of vegetables before eating.

Education of the community on personal hygiene such as hand washing and safe food preparation.

Elimination of the use of untreated human faeces as fertilizers.

To prevent hookworm infection, avoid walking barefooted in areas where hookworm is common and where there may be soil with human fecal contamination.

Avoid contact with soil that may be contaminated with human faeces, including where human fecal matter or wastewater is used to fertilize crops.

REFERENCES
WHO (2012).Helminth Control in School-age Children: a Guide for Managers of Control Programmes (PDF) (2 ed.). WHO Press, World Health Organization, Geneva, Switzerland. pp. 1–75. ISBN 978-92-4-154826-7.

 Yap P, Fürst T, Müller I, Kriemler S, Utzinger J, Steinmann P (August 2012). “Determining soil-transmitted helminth infection status and physical fitness of school-aged children”.Journal of Visualized Experiments. 66 (66): e3966. doi:10.3791/3966. PMC 3486755.

Ziegelbauer K, Speich B, Mäusezahl D, Bos R, Keiser J, Utzinger J (January 2012). “Effect of sanitation on soil-transmitted helminth infection: systematic review and meta-analysis”. PLoS Medicine. 9 (1): e1001162. doi:10.1371/journal.pmed.1001162. PMC 3265535.PMID 22291577.

https://www.cdc.gov/parasites/hookworm/

https://en.m.wikipedia.org/wiki/Soil-transmitted_helminthiasis

https://www.neglecteddiseases.gov/usaid-target-diseases/soil-transmitted-helminths

https://www.who.int/intestinal_worms/disease/en/

https://www.who.int/news-room/fact-sheets/detail/soil-transmitted-helminth-infections

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