Prevalence and risk factors of <i>Strongyloides stercoralis</i> infection among Orang Asli schoolchildren: new insights into the epidemiology, transmission and diagnosis of strongyloidiasis in Malaysia

Al-Mekhlafi, Hesham M.; Nasr, Nabil A.; Lim, Yvonne Ai‐Lian; Elyana, Fatin Nur; Sady, Hany; Atroosh, Wahib M.; Dawaki, Salwa; Anuar, Tengku Shahrul; Noordin, Rahmah; Mahmud, Rohela

doi:10.1017/s0031182019000945

Cited by 17 publications

(16 citation statements)

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“…Our population included mainly boys (60.6%), with a mean age of 7 years. No correlation was found between strongyloidiasis and age or sex in our cohort, even if a recent study on Malaysian children reported a significative relation with male gender and older age [ 35 ]. In our study, the African origin was significantly correlated with S. stercoralis infection, compared to other countries ( p = 0.013).…”

Section: Discussioncontrasting

confidence: 85%

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Strongyloidiasis in Children Outside the Tropics: Do We Need to Increase Awareness?

et al. 2021

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Strongyloidiasis belongs to the group of neglected tropical diseases, due to diagnostic difficulties and the lack of systematic screening. Studies on strongyloidiasis prevalence are often heterogenous and mainly performed in adults in endemic countries. We retrospectively enrolled 2633 children referred to a tertiary care hospital in Italy between 2009 and 2020 and tested for S. stercoralis infection. Sixty-one (2.3%) had a positive serology and for 55 of them, clinical and epidemiological information were available. Thirteen cases (24%) were diagnosed in Italian children without history residency or travel to foreign countries, while the remaining were internationally adopted or migrant children. Seropositive patients were mostly asymptomatic, and often eosinophilia was the only sign of strongyloidiasis. Sero-reactivity to Toxocara canis was found in 1/3 of patients. Ivermectin was used in 37 (75.5%) treated patients. A significant reduction of eosinophil levels and IgG titer was seen after treatment. Our study confirms that strongyloidiasis is usually asymptomatic in children. However, due to the ability of the parasite to cause a life-long infection together with the risk of a severe form in case of immunosuppression, it is important to identify and treat infected children. Special consideration should be reserved to high-risk groups, such as immigrants and international adoptees, where screening for S. stercoralis is indicated. However, the study highlights that sporadic cases of autochthonous strongyloidiasis in Italy may occur. Therefore, pediatricians should be aware of this condition, which is often under-recognized.

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Section: Discussioncontrasting

confidence: 85%

“…Regarding the pediatric age, limited studies are currently available only in endemic regions, showing a significantly higher seroprevalence compared to our study. In particular, in Angola, Cambodia, and Malaysia, the strongyloidiasis positivity rate of children was 21.4%, 24%, and 15.8%, respectively [ 7 , 35 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Strongyloidiasis in Children Outside the Tropics: Do We Need to Increase Awareness?

et al. 2021

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“…As a consequence, nearly 80% of the Orang Asli population are beneath the poverty line compared to 1.4% of the national population, and this hardship is reflected in a 20-year lower average life expectancy of just 53 years [13]. Several studies have highlighted the susceptibility of these populations to specific diseases [14, 15]. More recently a study of 73 adults from the semi-urbanized Temiar, an Orang Asli tribe of Kampong Pos Piah, in Perak, examined salivary microbiomes in the context of obesity – a growing concern and evidence of the epidemiological shifts in disease burden as these communities leave their more traditional existences [16].…”

Section: Introductionmentioning

confidence: 99%

The upper respiratory tract microbiome of indigenous Orang Asli in north-eastern Peninsular Malaysia

Cleary

Morris

Anderson

et al. 2020

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Background: Microbiome research has focused on populations that are predominantly of European descent, and from narrow demographics that do not capture the socio-economic and lifestyle differences which impact human health. This limits our understanding of human-host microbiota interactions in their broadest sense. Here we examined the airway microbiology of the Orang Asli, the indigenous peoples of Malaysia. In addition to exploring the carriage and antimicrobial resistance of important respiratory pathobionts, we also present the first investigation of the nasal microbiomes of these indigenous peoples, in addition to their oral microbiomes. Results: A total of 130 participants were recruited to the study from Kampung Sungai Pergam and Kampung Berua, both sites in the north-eastern state of Terengganu in Peninsular Malaysia. High levels of Staphylococcus aureus carriage were observed, particularly in the 18-65 age group (n=17/36; 47.2% 95%CI: 30.9-63.5). The highest carriage of pneumococci was in the <5 and 5 to 17 year olds, with 57.1% (4/7) and 49.2% (30/61) respectively. Sixteen pneumococcal serotypes were identified, the most common being the non-vaccine type 23A (14.6%) and the vaccine type 6B (9.8%). The nasal microbiome was significantly more diverse in those aged 5-17 years compared to 50+ years (p = 0.023). In addition, samples clustered by age (PERMANOVA analysis of the Bray-Curtis distance, p = 0.001). Hierarchical clustering of Bray-Curtis dissimilarity scores revealed six microbiome types. The largest cluster (n=28; 35.4%) had a marked abundance of Corynebacterium. Others comprised Corynebacterium with Dolosigranulum, two clusters were definable by the presence of Moraxella, one with and the other without Haemophilus, a small grouping of Delftia/Ochrobactum profiles and one with Streptococcus. No Staphylococcus profiles were observed. In the oral microbiomes Streptococcus, Neisseria and Haemophilus were dominant. Lower levels of Prevotella, Rothia, Porphyromonas, Veillonella and Aggregatibacter were also among the eight most observed genera. Conclusions: We present the first study of Orang Asli airway microbiomes and pathobiont microbiology. Key findings include the prevalence of pneumococcal serotypes that would be covered by pneumococcal conjugate vaccines if introduced into a Malaysian national immunisation schedule, and the high level of S. aureus carriage. The dominance of Corynebacterium in the airway microbiomes is particularly intriguing given its' consideration as a potentially protective commensal with respect to acute infection and respiratory health.

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“…Although the prevalence range for STH infection was wide (14.1 to 98.4%), eight of 12 studies recorded STH infection as more than 70.0%. Interestingly, the remaining studies found STH prevalence rates ranging from 14.1 to 48.0% in primary schoolchildren [ 15 , 17 , 18 , 23 ]. The prevalence is still much higher than in the general Malaysian population [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Diseases among Orang Asli community in Malaysia: a systematic review

2022

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Orang Asli, the indigenous people of Peninsular Malaysia, is a minority population and placed behind in terms of socioeconomy, education and health. The Malaysian government has supported Orang Asli since the second Malaysia Plan in the 1970s, resulting in changes in their living standard, access to health, education and occupation. Hence, this review aims to assess the recent prevalence of diseases among Orang Asli in Peninsular Malaysia. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) review protocol guided this systematic review. The research question was formulated based on Population, Interest, Comparison and Outcome (PICO). The selected databases include Web of Science, Scopus, Ovid and EBSCOhost. The process of identification, screening and inclusion identified 33 articles. The mixed methods appraisal tool (MMAT) was then used to rank the quality of the articles. Selangor is the most frequent state involved in this review (12 studies), followed by Perak (10 studies), Pahang (10 studies) and Kedah (one study). We categorised into four categories of diseases, namely neglected tropical disease (n = 20), non-communicable disease (n = 6), nutritional status (n = 5), and hepatic disease (n = 2). The prevalence of diseases among Orang Asli is higher than in the general population, especially for soil-transmitted helminth (STH) and malnutrition. There is increasing research on non-communicable diseases due to an increasing trend in the socioeconomic status and lifestyle of the Orang Asli. Government agencies and private organisations must work together to empower Orang Asli with a healthy lifestyle, improve their socioeconomic status, and enhance food security, all of which will improve Orang Asli's health and reduce the prevalence of diseases.

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Prevalence and risk factors of Strongyloides stercoralis infection among Orang Asli schoolchildren: new insights into the epidemiology, transmission and diagnosis of strongyloidiasis in Malaysia

Cited by 17 publications

References 70 publications

Strongyloidiasis in Children Outside the Tropics: Do We Need to Increase Awareness?

Strongyloidiasis in Children Outside the Tropics: Do We Need to Increase Awareness?

The upper respiratory tract microbiome of indigenous Orang Asli in north-eastern Peninsular Malaysia

Diseases among Orang Asli community in Malaysia: a systematic review

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