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Diversity and Prevalence of Helminths and Protozoa Among Pregnant Women in Tropical Ecuador: Implications for Chemotherapy
Manuel Calvopina
manuelcalvopina@gmail.com
Manuel Calvopina
One Health Research Group, Facultad de Medicina, Universidad de las Américas (UDLA), Quito, Ecuador;
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Jesse Contreras
Jesse Contreras
Department of Epidemiology, University of Michigan, Ann Arbor, Michigan;
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William Cevallos
William Cevallos
Instituto de Biomedicina, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador;
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Gwenyth Lee
Gwenyth Lee
Rutgers Global Health Institute and Department of Biostatistics and Epidemiology, Rutgers University, New Brunswick, New Jersey;
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Karen Levy
Karen Levy
Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington
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Joseph N. S. Eisenberg
jnse@umich.edu
Joseph N. S. Eisenberg
Department of Epidemiology, University of Michigan, Ann Arbor, Michigan;
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Deworming for pregnant women using a single dose of albendazole or mebendazole is recommended by the WHO in areas where the baseline prevalence of hookworm and/or trichuriasis is >20%. However, other helminths and protozoa infecting pregnant women are not affected by these drugs and dosages. To assess the prevalence and diversity of intestinal helminth and protozoan infections, we analyzed stool samples from pregnant women recently enrolled into a birth cohort, along a rural-urban gradient in northern coastal Ecuador from 2019 to 2022. Participants provided a stool sample in their third trimester (n = 444). Samples were concentrated by the Ritchie method and observed microscopically for the detection of cysts, eggs, and larvae. The overall prevalence of infection with one or more parasites was 69% (95% CI: 67–74%), ranging from 52% in urban participants to 76% in rural participants (percentile rank = 1.39, 95% CI: 1.07–1.87). This differential between urban and rural communities persisted when data were disaggregated into helminth and protozoan infections (prevalence = 19% and 46%, respectively, in urban participants compared with 42% and 58% among rural participants). The most prevalent helminth was Ascaris lumbricoides (27%), followed by Trichuris trichiura (13%) and hookworm (7.4%). Hymenolepis nana, Strongyloides stercoralis, and Enterobius vermicularis were also observed. Six protozoan pathogens were detected, including Entamoeba histolytica/dispar (23%), Giardia intestinalis (5%), and Balantidium coli, along with nine protozoa that are nonpathogenic or of debated pathogenicity. The high infection burden and diversity of intestinal parasites found in this study highlight a need to revise strategies for preventing and treating intestinal parasitic infections in pregnant women.
Author Notes
Financial support: This work was partially supported by an award from the
Disclosure: The study protocol was approved by the ethics committee of the Universidad San Francisco-Quito (2018-022M), Emory University (IRB00101202), and the Ministerio de Salud Pública del Ecuador (MSP-DIS-2019-0002-O).
Current contact information: Manuel Calvopina, One Health Research Group, Facultad de Medicina, Universidad de las Américas (UDLA), Quito, Ecuador, E-mail: manuel.calvopina@udla.edu.ec. Jesse Contreras and Joseph N. S. Eisenberg, Department of Epidemiology, University of Michigan, Ann Arbor, MI, E-mails: jdcon@umich.edu and jnse@umich.edu. William Cevallos, Instituto de Biomedicina, Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador, E-mail: wcevallos@uce.edu.ec. Gwenyth Lee, Rutgers Global Health Institute, Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, New Brunswick, NJ, E-mail: gwenyth.lee@globalhealth.rutgers.edu. Karen Levy, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, E-mail: klevyx@uw.edu.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 310 | 310 | 104 |
| Full Text Views | 12 | 12 | 3 |
| PDF Downloads | 19 | 19 | 5 |