Parasitic infections common in kids in low-resource US communities
Date:
March 3, 2023
Source:
Washington University in St. Louis
Summary:
Neglected by government officials and medical professionals,
parasitic infections can lead to lifelong health consequences,
according to a biological anthropologist.
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FULL STORY ==========================================================================
Most Americans view parasitic infections as a problem of the past or
one that only impacts low-income countries. However, new research from Washington University in St. Louis finds evidence that the problem is
likely widespread in low-resource communities throughout southern United
States where environmental conditions combined with infrastructural
neglect and inadequate access to health care create the perfect breeding
ground for these infections.
==========================================================================
In a small, preliminary study published on March 2 in American Journal
of Human Biology, 38% of children sampled from a rural Mississippi
Delta community were found to have either parasitic worms or protist
infections -- a single-cell parasitic organisms that can negatively
impact intestinal health.
Parasitic infections are a neglected health issue in low-resource
communities, according to Theresa Gildner, study co-author and
assistant professor of biological anthropology in Arts & Sciences at
WashU. School-age children are especially at risk for these infections
due to increased exposure through play, poor hand hygiene and their still-developing immune systems.
Left untreated, the infections can lead to nutritional deficiencies and lifelong health consequences. Gildner said many of the community members
they worked with during this project expressed frustration with state
and federal governments that do not listen to their concerns related to
these issues.
"This is a failure of all levels of government to provide basic services
to vulnerable citizens. Health conditions -- including parasitic and
intestinal infections -- linked with poor sanitation will likely worsen
in coming years as climate change and associated extreme weather events
further strain already weak infrastructure systems," said Gildner,
an expert on parasitic disease and health disparities.
According to Gildner, President Biden's infrastructure bill is a step
in the right direction, but more work is needed in the near future to
invest in crumbling infrastructure.
"I do not know if President Biden's infrastructure bill will directly help
the communities where we have worked -- we haven't heard anything from our community partners -- but I think there could be indirect benefits. For instance, drawing more attention to the immediate need for investment in failing infrastructure may lead to more localized projects that benefit
these communities," she said.
But any efforts to address these infrastructure needs should start
with direct and respectful community engagement by locally elected
officials. After all, she said, "Individuals living in these communities
have the best sense of what the issues are through their lived experiences
and may have ideas for what is most needed to improve conditions in their specific community." This is a failure of all levels of government to
provide basic services to vulnerable citizens. Health conditions --
including parasitic and intestinal infections -- linked with poor
sanitation will likely worsen in coming years as climate change
and associated extreme weather events further strain already weak infrastructure systems.
About the research Understanding U.S. infection patterns -- including
the current extent of parasitic infections and key sources of exposure --
is critical to improving health outcomes, Gildner said. Previous studies
in the U.S. have been case- based or focused exclusively on immigrant populations. Very few surveys have been conducted in regions with the
most risk factors for exposure.
In the summer of 2019, members of the Rural Embodiment and Community
Health (REACH) research team -- led by Gildner and Tara J. Cepon-Robins, associate professor of anthropology at the University of Colorado Colorado Springs (UCCS), and including WashU biologist Elizabeth K. Mallott and
former UCCS undergraduate student Isabella C. Recca -- traveled to the
rural Mississippi Delta to conduct preliminary research in the community.
They chose to direct their focus on a small, predominantly Black, rural community that is frequently affected by flooding and sewage backups
due to community-reported infrastructural neglect.
In total, 24 children -- including 12 boys and 12 girls ranging in
age from infant to 14 years old -- from 12 households participated in
the study.
Altogether, 38% of the children were found to have one or both types of parasitic infections.
Contrary to expectations, they found no significant differences in
infection status based on age, sex or household size, although Gildner acknowledges that could be due to the relatively small sample size. She
hopes ongoing research with a larger dataset will allow the team to
better test these patterns in the near future.
Last summer, the team collected additional samples from adults and in the
same Mississippi community, as well as in East St. Louis in a community
facing similar issues related to failing infrastructure, persistent
flooding and sewage backups, Gildner said. The team also is analyzing soil samples collected from various shared community spaces during the 2022
trip to better examine these patterns. And plans are underway to collect additional data in other Mississippi Delta communities this summer.
Education is key Lack of education is one of the reasons why parasitic infections often go undetected.
"One interesting thing that we noticed during our 2019 visit to
Mississippi is that some of the grandparents we spoke to were aware of
the threat posed by parasite infections locally because they had heard
of these issues as children," Gildner said. "One grandparent told us
they remembered public health educational programs that discussed the
risks posed by hookworm infection and encouraged community members to
wear shoes outdoors to prevent infection.
"However, that messaging stopped after their early childhood and they had always wondered why no one talked about these infections anymore. This
kind of messaging could be relatively straightforward to implement,
although basic information on key parasite infections would have to
be provided since many people are no longer aware of these diseases."
Even health care providers often assume that parasitic infection risk
is greatest for Americans traveling abroad. Educating health care
providers about the threat posed by parasitic infections in the U.S.,
how to recognize symptoms and test appropriately is key.
"Without this basic medical knowledge, diagnoses may be missed and
treatment delayed," Gildner said. "For instance, one participant this
past summer had been diagnosed with Helicobacter pylori, a bacterium we
have recently started studying that can cause stomach ulcers and certain gastric cancers in severe cases. However, she told us it took months and
visits to multiple doctors before she was properly tested and diagnosed,
in large part due to the assumption that symptomatic cases of this
bacterial infection aren't a significant concern in the U.S." Although it
is an option for regions suffering from heavy parasitic infection rates, preventative mass drug administration is not a practical first step to addressing the problem, Gildner explained. There's not enough public
awareness of the conditions and the safe effective drugs used to treat
common parasite infections are incredibly expensive in the U.S., she said.
However, Gildner would like to see more government investment in research
at other locations across the U.S. to help clarify the current extent
of parasite infections and identify key sources of exposure that could
be targeted to improve health outcomes.
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o Lead
========================================================================== Story Source: Materials provided by
Washington_University_in_St._Louis. Original written by Sara Savat. Note: Content may be edited for style and length.
========================================================================== Journal Reference:
1. Tara J. Cepon‐Robins, Elizabeth K. Mallott, Isabella C. Recca,
Theresa E. Gildner. Evidence and potential drivers of neglected
parasitic helminth and protist infections among a small preliminary
sample of children from rural Mississippi. American Journal of
Human Biology, 2023; DOI: 10.1002/ajhb.23889 ==========================================================================
Link to news story:
https://www.sciencedaily.com/releases/2023/03/230303105241.htm
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