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      Prevalence of Intestinal Helminths among Cancer Patients Who Are under Chemotherapy at the University of Gondar Comprehensive Specialized Hospital Oncology Clinic, Northwest Ethiopia

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          Abstract

          Background

          In developing countries, environmental and personal hygiene is playing a great role in the increasing of intestinal helminth infection. In countries with limited resources and poor hygiene practices, there is a substantial overlap of intestinal helminthic and chronic infections like HIV, TB, and cancer. Intestinal helminths like Ascaris lumbricoides, Trichuris trichiura, and hookworm cause malnutrition and induce a type-2 immune response that could worsen the severity and clinical outcomes of patients with cancer. Our aim was to determine the prevalence of intestinal helminths among cancer patients who are under chemotherapy. Methodology. A prospective cross-sectional study was conducted in volunteer cancer patients. Clinical information were collected from study participants using a structured questioner. Stool sample was collected for parasitological examination. Formol-ether concentration technique was done, and then, two microscopic slides were prepared. Examination was done by two laboratory technicians for the detection of helminths. SPSS version 22 was used for data analysis, and simple descriptive statistical analysis was done for data presentation.

          Result

          The total study participants were 41, of these 31 (75.6%) were females and 10 (24.4%) were male. Breast cancer and colonic cancer were the highest proportion with the others, 43.9% and 17.1%, respectively. The prevalence of intestinal parasites were 7/41 (17%). Hookworm 3/41(7.3%), Ascaris lumbricoides 3/41(7.3%), and Hymenolepis nana 1/41(2.4%) are the isolated parasite. Conclusions and Recommendations. The prevalence of intestinal helminths in cancer is lower than HIV and DM in the study area. However, the prevalence in these cancer patients is still high and needs deworming and health education for the better management of these cancer patients.

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          Hyuna Sung, Jacques Ferlay, Rebecca Siegel … (2021)
          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Type 2 immunity reflects orchestrated recruitment of cells committed to IL-4 production.

            David Voehringer, Kanade Shinkai, Richard M. Locksley (2004)
            Using IL-4 reporter mice we identified eosinophils, basophils, and Th2 cells as the three IL-4-producing cell types that appear in the lungs of mice infected with the migrating intestinal helminth, Nippostrongylus brasiliensis. Eosinophils were most prevalent, peaking by approximately 1000-fold on day 9 after infection, with Th2 cells and basophils at 3- and 10-fold lower numbers, respectively. Eosinophil and basophil expansion in blood in response to parasites and their capacity for IL-4 expression required neither Stat6 nor T cells. Th2 induction and expansion in draining lymph nodes was also Stat6 independent. In contrast, eosinophil (and Th2 cell) recruitment to the lung was dependent on Stat6 expression by a bone marrow-derived tissue resident cell, whereas basophil recruitment was Stat6 and IL-4/IL-13 independent but T cell dependent. Primary type 2 immune responses in the lung represent the focal recruitment and activation of discrete cell populations from the blood that have previously committed to express IL-4.
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              Are intestinal helminths risk factors for developing active tuberculosis?

              Hannah Akuffo, Sven Britton, Getahun Mengistu … (2006)
              To determine the prevalence of intestinal helminth infections in active tuberculosis patients and their healthy household contacts and to assess its association with active TB in an area endemic for both types of infections. Smear-positive pulmonary TB patients and healthy household contacts were tested for intestinal helminths using direct microscopy and the formol-ether concentration techniques. Three consecutive stool samples were examined before the start of TB chemotherapy. Sputum microscopy was done using the sodium hypochlorite concentration techniques. Participants were also tested for HIV by commercial sandwich enzyme linked immunosorbent assay. The study population consisted of 230 smear-positive TB patients and 510 healthy household contacts. The prevalence of intestinal helminths was 71% in patients and 36% in controls. HIV seroprevalence was significantly higher in patients than in controls (46.7%vs. 11.6%, P < 0.001). Conditional logistic regression analysis showed a strong association between TB and intestinal helminth infection (OR = 4.2, 95% CI 2.7-5.9, P < 0.001), and between TB and HIV infection (OR = 7.8, 95% CI 4.8-12.6, P < 0.0001). The odds of being a TB patient increased with the number of helminth species per person: in individuals with mono-infection it was 4.3 (95% CI 2.8-6.8); in people infected with two species was 4.7 (95% CI 2.5-8.7), and in patients infected with three or more helminths was 12.2 (3.9-52.6). Intestinal helminth infection may be one of the risk factors for the development of active pulmonary TB in addition to HIV infection. This finding may have important implications in the control of TB in helminth endemic areas of the world.
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                Author and article information

                Contributors
                Mulualem Lemma:
                ORCID: https://orcid.org/0000-0003-0425-422X
                Journal
                Journal ID (nlm-ta): J Cancer Epidemiol
                Journal ID (iso-abbrev): J Cancer Epidemiol
                Journal ID (publisher-id): jce
                Title: Journal of Cancer Epidemiology
                Publisher: Hindawi
                ISSN (Print): 1687-8558
                ISSN (Electronic): 1687-8566
                Publication date Collection: 2022
                Publication date (Electronic): 18 April 2022
                Volume: 2022
                Electronic Location Identifier: 4484183
                Affiliations
                1Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
                2Department of Internal Medicine, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
                Author notes

                Academic Editor: Arjun Singh

                Author information
                https://orcid.org/0000-0003-0425-422X
                Article
                DOI: 10.1155/2022/4484183
                PMC ID: 9038382
                SO-VID: b4c32035-f5d6-4bc3-927d-93ace03f5b4a
                Copyright © Copyright © 2022 Elsa Sitotaw et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 3 December 2021
                Date revision received : 10 March 2022
                Date accepted : 23 March 2022
                Funding
                Funded by: Department of Internal Medicine, School of Biomedical and Laboratory Science, Department of Medical Parasitology, and Department of Immunology and Molecular Biology
                Funded by: University of Gondar College of Medicine and Health Science
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Oncology & Radiotherapy
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy

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