Oesophagostomum epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Epidemiology and Demographics

Age

Prevalence is higher in children between ages 2-10. These age demographics are not yet sufficiently explained; possible factors include differential exposure to contaminated water and strength of immune response.

Gender

Females older than 5 years of ages have higher prevalence than males within the age group of 2-10. These gender discrepancies are not yet sufficiently explained; possible factors include differential exposure to contaminated water and strength of immune response.

Developing Countries

Oesophagostomiasis is endemic or potentially endemic to 35 countries; approximately 250,000 are infected worldwide, with 1 million more at risk according to the Gideon Infectious Diseases Database. Most of the cases originate in Africa, specifically in Ghana, Togo, Uganda, Nigeria, Zimbabwe, and other nearby countries. A few sporadic cases have been reported in countries in South America and Southeast Asia, including Brazil, Indonesia and Malaysia. The vast majority of clinical cases have been collected from northern Togo and Ghana, in West Africa. 156 cases from the areas alone were collected in a 2000 study; before then, only 116 cases were recorded in the literature. O. bifurcum infection in northern Togo and Ghana is found in virtually every village, with some rural areas exhibiting prevalence of as much as 90,000 per 100,000 population. A study done by Krepel in 1992 revealed a correlation between infection with O. bifurcum and N. americanus in that individuals living in endemic villages were either coinfected with both parasites or neither. This could be due to cofactors shared by both parasites, including poor hygiene, certain agricultural practices and the dearth of potable water suitable for consumption.

Below is a review of some epidemiological studies on the epidemiology of Oesophagostomum bifurcum in northern Togo and Ghana:

• "Human Oesophagostomum infection in northern Togo and Ghana: epidemiological aspects." By: Krepel et al. Annals of Tropical Medicine and Parasitology.1992. 86:289-300.

A regional survey of O. bifurcum infection was carried out in Togo and Ghana. The parasite was found in 38 of the 43 villages surveyed, with the highest prevalence rates reaching 59% in some small, isolated villages. Infection was found to be positively correlated with hookworm infection; however, the difficulty in distinguishing these parasites may have had some confounding effect. Infection rates were low in children under 3 years of age, beyond that, rates of infection increased dramatically until 10 years of age. Interestingly, females showed higher prevalence of infection (34%)than men (24%). Based on these epidemiological studies, this group was ale to conclude that tribe, profession, or religion had no effect on the prevalence of infection in the different communities surveyed. The habitats and life cycle of this parasite do not explain its distribution.

• "Clinical epidemiology and classification of human oesophagostomiasis." By: P.A. Storey et al. Trans R Soc Trop Med Hyg. 2000. 94:177-182.

The study investigated the clinical epidemiology of oesophagostomiasis by observing 156 cases in the Nalerigu hospital between 1996-1998. About 1 patient/week presented with this disease over the course of two years and 1% of all surgeries carried out were related to oesophagostomiasis. 13% of the patients presented with the multinodular form of the disease in which they had several nodules in their small intestine, abdominal pain, diarrhea, and weight loss. The other 87% of the patients presented with the Dapaong, or single, tumor form of the disease that was associated with inflammation in the abdomen, fever, and pain.