Soil-Transmitted Helminth (STH) infections are a significant health issue in the Western Pacific Region (WPR). This study aims to produce high-resolution spatial prediction STH prevalence maps for the WPR. Bayesian model-based geostatistical frameworks were developed for each STH species (Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis, and hookworm) to estimate infection prevalence at a spatial resolution of 1 km². A systematic review created a comprehensive database of STH prevalence surveys, which informed the geostatistical frameworks. Logistic regression models incorporating both fixed covariate effects and spatial random effects were applied to identify drivers of spatial distribution for each species. We analysed 227 surveys from 3122 locations across 15 countries in the WPR. Between 1998–2011 and 2012–2021 substantial reductions in the pooled prevalence of hookworm (21.3%–3.7%), A. lumbricoides (21.7%–6.5%) and T. trichiura (22.5%–9.7%) were observed, while S. stercoralis prevalence increased (13.3%–18.4%). High-resolution spatial prediction maps revealed notable geographical variations in STH prevalence, with persistent hotspots identified in China, Cambodia, Malaysia, and Vietnam. Altitude and distance to health facilities were positively associated with the prevalence of hookworm and A. lumbricoides, while sand content in soil was positively associated with all STH species. In contrast, coarse soil fragments and organic carbon content were negatively associated with the prevalence of T. trichiura and A. lumbricoides. The high-resolution spatial prediction maps produced in this study can inform resource prioritization to accelerate STH elimination efforts. 10.13039/501100000925 National Health and Medical Research Council (1153727 ACE-NTD).

This study assessed the accessibility and determinants of water, sanitation, and hygiene (WASH) facilities in Bangladesh's climate-sensitive coastal region, which is highly vulnerable to sea-level rise, salinity intrusion and extreme weather events. A cross-sectional survey was conducted from March to July 2023, involving 471 households across nine subdistricts within three coastal zones using a three-stage cluster sampling technique. Multivariable logistic regression was performed to identify the associated factors, considering WASH indicators (as defined by the WHO/UNICEF Joint Monitoring Program) as outcomes and sociodemographic characteristics as exposure variables. Findings revealed that, 56.9 % of households had limited access to drinking water, 43.3 % lacked improved sanitation, and 48.2 % were without basic hygiene facilities, while only 10.6 % had basic access to all three WASH services. Compared to the richest households, poor households (asset-based index) were 76 % less likely (adjusted odds ratio [AOR]: 0.24, 95 % confidence interval [CI]: 0.16-0.54) to have water access. Households located in the southeastern region had 1.67 (AOR: 1.67, 95 % CI: 1.02-2.74) times higher odds of having water access than those in the southwestern part. Larger households and those headed by fishermen were 39 % (AOR: 0.61, 95 % CI: 0.40-0.93) and 70 % (AOR: 0.30, 95 % CI: 0.14-0.65) less likely to have sanitation access compared with smaller households and those headed by service holders, respectively. Households having adults with primary incomplete or only primary education were significantly associated with reduced access to hygiene and combined WASH facilities, respectively, whereas wealth was a significant factor for WASH facilities. The findings thus underscore the need for targeted interventions including subsidised disadvantaged occupational groups and community-based education programs to improve WASH access in this vulnerable zone.

Background: Enterobiasis, caused by Enterobius vermicularis, is recognized as a common intestinal helminthiasis worldwide. Despite multiple surveys in Thailand, no pooled synthesis at the country level has been carried out to evaluate prevalence patterns, temporal trends, or vulnerable groups. Therefore, this systematic review and meta-analysis were undertaken to provide an updated and comprehensive estimate of the prevalence of E. vermicularis in Thailand and to identify high-risk populations for targeted interventions. Methods: The systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO: CRD420251053217). Studies reporting E. vermicularis infection in Thailand were systematically searched in international and Thai databases. Pooled prevalence and odds ratios (ORs) were calculated using random-effects models. Subgroup analyses and meta-regression were performed according to year, region, age, population type, and diagnostic method. Results: A total of 56 studies, including 52,765 participants, were analyzed. The overall pooled prevalence was estimated at 3.6% (95% confidence interval [CI]: 2.1–5.9%), with a decline observed in the subgroup analysis by publication year, from 4.75% in 2000–2009 to 1.15% in 2020–2023. The highest prevalence was reported in Central Thailand (7.93%). High infection rates were found among immigrant children (25.2%), hilltribe children (19.9%), Karen students (15.5%), and children in orphanages (11.4%). A markedly higher prevalence was detected by the Scotch tape method compared with direct smear/concentration (12.9% vs. 0.33%). No significant difference in infection risk was observed between males and females (OR = 1.03, p = 0.65). Conclusions: The pooled prevalence of E. vermicularis in Thailand was estimated at 3.6%, but this figure should be interpreted with caution due to high heterogeneity across studies. More meaningful insights were identified in subgroup analyses, which revealed a temporal decline in prevalence, geographic clustering in Central Thailand, and disproportionately high infection rates among socioeconomically disadvantaged child populations. No statistically significant association was found between gender and risk of infection. These patterns underscore the need for targeted screening, deworming, and hygiene interventions, along with the standardized use of the Scotch tape technique for accurate surveillance and comparability of future studies.

Trichostrongylus species are zoonotic gastrointestinal nematodes that occasionally infect humans, particularly in rural areas with close contact to livestock. However, the global prevalence of human trichostrongylosis remains uncertain. This systematic review and meta-analysis aimed to synthesize available prevalence data and describe regional and methodological differences in reported infections. Studies published between 2000 and 2025 reporting the prevalence of Trichostrongylus infections in humans (primarily T. colubriformis, T. axei, and T. orientalis) were searched in six databases (EMBASE, Ovid, PubMed, Scopus, Nursing & Allied Health Premium, and Web of Science) and Google Scholar. Pooled prevalence was estimated using a random-effects model. Subgroup analyses were conducted to assess prevalence by continent, country, population group, and diagnostic method. Thirty-seven studies from 14 countries, comprising 111,408 participants, were included. Most studies were conducted in Asia (23, 62.2%), particularly in Iran (12, 32.4%), and in Africa (12, 32.4%), mainly in Nigeria (5, 13.5%). The global pooled prevalence of Trichostrongylus infection was 1.2%. Prevalence was highest in Africa (1.7%), followed by South America (1.2%), Asia (1.0%), and Europe (0.8%). Subgroup analyses revealed substantial heterogeneity in prevalence across study populations, age groups, and detection methods (p < 0.05). Available evidence suggests that human Trichostrongylus infection remains a localized but persistent zoonotic concern in specific endemic regions, rather than a globally uniform problem. Diagnostic variability, limited regional coverage, and high heterogeneity highlight the need for standardized molecular diagnostics and broader surveillance to accurately define the global epidemiology of trichostrongylosis.

Background: Giardia duodenalis remains a neglected parasitic infection in Thailand, with uncertain national prevalence and limited data on genetic assemblages. This systematic review and meta-analysis aimed to estimate the pooled prevalence of G. duodenalis infections in Thailand and assess the distribution of assemblages to inform surveillance and control strategies. Methods: The protocol for this study was registered in PROSPERO (CRD42024629406). A comprehensive search was conducted across six databases: EMBASE, Ovid, PubMed, Scopus, Nursing & Allied Health Premium, and the Thai-Journal Citation Index (TCI). The methodological quality of included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist for observational studies. A meta-analysis using random-effects models estimated the pooled prevalence of G. duodenalis infections and the distribution of assemblages. Results: Sixty-three studies comprising of 47,989 participants were included. The prevalence of G. duodenalis infection varied substantially by diagnostic method, ranging from 1.40% using direct smear microscopy to 1.99% using concentration techniques, 3.66% with culture-based methods, 13.44% with immunoassays, and 8.98% with molecular techniques ( P < 0.0001). Prevalence also differed geographically, with the highest estimates in Western Thailand (12.22%) and the lowest in Northeastern Thailand (0.54%). Vulnerable groups, including orphans (15.14%) and preschool children (11.73%), carried a disproportionate burden of infection. Among the 240 samples analyzed by molecular methods, Assemblage B was the most common (55.0%), followed by Assemblage A (32.5%), mixed A/B infections (12.08%), and a single case of Assemblage F (0.42%). Conclusion: G. duodenalis remains endemic in Thailand, with transmission concentrated in socially vulnerable groups and regions with higher environmental risk. The predominance of Assemblage B and the underuse of molecular diagnostics highlight critical gaps in understanding transmission pathways. These findings suggest that control strategies in Thailand should prioritize high-risk populations and incorporate molecular epidemiology into routine surveillance to more effectively guide prevention efforts. Clinical trial: Not applicable.

Background and Objectives: Macrophage inflammatory protein-1α (MIP-1α) and MIP-1β act as signaling molecules that recruit immune cells to sites of infection and inflammation. This study aimed to synthesize evidence on blood levels of MIP-1α and MIP-1β in Plasmodium-infected individuals and to determine whether these levels differ between severe and uncomplicated malaria cases. Materials and Methods: The study protocol was registered in PROSPERO (CRD42024595818). Comprehensive literature searches were conducted in six databases (EMBASE, MEDLINE, Ovid, Scopus, ProQuest, and PubMed) to identify studies reporting blood levels of MIP-1α and MIP-1β in Plasmodium infections and clinical malaria. A narrative synthesis was used to describe variations in MIP-1α and MIP-1β levels between malaria patients and controls and between severe and non-severe malaria cases. Meta-analysis was used to aggregate quantitative data utilizing a random-effects model. Results: A total of 1638 records were identified, with 20 studies meeting the inclusion criteria. Most studies reported significantly higher MIP-1α and MIP-1β levels in malaria patients compared to non-malarial controls. The meta-analysis showed a significant elevation in MIP-1α levels in malaria patients (n = 352) compared to uninfected individuals (n = 274) (p = 0.0112, random effects model, standardized mean difference [SMD]: 1.69, 95% confidence interval [CI]: 0.38 to 3.00, I²: 96.0%, five studies, 626 individuals). The meta-analysis showed no difference in MIP-1α levels between severe malaria cases (n = 203) and uncomplicated cases (n = 106) (p = 0.51, SMD: −0.48, 95% CI: −1.93 to 0.96, I²: 97.3%, three studies, 309 individuals). Conclusions: This study suggests that while MIP-1α and MIP-1β levels are elevated in malaria patients compared to uninfected individuals, these chemokines show a limited ability to differentiate between severe and uncomplicated malaria or predict severe outcomes. Further research is needed to clarify their role in malaria pathogenesis and explore potential clinical applications.