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The World Health Organization recommends the use of the microscopy-based Kato-Katz thick smear for diagnosing soil-transmitted helminth (STH) infections. Despite its simplicity and cost-effectiveness, the Kato-Katz method faces challenges, including reader subjectivity and reduced sensitivity. Real-time polymerase chain reaction (qPCR) technology offers standardized readouts and higher sensitivity, making it suitable for STH diagnosis and monitoring the treatment efficacy of emodepside within the framework of randomized controlled trials. We evaluated the performance of Kato-Katz versus qPCR for assessing treatment efficacy in terms of cure rates, of single doses of 5, 10, 15, 20, 25 and 30 mg of emodepside compared to 400 mg albendazole. Spearman's rank correlation coefficient examined the correlation between STH eggs per gram in stool samples and qPCR Ct values. Diagnostic sensitivity of qPCR was calculated using a Bayesian latent class modelling approach with data from Ascaris lumbricoides infections. Agreement between Kato-Katz and qPCR at baseline was 93.57% for Trichuris trichiura, and 73.49% for both hookworm and A. lumbricoides. For the latter helminth qPCR demonstrated higher sensitivity (85.00% vs. 47.70%) and slightly lower specificity (93.40% vs. 99.40%) compared to Kato-Katz. We observed a fair to moderate agreement with negative correlation between Ct values and Kato-Katz egg counts. Treatment efficacy, as assessed by qPCR, was lower for all doses of emodepside and albendazole compared to Kato-Katz. Nonetheless, emodepside demonstrated higher cure rates against T. trichiura and A. lumbricoides infections compared to albendazole. Our study confirmed that qPCR is a sensitive diagnostic method for diagnosing STH infections compared to Kato-Katz and serves as a valuable tool for determining treatment efficacy in clinical trials. Furthermore, qPCR confirmed the better treatment efficacy of emodepside compared to albendazole, despite indicating lower cure rates than Kato-Katz.

Soil-transmitted helminthiases, particularly trichuriasis, affect over 500 million people, mostly in low- and middle-income countries. Traditional diagnostics fail to distinguish between Trichuris species, obscuring transmission patterns and treatment outcomes. Using nanopore-based full-length ITS2 rDNA sequencing, we analyzed 687 samples from Côte d’Ivoire, Laos, Tanzania, and Uganda, confirming the phylogenetic placement of two genetically distinct Trichuris species infecting humans, Trichuris trichiura and the recently described Trichuris incognita . The two Trichuris species reveal divergent geographic patterns and also presence in non-human primates, suggesting complex host-parasite dynamics. Within-country genetic variation indicates local adaptation and cryptic population structure. Importantly, we demonstrate that ITS2 fragment length is a robust, cost-effective diagnostic marker for differentiating T. incognita and T. trichiura , offering a practical alternative to sequencing for resource-limited settings. These findings expose the hidden complexity of Trichuris  spp. infections and highlight the urgent need to update diagnostic and control strategies to account for overlooked species diversity in endemic regions. Authors used nanopore-based ITS2 sequencing analysis to map the global distribution of human-infecting Trichuris  spp. They reveal a wide presence of T. incognita , its zoonotic potential, and provide insights for better control of infections.

Albendazole/ivermectin combination therapy is a promising alternative to benzimidazole monotherapy alone for Trichuris trichiura control. We used fecal DNA metabarcoding to genetically characterize Trichuris spp. populations in patient samples from Côte d'Ivoire showing lower (egg reduction rate <70%) albendazole/ivermectin sensitivity than those from Laos and Tanzania (egg reduction rates >98%). Internal transcribed spacer (ITS) 1 and ITS2 metabarcoding revealed the entire detected Côte d'Ivoire Trichuris population was phylogenetically distinct from T. trichiura found in Laos and Tanzania and was more closely related to T. suis. Mitochondrial genome sequencing of 8 adult Trichuris worms from Côte d'Ivoire confirmed their species-level differentiation. Sequences from human patients in Cameroon and Uganda and 3 captive nonhuman primates suggest this novel species, T. incognita, is distributed beyond Côte d'Ivoire and has zoonotic potential. Continued surveillance by using fecal DNA metabarcoding will be needed to determine Trichuris spp. geographic distribution and control strategies.

The neglected tropical disease trichuriasis is caused by the whipworm Trichuris trichiura , a soil-transmitted helminth that has infected humans for millennia. Today, T. trichiura infects as many as 500 million people, predominantly in communities with poor sanitary infrastructure enabling sustained faecal-oral transmission. Using whole-genome sequencing of geographically distributed worms collected from human and other primate hosts, together with ancient samples preserved in archaeologically-defined latrines and deposits dated up to one thousand years old, we present the first population genomics study of T. trichiura . We describe the continent-scale genetic structure between whipworms infecting humans and baboons relative to those infecting other primates. Admixture and population demographic analyses support a stepwise distribution of genetic variation that is highest in Uganda, consistent with an African origin and subsequent translocation with human migration. Finally, genome-wide analyses between human samples and between human and non-human primate samples reveal local regions of genetic differentiation between geographically distinct populations. These data provide insight into zoonotic reservoirs of human-infective T. trichiura and will support future efforts toward the implementation of genomic epidemiology of this globally important helminth. The whipworm Trichuris trichiura is a soil-transmitted helminth that causes the neglected tropical disease trichuriasis in humans. Here, the authors produce whole genome sequences of modern and ancient samples from humans and non-human primates to characterise the genomic diversity and evolution of this pathogen.

Introduction: Trichuris trichiura, a soil-transmitted helminth, resides in the large intestine of humans, causing an asymptomatic disease known as trichuriasis. This global health concern is particularly prevalent in low- or middle-income countries, representing a significant burden on public health as one of the most neglected tropical diseases. The diminishing effects of currently available anthelmintic drugs, attributed to escalating drug resistance, warrants an urgent need for alternative and more potent vaccines or drugs. A substantial portion of the proteins in the T. trichiura genome are uncharacterized and their annotation might offer insight into the parasite's invasion, interaction, and survival mechanisms inside the host. Hence, this study is aimed to provide functional annotations for the uncharacterized proteins identified in the proteome of T. trichiura. Methodology: The uncharacterized proteome of T. trichiura was subjected to physiological parameter computation, localization analysis, domain identification, homology, and druggability analysis. The programs used were evaluated using the Receiver Operating Characteristic (ROC) analysis. Results: Functional annotation was assigned to 165 out of the 1726 uncharacterized proteins. Out of these, 85 proteins were found to be non-homologous with the human host and considered to be potential novel drug targets. Two proteins were identified as essential proteins in the DEG database. Conclusions: Our study identified 165 new proteins from the uncharacterized proteome of the T. trichiura and several novel targets that can be further analyzed for drug designing and vaccine-related studies.

Matthew Berriman and colleagues report the whole-genome sequences of the human-infective whipworm Trichuris trichiura and the mouse-infective laboratory model Trichuris muris . Their transcriptome analyses and examination of T. muris infection in mice provide insights into host response to infection and potential drug targets for this major soil-transmitted helminth. Whipworms are common soil-transmitted helminths that cause debilitating chronic infections in man. These nematodes are only distantly related to Caenorhabditis elegans and have evolved to occupy an unusual niche, tunneling through epithelial cells of the large intestine. We report here the whole-genome sequences of the human-infective Trichuris trichiura and the mouse laboratory model Trichuris muris . On the basis of whole-transcriptome analyses, we identify many genes that are expressed in a sex- or life stage–specific manner and characterize the transcriptional landscape of a morphological region with unique biological adaptations, namely, bacillary band and stichosome, found only in whipworms and related parasites. Using RNA sequencing data from whipworm-infected mice, we describe the regulated T helper 1 (T H 1)-like immune response of the chronically infected cecum in unprecedented detail. In silico screening identified numerous new potential drug targets against trichuriasis. Together, these genomes and associated functional data elucidate key aspects of the molecular host-parasite interactions that define chronic whipworm infection.

Trichuriasis, caused by the parasitic nematode Trichuris trichiura , remains a major public health concern, particularly in resource-limited regions. Current anthelmintics show suboptimal efficacy against whipworm infections, highlighting the critical need for novel therapeutic strategies. This study provides a comparative framework by integrating transcriptional profiles from in vivo and in vitro models during the early infection phase of T. muris , a mouse model for T. trichiura . Through this approach, we demonstrate the potential of proximal colonoids as a model for investigating key aspects of host–parasite interactions, including epithelial invasion and transcriptional dynamics, during early T. muris infection. By employing dual-RNA sequencing, we not only characterize temporal gene expression dynamics of first-stage larvae but also identify host–parasite co-expression profiles, thereby shedding light on molecular pathways that may underlie infection establishment and host responses. This work builds upon and solidifies previous findings about the utility of organoid models for investigating early whipworm infection while providing a foundational resource for exploring intervention strategies targeting the initial stages of infection.

Nematodes comprise many species with diverse life histories and zoonotic potential. Globally, over 10,500 nematode species were reported in mammals, particularly rodents. In South and southern Africa, data on nematode diversity in native rodent populations remains limited. The current study aimed to address this gap by reporting nematode diversity in two Mastomys species ( Mastomys coucha and M. natalensis ) and conducting molecular analysis of an unidentified Trichuris species recovered from M. natalensis . A total of 68  M. natalensis and 27  M. coucha rodents were trapped across a wildlife-human/domestic animal interface in South Africa during October 2020. Gastrointestinal nematodes were recovered and morphologically identified. Morphometric assessment and Sanger sequencing of mitochondrial markers, internal transcribed spacer 1 and 2 (ITS1, ITS2) and cytochrome b ( cytb ) were performed on the unidentified Trichuris species. In total, 46 nematodes were identified representing two genera, Trichuris and Abbreviata , with an overall prevalence of 21.1%. Trichuris sp. dominated in M. natalensis and anthropogenically transformed habitats, while Abbreviata sp. was associated with M. coucha in the natural habitats. Morphometrics of the unidentified Trichuris sp. aligned with reported ranges for the genus, while phylogenetic analyses revealed a novel clade distinct from known Trichuris spp. The current study emphasises the importance of integrating morphometric and molecular analyses for accurate nematode identification. The potential public health threat of the novel Trichuris sp. in M. natalensis needs further investigation, given the zoonotic capability of Trichuris spp. and the proximity of rodents to humans in the study area.

Trichuris trichiura, a soil-transmitted helminth (STH), infection is highly prevalent in children and, if not treated, can cause adverse health consequences. Microscopy using the Kato-Katz method is the mainstay of STH diagnosis in most settings but has low sensitivity. This study aims to quantify prevalence and examine risk factors of trichuriasis among children in a malaria-endemic area. The study recruited 181 children aged <5 years old from a household survey conducted in 16 villages in Timika, Papua, Indonesia, from April to July 2013. Clinical and laboratory data were collected, and stool samples were analysed later using quantitative PCR (qPCR). The prevalence of T. trichiura infections was 13.8% (25/181; 95%CI, 9.1-19.7) by Kato-Katz microscopy examination and 31.5% (57/181; 95%CI, 24.8-38.8) by qPCR analysis, increasing the prevalence by 17.7% (p = 0.0001). Children aged >3 years old had a 3 times increased risk of having trichuriasis compared to younger ones (aOR 3.29 [95%CI, 1.42-7.63], p = 0.006). Children with Hb ≤ 10 g/dL were 2 times more likely to have trichuriasis compared to those with Hb > 10 g/dL, (OR 2.46 [95%CI, 1.14-5.31], p = 0.020). Malaria prevalence was 9.9% (18/181; 95%CI, 6-15.3). Coinfections with malaria increased the risk of anaemia (OR 11.7 [95%CI, 2.0-67.0], p = 0.004. No apparent association was found between trichuriasis and undernutrition (wasting and stunting). The prevalence of trichuriasis in under-five children is underestimated and together with malaria, the infections are associated with anaemia. Public health strategy should include STH prevention targeted to young children living in malaria-endemic areas.

Genome-scale metabolic models are widely used to enhance our understanding of metabolic features of organisms, host-pathogen interactions and to identify therapeutics for diseases. Here we present iTMU798, the genome-scale metabolic model of the mouse whipworm Trichuris muris . The model demonstrates the metabolic features of T. muris and allows the prediction of metabolic steps essential for its survival. Specifically, that Thioredoxin Reductase (TrxR) enzyme is essential, a prediction we validate in vitro with the drug auranofin. Furthermore, our observation that the T. muris genome lacks gsr-1 encoding Glutathione Reductase (GR) but has GR activity that can be inhibited by auranofin indicates a mechanism for the reduction of glutathione by the TrxR enzyme in T. muris . In addition, iTMU798 predicts seven essential amino acids that cannot be synthesised by T. muris , a prediction we validate for the amino acid tryptophan. Overall, iTMU798 is as a powerful tool to study not only the T. muris metabolism but also other Trichuris spp . in understanding host parasite interactions and the rationale design of new intervention strategies. In this work, Bay et al describe the construction of the first genome-scale metabolic model for the parasitic whipworm, Trichuris muris and use it to identify novel metabolic pathways and predict critical enzymes and essential metabolites for worm survival.