Abstract
Abstract Soil-transmitted helminth (STH) infections and diarrheal illness affect billions of people yearly. We conducted a cross-sectional survey in Nueva Santa Rosa, Guatemala to identify factors associated with STH infections and diarrhea using univariable and multivariable logistic regression models. On multivariable analyses, we found associations between STH infections and two factors: school-aged children (odds ratio (OR) vs. adults: 2.35, 95% CI 1.10–4.99) and household drinking water supply classified as ‘other improved’ (OR vs. ‘improved’: 7.00, CI 1.22–40.14). Finished floors in the household vs. natural floors were highly protective (OR 0.16, CI 0.05–0.50) for STH infection. In crowded households (>2.5 people/bedroom), observing water present at handwashing stations was also protective (OR 0.32, CI 0.11–0.98). When adjusted for drying hands, diarrhea was associated with preschool-age children (OR vs. adults: 3.33, CI 1.83–6.04), spending >10 min per round trip collecting water (OR 1.90, CI 1.02–3.56), and having a handwashing station ≤10 m near a sanitation facility (OR 3.69, CI 1.33–10.21). Our study indicates that familiar WASH interventions, such as increasing drinking water quantity and water at handwashing stations in crowded homes, coupled with a hygiene intervention like finished flooring may hold promise for STH and diarrhea control programs.
Highlights
The World Health Organization (WHO) estimates that 1.5 billion people are afflicted with soil-transmitted helminth (STH) infections (WHO b, )
STH infections are treated with anthelminthic drugs, which are commonly distributed in mass drug administration (MDA) campaigns to preschool-aged children (PSAC) and school-aged children (SAC)
Given the repeated findings that finished floors are protective against STH infections, we suggest that finished floors be considered and evaluated as a hygiene intervention, given the inconsistent impacts that the WASH intervention trials to date have had on STH infections (Freeman et al ; Patil et al ; Vaz Nery et al )
Summary
The World Health Organization (WHO) estimates that 1.5 billion people are afflicted with soil-transmitted helminth (STH) infections (WHO b, ). In 2010, an estimated 5.3 billion people worldwide lived in areas with stable transmission of at least one STH species (Pullan & Brooker ). STH infections are treated with anthelminthic drugs, which are commonly distributed in mass drug administration (MDA) campaigns to preschool-aged children (PSAC) and school-aged children (SAC). In addition to anthelminthic treatment, recent studies demonstrate the combination of safe drinking water, appropriate sanitation facilities, and good hygiene practices (WASH) along with STH programs (i.e., MDA campaigns) reduce STH reinfection (Strunz et al ). Many studies have suggested that diarrhea might be reduced through various WASH interventions that interrupt the fecal-oral route of transmission (Luby et al , ; Opryszko et al ). Other studies have found mixed or little effect of WASH interventions on diarrhea incidence (Null et al ; Reese et al ; Rogawski McQuade et al )
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