Assessing Soil-transmitted Helminth Infections and Drug Compliance in Water Sanitation and Hygiene Communities, Ogun State, Nigeria.

Neglected tropical diseases (NTDs) remain a major public health concern in sub-Saharan Africa, where inadequate sanitation and unsafe water contribute to ongoing transmission. This study examined the prevalence and associated risk factors of Schistosoma haematobium among school-aged children in 20 WASH-focused communities across four Local Government Areas in Ogun Central, Nigeria, between March 2021 and March 2023. Urine and stool samples were collected from 1019 pupils and analyzed using standard parasitological techniques, while structured questionnaires captured demographic information, WASH indicators, and attitudes toward anthelmintic treatment. The overall prevalence of S. haematobium was 2%. Significant associations were observed between infection and water sources (p < 0.05), toilet facilities (p = 0.045), and hematuria (p < 0.001). Age was also identified as a significant demographic factor influencing infection. These findings highlight the persistent vulnerability of children in WASH-dependent communities to urinary schistosomiasis and emphasize the need for integrated control strategies that combine improved sanitation, safe water supply, health education, and regular mass drug administration.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00436-025-08569-y.

Soil-transmitted helminthiasis (STH) and schistosomiasis (SCH) are among the most prevalent neglected tropical diseases (NTDs), affecting 1.5 billion globally, with a significant burden in sub-Saharan Africa, particularly Nigeria. These diseases impair health and contribute to socio-economic challenges, especially in children, undermining educational and future economic prospects. The 2030 NTD Roadmap highlights Mass Drug Administration (MDA) as a critical strategy for controlling these NTDs, targeting vulnerable populations like school-age children. Despite some successes, challenges persist, indicating the need for deeper insights into program implementation. This study focuses on the perspectives of health workers implementing MDA in selected local government areas (LGAs) of Ogun State, Nigeria, aiming to identify challenges and enablers that align with the broader NTD 2030 goals. The study used a qualitative research approach involving focus group discussions and in-depth interviews with health workers engaged in neglected tropical disease control programs in Ogun State, Nigeria, between July and September 2022. A semi-structured questionnaire guided the exploration of ideas, and the data were analyzed using the QRS Nvivo 12 software package. The study found that the school-based MDA control program's efficacy largely relies on strong collaborations and partnerships, particularly with educators, community heads, and other stakeholders. These alliances and strategic communication methods, like town announcements and media campaigns, have been pivotal in reaching communities. However, the program does grapple with hurdles such as parental misconceptions, limited funds, insufficient staffing, and misalignment with the Ministry of Education. It is recommended to boost funding, foster early stakeholder involvement, enhance mobilization techniques, and consider introducing a monitoring card system similar to immunization. The MDA Integrated Control Programs for STH and SCH in Ogun State schools demonstrate a holistic approach, integrating knowledge, collaboration, communication, and feedback. Health workers have shown commitment and adeptness in their roles. However, achieving maximum efficacy requires addressing critical barriers, such as parental misconceptions and funding challenges. Adopting the recommended strategies, including proactive communication, increased remuneration, and introducing a tracking system, can significantly enhance the program's reach and impact. The involvement of all stakeholders, from health workers to community leaders and parents, is essential for the program's sustainability and success.

Helminth Infections in Children.

An investigation on the epidemiology and risk factors associated with soil-transmitted helminth infections in Ijebu East Local Government Area, Ogun State, Nigeria

Background:Schistosomiasis is a Neglected Tropical Disease (NTD) that constitutes a public health problem in Sub-Saharan Africa (SSA), including Nigeria. There is need for updated information on the extent of the disease burden at community level to facilitate effective prioritization and monitoring of the disease.Methods:A cross-sectional study was conducted among school-aged children in Obudu Local Government Area (LGA), one of the 18 LGAs in Cross River State, Southern Nigeria. Seven schools from seven communities were randomly selected for this study. A total of 1,113 urine samples obtained from school-aged children were screened for Schistosoma haematobium (S. haematobium) eggs using standard parasitological method of diagnosis. Proteinuria and hematuria were evaluated using reagent test strips.Results:In this study, 153 (13.7%) children were infected with S. haematobium. More males (86 or 14.7%) were infected than females (67 or 12.7%); the differences were not statistically significant. The overall geometric mean intensity of infection was 13.3 eggs/10ml of urine. Females (13.69 eggs/10ml of urine) had the highest intensity of infection than males (12.91eggs/10ml of urine). Prevalence of hematuria was 152 (13.7%) (95% C.I. = 10.649 – 18.751%) while the prevalence of proteinuria was 172 (15.5%) (95% C.I. = 5.162 – 38.712%). Prevalence of infection significantly (p<0.001) varied among the schools from 7.8% to 28.9%. Children aged 5-9 years old had the highest prevalence of infection 46 (17.1%). The prevalence of urogenital schistosomiasis was 28.9%, 20.5% and 13.2%, respectively, among Betukwel, Ibong, and Ohong communities.Conclusion and Global Health Implications:Urinary schistosomiasis is still endemic in Obudu, Southern Nigeria but with decreased prevalence. Public health mitigation efforts such as mass chemotherapy, provision of safe water supply and sanitation facilities are recommended. Furthermore, health education should be encouraged within schools and communities.

Epidemiology and diagnosis of schistosomiasis in preschool-aged children in Azaguié, south Côte d'Ivoire

IntroductionBuruli ulcer (BU) is a highly ranked neglected tropical disease (NTD) of global health importance with increasing incidence in sub-Saharan Africa yet there is paucity of information on the epidemiology of BU in Nigeria. Incidentally, highly BU endemic Benin Republic shares proximity with Nigeria. This study was carried out to establish presence of BU and ascertain the level of BU perception among rural populace in Ogun State, south-west Nigeria.MethodsSecondary data (2009-2012) on incidence of BU was collected from a reference hospital. A cross-sectional survey using structured questionnaire administered to rural people and healthcare practitioners was conducted in three purposively chosen Local Government Areas (LGAs) in Ogun State based on unpublished reports of BU presence.ResultsData collected revealed 27 hospital confirmed BU cases between 2009-2012 across four LGAs (Obafemi Owode, Abeokuta North, Yewa North and Yewa South) while 14%(21/150) chronic ulcers (suspected to be BU) were discovered during the cross-sectional survey carried out in Odeda, Yewa South and North LGAs. Healthcare practitioners 63.6% (42/66) and 54.7% (82/150) rural people demonstrated poor level of BU perception respectively.ConclusionThis study provides evidence that BU exists in Ogun State and evaluates the poor perception that the affected rural populace has on the disease. This pilot study presents baseline information on BU in a rural setting in Ogun State South-west Nigeria hence the vital need for prompt public health involvement and further research on the epidemiology of BU.

Background: Schistosomiasis (SCH) and soil transmitted helminthiasis (STH) have been targeted for elimination as a public health problem (EPHP) within the World Health Organization (WHO)’s Roadmap for Neglected Tropical Diseases (NTDs) 2021–2030. One of the global strategies for the control and elimination of these diseases is the mass administration of praziquantel and albendazole/mebendazole without prior individual diagnosis. To measure the progress towards the 2030 target, we conducted an assessment to determine the impact of the 3–5 rounds of annual mass drug administration among school age children in Ekiti State. Such scientific insights into the impact of these treatments will facilitate improved planning and targeting of resources towards reaching the last mile. Methodology: This assessment was conducted in 16 local government areas (LGAs) of Ekiti State between October and November 2023. Samples were collected from pupils in 166 primary and junior secondary schools across 166 wards of the State. Urine and stool samples were collected from 7670 pupils of ages 5 to 14 years, following standard laboratory procedures. Urine membrane filtration techniques were used for urine preparation while the Kato–Katz technique was used for stool preparation. A novel AiDx digital microscope was used to examine the presence of any ova in the prepared specimen. Parasite ova in urine were reported as the number of ova/10 mL of urine, and were categorized as light infection (˂50 ova/10 mL of urine) or heavy infection (>50 ova/10 mL of urine) while ova of parasites in stool samples were reported as eggs per gram of stool (EPG) and categorized into light, moderate and heavy infection. Results: Overall, 0.76% (0.56–0.95) at 95% CI of the 7670 respondents were infected with Schistosomia haematobium. No Schistosoma mansoni infection was recorded in the study. Similarly, 3.9% (3.43–4.29) at 95% CI were infected with STHs. The overall prevalence of schistosomiasis had significantly reduced from 8.2% in 2008 to 0.8%, while the overall prevalence of STHs significantly reduced from 30.9% to 3.9% with Ascaris lumbricoides being the dominant species of STH. In the 16 LGAs assessed, Ekiti West had the highest S. haematobium prevalence of 4.26%. Ise/Orun and Oye ranked second and third with a prevalence of 3.48% and 2.40% respectively, while all other LGAs had <1% prevalence. The prevalence of STHs was highest in Ekiti-West with a prevalence of 10.45% while Emure and Ikole Local Governments had the lowest prevalence of 0.31% and 0.38%, respectively. There was no significant difference in the prevalence of schistosomiasis between male (0.76%) and female (0.75%) as p ≥ 0.05. Similarly, the difference in prevalence for STH among males (3.95%) was not significantly different from their female counterparts (3.77%), p ≥ 0.05. Conclusions: Based on the WHO guidelines, this study demonstrated that only three LGAs require continued MDA every 2/3 years, seven require only surveillance while six are now non-endemic for schistosomiasis. Similarly, two of the LGAs require one round of MDA yearly, eight LGAs need one round of MDA every two to three years and six LGAs are now below the treatment threshold and no longer require treatment for STH.

When I was One, I had just begun. When I was Two, I was nearly new. When I was Three, I was hardly me. When I was Four, I was not much more. When I was Five, I was just alive. But now I am Six, I'm as clever as clever, So I think I'll be six now for ever and ever. From Now We Are Six by A. A. Milne [1] This year we will begin our sixth year of publishing PLOS Neglected Tropical Diseases, the first open-access journal for the community of biomedical and social scientists, public health experts, and health care providers committed to studying the neglected tropical diseases (NTDs) (Figure 1). Jumpstarted with seed funds from the Bill & Melinda Gates Foundation, together with an editorial staff and a PLOS board of directors dedicated to editorial and journal capacity building in the world's low- and middle-income countries (LMICs), PLOS NTDs began in 2007 with an editorial entitled A New Voice for the Poor [2]. From the outset, PLOS NTDs worked to create a unique vision for publishing tropical medicine papers that was different from other journals in the field. By maintaining our dedication to the concept of open access, we hoped that PLOS NTDs would be read by a wide community of NTD experts while simultaneously attracting new people to the field. Figure 1 Cover of the PLOS NTDs inaugural issue, limited print edition. We began especially eager to embrace a larger community of scholars from LMICs, and to an extent we have achieved some successes on that front. Today, roughly 30 percent of our editorial board members are from LMICs. Brazil, China, and India are among the seven leading countries from which corresponding authors have submitted papers to PLOS NTDs since its founding (Table 1), and Argentina, Colombia, Mexico, and Thailand are among the top 20 countries submitting papers to PLOS NTDs. However, our editorial staff and board feel that we could improve our endemic country outreach, and we are aggressively seeking to expand the editorial board representation and papers that come from low-income countries in sub-Saharan Africa, the Middle East and North Africa, and South Asia, where submissions have been far fewer (Figure 2). Figure 2 Papers submitted and published by region between October 2007 and July 2012. Table 1 Top countries by number of submissions. We are deeply grateful to the Gates Foundation for their initial support, which ended more than two years ago. Today, we are pleased to report that we are at the “break-even point” financially. Currently, we receive close to 100 submissions each month—more than double the number of papers from when we first started. Unlike some of the other PLOS journals, which in some cases only accept one in ten papers submitted, our goal is to be more inclusive so as to strongly embrace authors and papers from LMICs. Today our acceptance rate at PLOS NTDs is roughly 50 percent, and whenever possible we try to provide intensive editorial support for submissions by LMIC authors. We are proud of the fact that our capacity building efforts have not occurred at the expense of quality. For the last three years, since we became eligible to receive a Thomson Reuters citation impact factor rating, our journal has had the highest ranking of any tropical medicine journal. We are pleased to report that this success has also not come at the expense of other tropical medicine journals, whose impact factors have also mostly increased over the years. Shortly after our launch, Dr. Richard Horton, The Lancet editor-in-chief, wrote a strong endorsement of our journal and our efforts at global outreach. We were very grateful for that support, and in that spirit we also hope to ensure that our editors and staff “lift all boats” in the area of tropical medicine publishing, especially for those journals and organizations committed to open access. After we began, the open-access journal Parasites & Vectors was launched by BioMed Central, and we especially want to wish them success, as well as other journals such as the American Journal of Tropical Medicine and Hygiene, which now offers open-access options. Ultimately, the leadership at PLOS feels strongly that there are more informative metrics available than those offered by conventional impact factor ratings. For instance, along with the other PLOS journals, we have implemented a system of article-specific metrics in order to determine the number of times that our articles are downloaded and viewed. We have determined that 20 of our PLOS NTDs articles have been downloaded at least 5,000 times each by our readers, while four articles have been downloaded more than 10,000 times, including articles on the origins of the treponematoses, NTDs in sub-Saharan Africa and Latin America, and even neglected infections of poverty in the United States. Our most widely viewed article has more than 30,000 downloads. We also follow blogosphere coverage and coverage by major media outlets—stories about PLOS NTDs appear regularly in leading newspapers such as the New York Times and the Guardian, as well as electronic media—in addition to community ratings and expert assessments. A word about journal scope: since our beginning we have tried to stay focused on the major NTDs afflicting the “bottom billion”, i.e., the world's 1.4 billion people who live in poverty and are disproportionately affected by these conditions [2]. We have subsequently responded to an increasing demand from the arbovirus community (especially regarding dengue papers) and experts in neglected bacterial and fungal infections (e.g., leptospirosis, mycobacterial infections such as Buruli ulcer and leprosy, and paracoccidioidomycosis) by increasing our editorial board representation in these areas. We also look forward to continuing our long-standing commitment to papers on neglected helminth and protozoan infections. In contrast, we have largely avoided papers that deal with falciparum malaria unless they also mention collateral effects on the NTDs. Instead, we feel there are excellent journals already out there that can handle such papers, including the open-access Malaria Journal. However, we have listened to the scientists and health professionals who make a compelling case that vivax malaria is a true NTD and have been reviewing papers on this disease for several years now. We anticipate that the scope of PLOS NTDs will continue to evolve and invite our readers to visit the journal scope section of our website and even to submit editorials that make a strong argument why the scope may require amendment or adjustment. As our journal expands and grows, we are working hard to ensure that papers submitted to PLOS NTDs receive a timely review and decision. Together with our deputy editors and associate editors, the PLOS editorial staff based in San Francisco and now also Cambridge, United Kingdom, meets continually to review its procedures and seeks ways to improve the quality of our reviews and shorten timelines. Currently, new research articles receive their first decision on average within 40 days of initial submission. Manuscripts that do not get sent to review receive a rapid response form the journal; on average, these decisions are sent to authors within 13 days of submission. Once a paper has been accepted, it spends an average of 46 days in production until publication. However, we feel these numbers can also be improved, and in the coming months we look forward to implementing revised or new practices and procedures to achieve those goals. In addition to its long-standing commitment to excellent and high quality science, in the coming years PLOS NTDs will continue a strong emphasis on advocacy and shaping NTD health and economic policy. We feel that our papers have helped to inform, advocate, and ultimately shape important financial commitments from the US and UK governments to support global NTD control and elimination efforts, as well as research and development for new control tools, i.e., drugs, insecticides, diagnostics, and vaccines. We believe that PLOS NTDs papers have also positively influenced government leaders and key private donors. In this issue, we present two special collections of articles published to date that have received a disproportionately frequent number of viewings. The first is a series of review articles contributed by Dr. Hotez and his colleagues on geopolitical aspects of the NTDs, including information on the distribution of the most important NTDs in South Asia, Central Asia, Oceania, Latin America, sub-Saharan Africa, the Middle East, the US, and the Canadian Arctic, published in PLOS NTDs over the last five years. The second collection, “Top Ten”, celebrates the success of the most viewed research articles—the top two in each year of our existence to date. We are also looking to feature and celebrate the achievements of our global community of NTD scientists and institutions with a series of Historical Profiles and Perspectives that will be published in the course of the coming year. The inaugural Historical Profile will highlight Centro Internacional de Entrenamiento e Investigaciones Medicas (CIDEIM) from Cali, Colombia. We want to get to know you better and learn from your experiences and achievements–please contribute to this series! Finally, we want to thank our outstanding managing editorial staff led by Marina Kukso in the San Francisco office, and the unwavering support of the PLOS leadership and board. To restate, our major purpose remains to serve the NTD community of scholars and public health experts. We exist for your benefit and look forward to hearing from you on the ways in which we can improve how we can help the world's “bottom billion” afflicted by the NTDs.

Spatial analysis of cholera outbreak in Egbeda local government area of Oyo State. Nigeria, June, 2013

Neglected tropical diseases (NTDs) are highly prevalent in Sub-Saharan Africa. In the World Bank's definition of poverty, nearly all people suffer from at least one NTD. Among the most widespread NTDs are malaria, HIV, and soil-transmitted helminths like lymphatic filariasis, schistosomiasis, trachoma, and onchocerciasis. A recent study suggests that NTDs may influence the evolution of HIV and AIDS, malaria, and tuberculosis. These interactions may be influenced by epidemiological, immunological, and clinical factors, which may impair the prognosis for those with HIV/AIDS, TB, or malaria. World Health Organization (WHO) suggests five main strategies for preventing and controlling NTDs for public health-intensified case management, vector control, preventive chemotherapy, sanitation, the provision of safe water, veterinary public health, and hygiene. Despite only using one method and doing it locally, to control, and eliminate the NTDs, these methods can be used as a mark for achieving the Sustainable Development Goals as they are mainly found in disadvantaged regions and environments. The development of pilot projects and initiatives can help achieve the Millennium Development Goals. The poor and marginalised could gain from innovative treatments for neglected diseases (particularly parasite infections) based on sustainability concepts and knowledge of key factors affecting health.

Neglected Tropical Diseases and the 2012 US Presidential Election

Epidemiology, spatial distribution and control of schistosomiasis mansoni in western Côte d'Ivoire

BackgroundSoil-transmitted helminthiases (STH) and schistosomiasis are parasitic neglected tropical diseases (NTDs) of significant public health importance globally, including Nigeria. Urogenital schistosomiasis is highly endemic in Apojola, a rural community in Ogun State, southwest Nigeria, but data on STH and intestinal schistosomiasis in the neglected community are lacking.ObjectivesTo determine the prevalence and intensity of STH and intestinal schistosomiasis and the risk factors associated with the infections in Apojola.MethodsThe study was community-based and cross-sectional. A structured questionnaire was used to obtain information on socio-demographic, personal, and household WASH characteristics of the study population. Stool samples were collected and processed for parasitological examination using the triplicate Kato-Katz (K-K) smears.ResultsA total of 283 individuals (males, 50.2%; females, 49.8%) aged 3 to 65 years (mean age ± S.D.: 19.6 ± 14.8 years) participated in the study. No case of intestinal schistosomiasis was recorded in the study, while the overall prevalence of any STH was 38.2%: A. lumbricoides (24.0%) and hookworms (25.8%). Prevalence of infection was not significantly different between males and females for any STH (40.1% vs. 36.2%, χ2 = 0.473, p = 0.492); A. lumbricoides (23.2% vs. 22.7%, χ2 = 0.012, p = 0.913); or hookworms (28.2% vs. 23.4%; p = 0.360; χ2 = 0.839), but significantly varied with age for any STH (χ2 = 22.225, p = 0.002); A. lumbricoides (χ2 = 16.354, p = 0.022); or hookworms (χ2 = 20.001, p = 0.006). The intensity of infection was neither associated with gender nor age and was mostly light. Walking barefoot, toilet type (absent/bush), and irregular washing of fruits and/or vegetables before consumption were significantly associated with STH.ConclusionOur data indicate that intestinal schistosomiasis is not prevalent in Apojola and that the community is a moderate-risk area for STH. Hence, the current annual preventive chemotherapy for STH (PC STH) with albendazole or mebendazole in school-aged children (SAC) through the school-based delivery programme should be extended to non-enrolled SAC and pre-SAC using other delivery platforms. This should be complemented with regular and effective health education campaigns as well as water, sanitation, and hygiene (WASH)-related interventions.

Intestinal parasitic infections remain a significant public health concern in Nigeria, particularly among school-aged children who are frequently exposed to poor sanitation, unsafe water sources, and inadequate hygiene practices. This study assessed the prevalence, distribution, and risk factors associated with intestinal parasite infections among primary school children in the Southern Senatorial District of Edo State, Nigeria, with a focus on Ascaris species and other common intestinal parasites. A cross-sectional study was conducted among 633 pupils aged 5 to 10 years across selected primary schools in the seven Local Government Areas (LGAs) of the Southern Senatorial of Edo State. Structured questionnaires were used to obtain sociodemographic and environmental data, while stool samples were collected and examined using standard parasitological techniques. Molecular characterization was performed on selected isolates of Ascaris species. Data were analyzed using descriptive statistics and Chi-square tests to assess associations between risk factors and infection prevalence. Of the 633 pupils examined, 145 tested positive for one or more intestinal parasites, giving an overall prevalence of 22.9%. Ascaris lumbricoides was the most prevalent parasite, followed by Ancylostoma spp., Taenia species, Entamoeba histolytica, and Strongyloides stercoralis. The highest infection rates were recorded in Ikpoba-Okha, Orhionmwon, and Oredo LGAs. A significant association (p &lt; 0.05) was observed between infection prevalence and LGA of residence as well as water source, with pupils relying on well and river water showing higher infection rates than those using treated tap water. Gender, age, and religion were not significantly associated with infection. Molecular analysis revealed moderate genetic diversity among Ascaris species isolates, indicating potential zoonotic and anthroponotic transmission routes. The study highlights a considerable burden of intestinal parasites among school children in the Southern Senatorial district of Edo State, driven largely by unsafe water sources and geographical disparities in sanitation. The dominance of Ascaris lumbricoides and its genetic variability underscores the need for integrated control strategies, including improved water supply, health education, regular deworming, and enhanced surveillance. Targeted interventions in high-risk LGAs are essential to reducing transmission and improving child health outcomes in the region.