Abstract
BackgroundMore than 1 billion people are currently infected with soil-transmitted helminths and schistosomes. The global strategy to control helminthiases is the regular administration of anthelmintic drugs to at-risk populations. However, rapid re-infection occurs in areas where hygiene, access to clean water, and sanitation are inadequate.MethodologyIn July 2011, inhabitants from two villages and seven hamlets of the Taabo health demographic surveillance system in south-central Côte d’Ivoire provided stool and urine samples. Kato-Katz and ether-concentration methods were used for the diagnosis of Schistosoma mansoni, soil-transmitted helminths (Ascaris lumbricoides, Trichuris trichiura, and hookworm), and intestinal protozoa. Urine samples were subjected to a filtration method for the diagnosis of Schistosoma haematobium. A questionnaire was administered to households to obtain information on knowledge, attitude, practice, and beliefs in relation to hygiene, sanitation, and defecation behavior. Logistic regression models were employed to assess for associations between questionnaire data and parasitic infections.Principal FindingsA total of 1,894 participants had complete data records. Parasitological examinations revealed prevalences of hookworm, S. haematobium, T. trichiura, S. mansoni, and A. lumbricoides of 33.5%, 7.0%, 1.6%, 1.3% and 0.8%, respectively. Giardia intestinalis and Entamoeba histolytica/E. dispar were detected in 15.0% and 14.4% of the participants, respectively. Only one out of five households reported the presence of a latrine, and hence, open defecation was common. Logistic regression analysis revealed that age, sex, socioeconomic status, hygiene, and defecation behavior are determinants for helminths and intestinal protozoa infections.Conclusions/SignificanceWe found that inadequate sanitation and hygiene behavior are associated with soil-transmitted helminths and intestinal protozoa infections in the Taabo area of south-central Côte d’Ivoire. Our data will serve as a benchmark to monitor the effect of community-led total sanitation and hygiene education to reduce the transmission of helminthiases and intestinal protozoa infections.
Highlights
Hundreds of millions of people are still affected by neglected tropical diseases (NTDs), in the developing world due to parasitic worm infections [1,2]
Current helminthiases control programs focus on preventive chemotherapy, that is the regular administration of anthelmintic drugs to at-risk populations, school-aged children
No treatments were given to participants identified with intestinal protozoa infections, as the results from the sodium acetate-acetic acid-formalin (SAF)-fixed stool samples subjected to an ether-concentration method were only available several weeks after completion of the field work and intestinal protozoa infection are often self-limiting
Summary
Hundreds of millions of people are still affected by neglected tropical diseases (NTDs), in the developing world due to parasitic worm infections (helminthiases) [1,2]. Current helminthiases control programs focus on preventive chemotherapy, that is the regular administration of anthelmintic drugs to at-risk populations, school-aged children [10,11]. The importance of integrated control approaches for the interruption of transmission of helminthiases is well established since almost a century [15,16], current control efforts emphasize drug interventions, and do not give sufficient attention to hygiene behavior, clean water, and adequate sanitation [17,18,19]. Rapid re-infection occurs in areas where hygiene, access to clean water, and sanitation are inadequate
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