Following the Worms: Detection of Soil-Transmitted Helminth Eggs on Mothers’ Hands and Household Produce in Rural Kenya

Lauren Steinbaum,John Mboya,Amy J Pickering,Jenna Swarthout

doi:10.4269/ajtmh.17-0072

Abstract

.Approximately one-quarter of the world’s population is infected with at least one species of soil-transmitted helminth (STH). The role of produce and hands in STH transmission is not well understood. We collected and processed mother hand rinse and garden-grown produce rinse samples from 116 rural households in Kakamega, Kenya, in an area previously identified to have high STH egg contamination in household soil. Ascaris was the only STH species detected; 0.9% of hand rinse, 3.5% of leafy produce, and 1.8% of root produce samples had Ascaris eggs. Our results indicate produce and hands can carry Ascaris eggs. However, due to the low detected prevalence of eggs on hands and produce, and a high prevalence of cooking the produce items tested, these pathways might have a minor contribution to STH exposure in this setting.

Highlights

An important limitation of past work is that soil-transmitted helminth (STH) transmission pathways within the household have not been thoroughly explored
We selected households enrolled in the control group of the WASH Benefits study, a randomized controlled trial that assessed the impact of WASH and nutrition interventions on child health in Western Kenya.[13]
An ongoing national school-based deworming program had been in effect in the study area since 2012.14,15 A study evaluating the national school-based deworming program in Kenya found the prevalence of STH infection in schoolchildren in Kakamega was 24.8% in 2014.14 The prevalence of Ascaris was 24.0%, Trichuris was 1.2%, and hookworm was 0.1%

Summary

Introduction

An important limitation of past work is that STH transmission pathways within the household have not been thoroughly explored. Studies have detected fecal bacteria contamination of the household environment (walls, utensils, toys, hands, water, produce, soil),[10,11,12] suggesting more work should be done to evaluate STH contamination along these fecal–oral transmission pathways. We collected 231 hand rinses, 218 produce rinses (including 143 leafy vegetables, 55 root vegetables, and 20 other produce items), and 11 blanks.

Objectives

Results

Conclusion