Prevalence, Intensity, and Correlates of Soil-Transmitted Helminth Infections among School Children after a Decade of Preventive Chemotherapy in Western Rwanda.

Joseph Kabatende,Ulf Bergman,Eleni Aklillu,Abbie Barry,Eugene Ruberanziza,Jean Bosco Mbonigaba,Emile Bienvenu,Lazare Ntirenganya,Michael Mugisha

doi:10.3390/pathogens9121076

Abstract

Preventive chemotherapy (PC) is a WHO-recommended core intervention measures to eliminate Soil-Transmitted Helminths (STH) as a public health problem by 2020, defined as a reduction in prevalence to <1% of moderate or high-intensity infection. We conducted a cross-sectional study to investigate the prevalence, intensity, and correlates of STH after a decade of PC in Rwanda. A total of 4998 school children (5–15 years old) from four districts along Lake Kivu in the western province were screened for STH using Kato-Katz. The overall prevalence of Soil-transmitted helminths among school children was 77.7% (range between districts = 54% to 92%). Trichirus trichiura was the most common STH (66.8%, range between districts = 23% to 88.2%), followed by Ascaris lumbricoides (49.9%, range between district = 28.5% to 63.3%) and hookworms (1.9%, range between districts = 0.6% to 2.9%). The prevalence of single, double and of triple parasite coinfection were 48.6%, 50.3%, and 1.1%, respectively. The overall prevalence of moderate or high-intensity infection for Trichirus trichiura and Ascaris lumbricoides was 7.1% and 13.9, respectively. Multivariate logistic regression model revealed that male sex, district, stunting, and schistosomiasis coinfection as significant predictors of STH infection. Despite a decade of PC implementation, STH remain a significant public health problem in Rwanda.

Highlights

Soil-transmitted helminth (STH) infections are the most common infections of neglected tropical diseases (NTDs) worldwide, primarily affecting the poorest and most deprived communities [1]
Out of the 4998 screened children, 3885 were infected with one or more STH parasites giving an overall prevalence of 77.7% STH infection
There was a significant difference in prevalence of STH infection between the 4 study districts, being highest in Rubavu (92%) and Ruszi districts (89%) compared to Nyamasheke (60%) and Rutsiro (54%)

Summary

Introduction

Soil-transmitted helminth (STH) infections are the most common infections of neglected tropical diseases (NTDs) worldwide, primarily affecting the poorest and most deprived communities [1]. Pathogens 2020, 9, 1076 suffer from one or more STH infections [1]. The most common species of STH that infect people are the roundworm (Ascaris lumbricoides), the whipworm (Trichirus trichiura), and various species of hookworms (Necator americanus Ancylostoma duodenale and Ancylostoma ceylanicum) [1]. Ascaris and Trichirus infections are transmitted through contaminated food and water, whereas hookworms are transmitted by skin penetration [3]. Children are by far the most disproportionately affected by STH, and infected children are usually malnourished and anemic because of the resultant nutritional deficiency. Numerous studies have indicated that poor water, sanitation, and hygiene (WASH)

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