Abstract
BackgroundSoil-transmitted helminths (STH) infect more than 2 billion humans worldwide, causing significant morbidity in children. There are few data on the epidemiology and risk factors for infection in pre-school children. To investigate risk factors for infection in early childhood, we analysed data prospectively collected in the ECUAVIDA birth cohort in Ecuador.Methods and FindingsChildren were recruited at birth and followed up to 3 years of age with periodic collection of stool samples that were examined microscopically for STH parasites. Data on social, demographic, and environmental risk factors were collected from the mother at time of enrolment. Associations between exposures and detection of STH infections were analysed by multivariable logistic regression. Data were analysed from 1,697 children for whom a stool sample was obtained at 3 years. 42.3% had at least one STH infection in the first 3 years of life and the most common infections were caused by A. lumbricoides (33.2% of children) and T. trichiura (21.2%). Hookworm infection was detected in 0.9% of children. Risk of STH infection was associated with factors indicative of poverty in our study population such as Afro-Ecuadorian ethnicity and low maternal educational level. Maternal STH infections during pregnancy were strong risk factors for any childhood STH infection, infections with either A. lumbricoides or T. trichiura, and early age of first STH infection. Children of mothers with moderate to high infections intensities with A. lumbricoides were most at risk.ConclusionsOur data show high rates of infection with STH parasites during the first 3 years of life in an Ecuadorian birth cohort, an observation that was strongly associated with maternal STH infections during pregnancy. The targeted treatment of women of childbearing age, in particular before pregnancy, with anthelmintic drugs could offer a novel approach to the prevention of STH infections in pre-school children.
Highlights
Soil-transmitted helminths (STH), including A. lumbricoides lumbricoides, T. trichiura trichiura, and hookworm, are estimated to infect more than 2 billion humans worldwide [1] of which 51 million children are considered to be at risk of morbidity [2]
Our data show high rates of infection with STH parasites during the first 3 years of life in an Ecuadorian birth cohort, an observation that was strongly associated with maternal STH infections during pregnancy
The targeted treatment of women of childbearing age, in particular before pregnancy, with anthelmintic drugs could offer a novel approach to the prevention of STH infections in pre-school children
Summary
Soil-transmitted helminths (STH), including A. lumbricoides lumbricoides, T. trichiura trichiura, and hookworm, are estimated to infect more than 2 billion humans worldwide [1] of which 51 million children are considered to be at risk of morbidity [2]. An estimated 35 million or more disability-adjusted life years [3] have been attributed to STH infections. Current strategies for the control of STH infections are primarily based upon periodic treatment of schoolchildren with anthelmintic drugs, and secondarily on education and improvements in sanitation. Treatment-based control strategies aim to control morbidity through reductions in the community transmission of STH infections [8]. Soil-transmitted helminths (STH) infect more than 2 billion humans worldwide, causing significant morbidity in children. To investigate risk factors for infection in early childhood, we analysed data prospectively collected in the ECUAVIDA birth cohort in Ecuador
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