Abstract
Soil-transmitted helminth (STH) infections are the most widespread of the neglected tropical diseases, primarily affecting marginalized populations in low- and middle-income countries. More than one billion people are currently infected with STHs. For the control of these infections, the World Health Organization (WHO) recommends an integrated approach, which includes access to appropriate sanitation, hygiene education, and preventive chemotherapy (i.e., large-scale, periodic distribution of anthelmintic drugs). Since 2010, WHO has coordinated two large donations of benzimidazoles to endemic countries. Thus far, more than 3.3 billion benzimidazole tablets have been distributed in schools for the control of STH infections, resulting in an important reduction in STH-attributable morbidity in children, while additional tablets have been distributed for the control of lymphatic filariasis. This paper (i) summarizes the progress of global STH control between 2008 to 2018 (based on over 690 reports submitted by endemic countries to WHO); (ii) provides regional and country details on preventive chemotherapy coverage; and (iii) indicates the targets identified by WHO for the next decade and the tools that should be developed to attain these targets. The main message is that STH-attributable morbidity can be averted with evidence-informed program planning, implementation, and monitoring. Caution will still need to be exercised in stopping control programs to avoid any rebound of prevalence and loss of accrued morbidity gains. Over the next decade, with increased country leadership and multi-sector engagement, the goal of eliminating STH infections as a public health problem can be achieved.
Highlights
Soil-transmitted helminthiasis and the control strategy recommended by the World Health OrganizationSoil-transmitted helminth (STH) infections are the most widespread of the neglected tropical diseases, primarily affecting marginalized populations in low- and middle-income countries
Since 2010, World Health Organization (WHO) has managed two donations of anthelmintics that are provided to ministries of health in endemic countries
The present paper summarizes anthelmintic treatment coverage data over a 10-year period (2008–2018) from over 690 reports submitted to WHO by ministries of health
Summary
Soil-transmitted helminthiasis and the control strategy recommended by the World Health OrganizationSoil-transmitted helminth (STH) infections are the most widespread of the neglected tropical diseases, primarily affecting marginalized populations in low- and middle-income countries. More than one billion people are currently infected with one, or several, of the most common STH species These include Ascaris lumbricoides, Trichuris trichiura, and the two hookworm species, Necator americanus and Ancylostoma duodenale [1,2]. Each of these four species has distinct characteristics, but they are considered as a single group because of similarities in transmission dynamics and the prevention and control measures needed. After 5 years of annual PC implementation, the PC program is re-evaluated to determine steps [4] This strategy is cost-effective and periodic surveys provide sufficient information for effective program implementation and timely adaptation. This coverage target is applied to the two other groups at highest risk of STH-related morbidity: preschool-age children and women of reproductive age [4,7]
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