Prevalence Of Soil-transmitted Helminths Research Articles

Exploring factors associated with Trichuris trichiura infection in school children in a high-transmission setting in Kenya

ObjectivesKenya has implemented a national school-based deworming program, which has led to substantial decline in the prevalence of soil-transmitted helminths (STHs), although some pockets of infections remain. To effectively design an STH control program that leads to significant reductions of Trichuris trichiura, there is a need to understand the drivers of persistent infection despite ongoing treatment programs. MethodsThis study was conducted between July and September 2019 at the south coast of Kenya, using a two-stage sampling design. First, a school-based cross-sectional survey was conducted in 2265 randomly selected school children from selected schools in areas known to be endemic for T. trichiura. After this, we conducted a nested case-control study wherein all children positive for T. trichiura (142) were matched to 148 negative controls based on age and village. A household survey was then conducted with all household members of cases and controls. In addition, a subsample of 116 children found to be infected with T. trichiura were followed up to assess the efficacy of albendazole at day 21 post-treatment. The predictors of presence of T. trichiura were investigated through multilevel logistic regression, considering clustering of infection. ResultsOverall, 34.4% of the children were infected with at least one STH species; T. trichiura was the most common (28.3%), 89.1% of those with T. trichiura had light-intensity infections. The prevalence of T. trichiura was significantly higher in male children and was positively associated with younger age and number of people infected with T. trichiura in a household. The parasitological cure rate and egg reduction rate of T. trichiura were 35% and 51%, respectively. Other STHs identified were hookworm (9.6%) and Ascaris lumbricoides (5.7%). ConclusionsT. trichiura remains a significant public health challenge in the study area with albendazole treatment efficacy against the parasite, remaining lower than the World Health Organization–recommended thresholds. Because of the observed focal transmission of T. trichiura in the current area, control efforts tailored to local conditions and targeting lower implementation units should be used to achieve optimal results on transmission.

Investigating the effect of a school-based WASH intervention on soil-transmitted helminth and schistosome infections and nutritional status of school children in Ethiopia: a quasi-experimental study

BackgroundThe impact of access to improved water, sanitation and hygiene (WASH) and health education on large-scale deworming programs aimed at controlling soil-transmitted helminth (STH) and schistosome (SCH) infections has not been well studied. We assessed the additional impact of improved WASH infrastructure and health education at schools on STH and SCH infections in Ethiopia.MethodsThe study used a quasi-experimental design under which 30 schools were assigned to either an intervention (15 schools) or control (15 schools) arm. Both arms received a standard deworming treatment and lunch. In the intervention arm, improved WASH and health education were provided. At three consecutive time points (baseline in 2013, 2014 and 2015), the prevalence and intensity of STH and SCH infections and the nutritional status [hemoglobin concentrations and physical growth (height and weight)] were determined. To verify whether interventions were successfully implemented, the WASH status at school and the student knowledge, attitudes and practices related to WASH (WASH-KAP) were recorded. Differences in metrics between arms at baseline (2013) and follow-up (2015) were assessed both within and between the arms.ResultsA significant increase in scores for both the school WASH and student KAP was found in the intervention arm, indicating successful implementation of the intervention. The prevalence of any STH infection was significantly reduced in the intervention arm but not in the control arm (F = 4.486, p = 0.034). There was a significantly greater reduction in the intensity of infection of hookworm and Ascaris lumbricoides compared to baseline in both arms. The intervention did not affect school children’s height-for-age z-score (intervention arm * time coef = 0.12, p = 0.400) and body mass index-for-age z-scores (intervention * time coef = − 0.06, p = 0.526). Hemoglobin concentrations increased significantly more in the control than the intervention arm (coef = − 0.16, p = 0.006).ConclusionsAlthough the intervention did increase school WASH and student WASH-KAP, our study found poor evidence of the additional benefit of improved WASH and health education to deworming and school food programs on parasite re-infection and the health outcomes of children.Graphical

A One Health approach toward the control and elimination of soil-transmitted helminthic infections in endemic areas

Soil-transmitted helminths (STHs) pose significant health challenges, particularly in developing countries. Over 2 billion people are estimated to have been infected with at least one STH species. These parasites rely on the soil for part of their life cycle and are transmitted to humans through ova ingestion or skin penetration. Key risk factors include poor water, sanitation, hygiene practices, limited healthcare access, and poverty. Globally, STHs are primarily controlled through chemo-preventive deworming of high-risk groups in moderate (where prevalence of STHs is between 20 % and 50 %) to highly endemic areas (prevalence >50 %). Despite the use of deworming to control the STHs in endemic areas, infections still occur. The aim of this article is to explore the potential for enhancing STH control and elimination as Neglected Tropical Diseases (NTDs) in endemic areas through an integrated approach—the One Health approach. The current control program has a single strategy of chemoprophylaxis; in the integrated approach to control of STHs, the parasite control strategies besides being based on the epidemiology of the parasite (endemicity), also include strategies based on the biology (transmission cycle) of the parasites and human behavior patterns in endemic areas. Through the involvement of local communities, healthcare authorities, and stakeholders, participatory approaches foster collaborative efforts to devise and implement control measures. By integrating this integrated approach into existing healthcare and educational initiatives, more effective results can be achieved. The promotion of health education, clean water access, improved sanitation, and hygiene awareness can further enhance control strategies and reduce STH prevalence sustainably. Here, we highlight the benefits of adopting an integrated (One Health) approach to tackle STHs in endemic areas. Through community empowerment and multi-sectorial collaboration, we can strengthen our collective efforts to combat STHs and alleviate the burden of these NTDs.

Is a mass drug administration deworming programme for school-aged children enough to reduce the prevalence of soil-transmitted helminths and Schistosoma mansoni in adults: a cross-sectional study from Togo

BackgroundThe world health organization (WHO) introduced the mass drug administration (MDA) strategy in order to reduce the prevalence of soil-transmitted helminths (STHs) and Schistosoma mansoni in endemic areas. However, this strategy is not implemented in adult population in Togo. Thus, the question arose if the present MDA strategy contributes to the reduction of transmission rates. The present study aimed to monitor the prevalence of STHs and S. mansoni among adult’s, between 2017 and 2022, in the central region of Togo.MethodsTwo cross-sectional studies were conducted in six villages in the central region of Togo in 2017 and 2022. Stool samples were collected from adults over the age of 18 years. To assess STHs and S. mansoni infections, real-time multiplex qPCR and Kato-Katz techniques were performed. Data were analysed using SPSS software version 21 and GraphPad PRISM version 9.2.0. A p-value less than 0.05 was considered statistically significant.ResultsA total of 210 and 289 individuals were recruited in 2017 and 2022, respectively. We detected significant increase in the prevalence of STHs and S. mansoni from 7.61% to 24.56% (p=0.0008) and from 27.62% to 46.36% (p=0.0014) by Kato-Katz and RT-qPCR, respectively. The prevalence of Ancylostoma duodenale infection was the highest with an increase from 7.14% to 23.53% by Kato-Katz and 9.09% to 40.0% by RT-qPCR.ConclusionThe prevalence of STHs and S. mansoni increased in the adult population in the central region of Togo from 2017 to 2022, despite the implementation of MDA in school-aged children. Hence, there is an urgent need to include adult individuals and adapt the MDA programme in the central region of Togo.

Protocol for spatial prediction of soil transmitted helminth prevalence in the Western Pacific region using a meta-analytical approach

BackgroundSoil transmitted helminth (STH) infections are estimated to impact 24% of the world’s population and are responsible for chronic and debilitating morbidity. Disadvantaged communities are among the worst affected and are further marginalized as infection prevalence fuels the poverty cycle. Ambitious targets have been set to eliminate STH infections, but accurate epidemiological data will be required to inform appropriate interventions. This paper details the protocol for an analysis that aims to produce spatial prediction mapping of STH prevalence in the Western Pacific Region (WPR).MethodsThe protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P) guidelines. The study design will combine the principles of systematic review, meta-analysis, and geospatial analysis. Systematic searches will be undertaken in PubMed, Scopus, ProQuest, Embase, and Web of Science for studies undertaken post 2000, to identify surveys that enable the prevalence of human STH infection within the WPR to be calculated. Covariate data for multivariable analysis will be obtained from publicly accessible sources. Survey data will be geolocated, and STH prevalence and covariates will be linked to produce a spatially referenced dataset for analysis. Bayesian model-based geostatistics will be used to generate spatially continuous estimates of STH prevalence mapped to a resolution of 1 km2. A separate geospatial model will be constructed for each STH species. Predictions of prevalence will be made for unsampled locations and maps will be overlaid for each STH species to obtain co-endemicity maps.DiscussionThis protocol facilitates study replication and may be applied to other infectious diseases or alternate geographies. Results of the subsequent analysis will identify geographies with high STH prevalence’s and can be used to inform resource allocation in combating this neglected tropical disease.Trial registrationOpen Science Framework: osf.io/qmxcj.

Prevalence and intensity of urinary schistosomiasis and soil-transmitted helminths among women of reproductive age in Mwaluphamba, Kwale

Objective: To assess the epidemiology of urinary schistosomiasis and soil-transmitted helminthiasis among women of reproductive age in Mwaluphamba, Kwale County, Kenya. Methods: A community-based cross-sectional study design was employed to randomly sample 422 women of reproductive age (15-<50 years) from four villages in Mwaluphamba location. Stool specimens were collected and examined using the Kato-Katz method, while filtration technique was used to analyze urine specimens. Participants’ sociodemographic details were obtained using a standardized questionnaire. Results: Urinary schistosomiasis prevalence was at 4.7% (20/422, 95% CI 2.8%-6.9%) while the prevalence of soil-transmitted helminthiasis infection was 4.5% (19/422, 95% CI 2.6%-6.7%). The infection intensities of urinary schistosomiasis among the study participants ranged from 1 to 120 eggs/10 mL of urine with median egg count of 18.45 eggs/10 mL. The patients were diagnosed with light infection, of 56.16 egg/gram and 48.48 egg/gram for Trichuris trichiura and hookworms, respectively. Women without latrines had 15.7 times higher risk of having urinary schistosomiasis compared to those with a latrine. Similarly, use of surface water (aOR=1.0, 95% CI 0.2-1.4, P=0.010) and crossing the river to go to a place (aOR=1.1, 95% CI 0.3-1.6, P=0.009) were statistically significant risk factors for getting urinary schistosomiasis. In bivariable regression analysis, defecating around the water source (OR=4.3, 95% CI 1.5-12.9) had a statistically significant association with the prevalence of soil-transmitted helminthiasis (P=0.008). Conclusions: This study has given an insight on the prevalence and intensity of urinary schistosomiasis and soil-transmitted helminthiasis in Mwaluphamba location that form a basis for strengthening the control and elimination programmes for these neglected tropical diseases.

Estimation of the Parasitic Burden of Soil-Transmitted Helminths Among Pregnant Women in the Maharashtra State of India Using qPCR: A Community-Based Study.

Soil-transmitted helminth (STH) infections are widespread in developing countries with inadequate sanitation facilities. These infections can lead to malnutrition, anemia, and other complications that can negatively impact both the mother's and fetus's health during pregnancy. This study aimed to estimate the burden of STH by Kato-Katz microscopy and quantitative polymerase chain reaction (qPCR) in pregnant women from rural India. The diagnostic accuracy of these two methods was also compared. A community-based cross-sectional study was conducted in rural areas of Wardha district of Maharashtra state. We randomly selected and interviewed 688 pregnant women. A total of 534 (77.61%) participants gave stool samples. Two containers (60 mL) labeled with a unique identification number were given to pregnant women to collect stool samples for Kato-Katz microscopy and qPCR. Stool specimens were transported to an accredited lab and examined within 24 hours. Suitable examinations were conducted to compare sensitivity between two tests. The results are presented for 534 participants who gave stool samples. The prevalence of any STH by Kato-Katz stool microscopy was 6.55% (95%CI 4.46-12.19), and that by qPCR was 20.41 (95%CI 17.53-29.40). The sensitivity of Kato-Katz microscopy was 29.17% compared to sensitivity of 90.83% by qPCR (P = 0.001). Pregnant women with STH infection have a significantly lower weight gain during pregnancy, and the majority were either mild or moderate anemic compared to those without STH. The study highlighted significant differences in prevalence of STH among pregnant women by Kato-Katz microscopy and qPCR. The sensitivity of qPCR for detecting STH was higher than that of Kato-Katz microscopy.

Soil-Transmitted Helminths in Kindergarten Children: Prevalence, Intensity and Associated Factors in Bule Hora Town.

Background: Soil-transmitted helminth (STH) infections are a common problem in Ethiopia. This parasite affects the physical and mental development of children, causing malnutrition and iron deficiency anaemia. However, there are inadequate studies that demonstrate the extent of STHs and associated factors among kindergarten children in South Ethiopia, particularly in the study area. Objective: The aim of this study is to determine the prevalence, intensity, and associated factors of STH infection among kindergarten students in Bule Hora town. Methods: An institution-based cross-sectional study was conducted among randomly selected 235 kindergarten children in Bule Hora town from January to February 2023. A pretested questionnaire was used to collect information on associated factors. EpiData and SPSS were used for data entry and analysis, respectively. Binary logistic regression analyses were performed to identify risk factors. Results: In the present study, the prevalence of STH was 28.5% (95% CI: 22.7%-34.3%). A. lumbricoides 26 (11.1%) was the most common parasite identified. The arithmetic mean (+SD) of the egg counts for each species of STHs was as follows: A. Lumbricoides 1886.9 (+2103.2), T. Trichiura 299.2 (+305.8), and hookworms 756.1 (+739.4). Factors that showed significant association in the current study were hand washing after the toilet (AOR: 2.992, 95% CI: 1.299-6.891,), fingernail trimming (AOR: 3.646, 95% CI: 1.704-7.798,), and shoe wearing habit (AOR: 2.143, 95% CI: 1.170-3.924,). Conclusion: STH infection is a health problem among kindergarten children in Bule Hora town. Comprehensive health education on the value of hygienic habits, improved sanitation, and routine deworming of kindergarten children should be included in prevention and control efforts.

The impact of community based interventions for the prevention and control of soil-transmitted helminths: A systematic review and meta-analysis.

Soil-transmitted helminths (STHs) are among the most common human infections worldwide and a major cause of morbidity. They are caused by different species of parasitic worms and transmitted by eggs released in faeces or when hookworm larvae penetrate the skin. The main control strategy in endemic regions is periodic treatment with deworming medication. In the last 10 years, there has been a scale-up of prevention and control activities with a focus on community-based interventions (CBIs). This review aims to systematically analyse the impact of CBIs on the prevalence and infection intensity of STHs. A systematic review was published on this topic in 2014, but there have subsequently been several new studies published which are included in this review. Electronic database search of MEDLINE (Ovid), Global Health Online (Ovid), Cochrane Library, Embase (Ovid) and Web of Science was conducted. Titles, abstracts, and full texts were screened by two independent reviewers according to predefined eligibility criteria. Data were extracted and a meta-analysis of included studies was conducted. A total of 11,954 de-duplicated titles were screened, and 33 studies were included in the review. 14 focussed on community-wide treatment, 11 studies investigated school-based interventions, and 3 studies investigating both. Results suggest that CBIs are effective in reducing the prevalence of Hookworm, Trichuris trichiura and Ascaris lumbricoides. School-based treatment and community-wide treatment, as well as annual and semi-annual deworming, all reduce STH prevalence significantly. Mass drug administration was effective in reducing the infection intensity of Hookworm (Mean difference: -211.36 [95% CI: -519.12, 96.39]), Trichuris trichiura (-736.69 [-1349.97, -123.42]) and Ascaris lumbricoides (-2723.34 [-5014.85, -431.84]). The results suggest that CBIs are effective in reducing the prevalence and intensity of STH infections. While most studies delivered preventive chemotherapy (PC), few studies explored the impact of interventions such as water, sanitation, and hygiene (WASH) or health education, which may be essential in preventing reinfection after PC.

Zoonotic Parasites and Their Association With Human Activities in Northern Tanzania: An Integrated Ecosystem Approach for One Health.

The community's awareness of the prevalence and impact of zoonotic diseases has been significantly underestimated, leading to insufficient implementation of control measures. This study was carried out in Northern Tanzania between 2019 and 2023 to investigate zoonotic parasites and the risks associated with human activities that contribute to zoonotic diseases. Cross-sectional surveys were conducted in 12 villages, including nine in Loliondo Division and three in Babati District. Focus Group Discussions and Key Informant Interviews were conducted to assess the community's knowledge and practices regarding the risks associated with zoonotic diseases in the surveyed areas. A total of 255 samples were collected from various sources, including latrines, households, livestock enclosures, domestic dogs, and chickens. Out of these samples, 152 tested positive for identifiable parasite eggs and oocysts. These parasites included hookworms (21.7%), Trichuris sp. (14.5%), Strongyloides sp. (13.8%), Eimeria sp. (19.7%), Taeniids (5.9%), Hymenolepis sp. (3.3%), Spirometra sp. (2.6%), and Dipylidium sp. (0.7%). Taeniids and Spirometra species were predominantly found in villages near protected areas such as Arash Sokoni, Oloipiri, Sukenya, Wasso, Orkuyiene, Haytemba, and Loliondo. Hookworms were most commonly detected in Arash Sokoni, Loliondo, Isuguro, and Hyatemba, while Strongyloides sp. was prevalent in Wasso, Sukenya, and Olobo villages. The quantitative analysis reveals significant associations between hygiene practices, proximity to livestock enclosures, ecological factors, and human-animal interaction, highlighting their pivotal roles in determining soil-transmitted helminth (STH) prevalence across different villages. This study reveals that there was a generally low level of awareness regarding zoonotic diseases and STHs. The detection of STH samples, combined with the limited understanding of zoonotic diseases, emphasizes the importance of taking proactive measures to reduce transmission risks. Prioritizing education and promoting awareness along with implementing comprehensive strategies are essential steps to effectively tackle the problems linked to STH infections and substantially lessen the public health burden caused by zoonotic diseases.

Soil-Transmitted Parasites and Non-Pathogenic Nematodes in Different Regions of Porto Alegre City, Brazil: A Comparison between Winter and Summer

We assessed the prevalence of soil-associated parasites and non-pathogenic nematodes in eight public areas of Porto Alegre (Rio Grande do Sul state, southern Brazil), the most populous city in Rio Grande do Sul. Soil samplings were carried out during the winter of 2022 and summer of 2023: A total of 80 samples were collected in winter and 80 in summer (ten samples from each sampling site per season), totaling 160 soil samples. The frequency of microscopic non-pathogenic nematode larvae was significantly higher (p = 0.048) in winter (93.75%) than in summer (82.50%). Considering the pooled data from winter and summer (n = 160) for human pathogenic parasites, the following frequencies were observed (using microscopy analysis): hookworm (filariform) larvae (1.25%), hookworm (rhabditiform) larvae (11.25%), Strongyloides spp. (filariform) larvae (0.63%), Strongyloides spp. (rhabditiform) larvae (2.5%), hookworm eggs (10.63%), Ascaris spp. eggs (10.00%), and Trichuris spp. eggs (1.25%). Hookworm (rhabditiform) larvae were the most frequent parasitic structures (15.00%) in winter, and A. lumbricoides eggs were the most frequent parasitic structures (8.75%) in summer. No statistically significant difference was observed in the frequency of pathogenic parasites between the seasons (p > 0.05). Toxoplasma gondii DNA was assessed, but all soil samples tested negative in molecular analysis. Our results indicate that soil from many regions of Porto Alegre shows a high prevalence of soil-transmitted helminths, indicating the need for improvements in social conditions and environmental sanitation in the city. Our study also suggests that climate change may affect soil biodiversity, potentially harming non-pathogenic nematodes and favoring human pathogenic parasites.

Soil-Transmitted Helminths: Prevalence and the Effect of Deworming in Children in Mutengene, South West Region, Cameroon

Soil-transmitted helminthes (STH) (A. lumbricoides, T. trichiura and hookworms) constitute a significant public health problem globally. These infections are widely distributed in tropical and subtropical areas and their transmission is highly dependent on the degree to which the environment is contaminated with infectious stages and the amount of contact between human hosts and polluted soil. There are three main intervention strategies for controlling STH infections including ant-helminthic drug treatment (deworming), improved sanitation and health education. The objectives of this study were to determine the prevalence of STH and assess the effects of de-worming among children 4 to 15 years old in Mutegene.
 It was a cross-sectional study, involving school children of both sexes. A systematic random sampling method was used to collect data. Basic demographic data was obtained from the class registers. A structured questionnaire was used to collect information. Stool samples were collected, transported to the laboratory for macroscopic and microscopic analysis. Data was analyzed using SPSS version 21 and the Chi-square test.
 The result obtained showed an overall prevalence of 3.6% (n=9) with the most frequent species being Trichuris trichiura 2.4% (n=6) followed by Hookworm 0.8% (n= 2) and the least was Ascaris lumbricoides 0.4 %(n=1). On the impact of de-worming, out of the 9 infected cases, seven (7) indicated that they had not taken worm medicines (neither albendazole nor mebendazole), one (1) did not know and only one (1) infected person was among those that had been de-wormed before. This showed that the deworming process had a positive impact in eliminating helminthiasis.
 In conclusion, the low prevalence could be explained by the prior de-worming of children. It was recommended that continuous health education should be given through community radios and television as a means of making the people understand the mode of transmission and methods of prevention of STH infection better.

High prevalence of soil-transmitted helminths and schistosomiasis among primary schoolchildren in Southwest Ethiopia: the need for health strategies alongside mass drug administration.

Soil-transmitted helminths (STH) and schistosomiasis remain widely prevalent in Ethiopia. The aim of this study was to evaluate the prevalence of STH and schistosomiasis among schoolchildren in Gidi Bench district (Southern Nations, Nationalities, and People's Republic, Southwest Ethiopia) and the association with knowledge and health-related behaviors. A cross-sectional study was conducted. Stool samples, analyzed by the Kato-Katz technique and a knowledge, attitudes and practices questionnaire, were collected. Out of 611 participants (mean age 12.8±3.1 y), 129 (21.1%) were infected with schistosomiasis and 382 (62.5%) had STH. More than 30% (n=195, 31.9%) were infected with a single intestinal parasite, while 138 (22.6%) and 47 (7.7%) were infected with two or three parasitic infections, respectively. Boys and those who did not participate in school clubs had higher infection rates (p=0.05). Lower parasitic infection was associated with using a latrine when available, washing hands and vegetables and wearing shoes regularly. Higher rates of infection were found among those who reported swimming and washing cloths and utensils in the river regularly. Schistosomiasis and STH were highly prevalent among schoolchildren in Gidi Bench district. Infection rates were associated with gender, lack of knowledge on parasitic infections and unhealthy behaviors. Findings from this study may assist in decision making regarding disease prevalence and methods of control alongside mass drug administration.

Effectiveness of one and two doses of ivermectin mass drug administration in reducing the prevalence and intensity of soil-transmitted helminth (STH) infections in Western Province, Solomon Islands: a cluster-randomised, before-after analysis

Ivermectin mass drug administration (MDA) is effective for controlling onchocerciasis and scabies, with evidence supporting its role in some species of soil-transmitted helminth (STH) infections. In the context of RISE, a cluster-randomised trial for scabies, this study evaluated the effectiveness of ivermectin MDA in reducing STH burden in the Western Province of Solomon Islands. Twenty villages were randomised 1:1 to receive ivermectin MDA as one dose (IVM-1) or two doses (IVM-2) for scabies. The effectiveness of one and two doses in reducing STH prevalence and intensity was evaluated before (May 2019) and 21 months after (February 2021) MDA in May 2019. All residents aged 12 months or older in the study villages were eligible to participate and provide stool specimens. Species-specific STH infection and intensity were assessed using quantitative PCR. We compared prevalence and intensity of infection between baseline and 21 months in each intervention arm individually using cluster-level analysis (adjusted for clustering) and individual-level analysis (adjusted for sex, age, and clustering). The primary outcomes were the prevalence risk difference (RD) from the cluster-level analysis, and the change in adjusted odds of infection from the individual-level analysis. Secondary outcomes included change in incident rates of mean eggs per gram (epg) of stool from baseline to 21 months, relative risk difference in prevalence and relative change in odds of infection between arms at 21 months. Sex data (male/female) were self-reported. Overall, STH infection was assessed in 830 participants from 18 villages at baseline and 1172 from 20 villages at follow-up. Females represented 58% (n=478) of the sample at baseline and 59% (n=690) at follow-up. We observed a reduction in Strongyloides spp. prevalence following two doses of ivermectin MDA in the cluster-level analysis from 7.0% (32/458 participants) to 1.2% (8/674 participants), corresponding to a RD of-0.07 (95% CI-0.14 to-0.01, p=0.036), and in the individual-level analysis (OR 0.11, 95% CI 0.04-0.33, p<0.001). T.trichiura prevalence decreased following one dose from 19.4% (74/372 participants) to 11.7% (56/505 participants) (OR 0.44, 95% CI 0.26-0.73, p=0.0040), while egg count reduced in both arms (IVM-1: IRR 0.28, 95% CI 0.11-0.70, p=0.0070; IVM-2: IRR 0.18, 95% CI 0.08-0.40, p<0.001), in the individual-level analysis. We did not detect a significant difference in effect measures between the one- and two-dose arms for any species after 21 months. Our study highlights the long-term benefits of ivermectin MDA in reducing the burden of Strongyloides spp. and T.trichiura. STH control programs should leverage the geographical overlap of NTDs, existing drug distribution channels, and broad-spectrum agents. The National Health and Medical Research Council of Australia.

Malaria and soil transmitted helminths among patients attending some hospitals in Kano Metropolis, Kano State, Nigeria

Soil-transmitted helminths (STHs) and Plasmodium falciparum are known to the causative agents of neglected tropical diseases that continue to pose significant public health challenges in Nigeria and other endemic countries. This study was aimed at determining malaria and STHs coinfection in Kano metropolis, Kano state, Nigeria. The prevalence of malaria and STHs was determined using microscopy and formol ether concentration methods, respectively. Data on socio-demographic and risk factors were collected from three hundred (300) patients using structured questionnaires. The findings revealed a high prevalence of malaria (92.7%) and low STHs (19.0%). Malaria was more prevalent in males (52.3%) than females (40.3%), with the highest prevalence observed among individuals aged 6 – 12 years (25.7%). The difference in malaria prevalence based on age was not statistically significant (p&gt;0.05), contrary to gender which showed a significant difference in their association (p&lt;0.05). STHs infections were more common in participants aged between 6 - 12 years (11.3%), and the difference in prevalence among age groups was statistically significant (p&lt;0.05). Among the study sites, patients exhibited a higher prevalence of Ascaris infection (14.3%) compared to Hookworm infection (4.6%). Co-infection was recorded in 19.0% of the patients, while 73.7% had malaria infection alone. During this study, malaria and STHs were prevalent in Kano metropolis and there was a co-infection of Malaria and STHs among patients attending the selected hospitals in Kano.

Baseline soil-transmitted helminth and schistosome infection in the Geshiyaro project, Ethiopia: A unique transmission interruption project using biometric fingerprinting for longitudinal individual analysis.

The Geshiyaro project aims to assess the feasibility of interrupting transmission of soil-transmitted helminths (STH) and schistosome (SCH) infection in the Wolaita zone of southern Ethiopia through high coverage community-wide mass drug administration (MDA), in combination with improved water, sanitation, and hygiene services and behaviour change communication delivered through the existing health care infrastructure. To accurately measure treatment coverage a population census was conducted enrolling individuals with biometric fingerprinting and barcoded ID cards. This paper details the baseline census and parasitology surveys conducted before the start of any interventions. The census was conducted in five of the 15 Wolaita districts between October 2018 and December 2019, enrolling all consenting participants from every household. Simultaneously, a cross-sectional parasitology survey was conducted in 130 out of 361 randomly selected communities from all 15 districts, with 100 individuals across all age groups (infant to adult) per community providing stool and urine for analysis by duplicate Kato-Katz and a point-of-care circulating cathodic antigen (POC-CCA) to test for Schistosoma mansoni and STH, and microhaematuria and urine filtration for Schistosoma haematobium. Of the 130 communities, 30 were randomly selected for annual, longitudinal parasitological monitoring, with 150 randomly selected individuals from infant to adult providing two days of stool and urine samples for analysis by the same diagnostic tests per community. In total 97,919 households participated in the baseline census enrolling 466,071 individuals, with parasitological data obtained from 10,785 people. At baseline, 15.5% were infected with at least one STH species, with Ascaris lumbricoides (9.5%), followed by hookworm (7.2%) and Trichuris trichiura (1.8%). Substantial heterogeneity in STH prevalence was observed between communities ranging from 0% to 61% where most infections were low intensity. Schistosoma mansoni infection was the dominant schistosome infection (0.85% by Kato-Katz and 13.3% by POC-CCA trace negative and 21.5% trace positive), with few Schistosoma haematobium infections identified (2.77% haematuria positive and 0.13% positive by urine filtration). While the national control program in Ethiopia has made good progress in reducing prevalence of STH and SCH in Wolaita since it was launched in 2015, there remain areas of persistent infection suggesting the existence of environmental or behavioural risk factors that contribute to ongoing transmission. This project aims to identify the most efficient intervention strategies to reduce community burden and reach interruption of transmission.

The Prevalence of Soil-Transmitted Helminths (STH) and Entamoeba spp. Infections in Southeast Asia: A Systematic Review

The Prevalence of Soil-Transmitted Helminths (STH) and Entamoeba spp. Infections in Southeast Asia: A Systematic Review

Community-wide versus school-based targeted deworming for soil-transmitted helminth control in school-aged children in Vietnam: the CoDe-STH cluster-randomised controlled trial

Soil-transmitted helminth (STH) infection control programs typically consist of school-based preventive chemotherapy (PC) targeted to school-aged children. STH reservoirs in untreated community members contribute to ongoing transmission in children. The CoDe-STH (Community Deworming against STH) trial, conducted in Dak Lak province, Vietnam, between October 2019 and November 2020, aimed to determine whether community-wide mass drug administration (MDA) is more effective than school-based targeted PC in reducing STH prevalence and intensity in children. In this two-arm cluster randomised controlled trial, 64 primary schools were randomly assigned 1:1 to receive either school-based targeted PC ("school arm") or community-wide MDA ("community arm"). A single dose of albendazole 400mg was used for deworming. The primary outcome was hookworm prevalence in schoolchildren, measured using quantitative real-time PCR. We also measured infection intensity for Necator americanus only, using qPCR cycle threshold (Ct) values converted into eggs per gram of faeces (EPG). Analysis was by intention to treat. The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000309189). The analysis included 4955 children in the school arm and 5093 children in the community arm. N.americanus was the dominant STH species. The relative reduction in hookworm prevalence was not significantly different between the school arm (30.1%, 95% confidence interval [CI] 20.5-36.9) and the community arm (34.6%, 95% CI 19.9-49.4). Due to lower baseline prevalence than expected, the study was underpowered to detect a difference in prevalence reduction between the study arms. The community arm showed significantly greater relative reduction in N.americanus infection intensity (56.0%, 95% CI 39.9-72.1) compared to the school arm (3.4%, 95% CI-24.7 to 31.4). The community arm also showed greater relative reduction in prevalence of moderate-to-heavy intensity (≥2000 EPG) N.americanus infections (81.1%; 95% CI 69.7-92.6) compared to the school arm (39.0%, 95% CI 13.7-64.2). Although no impact was seen on overall prevalence, community-wide MDA was more effective in lowering N.americanus infection intensity in schoolchildren compared to school-based targeted PC, measured 12 months after one round of albendazole deworming with high coverage. National Health and Medical Research Council, Australia (APP1139561).

Community and School-Based Surveys of Soil-Transmitted Helminth Infections on Samosir Island, Indonesia

Soil-transmitted helminth (STH) infections are common in tropical and sub-tropical regions where they can have substantial local public health impacts. This study aimed to evaluate the prevalence of STH infection in the community and children aged 6 to 11 years attending government-run schools in the Simanindo sub-district of Samosir Island. In total, 314 individuals in the community and 187 children aged 6 to 11 years attending government schools were invited to provide a fecal sample. All fecal samples were examined microscopically using the Kato-Katz technique. The prevalence of STH infection in the community was 46.8% (147/314). Infections were caused by Ascaris lumbricoides (n=52), followed by Trichuris trichiura (n=48), and hookworms (n=26). The prevalence of STH infection in school-age children was 4.8% in 2023. All infections in this cohort were due to T. trichiura. Even though the MDA program effectively controls A. lumbricoides and hookworm infections in school children, the problem of controlling T. trichiura infection remains. Therefore, selective treatment after fecal sample examination is needed to prevent T. trichiura infection and the potential for infection-associated anemia. Health education focusing on personal hygiene and environmental sanitation is still important for preventing STH infections. The suggestion is a new community-based survey with random sampling is necessary to ensure the present prevalence of STH in the community.

Prevalence and intensity of soil-transmitted helminth infections in Uganda: Results from population-based prevalence surveys in five districts.

Soil-transmitted helminth (STH) infections are caused by roundworms (Ascaris lumbricoides), whipworms (Trichuris trichiura), and hookworms (Necator americanus and Ancylostoma duodenale). In Uganda, baseline surveys conducted during the late 1990s and early 2000s suggested STH infections were common, with prevalence >50% among surveyed schoolchildren. In 2003, a national program was launched with mass preventative chemotherapy (PC) and health education for children 1-14 years old. Little evidence is available to show the impact of national deworming. We conducted population-based, cross-sectional household surveys in five districts (Buikwe, Kassanda, Kiryandongo, Kisoro, and Rubanda) in March and May 2022. Our primary objective was to estimate STH prevalence by species due to infections of any intensity and infections of moderate-to-heavy intensity among preschool-aged children (PSAC, 1-4 years old), school-aged children (SAC, 5-14 years old), and women of reproductive age (WRA, 15-49 years old). Laboratory technicians used duplicate Kato-Katz microscopy to determine fecal egg count. Overall, 3,352 PSAC; 3,884 SAC; and 1,226 WRA provided stool samples. The prevalence of any infection remained high in Kisoro at or above ~50% within all risk groups. In other districts, the prevalence of any infection ranged from approximately 5 to 16% among PSAC, 6 to 23% among SAC, and 12 to 19% among WRA. Moderate-to-heavy intensity infection prevalence was highest in Kisoro (~15-26%), followed by Rubanda (<5%), and was ≤1% in other districts. A. lumbricoides and T. trichiura infections were largely confined to Kisoro and Rubanda, whereas hookworm was most common in other districts. The STH prevalence has decreased markedly in three districts in Uganda. Based on our findings, the national deworming program should consider decreasing PC distribution frequency in these districts per the World Health Organization guidelines. Efforts are needed to understand why the Kisoro and Rubanda districts did not demonstrate similar gains.