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The impact of an 8-year mass drug administration programme on prevalence, intensity and co-infections of soil-transmitted helminthiases in Burundi

BACKGROUND: Soil-transmitted helminth (STH) infections are amongst the most prevalent infections in the world. Mass drug administration (MDA) programmes have become the most commonly used national interventions for endemic countries to achieve elimination. This paper aims to describe the effect of a...

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Autores principales: Ortu, Giuseppina, Assoum, Mohamad, Wittmann, Udo, Knowles, Sarah, Clements, Michelle, Ndayishimiye, Onésime, Basáñez, Maria-Gloria, Lau, Colleen, Clements, Archie, Fenwick, Alan, Magalhaes, Ricardo J. Soares
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034474/
https://www.ncbi.nlm.nih.gov/pubmed/27660114
http://dx.doi.org/10.1186/s13071-016-1794-9
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author Ortu, Giuseppina
Assoum, Mohamad
Wittmann, Udo
Knowles, Sarah
Clements, Michelle
Ndayishimiye, Onésime
Basáñez, Maria-Gloria
Lau, Colleen
Clements, Archie
Fenwick, Alan
Magalhaes, Ricardo J. Soares
author_facet Ortu, Giuseppina
Assoum, Mohamad
Wittmann, Udo
Knowles, Sarah
Clements, Michelle
Ndayishimiye, Onésime
Basáñez, Maria-Gloria
Lau, Colleen
Clements, Archie
Fenwick, Alan
Magalhaes, Ricardo J. Soares
author_sort Ortu, Giuseppina
collection PubMed
description BACKGROUND: Soil-transmitted helminth (STH) infections are amongst the most prevalent infections in the world. Mass drug administration (MDA) programmes have become the most commonly used national interventions for endemic countries to achieve elimination. This paper aims to describe the effect of an 8-year MDA programme on the prevalence, intensity of infection and co-infection of STH in Burundi from 2007 to 2014 and critically appraise the trajectory towards STH elimination in the country. RESULTS: Annual STH parasitological surveys (specifically, a “pilot study” from 2007 to 2011, an “extension study” from 2008 to 2011, and a “national reassessment” in 2014; n = 27,658 children), showed a significant drop in prevalence of infection with any STH (“pooled STH”) between baseline and 2011 in both studies, falling from 32 to 16 % in the pilot study, and from 35 to 16 % in the extension study. Most STH infections were of low intensity according to WHO classification. The national reassessment in 2014 showed that prevalence of pooled STH remained significantly below the prevalence in 2007 in both studies but there was no further decrease in STH prevalence from 2011 levels during this time. Spatial dependence analysis showed that prevalence of Trichuris trichiura and Ascaris lumbricoides had a tendency to cluster over the years, whilst only trends in spatial dependence were evident for hookworm infections. Spatial dependence fluctuated over the course of the programme for Ascaris lumbricoides and Trichuris trichiura. However, spatial trends in spatial dependence were evident in 2010 for Ascaris lumbricoides. Analysis of spatial clustering of intensity of infection and heavy infections revealed that the intensity changed over time for all parasites. Heavy intensity was only evident in Ascaris lumbricoides for 2008 and did not appear in proceeding years and other parasites. CONCLUSIONS: These results demonstrate that sustained annual MDA significantly reduced the prevalence of STH infection in school-age children but was unable to achieve elimination. Additionally, significant decline in prevalence was accompanied by a drop in spatial clustering of infection indicators across all sites from 2008. The lack of consistency in the results of the spatial dependence analysis highlights that MDA programmes can interrupt the normal transmission dynamics of STH parasites. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13071-016-1794-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-50344742016-09-29 The impact of an 8-year mass drug administration programme on prevalence, intensity and co-infections of soil-transmitted helminthiases in Burundi Ortu, Giuseppina Assoum, Mohamad Wittmann, Udo Knowles, Sarah Clements, Michelle Ndayishimiye, Onésime Basáñez, Maria-Gloria Lau, Colleen Clements, Archie Fenwick, Alan Magalhaes, Ricardo J. Soares Parasit Vectors Research BACKGROUND: Soil-transmitted helminth (STH) infections are amongst the most prevalent infections in the world. Mass drug administration (MDA) programmes have become the most commonly used national interventions for endemic countries to achieve elimination. This paper aims to describe the effect of an 8-year MDA programme on the prevalence, intensity of infection and co-infection of STH in Burundi from 2007 to 2014 and critically appraise the trajectory towards STH elimination in the country. RESULTS: Annual STH parasitological surveys (specifically, a “pilot study” from 2007 to 2011, an “extension study” from 2008 to 2011, and a “national reassessment” in 2014; n = 27,658 children), showed a significant drop in prevalence of infection with any STH (“pooled STH”) between baseline and 2011 in both studies, falling from 32 to 16 % in the pilot study, and from 35 to 16 % in the extension study. Most STH infections were of low intensity according to WHO classification. The national reassessment in 2014 showed that prevalence of pooled STH remained significantly below the prevalence in 2007 in both studies but there was no further decrease in STH prevalence from 2011 levels during this time. Spatial dependence analysis showed that prevalence of Trichuris trichiura and Ascaris lumbricoides had a tendency to cluster over the years, whilst only trends in spatial dependence were evident for hookworm infections. Spatial dependence fluctuated over the course of the programme for Ascaris lumbricoides and Trichuris trichiura. However, spatial trends in spatial dependence were evident in 2010 for Ascaris lumbricoides. Analysis of spatial clustering of intensity of infection and heavy infections revealed that the intensity changed over time for all parasites. Heavy intensity was only evident in Ascaris lumbricoides for 2008 and did not appear in proceeding years and other parasites. CONCLUSIONS: These results demonstrate that sustained annual MDA significantly reduced the prevalence of STH infection in school-age children but was unable to achieve elimination. Additionally, significant decline in prevalence was accompanied by a drop in spatial clustering of infection indicators across all sites from 2008. The lack of consistency in the results of the spatial dependence analysis highlights that MDA programmes can interrupt the normal transmission dynamics of STH parasites. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13071-016-1794-9) contains supplementary material, which is available to authorized users. BioMed Central 2016-09-22 /pmc/articles/PMC5034474/ /pubmed/27660114 http://dx.doi.org/10.1186/s13071-016-1794-9 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Ortu, Giuseppina
Assoum, Mohamad
Wittmann, Udo
Knowles, Sarah
Clements, Michelle
Ndayishimiye, Onésime
Basáñez, Maria-Gloria
Lau, Colleen
Clements, Archie
Fenwick, Alan
Magalhaes, Ricardo J. Soares
The impact of an 8-year mass drug administration programme on prevalence, intensity and co-infections of soil-transmitted helminthiases in Burundi
title The impact of an 8-year mass drug administration programme on prevalence, intensity and co-infections of soil-transmitted helminthiases in Burundi
title_full The impact of an 8-year mass drug administration programme on prevalence, intensity and co-infections of soil-transmitted helminthiases in Burundi
title_fullStr The impact of an 8-year mass drug administration programme on prevalence, intensity and co-infections of soil-transmitted helminthiases in Burundi
title_full_unstemmed The impact of an 8-year mass drug administration programme on prevalence, intensity and co-infections of soil-transmitted helminthiases in Burundi
title_short The impact of an 8-year mass drug administration programme on prevalence, intensity and co-infections of soil-transmitted helminthiases in Burundi
title_sort impact of an 8-year mass drug administration programme on prevalence, intensity and co-infections of soil-transmitted helminthiases in burundi
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034474/
https://www.ncbi.nlm.nih.gov/pubmed/27660114
http://dx.doi.org/10.1186/s13071-016-1794-9
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