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Community-level epidemiology of soil-transmitted helminths in the context of school-based deworming: Baseline results of a cluster randomised trial on the coast of Kenya

Most epidemiological studies of soil-transmitted helminth (STH) infections focus on school-going children. The majority of large-scale cross-sectional and longitudinal community-based studies have been conducted prior to the implementation of wide-scale mass drug administration (MDA). This study inv...

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Autores principales: Halliday, Katherine E., Oswald, William E., Mcharo, Carlos, Beaumont, Emma, Gichuki, Paul M., Kepha, Stella, Witek-McManus, Stefan S., Matendechero, Sultani H., El-Busaidy, Hajara, Muendo, Redempta, Chiguzo, Athuman N., Cano, Jorge, Karanja, Mary W., Musyoka, Leah W., Safari, Tuva K., Mutisya, Lennie N., Muye, Idris J., Sidigu, Maureen A., Anderson, Roy M., Allen, Elizabeth, Brooker, Simon J., Mwandawiro, Charles S., Njenga, Sammy M., Pullan, Rachel L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719894/
https://www.ncbi.nlm.nih.gov/pubmed/31398204
http://dx.doi.org/10.1371/journal.pntd.0007427
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author Halliday, Katherine E.
Oswald, William E.
Mcharo, Carlos
Beaumont, Emma
Gichuki, Paul M.
Kepha, Stella
Witek-McManus, Stefan S.
Matendechero, Sultani H.
El-Busaidy, Hajara
Muendo, Redempta
Chiguzo, Athuman N.
Cano, Jorge
Karanja, Mary W.
Musyoka, Leah W.
Safari, Tuva K.
Mutisya, Lennie N.
Muye, Idris J.
Sidigu, Maureen A.
Anderson, Roy M.
Allen, Elizabeth
Brooker, Simon J.
Mwandawiro, Charles S.
Njenga, Sammy M.
Pullan, Rachel L.
author_facet Halliday, Katherine E.
Oswald, William E.
Mcharo, Carlos
Beaumont, Emma
Gichuki, Paul M.
Kepha, Stella
Witek-McManus, Stefan S.
Matendechero, Sultani H.
El-Busaidy, Hajara
Muendo, Redempta
Chiguzo, Athuman N.
Cano, Jorge
Karanja, Mary W.
Musyoka, Leah W.
Safari, Tuva K.
Mutisya, Lennie N.
Muye, Idris J.
Sidigu, Maureen A.
Anderson, Roy M.
Allen, Elizabeth
Brooker, Simon J.
Mwandawiro, Charles S.
Njenga, Sammy M.
Pullan, Rachel L.
author_sort Halliday, Katherine E.
collection PubMed
description Most epidemiological studies of soil-transmitted helminth (STH) infections focus on school-going children. The majority of large-scale cross-sectional and longitudinal community-based studies have been conducted prior to the implementation of wide-scale mass drug administration (MDA). This study investigates age-related patterns in prevalence and intensity of STH infection, and associated risk factors, in a region of south coastal Kenya that had previously received three consecutive years of school-based deworming (2012–14) and four rounds of community-based MDA for lymphatic filariasis between 2003 and 2014. Between March and May 2015, a cross-sectional survey was conducted in 120 community clusters as a baseline for a cluster randomised trial. Individuals aged two years and above were randomly selected during household surveys and requested to provide stool samples, which were assessed for presence and intensity of STH using the duplicate Kato-Katz thick smear method. Species-specific predictors of presence and intensity were investigated through multilevel logistic regression and zero-inflated negative binomial regression models. Of the 19,684 individuals who provided a stool sample, 21.5% were infected with at least one STH. Hookworm was the predominant species, with an overall prevalence of 19.1%; Trichuris trichiura prevalence was 3.6% and Ascaris lumbricoides was negligible (0.4% prevalence). The vast majority were light intensity infections. Prevalence and intensity of hookworm infection were significantly higher in adults and males, and were associated with environmental conditions, low socio-economic status, household flooring, individual and household water, sanitation and hygiene (WASH) characteristics and behaviours, previous treatment, lack of shoe-wearing and not attending school. In contrast, T. trichiura was more commonly found in school-aged boys and those living in communities close to the coast, with reduced infection in the least poor individuals with private latrine access. Overall, results show that despite several years of school-based deworming, hookworm infection remains common among untreated adults in this population, suggesting that this strategy alone is insufficient to reduce community-wide hookworm infection and in the longer term to eliminate transmission. TRIAL REGISTRATION: ClinicalTrials.gov NCT02397772
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spelling pubmed-67198942019-09-10 Community-level epidemiology of soil-transmitted helminths in the context of school-based deworming: Baseline results of a cluster randomised trial on the coast of Kenya Halliday, Katherine E. Oswald, William E. Mcharo, Carlos Beaumont, Emma Gichuki, Paul M. Kepha, Stella Witek-McManus, Stefan S. Matendechero, Sultani H. El-Busaidy, Hajara Muendo, Redempta Chiguzo, Athuman N. Cano, Jorge Karanja, Mary W. Musyoka, Leah W. Safari, Tuva K. Mutisya, Lennie N. Muye, Idris J. Sidigu, Maureen A. Anderson, Roy M. Allen, Elizabeth Brooker, Simon J. Mwandawiro, Charles S. Njenga, Sammy M. Pullan, Rachel L. PLoS Negl Trop Dis Research Article Most epidemiological studies of soil-transmitted helminth (STH) infections focus on school-going children. The majority of large-scale cross-sectional and longitudinal community-based studies have been conducted prior to the implementation of wide-scale mass drug administration (MDA). This study investigates age-related patterns in prevalence and intensity of STH infection, and associated risk factors, in a region of south coastal Kenya that had previously received three consecutive years of school-based deworming (2012–14) and four rounds of community-based MDA for lymphatic filariasis between 2003 and 2014. Between March and May 2015, a cross-sectional survey was conducted in 120 community clusters as a baseline for a cluster randomised trial. Individuals aged two years and above were randomly selected during household surveys and requested to provide stool samples, which were assessed for presence and intensity of STH using the duplicate Kato-Katz thick smear method. Species-specific predictors of presence and intensity were investigated through multilevel logistic regression and zero-inflated negative binomial regression models. Of the 19,684 individuals who provided a stool sample, 21.5% were infected with at least one STH. Hookworm was the predominant species, with an overall prevalence of 19.1%; Trichuris trichiura prevalence was 3.6% and Ascaris lumbricoides was negligible (0.4% prevalence). The vast majority were light intensity infections. Prevalence and intensity of hookworm infection were significantly higher in adults and males, and were associated with environmental conditions, low socio-economic status, household flooring, individual and household water, sanitation and hygiene (WASH) characteristics and behaviours, previous treatment, lack of shoe-wearing and not attending school. In contrast, T. trichiura was more commonly found in school-aged boys and those living in communities close to the coast, with reduced infection in the least poor individuals with private latrine access. Overall, results show that despite several years of school-based deworming, hookworm infection remains common among untreated adults in this population, suggesting that this strategy alone is insufficient to reduce community-wide hookworm infection and in the longer term to eliminate transmission. TRIAL REGISTRATION: ClinicalTrials.gov NCT02397772 Public Library of Science 2019-08-09 /pmc/articles/PMC6719894/ /pubmed/31398204 http://dx.doi.org/10.1371/journal.pntd.0007427 Text en © 2019 Halliday et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Halliday, Katherine E.
Oswald, William E.
Mcharo, Carlos
Beaumont, Emma
Gichuki, Paul M.
Kepha, Stella
Witek-McManus, Stefan S.
Matendechero, Sultani H.
El-Busaidy, Hajara
Muendo, Redempta
Chiguzo, Athuman N.
Cano, Jorge
Karanja, Mary W.
Musyoka, Leah W.
Safari, Tuva K.
Mutisya, Lennie N.
Muye, Idris J.
Sidigu, Maureen A.
Anderson, Roy M.
Allen, Elizabeth
Brooker, Simon J.
Mwandawiro, Charles S.
Njenga, Sammy M.
Pullan, Rachel L.
Community-level epidemiology of soil-transmitted helminths in the context of school-based deworming: Baseline results of a cluster randomised trial on the coast of Kenya
title Community-level epidemiology of soil-transmitted helminths in the context of school-based deworming: Baseline results of a cluster randomised trial on the coast of Kenya
title_full Community-level epidemiology of soil-transmitted helminths in the context of school-based deworming: Baseline results of a cluster randomised trial on the coast of Kenya
title_fullStr Community-level epidemiology of soil-transmitted helminths in the context of school-based deworming: Baseline results of a cluster randomised trial on the coast of Kenya
title_full_unstemmed Community-level epidemiology of soil-transmitted helminths in the context of school-based deworming: Baseline results of a cluster randomised trial on the coast of Kenya
title_short Community-level epidemiology of soil-transmitted helminths in the context of school-based deworming: Baseline results of a cluster randomised trial on the coast of Kenya
title_sort community-level epidemiology of soil-transmitted helminths in the context of school-based deworming: baseline results of a cluster randomised trial on the coast of kenya
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719894/
https://www.ncbi.nlm.nih.gov/pubmed/31398204
http://dx.doi.org/10.1371/journal.pntd.0007427
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