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Post-intervention epidemiology of STH in Bangladesh: Data to sustain the gains
In 2008, Bangladesh initiated Preventive Chemotherapy (PCT) for school-age children (SAC) through bi-annual school-based mass drug administration (MDA) to control Soil-Transmitted Helminth (STH) infections. In 2016, the Ministry of Health and Family Welfare’s Program on Lymphatic Filariasis Eliminat...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746288/ https://www.ncbi.nlm.nih.gov/pubmed/33284834 http://dx.doi.org/10.1371/journal.pntd.0008597 |
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author | Dhakal, Sanjaya Karim, Mohammad Jahirul Al Kawsar, Abdullah Irish, Jasmine Rahman, Mujibur Tupps, Cara Kabir, Ashraful Imtiaz, Rubina |
author_facet | Dhakal, Sanjaya Karim, Mohammad Jahirul Al Kawsar, Abdullah Irish, Jasmine Rahman, Mujibur Tupps, Cara Kabir, Ashraful Imtiaz, Rubina |
author_sort | Dhakal, Sanjaya |
collection | PubMed |
description | In 2008, Bangladesh initiated Preventive Chemotherapy (PCT) for school-age children (SAC) through bi-annual school-based mass drug administration (MDA) to control Soil-Transmitted Helminth (STH) infections. In 2016, the Ministry of Health and Family Welfare’s Program on Lymphatic Filariasis Elimination and STH (ELFSTH) initiated district-level community impact assessments with Children Without Worms (CWW) using standardized, population-based sampling to measure the post-intervention STH burden across all ages (≥ 1 yr) for the three STH species. The Integrated Community-based Survey for Program Monitoring (ICSPM) was developed by CWW and was used to survey 12 districts in Bangladesh from 2017–2020. We excluded the first two district data as piloting caused some sampling errors and combined the individual demographic and parasite-specific characteristics from the subsequent 10 districts, linking them with the laboratory data for collective analysis. Our analysis identified district-specific epidemiologic findings, important for program decisions. Of the 17,874 enrolled individuals, our results are based on 10,824 (61.0%) stool samples. Overall, the prevalence of any STH species was substantially reduced to 14% from 79.8% in 2005. The impact was similar across all ages. STH prevalence was 14% in 10 districts collectively, but remained high in four districts, despite their high reported PCT coverage in previous years. Among all, Bhola district was unique because it was the only district with high T.trichuris prevalence. Bangladesh successfully lowered STH prevalence across all ages despite targeting SAC only. Data from the survey indicate a significant number of adults and pre-school age children (PSAC) were self-deworming with purchased pills. This may account for the flat impact curve across all ages. Overall prevalence varied across surveyed districts, with persistent high transmission in the northeastern districts and a district in the central flood zone, indicating possible service and ecological factors. Discrepancies in the impact between districts highlight the need for district-level data to evaluate program implementation after consistent high PCT coverage. |
format | Online Article Text |
id | pubmed-7746288 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-77462882020-12-31 Post-intervention epidemiology of STH in Bangladesh: Data to sustain the gains Dhakal, Sanjaya Karim, Mohammad Jahirul Al Kawsar, Abdullah Irish, Jasmine Rahman, Mujibur Tupps, Cara Kabir, Ashraful Imtiaz, Rubina PLoS Negl Trop Dis Research Article In 2008, Bangladesh initiated Preventive Chemotherapy (PCT) for school-age children (SAC) through bi-annual school-based mass drug administration (MDA) to control Soil-Transmitted Helminth (STH) infections. In 2016, the Ministry of Health and Family Welfare’s Program on Lymphatic Filariasis Elimination and STH (ELFSTH) initiated district-level community impact assessments with Children Without Worms (CWW) using standardized, population-based sampling to measure the post-intervention STH burden across all ages (≥ 1 yr) for the three STH species. The Integrated Community-based Survey for Program Monitoring (ICSPM) was developed by CWW and was used to survey 12 districts in Bangladesh from 2017–2020. We excluded the first two district data as piloting caused some sampling errors and combined the individual demographic and parasite-specific characteristics from the subsequent 10 districts, linking them with the laboratory data for collective analysis. Our analysis identified district-specific epidemiologic findings, important for program decisions. Of the 17,874 enrolled individuals, our results are based on 10,824 (61.0%) stool samples. Overall, the prevalence of any STH species was substantially reduced to 14% from 79.8% in 2005. The impact was similar across all ages. STH prevalence was 14% in 10 districts collectively, but remained high in four districts, despite their high reported PCT coverage in previous years. Among all, Bhola district was unique because it was the only district with high T.trichuris prevalence. Bangladesh successfully lowered STH prevalence across all ages despite targeting SAC only. Data from the survey indicate a significant number of adults and pre-school age children (PSAC) were self-deworming with purchased pills. This may account for the flat impact curve across all ages. Overall prevalence varied across surveyed districts, with persistent high transmission in the northeastern districts and a district in the central flood zone, indicating possible service and ecological factors. Discrepancies in the impact between districts highlight the need for district-level data to evaluate program implementation after consistent high PCT coverage. Public Library of Science 2020-12-07 /pmc/articles/PMC7746288/ /pubmed/33284834 http://dx.doi.org/10.1371/journal.pntd.0008597 Text en © 2020 Dhakal 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 Dhakal, Sanjaya Karim, Mohammad Jahirul Al Kawsar, Abdullah Irish, Jasmine Rahman, Mujibur Tupps, Cara Kabir, Ashraful Imtiaz, Rubina Post-intervention epidemiology of STH in Bangladesh: Data to sustain the gains |
title | Post-intervention epidemiology of STH in Bangladesh: Data to sustain the gains |
title_full | Post-intervention epidemiology of STH in Bangladesh: Data to sustain the gains |
title_fullStr | Post-intervention epidemiology of STH in Bangladesh: Data to sustain the gains |
title_full_unstemmed | Post-intervention epidemiology of STH in Bangladesh: Data to sustain the gains |
title_short | Post-intervention epidemiology of STH in Bangladesh: Data to sustain the gains |
title_sort | post-intervention epidemiology of sth in bangladesh: data to sustain the gains |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746288/ https://www.ncbi.nlm.nih.gov/pubmed/33284834 http://dx.doi.org/10.1371/journal.pntd.0008597 |
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