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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

PLoS Neglected Tropical Diseases Aug 15, 2019

Halliday KE, Oswald WE, Mcharo C, et al. - In view of the observation that in many regions of sub-Saharan Africa, including parts of Kenya, soil-transmitted helminth (STH) infections remain endemic, researchers assessed the distribution of STH species infection in a region of south coastal Kenya that had previously undertaken 3 consecutive years of school-based deworming (2012–14) and four rounds of community-based mass drug administration for lymphatic filariasis between 2003 and 2014. In addition, they sought for associated environmental, household and individual risk factors. A stool sample was obtained from 19,684 individuals; of these, 21.5% were infected with at least one STH. Hookworm, with an overall prevalence of 19.1%, was the predominant species; Trichuris trichiura was prevalent in 3.6% and Ascaris lumbricoides was prevalent in 0.4%. Adults and males had a significantly higher prevalence and intensity of hookworm infection; environmental conditions, low socio-economic status, household flooring, individual and household water, sanitation and hygiene traits and behaviors, previous treatment, lack of shoe-wearing, and not attending school, were noted to be associated with this infection. In contrast, school-aged boys and those living in communities close to the coast were noted to be infected with T. trichiura more commonly, with reduced infection in the least poor individuals with private latrine access. Overall, results show that untreated adults in this population continued to have hookworm infection despite several years of school-based deworming.

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