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Aisha A, Abbas S, Eed EM, Ahmed D, Irfan S, Rehman FU, Siddique S, Naeem M. Hepatitis E associated determinants and diagnostic biomarkers during pregnancy and its prenatal consequences in Multan, Punjab tertiary care setting (Pakistan). Am J Transl Res 2024; 16:2049-2058. [PMID: 38883386 PMCID: PMC11170620 DOI: 10.62347/slwm5449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/13/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVE Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis in the world. Hepatitis E infection is commonly widespread by the fecal oral routes and contaminated water. This study was designed to explore the prevalence and risk factors of hepatitis E infection in pregnant women of the Multan district, Pakistan. METHODS The study comprised of a total of 500 enrolled patients, among which, 105 pregnant females with hepatitis E infection fulfilled the criteria for anti-HEV antibodies. Pregnant women without significant complications and without hepatitis E infection were excluded from this study. Hepatic profile, complete blood count, coagulation markers, and standard protocol were also assessed for fetal maternal hemorrhage. RESULTS Our results showed that 105 patients (66.66%, CI 95%) had HEV infection with mean age 25±5 years. Serum bilirubin levels were increased in 74 patients (70.47%), aspartate transaminase was elevated > 200 IU/L in 71 patients (67.61%), alanine transaminase was above the 100 IU/L in 65 patients (245 IU/L), and low platelet counts were found in 45 patients (42.85%). Moreover, fetal distress cases were 9 (10.84%) and maternal distress cases were about 11 (13.25%). Fetal mortality cases were 39 (37.14%), and maternal mortality cases were about 22 (20.95%) due to hepatic comma, intravascular coagulation, and hepatic failure. CONCLUSION It was concluded that the prevalence of Hepatitis E during pregnancy is associated with high risk factors of unhygienic practices, blood transfusion, and noncompliance with universal infection control techniques. Maternal fatalities and fetal consequences were exacerbated by HEV infection.
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Affiliation(s)
- Ambreen Aisha
- Department of Biochemistry, Punjab Medical College, Faisalabad Medical University Faisalabad 38000, Pakistan
| | - Shafqat Abbas
- Faculty of Allied Health Sciences, Superior University Lahore Lahore 54000, Pakistan
| | - Emad M Eed
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University Taif, Saudi Arabia
| | - Dildar Ahmed
- Department of Biochemistry, Riphah International University Islamabad Islamabad 44000, Pakistan
| | - Sabahat Irfan
- Department of Biochemistry, University of Agriculture Faisalabad 38000, Pakistan
| | - Fariha Ur Rehman
- Institute of Microbiology, University of Agriculture Faisalabad Faisalabad 38000, Pakistan
| | - Sara Siddique
- Department of Biochemistry, University of Agriculture Faisalabad 38000, Pakistan
| | - Muhammad Naeem
- College of Life Science, Hebei Normal University Shijiazhuang 050024, Hebei, China
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Oyeyemi OT, Ogundahunsi O, Schunk M, Fatem RG, Shollenberger LM. Neglected tropical disease (NTD) diagnostics: current development and operations to advance control. Pathog Glob Health 2024; 118:1-24. [PMID: 37872790 PMCID: PMC10769148 DOI: 10.1080/20477724.2023.2272095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Abstract
Neglected tropical diseases (NTDs) have become important public health threats that require multi-faceted control interventions. As late treatment and management of NTDs contribute significantly to the associated burdens, early diagnosis becomes an important component for surveillance and planning effective interventions. This review identifies common NTDs and highlights the progress in the development of diagnostics for these NTDs. Leveraging existing technologies to improve NTD diagnosis and improving current operational approaches for deployment of developed diagnostics are crucial to achieving the 2030 NTD elimination target. Point-of-care NTD (POC-NTD) diagnostic tools are recommended preferred diagnostic options in resource-constrained areas for mapping risk zones and monitoring treatment efficacy. However, few are currently available commercially. Technical training of remote health care workers on the use of POC-NTD diagnostics, and training of health workers on the psychosocial consequences of these diagnostics are critical in harnessing POC-NTD diagnostic potential. While the COVID-19 pandemic has challenged the possibility of achieving NTD elimination in 2030 due to the disruption of healthcare services and dwindling financial support for NTDs, the possible contribution of NTDs in exacerbating COVID-19 pandemic should motivate NTD health system strengthening.
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Affiliation(s)
- Oyetunde T. Oyeyemi
- Department of Biosciences and Biotechnology, University of Medical Sciences, Ondo, Nigeria
- Department of Biological Sciences, Old Dominion University, Virginia, USA
| | - Olumide Ogundahunsi
- The Central Office for Research and Development (CORD), University of Medical Sciences, Ondo, Nigeria
| | - Mirjam Schunk
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU) institution, Munich, Germany
| | - Ramzy G. Fatem
- Schistosome Biological Supply Center, Theodor Bilharz Research Institute, Giza, Egypt
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Adamu MD, Mohammed Jabo A, Orji P, Zhang Y, Isiyaku S, Olobio N, Muhammad N, Barem B, Willis R, Bakhtiari A, Jimenez C, Solomon AW, Harding-Esch EM, Mpyet CD. Baseline Prevalence of Trachoma in 21 Local Government Areas of Adamawa State, North East Nigeria. Ophthalmic Epidemiol 2023; 30:599-607. [PMID: 34955073 PMCID: PMC10581668 DOI: 10.1080/09286586.2021.2013899] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/15/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine the prevalence of trachoma in each of the 21 local government areas (LGAs) of Adamawa State, Nigeria. METHODS A population-based cross-sectional survey was conducted in each of the 21 LGAs of Adamawa State between 2017 and 2019. With the support of Tropical Data (TD), surveys were planned and implemented in accordance with World Health Organization (WHO) recommendations. A two-stage cluster sampling technique was used in each LGA, 25 or 30 clusters were selected with a probability of selection proportionate to cluster size, and in each of these clusters, 25 or 30 households were enrolled for the survey. All residents aged 1 year and older within selected households were examined by TD-certified graders for trachomatous inflammation - follicular (TF) and trachomatous trichiasis (TT) using the WHO simplified grading scheme. Additionally, data were collected on household water and sanitation access. RESULTS All 21 LGAs had TF prevalence in 1-9-year-olds below 5%. The prevalence of TT unknown to the health system in people aged ≥15 years was ≥0.2% in three of the 21 LGAs. Access to improved water and sanitation facilities was <80% in the majority of the surveyed LGAs. Only 12 of the 21 LGAs had ≥50% household-level improved latrine access, and only Yola North had ≥80% household-level improved latrine access. CONCLUSION There is no need for mass treatment with antibiotics for trachoma elimination purposes in any of these LGAs. There is a need for active TT case finding and provision of community-based TT surgical services in three LGAs. Furthermore, engagement with water and sanitation agencies is needed to augment access to improved water and sanitation facilities across the State; this will help to avoid the recrudescence of active trachoma in the State.
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Affiliation(s)
| | | | - Philomena Orji
- Helen Keller International, Nigeria Country Office, Abuja, Nigeria
| | - Yaobi Zhang
- Helen Keller International, Regional Office for Africa, Dakar, Senegal
| | | | | | - Nasiru Muhammad
- Department of Ophthalmology, Usmanu Danfodiyo University, Sokoto, Nigeria
| | | | - Rebecca Willis
- International Trachoma Initiative, Task Force for Global Health, Decatur, Georgia, USA
| | - Ana Bakhtiari
- International Trachoma Initiative, Task Force for Global Health, Decatur, Georgia, USA
| | | | - Anthony W. Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Emma M. Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- London Centre for Neglected Tropical Disease Research, London, UK
| | - Caleb D. Mpyet
- Sightsavers Nigeria Country Office, Kaduna, Nigeria
- Department of Ophthalmology, University of Jos, Jos, Nigeria
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Adamu MD, Mohammed Jabo A, Orji P, Zhang Y, Isiyaku S, Olobio N, Muhammad N, Mshelia Auta L, Willis R, Bakhtiari A, Jimenez C, Solomon AW, Harding-Esch EM, Mpyet CD. Baseline Prevalence of Trachoma in 13 Local Government Areas of Borno State, Nigeria. Ophthalmic Epidemiol 2023; 30:628-636. [PMID: 36469560 PMCID: PMC10581670 DOI: 10.1080/09286586.2022.2053550] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 12/14/2021] [Accepted: 03/09/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE We set out to determine the baseline prevalence of trachoma in 13 Local Government Areas (LGAs) of Borno State, Nigeria. METHODS A population-based cross-sectional survey was conducted in each of 13 LGAs from 2017 to 2019, with the support of Tropical Data (TD). World Health Organization (WHO)-recommended protocols were used. With a probability-proportional-to-size systematic sampling method, 25 villages were selected per LGA in 2017 and 30 villages per LGA in 2019; in each village, 25 households were enrolled for 2017 surveys, while 30 were enrolled for 2019 surveys. All present, consenting residents aged ≥1 year were examined by TD-certified graders for trachomatous inflammation-follicular (TF) and trachomatous trichiasis (TT) using the WHO simplified grading scheme. Additionally, we collected data on household-level access to water, sanitation and hygiene (WASH) facilities. RESULTS One LGA (Magumeri) had TF prevalence in 1-9-year-olds ≥10%; two other LGAs (Monguno and Kaga) had TF prevalence between 5.0% and 9.9%. The prevalence of TT unknown to the health system was ≥0.2% in six LGAs. The proportion of households with access to improved water sources ranged from 30% (Kwaya Kusar) to 95% (Monguno); household-level access to improved latrines was lowest in Shani (7%) and highest in Maiduguri (95%). CONCLUSION Active TT case finding and strengthening of TT surgical services are needed in six LGAs. Mass drug administration (MDA) of antibiotics is needed in three LGAs to reduce the prevalence of active trachoma to below elimination thresholds. The trachoma elimination programme should engage WASH agencies to augment access to improved WASH facilities.
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Affiliation(s)
| | | | - Philomena Orji
- Helen Keller International, Nigeria Country office, Abuja, Nigeria
| | - Yaobi Zhang
- Helen Keller International, Regional Office for Africa, Dakar, Senegal
| | | | | | - Nasiru Muhammad
- Department of Ophthalmology, Usmanu Danfodiyo University, Sokoto, Nigeria
| | | | - Rebecca Willis
- International Trachoma Initiative, Task Force for Global Health, Decatur, Georgia, USA
| | - Ana Bakhtiari
- International Trachoma Initiative, Task Force for Global Health, Decatur, Georgia, USA
| | | | - Anthony W. Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Emma M. Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- London Centre for Neglected Tropical Disease Research, London, UK
| | - Caleb D. Mpyet
- Sightsavers Nigeria Country Office, Kaduna, Nigeria
- Department of Ophthalmology, College of Health Sciences, University of Jos, Jos, Nigeria
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Maddren R, Phillips A, Rayment Gomez S, Forbes K, Collyer BS, Kura K, Anderson R. Individual longitudinal compliance to neglected tropical disease mass drug administration programmes, a systematic review. PLoS Negl Trop Dis 2023; 17:e0010853. [PMID: 37459369 PMCID: PMC10374057 DOI: 10.1371/journal.pntd.0010853] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 07/27/2023] [Accepted: 06/05/2023] [Indexed: 07/28/2023] Open
Abstract
Repeated distribution of preventative chemotherapy (PC) by mass drug administration forms the mainstay of transmission control for five of the 20 recognised neglected tropical diseases (NTDs); soil-transmitted helminths, schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma. The efficiency of such programmes is reliant upon participants swallowing the offered treatment consistently at each round. This is measured by compliance, defined as the proportion of eligible participants swallowing treatment. Individually linked longitudinal compliance data is important for assessing the potential impact of MDA-based control programmes, yet this accurate monitoring is rarely implemented in those for NTDs. Longitudinal compliance data reported by control programmes globally for the five (PC)-NTDs since 2016 is examined, focusing on key associations of compliance with age and gender. PubMed and Web of Science was searched in January 2022 for articles written in English and Spanish, and the subsequent extraction adhered to PRISMA guidelines. Study title screening was aided by Rayyan, a machine learning software package. Studies were considered for inclusion if primary compliance data was recorded for more than one time point, in a population larger than 100 participants. All data analysis was conducted in R. A total of 89 studies were identified containing compliance data, 57 were longitudinal studies, of which 25 reported individually linked data reported by varying methods. The association of increasing age with the degree of systematic treatment was commonly reported. The review is limited by the paucity of data published on this topic. The varying and overlapping terminologies used to describe coverage (receiving treatment) and compliance (swallowing treatment) is reviewed. Consequently, it is recommended that WHO considers clearly defining the terms for coverage, compliance, and longitudinal compliance which are currently contradictory across their NTD treatment guidelines. This review is registered with PROSPERO (number: CRD42022301991).
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Affiliation(s)
- Rosie Maddren
- Department of Infectious Disease Epidemiology, Imperial College London, Saint Mary's Campus, Norfolk Place, London, United Kingdom
| | - Anna Phillips
- Department of Infectious Disease Epidemiology, Imperial College London, Saint Mary's Campus, Norfolk Place, London, United Kingdom
- FHI 360, Durham, North Carolina, United States of America
| | - Santiago Rayment Gomez
- Department of Infectious Disease Epidemiology, Imperial College London, Saint Mary's Campus, Norfolk Place, London, United Kingdom
| | - Kathryn Forbes
- Department of Infectious Disease Epidemiology, Imperial College London, Saint Mary's Campus, Norfolk Place, London, United Kingdom
- London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College London, Saint Mary's Campus, Norfolk Place, London, United Kingdom
| | - Benjamin S Collyer
- Department of Infectious Disease Epidemiology, Imperial College London, Saint Mary's Campus, Norfolk Place, London, United Kingdom
| | - Klodeta Kura
- Department of Infectious Disease Epidemiology, Imperial College London, Saint Mary's Campus, Norfolk Place, London, United Kingdom
| | - Roy Anderson
- Department of Infectious Disease Epidemiology, Imperial College London, Saint Mary's Campus, Norfolk Place, London, United Kingdom
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Ameen E, Nin Zhu S, Morales Guzman C, Taub E, Siles C, Meza Sanchez G, Vilcarromero S, Ramal C, Tangoa N, Marcos LA. Feasibility of Training Community Health Workers to Use Smartphone-Attached Microscopy for Point-of-Care Visualization of Soil-Transmitted Helminths in the Peruvian Amazon. Am J Trop Med Hyg 2023; 108:1175-1182. [PMID: 37068753 PMCID: PMC10540104 DOI: 10.4269/ajtmh.22-0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 11/21/2022] [Indexed: 04/19/2023] Open
Abstract
The prevalence of soil-transmitted helminths (STH) is high in communities within the Peruvian Amazon despite repeated mass-drug administration, demanding alternative strategies of control. Smartphone-attached microscopy (SAM) permits visualization of STH from a small portable microscope through a smartphone screen, potentially providing an inexpensive and rapid method of STH visualization in communities where diagnostic laboratories with microscopes are inaccessible. In this study, a total of 45 community health workers who work within the health systems of Loreto, Peru, attended a 1-day training session with lectures and practicums on STH and SAM. Participants received a pre- and post-intervention questionnaire. Post-intervention, participants were significantly more confident using SAM and identifying parasite images, symptoms, transmission, and treatment (P ≤ 0.0045). Post-intervention, participants correctly labeled a median of five of seven SAM apparatus components and five of eight steps of Kato-Katz technique, were less likely to choose taking medicine to prevent parasite infection (P = 0.0075), and were more likely to select Kato-Katz technique as a type of diagnostic test (P < 0.0001). Most participants felt ready to use SAM in their communities and stated that it could help rural communities far from health centers or laboratories (24%); provide faster identification, results, diagnosis (19%); permit at-home or on-the-spot visualization (14%); and save money (14%). Results show that community health workers show a high level of willingness and competency to learn about both STH and SAM and may be a yet-unexplored practical method of augmenting STH visualization, bringing healthcare to communities in Loreto with poor access to diagnostic laboratories and clinics.
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Affiliation(s)
- Eve Ameen
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
| | - Simon Nin Zhu
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
| | | | - Erin Taub
- Global Health Institute, Stony Brook University Hospital, Stony Brook, New York
| | | | | | | | - Cesar Ramal
- Universidad Nacional de la Amazonía Peruana, Iquitos, Peru
| | - Nolberto Tangoa
- Centro de Salud San Juan, Ministerio de Salud Peruana, Iquitos, Peru
| | - Luis A. Marcos
- Global Health Institute, Stony Brook University Hospital, Stony Brook, New York
- Infectious Diseases Division, Department of Medicine, Stony Brook University, Stony Brook, New York
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Velleman Y, Blair L, Fleming F, Fenwick A. Water-, Sanitation-, and Hygiene-Related Diseases. Infect Dis (Lond) 2023. [DOI: 10.1007/978-1-0716-2463-0_547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Godwin-Akpan TG, Chowdhury S, Rogers EJ, Kollie KK, Zaizay FZ, Wickenden A, Zawolo GVK, Parker CBMC, Dean L. The development, implementation, and evaluation of an optimal model for the case detection, referral, and case management of Neglected Tropical Diseases. PLoS One 2023; 18:e0283856. [PMID: 37163515 PMCID: PMC10171595 DOI: 10.1371/journal.pone.0283856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 03/19/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND People affected by Neglected Tropical Diseases (NTDs), specifically leprosy, Buruli ulcer (BU), yaws, and lymphatic filariasis, experience significant delays in accessing health services, often leading to catastrophic physical, psychosocial, and economic consequences. Global health actors have recognized that Sustainable Development Goal 3:3 is only achievable through an integrated inter and intra-sectoral response. This study evaluated existing case detection and referral approaches in Liberia, utilizing the findings to develop and test an Optimal Model for integrated community-based case detection, referral, and confirmation. We evaluate the efficacy of implementing the Optimal Model in improving the early diagnosis of NTDs, thus minimizing access delays and reducing disease burden. METHODS We used a participatory action research approach to develop, implement, and evaluate an Optimal Model for the case detection, referral, and management of case management NTDs in Liberia. We utilized qualitative and quantitative methods throughout the cycle and implemented the model for 12 months. RESULTS During the implementation of our optimal model, the annual number of cases detected increased compared to the previous year. Cases were detected at an earlier stage of disease progression, however; gendered dynamics in communities shape the case identification process for some individuals. Qualitative data showed increased knowledge of the transmission, signs, symptoms, and management options among community health workers (CHW). CONCLUSION The results provide evidence of the benefits of an integrated approach and the programmatic challenges to improve access to health services for persons affected by NTDs. The effectiveness of an integrated approach depends on a high level of collaboration, joint planning, and implementation embedded within existing health systems infrastructure.
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Affiliation(s)
| | - Shahreen Chowdhury
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Emerson J Rogers
- Neglected Tropical Disease Program, Ministry of Health, Oldest Congo Town, Monrovia, Liberia
| | - Karsor K Kollie
- Neglected Tropical Disease Program, Ministry of Health, Oldest Congo Town, Monrovia, Liberia
| | - Fasseneh Zeela Zaizay
- Neglected Tropical Disease Program, Ministry of Health, Oldest Congo Town, Monrovia, Liberia
| | - Anna Wickenden
- American Leprosy Mission, Greenville, South Carolina, United States of America
| | - Georgina V K Zawolo
- University of Liberia-Atlantic Centre for Research and Evaluation, Capitol Hill, Monrovia, Liberia
| | - Colleen B M C Parker
- Research Unit, Ministry of Health, Liberia, Oldest Congo Town, Monrovia, Liberia
| | - Laura Dean
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Shrestha A, Kunwar BM, Meierhofer R. Water, sanitation, hygiene practices, health and nutritional status among children before and during the COVID-19 pandemic: longitudinal evidence from remote areas of Dailekh and Achham districts in Nepal. BMC Public Health 2022; 22:2035. [PMID: 36344970 PMCID: PMC9640870 DOI: 10.1186/s12889-022-14346-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/19/2022] [Accepted: 10/04/2022] [Indexed: 11/09/2022] Open
Abstract
Background The COVID-19 pandemic drew hygiene to the center of disease prevention. The provision of adequate water, sanitation, and hygiene (WASH) services is crucial to protect public health during a pandemic. Yet, access to levels of water supply that support adequate hygiene measures are deficient in many areas in Nepal. We examined WASH practices and their impact on child health and nutritional status in two districts before and during the COVID-19 pandemic. Methods A longitudinal and mixed method study was conducted in March–May 2018 and November–December 2021. In total, 715 children aged 0–10 years were surveyed at baseline. Of these, 490 children were assessed at endline. Data collection methods included observations, a questionnaire, stool analysis, anthropometric measurements, water quality analysis, and an assessment of clinical signs of nutritional deficiencies. We conducted 10 in-depth interviews to understand major problems related to COVID-19. Results Most respondents (94.2%) had heard about COVID-19; however, they did not wear face masks or comply with any social distancing protocols. Almost 94.2% of the households self-reported handwashing with soap 5–10 times per day at endline, especially after defecation, compared to 19.6% at baseline. Water quality was better at endline than at baseline with median 12 to 29 CFU Escherichia coli/100 mL (interquartile range at baseline [IQR] = 4–101) at the point of collection and 34 to 51.5 CFU Escherichia coli/100 mL (IQR = 8–194) at the point of consumption. Fever (41.1–16.8%; p = 0.01), respiratory illness (14.3–4.3%; p = 0.002), diarrhea (19.6–9.5%; p = 0.01), and Giardia lamblia infections (34.2–6.5%, p = 0.01) decreased at endline. In contrast, nutritional deficiencies such as bitot’s spots (26.7–40.2%; p = 0.01), pale conjunctiva (47.0–63.3%; p = 0.01), and dermatitis (64.8–81.4%; p = 0.01) increased at endline. The inadequacy of the harvest and the lack of household income to meet households’ nutritional needs increased drastically (35.0–94.2%; p = 0.01). Conclusion We found that improved water quality and handwashing practices were associated with a decrease in infectious diseases. However, food security also decreased resulting in a high prevalence of nutritional deficiencies. Our findings underline that disaster preparedness should consider access to adequate WASH, nutrition, and health supplies. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14346-8.
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Abstract
Trachoma is a neglected tropical disease caused by infection with conjunctival strains of Chlamydia trachomatis. It can result in blindness. Pathophysiologically, trachoma is a disease complex composed of two linked chronic processes: a recurrent, generally subclinical infectious-inflammatory disease that mostly affects children, and a non-communicable, cicatricial and, owing to trichiasis, eventually blinding disease that supervenes in some individuals later in life. At least 150 infection episodes over an individual's lifetime are needed to precipitate trichiasis; thus, opportunity exists for a just global health system to intervene to prevent trachomatous blindness. Trachoma is found at highest prevalence in the poorest communities of low-income countries, particularly in sub-Saharan Africa; in June 2021, 1.8 million people worldwide were going blind from the disease. Blindness attributable to trachoma can appear in communities many years after conjunctival C. trachomatis transmission has waned or ceased; therefore, the two linked disease processes require distinct clinical and public health responses. Surgery is offered to individuals with trichiasis and antibiotic mass drug administration and interventions to stimulate facial cleanliness and environmental improvement are designed to reduce infection prevalence and transmission. Together, these interventions comprise the SAFE strategy, which is achieving considerable success. Although much work remains, a continuing public health problem from trachoma in the year 2030 will be difficult for the world to excuse.
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Genet A, Motbainor A, Samuel T, Azage M. Prevalence and associated factors of soil transmitted helminthiasis among school-age children in wetland and non-wetland areas of Blue Nile Basins, northwest Ethiopia: A community-based comparative study. SAGE Open Med 2021; 9:20503121211063354. [PMID: 34917385 PMCID: PMC8669120 DOI: 10.1177/20503121211063354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/01/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Different interventions have been done to reduce the burden of soil-transmitted helminths (STH). The available evidences in Ethiopia in either school or community-based school-aged children (SAC) have limitation in wetland areas. This study assessed the prevalence and associated factors of STH infection among SAC in wetland and non-wetland areas of Blue Nile Basins, Amhara Region, Northwest Ethiopia. Method: A community-based comparative study was conducted from October to November, 2019. Multistage stratified random sampling technique used to select 716 SAC. Data were collected using structured questionnaire and observational checklist. Stool samples were collected from children using tight-fitting plastic cups following the standard procedures. Data were coded and entered into Epi data version 4.6 and exported to SPSS version 20 software. Bivariate and multivariable logistic regression analysis was employed to identify factors associated with STH. Results: The overall prevalence of STH was 30.30% (95% CI: 26.90, 33.90) and did not show significant variation between wetland (33.60% (95% CI: 28.80, 39.60%)) and non-wetland (27.0% (95% CI: (21.90, 31.60)) areas. Presence of human feces near the house and certain habits such as nail trimming and playing with mud/soil was not different between wetland and non-wetlands. Nonetheless, the presence of human feces near the house of respondents was found to be significantly associated with STH infection (p value < 0.001). Moreover, other factors significantly associated with STH infection were lack of nail trimming (p value < 0.001) and playing with mud/soil (p value < 0.01). Conclusions: The prevalence of STH was high and did not show significant variation between the two areas. Emphasis needs to be given for hygiene and lifestyle-related factors.
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Affiliation(s)
- Almaw Genet
- Dangila Woreda Health Office, Dangila, Ethiopia
| | - Achenef Motbainor
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tsion Samuel
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Muluken Azage
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Cha S, Jin Y, Elhag MS, Kim Y, Ismail HAHA. Unequal geographic distribution of water and sanitation at the household and school level in Sudan. PLoS One 2021; 16:e0258418. [PMID: 34653204 PMCID: PMC8519438 DOI: 10.1371/journal.pone.0258418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 09/27/2021] [Indexed: 11/21/2022] Open
Abstract
The Sudanese Government launched the National SDG-6 Plan and commences its implementation to achieve and sustain universal and equitable access to basic WASH services by 2030. It is critical to understand the geographical heterogeneity of Sudan and patterns in the inequality of access to safe drinking water and sanitation. Through such research, the disease control strategy can be optimized, and resource allocation can be prioritized. We explored spatial heterogeneity and inequality in access to improved water and sanitation across Sudan by mapping the coverage at both the state and district levels. We decomposed the inequality across Sudan into within-state, between-state, within-district, and between-state inequalities using the Theil L and Theil T indices. We calculated the Gini coefficient to assess the inequality of access to improved water and sanitation, based on the deviation of the Lorenz curve from the line of perfect equality. The study population was 105,167 students aged 8–13 at 1,776 primary schools across the country. Geographical heterogeneity was prominent in the Central Darfur, South Darfur, East Darfur, Kassala, West Kordofan, and Blue Nile States, all of which showed severe inequality in access to an improved latrine at the household level in terms of the Theil T or Theil L index. The overall inequality in the coverage of improved sanitation went beyond the warning limit of 0.4 for the Gini coefficient. The inequality in terms of the Theil L and Theil T indices, as well as the Gini coefficient, was always higher for improved sanitation than for improved water at the household level. Within-state inequality accounted for 66% or more of national inequalities in the distribution of improved sanitation and drinking water for both the Theil L and Theil T indices. This is the first study to measure geographical heterogeneity and inequalities in improved water and sanitation coverage across Sudan. The study may help to prioritize resource allocation to areas with the greatest water and sanitation needs.
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Affiliation(s)
- Seungman Cha
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang, South Korea
| | - Yan Jin
- Department of Microbiology, Dongguk University College of Medicine, Gyeongju, South Korea
| | - Mousab Siddig Elhag
- Communicable and Non-Communicable Diseases Control Directorate, Federal Ministry of Health, Khartoum, Sudan
| | - Youngjin Kim
- Department of Global Development and Entrepreneurship, Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang, South Korea
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Boisson S, Wohlgemuth L, Yajima A, Peralta G, Obiageli N, Matendechero S, Baayenda G, Seife F, Hamilton H, Chase C, Barry FBM, Solomon AW, Velleman Y. Building on a decade of progress in water, sanitation and hygiene to control, eliminate and eradicate neglected tropical diseases. Trans R Soc Trop Med Hyg 2021; 115:185-187. [PMID: 33508098 PMCID: PMC7842107 DOI: 10.1093/trstmh/trab001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/21/2020] [Accepted: 01/18/2021] [Indexed: 11/20/2022] Open
Abstract
Water, sanitation and hygiene (WASH) are essential for the control and elimination of neglected tropical diseases (NTDs). The forthcoming NTD road map ‘Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021–2030’ encourages cross-sectoral collaboration and includes cross-cutting targets on WASH. This commentary reflects on collaborative efforts between the NTD and WASH sectors over the past years and encourages strengthened partnerships to support the new road map and achieve the 2030 agenda ambition of leaving no one behind.
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Affiliation(s)
- Sophie Boisson
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Leah Wohlgemuth
- Sightsavers and NTD NGO Network WASH Working Group, London, United Kingdom
| | - Aya Yajima
- Division of Programmes for Disease Control, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Genandrialine Peralta
- Health and the Environment Programme, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Nebe Obiageli
- Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | - Sultani Matendechero
- Division of Vector Borne and Neglected Tropical Diseases, Ministry of Health, Nairobi, Kenya
| | | | - Fikre Seife
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Helen Hamilton
- WaterAid and NTD NGO Network WASH Working Group, London, United Kingdom
| | - Claire Chase
- World Bank Water Global Practice, Washington DC, United States
| | - Fatoumata B M Barry
- World Bank Health, Nutrition and Population (HNP) Global Practice, Washington DC, United States
| | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Yael Velleman
- SCI Foundation and NTD NGO Network WASH Working Group, London, United Kingdom
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Donde OO, Atoni E, Muia AW, Yillia PT. COVID-19 pandemic: Water, sanitation and hygiene (WASH) as a critical control measure remains a major challenge in low-income countries. WATER RESEARCH 2021; 191:116793. [PMID: 33388470 PMCID: PMC7765770 DOI: 10.1016/j.watres.2020.116793] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 12/20/2020] [Accepted: 12/25/2020] [Indexed: 05/04/2023]
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the deadly respiratory disease called coronavirus disease of 2019 (COVID-19), an ongoing global public health emergency that has been declared a pandemic by the World Health Organization. We review literature on the transmission and control of SARS-CoV-2 and discuss the challenges of focusing on water, sanitation and hygiene (WASH) as critical control measures in low-income countries. A significantly higher prevalence of SARS-CoV-2 infection and COVID-19 related deaths has been reported for the United States of America and other high-income countries in Europe and Asia, regardless of advanced medical facilities in those countries. In contrast, much lower COVID-19 related morbidity and mortality rates have been documented in many low-income countries, despite having comparatively higher socioeconomic burdens and suboptimal medical facilities. By September 29, 2020 over one million deaths have been reported. On the same day, the cumulative total of COVID-19 related morbidity for Africa was 35,954 with 3.5% of the global COVID-19 related deaths. We present arguments for the relatively low COVID-19 morbidity and mortality rates in many low-income countries and discuss the critical importance of WASH for preventing the spread of infectious diseases like COVID-19. We observe that the key recommendations put forward by the World Health Organization to effectively control the pandemic have been difficult to implement in low-income countries. We conclude that the pandemic reinforces previous pronouncements that adequate and effective WASH measures are crucial for public health and recommend closer coordination between public health and WASH sectors.
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Affiliation(s)
- Oscar Omondi Donde
- Department of Environmental Science, Egerton University, P.O. Box 536, Egerton Kenya.
| | - Evans Atoni
- Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, Hubei, China
| | | | - Paul T Yillia
- International Institute for Applied Systems Analysis (IIASA), Schlossplatz 1 - A-2361 Laxenburg, Austria
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Desye B. COVID-19 Pandemic and Water, Sanitation, and Hygiene: Impacts, Challenges, and Mitigation Strategies. ENVIRONMENTAL HEALTH INSIGHTS 2021; 15:11786302211029447. [PMID: 34345174 PMCID: PMC8283044 DOI: 10.1177/11786302211029447] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/05/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND In order to protect public health during the outbreaks of infectious diseases including the pandemic COVID-19, provision of Water, Sanitation, and Hygiene (WASH) services is important. The challenges of inaccessible WASH services along with the pandemic COVID-19 in low-income countries can lead to a devastating problem. METHOD A systematic search of published articles was identified using PubMed, Web of Science, and Google Scholar, on relevant studies of COVID-19 and WASH services. Published articles were identified using abstracts and titles of the articles, followed by assessed for eligibility, and screening of the full text reports of relevant studies. RESULTS Electronic database search identified 798 articles from which 28 full text articles were included in the systematic review. A lack of access to WASH services in households, schools, health care facilities, and other public spaces were the main identified COVID-19 related public health risks. A lack of adequate data and financial shortages were the challenges for mitigating the problems of COVI-19 and WASH services. CONCLUSION This systematical review identified the impacts and challenges of COVID-19 in the provision of WASH services. The results implied that COVID-19 has significant impacts on WASH services that can affect the health of the public. Therefore, strengthening and ensuring access to WASH services are important for preventing COVID-19 and realizing human rights. Community engagement also can be used to support for prevention and control of COVID-19. Countries need to be expand their investment in WASH services as an important mechanism for mitigating COVID-19.
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Affiliation(s)
- Belay Desye
- Belay Desye, Department of Public Health, College of Medicine and Health Sciences, Adigrat University, P. O. Box: 50, Adigrat, Ethiopia.
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Solomon AW, Hooper PJ, Bangert M, Mwingira UJ, Bakhtiari A, Brady MA, Fitzpatrick C, Jones I, Kabona G, Kello AB, Millar T, Mosher AW, Ngondi JM, Nshala A, Renneker K, Rotondo LA, Stelmach R, Harding-Esch EM, Malecela MN. The Importance of Failure: How Doing Impact Surveys That Fail Saves Trachoma Programs Money. Am J Trop Med Hyg 2020; 103:2481-2487. [PMID: 33025878 PMCID: PMC7695084 DOI: 10.4269/ajtmh.20-0686] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Trachoma programs use annual antibiotic mass drug administration (MDA) in evaluation units (EUs) that generally encompass 100,000–250,000 people. After one, three, or five MDA rounds, programs undertake impact surveys. Where impact survey prevalence of trachomatous inflammation—follicular (TF) in 1- to 9-year-olds is ≥ 5%, ≥ 1 additional MDA rounds are recommended before resurvey. Impact survey costs, and the proportion of impact surveys returning TF prevalence ≥ 5% (the failure rate or, less pejoratively, the MDA continuation rate), therefore influence the cost of eliminating trachoma. We modeled, for illustrative EU sizes, the financial cost of undertaking MDA with and without conducting impact surveys. As an example, we retrospectively assessed how conducting impact surveys affected costs in the United Republic of Tanzania for 2017–2018. For EUs containing 100,000 people, the median (interquartile range) cost of continuing MDA without doing impact surveys is USD 28,957 (17,581–36,197) per EU per year, whereas continuing MDA solely where indicated by impact survey results costs USD 17,564 (12,158–21,694). If the mean EU population is 100,000, then continuing MDA without impact surveys becomes advantageous in financial cost terms only when the continuation rate exceeds 71%. For the United Republic of Tanzania in 2017–2018, doing impact surveys saved enough money to provide MDA for > 1,000,000 people. Although trachoma impact surveys have a nontrivial cost, they generally save money, providing EUs have > 50,000 inhabitants, the continuation rate is not excessive, and they generate reliable data. If all EUs pass their impact surveys, then we have waited too long to do them.
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Affiliation(s)
- Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Pamela J Hooper
- Task Force for Global Health, International Trachoma Initiative, Atlanta, Georgia
| | - Mathieu Bangert
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Upendo J Mwingira
- Neglected Tropical Disease Control Program, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, United Republic of Tanzania
| | - Ana Bakhtiari
- Task Force for Global Health, International Trachoma Initiative, Atlanta, Georgia
| | | | - Christopher Fitzpatrick
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Iain Jones
- Sightsavers, Haywards Heath, United Kingdom
| | - George Kabona
- Neglected Tropical Disease Control Program, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, United Republic of Tanzania
| | - Amir B Kello
- Expanded Special Project for Elimination of Neglected Tropical Diseases, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Tom Millar
- Sightsavers, Haywards Heath, United Kingdom
| | - Aryc W Mosher
- United States Agency for International Development, Washington, District of Columbia
| | | | - Andreas Nshala
- Department of International Maternal and Child Health, Faculty of Medicine and Pharmacy, University of Uppsala, Uppsala, Sweden.,IMA World Health, Dar es Salaam, United Republic of Tanzania
| | - Kristen Renneker
- Task Force for Global Health, International Trachoma Initiative, Atlanta, Georgia
| | | | | | - Emma M Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mwelecele N Malecela
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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Deshpande A, Miller-Petrie MK, Lindstedt PA, Baumann MM, Johnson KB, Blacker BF, Abbastabar H, Abd-Allah F, Abdelalim A, Abdollahpour I, Abegaz KH, Abejie AN, Abreu LG, Abrigo MR, Abualhasan A, Accrombessi MMK, Adamu AA, Adebayo OM, Adedeji IA, Adedoyin RA, Adekanmbi V, Adetokunboh OO, Adhikari TB, Afarideh M, Agudelo-Botero M, Ahmadi M, Ahmadi K, Ahmed MB, Ahmed AE, Akalu TY, Akanda AS, Alahdab F, Al-Aly Z, Alam S, Alam N, Alamene GM, Alanzi TM, Albright J, Albujeer A, Alcalde-Rabanal JE, Alebel A, Alemu ZA, Ali M, Alijanzadeh M, Alipour V, Aljunid SM, Almasi A, Almasi-Hashiani A, Al-Mekhlafi HM, Altirkawi KA, Alvis-Guzman N, Alvis-Zakzuk NJ, Amini S, Amit AML, Amul GGH, Andrei CL, Anjomshoa M, Ansariadi A, Antonio CAT, Antony B, Antriyandarti E, Arabloo J, Aref HMA, Aremu O, Armoon B, Arora A, Aryal KK, Arzani A, Asadi-Aliabadi M, Asmelash D, Atalay HT, Athari SM, Athari SS, Atre SR, Ausloos M, Awasthi S, Awoke N, Ayala Quintanilla BP, Ayano G, Ayanore MA, Aynalem YA, Azari S, Azman AS, Babaee E, Badawi A, Bagherzadeh M, Bakkannavar SM, Balakrishnan S, Banach M, Banoub JAM, Barac A, Barboza MA, Bärnighausen TW, Basu S, Bay VD, Bayati M, Bedi N, Beheshti M, Behzadifar M, Behzadifar M, Bejarano Ramirez DF, Bell ML, Bennett DA, Benzian H, Berbada DA, Bernstein RS, Bhat AG, Bhattacharyya K, Bhaumik S, Bhutta ZA, Bijani A, Bikbov B, Bin Sayeed MS, Biswas RK, Bohlouli S, Boufous S, Brady OJ, Briko AN, Briko NI, Britton GB, Brown A, Burugina Nagaraja S, Butt ZA, Cámera LA, Campos-Nonato IR, Campuzano Rincon JC, Cano J, Car J, Cárdenas R, Carvalho F, Castañeda-Orjuela CA, Castro F, Cerin E, Chalise B, Chattu VK, Chin KL, Christopher DJ, Chu DT, Cormier NM, Costa VM, Cromwell EA, Dadi AFF, Dahiru T, Dahlawi SMA, Dandona R, Dandona L, Dang AK, Daoud F, Darwesh AM, Darwish AH, Daryani A, Das JK, Das Gupta R, Dash AP, Dávila-Cervantes CA, Davis Weaver N, De la Hoz FP, De Neve JW, Demissie DB, Demoz GT, Denova-Gutiérrez E, Deribe K, Desalew A, Dharmaratne SD, Dhillon P, Dhimal M, Dhungana GP, Diaz D, Dipeolu IO, Do HT, Dolecek C, Doyle KE, Dubljanin E, Duraes AR, Edinur HA, Effiong A, Eftekhari A, El Nahas N, El Sayed Zaki M, El Tantawi M, Elhabashy HR, El-Jaafary SI, El-Khatib Z, Elkout H, Elsharkawy A, Enany S, Endalew DA, Eshrati B, Eskandarieh S, Etemadi A, Ezekannagha O, Faraon EJA, Fareed M, Faro A, Farzadfar F, Fasil AF, Fazlzadeh M, Feigin VL, Fekadu W, Fentahun N, Fereshtehnejad SM, Fernandes E, Filip I, Fischer F, Flohr C, Foigt NA, Folayan MO, Foroutan M, Franklin RC, Frostad JJ, Fukumoto T, Gad MM, Garcia GM, Gatotoh AM, Gayesa RT, Gebremedhin KB, Geramo YCD, Gesesew HA, Gezae KE, Ghashghaee A, Ghazi Sherbaf F, Gill TK, Gill PS, Ginindza TG, Girmay A, Gizaw Z, Goodridge A, Gopalani SV, Goulart BNG, Goulart AC, Grada A, Green MS, Gubari MIM, Gugnani HC, Guido D, Guimarães RA, Guo Y, Gupta R, Gupta R, Ha GH, Haagsma JA, Hafezi-Nejad N, Haile DH, Haile MT, Hall BJ, Hamidi S, Handiso DW, Haririan H, Hariyani N, Hasaballah AI, Hasan MM, Hasanzadeh A, Hassen HY, Hayelom DH, Hegazy MI, Heibati B, Heidari B, Hendrie D, Henok A, Herteliu C, Heydarpour F, Hidru HDD, Hird TR, Hoang CL, Hollerich GI, Hoogar P, Hossain N, Hosseinzadeh M, Househ M, Hu G, Humayun A, Hussain SA, Hussen MAA, Ibitoye SE, Ilesanmi OS, Ilic MD, Imani-Nasab MH, Iqbal U, Irvani SSN, Islam SMS, Ivers RQ, Iwu CJ, Jahanmehr N, Jakovljevic M, Jalali A, Jayatilleke AU, Jenabi E, Jha RP, Jha V, Ji JS, Jonas JB, Jozwiak JJ, Kabir A, Kabir Z, Kanchan T, Karch A, Karki S, Kasaeian A, Kasahun GG, Kasaye HK, Kassa GG, Kassa GM, Kayode GA, Kebede MM, Keiyoro PN, Ketema DB, Khader YS, Khafaie MA, Khalid N, Khalilov R, Khan EA, Khan J, Khan MN, Khatab K, Khater MM, Khater AM, Khayamzadeh M, Khazaei M, Khosravi MH, Khubchandani J, Kiadaliri A, Kim YJ, Kimokoti RW, Kisa S, Kisa A, Kochhar S, Kolola T, Komaki H, Kosen S, Koul PA, Koyanagi A, Krishan K, Kuate Defo B, Kugbey N, Kumar P, Kumar GA, Kumar M, Kusuma D, La Vecchia C, Lacey B, Lal A, Lal DK, Lam H, Lami FH, Lansingh VC, Lasrado S, Lebedev G, Lee PH, LeGrand KE, Leili M, Lenjebo TL, Leshargie CT, Levine AJ, Lewycka S, Li S, Linn S, Liu S, Lopez JCF, Lopukhov PD, Magdy Abd El Razek M, Mahadeshwara Prasad D, Mahasha PW, Mahotra NB, Majeed A, Malekzadeh R, Malta DC, Mamun AA, Manafi N, Mansournia MA, Mapoma CC, Martinez G, Martini S, Martins-Melo FR, Mathur MR, Mayala BK, Mazidi M, McAlinden C, Meharie BG, Mehndiratta MM, Mehrabi Nasab E, Mehta KM, Mekonnen T, Mekonnen TC, Meles GG, Meles HG, Memiah PTN, Memish ZA, Mendoza W, Menezes RG, Mereta ST, Meretoja TJ, Mestrovic T, Metekiya WM, Metekiya WM, Miazgowski B, Miller TR, Mini GK, Mirrakhimov EM, Moazen B, Mohajer B, Mohammad Y, Mohammad DK, Mohammad Gholi Mezerji N, Mohammadibakhsh R, Mohammed S, Mohammed JA, Mohammed H, Mohebi F, Mokdad AH, Moodley Y, Moradi M, Moradi G, Moradi-Joo M, Moraga P, Morales L, Mosapour A, Mosser JF, Mouodi S, Mousavi SM, Mozaffor M, Munro SB, Muriithi MK, Murray CJL, Musa KI, Mustafa G, Muthupandian S, Naderi M, Nagarajan AJ, Naghavi M, Naik G, Nangia V, Nascimento BR, Nazari J, Ndwandwe DE, Negoi I, Netsere HB, Ngunjiri JW, Nguyen CT, Nguyen HLT, Nguyen QP, Nigatu SG, Ningrum DNA, Nnaji CA, Nojomi M, Norheim OF, Noubiap JJ, Oancea B, Ogbo FA, Oh IH, Olagunju AT, Olusanya JO, Olusanya BO, Onwujekwe OE, Ortega-Altamirano DV, Osarenotor O, Osei FB, Owolabi MO, P A M, Padubidri JR, Pakhale S, Pana A, Park EK, Patel SK, Pathak A, Patle A, Paulos K, Pepito VCF, Perico N, Pervaiz A, Pescarini JM, Pesudovs K, Pham HQ, Pigott DM, Pilgrim T, Pirsaheb M, Poljak M, Pollock I, Postma MJ, Pourmalek F, Pourshams A, Prada SI, Preotescu L, Quintana H, Rabiee N, Rabiee M, Radfar A, Rafiei A, Rahim F, Rahimi S, Rahimi-Movaghar V, Rahman MA, Rahman MHU, Rajati F, Ranabhat CL, Rao PC, Rasella D, Rath GK, Rawaf S, Rawal L, Rawasia WF, Remuzzi G, Renjith V, Renzaho AM, Resnikoff S, Riahi SM, Ribeiro AI, Rickard J, Roever L, Ronfani L, Rubagotti E, Rubino S, Saad AM, Sabour S, Sadeghi E, Saeedi Moghaddam S, Safari Y, Sagar R, Sahraian MA, Sajadi SM, Salahshoor MR, Salam N, Saleem A, Salem H, Salem MR, Salimi Y, Salimzadeh H, Samy AM, Sanabria J, Santos IS, Santric-Milicevic MM, Sao Jose BP, Saraswathy SYI, Sarrafzadegan N, Sartorius B, Sathian B, Sathish T, Satpathy M, Sawhney M, Sayyah M, Sbarra AN, Schaeffer LE, Schwebel DC, Senbeta AM, Senthilkumaran S, Sepanlou SG, Serván-Mori E, Shafieesabet A, Shaheen AA, Shahid I, Shaikh MA, Shalash AS, Shams-Beyranvand M, Shamsi M, Shamsizadeh M, Shannawaz M, Sharafi K, Sharma R, Sheikh A, Shetty BSK, Shiferaw WS, Shigematsu M, Shin JI, Shiri R, Shirkoohi R, Shivakumar KM, Si S, Siabani S, Siddiqi TJ, Silva DAS, Singh V, Singh NP, Singh BBS, Singh JA, Singh A, Sinha DN, Sisay MM, Skiadaresi E, Smith DL, Soares Filho AM, Sobhiyeh MR, Sokhan A, Soriano JB, Sorrie MB, Soyiri IN, Spurlock EE, Sreeramareddy CT, Sudaryanto A, Sufiyan MB, Suleria HAR, Sykes BL, Tabarés-Seisdedos R, Tabuchi T, Tadesse DB, Tarigan IU, Taye B, Tefera YM, Tehrani-Banihashemi A, Tekelemedhin SW, Tekle MG, Temsah MH, Tesfay BE, Tesfay FH, Tessema ZT, Thankappan KR, ThekkePurakkal AS, Thomas N, Thompson RL, Thomson AJ, Topor-Madry R, Tovani-Palone MR, Traini E, Tran BX, Tran KB, Ullah I, Unnikrishnan B, Usman MS, Uthman OA, Uzochukwu BSC, Valdez PR, Varughese S, Veisani Y, Violante FS, Vollmer S, W/hawariat FG, Waheed Y, Wallin MT, Wang YP, Wang Y, Wangdi K, Weiss DJ, Weldesamuel GT, Werkneh AA, Westerman R, Wiangkham T, Wiens KE, Wijeratne T, Wiysonge CS, Wolde HF, Wondafrash DZ, Wonde TE, Worku GT, Yadollahpour A, Yahyazadeh Jabbari SH, Yamada T, Yaseri M, Yatsuya H, Yeshaneh A, Yilma MT, Yip P, Yisma E, Yonemoto N, Younis MZ, Yousof HASA, Yu C, Yusefzadeh H, Zadey S, Zahirian Moghadam T, Zaidi Z, Zaman SB, Zamani M, Zandian H, Zar HJ, Zerfu TA, Zhang Y, Ziapour A, Zodpey S, Zuniga YMH, Hay SI, Reiner RC. Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17. Lancet Glob Health 2020; 8:e1162-e1185. [PMID: 32827479 PMCID: PMC7443708 DOI: 10.1016/s2214-109x(20)30278-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/01/2020] [Accepted: 06/04/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. METHODS We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. FINDINGS Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4-40·7) to 50·3% (50·0-50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1-46·5) in 2017, compared with 28·7% (28·5-29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2-89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664-711) of the 1830 (1797-1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6-80·7) of countries from 2000 to 2017, and in 53·9% (50·6-59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. INTERPRETATION Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation. FUNDING Bill & Melinda Gates Foundation.
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Engels D, Hotez PJ, Ducker C, Gyapong M, Bustinduy AL, Secor WE, Harrison W, Theobald S, Thomson R, Gamba V, Masong MC, Lammie P, Govender K, Mbabazi PS, Malecela MN. Integration of prevention and control measures for female genital schistosomiasis, HIV and cervical cancer. Bull World Health Organ 2020; 98:615-624. [PMID: 33012861 PMCID: PMC7463188 DOI: 10.2471/blt.20.252270] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 11/27/2022] Open
Abstract
Female genital schistosomiasis as a result of chronic infection with Schistosoma haematobium (commonly known as bilharzia) continues to be largely ignored by national and global health policy-makers. International attention for large-scale action against the disease focuses on whether it is a risk factor for the transmission of human immunodeficiency virus (HIV). Yet female genital schistosomiasis itself is linked to pain, bleeding and sub- or infertility, leading to social stigma, and is a common issue for women in schistosomiasis-endemic areas in sub-Saharan Africa. The disease should therefore be recognized as another component of a comprehensive health and human rights agenda for women and girls in Africa, alongside HIV and cervical cancer. Each of these three diseases has a targeted and proven preventive intervention: antiretroviral therapy and pre-exposure prophylaxis for HIV; human papilloma virus vaccine for cervical cancer; and praziquantel treatment for female genital schistosomiasis. We discuss how female genital schistosomiasis control can be integrated with HIV and cervical cancer care. Such a programme will be part of a broader framework of sexual and reproductive health and rights, women's empowerment and social justice in Africa. Integrated approaches that join up multiple public health programmes have the potential to expand or create opportunities to reach more girls and women throughout their life course. We outline a pragmatic operational research agenda that has the potential to optimize joint implementation of a package of measures responding to the specific needs of girls and women.
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Affiliation(s)
- Dirk Engels
- Uniting to Combat NTDs, Chemin de la Gouille 8, 1291 Commugny, Switzerland
| | - Peter J Hotez
- National School of Tropical Medicine, Baylor College of Medicine, Houston, United States of America (USA)
| | | | - Margaret Gyapong
- Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Amaya L Bustinduy
- Clinical Research, London School of Hygiene and Tropical Medicine, London, England
| | - William E Secor
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Sally Theobald
- International Public Health, Liverpool School of Tropical Medicine, Liverpool, England
| | - Rachael Thomson
- Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, England
| | - Victoria Gamba
- Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
| | - Makia C Masong
- Catholic University of Central Africa, Yaoundé, Cameroon
| | - Patrick Lammie
- Neglected Tropical Diseases Support Center, The Task Force for Global Health, Decatur, USA
| | - Kreeneshni Govender
- Human Rights and Gender, Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland
| | - Pamela S Mbabazi
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Mwelecele N Malecela
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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19
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Aya Pastrana N, Lazo-Porras M, Miranda JJ, Beran D, Suggs LS. Social marketing interventions for the prevention and control of neglected tropical diseases: A systematic review. PLoS Negl Trop Dis 2020; 14:e0008360. [PMID: 32555705 PMCID: PMC7299328 DOI: 10.1371/journal.pntd.0008360] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 05/04/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Social marketing is an approach to behavior change that contributes to disease prevention and control. This study aimed to understand how social marketing interventions have addressed neglected tropical diseases (NTDs). It examined the characteristics, breadth of coverage, and outcomes of social marketing interventions focused on the prevention and control of these diseases. METHODOLOGY/PRINCIPAL FINDINGS Studies published in any language between January 1971 and April 2017, targeting at least one of the 17 NTDs prioritized in the World Health Organization (WHO) NTD Roadmap were considered. Included studies had interventions that applied both, at least one core social marketing concept, "social behavioral influence", and one social marketing technique, "integrated intervention mix", described in the Hierarchical Model of Social Marketing. This review is registered with PROSPERO CRD42017063858. Twenty interventions, addressing eight NTDs, met the inclusion criteria. They focused on behaviors related to four of the five WHO public health strategies for NTDs. Most interventions incorporated the concepts "relationship building" and "public / people orientation focus", and the technique "insight-driven segmentation". All the interventions reported changing behavioral determinants such as knowledge, 19 reported behavior change, and four influenced health outcomes. CONCLUSION/SIGNIFICANCE Evidence from this study shows that social marketing has been successfully used to address behaviors related to most of the five public health strategic interventions for NTDs recommended by the WHO. It is suggested that social marketing interventions for the prevention and control of NTDs be grounded on an understanding of the audience and adapted to the contexts intervened. Building stakeholder relationships as early as possible, and involving the publics could help in reaching NTD outcomes. Elements of the intervention mix should be integrated and mutually supportive. Incorporating health education and capacity building, as well as being culturally appropriate, is also relevant. It is recommended that ongoing discussions to formulate the targets and milestones of the new global Roadmap for NTDs integrate social marketing as an approach to overcome these diseases.
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Affiliation(s)
- Nathaly Aya Pastrana
- BeCHANGE Research Group, Institute for Public Communication, Università della Svizzera italiana, Lugano, Switzerland
| | - Maria Lazo-Porras
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - J. Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - David Beran
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Swiss School of Public Health+, Zurich, Switzerland
| | - L. Suzanne Suggs
- BeCHANGE Research Group, Institute for Public Communication, Università della Svizzera italiana, Lugano, Switzerland
- Swiss School of Public Health+, Zurich, Switzerland
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20
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Delea MG, Snyder JS, Woreta M, Zewudie K, Solomon AW, Freeman MC. Development and reliability of a quantitative personal hygiene assessment tool. Int J Hyg Environ Health 2020; 227:113521. [PMID: 32278303 PMCID: PMC7116344 DOI: 10.1016/j.ijheh.2020.113521] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/12/2020] [Accepted: 03/29/2020] [Indexed: 01/19/2023]
Abstract
Personal hygiene practices, including facewashing and handwashing, reduce transmission of pathogens, but are difficult to measure. Using color theory principles, we developed and tested a novel metric that generates quantitative measures of facial and hand cleanliness, proxy indicators of personal hygiene practices. In this cross-sectional study, conventional qualitative cleanliness metrics (e.g., presence or absence of nasal and ocular discharge, dirt under nails or on finger pads and palms) were also recorded. We generated Gwet’s agreement coefficients to determine the inter-rater reliability of novel and conventional metrics between various rating groups, where appropriate, including two non-blinded raters, non-blinded vs. blinded raters, three blinded raters, and blinded vs. computer raters. Inter-rater reliability of the novel metric was high across all rating groups, ranging from 0.98 (95% CI: 0.97, 0.99) to 0.90 (95% CI: 0.90, 0.91) for facial cleanliness, and 0.97 (95% CI: 0.96, 0.98) to 0.92 (95% CI: 0.91, 0.93) for hand cleanliness. Our novel metric generates more nuanced data than conventional qualitative metrics, and allows for quantifiable assessments of facial and hand cleanliness.
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Affiliation(s)
- Maryann G Delea
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA.
| | - Jedidiah S Snyder
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | | | | | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Matthew C Freeman
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
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21
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Tidwell JB, Fergus C, Gopalakrishnan A, Sheth E, Sidibe M, Wohlgemuth L, Jain A, Woods G. Integrating Face Washing into a School-Based, Handwashing Behavior Change Program to Prevent Trachoma in Turkana, Kenya. Am J Trop Med Hyg 2020; 101:767-773. [PMID: 31392952 PMCID: PMC6779218 DOI: 10.4269/ajtmh.19-0205] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Trachoma is the leading infectious cause of blindness, and facial cleanliness is associated with reduced odds of trachomatous inflammation and Chlamydia trachomatis infection, but there is little evidence of how to drive this behavior change at scale. We report the results of a program integrating face washing into a school-based handwashing promotion program in Turkana County, Kenya. Children aged 5–15 years participated in an intervention delivered to schools in two phases, along with a third phase receiving the intervention after the evaluation, which served as a control. The primary outcome was the number of face washing events that took place when handwashing occurred, which was measured by a 3-hour structured observation at all 67 schools, and a total of 3,871 handwashing events were observed. Differences in observed in face washing behavior between each phase and the control schools were calculated using log-binomial regression with clustering at the school level, whereas survey responses on knowledge of trachoma transmission and prevention were compared using χ2 tests adjusted for clustering at the school level. Face washing during handwashing events was higher in schools after 12 months (59.3%) and 20 months (44.2%) than in control schools (18.7%, P < 0.001). Trachoma knowledge was higher in schools evaluated after 12 months (80%) and 20 months (70%) than in control schools (42%, P < 0.001), and knowledge of some of key preventive behaviors was higher in intervention schools. Integrating face washing messages into school-based handwashing promotion programs increased face washing, which may help to prevent trachoma when combined with other interventions.
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Affiliation(s)
- James B Tidwell
- Harvard Kennedy School of Government, Cambridge, Massachusetts
| | - Cristin Fergus
- London School of Economics and Political Science, London, United Kingdom
| | | | | | - Myriam Sidibe
- Harvard Kennedy School of Government, Cambridge, Massachusetts
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22
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Errea RA, Vasquez-Rios G, Calderon ML, Siu D, Duque KR, Juarez LH, Gallegos R, Uriol C, Rondon CR, Baca KP, Fabian RJ, Canales M, Terashima A, Marcos LA, Samalvides F. Soil-Transmitted Helminthiasis in Children from a Rural Community Taking Part in a Periodic Deworming Program in the Peruvian Amazon. Am J Trop Med Hyg 2020; 101:636-640. [PMID: 31309921 PMCID: PMC6726937 DOI: 10.4269/ajtmh.18-1011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Children in the Peruvian Amazon Basin are at risk of soil-transmitted helminths (STH) infections. This study aimed to determine the prevalence of STH infection in children from a rural Amazonian community of Peru and to elucidate epidemiological risk factors associated with its perpetuation while on a school-based deworming program with mebendazole. Stool samples of children aged 2–14 years and their mothers were analyzed through direct smear analysis, Kato–Katz, spontaneous sedimentation in tube, Baermann’s method, and agar plate culture. A questionnaire was administered to collect epidemiological information of interest. Among 124 children, 25.8% had one or more STH. Individual prevalence rates were as follows: Ascaris lumbricoides, 16.1%; Strongyloides stercoralis, 10.5%; hookworm, 1.6%; and Trichuris trichiura, (1.6%). The prevalence of common STH (A. lumbricoides, T. trichiura, and hookworm) was higher among children aged 2–5 years than older children (31.6% versus 12.8%; P = 0.01). In terms of sanitation deficits, walking barefoot was significantly associated with STH infection (OR = 3.28; CI 95% = 1.11–12.07). Furthermore, STH-infected children more frequently had a mother who was concomitantly infected by STH than the non-STH–infected counterpart (36.4% versus 14.1%, P = 0.02). In conclusion, STH infection is highly prevalent in children from this Amazonian community despite routine deworming. Institutional health policies may include hygiene and sanitation improvements and screening/deworming of mothers to limit the dissemination of STH. Further studies are needed to address the social and epidemiological mechanics perpetuating these infections.
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Affiliation(s)
- Renato A Errea
- Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
| | - George Vasquez-Rios
- Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri.,Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria L Calderon
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Diego Siu
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kevin R Duque
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luciana H Juarez
- Scientific Society of Medical Students, Universidad Peruana Cayetano Heredia, Lima, Peru.,Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rodrigo Gallegos
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Celene Uriol
- Scientific Society of Medical Students, Universidad Peruana Cayetano Heredia, Lima, Peru.,Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Claudia R Rondon
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Katia P Baca
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rosario J Fabian
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Marco Canales
- Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Angelica Terashima
- Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luis A Marcos
- Infectious Diseases Division, SUNY/Stony Brook University, Stony Brook, New York.,Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Frine Samalvides
- Department of Infectious, Tropical and Dermatological Diseases, Hospital Cayetano Heredia, Lima, Peru.,Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru
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23
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Hasegawa M, Pilotte N, Kikuchi M, Means AR, Papaiakovou M, Gonzalez AM, Maasch JRMA, Ikuno H, Sunahara T, Ásbjörnsdóttir KH, Walson JL, Williams SA, Hamano S. What does soil-transmitted helminth elimination look like? Results from a targeted molecular detection survey in Japan. Parasit Vectors 2020; 13:6. [PMID: 31915050 PMCID: PMC6950881 DOI: 10.1186/s13071-019-3875-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 12/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Japan is one of the few countries believed to have eliminated soil-transmitted helminths (STHs). In 1949, the national prevalence of Ascaris lumbricoides was 62.9%, which decreased to 0.6% in 1973 due to improvements in infrastructure, socioeconomic status, and the implementation of national STH control measures. The Parasitosis Prevention Law ended in 1994 and population-level screening ceased in Japan; therefore, current transmission status of STH in Japan is not well characterized. Sporadic cases of STH infections continue to be reported, raising the possibility of a larger-scale recrudescence of STH infections. Given that traditional microscopic detection methods are not sensitive to low-intensity STH infections, we conducted targeted prevalence surveys using sensitive PCR-based assays to evaluate the current STH-transmission status and to describe epidemiological characteristics of areas of Japan believed to have achieved historical elimination of STHs. METHODS Stool samples were collected from 682 preschool- and school-aged children from six localities of Japan with previously high prevalence of STH. Caregivers of participants completed a questionnaire to ascertain access to water, sanitation and hygiene (WASH), and potential exposures to environmental contamination. For fecal testing, multi-parallel real-time PCR assays were used to detect infections of Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale and Trichuris trichiura. RESULTS Among the 682 children, no positive samples were identified, and participants reported high standards of WASH. CONCLUSIONS To our knowledge, this is the first STH-surveillance study in Japan to use sensitive molecular techniques for STH detection. The results suggest that recrudescence of STH infections has not occurred, and that declines in prevalence have been sustained in the sampled areas. These findings suggest that reductions in prevalence below the elimination thresholds, suggestive of transmission interruption, are possible. Additionally, this study provides circumstantial evidence that multi-parallel real-time PCR methods are applicable for evaluating elimination status in areas where STH prevalence is extremely low.
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Affiliation(s)
- Mitsuko Hasegawa
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,Doctoral Leadership Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Nils Pilotte
- Department of Biological Sciences, Smith College, Northampton, Massachusetts, USA.,Molecular and Cellular Biology Program, University of Massachusetts, Amherst, Massachusetts, USA
| | - Mihoko Kikuchi
- Doctoral Leadership Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.,The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,Department of Immunogenetics, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Arianna R Means
- Department of Global Health, University of Washington, Seattle, Washington, USA.,Department of Life Sciences, Natural History Museum, London, UK
| | - Marina Papaiakovou
- Department of Biological Sciences, Smith College, Northampton, Massachusetts, USA.,Department of Life Sciences, Natural History Museum, London, UK
| | - Andrew M Gonzalez
- Department of Biological Sciences, Smith College, Northampton, Massachusetts, USA
| | | | - Hiroshi Ikuno
- Department of Bacteriology, BML, Inc, Saitama, Japan
| | - Toshihiko Sunahara
- The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.,Department of Vector Ecology and Environment, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | | | - Judd L Walson
- Department of Global Health, University of Washington, Seattle, Washington, USA.,Department of Life Sciences, Natural History Museum, London, UK.,Departments of Medicine (Infectious Disease), Pediatrics and Epidemiology, University of Washington, Seattle, Washington, USA
| | - Steven A Williams
- Department of Biological Sciences, Smith College, Northampton, Massachusetts, USA.,Molecular and Cellular Biology Program, University of Massachusetts, Amherst, Massachusetts, USA
| | - Shinjiro Hamano
- Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan. .,Doctoral Leadership Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan. .,The Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
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24
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Vaz Nery S, Traub RJ, McCarthy JS, Clarke NE, Amaral S, Llewellyn S, Weking E, Richardson A, Campbell SJ, Gray DJ, Vallely AJ, Williams GM, Andrews RM, Clements ACA. WASH for WORMS: A Cluster-Randomized Controlled Trial of the Impact of a Community Integrated Water, Sanitation, and Hygiene and Deworming Intervention on Soil-Transmitted Helminth Infections. Am J Trop Med Hyg 2020; 100:750-761. [PMID: 30628573 DOI: 10.4269/ajtmh.18-0705] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Water, sanitation, and hygiene (WASH) interventions have been proposed as an important complement to deworming programs for sustainable control of soil-transmitted helminth (STH) infections. We aimed to determine whether a community-based WASH program had additional benefits in reducing STH infections compared with community deworming alone. We conducted the WASH for WORMS cluster-randomized controlled trial in 18 rural communities in Timor-Leste. Intervention communities received a WASH intervention that provided access to an improved water source, promoted improved household sanitation, and encouraged handwashing with soap. All eligible community members in intervention and control arms received albendazole every 6 months for 2 years. The primary outcomes were infection with each STH, measured using multiplex real-time quantitative polymerase chain reaction. We compared outcomes between study arms using generalized linear mixed models, accounting for clustering at community, household, and individual levels. At study completion, the integrated WASH and deworming intervention did not have an effect on infection with Ascaris spp. (relative risk [RR] 2.87, 95% confidence interval [CI]: 0.66-12.48, P = 0.159) or Necator americanus (RR 0.99, 95% CI: 0.52-1.89, P = 0.987), compared with deworming alone. At the last follow-up, open defecation was practiced by 66.1% (95% CI: 54.2-80.2) of respondents in the control arm versus 40.2% (95% CI: 25.3-52.6) of respondents in the intervention arm (P = 0.005). We found no evidence that the WASH intervention resulted in additional reductions in STH infections beyond that achieved with deworming alone over the 2-year trial period. The role of WASH on STH infections over a longer period of time and in the absence of deworming remains to be determined.
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Affiliation(s)
- Susana Vaz Nery
- The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, Australia.,Research School of Population Health, Australian National University, Canberra, Australia
| | - Rebecca J Traub
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, Australia
| | - James S McCarthy
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Naomi E Clarke
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Salvador Amaral
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Stacey Llewellyn
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Alice Richardson
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Suzy J Campbell
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Darren J Gray
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Andrew J Vallely
- The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, Australia
| | - Gail M Williams
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Ross M Andrews
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia.,Research School of Population Health, Australian National University, Canberra, Australia
| | - Archie C A Clements
- Faculty of Health Sciences, Curtin University, Perth, Australia.,Research School of Population Health, Australian National University, Canberra, Australia
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25
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Murenjekwa W, Makasi R, Ntozini R, Chasekwa B, Mutasa K, Moulton LH, Tielsch JM, Humphrey JH, Smith LE, Prendergast AJ, Bourke CD. Determinants of Urogenital Schistosomiasis Among Pregnant Women and its Association With Pregnancy Outcomes, Neonatal Deaths, and Child Growth. J Infect Dis 2019; 223:1433-1444. [PMID: 31832636 PMCID: PMC8064048 DOI: 10.1093/infdis/jiz664] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 12/11/2019] [Indexed: 11/28/2022] Open
Abstract
Background Schistosoma haematobium is a parasitic helminth that causes urogenital pathology. The impact of urogenital schistosomiasis during pregnancy on birth outcomes and child growth is poorly understood. Methods Risk factors for urogenital schistosomiasis were characterized among 4437 pregnant women enrolled in a cluster-randomized community-based trial in rural Zimbabwe. Infection was defined via urine microscopy (≥1 S. haematobium egg) and urinalysis (hematuria). Associations between infection and pregnancy outcomes were assessed in case-control analyses using conditional logistic regression. The association of maternal infection with birthweight and length-for-age Z scores (LAZ) at 1 and 18 months of age were assessed using generalized estimating equations. Results Urogenital schistosomiasis (egg positive and/or hematuria positive) was detected in 26.8% of pregnant women. Risk factors significantly associated with infection were maternal age, education, marital status, and religion; household drinking water source and latrine; study region; and season. Urogenital schistosomiasis was not significantly associated with adverse pregnancy outcomes (miscarriage, stillbirth, preterm, and small-for-gestational age), birthweight, neonatal death, or LAZ. Conclusions Including pregnant women in antihelminthic treatment programs would benefit a large number of women in rural Zimbabwe. However, clearance of the low-intensity infections that predominate in this context is unlikely to have additive benefits for pregnancy outcomes or child growth. Clinical Trials Registration NCT01824940.
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Affiliation(s)
| | - Rachel Makasi
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Robert Ntozini
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Bernard Chasekwa
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Kuda Mutasa
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - Lawrence H Moulton
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - James M Tielsch
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Jean H Humphrey
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Laura E Smith
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.,Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Andrew J Prendergast
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.,Blizard Institute, Queen Mary University of London, London, UK
| | - Claire D Bourke
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.,Blizard Institute, Queen Mary University of London, London, UK
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26
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Theory-driven formative research to inform the design of a national sanitation campaign in Tanzania. PLoS One 2019; 14:e0221445. [PMID: 31442255 PMCID: PMC6707585 DOI: 10.1371/journal.pone.0221445] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/06/2019] [Indexed: 02/07/2023] Open
Abstract
Introduction There are gaps in global understanding about how to design and implement interventions to improve sanitation. This formative study provided insights for the subsequent redesign of a government-led national sanitation campaign targeting rural populations in Tanzania. Methods The Behaviour Centred Design approach was used to investigate the determinants of toilet building, improvement and use. Varied, novel, and interactive research tools were employed in fifty-five households in two regions of rural Tanzania. Results were analysed to articulate a Theory of Change, which then informed intervention design. Results Participants valued hard work, enterprise, and improving their lives over many years. They wanted better toilets but felt no urgency to act quickly. A common emotional motivator for improving toilets was to protect children from disease (Nurture) but this was insufficient to drive rapid change. Disgust with traditional toilets meant they were built at a distance from the house: an ‘out of sight, out of mind’ attitude. Other powerful motives included the desire to improve living conditions (Create), and to become a modern Tanzanian (Status), albeit without ‘showing off’. Construction costs and water scarcity were the main stated barriers. Receiving information about realistic costs, support accessing materials, and visiting better latrines elsewhere were commonly reported reasons for improving latrines. Conclusions The resulting Theory of Change recommended that the intervention should surprise people with a novel conversation about toilets, promote toilets as a means of conferring status, and introduce a perceived urgency to ‘act now’. It should suggest that modest improvements would lead to a better life. Feelings of disgust and fear with poor quality toilets should be amplified, and barriers lessened through promoting transformational toilet improvements, and improving access to modern toilet products. This research provided considerable insight into sanitation behaviours in rural Tanzania, which informed creative intervention design.
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Exum NG, Kibira SPS, Ssenyonga R, Nobili J, Shannon AK, Ssempebwa JC, Tukahebwa EM, Radloff S, Schwab KJ, Makumbi FE. The prevalence of schistosomiasis in Uganda: A nationally representative population estimate to inform control programs and water and sanitation interventions. PLoS Negl Trop Dis 2019; 13:e0007617. [PMID: 31412023 PMCID: PMC6709927 DOI: 10.1371/journal.pntd.0007617] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 08/26/2019] [Accepted: 07/09/2019] [Indexed: 12/13/2022] Open
Abstract
Background To improve schistosomiasis control programs in Uganda, where intestinal schistosomiasis is a widespread public health problem, a country-wide assessment of the disease prevalence among all age ranges is needed. Few studies have aimed to quantify the relationships between disease prevalence and water and sanitation characteristics across Uganda to understand the potential to interrupt disease transmission with an integrated package of interventions. Methodology/Principal findings A nationally representative survey was undertaken that included a household and individual questionnaire followed by disease testing based on detection of worm antigens (circulating cathodic antigen–CCA), diagnosis and treatment. A comprehensive set of questions was asked of randomly sampled individuals, two years of age and above, to understand their water and sanitation infrastructure, open defecation behaviors, exposure to surface water bodies, and knowledge of schistosomiasis. From a set of 170 randomly sampled, geographically diverse enumeration areas, a total of 9,183 study participants were included. After adjustment with sample weights, the national prevalence of schistosomiasis was 25.6% (95% confidence interval (CI): 22.3, 29.0) with children ages two to four most at risk for the disease with 36.1% infected (95% CI: 30.1, 42.2). The defecation behaviors of an individual were more strongly associated with infection status than the household water and sanitation infrastructure, indicating the importance of incorporating behavior change into community-led total sanitation coverage. Conclusions/Significance Our results highlight the importance of incorporating monitoring and evaluation data into control programs in Uganda to understand the geographic distribution of schistosomiasis prevalence outside of communities where endemicity is known to be high. The high prevalence of schistosomiasis among the youngest age group, ineligible to receive drug treatment, shows the imperative to develop a child-appropriate drug protocol that can be safely administered to preschool-aged children. Water and sanitation interventions should be considered an essential investment for elimination alongside drug treatment. Schistosomiasis is a neglected tropical disease in sub-Saharan Africa that has remained intractable despite efforts to eliminate it through mass drug administration. The transmission cycle is perpetuated when sanitation infrastructure does not adequately capture infected urine or feces and local water bodies, with snail vectors, are contaminated. Schistosomiasis has been linked with stunting and cognitive deficits and there is particular concern for the most vulnerable age group under five years old who are undergoing critical intestinal development but are ineligible to receive drug treatment. Efforts to reduce the disease have focused on children and young adolescents in endemic areas, near water bodies where transmission is known to be high. In Uganda, where fresh water bodies are abundant and intestinal schistosomiasis is endemic, very little is understood about the disease prevalence at a national level. We conducted a large, nationally representative survey and found a national prevalence of 25.6% where the 2–4 year old children had the highest prevalence for schistosomiasis with 36.1% infected. The most significant risk-factor for the disease was an individual’s open defecation behaviors in surface waters. This emphasizes the need to include water and sanitation investments alongside drug treatment and behavior change to control schistosomiasis in Uganda.
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Affiliation(s)
- Natalie G. Exum
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
- * E-mail:
| | - Simon P. S. Kibira
- Department of Community Health and Behavioral Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | - Ronald Ssenyonga
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - Julien Nobili
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
| | - Alexandra K. Shannon
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
| | - John C. Ssempebwa
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Scott Radloff
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
| | - Kellogg J. Schwab
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
| | - Fredrick E. Makumbi
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
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Missamou F, Marlhand H, Dzabatou-Babeaux ASP, Sendzi S, Bernasconi J, D'Souza S, Bakhtiari A, Millar T, Willis R, Bengraïne K, Resnikoff S, Solomon AW. A Population-Based Trachoma Prevalence Survey Covering Seven Districts of Sangha and Likouala Departments, Republic of the Congo. Ophthalmic Epidemiol 2019; 25:155-161. [PMID: 30806542 PMCID: PMC6444200 DOI: 10.1080/09286586.2018.1546878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE We set out to estimate the prevalence of trachoma and access to water and sanitation in seven suspected-trachoma-endemic districts of northern Congo, surveyed as a single evaluation unit. METHODS From a complete list of rural villages in the seven districts, we systematically selected 22 with probability proportional to village size. In selected villages, we included all households where there were fewer than 25 in total, or used compact segment sampling to select a group of approximately 20 households by random draw. In each selected household, all consenting residents aged ≥1 year were examined by Global Trachoma Mapping Project-certified trachoma graders, and data collected on household-level access to water and sanitation. RESULTS In November and December 2015, 466 households were visited in 22 villages, and 2081 (88%) of 2377 residents of those households were examined. No examined individual had trichiasis. The age-adjusted prevalence of the active trachoma sign trachomatous inflammation-follicular (TF) in 1-9-year-olds was 2.5% (95%CI 0.9-4.5%). Only 39% (95%CI 35-44%) of households had access to an improved source of drinking water. Only 10% (95%CI 7-13%) of households had access to an improved sanitation facility. CONCLUSION Trachoma is not a public health problem in this part of Congo. Access to water and sanitation is inadequate.
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Affiliation(s)
- François Missamou
- a Directorate-General for the Fight against Communicable Diseases and HIV/AIDS , Ministère de la Santé et de la Population , Brazzaville , Congo
| | - Hemilembolo Marlhand
- a Directorate-General for the Fight against Communicable Diseases and HIV/AIDS , Ministère de la Santé et de la Population , Brazzaville , Congo
| | - Angelie S Patrick Dzabatou-Babeaux
- a Directorate-General for the Fight against Communicable Diseases and HIV/AIDS , Ministère de la Santé et de la Population , Brazzaville , Congo
| | - Samuel Sendzi
- a Directorate-General for the Fight against Communicable Diseases and HIV/AIDS , Ministère de la Santé et de la Population , Brazzaville , Congo
| | | | | | | | | | | | - Karim Bengraïne
- b Organisation pour la prevention de la cécité , Paris , France
| | - Serge Resnikoff
- b Organisation pour la prevention de la cécité , Paris , France
| | - Anthony W Solomon
- e Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.,f Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
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Alada JJ, Mpyet C, Florea VV, Boisson S, Willis R, Bakhtiari A, Muhammad N, Adamu MD, Umar MM, Olobio N, Isiyaku S, Adamani W, Amdife D, Solomon AW. Prevalence of Trachoma in Kogi State, Nigeria: Results of four Local Government Area-Level Surveys from the Global Trachoma Mapping Project. Ophthalmic Epidemiol 2019; 25:33-40. [PMID: 30806551 PMCID: PMC6444201 DOI: 10.1080/09286586.2017.1409359] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE To determine the prevalence of trachoma in four Local Government Areas (LGAs) of Kogi State, Nigeria. METHODS In June 2014, we conducted population-based, cross-sectional surveys according to Global Trachoma Mapping Project (GTMP) protocols in selected LGAs of Kogi State. In each LGA, 25 clusters were selected with probability proportional to size. In each of these clusters, 25 households were enrolled for the survey. All residents of selected households aged ≥1 year were examined by GTMP-certified graders for trachomatous inflammation-follicular (TF) and trichiasis using the simplified trachoma grading scheme. Data on sources of household water and types of sanitation facilities were collected through questioning and direct observation. RESULTS The age-adjusted TF prevalence in 1-9-year-olds ranged from 0.4% (95% CI 0.1-0.8%) in Bassa to 1.0% (95% CI 0.3-1.9%) in Omala. Across all four LGAs, only one case of trichiasis was found; this individual was in Omala, giving that LGA a trichiasis prevalence in individuals aged ≥15 years of 0.02% (95% CI 0.00-0.07%). Between 77 and 88% of households had access to water for hygiene purposes, while only 10-30% had access to improved sanitation facilities. CONCLUSION Trachoma is not a public health problem in any of the 4 LGAs surveyed. There is, however, the need to increase access to adequate water and sanitation services to contribute to the health and social and economic well-being of these communities.
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Affiliation(s)
- Joel J Alada
- a Department of Ophthalmology , Federal Medical Centre , Makurdi , Nigeria
| | - Caleb Mpyet
- b Department of Ophthalmology , University of Jos , Jos , Nigeria.,c Sightsavers , Kaduna , Nigeria.,d Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | - Victor V Florea
- e Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
| | - Sophie Boisson
- f Department of Public Health, the Environment and Social Determinants of Health , World Health Organization , Geneva , Switzerland
| | - Rebecca Willis
- g International Trachoma Initiative, Task Force for Global Health , Decatur , GA , USA
| | - Ana Bakhtiari
- g International Trachoma Initiative, Task Force for Global Health , Decatur , GA , USA
| | - Nasiru Muhammad
- h Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | - Mohammed D Adamu
- h Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | | | | | | | | | | | - Anthony W Solomon
- e Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland.,l Clinical Research Department , London School of Hygiene & Tropical Medicine , London , United Kingdom.,m London Centre for Neglected Tropical Disease Research , London , United Kingdom
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Mwale C, Mumbi W, Funjika M, Sokesi T, Silumesii A, Mulenga M, Mutati G, Kwendakwema D, Chelu C, Adamu Y, Alemayehu W, Al-Khatib T, Bakhtiari A, Dejene M, Massae PA, Mpyet C, Nwosu C, Willis R, Courtright P, Solomon AW. Prevalence of Trachoma in 47 Administrative Districts of Zambia: Results of 32 Population-Based Prevalence Surveys. Ophthalmic Epidemiol 2019; 25:171-180. [PMID: 30806543 PMCID: PMC6444202 DOI: 10.1080/09286586.2018.1546880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Purpose: A number of previous administrative-district-level baseline trachoma prevalence estimates in Zambia required verification. We used methodologies and systems for trachoma surveys considered to represent international best practice in order to generate reliable estimates of the prevalence of trachoma. Methods: Between March 2016 and July 2017, we undertook 32 population-based prevalence surveys covering 47 administrative districts. In each of the 32 evaluation units (EUs), we selected 31 households in each of 24 clusters. In selected households, trained, certified graders examined all residents aged 1 year and above for evidence of trachomatous inflammation—follicular (TF) and trichiasis. In eyes that had trichiasis, the presence or absence of trachomatous scarring (TS) was recorded, and the subject was asked about previous trichiasis management recommendations from health workers. Results: Five EUs (encompassing seven administrative districts) had prevalence estimates of trichiasis+TS unknown to the health system in ≥15-year-olds of ≥0.2%, and require public-health-level implementation of trichiasis surgery services. Eleven EUs (encompassing 16 administrative districts) had TF prevalence estimates in 1–9-year-olds of ≥5%. Intervention with the A, F and E components of the SAFE strategy for trachoma elimination is required for nearly 1.5 million people. Conclusion: Trachoma is a public health problem in some parts of Zambia. The Ministry of Health will continue to partner with other stakeholders to implement the multi-sectoral SAFE strategy. Consideration should be given to re-surveying other suspected-endemic administrative districts in which surveys using older methodologies returned TF prevalence estimates ≥5%.
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Affiliation(s)
- Consity Mwale
- a Lusaka Provincial Health Office , Lusaka , Zambia.,b University Teaching Eye Hospital , Lusaka , Zambia
| | - Willard Mumbi
- c Ophthalmology Unit , Kabwe General Hospital , Kabwe , Zambia
| | - Misa Funjika
- d Ophthalmology Unit , Ndola Teaching Hospital , Ndola , Zambia
| | - Teddy Sokesi
- d Ophthalmology Unit , Ndola Teaching Hospital , Ndola , Zambia
| | | | - Muma Mulenga
- b University Teaching Eye Hospital , Lusaka , Zambia
| | - Grace Mutati
- b University Teaching Eye Hospital , Lusaka , Zambia
| | | | | | - Yilikal Adamu
- g Department of Ophthalmology, Faculty of Medicine , Addis Ababa University , Addis Ababa , Ethiopia
| | - Wondu Alemayehu
- h The Fred Hollows Foundation , Addis Ababa , Ethiopia.,i Berhan Public Health and Eye Care Consultancy , Addis Ababa , Ethiopia
| | - Tawfik Al-Khatib
- j Prevention of Blindness Program , Ministry of Public Health & Population , Sana'a , Yemen.,k Department of Ophthalmology, College of Medicine , University of Sana'a , Sana'a , Yemen.,l Eye Unit , Al-Thawra Hospital , Sana'a , Yemen
| | | | - Michael Dejene
- n Michael Dejene Public Health Consultancy Services , Addis Ababa , Ethiopia
| | | | - Caleb Mpyet
- p Department of Ophthalmology , University of Jos , Jos , Nigeria.,q Sightsavers , Kaduna , Nigeria.,r Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | | | | | - Paul Courtright
- r Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | - Anthony W Solomon
- s Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.,t Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
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Alada JJ, Mpyet C, Florea VV, Boisson S, Willis R, Muhammad N, Bakhtiari A, Adamu MD, Pavluck AL, Umar MM, Isiyaku S, William A, Oyinloye FOP, Olobio N, Solomon AW. Prevalence of and risk factors for trachoma in Kwara state, Nigeria: Results of eight population-based surveys from the Global Trachoma Mapping Project. Ophthalmic Epidemiol 2019; 25:53-61. [PMID: 30806548 PMCID: PMC6444274 DOI: 10.1080/09286586.2018.1437188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Purpose: To determine the prevalence of and risk factors for trachoma in selected local government areas (LGAs) of Kwara State, Nigeria. Methodology: Population-based cross-sectional surveys were conducted in eight LGAs of Kwara State using Global Trachoma Mapping Project (GTMP) protocols. In each LGA, 25 villages were selected using probability-proportional-to-size sampling; 25 households were selected from each village using compact segment sampling. All residents of selected households aged ≥1 year were examined by GTMP-certified graders for trachomatous inflammation—follicular (TF) and trichiasis using the simplified trachoma grading scheme. Water, sanitation, and hygiene (WASH) data were also collected. Results: A total of 28,506 residents were enumerated in 4769 households across the eight LGAs. TF prevalence in children aged 1–9 years ranged from 0.2% (95% CI 0.0–0.3%) to 1.3% (95% CI 0.7–2.1%), while trichiasis prevalence in persons ≥15 years was <0.2% in each LGA. Access to improved water source was the lowest in Edu (62%), while access to improved sanitation facilities was the lowest in Asa (6%) and the highest in Ilorin East (64%). Children aged 1–4 years had 0.63 (95% CI 0.40–0.99) times lower odds of having TF compared to children aged 5–9 years. Children in households with ≥5 resident 1–9-year-old children had 1.63 (95% CI 1.02–2.60) times greater odds of having TF compared to those in households with <5 resident children. Conclusion: Trachoma is not a public health problem in Kwara State. Provision of adequate water and sanitation services should be a priority here, as a foundation for the health of the population.
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Affiliation(s)
- Joel J Alada
- a Department of Ophthalmology , Federal Medical Centre , Makurdi , Nigeria
| | - Caleb Mpyet
- b Department of Ophthalmology , University of Jos , Jos , Nigeria.,c Sightsavers , Kaduna , Nigeria.,d Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | - Victor V Florea
- e Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
| | - Sophie Boisson
- f Department of Public Health, Environmental and Social Determinants of Health , World Health Organization , Geneva , Switzerland
| | | | - Nasiru Muhammad
- h Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | | | - Mohammed D Adamu
- h Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | | | | | | | | | | | | | - Anthony W Solomon
- e Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland.,l Clinical Research Department , London School of Hygiene & Tropical Medicine , London , United Kingdom.,m London Centre for Neglected Tropical Disease Research , London , United Kingdom
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Krolewiecki AJ, Alvarez LI. Ivermectin for the Treatment of Soil-Transmitted Helmithiases. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2019. [DOI: 10.1007/s40506-019-00195-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Gichuki PM, Kepha S, Mulewa D, Masaku J, Kwoba C, Mbugua G, Mazigo HD, Mwandawiro C. Association between Schistosoma mansoni infection and access to improved water and sanitation facilities in Mwea, Kirinyaga County, Kenya. BMC Infect Dis 2019; 19:503. [PMID: 31174478 PMCID: PMC6556037 DOI: 10.1186/s12879-019-4105-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 05/17/2019] [Indexed: 11/24/2022] Open
Abstract
Background Schistosomiasis remains a public health problem in Central Kenya despite concerted control efforts. Access to improved water and sanitation has been emphasized as important control measures. Few studies have assessed the association between access to improved water sources and sanitation facilities with Schistosoma mansoni infection in different environmental settings. This study assessed the association between S. mansoni infection and household access to improved water sources and sanitation facilities in Mwea, Kirinyaga County, Kenya. Methods A cross sectional study was conducted between the months of August and October 2017. A total of 905 household heads from seven villages were interviewed and their stool samples screened for S. mansoni using the Kato Katz technique. Comparisons of demographic factors by S. mansoni infection were tested for significance using the chi-square test (χ2) or the Fisher exact test for categorical variables. Variables associated with S. mansoni infection were analyzed using univariable analysis and the strength of the association measured as odds ratio (OR) using mixed effects logistic regression at 95% CI, with values considered significant at p < 0.05. Results The overall prevalence of S. mansoni was, 23.1% (95% CI: 20.5–26.0%), with majority of the infections being of light intensity. Rurumi village had the highest prevalence at 33.3%, with Kirogo village having the least prevalence at 7.0%. Majority (84.1%) of the households lacked access to improved water sources but had access to improved sanitation facilities (75%). Households with access to piped water had the lowest S. mansoni infections. However, there was no significant association between S. mansoni infections with either the main source of water in the household (Odds Ratio (OR) =0.782 (95% CI: 0.497–1.229) p = 0.285 or sanitation facilities (OR = 1.018 (95% CI: 0.705–1.469) p = 0.926. Conclusion Our study suggests that S. mansoni is still a public health problem among all age groups in Mwea irrigation scheme, Kirinyaga County, Central Kenya. Majority of the households lacks access to improved water sources but have access to improved sanitation facilities. This study recommends initiatives to ensure adequate provision of improved water sources, and the inclusion of the adult community in preventive chemotherapy programs. Electronic supplementary material The online version of this article (10.1186/s12879-019-4105-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paul M Gichuki
- Eastern and Southern Africa Center for International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), P.O BOX 54840-00200, Nairobi, Kenya. .,School of Health Sciences, Meru University of Science and Technology, P.O BOX 972-60200, Meru, Kenya.
| | - Stella Kepha
- London School of Tropical Medicine and Hygiene, Keppel St, Bloomsbury, London, WCIE 7HT, UK.,School of Public Health, Pwani University, P.O BOX 195-80108, Mombasa, Kenya
| | - Damaris Mulewa
- Eastern and Southern Africa Center for International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), P.O BOX 54840-00200, Nairobi, Kenya
| | - Janet Masaku
- Eastern and Southern Africa Center for International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), P.O BOX 54840-00200, Nairobi, Kenya
| | - Celestine Kwoba
- Vectorborne diseases Control Unit, Ministry of Health, P.o box 86-10303, Wanguru, Kenya
| | - Gabriel Mbugua
- School of Health Sciences, Meru University of Science and Technology, P.O BOX 972-60200, Meru, Kenya
| | - Humphrey D Mazigo
- Department of Medical Parasitology, School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Charles Mwandawiro
- Eastern and Southern Africa Center for International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), P.O BOX 54840-00200, Nairobi, Kenya
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Wepnje GB, Anchang-Kimbi JK, Ndassi VD, Lehman LG, Kimbi HK. Schistosoma haematobium infection status and its associated risk factors among pregnant women in Munyenge, South West Region, Cameroon following scale-up of communal piped water sources from 2014 to 2017: a cross-sectional study. BMC Public Health 2019; 19:392. [PMID: 30971223 PMCID: PMC6458650 DOI: 10.1186/s12889-019-6659-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 03/14/2019] [Indexed: 11/24/2022] Open
Abstract
Background In 2014, a study in Munyenge revealed a high prevalence of urogenital schistosomiasis (UGS) among pregnant women. This study investigated he prevalence and risk factors of UGS in pregnancy following scale-up of piped water sources from 2014 to 2017. Secondly, we compared stream usage, stream contact behaviour, infection rate and intensity with the findings of 2014. Methods Consenting pregnant women reporting for antenatal care (ANC) in the different health facilities were enrolled consecutively between November 2016 and January 2018. Information on age, gravidity status, residence, marital status, educational level, occupation, household water source, frequency of contact with water and stream activities were obtained using a semi-structured questionnaire. Urine samples were examined for the presence of microhaematuria and S. haematobium ova using test strip and filtration/microscopy methods respectively. Data were analysed using univariate and multivariate regression analyses and relative risk reductions calculated. Results Of the 368 women enrolled, 22.3% (82) were diagnosed with UGS. Marital status (single) (aOR = 2.24, 95% CI: 1.04–4.79), primary - level of education (aOR = 2.0; 95% CI: 1.04–3.85) and domestic activity and bathing in the stream (aOR = 3.3; 95% CI: 1.83–6.01) increased risk of S. haematobium infection. Meanwhile, fewer visits (< 3 visits/week) to stream (aOR = 0.35, 95% CI = 0.17–0.74) reduced exposure to infection. Piped water usage was associated with reduced stream usage and eliminated the risk of infection among women who used safe water only. Compared with the findings of 2014, stream usage (RRR = 23 95% CI: 19–28), frequency (≥ 3 visits) (RRR = 69 95% CI: 59–77) and intensity of contact with water (RRR = 37 95% CI = 22–49) has reduced. Similarly, we observed a decrease in infection rate (RRR = 52, 95% CI = 40–62) and prevalence of heavy egg intensity (RRR = 71, 95% CI = 53–81). Conclusion Following increased piped water sources in Munyenge, S. haematobium infection has declined due to reduced stream contact. This has important implication in the control of UGS in pregnancy. Electronic supplementary material The online version of this article (10.1186/s12889-019-6659-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Godlove Bunda Wepnje
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Judith Kuoh Anchang-Kimbi
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon.
| | - Vicky Daonyle Ndassi
- Department of Zoology and Animal Physiology, Faculty of Science, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Leopold Gustave Lehman
- Department of Animal Biology, Faculty of Science, University of Douala, P.O. Box 24157, Douala, Cameroon
| | - Helen Kuokuo Kimbi
- Department of Medical Laboratory Science, Faculty of Health Sciences, University of Bamenda, P.O. Box 39, Bambili, Cameroon
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Khan MS, Pullan R, Okello G, Nyikuri M, McKee M, Balabanova D. "For how long are we going to take the tablets?" Kenyan stakeholders' views on priority investments to sustainably tackle soil-transmitted helminths. Soc Sci Med 2019; 228:51-59. [PMID: 30875544 DOI: 10.1016/j.socscimed.2019.02.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 02/24/2019] [Accepted: 02/26/2019] [Indexed: 11/18/2022]
Abstract
Recent global commitments to shift responsibility for Neglected Tropical Disease (NTD) control to affected countries reflect a renewed emphasis on sustainability, away from aid-dependency. This calls for a better understanding of how domestic stakeholders perceive investments in different strategies for NTD control. Soil transmitted helminths (STH) are among the NTDs targeted for elimination as a public health problem by international agencies through mass drug administration, provided periodically to at-risk population groups, often using drugs donated by pharmaceutical companies. This study was conducted in Kenya at a time when responsibilities for long running STH programmes were transitioning from external to national and sub-national agencies. Following an initial assessment in which we identified key domestic stakeholders and reviewed relevant scientific and government documents, the perspectives of stakeholders working in health, education, community engagement and sanitation were investigated through semi-structured interviews with national level policymakers, county level policymakers, and frontline implementers in one high-STH burden county, Kwale. Our conceptual framework on sustainability traced a progression in thinking, from ensuring financial stability through the technical ability to adapt to changing circumstances, and ultimately to a situation where a programme is prioritised by domestic policymakers because empowered communities demand it. It was clear from our interviews that most Kenyan stakeholders sought to be at the final stage in this progression. Interviewees criticised long-term investment in mass drug administration, the approach favoured predominantly by external agencies, for failing to address underlying causes of STH. Instead they identified three synergistic priority areas for investment: changes in institutional structures and culture to reduce working in silos; building community demand and ownership; and increased policymaker engagement on underlying socioeconomic and environmental causes of STH. Although challenging to implement, the shift in responsibility from external agencies to domestic stakeholders may lead to emergence of new strategic directions.
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Affiliation(s)
- Mishal S Khan
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine (LSHTM), UK.
| | - Rachel Pullan
- Faculty of Infectious and Tropical Diseases, LSHTM, UK
| | - George Okello
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Mary Nyikuri
- Institute of Health Care Management, Strathmore University, Kenya
| | - Martin McKee
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine (LSHTM), UK
| | - Dina Balabanova
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine (LSHTM), UK
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Amer K, Müller A, Abdelhafiz HM, Al-Khatib T, Bakhtiari A, Boisson S, El Arab GE, Gad H, Gordon BA, Madian A, Mahanna AT, Mokhtar S, Safa OH, Samy M, Shalaby M, Taha ZA, Willis R, Yacoub A, Mamdouh AR, Younis AK, Zoheir MBE, Courtright P, Solomon AW. Prevalence of trachoma in four marakez of Elmenia and Bani Suef Governorates, Egypt. Ophthalmic Epidemiol 2019; 25:70-78. [PMID: 30806536 PMCID: PMC6444193 DOI: 10.1080/09286586.2018.1446536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE In 2015, to determine where interventions are needed to eliminate trachoma as a public health problem from Egypt, we initiated population-based prevalence surveys using the Global Trachoma Mapping Project platform in four suspected-endemic marakez (districts; singular: markaz) of the governorates of Elmenia and Bani Suef. METHODS In each markaz, 30 households were selected in each of 25 villages. Certified graders examined a total of 3682 children aged 1-9 years in 2993 households, noting the presence or absence of trachomatous inflammation-follicular (TF) and trachomatous inflammation-intense (TI) in each eye. A total of 5582 adults aged ≥15 years living in the same households were examined for trachomatous trichiasis (TT). Household-level access to water and sanitation was recorded. RESULTS Three of four marakez had age-adjusted TF prevalence estimates in 1-9-year olds of >10%; the other markaz had a TF prevalence estimate of 5-9.9%. Estimates of the age- and gender-adjusted prevalence of unmanaged TT in adults ranged from 0.7% to 2.3%. Household-level access to water and sanitation was high. (We did not, however, measure use of water or sanitation facilities.) Conclusions: Each of the four marakez surveyed has trachoma as a public health problem, with a need for implementation of the SAFE (surgery, antibiotics, facial cleanliness, environmental improvement) strategy. Further mapping is also required to determine the need for interventions in other areas of Egypt.
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Affiliation(s)
- Khaled Amer
- a Ministry of Health and Population , Cairo , Egypt
| | - Andreas Müller
- b Centre for Eye Research , University of Melbourne , Melbourne , Australia
| | | | | | | | - Sophie Boisson
- f Department of Public Health, the Environment and Social Determinants of Health , World Health Organization , Geneva , Switzerland
| | | | - Hema Gad
- h Health Office , Deir Mawass , Egypt
| | - Bruce A Gordon
- f Department of Public Health, the Environment and Social Determinants of Health , World Health Organization , Geneva , Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | - Paul Courtright
- n Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | - Anthony W Solomon
- o Clinical Research Department , London School of Hygiene & Tropical Medicine , London , UK.,p Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
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Umar MM, Mpyet C, Muhammad N, Adamu MD, Muazu H, Onyebuchi U, William A, Isiyaku S, Flueckiger RM, Chu BK, Willis R, Pavluck AL, Olobio N, Apake E, Olamiju F, Solomon AW. Prevalence of trachoma in 13 Local Government Areas of Taraba State, Nigeria. Ophthalmic Epidemiol 2019; 25:18-24. [PMID: 30806533 PMCID: PMC6444197 DOI: 10.1080/09286586.2017.1368670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Purpose: The purpose of these surveys was to determine the prevalence of trachomatous inflammation—follicular (TF) in children aged 1–9 years and trichiasis prevalence in persons aged ≥15 years, in 13 Local Government Areas (LGAs) of Taraba State, Nigeria. Methods: The surveys followed Global Trachoma Mapping Project (GTMP) protocols. Twenty-five households were selected from each of 25 clusters in each LGA, using two-stage cluster sampling providing probability of selection proportional to cluster size. Survey teams examined all the residents of selected households aged ≥1 year for the clinical signs TF, trachomatous inflammation—intense (TI) and trichiasis. Results: The prevalence of TF in children aged 1–9 years in the 13 LGAs ranged from 0.0–5.0%; Ussa LGA had the highest prevalence of 5% (95%CI: 3.4–7.2). Trichiasis prevalence ranged from 0.0–0.8%; seven LGAs had trichiasis prevalences above the threshold for elimination. The backlog of trichiasis in the 13 LGAs (estimated combined population 1,959,375) was 3,185 people. There is need to perform surgery for at least 1,835 people to attain a trichiasis prevalence in each LGA of <0.2% in persons aged ≥15 years. In six of the 13 LGAs, 80% of households could access washing water within 1 km of the household, but only one LGA had >80% of households with access to improved latrines. Conclusion: One of 13 LGAs requires antibiotic mass drug administration for active trachoma. Community-based trichiasis surgery needs to be provided in seven LGAs. There is a need to increase household-level access to improved washing water and latrines across the State.
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Affiliation(s)
| | - Caleb Mpyet
- b Department of Ophthalmology , University of Jos , Jos , Nigeria.,c Sightsavers, Nigeria Country Office , Kaduna , Nigeria.,d Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology , University of Cape Town , South Africa
| | - Nasiru Muhammad
- e Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | - Mohammed D Adamu
- e Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | | | | | | | - Sunday Isiyaku
- c Sightsavers, Nigeria Country Office , Kaduna , Nigeria
| | | | - Brian K Chu
- h Task Force for Global Health , Decatur , GA , USA
| | | | | | | | | | | | - Anthony W Solomon
- k Clinical Research Department , London School of Hygiene & Tropical Medicine , London , United Kingdom.,l London Centre for Neglected Tropical Disease Research , London , United Kingdom
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Muhammad N, Mpyet C, Adamu MD, William A, Umar MM, Muazu H, Onyebuchi U, Isiyaku S, Flueckiger RM, Chu BK, Willis R, Pavluck A, Dalhatu A, Ogoshi C, Olobio N, Gordon BA, Solomon AW, For The Global Trachoma Mapping Project. Prevalence of trachoma in the area councils of the Federal Capital Territory, Nigeria: results of six population-based surveys. Ophthalmic Epidemiol 2019; 25:11-17. [PMID: 30806532 PMCID: PMC6444205 DOI: 10.1080/09286586.2017.1367409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Purpose: The World Health Organization’s (WHO’s) global trachoma elimination programme recommends mapping of trachoma at district level for planning of elimination activities in affected populations. This study aimed to provide data on trachoma prevalence for the Area Councils of Nigeria’s Federal Capital Territory (FCT). Methods: Using the Global Trachoma Mapping Project (GTMP) protocols, in March and April 2014, we conducted a population-based cross-sectional survey in each of the six Area Councils of FCT. Signs were defined based on the WHO simplified grading scheme. Results: 98% to 100% of the targeted households were enrolled in each Area Council. The number of children aged 1–9 years examined per Area Council ranged from 867 to 1248. The number of persons aged ≥15 years examined ranged from 1302 to 1836. The age-adjusted prevalence of trachomatous inflammation—follicular in 1–9-year-olds was <5% in each Area Council. The age- and gender-adjusted prevalence of trichiasis in those aged ≥15 years ranged from 0.0% to 0.3%; two Area Councils (Gwagwalada and Kwali) had prevalences above the 0.2% elimination threshold. The proportion of households with access to improved latrines and water sources ranged from 17 to 90% and 39 to 85% respectively. Conclusions: Gwagwalada and Kwali Area Councils need to perform more trichiasis surgeries to attain the trichiasis elimination prevalence target of 0.2% in persons aged ≥15 years. No Area Council requires mass antibiotic administration for the purposes of trachoma’s elimination as a public health problem. All Area Councils need to accelerate provision of access to improved water sources and latrine facilities, to achieve universal coverage.
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Affiliation(s)
- Nasiru Muhammad
- a Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | - Caleb Mpyet
- b Ophthalmology Department , University of Jos , Jos , Nigeria.,c Sightsavers , Kaduna , Nigeria.,d Kilimanjaro Centre for Community Ophthalmology International, Division of Ophthalmology , University of Cape Town , Cape Town , South Africa
| | - Mohammed Dantani Adamu
- a Ophthalmology Unit, Surgery Department , Usmanu Danfodiyo University , Sokoto , Nigeria
| | - Adamani William
- b Ophthalmology Department , University of Jos , Jos , Nigeria
| | | | | | | | - Sunday Isiyaku
- b Ophthalmology Department , University of Jos , Jos , Nigeria
| | | | - Brian K Chu
- h Task Force for Global Health , Decatur , GA , USA
| | | | - Alex Pavluck
- h Task Force for Global Health , Decatur , GA , USA
| | - Abbas Dalhatu
- i Federal Capital Territory Health Services , Abuja , Nigeria
| | - Chris Ogoshi
- n Health and Development Support Programme , Jos , Nigeria
| | | | - Bruce A Gordon
- j Department of Public Health, Environmental and Social Determinants , World Health Organization , Geneva , Switzerland
| | - Anthony W Solomon
- k Clinical Research Department , London School of Hygiene & Tropical Medicine , London , United Kingdom.,l London Centre for Neglected Tropical Disease Research , London , United Kingdom.,m Department of Control of Neglected Tropical Diseases , World Health Organization , Geneva , Switzerland
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A Case of Strange Worm Infection in a 21 Months Old Female in Karaj, Alborz Province, Iran. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:369-370. [PMID: 31205900 PMCID: PMC6556204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Tesfazion A, Zecarias A, Zewengiel S, Willis R, Mebrahtu G, Capa E, Mpyet C, Al-Khatib T, Courtright P, Solomon AW. Progress Towards Elimination of Trachoma as a Public Health Problem in Eritrea: Results of a Systematic Review and Nine Population-based Prevalence Surveys Conducted in 2014. Ophthalmic Epidemiol 2018; 25:121-130. [PMID: 30806541 PMCID: PMC6444204 DOI: 10.1080/09286586.2018.1545036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 09/21/2018] [Accepted: 11/01/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess Eritrea's progress towards elimination of trachoma as a public health problem, we reviewed and compiled current knowledge on the distribution and burden of trachoma in Eritrea, then undertook further population-based surveys where indicated, with support from the Global Trachoma Mapping Project (GTMP). METHODS For the systematic review, undertaken in March 2014, we searched (1) PubMed, using the terms ((blind* or trachoma or trichiasis) AND Eritrea); (2) the online database of rapid assessments of avoidable blindness; (3) our own grey literature collections; and (4) the Global Atlas of Trachoma database. In June and July 2014, we conducted nine population-based prevalence surveys, for each of which 30 villages were systematically selected with probability proportional to population size; in each village, 30 households were systematically selected. All consenting residents of selected households aged ≥1 year were examined by GTMP-certified graders for signs of trachoma. Data on household-level access to water and sanitation were also collected. RESULTS One previous rapid assessment of avoidable blindness, three peer-reviewed publications, and two grey literature reports detailing sets of trachoma prevalence surveys conducted in 2006 and 2011, respectively, were located. Post-intervention impact surveys were needed in seven evaluation units (EUs, framed at sub-Zoba-level: population range 40,000-120,000) of Debub and Northern Red Sea, while baseline surveys were needed in two EUs of Anseba. Four of the seven impact survey EUs and both baseline survey EUs returned trachomatous inflammation-follicular prevalences in 1-9-year-olds of ≥5%; six of the seven impact survey EUs and one of the two baseline survey EUs returned trichiasis prevalences in ≥15-year-olds of ≥0.2%. The prevalence of access to water and sanitation varied widely between EUs. CONCLUSION Interventions are still required in Eritrea to eliminate trachoma as a public health problem. Data from these surveys will guide the Ministry of Health to undertake programme planning using a sound evidence base.
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Affiliation(s)
- Andeberhan Tesfazion
- National Program for the Prevention of Blindness, Ministry of Health, Asmara, Eritrea
| | - Alem Zecarias
- National Program for the Prevention of Blindness, Ministry of Health, Asmara, Eritrea
| | - Solomon Zewengiel
- National Program for the Prevention of Blindness, Ministry of Health, Asmara, Eritrea
| | | | | | - Eva Capa
- The Fred Hollows Foundation, Sydney, Australia
| | - Caleb Mpyet
- Department of Ophthalmology, University of Jos, Jos, Nigeria
- Sightsavers, Kaduna, Nigeria
- Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Tawfik Al-Khatib
- Department of Ophthalmology, College of Medicine, University of Sana’a, Sana’a, Yemen
- Prevention of Blindness Program, Ministry of Public Health & Population, Sana’a, Yemen
- Eye Unit, Al-Thawra Hospital, Sana’a, Yemen
| | - Paul Courtright
- Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Anthony W. Solomon
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- London Centre for Neglected Tropical Diseases Research, London, UK
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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Courtright P, Rotondo LA, MacArthur C, Jones I, Weaver A, Negash BK, Olobio N, Binnawi K, Bush S, Abdala M, Haddad D, Bonfield A, Emerson P, Sarah V, Solomon AW. Strengthening the links between mapping, planning and global engagement for disease elimination: lessons learnt from trachoma. Br J Ophthalmol 2018; 102:1324-1327. [PMID: 29907634 PMCID: PMC6173819 DOI: 10.1136/bjophthalmol-2018-312476] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 05/20/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Trachoma is the leading infectious cause of blindness. Until recently, reliable data on the global extent of the disease, detailed plans for elimination, and government, donor and partner engagement were all inadequate. METHODS The trachoma community undertook a systematic, three-pronged strategy to map trachoma district by district, develop national-level trachoma elimination plans, and create a framework for governments, donors and partners to convene and coordinate in support of trachoma elimination. RESULT: There has been a frame-shift in internal and external perceptions of the global trachoma programme, from being an effort working towards disease control in focussed geographical areas, to one in the process of achieving worldwide disease elimination. Multiple factors contributed to the successful implementation of mapping, planning, and cross-sectional engagement of governments, partners and donors. CONCLUSIONS Elimination of trachoma is possible if the right combination of factors is in place. Planning for success is a critical first step. Some remaining challenges must still be addressed if the elimination targets are to be successfully attained.
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Affiliation(s)
- Paul Courtright
- Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | | | - Chad MacArthur
- Kilimanjaro Centre for Community Ophthalmology, Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Iain Jones
- Department for International Development, London, UK
| | - Angela Weaver
- United States Agency for International Development, Washington, DC, USA
| | | | | | - Kamal Binnawi
- Ministry of Health and Alneelain University, Khartoum, Sudan
| | | | - Mariamo Abdala
- Nacional Eye Care Program, Ministério da Saude de Mozambique, Maputo, Mozambique
| | | | | | - Paul Emerson
- International Trachoma Initiative, Atlanta, Georgia, USA
| | - Virginia Sarah
- International Coalition for Trachoma Control and The Fred Hollows Foundation, London, UK
| | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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BELACHEW A, ABRHA M, GEBREZGI Z, TEKLE D. Availability and utilization of sanitation facilities in Enderta district, Tigray, Ethiopia. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2018; 59:E219-E225. [PMID: 30397678 PMCID: PMC6196372 DOI: 10.15167/2421-4248/jpmh2018.59.3.826] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 06/19/2018] [Indexed: 11/16/2022]
Abstract
Introduction Despite concerted efforts by governmental and non-governmental organizations, water and adequate sanitation still remain a challenge worldwide. Therefore, this study assessed the availability and utilization of sanitation facilities in Enderta district of Tigray, Ethiopia. Methods A cross-sectional study was conducted in May 2016. An interview and observation were conducted in a total of 450 households. An interviewer administered questionnaire and observation checklist were used to collect the data. Multivariable logistic regression was done to identify the predictors of availability and utilization of latrine, hand washing, and drinking water. Results Out of 450 households, only 68.4% had latrine of which only 21.4% had hand washing facility near the toilet. Likewise, only 9.3% washed their hand after toilet. However, all households had access to improved water source. In this study, proper utilization of latrine, hand washing, and water facilities was observed in 53%, 42.4% and 36.2% of the study households, respectively. The family size and getting sanitation information from health care providers, health extension workers, and health development army had a positive effect on availability and utilization. Conclusions Though Community-Led total sanitation and hygiene approach has been implemented in the study area, the availability and proper utilization of latrine, and hand washing are still low. Only few households used drinking water properly. The education or information on hygienic practices found to affect the availability and utilization of the sanitation facilities positively. Therefore, strengthening the health extension workers and health development army to provide sustainable education and health information is needed.
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Affiliation(s)
- A.B. BELACHEW
- * Correspondence: Abate Bekele Belachew, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia - Tel. +251924703265 - Fax: +251344416675 - E-mail:
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Geographical heterogeneity and inequality of access to improved drinking water supply and sanitation in Nepal. Int J Equity Health 2018; 17:40. [PMID: 29609601 PMCID: PMC5880093 DOI: 10.1186/s12939-018-0754-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 03/20/2018] [Indexed: 11/25/2022] Open
Abstract
Background Per United Nations’ Sustainable Development Goals, Nepal is aspiring to achieve universal and equitable access to safe and affordable drinking water and provide access to adequate and equitable sanitation for all by 2030. For these goals to be accomplished, it is important to understand the country’s geographical heterogeneity and inequality of access to its drinking-water supply and sanitation (WSS) so that resource allocation and disease control can be optimized. We aimed 1) to estimate spatial heterogeneity of access to improved WSS among the overall Nepalese population at a high resolution; 2) to explore inequality within and between relevant Nepalese administrative levels; and 3) to identify the specific administrative areas in greatest need of policy attention. Methods We extracted cluster-sample data on the use of the water supply and sanitation that included 10,826 surveyed households from the 2011 Nepal Demographic and Health Survey, then used a Gaussian kernel density estimation with adaptive bandwidths to estimate the distribution of access to improved WSS conditions over a grid at 1 × 1 km. The Gini coefficient was calculated for the measurement of inequality in the distribution of improved WSS; the Theil L measure and Theil T index were applied to account for the decomposition of inequality. Results 57% of Nepalese had access to improved sanitation (range: 18.1% in Mahottari to 100% in Kathmandu) and 92% to drinking-water (range: 41.7% in Doti to 100% in Bara). The most unequal districts in Gini coefficient among improved sanitation were Saptari, Sindhuli, Banke, Bajura and Achham (range: 0.276 to 0.316); and Sankhuwasabha, Arghakhanchi, Gulmi, Bhojpur, Kathmandu (range: 0.110 to 0.137) among improved drinking-water. Both the Theil L and Theil T showed that within-province inequality was substantially greater than between-province inequality; while within-district inequality was less than between-district inequality. The inequality of several districts was higher than what is calculated by regression of the Gini coefficient and our estimates. Conclusions This study showed considerable geographical heterogeneity and inequality not evidenced in previous national statistics. Our findings may be useful in prioritizing resources to reduce inequality and expand the coverage of improved water supply and sanitation in Nepal.
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Tanser F, Azongo DK, Vandormael A, Bärnighausen T, Appleton C. Impact of the scale-up of piped water on urogenital schistosomiasis infection in rural South Africa. eLife 2018; 7:33065. [PMID: 29460779 PMCID: PMC5819946 DOI: 10.7554/elife.33065] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 01/31/2018] [Indexed: 12/31/2022] Open
Abstract
Recent work has estimated that sub-Saharan Africa could lose US$3.5 billion of economic productivity every year as a result of schistosomiasis and soil-transmitted helminthiasis. One of the main interventions to control schistosomiasis is the provision of safe water to limit the contact with infected water bodies and break the cycle of transmission. To date, a rigorous quantification of the impact of safe water supplies on schistosomiasis is lacking. Using data from one of Africa's largest population-based cohorts, we establish the impact of the scale-up of piped water in a typical rural South African population over a seven-year time horizon. High coverage of piped water in the community decreased a child's risk of urogenital schistosomiasis infection eight-fold (adjusted odds ratio = 0.12, 95% CI 0.06-0.26, p<0.001). The provision of safe water could drive levels of urogenital schistosomiasis infection to low levels of endemicity in rural African settings.
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Affiliation(s)
- Frank Tanser
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.,Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.,Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Daniel K Azongo
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Upper East Region, Ghana
| | - Alain Vandormael
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.,KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Till Bärnighausen
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,Institute of Epidemiology and Health Care, University College London, London, United Kingdom.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, United States.,Institute for Public Health, University of Heidelberg, Heidelberg, Germany
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Delea MG, Solomon H, Solomon AW, Freeman MC. Interventions to maximize facial cleanliness and achieve environmental improvement for trachoma elimination: A review of the grey literature. PLoS Negl Trop Dis 2018; 12:e0006178. [PMID: 29370169 PMCID: PMC5800663 DOI: 10.1371/journal.pntd.0006178] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 02/06/2018] [Accepted: 12/19/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Efforts are underway to scale-up the facial cleanliness and environmental improvement (F&E) components of the World Health Organization's SAFE strategy for elimination of trachoma as a public health problem. Improving understanding of the F&E intervention landscape could inform advancements prior to scale-up, and lead to more effective and sustained behavior change. METHODS/FINDINGS We systematically searched for relevant grey literature published from January 1965 through August 2016. Publications were eligible for review if they described interventions addressing F&E in the context of trachoma elimination programs. Subsequent to screening, we mapped attributes of F&E interventions. We then employed three behavior change frameworks to synthesize mapped data and identify potential intervention gaps. We identified 27 documents meeting inclusion criteria. With the exception of some recent programming, F&E interventions have largely focused on intermediate and distal antecedents of behavior change. Evidence from our analyses suggests many interventions are not designed to address documented determinants of improved F&E practices. No reviewed documents endorsed inclusion of intervention components related to behavioral maintenance or resilience-factors critical for sustaining improved behaviors. CONCLUSIONS If left unaddressed, identified gaps in intervention content may continue to challenge uptake and sustainability of improved F&E behaviors. Stakeholders designing and implementing trachoma elimination programs should review their F&E intervention content and delivery approaches with an eye toward improvement, including better alignment with established behavior change theories and empirical evidence. Implementation should move beyond information dissemination, and appropriately employ a variety of behavior change techniques to address more proximal influencers of change.
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Affiliation(s)
- Maryann G. Delea
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Department of Disease Control, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Hiwote Solomon
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Anthony W. Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Matthew C. Freeman
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
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Kirigia JM, Mburugu GN. The monetary value of human lives lost due to neglected tropical diseases in Africa. Infect Dis Poverty 2017; 6:165. [PMID: 29249201 PMCID: PMC5733961 DOI: 10.1186/s40249-017-0379-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 11/29/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) are an important cause of death and disability in Africa. This study estimates the monetary value of human lives lost due to NTDs in the continent in 2015. METHODS The lost output or human capital approach was used to evaluate the years of life lost due to premature deaths from NTDs among 10 high/upper-middle-income (Group 1), 17 middle-income (Group 2) and 27 low-income (Group 3) countries in Africa. The future losses were discounted to their present values at a 3% discount rate. The model was re-analysed using 5% and 10% discount rates to assess the impact on the estimated total value of human lives lost. RESULTS The estimated value of 67 860 human lives lost in 2015 due to NTDs was Int$ 5 112 472 607. Out of that, 14.6% was borne by Group 1, 57.7% by Group 2 and 27.7% by Group 3 countries. The mean value of human life lost per NTD death was Int$ 231 278, Int$ 109 771 and Int$ 37 489 for Group 1, Group 2 and Group 3 countries, respectively. The estimated value of human lives lost in 2015 due to NTDs was equivalent to 0.1% of the cumulative gross domestic product of the 53 continental African countries. CONCLUSIONS Even though NTDs are not a major cause of death, they impact negatively on the productivity of those affected throughout their life-course. Thus, the case for investing in NTDs control should also be influenced by the value of NTD morbidity, availability of effective donated medicines, human rights arguments, and need to achieve the NTD-related target 3.3 of the United Nations Sustainable Development Goal 3 (on health) by 2030.
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Affiliation(s)
| | - Gitonga N Mburugu
- Meru University of Science and Technology, P.O. Box 972-60200, Meru, Kenya
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Odagiri M, Muhammad Z, Cronin AA, Gnilo ME, Mardikanto AK, Umam K, Asamou YT. Enabling Factors for Sustaining Open Defecation-Free Communities in Rural Indonesia: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121572. [PMID: 29240667 PMCID: PMC5750990 DOI: 10.3390/ijerph14121572] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 11/14/2017] [Accepted: 12/08/2017] [Indexed: 12/31/2022]
Abstract
Community Approaches to Total Sanitation (CATS) programmes, like the Sanitasi Total Berbasis Masyarakat (STBM) programme of the Government of Indonesia, have played a significant role in reducing open defecation though still little is known about the sustainability of the outcomes. We assessed the sustainability of verified Open Defecation Free (ODF) villages and explored the association between slippage occurrence and the strength of social norms through a government conducted cross-sectional data collection in rural Indonesia. The study surveyed 587 households and held focus group discussions (FGDs) in six ODF villages two years after the government’s ODF verification. Overall, the slippage rate (i.e., a combination of sub-optimal use of a latrine and open defecation at respondent level) was estimated to be 14.5% (95% CI 11.6–17.3). Results of multivariate logistic regression analyses indicated that (1) weaker social norms, as measured by respondents’ perceptions around latrine ownership coverage in their community, (2) a lack of all-year round water access, and (3) wealth levels (i.e., not being in the richest quintile), were found to be significantly associated with slippage occurrence. These findings, together with qualitative analysis, concluded that CATS programmes, including a combination of demand creation, removal of perceived constraints through community support mechanisms, and continued encouragement to pursue higher levels of services with post-ODF follow-up, could stabilize social norms and help to sustain longer-term latrine usage in study communities. Further investigation and at a larger scale, would be important to strengthen these findings.
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Affiliation(s)
- Mitsunori Odagiri
- UNICEF Indonesia, World Trade Center 6 (10th Floor), Jalan Jenderal Sudirman Kav. 31, Jakarta 12920, Indonesia.
| | - Zainal Muhammad
- UNICEF Indonesia, Kupang Field Office, Gedung NTT Satu Data, Jl. Polisi Militer No. 2, Kupang 85111, Nusa Tenggara Timur, Indonesia.
| | - Aidan A Cronin
- UNICEF Indonesia, World Trade Center 6 (10th Floor), Jalan Jenderal Sudirman Kav. 31, Jakarta 12920, Indonesia.
| | | | - Aldy K Mardikanto
- National Development Planning Agency (Bappenas), Government of Indonesia, Jl. Taman Suropati No. 2, Menteng, Jakarta 10310, Indonesia.
| | - Khaerul Umam
- Planning, Research and Development Agency (Bapelitbang), Government of District of Alor, Jl. Bukit Doa Ayalon, Petleng, Alor Tengah Utara, Kabupaten Alor 85871, Nusa Tenggara Timur, Indonesia.
| | - Yameha T Asamou
- Alor District Health Office, Government of District of Alor, Jl. Profesor W.Z. Yohannes, Subo, Alor Selatan, Kabupaten Alor 85871, Nusa Tenggara Timur, Indonesia.
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Kassegne K, Zhang T, Chen SB, Xu B, Dang ZS, Deng WP, Abe EM, Shen HM, Hu W, Guyo TG, Nwaka S, Chen JH, Zhou XN. Study roadmap for high-throughput development of easy to use and affordable biomarkers as diagnostics for tropical diseases: a focus on malaria and schistosomiasis. Infect Dis Poverty 2017; 6:130. [PMID: 28965490 PMCID: PMC5623970 DOI: 10.1186/s40249-017-0344-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 08/02/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Interventions are currently being used against 'infectious diseases of poverty', which remain highly debilitating and deadly in most endemic countries, especially malaria, schistosomiasis, echinococcosis and African sleeping sickness. However, major limitations of current 'traditional' methods for diagnosis are neither simple nor convenient for population surveillance, and showed low sensitivity and specificity. Access to novel technologies for the development of adequate and reliable tools are expressly needed. A collaborative project between African Network for Drugs and Diagnostics Innovation and partner institutions in Africa and China aims to screen suitable serological biomarkers for diagnostic pipelines against these 'diseases of the poor'. METHODS Parasite-specific exposed versus unexposed individuals were screened and sera or urine/stools were collected through case-control studies in China and African countries. Target genes/open reading frames were selected, then will be cloned and cell-free expressed, quantified and immuno-detected. Target antigens/epitopes will be probed and screened with sera from exposed or unexposed individuals using a high-throughput antigen screening platform as the study progresses. The specificity and sensitivity of highly immunoreactive biomarkers will be evaluated as well, using enzyme-linked immunosorbent assays or dipsticks. DISCUSSION This roadmap explicitly unfolds the integrated operating procedures with focus on malaria and schistosomiasis, for the identification of suitable biomarkers that will aid the prioritization of diagnostics for population use. However, there is need to further validate any new diagnostic through comparison with standard methods in field deployable tests for each region. Our expectations for the future are to seek regulatory approval and promote the use of diagnostics in endemic areas.
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Affiliation(s)
- Kokouvi Kassegne
- National Institute of Parasitic Diseases (NIPD), Chinese Centre for Disease Control and Prevention, Shanghai, 200025 People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, National Centre for International Research on Tropical Diseases, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, Shanghai, 200025 People’s Republic of China
| | - Ting Zhang
- National Institute of Parasitic Diseases (NIPD), Chinese Centre for Disease Control and Prevention, Shanghai, 200025 People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, National Centre for International Research on Tropical Diseases, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, Shanghai, 200025 People’s Republic of China
| | - Shen-Bo Chen
- National Institute of Parasitic Diseases (NIPD), Chinese Centre for Disease Control and Prevention, Shanghai, 200025 People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, National Centre for International Research on Tropical Diseases, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, Shanghai, 200025 People’s Republic of China
| | - Bin Xu
- National Institute of Parasitic Diseases (NIPD), Chinese Centre for Disease Control and Prevention, Shanghai, 200025 People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, National Centre for International Research on Tropical Diseases, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, Shanghai, 200025 People’s Republic of China
| | - Zhi-Sheng Dang
- National Institute of Parasitic Diseases (NIPD), Chinese Centre for Disease Control and Prevention, Shanghai, 200025 People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, National Centre for International Research on Tropical Diseases, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, Shanghai, 200025 People’s Republic of China
| | - Wang-Ping Deng
- National Institute of Parasitic Diseases (NIPD), Chinese Centre for Disease Control and Prevention, Shanghai, 200025 People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, National Centre for International Research on Tropical Diseases, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, Shanghai, 200025 People’s Republic of China
| | - Eniola Michael Abe
- National Institute of Parasitic Diseases (NIPD), Chinese Centre for Disease Control and Prevention, Shanghai, 200025 People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, National Centre for International Research on Tropical Diseases, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, Shanghai, 200025 People’s Republic of China
| | - Hai-Mo Shen
- National Institute of Parasitic Diseases (NIPD), Chinese Centre for Disease Control and Prevention, Shanghai, 200025 People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, National Centre for International Research on Tropical Diseases, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, Shanghai, 200025 People’s Republic of China
| | - Wei Hu
- National Institute of Parasitic Diseases (NIPD), Chinese Centre for Disease Control and Prevention, Shanghai, 200025 People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, National Centre for International Research on Tropical Diseases, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, Shanghai, 200025 People’s Republic of China
- Department of Microbiology and Microbial Engineering, School of Life Science, Fudan University, Shanghai, 200433 People’s Republic of China
| | - Takele Geressu Guyo
- African Network for Drugs & Diagnostics Innovation (ANDI), Addis Ababa, Ethiopia
| | - Solomon Nwaka
- African Network for Drugs & Diagnostics Innovation (ANDI), Addis Ababa, Ethiopia
| | - Jun-Hu Chen
- National Institute of Parasitic Diseases (NIPD), Chinese Centre for Disease Control and Prevention, Shanghai, 200025 People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, National Centre for International Research on Tropical Diseases, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, Shanghai, 200025 People’s Republic of China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases (NIPD), Chinese Centre for Disease Control and Prevention, Shanghai, 200025 People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, National Centre for International Research on Tropical Diseases, Key Laboratory of Parasite and Vector Biology of the Chinese Ministry of Health, Shanghai, 200025 People’s Republic of China
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Echazú A, Juarez M, Vargas PA, Cajal SP, Cimino RO, Heredia V, Caropresi S, Paredes G, Arias LM, Abril M, Gold S, Lammie P, Krolewiecki AJ. Albendazole and ivermectin for the control of soil-transmitted helminths in an area with high prevalence of Strongyloides stercoralis and hookworm in northwestern Argentina: A community-based pragmatic study. PLoS Negl Trop Dis 2017; 11:e0006003. [PMID: 28991899 PMCID: PMC5648268 DOI: 10.1371/journal.pntd.0006003] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/19/2017] [Accepted: 10/01/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Recommendations for soil-transmitted helminth (STH) control give a key role to deworming of school and pre-school age children with albendazole or mebendazole; which might be insufficient to achieve adequate control, particularly against Strongyloides stercoralis. The impact of preventive chemotherapy (PC) against STH morbidity is still incompletely understood. The aim of this study was to assess the effectiveness of a community-based program with albendazole and ivermectin in a high transmission setting for S. stercoralis and hookworm. METHODOLOGY Community-based pragmatic trial conducted in Tartagal, Argentina; from 2012 to 2015. Six communities (5070 people) were enrolled for community-based PC with albendazole and ivermectin. Two communities (2721 people) were re-treated for second and third rounds. STH prevalence, anemia and malnutrition were explored through consecutive surveys. Anthropometric assessment of children, stool analysis, complete blood count and NIE-ELISA serology for S. stercoralis were performed. PRINCIPAL FINDINGS STH infection was associated with anemia and stunting in the baseline survey that included all communities and showed a STH prevalence of 47.6% (almost exclusively hookworm and S. stercoralis). Among communities with multiple interventions, STH prevalence decreased from 62% to 23% (p<0.001) after the first PC; anemia also diminished from 52% to 12% (p<0.001). After two interventions S. stercoralis seroprevalence declined, from 51% to 14% (p<0.001) and stunting prevalence decreased, from 19% to 12% (p = 0.009). CONCLUSIONS Hookworm' infections are associated with anemia in the general population and nutritional impairment in children. S. stercoralis is also associated with anemia. Community-based deworming with albendazole and ivermectin is effective for the reduction of STH prevalence and morbidity in communities with high prevalence of hookworm and S. stercoralis.
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Affiliation(s)
- Adriana Echazú
- Instituto de Investigaciones en Enfermedades Tropicales, Universidad Nacional de Salta-Sede Regional Orán, San Ramón de la Nueva Orán, Salta, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Marisa Juarez
- Instituto de Investigaciones en Enfermedades Tropicales, Universidad Nacional de Salta-Sede Regional Orán, San Ramón de la Nueva Orán, Salta, Argentina
| | - Paola A. Vargas
- Instituto de Investigaciones en Enfermedades Tropicales, Universidad Nacional de Salta-Sede Regional Orán, San Ramón de la Nueva Orán, Salta, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Silvana P. Cajal
- Instituto de Investigaciones en Enfermedades Tropicales, Universidad Nacional de Salta-Sede Regional Orán, San Ramón de la Nueva Orán, Salta, Argentina
| | - Ruben O. Cimino
- Instituto de Investigaciones en Enfermedades Tropicales, Universidad Nacional de Salta-Sede Regional Orán, San Ramón de la Nueva Orán, Salta, Argentina
- Facultad de Ciencias Naturales, Cátedra de Química Biológica, Universidad Nacional de Salta, Salta, Argentina
| | - Viviana Heredia
- Gerencia Sanitaria, Hospital Juan Domingo Perón, Tartagal, Salta, Argentina
| | - Silvia Caropresi
- Gerencia Sanitaria, Hospital Juan Domingo Perón, Tartagal, Salta, Argentina
| | - Gladys Paredes
- Gerencia Sanitaria, Hospital Juan Domingo Perón, Tartagal, Salta, Argentina
| | - Luis M. Arias
- Secretaria de Nutrición y Alimentación Saludable, Ministerio de Salud Pública de la Provincia de Salta, Salta, Argentina
| | - Marcelo Abril
- Departamento de Programas y Proyectos, Fundación Mundo Sano, Buenos Aires, Argentina
| | - Silvia Gold
- Departamento de Programas y Proyectos, Fundación Mundo Sano, Buenos Aires, Argentina
| | - Patrick Lammie
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Alejandro J. Krolewiecki
- Instituto de Investigaciones en Enfermedades Tropicales, Universidad Nacional de Salta-Sede Regional Orán, San Ramón de la Nueva Orán, Salta, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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Moser W, Schindler C, Keiser J. Efficacy of recommended drugs against soil transmitted helminths: systematic review and network meta-analysis. BMJ 2017; 358:j4307. [PMID: 28947636 PMCID: PMC5611648 DOI: 10.1136/bmj.j4307] [Citation(s) in RCA: 177] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective To evaluate efficacies of anthelmintic drugs against soil transmitted helminths in terms of cure rates and egg reduction rates.Design Systematic review and network meta-analysis.Data Sources PubMed, ISI Web of Science, Embase, ScienceDirect, the Cochrane Central Register of Clinical Trials, and the World Health Organization library database from 1960 until 31 December 2016.Study selection Randomised controlled trials evaluating the efficacy of a single dose regimen of albendazole, mebendazole, levamisole, and pyrantel pamoate against Ascaris lumbricoides, hookworm (Necator americanus and Ancylostoma duodenale) and Trichuris trichiura. The primary outcomes included cure rates analysed by network meta-analysis with mixed logistic regression models and egg reduction rates with mixed linear models.Results 55 and 46 randomised controlled trials were included in the analysis of cure rates and egg reduction rates, respectively. All drugs were highly efficacious against A lumbricoides Albendazole showed the highest efficacy against hookworm infections with a cure rate of 79.5% (95% confidence interval 71.5% to 85.6%) and an egg reduction rate of 89.6% (81.9% to 97.3%). All drugs had low efficacy against T trichiura, with mebendazole showing the highest cure rate of 42.1% (25.9% to 60.2%) and egg reduction rate of 66.0% (54.6% to 77.3%). Estimates for the years 1995 and 2015 showed significant reductions in efficacy of albendazole against T trichiura: by 2015 the egg reduction rates fell from 72.6% (53.7% to 91.5%) to 43.4% (23.5% to 63.3%; P=0.049) and the cure rates fell from 38.6% (26.2% to 52.7%) to 16.4 (7.7% to 31.3%; P=0.027).Conclusions All four currently recommended drugs show limitations in their efficacy profile. While only albendazole showed good efficacy against hookworm infection, all drugs had low efficacy against T trichiura The decrease in efficacy of albendazole against T trichiura over the past two decades is of concern. The findings indicate the need for strengthening efforts to develop new drug treatments, with a particular focus on drugs against T trichiura.
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Affiliation(s)
- Wendelin Moser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, PO Box, CH-4002 Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Christian Schindler
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, PO Box, CH-4002 Basel, Switzerland
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, PO Box, CH-4002 Basel, Switzerland
- University of Basel, Basel, Switzerland
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