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Soil-transmitted helminth (STH) infections in the Wolaita zone in Southern Ethiopia: mid-stage evaluation of the Geshiyaro project and progress towards the interruption of transmission.
Mengistu, Birhan; Liyew, Ewnetu Firdawek; Chernet, Melkie; Tasew, Geremew; Maddren, Rosie; Collyer, Benjamin; Anjulo, Ufaysa; Tamiru, Adugna; Forbes, Kathryn; Mehari, Zelalem; Deribe, Kebede; Yadeta, Teshale; Salasibew, Mihretab; Tollera, Getachew; Anderson, Roy.
Afiliação
  • Mengistu B; London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK. b.abtew@imperial.ac.uk.
  • Liyew EF; Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
  • Chernet M; Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
  • Tasew G; Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
  • Maddren R; London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK.
  • Collyer B; London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK.
  • Anjulo U; Disease Prevention and Health Promotion Core Process, Ministry of Health, Addis Ababa, Ethiopia.
  • Tamiru A; Disease Prevention and Health Promotion Core Process, Ministry of Health, Addis Ababa, Ethiopia.
  • Forbes K; London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK.
  • Mehari Z; Children's Investment Fund Foundation, London, UK.
  • Deribe K; Children's Investment Fund Foundation, London, UK.
  • Yadeta T; Children's Investment Fund Foundation, London, UK.
  • Salasibew M; Children's Investment Fund Foundation, London, UK.
  • Tollera G; Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
  • Anderson R; London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK.
Parasit Vectors ; 17(1): 355, 2024 Aug 21.
Article em En | MEDLINE | ID: mdl-39169385
ABSTRACT

BACKGROUND:

This paper documents changes in the prevalence and intensity of soil-transmitted helminth (STH) infections in the Geshiyaro project in the Wolaita zone of Southern Ethiopia.

METHODS:

The Geshiyaro project comprises three intervention arms. Arm 1 is subdivided into the Arm 1 pilot (one district) and Arm 1 (four other districts), both receiving integrated community-wide mass drug administration MDA (cMDA) with intensive water, sanitation, and hygiene (WaSH) interventions. Arm 2 involves 18 districts with cMDA interventions plus the existing government-led One WaSH program, while Arm 3 serves as a control with school-based MDA (sMDA) interventions plus the existing government-led One WaSH program in three districts. The study is designed as a cohort investigation over time, with the establishment of longitudinal sentinel sites where infection levels are assessed annually. A total of 45 longitudinal parasitological surveillance sentinel sites are being used across all three intervention arms to monitor STH prevalence and intensity of infection. From each of the 45 sentinel sites, 150 individuals were randomly selected, stratified by age and gender. The t-test and analysis of variance (ANOVA) were employed to compare infection prevalence and intensity across the three study arms over time.

RESULTS:

The prevalence of STH decreased significantly from 34.5% (30.6%, 38.5%) in 2019 to 10.6% (8.3%, 13.4%) in 2022/2023 (df = 1, P < 0.0001) in the Arm 1 pilot, from 27.4% (25.2%, 29.7%) in 2020 to 5.5% (4.4%, 6.7%) in 2023 (df = 1, P < 0.0001) in Arm 1, from 23% (21.3%, 24.8%) in 2020 to 4.5% (3.7%, 5.3%) in 2023 (df = 1, P < 0.001) in Arm 2, and from 49.6% (47.4%, 51.7%) in 2021 to 26.1% in 2023 (df = 1, P < 0.0001) in Arm 3. The relative reduction in the prevalence of any STH was the highest in the arms employing cMDA, namely Arm 2, with a decrease of 82.5% (79.3%, 84.2%), followed by Arm 1 with a reduction of 80.1% (75.3%, 84.6%), and then the Arm 1 pilot with a decrease of 69.4% (60.1%. 76.6%). Arm 3 employing sMDA had the lowest decrease, with a reduction of 46.9% (43.6%, 51%). The mean intensity of infection (based on Kato-Katz egg count measures) for Ascaris lumbricoides species, which was the dominant STH species present in the study area, decreased significantly in Arms 1 and 2, but only slightly in Arm 3. The prevalence of hookworm and Trichuris trichiura infections were found to be very low in all arms but also decreased significantly.

CONCLUSIONS:

The reduction in the prevalence and intensity of STH in Arms 1 and 2 revealed steady progress towards transmission interruption based on cMDA intervention, but additional efforts with MDA coverage and WaSH interventions are needed to achieve a prevalence threshold < 2% based on the quantitative polymerase chain reaction (qPCR) diagnostic method.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Solo / Helmintíase Limite: Adolescent / Adult / Animals / Child / Child, preschool / Female / Humans / Male País/Região como assunto: Africa Idioma: En Revista: Parasit Vectors Ano de publicação: 2024 Tipo de documento: Article País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Solo / Helmintíase Limite: Adolescent / Adult / Animals / Child / Child, preschool / Female / Humans / Male País/Região como assunto: Africa Idioma: En Revista: Parasit Vectors Ano de publicação: 2024 Tipo de documento: Article País de publicação: Reino Unido