scholarly journals Preventive chemotherapy for the control of strongyloidiasis in school-age children: Estimating the ivermectin need

2021 ◽  
Vol 15 (4) ◽  
pp. e0009314
Author(s):  
Donal Bisanzio ◽  
Antonio Montresor ◽  
Michael French ◽  
Richard Reithinger ◽  
Paola Rodari ◽  
...  
Keyword(s):  
Normal Approximation ◽  
Specific Treatment ◽  
Control Program ◽  
Strongyloides Stercoralis ◽  
School Age Children ◽  
School Age ◽  
Endemic Country ◽  
Loa Loa ◽  
Preventive Chemotherapy ◽  
Potential Market

Background Strongyloides stercoralis is a soil-transmitted helminth (STH) that affects approximately 600 million people worldwide. Interventions targeting S. stercoralis have not been implemented yet. Specific treatment (ivermectin) could be included in already ongoing preventive chemotherapy (PC) campaigns targeting other STHs. The aim of this study was to estimate the quantity of ivermectin needed for an integrated STH/S. stercoralis control program. Methododology/Principal findings Our study estimates the number of school- age children (SAC) (the main focus of STH deworming campaigns) in need of PC with ivermectin. The normal approximation of the binomial distribution was adopted to calculate the hypothetical prevalence distribution in each endemic country. Considering prevalence thresholds for PC equal to 10%, 15%, and 20%, we estimated the number of SAC in need of treatment. We adjusted the estimates accounting for ivermectin distributed in lymphatic filariasis and onchocerciasis elimination programs and excluded from our calculation areas where Loa loa is endemic. The global number of SAC that should be targeted in PC campaigns was estimated at 283.9 M (95% CI: 163.4–368.8), 207.2 M (95% CI: 160.9–380.7), and 160.7 M (95% CI: 86.6–225.7) when the threshold for intervention was set to 10%, 15%, and 20%, respectively. India, China, Indonesia, Bangladesh, and Nigeria accounted for about 50% of the global SAC would have to be covered by PC intervention. Conclusions/Significance Our analysis may support endemic countries to evaluate the ivermectin quantity needed for integrating strongyloidiasis in the existing STH programs. These estimates might also show to generic drug manufacturers the size of the potential market for ivermectin and encourage its production.

scholarly journals Associations between infection intensity categories and morbidity prevalence in school-age children are much stronger for Schistosoma haematobium than for S. mansoni

2021 ◽  
Vol 15 (5) ◽  
pp. e0009444
Author(s):  
Ryan E. Wiegand ◽  
W. Evan Secor ◽  
Fiona M. Fleming ◽  
Michael D. French ◽  
Charles H. King ◽  
...  
Keyword(s):  
Ultrasound Image ◽  
Infection Intensity ◽  
Control Program ◽  
Monitoring And Evaluation ◽  
World Health ◽  
Current Status ◽  
School Age Children ◽  
School Age ◽  
Preventive Chemotherapy ◽  
Urogenital Schistosomiasis

Background World Health Organization (WHO) guidelines for measuring global progress in schistosomiasis control classify individuals with Schistosoma spp. infections based on the concentration of excreted eggs. We assessed the associations between WHO infection intensity categories and morbidity prevalence for selected S. haematobium and S. mansoni morbidities in school-age children. Methodology A total of 22,488 children aged 6–15 years from monitoring and evaluation cohorts in Burkina Faso, Mali, Niger, Uganda, Tanzania, and Zambia from 2003–2008 were analyzed using Bayesian logistic regression. Models were utilized to evaluate associations between intensity categories and the prevalence of any urinary bladder lesion, any upper urinary tract lesion, microhematuria, and pain while urinating (for S. haematobium) and irregular hepatic ultrasound image pattern (C-F), enlarged portal vein, laboratory-confirmed diarrhea, and self-reported diarrhea (for S. mansoni) across participants with infection and morbidity data. Principal findings S. haematobium infection intensity categories possessed consistent morbidity prevalence across surveys for multiple morbidities and participants with light infections had elevated morbidity levels, compared to negative participants. Conversely, S. mansoni infection intensity categories lacked association with prevalence of the morbidity measures assessed. Conclusions/significance Current status infection intensity categories for S. haematobium were associated with morbidity levels in school-age children, suggesting urogenital schistosomiasis morbidity can be predicted by an individual’s intensity category. Conversely, S. mansoni infection intensity categories were not consistently indicative of childhood morbidity at baseline or during the first two years of a preventive chemotherapy control program.

scholarly journals Helminthiasis among School-Age Children and Hygiene Conditions of Selected Schools in Lafia, Nasarawa State, Nigeria

2019 ◽  
Vol 4 (3) ◽  
pp. 112 ◽  
Author(s):  
Eniola M. Abe ◽  
Onyinye C. Echeta ◽  
Akwashiki Ombugadu ◽  
Linus Ajah ◽  
Peter O. Aimankhu ◽  
...  
Keyword(s):  
Primary Schools ◽  
School Health ◽  
Strongyloides Stercoralis ◽  
School Age Children ◽  
Multiple Infections ◽  
School Age ◽  
School Health Program ◽  
Significant Difference ◽  
The Government ◽  
And Gender

The burden of soil-transmitted helminths (STHs) infections in Nigeria is enormous with serious public health significance. This study, therefore, assessed helminthiasis among school-age children and the hygiene conditions of schools in Lafia, Nasarawa State, Nigeria between December 2015 and April 2016 from four randomly selected primary schools. Stool samples were collected from 200 primary school pupils including 80 males (40%) and 120 females (60%) between five and 16 years, using clean sample bottles and a standard parasitology examination technique at the central laboratory at the Federal University, Lafia. An overall prevalence of 33.5% (67/200) helminths infections was recorded. A checklist of Ascaris lumbricoides, hookworm, Trichuris trichiura, and Strongyloides stercoralis was generated from the pooled data of the four studied schools in which A. lumbricoides occurred highest with 13% (26/200) while S. stercoralis was the least prevalent at 2.50% (5/200). Among the schools sampled, St. James Pilot Science Primary School’s children were the most infected at 44% (22/50). Multiple infections were observed in three of the four schools sampled. There was no significant difference (p > 0.05) in prevalence rates of different STHs infections in relation to age group and gender across schools. Our findings showed that the hygiene conditions in the studied schools were poor without water, hand washing materials, refuse bins, as well as poor sanitary conditions. This study also identified ova and larvae of STHs parasites in the analyzed soil samples from the studied schools. Most school-age children had knowledge about contamination but few among them washed their hands with water and soap. The obtained result indicated a negative association between the prevalence of STHs and the proportion of pupils that cleaned up with water after defection. We, therefore, advise that hygiene conditions in schools be improved and that the government should prioritize enrolling all primary schools in Nasarawa state for the school health program so as to reduce the burden of STHs among school-age children in the state.

scholarly journals Preventive chemotherapy coverage against soil-transmitted helminth infection among school age children: Implications from coverage validation survey in Ethiopia, 2019

PLoS ONE ◽  
2020 ◽  
Vol 15 (6) ◽  
pp. e0235281 ◽  
Author(s):  
Mekuria Asnakew Asfaw ◽  
Zerihun Zerdo ◽  
Chuchu Churko ◽  
Fikre Seife ◽  
Manaye Yihune ◽  
...  
Keyword(s):  
Helminth Infection ◽  
School Age Children ◽  
School Age ◽  
Preventive Chemotherapy

scholarly journals Controlling Soil-Transmitted Helminthiasis in Pre-School-Age Children through Preventive Chemotherapy

2008 ◽  
Vol 2 (3) ◽  
pp. e126 ◽  
Author(s):  
Marco Albonico ◽  
Henrietta Allen ◽  
Lester Chitsulo ◽  
Dirk Engels ◽  
Albis-Francesco Gabrielli ◽  
...  
Keyword(s):  
School Age Children ◽  
School Age ◽  
Preventive Chemotherapy ◽  
Soil Transmitted Helminthiasis

scholarly journals Preventive chemotherapy coverage against Soil-transmitted helminthiases among school age children in vertical versus integrated treatment approaches: Implications from coverage validation survey in Ethiopia

2020 ◽  
Author(s):  
Mekuria Asfaw ◽  
Zerihun Zerdo ◽  
Chuchu Churko ◽  
Fikre Seife ◽  
Manaye Yihune ◽  
...  
Keyword(s):  
At Risk ◽  
Integrated Treatment ◽  
School Age Children ◽  
School Age ◽  
Mass Treatment ◽  
Age Group ◽  
Preventive Chemotherapy ◽  
Treatment Coverage ◽  
Soil Transmitted Helminths ◽  
Sanitation And Hygiene

AbstractBackgroundSoil-transmitted helminths (STH) are widely distributed in Ethiopia with highest prevalence and burden. Since 2015 the country launched national deworming programme to control STH associated morbidity using mass treatment with Albendazole/Mebendazole. Data on routine coverage of Preventive chemotherapy (PC) are available at different level of the health system, however in some circumstances these reports are unreliable and evidence is lacking on validated treatment coverage against STH.MethodologyA community-based cross-sectional study was conducted in ten districts of Ethiopia; from January to April 2019. A total of 8154 SAC (4100 males and 4054 females) were participated from randomly selected households. Data were analysed using SPSS software (IBM, version 25); then di-aggregated by gender, age and school attendance and presented in tables and graphs.Principal findingsAlbendazole/Mebendazole mass treatment coverage against STH among school-age children was found to be 71%. In vertical (school-based) treatment approach, 4822(68.4%) were treated; whereas in integrated (community directed) approach, 963(86.9 %) were treated. The treatment coverage among males was 2948(71.9%), while among females it was 2837(70%). Based on age the treatment coverage in the age group 10-14 years was 77%; which is higher than the coverage in age group 5-9 years was 64.4%. In addition, the treatment coverage in school attendant was 81%; which is higher than coverage non-enrolled children (28%). The main deworming site was school, 5223(91%). Moreover, the main reported reasons for not swallowing drugs were not attending school, 422(19.75%) and drugs were not given, 397(18.6%).Concussions/significanceAlbendazole/Mebendazole mass treatment coverage against soil-transmitted helminths among school-age children was below the WHO recommendation (75%). Operational research is required to identify barriers for low coverage of ALB/MBD among children who are non-enrolled school-age children. Further, a call for action is required from different stakeholders to improve treatment coverage of ALB/MBD.Author SummaryNeglected Tropical Diseases (NTDs) are a group of communicable diseases, which inequitably affect the world’s poorest, marginalized, voiceless and powerless people. It is prevalent in areas with unsafe water, poor sanitation and hygiene. STH (ascariasis, hookworm, and trichuriasis), intestinal worms, are one of the common NTDs which are transmitted through contact with soil contaminated with human feces.Globally, more than 4 billion people are at risk for STH and with over 1 billion are already infected. In Ethiopia, about 81 million people are at risk for STH infection. School age children and pre-school age children are highly affected by the diseases, and it causes anemia, vitamin A deficiency, stunting, malnutrition, impaired development, and intestinal obstruction.As one of NTDS, ending STH can contribute to Ethiopia be on track of attaining universal health coverage (UHC). STH can be controlled, possibly eliminated by combined interventions of preventive chemotherapy with improved water, sanitation and hygiene (WASH). In Ethiopia, though remarkable attainments are made so far on controlling STH morbidity through mapping and scaling-up mass drug administration, still more work is required to increase coverage of PC and integration of PC with WASH to meet the national objectives of elimination or control of STH.

scholarly journals Urogenital schistosomiasis infection prevalence targets to determine elimination as a public health problem based on microhematuria prevalence in school-age children

2021 ◽  
Vol 15 (6) ◽  
pp. e0009451
Author(s):  
Ryan E. Wiegand ◽  
Fiona M. Fleming ◽  
Anne Straily ◽  
Susan P. Montgomery ◽  
Sake J. de Vlas ◽  
...  
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Public Health Problem ◽  
School Age Children ◽  
Infection Prevalence ◽  
School Age ◽  
Infection Level ◽  
Preventive Chemotherapy ◽  
Urogenital Schistosomiasis ◽  
Morbidity Control

Background Recent research suggests that schistosomiasis targets for morbidity control and elimination as a public health problem could benefit from a reanalysis. These analyses would define evidence-based targets that control programs could use to confidently assert that they had controlled or eliminated schistosomiasis as a public health problem. We estimated how low Schistosoma haematobium infection levels diagnosed by urine filtration in school-age children should be decreased so that microhematuria prevalence was at, or below, a “background” level of morbidity. Methodology Data obtained from school-age children in Burkina Faso, Mali, Niger, Tanzania, and Zambia who participated in schistosomiasis monitoring and evaluation cohorts were reanalyzed before and after initiation of preventive chemotherapy. Bayesian models estimated the infection level prevalence probabilities associated with microhematuria thresholds ≤10%, 13%, or 15%. Principal findings An infection prevalence of 5% could be a sensible target for urogenital schistosomiasis morbidity control in children as microhematuria prevalence was highly likely to be below 10% in all surveys. Targets of 8% and 11% infection prevalence were highly likely to result in microhematuria levels less than 13% and 15%, respectively. By contrast, measuring heavy-intensity infections only achieves these thresholds at impractically low prevalence levels. Conclusions/Significance A target of 5%, 8%, or 11% urogenital schistosomiasis infection prevalence in school-age children could be used to determine whether a geographic area has controlled or eliminated schistosomiasis as a public health problem depending on the local background threshold of microhematuria.

scholarly journals Control programs for strongyloidiasis in areas of high endemicity: an economic analysis of different approaches

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Dora Buonfrate ◽  
Lorenzo Zammarchi ◽  
Zeno Bisoffi ◽  
Antonio Montresor ◽  
Sara Boccalini
Keyword(s):  
Strongyloides Stercoralis ◽  
World Health ◽  
Health Priorities ◽  
School Age Children ◽  
First Year ◽  
Preventive Chemotherapy ◽  
United States Dollar ◽  
Base Scenario ◽  
Case Base ◽  
The Impact

Abstract Background Implementation of control programmes for Strongyloides stercoralis infection is among the targets of the World Health Organization Roadmap to 2030. Aim of this work was to evaluate the possible impact in terms of economic resources and health status of two different strategies of preventive chemotherapy (PC) compared to the current situation (strategy A, no PC): administration of ivermectin to school-age children (SAC) and adults (strategy B) versus ivermectin to SAC only (strategy C). Methods The study was conducted at the IRCCS Sacro Cuore Don Calabria hospital, Negrar di Valpolicella, Verona, Italy, at the University of Florence, Italy, and at the WHO, Geneva, Switzerland, from May 2020 to April 2021. Data for the model were extracted from literature. A mathematical model was developed in Microsoft Excel to assess the impact of strategies B and C in a standard population of 1 million subjects living in a strongyloidiasis endemic area. In a case base scenario, 15% prevalence of strongyloidiasis was considered; the 3 strategies were then evaluated at different thresholds of prevalence, ranging from 5 to 20%. The results were reported as number of infected subjects, deaths, costs, and Incremental-Effectiveness Ratio (ICER). A 1-year and a 10-year horizons were considered. Results In the case base scenario, cases of infections would reduce dramatically in the first year of implementation of PC with both strategy B and C: from 172 500 cases to 77 040 following strategy B and 146 700 following strategy C. The additional cost per recovered person was United States Dollar (USD) 2.83 and USD 1.13 in strategy B and C, respectively, compared to no treatment in the first year. For both strategies, there was a downtrend in costs per recovered person with increasing prevalence. The number of adverted deaths was larger for strategy B than C, but cost to advert one death was lower for strategy C than B. Conclusions This analysis permits to estimate the impact of two PC strategies for the control of strongyloidiasis in terms of costs and adverted infections/deaths. This could represent a basis on which each endemic country can evaluate which strategy can be implemented, based on available funds and national health priorities.

Prevalence of Soil-transmitted Helminth Infections Among School-age Children in Ethiopia: a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Muluken Azage ◽  
Achenef Motbainor ◽  
Genet Gedamu ◽  
Wendemagegne Enbiale
Keyword(s):  
Systematic Review ◽  
Control Strategies ◽  
Data Extraction ◽  
Meta Analysis ◽  
Control Measures ◽  
School Age Children ◽  
Cochrane Library ◽  
School Age ◽  
Preventive Chemotherapy ◽  
Pooled Prevalence

Abstract Background: In Ethiopia, soil-transmitted helminthiasis (STHs) infections remain the leading cause of morbidity among school-age children despite the progress in the implementation of control measures. Study findings regarding prevalence of STH among school-age children have been inconsistent and pooled prevalence of STH infections did not account double or triple infections of STH. Therefore, this systematic review and meta-analysis estimates the pooled prevalence of STH by accounting double or triple infections among school-age children in Ethiopia.Methods: Databases and search engines such as PubMed, Web of Science, EMBASE, CINAHL, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. Based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was employed to determine the prevalence of STH infections among school-age children. Published articles in the period between 1980 and 2020 were included in the analysis. Three authors independently extracted all data using a data extraction format sheet. STATA Version 16 statistical software was used for analysis. The Cochran’s Q-test was used to evaluate the heterogeneity of the studies and a random-effects model was done to determine pooled prevalence estimate.Results: The overall pooled estimate of STHs was 33% (95% CI:26-39%). The prevalence did not show statistically differ between before, 32.0% (95% CI:25-39%) and after, 33% (95% CI:26-39%) National NTDs control and elimination programme. The pooled prevalence of ascariasis before and after the implementation of NTDs programme was found to be 18% (12.0%, 24%) and 18% (9.0%, 27.0%), respectively with a total pooled estimate of 18.0% (13.0%, 23.0%). The prevalence of trichuris trichuria was also found to be 8.0% (4.0%, 12.0%) before the programme and 15.0% (4%, 26%) after the programme with a total pooled estimate of 10.0% (5.0%, 14.0%). The prevalence of hookworm was 14.0% (9.0%, 19.0%) before the programme and 9.0% (3.0%, 14.0%) after the programme with a total pooled estimate of 12% (8.0%, 17.0%). Conclusion: The overall polled prevalence of STHs in Ethiopia was found at moderate level based on the WHO classification. The recommended control strategies for STHs infections in school-age children at this level of prevalence such as providing preventive chemotherapy or treat all school-age children (enrolled and non-enrolled) once a year, improving sanitation and water supply and providing health education should be strengthen to mee the target of the national and WHO plan.

scholarly journals Modeling the Interruption of the Transmission of Soil-Transmitted Helminths Infections in Kenya: Modeling Deworming, Water, and Sanitation Impacts

2021 ◽  
Vol 9 ◽  
Author(s):  
Collins Okoyo ◽  
Graham Medley ◽  
Charles Mwandawiro ◽  
Nelson Onyango
Keyword(s):  
Worm Burden ◽  
Age Groups ◽  
Drug Efficacy ◽  
Control Program ◽  
School Age Children ◽  
School Age ◽  
Regular Treatment ◽  
Soil Transmitted Helminths ◽  
Age Structured ◽  
The Impact

Kenya, just like other countries with endemic soil-transmitted helminths (STH), has conducted regular mass drug administration (MDA) program for the last 5 years among school aged children as a way to reduce STH infections burden in the country. However, the point of interruption of transmission of these infections still remains unclear. In this study, we developed and analyzed an age structured mathematical model to predict the elimination period (i.e., time taken to interrupt STH transmission) of these infections in Kenya. The study utilized a deterministic age structured model of the STH population dynamics under a regular treatment program. The model was applied to three main age groups: pre-school age children (2–4 years), school age children (5–14 years), and adult populations (≥15 years) and compared the impact of two interventions on worm burden and elimination period. The model-simulated results were compared with the 5 year field data from the Kenyan deworming program for all the three types of STH (Ascaris lumbricoides, Trichuris trichiura, and hookworm). The model demonstrated that the reduction of worm burden and elimination period depended heavily on four parameter groups; drug efficacy, number of treatment rounds, MDA and water, sanitation and hygiene (WASH) coverage. The analysis showed that for STH infections to be eliminated using MDA alone in a short time period, 3-monthly MDA plan is desired. However, complementation of MDA with WASH at an optimal (95%) coverage level was most effective. These results are important to the Kenyan STH control program as it will guide the recently launched Breaking Transmission Strategy.

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