scholarly journals A Systematic Review and Metanalyis of Soil Transmitted Helminths Infections Among Preschool and School-age Children in Ethiopia: Evaluation of Neglected Tropica Diseases (NTDS) Elimination Program by 2020

2020 ◽  
Author(s):  
Legese Chelkeba ◽  
Tsegaye Melaku ◽  
Daniel Emana ◽  
Worku Jimma

Abstract Background: Comprehensive nationwide on prevalence, geographic distribution of different species and time trends of soil-transmitted helminths (STHs) are lacking. Therefore, the aim of this study was to provide a summary and location of the available data on STHs infection among preschool and school-age children in Ethiopia. Methods: The search were carried out in Medline via PubMed, Scopus, Science Direct, Web of Science and Google Scholar on data published between 1995 to Fabruary 2020 for studies describing rate of STHs infection among preschool and school-age in Ethiopian. We followed Patient, intervention, Comparsion and Outcome (PICO) approach to identify the studies. Endnote citation manager software version X9 for Windows was utilized to collect and organize search outcomes (into relevant and irrelevant studies) and for removal duplicate articles . We conducted meta-regression to understand the trends and the source of heterogeneity and pooled the prevalence using ‘metaprop’ command using STATA software version 14.Results: A total of 29,311 of the 61,690 children examined during the period under review were infected with one or more species of intestinal parasites yielding an overall prevalence of 48 % (95%CI: 43-53%). The overall pooled estimate of STHs was 33% (95% CI: 28-38%). The prevalence was 44% (95%CI : 31% - 58%) in SNNPR, 34%((95%CI : 28% - 41%) in Amhara region, 31% (95%CI : 19% - 43%) in Oromia region and 10% (95%CI : 7% - 12%) in Tigray region. Soil-transmitted helminths infection rate has been decreasing from 44% (95% CI:30-57%) pre-Mass Drug Administration (MDA) era (1997-2012) to 30% (95% CI:25-34%) post-MDA (2013-2020), although statistically not significant (p = 0.45). A. lumbricoides was the predominant species with a prevalence of 17%. Conclusion: Southern Nations Nationalities and Peoples Region , Amhara and Oromia regions carry the highest burden and are categorized to Moderate Risk Zones (MRZ) and therefore, requiring mass drug administration (MDA) once annually with Albendazole or Mebendazole. Prevalence of SHTs decreased after MDA compared to before MDA, but the decline was not statistically significant. A. lumbricoides was the predominant species of STHs among preschool and school-age children in Ethiopia.

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Zerihun Zerdo ◽  
Tsegaye Yohanes ◽  
Befikadu Tariku

Mass drug administration (MDA) to the most risky population including school-age children (SAC) is the central strategy to control soil-transmitted helminth (STH) infection. The present study was aimed at estimating the prevalence of STHs reinfection three months posttreatment and associated risk factors among SAC in Chencha district. A cross-sectional study design was employed from April 20 to May 5, 2015, to enroll 408 SAC. Structured questionnaire and Kato-Katz thick smear technique were used to interview parents or guardians and quantify the number of eggs per gram of stool. Pearson chi-square and logistic regression were used to assess the association between predictor variable and STH reinfection. The prevalence of STHs within three months of mass chemotherapy among SAC was 36.8% which is 93.4% of the prevalence (39.4%) before treatment. The estimated prevalence of reinfection (95%CI) forAscaris lumbricoides,Trichuris trichiura, and hookworms was 23.8% (21.1–28.2), 16.2% (12.7–20.1), and 1.0% (0.3–2.5), respectively. Children of merchant fathers were more likely to be reinfected by STHs in Chencha district. In conclusion, there is rapid reinfection after mass chemotherapy among SAC in Chencha district. Further studies should be carried out to generate cost efficient methods that can supplement mass drug administration to accelerate the control of STHs.


2021 ◽  
Author(s):  
Anthony Danso-Appiah ◽  
Amadou Djirmay Garba ◽  
Nathan C Lo ◽  
Massimiliano Orso ◽  
Kwadwo Owusu Akuffo ◽  
...  

Background WHO-recommended prevalence thresholds for deciding schistosomiasis mass drug administration (MDA) are based on anecdotal evidence and unclear. Objectives This systematic review and meta-analysis commissioned by the WHO, as part of its new schistosomiasis evidence-based guideline development, was to generate a single and global prevalence threshold that should be applied in MDA programmes. Methods We searched several databases from 1979 to 31st March 2021 without language restriction. Two reviewers selected studies, extracted data and assessed the risk of bias using relevant risk of bias tools and resolved disagreements through discussion. The review followed the PRISMA guidelines. Data were analysed and presented as prevalence reduction (PR) and relative risk (RR) for dichotomous outcomes or mean difference for continuous outcomes with their 95% confidence intervals (CIs). Meta-regression of observations on prevalence rates and intensity of infection of MDA programmes and sensitivity analyses to assess the robustness of the results to the risk of bias components were performed. Evidence on benefits, harms, values, preferences, compliance, acceptability, equity and feasibility were also assessed. The overall level of evidence was graded using GRADE. Results Out of 1,232 studies retrieved, 38 studies met our inclusion criteria and 34 studies were included in the meta-analysis. No direct relation was observed between prevalence and intensity of infection. Praziquantel reduced prevalence of S. haematobium in school age children (SAC) at 12 months (RR 0.38, 95% CI 0.28 to 0.52; 8 studies, n=37,868); at 24 months (RR 0.30; 95% CI 0.30 to 0.52; 7 studies; n=37107); at 36 months (RR 0.39, 95% CI 0.21 to 0.71; 5 studies, n=28,146). There was no significant reduction in prevalence at 48 months (2 studies, n=10,954). For S. mansoni, there were reductions in prevalence at 12 months (RR 0.56, 95% CI 0.46 to 0.69; 14 studies, n=86,073); 24 months (RR 0.46; 95% CI 0.32 to 0.66; 14 studies; n=83,721);36 months (RR 0.44, 95% CI 0.33 to 0.58; 7 studies, n=70,933) and at 48 months (RR 0.25, 95% CI 0.11 to 0.59; 5 studies; n=27,483). Further analyses were performed from a series of created prevalence thresholds of 5%, 10%, 15%, 20%, 30% and ≥40% which showed differences in effect of MDA when each of the thresholds was applied. For annual MDA of school age children (SAC), school-based treatment (SBT) appears to perform better than community-wide treatment (CWT) in terms of prevalence reduction. For the different schistosome species, the model suggests, using the same prevalence threshold, it will take shorter time to reach elimination for S. haematobium than S. mansoni; annual MDA using SBT approach for S. haematobium will require about 10 years to achieve elimination whereas it will take over 10 years to around 15 years to achieve elimination for S. mansoni. Conclusion The evidence presented in this systematic review suggests that 10% prevalence should be used as the global prevalence threshold for implementing MDA in endemic countries.


2019 ◽  
Vol 7 ◽  
Author(s):  
Yakuba M. Bah ◽  
Jusufu Paye ◽  
Mohamed S. Bah ◽  
Abdulai Conteh ◽  
Sam Saffa ◽  
...  

2020 ◽  
Vol 8 ◽  
pp. 205031212095469
Author(s):  
Zeleke Mekonnen ◽  
Derartu Hassen ◽  
Serkadis Debalke ◽  
Abebaw Tiruneh ◽  
Yaregal Asres ◽  
...  

Introduction: Soil-transmitted helminth infections and malnutrition are major health problems of school-age children in developing countries. Malnutrition and soil-transmitted helminth infections often co-exist with synergetic consequences. Objective: The aim of this study was to determine the prevalence and intensity of soil-transmitted helminths and its association with nutritional status of school-age children. Methods: School-based cross-sectional study was carried out from April to May 2014 among 404 elementary school-age children in Jimma Town, Southwest Ethiopia. Data on background characteristics were collected using structured interviewer administered questionnaire. Anthropometric measurements were taken according to World Health Organization standard. Fresh single stool sample was collected from each study participant and examined using direct wet mount and McMaster techniques. Anthropometric indices were generated using WHO AnthroPlus software. Multivariable logistic regression models were fitted to isolate independent predictors of intestinal parasitic infection and nutritional status using STATA-MP software. All tests were two-sided and P < 0.05 was used to declare statistical significance. Results: The overall prevalence of intestinal parasites and soil-transmitted helminths were 68.6% (n = 277) and 55.0% (n = 222), respectively. A total of eight species of intestinal parasites were identified in this study, Trichuris trichiura being the most common parasite identified followed by Ascaris lumbricoides. Study participants who had a habit of open defecation were two times more likely to be infected with soil-transmitted helminths (adjusted odds ratio = 1.9, 95% confidence interval: 1.0–3.4). The overall prevalence of stunting and thinness were 21.0% (n = 85) and 6.9% (n = 28), respectively. The odds of stunting was significantly high (adjusted odds ratio = 4.0, 95% confidence interval: 1.7–9.7) among children who had fathers working as daily labourers and children with personal dietary diversity score of ⩽3 (adjusted odds ratio = 3.5, 95% confidence interval: 1.5–8.0). T. trichiura infection (adjusted odds ratio = 9.4, 95% confidence interval: 2.0–44.8) was identified as an independent predictor of stunting among school-age children. Conclusion: Both the prevalence of soil-transmitted helminths and stunting are high among school-age children in Jimma Town. Although there was no statistically significant association between the STHs, in general, T. trichiura was reported as predictor of stunting. The results imply the need for strengthening strategies for reduction of parasitic infection to curb the pervasively high prevalence of stunting.


2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Getaneh Alemu ◽  
Feleke Mekonnen ◽  
Mezgebu Nega ◽  
Chalachew Muluneh

Background. Ethiopia is one of the tropical countries with a heavy burden of soil-transmitted helminths. As a result, the nation has been implementing mass drug administration, water, sanitation, and hygiene and health extension programs to control those parasites. Hence, updated data about the prevalence and trend of parasites over time has a pivotal role to assess the success of existing control programs. Methods. Studies conducted between 2000 and 2018 were searched from PubMed, Google Scholar, and local journals for systematic reviews and meta-analysis following the PRISMA guideline and checklists. Eligible studies were selected based on preset inclusion and exclusion criteria. The quality of the included studies was assessed using the Newcastle-Ottawa Scale in meta-analysis. Heterogeneity between studies was assessed using the Cochran Q test and I 2 test statistics based on the random effect model. Comprehensive meta-analysis (CMA 2.0) was used to calculate the pooled prevalence, and metaregression was run to assess the trend of parasite prevalence over time. Results. Thirty-eight studies recruiting 16,266 participants were included in the review. The pooled prevalence of intestinal parasites was 52.0% (95% CI: 44.4-59.5). Amhara region was with the highest prevalence (60.3%; 95% CI: 50.1-69.6). Among soil-transmitted helminths, Ascaris lumbricoides (11.2%; 95% CI: 8.4-14.8) was with the highest pooled prevalence followed by hookworms (10.4%; 95% CI: 7.9-13.7) and Trichuris trichiura (3.6%; 95% CI: 2.4-5.4). Metaregression analysis revealed that all soil-transmitted helminths did not show a significantly decreasing trend over time ( p > 0.05 ). Conclusion. Despite various control efforts having been made, soil-transmitted helminths are of high distribution, and their prevalence is not significantly decreasing in Ethiopia. Hence, other control approaches like community-led sanitation should be integrated with mass drug administration to achieve the national goal of soil-transmitted helminth elimination by 2025.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049734
Author(s):  
Katya Galactionova ◽  
Maitreyi Sahu ◽  
Samuel Paul Gideon ◽  
Saravanakumar Puthupalayam Kaliappan ◽  
Chloe Morozoff ◽  
...  

ObjectiveTo present a costing study integrated within the DeWorm3 multi-country field trial of community-wide mass drug administration (cMDA) for elimination of soil-transmitted helminths.DesignTailored data collection instruments covering resource use, expenditure and operational details were developed for each site. These were populated alongside field activities by on-site staff. Data quality control and validation processes were established. Programmed routines were used to clean, standardise and analyse data to derive costs of cMDA and supportive activities.SettingField site and collaborating research institutions.Primary and secondary outcome measuresA strategy for costing interventions in parallel with field activities was discussed. Interim estimates of cMDA costs obtained with the strategy were presented for one of the trial sites.ResultsThe study demonstrated that it was both feasible and advantageous to collect data alongside field activities. Practical decisions on implementing the strategy and the trade-offs involved varied by site; trialists and local partners were key to tailoring data collection to the technical and operational realities in the field. The strategy capitalised on the established processes for routine financial reporting at sites, benefitted from high recall and gathered operational insight that facilitated interpretation of the estimates derived. The methodology produced granular costs that aligned with the literature and allowed exploration of relevant scenarios. In the first year of the trial, net of drugs, the incremental financial cost of extending deworming of school-aged children to the whole community in India site averaged US$1.14 (USD, 2018) per person per round. A hypothesised at-scale routine implementation scenario yielded a much lower estimate of US$0.11 per person treated per round.ConclusionsWe showed that costing interventions alongside field activities offers unique opportunities for collecting rich data to inform policy toward optimising health interventions and for facilitating transfer of economic evidence from the field to the programme.Trial registration numberNCT03014167; Pre-results.


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