Background The scientific community has recently summarized the desired characteristics for diagnostic tools across the different phases of a soil-transmitted helminth (STH) mass drug administration (MDA) program. Although serology meets some of the desired criteria, there is a scarcity of data on baseline serological profiles in human populations, both prior to and during MDA programs. Methods In this study, we compared the copromicroscopic and the serological infection profiles in 600 school-aged children (SAC) and 600 adults at the advent of the MDA program in Jimma Town, Ethiopia. The serological profiles were examined by two ELISAs that measure IgG4 responses to the Ascaris suum haemoglobin antigen (AsHb) and a somatic extract of lung stage larvae (AsLungL3). Three years into the MDA program, we sampled another group of 600 SAC from the same schools to assess the reduction in prevalence and intensity of Ascaris infections measured by copromicroscopy and serology.
BackgroundInfections with Schistosoma mansoni and soil-transmitted helminthes (STHs) are major public health problems in Ethiopia. However, information was scarce on the current status of these infections to guide an intervention in the study area. Therefore, this study was conducted to assess the prevalence of infections with S. mansoni and STHs and associated factors among school children in southern Ethiopia.MethodsThis cross-sectional study investigated children who were attending the Finchawa and Tullo junior elementary schools and were residing along the shore of the lake Hawassa in January and February, 2015. A total of 374 students were selected using systematic random sampling technique. Data on socio-demography and related factors was collected using structured questionnaires. A single stool sample was collected from each child and processed using formol-ether concentration technique and examined microscopically for parasites’ ova/larva.ResultsThe prevalence of parasitic infection with one or more than one helminthiasis was found to be 67.9%. Seven different types of helminths were identified and the most prevalent parasites were Ascaris lumbricoides (44.4%), followed by S. mansoni (31%), Trichuris trichiura (11%), and hookworms (7.7%). The rate of infection with STHs was 52.4%. Single, double, triple and quadruple infections were 42.2, 22.5, 2.4, and 0.8%, respectively. Children who practiced open-field defecation (AOR, 3.6; 95% CI 1.6–8.0; p = 0.001) and had not always washed their hands before eating a meal (AOR, 5.0; 95%CI 2.15–11.7; p <0.001) were more infected with STHs. Moreover, the rate of S. mansoni infection was significantly higher among children who were attending the Finchawa school (AOR, 2.13; 95% CI 1.31–3.46; p = 0.002), aged 11–15 years (AOR, 1.97; 95% CI 1.22–3.19; p = 0.006), had swum in the lake Hawassa (AOR, 2.73; 95%CI 1.20–6.17; p = 0.016), and had involved in irrigation-related activities (AOR, 1.68; 95%CI 1.04–2.71; p = 0.034).ConclusionThe study showed high prevalence of STHs and moderate rate of schisotosomiasis. Mass deworming twice a year for STHs and once every two years for S. mansoni, further to strengthening other prevention measures, is critically needed to reduce these infections to inconsequential level.
Background It remains largely unknown where and how infections with soil-transmitted helminths (STHs; Ascaris, Trichuris, Necator and Ancylostoma) occur. We therefore aimed to identify possible sources of infection by assessing the environmental contamination in an STH-endemic area. Methods We first performed a series of laboratory experiments designed to optimize a soil straining-flotation method to detect and quantify Ascaris and Trichuris eggs in soil, and to validate the diagnostic performance of the optimized method when followed by microscopy and qPCR. In a second phase, we applied this method to assess the level of STH contamination in 399 environmental samples collected from 10 school compounds, 50 households and 9 open markets in Jimma Town (Ethiopia). Subsequently, we explored associations between the environmental contamination and both the corresponding STH epidemiology at the level of the schools and the household characteristics. Finally, we assessed the knowledge, attitude, and practice (KAP) towards STHs in school children. Principal findings Our soil straining-flotation method has an analytical sensitivity of 50 eggs per 100 grams of soil and egg recovery rate of 36.0% (Ascaris) and 8.0% (Trichuris). The analysis of field samples with both microscopy and qPCR revealed the presence of 8 different helminth species of medical importance, including but not limited to the human STHs. There was a significant association between the environmental contamination and prevalence of any STH infections at the school level only. The KAP indicated a lack of knowledge and awareness of STHs. Conclusions/Significance Our optimized straining-flotation method has a moderate diagnostic performance and revealed that life stages of helminths are ubiquitous in the environment, which might be due to the poor sanitary facilities at both the schools and the households, and a poor level of KAP towards STHs. Further research is required to gain more insights into the contribution of these life stages to transmission.
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