In a systematic review and meta-analysis, Eric Strunz and colleagues examine whether improvements in water, sanitation, and hygiene (WASH) practices are associated with reduced risk of infections with soil-transmitted helminths. Please see later in the article for the Editors' Summary

This is the protocol for a review and there is no abstract. The objectives are as follows:To assess the effectiveness of water, sanitation, and hygiene interventions to prevent soil-transmitted helminth infection.

Vitamin A deficiency (VAD) and soil-transmitted helminthiasis (STH) represent two widely prevalent and often overlapping global health problems. Approximately 75% of countries with moderate or severe VAD are coendemic for STH. We reviewed the literature on the complex relationship between STH and VAD. Treatment for STH significantly increases provitamin A (e.g., β-carotene) levels but is associated with minimal increases in preformed vitamin A (retinol). Interpretation of the data is complicated by variations in STH infection intensity and limitations of vitamin A biomarkers. Despite these challenges, increased coordination of STH and VAD interventions represents an important public health opportunity.

BackgroundBetween 2007 and 2012, Children Without Worms (CWW) oversaw the Johnson & Johnson (J&J) donation of Vermox (mebendazole) for treatment of school-age children to control soil-transmitted helminthiasis (STH). To identify factors associated with on-time, delayed, or missed mass drug administration (MDA) interventions, and explore possible indicators for supply chain performance for drug donation programs, we reviewed program data for the 14 STH-endemic countries CWW supported during 2007–2012.MethodologyData from drug applications, shipping records, and annual treatment reports were tracked using Microsoft Excel. Qualitative data from interviews with key personnel were used to provide additional context on the causes of delayed or missed MDAs. Four possible contributory factors to delayed or missed MDAs were considered: production, shipping, customs clearance, and miscellaneous in-country issues. Coverage rates were calculated by dividing the number of treatments administered by the number of children targeted during the MDA.Principal FindingsOf the approved requests for 78 MDAs, 54 MDAs (69%) were successfully implemented during or before the scheduled month. Ten MDAs (13%) were classified as delayed; seven of these were delayed by one month or less. An additional 14 MDAs (18%) were classified as missed. For the 64 on-time or delayed MDAs, the mean coverage was approximately 88%.Conclusions and SignificanceTo continue to assess the supply chain processes and identify areas for improvement, we identified four indicators or metrics for supply chain performance that can be applied across all neglected tropical disease (NTD) drug donation programs: (1) donor having available inventory to satisfy the country request for donation; (2) donor shipping the approved number of doses; (3) shipment arriving at the Central Medical Stores one month in advance of the scheduled MDA date; and (4) country programs implementing the MDA as scheduled.

Purpose:This study evaluated an Adolescent Community Reinforcement Approach (A-CRA) and Assertive Continuing Care (ACC) program targeting Hispanic adolescents at risk for substance abuse.Method:The Clinic for Education, Treatment, and Prevention of Addiction (CETPA, Inc.), a behavioral health provider offering culturally appropriate substance use and mental health services, carried out the intervention. We examined longitudinal substance use data in relation to time spent in the program and possible confounders.Results:We analyzed data from 72 adolescent clients collected between 2010 and 2012. Self-reported data were evaluated to determine if time spent in the program was associated with substance use reduction. The data were correlated, zero-inflated, and overdispersed; consequently, we employed a mixed-effects zero-inflated negative-binomial model. Time spent in CETPA’s program was significantly associated with reductions in the number of days of substance use (p = .039), but not with the likelihood of fully abstaining from use (p = .290). For non-abstinent participants who spend a year in the program, our models revealed an average decline of 46% in reported days of substance use.Conclusions:A culturally tailored and age-appropriate substance abuse program for Hispanic adolescents resulted in a significant reduction of the numbers of days using alcohol, drugs, or other illicit substances. The A-CRA/ACC approach can yield successful results in culturally diverse settings.