A Scoping Review and Prevalence Analysis of Soil-Transmitted Helminth Infections in Honduras

Abstract

BackgroundHonduras is endemic for soil-transmitted helminth (STH) infections, but critical information gaps still remain on the prevalence and intensity of these infections as well as on their spatial distribution at subnational levels.ObjectivesFirstly, to review the research activity on STH infections in Honduras and secondly, to carry out a national prevalence analysis and map the geographical distribution of these infections in children.MethodsA systematic search was conducted of the published and grey literature to identify scientific work on the impact and prevalence of STH infections done between May 1930 and June 30, 2012. International databases and Honduran journals were searched. Grey literature was gleaned from local libraries and key informants. Select studies conducted between 2001 and 2012 were used to produce prevalence maps and to investigate association between STH prevalence and socio-economic and environmental factors.ResultsOf 257 identified studies, 211 (21.4% peer-reviewed) were retained for analysis and categorized as clinical research (10.9%), treatment efficacy studies (8.1%) or epidemiological studies (81%). Prevalence analysis and geographical mapping included 36 epidemiological studies from Honduras's 18 departments and 23% of its municipalities. Overall STH prevalence was >50% in 40.6% of municipalities. Prevalences above 20% for each trichuriasis, ascariasis, and hookworm infection were found in 68%, 47.8%, and 7.2% of studied municipalities, respectively. Municipalities with lower human development index, less access to of potable water, and with higher annual precipitation showed higher STH prevalences.ConclusionsThis is the first study to provide a comprehensive historic review of STH research activity and prevalence in Honduras, revealing important knowledge gaps related to infection risk factors, disease burden, and anti-parasitic drug efficacy, among others. Our decade-long prevalence analysis reveals geographical differences in STH prevalence and these findings suggest that differential intervention strategies might be necessary in Honduras for the control of these infections.

Immune Profile of Honduran Schoolchildren with Intestinal Parasites: The Skewed Response against Geohelminths

“…School teachers reported that the school is reached by the national deworming program and thus receives a single-dose 400 mg albendazole tablet per child on a yearly basis. No records are kept at the school in terms of deworming tablets intake and no parasitological baseline data have been obtained during governmental surveys (data reviewed in [27]). To our knowledge, prior to the present study, two parasitological surveys had been undertaken in the study community.…”

“…The concerning association between trichuriasis and chronic malnutrition, along with the fact that T. trichiura has been found consistently as the most prevalent geohelminth in Honduras [27, 35, 36], suggests that (i) a reexamination of the current deworming guidelines are necessary; (ii) improvements in sanitary conditions and health education are indispensable components of STH control initiatives; and (iii) it is important to monitor for potential benzimidazole resistance in this parasite [37]. …”

School hygiene and deworming are key protective factors for reduced transmission of soil-transmitted helminths among schoolchildren in Honduras

“…Finally, the frequency of deworming in the schools showed only a marginally significant effect in T. trichiura prevalence, which is likely due to the low efficacy of single-dose albendazole/mebendazole against this parasite [66, 67, 85]. This might explain why this and other Honduran studies show that T. trichiura is becoming the predominant STH species in the country [20]. …”

“…Since 2001, the Honduran government has systematically tackled the challenge of decreasing the burden of these infections [10, 20]. Preventive chemotherapy through national deworming campaigns targeting school-age children (and more recently pre-school children) implemented by the Ministries of Health and Education with the technical support of PAHO/WHO has been the chief intervention, as is the case in all endemic countries [4].…”

Soil-Transmitted Helminths, Poverty, and Malnutrition in Honduran Children Living in Remote Rural Communities

“…Increased prevalence was associated with lower Human Development Index (HDI). 12 Other studies describing the prevalence, health impact, and risk factors of STH infections in Honduran schoolchildren have recently been undertaken in the rural populations 7,13 and across the country's ecological regions.…”