An updated atlas of human helminth infections: the example of East Africa

Brooker, Simon; Kabatereine, Narcis B.; Smith, Jennifer L.; Mupfasoni, Denise; Mwanje, Mariam T.; Ndayishimiye, Onésime; Lwambo, N. J. S.; Mbotha, Deborah; Karanja, Peris; Mwandawiro, Charles; Muchiri, Eric M.; Clements, Archie C. A.; Bundy, Donald; Snow, Robert W.

doi:10.1186/1476-072x-8-42

Cited by 162 publications

(166 citation statements)

References 46 publications

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“…9 A recent review of worm infection in East Africa reported median prevalence estimates in Nyanza Province of A. lumbricoides (18.5%), T. trichiura (11.9%), and hookworm (17.6%). 47 Third, there was considerable heterogeneity in delivery and uptake of the intervention. Only 25% of schools in the intervention reached the Government of Kenya standards for pupil/latrine ratios, only 25% had soap available for hand washing.…”

Section: Discussionmentioning

confidence: 99%

The Impact of a School-Based Hygiene, Water Quality and Sanitation Intervention on Soil-Transmitted Helminth Reinfection: A Cluster-Randomized Trial

Freeman¹,

Clasen²,

Brooker³

et al. 2013

The American Society of Tropical Medicine and Hygiene

120

117

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Abstract. We conducted a cluster-randomized trial to assess the impact of a school-based water treatment, hygiene, and sanitation program on reducing infection with soil-transmitted helminths (STHs) after school-based deworming. We assessed infection with STHs at baseline and then at two follow-up rounds 8 and 10 months after deworming. Forty government primary schools in Nyanza Province, Kenya were randomly selected and assigned to intervention or control arms. The intervention reduced reinfection prevalence (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.31-1.00) and egg count (rate ratio [RR] 0.34, CI 0.15-0.75) of Ascaris lumbricoides. We found no evidence of significant intervention effects on the overall prevalence and intensity of Trichuris trichiura, hookworm, or Schistosoma mansoni reinfection. Provision of school-based sanitation, water quality, and hygiene improvements may reduce reinfection of STHs after school-based deworming, but the magnitude of the effects may be sex-and helminth species-specific.

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Section: Discussionmentioning

confidence: 99%

The Impact of a School-Based Hygiene, Water Quality and Sanitation Intervention on Soil-Transmitted Helminth Reinfection: A Cluster-Randomized Trial

Freeman¹,

Clasen²,

Brooker³

et al. 2013

The American Society of Tropical Medicine and Hygiene

120

117

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“…Available data for Uganda indicate substantially higher rates of hookworm infestation in different settings (36,(60)(61)(62) . The atlas of human helminths in East Africa reports that at 6·5 %, the Central Region has the lowest prevalence of hookworm infestation in Uganda (19) . Ruralurban differences could account for the low prevalence we found as lower prevalence of hookworm infestation has been demonstrated in urban areas compared with rural areas (63)(64)(65) , although contradictory data have been reported from Zanzibar (66) .…”

Section: Discussionmentioning

confidence: 99%

The aetiology of anaemia during pregnancy: a study to evaluate the contribution of iron deficiency and common infections in pregnant Ugandan women

Baingana

Enyaru

Tjalsma

et al. 2014

Public Health Nutr.

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Objective: To describe the aetiology of anaemia in pregnant Ugandan women and explore Fe deficiency and common infections as contributors to anaemia in this population. Design: Cross-sectional study in which Hb, ferritin, transferrin receptor (sTfR), C-reactive protein, α-1 acid glycoprotein, hepcidin, malaria, hookworm infestation, syphilis and Helicobacter pylori infection were assessed. Setting: Antenatal care clinic at Kawempe Health Centre, Kampala, Uganda. Subjects: HIV-negative women (n 151) in their first or second pregnancy at 10-16 weeks' gestation. Results: The prevalence of anaemia was 29·1 %. Fe deficiency was 40·4 % and 14·6 % based on ferritin <30 μg/l and on adjusted ferritin <12 μg/l respectively, and 6·6 % based on sTfR >8·3 μg/ml. The prevalence of Fe-deficiency anaemia was 9·3 % based on ferritin <30 μg/l, 6·6 % based on adjusted ferritin <12 μg/l and 4·3 % based on sTfR >8·3 μg/ml. Hepcidin concentration was positively correlated with ferritin concentration (n 151, r = 0·578, P < 0·00001). H. pylori infection was highly prevalent (70 %) while malaria, hookworm infestation and syphilis were not common. Of all women, 60·3 % had α-1 acid glycoprotein >1 g/l and/or C-reactive protein >5 mg/l. Malaria parasitaemia (OR = 6·85; 95 % CI 1·25, 37·41, P = 0·026) and Fe deficiency defined using sTfR (OR = 5·58; 95 % CI 1·26, 24·80, P = 0·024) were independently and positively associated with anaemia. Populationattributable risk factors for anaemia for raised C-reactive protein, Fe deficiency defined by sTfR >8·3 μg/ml and presence of malaria parasites were 41·6 (95 % CI 11·1, 72·2) %, 13·5 (95 % CI 2·0, 25·0) % and 12·0 (95 % CI 1·4, 22·6) %, respectively. Conclusions: Infections and inflammation are of greater significance than Fe deficiency in the aetiology of anaemia in pregnant Ugandan women during the first trimester. Keywords Anaemia Iron status Pregnancy Infection UgandaNearly 25 % of the world's population suffers from anaemia, with pregnant women and children of pre-school age the most affected (1) . In Uganda, anaemia is the third leading cause of in-patient mortality (2) . In 2011, 49 % of under-fives, 23 % of women of child-bearing age and 31 % of pregnant women in Uganda had anaemia (3) . Anaemia in developing countries has a multifactorial aetiology which includes Fe deficiency (ID) due to dependence on predominantly plant-based diets from which adequate Fe cannot be absorbed (4,5) . Infections such as malaria and hookworm infestation also contribute significantly to the high prevalence of anaemia in many settings (6) . Additionally, infection and inflammation defined by raised biomarkers contribute to anaemia as was demonstrated in a study in Malawi in which C-reactive protein (CRP) was elevated in 73·5 % of anaemic pregnant women who were Fe-replete by bone marrow assessment (7) . Hinderaker et al. (8) also found an association between elevated CRP and anaemia in pregnant women in rural Tanzania. More recently, Helicobacter pylori, the most common infection globally, has been

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“…This is due in part to the logistical advantages of school-based treatment, and in part to a perception of greater benefit connected with deworming in SAC. 8 The majority of research defining burden has also been performed in SAC, 9 however PSAC can also have considerable prevalence of STH infection 10,11 and experience morbidity. Furthermore, evidence does exist that PSAC benefit from deworming, [12][13][14] and others have advocated for their inclusion in MDA.…”

Section: Introductionmentioning

confidence: 99%

“…9,20,21 Plausible mechanisms are sanitation and hygiene conditions that favor STH transmission. 22,23 This susceptibility of slum areas, which house an estimated one-third of the world's population, 24 has been periodically recognized and addressed through deworming campaigns 21,25 and intervention trials 14,[26][27][28] ; however, there is no explicit guidance or consistent practice on distinguishing slums from other areas in agro-ecological zoning.…”

Section: Introductionmentioning

confidence: 99%

Soil-Transmitted Helminths in Pre-School-Aged and School-Aged Children in an Urban Slum: A Cross-Sectional Study of Prevalence, Distribution, and Associated Exposures

Davis¹,

Worrell²,

Wiegand³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Soil-transmitted helminths (STHs) are controlled by regular mass drug administration. Current practice targets school-age children (SAC) preferentially over pre-school age children (PSAC) and treats large areas as having uniform prevalence. We assessed infection prevalence in SAC and PSAC and spatial infection heterogeneity, using a cross-sectional study in two slum villages in Kibera, Nairobi. Nairobi has low reported STH prevalence. The SAC and PSAC were randomly selected from the International Emerging Infections Program's surveillance platform. Data included residence location and three stools tested by Kato-Katz for STHs. Prevalences among 692 analyzable children were any STH: PSAC 40.5%, SAC 40.7%; Ascaris: PSAC 24.1%, SAC 22.7%; Trichuris: PSAC 24.0%, SAC 28.8%; hookworm 0.1%. The STH infection prevalence ranged from 22% to 71% between sub-village sectors. The PSAC have similar STH prevalences to SAC and should receive deworming. Small areas can contain heterogeneous prevalences; determinants of STH infection should be characterized and slums should be assessed separately in STH mapping.

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An updated atlas of human helminth infections: the example of East Africa

Cited by 162 publications

References 46 publications

The Impact of a School-Based Hygiene, Water Quality and Sanitation Intervention on Soil-Transmitted Helminth Reinfection: A Cluster-Randomized Trial

The Impact of a School-Based Hygiene, Water Quality and Sanitation Intervention on Soil-Transmitted Helminth Reinfection: A Cluster-Randomized Trial

The aetiology of anaemia during pregnancy: a study to evaluate the contribution of iron deficiency and common infections in pregnant Ugandan women

Soil-Transmitted Helminths in Pre-School-Aged and School-Aged Children in an Urban Slum: A Cross-Sectional Study of Prevalence, Distribution, and Associated Exposures

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