Effect of Sanitation on Soil-Transmitted Helminth Infection: Systematic Review and Meta-Analysis

Ziegelbauer, Kathrin; Speich, Benjamin; Mäusezahl, Daniel; Bos, Robert; Keiser, Jennifer; Utzinger, Jürg

doi:10.1371/journal.pmed.1001162

Cited by 490 publications

(414 citation statements)

References 78 publications

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“…Increased durations among children of less educated mothers, in turn, may result from such women being less aware of the importance of improved hygiene practices in limiting infection exposure (Wani SA et al, 2007). For A. lumbricoides, the increased infection durations in households with no indoor bathrooms is consistent with reports that poor sanitation facilities increases the risk of A. lumbricoides infections (Strunz EC et al, 2014;Ziegelbauer K et al, 2012). Finally, the association of reduced water access and dirt flooring with increased E. intestinalis trophozoite and fecal cyst counts (Langford TD et al, 2002;Venkatesan et al, 1996).…”

Section: Discussionsupporting

confidence: 57%

Household and personal factors are sources of heterogenity in intestinal parasite clearance among Mexican children 6–15 months of age supplemented with vitamin A and zinc

Srinivasan¹,

Lawa

Rosado

et al. 2016

Acta Tropica

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Z., Household and personal factors are sources of heterogenity in intestinal parasite clearance among Mexican children 6ndash15 months of age supplemented with vitamin A and zinc.Acta Tropica http://dx.doi.org/10. 1016/j.actatropica.2015.12.001 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Household Graphical Abstract Highlights Gut parasite clearance heterogeneity evaluated among supplemented children. 76  Vitamin A-zinc effects on Giardia or Ascaris clearance lower with no piped water access. 88 Zinc efficacy on E. histolytica clearance greater when mothers< 6 years of education. 85  Clearance heterogeneity is due to exposure risk differences and baseline immune responses. 90 ABSTRACT A randomised, double-blind, placebo-controlled trial was carried out among Mexico children aged 6-15 months to determine how household characteristics modify vitamin A and zinc supplementation efficacy on Ascaris lumbricoides, Giardia intestinalis and Entamoeba histolytica/E. dispar infection durations. Children assigned to receive vitamin A every 2 months, a daily zinc supplement, a combined vitamin A-zinc supplement or a placebo were followed for 1 year. Parametric hazard models were fit to infection durations stratified by personal and household factors. Children supplemented with vitamin A and zinc combined from households lacking piped water and children in all three treatment arms from households with dirt floors had longer G. intestinalis and A. lumbricoides infection durations than their counterparts, respectively. Shorter E. histolytica/E.dispar durations were found among zinc-supplemented children of mothers who had < 6 years of education and no indoor bathrooms. Heterogeneity in supplementation efficacy among children may reflect differences in exposure risk and baseline immune responses.

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Section: Discussionsupporting

confidence: 57%

Household and personal factors are sources of heterogenity in intestinal parasite clearance among Mexican children 6–15 months of age supplemented with vitamin A and zinc

Srinivasan¹,

Lawa

Rosado

et al. 2016

Acta Tropica

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“…The lower prevalence of STH infections observed among pupils from WASH resources programming schools compared with those from non-WASH resource programming schools, further provides evidence to support the ongoing discussion that WASH resources may have secondary influence on the transmission of STH (Freeman et al 2012(Freeman et al , 2013Ziegelbauer et al 2012;Campbell et al 2014). However, STH prevalence levels in WASH resourced schools are still above mandatory treatment levels (i.e.…”

Section: Discussionmentioning

confidence: 70%

A preliminary survey of school-based water, sanitation, hygiene (WASH) resources and soil-transmitted helminthiasis in eight public schools in Odeda LGA, Ogun State, Nigeria

et al. 2017

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This cross-sectional study was undertaken to assess the status of school-based water, sanitation and hygiene (WASH) resources and soil-transmitted helminthiasis (STH) in Odeda, Ogun State, Nigeria. The status and condition of WASH resources were determined in eight selected schools (three with WASH support and five without). Stool samples were also collected from 428 pupils from both school categories and screened for STH infections. Findings showed that water and sanitation conditions of WASH resource programming schools were better than those in schools without WASH support. However, pupils' knowledge about STH infections and basic hygiene were not significantly different between both categories of school (P > 0·05). The prevalence of Hookworm, Ascariasis and Trichuriasis cases recorded were 26·2, 18·2 and 1·6% respectively, with an overall prevalence of 33·4%. By school categories, Ascariasis (14·9 vs 20·6), Hookworm (17·7 vs 32·0), Trichuriasis (1·7 vs 1·6) and, any STH prevalence (27·4 vs 37·5) were recorded for schools with WASH resource programming and those without respectively. A greater portion of the infected children 95 (66·4%) were from schools without WASH support. Our findings imply that WASH resource may have very positive impact on the control of STH among school children. However, there is need for improvement on coverage, adequacy and maintenance of WASH facilities in school.

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“…The distribution of infections is governed by social-ecological systems with poverty playing a key role in maintaining high levels of endemicity. Indeed, the highest rates and intensity of infection and public health burden are concentrated in poor communities in tropical and subtropical areas (de Silva et al, 2003;Tchuem Tchuenté, 2011;Lustigman et al, 2012;Ziegelbauer et al, 2012). The highest infection intensities are usually observed in schoolaged children, whilst there is a decline in prevalence and intensity of infection with age (Anderson and May, 1985;de Silva et al, 2003;Bethony et al, 2006;Brooker et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Spatial analysis and risk mapping of soil-transmitted helminth infections in Brazil, using Bayesian geostatistical models

et al. 2013

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Abstract. Soil-transmitted helminths (Ascaris lumbricoides, Trichuris trichiura and hookworm) negatively impact the health and wellbeing of hundreds of millions of people, particularly in tropical and subtropical countries, including Brazil. Reliable maps of the spatial distribution and estimates of the number of infected people are required for the control and eventual elimination of soil-transmitted helminthiasis. We used advanced Bayesian geostatistical modelling, coupled with geographical information systems and remote sensing to visualize the distribution of the three soil-transmitted helminth species in Brazil. Remotely sensed climatic and environmental data, along with socioeconomic variables from readily available databases were employed as predictors. Our models provided mean prevalence estimates for A. lumbricoides, T. trichiura and hookworm of 15.6%, 10.1% and 2.5%, respectively. By considering infection risk and population numbers at the unit of the municipality, we estimate that 29.7 million Brazilians are infected with A. lumbricoides, 19.2 million with T. trichiura and 4.7 million with hookworm. Our model-based maps identified important risk factors related to the transmission of soiltransmitted helminths and confirm that environmental variables are closely associated with indices of poverty. Our smoothed risk maps, including uncertainty, highlight areas where soil-transmitted helminthiasis control interventions are most urgently required, namely in the North and along most of the coastal areas of Brazil. We believe that our predictive risk maps are useful for disease control managers for prioritising control interventions and for providing a tool for more efficient surveillance-response mechanisms.

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Effect of Sanitation on Soil-Transmitted Helminth Infection: Systematic Review and Meta-Analysis

Abstract: A systematic review and meta-analysis by Kathrin Ziegelbauer and colleagues finds that sanitation is associated with a reduced risk of transmission of helminthiases to humans.

Cited by 490 publications

References 78 publications

Household and personal factors are sources of heterogenity in intestinal parasite clearance among Mexican children 6–15 months of age supplemented with vitamin A and zinc

Household and personal factors are sources of heterogenity in intestinal parasite clearance among Mexican children 6–15 months of age supplemented with vitamin A and zinc

A preliminary survey of school-based water, sanitation, hygiene (WASH) resources and soil-transmitted helminthiasis in eight public schools in Odeda LGA, Ogun State, Nigeria

Spatial analysis and risk mapping of soil-transmitted helminth infections in Brazil, using Bayesian geostatistical models

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