Integrated School-Based Surveillance for Soil-Transmitted Helminth Infections and Lymphatic Filariasis in Gampaha District, Sri Lanka

Abstract

Abstract. We explored the practicality of integrating surveillance for soil-transmitted helminthiasis (STH, assessed by Kato-Katz) with transmission assessment surveys for lymphatic filariasis (LF) in two evaluation units (EUs) in Gampaha district, Sri Lanka (population 2.3 million). The surveys were performed 6 years after five annual rounds of mass drug administration with diethylcarbamazine and albendazole. Each transmission assessment survey tested children (N = 1,462 inland EU; 1,642 coastal EU) sampled from 30 primary schools. Low filarial antigenemia rates (0% and 0.1% for the inland and coastal EUs) suggest that LF transmission is very low in this district. The STH rates and stool sample participation rates were 0.8% and 61% (inland) and 2.8% and 58% (coastal). Most STH detected were low or moderate intensity Trichuris trichiura infections. The added cost of including STH testing was~$5,000 per EU. These results suggest that it is feasible to integrate school-based surveillance for STH and LF.

Periodic deworming practice in Sri Lanka: Is it based on evidence, misconceptions or commercialism?

“…A national survey done about 15 years ago (2002)(2003) reported that only 6.9% of children has geohelminths with very low prevalence of all three species (roundworm-2.8%, whipworm-4.0% and hookworm-1.2%) 9 . These low figures were confirmed by subsequent studies which identified regional variations with low-and high-prevalence areas [10][11][12] . A study done in 2012 reported an extremely low prevalence (1.8%) of all geohelminths 10 in the Gampaha district (a semi-urban district of Sri Lanka) and similar low rates (roundworm-2%, whipworm-0.7% and hookworm-5%) were reported in rural areas of Sri Lanka 11 .…”

“…These low figures were confirmed by subsequent studies which identified regional variations with low-and high-prevalence areas [10][11][12] . A study done in 2012 reported an extremely low prevalence (1.8%) of all geohelminths 10 in the Gampaha district (a semi-urban district of Sri Lanka) and similar low rates (roundworm-2%, whipworm-0.7% and hookworm-5%) were reported in rural areas of Sri Lanka 11 . In contrast, a study done in 2009 in the plantation sector spreading across Nuwara-Eliya, Badulla, Kegalle, Ratnapura and Kandy districts reported the prevalence of geo-helminths as 29% (roundworm-24%, whipworm-6% and hookworm-5%).…”

Factors Associated with the Performance and Cost-Effectiveness of Using Lymphatic Filariasis Transmission Assessment Surveys for Monitoring Soil-Transmitted Helminths: A Case Study in Kenya

“…As albendazole is effective against both LF and STH it has recently been proposed to integrate STH surveillance into the TAS to evaluate the impact of LF programs on STH, and thus guide the transition from community-based deworming for LF control to school-based deworming for STH control 6. Integrated assessment of STH within a TAS has to date been piloted in Benin, Tonga,7 and Sri Lanka 8…”

The Impact of Lymphatic Filariasis Mass Drug Administration Scaling Down on Soil-Transmitted Helminth Control in School-Age Children. Present Situation and Expected Impact from 2016 to 2020

“…WHO has published a protocol to help countries integrate STH data collection in TAS [13]. Two studies conducted in Sri Lanka and Burkina Faso on assessment of STH morbidity and prevalence during LF TAS enabled these countries to review their STH control strategies leading up to 2020 [14, 15]. STH data collected during TAS showed that in Burkina Faso SAC do not need deworming in area where LF MDA stopped; the STH prevalence and intensity had dropped significantly and the country is planning to review its strategy to consolidate these gains.…”