Model-based geostatistical design and analysis of prevalence for soil-transmitted helminths in Kenya: Results from ten-years of the Kenya national school-based deworming programme

Okoyo, Collins; Minnery, Mark; Orowe, Idah; Owaga, Chrispin; Campbell, Suzy J.; Wambugu, Christin; Olick, Nereah; Hagemann, Jane; Omondi, Wyckliff P.; McCracken, Kate; Montresor, Antonio; Medley, Graham F.; Fronterre, Claudio; Diggle, Peter; Mwandawiro, Charles

doi:10.1016/j.heliyon.2023.e20695

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…This study offers an in-depth evaluation of the prevalence, intensity and associated risk factors of STH in selected schools participating in the NSBDP within Trans Mara West sub-county Narok county, Kenya. Narok has consistently exhibited a prevalence exceeding 20% for any STH infection since commencement of the NSBDP and up to this study [ 17 ]. The data generated from this study will contribute to the existing knowledge and aligns with the overarching objective of eliminating NTDs by 2030 [ 30 ].…”

Section: Discussionmentioning

confidence: 81%

“…A comprehensive monitoring and evaluation (M & E) process measured the impact of the NSBDP on reducing the burden of STH and schistosomes through repeat cross-sectional surveys pre and post mass drug administration (MDA). The results of these have been published for baseline [ 14 ], first three years [ 15 ], after five years [ 13 ] and year 6 (the year 2018) results [ 16 ] and more recently after this study year 10 results [ 17 ]. Generally, at baseline Narok and Vihiga counties which fall in the Rift Valley and Western regions respectively of Kenya had a prevalence of above 50% for any STH infection [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of soil-transmitted helminthiasis among school-aged children in pastoralist communities of Kenya: A cross-sectional study

Kihoro,

Mulewa,

Okoyo

et al. 2024

PLoS ONE

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Introduction Soil-transmitted helminthiasis (STH) are a major public health problem in Sub-Saharan Africa. In Kenya, the National School Based Deworming Program (NSBDP) was launched in 2012 with a goal of reducing STH prevalence in school-aged children (SAC) to <1%, however monitoring and evaluation results have consistently showed > 20% prevalence in Narok County. We conducted a study to investigate factors associated with STH infections among SAC in Narok County. Methodology A cross-sectional study was conducted among 514 SAC from five schools in Trans Mara West sub-county, Narok County. The sub-county was selected because it had participating schools within the NSBDP with a high prevalence of STH infection. Participants were selected using systematic random sampling. Stool samples collected from participants were examined for STH eggs using Kato-Katz technique. An open data kit questionnaire was used to collect socio-demographics, household, and STH knowledge information from 139 of the 514 SAC. Descriptive statistics was used to summarize the data, prevalence and mean intensity of infections were calculated, and logistic regression used to determine factors associated with STH infections. Results The overall prevalence of any STH infection was 24.6% (95%CI: 21.1–28.6). Trichuris trichiura 14.4% (95%CI: 11.7–17.8), Ascaris lumbricoides 12.5% (95%CI: 9.9–15.7) and hookworm 0%. From multivariable analysis the only factors significantly associated with increased risk of STH infection were, children attending Karda and Nkarano schools with aOR = 5.29 (95%CI: 1.45–19.24); p = 0.011 and aOR = 4.53 (95%CI: 1.29–15.97); p = 0.019 respectively. For A. lumbricoides, children attending Nkarano School were associated with a significant risk of infection with aOR = 7.81 (95%CI: 1.81–33.63); p = 0.006. Conclusions Despite the ongoing work of NSBDP, the STH prevalence is still ≥ 20% in Trans Mara West sub-county Narok County, among SAC. This underscores the need for continued annual MDA. Additionally, if possible, drug combinations may effectively manage T. trichiura, the region’s most common helminth. The study found a correlation between children attending specific schools and STH infection risk, suggesting the importance of health education and improved water, sanitation, and hygiene practices holistically both in schools and associated catchment areas that can act as STH reservoirs to alleviate the burden of STH.

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Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Epidemiology of soil-transmitted helminthiasis among school-aged children in pastoralist communities of Kenya: A cross-sectional study

Kihoro,

Mulewa,

Okoyo

et al. 2024

PLoS ONE

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“…Five years after implementing school-based PC, Kenya succeeded in a significant reduction (61.7%) of the prevalence of STH infections [ 4 ]. However, a 2021 survey of the school-based PC program showed that the prevalence of STH infections remained high in the western part of the country (10–20%) among school children [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of copromicroscopy, multiplex-qPCR and antibody serology for monitoring of human ascariasis in endemic settings

Mugo,

Rausch,

Musimbi

et al. 2024

PLoS Negl Trop Dis

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Background The standard diagnosis of Ascaris lumbricoides and other soil-transmitted helminth (STH) infections relies on the detection of worm eggs by copromicroscopy. However, this method is dependent on worm patency and shows only limited accuracy in low-intensity infection settings. We aimed to decipher the diagnostic accuracy of different antibodies using various Ascaris antigens in reference to copromicroscopy and quantitative PCR (qPCR), four months after national STH preventative chemotherapy among school children in western Kenya. Methodology STH infection status of 390 school children was evaluated via copromicroscopy (Kato-Katz and mini-FLOTAC) and qPCR. In parallel, Ascaris-specific antibody profiles against larval and adult worm lysates, and adult worm excretory-secretory (ES) products were determined by enzyme-linked immunosorbent assay. Antibody cross-reactivity was evaluated using the closely related zoonotic roundworm species Toxocara cati and Toxocara canis. The diagnostic accuracy of each antibody was evaluated using receiver operating curve analysis and the correspondent area under the curve (AUC). Principal findings Ascaris was the predominant helminth infection with an overall prevalence of 14.9% (58/390). The sensitivity of mini-FLOTAC and Kato-Katz for Ascaris diagnosis reached only 53.5% and 63.8%, respectively compared to qPCR. Although being more sensitive, qPCR values correlated with microscopic egg counts (R = -0.71, P<0.001), in contrast to antibody levels. Strikingly, IgG antibodies recognizing the ES products of adult Ascaris worms reliably diagnosed active Ascaris infection as determined by qPCR and microscopy, with IgG1 displaying the highest accuracy (AUC = 0.83, 95% CI: 0.75–0.91). Conclusion IgG1 antibody responses against adult Ascaris-ES products hold a promising potential for complementing the standard fecal and molecular techniques employed for monitoring Ascaris infections. This is of particular importance in the context of deworming programs as the antibody diagnostic accuracy was independent of egg counts.

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Using geostatistics to fight neglected tropical diseases

Purkiss,

Clark,

Giorgi

2024

Significance

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Model-based geostatistical design and analysis of prevalence for soil-transmitted helminths in Kenya: Results from ten-years of the Kenya national school-based deworming programme

Cited by 4 publications

References 19 publications

Epidemiology of soil-transmitted helminthiasis among school-aged children in pastoralist communities of Kenya: A cross-sectional study

Epidemiology of soil-transmitted helminthiasis among school-aged children in pastoralist communities of Kenya: A cross-sectional study

Evaluation of copromicroscopy, multiplex-qPCR and antibody serology for monitoring of human ascariasis in endemic settings

Using geostatistics to fight neglected tropical diseases

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