School Water, Sanitation, and Hygiene, Soil-Transmitted Helminths, and Schistosomes: National Mapping in Ethiopia

Abstract

BackgroundIt is thought that improving water, sanitation, and hygiene (WASH) might reduce the transmission of schistosomes and soil-transmitted helminths, owing to their life cycles. However, few large-scale studies have yet assessed the real extent of associations between WASH and these parasites.Methodology/Principal FindingsIn the 2013–2014 Ethiopian national mapping of infections with these parasites, school WASH was assessed alongside infection intensity in children, mostly between 10 and 15 years of age. Scores were constructed reflecting exposure to schistosomes arising from water collection for schools, from freshwater sources, and the adequacy of school sanitation and hygiene facilities. Kendall’s τb was used to test the WASH scores against the school-level arithmetic mean intensity of infection with each parasite, in schools with at least one child positive for the parasite in question.WASH and parasitology data were available for 1,645 schools. More frequent collection of water for schools, from open freshwater sources was associated with statistically significantly higher Schistosoma mansoni infection intensity (Kendall’s τb = 0.097, 95% confidence interval, CI: 0.011 to 0.18), better sanitation was associated with significantly lower Ascaris lumbricoides intensity (Kendall’s τb = -0.067, 95% CI: -0.11 to -0.023) and borderline significant lower hookworm intensity (Kendall’s τb = -0.039, 95% CI: -0.090 to 0.012, P = 0.067), and better hygiene was associated with significantly lower hookworm intensity (Kendall’s τb = -0.076, 95% CI: -0.13 to -0.020). However, no significant differences were observed when comparing sanitation and infection with S. mansoni or Trichuris trichiura, or hygiene and infection with A. lumbricoides or T. trichiura.Conclusions/SignificanceImproving school WASH may reduce transmission of these parasites. However, different forms of WASH appear to have different effects on infection with the various parasites, with our analysis finding the strongest associations between water and S. mansoni, sanitation and A. lumbricoides, and hygiene and hookworm.

Intestinal parasites among rural school children in southern Ethiopia: A cross-sectional multilevel and zero-inflated regression model

“…Compared with the 24.6% prevalence found in Ethiopia (16), 26.3% in the Democratic Republic of Congo, and 26.5% found in Kenya (47, 48), we found a higher prevalence of T. trichiura infection. Our findings also revealed higher rates of A. lumbricoides infection compared with rates of 10.6% to 13% in other areas of southern Ethiopia (12, 49). The rate for hookworm infection in this study aligned with the 7.4% rate found during national mapping (49).…”

“…Our findings also revealed higher rates of A. lumbricoides infection compared with rates of 10.6% to 13% in other areas of southern Ethiopia (12, 49). The rate for hookworm infection in this study aligned with the 7.4% rate found during national mapping (49). However, it is lower than the 56.8% (16), 46.9% (50), and 18% reported in other regions of Ethiopia (24).…”

National mapping of soil-transmitted helminth and schistosome infections in Ethiopia

“…In addition, a questionnaire was conducted to collect information on water, sanitation and hygiene (WASH) at the school level. The results of this questionnaire and parasite infection for the rst round of survey were reported elsewhere by Grimes et al [21].…”

Influences of Land-Use Dynamics and Surface Water Systems Interactions on Water-Related Infectious Diseases—A Systematic Review

“…Further, there were missing studies in the literature on malaria with links to LULC in 2016 and 2017. It was identified that studies on hookworm were found only in 2016 [66].…”