Soil-transmitted helminthiasis in four districts in Bangladesh: household cluster surveys of prevalence and intervention status.

Autor: Davlin SL; Children Without Worms, The Task Force for Global Health, 325 Swanton Way, Decatur, GA, USA., Jones AH; Children Without Worms, The Task Force for Global Health, 325 Swanton Way, Decatur, GA, USA., Tahmina S; Communicable Disease Control Department, Directorate General of Health Services, Ministry of Health and Family Welfare, Road # 29, New DOHS, Mohakhali, Dhaka, Bangladesh., Kawsar AA; Elimination of Lymphatic Filariasis & STH Control Program, Directorate General of Health Services, Ministry of Health & Family Welfare, Road # 29, New DOHS, Mohakhali, Dhaka, Bangladesh., Joshi A; Children Without Worms, The Task Force for Global Health, 325 Swanton Way, Decatur, GA, USA., Zaman SI; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, C/O DOHS, Road # 29, New DOHS, Mohakhali, Dhaka, Bangladesh., Rahman MM; Elimination of Lymphatic Filariasis & STH Control Program, Directorate General of Health Services, Ministry of Health & Family Welfare, Road # 29, New DOHS, Mohakhali, Dhaka, Bangladesh., Morawski BM; Children Without Worms, The Task Force for Global Health, 325 Swanton Way, Decatur, GA, USA., Deming MS; Children Without Worms, The Task Force for Global Health, 325 Swanton Way, Decatur, GA, USA., Imtiaz R; Children Without Worms, The Task Force for Global Health, 325 Swanton Way, Decatur, GA, USA., Karim MJ; Elimination of Lymphatic Filariasis & STH Control Program, Directorate General of Health Services, Ministry of Health & Family Welfare, Road # 29, New DOHS, Mohakhali, Dhaka, Bangladesh. jahirulkarim@gmail.com.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2020 May 12; Vol. 20 (1), pp. 672. Date of Electronic Publication: 2020 May 12.
DOI: 10.1186/s12889-020-08755-w
Abstrakt: Background: In 2016, after 8 years of twice-annual nationwide preventive chemotherapy (PC) administration to school-age children (SAC), the Bangladesh Ministry of Health & Family Welfare (MOHFW) sought improved impact and intervention monitoring data to assess progress toward the newly adopted goal of eliminating soil-transmitted helminthiasis (STH) as a public health problem.
Methods: We surveyed four Bangladeshi districts between August and October 2017. We conducted a multi-stage, cluster-sample, household survey which produced equal-probability samples for preschool-age children (PSAC; 1-4 years), SAC (5-14 years), and adults (≥ 15 years). Standardized questionnaires were administered, using Android-based smart phones running an Open Data Kit application. Stool samples were collected and testing for STH prevalence and infection intensity used the Kato-Katz technique.
Results: In all, 4318 stool samples were collected from 7164 participants. Estimates of STH prevalence by risk group in three of the four surveyed districts ranged from 3.4 to 5.0%, all with upper, 1-sided 95% confidence limits < 10%. However, STH prevalence estimates in Sirajganj District ranged from 23.4 to 29.1%. Infections in that district were spatially focal; four of the 30 survey clusters had > 50% prevalence in at least one risk group. Among all tested specimens, Ascaris lumbricoides was the most common STH parasite [8.2% (n = 352)], followed by Trichuris trichiura [0.9% (n = 37)], and hookworm [0.6% (n = 27)]. In each district, PC coverage among SAC was above the 75% program target but did not exceed 45% among PSAC in any district. Improved sanitation at home, school, or work was over 90% in all districts.
Conclusions: In the three low-prevalence districts, the MOHFW is considering decreasing the frequency of mass drug administration, per World Health Organization (WHO) guidelines. Also, the MOHFW will focus programmatic resources and supervisory efforts on Sirajganj District. Despite considering WHO guidance, the MOHFW will not expand PC administration to women of reproductive age partly due to the low prevalence of hookworm and T. trichiura, the STH parasites that contribute most to morbidity in that risk group. Data collected from surveys such as ours would help effectively guide future STH control efforts in Bangladesh and elsewhere.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje