Monitoring the impact of a national school based deworming programme on soil-transmitted helminths in Kenya: the first three years, 2012 – 2014
| Autor: | M. C. Freeman, Sammy M. Njenga, Birgit Nikolay, Mariam T. Mwanje, Charles Mwandawiro, Joshua V. Garn, Dunstan A Mukoko, Rachel L. Pullan, Elses Simiyu, Jimmy H. Kihara, Simon Brooker, Collins Okoyo |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Male
Veterinary medicine medicine.medical_specialty Kenya Adolescent Cross-sectional study education 030231 tropical medicine Helminthiasis School-based deworming Deworming Soil Young Adult 03 medical and health sciences 0302 clinical medicine Helminths Environmental health parasitic diseases Prevalence medicine Animals Humans 030212 general & internal medicine Ascaris lumbricoides Trichuris trichiura Child Mass drug administration Anthelmintics Schools biology business.industry Research medicine.disease biology.organism_classification Cross-Sectional Studies Infectious Diseases Hookworms Child Preschool Tropical medicine Female Parasitology business |
| Zdroj: | Parasites & Vectors |
| ISSN: | 1756-3305 |
| DOI: | 10.1186/s13071-016-1679-y |
| Popis: | Background In 2012, the Kenyan Ministries of Health and of Education began a programme to deworm all school-age children living in areas at high risk of soil-transmitted helminths (STH) and schistosome infections. The impact of this school-based mass drug administration (MDA) programme in Kenya is monitored by the Kenya Medical Research Institute (KEMRI) as part of a five-year (2012–2017) study. This article focuses on the impact of MDA on STH infections and presents the overall achieved reductions from baseline to mid-term, as well as yearly patterns of reductions and subsequent re-infections per school community. Methods The study involved a series of pre- and post-intervention, repeat cross-sectional surveys in a representative, stratified, two-stage sample of schools across Kenya. The programme contained two tiers of monitoring; a national baseline and mid-term survey including 200 schools, and surveys conducted among 60 schools pre- and post-intervention. Stool samples were collected from randomly selected school children and tested for helminth infections using Kato-Katz technique. The prevalence and mean intensity of each helminth species were calculated at the school and county levels and 95 % confidence intervals (CIs) were obtained by binomial and negative binomial regression, respectively, taking into account clustering by schools. Results The overall prevalence of STH infection at baseline was 32.3 % (hookworms: 15.4 %; Ascaris lumbricoides: 18.1 %; and Trichuris trichiura: 6.7 %). After two rounds of MDA, the overall prevalence of STH had reduced to 16.4 % (hookworms: 2.3 %; A. lumbricoides: 11.9 %; and T. trichiura: 4.5 %). The relative reductions of moderate to heavy intensity of infections were 33.7 % (STH combined), 77.3 % (hookworms) and 33.9 % (A. lumbricoides). For T. trichiura, however, moderate to heavy intensity of infections increased non-significantly by 18.0 % from baseline to mid-term survey. Conclusion The school-based deworming programme has substantially reduced STH infections, but because of ongoing transmission additional strategies may be required to achieve a sustained interruption of transmission. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1679-y) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|