It is estimated that in Latin America and the Caribbean (LAC) at least 13.9 million preschool age and 35.4 million school age children are at risk of infections by soil-transmitted helminths (STH): Ascaris lumbricoides, Trichuris trichiura and hookworms (Necator americanus and Ancylostoma duodenale). Although infections caused by this group of parasites are associated with chronic deleterious effects on nutrition and growth, iron and vitamin A status and cognitive development in children, few countries in the LAC Region have implemented nationwide surveys on prevalence and intensity of infection. The aim of this study was to identify gaps on the mapping of prevalence and intensity of STH infections based on data published between 2000 and 2010 in LAC, and to call for including mapping as part of action plans against these infections. A total of 335 published data points for STH prevalence were found for 18 countries (11.9% data points for preschool age children, 56.7% for school age children and 31.3% for children from 1 to 14 years of age). We found that 62.7% of data points showed prevalence levels above 20%. Data on the intensity of infection were found for seven countries. The analysis also highlights that there is still an important lack of data on prevalence and intensity of infection to determine the burden of disease based on epidemiological surveys, particularly among preschool age children. This situation is a challenge for LAC given that adequate planning of interventions such as deworming requires information on prevalence to determine the frequency of needed anthelmintic drug administration and to conduct monitoring and evaluation of progress in drug coverage.
Abstract. We present an example of a tool for quantifying the burden, the population in need of intervention and resources need to contribute for the control of soil-transmitted helminth (STH) infection at multiple administrative levels for the region of Latin America and the Caribbean (LAC). The tool relies on published STH prevalence data along with data on the distribution of several STH transmission determinants for 12,273 sub-national administrative units in 22 LAC countries taken from national censuses. Data on these determinants was aggregated into a single risk index based on a conceptual framework and the statistical significance of the association between this index and the STH prevalence indicators was tested using simple linear regression. The coefficient and constant from the output of this regression was then put into a regression formula that was applied to the risk index values for all of the administrative units in order to model the estimated prevalence of each STH species. We then combine these estimates with population data, treatment thresholds and unit cost data to calculate total control costs. The model predicts an annual cost for the procurement of preventive chemotherapy of around US$ 1.7 million and a total cost of US$ 47 million for implementing a comprehensive STH control programme targeting an estimated 78.7 million school-aged children according to the WHO guidelines throughout the entirety of the countries included in the study. Considerable savings to this cost could potentially be made by embedding STH control interventions within existing health programmes and systems. A study of this scope is prone to many limitations which restrict the interpretation of the results and the uses to which its findings may be put. We discuss several of these limitations.
BackgroundMany small studies have been done in Honduras estimating soil-transmitted helminthiasis (STH) prevalence but a country-wide study was last done in 2005. The country has the highest burden of malaria among all Central American countries. The present study was done to estimate country-wide STH prevalence and intensity, malaria prevalence and nutritional status in school going children.Methods and FindingsA cross-sectional study was conducted following PAHO/WHO guidelines to select a sample of school going children of 3rd to 5th grades, representative of ecological regions in the country. A survey questionnaire was filled; anthropometric measurements, stool sample for STH and blood sample for malaria were taken. Kato-Katz method was used for STH prevalence and intensity and rapid diagnostic tests, microscopy, and polymerase chain reaction (PCR) were used for malaria parasite detection. A total of 2554 students were studied of which 43.5% had one or more STH. Trichuriasis was the most prevalent (34%) followed by ascariasis (22.3%) and hookworm (0.9%). Ecological regions II (59.7%) and VI (55.6%) in the north had the highest STH prevalence rates while IV had the lowest (10.6%). Prevalence of one or more high intensity STH was low (1.6%). Plasmodium vivax was detected by PCR in only 5 students (0.2%), all of which belonged to the same municipality; no P. falciparum infection was detected. The majority of children (83%) had normal body mass index for their respective age but a significant proportion were overweight (10.42%) and obese (4.35%).ConclusionsBiannual deworming campaigns would be necessary in ecological regions II and VI, where STH prevalence is >50%. High prevalence of obesity in school going children is a worrying trend and portends of future increase in obesity related diseases. Malaria prevalence, both symptomatic and asymptomatic, was low and provides evidence for Honduras to embark on elimination of the disease.
: participación en el trabajo de campo Todos los autores participaron en el desarrollo del protocolo, el análisis de la información y la elaboración del artículo científico. Introducción. El Salvador no cuenta con datos actualizados de prevalencia en menores de 15 años de la infección por helmintos transmitidos por contacto con el suelo. Además, al ser uno de los países en las Américas que reporta un número bajo de casos de malaria, se considera que su eliminación allí es factible. Objetivo. Determinar la prevalencia y la intensidad de la infección por geohelmintos y la prevalencia de Plasmodium spp. en escolares de 8 a 10 años de El Salvador. Materiales y métodos. Se hizo un estudio de corte transversal en las cinco zonas eco-epidemiológicas del país (planicie costera, depresión central, cadena volcánica, cadena costera y zona montañosa). La presencia de geohelmintiasis se estudió en 1.325 estudiantes y, la de malaria, en 152. Se utilizó la técnica de Kato-Katz para la detección de geohelmintos, y para el diagnóstico de la malaria, una prueba rápida, el estudio mediante microscopía y la prueba de reacción en cadena de la polimerasa. Resultados. La prevalencia total de geohelmintiasis fue de 7,9 % (IC 95% 6,6-9,5). En la planicie costera fue de 14,9 % (IC 95% 10,9-19,7); en la depresión central, de 9,4 % (IC 95% 6,5-13,3); en la cadena volcánica, de 6,6 % (IC 95% 4,2-10,5); en la cadena costera, de 5,9 % (IC 95% 3,8-9,4), y en la cadena montañosa, de 2,6 % (IC 95% 1,4-5,7). La proporción de infección de gran intensidad debida a cualquiera de las especies de geohelmintos fue de 0,3 %. No se encontraron escolares infectados con Plasmodium spp. Conclusión. La prevalencia de geohelmintos fue baja y la especie más prevalente fue Trichuris trichiura. La intensidad de la infección debida a cualquiera de las especies de geohelmintos fue leve (<1 %). Los factores de riesgo asociados a la infección por geohelmintos fueron la defecación al aire libre, no usar calzado y vivir en la planicie costera. Prevalencia e intensidad de la infección por geohelmintos y prevalencia de la malaria en escolares de El SalvadorPalabras clave: helmintos, helmintiasis, malaria, Ascaris, Trichuris, infecciones por uncinaria, prevalencia, El Salvador. doi: http://dx.doi.org/10.7705/biomedica.v35i3.2408 Prevalence and intensity of infection by soil-transmitted helminths and prevalence of malaria among schoolchildren in El SalvadorIntroduction: El Salvador does not have recent data on the prevalence of infection with soil-transmitted helminths among children aged under 15 years of age. As one of the countries in the Americas that reports few malaria cases, eradication of this disease from El Salvador is considered to be feasible. Objective: To determine the prevalence and intensity of infection by soil-transmitted helminths, as well as the prevalence of Plasmodium spp. in schoolchildren aged 8-10. Materials and methods: A cross-sectional study was carried out in each of the five eco-epidemiological zones of the country (coastal plain, central bas...
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