Factors Associated with the Performance and Cost-Effectiveness of Using Lymphatic Filariasis Transmission Assessment Surveys for Monitoring Soil-Transmitted Helminths: A Case Study in Kenya

Smith, Jennifer L.; Sturrock, Hugh J. W.; Assefa, Liya; Nikolay, Birgit; Njenga, Sammy M.; Kihara, Jimmy; Mwandawiro, Charles; Brooker, Simon

doi:10.4269/ajtmh.14-0435

Cited by 15 publications

(15 citation statements)

References 25 publications

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“…It con rms Ethiopia as having a signi cant burden of both SCH and STH. In line with levels of infection found in neighbouring countries, such as Uganda [36], Tanzania [37] and Kenya [38]. Reducing SCH and STH infection in populous, high burden countries such as Ethiopia will be crucial for the global community to reach its ambitious 2020 and 2030 goals, under the umbrella of the WHO [1].…”

Section: Discussionmentioning

confidence: 99%

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

Leta

Mekete

Wuletaw

et al. 2020

Preprint

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Background: An accurate understanding of the geographical distributions of both soil-transmitted helminths (STHs; Ascaris lumbricoides, Trichuris trichiura, and the hookworms Necator americanus and Ancylostoma duodenale) and schistosomes (SCH; Schistosoma mansoni and S. haematobium) is pivotal to be able to effectively design and implement mass drug administration (MDA) programmes. The objective of this study was to provide up-to-date data on the distribution of both STH and SCH in Ethiopia to inform the design of the national control program and to be able to efficiently achieve the 75% MDA coverage target set by the WHO.Methods: Between 2013 and 2015, we assessed the distributions of STH and SCH infections in a nationwide survey covering 153,238 school-aged children (aged 5–15 years), from 625 woredas (districts), representing all nine Regional States and two City Administrations of Ethiopia. Nationwide disease maps were developed at the woreda level to enable recommendations on the design of the national MDA programme.Results: The prevalence of any STH infection across the study population was 21.7%, with A. lumbricoides (12.8%) being the most prevalent STH, followed by hookworms (7.6%) and T. trichiura (5.9%). The prevalence for any SCH was 4.0% in areas where both SCH species were evaluated. Schistosoma mansoni was the most prevalent SCH (3.5 vs 0.3%). STHs were more prevalent in southwest Ethiopia, whereas SCH was found mostly in the west and northeast of the country. The prevalence of moderate-to-heavy intensity infections was 2.0% for STHs and 1.6% for SCH. For STH, a total of 251 woredas were classified as moderately (n = 178) or highly endemic (n = 73), and therefore qualify for an annual and biannual MDA program, respectively. For SCH, 67 woredas were classified as endemic and 8 as highly endemic, and hence they require every two years and annual MDA programme, respectively.Conclusions: The results confirm that Ethiopia is endemic for both STHs and SCH, posing a significant public health problem. Following the WHO recommendations on mass drug administration, 18 and 14 million school-aged children are in need of MDA for STHs and SCH, respectively, based on the number of SACs that live on the eligible geographical areas.

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Section: Discussionmentioning

confidence: 99%

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

Leta

Mekete

Wuletaw

et al. 2020

Preprint

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“…Current guidelines recommend that monitoring is conducted in schools, as school children are the main targets of control [ 14 ]. More recently, transmission assessment surveys (TAS) for lymphatic filariasis have been proposed as an alternative platform for monitoring STH infection [ 15 ], and the implementation of TAS in the wider community provides the opportunity to reliably track STH across a range of age classes [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Should the Goal for the Treatment of Soil Transmitted Helminth (STH) Infections Be Changed from Morbidity Control in Children to Community-Wide Transmission Elimination?

et al. 2015

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“…The possibility of collecting fecal specimens in the field, adding a fixative, and analyzing the samples several days later in a central laboratory could overcome the time limitation of working on fresh samples, and hence improve the easiness and the quality of soil-transmitted helminthiasis diagnosis. For example, it has been suggested to integrate soil-transmitted helminthiasis within transmission assessment surveys (TAS) that are conducted in the context of the program to eliminate lymphatic filariasis [ 13 – 15 ]. Usually, the TAS team remains in a school (or a village) only for few hours for collecting and analyzing blood samples [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

How Long Can Stool Samples Be Fixed for an Accurate Diagnosis of Soil-Transmitted Helminth Infection Using Mini-FLOTAC?

Barda

Albonico²,

Ianniello

et al. 2015

PLoS Negl Trop Dis

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BackgroundKato-Katz is a widely used method for the diagnosis of soil-transmitted helminth infection. Fecal samples cannot be preserved, and hence, should be processed on the day of collection and examined under a microscope within 60 min of slide preparation. Mini-FLOTAC is a technique that allows examining fixed fecal samples. We assessed the performance of Mini-FLOTAC using formalin-fixed stool samples compared to Kato-Katz and determined the dynamics of prevalence and intensity estimates of soil-transmitted helminth infection over a 31-day time period.MethodologyThe study was carried out in late 2013 on Pemba Island, Tanzania. Forty-one children were enrolled and stool samples were subjected on the day of collection to a single Kato-Katz thick smear and Mini-FLOTAC examination; 12 aliquots of stool were fixed in 5% formalin and subsequently examined by Mini-FLOTAC up to 31 days after collection.Principal FindingsThe combined results from Kato-Katz and Mini-FLOTAC revealed that 100% of children were positive for Trichuris trichiura, 85% for Ascaris lumbricoides, and 54% for hookworm. Kato-Katz and Mini-FLOTAC techniques found similar prevalence estimates for A. lumbricoides (85% versus 76%), T. trichiura (98% versus 100%), and hookworm (42% versus 51%). The mean eggs per gram of stool (EPG) according to Kato-Katz and Mini-FLOTAC was 12,075 and 11,679 for A. lumbricoides, 1,074 and 1,592 for T. trichiura, and 255 and 220 for hookworm, respectively. The mean EPG from day 1 to 31 of fixation was stable for A. lumbricoides and T. trichiura, but gradually declined for hookworm, starting at day 15.Conclusions/SignificanceThe findings of our study suggest that for a qualitative diagnosis of soil-transmitted helminth infection, stool samples can be fixed in 5% formalin for at least 30 days. However, for an accurate quantitative diagnosis of hookworm, we suggest a limit of 15 days of preservation. Our results have direct implication for integrating soil-transmitted helminthiasis into transmission assessment surveys for lymphatic filariasis.

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Factors Associated with the Performance and Cost-Effectiveness of Using Lymphatic Filariasis Transmission Assessment Surveys for Monitoring Soil-Transmitted Helminths: A Case Study in Kenya

Cited by 15 publications

References 25 publications

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

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

Should the Goal for the Treatment of Soil Transmitted Helminth (STH) Infections Be Changed from Morbidity Control in Children to Community-Wide Transmission Elimination?

How Long Can Stool Samples Be Fixed for an Accurate Diagnosis of Soil-Transmitted Helminth Infection Using Mini-FLOTAC?

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