The Epidemiology of Soil-Transmitted Helminths in Bihar State, India

Abstract

BackgroundSoil-transmitted helminths (STHs) infect over a billion individuals worldwide. In India, 241 million children are estimated to need deworming to avert the negative consequences STH infections can have on child health and development. In February-April 2011, 17 million children in Bihar State were dewormed during a government-led school-based deworming campaign. Prior to programme implementation, a study was conducted to assess STH prevalence in the school-age population to direct the programme. The study also investigated risk factors for STH infections, including caste, literacy, and defecation and hygiene practices, in order to inform the development of complementary interventions.MethodsA cross-sectional survey was conducted among children in 20 schools in Bihar. In addition to providing stool samples for identification of STH infections, children completed a short questionnaire detailing their usual defecation and hand-hygiene practices. Risk factors for STH infections were explored.ResultsIn January-February 2011, 1279 school children aged four to seventeen provided stool samples and 1157 children also completed the questionnaire. Overall, 68% of children (10-86% across schools) were infected with one or more soil-transmitted helminth species. The prevalence of ascariasis, hookworm and trichuriasis was 52%, 42% and 5% respectively. The majority of children (95%) practiced open defecation and reported most frequently cleansing hands with soil (61%). Increasing age, lack of maternal literacy and certain castes were independently associated with hookworm infection. Absence of a hand-washing station at the schools was also independently associated with A. lumbricoides infection.ConclusionsSTH prevalence in Bihar is high, and justifies mass deworming in school-aged children. Open defecation is common-place and hands are often cleansed using soil. The findings reported here can be used to help direct messaging appropriate to mothers with low levels of literacy and emphasise the importance of water and sanitation in the control of helminths and other diseases.

Modeling the economic and epidemiologic impact of hookworm vaccine and mass drug administration (MDA) in Brazil, a high transmission setting

“…Relative reductions in total population prevalence with vaccination ranged from 1.0% to 46.7% at year 20, compared to annual MDA use with 56.2% coverage. A vaccine would potentially be effective in other high prevalence areas (e.g., India[41], Nigeria[42], and Lao People's Democratic Republic[43]).…”

Recent advances and perspectives in molecular epidemiology of Taenia solium cysticercosis

“…2) (Robertson et al, 2013(Robertson et al, , 2014. However, T. solium tapeworms have rarely been confirmed even through microscopic examination of feces for the soil transmitted helminthiases (STHs) (Carney et al, 1980;Saksirisampant et al, 2002;Belizario et al, 2004;Kepha et al, 2015;Greenland et al, 2015;Ngui et al, 2015). In most of STH surveys, there is no record of Taenia eggs.…”

Soil‐transmitted Helminthiasis in India

“…The initial national program to eliminate STH in India used a phased-in approach that began in 2011. At that time, approximately 17 million children living in Bihar state, in East India, participated in a government-led school-based deworming program to address the high prevalence (67.5%) of STH (Greenland et al, 2015). This program was considered one of the largest globally at the time.…”