Associations between school- and household-level water, sanitation and hygiene conditions and soil-transmitted helminth infection among Kenyan school children

doi:10.1186/s13071-015-1024-x

. 2015 Aug 7:8:412.

doi: 10.1186/s13071-015-1024-x.

Associations between school- and household-level water, sanitation and hygiene conditions and soil-transmitted helminth infection among Kenyan school children

M C Freeman ¹, A N Chard ², B Nikolay ³, J V Garn ⁴, C Okoyo ⁵, J Kihara ⁶, S M Njenga ⁷, R L Pullan ⁸, S J Brooker ⁹, C S Mwandawiro ¹⁰

Affiliations

¹ Department of Environmental Health, Emory University, Atlanta, Georgia, USA. matthew.freeman@emory.edu.
² Department of Environmental Health, Emory University, Atlanta, Georgia, USA. achard@emory.edu.
³ Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. birgit.nikolay@lshtm.ac.uk.
⁴ Department of Environmental Health, Emory University, Atlanta, Georgia, USA. jgarn@emory.edu.
⁵ Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya. collinsomondiokoyo@gmail.com.
⁶ Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya. jimmykihara09@gmail.com.
⁷ Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya. SNjenga@kemri.org.
⁸ Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. Rachel.Pullan@lshtm.ac.uk.
⁹ Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. Simon.Brooker@lshtm.ac.uk.
¹⁰ Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya. CMwandawiro@kemri.org.

PMID: 26248869
PMCID: PMC4528701
DOI: 10.1186/s13071-015-1024-x

Associations between school- and household-level water, sanitation and hygiene conditions and soil-transmitted helminth infection among Kenyan school children

M C Freeman et al. Parasit Vectors. 2015.

. 2015 Aug 7:8:412.

doi: 10.1186/s13071-015-1024-x.

Authors

M C Freeman ¹, A N Chard ², B Nikolay ³, J V Garn ⁴, C Okoyo ⁵, J Kihara ⁶, S M Njenga ⁷, R L Pullan ⁸, S J Brooker ⁹, C S Mwandawiro ¹⁰

Affiliations

¹ Department of Environmental Health, Emory University, Atlanta, Georgia, USA. matthew.freeman@emory.edu.
² Department of Environmental Health, Emory University, Atlanta, Georgia, USA. achard@emory.edu.
³ Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. birgit.nikolay@lshtm.ac.uk.
⁴ Department of Environmental Health, Emory University, Atlanta, Georgia, USA. jgarn@emory.edu.
⁵ Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya. collinsomondiokoyo@gmail.com.
⁶ Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya. jimmykihara09@gmail.com.
⁷ Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya. SNjenga@kemri.org.
⁸ Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. Rachel.Pullan@lshtm.ac.uk.
⁹ Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. Simon.Brooker@lshtm.ac.uk.
¹⁰ Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya. CMwandawiro@kemri.org.

PMID: 26248869
PMCID: PMC4528701
DOI: 10.1186/s13071-015-1024-x

Abstract

Background: Soil-transmitted helminths, a class of parasitic intestinal worms, are pervasive in many low-income settings. Infection among children can lead to poor nutritional outcomes, anaemia, and reduced cognition. Mass treatment, typically administered through schools, with yearly or biannual drugs is inexpensive and can reduce worm burden, but reinfection can occur rapidly. Access to and use of sanitation facilities and proper hygiene can reduce infection, but rigorous data are scarce. Among school-age children, infection can occur at home or at school, but little is known about the relative importance of WASH in transmission in these two settings.

Methods: We explored the relationships between school and household water, sanitation, and hygiene conditions and behaviours during the baseline of a large-scale mass drug administration programme in Kenya. We assessed several WASH measures to quantify the exposure of school children, and developed theory and empirically-based parsimonious models.

Results: Results suggest mixed impacts of household and school WASH on prevalence and intensity of infection. WASH risk factors differed across individual worm species, which is expected given the different mechanisms of infection.

Conclusions: No trend of the relative importance of school versus household-level WASH emerged, though some factors, like water supply were more strongly related to lower infection, which suggests it is important in supporting other school practices, such as hand-washing and keeping school toilets clean.

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Figures

Fig. 1

Fig. 1

Prevalence of infection for combined helminth infection and individual species

Fig. 2

Fig. 2

Prevalence of school and household water and sanitation conditions

See this image and copyright information in PMC

References

1. Bethony J, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, Hotez PJ. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 2006;367(9521):1521–1532. doi: 10.1016/S0140-6736(06)68653-4. - DOI - PubMed
1. Pullan RL, Smith JL, Jasrasaria R, Brooker SJ. Global numbers of infection and disease burden of soil transmitted helminth infections in 2010. Parasit Vectors. 2014;7(1):37. doi: 10.1186/1756-3305-7-37. - DOI - PMC - PubMed
1. Brooker S. Estimating the global distribution and disease burden of intestinal nematode infections: adding up the numbers–a review. Int J Parasitol. 2010;40(10):1137–1144. doi: 10.1016/j.ijpara.201004004. - DOI - PMC - PubMed
1. Utzinger J, Raso G, Brooker S, de Savigny D, Tanner M, Ornbjerg N, Singer BH, N'Goran EK. Schistosomiasis and neglected tropical diseases: towards integrated and sustainable control and a word of caution. Parasitol. 2009;136(13):1859–1874. doi: 10.1017/S0031182009991600. - DOI - PMC - PubMed
1. Jia T-W, Melville S, Utzinger J, King CH, Zhou X-N. Soil-transmitted helminth reinfection after drug treatment: a systematic review and meta-analysis. PLoS Negl Trop Dis. 2012;6(5) doi: 10.1371/journal.pntd.0001621. - DOI - PMC - PubMed

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[1] Bethony J, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, Hotez PJ. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 2006;367(9521):1521–1532. doi: 10.1016/S0140-6736(06)68653-4. - DOI - PubMed

[2] Bethony J, Brooker S, Albonico M, Geiger SM, Loukas A, Diemert D, Hotez PJ. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 2006;367(9521):1521–1532. doi: 10.1016/S0140-6736(06)68653-4. - DOI - PubMed

[3] Pullan RL, Smith JL, Jasrasaria R, Brooker SJ. Global numbers of infection and disease burden of soil transmitted helminth infections in 2010. Parasit Vectors. 2014;7(1):37. doi: 10.1186/1756-3305-7-37. - DOI - PMC - PubMed

[4] Pullan RL, Smith JL, Jasrasaria R, Brooker SJ. Global numbers of infection and disease burden of soil transmitted helminth infections in 2010. Parasit Vectors. 2014;7(1):37. doi: 10.1186/1756-3305-7-37. - DOI - PMC - PubMed

[5] Brooker S. Estimating the global distribution and disease burden of intestinal nematode infections: adding up the numbers–a review. Int J Parasitol. 2010;40(10):1137–1144. doi: 10.1016/j.ijpara.201004004. - DOI - PMC - PubMed

[6] Brooker S. Estimating the global distribution and disease burden of intestinal nematode infections: adding up the numbers–a review. Int J Parasitol. 2010;40(10):1137–1144. doi: 10.1016/j.ijpara.201004004. - DOI - PMC - PubMed

[7] Utzinger J, Raso G, Brooker S, de Savigny D, Tanner M, Ornbjerg N, Singer BH, N'Goran EK. Schistosomiasis and neglected tropical diseases: towards integrated and sustainable control and a word of caution. Parasitol. 2009;136(13):1859–1874. doi: 10.1017/S0031182009991600. - DOI - PMC - PubMed

[8] Utzinger J, Raso G, Brooker S, de Savigny D, Tanner M, Ornbjerg N, Singer BH, N'Goran EK. Schistosomiasis and neglected tropical diseases: towards integrated and sustainable control and a word of caution. Parasitol. 2009;136(13):1859–1874. doi: 10.1017/S0031182009991600. - DOI - PMC - PubMed

[9] Jia T-W, Melville S, Utzinger J, King CH, Zhou X-N. Soil-transmitted helminth reinfection after drug treatment: a systematic review and meta-analysis. PLoS Negl Trop Dis. 2012;6(5) doi: 10.1371/journal.pntd.0001621. - DOI - PMC - PubMed

[10] Jia T-W, Melville S, Utzinger J, King CH, Zhou X-N. Soil-transmitted helminth reinfection after drug treatment: a systematic review and meta-analysis. PLoS Negl Trop Dis. 2012;6(5) doi: 10.1371/journal.pntd.0001621. - DOI - PMC - PubMed

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Associations between school- and household-level water, sanitation and hygiene conditions and soil-transmitted helminth infection among Kenyan school children

Affiliations

Associations between school- and household-level water, sanitation and hygiene conditions and soil-transmitted helminth infection among Kenyan school children

Authors

Affiliations

Abstract

Figures

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources