Factors associated with soil-transmitted helminths infection in Benin: Findings from the DeWorm3 study
Background Despite several years of school-based MDA implementation, STH infections remain an important public health problem in Benin, with a country-wide prevalence of 20% in 2015. The DeWorm3 study is designed to assess the feasibility of using community-based MDA with albendazole to interrupt th...
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| Veröffentlicht in: | PLoS neglected tropical diseases 2021-08, Vol.15 (8), p.e0009646-e0009646 |
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| creator | Avokpaho, Euripide F. G. A Houngbégnon, Parfait Accrombessi, Manfred Atindégla, Eloïc Yard, Elodie Rubin Means, Arianna Kennedy, David S Littlewood, D. Timothy J Garcia, André Massougbodji, Achille Galagan, Sean R Walson, Judd L Cottrell, Gilles Ibikounlé, Moudachirou Ásbjörnsdóttir, Kristjana Hrönn Luty, Adrian J. F |
| description | Background Despite several years of school-based MDA implementation, STH infections remain an important public health problem in Benin, with a country-wide prevalence of 20% in 2015. The DeWorm3 study is designed to assess the feasibility of using community-based MDA with albendazole to interrupt the transmission of STH, through a series of cluster-randomized trials in Benin, India and Malawi. We used the pre-treatment baseline survey data to describe and analyze the factors associated with STH infection in Comé, the study site of the DeWorm3 project in Benin. These data will improve understanding of the challenges that need to be addressed in order to eliminate STH as a public health problem in Benin. Methods Between March and April 2018, the prevalence of STH (hookworm spp., Ascaris and Trichuris trichiura) was assessed by Kato-Katz in stool samples collected from 6,153 residents in the community of Comé, Benin using a stratified random sampling procedure. A standardized survey questionnaire was used to collect information from individual households concerning factors potentially associated with the presence and intensity of STH infections in pre-school (PSAC, aged 1-4), school-aged children (SAC, aged 5-14) and adults (aged 15 and above). Multilevel mixed-effects models were used to assess associations between these factors and STH infection. Results The overall prevalence of STH infection was 5.3%; 3.2% hookworm spp., 2.1% Ascaris lumbricoides and 0.1% Trichuris. Hookworm spp. were more prevalent in adults than in SAC (4.4% versus 2.0%, respectively; p = 0.0001) and PSAC (4.4% versus 1.0%, respectively; p |
| doi_str_mv | 10.1371/journal.pntd.0009646 |
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G. A ; Houngbégnon, Parfait ; Accrombessi, Manfred ; Atindégla, Eloïc ; Yard, Elodie ; Rubin Means, Arianna ; Kennedy, David S ; Littlewood, D. Timothy J ; Garcia, André ; Massougbodji, Achille ; Galagan, Sean R ; Walson, Judd L ; Cottrell, Gilles ; Ibikounlé, Moudachirou ; Ásbjörnsdóttir, Kristjana Hrönn ; Luty, Adrian J. F</creator><contributor>Chai, jong-Yil</contributor><creatorcontrib>Avokpaho, Euripide F. G. A ; Houngbégnon, Parfait ; Accrombessi, Manfred ; Atindégla, Eloïc ; Yard, Elodie ; Rubin Means, Arianna ; Kennedy, David S ; Littlewood, D. Timothy J ; Garcia, André ; Massougbodji, Achille ; Galagan, Sean R ; Walson, Judd L ; Cottrell, Gilles ; Ibikounlé, Moudachirou ; Ásbjörnsdóttir, Kristjana Hrönn ; Luty, Adrian J. F ; Chai, jong-Yil</creatorcontrib><description><![CDATA[Background Despite several years of school-based MDA implementation, STH infections remain an important public health problem in Benin, with a country-wide prevalence of 20% in 2015. The DeWorm3 study is designed to assess the feasibility of using community-based MDA with albendazole to interrupt the transmission of STH, through a series of cluster-randomized trials in Benin, India and Malawi. We used the pre-treatment baseline survey data to describe and analyze the factors associated with STH infection in Comé, the study site of the DeWorm3 project in Benin. These data will improve understanding of the challenges that need to be addressed in order to eliminate STH as a public health problem in Benin. Methods Between March and April 2018, the prevalence of STH (hookworm spp., Ascaris and Trichuris trichiura) was assessed by Kato-Katz in stool samples collected from 6,153 residents in the community of Comé, Benin using a stratified random sampling procedure. A standardized survey questionnaire was used to collect information from individual households concerning factors potentially associated with the presence and intensity of STH infections in pre-school (PSAC, aged 1-4), school-aged children (SAC, aged 5-14) and adults (aged 15 and above). Multilevel mixed-effects models were used to assess associations between these factors and STH infection. Results The overall prevalence of STH infection was 5.3%; 3.2% hookworm spp., 2.1% Ascaris lumbricoides and 0.1% Trichuris. Hookworm spp. were more prevalent in adults than in SAC (4.4% versus 2.0%, respectively; p = 0.0001) and PSAC (4.4% versus 1.0%, respectively; p<0.0001), whilst Ascaris lumbricoides was more prevalent in SAC than in adults (3.0% versus 1.7%, respectively; p = 0.004). Being PSAC (adjusted Odds Ratio (aOR) = 0.2, p< 0.001; adjusted Infection Intensity Ratio (aIIR) = 0.1, p<0.001) or SAC (aOR = 0.5, p = 0.008; aIIR = 0.3, p = 0.01), being a female (aOR = 0.6, p = 0.004; aIIR = 0.3, p = 0.001), and having received deworming treatment the previous year (aOR = 0.4, p< 0.002; aIIR = 0.2, p<0.001) were associated with a lower prevalence and intensity of hookworm infection. Lower income (lowest quintile: aOR = 5.0, p<0.001, 2.sup.nd quintile aOR = 3.6, p = 0.001 and 3.sup.rd quintile aOR = 2.5, p = 0.02), being a farmer (aOR = 1.8, p = 0.02), medium population density (aOR = 2.6, p = 0.01), and open defecation (aOR = 0.5, p = 0.04) were associated with a higher prevalence of hookworm infection. Lower education-no education, primary or secondary school- (aIIR = 40.1, p = 0.01; aIIR = 30.9, p = 0.02; aIIR = 19.3, p = 0.04, respectively), farming (aIIR = 3.9, p = 0.002), natural flooring (aIIR = 0.2, p = 0.06), peri-urban settings (aIIR = 6.2, 95%CI 1.82-20.90, p = 0.003), and unimproved water source more than 30 minutes from the household (aIIR = 13.5, p = 0.02) were associated with a higher intensity of hookworm infection. Improved and unshared toilet was associated with lower intensity of hookworm infections (aIIR = 0.2, p = 0.01). SAC had a higher odds of Ascaris lumbricoides infection than adults (aOR = 2.0, p = 0.01) and females had a lower odds of infection (aOR = 0.5, p = 0.02). Conclusion Hookworm spp. are the most prevalent STH in Comé, with a persistent reservoir in adults that is not addressed by current control measures based on school MDA. Expanding MDA to target adults and PSAC is necessary to substantially impact population prevalence, particularly for hookworm. Trial registration ClinicalTrials.gov NCT03014167.]]></description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0009646</identifier><identifier>PMID: 34403424</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Adults ; Age ; Albendazole ; Aquaculture ; Ascaris lumbricoides ; Biology and Life Sciences ; Defaecation ; Defecation ; Disease transmission ; Education ; Eggs ; Ethics ; Feasibility studies ; Females ; Helminthiasis ; Households ; Infections ; Laboratories ; Medicine and Health Sciences ; People and Places ; Polls & surveys ; Population ; Population density ; Public health ; Random sampling ; Risk factors ; Sanitation ; Social Sciences ; Statistical sampling ; Statistics ; Surveying ; Transmission ; Tropical diseases ; Urban areas ; Urban environments ; Womens health</subject><ispartof>PLoS neglected tropical diseases, 2021-08, Vol.15 (8), p.e0009646-e0009646</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. 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Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c601t-9fe670161525327a3d8042922d5974c20067b56a67ebe4e0ab191e0253f8d64b3</citedby><cites>FETCH-LOGICAL-c601t-9fe670161525327a3d8042922d5974c20067b56a67ebe4e0ab191e0253f8d64b3</cites><orcidid>0000-0001-8830-3425 ; 0000-0002-3429-3345 ; 0000-0002-9498-6688 ; 0000-0002-3263-3457 ; 0000-0003-0004-6167 ; 0000-0002-2718-4001 ; 0000-0003-2321-0505 ; 0000-0001-9550-9413 ; 0000-0002-3517-1729 ; 0000-0002-1808-472X ; 0000-0002-7964-8963</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396766/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396766/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids></links><search><contributor>Chai, jong-Yil</contributor><creatorcontrib>Avokpaho, Euripide F. G. A</creatorcontrib><creatorcontrib>Houngbégnon, Parfait</creatorcontrib><creatorcontrib>Accrombessi, Manfred</creatorcontrib><creatorcontrib>Atindégla, Eloïc</creatorcontrib><creatorcontrib>Yard, Elodie</creatorcontrib><creatorcontrib>Rubin Means, Arianna</creatorcontrib><creatorcontrib>Kennedy, David S</creatorcontrib><creatorcontrib>Littlewood, D. Timothy J</creatorcontrib><creatorcontrib>Garcia, André</creatorcontrib><creatorcontrib>Massougbodji, Achille</creatorcontrib><creatorcontrib>Galagan, Sean R</creatorcontrib><creatorcontrib>Walson, Judd L</creatorcontrib><creatorcontrib>Cottrell, Gilles</creatorcontrib><creatorcontrib>Ibikounlé, Moudachirou</creatorcontrib><creatorcontrib>Ásbjörnsdóttir, Kristjana Hrönn</creatorcontrib><creatorcontrib>Luty, Adrian J. F</creatorcontrib><title>Factors associated with soil-transmitted helminths infection in Benin: Findings from the DeWorm3 study</title><title>PLoS neglected tropical diseases</title><description><![CDATA[Background Despite several years of school-based MDA implementation, STH infections remain an important public health problem in Benin, with a country-wide prevalence of 20% in 2015. The DeWorm3 study is designed to assess the feasibility of using community-based MDA with albendazole to interrupt the transmission of STH, through a series of cluster-randomized trials in Benin, India and Malawi. We used the pre-treatment baseline survey data to describe and analyze the factors associated with STH infection in Comé, the study site of the DeWorm3 project in Benin. These data will improve understanding of the challenges that need to be addressed in order to eliminate STH as a public health problem in Benin. Methods Between March and April 2018, the prevalence of STH (hookworm spp., Ascaris and Trichuris trichiura) was assessed by Kato-Katz in stool samples collected from 6,153 residents in the community of Comé, Benin using a stratified random sampling procedure. A standardized survey questionnaire was used to collect information from individual households concerning factors potentially associated with the presence and intensity of STH infections in pre-school (PSAC, aged 1-4), school-aged children (SAC, aged 5-14) and adults (aged 15 and above). Multilevel mixed-effects models were used to assess associations between these factors and STH infection. Results The overall prevalence of STH infection was 5.3%; 3.2% hookworm spp., 2.1% Ascaris lumbricoides and 0.1% Trichuris. Hookworm spp. were more prevalent in adults than in SAC (4.4% versus 2.0%, respectively; p = 0.0001) and PSAC (4.4% versus 1.0%, respectively; p<0.0001), whilst Ascaris lumbricoides was more prevalent in SAC than in adults (3.0% versus 1.7%, respectively; p = 0.004). Being PSAC (adjusted Odds Ratio (aOR) = 0.2, p< 0.001; adjusted Infection Intensity Ratio (aIIR) = 0.1, p<0.001) or SAC (aOR = 0.5, p = 0.008; aIIR = 0.3, p = 0.01), being a female (aOR = 0.6, p = 0.004; aIIR = 0.3, p = 0.001), and having received deworming treatment the previous year (aOR = 0.4, p< 0.002; aIIR = 0.2, p<0.001) were associated with a lower prevalence and intensity of hookworm infection. Lower income (lowest quintile: aOR = 5.0, p<0.001, 2.sup.nd quintile aOR = 3.6, p = 0.001 and 3.sup.rd quintile aOR = 2.5, p = 0.02), being a farmer (aOR = 1.8, p = 0.02), medium population density (aOR = 2.6, p = 0.01), and open defecation (aOR = 0.5, p = 0.04) were associated with a higher prevalence of hookworm infection. Lower education-no education, primary or secondary school- (aIIR = 40.1, p = 0.01; aIIR = 30.9, p = 0.02; aIIR = 19.3, p = 0.04, respectively), farming (aIIR = 3.9, p = 0.002), natural flooring (aIIR = 0.2, p = 0.06), peri-urban settings (aIIR = 6.2, 95%CI 1.82-20.90, p = 0.003), and unimproved water source more than 30 minutes from the household (aIIR = 13.5, p = 0.02) were associated with a higher intensity of hookworm infection. Improved and unshared toilet was associated with lower intensity of hookworm infections (aIIR = 0.2, p = 0.01). SAC had a higher odds of Ascaris lumbricoides infection than adults (aOR = 2.0, p = 0.01) and females had a lower odds of infection (aOR = 0.5, p = 0.02). Conclusion Hookworm spp. are the most prevalent STH in Comé, with a persistent reservoir in adults that is not addressed by current control measures based on school MDA. Expanding MDA to target adults and PSAC is necessary to substantially impact population prevalence, particularly for hookworm. Trial registration ClinicalTrials.gov NCT03014167.]]></description><subject>Adults</subject><subject>Age</subject><subject>Albendazole</subject><subject>Aquaculture</subject><subject>Ascaris lumbricoides</subject><subject>Biology and Life Sciences</subject><subject>Defaecation</subject><subject>Defecation</subject><subject>Disease transmission</subject><subject>Education</subject><subject>Eggs</subject><subject>Ethics</subject><subject>Feasibility studies</subject><subject>Females</subject><subject>Helminthiasis</subject><subject>Households</subject><subject>Infections</subject><subject>Laboratories</subject><subject>Medicine and Health Sciences</subject><subject>People and Places</subject><subject>Polls & surveys</subject><subject>Population</subject><subject>Population density</subject><subject>Public health</subject><subject>Random sampling</subject><subject>Risk factors</subject><subject>Sanitation</subject><subject>Social Sciences</subject><subject>Statistical sampling</subject><subject>Statistics</subject><subject>Surveying</subject><subject>Transmission</subject><subject>Tropical diseases</subject><subject>Urban areas</subject><subject>Urban environments</subject><subject>Womens health</subject><issn>1935-2735</issn><issn>1935-2727</issn><issn>1935-2735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNptkt2K1DAYhoso7o_egWBBkD2ZMf9tPRDW1dGFBU8UD0OafJ1maJMxSZW9G6_FKzN1quzIkoOEL0_e7ydvUTzDaI1phV_t_BScGtZ7l8waIdQIJh4Up7ihfEUqyh_eOZ8UZzHuEOINr_Hj4oQyhigj7LTYbpROPsRSxei1VQlM-cOmvozeDqsUlIujTXO0h2G0LvWxtK4Dnax3v35aV74FZ93rcmOdsW4byy74sUw9lO_gqw8jLWOazO2T4lGnhghPl_28-LJ5__nq4-rm04frq8ublRYIp1XTgagQFpgTTkmlqKkRIw0hhjcV0wQhUbVcKFFBCwyQanGDAWW4q41gLT0vnh9094OPcplRlIRXlHFOsMjE9YEwXu3kPthRhVvplZV_Aj5spQrJ6gEkIqw2UDcN04YJjtqOGSRE7r41LVGQtd4s2aZ2BKPB5YkNR6LHN872cuu_y5o2ohJzMReLQPDfJohJjjZqGAblwE9z3YLkqmuMMvriP_T-7hZqq3ID-ad8zqtnUXkpKtpkN2CeqfU9VF4GRqu9g87m-NGDl3ce9KCGbAQ_TLML4jHIDqAOPsYA3b9hYCRn3_6tWs6-lYtv6W9w4eCs</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Avokpaho, Euripide F. 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G. A ; Houngbégnon, Parfait ; Accrombessi, Manfred ; Atindégla, Eloïc ; Yard, Elodie ; Rubin Means, Arianna ; Kennedy, David S ; Littlewood, D. Timothy J ; Garcia, André ; Massougbodji, Achille ; Galagan, Sean R ; Walson, Judd L ; Cottrell, Gilles ; Ibikounlé, Moudachirou ; Ásbjörnsdóttir, Kristjana Hrönn ; Luty, Adrian J. F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c601t-9fe670161525327a3d8042922d5974c20067b56a67ebe4e0ab191e0253f8d64b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adults</topic><topic>Age</topic><topic>Albendazole</topic><topic>Aquaculture</topic><topic>Ascaris lumbricoides</topic><topic>Biology and Life Sciences</topic><topic>Defaecation</topic><topic>Defecation</topic><topic>Disease transmission</topic><topic>Education</topic><topic>Eggs</topic><topic>Ethics</topic><topic>Feasibility studies</topic><topic>Females</topic><topic>Helminthiasis</topic><topic>Households</topic><topic>Infections</topic><topic>Laboratories</topic><topic>Medicine and Health Sciences</topic><topic>People and Places</topic><topic>Polls & surveys</topic><topic>Population</topic><topic>Population density</topic><topic>Public health</topic><topic>Random sampling</topic><topic>Risk factors</topic><topic>Sanitation</topic><topic>Social Sciences</topic><topic>Statistical sampling</topic><topic>Statistics</topic><topic>Surveying</topic><topic>Transmission</topic><topic>Tropical diseases</topic><topic>Urban areas</topic><topic>Urban environments</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Avokpaho, Euripide F. G. A</creatorcontrib><creatorcontrib>Houngbégnon, Parfait</creatorcontrib><creatorcontrib>Accrombessi, Manfred</creatorcontrib><creatorcontrib>Atindégla, Eloïc</creatorcontrib><creatorcontrib>Yard, Elodie</creatorcontrib><creatorcontrib>Rubin Means, Arianna</creatorcontrib><creatorcontrib>Kennedy, David S</creatorcontrib><creatorcontrib>Littlewood, D. Timothy J</creatorcontrib><creatorcontrib>Garcia, André</creatorcontrib><creatorcontrib>Massougbodji, Achille</creatorcontrib><creatorcontrib>Galagan, Sean R</creatorcontrib><creatorcontrib>Walson, Judd L</creatorcontrib><creatorcontrib>Cottrell, Gilles</creatorcontrib><creatorcontrib>Ibikounlé, Moudachirou</creatorcontrib><creatorcontrib>Ásbjörnsdóttir, Kristjana Hrönn</creatorcontrib><creatorcontrib>Luty, Adrian J. F</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ASFA: Aquatic Sciences and Fisheries Abstracts</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 3: Aquatic Pollution & Environmental Quality</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) Professional</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Avokpaho, Euripide F. G. A</au><au>Houngbégnon, Parfait</au><au>Accrombessi, Manfred</au><au>Atindégla, Eloïc</au><au>Yard, Elodie</au><au>Rubin Means, Arianna</au><au>Kennedy, David S</au><au>Littlewood, D. Timothy J</au><au>Garcia, André</au><au>Massougbodji, Achille</au><au>Galagan, Sean R</au><au>Walson, Judd L</au><au>Cottrell, Gilles</au><au>Ibikounlé, Moudachirou</au><au>Ásbjörnsdóttir, Kristjana Hrönn</au><au>Luty, Adrian J. F</au><au>Chai, jong-Yil</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors associated with soil-transmitted helminths infection in Benin: Findings from the DeWorm3 study</atitle><jtitle>PLoS neglected tropical diseases</jtitle><date>2021-08-01</date><risdate>2021</risdate><volume>15</volume><issue>8</issue><spage>e0009646</spage><epage>e0009646</epage><pages>e0009646-e0009646</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract><![CDATA[Background Despite several years of school-based MDA implementation, STH infections remain an important public health problem in Benin, with a country-wide prevalence of 20% in 2015. The DeWorm3 study is designed to assess the feasibility of using community-based MDA with albendazole to interrupt the transmission of STH, through a series of cluster-randomized trials in Benin, India and Malawi. We used the pre-treatment baseline survey data to describe and analyze the factors associated with STH infection in Comé, the study site of the DeWorm3 project in Benin. These data will improve understanding of the challenges that need to be addressed in order to eliminate STH as a public health problem in Benin. Methods Between March and April 2018, the prevalence of STH (hookworm spp., Ascaris and Trichuris trichiura) was assessed by Kato-Katz in stool samples collected from 6,153 residents in the community of Comé, Benin using a stratified random sampling procedure. A standardized survey questionnaire was used to collect information from individual households concerning factors potentially associated with the presence and intensity of STH infections in pre-school (PSAC, aged 1-4), school-aged children (SAC, aged 5-14) and adults (aged 15 and above). Multilevel mixed-effects models were used to assess associations between these factors and STH infection. Results The overall prevalence of STH infection was 5.3%; 3.2% hookworm spp., 2.1% Ascaris lumbricoides and 0.1% Trichuris. Hookworm spp. were more prevalent in adults than in SAC (4.4% versus 2.0%, respectively; p = 0.0001) and PSAC (4.4% versus 1.0%, respectively; p<0.0001), whilst Ascaris lumbricoides was more prevalent in SAC than in adults (3.0% versus 1.7%, respectively; p = 0.004). Being PSAC (adjusted Odds Ratio (aOR) = 0.2, p< 0.001; adjusted Infection Intensity Ratio (aIIR) = 0.1, p<0.001) or SAC (aOR = 0.5, p = 0.008; aIIR = 0.3, p = 0.01), being a female (aOR = 0.6, p = 0.004; aIIR = 0.3, p = 0.001), and having received deworming treatment the previous year (aOR = 0.4, p< 0.002; aIIR = 0.2, p<0.001) were associated with a lower prevalence and intensity of hookworm infection. Lower income (lowest quintile: aOR = 5.0, p<0.001, 2.sup.nd quintile aOR = 3.6, p = 0.001 and 3.sup.rd quintile aOR = 2.5, p = 0.02), being a farmer (aOR = 1.8, p = 0.02), medium population density (aOR = 2.6, p = 0.01), and open defecation (aOR = 0.5, p = 0.04) were associated with a higher prevalence of hookworm infection. Lower education-no education, primary or secondary school- (aIIR = 40.1, p = 0.01; aIIR = 30.9, p = 0.02; aIIR = 19.3, p = 0.04, respectively), farming (aIIR = 3.9, p = 0.002), natural flooring (aIIR = 0.2, p = 0.06), peri-urban settings (aIIR = 6.2, 95%CI 1.82-20.90, p = 0.003), and unimproved water source more than 30 minutes from the household (aIIR = 13.5, p = 0.02) were associated with a higher intensity of hookworm infection. Improved and unshared toilet was associated with lower intensity of hookworm infections (aIIR = 0.2, p = 0.01). SAC had a higher odds of Ascaris lumbricoides infection than adults (aOR = 2.0, p = 0.01) and females had a lower odds of infection (aOR = 0.5, p = 0.02). Conclusion Hookworm spp. are the most prevalent STH in Comé, with a persistent reservoir in adults that is not addressed by current control measures based on school MDA. Expanding MDA to target adults and PSAC is necessary to substantially impact population prevalence, particularly for hookworm. Trial registration ClinicalTrials.gov NCT03014167.]]></abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>34403424</pmid><doi>10.1371/journal.pntd.0009646</doi><orcidid>https://orcid.org/0000-0001-8830-3425</orcidid><orcidid>https://orcid.org/0000-0002-3429-3345</orcidid><orcidid>https://orcid.org/0000-0002-9498-6688</orcidid><orcidid>https://orcid.org/0000-0002-3263-3457</orcidid><orcidid>https://orcid.org/0000-0003-0004-6167</orcidid><orcidid>https://orcid.org/0000-0002-2718-4001</orcidid><orcidid>https://orcid.org/0000-0003-2321-0505</orcidid><orcidid>https://orcid.org/0000-0001-9550-9413</orcidid><orcidid>https://orcid.org/0000-0002-3517-1729</orcidid><orcidid>https://orcid.org/0000-0002-1808-472X</orcidid><orcidid>https://orcid.org/0000-0002-7964-8963</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1935-2735 |
| ispartof | PLoS neglected tropical diseases, 2021-08, Vol.15 (8), p.e0009646-e0009646 |
| issn | 1935-2735 1935-2727 1935-2735 |
| language | eng |
| recordid | cdi_plos_journals_2573455216 |
| source | DOAJ Directory of Open Access Journals; PubMed Central Open Access; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adults Age Albendazole Aquaculture Ascaris lumbricoides Biology and Life Sciences Defaecation Defecation Disease transmission Education Eggs Ethics Feasibility studies Females Helminthiasis Households Infections Laboratories Medicine and Health Sciences People and Places Polls & surveys Population Population density Public health Random sampling Risk factors Sanitation Social Sciences Statistical sampling Statistics Surveying Transmission Tropical diseases Urban areas Urban environments Womens health |
| title | Factors associated with soil-transmitted helminths infection in Benin: Findings from the DeWorm3 study |
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