Demographic characteristics of focus group participants (N = 211).

<p>Demographic characteristics of focus group participants (N = 211).</p

Clinical characteristics of focus group patients (N = 74).

<p>Clinical characteristics of focus group patients (N = 74).</p

Bivariate Associations for Selected Water, Sanitation, and Hygiene-related Risk Factors with Any Soil-Transmitted Helminth Infection among PSAC and SAC Children.

<p>Bivariate Associations for Selected Water, Sanitation, and Hygiene-related Risk Factors with Any Soil-Transmitted Helminth Infection among PSAC and SAC Children.</p

Participant flowchart showing participant selection, inclusion and analysis 2012.

<p>Participant flowchart showing participant selection, inclusion and analysis 2012.</p

Household elevation surface interpolation generated using kriging method.

<p>Household elevation surface interpolation generated using kriging method.</p

Unprogrammed Deworming in the Kibera Slum, Nairobi: Implications for Control of Soil-Transmitted Helminthiases

<div><p>Background</p><p>Programs for control of soil-transmitted helminth (STH) infections are increasingly evaluating national mass drug administration (MDA) interventions. However, “unprogrammed deworming” (receipt of deworming drugs outside of nationally-run STH control programs) occurs frequently. Failure to account for these activities may compromise evaluations of MDA effectiveness.</p><p>Methods</p><p>We used a cross-sectional study design to evaluate STH infection and unprogrammed deworming among infants (aged 6–11 months), preschool-aged children (PSAC, aged 1–4 years), and school-aged children (SAC, aged 5–14 years) in Kibera, Kenya, an informal settlement not currently receiving nationally-run MDA for STH. STH infection was assessed by triplicate Kato-Katz. We asked heads of households with randomly-selected children about past-year receipt and source(s) of deworming drugs. Local non-governmental organizations (NGOs) and school staff participating in school-based deworming were interviewed to collect information on drug coverage.</p><p>Results</p><p>Of 679 children (18 infants, 184 PSAC, and 477 SAC) evaluated, 377 (55%) reported receiving at least one unprogrammed deworming treatment during the past year. PSAC primarily received treatments from chemists (48.3%) or healthcare centers (37.7%); SAC most commonly received treatments at school (55.0%). Four NGOs reported past-year deworming activities at 47 of >150 schools attended by children in our study area. Past-year deworming was negatively associated with any-STH infection (34.8% vs 45.4%, p = 0.005). SAC whose most recent deworming medication was sourced from a chemist were more often infected with <i>Trichuris</i> (38.0%) than those who received their most recent treatment from a health center (17.3%) or school (23.1%) (p = 0.05).</p><p>Conclusion</p><p>Unprogrammed deworming was received by more than half of children in our study area, from multiple sources. Both individual-level treatment and unprogrammed preventive chemotherapy may serve an important public health function, particularly in the absence of programmed deworming; however, they may also lead to an overestimation of programmed MDA effectiveness. A standardized, validated tool is needed to assess unprogrammed deworming.</p></div

Proportion of children in each age group whose parents reported that they had been dewormed at least once during the previous year, Kibera, Kenya, 2012.

<p>Numbers in parentheses represent denominators for each age group.</p

Sources of drugs for the most recent deworming, overall and by child type, among children who were reported as taking deworming medications at least once during the past year, Kibera, Kenya, 2012.

<p>Sources of drugs for the most recent deworming, overall and by child type, among children who were reported as taking deworming medications at least once during the past year, Kibera, Kenya, 2012.</p

Total number of intact mosquitoes collected in Gaibandha (G) and Panchagarh (P) districts in September-November 2016. Mosquitoes only identified to genus are not included.

<p>Total number of intact mosquitoes collected in Gaibandha (G) and Panchagarh (P) districts in September-November 2016. Mosquitoes only identified to genus are not included.</p

Molecular xenomonitoring for <i>Wuchereria bancrofti</i> in <i>Culex quinquefasciatus</i> in two districts in Bangladesh supports transmission assessment survey findings

<div><p>Background</p><p>Careful monitoring for recrudescence of <i>Wuchereria bancrofti</i> infection is necessary in communities where mass drug administration (MDA) for the elimination of lymphatic filariasis (LF) as a public health problem has been stopped. During the post-MDA period, transmission assessment surveys (TAS) are recommended by the World Health Organization to monitor the presence of the parasite in humans. Molecular xenomonitoring (MX), a method by which parasite infection in the mosquito population is monitored, has also been proposed as a sensitive method to determine whether the parasite is still present in the human population. The aim of this study was to conduct an MX evaluation in two areas of Bangladesh, one previously endemic district that had stopped MDA (Panchagarh), and part of a non-endemic district (Gaibandha) that borders the district where transmission was most recently recorded.</p><p>Methodology/Principal findings</p><p>Mosquitoes were systematically collected from 180 trap sites per district and mosquito pools were tested for <i>W</i>. <i>bancrofti</i> using real-time PCR. A total of 23,436 intact mosquitoes, representing 31 species, were collected from the two districts, of which 10,344 (41%) were <i>Culex quinquefasciatus</i>, the vector of <i>W</i>. <i>bancrofti</i> in Bangladesh. All of the 594 pools of <i>Cx</i>. <i>quinquefasciatus</i> tested by real-time PCR were negative for the presence of <i>W</i>. <i>bancrofti</i> DNA.</p><p>Conclusions/Significance</p><p>This study suggested the absence of <i>W</i>. <i>bancrofti</i> in these districts. MX could be a sensitive tool to confirm interruption of LF transmission in areas considered at higher risk of recrudescence, particularly in countries like Bangladesh where entomological and laboratory capacity to perform MX is available.</p></div