Effectiveness of albendazole on soil transmitted nematodes among school children-: a case of Kakamega County, Kenya

Background: Recent assessment by WHO on Soil Transmitted Nematodes (STN) point that their morbidity is still high in people mainly in children. A. lumbricoides globally infects 1.2 billion people and T. trichiura 795 million worldwide. Infections with Ancylostoma duodenale and Necator americanus 740 million leading to 135,000 deaths per year. It became necessary to find out the effectiveness of Albendazole on soil transmitted Nematodes among school children- a case of kakamega county, kenya.Methodology: Study respondents were selected fom public primary school children in Kakamega County. A total of 731 and 665 (pre & post) children in 7 primary schools in three sub counties of Kakamega County were recruited in the study.Pre-treatment survey was done in March, 2014 and follow up in September 2014. Fecal samples were examined for the presence of STN . 14 days after treatment using Kato- Katz method. The total number of eggs were expressed as eggs/gm of feaces (epg). Pretreatment prevalence was 43.5% for Ascaris lumbricoides, 1.8% for hookworm and 0.9% for Trichuris trichiura.Results: Mean intensity of hookworm, A. lumbricoides and T. trichiura infections in the pre-and post-surveys were reduced by 1.2%, 98.4% and 100% respectively. Prevalence decreased to 2.3% for Ascaris lumbricoides and 0 % for T. trichiura. Post treatment prevalence of A. lumbricoides and T. trichiura infections were significantly reduced by 94.8% and 100% respectively. A slight increase in hookworm prevalence was observed. However, this increase was not significant (p=0.993).Conclusion: The therapeutic efficacy of Albendazole indicated a good reduction in parasite burden. Albendazole satisfactorily reduced STN infection while for hookworm there was a non-significant increase in prevalence.Keywords: Cure rate, egg reduction rate, albendazole, Keny

Current Status of Soil-Transmitted Helminths among School Children in Kakamega County, Western Kenya

Background. School age children are at high risk of soil-transmitted helminth (STH) worldwide. In Kenya, STH infections in children remain high despite the periodic administration of anthelmintic drugs. Our study assessed the prevalence and intensity of STH in primary school-aged children in Kakamega County, western Kenya. Methodology. We carried out a cross-sectional study on a population of 731 children attending 7 primary schools in March 2014. Children aged 4–16 years were examined for STH by the quantitative Kato-Katz technique. Infection intensities were expressed as eggs per gram (epg) of faeces. Findings. Among 731 school children examined for STH, 44.05% were infected. Highest prevalence of STH was in Shitaho primary school where 107 participants were examined and 62.6% were infected with mean intensity of 11667 epg. Iyenga had the least prevalence where 101 participants were examined and 26.7% were infected with mean intensity of 11772 epg. A. lumbricoides was the most prevalent STH species with 43.5% infected, while hookworm infections were low with 1.8% infected. Conclusion. Prevalence of STHs infections in Kakamega County remains high. We recommend guidelines and other control strategies to be scaled up to break transmission cycles

Ascaris lumbricoides Infection Following School-Based Deworming in Western Kenya: Assessing the Role of Pupils' School and Home Water, Sanitation, and Hygiene Exposures.

Water, sanitation, and hygiene (WaSH) technologies and behaviors can prevent infection by soil-transmitted helminth species independently, but may also interact in complex ways. However, these interactions are poorly understood. The purpose of this study was to characterize how school and home WaSH exposures were associated with Ascaris lumbricoides infection and to identify relevant interactions between separate WaSH technologies and behaviors. A study was conducted among 4,404 children attending 51 primary schools in western Kenya. We used multivariable mixed effects logistic regression to characterize how various WaSH exposures were associated with A. lumbricoides infection after annual school-based deworming. Few WaSH behaviors and technologies were independently associated with A. lumbricoides infection. However, by considering relevant interdependencies between variables, important associations were elucidated. The association between handwashing and A. lumbricoides depended largely upon the pupils' access to an improved water source. Among pupils who had access to improved water sources, A. lumbricoides prevalence was lower for those who handwashed both at school and home compared with neither place (odds ratio: 0.38, 95% confidence interval: 0.18-0.83; P = 0.01). This study contributes to a further understanding of the impact of WaSH on A. lumbricoides infection and shows the importance of accounting for interactions between WaSH technologies and behaviors

Comparing the performance of circulating cathodic antigen and Kato-Katz techniques in evaluating Schistosoma mansoni infection in areas with low prevalence in selected counties of Kenya: a cross-sectional study

Abstract Background Kato-Katz technique has been the mainstay test in Schistosoma mansoni diagnosis in endemic areas. However, recent studies have documented its poor sensitivity in evaluating Schistosoma mansoni infection especially in areas with lower rates of transmission. It’s the primary diagnostic tool in monitoring impact of the Kenya national school based deworming program on infection transmission, but there is need to consider a more sensitive technique as the prevalence reduces. Therefore, this study explored the relationship between results of the stool-based Kato-Katz technique with urine-based point-of-care circulating cathodic antigen (POC-CCA) test in view to inform decision-making by the program in changing from Kato-Katz to POC-CCA test. Methods We used two cross-sectional surveys conducted pre- and post- mass drug administration (MDA) using praziquantel in a representative random sample of children from 18 schools across 11 counties. A total of 1944 children were randomly sampled for the study. Stool and urine samples were tested for S. mansoni infection using Kato-Katz and POC-CCA methods, respectively. S. mansoni prevalence using each technique was calculated and 95% confidence intervals obtained using binomial regression model. Specificity (Sp) and sensitivity (Sn) were determined using 2 × 2 contingency tables and compared using the McNemar’s chi-square test. Results A total of 1899 and 1878 children were surveyed at pre- and post-treatment respectively. S. mansoni infection prevalence was 26.5 and 21.4% during pre- and post-treatment respectively using POC-CCA test, and 4.9 and 1.5% for pre- and post-treatment respectively using Kato-Katz technique. Taking POC-CCA as the gold standard, Kato-Katz was found to have significantly lower sensitivity both at pre- and post-treatment, Sn = 12.5% and Sn = 5.2% respectively, McNemar test χ2 m = 782.0, p < 0.001. In overall, the results showed a slight/poor agreement between the two methods, kappa index (k) = 0.11, p < 0.001, inter-rater agreement = 77.1%. Conclusions Results showed POC-CCA technique as an effective, sensitive and accurate screening tool for Schistosoma mansoni infection in areas of low prevalence. It was up to 14-fold accurate than Kato-Katz which had extremely inadequate sensitivity. We recommend usage of POC-CCA alongside Kato-Katz examinations by Schistosomiasis control programs in low prevalence areas

Correction: Prevalence, intensity and associated risk factors of soil-transmitted helminth and schistosome infections in Kenya: Impact assessment after five rounds of mass drug administration in Kenya.

[This corrects the article DOI: 10.1371/journal.pntd.0008604.]

Prevalence, intensity and associated risk factors of soil-transmitted helminth and schistosome infections in Kenya: Impact assessment after five rounds of mass drug administration in Kenya.

BackgroundIn Kenya, over five million school age children (SAC) are estimated to be at risk of parasitic worms causing soil-transmitted helminthiasis (STH) and schistosomiasis. As such, the Government of Kenya launched a National School Based Deworming (NSBD) program in 2012 targeting the at-risk SAC living in endemic regions, with the aim of reducing infections prevalence to a level where they no longer constitute a public health problem. The impact of the program has been consistently monitored from 2012 to 2017 through a robust and extensive monitoring and evaluation (M&E) program. The aim of the current study was to evaluate the parasitological outcomes and additionally investigate water, sanitation and hygiene (WASH) related factors associated with infection prevalence after five rounds of mass drug administration (MDA), to inform the program's next steps.Materials and methodsWe utilized a cross-sectional design in a representative, stratified, two-stage sample of school children across six regions in Kenya. A sample size of 100 schools with approximately 108 children per school was purposively selected based on the Year 5 STH infection endemicity prior to the survey. Stool samples were examined for the presence of STH and Schistosoma mansoni eggs using double-slide Kato-Katz technique, urine samples were processed using urine filtration technique for the presence of S. haematobium eggs. Survey questionnaires were administered to all the participating children to collect information on their demographic and individual, household and school level WASH characteristics.Principal findingsOverall, STH prevalence was 12.9% (95%CI: 10.4-16.1) with species prevalence of 9.7% (95%CI: 7.5-12.6) for Ascaris lumbricoides, 3.6% (95%CI: 2.2-5.8) for Trichuris trichiura and 1.0% (95%CI: 0.6-1.5) for hookworm. S. mansoni prevalence was 2.2% (95%CI: 1.2-4.3) and S. haematobium prevalence was 0.3% (95%CI: 0.1-1.0). All the infections showed significant prevalence reductions when compared with the baseline prevalence, except S. mansoni. From multivariable analysis, increased odds of any STH infections were associated with not wearing shoes, adjusted odds ratio (aOR) = 1.36 (95%CI: 1.09-1.69); p = 0.007; high number of household members, aOR = 1.21 (95%CI: 1.04-1.41); p = 0.015; and school absenteeism of more than two days, aOR = 1.33 (95%CI: 1.01-1.80); p = 0.045. Further, children below five years had up to four times higher odds of getting STH infections, aOR = 4.68 (95%CI: 1.49-14.73); p = 0.008. However, no significant factors were identified for schistosomiasis, probably due to low prevalence levels affecting performance of statistical analysis.ConclusionsAfter five rounds of MDA, the program shows low prevalence of STH and schistosomiasis, however, not to a level where the infections are not a public health problem. With considerable inter-county infection prevalence heterogeneity, the program should adopt future MDA frequencies based on the county's infection prevalence status. Further, the program should encourage interventions aimed at improving coverage among preschool age children and improving WASH practices as long-term infection control strategies

Current Status of Soil-Transmitted Helminths among School Children in Kakamega County, Western Kenya

Background. School age children are at high risk of soil-transmitted helminth (STH) worldwide. In Kenya, STH infections in children remain high despite the periodic administration of anthelmintic drugs. Our study assessed the prevalence and intensity of STH in primary school-aged children in Kakamega County, western Kenya. Methodology. We carried out a cross-sectional study on a population of 731 children attending 7 primary schools in March 2014. Children aged 4-16 years were examined for STH by the quantitative Kato-Katz technique. Infection intensities were expressed as eggs per gram (epg) of faeces. Findings. Among 731 school children examined for STH, 44.05% were infected. Highest prevalence of STH was in Shitaho primary school where 107 participants were examined and 62.6% were infected with mean intensity of 11667 epg. Iyenga had the least prevalence where 101 participants were examined and 26.7% were infected with mean intensity of 11772 epg. A. lumbricoides was the most prevalent STH species with 43.5% infected, while hookworm infections were low with 1.8% infected. Conclusion. Prevalence of STHs infections in Kakamega County remains high. We recommend guidelines and other control strategies to be scaled up to break transmission cycles

Results of a national school-based deworming programme on soil-transmitted helminths infections and schistosomiasis in Kenya: 2012–2017

Abstract Background Soil-transmitted helminth (STH) and schistosome infections are among the most prevalent neglected tropical diseases (NTDs) in the world. School-aged children are particularly vulnerable to these chronic infections that can impair growth, nutritional status and cognitive ability. Mass drug administration (MDA) delivered either once or twice annually is a safe and effective approach recommended by the World Health Organization (WHO) to reduce worm burden. In 2012, Kenya began a national school-based deworming programme (NSBDP) aimed at reducing infection and associated morbidity. The change in prevalence and intensity of these infections was monitored over five years (2012–2017). Here, we present the changes in STH and schistosome infections between baseline and endline assessments, as well as explore the yearly patterns of infection reductions. Methods We used series of pre- and post-MDA intervention, repeat cross-sectional surveys in a representative, stratified, two-stage sample of schools in 16 counties of Kenya. The programme consisted of two tiers of monitoring; a national baseline, midterm and endline surveys consisting of 200 schools, and pre- and post-MDA surveys conducted yearly consisting of 60 schools. Stool and urine samples were collected from randomly selected school children and examined for STH and schistosome infections using Kato-Katz and urine filtration techniques respectively. Results Overall, 32.3%, 16.4% and 13.5% of the children were infected with any STH species during baseline, midterm and endline assessment, respectively, with a relative reduction of 58.2% over the five-year period. The overall prevalence of S. mansoni was 2.1%, 1.5% and 1.7% and of S. haematobium was 14.8%, 6.8% and 2.4%, respectively, for baseline, midterm and endline surveys. We observed inter-region and inter-county heterogeneity variation in the infection levels. Conclusions The analysis provided robust assessment of the programme and outlined the current prevalence, mean intensity and re-infection pattern of these infections. Our findings will allow the Government of Kenya to make informed decisions on the strategy to control and eliminate these NTDs. Our results suggest that complimentary interventions may have to be introduced to sustain the chemotherapeutic gains of MDA and accelerate attainment of elimination of these NTDs as a public health problem in Kenya

MOESM1 of Comparing insecticide-treated bed net use to Plasmodium falciparum infection among schoolchildren living near Lake Victoria, Kenya

Additional file 1: Table S1. Univariable analysis of factors associated with malaria infection prevalence

Additional file 1: Figure S1. of Monitoring the impact of a national school based deworming programme on soil-transmitted helminths in Kenya: the first three years, 2012 – 2014

Outline of the 5-year monitoring and evaluation programme. Table S1. Intensity thresholds for light, moderate and heavy infections with Ascaris lumbricoides, Trichuris trichiura, hookworms and schistosomes. Table S2. Y1 baseline and Y3 mid-term prevalence % (95 % CI) and relative reduction (RR) by county. Table S3. Y1 baseline and Y3 mid-term average intensity (epg) (95 % CI) and relative reduction (RR) by county. Table S4. Overall prevalence (%) and average intensity (epg) of STH: Based on the 59 schools. (DOCX 54 kb