Prevalence of soil-transmitted helminth infections among primary school children in the four surveyed districts (N = 1157).

<p>* denominators vary due to missing data</p><p>^{^} refers to number of children positive for at least one species of soil transmitted helminth</p><p>^# Percentages calculated using the total number of children with double infections</p><p>Prevalence of soil-transmitted helminth infections among primary school children in the four surveyed districts (N = 1157).</p

Local caste classification and adopted categories used to describe castes.

<p>Local caste classification and adopted categories used to describe castes.</p

Prevalence of soil-transmitted helminths in the 20 schools in Bihar.

<p>Prevalence of soil-transmitted helminths in the 20 schools in Bihar.</p

Risk factors for hookworm and <i>A</i>. <i>lumbricoides</i> infection, Bihar India (N = 1157).

<p>RR = risk ratio, 95%CI = 95% confidence interval, P = p value. Univariate analysis takes account of clustering within schools. The model was restricted to two districts (Aurangabad and Gopalganj) due to data collection errors for some variables in the other districts.</p><p>For caste classification see <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003790#pntd.0003790.t001" target="_blank">Table 1</a>. Castes 5 and 6 were combined for analysis due to small numbers. Muslims were excluded from the caste classification and are therefore presented collectively and separately.</p><p>Maternal education (literacy) was assessed by asking the child whether their mother can read their hindi textbook. The proportions of literate mothers were similar for muslims and hindus, even in urdu speaking schools. All responses are therefore included in analysis.</p><p>Defecation practice: variable created from questions pertaining to frequency (usually, sometimes, never) of use of an open field, river, jungle or latrine for defecation. Almost all open defecation (98%) takes place in an open field.</p><p>Hand-hygiene practice: 95% of individuals within the "soil, ash or water" category use only soil to hand-wash after using the toilet.</p><p>Risk factors for hookworm and <i>A</i>. <i>lumbricoides</i> infection, Bihar India (N = 1157).</p

Structure of the state government ministries and offices and respective roles in the deworming programme in Bihar state.

<p>Leveraging of the existing state government structures was critical for the successful rollout of large-scale operations, including drug procurement and delivery, training, community sensitization, and reporting.</p

Examples of community sensitization and awareness posters.

<p>Phase-wise information on the programme. The posters were also translated into Hindi and demonstrate the level of dissemination of programme information to the communities, including dates to expect the deworming day to occur as well as the”mop-up” days to cover children who could not attend the deworming day. The repeating dates across the months provided a tactic with which to galvanize the deworming days in community members’ minds.</p

Predictive prevalence map of soil-transmitted helminths in Bihar state.

<p>Predictive mapping was used to inform the state wide deworming coverage in Bihar. The map shows areas of high prevalence (≥50% infection) in red, and moderate prevalence (≥20% and <50% infection) in orange. The map presented was developed by Jenny Smith as part of the Global Atlas of Helminth Infections project (<a href="http://www.thiswormyworld.org/" target="_blank">www.thiswormyworld.org</a>)</p

School-based deworming cascaded training and programme rollout in Bihar.

<p><b>A,</b> The incremental three-phased approach, including numbers targeted in each phase. Timelines are shown, with indications of planning phases (light grey), training phases (light purple), and district-level activity (dark blue). Deworming days are indicated in red arrows. District-level activity includes school-level activities and the cascaded training of teachers and Primary Health Centre staff. <b>B</b>, Structure and design of cascaded training sessions from programme level to school level, including numbers trained and trainees. The cascaded system of training and dissemination of materials led to significant cost reductions and maximized use of available resources. Abbreviations: DtW/PCD, Deworm the World and the Partnership for Child Development; DIET, District Institute of Education and Training; SIHFW, State Institute of Health and Family Welfare; SCERT, State Council of Education Research and Training; CRP, Cluster Resource Persons; ASHA, Accredited Social Health Activist; BRP, Block Resource Persons; BHM, block health managers; CRCC, Cluster Resource Centres Coordinator; PHC, Primary Health Centre; ANM, Auxiliary Nurse Midwife; HQ, headquarters.</p