@article{article,
  keywords = {Soil-transmitted helminthiasis, Elimination, Public health , Mali},
  author = {Traore M and Maiga FK and Keita M and Guindo B and Sacko M and Doumbia SS and Doumbia MN and Dembele B and Coulibaly YI and Stern C and Reid S and Serna A and Fleming FM and Weaver AM and Zhang Y},
  title = {Achieving elimination of soil-transmitted helminthiasis as a public health problem in Mali},
  abstract = {<p><strong>Introduction</strong></p>

<p>Mali was endemic for soil-transmitted helminthiasis (STH), mainly hookworms in the southern regions. Following baseline mapping, mass drug administration (MDA) for STH was integrated with MDA for schistosomiasis for school-aged children (SAC) or lymphatic filariasis (LF) for populations aged five and older and vitamin A supplementation for preschool children. Epidemiological evaluations were conducted to assess progress towards eliminating STH as a public health problem.</p>

<p><strong>Methods</strong></p>

<p>Cross-sectional studies were conducted in schools in 2004{\textendash}2005 at baseline and in 2014{\textendash}2019 for integrated evaluation with either schistosomiasis assessments or LF transmission assessment surveys (TAS). Children aged 7{\textendash}14 years (6{\textendash}7 years in TAS-STH surveys) were selected through systematic random sampling, and stool samples from selected children were examined using the Kato{\textendash}Katz method for the eggs of any species of STH. The prevalence of infection and the prevalence of moderate-intensity and heavy-intensity (MHI) infections were calculated.</p>

<p><strong>Results</strong></p>

<p>A total of 13 769 SAC were examined at baseline in 2004{\textendash}2005, with an overall STH prevalence of 6.3\% (95\% CI 5.9\% to 6.7\%). Overall STH prevalence was the highest in Sikasso (22.9\%), followed by Segou (9.4\%). The prevalence of MHI infections ranged from 0\% to 9.0\% among the survey sites, with high prevalences (2.9{\textendash}9.0\%) in some communities in the Sikasso region. The predominant species of STH infection was hookworm, with negligible infection by Ascaris lumbricoides and Trichuris trichiura . Integrated schistosomiasis/STH impact assessments from 2014 to 2017 sampled 5776 children, with an overall prevalence of 0.1\% (95\% CI 0.1\% to 0.3\%) and 0\% MHI infections. The integrated TAS-STH surveys in 2018{\textendash}2019 in 29 districts further confirmed an overall low STH prevalence of 0.1\% (95\% CI 0.0\% to 0.3\%). These results indicate the progress towards the national goal of eliminating STH as a public health problem in Mali and highlight the need for continued surveillance in certain regions.</p>

<p><strong>Conclusion</strong></p>

<p>Through over a decade of integrated treatment overcoming major security challenges, Mali may have successfully eliminated STH as a public health problem in all regions, one of the first countries in Africa to achieve this milestone.</p>
},
  year = {2025},
  journal = {BMJ Global Health},
  volume = {10},
  pages = {1-10},
  month = {11/2025},
  publisher = {BMJ},
  issn = {2059-7908},
  url = {https://gh.bmj.com/content/bmjgh/10/11/e017092.full.pdf},
  doi = {10.1136/bmjgh-2024-017092},
  language = {ENG},
}