@article{31533,
  keywords = {Bolivia, Deworming program, Neglected tropical diseases (NTDs), Prevalence, preventive chemotherapy, protozoonosis, school-age children, Soil-transmitted helminthiases, Survey, tapeworms},
  author = {Spinicci M and Macchioni F and Rojo D and Gamboa H and Liz Villagrán A and Vallejos Y and Strohmeyer M and Roselli M and Gabrielli S and Cancrini G and Monasterio J and Castellanos P and Adolfo Paredes G and Maury S and Zárate A and Rocabado R and Olliaro P and Montresor A and Bartoloni A},
  title = {Scaling down a deworming program among school-age children after a thirty-year successful intervention in the Bolivian Chaco.},
  abstract = {<p><strong>OBJECTIVE: </strong>Preventive chemotherapy is the WHO-recommended control method for soil-transmitted helminthiases. In the Bolivian Chaco, 6-monthly single-dose mebendazole delivery to school-age children achieved a dramatic decrease in soil-transmitted helminthiases prevalence between 1987 and 2013. Consequently, in September 2016, preventive chemotherapy delivery was interrupted in 9 rural communities. In compliance with WHO recommendations, we intensified surveillance to monitor soil-transmitted helminthiases prevalence and detect potential changes that would require interventions.</p>

<p><strong>METHODS: </strong>We conducted two cross-sectional parasitology surveys 12 months apart (September 2016 - 2017) amongst school-age children living in the communities where preventive chemotherapy delivery had been halted. Study design, methods of sampling and sample analysis technique (direct microscopy, Kato-Katz technique) followed WHO recommendations, aiming to obtain data representative of the Bolivian Chaco ecological zone.</p>

<p><strong>RESULTS: </strong>We collected 426 samples in 2016 and 520 in 2017. Soil-transmitted helminthiases prevalence was unremarkable: 0.7% (95%CI 0-1.5%) in 2016 and 0.8% (0-1.5%) in 2017. Conversely, the prevalence of tapeworms (13% in 2016, 12% in 2017) and intestinal protozoan infections (81% in 2016 and 75% in 2017) continued to be high.</p>

<p><strong>CONCLUSIONS: </strong>Our findings support the role of preventive chemotherapy in reducing soil-transmitted helminthiases transmission, as otherwise poor hygienic and health conditions persist in the Bolivian Chaco. A national survey, involving areas from all the ecological zones of Bolivia, is now warranted. This article is protected by copyright. All rights reserved.</p>
},
  year = {2018},
  journal = {Tropical medicine & international health : TM & IH},
  issn = {1365-3156},
  doi = {10.1111/tmi.13058},
  language = {eng},
}