03345nas a2200361   4500000000100000008004100001260001700042653003500059653001600094653001900110653000900129100001300138700001300151700001200164700001300176700001200189700001500201700001500216700001400231700001700245700001200262700001100274700001200285700001500297700001400312700001200326245009500338856006000433300000900493490000700502520246000509022001402969       2025                            d  c11/2025bBMJ10aSoil-transmitted helminthiasis10aElimination10aPublic health 10aMali1 aTraore M1 aMaiga FK1 aKeita M1 aGuindo B1 aSacko M1 aDoumbia SS1 aDoumbia MN1 aDembele B1 aCoulibaly YI1 aStern C1 aReid S1 aSerna A1 aFleming FM1 aWeaver AM1 aZhang Y00aAchieving elimination of soil-transmitted helminthiasis as a public health problem in Mali  uhttps://gh.bmj.com/content/bmjgh/10/11/e017092.full.pdf  a1-100 v103 a<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 2004–2005 at baseline and in 2014–2019 for integrated evaluation with either schistosomiasis assessments or LF transmission assessment surveys (TAS). Children aged 7–14 years (6–7 years in TAS-STH surveys) were selected through systematic random sampling, and stool samples from selected children were examined using the Kato–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 2004–2005, 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 (2.9–9.0%) 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 2018–2019 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>
  a2059-7908