03287nas a2200373   4500000000100000008004100001653002100042653000900063653002600072653001500098653001700113653002000130653001500150653000900165653001100174653001800185653001100203653001300214653001800227653001200245100002500257700001500282700001700297700001200314700001300326700001100339700001500350700001600365245012700381300001100508490000800519520237200527022001402899       2015                            d10aSpatial analysis10aSoil10aSocioeconomic Factors10aSanitation10aRisk Factors10aRisk Assessment10aPrevalence10aMale10aHumans10aHelminthiasis10aFemale10aCambodia10aBayes Theorem10aAnimals1 aKaragiannis-Voules D1 aOdermatt P1 aBiedermann P1 aKhieu V1 aSchär F1 aMuth S1 aUtzinger J1 aVounatsou P00aGeostatistical modelling of soil-transmitted helminth infection in Cambodia: do socioeconomic factors improve predictions?  a204-120 v1413 a<p>Soil-transmitted helminth infections are intimately connected with poverty. Yet, there is a paucity of using socioeconomic proxies in spatially explicit risk profiling. We compiled household-level socioeconomic data pertaining to sanitation, drinking-water, education and nutrition from readily available Demographic and Health Surveys, Multiple Indicator Cluster Surveys and World Health Surveys for Cambodia and aggregated the data at village level. We conducted a systematic review to identify parasitological surveys and made every effort possible to extract, georeference and upload the data in the open source Global Neglected Tropical Diseases database. Bayesian geostatistical models were employed to spatially align the village-aggregated socioeconomic predictors with the soil-transmitted helminth infection data. The risk of soil-transmitted helminth infection was predicted at a grid of 1×1km covering Cambodia. Additionally, two separate individual-level spatial analyses were carried out, for Takeo and Preah Vihear provinces, to assess and quantify the association between soil-transmitted helminth infection and socioeconomic indicators at an individual level. Overall, we obtained socioeconomic proxies from 1624 locations across the country. Surveys focussing on soil-transmitted helminth infections were extracted from 16 sources reporting data from 238 unique locations. We found that the risk of soil-transmitted helminth infection from 2000 onwards was considerably lower than in surveys conducted earlier. Population-adjusted prevalences for school-aged children from 2000 onwards were 28.7% for hookworm, 1.5% for Ascaris lumbricoides and 0.9% for Trichuris trichiura. Surprisingly, at the country-wide analyses, we did not find any significant association between soil-transmitted helminth infection and village-aggregated socioeconomic proxies. Based also on the individual-level analyses we conclude that socioeconomic proxies might not be good predictors at an aggregated large-scale analysis due to their large between- and within-village heterogeneity. Specific information of both the infection risk and potential predictors might be needed to obtain any existing association. The presented soil-transmitted helminth infection risk estimates for Cambodia can be used for guiding and evaluating control and elimination efforts.</p>
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