Feasibility of Helminth Worm Burden as a Marker for Assessing the Impact and Success of Water, Sanitation, and Hygiene Interventions (WASH) for the Control of Neglected Tropical Diseases

The Neglected Tropical Diseases (NTDs), most notably, helminthiasis thrives in tropical settings, where access to improved sanitation, potable water source, and personal and domestic hygiene facilities are limited or lacking. Ensuring increased and adequate access to improved Water, Sanitation and Hygiene (WASH) facilities has been flagged as a complementary tool for ongoing control and elimination efforts. However, evidence demonstrating the impacts of WASH investments on NTDs is scanty. Available integrated database on WASH and NTDs are collected using different tools at varying spatial scales, and in most cases without georeferencing details. These datasets are thus misaligned, making it difficult for geostatistical and modelling analysis that are useful for impact assessments. Therefore, our review suggests; (1) adequate georeferencing of WASH and NTDs sector data, (2) revision and standardization of data collection tools on access and usage of WASH resources, and incorporation of indicators aimed at assessing the risk of helminthiasis, and (3) including standardized WASH assessment questionnaires in epidemiological surveys on helminthiasis. We propose the collection of WASH-NTDs data at the same spatial resolution favors robust geostatistical analysis, making it possible to evaluate and monitor the impact of WASH investments on helminthiasis burden.