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Soil‐transmitted helminth infections after mass drug administration for lymphatic filariasis in rural southern India

Abstract
Objectives
Targeted deworming is the current strategy for control of morbidity associated with soil-transmitted helminths (STH) among at-risk populations: preschool-aged children, school-aged children, and women of childbearing age. We report the prevalence and intensity of STH in a district after lymphatic filariasis MDA in southern India where albendazole was co-administered from 2001.

Methods
Children aged 2 to 15 years and adults (defined as ≥15 years) in a rural administrative block of Tamil Nadu were recruited using a probability proportional to size method. Stool samples were screened and eggs per gram (EPG) determined by Kato-Katz method. Multilevel logistic regression and multilevel negative binomial regression analyses were used to identify factors associated with infection and intensity, respectively.

Results
Of 862 participants who provided samples, 60 (7.0%; 95% confidence interval (CI): 5.3 – 8.7) were positive for STH with a predominance of hookworm infections (n=57, 6.6%; 95% CI: 5.0 – 8.3). Increasing age (odds ratio (OR): 1.09; 95% CI: 1.04 – 1.15) and regular usage of the toilet (OR: 0.32; 95% CI: 0.12 – 0.88) were independently associated with hookworm infection and age was significantly associated with increasing intensity of hookworm infection (infection intensity ratio (IIR): 1.28; 95% CI: 1.19 – 1.37). A brief review of STH prevalence in endemic settings prior to and after stoppage of LF MDA indicated that, in most settings, a substantial reduction in STH prevalence is seen.

Conclusion
Community-wide MDA in all age groups in these post-LF MDA districts with low prevalence and light intensity infections could result in transmission interruption of STH.

More information

Type
Journal Article
Author
Puthupalayam Kaliappan S
Ramanujam K
Manuel M
Farzana J
Janagaraj V
Laxmanan S
Muliyil J
Sarkar R
Kang G
Walson JL
Ajjampur S