Trends in prevalence of soil-transmitted helminth and major intestinal protozoan infections among school-aged children in Nepal

Trop Med Int Health. 2016 Jun;21(6):703-19. doi: 10.1111/tmi.12700. Epub 2016 May 11.

Abstract

Objectives: To assess the trends in prevalence of soil-transmitted helminths (STHs), Entamoeba histolytica and Giardia lamblia among school-aged children in Nepal between 1990 and 2015.

Methods: Systematic literature search in PubMed, MEDLINE, EMBASE, Google Scholar and local peer-reviewed journals for papers published between 1990 and December 2015. We conducted metaregression and meta-analyses to pool studies where applicable.

Results: Thirty-nine studies that examined a total of 14 729 stool specimens were included in the meta-analyses. The metaregression of prevalence of hookworms, roundworm, and whipworm showed a significantly decreasing trend over time. In or after 2004, the pooled prevalence of hookworm infections was 1.53% (95% CI, 0.73-2.59), of roundworm 4.31% (95% CI, 2.52-6.53) and of whipworm 2.89% (95% CI, 1.33-4.97) vs. 16.54% (95% CI, 7.64-27.97) for hookworm, 25.20% (95% CI, 13.59-38.97) for roundworm and 11.54% (95% CI 4.25-21.76) for whipworm in 1993-2003. E. histolytica and G. lamblia had stable prevalence since early 1990s, with a pooled prevalences of 4.12% (95% CI, 2.73-5.77) and 9.40% (95% CI, 7.15-11.92), respectively. The prevalence of G. lamblia was significantly higher in urban areas.

Conclusions: We observed a sharp decrease in prevalence of STHs among school-aged children in Nepal in the past decade with prevalences dropping below 5% for STHs with no variation in prevalence in rural and urban areas. However, the prevalence of E. histolytica and G. lamblia remained stable over time. These results suggest that school-based deworming programmes rolled out during the study period had an observable impact on prevalence of STHs.

Keywords: Entamoeba histolytica; Giardia lamblia; Nepal; Népal; STH; prevalence; prevalencia; prévalence; soil-transmitted helminth; tendance; tendencias; trend.

Publication types

  • Review

MeSH terms

  • Ancylostomatoidea
  • Animals
  • Child
  • Cross-Sectional Studies
  • Entamoeba histolytica*
  • Giardia lamblia*
  • Helminthiasis / epidemiology*
  • Helminthiasis / prevention & control
  • Helminthiasis / transmission
  • Helminths*
  • Humans
  • Intestinal Diseases / epidemiology*
  • Intestinal Diseases / parasitology
  • Intestinal Diseases / prevention & control
  • Intestinal Diseases, Parasitic / epidemiology
  • Intestinal Diseases, Parasitic / parasitology
  • Intestinal Diseases, Parasitic / prevention & control
  • Intestinal Diseases, Parasitic / transmission
  • Nepal / epidemiology
  • Prevalence
  • Protozoan Infections / epidemiology*
  • Protozoan Infections / parasitology
  • Protozoan Infections / prevention & control
  • Protozoan Infections / transmission
  • Soil*
  • Trichuris

Substances

  • Soil