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

Trop Med Int Health. 2022 Jan;27(1):81-91. doi: 10.1111/tmi.13697. Epub 2021 Nov 16.

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 (LF) mass drug administration (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 (MLR) and multilevel negative binomial regression (MNBR) 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 before and after the 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.

Keywords: Kato-Katz; hookworm; intensity; mass drug administration; prevalence; soil-transmitted helminths.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Albendazole / administration & dosage
  • Albendazole / therapeutic use*
  • Animals
  • Anthelmintics / administration & dosage
  • Anthelmintics / therapeutic use*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Elephantiasis, Filarial / drug therapy
  • Elephantiasis, Filarial / epidemiology*
  • Elephantiasis, Filarial / parasitology
  • Feces / parasitology
  • Female
  • Humans
  • India / epidemiology
  • Infant
  • Male
  • Middle Aged
  • Prevalence
  • Rural Health Services
  • Soil Microbiology*
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Anthelmintics
  • Albendazole