1. A first nation-wide assessment of soil-transmitted helminthiasis in Fijian primary schools, and factors associated with the infection, using a lymphatic filariasis transmission assessment survey as surveillance platform.
- Author
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Kim SH, Stothard JR, Rinamalo M, Rainima-Qaniuci M, Talemaitoga N, Kama M, Rafai E, Jang S, Kim JY, Oh YM, Kim EM, Hong ST, Lowry JH, Verweij JJ, Kelly-Hope LA, and Choi MH
- Subjects
- Adolescent, Ancylostomatoidea isolation & purification, Animals, Ascaris isolation & purification, Child, Child, Preschool, Cross-Sectional Studies, Elephantiasis, Filarial epidemiology, Female, Fiji epidemiology, Helminthiasis epidemiology, Humans, Male, Parasite Egg Count, Prevalence, Shoes, Students, Surveys and Questionnaires, Trichuris isolation & purification, Water Supply, Ascariasis epidemiology, Hookworm Infections epidemiology, Trichuriasis epidemiology
- Abstract
Background: Soil-transmitted helminthiasis (STH) is endemic in Fiji but its prevalence is not known and likely to have changed after a decade of mass drug administration (MDA) for lymphatic filariasis (LF). By linking with LF transmission assessment surveys (LF-TAS), we undertook the first nation-wide assessment of STH in Fijian primary schools, as well as an analysis of factors associated with STH infections., Methodology/principal Findings: A cross-sectional assessment for STH was conducted in all four Divisions of Fiji from 2014 to 2015. In the Western, Central, and Northern Divisions, schools were sub-sampled after LF-TAS, while, in the Eastern Division, schools were selected via simple random sampling. For the diagnosis of STH, stool samples were examined by coproscopy with a single Kato-Katz thick smear (KK) and the formol-ether-acetate concentration technique, except for the samples from the Eastern Division where only KK was used. Mean prevalence of any STH among class 1-2 students at the national level was 10.5% (95% CI: 6.9-15.5). Across the three Divisions via LF-TAS, the prevalence levels for ascariasis were 8.7% (95% CI: 4.3-16.6), hookworm 3.9% (95% CI: 2.3-6.6) and trichuriasis 0%. In the Eastern Division, ascariasis prevalence was 13.3% (95% CI: 6.4-25.6), and hookworm 0.7% (95% CI: 0.2-2.5), with one case of trichuriasis. Among class 3-8 students, ascariasis prevalence was lower. Lower risk of any STH was associated with wearing shoes (adjusted OR 0.54, 95% CI: 0.32-0.90) and having piped water from the Fiji Water Authority at home (adjusted OR 0.48, 95% CI: 0.25-0.92)., Conclusions: After a decade of community-based LF-MDA, STH in school-age children in Fiji is now close to 10%, but localities of endemicity remain. Preventive chemotherapy should be maintained in areas with elevated STH prevalence alongside targeted delivery of integrated WASH interventions. LF-TAS has provided an opportunity to develop future public health surveillance platforms., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2020
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