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Elimination of morbidity due to soil-transmitted helminthiases among Afghan schoolchildren.
Acta Trop. 2019 Sep; 197:105035.AT

Abstract

Large sectors of the Afghan population have limited access to safe water and sanitation, which increases the risk of transmission of water- and food- borne diseases, including Soil-Transmitted Helminth (STH) infections. STHs interfere with the human host's health status, and their burden of disease is highest among children of school age. Based on the results of a nationwide survey conducted in 2003, which showed an STH prevalence of 47.2%, and with the aim of reducing morbidity among school children, Afghanistan has been conducting nationwide deworming for preschool-age and school-age children since 2004. In 2017, 14 years after the first baseline assessment, a follow-up survey was carried out among schoolchildren aged 8-10 years to provide an update on STH epidemiology and facilitate evidence-informed planning of future deworming campaigns. Stool samples were collected from 2263 pupils aged 8-10 years in five provinces representing the different ecological zones of the country - Kabul, Balkh, Herat, Nangarhar and Kandahar. Microscopic examination was carried out by the Kato-Katz thick smear technique, to assess the presence and the number of parasites and/or their eggs. The survey revealed that 26.6% of the sample was infected with at least one of the STH, a marked decrease from the level registered in 2003. The most prevalent infection was the one with A. lumbricoides (25.7%), followed by T. trichiura (1.0%) and hookworms (0.1%). All positive children were noted to have light-intensity infections, compared to the previous survey where 9.7% of the sample had moderate-to-heavy intensity infections. Only 0.2% of the children had co-infection with two or more parasites. Meanwhile, 6.8% of the students were found infected with the dwarf tapeworm, Hymenolepis nana. The absence of infections of moderate-to-heavy intensity after several yearly rounds of deworming and overall improvements in provision of safe water and sanitation, indicates successful control of morbidity due to STH and, overall, their elimination as a public-health problem from Afghanistan. Nevertheless, current levels of prevalence of infection still show persistence of active transmission of STHs, thus justifying the continued implementation of mass deworming interventions among children. The permanent elimination of STH transmission, however, will be possible only when the country reaches a sanitation level sufficient to impede fecal contamination of the environment with human excreta.

Authors+Show Affiliations

World Health Organization Country Office, Kabul, Afghanistan. Electronic address: safina@who.int.World Health Organization Country Office, Kabul, Afghanistan.Child and Adolescent Health Department, General Directorate of Preventive Medicine, Ministry of Public Health, Kabul, Afghanistan.Division of Communicable Diseases, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt.Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.Division of Communicable Diseases, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31128094

Citation

Safi, Naimullah, et al. "Elimination of Morbidity Due to Soil-transmitted Helminthiases Among Afghan Schoolchildren." Acta Tropica, vol. 197, 2019, p. 105035.
Safi N, Warusavithana S, Shah Alawi SA, et al. Elimination of morbidity due to soil-transmitted helminthiases among Afghan schoolchildren. Acta Trop. 2019;197:105035.
Safi, N., Warusavithana, S., Shah Alawi, S. A., Atta, H., Montresor, A., & Gabrielli, A. F. (2019). Elimination of morbidity due to soil-transmitted helminthiases among Afghan schoolchildren. Acta Tropica, 197, 105035. https://doi.org/10.1016/j.actatropica.2019.05.026
Safi N, et al. Elimination of Morbidity Due to Soil-transmitted Helminthiases Among Afghan Schoolchildren. Acta Trop. 2019;197:105035. PubMed PMID: 31128094.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Elimination of morbidity due to soil-transmitted helminthiases among Afghan schoolchildren. AU - Safi,Naimullah, AU - Warusavithana,Supriya, AU - Shah Alawi,Sayed Ali, AU - Atta,Hoda, AU - Montresor,Antonio, AU - Gabrielli,Albis Francesco, Y1 - 2019/05/22/ PY - 2018/09/25/received PY - 2019/05/19/revised PY - 2019/05/20/accepted PY - 2019/5/28/pubmed PY - 2019/12/4/medline PY - 2019/5/26/entrez KW - Afghanistan KW - Deworming KW - Sanitation KW - Soil-transmitted helminth KW - Water KW - Worms SP - 105035 EP - 105035 JF - Acta tropica JO - Acta Trop. VL - 197 N2 - Large sectors of the Afghan population have limited access to safe water and sanitation, which increases the risk of transmission of water- and food- borne diseases, including Soil-Transmitted Helminth (STH) infections. STHs interfere with the human host's health status, and their burden of disease is highest among children of school age. Based on the results of a nationwide survey conducted in 2003, which showed an STH prevalence of 47.2%, and with the aim of reducing morbidity among school children, Afghanistan has been conducting nationwide deworming for preschool-age and school-age children since 2004. In 2017, 14 years after the first baseline assessment, a follow-up survey was carried out among schoolchildren aged 8-10 years to provide an update on STH epidemiology and facilitate evidence-informed planning of future deworming campaigns. Stool samples were collected from 2263 pupils aged 8-10 years in five provinces representing the different ecological zones of the country - Kabul, Balkh, Herat, Nangarhar and Kandahar. Microscopic examination was carried out by the Kato-Katz thick smear technique, to assess the presence and the number of parasites and/or their eggs. The survey revealed that 26.6% of the sample was infected with at least one of the STH, a marked decrease from the level registered in 2003. The most prevalent infection was the one with A. lumbricoides (25.7%), followed by T. trichiura (1.0%) and hookworms (0.1%). All positive children were noted to have light-intensity infections, compared to the previous survey where 9.7% of the sample had moderate-to-heavy intensity infections. Only 0.2% of the children had co-infection with two or more parasites. Meanwhile, 6.8% of the students were found infected with the dwarf tapeworm, Hymenolepis nana. The absence of infections of moderate-to-heavy intensity after several yearly rounds of deworming and overall improvements in provision of safe water and sanitation, indicates successful control of morbidity due to STH and, overall, their elimination as a public-health problem from Afghanistan. Nevertheless, current levels of prevalence of infection still show persistence of active transmission of STHs, thus justifying the continued implementation of mass deworming interventions among children. The permanent elimination of STH transmission, however, will be possible only when the country reaches a sanitation level sufficient to impede fecal contamination of the environment with human excreta. SN - 1873-6254 UR - https://www.unboundmedicine.com/medline/citation/31128094/Elimination_of_morbidity_due_to_soil_transmitted_helminthiases_among_Afghan_schoolchildren_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0001-706X(18)31200-2 DB - PRIME DP - Unbound Medicine ER -