Reassessment of the prevalence of soil-transmitted helminth infections in Sri Lanka to enable a more focused control programme: a cross-sectional national school survey with spatial modelling
Summary: Background: In Sri Lanka, deworming programmes for soil-transmitted helminth infections became an integral part of school health in the 1960s, whereas routine antenatal deworming with mebendazole started in the 1980s. A 2003 national soil-transmitted helminth survey done among schoolchildr...
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Elsevier
2019-09-01
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Series: | The Lancet Global Health |
Online Access: | http://www.sciencedirect.com/science/article/pii/S2214109X19302530 |
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language |
English |
format |
Article |
sources |
DOAJ |
author |
Dileepa Senajith Ediriweera, MSc Sharmini Gunawardena, ProfMD Nipul Kithsiri Gunawardena, ProfPhD Devika Iddawela, ProfPhD Selvam Kannathasan, ProfPhD Arumugam Murugananthan, MPhil Channa Yahathugoda, ProfPhD Arunasalam Pathmeswaran, ProfMD Peter John Diggle, ProfPhD Nilanthi de Silva, ProfMD |
spellingShingle |
Dileepa Senajith Ediriweera, MSc Sharmini Gunawardena, ProfMD Nipul Kithsiri Gunawardena, ProfPhD Devika Iddawela, ProfPhD Selvam Kannathasan, ProfPhD Arumugam Murugananthan, MPhil Channa Yahathugoda, ProfPhD Arunasalam Pathmeswaran, ProfMD Peter John Diggle, ProfPhD Nilanthi de Silva, ProfMD Reassessment of the prevalence of soil-transmitted helminth infections in Sri Lanka to enable a more focused control programme: a cross-sectional national school survey with spatial modelling The Lancet Global Health |
author_facet |
Dileepa Senajith Ediriweera, MSc Sharmini Gunawardena, ProfMD Nipul Kithsiri Gunawardena, ProfPhD Devika Iddawela, ProfPhD Selvam Kannathasan, ProfPhD Arumugam Murugananthan, MPhil Channa Yahathugoda, ProfPhD Arunasalam Pathmeswaran, ProfMD Peter John Diggle, ProfPhD Nilanthi de Silva, ProfMD |
author_sort |
Dileepa Senajith Ediriweera, MSc |
title |
Reassessment of the prevalence of soil-transmitted helminth infections in Sri Lanka to enable a more focused control programme: a cross-sectional national school survey with spatial modelling |
title_short |
Reassessment of the prevalence of soil-transmitted helminth infections in Sri Lanka to enable a more focused control programme: a cross-sectional national school survey with spatial modelling |
title_full |
Reassessment of the prevalence of soil-transmitted helminth infections in Sri Lanka to enable a more focused control programme: a cross-sectional national school survey with spatial modelling |
title_fullStr |
Reassessment of the prevalence of soil-transmitted helminth infections in Sri Lanka to enable a more focused control programme: a cross-sectional national school survey with spatial modelling |
title_full_unstemmed |
Reassessment of the prevalence of soil-transmitted helminth infections in Sri Lanka to enable a more focused control programme: a cross-sectional national school survey with spatial modelling |
title_sort |
reassessment of the prevalence of soil-transmitted helminth infections in sri lanka to enable a more focused control programme: a cross-sectional national school survey with spatial modelling |
publisher |
Elsevier |
series |
The Lancet Global Health |
issn |
2214-109X |
publishDate |
2019-09-01 |
description |
Summary: Background: In Sri Lanka, deworming programmes for soil-transmitted helminth infections became an integral part of school health in the 1960s, whereas routine antenatal deworming with mebendazole started in the 1980s. A 2003 national soil-transmitted helminth survey done among schoolchildren found an overall prevalence of 6·9%. In our study, we aimed to reassess the national prevalence of soil-transmitted helminth infections to enable implementation of a more focused control programme that targets smaller administrative areas at risk of continued transmission. Methods: We did a cross-sectional, school-based, national survey using multistage stratified cluster sampling, covering all nine provinces as well as populations at high risk of soil-transmitted helminth infections living in urban slums and in plantation-sector communities. Our study population was children aged 5–7 years attending state schools. Faecal samples were collected and analysed with duplicate modified Kato-Katz smears. We modelled the risk of soil-transmitted helminth infection using generalised linear mixed-effects models, and we developed prevalence maps to enable informed decision making at the smallest health administrative level in the country. Findings: Between Jan 23 and May 9, 2017, we recruited 5946 children from 130 schools; 4276 (71·9%) children provided a faecal sample for examination. National prevalence of soil-transmitted helminth infection was 0·97% (95% CI 0·63–1·48) among primary schoolchildren. Prevalence in the high-risk communities surveyed was higher than national prevalence: 2·73% (0·75–6·87) in urban slum communities and 9·02% (4·29–18·0) in plantation sector communities. Our prevalence maps showed that the lowest-level health administrative regions could be categorised into low risk (prevalence <1%), high risk (prevalence >10%), or intermediate risk (1–10%) areas. Interpretation: Our survey findings indicate that the national prevalence of soil-transmitted helminth infection has continued to decline in Sri Lanka. On the basis of WHO guidelines, we recommend discontinuation of routine deworming in low-risk areas, continuation of annual deworming in high-risk areas, and deworming once every 2 years in intermediate-risk areas, for at least 4 years. Funding: Task Force for Global Health and WHO. |
url |
http://www.sciencedirect.com/science/article/pii/S2214109X19302530 |
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doaj-a43ab7d3995d48849750adc5798bc8662020-11-25T01:21:19ZengElsevierThe Lancet Global Health2214-109X2019-09-0179e1237e1246Reassessment of the prevalence of soil-transmitted helminth infections in Sri Lanka to enable a more focused control programme: a cross-sectional national school survey with spatial modellingDileepa Senajith Ediriweera, MSc0Sharmini Gunawardena, ProfMD1Nipul Kithsiri Gunawardena, ProfPhD2Devika Iddawela, ProfPhD3Selvam Kannathasan, ProfPhD4Arumugam Murugananthan, MPhil5Channa Yahathugoda, ProfPhD6Arunasalam Pathmeswaran, ProfMD7Peter John Diggle, ProfPhD8Nilanthi de Silva, ProfMD9Centre for Health Informatics, Biostatistics and Epidemiology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka; Correspondence to: Dileepa Senajith Ediriweera, Centre for Health Informatics, Biostatistics and Epidemiology, Faculty of Medicine, University of Kelaniya, Ragama 11010, Sri LankaDepartment of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri LankaDepartment of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama, Sri LankaDepartment of Parasitology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri LankaDepartment of Parasitology, Faculty of Medicine, University of Jaffna, Jaffna, Sri LankaDepartment of Parasitology, Faculty of Medicine, University of Jaffna, Jaffna, Sri LankaDepartment of Parasitology, Faculty of Medicine, University of Ruhuna, Galle, Sri LankaDepartment of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri LankaCentre for Health Informatics, Computing and Statistics, University of Lancaster, Lancaster, UKDepartment of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama, Sri LankaSummary: Background: In Sri Lanka, deworming programmes for soil-transmitted helminth infections became an integral part of school health in the 1960s, whereas routine antenatal deworming with mebendazole started in the 1980s. A 2003 national soil-transmitted helminth survey done among schoolchildren found an overall prevalence of 6·9%. In our study, we aimed to reassess the national prevalence of soil-transmitted helminth infections to enable implementation of a more focused control programme that targets smaller administrative areas at risk of continued transmission. Methods: We did a cross-sectional, school-based, national survey using multistage stratified cluster sampling, covering all nine provinces as well as populations at high risk of soil-transmitted helminth infections living in urban slums and in plantation-sector communities. Our study population was children aged 5–7 years attending state schools. Faecal samples were collected and analysed with duplicate modified Kato-Katz smears. We modelled the risk of soil-transmitted helminth infection using generalised linear mixed-effects models, and we developed prevalence maps to enable informed decision making at the smallest health administrative level in the country. Findings: Between Jan 23 and May 9, 2017, we recruited 5946 children from 130 schools; 4276 (71·9%) children provided a faecal sample for examination. National prevalence of soil-transmitted helminth infection was 0·97% (95% CI 0·63–1·48) among primary schoolchildren. Prevalence in the high-risk communities surveyed was higher than national prevalence: 2·73% (0·75–6·87) in urban slum communities and 9·02% (4·29–18·0) in plantation sector communities. Our prevalence maps showed that the lowest-level health administrative regions could be categorised into low risk (prevalence <1%), high risk (prevalence >10%), or intermediate risk (1–10%) areas. Interpretation: Our survey findings indicate that the national prevalence of soil-transmitted helminth infection has continued to decline in Sri Lanka. On the basis of WHO guidelines, we recommend discontinuation of routine deworming in low-risk areas, continuation of annual deworming in high-risk areas, and deworming once every 2 years in intermediate-risk areas, for at least 4 years. Funding: Task Force for Global Health and WHO.http://www.sciencedirect.com/science/article/pii/S2214109X19302530 |