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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

Kim, Sung Hye, Stothard, Russell ORCID: https://orcid.org/0000-0002-9370-3420, Rinamalo, Milika, Rainima-Qaniuci, Meleresita, Talemaitoga, Nemani, Kama, Mike, Rafai, Eric, Jang, Seoyun, Kim, Ji Young, Oh, Yoo Min, Kim, Eun-Min, Hong, Sung-Tae, Lowry, John H., Verweij, Jaco J., Kelly-Hope, Louise ORCID: https://orcid.org/0000-0002-3330-7629 and Choi, Min-Ho (2020) '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'. PLoS Neglected Tropical Diseases, Vol 14, Issue 9, e0008511.

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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.

Item Type: Article
Subjects: QX Parasitology > Helminths. Annelida > QX 200 Helminths
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 880 Filariasis and related conditions (General)
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pntd.0008511
Depositing User: Cathy Waldron
Date Deposited: 30 Sep 2020 15:35
Last Modified: 21 Oct 2020 11:08
URI: https://archive.lstmed.ac.uk/id/eprint/15687

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