Prevalence and intensity of soil-transmitted helminth infections of children in sub-Saharan Africa, 2000-18: a geospatial analysis.

Adolescent Africa South of the Sahara / epidemiology Animals Child Child, Preschool Female Helminthiasis / epidemiology Helminths Humans Male Prevalence Severity of Illness Index Soil / parasitology Spatial Analysis

Journal

The Lancet. Global health
ISSN: 2214-109X
Titre abrégé: Lancet Glob Health
Pays: England
ID NLM: 101613665

Informations de publication

Date de publication:
01 2021
Historique:
received: 03 03 2020
revised: 02 09 2020
accepted: 03 09 2020
pubmed: 19 12 2020
medline: 28 1 2021
entrez: 18 12 2020
Statut: ppublish

Résumé

Driven by global targets to eliminate soil-transmitted helminths as a public health problem, governments have rapidly rolled out control programmes using school and community-based platforms. To justify and target ongoing investment, quantification of impact and identification of remaining high-risk areas are needed. We aimed to assess regional progress towards these targets. We did a continental-scale ecological analysis using a Bayesian space-time hierarchical model to estimate the effects of known environmental, socioeconomic, and control-related factors on the prevalence of soil-transmitted helminths, and we mapped the probability that implementation units had achieved moderate-to-heavy intensity infection prevalence of less than 2% among children aged 5-14 years between Jan 1, 2000, and Dec 31, 2018. We incorporated data from 26 304 georeferenced surveys, spanning 3096 (60%) of the 5183 programmatic implementation units. Our findings suggest a reduction in the prevalence of soil-transmitted helminths in children aged 5-14 years in sub-Saharan Africa, from 44% in 2000 to 13% in 2018, driven by sustained delivery of preventive chemotherapy, improved sanitation, and economic development. Nevertheless, 1301 (25%) of 5183 implementation units still had an estimated prevalence of moderate-to-heavy intensity infection exceeding the 2% target threshold in 2018, largely concentrated in nine countries (in 1026 [79%] of 1301 implementation units): Nigeria, Democratic Republic of the Congo, Ethiopia, Cameroon, Angola, Mozambique, Madagascar, Equatorial Guinea, and Gabon. Our estimates highlight the areas to target and strengthen interventions, and the areas where data gaps remain. If elimination of soil-transmitted helminths as a public health problem is to be achieved in sub-Saharan Africa by 2030, continued investment in treatment and prevention activities are essential to ensure that no areas are left behind. Bill & Melinda Gates Foundation.

Sections du résumé

BACKGROUND
Driven by global targets to eliminate soil-transmitted helminths as a public health problem, governments have rapidly rolled out control programmes using school and community-based platforms. To justify and target ongoing investment, quantification of impact and identification of remaining high-risk areas are needed. We aimed to assess regional progress towards these targets.
METHODS
We did a continental-scale ecological analysis using a Bayesian space-time hierarchical model to estimate the effects of known environmental, socioeconomic, and control-related factors on the prevalence of soil-transmitted helminths, and we mapped the probability that implementation units had achieved moderate-to-heavy intensity infection prevalence of less than 2% among children aged 5-14 years between Jan 1, 2000, and Dec 31, 2018.
FINDINGS
We incorporated data from 26 304 georeferenced surveys, spanning 3096 (60%) of the 5183 programmatic implementation units. Our findings suggest a reduction in the prevalence of soil-transmitted helminths in children aged 5-14 years in sub-Saharan Africa, from 44% in 2000 to 13% in 2018, driven by sustained delivery of preventive chemotherapy, improved sanitation, and economic development. Nevertheless, 1301 (25%) of 5183 implementation units still had an estimated prevalence of moderate-to-heavy intensity infection exceeding the 2% target threshold in 2018, largely concentrated in nine countries (in 1026 [79%] of 1301 implementation units): Nigeria, Democratic Republic of the Congo, Ethiopia, Cameroon, Angola, Mozambique, Madagascar, Equatorial Guinea, and Gabon.
INTERPRETATION
Our estimates highlight the areas to target and strengthen interventions, and the areas where data gaps remain. If elimination of soil-transmitted helminths as a public health problem is to be achieved in sub-Saharan Africa by 2030, continued investment in treatment and prevention activities are essential to ensure that no areas are left behind.
FUNDING
Bill & Melinda Gates Foundation.

Identifiants

DOI: 10.1016/S2214-109X(20)30398-3 PMID: 33338459 PMC: PMC7786448
pubmed: 33338459
pii: S2214-109X(20)30398-3
doi: 10.1016/S2214-109X(20)30398-3
pmc: PMC7786448
pii:
doi:

Substances chimiques

Soil 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e52-e60

Subventions

Organisme : World Health Organization
ID : 001
Pays : International
Organisme : Medical Research Council
ID : MR/N011570/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/N011570/2
Pays : United Kingdom

Informations de copyright

Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

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Auteurs

Benn Sartorius (B)

Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA; Department of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa. Electronic address: benn.sartorius1@lshtm.ac.uk.

Jorge Cano (J)

Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK; Expanded Special Project for Elimination of Neglected Tropical Diseases, WHO Regional Office for Africa, Brazzaville, Democratic Republic of the Congo.

Hope Simpson (H)

Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.

Lucy S Tusting (LS)

Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK.

Laurie B Marczak (LB)

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.

Molly K Miller-Petrie (MK)

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.

Boniface Kinvi (B)

Expanded Special Project for Elimination of Neglected Tropical Diseases, WHO Regional Office for Africa, Brazzaville, Democratic Republic of the Congo.

Honorat Zoure (H)

Expanded Special Project for Elimination of Neglected Tropical Diseases, WHO Regional Office for Africa, Brazzaville, Democratic Republic of the Congo.

Pauline Mwinzi (P)

Expanded Special Project for Elimination of Neglected Tropical Diseases, WHO Regional Office for Africa, Brazzaville, Democratic Republic of the Congo.

Simon I Hay (SI)

Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.

Maria Rebollo (M)

Expanded Special Project for Elimination of Neglected Tropical Diseases, WHO Regional Office for Africa, Brazzaville, Democratic Republic of the Congo.

Rachel L Pullan (RL)

Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Prevalence and intensity of soil-transmitted...
questionsmedicales.fr › Régions géographiques › Afrique › Afrique subsaharienne › Prevalence and intensity of soil-transmitted...
questionsmedicales.fr › Eucaryotes › Animaux › Prevalence and intensity of soil-transmitted...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Prevalence and intensity of soil-transmitted...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Enfant d'âge préscolaire › Prevalence and intensity of soil-transmitted...
questionsmedicales.fr › Infection › Maladies parasitaires › Helminthiase › Prevalence and intensity of soil-transmitted...
questionsmedicales.fr › Eucaryotes › Animaux › Invertébrés › Helminthes › Prevalence and intensity of soil-transmitted...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Prevalence and intensity of soil-transmitted...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Morbidité › Prévalence › Prevalence and intensity of soil-transmitted...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enquêtes et questionnaires › Enquêtes de santé › Indicateurs d'état de santé › Acuité des besoins du patient › Indice de gravité de la maladie › Prevalence and intensity of soil-transmitted...
questionsmedicales.fr › Environnement et santé publique › Environnement › Sol › Prevalence and intensity of soil-transmitted...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse spatiale › Prevalence and intensity of soil-transmitted...