背景:土壤传播的蠕虫病(STH)是撒哈拉以南非洲的主要公共卫生问题。在肯尼亚,国家学校驱虫计划(NSBDP)于2012年启动,目标是将学龄儿童的STH患病率(SAC)降低到<1%,然而,监测和评估结果一致显示,纳罗克县的患病率>20%。我们进行了一项研究,以调查纳罗克县SAC中与STH感染相关的因素。
方法:在跨马拉西部县的五所学校的514个SAC中进行了一项横断面研究,纳罗克县。之所以选择该县,是因为它在NSBDP中有参与的学校,并且STH感染率很高。采用系统随机抽样方法选择参与者。使用Kato-Katz技术检查从参与者收集的粪便样品的STH卵。一个开放的数据套件问卷被用来收集社会人口统计数据,家庭,和来自514个SAC中的139个的STH知识信息。描述性统计数据被用来总结数据,计算感染的患病率和平均强度,和逻辑回归用于确定与STH感染相关的因素。
结果:任何STH感染的总患病率为24.6%(95CI:21.1-28.6)。Trichuristrichiura14.4%(95CI:11.7-17.8),蛔虫12.5%(95CI:9.9-15.7),钩虫0%。从多变量分析,与STH感染风险增加显著相关的唯一因素是,在Karda和Nkarano学校上学的儿童的aOR=5.29(95CI:1.45-19.24);p=0.011和aOR=4.53(95CI:1.29-15.97);p=0.019。对于A.lumbricoides,就读于Nkarano学校的儿童与感染的显著风险相关,aOR=7.81(95CI:1.81-33.63);p=0.006.
结论:尽管NSBDP正在进行工作,跨马拉西县纳罗克县的STH患病率仍≥20%,在SAC中。这突出表明需要持续的年度MDA。此外,如果可能,药物组合可以有效地管理T.trichiura,该地区最常见的蠕虫。研究发现,在特定学校上学的儿童与STH感染风险之间存在相关性,表明健康教育和改善水的重要性,卫生,学校和相关集水区的卫生习惯和卫生习惯,这些措施可以充当STH水库,以减轻STH的负担。
BACKGROUND: Soil-transmitted
helminthiasis (STH) are a major public health problem in Sub-Saharan Africa. In Kenya, the National School Based Deworming Program (NSBDP) was launched in 2012 with a goal of reducing STH prevalence in school-aged children (SAC) to <1%, however monitoring and evaluation results have consistently showed > 20% prevalence in Narok County. We conducted a
study to investigate factors associated with STH infections among SAC in Narok County.
METHODS: A cross-sectional
study was conducted among 514 SAC from five schools in Trans Mara West sub-county, Narok County. The sub-county was selected because it had participating schools within the NSBDP with a high prevalence of STH infection. Participants were selected using systematic random sampling. Stool samples collected from participants were examined for STH eggs using Kato-Katz technique. An open data kit questionnaire was used to collect socio-demographics, household, and STH knowledge information from 139 of the 514 SAC. Descriptive statistics was used to summarize the data, prevalence and mean intensity of infections were calculated, and logistic regression used to determine factors associated with STH infections.
RESULTS: The overall prevalence of any STH infection was 24.6% (95%CI: 21.1-28.6). Trichuris trichiura 14.4% (95%CI: 11.7-17.8), Ascaris lumbricoides 12.5% (95%CI: 9.9-15.7) and hookworm 0%. From multivariable analysis the only factors significantly associated with increased risk of STH infection were, children attending Karda and Nkarano schools with aOR = 5.29 (95%CI: 1.45-19.24); p = 0.011 and aOR = 4.53 (95%CI: 1.29-15.97); p = 0.019 respectively. For A. lumbricoides, children attending Nkarano School were associated with a significant risk of infection with aOR = 7.81 (95%CI: 1.81-33.63); p = 0.006.
CONCLUSIONS: Despite the ongoing work of NSBDP, the STH prevalence is still ≥ 20% in Trans Mara West sub-county Narok County, among SAC. This underscores the need for continued annual MDA. Additionally, if possible, drug combinations may effectively manage T. trichiura, the region\'s most common helminth. The
study found a correlation between children attending specific schools and STH infection risk, suggesting the importance of health education and improved water, sanitation, and hygiene practices holistically both in schools and associated catchment areas that can act as STH reservoirs to alleviate the burden of STH.