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Impact of single annual treatment and four-monthly treatment for hookworm and Ascaris lumbricoides, and factors associated with residual infection among Kenyan school children

Title: Impact of single annual treatment and four-monthly treatment for hookworm and Ascaris lumbricoides, and factors associated with residual infection among Kenyan school children
Authors: Kepha, S
Mwandawiro, CS
Anderson, RM
Pullan, RL
Nuwaha, F
Cano, J
Njenga, SM
Odiere, MR
Allen, E
Brooker, SJ
Nikolay, B
Item Type: Journal Article
Abstract: Background School-based deworming is widely implemented in various countries to reduce the burden of soil-transmitted helminths (STHs), however, the frequency of drug administration varies in different settings. In this study, we compared the impact of a single annual treatment and 4-monthly treatment over a follow-up among Kenyan school children, and investigated the factors associated with residual infection. Methods We performed a secondary analysis of data from a randomized trial investigating whether deworming for STHs alters risk of acquiring malaria. Children received either a single treatment or 4-monthly albendazole treatments were followed longitudinally from February 2014 to October 2014. The relative impact of treatment and factors associated with residual infections were investigated using mixed-effects regression models. Predisposition to infection was assessed based on Spearman’s rank and Kendall’s Tau correlation coefficients. Results In the 4-monthly treatment group, the proportion of children infected with hookworm decreased from 59.9 to 5.7%, while Ascaris lumbricoides infections dropped from 55.7 to 6.2%. In the single treatment group, hookworm infections decreased over the same time period from 58.7 to 18.3% (12.6% absolute difference in reduction, 95% CI: 8.9–16.3%), and A. lumbricoides from 56.7 to 23.3% (17.1% absolute difference in reduction, 95% CI: 13.1–21.1%). There was strong evidence for predisposition to both STH types. Residual hookworm infection among children on 4-monthly treatment were associated with male sex and baseline nutritional status, whereas A. lumbricoides infection was associated with individual and school-level infection at baseline, latrine cleanliness at schools. Conclusions This study found that 4-monthly treatment w more effective than single annual treatment. Repeated treatments led to dramatic reductions in the intensities of STHs, but did not completely clear infections among school children in Kenya, a presumed reflection of reinfection in a setting where there is ongoing transmission.
Issue Date: 9-Feb-2017
Date of Acceptance: 13-Jan-2017
URI: http://hdl.handle.net/10044/1/65677
DOI: https://dx.doi.org/10.1186/s40249-017-0244-z
ISSN: 2049-9957
Publisher: BioMed Central
Journal / Book Title: Infectious Diseases of Poverty
Volume: 6
Copyright Statement: © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Sponsor/Funder: Bill & Melinda Gates Foundation
Funder's Grant Number: ITDCVH45
Keywords: Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
School-based deworming
Soil-transmitted helminths
Albendazole
School children
Kenya
TRANSMITTED HELMINTH INFECTIONS
ANTHELMINTIC TREATMENT
PRESCHOOL-CHILDREN
INTESTINAL HELMINTHS
OPEN-LABEL
REINFECTION
PREDISPOSITION
EPIDEMIOLOGY
METAANALYSIS
HOUSEHOLD
Adolescent
Ancylostomatoidea
Animals
Anthelmintics
Ascariasis
Ascaris lumbricoides
Child
Child, Preschool
Female
Hookworm Infections
Humans
Longitudinal Studies
Male
Schools
Students
Treatment Outcome
Publication Status: Published
Article Number: ARTN 30
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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