Published: January 26, 2023 | File type: PDF

Interventions to improve water, sanitation, and hygiene for preventing soil-transmitted helminth infection (Review)

Joshua V Garn, Jennifer L Wilkers, Ashley A Meehan, Lisa M Pfadenhauer, Jacob Burns, Rubina Imtiaz, Matthew C Freeman

Published on the Cochrane Library’s Cochrane Database of Systematic Reviews, the review Interventions to improve water, sanitation, and hygiene for preventing soil-transmitted helminth infection was written by Garn et al. You may find the full publication here.

An estimated 1.5 billion people are affected with soil transmitted helminth (STH) infections worldwide, and despite deworming, reinfection occurs soon after. The interruption of transmission is unlikely without the implementation of complementary control efforts in water, sanitation, and hygiene (WASH) access and behaviours. The review is an appraisal of 32 studies that reported on the primary outcome of STH infection due to the WASH access or practice interventions, that were conducted in areas where STH is endemic. Using a random effects meta-analysis to pool study estimates, it showed that the WASH interventions under study may result in a slight reduction of any STH, with an odds ratio (OR) of 0.86 amongst RCTs (95% confidence interval (CI) 0.74 to 1.01; moderate‐certainty evidence) and an OR of 0.71 amongst non‐RCTs (95% CI 0.54 to 0.94; low‐certainty evidence). The authors conclude that whilst the available evidence suggests that the WASH interventions under study may slightly protect against STH infection, WASH also serves as a broad preventive measure for many other diseases that have a fecal oral transmission route of transmission. The biological plausibility for improved access to WASH to interrupt transmission of STHs is clear, but WASH interventions as currently delivered have shown impacts that were lower than expected, therefore further rigorous implementation research and evaluation is required of the impact of future WASH interventions providing benefit to users co-infected with STH infections.