Published: January 17, 2021 | File type: PDF

Post-intervention epidemiology of STH in Bangladesh: Data to sustain the gains

Sanjaya Dhakal, Mohammad Jahirul Karim, Abdullah Al Kawsar, Jasmine Irish, Mujibur Rahman, Cara Tupps, Ashraful Kabir, Rubina Imtiaz

The government of Bangladesh conducted school-based mass drug administration (MDA) for over 10 years to control soil-transmitted helminth (STH) infections. School-based evaluations of MDA indicate a reduction in STH burden among school-aged children (SAC). To further assess the impact on the community, Children Without Worms and the Ministry of Health and Family Welfare’s Program on Elimination of Lymphatic Filariasis and STH (ELFSTH) initiated district-level community impact surveys in 12 districts. We share the results from 10 of those districts here (the first two pilots were excluded because of possible sampling errors).

Our analysis of 10,824 interviews and stool samples from 10 districts showed an estimated 14% of community members infected with at least one species of STH. This finding is substantially lower than the baseline STH prevalence (79.8%) estimated in 2005. A reduction in STH burden was achieved across all ages despite the MDA program treating only SAC. Deworming source data showed significant numbers of adults and pre-school age children (PSAC) self-dewormed with locally purchased pills.

Prevalence varied across the surveyed districts, with persistent high transmission in the northeastern districts and a district in the central flood zone, indicating possible ecological and service factors contributing to persistent infections. Variable impact across districts highlights the need for sub-national-level data to evaluate program performance following the consistent high intervention and could be attributable to many additional factors.

Dhakal, S., Karim, M.J., Kawsar, A.A., Irish, J., Rahman, M., Tupps, C., Kabir, A., Imtiaz, R. (2020). Post-intervention epidemiology of STH in Bangladesh: Data to sustain the gains. PLOS Neglected Tropical Diseases 14(12): e0008597.