Soil-transmitted helminth infections among pre-school aged children in Gamo Gofa zone, Southern Ethiopia: Prevalence, intensity and intervention status

Background Soil-transmitted helminths (STH), i.e., Ascaris lumbricoides, Trichuris trichiura and hookworms are among the most prevalent Neglected Tropical Diseases (NTDs) in Ethiopia. Although pre-school aged children pay a high morbidity toll associated with STH infections, evidence on prevalence, intensity and intervention status is lacking in Ethiopia. This study, therefore, aimed to address these gaps to inform decision made on STH. Methods We did a community-based cross-sectional study in five districts of Gamo Gofa zone, Southern Ethiopia; in January 2019. Data were collected using pre-tested questionnaire, and the Kato-Katz technique was used to diagnose parasites eggs in stool. Then, collected data were edited and entered into EpiData 4.4.2, and exported to SPSS software (IBM, version 25) for analysis. Results A total of 2462 PSAC participated in this study. Overall, the prevalence of STH was 23.5% (578/2462) (95% confidence interval (CI) = 21.8%–25.2%). As caris lumbricoides was the most prevalent (18.6%), followed by Trichuris trichiura (9.2%), and hookworms (3.1%). Of the total, 7.4% PSAC were infected with two STH species. Most of the positive cases with STH showed low infection intensities, while 15.1% ascariasis cases showed moderate infection intensities. The study found that 68.7% of PSAC were treated with albendazole. Also, household’s level data showed that 39.4% used water from hand-dug well; 52.5% need to travel ≥30 minutes to collect water; 77.5% did not treat water, and 48.9% had no hand washing facility. In addition, almost 93% care givers achieved less than the mean knowledge and practice score (≤5) on STH prevention. Conclusions This study showed that significant proportions of pre-school aged children are suffering from STH infections despite preventive chemotherapy exist at the study area. Also, gaps in the interventions against STH were highlighted. Thus, a call for action is demanding to eliminate STH among PSAC in Ethiopia by 2030.


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Although pre-school age children pay high morbidity toll associated with STH infections, 29 evidence on prevalence, intensity and intervention status is lacking in Ethiopia. This study, 30 therefore, aimed to address these gaps to inform decision made on STH.

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We did a community-based cross-sectional study in five districts of Gamo Gofa zone,

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A total of 2462 PSAC participated in this study. Overall, the prevalence of STH was 23.5% 39 (578/2462) (95% confidence interval (CI) = 21.8-25.2%) with highest prevalence (33.8%) in 40 Chencha district. Ascaris lumbricoides was the most prevalent (18.6%), followed by 41 Trichuris trichiura (9.2%), and hookworms (3.1%). Of the total, 7.4% PSAC were infected 42 with two STH species. Most of the positive cases with STH were showed low infection 43 intensities while 15.1% ascariasis cases were revealed the moderate infection intensities. It is 44 found that 68.7% of PSAC were treated with albendazole. Also, household's level data 45 showed that 39.4% used water from hand-dug well, and 48.9% not had hand washing facility.

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In addition, almost 93% mothers or guardians achieved less than the mean knowledge and

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In line WHO's goal, Ethiopia has also set a similar goal to achieve by the same year [12].

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To achieve these goals, in areas where prevalence of any soil-transmitted infection is 20% or 84 higher, periodic mass administration of preventive chemotherapy (deworming) using annual 85 or biannual single-dose albendazole or mebendazole is recommended by WHO for all pre-86 school and school age children (10). . This implies that PC was started before ten years 98 to combat STH in PSAC at study area. However, the impact of deworming on STH infection 99 status among PSAC is not monitored and evaluated, and evidence is lacking at national level 100 on prevalence, intensity and intervention status of STH infections among PSAC. Therefore, 101 the present study aimed to determine prevalence, intensity, and intervention status of STH 102 infections among preschool children in Gamo Gofa zone and to inform decision-making. .      considerable amount of hookworm infections (10%) were revealed (Figure 2). The prevalence of STH infections across the age-group (1 -5 years) was slightly higher at ≤2 207 years while comparing across the age-group (1-5 years). On the other hand, prevalence of any 208 STH infections among females (24.3%) was a little higher than the male's (22.7%), and a 209 higher prevalence of STH infections (24.6%) in rural area was noticed than urban (20.1%).

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Children who did not receive PC in the last one year had slightly higher prevalence of STH 211 infections compared to those who received PC (23.9% versus 18.7%), (Table 3).    (Table 5).

III. Water, Sanitation and Hygiene (WASH)
256 Table 6 presents the details on WASH characteristics at HHs level. This study also revealed 257 households data as, 39.4% used water from hand-dug well, 52.5% of need to move more than 258 30 minutes to collect water, 77.5% did not use treat water, and 48.9% did not own hand 259 washing facility (Table 6).  water from well, 52.5% were walking more than 30 minutes to collect water, 77.5 % did not treat water, and 48.9% of not had hand washing facility. Of the total surveyed mothers or 325 guardians, almost 93% achieved less than the mean KP score (≤5) on prevention of STH, 326 42.7% did not wash hand after defecation, and 77.7% got information on STH from health 327 extension workers (HEWs). The possible reason for these findings could be related to weak 328 and inconsistent social behavioral change communication (SBCC) intervention.

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The most outstanding strength of our study is that it is addressing an important national 330 operational research priority which is focusing on parasitological monitoring and control 331 strategies of STH among pre-school age children.

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In this study, there are limitations that need to be taken into account. There might be 333 underestimation of prevalence of STH due to the fact that (1)