Model-based geostatistical design and analysis of prevalence for soil-transmitted helminths in Kenya: Results from ten-years of the Kenya national school-based deworming programme
Collins Okoyo,
Mark Minnery,
Idah Orowe,
Chrispin Owaga,
Suzy J. Campbell,
Christin Wambugu,
Nereah Olick,
Jane Hagemann,
Wyckliff P. Omondi,
Kate McCracken,
Antonio Montresor,
Graham F. Medley,
Claudio Fronterre,
Peter Diggle,
Charles Mwandawiro
Affiliations
Collins Okoyo
School of Mathematics, University of Nairobi, Nairobi, Kenya; Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya; Department of Epidemiology, Statistics and Informatics (DESI), Kenya Medical Research Institute, Nairobi, Kenya; Corresponding author. Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi, Kenya.
Mark Minnery
Deworm the World, Evidence Action, Washington DC, United States
Idah Orowe
School of Mathematics, University of Nairobi, Nairobi, Kenya
Chrispin Owaga
Deworm the World, Evidence Action, Nairobi, Kenya
Suzy J. Campbell
Deworm the World, Evidence Action, Washington DC, United States
Christin Wambugu
Division of Adolescent and School Health (DASH), Ministry of Health, Nairobi, Kenya
Nereah Olick
School Health, Nutrition and Meals Unit (SHNMU), Ministry of Education, Nairobi, Kenya
Jane Hagemann
Deworm the World, Evidence Action, Washington DC, United States
Wyckliff P. Omondi
Division of Vector Borne and Neglected Tropical Diseases (DVBNTD), Ministry of Health, Nairobi, Kenya
Kate McCracken
Deworm the World, Evidence Action, Washington DC, United States
Antonio Montresor
Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
Graham F. Medley
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
Claudio Fronterre
Centre for Health Informatics, Computing and Statistics (CHICAS), Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
Peter Diggle
Centre for Health Informatics, Computing and Statistics (CHICAS), Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
Charles Mwandawiro
Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya
Background: Kenya is endemic for soil-transmitted helminths (STH) with over 6 million children in 27 counties currently at-risk. A national school-based deworming programme (NSBDP) was launched in 2012 with a goal to eliminate parasitic worms as a public health problem. This study used model-based geostatistical (MBG) approach to design and analyse the impact of the NSBDP and inform treatment strategy changes. Methods: A cross-sectional study was used to survey 200 schools across 27 counties in Kenya. The study design, school selection and analysis followed the MBG approach which incorporated historical data on treatment, morbidity and environmental covariates to efficiently predict the helminths prevalence in Kenya. Results: Overall, the NSBDP geographic area prevalence for any STH was estimated to sit between 2 % and 0.999. Species-specific thresholds were between 2 % and 0.999. Conclusions: Based on the World Health Organization guidelines, STH treatment requirements can now be confidently refined. Ten counties may consider suspending treatment and implement appropriate surveillance system, while another 10 will require treatment once every two years, and the remaining seven will require treatment once every year.
