PLoS Neglected Tropical Diseases (Aug 2021)

Factors associated with soil-transmitted helminths infection in Benin: Findings from the DeWorm3 study.

  • Euripide F G A Avokpaho,
  • Parfait Houngbégnon,
  • Manfred Accrombessi,
  • Eloïc Atindégla,
  • Elodie Yard,
  • Arianna Rubin Means,
  • David S Kennedy,
  • D Timothy J Littlewood,
  • André Garcia,
  • Achille Massougbodji,
  • Sean R Galagan,
  • Judd L Walson,
  • Gilles Cottrell,
  • Moudachirou Ibikounlé,
  • Kristjana Hrönn Ásbjörnsdóttir,
  • Adrian J F Luty

DOI
https://doi.org/10.1371/journal.pntd.0009646
Journal volume & issue
Vol. 15, no. 8
p. e0009646

Abstract

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BackgroundDespite several years of school-based MDA implementation, STH infections remain an important public health problem in Benin, with a country-wide prevalence of 20% in 2015. The DeWorm3 study is designed to assess the feasibility of using community-based MDA with albendazole to interrupt the transmission of STH, through a series of cluster-randomized trials in Benin, India and Malawi. We used the pre-treatment baseline survey data to describe and analyze the factors associated with STH infection in Comé, the study site of the DeWorm3 project in Benin. These data will improve understanding of the challenges that need to be addressed in order to eliminate STH as a public health problem in Benin.MethodsBetween March and April 2018, the prevalence of STH (hookworm spp., Ascaris and Trichuris trichiura) was assessed by Kato-Katz in stool samples collected from 6,153 residents in the community of Comé, Benin using a stratified random sampling procedure. A standardized survey questionnaire was used to collect information from individual households concerning factors potentially associated with the presence and intensity of STH infections in pre-school (PSAC, aged 1-4), school-aged children (SAC, aged 5-14) and adults (aged 15 and above). Multilevel mixed-effects models were used to assess associations between these factors and STH infection.ResultsThe overall prevalence of STH infection was 5.3%; 3.2% hookworm spp., 2.1% Ascaris lumbricoides and 0.1% Trichuris. Hookworm spp. were more prevalent in adults than in SAC (4.4% versus 2.0%, respectively; p = 0.0001) and PSAC (4.4% versus 1.0%, respectively; pConclusionHookworm spp. are the most prevalent STH in Comé, with a persistent reservoir in adults that is not addressed by current control measures based on school MDA. Expanding MDA to target adults and PSAC is necessary to substantially impact population prevalence, particularly for hookworm.Trial registrationClinicalTrials.gov NCT03014167.