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Okoyo C, Minnery M, Orowe I, Owaga C, Campbell SJ, Wambugu C, Olick N, Hagemann J, Omondi WP, McCracken K, Montresor A, Medley GF, Fronterre C, Diggle P, Mwandawiro C. 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. Heliyon 2023; 9:e20695. [PMID: 37829802 PMCID: PMC10565763 DOI: 10.1016/j.heliyon.2023.e20695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 10/14/2023] Open
Abstract
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 <10 % with a high predictive probability of >0.999. Species-specific thresholds were between 2 % and <10 % for Ascaris lumbricoides, 0 % to <2 % for hookworm, and 0 % to <2 % for Trichuris trichiura, all with high predictive probability of >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.
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Affiliation(s)
- 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
| | - Mark Minnery
- Deworm the World, Evidence Action, Washington DC, United States
| | - Idah Orowe
- School of Mathematics, University of Nairobi, Nairobi, Kenya
| | | | | | - 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
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