MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary's Campus, London, W2 1PG, UK.
London Centre for Neglected Tropical Disease Research, London, UK.
Parasit Vectors. 2022 Nov 4;15(1):410. doi: 10.1186/s13071-022-05465-7.
The Geshiyaro project is a 5-year intervention to assess the impact of community- and school-based water, sanitation, and hygiene (WaSH) interventions on reducing infection with soil-transmitted helminths (STH) and schistosome parasites in combination with deworming in Wolayita zone, Ethiopia.
A population-based, cross-sectional census and parasitological mapping activity was conducted between 2018 and 2019. Individuals in the census were identified using either a registered study ID card or biometric fingerprint to enable linkage of their household WaSH data with baseline STH and schistosome prevalence for risk analysis.
Prevalence of STH was 15.5% for any STH species, 9.47% for Ascaris lumbricoides, 1.78% for Trichuris trichiura, and 7.24% for hookworm. Intestinal schistosomiasis (Schistosoma mansoni) infection prevalence was 0.85% by Kato Katz, 21.6% by POC-CCA trace positive (Tr +), and 13.3% trace negative (Tr-). Microhaematuria was 2.77%, with 0.13% of people examined with S. haematobium eggs detected by urine filtration. At the household level, increased (> 30 min) time taken to collect drinking water, sharing a latrine, and lack of handwashing facilities were all associated with a greater risk of A. lumbricoides, hookworm, and S. mansoni infection. Not disposing of infant stool at the household and clothes washing/recreational freshwater contact were significantly associated with higher risk of schistosomiasis infection. Aggregating WaSH data at the community level showed odds of A. lumbricoides, hookworm, and T. trichiura infection were significantly lower as both community sanitation coverage and access to improved drinking water improved.
The principal finding of this study is that lack of access to WaSH, such as improved drinking water and shared toilet and hand-washing facilities, were linked to an increased risk of infection with STH and schistosome parasites. These associations are difficult to establish at an individual household level because of wide variability in access between houses but are detectable when coverage is aggregated at the community level. Maintenance of WaSH facilities as well as increased access within the whole community is important in influencing the community-wide prevalence of infection with STH and schistosome parasites.
Geshiyaro 项目是一项为期 5 年的干预措施，旨在评估社区和学校为基础的水、环境卫生和个人卫生（WASH）干预措施对减少土壤传播性蠕虫（STH）和血吸虫寄生虫感染的影响，同时结合驱虫在埃塞俄比亚沃莱塔地区的效果。
在 2018 年至 2019 年期间，进行了一项基于人群的横断面普查和寄生虫绘图活动。使用已注册的研究身份证或生物特征指纹识别普查中的个体，以便将其家庭 WASH 数据与基线 STH 和血吸虫流行率相关联，以进行风险分析。
任何 STH 物种的 STH 流行率为 15.5%，蛔虫感染率为 9.47%，鞭虫感染率为 1.78%，钩虫感染率为 7.24%。肠道血吸虫病（曼氏血吸虫）感染率为 0.85%（加藤法），21.6%（POC-CCA 痕量阳性（Tr+））和 13.3%（痕量阴性（Tr-））。微量血尿为 2.77%，尿液过滤检测到 0.13%的人有埃及血吸虫卵。在家庭层面上，收集饮用水的时间增加（>30 分钟）、共用厕所和缺乏洗手设施都与感染蛔虫、钩虫和曼氏血吸虫的风险增加有关。在家里没有处理婴儿粪便以及衣服洗涤/娱乐性淡水接触与感染血吸虫病的风险显著相关。将 WASH 数据汇总到社区层面显示，随着社区卫生覆盖率和获得改善饮用水的机会增加，感染蛔虫、钩虫和鞭虫的几率显著降低。
本研究的主要发现是，缺乏获得 WASH 的机会，如改善饮用水和共享厕所和洗手设施，与 STH 和血吸虫寄生虫感染的风险增加有关。由于家庭之间的获得机会差异很大，因此这些关联很难在家庭层面上建立，但在社区层面上汇总覆盖率时是可以检测到的。维护 WASH 设施以及在整个社区增加获得机会对于影响社区范围内 STH 和血吸虫寄生虫感染的流行率非常重要。
