Okoyo Collins, Minnery Mark, Orowe Idah, Owaga Chrispin, Campbell Suzy J, Wambugu Christin, Olick Nereah, Hagemann Jane, Omondi Wyckliff P, McCracken Kate, Montresor Antonio, Medley Graham F, Fronterre Claudio, Diggle Peter, Mwandawiro Charles
School of Mathematics, University of Nairobi, Nairobi, Kenya.
Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya.
Heliyon. 2023 Oct 5;9(10):e20695. doi: 10.1016/j.heliyon.2023.e20695. eCollection 2023 Oct.
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.
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.
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 0 % to <2 % for hookworm, and 0 % to <2 % for , all with high predictive probability of >0.999.
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.
肯尼亚是土壤传播蠕虫（STH）的地方性流行区，目前27个县有超过600万儿童面临感染风险。2012年启动了一项全国性的学校驱虫计划（NSBDP），目标是消除寄生虫作为一个公共卫生问题。本研究采用基于模型的地质统计学（MBG）方法来设计和分析NSBDP的影响，并为治疗策略的改变提供依据。
采用横断面研究方法对肯尼亚27个县的200所学校进行调查。研究设计、学校选择和分析遵循MBG方法，该方法纳入了治疗、发病率和环境协变量的历史数据，以有效预测肯尼亚的蠕虫流行率。
总体而言，NSBDP地理区域内任何STH的流行率估计在2%至<10%之间，预测概率高，>0.999。特定物种的阈值在2%至<10%之间，钩虫为0%至<2%，蛔虫为0%至<2%，所有预测概率均>0.999。
根据世界卫生组织的指南，现在可以自信地完善STH治疗要求。10个县可考虑暂停治疗并实施适当的监测系统，另外10个县每两年需要治疗一次，其余7个县每年需要治疗一次。
