Prevalence and Correlation Analysis of Soil-Transmitted Helminths Infections and Treatment Coverage for Preschool and School Aged Children in Kenya: Secondary Analysis of the National School Based Deworming Program Data

Background: Soil-transmitted helminths (STH) are among the most common parasitic infections globally, disproportionately affecting children. Treatment of STH in Kenya is often targeted at preschool (PSAC) and school aged (SAC) children delivered through annual mass drug administration (MDA) in prima...

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Main Authors: Collins Okoyo (Author), Suzy J. Campbell (Author), Mark Minnery (Author), Chrispin Owaga (Author), Nelson Onyango (Author), Graham Medley (Author), Charles Mwandawiro (Author)
Format: Book
Published: Frontiers Media S.A., 2021-07-01T00:00:00Z.
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100 1 0 |a Collins Okoyo  |e author 
700 1 0 |a Collins Okoyo  |e author 
700 1 0 |a Suzy J. Campbell  |e author 
700 1 0 |a Mark Minnery  |e author 
700 1 0 |a Chrispin Owaga  |e author 
700 1 0 |a Nelson Onyango  |e author 
700 1 0 |a Graham Medley  |e author 
700 1 0 |a Charles Mwandawiro  |e author 
245 0 0 |a Prevalence and Correlation Analysis of Soil-Transmitted Helminths Infections and Treatment Coverage for Preschool and School Aged Children in Kenya: Secondary Analysis of the National School Based Deworming Program Data 
260 |b Frontiers Media S.A.,   |c 2021-07-01T00:00:00Z. 
500 |a 2296-2565 
500 |a 10.3389/fpubh.2021.645522 
520 |a Background: Soil-transmitted helminths (STH) are among the most common parasitic infections globally, disproportionately affecting children. Treatment of STH in Kenya is often targeted at preschool (PSAC) and school aged (SAC) children delivered through annual mass drug administration (MDA) in primary schools. Understanding group-specific prevalence and dynamics between treatment and coverage is critical for continued treatment success. This study aims to provide detailed information on group-specific infection prevalence and relative reductions (RR), and their relationships with treatment coverage over time. Additionally, it aims to quantify the correlation between the observed school level infection prevalence and treatment coverage.Methods: Secondary analysis of existing data collected between 2012 and 2018 by the monitoring and evaluation (M&E) program of the National School-Based Deworming (NSBD) program was used. The M&E program conducted surveys utilizing cross-sectional study design, at four survey time points, in a nationally-representative sample of schoolchildren across counties in Kenya. In each participating school, the program randomly sampled 108 children per school, of both groups. Infection prevalence was estimated using binomial regression, RR in prevalence using multivariable mixed effects model, statistical correlations using structural equation modeling, and change-point-analysis using the binary segmentation algorithm.Results: Overall, STH prevalence for PSAC was 33.7, 20.2, 19.0, and 17.9% during Year 1 (Y1), Year 3 (Y3), Year 5 (Y5), and Year 6 (Y6) surveys, respectively with an overall RR of 46.9% (p = 0.001) from Y1 to Y6. Similarly, overall STH prevalence for SAC was 33.6, 18.4, 14.7, and 12.5% during Y1, Y3, Y5, and Y6 surveys, respectively with an overall RR of 62.6% (p < 0.001). An overall (all time points) significant but very weak negative correlation was found between treatment coverage and undifferentiated STH prevalence (r = −0.144, p = 0.002) among PSAC but not in SAC. Further, we observed inter-county heterogeneity variation in infection prevalence, RR, as well as correlations.Conclusion: The analysis showed that after six rounds of MDA, prevalence of STH has significantly declined among both groups of children, however not to a point where it is not a public health problem (below 1%). The analysis, additionally established an overall significant but weak negative correlation between treatment coverage and prevalence, indicating that the current treatment coverage might not be sufficient to drive the overall STH prevalence to below 1%. These findings will allow STH control programs in Kenya to make decisions that will accelerate the attainment of STH elimination as a public health problem. 
546 |a EN 
690 |a correlation analysis 
690 |a soil-transmitted helminths 
690 |a treatment coverage 
690 |a school-based deworming 
690 |a prevalence 
690 |a Kenya 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n Frontiers in Public Health, Vol 9 (2021) 
787 0 |n https://www.frontiersin.org/articles/10.3389/fpubh.2021.645522/full 
787 0 |n https://doaj.org/toc/2296-2565 
856 4 1 |u https://doaj.org/article/c15b6b3b7fcb43b48a83de0f67c37d10  |z Connect to this object online.