How effective is school-based deworming for the community-wide control of soil-transmitted helminths?
The London Declaration on neglected tropical diseases was based in part on a new World Health Organization roadmap to "sustain, expand and extend drug access programmes to ensure the necessary supply of drugs and other interventions to help control by 2020". Large drug donations from the p...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | http://europepmc.org/articles/PMC3585037?pdf=render |
| _version_ | 1828365469251272704 |
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| author | Roy M Anderson James E Truscott Rachel L Pullan Simon J Brooker T Deirdre Hollingsworth |
| author_facet | Roy M Anderson James E Truscott Rachel L Pullan Simon J Brooker T Deirdre Hollingsworth |
| author_sort | Roy M Anderson |
| collection | DOAJ |
| description | The London Declaration on neglected tropical diseases was based in part on a new World Health Organization roadmap to "sustain, expand and extend drug access programmes to ensure the necessary supply of drugs and other interventions to help control by 2020". Large drug donations from the pharmaceutical industry form the backbone to this aim, especially for soil-transmitted helminths (STHs) raising the question of how best to use these resources. Deworming for STHs is often targeted at school children because they are at greatest risk of morbidity and because it is remarkably cost-effective. However, the impact of school-based deworming on transmission in the wider community remains unclear.We first estimate the proportion of parasites targeted by school-based deworming using demography, school enrolment, and data from a small number of example settings where age-specific intensity of infection (either worms or eggs) has been measured for all ages. We also use transmission models to investigate the potential impact of this coverage on transmission for different mixing scenarios.In the example settings <30% of the population are 5 to <15 years old. Combining this demography with the infection age-intensity profile we estimate that in one setting school children output as little as 15% of hookworm eggs, whereas in another setting they harbour up to 50% of Ascaris lumbricoides worms (the highest proportion of parasites for our examples). In addition, it is estimated that from 40-70% of these children are enrolled at school.These estimates suggest that, whilst school-based programmes have many important benefits, the proportion of infective stages targeted by school-based deworming may be limited, particularly where hookworm predominates. We discuss the consequences for transmission for a range of scenarios, including when infective stages deposited by children are more likely to contribute to transmission than those from adults. |
| first_indexed | 2024-04-14T05:31:37Z |
| format | Article |
| id | doaj.art-0bdc2e58171c4fb3bb5c2166596ce301 |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-04-14T05:31:37Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-0bdc2e58171c4fb3bb5c2166596ce3012022-12-22T02:09:46ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352013-01-0172e202710.1371/journal.pntd.0002027How effective is school-based deworming for the community-wide control of soil-transmitted helminths?Roy M AndersonJames E TruscottRachel L PullanSimon J BrookerT Deirdre HollingsworthThe London Declaration on neglected tropical diseases was based in part on a new World Health Organization roadmap to "sustain, expand and extend drug access programmes to ensure the necessary supply of drugs and other interventions to help control by 2020". Large drug donations from the pharmaceutical industry form the backbone to this aim, especially for soil-transmitted helminths (STHs) raising the question of how best to use these resources. Deworming for STHs is often targeted at school children because they are at greatest risk of morbidity and because it is remarkably cost-effective. However, the impact of school-based deworming on transmission in the wider community remains unclear.We first estimate the proportion of parasites targeted by school-based deworming using demography, school enrolment, and data from a small number of example settings where age-specific intensity of infection (either worms or eggs) has been measured for all ages. We also use transmission models to investigate the potential impact of this coverage on transmission for different mixing scenarios.In the example settings <30% of the population are 5 to <15 years old. Combining this demography with the infection age-intensity profile we estimate that in one setting school children output as little as 15% of hookworm eggs, whereas in another setting they harbour up to 50% of Ascaris lumbricoides worms (the highest proportion of parasites for our examples). In addition, it is estimated that from 40-70% of these children are enrolled at school.These estimates suggest that, whilst school-based programmes have many important benefits, the proportion of infective stages targeted by school-based deworming may be limited, particularly where hookworm predominates. We discuss the consequences for transmission for a range of scenarios, including when infective stages deposited by children are more likely to contribute to transmission than those from adults.http://europepmc.org/articles/PMC3585037?pdf=render |
| spellingShingle | Roy M Anderson James E Truscott Rachel L Pullan Simon J Brooker T Deirdre Hollingsworth How effective is school-based deworming for the community-wide control of soil-transmitted helminths? PLoS Neglected Tropical Diseases |
| title | How effective is school-based deworming for the community-wide control of soil-transmitted helminths? |
| title_full | How effective is school-based deworming for the community-wide control of soil-transmitted helminths? |
| title_fullStr | How effective is school-based deworming for the community-wide control of soil-transmitted helminths? |
| title_full_unstemmed | How effective is school-based deworming for the community-wide control of soil-transmitted helminths? |
| title_short | How effective is school-based deworming for the community-wide control of soil-transmitted helminths? |
| title_sort | how effective is school based deworming for the community wide control of soil transmitted helminths |
| url | http://europepmc.org/articles/PMC3585037?pdf=render |
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