Soil-transmitted helminths and schistosome infections in Ethiopia: a systematic review of progress in their control over the past 20 years
Abstract Background Ethiopia has set the ambitious national targets of eliminating soil-transmitted helminths (STH) and schistosomiasis (SCH) as public health problems by 2020, and breaking their transmission by 2025. This systematic review was performed to provide insight into the progress made by...
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | Parasites & Vectors |
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| Online Access: | https://doi.org/10.1186/s13071-021-04600-0 |
| _version_ | 1797801588281049088 |
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| author | Rosie Maddren Anna Phillips Alison Ower Toby Landeryou Birhan Mengistu Ufaysa Anjulo Ewnetu Firdawek Nebiyu Negussu Roy Anderson |
| author_facet | Rosie Maddren Anna Phillips Alison Ower Toby Landeryou Birhan Mengistu Ufaysa Anjulo Ewnetu Firdawek Nebiyu Negussu Roy Anderson |
| author_sort | Rosie Maddren |
| collection | DOAJ |
| description | Abstract Background Ethiopia has set the ambitious national targets of eliminating soil-transmitted helminths (STH) and schistosomiasis (SCH) as public health problems by 2020, and breaking their transmission by 2025. This systematic review was performed to provide insight into the progress made by the national STH and SCH control programme purposed with reaching these targets. Methods Studies published on STH and SCH in Ethiopia were searched for using Web of Science, PubMed, Scopus, and the resulting references of selected studies. Prevalence and intensity were analysed, stratified by region, age, and diagnostics. Results A total of 231 papers published between 2000 and 2020 were included. Over the past two decades, Trichuris trichiura (TT) infection has shown the most statistically significant decrease (93%, p < 0.0001), followed by Schistosoma mansoni (SM) (69%, p < 0.0001), Ascaris lumbricoides (AL) (67%, p < 0.0001) and Schistosoma haematobium (83%, p = 0.038) infections. Geographically, parasite burden has only consistently shown a significant reduction in the Southern Nations, Nationalities and Peoples’ Region of Ethiopia, where AL, TT, hookworm and SM significantly decreased by 80% (p = 0.006), 95% (p = 0.005), 98% (p = 0.009) and 87% (p = 0.031), respectively. Prevalence of STH was highest among adults across all species, contrary to typical age-infection profiles for TT and AL that peak among school-aged children. Expanding treatment to the whole community would target reservoirs of adult and preschool-aged infection within the community, assisting Ethiopia in reaching their national transmission break targets. There was substantial heterogeneity in diagnostic methods used across studies, the majority of which predominantly used single-slide Kato–Katz. This low slide frequency provides poor diagnostic sensitivity, particularly in low endemic settings. Conclusion The prevalence of STH and SCH in Ethiopia has decreased over time due to the strategic use of anthelmintics. Both standardising and increasing the sensitivity of the diagnostics used, alongside the ubiquitous use of parasite intensity with prevalence, would enable a more accurate and comparable understanding of Ethiopia’s epidemiological progress. Further work is needed on community-wide surveillance in order to understand the burden and subsequent need for treatment among those outside of the standard school-based control program. Graphical Abstract |
| first_indexed | 2024-03-13T04:52:26Z |
| format | Article |
| id | doaj.art-a4f1d3cd3e2748749e33ee327b16931c |
| institution | Directory Open Access Journal |
| issn | 1756-3305 |
| language | English |
| last_indexed | 2024-03-13T04:52:26Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
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| series | Parasites & Vectors |
| spelling | doaj.art-a4f1d3cd3e2748749e33ee327b16931c2023-06-18T11:08:03ZengBMCParasites & Vectors1756-33052021-02-0114111510.1186/s13071-021-04600-0Soil-transmitted helminths and schistosome infections in Ethiopia: a systematic review of progress in their control over the past 20 yearsRosie Maddren0Anna Phillips1Alison Ower2Toby Landeryou3Birhan Mengistu4Ufaysa Anjulo5Ewnetu Firdawek6Nebiyu Negussu7Roy Anderson8London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College LondonLondon Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College LondonLondon Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College LondonLondon Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College LondonChildren Investment Fund FoundationDisease Prevention and Health Promotion Core Process, Ministry of HealthBacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health InstituteNeglected Tropical Diseases, Federal Ministry of HealthLondon Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College LondonAbstract Background Ethiopia has set the ambitious national targets of eliminating soil-transmitted helminths (STH) and schistosomiasis (SCH) as public health problems by 2020, and breaking their transmission by 2025. This systematic review was performed to provide insight into the progress made by the national STH and SCH control programme purposed with reaching these targets. Methods Studies published on STH and SCH in Ethiopia were searched for using Web of Science, PubMed, Scopus, and the resulting references of selected studies. Prevalence and intensity were analysed, stratified by region, age, and diagnostics. Results A total of 231 papers published between 2000 and 2020 were included. Over the past two decades, Trichuris trichiura (TT) infection has shown the most statistically significant decrease (93%, p < 0.0001), followed by Schistosoma mansoni (SM) (69%, p < 0.0001), Ascaris lumbricoides (AL) (67%, p < 0.0001) and Schistosoma haematobium (83%, p = 0.038) infections. Geographically, parasite burden has only consistently shown a significant reduction in the Southern Nations, Nationalities and Peoples’ Region of Ethiopia, where AL, TT, hookworm and SM significantly decreased by 80% (p = 0.006), 95% (p = 0.005), 98% (p = 0.009) and 87% (p = 0.031), respectively. Prevalence of STH was highest among adults across all species, contrary to typical age-infection profiles for TT and AL that peak among school-aged children. Expanding treatment to the whole community would target reservoirs of adult and preschool-aged infection within the community, assisting Ethiopia in reaching their national transmission break targets. There was substantial heterogeneity in diagnostic methods used across studies, the majority of which predominantly used single-slide Kato–Katz. This low slide frequency provides poor diagnostic sensitivity, particularly in low endemic settings. Conclusion The prevalence of STH and SCH in Ethiopia has decreased over time due to the strategic use of anthelmintics. Both standardising and increasing the sensitivity of the diagnostics used, alongside the ubiquitous use of parasite intensity with prevalence, would enable a more accurate and comparable understanding of Ethiopia’s epidemiological progress. Further work is needed on community-wide surveillance in order to understand the burden and subsequent need for treatment among those outside of the standard school-based control program. Graphical Abstracthttps://doi.org/10.1186/s13071-021-04600-0Soil-transmitted helminthsSchistosomiasisTransmission breakEthiopiaControl programmePrevalence |
| spellingShingle | Rosie Maddren Anna Phillips Alison Ower Toby Landeryou Birhan Mengistu Ufaysa Anjulo Ewnetu Firdawek Nebiyu Negussu Roy Anderson Soil-transmitted helminths and schistosome infections in Ethiopia: a systematic review of progress in their control over the past 20 years Parasites & Vectors Soil-transmitted helminths Schistosomiasis Transmission break Ethiopia Control programme Prevalence |
| title | Soil-transmitted helminths and schistosome infections in Ethiopia: a systematic review of progress in their control over the past 20 years |
| title_full | Soil-transmitted helminths and schistosome infections in Ethiopia: a systematic review of progress in their control over the past 20 years |
| title_fullStr | Soil-transmitted helminths and schistosome infections in Ethiopia: a systematic review of progress in their control over the past 20 years |
| title_full_unstemmed | Soil-transmitted helminths and schistosome infections in Ethiopia: a systematic review of progress in their control over the past 20 years |
| title_short | Soil-transmitted helminths and schistosome infections in Ethiopia: a systematic review of progress in their control over the past 20 years |
| title_sort | soil transmitted helminths and schistosome infections in ethiopia a systematic review of progress in their control over the past 20 years |
| topic | Soil-transmitted helminths Schistosomiasis Transmission break Ethiopia Control programme Prevalence |
| url | https://doi.org/10.1186/s13071-021-04600-0 |
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