Epidemiology of soil-transmitted helminths using quantitative PCR and risk factors for hookworm and Necator americanus infection in school children in Dak Lak province, Vietnam
Abstract Background Soil-transmitted helminth (STH) infection is driven by a complex interaction of demographic, socioeconomic and behavioural factors, including those related to water, sanitation and hygiene (WASH). Epidemiological studies that measure both infection and potential risk factors asso...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | Parasites & Vectors |
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| Online Access: | https://doi.org/10.1186/s13071-023-05809-x |
| _version_ | 1797789934035140608 |
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| author | Angus Hughes Dinh Ng-Nguyen Naomi E. Clarke Clare E. F. Dyer Sze Fui Hii Archie C. A. Clements Roy M. Anderson Darren J. Gray Luc E. Coffeng John M. Kaldor Rebecca J. Traub Susana Vaz Nery |
| author_facet | Angus Hughes Dinh Ng-Nguyen Naomi E. Clarke Clare E. F. Dyer Sze Fui Hii Archie C. A. Clements Roy M. Anderson Darren J. Gray Luc E. Coffeng John M. Kaldor Rebecca J. Traub Susana Vaz Nery |
| author_sort | Angus Hughes |
| collection | DOAJ |
| description | Abstract Background Soil-transmitted helminth (STH) infection is driven by a complex interaction of demographic, socioeconomic and behavioural factors, including those related to water, sanitation and hygiene (WASH). Epidemiological studies that measure both infection and potential risk factors associated with infection help to understand the drivers of transmission in a population and therefore can provide information to optimise STH control programmes. Methods During October and November 2019, we conducted a cross-sectional survey of the prevalence and intensity of STH infection and associated risk factors among 7710 primary-school-age children from 64 primary schools across 13 districts in Dak Lak province, Vietnam. Quantitative PCR (qPCR) was used to detect and quantify STH infections. Results The predominant STH species was the hookworm Necator americanus (overall cluster-adjusted prevalence of 13.7%), and its prevalence was heterogeneously distributed across surveyed schools (0% to 56.3%). All other STH species had a prevalence of less than 1%. Using mixed-effects logistic regression, we found that the adjusted odds ratio (aOR) was significantly higher for both infection and moderate-to-heavy-intensity infection with N. americanus among children from multiple ethnic minority groups, compared to children from the majority group (Kinh). Adjusted odds of infection with N. americanus were also higher in children who reported practising open defecation at school (aOR 1.42, 95% CI 1.05, 1.93, P = 0.02) and in those who had an unimproved household water supply (aOR 1.28, 95% CI 1.04, 1.57, P = 0.02). Conversely, children with a flushing household toilet had a reduced risk of infection (aOR 0.58, 95% CI 0.47, 0.70, P < 0.01), as did those whose primary female carer attended secondary (aOR 0.65, 95% CI 0.51, 0.84, P < 0.01) or tertiary education (aOR 0.39, 95% CI 0.24, 0.63, P < 0.01). Conclusions This study is the largest reported prevalence survey of STH infections conducted using qPCR as a diagnostic technique. The findings of higher adjusted odds of infection amongst ethnic minority children highlight that STH control programmes may not be reaching certain population groups and that additional culturally appropriate approaches may be required. Additionally, the associations between specific WASH factors and infection indicate potential programmatic targets to complement preventive chemotherapy programmes. Graphical Abstract |
| first_indexed | 2024-03-13T01:57:42Z |
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| id | doaj.art-baa53482a8c54c66bce087001f8c4a5e |
| institution | Directory Open Access Journal |
| issn | 1756-3305 |
| language | English |
| last_indexed | 2024-03-13T01:57:42Z |
| publishDate | 2023-06-01 |
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| spelling | doaj.art-baa53482a8c54c66bce087001f8c4a5e2023-07-02T11:09:10ZengBMCParasites & Vectors1756-33052023-06-0116111410.1186/s13071-023-05809-xEpidemiology of soil-transmitted helminths using quantitative PCR and risk factors for hookworm and Necator americanus infection in school children in Dak Lak province, VietnamAngus Hughes0Dinh Ng-Nguyen1Naomi E. Clarke2Clare E. F. Dyer3Sze Fui Hii4Archie C. A. Clements5Roy M. Anderson6Darren J. Gray7Luc E. Coffeng8John M. Kaldor9Rebecca J. Traub10Susana Vaz Nery11School of Population Health, University of New South WalesFaculty of Animal Sciences and Veterinary Medicine, Tay Nguyen UniversityThe Kirby Institute for Infection and Immunity in Society, University of New South WalesThe Kirby Institute for Infection and Immunity in Society, University of New South WalesFaculty of Veterinary and Agricultural Sciences, University of MelbourneFaculty of Health Sciences, Curtin UniversityDepartment of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College LondonResearch School of Population Health, Australian National UniversityDepartment of Public Health, Erasmus MC, University Medical Centre RotterdamThe Kirby Institute for Infection and Immunity in Society, University of New South WalesFaculty of Veterinary and Agricultural Sciences, University of MelbourneFaculty of Animal Sciences and Veterinary Medicine, Tay Nguyen UniversityAbstract Background Soil-transmitted helminth (STH) infection is driven by a complex interaction of demographic, socioeconomic and behavioural factors, including those related to water, sanitation and hygiene (WASH). Epidemiological studies that measure both infection and potential risk factors associated with infection help to understand the drivers of transmission in a population and therefore can provide information to optimise STH control programmes. Methods During October and November 2019, we conducted a cross-sectional survey of the prevalence and intensity of STH infection and associated risk factors among 7710 primary-school-age children from 64 primary schools across 13 districts in Dak Lak province, Vietnam. Quantitative PCR (qPCR) was used to detect and quantify STH infections. Results The predominant STH species was the hookworm Necator americanus (overall cluster-adjusted prevalence of 13.7%), and its prevalence was heterogeneously distributed across surveyed schools (0% to 56.3%). All other STH species had a prevalence of less than 1%. Using mixed-effects logistic regression, we found that the adjusted odds ratio (aOR) was significantly higher for both infection and moderate-to-heavy-intensity infection with N. americanus among children from multiple ethnic minority groups, compared to children from the majority group (Kinh). Adjusted odds of infection with N. americanus were also higher in children who reported practising open defecation at school (aOR 1.42, 95% CI 1.05, 1.93, P = 0.02) and in those who had an unimproved household water supply (aOR 1.28, 95% CI 1.04, 1.57, P = 0.02). Conversely, children with a flushing household toilet had a reduced risk of infection (aOR 0.58, 95% CI 0.47, 0.70, P < 0.01), as did those whose primary female carer attended secondary (aOR 0.65, 95% CI 0.51, 0.84, P < 0.01) or tertiary education (aOR 0.39, 95% CI 0.24, 0.63, P < 0.01). Conclusions This study is the largest reported prevalence survey of STH infections conducted using qPCR as a diagnostic technique. The findings of higher adjusted odds of infection amongst ethnic minority children highlight that STH control programmes may not be reaching certain population groups and that additional culturally appropriate approaches may be required. Additionally, the associations between specific WASH factors and infection indicate potential programmatic targets to complement preventive chemotherapy programmes. Graphical Abstracthttps://doi.org/10.1186/s13071-023-05809-xSoil-transmitted helminthsVietnamPrevalence surveyRisk factorsQuantitative polymerase chain reactionSchool-age children |
| spellingShingle | Angus Hughes Dinh Ng-Nguyen Naomi E. Clarke Clare E. F. Dyer Sze Fui Hii Archie C. A. Clements Roy M. Anderson Darren J. Gray Luc E. Coffeng John M. Kaldor Rebecca J. Traub Susana Vaz Nery Epidemiology of soil-transmitted helminths using quantitative PCR and risk factors for hookworm and Necator americanus infection in school children in Dak Lak province, Vietnam Parasites & Vectors Soil-transmitted helminths Vietnam Prevalence survey Risk factors Quantitative polymerase chain reaction School-age children |
| title | Epidemiology of soil-transmitted helminths using quantitative PCR and risk factors for hookworm and Necator americanus infection in school children in Dak Lak province, Vietnam |
| title_full | Epidemiology of soil-transmitted helminths using quantitative PCR and risk factors for hookworm and Necator americanus infection in school children in Dak Lak province, Vietnam |
| title_fullStr | Epidemiology of soil-transmitted helminths using quantitative PCR and risk factors for hookworm and Necator americanus infection in school children in Dak Lak province, Vietnam |
| title_full_unstemmed | Epidemiology of soil-transmitted helminths using quantitative PCR and risk factors for hookworm and Necator americanus infection in school children in Dak Lak province, Vietnam |
| title_short | Epidemiology of soil-transmitted helminths using quantitative PCR and risk factors for hookworm and Necator americanus infection in school children in Dak Lak province, Vietnam |
| title_sort | epidemiology of soil transmitted helminths using quantitative pcr and risk factors for hookworm and necator americanus infection in school children in dak lak province vietnam |
| topic | Soil-transmitted helminths Vietnam Prevalence survey Risk factors Quantitative polymerase chain reaction School-age children |
| url | https://doi.org/10.1186/s13071-023-05809-x |
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