Predicted short and long-term impact of deworming and water, hygiene, and sanitation on transmission of soil-transmitted helminths.
Background Regular preventive chemotherapy (PCT) targeting high-risk populations is an effective way to control STH in the short term, but sustainable long-term STH control is expected to require improved access to water, sanitation, and hygiene (WASH). However, experimental studies have not been ab...
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ftdoajarticles:oai:doaj.org/article:fa7014d6d2884c2ab9f776fa162381b1 2023-05-15T15:15:20+02:00 Predicted short and long-term impact of deworming and water, hygiene, and sanitation on transmission of soil-transmitted helminths. Luc E Coffeng Susana Vaz Nery Darren J Gray Roel Bakker Sake J de Vlas Archie C A Clements 2018-12-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006758 https://doaj.org/article/fa7014d6d2884c2ab9f776fa162381b1 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0006758 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006758 https://doaj.org/article/fa7014d6d2884c2ab9f776fa162381b1 PLoS Neglected Tropical Diseases, Vol 12, Iss 12, p e0006758 (2018) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006758 2022-12-31T05:59:59Z Background Regular preventive chemotherapy (PCT) targeting high-risk populations is an effective way to control STH in the short term, but sustainable long-term STH control is expected to require improved access to water, sanitation, and hygiene (WASH). However, experimental studies have not been able to conclusively demonstrate the benefit of WASH in preventing STH (re-)infections. We investigated the impact of WASH on STH infections during and after PCT using mathematical modelling. Methods and findings We use the individual-based transmission model WORMSIM to predict the short and long-term impact of WASH on STH transmission in contexts with and without PCT. We distinguish two WASH modalities: sanitation, which reduces individuals' contributions to environmental contamination; and hygiene, which reduces individuals' exposure to infection. We simulate the impact of varying levels of uptake and effectiveness of each WASH modality, as well as their combined impact. Clearly, sanitation and hygiene interventions have little observable short-term impact on STH infections levels in the context of PCT. However, in the long term, both are pivotal to sustain control or eliminate infection levels after scaling down or stopping PCT. The impact of hygiene is determined more by the effectiveness of the intervention than its overall uptake, whereas the impact of sanitation depends more directly on the product of uptake and the effectiveness. Interpretation The impact of WASH interventions on STH transmission highly depends on the worm species, WASH modality, and uptake and effectiveness of the intervention. Also, the impact of WASH is difficult to measure in the context of ongoing PCT programmes. Still, we show a clear added benefit of WASH to sustain the gains made by PCT in the long term, such that PCT may be scaled down or even stopped altogether. To safely stop or scale down PCT, policy for WASH and PCT should be integrated. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 12 12 e0006758 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Luc E Coffeng Susana Vaz Nery Darren J Gray Roel Bakker Sake J de Vlas Archie C A Clements Predicted short and long-term impact of deworming and water, hygiene, and sanitation on transmission of soil-transmitted helminths. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Regular preventive chemotherapy (PCT) targeting high-risk populations is an effective way to control STH in the short term, but sustainable long-term STH control is expected to require improved access to water, sanitation, and hygiene (WASH). However, experimental studies have not been able to conclusively demonstrate the benefit of WASH in preventing STH (re-)infections. We investigated the impact of WASH on STH infections during and after PCT using mathematical modelling. Methods and findings We use the individual-based transmission model WORMSIM to predict the short and long-term impact of WASH on STH transmission in contexts with and without PCT. We distinguish two WASH modalities: sanitation, which reduces individuals' contributions to environmental contamination; and hygiene, which reduces individuals' exposure to infection. We simulate the impact of varying levels of uptake and effectiveness of each WASH modality, as well as their combined impact. Clearly, sanitation and hygiene interventions have little observable short-term impact on STH infections levels in the context of PCT. However, in the long term, both are pivotal to sustain control or eliminate infection levels after scaling down or stopping PCT. The impact of hygiene is determined more by the effectiveness of the intervention than its overall uptake, whereas the impact of sanitation depends more directly on the product of uptake and the effectiveness. Interpretation The impact of WASH interventions on STH transmission highly depends on the worm species, WASH modality, and uptake and effectiveness of the intervention. Also, the impact of WASH is difficult to measure in the context of ongoing PCT programmes. Still, we show a clear added benefit of WASH to sustain the gains made by PCT in the long term, such that PCT may be scaled down or even stopped altogether. To safely stop or scale down PCT, policy for WASH and PCT should be integrated. |
format |
Article in Journal/Newspaper |
author |
Luc E Coffeng Susana Vaz Nery Darren J Gray Roel Bakker Sake J de Vlas Archie C A Clements |
author_facet |
Luc E Coffeng Susana Vaz Nery Darren J Gray Roel Bakker Sake J de Vlas Archie C A Clements |
author_sort |
Luc E Coffeng |
title |
Predicted short and long-term impact of deworming and water, hygiene, and sanitation on transmission of soil-transmitted helminths. |
title_short |
Predicted short and long-term impact of deworming and water, hygiene, and sanitation on transmission of soil-transmitted helminths. |
title_full |
Predicted short and long-term impact of deworming and water, hygiene, and sanitation on transmission of soil-transmitted helminths. |
title_fullStr |
Predicted short and long-term impact of deworming and water, hygiene, and sanitation on transmission of soil-transmitted helminths. |
title_full_unstemmed |
Predicted short and long-term impact of deworming and water, hygiene, and sanitation on transmission of soil-transmitted helminths. |
title_sort |
predicted short and long-term impact of deworming and water, hygiene, and sanitation on transmission of soil-transmitted helminths. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2018 |
url |
https://doi.org/10.1371/journal.pntd.0006758 https://doaj.org/article/fa7014d6d2884c2ab9f776fa162381b1 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 12, Iss 12, p e0006758 (2018) |
op_relation |
https://doi.org/10.1371/journal.pntd.0006758 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006758 https://doaj.org/article/fa7014d6d2884c2ab9f776fa162381b1 |
op_doi |
https://doi.org/10.1371/journal.pntd.0006758 |
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PLOS Neglected Tropical Diseases |
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12 |
container_issue |
12 |
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e0006758 |
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