Association between water, sanitation, and hygiene access and the prevalence of soil-transmitted helminth and schistosome infections in Wolayita, Ethiopia

• DOI: 10.1186/s13071-022-05465-7
• Publication Date: 2022-11-04T20:19:11Z
• Authors: Anna E. Phillips; Alison K. Ower; Kalkidan Mekete; Ewnetu Firdawek L...; Rosie Maddren; Habtamu Belay; Melkie Chernet; Ufaysa Anjulo; Birhan Mengistu; Mihretab Salasibew; Geremew Tasew; Roy Anderson
• Keywords: Ancylostomatoidea; Helminthiasis; Water, Sanitation, & Hygiene; Infectious and parasitic diseases; RC109-216; Soil; Hookworm Infections; Feces; 03 medical and health sciences; 0302 clinical medicine; Helminths; Schistosomatidae; Prevalence; Schistosomiasis; Interruption of transmission; Animals; Humans; Sanitation; 2. Zero hunger; Research; Drinking Water; Soil-transmitted helminths; Infant; Hygiene; Schistosoma mansoni; 6. Clean water; 3. Good health; Cross-Sectional Studies; WaSH; Ethiopia

AbstractBackgroundThe Geshiyaro project is a 5-year intervention to assess the impact of community- and school-based water, sanitation, and hygiene (WaSH) interventions on reducing infection with soil-transmitted helminths (STH) and schistosome parasites in combination with deworming in Wolayita zone, Ethiopia.MethodsA population-based, cross-sectional census and parasitological mapping activity was conducted between 2018 and 2019. Individuals in the census were identified using either a registered study ID card or biometric fingerprint to enable linkage of their household WaSH data with baseline STH and schistosome prevalence for risk analysis.ResultsPrevalence of STH was 15.5% for any STH species, 9.47% forAscaris lumbricoides, 1.78% forTrichuris trichiura, and 7.24% for hookworm. Intestinal schistosomiasis (Schistosoma mansoni) infection prevalence was 0.85% by Kato Katz, 21.6% by POC-CCA trace positive (Tr +), and 13.3% trace negative (Tr-). Microhaematuria was 2.77%, with 0.13% of people examined withS. haematobiumeggs detected by urine filtration. At the household level, increased (> 30 min) time taken to collect drinking water, sharing a latrine, and lack of handwashing facilities were all associated with a greater risk ofA. lumbricoides, hookworm, andS. mansoniinfection. Not disposing of infant stool at the household and clothes washing/recreational freshwater contact were significantly associated with higher risk of schistosomiasis infection. Aggregating WaSH data at the community level showed odds ofA. lumbricoides,hookworm, andT. trichiurainfection were significantly lower as both community sanitation coverage and access to improved drinking water improved.ConclusionsThe principal finding of this study is that lack of access to WaSH, such as improved drinking water and shared toilet and hand-washing facilities, were linked to an increased risk of infection with STH and schistosome parasites. These associations are difficult to establish at an individual household level because of wide variability in access between houses but are detectable when coverage is aggregated at the community level. Maintenance of WaSH facilities as well as increased access within the whole community is important in influencing the community-wide prevalence of infection with STH and schistosome parasites.Graphical Abstract