Achieving elimination of soil-transmitted helminthiasis as a public health problem in Mali
Bibliographic Data
Introduction Mali was endemic for soil-transmitted helminthiasis (STH), mainly hookworms in the southern regions. Following baseline mapping, mass drug administration (MDA) for STH was integrated with MDA for schistosomiasis for school-aged children (SAC) or lymphatic filariasis (LF) for populations aged five and older and vitamin A supplementation for preschool children. Epidemiological evaluations were conducted to assess progress towards eliminating STH as a public health problem. Methods Cross-sectional studies were conducted in schools in 2004–2005 at baseline and in 2014–2019 for integrated evaluation with either schistosomiasis assessments or LF transmission assessment surveys (TAS). Children aged 7–14 years (6–7 years in TAS-STH surveys) were selected through systematic random sampling, and stool samples from selected children were examined using the Kato–Katz method for the eggs of any species of STH. The prevalence of infection and the prevalence of moderate-intensity and heavy-intensity (MHI) infections were calculated. Results A total of 13 769 SAC were examined at baseline in 2004–2005, with an overall STH prevalence of 6.3% (95% CI 5.9% to 6.7%). Overall STH prevalence was the highest in Sikasso (22.9%), followed by Segou (9.4%). The prevalence of MHI infections ranged from 0% to 9.0% among the survey sites, with high prevalences (2.9–9.0%) in some communities in the Sikasso region. The predominant species of STH infection was hookworm, with negligible infection by Ascaris lumbricoides and Trichuris trichiura . Integrated schistosomiasis/STH impact assessments from 2014 to 2017 sampled 5776 children, with an overall prevalence of 0.1% (95% CI 0.1% to 0.3%) and 0% MHI infections. The integrated TAS-STH surveys in 2018–2019 in 29 districts further confirmed an overall low STH prevalence of 0.1% (95% CI 0.0% to 0.3%). These results indicate the progress towards the national goal of eliminating STH as a public health problem in Mali and highlight the need for continued surveillance in certain regions. Conclusion Through over a decade of integrated treatment overcoming major security challenges, Mali may have successfully eliminated STH as a public health problem in all regions, one of the first countries in Africa to achieve this milestone
Developing country · Global health · Health security · Helminthiasis · Public health · Public health policy · Parasites and Host Interactions · Parasitic Infections and Diagnostics · Zoonotic diseases and public health · Health Policy
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