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Scaling down of a deworming programme among school‐age children after a thirty‐year successful intervention in the Bolivian Chaco
Author(s) -
Spinicci Michele,
Macchioni Fabio,
Rojo David,
Gamboa Herlan,
Villagrán Ana Liz,
Vallejos Yolanda,
Strohmeyer Marianne,
Roselli Mimmo,
Gabrielli Simona,
Cancrini Gabriella,
Monasterio Joaquín,
Castellanos Paul,
Paredes Grover Adolfo,
Maury Sdenka,
Zárate Adolfo,
Rocabado Rodolfo,
Olliaro Piero,
Montresor Antonio,
Bartoloni Alessandro
Publication year - 2018
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13058
Subject(s) - deworming , helminthiasis , environmental health , public health , epidemiology , medicine , tropical medicine , mebendazole , psychological intervention , veterinary medicine , helminths , ecology , biology , immunology , pathology , nursing
Objective Preventive chemotherapy is the WHO‐recommended control method for soil‐transmitted helminthiases. In the Bolivian Chaco, 6‐monthly single‐dose mebendazole delivery to school‐age children achieved a dramatic decrease in soil‐transmitted helminthiases prevalence between 1987 and 2013. Consequently, in September 2016, preventive chemotherapy delivery was interrupted in nine rural communities. In compliance with WHO recommendations, we intensified surveillance to monitor soil‐transmitted helminthiases prevalence and detect potential changes that would require interventions. Methods We conducted two cross‐sectional parasitology surveys 12 months apart (September 2016–2017) among school‐age children living in the communities where preventive chemotherapy delivery had been halted. Study design, methods of sampling and sample analysis technique (direct microscopy, Kato‐Katz technique) followed WHO recommendations, aiming to obtain data representative of the Bolivian Chaco ecological zone. Results We collected 426 samples in 2016 and 520 in 2017. Soil‐transmitted helminthiasis prevalence was unremarkable: 0.7% (95% CI 0–1.5%) in 2016 and 0.8% (0–1.5%) in 2017. Conversely, the prevalence of tapeworms (13% in 2016, 12% in 2017) and intestinal protozoan infections (81% in 2016 and 75% in 2017) continued to be high. Conclusions Our findings support the role of preventive chemotherapy in reducing soil‐transmitted helminthiases transmission, as otherwise poor hygienic and health conditions persist in the Bolivian Chaco. A national survey, involving areas from all the ecological zones of Bolivia, is now warranted.