@article{fdi:010082706,
  title = {{F}actors associated with soil-transmitted helminths infection in {B}enin : findings from the {D}e{W}orm3 study},
  author = {{A}vokpaho, {E}fga and {H}oungbegnon, {P}. and {A}ccrombessi, {M}. and {A}tindegla, {E}. and {Y}ard, {E}. and {M}eans, {A}. {R}. and {K}ennedy, {D}. {S}. and {L}ittlewood, {D}. {T}. {J}. and {G}arcia, {A}ndr{\'e} and {M}assougbodji, {A}. and {G}alagan, {S}. {R}. and {W}alson, {J}. {L}. and {C}ottrell, {G}illes and {I}bikounle, {M}. and {A}sbjornsdottir, {K}. {H}. and {L}uty, {A}drian},
  editor = {},
  language = {{ENG}},
  abstract = {{A}uthor summary {D}espite several years of deworming campaigns targeting school-aged children, soil-transmitted helminths ({STH}) remains a public health problem in most developing countries, including {B}enin. {T}he burden is mostly on children and pregnant women, but also on the whole society. {S}oil-transmitted helminths are responsible for malnutrition, anemia, low birth weight, cognitive impairment, decrease of school performance, and subsequently economic loss. {T}he current strategy of the {B}enin {N}ational {N}eglected {T}ropical {D}iseases ({NTD}) {P}rogram is to achieve {STH} control through mass drug administration campaigns targeting school-aged children ({SAC}). {T}he baseline data of {D}eworm3 study, implemented in {C}ome, southern {B}enin, as part of a multicountry ({B}enin, {M}alawi and {I}ndia) {STH} elimination trial, shows that previous school deworming campaigns decreased {STH} prevalence; however there is a persistent reservoir of {STH} infection in adults and pre-school aged children that should be targeted for a better impact. {I}n order to eliminate {STH} as a public health problem, {B}enin {N}ational {NTD} {P}rogram would need to increase its target population, from the {SAC} to the whole community. {T}he future results of {D}eworm3 trial would demonstrate whether the {STH} elimination goal {STH} using community wide mass drug administration would be achievable. {B}ackground {D}espite several years of school-based {MDA} implementation, {STH} infections remain an important public health problem in {B}enin, with a country-wide prevalence of 20% in 2015. {T}he {D}e{W}orm3 study is designed to assess the feasibility of using community-based {MDA} with albendazole to interrupt the transmission of {STH}, through a series of cluster-randomized trials in {B}enin, {I}ndia and {M}alawi. {W}e used the pre-treatment baseline survey data to describe and analyze the factors associated with {STH} infection in {C}ome, the study site of the {D}e{W}orm3 project in {B}enin. {T}hese data will improve understanding of the challenges that need to be addressed in order to eliminate {STH} as a public health problem in {B}enin. {M}ethods {B}etween {M}arch and {A}pril 2018, the prevalence of {STH} (hookworm spp., {A}scaris and {T}richuris trichiura) was assessed by {K}ato-{K}atz in stool samples collected from 6,153 residents in the community of {C}ome, {B}enin using a stratified random sampling procedure. {A} standardized survey questionnaire was used to collect information from individual households concerning factors potentially associated with the presence and intensity of {STH} infections in pre-school ({PSAC}, aged 1-4), school-aged children ({SAC}, aged 5-14) and adults (aged 15 and above). {M}ultilevel mixed-effects models were used to assess associations between these factors and {STH} infection. {R}esults {T}he overall prevalence of {STH} infection was 5.3%; 3.2% hookworm spp., 2.1% {A}scaris lumbricoides and 0.1% {T}richuris. {H}ookworm spp. were more prevalent in adults than in {SAC} (4.4% versus 2.0%, respectively; p = 0.0001) and {PSAC} (4.4% versus 1.0%, respectively; p<0.0001), whilst {A}scaris lumbricoides was more prevalent in {SAC} than in adults (3.0% versus 1.7%, respectively; p = 0.004). {B}eing {PSAC} (adjusted {O}dds {R}atio (a{OR}) = 0.2, p< 0.001; adjusted {I}nfection {I}ntensity {R}atio (a{IIR}) = 0.1, p<0.001) or {SAC} (a{OR} = 0.5, p = 0.008; a{IIR} = 0.3, p = 0.01), being a female (a{OR} = 0.6, p = 0.004; a{IIR} = 0.3, p = 0.001), and having received deworming treatment the previous year (a{OR} = 0.4, p< 0.002; a{IIR} = 0.2, p<0.001) were associated with a lower prevalence and intensity of hookworm infection. {L}ower income (lowest quintile: a{OR} = 5.0, p<0.001, 2(nd) quintile a{OR} = 3.6, p = 0.001 and 3(rd) quintile a{OR} = 2.5, p = 0.02), being a farmer (a{OR} = 1.8, p = 0.02), medium population density (a{OR} = 2.6, p = 0.01), and open defecation (a{OR} = 0.5, p = 0.04) were associated with a higher prevalence of hookworm infection. {L}ower education-no education, primary or secondary school- (a{IIR} = 40.1, p = 0.01; a{IIR} = 30.9, p = 0.02; a{IIR} = 19.3, p = 0.04, respectively), farming (a{IIR} = 3.9, p = 0.002), natural flooring (a{IIR} = 0.2, p = 0.06), peri-urban settings (a{IIR} = 6.2, 95%{CI} 1.82-20.90, p = 0.003), and unimproved water source more than 30 minutes from the household (a{IIR} = 13.5, p = 0.02) were associated with a higher intensity of hookworm infection. {I}mproved and unshared toilet was associated with lower intensity of hookworm infections (a{IIR} = 0.2, p = 0.01). {SAC} had a higher odds of {A}scaris lumbricoides infection than adults (a{OR} = 2.0, p = 0.01) and females had a lower odds of infection (a{OR} = 0.5, p = 0.02). {C}onclusion {H}ookworm spp. are the most prevalent {STH} in {C}ome, with a persistent reservoir in adults that is not addressed by current control measures based on school {MDA}. {E}xpanding {MDA} to target adults and {PSAC} is necessary to substantially impact population prevalence, particularly for hookworm.},
  keywords = {{BENIN}},
  booktitle = {},
  journal = {{PL}o{S} {N}eglected {T}ropical {D}iseases},
  volume = {15},
  numero = {8},
  pages = {e0009646 [27 p.]},
  ISSN = {1935-2735},
  year = {2021},
  DOI = {10.1371/journal.pntd.0009646},
  URL = {https://www.documentation.ird.fr/hor/fdi:010082706},
}