Findings suggest interrupting STH transmission is most feasible in countries in the Americas and parts of Asia, and least feasible in countries in sub-Saharan Africa, but there were important exceptions to these trends.
The Lancet Infectious Diseases has published an article assessing feasibility by country of achieving interruption of soil-transmitted helminths (STH).
Authors developed a conceptual framework to identify the epidemiological, socioeconomic, political and financial factors that influence the feasibility of interrupting transmission of STH. They then assembled country-level spatial data and used four different statistical methods to develop a score of the feasibility of interrupting STH transmission. Authors found that the most important determining factors were:
- underlying intensity of STH transmission
- current implementation of control programmes for neglected tropical diseases
- whether countries receive large-scale external funding
- strength of countries’ health systems
The scoring suggested that interrupting STH transmission is most feasible in countries in the Americas and parts of Asia, and least feasible in countries in sub-Saharan Africa, but there were important exceptions to these trends, such as Ghana and Kenya.
The findings are timely given recent emphasis on and funding for NTD control methods, specifically interrupting transmission for STH. During a meeting in Paris in April 2014 to mark the second anniversary of the London Declaration on NTDs, partners committed over $120 million to scale up deworming efforts and for research into interrupting disease transmission. This included $50 million pledges each from both the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation, with BMGF supporting studies to test the feasibility of interrupting STH transmission.
This analysis provides the first quantitative assessment of the potential for interrupting STH transmission, and for identifying the crucial factors that might support or hinder this process. In terms of country feasibilities, authors categorised countries as (i) most feasible, (ii) feasible, (iii) less feasible, (iv) unfeasible, and (v) highly unfeasible. For the full breakdown, please refer to the paper.
Professor Simon Brooker, lead author of the study, says: ‘‘The main emphasis of STH control should remain scaling-up school-based deworming, but in some settings, it may be possible to move beyond this goal and achieve local elimination. We know from history that this is possible, and our analysis seeks to provide a robust, evidence-based approach for deciding where elimination may or may not be possible today.”
Authors:
Simon Brooker
Birgit Nikolay
Dina Balabanova
Rachel Pullan
All from the London School of Hygiene & Tropical Medicine
Read the paper in the Lancet Infectious Diseases.
Read commentary by Children Without Worms Director David Addiss.