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Open AccessArticle

Mapping Soil-Transmitted Helminth Parasite Infection in Rwanda: Estimating Endemicity and Identifying At-Risk Populations

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Neglected Tropical Diseases and Other Parasitic Diseases Unit, Malaria and Other Parasitic Diseases Division, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda
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UQ Spatial Epidemiology Laboratory, School of Veterinary Science, the University of Queensland, Gatton 4343, Queensland, Australia
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Children Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane 4101, Queensland, Australia
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Schistosomiasis Control Initiative (SCI), Department of Infectious Diseases Epidemiology, Imperial College, London SW7 2AZ, UK
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The END Fund, New York, NY 10016, USA
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Microbiology Unit, National Reference Laboratory (NRL) Division, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda
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Malaria and Other Parasitic Diseases Division, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda
*
Author to whom correspondence should be addressed.
Co-first authors.
Trop. Med. Infect. Dis. 2019, 4(2), 93; https://doi.org/10.3390/tropicalmed4020093
Received: 14 May 2019 / Revised: 11 June 2019 / Accepted: 12 June 2019 / Published: 14 June 2019
(This article belongs to the Special Issue Spatial Epidemiology of Neglected Tropical Diseases (NTDs))
Soil-transmitted helminth (STH) infections are globally distributed intestinal parasite infections caused by Ascaris lumbricoides, Trichuris trichiura, and hookworms (Ancylostoma duodenale and Necator americanus). STH infection constitutes a major public health threat, with heavy burdens observed in many of the world’s tropical and subtropical regions. Mass drug administration and sanitation improvements can drastically reduce STH prevalence and associated morbidity. However, identifying targeted areas in need of treatment is hampered by a lack of knowledge on geographical and population-level risk factors. In this study, we applied Bayesian geostatistical modelling to data from a national school-based STH infection survey in Rwanda to (1) identify ecological and population-level risk factors and (2) provide comprehensive precision maps of infection burdens. Our results indicated that STH infections were heterogeneously distributed across the country and showed signatures of spatial clustering, though the magnitude of clustering varied among parasites. The highest rates of endemic clustering were attributed to A. lumbricoides infection. Concordant infection patterns among the three parasite groups highlighted populations currently most at-risk of morbidity. Population-dense areas in the Western and North-Western regions of Rwanda represent areas that have continued to exhibit high STH burden across two surveys and are likely in need of targeted interventions. Our maps support the need for an updated evaluation of STH endemicity in western Rwanda to evaluate progress in MDA efforts and identify communities that need further local interventions to further reduce morbidity caused by STH infections. View Full-Text
Keywords: Ascaris lumbricoides; Trichuris trichiura; hookworm; soil-transmitted helminth; spatial epidemiology; Rwanda Ascaris lumbricoides; Trichuris trichiura; hookworm; soil-transmitted helminth; spatial epidemiology; Rwanda
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Ruberanziza, E.; Owada, K.; Clark, N.J.; Umulisa, I.; Ortu, G.; Lancaster, W.; Munyaneza, T.; Mbituyumuremyi, A.; Bayisenge, U.; Fenwick, A.; Soares Magalhães, R.J. Mapping Soil-Transmitted Helminth Parasite Infection in Rwanda: Estimating Endemicity and Identifying At-Risk Populations. Trop. Med. Infect. Dis. 2019, 4, 93.

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Trop. Med. Infect. Dis., EISSN 2414-6366, Published by MDPI AG
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