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首页> 外文期刊>Frontiers in Public Health >Prevalence and Correlation Analysis of Soil-Transmitted Helminths Infections and Treatment Coverage for Preschool and School Aged Children in Kenya: Secondary Analysis of the National School Based Deworming Program Data
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Prevalence and Correlation Analysis of Soil-Transmitted Helminths Infections and Treatment Coverage for Preschool and School Aged Children in Kenya: Secondary Analysis of the National School Based Deworming Program Data

机译：肯尼亚幼儿园和学校年龄儿童的患病率和治疗覆盖的患病率和相关分析：国家校基于学校的驱虫计划数据的二次分析

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Background: Soil-transmitted helminths (STH) are among the most common parasitic infections globally, disproportionately affecting children. Treatment of STH in Kenya is often targeted at preschool (PSAC) and school aged (SAC) children delivered through annual mass drug administration (MDA) in primary schools. Understanding group-specific prevalence and dynamics between treatment and coverage is critical for continued treatment success. This study aims to provide detailed information on group-specific infection prevalence and relative reductions (RR), and their relationships with treatment coverage over time. Additionally, it aims to quantify the correlation between the observed school level infection prevalence and treatment coverage. Methods: Secondary analysis of existing data collected between 2012 and 2018 by the monitoring and evaluation (M&E) program of the National School-Based Deworming (NSBD) program was used. The M&E program conducted surveys utilizing cross-sectional study design, at four survey time points, in a nationally-representative sample of schoolchildren across counties in Kenya. In each participating school, the program randomly sampled 108 children per school, of both groups. Infection prevalence was estimated using binomial regression, RR in prevalence using multivariable mixed effects model, statistical correlations using structural equation modeling, and change-point-analysis using the binary segmentation algorithm. Results: Overall, STH prevalence for PSAC was 33.7, 20.2, 19.0, and 17.9% during Year 1 (Y1), Year 3 (Y3), Year 5 (Y5), and Year 6 (Y6) surveys, respectively with an overall RR of 46.9% ( p = 0.001) from Y1 to Y6. Similarly, overall STH prevalence for SAC was 33.6, 18.4, 14.7, and 12.5% during Y1, Y3, Y5, and Y6 surveys, respectively with an overall RR of 62.6% ( p 0.001). An overall (all time points) significant but very weak negative correlation was found between treatment coverage and undifferentiated STH prevalence ( r = ?0.144, p = 0.002) among PSAC but not in SAC. Further, we observed inter-county heterogeneity variation in infection prevalence, RR, as well as correlations. Conclusion: The analysis showed that after six rounds of MDA, prevalence of STH has significantly declined among both groups of children, however not to a point where it is not a public health problem (below 1%). The analysis, additionally established an overall significant but weak negative correlation between treatment coverage and prevalence, indicating that the current treatment coverage might not be sufficient to drive the overall STH prevalence to below 1%. These findings will allow STH control programs in Kenya to make decisions that will accelerate the attainment of STH elimination as a public health problem.
机译：背景：土壤传播的Helminths（STH）是全球最常见的寄生虫感染，不成比例地影响儿童。在肯尼亚治疗肯尼亚的治疗往往是通过在小学年度大众药物管理局（MDA）提供的学龄前（PSAC）和学龄儿童（SAC）儿童。了解治疗和覆盖之间的特异性患病率和动态对于持续的治疗成功至关重要。本研究旨在提供有关群体特异性感染患病率和相对减少（RR）的详细信息，以及随着时间的推移与治疗覆盖的关系。此外，它旨在量化观察到的学校水平感染患病率和治疗覆盖之间的相关性。方法：通过国家校本驱逐（NSBD）计划的监测和评估（M＆E）计划，2012和2018之间收集的现有数据的二次分析。 M＆E计划在肯尼亚跨越县的国家代表性上学，在四个调查时间点进行调查。在每所参展学校，该计划每所学校的108名儿童随机取样。使用二项式回归，使用多变量混合效应模型，使用结构方程建模的统计相关性，使用二进制分割算法进行统计相关性，估计感染流行率。结果：总体而言，PSAC的STH普遍性为33.7,20.2,19.0和17.9％，分别与整体RR分别为3（Y3），第3（Y3），5（Y5）和6年（Y6）调查从Y1至Y6的46.9％（p = 0.001）。类似地，在Y1，Y3，Y5和Y6调查中，SAC的总体STH患病率为33.6,18.4,14.7和12.5％，总RR为62.6％（P <0.001）。在PSAC中的治疗覆盖率和未分化的STH患病率（R = 0.144，P = 0.002）之间发现了总体（所有时间点）显着但非常弱的负相关性。此外，我们观察到县间间的异质性变异感染患病率，RR和相关性。结论：分析表明，在六轮MDA后，两组儿童患病程度显着下降，然而不到其不是公共卫生问题（低于1％）。分析，另外建立了治疗覆盖率与患病率之间的总体显着但弱的负相关，表明当前的处理覆盖率可能不足以使整体的STH流行率降至1％以下。这些调查结果将允许在肯尼亚的某些控制计划做出决定，将加速达到其作为公共卫生问题的灭绝的决定。

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