Assessment of the burden of soil-transmitted helminthiasis after five years of mass drug administration for Onchocerciasis and Lymphatic filariasis in Kebbi State, Nigeria

There is a hypothesis that Mass drug administration (MDA) of ivermectin and albendazole for the treatment of onchocerciasis and lymphatic filariasis could have an impact on the burden of soil-transmitted helminthiasis (STH) in MDA communities. We, therefore, assessed the burden of STH (Ascaris lumbricoides, Trichuris trichiura, and hookworm) infections in nine communities from 3 LGAs (two MDA local government areas (LGAs) and one control LGA) in Kebbi State, Nigeria after 5-years (2010-2015) of MDA for onchocerciasis and/or lymphatic filariasis. We also administered questionnaire to obtain demographic information and history of MDA in the past five years. The three LGAs are Bagudo (Ivermectin MDA); Zuru (Ivermectin/Albendazole MDA) and Dandi (No MDA). The study was a cross sectional survey. The total number of people that complied with provision of stool samples and questionnaire were 1357 persons; stool samples collected were examined for STH infections in the three LGAs. Zuru LGA had the highest prevalence of STH (41.89, 95% CI: 37.08-46.81) followed by Dandi LGA (24.66, 95% CI: 20.69-28.97) and Bagudo LGA (3.36, 95% CI: 1.97-5.32). Prevalence of STH infection was not significantly different among age group and sex. Geometric mean intensity per gram of infection for both A. lumbricoides and Hookworm were highest in Zuru LGA with (1.16 GMI, 95% CI: 0.97-1.36) and (1.49 GMI, 95% CI: 1.29-1.70) respectively. Treatment coverage was less than 65% from 2010 to 2013 in the intervention LGAs. The study shows that STH is still a public health problem in Zuru LGA (IVM + ALB) and requires MDA of albendazole for STH control to continue, while Dandi LGA (No MDA history) requires MDA with albendazole to scale up treatment for STH control.