Transcript Elimination of Soil Transmitted Helminths: One village at

Elimination of Soil Transmitted
Helminths: One village at a time.
Humpress Harrington
(B.N, M.Ed)
Head, Pacific Adventist University Atoifi
Campus
Gut worms = Soil transmitted helminths
Worms that live in the intestines
–Roundworms
–Hookworms
–Whipworms
Lifecycle of hookworm
Female
Male
juvenile
Penetrates skin
Soil
Infective larvae in soil
In person
Integrated control
Worm Tablets
Footwear /
wash hands
Use Formal Toilets
Community-wide treatment
• Worms killed, but return over time
STH research at Atoifi
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April 2011 – survey of Atoifi and Na’au
April 2012 – survey of Abitona and Sifilo
December 2013 – resurvey Na’au
March 2014 – STH training workshop
August 2014 – survey of Kwai and Ngongosila
Methods
• A cross-sectional survey
• All residents older than 1 year were invited to
participate by:
– Providing a single sample of faeces that was
examined using a modified Kato-Katz technique
– Completing a questionnaire that asked
demographic and STH-related behaviour
questions.
Atoifi STH team
Results: 4 villages
• Participation rate was 52.8%, with 402 participants
comprising 49.8% males.
• Overall prevalence of hookworm was 22.6% (91/402)
(CI 0.95 18.6%-27.1%).
Health infrastructure and behaviours
• Respondents from Atoifi reported washing
hands before eating more often
• More frequently wore footwear outside
• Atoifi had safer defaecation practices
• Related to prevalence of hookworm in the
four villages
Island villages: Kwai and Ngongosila
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Participation rate was 70.7% (576/815)
STH prevalence 65.8% (379/576)
Roundworm most common
Hookworm prevalence 20-30% (similar to
Abitona, Na’au, Sifilo)
• Some whipworm
Action arising from the survey
• Feedback of results
• Hospital actions (MDA - albendazole)
• Community actions
Each village is different!
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Different prevalences of STH
Different issues about toilets
Physical challenges
Social challenges
Cultural challenges
One village at a time!
• Each village needs a different solution
• Solutions must come from the community
• Using mapping and qualitative methods to
work in a participatory way looking for long
term solutions
Where to Next?
• Assist the communities to develop their own
project proposals for funding for safe water
supply and appropriate toilets
• Write manuscripts for publication
• Establish Atoifi as the research centre for STH in
Solomon Islands
• Seek additional funds to do STH surveys in other
provinces
• Work closely with Water Supply and Sanitation
division of the Ministry of Health and NGOs