Household Finished Flooring and Soil-Transmitted Helminth and Giardia Infections among Children in Rural Bangladesh and Kenya: A Prospective Cohort Study

Household Finished Flooring and Soil-Transmitted Helminth and Giardia Infections among Children in Rural Bangladesh and Kenya: A Prospective Cohort Study

Published: Mar 01, 2021
Publisher: The Lancet Global Health, vol. 9, issue 3
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Authors

Jade Benjamin-Chung

Yoshika S. Crider

Andrew Mertens

Ayse Ercumen

Amy J. Pickering

Audrie Lin

Lauren Steinbaum

Jenna Swarthout

Mahbubur Rahman

Sarker M. Parvez

Rashidul Haque

Sammy M. Njenga

Jimmy Kihara

Stephen P. Luby

John M. Colford, Jr.

Benjamin F. Arnold

Background

Soil-transmitted helminths and Giardia duodenalis are responsible for a large burden of disease globally. In low-resource settings, household finished floors (eg, concrete floors) might reduce transmission of soil-transmitted helminths and G duodenalis.

Methods

In a prospective cohort of children nested within two randomised trials in rural Bangladesh and Kenya, we estimated associations between household finished flooring and soil-transmitted helminths and G duodenalis prevalence. In 2015–16, we collected stool samples from children aged 2–16 years in rural Bangladesh and Kenya. We detected soil-transmitted helminth infection using quantitative PCR (qPCR; Bangladesh n=2800; Kenya n=3094), and G duodenalis using qPCR in Bangladesh (n=6894) and ELISA in Kenya (n=8899). We estimated adjusted prevalence ratios (aPRs) using log-linear models adjusted for potential confounders.

Findings

7187 (92·2%) of 7795 children in Bangladesh and 9077 (93·7%) of 9686 children in Kenya provided stool specimens that were analysed by qPCR. At enrolment, 691 (10%) households in Bangladesh and 471 (5%) households in Kenya had finished floors. In both countries, household finished flooring was associated with lower Ascaris lumbricoides prevalence (Bangladesh aPR 0·33, 95% CI 0·14–0·78; Kenya 0·62, 0·39–0·98) and any soil-transmitted helminths (Bangladesh 0·73, 0·52–1·01; Kenya 0·57, 0·37–0·88). Household finished floors were also associated with lower Necator americanus prevalence in Bangladesh (0·52, 0·29–0·94) and G duodenalis prevalence in both countries (Bangladesh 0·78, 0·64–0·95; Kenya 0·82, 0·70–0·97).

Interpretation

In low-resource settings, living in households with finished floors over a 2-year period was associated with lower prevalence of G duodenalis and some soil-transmitted helminths in children.

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