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Household finished flooring and soil-transmitted helminth and Giardia infections among children in rural Bangladesh and Kenya: a prospective cohort study

Year: 2021
Type: article
Abstract: 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. FUNDING: Bill & Melinda Gates Foundation and Task Force for Global Health.
DOI: 10.1016/s2214-109x(20)30523-4
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, Clair Null, Stephen P Luby, John M Colford, Benjamin F Arnold
Institutions: University of California, Berkeley, North Carolina State University, Tufts University, Exponent (United States), International Centre for Diarrhoeal Disease Research, Kenya Medical Research Institute, Mathematica Policy Research, Stanford University, University of California, San Francisco
Language: English
Subfield: Parasitology
Open Access status: gold
Estimated APC paid: $5,000
OpenAlex ID: W3037249771
FWCI: 4.293
Cites: 52
Cited by: 39
Related to: 10