According to a recent study in rural Kenya, water treatment alone is sufficient to cause an 18% reduction in roundworm infections. The study explored the effects of water quality, sanitation, handwashing, and nutritional interventions because of the increasing rates of the intestinal worm and Giardia infections. Addition of sanitation and hand washing could increase the reduction to 22%. The other parasitic infections examined did not have significant reductions from any of the interventions.
Intestinal worm and protozoan infections affect more than 1 billion children worldwide. They are associated with stunted growth and impaired cognitive development. They often reside in the soil and contaminated drinking water or fecal-contaminated surfaces. They lead to common infections in children in low resource settings.
High re-infection rates have prevented school-based mass drug administration programs from controlling the transmission of these parasitic infections. The study authors hypothesised that improved water quality, sanitation, hygiene and/or nutrition could interrupt the environmental transmission of parasites, but few trials evaluating these interventions have measured actual infections as an outcome.
“Out of all the interventions we tested, we were extremely surprised that water treatment appeared to be the most effective at reducing roundworm infections. Water treatment is a relatively unexplored strategy for intestinal worm control. At least 800 million people in the world are infected by a roundworm (Ascaris lumbricoides), so even a relative reduction of 18% from water treatment interventions could have a major beneficial impact. Our study also suggests that water treatment could complement large-scale deworming medication delivery programs in the global effort to eliminate roundworm infections,” said Amy Pickering, the first author of the study.
With reinfection rates reaching 94% after deworming treatment for roundworm infection, a combined approach of mass drug administration and environmental controls (water, sanitation, hygiene) could be critical to gaining an upper hand on these endemic infections, the researchers concluded.
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