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

juvenile

Soil

MaleFemale

In person

Penetrates skin

Infective larvae in soil

Integrated controlWorm Tablets

Use Formal ToiletsFootwear / wash hands

Community-wide treatment

• Worms killed, but return over time

STH research at Atoifi• 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

• 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!

• 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