Honduras became the first country in Latin America and the Caribbean to launch its national and integrated plan addressing neglected tropical diseases (NTDs) in April 2012; however, information gaps regarding the prevalence and intensity of soil-transmitted helminth (STH or intestinal worm) infections remained. The first comprehensive historic review of soil-STH prevalence and research studies done in Honduras was recently published – the information analyzed and presented in the new article will be instrumental in the successful implementation of the country’s national plan on NTDs.
The article, titled “A Scoping Review and Prevalence Analysis of Soil-Transmitted Helminth Infections in Honduras,” was published in PLOS Neglected Tropical Diseases. Sabin Vaccine Institute’s Dr. Maria Elena Bottazzi, herself a Honduran and Deputy Director of Sabin’s Product Development Partnership, is one of the authors.
As part of their efforts, the researchers conducted a review of hundreds of studies dating back to May 1930, some of which had not been published. Using studies published between 2001 and 2012 that included epidemiological data from Honduras’ 18 departments, the researchers were able to produce STH prevalence maps. The researchers included the most recent information available after consulting with various groups involved in STH control activities, including the Ministry of Health, the Healthy Schools Program, the Parasitology Department of the School of Microbiology (part of the National Autonomous University of Honduras, UNAH), the World Food Program and the Pan American Health Organization (PAHO).
The results from their review are astounding – the researchers found that the prevalence of STH in 40.6 percent of the municipalities in Honduras is greater than 50 percent. The World Health Organization (WHO) recommends mass drug administration (MDA) campaigns to take place, without previous diagnosis, once a year in communities with STH prevalence over 20 percent, and twice a year in communities with STH prevalence over 50 percent. This strategy not only reduces the morbidity and the intensity of infection on those already infected with this NTD, but it also helps protect the entire community from further infection.
The researchers also found that the STH prevalence was higher in municipalities with a lower socioeconomic status – those characterized by having a lower human development index and less access to safe drinking water or improved sanitation.
The Sabin Vaccine Institute’s Global Network for Neglected Tropical Diseases recently traveled to Honduras and witnessed the effects of intestinal worms on some of Honduras’ poorest communities, including those in the department of Choluteca. After speaking with a head teacher at Escuela Urbana Mixta Pedro Nufio (1st to 6th grade), we learned that 880 students attending the school were at risk for intestinal worms.
View photos from the trip below:
Children in Choluteca and across Honduras are being treated annually for intestinal worms thanks to Honduras’ national plan of action against NTDs. However, many children are still heavily infected. For example, some students in Choluteca expelled worms through their mouth and nose after receiving treatment – a sign of heavy infection.
However, progress is being made and the deworming of preschool children has been institutionalized as part of national vaccination week activities in the country. Honduras is continuing to lead in one of the fundamental components in the fight against NTDs: integration with infrastructure improvements in water and sanitation, supported by community education campaigns. This type of cross-sectoral integration will bring us closer to achieving the NTD 2020 control and elimination goals set by the WHO Roadmap.
We look forward to sharing stories of how the government of Honduras and its partners use the findings from this study to successfully implement their national plan on NTDs! We invite you to follow Dr. Bottazzi (@mebottazzi) and the PLOS NTDs journal (@PLOSNTDs) on Twitter, to keep up with new developments in the NTD field.