title: Patterns and risk factors of helminthiasis and anemia in a rural and a peri-urban community in Zanzibar, in the context of helminth control programs.
abstract: BACKGROUND
  The control of helminth infections and prevention of anemia in developing countries are of considerable public health importance. The purpose of this study was to determine patterns and risk factors of helminth infections and anemia in a rural and a peri-urban community of Zanzibar, Tanzania, in the context of national helminth control programs.
  
  
  RESULTS
  We carried out a community-based cross-sectional study in 454 individuals by examining at least two stool samples with different methods for soil-transmitted helminths (Ascaris lumbricoides, hookworm, Strongyloides stercoralis, and Trichuris trichiura) and one urine sample for Schistosoma haematobium. Finger-prick blood was taken to estimate anemia levels and to detect antibody reactions against ascariasis, strongyloidiasis and schistosomiasis, using an enzyme-linked immunosorbent assay (ELISA) approach. Parasitological methods determined a helminth prevalence of 73.7% in the rural, and 48.9% in the peri-urban setting. Most helminth infections were of light intensity with school-aged children showing the highest intensities. Multiple helminth species infections were pervasive in rural dwellers regardless of age. More than half of the participants were anemic, with a particularly high prevalence in the peri-urban setting (64.7%). Risk factors for helminth infections were age, sex, consumption of raw vegetables or salad, recent travel history, and socio-economic status.
  
  
  CONCLUSIONS
  After several years of chemotherapy-based morbidity control efforts in Zanzibar, helminth prevalences are still high and anemia is common, but helminth infection intensities are low. Hence, chemotherapy should be continued, and complemented with improved access to clean water, adequate sanitation, and health education, along with poverty alleviation measures for a more enduring impact.
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Knopp
authors.forename: Khalfan A
authors.initials: KA
authors.lastname: Mohammed
authors.forename: J Russell
authors.initials: JR
authors.lastname: Stothard
authors.forename: I Simba
authors.initials: IS
authors.lastname: Khamis
authors.forename: David
authors.initials: D
authors.lastname: Rollinson
authors.forename: Hanspeter
authors.initials: H
authors.lastname: Marti
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000723:Ancylostomatoidea / Q000302:isolation & purification; D000740:Anemia / Q000453:epidemiology* / Q000469:parasitology* / Q000517:prevention & control; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D000909:Antibodies, Helminth / Q000097:blood; D017164:Ascaris lumbricoides / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005243:Feces / Q000469:parasitology; D005260:Female; D006373:Helminthiasis / Q000150:complications* / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D012548:Schistosoma haematobium / Q000302:isolation & purification; D017171:Strongyloides stercoralis / Q000302:isolation & purification; D013636:Tanzania / Q000453:epidemiology; D014258:Trichuris / Q000302:isolation & purification; D014556:Urine / Q000469:parasitology
chemical_list: D000871:Anthelmintics; D000909:Antibodies, Helminth