title: Risk of human helminthiases: geospatial distribution and targeted control.
abstract: OBJECTIVE
  We conducted a cross-sectional survey in 2012 among 22 rural barangays in Northern Samar, the Philippines in order to determine the prevalence of single and multiple species helminth infections, their geospatial distribution and underlying risk factors.
  
  
  METHODS
  A total of 10,434 individuals who had completed both a medical questionnaire and a stool examination were included in the analysis. Barangay specific prevalence rates were displayed in ArcMap.
  
  
  RESULTS
  The prevalence of Trichuris trichiura infection was found to be the highest at 62.4%, followed by Ascaris lumbricoides, hookworm and S. japonicum with the prevalence rates of 40.2%, 31.32%, and 27.1%, respectively. 52.7% of people were infected with at least two parasites and 4.8% with all four parasites. Males aged 10-19 years were the most vulnerable to coinfection infection. Students, fishermen, farmers and housewives were the most vulnerable occupations for co-infection of A. lumbricoides and T. trichiura. Considerable heterogeneity in the spatial distribution was observed for the different parasite species. There was a considerably higher risk of A. lumbricoides and T. trichiura co-infection in villages with no schistosomiasis infection (P<0.0001) regardless of MDA treatment.
  
  
  CONCLUSIONS
  A better understanding of the geospatial distribution of multi-parasitism will guide future integrated strategies leading to elimination.
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Australia.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Yu
authors.affiliation: Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia. Electronic address: a.ross@griffith.edu.au.
authors.forename: Allen G
authors.initials: AG
authors.lastname: Ross
authors.affiliation: Research Institute for Tropical Medicine, Department of Health, the Philippines.
authors.forename: Remigio M
authors.initials: RM
authors.lastname: Olveda
authors.affiliation: Centre for Tropical and Emerging Global Health Diseases, University of Georgia, USA.
authors.forename: Donald A
authors.initials: DA
authors.lastname: Harn
authors.affiliation: QIMR Berghofer Medical Research Institute, Australia.
authors.forename: Yuesheng
authors.initials: Y
authors.lastname: Li
authors.affiliation: Municipal Medical Officer of Health, Palapag, Northern Samar.
authors.forename: Delia
authors.initials: D
authors.lastname: Chy
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Australia.
authors.forename: Gail M
authors.initials: GM
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000818:Animals; D001196:Ascariasis / Q000453:epidemiology; D017164:Ascaris lumbricoides; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D062306:Geography, Medical; D006373:Helminthiasis / Q000453:epidemiology*; D006725:Hookworm Infections / Q000453:epidemiology; D006801:Humans; D008297:Male; D010679:Philippines / Q000453:epidemiology; D015995:Prevalence; D018570:Risk Assessment; D012424:Rural Population; D014257:Trichuriasis / Q000453:epidemiology; D055815:Young Adult
keywords: ArcMap; Control; Geospatial Distribution; Intestinal helminths; Mass Drug Administration (MDA); Risk Factors